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.

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

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

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

Not fixing yourself

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

Good Studio/AdobeStock

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

“Phantom Brain Pain”

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

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

“I give up”

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

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

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

Hope

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

ipopba.AdobeStock

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

References

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

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

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

Feeling safe

The DOC Journey is based on our three and five-day workshops that we have held since 2013. From the beginning we were amazed how many people would break free of their pain within time frame of the workshop. We always warned them that they would dive back into The Abyss when they returned home to their “triggers.” But somehow they had reconnected to the part of their nervous system that was safe and relaxed. Once they tasted that deep sense of peace and connection, they had a sense of what was possible. They would learn their own ways to return to that state. Many moved on to a life they had never before experienced.

I had not expected such a response and did not understand what had happened. But every workshop was a similar experience. I finally concluded that I wasn’t doing that much, but the shift was because people were learning and sharing enjoyable experiences in a structured and safe environment. Several participants described it as being in an adult summer camp.

Research shows us that loneliness causes many physical symptoms including chronic pain and, of course, being in pain is isolating. (1) Social connection is a deep basic human need and the foundation of how we developed language and human consciousness. It is tragic that over 50% of Americans are lonely and socially isolated. (2) Social isolation is crushing to your soul.

Characteristics of success

There is never an exact answer to a given person’s specific situation, since each one of us is so unique. However, there are some patterns that have emerged in patients who have done well.

• Back in Control: A Surgeon’s Roadmap Out of Chronic Pain provides a foundation and framework for moving forward.
• The sequence of learning is critical in that you have to understand the nature and parts of a problem before you can solve it.
• You can’t move forward until you have broken the links to the past.
• It is critical to implement the strategies that work the best for you into your day-to-day life. They are not difficult, but just passive learning doesn’t work.
• Re-engaging with friends, family, and your community is a powerful aspect of healing.

All these variables are important. Chronic pain is a complex problem and simplistic isolated treatments can’t and don’t work.

Our online Q&A

What I again did not anticipate was how effectively a community could be created online. It almost seems have had more impact than our in-person workshops. Here is one participant’s email.

The Q&A sessions I attend 2x per week are such an important part of my support system as I’ve started navigating The DOC Journey. I’ve suffered with chronic pain for over three years, and after two spine surgeries that provided no relief of my symptoms, I felt very alone and confused. I found this special community during a time when I felt little hope, and I know the timing was providential. As I process my journey with others that understand what I’m going through, I am able to give and receive support and encouragement, along with obtaining many tools that are making a significant difference in how I am able to show up in my life. This community is something I will always be grateful for!

Overview of the sessions

The Q&A format is a powerful force in creating change. We know that human connection is essential for health and that being socially isolated has detrimental effects on your health. One of the consequences is chronic pain. There are other manifestations and the effects are estimated to be equivalent to smoking 3/4 of a pack of cigarettes per day. (2)

Rules of Engagement

Much of the effectiveness of The DOC Journey is stimulating the formation of new circuits in your brain that bypass those that are creating pain. Your brain will develop wherever you place your attention and one of the reasons that any patient of mine was never allowed to EVER discuss his or her pain with ANYONE except their medical providers.

• The cardinal rule of participating in this group is never discussing your pain or medical care – even if asked.
• Ask yourself what you can do to be of help to others on the Q&A.
  • Specifically, please be mindful that each person in the small group breakouts of 3-4 has a chance to share.
• Understand the concept of mirror neurons-your mood has a direct mirror neuron effect on others. The term is called “co-regulation.” (3)
  • I have personally found that a little expressive writing, active meditation, or breathing exercises before the session is a big help if I am a bit out of sorts.
• Although your participation with comments and questions is welcomed, please don’t feel obligated. We want you to feel comfortable with the group.
• The sessions are intended to deepen your skills and answer questions. It is not focused on teaching. Reading my book, Back in Control: A Surgeon’s Roadmap Out of Chronic Pain will provide the framework for you to move forward.
• The DOC (Direct your Own Care) Journey provides a sequence that will keep you moving forward and it is based on our workshops. The sequence is:

• • Awareness
  • Hope
  • Forgiveness
  • Play

Meeting Agenda

• 11:50 – noon – Informal discussion/ catching up
• 12:00-12:05 – Relaxation exercise
• 12:05 to 12:15 – Didactic session/Sharing successes and challenges
• 12:15 to 12:30 – Open discussion and questions
• 12:30 – 12:50 – Small group breakout sessions – discussions will be based that day’s topic or what may have been brought up in the sharing session.
• 12:50 to 1:00 – Closing discussion

I will be prompt regarding time and will stop the didactic/ sharing at 12:15 – 12:20 and we will begin the open discussion. Please email me at dnhanscom@gmail.com with questions you’d like addressed or if you would like to share your perspective. You don’t have to be pain free to share. Small victories are the key to all of this. We would like to find out what you have found useful.

Letting go

The DOC Journey is a paradoxical one at almost every step. Repeated conversations are helpful in learning to process your environment in a different manner. Hearing about other approaches is helpful, but the best part is sharing your challenges and success with others.

References:

1. Cacioppo, John and William Patrick. Loneliness: The Need for Social Connection. Norton, New York, NY, 2008.
2. Cigna US Loneliness Index 2018. Report published by Cigna Insurance Company.
3. Porges, Stephen. The Polyvagal Theory. Norton, New York, NY, 2011.

The post People – The Most Powerful Part of The DOC Journey first appeared on Back in Control.

The post People – The Most Powerful Part of The DOC Journey appeared first on Back in Control.

In August of 2013 I put on a 5-day workshop at the Omega institute in Rhinebeck, NY with 11 participants. The other two faculty were Dr. Fred Luskin from Stanford and my wife, Babs Yohai, who is a professional performer (tap dancer). We designed it to address many variables that affect the perception of chronic pain.

One antidote for anxiety is structure. As pain induces relentless anxiety we created a tightly scheduled structure. We presented videos of patients who had healed, bringing hope into the equation. Major emphasis was placed on forgiveness presented by Dr. Fred Luskin, author of Forgive for Good. The frustration around chronic pain disconnects us from others and ourselves. You cannot move forward until you can let go.

Social isolation

The factor that we wanted to most address was the problem of social isolation. I have long-witnessed that most of my patients in chronic pain become socially isolated. It is difficult to want to be with other people when you are miserable. Unfortunately you then have more time to think about your pain and really etch in the pain pathways. It is somewhat of a disaster.

“The Cup Song”

The participants were paired a partner for the week. We spent time sharing past experiences and remembering who we really were. Bab’s role turned out to be one of the more important one in that she took us through many somatic exercises, including several hand rhythms. The most enjoyable one was, The Cup Song.

We all struggled, especially me. We began to laugh and the whole mood of a bunch of adults struggling with “The Cup Song” began to change. By the middle of the week many people began to experience less pain. A year later at least half of the group that we have kept in touch with has continued to do well.

A letter from a participant

This is a letter from one of the participants who initially struggled and continued to struggle for a while. I wasn’t sure which way he would go. He is a remarkably nice person and was a major factor in the success of the week. He had the courage to stand up and share his new interest in learning the xylophone – except he had not yet learned to play it. The fact that he was willing to be vulnerable at that level instantly changed the feel of the whole room. On Wednesday evening he recited three poems, again helping all of us feel more comfortable sharing.

Here is his letter and new poem about one year after the workshop:

I haven’t the language of emotion! I never learned it. I haven’t learned it, yet. I think this may have something to do with my block in writing down thoughts, too. If this is an accurate assessment, I think the whole poetry thing is a good prescription.

Amadinda – after James Wright, author of “A Blessing”

Just off the path through the porch of my house

Stands a xylophone.

Crafted from 2 x 4 lumber.

The keys rest on a rope sling

Like a hammock.

Sliding two red mallets from the holder

I stand with hands hovering

Anticipating inspiration.

If the music inside me ever gets out

I will burst into blossom.

A remarkable experience

We held a second Omega seminar in August of 2014 with 20 participants. Again we witnessed many stunning turnarounds in a short period of time. Others are gradually figuring it out.

What we learned is that the workshop is not a formula. It is a structured environment where people could learn, relax, open up, and connect. In the end it is people that heal each other.

The post Ready to Blossom – Omega 13 first appeared on Back in Control.

The post Ready to Blossom – Omega 13 appeared first on Back in Control.