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.

• 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

The post Suicide – A Horrible Way to Escape from Pain first appeared on Back in Control.

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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.

The post Gun Violence – No Action in a Reaction first appeared on Back in Control.

The post Gun Violence – No Action in a Reaction appeared first on Back in Control.

• Most patients in chronic pain are frustrated and angry, whether they recognize it or not. Why wouldn’t they be? They are trapped by unpleasant sensory input.
• Unresolved anxiety is the driving force behind anger. Anger is your body’s concerted neurochemical last ditch effort to regain control.
• Being chronically angry is tragic and damaging to your health, quality of life, and to those close to you.
• Recognizing the impact it has is an important step in learning to process it.

Anger is destructive. Although acute situational anger is necessary for navigating life’s pitfalls, remaining chronically angry will physically damage you, your quality of life, and relationships. It is also the tipping point of allowing healing to occur versus remaining in pain.

The tipping point

Although you can experience significant improvement in your pain without processing your anger, it is usually modest compared to those who experience dramatic healing from acquiring the skills of processing and letting go of anger. Creating a shift in your brain to enjoyable neurological circuits and stimulating the formation of new ones is one of the core concepts in healing. The vast majority of people suffering from chronic pain are still angry at the person or situation that caused the pain.¹ That means your nervous system is connected to the past, and instead of moving forward, you are stuck.

A metaphor that illustrates the impact of anger is how they handle elephants in India. When the elephants are small, they train them to stay in one place by tying one foot to a stake with a chain.  When the elephant has grown into a huge adult, it will still be held in place by the same type of small stake. Even though the chain could be broken with minimal effort, they have been programmed to think of the stake as unbreakable. Anger is similar in that it anchors you down, while at the same time, it would require minimal effort to “break the chain.” So, your brain is on high alert and your body is being flooded with intense threat physiology.

Letting go isn’t nearly as difficult as you might think and the impact on a person’s life happens quickly. The anger switch is either on or off and there is not much middle ground. Within weeks of crossing this threshold there is usually a significant improvement in pain, other physical symptoms abate, and anxiety drops. The difficulty is in making the initial decision to give up anger because it is so powerful and addicting.

Rachel’s Story

Rachel was a middle-aged woman who had undergone four major spine surgeries and still had ongoing pain. I had performed the last two surgeries, each of which gave her about six months of relief. When the pain returned, the new studies were fine and there was nothing I could do to surgically help her. By this time, she knew my lines well, but was not buying the pain circuits idea and that ongoing anger could keep this much pain fired up. I finally gave up and encouraged her to get another opinion. About a year later I received a jubilant email from her that she was free of pain. Her comment was, “Who would have thought it was the anger?” Once she crossed that line, her pain resolved within a few weeks. She remarried and learned to thrive in the midst of ongoing personal adversity. She let go, moved forward, and created her own life.

Your brain trapped in pain

In addition to having a shorter life span,² the ongoing inflammation also includes your brain. You can’t think clearly because blood flow is shifted away from the rational thinking centers (frontal lobe) and your brain physically shrinks.³Fortunately, it regains normal size after the pain resolves. It is a catch-22 in that decrease in cognition and comprehension often blocks engagement with treatment. It is the reason why The DOC Journey is arranged in a specific sequence. It is critical to approach all of this in a systematic manner with first bringing your brain back “online” and then you will have the capacity to learn the skills to effectively process anger.

Quality of life

Suffering from unrelenting pain is like having your soul pounded into the ground by a pile driver. Your life is being systematically destroyed. You may have achieved a full and successful life only to have it consumed by pain. No one warned you in high school that this could happen. The dark place that develops in and envelops your mind is deep. My patients cannot find words to describe the depth of frustration they feel being in “The Abyss.”

Anger ushers you into The Abyss and it is anger that keeps you there. People intellectually know that being chronically angry, as most patients in pain understandably are, is not a great way to live life. A high percentage of the population lives in chronic pain. There are over 100 million people in the U.S. alone suffering from chronic pain.⁴ There are many ways to fall into and remain in The Abyss including:

• Not being willing to tolerate uncertainty, which translates into not being open to new ideas
• Needing validation
• Disguising your anger from others and yourself
• Choosing to remain a victim (maybe you are not aware of being in that role)
• Keeping this as your baseline state
• Being a perfectionist
• Repeatedly having your hopes dashed

Your relationships

 Pain = Frustration. In the presence of unrelenting pain this frustration can be intense. You become disconnected from subtle cues in your immediate surroundings and your awareness goes to zero. Lack of awareness is the essence of abuse. Although you may not see it that way, your family, especially your children are perceiving you much differently. They are completely dependent on you, have no control, and they are fearful, if not terrified when you are upset. At a minimum, you have ceased to become the source of peace, love, joy and happiness within your family. There is a high chance you are not volunteering to be their coach or taking an active role in their lives. Chronic pain takes a terrible toll on those close to you.

