Hi Dr Hanscom,

I have been meaning to check in with you for a while now and let you know that the DOC program seems to have worked for me. My lower back & leg pain has disappeared and I’m a firm believer in the process, especially the concept that anxiety is the driver of tension and pain in many cases. I picked up the book, Forgive for Good at your recommendation back in the winter and found it to be excellent. I’ve also been doing mindfulness training and it’s been extremely helpful.  If you aren’t familiar with the book, The  The Mindful Way through Depression, I’d definitely recommend checking it out.

I hope you are doing well and enjoying the summer now that it’s finally arrived.

Best, Jean

My Perspective

This patient is the daughter of an esteemed colleague of mine. She had burned out of practicing law and had embarked on a pre-med pathway at the age of 38. She had experienced low back pain for over two years. There was also significant pain, numbness, and tingling throughout her right leg. She had a normal MRI of her thoracic and lumbar spine. Electrical testing of her leg did not show any specific problems with the nerves. As I knew her father so well, I was especially anxious not to miss anything that might be serious. I could not find a structural cause for her symptoms.

I first saw her about 18 months ago, and on our last visit six months ago, she was just a little better. I tried not to be too discouraged but, I was not sure she was going to improve.

What is remarkable about her recovery is that it was truly self-directed. She did not see me in follow-up nor did she see another physician. I had recommended a mental health professional, as I thought she might be depressed. But she wouldn’t engage in that conversation. She did use the Feeling Good book and was diligent writing in David Burn’s three-column format. She also pursued obtaining a good night’s sleep, utilized the re-programming tools such as active meditation, and worked out regularly in the gym. Two years later she is re-pursuing her medical school dream.

This story is not an exception. With full engagement with a structured program the results are consistent.

The post Depression Masking as Pain first appeared on Back in Control.

The post Depression Masking as Pain appeared first on Back in Control.

A chaotic, even abusive upbringing predicts a long and harsh life. There are many chronic mental and physical health issues that occur that shorten lifespan and also markedly compromise quality of life. Raised in this environment, a child cannot reach his or her full potential when so much energy is consumed by trying to survive. Consider a young plant in rich soil with plenty of sunlight and water. Compare it to the same plant in poor soil, limited sunlight, little water. It may even look a different species.

Feeling unsafe

When we don’t feel safe, we’ll do whatever we can to achieve it. Feeling unsafe drives many, if not most destructive behaviors. Feel trapped causes us to react aggressively to solve the situation. The physiological response is called anger, which represents the body’s powerful last-ditch effort to regain control.

Since the most stressful problems are ones we can’t solve, sustained anger (threat physiology) turns into rage, destructive behaviors, and chronic illnesses as the body breaks down. Consider how many life situations are unsolvable. One of the deadliest and universal problems is feeling trapped by our thoughts.

We cannot escape our thoughts. Suppressing unpleasant thoughts fires up the threat response even more than experiencing them. Suppression causes the hippocampus (memory center) of the brain to shrink¹ and increases craving for opioids.²  Distracting ourselves with experiences, pursuing pleasure, adventures, and achievements also fires up the immune system.³

So how do we behave?

ADDICTIONS

Addictions create a sense of safety while engaged in the activity, but obviously are not long-term solutions. The reason addictions are so destructive is they temporarily mask mental and physical pain, and pursuing relief is compelling.

POWER

A deadly outcome of feeling chronically unsafe is the relentless pursuit of power in order to gain more control. It can’t and doesn’t work, but few of us are taught alternatives. The manifestations are almost infinite and infiltrate every domain of our lives and relationships with others. People closest to us are the most affected. No one wants to be controlled, yet trying to control others is almost universal. Anger is generated in those being controlled and also in those exerting control. There is never enough to assuage the unconscious brain. Unfortunately, anger is intentionally destructive, as it is your body’s last-ditch effort to survive emotionally or physically.

The data is deep, beginning in the schoolyard. We try to avoid anxiety, or – if we already have it – we try to get rid of it. Nothing enhances our feeling of control more than by gaining power in some way. This need is expressed in our interactions with each other; in fact, it dictates much of human relations.

Every child has significantly increased anxiety when they leave home to begin school, regardless of their family situation. They want to be accepted but there is also the greater need to diminish their fear. The need to get rid of fear and gain power is played out in forming cliques, excluding others, and overt bullying.

Researchers did a study of students who have been bullied versus the bullies to see if there was any difference in their physiological makeup. ⁴ They looked at the levels of a substance called C-reactive protein (CRP), which is elevated in the presence of inflammation; it’s often drawn to determine the presence of a hidden infection. Chronically elevated levels also indicate a stressed and overactive immune system. It is not desirable to have an elevated CRP.

The study revealed that children who had been bullied had significantly elevated levels of CRP compared to those who had not been bullied. Being bullied as your introduction to the real world is not a great start. What I find even more disturbing is that the levels of CRP in bullies was lower than the norm. As it turns out, there is both a social and physiological reward for possessing more power. How all of this plays out in adulthood is not subtle. Why would you want to give up power and control? Especially when feeling the pain of anxiety is the other option.

Every child has a strong need to be accepted, yet what should we make of the fact that it gives him or her more power (and self-esteem) to reject someone else? This is an endless loop, the root cause of which is the solvable problem of anxiety.

SELF-ESTEEM

The other as futile effort to counteract these deeply upleasant survival sensations is to pursue more self-esteem. This is problematic for seversal reasons. First, it is a gross mismatch of your unconsious brain overpowering your conscious brain by about a million to one. Anxiety and anger are hardwired automatic survival reactions over which we have absolutely no control.

Second, the unconscious brain never stops for a millisecond and is always on the lookout for danger. It is why we evolved and stay alive. The conscious brain’s attention is not sustainable and we quickly develop cognitive fatigue trying to stay happy. We also become physically tired as 20 to 25% of your entire body’s energy is used to run your brain.

