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.

The post Bullying is Good for Your Health first appeared on Back in Control.

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 This blog is written in conjunction with Dr. Les Aria, who is an experienced pain psychologist working in Northern California. He brings a wide range of approaches into successfully treating and solving chronic mental and physical pain.

Being triggered and stressed is so common during the holidays that it is somewhat normalized. Yet hope springs eternal and we keep gravitating back to the same historically chaotic situations. Why do some levels of crises keep happening at Holiday family gatherings? This article is written with all due respect to those of you who are socially isolated, which is devastating and magnified during the Holiday season.

There are many ways to enjoy your family and close friends during this time of year regardless of their behaviors and your stresses. It is supposed to be a season of peace and joy. Understanding the nature of the problem allows solutions.

We acknowledge the many additional stresses around the holidays that have been discussed in many venues and numerous excellent suggestions have been made. However, once you have navigated the obstacles to actually being with your friends or family, it would be reasonable to expect to relax and enjoy them.

Defining a trigger

The basic problem arises from people in close relationships triggering each other. What does being “triggered” mean? We survive by learning from prior experiences what is safe or threatening. This includes your emotional states and consciousness, which are processed in a similar manner as physical threats. Many, if not most, of these mental threats are perceived and are based on cognitive distortions. It is the reason many of us have a baseline state of being “fired up.”

So, anytime you feel anxious or angry, something in the present has been connected to a situation in the past that was perceived as threatening or was dangerous. Your adult brain will still process it in the same manner. You have been triggered. The problem arises from the fact that you are now in the past and not the present. You have lost awareness of the present moment, which is at the core of functional human relationships.

As your earliest and most powerful programming happens with your immediate family, they are the strongest and most consistent triggers. Close relationships are not far behind. The deeper problem is that when you are in this state of threat physiology, the activity of your brain shifts from the neocortex (thinking centers) of your brain to the lower regions (survival) of your brain and you cannot think clearly. It is not possible. So, then your behaviors or those of others may be less than ideal. What can you do? Here are some suggestions.

Dealing with triggers

The first and necessary step is to understand the problem and there are many resources that will help you understand the nature of chronic mental and physical pain. The essence of chronic disease is sustained exposure to your body’s threat chemistry or in other words, being constantly triggered. Here are a few practical suggestions.

Triggers are a whole-body response to a real or perceived threat. Here are 3 behavioral/ physical cues to help you identify that you are being triggered before becoming fully activated by past family triggers.

1. Mood Shifts: Notice when you experience a mood shift. Do not suppress those emotions. Burying emotions alive will lead you to step on them at some point during the holidays–KABOOM!
2. Tension Shifts: Notice when you experience sudden muscle tension in your body. Check your shoulders right now! Left = Anxiety and Right = Anger/suppression of emotions/complaining all day long!
3. Breath Shifts: Notice how often you hold your breath when around certain family members. You know who they are! Are you holding your breath? Are you breathing shallowly? Are you breathing rapidly?

What are the triggers when you are around your family?

1. Criticism is one of the most common triggers.
2. Financial worries from food to travel plans.
3. Feeling pressured to be happy or positive

These are just a few of many triggers–know yours.

*Note: Your physiological states determine your psychological states; vice-versa.

 If you are already feeling stressed or wired, be careful. Your nervous system is “trigger happy” and you’ll not only ruin your experience but create chaos for others.

Practical tips to process triggers

1. Manage expectations. Holidays have a way of making wanting to feel like what Hollywood puts out – this amazing, beautiful scene where we all get along. Not everyone experiences such stuff. Dashed hopes make things worse. Once you understand how to remain calm during any level of chaos, no one can take away your capacity to enjoy yourself.
2. Utilize your Mindbody practices. They are learned skills and include breathwork, meditation, exercising, expressive writing, restful sleep, humming, relaxing music, and mindfulness. Each person has their own set of tools that works best for them. If you haven’t learned to regulate your stress response, please make the effort to do so. They eventually become automatic with practice, and the Holidays are a great opportunity to practice.
3. Avoid all negative conversation–period. No complaining, gossiping, criticism, giving unasked for advice, or discussing your pain or medical care. This is something that is basic to healing and you’ll do the rest of your life. Consider how much time you are spending in this type of activity.
4. “5–3–2” is a strategy to create some “space” in your brain before you take any actions. The numbers represent the words describing each step.
   1. No action in a reaction
   2. Flip the switch
   3. Move on

The details are discussed in this article.

 5. Take time for yourself. This is something we practice and preach about. Set time aside from everyone. Go for a walk before the hoopla starts if you are staying over with your family. Break away from the family during the day or when you need some space to “come back online.”

Summary

Keep your perspective! Remember that you always have choices–once your brain is back “online.” Keep focused on who or what is important to you. How do you wish to show up for the holidays?  Practicing the skills we discussed, especially noticing when you are triggered and doing something about it will help you keep your love, peace, and joy during the holidays.

As always –be kind to yourself. Let the Holidays begin!

The post No One Can Take Away Your Holiday Joy – But You first appeared on Back in Control.

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Feeling safe

There are many benefits of feeling safe and secure, with the first one being your body’s chemical makeup consists of reward hormones and you feel great. The opposite occurs if you constantly feel on guard. It is in the first scenario that you feel free to create, explore, play and use your imagination. Your capacity to interact with the world in a meaningful and effective manner is increased.

When you are constantly on hyper-vigilant and trying to protect yourself from real or imagined threats, your short and long-term quality of life will be compromised. One of the effects is that more situations in the present will resemble what you learned was unsafe in your childhood. You will be over-reacting to scenarios that really aren’t dangerous, but your brain won’t know it. Your body will feel under threat and your chemical makeup will keep you on “high-alert”. It will be harder to relax and enjoy your life.

ACE score

This is documented by the ACE (adverse childhood experiences) study done in 1996. (1) A survey of challenging childhood circumstances was given to over 17,000 people and health surveys were administered. There were ten exposures.

Household dysfunction

• Substance Abuse
• Parental separation/ divorce
• Parent with mental illness
• Battered mother
• Criminal behavior

Abuse

• Physical
• Psychological
• Sexual

Neglect

• Emotional
• Physical

Only 30% of participants had a score of zero and 26% had a score of 3 or more. There were increased chances of severe health consequences with higher ACE scores.

