Take charge of your brain

Regardless of the location and origin of the pain, you can retrain your brain to create alternative circuits around the old ones. It is similar to learning a new language or any other skill. As the newer, non-painful area of the brain is developed, the area causing the pain with be used less. At some tipping point, with repetition, the pain can and will disappear. There are three steps in creating these new circuits:

• Awareness
• Detachment
• Reprogramming

Mastery

The harder you try to “fix” or suppress the old pain pathways the more active they will become. Your brain will develop wherever you place your attention. If your attention is on the problem instead of the solution, you will remain stuck. You can’t learn French by trying to correct your English. This “rewiring” doesn’t require deep examination of your life, although that is helpful for other reasons. It is simply a learned skill to be mastered.

Shuhari

A friend of mine pointed out to me that in the Japanese martial arts there is the concept of “Shuhari” that describes the sequence to mastery. These concepts are from Wikipedia.

The word is really three words.

• “Shu” is “to learn”
• “Ha” is “to detach or digress”
• “Ri” implies “moving on” or “transcendence”

Mastery of your pain

“To learn” – awareness

You must first become aware of what “programs” in your head are running your life. This is true for both physical and emotional pain, as they are processed in a similar area of the brain with the result being sustained elevations of your stress hormones. Most of us don’t like pain, so we try to avoid or suppress it. You must understand and feel your pain before you can effectively create the “detours”. Otherwise you will be just running into a solid wall and bouncing from treatment to treatment.

Detach/ digress

You then have to separate from yourself to see what the options are to move forward. It is impossible to make reasonable choices if you are always reacting. It is similar to a football running back who has to see the hole in the line before he can progress up the field. I have one friend who visualizes himself sitting in a large theater. He “watches” himself on the big screen dealing with the situation in front of him. He feels like he can make better decisions. His ability to handle stress is unbelievable.

Another method to create space between you and your thoughts is expressive writing. I mention it many times in the DOC process because it is the one mandatory step to really allow change to occur. You cannot control your thoughts but you can separate from them. With the expressive writing, your thoughts are on the table and this “space” is connected to you by vision and feel. No one knows why it works so well and it has documented to be effective in over 1000 research papers. It also isn’t difficult or time-consuming.

Transcend

I have used the word reprogramming for the final step of creating new circuits. However, I like the word transcendence. It implies that not only have you moved through the obstacles you are far above them. Regaining your perspective on life is a critical step. I have often described the final phase of the DOC project as the spiritual journey. It can be manifested in an infinite number of ways and people often will thrive at level they never knew existed.

Even phantom pain can disappear

For many years, I did not understand how powerful neuroplasticity was in altering one’s reality. I knew many different pains could disappear, such as neck and back pain. I did not think that leg or arm pain could be altered and certainly not phantom limb pain. I was not only wrong, I now am convinced you can rewire your pain from any source.

Jenny was a young woman in her 20’s who had suffered a traumatic amputation of her right leg below her knee in a car accident. She developed severe phantom limb pain. Even though her leg was gone, she not only could feel the leg, but it was painful. She also had prior long-term substance abuse issues and had been suffering from neck chronic pain for many years. Her childhood was chaotic and was now in an abusive marriage with two children. Life was not treating her well,.

A couple of years ago, when the federal government mandated that physicians cut back on prescribing narcotics and her dosage was dramatically decreased. She flipped out and understandably so. She became extremely angry and aggressive with her doctors and her pain also worsened. Phantom pain is particularly problematic in that there is nothing physically that can be done for a leg that isn’t there. You can’t even rub it and is one of the reasons that is such a terrible problem.

Her doctors didn’t know what to do and she was sent to the pain center where she immediately verbally attacked her pain psychologist. He is a remarkable person and simply heard her out. Over several months, she began working with the expressive writing and relaxation tools. Medications were adjusted as needed. She understood the effect of anger on her pain and the need for forgiveness, letting go, and moving forward. Six months later she was off narcotics, had no phantom leg pain, and returned to school to become a marriage and family counselor. She wasn’t just “managing her pain” or “living the best life she could with the pain.” It was gone. Additionally, she was learning to enjoy life in a way that she had never before experienced.

The gift of mastery

Shuhari – the steps to mastery are universal. View your journey through chronic pain as a learned skill. What you probably cannot see at the moment is that when you have transcended your pain you will have been given the greatest gift that life has to offer – deep gratitude. Your appreciation of every second of life without pain is profound.

