Self-esteem

Every human is judgmental. It is an inherent aspect of survival.  However, it is not a trait that engenders close enjoyable relationships or peace of mind. It is made worse by our cultural programming that having self-esteem is essential for happiness. Nothing could be further from the truth. To attain and maintain high self-esteem requires endless comparison to those around you and also to norms that society, your family, friends, and you have set for yourself. You will eventually wear down and crash. There is not an endpoint to this process.

The pursuit of self-esteem can’t and doesn’t work. At some level, we all know this. Whenever your peace of mind and/ or identity is at the mercy of external circumstances, including other’s opinions, you’re at the mercy of them. Also, it gives others power to shut you down, which is one of their efforts to improve their self-esteem. You are riding on a universal merry-go-round that will never let you get off. The eye of the storm

Envy

As these attempts at “improving self-esteem” eventually and miserably fail, the next level of emotion is envy. It isn’t pretty and interferes with almost every aspect of life from work to your personal life. Although you may be on the same pursuit of happiness like the rest of us, it can’t happen if you are perpetually envious. Happiness and envy are not compatible emotions. What is even more ironic is that when you are judging someone else, you are just projecting your view of yourself onto someone else and broadcasting your insecurities to the world.

I have an exercise you may want to consider. Think of someone that you dislike. He or she usually isn’t too difficult to identify. Then in one column, write down as many things about them that you dislike. The to the right of each pronouncement, write down what you dislike about you in a similar area. You may not like his or her work ethic. Maybe you think they are lazy?  Do you procrastinate? Or are you in a reactive pattern where you are a workaholic? “He’s fat!” Are you happy with your weight? Maybe people think you are too thin. You don’t like her political views. Who is to say yours are more correct.

What is fascinating and disturbing is that many people are often unhappy about other’s success, even if they are a close friend.

Schadenfreude

There are two basic types of envy. One is being unhappy with another’s success, whether it is a friend or competitor. The other is silently rejoicing when someone you are envious of suffers a loss. The term for this second scenario is “schadenfreude”. Both elicit feelings of guilt because we know we shouldn’t feel this way. But when you try not to feel a certain way, it becomes worse. It’s even more problematic if you feel the person you have envied didn’t originally deserve his or her success.

In light of the current neuroscience research, we now understand the impact of sustained frustration on your body’s chemistry and the resulting physical symptoms. This unknown writer succinctly points out that good health is the essence of living a good life. Yet, when we spend our energies comparing ourselves to others, we are frequently frustrated. This chronic anger with the attendant elevated levels of stress hormones wreaks havoc with every organ in your body and you’ll eventually get sick.

Envy and pain

I’ve had as much of a challenge with self-esteem and envy as anyone. I came from a tough household and it seemed if everyone had a life that I wanted. I was envious of friends, accomplishments, adventures, families, and the list went on. What is now obvious in retrospect was that my mother was insanely envious and our family’s situation was never good enough. She would become unhappy to the point that our whole family would move to another town to start over. The cycle would begin again and she would complain about any and everything. By the time I was 18 years old, we had lived in 11 different houses. After I refused to move from my high school area in Napa Valley, they kept on moving. It’s clear where I learned this pattern of behavior.

When I ended up in chronic pain, it all become much more intense. It seemed everyone had something I wanted. The first thing I was envious of was not being in pain. Then it seemed that everyone had a better family life than I did. I become more and more socially isolated and I withdrew even more. Although, I wanted to re-engage with friends, my fear of rejection became almost a phobia. Holidays were particularly unpleasant. It seemed like every person in the world was having a better time than I was. Of all the terrible experiences I endured, the loneliness was crushing. It is one of the reasons I have described the world of chronic pain as, “The Abyss”.

Self-destruction

Additionally, anger is destructive, including self-destructive. One of the ways this plays out is disregarding your own health. All of us have a choice of how we choose to treat our bodies. Chronic frustration is possibly the main reason why you wouldn’t choose to feel physically great. It’s hard to really enjoy life if you don’t feel vigorous and energized. Ongoing self-neglect is a form of slow suicide. You’re angry and take it out on yourself. We all have some degree of self-destructive behavior and many of us have a lot. So, the emotions that you might be feeling from another’s success are sucking you dry. You now have less of a chance of “being successful” whatever that might mean. Jealousy and frustration aren’t solving much.

Moving forward

I have undergone many phases of healing. However, I have never forgotten the intensity of the loneliness and envy. It was the accidental discovery of the expressive writing exercises that halted the downward descent and it is still the one necessary starting point of the healing process.

One exercise I frequently discuss with my patients is similar to the one I presented above. I ask them in the room to visualize someone they dislike. They have read enough of the DOC process to quickly understand where I am going. I point out that they know the being judgmental is problematic and then I ask them what happens when they try to not be judgmental. Of course, you will become more judgmental. So, whether you are judgmental or not judgmental, your nervous system remains fired up. What can you do? Write down your specific thoughts and immediately destroy them. This allows you simply to separate from your thoughts, not to solve or change them. You may not become friends with this person or even like them. But in that “space” you’ve created, possibilities arise. Once you can see your judgements as a projection of you, you may be able see this person in a different light. At a minimum, it certainly makes life more interesting.

The Way to Love

So, the solution doesn’t lie in “not being envious.” Another key to dealing with it is to become more aware of it and the impact on your quality of life. I have now incorporated Anthony DeMello’s book, The Way to Love, into the DOC process. He defines love as awareness.  I frequently re-read a few pages. He’s clear on the consequences of being attached to your external circumstances for your peace of mind. Becoming aware is a critical step and a significant part of the solution.

Although, it’s a daily, minute to minute exercise in awareness, not being caught in the quicksand of envy has been a remarkably freeing experience. Try it. At least become aware of your resistance to living a different life.

1. I was going through some old files and happened to find this paragraph that I had clipped out over 30 years ago when I began my spine practice. It initially had a big influence on me and I would read it intermittently to remind myself to keep both feet on the ground regardless of major successes or failures. Life began to cave in on me and I lost touch with these concepts amongst many other losses. I don’t know the source but the wisdom of it struck a deep chord with me. A reader just let me know the writer was Aleksandr Solzhenitsyn.
2. Schadenfreude: Understanding Pleasure at the Misfortune of Others. Wilco W. van Dijk, Jaap W. Ouwerkerk; Cambridge University Press, Jul 24, 2014.

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Anxiety, Power, and Bullying

To be connected to other people is one of the strongest human drives. Humans evolved by interacting with other humans. We also have a deep need for acceptance. This sets up a serious contradiction because our even deeper need is to avoid anxiety.

We try to avoid anxiety, or – if we already have it – we try to get rid of it. One common method we use is to increase our sense of control. Nothing enhances our feeling of control more than by gaining power in some way. This tendency comes out in our interactions with each other; in fact, it dictates much of human relations.

