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

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

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

Not fixing yourself

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

Good Studio/AdobeStock

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

“Phantom Brain Pain”

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

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

“I give up”

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

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

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

Hope

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

ipopba.AdobeStock

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

References

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

The post How healing happens first appeared on Back in Control.

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The gift of life

Every living creature, from one-celled organisms to mammals, have a reaction to threats that improves it odds of survival. It is intended to be so unpleasant that action has to be taken to resolve it. Once the danger is passed, the chemistry of the organism returns to a neutral or safe state. Humans have the additional characteristic of language and consciousness. Unpleasant thoughts and emotions cause the same reaction except that we can’t escape them. Repressed thoughts and emotions are even more problematic. Every person has to deal with this issue at some level. Although every animal has this response to danger, humans have labeled it “anxiety”. It describes your total bodily response to threat; it is not the cause. It signals danger and it is the pain – and also a gift.

It is critical that you separate your identity from this powerful reaction. It is amoral and unpleasant and not who you are.  The first step is to get rid of the word, “anxiety” from your vocabulary and substitute, “elevated stress chemicals” or “survival response.” So, regardless of how you accomplish it, lowering your stress hormones and levels of inflammatory proteins/cells decreases this unpleasant sensation. It does not respond rational means.

When your stresses overwhelm the coping capacity of your nervous system, you will experience mental or physical symptoms. There are ways of increasing the resiliency of your nervous system and also methods to process stress so it has less of an impact. But this response is part of life and inevitable. When it occurs, you will want to minimize the time spent in this state. This set of tools directly lower your elevated stress reaction.

Taking control of your body’s neurochemical state

Much of the effect is modulated through the vagus nerve, which is at the core of the autonomic nervous system. It is calming and strongly anti-inflammatory. Many of these suggestions directly stimulate this nerve.

Changing sensory input

• • Active meditation/mindfulness – you are placing your attention on something more pleasant.
  • Deep tissue or light touch massage
  • A cold compress to the face (Mäkinen), especially after exercising or if acutely stressed.
  • Connecting with nature – historically a basic aspect of the human experience.
    • Walking barefoot in the sand.
    • “Hearing” the silence
    • Taking in all of the senses
      • Birdwatching
      • Learn about the flowers and trees
      • Notice different smells and fragrances
    • Awareness
      • Become aware of your feelings of anxiety and anger and train yourself to separate from and observe them.
      • Awareness is a powerful tool. A pain psychologist and close friend of mine pointed out that, “You have to feel to heal.”

Breath work directly stimulates the vagus nerve, which is strongly anti-inflammatory (Mason).

A lot of research has been done on the effectiveness of meditation. It is challenging to measure as there are so many schools of thinking that espouse different methods. However, one common factor that has  been documented in an extensive medical literature review  (Zaccaro), is slow breathing.

• A respiratory rate of < 6 breaths per minute (bpm) and < 10 bpm was consistently correlated with stimulation of the parasympathetic nervous system, which also decreases inflammatory cytokines (communication proteins). Whether you paid attention to your breath or not, was not a factor.
• Breathing through your nose during either inspiration or expiration could be of some benefit.
• One deep breath, followed by a slow exhalation
• Meditation with deep breathing. Try using a counting method (such as 4 counts breathing in and 4 counts out; or 4 counts in, hold for 7, and release for 8)
• Alternating nostril breathing (block one nostril while breathing in and the other nostril while breathing out)
• Focus solely on your breath (Mason).

Calming activities

• • Acupuncture
  • Exercise – hard workouts
  • Biofeedback
  • Medical hypnosis
  • Yoga, Tai Chi, Chi Gong

Visualization

• • Remembering in detail the most enjoyable of your life.
    • Connect with and feel it.
  • Visualize what others are seeing when you are upset.
    • Would you be attracted to you?
    • Would you want to be around you?
    • Is this really how you want to treat those who care about you?

Decrease stimulation of your nervous system

A sensitized nervous system more quickly creates anxiety. So, it is important to be mindful of activities that fire up your brain. It is not a matter of right or wrong. The point is to observe the effects on your nervous system. Consider what you feel happening to your body when you:

• Play intense video games or watch violent movies
• Argue with family members
• Watch news that upsets you

Some additional suggestions to remain calm include:

• No discussing your pain or medical care with anyone except your health care providers.
• Limiting the time that you spend watching news and other over-simulating programs.
• Choose less intense video games.
• No complaining about anything, including the pandemic.
• No criticizing anyone. You are simply projecting your view of yourself onto them.
• No offering advice that is not requested. How do you feel when you are on the receiving end?
• No gossip

These techniques are effective and necessary short-term strategies, they can be incorporated into the larger picture to solve your pain. The bottom line is to use common sense to actively calm yourself and avoid activities that stress your nervous system. It is surprising how much difference it can make.

References:

Berk LS, et al. The neuroendocrine and stress hormone changes during mirthful laughter. Am J Med Sci (1989); 6:390–396.

Kok BE, et al. How positive emotions build physical health: perceived positive social connections account for the upward spiral between positive emotions and vagal tone [published correction appears in Psychol Sci (2016); 27: 931]. Psychol Sci (2013); 24: 1123‐1132. doi:10.1177/0956797612470827.

