• Connecting to every aspect of your life is difficult but is at the core of allowing your body to heal.
• “Being” with your past may be challenging but is necessary in order to learn and grow.
•  It is the opposite of pursuing self-esteem, which separates you from you.
• The “C” quence is connection, confidence, and creativity. Creativity is where deep healing happensthrough neuroplasticity.

Connecting to your past provides “neuroshment”¹ for healing.

Safety vs. threat

Feeling safe is a basic need and core driving force of life. We’ll resort to whatever means required in order to achieve it. A state of safety allows growth, regeneration, optimum function, good health, and a deep sense of contentment. Feeling threatened causes your body to go into a “flight or fight” reaction, which consists of stress hormones, increased fuel consumption, excitatory neurotransmitters, inflammation, and anxiety. A term for this reaction is, “threat physiology”.

Life is sustainable because the body regenerates and heals, but it must be in a safe state for enough time to refuel, strengthen, and build up reserves to fight another day. Even severe stress can be dealt with when there is enough time in safety to regenerate. So, healing happens by decreasing time in threat and increasing time in safety. These are separate, but linked sets of skills. One is using methods to lower the levels of stress chemicals and the other is learning to nurture joy.

This journey is reflected in a metaphor of a tree that I call, the “C”quence of healing allowing you go from reactive to creative.

• Connection
• Confidence
• Creativity

CONNECTION – the soil

The ground represents every second of your entire past and is the source for learning and future growth. There is one major root in any tree, called the taproot, which grows straight down in search of water and nutrients. The trees with deepest ones are found in harsh dry environments. A tree may initially show little growth for a few years until the taproot is more mature. Roots grow relentlessly and will even grow through rock. The more developed and complex the root system, the better the chances for survival and growth.

All humans have experienced some degree of trauma. Our needs are not always immediately met even in the best of circumstances, and adversity never stops. Many people have suffered severe, even extreme childhood trauma, and there is plenty more to be had in adulthood. We don’t feel good about it and might even feel ashamed.

As a result, considerable time and energy is spent on analyzing, fixing, covering up, whitewashing, or suppressing the past. Somehow, we feel that by spending a lot of time dealing with past, we’ll have a better life. The problem is that your attention is focused on the problems and not the solutions. Since your incredibly adaptable brain develops where you place your attention, you are magnifying the unpleasant aspects of your life. Focusing on fixing the past also requires a lot of energy that could be used in dealing with the present, and thriving.

“Neuroshment”

Specific skills are required to allow you to be with your past, as much of it may be unpleasant, painful, and difficult to be with. Digging in and being with your past is the opposite of seeking self-esteem. One patient who successfully broke free from 55 years of pain coined a term for using the past for future growth,“neuroshment.” Your brain physically changes its structure as it adapts to ongoing sensory input. This property is called neuroplasticity, and you can create the brain of your choice.

TRUNK—SKILLS

The trunk represents the confidence that emanates from being able to deal with every aspect of your life and not run from it. Since, there are many ways to effectively process the past, you are grounded and can deal with even severe adversity.

The term for this set of skills is “dynamic healing.” It acknowledges the interactions between you and your circumstances that create flight-or-fight body chemistry. There are many tools in each portal, none of them are difficult, but require learning and repetition to master them.

Anytime you are anxious or frustrated, you are reacting to something unpleasant from the past. You are in flight or fight, the blood flow to your neocortex (thinking brain). It is impossible to think clearly. You have also lost awareness of the present moment. These survival reactions are powerful, automatic, and you have no control over them. It is the reason that being with the past is difficult and specific tools are required to regulate your body back into safety. Deeply connecting with who you are provides “neuroshment” for future growth and confidence to deal with life’s challenges. This is a sharp contrast to seeking self-esteem to “feel better” about yourself. You are not grounded.

