New Program Day 5: Changing Your Brain

[Christie Uipi MSW]

That's a great question that I'm sure is on everyone's mind. It sounds like she developed new habits of mind, like Alan is describing. She probably started with developing awareness of how her mind was driving toward fear thoughts, like in today's homework. Given that she works with Alan, she was probably following the steps that will be covered in this program (we still have 16 days!).

I think that the very toughest problem in all of this is in the implementation. It's easy to grasp the concepts when they are laid out so clearly. The hard work is in developing the new habits of mind (i.e. new neural pathways). That takes time, willpower, focus, and discipline. Developing awareness (or mindfulness) of your brain's current habits is always the first step.

You're spot on here, Forest. Kicking the fear around the pain, followed by breaking the cycle of fear I had around all sorts of things in my life, was my first step. It takes awareness, and it takes practice!!! I cannot underline the importance of this first step enough - simply being aware of the way that I was scaring myself (pressuring myself, criticizing myself, etc) throughout the day. It helped me take a stand and say that I was done treating myself so harshly. We'll learn more about this as the program continues!

 

[gutter3]

I have noticed the fear I have regarding the pain, I am always worrying about making it worse and if I'll ever get better. One thing I noticed is I don't have the self confidence that I can do this on my own. There's always the doubt, that I'm not doing it right or what if I try and keep failing. I know I have TMS, I've been able to lessen the pain sometimes. But I still lack the self confidence that I can do this on my own.

I know I need to work on changing the neural pathways, I am very grateful for this information as I have never thought of it this way. I was doing good for awhile but then an adoption fell thru, I bought a new house while trying to sell my old house. All the while I am balancing 2 mortgages. My wife is supportive but she has depression issues and since my chronic pain has taken over our lives the last 3 years her depression is coming back. I try to be strong for myself and my family but it's hard. I just can't seem to gain that self confidence back.

I hurt my neck a couple weeks ago which didn't help things. So now I'm constantly worried I'll do it again. I have chronic muscle spasms in both traps and all throughout my neck and scapulas. And because of the spasms I am always guarded. Which I know makes the spasms worse but I don't know how to move naturally anymore.

So any advice on how to gain my self confidence back would be helpful. Any experiences or things you have tried would be helpful.

 

[Eugene]

Hey Eugene! I've kicked a number of symptoms, as Alan mentioned, with the hand/wrist pain being the last to go. I am always honest with my patients, so I'll be honest with all of you guys, too. My pain is, for all intensive purposes, gone. It doesn't interfere with my daily life, it doesn't cause me distress, and I am definitely not afraid of it coming back. That being said, those neural pathways in my brain are still there somewhere. Once or twice a month, I'll notice my wrist/hand pain pop back up (or maybe I'll notice my neck pain, or my leg pain, or one of my other symptoms). But that doesn't scare me. When I notice a pain symptom come back to say "hi," I just say wave at it as it goes by me. I use it as a chance to check in with myself and say, "What's going on? Where's my anxiety?" Because I have no fear that the pain will "stick," and I have no fear around the pain sensation itself, the pain will dissolve/disappear within a couple of hours.

For me, I don't feel pressure to make sure the pain is "totally gone" forever. It can pop up here and there, that's okay. I know what to do when it comes on, and it doesn't scare me anymore

Wow! That honesty is very much appreciate Christie.

I've had pain for about two years, but since Tuesday I've noticed a marked decrease, which is remarkable considering I've read five or six books on TMS (including to Dr Sarno ones), but for some reason the talk of neural pathways really seems to have touched a nerve

And the video demonstration of the lady with the neck pain and now the audio of what happened to you, just seem to be helping me to realize this pain is a creation of my brain. I know I've read that so many time in books, but this time it really seems to be getting into my thick skull for the first time.

What you've said about your outlook to the pain that comes back from time is another valuable lesson for me. Thanks again Christie.

 

[Click#7]

Howard Schubiner likes to say that all pain is in your head. That even if you stub your toe, the pain is processed in your brain.

