• Anxiety is an unpleasant sensation generated by your body’s physiological response to real or perceived danger.
• It compels you to take action to resolve the threat and live another day.
• If you cannot escape or solve the threat, your body’s stress response intensifies and you become angry.
• Anger is irrational, powerful, destructive, and not subject to control. 5–3–2 is an approach to minimize the damage.

“Genealogy” of Anger

The perception of threat of any kind creates a neurochemical inflammatory stress reaction that is experienced as anxiety.

The sensation of anxiety creates a compelling need to resolve the threat.

When you are trapped (loss control), your body increases the stress response in an effort to regain control.

You are now angry (hyperactivated threat reaction).

Anger = turbocharged anxiety.

Neither anxiety nor anger is subject to being controlled. They are powerful automatic reactions. Your choice is how you react to them.

5–3–2: A sequence that allows your brain to be back online

The biggest problem with anger is that, since it is your last-ditch effort to survive, your brain activity shifts from the neocortex (rational thinking area) to your midbrain (reflex survival center). When you are angry, you have lost awareness of others’ needs, it is all about you, and it’s destructive by design. It’s physiologically impossible to think clearly and while you are in this state; you must just stop—somehow. Taking any action while you are angry rarely improves your life or relationships and is usually damaging.

Here is a sequence of steps you can use to minimize its impact. 5-3-2 is the number of words in each step.

• No action in a reaction
• Flip the switch
• Move on

5—No action in a reaction. First, recognize that you are upset. There are many ways anger is disguised. Then you must acknowledge that any action, physical or verbal, is not going to be helpful in the long run. It may feel like you are thinking clearly, but you have to intellectually understand that you cannot. Your brain really is offline. Finally, don’t take any action while you are upset. Say nothing. Leave the room. Take a walk. The anger may lessen quickly or last for a while. Much of it depends how skilled you are at processing anger, and everyone is different.

3—Flip the switch. Anger is so powerful that you will never be able to give it up nor will you want to. Flipping the switch means that you let your anger drop enough that you are able to think more rationally. Then you make a decisive choice to come out of the victim mode. However, it is important not to flip the switch until you think you can actually do it. You may drop right back into anger, and you just keep making the choice to change direction.

2—Move on. Once you have returned to a rational state of mind, you’ll be able to address the upsetting situation more clearly and constructively. What is interesting is that often what seemed so important and intense just disappears. Since anger is a trigger within you, and the situation or a person is what set it off, the “problem” often ceases to exist. It is critical to keep moving forward into the life that you want or the solution you desire. If you spend your time trying to keep solving what makes you upset, the list is endless, it isn’t that enjoyable, and you’ll drag yourself back into The Abyss.

There are many facets to anger and ways to process it to minimize its impact on your life. This little 5-3-2 strategy will get you started, and you’ll find it useful many times a day. Don’t let anger run your life—starting today.

Recap

Anger is destructive and it is supposed to be. It is a last-ditch survival mechanism will compel you to do whatever it takes to physically and mentally survive. It is a physiological state and the additional problem is that the activity in your brain shifts from the neocortex (thinking center) to your limbic region (survival region). It is not possible to think clearly or creatively. So, the first step is recognising that you are angry (there are many disguises) and understand any actions, physically or verbally, are going to inflict damage. This a simple decision because you won’t benevolent in this state.

Second, after you have allowed yourself to calm down, then “flip the switch.” This is also another simple and definitive decision because anger is addictive and irrational. You will never want to give it up. You make a decision, “I am not going to remain in a victim mode.” Why do you want to give up your peace of mind to someone you dislike or a situation that is intolerable. You may have to do this multiple times a day as there is no end to life’s challenges.

Finally, just move on. Get on with your day. Take a break. Pursue your projects. As you spend more time engaging in activities you enjoy, your brain will evolve in that direction. It is remarkable how effective the “5-3-2” strategy works.

Questions and considerations

1. One of the most challenging aspects of dealing with anger is recognising it. Maybe it has become normalised. There are many disguises and it is important to recognise them.
2. You must allow yourself to deeply feel your anger while at the same time, not acting on it. Suppressing it creates even more havoc.
3. Have you considered how much time you spend being angry? If you think you are rarely angry, think again. It is basic to your survival and there is no getting rid of it.
4. Taking no action in reaction is difficult and requires discipline and repetition. It is a powerful and overwhelming emotion.
5. If you can learn and use this sequence, you will quickly notice an improvement in your relationships. Think about how you feel when you are around someone who is upset. Think how you might appear to others when you are angry. Anger is not attractive.

The post “5–3–2” – Processing Anger in Three Steps first appeared on Back in Control.

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• All of us are “wronged” every day and often multiple times. The wrongs may be real or perceived.
• Your choice centers around how you want to process them.
• Do you hold on to it them or let go and move on?
• You always have this choice. One problem is that the more legitimate your anger, the harder it is to let it go.
• Recognizing the nature of a “grievance story” is the first step.

I have held three and five-day workshops at the Omega Institute in Rhinebeck, NY with Dr. Fred Luskin, a Stanford psychologist and author of Forgive for Good,¹ my wife, Babs Yohai, a professional tap dancer, and my stepdaughter, Jasmine, who is an expressive arts practitioner. The tightly-structured seminar is based on awareness, hope, forgiveness, and play. Most people experienced major shifts in their pain and mood during the week and continue to improve following their attendance.

There were three ground rules: 1) you could not complain about your pain or let the other participants know where you were hurting 2) medical care could not be discussed 3) no complaining – period. Most participants were initially thrown off by not being able to discuss their pain, but quickly realized how important it was in contributing to his or her healing. What I had not realized prior to conducting these workshops is how much people complain – not only about their pain, but also about life in general. How can you enjoy your life when you are continually upset?

Your Grievance Story

One of the first concepts that Dr. Luskin presents in his book, Forgive for Good,¹ is that if you tell the same story of woe more than three times to others where you are the victim, you have a “grievance story.” He points out that this person or situation is “renting too much space in your mind.”

Directing your attention

Your nervous system will rewire and mature in whatever direction you place your attention. How much time do you spend thinking (obsessing) about your pain? How aware are you of other’s needs? What percent of your conversations are spent discussing some aspect of your suffering? Do you really enjoy discussing your pain? Don’t you become tired of it? Are you driving friends and family away?

BTW, talking to your dog or cat is OK. It is a variation of expressive writing, and they listen.

Recognizing your grievance stories

Grievance stories are common and every day, life does not go exactly as you planned. It becomes easy to look at “patterns” and feel that this person always does this to you, or your employment situation is adverse. The home is also a great source of grievance stories. Dr. Luskin defines a grievance story as being you telling the same story of being wronged to three different people. It is a simple yet sobering definition because we are upset, it feels good to vent and feel supported. Maybe once is fine, but how long do you want to remain a victim of circumstances? The only person who will continue to suffer is you. If you apply this simple concept to your life and conversations, you might be shocked at how many of these stories you have and how often you share them.

