Profits over quality

The business of medicine, like any other business, is focused on making a profit. There are computer programs that monitor physicians’ contribution to the profit margin. The most revenue comes from performing procedures, many of which have been documented to be ineffective. (1) The downside risks include unnecessary costs, significant risks and patients are often worse off than before the intervention. (2) It has also been documented that only about 10% of spine surgeons are addressing the known risk factors for poor surgical outcomes. (3) Dr. Ian Harris, who is an orthopedic spine surgeon from Australia, has done extensive research on the utilization of ineffective procedures. He wrote a book, Surgery: The Ultimate Placebo, where he extensively documents the data behind many procedures that have been proven to be of no benefit and it hasn’t stopped physicians from using them – at all. (4)

What works

Effective treatments are often not covered or don’t have a way of generating revenue. For example, expressive writing has be shown to been helpful in multiple medical conditions in over 1,000 research papers. (4) Yet, I had never heard of it until I accidentally ran across it in 2003. It costs nothing, has minimal risk and is rarely presented as a treatment option. It has proven to decrease symptoms of asthma, depression, rheumatoid arthritis, improve student’s athletic and academic performance and diminish many other symptoms. I had dinner with the original author of the technique, James Pennebaker, who is a psychologist from Austin, TX. The methods may differ, but it has only been reinforced as an effective tool. There is a lot of debate of why it works, but not about whether it works.

Mindfulness-based stress reduction has also been demonstrated to decrease pain in many papers and is usually not covered by insurance. I watched several excellent pain programs in the Puget Sound shut down because they could not afford to keep them open. Listening is a proven healing modality in addition to being a basic requirement to understand a given patient’s whole situation. Dr. Francis Peabody, a famous Boston physician, was concerned about the intrusion of technology into the patient-physician relationship. One of his more notable quotes was, “The secret of care is caring for the patient.” He wrote this in 1927. (5)

The business of medicine

Currently, mainstream medicine is pretending to deliver medical care. At the same time, people still trust their physicians. My observation is that it isn’t the individual physicians that are the issue. The corporatization of medicine is backing us into a tight corner. Not only are we not given the time to talk to our patients, many are often penalized heavily for not being “productive enough.”

One problem that is not often acknowledged is that of inducing a depression from repeatedly dashing people’s hopes. This was powerfully demonstrated by Harry Harlow. (6)

Harry Harlow

Harry Harlow was an internationally renowned psychologist who pioneered research in human maternal-infant bonding using primates.  During the first half of the 20^th century, it was felt that mothers should touch their children as little as possible.  The leading mental health professionals aggressively discouraged mother-child interaction in research papers, lectures, books, and the media.  Interestingly, or tragically enough, their recommendations were based on rodent research.  Dr. Harlow was the leading force in changing the tide of opinion using various species of monkeys. His story is well-presented in an entertaining book, Love at Goon Park by Deborah Blum. (6)

In the 1960s, he turned his attention, also based on primate research, to some of the smaller details of human interaction.  One model he worked on for a while was that of inducing depression.  He used various isolation methods and ways of simulating parental neglect or even abuse. He was able to consistently produce monkeys that were seriously disturbed, but he wasn’t able to cause depression.  At the time, he was experiencing his own severe depression associated with his wife’s diagnosis of terminal cancer.

He finally found a consistent methodology by devising an apparatus that resembled an upside-down pyramid. The sides were steep, but still allowed the monkey to climb to the top to peek outside. The top was covered with mesh. For the first couple of days, the monkeys would repeatedly climb up to look out and quickly slide back down. Within a couple of days they would give up, sit in the middle of the device, and not move. They became almost unresponsive, and when they returned to their families, they would not revert back to normal social behavior. It didn’t matter what problems the monkey had prior to the experiment. The abnormal monkeys became worse and normal monkeys suffered the same fate. Even the “best” monkeys from stimulating and interactive families would succumb. The researchers called the apparatus, “The Pit of Despair”. It was felt by the research team that this “learned helplessness” was from a combination of feeling the loss of a good life reinforced by occasional glimpses of the outside world and feeling trapped. Within a half a week, every monkey spiraled down.

Physical therapy, chiropractic adjustments, injections, acupuncture, vocational retraining, medications, traction, inversion tables, and finally surgery. How many times can your expectations be dashed before you lose hope?

1. Jonas, JB, et al. Are invasive procedure effective for chronic pain? A systematic review. Pain Medicine (2019); 20: 1281-1293.
2. Perkins, FM, and Henrik Kehlet. Chronic pain as an outcome of surgery. Anesthesiolgy (2000); 93: 1123-1133.
3. Young AK, et al. “Assessment of presurgical psychological screening in patients undergoing spine surgery.” Journal Spinal Disorders Tech (2014); 27: 76-79.
4. Harris, Ian. Surgery, The Ultimate Placebo. New South Publishing, Sydney, Australia, 2016.
5. Peabody, FW. The Care of the Patient. NEJM (1927); 88:877-882.
6. Blum, Deborah. Love at Goon Park. Perseus Publishing, New York, NY, 2002.

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I received this message from a person I have never met or communicated with. She had engaged in learning the tools to heal.

The key to healing mental and physical pain happen from learning two separate sets of skills. The first is separating identity from your necessary survival circuits, developing a “working relationship with them. The second is shifting your brain onto more enjoyable and functional circuits. You cannot experience play and joy will simultaneously fighting pain.

You also cannot heal your body, including your brain. It already knows how to heal, and the healing stories are nothing short of miraculous. But life itself is a miracle. Our conscious brain gets in the way and blocks healing. You only must believe your body can heal, let go, and allow it to occur. Her email is typical of what happens, and the healing is deep and transformative.

Not fixing yourself

One of the most difficult challenges is letting go of trying to fix yourself to rid yourself of the mental and physical pain. Why wouldn’t you? You are trapped in miserable place without an apparent way out. It is bad enough enduring the pain, but when you get angry about it, you have now doubled down, and your brain is really on fire. Dr. John Sarno, a famous physiatrist and author used the term “rage”.¹

Good Studio/AdobeStock

However, trying to solve the pain places your attention on it and reinforces it. But when you try not to think about your pain or distract yourself, the thought suppression inflames your brain even more. Either way, you are trapped. Specifically considering self-esteem, which is an endless set of judgments, trying not to be judgmental is impossible. Positive thinking is another form of suppression. Even reading self-help books is another way of staying focused on the problem. Even with my books, there is a tipping point where I recommend people stop reading them and focus on practicing and implementing the tools they have learned.

“Phantom Brain Pain”

There is the additional problem of thinking that something is being missed, and these thoughts become independent sets of circuits. They really are not responsive to reason, and the ongoing pursuit of reassurance only reinforces them. Along with all RUTs (repetitive unpleasant thoughts), I call this phenomenon, “phantom brain pain.” In my mind, the same issues are in play as phantom limb pain, where the suffering is intense, and you cannot even touch the absent limb to calm yourself. How can this happen. The known “source” of pain is completely gone, and the patient still feels the limb and the pain. So, where does this pain exist?

