We are all programmed by our past The way we survive is that our brain is constantly comparing the present to the past and any situation that triggers a hint of a prior threatening scenario, will create a danger signal. There are over 20 million bits of sensory input being processed every second. This warning system has different forms – hot, cold, sharp, pressure, dizzy, bright, loud, bitter, rancid, and the list is long. However, they are all creating a similar reaction of being unpleasant enough to compel you to take action to solve it. They can all be lumped under the word, “pain” and the simultaneous reaction of anxiety.

Since this is what our brain is repetitively processing the environment every second, it is all being deeply programmed into your nervous system. It is also the reason that chronic pain (anxiety) almost always worsens with time. You are becoming more skilled in recognizing and feeling the pain. It is similar to a pianist practicing to the point where he or she develops the skills to be considered a virtuoso performer. The term for this process is, “neuroplasticity.” We are all programmed by our past up to this exact second.

The Talent Code What does this have to do with my golf swing? One of the first books I have historically had my patients read is a book called The Talent Code by Dan Coyle. He has done a wonderful job of looking at the factors that create genius. It is a growing observation that genius is rarely born. It occurs after about 10,000 hours of repetition. However, it is a specific kind of repetition called “deep learning.” The other two factors are “ignition” (obsessive repetitions) and “master coaching” (laying down the correct pathways).

Deep learning is the most basic concept in that it is necessary to enter information into your brain in a way that you can retain it. Each of us knows that if you just read or hear some new information that you will retain very little of it. It is necessary to use some technique such as visualization, verbally repeating new thoughts and concepts to yourself, writing them down, analyzing and challenging the ideas, re-interpreting material according to your perception of it, etc. By using techniques you are comfortable with, you can increase your learning by 500 to 600%. Conversely, random repetitions will decrease learning by 15-20%. In other words, you must actively process information to retain it and make it part of your nervous system. Master coaching keeps the repetitions within a narrow range.

Holt’s deep learning So, my way I approached golf was to take a lesson, learn a new concept, not practice enough, and jump to another concept. It is no wonder that I never came close to being an expert. My son’s best friend, Holt, won the 2007 US Mogul skiing championship by using deep learning. He broke down one of jumps called a “D-spine” into 13 different parts. Each practice jump was focused on just one of the components. It is a stunt where the skier does both a back flip and rotates sideways. He could lay down a competitive run almost 80% of the time, which is stunning considering the complexity of the sport. And he did it by practicing about a third as much as most of his competitors. Consider chronic pain. You are trapped by relentless unpleasant sensations without an obvious alternative. The pain impulses fit the definition of “deep learning” in that they are so specific. The obsessive repetition is self-apparent and these circuits don’t require master coaching.

Stimulating neuroplasticity So, these basic automatic survival circuits are permanently embedded. Paradoxically, the more you pay attention to them or, even worse, suppress them, the stronger they will become. The key is to reprogram your brain to have alternative and more functional responses to threat – whether it is real or perceived. There are three steps: 1) awareness of the automatic response 2) create some “space” between the stimulus and reaction  3) substitute a response that is your choice. With repetition your brain will develop new circuits that are more pleasant and eventually automatic. You are creating a new nervous system within your current one. It is similar to having a virtual desktop installed on your computer. By trying to “fix” my bad golf swing, I got nowhere. If I had created and pursued a vision of what I wanted to create, I may have had more success. You have heard the saying, “Practice makes perfect.” What is more true is, “Perfect practice makes perfect.” Why keep embedding your mistakes or dysfunctional reactive patterns?    

“I read your book and I still hurt” It is common for people to say that they have read multiple books, including Back in Control, and they still feel the same. Yet when I ask them what reprogramming skills they are regularly using, the answer is always the same – none or maybe just a couple on occasion. You don’t want your brain’s reactive response to a threat to always be unpleasant. Even worse, what we often perceive as a threat is actually not a threat. It is a “cognitive distortion” and really a huge waste of time and energy. If you want to break free from pain, you have to develop a regular practice. It does not require much time once you have learned the healing concepts.

The DOC Journey presents a sequence of learning that allows you to first understand the nature of the problem, develop a strong foundation by using tools to calm and stabilize your nervous system, provides strategies to break free from your past programming, and most importantly move forward into the life that you desire. What kind of golf game (life) do you desire? I am probably not going to commit to a great golf swing at this point in my life. You have no idea how much I know about the mechanics of the swing, but I don’t want to spend that much time practicing. But I am committed to learning as much as I can about the latest neuroscience research around chronic disease and bringing these ideas into the public domain. My personal challenge is presenting them as clearly as possible. I am excited about learning these skills and encouraged that patients are responding more quickly. I am continually inspired by people’s persistence and courage in the face of the adversity of chronic pain.