Every child has significantly increased anxiety when they leave home to begin school, regardless of their family situation. They want to be accepted but there is also the greater need to diminish their fear. The need to get rid of fear and gain power is played out in forming cliques, excluding others, and overt bullying.

Researchers did a study of students who have been bullied versus the bullies to see if there was any difference in their physiological makeup. They looked at the levels of a substance called C-reactive protein (CRP), which is elevated in the presence of inflammation; it’s often drawn to determine the presence of a hidden infection. Chronically elevated levels also indicate a stressed and overactive immune system. It is not desirable to have an elevated CRP.

The study revealed that children who had been bullied had significantly elevated levels of CRP compared to those who had not been bullied. Being bullied as your introduction to the real world is not a great start. What I find even more disturbing is that the levels of CRP in bullies was lower than the norm. As it turns out, there is both a social and physiological reward for possessing more power. How all of this plays out in adulthood is not subtle. Why would you want to give up power and control? Especially when feeling the pain of anxiety is the other option. (1)

Every child does have a strong need to be accepted, yet what should we make of the fact that it gives him or her more power (and self-esteem) to reject someone else? This is an endless loop, the root cause of which is the solvable problem of anxiety. The myth of self-esteem

Sartatoga Teen Hangs Herself

I don’t know how you can measure the impact of bullying on our society. The suffering encountered at such an early and innocent age is deep and it’s rampant. Three 16 y/o boys raped a young girl in the Bay Area. What is much more disturbing is that instead of rallying to support her in a time of extreme distress, her classmates turned on her. A photo went viral. She was verbally abused both directly and over cyberspace. “Slut”. “Will you have sex with me?” She is now dead from hanging herself.

I was talking to a patient who was a middle-age school teacher. She was experiencing total body pain. She was clearly a broken woman and could hardly lift her head to look at me. She had been severely bullied throughout middle and high school and couldn’t shake it. The conversation with her was incredibly discouraging.

One of my colleagues had her son bullied badly beginning at age seven. Nothing seemed to work to stop it. Finally, at age 25 he simply gave up. He could no longer tolerate the relentless anxiety engendered by the experience. As sad as his mother was telling me his story, she felt that he was finally at peace. It was an intense moment to hear her say that about her own son.

Some observations

First, most bullying occurs at a level well below the teachers’ radar. Just being excluded from a group can be devastating. It is not going to be possible to put the responsibility solely on the their shoulders.

Second, our children are at an age where they are discovering and creating their identity. Most of it depends on some type of approval from their peers. For some reason the approval usually needs to come from the person or group who is the least likely to give it. When someone else defines your identity, that person has power over you.

Third, people wring their hands and point out that all of this should be done in the family. There are several significant problems with this thinking. I resent the term “dysfunctional family”. That implies that there are functional families. I have yet to see one. Humans consistently have significant problematic behavioral patterns, and is most deeply played out in the home setting.

Even if a child comes from a less dysfunctional family, they may become targets for the bullies. They are similar to a domestic animal turned loose into the wild. They either fold or become tough. Neither is great.

Fourth, the argument goes that school is an important socialization process. Really?? Going into an environment where peace, love and joy are hammered into the ground does not create a person who is loving and compassionate. They are just learning dysfunctional survival skills. Behavioral patterns set before age 12 are permanent. Bullies as children have a high chance of exhibiting aggressive behavior as adults as well as experiencing chronic pain. Many children with their egos destroyed will live the rest of their lives in fear.

Fifth, home-schooled children have been shown to do well later in life. My observation of several families that have taken it on is the their children are more creative and thrive without the hierarchy of the schoolroom. Here is an example of the work of some close friends of mine. They have been home-schooled and creativity oozes out of them. Beautiful

Sixth, look at what is happening to our society. We have a life that any generation prior to a hundred years ago could not imagine. Are we happier and more loving? We are passing along peace and love to our kids – especially in school. External possessions and accomplishments don’t change human nature. The incidence of chronic pain has skyrocketed in adolescents. (2)

Finally, there is a high correlation between the ACE score (Adverse Childhood Events) and disability. As pain drives anxiety and frustration and vice versa this shouldn’t be a surprise. These pathways are linked. We are not going to solve the chronic pain problem, which is crippling our society, unless we tackle it beginning in kindergarten. (3)

Solutions

Human behavior and survival revolves around avoiding anxiety. We’ll do anything to avoid the feeling, including holding on to our pain. Any change creates more anxiety. The key is learning to process and live with anxiety, so as to not have such a need for power.

Neuroscience research has shown us the powerful full body reaction that creates anxiety. You can’t control it, but you can calm and re-direct it. It is the core of the DOC process. Anxiety is the pain.

We’re also observing the power of the family in programming behaviors. Were you ever a bully? Do you still intimidate your co-workers, colleagues or family? Could your child’s bullying be learned from you? Were you bullied when you were younger? What effects of it might you be bringing into your current life? Are you often frustrated, angry or upset? What effect do you think it’s having on your quality of life? Do you even want to give up the power of your pain? You might have a legitimate reason to hold on to remaining upset? But who’s continuing to suffer?

Awareness

I think almost everyone agrees that bullying is a problem. However, we may not be aware that we might be part of the problem. The first step is understanding how your behavior might be perceived by those close to you. I can tell you it is a humbling exercise. A book given to me by a close colleague has had an impact on me. It is called, The Way to Love, by Anthony DeMello. He defines love as “awareness.” How can you meet someone’s need without understanding them or getting to know who that person is. Bullying would be the antithesis of awareness, as you are meeting only your own needs. I read a few pages weekly to remind me of the concepts.

Treating anxiety and anxiety with the correct approach on a widespread basis would have an effect on bullying, your child’s quality of life, and on your life. Commit to your own healing and reach out to heal your family. Watch the impact.

Although bullying is physically healthier than being bullied, it destroys the essence of life, which is healthy, thriving relationships. Bathing your body in reward chemicals emanating from giving back, a sense of purpose and play is a much better way to live.

1. Copeland W, et al.” Childhood bullying involvement predicts low-grade systemic inflammation into adulthood.” PNAS (2014); 111: 7570-7575.
2. Simons L, et al. “Pediatric Pain Screening Tool: rapid identification of risk in youth with pain complaints.” Pain (2015); 156: 1511-1518.
3. Anda RF, et al. “The enduring effects of abuse and related adverseexperiences in childhood. A convergence of evidence from neurobiology and epidemiology.” European Archives of Psychiatry and Clinical Neuroscience (2006); 256: 174–186.

