• When you are suffering for any reason, you mind races, which makes it harder to think clearly.
• Doing battle with your thoughts or suppressing them makes it all worse.
• Simply placing your attention on a specific sensation for a short time separates you from your racing thoughts.
• Your body also calms down, your thinking brain functions better, you can better engage in learning, and live your life with more clarity.

 Dr. Daniel Wegner out of Harvard, wrote a paper in 1987 called, Paradoxical Effects of Thought Suppression.¹  He demonstratedthat the more you try not to think about something the more you will think about it. The paper has been nicknamed, “White Bears.” This not news to any of us. But he also demonstrated that there was a trampoline effect, in that you think about it a lot more. When you frame this discussion in terms neurological circuits and programming this phenomenon becomes a huge problem. Disruptive thoughts progress with age.

A basic tenet of many Eastern philosophies is that worrying about the future and thinking about the past causes internal unrest. There is anxiety around the future and many regrets and frustrations about the past. Staying in the present moment is key, but how do you accomplish it?

You cannot control your mind with your mind. When your mind is racing your body will be tense and tight. The harder you try to calm down your thoughts, the faster your brain will spin. Neurological circuits are deeply embedded, especially the unpleasant ones you instinctively fight.

Active meditation

As you cannot fix, repair, or outrun them, one option is shifting from them to more functional and enjoyable circuits. This is quickly accomplished by focusing your attention on a specific sensation from your immediate surroundings. Any sense works – sound, smell, taste, feel, pressure, and sight. My term for this tool is “active mediation.” It is an abbreviated version of mindfulness, and you focus on any sensation for a few seconds up to a minute. You have connected your consciousness to the present moment. The intention is incorporating this practice frequently into your daily routine until it becomes habitual.

Three steps from Eastern philosophy.

• Relaxation
• Stabilization
• Focusing on a sensation

I learned them in a workshop given by Alan Wallace, a prominent researcher in integrating Buddhist contemplative practices with Western science.

Active meditation in practice

I practiced this daily during my hectic days at work. I often did it with my patients in clinic, especially if I was running behind. We sat back in our chairs, let our shoulders sag, jaws relax, took a long deep breath, and slowly let it go. (Relaxation). We stayed relaxed for 5-10 seconds (stabilization), while I had them listen to the ventilation system. Then our attention shifted to voices outside the door, our feet on the floor, and back to the vent. It took about a minute.

Invariably, everyone felt more relaxed and I heard my voice change to a softer pitch. Our attention had shiftedoff of racing thoughts to the current moment through sensory awareness. I encouraged them to do this often until became automatic.

You can also do this much faster for just three to five seconds. Simply engage with any sensation for short periods as often as possible throughout the day. During surgery, I would engage with active meditation with essentially every move I made.  My “go to” sensation was grip pressure on my surgical instruments. There is more feel and control with light touch. Eventually, the sensation and moves I made become so automatic that I developed a “safe zone”, and it would have required a conscious choice to be unsafe. The consistency of my performance improved my enjoyment of the day as well.

Listening

Another rendition of this tool is listening; I mean really listening in a way that you can visualize the other person’s perspective and realizing that the words they are saying mean something different to them than they do to you. It is remarkably more interesting to hear other’s perspectives rather than replaying your own.

The past is the past

You cannot change the past or control the future, and neurological circuits are permanently embedded. Tryingharder to analyze and fix them stimulates and reinforces these patterns (neuroplasticity). Going to battle with them is deadly. Simply shift your attention to any immediate sensory input. That is it and it is that simple.

Homework

1. Begin using this strategy right now. Sit back in your chair and let yourself relax from your head to toe. As you do this, focus on different sensations.
2. Then do this for 5-10 seconds through the day. Just let your attention land on a sensation while you continue your activities.
3. Keep doing this daily and indefinitely. With repetition, you’ll do this automatically. It is an important foundational tool on which to rebuild your nervous system.
4. Small calming steps add up, body chemistry shifts from threat to safety, and your neocortex (thinking centers) function better.
5. You cannot control your thoughts, but you can separate from them and redirect your focus.

References

1. Wegener, D.M., et al. Paradoxical effects of thought suppression. Journal of Personality and Social Psychology (1987); 53: 5-13.