Third, we are programmed by everyone around us about who we should be or not be. These voices in our heads become as concrete as any object and we act on them. Unfortunately, the “stories” in our heads are essentially all cognitive distortions. Self-esteem represents a huge distortion of labeling. We expend a tremendous amount of energy building up our ego, and then spend endless efforts defending it. The relentless pursuit of self-esteem disconnects us from the reality immediately in front of us. In other words, you lose awareness of other’s needs and relationships are compromised. Look at the human experience of how terribly we treat each other as individuals and societies. We have the resources to create a planet that could thrive yet we are at the mercy of our personal and societal “stories.”

What can you do?

Learn vulnerability. Being vulnerable is at the core of meaningful human relationships, but there is no reward in nature for being physically vulnerable.  Since emotional pain is processed in similar regions of the brain as physical pain, there are penalties for being emotionally vulnerable. Language creates a massive problem causing emotional pain that is much more complex than in other mammals. Anger, as unpleasant as it is, is powerful, addicting, and masks being vulnerable. Anger creates a sense of emotional safety, but no one around you feels safe. How do you learn to be vulnerable when you are used to dealing with a lot of anger?

DYNAMIC HEALING

Needing to pursue the above-mentioned destructive behaviors drops as you address the root cause of sustained threat physiology. You cannot control the survival reactions but there are numerous ways to regulate your physiology. When your body is bathed in safety physiology, you feel safe, connected, and incredibly relaxed. We use the term, “dynamic healing”, which addresses factors affecting your physiology.

• Input – dealing with life’s challenges in a manner that less impact on your nervous system.
• State of the nervous system – calm or hyperactive
• Output or the physiology – can be directly regulated from threat to safety.

The details of the Dynamic Healing model are beyond the scope of this discussion. The focus is on you and learning skills in each category to create “cues of safety”, and not on fixing or solving your pain. It is a healing process, and not “self-help”.

RUTs (repetitive unpleasant thoughts)

Regarding the onslaught of unpleasant thoughts, consider the metaphor of a hornet’s nest, with the nest being your brain, and the hornets your thoughts. At rest, the hornets are busy collecting food, building the nest, cleaning house, and reproducing. If the nest is shaken, the hornets will become aggressive and defend themselves. When your nervous system is inflamed and hyperactive, your thought patterns become intense, since your conscious brain interprets your internal physiology.

The usual approach is to use cognitive rational techniques to counter bad thoughts with good thoughts, which is an impossible task. Then we put up our “shield” (self-esteem, self-affirmations) to protect us. It also overwhelming and wears us down. Exerting increased control (suppression) is also futile. Then the more attention you pay to the thoughts your brain is fired up even more. It is a bi-directional process.

The answer lies in “quit shaking the nest.” The hornets will calm down and return to their usual activities. As your nervous system calms down, your unpleasant thought patterns will lessen, which in turn helps calm your brain. Although cognitive approaches lower the input into the nervous system, calming it down is a separate skill. There are endless other ways besides unpleasant thoughts that fire it up.

There are four aspects of creating a safe relationhip with your thoughts.

• Thought separation
• Calming the nervous system (processing anger)
• Creativity – stimulating new neurological circuits away from the unpleasant ones.
• Dissolution of the ego – once you learn to feel safe, there is less need for it.

Calming your nervous system allows you to feel safe. It allows you to break free of ruminating thought patterns frees you up to create and live life on your terms.

References

1. Hulbert JC, et al. Inducing amnesia through systemic suppression. Nature Communications (2016); 7:11003 | DOI: 10.1038/ncomms11003
2. Garland EL, et al. Thought suppression as a mediator of the association between depressed mood and prescription opioid craving among chronic pain patients. J Behav Med (2016); 39:128–138. 10.1007/s10865-015-9675-9
3. 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
4. Copeland W, et al.” Childhood bullying involvement predicts low-grade systemic inflammation into adulthood.” PNAS (2014); 111: 7570-7575.

The post Our Need to Feel Safe first appeared on Back in Control.

The post Our Need to Feel Safe appeared first on Back in Control.

Anxiety, Power, and Bullying

To be connected to other people is one of the strongest human drives. Humans evolved by interacting with other humans. We also have a deep need for acceptance. This sets up a serious contradiction because our even deeper need is to avoid anxiety.

We try to avoid anxiety, or – if we already have it – we try to get rid of it. One common method we use is to increase our sense of control. Nothing enhances our feeling of control more than by gaining power in some way. This tendency comes out in our interactions with each other; in fact, it dictates much of human relations.

Every child has significantly increased anxiety when they leave home to begin school, regardless of their family situation. They want to be accepted but there is also the greater need to diminish their fear. The need to get rid of fear and gain power is played out in forming cliques, excluding others, and overt bullying.

Researchers did a study of students who have been bullied versus the bullies to see if there was any difference in their physiological makeup. They looked at the levels of a substance called C-reactive protein (CRP), which is elevated in the presence of inflammation; it’s often drawn to determine the presence of a hidden infection. Chronically elevated levels also indicate a stressed and overactive immune system. It is not desirable to have an elevated CRP.

The study revealed that children who had been bullied had significantly elevated levels of CRP compared to those who had not been bullied. Being bullied as your introduction to the real world is not a great start. What I find even more disturbing is that the levels of CRP in bullies was lower than the norm. As it turns out, there is both a social and physiological reward for possessing more power. How all of this plays out in adulthood is not subtle. Why would you want to give up power and control? Especially when feeling the pain of anxiety is the other option. (1)

Every child does have a strong need to be accepted, yet what should we make of the fact that it gives him or her more power (and self-esteem) to reject someone else? This is an endless loop, the root cause of which is the solvable problem of anxiety. The myth of self-esteem

Sartatoga Teen Hangs Herself

I don’t know how you can measure the impact of bullying on our society. The suffering encountered at such an early and innocent age is deep and it’s rampant. Three 16 y/o boys raped a young girl in the Bay Area. What is much more disturbing is that instead of rallying to support her in a time of extreme distress, her classmates turned on her. A photo went viral. She was verbally abused both directly and over cyberspace. “Slut”. “Will you have sex with me?” She is now dead from hanging herself.

I was talking to a patient who was a middle-age school teacher. She was experiencing total body pain. She was clearly a broken woman and could hardly lift her head to look at me. She had been severely bullied throughout middle and high school and couldn’t shake it. The conversation with her was incredibly discouraging.

