• Honor your suffering. You are trapped by physical and mental sensations without an apparent way out.
• You feel extremely isolated but many people in this hole (The Abyss) are also suffering badly. You are not alone.
• Your rightful frustration (rage) fires up your symptoms even more.
• Systematically learning and using tools to calm your body, will allow you to heal.

The Depth of Your Suffering – Darkness

All of us seek safety – physically and mentally. When we don’t feel safe, our bodies switch to a flight or fight mode, and we feel stressed. Another descriptive word is “anxious”, which is simply the feeling generated when you sense danger. We yearn for safety and detest anxiety, and when we can’t resolve the problem causing us to feel uneasy, we feel trapped. The word for this more intense bodily response is anger. It is our last-ditch effort to regain control and feel safe. When we still can’t escape a real or perceived threat, our bodies break down with the outcome being chronic mental and physical diseases.

Anxiety and anger are not psychological constructs; they are your body’s warning signals, and they evolved to be intentionally unpleasant. They are the pain and are manifested in many ways. Even with physical symptoms, the cause is unclear. There are reasons. Chronic stress translates into threat physiology (how your body functions), which causes symptoms, illness, and disease. Unless you know how to effectively process stress, you are trapped.

Feeling trapped causes deep suffering, creates many problems. BTW, everyone suffers. There are degrees, and not having basic needs met such as safety, food, shelter, and companionship creates havoc with every aspect of your health and life. I do not want to dishonor this level of suffering. For example, the incidence of significant anxiety issues is 100% if your income level is less than 19,000/ year.¹ This is 1994 data that translates in approximately $38,000 in 2024.

We are also trapped by being a species with language, abstract thinking, and awareness of the finite nature of life. We can’t escape death. In addition to our physical challenges to staying alive, we cannot escape our thoughts. We have no protection from mental pain and suppressing unpleasant thoughts inflames the brain even more. These translate into RUTs, (repetitive unpleasant thoughts). They are universal varying in severity and frequency. The range is:

• Occasional unwanted thoughts
• Repetitive thoughts
• RUTs
• Repetitive disruptive thoughts
• Invasive thoughts

 “The Abyss”

One afternoon, I was listening to a patient attempting to describe the depth of her suffering and it hit me how deep and hopeless this hole is for most people. I realized that words were inadequate to encapsulate the degree of misery. Since no one seemed to have any answers, there was no apparent way out. The description that seemed to fit for this dark, bottomless pit was “The Abyss”.

A recent research paper documented that the effect of chronic pain on one’s life is similar te the impact of terminal cancer.² You hadn’t anticipated the possibility of your life being consumed by pain. The paper showed that chronic pain was worse in that with cancer, you at least know the diagnosis and there is an endpoint, one way or the other. This statement might sound harsh in that suffering from terminal cancer is horrible, but ongoing pain (mental and physical) without knowing if there is an endpoint is even worse.

A stark example of how uncertainty can eat away at you is illustrated in Dr. Viktor Frankl’s book, Man’s Search for Meaning.³ He was an Austrian psychiatrist who was imprisoned in a concentration camp during WWII. He lost several close family members and experienced unspeakable horrors. As he describes his personal experience, it is difficult to imagine anyone enduring even a fraction of what he witnessed and endured. Yet, he points out that the worst part of it all was not knowing when it was going to end. 

Life in The Abyss

In addition to other life stresses, patients are trapped by unpleasant mental and physical symptoms, illnesses,and diseases. You are also trapped by the medical system, which is not consistently showing you a way out. Over time, you become discouraged (despondent). My equation for it is:

The Abyss = Anxiety/Anger x Time

Why isn’t pain part of this equation? It is because anxiety is the pain. When you are stuck in a whirlpool of relentless anxiety and frustration, life goes dark.

How deep is this hole? Here is a short list of the suffering I have encountered both personally and witnessed in my patients.

