Drug-free Solutions to Chronic Pain

One truth I have learned about chronic physical pain is the more you fight it the worse it gets. Another is that traditional methods for relieving pain often ignore a crucial player:  the mind.

After experiencing only partial pain relief from my spinal fusion 10 months ago, I became convinced that there was another issue that contributing to my chronic pain.  This led me to investigate solutions other than additional surgery or the use of medications to treat this pain.

In my previous blog titled “Get Out of Your Chronic Pain and Into Your Life,” I discussed the benefits of Acceptance and Commitment Therapy (ACT) in contending with pain.  In this blog, I am going to introduce you to physician Dr. John Sarno whose treatment of chronic pain was featured in a 20/20 segment.

 

As a brief recap of last week’s blog, it is our attempts to combat or avoid pain that keeps us in the trenches with our pain.  Like for many of you, pain killers only reduced my pain; they never eliminated it.  I also tried physical therapy, acupuncture, and chiropractic.  Again, the relief was only partial and temporary.   What was constant was my preoccupation with that pain.  I was thinking about it continually throughout the day.  Sadly, this preoccupation with pain made my world smaller and smaller.  I avoided physical activities that I used to enjoy and withdrew from friends and family because of the pain.

 

ACT recognizes that total elimination of pain my not be possible for some of us.  So we have a choice:  we can live on the sidelines of our life with pain, or we can commit to re-engaging our lives despite the pain.  Amazingly, though, it is this re-engagement with life that allows us to experience freedom from our pain.  To test the validity of this, think of what happens to your pain when you are laughing with friends or fully engaging in a hobby.  For me, the pain disappears because I am not focusing my attention on it.

 

Like ACT, re-engagement in your life is at the core of Dr. John Sarno’s work.  In his New York Times bestselling book, Healing Back Pain, Sarno says that chronic pain is the result of suppressed emotions.  His term for this pain, regardless of whether it manifests in the back, neck, or other parts of the body, is Tension Myositis Syndrome (TMS).  The source of this pain?  Suppression of emotions.  For those of you who experience migraines, it is clear that the pain is not something structurally wrong with your brain but that it is brought on by stress and the negative emotions it creates.  So too it is with chronic back and neck pain, according to Sarno.

 

“TMS is a sideshow designed to distract you from what is going on emotionally,” Sarno says.   Because our minds do not want to deal with painful emotions, that pain is manifested in our bodies, just like stress is manifested as intense headaches for migraine sufferers.

 

Interestingly, if you randomly picked 40 adults from the streets and gave each an MRI, you would find that many of them have structural issues with their backs—like ruptured or bulging disk. Yet, some of those people are not experiencing back pain.  In fact, orthopedic surgeons who see these supposed structural “problems” cannot determine just from the MRI whether that person is in pain.  Interestingly, too, when an MRI for a non-spine related issue reveals one of these back “problems,” the patient often experiences the sudden sensation of back pain.

 

So how can TMS cause pain?  The brain is the most complex creation in the known universe.  One of its functions is regulating oxygen levels in the body.  It provides more oxygen to the muscles when an external threat activates the fight or flight response.  Just as the brain can oxygenate the body more, it can also deprive parts of the body of oxygen.  “The direct reason for pain is mild oxygen deprivation,” Sarno says in drawing the connection between TMS and chronic pain.

 

So how do you treat TMS and the chronic physical pain it produces?   In Healing Back Pain, Sarno suggests a series of exercises that will get you in touch with the unpleasant emotions that cause TMS.  Often these emotions are in the form of anger or rage that the mind has suppressed, keeping us unaware of their presence.  Frequently, these suppressed emotions are rooted in childhood trauma, Sarno states.

 

If working through these exercises on your own doesn’t eliminate your chronic pain, Sarno recommends seeking out a therapist to guide you through them in order to  surface and release these pain-producing emotions.

 

Overall, the connection between ACT and Sarno’s work is freeing ourselves of the thoughts and emotions that create our pain and suffering. For those of you who are experiencing chronic pain, consider asking yourself this question: “Am I going to live my thoughts and emotions and the pain those create or am I going to live my life and the joy that can bring?”

