The worst part of my ordeal was the mental pain and being bombarded with unpleasant and intrusive thoughts. It was the most disturbing aspect of it all and the more I did battle with them, the more intense they became. I had already slipped into an “internal OCD” (obsessive compulsive disorder) five years earlier. It  manifested with repetitive disturbing thoughts that I countered with positive thoughts. Internal OCD does not have external characteristics such as hand washing and counting.

I had begun the expressive writing about six months earlier with a lot of success. My anxiety and other physical symptoms had diminished but I was still struggling on many fronts.

“I am a victim”

On Mother’s Day of 2002, I suddenly realized what being a victim entailed and saw that I was deeply enmeshed inthat role. Up to that point, I had no idea that I was even angry. I was just “right” and “frustrated.” But since I had so many legitimate reasons for feeling this way, I never considered myself as angry. In fact, my concept was that I had dealt with anger and had moved on. Nothing could have been further from the truth.

I felt a deep shift and over the next six weeks, more of my physical symptoms began to resolve, with the most unexpected one being that the ringing in my ears (tinnitus) decreased dramatically. After 25 years of dealing with it, I had assumed that it was a permanent symptom. However, many of the disturbing thoughts persisted and were interfering with my capacity to enjoy my life. I felt stuck.

The circus mirrors

One day, I suddenly had an image of myself standing in front of the kind of reflecting mirrors that you see in the circus. I was staring at repeating versions of  myself, going into infinity. I could see the battle playing out in my brain – a disruptive thought followed by a  counterthought – without an end. This had been playing out in me for years. I realized that there was nothing I could do and I “gave up.” I had reached a point where I had to let go. I truly became deeply discouraged yet at the same time, this realization was accompanied by a deep physical feeling of release. I was perplexed.

I continued to use all the tools of writing, mindfulness, forgiveness, etc. But with my new outlook, I began to move forward with my life and within six months most of my physical and mental symptoms (Including the obsessive thoughts) had dramatically abated. I didn’t realize it at the time, but it turned out that letting go and moving on was the definitive answer. This was well before I understood the concepts of neuroplasticity. Your brain develops whereveryou place your attention and I had been reinforcing the problem by trying to fix it.

Take a break

My patients and I frequently discuss the idea of taking a break from The DOC Journey. They have been diligent in reading, writing, not discussing their pain or medical care, meditating, processing anger, and even working hard at play. But they continued to be frustrated because, even though their pain had diminished, their anxiety levels remained too high, upsetting thoughts continued to bombard them, and they still didn’t have the quality of life that would allow them to thrive.

Perfectionism came into play in that he or she wanted to be the best student and really do it right. But the harder they worked at it, their neurologic energy was still directed at themselves. Inadvertently, by stimulating neuroplastic changes towards the problem, they were reinforcing these unpleasant neurological circuits.

Remember that the victim role (including perfectionism) is so powerful, you will never want to give it up – even afteryou have felt how free you can be. It is too strong of a survival need. The  decision to let go of the victim role is a day-by-day decision, sometimes a minute-by-minute one. Being triggered is inherent to being alive, and you have to decide if and when you want to let go, and when you are ready, just do it. I have not found an alternative and logic doesn’t work. I call it, “flipping the switch.”

Bill

Occasionally, at the end of an office visit, I asked my patient to sit in the exam room and not leave until they committed to “letting go” of the victim role. They may have sat for 10-20 minutes before they left. Walking out the door was symbolic of them stepping into their new life. It was surprising how effective that simple action could be.

Bill was a middle-aged, small-business owner who had been in chronic pain for over twenty years. He had done quite well with the DOC principles, along with the help of one my colleagues. One day Bill was triggered by one of his business partners and fell deeply back into the Abyss of pain and despair, to a depth he had not experienced before. He was becoming suicidal. Unfortunately for me—but fortunately for others— through my own experience, I gained extensive insights into suicide and realized that anger is what pounds your soul into the ground. Bill was in an extreme victim mode. I called him out on it during an extremely intense conversation. Although it was nerve wracking for both of us,  it clicked. He sat in the exam room for about half an hour.  When I saw him back a few months later, he was achanged man and re-entering the workforce.

A friend sent me this poem:

“She Just Let Go”

She let go. Without a thought or a word, she let go.

She let go of the fear. She let go of the judgments.

She let go of the confluence of opinions swarming around her head

She let go of the committee of indecision within her.

She let go of all the “right” reasons. Wholly and completely, without hesitation or worry,

She just let go.

She didn’t ask anyone for advice.

She didn’t read a book on how to let go….

She didn’t search the scriptures.

She just let go.

She let go of all of the memories that held her back.

She let go of all the anxiety that kept her from moving forward.

She let go of the planning and all of the calculations about how to do it just right.

She didn’t promise to let go.

She didn’t journal about it.

She didn’t write the projected date in her day timer.

She made no public announcement and put no ad in the paper.

She didn’t check the weather report or read her daily horoscope.

She just let go.

She didn’t analyze whether she should let go.

She didn’t call her friends to discuss the matter.