Losses include:

• Independence
  • Financial
  • At the mercy of the disability system
• Capacity to enjoy good music, friends, fine food, and hobbies without the experience being marred by pain
• Peaceful family life
• Feeling good – there are over 30 symptoms created by a chronically activated nervous system. There are also many other mental and physical disease states. Your body breaks down.
• Integrity – people don’t believe you and often the harder you try to convince your friends, family, peers, employers, and health care providers, the less you are believed.
  • Being labeled – malingerer, drug-seeker, lazy, not motivated, and difficult
• Unlimited physical activity
• Peace of mind – RUTs are relentless and may be the worst part of the ordeal.
• Hope – this may be the worst aspect of it all. Repeatedly having your hopes dashed induces a depression.

No Way Out

Consider the depth of “The Abyss.” Your soul is being pounded into the ground by a pile driver of anxiety/anger as you remain trapped in your body, riddled by mental and physical pain. Your life is being systematically destroyed, but in some cruel cosmic joke, you’re alive to bear witness – without hope. This dark place in your mind is unusually deep – bottomless. And no one is listening………

Recap

Allow yourself to comprehend the depth of your suffering and degree of damage your pain has inflicted on your life. Awareness is the first step in successfully reversing this downward spiral. Right now, you are at the bottom, except there is no bottom……

Chronic illnesses are complex and random treatments can’t and don’t work. It is necessary to break your unique situation into its component parts and systematically deal with them. There is a way out of this incredibly dark place, but you cannot go from the depths of suffering to better health with willpower and belief. As you methodically acquire knowledge and skills to deal with each aspect of your situation, you’ll be able calm and re-route your body to break free and heal.

Questions and considerations

1. First, give yourself a break. You are suffering badly. Many treatments have failed, and you may even be worse. No one seems to be able to show you a way out or even offer hope. There is no reason to have positive feelings about any of this. Allow yourself to feel the depth of your suffering and frustration. Express it a piece of paper and immediately tear it up. A few people have difficulty processing the feelings released with this exercise, and if you feel uncomfortable, immediately stop.
2. Consider what is important to you in life, but you can’t access or experience them. Write down two or three things you would like to experience. Not being in pain is not one of the choices. You’ll see why as the course unfolds and it is also a given. None of us want to be in pain.
3. List three to five of your most intolerable symptoms. For many people, the relentless onslaught of unpleasant thoughts is the worst aspect of it all.
4. Give yourself credit for staying on your feet long enough to keep trying. A willingness to learn and practice is the number one factor predicting success.

 References:

1. Kessler RC, McGonagle KA, Zhao S, et al. Lifetime and 12-month prevalence of dsm-iii-r psychiatric disorders in the united states: Results from the national comorbidity survey. Arch Gen Psychiatry. 1994; 51(1): 8-9.
2. O’Connor AB. Neuropathic pain: quality-of-life impact, costs, and cost effectiveness of therapy. Pharmacoeconomics (2009); 27: 95- 112.
3. Frankl, Viktor. Man’s Search for Meaning. Beacon Press, Boston, MA, 1959,1962,1984, 2006.

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Disneyland

While in medical school, I was at Disneyland with several of my friends. I had been there many times and one of my favorite rides was “Pirates of the Caribbean”. I enjoyed the music, art, and the general excitement of it all. The sensation of quickly sliding down to the next level in a boat was also a lot of fun. For some reason, I suddenly looked at the pirate scenes more closely.

“Pirates of the Caribbean”

As we entered the large room with a captured ship, there was a terrified bound woman getting ready to walk the gangplank. Behind her, several pirates were gleefully observing while getting the next victim ready. The scene of the captured town in flames showed a group of young frightened women on a platform being auctioned off to the highest bidder. Three or four women were being chased around the burning buildings attempting to escape their pirate pursuers. Several pirates were lying on the ground drunk, disinterestedly watching the whole scene. Another prisoner was trapped in a burning jail cell trying to persuade a dog to come closer, as the dog had the keys to the cell in his mouth.

We entered the main pirate’s lotto, which had piles of loot scattered everywhere. There lay the drunken captain, lounging in the midst of it. Many personal items were depicted in the middle of the mass of treasures.

