I went skiing for the first time when I was 14. Our family was not a ski family, but my father decided to take us on a ski vacation at Mammoth Mountain. The whole trip was somewhat of a disaster as we were so unprepared. I got to the mountain too late for ski school, so my brother, who had skied once said he would teach me. We ended up on an intermediate slope. In spite of his best non-efforts, I twisted my knee, tore one of the ligaments, and ended up in a long leg cast for eight weeks.

No choice

For those of you who have never skied, being on a slope that is above your skill level is not only frightening, but it can also border on terrifying. Most skiers have experienced this scenario at least once. But any situation in life where you are in above your head elicits a similar response. What makes skiing unique is that you have no choice. You must get down the hill by the end of the day.

You must also make it through life. Consider life as a major ski resort with many choices except one. When you check into the ticket window early every morning, instead of buying a ticket, you are assigned to ride one chairlift. You must ride it regardless of the difficulty of the run or your expertise. No one is going to help you down.

Ski runs

The difficulty of a run is rated by colors. The easiest slope is called the “magic carpet.” You stand with your skis on a moving belt and get off on a hill that is almost flat. Green circles are usually accessed by chairlifts and the runs are smooth and gentle for beginners.  A blue square indicates a somewhat steeper slope for intermediate skiers. Some runs have bumps called moguls. Black diamond runs are steep, usually ungroomed, and often have many moguls. Double black diamond runs are challenging even for high level skiers and dangerous for beginners. There are many warning signs saying, “experts only.”

Life

One problem we all face is that life is full of double black diamond runs. However, it is all relative. Anytime you are on a hill that is beyond your skill level, it is problematic. A beginner skier on an intermediate hill is not having a great time. Consider a beginner skier who has to navigate a double black diamond run. It is truly terrifying.

The core cause of all chronic mental and physical illness is sustained levels of stress. Stress can be defined as threat physiology or flight or fight. This state is necessary in order to keep you alive. The reason why chronic stress is so deadly is that you have no time to rest and regenerate. For example, the reason your heart can function for so long is that it rests between beats.

Dynamic Healing

There are three aspects of staying alive: 1) your input or stresses, 2) the nervous system which processes sensory input, 3) and the output, which is your body’s physiology. It can be in threat or safety. Sustained threat physiology is what creates mental and physical illnesses. It is the balance between your circumstances and coping mechanisms that determines your body’s chemical state. The essence of healing is decreasing your exposure to threat physiology and increasing time in safety. These are acquired skills.

They consist of processing input (stress) so it has less impact on your nervous system, calming the nervous system so as to be less reactive, and directly lowering your threat physiology. All three portals are accessed daily, and it requires repetition to make them automatic. Over time, you will be a “professional at living life.”

On the slopes

Taking this back to the ski resort metaphor, anytime you are in over your head, you will be in threat physiology. Your goal is to increase your skill level to the point where you have less of a chance of being on a hill that is frightening to you. Before you begin, you must have equipment that is safe and comfortable, including  being dressed according to the weather (too hot or too cold is a problem). Skiing requires strength, flexibility, and endurance, so conditioning is also important.

But the next step once your skis are on, is that you must learn to stop, regardless how steep the hill is. Even on a bunny hill, this is critical. On expert terrain, you must be able to set a firm edge. You cannot learn anything until you can stop. My wife endlessly reminds me that the first time I took her skiing, I neglected this detail, and she stopped by running into a building. It was a slow speed, so she wasn’t injured; but she wasn’t that happy.

Why do you ski? Why do you live?

Your desire is to enjoy your experience as much as possible. For example, if you are an intermediate skier on a blue slope, you can feel relaxed, work on skills, let the skis do the work, and have a great time. Isn’t that the reason you are skiing? But what if you are a blue skier on a black run or a green skier on a double black diamond run. It really is terrifying, and one experience will cause people to quit forever. But you have no choice. Life keeps coming at all of us and there is no end to the challenges. What are you going to do? You cannot stay on top of the hill all night. You don’t want to fall down a double black run at a high speed. It happens and people get hurt.

Then consider the scenario of an expert skier on an intermediate run well below his or skill level. Normally, it is an enjoyable experience. But today is 12 degrees, the wind is blowing about 20 mph, it is foggy, hard to see, and extremely icy. The expert skier must go into a defensive survival mode and might be OK. But it isn’t  much fun. What if you are green skier on a double-black diamond run in these conditions? It is beyond terrifying and also life threatening.

Good luck – or is it luck?

You cannot control most of the circumstances in your life, but you can develop skills to deal with them more effectively. Many more days will be enjoyable, and you also possess the confidence to deal with severe adversity. Your body frequently goes into threat physiology because it is protecting you. But you don’t have to stay there.

Few of us are taught the life skills of regulating our physiology (stress) and even fewer are taught to nurture joy. You might say, I don’t want to learn how to ski. I don’t like it. Good luck. You still have to check in at the ticket window and get your assignment for the day. We spend a lot of time learning many different skills but not much attention is spent on learning how to navigate life.

The post Downhill Skiing is Dangerous – So is Life first appeared on Back in Control.

The post Downhill Skiing is Dangerous – So is Life appeared first on Back in Control.

• Healing chronic illness happens by moving towards health not by “fixing” yourself.
• An analogy can be made to becoming a professional baseball player. The goal is to be “safe” as often as possible.
• Your skills to process adversity and nurture joy improve with focused repetition. Attempting to get rid of your mental and physical pain without specific tools is futile, frustrating, and counterproductive. Focusing on your problems only reinforces them.
• Healing is a dynamic daily process,  and you frequently make outs. That is life. Keep moving forward towards the life you desire.

“When is my anxiety and pain going to go away?” This is the wrong question. If you are monitoring your progress in terms of how you feel, your pain (mental and physical) is at the center of your life, and you are reinforcing survival circuits and reactions. The better question is, “how can I learn skills to feel safe?” It is while you are in safety that your body refuels, regenerates, and heals. Your focus must be on learning and practicing becoming a “professional at living life.” As you heal, many, if not most of your symptoms will improve or resolve. When they recur, which they always do, you possess skills to calm yourself and move on.