She didn’t do a five-step Spiritual Mind Treatment.

She didn’t call the prayer line.

She didn’t utter one word.

She just let go.

No one was around when it happened.

There was no applause or congratulations.

No one thanked her or praised her.

No one noticed a thing.

Like a leaf falling from a tree,

She just let go.

There was no effort. There was no struggle.

It wasn’tgood, and it wasn’t bad.

It was what it was, and it is just that.

In the space of letting go, she let it all be.

A small smile came over her face.

A light breeze blew through her.

And the sun and the moon shone forevermore.

–Rev. Safire Rose

This poem “She Just Let Go” by Reverend Safire Rose beautifully conveys the essence of The DOC Journey. Letting go is the simplest and simultaneously the most difficult aspect of the healing process. Our anger is powerful and often legitimate. We are accustomed to fixing others and ourselves, but our attention is still on our flaws and those of others. Too much attention to shortcomings inadvertently strengthens our unpleasant neurological circuits.

The DOC Journey provides guidance and tools to get to a place where you are able to let go. The freedom you will experience is remarkable. For me, it was unlike anything I had ever experienced in my life. Watching people enter this realm is inspiring and is a major factor in motivating me to keep me moving forward with this project.

Reconnecting with Your True Self

On Saturday, November 6th, Dr. Les Aria, a friend of mine, and I are holding a workshop that is being hosted through The Open Center in New York. We will be discussing both the process of letting go using specific strategies to connect to the best part of who you are. The intention is for you to leave with a clear concept of the power of the unconscious survival mind, how to develop a “working relationship” with it, and move forward into the life you desire. Click this link to take a look at the course and register.

The post “She Just Let Go” first appeared on Back in Control.

The post “She Just Let Go” appeared first on Back in Control.

• Connect mainstream medicine with existing science – most symptoms, illness and disease  are created by the body’s physiology (how it functions), and not structures.
• Establish the necessity of a trusting dynamic relationship with your clinician. Feeling heard and safe is not a luxury. They are healing modalities in that they shift physiology from threat to safety. Also, if we don’t know you and understand the details of your situation, how can we make accurate decisions.

Most chronic mental and physical disease is caused by the body being in a sustained state of flight or fight (threat physiology). The fallout of treating most diseases from a structural paradigm isn’t effective and causes harm. It is particularly damaging in spine surgery, and the rates of spine surgery for chronic low back pain continue to skyrocket. It eventually became clear that we were performing low back fusions for anxiety (sensation created by threat physiology) with a success rate of less than 30%.¹

Understanding chronic symptoms, illness, and disease

My efforts evolved out of my own 15-year struggle with chronic mental and physical pain. Most of my approaches failed and then some began to help. As I pursued treatments that worked and abandoned the ones that didn’t, I inadvertantly escaped out of this Abyss in 2003. All 17 of my symptoms resolved and continued to improve. However, I still had no idea why I become ill and why I healed. I was shocked, as many of my fellow clinicians, that the answers have been in literature of over 60 years.

In 1962, two researchers clearly documented that stress causes illness, disease, and early death.² I was aware of this data, but I did not connect the dots. I treated my patients from the paradigm that it was my responsibility was to find a structural cause of pain, and I felt badly if I could not find a reason to perform surgery. I aggressively performed fusions for low back pain for the first 8 years of my practice. When a paper out of Washington State³ showed a success rate of less than 25% for low back fusions for pain, I stopped doing them, but did not know what to do.

The healing journey

My current approach represents what I learned from my struggles, witnessing what helped hundreds of my patients heal, and now understanding the science behind these concepts. The DOC Journey course and app and my other efforts are simply a framework that presents documented science in amanner and sequence that is accessible by patients and clinicians. My vision is to connect medicine with known science of chronic stress causing illness, with the fundamental idea being that the doctor patient relationship is at the core of healing. If a patient can’t feel safe with their health care provider, the rest of the treatments are of limited value.

Many people heal with just these self-directed concepts, but outcomes are always better and more consistent with added resources. This framework is intended to allows patients to take charge their care, the clinician can leverage his or her efforts, and provides a long-term template for ongoing learning and healing. It evolved out of my busy practice with increased efficiency, effectiveness, and enjoyment. It is inspiring and energizing to witness patients emerge from hopelessness to thriving.

An important aspect of these concepts is the clinician learning and implementing these approaches in their personal and professional life. A dynamic working partnership can  then be created when both parties understand these healing principles. These resources are an adjunct and/or foundation for other clinical practices, and not an alternative.

Anxiety is a physiological state

It took me many years to realize that anxiety is not primarily a psychological issue. It is the intentionally unpleasant feeling generated by your body when in flight or fight. Avoiding this powerful sensation is the driving force behind human behavior, and much of it is dysfunctional. We are not taught how to regulate our body’s danger response. Our conscious brain is no match and our efforts to control it create a lot of misery for us and those around us.

It is actually a gift that keeps us alive. This survival warning signal is necessary, and the key is developing a “working relationship” with it. It is what you have and not who you are.

This is an article I wrote for Psychology Today regarding the mental health crises.