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There is no reward for being vulnerable for any species of life from one-celled organisms to homo sapiens. Consequences are severe and often swift. It is never safe to be off-guard, and different species create ways to be safe. They need to replenish fuel to fight another day. For example, a dolphin sleeps with one eye open. Many species form protective groups. Consider the number of ways creatures hide or camouflage themselves. Many species simply have thousands of offspring, so a few will survive. When these strategies fail, the final phase is whatever aggressive response they have available to them. The more strength and power, the better.

The added dimension of language

Humans have language, which creates another level of issues around seeking safety. We possess abstract thinking that allows us to engage in the arts, create coordinated societal actions, and have complex relationships with others. We rose to the top of the food chain because of our capacity to cooperate with each other. We have a strong evolutionary need to have close connections and relationships. For example, being socially isolated or lonely has the same effect on your health as smoking 15 cigarettes a day.¹ Look how much effort is put into seeing close friends and family during the holidays. We want to be with each other and the closer the better.

But one of the most perverse aspects of being human, is that successful thriving relationships require vulnerability and trust. These traits are the antithesis of feeling safe. Additionally, emotional/ mental pain is processed in a similar manner as physical pain.² “You hurt my feelings” and You broke my heart” reflect this phenomenon. So, we don’t like pain in any form, yet we have to become vulnerable in order to have deep and satisfying relationships. It is a huge problem, and it is not playing out well for the human race.

By definition, every interaction with another person requires taking a risk of being rejected or hurt. Even checking out at the grocery store involves trusting him or her to accurately document your purchases and help you with your bags. It is nice if they are in a good mood and are friendly. But what if they are having a bad day? Then there are deeper relationships such as being on a team, doing a project together, starting up any type of relationship, and living together. Being rejected at some level of the interaction is not only common, but also the rule. As you become more and more trusting, at some tipping point the level of vulnerability for that relationship will be reached, and one person will pull back or even reject it.

Your options

At this point, your choices are to 1) quit taking risks associated with interacting with others 2) engage but experience social anxiety 3) use whatever power you possess to control others 4) learn to be vulnerable. Since we don’t inherently possess the ability to feel vulnerable, the other less functional strategies are more commonly utilized.

Some form of anger is universal. Why? It keeps you safe. It protects you from both emotional and physical pain. Even if you don’t actually have the power to change the situation, you may feel like you do. Raw anxiety is intolerable and why we hold on to anger.

Why let go of anger?

• The main reason is that you simply cannot heal or thrive when you remain angry. The essence of healing is normalizing your body’s neurochemical state to that of a safety profile, which is profoundly restorative. If your whole system remains fired up, how can that happen? It can’t and won’t.
• Your brain structurally adapts to your focus of attention. You cannot move forward until you let go of the past, especially your deepest wounds. Most people in chronic pain remain angry at the situations or people who have harmed them. The more legitimate your gripe, the harder it is to move on. But how does holding on to the past make your life more enjoyable?
• Anger is destructive, as it is supposed to be. It’s your body’s last ditch effort to escape threat. It is destructive in every direction, including self-destruction. It is the reason why many people completely neglect every aspect of their health. It is tantamount to slow suicide.
• Anger is abusive and destroys relationships. The key element of successful human interactions is awareness of your needs and others’ needs. How else can you constructively interact with those close to you? Anger completely blocks awareness.
• Anger destroys families. Human consciousness evolved through language and social interactions. The ability to cooperate took homo sapiens from the bottom to the top of the food chain. The need for human connection is deep. Unfortunately, close connections are also the strongest triggers. Why would you ever be unkind to someone you care for so much? Why is the incidence of domestic abuse so high? It is maybe the most disturbing paradox of our human existence.
• Anger is the manifestation of the fight mode of the survival response. All organ systems are affected. The blood supply to your gut, bladder, and the frontal lobes of your brain diminishes and is shunted to your heart, lungs, and skeletal muscles. You can’t think clearly, although it might feel like you can. It is critical to, “Take no action in a reaction.”

Interacting with others involves taking the risk of being rejected or even hurt. There are physical risks, such as trusting a business partner who might run off with your money. What about your partner or spouse, who takes off with another person? These are deep ones, but simply reaching out to another person in friendship creates some level of anxiety.

Train your brain

You can use avoidance, suffer from chronic social anxiety, or resort to power and control to feel safe. The healthiest and most satisfying option is learning to be vulnerable and process rejection. In other words, being with anxiety. Being or feeling rejected is inherent to relationships, and unless you understand this, your world will become progressively smaller. Training yourself to lower your threat physiology (anxiety) instead of fighting it allows you to navigate life more easily. BTW, social connections are anti-inflammatory and lower anxiety.³ Addressing social anxiety is a bi-directional process. You can nurture joy, more easily interact with others, feel safer, and create the life you desire.

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References

1. Cigna US Loneliness Index. Cigna: 2018.
2. Eisenberger N. “The neural bases of social pain: Evidence for shared representations with physical pain.” Psychosom Med (2012); 74: 126-135.
3. Dantzer R, et al. Resilience and immunity. Brain, Behavior, and Immunity (2018); 74:28-42.https://doi.org/10.1016/j.bbi.2018.08.010

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“The gift of the unconscious “– life

The interoceptive nervous system is intertwined with every cell and organ in your body. The interpretation of these internal signals gives rise to consciousness. The warning signals evolved to be intensely unpleasant so as to compel the organism optimize function and act in order to survive. Conversely, sensations of safety became equally as powerful to drive cooperation and reproduction. The reward and warning system are both always active and in a delicate balance. This finely tuned interaction allows immediate action in either direction. However, since survival is clearly the primary need, unpleasant sensations will be more frequent. Most of the time, your actions will minimize them quickly, and avoiding physical pain and unpleasant sensations is how we are programmed to stay alive. This incredibly powerful complex unconscious system is the “gift of life.”

“The curse of cognitive consciousness” – RUTs

Language allows us to possess “cognitive consciousness”, and the capacity to describe these sensations. Meaning is given to the feelings generated by these neurochemical reactions reflecting danger and safety. Since we are always on some degree of alert for trouble, there is an endless stream of RUTs (repetitive unpleasant thoughts). Since physiology (how the body functions) affects every cell in your body, it is all encompassing, feels like who you are, and becomes a core part of your identity. So, the “gift of life” translates into the “curse of cognitive consciousness.”

Our brains become inflamed and hyperreactive with excitatory neurotransmitters and inflammatory cells when in flight or fight physiology. Humans describe these sensations generated from an activated threat response, “anxiety and anger.” They are physiologic states and not psychological.^1,2 Blood flow in the brain shifts from the neocortex (thinking centers) to the limbic system (fear and survival regions) so you cannot think as clearly when you are under real or perceived stress. An inflamed brain fires up even more RUTs, which are also perceived as dangerous and there is no end to this cycle.

