• 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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The title of this song¹ is a common way many of us deal with adversity. However, it encompasses both halves of the “ironic effect” and the actual well-documented outcome of this approach to life is more worry and sadness.

What is “the ironic effect” and how does it work?

There two aspects of it.

First, it is well known that if you suppress unpleasant thoughts, not only will they become stronger, but there is also a trampoline effect where they become much stronger.² We often joke about it, but it is serious problem that disrupts your quality of life, drives fight or flight physiology, and causes many symptoms, illnesses, and diseases. “Don’t worry” is thought suppression.

Secondly, and less known, is that setting high ideals and standards for yourself  will take you down in the other direction. For example, if you strive for happiness, you will experience sadness. If you allow sadness, you will be happier.³ So, the higher your ideals and intentions, the higher your chances of being riddled by anxiety.

Why does this phenomenon occur? The answer lies in the massive impact of the unconscious survival brain compared to the limited power of the conscious brain. Your unconscious brain processes about 40 million bits of information per second compared to your conscious brain dealing with about 40 per second. It is a million times stronger. Let’s look at the problem of “being happy.”

The pursuit of happiness

“Happy” is a conscious construct. The problem is that your conscious brain is no match for your survival reactions that evolved to be so unpleasant as to compel us to take actions to survive. The data shows that by trying to outrun or compensate for your stresses by pursuing pleasure, you’ll cause a highly inflammatory reaction. Your DNA dictates the production of destructive inflammatory cells call, “warrior monocytes” that attack your own tissues in addition to bacteria, viruses, and other foreign invaders.⁴ The sensation generated by this inflammatory response is anxiety.

Another aspect of this ironic effect is that by pursuing happiness, you’ll worry about the ways you might not achieve it. You have set a largely unconscious standard of what happy is for you. As you monitor your happiness, you are in ongoing self-judgmental mode that wears you down.

Happy is also a label, which is a core cognitive distortion.⁵ What is it and how encompassing is it? What percent of the time do you have to be in a happy state to label yourself as “happy?” What activities and accomplishments are required to reach your criteria? How do you react when daily challenges interrupt this state of mind?

Philosophers and psychologists have viewed attachment as the root of suffering. Anthony DeMello has a concise definition of it.⁶ If something feels good you want more and if it is unpleasant, you want less. Being attached to “happy” will paradoxically increase your suffering. The most well-intentioned people are the most subject to the ironic effect in that the higher their ideals, the greater the chance they’ll be riddled with racing thoughts and anxiety.

“Don’t worry?”

We all know the problems that occur when you try not think about something. One classic paper was published in 1987,² The Paradoxical Effects of Thought Suppression.” Again, more well-intentioned people will suppress a higher percent of “unacceptable” thoughts and also give meaning to them. They are just thoughts but will become more powerful as they keep being interpreted as good or bad.

Repetitive Unpleasant Thoughts  (RUT’s) are universal. When you have a bizarre, even unspeakable thought, of course you would suppress it. Why wouldn’t you?  It has nothing to do with anything about you or your value system. As it arises again and again, it is instantly suppressed.  Eventually suppression becomes automatic, which is called repression. Seems pretty normal, right? Except what happens is that your nervous system inadvertently gave this random thought a tremendous amount of power. Every time that thought is suppressed/ repressed, that neurological circuit has been reinforced. These circuits become stronger and connected with more experiences.⁷ Eventually, you may end up spending a lot of mental energy dealing with these anxiety-producing, disruptive thought(s). As you feel trapped and frustrated, these circuits are driven even harder from your brain being inflamed.

These disruptive thoughts become your “demons.” They are not your demons. They are the opposite of who you are and who you are not. My term for these irrational, non-responsive neurological patterns are “robots”. You cannot deal with a robot. You cannot talk to it or reason with it. There is absolutely nothing that can be done from a rational standpoint to change an unresponsive neurological circuit. In fact, when you discuss your demons and try to figure out why they are there, you are firing up and adding even morecomplexity to the circuits. They become even stronger and you can’t unlearn them. How do you “unlearn” to ride a bike? You can’t. They really are RUT’s.

Allow worry?

No one wants to talk about the existence of RUT’s because they are so disruptive, and often feel shameful. The initial step is to understand the nature of the problem and realize that these thoughts are emanating from your unconscious brain. You must separate your identity from them. They are just thoughts, are also universal, and you don’t have to personally identify with them.

The unpleasant emotions connected with them are your body’s physiology responding to the perceived threats. Remember, they are actually the opposite of who you are as a well-meaning person.

Fortunately, there are solutions that have been known for centuries, but don’t seem to be readily apparent in our modern world. The principles revolve around allowing yourself to be with your painful emotions, use strategies to calm down your threat physiology, and then choose joy. With repetition you’ll reprogram your survival reactions into more pleasant alternatives. As emotional pain is processed in similar regions of the brain as physical pain, it hurts.⁸ Professional support and direction are often needed.