“Pirate’s Cove”

Many years ago, I was in New England on a family vacation. We were playing miniature golf at a “Pirate’s Cove”. I looked up and there was a cage that housed prisoners until they starved to death. On each hole there was a continuing story about Captain Blackbeard. Part of the tale involved his marriage to his 12^th wife who was 16 years old. The governor of the state attended the wedding, as it was a major societal event.

Why?

What is it about pirates that we admire and romanticize so much? What characteristics should we embrace? The aspect I find particularly disturbing is that their terror is guised under the cloak of light fun and entertainment. This exposure begins in childhood for essentially all of us.

They rob at will. They not only just kill their victims, they often use perverse methods of torturing them to death. What is admirable about raping and selling women and children? The prisoner potentially being burned alive did not seem much of a concern to them. Why did the governor of a Southern State attend the marriage of a brutal older man to an underage girl? Why did I need to learn about that story while enjoying an evening of miniature golf with my family? Society has frowned on divorce for centuries. What about 12 marriages?

Do we admire what the Nazis did to their prisoners? Are their unspeakable deeds minimized in children’s rides or miniature golf courses?

My relative as a pirate prisoner

In the late 1700’s, I had a distant relative who was captured by pirates. My genealogist brother researched the story. He was one of 30 prisoners that were allowed to live, but they were enslaved. The conditions were so harsh that after three years only three were left alive. Thomas Jefferson finally paid his ransom. He was so brutally treated that he was disabled for the rest of his life. He passed away a few years after his ordeal. Another entire Hanscom family was murdered in a different pirate raid.

Packaging evil deeds in fun – normalizing abuse

It’s my feeling that when horrible deeds are packaged and presented in a way that minimizes the severity of their effect, it has a corrosive effect on who we are as humans. It becomes easier to ignore things around us that are unacceptable. Verbal abuse would be one of those amongst an infinite list.

Might this be confusing for children? They are taught to treat those around them with respect, yet simultaneously are being presented with the idea that being a pirate would be somewhat of the ultimate dream – freedom to do whatever you want to whomever you want without consequences.

I have worked with a medical system in Alaska that provides high quality medical care to a population of Native American Indians. They have recognized that abuse of any kind is detrimental to one’s health and the data is clear that an abusive upbringing is associated with poor mental and physical health. They have committed to eliminating abuse within this generation and have developed a remarkable infrastructure to address the problem. Several of the programs are focused on victims telling their stories. What I had not realized was the severity of the abuse and it is so common that in many villages it is the norm. The population had become de-sensitized to the problem although they weren’t de-sensitized to the suffering. It’s a terrible cycle. Bringing the abuse into awareness through telling their stories has been a major step in defining the problem and solutions are being implemented. Awareness is always the first step in solving a problem in any domain.

Aced out

Awareness of suffering

I have become acutely aware of my own suffering and those around me. It was a rough experience that brought me to this awareness. It is now clear to me how violence mixed with entertainment contributed to my inability to really appreciate the depth of others’ pain. Do you find pirate tales and violent movies entertaining? I did for much of my life.

Chronic pain is misery that is endless. Put yourself in the shoes of those poor pirate prisoners and imagine how they must have felt. Consider the suffering of other people around you who are in chronic pain. There are plenty. In the U.S. alone there are over 100 million people in chronic pain.

Awareness

The first step of reprogramming your nervous system is awareness. There’s nothing noble about pirates or the suffering they inflict. Become aware of how becoming desensitized affects your connection to the pain of those around you. If we are to evolve, issues such as these must be addressed both individually and as a society. Calling out the damage inflicted by packaging bad behavior under the guise of entertainment would be a significant concrete step.

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• Many of us become upset about the state of the world, which is definitely worrisome and disturbing. However, you have no control, your nervous system is fired up, and there is not an endpoint.
• We all have plenty of problems that we have to deal with without adding on ones that are irrelevant to our day-to-day life.
• Other tools that lower your stress response will be less effective if you continue to remain agitated about scenarios outside your sphere of influence.
• Learning to let go and focus on what you can change will free up energy and creativity to live a more enjoyable life. As you move towards this life, your pain circuits will atrophy from disuse.
• Creating and shifting onto more pleasurable neurological circuits allows you to heal. This process is at the core of The DOC Journey.
• “Choose your battles.” There are plenty of choices.

