There is no reward for being vulnerable for any species of life from one-celled organisms to homo sapiens. Consequences are severe and often swift. It is never safe to be off-guard, and different species create ways to be safe. They need to replenish fuel to fight another day. For example, a dolphin sleeps with one eye open. Many species form protective groups. Consider the number of ways creatures hide or camouflage themselves. Many species simply have thousands of offspring, so a few will survive. When these strategies fail, the final phase is whatever aggressive response they have available to them. The more strength and power, the better.

The added dimension of language

Humans have language, which creates another level of issues around seeking safety. We possess abstract thinking that allows us to engage in the arts, create coordinated societal actions, and have complex relationships with others. We rose to the top of the food chain because of our capacity to cooperate with each other. We have a strong evolutionary need to have close connections and relationships. For example, being socially isolated or lonely has the same effect on your health as smoking 15 cigarettes a day.¹ Look how much effort is put into seeing close friends and family during the holidays. We want to be with each other and the closer the better.

But one of the most perverse aspects of being human, is that successful thriving relationships require vulnerability and trust. These traits are the antithesis of feeling safe. Additionally, emotional/ mental pain is processed in a similar manner as physical pain.² “You hurt my feelings” and You broke my heart” reflect this phenomenon. So, we don’t like pain in any form, yet we have to become vulnerable in order to have deep and satisfying relationships. It is a huge problem, and it is not playing out well for the human race.

By definition, every interaction with another person requires taking a risk of being rejected or hurt. Even checking out at the grocery store involves trusting him or her to accurately document your purchases and help you with your bags. It is nice if they are in a good mood and are friendly. But what if they are having a bad day? Then there are deeper relationships such as being on a team, doing a project together, starting up any type of relationship, and living together. Being rejected at some level of the interaction is not only common, but also the rule. As you become more and more trusting, at some tipping point the level of vulnerability for that relationship will be reached, and one person will pull back or even reject it.

Your options

At this point, your choices are to 1) quit taking risks associated with interacting with others 2) engage but experience social anxiety 3) use whatever power you possess to control others 4) learn to be vulnerable. Since we don’t inherently possess the ability to feel vulnerable, the other less functional strategies are more commonly utilized.

Some form of anger is universal. Why? It keeps you safe. It protects you from both emotional and physical pain. Even if you don’t actually have the power to change the situation, you may feel like you do. Raw anxiety is intolerable and why we hold on to anger.

Why let go of anger?

• The main reason is that you simply cannot heal or thrive when you remain angry. The essence of healing is normalizing your body’s neurochemical state to that of a safety profile, which is profoundly restorative. If your whole system remains fired up, how can that happen? It can’t and won’t.
• Your brain structurally adapts to your focus of attention. You cannot move forward until you let go of the past, especially your deepest wounds. Most people in chronic pain remain angry at the situations or people who have harmed them. The more legitimate your gripe, the harder it is to move on. But how does holding on to the past make your life more enjoyable?
• Anger is destructive, as it is supposed to be. It’s your body’s last ditch effort to escape threat. It is destructive in every direction, including self-destruction. It is the reason why many people completely neglect every aspect of their health. It is tantamount to slow suicide.
• Anger is abusive and destroys relationships. The key element of successful human interactions is awareness of your needs and others’ needs. How else can you constructively interact with those close to you? Anger completely blocks awareness.
• Anger destroys families. Human consciousness evolved through language and social interactions. The ability to cooperate took homo sapiens from the bottom to the top of the food chain. The need for human connection is deep. Unfortunately, close connections are also the strongest triggers. Why would you ever be unkind to someone you care for so much? Why is the incidence of domestic abuse so high? It is maybe the most disturbing paradox of our human existence.
• Anger is the manifestation of the fight mode of the survival response. All organ systems are affected. The blood supply to your gut, bladder, and the frontal lobes of your brain diminishes and is shunted to your heart, lungs, and skeletal muscles. You can’t think clearly, although it might feel like you can. It is critical to, “Take no action in a reaction.”

Interacting with others involves taking the risk of being rejected or even hurt. There are physical risks, such as trusting a business partner who might run off with your money. What about your partner or spouse, who takes off with another person? These are deep ones, but simply reaching out to another person in friendship creates some level of anxiety.

Train your brain

You can use avoidance, suffer from chronic social anxiety, or resort to power and control to feel safe. The healthiest and most satisfying option is learning to be vulnerable and process rejection. In other words, being with anxiety. Being or feeling rejected is inherent to relationships, and unless you understand this, your world will become progressively smaller. Training yourself to lower your threat physiology (anxiety) instead of fighting it allows you to navigate life more easily. BTW, social connections are anti-inflammatory and lower anxiety.³ Addressing social anxiety is a bi-directional process. You can nurture joy, more easily interact with others, feel safer, and create the life you desire.

.

References

1. Cigna US Loneliness Index. Cigna: 2018.
2. Eisenberger N. “The neural bases of social pain: Evidence for shared representations with physical pain.” Psychosom Med (2012); 74: 126-135.
3. Dantzer R, et al. Resilience and immunity. Brain, Behavior, and Immunity (2018); 74:28-42.https://doi.org/10.1016/j.bbi.2018.08.010

The post Social Anxiety – Vulnerability Doesn’t Feel Safe first appeared on Back in Control.

The post Social Anxiety – Vulnerability Doesn’t Feel Safe appeared first on Back in Control.