Bringing grievances home

People commonly bring their complaints about work or the day home. They somehow feel it is important to share and “download” the problems. Even if you are not upset at your family member or others in the house, it brings in an unpleasant energy and upsets your home. Home is a place to rest and regenerate and complaining about the day doesn’t create peace. Through the mirror neurons effect of the brain, you’ll directly fire up similar areas in other peoples’ brains. We all know that just being around someone who is frustrated is not great.

Frequently, the scenarios at work or with your disability situation are not solvable, the grievances may be legitimate (they usually are), and you’ll continue to remain upset and disrupt your family. All parties eventually get worn down. Whatever your issue is, you own it. It is not others’ responsibility to solve it or even make you feel  better. So, what is the end point? It is you. You have a choice of how you relate to your troubles. You don’t have be happy about what is happening, but it is important to stop complaining. Recognizing your grievance stories is the first step. They are not only “renting too much space” in your mind, but they have also moved into your house.

Georgia

One of the most dramatic turnarounds I have witnessed was a patient who came to me to treat her scoliosis. Her curve was about 60 degrees and she was suffering from chronic back pain. There is little evidence linking scoliosis to chronic pain. Since her spine was still balanced, I was not inclined to consider a surgical procedure. It would have involved at least 8 hours of surgery with a complication rate of over 50%. She had been wheelchair-bound for about 10 years and was taking a lot of narcotics. I told her that I would consider surgery only if she engaged in the rehab process as outlined in my book. I asked one of my colleagues to help out with her healing process. Within a couple of months, we realized that she was not taking any responsibility for her condition and was unwilling to put forth any significant effort. We decided to discharge her from our care, as we clearly were not being helpful.

About a year later, she re-appeared on my schedule. I have to confess – I was dreading walking into the room, since I had already given her so many admonitions to engage. I opened the door and she was standing there without any support, was off all of her narcotics, and did not have any pain. She was working out in the gym and getting back to re-engaging with her friends. I was stunned.

Of course, I was more than a little curious about what had happened. She admitted that she had been sitting in her house for years,  obsessing about everything that had gone wrong in her life. Essentially, all of her conversations were focused on her problems that were created by her pain. She had been in a couple of car accidents and had gone through a bitter divorce. She resonated with the forgiveness section of the DOC project, and quit talking about her miseries. She decided to let go and move on. Within six weeks the pain began to abate, and by four months it was gone. And even though I saw her at a later date in the hospital (she had a fall), Georgia was still living the life she had always wanted to live and radiated energy and joy.

Recap – Stop it

Stop discussing your pain, medical care, or even any of your troubles with the world – NOW. There are no shortcuts. You are not going to move forward while hanging on to your grievances. Every day is an opportunity to begin anew. Behavioral patterns are so deep that changing your conversation to enjoyable topics may be difficult. It will initially be challenging, but you will be surprised at the effectiveness of this simple strategy. Can’t do it? Really? It’s time to ask yourself – how badly do you want to heal? It is surprising at the number of people who unconsciously hold onto the power of their suffering.

Questions and considerations

1. Make a list of stories of woe that you often share with others and then focus on three that seem the most important. Then just stop talking about them. Eventually you’ll be less inclined to discuss them.
2. A major aspect of healing is nurturing joy. Consider how often you are doing this compared to the amount of time spent complaining.
3. Ask people who are close to you about how much time you spend sharing your problems and how they feel about it. What are some of the themes? You may not like the answers, but you’ll understand the importance of changing your patterns.
4. Consider how you feel when one of your close friends or family is constantly complaining? How do you think you appear to others when you are in this mode.
5. Are you being the person you would like to hang out with?

References

1. Luskin, Fred. Forgive for Good. Harper Collins, New York, NY, 2002.

The post Grievance Stories first appeared on Back in Control.

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10 years in a wheelchair

Jane, a woman in her early 60s, was exactly such a patient. She’d lived with severe scoliosis all her life. Then, in 2001, she was rear-ended while driving, and the following year, she had a bad fall while grocery shopping. By the time she came to see me, she had severe pain everywhere. She’d been using an electric wheelchair for nearly a decade. She was taking over 200 mg of morphine per day and high doses of anti-anxiety drugs.

When I examined her, she was tilted forward and to the left, barely able to stand. Her spinal curve was severe enough that I recommended surgery but I warned her that the treatment had a high rate of complication.  Because of this, it was unsafe to do the operation until her medications were stabilized, her pain significantly diminished, and she was more mobile. The term we use is “prehab” or rehabilitation before surgery to optimize the outcome.

I gave her my book, Back in Control and referred her to a colleague to coordinate her care. She was not that interested and they mutually agreed to not continue care. Eight months passed and I saw her on my schedule. I was curious because I knew the size of her curve and the severity of her pain. High-dose narcotics makes it all the more difficult because they sensitize the nervous system. I did not have high expectations…

Out of the wheelchair

I was shocked when I walked into the room and there was no wheelchair, walker, or cane. She was standing up to greet me. She was off all of her medications, had no pain, and was working out in the gym three times per week. She was animated, smiling, and engaging. I ended up an hour behind in schedule, as I wanted to find out what had turned her life around.

Jane admitted that she had spent the last 10 years sitting alone in her house stewing over all the wrongs that had been done to her. She only went out when necessary. After understanding the linkage between anger and the pain pathways, she decided to forgive. She forgave her ex-husband, the person driving the car that had hit her, the people involved in her legal battle, and the medical system that had not helped her. This process took several months to work through – but within weeks of doing so, her pain began to abate.  She still had scoliosis but as her pain diminished, she stopped stooping over protectively to guard her back. She now could stand up straight and tall.

Reconnecting through forgiveness

Forgiveness researchers, such as Dr. Fred Luskin, have shown how rumination and anger influence central and autonomic nervous system function and impair functioning of the hypothalamic-pituitary adrenal cortical axis (stress system). While forgiveness is seen as a coping mechanism that helps to relieve the stress of anger, it also has direct and indirect effects on health and nervous and endocrine function.

It has been my position that anxiety-induced anger is the driver of chronic pain. The manifestations of unrelenting anger are profound and one of them is becoming socially isolated. Now you have all the time in the world to think about your pain and all the ways you have been treated badly. You body is full of adrenaline, which decreases the blood supply to the frontal lobe (thinking area) of your brain. Indeed, it is well-documented that patients’ brains shrink in the presence of chronic pain. Between the adrenaline and not using the creative part of your brain, that would make sense. Fortunately, your brain will re-expand with resolution of the pain. (2) Anxiety, anger and adrenaline

Social isolation

Besides moving too fast, our modern societal structure does not encourage us to interact with each other in a meaningful way. I read a US News & World Report article several years ago, which reported that the average number of close friends that person in the US had was 2.2. That means that many people have essentially no close friends.