We know that the most stressful situations are those that are beyond our control, and it is also stressful trying to avoid stress. It is much more productive to learn to skillfully process it in a manner that has less of an impact on your nervous system and makeup of your body’s physiology. However, there are stresses that we unnecessarily create for ourselves. One common way is to not recognize our “errors in thinking” called “cognitive distortions. The other is mentally getting and remaining upset about situations that we have absolutely no control over. But think about it. We have enough to legitimate worries already. Why do we do this?

Anger is a powerful force and intended to keep you safe. It is a basic reaction and necessary to stay alive. Every living creature exhibits some version of it. Humans are different only in they uniquely possess language and a consciousness. We have to navigate a whole different level of mental threats that are not present in the animal kingdom. They are deadly in that neuroscience has demonstrated the unpleasant thoughts and emotions are processed by your body in a similar manner as physical threats, but you cannot escape from them. So, there is a baseline level of threat that is present for every human being that can become disruptive for many people – maybe most of us.

The essence of humanity – vulnerability

We don’t want to give up our anger because we’ll feel vulnerable, and there are few, if any rewards, in nature for being that way. You won’t survive. What is perverse about the human condition is that the best part of it is having enjoyable relationships with others, which requires awareness and vulnerability. But you cannot give up anger until you can allow yourself to tolerate uncertainty.

There are many ways of holding onto anger, with one of the more common ones being that of taking on the world’s suffering. You can remain angry indefinitely because there is little you can do about most of it. You can only make a difference in your own sphere of influence. Continuing to be upset about circumstances beyond your control, not only drains your energy, but if sustained, translates into unfavorable body chemistry with a much higher chance of developing a serious illness or disease.

Taking on the world’s suffering

There are plenty legitimate reasons to be upset or even enraged in this era of COVID, partisan politics, racism, homelessness, class inequities, elder and child abuse, human trafficking, terrorism, religious/ political persecution, and the list is endless. Which ones are you the most upset about? I have my top five.

Here is a letter from an old high school buddy of mine that reflects the problem. He is suffering from ongoing disabling back and leg pain.

“…… violence in nature is difficult for me, but human cruelty to others is incredibly upsetting. I have been this way since childhood. I am very sensitive, and I almost do not feel at home on this planet. I feel wired and tired at the same time.”

Meaning in the midst of suffering

I suggested that he read two books. One was Man’s Search for Meaning by Viktor Frankl.¹ He was an Austrian psychiatrist who survived the WWII concentration camps and found meaning and purpose in the midst of extreme suffering – even his own.  He made  a choice to thrive regardless of the incredible misery he was immersed in. Few people could accomplish what he did, but he did show us what was possible. There is always a choice regarding how we deal with our daily adversities and the cruelty of the world. Of note, many camp survivors understandably did not do well after the ordeal because of severe PTSD, while he went on to a brilliant career and was a prolific author.

The other book was The Swerve by Stephen Greenblatt² that tells the story of the discovery of an ancient Greek manuscript that contained the poem, The Nature of Things written by Lucretius. This finding was a factor in ushering humanity out of the dark ages. This book takes you into the lives of people living in the 1400’s – the Dark Ages. The extent of cruelty is indescribable and most of the population was controlled by fear and terror. We are fortunate to live in an era that has some level of freedom, although this is unfortunately still not true for many people. However, this reality was the norm for most people for thousands of years. Somehow, Lucretius, in the midst of the darkness of living in ancient times pointed out that all each person can and should do is to live a full, rich and meaningful life.

No one is asking you to be happy about the extreme suffering experienced by many at the hands of others. You don’t have to accept it. However, it is important to focus on whatever you can within your power to make the world a better place. Mentally taking on the totality of the misery of the world and remaining upset is common way of remaining in the victim role. Your life energy is diminished and the net result is that you are not able to be a source of light to those close to you.