The key to healing lies in separating from your racing necessary survival circuits, developing a “working relationship with them, and dynamically shifting your brain into more enjoyable and functional circuits – and letting go. You cannot experience play and joy while simultaneously fighting pain.

“I give up”

I vividly recall feeling like I was in the midst of a major battle with unpleasant thoughts. The mental pain was a much bigger problem than my physical symptoms. I was never bothered during surgery with them in that I was so focused on what I was doing. For a long time, I was also fine in clinic while I was connecting with my patients. Towards the end of my ordeal, even being at work did not help, and I was pummelled every two or three minutes with ever-increasing intense, intrusive, and vivid thoughts. Meanwhile, I was trying everything possible to deal with them, including working with a psychiatrist. Nothing helped and in fact, it all seemed make things worse. It was around this period where I came close to committing suicide.

One evening, I had read yet another self-help book and I had a flash of a vision that I was standing in front of a repeating circus mirror. I can still see it. It was about six feet high, and it was in a tent. I was looking at endless images of myself. At that time, I was doing what felt like hand-to-hand combat with my thoughts. I would have a disturbing thought, and then counter it with a “good” thought. I was wearing down quickly. I could see that there was no rational solution to these RUTs. I said to myself, “I can’t do this anymore and I quit.” I felt my identity was stripped down to nothing and felt there was little left of what I thought was me.

I honestly gave up and was not sure what I was going to do next. Instead of feeling despondent, I felt a strange sense of freedom, and it turned out that “giving up” the fight was the right answer. It was after that moment, things began to change for the better. I had much to learn, but at least I had inadvertently created some “space” in my brain to allow healing to begin.

Hope

This is a link to a collection of patients’ success stories that I call, “Stories of Hope.” Essentially everyone who is trapped in the Abyss of chronic pain is in a very dark place. Knowing you are not alone is important.

ipopba.AdobeStock

It is impossible to let go of “fixing” without the tools to accomplish it and also learning how to feel safe. You can’t force it and as per her email, you just have to keep moving forward, and it will happen when you are ready. I also wish for you that it happens sooner than later, but persistence is the key. You will learn to regulate your stress physiology and become much better at nurturing joy and creativity. Your behaviors become automatic, your skills will increase and improve, and you can let go and live your life.

References

1. Sarno, John. Mind Over Back Pain. Warner Books, New York, NY.

The post How healing happens first appeared on Back in Control.

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• 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.

• Much of our identity or self-esteem revolves around the “stories” we create to make sense out of the world.
• Many if not most of our stories involve judgment and labeling, which are classic cognitive distortions. They are not real although they seem real.
• Once you become aware of both the nature of these stories and the damaging effects on the quality of your life, you will be able to let go and move on.
• Life is much easier and free when you shed them.

Another level of awareness involves judgment and storytelling. We are programmed from birth to be a certain way or not based on the opinions of our parents, siblings, teachers, peers, and society. Each input is processed by your brain to create your version of life and how to best live it. The problem is that we are living out these stories, but we are not necessarily connected to who we actually are. These judgments/ stories tend to be rough and inflexible self- criticisms. The brain will focus on the negative judgments that ramp up our emotions because that is what is supposed to do – be on the lookout for danger. What does all of this have to do with being in pain? It fires up our flight or fight response, is inflammatory, sensitizes our nervous system, and we feel more pain.

These “stories” we have about ourselves that we project onto the world is the way we create our egos or self-image. One term for this process is “self-esteem.” It is a deadly process that is a root cause of many bad behaviors. Humans are focused on not being vulnerable because it threatens survival. We also know that emotional pain is as or more disruptive to your well-being as physical pain. So, we spend a tremendous amount of energy on appearing powerful–both to ourselves and the world.

The problem is that it can’t and doesn’t work. The unconsciousness survival response which is the source for the sensation we call anxiety, is far more powerful than our conscious brain. The personal and societal consequences are severe. Our “identity” is defined by our mental constructs of ourselves, most of which is created by the perceptions and reactions of those close to us. This is even a bigger problem if you were raised in a chaotic or abusive environment. Instead of feeling safe and connected, you are constantly “on alert” and you also have to build your own identity (façade).

What is more convoluted is that your identity becomes dependent on being accepted and validated by others but it is more powerful to withhold approval or even bully someone that you perceive is weaker. This circular power struggle continues throughout life unless you understand and use the tools that will pull you out of this game.

“ANTS”

It  becomes even more complicated when you begin to understand how the human brain works and much, if not most of our self-esteem (or lack thereof) is based on cognitive distortions. Dr. David Burns, in his best-selling book, Feeling Good,¹ categorizes them into ten “errors of thinking.” He uses the term “ANTS” to describe them, which stands for “automatic negative thoughts.” Some of the categories are:

• Labeling
• “Should thinking”
• Minimizing the positive
• Emphasizing the negative – “Not good enough”
• Mind reading
• Catastrophizing

I highly recommend looking at his book to understand them and become aware how much space they occupy in your conscious brain.

For example, imagine someone at work walked by you and didn’t acknowledge you. You might think they’re upset with you about a situation that occurred the day before. The error in thinking in this case would be “mind reading.” You can’t read other people’s minds. It’s possible that the other person had just received some bad news and wasn’t engaging with anyone. But you don’t really know. Making assumptions consumes emotional energy.

Labeling

Then there is the error of labeling. For example, a frequently late spouse becomes “inconsiderate.” A forgetful teenager becomes “irresponsible.” In the act of labeling, especially negative labeling, you’re overlooking the details of a given set of circumstances and also someone’s good qualities. You have limited your capacity to enjoy interacting with them.

Then there are the labels we have for ourselves: you knock something over and call yourself “clumsy.” If a lover breaks up with you, then you’re “unlovable.”  Rehashing these critical self-judgments in our minds turns them into deeply embedded stories. Such stories are much harder to move on from than single judgments. Once a judgment sets into a story, you tend to lose perspective. Over time, faulty thinking becomes your version of reality.

Regardless of what sets these patterns of thinking off, they are a universal part of the human experience called consciousness. My cat doesn’t have this problem. This is true whether chronic pain is involved or not. With chronic pain you have the added frustration of the physical stimulus to keep these circuits really spinning.

Self-Perceived Flaws

To better understand the story concept, consider common situations where the brain focuses on a self-perceived flaw that is not physically painful. It might be your height, weight, the shape of your body, or even an individual body part. Or it might be some particular quality, such as a lack of intelligence, athletic skill, musical talent, etc.

Thinking about these flaws over and over snares you in a destructive cycle of spinning neural circuits. For example, many years ago I had a patient with neck pain who was absolutely convinced that he was “stupid.” His self-labeling wasn’t rational, as he was clearly a bright guy. I don’t know if his view of himself somehow triggered it, but he eventually developed a significant chronic burning sensation around his mouth.