One of my colleagues had her son bullied badly beginning at age seven. Nothing seemed to work to stop it. Finally, at age 25 he simply gave up. He could no longer tolerate the relentless anxiety engendered by the experience. As sad as his mother was telling me his story, she felt that he was finally at peace. It was an intense moment to hear her say that about her own son.

Some observations

First, most bullying occurs at a level well below the teachers’ radar. Just being excluded from a group can be devastating. It is not going to be possible to put the responsibility solely on the their shoulders.

Second, our children are at an age where they are discovering and creating their identity. Most of it depends on some type of approval from their peers. For some reason the approval usually needs to come from the person or group who is the least likely to give it. When someone else defines your identity, that person has power over you.

Third, people wring their hands and point out that all of this should be done in the family. There are several significant problems with this thinking. I resent the term “dysfunctional family”. That implies that there are functional families. I have yet to see one. Humans consistently have significant problematic behavioral patterns, and is most deeply played out in the home setting.

Even if a child comes from a less dysfunctional family, they may become targets for the bullies. They are similar to a domestic animal turned loose into the wild. They either fold or become tough. Neither is great.

Fourth, the argument goes that school is an important socialization process. Really?? Going into an environment where peace, love and joy are hammered into the ground does not create a person who is loving and compassionate. They are just learning dysfunctional survival skills. Behavioral patterns set before age 12 are permanent. Bullies as children have a high chance of exhibiting aggressive behavior as adults as well as experiencing chronic pain. Many children with their egos destroyed will live the rest of their lives in fear.

Fifth, home-schooled children have been shown to do well later in life. My observation of several families that have taken it on is the their children are more creative and thrive without the hierarchy of the schoolroom. Here is an example of the work of some close friends of mine. They have been home-schooled and creativity oozes out of them. Beautiful

Sixth, look at what is happening to our society. We have a life that any generation prior to a hundred years ago could not imagine. Are we happier and more loving? We are passing along peace and love to our kids – especially in school. External possessions and accomplishments don’t change human nature. The incidence of chronic pain has skyrocketed in adolescents. (2)

Finally, there is a high correlation between the ACE score (Adverse Childhood Events) and disability. As pain drives anxiety and frustration and vice versa this shouldn’t be a surprise. These pathways are linked. We are not going to solve the chronic pain problem, which is crippling our society, unless we tackle it beginning in kindergarten. (3)

Solutions

Human behavior and survival revolves around avoiding anxiety. We’ll do anything to avoid the feeling, including holding on to our pain. Any change creates more anxiety. The key is learning to process and live with anxiety, so as to not have such a need for power.

Neuroscience research has shown us the powerful full body reaction that creates anxiety. You can’t control it, but you can calm and re-direct it. It is the core of the DOC process. Anxiety is the pain.

We’re also observing the power of the family in programming behaviors. Were you ever a bully? Do you still intimidate your co-workers, colleagues or family? Could your child’s bullying be learned from you? Were you bullied when you were younger? What effects of it might you be bringing into your current life? Are you often frustrated, angry or upset? What effect do you think it’s having on your quality of life? Do you even want to give up the power of your pain? You might have a legitimate reason to hold on to remaining upset? But who’s continuing to suffer?

Awareness

I think almost everyone agrees that bullying is a problem. However, we may not be aware that we might be part of the problem. The first step is understanding how your behavior might be perceived by those close to you. I can tell you it is a humbling exercise. A book given to me by a close colleague has had an impact on me. It is called, The Way to Love, by Anthony DeMello. He defines love as “awareness.” How can you meet someone’s need without understanding them or getting to know who that person is. Bullying would be the antithesis of awareness, as you are meeting only your own needs. I read a few pages weekly to remind me of the concepts.

Treating anxiety and anxiety with the correct approach on a widespread basis would have an effect on bullying, your child’s quality of life, and on your life. Commit to your own healing and reach out to heal your family. Watch the impact.

Although bullying is physically healthier than being bullied, it destroys the essence of life, which is healthy, thriving relationships. Bathing your body in reward chemicals emanating from giving back, a sense of purpose and play is a much better way to live.

1. Copeland W, et al.” Childhood bullying involvement predicts low-grade systemic inflammation into adulthood.” PNAS (2014); 111: 7570-7575.
2. Simons L, et al. “Pediatric Pain Screening Tool: rapid identification of risk in youth with pain complaints.” Pain (2015); 156: 1511-1518.
3. Anda RF, et al. “The enduring effects of abuse and related adverseexperiences in childhood. A convergence of evidence from neurobiology and epidemiology.” European Archives of Psychiatry and Clinical Neuroscience (2006); 256: 174–186.

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

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

There is no reward for being vulnerable for any species of life from one-celled organisms to homo sapiens. Consequences are severe and often swift. It is never safe to be off-guard, and different species create ways to be safe. They need to replenish fuel to fight another day. For example, a dolphin sleeps with one eye open. Many species form protective groups. Consider the number of ways creatures hide or camouflage themselves. Many species simply have thousands of offspring, so a few will survive. When these strategies fail, the final phase is whatever aggressive response they have available to them. The more strength and power, the better.

The added dimension of language

Humans have language, which creates another level of issues around seeking safety. We possess abstract thinking that allows us to engage in the arts, create coordinated societal actions, and have complex relationships with others. We rose to the top of the food chain because of our capacity to cooperate with each other. We have a strong evolutionary need to have close connections and relationships. For example, being socially isolated or lonely has the same effect on your health as smoking 15 cigarettes a day.¹ Look how much effort is put into seeing close friends and family during the holidays. We want to be with each other and the closer the better.

But one of the most perverse aspects of being human, is that successful thriving relationships require vulnerability and trust. These traits are the antithesis of feeling safe. Additionally, emotional/ mental pain is processed in a similar manner as physical pain.² “You hurt my feelings” and You broke my heart” reflect this phenomenon. So, we don’t like pain in any form, yet we have to become vulnerable in order to have deep and satisfying relationships. It is a huge problem, and it is not playing out well for the human race.

