A representative definition of “Authentic Self”

This is a piece from “A to Zen” from the Internet that represents a common line of thinking about the term, “authentic self.”¹ The problem is that in the human experience, our powerful behavioral patterns win out and these enviable traits are buried. Then it becomes even more frustrating when we can’t live up to our “standards.” The cycle continues in that we may actually engage in destructive behaviors even though we know better.

In general, when talking about someone who is authentic, we mean that they are genuine, honest, and real.

An authentic person is someone who is comfortable in their skin and doesn’t feel the need to put on a front to fit in and be accepted by others. They know who they are, and they don’t hide it.

They understand their purpose and follow their life’s passion. They don’t chase after money, status, and possessions and are not immorally competitive, for they are not fearful of anyone.

However, this doesn’t mean they don’t live a wealthy life and enjoy nice things, but they define and strive for success to their own standard. 

7 SIGNS YOU ARE AN AUTHENTIC PERSON

1. YOU ARE ACCEPTING OF YOURSELF AND OTHERS

2. YOU HAVE A HEALTHY EGO

3. YOU HAVE A REALISTIC PERCEPTION OF REALITY

4. YOU ACCEPT MISTAKES (AND LEARN FROM THEM)

5. YOU ARE EMOTIONALLY MATURE 

6. YOU ARE CONSIDERATE TOWARDS OTHERS

7. YOU DON’T FEEL THREATENED BY OTHERS

What if you don’t have these traits? The problem is that few of us consistently exhibit many of these admirable qualities. Where would you have learned them if you were raised in a chaotic environment? Even if we possess some of them, how often do they get sabotaged, and how many of us have all of them. If the authentic self becomes an “internal standard” of being, then our self-critical voices will chime in to remind us how often we don’t (can’t) live up to these ideals, we are less accepting of ourselves, more frustrated, inflamed, and will experience more mental and physical pain.

Your ”authentic self”

Your authentic self is right here in front of you. It is the summation of your life programming from your parents, siblings, peers, teachers, employers, societal norms, and the marketing world. In other words, you are the product of who everyone else has told you to be. These messages are internalized and become your own inner voice telling you how you should be. The outcome is a lot of noise in your brain of self-judgement and that of others. We call it “self-esteem.” It is a mismatch of your powerful unconscious brain versus your conscious one. It is endless and wears you down.

David Eagleman in his brilliant book, Livewired, points out that humans are uniquely dependent on their parents for physical survival compared to most mammals. A baby is completely helpless and cannot survive on its own for many years.²

The emotional brain is even more complex in that we have language with an infinite number of possibilities. We are programmed by every moment of our lives, which means none of us are the same. Humans give meaning to everything, and no two people can look at a physical object in the same way. Thoughts and concepts are much more complex, and we are downloaded first with concrete concepts, then abstract ideas, and we don’t develop deep philosophical thinking for many years.

We are completely at the mercy of our environment as to what is inputted into our brains. What becomes more problematic is that thoughts and ideals are perceived as real to a given person as a car or table.³ They become our version of reality or life filter. Once this life lens is set, it becomes reinforced over a lifetime – unless you choose to become aware of it and change it.

Who are you?

So, we are who the world has told us we should be. We have programmed behavioral patterns that are the foundation of our existence. Most of them result from the basic need to survive. Few of us are taught how to nurture joy. Who are we?

You are who you are today. You can see yourself by becoming aware of what you react to, what makes you anxious and angry, what are your behaviors and attitudes towards yourself and others, how much personal responsibility you take for your actions, and what level of compassion and empathy you FEEL for others.

For example, most of us know that compassion is a good idea. But what happens when you are upset. You may say or do things that you are not proud of, and compassion goes right out the window. It is because compassion is a conscious construct and anger automatically arises from your unconscious brain. It is a million to one mismatch. It is that reaction in the moment is who you are because something in the present connected you to something threatening (or perceived as such) in the past. You are there and not here. It is also who you are.

“Love Your Enemies”

Anthony DeMello in his book, The Way to Love, has a chapter called, “Love Your Enemies.” He points out that if someone angers you, you should thank them. The problem is not them, but in you. Their words or actions triggered a response in you that allows you to have more awareness of what is inside of you.⁴ It is challenging in that it still feels like the other person causing the problem, but it is you that is being triggered. The exception, of course, is physical or emotional abuse. Anger is a necessary protective reaction.

