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 They tend to become socially isolated and withdrawn, even within their own home.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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The post Listen to Your Family–No Advice or Criticism appeared first on Back in Control.

It’s not them, it’s us

Regardless of your political leanings, our politicians are not the problem with our society. I am not a great historian but it was clear all of our recent political candidates for president exuded anger, righteous indignation and were human verbal flame throwers. Whatever happened to focusing on the issues and the different choices in solving them? They are not the problem. It is us. We are angry and politics are simply a reflection of our collective consciousness. It would not have mattered who won. The problem is deep and has been there throughout human history. Cultural angst festers, explodes and re-accumulates. We continue to espouse world peace but have never been able to break this cycle. This time we can and world peace is a possible.

Insanity is 

Doing the same thing

Over and over

And expecting a different result.

-Albert Einstein

It is a possibility because we just underwent a bloodless revolution. We irrationally threw out anything that had to do with the current political structure and tore through both the Democratic and Republican party. How is this possible? You might be thinking that my line of thinking is implausible. It is not. We now have a choice of deciding what we really want – as a people, not by political leanings – unless you want to hold on to it.

Anger/ Rage

Anger is the problem. It does not matter what religion, race, political belief, sexual preference you are. It also does not matter how justified you are in your anger. The more legitimate your anger, the more difficult it is to let it go. It will still destroy you. There are many problems created by continuing to remain in this state.

• You cannot think clearly when you are upset. It is a self-centered reactive survival response that happens in your powerful unconscious brain. Dwight Eisenhower finally realized that he could not make good choices when he was angry.
• Through a neurological phenomenon of mirror neurons your anger will stimulate anger in those around you. Have you noticed that when you yawn others around you will yawn? It is a direct stimulation of that part of the other person’s brain. That is why it is so critical for a leader not to negatively set off this process on a large scale.
• The only way issues are solved through anger is a fight and the most powerful entity wins. Is that what we want?

What is the solution?

The solution is you? You have heard the oft-repeated quote, “The only person you can change is you.” It is true and it works. The first step is awareness of:

• Your anger
• Its effect on your quality of life
• Your family’s experience when you are upset.
• Your co-workers’ reactions and impact on their quality of life.
• Your personal impact on society.
• The nature of anger
  • It is driven by anxiety
  • It happens when you lose control

Healing

Awareness is the first step of healing. You cannot solve a problem that you don’t understand. One of my remarkably successful mentors made a comment about a recent turn of events, “Never waste a crisis.”

We are now painfully aware of our societal anger and we can choose to be a part of it or look at it as an opportunity learn how to personally process it and share our awareness in our circles of influence. Once you are aware of the nature of the problem you can find the solution. If you choose to remain angry, you have also lost your right to complain. You have made a choice to continue to spiral down into your own personal societal abyss. No politician or external circumstance will ever bring you deep happiness and joy.

My challenge – to you and me

I am challenging you to wake up, look up and move forward – with your individual and societal pain. You will soon leave your pain behind and also made a significant contribution to our collective consciousness and planet.

The second edition of my book is based on the recent neuroscience research that is demonstrating that emotional and physical pain are equivalent entities since they are processed in similar areas of the brain. Since you cannot escape your thoughts, you are trapped – and angry. This is not a political problem.

Become aware of the relationship between anxiety and anger, incorporate the principles into your own life and become part of the solution. There is not another alternative. World peace then becomes a possibility and at some tipping point becomes a probability. It is the next step in the evolution of human consciousness.

I am upset about many terrible trends that are occurring and the fog of anger that is engulfing us. I have my own work to do………

The post Society’s Pain and World Peace first appeared on Back in Control.

The post Society’s Pain and World Peace appeared first on Back in Control.

ANGER

ANGEL

Love and rage are both four-letter words.

A

N

G

E

R  A  G  E

A

N

G

E

L O V E

The difference between the words anger and angel is one letter.

What a difference a letter makes.

The post Anger versus Angel first appeared on Back in Control.

The post Anger versus Angel appeared first on Back in Control.