Chronic pain played out in the family

• Mirror neurons– when a small baby smiles back at you, it is simply because the smiling center of his or her brain was stimulated. When your partner or spouse is in a bad mood it lights up the same region of your brain.
• Anger is often abusive. The least logical place to take out your frustrations is on your family. Yet the family is often the most common target of people in pain.
• Patients in pain often do not feel believed by other family members that they are in pain. When they express pain, either verbally or by actions, the response of those close to them may be hostile. Research shows that the pain increases. It is a toxic and unpleasant cycle.⁵
• Patients in pain will often discuss their pain with anyone who will listen. Obviously, the family will hear the most complaining. Pain circuits are not only reinforced, everyone around is frustrated because there is not much they can do to help. They also become worn out with listening and it’s also not that interesting.
• Even families who are pretty functional are seriously impacted by a member suffering from chronic pain. I found few exceptions.

This article reflects only the smallest fraction of the ways anger can and will destroy your life and the lives of those close to you. It is simply a higher level of response to threat and the frontal lobes of your brain don’t optimally function. It is the antithesis of awareness, which is the essence of functional relationships, including that to yourself. Learning the skills to process anger daily is a major step in taking back your life.

Our afflictions are not imposed by the Divine.

Rather, they lead us to the Divine more often than our joys do.

Do not resist the bitter pills in your life;

know that they will lead you to a greater awareness.

Bernie Siegel, MD and author

Recap

The essence of enjoyable and functional human relationships is being aware of your needs and those close to you. It also requires allowing yourself to be vulnerable. Anger blocks both awareness and vulnerability and is actually destructive. Being trapped by any situation, especially pain, creates endless frustration. You are now being pulled into a dark hole that I call, “The Abyss” and your life as you knew it can disappear.

Anger impacts every aspect of your life, and you are tethered to the past. Releasing yourself is not difficult with the right approach. Trying to move forward without using specific tools is impossible. Take some time to become aware of the effects of anger.

References

1. Eccleston C, Williams AC, Rogers WS. Patients’ and professionals’ understandings of the causes of chronic pain: blame, responsibility and identity protection. Soc Sci Med (1997); 45: 699–709.
2. Rahe R, et al. Social stress and illness onset. J Psychosomatic Research (1964); 8:35.
3. 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.
4. Committee on Advancing Pain Research, Care and Education; Institute of Medicine Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. National Academies Press, 2011.
5. Burns, JW, et al. Temporal associations between spouse criticism/ hostility and pain among patients with chronic pain: A within-couple daily diary study. Pain (2103); 154: 2715-2721.

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If you won’t let go (and you do have a choice), you’ll become ill – and often with a serious illness or disease. That data is clear. Here is a link to a well-known Holmes-Rahe scale that lists and scores known sources of stress. If you score > 300 points, there is an 80% chance that you will experience serious health problems within two years.

We are all “geniuses” at suffering. We have to process it daily and most of us have not been taught the correct skills in processing stress. To become equally skilled at enjoying our lives requires repetition – of specific tools. Consider what this situation is doing to the players in this situation.

“Paradise”

We were back East for a week on vacation and enjoying a beautiful spot on the Atlantic Ocean and on a large bay. It could not have been more idyllic. We were being shown around the area by our hosts and as we drove towards the end of the road, we came upon some smaller houses that looked like an inviting community. Then we came upon these signs.

We looked to the right and there was a nice looking fence that was about 100 feet long. But it was just a single partition with the only function being to block the neighbors view. This is all we know. Regardless of the reasons behind the construction of this barrier, from a neuroprogramming and health perspective this situation is a disaster.

“Home”

Home is the place to relax and enjoy your friends and family – and your neighbors. So, every time you drive up your house, your nervous system and consequently your body’s chemistry is going be fired up. Your physiology is in a sustained  flight or fight mode, and this scenario eventually not only destroys your quality of life, but your immune system attacks your own tissues causing many chronic diseases. It one of the reasons that not discussing your pain or medical care with others besides your providers has been such a necessary and powerful part of healing.

