Each new year, many of us spend time figuring out how we’ll make it better and also to really complete some projects that we have been putting off, maybe for decades. Few of us are able to accomplish a fraction of what we envision. Why? It’s because our unconscious behavioral patterns are so powerful and are going to win over our rational mind.

ACE study

This process has been documented in the now famous and replicated “ACE” study performed on about 17,000 Kaiser patients in the mid-1990’s. (1) ACE stands for, “adverse childhood experiences.” Eight then ten questions were answered by the cohort and then the population’s health was looked at compared to the severity of the ACE score. The following questions were asked:

Abuse

• Emotional – recurrent threats, humiliation (11%)
• Physical – beating, not spanking (28%)
• Contact sexual abuse (28% women, 16% men, 22% overall)

Household dysfunction

• Mother treated violently (13%)
• Household member was alcoholic or drug user (27%)
• Household member was imprisoned (6%)
• Household member was chronically depressed, suicidal, mentally ill, or in a psychiatric hospital (17%)
• Not raised by both biological parents (23%)

Neglect

• Physical (10%)
• Emotional (15%)

This study was done on a sample of middle-class Kaiser patients and chronic pain was not taken into account. What is shocking is that only a third of the group had and ACE score of 0 and over a third had a score of 3 or more. It would be anticipated that these numbers would be worse in a lower income group, as there would be more stress and also in a group suffering from chronic pain. The higher the ACE score, the greater the negative impact on a person’s health. Aced out

“Damaged”

My ACE score is 4. At one point a friend of mine gave me a book, Damaged, which related the story of a young man who was so abused that he was never able to pull out of his tailspin. It was his way of saying to me, “You’re going to have to live with all of this internal chaos. You’re not going to be able to surmount your childhood abuse.” I know it was a well-intentioned move, but I was devastated, to say the least. I am sure the feeling it wasn’t too far off from what many of you have experienced when your physician tells you that everything has been done and you’re going to live with the pain. Many of you have also discovered through your self-healing journey that this simply isn’t true.

The health consequences are clear and severe as the ACE score climbs. They include:

• Early mortality
• Obesity
• Substance abuse
• Anxiety/ depression
• Teen promiscuity
• Attempted suicide
• Early smoking/ heart and lung disease
• High risk health behaviors
• Abusive behavior within their own families

What really caught my attention about this study is that it arose out of an intense weight loss program that was quite successful in helping the participants lose a large amount of weight. Yet the most successful ones were the most likely to drop out. It turns out that obesity does serve a function and the higher the ACE score, the more likely they were to return to their prior eating patterns.

Mental or physical health – which is more critical?

Good intentions

“The Road to Hell is Paved with Good Intentions”. This phrase is defined as, “Merely intending to do good, without actually doing it, is of no value.” (2)

I have years of my own resolutions that I have made and not followed through on. That has changed and I now follow through more often. However, it isn’t because of more will power or determination. It’s because I “gave up” and settled into what is real for me. My reality is that my core patterns revolve around being a victim. I was a victim and it was reinforced every day, until I became aware of being a victim was. I couldn’t solve what I wasn’t aware of. Although I made a lot of progress in 2002 after I began to use the expressive writing exercise, it wasn’t until I even learned the word, “victim”, did I begin to truly heal. I certainly had no clue that the word applied to me. In my mind, I had been “enlightened” for years, as I had done a lot of personal work.

By settling into what was and is for me, I’ve been able to move forward. I did the Hoffman process in 2009, which gave me even more clarity. It was there I learned that the victim role is permanent and will continue to manifest itself in more and more subtle ways, especially when I work even harder to disguise it and remain “enlightened”.

I had another insight as to why I was able to re-create my life. I recently read a book, How Emotions are Made, by Lisa Feldman Barrett. She runs a neuroscience research lab and presents data explaining the formation of human consciousness. Every millisecond we are interpreting sensory input to make sense out of environment, including thought and concepts. They become imbedded in our brains and are our version of reality. The are as real to us as the chair you are sitting in. You are programmed by your past. I was initially discouraged about this idea until she pointed out that from this second forward you have a choice about how you want to program your nervous system. Repetition is key and I found it encouraging that I have that much choice about my life and what reality I want to create.

