• A basic trait of human consciousness is to give meaning to everything from objects to experiences.
• These perceptions and concepts are embedded in our brains as concretely as physical objects.
• They are our individual version of reality, and we live our life accordingly.
• By definition, we are unable to be aware of them since they are our frame of reference.
• Understanding the depth of our individuality would allow us to better get along with each other.

Awareness is essential to stimulating healing neuroplastic changes in your brain in that you cannot stimulate your brain to develop in a given direction unless you know where you are starting from. Awareness is both a tool and foundation for moving forward with every aspect of your life. Of the different kinds of awareness, ingrained attitudes and thought patterns are the most problematic. By definition, you cannot see them without actively seeking them out.

Ingrained Patterns – Blind Spots

By definition, we are all programmed/ brainwashed by our past. Every action you take today is determined by your ENTIRE life experience up to this very second. Most living creatures are able to fend for themselves immediately or relatively quickly from birth. Humans are unique in that we have NO capacity to do so, and it takes many years to acquire even basic physical survival skills. Additionally, since we have a unique emotional life based on language, there is another layer of extremely complex learning that occurs throughout a lifetime. Each human being’s inner self has little in common with any other person.

David Eagleman, in his book, Livewired,¹ succinctly points out how the human brain develops by interacting with other humans. If you are raised in a richly stimulating and nurturing environment your view of the world is much different than someone who was raised in a chaotic and threatening household. It is also the reason that childhood trauma has such an effect on your quality of life and health.² A significant part of your brain development happens within the first few years of life.

Your life lens

As you continue to interpret your ongoing reality through this lens, it is reinforced. You’ll embrace confirmatory data and reject what is in conflict with it. The marketing term for this phenomenon is, “reactance”, and is the reason that facts don’t change people’s minds.³ Your life trajectory will be consistent with your outlook. If you have been programmed to constantly be on high alert, your whole body will be on guard even when you are actually safe. The severe consequences of early childhood trauma on your mental and physical health have been well-documented.² However, you also have to understand that even in the best of households, there is still a lot going on. Although you may have a more functional life lens, you still cannot truly see the world through other’s eyes. Of course, there is the ongoing trauma of dealing with life’s inevitable challenges for everyone.

These attitudes and behaviors we develop over a lifetime of exposure to our circumstances are what I call ingrained patterns. What makes all of this more challenging is that our perceptions are embedded in our brains as concretely as of physical sensations and objects, such as a chair or table. I used to say that thoughts are real because they cause neurochemical responses in our bodies. But they are not reality. I was wrong.⁴

Your ego blocks awareness

You cannot see these attitudes and behaviors because they are inherent to your identity or ego. This basic trait of human consciousness may be the greatest obstacle to people getting along. Although we are infinitely unique individuals, we don’t tolerate differences well. It is why we become so attached to our politics, religion, belief systems, etc. It is also the reason that humans treat each other so badly based on labels. One example, amongst an endless list, was how we locked up “communists” during the McCarthy era of the 1950’s and 1960’s. It is why so many minority groups are persecuted, but they also often treat each other badly.

We are hard-wired enough that we don’t recognize or “feel” these patterns; it’s just what we do. It’s behavior that sits under many layers of defenses and has to be “dug out” by each person – if you want to. Our family-influenced habits and actions are much more obvious to our spouses and immediate family than they are to us; we can only get in touch with them through counseling, seminars, psychotherapy, self-reflection, spousal feedback, etc. What you are not aware of can and will control you.

The Polyvagal Theory and autonomic nervous system

In addition to the ingrained patterns controlling your life, your body is constantly automatically picking up cues of threats in your subconscious mind. You don’t have to think about not walking in front of an oncoming car. You just don’t do it. It is similar for the emotional aspect of your nervous system. If a person or conversation reminds you of an unpleasant situation in the past, your autonomic nervous system sends out signals to increase your heart rate, blood pressure, respiratory rate, and level of alertness. This flight or fight response also fires up your immune system and inflammatory response. When this response is sustained, there is a high chance of becoming ill or developing a serious disease.

There is deep research measuring the deleterious effects of chronic stress transmitted throughout your body via the autonomic nervous system. It is the part of your nervous system that automatically monitors your body’s internal functions and continually sends out signals to adapt to the sensory input. One of the pioneers in this field, Dr. Steven Porges, has organized much of this knowledge in his dissertation called The Polyvagal Theory.⁵ There are various methods of measuring the state of your body’s reactivity and also ways of learning to calm it down.

A humbling and enlightening day at Hyde

Hyde is a boarding high school that emphasizes character over academics and includes the whole family in a learning process. I didn’t realize the depth of my own ingrained patterns until one weekend while attending a weekend Hyde parent’s seminar.