The term "in your head" generally implies that the pain is imaginary. I’ve always found the idea that some pain is considered real and some pain isn’t rather bizarre. Pain is pain, and it is always real.

A study at the University of Pittsburgh investigated this very phenomenon. Researchers used an electrical device to induce pain in a group of subjects. While doing so, they watched the pain center of their brains on an fMRI machine to see what areas lit up. Then, they took the same subjects, hypnotized them, and induced pain through suggestion. The same areas of the brain lit up!

They showed that whether the pain was induced physically or induced through hypnosis, the sensation was the same as far as the brain was concerned.

Pain is pain, and it is always real, regardless of whether it's induced physically or hypnotically, regardless of whether it's caused by structural damage to the body or neural pathways in the brain.

Then why can't you rid yourself of pain through hypnosis ? I wondered this and even thought of trying it....did the University of Pittsburgh try with their patients ? Pain and pain and yep it's real as we all know. I don't think regardless that pain was meant to become chronic whether it was caused by structural damage or emotional subconscious rage. Food for thought Alan, I think a great case study of both emotional and structural would be John F. Kennedy. He had it all from childhood pressures of just growing up a competitive Kennedy, War Hero, 3-4 back surgeries, to the pressures of being our President. I would be willing to bet he had TMS....

 

[Cara]

Once or twice a month, I'll notice my wrist/hand pain pop back up (or maybe I'll notice my neck pain, or my leg pain, or one of my other symptoms). But that doesn't scare me. When I notice a pain symptom come back to say "hi," I just say wave at it as it goes by me. I use it as a chance to check in with myself and say, "What's going on? Where's my anxiety?" Because I have no fear that the pain will "stick," and I have no fear around the pain sensation itself, the pain will dissolve/disappear within a couple of hours.

For me, I don't feel pressure to make sure the pain is "totally gone" forever. It can pop up here and there, that's okay. I know what to do when it comes on, and it doesn't scare me anymore [/QUOTE]

This is one of the more encouraging things I've read. My pain pops up every now and then too, but the biggest difference for me is that I don't panic that I've done something "wrong" or that I'm going to get worse. Sometimes it's gone in minutes, sometimes in a day. I like your image of waving to it as it goes by. I am learning to see it as a reminder that TMS exists and that I'm learning to be kinder and gentler to myself. Someday, I plan to be grateful to my mind body for its TMS. I might already be. (And, of course, I am forever grateful to Dr. Sarno and the programs on this wiki for helping me get my life back. Thanks for these daily lessons!)

 

[Lauren T]

I agree with everyone - easy bites and a steady diet of this forum helps me too. I have tinnitus really badly over 16 years but now it is crazy consistently loud. I've also become a hypochondriac over the last several years and it all boils down to habitual fear patterns. Every pain becomes a fatal illness. I love that I am working to change my brain!!! Thank you!

I'm back in the drivers seat

 

[Maximus]

I have had RSI, incl. hand, wrist, lower/upper arm/shoulder/neck/back pain for almost a decade and found out about TMS a couple of years ago. Got somewhat better after that to the point that I could work again, but still have to cope with limitations. Not being able to carry things, go to the gym, use a mouse etc. I am strongly convinced that fear is one of the important drivers of my not getting better, so it's good that this is addressed in much detail. Breaking through this pain is going to be a challenge, but like Lauren, I hope this new 'program' will bring me back in the driver's seat. It won't be easy though. Accepting the pain as something harmless is one thing, but getting to the real issues that the pain is trying to cover (the deeper emotions) is a different thing. Hopefully Aland Gordon is going to write/talk about that a bit more in the next weeks.

 

[Christie Uipi MSW]

Wow! That honesty is very much appreciate Christie.

I've had pain for about two years, but since Tuesday I've noticed a marked decrease, which is remarkable considering I've read five or six books on TMS (including to Dr Sarno ones), but for some reason the talk of neural pathways really seems to have touched a nerve

And the video demonstration of the lady with the neck pain and now the audio of what happened to you, just seem to be helping me to realize this pain is a creation of my brain. I know I've read that so many time in books, but this time it really seems to be getting into my thick skull for the first time.