I could write a book on this topic of letting go, but I will ask you a question. “Why do want to keep someone in your life who you dislike or even despise?” You have given that person deep control. It is one of the least logical things we do in the human experience – giving up our power to live our own lives.

This is truly mortal combat. They are physiologically destroying each other. Who is going to let go? Or maybe, the actual issue is who is going to become seriously ill first and be forced to focus on more important issues such as staying alive.

Consider an alternative that my friend Bernie Siegal might suggest. Here is the blog he happened to share this week. Bernie Siegel is a surgeon and author of several books, including, Love, Medicine and Miracles. (1) He has also documented the stories of many terminal cancer survivors and still runs a group where they share their stories. Love and connection is the common theme. As destructive as hate is, love is an equally powerful healing force.

Bernie’s letter

 “Indeed, this need of individuals to be right is so great that they are willing to sacrifice themselves, their relationships, and even love for it.”

–Reuel Howe

Author of The Miracle of Dialogue

Many people choose to be right rather than happy. They will argue to the bitter end about the “rightness” of their thoughts and actions.  They do not care about what they are doing to the people they are arguing with.

Why do they behave this way?  Are they perfect?  No, few of us could claim to be that.  They are simply unwilling to view their fallibility and confess to the weaknesses that come along with being human.

When you are willing to give up being right, you will find peace and happiness.  It is when you are ready to learn that you will be right.

If you wish to be happy and free, give up having to be right all the time.

Peace,
– Bernie

Think what could be possible if one of the neighbors adopted Bernie’s approach. If he senses someone who is upset, regardless of their behavior he says, “I love you.” What would the world be like?  What about your own life?

References:

1. Siegel, Bernie. Love, Medicine, and Miracles. Harper and Rowe, New York, NY, 1986.

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Physical consequences

A paper was sent to me this week by a friend and colleague of mine that documents some of the consequences. It is a British study pulled out of a group of over a half a million people. (1) They compared the mortality rate of those with chronic widespread pain with those without any chronic pain. The increased mortality rate was stunning. Overall the chances of dying early were over double. The causes of were death for higher for: 1) cancer – 173% 2) cardiovascular – 320% 3) respiratory – 566% 4) other diseases – 400%.

What led to this increased mortality? It was not the pain. It was related to factors associated with being in chronic pain that were preventable.

• Smoking
• Obesity
• Lack of exercise
• Poor diet

Their conclusion was that addressing these lifestyle factors could reduce mortality by around 35%. I agree with this approach but why not solve the chronic pain? The motivation to live life more fully will return once you are no longer being crushed.

Trapped

Not only are you crushed by the pain but also by the emotions associated with it. You are trapped. When you are trapped by anything such as finances, an unpleasant job, an abusive relationship at home, work or school you will get upset. Being trapped by pain is even more of a problem. Then there is the additional problem of the medical profession not offering you a way out and people don’t really believe you’re in pain. Dr. Sarno was one who used the word, “rage” to describe the situation. My term is “The Abyss.” It is so dark in this hole without hope that words do not come close describing the isolation and despair that consume you. Although addressing these “modifiable lifestyle factors” will help, it is difficult to sustain when you are legitimately frustrated and often trying just to make it to the next day.

Solve the pain. Escape from “The Abyss” and then no one can stop you from thriving. I have watched hundreds of people heal and it is inspiring to watch how quickly they move on. Given a chance, humans are driven to pursue health and happiness. They don’t have to be motivated.

A phrase I commonly hear is, “Who would have thought it was the anger?” You have often heard me cite the phrase, “Neurons that fire together, wire together.” Chronic pain is linked to anger pathways and anger increases pain. Anxiety, anger and adrenaline You are not going to heal, including caring for yourself, until you address your anger – no matter how legitimate it might be. Essentially, you have the choice to let go of your suffering and move on.

Jane

I spent years talking to a patient about anger and she wasn’t buying it. She had already undergone four surgeries and wanted me to do another. Her spine wasn’t perfect and I was tempted. I also knew how much chaos was occurring in her life. I finally said, “No. Feel free to see another surgeon.” I had used all my lines on her and I gave up. About a year later I received an incredible email that she had been free of pain for a while and was re-married with a beautiful new family. She often sends me photos. Happy doesn’t begin to describe the look on her face. It has been one of the most rewarding and unexpected turnarounds I have witnessed. She will be sharing her story on “The Stories of Hope” section. She finally admitted that anger was the problem and she couldn’t see it.