THE BRANCHES—CREATIVITY

Connection and confidence represent the skills needed to regulate your threat physiology, but healing occurs with creativity. Brain circuits are stimulated reflecting the life you want as you “rebuild” the brain (life) that you choose. You cannot “fix” yourself. Your attention is on the problem and where your brain will develop (neuroplasticity).

But you can’t pursue pleasure in order counteract the survival circuits. They are too powerful and relentless, and your creative brain doesn’t work well while in threat physiology. Pursuing pleasure to outrun your unpleasant survival sensations has been shown to increase inflammation.²

The concept of healing through creativity is possibly the most important and difficult to comprehend and put into action. We are programmed to react and fix and are uncomfortable letting go. But you must let to in order to move forward. If you take the letter “C” out from “reactive”, it becomes “Creative.” You must become aware, create some “space” to see first in order to be able to make rational choices.

Deep healing

Sustained stress keeps your body activated, breaks it down, and increases the odds of developing a chronic mental or physical disease. The relevant issues are the intensity, duration, and your coping skills. Consider how long it would take for your car to break down if you were driving down the freeway at 70 mph in second gear. What if the car (your body) wasn’t tuned up, hadn’t had regular service, or was a cheap model? Compare this scenario to cruising in a well-maintained luxury car in 5^th gear at the same speed. You could drive for a long time. Your body isn’t so different. What model of car are you and how are you caring for you?

Recap

“Neuroshment” from a complex root system and solid trunk, allows a tree to grow branches of all sizes. You willconnect into your creativity and train your brain to evolve in any direction. This is where the deepest healing occurs. You are moving towards joy and away from pain.

Nurturing joy requires skills that few of us are taught. Creativity requires awareness, and you must see “C” first in order to know where you are at and then make ongoing proactive choices.

In order to reach higher, you must first dig deeper. Consider a tree as a metaphor for your healing journey. Become a professional at living life and watch your life change from ReaCtive to Creative.

Questions and considerations

1. Many, if not most of us have a less than ideal past. The human experience is messy. What you perceived as dangerous as a child is probably not threatening as an adult. But your brain doesn’t know that and will continue to react similar cues.
2. How do you feel when your attention lands on emotionally difficult situations from the past or is triggered by an event today? Reassuring yourself that you are OK actually places your attention on the problem and reinforces it.
3. Connecting with every aspect of your past and allowing yourself to be with a wide range of unpleasant emotions causes them to lessen. However, the discomfort you feel may be intolerable. There are ways to train yourself to be with these feelings and move forward.
4. Consider how much effort we spend trying to “fix” ourselves. It can’t and doesn’t work. Remember when you felt that life had endless possibilities. How did it feel? That is where you want to return.
5. The most important shift in thinking about having a better life is that it happens by nurturing creativity and joy. But you have to let go in order to move forward. It is a daily ongoing process that allows you to “rebuild” your brain and live the life of your choice. Quit fighting darkness; turn on the lights.

References

1. Term coined by Rita Salvador who learned to thrive after being in chronic mental and physical pain for over 55 years.
2. 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 The “C”quence of Healing Chronic Illness first appeared on Back in Control.

The post The “C”quence of Healing Chronic Illness appeared first on Back in Control.

• Pain from any body part is a protective danger signal that guides our behavior and physical responses to avoid danger and remain safe.
• This system is called the nociceptive system, which guides behaviors to not exceed the limits of a given structure.
• Feedback from internal organs is called interoception, and the nervous system maintains a delicate balance through hormones, inflammatory responses, neurotransmitters, and metabolism (fuel consumption).
• Unpleasant mental input is perceived in similar regions of the brain as physical pain, but there is no automatic withdrawal or avoidance response. Suppression increases the intensity. We have no protection from mental pain.

Although humans are programmed to avoid or resolve physical threats, we do not have inherent mechanisms to deal with mental threats.

Staying Alive

Every living creature, from single-celled organisms to mammals, has two biological mandates. The first is to survive, and the second is to pass their genes to the next generation.