My regional West Coast Hyde group had already worked me over about some of my own issues. I wasn’t in a great mood and decided to not contribute much to the group dynamic. As a result, I actually ended up listening. I watched one father trying to be a perfect Hyde seminar parent. He was a great, well-intentioned guy, but these very qualities were clearly blocking him from connecting with his son. I realized how often my idealism had a similar effect.

One of the exercises was to write a final letter to myself about my core values. I decided to open up my mind a little more and asked myself the question, “If I have done so much personal work, why am I still such a workaholic?” During the session, a story kept popping into my head from when I was a first-year orthopedic resident in Honolulu, Hawaii. About three months into my training, I overheard one of the other residents talking about admitting a patient with severe back pain who also had an anxiety disorder. I asked him, “What do you mean by anxiety disorder?” I had no idea what anxiety was; I had to look it up in a textbook.

Eventually, I developed a severe anxiety disorder. As I sat in the Hyde seminar, I couldn’t figure out how I could have gone through college, medical school, two years of internal medicine residency, and not have had a clue about the nature of anxiety. Obviously, I’d encountered many anxiety-provoking situations.

Suddenly a bomb went off in my head. Anxiety was all that I knew. I’d been raised in an abusive household, never knowing when my mother would explode. Fear was the basis for most of my behavior. My energy as a child was spent trying not to set my mother off and/or calming her down. Most of my energy in adulthood was spent in avoiding unpleasant emotions. I dealt with anger by disguising and suppressing it. My anxiety was held at bay by the power of anger and staying distracted, mostly by obsessive work patterns.

Infinite variety

Think how different our world would be if humans understood the infinitely deep depth of differences that define each one of us. Yet somehow, we not only don’t embrace this concept, but we also actively try to change others into what we think we should be. Why? It is anxiety-producing to have your life views challenged.

Consider the atrocities committed throughout history as a consequence of this way of thinking. What if our focus was becoming as aware as possible of other’s views in contrast to ours, consider them, and continually work on finding common ground? World peace would actually be a possibility. It is ironic that we do completely the opposite with unspeakably severe consequences.

Recap

It is, by definition, impossible to recognize your own ingrained patterns without being open to outside input and having the desire to develop self-awareness. Usually, it takes some type of interaction with another person in an individual or group setting. Hyde was one example of a structured interaction that allowed me to realize my deeper patterns. The didactic aspect was critical, but my paradigm shift would not have occurred without the support of the people in that room.

You cannot see yourself the way others see you. You must first decide to learn more about these patterns from outside sources to understand their impact on you and others close to you. Life becomes infinitely more interesting when you choose awareness.

Questions and considerations

1. Consider the number of seconds in your life with each one representing a piece of data that is interpreted by your brain to create meaning for your actions and life.
2. Not only are there an almost infinite number of variables, but the analytical process is also based on your prior experiences. At some tipping point, you transition from being “open and impressionable” to developing beliefs and opinions that bias ongoing input.
3. As you age, your “filter” or “lens” becomes more reinforced, and facts essentially never change people’s opinions. You are asking someone to change the essence of their identity and being.
4. Consider how infinitely different each of us is and focus on trying to see the world through others’ eyes instead of unconsciously defending your own positions.
5. It is anxiety-producing to be completely open and aware instead of hiding behind your ego. However, once you learn to process anxiety by regulating your body’s chemistry, you’ll be free to live life on your terms – and be able to give back to others.

 References

1. Eagleman, David. Pantheon Books, New York, NY, 2020.
2. Fellitti VJ and RF Anda. The Hidden Epidemic: The Impact of Early Life Trauma on Health and Disease; Chapter 8. Cambridge University Press, 2009.
3. Berger J. Simon and Schuster, New York, NY, 2020.
4. Feldman Barrett, Lisa. How Emotions are Made. Houghton Mifflin Harcourt, New York, NY, 2017.
5. Porges, Stephen. The Polyvagal Theory. Norton and Co., New York, NY, 2011.

The post Awareness–Ingrained Patterns/ Your Life Lens first appeared on Back in Control.

The post Awareness–Ingrained Patterns/ Your Life Lens appeared first on Back in Control.

Hard times

Life doesn’t always go as planned. He hit some difficult personal circumstances and began to underperform. One incident was a high-speed fall where he missed hitting a tree by just a few feet. His left ski hit a small rock throwing him forward. He landed on this left shoulder and dislocated it. He felt for the first time that was going to die, as he hit the snow. He began to ski “not to lose”, which can’t work at a world-class level of competition. The harder he worked the worse it seemed to get.