I am a pretty social person but when I was in the midst of my own burnout I became isolated. It wasn’t that there weren’t people around. I had so many intensely negative thoughts about myself whirling around in my head that I couldn’t believe that anyone would want to hang out with me. The loneliness was crushing. When I arrived back in Seattle in 2003, a close friend invited me over for a barbeque and I was shocked. I have not forgotten that day and it was the beginning of my re-entering life.

People being with people

We have held three five-day Omega workshops and this year we will be putting on a weekend seminar with Dr. Bernie Siegel, author of Love, Medicine, and Miracles. My priority was to create a safe environment where people could be with other people and share experiences. One of the most effective ways to re-connect is play and as people began to relax and laugh their pain would disappear. Of course it, returned when they returned to the real world and their triggers. But most of the participants learned the skills to consistently remain out of pain. The more satisfying aspect of the process though was that as the pain abated many re-engaged with their lives in a much more powerful way. Play

As we presented our material throughout the week, I realized that we did not have to do much. It was the participants being with other people that created healing. It was remarkable. Dr. Louis Cozolino wrote an exhaustive review in his book, The Neuroscience of Human Relationships. (3) He points out that humans evolved by interacting with other humans. Therefore, the consequences of becoming isolated are consistent and often severe. Studies out of Australia have shown that there are damaging mental health effects when workers become disabled and out of the workflow of the day. Sitting around the house without a sense of purpose is not a great way to thrive. (4)

One of the first Omega participants sent me this video link. She experienced profound healing after being in pain for over 35 years and has been a true inspiration. TED talk: Our lonely society makes it hard to come home from war

This Fox segment was filmed with another one of our Omega participants. She has a great story amongst many others. We never anticipated the power of people healing people.  Video: Write your way out of pain

Jane was in a wheelchair for over 10 years and on high dose narcotics with a severe spinal deformity. It was by her working past her anger, getting out of the house and re-connecting with her friends did she heal. No medical treatment can replicate the power of the body to heal itself. Anger disconnects – play connects.

1. Eisenberger N. “The neural bases of social pain: Evidence for shared representations with physical pain.” Psychosom Med (2012); 74: 126-135.
2. Seminowicz DA, et al. “Effective treatment of chronic low back pain in humans reverses abnormal brain anatomy and function.” The Journal of Neurosci­ence (2011); 31: 7540-7550.
3. Cozolino, Louis. The Neuroscience of Human Relationships. Norton and Co. New York, NY, 2014.
4. Waddell, G and Kim Burton. Is Work Good for Your Health and Well-Being? TSO. London, England, 2006.

Listen to the Back in Control Radio podcast Social Isolation and Chronic Pain

The taste of freedom – Omega 2017

Social Isolation and Chronic Pain

The post The Pain of Social Isolation first appeared on Back in Control.

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• Forgiveness does not have to be that difficult. You are simply making a choice of not letting a situation or someone you dislike ruin your day.
• It specifically is part of the “input” aspect of dealing with anger.
• Anger is present in everyone’s life every day.
• There are different ways of accessing forgiveness. It doesn’t have to be an insurmountable obstacle. “Flipping the switch” is an abbreviated version of it.
• Don’t let anger run you.

Forgiveness is a big word and a loaded one for most of us. There are many situations that seem (or are) unforgiveable. But ongoing anger, which reflects a hyper-activated threat response, is deadly when it is sustained. The essence of the reaction is feeling trapped – by anything, including pain. The depth of your frustration is indescribable and is the driving force keeping you in The Abyss.

It is more useful to reframe forgiveness as just one aspect of “anger processing,” which is a multi-pronged approach to lower your stress chemistry. Forgiveness specifically addresses input into your nervous system that sends out messages of danger creates a heightened state of alert. Holding onto the past is a major reason your body will remain in this state, and eventually it breaks down. The focus of processing anger is bringing your body’s physiology back into a state of feeling safe.

Genealogy of anger

The sequence of becoming angry is:

• Circumstance or person who has wronged you (real or perceived)
• Blame
• Victim
• Anger

Anger is so powerful that no one ever wants to let it go. Becoming aware of this universal unwillingness to move on is a critical first step. Being a victim is a strong role, and it helps you feel safe, whether you are or not. You are never going to wake up one day and feel that you want to give it up. You must keep making ongoing choices to “let go.”

Then the next step is being aware when you are in a victim role. There are many disguises. Unfortunately, this hyper-vigilant neurochemical state (anger) shuts down the rational frontal cortex of your brain, and your glial cells (support system for neurons) throw off inflammatory markers, which sensitize your nervous system. This cascade of events blocks access to being open, having insight, treatment, and healing.

You simply have to decide whether you want to remain in this role or move on. There is no magic or shortcuts. It is an ongoing intellectual choice of, “I don’t want to continue being a victim.” One term for this decision is, “flipping the switch.” It might be considered an abbreviated version of forgiveness and is accessible quickly.

Levels of forgiveness

At its most basic level forgiveness is simply “cutting the cord” and “letting go.” This is different than “acceptance” and “suppressing.” It is an intellectual decision you make every time your attention lands on an upsetting spot. That is it and all that is necessary to free yourself from the past. You have definitively altered the input.

A deeper level of forgiveness would be seeing the situation through the other party’s eyes and have some understanding of where he or she is coming from. This allows you “let go” a little more deeply.

Developing compassion for the other person is what a lot of people consider forgiveness. You realize that there is a high chance that they are suffering and the reason they acted badly. But it may be essentially impossible to achieve, especially if there is ongoing abuse. It is not necessary to reach this level to effectively process anger.

Processing anger is a skill you’ll use daily. It is a powerful statement to you and the world that you are going to live your life on your terms, and no one person or situation is going to take that away from you. It is the tipping point of healing in that you cannot create the necessary shift in your brain to move on without letting go of the past.