In order to avoid danger, seek safety, and stay alive, data is gathered through sensors located on every cell in your body. All this information continually interpreted by your nervous system to assess whether the situation is safe or dangerous. Signals are then sent out from the nervous system to regulate and control your body’s next actions to optimize survival. So, a major point is that the nervous system is necessary to interpret the intensity and type of input from the pain sensors. Otherwise, pain would not exist.

There are many different pain signals such as hot/cold, loud/soft, sharp/ dull, pressure, light touch, and position. When these pain receptors send messages to the brain that a given structure in the body is at risk for danger, the brain sends out automatic signals to withdraw from the dangerous situation. Pain is protective and we cannot survive without it. It is a gift.

This unconscious protective system is called the nociceptive pain system. What you may not realise is that this system is focused on guiding our actions and behaviours in order to avoid pain and we can get on with our lives safely. So, we are not aware of its role most of the time. It is only when the limits of a given bodily structure are approximated or exceeded that your brain receivesan intensity of signals that it interprets as, “danger!” These signals have evolved to be so unpleasant so as to compel action. It is how living creatures evolved and survive. It is also the reason why when the finely tuned protective pain system becomes unbalanced and suffering from chronic pain is so tragic.

Protective responses

There are four levels of responses to input from your external environment and internal organs. The variables are intensity and duration.

1. None/protective: Your body is guided to remain safe.
2. Withdrawal: Any physically perceived threat is met with a quick response.
3. Symptoms/Illnesses: Prolonged threat – diminishes/resolves with a lower threat load.
4. Diseases: Sustained threat – your body breaks down, causing structural damage.

There are rare instances where people are born without pain fibers. Since they lack protective sensation, their tissues and joints break down, become deformed, and infected. They live only 10-15 years and usually die from infection. There are also diseases that destroy protective sensation such as leprosy and diabetes. Again, the limits of the tissues are regularly exceeded, and they break down. Often a joint will become a “bag of bones.” Survival depends on your brain accurately processing sensory input, detecting threats, and sending out signals to take protective actions.

Uniquely human

In addition to input from your eyes, ears, nose, mouth, skin, and internal organs, humans also receive input in the form of threatening thoughts. Unpleasant thoughts are processed in similar regions of the brain as physical pain¹, which creates a flight or fight response. Hence the phrase, “You hurt my feelings.”

The brain generates survival signals that are intended to be so unpleasant that the organism is compelled to respond in a way to resolve the threat. Once the problem is solved, your body returns to its baseline. Whenever a given response doesn’t solve real or perceived danger, the body’s physiology remains in an activated threat state. Sustained threat causes symptoms, illness, and disease.

Many, if not most, people have stresses that are not solvable, and avoiding stress becomes its own stress. As your body kicks in more of a stress response, you’ll feel angry. The longer and more intensely you feel trapped, the greater the effects on your body.

There are many ways of minimizing the impact of stress. However, a universal problem is the inability to escape from unpleasant thoughts. This may be a powerful force in driving chronic disease with sustained threat physiology keeping your body in overdrive.

Your brain on fire

A significant percentage of your brain is intertwined with the immune system, and signaling molecules (cytokines) fire up an inflammatory response. Your brain is not only hyperreactive but also inflamed. So, thoughts fire up the nervous system, and then your brain fires off disruptive thoughts.

SciePro/ AdobeStock

Your thoughts, concepts, and behavioral reactions eventually become permanently embedded (memorized) in your brain and are unresponsive to rational interventions.² They become your “demons” that strengthen over time. Essentially, all humans have some level of annoying, undesirable thoughts that aren’t problematic. Many experience them at a level that interferes with their enjoyment of life but doesn’t affect their capacity to function. Others are greatly affected without carrying a diagnosis of OCD (obsessive-compulsive disorder). Coping behaviors include suppressing thoughts, rigid thinking, binge eating, eating disorders, skin picking, nail biting, hair pulling, “worrying,” hyper-focusing on appearance, body image issues, and addictions.