Suffering from chronic pain throws your whole body out of kilter? You have nothing to lose by just engaging in risk-free, age-old proven treatments and seeing what happens.

This paper gives additional meaning to a phrase I frequently hear, “I just want my life back.” Take it back. You might be losing it faster than you think.

Addendum

I just received an email from a reader who pointed out that many people, if not most people in chronic pain do make a strong effort to address the factors that are mentioned above. I do agree with her comments. However, people who work hard at staying healthy, yet still suffer from chronic pain, are often frustrated because their best efforts are still not able to solve the problem. Unfortunately, this legitimate frustruation still creates chronically elevated levels of stress chemicals. That plays itself out in multiple physical symptoms, including a compromised immune system. I would encourage those of you who feel and are trapped in this maze to keep persisting. I am continually blown away by people’s stories who find their way out through what I have historically considered unsolvable situations.

1. Macfarlane GJ, et al. Persons with chronic widespread pain experience excess mortality; longitudinal results from UK Biobank and meta-analysis. Ann Rheum Dis (2017); 0: 1-8.

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Howard’s letter

David,

You play golf, so you understand the setting. I will make this brief. When I reached my 80’s, handicap kept going up. We play for small stakes, so the most one of us could lose was $30-40. We changed the format to skins (slightly easier way of betting on the game) and the maximum one could lose was $9.

I was down maybe $300 and I started taking lessons. I was serious. I practiced with a broom or club 7 days a week, bought new irons, practiced on the range and practice area as often as possible. My handicap topped off at 28. One of my playing partners was a 10 handicap player. He is a successful business owner and he HATES to lose, throws his clubs, and pouts. Our handicaps frozen during the fall and winter. He was winning almost every week.

Recently, he lost $1 on Saturday, and $9 on Sunday. I won a few dollars. It was OK, when he won for years, but when I won for a week or so, not so fun. One Sunday, he informed me he would not play in any game I was in, “He couldn’t compete”. I became angry, sent an email eviscerating him and cc’d others, which infuriated him. Remember, it was OK when I lost every week. Also, I had been the one to set up games, invited others to join us, made tee times, keep score, etc. He stopped talking to me.

I became so angry that I thought of him and his childishness incessantly. Guess What?  After a week I started feeling ill. I had trouble sleeping and became listless in a few days. I came down with he worst cold in years.

After a week, I went to him and apologized. I received immediate relief. Took some over-the-counter meds. My Anger, Resentment, Stress, etc., was gone. And my cold was almost gone in two days. I was lucky I just got a cold…..

I was the one being childish, judgmental. I was the one who had developed the problem. I was the one who developed the stress leading to a cold. He didn’t do anything wrong, until, I “deemed it so”.

Thanks, Howard

Stress and Disease

 There are many studies that document the relationship between stress and disease. Stress causes alterations in the hypothalamic pituitary axis (HPA) in the center of your brain. This is the area of the brain that controls the levels of various hormones throughout the body. A recent article focused on the specific effects on the immune system. Your immune system is comprised of multiple types of special blood cells, called white blood cells (WBC’s). There are many types that each respond to a chemical signal. Some are focused on viruses while others concentrate on different families of bacteria. Any substance that immune system does not recognize it surrounded and destroyed by these cells.

Researchers exposed volunteers to a virus that is known to cause a common cold. (1) They measured the immune system’s response in those who reported being under stress versus those did feel like they were under undue pressure. They discovered that the sensitivity of the response was compromised and that the immune systems was overactive. The cold symptoms were caused by this inflammatory response. “The immune cells became insensitive to cortisol’s regulatory effect” and the out-of-control inflammatory response caused the symptoms.

So the symptoms of a cold are not directly caused by the virus but by the body’s reaction that is out of proportion to the threat. In other words, cold symptoms are a side effect of the body’s immune system.

Is your cold “in your head?”

All of us know that we are more apt to get sick when we are feeling under a lot of stress. Is it psychological? It is not. There is a direct effect on your body’s chemistry that compromises your ability to fend off bacterial and viral threats. Recent advances in technology allow scientists to more precisely measure the immune response. Howard is right. He got away with just having a cold. The links between chronic stress and serious autoimmune disorders, cardiac disease, depression and cancer are well-documented.

Additionally, the speed of peripheral nerve conduction is increased by 30-40% in animal studies when they are stressed in the lab. (2) Therefore, you will physically feel more pain when you are having a bad day. Is there really anything staying so upset about that is worth your health and quality of life? It is time for all of us to chill out!