Something similar often happens in the entertainment industry, where performers commonly focus only on their negative reviews. My wife, who is a tap dancer, has seen this in her profession for years. She pointed out to me that a performer might have 99 positive reviews but will fixate on the one that’s negative. It’s a common saying among entertainers that, “You’re only as good as your worst critic.”

ANT’s and Relationships

Another destructive phenomenon is focusing on a spouse or partner’s negative traits. The other person usually has innumerable positive qualities that are forgotten in the face of their “flaw.” Over time the “story” we tell ourselves can become so strong it can break apart an otherwise great relationship. If you realized that you were just projecting your own negative perception of yourself onto him or her, you might think twice about verbalizing your thoughts. You might as well talk into a bullhorn and broadcast, “This is what I think about me.”

What’s curious to me is why the human brain does not become equally fixated on positive traits. Reconsidering Wegner’s “white bears” experiment,² maybe it’s because we don’t suppress positive thoughts. As proven in his experiment, fixation goes hand in hand with suppression.

Let your ego go

You may be unaware how much of your identity is wrapped up in creating and reinforcing these stories about who you are. So, you may spend much of your time in an agitated state and not know why.

But awareness of these stories is what can dissolve them. These perceived thought distortions are just as damaging as real threats, but with awareness, you can separate from them, and then redirect your attention where you choose. You don’t have to “fix” them because they are not real (even though they seem that way). You can train your brain to let go and move past them.

Awareness is the starting point and as these stories about yourself and others drop way, you’ll begin to experience your life at a deeper and more interesting level.

Recap

Self-esteem is a disaster at every conceivable level as it not only separates you from others, but you also can’t even work your way back to finding out who they really are. And what about the effects on you. You are not connected to yourself. It requires a tremendous amount of mental energy to create and maintain your ego, and it just a collective opinion of what the world has programmed you to be.

You can’t fix this issue. It is at the core of human language and consciousness. But by becoming aware of the issues around this situation, they will lose their power, and you’ll be free.

Questions and considerations

1. Please look at one of several books by Dr. David Burns, where he presents these 10 categories of cognitive distortions. You may be surprised to discover how much of your self-esteem is made up from these stories.
2. It is one of the easiest problems to deal with in that since these are truly distortions there is nothing to do except to be aware of them, separate, and move on.
3. Consider how much of your day is consumed by racing thoughts you can’t control. Every minute in this state reinforces unp neurological circuits and you are moving the wrong direction.
4. Healing occurs as you focus your attention on where you want your life to go and what you want it to look like. But you have to first let go before you can move forward.

References

1. Burns, David. Feeling Good. Avon Books, 1999.
2. Wegener DM, et al. “Paradoxical effects of thought suppression.” Journal of Personality and Social Psychology (1987); 53: 5-13.

The post Deadly Nature of Self-esteem first appeared on Back in Control.

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Objectives

• Since emotional pain is processed in a similar manner as physical pain, why would you want to feel it? It is why our first instinct is to repress it.
• Repressed/ suppressed emotions fire up the nervous system even more than expressed unpleasant emotions.
• People spend much of their lives on avoiding pain. Why wouldn’t we?
• Since we cannot escape our consciousness, we have an additional relentless source of pain that other mammals don’t have.
• Yet allowing yourself to feel emotional pain is a necessary step in rerouting your brain away from it.

Why is there such a block to experiencing deep emotions? It lies in our evolution. Being physically vulnerable is not rewarded in nature. It really is survival of the fittest and being vulnerable is paramount to death. For example, in herds or packs of animals, the weaker ones are pushed to the edge of the pack, where they are susceptible  to predators. The stronger leaders are more protected. We know what happens to the weakest hen in a chicken coop. Humans are programmed with the same survival instincts. There is a huge difference in that we possess language, that creates another level of mental threats. Since we cannot escape our thoughts, we are all subjected to some level of ongoing threat physiology unless we implement specific strategies to process them. It is at the core of all chronic diseases, including chronic pain.¹

Research shows that mental threats are processed in a similar manner in your brain as physical pain. They share overlapping neurological circuitry.² It is no wonder that we expend a tremendous amount of energy avoiding emotional pain. “You hurt my feelings,” is a classic statement that also characterizes the situation. We are programmed to be strong to survive and it hurts to feel. So there doesn’t seem to be much incentive to change anything. The common strategy is to suppress (conscious act) or repress (unconscious reaction) our thoughts and emotions. They are deadly approaches, but that is all most of us know and how we were raised. “Children should be seen and not heard” is a phrase I heard frequently. Or “Life is tough, deal with it.”

But there is a powerful reason to consider training and allowing yourself to feel. Awareness and vulnerability are the essence of successful relationships in all aspects of your life. It is a challenging learned skill with one aspect of it being figuring out who you can truly trust – and you will repeatedly fail. If a person betrays your trust, the outcome can be devastating. Then what do you do? Learning to be vulnerable means allowing yourself to feel the pain, processing it, and continuing to move forward. Many people quit trying at a certain breaking point and others never begin.

Breach of trust

It is also the reason that being raised in an abusive family situation is so damaging. The people that the universe entrusted to care for and nurture you broke that trust. How can you be vulnerable and allow yourself to feel if you never knew what it was like to feel safe? That was your parent’s basic responsibility; to provide a safe haven and nurture you.

Consider a feral cat that has to fend for itself from birth. Its reality is that it cannot relax, and it is challenging to tame. If you are that child that doesn’t ever know the feeling of being safe, life does not get easier, and your hypervigilance will continue to progress. Your body will be under constant attack from stress hormones and inflammatory cells. The data around a chaotic childhood is compelling; you not only have a higher chance of developing a serious illness or disease, but life spans are shortened.³

The consequences of repression/ suppression

Not only does repression/ suppression of emotions keep your flight or fight response fired up, but it also causes brain damage. The hippocampus is an important structure in your brain that is at the center of memory retrieval. It has been shown that suppression of unpleasant memories induces amnesia of other events surrounding the unpleasant one. It also affects new learning and processing of new information. The final sentence of this paper says, “Efforts to forget a troubling past, ironically, may leave amnesia for the present in their wake.”⁴

The way out

You cannot go from repressing/ suppressing painful emotions to being free from their grip without specific approaches. You have to “feel to heal” but if you were exposed to the full force of your unpleasant emotions, it would be intolerable. The pain would be too intense. It is impossible. Instead, there is a process called, “pendulation.” The idea is that you allow yourself to be exposed to a level of emotions you can tolerate, pull back, and re-engage when you are ready. It is lifelong process that eventually becomes automatic. Then instead of your energy being consumed by keeping a lid on your emotions, you are free to step into your life and thrive.

It is the reason that The DOC Journey has evolved the way it has. It begins with you connecting with your disbelief, engaging in simple calming tools, and gradually teaching you the skills to minimize your exposure to threat physiology and create safety. In other words, you will learn to efficiently process stress and also be nice to yourself. Mind over matter does not work nor does positive thinking. Both of those block connection to your emotions.