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• Most of us intellectually understand that the only moment we have in life is this very one. That is it.
• Being in medicine for over 40 years has shown me the incredible unpredictability of life. Life changes in second – sudden heart attack, bad car accident, diagnosis of terminal cancer, and the list is endless.
• But our minds play tricks on us by constantly worrying about the future and hanging onto regrets from the past.
• This problem arises from our unconscious mind that is protecting us. It is continually scanning the present looking for situations from the past that were perceived or were actually dangerous.
• So, your actions today are a result of your cumulative perceptions of what is safe – or not.
• You can’t control this response but by using tools to stay connected to the moment, its impact is lessened.

Commitment to change is one thing but sticking with it is challenging. One way to help yourself along is to bite off small bits at a time and proactively make the choices all day long. It will become a habit and your norm. A starting point is repeatedly asking yourself a simple question, “Who do I choose to be today?”

A tough start to my day

One morning I woke up feeling low, having just completed eight straight 15-hour workdays, including a long weekend. As I lay there exhausted on a Tuesday morning, I reviewed my choices: either 1) stay in bed feeling sorry for myself; or 2) give thanks for the opportunity to help so many patients during the week, be grateful for how well the week went, and meet my work-out group early at the gym. I chose the second alternative. I got up, worked out, went into the office, and gave 100% to each patient and my staff. I’m not saying it was easy; but it turned out to be a great day.

Proactively choosing how to experience your day is the farthest thing from “positive thinking.” No one is asking you to pretend to be happy when you are coping with a difficult situation, especially your ongoing pain. On the contrary, you must be aware of the depth of your frustration before you can choose to live a full and productive life with or without pain – or decide to enjo. Positive substitution—filling your life with positive experiences— is the essence of neurological reprogramming.

A Tough Beginning

Recently, I was talking to a friend’s teenage son. This kid was good-looking, athletic, and personable; yet he felt isolated, insecure, anxious, and emotionally unstable. He continually compared himself to others and tried to fit in. He was also justifiably upset about his family situation. His father, who was extremely critical of him, had essentially abandoned him by moving out of the country. I  understood where he was coming from, since his experience was not much different from mine at his age.

About halfway through our conversation I realized that he too, had a choice. I pointed out that, after years of stress, he had remained remarkably intact. He could choose to be proud of his resilience in the face of adversity and use this gift to take on new challenges. I could see his eyes light up.

Some suggestions

FOMO (Fear of Missing Out) seems to be rampant in this modern era. Maybe it is because we are overwhelmed with options? What we are missing out on is enjoying our day. It is a deeply embedded thinking pattern that doesn’t resolve over time. It requires specific approaches.

You can’t “solve” FOMO. By trying not to be this way, you’ll actually reinforce these circuits. The answer lies in cultivating connection, meaning, and purpose. Trying to be “happy” actually doesn’t work due to the “ironic effect.”¹

• Nurture deep gratitude for you have. It may not be as much as you want but focus on it.
• Compare your situation to those who are less well off than you. It may not seem possible in light of your pain but start somewhere.²
• Become aware of how frantic you get about your “to do” list and how endless it is. It is endless for all of us.
• Then don’t put ANYTHING on your list that you are not going to do TODAY.
• Frequently practice active meditation or breath work to calm yourself. It is one tool that connects you to the moment you are in.
• Listen to some of your favorite music – especially if it is connected to enjoyable experiences from the past.
• What is one thing you can do today that brings you pleasure? – a cup of coffee  your favorite donut; a call to a close friend; a compliment to a family member or friend; anything. There is an endless of list of small deeds that can change your day.

Recap – Your choice

What do you want out of your life? Is it more than being a sufferer enduring pain? Do you really want to live your one life this way? Of course not, you may be thinking. But trust me. It is unlikely that you will magically wake up one morning and find your troubles gone. Focusing on solutions is an ongoing conscious choice because your powerful unconscious brain automatically gravitates towards the problems. There are no shortcuts.

So, who do you want to be today? Choose carefully because you will either be reinforcing old neurological circuits or creating new ones. What is your choice this year, this month, today, the next 15 minutes, or this minute? Carve a few minutes out every morning to ask yourself that question, ponder your options, and commit to whatever choice you make.