• Depression/ anxiety
• Obesity/ eating Disorders
• Heart disease/ hypertension
• Suicide
• Teen high-risk behaviors/ pregnancy
• High risk of being a victim of domestic violence
• Substance abuse
• Smoking/ COPD
• Unstable home/ family life
• Poor workplace performance
• Early death

America, on the whole, is not doing a great job of parenting. We are modeling behaviors that we wouldn’t want to see in our children. My ACE score is five and I developed 17 of over 30 possible symptoms related to sustained exposure to high levels of stress hormones. My migraines began when I was five years-old. The list began to grow and reached 17 of them by the time I was 37. Yet no physician could provide an answer or a treatment approach. All of symptoms have resolved. But that is not the message of this article. It was your parent’s responsibility to both protect and nurture you. Mine did not. What about yours? What kind of home environment are you currently  creating for your family?

Oak tree vs army barrack

One of my favorite personal metaphors is that of a large Valley Oak tree, which were abundant in Napa Valley, CA before there were so many vineyards. I view the role of parents of being the trunk of the tree, providing stability. One responsibility is for each member to continue to evolve through awareness and self-exploration, which creates deeper roots and emotional support. The first responsibility of parents is to each other and continuing to create a lasting stable and loving relationship. The expansive branches are the opportunities for all the individuals in the family to be creative and also be protected from the elements.

The opposite scenario is that of a military barrack. There is rigid order and unwavering expectation that every command will be immediately responded to. Nothing you can or will do will be “good enough.” If you don’t comply as deemed adequate by one of your superiors, you will be disciplined and often harshly. You may be made into an example. You can never let your guard down, especially in the presence of your officers. The list of demands is endless with an equally long range of possible consequences. Does any of this feel familiar? I don’t what percent of families have this framework as the reference point, but based on the ACE data, I would daresay that it is high. Is it any wonder that so many of us have this voice in our heads of, “Not good enough.” It can be deeply embedded in your brain and you can’t outrun your mind.

There several factors that result in a home that more resembles an army barrack than a spreading oak tree.

• It was the way you were raised and the way parenting was modeled.
• Everyone has anxiety and it is intended create control behavior. The more control you exert, the less anxiety. Since your family is dependent on you, they cannot easily escape from your need for control.
• You have labeled yourself as the parent and somehow you have a responsibility to “raise your child” properly. I read a book, Parent Effectiveness Training when my son was young and thank goodness I read it so early. The book had a major impact on my life. One core principle is that the label of “child” disappears, and it becomes a human-to-human interaction. Prior to reading it, my obsession was discipline and control and I was highly critical of “permissive parents.”
• All of these family issues are dramatically magnified if one or both parents are suffering from chronic mental or physical pain. You are trapped, angry, and awareness of other’s needs is blocked. It is the essence of abuse.

Awareness

All of the healing process begins with awareness of what is happening in the current moment. What is your family environment like now? Each half of the couple needs to write it down and compare notes. If you can’t have a civil conversation, then you already have your answer. Anger that is often front and center will also block constructive dialogue.

Moving forward

What kind of family life would you like to create? What is your vision. This step should be done as a couple.

How do you want to accomplish it and what is the timeline? What doesn’t work is waiting your pain to first resolve. Every day your family is encompassed by anger, it is damaging them.

Any and every person has the capacity to thrive and move forward when starting from a strong foundation based on love, support, laughter, safety, and play. Eventual successes will be more sustained. One is also able to enjoy life.

It has been known for decades that employees thrive in this kind of work environment. Why not allow your family to thrive?

1. Anda RF, et al. The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience (2006); 256: 174–186.

The post Do You Feel Safe in Your Own Home? first appeared on Back in Control.

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Feeling safe

The DOC Journey is based on our three and five-day workshops that we have held since 2013. From the beginning we were amazed how many people would break free of their pain within time frame of the workshop. We always warned them that they would dive back into The Abyss when they returned home to their “triggers.” But somehow they had reconnected to the part of their nervous system that was safe and relaxed. Once they tasted that deep sense of peace and connection, they had a sense of what was possible. They would learn their own ways to return to that state. Many moved on to a life they had never before experienced.

I had not expected such a response and did not understand what had happened. But every workshop was a similar experience. I finally concluded that I wasn’t doing that much, but the shift was because people were learning and sharing enjoyable experiences in a structured and safe environment. Several participants described it as being in an adult summer camp.

Research shows us that loneliness causes many physical symptoms including chronic pain and, of course, being in pain is isolating. (1) Social connection is a deep basic human need and the foundation of how we developed language and human consciousness. It is tragic that over 50% of Americans are lonely and socially isolated. (2) Social isolation is crushing to your soul.

Characteristics of success

There is never an exact answer to a given person’s specific situation, since each one of us is so unique. However, there are some patterns that have emerged in patients who have done well.

• Back in Control: A Surgeon’s Roadmap Out of Chronic Pain provides a foundation and framework for moving forward.
• The sequence of learning is critical in that you have to understand the nature and parts of a problem before you can solve it.
• You can’t move forward until you have broken the links to the past.
• It is critical to implement the strategies that work the best for you into your day-to-day life. They are not difficult, but just passive learning doesn’t work.
• Re-engaging with friends, family, and your community is a powerful aspect of healing.

All these variables are important. Chronic pain is a complex problem and simplistic isolated treatments can’t and don’t work.

Our online Q&A

What I again did not anticipate was how effectively a community could be created online. It almost seems have had more impact than our in-person workshops. Here is one participant’s email.

The Q&A sessions I attend 2x per week are such an important part of my support system as I’ve started navigating The DOC Journey. I’ve suffered with chronic pain for over three years, and after two spine surgeries that provided no relief of my symptoms, I felt very alone and confused. I found this special community during a time when I felt little hope, and I know the timing was providential. As I process my journey with others that understand what I’m going through, I am able to give and receive support and encouragement, along with obtaining many tools that are making a significant difference in how I am able to show up in my life. This community is something I will always be grateful for!