                                                                     Goodtime/Adobe Stock

While we have an automatic withdrawal response (nociceptive system) for acute physical pain, there is no such response for mental pain. Suppressing RUTs only fires up threat physiology more and further creates more RUTS. There is no end to this loop, and we have no protection from mental pain.³

We attempt to create “good thoughts” from our conscious brain to counter the “bad” thoughts. This is an impossible task, as the unconscious brain continues to remain “fired up” and the bad thoughts continue to fly. Cognition requires conscious mental effort, consumes energy, is a gross mismatch of power, and is not sustainable. The unconscious brain processes between 20-40 million bits of information per second and our conscious brain deals with only about 40 per second. This interaction is why RUTs are so common, miserable for many, and the consequences are often severe.

Consequences of RUTs

One consequence is that well-intentioned people are more affected in that they may view themselves negatively because these thoughts are such a dark contrast to who they perceive they are or what they stand for. They don’t realize that these thoughts are interpretations of feelings generated from the unconscious brain. Efforts to combat RUTs often border on heroic, but the fallout is that people who potentially could significantly contribute to the common good are often crippled by anxiety (threat physiology) or just get worn down.

Less well-intentioned people may simply act out these thoughts and impulses without a lot of self-judgment. Hence, history is replete with tyranny and control. There is actually a physiological reward for power and control. Bullies have been documented to have lower inflammatory markers than average, whereas those who have been subjected to being bullied have higher inflammatory markers.⁴

Not only do humans expend a lot of energy fighting bad thoughts with good ones, but we also create “stories” to feel better about ourselves. We call it ego, self-esteem, or identity. As the powerful unconscious brain continues to keep us alive regardless of what we think or feel, there is no end to our efforts to create an identity that is bulletproof.

Another, more primitive solution, is exerting power and control based on these stories. The solution to anxiety is control, but without a way of decreasing RUTs, there is also no limit to what we do to control ourselves and others. These “stories” are often the basis evil actions. Once we label someone or a group of people as “less than” than we can justify any action in order to “bring them in line” or exterminate them. Labels are cognitive distortions that destroy awareness of details and the needs of others.^5,6

“The gift of cognitive consciousness” – choice

Anytime you are anxious or frustrated, you are reacting to something that was perceived as dangerous from the past. You are no longer in the present and cannot clearly see the details of the situation in front of you. You can will your way back to neutral or better for periods of time. But you have now lost choice, which is the gift of consciousness. It is truly a gift in that you can use the body’s property of neuroplasticity to create any brain (and reality) that you wish. But you cannot access it while you feel under threat. It is simply not possible.

The gift of our unconscious is life, and it keeps us alive at any cost. RUTs reflect this effort and are the curse of cognitive consciousness. Separating our identity from them and regulating our physiology from threat to safety allows us to access the gift of consciousness, which is choice. There are no shortcuts. You must  separate your identity from your survival reactions with awareness create choices. You are “letting go” (“Cing” first) in order to proactively move forward into creating the brain (neuroplasticity) and life you desire . Our lives can and will transform from reaCtive to Creative.

Why has this not been figured out long ago? Maybe it is because anxiety and anger have historically been placed into psychological/ mental categories instead of understanding they are such powerful activated physiological states. Avoiding the sensation of anxiety (vulnerability) drives most of human behavior. Much of it is dysfunctional and destructive. Medicine has not collectively acknowledged threat physiology as the driving force behind chronic mental/ physical symptoms, illness, and disease. It is no wonder that the burden of chronic disease continues spiral out of control.

The human race is a reactive species that knows how to physically survive. We have choice but can’t seem to access it with enough regularity to proactively create a thriving life and planet. Awareness allows choice and is where mental and physical healing begins.

References

1. Teed AR, et al. Association of generalized anxiety disorder with autonomic hypersensitivity and blunted ventromedial prefrontal cortex activity during peripheral adrenergic stimulation. JAMA Psychiatry (2022); doi:10.1001/jamapsychiatry.2021.4225
2. Takahashi A, et al. Aggression, social stress, and the immune system in humans and animal models. Front. Behav. Neurosci. (2018); 12:56. Doi: 10.3389/fnbeh.2018.00056
3. Wegner, DM. Ironic processes of mental control (1994); 101:34-52.
4. Copeland W, et al.” Childhood bullying involvement predicts low-grade systemic inflammation into adulthood.” PNAS (2014); 111: 7570-7575.
5. Burns, David. Ten Days to Self-Esteem. Harper Collins, New York, 1993.
6. De Mello, Anthony. The Way to Love: The Last Meditations of Anthony De Mello. Doubleday, New York, NY,1992.

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Your Hand Over the Heat

If you were to put your hand close to a hot burner on a stove, what would happen to your level of anxiety?

• It would quickly escalate.
• You would withdraw your hand.
• You would protect yourself.
• Anxiety would be alleviated.

What would happen to your anxiety if you were forced to leave your hand over the burner?

• It would go through the roof.
• You would feel trapped and extremely angry.

I don’t believe you’re OK.

Anxiety is a Programming Problem

The changes to the central nervous system during chronic pain represent a programming problem rather than a psychological problem.

• Anxiety gains strength with time and repetition.
• Anger is a powerful force that covers up the feeling of anxiety
• Anger spins anxiety-inducing neurological circuits more quickly.
• We deal with anxiety by exerting some form of control.
• If you are successful in controlling the situation or yourself, then your anxiety is alleviated.
• Without control, you become frustrated or angry. Anger = loss control

With chronic pain, you have, metaphorically, lost your ability to “withdraw your hand from the red hot burner.” How can you rate yourself as a zero on anxiety and irritability? If you had no other stress in your life, chronic pain alone would be enough to destroy the quality of your life.

There are several other stress factors to consider with chronic pain.

• People in chronic pain don’t see an end to their suffering. They lose hope in returning to a pain-free life.
• Chronic pain patients are truly victims of pain. So it’s more difficult to let go and not have anger run your life.
• When chronic pain patients suppress anxiety and anger, these negative feelings become much stronger. (2)  White Bears and ANTS.

Being Pain-Free is a Basic Need

We all deserve to live free of constant pain. Being pain-free is a basic need. It has been shown that the impact of chronic pain on a person’s quality of life is equivalent to having terminal cancer. (1) We cannot accomplish higher goals and flourish as human beings without first securing the comfort of being in our bodies. I discuss this in “Maslow’s Miss”  and in the video: “Your Hand Over the Stove.”

“The Link Between Pain and Anxiety”. Inspire, January 21st, 2013

1. Fredheim OM et al. “Chronic non-malignant pain patients report as poor health-related quality of life as palliative cancer patients.” Acta Anaesthesiologica Scandinavica (2008); 52: 143 – 148.
2. Wegener, DM et al. “Paradoxical effects of thought suppression. Journal of Personality and Social Psychology (1987); 53: 5 – 13.