• Mental rigidity is a transdiagnostic process that spans many mental health diagnoses
• Creating mental flexibility may be an important early intervention in successfully treating them.
• The need to suppress unpleasant thoughts is a driver of this process.
• Creating mental flexibility is challenging in that people must be trained to tolerate and process unpleasant thoughts.
• Mindfulness Based Interventions (MBIs) have been shown to decrease mental rigidity.

Another form of suppression?

Mental rigidity is a variation of suppressing thoughts in that you will allow yourself only certain sets and types of thoughts and emotions. You don’t allow yourself to feel so happy or sad. Your emotional bandwidth is limited and can be compared to a bowling with rubber bumpers in the gutters. This may work to a large degree, but since you are constantly monitoring your thoughts, it is difficult to see and hear messages from others. You are unaware, which is at the core of abuse. Seeing and meeting only your needs causes one to behave in a manner that may hurt and damage others. Also, mental inflexibility is a common trait shared by many mental health diagnoses.¹

It gets worse. Rigid thinking around belief systems creates deep circuits in your brain (“stories”) that detach you not only from others but also the needs of society. These obsessive thought patterns seem “normal” to a given person. And when your brain is ruminating on these circuits, you have largely “crowded out” unpleasant repetitive thoughts. So, it is helpful for you, but not so much for others. Inevitably, there will be conflicts with those who have differing patterns of rigidity that are not subject to rational conversation. The perverse aspect of this is that the ensuing angry conflicts are powerful, further mask anxiety, and are addicting. Why would you want to give up the power of anger to feel anxious. Maybe it is your energy source that drives you to be “successful?”

Rigidity can revolve anything. Religion, politics, business, race, social class, personal opinions, noble ideology, and sports. The opinions can be small or global. They manifest as rhetoric (labeling), which completely covers up the real issues or specifics of who a person it.

                                                elit76_d/ AdobeStock

Reactance

It gets even darker. We will do almost anything to avoid or escape from the relentless barrage of negative thoughts. The science shows that thoughts and concepts become embedded in our brain similar to us defining any physical objective.² In other words, these fixed ideas become our life lens or world view. At some tipping point it hardens, and a phenomenon happens called “reactance.” This is a basic known fact in the marketing world.³ Facts never change one’s opinion. If they agree with your views, they are reinforced. However, when are not in agreement, you’ll reject them as invalid, and it strengthens your perspective even more. The more concrete your world view, the more definitive your actions will be to defend it.

The darkest aspect of it all is that many people feel the strength of their convictions (stories) to the point that they have the right, even responsibility to impose it on others. Hence, the outcome is extremely bad actions that occur both at a personal and world level.

We all have some aspect of this trait in that we feel that our perspective is the correct one, and we’ll freely be critical of those who don’t meet our “standards.” We may just think it or take varying degrees of action. Regardless of what you do, you have now lost awareness of the details of another person or situation. How can you act or react in a productive/ proactive manner?

Abuse

What about being raised in a dysfunctional or even abusive family? Your life lens is created from a hostile and dangerous environment. Going forward, you’ll constantly be in high alert similar to a feral cat. This environment creates a terribly destructive life view that also becomes stronger over time – unless you actively reprogram it.

The essence of abuse is not being aware of other’s needs. Rigid thinking takes unawareness to the highest level. It is often couched in seductive rhetoric. People in power understand the power of simple repetition and can program in anything they wish, regardless of whether it is logical or true.

The disease blocks treatment

How can this be solved? One of the most perverse aspects of the problem is that essentially all mental disorders are manifestations of chronic inflammation and other aspects of threat physiology. It this state your brain is inflamed, your neocortex (thinking regions) become less active, and it is challenging to open up your mind to new learning. Additionally, the rigidity also compromises awareness and curiosity.

Recent research has demonstrated that Mindfulness-Based Interventions (MBIs) are effective in increasing the connectivity between regions of the brain that define self. The term is the “Pattern Theory of Self.” Alterations that affect the dynamic interaction, are a factor in creating mental rigidity. The effects are manifested in many psychopathologies.

LoloStock/ Adobe Stock

By increasing the functional connectivity in regions connected with a sense of self and decrease the activity in interpreting the self’s relationship to the world, mental flexibility is increased. Indeed, MBIs are documented to more effective than many “gold standards” of psychological treatments.²

Chronic mental and physical illness and diseases are complex, and one type of intervention alone would not be expected to be a solution. However, MBI’s promise to be an entry point in breaking through the barrier of anger and rigidity to pursue a truly healing process. Many, if not most, chronic diseases are curable or at least can be halted. Research is beginning to offer real solutions.

Recap

Repetitive unpleasant thoughts (RUTs) are a driver of mental rigidity. It is a form of trying to control thoughts that is a common thread across many mental health diagnoses. Decreasing mental rigidity is a target for improving mental health interventions. It has been documented to be effective both clinically and with brain imaging. Mindfulness based interventions (MBIs) are a category of interventions that are effective in improving mental flexibility; and are potentially an entry point for effective solutions.

References

1. Giommi F, et al. The (in)flexible self: Psychopathology, mindfulness, and neuroscience. International Journal of Clinical and Health Psychology (2023); 23:100381. https://doi.org/10.1016/j.ijchp.2023.100381
2. Feldman-Barrett, Lisa. How Emotions are Made, Mariner Books, 2017.
3. Berger Jonah. The Catalyst. Simon and Schuster, New York, NY. 2020.

The post Mental Rigidity – A Core Trait of Many Mental Health Diagnoses first appeared on Back in Control.

The post Mental Rigidity – A Core Trait of Many Mental Health Diagnoses appeared first on Back in Control.

