• You probably have been trapped by anxiety for so long, and consumed by trying to find a way out, the idea giving back seems almost impossible. You may not even have the energy to try.
• Although, you have learned many strategies to process anxiety and anger, letting go and moving into enjoyable neural circuits is where the deep healing occurs.
• Giving back to others is a step beyond in that you are shifting your attention away from you (and your anxiety). With repetition, you’ll continue to move farther away from your mental and physical pain circuits.
• One of the first steps is nurturing compassion (awareness).

One of the most powerful ways of moving forward on your healing journey is giving back to others. However, you must first connect with yourself, anxiety, and all, in order to be able to effectively connect with others.

Empathy/ compassion

The Oxford dictionary defines empathy as, “the ability to understand and share the feelings of another.” It is a core component of nurturing human relationships. If you don’t have some sense of how someone close to you is feeling, you can’t interact with them in a meaningful way. You might as well be in another room. The capacity to feel empathy is an inherent part of the human experience because from an evolutionary perspective, it was the species of humans who learned to cooperate that had the highest likelihood of survival.

Compassion is the next step in healthy relationships that follows empathy. You first have to have the ability to see a situation through the other person’s eyes with an understanding of what it might be like to be in a similar circumstance. Compassion is a desire to help out and contribute. Nurturing compassion has two parts: 1) engaging in practices that engender empathy, and 2) removal of any interference connecting you with your own compassion

The disconnect–anger

Compassion is another word for love, and Anthony de Mello in his book, The Way to Love,¹ defines love as awareness. Being aware means you are fully connected to the moment you are in. Anytime you are anxious or angry, the past is playing out in the present. In other words, you have learned that the current situation feels or is threatening based on your past experiences. It is how we survive. For example, you would not want to learn to avoid a hot burner on a stove every time you are close it.

Additionally, when you are upset, your brain becomes inflamed from small inflammatory proteins called cytokines. Your nervous system is hypersensitive, and everything is magnified. Additionally, these communicating proteins signal a shift in the blood supply from the neocortex (thinking centers) to the midbrain (survival region). You are not only not aware, but you can’t think clearly. Have you noticed how whatever you were so angry about often resolves when you calm down?

When you are consumed with frustration and anger, it is only about you and it is not possible to be aware of other’s needs. So, the foundational step of empathy is compromised. You might feel you have empathy in spite of being upset. You do – only after you calm down. But when you are trapped by anxiety and pain, when do you have any chance to calm down? So, you end up pushing people away who could nurture and support you, and the cycle continues.

Then people in pain often form bonds with others who are also angry and trapped. They may seem like close relationships in that you feel the conversations around common suffering seem intimate. They are. But you are both reinforcing each other’s survival circuits. Belonging to a pain support group has been shown to worsen the prognosis for recovery.² Carolyn Myss is a well-know healer who calls this process, “woundology.”³

We all have a deep need to help those around us. But when you are angry, compassion goes right out the window. It is an interference that must be dealt with before you can feel compassion and engage in helpful acts.

JK Rowling and giving back

I’ve watched this Harvard commencement address given by J.K. Rowling in 2008 (se below) many times. It is one of the most inspiring speeches I have ever heard. She was determined to follow her own passion while at the same time remembering and honoring her past. I would encourage you to take the time to listen to it. In addition to being a highly acclaimed author, she is also a remarkable speaker. Her commitment to honoring her journey and giving back is extraordinary.

Nurturing Compassion

So, there are two parts to nurturing compassion. The metaphor of “filling the tub” continues to be a foundational concept. The first step on a given day,  is you must first “de-energize” anxiety/ anger. They block connection to awareness and also to yourself. Compassion will emerge and some level of it is inherent in each person. I know for some of you that have experienced severe (unspeakable) trauma that this may seem hard to believe. It takes time to connect with it and often expert guidance.⁴

Then the second aspect to consider  is actively nurturing compassion after you have connected with it. We are programmed with a strong self-critical voice almost from birth. Why not change the programming to compassion?⁵

I have a few suggestions to consider, which might help you formulate your own ideas of how to connect to your core values and give back.

