He defines resilience as, the process that allows individuals to adapt to adverse conditions and recover from them. Stress susceptible individuals have a different immune system profile than that of resilient individuals. He reviews the four most notable factors that affect resiliency and therefore the reactivity of the immune system. It is desirable for the immune system to quickly respond to an acute threat and equally important for it to quickly calm down. In fact, short-term stresses enhance immune function. But chronic psychological stress tends to suppress the immune response.

The psychological factors are:

• Positive affect – “can do” attitude
• Personal control
• Optimism
• Social support

It works both ways

Although, being exposed to chronic threats is problematic, how you process them is critical. One study showed that a positive affect (happiness, joy, excitement, enthusiasm, and contentment) predicted better self-rated health than hunger, shelter, and safety. (2). A classic example is the story of Viktor Frankl, an Austrian psychiatrist who found a way to thrive in the midst of the horrors of a concentration camp. He relates this incredible experience in his autobiography, Man’s Search for Meaning. (3)

Social connection was shown to counteract increased mortality in men over 50 exposed to high levels of stress over a seven-year period. (4)

It also works the other way around. When the immune system is chronically activated it can induce many unpleasant reactions. The brain is also compromised of glial cells that support the neurons and also throw off small proteins called cytokines. Under threat, inflammatory cytokines are produced that sensitize the nervous system. The inflammation can induce some of the physical manifestations of depression such as poor appetite, fatigue, and insomnia. Eventually, thinking capacity is affected. The immune system directly affects the psychological state of the person and the psychological state affects the immune system.

He also reviews the role of diet on the microbiome of the gut and poor-quality diet reduces resilience and is a risk factor for major depression. (1)

These are just a few points from his extensive review paper regarding the relationship between a person’s ability to adapt to adversity affecting the immune response but also the state of the immune response affecting the capacity to effectively deal with adversity.

You can retrain your brain

The good news is that a person can be trained to be more resilient in all of these domains. The DOC Journey is one program that presents a framework that allows participants to systematically address each of these areas.

• Sense of personal control – learning tools to regulate your body’s stress response is powerful.
  • For healing to occur, you must take control of your own care – and life.
  • You must quit blaming – period. There are no shortcuts to this step.
  • Knowledge is power and allows more control over your decisions.
  • Learning organizational tools enables you to execute your plans based on your vision.
• Positive affect
  • Positive thinking is problematic in that you are just suppressing negative thinking. If something is unpleasant, there is no benefit in pretending otherwise. However, a positive outlook focuses your brain on where you want to go and is a core aspect of the program.
  • Look at obstacles as challenges as an opportunity to practice your skills rather than viewing yourself as a victim.
  • “Do” instead of “try”
• Optimism
  • By understanding the nature of the problem and the principles behind the solution bring a tremendous amount of hope back into a person’s life. Being stuck in chronic pain without any idea how to navigate your way out is possibly one of the worse experiences of the human condition. It is ironic that being in The Abyss of pain is inflammatory and physically exacerbates the pain.
• Social connection
  • Group sessions have been the hallmark of The DOC Journey since 2013. We quickly noticed the healing power of a group in where you can share and feel safe. We have been excited in that our twice-weekly virtual sessions have been as effective as our in-person workshops. We have historically been perplexed why this has been the case but have learned that oxytocin (social bonding hormone) is strongly anti-inflammatory. Other hormones such as dopamine (rewards), serotonin (anti-depressant), growth hormone, and GABA chemicals (anti-anxiety) also create a profound sense of safety and contentment.

The video below is a compilation created from the experiences of some of our participants in our weekly group sessions. I am continually inspired by their persistence and determination to keep moving forward. Sharing in a safe environment is powerful. I have personally benefited and have greatly enjoyed getting to know this group.

The DOC Journey Q&A – The Power of Social Connection

References:

1. Dantzer R, et al. Resilience and immunity. Brain Behav Immun (2018); 74:28-42. doi:10.1016/j.bbi.2018.08.010
2. Pressman SD, Gallagher MW, Lopez SJ, 2013 Is the emotion-health connection a “first-world problem”? Psychol. Sci (2013);24:544–549.
3. Frankl V. Man’s Search for Meaning. Beacon Press, Boston, MA, 1959, 1962, 1984, 1992, 2006.
4. Rosengren A, Orth-Gomer K, Wedel H, Wilhelmsen L. 1993 Stressful life events, social support, and mortality in men born in 1933. Br. Med. J (1993); 307:1102–1105.