Major league baseball

Consider your life journey in the context of becoming a major league baseball player. You are the hitter and life is the pitcher. The pitcher is not your friend, and neither is life. Every living creature has to compete for resources to stay alive, much less thrive. Your goal is to get on base safely as often as you can.

Life throws us every type of pitch at any speed—fastball, curve, slider, sinker, and changeup. It may be delivered overhand, sidearm, or even underhand (submarine pitch). Don’t forget the knuckleball that is thrown without the ball having any spin. Although it is a slower pitch, it “floats” so much that it is unpredictable where it is going to end up. Major league catchers even have to wear an oversize catcher’s glove in order to be able to consistently catch it. Some pitchers “cheat” with spitballs, which increase the movement of the ball and are illegal. That a human ever hits a major league pitch borders on miraculous.

There are several ways to reach base safely. You might get on with a walk, an error, balk, dropped third strike by the catcher, base hit, or being hit by a pitch. It requires years of repetition to develop a disciplined eye for “your pitch”, have the patience to walk (especially with two strikes), have a reproducible consistent swing, and be in excellent physical and mental shape. Years of coaching and practice are required to make it to the majors.

The skill level ranges from knowing nothing about baseball, to playing T-ball (hitting a plastic ball off of a stand), little league, high school, college, minor leagues (A, AA, AAA levels) and finally the majors. A nickname for the highest level is the “circus”— not a subtle analogy to life.

Baseball is considered one of the more perverse and stressful sports. The “team” effort is a collection of individual efforts and collaboration.  This is in contrast to a sport, such as basketball or soccer where perfecting teamwork with passing, defense, and strategy is equally as critical. Mistakes in these other team sports and are less obvious and usually have less impact on the overall outcome. So, in baseball, heroic feats are highlighted but so are mistakes. One error or strikeout can cost the game or even a whole season. Life is even a higher stakes contest, and the smallest poor choice can alter your life’s trajectory.

Keep in mind that the best players make an out a high percentage of the time. Life keeps coming at us and sometimes we do well and often we don’t. That is not failure; it is just life. Most of us are not taught the basic skills of effectively navigating adversity, regulating our body’s chemistry, and nurturing joy. We are tossed into life doing the best we can to survive. Our examples of how to live are taught to us by our parents, teachers, peers, and society, who also did not learn effective self-regulating skills. It is no wonder that there is so much suffering and societal chaos.

Creating Safety

With regards to chronic mental and physical pain, we are generally focused on resolving symptoms. But that causes your brain to develop where you don’t want it to, instead of creating what you want (neuroplasticity). You must separate from what you don’t want and learn to “get on base,” by creating safety physiology. In this state, your body regenerates and heals. The more time you can spend in safety, the better.

The key to healing is developing your own set of strategies to live life skillfully. The approaches fall in two different arenas. One is efficiently processing adversity and the other is nurturing joy. Each person is unique and attains his or her own best skill set in each realm. If you are waiting for a medical provider, course, or book to fix you, how is that going to work?

Practice, practice, practice

Your skills will be limited in the beginning. You must attain a minimum level of expertise to play the game, including just learning the rules and strategies. Initially, you will make an out most of the time, but it is critical to always treat yourself with kindness, regardless of your result at the plate.

As you work your way through the system, starting with little league, high school, and then Single A ball to the Majors, you’ll begin to feel better. The good news with chronic illness is that it doesn’t require years as much as it requires repetition of the correct approaches for you. Each person progresses at his or her own speed.

Many people experience enough relief that they stop learning and practicing, even though he or she may just be entering the minor leagues with regards to their level of expertise. But once you are out of the “Abyss” and moving forward, you are just beginning your journey. Why would you stop? If you were aiming for the majors, why would you just drop out? You might feel that you don’t want to put in that much effort, or it is too much work. What is work is fighting anger, anxiety, and pain for the rest of your life. Even at the top level, professional athletes and performers utilize coaches. Why would you not want to attain the highest expertise for navigating your whole life?

“I don’t want any pain.”

One common trap in dealing with pain, is that people want it gone forever. If they heal and then relapse, they’ll become upset and self-critical. Even worse, they might blame someone for their troubles. Staying alive is a challenge and there will always be some level of pain every day. It may be minimal. Sometimes your stresses may be overwhelming, or your nervous system may be hyper-reactive, and you’ll go into threat physiology. But you’ll understand how to lower it quickly. Eventually, you’ll learn better ways to avoid it.

Recap

Focus your efforts on becoming a “professional at living life.” Your focus is on learning better skills instead of trying to get rid of your pain. As you come out of The Abyss, you’ll have more energy to learn even faster, and life becomes easier. Of course, you want less suffering, but you must focus on solutions instead of the problems. It is a never-ending but progressively more enjoyable journey.

Questions and considerations

1. Switching your focus from fixing to creating yourself is a huge paradigm shift. Like all creatures we react more to threats. Humans are a reactive species, and we often don’t respond until situations become crises.
2. Few of us understand the physiological basis of chronic illnesses. They arise from the body malfunctioning and healing happens as it returns to normal function. What about learning to maximally optimize it?
3. Baseball is just one example of a performance. Consider one that you relate to more-music, art, electronics, computers, endurance sports, or dance. You can consider them in terms of a hobby or developing expertise. Life is not a hobby.
4. Turn your energy to becoming the highest-level performer of life. It is much easier than just trying to survive it. Attempting to hit a 95-mph fastball without adequate skills is impossible. Is life so different?
5. Take note of where most of your daily attention is focused. Consider what you were excited about when you were younger. Are you focused more on what you wish for or on avoiding what you don’t want? The answer is where your brain and nervous system will develop.

The post Navigating Life is Similar to Playing Major League Baseball first appeared on Back in Control.

The post Navigating Life is Similar to Playing Major League Baseball appeared first on Back in Control.

• 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.