Overview of the sessions

The Q&A format is a powerful force in creating change. We know that human connection is essential for health and that being socially isolated has detrimental effects on your health. One of the consequences is chronic pain. There are other manifestations and the effects are estimated to be equivalent to smoking 3/4 of a pack of cigarettes per day. (2)

Rules of Engagement

Much of the effectiveness of The DOC Journey is stimulating the formation of new circuits in your brain that bypass those that are creating pain. Your brain will develop wherever you place your attention and one of the reasons that any patient of mine was never allowed to EVER discuss his or her pain with ANYONE except their medical providers.

• The cardinal rule of participating in this group is never discussing your pain or medical care – even if asked.
• Ask yourself what you can do to be of help to others on the Q&A.
  • Specifically, please be mindful that each person in the small group breakouts of 3-4 has a chance to share.
• Understand the concept of mirror neurons-your mood has a direct mirror neuron effect on others. The term is called “co-regulation.” (3)
  • I have personally found that a little expressive writing, active meditation, or breathing exercises before the session is a big help if I am a bit out of sorts.
• Although your participation with comments and questions is welcomed, please don’t feel obligated. We want you to feel comfortable with the group.
• The sessions are intended to deepen your skills and answer questions. It is not focused on teaching. Reading my book, Back in Control: A Surgeon’s Roadmap Out of Chronic Pain will provide the framework for you to move forward.
• The DOC (Direct your Own Care) Journey provides a sequence that will keep you moving forward and it is based on our workshops. The sequence is:

• • Awareness
  • Hope
  • Forgiveness
  • Play

Meeting Agenda

• 11:50 – noon – Informal discussion/ catching up
• 12:00-12:05 – Relaxation exercise
• 12:05 to 12:15 – Didactic session/Sharing successes and challenges
• 12:15 to 12:30 – Open discussion and questions
• 12:30 – 12:50 – Small group breakout sessions – discussions will be based that day’s topic or what may have been brought up in the sharing session.
• 12:50 to 1:00 – Closing discussion

I will be prompt regarding time and will stop the didactic/ sharing at 12:15 – 12:20 and we will begin the open discussion. Please email me at dnhanscom@gmail.com with questions you’d like addressed or if you would like to share your perspective. You don’t have to be pain free to share. Small victories are the key to all of this. We would like to find out what you have found useful.

Letting go

The DOC Journey is a paradoxical one at almost every step. Repeated conversations are helpful in learning to process your environment in a different manner. Hearing about other approaches is helpful, but the best part is sharing your challenges and success with others.

References:

1. Cacioppo, John and William Patrick. Loneliness: The Need for Social Connection. Norton, New York, NY, 2008.
2. Cigna US Loneliness Index 2018. Report published by Cigna Insurance Company.
3. Porges, Stephen. The Polyvagal Theory. Norton, New York, NY, 2011.

The post People – The Most Powerful Part of The DOC Journey first appeared on Back in Control.

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I plateaued for about six months but now had some hope. I had always perceived myself as “cool under pressure” and felt that most things weren’t worth getting upset about. I could not have more wrong. What I was highly skilled at was suppressing anger. It exploded and I did not process it well.

I first had to admit that I had a lot of anger, but since “I was right”, I didn’t perceive it was a problem. So, I wasn’t progressing much and my life continued to disintegrate. Over about six months, I was finally able to learn some basic anger concepts and skills and began to rebuild my existence. What I did not expect is that my all of my physical symptoms began to improve and six months later, they had all but disappeared. I was shocked and still did not understand the role of sustained anger and elevated stress hormones/ cytokines causing inflammation.

From reactive to creative

Many people get to this spot of a dramatic turnaround and stop the journey, which is fine. They are excited, as am I, and they usually continue to do well. However, I also think that they have missed the best part. Instead of having to fight your way out of The Abyss, you have the opportunity to further connect to who you are, move forward from your center in a powerful way, and experience life at a level you never knew was possible. That is what this phase, Expanding Your Horizon is about.

The healing journey is based on connecting to your own capacity to heal, learning tools to optimize your body’s chemistry, feeling safe, and then creating the life that you want. As you move towards your idea of what you want your life to look like, you’ll be shifting off the pain circuits and nurturing ones that bring you pleasure and satisfaction. As you move into regaining your life perspective, connecting with your passions, play, and giving back, you’ll be spending much less time reinforcing your pain circuits and thrive.

Here are the areas to address that will enable you to experience the best part of your journey:

• Sleep – still the cornerstone
• Effectively processing stress – Life never stops coming at us
• Physical conditioning – is simply one of the best ways to feel better
• Medication management – a thoughtful approach will simplify this aspect of your care.
• Life outlook – is one of the most critical aspects of your journey. You have to know where you want to go to get there. How you do it is also important.
• A deeper understanding of chronic pain – will allow you to be innovative in dealing with it and allow you to have more control of your care.
• Family dynamics – turned out to be maybe the most powerful force in holding people back, but when addressed with a structured approach was remarkably helpful in healing – for the patient and the whole family.

Moving forward

Addressing sleep was the first step in the evolution of the DOC process. Twenty years ago, only a small percent of physicians dealt with sleep issues. I took an aggressive approach and would begin with “sleep hygiene” measures. But if a patient wasn’t responding within a couple of weeks, I would use combinations of sleep medications. Most people would respond within six to eight weeks. A significant percent of patients experienced a dramatic improvement in their pain. It wasn’t until years later, that I read a major paper showing that lack of sleep could induce chronic pain. (2) Unfortunately, it is still common to have major risky interventions done or recommended before sleep is addressed.

Processing stress became inherent in my practice as I worked with patients dealing with the problems created by being in chronic pain. I had experienced a lot of benefit with the book, Feeling Good, as I mentioned above and I had my patients use it. I quickly noticed that the only ones who responded were those who did the recommended writing. Other stress management approaches emerged over time. I eventually learned that stress is not the problem, as much as your reaction to it.

Addressing Physical Factors is basic to musculoskeletal care.

• Physical therapy must be tailored to a patient’s specific needs.
• Aerobic conditioning has long been documented to improve pain.
• Weight training not only increases strength but also stimulates the release of hormones that enhance your sense of well-being. It also seems to have a neurological component in that you are on the offensive, taking charge instead of being at the mercy of your pain.
• Nutrition is critical. For example, an anti-inflammatory diet can quickly lower your pain. Intermittent fasting consistently lowers inflammation.
• Bone health – osteoporosis (low bone density) creates havoc with the quality of your life and is both preventable and treatable.