What you've said about your outlook to the pain that comes back from time is another valuable lesson for me. Thanks again Christie.

Keep it up!! Once it starts clicking, you can really get on a roll. Stay motivated and know that it is okay to have hope. Sending you my very best for your continued healing!

 

[Alan Gordon LCSW]

OK so far so good, but if a pain patient's back hurts you do not (or do you) try to convince them that the pain is all in his/her head?

Assuming that the pain is TMS, I generally explain to patients the relationship between the mind and the body, and how neural pathways work. Sometimes I'll even site some studies if I think it will help. I don't use the term "in your head," because they might interpret that as meaning that their pain isn't real. And the pain is very much real. Finally, I try to give them hope that with the right set of tools, the pain is something that they can overcome.

 

[zaqxsw]

I'm not active in this forum, but thought I would comment.

I was disabled by TMS, and I'm sure it was TMS, in April of 2013, four years ago. I went completely through the medical system, including MRI's, flex X-RAYS, epidural spinal injections, neurosurgeons, and orthopedic surgeons. Nothing wrong with my back/spine that my age wouldn't explain. I had no surgery, and no one even recommended I have any.

I was "laid up" for over three months before I started living again by ignoring the pain. I'll make a very long story short:

It's over four years later, I have grown immensely, studied enormously, and have no fear of the pain at all. I have done everything you could possibly do physically, really hard things, with no fear BECAUSE IT DOSN'T INCREASE MY PAIN! I do not even have a slight hesitation in a physical task. What I do doesn't matter.

So, I definitely know I'm not physically disabled, but the pain is still there......... Really nasty pain. Not sore, that's good pain, I have nasty pain.

I think Ace1, whoever he is, summed it up well years ago in the attached file. It's a long journey and it isn't just about the fear of pain or any quick fix. It is about fears, but each of us have our own.

If you're older, you better start giving up on the things necessary in the first half of your life which, hopefully you've done them, and learn to let go and open up to a completely new life in the second part. The anxiety, fears, self/ego image have to go. Don't ever think it's easy or you will never get there. As Ace1 says, I still work on it every day........

Oh, and the positive affirmations in bold at the beginning of the file are mine, not Ace1's. I created my own .docx from his post.

 

[James59]

Alan, I love the way you're presenting this course in concise, easily digestible servings. So far there's been nothing too complex to wrap my head around, and the lessons fit together nicely.

Christie, your story is is inspiring. You went from barely moving to doing cartwheels! Right now I'm barely moving, but you've given me a nugget of hope that I can get out and about again, not for cartwheels but for long brisk walks which I miss terribly.

 

[James59]

For those who are having trouble shifting from the "pain as a distraction from suppressed emotions" theory to the "pain is generated by fear" theory I think I see a way to bridge that gap. If you're familiar with A Course In Miracles you know that the only two emotions are love and fear. All other emotions spring from those two. Anger and rage are just the effects of fear. After all, you can't be angry with something or someone unless you fear them first. Without fear, anger has no foundation. And suppressing fear-based emotions is itself an act of fear - the fear of fear itself. So dealing with fear as the root cause of TMS makes a lot of sense to me.

 

[birdsetfree]

Hey Eugene! I've kicked a number of symptoms, as Alan mentioned, with the hand/wrist pain being the last to go. I am always honest with my patients, so I'll be honest with all of you guys, too. My pain is, for all intensive purposes, gone. It doesn't interfere with my daily life, it doesn't cause me distress, and I am definitely not afraid of it coming back. That being said, those neural pathways in my brain are still there somewhere. Once or twice a month, I'll notice my wrist/hand pain pop back up (or maybe I'll notice my neck pain, or my leg pain, or one of my other symptoms). But that doesn't scare me. When I notice a pain symptom come back to say "hi," I just say wave at it as it goes by me. I use it as a chance to check in with myself and say, "What's going on? Where's my anxiety?" Because I have no fear that the pain will "stick," and I have no fear around the pain sensation itself, the pain will dissolve/disappear within a couple of hours.

