Hi Dr Hanscom,

I have been meaning to check in with you for a while now and let you know that the DOC program seems to have worked for me. My lower back & leg pain has disappeared and I’m a firm believer in the process, especially the concept that anxiety is the driver of tension and pain in many cases. I picked up the book, Forgive for Good at your recommendation back in the winter and found it to be excellent. I’ve also been doing mindfulness training and it’s been extremely helpful.  If you aren’t familiar with the book, The  The Mindful Way through Depression, I’d definitely recommend checking it out.

I hope you are doing well and enjoying the summer now that it’s finally arrived.

Best, Jean

My Perspective

This patient is the daughter of an esteemed colleague of mine. She had burned out of practicing law and had embarked on a pre-med pathway at the age of 38. She had experienced low back pain for over two years. There was also significant pain, numbness, and tingling throughout her right leg. She had a normal MRI of her thoracic and lumbar spine. Electrical testing of her leg did not show any specific problems with the nerves. As I knew her father so well, I was especially anxious not to miss anything that might be serious. I could not find a structural cause for her symptoms.

I first saw her about 18 months ago, and on our last visit six months ago, she was just a little better. I tried not to be too discouraged but, I was not sure she was going to improve.

What is remarkable about her recovery is that it was truly self-directed. She did not see me in follow-up nor did she see another physician. I had recommended a mental health professional, as I thought she might be depressed. But she wouldn’t engage in that conversation. She did use the Feeling Good book and was diligent writing in David Burn’s three-column format. She also pursued obtaining a good night’s sleep, utilized the re-programming tools such as active meditation, and worked out regularly in the gym. Two years later she is re-pursuing her medical school dream.

This story is not an exception. With full engagement with a structured program the results are consistent.

The post Depression Masking as Pain first appeared on Back in Control.

The post Depression Masking as Pain appeared first on Back in Control.

Perhaps this game is like weeding.

The trick is to become so practiced

that you can sing while you do it,

that when you see one beginning to sprout

you will by instinct

lay your fingers in the earth,

find its root,

and set it free.

                            Alec

The beginnings of the DOC project

The DOC project originally started by me sharing some stress management tools that had pulled me out of a deep burnout. I had no clue that chronic pain was solvable, but I wanted to help my patients cope with it. When I began to address sleep, I noticed that many people were having less pain, which caught my attention. I had no access to psychologists, so I began to recommend David Burn’s book, Feeling Good. It is book-based cognitive behavioral therapy. People began to feel better.

I was also continuing to deal with my extreme anxiety, but I was not breaking loose. I was also suffering from over a dozen other physical symptoms. As I continued to rapidly spiral down, as my stresses became extreme, I was forced to acknowledge that I had some anger. I had not a clue that I had anger. Not only was it there, it was my core.

Healing

I honestly don’t know how I got through the next six months or what tools I used to process my anger. I had no anger management skills and I also did not realize how much perfectionism fuels it. I thought I simply had “high standards.” I learned of the many disguises of anger. I now know that anxiety and anger are the same entity, representing the feeling caused by elevated stress hormones and inflammatory markers. Somehow, I got through It with a major step being that I understood what being a victim was and made a simple decision to come out of that role. My anxiety dropped through the floor and most of my physical symptoms disappeared.

Many years ago a patient gave me the book Forgive for Good, by Dr. Fred Luskin. Although patients had done pretty well with the tools I was offering, it is when Forgive for Good entered the picture that people began to go pain free. Pain and anger pathways are so intertwined that you cannot calm the pain pathways until you can let go of anger. “Neurons that fire together, wire together.”

Dr. Luskin and I have become friends and have put workshops on together. He taught me that forgiveness is an ongoing daily process. You will be frequently triggered. They key is becoming aware when you have slipped into the victim role and use your set of tools to come out quickly. This poem is especially relevant in light this concept. It is also humbling that each time you are triggered, you always hit the concrete floor. It is a powerful reaction.

Your deepest wounds

It also must be forgiveness of your deepest wounds, or maybe better stated, “your deepest wound.” Otherwise your nervous system will remain fired up and the pain switches will remain “on.” I cannot remember a person who broke free from the grip of chronic pain without letting go of anger.

It happened again last week. A member of the weekly Q & A groups had been struggling with chronic pain throughout her body for many years. She had a difficult relationship with a close friend. She was diligent in doing the expressive writing and relaxation exercises, which had helped. But somehow, in listening to other people’s experiences she suddenly was able to completely let go and her pain was gone the next day. She was shocked and I am always surprised when these breakthroughs occur – and it is ALWAYS around anger. She will be triggered again and have more pain. But once she has tasted the experience, she’ll find her way back quickly. It the reason I am so passionate about this project.

Alec is a friend and classmate of my stepdaughter. He was 26 and talented in the performance arts, as well as writing poetry. His poem above is remarkably insightful for any age. Think what the world would be like if we practiced the concepts he simply lays out. How often does the word, “forgiveness” cross your mind?

You cannot forgive too deeply or too often. Could you sing while you do it? Think what your life could be like.