Awareness

A while ago another level of awareness arose in me. It was that essentially my whole being was created around truly being victim. I had been trying to fix and solve it for decades. However, if victim part of me “disappeared”, I would cease to exist as me. When I finally learned that the answer was to assimilate it, I’ve been able to create a reality that is rich, functional, productive, rewarding and a lot of fun. Solving the unsolvable

I would suggest that one resolution that’s more possible to keep is simply committing to becoming more aware. It isn’t possible to solve anything unless you understand the nature of the issues. I spent over three decades doing battle with adversaries that I didn’t know or see. I just kept fighting and fighting. Settling in and “being” takes much less effort. Paradoxically, you will have more energy to actually accomplish your dreams.

1. Felitti VJ, Anda Rf, Nordenberg D, et al. The relationship of adult health status to childhood abuse and household dysfunction. American Journal of Preventive Medicine (1998); 14:245-258.
2. The New Dictionary of Cultural Literacy, Third Edition, Houghton Mifflin Company, 2005.

The post Why are New Year’s Resolutions So Hard to Keep? first appeared on Back in Control.

The post Why are New Year’s Resolutions So Hard to Keep? appeared first on Back in Control.

Sophia relaxed

Like most cats, she is clean and easily learned to use her litter box. About a year after we adopted her, she began to mess on the carpets and sometimes on our bed. We somewhat panicked and called the vet. She didn’t have a lot of suggestions but did point out that cats have strong behavioral patterns and can’t be trained like a dog. The episodes would occur when we were packing for a trip. Then she would pee in the suitcase. We were assuming that she was “angry” and acting out. After we were back home for a few days, things would settle back into a routine.

Last Thanksgiving, we took our usual precautions of locking her out of the bedroom and keeping the suitcases somewhat out of sight. I woke up early and saw that she had thrown up twice and created two unpleasant messes both up and downstairs. I also noticed she was meowing frequently and following my wife everywhere she went. It finally hit me that she wasn’t a malevolent cat with an agenda. She was anxious and it was manifesting in creating physical gastrointestinal (GI) symptoms. She had irritable bowel syndrome (IBS).

  Feeling abandoned

IBS

The essence of IBS is the occurrence of multiple disruptive GI symptoms. They are unpredictable in their type and timing. Symptoms include:

• Constipation
• Diarrhea
• Abdominal pain
• Excessive gas
• Bloating/ cramping
• Nausea/ vomiting

The symptoms are more frequent in females and are associated with multiple other physical symptoms. It is one of the most common reasons that people seek medical care. I am going to simplify the cause and effect. Anxiety is the sensation that is experienced when your body is full of stress chemicals such as cortisol, histamines, endorphins and adrenaline. Any mental or physical threat results in different levels of these hormones depending on its severity. Unpleasant mental input (thoughts and concepts) are more problematic because humans can’t escape their thoughts. This results in chronic exposure to an adverse chemical environment and people become ill. The list is almost endless but here are some of the ones listed as being associated with IBS:

• Fibromyalgia
• Chronic fatigue syndrome
• Chronic pelvic pain
• Dyspepsia
• Gastroesophageal reflux
• Major depression
• Panic disorder
• PTSD
• Higher chance of inflammatory bowel diseases such as Crohn’s Disease and Ulcerative colitis.

Physical symptoms

There is a paper out of Sweden (1) that documents a strong association between chronic stress and all autoimmune disorders, including the inflammatory bowel disorders. All these symptoms are included in the list of problems that are associated with chronic pain. The constellation of these symptoms is what I have termed, “Neurophysiologic Disorder” (NPD). Other names include:

• Stress Illness Syndrome
• Mind Body Syndrome (MBS)
• Tension Myoneural Syndrome (TMS)
• Central Sensitization Syndrome (CSS)

The bottom line is that a sustained adverse chemical environment causes physical symptoms. In addition to the above symptoms there is a higher incidence of heart disease, obesity, diabetes and early death. (2) This unconscious survival response is about a million times stronger than the conscious brain and can’t primarily be addressed by psychological means, although it has a role. The key to solving these symptoms is to use techniques to change the body’s chemistry to a more favorable environment. When you are truly relaxed, laughing and at play, your body is full of oxytocin (love drug), serotonin (antidepressant), dopamine (reward drug) and GABA chemicals (similar to Valium). This is a great chemical bath and you will feel relaxed along with a high chance that your physical symptoms will abate.