Profits over quality

The business of medicine, like any other business, is focused on making a profit. There are computer programs that monitor physicians’ contribution to the profit margin. The most revenue comes from performing procedures, many of which have been documented to be ineffective. (1) The downside risks include unnecessary costs, significant risks and patients are often worse off than before the intervention. (2) It has also been documented that only about 10% of spine surgeons are addressing the known risk factors for poor surgical outcomes. (3) Dr. Ian Harris, who is an orthopedic spine surgeon from Australia, has done extensive research on the utilization of ineffective procedures. He wrote a book, Surgery: The Ultimate Placebo, where he extensively documents the data behind many procedures that have been proven to be of no benefit and it hasn’t stopped physicians from using them – at all. (4)

What works

Effective treatments are often not covered or don’t have a way of generating revenue. For example, expressive writing has be shown to been helpful in multiple medical conditions in over 1,000 research papers. (4) Yet, I had never heard of it until I accidentally ran across it in 2003. It costs nothing, has minimal risk and is rarely presented as a treatment option. It has proven to decrease symptoms of asthma, depression, rheumatoid arthritis, improve student’s athletic and academic performance and diminish many other symptoms. I had dinner with the original author of the technique, James Pennebaker, who is a psychologist from Austin, TX. The methods may differ, but it has only been reinforced as an effective tool. There is a lot of debate of why it works, but not about whether it works.

Mindfulness-based stress reduction has also been demonstrated to decrease pain in many papers and is usually not covered by insurance. I watched several excellent pain programs in the Puget Sound shut down because they could not afford to keep them open. Listening is a proven healing modality in addition to being a basic requirement to understand a given patient’s whole situation. Dr. Francis Peabody, a famous Boston physician, was concerned about the intrusion of technology into the patient-physician relationship. One of his more notable quotes was, “The secret of care is caring for the patient.” He wrote this in 1927. (5)

The business of medicine

Currently, mainstream medicine is pretending to deliver medical care. At the same time, people still trust their physicians. My observation is that it isn’t the individual physicians that are the issue. The corporatization of medicine is backing us into a tight corner. Not only are we not given the time to talk to our patients, many are often penalized heavily for not being “productive enough.”

One problem that is not often acknowledged is that of inducing a depression from repeatedly dashing people’s hopes. This was powerfully demonstrated by Harry Harlow. (6)

Harry Harlow

Harry Harlow was an internationally renowned psychologist who pioneered research in human maternal-infant bonding using primates.  During the first half of the 20^th century, it was felt that mothers should touch their children as little as possible.  The leading mental health professionals aggressively discouraged mother-child interaction in research papers, lectures, books, and the media.  Interestingly, or tragically enough, their recommendations were based on rodent research.  Dr. Harlow was the leading force in changing the tide of opinion using various species of monkeys. His story is well-presented in an entertaining book, Love at Goon Park by Deborah Blum. (6)

In the 1960s, he turned his attention, also based on primate research, to some of the smaller details of human interaction.  One model he worked on for a while was that of inducing depression.  He used various isolation methods and ways of simulating parental neglect or even abuse. He was able to consistently produce monkeys that were seriously disturbed, but he wasn’t able to cause depression.  At the time, he was experiencing his own severe depression associated with his wife’s diagnosis of terminal cancer.

He finally found a consistent methodology by devising an apparatus that resembled an upside-down pyramid. The sides were steep, but still allowed the monkey to climb to the top to peek outside. The top was covered with mesh. For the first couple of days, the monkeys would repeatedly climb up to look out and quickly slide back down. Within a couple of days they would give up, sit in the middle of the device, and not move. They became almost unresponsive, and when they returned to their families, they would not revert back to normal social behavior. It didn’t matter what problems the monkey had prior to the experiment. The abnormal monkeys became worse and normal monkeys suffered the same fate. Even the “best” monkeys from stimulating and interactive families would succumb. The researchers called the apparatus, “The Pit of Despair”. It was felt by the research team that this “learned helplessness” was from a combination of feeling the loss of a good life reinforced by occasional glimpses of the outside world and feeling trapped. Within a half a week, every monkey spiraled down.

Physical therapy, chiropractic adjustments, injections, acupuncture, vocational retraining, medications, traction, inversion tables, and finally surgery. How many times can your expectations be dashed before you lose hope?

1. Jonas, JB, et al. Are invasive procedure effective for chronic pain? A systematic review. Pain Medicine (2019); 20: 1281-1293.
2. Perkins, FM, and Henrik Kehlet. Chronic pain as an outcome of surgery. Anesthesiolgy (2000); 93: 1123-1133.
3. Young AK, et al. “Assessment of presurgical psychological screening in patients undergoing spine surgery.” Journal Spinal Disorders Tech (2014); 27: 76-79.
4. Harris, Ian. Surgery, The Ultimate Placebo. New South Publishing, Sydney, Australia, 2016.
5. Peabody, FW. The Care of the Patient. NEJM (1927); 88:877-882.
6. Blum, Deborah. Love at Goon Park. Perseus Publishing, New York, NY, 2002.

The post “The Pit of Despair” first appeared on Back in Control.

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Here is a famous quote from Gabriel Garcia Marquez.¹

It is not true that people stop pursuing dreams because they grow old.

They grow old because they stop pursuing their dreams.

Gabriel Garcia Marquez

This is a wonderful quote except I have a different take on it.

People grow old because their dreams are crushed by anxiety.

Stress

Stress is the sum total of the obstacles we face every minute to stay alive. When your body is in a flight or fight state, the sensation is called “anxiety.” This reaction is present in every living species, but humans have language and can name it. It is challenging to achieve your dreams and experience the life you wish while feeling stressed. Your creativity and choice are compromised while you are in a survival mode; the blood flow in your brain shifts from the neocortex (thinking centers) to the limbic system (flight or fight).

The Holmes scale², developed in the 1960s, quantifies levels of stress connected with life events, and you can calculate your own cumulative score. A score of 300 points or more correlates to an 80% chance of a health breakdown within 24 months. In spite of overwhelming data connecting chronic stress with illness, disease, and early mortality, we are generally taught that stress and anxiety are “psychological” issues. Nothing could be further from reality. Why does chronic stress cause mental and physical illnesses?

One of my close friends and colleagues were discussing the role of stress leading to health problems and we decided to assess ourselves with Holmes scale. He had been dealing with an unspeakable number of challenges for several years. His score was 435 and then he told me that he had been diagnosed with cancer a few months earlier. Fortunately, he did well with treatment.