Joy

Choosing joy is different than positive thinking, which is another form of thought suppression. It entails having a positive outlook, “taking the hits,” and consistently making positive choices. But you can’t make the positive choices without knowing where you are at in the moment. “What you can feel, you can heal.”⁹ As you learn to be with your mental pain instead of fighting it, these unpleasant circuits will become less active. It is similar to any skill that fades without practice.

Be with worry and choose happy. Learning skills to accomplish this allows you rise above your “RUT’s” and live a more enjoyable life.

References:

1. McFerrin, Bobby. Released 1988; Number 1 single from album Simple Pleasures.

1. Wegener, D.M., et al. “Paradoxical effects of thought suppression.” Journal of Personality and Social Psychology (1987); 53: 5-13.
2. Wegner D. The Seed of Our Undoing. Psychological Science Agenda, January/February, 1999, 10-11.
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. Burns, David. Feeling Good. Avon Books, Harper Collins, New York, NY, 1999.

6. DeMello, Anthony, The Way to Love. Double Day, New York, NY, 1992.
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
8. Eisenberger NI, et al An experimental study of shared sensitivity to physical pain and social rejection. Pain (2006); 126:132-138.
9. John Gray, author of Men are from Mars, Women are from Venus. Harper Collins, New York, NY, 1992.

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“Don’t turn the ball over!”

Which brings us to the Golden State Warriors, who have become an NBA basketball dynasty. There are many facets to winning a game, involving strategies and skills that are well beyond my comprehension. However, one aspect of winning is minimizing the number of times you turn the ball over. Each time you turn the ball over, you open the door to making a bad pass or having the ball stolen by the opposing team. But it also involves a different energy than free throws, shooting, conditioning, and ball handling. There are many factors causing ball turnover; it always means less control.

The Warriors are legendary for their ability to move the ball around quickly, and you would expect a higher number of turnovers. It was a topic prompting discussion in multiple public forums, and decreasing turnovers must have been a focus of the team. However, something I read in the newspaper one day caught my attention: The Warriors had decided to quit worrying about turnovers and just play.

It was inspiring to watch their performance improve. Not long after, they went on to win the NBA championship.

Their experience is a classic example of “the ironic effect.” Trying not to think of something not only causes you to think about it more, but it also sets off a documented trampoline effect, you’ll think about it a lot more. Focusing on the highest level of performance is much different than “not trying to make mistakes.”

Skiing “not to lose”

My son is a world-class mogul skier and won the Junior Nationals championship in dual moguls two years in a row. He then hit many rough spots, including multiple significant injuries. One of them was a high-speed fall than caused his left shoulder to dislocate. He was moving so fast that he thought he was going to die as he hit the snow and narrowly missed a tree. He lost some of his edge of being infallible. He didn’t quit; he began skiing, “not to lose.” Of course, at that level, you also can’t win. His efforts to improve kept getting sabotaged in spite of an incredible commitment to conditioning and practice. In the midst of a few more injuries, including nine concussions, he really struggled.

He engaged the expertise of an athletic performance coach, David Elaimy, with an emphasis on connecting with one moment at time and visualizing what he wanted to accomplish. He also understood the powerful effects of expressive writing, writing down thoughts then destroying the paper they’re written on. It is the one exercise that breaks up the need for mental control, which is the driving force behind the ironic effect and repetitive thought patterns.¹

As he stood at the starting gate for his last attempt at qualifying for the U.S. ski team, my son carved in the snow  the word, “fail” with his ski pole, then trusted himself to execute what he already knew how to do—ski at the highest level. He went on to ski the best run of his life and qualified for a shot at the Olympic Freestyle team. For other reasons, a skier who finished below him was chosen for the team. But he did it. He broke through and performed to his potential under extreme pressure.

What does this have to do with pain?

There are two separate but tightly linked areas of expertise involved in resolving mental and physical pain.

One is learning how to process stress by developing a “working relationship” with your powerful survival fight-or-flight response. By learning the tools to stop fighting it, you can place your attention on what you want to accomplish.

The other is learning to nurture yourself and actively create the life you want. Few of us have been taught these skills.Your nervous system and body’s physiology will shift from an activated defensive state to that of safety, with profound benefits to your mental and physical health.

Winning is not the same as “not losing”

By trying “not to turn the ball over,” your powerful unconscious brain is trying to help with that effort, but it is also taking attention and energy away from what you desire. Focusing on what you want to accomplish is a more effective way of enjoying your life.

I have no idea whether the Warrior’s coaching staff was aware the ironic effect. I am even not sure whether turnovers dropped much. But the switch likely allowed them to focus more attention on execution.

Successfully dealing with ironic effect has a major influence on people’s quality of life. I have witnessed hundreds of people heal. that way. Deep healing cannot occur while you are in a sustained defensive mode, in fight or flight. Life is meant to be more than just surviving. Becoming a “professional” at living your life allows you spend less time feeling stressed, and decreases your exposure to fight or flight physiology. To win, you must practice winning.

References

1. Wegener DM. The Seed of Our Undoing. Psychological Science Agenda (1999)/ 10-11.
2. Wegener, D.M., et al. Paradoxical effects of thought suppression. Journal of Personality and Social Psychology (1987); 53: 5-13.

