Anger is the body’s effort to regain control of a situation that you perceive as threat. It’s the most basic of survival reactions. It is only about your survival and by definition is destructive. In an enraged state of mind, you’ll do whatever it takes to take care of yourself. It doesn’t matter whether the danger is real or perceived because your body’s neurochemical reaction is the same – adrenaline, cortisol, histamines and other stress chemicals. In addition to the many physical reactions to these hormones (rapid heart rate and breathing, sweating, widened pupils, etc.), they also decrease the blood supply to the frontal lobe of your brain. You can’t think clearly or see options when you’re trying to “escape.” Many acts of aggression and violence, if not most, occur while in this state of mind. It is truly temporary insanity and it’s dangerous.

Steve’s story

This situation was highlighted to me by a friend of mine, Steve, who is about my age. We were discussing the pros and cons of gun control. He told me a chilling story that occurred while he was in his early twenties and recently married.

At the time, he felt strongly that it was important to keep a gun in the house not only to protect himself, but also his new wife. He was comfortable with guns and knew all the safety rules. His wife had equally intense feelings about not having firearms in the house.

They had been out for the evening a few weeks earlier at a bar. An acquaintance of hers started to talk to them and became somewhat inappropriate in his comments. She and Steve left early to avoid an impending confrontation. There didn’t seem to be much more to it.

Two weeks later, this “acquaintance” knocked on Steve’s door and asked to speak to his wife. That was the last straw for him. They began to exchange some harsh words and Steve, according to his account, “lost it.” He went running to the bedroom to get the gun and settle this once and for all. He said the jealous rage that hit him was indescribable. He fully intended to finish this guy off – except that his wife had hidden the gun. It still wasn’t a pretty ending, but it was game-over as far as using a gun. He was able to regain his senses enough in the few minutes of searching for the weapon, that he figured this was going to be a really bad idea.

The next 40 years

Forty years later, he and his wife have raised a beautiful family. He owns his own business and enjoys talking about the Golden State Warriors with us. There is no question in his mind that he came extremely close to spending those years in prison.

Each person’s world is defined by his or her nervous system taking in sensations from all the different receptors (eyes, ears, skin, nose, etc.), unscrambling the signals and defining reality. There’s nothing inherent in your eyes that defines that a chair is a chair or a lamp is a lamp.  For example, if you have a stroke in the vision center of your brain (occipital lobe), you’ll be completely blind although your eyes work perfectly fine. Humans have a serious problem of consciousness in that thoughts and belief systems become embedded in our brains the same way as any other object. They are as real to you as that chair. Clearly, actions taken in response to upsetting thoughts are real.

Connected to the past

When you’re anxious or angry, your brain just connected with some unpleasant experience in the past and your nervous system is saying, “Danger – take action – now.” Rational thinking isn’t part of this reaction and things happen quickly.

It’s critical not to suppress the reaction because it fires your body up even more. Over time, people become ill from the sustained chemical assault of stress hormones. So, if you experience anger, it’s a problem and suppressing it is even worse. What do you do?

“No action in a reaction.” You must allow yourself to feel the upsetting feelings and emotions and then discipline yourself never to engage with anyone or anything when you are in this state of mind – ever. It’s tough because the reactions are so strong and there’s never an endpoint where you’ll cease to be angry. You will fail at different levels, but the skill improves with time and repetition. The key is to create some “space” between the perceived threat and the automatic survival reaction. In that “space,” you can choose a different and more appropriate response. Your brain changes structure and shape every second (neuroplasticity) and eventually the automatic reaction will be more appropriate. Here is one approach called, “5-3-2.”

Steve was lucky. His wife hiding the gun gave him that “space”, which was not having access to the gun. He was able to calm down enough to resolve the situation. When you’re angry, it doesn’t matter what your mental health is. You’ll act in a self-protective manner regardless of the costs. Steve is about as good-hearted of a person as you’ll ever meet. Having him spend his life in prison (or anyone’s life) based on a 15-minute reaction isn’t logical.

Guns are just one manifestation of anger in action

Decreasing gun violence by improving society’s mental health is missing the mark. The topic is complicated but the discussion regarding solutions needs to center on the fact the anyone can have an irrational reaction in a fit of rage. Steve wasn’t mentally ill and this situation could happen to any of us. Forget about guns for a second. What about the levels of verbal, sexual and physical abuse that are so common in American families? It intellectually doesn’t make sense to treat those you love so aggressively, yet abuse is rampant in our educated modern society. Gun violence is just one manifestation and is the tip of the iceberg. Anger is the driving force and needs to come to the forefront of any discussion about violence and abuse.

The person who is a “cold-blooded killer” represents a different scenario. People in this category are defined as sociopaths or psychopaths.  Although the killer may have global anger at some perceived societal or racial wrong, the actual act doesn’t usually occur in a fit of rage. However, this scenario represents a sustained state of anger where these thinking patterns become embedded in the brain and become stronger over time. It becomes the lens that life is viewed through and eventually their version of reality. At some tipping point, taking action is almost inevitable.