What is so rewarding about this whole process is that people not only break out of the Abyss of pain, but they often end up leading a life that they never knew was possible. It is moving onto these more enjoyable neurological circuits that creates healing.

Recap

Why don’t more people pursue a path of self-discovery? It is painful. We spend a lot of energy working on feeling good to avoid feeling bad. The true answer lies in training yourself to tolerate “bad” and “good” can and will emerge. It is learned and accessible skill.

Questions and considerations

1. Have you ever wondered why you don’t want to feel unpleasant emotions? You are being physically threatened. It is because they are painful because pain has a common neurological circuitry whether the pain is mental or physical.
2. Anxiety is the sensation generated by your body’s chemistry when you are in flight or fight. It is intended to be so unpleasant that you are forced to take action to escape. We will do almost anything to avoid it.
3. It is ironic that the main strategy we use, suppression/ repression is the worst choice. In addition to depleting your life energies, it causes damage to your brain. You do have to feel to heal.
4. Consider your situation. You may be suffering from physical pain, but what about your anxiety? Which one is more challenging to deal with?
5. Fortunately, as you solve your mental pain, the physical symptoms usually abate.

 References      

1. Wegner DM. The seed of our undoing. Psychological Science Agenda (1999); Jan/Feb:10-11.
2. Eisenberger NI, et al. An experimental study of shared sensitivity to physical pain and social rejection. Pain (2006); 126:132-138. doi: 10.1016j.pain.2006.06024
3. Smyth J, et al. Stress and disease: A structural and functional analysis. Social and Personality Psychology Compass (2013); 7/4: 217-227. doi: 10.1111/spc3.12020
4. Hulbert JC, et al. Inducing amnesia through systemic suppression. Nature Communications (2016); 7:11003 doi: 10.1038/ncomms11003

The post You Have to Feel to Heal – Emotional Awareness first appeared on Back in Control.

The post You Have to Feel to Heal – Emotional Awareness appeared first on Back in Control.

• Humans are subject to an endless barrage of unpleasant thoughts that cannot be controlled.
• These thoughts are sensory input that is disruptive and creates a flight or fight response.
• Resisting them makes them stronger.
• It is much more effective to switch your attention to different sensory inputs that is neutral or calming.

Humans survive by the brain interpreting impulses from various sensors located in every millimeter of your body and interpreting the sum total as safe or a threat. Every sense has a threshold that indicates danger – hot, cold, bitter, loud, bright, sharp, pressure, burning, nausea, etc. Without that immediate feedback, you could not protect yourself.

Humans have a unique characteristic in that unpleasant thoughts create the same defensive reaction, but since we can’t escape them, we are often subjected to prolonged elevations of stress hormones and inflammation. Suppressing them, which is somewhat the norm, makes the situation even worse. What can you do?

Instead of doing battle with these thoughts, you can switch sensory input. There are many choices. You can listen to enjoyable music, practice meditation, mindfully notice small details of your day, take slow deep breaths, pay attention to your breathing, engage with your passion whether it is at work or play, and deepen your relationships with your friends, family, and colleagues. In other words, by fully engaging with what is directly in front of you, your mind has gone that direction.

But it goes both ways. If you choose to remain angry, complain, be critical, and constantly discuss your problems, your body will react in kind, and you will remain on high alert. Being aware of your environment, whether it is pleasant or unpleasant is the first step and then you have a choice to remain in an agitated state or to use tools to calm down. The exact tool doesn’t matter as long it is effective for you. As has been mentioned, many of us are so used to being agitated, we aren’t aware of it or its impact on others.

Environmental Awareness

Being aware of your senses – known as environmental awareness –  is a strategy that allows you to switch sensory input from racing thoughts to another sensation. It doesn’t matter which sense you choose. I practice one that I call “active meditation” or “meditation on the run.”

During my years of performing complex spine surgery, there were occasional complications that were considered well within the scope of care. But the consequences were sometimes severe, and I was committed to bringing them down to zero. But no matter how hard I tried, I wasn’t able to eliminate them. My own thoughts were interfering with my performance.

Things changed when I decided to enlist the help of a performance coach to improve my consistency. I brought him into the operating room and clinic so he could better understand my world. For 18 months, he and I underwent regular debriefings and coaching. I began to use “active meditation” in the operating room. The most common interferences I felt during surgery were frustration, anxiety, distraction, complacency, and moving too quickly.

Active meditation in action

This meditation model is not based on suppressing interference – for instance, if you’re frustrated, you don’t pretend otherwise. Rather, face the frustration, detach from it, and proceed in the manner of your choice. I learned to identify interferences either before or during surgery, and then used mindfulness-based approaches to let go of them quickly. This version of mindfulness is fast. It took about 3-5 seconds and was repeated frequently during a case. It was often connected with one quick deep breath in and a slower one out.

Setting up the day

Each surgical morning, I woke up and assessed how I was feeling. Like everyone, my feelings ranged from calm and relaxed to tired and anxious. I would sense smells, touch, and taste, etc. I felt the water on my back in the shower. I savored my coffee. I also reminded myself that although that day’s surgery is “just another case” for me, it’s one of the most important days of my patient’s life.

I continued this process in the operating room. I carefully arranged the room, talked to each member of the surgical team, and reviewed the imaging studies. I remained focused and immersed in what was right in front of me.

During surgery, awareness allowed me to perform my next move at an optimum level. I felt my grip pressure on each surgical tool; noticed the shape of the contours of the anatomy; felt my shoulder and arm muscles stay relaxed; and watched the flow of the case.

If I noticed disruptive thoughts and emotions enter my consciousness, I quickly practiced my environmental awareness techniques in order to re-focus. I would usually focus on light touch. With practice, I learned to be fully connected to each move, so I could “program” myself into the “zone.” Eventually, it all became automatic. I was so connected to each move that I might experience 10 distracting thoughts in a six-hour case. It was a remarkable shift from dealing with endless racing thoughts.

Surgery evolved into wonderful experience for me. I eagerly looked forward to Monday instead of surviving until Friday. I committed to getting a good night’s sleep before every surgical day. If I woke up “wired” and uneasy, I slowed down until I felt relaxed, no matter how many things were on my to-do list.

The same approach is a core tool to remain calm throughout your day. It is more difficult outside the OR with less structure. But with repetition, it will become automatic.

The “to do” list

I use my “to do” list as an opportunity to practice mindfulness. I remind myself that this list is an expression of my life, and so I deliberately become aware as I go about each item. For instance, when I had an appointment with a patient, I would carefully focus on listening to myself talk to him or her. Of course, carefully listening to them was critical. I felt the pen on the paper as I jotted down notes. I also practiced meditative techniques, such as “watching” disruptive thoughts such as “need to finish up here, I have other things to do” enter my consciousness and then leave. I reminded myself that my goal was to engage and enjoy every second of my “to do” list. It didn’t always work, but it’s surprising how often it did. It is still part of my day.