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In 2003, a neurosurgeon performed a laminectomy of his neck. That’s an operation where the lamina or the bone over the back of the spinal cord is removed to relieve pressure. He seemed to improve for a little while. In 2005, his symptoms worsened, and in 2009, he underwent a fusion through the front of his neck between his 5^th and 6^th vertebrae. Again there was a slight improvement but two years later he was in my office with crippling pain throughout his whole body.

Normal studies

As I talked to him, I could see how desperate he was for relief. He also wasn’t sleeping and his anxiety and frustration were a 10/10 on my spine intake questionnaire. I couldn’t find any neurological problems on my physical exam. When I looked at his neck MRI, I could see where the two prior surgeries had been performed, but there were no pinched nerves. The alignment and stability of the vertebrae were also fine. He also had undergone several workups of his brain and the rest of his nervous system. Everything was normal.

When I explained to him that I did not see a structural problem that was amenable to surgery he became understandably upset.  He was stuck on the idea that the prior surgeries had helped and that I was missing something. It didn’t matter what I said or how I explained the situation to him. He wasn’t buying it.

What I didn’t tell him was that I had also looked at his scans he had prior to undergoing each surgery. Telling a patient that they did not really need a prior surgery is a very unproductive, unpleasant interaction; I didn’t see why this patient’s prior surgeries were performed. On the first MRI of his neck, there were no bone spurs and the spinal cord was completely free. There wasn’t a structural problem that could have been corrected by surgery. On the scan before the second operation, there also wasn’t a hint of anything that could be causing any symptoms of any type.

The power of placebo

What’s difficult for patients (and physicians) to realize is that the placebo rate for any medical or surgical treatment is between 25-30% or even higher. The response and improvement is not only real but is powerful. It is the result of your body’s own healing capacity. It is a desired response, and you feel less pain.

The pain-killing effects of a placebo are reversed with Narcan, which is the drug used to reverse the effect of narcotics. There is a part of the frontal lobe of your brain that shuts off pain pathways for short periods of time. Another example is the placebo effect of cardiac medications causes the heart rhythms to actually change. Just because a prior surgery or procedure on normal age-appropriate anatomy might have been temporarily effective is irrelevant. It should have nothing to do with current decision-making. I tell my patients “If I can see it, I can fix it” and  “If I can’t see it, I can’t surgically correct it.” It’s critical to have a specific structural problem with matching symptoms before surgery becomes an option. Surgery: The Ultimate Placebo

I suggested that he take a look at the DOC website and I would be happy to explain the whole program to him in as much detail as needed. He was so angry that I didn’t think I’d hear from him again.

Early engagement

Over the next couple of months, I received a couple of emails and had a telephone conversation that seemed to go pretty well.  He was willing to engage in the DOC protocol and began some of the writing exercises. I had a second phone conversation with him a couple of weeks later that seemed to go even better. He was able to recognize that his thought of me “missing something that needed to be fixed” was an obsessive thinking pattern. I was encouraged and thought that maybe I had been able to break through his “story.”

Time went by and our third and final conversation was dismal. He couldn’t let go of the thought that “something was being missed” and that his seventh cervical vertebra was “out of alignment.” I assured him it was OK. As a surgeon, I am also quite obsessive about not missing problems that I can fix. At this point, it didn’t matter. He’d found a surgeon who was going to fuse his neck.

Injury conviction

Physicians use the term “injury conviction” to describe this phenomenon. It is the relentless pursuit of a cause for your symptoms that is well beyond reason. My concept has changed in that I feel this pattern of thinking becomes its own irrational set of neurological circuits. It is similar to phantom limb pain and my term is “phantom brain pain.” Regardless of whether the original source of pain is there, the symptoms are the same. Rational arguments have absolutely no effect.

Hell

I wrote a post Anxiety and Anger: The Highway to Hell. Unfortunately, if you’re in this pattern, you’re in Hell, and the only way out is through you. The deep tragedy is that if you don’t realize you’re in Hell, you’ll remain there. I never give up, but I have learned to let go when I can’t penetrate that firewall of obsessive thinking. For those of you that have let yourself out this hole, I am open to suggestions as to what gave you the insight to move forward. Awareness is the basis of the entire DOC process and is always the first step.

I don’t know how many more tests and surgeries he’ll undergo over the next 30 years. The personal cost to him and society will be enormous.

What’s puzzling is that if any of the surgeons who’d chosen to operate on this man’s essentially normal anatomy were examined by a board examiner about their indications for his surgeries, they’d be failed immediately for giving a “dangerous answer.” It’s our medical responsibility to you to not offer risky procedures that have been documented to be ineffective.

Video: “Get it Right the First Time”

The post How Many More Neck Surgeries? first appeared on Back in Control.

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• Many people are focused on controlling anger and anxiety with behavioural approaches.
• These powerful reactions are not controllable and suppressing them increases threat physiology.
• We all need to be heard, supported, and taught methods to regulate and lower these responses.
• Avoiding or suppressing stress causes damage to our bodies and causes chronic illnesses.

How many of us have heard the phrase, “children should be seen and not heard?” Or what about, “spare the rod and spoil the child.” How often were your parents not really there for you when you were upset?

DimaBerlin/ AdobeStock

Kari is a woman who I met in 2018 when she asked me to speak at her company’s annual disability conference. I presented the nature of chronic pain and approaches to solve it. I did not realize that she jumped right in with both feet and learned the concepts. She contacted me about a year later, and shared how excited she was about how much her life had improved. We have remained in close touch and here is her recent email. I had told her about a remarkable turnaround of a 24-year-old gentleman who had broken out of his bipolar disorder, anxiety, major depression, and pain migrating around his entire body.

Her letter

Hi David, is this the young man with Bipolar you mentioned during our call?  What an incredible transformation! 

You know what hit me the other night, few children are taught how to process anxiety so they do the best they can on their own and usually create inaccurate perceptions of themselves and learn ineffective and often damaging behaviors to deal with it (the 7-year-old creates the 50-year-old).  Parents should be doing this, but many parents are trapped in their own heads with repetitive negative thoughts and don’t know how to teach their children these skills as they haven’t learned them either.  And the cycle of dysfunction continues….

A little personal story here….My aunt gave me my grandmother’s book of prayers.  My grandma was an extremely anxious woman and pretty OCD.  I was thumbing through her book and noticed my grandma had written in the margins, underlined certain passages, etc.  In the section on anxiety, she had underlined several times that “anxiety is a sin.”  My poor Grandmother thought she was a sinner her entire life because she was anxious!  How awful!