Obsessive thought patterns and OCD

Crippling anxiety is what almost took me out. It initially manifested with panic attacks and progressed to severe OCD (Obsessive Compulsive Disorder) for over 15 years. The hallmark of OCD is repetitive intrusive thoughts that for me became quite intense. I had “internal OCD” which consists of a disturbing thought following by a compensatory counterthought. There were no external behaviors. So, I had no idea of what was going on, and there seemed to be no endpoint.

OCD is relatively common,⁴ and variations include nail biting, hoarding, body image disorder, skin picking, hair pulling, and eating disorders. Additionally, many if not most people are bothered by disruptive thought patterns or ruminations, which detract from quality of life. One could also consider addictive behaviors in light of efforts to escape these repetitive unpleasant thoughts. Much of the mental health world views OCD and ruminating thoughts as unsolvable and the approach is to manage them. The missing link is that threat physiology is not being adequately addressed. Half the brain consists of glial cells, which have cytokine receptors and are part of the immune response.  A fired-up brain fires off a lot of thoughts.

My hypothesis is that RUTs (repetitive unpleasant thoughts) are a major driver of chronic mental and physical disease by stimulating sustained threat physiology. Humans are trapped by unpleasant thoughts with the main variables being frequency and intensity. They are a universal function of human consciousness. They may be a significant factor in driving teens to commit suicide, “deaths of despair.” However, I am seeing RUTs create misery in every age group, and as young as 6 years old. RUTs were the main source of my misery followed closely by social isolation.

I no longer suffer from OCD, and I escaped from this Abyss over 20 years ago. I don’t even have the disruptive thoughts I had before I became ill. It has taken many years to figure out how and why I escaped from these obsessive thought patterns. High level achievers are particularly prone to them. This is a link to the section I created on my website that presents my concepts of a solution.

This RUTS section is a rough outline of my upcoming book. Solutions are discussed first and the background of the problem later. There is a large body of research of the mental mechanics of the brain, physiology, consciousness, and effects of stress. I learned a sequence of healing while helping many other people out of this hole and it continues to evolve.

Action needed soon

The burden of chronic disease continues to rise in the US and lifespans are dropping compared to other developing countries. We spend almost four times as much per capita as any other nation.⁵ The business of medicine has essentially kidnapped all of us – clinicians and patients. How can thoughtful decisions be made without patients feeling heard and clinicians not understanding all of the dimensions of their lives generatingthreat physiology (anxiety)?

Performing risky and expensive interventions that are not data-based are causing a lot of harm. “First do no harm.” Individually and as a society, do we embrace this core manifesto or is this just rhetoric? I feel there is some urgency for change as the fabric of our society is coming apart.

Clinicians allied with patients are the only possibility of taking back our medical care. It will require ongoing collaboration from all parties. Whether my resources or another similar set are utilized, we have to treat people in a manner that honors the body’s physiology and capacity to heal. We have the data. Let’s implement what we already know!

References

1. Carragee EJ, et al. “A Gold Standard Evaluation of the ‘Discogenic Pain’ Diag­nosis as Determined by Provocative Discography.” Spine (2006) 31:2115-2123.
2. Holmes TH, Rahe RH. The Social Readjustment Rating Scale.J Psychosom Res (1967); 11:213–8. doi:1016/0022-3999(67)90010-4
3. Franklin GM, et al. “Outcome of lumbar fusion in Washington State Workers’ Compensation.” Spine (1994); 19:1897–903.
4. Carmi, L., Brakoulias, V., Arush, O.B.et al. A prospective clinical cohort-based study of the prevalence of OCD, obsessive compulsive and related disorders, and tics in families of patients with OCD. BMC Psychiatry22, 190
5. Bezruchka S. Increasing Mortality and Declining Health Status in the USA: Where is Public Health?Harvard Health Policy Review [internet]. 2018.

The post David Hanscom’s Mission and Resources first appeared on Back in Control.

The post David Hanscom’s Mission and Resources appeared first on Back in Control.

1. Repetitive Unpleasant Thoughts (RUTs) are solvable with a multi-pronged self-directed approach.
2. Consider the four aspects in the metaphor of a popcorn machine.
3. They are 1) the kernels 2) the cooking pot 3) the storage compartment 4) the power source.
4. All facets must be addressed daily, so the only person that can solve them is you.

You cannot control your thoughts and the “need for mental control” is what causes so much trouble. RUTs are solvable by approaching them from all of these perspectives.

• Thought diversion
• Calming the nervous system
• Redirecting your brain towards positive circuits
• Dissolution of your ego

Consider these aspects of calming your mind as a metaphor of a movie theater popcorn machine. The kernels of corn represent your disruptive thoughts. The cooking pot is your fired up nervous system. Obsessive thoughts are the popped corn, and the storage area is your working memory.

Thought diversion

Having fewer kernels of corn enter the cooker is an important step. You can divert your thoughts in several ways.

• Expressive writing
• Mindfulness/ active meditation
• Cognitive behavioral approaches – recognizing and separating from cognitive distortions.