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The post The Golden State Warriors and the “Ironic Effect” appeared first on Back in Control.

• Unpleasant thoughts are impossible to avoid and can significantly impact your quality of life.
• They are a “neurological trick” created by your unconscious brain. They are not subject to rational interventions.
• The root cause of the problem is the human need for mental control. It sets off two different reactions.
  • One is that suppressing unpleasant thoughts causes them to become more frequent and stronger.
  • The other one is that when you try to think about something, you’ll think about it less.
• The final outcome is obsessive thought patterns that fire up your nervous system, which causes you to be in a sustained flight or fight response. This state compromises your mental and physical health.
• The DOC Journey teaches you recognize the nature of these thoughts, and you can move past them into the life that you want.

The inability to escape from unpleasant thoughts has a major impact on many people’s quality of life. Much energy is spent in attempting to control or suppress them. It turns out that they arise from the unconscious brain as a reflex, and they are much more powerful than your conscious brain. Rational interventions cannot and do not work.

The problem arises because these disruptive thoughts become stronger with time and repetition, are memorized, and evolve into obsessive patterns. A historical research term for them is, “URT’s” (Unpleasant Repetitive Thoughts). (1) My description is “RUTs” (Repetitive Unpleasant Thoughts). I refer to this phenomenon as “Phantom Brain Pain.”

Then there even a bigger issue in that they are processed in a similar manner as physical threats and stimulate your body into a flight or fight response (threat physiology). It is important to have this survival response, but it is deadly when it is prolonged. Your body is in high gear and your inflammatory cells are attacking your own body’s tissues. However, thought suppression is only part of this story.

The Ironic Effect

A significant obstacle to health and well-being is the “ironic effect.” We all know that when you suppress thoughts and emotions that they become more powerful and disruptive. (2) But a lesser known, and even more deadly problem is that when you try to think of something, you’ll think about it less. (3) Your conscious intention is overwhelmed by your unconscious brain focusing on ways you may not achieve this goal. Since the unconscious brain is so powerful, it is a huge mismatch.

The problem is that the more well-intentioned you are, the more likely this universal process will kick in. If your intention is to be out of pain, inadvertently, you’ll think about the pain more and reinforce it. The research shows that if you seek happiness, you’ll end up sad. If you try to be sad, you’ll end up buoyantly happy. If you try not to stereotype people, you’ll end up being more prejudiced. It is a major human existence problem in that many people who want to contribute to the world’s well-being, end up being crippled by overwhelming unpleasant thoughts and crippling anxiety. People with few scruples are not as bothered by this ironic effect and perhaps why many people in power run over people that are more conscientious.

The “seed” of this ironic process is the need for mental control – any control. (3)  The effect varies considerably from individual to individual, but it is consistently present. As bad as it sounds, and it is problematic, the solution is incredibly simple. Just write down your thoughts on a piece of paper and destroy it. The act is that of giving up mental control and it is without risk. It is the reason The DOC Journey has you begin this exercise before you get into the substance of the course. Every human being should do this daily like brushing your teeth. Look at it as cleaning out the lint trap of your dryer. Even a few minutes a day interrupts this reactive process. It is also the reason why expressing writing is the one “mandatory” step without an alternative.

Moving past these obsessive thought patterns

Understanding the powerful irrational nature of these inner critical voices will change your life in several ways. First, they are a neurological mechanism intended to protect you. You cannot take them personally. This realization allows you to learn to separate your identity from this reflex and access who you are and want to be. Your “demons” are actually suppressed thoughts and who you are NOT. Again, the more of a well-intentioned person you are, the more intense the thoughts. It really isn’t fair.

The other mechanism of trying to think noble and positive thoughts creates the opposite effect in that you think about them less. It creates disruptive thought patterns such as, “not good enough”, “just work harder,” “I’m a loser,” and “why does this always happen to me?” It is also problematic in that they push you to become “successful”, but you may not be able to feel it. A common scenario is the “imposter syndrome.” It seems many highly successful people feel like frauds even though there is abundant evidence to the contrary.

Where is your attention?

Whatever the reason, the end result is the same. You spend a significant amount of your life energy trying to squelch these voices and they won’t respond because they can’t. In fact, they will become stronger in that you are paying attention to them and stimulating neuroplastic changes in brain. It is similar to spinning a basketball ball on the tip of your finger. It will keep spinning as you put more energy into it. Also consider these thoughts as “dust devils” that are mini-tornadoes that occur in the prairie. They spin extremely fast, they cannot be stopped, or even penetrated.

So, the second way your life will be impacted is that once you understand the problem and realize you are wasting your energy trying to assuage this noise, you can move past them. The energy is now available to turn towards the future and construct the life you desire. Going back to the basketball comparison, as you stop paying attention to these circuits, they will slow down and may stop spinning almost completely. You cannot “fix” these thought patterns. The key is to first separate from them (expressive writing), and then create circuits in your brain that are much more enjoyable. You can also shift onto the part of your brain that already knows how to play. All of this can happen quickly with practice. The energy now available to go this direction will amaze you. You’ll quit trying to solve the unsolvable.

