• Social isolation is both a contributing factor to anxiety and also a result of it.
• When you are suffering, it is challenging to reach out to others in a meaningful way.
• The physiological effects are devastating, with significant mental and physical consequences.
• It even affects the expression of your genome (DNA) in forming aggressive inflammatory cells that destroy your own tissues.
• The loneliness and isolation that many people experience is one of the worst aspects of the whole experience of dealing with chronic illness.
• Conversely, reconnecting with your family, friends, and colleagues is a powerful force for healing.
• The catch-22 is feeling good enough to begin reaching out. It is one of the reasons that there is a sequence to the healing journey. Each person is ready at a different point along the way.

Loneliness and social isolation may some of the worst aspects of suffering from any chronic illness. Over 50% of Americans are socially isolated regardless of where they live or the size of the town or city. It is ironic in that social isolation is such a significant contributing factor to poor health in this modern era. It is also dangerous. It is estimated that the effects on one’s health is equivalent to smoking about 15 cigarettes/ day.¹ Sadly, the age group that is the most affected are those in college and in their 20’s. This stage of your life has the potential to be the best of times.

 Consumed by suffering

When suffering from crippling anxiety and other physical symptoms, you spend a lot of your conscious hours looking on the Internet, seeking medical care, trying different treatments, and discussing your problems with anyone who will listen. Why wouldn’t you? Your life has been consumed and you want it back. Unfortunately, in spite of your best efforts to move forward, from a brain development and physiological perspective, you are moving the wrong direction. Here are some of the effects:

• Unpleasant circuits in your brain are reinforced.
• Pleasant one become less active with disuse.
• You drive people away that you used to have fun with and bond with others who are in a similar condition.
• Eventually, many people are so drained from the endless battle with their suffering, they become isolated, even in the midst of their own family.
• Oxytocin is a hormone that causes social bonding and is also powerfully anti-inflammatory. Lack of connection drops it down and your inflammatory state becomes even higher.

Some data

The effects of social isolation are deep. They go right down to the expression of your DNA directing the production of proteins that are the essence of life. There are about 20-30 genes that effect the production of certain white blood cells called monocytes. White blood cells are at the core of fighting foreign material in your body, including cancer cells, viruses, and bacteria. There is an over-active form of them called, “warrior monocytes” that are too aggressive and also attack your body’s own tissues creating many diseases states and symptoms. Anxiety is one of these inflammatory states. The most powerful factor causing the creation of these cells is social isolation. The second factor was chronic stress (anxiety).²

Dr Dantzer wrote an extensive review paper³ looking at the social influences on inflammation. There are many factors that affect inflammatory markers, and he presented the top four factors that lowered inflammation.

• A sense of control
• Hope/ optimism
• Positive affect/ attitude
• Social connection

Humans evolved by having language and being able to cooperate through social connection. It is the reason we are so tribal, and unfortunately, we haven’t evolved enough as a species to view every person as part of the human tribe. There is an evolutionary basis for excluding groups of people, as we compete for resources. That being said, social connection is a deep need, and it is expressed in your physiological state.

Another paper out of UCLA reported on a study where a volunteer was placed in a special MRI scanner called a functional MRI (fMRI). It highlights area of increased brain activity. The volunteer then played a computer-based video game where he or she was in a game of three-way catch. The computer was programmed at a certain point to exclude the volunteer and the ball was “tossed” between the remaining two players. The volunteer did not know the other two players were just the computer. Guess what? Even though it was just a computer game, and the volunteer could not physically see the other players, the centers of the brain that are active in chronic physical pain lit up. In other words, emotional pain is processed in a similar manner. ⁴

The catch-22 of social isolation

I will only say that becoming socially isolated and feeling lonely was one of the worst aspects of my 15 years of suffering. The only word that slightly described the feeling was, “crushing.” I began to experience deep self-deprecating thoughts that revolved around, “why would anyone want to hang around with me?”, and “I don’t have anything interesting to say.” These thought patterns were endless. This occurred despite me generally being very social person. Just the feeling of being lonely felt like an Abyss and was paralyzing with regards to re-engaging. I really could not see an end to it.