Recap

Environmental awareness engages me in the present moment regardless of the circumstances. It is not positive thinking, but just switching to a different sensory input. With repetition, it became and remains somewhat automatic. In the presence of ongoing pain, it is not the final solution, but will calm you so other tools can contribute.  It is a simple strategy without a downside.

This is the first and most basic of the different types of awareness. The other types of awareness are more challenging – emotional, judgment, and ingrained patterns. It is one of the reasons it is important to implement your own version of environmental awareness that will help you deal with the other ones that are more stimulating.

Questions and considerations

1. Many of you have heard the phrase, “be here now.” It is brilliant except it is rather hard to do. By actively engaging with a given sensation, you are here now. Your attention cannot be in two places at once.
2. Then consider a more complex phase in action. As you engage in various activities, interesting or not, by immersing yourself in every aspect of them, you’ll become more connected and calmer. For example, imagine you are sitting in an important lecture. By listening to every word, you’ll find it more interesting and have a much higher chance of learning what you need to learn. Detailed notetaking also has the same effect.
3. If you can actively learn this awareness skill, notice how much calmer your mind becomes. Listening to another person’s tone of voice and content is a great one to focus on and is more interesting than hearing yourself.

The post Connecting to Life with Your Senses – Environmental Awareness first appeared on Back in Control.

The post Connecting to Life with Your Senses – Environmental Awareness appeared first on Back in Control.

• A significant aspect of your healing journey is stimulating your brain to create a new set of circuits that are pleasurable.
• The sequence to change your brain is 1) awareness 2) separation (create some “space” 3) redirecting or reprogramming.
• None of this can happen without you being aware of where you are starting.
• Four levels of awareness are presented.

It is interesting how most of us want to become aware of the details of a product or situation before we feel we can make a good decision. It is only logical. Yet we tend to make quick reactive decisions about our own health or body. Part of this is because when we are trapped by anything, especially pain, we go into a reactive mode, which is irrational, hardwired, and powerful. Reactive patterns of thinking preclude awareness. The blood supply of your brain shifts from the neocortex (thinking centers) to the lower parts of the brain (survival) and your automatic circuits are in play. This scenario is the opposite of being aware.

With your brain “on fire” it requires specific skills to deenergize these circuits to allow the possibility of better awareness. Awareness also becomes one of the basic tools to calm down your fight or flight response. It is tricky in that somehow you have to penetrate back into your thinking brain and realize you are in this state of mind. You’ll eventually understand, with practice, that deep awareness is an incredibly powerful tool and platform for living your life.

Awareness is the beginning

Awareness can be defined as, “Being fully connected to the present moment.”

Why would awareness be brought up in the middle of a project dealing with chronic pain? First of all, no problem is solvable without understanding it. Chronic pain is incredibly complex and becoming deeply aware of the nature of the neurochemical nature of it is critical. But awareness is also a powerful tool in solving it. Awareness is the first step stimulating your brain to rewire (neuroplasticity). You can’t change something you can’t see.

Awareness is a powerful tool that will be critical throughout your Journey and eventually your life. There are four perspectives to consider:

• Environmental
• Emotional
• Storytelling/Judgmental
• Ingrained patterns

Environmental awareness involves placing your attention on a single sensation – taste, touch, sound, temperature, etc. When you switch your sensory input from racing thoughts to a different sensation, it dampens the stress hormone response. This is the basis of mindfulness – fully experiencing what you are doing in the moment.

I use an abbreviated version that I call “active meditation,” which is placing my attention on a specific sensory input for 5 to 10 seconds. It is simple and can be done multiple times per day. Eventually, it becomes somewhat automatic and a “go to” resource for calming yourself throughout the day.

MEDITATION

Meditation is an advanced environmental awareness that taps into emotions, judgments, and even your ingrained patterns. There are various methods and schools of thought to connect fully with the present moment. One basic technique is to focus only on your breath, becoming aware of as many aspects of your breathing as you can. As you do this, you’ll become immersed in the moment. Various distracting thoughts will enter your mind, but instead of becoming enmeshed with them, you simply watch them come, and then watch them leave. The goal is not to ignore these thoughts, but to learn how to not react to them. This is the process of detachment. After the momentary distraction, you gently pull yourself back to your breathing as quickly as possible.

When you meditate, you don’t try to slow down or control your racing thoughts. Instead, you “de-energize” them so that they have less control over you. As you develop the ability to stay in the present moment, the thoughts become less relevant and decrease—often dramatically. The key is to not try and edit, fix, or control them; that will only make them stronger.

Emotional awareness is more challenging. Allowing yourself to feel all of your emotions is a big step in healing; you can’t change what you can’t feel. However, you have to train yourself to tolerate feeling vulnerable, which most of us hate. We are programmed to be tough and take care of ourselves. Being vulnerable is not rewarded in the rest of the animal world and is often punished in the human experience.

One of my colleagues coined a phrase, “You have to feel to heal.” If you are intent on avoiding pain, you’ll become worn down. The key is to assimilate unpleasant feelings into your day-to-day life.

Judgment/ Storytelling is a major contributor to creating mental chaos in our lives. Dr. David Burns in his book Feeling Good¹ outlines 10 cognitive distortions that are a core part of our upbringing. Some of them include:

• Labeling yourself or others
• “Should” thinking – the essence of perfectionism
• Focusing on the negative
• Minimizing the positive
• Catastrophizing
• Emotional reasoning

You can’t fix these “errors” in thinking, since they are deeply embedded in our brains. But gaining awareness allows you to substitute more rational thought patterns. This is the essence of cognitive behavioral therapy (CBT).¹ Another approach, called Acceptance Commitment Therapy (ACT),² creates an awareness of these distortions and then you train yourself to just be with the emotions created by them. As your reactions to disruptive thoughts decreases, you are able to re-direct your attention and calm your nervous system on your terms.

It is also becoming increasingly clear to me why the concept of self-esteem is such an incredibly damaging idea. It represents an attempt to counteract the deeply unpleasant feelings generated by your unconscious brain’s need to keep you alive and it is gross mismatch. What is also apparent that much our “self-esteem” is based on various combinations of the above-mentioned distortions. The good news is that once you understand the nature of these distortions, there is nothing you have to do. They are not real. The sequence is becoming aware of them (not ignore), create some space with the tools that you connect with, and then just move on to what you want. You don’t have to change your life. You alter your reactions, and your life will change. It is remarkable how powerful this approach is in light of how little effort is required.