Questions and considerations

1. The impact of chronic pain on your life has been documented to be that of having terminal cancer – except worse.³ So, first of all, honor your own suffering and give yourself a break.
2. Depending on the severity of your suffering, you may not feel like nurturing a better life, even for a few minutes. This is one point in your journey that you must begin somewhere, and the next 10 minutes is the place.
3. Then you have to keep repeating it, whether you feel like it or not.
4. Even when you are feeling better (and it will happen with practice), you’ll still gravitate towards the negative because that is what your powerful unconsciousness brain is supposed to do – protect you from danger.
5. To have a good life, you have to live a good life. It is just the way your nervous system works.

References

1. Wegner DM. The seed of our undoing. Psychological Science Agenda (1999); Jan/Feb:10-11.
2. Dalai Lama. The Art of Happiness. Penguin Random House. New York, NY, 1998.
3. Fredheim OM, Kaasa S, Fayers P, Saltnes T, Jordhøy M, Bortchgrevink PC. Chronic non-malignant pain patients report as poor health-related quality of life as palliative cancer patients. Acta Anaesthesiol Scand (2008); 52:143-148. 

The post Who Do You Choose to be Today? first appeared on Back in Control.

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• Humans are subject to an endless barrage of unpleasant thoughts that cannot be controlled.
• These thoughts are sensory input that is disruptive and creates a flight or fight response.
• Resisting them makes them stronger.
• It is much more effective to switch your attention to different sensory inputs that is neutral or calming.

Humans survive by the brain interpreting impulses from various sensors located in every millimeter of your body and interpreting the sum total as safe or a threat. Every sense has a threshold that indicates danger – hot, cold, bitter, loud, bright, sharp, pressure, burning, nausea, etc. Without that immediate feedback, you could not protect yourself.

Humans have a unique characteristic in that unpleasant thoughts create the same defensive reaction, but since we can’t escape them, we are often subjected to prolonged elevations of stress hormones and inflammation. Suppressing them, which is somewhat the norm, makes the situation even worse. What can you do?

Instead of doing battle with these thoughts, you can switch sensory input. There are many choices. You can listen to enjoyable music, practice meditation, mindfully notice small details of your day, take slow deep breaths, pay attention to your breathing, engage with your passion whether it is at work or play, and deepen your relationships with your friends, family, and colleagues. In other words, by fully engaging with what is directly in front of you, your mind has gone that direction.

But it goes both ways. If you choose to remain angry, complain, be critical, and constantly discuss your problems, your body will react in kind, and you will remain on high alert. Being aware of your environment, whether it is pleasant or unpleasant is the first step and then you have a choice to remain in an agitated state or to use tools to calm down. The exact tool doesn’t matter as long it is effective for you. As has been mentioned, many of us are so used to being agitated, we aren’t aware of it or its impact on others.

Environmental Awareness

Being aware of your senses – known as environmental awareness –  is a strategy that allows you to switch sensory input from racing thoughts to another sensation. It doesn’t matter which sense you choose. I practice one that I call “active meditation” or “meditation on the run.”

During my years of performing complex spine surgery, there were occasional complications that were considered well within the scope of care. But the consequences were sometimes severe, and I was committed to bringing them down to zero. But no matter how hard I tried, I wasn’t able to eliminate them. My own thoughts were interfering with my performance.

Things changed when I decided to enlist the help of a performance coach to improve my consistency. I brought him into the operating room and clinic so he could better understand my world. For 18 months, he and I underwent regular debriefings and coaching. I began to use “active meditation” in the operating room. The most common interferences I felt during surgery were frustration, anxiety, distraction, complacency, and moving too quickly.

Active meditation in action

This meditation model is not based on suppressing interference – for instance, if you’re frustrated, you don’t pretend otherwise. Rather, face the frustration, detach from it, and proceed in the manner of your choice. I learned to identify interferences either before or during surgery, and then used mindfulness-based approaches to let go of them quickly. This version of mindfulness is fast. It took about 3-5 seconds and was repeated frequently during a case. It was often connected with one quick deep breath in and a slower one out.

Setting up the day

Each surgical morning, I woke up and assessed how I was feeling. Like everyone, my feelings ranged from calm and relaxed to tired and anxious. I would sense smells, touch, and taste, etc. I felt the water on my back in the shower. I savored my coffee. I also reminded myself that although that day’s surgery is “just another case” for me, it’s one of the most important days of my patient’s life.

I continued this process in the operating room. I carefully arranged the room, talked to each member of the surgical team, and reviewed the imaging studies. I remained focused and immersed in what was right in front of me.