Your real “Authentic Self”

This all sounds a bit hopeless but there is a lot of hope once you realize the depth of your programming and how it is playing out today. The key word is, “awareness.” Once you are aware of how your past is continually playing out in the present, you can direct where you want your brain to develop going forward. It continues to change every second and the term is called, “neuroplasticity.” The sequence is 1) awareness 2) separation 3) reprogramming. Without awareness, you’ll continue to be mired in the past.

As you learn to take full responsibility for every one of your actions without judgement, you can create any reality you want by consistently making better choices, and the above-mentioned traits can be nurtured daily.

This new evolving person is still your authentic self. You just don’t have to keep searching for it.

References

1. By Marissa on” A to Zen Life,” June 11, 2022. https://atozenlife.com/authentic-person/
2. Eagleman, David. Livewired. Cannongate Books, Edinburgh, UK, 2020.
3. Feldman Barret, Lisa. How Emotions are Made. Houghton, Mifflin, Harcourt, New York, NY, 2018.
4. DeMello, Anthony. The Way to Love. Bantam Doubleday Dell Publishing Group. New York, NY, 1995.

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There are several factors to consider with regards to forgiveness:

• It is not an intellectual exercise. You have to be able to feel and acknowledge the depth of your anger before you can let go.
• You will always possess anger. You are not going to get rid of it. It is a survival reaction. Forgiveness is an ongoing daily practice.
• It is critical to become aware of and let go of your deepest wounds. Forgiving smaller wrongs is helpful, but is not going to really alter your body’s chemistry. Global ongoing anger is deadly.
• The final step of forgiveness is generating deep compassion for the person or situation that hurt you. You might be thinking at this moment, “No way!!” It is not a matter of liking this person, but do you really want to continue to give control of your quality of life to who you rightly despise?
• Deep compassion will move your brain activity off of the pain circuits and create a wonderful chemical environment. Why would you not want to exist in this state?
• BTW, it is common, if not the rule, that people become addicted to their pain and being in the victim role. It is irrational and the biggest block to healing. If you are already reacting to these first few sentences, you are in this role. I know because I was one of those people for most of my life.

Empathy/ compassion

The Oxford dictionary defines empathy as, “the ability to understand and share the feelings of another.” It is a core component of nurturing human relationships. If you don’t have some sense of how someone close to you is feeling, you can’t interact with them in a meaningful way. You might as well be in another room. The capacity to feel empathy is an inherent part of the human experience because from an evolutionary perspective, it was the species of humans who learned to cooperate that had the highest likelihood of survival.

 

 

Compassion is the next step in healthy relationships that follows empathy. You first have to have the ability to see a situation through the other person’s eyes with an understanding of what it might be like to be in a similar circumstance. Compassion is a desire to help out. Nurturing compassion has two parts: 1) engaging in practices that engender empathy, and 2) removal of any interference connecting you with your own compassion.

The disconnect–anger

The problem is that when you are consumed with frustration and anger, it is only about you and it is not possible to be aware of other’s needs. So, the foundational step of empathy is compromised. You might feel you have empathy in spite of being upset. You might–after you calm down. But often people in pain are constantly frustrated and many of their relationships are based on bonding with other people who are angry. It seems like a close relationship with intimate conversations around suffering. But do you really know the person beneath the pain? It is a vicious cycle and one of the reasons why it is so important to never discuss your pain or medical care with anyone except your providers – ever!!

Anger wins over compassion

We all have a deep need to help those around us. But when you are angry, compassion goes right out the window. It is the interference that needs to be dealt with before you can feel compassion and engage in helpful acts. Only then are you able to implement practices to increase your empathy–starting with awareness.

Brenda

Patients freed of pain often want to give back—and in a big way. Brenda was a patient who became paraplegic from an unfortunate series of events surrounding spine surgery. She wasn’t happy before the complication occurred and certainly not after it. Using the methods she learned in the book, Forgive for Good (1) made a tremendous impact on her outlook, mood, and pain.