The post Forgiveness as a Habit first appeared on Back in Control.

The post Forgiveness as a Habit appeared first on Back in Control.

Searching for an answer

A few years ago I had a great deal of stress that landed in my neck and I couldn’t find any relief anywhere for more than 18 months. I saw many professionals – spine surgeons (no structural issue); chiropractor (looked like chronic whiplash symptoms), occupational therapist (recommended diet changes, flats, exercises, saunas, massages) and physical therapist (heat treatments, TENS treatment, exercises, massage) and nothing was working. In fact, when I went to the chiropractor he snapped my neck without asking or explaining prior to doing it and I felt an electric like shock feeling go through my back. For the next 10-12 months, I now had not only neck pain but a deep ache going down both arms. My sleep was disrupted, I was tearful, struggling with focus at work and I didn’t want to do anything.

Omega workshop

I shared my struggle with Dr. Fred Luskin, who shared Dr. Hanscom’s book, Back in Control, with me. I started to implement some of his suggestions with the first being focusing on improving my sleep. I attended the Omega training shortly after and learned more about the impact of stress and the mind-body connection. I saw others improving before my eyes and yet I found myself being miserable. I could hardly sit through the classes and was edgy and irritable but determined to learn.

It took another few months but by addressing the stress, improving my sleep, and taking glucosamine I have been pain-free for a number of years. What is even better than that is that when I feel the neck muscles tightening from either stress or behaviors (too much computer work), I can focus on getting good sleep, anti-inflammatory diet, add the glucosamine back in and now avoid major relapses. In fact, once I recovered I have never reached the same level of pain again.

Moving on

I have been so impressed with Dr. Hanscom’s work and insights into the mind-body connection that I have been focusing my PhD studies in Mind Body medicine on chronic pain and stress management. I now share the tools that I have learned and the Back In Control book with every client I work with who struggles with chronic pain.

I will be forever grateful to Dr. Luskin who led me to Dr. Hanscom and Dr. Hanscom for putting his understanding out to the world. As I have heard him say many times, “If you calm the system down surgery may no longer be necessary. If surgery is necessary, calming the system down before the surgery has much better outcomes.” Prehab

Thank you Dr. Hanscom for looking out for the greater good and not the bottom dollar. Hospitals and pharmaceuticals would prefer pain management but the DOC (Direct your Own Care) can significantly reduce pain and in some cases even cure without all the negative side effects.

How many more neck surgeries?

Omega 2018 workshop

The post Chronic Neck Pain Gone – DOC Prevents Relapse first appeared on Back in Control.

The post Chronic Neck Pain Gone – DOC Prevents Relapse appeared first on Back in Control.

The final and most important thought is that there is no goal to the DOC program. People often become overwhelmed with all of the exercises and other books to read. The “goal” of this journey is to connect with day and moment you are in with the tools you posses. You will become more skilled with them over time but there is also no endpoint. You can fully engage right this second by simply placing your attention on what is in front of you and becoming aware of your reaction. Welcome to your new life.”

These are the last two paragraphs of the new edition of my book. Several years ago I was struggling with my ongoing quest to become a better person. I was intent on fixing myself, but it suddenly occurred to me that there was no endpoint. The picture that jumped into my mind was that of the repeating circus mirrors where there is no end to the images that are produced just by the angles of mirrors reflecting off of each other. I was continually judging myself and looking for the one answer that would permanently change my life. I was an “epiphany addict.” I realized that the answer to my conundrum was that there was not an answer. I had to live my life with the tools I had at the moment, regardless of my pain. I began to heal – really heal. I had to give up, let go, and enjoy my day.

The endless climb

Another metaphor that has come out of my journey is that of climbing a high, steep mountain and at the peak is the ideal version of me. The problem is that this rendition of me is unattainable. I had been climbing for many years, which was consuming much of my life’s energy. The other picture that arose in my mind was that of a bunch of balloons tied to a railing. The strings represented the numerous reactive patterns that kept me tied to the past and blocking me from enjoying the present. I realized that the DOC process was effectively cutting the strings. I was able to break free and float upward, which consumes no energy.

Play

Patients frequently ask how how long it takes to become free of their pain. It can happen in the next five minutes or in a year. It depends when you are able to re-connect with best part of who you are. I did not understand that this was possible until my wife, a professional tap dancer, my daughter, an expressive arts therapist, Dr. Fred Luskin, author of Forgive for Good, and I put on several five-day workshops at the Omega Institute in Rhinebeck, NY. It was based on structure, hope, forgiveness and play. Within a day or so after we began to relax to the point of laughing with each other, most of the participants had a significant decrease in their pain. The Cup Song Some had a delayed response months later. Everyone went back into their pain pathways when they returned home to their triggers. But many continued to practice the tools to stay connected with themselves and have remained out of chronic pain for years. Many of the turnarounds are dramatic. Your play pathways are right there. You can find them in the next few minutes, pain or no pain. Anger disconnects; play connects.