Ingrained thought patterns are the most problematic. Another term for this aspect of consciousness is “blind spots.” Recent neuroscience research has revealed that thoughts, concepts, and ideals become embedded in our brains and are just as real to you as the chair you are sitting in.^3, We are all programmed by our pasts – every second up this very moment. In fact, higher level mammal’s brain development is dependent on interactions with the environment. Primate experiments have shown that monkeys that are raised from birth in isolation cannot interact with others and are a threat to their offspring.⁴Case studies of people raised in severely deprived homes cannot learn to interact with others or feel appropriate emotions. The behaviors are irreversible. We are hardwired to survive but not to thrive.⁵

Your thoughts and beliefs are your version of reality. That is why people often engage in aggressive behavior when their belief systems are challenged. Or the opposite scenario may occur, which is becoming passive. There is a reason why passive aggressive behavior is so prevalent. Either way, challenges to your core life outlook are deeply disturbing. By definition, your belief system is your “filter” through which you interpret your environment and take the best actions to survive and hopefully thrive.

But while in pain, many of our behaviors are less than ideal. How could they be otherwise in the context of so much suffering and misery? But since these deep reactions have always been there from infancy, you can’t see them or understand the impact they are having on those close to you. Having a strong support system is an important part of your recovery from chronic pain because positive relationships have a calming effect. Unfortunately, many of us who experience chronic pain also drive people close to us away. Only awareness of your own patterns can grant you freedom from this cycle. By definition, you are not going to be able to see these patterns without outside observation. Seeing how others see you is challenging.

 Recap

Understanding and practicing awareness is the first step in reprogramming your brain. Your brain’s structure is physically altered. The sequence is as follows: awareness, separation, and re-programming.

Environmental awareness is the foundational first step. Spending time with “active meditation” both changes the sensory input from unpleasant and disruptive to neutral or pleasant. Regardless of where you are in your journey, practicing awareness will help calm you down.

When you are ready for the second level of emotional awareness, simply watch your emotions pass by. Then, pull yourself back into seeing, hearing, and feeling as quickly as possible. It is a little challenging, as emotions often evoke powerful reactions. Training yourself to be with these feelings instead of fighting them is a learned skill and may require some support from a professional.

The third level – judgment – is a lifetime journey. The key is to be persistent in not judging others or yourself. A good starting point is understanding than whenever you place a positive or negative judgment on someone else, you have simply projected your view of yourself onto the world. As you become aware of these cognitive distortions, you will be able to regain control of your life.

Remember that in the fourth level of ingrained patterns, it is impossible to see yourself through your own eyes. This is where resources such as psychologists, good friends, spouses, children, and seminars are helpful. The key is being open and willing to listen. You will also learn humility.

While it may feel like a monumental task, there no greater freedom than living in awareness. Once you are in control of the narrative, it is important to ask – how do you want to live the story of your life?

Questions and considerations

1. Developing a deep awareness is an important step in moving on. The opposite energy is suppression thoughts and emotions, which is not only counterproductive but has also been shown to cause damage to the memory center of your brain.
2. Challenge yourself to see yourself the way others might see you. You may not like it at first.
3. Then begin to look at the way others see themselves vs your perception of them.
4. There are infinite variations of awareness, and these four categories are only suggested to help organize your thinking about the topic.
5. Once your consciousness begins to kick into this mode, life becomes incredibly more interesting. At some point, we all become worn out with our versions of the world. Just sit back, listen, and enjoy.

References

1. Burns David. Feeling Good. Harper Collins, New York, NY, 2008.
2. Schwartz Dick. No Bad Parts. Sounds True. Boulder, CO, 2021.
3. Feldmann Barrett, Lisa. How Emotions are Made. Houghton Mifflin Harcourt. New York, NY, 2017.
4. Blum Deborah. Love at Goon Park. Perseus Publishing. Philadelphia, PA, 2002.
5. Eagleman David. Penguin Random House, New York, NY, 2021.
6. Hulbert JC, et al. Inducing amnesia through systemic suppression. Nature Communications (2016). doi: 10.1038/ncomms1103

The post Flip Your Consciousness – 4 Types of Awareness first appeared on Back in Control.

The post Flip Your Consciousness – 4 Types of Awareness appeared first on Back in Control.

• Every action we take today is determined by what we learned from our past.
• Each one of us has a unique lens and our version of reality, so it is impossible to see things the way they really are.
• A basic step in deepening your awareness of the present is understanding when you are unaware. There are many clues.
• As youbecome more aware of being in the past – positive or negative, clarity will emerge. It is much more interesting than continually projecting your version of reality onto the world.
• You will also be free.

 Every decision and move you make this moment is determined by all your past experiences up to this very second. It is how every living creature stays alive. Is the situation safe or dangerous? It is how we evolved and the species that ignored the cues or didn’t adapt, didn’t survive.

Consciousness and unawareness

Humans have an additional layer of issues in that language and consciousness requires another level of awareness to survive and thrive. Many threats, such as shaky finances, verbal abuse, being bullied at school or work, authoritarianism, racism, and a host of other issues are real threats. However, if you step back, many situations that are perceived as threats are actually cognitive distortions. Although the threats are not real, they seem that way and still fire up your nervous system and fight or flight response. Since we cannot escape our thoughts, they are particularly damaging because the reaction is sustained, and your body breaks down. It is well-documented that chronic stress causes illness and disease. ^1,2

There are a couple of factors to consider, in that we are programmed almost from the day we are born, to be a certain way according to the opinions of your parents, educators, peers, colleagues, society, and the marketing world. Marketing is especially problematic in that it is in their best interest to encourage you to feel badly about yourself. The marketing efforts are focused on offering solutions to help you feel better about yourself – for a price. Unfortunately, the solutions are only temporary, and your brain keeps telling you (with ongoing messaging), that you are still not good enough. Then you project the world’s opinion of you onto yourself, and onto others. Just as a quick aside, when you are critical of others, you might as well carry a bullhorn telling the world that is how you feel about yourself. It is just the way consciousness works.

Self esteem

Self-esteem is held up as something to be desired. It may be the deadliest concept ever propagated on the human race. It involves endless judgements of “better than” or “less than.” It is extension of our survival instincts in the emotional world. What makes it worse it that most of our self-esteem is based on cognitive distortions and with repetition, they become embedded in our brain as “reality.” It has been documented in the neuroscience of consciousness research that our thoughts and abstract thinking become embedded our brain as concretely as a car or a table. Consider the concept of colors. My cat probably recognizes red from white but doesn’t have a name for it.

Work with your anxiety/ anger

The nail in this coffin is that anxiety and anger are powerful, HARD WIRED, and unpleasant survival reactions and sensations that are generated when you are in a flight or fight response, and hundreds of thousands of times more powerful than your conscious brain. They are necessary, the gift of life, and not subject to rational interventions. We spend much of our lives trying run from these sensations and take them personally. One outcome is that we generate labels on ourselves and others. Labels, positive or negative, completely block awareness.

The skill of developing a “working relationship with anxiety and anger is another discussion. The message of this article is that using self-esteem to compensate is a mismatch, ineffective, endless, wears us out, and eventually can destroy us. Any time you are anxious or frustrated, you have blocked true awareness of the variables contributing to a given situation. Something in the present triggered a memory from the past that either was dangerous or perceived as such. You, by definition, are no longer in the present and have lost awareness. You can only see the world through your eyes, it is about you, the blood supply of your brain has shifted away from the thinking centers down to the lower survival centers, and your  behavior may not be the best. It is the reason for the phrase, “no action in a reaction.”