Begin with your disbelief

Your success with this course is not about generating belief in David Hanscom, The DOC Journey, or any other set of resources. That would be a form of thought suppression. Positive thinking generates the same thought pattens through the ironic effect. Your journey must begin and continue by connecting with what is happening at the moment. As you begin this course, that would be acknowledging your disbelief and downright cynicism. You have tried almost everything presented in this course at least once. Why should this experience be any different? Like trying to be happy ends up being sad, wanting to be free of pain causes you to be in more pain. If you can’t seem to get past positive thinking, keep trying. We all want to believe and experience happiness but living in chronic pain is tough.

The DOC Journey presents deeply researched tools that will allow you to calm and down re-route your nervous system as well as ways to regulate your body’s chemical state. It begins where you are and sequentially teaches you tools to accomplish this one step at a time. The way out of pain is truly paradoxical and why The DOC Journey is presented in a planned sequence. It also reflects the journey taken by many successful patients.

Recap:

Unpleasant repetitive thoughts are the “curse of consciousness.” They are unique to being human in that we possess language and can create abstract thoughts and concepts. They become our version of reality and identity. (4) We may spend a lot of time trying to fix or escape from them, but it isn’t possible. They are relentless and irrational.

Understanding the neurological mechanism of how they occur allows you to recognize them for what they are, connect to your own value system, and move past them into a much more enjoyable life experience.

References

1. Makovac E, et al. Can’t get it off my brain: Meta-analysis of neuroimaging studies on perseverative cognition. Psychiatry Research: Neuroimaging (2020); 295:111020. doi.org/10.1016/j/psychresns.2019.111020
2. Wegener DM, et al. “Paradoxical effects of thought suppression.” Journal of Personality and Social Psychology (1987); 53: 5-13.
3. Wegener DM. The Seed of Our Undoing. Psychological Science Agenda (1999)/ 10-11.
4. Feldman-Barrett. How Emotions are Made. Mariner Books; Main Market Ed. 2018.

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• Body image disorders
• Eating disorders
• Crohn’s Disease and Ulcerative Colitis
• Irritable Bowel and Spastic Bladder
• Depression/ OCD/ Bipolar disorder

Remember, anxiety is simply the sensation you feel when your body is flooded with stress hormones, which affects every cell in your body. Since each organ system will respond in its own way, there are at least 30 different physical symptoms that can be generated in this hyper-vigilant chemical environment.

I gave a lecture about dealing with stress at a local high school a few years ago and over 300 of the 1,500 students were on daily medications for a chronic illness. This phenomenon is occurring in an era of unprecedented opportunity. What is going on?

Anxiety Basics

There are books written about why there is so much societal angst. However, conjecturing about all the reasons is of limited value unless the core problem of relentless anxiety is addressed. Since this unconscious survival sensation is much more powerful than the conscious brain, it isn’t responsive to isolated rational interventions. The way to solve anxiety is to decrease your levels of stress hormones. It’s a learned skill that improves with repetition.

The dark side of human consciousness is that a mental threat is processed in a similar manner as a physical one. It takes the form of Unpleasant repetitive thoughts (URT’s) (1), from which you can’t escape. Disruptive thoughts are maybe greatest reason for sustained anxiety. Most of us suppress them, which is the one worst thing to do. Research has shown that this creates a trampoline effect, where not only are the unpleasant thoughts stronger, they are a lot stronger. (2) One effective way of addressing the problem of URT’s is to become aware of them, understand their impact and then reframe the situation.

Unreachable Expectations

In this modern era, one of the greatest sources of anxiety is dealing with unreachable expectations, and winning is one of the ultimate goals. Somehow, success (your perception of “winning”) is going to bring you peace of mind. Really? That isn’t even a reasonable concept. How many “winners” have we watched self-destruct, yet we keep pursuing the dream that money, power, accomplishment, and attractiveness will quell our fears. The problem is that you can’t outrun your mind.

What is even more problematic is that our concepts of success and failure become attached to our identity and vice versa. Modern neuroscience research has shown that thoughts and ideas become embedded in our brain, in the same way as physical objects. (3) In other words, the only reason a dish is a dish is because your brain has unscrambled visual and tactile senses and decided that it is a dish. This is true for everything. None of your body’s sensors have any inherent capacity to determine the nature of your reality and environment.

So, our perception of self is programmed in by our past experiences, and is as real as the chair you are sitting on. Much of it is determined by your definition of success and failure. They are “stories” that run your life. It is also the reason why it is impossible to truly see an issue from another person’s perspective.

These many negative stories become stronger over time, alter your body’s chemistry and compromise your sense of well-being. In contrast to this sustained assault of stress hormones generated by your “stories”, consider the feelings generated by being full of oxytocin (love drug), serotonin (antidepressant), GABA (anti-anxiety) and dopamine (rewards), when you are at play.  Instead of pursuing happiness through achieving your goals, why not get happy first and then pursue your dreams? Part of that pursuit is learning how to “fail”. A major aspect of this approach is understanding the impact of your “failure stories” and realizing how irrational many of them are.