After she embraced true forgiveness, her overwhelming urge was to help others in wheelchairs who were suffering from chronic pain. She was happier in a wheelchair than she was walking, anxious, and angry. She then descended back into her Abyss of chronic pain for several years. I recently heard from her, and she had pulled herself back out. Once you’ve tasted true freedom, you’ll know how to return to it.

Nurturing Compassion

I have a few suggestions to consider, which might help you formulate your own ideas of how to give back.

• Remain committed to your own journey. You can’t help others if you are not doing well.
• Practice awareness. Remain aware of yours and others’ needs, listen carefully to others and try to see situations through their eyes.
• Don’t discuss your pain, complain, give unasked-for advice or be critical. None of these are compassionate acts. It is a little harder than you might think, because all of us complain. It really isn’t that enjoyable.
• Learn a compassion-based meditation practice. I don’t meditate easily and I have condensed my  practice to, “be nice” regardless of the situation. It is humbling to see how difficult this is.
• Your highest priority is your immediate family. Even if you’re in pain, always treat them well.

Compassion requires a sequence of actions

It seems almost impossible to forgive those you have wronged you or commit evil deeds. It is indeed extremely challenging. The first step is to realize how much suffering they are experiencing that drives them to act so badly. They are living in a dark world and may not have ever known love or what it even looks like.

Also remember that you don’t have to like the person who has committed bad deeds. That is a much different energy than letting go and having compassion.

Anger will block compassion. It has to be processed first. There is no way around it. The way you can and will nurture compassion for you, is to develop it towards others around you. It is the step beyond forgiveness.

Moving Forward

A growing body of research is showing that most people won’t let go of the situation or person who wronged them. (2) Hanging on to resentment has been shown to increase pain and compromise one’s quality of life. (3) Forgiveness is correlated with less mental distress, pain, and an increased capacity to enjoy life. (4)

Make a random list of ideas of ways to give back that are interesting to you–write them down. They can be small actions.

• Pick the top five
• Prioritize them.
• Pick one.
• Develop a focused plan.
• Do it!

What is your vision of what you’d like your life to look like in one year/ five years?

• Be as detailed as possible.
• Learn organizational skills to implement your vision.
  • Getting Things Done (5) by David Allen is an excellent resource.

Creating your vision and moving forward with or without your pain requires compassion and a commitment to yourself. It is the surest way to leave your pain behind as you actively re-engage with an enjoyable life. It is your time to thrive!!

References

1.  Luskin, Fred. Forgive for Good. Harper Collins, New York, NY. 2002.

2.  Burns JW: Anger management style and hostility: Predicting symptom-specific physiological reactivity among chronic low back pain patients. J Behav Med (1997);  20:505-522.

3.  Burns JW, Johnson BJ, Devine J, Mahoney N, Prawl R. Anger management style and the prediction of treatment outcome among male and female chronic pain patients. Behav Res Ther (1998)l 36:1051-1062.

4.  Carson, JW, et al. Forgiveness and Chronic Low Back Pain: A Preliminary Study Examining the Relationship of Forgiveness to Pain, Anger, and Psychological Distress. The Journal of Pain (2005); 6: pp 84-91.

5.  Allen, David. Getting Things Done. Penguin Books, New York, NY, 2015.

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The First Day of School

Every child entering school has a baseline anxiety that is heightened by leaving the familiar surroundings of home even if the home environment is dysfunctional. We are not taught how to process anxiety at any age, especially early on. It has been disturbing to me, as I talk to my patients in pain, that many report having significant anxiety since age five or six. I realize that I have a self-selected group but the vast majority of them report crippling anxiety during their teens.

One of the main antidotes for anxiety is control. The more power you have the more control you can exert. Since every child has this need for affirmation, he or she is launched into a power struggle without an endpoint. What makes it even more problematic is you are now placing your sense of well-being into the hands of another person, who’s self-worth is reinforced by putting you down. It is a deadly cycle.

Power

There is also a physiological reward for possessing power. Every human being depends on anxiety for survival. Your nervous system, through all of the senses is constantly scanning the environment for danger. This is an unconscious function that you will become aware of only when a certain threshold is reached. You are constantly controlling your environment or your behavior to minimize anxiety. The corollary of this scenario is that the more power you possess the more control you can exert. Indeed, the benefits of power have been demonstrated in a study looking at inflammatory markers in students who have been bullied versus the bullies.