• Remain committed to your own journey. You can’t help others if you are not doing well.
• Practice awareness. Remain aware of yours and other’s needs, listen carefully to others and try to see situations through their eyes.
• Don’t discuss your pain, complain, engage in malicious gossip, give unasked-for advice, or be critical. None of these are compassionate acts. It is a little harder than you might think because all of us exhibit these tendencies.
• Your highest priority is your immediate family. Even if you’re miserable, treat them well – no exceptions.
• Make a random list of ideas of ways to give back that are interesting to you—write them down. They can be small actions.
  • Pick the top five
    • Prioritize them
    • Pick one
  • Develop a specific plan.
  • Do it!!
• Create a vision of what you’d like your life to look like in one year and five years.
  • Be as specific as possible.
  • Learn organizational skills to implement your vision.
    • Getting Things Doneby David Allen⁶

Recap

The first step in giving back is understanding how anxiety and anger block awareness and compassion. This is particularly true when you feel trapped. These survival reactions will continue to grow and crush your quality of life. How could you possibly reach out in this state of mind?

Giving back a process that includes learning skills, cultivating awareness in yourself, becoming aware of the needs of those close to you, and then in others. Then you are able to effectively give back. As you move away from your troubles, you’ll continue to heal. Awareness, compassion, and love are reflections of safety physiology, and your body can regenerate and heal.

It’s easy to feel that J.K. Rowling was lucky; how can she not enjoy her life with the success she’s experienced? Luck is winning the lottery. We are all aware of high-profile public figures who spent their lives fighting addictions with many not surviving. What didn’t they possess? Their stories of self-destruction are legendary. J.K. Rowling didn’t have an easy start, but she continued to stay connected to her passion and compassion in spite of many obstacles. Giving back is a high priority for her. It is a complete reversal of where your energies are focused when you trying to fight your way out of a world filled with anxiety, pain, and frustration.

Questions and considerations

1. As you read this lesson, you may not feel that you are ready to give back to others and you may not. That is fine and it is important to be OK with that. Remember, the essence healing is connecting to who you are and where you are at today.
2. Another core concept is learning to have compassion for yourself. So, if you aren’t ready, don’t be hard on yourself. Be kind.
3. You are not going to have more compassion for others than you do for yourself.
4. Practice compassion. When you have a choice, choose joy. It will become habitual over time.
5. This is much different than positive thinking where you might be trying to rationalize or minimize your suffering. A better term might be, “positive choices.”

References

1. de Mello, Anthony. The Way to Love. Bantam Doubleday Dell Publishing Group. New York, NY, 1992.
2. Friedberg F, et al. Do support groups help people with chronic fatigue syndrome and fibromyalgia? A comparison of active and inactive members. The Jrn of Rheumatology (2005); 32:2416-2420.
3. Myss, Carolyn. Why People Don’t Heal and How They Can. Three Rivers Press. New York, NY. 1997.
4. Van Der Kolk, Bessel. The Body Keeps the Score. Penguin Random House. New York, NY, 2014.
5. The Dali Lama and Howard Cutler. The Art of Happiness. Riverhead Books. New York, NY, 2009.
6. Allen, David. Getting Things Done. Penguin Books, New York, NY. 2015.

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The ultimate sacrifice

His book caught my attention in the first chapter when he related the story of his missionary family moving to a remote area of India where no one had ventured because of a deadly type of malaria. Sure enough, his father died relatively soon from it, but his mother spent the rest of her life there serving the medical needs of these people living in incredibly remote area. He went on to become an orthopedic hand surgeon and spent the first years of his practice in India dealing with patients with leprosy. You may know that they routinely develop severe grotesque deformities of their arms and legs. He would perform corrective surgery and kept meticulous records of his approaches both for learning and teaching.

Leprosy

Since the beginning of time, lepers have been treated as outcasts with their limb and facial deformities being nothing short of hideous. After it was figured out that that the leprosy bacteria was the reason for these problems, they still were not treated that well, but at least it wasn’t some type of evil humor or demon possession. Doctors felt that the bacterium directly attacked the tissues and caused the disfigurement.

Dr. Brand figured out that the deformities were not directly caused from the leprosy bacteria, but because the bacteria destroyed sensory nerves and they had lost protective sensation. Your pain system sends signals to the brain, which interprets them to indicate danger any time the limits of a structure or tissue are being challenged that could result in damage. For example, a morsel of food would fall into the cooking fire and the person would reach right into the coals to lift it out. If there was an injury to an ankle, normally you would rest in order to allow it to heal. These people would just keep walking and eventually the joint would disintegrate. A common descriptive term is, “a bag of bones.”