Safety

We want to feel safe. In this state our body’s chemistry consists of anti-inflammatory molecules called cytokines. Fuel consumption is lowered (metabolism). There are about 80 billion neurons in your brain that communicate by molecules called neurotransmitters. When feeling safe, these molecules are calming. Hormones include dopamine (reward), serotonin (mood elevator), growth hormone, and oxytocin (social bonding). Emotions represent feelings generated by your physiological state (how the body functions) and safety creates a sense of connection, contentment, and joy. Another term describing this state is “rest and digest.” Your body must refuel, regenerate, and heal in order to sustain life and health.

Threats

What happens when you don’t feel safe? Your body goes into various levels of threat physiology (flight or fight) to optimize survival. It is designed to deal with acute threats effectively and quickly, but it doesn’t do well when your challenges are unrelenting. At the core of all chronic mental and physical disease is being in a sustained stressed state.³ Here is what is going on.

Activated inflammatory cytokines fire up your immune system. In addition to fighting off viruses, bacteria, and other foreign materials, your own tissues are attacked.⁴ Neurotransmitters switch from calming to excitatory and your nervous system is hyperactive. Fuel is consumed from every cell in your body, including your brain. Chronic disease states cause physical shrinkage of your brain.⁵ Fortunately, it regrows as you heal. Stress hormones include adrenaline, noradrenaline, histamines, and vasopressin, which shift your body from thinking to fleeing. This situation can be likened to driving your car down the freeway at 65 mph in second gear. It will break down more quickly than if you are cruising in 5^th gear.

The driving force behind chronic mental and physical disease is sustained exposure to stress physiology. The solution lies in using approaches to increase “cues of safety” and allow your body to rest and regenerate whenever you can.

Dynamic Healing

Sustained stress translates into threat physiology, which creates symptoms. In mainstream medicine, we are just treating symptoms instead of addressing the root cause being the interaction between your stresses and nervous system. We don’t have time to know you, understand the nature of your circumstances, or how we can help you calm down. Treating only symptoms is similar to putting out an oil well fire with a garden hose. It is no wonder that the burden of chronic disease and suffering continues to skyrocket.⁶ In fact, you often feel more stressed while interacting with the medical system. We introduce the concept of “dynamic healing.

Dynamic Healing is a framework that categorizes interventions that decrease exposure to threat and increase safety. The three portals are:

• Input – processing your stresses in a manner to have less impact on your nervous system
• The nervous system – there are ways to lower its reactivity
• The output – directly stimulating your body to go from stress to calming physiology.

This model organizes known research to both clinicians and patients. You can regain control of your care and create a partnership with your provider.

Why not become a “professional” at living life?

Consider the process as becoming a “professional at living life.” It is similar to acquiring any skill such as playing the piano. You must learn the basics, incorporate them into your daily life, and then continue to deepen your expertise with practice. Mastery is critical, and as they become habituated and automatic, life becomes easier to navigate.

Additionally, the power of neuroplasticity (changing your brain) is powerful and unlimited. You can program your brain in whichever direction you wish, away from unpleasant survival circuits.

Modern stresses

Times have changed since 1962 regarding the Holmes-Rahe scale. The industrial revolution occurred only about 200 years ago. In light of over four billion years of evolution, this not even a drop of water in the ocean. The level of daily sensory input dramatically increased. Now we are in the information revolution that began in 1980’s forcing us to process magnitudes more information. Smart phones came online in 2007, and along with the barrage of social media, we are on a massive sensory overload. The human brain has not evolved to keep up with it. So, we have ongoing stress levels that weren’t present even several hundred years ago. It is somewhat perverse that we have so many anxiety-related problems when we have access to more physical comforts than any generation in history. One fallout is that of teen suicide, “deaths of despair”, have risen dramatically correlating with the advent of the bi-directional smart phone.⁷

A healing sequence

The DOC (Direct your Own Care) Journey course teaches skills to optimize your capacity to enjoy life by effectively dealing with adversity and nurturing joy. These are two separate, but linked, skill sets. As you lower your time feeling stressed and increase your sense of safety and joy, your body will regenerate and heal – mentally and physically. Your brain physically changes (neuroplasticity), pleasurable circuits strengthen, and pain (mental and physical) regions atrophy. You can reprogram your brain away from almost anything with persistence and repetition. The exciting aspect of neuroplasticity is that at some tipping point, your healing continues to build on itself and there is no limit as to what life (brain) you wish to create.

What do want out of this life? Decrease your exposure to threat physiology, increase time in safety, enjoy your life, heal, and thrive.

Homework

1. Take the Holmes-Rahe stress assessment test.
2. Write down the details of each category affecting your life.
3. Consider what percent of your time you spend fighting off stresses compared to nurturing joy. Where is your brain developing?
4. The most stressful stresses are the ones you can’t solve. It is why you must learn techniques to minimize their impact, calm your nervous system, and spend less time exposed to threat physiology.
5. What is one aspect of your life that is the most important to you? Write it down. Are you willing to pursue it?
6. Your body is a complex powerful survival machine. It has evolved to seek safety, deal with threats, break loose, and thrive. Allow it to do its job.

 References

1. Gabriel García Márquez. Cien años de soledad (One Hundred Years of Solitude. 1967. Editorial Sudamericanos, S.A., Buenos Aires.
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. Furman D, et al. Chronic Inflammation in the etiology of diseases across the life span. Nature Medicine (2019); 25:1822-1832.
4. 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
5. Seminowicz DA, et al. “Effective treatment of chronic low back pain in humans reverses abnormal brain anatomy and function.” The Journal of Neuroscience (2011); 31: 7540-7550.
6. Bezruchka S. Increasing Mortality and Declining Health Status in the USA: Where is Public Health?Harvard Health Policy Review [internet]. 2018.
7. Miron O, et al. Suicide rates among adolescents and young adults in the United States, 2000-2017. JAMA (2019); 321: 2362. doi:10.1001/jama.2019.5054 – Connection with cell phones made by Dr. Rob Lustig lecture on 12.1.21 – https://drive.google.com/drive/folders/182pygqTnS2GPQ4LUmioO06zkRf4-jpIH

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My first year in training

I will never forget my first holiday season as an internal medicine resident in Spokane, WA. I learned that the holidays are a nightmare for the medicine service, especially the GI service. Diabetics don’t take their insulin and their sugars go out of control. Cardiac patients don’t take their meds and are admitted for chest pain and abnormal rhythms. The GI service is the worst in that patients with liver disease drink more and develop major bleeding in their gut. People are depressed and the stress of the holidays puts them over the edge.