I thought I was so smart because I figured out that Sophia had IBS. Then I looked it up on the Internet and IBS is an established diagnosis for cats. The symptoms are similar. One of the listed causes is, “separation anxiety.” This is probably what is happening with our cat. At least she isn’t an angry cat that is acting out.

Childhood trauma

There is a high association between childhood trauma and many adult illnesses. This also includes a shortened life span. IBS is one of the problems that is connected with Adverse Childhood experiences (ACE). Reactions to the environment are programmed in by your parents and are the basis for future learning. Early dysfunctional parental patterning will worsen with time. It isn’t possible to see your own dysfunctional reactions because it is your own personal norm. As I was developing many physical and mental symptoms, I thought I was fine. I fancied myself as being somewhat “enlightened” since I had engaged in so much self-exploration. Little did I know I was reinforcing the patterns that were the source of my problems. I had no clue that I was angry. I just had “high standards” of myself and expected others to have the same. So I was constantly judgmental of me and others. I was just “frustrated”.

Sophia was a rescue cat and abandoned by the side of the road before she was weaned. My wife was at a farmer’s market and called me about bringing her home. As she was holding her, Sophia instantly attached herself to her neck and began nursing. Of course, some serious bonding was happening at that moment. We always thought she would stop doing it, but nine years later she hops on the bed every morning and nurses more fervently than ever. If my wife doesn’t let her do her thing, there’s a noticeable difference in her behavior throughout the day.  Early patterns are permanent.

The day she came home

Solution

The DOC process represents a set of concepts that allows you to become aware of when you are triggered and teaches you strategies to alter your body’s chemistry to a more favorable state. Not only will IBS symptoms resolve but so will the multiple other ones. I was experiencing 17 of them simultaneously while I was in the depths of my own Abyss. It is still surprising to see most of these gone. I had migraines, tinnitus, and burning feet for over 25 years. Who would have thought they’d disappear?

1. Song H, et al. Association of stress-related disorders with subsequent autoimmune disease. JAMA (2018); 319: 2388-2400.
2. Faletti VJ and RF Anda. The relationship of adverse childhood experiences to adult medical disease, psychiatric disorder and sexual behavior: implications for healthcare. The Impact of Early Life Trauma on Health and Disease: The Hidden Epidemic – Chapter 8. Editors Ruth A Lanius, Eric Vermetten and Clare Pain. Cambridge University Press, 2018.

The post My Cat has Irritable Bowel Syndrome? first appeared on Back in Control.

The post My Cat has Irritable Bowel Syndrome? appeared first on Back in Control.

Each new year, many of us spend time figuring out how we’ll make it better and also to really complete some projects that we have been putting off, maybe for decades. Few of us are able to accomplish a fraction of what we envision. Why? It’s because our unconscious behavioral patterns are so powerful and are going to win over our rational mind.

ACE study

This process has been documented in the now famous and replicated “ACE” study performed on about 17,000 Kaiser patients in the mid-1990’s. (1) ACE stands for, “adverse childhood experiences.” Eight then ten questions were answered by the cohort and then the population’s health was looked at compared to the severity of the ACE score. The following questions were asked:

Abuse

• Emotional – recurrent threats, humiliation (11%)
• Physical – beating, not spanking (28%)
• Contact sexual abuse (28% women, 16% men, 22% overall)

Household dysfunction

• Mother treated violently (13%)
• Household member was alcoholic or drug user (27%)
• Household member was imprisoned (6%)
• Household member was chronically depressed, suicidal, mentally ill, or in a psychiatric hospital (17%)
• Not raised by both biological parents (23%)

Neglect

• Physical (10%)
• Emotional (15%)

This study was done on a sample of middle-class Kaiser patients and chronic pain was not taken into account. What is shocking is that only a third of the group had and ACE score of 0 and over a third had a score of 3 or more. It would be anticipated that these numbers would be worse in a lower income group, as there would be more stress and also in a group suffering from chronic pain. The higher the ACE score, the greater the negative impact on a person’s health. Aced out