Healing

I noticed very early on that my patients would check off, “re-engaging with family and friends” as part of their healing. Social interactions are tricky in that you be rejected sometimes and hence one of the reasons people have social anxiety. It is greatly magnified when you are already experiencing chronic mental and/or physical pain. So not only do you not have the energy to reach out to others, feeling inadequate may also contribute. Here are some suggestions.

• Be kind to yourself. You are doing the best you can.
• People who you used to be friends with may not have as much in common with you and you may be rejected.
• Others you have bonded with through your pain may also reject you as you heal. You are no longer validating their suffering, and as you heal, they are confronted with their own inability or unwillingness to pursue the same journey.
• So, the first step in returning to a normal life, is to be prepared for these kinds of interactions.

Then just move forward in any way that you can.

• Call old friends or family members. Many of them are in the same condition you are. It is remarkable how common it is to be trapped by anxiety and pain. However, as mentioned many times, conversations around these topics are counterproductive for all parties.
• Re-engage with old skills such as art, music, and hobbies.
• Read interesting books or watch inspiring movies. They are great topics for conversation.
• Join a club. You don’t need to be an expert. There are numerous choices such as birdwatching, Scrabble, ping pong, book, movie, and history clubs, walking with friends, and music.
• Find ways to give back and there are endless options. One of my successful patients was “trapped” in a nursing home and spiraling back down into the Abyss. She decided to become an advocate for other patients who had dementia. Within a few weeks, her whole mood and outlook dramatically improved.

Recap

Loneliness is crushing and both a contributing factor to chronic illness and also a result of it. A significant aspect of healing is reengaging with those around you. What makes this all the more difficult is that while you are suffering, you may not have the interest or energy to reach out to others. Then if you are still in the mode of discussing your troubles, you will push people away who can nurture you, or attract others who are also frustrated with their suffering, and they will pull you deeper into The Abyss. This cycle is deadly.

That is why you must empirically make decisions to keep reaching out and connecting regardless of how you feel. You will feel awkward, especially when you have taken medical conversations and complaining off of the table as topics. The connections can be as simple as a phone call, reaching out to old friends, or joining a book club. The key is doing something – anything to reach out and break out of your patterns.

Humans and language evolved through language and social connection. It is one of the most basic of needs. Actively reaching out and giving back is a powerful move to stimulate your brain to rewire and heal. To have a good life, you must live a good life. It requires practice.

 Questions and considerations

1. You might be sitting here and feeling overwhelmed by the thought of even trying to reach out. That is OK and understandable. You can’t just flip this one around on a dime.
2. Just do something. Anything. You have heard the term, “baby steps” many times.
3. The problem is that when your brain has been barraged with negative thought patterns, you may feel people may not want to be around you. That is a classic common cognitive distortion of, “mind reading.” Maybe they don’t and you also have to be OK with that. Maybe they are in the same situation as you are and don’t have the energy to engage.
4. I can personally vouch for how distorted thinking patterns become from my own experience. For a long time, even after I was much better, I was still quite self-conscious.
5. Humans evolved by interacting with other humans. Somehow, re-engaging with life has to be part of your healing journey.

References

1. Cigna US Loneliness Index 2018. Report published by Cigna Insurance Company.
2. Cole SW, et al. Social Regulation of gene expression in human leukocytes. Genome Biology (2007); 8:R189. doi: 10.1186/gb-2007-8-9-r189

3. Dantzer R, et al. Resilience and immunity. Brain, Behavior, and Immunity (2018); 74:28-42. https://doi.orgl/10/1016/j.bbi.2018.08.010
4. Eisenberger N. “The neural bases of social pain: Evidence for shared representations with physical pain.” Psychosom Med (2012); 74: 126-135.

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• Connecting with your sense of play is one of the most powerful ways of shifting your physiology from threat to safety.
• Play circuits are also simply more pleasant.
• Everyone has some level of play in their life, although for some, it is quite limited.
• The interactions created while at play is one of the basic ways humans learn to cooperate with each other, including reading body language, interpreting tone of voice, and negotiating boundaries.
• When suffering from chronic anxiety and other symptoms, play circuits are used less and don’t evolve.
• Nurturing a sense of play and joy is a learned skill that requires thoughtful repetitions. These are not usually taught to us throughout our life experience,
• The benefits of reconnecting with play are healing and have a significant impact on your health and quality of life.