C-reactive protein is a blood test that is elevated in the presence of inflammation. It is often drawn to determine the presence of a hidden infection. Chronically elevated levels also indicate a stressed and overactive immune system. One consequence can be occlusion of the blood vessels to the heart. It isn’t great to have an elevated C-reactive protein.

Researchers drew samples of this marker on children who had been bullied and found significantly elevated levels of C-reactive protein compared to those who had not been bullied. (1) Being bullied, as your introduction to the real world is a tough start. School or Prison: What is the Difference? What I find even more disturbing is that the levels of C-reactive protein in bullies were lower than the norm. There is both a social and physiological reward for possessing more power. How all of this plays out in adulthood is not subtle. Why would you want to give up the power of anger?

Bullied at work

I had another patient who I had worked with for several months to avoid yet another spine surgery. It looked like he had re-ruptured a disc but I wasn’t sure how new it was. Over six weeks his symptoms abated. Several month later he returned with the pain being the worst it had been in a while. I have learned that stress can cause pain flareups because stress chemicals cause an increase in nerve conduction. I asked him if there was anything going on that might be causing more stress than normal. He was being severely bullied at work by almost all of his co-workers. It had been going on for a while. After some discussion, he made a decision to go to Human Resources as well as directly dealing with the bullies. His pain quickly abated.

First of all, to those of you reading this who are one of the people intimidating others around you, “Stop it.” What are you thinking? Are you continuing your playground behavior? Is your behavior something your children would be proud of? Do you want your children to behave in a similar manner?

Second, the name for this trend is, “mobbing.” If you can’t go to work and enjoy what you are doing, where do you escape to? We spend most of our waking hours at work? With your body under a sustained stress chemical assault, why would you not eventually become ill or disabled? Destroyed by bullies

Finally, it has taken me many years to figure out the major block to healing pain is that people become addicted to pain and won’t/ can’t let it go. They would have to learn to live with more anxiety for a while and they don’t want to. Then become honest with yourself and admit that you don’t want to give it up and then becoming angry at the medical profession who is trying to heal you, which also adds fuel to your fire.

“I can’t let go”

I have patient who I have seen over several years. He is middle-aged and has experienced low back pain for over 10 years. He has disc degeneration that is not amenable to surgery. He never bought off on the idea of addressing his pain using the DOC concepts and did not want to let go of his anger. When he showed up in my office a couple of years later I vividly recalled our prior conversation, as the emphasis had not changed. He said, “I can’t let go of my anger.” I pointed out that no one was forcing him to hold on to it. I didn’t know any of the details of why he was so upset. I reminded him that he was the only one who was continuing to suffer. Dr. Luskin in his book, Forgive for Good uses the term, “renting too much space in your mind.”  I asked him again, “What could be so hard to forgive compared to this level of ongoing pain?” He didn’t answer me and walked out the door.

Compassion??

Although we can pay lip service to the concept of living a compassionate life, the unconscious survival patterns will always win out when we are exposed to stressful situations. The Angry Meditator The problem is further magnified by society’s emphasis on accomplishments and winning rather than play. The quest for power is endless since anxiety progresses with age.

Although power is necessary to deal with bullies who are terrorizing the world, fighting violence with violence is not a viable long-term solution. Anxiety-driven anger is the root problem. Understanding that anxiety is powerful automatic neurological response that is not amenable to rational interventions is the first step in solving it. Then presenting the solutions based on de-adrenalizing and re-routing the nervous system must be approached from public health perspective. If we began in pre-school we could  create a massive shift in human behavior and relationships. Why are we continuing to nurture a school environment where being a bully is your best chance of surviving? What has happened to the concept of play?

The First and Last Day of School

1. Copeland W, et al.” Childhood bullying involvement predicts low-grade systemic inflammation into adulthood.” PNAS (2014); 111: 7570-7575.

