Dr. Hanscom's Blog Darkness – “The Abyss”

When you’re suffering from chronic pain, your nervous system is ablaze. The medical term for this is “central sensitization syndrome” (CSS). Indeed, animal research has shown that when your body is full of adrenaline and other stress chemicals that the speed of nerve conduction increases (almost doubles), so you’ll experience even more pain. (1) It’s a terrible cycle. These patterns of brain activity can now be visualized with functional MRI scans (fMRI), and researchers are identifying some of the neurological patterns associated with chronic pain. (2)

It is also becoming clear that unpleasant mental and physical sensations are processed in a similar manner and both result in a survival neuro-chemical response. (3) The sum total of this reaction is anxiety. Anxiety is the pain and is not primarily a psychological issue. This process is the essence of the unconscious survival aspect of the nervous system and is approximately one million times stronger than the conscious brain. You can’t control it. Since humans, and all living creatures, evolved from avoiding anxiety, we’ll do anything we can to avoid it.

But humans have a problem in that we can’t escape our thoughts. We’re all trapped by them. The more you fight or try to avoid them, the stronger they become and over time anxiety worsens. The additional problem is that the sustained level of stress hormones creates many physical symptoms because each organ system will respond in its unique way. So now you’re trapped by your thoughts, pain, multiple physical symptoms and often life circumstances. When any living organism is trapped, more adrenaline and cortisol is secreted in an attempt to solve the problem and further ensuring survival. You become angry and the levels of these chemicals skyrocket.

“The Abyss”

One afternoon, I was listening to a patient attempt to describe the depth of her suffering and it hit me how dark and deep this hole of chronic pain is for most people. I had a flashback to my own experience and not only did I not know how I ended up in this level of misery, I had no hope and wasn’t being given any answers. I kept descending deeper and deeper into darkness. I realized that words couldn’t come close to describing this scenario. At that moment, the word that came to mind was a deep dark abyss.







The medical profession is not only not solving the problem of chronic pain, we’re making it worse. When I lecture to various groups of physicians, I’ll ask the audience how many of them enjoy treating chronic pain. Essentially no one raises their hands. Since one and three Americans suffer from chronic pain, a high percent of their patients are dealing with it. (4) The frustration doesn’t arise from lack of compassion or motivation. We’re not properly trained to deal with it. We’re focused on treating symptoms instead of dealing with the root cause of relentless and progressive anxiety creating physical symptoms. If I hadn’t gone through my ordeal with pain, I wouldn’t have any idea either. I did spend the first eight years of my practice aggressively performing surgery for pain. Didn’t work.

So, we’re trained to recommend procedures for a neurological problem (5) and it can’t and doesn’t work. We’re continuing to take this approach in spite of medical research that says procedures generally don’t work and our pain epidemic is worsening. (6) What is even more problematic is that animal research shows that one effective way of inducing depression is to repeatedly dash one’s hopes. You’re offered solutions with a lot of positive anticipation and then are repeatedly disappointed. How this plays out is described in my post, “The Pit of Despair”.

If you attempt to solve chronic pain with a procedure, there is little chance that it will have a sustained effect. You can’t effectively treat a neurological disorder with isolated and random physical interventions. Patients are bounced around the medical system indefinitely and become discouraged (despondent). My equation for “The Abyss” is:

The Abyss = Anxiety x Anger x Time​

The Losses

As I attempt to describe this abyss, I am still overwhelmed with my inability to find words that express the depth of suffering. You’ve lost control over your happiness, ability to engage with your career, family, friends, and hobbies. Some of the losses include:

• Unlimited physical activity
• Independence
  • Financial
  • Enmeshed in the disability system
• Ability to enjoy good music, food, hobbies, etc., without the experience being marred by pain
• Peaceful family life
• Integrity – people don’t believe you and often the harder you try to convince your friends, family, peers, employers, and health care providers the less you are believed.
• Being labeled – malingerer, drug-seeker, lazy, not motivated, difficult, etc.
• Hope – this may be the worst aspect of it all.

You’re trapped beyond words and you’re understandably angry. Dr. John Sarno called it “rage”. Additionally, the more legitimate your anger, the harder it is to let it go.

No Way Out

Consider the depth of “The Abyss”. Your soul is being pounded into the ground by a pile driver as you remain in your dismal body. Your life is being systematically destroyed, but in some cruel cosmic joke, you’re alive to bear witness – without hope.







Dr. Viktor Frankl was an Austrian psychiatrist who survived the concentration camps in WWII. He describes the ordeal in detail in his book, Man’s Search for Meaning. Every detail of this book is sobering and disturbing. The physical abuse he describes is incomprehensible. However, what was unbelievable to me was that he said the worst part of the experience was wondering if and when it would end.