Medication management is critical. You need symptomatic relief to give you “the space” to learn and implement the tools to heal. They will become much less important as your pain resolves and no one really wants to be dependent on medications. They are expensive and a hassle.

My approach was the reverse of what is usually done. I would keep patients on the same medications, including narcotics. Medication discussions were always face-to-face. Although, the goal was to wean down, the patient always had the last say regarding how quickly this would occur. Anxiety is the pain and going to war over medications is counter-productive. With the patient in charge, he or she had control (an antidote to anxiety) and I rarely had a problem with patients coming off of their meds. In fact, as the pain dropped, the side effects increased and they were anxious to stop taking them. The only criteria I required was that they had to be actively engaged in the other aspects of the structured care approach.

Life outlook is one the most important aspects of healing. Goal setting is a core aspect of stimulating neuroplasticity. Your brain will develop wherever you place your attention. It is similar to learning a new language. You have to decide what you want your life to look like, what you want in it, and then pursue it. Otherwise you are still focused on the problem and not the solution. A corollary aspect of this is forgiveness. You can’t move forward until you can let go.

Awareness of the nature of chronic pain is important because it is so complex and each individual is unique. The traditional approach is to manage it, not solve it. Random simplistic treatments are used to treat symptoms and not address the core problem of a fired up nervous system and sustained exposure to elevated stress chemicals. The DOC process is a framework that allows you break down pain as it relates to you into its components. It allows you to address all of them simultaneously. It is this multi-pronged approach that is what is so effective in successfully treating chronic pain.

The final component regarding family dynamics came about over the last few years of my practice in Seattle. We had known that chronic pain takes a terrible toll on the family. It became clear that a patient could engage in many aspects of the DOC process but the family dynamics would sabotage everything. Conversely, by addressing the family interactions around pain, patients would often experience powerful healing. We began to set up rules around pain in the household. The basic one was that the patient could not discuss their pain with anyone – ever – especially with their family. The corollary was no complaining, giving unasked-for advice, or criticizing. Basically – be nice.

From reactive to creative

Don’t stop now when you are really just beginning. It is a triumph to be out of The Abyss, but there is much more to life than just surviving. Most people have been fighting the pain for so long that they have forgotten what it is like to relax and enjoy it.

If you take the word, reactive and move the “c” to the front, you have the word creative. If you can “c” first, you have some space to look at your options and create your reality.

1. Burns D. Feeling Good. Avon Books, New York, 1999.
2. Agmon M and G Armon. “Increased insomnia symptoms predict the onset of back pain among employed adults.” PLOS One (2014); 8: e103591. pp 1-7.

The post Expanding Your Horizon–Your New Life first appeared on Back in Control.

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Then you add partners (your children) who have a much deeper relationship with the business of being a family. They are completely dependent on the family unit as a base of operations, for patterning for their emotional makeup, developing coping strategies, and learning most of their life relationship skills. They need a safe and nurturing environment to develop a strong identity and thrive.

Your family as a business

A successful enterprise generally has an idea of its purpose and it is often elucidated in a business plan. It begins with a vision and mission statement. It starts with assessing where you are, where do you want to go, and how are you going to get there? Without a least a simple description of these steps, you will remain in a reactive mode and focusing more on surviving day to day. You can do it, but is the life you have the life that you want?

There has to be some structure and delineation responsibilities and tasks. One can’t happen that well without the other. So, learning organizational and execution skills is important.

Then there are the finances, which is well-known to be the most common reason for family conflict. The battles will be more intense without clear data and a sense of how to manage money as a family unit. Who can spend what with what constraints?

Finally, why are you a family and what is your vision of enjoying life? Has your family been under so much stress that you have forgotten the reason you are together in the first place?

Some starting suggestions

There are an endless number of ways this can all play out but the most important step is just doing it. Here are a few suggestions.

• Create a mission statement
  • Make it as detailed as you are comfortable with.
  • Create protected time in a retreat atmosphere without any digital devices or outside interferences.
  • Write down and create your document quickly.
  • Put it in a spot that is easily seen and refer to it frequently.
• Hold regular family meetings with guidelines and an agenda.
  • Have a defined start and stop time.
  • No fighting (Different than a direct discussion).
  • Frequency
    • Weekly short ones at a regular time
    • Quarterly evening meetings to stay connected with the mission statement
    • Annual retreat to update the vision and mission statement.
  • Look up resources to create a more detailed family planning process.
    • Here is one great set of suggestions from a businessman written in the Wall Street Journal.

How can I do this when I am in pain?

I am extremely aware of the obstacles that are present when a family member is in chronic pain. As we worked with many families over the years, it became apparent how destructive chronic pain was to the whole family. Often, it bordered on complete chaos, just trying to get through the day. You may think that these suggestions are ridiculous in light of your suffering. And BTW, they are. That is why the rest of the healing process must be learned well enough to begin to calm down your nervous system. The essence of healing chronic pain is feeling safe, which means you are able to optimize your body’s chemical profile from stress hormones to relaxation ones. You will be able to think more clearly and begin to consider creating a functional family unit.

However, structure is also a powerful antidote for anxiety. There is a strong bi-directional effect, in that a stable family unit aids in aiding your healing. Even a discussion about how this might look in the midst of the disruption caused by your pain can begin to break up the cycle. Just the one rule of NEVER discussing your pain with anyone, especially your family members causes a shift in the energy of the home. Holding family meetings, even if they are disorganized will add to the process. Making a family decision to, “Be nice” is a major step, even if you frequently fail.

You may still be thinking that none this makes any sense and I must not have any idea of what chronic pain does to a family. Let me give you a couple of insights that represent the tip of the iceberg.

I do know family chaos

My father was a physician who simply was never home. My mother was emotionally unstable and had four children in five years, which put her right over the edge. She suffered from chronic pain and would find ways to get a hold of opioids and benzos. She was a hoarder and would sit in her room most of the day trying to clean it. My father would frequently come home at nine o’clock at night and have to wash piles of dirty dishes. Whenever they sat down to pay bills, there was at least a two-hour screaming match. There was no sense of direction and there was also no way to make my mother happy. We kept moving from city to city and I lived in 12 different houses by the time I was 16 years old. My mother would focus on the negatives of a given situation and her endless complaining was a significant factor in causing us to move so often.