During surgery, awareness allowed me to perform my next move at an optimum level. I felt my grip pressure on each surgical tool; noticed the shape of the contours of the anatomy; felt my shoulder and arm muscles stay relaxed; and watched the flow of the case.

If I noticed disruptive thoughts and emotions enter my consciousness, I quickly practiced my environmental awareness techniques in order to re-focus. I would usually focus on light touch. With practice, I learned to be fully connected to each move, so I could “program” myself into the “zone.” Eventually, it all became automatic. I was so connected to each move that I might experience 10 distracting thoughts in a six-hour case. It was a remarkable shift from dealing with endless racing thoughts.

Surgery evolved into wonderful experience for me. I eagerly looked forward to Monday instead of surviving until Friday. I committed to getting a good night’s sleep before every surgical day. If I woke up “wired” and uneasy, I slowed down until I felt relaxed, no matter how many things were on my to-do list.

The same approach is a core tool to remain calm throughout your day. It is more difficult outside the OR with less structure. But with repetition, it will become automatic.

The “to do” list

I use my “to do” list as an opportunity to practice mindfulness. I remind myself that this list is an expression of my life, and so I deliberately become aware as I go about each item. For instance, when I had an appointment with a patient, I would carefully focus on listening to myself talk to him or her. Of course, carefully listening to them was critical. I felt the pen on the paper as I jotted down notes. I also practiced meditative techniques, such as “watching” disruptive thoughts such as “need to finish up here, I have other things to do” enter my consciousness and then leave. I reminded myself that my goal was to engage and enjoy every second of my “to do” list. It didn’t always work, but it’s surprising how often it did. It is still part of my day.

Recap

Environmental awareness engages me in the present moment regardless of the circumstances. It is not positive thinking, but just switching to a different sensory input. With repetition, it became and remains somewhat automatic. In the presence of ongoing pain, it is not the final solution, but will calm you so other tools can contribute.  It is a simple strategy without a downside.

This is the first and most basic of the different types of awareness. The other types of awareness are more challenging – emotional, judgment, and ingrained patterns. It is one of the reasons it is important to implement your own version of environmental awareness that will help you deal with the other ones that are more stimulating.

Questions and considerations

1. Many of you have heard the phrase, “be here now.” It is brilliant except it is rather hard to do. By actively engaging with a given sensation, you are here now. Your attention cannot be in two places at once.
2. Then consider a more complex phase in action. As you engage in various activities, interesting or not, by immersing yourself in every aspect of them, you’ll become more connected and calmer. For example, imagine you are sitting in an important lecture. By listening to every word, you’ll find it more interesting and have a much higher chance of learning what you need to learn. Detailed notetaking also has the same effect.
3. If you can actively learn this awareness skill, notice how much calmer your mind becomes. Listening to another person’s tone of voice and content is a great one to focus on and is more interesting than hearing yourself.

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• There is deep basic science research that has revealed the nature of chronic pain and this understanding will allow you to discover your version of a solution. The essence of the problem is sustained exposure to threat and the core of the solution lies in finding safety.
• Create safety by learning skills to:
  • Stimulate neuroplasticity – create and shift to new neurological circuits in your brain.
  • Learn to regulate your body’s neurochemical response to threats (stresses).
• As you learn about chronic pain, it is helpful to simply get started using some of these core tools to “jump start” the healing process.
  • Expressive writing
  • Active meditation
  • Restful sleep
  • No discussing your pain or medical care with others – especially your family

Many years ago, I would spend hours explaining chronic pain to my patients in the office but it was too complicated and it wore me out. That is when I decided to write, Back in Control. Patients would have a better understanding but there was no action. The website, www.backincontrol.com was the action plan and evolved into a self-directed process that allowed hundreds of people to break free from their chronic pain. The DOC Journey is the next rendition of the program. But the healing process begins when you begin to use methods that stimulate your brain to change. During the last few years of my practice I would ask patients to simply begin to learn and use the basic tools as quickly as possible and the rest of the concepts would fall into place. This is the first lesson of The DOC Journey.

 The nature of chronic pain (mental and physical) – sustained threat vs. safety

The essence of chronic illness, including chronic pain, is your body’s reaction to sustained stress because it responds with profound elevations of stress hormones, metabolic activity (rate of fuel consumption), and inflammatory markers (destroys invaders and your own tissues). The result is many different disruptive mental and physical symptoms.