My mother was also very anxious – no surprise there.  In 6^th grade, I had a boyfriend, nothing very serious at that age of course, but I went to school one day and here my best friend was now with my boyfriend.  I came home and was crying in my bedroom, mostly because my best friend had stabbed me in the back over a boy.  My mom came in and asked me what was wrong and when I told her, her response was, “get a real problem”. 

My mom was very stressed at the time with my two younger siblings and my dad always being at the bar – he was no help.  From that moment on, I never told her anything about my life that wasn’t positive and became very depressed all through junior high and high school. Not having a parent to support me emotionally really messed me up and caused me to create all these negative perceptions about myself that took me 40 years to get over.

I am grateful that I have broken the cycle of dysfunction with my son – we talk openly about these things, and he is a very high functioning and happy person. 

It’s all just so insane and sad.  Anyways, thanks for letting me share.  It was the sequence of concepts you presented that broke the cycle for me. Kari

Anger and love

Anger is a trait that blocks openness and engagement. One aspect of flight or fight physiology is that your necortex (thinking areas) are down regulated from stress hormones, the limbic system (fear) regions are activated, and you don’t even have good access to your rational thinking. Frustrated people are not rational, and there are no exceptions. Even more disturbing is that you can become crosswired and pain can be connected to “love”.

Our friend Sheila was standing in the checkout line at a grocery store when she heard a young mother screaming at her young five year-old daughter to put something back on the shelf. She suddenly hauled off and slapped her with a full swing. Almost at the same time the young girl began to cry, she held out her arms and ran to her mother to comfort her. Who else was there to console her? Talk about becoming cross-wired – the girl’s source of pain was also her bastion of love and protection.

My childhood experience with “love”

My mother would fly into rages that would last for two or three days. We never knew what would set them off, although we imagined many possibilities. We thought it was associated with our behavior, but no matter how hard we tried to avoid upsetting her, it just happened. After every tirade she would profusely apologize, and tell us how much she loved us. It was quite confusing. What even seems more bizarre in retrospect was that I was convinced that our parents loved us. I recall telling friends of mine in middle school that although my parents had some faults, at least I knew they loved us? Really??

The answer really is yes. My mother spent hours driving us around, volunteering at school, and talked about us in glowing terms to anyone that would listen. What I did not know as a young child is how disconnected anger (she also had chronic pain) can make you. She essentially entered a different reality when she became upset. From our perspective this was all a part of parental support and love.

It was so mixed up in my head that I did not even realize that anger was part of my life until I was almost 50 years old. It was just normal for me to become “frustrated” and since I was “right”, I did not have a clue that this was what anger looked like. I don’t think those close to me felt the same way. But at the same time, I was experiencing over 17 different physical and mental symptoms. I was disconnected.

What is your concept of love?

When you are an infant or child your mind is a blank slate being downloaded from your environment. If your symbols of love and protection are combined with mental or physical neglect or abuse, your concept of love will be much different than someone who was raised in a warm, caring, nurturing, and loving environment. In retrospect it is disturbing to me that I was so verbal about how much my mother loved me in the midst of a violent environment.

Sviatoslav Kovtun/AdobeStock

We all need to be seen AND heard

The common theme of these three situations is that a child was anxious and upset. The interventions took the form of suppressing and attempting to extinguish these behaviors, which were caused by a powerful unpleasant survival reaction. Many of us are taught from an early age that, “it is better to look good than feel good.” The root problem causing the reaction is often not addressed. You don’t feel heard, and you quickly learn that suppressing your feelings is better than having to deal with them. Except, what you don’t realize is that suppressing thoughts and emotions is like turning the heat up on a pressure cooker. The consequences are usually severe. The hippocampus of your brain (memory center) both shrinks and malfunctions.

The solution lies in the saying, “you have to feel to heal.” And then using strategies to regulate your flight or fight state to safety physiology. By dampening the driving force, not only will behaviors improve, but you can also live life in awareness and freedom.

References

1. Hulbert JC, et al. Inducing amnesia through systemic suppression. Nature Communications (2015); published 3.15.2016. 7:11003 | DOI: 10.1038/ncomms11003

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My arms reach upward as the mind and hair are disintegrating, reaching through burning into the light. Grounded in the earth, I dance. My heart lifts up, surrendering into light, moving with the energy, letting go of resistance, opening to the possibility of a new layer of growth, channeling wild fury and mad aliveness. I am here to be bold and to show the real, raw intensity of what my past two months have been like. I have had a rash on my skin from an unknown cause that erupts as red welts on my arms. Ouch. I am in process of getting tested to discover the underlying root cause, but in the meantime, enduring outrageous jumping-out-of-my-skin irritation *%?#*! Yikes! I am using this intense experience to build endurance and stamina… to practice staying grounded and present in the midst of such reactivity, this is for real. Just as in nature, there are wild storms as well as peaceful meadows, I see this energy may be an aspect of shadow anger that has been suppressed that is now erupting, in my body as well as in the collective….what if I can welcome even this and thus become more whole.

This intense description of suffering reflects several important concepts. This type and pattern of pain is uniquely difficult to endure.

First point is that there is a clear cause for the skin rashes. When your body’s physiology (how it functions) is in a flight or fight mode, inflammatory mast cells are activated. Each cell has many granules of inflammatory chemicals that released that create intense reactions. They include:

• Allergic reactions – migratory skin rashes with burning/ anaphylactic reactions
• Irritable bowel syndrome – stomach pain, diarrhea, constipation
• Burning, itching, hot, cold sensations throughout your body
• Irritable bladder (interstitial nephritis)

Mast cell releasing histamine during allergic response – Dr_Microbe/AdobeStock

MUS or MES?

There is testing is being done to find out the cause, but most of medicine is looking in the wrong places. The diagnosis of MUS (medically unexplained symptoms) may be applied to this situation. It is a common diagnosis that could not be more wrong. When your body is in sustained flight or fight, everything is wrong. Every cell in your body is bathed in this stress chemistry bath and the reason why there are so many different symptoms. The correct term should be MES (medically explained symptoms).

The next point is  this person has correctly identified that this is the shadow side of anger. However, the terminology is tricky in that anger is also the sensation generated by threat physiology. Anger and the pain are the same entity. The better term for anger is “hyper activated threat physiology.” It is not a psychological problem. The key to treating both of them is learning methods to lower your stress chemistry. It is one of the main focuses of The DOC Journey. It requires a multi-pronged self-directed approach that is not difficult but requires commitment to develop the expertise to regulate your physiology.

Connecting to the pain

What is unusual about this story is the degree to which these symptoms are being embraced and being a source of learning to move to a higher place. Most of us want to fight or run from them, which unfortunately reinforces the pain circuits. Being with your pain, mental or physical, is a major aspect of healing. There is a saying, “what you resist will persist.” It is similar to trying to escape from a finger trap. The harder you pull, the tighter the trap becomes and the key is letting it loosen first and gently remove it.