The post The Bidirectional Interaction between Resilience and Your Immune System first appeared on Back in Control.

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• Body image disorders
• Eating disorders
• Crohn’s Disease and Ulcerative Colitis
• Irritable Bowel and Spastic Bladder
• Depression/ OCD/ Bipolar disorder

Remember, anxiety is simply the sensation you feel when your body is flooded with stress hormones, which affects every cell in your body. Since each organ system will respond in its own way, there are at least 30 different physical symptoms that can be generated in this hyper-vigilant chemical environment.

I gave a lecture about dealing with stress at a local high school a few years ago and over 300 of the 1,500 students were on daily medications for a chronic illness. This phenomenon is occurring in an era of unprecedented opportunity. What is going on?

Anxiety Basics

There are books written about why there is so much societal angst. However, conjecturing about all the reasons is of limited value unless the core problem of relentless anxiety is addressed. Since this unconscious survival sensation is much more powerful than the conscious brain, it isn’t responsive to isolated rational interventions. The way to solve anxiety is to decrease your levels of stress hormones. It’s a learned skill that improves with repetition.

The dark side of human consciousness is that a mental threat is processed in a similar manner as a physical one. It takes the form of Unpleasant repetitive thoughts (URT’s) (1), from which you can’t escape. Disruptive thoughts are maybe greatest reason for sustained anxiety. Most of us suppress them, which is the one worst thing to do. Research has shown that this creates a trampoline effect, where not only are the unpleasant thoughts stronger, they are a lot stronger. (2) One effective way of addressing the problem of URT’s is to become aware of them, understand their impact and then reframe the situation.

Unreachable Expectations

In this modern era, one of the greatest sources of anxiety is dealing with unreachable expectations, and winning is one of the ultimate goals. Somehow, success (your perception of “winning”) is going to bring you peace of mind. Really? That isn’t even a reasonable concept. How many “winners” have we watched self-destruct, yet we keep pursuing the dream that money, power, accomplishment, and attractiveness will quell our fears. The problem is that you can’t outrun your mind.

What is even more problematic is that our concepts of success and failure become attached to our identity and vice versa. Modern neuroscience research has shown that thoughts and ideas become embedded in our brain, in the same way as physical objects. (3) In other words, the only reason a dish is a dish is because your brain has unscrambled visual and tactile senses and decided that it is a dish. This is true for everything. None of your body’s sensors have any inherent capacity to determine the nature of your reality and environment.

So, our perception of self is programmed in by our past experiences, and is as real as the chair you are sitting on. Much of it is determined by your definition of success and failure. They are “stories” that run your life. It is also the reason why it is impossible to truly see an issue from another person’s perspective.

These many negative stories become stronger over time, alter your body’s chemistry and compromise your sense of well-being. In contrast to this sustained assault of stress hormones generated by your “stories”, consider the feelings generated by being full of oxytocin (love drug), serotonin (antidepressant), GABA (anti-anxiety) and dopamine (rewards), when you are at play.  Instead of pursuing happiness through achieving your goals, why not get happy first and then pursue your dreams? Part of that pursuit is learning how to “fail”. A major aspect of this approach is understanding the impact of your “failure stories” and realizing how irrational many of them are.

A close friend of mine sent this piece to me on stress. I don’t know the person who gave this seminar, but I think it is excellent and reflects many of the tools to just let go, reframe many of your created  “adversities”  and enjoy your life. Where are you actually going and what’s the rush?

A Great Lesson on Stress

A young lady confidently walked around the room with a raised glass of water  while leading a seminar and explaining stress management to her audience. Everyone knew she was going to ask the ultimate question, ‘Half empty or half full?’  She fooled them all. “How heavy is this glass of water?” she inquired with a smile.  Answers called out ranged from 8 oz. to 20 oz.

She replied, “The absolute weight doesn’t matter.  It depends on how long I hold it. If I hold it for a minute, that’s not a problem. If I hold it for an hour, I’ll have an ache in my right arm. If I hold it for a day, you’ll have to call an ambulance. In each case it’s the same weight, but the longer I hold it, the heavier it becomes.”

She continued, “and that’s the way it is with stress.  If we carry our burdens all the time, sooner or later, as the burden becomes increasingly heavy, we won’t be able to carry on. As with the glass of water, you have to put it down for a while and rest before holding it again. When we’re refreshed, we can carry on with the burden – holding stress longer and better each time we practice.”