I still have good days and bad days. Good months and bad months. I am steadily getting better at using the tools that I present to others and also realize it is a lot easier to talk about them than practice them. My issue is that I take myself too seriously and there is only so much that I can do. I have not been great in taking care of myself and that is my first responsibility, as it is yours.

Begin your new life – NOW

Take five or ten minutes and become aware of your current approach to life. Start with active meditation and place your attention on sensations and relax. Remember a time when you were happy and free – even if it was for a short period of time. Then decide to connect with that part of your brain for the rest of the day. You may not initially succeed or perhaps it may happen for a few moments. It is an exercise that will improve with practice.  Then contrast this energy with your life when you are justifiably angry about your circumstances. Think about how you appear to your family and friends when you are upset versus when you have a big smile on your face. Most of us cannot change or control the majority of situations we get stuck in. We are able to choose our responses. The mirror maze effect can drive you and your family into the ground or carry you forward to a great life. Protect your family from your pain

These concepts have existed for thousands of years and are are universal truths. I feel privileged that I have had the opportunity to pass my interpretation of them to others.

Enjoy your day today

The post The Essence of the DOC Process first appeared on Back in Control.

The post The Essence of the DOC Process appeared first on Back in Control.

• Forgiveness – is a selfish act that entails refusal to allow others, the past or circumstances to affect your day.
• Being aware of nature of the chemical reaction to a threat and that stress is not as much of a problem, as your response to it that drains you of your life energy.
• Understand you have a choice of whether to remain in the situation that is creating the stress. In other words, are you choosing to remain in a perceived or real victim mode. Let me explain using traffic as an illustration.
• “Kill your ego.” This was advice given by David Burns, author of Feeling Good, at one of his workshops. This a large topic but do become aware of how much energy you spend defending the image of you that you have created. It is one of the reasons I feel that self-esteem is such a deadly concept.

Traffic

Why would you get upset when someone cuts you off in traffic or suddenly pulls out in front of you? There was no physical harm. Your heart and respiratory rate may have increased. What drains you of your energy is getting upset at the person who cut you off. Maybe you have a story in your head about “idiot drivers” that is reinforced every time you get behind the wheel. Consequently, your body is full of adrenaline and you are physically burning energy that is completely wasted.

“The unenforceable rules”

Dr. Luskin, author of Forgive for Good, has a term for this phenomenon. He calls it “the unenforceable rules. You might wish that people would not cut you off or pull out in front of you, which is fine. However, when that wish turns into a demand in your head that, “I should not be exposed to this kind of bad behavior”, you now have a problem that is not solvable. Your driving experience is going to consistently be stressful when it could be a time to relax and enjoy the trip. You might ask, “What are my choices?’

Your choices

First of all, if you you are going to assume the responsibility of driving that means you are going to have to deal with drivers who may not feel the same way. Texting, drinking, drugs, etc. are all potential issues or maybe the driver who upset you just lost her job. Taking the position that all drivers should perform well is not reality. So you have a choice to accept the fact that essentially every time you get in the car there is going to be multiple situations are less than ideal. Then you can relax, stay alert, deal with them and enjoy your trip.

Your second choice is to avoid driving. That is an option. You may not like it. But it would solve your problem. The only choice that does not make any sense is to continue to be upset every time you drive.

Mayor Moran

I ran across these pictures a few months ago that help illustrate my point.

When your body is consistently full of stress hormones you have a much higher chance of becoming ill. This has been documented in hundreds of studies with a classic one being published in 1964. (1)

Who knows how long he would have lived if he had remained in his business and political world but his story does illustrate a dramatic turnaround. He chose to decrease his stress. My observation is that he also took charge of his life and made a decision to improve his odds of staying alive.

My choice

I made the opposite decision in 1990 when I began my slide into a severe burnout and depression. I instinctively knew that I could not run from this and that changing to a less stressful career was not gong to be the answer for me. Maybe I was right and maybe not. I dove in and fully committed to finding the answers to my unexplained onset of anxiety through every possible means. But I almost did not survive the ordeal.

I was lucky and have been able to share what I learned from suffering from chronic pain for over 15 years. I did learn that I was the problem and that I had a choice of how to react to my environment. I have steadily improved this skill although I wish I was much better at it. I have much more stress on my plate now than when I buckled in 1990. I also have much more energy as I am not remaining unhappy about situations I cannot affect or change.

Perhaps a combined approach of cutting back a least a little while learning these tools would have been better decision. I don’t get a re-do. So here I am, incredibly grateful that I did make it and can share my story. Patients often tell me that I just don’t understand the pain that they are in. Fifteen years is a long time to be in pain and seven of those were living on a razor blade. I do understand that he or she might be suffering as much as I did; but not more. I have been given a second shot at life and have taken control of creating it. You have that same choice.

The way to take back your life is to assume responsibility for every aspect of it. If you find yourself blaming others for ANY of your problems, wake up.

1. Rahe RH, et al. “Social stress and illness onset.” Jrn Psychosomatic Res. (1964); 8: 35.

The post Take Back Your Life first appeared on Back in Control.

The post Take Back Your Life appeared first on Back in Control.