Methods of changing the input

There are various ways of accessing forgiveness and not letting the past interfere with your day. I learned many of these following concepts from Dr. Fred Luskin, who is a friend of mine and author of Forgive for Good¹. Some suggestions include:

• Understand how detrimental it is to hold on to the past and not live in the present. Dr. Luskin calls this scenario “renting too much space in your mind.”
• Just “let go.” Is this person or situation worth disrupting your day and peace of mind? Use the “5 – 3 – 2” strategy to minimize any damage caused by anger and maximize your capacity to enjoy your life.
• Reframe the situation. Make a choice not to view yourself as a victim and look at challenges as opportunities. “Never waste a crisis.”
• Cultivate awareness—just being aware of your anger can dissolve it. Especially when you realize that it exists only within you.
• Identify your grievance stories—Dr. Luskin also makes the observation that if you tell the same story more than three times where you are the victim, you have a “grievance story.”
  • This is particularly relevant when suffering from chroni pain when it really was someone else’s fault. How long do you want that person or employer to run your life? They are not worth your time.
• “The unenforceable rules”—There are many situations and people in life that you wish would be different, but you have no control or say. It is fine to want a better scenario, but when that wish turns into a mental demand, it is problematic. Spending time being upset about things you have no control over is a complete waste of time.
• Have compassion—I mention this gingerly because this step is difficult and not mandatory to move on. Most people, including me, can’t achieve this without professional help.
• Please just don’t read this list. Processing anger requires daily practice and many approaches. Forgiveness is an important aspect of it.

Essentially every person I have seen truly heal has learned to recognize and process his or her anger. Although you can somewhat improve without dealing with it, the real breakthroughs won’t happen without letting go. Each person will learn these skills at their own pace. It is powerful and we have observed that letting go of anger is the “shortcut to healing.”

Recap

Anger is so powerful and necessary that you will never want to give it up. Besides, you can’t control it. Life keeps coming at us and you’ll have the opportunity to practice dealing with it daily.

You can choose what you want to input into your nervous system, and you can also what you want to hang onto. Forgiveness is one of the tools that allows you to “let go” and move on. But every time you think about the situation or person who wronged you, your nervous system will fire up.

Realize that forgiveness is just one of the tools of anger processing that may not be relevant to a given situation or you can’t access it. Putting it into context of being only one of the approaches helps you to use it quickly and efficiently. Maybe it lasts for only a few minutes. That’s fine. You can do it again, and again, and again.

Questions and considerations

1. If you are this far into the course, you have realized that you are angry. Everyone is and it is particularly intense when trapped by your thoughts and/or physical pain. However, some people still are not connected to it or are not aware of the magnitude of its impact. Consider how connected or not you are to your anger.
2. Review the disguises of anger. We may not want to present an angry front to others or ourselves. We are incredibly skilled at disguising it. What might be your set of disguises?
3. Many people have a long history with the word, “forgiveness.” You might feel badly because you can’t or won’t let of anger. No one really can. This is a massive end-of-the-line survival reaction that you have no control over. Understand, your way of “letting go” may be completely different than your concept of forgiveness.
4. The strategies mentioned above are methods to forgive. As you can see, there are many variations. This word is not as concrete as you might think. Find out what works best for you.

References

1. Luskin, Dr. Fred. Forgive for Good. Harper One, New York, 2003.

The post Forgiveness is Not What You Think – Learn It first appeared on Back in Control.

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However, you cannot go from pain to play without tools and strategies. It is too big of a leap. The impact of chronic pain on your quality of life has been documented to be equivalent to suffering from terminal cancer – except that it is even worse.¹ We acknowledge the severity of your suffering, and it is why I use the term, “The Abyss” to describe how dark this place is.

Two aspects of healing

The DOC Journey app considers the healing process in two ways that are interconnected.

• Efficiently processing stress – the protective reactions of anxiety and anger. They are gifts that allowed us to evolve and how we survive. You must develop a “working relationship” with them. They are what you inherently possess, but not who you are. This is a necessary skill set in that you can’t move forward without letting go.
• Moving into your life’s vision of what you desire. This is where the deep healing occurs. The strategies you’ll learn will stimulate your brain to physically change (neuroplasticity). As you move away from the pain circuits and more pleasurable ones are nurtured, you will thrive.

Play for the sake of play

You cannot use play and pleasure to distract yourself from being in pain. Anxiety, anger, and pain are too powerful. It is why the healing journey consists of separate facets –  neutralizing the survival circuits and moving into safety. It is a dynamic process with no beginning or end. It’s life.

Visualize your life as a bathtub. The water flowing in through the faucet represents the enjoyable, rejuvenating parts of life. Then picture an unusually large drain that represents anxiety and anger. When you’re agitated and anxious, the drain is wide open, and it won’t matter how much water you run into the tub, it will never fill up. It’s impossible to build up your energy reserves enough to heal.

The DOC Journey app will teach you ways to dynamically plug the drain. You will use them multiple times a day indefinitely, and they quickly become automatic. However, this step alone doesn’t create healing or give you a good life.

To have an enjoyable life, you must live an enjoyable life.

Now imagine running the bath water with the drain closed. You’ve learned how to effectively process your stresses, so you can relax in the tub and enjoy yourself. You can create whatever life you desire. These learned skills are a bit challenging when you are used to spending so much of your life’s energy escaping from pain.

Similar to learning a new language, your brain will develop in whatever direction you place your attention (neuroplasticity). You cannot learn French by fixing your English. The default language for humans is survival and pain. Trying to fix yourself focuses your attention on the problem and reinforces these pain circuits. Learning French requires repetition and practice. In order to experience and enjoyable life, you must live and nurture it. This is where deep healing occurs.

The physiology of threat and safety

Physiology is the term used to describe the operations of your body. It is largely unconscious, automatic, incredibly complex, and powerful.

ANXIETY/ PAIN

Anxiety is a physiological state. It is the sensation you experience when you sense real or perceived danger. Your body is being directed to mobilize resources to enhance your chances of survival. It is intended to be deeply unpleasant so as to mobilize you to take action to optimize your actions and function (physiology) to live another day.

It is well documented in the medical literature that chronic stress kills. Why? It is because when you are exposed to threats in any form, your body goes into a defensive survival state of “flight or fight” where you are consuming energy. When this is sustained, your body utilizes energy from your own tissues, including tendons, ligaments, fat cells, internal organs, brain cells by breaking them down. This response also includes the powerful immune system, which is intended to ward off cancer cells, viruses, bacteria, and any foreign invaders. However, when it remains fired up, your inflammatory cells will also attack and destroy your own tissues. The end results are mental and physical symptoms, illnesses, and diseases.

Humans have and additional trait in that we possess language and consciousness. Although there are many benefits, there is a severe downside that I call, “The Curse of Consciousness.” Thoughts are sensory input that also create this threat physiological state. Since we cannot escape them, every person is subjected to some level of ongoing stress physiology.

SAFETY/ PLAY

Play is also a physiological state and the home run for healing. It is necessary for your body to be in a safe state in order to rest and regenerate to build up your reserves for inevitable daily threats. When you are in a “rest and digest” state, you are repairing tissues and storing fuel.

The essence of chronic mental and physical disease is sustained exposure to threats. The foundation of sustaining life is minimizing your exposure to fight or flight chemistry and maximizing your time in safety.