This lack of structure and stability did have a severe impact on me and most of my life efforts were focused on running from all of this chaos. I did escape with one of the strategies being that of an overachiever. It worked until it didn’t. I ran out of fuel and crashed at age 37. I was on the same pathway as my family; reacting and surviving instead of pursuing a vision. I spent the next 15 years in severe chronic pain.

If you don’t make a decision to take control of your life and be in charge of your family, who will? Where is the endpoint? Creating and executing a plan for you and then for your family will be part of being able to calm down your turbo-charged nervous system. Continuing to wander without direction will not. You may not feel like you can or want to take this step of creating structure for your family. Just do it. It will have a remarkable healing effect on everyone.

You started out like this.

What does it all look like now?

The post Develop a “Family Business” Business Plan first appeared on Back in Control.

The post Develop a “Family Business” Business Plan appeared first on Back in Control.

I have also witnessed several families re-uniting. Here is one of these stories.

Needed Surgery

Bill was a middle-aged executive who has experienced many stress-related physical symptoms. He had a structural low back problem that required a multiple-level decompression. He had severe pain in both of his legs that completely resolved with the operation.

He initially was not open to any of the ideas of the DOC project, but his pathology was so severe that I proceeded relatively quickly instead of having him go through the rehab prior to surgery (prehab). About a year later all of his pre-op symptoms recurred. I offered him a three level fusion to relieve his leg pain, but I was also suspicious he had triggered his old pain circuits. Although he was initially resistant to the rehab concepts, the magnitude of the recommended operation cause him to reconsider and he felt he had nothing to lose. Surgery was still on the table because his bone spurs were quite impressive.

WHEN A PRIOR PAIN CIRCUITS ARE TRIGGERED YOU CANNOT TELL THEM APART FROM THEM BEING CREATED BY A STRUCTURAL PROBLEM. THE PAIN IS IN EXACTLY THE SAME LOCATION AND HAS THE SAME INTENSITY – OR WORSE.

Within two weeks his pain abated and by six weeks it disappeared. What had fired up his nervous system and pain were problems at work, as well as serious issues with his marriage. A few months later his wife left him. Although he accepted his responsibility for her needing to leave he had a difficult time dealing with it. However, his pain didn’t return and he was becoming more proficient at using his tools to keep his nervous system calmed down. For me, this was all surprising because I had assumed that we would still be performing a surgical procedure.

Waking Up – his wife returned

Over the next couple of years he worked with a pain psychologist, psychiatrist, and with the DOC concepts. I saw him about every 4-6 weeks. Not only did his pain continue to remain minimal, his entire personality transformed from being obsessive and controlling to extremely warm and engaging. (Of course, it was always there) He came off all of his psych meds. One day he came to the office and he was beaming. His wife was coming back. This was the second couple I had seen re-united over a short period of time.

His letter

Dear Dr. Hanscom,

Fantastic to see you. During our meeting today, Sarah e-mailed me her travel plans. She leaves Wisconsin Monday, driving the car I bought her before we wed. Nevertheless, my outlook is “open hands”. (David Burn’s concept) I can be and am happy (enough) on my own with or without Sarah. Or with or without any romantic partner, I stand on my own.

I checked the DOC site for the printed version of Back In Control and I just bought it. As a DOC project participant, I want to share some of my experience.

I’ve nearly eliminated my physical pain and my residual “background” pain from psoriatic arthritis NO LONGER HURTS. This pain no longer gets to my emotions, UNLIKE the princess in The Princess and the Pea. But I still feel exquisitely vulnerable to emotional pain. To me, emotional pain really hurts badly. There’s just no other way to describe it.

But I have made progress. And just as in life my progress is NOT a straight line. I’ve had setbacks followed by advances then a stumble – just like real life. Here is what I credit, first and foremost.

First, without a doubt: Writing and throwing away the paper IMMEDIATELY afterwards. I regard throwing away the paper as equally important as purging the bladder & bowel. Writing and throwing away the paper MUST BE done to avoid systemic toxicity (My analogy is that it is similar to brushing your teeth).

Second: Physical exercise. Three times a week minimum of vigorous “break-a-heavy-sweat” exercise. It also MUST BE done to avoid systemic toxicity.

Third: I read. (For the record, the very first book that I read was: Back in Control.  Were it not for Back In Control by David Hanscom I wouldn’t have been nearly as motivated to read all these other books:

• The Pain Chronicles – Melanie Thernstrom
• Forgive for Good – Fred Luskin, PhD
• The Talent Code – Dan Coyle
• The Traveler’s Gift – Andy Andrews
• Epictetus and The Art of Living – Sharon LeBell
• Full Catastrophic Living – John Kabat-Zinn
• Journey into Love – Kani Comstock
• Demystifying Love – Stephen Levine
• Man’s Search for Meaning – Viktor Frankl
• Awareness – Anthony De Mello
• Thanks – Robert Emmons
• Feeling Good Together – David Burns, MD

Needless to say, I hadn’t read a single one of these books before embarking on the concepts presented in The DOC Journey.

Lastly I’ve got a personal recommendation –  cry. Not like an actor on TV, I mean really cry. And cry hard. You will feel better. It might take 3 hours or 3 days, but you WILL feel better. Show me a man with no cry in him and I’ll show you a severe case of deadly fired up nervous system and denial!

Best Regards,

Bill

P.S.

One item:  The “think positive” myth:

I know it’s just bull but I can clearly describe why…it’s about phonyness… or trying to pretend something bad is actually good? I mean this section on DOC delves into the fallacy of positive thinking:

• “Positive thinking is another way of suppressing negative thinking. This is a tricky concept in that by committing to a process of true forgiveness the results are very positive. You first have to go through the steps (allowing yourself to feel pain) to achieve the positive result.”

Can I convince my dad to stop saying, “think positive son!?” Maybe I’ll let him say his thing and ignore it. I once tried to articulate this point to my dad, but I couldn’t clearly describe the fallacy of the “power of positive thinking”.