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The consequences of endlessly striving for self-esteem aren’t just dire for the individual, but for the society as a whole, as those in charge – of families, companies, countries, anything — judge others harshly, driving them into the ground on their path to power. At its worst, the quest for greater self-esteem leads to despotism, war, and mass murder, blocking world peace. What can be done about this dangerous scenario? The real key to harmony for us as individuals and as a society is not self-esteem but compassion. Only by practicing compassion – for ourselves and others — can we make our world a more peaceful one. The road to compassion starts at the point where you become aware of your own efforts to inflate your self-esteem, which can be traced back to anxiety.

Compassion

Let’s look at compassion first. Compassion is now recognized as vital force in our society: in fact, there is a group (in which I am a partner) called “A Charter for Compassion” founded by Karen Armstrong, a prominent theologian. The group’s mission is to promote compassion on an international level. It’s a great and important cause but we have one major challenge: while the idea of using compassion to bring about peace (in our world and in ourselves) has been around for a long time, there has been no lasting change.

In her book, Twelve Steps to a Compassionate Life, Armstrong points out that 2,500 years ago, Confucius had remarkable insight about the importance of compassion and worked to spread the word about it. In spite of his significant efforts, though, he felt that he’d failed to convince any world leaders to act in a compassionate way. The challenge continues today.

Self-Esteem, Anxiety, and Judgment

Now let’s consider the origins of our inability to achieve world peace: the pursuit of self-esteem, which is rooted in the universal feelings of anxiety and anger. Here’s how the sequence unfolds: we don’t like to feel anxious, so when the feeling starts, we struggle to gain control of the situation that’s causing it. If we can’t gain (or retain) control, we become angry. Anger covers up the anxiety, making us feel more in control and more powerful. It’s a vicious cycle in which those in power see no logical reason to give it up.

In trying to gain more self-esteem, we inevitably compare ourselves to others, which results in harsh judgments. This is problematic for several reasons: first, these negative feelings don’t help you enjoy your day. Second, although you might intellectually believe that “all men are created equal,” actively judging anyone – whether it’s a friend or a homeless person on the street — means you haven’t internalized this belief. Third, negative judgment leads to ill treatment of others (even if we display a veneer of civility). Lastly, self-esteem has odd blinders; whatever defines us most is what we most often judge in others. Think about this for a while.

Do you often make negative judgments? Ask yourself the following questions:

• If you are intellectual do you view people who are less educated or less intelligent as your equal?
• If you are in incredible physical shape, how do you judge the other 95% of the population that is not fit?
• What if you are poor? Do you identify with your “simple” life so much that you judge those who have more than you?
• If you aren’t poor, how do view those who have less than you? Do you treat them the same way you would treat your boss or your family?
• If you are attractive and are defined by your looks, how do you feel about those who are physically challenged?

We really all are equal

In answering these questions, remember that every human being is flawed. The beauty of this realization is that it allows us to see that not only were we are all created equal; we truly are equal. Being judgmental interferes with our ability to enjoy the human experience at the deepest level, which is tragic for you and everyone you come in contact with. When you judge someone as being “less than” you, it enables you to rationalize some pretty bad behavior. In labeling that person, you’ve lost the capacity to view the world through that person’s eyes. It’s the antithesis of compassion. The essence of compassion is awareness.

What is really odd about this process is that you may focus so hard on the few traits you define yourself by that you become detached from the feelings of worthlessness you possess in multiple other areas. This disconnection can and will lead to aberrant behaviors. Here’s a recap of the sequence:

• Anxiety is a universal trait
• Anxiety drives the need for self-esteem
• The pursuit of self-esteem leads to a pattern of judgment
  • Of others
  • Of self
•  Working on your self-esteem is an attempt to gain more power and there is no endpoint.

Remember that in the end, no matter how hard you work on your self-esteem, there will always be people in your “target” zone who are more competent, skilled, wealthy, etc. So at the same time you feel superior to many, you also feel inferior to many. By the way, how are you keeping score?

Guaranteed to Fail

Also keep in mind that instead of making you happy, self-esteem pretty much guarantees that happiness will always elude you. For example, suppose you are brilliant in your field of work but are physically out of shape and cannot get on top of it. Does your brilliance overcome your negative feelings about your body? The answer is: probably not. There are a million traits to feel good or bad about, which is one of the reasons that self-esteem is so ineffective in allaying anxiety. It eventually becomes destructive.