A close friend of mine sent this piece to me on stress. I don’t know the person who gave this seminar, but I think it is excellent and reflects many of the tools to just let go, reframe many of your created  “adversities”  and enjoy your life. Where are you actually going and what’s the rush?

A Great Lesson on Stress

A young lady confidently walked around the room with a raised glass of water  while leading a seminar and explaining stress management to her audience. Everyone knew she was going to ask the ultimate question, ‘Half empty or half full?’  She fooled them all. “How heavy is this glass of water?” she inquired with a smile.  Answers called out ranged from 8 oz. to 20 oz.

She replied, “The absolute weight doesn’t matter.  It depends on how long I hold it. If I hold it for a minute, that’s not a problem. If I hold it for an hour, I’ll have an ache in my right arm. If I hold it for a day, you’ll have to call an ambulance. In each case it’s the same weight, but the longer I hold it, the heavier it becomes.”

She continued, “and that’s the way it is with stress.  If we carry our burdens all the time, sooner or later, as the burden becomes increasingly heavy, we won’t be able to carry on. As with the glass of water, you have to put it down for a while and rest before holding it again. When we’re refreshed, we can carry on with the burden – holding stress longer and better each time we practice.”

So, as early in the evening as you can, put all your burdens down. Don’t carry them through the evening and into the night. Pick them up again tomorrow if you must.

1. Accept the fact that some days you’re the pigeon, and some days you’re the statue!
2. Always keep your words soft and sweet, just in case you have to eat them.
3. Always read stuff that will make you look good if you die in the middle of it.
4. Drive carefully… It’s not only cars that can be recalled by their Maker.
5. If you can’t be kind, at least have the decency to be vague.
6. If you lend someone $20 and never see that person again, it was probably worth it.
7. It may be that your sole purpose in life is simply to serve as a warning to others.
8. Never buy a car you can’t push.
9. Never put both feet in your mouth at the same time, because then you won’t have a leg to stand on.
10. Nobody cares if you can’t dance well;  just get up and dance.
11. Since it’s the early worm that gets eaten by the bird, sleep late.
12. The second mouse gets the cheese.

My past formula for “success” – highly NOT recommended

As I went through this list, I pondered my historical approach in each category, and I’m not making this up. One of my basic core beliefs was that of being “cool under pressure” and I could take on an unlimited amount of stress.

1. It is important to always be on top. If someone dumps on me, I’m a “loser”.
2. If there is an obvious problem, it is necessary to speak up (not such soft voice).
3. I have always liked good books and don’t like to waste that much time on something that isn’t informative, entertaining or inspiring.
4. My time is valuable, and I’ll do whatever I need to do to get there quickly. (I had 14 speeding violations in five different states between ages 18 to 25. Thank goodness it was well before there were computers)
5. If someone is “wrong” from my perspective, it’s my role (duty) to correct them.
6. I am not forgetting that person who shortchanged me. I don’t care how long it’s been.
7. Having some variation of a “purpose” has defined my existence. My identity was based on my ideals and I couldn’t always clearly see who or what was right in front of me.
8. I actually don’t care much about cars one way or the other.
9. One day, one of my fellows asked me, “Don’t you ever get tired of talking?”
10. I don’t dance. I’m not very good at it.
11. There aren’t enough hours in the day, and I have to get up early.
12. What if the first mouse gets the cheese?

The bottom line is give yourself a break. What are your ideals? How do you mentally punish yourself if you don’t live up to your own expectations. It’s great to be successful at whatever you set out to do. But does it define you? Are your endeavors grounded in reality. I did define “me” by my achievements, and many efforts were driven by “magical thinking” and unattainable goals.  I used my adrenaline drive to become “successful”, yet it was this same energy that caused me to sink into chronic pain and become physically ill. Another version of her advice is reflected in this poem sent to me by one of my patients, She Just Let Go.

I wish I had figured this out many years ago, but my life and parenting advice (if I am asked) has boiled down the word, “play.” If you can’t enjoy your family and life today, when will you?

Enjoy your day today

1. Garland, EL. Brown, SM, and MO Howard. 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.
2. Wegner, D. M. (1994). Ironic processes of mental control. Psychological Review, 101, 34–52.
3. Feldman-Barrett, Lisa. How Emotions Are Made: The Secret Life of the Brain. Houghton Mifflin Harcourt Publishing, New York, New York, 2018.

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“Now I will read the whole book. Recommend 100%”

–An Amazon reader

Breaking my fall

The above quote is an Amazon review of the second edition of my book, Back in Control. Feedback like this from readers bolsters my belief in the expressive writing exercise and how critical it is to the DOC (Direct your Own Care) process.

I completely understand what the reader went through: After over fifteen years of trying everything I could get my hands on to relieve my pain—“desperate” does not begin to describe my frantic search for a solution—I had lost all hope. Then, in 2002, I inadvertently discovered expressive writing and put it to the test. Within two weeks I noticed a shift in my mood, and within six months I had pulled myself out of the deadly tailspin of chronic pain.