The DOC Journey app

The DOC Journey app will help you create experiences to relax and relearn to play. The optimum chemical composition for your health is when you are laughing and connected to the present moment. The sequence of the app is based on the following:

• Awareness – necessary for solving any challenge
• Hope – an anti-inflammatory powerful healing force
• Letting go/ processing anger – you can’t move forward while holding onto the past.
• Moving forward/ Play – a profound shift in your body’s chemistry

The app is educational and also has a toolbox you can easily access anytime. The best part of this journey though, is that you’ll learn to “Wake the fun up” – and thrive.

Recap

Visualize trying to cross a large scenic mountain lake while rowing a boat with a big hole in the bottom of it. The boat is slowly sinking, and you can’t easily both bail and navigate. Most of your efforts are focused on trying to stay afloat, and you don’t much energy left to take in the beautiful view and experience peace.

The hole again represents the drain created by ongoing anxiety and frustration. Trying to outrun your automatic survival reactions can’t and doesn’t work. Processing stress and creating your vision are two separate but intertwined aspects of healing. Once you can efficiently plug the hole, you’ll have the energy to live and enjoy your life journey.

Prepare yourself to navigate your life. Do it now because it won’t just happen. You have only one shot at this human experience.

References

1. Fredheim OM, Kaasa S, Fayers P, Saltnes T, Jordhøy M, Bortchgrevink PC. Chronic non-malignant pain patients report as poor health-related quality of life as palliative cancer patients. Acta Anaesthesiol Scand )2008); 52:143-148.

The post “Wake the Fun Up” – The DOC Journey App first appeared on Back in Control.

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• Anger is a hard wired automatic survival reaction, and it is impossible to get rid of, conquer, or transform it into a more constructive experience.
• We are not programmed to be vulnerable, so we don’t have a good reason to give up anger, nor will we ever want to. Anger is protective but also damages human relationships.
• Understanding the various obstacles to dealing with anger effectively is an important step in learning how to process it.
• Many, if not most people, do not want to give up their anger (pain). There are reasons why.

The unwillingness to process anger, let go, and move on is the greatest obstacle to healing. And without learning to let go and move on towards what you want, it is impossible to heal from mental or physical pain. Nonetheless, even hearing compelling stories of healing, a high percent of people simply had no interest in pursuing a healing process. The excuses were endless, but it boiled down to not being able to let go.

I spent at least five years trying to convince people to pursue these concepts, and the harder I tried, the more resistance I ran into. To be clear, I never found a way to engage them, and I finally realized that it was important for me to conserve my energy for those who were open to learning and change. So, the first point I want to make is that I am wide open to suggestions regarding ways of presenting these ideas in a manner that reaches more people. I am a bit discouraged, but not giving up.

That being said, I have learned a lot about the reasons why people won’t give up their anger, and they are definitely unique to a given person.

Obstacles to addressing anger

The main reason preventing people from letting go, is that anxiety and anger are hard wired into our brains. They are both words that describe your sensations generated being in flight (anxiety), or fight (anger). Under any perception of real or imagined threat, there is an instant reaction that compels you to take action to ensure survival. You cannot reason with or do battle with these circuits. As my friend, Dr. Bruce Lipton, points out, “There is nobody home.” You might as well lift up the hood to your car and talk to the engine. They are necessary for survival and are necessary gifts.

Second, when you are anxious and especially upset, your body is full of inflammatory proteins call cytokines. These small proteins are the ways that cells locally communicate with each other. At a certain threat threshold, they signal anger (fight or flight) and cause the blood supply to shift from the thinking centers of the brain (neocortex) to the lower survival regions of the brain. You physically can’t think straight. So, a significant aspect of chronic disease is that the inflammatory nature of it blocks the ability to treat it. Some patients report a sense of “brain fog.” It is not a psychological term. It is your brain “on fire.”

Then if your anger/ anxiety is sustained, the inflammation and elevated metabolism (rate of fuel burn) physically robs your brain of fuel and destroys neurons. You have heard me mention multiple times, that chronic pain causes physical shrinkage of your brain. Fortunately, it will regenerate through the healing process.¹ How can you learn how to understand a new treatment approach if you can’t think clearly?

Fourth, racing thoughts become permanently etched into your brain and become obsessive though patterns. They realty are not responsive to rational interventions. One metaphor is that of dust devils that are small mini-tornados that are common in the open prairie. Your brain has trillions of them, so even if the smallest percent become powerful, that is a problem. It also universal and a trait of possessing consciousness and language. My term for it is “phantom brain pain” because it is a similar process as phantom limb pain. It can occur in any part of the body, including your mind.

But a major issue with letting go of anger is that it protects you from being or feeling vulnerable. There is no reward in nature with any species, including humans, for being vulnerable. You are dead. Remember, the main responsibility of your hard wired unconscious brain is to keep you alive, not to provide you a good time. The problem for humans is that being vulnerable is at the core of successful relationships.² It is a huge dilemma.

Finally, anger is addicting. Why would we not want to hold onto it? It is powerful or at least feels powerful. A basic human drive is to feel safe. Anger does give you more power and control, and you feel safer (even though it may not be true).

The rewards of anger – and winning

There is even a physiological reward for power. It has been shown that people who are bullied have higher inflammatory markers than students who were not harassed.³ What is more disturbing is that the bullies have lower levels of inflammation. A 50-year study in Britain showed that about 40% of adults were bullied while in middle school and high school. The long-term consequences were brutal.⁴

What we are calling, “socialization” is really a huge power struggle. You would think we would behave better as adults, but the behaviors frequently carry over. For example, there is a phenomenon called “mobbing” where co-workers will gang up on a given worker.

You may not want to hear this, but people in pain are often “bullies.” They can make endless demands on the family and caregivers. They may not be that nice about it. Instead of being sources of peace and love, they are emanating a negative energy that creates chaos. They may not be enjoying it but also don’t know how to give it up. It is a vicious cycle.

Additional barriers

Other obstacles to letting go include:

• You may not recognize that you are angry. It is your baseline state.
• The more legitimate your anger, the harder it is to let it go.
• If you are socially isolated, it is challenging to keep up and hone your interpersonal skills, especially when you are in pain.
• Not understanding the nature of letting go. It is a powerful move of taking your life back, not one of weakness.

 Recap

The one factor that predicts healing is willingness to learn the tools to calm and reroute your nervous system. Why would not everyone want to do this? A high percent of people have no interest even in spite of ongoing misery and endlessly seeking medical care.

This lesson presents some of the reasons why this is such a problem, but the essence of it is that the disease itself is what blocks treatment. Anger is the sensation created by a fired up nervous system, increased rate of fuel consumption, and inflammation. The inflammatory markers (cytokines) create a shift in the blood supply from the neocortex of brain (thinking centers) to the lower parts of the brain (survival regions). So, we can’t think clearly enough even to begin to engage. Chronic pain is especially problematic, in that the amount of anger generated by being trapped in pain is unspeakable. That is why a famous rehab physician, Dr. John Sarno, called it “rage.”⁵ My term is being in “The Abyss.” It is a very dark spot and sometimes it is so hard to see any light that nothing happens.

