1. Alan has completed the new Pain Recovery Program. To read or share it, use this updated link: https://www.tmswiki.org/forum/painrecovery/
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Dr. Hanscom's Blog You Cannot Fix Yourself

Discussion in 'Mindbody Blogs (was Practitioner's Corner)' started by Back In Control Blog, Jan 28, 2013.

  1. Back In Control Blog

    Back In Control Blog Well known member

    You can only implement strategies that allow your brain to heal. Let me explain.
    A Good Student
    I am learning that being a “good student” of the DOCC project is not always the best course of action. I used to be very encouraged when a given patient would avidly read all of the books, take notes, and really learn the material presented in “Back in Control.” But I eventually noticed that some would become stalled and frustrated. If you think in terms of circuits and not psychology it makes sense.
    Pain and anxiety pathways are permanent. You cannot change them. If you focus your efforts on understanding them so they can be fixed, forget about it. These pathways are now running the show in even a more powerful way. There is too much attention being focused on them. These pathways will become stronger and more complex. The DOCC project can become its own monster.
    Awareness vs. Understanding
    Since these pathways are permanent the only solution is to create new pathways around the old ones. Fortunately this is an effective process. The reprogramming process involves awareness, detachment, and reprogramming. Becoming aware of the circuits is much different than “understanding” them. All you must do after awareness is to detach and move on.
    Another strategy often used to deal with disruptive circuits is to ignore them with positive thinking. You are still letting the circuits rule. Positive thinking is just another way of trying not to think about something and paradoxically the pathways will explode.
    Positive Thinking vs. Positive Experiences
    But my main point in writing this post is to clarify the difference between positive thinking and engaging in positive experiences. The goal of the DOCC project is to provide you with the strategies to connect with you who really are and shift your nervous into much more enjoyable place. It is important to reconnect with old friends, try new hobbies, develop family traditions, learn a spiritual practice, enjoy good food, etc. Any experience that moves your brain into a positive experience will be helpful. When a patient is overly consumed with learning the details of the DOCC project they are not moving into a more enjoyable place.
    A frequent piece of advice I have been giving more often is, “Stop. Take a defined part of the day to advance your knowledge about pain but then drop it. Work on re-visiting the words ‘play’ and ‘fun’.” (BTW, fun and anger are not compatible concepts). As your brain reconnects with more enjoyable experiences your pain will quickly become less intense or disappear. Conceptually it is a much more powerful way to forge ahead.
    Enjoy Your Day Today
    Jilly likes this.
  2. Jilly

    Jilly Well known member

    Another strategy often used to deal with disruptive circuits is to ignore them with positive thinking. You are still letting the circuits rule. Positive thinking is just another way of trying not to think about something and paradoxically the pathways will explode.

    This is a great realization ... Thank You Dr. Hanscom
  3. Dr James Alexander

    Dr James Alexander TMS author and psychologist

    great suggestions here thanks David. However, in regards to pain and anxiety pathways being permanent, there is clear evidence emerging from neuroscience that learnings (once consolidated on a neurological level) can be re-consolidated in a different manner at a later time, i.e an actual altering of the pathways and their synaptic connections, in order to eliminate symptoms. This does not tend to happen in the course of normal experience, but is evident in some psychotherapeutic encounters (not all). Some therapies (eg. EMDR, Coherence Therapy, EFT, some Gestalt techniques, etc) appear to be directly altering the neural pathways via setting up reconsolidation processes and experiences, and others at times appear to stumble across the same outcomes almost by fluke. Ecker, Ticic & Hulley have recently published a book (Unlocking the Emotional Brain- eliminating symptoms at their roots using memory reconsolidation- 2012). Apparently it summarises and presents the neuroscience evidence of the last decade in regards to reconsolidation, and demonstrates how difference therapies can achieve this. I've got it on order but it hasnt arrived as yet, but you can hear Ecker discussing these notions in a recent Shrink Rap Radio podcast (there is a link to this on my website: www.drjamesalexander-psychologist.com). I think if psychology can deliberately run with what the neuroscience is demonstrating, then we are on threshold of becoming a much more effective service to humanity- and of course, it is very promising for TMS sufferers.
    tarala and Jilly like this.
  4. tarala

    tarala Well known member

    Unlocking the Emotional Brain sounds really interesting, I'll have a listen to the podcast.