So, as early in the evening as you can, put all your burdens down. Don’t carry them through the evening and into the night. Pick them up again tomorrow if you must.

1. Accept the fact that some days you’re the pigeon, and some days you’re the statue!
2. Always keep your words soft and sweet, just in case you have to eat them.
3. Always read stuff that will make you look good if you die in the middle of it.
4. Drive carefully… It’s not only cars that can be recalled by their Maker.
5. If you can’t be kind, at least have the decency to be vague.
6. If you lend someone $20 and never see that person again, it was probably worth it.
7. It may be that your sole purpose in life is simply to serve as a warning to others.
8. Never buy a car you can’t push.
9. Never put both feet in your mouth at the same time, because then you won’t have a leg to stand on.
10. Nobody cares if you can’t dance well;  just get up and dance.
11. Since it’s the early worm that gets eaten by the bird, sleep late.
12. The second mouse gets the cheese.

My past formula for “success” – highly NOT recommended

As I went through this list, I pondered my historical approach in each category, and I’m not making this up. One of my basic core beliefs was that of being “cool under pressure” and I could take on an unlimited amount of stress.

1. It is important to always be on top. If someone dumps on me, I’m a “loser”.
2. If there is an obvious problem, it is necessary to speak up (not such soft voice).
3. I have always liked good books and don’t like to waste that much time on something that isn’t informative, entertaining or inspiring.
4. My time is valuable, and I’ll do whatever I need to do to get there quickly. (I had 14 speeding violations in five different states between ages 18 to 25. Thank goodness it was well before there were computers)
5. If someone is “wrong” from my perspective, it’s my role (duty) to correct them.
6. I am not forgetting that person who shortchanged me. I don’t care how long it’s been.
7. Having some variation of a “purpose” has defined my existence. My identity was based on my ideals and I couldn’t always clearly see who or what was right in front of me.
8. I actually don’t care much about cars one way or the other.
9. One day, one of my fellows asked me, “Don’t you ever get tired of talking?”
10. I don’t dance. I’m not very good at it.
11. There aren’t enough hours in the day, and I have to get up early.
12. What if the first mouse gets the cheese?

The bottom line is give yourself a break. What are your ideals? How do you mentally punish yourself if you don’t live up to your own expectations. It’s great to be successful at whatever you set out to do. But does it define you? Are your endeavors grounded in reality. I did define “me” by my achievements, and many efforts were driven by “magical thinking” and unattainable goals.  I used my adrenaline drive to become “successful”, yet it was this same energy that caused me to sink into chronic pain and become physically ill. Another version of her advice is reflected in this poem sent to me by one of my patients, She Just Let Go.

I wish I had figured this out many years ago, but my life and parenting advice (if I am asked) has boiled down the word, “play.” If you can’t enjoy your family and life today, when will you?

Enjoy your day today

1. Garland, EL. Brown, SM, and MO Howard. Thought suppression as a mediator of the association between depressed mood and prescription opioid craving among chronic pain patients. J Behav Med (2016); 39:128-138.
2. Wegner, D. M. (1994). Ironic processes of mental control. Psychological Review, 101, 34–52.
3. Feldman-Barrett, Lisa. How Emotions Are Made: The Secret Life of the Brain. Houghton Mifflin Harcourt Publishing, New York, New York, 2018.

The post Success is a “Story” first appeared on Back in Control.

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It’s because every human being is attached to being a victim since it feels so powerful. It also masks feelings of anxiety and vulnerability, which we hate. Even after many years of being out of pain and practicing the DOC concepts, I frequently still dive into being a victim. It is a core pattern for me, and I finally realized that it isn’t going to ever disappear. The greatest obstacle to solving chronic pain is the willingness to learn about the nature of it and use the strategies to solve it. We become addicted to the power of pain. But here’s the problem.

A few years ago I labeled myself as “enlightened”, which meant in my mind that I was above going into the victim mode and could maintain a sense of tranquility regardless of the circumstances. It was a bad idea and it turned out that my “enlightenment” was just another form of suppressing negative thinking. Suppressed anger and labeling both block awareness and my relationships suffered.

The problem is that when you’re in the victim mode, it is a complete package of behaviors and the behavioral patterns are much stronger than your conscious brain. Every time you’re upset you are now a real or perceived victim. By definition you’ll engage in destructive behaviors, including self-destructive ones. Even though you “know better”, it won’t stop you. The conscious brain is no match this energy.

