• There are many different physical and mental symptoms that are possible when you are in sustained flight or fight physiology.
• At my lowest point, I was experiencing 17 of them. No one could tell me what was happening despite seeing many physicians. I suffered for over 15 years.
• The mental pain was the worst part of my ordeal.
• One reason this process has been effective for so many people was that I learned many important details from my own harsh experience.
• My symptoms resolved and I am grateful I can pass along the healing principles.

I was driving across a bridge late one night, when my heart began to suddenly pound at a furious pace. I couldn’t breathe. I was sweaty, light-headed, and I thought I was dying from a heart attack. I was only 37 years old. This was the first of many panic attacks I would have over the next two years. In one minute, I went from being a fearless spine surgeon to experiencing relentless, progressive anxiety. I wouldn’t emerge from this slow spiral into hell for 13 years. What happened and why so suddenly?

The beginning

My first migraine happened on the 4^th of July. I was five and excited because the local fireworks were being set off in the town commons, directly across the street from our house. But as the sun set, my head began to throb and by 10 o’clock I felt like I was being hit with a sledgehammer. The fireworks less than 100 yards away weren’t helpful.

This was the first of 17 symptoms of a stressed nervous system I developed over the next 50 years. My suffering included tinnitus, burning feet, prolonged tendonitis, insomnia, anxiety, Obsessive Compulsive Disorder (OCD), major depression, migratory skin rashes, crushing chest pain, sweats, PTSD, back and neck pain, heart palpitations, light-headedness, and tension headaches. At my lowest point, I was experiencing all of them simultaneously.

The “perfect” family

My father was a family doctor in a small, New England town. He was highly respected and appreciated. My mother was active in many local activities. I was the oldest of four children, with two brothers and a sister. People would often comment on our  “beautiful family.” We were – from the outside.

Inside our house, my mother was in an intense rage most of the time. She was physically and verbally abusive to me and my three younger siblings. My father wasn’t around much, and he didn’t comprehend the full extent of the situation.Since this was all, we knew, we thought this was what life was supposed to be like.

Interestingly, one of the few things that would cut her anger short was one of my migraines. She would instantly become a loving and nurturing mother, placing cold compresses on my forehead, and keeping everyone quiet.

My new identity

When I entered high school, I felt a deep shift. I was increasingly aware that my family life was not ideal, and I decided that I had had enough. I “shut the door” on my past

Although I still lived at home, I mentally separated from the chaos. I embarked on a quest to create a new identity. I became an excellent student, trumpet player, hard worker, leader, and athlete. During my junior year in college, I took 18 to 21 hours of credit every quarter, worked construction 10-20 hours a week, played sports, had an active social life, ran for student body president, and pulled off a 4.0 GPA. I was having the time of my life. I wasn’t sleeping much.

I continued to graduate from medical school with honors and was accepted in a competitive orthopedic residency in Hawaii. With a great wife, a home in Hawaii, and a promising career, I thought I had it made. I was unaware that I was keeping busy to outrun my past and I had also become a master at suppressing unpleasant emotions.

I completed two years of internal medicine residency before I entered surgical training in Hawaii. Most orthopedic residents undergo a couple of years of general surgery residency before specializing and are comfortable in the operating room. I had never made a skin incision or even knew how to tie a knot. However, handling stress was such a core part my existence, I did not feel it. I was wrapped up in my identity of being “cool under pressure.”

I noticed that my feet burned while I was jogging, which I thought was due to the warm, Hawaiian pavement. My migraines were more frequent, and I had a reoccurrence of warts over both of my hands. One afternoon, while in a weekly orthopedic conference, I noticed some vivid, intrusive thoughts entering my mind. I didn’t think too much about it, but I felt a bit unsettled. Still, I was on top of the world, enjoying my family, learning, and living in a paradise.

Stress

The wheels started to come off when during my post-residency spine fellowship at one of the top programs in the world. It was not as physically demanding as the rest of my residency, but the expectations were extremely high. My migraines were occurring every other week, my ears started to ring, while my feet continued to burn. I pushed through it all.

My “iron man identity” continued to evolve. It seemed that I could handle an unlimited amount of stress. It was my badge of honor. The obstacles I encountered in private practice dwarfed any prior challenges in my training. I recall sitting at my desk one night after working yet another 14-hour day. A patient had developed a serious postoperative wound infection. Another one had gotten into a fight with a security guard. I discovered I wasn’t getting a paycheck that month because of the high office overhead. My mindset was, “ Bring it on.”

