• 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

The post Healing through Play – It is Safety Physiology first appeared on Back in Control.

The post Healing through Play – It is Safety Physiology appeared first on Back in Control.

• Your brain is incredibly neuroplastic and can change quickly in whatever direction you choose.
• We automatically know how to feel pain. What about feeling pleasure? It gets buried in the stresses of life.
• Play and social connection are inherent in all of us and using feel and visualization to connect with it will create a rapid shift.
• Enjoying life in so many dimensions is a unique human trait, and we can thrive if it is nurtured.

When you are experiencing relentless pain, life becomes heavy. You are just trying to keep your head above water from dealing with stress. Your life devolves into surviving in addition to carrying a pain burden. You may have forgotten what it’s like to live your life with deep joy and excitement. We have suggested that creating a positive vision for your life and pursuing it  shifts your brain onto more pleasant circuits. Another dimension of process is connecting to feelings of freedom and pleasure from your past. It may initially take some effort to find them, but they are there. I would suggest an ongoing process that I have personally found helpful.

Connecting

Find a quiet time and place where you can just think and possibly go into a meditative state. Think back to an event in your life when you felt carefree and joyous. It could any number of situations at any point in time. Visually take yourself back there, remembering as many details as you can. Possibilities include:

• Dreams/ goals
• The weather/ temperature
• The conversations
• Attitudes
• Friends/ who you were with
• The activities
• Specific feelings and emotions
• What music, movies, sports, and art did you enjoy during this period?
• Are there songs and artists that you were particularly connected to?

Face and connect with your current reality

Spend as much time as you can with this exercise and repeat it often. Once you have really internalized some of these joyous experiences then sit down and fully experience your present life – pain and all. What happened to your sense of play and excitement?

• Compare it visually and emotionally to one of the times mentioned above.
• Note the gap.
• Make a commitment to get joy back and hold onto it. It requires repetition to change your brain.
• When you fall back into The Abyss (it happens frequently), again note the difference compared to your great moments.
• Don’t worry about making a “plan.” This is an exercise of feeling and waking up parts of your nervous system that have been dormant.

Pain or pleasure?

Believe it or not, you have a choice. You remember that one of the cardinal rules of healing is not sharing your mental or physical pain with others, especially with your family. It is completely understandable why you would want to, but where is your brain developing? I just talked to a gentleman who stated that over 90% of his waking hours are spent in either complaining about his pain and medical care or searching for a solution. Almost everyone in chronic pain does this, including me – for 15 years. I definitely had forgotten what feeling good felt like.

This exercise represents the opposite experience. As you connect with the best part of your brain, your body chemistry is dramatically altered into a safety profile where your body can rest, regenerate, and heal. We also know that optimism and a positive attitude directly lower inflammation in your body, and therefore the pain.¹This is not a light psychological game. It is a powerful way to alter your body’s chemistry.

A movie?

Watching a movie connected with a past pleasurable experience is also effective in waking up your brain. It is slightly different than just watching a funny movie to distract yourself. One movie that caught me off guard many years ago was “Happy Gilmore.” I had just flown in from Seattle to Sun Valley and I was exhausted. I was laying on the floor next to my son, who was about 15 at the time. Somehow, it seemed like one of the most entertaining movies I had ever seen. I don’t recall ever laughing so hard for so long. It connected me to a moment in time that I won’t forget. I have watched it at least 20 more times over the years, and it still lightens my mood. For each person, it will be a unique movie, song, or event.

Interestingly, for those of you who have seen it, there is a section where Adam Sandler goes to his “happy place” when he is stressed. The movie is simply silly, but this part happens to be right on with regards to using visualization to pull yourself out of a hole.

Visualization

It is well-known that performers do repeated visualizations before individual events, whether it is in music, sports, performing arts, or even surgery. Circuits are being burned into your brain that allow you to perform without overthinking. How else could an ice skater, concert pianist, or mogul skier perform such feats so quickly. In a book that I have recommended to my patients for years, The Talent Code,² the author points out that some teams have their tennis players swing a racket without a ball for three months. Why not apply these same tools to making pleasure your default mode?

Stories from the Mountains: Connecting to the Intelligence of the Heart 

Recap

The goal of this exercise to wake up dormant parts of your brain. Play and pleasure become buried by pain and survival. It is different than creating a vision or a business plan. You are reconnecting to the powerful emotional part of your brain. You can nurture it and watch it “wake up.” Feeling these sensations and experiencing these memories is key. Remember, reconnect, and “wake the fun up.”

Questions and considerations

1. Consider how the quality of your life has been taken away by being in chronic pain. No one warned you about this possibility when you were in high school.
2. Take a moment to remember a time when you were excited about the future and what you might experience and accomplish.
3. This exercise is a process to refuel feelings of enjoyment that have been buried, but not gone. Remember, pain circuits are permanent, but so are pleasurable ones.
4. As you nurture the more enjoyable aspects of your brain, you’ll use the pain areas less and they will atrophy. By trying to “fix” your pain, you’ll reinforce them.
5. Healing occurs as you become proficient at processing stress/ pain, but you also have to move into the part of your brain that involves play.
6. Anxiety is a threat physiological state of flight or fight, and play is a safety physiological state of rest and regenerate. Where would you like to spend your time?

References

1. Dantzer R, et al. Resilience and immunity. Brain, Behavior, and Immunity (2018); 74:28-42. doi.org/10.1016.j.bbi.2018.08.010
2. Coyle Dan. The Talent Code. Random House, New York, NY, 2009.

The post Feel the Life You Want  first appeared on Back in Control.

The post Feel the Life You Want  appeared first on Back in Control.

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.

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