He began to work with a performance coach in Seattle, David Elaimy in 2006. He was 22. I sponsored him and his best friend, Holt, to work with David over the next several years. Nick climbed to 5^th in North America on the NorAm circuit. Holt went on to win the National Championship in 2007. It was a tough competition for Nick, as he did not make finals after a fall on the top jump.

Injuries

In 2008, Nick had good shot at the National Championship. Our whole family and David Elaimy were watching Nick warm up on a tough course in Killington, VT. He appeared to be one of the few skiers who was mastering the steep course with firm snow. Suddenly he pulled over and sat down. With a very slight twist his anterior cruciate ligament in his left knee popped. He rehabbed quickly after surgery to ski the next season. Then he popped the cruciate ligament in his other knee. He again worked hard enough to compete the next season. Then he partially tore his ankle in practice as he over-rotated on a back flip in heavy snow. His next injury was a ruptured the disc in his lower back between his 4^th and 5^th vertebrae. There wasn’t much pain but it weakened his left quadriceps. He had already experienced nine concussions. You get the idea. He wasn’t giving up easily.

The final straw seemed to be a golf injury. He was driving the cart with his left leg hanging out the side. He was relaxed and not paying too much attention to driving. He caught his foot between the cart and a railway tie as he crossed a small wooden bridge. His ankle snapped requiring yet another surgery. After a lot of conversation we all decided that continuing to ski did not seem like a good idea. I was personally relieved. He was finishing school and had a great job lined up.

Competing again?

He decided to compete again. I was not supportive, but at age 29 it was clearly his decision. It was not only risky, it seemed as if he didn’t have much of a chance. To qualify for a US ski team spot and a World Cup spot he had to finish a combined first or second over two days at a national qualifying event. He lined up a sponsor and began training in September for the December competition. He traveled to Australia, Europe, and Canada, working extremely hard. The first week while in Canada the rope tow was not open. He climbed the hill over 150 times just to practice one jump.

Fear of failure

But another major problem had evolved in addition to his injuries. He had lost his consistency and every year would ski poorly under the pressure of the national qualifying competition. It became a head-trip and even the pattern of failure became predictable. His top jump was an impressive backflip with a full twist and he would ski a great top 2/3 of the run. On the bottom jump he would over-rotate, sit back just a little, and immediately be out of the competition. For three years in a row, it was the same mistake. It didn’t seem to matter how many times he practiced the jump or how well he did in the warm-up runs. He wasn’t laying down winning runs under pressure. He only had the first two runs of the season to finish in the top two and that was it.

It is always tricky when giving your children advice when they haven’t asked for it. Although Nick is mentioned throughout my book, Back in Control, he hasn’t quite gotten around to reading it. (Nor has my wife or daughter). I suggested that he engage with the expressive writing exercises, which is the foundation of the DOC project. It is the tool that begins to break up the cycle of racing thoughts. He politely listened without a response, but actually began to implement it. He had also done the Hoffman process a few years earlier and had continued to use some of the visualization and somatic tools.

Selections 2013

Every December the national qualifying event is called “Selections”. The top two finishers are guaranteed spots on the US ski team. This year it was held in Winter Park, CO. It is a two-day event held on Thursday and Saturday.

On the first day of competition he qualified 13^th out of a field of 75. As the top 16 skiers get a second run he made finals. There is no carry-over from the first run and he finished 6^th, which kept him in the hunt for a top-two finish.

On Saturday he qualified 11^th. It was an excellent accomplishment and was a great run. But anything less than a first or second on the final run was not going to cut it. He finally did it!! On the finals run he missed a first place finish by one hundredth of a point. He skied the run of his life under intense pressure.

They took the top six skiers for a “super finals” and he did it again – he finished second by the smallest of margins.

Making the US Ski Team – Not

For all of us that have watched him compete it is hard to describe how great it was to see him pull this off after years of so much focused effort. His overall standing for the two days was 3^rd. It wasn’t quite a guarantee but often a 3^rd spot opens up on the US ski team and he had clearly elevated his game. Then his dream came true.  A 3^rd spot opened up. But the coaches gave it to the 4th place finisher who he had soundly beaten.

Five years ago he would have been out of his mind for weeks. Making the US ski team had consumed him for over half of his life. And he was upset – for about two days. By the time he told me a week later he had let it go and had enjoyed a wonderful holiday with his girlfriend and friends. I flew over the next weekend to ski with him and he really had moved on. We had a great few days together. The elephant’s noose

I asked him how he had raised his level of skiing to almost winning the event. That is when he told me he had been doing a lot of the expressive writing and immediately destroying it. I was surprised and pleased that my son had actually listened to his father’s advice. He had increased the writing a lot during the competition week. A friend of mine asked him about the Hoffman process. Nick started thinking about the events and reminisced that he actually had used many of the Hoffman tools during the competition.

