Q&A: How can I prevent a conditioned response?

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What are conditioned responses, how are they related to TMS/PPD and how can I prevent them?

Answer by Alan Gordon, LCSW

An image of Alan Gordon, LCSW
Alan Gordon, LCSW

Alan Gordon's Profile Page / Bio Page / Psychophysiologic Disorders Association (PPDA) Board Member/ Miracles of Mindbody Medicine / Website

My favorite example of a conditioned response involves awesome comedian/author/Academy Awards host, Steve Martin.

Back in the late 60s, Steve Martin was on top of the world. Young, good looking, famous, he had it all. Then one day he walked into a movie theater, and it all came crashing down.

Halfway through the movie, he remembers, “I sat in stoic silence as my heart began to race above two hundred beats per minute and the saliva drained from my mouth so completely that I could not move my tongue.”

It was a massive, terrifying, life-altering anxiety attack.

And then, the next day he was fine.

Three weeks later, he met his friends at a movie. Waiting in line to get popcorn, he had the unfortunate thought, “Last time I was at the movies, I had that awful panic attack, I hope that doesn’t happen again.”

Boom, panic attack.

He didn’t go to another movie for ten years.

This is a conditioned response. The anxiety attack became linked with the movie theater, and every time he went to the movies, a panic attack resulted.

Now, it wasn’t the movie theater that caused the panic attack, it was the belief that the movie theater was causing the panic attack- that caused the panic attack.

So it is with PPD. Your mind wants to keep you preoccupied with the pain. Getting you to believe that your pain is structural is one of your mind’s primary ways of accomplishing this. And the conditioned response is the fuel for thinking physically.

I’ve worked with several hundred PPD clients, and without exception every one of them had a conditioned response associated with their pain.

“My back hurts every time I sit.” “My knee hurts every time I run.” “I get a headache every time I drive to the Valley.”

Conditioned responses perpetuate fear, preoccupation, and thinking physically instead of psychologically. They’re a clever strategy by your mind to keep the wool pulled over your eyes.

A great way to eliminate conditioned responses is to sell yourself on the following: “It isn’t the sitting that’s causing my back pain, it’s the belief that sitting is causing my back pain that’s causing my back pain.”

Getting to the point where you truly believe this is difficult for some people, but it’s an important step. Use the evidence that you’ve accumulated (some examples include having been diagnosed with PPD, the knowledge that your symptoms move around, certain times when your pain was minimal or nonexistent when you were sitting but distracted, etc.) to pound into your brain that the connection between the physical activity/physical position and your pain is not a cause and effect relationship.

Once you’ve sold yourself on this reality, it’s helpful to just let it go. Don’t try so hard to get rid of your pain. Your new goal becomes outcome independence. You attempt to alter your definition of success: It is no longer “I succeed if I take a walk around the block and have no pain,” and is replaced by, “I succeed if I take a walk around the block and don’t care whether or not I have pain.”

Remember, the pain feeds on fear and attention. You take away those two things and you’re in good shape.

Poor Steve Martin had to miss all of his own movie premieres for an entire decade. Had he only recognized that it was simply a conditioned response and laughed it off, he could have enjoyed “The Jerk” and “The Man with Two Brains” with the rest of us.


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