A few weeks later, I crashed with the panic attack.

It was only the beginning

Little did I know how severe these symptoms would become and how many more would occur. Skin rashes popped up and disappeared all over my body, my scalp itched, my nightmares became more intense, I had deep aching pains in my upper back, and intermittent crushing chest pain.

There were other terrible aspects of my ordeal. I am a social person and since I didn’t feel great, I quit spending as much time with my friends. The loneliness was crushing. No marriage could have survived all these untreated symptoms because I was often not in a great mood. I worked at hiding it from almost everyone.

As my family disintegrated, I descended into a full-blown obsessive-compulsive disorder (OCD). I had the internal version, which is experiencing vivid intrusive thoughts, that I would then try to counter with “good” thoughts. I was in an endless, unwinnable battle and my thoughts progressed to disturbing impulses. Along with my many other symptoms, I was in bad shape. I then made the mistake of reviewing some articles on OCD and discovered that the prognosis was (and still is) poor. The best outcome would be to somehow manage or diminish the symptoms with medications or behavioral therapy. I became totally despondent. There was no escape and I sunk into a major suicidal depression. Still, no one could explain to me what was going on or how to solve it

Penetrating the facade

I now understand that major life changes, especially around family dynamics, create more stress and symptoms. The stresses can be positive or negative. The problem with major family events is that they penetrate the façade, and I had been working on mine for decades. A major shift in my symptoms occurred with the birth of my son. My divorce was disastrous. The burning in my feet increased to the point where they felt like they were in a toaster oven. The ringing in my ears was intolerable, I couldn’t sleep, all my other symptoms worsened, and the unrelenting anxiety was the worst part of my ordeal.

I pursued many self-help books, took medications, saw other physicians, underwent multiple diagnostic tests, and aggressively pursued psychotherapy and counseling. I was both open to anything and desperate.

I would’ve thought that meeting my current wife would have been the answer to my suffering. We had an instant connection and I fell in love – except it felt like I was falling off a cliff. I lost more control. When I mustered up the courage to tell her that I was in love with her, she thought I was going to tell her that I had terminal cancer. My suffering dramatically worsened, and I was beginning to seriously give up. No avenue of treatment was working. I had no hope.Slowly, things changed. I escaped the grip of chronic pain in 2003 and continued to gain a deeper understanding of the problem, as well as the principles behind the solutions.

Recap

One reason that the concepts presented in Back in Control  have been helpful for so many people is that they evolved from my prolonged suffering. Almost everything I tried failed, and when I experienced the faintest glimpse of a way out, I kept building on it, step-by-step. Not only I am I doing well, but I am thriving. It is my  privilege to share these strategies with you and be a witness to your healing journey.

Chronic pain has multiple manifestations. Each person has a different experience and must find their own way out. But contrary to common perception, chronic pain is a solvable problem. I am one of the success stories.

The post My Descent Into The Abyss first appeared on Back in Control.

The post My Descent Into The Abyss appeared first on Back in Control.

One is that going back into The Abyss is inevitable and part of life. The key is to learn to use the tools more skillfully to come back out of it. The second point is that none of us really have the luxury of remaining angry without significant mental or physical consequences. Your body’s physiology is on overdrive and people get sick.

I was aware of this possibility when he first began to deal with the situation with his neighbor. I even warned him about it. Even though he intellectually knew anger was a problem, it is a powerful force that pulled him in. He not only became ill, but seriously so. None of us have the luxury of remaining angry without paying a price. Interestingly, effectively processing anger ALWAYS is the gateway to true healing and that is also part of this story.

Tom’s latest encounter with anger

I lived more than 22 years in debilitating chronic pain. I lost my business and seriously damaged many relationships. Having had 28 surgeries including 7 spinal operations, my medical history includes 3 heart attacks, opioid addiction, and a suicide attempt. I was trapped in the hell of the abyss for a third of my life. Since discovering Dr. Hanscom’s book “Back in Control” several years ago I have been free from chronic pain. Now at age 67, I have survived and am thriving.

This past winter I became very stressed and angry at my neighbor lasting a few months. He notified me  that he planned to cut down the cedar trees surrounding my front yard sanctuary, I was furious. My cobblestone courtyard, complete with a triple waterfall was ringed by towering evergreen cedars and my covered front porch. It was green, quiet, and very private. I loved it as my place for meditation and relaxation. My rocking chair was my perch as I watched the hummingbirds zip around my hanging baskets and frolic in my fountain. The sound of the waterfalls is music to my ears. My neighbor made me so upset for what he’d done to me, as I became a victim! I went indoors to the basement and literally screamed. I allowed myself to remain angry; incensed, for 3 months. It made me sick.