For me, I don't feel pressure to make sure the pain is "totally gone" forever. It can pop up here and there, that's okay. I know what to do when it comes on, and it doesn't scare me anymore

I relate to where you are in your recovery. I am probably at a similar stage. Isn't is empowering! I am working on a video for your fight the fear challenge that will show me before and after. I was super impressed with your graceful cartwheels! And I'm so happy for your new lease on life and renewed confidence in the way you are living it.

 

[jennplac]

Thank you Alan for this great program and really distilling the essence of what we need to do. And Christie, hearing your story is inspiring and really motivating for me. I have had TMS for close to 2 years now and I am still working on dealing with fear and agree that the first step is awareness. One thing I am really confused about is whether excitement e.g., due to looking forward to an event like a holiday, or something really exciting like starting a new relationship, can be interpreted by the body as anxiety. Because in the body (physiological sensations), this positive excitement feels sort of similar to anxiety/fear. So I am wondering whether the same ANS response is activated in both cases? And if the body does not know the difference between me experiencing fear versus something positive and exciting and secretes more cortisol into my system, should I be avoiding these activities? And related to this, is the aim to always bring ourselves into a state of peace and calm, so our fight/flight/freeze is not constantly activated? I would really appreciate some clarification as this confuses me. Many thanks.

 

[hodini]

Howard Schubiner likes to say that all pain is in your head. That even if you stub your toe, the pain is processed in your brain.

The term "in your head" generally implies that the pain is imaginary. I’ve always found the idea that some pain is considered real and some pain isn’t rather bizarre. Pain is pain, and it is always real.

A study at the University of Pittsburgh investigated this very phenomenon. Researchers used an electrical device to induce pain in a group of subjects. While doing so, they watched the pain center of their brains on an fMRI machine to see what areas lit up. Then, they took the same subjects, hypnotized them, and induced pain through suggestion. The same areas of the brain lit up!

They showed that whether the pain was induced physically or induced through hypnosis, the sensation was the same as far as the brain was concerned.

Pain is pain, and it is always real, regardless of whether it's induced physically or hypnotically, regardless of whether it's caused by structural damage to the body or neural pathways in the brain.

Hello Alan,
I was wondering if you could provide a link or cite to the University of Pittsburg study mentioned above? Thank you.

 

[Kat]

Thank you Alan and Christie for the recording – I've listened to it several times, and for some reason find it very soothing! I've started to notice that my whole approach to life is fear-based, and I am fearful pretty much every waking second (and probably while asleep too, as am prone to nightmares). I understand that I need to let go of my fears – including the dreaded fear of pain – but I guess I am holding on to fear because I don't feel it's safe to let it go. Life seems quite scary to me altogether, and if I really analyse my thoughts and feelings, I realise that I am constantly afraid, of so many things – some similar to Christie, such as pressure and perfectionism, but also abandonment, due to my dad leaving age 3 and my mom not being a mentally healthy parent. And the pain fears on top of the other fears, have really overwhelmed me, so I've felt as if I'm in a constant state of crisis ever since my back injury 9 years ago. But hopefully Alan will be showing us some techniques to help counteract fears that keep cropping up for some of us. I would be very happy to not have to live in fear anymore, but I guess I'm worried (more fear!) that my fears are perhaps too deep? But I will give it my best shot and hopefully this will make a difference.

 

[Lauren T]

Thank you Alan and Christie for the recording – I've listened to it several times, and for some reason find it very soothing! I've started to notice that my whole approach to life is fear-based, and I am fearful pretty much every waking second (and probably while asleep too, as am prone to nightmares). I understand that I need to let go of my fears – including the dreaded fear of pain – but I guess I am holding on to fear because I don't feel it's safe to let it go. Life seems quite scary to me altogether, and if I really analyse my thoughts and feelings, I realise that I am constantly afraid, of so many things – some similar to Christie, such as pressure and perfectionism, but also abandonment, due to my dad leaving age 3 and my mom not being a mentally healthy parent. And the pain fears on top of the other fears, have really overwhelmed me, so I've felt as if I'm in a constant state of crisis ever since my back injury 9 years ago. But hopefully Alan will be showing us some techniques to help counteract fears that keep cropping up for some of us. I would be very happy to not have to live in fear anymore, but I guess I'm worried (more fear!) that my fears are perhaps too deep? But I will give it my best shot and hopefully this will make a difference.

