Neurological circuits are permanent Pain pathways are permanent. So are the related anxiety and anger circuits. I am personally reminded of this fact on a daily basis. It happened in a particularly dramatic fashion while on vacation in Italy. Florence My wife lived in Florence, Italy from 1983 to 1990. She is fluent in Italian and has a wonderful group of friends in the area. We try to get back every year to spend some time with them. It is a remarkably enjoyable experience. Relaxing is not one my most highly developed skills. But I did it. We had been staying in a small apartment in the lower part of one our best friend’s house. It had a beautiful view. We had shared some great meals with them, met some new friends, and I had stayed off the computer. I remember lying in bed towards the end of the trip thinking how nice it would be to be in this state of mind more often. Ugolino We had decided to play nine holes of golf together at one of the oldest golf courses in Italy. It was in a spectacular spot. My wife learned to play golf a couple of years ago and she was very excited to be able to play in one of her favorite places in the world on a beautiful day. Those of you who play golf with your spouse know that is a tricky adventure. Somehow it brings out the deepest issues in a relationship very quickly (and consistently). Our game at Ugolino She had a great shot off of the first tee. The second shot was excellent and reached the green but in the right sand trap. I waited for her to hit out the trap once, then twice. After the third attempt I suggested that maybe she could pick up the ball. Additionally we had two local Italians behind us who were beginning to yell at us. She said, “No!!” The second hole went pretty well except there were a few extra shots. Nonetheless she was playing pretty well as I was working on letting go of our less-than-ideal interaction on the first hole. I was a little anxious on the third hole in that our pace-of-play was a little slow. I admittedly have a strong reaction to being held up on the golf course by groups in front of me but I really don’t do that well when I am part of a group that is holding up the rest of the course. I suggested that maybe we could let the people behind us play through. That was met with a “No”! The 4th hole was fine while I again worked on enjoying my day. On the 5th hole she hit the shot of her life on a long par three on to the green and the round began to pick up. #6 The tee shot on the sixth hole was across a pretty wide ravine. She decided to pull her driver. I said, “Honey, you have not missed a tee shot with your three-wood all day and you can easily cross this hazard.” Three shots and three balls later with the driver we were finally in play. We hit our second shots pretty well. Then she needed to find the restroom, which was nowhere to be found. There were now two groups playing up on us. As she was “coaching” me on how to drive the golf cart back to the clubhouse my brain exploded and I went into my infamous, highly developed victim mode. It came out as clenching my jaw and saying nothing. However, my body language was not subtle. She was not quite sure why I was so upset. Gone The rest of the round is not worth describing. I will only tell you that I was the only one playing the ninth hole and my golfing partner was walking. Here I was after being incredibly relaxed, on a wonderful day in Italy, with my beautiful wife in the worst mood you can imagine. I intellectually knew that the anger/victim pattern has nothing to do with the person or situation that set it off. It was I being triggered, but I could still not stop the reaction. Knowing this made it even worse as I also get a little hard on myself when I fail. At least one of us was sane She was thinking, “What kind of person am I married to?” However, she is a remarkably wise and understanding wife. She was able to see me separately from my reaction and did not engage with me until I calmed down. Historically this encounter would have wiped out the rest of our vacation. I did recognize my temporary insanity and in about 30 minutes I was fine. We had a wonderful lunch and evening. I hung a picture of the golf course in my office to remind me that victim patterns are universal and permanent. It does not matter how great your external circumstances might be, they have little effect on what goes on in your head. Anger will always be with you This experience was extremely humbling and enlightening. I used to think the goal of the DOCC project and somatic work was to “conquer” anger and never go into the victim mode. That thinking actually makes things much worse in that you are actually just suppressing anger. It is a disaster. Since that day I have committed to being more aware and honest with myself of when I dive into that hole. Paradoxically it does occur less often and although the sequence is always the same the duration is shorter and the intensity is diminished. Make no mistake about this fact. Every human has a deep victim pattern. That is because we are limited in what we can do to influence our environment and we truly are victimized on a regular basis. It is how you relate to this reality is what deeply affects the quality of your life. “You don’t need surgery” Any time a patient comes in with chronic pain and rates him or herself as a zero on anxiety, depression, and irritability our whole staff recognizes we are in for a difficult interaction regardless how hard we try to be of service. As soon as I point out that I don’t see anything that I can do surgery on he or she often explodes. It is usually very intense and they can be verbally abusive to my staff. They don’t dare take me on. The more we try to calm them down the worse it gets. We have learned to let go very quickly and offer to see them back if they wish. We feel upset in that we know what is possible for them but they don’t have the capacity to engage. Your circumstances don’t make that much difference I have one patient, who has experienced an extreme amount of stress in the form of domestic violence, financial disasters, and a poorly done spine surgery. Even though my surgery solved the structural spine problem his pain did not abate – at all. Pain and anger are so entwined that you cannot experience pain relief until you can truly let go of your legitimate anger. That includes your anger at the surgeon who screwed up your surgery, the employer who do not have adequate safety guards, or the person who rear-ended you at a high speed and was drunk. He keeps explaining to me how great his life is now with better finances, a great relationship, etc. but he still has pain that now envelops his whole body. I am reminded of Ugolino. Your life can be perfect. Your victim pattern is not going away. Unless you can let your anger go your pain will always be with you.