The solution lies in learning the tools to create sense of safety, which normalizes your body’s survival fight or flight reaction. Successfully implementing these strategies causes a shift your mood, pain, and other physical symptoms. I am suggesting to dive in and begin using some of these basic foundational strategies right away. Why wait?

Creating Safety

Neuroplasticity is a term that describes your brain’s capacity to change its structure. You can form new connections, grow cells, increase the insulation around the nerves (myelin), and shift from unpleasant to pleasant circuits. Your brain physically changes in shape and structure based on programming.

As you learn strategies to regulate your body’s responses to stress, you have regained control, which creates safety. There are many ways to accomplish this and with repetition the process becomes automatic. It is like an athlete or musician attaining a high-level of skill. It cannot be done by just reading a book.

Let’s begin with these core strategies – Now

• Begin expressive writing. It is the one mandatory step to start. People can improve without doing it, but I have rarely seen people go pain free without engaging in this exercise. It has been documented in over a thousand research papers to be effective in creating significant shifts in multiple organ systems. (1)
• Practice active meditation. This involves placing your attention on a physical sensation for five to ten seconds as often as you can remember. You are switching to neutral or pleasant sensory input which causes less of a reaction in your nervous system. It requires minimal time and effort.
• Adequate sleep is critical. Lack of sleep has been shown to cause chronic pain. (2) With a multi-pronged approach, restful sleep can usually be achieved within 4-6 weeks. Medications may be needed for a few months.
• Never discuss your pain or medical situation with anyone except your medical providers. The solution for chronic pain lies in rewiring your brain around your memorized pain circuits. Your nervous will develop and evolve wherever you place your attention.

Why should this program work?

An important early step is to acknowledge and embrace your skepticism. Why should this DOC Journey work? You have been bounced around, promised relief time and time again, undergone failed interventions, and your pain is worse than ever. There is not any reason to think that this is going to work. I agree. In fact, primate research has shown that you can induce a major depression by repeatedly dashing hope. (3)

Every treatment offered in this program has been well-documented by decades of deep medical research; implement what is already known. I have watched well over 1500 patients break free from chronic pain and not only regain their life but thrive at a level they had never experienced at any point in their lives. It happened by them learning and using this DOC Journey sequence that evolved from my experience coming out of severe chronic pain and discovering what was effective with my patients.

What is not helpful is “believing” in the DOC Journey or David Hanscom, using positive thinking, or affirmations. It is about connecting with your current reality, which is unpleasant enough for you to sign up for this Journey. You are rightfully angry, frustrated, and trapped. It is the starting point. Feeling and knowing where you are at allows you to learn the strategies that allow you change direction. One successful patient commented what you need is a, “suspension of disbelief.”

Anything is possible

The DOC Journey begins with acknowledging doubt, learning awareness, and allowing hope to re-enter. Research has shown that hope and optimism are anti-inflammatory. (4) There is a lot of hope in hearing about other’s successes. I am increasingly convinced you can stimulate your brain to rewire around almost any pain regardless of the source.

I got another reminder when a patient who I never personally treated resolved his pain largely through The DOC Journey approach. He is now in his late 60’s and had experienced severe pain for over 22 years. He lost his marriage and business, ended up addicted to high-dose narcotics and attempted suicide. During this period, he underwent 28 surgeries. He has not only been free from pain for over five years, but he is enthusiastic that he has not felt this good since he was 30 years old. Historically, I would never have thought that this was possible in light of the severity of his trauma.

Please acknowledge your disbelief, embrace it, start with using these basic tools, and you’ll learn as you go. Helping patients emerge from The Abyss of chronic pain has been the most rewarding phase of my career. I am continually inspired by the resiliency of the human spirit and I am honored to be a part of your journey.

Recap of Lesson one – “Let’s Start Now”

Healing your pain requires repetition of tools that simulate your brain to change (neuroplasticity) and calm down your body’s survival response. The sooner you can engage with these strategies, the quicker you can begin to heal. That is why you might as well begin to use them ASAP. You will learn more about the nature of chronic pain and the principles behind solving it in a logical stepwise sequence throughout the rest of the course.

The next lesson will expand on the concept of threat vs safety and then more detailed explanations of these basic tools will be presented as you progress through leg one.