My perspective on Bill’s journey

There are numerous points I could emphasize about his transformation, as it has completely enveloped him. I would like to touch on a few.

1 – Do you need your pain?

The first point is that he clearly expressed what I have observed for a long time: Humans consciously and unconsciously will do whatever it takes to avoid emotional pain. That includes experiencing physical pain, even if it is self-inflicted. I feel this is one of major reasons that patients won’t engage in that you have to learn to feel pain in order to move through it.

2 – Anyone can get better

The second is that with persistent engagement in the healing principles most people improve. It’s a matter of time and commitment. He was in as bad a mental and physical state as anyone I have worked with. Now he is pain free and thriving.

3 – The absolute block – Obsessive thought patterns

The third is that one of the core symptoms of NPD is obsessive thought patterns. This is a huge problem in that it also the symptom that blocks treatment. The one variable that predicts success is openness to engagement. In chronic pain, you’re legitimately angry and your mind is going a thousand miles an hour. It interferes with rational thinking. Some of the more common thoughts I hear are:

• “I’m feeling the pain right here. It’s not imaginary.”
• “The doctor is missing something. There has to be a reason for my pain.”
• “I’ve tried everything you’ve suggested, and it hasn’t worked. Why should I try this?”
• “I’m not angry!”

“You don’t believe me”

Then when I tell them that their spine has degeneration that is normal for their age and surgery isn’t indicated, they will often explode with anger. As I am not offering them an operation or a procedure I must not really believe that they are experiencing severe pain. I do believe them, but there doesn’t seem to be anything I can do to convince them to at least learn about the nature of chronic pain. I feel badly, but I have to let go quickly and hope they’ll circle back around again.

It took Bill over a year to be open and a few months to really immerse himself in NPD principles. I don’t know why he decided to engage, and I don’t think he does either. I do know that he is one of many examples that keeps me fired up about moving forward with this project.

The post A Couple Re-united first appeared on Back in Control.

The post A Couple Re-united appeared first on Back in Control.

Three of the couples have been married about 40 years. Most of us didn’t make it that long. Since the family issues have become one of the main focuses of the healing process from pain, I asked both halves of each couple what was working for them. Here are their comments.

Bernie and Carolyn

Bernie worked night shifts for many years and they were forced to have a lot of space in their marriage. Although there were some negatives, they felt that it was helpful in making them develop their own styles and interests. They also had a shared value system and were active in the church. They enjoyed a strong sense of community and giving back. Social isolation

Finally, they often “ignored the problem” and eventually it disappeared or “just wasn’t worth fighting about.”

Ken and Merrilee

Merrilee:

“Love them even though they change.”

She felt the honeymoon ended when her focus shifted from making her husband happy back to her happiness. “Life keeps coming at you and you just don’t have the same energy to keep giving.” She has been reconnecting to being more emotionally supportive going forward and enjoying her family more.

She shared that her daughter had a wonderful perspective in that she quit worrying about herself and concentrated on being “the wife that her husband deserves.” Without expectations, his behavior and their relationship improved. She also performed “deliberate acts of service.”

Ken:

He felt that respect for each other’s views was important. There is rarely one answer and it doesn’t have to be repeated scenarios of “win or lose.” This perspective evolved about five years into his marriage and involved better awareness and willingness to listen.

He also realized that under stress that he would remain aloof and withdraw and that sharing everything, enjoyable or unpleasant, was critical. A turning point occurred when their daughter incurred severe life-threatening injuries in a boating accident and everyone pitched in and pulled together. Shared adversity became a strong bond.

Jennifer and Gary

They both shared that maintaining a sense of humor was the cornerstone of why they had thrived for so long. They just “laugh a lot.” Consequently, they don’t seem to trigger each other that much. Their main advice to their children is, “Find someone with a sense of humor.”

Shared values were also important. They cared about similar issues. Appearances and material things aren’t that important to them. They really enjoy traveling together.

Respect was also in the forefront of their relationship. They espoused being kind and treating each other and others well. “Being tired” wasn’t an excuse to behave poorly. They consciously don’t speak badly about each other to others.

Chronic pain and your family

There are many books giving marriage advice, but I was impressed how these observations reflected a lot of wisdom. Chronic pain introduces an intense angry energy into the home and the effects are consistently devastating. Every time I ask a patient’s partner about the impact, the response is strong. It’s a disaster.

Chronic pain is a legitimate reason to be angry. You’re trapped – from every direction. Why would you not be angry? The problem is that anger is destructive and the family you treasure now becomes one of the targets of your anger, even if it isn’t directly focused on them. As they react back, then it triggers your pain and there is not an end to this vicious cycle.

We are seeing tremendous success in guiding families to create structures to break up these unconscious survival patterns. They are powerful reactive survival responses that aren’t subject to rational interventions. These strategies are outlined in multiple posts in the family section of this website.

One of the most effective approaches, after the chaos has settled a bit, is to proactively recreate a life that you want beginning at home. The wisdom of these couples encapsulates this concept. It also happens to be the foundation for our three-day workshops, which are based on awareness, hope, forgiveness and play. Omega 17

Awareness

All the couples felt respect was essential, but to have it you must to be able to listen and become aware of the other person’s needs. When you’re angry, you’ve completely lost awareness. It’s crucial to be aware that you are upset and not take action while you are reacting. This one is tough and an ongoing challenge for me personally. However, anger is about your own needs and is destructive to others and relationships. You have to disengage until you can calm down and then discuss the possible solutions to the problem.

Committing to the other person’s needs or well-being also requires a keen awareness of what those might be. Awareness is the foundation of any relationship in all arenas of your life.

Hope

What were your dreams for your life and family on the day of your wedding? Why did you want to be with this person? That energy seems to be commonly crushed by life stresses for many families. One of the suggestions we make to couples is to spend an hour remembering the most enjoyable and happy times of their relationship. Most couples with pain in the family haven’t done that for a while and often find it difficult to get back to that spot. If you can’t re-connect with why you are together in the first place, then you have to really dig in and figure a few things out. You’re in a pressure cooker.