He died?

We had a resident’s clinic once a week. One of my favorite patients was an 80 year-old gentleman, who was as nice of a person as you could meet. He had some moderate lung disease but otherwise was fairly healthy. He was admitted to the hospital on Christmas Eve with respiratory failure. It didn’t make sense to any of us, as his lung disease wasn’t that severe. We had a whole team working intensely to solve the puzzle. It didn’t matter. He died two days later. During the course of the hospitalization I found out that his son who lived in Seattle had not invited him over for Christmas and he had become despondent. I have since learned that the will to die is as strong as the will to live.

My descent into loneliness

I could not figure  this increase in illness and depression over the holidays for many years – until I descended into my own anxiety-driven depression and chronic pain. There were many unpleasant (terrible) aspects of being in the abyss, but maybe the worst one was feeling alone. I am an extremely social person. As I became progressively more anxious and reactive I began to feel isolated. In retrospect I realize that a lot of this was occurring in my own head. My friends were not avoiding me. I was not interacting with them. While I was trying to survive the terror of raw anxiety I was not able to reach out to others. I became more withdrawn and felt uncomfortable even talking to people. Discovering I had NPD

Obsessive thought patterns

What began to happen is that I developed what I now recognize as an obsessive thought pattern (classic symptom of the Neurophysiologic Disorder) that everyone else had a better life than I did. It did not matter what the evidence was to the contrary. I could not shake that thought. The holiday season made it much worse. First, it reminded me of times that were much better and I felt even more sorry for myself. Secondly, people really seemed like they were having a better time than I was. (jealous/angry). Finally it seemed like the merriment around me was almost mocking my plight. For over 10 years I would become dark around the holidays.

I became socially isolated. I imagined that people just didn’t want to be around me and the story in my head became strong and convincing. Fortunately, I had a few people that I connected with that could see through the storm of my thoughts. It was that human connection that kept me going. But the feeling of loneliness was one of the worst aspects of my descent into chronic pain.

Social exclusion and the ACC

A study published in 2003 (1) looked at the brains of volunteers who were hooked up to a functional MRI scanner (fMRI) which highlights metabolic activity of the brain in response to different stimuli. The volunteers were visually involved in a computer game of “three way catch”. They were not told that the other two “players” were just the computer. At a certain point they were suddenly excluded from the game while the other two “players” threw the ball back and forth another 45 times. The volunteer would consistently feel excluded and experience emotional distress. Interestingly, a part of the frontal lobe, the ACC, would light up. This part of the brain is “the neural alarm system.” It lights up when something in the environment is not right or threatening. Not surprisingly pain is a basic signal that also lights up this area. This study documented that emotional pain lights up the same area.

So chronic pain creates yet another vicious loop. Pain lights up the ACC (anterior cingulate cortex). While in pain you feel much less inclined to be social, which then reinforces the stimulation of the ACC. You now have added emotional pain to the physical pain.

Where does chronic pain begin?

People need people. People need to connect first with themselves and then with others. There are many societal factors, in addition to chronic pain, that create social isolation. It is unclear whether the social isolation that stimulates this “neuro warning center” could be the starting point of chronic pain.

Omega

My wife, Dr. Fred Luskin, and I put on a five-day seminar at the Omega Institute last summer. There were 11 participants who experienced a significant shift in their mood and pain during the week. As they went back to their home environment some had their pain return and many remained relatively pain free. The essence of the week was that we were able to relax and connect with one another. My impression was that the environment allowed us to open up and share. The capacity of people to heal each other was powerful. (The workshop was July 19-24, 2015.) “The Cup Song??”

The holiday season during my burnout was the equivalent of being excluded from the computer game. I’m sure that if I was placed into a fMRI during that period my ACC would have lit up like a small nuclear reactor. The sense of social exclusion was crushing. My Battle With NPD

I was very fortunate to not only escape from the abyss, but thrive. I wish the same for you in 2016.

1. Eisenberger, Naomi, et al. “Does Rejection Hurt? An fMRI Study of Social Exclusion”. Science, 2003, pp. 290 – 292.

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I received this message from a person I have never met or communicated with. She had engaged in learning the tools to heal.

The key to healing mental and physical pain happen from learning two separate sets of skills. The first is separating identity from your necessary survival circuits, developing a “working relationship with them. The second is shifting your brain onto more enjoyable and functional circuits. You cannot experience play and joy will simultaneously fighting pain.

You also cannot heal your body, including your brain. It already knows how to heal, and the healing stories are nothing short of miraculous. But life itself is a miracle. Our conscious brain gets in the way and blocks healing. You only must believe your body can heal, let go, and allow it to occur. Her email is typical of what happens, and the healing is deep and transformative.

Not fixing yourself

One of the most difficult challenges is letting go of trying to fix yourself to rid yourself of the mental and physical pain. Why wouldn’t you? You are trapped in miserable place without an apparent way out. It is bad enough enduring the pain, but when you get angry about it, you have now doubled down, and your brain is really on fire. Dr. John Sarno, a famous physiatrist and author used the term “rage”.¹

Good Studio/AdobeStock

However, trying to solve the pain places your attention on it and reinforces it. But when you try not to think about your pain or distract yourself, the thought suppression inflames your brain even more. Either way, you are trapped. Specifically considering self-esteem, which is an endless set of judgments, trying not to be judgmental is impossible. Positive thinking is another form of suppression. Even reading self-help books is another way of staying focused on the problem. Even with my books, there is a tipping point where I recommend people stop reading them and focus on practicing and implementing the tools they have learned.

“Phantom Brain Pain”

There is the additional problem of thinking that something is being missed, and these thoughts become independent sets of circuits. They really are not responsive to reason, and the ongoing pursuit of reassurance only reinforces them. Along with all RUTs (repetitive unpleasant thoughts), I call this phenomenon, “phantom brain pain.” In my mind, the same issues are in play as phantom limb pain, where the suffering is intense, and you cannot even touch the absent limb to calm yourself. How can this happen. The known “source” of pain is completely gone, and the patient still feels the limb and the pain. So, where does this pain exist?