This is the real secret of life –

to be completely engaged with what you are doing

in the here and now.

And instead of calling it work,

realize it is play.

~Alan W. Watts

Play is a physiological state that reflects a sense of safety. You cannot play or feel playful if you are in a survival mode. The essence of escaping from the grip of crippling anxiety is feeling safe. In this state your body is full of relaxing chemicals such as oxytocin (love/bonding drug), serotonin (antidepressant), GABA hormones (anti-anxiety), dopamine (rewards), and small anti-inflammatory proteins called cytokines. Your metabolic rate (fuel consumption) also drops, which allows your energy reserves to be replenished. This scenario not only creates a deep sense of well-being, but it is also healing.

The data regarding the devastating effects of chronic stress on your mental and physical health is extensive and deep. Prolonged exposure to the body’s neurochemical survival response predictably causes illness and disease and shortens life.^1,2,3

Research also shows that cultivating optimism, having a sense of purpose, and feeling hopeful has the opposite effect. When people learned how to skillfully process their stress and nurture joy, they experienced an improvement in anxiety and many other symptoms.⁴ One paper had participants visualizing their best self for five minutes a day over a course of two weeks. They all noted significant improvements in anxiety.⁵

 Play

In our workshops, we discovered that shared play is a powerful force and most of the participants had a significant improvement in their anxiety and pain during the three or five – day events. It happened after people began to relax, share, let go, and laugh together. We initially didn’t understand reasons why people could shift so quickly after being so miserable for years. I now understand that anxiety reflects a sustained inflammatory state that also causes many other symptoms. Feeling connected to others in a relaxing environment stimulates the release of oxytocin. Oxytocin is a hormone that is critical for social bonding and is also powerfully anti-inflammatory. The participants felt safe in this setting and several people commented that they felt like they were in an “adult summer camp.”

Of course, when they returned home to their triggers, their anxiety and pain would reappear. But now they not only possessed new knowledge and tools, but they had reconnected to feeling playful, and relaxed. Many had not felt that way for years. Now they had a memory that they could return to and over time, and they became skilled at it. Years later, many have continued to thrive.

The basis of The DOC Journey is learning how to re-program your brain away from embedded anxiety circuits by stimulating neuroplastic changes in the brain. This requires repetition and eventually it becomes automatic. However, you can make this change happen even faster by shifting onto pre-existing play circuits.

All mammals have play as a part of their development. It is a multi-dimensional experience that processes many environmental cues and reactions are learned that are appropriate to the situation. Play is a core step in how we developed language and consciousness. Even if they feel deeply buried or almost non-existent, your play circuits are there, waiting to be accessed.⁶ Any skill that is not practiced will fade, but those neural circuits can be re-awakened.

As you use the playful part of your brain more and spend less time feeling anxious, your brain’s structure and neurological activity physically changes and grows . Conversely, when you experience chronic stress, your brain physically shrinks. Fortunately, as you heal and create more connections, it re-expands.⁷

I used to play trumpet in high school

An example of how this works is to consider a skill you had in middle or high school. Without practice, it has faded, but the memory is still there. I played trumpet in high school and a little bit in college as well. I could play reasonably well through medical school, but it all disappeared in the midst of the rigors of residencies and fellowships. I recently picked it back up, and although I have no lip strength or dexterity, I still remember the basic techniques and hope to re-connect with them quickly. It is doable, whereas if I were to try to learn a completely new instrument, it would take much longer.

My wife started playing the guitar again after a 30-year hiatus, and within a few weeks, was able to finger-pick like the old days. One day, it just all came back to her, and she  quickly progressed beyond where she left off.

The same is true for you – your play circuits are still there, waiting to be re-vitalized.

A deliberate decision

Many years ago, I was pondering my own journey out of The Abyss and considering some additional approaches. It hit me that the words “work” and “play” are somewhat arbitrary. I realized that my vacations were spent largely with trying to recover from the rigors of work. I didn’t have the energy to fully engage in enjoying my time off.

