• Many people are focused on controlling anger and anxiety with behavioural approaches.
• These powerful reactions are not controllable and suppressing them increases threat physiology.
• We all need to be heard, supported, and taught methods to regulate and lower these responses.
• Avoiding or suppressing stress causes damage to our bodies and causes chronic illnesses.

How many of us have heard the phrase, “children should be seen and not heard?” Or what about, “spare the rod and spoil the child.” How often were your parents not really there for you when you were upset?

DimaBerlin/ AdobeStock

Kari is a woman who I met in 2018 when she asked me to speak at her company’s annual disability conference. I presented the nature of chronic pain and approaches to solve it. I did not realize that she jumped right in with both feet and learned the concepts. She contacted me about a year later, and shared how excited she was about how much her life had improved. We have remained in close touch and here is her recent email. I had told her about a remarkable turnaround of a 24-year-old gentleman who had broken out of his bipolar disorder, anxiety, major depression, and pain migrating around his entire body.

Her letter

Hi David, is this the young man with Bipolar you mentioned during our call?  What an incredible transformation! 

You know what hit me the other night, few children are taught how to process anxiety so they do the best they can on their own and usually create inaccurate perceptions of themselves and learn ineffective and often damaging behaviors to deal with it (the 7-year-old creates the 50-year-old).  Parents should be doing this, but many parents are trapped in their own heads with repetitive negative thoughts and don’t know how to teach their children these skills as they haven’t learned them either.  And the cycle of dysfunction continues….

A little personal story here….My aunt gave me my grandmother’s book of prayers.  My grandma was an extremely anxious woman and pretty OCD.  I was thumbing through her book and noticed my grandma had written in the margins, underlined certain passages, etc.  In the section on anxiety, she had underlined several times that “anxiety is a sin.”  My poor Grandmother thought she was a sinner her entire life because she was anxious!  How awful!

My mother was also very anxious – no surprise there.  In 6^th grade, I had a boyfriend, nothing very serious at that age of course, but I went to school one day and here my best friend was now with my boyfriend.  I came home and was crying in my bedroom, mostly because my best friend had stabbed me in the back over a boy.  My mom came in and asked me what was wrong and when I told her, her response was, “get a real problem”. 

My mom was very stressed at the time with my two younger siblings and my dad always being at the bar – he was no help.  From that moment on, I never told her anything about my life that wasn’t positive and became very depressed all through junior high and high school. Not having a parent to support me emotionally really messed me up and caused me to create all these negative perceptions about myself that took me 40 years to get over.

I am grateful that I have broken the cycle of dysfunction with my son – we talk openly about these things, and he is a very high functioning and happy person. 

It’s all just so insane and sad.  Anyways, thanks for letting me share.  It was the sequence of concepts you presented that broke the cycle for me. Kari

Anger and love

Anger is a trait that blocks openness and engagement. One aspect of flight or fight physiology is that your necortex (thinking areas) are down regulated from stress hormones, the limbic system (fear) regions are activated, and you don’t even have good access to your rational thinking. Frustrated people are not rational, and there are no exceptions. Even more disturbing is that you can become crosswired and pain can be connected to “love”.

Our friend Sheila was standing in the checkout line at a grocery store when she heard a young mother screaming at her young five year-old daughter to put something back on the shelf. She suddenly hauled off and slapped her with a full swing. Almost at the same time the young girl began to cry, she held out her arms and ran to her mother to comfort her. Who else was there to console her? Talk about becoming cross-wired – the girl’s source of pain was also her bastion of love and protection.

My childhood experience with “love”

My mother would fly into rages that would last for two or three days. We never knew what would set them off, although we imagined many possibilities. We thought it was associated with our behavior, but no matter how hard we tried to avoid upsetting her, it just happened. After every tirade she would profusely apologize, and tell us how much she loved us. It was quite confusing. What even seems more bizarre in retrospect was that I was convinced that our parents loved us. I recall telling friends of mine in middle school that although my parents had some faults, at least I knew they loved us? Really??

The answer really is yes. My mother spent hours driving us around, volunteering at school, and talked about us in glowing terms to anyone that would listen. What I did not know as a young child is how disconnected anger (she also had chronic pain) can make you. She essentially entered a different reality when she became upset. From our perspective this was all a part of parental support and love.