The key to healing lies in separating from your racing necessary survival circuits, developing a “working relationship with them, and dynamically shifting your brain into more enjoyable and functional circuits – and letting go. You cannot experience play and joy while simultaneously fighting pain.

“I give up”

I vividly recall feeling like I was in the midst of a major battle with unpleasant thoughts. The mental pain was a much bigger problem than my physical symptoms. I was never bothered during surgery with them in that I was so focused on what I was doing. For a long time, I was also fine in clinic while I was connecting with my patients. Towards the end of my ordeal, even being at work did not help, and I was pummelled every two or three minutes with ever-increasing intense, intrusive, and vivid thoughts. Meanwhile, I was trying everything possible to deal with them, including working with a psychiatrist. Nothing helped and in fact, it all seemed make things worse. It was around this period where I came close to committing suicide.

One evening, I had read yet another self-help book and I had a flash of a vision that I was standing in front of a repeating circus mirror. I can still see it. It was about six feet high, and it was in a tent. I was looking at endless images of myself. At that time, I was doing what felt like hand-to-hand combat with my thoughts. I would have a disturbing thought, and then counter it with a “good” thought. I was wearing down quickly. I could see that there was no rational solution to these RUTs. I said to myself, “I can’t do this anymore and I quit.” I felt my identity was stripped down to nothing and felt there was little left of what I thought was me.

I honestly gave up and was not sure what I was going to do next. Instead of feeling despondent, I felt a strange sense of freedom, and it turned out that “giving up” the fight was the right answer. It was after that moment, things began to change for the better. I had much to learn, but at least I had inadvertently created some “space” in my brain to allow healing to begin.

Hope

This is a link to a collection of patients’ success stories that I call, “Stories of Hope.” Essentially everyone who is trapped in the Abyss of chronic pain is in a very dark place. Knowing you are not alone is important.

ipopba.AdobeStock

It is impossible to let go of “fixing” without the tools to accomplish it and also learning how to feel safe. You can’t force it and as per her email, you just have to keep moving forward, and it will happen when you are ready. I also wish for you that it happens sooner than later, but persistence is the key. You will learn to regulate your stress physiology and become much better at nurturing joy and creativity. Your behaviors become automatic, your skills will increase and improve, and you can let go and live your life.

References

1. Sarno, John. Mind Over Back Pain. Warner Books, New York, NY.

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• The “C”quence of healing is connection, confidence, and creativity.
• You must first become aware of and connect with all aspects of your past in order to move forward.
• Confidence originates from being deeply connected to it.
• It is the antithesis of pursuing self-esteem where your efforts are spent trying to outrun your past.
• Ironically, as you allow yourself to be with your unpleasant aspects of your past, self-esteem will grow.

In our efforts to feel better about the intentionally unpleasant feelings generated by our flight or fight physiology, we pursue self-esteem. It is mismatch of the powerful unconscious brain and your conscious part of it. You can’t win and the harder you try, the deeper you’ll sink into despair. It is also a universal problem. The opposite energy emanates from being with every aspect of your past instead of trying to outrun or mask it.

Going Deep

Consider a tree as a metaphor for your life. The soil represents your entire past and is the source for learning and future growth. There is one major root in any tree that is called the taproot. It 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 some level of trauma. Our needs are not always immediately met even in the best of circumstance and adversity never stops coming at us. 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 feel ashamed of it. So, a lot of time and energy is spent on analyzing, fixing, covering up, whitewashing, or suppressing the past. Why wouldn’t we? 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. It is where your brain will develop. It also requires a lot of energy that could be used in dealing with the present and thriving.

 Awareness – “C’ing”

The first step in problem solving is seeing ALL aspects of a given problem AND then having choices how to respond. To be creative, the “C/see” needs to be first. All of us know that certain phrases, behaviors, situations, people, etc. will elicit a fairly predictable and rapid reaction. You are reacting before you have even absorbed or comprehended the full scope of the problem. Consequently, you may make a flawed decision. Unfortunately, these learned reactions strengthen with age and repetition. The phrase, “you can’t teach an old dog new tricks” is an accurate phrase. It is not that the dog cannot be taught. Embedded reactive patterns of thinking must be broken up first.

Unawareness

The first step in cultivating deeper awareness is recognizing when you are unaware. Awareness is the opposite of projecting your perception of the world onto others and situations.

Clues include feeling anxious or angry, being critical or judgmental, holding onto rigid belief systems in any domain, gossiping, complaining, “being right”, not fully listening to other’s opinions, intolerance, labeling others, and creating an identity based on ideals. All of us engage in some of these actions every day. It is inherent in being human and having language. Suppressing these traits is even worse, in that you’ll have no hope for change if you don’t know where you are starting from. The key is nurturing awareness of these actions, observing them, and then deciding what to do next.

Without knowing you are unaware, you’ll continue to reinforce your current life outlook (self-image/esteem) with “input” that supports it. What is more problematic is that if you receive conflicting data, you’ll reject it. This is an even more powerful force in strengthening your outlook and “life filter.” How can you really learn and change? Continually projecting your views eventually becomes tedious and you’ll become more “set in your ways.” It is the way your brain works. The marketing world calls this phenomenon, “reactance”, and they use it to their advantage.¹

What are you connecting to?

The basic awareness that must be cultivated is understanding what are you connecting to? By default, you are connected to your past programming. Much of it is unpleasant and  you may be reinforcing the same trajectory deeper into the abyss. Or you may be trying to outrun it by pursuing pleasure. But since you cannot outrun your subconscious mind, it can’t and doesn’t work. A common approach is to achieve, acquire, and accomplish and create a life that appears wonderful to others but is not based on solid ground. The same adrenalized  energy that takes you up the mountain of “success” may cause you to fall down the other side. For example, consider the problem of “imposter syndrome.”

The connection that is necessary for growth is allowing yourself to feel regardless of how uncomfortable it may be. “You have to feel to heal,” has been said in almost every domain of mental health. Being OK with uncomfortable emotions is at the core of healing. This has been around well before modern neuroscience. As you resist unpleasant thoughts and emotions, you are inadvertently placing more attention to them, and they will flourish. That is not what you want.