Repetitive Unpleasant Thoughts (RUTs) are worsened when trying to fight or control them³. Attempts at mental control drive them much harder, as more attention reinforces them. Suppressing them is even worse. Then, feeling trapped creates intense angry, irrational reactions. The resultant dysfunctional behaviors create a lot of damage to you and others around you, in addition to illness, symptoms, and disease. We do not have an automatic withdrawal response to mental pain – we have no protection at all.

Recap

This inability to protect ourselves from unpleasant thoughts drives threat physiology, creates many dysfunctional behaviors, and causes symptoms, illness, and disease. There are many benefits to human consciousness, but this aspect of it is “the curse of cognitive consciousness.” We have learned to physically survive but have not consistently figured out how to thrive.

References

1. Eisenberger N. “The neural bases of social pain: Evidence for shared representations with physical pain.” Psychosom Med (2012); 74: 126-135.
2. Feldman Barrett, Lisa. How Emotions are Made. Houghton Mifflin Harcourt, New York, NY, 2018.
3. Wegener DM. The Seed of Our Undoing. Psychological Science Agenda (1999)/ 10-11.

The post We have no protection from mental pain first appeared on Back in Control.

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• 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.

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

• Avoiding danger is what keeps us alive. Humans call this signal anxiety.
• Avoiding this sensation drives much of dysfunctional human behaviour. We know how to stay alive but not necessary thrive.
• Anxiety is a physiological reaction that is about a million times stronger than the conscious brain. It cannot be controlled.
• We can auto-regulate and redirect it. Addressing anxiety at the root physiological cause will solve many mental health problems.

Why is Anxiety Considered a Psychological Diagnosis?

Anxiety is simply a warning signal. Every form of life has a withdrawal/ avoidance response to real or perceived danger. All life forms, from one-celled organisms to humans respond with complex changes to optimize the odds of survival. This unconscious automatic reaction is powerful and has evolved to feel extremely unpleasant in higher life forms. It compels action to lessen the sensations. The species who did not pay attention to these danger signals, simply did not survive.

 Staying alive

When you sense danger, how do you feel – anxious? Although this a basic survival feeling, humans have the capacity to name it. It is the result of stress, threats, and life challenges, not the cause. Avoiding this sensation is the driving force behind much of human behavior, and seeking safety is necessary to store up reserves to fight another day.

What happens in your body that creates this sense of dread? The term is, “threat physiology.”

Threat physiology

Physiology is the term that refers to how your body functions. Your survival reactions are mostly unconscious, and about 40 million bits of information are processed per second. Our conscious brain deals with only about 40 bits per second. Your unconscious brain is a million times stronger than your conscious brain; the responses are hardwired and automatic, and the reason it is not subject to being controlled. However, it can be regulated and reprogrammed.

Examples of physiological actions are heart rate, blood pressure, blinking your eyes, acid-base balance, sweating, breathing, bowel and bladder function, hunger, and the list is almost endless.

These are some of drivers activating threat physiology.

• Stress hormones – adrenaline, noradrenaline, histamines – ready the body for fight and flee
• Cortisol – mobilize fuel (glucose) from tissues throughout your body.
• Glutamate – Neurotransmitters change from calming to excitatory to increase alertness and sensitivity to danger signals.
• Inflammatory cytokines (small molecules that transmit signals between cells) – the many aspects of the immune system kick into action.

Anxiety is a physiological state

This is a small fraction of actually what occurs in fight or flight physiology. Consider how you feel when your body is in this state. Here is a suggested word progression.

• Alert
• Nervous
• Afraid
• Angry
• Paranoid
• Terrorized

They fall under the umbrella of “anxiety” or “fear.” We will do almost anything to avoid this sensation resulting in many bad behaviors. Psychological diagnoses are ALL anxiety driven. The exceptions are in the positive psychology domain.

A paradigm shift

The way we view mental health must change. Here are some suggestions.