Feeling safe

There are many benefits of feeling safe and secure, with the first one being your body’s chemical makeup consists of reward hormones and you feel great. The opposite occurs if you constantly feel on guard. It is in the first scenario that you feel free to create, explore, play and use your imagination. Your capacity to interact with the world in a meaningful and effective manner is increased.

When you are constantly on hyper-vigilant and trying to protect yourself from real or imagined threats, your short and long-term quality of life will be compromised. One of the effects is that more situations in the present will resemble what you learned was unsafe in your childhood. You will be over-reacting to scenarios that really aren’t dangerous, but your brain won’t know it. Your body will feel under threat and your chemical makeup will keep you on “high-alert”. It will be harder to relax and enjoy your life.

ACE score

This is documented by the ACE (adverse childhood experiences) study done in 1996. (1) A survey of challenging childhood circumstances was given to over 17,000 people and health surveys were administered. There were ten exposures.

Household dysfunction

• Substance Abuse
• Parental separation/ divorce
• Parent with mental illness
• Battered mother
• Criminal behavior

Abuse

• Physical
• Psychological
• Sexual

Neglect

• Emotional
• Physical

Only 30% of participants had a score of zero and 26% had a score of 3 or more. There were increased chances of severe health consequences with higher ACE scores.

• Depression/ anxiety
• Obesity/ eating Disorders
• Heart disease/ hypertension
• Suicide
• Teen high-risk behaviors/ pregnancy
• High risk of being a victim of domestic violence
• Substance abuse
• Smoking/ COPD
• Unstable home/ family life
• Poor workplace performance
• Early death

America, on the whole, is not doing a great job of parenting. We are modeling behaviors that we wouldn’t want to see in our children. My ACE score is five and I developed 17 of over 30 possible symptoms related to sustained exposure to high levels of stress hormones. My migraines began when I was five years-old. The list began to grow and reached 17 of them by the time I was 37. Yet no physician could provide an answer or a treatment approach. All of symptoms have resolved. But that is not the message of this article. It was your parent’s responsibility to both protect and nurture you. Mine did not. What about yours? What kind of home environment are you currently  creating for your family?

Oak tree vs army barrack

One of my favorite personal metaphors is that of a large Valley Oak tree, which were abundant in Napa Valley, CA before there were so many vineyards. I view the role of parents of being the trunk of the tree, providing stability. One responsibility is for each member to continue to evolve through awareness and self-exploration, which creates deeper roots and emotional support. The first responsibility of parents is to each other and continuing to create a lasting stable and loving relationship. The expansive branches are the opportunities for all the individuals in the family to be creative and also be protected from the elements.

The opposite scenario is that of a military barrack. There is rigid order and unwavering expectation that every command will be immediately responded to. Nothing you can or will do will be “good enough.” If you don’t comply as deemed adequate by one of your superiors, you will be disciplined and often harshly. You may be made into an example. You can never let your guard down, especially in the presence of your officers. The list of demands is endless with an equally long range of possible consequences. Does any of this feel familiar? I don’t what percent of families have this framework as the reference point, but based on the ACE data, I would daresay that it is high. Is it any wonder that so many of us have this voice in our heads of, “Not good enough.” It can be deeply embedded in your brain and you can’t outrun your mind.

There several factors that result in a home that more resembles an army barrack than a spreading oak tree.

• It was the way you were raised and the way parenting was modeled.
• Everyone has anxiety and it is intended create control behavior. The more control you exert, the less anxiety. Since your family is dependent on you, they cannot easily escape from your need for control.
• You have labeled yourself as the parent and somehow you have a responsibility to “raise your child” properly. I read a book, Parent Effectiveness Training when my son was young and thank goodness I read it so early. The book had a major impact on my life. One core principle is that the label of “child” disappears, and it becomes a human-to-human interaction. Prior to reading it, my obsession was discipline and control and I was highly critical of “permissive parents.”
• All of these family issues are dramatically magnified if one or both parents are suffering from chronic mental or physical pain. You are trapped, angry, and awareness of other’s needs is blocked. It is the essence of abuse.

Awareness

All of the healing process begins with awareness of what is happening in the current moment. What is your family environment like now? Each half of the couple needs to write it down and compare notes. If you can’t have a civil conversation, then you already have your answer. Anger that is often front and center will also block constructive dialogue.

Moving forward

What kind of family life would you like to create? What is your vision. This step should be done as a couple.

How do you want to accomplish it and what is the timeline? What doesn’t work is waiting your pain to first resolve. Every day your family is encompassed by anger, it is damaging them.

Any and every person has the capacity to thrive and move forward when starting from a strong foundation based on love, support, laughter, safety, and play. Eventual successes will be more sustained. One is also able to enjoy life.

It has been known for decades that employees thrive in this kind of work environment. Why not allow your family to thrive?

1. Anda RF, et al. The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience (2006); 256: 174–186.

The post Do You Feel Safe in Your Own Home? first appeared on Back in Control.

The post Do You Feel Safe in Your Own Home? appeared first on Back in Control.

So I was driven beyond words to “prove myself” and worked extremely hard to become accomplished to fill this gap. I became “successful”. But the adrenaline drive that took me up the hill took me right back down the other side, ending up with a shattered life and a suicidal depression. No one on the outside could even sense the depth of the drive or the intense angst that propelled it. So how do you define “success”? With physician burnout approaching 60% across the board, this is becoming even a bigger question.

Amongst teens, this is also a significant problem in that social media makes it seem even more that everyone has a dream life; except that there is a huge increase in adolescent chronic pain, heroin use, suicide, and generalized unrest. There is a word, “FOMO” (fear of missing out) that encapsulates the situation.