Are you connecting to you or your ideals? It is common to pursue better self-esteem, which consists of the “stories” in our minds that we create in order to understand our place in the world. Unfortunately, most of these arise from who everyone else thinks we should be and by the time we are old enough to make our own way, our life lens is embedded in our nervous system. Many of these stories are cognitive distortions and have little to do with the reality right in front of us. As they become more repetitive thought patterns, they occupy a lot of our consciousness and push out our capacity for enjoyment.

There are many ways to train yourself to tolerate difficult and intrusive thoughts and emotions. Learning these skills to process stress is much different than trying to avoid it, suppress it, or remaining a victim.

“Neuroshment”

Anytime you are anxious or frustrated, you are reacting to something in the past that you perceived as dangerous or was dangerous. It can be a mental or physical threat. Digging in and being with your past is the opposite of seeking self-esteem.

The “soil” of your past is the source of “neuroshment” (2) for future growth. The ongoing question is, “what can I learn?” Be with the past, increase your awareness of your history, reactions, and be present with it all. Watch your self-esteem flourish.

References

1. Berger, Jonah. The Catalyst. Simon and Schuster, New York, NY, 2020.
2. Word invented and conceptualised by Rita Salvador who broke free after suffering for over 50 years.

Recap

Confidence emerges from being solidly anchored in every aspect of your past. Much of it is uncomfortable, but it is what is there. Suppressing or running from your past can’t work and consumes a tremendous amount of life energy. You also cannot make good decisions without knowing where you are starting from. You may require professional help to assimilate your past. Also understand that the “stories” you create can anchor you in it. Immerse yourself and use tools to break free. BTW, if you can connect and be with the “bottom” there is nowhere to go but up.

Questions and considerations

1. Your ego consists of the “stories” you create to present a confident front to the world. Why wouldn’t you? Being vulnerable is often punished.
2. Consider that when you are upset, it is often about defending your ego.
3. Are you able to tolerate unpleasant feelings? Do you avoid them?
4. Emotional pain shares similar brain circuits as physical pain. Why would you want to hurt? But where is the escape from these thoughts?
5. First learn to be with the pain and learn the strategies to move forward.

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Each new year, many of us spend time figuring out how we’ll make it better and also to really complete some projects that we have been putting off, maybe for decades. Few of us are able to accomplish a fraction of what we envision. Why? It’s because our unconscious behavioral patterns are so powerful and are going to win over our rational mind.

ACE study

This process has been documented in the now famous and replicated “ACE” study performed on about 17,000 Kaiser patients in the mid-1990’s. (1) ACE stands for, “adverse childhood experiences.” Eight then ten questions were answered by the cohort and then the population’s health was looked at compared to the severity of the ACE score. The following questions were asked:

Abuse

• Emotional – recurrent threats, humiliation (11%)
• Physical – beating, not spanking (28%)
• Contact sexual abuse (28% women, 16% men, 22% overall)

Household dysfunction

• Mother treated violently (13%)
• Household member was alcoholic or drug user (27%)
• Household member was imprisoned (6%)
• Household member was chronically depressed, suicidal, mentally ill, or in a psychiatric hospital (17%)
• Not raised by both biological parents (23%)

Neglect

• Physical (10%)
• Emotional (15%)

This study was done on a sample of middle-class Kaiser patients and chronic pain was not taken into account. What is shocking is that only a third of the group had and ACE score of 0 and over a third had a score of 3 or more. It would be anticipated that these numbers would be worse in a lower income group, as there would be more stress and also in a group suffering from chronic pain. The higher the ACE score, the greater the negative impact on a person’s health. Aced out

“Damaged”

My ACE score is 4. At one point a friend of mine gave me a book, Damaged, which related the story of a young man who was so abused that he was never able to pull out of his tailspin. It was his way of saying to me, “You’re going to have to live with all of this internal chaos. You’re not going to be able to surmount your childhood abuse.” I know it was a well-intentioned move, but I was devastated, to say the least. I am sure the feeling it wasn’t too far off from what many of you have experienced when your physician tells you that everything has been done and you’re going to live with the pain. Many of you have also discovered through your self-healing journey that this simply isn’t true.

The health consequences are clear and severe as the ACE score climbs. They include:

• Early mortality
• Obesity
• Substance abuse
• Anxiety/ depression
• Teen promiscuity
• Attempted suicide
• Early smoking/ heart and lung disease
• High risk health behaviors
• Abusive behavior within their own families

What really caught my attention about this study is that it arose out of an intense weight loss program that was quite successful in helping the participants lose a large amount of weight. Yet the most successful ones were the most likely to drop out. It turns out that obesity does serve a function and the higher the ACE score, the more likely they were to return to their prior eating patterns.

Mental or physical health – which is more critical?

Good intentions

“The Road to Hell is Paved with Good Intentions”. This phrase is defined as, “Merely intending to do good, without actually doing it, is of no value.” (2)

I have years of my own resolutions that I have made and not followed through on. That has changed and I now follow through more often. However, it isn’t because of more will power or determination. It’s because I “gave up” and settled into what is real for me. My reality is that my core patterns revolve around being a victim. I was a victim and it was reinforced every day, until I became aware of being a victim was. I couldn’t solve what I wasn’t aware of. Although I made a lot of progress in 2002 after I began to use the expressive writing exercise, it wasn’t until I even learned the word, “victim”, did I begin to truly heal. I certainly had no clue that the word applied to me. In my mind, I had been “enlightened” for years, as I had done a lot of personal work.

By settling into what was and is for me, I’ve been able to move forward. I did the Hoffman process in 2009, which gave me even more clarity. It was there I learned that the victim role is permanent and will continue to manifest itself in more and more subtle ways, especially when I work even harder to disguise it and remain “enlightened”.

I had another insight as to why I was able to re-create my life. I recently read a book, How Emotions are Made, by Lisa Feldman Barrett. She runs a neuroscience research lab and presents data explaining the formation of human consciousness. Every millisecond we are interpreting sensory input to make sense out of environment, including thought and concepts. They become imbedded in our brains and are our version of reality. The are as real to us as the chair you are sitting in. You are programmed by your past. I was initially discouraged about this idea until she pointed out that from this second forward you have a choice about how you want to program your nervous system. Repetition is key and I found it encouraging that I have that much choice about my life and what reality I want to create.