Expressive writing in its various forms is simply a separation exercise. Your thoughts are on a piece of paper separated from you by vision and feel, both part of the unconscious brain. It is critical to immediately destroy it, so you can write with absolute freedom. It is the most miserable and disturbing thoughts that we suppress the most. As your body chemically reacts to them, they become real and part of your version of reality. The reality is that they are who you are not. The other reason to destroy them is to not analyze them. They are not “issues”, they are just thoughts. Rehashing them creates more of a tangled mess.

Mindfulness/ active meditation puts your attention on physical sensations that creates a shift away from your racing thoughts. It can be any sensation and can last for just a few seconds . Or you can train yourself to live much of your day in a mindful manner. Instead of doing battle with these thoughts, you have turned away from them.

Another strategy is cognitive behavior therapy (CBT). David Burns has defined ten categories of cognitive distortions that impact our decision-making and quality of life. Instead of believing these distortions, you can train your brain to recognize them for what they are, separate from them, and move on. The beauty of cognitive distortions is that there is nothing to do since they are not real in the first place.

Turning down the heat – anger

The second aspect of calming down the nervous system, is represented by “turning down the heat” of the cooker. We know that unpleasant thoughts fire up the nervous system, but an inflamed brain also throws off more extraneous thoughts. Notice how your mind races when you are upset or feel trapped for any reason. You are fighting for a way out. This is the basic survival response for a physical threat that increases your chances of survival. It doesn’t work for emotional survival. Fighting your thoughts not only increases the intensity of them, but you are also consuming a lot of fuel (glucose), as your brain consumes between 20-25% of your metabolic energy. Additionally, the activity of your brain shifts from your neocortex (thinking region) to the limbic region (survival areas) and you are unable to think clearly. The creativity you need to solve a problem is compromised.

Anxiety is the sensation generated by an activated threat response and anger is a hyperactivated one. They are physiological states and not primarily psychological. Your unpleasant thoughts are sensory input and emotions are what you feel (physiology). Anxiety and anger are the same entity, varying in intensity. Anxiety evolved to be extremely unpleasant, as it is the driving force to avoid danger and survive. The solution to anxiety is solving the threat. But when the problem is unsolvable, your body increases the survival response, and you’ll be angry. They are both activated physiological threat states.

Anxiety and anger are hardwired reactions that we have no control over. If you are triggered, you are triggered. What you do have a say about is your response to it. You can regulate your physiology through three different portals.

• Input – how you process your stress
• Lowering the reactivity of your nervous system – sleep, diet, exercise, somatic therapy
• Output – tools to stimulate the vagus nerve, which is highly anti-inflammatory – breath work, humming, listening to certain pitches of music, and vagal stimulation.

My term for dealing with anger is “anger processing.” There are many layers to it and none of these are difficult. It is a learned set of skills that are used daily and indefinitely. Unless you learn to lower this powerful (and addicting) survival reaction, you will continue to experience intense repetitive thoughts.

To have a good life, you must live a good life

The real and definitive healing occurs as you nurture and live the life that you want. Re-directing your attention to pleasant circuits is a separate set of skills. You cannot be really creative if you are continually fighting RUTs.

This is represented by how you deal with the popped kernels of corn. Over time, your attention may become consumed by unpleasant thoughts and the holding area of the popcorn machine is filled up. There is nowhere to go. By diverting the thoughts and turning down the heat, there will be less popcorn. But regardless of how quickly the machine fills up, it must be emptied to create some “space” for new input to allow for the sequence of stimulating your brain to change (neuroplasticity). The sequence is awareness, creating some space, and then redirecting your attention to what you want.

This “space” can be created in many ways including adequate sleep, exercise, anti-inflammatory diet, not discussing pain, etc. If you are trying to compensate for your anxiety with distracting activities, it is not possible. Your survival brain is too powerful. It is the reason that thought diversion and effectively processing anger are so critical. Then you have choices. Eventually, as you become more engaged in the life that you want and remain connected to it, obsessive thoughts are crowded out.

Pull the Plug – Ego dissolution

The driving force of ego is the pursuit of self-esteem, which It is an ongoing judgment pattern without an endpoint. It consists of an endless stream of thoughts and stories, most of which are cognitive distortions. You’ll wear down, RUTs will increase, your physiology attacks your own body, and you may become ill. BTW, self-esteem is a core cognitive distortion of “labeling.” As you develop your own story of who you are, it takes a lot of mental energy to maintain and defend it. Hence, a whirlwind of competing thoughts.

The final step of dissolving your ego, is the definitive solution. You cannot force or make it happen. You are allowing it to dissolve with awareness as the other three aspects are in play. The kernels of corn (unpleasant thoughts) dramatically decrease when there is no need to defend your ego and let go of pursuing self-esteem. You have “pulled the plug”  and remain connected to the present moment.

Recap

RUTs fire up the nervous system and an inflamed nervous system fires up RUTs. Both aspects must be addressed to decrease and essentially resolve RUTs. Definitive healing happens as your brain shifts to creative and functional circuits. Eventually, you’ll understand the futility of chasing self-esteem to offset your powerful flight or fight neurochemistry. Without having to defend your “identity”, disruptive thoughts will fade away.