Questions and considerations

1. Several or none of these barriers to letting go of your anger may be relevant to your situation. If they do not and you are not willing to learn ways to let go and heal, then what are your own obstacles.
2. If you have come this far in the course, that is a huge accomplishment. If these ideas did apply to you, you have surmounted them enough to engage.
3. For some people, positive changes can occur quickly, and they are not prepared to deal with the speed of change. Generally, they will pull back but eventually re-engage. Pulling back happens for the same reasons that originally blocked learning. Understanding your personal blocks allows you to work back around them quickly.
4. Do you really want to let go of your anger? The answer is, “no” for all of us. But you may want to have a better life.

References

1. Seminowicz DA, et al. Effective Treatment of Chronic Low Back Pain in Humans Reverses Abnormal Brain Anatomy and Function. The Journal of Neurosci­ence (2011); 31: 7540-7550.
2. De Mello, Anthony. The Way to Love: The Last Meditations of Anthony De Mello. Doubleday, New York, 1992.
3. Copeland W, et al. Childhood bullying involvement predicts low-grade systemic inflammation into adulthood. PNAS (2014); 111: 7570-7575.
4. Takizawa R, et al. Adult health outcomes of childhood bullying victimization: Evidence from a five-decade longitudinal British birth cohort. Am J Psychiatry (2014); 171:777-784.
5. Sarno, John. Mind Over Back Pain. Berkeley, New York, 1999.

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One is that going back into The Abyss is inevitable and part of life. The key is to learn to use the tools more skillfully to come back out of it. The second point is that none of us really have the luxury of remaining angry without significant mental or physical consequences. Your body’s physiology is on overdrive and people get sick.

I was aware of this possibility when he first began to deal with the situation with his neighbor. I even warned him about it. Even though he intellectually knew anger was a problem, it is a powerful force that pulled him in. He not only became ill, but seriously so. None of us have the luxury of remaining angry without paying a price. Interestingly, effectively processing anger ALWAYS is the gateway to true healing and that is also part of this story.

Tom’s latest encounter with anger

I lived more than 22 years in debilitating chronic pain. I lost my business and seriously damaged many relationships. Having had 28 surgeries including 7 spinal operations, my medical history includes 3 heart attacks, opioid addiction, and a suicide attempt. I was trapped in the hell of the abyss for a third of my life. Since discovering Dr. Hanscom’s book “Back in Control” several years ago I have been free from chronic pain. Now at age 67, I have survived and am thriving.

This past winter I became very stressed and angry at my neighbor lasting a few months. He notified me  that he planned to cut down the cedar trees surrounding my front yard sanctuary, I was furious. My cobblestone courtyard, complete with a triple waterfall was ringed by towering evergreen cedars and my covered front porch. It was green, quiet, and very private. I loved it as my place for meditation and relaxation. My rocking chair was my perch as I watched the hummingbirds zip around my hanging baskets and frolic in my fountain. The sound of the waterfalls is music to my ears. My neighbor made me so upset for what he’d done to me, as I became a victim! I went indoors to the basement and literally screamed. I allowed myself to remain angry; incensed, for 3 months. It made me sick.

The symptoms begin

Soon after finding out that the demise of my sanctuary was imminent, my right eye started to constantly tear up resulting in tears streaming down my face. Being very upset, I’m sure my emotional state caused the tears to stream.  The tear duct clogged up which resulted in me needing surgery, which included the surgeon accidently burning the inside of my nose due to a surgical error. After the first surgery they “…went back in there…” a second time. The pain was indescribable, some of the worst I’ve ever experienced. I HATE the term “going back in there”. Twenty years ago, my neurosurgeon went “back in there” 3 times. It didn’t help.

The demolition date for the trees was set, and my sanctuary was decimated on the morning of my 67^th birthday. My green amphitheater was gone in a matter of hours along with my sanctuary and privacy. The neighbor’s house  towered over my courtyard with an unimpeded view of my yard and porch. I implored him to buy tall replacement plants to restore some of my privacy, but he said, “I don’t care…that’s your problem”. I talked him into allowing me to buy  the replacements. He chipped in all of $200 towards my $2,500 cost to plant his plants in his yard. My anger escalated. The sanctuary should by restored in about 10 years. Meanwhile I’m building a replacement sanctuary in the backyard.

More problems

Just as I was healing from the complications of my eye surgery, I woke one night in a lot of pain. As I sat up, I was overcome with pain in my right flank. I laid back down desperately trying to determine what was happening. I writhed in pain the rest of the night refusing to admit I was in trouble and telling my wife I was hurting. By the time I decided I needed to get to the hospital I could no longer sit up as the pain was too intense. My wife called 911.

My anxiety level skyrocketed. I was frightened by the duration and intensity of the pain.  A CT scan revealed a blockage in my right renal artery. The doctor said it was like the kidney had a heart attack (infarction). My right kidney was damaged, and its function was reduced by about 50%. They medicated and admitted me to the hospital.

Now COVID–and The Abyss

The nurse woke me at 2:30AM and said, “Sir, please wake up, you aren’t going to like what I have to tell you.” She was right, I didn’t like it when she told me my hospital roommate had Covid-19. He was an elderly man with serious respiratory distress. He had been coughing and hacking for the past 2 hours with no mask and the door closed. I bolted from the room and was quarantined for the remainder of my four-day hospital stay. No visitors allowed.

I was already on edge worried about producing another clot and having another stroke before the Covid-19 exposure. With the news that I’d been exposed, I went over the edge and quickly descended to the bottom of the abyss. I couldn’t talk or think straight. Everything around me went dark as I was in dire pain both emotionally and physically. With my comorbidities including COPD, congestive heart failure, and a prior stroke I was at high risk for succumbing to the virus. I thought I may die from the kidney blood clot and/or the virus exposure. My anxiety level was off the charts.

There was no social interaction for the next 4 days. Staff came in daily in “moon suits”. I couldn’t see anyone I knew during my 4 day stay. When discharged, I was quarantined at home until I tested negative; 10 long days after my exposure.

Clenched teeth–the descent continues

The day I was admitted to the hospital was the same day that I was set to have oral surgery. A week before the kidney problem appeared, I had broken and/or damaged my lower 4 lower front teeth. While chewing, I clamped down too hard and the front teeth landed behind the lower teeth breaking  them. I was crushing my food as my jaw was set and tense still manifesting the anger since I was not ready to let it go. It cost $10,000 for dental repairs because I was stubbornly holding onto my anger rather than processing it and letting it go. 