By definition, every interaction with another person requires taking a risk of being rejected or hurt. Even checking out at the grocery store involves trusting him or her to accurately document your purchases and help you with your bags. It is nice if they are in a good mood and are friendly. But what if they are having a bad day? Then there are deeper relationships such as being on a team, doing a project together, starting up any type of relationship, and living together. Being rejected at some level of the interaction is not only common, but also the rule. As you become more and more trusting, at some tipping point the level of vulnerability for that relationship will be reached, and one person will pull back or even reject it.

Your options

At this point, your choices are to 1) quit taking risks associated with interacting with others 2) engage but experience social anxiety 3) use whatever power you possess to control others 4) learn to be vulnerable. Since we don’t inherently possess the ability to feel vulnerable, the other less functional strategies are more commonly utilized.

Some form of anger is universal. Why? It keeps you safe. It protects you from both emotional and physical pain. Even if you don’t actually have the power to change the situation, you may feel like you do. Raw anxiety is intolerable and why we hold on to anger.

Why let go of anger?

• The main reason is that you simply cannot heal or thrive when you remain angry. The essence of healing is normalizing your body’s neurochemical state to that of a safety profile, which is profoundly restorative. If your whole system remains fired up, how can that happen? It can’t and won’t.
• Your brain structurally adapts to your focus of attention. You cannot move forward until you let go of the past, especially your deepest wounds. Most people in chronic pain remain angry at the situations or people who have harmed them. The more legitimate your gripe, the harder it is to move on. But how does holding on to the past make your life more enjoyable?
• Anger is destructive, as it is supposed to be. It’s your body’s last ditch effort to escape threat. It is destructive in every direction, including self-destruction. It is the reason why many people completely neglect every aspect of their health. It is tantamount to slow suicide.
• Anger is abusive and destroys relationships. The key element of successful human interactions is awareness of your needs and others’ needs. How else can you constructively interact with those close to you? Anger completely blocks awareness.
• Anger destroys families. Human consciousness evolved through language and social interactions. The ability to cooperate took homo sapiens from the bottom to the top of the food chain. The need for human connection is deep. Unfortunately, close connections are also the strongest triggers. Why would you ever be unkind to someone you care for so much? Why is the incidence of domestic abuse so high? It is maybe the most disturbing paradox of our human existence.
• Anger is the manifestation of the fight mode of the survival response. All organ systems are affected. The blood supply to your gut, bladder, and the frontal lobes of your brain diminishes and is shunted to your heart, lungs, and skeletal muscles. You can’t think clearly, although it might feel like you can. It is critical to, “Take no action in a reaction.”

Interacting with others involves taking the risk of being rejected or even hurt. There are physical risks, such as trusting a business partner who might run off with your money. What about your partner or spouse, who takes off with another person? These are deep ones, but simply reaching out to another person in friendship creates some level of anxiety.

Train your brain

You can use avoidance, suffer from chronic social anxiety, or resort to power and control to feel safe. The healthiest and most satisfying option is learning to be vulnerable and process rejection. In other words, being with anxiety. Being or feeling rejected is inherent to relationships, and unless you understand this, your world will become progressively smaller. Training yourself to lower your threat physiology (anxiety) instead of fighting it allows you to navigate life more easily. BTW, social connections are anti-inflammatory and lower anxiety.³ Addressing social anxiety is a bi-directional process. You can nurture joy, more easily interact with others, feel safer, and create the life you desire.

.

References

1. Cigna US Loneliness Index. Cigna: 2018.
2. Eisenberger N. “The neural bases of social pain: Evidence for shared representations with physical pain.” Psychosom Med (2012); 74: 126-135.
3. Dantzer R, et al. Resilience and immunity. Brain, Behavior, and Immunity (2018); 74:28-42.https://doi.org/10.1016/j.bbi.2018.08.010

The post Social Anxiety – Vulnerability Doesn’t Feel Safe first appeared on Back in Control.

The post Social Anxiety – Vulnerability Doesn’t Feel Safe appeared first on Back in Control.

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

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

“I am a victim”

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

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

The circus mirrors

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

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

Take a break

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

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

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

Bill

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

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

A friend sent me this poem:

“She Just Let Go”

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

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

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

She let go of the committee of indecision within her.

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

She just let go.

She didn’t ask anyone for advice.

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

She didn’t search the scriptures.

She just let go.

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

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

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

She didn’t promise to let go.

She didn’t journal about it.

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

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

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

She just let go.

She didn’t analyze whether she should let go.

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

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

She didn’t call the prayer line.

She didn’t utter one word.

She just let go.

No one was around when it happened.

There was no applause or congratulations.

No one thanked her or praised her.

No one noticed a thing.

Like a leaf falling from a tree,

She just let go.

There was no effort. There was no struggle.

It wasn’tgood, and it wasn’t bad.

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

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

A small smile came over her face.

A light breeze blew through her.

And the sun and the moon shone forevermore.

–Rev. Safire Rose

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

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

Reconnecting with Your True Self

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

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

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

• The root cause of suicide is feeling trapped and mental and physical pain are problematic.significant reasons to feel this way.
• Since mental and physical pain share similar brain circuits, they both create a lot of misery.
• Modern medicine largely assumes illnesses and symptoms are caused by identifiable structural problems. As most are created from the body’s chemistry, it can’t work.
• There is a reliable way out of chronic pain with the correct paradigm, obviating the need to escape it by committing suicide.

I recently received this letter from a close friend of mine who is a movement, dance, and rhythm specialist who uses creative tools to allow people to calm down and feel safe. Instead of you sensing danger, which creates a flight or fight response, feeling a sense of safety causes a profound shift in your body’s chemistry to anti-inflammatory. Fuel supplies are replenished, your brain becomes less reactive, the speed of nerve conduction slows down, and your pain diminishes.

famveldman/Adob

Feeling safe is healing

Regardless of how feeling safe is accomplished, the outcome of seeing chronic pain resolve is rewarding. When you are no longer fighting off pain and anxiety, patients can create the life they choose and thrive at a level they never knew was possible. Mainstream medicine is focused on treating symptoms and not the root cause of sustained flight or fight physiology (how the body functions). Chronic disease, including pain, is a complex problem, and treatments must address all the relevant issues and be individualized. It is not difficult to do. She and I become a bit upset when we see what is possible compared to random symptomatic interventions being offered in mainstream medicine. Not addressing the root cause of chronic pain is incredibly frustrating for patients and clinicians. By the way, most of us were not trained with the correct paradigm of chronic pain.