References:

1. Pennebaker JW and JM Smyth. Opening Up by Writing It Down. The Guilford Press, New York, NY, 2016.
2. Agmon M and G Armon. Increased insomnia symptoms predict pain among employed adults. PLoS One (2014);9:e103591. doi:10.1371/journal.pone.0103591
3. Blum D. Love at Goon Park. Perseus Books, New York, NY, 2002.
4. Dantzer R, et al. Resilience and immunity. Brain Behav Immun (2018);74:28-42. doi:10.1016/j.bbi.2018.08.010

The post Let’s Start Now and Learn the Details Later first appeared on Back in Control.

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There are three parts to solving your pain:

• The first is to understand chronic pain. It is a neurological problem that is different than acute pain.
• Second, all the variables relevant to your situation must be addressed simultaneously.
• Finally, every successful patient has taken control of his or her own care.

Introduction to Chronic Pain

 Pain impulses begin with stimulation of pain receptors and are sent to the brain through peripheral nerves and the spinal cord. In the brain a substance called myelin is laid down with repetition that etches in these pain circuits. Myelin can roughly be compared to the insulation around an electric wire that improves the speed of conduction. The process is similar to an athlete, artist or musician learning a skill. However the frequency of chronic pain impulses is more like a machine gun. Pain circuits become deeply embedded in the nervous system within six to twelve months. Similar to knowing how to ride a bicycle they are permanent.

Pain signals danger, which creates anxiety. Your body secretes adrenaline, cortisol and other stress chemicals, which protects you by increasing your heart rate and increasing the blood flow to your muscles. It also shuts down the blood supply to the frontal lobe of your brain (your thinking center) and amplifies the sensation of pain. Every millisecond of your life has evolved around avoiding anxiety. It is the only reason the human organism has survived. Your bodily responses to the environment are not centered on having a great time. Anxiety, Anger, and Adrenaline

Trapped by Pain

When you continue to be trapped by pain (or any life circumstance) you will become frustrated and angry. Anger results from loss of control. Any time you cannot fulfill a basic need such as air, food, or water you will become anxious then angry. Not being in pain is a basic need. Maslow’s miss Anger stimulates the body’s physiological response to meet that need. Therefore anger is anxiety with a chemical kick. Now the adrenaline levels really are elevated, which does improve your chances of solving a given problem. But it destroys the quality of your life, especially your close relationships. A terrible vicious cycle ensues – more pain, more adrenaline, more pain, and so on. Where and how does it stop? For most people it does not and it consumes them and everything around them. It is the worst part of the human experience. Your Hand Stuck Over the Stove

Anxiety is a neurophysiological response to a threat. It’s a mental reflex that sets off an automatic protective response. So similar to pain circuits anxiety pathways are also permanently etched in and become stronger with repetition. That is why every human experiences increasing anxiety with age. If they don’t, then their body will adversely respond with other physical responses. There are over 30 different symptoms that may occur. There are no exceptions. It is just a matter of degree, type of manifestations and coping skills.

As chronic pain always creates anxiety and frustration they are neurologically linked. Neuroscientists have a saying, “Neurons that fire together, wire together.”

It sounds like a dismal situation and it is if you approach the problem with traditional methods. Trying to deal with irrational pathways with rational means cannot work. The unconscious brain is a more than a million time stronger than the conscious brain. The more attention that is paid to what I call “The Terrifying Triad” of pain, anxiety, and anger the stronger they will become. If you try to ignore them then it becomes even worse. The more you try not to think about something you will think about it more. So what is the solution? White bears

Neuroplasticity

It has been recently discovered that the brain has a tremendous capacity to change at any age. The descriptive term is “neuroplasticity.” We do know that in chronic pain peoples’ brains physically shrink. Fortunately it re-expands with resolution of the pain. It is possible by using simple tools to both shift off these pathways onto non-painful circuits and to stimulate the formation of new pathways. Although there are many ways of accomplishing this I am presenting the starting point, which has been the foundation for essentially every patient I have seen successfully become pain free.

Stimulating Brain Change – Awareness, Separation, Reprogramming

 There are three steps to shifting and creating alternate brain pathways.

• You must first become aware of your automatic response to a given stress. It will always be a rapid protective response.
  • Stress by definition is always a threat – otherwise it wouldn’t be stress.
• Then you must create a space, or separate, in order for you to substitute a more appropriate or functional reaction.
• Reprogramming is the final step.