2.  Sheldon Cohen, Denise Janicki-Deverts, William J. Doyle, Gregory E. Miller, Ellen Frank, Bruce S. Rabin, and Ronald B. Turner. Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. PNAS, April 2, 2012 DOI: 1073/pnas.1118355109
3. X. Chen, P.G. Green, and J.D. Levine. “Stress enhances muscle nociceptor activity in the rat. Neuroscience (2011); 185: 166-173.

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I will never forget a 40 year-old woman I met in the office a few years ago. She had suffered from chronic pain that enveloped almost her entire body since her late teenage years. She was anxious, depressed, and would barely lift her head to talk to me. The depth of her sadness struck me. She did not have a structural spine problem, and I began to discuss some of the ways she could approach solving her chronic pain. Shortly into the conversation she related to me that she had been severely bullied in high school and in spite of her best efforts she did not seem to be able to get past it. I never saw her back.

Dreams shattered

I was pretty shaken by the encounter in that she seemed so broken. I was talking to my assistant about the encounter and she told me a story about her daughter that happened in high school. She loved animals and had a cat that she adored. Her dream was to become a veterinarian. She was asked to the prom by a boy she did not care for and turned him down. He became very aggressive. He and a friend began to taunt her and threatened to kill her cat. They did. They killed her cat and then proceeded to make cat sounds every time they saw her at school. Her life was never the same and she did not pursue her dream. As a cat lover this story was quite upsetting to me.

Bullying affects the body’s chemistry

A study was reported in the New York Times last week about the effects on the body’s chemistry from being bullied. C-reactive protein (CRP) is a blood test that measures the level of inflammation in the body. It is sensitive and I order it frequently if I am suspicious of an infection. High levels have been correlated with heart disease.

The study was out of the department of psychiatry from Duke University. Researchers followed 1420 boys and girls between the ages of 9 to 21 with extensive interviews of close family and friends. (1) The CRP was elevated in direct proportion to the amount of bullying they had experienced. In contrast, bullies had lower levels of CRP – even lower than individuals who were not exposed to bullying. It was postulated that the increased social status of the bully might have “biological advantages.” Anger = loss of control

Stress causes changes in the body’s chemistry and every organ system is affected creating a multitude of physical responses. There are over 30 symptoms of the Neurophysiological Disorder (NPD). Prolonged stress is even worse. It is similar to trying to run a marathon at sprint speed. You will collapse and often quickly. The symptoms are not subtle.

Letting go – NOT

I have long observed that many patients have no interest in engaging in the DOC program. They don’t seem to want to let go of their anger. I think the reasons for a given person are complex but I do think that the need to remain angry is deep. If you are the bully there is a feeling (and bodily response) of power that is difficult to let go of. If you are the victim then feeling powerless is stressful. But it is also a familiar pattern and the only haven of power you have left. In the victim mode you are angry and you do feel powerful. You can then exert that power over your employer, the medical system, and your family. If down deep you feel powerless, what other choices do you have? Advantages of victimhood

Power

I suspect that the bully’s bodily response is mediated through the pleasure centers and the victim’s through the fight or flight system. There is power in being a bully and there is power in remaining a victim. I don’t know what the chances are of a bully developing chronic pain but I do think the odds are much higher in the bullied group. Being bullied does cause an increase in inflammatory markers and there is an established link with chronic stress and  autoimmune disorders such as systemic lupus, ulcerative colitis, Crohn’s disease, and rheumatoid arthritis? (2)

Pain pathways and anger pathways are inextricably linked. You will not solve your chronic pain until you can let go of the past at a deep emotional level. Do you really want to heal?

1. Copeland W, et al. Childhood bullying involvement predicts low-grade systemic inflammation into adulthood. PNAS (2014); 111: 7570-7575.
2. Song, H, et al. Association of stress-related disorder with subsequent autoimmune disease. JAMA (2018); 319: 2388-2400.