Much of the problem had to do with how I viewed work and my strong reactions in dealing with the challenges of being a spine surgeon. I decided that I would work on removing those labels from my life.

If I loved my work, and spent most of my waking hours doing it, why call it work? I decided to just embrace the whole experience. My entire team relaxed, and I enjoyed my patients, fellows, and colleagues a lot more. We had fun to the point where sometimes we would have to work on toning it down while we were in clinic.

At the same time, one of my mentors told me, “Challenges are an opportunity to practice your stress-coping skills and are part of any endeavor.” I began to embrace challenges head on and my reactions to stress dropped dramatically. By seeing problems as opportunities, I was both more effective and engaged with the difficult aspects of my job. This simple paradigm shift created a world of difference.

Play is a mindset

A word of caution – I am not referring to play as a way to distract yourself from your suffering. You can’t outrun your mind. Rather, it is mindset of curiosity, deep gratitude, listening, anticipation, awareness, and improving your skills to calm your nervous system. Nothing initially has to change in your life. My work environment was unchanged. It was my attitude that changed. I chose different words every day to reflect a sense of play. The result was a sense of contentment and peace.

Remember, nurturing joy is a learned skill along with processing  stress. You will eventually become an expert. At some tipping point, you’ll simply refuse to let people or situations ruin your day. You’ll also progress to being a source of peace and vitality. That is a long way from being trapped by anxiety and pain,

Recap – Moving forward

Play is one of the most effective ways to give your nervous system cues of safety. However, in the presence of relentless anxiety and pain, this probably seems impossible, and it is without effective tools and an approach that works well for you. You must simultaneously learn to de-energize anxiety and anger while nurturing safety.

Play to distract yourself from unpleasant feelings doesn’t work and is actually counterproductive. You cannot outrun your mind and your inflammatory markers go straight up. Conversely, living life with connection and purpose causes them to plummet.⁸

Choose play –  every day and watch your life transform.

Questions and considerations

1. Have you noticed that much of your vacation is spent trying to recuperate from work? By viewing work as play, you may have more energy to enjoy your time off.
2. You have heard the phrase, “don’t sweat the small stuff.” This is another way of letting go and simply enjoying your day.
3. There are many ways to connect with play. They include deep gratitude, a sense of curiosity, cultivating a sense of humor, and consistently choosing joy as opposed to complaining or feeling like a victim. When where you taught to nurture these traits?
4. As you continue to make these choices, your brain will begin to move in this direction automatically. Consider how much your brain is being programmed with negative self-talk and external messaging.
5. Notice how your mood affects those close to you. A good mood is contagious because it directly stimulates a similar area of the other person’s brain through “mirror neurons.” Conversely, a negative mindset is also having a ripple effect.

References

1. Tennant F. The physiologic effects of pain on the endocrine system. Pain Ther. 2013;2(2):75-86.
2. Torrance N, Elliott AM, Lee AJ, Smith BH. Severe chronic pain is associated with increased 10-year mortality: a cohort record linkage study. Eur J Pain. 2010;14(4):380-386.
3. Rahe R, et al. “Social stress and illness onset.” J Psychosomatic Research (1964); 8: 35.
4. Hausmann, LRM, et al. Reduction of bodily pain in response to an online positive activities intervention. Jrn of Pain (2014); 15: 560-567.
5. Meevissen,YMC, et al. Become more optimistic by imagining a best possible self: Effects of a two-week intervention. Jrn of Behavior Therapy and Experimental Psychiatry (2011); 42: 371-378.
6. Brown, Stuart, and Christopher Vaughan. Play: How it Shapes the Brain, Opens the Imagination, and Invigorates the Soul. Penguin Group, New York, NY, 2009.
7. Seminowicz, David A., et al. “Effective Treatment of Chronic Low Back Pain in Humans Reverses Abnormal Brain Anatomy and Function.” The Journal of Neuroscience (2011); 31: 7540-7550.
8. Cole SW, et al. Social Regulation of gene expression in human leukocytes. Genome Biology (200); 8:R189. doi: 10.1186/gb-2007-8-9-r189

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My wife, Babs, and stepdaughter, Jasmine, and I have done these workshops together since 2013. Each year, we are energized and inspired by the shifts in mood, outlook, and physical symptoms that occur within a just few days. We have been perplexed for years why this is such a consistent outcome and the last few years of neuroscience research has now explained what happens. It revolves around experiencing threat versus safety.