References:

1. Coyle, Dan. The Talent Code: Greatness isn’t Born. It’s Grown. Here’s How. Random House, New York, NY, 2009.

The post Become a Genius at Solving Pain first appeared on Back in Control.

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• Modern civilization offers more opportunities than any other era of human history. Yet our mental health is declining.
• We have been led to believe that experiences, knowledge, possessions, and accomplishments can make us happy.
• You cannot outrun your mind. It is a futile effort because your unconscious survival reactions dictate how you feel.
• The key is to learn approaches to calm your body’s flight or fight response and “just be.”

Chronic mental and physical Illnesses are rampant amongst teenagers. A 2014 paper out of Indianapolis demonstrated an 830 percent increase in hospital admissions for pain in adolescents over a seven-year span. In the vast majority of patients, a cause of the symptoms could not be found. I gave a talk at a high school a few years ago and was told that over 350 of the 1500 students had a chronic medical problem that had to be monitored. Eating disorders are increasing, even amongst males. Teen suicide is a serious problem. We have more resources and opportunities at our disposal than at any point in human history. We live in a free country with unlimited opportunities. Yet much of the population is miserable. We keep wringing our hands about the problem but are not coming up with real solutions. What is going on?

We are not addressing the root cause, anxiety, with an effective paradigm. It is a powerful physiological (how the body functions) response to real or perceived danger, and avoiding it is a driving force behind much of human behavior. All life has some form of a “flight or fight” reaction. Humans have language and describe it with the word, “anxiety.” It is automatic, hard-wired, unresponsive to conscious control, and evolved to be incredibly unpleasant. A common approach to quell anxiety is to experience, accomplish, achieve, and remain busy in order to outrun it. It is impossible to avoid feeling your body’s chemistry. A fired up nervous system also interprets these sensation and creates an endless flow unpleasant thoughts that I call, “RUTs” (repetitive unpleasant thoughts). You cannot escape your body or outrun your mind. Our modern era of opportunity has actually worsened this scenario. We didn’t evolve to process so much information in a day.

Choices

First, we have too many choices. I will never forget during my psychology course in medical school learned that volunteers’ anxiety was as high when given choices about equivalent positive or negative options. Humans have trouble with choice and we don’t like feeling anxious.

Trapped by success

Second, we are encouraged to experience life to the fullest and achieve. We are entering organized sports at an early age, traveling the world, and given wonderful options of becoming creative. There is no limit as to what is possible. That also the problem. You can achieve many things but you cannot outrun your mind. What is even more of a problem is that when you have accomplished what you think should give you peace of mind and you are still unhappy, where do you go next? Then you really feel trapped.

I recall riding a chairlift with my son in Utah during the midst of my anxiety-driven burnout. There was about a foot and a half of fresh powder, my 10-year old son was an accomplished skier, we were spending a wonderful day together, and I was miserable. I also had a great practice, beautiful family, nice house, and was becoming financially secure. The sense of being trapped was overwhelming. What else was I supposed to do to be “happy?”

That same year I was talking to a middle-aged gentleman in my office who broke down crying because he had sold his business for 45 million dollars and did not know what to do. It had been his life. His anxiety was crippling. Over an 18-month span while I lived in Sun Valley, ID six men between 45 – 60 committed suicide. All of them on the surface were accomplished, had experienced many adventures, had families, friends, and were wealthy. It wasn’t enough. I do not know details, but there is a well-documented link between rumination and suicide. (1)

Your personal brain scanner

Third, even when your situation is idyllic your brain continues to search for threats. The human body is designed to firstsurvive; not to have a great time. Humans also have the problem in that danger can be created in our minds, which Dr. David Burns terms, “cognitive distortions”. These become our ego. The  “stories” we create to feel better about ourselves are compilation of faulty thinking and “good self-esteem” is a massive cognitive distortion of labeling.

Many of us are driven by our self-critical voice, which represents the cognitive distortion of “should thinking.” Perfectionism is a particularly insidious version of it, and we may drive ourselves unmercifully to attain remarkable heights. Since our “ideal self” is unattainable we have set ourselves up for endless and progressive frustration. My son, Nick, and his best friend, Holt, were competing in mogul skiing at a national level their focus was on winning. If they lost, then they were pretty unhappy until the next event. David Elaimy, their performance coach and I kept trying to tell them to enjoy the process and be happy they were able to travel the world and compete. The day after Holt won the national championship he finally said, “You were right. I still have to get up and go to work. My life has not changed that much.” When your peace of mind is dependent on your circumstances or other’s opinions, you are at the mercy of them.