 

Together, ACT and Sarno’s work can be a very effective way of treating chronic pain.   So if you are experiencing chronic pain despite surgery, pain medications, and other treatments, consider getting to know ACT and Sarno’s approach.  The 20/20 segment that features Sarno is available on YouTube.  An excellent resource for the ACT approach is the workbook Living Beyond Your Pain by Joanne Dahl and Tobias Lundren.

Three Steps to Releasing from Anxiety

Mark Twain said, “Some of the worst things in my life never even happened.”  So it is true with me and probably with you as well.  When we follow our anxiety-ridden thoughts to their destination, inevitably we arrive at dark and fearsome places.

Anxiety is always about what MIGHT go wrong.  It hijacks our thought processes and takes us into fretful realms.  We may rise up in revolt, but the flight path seems predetermined and out of our control.

If this process is all too familiar, it’s because we have boarded that plane many times.  We think of an upcoming event or a task, and we play out the scenarios in our minds.  Then, as it often does, that inner terrorist rises from his seat and, before we can stop it,  we are captive passengers on Air Anxiety.

If you’re like me, you have worked hard to avoid anxiety’s emotional hijacking.  And we have tried a variety of methods to do so: affirmations, meditation, positive thinking, changing the thought channel.  Some of us have felt temporary relief from anxiety through the use of alcohol, prescribed and unprescribed drugs, gaming, Internet, and Facebook. Though we resist the tendency, we end up—time and again—passengers on an anxious journey.

Finally, after decades of struggling with anxiety, I have found a solution to this emotional hijacking in Acceptance and Commitment Theory (ACT).  And more specifically, in a very accessible book called Things Might Go Terribly, Horribly Wrong that applies the core tenets of ACT to anxiety.

“The principle reasons we get anxious is to protect ourselves from anticipated pain,” according to Kelly G. Wilson and Troy Dufrene, authors of the book.

Pain is an inevitable part of life.  Because we have an aversion to pain, we all become anxious at the thought of it.  And ACT acknowledges that all of us—even Zen masters—have anxious thoughts during a typical day.

This is because our brains developed in a very threatening environment.  We were not only predator but also prey.  What was bad was bad AND what could be bad was also bad.  So actual danger and the possibility of danger became one and the same thought.

ACT, however, provides a powerful psychological tool to cope with anxiety.   One of the keys to releasing from anxiety, Wilson and Dufrene say, is not engaging it.  When we spot a bear in the distance, it’s best to back away and create distance.  Same with our anxious thoughts.  When we feel ourselves being pulled into the thought, we need to disengage.

How do we do that?  By first understanding that all thinking is divided into two categories: the ruminating mind and the experiencing mind.  Rumination is what happens when the mind wanders.  Its domain is the past and the future.  The experiencing mind is about connection to the present moment.   If this sounds like mindfulness, then you are right.

Once we have this awareness, we can apply the concepts Wilson and Troy present that are based on ACT principles. They recommend that when a thought begins to generate anxiety, we apply this three-step process to release from its grip:

  1. Identify the thought. When we name the anxious thought, we alert ourselves to it and avoid stepping into its snare.

 

  1. Step back from it. The more we fight the thought, the more we get swept away in it. This includes trying to change the anxious thought to a positive thought.  Brain research has proved that the thought will recoil with even more power if we try to push it away from our consciousness. Instead, we release (defuse) from the thought rather than fuse with it.

 

  1. Make contact with the present moment. Change your attention from the future or past to the here and now.  Instead of sitting on the coach allowing your mind to toggle back and forth between the past and future, find something that you value to engage your mind in the present. This keeps you from endlessly reprocessing the past or worrying about the future. “Anxiety is always out of place in the present moment,” according to Wilson and Dufrene.

The key, then, to freedom from anxiety is to remain in the experiencing mind.  Anxiety cannot co-exist with the present moment because anxiety is always what could happen, not what is happening.

When we apply these three simple steps at the onset of an anxious thinking, we can find a freedom from anxiety that is simply more effective than other methods.  With practice, we can come to know a freedom from anxiety that is as refreshing as a good night’s sleep.

“If you can learn to remain connected to what’s going on in your life right now, accepting both the sweet and the sad, holding lightly the stories about what’s possible while turning your actions toward things that matter to you” then you have succeeded, as Wilson and Dufrene say, in avoiding the snare of anxiety.

May you all experience the joy of an anxiety-free life.