Fight or flight/ rest and digest

Any mental or physical threat, real or perceived, fires up your body’s flight or fight response through the sympathetic nervous system. The reaction includes stress hormones, inflammation, and elevated metabolism (fuel consumption); and you are on alert, anxious, and agitated. If the perception of danger is prolonged, then your body will respond with many different symptoms and often illness. Chronic stress (threat) keeps you in this heighted state and has been documented in many studies to be deadly. (1)

The essence of the solution lies in finding safety, which creates a “rest and digest” state that allows you to regenerate, drop inflammation, and slow down your metabolism; you feel relaxed with less pain. There are many ways to induce this state of safety. The workshop creates an atmosphere that allows this to happen. Dr. Robert Dantzer and several other researchers wrote an extensive review looking at the interaction of social factors influencing inflammation (pain) and how the inflammatory condition impacts your behaviors. (2) The main ones with most impact are:

• Social connection
• Positive affect (emotional state)
• Sense of control
• Optimism/ Hope

These workshops address all these issues and each of them is calming and directly anti-inflammatory communicated through the Vagus nerve (10^th cranial nerve). Dr. Stephen Porges, through his research and writing on the Polyvagal theory, has nicely laid out the afferent input into the midbrain and its efferent output allows safe human interaction. (3)

Social Connection

There are few times and places where you can feel safe with others. Life is competitive and it’s challenging to get a break. School has many layers of stress. Bullying is rampant. Close friends often turn on each other. Social media has intruded on privacy and quiet time. Research has shown that only about a third of families are relatively free of chaos. Other stressful arenas include sports, music, the arts, employment, and social status. Where’s there a place to rest?

We quickly realized that we didn’t have to do much after we set up the weekend. Participants in a safe and structured setting healed each other. It was also a remarkable experience for us being in the presence of those who are so supportive of each other. Oxytocin is a bonding hormone that is secreted in safe and social situations and is anti-inflammatory.

Positive affect/ play

The  weekend is also focused on re-connecting people with each other by sharing enjoyable experiences. Many of the activities are held in small groups of four or five. Participants can feel safe and it’s remarkable how quickly healing occurs. Much of the weekend is spent in play, which is a great venue to feel safe.

Babs and Jasmine are important contributors by leading you in rhythm, song, relaxation exercises, and sharing.

 Sense of control (The “ring of fire”)

There are many tools that allow you to regulate your own body’s neurochemistry and responses to threats. Just this sense of control is anti-inflammatory. Additionally, understanding the nature of chronic mental and physical pain will enable you to personalize solutions.

Awareness of your current state of being is the first step and we use a tool called, “The Ring of Fire.” Being aware of which color you are in at the moment, allows you to choose your direction. The green center is where you rest and regenerate. Blue is “life.” The red ring of anxiety and frustration is an inherent part of life that must be navigated skillfully. The goal is to be able to exist in any part of the “circle of life” on your own terms.

Hope/ optimism

People in chronic pain lose hope. The loss of hope contributes to the actual pain by increasing inflammation by speeding up nerve conduction. We will be sharing many stories of hope with the group. Regaining hope is powerful.

Comments from prior classes

“I’m still high from the weekend. And off all pain meds (even Advil) after 10 years on opioids…………..    Interesting how the class responded to my hooping (hula hoop). I can see Babs and Jaz doing a session, maybe a half-hour?  What do you think? Neuroplasticity, endorphins, fun!  Whether people catch on right away or not, laughter will be a result.  It could take practice, just like learning the cup song.  And for any resistant males, emphasize that it will improve their sex lives!”

“The program has been enormously helpful, and I can only conclude that it’s helping me to live in a more authentic way, which I feel makes my unconscious happy! I think when you have an abusive parent you have to suppress your feelings so much that suppression, avoidance and denial become your coping mechanisms. But as you know, it’s no way to live your life.