Golf and life

Golf is one sport that highlights this issue. David Elaimy, is a performance coach who teaches our fellows performance concepts to be utilized in surgery. He pointed out that at the end of a round of golf that 80% of golfers are unhappy with their game – because of the score. It personally took me years to get past the score but my biggest accomplishment in golf is truly enjoying being outside with my friends and seeing how well I can do. I do not have the time to drop my handicap but it no longer makes sense to me to spend any part of my free time being frustrated about a score. It is just a story.

A life-changing moment on the golf course

Here is a letter from one of my administrative colleagues who I really enjoyed working with. He had read my post, The Tale of Two Golf Holes. The joy of my second hole-in-one had been completely wiped out by my frustration. It was one of the most enlightening moments of my life.

Dear Dave,

The frustration and joy of golf can easily lead to some strong emotions including anger. I know my brother and I struggled with that for a long time, until one day I realized what it is all about.

My brother was having a particularly difficult day on the course with my Dad some years ago and was just about ready to throw a fit. My Dad told him to stop playing. They both laid down on the green, looked up at the clouds on a beautiful day and took a moment to appreciate spending time together outside with nobody else around. “This is what it is all about.” My brother walked up back to his ball and asked my Dad, “So I don’t have to keep playing, I can just walk the rest of this hole and start back up on the next one if I want?” Right as my Dad was about to affirm his question he whispers to my brother to turn around. Not five feet behind him stood a deer.

My dad and brother always describe this as one of their epiphany moments, and for me it illustrates that golf is just a game. While it can be challenging and frustrating, you can’t let that aspect of the game get the best of you and distract you from the joy and awe it can bring. Great article Dave, it really got me thinking of just how toxic anger towards something or someone can be, and how powerful forgiveness can be. (this includes perfectionism –  anger towards yourself). Best, George

Be all that you can be?

Defining myself by my accomplishments and “score” has been my entire life. These deeply etched in behavioral patterns are not going to disappear. However, by being aware of their presence and power allows me to separate my “identity” from them. The solution lies learning tools to pull into the “centre of the storm”, skilfully deal with adversity, and nurture joy. It is an ongoing daily lifetime practice. So, just “be” – and enjoy your day.

References

1. Morrison, R., & O’Connor, R.C. A systematic review of the relationship between rumination and suicidality. Suicide and Life-Threatening Behaviour (2008); 38:523-538.

The post Be All that You Can Be – or Just Be first appeared on Back in Control.

The post Be All that You Can Be – or Just Be appeared first on Back in Control.

Pain pathways are permanent. So are the intertwined anxiety and anger circuits. I am personally reminded of this fact on a daily basis. It happened in a particularly dramatic fashion while on vacation in Italy.

Florence

My wife lived in Florence, Italy from 1983 to 1990. She is fluent in Italian and we have a wonderful group of friends in the area. We try to get back every year to spend some time with them. It is always a remarkably enjoyable experience.

Relaxing is not one my most highly developed skills. But I did it. We had been staying in a small apartment in the lower part of one our best friend’s house. It had a beautiful view. We had shared some great meals with them, met some new friends, and I had stayed off the computer. I remember lying in bed towards the end of the trip thinking how nice it would be to be in this state of mind more often.

Ugolino

We had decided to play nine holes of golf together at one of the oldest golf courses in Italy. It was in a spectacular spot. My wife learned to play golf a couple of years ago and she was very excited to be able to play in one of her favorite places in the world on a beautiful day. Those of you who play golf with your spouse know that is a tricky adventure. Somehow it brings out the deepest issues in a relationship quickly (and consistently).

Our game at Ugolino

She had a great shot off of the first tee. The second shot was excellent and reached the green but in the right sand trap. I waited for her to hit out the trap once, then twice. After the third attempt I suggested that maybe she could pick up the ball. Additionally we had two local Italians behind us who were beginning to yell at us. She said, “No!!”

The second hole went pretty well except there were a few extra shots. Nonetheless she was playing pretty well as I was working on letting go of our less-than-ideal interaction on the first hole.

I was a little anxious on the third hole in that our pace-of-play was a little slow. I admittedly have a strong reaction to being held up on the golf course by groups in front of me but I really don’t do that well when I am part of a group that is holding up the rest of the course. A tale of two golf holes I suggested that maybe we could let the people behind us play through. That was met with a “No”!

The 4^th hole was fine while I again worked on enjoying my day. On the 5^th hole she hit the shot of her life on a long par three on to the green and the round began to pick up.