Devastating spine surgery

This is particularly true in spine surgery, as we continue to witness major surgeries performed on normally aging spines. Degenerative changes of the spine have been well-documented to not be a source of chronic back pain.¹ The success rate of a fusion or artificial disc is less than 30% at the two-year follow-up.² Why are we continuing to offer this operation? There are many problems created by operating in these circumstances, and suicide is one of them.

Her email

Sad news today. I received a phone call from someone that I have successfully worked with. He has been transformed from being bed bound with ‘a broken back’ to full potential. He wouldn’t phone me unless there was an emergency, so I took the call. He was in uncontrolled misery, crying, but eventually calmed down. His sister, living with ‘a broken back’ fixed with multiple rods and screws, was in unbearable pain for years post multiple surgeries from what I can gather. She refused all help, such as our approach and relatives in general. She jumped in front of a train in France. She was killed by the train, and was described as being under unrelenting stress and pain.

A sharp reminder of why we do this.

We plod on, in my case with a heavy heart, and I remind myself that if only one person hears that is enough.

Disability, surgery, and suicide

In a series of about 300 Workers Comp patients who had undergone a lumbar fusion for back pain, there were nine suicides. This data was not published. I had two patients early on in my career commit suicides. This was in the era of my practice where I was zealously performing fusions for back pain and actually felt frustrated when I could not find a reason to perform surgery. As a referral surgeon, I was viewed as their last hope. I knew nothing about the neurochemical nature of chronic pain. I had sent one to the local pain clinic, and the other one walked out of my office and shot himself later that afternoon.

Here are some of the issues around suicide. It is a complex topic, so I am just listing a few.

• I eventually learned that when my patients were complaining of pain, they were often referring to mental pain in the form of repetitive unpleasant thoughts (RUTs). There is a clearly documented association between ruminations and suicide.
• Mental and physical pain are processed in similar regions of the brain, and unpleasant thoughts and emotions hurt. What is particularly problematic is that many disability systems won’t allow treatments for a “mental health diagnosis.” What is being overlooked is that they are the same problem. The data is overwhelming.
• Until I learned to help people with mental pain, it was nearly impossible to solve the physical pain, with or without surgery. This was true even for surgical problems.³
• Both fire up the immune system, including the immune cells in your brain. A sensitized brain magnifies everything, and life caves in on people.
• It is my feeling that RUTs are a driving force in most chronic disease states – mental or physical. You are trapped by your thoughts; there is not a protective withdrawal response as there is with physical pain. We have no protection, and suppressing them creates even more havoc.
• Failed surgery in any field of medicine is devastating. You are offered a chance at a cure or significant improvement and commit to a risky and expensive procedure. You have a lot of hope, and it is dashed. Repeatedly dashing hope induces depression.⁴
• Learning to deal with anger is always the tipping point of healing. With failed surgery, there is now the additional and legitimate anger at the surgeon who did not deliver on the implied relief. If you knew that the success rate of a given procedure was less than 30%, would you go through with it?

Dealing with suicide head-on

I have dealt with almost every aspect of suicide. I have over 20 medical colleagues dead from suicide, including my fellow spine fellow. I almost committed suicide myself in 2002. My employee’s husband shot himself while talking to her on the phone. I have helped pull many colleagues back from the brink of going through with it. A whole group of us tried to help a fellow spine surgeon, and we failed. He walked out of my operating room and went out and shot himself. I have had numerous face-to-face conversations with patients who have threatened to kill themselves if I did not do the surgery that they wanted. Fortunately, I was much better at understanding how trapped they felt, and each one eventually healed and went on to thrive.

Trapped

I have concluded that the common denominator driving people to suicide is feeling trapped, including:

• RUTs – Repetitive Unpleasant Tho
• Physical pain
• Relationships
• Finances
• Lack of opportunity
• Being stuck in any form of disability system
• Immobility

Dr. Sarno, a famous physiatrist, recognized the impact of chronic pain and used the term “rage” to describe the feeling.⁵ You are additionally trapped by:

• Not feeling heard
• Being labeled
• Being dismissed by almost everyone, including those close to you.
• Not having the true nature of chronic pain explained to you
• Being given the diagnosis of “MUS” (Medically Unexplained Symptoms)
• Scattered medical care dealing only with symptoms and not root causes
• Not knowing when or if it will end

There are several papers documenting that the impact of suffering from chronic pain on your life is equivalent to having terminal cancer, except it is actually worse. As bad as it is, at least you understand the problem. There is also usually a defined endpoint, hopefully for the better.⁶

Hicham Sanbaoui1/Wirestock

Understand the problem – know the solution

Chronic pain, mental or physical, is consistently solvable by first understanding its nature. The current definition out of Chicago is the following: “…….chronic pain is an embedded memory that becomes connected with more and more life experiences, and the memory cannot be erased.”(7) So, procedures aimed at structural problems alone cannot and don’t work. It is one of the reasons I use the term “The Abyss” to describe the depth of despair being trapped in pain.

Conversely, although these brain circuits are permanent, you can consistently reprogram your brain around them. Like any new skill, it requires an open mind, repetition, and commitment to yourself. Your brain physically changes structure, inflammation drops down, and people often not only escape from chronic pain, but they thrive. It is also the reason I quit my spine surgery practice to pursue getting these concepts out into mainstream medicine. There is nothing more rewarding than helping patients help themselves out of this hole.

References

1. Jensen MC, et al. Magnetic resonance imaging of the lumbar spine in people without back pain. NEJM (1994); 331:69-73.
2. Carragee, EJ et al. A Gold Standard Evaluation of the ‘Discogenic Pain’ Diagnosis as Determined by Provocative Discography. Spine (2006) 31: 2115 – 2123
3. Perkins, FM and H Kehlet. “Chronic pain as an outcome of surgery: A Review of Predictive Factors.” Anesthesiology (2000); 93: 1123 – 1133.
4. Blum, Deborah. Love at Goon Park. Perseus Publishing, New York, NY, 2002.
5. Sarno, John. Healing Back Pain. Warner Books, New York, NY,1991.
6. O’Connor AB. Neuropathic pain: quality-of-life impact, costs, and cost-effectiveness of therapy. Pharmacoeconomics (2009); 27: 95- 112.
7. Mansour AR, et al. Chronic pain: The role of learning and brain plasticity. Restorative neurology and neuroscience (2014); 32:129-139. doi: 10.3233.RNN-139003

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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.