“Damaged”

My ACE score is 4. At one point a friend of mine gave me a book, Damaged, which related the story of a young man who was so abused that he was never able to pull out of his tailspin. It was his way of saying to me, “You’re going to have to live with all of this internal chaos. You’re not going to be able to surmount your childhood abuse.” I know it was a well-intentioned move, but I was devastated, to say the least. I am sure the feeling it wasn’t too far off from what many of you have experienced when your physician tells you that everything has been done and you’re going to live with the pain. Many of you have also discovered through your self-healing journey that this simply isn’t true.

The health consequences are clear and severe as the ACE score climbs. They include:

• Early mortality
• Obesity
• Substance abuse
• Anxiety/ depression
• Teen promiscuity
• Attempted suicide
• Early smoking/ heart and lung disease
• High risk health behaviors
• Abusive behavior within their own families

What really caught my attention about this study is that it arose out of an intense weight loss program that was quite successful in helping the participants lose a large amount of weight. Yet the most successful ones were the most likely to drop out. It turns out that obesity does serve a function and the higher the ACE score, the more likely they were to return to their prior eating patterns.

Mental or physical health – which is more critical?

Good intentions

“The Road to Hell is Paved with Good Intentions”. This phrase is defined as, “Merely intending to do good, without actually doing it, is of no value.” (2)

I have years of my own resolutions that I have made and not followed through on. That has changed and I now follow through more often. However, it isn’t because of more will power or determination. It’s because I “gave up” and settled into what is real for me. My reality is that my core patterns revolve around being a victim. I was a victim and it was reinforced every day, until I became aware of being a victim was. I couldn’t solve what I wasn’t aware of. Although I made a lot of progress in 2002 after I began to use the expressive writing exercise, it wasn’t until I even learned the word, “victim”, did I begin to truly heal. I certainly had no clue that the word applied to me. In my mind, I had been “enlightened” for years, as I had done a lot of personal work.

By settling into what was and is for me, I’ve been able to move forward. I did the Hoffman process in 2009, which gave me even more clarity. It was there I learned that the victim role is permanent and will continue to manifest itself in more and more subtle ways, especially when I work even harder to disguise it and remain “enlightened”.

I had another insight as to why I was able to re-create my life. I recently read a book, How Emotions are Made, by Lisa Feldman Barrett. She runs a neuroscience research lab and presents data explaining the formation of human consciousness. Every millisecond we are interpreting sensory input to make sense out of environment, including thought and concepts. They become imbedded in our brains and are our version of reality. The are as real to us as the chair you are sitting in. You are programmed by your past. I was initially discouraged about this idea until she pointed out that from this second forward you have a choice about how you want to program your nervous system. Repetition is key and I found it encouraging that I have that much choice about my life and what reality I want to create.

Awareness

A while ago another level of awareness arose in me. It was that essentially my whole being was created around truly being victim. I had been trying to fix and solve it for decades. However, if victim part of me “disappeared”, I would cease to exist as me. When I finally learned that the answer was to assimilate it, I’ve been able to create a reality that is rich, functional, productive, rewarding and a lot of fun. Solving the unsolvable

I would suggest that one resolution that’s more possible to keep is simply committing to becoming more aware. It isn’t possible to solve anything unless you understand the nature of the issues. I spent over three decades doing battle with adversaries that I didn’t know or see. I just kept fighting and fighting. Settling in and “being” takes much less effort. Paradoxically, you will have more energy to actually accomplish your dreams.

1. Felitti VJ, Anda Rf, Nordenberg D, et al. The relationship of adult health status to childhood abuse and household dysfunction. American Journal of Preventive Medicine (1998); 14:245-258.
2. The New Dictionary of Cultural Literacy, Third Edition, Houghton Mifflin Company, 2005.

The post Why are New Year’s Resolutions So Hard to Keep? first appeared on Back in Control.

The post Why are New Year’s Resolutions So Hard to Keep? appeared first on Back in Control.

