So I was driven beyond words to “prove myself” and worked extremely hard to become accomplished to fill this gap. I became “successful”. But the adrenaline drive that took me up the hill took me right back down the other side, ending up with a shattered life and a suicidal depression. No one on the outside could even sense the depth of the drive or the intense angst that propelled it. So how do you define “success”? With physician burnout approaching 60% across the board, this is becoming even a bigger question.

Amongst teens, this is also a significant problem in that social media makes it seem even more that everyone has a dream life; except that there is a huge increase in adolescent chronic pain, heroin use, suicide, and generalized unrest. There is a word, “FOMO” (fear of missing out) that encapsulates the situation.

My first clue that this perspective was a problem was when I read a book, The Art of Happiness based on the teachings of the Dali Lama. He pointed out how much more productive it was to compare yourself and your circumstances to those who were less fortunate than it was to think about what you didn’t have.

“Anxiety with Success”

I became aware of another pattern of thinking in the midst of my Hoffman process. It was experiencing “anxiety with success.” The Hoffman process presented an organized format, which allowed me to become aware of my embedded reactive behavioral patterns. It turns out that the success that I was working at so diligently, was creating intense anxiety. Talk about driving down the freeway of life in the wrong direction.

Why??

I was the oldest of four children in a household with a difficult mother who suffered from chronic pain. I was the problem-solver in the family beginning around seven years-old. The baseline state of our family was chaos. The Hoffman process taught me to diagram what they term is a vicious cycle. Here’s the sequence:

• Chaos (severe and my baseline state)
• Problem-solving/conflict resolution mode (strong role, especially for a child)
• Problem solved (I felt I had some power)
• Period of calm (anxiety ensued in that we didn’t know how long it would last)
• Need for chaos (my comfort zone)
• Chaos (back in action)

Self-Sabotage

I’ve had a lot of successes and also many failures. One pattern of behavior I hadn’t seen was that I’d have some success and then somehow I rarely followed through. Or I would get into a reactive mode and walk away from potentially major successes. I then spent a lot of time wondering what happened and then beating myself up. All of this was not only a waste of time, but consumed a lot of emotional energy.

When the behavioral pattern that emerged was that I had extreme “anxiety with success”, I was shocked. I had spent the major part of my waking hours trying to be successful in whatever I attempted, yet I was creating situations that caused intense anxiety. How could this be? I’ve since learned that this is a fairly common problem.

Gratitude

Becoming aware of this sequence allowed me to use the various tools in the DOC process to work through the parts of this vicious cycle. I wasn’t as effective at dealing with the “anxiety of success” as I was with other patterns. As I continued to work with my teacher, Kani Comstock, she pointed out something that allowed me to better enjoy my life. It was gratitude.

Enduring Pain

I have endured a lot and so have most of you. Chronic pain with all of its many layers isn’t a small problem. I got lucky in coming out of this hole. Eventually, I was able to figure out many factors that contributed what I feel was almost a miracle. Amongst many things in life I am grateful for, I’m happy to be able to share these concepts with you.

It Has Been Worth It

Although I have seen hundreds of patients become pain free, this isn’t a numbers game with me. Even if my life experience allowed just one of my patients to achieve a pain free state, it has all been worthwhile. Every time a patient comes in excited about their relief of pain, I’m still fascinated and somewhat in a state of disbelief. At my core, I’m a surgeon and I don’t understand all of the variables that cause this to happen. Not only do they become pain free, but also they rapidly begin to recreate the life that they had lost and go well beyond what they ever had. I’ve seen several patients have their spouses come back to them and create a thriving relationship. Many families are able to enjoy a much happier home life.

That I have been able to contribute to their healing is a gift to me that I never would have imagined possible.

Giving Back

The post Anxiety with Success first appeared on Back in Control.

The post Anxiety with Success 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.

As these family patterns are so familiar it is anxiety-producing to change or even think about changing them. Your family feels the same way. All parties involved have a vested interest in having you remain unchanged – regardless of how miserable you might be. “Misery loves company” is not a joke.

Paraplegic

I have a patient who became paraplegic after spine surgery at an outside institution.  He has had multiple medical problems associated with his paraplegis in addition to suffering chronic pain in his back and legs.  Working through the phases of the DOC project has resulted in a significant decrease in pain. Unexpectedly, his bipolar disorder of over 40 years disappeared and he was able to discontinue his medications. The key was addressing his deep anger. The transformation was dramatic. He felt happier in a wheelchair than when he was bipolar and walking.

“I don’t want to see you”

I had been seeing him monthly for several years. We had entered the goal-setting phase of his rehab. He was interested in interacting with other people who are wheelchair-bound.  This fall, he was able to purchase a laptop computer and start pursuing his dream.  Then he called my assistant and told us that he was not going to be seeing me anymore. My first response was to wonder what I had done to upset him. He had truly been an inspirational person, so I gave him a call to ask why he no longer wanted to see me.

Thanksgiving

What happened was this: his family from the East joined him for Thanksgiving; instead of being excited and supportive of his transformation, they destroyed him. They told him that there was no use in reaching out to other paraplegics. They also reminded him that he had been diagnosed with a bipolar disorder since he was 12 years old and told him that the disorder is incurable. Finally, the family instructed the patient to stop seeing me.

The family environment that contributed to him becoming bipolar was now focused on keeping him that way. His deep changes were upsetting to his family because there was a major redefinition of roles taking place. He had been the sick one. If he could create this depth of insight and healing, why couldn’t they do the same?