Awareness

A while ago another level of awareness arose in me. It was that essentially my whole being was created around truly being victim. I had been trying to fix and solve it for decades. However, if victim part of me “disappeared”, I would cease to exist as me. When I finally learned that the answer was to assimilate it, I’ve been able to create a reality that is rich, functional, productive, rewarding and a lot of fun. Solving the unsolvable

I would suggest that one resolution that’s more possible to keep is simply committing to becoming more aware. It isn’t possible to solve anything unless you understand the nature of the issues. I spent over three decades doing battle with adversaries that I didn’t know or see. I just kept fighting and fighting. Settling in and “being” takes much less effort. Paradoxically, you will have more energy to actually accomplish your dreams.

1. Felitti VJ, Anda Rf, Nordenberg D, et al. The relationship of adult health status to childhood abuse and household dysfunction. American Journal of Preventive Medicine (1998); 14:245-258.
2. The New Dictionary of Cultural Literacy, Third Edition, Houghton Mifflin Company, 2005.

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 This blog is written in conjunction with Dr. Les Aria, who is an experienced pain psychologist working in Northern California. He brings a wide range of approaches into successfully treating and solving chronic mental and physical pain.

Being triggered and stressed is so common during the holidays that it is somewhat normalized. Yet hope springs eternal and we keep gravitating back to the same historically chaotic situations. Why do some levels of crises keep happening at Holiday family gatherings? This article is written with all due respect to those of you who are socially isolated, which is devastating and magnified during the Holiday season.

There are many ways to enjoy your family and close friends during this time of year regardless of their behaviors and your stresses. It is supposed to be a season of peace and joy. Understanding the nature of the problem allows solutions.

We acknowledge the many additional stresses around the holidays that have been discussed in many venues and numerous excellent suggestions have been made. However, once you have navigated the obstacles to actually being with your friends or family, it would be reasonable to expect to relax and enjoy them.

Defining a trigger

The basic problem arises from people in close relationships triggering each other. What does being “triggered” mean? We survive by learning from prior experiences what is safe or threatening. This includes your emotional states and consciousness, which are processed in a similar manner as physical threats. Many, if not most, of these mental threats are perceived and are based on cognitive distortions. It is the reason many of us have a baseline state of being “fired up.”

So, anytime you feel anxious or angry, something in the present has been connected to a situation in the past that was perceived as threatening or was dangerous. Your adult brain will still process it in the same manner. You have been triggered. The problem arises from the fact that you are now in the past and not the present. You have lost awareness of the present moment, which is at the core of functional human relationships.

As your earliest and most powerful programming happens with your immediate family, they are the strongest and most consistent triggers. Close relationships are not far behind. The deeper problem is that when you are in this state of threat physiology, the activity of your brain shifts from the neocortex (thinking centers) of your brain to the lower regions (survival) of your brain and you cannot think clearly. It is not possible. So, then your behaviors or those of others may be less than ideal. What can you do? Here are some suggestions.

Dealing with triggers

The first and necessary step is to understand the problem and there are many resources that will help you understand the nature of chronic mental and physical pain. The essence of chronic disease is sustained exposure to your body’s threat chemistry or in other words, being constantly triggered. Here are a few practical suggestions.

Triggers are a whole-body response to a real or perceived threat. Here are 3 behavioral/ physical cues to help you identify that you are being triggered before becoming fully activated by past family triggers.

1. Mood Shifts: Notice when you experience a mood shift. Do not suppress those emotions. Burying emotions alive will lead you to step on them at some point during the holidays–KABOOM!
2. Tension Shifts: Notice when you experience sudden muscle tension in your body. Check your shoulders right now! Left = Anxiety and Right = Anger/suppression of emotions/complaining all day long!
3. Breath Shifts: Notice how often you hold your breath when around certain family members. You know who they are! Are you holding your breath? Are you breathing shallowly? Are you breathing rapidly?

What are the triggers when you are around your family?

1. Criticism is one of the most common triggers.
2. Financial worries from food to travel plans.
3. Feeling pressured to be happy or positive

These are just a few of many triggers–know yours.

*Note: Your physiological states determine your psychological states; vice-versa.

 If you are already feeling stressed or wired, be careful. Your nervous system is “trigger happy” and you’ll not only ruin your experience but create chaos for others.

Practical tips to process triggers

1. Manage expectations. Holidays have a way of making wanting to feel like what Hollywood puts out – this amazing, beautiful scene where we all get along. Not everyone experiences such stuff. Dashed hopes make things worse. Once you understand how to remain calm during any level of chaos, no one can take away your capacity to enjoy yourself.
2. Utilize your Mindbody practices. They are learned skills and include breathwork, meditation, exercising, expressive writing, restful sleep, humming, relaxing music, and mindfulness. Each person has their own set of tools that works best for them. If you haven’t learned to regulate your stress response, please make the effort to do so. They eventually become automatic with practice, and the Holidays are a great opportunity to practice.
3. Avoid all negative conversation–period. No complaining, gossiping, criticism, giving unasked for advice, or discussing your pain or medical care. This is something that is basic to healing and you’ll do the rest of your life. Consider how much time you are spending in this type of activity.
4. “5–3–2” is a strategy to create some “space” in your brain before you take any actions. The numbers represent the words describing each step.
   1. No action in a reaction
   2. Flip the switch
   3. Move on

The details are discussed in this article.

 5. Take time for yourself. This is something we practice and preach about. Set time aside from everyone. Go for a walk before the hoopla starts if you are staying over with your family. Break away from the family during the day or when you need some space to “come back online.”

Summary

Keep your perspective! Remember that you always have choices–once your brain is back “online.” Keep focused on who or what is important to you. How do you wish to show up for the holidays?  Practicing the skills we discussed, especially noticing when you are triggered and doing something about it will help you keep your love, peace, and joy during the holidays.

As always –be kind to yourself. Let the Holidays begin!

The post No One Can Take Away Your Holiday Joy – But You first appeared on Back in Control.

The post No One Can Take Away Your Holiday Joy – But You appeared first on Back in Control.