Instead of being all that you can be, it is much easier to “just be.” There is no place, physically or mentally, that you have to go to. As your mind quiets down, you can just enjoy your day and appreciate the moment you are in.

Questions and considerations

1. Consider how much RUTs interfere with your enjoyment of life. Maybe they are minimal. Or have they been present for so long that they seem normal?
2. OCD is a diagnosis that has limited value. It does imply an intensity of bothersome thoughts that disrupts your ability to function in daily life. But at what tipping point would you call RUTs OCD?
3. Consider all aspects of healing. They are all important and happen simultaneously every day without an endpoint. As you increase your skills, they become habitual, requires little effort, you create “space” to reprogram your brain, and move forward away from these circuits.

The post The Popcorn Machine – Healing RUTS first appeared on Back in Control.

The post The Popcorn Machine – Healing RUTS appeared first on Back in Control.

• Mental and physical pain are processed in similar regions of the brain.
• Our inability to escape from RUT’s relentlessly drives flight or fight physiology, and people may become ill.
• There is a healing sequence to solve them – separation of identity, thought diversion, lowering anger, moving into creativity, and dissolving your ego.
• It is a dynamic process with all of these happening daily. Eventually, as it becomes automatic, and you are free to live your life.

Obsessive Compulsive Disorder (OCD) is manifested by extreme anxiety that is driven by Repetitive Unpleasant Thoughts (RUT’s). Most people associate it disruptive compulsive behaviors such as hand washing, climbing up and down stairs, following a rigid daily regime, and the list is endless. However, there is also a form of OCD called, “internal OCD” where a person has an unpleasant thought and “counteracts” it with a pleasant thought. Either form has no endpoint and is considered a diagnosis to be managed and not solved. That is simply not true.

RUT’s are universal

Essentially every human being has some level of RUT’s. At what point do they become severe enough to be considered OCD? Why not discard the diagnosis and consider the process on a spectrum of human consciousness. The classic definition of OCD is when the thoughts/behaviors interfere with your capacity to carry out activities necessary to live a functional life.

What about enjoying your life? With internal OCD, there are no outward manifestations, but your quality of life might range from unremarkable to miserable. There also many “acceptable” behaviors such as working hard, overexercising, “passionate pursuit” of a hobby or vocation. All of these can be just fine, but what is driving them?

As I have talked to patients carefully over the 40 years, I gradually learned that mental pain is a much bigger problem than physical pain. I would ask patients that if could get rid of their physical pain with surgery and they would still have their ongoing anxiety versus resolving their anxiety and living with the pain, the majority of people wanted to get rid of the mental pain.

Related behaviors

There are also come cousins of OCD. Consider them in the context of behaviors to cope with the unpleasant sensations created by anxiety (threat physiology). They include:

• Hair pulling
• Nail biting
• Eating disorders
• Excessive attention to physical appearance
• Hoarder’s syndrome
• Skin picking
• Cutting
• Extreme convictions regarding religion, politics, or any social issue
  • Imposing these “ideals” on others is the next step because control lowers inflammation. The more power the more control.

Any addiction is an attempt to mask anxiety.

Avoiding anxiety (threat physiology) drives most human behavior

Avoiding anxiety is the driving force keeping all living creatures alive. It is the result of stresses and challenges, not the cause. Amongst the many stressors in our lives, the inability to escape from our thoughts is a major one, maybe the worst. Although we cannot control our thoughts, many activities create sense of control. Suppressing RUT’s just makes them-worse.

“Worrying” seems normal to many people. But is not particularly enjoyable. Why do we spend so much time worrying about so many things, many of which we have no control over? One reason is that it provides a feeling of control. Somehow, worrying enough will help solve the problem. What it does is that it keeps your brain and body fired up and you have less energy to effectively deal with challenges.

Or maybe you have an “anxiety disorder.” Everyone has anxiety, so why would we call it a disorder and why would you personalize these intentionally unpleasant sensations that evolved to keep you alive. It is what you have, not who you are.

What about those who don’t have any of these behaviors. Even many well-adjusted people living normal enjoyable lives can experience a level of RUT’s that interfere with their quality of life. Actually, when life is relatively calm, these repetitive thought patterns can significantly increase. Then as one pursues pleasurable activities to distract themselves, it doesn’t work and is actually highly inflammatory. The data shows that a hedonistic lifestyle creates aggressive inflammatory cells called “warrior monocytes.” In addition to attacking viruses and bacteria, they also go after your own tissues. The other factors that stimulate their formation is social isolation and CHRONIC stress.¹ Your body knows how to effectively deal with acute stress, but it needs a break to rest and regenerate.

Degrees of OCD

Obsessive thought patterns are inherent in human cognitive consciousness. There are degrees of intensity, and they vary day-to-day depending on the level of your stressors and the state of your nervous system – calm or hyperactive. Again, even if your life is relatively calm, they can also be problematic.