What I am concerned about is that this is intense pain and unless there are other approaches being used to move forward, you’ll eventually become worn down. White knuckling alone can’t and won’t work. Combined with other tools, this is a remarkably powerful step. In the “C” quence of healing, connecting with your pain is a foundational step, but not the final solution.

Anger – the tipping point

The most significant tipping point in healing is learning to process anger and move forward. This is challenging in that when you are suffering from chronic pain, you have a legitimate reason to be extremely angry. These symptoms are intense and it is hard to “make space” in order to heal. I have always been in favour of doing whatever is needed in order to provide symptomatic relief. Some options include medications, biofeedback, local measures, vagal stimulation, and possibly spinal cord stimulation. None of this are definitive solutions, but in the context of a healing journey, can be very helpful.

Scottish Fold Cat – koldunova/AdobeStock

Ants under the skin

I have a close friend of mine who developed sensations of ants crawling under his skin throughout his whole body. He was more than miserable. I talked him through the concepts behind solving these symptoms. One way of lowering inflammation is by stimulating the vagus nerve. It is the 10th cranial nerve that originates in the middle part of the brain and connects to every internal organ and the immune system. It is highly anti-inflammatory. He re-engaged in the expressive writing, active meditation, and then used various breath techniques that stimulate the vagus nerve. He used them with a vengeance. Within a couple of weeks, the sensations resolved, and have been gone for over 6 months. There are still other things he can do to keep moving forward, but his remarkable focus on one set of techniques to jump start the process was remarkable. The other factor was him taking charge of his situation.

My story

My personal experience included severe burning sensations that enveloped both of my feet for over 20 years. During the worst period of my ordeal, I felt like they were in toaster ovens, especially at night. I took off my shoes whenever possible. I underwent many tests to find the cause and nothing was found. These symptoms have been gone for over 19 years with just occasional tingling. I also had skin rashes that would randomly appear on my arms, wrists, and legs. They were preceded by severe burning for 10-15 minutes, would last for several hours, and then disappear. Those have also resolved unless I quit using the tools I teach everyone else. If I stop doing expressive writing for a few weeks, the first symptoms to show up are skin rashes on the backs of my wrists.

Summary

This story represents the major paradox in treating chronic pain. The tipping point is processing the legitimate anger about having it, but how do you not be angry when suffering at this level? It happened for me and also for hundreds of other patients I have witnessed breaking free. I can’t completely explain how I broke free or how I got there. The common theme is persistence in using the tools and layering on others. Jumping around for a solution doesn’t work and it is counterproductive. In the depths of my frustration, I remember the deep sensation of being fed up with it all and moving on. Although I been trying to use many tools with quite a bit of success, it marked the tipping point of my symptoms resolving over the next six months. Your body knows how to heal.

The post Fierce Pain – Medically Explainable Symptoms (MES) first appeared on Back in Control.

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• Avoiding danger is what keeps us alive. Humans call this signal anxiety.
• Avoiding this sensation drives much of dysfunctional human behaviour. We know how to stay alive but not necessary thrive.
• Anxiety is a physiological reaction that is about a million times stronger than the conscious brain. It cannot be controlled.
• We can auto-regulate and redirect it. Addressing anxiety at the root physiological cause will solve many mental health problems.

Why is Anxiety Considered a Psychological Diagnosis?

Anxiety is simply a warning signal. Every form of life has a withdrawal/ avoidance response to real or perceived danger. All life forms, from one-celled organisms to humans respond with complex changes to optimize the odds of survival. This unconscious automatic reaction is powerful and has evolved to feel extremely unpleasant in higher life forms. It compels action to lessen the sensations. The species who did not pay attention to these danger signals, simply did not survive.

 Staying alive

When you sense danger, how do you feel – anxious? Although this a basic survival feeling, humans have the capacity to name it. It is the result of stress, threats, and life challenges, not the cause. Avoiding this sensation is the driving force behind much of human behavior, and seeking safety is necessary to store up reserves to fight another day.

What happens in your body that creates this sense of dread? The term is, “threat physiology.”

Threat physiology

Physiology is the term that refers to how your body functions. Your survival reactions are mostly unconscious, and about 40 million bits of information are processed per second. Our conscious brain deals with only about 40 bits per second. Your unconscious brain is a million times stronger than your conscious brain; the responses are hardwired and automatic, and the reason it is not subject to being controlled. However, it can be regulated and reprogrammed.

Examples of physiological actions are heart rate, blood pressure, blinking your eyes, acid-base balance, sweating, breathing, bowel and bladder function, hunger, and the list is almost endless.

These are some of drivers activating threat physiology.

• Stress hormones – adrenaline, noradrenaline, histamines – ready the body for fight and flee
• Cortisol – mobilize fuel (glucose) from tissues throughout your body.
• Glutamate – Neurotransmitters change from calming to excitatory to increase alertness and sensitivity to danger signals.
• Inflammatory cytokines (small molecules that transmit signals between cells) – the many aspects of the immune system kick into action.

Anxiety is a physiological state

This is a small fraction of actually what occurs in fight or flight physiology. Consider how you feel when your body is in this state. Here is a suggested word progression.

• Alert
• Nervous
• Afraid
• Angry
• Paranoid
• Terrorized

They fall under the umbrella of “anxiety” or “fear.” We will do almost anything to avoid this sensation resulting in many bad behaviors. Psychological diagnoses are ALL anxiety driven. The exceptions are in the positive psychology domain.

A paradigm shift

The way we view mental health must change. Here are some suggestions.

• Eliminate the word anxiety from the DSM coding system. It is the driving force and cause of poor mental and physical health.
• Most psychological diagnoses are descriptions of behaviors driven by the sensations created by threat physiology. Descriptions are less pejorative than labels (diagnoses).
• Substitute the word anxiety with the phrase, “activated threat physiology.”
• Anger is “hyperactived threat physiology.”

“Dynamic Healing”

The root cause of our mental health crisis is sustained threat physiology. There are many ways of lowering it and creating “cues of safety.” The model is called “Dynamic Healing” and is at the core of how medicine should be delivered. The portals are:

• The input – you can process your stresses so as to have less impact on your nervous system.
• The nervous system – the resiliency can be increased so it takes more stress to set off the flight or fight response.
• The output – your nervous systems takes in sensory input, summates them, and sends out signals of threat or safety. There are ways to directly dampen the threat response.

None of the approaches are difficult and require few resources. There are many clinicians in all medical fields that understand and are applying these approaches. It is just not happening on a wide enough scale.