Fairway 9

#6

The tee shot on the sixth hole was across a pretty wide ravine. She decided to pull her driver. I said, “Honey, you have not missed a tee shot with your three-wood all day and you can easily cross this hazard.” Three shots and three balls later with the driver we were finally in play. We hit our second shots pretty well. Then she needed to find the restroom, which was nowhere to be found. There were now two groups playing up on us. As she was “coaching” me on how to drive the golf cart back to the clubhouse my brain exploded and I went into my infamous, highly developed victim mode. It came out as clenching my jaw and saying nothing. However, my body language was not subtle. She was not quite sure why I was so upset.

Gone

The rest of the round is not worth describing. I will only tell you that I was the only one playing the ninth hole and my golfing partner was walking.

Here I was after being incredibly relaxed, on a wonderful day in Italy, with my beautiful wife in the worst mood you can imagine. I intellectually knew that the anger/victim pattern has nothing to do with the person or situation that set it off. I was triggered, but I could still not stop the reaction. Knowing this made it even worse as I also get a little hard on myself when I fail.

At least one of us was sane

She was thinking, “What kind of person am I married to?” However, she is a remarkably wise and understanding wife. She was able to see me separately from my reaction and did not engage with me until I calmed down. Historically this encounter would have wiped out the rest of our vacation. I did recognize my temporary insanity and in about 30 minutes I was fine. We had a wonderful lunch and evening.

I hung a picture of the golf course in my office to remind me that victim patterns are universal and permanent. It does not matter how great your external circumstances might be, they have little effect on what goes on in your head.

Anger will always be with you

This experience was extremely humbling and enlightening. I used to think the goal of the DOC project and somatic work was to “conquer” anger and never go into the victim mode. That thinking actually makes things much worse in that you are actually just suppressing anger. It is a disaster. Since that day I have committed to being more aware and honest with myself of when I dive into that hole. Paradoxically it does occur less often and although the sequence is always the same the duration is shorter and the intensity is diminished.

Make no mistake about this fact. Every human has a deep victim pattern. That is because we are limited in what we can do to influence our environment and we truly are victimized on a regular basis. It is how you relate to this reality is what deeply affects the quality of your life. The advantages of victimhood

“You don’t need surgery”

Any time a patient comes in with chronic pain and rates him or herself as a zero on anxiety, depression, and irritability our whole staff recognizes we are in for a difficult interaction regardless how hard we try to be of service. As soon as I point out that I don’t see anything that I can do surgery on he or she often explodes. It is usually very intense and they can be verbally abusive to my staff. They don’t dare take me on. The more we try to calm them down the worse it gets. We have learned to let go very quickly and offer to see them back if they wish. We feel upset in that we know what is possible for them but they don’t have the capacity to engage. Anger simplified

Your circumstances don’t make that much difference

I have one patient, who has experienced an extreme amount of stress in the form of domestic violence, financial disasters, and a poorly done spine surgery. Even though my surgery solved the structural spine problem his pain did not abate – at all. Pain and anger are so entwined that you cannot experience pain relief until you can truly let go of your legitimate anger. That includes your anger at the surgeon who screwed up your surgery, the employer who do not have adequate safety guards, or the person who rear-ended you at a high speed and was drunk. He keeps explaining to me how great his life is now with better finances, a great relationship, etc. but he still has pain that now envelops his whole body.

I am reminded of Ugolino. Your life can be perfect. Your victim pattern is not going away. Unless you can let your anger go your pain will always be with you.

The post Ugolino first appeared on Back in Control.

The post Ugolino appeared first on Back in Control.

Thanksgiving weekend of 2008, I was playing golf with three close friends. All were significantly better golfers than I. The one thing I have accomplished in golf is the ability to have a great time on the course, regardless of the score. This group was one I had played a lot of golf with, and we were having a wonderful day in the bay area of California at my brother-in-law’s club.

Tough first four holes

The first three holes engendered optimism. I had two pars and a bogey. I stepped up to the fourth tee and promptly hooked my ball left out-of-bounds. My second shot off the tee was fairly long but off to the right. I was laying three. My next shot didn’t need to be so ambitious.  Nevertheless, I decided to go beyond my comfort zone and hit a low shot that would fade to the right under a branch that was about 60 feet off of the ground. I hit the shot of my life. It sailed off of my club and began a slow descent to the right heading towards the pin. The tree branch was one inch too low. Not only did my ball hit the branch, but it bounced 40 feet to the left out of bounds. I ended up with a nine.

At this point, I was debating the merits of continuing to keep score but decided to record the nine and move on. The next couple of holes were a struggle, but finally woke up and had a good run in the middle. The 16th hole took me down a bit with some remarkably bad shots.