Awareness and Detachment – Expressive Writing

Humans have a problem in that unpleasant thoughts create the same response as a physical threat but you can’t escape from them. They key is to simple separate from them. I have discovered the easiest and most effective way of developing an awareness of my response to stress is to simply write down my negative or positive thoughts and destroy them. It has been shown in over 300 research papers that this is an effective way of changing the body’s response to stress. Stress isn’t the main problem. It’s your response to it.

There are two reasons to tear up, shred, or burn your writing. It’s not to get rid of the thoughts. They’re permanently embedded. The first is so you can write with complete freedom. Any thoughts, positive or negative will do. Write and Don’t Stop The more important reason it to not spend any time or energy analyzing them. Your attention will be focused in that direction and you’ll be reinforcing them. You might as well place your hand into a hornet’s nest.

In my opinion the writing accomplishes several things.

• It creates an awareness that these random thoughts are in your nervous system and that they are just thoughts.
• As the paper is a physical distance from you it allows you to separate from these thoughts. It is easier to see that they are just thoughts and have nothing to do with your reality.
• This space is connected with vision and feel, which connects with the unconscious.
• As you are connecting a thought with a physical sensation, you are creating new pathways.

Expressive writing creates awareness and separation with one exercise. It is simple and concrete – and doable. It was the first treatment that was helpful for me after trying to solve my chronic pain for over 15 years. I was lucky to have discovered it, as I was nearing the end of what I could tolerate. Video: Write Your Way Out of Chronic Pain

Warning: Please note that many people may experience an early decrease in mood and sense of well-being. Pain may also initially increase. This is not a bad prognosis for a long-term beneficial effect. It is recommended that you limit the writing to about 20 minutes per time until you are feeling better. If you feel too uncomfortable stop the writing immediately and contact your physician or mental health professional. The Dangers of Positive Thinking

Reprogramming

Reprogramming can be accomplished in thousands of ways such as music, hobbies, talking to friends, acupuncture, etc. However there is one core method that I feel is basic to the reprogramming process. I call it “active meditation”. It is more often referred to as mindfulness. It is simply placing your attention on sensations. Any one will do – taste, feel, sound, pressure, etc. There are three steps and it just takes five to ten seconds per time. (1)

• The first step is to relax
• Let yourself stabilize
• Finally, place your attention on any sensation. Taste your food. Feel the breeze. Listen to sounds.

I feel the active meditation accomplishes several things. As you relax your body will begin to secrete less adrenaline. By placing your attention on a given sensation your nervous system is no longer on the pain pathways. You have shifted off of them and are now truly in the present moment. As you continue to do this throughout the day it becomes more and more automatic. Eventually as you use the pain pathways less they will become weaker and the other pathways will become stronger.

One metaphor that comes to mind is that of diverting a large river into another channel. There is very little water that will initially flow through the new riverbed but with continued excavation there will be more and more flow. Eventually just the force of the water will create a new river. The old riverbed is still there. (It is permanent) but is much less developed. As you use your pain pathways less and the new pathways more, at some tipping point you will go to pain free.

Begin the writing/ active meditation NOW

The DOC project addresses the other factors that affect your pain experience. But the expressive writing/ active meditation is the core starting point. I ask all of my patients to begin that evening. I suggest that they write once or twice a day for at least 10 to 15 minutes. The active meditation should be done as many times as you happen to think about it. I am guessing that I do it 20 – 30 times a day. It eventually becomes an unconscious habit.

As nothing really changes until the writing/ active meditation begins I ask my patients to begin these exercises before they do much reading. I can instantly tell on the second visit whether they have started the expressive writing. People notice changes in their mood quickly although the pain may not have resolved. The research does show that most people will experience an initial dip in their mood and sometimes increased pain for a few days or weeks. Then I know they are actually writing.

Expressive writing/ active meditation alone is not the solution to your pain any more than reading my book. But these exercises are incredibly powerful especially considering how simple they are. BTW, what is the downside? How high are the stakes? Do you really want to continue to live like this? Was this your high school dream? You have once chance at this life. Take it!!

1) Learned from a workshop put on by Alan Wallace, PhD

The post Introductory DOC Concepts first appeared on Back in Control.

The post Introductory DOC Concepts appeared first on Back in Control.