The symptoms begin

Soon after finding out that the demise of my sanctuary was imminent, my right eye started to constantly tear up resulting in tears streaming down my face. Being very upset, I’m sure my emotional state caused the tears to stream.  The tear duct clogged up which resulted in me needing surgery, which included the surgeon accidently burning the inside of my nose due to a surgical error. After the first surgery they “…went back in there…” a second time. The pain was indescribable, some of the worst I’ve ever experienced. I HATE the term “going back in there”. Twenty years ago, my neurosurgeon went “back in there” 3 times. It didn’t help.

The demolition date for the trees was set, and my sanctuary was decimated on the morning of my 67^th birthday. My green amphitheater was gone in a matter of hours along with my sanctuary and privacy. The neighbor’s house  towered over my courtyard with an unimpeded view of my yard and porch. I implored him to buy tall replacement plants to restore some of my privacy, but he said, “I don’t care…that’s your problem”. I talked him into allowing me to buy  the replacements. He chipped in all of $200 towards my $2,500 cost to plant his plants in his yard. My anger escalated. The sanctuary should by restored in about 10 years. Meanwhile I’m building a replacement sanctuary in the backyard.

More problems

Just as I was healing from the complications of my eye surgery, I woke one night in a lot of pain. As I sat up, I was overcome with pain in my right flank. I laid back down desperately trying to determine what was happening. I writhed in pain the rest of the night refusing to admit I was in trouble and telling my wife I was hurting. By the time I decided I needed to get to the hospital I could no longer sit up as the pain was too intense. My wife called 911.

My anxiety level skyrocketed. I was frightened by the duration and intensity of the pain.  A CT scan revealed a blockage in my right renal artery. The doctor said it was like the kidney had a heart attack (infarction). My right kidney was damaged, and its function was reduced by about 50%. They medicated and admitted me to the hospital.

Now COVID–and The Abyss

The nurse woke me at 2:30AM and said, “Sir, please wake up, you aren’t going to like what I have to tell you.” She was right, I didn’t like it when she told me my hospital roommate had Covid-19. He was an elderly man with serious respiratory distress. He had been coughing and hacking for the past 2 hours with no mask and the door closed. I bolted from the room and was quarantined for the remainder of my four-day hospital stay. No visitors allowed.

I was already on edge worried about producing another clot and having another stroke before the Covid-19 exposure. With the news that I’d been exposed, I went over the edge and quickly descended to the bottom of the abyss. I couldn’t talk or think straight. Everything around me went dark as I was in dire pain both emotionally and physically. With my comorbidities including COPD, congestive heart failure, and a prior stroke I was at high risk for succumbing to the virus. I thought I may die from the kidney blood clot and/or the virus exposure. My anxiety level was off the charts.

There was no social interaction for the next 4 days. Staff came in daily in “moon suits”. I couldn’t see anyone I knew during my 4 day stay. When discharged, I was quarantined at home until I tested negative; 10 long days after my exposure.

Clenched teeth–the descent continues

The day I was admitted to the hospital was the same day that I was set to have oral surgery. A week before the kidney problem appeared, I had broken and/or damaged my lower 4 lower front teeth. While chewing, I clamped down too hard and the front teeth landed behind the lower teeth breaking  them. I was crushing my food as my jaw was set and tense still manifesting the anger since I was not ready to let it go. It cost $10,000 for dental repairs because I was stubbornly holding onto my anger rather than processing it and letting it go. 

 It became  obvious to me that I was triggered by the neighbor and was profoundly angry and resentful of what he had done to ME (the victim). Whenever I thought about or saw my neighbor, I’d have a real bad reaction.

There were 3 major health events within 100 days of my neighbor announcing that he was going to remove the trees that guarded my sanctuary. #1) required one surgery and two intensely painful “procedures”. #2) I broke my teeth by biting down too hard. #3) I had the renal artery infarction of the right kidney.