When he was in his own familiar patterns, which were based on anger, he could not see his anger or their anger. Today he saw it as clear as day. He had not been chronically angry for over a year and was moving forward quickly. To now see the people you love live in anger was extremely distressing.

Family Patterns

Family patterns are passed down from generation to generation.  From birth to age 12, your family environment is “downloaded” into your brain. It is your database for the rest of your life and also your frame of reference. What are your patterns? Are you being held back by your own patterns that you cannot recognize? Are you unconsciously making sure that the people close to you maintain a certain familiarity, even though it may be destructive?  Do you have control issues?  Do you feel controlled?

Wake up. Your life will not improve until you become aware of your behavioral patterns and the impact they have on those around you.  If you are chronically angry, you cannot see anything clearly, and like me, you may not even be aware you have any issues with anger.

I had a great discussion with that patient and he continued to see me for about six months. The phase of breaking free of his family patterns was challenging. In order to break free, he had to first recognize that he was trapped. He was undertaking a significant step, one that I’ve talked about before in “ Anger: The Continental Divide.” Personally, I had never understood how strongly these family patterns could hold you down. I thought his family would have been ecstatic. He was happy for the first time in his life. His family was not.

Back into the abyss

I am rewriting this story after about a year. For about six months his mood and pain were great and rehab was moving forward. The anger returned for reasons that are unclear. He was never completely the same after that Thanksgiving holiday. He did quit seeing me, his anger consumed him. His pain returned and his mood turned black. I don’t know all of the issues that pulled him back into the abyss but his family was a significant part of of it.

What effect is your family having on your journey? Are they your cheerleaders – or not?

The crab bucket

The post Breaking Loose – NOT first appeared on Back in Control.

The post Breaking Loose – NOT appeared first on Back in Control.

Climbing the Mountain

Picture a steep mountain with a ten-foot smooth block wall running up the center of it. I am climbing up this incline on the left side of the wall. There is no path and I have to fight through thick brush as I work my way up. After the process, I felt like I opened a door in the wall and walked through to the right side, which has a stairway. I’m still climbing the same difficult mountain but I’m not fighting myself. Becoming aware of my deeply-embedded behavioral patterns has allowed me to navigate around and through them.

A Laser Beam

The Center of Public Leadership at Harvard has offered the Hoffman process to its graduates. The process enables you to become more creative and focused, both of which are important for leadership. I took the post-Hoffman leadership pathway and I’ve accomplished more in a leadership role in a few years than I did the first 22 years of my career. I came out of Hoffman like a laser beam with a clear vision. I haven’t deviated a millimeter since the day I walked out of it.

Hoffman also gave me the insight to put words to what I had inadvertently done for myself through expressive writing, which is awareness, separation and reprogramming of my thoughts. I hadn’t seen this sequence earlier. I hadn’t wanted to do Hoffman and went only because my wife had asked me to. She had gone through it about six months earlier. I had been in therapy for over 12 years and thought I had life figured out. I was doing well before Hoffman and didn’t think would be useful. What Hoffman gave me was clarity and and the tools to clear out the interference. None of this DOC process or my book would have been possible without this experience. One of my ingrained core patterns was procrastination. I still use the tools daily.

Pain Free

On the last evening of the process, there is closing ceremony. Hoffman graduates attend the ceremony to support friends and family that have just completed the process. Many will stand up and share some of their post-Hoffman life experiences.

After my ceremony, three different businessmen stood up and gave glowing testimonials on how Hoffman had influenced their lives. Then a woman stood up who was a bit of an awkward public speaker. It was initially uncomfortable watching her stumble through her sentences. She had recently finished the process a month earlier and had been in chronic pain for over ten years. She had traveled the world and spent over $400,000 looking for a cure. As she continued her testimonial, she started warming up and her demeanor transformed into that of a well-educated, confident person. She said, “I spent all this money, traveled the to the ends of the earth, underwent many tests and treatments, and all I needed to have done was to come to Hoffman to discover that I was just fine.”  She was almost pain-free for the first time in years.

If every person could learn and practice the tools learned during the Hoffman process, patterns of behavior being passed from generation to generation would be broken and the world would change. That was Bob Hoffman’s vision in 1967 when he founded Hoffman.

My Son’s Experience

My son did the process at age 25. Being in the world of freestyle mogul skiing didn’t seem like a great fit with Hoffman and I wasn’t sure it was going to be that helpful. He had an easier experience than I did since he didn’t have 56 years of patterns etched into his brain. The word he used after the process was “cleansed.”  It was a little disconcerting knowing I was the one who had imprinted some difficult patterns on my son. It was incredibly rewarding seeing him go through the process and begin his own journey. He also still actively uses the tools and it had a significant impact on his life. Nick’s winning run – off of the hill

Not everyone is able to access the Hoffman process, but the neuroplasticity concepts that have been presented in Back in Control are powerful. Used on a regular basis they will change your life – if you’re open to change.

More Perspective

I did an interview about the impact Hoffman had on my life, “A Surgeon’s Perspective on the Hoffman Process”, Staying Connected. I also did a radio interview with Hoffman where I describe the relationship between the Mind Body Syndrome (MBS) and Chronic pain. Hoffman essentially looks at your entire life in terms of the Mind Body Syndrome, which I now call Neurophysiologic Disorder (NPD) although they were not initially aware of this link. My feeling is that Hoffman should be considered only after you are out of “The Abyss” and are able to move forward. It’s an integration process and many parts of your journey will come together allowing you to create a clear vision.

Trapped for 18 years by scoliosis surgery

The post My Hoffman Experience first appeared on Back in Control.

The post My Hoffman Experience appeared first on Back in Control.