The bottom-line is that anyone can make a huge mistake in a fit of anger and immediate access to a weapon magnifies the impact. Everyone is so busy defending their positions around firearms, that the root cause issues aren’t being discussed. Any form of violence, especially within the family, is a major public health issue. Is inflicting daily abuse on someone who is dependent on you a less of problem than using a gun?

It’s important to be aware of when you are angry and NOT suppress it, but also understand the dangers of it.  Learn to “be with your pain” and resolve to take no action when you’re in a reaction. Steve happened to have “space” created for him at the moment. It’s important to learn how to quickly create your own space any time you’re upset before you act. We’re happy that Steve is around and that we are able to enjoy spending time with him.

Anger is universal, an automatic survival reaction emanating from our powerful unconscious brain that we have no control over. However, we do have a choice of how we respond to and it is a learned skill set. The solutions are straightforward, easily learned, and can be implemented from a public health perspective. We need to get our society’s brains back “online” soon.

The post Gun Violence – No Action in a Reaction first appeared on Back in Control.

The post Gun Violence – No Action in a Reaction appeared first on Back in Control.

Disneyland

While in medical school, I was at Disneyland with several of my friends. I had been there many times and one of my favorite rides was “Pirates of the Caribbean”. I enjoyed the music, art, and the general excitement of it all. The sensation of quickly sliding down to the next level in a boat was also a lot of fun. For some reason, I suddenly looked at the pirate scenes more closely.

“Pirates of the Caribbean”

As we entered the large room with a captured ship, there was a terrified bound woman getting ready to walk the gangplank. Behind her, several pirates were gleefully observing while getting the next victim ready. The scene of the captured town in flames showed a group of young frightened women on a platform being auctioned off to the highest bidder. Three or four women were being chased around the burning buildings attempting to escape their pirate pursuers. Several pirates were lying on the ground drunk, disinterestedly watching the whole scene. Another prisoner was trapped in a burning jail cell trying to persuade a dog to come closer, as the dog had the keys to the cell in his mouth.

We entered the main pirate’s lotto, which had piles of loot scattered everywhere. There lay the drunken captain, lounging in the midst of it. Many personal items were depicted in the middle of the mass of treasures.

“Pirate’s Cove”

Many years ago, I was in New England on a family vacation. We were playing miniature golf at a “Pirate’s Cove”. I looked up and there was a cage that housed prisoners until they starved to death. On each hole there was a continuing story about Captain Blackbeard. Part of the tale involved his marriage to his 12^th wife who was 16 years old. The governor of the state attended the wedding, as it was a major societal event.

Why?

What is it about pirates that we admire and romanticize so much? What characteristics should we embrace? The aspect I find particularly disturbing is that their terror is guised under the cloak of light fun and entertainment. This exposure begins in childhood for essentially all of us.

They rob at will. They not only just kill their victims, they often use perverse methods of torturing them to death. What is admirable about raping and selling women and children? The prisoner potentially being burned alive did not seem much of a concern to them. Why did the governor of a Southern State attend the marriage of a brutal older man to an underage girl? Why did I need to learn about that story while enjoying an evening of miniature golf with my family? Society has frowned on divorce for centuries. What about 12 marriages?

Do we admire what the Nazis did to their prisoners? Are their unspeakable deeds minimized in children’s rides or miniature golf courses?

My relative as a pirate prisoner

In the late 1700’s, I had a distant relative who was captured by pirates. My genealogist brother researched the story. He was one of 30 prisoners that were allowed to live, but they were enslaved. The conditions were so harsh that after three years only three were left alive. Thomas Jefferson finally paid his ransom. He was so brutally treated that he was disabled for the rest of his life. He passed away a few years after his ordeal. Another entire Hanscom family was murdered in a different pirate raid.

Packaging evil deeds in fun – normalizing abuse

It’s my feeling that when horrible deeds are packaged and presented in a way that minimizes the severity of their effect, it has a corrosive effect on who we are as humans. It becomes easier to ignore things around us that are unacceptable. Verbal abuse would be one of those amongst an infinite list.

Might this be confusing for children? They are taught to treat those around them with respect, yet simultaneously are being presented with the idea that being a pirate would be somewhat of the ultimate dream – freedom to do whatever you want to whomever you want without consequences.

I have worked with a medical system in Alaska that provides high quality medical care to a population of Native American Indians. They have recognized that abuse of any kind is detrimental to one’s health and the data is clear that an abusive upbringing is associated with poor mental and physical health. They have committed to eliminating abuse within this generation and have developed a remarkable infrastructure to address the problem. Several of the programs are focused on victims telling their stories. What I had not realized was the severity of the abuse and it is so common that in many villages it is the norm. The population had become de-sensitized to the problem although they weren’t de-sensitized to the suffering. It’s a terrible cycle. Bringing the abuse into awareness through telling their stories has been a major step in defining the problem and solutions are being implemented. Awareness is always the first step in solving a problem in any domain.