Conserve your energy

A Heron

Heron stands in the blue estuary

Solitary, white, unmoving for hours

A fish! Quick avian darting

The prey captured

– 365 Tao³

This is a powerful metaphor for us in that we are responsible for only what is in front of us and within our control. Conserving your energy allows you to act decisively and quickly when it is required to do so. Remaining agitated drains you and is not helpful.

These books drove home that the history of the human race is largely extreme suffering, and we are the lucky to be alive in this modern era in spite of the ongoing challenges. I easily can get stuck on what is wrong and contribute to the world’s collective suffering, or I can step up, learn to enjoy my life, and be a conduit for happiness. This is a choice to be made multiple times every day.

Recap

The essence of healing is using tools and approaches to minimize your exposure to threat physiology. Your chemical state is partially determined by the nature of your input. If you are agitated for any perceived or legitimate reason, your body chemistry will be altered.

Choosing to remain angry about situations that are beyond your control is a sure way to remain upset. It creates a negative baseline perception of life, and makes it more difficult to find enjoyment, which is a physiological state of safety and is the essence of healing.

Letting go of situations that you have no control over frees up a tremendous amount of energy to live a more fulfilled and pleasurable life. You are then able to contribute to the well-being of those close to you. “Letting go” is a learned skill and requires a sequence of steps to acquire it.

This post presents a common way of being and remaining a victim. You may not yet see how this term even applies to you. But it is universal, and anger is an essential  of remaining alive. It is just that you want your anger to be situation specific, appropriate, and time limited. The first step in moving forward is always being aware of where you are.

Questions and considerations

1. The human existence has always been difficult, with one of the most disturbing aspects of it being how badly we treat each other. There is nothing you can do about this situation.
2. There is an endless list of wrongs and injustices to be upset about. Make a list of your top five. It is OK to be upset, but it is not helpful to remain in an agitated state about them. You are not helping you, your pain, or your family. It is a classic way of remaining in a victim role – indefinitely.
3. Remaining agitated, regardless of the reason, will drain your energy, and make it less likely that you will take action to contribute to helping others.
4. If your main contribution is creating a haven of safety and joy within your own home, that is more than enough.

References

1. Frankl V. Man’s Search for Meaning. Washington Square Press, 1959.
2. Greenblatt, Stephen. The Swerve: How the World Became Modern. W. Norton Co. New York, 2011.
3. Deng Ming Dao. 365 Tao: Daily Meditations. p. 14. HarperCollins, San Francisco, CA, 1992.

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• When stresses overwhelm the coping capacity of your nervous system, your body will go into flight or fight physiology.
• You have choices regarding what you input into your nervous system.
• If your attention dwells on disturbing topics, you’ll remain agitated, which fires up the physiology of your whole body.
• You may not be aware of the many ways you’re continually keeping your physiology fired up.

Anger and anxiety are words that describe agitated physiological states and are sensations generated by your body’s response to threats. When states of agitation are sustained, your body’s physiology causes physical damage to your tissues, sensitizes your perception of sensory input, and detracts from your capacity to enjoy life. Mental and physical pain will also increase. To some degree, you are in charge of the information going into your nervous system, and what you choose to input into your nervous system will affect your body’s chemistry (output).

What are you choosing to input?

Living creatures stay alive by scanning their environment and interpreting the resulting sensory input to determine whether a situation is safe or dangerous. Your nervous system coordinates your body’s internal and external responses to adapt and move on. Much of this process of adaptation involves your autonomic nervous system, which regulates your internal organs and the makeup of your body’s chemistry. When you feel threatened, your body reacts by upping its rate of energy consumption (preparing to fight or flee) and kindling inflammation (putting the immune system on guard against wounds). When this physiological state is sustained, you have a significant chance of becoming ill, as you are consuming resources to surivive.¹

Humans have the additional input of consciousness. Any threatening thoughts or concepts will cause your body to go into fight or flight. Consider the various ways we upset ourselves that we have conscious choices about. Simply recognizing the effects and choosing different calming input can significantly change your body’s physiology to a healing state of safety.