I recently had a conversation with a young professional about self-esteem. He told me that in any social situation that he is in he feels like he is the most intelligent person in the room. It does not matter who is in the group or if it is in his area of expertise. He then went into a somewhat complicated explanation why he thought this was the case. I could only feel sorry for him as I realized how much of his life energies were being consumed by this process.

Solutions

We’ve established that anxiety and the resulting negative judgment lead to the pursuit of self-esteem, which, in turn, results in power struggles. The resulting judgment blocks awareness, which is the foundation of compassion. As self-esteem is so widely promoted how is world peace even a concept? What is the solution to this problem? First, we have to start at the individual level and deal with our anxiety/judgments. The most effective technique is a strategy called reprogramming, which essentially “resets” your nervous system via the following tactics: 1) awareness, 2) detachment, and 3) reprogramming.

The first step is to become aware of your anxiety/judgments. One effective method is to either write down or speak your judgmental thoughts, which allows you to separate from the, which accomplishes the second step.

The detachment process doesn’t get rid of your judgments; they will still be there the next time you interact with the same person. However, in separating from your thoughts, your negativity is no long running the show. You don’t have to like this person but you’ve created a situation where the possibility of liking him or her one-day exists. At a minimum you can do business or interact with them without it disrupting your peace of mind. This third step is the reprogramming part of the process.

Note that it may be tempting to try and suppress your anxiety-driven judgments, but this won’t work; the anxiety that lies beneath our judgments is a mental reflex, and impossible to deal with in any way that might seem rational.

“Not being judgmental”

I have an ongoing discussion with my patients about why suppressing their judgments doesn’t work. For instance, suppose they’ve decided to turn over a new leaf and not be judgmental of a person they don’t like, such as a coworker or relative. The next time they interact with this person, what happens? In trying not to think negative thoughts about the other person, they focus on these thoughts even more, literally “firing up” their neurological circuits of judgment. It’s a problematic way to run one’s life, since lack of awareness results in detached and even bizarre behavior.

There are other, effective methods for breaking the negative cycle of self-esteem:

• Treat anxiety/anger as a Neurophysiological Disorder (NPD) symptom.
  • Become aware of your own self-esteem needs and resulting judgmental nature.
  • If you are working on your self-esteem, realize that you are using rational means to deal with the powerful unconscious brain. It is a mismatch.t
  • Become aware of the impact of your judgmental behavior on yourself and others.
    • Stop it – now.
      • Every person, every time. No exceptions.
  • This work is done via small, multiple daily interactions.
    • Example: avoid taking part in gossiping.
    • Connect with who you are. It does not matter how you compare with others.

Once you become aware of the destructive nature of pursuing self-esteem, you can implement tools to change, creating the possibility for peace within you and around you.

World Peace – Act Now or Quit Talking

The concept of world peace has been in my thoughts my entire life. Though I have at times been hopeful, it currently seems like we are headed the wrong direction. In fact, sometimes I feel that much of the free world is heading back into the Dark Ages. Many parts of the world still live in the same conditions as the Dark Ages, subject to absolute control by a few leaders, with severe consequences for breaking the arbitrary rules. Can the human condition ever overcome its own nature? What would it take for us to achieve world peace? This is the question that needs to be answered; otherwise let’s quit talking about it and deal with the reality that it’s never going to happen.

Consider this breakdown:

• World Peace is a result of having….
• Compassion, which only occurs if we…
• Remove what’s blocking compassion: our need for power/pursuit of self-esteem
• The drive for power/self-esteem can only be stopped if we address…
  • Anxiety/ anger, which has to happen at the…
  • Individual level, because…
    • The institutions that can create world peace are a result of the collective consciousness

Compassion is contagious. The more compassionate you are with your partner, children, friends, coworkers, or a stranger on the street, the more likely they will be compassionate to those around them.

Change Your Behavior, Change Your World

Most everyone would agree that world peace is a good idea, so how do we go about achieving it? Besides being compassionate to your fellow man, it helps to let others know about the destructive nature of self-esteem.