My first clue that this perspective was a problem was when I read a book, The Art of Happiness based on the teachings of the Dali Lama. He pointed out how much more productive it was to compare yourself and your circumstances to those who were less fortunate than it was to think about what you didn’t have.

“Anxiety with Success”

I became aware of another pattern of thinking in the midst of my Hoffman process. It was experiencing “anxiety with success.” The Hoffman process presented an organized format, which allowed me to become aware of my embedded reactive behavioral patterns. It turns out that the success that I was working at so diligently, was creating intense anxiety. Talk about driving down the freeway of life in the wrong direction.

Why??

I was the oldest of four children in a household with a difficult mother who suffered from chronic pain. I was the problem-solver in the family beginning around seven years-old. The baseline state of our family was chaos. The Hoffman process taught me to diagram what they term is a vicious cycle. Here’s the sequence:

• Chaos (severe and my baseline state)
• Problem-solving/conflict resolution mode (strong role, especially for a child)
• Problem solved (I felt I had some power)
• Period of calm (anxiety ensued in that we didn’t know how long it would last)
• Need for chaos (my comfort zone)
• Chaos (back in action)

Self-Sabotage

I’ve had a lot of successes and also many failures. One pattern of behavior I hadn’t seen was that I’d have some success and then somehow I rarely followed through. Or I would get into a reactive mode and walk away from potentially major successes. I then spent a lot of time wondering what happened and then beating myself up. All of this was not only a waste of time, but consumed a lot of emotional energy.

When the behavioral pattern that emerged was that I had extreme “anxiety with success”, I was shocked. I had spent the major part of my waking hours trying to be successful in whatever I attempted, yet I was creating situations that caused intense anxiety. How could this be? I’ve since learned that this is a fairly common problem.

Gratitude

Becoming aware of this sequence allowed me to use the various tools in the DOC process to work through the parts of this vicious cycle. I wasn’t as effective at dealing with the “anxiety of success” as I was with other patterns. As I continued to work with my teacher, Kani Comstock, she pointed out something that allowed me to better enjoy my life. It was gratitude.

Enduring Pain

I have endured a lot and so have most of you. Chronic pain with all of its many layers isn’t a small problem. I got lucky in coming out of this hole. Eventually, I was able to figure out many factors that contributed what I feel was almost a miracle. Amongst many things in life I am grateful for, I’m happy to be able to share these concepts with you.

It Has Been Worth It

Although I have seen hundreds of patients become pain free, this isn’t a numbers game with me. Even if my life experience allowed just one of my patients to achieve a pain free state, it has all been worthwhile. Every time a patient comes in excited about their relief of pain, I’m still fascinated and somewhat in a state of disbelief. At my core, I’m a surgeon and I don’t understand all of the variables that cause this to happen. Not only do they become pain free, but also they rapidly begin to recreate the life that they had lost and go well beyond what they ever had. I’ve seen several patients have their spouses come back to them and create a thriving relationship. Many families are able to enjoy a much happier home life.

That I have been able to contribute to their healing is a gift to me that I never would have imagined possible.

Giving Back

The post Anxiety with Success first appeared on Back in Control.

The post Anxiety with Success appeared first on Back in Control.

So, when the patient’s partner is snippy, critical, or hostile, the patient tends to feel worse, too. The region of the brain that elicits a bad mood simply is stimulated. Conversely, if one partner is in a great mood, the other tends to be happier.

That is why—indirectly for my patients’ sake and directly for that of their partners—I believe it is vital that both partners learn tools such as expressive writing and adding more play into their lives, that enable them to live a joyful life.

Where is the support?

However, there may be an additional issue beneath the surface because it is remarkably difficult to convince other members of the household to engage in these tools. If you care for your family member, why would you not try to do as much as possible to help him or her heal? I ran across this article that partially explains why. Family members may not believe that a patient really is experiencing that much pain. It may be more common than I believed. Therefore, their compassion may understandably be limited.

Couple’s study

A multi-center published in 2013 (1) measured the following variables in 105 couples over two weeks:

• Patient’s pain
• Spouse’s observations of patient’s pain behaviors such as complaining, grimacing or grabbling.
• The patient’s perceived criticism or hostility from his or her partner

The following observations were made:

• Patient’s pain increased for over three hours when they felt hostility or were criticized.
• Patient’s observed pain behavior consistently created a negative reaction from their partner.
• These interactions were consistent. The assumption was that long-term low level negative interactions will erode relationships and quality of life.

This interaction is similar to what has been found in depression research. Depressed patients act in ways that cause rejection from others, which in turn exacerbates the depression.

There is no question that chronic pain is a family issue. The couples study does not even take into account the damage an angry person in chronic pain can inflict on his close relationships. The family unit can become a living hell and it can seem like a hopeless situation. But, like the patient’s condition, the family dynamic can get better, with the right tools. It did with me.

Pain = anger= abuse

Feeling Good Together

David Burns, MD is a Stanford psychiatrist and the author of Feeling Good. I attended his five-day seminar a few years ago where advanced Cognitive Behavioral Therapy (CBT) techniques were presented. One afternoon was devoted to relationships. He had been given a large advance to write a similar book applying (CBT) to relationships. He then used these techniques on 50 couples without any success. He returned the advance and went on a five-year quest to find out what was really going on. Subsequently, he wrote a second remarkable book called Feeling Good Together. One stunning insight from this book that hit me hard was that, when your partner acts in a way that upsets you, of course you want to blame him or her; but you are the one who set it up. It was your actions that caused your partner to react in a way that made you angry.