UNSOLVABLE PROBLEMS

A common means of becoming and remaining upset is focusing on situations that we have no control over. It is an effective way of maintaining an unpleasant physiological threat state. Dr. Fred Luskin, director of the Stanford Forgiveness Project and author of Forgive for Good,² has a term called, “the unenforceable rules.” His point is that it is fine to wish people would behave in a better manner, but you can’t control other’s behavior; especially at a societal level. It is easy to complain about politics, abuses in almost every arena of life, the unequal distribution of wealth, human trafficking, blatant misuse of power, the educational system, and bullying.  There are endless societal problems to be upset about, and it is a deeply justified reaction.

When these unpleasant thoughts rise to the level that you are reacting to them, you are consuming energy that you could otherwise use to actually make a difference in your own sphere of influence. Unfortunately, when you are agitated, your inflammatory markers are elevated,³ which increases the speed of nerve conduction;⁴ the brain is sensitized, and any pain will be magnified.

Here is a letter from a person who has been suffering from chronic pain for many years.

…… violence in nature is difficult for me, but human cruelty to others is incredibly upsetting. I have been this way since childhood. I am very sensitive, and I almost do not feel at home on this planet. I feel wired and tired at the same time.

Her outlook is understandable, and I think most people feel this way. However, she is “wired and tired” from being in a sustained flight or fight state.

Healing occurs only by stimulating your physiology to move into a state of safety. and It is almost impossible to accomplish while remaining agitated about situations you have no control over.

COMPLAINING

Another way we  remain agitated is by complaining, engaging in malicious gossiping, being judgmental, and giving unasked-for advice. How can this input bring your body’s physiology into that of feeling safe? When you are suffering from chronic pain, your overall life outlook may be clouded, and these behaviors may become more frequent. Although you have legitimate issues to be upset about, you are also reinforcing unpleasant neurological circuits in your brain. A better alternative is choosing to place your attention on more functional or more positive neurological circuits.

WHAT ARE YOU WATCHING?

What about what we choose to watch? Violent movies and video games fire up your nervous system and consequently your whole body. You have to ask yourself why would you choose to do this to yourself? It is a surefire way of being in a heightened state of flight or fight. Unfortunately, with repetition, it may become normalized, and you may not appreciate your body being in this state, although it has detrimental effects on your mental and physical health.

THE NEWS

Another behavior to consider is how much time do you spend watching the news? It goes without saying that most newsis upsetting. Although it is fine and important to have a feel for current events that affect our daily lives, watching the news for hours is counterproductive. You are sedentary (exercise is anti-inflammatory)⁵ and you are not viewing material that is creating a sense of relaxation and peace.

Moving forward

Understanding the effects of what you are inputting into your nervous system is important in calming it down. Initially, they may be so ingrained that you can’t see them or the effects they are having on the quality of your life. It takes practice to notice and is also challenging to change. How much of your life has been consumed by them. Are they productive?

You may notice that as you back away from these activities, you may feel more anxious, as you are less distracted. Anxiety is unpleasant and it takes practice to learn to tolerate it. Eventually, as you quit fighting this sensation, it will be less powerful and integrated into your daily life. It is a stepwise process and a learned skill.

Quit upsetting yourself

Here are some suggestions regarding changing your input in order to quiet down your threat physiology.

• Create a list of societal issues that are deeply upsetting to you. Feel how enormous and terrible these problems are. Express your feelings on paper – and tear it up. This can be done repeatedly. Paradoxically, you have more energy to take action in some domain you have a say in.
• Stop engaging in the following activities:
  • Watching violent movies or playing intense video games
  • Complaining about the states of various world affairs that are particularly upsetting to you.
  • Complaining about anything. If you can’t do something constructive, don’t spend time with it.
  • Giving unasked-for-advice or being verbally critical. Consider how you feel when someone does this to you. Both parties are on the defensive, social connection is compromised, and your nervous systems are fired up.
  • Malicious gossiping. Consider why are you engaging in it? You are in a small or big way, robbing a person of his or her reputation. You certainly are not creating a sense of peace and safety.
  •  Spending long periods of time watching the news. Limit yourself to maybe 30 minutes a day or just skim the daily headlines.