It’s possible I may still need surgery eventually, but if so, I feel that thanks to following the program, I’d be able to do it in a conscious and aware manner. Before, I felt very strongly that It would be a mistake.”

“………….  My family and co-workers are amazed at my progress. I am especially committed to no longer talking about my pain and to writing on a regular basis. I am getting (have gotten) my life back!”

Several commented, “I feel like I just spent a weekend away at camp.”

Reconnection to you

We have always been aware that when returning home, the pain will recur. But tasting freedom from pain is powerful. Every cell in your body is created to survive and thrive. If you allow yourself to be open to possibilities, it is a matter of time before you find your way to healing. Many participants have leveraged these workshops to a more enjoyable life.

References:

1. Rosengren A, Orth-Gomer K, Wedel H, Wilhelmsen L. 1993 Stressful life events, social support, and mortality in men born in 1933. Br. Med. J (1993); 307:1102–1105.
2. Dantzer R, et al. Resilience and immunity. Brain Behav Immun (2018); 74:28-42. doi:10.1016/j.bbi.2018.08.010
3. Porges, Steven. The Polyvagal Theory. Norton and Co., New York, NY, 2011.

Ffvb

through the Vagus nerve (10^th cranial nerve).

The post Experiencing Safety: Solving Chronic Pain: An Immersive Weekend Retreat first appeared on Back in Control.

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Loneliness causes many physical problems including a higher mortality rate equivalent to smoking 15 cigarettes per day. Mental health problems continue to increase and approximately 1 in 6 adults suffer from a mental health condition. Most also suffer from loneliness. (1)

Anxiety is the driver

I have observed from working with many patients and my own experience with loneliness during my ordeal with chronic pain, that there is a circular interaction with anxiety, anger and becoming isolated.  For many, I feel the starting point is anxiety, which is the pain.

There are an endless number of reasons for humans in this day and age to have disruptive anxiety. This has been endlessly discussed in the media. However, once it kicks into gear, there is no turning back and it will become relentlessly progressive. Since is an automatic unconscious survival response that is much more powerful than your conscious brain, you can’t control it or solve it with rational means. You also will never be rid of it, since without it, you would not survive for more than a few minutes.

The key to lowering anxiety is learning to assimilate it into your life. It is intended to be unpleasant, since it is your basic warning system. As you learn to work with it and quit fighting it, you will be able to lower your stress chemicals and de-energize it. Anxiety both protects you and also allows you to navigate new challenges.

OCD

The interaction I experienced while in pain was that I was crippled with anxiety in the form of disruptive unpleasant thoughts that evolved into an obsessive compulsive disorder (OCD). I had become a major spine surgeon by suppressing anxiety and wasn’t connected to it. I also thought anxiety was a psychological problem when it actually is simply a physiological reaction to a mental or physical threat.

As my anxiety progressed, I became more isolated. My patterns of thinking changed dramatically, and I was consumed with thoughts of self-deprecation and why would anyone want to hang out with me? This was occurring in spite of me historically being a social person to a fault. I had a wonderful group of friends from middle school on. There was no new activity I was not up for trying. In college, I took more than a full academic load, worked heavy construction 10-20 hours a week, played intramural sports, and spent a lot of time with my friends. I don’t remember sleeping much.

Trapped

As I spiraled down with progressive anxiety, I became severely depressed. I now know that depression is a group of symptoms driven by anxiety. The isolation progressed rapidly over five years, in spite of having warm and very nice people around me. I couldn’t connect. I was so busy trying to survive, I couldn’t reach out to others. As others tried to reach out to me and failed, they eventually quit trying as hard, which only made it even harder for me to. I don’t have the words to describe the feeling, but it was crushing, suffocating and one of most intolerable experiences I have ever had and, even worse, there did not seem to be a way out. I use the word, “Abyss” to describe being in chronic pain. I think the loneliness was a step beyond or below. Even thinking about it 20 years later is causing my stomach to knot up.