Diabetes

When he returned to the United States from India in the 60’s, he began to notice similarities between his patients with diabetic foot and leg breakdown and his observations of leprosy. There were poorly healing skin ulcerations, infections that would not heal easily, and joints were severely breaking down. Doctors felt that the elevated blood sugars were the cause of the problem. He quickly noted that it was the same problem that existed in lepers; the sensory nerves were being damaged and that they losing protective sensation. It was his pioneering work that led to more aggressive control of blood sugars, protective footwear, healing casts, and patient education to learn ways to protect themselves. He made a huge difference in many people’s lives.

 Congenital indifference to pain

He also described the problems that are created when people are born without a functioning pain system. It is a rare condition called, “congenital indifference to pain.” They have no way of programming their brain as to what might be dangerous or safe. They routinely exceed the limits of their tissues. They don’t even know how to avoid a hot stove. Their lifespan is only about 10-15 years and they die from repeated infections.

Dr. Brand, as a part of his work and research, was given a large government grant to develop a device that would warn people without protective sensation of danger. He devised a tight fitting body sensor suit that would send unpleasant warning signals to the brain when there was potential tissue damage. For example, if a person was using a wrench to tighten a bolt and was pulling too hard, they would receive an unpleasant electrical jolt. The problem was that the person didn’t want to be bothered and would just remove the glove and proceed to damage his or her joints.

The state of your central nervous system

After multiple attempts, everyone gave up. There has never been a solution for someone not having a protective pain system. The problem is that it is incredibly complex system that exists in a delicate balance. Additionally, the final perception of pain is determined by the state of your central nervous system as well as your prior experiences. For example, one night of poor sleep will significantly increase your pain the next day. (2) Consistent lack of sleep actually causes chronic low back pain. (3) Arguing with your spouse instantly increases pain. (4) Running into the bully at school may cause your stomach to churn. This list is infinite. Why would this be the case? Because pain is only pain because your brain says it is so. Your brain is analyzing about 20 million bits of information per second and is programmed to keep you safe and alive. The species of creatures who did not pay attention to environment cues did not survive. Pain is a major part of all of this and is a gift that allows you to safely navigate this planet.

The curse of chronic pain

Chronic pain is not a gift. For many reasons this intricate and balanced pain system is broken. It continues to fire away even when there is no danger. So, now you have a scenario where you are experiencing a sensation that is intended to be so unpleasant that it compels you to take protective action, but you cannot turn it off. It is like a car alarm that won’t turn off except it is incredibly more disruptive. It may be one of the worst experiences of the human existence.  Research has shown that living in chronic pain has a similar impact on a person’s life as experiencing terminal cancer. (5) The problem is that while suffering from chronic pain, you are not being told the nature of the problem, and where is the endpoint? You could argue that it is worse than having terminal cancer.

Fortunately, chronic pain is solvable by first understanding the nature of the problem and then learning approaches to bring the system back into balance. The DOC Journey represents the sequence of many patients who have broken out of the grip of pain. You first have to understand the nature of a problem before you can solve it.

The Journey also begins by embracing your disbelief. You have already tried everything that has been suggested, why would you try this process? Although a positive vision is necessary to move forward, this Journey is not about positive thinking. It is about becoming connected and engaged to what is right in front of you regardless of how pleasant or unpleasant it may be. Then you can move on.

Don’t let the gift of pain that has spun out of control take way from your gift of life. Treat yourself this Holiday by taking  your life back.

1. Yancey, P and Paul Brand. Pain: The Gift Nobody Wants. DIANE Publishing Company (1999).
2. Kahol K, et al. “Effect of fatigue on psychomotor and cognitive skills.” Am Jrn Surg (2008); 195: 195-204.
3. Agmon M and Galit Armon. “Increased insomnia symptoms predict the onset of back pain among employed adults.” PLOS One (2014); 9: 1-7.
4. Burns, JW, et al. Temporal associations between spouse criticism/ hostility and pain among patients with chronic pain: A within-couple daily diary study. Pain (2103); 154: 2715-2721.