Dr. Fred Luskin, a psychologist out of Stanford, conducted several research studies regarding the effects of forgiveness on the human body and mind. His concepts are presented in his book, Forgive for Good. His results were consistent and dramatic. Forgiveness heals. Two of his studies involved the parents of children who had been murdered. The more legitimate your anger the more difficult it is to let it go. Having a child murdered is possibly the deepest reason to hold on to it. But what happens, as you remain upset, is that the quality of the rest of your life is severely compromised. The person you truly despise now has control over the rest of your life indefinitely. It is critical to understand this problem and honor yourself and family by living a happy life. It turns out that forgiveness is the most powerful way to move on. Moving forward with your pain

The elephant’s noose

I have a friend who told me a story about his younger brother who suffers terribly from anxiety, depression and generalized chronic pain. He’s been introduced to the concepts presented in my book, but hasn’t engaged in the healing process. He’s focused on a situation where he was left for a short period of time with his grandparents around age 5 while his parents took a vacation. He is convinced that he was abandoned and won’t let it go.

One aspect of forgiveness that I learned from Dr. Luskin is that it’s is a process that has no beginning or end point. It’s a matter of continuing to be aware of your anger and keep letting it go. But what caught my attention was his comment, “It’s fine to blame your parents for your problems until you’re 18 years-old. But at that point you need to own the fact that you’re an adult and take full responsibility that you’re now continuing to screw up your own life.”

Dr. Sarno who understood these concepts over 30 years ago, used the word “rage”. Being trapped by any unpleasant situation over a prolonged period of time will create it. His observation was that many of his patients, by recognizing this link, would experience profound healing. The essence of the problem is that sustained anger has a pronounced effect on the levels of stress hormones and this translates into physical symptoms.

A good friend of mine sent this audio show to me aired on NPR. It’s a story of forgiveness and healing. You are the one, and only one, who has the capacity to let go and to heal yourself.

NPR audio podcast: “Finding Health by Letting Go of Hate”

The post “Finding Health by Letting Go of Hate” first appeared on Back in Control.

The post “Finding Health by Letting Go of Hate” 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.

His tests and treatment were as follows:

• His lumbar MRI showed disc degeneration at every level but no instability.
• He had crippling anxiety including fairly frequent panic attacks.
• He was open to psychological care.
• I engaged him a structured rehab program, but essentially every request we made for biofeedback, psychological intervention, mindfulness/meditation, and back school was denied by Worker’s Comp—over and over again.
• I somewhat kept him on his feet by seeing him back every couple of weeks for about six months. We kept requesting care.  Even personal phone calls to his claims examiner were of no avail.

I referred him to a pain specialist that I have teamed up with, and he continued with a similar program but again with no support from Workers’ Comp.

• The patient still complained of severe crippling anxiety and was somewhat desperate for mental health care.
• I am not currently his treating physician but last week my colleague emailed me and asked me to re-evaluate him.
• It has been recommended to him that he have a two-level lumbar fusion for his degenerated discs.  My friend begged him not to pursue it.
• The patient is anxious, frustrated, and does not want to talk to me or anyone else.  He is now intent on pursuing surgery.

So look at this situation.

• We know that chronic pain increases anxiety and frustration, which exacerbates pain.
• Psychosocial stress is a better predictor of outcome than the surgical pathology.
• The return-to-work rate at one year from a lumbar fusion for low back pain in the State of WA is 15%.
• The patient has documented severe untreated anxiety.
• In addition to his baseline anxiety, interacting with the Worker’s Comp system has pushed him almost into a rage.
• The state still will not pay for any mental health resources
• They will pay for an operation that will cost them between 50-75 thousand dollars and has a re-operation rate between 15-20% within the first twelve months of the index operation.
• If he does not undergo surgery, his claim will be closed and he does not have the emotional capacity to compete in the work force.

I have no ability to intervene, as I am no longer his treating physician.  I realize that “this is not my problem.”  That is correct.  It is not my problem; it belongs to all of us.

Does anyone have any suggestions?

BF

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