It was so mixed up in my head that I did not even realize that anger was part of my life until I was almost 50 years old. It was just normal for me to become “frustrated” and since I was “right”, I did not have a clue that this was what anger looked like. I don’t think those close to me felt the same way. But at the same time, I was experiencing over 17 different physical and mental symptoms. I was disconnected.

What is your concept of love?

When you are an infant or child your mind is a blank slate being downloaded from your environment. If your symbols of love and protection are combined with mental or physical neglect or abuse, your concept of love will be much different than someone who was raised in a warm, caring, nurturing, and loving environment. In retrospect it is disturbing to me that I was so verbal about how much my mother loved me in the midst of a violent environment.

Sviatoslav Kovtun/AdobeStock

We all need to be seen AND heard

The common theme of these three situations is that a child was anxious and upset. The interventions took the form of suppressing and attempting to extinguish these behaviors, which were caused by a powerful unpleasant survival reaction. Many of us are taught from an early age that, “it is better to look good than feel good.” The root problem causing the reaction is often not addressed. You don’t feel heard, and you quickly learn that suppressing your feelings is better than having to deal with them. Except, what you don’t realize is that suppressing thoughts and emotions is like turning the heat up on a pressure cooker. The consequences are usually severe. The hippocampus of your brain (memory center) both shrinks and malfunctions.

The solution lies in the saying, “you have to feel to heal.” And then using strategies to regulate your flight or fight state to safety physiology. By dampening the driving force, not only will behaviors improve, but you can also live life in awareness and freedom.

References

1. Hulbert JC, et al. Inducing amnesia through systemic suppression. Nature Communications (2015); published 3.15.2016. 7:11003 | DOI: 10.1038/ncomms11003

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A representative definition of “Authentic Self”

This is a piece from “A to Zen” from the Internet that represents a common line of thinking about the term, “authentic self.”¹ The problem is that in the human experience, our powerful behavioral patterns win out and these enviable traits are buried. Then it becomes even more frustrating when we can’t live up to our “standards.” The cycle continues in that we may actually engage in destructive behaviors even though we know better.

In general, when talking about someone who is authentic, we mean that they are genuine, honest, and real.

An authentic person is someone who is comfortable in their skin and doesn’t feel the need to put on a front to fit in and be accepted by others. They know who they are, and they don’t hide it.

They understand their purpose and follow their life’s passion. They don’t chase after money, status, and possessions and are not immorally competitive, for they are not fearful of anyone.

However, this doesn’t mean they don’t live a wealthy life and enjoy nice things, but they define and strive for success to their own standard. 

7 SIGNS YOU ARE AN AUTHENTIC PERSON

1. YOU ARE ACCEPTING OF YOURSELF AND OTHERS

2. YOU HAVE A HEALTHY EGO

3. YOU HAVE A REALISTIC PERCEPTION OF REALITY

4. YOU ACCEPT MISTAKES (AND LEARN FROM THEM)

5. YOU ARE EMOTIONALLY MATURE 

6. YOU ARE CONSIDERATE TOWARDS OTHERS

7. YOU DON’T FEEL THREATENED BY OTHERS

What if you don’t have these traits? The problem is that few of us consistently exhibit many of these admirable qualities. Where would you have learned them if you were raised in a chaotic environment? Even if we possess some of them, how often do they get sabotaged, and how many of us have all of them. If the authentic self becomes an “internal standard” of being, then our self-critical voices will chime in to remind us how often we don’t (can’t) live up to these ideals, we are less accepting of ourselves, more frustrated, inflamed, and will experience more mental and physical pain.

Your ”authentic self”

Your authentic self is right here in front of you. It is the summation of your life programming from your parents, siblings, peers, teachers, employers, societal norms, and the marketing world. In other words, you are the product of who everyone else has told you to be. These messages are internalized and become your own inner voice telling you how you should be. The outcome is a lot of noise in your brain of self-judgement and that of others. We call it “self-esteem.” It is a mismatch of your powerful unconscious brain versus your conscious one. It is endless and wears you down.