That insight had a major impact on my awareness of my own behavior—not just toward my wife, but in my relationships with everyone. However, I found it to be by far the hardest part of my journey. Whenever I feel upset as a result of something my spouse says or does, it still feels like it is she, not I, who caused the upset. It has taken me years to consider the effect my words and behavior have on others’ feelings. I still have a long way to go. It is unbelievably humbling.

Protect your family from your pain

The Marriage-go-round

How do you break the cycle of pain behavior, criticism from your partner, and more pain? Let’s face it: You have the choice whether to engage in pain behavior or not. At some level you must know that your partner is going to react negatively to it, but you do it anyway. When you feel the hostility and criticism from your partner, your pain increases. This is expected, since we know that stress chemicals increase the speed of nerve conduction, resulting in more pain. (2) Since there is seemingly no end to the pain, the cycle can continue for a long time. You’re already mad at your partner; why not continue to be irritating?

If endless conflict is damaging your whole family, consider it an opportunity to work through the solution together and come out stronger than ever before. The solution for chronic pain is not difficult once you understand the nature of the problem. It turns out—and I say this from experience—that anxiety and anger are the pain. Use the DOC tools to help you, your partner, and other family members to live a life you all cherish.

Listen to the Back in Control Radio podcast The Chronic Pain Marriage Go Round

1. Burns, JW, et al. Temporal associations between spouse criticism/ hostility and pain among patients with chronic pain: A within-couple daily diary study. Pain (2103); 154: 2715-2721.
2. Chen X, et al. “Stress enhances muscle nociceptor activity in the rat.” Neuroscience (2011); 185: 166-173

The post The Chronic Pain Marriage-Go-Round first appeared on Back in Control.

The post The Chronic Pain Marriage-Go-Round appeared first on Back in Control.

Larry’s Note

“It was only when I lay there on rotting prison concrete that I sensed within myself the first strings of good. Gradually it was disclosed to me that the line separating good and evil passes not through states, nor between classes and not between political parties either – but right through every human heart and through all human hearts . . . . . . .   Mike (the counselor) helped me nourish my soul there and I say without hesitation, “Bless you prison and Mike for having been in my life. I see the stars through the bars.”

Stanford Prison Experiment

I think all have us have wondered what we would do if we were in a situation where you were placed in a position of absolute power over other people. This TED talk by Phil Zimbardo reveals a chilling answer. It has been demonstrated in several experiments that circumstances dictate behavior more than who you are. He conducted a now famous Stanford Prison Experiment in 1972. He arbitrarily divided a group of young men into “prisoners” and “guards”. These were normal people as volunteers with mental health issues were screened out. The experiment began with the City Police “arresting” the “prisoners” and processing them into jail. The behavior of the “guards” rapidly became quite abusive. It deteriorated to the point where they halted the two-week experiment after only five days. Several of the volunteers had mental breakdowns.

Milgram experiment

He cites another famous social experiment performed by Stanley Milgram in 1963. Volunteers, who were the” teachers”, were asked to administer an electric shock to a “learner” who was administered an electric shock every time he or she missed a simple question. The study was presented as measuring the effectiveness of negative reinforcement on improving learning. It was really intended to find out how much “punishment” the volunteer teacher was willing to administer to the learner.

The “learner” was a researcher who simulated the verbal reaction of progressive “electric shocks”, which the he was not really receiving. However the volunteer “teacher” did think that he or she was actually administering the “punishment”. There was a scientist encouraging the “teacher” to keep pushing the button in spite of the loud screams of the “learner”. The original thoughts were that only a small percent of the volunteers would continue to push the buttons, but it turned out that 65% of them continued up into the “lethal range”. Nobody liked the outcome of this experiment since it was felt that only zealots and sociopaths would be the ones to act in this manner. It turns out that this potential behavior exists in all of us. The situational variables can be the more powerful influence on our behavior. It also turns out that power without accountability is a major factor.

One of Dr. Zimbardo’s quotes is, “The line between good and evil is permeable and almost anyone can be induced to cross it when pressured by situational forces.”

Dr. Zimbardo’s TED talk, The Psychology of Evil

Your family

In a family situation there is little accountability for bad behavior. What is even more problematic that anger, which is universal in chronic pain, clouds your awareness of the impact of anger on those close to you. Many if not most people that are angry are not even aware that there is a problem. The essence of abuse is lack of awareness. Anger is the antithesis of awareness and is abusive. It is present in every human being and you have to first be aware of it before you can address it. Unfortunately, those who are the most vulnerable suffer the most from since they are easy targets. Pain=Anger=Abuse

I often ask my patients to ask his or her family members what it is like for them when he or she is angry. Is your family excited to see you walk through the door or are they afraid of what might erupt. Invariably they return quite shaken up. I do not have the time or expertise to get into the details. My strong advice is to simply, “Stop it.” There are no excuses or shortcuts on this one. Anger is irrational and destructive. I also ask them to create a detailed action plan of what all the members of the family can do when the anger erupts.

I also ask my patients to not give any unasked for advice to his or her spouse or children for a month. Only listen. Everyone’s eye’s widen. I will admit that this is difficult and I also struggle with this one. Just listen. It is where awareness begins. BTW, it is much more interesting. Protect Your Family from Your Pain

Good and evil are in all of us

 As well-intentioned and good of a person you might be all of us have the potential to be abusive. The combination of anger, power over your family and little accountability is similar to that which was created in these experiments. Do you want your household to be a haven or hell? It is completely your choice.