OCD, the extreme manifestation of this situation is considered a diagnosis to be managed and can’t be solved. However, medicine has not consistently addressed the body’s physiology. When you are in a flight-or-fight state, your brain also becomes inflamed and these thoughts will fly out like clay pigeons at a shooting range, except there are trillions of them. The medical profession has also not acknowledged the seriousness of the effects of less intense RUT’s on people’s sense of well-being and health. They still drive threat physiology. They are often referred to as a “monkey mind” or he/ she is just having a nervous breakdown. These thinking patterns are a problem and our inability to escape them is even more problematic.

Solution principles

There are four aspects of solving RUT’s and each of them will be discussed in detail in future posts. They all happen simultaneously and indefinitely. Eventually, as your brain evolves away from them, you no longer have to “work at dealing with them. They are:

• Diverting, not controlling, them – mindfulness, expressive writing, cognitive behavioral therapy (CBT)
• “Turning down the heat” – when you are trapped by anything, your threat state fires up even more, and you are angry. Anxiety is activated and anger is hyper-activated threat physiology.
• Nurturing creativity and joy. This is where the real healing occurs as you move away from these spinning circuits.
• Dissolution of your ego – we work hard to attain enough self-esteem to feel better about ourselves. However, most of it is based on cognitive distortions that drive RUT’s even more. Without an ego to defend, these racing thoughts will abate – often dramatically.

This set of approaches evolved from my own 15-year ordeal with severe “internal OCD.” Not only do I not experience these vivid, almost visual thoughts, I don’t seem to have the random distracting thoughts I had before I became ill. There is also a vast amount of research looking at the mechanisms of why and how they occur, and now there is lot of neuroscience data supporting these ideas. The challenge is to present them in a manner so you can pursue your own healing journey. No one else can do it for you.

As your brain heals, your body heals. As your body heals, your brain will heal. The reality is that they are just part of one unit – you.

Recap

Our inability to escape our unpleasant thoughts is inflammatory. Since half of your brain has inflammatory receptors, it also fires up. The diagnosis of OCD is considered to be relatively uncommon, except many people suffer from RUT’s that interfere with the quality of their life. Obsessive thought patterns are considered to be unsolvable and just managed. However, medicine is not generally addressing the physiology. There are four aspects of dealing with OCD that will lower the intensity of these thoughts:thought diversion, lowering anger, moving into the creative part of your brain, and allowing your ego to dissolve. They are solvable.

 Questions and considerations

1. What percentage of your waking hours are you occupied with racing thoughts?
2. Do you find yourself avoiding thinking about certain things? Do you notice how often they keep popping up?
3. Are you aware how common they are and how many people are bothered by them?
4. The medical world doesn’t consider OCD a problem that can be solved and the lesser issue of RUT’s is not often addressed. By using all of the approaches presented, they are not only solvable, but you can move into a wonderful life
5. RUT’s are a function of the mechanics of the mind. Talk therapy alone is ineffective and it can be likened to having a conversation with the engine of your car.
6. It is important to understand that these “stories” and thoughts become embedded in our brains as concretely as any physical object. The problem is that since this is your frame of reference, how can you really see the problem? They become normalized.

 References

1. Cole SW, et al. Social regulation of gene expression in human leukocytes. Genome Biology (2007); 8:R189. doi:10.1186/gb-2007-8-9-r189

The post Four Aspects of Solving RUT’s first appeared on Back in Control.

The post Four Aspects of Solving RUT’s appeared first on Back in Control.

Loneliness causes many physical problems including a higher mortality rate equivalent to smoking 15 cigarettes per day. Mental health problems continue to increase and approximately 1 in 6 adults suffer from a mental health condition. Most also suffer from loneliness. (1)

Anxiety is the driver

I have observed from working with many patients and my own experience with loneliness during my ordeal with chronic pain, that there is a circular interaction with anxiety, anger and becoming isolated.  For many, I feel the starting point is anxiety, which is the pain.

There are an endless number of reasons for humans in this day and age to have disruptive anxiety. This has been endlessly discussed in the media. However, once it kicks into gear, there is no turning back and it will become relentlessly progressive. Since is an automatic unconscious survival response that is much more powerful than your conscious brain, you can’t control it or solve it with rational means. You also will never be rid of it, since without it, you would not survive for more than a few minutes.

The key to lowering anxiety is learning to assimilate it into your life. It is intended to be unpleasant, since it is your basic warning system. As you learn to work with it and quit fighting it, you will be able to lower your stress chemicals and de-energize it. Anxiety both protects you and also allows you to navigate new challenges.

OCD

The interaction I experienced while in pain was that I was crippled with anxiety in the form of disruptive unpleasant thoughts that evolved into an obsessive compulsive disorder (OCD). I had become a major spine surgeon by suppressing anxiety and wasn’t connected to it. I also thought anxiety was a psychological problem when it actually is simply a physiological reaction to a mental or physical threat.