“True awareness”

It is not possible. The best you can hope for is cultivating and nurturing it. Each person views the world through his or her “programming” and is his or her reality. So, learning when you are unaware is a necessary first step. Then a deeper awareness can emanate and evolve. Awareness will beget more awareness. Here some suggestions of cultivating an awareness of your unawareness.

 Clues to unawareness

How can you tap into your unawareness? One way is to look for cues in certain behaviors and attitudes that may mean you’re out of touch with how you’re feeling. Some examples include:

• Having a rigid opinion about almost anything: religion, politics, someone’s character, etc.
• Being told you’re stubborn or “not listening”
• Interrupting someone to offer an opinion before you’ve heard theirs in total
• Being “right”
• Consistently thinking about something besides what you’re doing
• Thinking you’re wiser than your children
• Acting on impulse
• Feeling anxious or angry – This is the most basic. Something in the present connected to something in the past that was or perceived as dangerous. By definition, you are there and not here. Awareness is impossible while you are in one of these powerful states. What is really ironic, is that when you are angry, you feel like you have a perfect understanding of the issues. The term for this is, “negative transference.” You are actually completely disconnected because it is only about you.
• Judging yourself or others negatively or positively
  • Being persistently critical of your spouse, partner and/or children
  • Giving unasked-for advice
  • Gossiping

Recap

We are all programmed from birth to be certain ways by our parents, peer, educators, and society. These concepts become our version of reality that is as concrete as your concepts of a house or a car. Our brains create an interpretation essentially everything. That is the reason true awareness is impossible as each person perceives their view of life as the correct one – whether is positive or negative.

The necessary step in seeing situations in more depth and with clarity is understanding the clues of being unaware. You cannot change the scenarios when you are unaware. It is beyond your control. So, creating some “space” and watching your reactions allows you to see the world through other’s eyes. Being aware of when you are unaware begins a process that will open up your thinking and is incredibly interesting compared to continuing to watch reruns of your own projections. It is also the first step in reprogramming your brain in that you cannot create change unless you know where you are starting from.

Questions and considerations

1. We hear stories of people who join groups and become brainwashed. It is remarkable how difficult it is to bring many of them back into a functional life. Why is that? It is because any idea regardless of its merit, becomes “reality” with repetition. It is now the world view through which new data is processed. Conflicting data is discarded and confirming input reinforces. What makes this situation so challenging is that the physical structure of your brain changes and why it is impossible to change someone’s mind with “facts.”
2. Have you considered that all of us are “brainwashed” by our own lives? We are continually looking for data to confirm our views and our identity. It is anxiety producing if our basic perceptions of life are challenged.
3. It is also the reason why so many people choose not to pursue the pathway to true awareness, which involves every aspect of your life. However, as unpleasant as it might sound, it is much easier than continuing to carry your past on your back.
4. Being willing to become aware of your unawareness is the only place you can begin, and deeper awareness will emerge – if you allow it to.

 References

1. Smyth J, et al. Stress and disease: A structural and functional analysis. Social and Personality Psychology Compass (2013);7/4:217-227. 10.1111/spc3.12020
2. Torrance N, et al. Severe chronic pain is associated with increased 10-year mortality: a cohort record linkage study. Eur J Pain (2010);14:380-386.

The post Becoming Aware of Being Unaware first appeared on Back in Control.

The post Becoming Aware of Being Unaware appeared first on Back in Control.

• All of our actions this minute are determined by all of your past experiences up to this very second. Each of us has a unique perspective on life.
• Awareness involves seeing past your own personal biases and seeing the world more as it actually is.
• You cannot change anything until you know where you are starting from.
• You must allow yourself to feel your mental as well as physical pain before you can reprogram in new circuits.
• Without awareness, healing is impossible.

 Awareness is a necessary step on your journey to health, as what you’re not aware of can and will control you. If you’re unaware of the impact of your circumstances/ stresses on your body’s neurochemical response, you will be ruled by feelings that you have no idea of where they are coming from.

 Additionally, how can you solve a problem in any realm if you don’t understand the relevant aspects of it; especially if the problem is complex? Consider the complexity of building a skyscraper or launching a spaceship. There are endless details that have to not only be addressed but mastered. None are unimportant.

When the Challenger space shuttle exploded in 1986, killing the seven crew members, it was discovered that a small “O-ring” leak was the root cause of the explosion. What is disturbing was that there was knowledge of the potential problem from the beginning in 1971 that was repeatedly covered up. So, the people making the final decisions were not fully aware of it as the signal was given to launch the spacecraft. However, the complexity of the Challenger launch pales when compared to the intricacy of the human organism.

The human body

There are about 30 trillion cells in the human body and 80 billion brain cells. Each neuron is connected to 10,000 other neurons. This central control system maintains a precise balance of the body’s chemistry, organ function, acid base balance, metabolism, blood flow, temperature, heart rate, and this list is almost infinite. Every bodily function is balanced by opposing input  that maintains these delicate reactions. The baseline state is called, “homeostasis.”

You, through various sensors, are in constant contact with the external and internal environment to monitor and control your responses in order to survive, regenerate, and thrive. Pain is just one of the many sources of sensory input. You cannot interpret or treat a patient’s symptoms (reactions to the environment) without understanding the world they live in and also their coping capacity.

But one step deeper is the need for the patient to become fully aware of all the factors that are affecting his or her’s bodily functions. The only person than can really figure this out is you. The way you process the world around you is based on your unique early childhood programming. It is the “filter” by which you interpret sensory input – whether it is physical or mental. If you were raised in a chaotic family without feeling nurtured and safe, you have been programmed to view the world from a hypervigilant perspective. So, your baseline existence is on “high alert.” This creates a chronically defensive neurochemical state in your body and the data shows the people become ill with serious diseases and don’t live as long.¹

Defining Awareness

Awareness is seeing the world as it actually is – not just through your interpretation of it. Pure awareness is essentially impossible in the human experience; we all look at life through our pre-programmed perceptions of reality that starts to develop at birth. But the closer we can come to pure awareness, the more functional we can be as human beings.

Awareness is the key to developing meaningful relationships; in a one-on-one encounter, the greater your capacity to see a situation through the other person’s eyes, the greater chance of developing intimacy. As important awareness is seeing the effects of your behaviors on others. Intellectually, we understand the importance of awareness, and yet most of us continue to struggle with gaining true awareness. Why is that? Consider the following:

• Anxiety clouds awareness, but we are often not aware of our anxiety until it becomes disruptive.
• Awareness and anger cannot co-exist. When you are angry, the blood supply is shifted from the neocortex (thinking centers of your brain) to the lower survival centers. By definition, it is not possible to accurately assess all the variables of a situation and come up with a creative solution.
• We all know that nothing really is accomplished in a heated argument. Anger is destructive.
• This situation is worse when you are trapped by chronic mental or physical pain. The most challenging aspect of healing is breaking through this barrier and nurturing awareness.