• Eliminate the word anxiety from the DSM coding system. It is the driving force and cause of poor mental and physical health.
• Most psychological diagnoses are descriptions of behaviors driven by the sensations created by threat physiology. Descriptions are less pejorative than labels (diagnoses).
• Substitute the word anxiety with the phrase, “activated threat physiology.”
• Anger is “hyperactived threat physiology.”

“Dynamic Healing”

The root cause of our mental health crisis is sustained threat physiology. There are many ways of lowering it and creating “cues of safety.” The model is called “Dynamic Healing” and is at the core of how medicine should be delivered. The portals are:

• The input – you can process your stresses so as to have less impact on your nervous system.
• The nervous system – the resiliency can be increased so it takes more stress to set off the flight or fight response.
• The output – your nervous systems takes in sensory input, summates them, and sends out signals of threat or safety. There are ways to directly dampen the threat response.

None of the approaches are difficult and require few resources. There are many clinicians in all medical fields that understand and are applying these approaches. It is just not happening on a wide enough scale.

There is no question that symptoms and behaviors must also be addressed while people heal. But if the root cause is not dealt with, their suffering will continue. Hence, the nationwide burden and fallout of poor chronic mental health continues to skyrocket.

Let’s do this!!

Our mental health crise reflects a lot of needless suffering as deep science has pointed the way to effective treatments for over 40 years. Most of clinical medicine is not connected to the data or is categorically ignoring it. It is certainly not being widely taught in medical school.

Where will the energy come from to wake us all up? It has to emanate from the public demanding better care because the business of medicine seems to have little interest in true change. It is the responsibility of the medical profession to honor the known data and implement what is already known.

The answers for our mental health crises are right in front of us if we just pay attention. Take your medical care and life back. It is your right.

The post There is an Answer to the Mental Health Crisis first appeared on Back in Control.

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

“Genealogy” of Anger

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

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

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

You are now angry (hyperactivated threat reaction).

Anger = turbocharged anxiety.

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

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

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

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

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

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

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

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

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

Recap

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

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

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

Questions and considerations

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

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

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There is a growing group of health care professionals who are determined change the current trajectory of medical care. There is an ever-increasing burden of chronic mental and physical disease¹, current approaches are not working, yet we are continuing to embrace them.

The core of chronic disease

Chronic disease is created by your body’s sustained exposure to stress hormones, increased metabolism (fuel consumption), and inflammation. The term is for this situation is, “threat physiology.” The solution lies in learning methods to bring your body into safety physiology, which is necessary for regeneration and healing.

An informal workgroup was created in early 2020 consisting of research scientists and clinicians. We meet twice a month for an hour and have discovered that there is deep research documenting the effects of chronic stress on your body.^2,3,4 Historically, these scientists have not had a consistent forum to communicate with each other and most of this knowledge has not entered clinical care.

A deeper understanding of the nature of chronic disease, including chronic mental and physical pain, offers possibilities of solutions. Indeed, many clinicians have watched many patients break free from chronic pain as they have learned the principles and tools to alter their body’s physiology from threat to safety.

Is your body a parked car?

A parked car has no “symptoms.” You have to start it so see what is going on and then systematically test it if it is not running well. But what if it is a new car that runs out of gas, or the wrong fuel was put into the tank? What if you drove it in second gear for days at 80 mph? There will be “symptoms” before there are structural changes from it breaking down.

Of note, your body is never “turned off.” In fact, the complexity of interactions happens at around 20-30 million bits of information per second.⁵ It is well-beyond human comprehension about how it all works together although we are gaining some ground. We have no clue about human consciousness. We know rough concepts about what part of the brain lights with what input. One of my more skeptical spine fellows pointed out that current technology is a start, but he likened it to seeing what a person is making for dinner from a plane flying at 35,000 feet without magnification.