Moving on

How did I go from lounging in the green circle in my sanctuary to being in the red circle back in the pit of darkness and despair? By failing to address and process my anger I caused myself  to be sick. I knew how to calm myself through meditation, processing anger and climb out of the pit. Finally, I flipped the switch on my anger toward the neighbor and subsequently let the whole problem go. I’m building a new refuge and I’m back to greeting my neighbor. The eye healed completely, the teeth were replaced, and the kidney suffered some damage but is now stable. The most important consequence from this incident was me having to consciously decide that I was not going to be the victim and that I need to maintain my “practice” of the DOC Journey’s main tenets. Meditate and relax your nervous system. Refuse to discuss your pain problem with others, and always process your anger expeditiously.

My new life

Having been on The DOC Journey for 7 years, I’ve NEVER felt better in my life. My chronic pain is gone; my anxiety is under control. Over the 20+ years while in the abyss my anxiety was so high the future terrified me.  The pain haunted and tormented me. Now I eagerly look forward to today with, awareness, renewed energy, and a pain free existence. My reaction to what was previously unending pain was living an angry, sedentary, reclusive, and psychologically paralyzed life. I’m now very active walking, swimming, and practicing yoga daily. I no longer perseverate about problems and issues over which I have no control. The physical activity promotes awareness, positive thoughts and the never ending “chatter” in our minds. I’m happier now than I’ve ever been in my lifetime. I’ve learned when and how to “flip the switch”.

The consequences of anger

I have learned a lot about anger from observing hundreds of patients navigate it or not and from my own journey out of chronic pain. There are no shortcuts. If you decide to remain angry, you are choosing to hold onto your pain. What makes this challenging is that anger is powerful, it protects you from feeling vulnerable. Additionally, the more legitimate your anger, the harder it is to let go. Tom certainly had a lot of legitimate reasons to remain angry.

Anger is so powerful, no one ever wants to really give it up. I have used a term, “flip the switch.” You just have to decide to move on. Life is never fair and other wrongs will continue to be done to you. If you continue to hold onto them, it becomes a heavy load. It also compromises your immune system and you’ll have a significant chance of becoming ill. Tom’s story is a classic example.

Processing anger is a learned skill set that will allow you to live the life you choose on your own terms. Tom continues to be a major inspiration for me.

Addendum

I’m trying to adjust to this feeling of well-being. I’m so relieved to not be in pain anymore that I could shout it from the rooftop. One thing we need to pay attention to is the “why”. Why me and not so many others?  But also, what traits, characteristics or beliefs do I and others share that have successfully made the transition from chronic pain to a pain free existence? That question hangs in my head daily.

Best. Tom

The post Anger and Illness–Cause and Effect first appeared on Back in Control.

The post Anger and Illness–Cause and Effect appeared first on Back in Control.

The nature of illness

All physical and mental symptoms are the result of you gathering data from your surroundings from different sensors, your brain interpreting the sum total as safe, neutral, or threatening, and then you automatically responding in a manner to ensure survival. You may or may not be aware of the reactions. They can be dictated by signals from chemicals, small proteins (cytokines) produced from your cells, signalers from the nervous system (neurotransmitters), or signalers from our glands running through our blood (hormones).

The term, “mind body” is not a useful term in that it implies that there is a separation between them. There is actually just you; one system that responds as a unit. Your nervous system, including your brain, is simply one of the many ways your cells communicate to coordinate your functions. The mind and the body are inaccurate constructs and distractions to understanding illness and disease compared to wellness and health.

Safety

With cues of safety from your environment, including your mind, your response will be signalers such as safety cytokines (anti inflammation and pr- anabolism), GABA (calm), acetylcholine (restoration), serotonin (contentment), dopamine (rewards), oxytocin (connection and bonding), growth hormone and growth factors (regeneration). The immune response will be strong yet inflammation low when stimulated by safety cytokines. Clinically the result is feeling less inflamed, less painful, relaxed, composed, present with a slower heart rate, blood pressure and breathing. The more time that can be spent in this regenerative state the better for health and wellness.

Your body’s goal is to survive. Defeating or dissipating threats and discord and maintaining safety and harmony to keep your range of behaviors and chemistry in a stable restorative and regenerative zone is key to thriving. The nociceptive (pain) and the emotion systems, both with and without awareness, guide you to take actions to avoid harm. When you experience an uncomfortable or unpleasant feelings from any source, it is simply signaling danger and then you can take appropriate steps to find safety.

Threat

Environmental cues of threat or internally generated ones are met with a defensive response including stimulation of your immune system with elevations of inflammation, elevated metabolism to provide fuel for defense, and increases in multiple stress signalers including the threat cytokines (IL1, IL6, IL17, TNF), inflammatory chemicals, (histamine, prostaglandins), mobilizing neurotransmitters (glutamate, dopamine, noradrenaline), and stress hormones (adrenaline, cortisol, aldosterone, vasopressin and endorphins).