This is the idea put forth in the book Influencer: The Power to Change Anything written by people who are highly skilled in creating change. The book is about pinpointing which behaviors need to be modified in order to create the desired result. For example, if you wanted to improve people’s dental hygiene habits, you might think you should display this message on every billboard in the country: “Practicing good dental hygiene results in healthier teeth and gums.” This tactic wouldn’t change a thing, however. But if you systematically educated the population about regular and correct methods of brushing and flossing your teeth, you’d achieve your goal.

Let’s consider this idea in the context of world peace. You can promote the concept that world peace is a good idea, but you won’t get anywhere unless you specify to others what behaviors need to change. One might be to stop working on their self-esteem and instead, practicing awareness and compassion. True lasting change can only occur one person at a time and everyone is important.

Video:

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Dr. Sarno

He is a well-known physiatrist who described the “tension myositis syndrome.” (TMS) I had been familiar with his observations described in his best-selling 1984 book, Mind Over Back Pain. He felt that the nervous system was created muscle tension and inflammation. He also made the astute observation that anger or rage was a critical factor in the evolution of chronic pain. He was partially correct about the anger, but modern neuroscience research has shown that the symptoms are created from the physiological response to threat and not primarily from muscle tension.

Dr. Schubiner

Howard Schubiner is a pain physician who practices in Detroit, MI, who spent time with Dr. Sarno. He has authored a book, Unlearn Your Pain, which addresses chronic pain as one of the symptoms of the Mind Body Syndrome (MBS), which is another name for the tension myositis syndrome. I have chosen the term, Neurophysiologic Disorder (NPD).

In March of 2011, he was one of the keynote speakers of a seminar I co-chaired, A Course on Compassion-Empathy in the Face of Chronic Pain. I had a vague understanding of what I had been through but was still searching for more answers. As I sat in the lecture I had a deep insight into my experience and it instantly all made sense. He concisely presented the over 30 possible symptoms of stressed nervous system and I realized that I had experienced almost half of them. In chapter five of his book, Unlearn Your Pain, Dr. Schubiner lists 33 symptoms of NPD (He uses the term Mind Body Syndrome).

The Neurophysiological Disorder (NPD) – Make the Right Diagnosis

As your nervous system is connected to and controls every cell in your body, the potential symptoms and combinations are almost endless. Mainstream medicine does not embrace these concepts and that would, historically, include me. I have both watched it and experienced it. Our medical culture has “medicalized” a neurological diagnosis. The first step in being successful in treating any disease is making the correct diagnosis.

My Experience with NPD

Here is the list of my symptoms of NPD. I will tell the stories in detail in later posts.

• Migraine headaches
• Migratory skin rashes
• Severe burning in both of my feet
• Obsessive compulsive disorder
• PTSD
• Anxiety/panic attacks
• Severe depression
• Chronic tendonitis
• Heartburn/acid reflux
• Tinnitus
• Insomnia
• Back/neck pain
• Tension headaches
• Unrelenting itching
• Chest pain
• Palpitations

Every one of these symptoms has vanished or is at a level that causes minimal interference with my quality of life. However, if I quit practicing the principles that I am teaching some of my symptoms will re-occur in about two weeks. These are permanent pathways. Usually my ears will begin to ring, my feet will burn and a skin rash will appear on the back of both of my wrists.  Fail well

Terminology

There have been many attempts at using a term to describe the array of symptoms that occur when your body is full of adrenaline and cortisol. These terms include:

• Tension Myositis Syndrome (TMS)
• Mind Body Syndrome (MBS)
• Stress Illness Syndrome
• Central Sensitization Syndrome
• Neurophysiologic Disorder (NPD)

All of these terms are describing the same process. Any stress, perceived or real is going to put your body into a fight-or-flight mode and you will experience multiple physical symptoms. The key to healing is feeling safe, which creates a wonderful chemical environment where you can both physically and mentally thrive. It is a learned skill that is not difficult.

The post My Battle with NPD first appeared on Back in Control.

The post My Battle with NPD appeared first on Back in Control.

I am on a much-needed vacation this week in Italy.  From 1980 until 1990, my wife lived in Florence.  We have many friends in Italy we like to visit as much as we can.  It is a unique opportunity for me in that she is fluent in Italian and we are able to spend time in our friends’ homes in the heart of Tuscany.  There is nothing quite like sitting down to a home-cooked Italian meal overlooking a beautiful valley.