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I have launched a major effort to change the way we think about disease; whether it is mental for physical. EVERY chronic disease state exhibits elevated levels of inflammatory markers. The immune system is critical for survival and this inflammatory process is supposed to destroy invaders and subside after the threat has passed. However, when you are exposed to sustained threat, this inflammatory reaction will destroy your tissues. One of the responses is elevations of pro-inflammatory cytokines (very small proteins) that signal white blood cells to go to war against foreign invaders (antigens). Threats come in many forms. Here is a short list:

• Abusive family – health issues arising from an abusive past are serious.
• Poverty
• Chronic fear of authority – is a major reason why blacks have such a high mortality rate.
• Virus’s/ bacteria/ fungi
• Being the target of bullies – being bullied is a terrible threat and markedly elevates inflammatory markers.
• Repressed emotions – now being documented with brain imaging and blood tests
• Anxiety/ Anger – is an inflammatory reaction to threat. It is not primarily psychological.
• Body image/ eating issues – obsessive thought patterns are extremely disruptive.
• Chronic pain – impact has been documented to be similar to having terminal cancer (1).

The result is chronic disease:

• Parkinson’s
• Anxiety/ Depression
• OCD (obsessive compulsive disorder)
• Cardiac disease
• Adult onset diabetes
• Obesity
• Autoimmune disorders

COVID-19

These are just a few examples of chronic illnesses that have serious implications for the COVID-19 lung problems. If you have an elevated baseline of inflammatory proteins, there is higher chance that you will cross the critical threshold of too many cytokines and become seriously ill. This inflammatory response causes the blood vessels to open up so plasma and white blood cells leak into your lungs. You cannot exchange air and you drown in your own fluids. It is not your immune system that causes death, it is the inflammatory response.

I put together this pamphlet that makes recommendations that will lower inflammation. There is no guarantee, of course, that they will keep you alive, but you can up the odds. None of these 10 recommendations are difficult and also have implications for solving other chronic diseases. There is no downside and a lot of potential upside. The more of these you can incorporate the better.

I am asking you to share this following overview with every person you know and also ask them to pass it along. Not only will you be better able to withstand the complications of the COVID-19 virus, you will be helping your friends, family, and colleagues. Every recommendation is based on decades of deep medical literature with the most basic one being that, “stress kills.” It is critical to ask the question, “Why?”

 The “Thrive and Survive” overview

Since the COVID-19 outbreak, and after testing positive for the virus, David Hanscom, MD has been working with other health and medical professionals exploring the connection between inflammation and chronic disease through the lens of the Polyvagal Theory. Like David, the experts he teamed up with, are passionate about the well-being of ALL humanity. Together, they discovered various possibilities to recover from COVID-19 and the process is a similar to Dr. Hanscom’s method for relieving chronic pain. It is about paying attention to the small details.

Here is a link to the pdf entitled: Plan A – Thrive and Survive COVID-19. It’s a “How to” manual with steps to take on lower the pre-illness cytokine load. The key is to remain below the critical threshold where organ failure occurs. Essentially everyone that has not survived COVID-19 has another condition that is associated with elevated inflammatory cytokines. The manual is free of charge, available to anyone.

Experts including: Dr. Stephen Porges, originator of the Polyvagal Theory educated this team on how to interpret patient data in light of what is happening with the autonomic nervous system. Interventions can then be timed to support the natural sequence of fight, flight, freeze and faint. And, Dr. Clawson, a rehab physician explains cytokines. Specifically, how they link to inflammation and how to reduce it. The practical steps  they suggest to support whatever phase of defense the body is in  looks promising. By lowering your cytokine load before you are exposed, you should have a higher chance of staying below the critical cytokine threshold that causes death. Each step has a direct impact on lowering your inflammatory cytokine load.

In the meantime,  here’s a link to the  Psychology Today post  which is an overview of the process. Feel free to post and forward to those who you believe will benefit. Implementing these tools have the potential to make an impact on this pandemic with well-established practices done in sequence.

Please copy and paste this overview and pass along.

 Each person who improves their body’s defenses against threats, will be contributing to the overall solution for this pandemic.

We will be presenting Plan B, “Polyvagal and Global Cytokine Theory of Safety and Threat–Covid-19”, to the medical community shortly. There are many interventions that systematically applied will improve survival. Many have already been shown to be effective but are being used sporadically. If the mortality of the epidemic drops dramatically, this epidemic is over. Getting the virus is not a problem. It is the dying part of it all. Please help yourself and help those close to you.

1. Fredheim OM et al. Chronic non-malignant pain patients report as poor health-related quality of life as palliative cancer patients. Acta Anaesthesiologica Scandinavica (2008); 52: 143 – 148.