The Way to Love by Anthony DeMello

The post “Stars Through the Bars” first appeared on Back in Control.

The post “Stars Through the Bars” appeared first on Back in Control.

I have been aware that many partners remain noticeably silent during my interviews with the patient. At the end of the visit I assign homework. The first step is to have my patient learn about chronic pain. I give them a copy of my book or suggest that they read any book that they might prefer. I schedule a repeat visit within a few weeks to discuss the concepts and develop a plan.

I will also ask his or her partner to learn about pain and fully engage in the DOC project. “If you don’t have chronic pain, just use the word ‘stress’ or ‘anxiety.” I point  out that it would be beneficial for them personally to immerse themselves in the concepts. The tools are excellent stress management technique

The benefits to the patient

But the main reason I ask his or her partner to fully engage is that there is a neurological phenomenon of mirror neurons. Actions and words directly stimulate similar parts of the other’s brain. For example, when you smile at a baby he or she will usually smile back. It is not because the baby is happy. The smiling center of the baby’s brain was stimulated. It is a similar process when a person’s laugh will usually cause others to laugh – even though they have no idea what they are laughing at.

I then ask my patient’s partner the question, “What is your day like when your partner is having a bad day?” The response is uniformly, “Bad.” I point out that what do you think your partner’s day is like when you are upset. Many have not thought about that possibility. Maybe they are ruining the day for him or her? I explain that this is not a psychological phenomenon but it is neurological through the mirror neuron effect. Conversely, if he or she is also healing and growing it will stimulate the healthier parts of their partner’s brain. I have long observed that couples who both participate benefit greatly.

In spite of my being as clear (blunt) as I can, it is rare that a partner will engage without me nagging three or four times and even then they resist. This is often true even when they observe their partner experiencing dramatic healing. Why?

Why won’t partners engage?

I just have some thoughts. Based on my personal experience being raised by a mother in chronic pain it is clear that the person in pain has a lot of power within the family. My mother was endlessly angry and was physically and emotionally abusive. She also always got her way – regardless of the consequences. Anytime she was challenged she retreated to her room because she did not feel well. Her pain and behavior would delay and destroy simple family events. She felt she had the right to lash out at anyone anytime she wanted to. Pain=Anger=Abuse

No matter how committed a partner might be it is very difficult to live with someone in pain. How could you not be resentful? Although you might consciously want your partner to feel better, I am guessing that there might be some deep, buried feelings that would block supportive action.

What needs are being met?

Chronic pain is also a complex family issue in that to remain together as a couple there must be needs that are being met by their partner being ill.   Do they have an unconscious need to be controlled? Has he or she been abused in the past and it is a familiar pattern? If a person in a family gets better then it calls the others out. They have lost some of their own excuses not to heal. I have witnessed patients improve, even for a few years, get pulled back into the disabled role by intense family pressure. Breaking Loose – Not Quite

Dr. Bernie Siegel’s Observations

I have enjoyed getting to know and work with Dr. Siegel, who is a surgeon and author of several books, including Love, Medicine and Miracles. He has taught me a lot about human nature and has helped many people with serious diseases tap into their own healing powers. He has some insights into the family dynamics around pain.

“If I don’t have my pain how do I get attention?”

SIEGEL’S SIGN

When everyone in the family looks worn or ill and one person doesn’t guess who has the ‘pain’.”

“One family told me they hired a nurse for their sick sister and she would wake them up at night and let the nurse sleep. Also I guaranteed her a cure at her next office visit and privately told the family to watch what happens. She never returned to the office but would meet me in the ER now and then for help.”

It has become clear to me that many people don’t want to give up their pain. Even though they are still truly suffering, they somehow become addicted to power of it and the ability to retain the attention of the whole family. There is also the trend for a family member to assume the identity of a caretaker to the point of neglecting his or her own needs.

Are you really willing to give up the power of your pain? It is anxiety-producing to give up lifelong behavioral patterns? You might be one of the people I have asked to help out with healing my patient and your life partner. How serious are you about really wanting him or her to experience a rich and full life? Could you be the person who is having some your needs met by taking care of someone who is disabled? Most of this occurs at a deep unconscious level. I am encouraging you to take a good look at your family dynamics. The fact you are reading this post is a good start.

The Crab Bucket 

The post Pain Rules the Roost first appeared on Back in Control.

The post Pain Rules the Roost appeared first on Back in Control.

The rhetoric

Some of the historical rhetoric used around bullying as included:

• “We just don’t have the resources to monitor everyone.”
• “Defending yourself is a part of growing up.”
• “It is important to learn to stand up for yourself.”
• “Kids will be kids.”

In defense of the teachers, schools are understaffed and teachers are overworked. Much of this behavior occurs at a level that is impossible to monitor. Fortunately, this conversation is changing.

Schools versus prison

From the perspective of the person being constantly bullied at school, it can be compared to serving prison time. You spend much of your awake time in a place you hate and you aren’t allowed to leave; the authority commanding you to stay in this desperate place does’t have adequate systems in place to protect you from the relentless attacks of your peers.

BTW, even prison can be a place of learning. This is a commentary that prison doesn’t have to be the way it is in the United States. Norway is far ahead of the US regarding the way they treat their prisoners. This video was sent to me by one of my friends from the Charter for Compassion.

Rite of passage?

There is an ill-defined mindset that seems to suggest that attending school is where you become “socialized”.  Enduring bullying results in dysfunctional survival skills. I wonder what percentage of patients suffering from chronic pain were bullied during their teen years.