Before his final “almost-winning run” he was dealing with his fears of failing under pressure. In the starting gate he took his ski pole and wrote the word, “fail” in the snow and then used his skis to bash it. Hoffman graduates will recognize it as one of the basic tools of the process. He proceeded to ski the run of his life.

“The Winning Run”

From my perspective his “winning run” was letting go of being passed over for a US Ski team spot. He seemed to move past it far quicker than I did. Dealing with adversity is maybe the one most important traits that will allow you to live an enjoyable and productive life. I realized that my son had grown up.

The post Nick’s Winning Run – Off of the Hill first appeared on Back in Control.

The post Nick’s Winning Run – Off of the Hill appeared first on Back in Control.

You’re never going to get rid of anxiety or anger. They are a necessary part of life. It has been demonstrated that avoiding these emotions will just increase their frequency. In the famous White Bears study, Dr. Wegner demonstrated that when you to try not to think about something, you will inevitably think about it more. Ignoring your anxiety and frustration will not get rid of those feelings, and the concept of self-esteem won’t help for a variety of reasons.

First, self-esteem involves endless judgments of you versus those around you. You are either “better than” or “worse than” the people around you. This line of reasoning creates labels; you cannot really see who other people are, what their needs might be, and how you might help. You have lost awareness. This is the antithesis of what is necessary for the world to become a better place – the acceptance and celebration of differences.

Second, attempting to build self-esteem involves using rational methods to deal with irrational neurological circuits. The emotional unconscious brain is much more powerful than the intellect; it’s a huge mismatch.

Third, what happens after you’ve achieved the things that should have alleviated your frustrations and anxiety, and it doesn’t work? (and it won’t) You will become more frustrated because there’s nowhere left to go. The list of high-profile people who have self-destructed is long. They usually had every imaginable comfort life has to offer. It’s impossible to outrun your mind.

Achievement Doesn’t Work

In the medical profession, it expected that you encounter death frequently. What is not as talked about is how often those deaths are of fellow medical caregivers taking their own lives. I know of 19 medical colleagues who are dead from suicide. Two close friends, and also four out of my eighty medical school classmates are dead from suicide.

These aren’t just numbers to me. I had a friend who was an excellent spine surgeon and one of those guys you could count on for anything. He had spent the day in surgery with me, assisting with a difficult operation. At two o’clock he shook my hand and said, “Nice case, I have an appointment I can’t miss.” He walked out, and three hours later shot himself.

All of them were “living the dream.” They were highly educated, wealthy, with big reputations, beautiful families – the list is endless. They possessed more than enough to have self-esteem. Yet the anxious, perfectionistic drive that pushed them to the top destroyed them.

Perfectionism

Perfectionism is rampant in the medical culture. Although “perfect” sounds reasonable when applied to surgery, it is actually deadly. What it does it creates an intense, chronic anxiety of “never being good enough,” and then frustration of never being able to achieve these unattainable goals. Perfectionism fosters anxiety-driven anger. Over time, the anxiety becomes intolerable. People don’t kill themselves because they are depressed. It is an angry act. Anger is destructive and the ultimate act of destruction is to destroy yourself.

I know this first-hand because I went through a similar experience that came to a head in 2002. I was actively suicidal with extreme anxiety for 18 months and crossed the line to put my plan into action. I was lucky. I made it through this gauntlet. I eventually published my story in 2011, in our national spine publication, SpineLine.

Nick and Holt

In my book, Back in Control, I talk about my son, Nick, and his friend Holt, who are both world-class mogul skiers. I learned many of the performance concepts presented in my book from watching them deal with the adversities of competing under intense pressure, while being at the mercy of judges. They were also obsessed with winning as the ultimate goal. Through working with an athletic performance coach, David Elaimy and also myself, they were able to learn to enjoy the journey regardless of the outcome.

In 2007, Holt won the national championship in mogul skiing. He felt that significant contributing factors to his victory were the awareness and visualization techniques presented in my book. One principle was letting go and performing with freedom. By connecting with his best effort instead of the outcome, his performance soared. The day after his victory, he turned to me and said, “You were right. Winning changed my life for about twelve hours. Life moves on.”

No matter your profession – a surgeon or an athlete – if you are connected with who you are, then you can create the life you want. If you are creating a life to fill a hole inside you, it becomes a major problem. It’s important and rewarding to strive for excellence; it just has nothing to do with decreasing anxiety and frustration.

“Better Not Look Down”

The post The Myth of Self-Esteem first appeared on Back in Control.

The post The Myth of Self-Esteem appeared first on Back in Control.