My List        

I have a list of various behaviors I do when I am upset. They include: a) stopping my own practice of expressive writing b) quit exercising c) eating poorly and at irregular hours d) feeling in a bad mood and making sure those around me are fully experiencing it with me, e) making excuses for not getting things done f) blaming others. There are many others that are subtler and some that are quite destructive. These actions are just a small aspect of my anger response. I was truly a victim of a chaotic family and unfortunately this pattern is a significant part of my core behavioral patterns.

If you feel that you aren’t angry or don’t exhibit this kind of behavior think again – or seriously ask those close to you what their observations are? Every human has this problem whether he or she recognizes it or not.

What Do You Do?

I’ve finally given up trying to not be angry. It takes too much energy and it is an inherent part of life. I am continually working on approaches to deal with it.

First, it’s critical that I am aware that I’m angry. There are many ways to disguise it, including rationalization. Since I’m “right” then what I’m experiencing really isn’t anger. My default disguise is just “feeling frustrated.” It works both ways. I may not feel angry or frustrated, but I am engaged in self-destructive behaviors. As I mentally work backwards, I can usually see that I’m upset and what the trigger was that set me off.

Second, I’ve accepted that I like the power of being a victim and after over 20 years of recognizing and watching it, that the role isn’t ever going to disappear. I will never wake up one morning and ever want to give it up. I focus on becoming more aware when I have gone into that mode and more importantly, observing people’s reactions to my words and actions.

Third, since I teach about the consequences of anger and benefits of forgiveness, I become upset with myself for being angry. It’s a double-hit. I work on “failing well,” since it’s inevitable that I’m going to behave badly. Being a self-critical perfectionist magnifies the problem.

Finally, a strategy I’ve adopted with some success is minimizing destructive behaviors while I’m upset.

Cut Your Losses

Logically, minimizing the destructive aspect of anger is my only choice. Some examples that I am working with include:

• Eating a lesser amount of junk food.
• Exercising even for five or ten minutes, regardless of how I feel.
• Re-engaging with the expressive writing exercise– even if it’s only a couple of sentences.
• Not making anyone the target of my frustrations, especially my family.
• Looking at what set me off and how the situation might look from his or her viewpoint. What may I have said or done to start the reaction?
• Recognizing that my anger response is often out of proportion to situation. Just being aware of it has helped me step back and not take action while I am in this fired up state of mind.

I’m making progress in cutting my losses. Some weeks are better than others.

Addictions

I have an extensive experience in weaning patients off of high doses of opioids and other addicting drugs. My view is that an addiction is an addiction regardless of the form it takes. They all inflict varying forms of damage to your body and life. The problem with drugs is that the toll is so high. The general approach to rehabilitation is structure and control, which is effective for many people, but often isn’t sustainable.

The key is to understand that the driving force behind addiction is anxiety. No one wants to be an addict, but unrelenting anxiety is intolerable. Anxiety is an unconscious neurochemical survival response and necessary for survival. When you can’t escape it, you’ll produce more stress hormones and become angry. Since it isn’t primarily psychological, it’s not subject to isolated rational interventions.

So, when a patient goes into the self-destructive role, I ask if there is a set of  “victim behaviors” that are less destructive? Instead of feeling guilty about “failing,” can you connect with compassion for yourself? There is a much higher chance you’ll come out of the hole more quickly and move forward towards the life you really want. One of the approaches is to learn how to “fail well.”

What about You?

What is your “anger package?” What self-destructive and other destructive behaviors do you engage in when you are feeling sorry for yourself? Is being angry and acting badly so much a part of your life that you don’t even feel anger is a problem? I frequently see patients who tell me they are not angry but it is clear that he or she has not taken one step to care for his or her health. Self-neglect is one of the ultimate self-destructive anger-based behaviors that is akin to a slow suicide. There is no other explanation for it. You have to be aware you are in this mode before you can address it.

What can you do to minimize the damage when you are in your victim mode? Can you contain yourself when you feel like yelling? Are you able to simply eat less when you feel like binging? What about having just a few cigarettes instead of smoking for a week? Are you able to allow yourself to fail and get back on track quickly? Is there something you can do besides jumping back into your full drug habit? Even if you completely fail, how quickly can you let yourself off of the hook?

Anxiety and anger will always be a part of your life? What can you do to limit the damage?

The post Anger: Damage Control first appeared on Back in Control.

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