Bullies are cowards. They are amongst the most insecure anxiety-ridden people on the planet. Their anger is an attempt to mask their vulnerability and helplessness, to regain a feeling of power and control. The angry bully is so anxious and scared that he’ll inflict wanton violence on the physically weak to hide his own anxiety. The bigger the bully, the more anxiety he or she is trying to cover up. Humans hate the feeling of anxiety so much that they will do anything possible to avoid it. It’s no accident that the weakest of the crowd often gets picked on the most. The weak remind bullies of what they are trying to run from—their own vulnerability. On the other hand though, bullies hate the secure and self-assured. It is a grim reminder of who they are not.

All this being said, I have tremendous compassion for bullies.

• They can’t face their own anxiety and vulnerability.
• They cannot experience any meaningful depth of relationships—especially long-term.
• There is a lot of noise and chaos in their brains.
• There is a high chance that their home is probably not overflowing with peace and love.
• They must be hyper-vigilant to maintain their power.

It’s not a great life.

Can’t give it up

It is also difficult to break out of the bullying pattern. It is powerful and addicting. Why would bullies want to give it up? Since the bullies are not going to willingly give up their power, the only short-term choice is to face it with power. There can be no tolerance of this behavior by anyone at any level at any time. Even if we cannot change the bully, we must protect the classmates that are being permanently injured by this incredibly cowardly behavior. Fellow classmates are a potential resource to stop the abuse. Addressing the root cause of unrelenting anxiety is the longer-term solution.

Pain and your family

I wrote a post, “Pain = Anger = Abuse.” The main point of the article was that while you are angry, you are detached from the current reality immediately in front of you. You do not have any awareness of the needs of those who are close to you. It is this lack of awareness that is the essence of abuse. Unfortunately, chronic pain creates a lot of legitimate anxiety and anger. The chronic nature of it makes it much worse and often patients are essentially in a rage. In that state of mind, it is almost impossible not to be abusive. (For more on the connection between anxiety and anger, check out “Your Hand Stuck Over the Stove”).

During my Hoffman Process, I learned that your family’s behavioral patterns and attitudes are passed down to you. For the first 12 years of your life, you are downloading your family patterns into your own behavior. You don’t have much say in the behavioral influences the get etched into your brain. From that point on, these behavioral patterns are your data base. The rest of your life is spent either adopting or rejecting these patterns. Consequently, your children are a direct reflection of you. Is your child is a bully? If so, where did he or she learn that behavior? Is there a chance he or she learned it from you, your partner, or both.

Maybe your child is a bully and you don’t even recognize it, because aggressive bullying behavior is normal behavior to you. Were you a bully in middle school or high school? Bullying behavior does not spontaneously disappear. It often just takes on different forms. What is your behavior like now? Are you willing to look at it?

“Cool Kid”

This video is a parody of the recent Justin Bieber video, “Boyfriend.” It was created by my nephew and is titled, “Cool Kid.” It is a well-done commentary reflecting the views of many students trapped in our school system.

Bullying is deeply woven into the fabric of chronic pain. It is each person’s challenge and responsibility to define and face up to his or her role in this pervasive problem.

The post School or Prison – What’s the Difference? first appeared on Back in Control.

The post School or Prison – What’s the Difference? appeared first on Back in Control.

Chronic pain is dangerous. When you are trapped by anything in life, especially pain, you’ll become angry. When you’re angry, everything is completely about you and your efforts to escape. You can no longer see the needs of those around you, much less respond to them. The essence of abuse is being unaware. Anger destroys awareness to the point that you can’t recognize your unawareness. Pain = anger = abuse

“But I would never be abusive”

You might not like hearing the word “abusive” even mentioned, much less think that it might in some way apply to you. There are many barriers to waking up to the possibility that the word does pertain to you.

• The most common barrier is this: many people are so used to being “frustrated” that negative emotions become a baseline. These people cannot perceive themselves as angry. For them, their anger is just a normal state to be in.
  • In the world of chronic pain, frustration and anger are synonyms. However, frustration is anger.
  • When you are upset, you feel so right that you cannot imagine someone not seeing your viewpoint. However, your anger blocks you from seeing the perspective of others.
    • This is particularly true when you are dealing with your children.

Chronic pain doesn’t elicit peace and joy

Everyone with significant chronic pain is angry. It is only a matter of how connected you allow yourself to be with your anger. If you are finding yourself upset this very moment while reading this, then this statement particularly applies to you.

I have seen hundreds of patients become pain free, and it doesn’t really happen until anger is acknowledged and addressed.

• Anger and pain are linked neurological circuits.
• They feed off of each other

I recognize abuse daily

For many years, I never put pain and abuse in the same sentence. I didn’t see the link. Now, it’s more than clear.

• Almost every time I mention how difficult it must be to live with someone in chronic pain, the patient’s spouse begins to involuntarily nod.
  • Many start crying.
  • I ask my patients to think about what it must be like for their children when they’re angry. They invariably get a wide-eyed look and take a deep breath.
  • I watch patients snap at their children in clinic. They seem to think it’s OK.

You won’t be able to see your own abuse

Few people wake up in the morning and think about the ways they can make their families miserable. Even those who are making their families unhappy, don’t realize they’re doing so. They are too busy thinking about themselves to notice. If you are in significant chronic pain, you can only partially see the needs of those around you. You have to make some stopgap rules. Here are some that I have suggested with some success.

The family rules of anger

1) When you’re upset, just disengage.