But the expressive writing exercise seems so simple, I fear that, when I recommend it to patients, many of them feel that I don’t believe they are really in pain nor do I understand the depth of their suffering. Yet, in addition to my experience and that of many other chronic pain sufferers, over 300 research papers document its effectiveness; while essentially no papers validate the benefit of a spine fusion for low back pain. Compared to spine surgery, how much risk is there in writing down your thoughts and then discarding the pages? What can you lose by trying it out?

I have consistently observed that expressive writing is the first step toward healing, and little of substance happens until a patient engages the process. When I walk into an exam room, I can tell within thirty seconds if my patient has started to write. If not, I offer more details of its importance. I tell my patients that reading my book is helpful, but it will not make a difference in their mood or in their level of pain. I ask them to return a few weeks after they begin writing.

“This is ridiculous!”

One patient, a professor, came to me with lower back nerves that were so tightly pinched, they were causing leg pain. He refused to do the writing. I told him I thought he would benefit from a simple operation, called a laminotomy, to relieve the pressure. However, I said he would need to find another surgeon, since he was not willing to employ even the simplest tools to contribute to his recovery. A few weeks later, he returned. Laughing, he said, “This is ridiculous! I began the writing and within a week my pain was gone!” He began to employ the rest of the DOC strategies. Three years later, he is still pain free. He may need surgery someday; but now, it would make no sense. Why perform surgery on someone who is feeling fine?

Mental pain = physical pain

I have a theory to explain why expressive writing works so well to alleviate chronic pain, and it comes from my review of the latest neuroscience research, for the second edition of my book. The studies find that the nervous system processes thoughts the same way that it responds to physical sensations such as taste, smell, and pain. All these stimuli—whether they are thoughts, feelings, or physical sensations—are interpreted as sensory input, they travel the same neural pathways, and the body responds with essentially the same chemical reactions. So, from a purely neurological standpoint, emotional pain and physical pain are equivalent stimuli. In fact, I’m now convinced that anxiety is actually the pain. If that sounds crazy, consider this: Most of my patients, when I ask them if they would rather relieve their physical pain or the mental anguish that goes along with it, say they wish to be free of the anxiety. That is the intolerable part.  That certainly was my experience. Am I operating on your pain or anxiety?

Compared to other living creatures, we humans have the unique problem of harboring unpleasant thoughts that are difficult or even impossible to escape from. Each person struggles with anxiety over the course of his or her lifetime, either addressing it or masking it, with varying decrees of success. All the writing does is free you from these repetitive circuits, so that you can redirect your attention and focus on other things. That’s it. It is neither a solution nor a “fixing” exercise. It’s more of a “disassociation” exercise.

The neuroscience research has shown that chronic pain is driven by the emotional regions of the brain. Since writing taps into and releases strong emotions such as anger, blame and anxiety there is “space” for other more positive connections. (1)

Just start the expressive writing

So I ask my patients to begin their expressive writing even before they read my book or dive into my website, and to destroy their written pages immediately after they finish them. There are two good reasons for not saving your pages: First, knowing that no one else will see them, you can write with complete freedom. You do not want to censor any thoughts or feelings, no matter how harsh or otherwise unacceptable they may seem to you. (Research shows that suppressing thoughts can damage the memory center of your brain.) (2) Second, as I mentioned in the last section, the writing is meant only to create distance from your thoughts. For our purposes, analyzing your thoughts and feelings is counter-productive. It focuses your attention on those negative thoughts, which further reinforces the pain-inducing neural pathways. Trying to “fix” yourself is like placing your hand into a hornet’s nest. A pain colleague has succinctly pointed out that holding on to your written words from the expressive writing exercise means you are holding on to your pain.

Certainly many other forms of creative writing are meant to be saved and refined. But expressive writing is only an exercise, to be performed once or twice a day, and its output is to be discarded. If you can’t write, you could record your thoughts audibly, although saying them out loud engages a different set of brain circuits. David Burns, in his book Feeling Good, suggests standing in front of a mirror and verbalizing the self-critical thoughts in your head. Notice how hard on yourself you are. Would you ever talk to another human being that way?

Make it a routine

Consider expressive writing as something you do automatically every day, like brushing your teeth. You’ll find that it’s such a powerful tool that it is habit forming. I’ve made it part of my daily routine, although I confess that sometimes I neglect it. During these periods, within a couple of weeks, symptoms of neurophysiologic disorder (NPD) predictably return. My sleep quality drops, I am more reactive, my scalp itches, my feet burn, and rashes reappear on my wrists. My wife will ask me, “Honey, have you been doing your writing?”

Resistance to Expressive Writing

It is remarkable how resistant so many people are to this simple but profound exercise. There is no cost or risk. It can be done anywhere and it only takes a few minutes. How much time do you spend on your smartphone? Why on earth wouldn’t you do this? I have so many more thoughts on this subject, which I will discuss at a later date; but for now, I have only one question for you: How much do you really want to give up your pain?

1. Hashmi J, et al. Shape shifting pain: chronification of back pain shifts brain representation from nociceptive to emotional circuits. Brain (2013); 136; 2751–2768.
2. Hulbert J, et al. Inducing amnesia thought systemic suppression. Nature Communications (2016); 7:11003.