ACE’s

It is clear from data produced from the ACE (Adverse Childhood Experiences) study that we, as a culture are not parenting very well. The list of ACE’s is the following:

Household dysfunction

• Substance abuse
• Parental separation/ divorce
• Criminal behavior
• Mental illness
• Battered mother

Abuse

• Psychological
• Sexual
• Physical

Neglect

• Emotional
• Physical

The higher the ACE score, the greater the chances of the children experiencing depression addiction, extreme obesity, anxiety, suicide, partner violence, etc. The list is long. (1)

What is striking is that only 30% of children had an ACE score of zero. Over 35% had an ACE score of 3 or higher. It is ironic and unfortunate that the people you care for the most are also the ignition for strong unpleasant reactions. Why is this the case?

Our programming

We are programmed from birth by our environment. It matters little what you “teach” your child. It is how you behave. So each of us have patterns of behavior that are imbedded in our nervous systems that are a result of witnessing the actions of our parents. Whether you adopt or reject the patterns, the patterns are still running your life. The behaviors play out the most strongly in our new families regardless of the makeup. They originate in the unconscious part of your brain and are not solvable – especially when you are not aware of their magnitude or existence. Hoffman process

So as you begin to engage in the DOC principles with some success, it is difficult to move forward when you are continually being triggered at home. We do know that pain and anger are linked pathways. Additionally, these reactions are so powerful, none of us want to give them up, even though we know better. The family unit may be the most critical aspect of keeping you stuck in the Abyss of pain. The crab bucket  It may also be the most influential in pulling you out of it. A promising sequence involving the whole family is beginning to emerge. Here is how I finish a typical office visit after I have done my evaluation and explained the relevant issues.

Beginning the family healing

I hand them a copy of my book and show them this website, www.backincontrol.com. I ask all members of the household to go “all in”, whether or not they have pain. Everyone has anxiety, which is the pain. After I have suggested that they begin the expressive writing combined with active meditation, I jump to the final step of Stage 1 – Do not share your pain.

Here are the guidelines:

• When you walk out the door of this office you are never to discuss your pain with anyone – especially your family. BTW, no complaining about anything – period.
• On the way home you are to spend the time reminiscing about era of your relationship when you had the most fun. Remember your dreams, friends, adventures, conversations and shared suffering in detail.
• When you walk through the door of your house that same energy will be brought into the home and nurtured – without exception and indefinitely. If you must argue – take it outside. My nurse pointed out to me that you cannot have a bar fight in a bar. Why do you want your home to be a no-holds-barred fighting arena?
• They must make a commitment to honor this part on not engaging with each other when they are upset and I ask them both to verbally affirm it.
• I show them the link to “Protect Your Family from Your Pain.” Each of them has permission to withdraw from any unpleasant interaction – without reprisal. Each party also has permission to ask the other to person stop discussing his or her pain.

It has been eye-opening for me to see how much time people spend talking about their pain or what is wrong with their lives. It is not that interesting. It is incredibly frustrating for family and friends to constantly hear about it. There is nothing they can do to help. It is also interesting how responsible family members feel to help the other person solve the pain and also how the person in pain can hold the family’s feet to the fire to help. It is a deadly cycle. Your pain is yours and yours alone. It’s your responsibility to own and solve it.

I’ve had patients blurt out, “Well what can I talk about?” Almost anything is more interesting than pain. The alternatives are infinite. You have to first unhook from your pain before you can re-experience these wonders.

Not sharing the pain

I have been heading towards this conversation for a while and have taken it up several notches over this last year. It has been encouraging and change can occur quickly. I had a woman who had been in pain for over 30 years, in addition to some other significant neurological problems. She had a strong right to complain and be upset. The problem was that her husband was simply worn out. The tension in the room was high and uncomfortable. When I introduced the rule of not talking about pain, he immediately had a smile emerge and both of them relaxed a bit. I said, “I want you both to fully engage but separately. Imagine a 10-foot steel-reinforced concrete wall between the two of you regarding the topic of pain.” I then went on to explain the above-mentioned rules.