Last night was one of those evenings.  Our friends not only put us up in their apartment, they had us over to dinner with several other friends.  The conversation drifted towards medical care.  One of the guests had experienced some medical problems of a moderate nature that required several physician visits and a couple of procedures.  He said that the aspect of his care that most struck him was that at no point during his care did anyone from the receptionist to the doctor ask him how he was doing.  Additionally, when he was asked some detailed questions about his condition, he was asked if he was a doctor.  When he replied that he was not, he was told that he had been informed enough and that he should not ask so many questions.  You might imagine his frustration.

I have witnessed a lot of success with the DOCC protocol, but it has become increasingly clear that the protocol is just a framework. It helps organize both the physician’s and patient’s thinking about chronic pain and therefore makes it much easier to create a treatment plan.  It is the patient who organizes and implements the plan. The physician is more in the role of a “coach” as well as being continually aware that there might be a potential structural problem.

About a year ago, I was talking to the pain psychologist I work with about what we were doing that seemed to be more helpful to our patients than either of us had historically observed.  She kept insisting that I was the factor that made the difference.  I was sure it was the DOCC protocol and the work she does.  After more and more positive results, I finally agreed that I played a major role in their recovery.  To clarify, I don’t believe that I have a special gift or am the world’s best doctor.  I simply stay committed to my work with the patient.  With increased attention over the last couple of years, I have seen more patients who had been in pain for decades become pain free.

Through my numerous difficult experiences, I have had many layers of my own personal labels stripped off.  Physicians, especially surgeons, are perfectionists.  It gives us an early competitive edge in high school and college.  It is somehow held up as a virtue by our medical culture and demanded by society.  Unfortunately, it is a complete disaster with regards to our ability to connect with our patients.  By definition a perfectionist is continually judging himself or herself by an unattainable standard.  As I have labeled myself, I have labeled others around me.  As it has been my reality for over 50 years I had no clue that this process was taking place.  I recently wrote an article, “The Cry of Chronic Pain—No One is Listening.”  The essence of the article is that once you have a label of a “chronic pain patient” placed on you, the world, including you, feels that it is just “something you have to live with” and your care becomes essentially palliative care.

I recognize that labeling is universal but it is not constructive.  I am aware that I label people constantly. As I work to become aware of the label I am placing, I am able to eventually see who you truly are.  You are a whole person.  Neither you nor I are the labels we place on each other.

The energy for your healing journey comes from you, not me.  What I contribute is that I am able to see you as a whole person and you are somehow able to remember that part of you that is really you.  When that part of you “wakes up,” there is no stopping you.  You are your own oasis in the middle of the desert.  I cannot ever tell who will engage or when.  The DOCC project is just a rough framework and every journey is completely different.  I am continually energized and inspired by the incredible obstacles you overcome to return to a rich, pain free life.

I recognize that essentially all physicians are compassionate.  Many physicians have figured out this journey and most have not had to experience burnout to learn it.  I am continually humbled by numerous examples of deep compassion by my colleagues.

I always thought I was compassionate. I was very well intentioned and always gave every patient my best shot.  However, the physician burnout rate is around 50% and we truly have a life full of more stress than you can imagine.  If you are just trying to survive, there is only so much you can give.  Additionally we have no resources or tools to help us out.  The safety net is a concrete floor.  It has been shown in several studies that it is during the third year of medical school that compassion takes a dive.

I am not writing this post for you to begin looking for a physician who is compassionate.  It is not a bad idea, but it is not necessary for you to heal.  Remember this process is about you taking full responsibility for every aspect of your care and your life.  You don’t need me.  You don’t need the DOCC project.  You just need to connect with that part of yourself that is whole and wants to thrive. The person who you need to experience compassion from is you. Use whatever means you have at your disposal to figure this out.  It will probably take some outside help but there are multiple resources. Quit trying to “figure all of this out” and just go.

NH, BF

The post Compassion and an Italian Dinner first appeared on Back in Control.

The post Compassion and an Italian Dinner appeared first on Back in Control.