Mäkinen TM, et al. Autonomic nervous function during whole-body cold exposure before and after cold acclimation. Aviat Space Environ Med.

Mason H, et al. Cardiovascular and respiratory effect of yogic slow breathing in the yoga beginner: what is the best approach? Evid Based Complement Alternat Med (2013); 2013:743504. doi:10.1155/2013/743504.

Miller M, et al. Positive emotions and the endothelium: Does joyful music improve vascular health? Circulation (2008); 118: S1148

Vickhoff, B, et al. Music structure determines heart rate variability of singers. Frontiers in psychology (2013); 4: 334. 10.3389/fpsyg.2013.00334.

Zaccaro A, et al. How breath control can change your life: A systematic review on psycho-physiological correlates of slow breathing. Frontiers of Neuroscience (2018); 12: 1-16.

The post Directly Calming the Threat Response first appeared on Back in Control.

The post Directly Calming the Threat Response appeared first on Back in Control.

• 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.

The post Success is a “Story” first appeared on Back in Control.

The post Success is a “Story” appeared first on Back in Control.

It is only about me

The problem is that our primitive brains are wired to ensure our survival, at all costs. At the same time, the reason we as a species survived at all is that we learned to cooperate with each other. Unfortunately, our highly evolved consciousness, which allowed us to dominate earth’s food chain, is no match for our unconscious survival instincts. So our conscious efforts to control our instinctive patterns of behavior usually are doomed to failure. The neurophysiological basis of chronic pain

Your “story”

Since our survival behaviors are often not exactly virtuous, we do many things to “dis-identify” from them. The common strategy is to concoct a story of who we are, called self-image, largely based on external feedback. Another expression for this activity is building self-esteem. We aspire to high self-esteem by avoiding negative thoughts about ourselves and reinforcing positive ones. Trying not to be judgemental

Now, part of this practice yields positive results. Our brains will develop in areas where we place attention; and consistently choosing a positive outlook is healthy. The problem arises from suppressing the unconscious tendency to be on the alert for danger, which has serious consequences. Your personal brain scanner You are now focusing energy doing battle with powerful unconscious neurological circuits. You cannot win. You are inadvertently reinforcing them and wearing yourself down. There is also evidence that such suppression damages the memory centers of the brain; and in addition, may facilitate a disposition to drug addiction. Ever wonder why it is so hard to hold on to our positive thoughts and feelings? It is because our brains are always busy looking for the negative, for the worst case scenario—for our survival. The myth of self-esteem

Body image disorders

It’s incredible to me how many supermodels have body image disorders. It might have to do with the fact that so much of their “identity” is based on physical appearance. Of all the features we like and appreciate about our bodies, what do our minds tend to fixate on? On that one feature or idiosyncrasy we dislike. Since we cannot easily change it, we are trapped. It is my guess that great majority of us has some degree of body image disorder.

The same holds true of any trait we value for our identity: Intelligence, athletic skill, artistic or musical talent, toughness, net worth—the list is endless. The more important the attribute, the greater the potential for progressive anxiety.

I had lunch with a young body builder, one of the strongest people I have ever known. Hard as I tried, I could not avoid staring at his biceps, which were so large that they sagged almost parallel to the ground when he leaned his elbows on the table. He proceeded to share with me he how bad he felt about his body because he felt so “small”. It drove him to work out almost two hours a day. It hit me how strongly our images of ourselves could affect us. Many of them do not reflect reality and detract from our capacity to enjoy our lives.

One of my patients was an absolutely stunning woman with an eating disorder. When I asked her, “How would you feel if I obtained 10,000 signatures attesting to how attractive you are,” guess what she said: “They don’t really know me.”

Connecting

So what is the answer? Let it go. You are never going to win the battle with your unconscious brain. It is impossible. But you can learn to calm down your nervous system and to create new pathways that circumvent negative circuits. The general term is somatic work, and there are many avenues to get there. The focus is on clearing out the noise in your head to connect with yourself and your own capacity to heal.

Who are you allowing to define you?

“The World’s Ugliest Woman”

This video showcases a woman with a congenital disfiguring disability, who describes her struggle and resolution with self-image. She is truly inspirational. I am not sure I could have created a full and meaningful life if I had to deal with her condition. What is disturbing about her story is that someone posted her picture on the Internet with the label “The World’s Ugliest Woman.” Even more upsetting is that, of the thousands of comments, she did not find one that was supportive. What is uplifting is that, despite all the attacks from mean people, she still managed to transcend their shallow values. School or prison – What’s the difference? -Bullying

The Way to Love

I read the late Anthony DeMello’s book, The Way to Love weekly, to keep his ideas fresh in my consciousness. He presents the most compelling picture of the “attachment” trap, and provides a brilliant solution. As you become aware of your attachment to defining ourselves by external things, you have the power to dissolve it – if you want. The result is a life of freedom that is almost unimaginable.

Let go. Learn to be accepting of uncomfortable feelings. It is a learned skill using effective tools. Increase your awareness and let your ego diminish, along with your pain.

The post Your “Identity” Can Destroy You first appeared on Back in Control.

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