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Trying not to think about something will cause you to think about it more. All of us know this phenomenon but we don’t know how to deal with it. The deadliest emotion we suppress is anxiety. It is a survival response and our whole being is repulsed by it. Prolonged exposure to raw anxiety is the worst part of the human existence. It is a universal problem that few people want to admit to much less discuss.

Nate

A few weeks ago, I was discussing the problem with one of my best friends, George. He has an 11-year-old son, Nate, who is personable, athletic, good-looking, and has many friends. He has a wonderful family life. George has engaged his family with many of the principles of dealing with Neurophysiologic Disorder. (NPD) One of the exercises is the writing down of his  thoughts and throwing them away. Recently he suggested that Nate draw a picture of himself with these thoughts.

He showed me the drawing. It was brutal. “I am ugly. I have no friends. No one likes me. I am stupid.” The list went on for 15 thoughts that were equally as negative. How could this be? He is living a childhood that remarkably rich and supportive. It reinforced to me that every human being struggles with disruptive thoughts.

Harvard study – white bears

In 1987 Dr. Daniel Wegner, a Harvard psychologist published a paper, The Paradoxical Effects of Thought Suppression. (1) The experiment is commonly referred to as “White Bears”. He asked a group of students not to think about white bears. He designed it in a way that demonstrated that when you try not to think about something, not only do you think about it more; you think about it a lot more. He used the term, “trampoline effect.” He pointed out in an essay; The Seed of our Own Undoing, that simply writing down or saying the thoughts you are suppressing interrupts the phenomenon.

“ANTS”

David Burns in his book, Feeling Good (2) uses a term he calls “ANTS”, which stands for “automatic negative thoughts”.  These ANTS are a universal part of the human experience. Since I picked up his book in 1990, I have always wondered why we don’t have “APTS” or “automatic positive thoughts.”  WE DON’T SUPPRESS POSITVE THOUGHTS.

Pain, ANTS, and white bears

People suffering from chronic pain lose their sense of humor. Pain causes anxiety and when you are it, extreme frustration and anger will run your life. Anger results from loss of control. What causes the need for control is anxiety. Anger is just anxiety on steroids. One step worse than suppressing anxiety is suppressing anger. The eventual outcome is rage. My term for the darkness that consumes my patients in pain (and historically me) is the “Abyss.”

There is a solution

I have learned that pain, anxiety, and anger are classic symptoms of the Neurophysiologic Disorder (NPD). Dr. John Sarno first described it in the 1980’s under the term, “Tension Myositis Syndrome” (TMS).  (3) There are least 30 other MBS symptoms connected to and caused by the nervous system. (4) The nervous system component is NOT psychological it is a programming issue. Like any learned skill such as riding a bicycle these pathways are permanent.

Anxiety is a physiological reaction to sensory input of any kind including thoughts. It results in behavior that causes you to react in a way to protect yourself. You can talk about it all day long, but you cannot get rid of anxiety whether it is from a  mental or physical source. It is a symptom of NPD.

Fortunately your conscious brain focuses on one thing at a time. That is why we are not safe texting and driving. When your mind is here it is not there. By creating alternate pathways around your fixed circuits, you can shift your nervous system into a new set of pathways. Additionally, we now know your brain can grow new nerve cells at any age. The term is “neuroplasticity.” At a certain tipping point your pain pathways will become dormant. The switches are turned off. Anxiety and anger also will dramatically drop.

I experienced 17 of the 33 symptoms of NPD disappear. I not only have my life back, but I also have a new life.

Connecting thoughts with physical sensations is one way of creating new pathways. One foundation of treating NPD is the simple the act of writing down your thoughts and immediately throwing them away.

Patients won’t write

But I often cannot persuade my patients to begin this exercise. It’s the necessary foundational step of the reprogramming process, which is to create an awareness of these ANTS. The thoughts can be positive or negative. I have my tear them up both to write with freedom and not to spend any time analyzing them. This exercise is only a separation process from your conscious thoughts.

Regarding the negative thoughts that arise, my patient’s first response is, “This is not who I am.” That is correct. These thoughts are not who you are. They are JUST neurological connections and the opposite of you who are. Otherwise, you would not be suppressing them. You are only giving them life by blocking them. Your brain will develop wherever you place your attention.

We all know that being reassured that our hidden thoughts aren’t valid does not make them disappear. I could collect dozens of signatures and testimonials from Nate’s peers and give them to him. He could win a “greatest human being contest” along with a big trophy. How would that work? I predict, based on my personal experience with NPD, the next set of thoughts would be centered on, “They don’t really know me.”

Possibilities

What if we could teach these simple writing exercises to our children in pre-school? We would have a shot at solving chronic pain at a societal level.

References

1. Wegener, D.M., et al. “Paradoxical effects of thought suppression.” Journal of Personality and Social Psychology (1987); 53: 5-13.
2. Burns, David. Feeling Good. Avon Books, Harper Collins, New York, NY, 1999.
3. Sarno, John.Mind Over Back Pain. Berkley, 1999
4. Schubiner, Howard.Unlearn Your Pain. Mind Body Publishing, 2010.

