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Summary:

In this video series we’ve been learning about how chronic pain and associated suffering develop.  The idea is to understand the chronic processes, so that you can make choices about how to reverse them and reclaim your sense of well-being and ability to function and live your life. The previous videos in this series shared how the body-mind “learns” chronic pain.  You can also “unlearn” chronic pain.  This video begins to explain how. I spoke in previous videos about the biological processes that are involved in the development of chronic pain.  Have a look at those if you haven’t seen them yet.  You can see those posts HERE. We discussed how protective responses are built into the pain processing and movement control systems of your body-mind.  These processes get knocked “off the rails” by certain factors.  And persistent pain leads to gradual changes in those systems that can unfortunately make pain worse.  It’s like vicious cycles, where the pain system gets sensitized, and the movement control system stops working as well.  So movement hurts, and pain spreads. It’s richer than that, as persistent pain and the resulting stress-response lead to measurable changes in gene expression, hormonal regulation, cellular energy production, emotional regulation, immune balance, and gastrointestinal function.  And these all feed back into one another and can increase pain. So there is this snowball effect, where vicious cycles of biological relationships propagate forward and create the disease of chronic pain. The good news is that many of those changes can be reversed.  In my experience, your own mind/body connection is a crucial place to start the changes.  One great place to start is by developing the quality of ‘mindfulness”, which starts to shift the reactivity of the protective responses.  Just like your brain-body learns chronic pain, mindfulness can start the process of unlearning.

Did You Know:

  • Dr Shiller is available for telemedicine consultation in CT, NJ, and Florida.  worldwide regarding chronic pain, fibromyalgia, autoimmune disease, fatigue, and stress-related illness.  His US-based consultations are offered in conjunction with Rose Wellness to enhance the quality of care and ease of your experience as a patient.   Contact the office or schedule a consultation at Rose Wellness.
  • Movement Toward Health is an affordable and effective training program to teach you to heal and feel better and improve your functioning.  It will teach you to integrate breathing techniques, mindfulness, and mindful movement techniques that are drawn from Dr Shiller’s 30+ years learning, practicing, and teaching these approaches to people suffering chronic pain and chronic illness.    To get more info and be notified of the next start date CLICK HERE.
  • Dr Shiller gives regular free mind-body training sessions on zoom. You can get the schedule and register at www.mindbodygroove.com

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Full Transcript:

All right, so in the last video, we talked about how chronic pain and illness are processes that gradually develop over time, that genetics and life experiences and various triggers can start this process, and that your biology shifts, your system, your mind body system so to speak practices various protective and maladaptive responses and that is built into your neural networks, so practicing it over time, your system learns it and it becomes kind of set, and that is affecting your neurologic activities and emotional and mental responses, your neuromuscular functioning of your motor system, your gastrointestinal system, your hormones, your immune system.  To varying degrees, those are all influenced, because it is all one system, and it is all working together, presumably to protect you from danger but effectively to generate these secondary problems of chronic pain and chronic illness.  The system gets unbalanced, the neural networks change, gene expression can change, and the outcome is chronic pain and chronic illness, and just like it can be learned, it can be unlearned, and so this video is going to start talking about how do you help the healing process, how do you unlearn chronic pain, how do you relearn health? Healing is a learning process, it is about the conscious choices that you make on a daily basis, lifestyle, behavior, habits, thought patterns, mindset.  You could break it into three parts, because I like to do that to make it easier and they are called three M’s, there is your mind body system, your metabolic or biochemical system, and your motor or your movement system, and all of those are ways that you can kind of grab hold of your physiology and on a regular consistent basis start to shift your physiology towards health.   Obviously there is a lot to unpack there, but the point is that you really need to think about it as I am taking charge of my health.  I am not expecting someone to fix me.  I am not looking for an overnight miracle that suddenly I am going to be better.   What I am looking for is gradual change over time that happens, because I have made conscious choices, and I have been doing stuff to help my mind body system to optimize my metabolic system, nutrition, inflammation, all of that, and to actually use the power of my movement system to help my body heal. This whole aspect of retraining and unlearning pain and illness and relearning health.  There are these two parts of aspects of unlearning the bad stuff and learning the good stuff, pretty simple, right? Let us start by talking about unlearning the bad stuff and you got to start that conversation by talking about stress and almost everybody now knows that you have a stress response and you have a relaxation response, this is physiology that has been demonstrated for 50 years and interventions to evoke the relaxation response have been tested over and over and over again in so many different realms of health and showing their benefit, because they balance that system out.   You are meant to go through stress in life, life is not meant to be stress-free despite what the magazines tell you, but the point is, you have stress and then you have relaxation, and the system is in balance. Most of us in our current time are stressed, there is a lot of difficult things going on in the world, and if you have got chronic pain, chronic illness, there is a protective stress response going on and you probably like overdoing it on the stress response and under-doing the relaxation response. Simple techniques, there is a bunch of different ones, can actually evoke the relaxation response, and lots of research showing us that those are beneficial in a variety of different kinds of conditions and situations, to enhance well-being, to help people cope with pain, to reduce the effects of chronic illness in various ways on various organ systems.   The key is consistency. We are talking about a learning model.  We are talking about the body has practiced for months or years, an unbalanced stress response and all of that influences in the whole body-wide system, and so what you are looking at doing is shifting that, and that means consistency, nerves that fire together wire together, you want to shift your neural networks, you want to bathe your whole body and mind in biochemistry that starts to shift gene expression overtime.  You want to try to do it on a regular basis.   Hopefully that all makes sense, but there are a couple of problems with relaxation training.   I have been teaching meditation for a lot of years, and what I hear over and over again from a lot of people is, “doc, I try to relax and I get more tense.”  It is  a really common thing, because you know what, if I am trying to do something, I am not relaxing, effort is the opposite of relaxing, and what you could say is stress is when we are trying to put an unbalanced force on something, an absence of stress is just stopping, it is effortless, there is no effort, there is no trying to get anywhere, and so a lot of the relaxation response methods that are sort of like active, “Hey, you are going to relax,” they can trip a person up that way.  If it works for you, great, do it.   In my own experience, just simply bringing the awareness to the present moment, bringing awareness to the sensual experience of life, bodily sensations, breathing, sounds, textures, even the taste of food, that is all about bringing your awareness and your consciousness into the here and now, and there is not stress here and now.  Mental emotional stress comes from future and past; it comes from comparing and thinking and striving and yearning and trying, and when you just bring your awareness into the here and now, the whole system starts to calm down and relax.   In my experience, that is often a big change for people who are sort of stuck in the “I can’t meditate, I can’t relax.” Okay, so do not meditate, do not relax, just pay attention in a structured way, just notice what you are experiencing, notice your breathing, let your breathing be like waves coming in from the sea and rolling up on the shore and rolling out to the sea. It is an experiential process.   The second big challenge with relaxation and stress management in general is what I have heard from so many people, which is, “I feel great when I am  doing it, but then as soon as I get back to life, wow, everything hits me and suddenly like I am  back into the vortex, and I am into the reactivity” and you know whatever it is, like the wife or the husband or the co-worker who does something unkind or the pain flare or the financial issues that trigger something, and before you know it, you have fallen back in the hole.   So, what do you do about that?   One of the first things you do about that is realize that it is totally normal, if you have been practicing being in a reactive stress state for months or years, then your body is used to it, that is what we are talking about here, we are trying to change physiologic habits, and it can take time, and it is totally normal that you get pulled back into the challenging stuff.   There is a deeper level to this if you start really thinking about the structure of a human being and a human soul, which is that we often have areas in our deeply held experience in our heart, even in our bodily memory that are associated with painful traumatic experiences, and until we start to actually unravel that and unwind that, they are going to still pull, they are going to pull our attention, they are going to pull our physiology, they are going to have a pull on your emotional experiences.   That is where it gets a bit deeper, because the idea of bringing your attention and your awareness to the present moment experience, yes, it can be very relaxing, but there is a deeper process. What happens is you develop this quality of your own mind that is able to be present, and you actually gradually condition your mind and your emotions to observe what is going on without getting sucked into the drama, without getting sucked into the judgments and the habits of self-blame, self-judgment, criticism of self or others and the emotional reactivity that they create.   In my own experience and what I have witnessed with so many people, there is this process by which the awareness develops overtime, there is a part of your mind and soul that is elevated above your emotional reactivity, and you develop it, you build it, you condition it, you teach it, you learn it by practicing it, and that is why the real benefits from meditation happen from practice. By doing it on a consistent basis, by observing, by being present, by letting go of the reactivity, by falling off and getting sucked into it and then letting go again.   It is a training process whereby you are essentially saying to your whole being, I am paying attention, and I am here, and I am not going to go down those pathways, I am saying no essentially to the normal reactivity, like I am sitting there and breathing, and I am paying attention, and I notice the thought that comes up that often triggers me, and I choose to just let it go.  I notice an emotion that might come up, that might trigger me, maybe it is sadness or fear, and I just choose to hold it; I decide to compassionately relate to it.   Okay, there is a difficult emotion, I am feeling fear, I am experiencing pain, let me just be present to that as if it was a little child who needed my loving care and attention and hold it in my heart without getting into the whole reactive, oh my gosh, how’s it going to change, I can’t live like this.  The things, the habits of reactivity that naturally become part of our being when we are dealing with chronic pain and illness can be unlearned and that is really what mindfulness training is about, there is a lot of different layers to it, but the basic idea is developing awareness and consciousness that are present, discerning, and compassionate. Which means I understand why this could happen, with all the different things that have gone on in life that have happened to me, that have happened to the world, of course, this is what is happening right now.  I am falling back into fear and irritation and anger.  I am slipping into chronic pain.  I have been rehearsing it for 10 years.   Okay, I am noticing it, I am letting go, I am not getting caught in the spiral, and what happens is that there is this part of your mind or your brain or your being depending on who you want to think about it, that you develop, and it gets called mindfulness in some circles, in the teachings of Torah and Kabbalah, it is the higher soul, it is the Neshama, the part of us that is just present to our life experience and can connect our sort of lower needs and drives with our higher aspirations, and it is your biggest ally in healing. Many of the people who I serve appreciate shorter videos, because it is easy to absorb that way, and we are going to continue to learn about unlearning pain, but I am we will just to take a break here and continue in the next video, you can find that whether on the blog or on the YouTube page or elsewhere, just look for the next number in the sequence and please join me there, please share if you find this interesting, and talk to you soon.
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