Forgiveness

This is a self-evident truth that most of us forget in the midst of relationship issues. It is easy to be judgmental of your partner’s “faults.” However, when you are judgmental you are just projecting your view of you onto someone else. When you have labeled anyone, either positively or negatively you have lost awareness and you have little or no idea who this person is, and you cannot see the world or situation through his or her eyes. All the couples had their own style of letting go and moving on. Fighting is the antithesis of love, compassion and respect. Would you talk to a stranger or fellow worker the way you talk to your partner?

My wife and I have a little saying, “Anger isn’t attractive.” It’s true. However, although it’s easy to see how unattractive the other person is in that state, it’s challenging to see how you appear to others when you are in that mode. Do you want to remain that way? Is that the way you want people to consistently perceive you? Isn’t it great to be around someone who laughs a lot? Wouldn’t you want to be that person? You can’t get there without deep forgiveness.

Play

One of the more definitive solutions to solving chronic pain is play. There is a surge of wonderful chemicals such as serotonin, GABA chemicals (Valium-like chemicals), oxytocin (the love drug) and dopamine (the pleasure hormone). As the body chemistry switches into this mode, there is a profound effect on all of your body’s organ systems and many physical symptoms resolve. Why wouldn’t you want to spend most of your time in this state? What was a common theme with all of the three couples? Actively cultivating pleasure is a learned skill and needs to be nurtured. Taking things in stride with a sense of humor is the essence of this aspect of relationships. We have been amazed at how frequently we have observed how much controversy is generated around how to load the dishwasher. That might be good starting place to step back and just laugh about how deeply we get pulled into situations of little consequence. We can do better than that.

Life is full of adversity and you can either support each other or bring each other down. I have never advocated positive thinking or enjoying adversity. However, sharing challenges together is an intense bond and it’s helpful to bring a sense of adventure and play to all of this. Challenges will always be coming at us. Without making a conscious effort, play will be pushed aside. It’s critical to be able to regenerate your energy daily.

Chronic pain infiltrates every aspect of your life – especially into your family. It appears to be one of the most powerful forces keeping you in pain. However, with relatively simple strategies, the energy can be switched to your close relationships being a wonderful connection to healing – for both you and your family.

Healing begins at home

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Chronic pain takes a terrible toll on families. People in pain often have forgotten what it’s like to have fun. They tend to become socially isolated and withdrawn, even within their own home. Much of the conversation centers around pain and medical care. It becomes tedious and frustrating because there is little that can be done to solve the problem. Additionally, it’s common for patients to lash out with their family being the closest target. A term used to describe the anger associated being trapped by pain is “rage”. (1)

Trapped

But now the whole family is also trapped. The scenarios become apparent quickly within the first couple of visits. So, I ask them a simple question, “Do you like your family?” The answer is always, “Of course!” The essence of the problem is that anger has become so normalized within the household that they can’t see effects of their pain on those around them. The core of human relationships is being aware of other’s needs from their perspective. The essence of abuse is lack of awareness and anger obliterates it.

Then I ask, “If your family is so important to you, why would you allow yourself to get so upset with them? Would you yell at a stranger the way you talk to your family?” Of course not. “Then why would you treat your family, who you deeply care about, better than someone you have no connection to?” Protect your family from your pain

Homework

After a brief conversation, I assign some homework. I want them to individually ask each family member what it’s like for him or her when they are exposed to their anger. Then I ask them to consider, “How do you look when you’re angry?”  Why would you want them to see you in that state?” Anger isn’t attractive and you’re no exception.

How do you want your family to feel when they hear your footsteps approaching the front door? Are they excited or are they dreading it? Are they on hold until they see what mood you’re in? What do you want them to feel? Do you enjoy playing with your family? How often to you do it? Can you really play if you aren’t in a good mood? Is your family a haven of safety and joy?

Who’s the adult?

I was taken aback a few years ago while talking to a large muscular patient. It was slightly intimidating just being in the room with him. He was a high-level businessman who had suffered from chronic neck pain for years. I asked him if he ever got upset? He initially said he didn’t and then admitted he did occasionally. That turned out to be a daily occurrence and happened multiple times a day. I asked him, “Who’s the target of your anger?” He replied, “My daughter.” I asked him how old she was, and he said, “Ten.”

I was startled because the focus of anger tends to be the partner. I asked him who was the adult in this scenario, and how do you think she might feel being the focus of his rage. He hadn’t considered that angle, but he couldn’t let go of how much she was upsetting him.

Awareness

The second part of the homework is that I want him or her to practice awareness beginning when they walk out my office door. The assignment is that they are not to give any advice to their partner or children until the next visit. None, unless specifically asked. I also ask them to consider some of following.  “How often do you give unasked-for-advice? Do you realize that you’re actually telling them that they aren’t good enough the way they are? Are you overtly critical? Do you enjoy or appreciate being criticized? How would you react? How do you expect them to react?”

Triggers

It appears that the family is one of the greatest factors in propagating pain and anxiety. One of the most perverse parts of the human condition is that the species that survived did so because they learned to cooperate with other humans. The need for human connection is deep and the deeper the better – except that the triggers that set you off are stronger. So potentially the most safe and secure place in your home is often the most dangerous.

You don’t feel safe because your body has betrayed you and you’re being constantly assaulted by pain. Then it plays out in your home and no one feels safe. Is this what you had in mind when you got together with your partner and were excited about building a future together? What happened? What can you do? You have choices and the first step is becoming aware of the depth of the problem. Healing begins at home

Even if you think your family environment isn’t a problem, I would challenge you to still ask your family the above-mentioned questions. These issues are universal, and you’ll be surprised and sobered at the answers. The good news is that with becoming more aware, the family environment can quickly improve. We were excited by speed and depth of the changes. The whole family feels hope.

This is an essay sent to me by one of my patients on Mother’s Day

Here are a couple of books that I have frequented recommended regarding parenting and improving your relationship with your partner. They have both had a significant and humbling impact on my interactions with my family. Looking back on my experience with pain, it is incredibly frustrating to see how my endless quest to find a cure for my pain interfered with my relationships both in and out of the home.

• Gordon, Thomas. Parent Effectiveness Training. Three Rivers Press, NY, NY, 1970, 1975, 2000.
• Burns, David. Feeling Good Together. Broadway Books, NY, NY, 2008.