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Anger is the body’s effort to regain control of a situation that you perceive as threat. It’s the most basic of survival reactions. It is only about your survival and by definition is destructive. In an enraged state of mind, you’ll do whatever it takes to take care of yourself. It doesn’t matter whether the danger is real or perceived because your body’s neurochemical reaction is the same – adrenaline, cortisol, histamines and other stress chemicals. In addition to the many physical reactions to these hormones (rapid heart rate and breathing, sweating, widened pupils, etc.), they also decrease the blood supply to the frontal lobe of your brain. You can’t think clearly or see options when you’re trying to “escape.” Many acts of aggression and violence, if not most, occur while in this state of mind. It is truly temporary insanity and it’s dangerous.

Steve’s story

This situation was highlighted to me by a friend of mine, Steve, who is about my age. We were discussing the pros and cons of gun control. He told me a chilling story that occurred while he was in his early twenties and recently married.

At the time, he felt strongly that it was important to keep a gun in the house not only to protect himself, but also his new wife. He was comfortable with guns and knew all the safety rules. His wife had equally intense feelings about not having firearms in the house.

They had been out for the evening a few weeks earlier at a bar. An acquaintance of hers started to talk to them and became somewhat inappropriate in his comments. She and Steve left early to avoid an impending confrontation. There didn’t seem to be much more to it.

Two weeks later, this “acquaintance” knocked on Steve’s door and asked to speak to his wife. That was the last straw for him. They began to exchange some harsh words and Steve, according to his account, “lost it.” He went running to the bedroom to get the gun and settle this once and for all. He said the jealous rage that hit him was indescribable. He fully intended to finish this guy off – except that his wife had hidden the gun. It still wasn’t a pretty ending, but it was game-over as far as using a gun. He was able to regain his senses enough in the few minutes of searching for the weapon, that he figured this was going to be a really bad idea.

The next 40 years

Forty years later, he and his wife have raised a beautiful family. He owns his own business and enjoys talking about the Golden State Warriors with us. There is no question in his mind that he came extremely close to spending those years in prison.

Each person’s world is defined by his or her nervous system taking in sensations from all the different receptors (eyes, ears, skin, nose, etc.), unscrambling the signals and defining reality. There’s nothing inherent in your eyes that defines that a chair is a chair or a lamp is a lamp.  For example, if you have a stroke in the vision center of your brain (occipital lobe), you’ll be completely blind although your eyes work perfectly fine. Humans have a serious problem of consciousness in that thoughts and belief systems become embedded in our brains the same way as any other object. They are as real to you as that chair. Clearly, actions taken in response to upsetting thoughts are real.

Connected to the past

When you’re anxious or angry, your brain just connected with some unpleasant experience in the past and your nervous system is saying, “Danger – take action – now.” Rational thinking isn’t part of this reaction and things happen quickly.

It’s critical not to suppress the reaction because it fires your body up even more. Over time, people become ill from the sustained chemical assault of stress hormones. So, if you experience anger, it’s a problem and suppressing it is even worse. What do you do?

“No action in a reaction.” You must allow yourself to feel the upsetting feelings and emotions and then discipline yourself never to engage with anyone or anything when you are in this state of mind – ever. It’s tough because the reactions are so strong and there’s never an endpoint where you’ll cease to be angry. You will fail at different levels, but the skill improves with time and repetition. The key is to create some “space” between the perceived threat and the automatic survival reaction. In that “space,” you can choose a different and more appropriate response. Your brain changes structure and shape every second (neuroplasticity) and eventually the automatic reaction will be more appropriate. Here is one approach called, “5-3-2.”

Steve was lucky. His wife hiding the gun gave him that “space”, which was not having access to the gun. He was able to calm down enough to resolve the situation. When you’re angry, it doesn’t matter what your mental health is. You’ll act in a self-protective manner regardless of the costs. Steve is about as good-hearted of a person as you’ll ever meet. Having him spend his life in prison (or anyone’s life) based on a 15-minute reaction isn’t logical.

Guns are just one manifestation of anger in action

Decreasing gun violence by improving society’s mental health is missing the mark. The topic is complicated but the discussion regarding solutions needs to center on the fact the anyone can have an irrational reaction in a fit of rage. Steve wasn’t mentally ill and this situation could happen to any of us. Forget about guns for a second. What about the levels of verbal, sexual and physical abuse that are so common in American families? It intellectually doesn’t make sense to treat those you love so aggressively, yet abuse is rampant in our educated modern society. Gun violence is just one manifestation and is the tip of the iceberg. Anger is the driving force and needs to come to the forefront of any discussion about violence and abuse.

The person who is a “cold-blooded killer” represents a different scenario. People in this category are defined as sociopaths or psychopaths.  Although the killer may have global anger at some perceived societal or racial wrong, the actual act doesn’t usually occur in a fit of rage. However, this scenario represents a sustained state of anger where these thinking patterns become embedded in the brain and become stronger over time. It becomes the lens that life is viewed through and eventually their version of reality. At some tipping point, taking action is almost inevitable.

The bottom-line is that anyone can make a huge mistake in a fit of anger and immediate access to a weapon magnifies the impact. Everyone is so busy defending their positions around firearms, that the root cause issues aren’t being discussed. Any form of violence, especially within the family, is a major public health issue. Is inflicting daily abuse on someone who is dependent on you a less of problem than using a gun?

It’s important to be aware of when you are angry and NOT suppress it, but also understand the dangers of it.  Learn to “be with your pain” and resolve to take no action when you’re in a reaction. Steve happened to have “space” created for him at the moment. It’s important to learn how to quickly create your own space any time you’re upset before you act. We’re happy that Steve is around and that we are able to enjoy spending time with him.

