Day 4: Breaking the Pain Cycle My two-year-old niece is incredibly rambunctious. The day she learned how to walk, she learned how to run, and ever since then, she runs everywhere. She is the Forest Gump of toddlers. But because her ambition exceeds her level of coordination, she falls often. And there’s a moment just after she falls, when she looks at you and waits to see how you react, before determining how she feels. If you run over to her, concerned, worried, frantically asking if she’s okay, she’ll start crying...convinced that she must have taken quite a spill. If instead, you calmly say, “Hey, it looks like you took a little stumble,” she’s back up and running before you even finish your sentence. The way you react will either reinforce a sense of danger or a sense of safety. The Fear Behind the Pain Pain is a danger signal. And in the case of neural pathway pain, the way we react determines whether this signal stays on or switches off. When we react to pain with fear, it reinforces a sense of danger, and the pain persists. Fear is the fuel for the pain. If you overcome your fear, it deactivates your danger signals and the pain stops. So in truth, this is not a pain problem you have, it’s a fear problem. The pain is just the consequence. Of course, overcoming the fear of your pain is easier said than done. It's hard not to be afraid of something that is so inherently scary. But that’s the goal, and it’s one of the things we’re going to be working toward for the next few weeks. A couple months ago, Howard Schubiner and I did a training in Michigan. We wanted to do a live demonstration with someone to show the relationship between pain and fear. A nurse practitioner named Felicia volunteered. Felicia had had chronic neck pain for 20 years, and for 20 years she’d interpreted that pain as dangerous. Over the course of several minutes, Felicia was able to eliminate her fear around the pain, and the pain went away. Here’s a video of the live demo: Assuming you have neural pathway pain, if you overcome you fear, the pain will disappear. It may not happen immediately, but it will eventually fade, as you've cut off its fuel source. The Subtle Forms of Fear What if you're not actually scared of your pain...what if it's more frustration or despair? These feelings seem like they’re different than fear, but they’re actually under the same umbrella. Fear is a feeling induced by perceived danger, and it gives us the desire to escape. Frustration and despair lead to a desire to escape from our current situation... Subtle as they may be – frustration and despair are forms of fear, and can keep our danger signals activated. So when we talk about overcoming fear, we're including frustration, despair, anguish, irritation, annoyance, vexation, and anything else that communicates the message, "This is a bad thing that I want get away from." Outcome Independence In the earlier clip, Felicia was able to eliminate her fear around the pain by being outcome independent. Outcome independence means your definition of success isn't tied to a specific result. I came upon outcome independence by accident. In 2004, I had chronic back pain, and I would take long walks every night. I would constantly monitor my symptoms: How soon would the pain start? How quickly would it intensify? How bad was it when I got home? If I had a “good” walk, I’d feel confident, hopeful, and good about myself. If I had a “bad” walk, I’d feel scared, frustrated, and despairing. This went on for two years. Finally one day, I’d had enough. I was sick and tired of my mood, my outlook on life, and my feelings about the future being so dependent on the pain. And I was done. I changed my definition of success. A “good” walk was no longer one with less pain, it was one where I felt okay regardless of the pain. I took pride in my growing ability to determine my own mood. I celebrated the accomplishment of feeling good about myself even when the pain was bad. I broke free from the prison of fear. And much to my surprise, within a couple months, my walks were pain-free. Without even knowing what I was doing, I eliminated the pain’s fuel source: fear. Outcome independence is not something that comes easily. It’s hard to change deeply ingrained habits, and you’ll falter often. But with practice and discipline, with exposure and repetition, you can get there. And it all starts with a single decision: I’m done being afraid.