“The most basic and powerful way to connect to another person is to listen. Just listen. Perhaps the most important thing we ever give each other is our attention…. A loving silence often has far more power to heal and to connect than the most well-intentioned words.”

~Rachel Naomi Remen

References

1. Sarno, John. Healing Back Pain: The Mind-Body Connection. Warner Books, NY, NY, 1991.

Listen to the Back in Control Radio podcast Do You Like Your Family – Listen

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Learning to enjoy life

We have been evolving for millions of years and human consciousness began with the cognitive revolution about 70,000 years ago. (1) Additionally, the unconscious brain is a million times stronger than the conscious brain and although we often know our behavior is less than ideal the behavioral patterns always win. We are not designed to have a good time. That is a learned skill.

Dr. Luskin, a friend of mine and author of Forgive for Good has taught me a lot about anger, forgiveness and the body’s need to protect itself. One of his points has been that the human organism has only one function – and that is to survive. So, your brain is constantly scanning the environment for danger, analyzing every sensory input.

There are few times and places where you can feel safe. Life is competitive and it’s challenging to get a break. School has many layers of stress. Bullying is rampant. Close friends often turn on each other. Social media has intruded on privacy and quiet time. Research has shown that only about a third of families are relatively free of chaos. Other stressful arenas include sports, music, the arts, employment, and social status. Where’s there a place to rest?

Additionally, when you are suffering from chronic pain you are really trapped. You’re being attacked by your own nervous system. As your body is subjected to sustained levels of stress chemicals, such as adrenaline, cortisol, histamines and endorphins you will experience a myriad of other physical symptoms. It has been shown that the impact of chronic pain on your life is equivalent to suffering from terminal cancer. (2) The problem with chronic pain is that there usually isn’t an endpoint. It is a terrible state of being.

Connection

The Omega weekend is focused on re-connecting people with each other, which helps a person in pain connect to themselves. It is tightly structured with a lot of sharing of enjoyable experiences. Many of the activities are held in small groups of four or five. Participants can feel safe and it’s remarkable how quickly healing occurs. Much of the weekend is spent in play, which is a great venue to feel safe. We quickly realized after the first seminar in 2013 that we didn’t have to do much after we set up the weekend. Participants healed each other. It is also a remarkable experience for us being in the presence of those who are so supportive of each other.

Here is an overview of the workshop and the link to the course registration.

The seminar is based on:

• Awareness – You have to understand a problem before you can solve it.
• Hope – most people in pain have lost hope of a solution. We’ll share many success stories.
• Forgiveness – You have to let go before you can move forward.
• Play – We all have the capacity to play but it often gets buried in the morass of life and pain. It is the most powerful way to move forward.

Many of the participants experienced significant shifts in their pain and mood during the weekend. The hope is that you’ll reconnect to the part of your brain that already knows how to enjoy life. The solution to pain is not trying to fix it but to first learn to be comfortable with it, separate and then move away from it. As you quit fighting the pain, it will lose its energy and diminish. This process is the main focus of Saturday morning –  “The ring of fire”.

Family dynamics and pain

Human connection is a basic need and how consciousness evolved. People who are socially isolated have a similar area of the brain light up as in being in pain. It’s common, if not the rule, to become progressively isolated when in pain. You just don’t have the energy to interact with others. Then the loneliness becomes crushing. People will often endure terrible domestic abuse just to avoid being alone. One of the most perverse aspects of the human experience is that we turn to our family for meaningful connection and the deeper the relationships the better – except the closer the relationship the more powerful the triggers that set off anxiety and anger. At the same time the family can provide the deepest sense of safety, it is also the most vulnerable and most unpredictable area of life. Saturday afternoon will be focused on the role of the family in both healing and exacerbating pain. I warn the group that once you’re home and back amongst your triggers, the pain will return. But you have tasted freedom and will continue to evolve the tools return to it more and more quickly.

We request that the participants become familiar with the DOC concepts and be actively engaged in using the basic tools. The intention is to deepen your healing journey and support each other. Commonly, the process provides the needed push to propel you onto your new life. The group will be limited to 30 people to keep it interactive.

Some of the stories

We have dozens of great stories emerging from the weekend. One remarkable story is about a young man who flew in from Toronto to the Seattle workshop. He had been struggling with substance abuse problems for over 10 years and had been clean for about 8 months prior to the workshop. He had been through three stints of comprehensive rehab and desperately wanted to get on with a productive life. He was quiet but interactive and asked great questions. I wasn’t sure how much of an impact all of this was making on him. I talked to him a few months later and he had returned to a difficult situation where his “friend” and roommate had stolen money from him. He said that historically he would have remained angry and probably would have gone back to the drugs. He was able to use the DOC strategies to calm down and come out of his reactive mode quickly. I had a great conversation with him. He said the crux of his success was that, “I let the pain in. I’m no longer on the run.”

A middle-aged businesswoman had been experiencing pain in her right tailbone for over seven years and had difficulty sitting. She also was experiencing over 20 other symptoms of a fired up nervous system. I looked over her intake questionnaire and wasn’t sure she would benefit from the course. Over the last two days of workshop she experienced a marked decrease in her pain and it disappeared over the following weekend. She is continuing to thrive, got married and returned to part-time work. We have stayed in touch with her triumphs and struggles.

One woman had been experiencing chronic headaches for over 10 years. She had also developed abdominal pain and right leg pain that was persistent for a couple of years. She shared with us that she had been walking in the Omega garden on Tuesday, when her whole body seemed to have a deep reaction. She was passing by some rocks that others had written on. They were short tributes. She stopped and wrote a short poem honoring a stillborn baby that died two years earlier. She had never gotten to see her before she was buried. She woke up Wednesday morning without a headache for the first time in 10 years, her leg pain disappeared, as well as her abdominal pain. Needless to say, the whole group was stunned. She had no pain the rest of the week and has continued to enjoy life for the last four years.

We are looking forward to meeting this new group and have enjoyed remaining in touch with many of the alumni.

1. Harari, Yuval Noah. Sapiens. Harper Collins, NY, 2015.
2. O’Connor AB. Neuropathic pain: quality-of-life impact, costs and cost effectiveness of therapy. Pharmacoeconomics. 2009;27(2):95- 112.
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