Anger is universal, an automatic survival reaction emanating from our powerful unconscious brain that we have no control over. However, we do have a choice of how we respond to and it is a learned skill set. The solutions are straightforward, easily learned, and can be implemented from a public health perspective. We need to get our society’s brains back “online” soon.

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• Our core life outlook is programmed by every second of our life to the present moment.
• Each person has infinitely unique perspective and feel there are basic ways we “should” live our lives.
• When others (or ourselves) don’t meet our internal standards, we’ll often become critical and demanding.
• When your wishes turn into demands, internally or externally, you have created “unenforceable rules.”
• Remaining upset about situations you have no control over burns up your reserves, and you’ll develop unpleasant symptoms and/or become ill.
• Understanding the problem allows solutions.

“Should”

There are many reasons for resentment and one of them is the word, “should”. Dr. Fred Luskin in his book, Forgive for Good,¹ presents a concept of the “unenforceable rules.” There are many situations that irritate us daily and a can consume a lot of energy. Many of the frustrations arise from situations that we have little or no control over, such as other’s behavior. Dr. Luskin points out that it’s fine to wish someone would behave differently, but when that wish becomes a demand in your mind then you are wasting your time, consuming energy, and destroying relationships. Thinking, “I wish my son had better manners” is much different than, “He has to act better and I am going to have a say about it.”

This type of thinking pervades almost every aspect of our lives and the closer the relationships the more intense the interaction. Make a list of behaviors of how others should act. What happens when they irritate you? Do you give advice, snap at them, nag, or give unasked-for advice?

If you’re critical, either openly or silently, of your other’s actions, you’ll foster resentment within you. The people you are critical of are not any happier about being criticized than you are when you feel judged. What makes all of this more ironic is that when you are judgmental, you are just projecting your own opinion of yourself onto others. As you can see, this is a tangled mess.

Where does it come from?

It arises from within us. We are programmed from birth to be what everyone around thinks we should be. Your parents are the earliest and most powerful influences, but everyone has an effect – friends, colleagues, employers, co-workers, society, and the marketing world. So, the word “should” becomes the guiding force of our lives. Other descriptions are “self-esteem”, “perfectionism”, and the “self-critical voice.” They are relentless and a major factor wearing us down and compromising the quality of our lives. Additionally, there is no way for humans to escape from their thoughts and consciousness. Stress in the form of “URT’s” (Unpleasant Repetitive Thoughts)² causes a chronic stress state and may be the underlying driving force behind all mental and physical diseases.

So, we are also the target of our own “unenforceable rules” and then project them onto others. It is how human consciousness works. As dismal as this situation is and it is as disruptive as it sounds, it is a solvable problem. There are many ways to calm the nervous instead of trying to control it. The first step is understanding the nature of your self-critical voice, nurturing awareness of how it looks, and feeling its impact on you and others around you.

Suggestions for “should” to “would like”

First, everyone sees the world from their own perspective and it feels like the “correct” one. Work on suspending judgment and try only to listen.

Second, keep reminding yourself of the “unenforceable rules”. You have little control over most of the situations that irritate you. This is especially true when others are trying to control you. Train yourself not to react when you feel judged and become aware of when you are judging and making demands based on your “standards.”

Third, everyone’s perspective is valid – especially your children’s. Only listen to your children for a month (preferably indefinitely) without giving advice or being critical. Consider reading Parent Effectiveness Training by Dr. Thomas Gordon.³ He was a child psychiatrist who presents remarkable insights into how your children are viewing your behavior and words. Often a child can see a situation more clearly than a parent who is upset.

Finally, just let go. Enjoy your day with whatever tools you have. All these patterns and reactions are almost infinite and have no endpoint. Quit trying to “talk it out” and realize that anytime you are anxious or angry, you’re in a survival reactive pattern that isn’t subject to rational interventions.”

All of these strategies center around awareness. It’s critical to see when you have transitioned from, “Would like” to “Should.” Then let go and move on.

Recap

I was putting up our Christmas tree one year and the strings of lights had become tightly tangled. As you well know, the solution is to loosen it all up and slowly unravel it. I got a little frustrated and started to yank on the wires and of course made it much worse. Understanding how you have become ensnared in your life outlook is a critical step in untangling it. Then look at how your views are projected onto others.

Ongoing self and other-directed “should” thinking erodes our enjoyment of life. Awareness is key to solving it. Are you being the person that you want others to be. If you are in a critical mode, is that attractive to people around you? Would you want to hang out with you? Awareness of how your actions and attitudes appear to others is humbling and also allows change. You’re your nervous system becomes more regulated and calmer, you’ll be the change you’d like to see and it is contagious.

Questions and Considerations

1. By definition, each of us has self and world views that are unique and how we determine our place in life. It is challenging to see situations through another person’s eyes.
2. So, we have a fairly fixed life lens and other’s actions validate or invalidate this view. We have an instinctive impulse to bring people around to what we think is right and become upset when they don’t respond.
3. We can’t control other people, although we certainly all try. None of us like to be controlled; yet we still do it.
4. Consider the actions in others that are upsetting to you, the amount of energy you are expending in this state, and how you might be trying to influence them to change.
5. You might wish others would behave in a way that is more in line with your thinking, but when, “would be nice” turns to, “should be this way”, you are keeping your body in a threat state, expending needless energy, and detracting from the quality of your life and others. You may also become ill.
6. Understanding how infinitely different each of us are is an important starting point. Be kind to others and to yourself.

 References

1. Luskin, Fred. Forgive for Good. Harper Collins, New York, NY, 2003.
2. Makovac E, et al. Can’t get it off my brain: Meta-analysis of neuroimaging studies on perseverative cognition. Psychiatry Research: Neuroimaging (2020); 295:111020. doi.org/10.1016/j/psychresns.2019.111020
3. Gordon, Thomas. Parent Effectiveness Training. Crown Publishing, New York, NY, 2000.

The post From “Would Like” to “Should” – The Unenforceable Rules first appeared on Back in Control.

The post From “Would Like” to “Should” – The Unenforceable Rules appeared first on Back in Control.