    I hope you were you okay in the floods down there? We only just got internet back today, so I have a lot of forum catching up to do!
    Jilly likes this.
  5. Dr James Alexander

    Dr James Alexander TMS author and psychologist

    yes, there are two really interesting pod cast interviews with Bruce Ecker on Wise Counsel as well as the Shrink Rap radio interview. I can recommend his book 'Depth oriented brief therapy' as well. It provides an excellent method (Coherence Therapy) to help people suffering from TMS with, and it totally consistent with TMS theory.
    Forest and Jilly like this.
  6. Jilly

    Jilly Well known member

    I'm going to search your page for the pod casts and learn more about Coherence Therapy...Thank You Dr. Alexander
  7. tarala

    tarala Well known member

    I found this podcast really interesting, and think I will get the book. I think in therapy I use all of the elements that he talks about, but not necessarily within the time frame that is necessary for reconciliation. I've also tried it in connection with my own journaling, by using the journaling to get in touch with childhood anger and other emotions, then doing the reconciliation process.

    The only thing I wonder about is when people's negative experiences have perpetuated a life where those experiences aren't actually challenged. For example, if a parent hurt a child by telling him, "You will never amount to anything," and that belief caused numerous failures in life, the client might not feel like there is evidence that he has amounted to anything.
  8. Dr James Alexander

    Dr James Alexander TMS author and psychologist

    tarala- the sense i make of it is as follows. Such a person who you have described above is going to present with problems ('symptoms'). Within this will be cognitions in relation to the self (I'm no good) , others (they are harsh and punitive) and the world (its a dangerous place); feelings (anxious, fearful, shame), and behavours (withdrawal, avoidance, etc); physiological consequences, and there may also be chronic pain. He will have an understandable dislike of the symptoms (his 'anti-symptom position'), which operates on a conscious level- its this that he is asking for help from- 'i hate being like this and really want to change'. At an unconscious level, for these symptoms to have been maintained over many years, there must be a way in which it is more important for him to have them than to not have them. In some way, these symptoms actually represent a 'solution' to an emotional problem which was created for him in a specific context, eg. dad telling him he'd never amount to anything. There was an implicit learning which he gained from this context, eg. 'if i poke my head up, someone will shoot at me and i'll fail- so its better and less painful to keep my head down and never try.' This is his 'emotional truth', a knowing which has been powerfully learnt at an unconscious level, which has been resistant to change over his whole life. These emotional schemas are extremely tenacious, as the brain (for survival reasons) 'burn' them in neurologically where they remain- unless a reconsolidation experience occurs. And it is these schemas which keep on driving the perception of the self, world and others, and keep generating the symptoms. From what Ecker et al are saying, such symptom generating schemas will continue (and keep on creating situations which reinforce them) until a reconsolidation experience occurs. Such an experience involves reactivating the emotional distress. Then seeking the emotional truth which underlies it (this is unconscious)- then experiencing the emotional truth, bringing it into conscious awareness. This disrupts the standard relationship between the conscious anti-symptom position (i hate being like this), and the unconscious pro-symptom position (being like this keeps me safe). Apparently, this disruption can create reconsolidation. Added to this, other forms of disruption can help, e.g awareness of exceptions to the problem rule (previous success experiences).These differences then need to be synthesises in conscious awareness.

    The important thing about this approach, and memory reconsolidation more broadly, is that in order to be powerfully effective, it must be completely experiential, ie. it is often not enough for the person to gain an intellectual insight into their pro-symptom position as a cognitive process. The anti symptom position must be emotionally/cognitively/physiologically experienced; then the pro symptom position (and/or the exception experience) must also be emotionally/cognitively/physiologically experienced- to do so in imagination is sufficient. The approach often uses imaginal dialogue with people in the situations in which the problems arose, which evokes all the above. Their recent book states that specific therapeutic experiences (as in Coherence therapy, EMDR, amongst others) are consistent with what the neuroscientists have found are essential for memory reconsolidation. The result is that while the memories are still intact, the emotional baggage associated with them (the symptoms) have been eradicated. They cite evidence that this occurs at a synaptic level (only discovered by neuroscience in 2004).

    The obvious importance of this for TMS pain is that it is the unconscious schemas which are driving the pain, e.g the world and all the people in it are dangerous. The mind/brain devises a strategy (based on an emotional truth- its better to be invisible/or to be in physical pain and elicit sympathy rather than anger/or distract myself with physical pain) than it is to experience the emotional pain that goes with the schema. A reconsolidation experience can change this schema and the associated emotional distress- in which case there is no need to retain the symptom as it no longer serves a purpose. I know that many sufferers of TMS are looking for a self hep cure- and many of them can get it via books etc. But, i also think the reality is that there is a portion of people who are not getting better from information alone, and will require therapy in order to get over their pain. I suspect that therapeutic approaches which are consistent with this reconsolidation phenomenon are the ones which are most effective in treating TMS. As the neuroscience demonstrates, there are specific elements of a process that need to be in place for reconsolidation to occur.

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