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An unhappy reader

“Your book about back pain is bullshit! I learned the hard way that pain is an indication something is wrong. The unsuspecting public goes to idiot doctors like you that say, ‘It’s all in your head you crazy bitch.’ Guess what, that pain I was told was all in my head was my back being destroyed. But doctors, mostly men, like to tell women, ‘ We’re just some crazy bitch looking for attention.’ I think the way male doctors have treated female patients is criminal. By the way/after over 20 years of disability and pain a female doctor discovered my problem. She was stunned at the number of doctors I had seen and all the misdiagnosis and “crazy” “not real” “imagined” pain, etc. Of course they were mostly male doctors talking down about me and being too lazy to do their job. As a result of lazy doctors and doctors like you perpetrating the, ‘it’s all in your head theory’ I am severely disabled now and must endure very painful surgeries. Why don’t you actually help and write a book about how to diagnose, because patients believe medicine is a science, not a game doctors play with our lives.”

Part of my practice

“I want surgery and you aren’t going to do it for me. You are the worst doctor I have ever met.” This patient decided to express his feelings screaming them at the top of his lungs as he walked out the office.

“I read your book. I still hurt.”

“Hanscom is a charlatan.”

I understand the problem. A patient comes to me with surgery being the last hope for them. It’s unrewarding and unsettling to not be able to meet that need. However, surgery is only indicated for structural conditions that can be clearly identified on an imaging study and the symptoms match the abnormality.

Trapped by pain

Being trapped by chronic pain is a terrible thing and a horrible way to exist on this planet. You are not only trapped by the pain but by the medical system that keeps bouncing you around. Employers, claims managers, your friends and family don’t believe you; you feel and are labeled. There is little question that you have many legitimate reasons to be upset. The problem is that you are the one who suffers the most by remaining in this state of mind. The consequences are severe:

• The pain experience is amplified regardless of origin.
• Anger is never attractive; you drive people away. Slowly, but surely, you will become socially isolated. Happy Holidays – Not
• It’s all about you. Anger is a survival mechanism and the needs of others will pale in your mind compared to yours.
• Anger is always the first step in engendering the many forms of abuse; the essence of abuse is unawareness of others needs; or feeling your needs are more important. Pain=Anger=Abuse
• It just isn’t that much fun being angry. Play

Guess what – it is you

The most difficult aspect of anger I struggle with is that the anger response has nothing to do with the person or situation that set it off. Anger is only a neurological pattern that exists within you that was triggered. It just doesn’t feel that way. Understanding that anger is an opportunity for self-discovery is a paradigm shift that will change your life – and your pain. The first step is being aware that your frustrations are only within you. Taking responsibility to learn what it means for your personal growth is the next step. “But You are Still Angry”

Anthony De Mello

Anthony De Mello was a Jesuit priest who clearly delineated the issue. I was recently re-introduced to his work through a book given to me by a fellow physician, The Way to Love. He states the problem with anger very clearly.

How could you go about creating a happy, loving, peaceful world? By learning a simple, beautiful, but painful art called the art of looking. This is how you do it: Every time you find yourself irritated or angry with someone, the one to look at is not that person but yourself. The question to ask is not, ‘What’s wrong with this person?’ but ‘What does this irritation tell me about myself?’ Do this right now. Think of some irritating person you know and say this painful, but liberating sentence to yourself. ‘The cause of my irritation is not in this person but in me.’ Having said that, begin the task of finding out how you are causing the irritation. First look into the very real possibility that the reason why this person’s defects or so-called defects annoy you is that you have them in yourself. But you have repressed them and so are projecting them unconsciously into the other. This is almost always true, but hardly anyone recognizes it. So search for this person’s defects in your own heart and in your unconscious mind, and your annoyance will turn to gratitude that his or her behavior has led you to self-discovery.

“But I’m right”

Although you feel a strong conviction of the rightness of your views and you have all the right in the world to be angry, it is still only destructive. Nothing constructive will ever happen from words said or actions taken while angry. It feels energizing and directed. It is actually only energy drained and it’s unfocused. It will engulf you along with everyone close to you. It is similar to setting off a tear gas bomb in a crowd and you don’t have a protective mask. You’re also equally affected.

Neurons that fire together wire together

Since pain and anger are intertwined neurological circuits, it’s impossible to experience meaningful long-term pain relief until you have let go of the past along with all of the wrongs that have been heaped on you. I have stated from the beginning that, “Anger is the Continental Divide of chronic pain”. You must let go and there are endless ways to go about it. There’s no shortcut.

It was about six months after I took responsibility for my own anger that my pain and other Neurophysiologic Disorder (NPD) symptoms disappeared. Dr. Luskin’s book, Forgive for Good, entered my practice about six years ago; that is when my patients began to consistently become free of pain.

You may not feel you have much choice about the severity of your pain, but you do have a choice regarding your relationship with anger. That’s the choice you must make to experience this freedom.

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