 It became  obvious to me that I was triggered by the neighbor and was profoundly angry and resentful of what he had done to ME (the victim). Whenever I thought about or saw my neighbor, I’d have a real bad reaction.

There were 3 major health events within 100 days of my neighbor announcing that he was going to remove the trees that guarded my sanctuary. #1) required one surgery and two intensely painful “procedures”. #2) I broke my teeth by biting down too hard. #3) I had the renal artery infarction of the right kidney.

Moving on

How did I go from lounging in the green circle in my sanctuary to being in the red circle back in the pit of darkness and despair? By failing to address and process my anger I caused myself  to be sick. I knew how to calm myself through meditation, processing anger and climb out of the pit. Finally, I flipped the switch on my anger toward the neighbor and subsequently let the whole problem go. I’m building a new refuge and I’m back to greeting my neighbor. The eye healed completely, the teeth were replaced, and the kidney suffered some damage but is now stable. The most important consequence from this incident was me having to consciously decide that I was not going to be the victim and that I need to maintain my “practice” of the DOC Journey’s main tenets. Meditate and relax your nervous system. Refuse to discuss your pain problem with others, and always process your anger expeditiously.

My new life

Having been on The DOC Journey for 7 years, I’ve NEVER felt better in my life. My chronic pain is gone; my anxiety is under control. Over the 20+ years while in the abyss my anxiety was so high the future terrified me.  The pain haunted and tormented me. Now I eagerly look forward to today with, awareness, renewed energy, and a pain free existence. My reaction to what was previously unending pain was living an angry, sedentary, reclusive, and psychologically paralyzed life. I’m now very active walking, swimming, and practicing yoga daily. I no longer perseverate about problems and issues over which I have no control. The physical activity promotes awareness, positive thoughts and the never ending “chatter” in our minds. I’m happier now than I’ve ever been in my lifetime. I’ve learned when and how to “flip the switch”.

The consequences of anger

I have learned a lot about anger from observing hundreds of patients navigate it or not and from my own journey out of chronic pain. There are no shortcuts. If you decide to remain angry, you are choosing to hold onto your pain. What makes this challenging is that anger is powerful, it protects you from feeling vulnerable. Additionally, the more legitimate your anger, the harder it is to let go. Tom certainly had a lot of legitimate reasons to remain angry.

Anger is so powerful, no one ever wants to really give it up. I have used a term, “flip the switch.” You just have to decide to move on. Life is never fair and other wrongs will continue to be done to you. If you continue to hold onto them, it becomes a heavy load. It also compromises your immune system and you’ll have a significant chance of becoming ill. Tom’s story is a classic example.

Processing anger is a learned skill set that will allow you to live the life you choose on your own terms. Tom continues to be a major inspiration for me.

Addendum

I’m trying to adjust to this feeling of well-being. I’m so relieved to not be in pain anymore that I could shout it from the rooftop. One thing we need to pay attention to is the “why”. Why me and not so many others?  But also, what traits, characteristics or beliefs do I and others share that have successfully made the transition from chronic pain to a pain free existence? That question hangs in my head daily.

Best. Tom

The post Anger and Illness–Cause and Effect first appeared on Back in Control.

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• They are, first of all, the same entity. Anxiety is the sensation generated by your autonomic nervous system’s response to a threat. Stress hormones and inflammatory proteins are elevated and when a given situation doesn’t resolve (chronic pain), more of these molecules are secreted in an effort to regain control. The result is anger, which is anxiety with a neurochemical chemical kick. It is a response to the environment and not primarily a psychological issue.
• Anxiety and Anger are universal, powerful and necessary for life. You are not going to get rid of them.
• Anxiety represents a feeling of vulnerability and helplessness. The intention is to be so unpleasant that it compels us to take action to decrease it. So, we are hard-wired to avoid this emotion at all costs. In nature, there are significant penalties for being vulnerable.
• Anger feels powerful and is often effective in regaining control. It is a rapid response that solves or masks anxiety. It also gives you the extra boost to resolve a threat.
• But what happens to your thinking when you are angry? The blood flow to the frontal lobes of your brain is diminished, the inflammatory proteins in your brain sensitize you to sensory input, and much of your reaction emanates from the more primitive centers of your brain. You are flooded with a barrage of angry, intense, and irrational thoughts. It is temporary insanity.

• Anger both masks the feeling of anxiety and also turbocharges the system, which created it.

Reasons to forgive

There are numerous reasons to process and let go of your anger.

• The main one is that you simply cannot heal 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 you whole system is fired up and remains so, how can that happen? It can’t and won’t. You can improve somewhat without forgiveness, but the deep healing can’t occur until you can calm down and truly let go.
• Another core concept of solving pain is stimulating neuroplastic changes in your brain. You physically can cause your brain to change its structure based on where you place your attention (suppression doesn’t work). That means you have to move towards your vision of what you would like your life to be like instead of continually trying to fix your prior life. 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 onto the past make your life more enjoyable.
• Anger is destructive, as it is supposed to be. It your body’s last ditch effort to escape threat. It is destructive in every direction, including self-destructive. It is the reason why many people completely neglect every aspect of their health. It is tantamount to slow suicide.
• Anger is abusive. It also 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 at every level.
• Anger destroys families. We evolved language and the human consciousness through language and social interactions. It is ability to cooperate that took homo sapiens from the bottom to the top of the food chain. There is a deep need for human connection. Unfortunately, close family 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.

• When you are angry, you are in the fight mode of the survival response of fight, flight, freeze, or faint. Your body’s response is to mobilize every resource to survive. 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 seem like you are. That is why it is so critical to, “take no action in a reaction.”
• The problem is that this reaction that blocks awareness also blocks the creativity needed to constructively solve the problem. It really does represent temporary insanity.
• Forgiveness is the most powerful and definitive move that you can make to take charge of your life. It is actually a selfish and bold act. You are no longer allowing someone you dislike (despise) continue to be in your head and run your life. You don’t have to like this person–ever. You are just breaking the link between the past and present.
• I often asked my patients that what is your day like when you are angry? Forget about your pain. It isn’t a great day. So regardless whether you are in pain or not, anger will compromise your capacity to enjoy your day. You are in Hell and you may be so used to being there that you might not even know it. Take a deep breath and think about this scenario for a while………

Why hold onto anger?

It keeps you safe. It protects you from both emotional and physical pain. There are few, if any, rewards in nature for being vulnerable and humans are part of this reality. In essence, you are being asked to give up your anger so you can experience anxiety. Raw anxiety is an unpleasant feeling. It is this interaction that may be the root cause of why it is commonly thought that you cannot really be open for change until you “hit bottom.” In other words, the anxiety is so out of control that it can no longer be contained by either functional or dysfunctional means.