The myth of MUS (Medically Unexplained Symptoms)

How would you feel if you tried to run a marathon without any training? What if I decided to play NFL football, even for one play? My body is “normal” (could be better) but I would quickly develop symptoms. Most bodily symptoms, illness, and disease are physiological issues and not structural. Medicine has gone completely the opposite direction, addressing most problems as structural, and if they can’t “find” anything, it must not be “real.” There is even a new term that arose in 2002 called, “MUS” (Medically Unexplained Symptoms).⁶ That could not be farther from the truth. Looked at from the perspective of the body’s function, the correct term would be, “MES” (Medically Explained Symptoms).

This summit brings together pioneers of many disciplines of care who have dedicated their lives and careers to making life better for everyone – providers and patients. You will hear the research and data directly from them. I will warn you that you may not understand some of the deeper data in some of the presentations, but you will definitely get a feel of the concepts.

A letter from some of the presenters

Thank you so much for joining us for this paradigm-shifting two-day virtual Summit about the common basis for chronic disease, including chronic pain.

 Stephen Porges, Les Aria, DR Clawson, and David Hanscom have been working together with an extended community of doctors, scientists, and researchers to better understand each other’s fields of expertise and how they fit into addressing chronic pain. It has been fascinating and exciting to see the evolution of so many concepts and how they fit together in a cohesive model.

The Speakers

This group of speakers has been researching and documenting best practices around solving chronic pain. They include EAET (Emotional Awareness and Expression Therapy), PRT (Pain Reprocessing Therapy), and ISTDP (Intensive Short-Term Dynamic Psychotherapy). They  developed, refined, and documented the effectiveness of these approaches.

• Howard Schubiner, MD – EAET, PRT
• Tor Wager, PhD – Documented the effectiveness of PRT with fMRI’s
• Allan Abbass, MD – ISTDP
• Yoni Ashar, MD – PRT

These speakers are true pioneers in their fields.

• Steven Hayes, PhD – Founder of ACT (Acceptance and Commitment Theory)
• Angelos Halaris, MD – Early pioneer in the field of psychoneuroimmunology
• Richard Gevirtz, PhD – Deep research documenting the role of the autonomic nervous system in the creation of disease.
• Stephen Porges, PhD – Originator of the Polyvagal Theory

Some researchers that have made core contributions are:

• Sue Carter, PhD – International expert on oxytocin/ vasopressin
• Naomi Eisenberger, PhD and Robert Lustig, MD – renowned for linking mental health to physiology, metabolism, and neural circuitry.

Clinicians who are presenting the implementing these ideas include some of the above speakers and:

• David Clawson, MD – physiatrist/ chronic pain/ rehab
• Nicole Sachs, LCSW – leader in mind/ body medicine
• Steve Overman, MD – rheumatology
• Les Aria, PhD – chronic pain/ clinical psychologist
• David Hanscom, MD – orthopedic spine surgeon

Bruce Lipton, PhD is the author of the “Biology of Belief” who was also a pioneer in presenting many of these ideas over 30 years ago.⁵ He is the final speaker. What is fascinating is how modern neuroscience has confirmed many of his concepts. Your belief systems affect the expression of your genetic code (epigenetics), your inflammatory markers, the function of the mitochondria (fuel generators in each cell), and are connected with many chronic disease states.

Mental threats are the bigger problem

This brings us to the second day where we present the data on how mental stress creates sustained threat physiology, and the result is many physical and mental symptoms, including chronic pain.

Bringing so many disciplines together has been deeply rewarding and enriching for all of us and we hope it will be for you too. Pull up a comfortable chair and immerse yourself in the weekend. We are looking forward to exploring these ideas together and setting the foundation for next year’s progression of these concepts.

The Summit is intended to present these emerging ideas to a wide audience and further deepen the cross-fertilization of ideas amongst the participants. Whether you are a doctor, health professional working with chronic pain patients, caregiver, sufferer yourself, or a basic science researcher, you will discover a different way of looking at the source of the issue as well as some innovative solutions.

Best regards,

David Hanscom

Steve Porges

Les Aria

DR Clawson

The Summit

Many of the presenters have educational materials, books, courses, and apps that are useful for both clinicians and patients. They will be organized, and links provided at the course.