I was shocked when they returned a month later. They were animated and laughing. Her pain was down by about 60% and both of their moods were dramatically improved. They had re-discovered how to have a good time. Remember that although pain pathways are permanent, so are play pathways. You just have to re-connect with them. It is a powerful way to move forward. Interestingly, some of her neurological symptoms had improved. They could hardly contain their excitement about the possibilities. The only negative of the day was that I was so interested in what had transpired that I got hopelessly behind in clinic.

Safe

It has also struck me that one of the core concepts of healing is feeling safe, which is hard to do in this world amongst fellow workers, classmates, bosses, and most importantly from yourself. We endure an endless barrage of negative self-talk. However, you do have a choice about what you want to create at home. I think that by constructing a “safe house” that you are more able to do the same in other areas of life.

I have decided that the focus of my next book will be on both protecting the family from chronic pain and using that same energy to connect to the body’s capacity to heal. I am looking forward to seeing where this might go.

Happy Mother’s Day!!

Listen to the Back in Control Radio podcast Parenting – Creating Your Own Triggers

1. Anda RF, Felitti VJ, Bremner JD, Walker JD, Whitfield C, Perry BD, et al. The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiatry Clin Neurosci 2006;256:174–86.

The post Begin Your Healing Journey at Home first appeared on Back in Control.

The post Begin Your Healing Journey at Home appeared first on Back in Control.

The headquarters of the Hoffman Process is located in Rafael, CA. They offer the process in the US in two locations–one in California and the other in Massachusetts. There are thirteen centers around the world, and over 80,000 people have gone through the process.

Bob Hoffman conceived the Hoffman process in 1960. His premise was that a child instinctively mimics the patterns or behavior of his or her parents so as to receive love, care, and attention. He calls this behavior “negative love syndrome.” It is a basic survival skill. He developed tools to learn to recognize these patterns, detach from them, and create more functional pathways. Even in the most functional families, there are many dysfunctional patterns of behavior. Many of us were raised in less than optimally functioning families. ACED out

My wife led the way

My wife did the process in November of 2008. It had a significant positive impact on her life, outlook, and mood. I was impressed, but I was “doing fine” and did not feel a need to engage in the process. Still, I felt that was important that we stay on the same page in regards to our personal growth and our growth as a couple, so I went through the process in February of 2009.

I was looking forward to a relaxing eight-day vacation without access to cell phones or computers. I had also heard the food was excellent. The week turned out to be one of the most creative intense experiences I have ever undergone and it changed the trajectory of my life. I came out of there like a laser beam and have not deviated a millimeter since the day I left.

The experience

The process is taught to groups of 20 to 40 participants. It is a shared experience, but you don’t share experiences. No one knows anything about anyone else’s story. The intent is to just give you the tools to learn how to process your negative patterning in order for you to have a clear connection to who you are.

It is almost all experiential. It is an intense process of reprogramming that cannot be duplicated in real life. The teachers are extraordinary people. The process utilizes writing, visualization, philosophy, art, auditory, and tactile sense to go through the phases of reprogramming your nervous system.

Neuroplasticity

Although Bob Hoffman did not have a medical background, the concept from a neurological reprogramming viewpoint is brilliant. All the phases I have discussed of increasing awareness, separating, and reprogramming are done in a manner that ensures you will come out looking at life differently and connected to your “authentic self.”

Instead of processing one thought at a time, whole patterns of thinking are processed. Although I had inadvertently done my own reprogramming for years, I had no concept of what I had been doing. I also didn’t comprehend the intensity of what could be done.  The Hoffman Process concentrated years of writing into days. The process also pulls your nervous system into a place where a lot of early programming occurred and allows you to reprogram at a deep level. I feel like five years of progress was accomplished in a week.

Time It

It is one of the most creative and novel experiences I have been exposed to.  I don’t recommend Hoffman as a starting point for your journey back to full health, but you should at some point seriously consider participating in the Process. It will enable you to acheive a higher level of connection to you really are, minus the patterns of behavior that are so disruptive to our sense of well being.

I talk a little more about this in, “A Surgeon’s Perspective on the Hoffman Process”. It’s an interview I did about Hoffman.

Hoffman, Mind Body Syndrome, and Chronic Pain. Hoffman Radio Interview November 2102

BF

The post Hoffman Process first appeared on Back in Control.

The post Hoffman Process appeared first on Back in Control.