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There are several factors to consider with regards to forgiveness:

• It is not an intellectual exercise. You have to be able to feel and acknowledge the depth of your anger before you can let go.
• You will always possess anger. You are not going to get rid of it. It is a survival reaction. Forgiveness is an ongoing daily practice.
• It is critical to become aware of and let go of your deepest wounds. Forgiving smaller wrongs is helpful, but is not going to really alter your body’s chemistry. Global ongoing anger is deadly.
• The final step of forgiveness is generating deep compassion for the person or situation that hurt you. You might be thinking at this moment, “No way!!” It is not a matter of liking this person, but do you really want to continue to give control of your quality of life to who you rightly despise?
• Deep compassion will move your brain activity off of the pain circuits and create a wonderful chemical environment. Why would you not want to exist in this state?
• BTW, it is common, if not the rule, that people become addicted to their pain and being in the victim role. It is irrational and the biggest block to healing. If you are already reacting to these first few sentences, you are in this role. I know because I was one of those people for most of my life.

Empathy/ compassion

The Oxford dictionary defines empathy as, “the ability to understand and share the feelings of another.” It is a core component of nurturing human relationships. If you don’t have some sense of how someone close to you is feeling, you can’t interact with them in a meaningful way. You might as well be in another room. The capacity to feel empathy is an inherent part of the human experience because from an evolutionary perspective, it was the species of humans who learned to cooperate that had the highest likelihood of survival.

 

 

Compassion is the next step in healthy relationships that follows empathy. You first have to have the ability to see a situation through the other person’s eyes with an understanding of what it might be like to be in a similar circumstance. Compassion is a desire to help out. Nurturing compassion has two parts: 1) engaging in practices that engender empathy, and 2) removal of any interference connecting you with your own compassion.

The disconnect–anger

The problem is that when you are consumed with frustration and anger, it is only about you and it is not possible to be aware of other’s needs. So, the foundational step of empathy is compromised. You might feel you have empathy in spite of being upset. You might–after you calm down. But often people in pain are constantly frustrated and many of their relationships are based on bonding with other people who are angry. It seems like a close relationship with intimate conversations around suffering. But do you really know the person beneath the pain? It is a vicious cycle and one of the reasons why it is so important to never discuss your pain or medical care with anyone except your providers – ever!!

Anger wins over compassion

We all have a deep need to help those around us. But when you are angry, compassion goes right out the window. It is the interference that needs to be dealt with before you can feel compassion and engage in helpful acts. Only then are you able to implement practices to increase your empathy–starting with awareness.

Brenda

Patients freed of pain often want to give back—and in a big way. Brenda was a patient who became paraplegic from an unfortunate series of events surrounding spine surgery. She wasn’t happy before the complication occurred and certainly not after it. Using the methods she learned in the book, Forgive for Good (1) made a tremendous impact on her outlook, mood, and pain.

After she embraced true forgiveness, her overwhelming urge was to help others in wheelchairs who were suffering from chronic pain. She was happier in a wheelchair than she was walking, anxious, and angry. She then descended back into her Abyss of chronic pain for several years. I recently heard from her, and she had pulled herself back out. Once you’ve tasted true freedom, you’ll know how to return to it.

Nurturing Compassion

I have a few suggestions to consider, which might help you formulate your own ideas of how to give back.

• Remain committed to your own journey. You can’t help others if you are not doing well.
• Practice awareness. Remain aware of yours and others’ needs, listen carefully to others and try to see situations through their eyes.
• Don’t discuss your pain, complain, give unasked-for advice or be critical. None of these are compassionate acts. It is a little harder than you might think, because all of us complain. It really isn’t that enjoyable.
• Learn a compassion-based meditation practice. I don’t meditate easily and I have condensed my  practice to, “be nice” regardless of the situation. It is humbling to see how difficult this is.
• Your highest priority is your immediate family. Even if you’re in pain, always treat them well.

Compassion requires a sequence of actions

It seems almost impossible to forgive those you have wronged you or commit evil deeds. It is indeed extremely challenging. The first step is to realize how much suffering they are experiencing that drives them to act so badly. They are living in a dark world and may not have ever known love or what it even looks like.

Also remember that you don’t have to like the person who has committed bad deeds. That is a much different energy than letting go and having compassion.

Anger will block compassion. It has to be processed first. There is no way around it. The way you can and will nurture compassion for you, is to develop it towards others around you. It is the step beyond forgiveness.

Moving Forward

A growing body of research is showing that most people won’t let go of the situation or person who wronged them. (2) Hanging on to resentment has been shown to increase pain and compromise one’s quality of life. (3) Forgiveness is correlated with less mental distress, pain, and an increased capacity to enjoy life. (4)

Make a random list of ideas of ways to give back that are interesting to you–write them down. They can be small actions.