• All of us are “wronged” every day and often multiple times. The wrongs may be real or perceived.
• Your choice centers around how you want to process them.
• Do you hold on to it them or let go and move on?
• You always have this choice. One problem is that the more legitimate your anger, the harder it is to let it go.
• Recognizing the nature of a “grievance story” is the first step.

I have held three and five-day workshops at the Omega Institute in Rhinebeck, NY with Dr. Fred Luskin, a Stanford psychologist and author of Forgive for Good,¹ my wife, Babs Yohai, a professional tap dancer, and my stepdaughter, Jasmine, who is an expressive arts practitioner. The tightly-structured seminar is based on awareness, hope, forgiveness, and play. Most people experienced major shifts in their pain and mood during the week and continue to improve following their attendance.

There were three ground rules: 1) you could not complain about your pain or let the other participants know where you were hurting 2) medical care could not be discussed 3) no complaining – period. Most participants were initially thrown off by not being able to discuss their pain, but quickly realized how important it was in contributing to his or her healing. What I had not realized prior to conducting these workshops is how much people complain – not only about their pain, but also about life in general. How can you enjoy your life when you are continually upset?

Your Grievance Story

One of the first concepts that Dr. Luskin presents in his book, Forgive for Good,¹ is that if you tell the same story of woe more than three times to others where you are the victim, you have a “grievance story.” He points out that this person or situation is “renting too much space in your mind.”

Directing your attention

Your nervous system will rewire and mature in whatever direction you place your attention. How much time do you spend thinking (obsessing) about your pain? How aware are you of other’s needs? What percent of your conversations are spent discussing some aspect of your suffering? Do you really enjoy discussing your pain? Don’t you become tired of it? Are you driving friends and family away?

BTW, talking to your dog or cat is OK. It is a variation of expressive writing, and they listen.

Recognizing your grievance stories

Grievance stories are common and every day, life does not go exactly as you planned. It becomes easy to look at “patterns” and feel that this person always does this to you, or your employment situation is adverse. The home is also a great source of grievance stories. Dr. Luskin defines a grievance story as being you telling the same story of being wronged to three different people. It is a simple yet sobering definition because we are upset, it feels good to vent and feel supported. Maybe once is fine, but how long do you want to remain a victim of circumstances? The only person who will continue to suffer is you. If you apply this simple concept to your life and conversations, you might be shocked at how many of these stories you have and how often you share them.

Bringing grievances home

People commonly bring their complaints about work or the day home. They somehow feel it is important to share and “download” the problems. Even if you are not upset at your family member or others in the house, it brings in an unpleasant energy and upsets your home. Home is a place to rest and regenerate and complaining about the day doesn’t create peace. Through the mirror neurons effect of the brain, you’ll directly fire up similar areas in other peoples’ brains. We all know that just being around someone who is frustrated is not great.

Frequently, the scenarios at work or with your disability situation are not solvable, the grievances may be legitimate (they usually are), and you’ll continue to remain upset and disrupt your family. All parties eventually get worn down. Whatever your issue is, you own it. It is not others’ responsibility to solve it or even make you feel  better. So, what is the end point? It is you. You have a choice of how you relate to your troubles. You don’t have be happy about what is happening, but it is important to stop complaining. Recognizing your grievance stories is the first step. They are not only “renting too much space” in your mind, but they have also moved into your house.

Georgia

One of the most dramatic turnarounds I have witnessed was a patient who came to me to treat her scoliosis. Her curve was about 60 degrees and she was suffering from chronic back pain. There is little evidence linking scoliosis to chronic pain. Since her spine was still balanced, I was not inclined to consider a surgical procedure. It would have involved at least 8 hours of surgery with a complication rate of over 50%. She had been wheelchair-bound for about 10 years and was taking a lot of narcotics. I told her that I would consider surgery only if she engaged in the rehab process as outlined in my book. I asked one of my colleagues to help out with her healing process. Within a couple of months, we realized that she was not taking any responsibility for her condition and was unwilling to put forth any significant effort. We decided to discharge her from our care, as we clearly were not being helpful.

About a year later, she re-appeared on my schedule. I have to confess – I was dreading walking into the room, since I had already given her so many admonitions to engage. I opened the door and she was standing there without any support, was off all of her narcotics, and did not have any pain. She was working out in the gym and getting back to re-engaging with her friends. I was stunned.

Of course, I was more than a little curious about what had happened. She admitted that she had been sitting in her house for years,  obsessing about everything that had gone wrong in her life. Essentially, all of her conversations were focused on her problems that were created by her pain. She had been in a couple of car accidents and had gone through a bitter divorce. She resonated with the forgiveness section of the DOC project, and quit talking about her miseries. She decided to let go and move on. Within six weeks the pain began to abate, and by four months it was gone. And even though I saw her at a later date in the hospital (she had a fall), Georgia was still living the life she had always wanted to live and radiated energy and joy.

Recap – Stop it

Stop discussing your pain, medical care, or even any of your troubles with the world – NOW. There are no shortcuts. You are not going to move forward while hanging on to your grievances. Every day is an opportunity to begin anew. Behavioral patterns are so deep that changing your conversation to enjoyable topics may be difficult. It will initially be challenging, but you will be surprised at the effectiveness of this simple strategy. Can’t do it? Really? It’s time to ask yourself – how badly do you want to heal? It is surprising at the number of people who unconsciously hold onto the power of their suffering.

Questions and considerations

1. Make a list of stories of woe that you often share with others and then focus on three that seem the most important. Then just stop talking about them. Eventually you’ll be less inclined to discuss them.
2. A major aspect of healing is nurturing joy. Consider how often you are doing this compared to the amount of time spent complaining.
3. Ask people who are close to you about how much time you spend sharing your problems and how they feel about it. What are some of the themes? You may not like the answers, but you’ll understand the importance of changing your patterns.
4. Consider how you feel when one of your close friends or family is constantly complaining? How do you think you appear to others when you are in this mode.
5. Are you being the person you would like to hang out with?

References

1. Luskin, Fred. Forgive for Good. Harper Collins, New York, NY, 2002.

The post Grievance Stories first appeared on Back in Control.

The post Grievance Stories appeared first on Back in Control.