Aced out

Awareness of suffering

I have become acutely aware of my own suffering and those around me. It was a rough experience that brought me to this awareness. It is now clear to me how violence mixed with entertainment contributed to my inability to really appreciate the depth of others’ pain. Do you find pirate tales and violent movies entertaining? I did for much of my life.

Chronic pain is misery that is endless. Put yourself in the shoes of those poor pirate prisoners and imagine how they must have felt. Consider the suffering of other people around you who are in chronic pain. There are plenty. In the U.S. alone there are over 100 million people in chronic pain.

Awareness

The first step of reprogramming your nervous system is awareness. There’s nothing noble about pirates or the suffering they inflict. Become aware of how becoming desensitized affects your connection to the pain of those around you. If we are to evolve, issues such as these must be addressed both individually and as a society. Calling out the damage inflicted by packaging bad behavior under the guise of entertainment would be a significant concrete step.

The post Romanticizing Pirates – Normalizing Suffering and Abuse first appeared on Back in Control.

The post Romanticizing Pirates – Normalizing Suffering and Abuse appeared first on Back in Control.

Power

Many patients have no interest in giving up their pain. Being a victim is a powerful role – and for many is synonymous with love. Some of the reasons to remain a victim and angry are:

• It is a familiar pattern
• You are not aware or connected to your anger
• It effectively covers up feelings of anxiety
• You can use it to manipulate those around you
• Expectations are lowered – of you and others

Another one came to my attention few weeks ago. We were relaxing with couple of friends at a winery on a Saturday afternoon in Napa Valley. I was discussing how my book, Back in Control, was doing. Although I have witnessed hundreds of patients becoming pain free, many people simply do not want consider looking at any information about chronic pain or a structured care process. They are not open to new ideas and engaging with the tools.

Anger and love

Anger is the common trait that blocks openness and engagement. Frustrated people are not rational; there are no exceptions. Our conversation moved on to the reasons why people want to hang on to their anger, (and pain). One possibility was discussed that I had forgotten about – pain can be connected to love.

Our friend Sheila was standing in the checkout line at a grocery store when she heard a young mother screaming at her young five year-old daughter to put something back on the shelf.  She suddenly hauled off and slapped her with a full swing. Almost at the same time the young girl began to cry, she held out her arms and ran to her mother to comfort her. Who else was there to console her? Talk about becoming cross-wired – the girl’s source of pain was also her bastion of love and protection.

My childhood experience with “love”

My mother would fly into rages that would last for two or three days. We never knew what would set them off, although we imagined many possibilities. We thought it was associated with our behavior, but no matter how hard we tried to avoid upsetting her, it just happened. After every tirade she would profusely apologize and tell us how much she loved us. It was quite confusing. What even seems more bizarre in retrospect was that I was convinced that our parents loved us. I recall telling friends of mine in middle school that although my parents had some faults, at least I knew they loved us? Really?

The answer really is yes. My mother spent hours driving us around, volunteering at school, and talked about us in glowing terms to anyone that would listen. What I did not know as a young child is how disconnected anger (she also had chronic pain) can make you. She essentially entered a different reality when she became upset. From our perspective this was all a part of parental support and love.

I am not angry

It was so mixed up in my head that I did not even realize that anger was part of my life until I was almost 50 years old. It was just normal for me to become “frustrated” and since I was “right”, I did not have a clue that this was what anger looked like. I don’t think those close to me felt the same way. Creative vs. reactive

A familiar phrase I hear weekly from my patients is, “I am not angry. I just want to get rid of my pain.” My reply is, “Are you happy about your pain?” It only takes a few more questions to uncover a multitude of things he or she is frustrated with, including me who is not going to be able to immediately get rid of their pain.

What is your concept of love?

When you are an infant or child your mind is a blank slate being downloaded from your environment. If your symbols of love and protection are combined with mental or physical abuse your concept of love will be much different than someone who was raised in a warm, caring, nurturing, and loving environment. In retrospect it is disturbing to me that I was so verbal about how much my mother loved me in the midst of a violent environment.

“Neurons that fire together wire together” is a commonly-used phrase amongst neuroscientists, as the brain learns and functions by association.What is your interpretation of love? What feels the most familiar to you? Is pain a more comfortable pattern? Do you know anything else? How do treat others close to you with your version of love? Are you creating a home filled with peace and joy or are they a target for your frustrations? You do have a choice to move on to a better life.

The post Violence and Love first appeared on Back in Control.

The post Violence and Love appeared first on Back in Control.