My depression became severe. I lost all hope in spite of aggressively seeking professional help and reading many self-help books. One that I picked up was, Darkness Visible: A Memoir of Madness, where the author described his own struggle with major depression. (2) What struck me was that he was famous, wealthy, and had recently received a lifetime achievement award for his literary excellent. In spite of it all, he was miserable. What struck me about his story, is that he didn’t find or offer a solution. He  had nowhere to go and just remained in one spot. I couldn’t explain what happened to me but I felt a deep shift. That is all I can say. I did not immediately begin to heal, but I somehow realized that I was on the wrong track in my endless pursuit of a cure. The answers where inside of me. In an odd way, I gave up, which turned out to be the eventual answer.

It is OK to be on “The Bottom”

It is OK to be depressed. Anxiety is normal and fighting it gives it more power and it does become disruptive. Your brain will develop wherever you place your attention, especially if you are suppressing. By remaining still, I gave myself some space to heal. I become aware of many aspects of my life and experience that weren’t possible while I was traveling so fast. I quit trying to fix myself and inadvertently allowed my brain to heal. I became more connected to me.

This song is written and performed by my nephew, who I have spent many hours talking to about anxiety, depression, and life. His struggle with it was epic but he not only made it through, he is thriving. One of his gifts from the ordeal is having insights into the magnitude of the problem and has a deep appreciation for life. This song, The Bottom, reflects his perspective.

Alex Hanscom – The Bottom

Learning to be with yourself, including your fears, is key to moving forward in life on your terms and not at the mercy of other’s opinions. It is also much easier and you are able to reach out to others and be aware of their needs. It works the other way around in creating an upward spiral. I have rekindled many friendships because I have healed, but my connections are also part of the healing journey.

1. Cigna U.S. Loneliness Index. Published survey results, 2018.
2. Styron, William. Darkness Visible: A Memoir of Madness. Random House, New York, NY, 1990.

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Loneliness

There is an even more destructive aspect of it that has been looked at in numerous research papers – loneliness. Most of the data I will be quoting is from a government-sponsored review, “Loneliness Matters: A Theoretical and Empirical Review of Consequences and Mechanisms”. (1)

The first point of the article is that loneliness is a “perceived social isolation” and social people can still feel isolated and many can live solitary lives and feel quite content. They define loneliness as, “……. a distressing feeling that accompanies the perception that one’s social needs are not being met by the quantity or especially the quality of one’s social relationships.”

What caught my attention was “the quality of the social relationships.” There are many social consequences of suffering from chronic pain. One of them is feeling trapped and frustrated. It is difficult to be aware of other’s needs when you are upset, which is the essence of relationship building. You will also attract people with a similar energy and patients in chronic pain often spend a lot of their time talking about their pain. First of all, your pain is not that interesting to other people and those that you might want to spend more time with will gradually wander out of your life. Secondly, the ones who remain with you wallowing in your misery will help keep you in your misery. Third, my wife and I have saying that, “Anger isn’t attractive.” I wish it were a joke. The problem really is that I can only see it from my perspective and cannot really see how I appear when I am upset. (I am sure it can’t be that bad………). Finally, while you are angry creates a scenario for abuse. I have written many posts on this topic. You get the idea. Chronic pain has a high chance of creating or increasing loneliness with severe consequences. They include:

• Elevated blood pressure, overweight, coronary artery disease, higher cholesterol
• Higher mortality from all causes
• Suicide
• Impaired judgment, decreased cognition, depressive symptoms. personality disorders, psychoses, dementia/ Alzheimer’s, cognitive decline with aging,
• Impaired self-regulation
• Impaired quality of sleep with all the attendant problems connected with poor sleep
• Higher levels of stress chemicals such as cortisol while at the same time decreasing the body’s responsiveness to the cortisol.
  • This sequence leads to poorly regulated inflammatory response.

I am cutting this list short. There did not seem to be an end to it and the physical symptoms are so similar to those being produced in chronic pain with the body’s sustained levels of adrenaline and cortisol. Which is first – the loneliness or pain? Not sure it matters, as the solution is the same.

The DOC (Direct your Own Care) process allows the patient to understand the parts of their chronic pain so as to eventually solve it. It must be implemented by the patient. Most of the process is self-directed and addresses some of the blocks to social interactions, which includes a hyper-vigilant nervous system. But it goes both ways in that I have noticed for a while that part of many of my patients’ healing is re-connecting with family and friends.