You can register here. The Summit will be recorded and with registration the recordings will be available for 30 days after the conference.*

*CME credits are available only for those who attend the live conference.

This is not just another pain summit. It is the coming together and flow of innovative ideas and concepts. Be a part of our efforts to bring medicine closer to practicing and implementing known and documented effective interventions for chronic mental and physical disease.

References:

1. O’Neill Hayes T and S Gillian. Chronic Disease in the US: A Worsening Health and Economic Crisis. AmericanActionForum.org, September 10^th, 2020.
2. Dantzer R, et al. Resilience and immunity. Brain, Behavior, and Immunity (2018); 74:28-42.
3. Cole SW, et al. Social regulation of gene expression in human leukocytes. Genome Biology (2007); R189. doi: 1086/gb-2007-8-9-r189
4. Naviaux R. Perspective: Cell danger response Biology—The new science that connects environmental health with mitochondria and the rising tide of chronic illness. Mitochondrion (2020); 51:40-45.
5. Lipton, Bruce. The Biology of Belief. Hay House, Los Angeles, CA, 2016.
6. Edwards TM, et al. The treatment of patients with medically unexplained symptoms in primary care: A review of the literature. Mental Health and Family Medicine (2010); 7:209-221.

The post Not Just Another Pain Conference – The 2nd Annual Pain Summit first appeared on Back in Control.

The post Not Just Another Pain Conference – The 2nd Annual Pain Summit appeared first on Back in Control.

• Awareness is at the center of life. You cannot make good decisions without understanding the relevant variables.
• It is also an important tool in and of itself. By understanding the different types of awareness and knowing where you are in given moment, you can navigate life’s challenges more easily.
• The “circle of life” represents three states of the human experience and reflects the state of your body’s physiological state.
• Combining awareness skills with the “circle of life” allows you to selectively use tools to regulate your body’s chemistry.
• You can navigate life on your terms.

Awareness is both at the core of survival and also thriving. These are learned and separate skills. Survival is instinctual and whatever tools you have become embedded over your lifetime. However, many of our actions are not only ineffective but can make situations worse. Acquiring effective stress processing skills is important.

Thriving is not as instinctual and it must be cultivated and nurtured. If you are trying to use pleasant experiences, power, and material possessions to compensate for unpleasant survival emotions, it can’t and doesn’t work. You cannot outrun your mind. They key to thriving is developing a “working relationship” with anxiety and anger, and then you are able to create the life you want. Solving problems doesn’t yield a good life. You have to live a good life to have a good life.

Additionally, awareness is critical to processing life. You can’t solve problems in any domain without understanding details from both your perspective and also that of other involved parties. If you are projecting your views onto a given situation, you are not going to come up with consistently viable solutions. For example, you may have repeated troubles with relationships at home and work and can’t figure out why.

Putting awareness to work

The first necessary step in using awareness is looking at clues that you are not as aware as you think you are. BTW, if you think you are “aware” or “enlightened”, then you have already demonstrated that you are not aware. Any labels, positive or negative, block awareness.

Then seeing your unawareness will allow to deepen your awareness and start you down the pathway of using awareness as a tool.

Second, understanding and nurturing the different types of awareness enables you to learn skills in each of these arenas. Here are four suggested types to use as a baseline.

• Environmental
• Emotional
• Judgment/ “The stories”
• Ingrained patterns

Environment awareness a tool to be used daily and as you train your brain to connect to specific sensory inputs, it takes your attention away from disruptive thought patterns. As you continue to practice, it becomes more automatic, and your mind can calm down.

Emotional awareness is difficult in that you are training your brain to experience pain that you have been suppressing and repressing. Remember, emotions are what you are feeling in various physiological states – safety versus threat. They drive your behavior in order to avoid danger and seek safety. Since mental and physical pain are processed in a similar manner, emotional pain actually hurts. So, why would you want to feel it? Because suppressed/ repressed emotions fire up your body’s nervous system and chemistry even more.