As my anxiety progressed, I became more isolated. My patterns of thinking changed dramatically, and I was consumed with thoughts of self-deprecation and why would anyone want to hang out with me? This was occurring in spite of me historically being a social person to a fault. I had a wonderful group of friends from middle school on. There was no new activity I was not up for trying. In college, I took more than a full academic load, worked heavy construction 10-20 hours a week, played intramural sports, and spent a lot of time with my friends. I don’t remember sleeping much.

Trapped

As I spiraled down with progressive anxiety, I became severely depressed. I now know that depression is a group of symptoms driven by anxiety. The isolation progressed rapidly over five years, in spite of having warm and very nice people around me. I couldn’t connect. I was so busy trying to survive, I couldn’t reach out to others. As others tried to reach out to me and failed, they eventually quit trying as hard, which only made it even harder for me to. I don’t have the words to describe the feeling, but it was crushing, suffocating and one of most intolerable experiences I have ever had and, even worse, there did not seem to be a way out. I use the word, “Abyss” to describe being in chronic pain. I think the loneliness was a step beyond or below. Even thinking about it 20 years later is causing my stomach to knot up.

My depression became severe. I lost all hope in spite of aggressively seeking professional help and reading many self-help books. One that I picked up was, Darkness Visible: A Memoir of Madness, where the author described his own struggle with major depression. (2) What struck me was that he was famous, wealthy, and had recently received a lifetime achievement award for his literary excellent. In spite of it all, he was miserable. What struck me about his story, is that he didn’t find or offer a solution. He  had nowhere to go and just remained in one spot. I couldn’t explain what happened to me but I felt a deep shift. That is all I can say. I did not immediately begin to heal, but I somehow realized that I was on the wrong track in my endless pursuit of a cure. The answers where inside of me. In an odd way, I gave up, which turned out to be the eventual answer.

It is OK to be on “The Bottom”

It is OK to be depressed. Anxiety is normal and fighting it gives it more power and it does become disruptive. Your brain will develop wherever you place your attention, especially if you are suppressing. By remaining still, I gave myself some space to heal. I become aware of many aspects of my life and experience that weren’t possible while I was traveling so fast. I quit trying to fix myself and inadvertently allowed my brain to heal. I became more connected to me.

This song is written and performed by my nephew, who I have spent many hours talking to about anxiety, depression, and life. His struggle with it was epic but he not only made it through, he is thriving. One of his gifts from the ordeal is having insights into the magnitude of the problem and has a deep appreciation for life. This song, The Bottom, reflects his perspective.

Alex Hanscom – The Bottom

Learning to be with yourself, including your fears, is key to moving forward in life on your terms and not at the mercy of other’s opinions. It is also much easier and you are able to reach out to others and be aware of their needs. It works the other way around in creating an upward spiral. I have rekindled many friendships because I have healed, but my connections are also part of the healing journey.

1. Cigna U.S. Loneliness Index. Published survey results, 2018.
2. Styron, William. Darkness Visible: A Memoir of Madness. Random House, New York, NY, 1990.

The post “The Bottom” first appeared on Back in Control.

The post “The Bottom” appeared first on Back in Control.

A functional pain system is critical to your health and even survival. He presented several stories of children born without a pain system. Their body quickly becomes deformed from over-stressing their joints and skin breakdown. The average lifespan of these children was only 15 years. I knew him when he moved to Seattle to be close to his family. He was over 90 years-old and still writing and lecturing all over the world. He was one of my true inspirations.

My Gift

I have slowly realized that I have been granted a similar gift that I did not want, nor would I accept it again if it were offered to me. It is the gift of prolonged severe suffering in the form of both physical and mental pain. I slipped into an anxiety-driven depression/ burnout in 1988, and developed symptom after symptom of the Neurophysiologic Disorder (NPD). At one point I was experiencing 16 of the over 30 symptoms outlined by Dr. Schubiner in his book, Unlearn Your Pain.

OCD

The worst part of the descent into oblivion began in 1995 when I developed a full-blown Obsessive Compulsive Disorder (OCD). I had always thought it was a loose term for some compulsive habits and felt it was some type of TV joke. It is the ultimate anxiety disorder manifested by intense, repetitive intrusive thoughts. They never stopped and became increasingly intense. By 2002 I was done and ready to check out. I will never completely understand why I survived. I have 18 medical colleagues that have committed suicide. Most recently it was one of my best friends in the spine surgery world and the other was an orthopedic surgeon acquaintance that I did some business with. Both had everything life that one could ask for.

While I was living in Sun Valley, six men between the ages of 45 – 60 committed suicide over a span of 18 months. All were extremely successful and prominent in the community. Why?

Anxiety

Raw anxiety is intolerable. It mental pain that I couldn’t escape. I cannot describe my suffering in words. My best metaphor is a “branding iron on my brain.”

I got extremely lucky in pulling out of it. In 2002 I began to heal and by 2004 began to thrive. The last five years have been the richest I could ever imagine. All of my NPD symptoms resolved, and flare only if I quit practicing the principles I have outlined in my book. So what are my gifts? This does not sound that convincing yet. They are many:

My Gifts

• Every day I am alive I can appreciate it at a depth I could not have imagined. It is a marked contrast to extreme suffering.