So, it is not an unwillingness to give up anger that is the problem. It is inability to feel and tolerate vulnerability. That is why a critical aspect of The DOC Journey is the sequencing that allows you to learn tools that allow you to feel safe. You will learn how to regulate your body’s neurochemical reaction to both internal and external threats. Each person is unique and has to engage with the process on his or her own terms.

One of the antidotes to anxiety/ anger is control. But another one is to give up the need for control. That is what the whole DOC Journey is about–awareness, calming down, stimulating neuroplasticity, letting go, moving towards a vision, and enjoying your life. You can’t fix chronic pain, but you can crowd it out of your brain and life.

What do you want? What do you really want? Don’t try. Do it!!

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The DOC Journey is a condensed set of core resources that reflects the experience of hundreds of patients suffering from chronic pain that have successfully taken their lives back. It reflects the evolution of our knowledge of about pain and how to more clearly present the problem, principles behind the solutions, and how to continue to thrive and move forward once you have broken free.

The guided course is one one of the resources that provides a guided pathway through the maze of choices offered to patients. It provides background information, tools, strategies and support that enables you to develop a game plan around your unique set of issues and circumstances. As it’s a largely self-directed process, you can then create partnerships with your medical and non-medical providers to solve your pain.

Back in Control: A Spine Surgeon’s Roadmap Out of Chronic Pain provides the framework for a deeper understanding the nature of chronic pain and breaks it down in its component parts. It is recommended that you use it as your reference book.

Overview of the guided course

This course is organized around principles we learned in our workshops. We witnessed profound shifts in pain and mood during the three or five-day events and we were consistently amazed by the magnitude of the changes. For those who continued to learn and practice the tools, the outcomes were sustained. Your brain can only rewire by consistent repetition. This is the sequence that emerged from our experience.

• Awareness – first step in solving anything
• Hope – has been shown to be a powerful healing force
• Forgiveness – you cannot move forward until you have let go.
• Play – is how we evolved and figured out human relationships. Re-connecting with this energy is precipitates rapid changes. It does take a series of steps to get there.

Why this sequence

This process is evolved from my own 15-year suffering from severe chronic pain. There was no reason it should have happened and I was extremely fortunate to break out of it. It all began with a panic attack in 1990 out of the blue. I was under a lot of stress but nothing more than I was used to. For 30 years I have been searching for the answer of how could my life been so dramatically and permanently altered in 10 minutes?

I broke free from the grip of pain in 2003, but I only knew that some writing exercises that I had inadvertently began to engage in seemed to be a significant factor. I still did not know why it happened and I certainly didn’t know anything about chronic pain. The neuroscience research since 2009 has clearly revealed the answers and the solutions.

I feel the reason that this journey has been so successful for well over 1500 patients is that I painfully traveled every millimeter of it and learned a process from mostly from what didn’t work. If some approach seemed to have promise, I pursued it personally and shared the ideas with my patients. It is still evolving and I am excited in that I am able to present it more clearly and my patients have been able to respond more quickly.

Awareness is the foundation of healing. You will develop an awareness of:

• The nature of chronic pain – as opposed to acute pain, there is nothing useful about being in ongoing pain. Mental pain is a bigger issue than physical pain.
• Your situation. What factors are relevant to your specific situation? What is your diagnosis? Has it been clearly explained to you?
• The principles behind solving chronic pain. Once you understand the problem and the nature of the solutions, you’ll be able to take charge of your own care.

Hope has been shown to exert a favorable effect on the inflammatory response and is a key factor in healing. (1) Loss of it is a common theme with almost every patient experiencing chronic pain. You are suffering miserably, no one can tell you what is wrong with you, you’ve been told that you just have to live with it and do the best you can, and no really believes how much pain you are in. Where is the endpoint? Not only do patients break loose from the grip of chronic pain, they often thrive at a level they never conceived possible. You will hear many of their stories.

Forgiveness is critical and is the dividing line between healing or remaining stuck. Your brain processes mental pain in the same way as a physical threat. Most people in pain hold onto the situation or person who wronged them. (2) It is understandable, but you cannot heal and move forward until you let go. Forgiveness is learned skill and a powerful statement that you are taking your life back!

Play is how mammals learn to socialize. Humans take it to a different level since we have language added to the mix. You learn safety vs. threat, body language, negotiation skills, effect of tone of voice, etc. When you are in a play mode your body’s chemistry is optimized and your sense of contentment and well-being is increased. This is not play intended just to distract you, but rather that in which you are fully engaged in something you love.

The goal

You will learn methods that will stimulate physical changes in brain (neuroplasticity) and can re-direct your nervous system to form more functional circuits. The outcome is to optimize your body’s reaction from one threat to safety. The final signal to your body’s cells is sent through cytokines. These are extremely small communication proteins. The defensive one are inflammatory (Pro-I) and the safety cytokines are anti-inflammatory (Anti-I). You will learn to regulate your body’s chemistry and inflammation to create a favorable healing environment. The effects are often profound with all parties excited and somewhat incredulous at the degree of healing.

Navigating the course

The core journey is arranged in sequence that begins at where you are at suffering from unrelenting pain and lays down a foundational set of concepts and tools in order to move forward. The intention is for you to move at your own pace, as the healing process is different for everyone. Some people experience rapid relief of pain within a few weeks. Most people experience significant shifts in pain and mood within 3-6 months. But never give up. I have had many patients email me years later that they had broken free from the bonds of pain.

Although there is often some improvement early in the Journey, the tipping point for deep healing always occurs around processing anger, which is inevitable when you are trapped in misery. Anger is protective and we are not programmed to be vulnerable. It threatens survival. That is why the DOC Journey is arranged in this order. You must first be ready to let go before you can accomplish it.

The guided course

There are seven legs to this guided journey with “rest stops” along the way. The reason for the stops is to embed and practice your tools. Calming your nervous system and optimizing your body’s chemistry is a learned skill set. Each person will find his or her own best set of methods.

Leg 1 – Preparing for your journey

Leg 2 – Starting your trip

Leg 3 – Anxiety is the Pain

Leg 4 – Awareness

Leg 5 – Anger processing – the Tipping Point

Leg 6 – Moving Towards Your Vision

Leg 7 – Expanding the Center of Your Circle of Life

The DOC Journey

Although this course is a core aspect of The DOC Journey, other resources are available that will provide additional support and depth of knowledge about how to proceed. The group coaching is especially helpful. Many of your questions will be also be answered with the video tutorials, which are connected to the appropriate lesson and also accessible in the Toolbox.

The best part of The DOC Journey is that the effects continue indefinitely. You have “changed your filter” and you’ll continue to process your environment with this new perspective. Since your brain keeps physically changing, it takes an active effort to turn back. Once you own your life, it is yours.

The post The Guided Course of “The DOC Journey” first appeared on Back in Control.

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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.