Awareness of the stories you create about your life to make sense out where you fit into the world is particularly deadly. Many of these stories have been programmed in by your family, friends, and society. A high percent of them are actually cognitive distortions that continue to keep you ramped up even when your circumstances are good. The good news is that you don’t have to do anything about them because they are not based on reality. You can just become aware, separate, and move forward. If you choose to prove them wrong or ignore them, you have inadvertently reinforced them.

The ingrained patterns are the essence of who you are, make up your life view, and evolve to become the lens through which all new information is processed. Since the human brain is programmed by interacting with others, each individual is incredibly unique. The early input is critical as it sets the trajectory for the rest of your life. By definition, you cannot see these patterns without outside help as they are your frame of reference. Creating a clear awareness of your past programming is a necessary powerful way of switching your life from a reactive to a creative mode. It is also a much more interesting way of interacting with others, as opposed to constantly projecting your views onto them.

Third, once you become more familiar and skilled in developing these levels of awareness, you can actively use them as tools to calm down and re-direct your nervous system. Some people make the strong argument that awareness is the only tool you need to heal. We know that you can’t “fix” yourself. Your attention is focused on the problem and from a neuroplasticity perspective, you are reinforcing it. With awareness, you can watch yourself respond, somehow you are getting out of your own way and allowing yourself to heal. You have become an observer of your own healing. Remember, the steps required to create neuroplastic changes in your brain are: 1) awareness 2) separation (create some “space”), and 3) redirecting your attention.

Finally, the “circle of ife”, which contains the “ring of fire,” can be used as a foundational template for implementing awareness into your daily life. On a given day or moment, you can quickly assess your relationship with any of the four kinds of awareness and see which part of the “circle of life” you are in. You then have a choice of using your tools to move in the direction of your choice. But you can’t redirect unless you know where you are starting from. You will notice that moving easily between all aspects of your life on your terms is the goal of The DOC Journey. Then you are beginning your real journey of life.

The” circle of life” is the signature tool of The DOC Journey. The challenging aspect of this tool is that you must allow yourself to feel everything – but only as you can tolerate it. Allowing yourself to feel anxious is difficult because no living creature is programmed allow vulnerability. The consequences are harsh. Yet with language, we have the capacity to develop complex relationships, which requires vulnerability. It is a frustrating aspect of the human condition.

The good news is that once you are aware of where you are at in the circle, you do have choices. You can remain where you are – even if you are in the red, take a “refueling break by entering the green center, or move on by engaging in blue activities.

Freedom is being fully immersed in every element of your circle of life – on your own terms. It begins with awareness.

Recap

The essence of chronic mental and physical disease is being exposed to sustained levels of threat physiology. Your body is consuming resources for survival, and you cannot heal in this scenario. Healing can only occur when you feel safe enough to replenish your reserves. But a major block to seeking safety is not recognizing your body’s cues that you are in flight or fight. There are many ways of it covering it up, but your body is still in high gear.

You must learn to become aware of your physiological state and choose where and when you want to go or stay . Whatever set of tools you decide to implement begins with awareness. Where in the “circle of life” are you at this minute?

Questions and considerations

1. There is a tendency to look for a definitive cure for pain, which doesn’t make any sense. Your body’s interaction with the world is dynamic and your physiology changes by the millisecond. Life keeps coming at us.
2. When you are in fight or flight, you simply aren’t going to feel good. You are not supposed to, as the sensations evolved by creatures paying attention and taking action to survive. The species who were not aware enough did not survive. So, anxiety is intended to be so unpleasant, we’ll do almost anything to avoid it.
3. That is what makes awareness so challenging. You must feel and acknowledge your threat physiology before you can change directions.
4. Your tools will allow you to process stress more efficiently so as to minimize your time in threat physiology. Healing occurs as you learn how to feel safe.

The post Awareness as a Tool – The “Circle of Life” first appeared on Back in Control.

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