• Pick the top five
• Prioritize them.
• Pick one.
• Develop a focused plan.
• Do it!

What is your vision of what you’d like your life to look like in one year/ five years?

• Be as detailed as possible.
• Learn organizational skills to implement your vision.
  • Getting Things Done (5) by David Allen is an excellent resource.

Creating your vision and moving forward with or without your pain requires compassion and a commitment to yourself. It is the surest way to leave your pain behind as you actively re-engage with an enjoyable life. It is your time to thrive!!

References

1.  Luskin, Fred. Forgive for Good. Harper Collins, New York, NY. 2002.

2.  Burns JW: Anger management style and hostility: Predicting symptom-specific physiological reactivity among chronic low back pain patients. J Behav Med (1997);  20:505-522.

3.  Burns JW, Johnson BJ, Devine J, Mahoney N, Prawl R. Anger management style and the prediction of treatment outcome among male and female chronic pain patients. Behav Res Ther (1998)l 36:1051-1062.

4.  Carson, JW, et al. Forgiveness and Chronic Low Back Pain: A Preliminary Study Examining the Relationship of Forgiveness to Pain, Anger, and Psychological Distress. The Journal of Pain (2005); 6: pp 84-91.

5.  Allen, David. Getting Things Done. Penguin Books, New York, NY, 2015.

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One of the worst aspects of being trapped in chronic pain is losing hope. No one can give you a diagnosis or explain why you are so miserable, multiple ineffective treatments are failing to provide lasting relief, you are being bounced around the medical system, the pain is often unbearable yet you are often not believed, but the worst part is there doesn’t appear to be any end to it.

I met Kent Bassett about five years ago. He is a talented film producer who found his way out of chronic pain using his version of tools he learned from Dr. John Sarno.

Dr. Sarno taught Dr. Howard Schubiner about the mind body connection and was a key figure in his career shift towards this work about 16 years ago. Dr. Schubiner, in turn, was the one who opened my eyes to the simple fact that the mind and body were linked. In all my years of training, this possibility was never mentioned. I had asked him to be the keynote speaker at a medical education course I had organized, A Course on Compassion: Empathy in the Face of Chronic Pain. Even at this early phase of my learning, I realized that the patient physician relationship was a key factor in healing and many patients are labeled by their providers. My goal was to show the audience the tools to work past the labels (we all label people) and get to know their patients.

Dr. Schubiner’s talk was on the nature of chronic pain. I had an idea how it evolved but didn’t comprehend the effects of sustained stress creating physical symptoms by alterations in the body’s chemistry. He began to go through his list of 33 symptoms, and I realized that I had experienced over 16 of them. They had mostly resolved but I didn’t know why. In about 10 minutes, over 20 years of searching for an answer came together. The last five years of neuroscience research has revealed many more insights. I was able to publish the first edition of my book, Back in Control in 2012 and the second edition in 2016. For those of you that have benefited from these ideas, Drs. Sarno and Schubiner are a big part of your, “Thanks!!”

Learn another language

One of the most important aspects of healing is turning your attention from you to others around you and actively helping them come out of the abyss of pain. The process depends on neuroplasticity and your brain will develop wherever you choose to place your attention. It is similar to learning a new language or any other skill.

After his complete recovery from devastating chronic pain, Kent made a choice to use his talents to create a film to present hope and methods to the world on how to move forward. His energy and persistence is remarkable, and he produced a major feature-length documentary telling the story of three patients healing without the backing of a large production company. He donated a tremendous amount of time while working full-time. He has often been down to the bottom of the barrel financially. I have to admit that although I was extremely impressed with his energy, I didn’t think he or anyone could pull this off. Along the way, Kent enlisted the help of a talented film producer, Marion Cunningham. The two of them have made an amazing film. You will see from the trailer what a contribution he has made. At the end of the day, he just wanted to share his success with as many people as possible.

Chronic pain is solvable

Dr. Schubiner, Kent Bassett, Marion Cunningham and I are amongst a growing number of people who have observed that suffering from chronic pain is a solvable problem, whereas the medical profession views it as a diagnosis to be managed. The goal is to learn to live your live as functionally as you can with the pain. Not only do we see people have their pain resolve, they thrive at a level they have never comprehended. It is an incredibly rewarding and inspiring experience for us.