Clinically, you are on “high alert” and there are numerous bodily responses to threat. The basic ones include an increased heart rate, rapid breathing, increased speed of nerve conduction (increases pain), elevated blood pressure, sweating, muscle tension, and a sense of danger that we call anxiety. There also numerous symptoms created by this physiological state. They include tension and migraine headaches, neck and low back pain, skin rashes, stomach cramps, depression, bipolar, burning sensations in various parts of your body, and there over 30 different responses. Although the chemical environment encompasses your whole body, each organ and organ system will manifest its unique response.

Symptoms, illness, and disease

 When the threat is transient or resolvable, there will be different physiology that will quickly abate the symptoms. When the threat is more prolonged, people will develop illnesses and diseases that, also, are reversible with appropriate treatment including the removal of threats and restoration of safety. When threat is sustained people can develop serious illness and diseases that may cause permanent tissue damage and create physical, mental and social havoc.

 What causes disease? There are two aspects consider.

• Your nervous system/ body
  • Your inherent coping skills
  • Your current state of reactivity influenced by diet, exercise, sleep, meds, etc.
• Your environment or perception of it
  • The magnitude and duration of threat – the inability to find safety

So, it is the interaction of the surrounding stressors with the human organism that determines the manifestation of physical and mental symptoms; illness and disease versus wellness and health.

The current state of “mainstream” medicine

Modern medicine has nullified these aspects of care in that we are not given the time nor are we encouraged to talk to our patients. From the beginning, we are not providing cues of safety. Then, we don’t know our patients and their coping capacity and really don’t know much about their environment. We are given only the time to treat symptoms. We are ignoring the root cause of the problem–total threat load. It is similar to putting out a major fire with a garden hose. It can’t and doesn’t work. Indeed, there is an ongoing and growing epidemic of chronic disease – both mental and physical, social and spiritual.

Solving our medical care crisis

Our medical care crisis could be solved with one simple move – significantly increase the reimbursement for talking to patients. This would allow a sense of safety, allow providers to assess both the patient and his or her surroundings, and direct them to resources to reduce the threats in their lives, improve safety,  coping and connection skills and provide tools to more effectively process their stresses.

The other half of the equation is to quit paying as much for procedures and also not reimburse for interventions that have been proven to be ineffective or damaging.

Addressing  root causes

A basic concept in extinguishing a fire is to deprive it of its fuel. Forest fires are the classic example. Fire breaks eliminate fuel and are only ineffective if the fire is so powerful as to jump over them. Fire retardants cover wood in a manner that it cannot be consumed. If water is used, it may be delivered in a mist, which helps lower the oxygen available. Water also removes heat. A carbon dioxide fire extinguisher displaces oxygen and suffocates it. The bottom line is that to fight a fire you have to address one of the root causes of it – oxygen, heat, or fuel.

Treating only symptoms is not only ineffective, the “fire” will continue to burn causing ongoing tissue damage. Successfully minimizing the impact of chronic illness requires minimizing the multitude of threats and maximizing access and opportunities for safety. coping and connection while also improving skills to better process toxic environmental inputs.

Summary

Every mental and physical symptom is created by the interaction between your surroundings and your body. Your body contains trillions of sensors that collect data that is sent to and processed by your central nervous system. Unpleasant sensations compel you to take action signaled by your brain and local tissues to resolve threat. Pleasant input causes you to take actions that are restful and regenerative.

The two factors creating symptoms and disease are you (and you coping capacity) and your surroundings (stressors). When you stresses overwhelm your coping capacity, you’ll experience symptoms, maybe become ill, or develop a serious disease. The solution lies in 1) increasing your coping capacity and 2) teaching you skills to more effectively process stress so it has less of an impact on your body, health, and sense of well-being. As you learn to regulate your body’s neurochemistry, you’ll have control, a sense of safety, and thrive. The DOC (Direct your Own Care) Journey presents a well-traveled sequence of lessons that will allow you to master these skills.

References

1. O’Neill Hayes, Tara and Serena Gillian. Chronic disease in the United States: A worsening health and economic crisis. Americanactionforum.org; September 10th, 2020.

Plan A–Thrive and Survive COVID-19, 2nd edition; Loving Life Lengthens It

The post Essence of Illness first appeared on Back in Control.

The post Essence of Illness appeared first on Back in Control.