 

[Lauren T]

I think teaching ourselves new habits - making those tough choices NOT to be afraid even though we are feeling it, is the creating of new habits of mind which help get us to independant outcome,,,. That is my hope and the course helps me practice. I think it's great!

 

[Porpoise]

Thanks to Alan for this fantastic program! I’ve come to definitely see fear as pivotal to the way my pain got set in its pattern and perpetuates itself.

I very much relate to what Kat said about ‘pacing’ in the Day 4 thread (I wasn’t sure whether which thread to reply to but decided that Day 5 is the most appropriate as it is about fear!). I was introduced to ‘pacing' very soon after I started experiencing pain, and looking back I now think it did more than anything else to cement my pattern of associating activity with pain. It gave me the idea that I ‘could’ only do stuff when I’d increased it gradually, and definitely limited the amount I could walk and do other activities compared with when I started. As the pattern became more and more set, I became afraid that if I did 'too much' too quickly I’d ‘crash’ or ‘flare’ (the words used by some in the pain management area, especially in relation to fibromyalgia). I suspect that when people learn about this ‘crash or burn ‘idea it more or less becomes a self-fulfilling prophecy. The concept of pacing now does give me a way to slowly build activities in a way that’s not too overwhelming, but it was a trap that I now wish I hadn’t fallen into.

As some others have shared, my fear is not of structurally harming myself, but of just having more pain. In my case, the fear is that if I do ‘too much’, I may not be able to cope with the pain and my even make myself worse. I realise that the fear comes from the advice given to people with fibromyalgia to avoid ‘crash and burn’. The fear is that because my nervous system is so sensitised that if I push it just a bit too far I could make myself even worse. I’d be curious if others have found ways to address this specific fear. It’s heightened by the fact that the full force of the pain (and sometimes malaise) often only hits much later, so I can't tell how much pain I'll have until well afterwards (sneaky pain!).

For myself, I don’t so much gravitate to the idea of ‘overcoming’ fear. If fear is an emotion like any other, then wouldn’t trying to fight is be as counterproductive as trying to ‘overcome ‘anger’, for instance? It probably amounts to much the same thing, but I try to think of it as accepting the fear, letting myself feel it, but trying to not let it completely control my behaviour. Years after first having symptoms, I’m still struggling with what dealing with fear means. Does it mean not resisting fear and accepting it, or treating it as the inner bully and standing up to it?

 

[bluesboy63]

Me too! The hardest time of day for me is when i wake up and am lying in bed. That's when my Eeyore kicks in. The first thing my brain does is scan my body and take pain inventory: "Where is the pain today? Is it still in my shoulders? Yup, well maybe I really do need a new bed. Or is it just in my head? What if I get the expensive new bed and my shoulders still hurt? How are my feet? Oh darn it, they still hurt too. Are they going to hurt when I step out of bed? Will it be better or worse than yesterday? Do my fingers still hurt? Let me just push on this one to test if the pain is still there. Darn it! They still hurt too." Then I scold my brain, knowing that that type of fear focus is not helpful. But I can't seem to turn the darn loop off! Then my Tigger kicks in and I get out of bed. My feet hurt on and off throughout the day but I push through it, my shoulders ease up with my yoga, and I try to ignore my 2 fingers as I bounce about my day. The pain in those 3 places never completely goes away but I just try to ignore it. What I would really, really, really like is to wake up in the morning and NOT automatically scan for pain. This is the habit or pattern I want to break.

WOW! You just described my ritual every day when I wake up! The only thing I would add to your list for me is vertigo/dizziness, which is at this point such a fear that the other things are secondary. This is the exact reason I am currently weaning myself off of an addiction to Ativan. Even though it was a small dose, 1mg, I would take it immediately upon rising every morning to get my mind to shut off. Once it kicked in, my day was in full swing and I wasn't as focused on it. An idle mind is our worst enemy!