It is almost universal that those who have experienced this remarkable level of healing want to give back. This is true both of patients and providers. I think one reason is that the contrast between extreme suffering and living a full expansive life is so great, that it’s hard to watch others suffer when the solutions are so available.

This is the link to Kent and Marion’s website for his film, This Might Hurt. They are in the final fund-raising stage to mobilize the resources to bring this documentary to the world. Giving back is a powerful way to keep moving forward – farther than you can imagine. If you are inclined to help his efforts, it would be appreciated. – especially by those who will find the film helpful in beginning their own healing journey. It has to start with hope.

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My vision is to bring the DOC (Direct your Own Care) principles into mainstream consciousness. It has become clear that the DOC project is one that is best implemented by primary care physicians. Back in Control is a wellness book, not a “solving chronic pain” one. Most of you know that you can’t solve chronic pain because your attention is still on your misery. You have to move toward your vision of how you want to live your life with or without your pain. Paradoxically, as you become healthier, your pain will abate or resolve. We have witnessed this phenomenon hundreds of times. I also practice these concepts daily.

My focus will be in several areas:

• Building a business structure that scales the DOC process to reach a much wider audience.
• Teaching medical providers in any realm how to treat chronic pain. Only about 20% of physicians are comfortable treating chronic pain and less than 1% enjoy it. We aren’t trained correctly in spite of recent neuroscience research providing many answers.
• Educating the public to take responsibility for their own care. This requires learning about chronic pain.
• I am writing three more books:
  • Do You Really Need Spine Surgery?
  • Chronic Pain and Your Family
  • Optimizing Performance In and Out of the OR Applying Athletic Performance Principles
• We are scaling the workshops that we have held at the Omega Institute. It turns out that the group setting is a powerful resource we have seen to move people out of pain.
• I am starting a movement around physician wellness. The burnout rate among physicians is between 50-60% and steadily rising. It has a tremendous impact on patient care. The DOC process is just a framework of care that allows productive discussions to occur and the patient is able to create their own solutions. However, the doctor/ patient relationship is a critical piece of it. It is hard to reach out to patients when you are trying to personally survive. Physicians have 2-4 times the suicide rate of the general population depending on gender and specialty.
• Finally, my biggest focus is on changing the fee structure for medical care. Many recommended interventions in spine care and other specialties have been documented to be ineffective while most effective treatments are generally not covered by insurance. The most necessary part of care is for your physician to listen and you to be heard. It is the one aspect of care that that has been taken from all of us. Creating a fee schedule that allows providers to take the time to get to know you will change the nature of medical care.

Grassroots effort

I am asking for your help. It’s clear that change is going to have to occur from the ground up. The business of medicine has firmly embedded a production approach to your care. It is not going to change. Here is a quote sent to me by one of my mentors.

A new scientific truth does not triumph by convincing its opponents and making them see the light; but rather because its opponents eventually die, and a new generation grows up that is familiar with it.

–Max Planck

How can you contribute?

People often ask me how they can pass on what they have learned. Here are some suggestions that would be of great help to my efforts.

• Continue on your own healing journey. The concepts presented in the DOC process are ones that need to be practiced for a lifetime. Patients often feel well enough that they stop at Stage 2. Stages 3 and 4 are the creative parts of it and where it all really happens. Don’t stop.
• Your personal transformation will have a strong healing effect on those you are close to. There is a direct mirror neurons effect.
• Encouraging friends and family to sign up for the weekly email updates on backincontrol.com.
• Share links on social media.
• Write a quick review of Back in Control on the Amazon or Barnes and Noble websites.
• Let your providers know about the DOC concepts and that they can contact me. My intent with the combination of the book and website is to enable the patient to take control of his or her own care and form a partnership with your physician and other medical professionals. Not only are your visits productive, but are more enjoyable. There isn’t a day in clinic that I don’t emerge more energized and inspired.
• Share your personal success on the “Stories of Hope” section of this website. Hope is a powerful force in healing pain.

Thanks to all of you for your interest and support. It’s what keeps me moving forward. For me, it is truly a new horizon and adventure and I am looking forward to seeing how it evolves.

The post Moving Forward – A New Horizon first appeared on Back in Control.

The post Moving Forward – A New Horizon appeared first on Back in Control.

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

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

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

“Anxiety with Success”

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

Why??

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

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

Self-Sabotage

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

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

Gratitude

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

Enduring Pain

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

It Has Been Worth It

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

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

Giving Back

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

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

The post Compassion first appeared on Back in Control.