A recent research paper documented that the effect of chronic pain on one’s life is similar to the impact of terminal cancer. (7) It’s ironic that you’ve worked hard towards achieving what you thought would be a successful and full life. You hadn’t anticipated the possibility of your life being consumed by pain. This dark place that develops in your mind is unusually deep – bottomless.





Related posts:

1. “The Abyss”
2. Descending into The Abyss – My Story
3. Escaping the Abyss – Which One??

 

This is really depressing I was hoping for an uplifting conclusion...

 

Colls, the answer is at the bottom of the post - "The Abyss" is the first of three blogs by Dr. Hanscom, and there is an obvious progression!

I just read #3 (the links take you to his website backincontrol.com) and it was a good wake-up call for me. I've been struggling lately - nothing like what I was dealing with in the pre-Sarno days, mind you, because I know fully-well what's going on. But I keep thinking that just knowing about the mechanism is enough - which simply isn't true, as I've often advised others! The truth is that I haven't taken the time or energy to really acknowledge what my brain is trying to suppress right now.

Dr. Hanscom doesn't pull any punches, and what he has to say hit me in a way that I apparently needed. Some of my takeaways (not necessarily as he wrote them) are:
- we humans keep trying to distract ourselves via escapism - as a long-term strategy, it doesn't work
- rage is still ultimately at the bottom of our symptoms
- "positive thinking" is not the solution (I've often said that it's a shallow form of distraction)
- "mind over matter" is not the solution (pretty much the same thing, I think - treating the outward symptoms instead of what's really going on)
- this is a FACT, written by an MD: "unpleasant thoughts create the same chemical reaction in your body as threatening physical input. Any sustained threat is eventually going to make you sick in a number of different ways."

Dr. Hanscom shares his own struggles with chronic pain in a very intimate and grounded way that is extremely unusual for an MD. I think he's awesome.

 

I think he's awesome too, and not only because he was the man that helped me start to heal. I consider him to be a doctor with an artist's soul and this means he embraces the vulnerabilities and realities of the human condition in ways the happy clappy crowd tend to deny or insist you crash through to the other side.

Hansom's sensitivity and awareness allows him to explore these states and experiences tenderly, to explore the minutiae including the darkness of the abyss. I have often reflected on the absence of discussions on the shadow and the darker elements of the human psyche and experience in the TMS world. Given how key repression is, why is there such a dearth of discussion?

Much as I appreciate Sarno's work it is woolly and lacking in depth (which could easily have come from an exploration of the Freudian or other depth psychologists), whereas the contributions of people like Hanscom bring these neglected elements to the fore. (My personal favourite post of his is this one which is replete with overtones of historical sorcery...a poppet for your pain...: http://www.tmswiki.org/forum/threads/out-of-the-valley-with-dolls.13889/ (Dr. Hanscom's Blog - Out of the Valley, with Dolls)).

Interesting that Hanscom has been denounced for being "too scientific, too medical". I'm sure his foray into these more shamanistic elements will fry a few circuits. Personally I love to see someone leaving no stone unturned in pursuit of a cure for those he cares about. The healing vista is beautiful.

 

I found Dr. Hanscom's book, 'Back in Control' to be both resourceful and inspiring. I have not taken the time to digest his blog, but now intend to do so. I must agree that rage is at the pit of our suffering. I recently told part of my own tale of misery to a massage therapist/friend. We talked about rage as a base of much physical and physic suffering. She said she had never considered rage, it was too scary a thought she supposed. Expressing rage is potentially dangerous. I knew rage as a young woman and understand how it can encompass our whole body into someone other than what we have portrayed. It is scary. I once had a psychological trainer (who was giving a seminar) say that rage is the build up of years of unexpressed anger. I thought this was insightful and definitely food for thought.
Anyway, thanks for posting this. Good discussion, good information.
Lainey

 

I think our thoughts only pose a problem when we believe them. I'm becoming pretty good at calling them out as B.S. Then they just move away and don't stick around. I agree that positive thoughts aren't the answer. I try to nurture a place of "no thought", through engaging in activities or natural settings that take me out of my mind and place me firmly in the present moment or in a state of "flow". Then everything unfolds without my judging it or interpreting it. That is where my nervous system gets the most rest and peace.

 

Ellen
No thought is definitely a good place to be at times, yet mostly my mind is filled with thought. I am a long time meditator but recent life events (of the last five or so years) have made my meditation practice difficult. I get in the way of my own peace of mind. I like your nurturing of "no thought" via engaging natural settings as a way to let my mind chill, but, once again, this is no longer easy for me. Getting outside, which used to be my solace, is not as easy for me now, but I do persist, though not as often as I could/should. My peace of mind, so to speak, is a work in progress. I am discouraged by this yet remain hopeful for a better physical outcome nevertheless.
Thanks for your post. A well-taken reminder of how our thoughts can overtake us and sabotage our well-being.
Lainey

 

Me too! But I am finding it gets easier with practice. Or maybe I'm just mellowing out with age.