Become a light

Your individual contribution to the human experience lies in creating positive changes in yourself and being available to others you care about.  However, you can’t reach out if you are consumed by pain and frustration. You may be so deeply involved in dealing with the negatives of the human condition that it may not seem possible to be any other way. But you have a choice.

Not only is a constructive mindset —not to be confused with mindless positive thinking—attainable, it is possible in the worst of circumstances.

Exhibit A is Man’s Search for Meaning , written by Viktor Frankl,⁶ an Austrian psychiatrist who survived the WWII concentration camps. He bore witness to the worst horrors of the human experience, lost much of his family, and still found meaning and purpose in the midst of extreme suffering. The question he kept asking was, “What is life asking of me now?” Few of us could pull this off, but he demonstrated it could be done. Keeping perspective on a given day when the challenges seem unsurmountable is in sharp contrast to feeling like a victim.

The Swerve  by Stephen Greenblatt⁷ tells the story set in the mid-15^th century of the discovery of an ancient Greek manuscript. Greenblatt defined “The Swerve” as an event that is so significant that it altered the course of human history. The manuscript written in 60 BC contained the poem, The Nature of Things by Lucretius. Somehow, Lucretius figured out that matter was made up of particles called, “atoms.” The Church realized that if this was widely known, that there was a more powerful force than their authority, they would lose their hold on the population. Indeed, after this poem was discovered, it seemed to be a factor in ushering humanity out of the Dark Ages.

The most remarkable aspect of Lucretius’ poem is that he concluded, even while living in the midst of the misery and brutality of ancient times, that all each person can and should do is to live a full, rich, and meaningful life.

Both of these books drive home that the world—then and now—is full of extreme suffering. It is easy to become focused on what is wrong or we can step up and do what we can to alleviate it. Living life with sense of purpose improves your quality of life and contributes to happiness.⁸ It also pulls you out of threat physiology and allows you to refuel and regenerate.

Recap

Healing from chronic illness requires your body to be in a state of safety. You can’t heal while consuming your body’s resources while in threat. In a way, accomplishing this by carefully avoiding upsetting input is the easiest aspect of solving your chronic mental and physical pain.

Awareness of the effects of various inputs is the starting point. Then becoming more aware of the numerous ways you engage in these activities is important. As you use your brain’s survival circuits less and nurture more pleasurable ones, you will be able to experience a more gratifying life. To have a good life, you must live a good life.

 References

1. Smyth J, et al. Stress and disease: A structural and functional analysis. Social and Personality Psychology Compass (2013); 7/4217-227. 10.1111/spc3.12020
2. Luskin, Fred. Forgive for Good. Harper Collins, New York, NY, 2003.
3. Shields GS, et al. Psychosocial interventions, and immune system function. JAMA Psychiatry (2020); doi: 10.1001/jamapsychiatry.2020.0431
4. Chen X, et al. Stress enhances muscle nociceptor activity in the rat. Neuroscience (2011); 185: 166-173. Evans, Patricia. Verbal Abuse: Survivors Speak Out. Avon Media Corporation, Avon, MA, 1993.
5. Sallis R, et al. Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48440 adult patients. Br J Sports Med (2021); 0:1-8. doi: 10.1136/bjsports-2021-104080
6. Frankl, Viktor. Man’s Search for Meaning. Beacon Press, Boston, MA, 1959.
7. Greenblatt, Stephen. The Swerve. Norton and Co., New York, NY, 2011.
8. 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

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My creative artist friend, Ernesto, endured a rough couple of years and for a while he “disappeared”. The details are not important. What is important is that he is back and thriving. This piece is a statement of his time in the “Abyss.”