I stepped up to the par three 17th hole having to work a little harder at enjoying myself. It was a beautiful day and the course has a panoramic view of the whole bay area, including the Golden Gate Bridge. I pulled myself into that reality after a couple of deep breaths.

The perfect bounce

The hole was 165 yards away, downhill, and to the right. My three friends, of course, had hit three nice shots. I stepped up with an eight-iron feeling that I did not have much to lose. I hit the sweet spot and killed it. But it was clearly going to be too long. The ball was drifting to the right and headed off the back of the green. It was one of those bittersweet moments of feeling like I had hit the perfect shot but still needed some luck just to salvage the hole. The ball landed, took one bounce, directly hit the flag and dropped into the hole.

I will never forget that moment. Everyone started to cheer. I was not sure that it had really happened. We could not stop yelling. The rest of my life seemed somewhat small. The best part was that I was able share it with my friends. Even as I am writing this story, the memory of that event still gives me chills. There are not words to describe the depth of enjoyment and pleasure I felt that day. One my playing partners gave me a beautiful plaque with a picture, the ball, and the scorecard commemorating the experience.

Even though I am not a good golfer, after taking so many lessons, I have a reasonable understanding of the golf swing. I have taught over a dozen people to play, most of whom have long surpassed me. One of those people is my best friend, who is my golfing buddy most weekends. We have a great time relaxing and coaching each other. My only solace as I routinely watch him beat me is that he must have had a great teacher.

Golfing on a busy Sunday afternoon 

One weekend, my wife and I joined my friend and his wife for a Sunday afternoon of golf at a course in Alameda by the bay. It is an executive course that is nicely laid out and fairly challenging. We arrived early and spent a couple of hours at the driving range. My friend worked with my wife and I worked with his wife. (It is a lot safer that way).  His wife had not played much golf, and I was hesitant to give her too many things to work on. Every concept I gave her she mastered in about five swings. An hour later she was hitting her driver over 160 yards. My wife was also enjoying her time working on her swing. I was getting very relaxed, which is not my normal state.

As we headed over to the course, I had some anxiety about the situation. I have learned over the years that no one cares about your golf score except you. But most experienced golfers care about the pace of play. I have difficulty enjoying a round when the group in front of us is holding up play. However, my frustration level can become extreme if I am in a group that is holding up the rest of the course. His wife had never been on a golf course and my wife had only been on one a couple of times. Somehow, we decided to have a friendly competition and keep score between the families. Golfers know that any competition slows the game down and I did not think that this was a great idea. As I was only one out of four, with one of the others being my wife, I lost that discussion.

Delaying play

The course started out empty, and we were having a wonderful afternoon. Our wives had some great shots. I was playing with my usual inconsistency and my golfing buddy was playing with his usual consistency. At the fourth hole, another group began to have to wait for us. Between the fourth and fifth hole we had to walk past the starter’s booth. She walked out and yelled at me, “You have taken 80 minutes to play four holes. You have to step it up.” My relaxed state of mind began to wane. We let that group play through the fifth hole but by the seventh hole we had three other groups stacked up behind us. My suggestions to my group to help speed up our pace of play were going unheeded. I was losing my mind, and my frustration level was a 12 out of 10. I was additionally frustrated in that I was with some of the closest people in my life, and I particularly wanted my wife and I to have a great experience on the course. I wasn’t saying much, but my wife was not fooled and became upset at me being upset. You all know how that works. Now my frustration factor was at a 20 out of 10.

I stepped up to the ball. The hole was a flat par three that was 208 yards. I took my five-wood and hit a low shot that started out to the right and began to drift left. The ball landed about 20 yards in front of the green, continued to roll left towards the hole, hit the flag and dropped into the hole.

The power of anger

There was not a flicker of response inside of me. Nothing. I was so frustrated about holding up the rest of the course that I just turned around and walked away. Everyone else was excited. I felt nothing. Even when I walked up to the hole and physically pulled my ball out of the cup, there was a slight sensation that this was sort of cool that I had hit another hole in one. But that was it.

The contrast between the two experiences was dramatic. As much pleasure that I had etched into my mind from my first hole-in-one, I have only frustration burned into my head with the second hole-in-one. Even as I am sitting here writing this story and thinking about that moment, it causes me to feel a pit in my stomach.

Anger has the power to destroy every part of your life that is meaningful and good. I am unsure how to commemorate this second hole-in-one.

The post A Tale of Two Golf Holes first appeared on Back in Control.

The post A Tale of Two Golf Holes appeared first on Back in Control.