Becoming Aware

There are several types of awareness that are necessary to learn for you to solve your chronic mental and physical pain.

• Understanding the nature of chronic pain. It is a neurochemical problem that is rarely amenable to structural interventions such as injections and surgery.
• Becoming aware of the principles underlying the solutions. They are centered around rewiring around the unpleasant (and permanent) circuits in your brain and also learning how to lower your body’s inflammatory response to threat.
• Awareness of how your environment is affecting your sense of well-being. For example, if you are in an abusive relationship, no medical interventions will counteract your body’s need to survive. The root cause must be addressed, and every situation is different
• What was your home life like during the first 12 years of your life? Was it loving, supportive, and nurturing or chaotic? It sets the stage for how your brain develops the rest of your life.

Awareness – the foundation for stimulating neuroplasticity

 Using techniques and approaches that stimulate your brain to physically change structure is a core concept in solving chronic pain. All of our basic survival skills are memorized and are automatic. For example, you don’t think about which muscle to fire next when you walk or talk. How about learning an athletic or artistic skill? The same holds true for unpleasant experiences, such as disruptive thought patterns or pain. Just like riding a bicycle, they are permanently embedded in your nervous system. In order to reroute or create new and more enjoyable circuits, you have to be aware of what is already there. If you are continually doing battle with an unknown opponent, how effective are your efforts going to be?

Also, these survival circuits are hardwired in and not responsive to rational interventions. We spend a lifetime trying to solve or outrun these survival sensations, yet you might as well be talking to the engine of your car. The only approach (and it is effective) is reprogramming them with awareness and repetition.

So, one basic aspect of solving pain, is to allow yourself to feel it. You might say, “I am already in pain and feel terrible.” But what is usually happening is that we are suppressing emotional pain, which is processed in a similar area of the brain. If you don’t allow yourself to feel emotional pain (being vulnerable) then you will experience physical symptoms. There is no place to run.

The basic steps of stimulating neuroplasticity are:

• Awareness
• Separation
• Reprogramming

You have to feel to heal.

Chronic pain is resolvable once you become aware of its nature, your reactions to it, the relevant variables that affect your perception of it, and learning your set of tools to drop it down and reprogram your nervous system.

Recap

You cannot solve any problem unless you understand it in detail. Chronic pain is a complex problem, and each person has a unique experience. Being aware of all of the factors that affect your pain is critical. You also cannot move forward until you understand where you are at right now.

Every living creature has to be continually aware of its circumstances to ensure survival. Humans have another layer added in the form of language and consciousness. To enjoy rich and fulfilling relationships requires being aware of another’s needs as well as your own. When you are trapped in pain, awareness cannot exist as the blood supply shifts away from the thinking centers of your brain to the lower survival centers. You attention is only on you.

Breaking through this barrier to awareness is a challenge, but once it occurs, life becomes an abundance of opportunities instead of an endless barrage of challenges.

Questions and considerations

1. Many people are so used to being in a survival mode that they are not aware of the possibility of living a great life. Could this be you?
2. Even though you might be miserable, somehow the idea of change is more threatening, and you may not try anything. How badly do you want to heal? Many people when confronted with that question, actually do not want to change.
3. Pain and anger are addicting. They feel powerful and no one wants to give it up. Understanding this scenario is important.
4. Awareness requires you to feel the pain and stop fighting it. Then healing can occur.
5. It is easy to be aware of other’s “flaws.” Are you able to see your own?

References  

1. Keller A, et al. Does the perception that stress affects health matter? The association with health and mortality. Health Psychol (2012); 31:677-684. doi:10.1037/a0026743

The post Awareness – The Starting Point for Deep Healing first appeared on Back in Control.

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Awareness is the essence of healing 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 your life. There are four patterns of awareness that work for me.

Environmental awareness is placing your attention on a single sensation – taste, touch, sound, temperature, etc. What you are doing is switching sensory input from racing thoughts to another sensation. This is the basis of mindfulness – fully experiencing what you are doing in the moment.

I use an abbreviated version that I call “active meditation,” which is placing my attention on a specific sensory input for 5 to 10 seconds. It is simple and can be done multiple times per day.

Emotional awareness is more challenging. It often works for a while, but then it doesn’t. When you are suppressing feelings of anxiety, your body’s chemistry is still off and full of stress hormones. This translates into physical symptoms.

Allowing yourself to feel all of your emotions is the first step in healing because you can’t change what you can’t feel. Everyone that is alive has anxiety. It is how we survive.

Judgment is a major contributor to creating mental chaos in our lives. Dr. David Burns in his book Feeling Good outlines 10 cognitive distortions that are a core part of our upbringing. Some of them include:

• Labeling yourself or others
• “Should” thinking – the essence of perfectionism
• Focusing on the negative
• Minimizing the positive
• Catastrophizing
• Emotional reasoning

Becoming aware of these errors in thinking allows you to substitute more rational thought patterns.

Ingrained attitudes and thought patterns are problematic. By definition, you cannot see them without actively seeking them out.

Our family interactions in childhood are at the root of how we act as adults. The behaviors we develop over a lifetime of exposure to our environment are what I call ingrained patterns. They stem from our upbringing and the fact that our brain is somewhat “hard-wired” during our formative years. We now know from recent neuroscience research that concepts and attitudes are embedded in our brains as concretely as our perception of a chair or table. I used to say that thoughts are real because they cause neurochemical responses in your body. But they are not reality. I was wrong.

It turns out that your thoughts and ideals are your version of reality. Your current life outlook continues to evolve along your early programming or your “filter.” 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.

It is critical to understand that these are attitudes and behaviors that you cannot see because they are inherent to who you are. It is also maybe the greatest obstacle to people getting along. 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. 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.

Awareness in the operating room

Here is one example from the performance arena while at work. (My wife could give you dozens in the personal arena.) A few years ago, in the operating room I became aware that I consistently started to speed up towards the end of each case. I also realized that over the years, probably 80% of my dural tears (the envelope of tissue containing the neural elements and cerebrospinal fluid) had occurred in the last thirty minutes of a long case. The fatigue factor is an issue, but the speed issue is more critical. I still often didn’t notice that I was speeding up; I needed feedback from my partners or assistants, so I asked them to act as my “coaches.” I’d stop for a few seconds and say, “The difficult part of this case is done. It would be easy for me to relax and hurry to finish. Please speak up if you see me starting to rush.” Every move in spine surgery is critical, so I had to make the choice to consciously slow down. The end of a case is just as important as the beginning and middle. My complication rate dropped dramatically.

This is a brief overview of how awareness plays a role in successfully navigating daily life. It’s something of a paradox in that when one is truly immersed in the moment there are no levels of awareness. It’s just complete “engagement-in-the-present-moment” awareness. There’s many layers to this discussion, but I hope this is a good starting point. Life does become much more interesting.

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