• Stop and take your own “time-out.”
• No relationship is improved with interactions based on anger–EVER!
• Have a family meeting and ask your children and spouse/significant other what it’s like to be around you when you are angry.
  • The answers aren’t pleasant.

2) The apologies later don’t work or make up for anything.

• Ask your family.

3) Imagine that you are your child watching you walk through the front door after just having an argument with your boss or claims examiner.

• Would you be excited or full of dread?

4) How attractive is your partner when he or she is angry? Compare that to when they are smiling.

• So how attractive do you think you look when you are upset?
• ANGER ISN’T ATTRACTIVE!

5) Listen–only listen for at least a month.

• Do not give ANY advice to your children or partner for at least a month.
• It should preferably last indefinitely.
• Advice should only be given when asked for.

6) Your opinion of your children’s “values” is not helpful.

• Find out who they are.
• They are more interesting than you think.

7) Make a commitment to be a source of inspiration and joy to your family–not a nightmare.

• Your family dynamic will change within weeks.

Don’t delay taking action

Anger is a major family problem. You love your family and the last people you would want to hurt would be them. Yet when you are angry, you are destroying them.

Not only do love your family but you also need their support. Don’t drive them away.

Protect them from your pain—NOW!

BF

The post Protect Your Family from Your Pain first appeared on Back in Control.

The post Protect Your Family from Your Pain appeared first on Back in Control.

People of the Lie

I read a book during my late teens that shed some light on my mother’s behavior. It is a brilliant book by Scott Peck called People of the Lie. The book begins with the story of a 12 year-old boy who has a near-psychotic break after being given a 22-caliber rifle for Christmas. His parents were confused because they felt that they were making a positive statement to him. Their son was entering his teen years and they wanted to send him the message that they trusted him enough to give him as big a responsibility as owning a gun. The problem was that it was the same gun his 15 year-old brother used to commit suicide the prior Christmas.

The Essence of Abuse

The essence of abuse is being unaware of another person’s needs. If you are consumed by anxiety and just trying to keep your head above water, there is a high chance you are unable to view a given situation through another person’s eyes.

This is taken a step further with regards to anger. When you are angry, you cannot see anything clearly. It is truly all about you. Anger is temporary insanity, and it is dangerous to interact with people or make decisions in that state of mind. When you are experiencing chronic pain, you are frustrated and angry much of the time. You have a legitimate gripe in that your basic need to be pain-free is not being met. Maslow’s miss You feel the world, including your family, owes you something. You feel justified when you vent your anger whether it is directed at someone or just expressed.

Your Family’s Perspective

It is becoming increasingly clear that chronic pain is a major family issue. Its effect on a family is usually devastating and I frequently bring the topic up in clinic. Rarely, do I have people disagree with my statement, “Chronic pain is disruptive and is rough on your family. Family members in the room invariably begin to nod their heads. It is like a dark cloud over the household. I ask them if they love their family and the answer is always, “Of course.” Then I ask them if they snap at their family when they are upset. You can guess the answer. I point out to them that everyone has a choice of creating a safe haven for themselves at home. If you are upset, why would your family be a target. They are the least logical choice.

How do you think your children or partner perceives your mood and actions?  You are frustrated because you have lost control of the pain and your life. How much control do you think a five-year old has when you are angry or in a rage after yet again being disappointed by the medical world or beat up by the worker’s comp system? Pain Rules the Roost

You may not perceive your actions as abusive. I guarantee you, it is abuse.

Rules of Engagement

I ask my patients as part of their healing process to ask their family what it is like to be around them when they are upset?  I ask them to visualize scenarios from the receiving parties eyes. The answers are not pretty.

I also ask my patients to never talk to their family when they are upset. They have to go to another room or leave the house. They cannot re-engage until they have calmed down. You cannot suppress or control anger. But you don’t have to become a living weapon. Anger must be dealt with using one of the strategies that have been presented in other parts of this web site. Protect Your Family from Your Pain

One homework assignment I ask a family to do on their way home from my visit is to recall a time in their relationship that was full of happiness and joy. Their eyes widen when they realize that they have not connected with that energy for a long time. They are to recall as much detail as they can about that era and then I ask them to work immediately on creating that environment. Their pain is not the family’s problem.

Then I point out one of the basic rules of healing from pain to never share their pain with anyone – ever. The moment they walk out the door they will never complain about pain. You can just feel the relief in the partner, spouse or child within seconds. Your family member cannot help you and they will become frustrated. Besides, your pain is not that interesting of a subject. Do you really enjoy discussing your pain compared to discussing an interesting topic or learning new ideas? How interesting are you to your friends and family when you not only continue to talk about your pain but do it over and over again. Just stop it – now. You are only reinforcing the pain pathways. The chronic pain marriage-go-round

Many people, including me, are addicted to the power of pain and simply do not want to give it up. You are probably not the one reading this post but it is important to understand how powerful pain is. No one, at the end of the day, really wants to give it up. It is only solved by remaining aware of its effect on you and how if affects others. The clearest delineation of this tendency is outlined by Anthony DeMello in his book, The Way to Love. He defines love as awareness and anger blocks it – completely. My victim/ anger pathways run deep and I read a few pages of this book every week. It has taken me a while to accept that these are permanent pathways and the only logical answer is to commit to remaining aware of when they are triggered. I have learned to come out of the Abyss more quickly.

Wake up! There are 116 million of you in the US suffering from chronic pain. That is one in three. If you consider the effect your pain is having on your family, the numbers of people affected have to be well over half of the population.

The post Pain = Anger = Abuse first appeared on Back in Control.

The post Pain = Anger = Abuse appeared first on Back in Control.