There are multiple physical and mental manifestations of a chronically fired up nervous system. With engagement of the principles that calm it down, the improvements in my patients’ quality of life are consistent and frequently dramatic. The foundational step continues to be the writing exercises. I don’t know all of the reasons why it is so impactful, but its effectiveness has been documented on over 2200 research papers published since 1986.

Stimulating neuroplastic changes in the structure of your brain is key to healing. However, you must continually be aware of the impact of your past experiences on today’s actions. Then you are able to redirect and program your nervous system in the direction of your choice.

Reprogramming

There are three aspects of the re-programming process:

• Awareness
• Separation
• Re-programming

Most of us seem to be fairly enmeshed in our past, and it affects much of our current behavior. We all have many past negative experiences to process, and we do our best to deal with them. Strategies include:

• Suppressing
• Analyzing
• Ignoring
• “Re-writing” it
• Escaping through addictions
• Pursuing self-esteem

The expressive writing allows you to combine awareness and separation

Brain circuits are permanent

You cannot change the past, or the neurological connections to it. Memories may fade with time, but once a given memory is retrieved, it is completely present. Our inability to alter the past certainly doesn’t keep us from expending tremendous energy in trying to do so. It is more effective to connect and be with the past, and then release from it.

The Train

Picture a long completely loaded freight train. It’s impressive that engines have been developed to pull that kind of a load; even up a significant incline. It isn’t dissimilar to how we drag our past into the current day and can still function.

The writing exercises allow me to disconnect from the past—immediately. It creates an awareness of what is contained in the “train cars of my life”. The space created between the thoughts now on a piece of paper and me is the separation process. It’s as if I simply unhooked the first car from the engine.

Who Says I Have to Pull this Load?

There is no rule of life that says I have to stay connected to that huge load. And I still have the same power of the engines that is now pulling NOTHING. The available energy to be creative is almost limitless. I just regret that there is a physical limit to what my body can take.

Being “unhooked” from that load allows me to use the tools I have learned to more fully engage in the present moment, which is the re-programming part of neuroplasticity. The tool I use the most is “active meditation”. That is choosing a physical sense to become as aware of as much as possible throughout the day. I tend to choose sound or food at mealtime.

Writing Seems to be a Great Foundation

There are now over two thousand research papers documenting the effectiveness of various writing exercises creating a separation from these unpleasant neurological circuits. I still haven’t seen anyone be that successful without using the expressive writing as the foundational step.

Leave the past behind you—now. You can spend a lifetime trying to unload the freight in these cars, or you can take a few minutes to disconnect from it.

The post Unhooking from the Train first appeared on Back in Control.

The post Unhooking from the Train appeared first on Back in Control.

• You can only engage in the tools that enable your brain to heal itself.
  • The basic starting point is regularly practicing active mediation.
• In fact, the more focused you are on getting rid of your pain, the lower the odds are that the pain will abate.
•  Pain will still be running the show.
  • It is important move forward with or without your pain
• The new neurological pathways do not have to embody pain.

I have a metaphor that I share it with many of my patients. Trying to “fix” chronic pain is like putting your hand into the middle of a hornet’s nest. You cannot be successful in controlling these powerful survival responses. The process is that of connecting with your true nature and letting go – like a bunch of balloons.

A Bunch of Balloons

Imagine climbing a large mountain the size of Mount Rainier. At the peak, there is a “better you.”  The climb represents our endless quest for self-improvement. This journey takes endless forms: self-help books, healers, psychologists, medications, etc. There is a significant problem with this situation: “What does that ‘better you’ look like?” You may have a vague idea, but generally it is a concept that is idealized and humanly unattainable. Additionally, you are expending a tremendous amount of your life energy on this endless quest.

Instead, imagine a bunch of balloons tied to a railing. The strings represent your neurological patterns that are holding you down. What the various reprogramming tools accomplish is to cut the strings. Eventually, you will take off. There is no longer a goal to achieve a “better you.” You are able to enjoy the life you have with what you have. You are also not expending any effort and the potential is limitless.

You are fine just the way you are this minute. There are many interferences connecting with your true value system. Once you re-connect with who you really are, your life will change. Remember: the consistent result of many patients going through this process is a rich pain-free life.  The main variable is the degree of commitment – and letting go.

The post A Bunch of Balloons first appeared on Back in Control.

The post A Bunch of Balloons appeared first on Back in Control.