I spend over eight years in darkness. There are many terrible aspects of the experience but one of the worst is that much of what you are experiencing cannot be seen. No one really believes you, although many try. Even more frustrating is that you cannot express the depth of your suffering with words. His sculpture instantly spoke to me and I love the name he gave her. She now occupies a space in my office.

There is not a day or minute that passes that I am not grateful to be able to be here and actually thrive. For years I did not think it was possible nor did I have any shred of hope. In the end experiencing this depth of suffering turned out to be a gift that has allowed me to guide many others out of their physical and emotional pain.

ILOHLA  (ee-LOH-lah) “to become strong” (Southern Africa)

In making this sculpture I wanted to represent the power of the human spirit. In spite of — or perhaps because of — the traumas of life: pain, emotional scarring, inner turmoil, suffering, we are all capable of inner growth. Seeing oneself not as a victim of external circumstance but as a survivor, allows one to view adverse personal experiences as a path to renewed inner strength and power.

In creating this piece, I asked myself “How can I express physical and tangible suffering, as well as the growth and strength a person may have gained from experiencing them?”  To accomplish this I used the body as a landscape. Similar to reading a road map, one only has to look in order to see the pain of the experience.

My goal is to create art that touches the heart and spirit of the viewer and is a vehicle for self-discovery and personal growth.  I hope you enjoy “ILOHLA.”

— Ernesto Sanchez, August 2013

The post To Become Strong – “ILOHLA” first appeared on Back in Control.

The post To Become Strong – “ILOHLA” appeared first on Back in Control.

Repetitive thoughts

When you suffer, you have the same set of thoughts over and over; a process that clearly reinforces a given neurological circuit. Suffering takes many forms. Ways it is manifested include complaining, arguing, manipulation, gossiping, etc. There are often strong repetitive thoughts regarding the mess that your life has become. The resulting anger is the jet fuel that gets these circuits really spinning. It is almost impossible to “let it go,” because the anger feels so justified. The situation is already miserable even before we consider the unrelenting pain.

The process is similar to a person learning any skill with repetition. Athletics, music, art, computers, dance, racing, language, etc. Any skill you have was acquired with repeated specific focused movements. The problem with pain, mental or physical is that the impulses hit your nervous system so fast and are persistent. Whether you suppress or experience your suffering doesn’t matter. The outcome is the same and it is a programming problem.

Additionally, recent neuroscience on the nature of human consciousness has shown that thoughts and concepts are embedded into our brains in the same way concrete objects are discerned, such as shape, texture, color, categories, etc. In my first book, I pointed out that thoughts are real because the human body reacts to them with a neurochemical response. I was wrong. Thoughts are your version of reality and are as real to you as the chair you are sitting in. We are all deeply and completely programmed by our past experiences.

Not letting go

I recently had a patient who was convinced that somehow the orthopedic surgeon had done a poor job on his rotator cuff surgery five years earlier. Although he was in my office to look at his neck, he continued to rant about how he had been irreversibly damaged by this surgeon. I don’t know how well the surgery went compared to how well he had done his rehab after the shoulder surgery. He was so focused on the story and the sensations around his shoulder that I could not even touch his skin around the shoulder girdle. Regardless of the reason for his condition, his daily quality of life was additionally compromised by these repetitive, ruminating thoughts.

Often patients with chronic pain see a psychologist for help in dealing with negative thoughts/suffering. This is a generally a good idea — I am a strong proponent of psychological support for almost any situation. However, it must be used in the correct context. In my experience, if your sessions are used only to talk about your problems, you are merely firing up negative neurological circuits and making them more complex.  It can be a form of “sophisticated suffering.”  For psychological interventions to work, you also need a “reprogramming” component. Not sharing your pain

Repetition is a huge factor in deeply embedding pain circuits. It also the reason we ask people not to discuss their pain or medical care with ANYONE, except their immediate health care providers. Since mental pain is a bigger problem than physical pain, this recommendation also extends to no complaining, gossiping, criticism, and giving unasked-for advice. In other words, just listen and be nice. Your brain will follow in kind.

The post Suffering first appeared on Back in Control.

The post Suffering appeared first on Back in Control.