The post Compassion appeared first on Back in Control.

A functional pain system is critical to your health and even survival. He presented several stories of children born without a pain system. Their body quickly becomes deformed from over-stressing their joints and skin breakdown. The average lifespan of these children was only 15 years. I knew him when he moved to Seattle to be close to his family. He was over 90 years-old and still writing and lecturing all over the world. He was one of my true inspirations.

My Gift

I have slowly realized that I have been granted a similar gift that I did not want, nor would I accept it again if it were offered to me. It is the gift of prolonged severe suffering in the form of both physical and mental pain. I slipped into an anxiety-driven depression/ burnout in 1988, and developed symptom after symptom of the Neurophysiologic Disorder (NPD). At one point I was experiencing 16 of the over 30 symptoms outlined by Dr. Schubiner in his book, Unlearn Your Pain.

OCD

The worst part of the descent into oblivion began in 1995 when I developed a full-blown Obsessive Compulsive Disorder (OCD). I had always thought it was a loose term for some compulsive habits and felt it was some type of TV joke. It is the ultimate anxiety disorder manifested by intense, repetitive intrusive thoughts. They never stopped and became increasingly intense. By 2002 I was done and ready to check out. I will never completely understand why I survived. I have 18 medical colleagues that have committed suicide. Most recently it was one of my best friends in the spine surgery world and the other was an orthopedic surgeon acquaintance that I did some business with. Both had everything life that one could ask for.

While I was living in Sun Valley, six men between the ages of 45 – 60 committed suicide over a span of 18 months. All were extremely successful and prominent in the community. Why?

Anxiety

Raw anxiety is intolerable. It mental pain that I couldn’t escape. I cannot describe my suffering in words. My best metaphor is a “branding iron on my brain.”

I got extremely lucky in pulling out of it. In 2002 I began to heal and by 2004 began to thrive. The last five years have been the richest I could ever imagine. All of my NPD symptoms resolved, and flare only if I quit practicing the principles I have outlined in my book. So what are my gifts? This does not sound that convincing yet. They are many:

My Gifts

• Every day I am alive I can appreciate it at a depth I could not have imagined. It is a marked contrast to extreme suffering.

• I can look any patient in the eye and let them know that I understand your suffering. “You may be suffering as much as I suffered but not more.” I know where they might be going and where they are at as the come out of “The Abyss.”

• I understand the endless quest to find the one answer to the pain.
• I know loneliness.
• I did not have a shred of hope. NONE. Having the physical surroundings of success made it even worse in that I had worked so hard to attain them and I was still miserable. My efforts to find happiness had not worked. That included friends, family, and incredible experiences. I could not run from my mind. If none of that worked I developed a deep feeling of desperation of,  “What do I do next?”

• As I have learned to accept myself (the medical world is not an accepting culture), I can accept my patients wherever they are at. I know them better and it is one of the most enjoyable aspects of my practice.
• I have learned when I can help and when I cannot.

• I no longer let patients make surgical decisions when they are under extreme personal stress. In the past I never really was aware of the degree of their personal suffering in addition to the pain. The lines between mental and physical pain overlap.

• I saw patient a few months ago who came to me for a second opinion. She had seen a surgeon for correction of a spinal deformity. She did have the deformity and surgery would have been helpful. The problem was that she was scheduled for a 10-hour procedure just a week after meeting the surgeon for the first time. A month earlier her 34 year-old daughter had died of cancer.

Gratitude

The greatest gift has been gratitude. That was not a familiar word for me until a few years ago. I was charging full steam ahead just doing the best job I could. I am grateful that I am able to share the tools I learned coming out of my burnout and witnessing so many patients experiencing the same success.

I am a surgeon and do not understand all of the reasons why the dramatic turnarounds occur with such regularity. I am not a neuroscientist. But it is a completely unexpected phase of my career and is incredibly rewarding.

The post The Gift of Pain – Thanksgiving 2013 first appeared on Back in Control.

The post The Gift of Pain – Thanksgiving 2013 appeared first on Back in Control.

ANGER

ANGEL

Love and rage are both four-letter words.

A

N

G

E

R  A  G  E

A

N

G

E

L O V E

The difference between the words anger and angel is one letter.

What a difference a letter makes.

The post Anger versus Angel first appeared on Back in Control.

The post Anger versus Angel appeared first on Back in Control.