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Thought suppression

Disturbing thoughts are universal. When you have a bizarre, even unspeakable thought, of course you would suppress it. Why wouldn’t you?  It has nothing to do with anything about you or your value system. Then, as it arises again and again, it is instantly suppressed.  Eventually the suppression of the thought is automatic. Seems pretty normal, right? Except what happened is that your nervous system inadvertently gave this random thought a tremendous amount of power. Every time that thought is suppressed, that neurological circuit has been reinforced. Over many years, this circuit becomes much stronger and becomes connected with more experiences. (2) Eventually, you may consciously or unconsciously end up spending a lot of mental energy dealing with this anxiety-producing, disruptive thought(s). As you have less success in controlling the ever-increasing and powerful thoughts, you will probably become frustrated, which drives the circuits even harder.

Another variation of this phenomenon is the development of obsessive thought patterns around “forbidden activities or topics.” (3) Just inadvertent  curiosity will stimulate barrages of thoughts. What is perverse is that it is the more well-intentioned person who is more subject to this sequence. This programming process is similar to an accomplished musician or artist learning their skill. It requires years of repetition to reach the highest level. Disruptive thoughts hit the nervous system like a machine gun without an endpoint.

Your reality – your thoughts

You might ask what is the big deal? These are just thoughts. Neuroscience research has demonstrated that thoughts are your version of reality, similar to learning a cat is a cat. Your brain has to unscramble sensory input from all receptors every second to define anything. Your eyes have no capacity to interpret anything. For example, if a person suffers a stroke of the occipital lobe at the back of the brain, they can’t see even though every other component of the visual system is functioning. The term is “cortical blindness.” This is true for all sensations. To develop consciousness, your nervous system has to interpret words, body language, tone of voice, visual cues, etc. for every thought to decide where it fits and what it means. Thoughts and concepts are embedded in the same way as physical reality. We are programmed by our past and the lens through which we interpret the present. As disruptive thoughts strengthen with repetition, they even become associated with physical reactions making them even more “real.” Every human has to deal with this problem of consciousness at some level. It is often overwhelming efforts to escape result in many untoward behaviors and acting out.

Demons

These disruptive thoughts become your “demons.” They are not your demons. They are irrational, non-responsive neurological patterns that I call “robots”. You cannot deal with a robot. You cannot talk to it or reason with it. There is absolutely nothing that can be done from a rational standpoint to change an unresponsive neurological pathway. In fact, when you discuss your demons and try to figure out why they are there, you are firing up and adding complexity to the circuits. They become even stronger and you can’t unlearn them. How do you “unlearn” to ride a bike? You can’t.

It’s almost surreal that we spend so much time and energy trying to contain and deal with our demons. Not only are they not who we are, they are the opposite of who we are.  Otherwise, we would not have suppressed the thoughts in the first place. It is like changing the oil in your car when your radiator is leaking. Eventually, you are just worn down. The other consequence of this relentless repetition of unpleasant thoughts is that your body is responding with stress chemicals, which affects every cell in your body. People become ill.

A common example is that of a body image disorder. It is my contention that every person has some level of body image issues and at some tipping point they may become disruptive. Consider that there is always some aspect of your body that you don’t like. Usually it is a minimal issue that is “not a big deal”. Why even think about it? Except you live in your body and there is no escape from that tiny thought. By tossing the thought aside, you just gave it attention and it will grow and continue to do so every time the thought arises. It is also why some of the most beautiful people on the planet may suffer more than the average person because their attention is on their appearance.

Solutions

The first step in dealing with all of this is understanding the nature of the problem. These “demons” are as real to you as the chair you are sitting on. They create tremendous anxiety, which is frequently intolerable. Anxiety is not primarily psychological. It is measure of your stress chemicals and intended to create a deep feeling of dread to compel you to take action to solve a given threat. When you can’t escape the “threat”, life can be pretty miserable. It is critical to remember that rational approaches don’t work and actually may be counter-productive.

Second, you have to view these repetitive thoughts from a mechanical viewpoint and depersonalize them.  Everyone has some level of them. They are just there and are NOT who you are. Don’t give them any further personal energy. Your brain will develop wherever you place your attention.

Third, there are many strategies to rewire your brain and create new more enjoyable circuits. The term is “neuroplasticity” and the basic sequence is awareness, separation and redirecting. The tools are simple and effective with repetition. Mental pain appears to be a greater problem for most people than physical pain, although neither one is great. Your “demons” are one of the more intense aspects of it. The DOC process presents many proven strategies to rewire your brain, and each person figures out his or her unique approach.

Consider the solution being similar to cleaning out the lint in a dryer. It needs to be done regularly. Otherwise, the dryer will lose efficiency and eventually break down. I consider the use of these tools “neurological maintenance.” It is the way the nervous system functions. Think in terms of neuroplasticity. THERE ARE NO RATIONAL SHORTCUTS.

1. Wegner
2. Mansour
3. Obsessive

JYR, BF

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