1. Hashmi, JA et al. “Shape shifting pain: Chronification of back pain shifts brain representation from nociceptive to emotional circuits.” Brain(2013); 136: 2751 – 2768.

A Bunch of Balloons

Play

The post Mastering Pain – Shuhari first appeared on Back in Control.

The post Mastering Pain – Shuhari appeared first on Back in Control.

Dr. Gordon Irving was the medical director of the Pain center at Swedish Hospital in Seattle, WA. He developed a wonderful set of resources for dealing with chronic pain. His version of a structured program was STOMP (Structuring Your Own Management of Pain). He and I co-edited this guide that will link you to many resources, which will enable you to take charge of your care.

“You Can Only Lose Brain Cells”

Historically scientists have thought that a person was born with a maximum number of neurons and you would slowly lose them over a lifetime. Although the brain activity the first few years of life is intense it has been clearly shown that the brain can change at any age—for better or worse.

Neuroplasticity

Neuroplasticity is the term that refers to the ability of the brain to adapt and change. It is your choice whether you want to direct in a positive or negative direction. Your brain will develop wherever you place your attention. Several of the ways it can occur are:

• Growth of new nerve cells (neurons)
• Shrinking of neurons from disuse
• Increasing or decreasing the number of connections per neuron
• Laying down or losing layers of insulation (myelin). This layer improves the speed of nerve conduction
• Substitution of an injured part of the brain with an already functioning area. The new area takes on new capacities.

The bottom line is that your brain is constantly in a dynamic state of change every millisecond, depending on how much it is stimulated—or not.

• There is an incredible upside potential because the nervous system has a large capacity to continue to positively change if it is kept active and creative.
• The terrible dark side is that when your brain shrinks or atrophies when suffering from chronic pain, then you have less ability to act rationally to pull yourself out of the hole. It is still a solvable problem, but you need help and tools.

Brain Changes are Measurable

With the advent of modern brain scans that can actually measure brain size and activity we are able to document these changes and they happen quickly.

A recent study showed that certain parts of medical students’ brains would significantly enlarge within a few months after starting school. (1)

It has also been shown that the brains of patients in chronic pain shrink. Fortunately the brain also re-expands with successful resolution of their pain. (2)

Brain Shrinks??

Why would your brain shrink in the presence of chronic pain? Conceptually, your nervous system gets stuck on repetitive thought and pain patterns that grow into monstrous circuits, and less time is spent on creative ones. The brain area that enjoys good friends, music, art, wine, etc. gradually shrinks with disuse. There is a huge amount of neural activity involved with these enjoyable endeavors that just does not occur in the presence of unrelenting pain.

Once pain circuits are laid down in your brain they are permanent. They may become less functional but they are not going to disappear. Once you know how to ride a bicycle or walk you cannot unlearn the skill.

Creating Detours

So what is the solution?  You must lay down alternate pathways or detours around the existing problematic pathways, or you can create a shift on to more enjoyable ones. Once you learn the tools and choose the ones that are the best fit for you it is remarkable how consistently the pain will diminish and may even disappear.

There are three aspects of healing:

• Awareness – You must understand chronic pain as it relates to you before you can solve it.
• Treating all aspects of your pain simultaneously – similar to fighting a forest fire.
• You take charge – each human is incredibly unique and complex. You are the only one who can find your own solution.

Welcome to a big adventure and the evolution of your new brain. It will be you that will do the brain building. The STOMP program is a variation of the DOC concepts, and you will discover additional approaches to help move you forward. They are both frameworks for you to organize your thinking and break your problem down into its component parts. The best news is that the healing journey is largely self-directed and you will learn to find the best resources that will work for you. We have found that chronic pain is not a life sentence to be managed, but is solvable.

1. Dragananski, et al. Temporal and spatial dynamics of brain structure changes during extensive learning. The Journal of Neuroscience 2006; 26: 6314-6317.
2. Apkarian AV, Sosa Y, Sonty S. Chronic Back Pain is associated with decreased prefrontal and thalamic gray matter density. Journal of Neuroscience 2004; 24: 10410 -10415.

The post Mold Your Brain: Neuroplasticity first appeared on Back in Control.

The post Mold Your Brain: Neuroplasticity appeared first on Back in Control.