• I can look any patient in the eye and let them know that I understand your suffering. “You may be suffering as much as I suffered but not more.” I know where they might be going and where they are at as the come out of “The Abyss.”

• I understand the endless quest to find the one answer to the pain.
• I know loneliness.
• I did not have a shred of hope. NONE. Having the physical surroundings of success made it even worse in that I had worked so hard to attain them and I was still miserable. My efforts to find happiness had not worked. That included friends, family, and incredible experiences. I could not run from my mind. If none of that worked I developed a deep feeling of desperation of,  “What do I do next?”

• As I have learned to accept myself (the medical world is not an accepting culture), I can accept my patients wherever they are at. I know them better and it is one of the most enjoyable aspects of my practice.
• I have learned when I can help and when I cannot.

• I no longer let patients make surgical decisions when they are under extreme personal stress. In the past I never really was aware of the degree of their personal suffering in addition to the pain. The lines between mental and physical pain overlap.

• I saw patient a few months ago who came to me for a second opinion. She had seen a surgeon for correction of a spinal deformity. She did have the deformity and surgery would have been helpful. The problem was that she was scheduled for a 10-hour procedure just a week after meeting the surgeon for the first time. A month earlier her 34 year-old daughter had died of cancer.

Gratitude

The greatest gift has been gratitude. That was not a familiar word for me until a few years ago. I was charging full steam ahead just doing the best job I could. I am grateful that I am able to share the tools I learned coming out of my burnout and witnessing so many patients experiencing the same success.

I am a surgeon and do not understand all of the reasons why the dramatic turnarounds occur with such regularity. I am not a neuroscientist. But it is a completely unexpected phase of my career and is incredibly rewarding.

The post The Gift of Pain – Thanksgiving 2013 first appeared on Back in Control.

The post The Gift of Pain – Thanksgiving 2013 appeared first on Back in Control.

Dr. Sarno

He is a well-known physiatrist who described the “tension myositis syndrome.” (TMS) I had been familiar with his observations described in his best-selling 1984 book, Mind Over Back Pain. He felt that the nervous system was created muscle tension and inflammation. He also made the astute observation that anger or rage was a critical factor in the evolution of chronic pain. He was partially correct about the anger, but modern neuroscience research has shown that the symptoms are created from the physiological response to threat and not primarily from muscle tension.

Dr. Schubiner

Howard Schubiner is a pain physician who practices in Detroit, MI, who spent time with Dr. Sarno. He has authored a book, Unlearn Your Pain, which addresses chronic pain as one of the symptoms of the Mind Body Syndrome (MBS), which is another name for the tension myositis syndrome. I have chosen the term, Neurophysiologic Disorder (NPD).

In March of 2011, he was one of the keynote speakers of a seminar I co-chaired, A Course on Compassion-Empathy in the Face of Chronic Pain. I had a vague understanding of what I had been through but was still searching for more answers. As I sat in the lecture I had a deep insight into my experience and it instantly all made sense. He concisely presented the over 30 possible symptoms of stressed nervous system and I realized that I had experienced almost half of them. In chapter five of his book, Unlearn Your Pain, Dr. Schubiner lists 33 symptoms of NPD (He uses the term Mind Body Syndrome).

The Neurophysiological Disorder (NPD) – Make the Right Diagnosis

As your nervous system is connected to and controls every cell in your body, the potential symptoms and combinations are almost endless. Mainstream medicine does not embrace these concepts and that would, historically, include me. I have both watched it and experienced it. Our medical culture has “medicalized” a neurological diagnosis. The first step in being successful in treating any disease is making the correct diagnosis.

My Experience with NPD

Here is the list of my symptoms of NPD. I will tell the stories in detail in later posts.

• Migraine headaches
• Migratory skin rashes
• Severe burning in both of my feet
• Obsessive compulsive disorder
• PTSD
• Anxiety/panic attacks
• Severe depression
• Chronic tendonitis
• Heartburn/acid reflux
• Tinnitus
• Insomnia
• Back/neck pain
• Tension headaches
• Unrelenting itching
• Chest pain
• Palpitations

Every one of these symptoms has vanished or is at a level that causes minimal interference with my quality of life. However, if I quit practicing the principles that I am teaching some of my symptoms will re-occur in about two weeks. These are permanent pathways. Usually my ears will begin to ring, my feet will burn and a skin rash will appear on the back of both of my wrists.  Fail well

Terminology

There have been many attempts at using a term to describe the array of symptoms that occur when your body is full of adrenaline and cortisol. These terms include:

• Tension Myositis Syndrome (TMS)
• Mind Body Syndrome (MBS)
• Stress Illness Syndrome
• Central Sensitization Syndrome
• Neurophysiologic Disorder (NPD)

All of these terms are describing the same process. Any stress, perceived or real is going to put your body into a fight-or-flight mode and you will experience multiple physical symptoms. The key to healing is feeling safe, which creates a wonderful chemical environment where you can both physically and mentally thrive. It is a learned skill that is not difficult.

The post My Battle with NPD first appeared on Back in Control.

The post My Battle with NPD appeared first on Back in Control.