Omega 2017

When I was given the opportunity of hold another workshop at the Omega Institute this summer, I realized that we could add another dimension to the healing process – feeling the healing power of others. I have seen that once your brain connects with part of you that knows peace, love, joy and connection you will instinctively learn the (your) way to return to it. The Way to Love

The Omega Institute is a well-known retreat center in Upstate New York. We have witnessed many remarkable turnarounds in participant’s pain and quality of life during three prior five-day workshops we had held in 2013 – 15. This year we were asked to hold a weekend session beginning Friday evening, Saturday, including the evening, and ending Sunday at noon. We weren’t sure what could be accomplished in such a short period of time. It turned out to be as powerful as any of the others.

Faculty:

• David Hanscom, MD
  • Orthopedic Spine Surgeon, Seattle, WA
  • Author of Back in Control: A Surgeon’s Roadmap Out of Chronic Pain
• Bernie Siegel, MD
  • Pediatric General Surgeon
  • Author of:
    • Love, Medicine and Miracles
    • The Art of Healing
• Jasmine Yohai, MA
  • Expressive arts therapist

•  Babs Yohai
  • Movement artist, professional tap dancer

The workshop

Since time was limited, we stayed focused on accomplishing one goal; that was to create an environment where people could feel safe, relax and share the experience with others. Somewhat surprisingly, that atmosphere was created within the first hour. Maybe one of the reasons was we all knew time was short, people had traveled from all over the world and they were ready to fully engage.

The small groups immediately got to know each other and I had to “break them up” to get on with the evening. When I announced the ground rule of not discussing pain the room went silent.  Not only were they not to discuss their pain this weekend, they were never to discuss it with anyone ever again. They could write it down. We did have the room do the expressive writing for five minutes and we collected the torn up pieces of paper.

The weekend included lectures on the nature of chronic pain, structured conversations, rhythm, “The Cup Song”, mindfulness, drawing, sharing, and support. The details are not important but the group’s commitment to each other to creating a safe place was remarkable and we did it – in a weekend!! I think that all of were surprised (shocked) how enjoyable it was.

Comments from the class

“I’m still high from the weekend at Omega. And off all pain meds (even Advil) after 10 years on opioids…………..    Interesting how the class responded to my hooping. I can see Babs and Jaz doing a session, maybe a half-hour?  What do you think? Neuroplasticity, endorphins, fun!  Whether people catch on right away or not, laughter will be a result.  It could take practice, just like learning the cup song.  And for any resistant males, emphasize that it will improve their sex lives!”

“The program has been enormously helpful and I can only conclude that it’s helping me to live in a more authentic way, which I feel makes my unconscious happy! I think when you have an abusive parent you have to suppress your feelings so much that suppression, avoidance and denial become your coping mechanisms. But as you know, it’s no way to live your life.

It’s possible I may still need surgery eventually, but if so, I feel that thanks to following the program, I’d be able to do it in a conscious and aware manner. Before, I felt very strongly that It would be a mistake.”

“………….  My family and co-workers are amazed at my progress. I am especially committed to no longer talking about my pain and to writing on a regular basis. I am getting (have gotten) my life back!”

Several commented, “I feel like I just spent a weekend away at camp.”

You can’t outrun your pain

I don’t want to give you the impression that we were just trying to have a good time to distract ourselves from pain. The atmosphere was created by people taking risks and being vulnerable. I was relentless in pointing out that you cannot run from your pain or even solve it. In fact, the goal of the DOC process is to not get rid of your pain. It is to live a full life with your pain and only then will it begin to lose its power. I challenged them to live their life now – this weekend with pain. The connections that were made were clear and deep. There is no other way to move through your pain. It is the same pathway you will use to re-connect with yourself. The ring of fire

Tasting freedom from pain is powerful. Every cell in your body is created to survive and thrive. If you allow yourself to be open to possibilities, it is a matter of time before you find your way to healing.

1. Hawkley LC and JT Cacioppo. Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Ann Behav Med (2010); 40: doi:10.1007/s12160-010-9210-8.

The post The Taste of Freedom – Omega 2017 first appeared on Back in Control.

The post The Taste of Freedom – Omega 2017 appeared first on Back in Control.