There is no question that symptoms and behaviors must also be addressed while people heal. But if the root cause is not dealt with, their suffering will continue. Hence, the nationwide burden and fallout of poor chronic mental health continues to skyrocket.

Let’s do this!!

Our mental health crise reflects a lot of needless suffering as deep science has pointed the way to effective treatments for over 40 years. Most of clinical medicine is not connected to the data or is categorically ignoring it. It is certainly not being widely taught in medical school.

Where will the energy come from to wake us all up? It has to emanate from the public demanding better care because the business of medicine seems to have little interest in true change. It is the responsibility of the medical profession to honor the known data and implement what is already known.

The answers for our mental health crises are right in front of us if we just pay attention. Take your medical care and life back. It is your right.

The post There is an Answer to the Mental Health Crisis first appeared on Back in Control.

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Anger is the body’s effort to regain control of a situation that you perceive as threat. It’s the most basic of survival reactions. It is only about your survival and by definition is destructive. In an enraged state of mind, you’ll do whatever it takes to take care of yourself. It doesn’t matter whether the danger is real or perceived because your body’s neurochemical reaction is the same – adrenaline, cortisol, histamines and other stress chemicals. In addition to the many physical reactions to these hormones (rapid heart rate and breathing, sweating, widened pupils, etc.), they also decrease the blood supply to the frontal lobe of your brain. You can’t think clearly or see options when you’re trying to “escape.” Many acts of aggression and violence, if not most, occur while in this state of mind. It is truly temporary insanity and it’s dangerous.

Steve’s story

This situation was highlighted to me by a friend of mine, Steve, who is about my age. We were discussing the pros and cons of gun control. He told me a chilling story that occurred while he was in his early twenties and recently married.

At the time, he felt strongly that it was important to keep a gun in the house not only to protect himself, but also his new wife. He was comfortable with guns and knew all the safety rules. His wife had equally intense feelings about not having firearms in the house.

They had been out for the evening a few weeks earlier at a bar. An acquaintance of hers started to talk to them and became somewhat inappropriate in his comments. She and Steve left early to avoid an impending confrontation. There didn’t seem to be much more to it.

Two weeks later, this “acquaintance” knocked on Steve’s door and asked to speak to his wife. That was the last straw for him. They began to exchange some harsh words and Steve, according to his account, “lost it.” He went running to the bedroom to get the gun and settle this once and for all. He said the jealous rage that hit him was indescribable. He fully intended to finish this guy off – except that his wife had hidden the gun. It still wasn’t a pretty ending, but it was game-over as far as using a gun. He was able to regain his senses enough in the few minutes of searching for the weapon, that he figured this was going to be a really bad idea.

The next 40 years

Forty years later, he and his wife have raised a beautiful family. He owns his own business and enjoys talking about the Golden State Warriors with us. There is no question in his mind that he came extremely close to spending those years in prison.

Each person’s world is defined by his or her nervous system taking in sensations from all the different receptors (eyes, ears, skin, nose, etc.), unscrambling the signals and defining reality. There’s nothing inherent in your eyes that defines that a chair is a chair or a lamp is a lamp.  For example, if you have a stroke in the vision center of your brain (occipital lobe), you’ll be completely blind although your eyes work perfectly fine. Humans have a serious problem of consciousness in that thoughts and belief systems become embedded in our brains the same way as any other object. They are as real to you as that chair. Clearly, actions taken in response to upsetting thoughts are real.

Connected to the past

When you’re anxious or angry, your brain just connected with some unpleasant experience in the past and your nervous system is saying, “Danger – take action – now.” Rational thinking isn’t part of this reaction and things happen quickly.

It’s critical not to suppress the reaction because it fires your body up even more. Over time, people become ill from the sustained chemical assault of stress hormones. So, if you experience anger, it’s a problem and suppressing it is even worse. What do you do?

“No action in a reaction.” You must allow yourself to feel the upsetting feelings and emotions and then discipline yourself never to engage with anyone or anything when you are in this state of mind – ever. It’s tough because the reactions are so strong and there’s never an endpoint where you’ll cease to be angry. You will fail at different levels, but the skill improves with time and repetition. The key is to create some “space” between the perceived threat and the automatic survival reaction. In that “space,” you can choose a different and more appropriate response. Your brain changes structure and shape every second (neuroplasticity) and eventually the automatic reaction will be more appropriate. Here is one approach called, “5-3-2.”

Steve was lucky. His wife hiding the gun gave him that “space”, which was not having access to the gun. He was able to calm down enough to resolve the situation. When you’re angry, it doesn’t matter what your mental health is. You’ll act in a self-protective manner regardless of the costs. Steve is about as good-hearted of a person as you’ll ever meet. Having him spend his life in prison (or anyone’s life) based on a 15-minute reaction isn’t logical.

Guns are just one manifestation of anger in action

Decreasing gun violence by improving society’s mental health is missing the mark. The topic is complicated but the discussion regarding solutions needs to center on the fact the anyone can have an irrational reaction in a fit of rage. Steve wasn’t mentally ill and this situation could happen to any of us. Forget about guns for a second. What about the levels of verbal, sexual and physical abuse that are so common in American families? It intellectually doesn’t make sense to treat those you love so aggressively, yet abuse is rampant in our educated modern society. Gun violence is just one manifestation and is the tip of the iceberg. Anger is the driving force and needs to come to the forefront of any discussion about violence and abuse.

The person who is a “cold-blooded killer” represents a different scenario. People in this category are defined as sociopaths or psychopaths.  Although the killer may have global anger at some perceived societal or racial wrong, the actual act doesn’t usually occur in a fit of rage. However, this scenario represents a sustained state of anger where these thinking patterns become embedded in the brain and become stronger over time. It becomes the lens that life is viewed through and eventually their version of reality. At some tipping point, taking action is almost inevitable.

The bottom-line is that anyone can make a huge mistake in a fit of anger and immediate access to a weapon magnifies the impact. Everyone is so busy defending their positions around firearms, that the root cause issues aren’t being discussed. Any form of violence, especially within the family, is a major public health issue. Is inflicting daily abuse on someone who is dependent on you a less of problem than using a gun?

It’s important to be aware of when you are angry and NOT suppress it, but also understand the dangers of it.  Learn to “be with your pain” and resolve to take no action when you’re in a reaction. Steve happened to have “space” created for him at the moment. It’s important to learn how to quickly create your own space any time you’re upset before you act. We’re happy that Steve is around and that we are able to enjoy spending time with him.

Anger is universal, an automatic survival reaction emanating from our powerful unconscious brain that we have no control over. However, we do have a choice of how we respond to and it is a learned skill set. The solutions are straightforward, easily learned, and can be implemented from a public health perspective. We need to get our society’s brains back “online” soon.

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