David Eagleman in his brilliant book, Livewired, points out that humans are uniquely dependent on their parents for physical survival compared to most mammals. A baby is completely helpless and cannot survive on its own for many years.²

The emotional brain is even more complex in that we have language with an infinite number of possibilities. We are programmed by every moment of our lives, which means none of us are the same. Humans give meaning to everything, and no two people can look at a physical object in the same way. Thoughts and concepts are much more complex, and we are downloaded first with concrete concepts, then abstract ideas, and we don’t develop deep philosophical thinking for many years.

We are completely at the mercy of our environment as to what is inputted into our brains. What becomes more problematic is that thoughts and ideals are perceived as real to a given person as a car or table.³ They become our version of reality or life filter. Once this life lens is set, it becomes reinforced over a lifetime – unless you choose to become aware of it and change it.

Who are you?

So, we are who the world has told us we should be. We have programmed behavioral patterns that are the foundation of our existence. Most of them result from the basic need to survive. Few of us are taught how to nurture joy. Who are we?

You are who you are today. You can see yourself by becoming aware of what you react to, what makes you anxious and angry, what are your behaviors and attitudes towards yourself and others, how much personal responsibility you take for your actions, and what level of compassion and empathy you FEEL for others.

For example, most of us know that compassion is a good idea. But what happens when you are upset. You may say or do things that you are not proud of, and compassion goes right out the window. It is because compassion is a conscious construct and anger automatically arises from your unconscious brain. It is a million to one mismatch. It is that reaction in the moment is who you are because something in the present connected you to something threatening (or perceived as such) in the past. You are there and not here. It is also who you are.

“Love Your Enemies”

Anthony DeMello in his book, The Way to Love, has a chapter called, “Love Your Enemies.” He points out that if someone angers you, you should thank them. The problem is not them, but in you. Their words or actions triggered a response in you that allows you to have more awareness of what is inside of you.⁴ It is challenging in that it still feels like the other person causing the problem, but it is you that is being triggered. The exception, of course, is physical or emotional abuse. Anger is a necessary protective reaction.

Your real “Authentic Self”

This all sounds a bit hopeless but there is a lot of hope once you realize the depth of your programming and how it is playing out today. The key word is, “awareness.” Once you are aware of how your past is continually playing out in the present, you can direct where you want your brain to develop going forward. It continues to change every second and the term is called, “neuroplasticity.” The sequence is 1) awareness 2) separation 3) reprogramming. Without awareness, you’ll continue to be mired in the past.

As you learn to take full responsibility for every one of your actions without judgement, you can create any reality you want by consistently making better choices, and the above-mentioned traits can be nurtured daily.

This new evolving person is still your authentic self. You just don’t have to keep searching for it.

References

1. By Marissa on” A to Zen Life,” June 11, 2022. https://atozenlife.com/authentic-person/
2. Eagleman, David. Livewired. Cannongate Books, Edinburgh, UK, 2020.
3. Feldman Barret, Lisa. How Emotions are Made. Houghton, Mifflin, Harcourt, New York, NY, 2018.
4. DeMello, Anthony. The Way to Love. Bantam Doubleday Dell Publishing Group. New York, NY, 1995.

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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

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Behavioral patterns laid into your nervous system are the essence of your life view. Until you become aware of them and their effect on your day-to-day life you cannot connect with the core of you really are. Being around your family usually will precipitate a massive resurgence of these patterns. BTW, any time you are anxious or angry you are in a patterned behavior.

As these family patterns are so familiar it is very 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 had a patient who became paraplegic after spine surgery at an outside institution. He had multiple medical problems associated with his paraplegia in addition to suffering chronic pain in his back and legs. Working through the phases of the DOC project had 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 wheelchair-bound people to help them cope with their disability. He purchased a laptop computer and started 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. I gave him a call to ask why he no longer wanted to see me.

Thanksgiving

What happened was that 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 bluntly reminded him that he had been diagnosed with a bipolar disorder since he was 12 years old and that the disorder is incurable. Finally, the family instructed him 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 theirs. 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?  (For more on this, you might want to check out My Interpretation of Hoffman.)

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.

I had a great discussion with him 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. The crab bucket

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?

Pain Rules the Roost

NH, BF

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