“Many a times, doctors, the worshipers of science, are helpless. They know a few technical things and perform their duty diligently. But they wait for nature to take its course as well.”
― Anuradha Bhattacharyya, One Word
admin - Fri, 12/17/2021 - 10:52
Dr schuniner is director of the Body Providence Hospital, Southfield Michigan, USA. He is also a clinical professor of Michigan State University College of Human Medicine.
about pain:
There's certainly tremendous amount of suffering AND PAIN in the world: Tremendous amount of abuse, tremendous amount of poverty, tremendous amount of injustice, tremendous amount of racism, discrimination against people and more. I would argue that there's also always some degree of choicee that people have. Victor Frankel wrote about that and lived that in his life. no matter what your external circumstances are And admittedly, many external circumstances are extremely difficult. there's always some choice, how you think, if you're going to live, how are you going to live? Given your circumstances, many circumstances are not changeable, but we can choose to change our attitude. We can choose to change our mood. We can choose to change how we think about our circumstances, and we can choose to find meaning and purpose in our lives. we can choose to find social connections and we can choose compassion WHICH AS I SEE IT- THESE ARE THE INGREDIENTS NEEDED FOR HEALING.
Why does pain linger?
Pain lingers because people think they're injured. Pain lingers because they think there's ongoing damage. Pain lingers because there's fear of the injury because the medical profession tells them you have CRPS or you have RSI or you have fibromyalgia, et cetera. You look them up and you read they're incurable. So pain lingers because of fear of pain and the conceptualization of it as being incurable and that you have ongoing damage.
The big cause of persistent pain
On top of that, pain lingers because of focus on the pain, because of frustration with the pain, because of trying to heal it and using all these different techniques, including injections and diets and surgery and massage and acupuncture and physical therapy. when none of it works, you get more and more frustrated. all that fuels the danger and alarm signal in the brain. the third reason why pain tends to persist and linger is because of emotional trauma : childhood trauma and stress in people's lives. if they have an ongoing situation with their work or their child or their spouse or their neighbor or the political situation in the country or the virus situation in the world, all those things can fuel this danger alarm mechanism and make pain linger. those are the main reasons why pain will persist in some folks.
Research about chronic pain
The vast majority of people with chronic pain do not have a structural problem. We did a recent study where we evaluated very carefully over 200 people with chronic neck and back pain, and we found that 85% of them do not have a structural problem. They may have had injuries. Many people have had injuries as human beings are designed to be injured and to heal all injuries. If you have a severe structural problem, you may end up with a curvature of the spine. You may end up with the leg length discrepancy.
Scars do not hurt
There's a lot of structural disorders that can be severe and can lead to deformities, but our body adapts to those deformities. Our brain adapts to those deformities. If pain is occurring after an injury after the injury is healed, it's because the brain has taken over that pain. The brain has learned that pain because the injury has healed and scars do not hurt.
Sometimes we heal with scarring. Scars are not painful. There's this idea that someone has a car accident or a mild injury, and then they have pain because of that injury. No, that's not the case.
I was just talking to a friend of mine who spent some time in West Africa working in a rural area, and he's met people with tremendous injuries, head injuries that we would call concussions and traumatic brain injuries, people with all variety of cuts and scrapes and broken bones. he did not see chronic pain in that population. There was no chronic pain, there was no chronic head injury, there was no concussion lasting injury. There was no whiplash injuries that lasted for months or years.
osteoarthritis does not necessarily have to be painful
Everyone gets wear and tear of their bodies over time. Everyone gets some degree of osteoarthritis over time. And if you look at X rays of people's joints as they age, they get more and more osteoarthritis. But not all of that is going to be painful.
We are over diagnosing
if you look at the correlation between people's pain and people's X rays, there's no good correlation, very poor correlation between X ray evidence of osteoarthritis and pain. Now, clearly, some people have severe levels of osteoarthritis and some of them will need a joint replacement. That's fine. That is true. But it is over. In our modern medical world, we're over diagnosing.
about inflammation:
there's no question that stress and emotional trauma can cause changes in inflammatory markers, CRP Esr and other blood markers. some people who have stress and trauma are more likely to develop autoimmune disorders like Arthritis lupus Crohn's disease or ulcerative colitis. There's no question about that, but not but people with headache and back pain and ibs or fibromyalgia, in my opinion, they may have high inflammatory markers, but it's not inflammation that's causing the pain.
What is causing the pain?
macro inflammation occurs in rheumatoid arthritis and lupus, and that can certainly cause pain. But the vast majority of people with chronic pain have headache, back pain, irritable bowel syndrome, or chronic pain syndrome. Those people do not have macro inflammation. They have microinflammation, but everyone has microinflammation. Everyone has inflammation in their arteries and gums, and many other places. stress can cause that. But the pain and the symptoms are due to neural circuits in the brain that have been learned that have been reinforced, that have been turned on and that can be turned off.
Pain can change within seconds
you can lower pain by changing the brain without changing inflammation. Because inflammation doesn't change within seconds. Pain can change within seconds. When you do our work with people, their pain can turn on and off within seconds. Within minutes, inflammation changes over days or weeks. I feel strongly about this because people are promoting the pain needs to be healed by changing inflammation. Thisa isn't the case.
macro inflammation can cause pain. Macroinflammation is generally local. You have an abscess in your throat. That's a local macro inflammation. You have macro inflammation in your joints. You have rheumatoid arthritis in your hand. There's inflammation, it's red, it's hot, it's swollen. That's local. systemic is everywhere. And systemic inflammation is microinflammation, and that is present in a lot of people to more or less degree. But for the vast majority of those people, it's not causing pain. It may go down with relief of stress. But you see stress causes inflammation and stress can cause neural circuits causing pain.
inflammation is not the cause of the pain
if you give people diets to lower inflammation to change their diet, that's not going to change their back pain or their headache or their ibs. It may change it by a placebo effect of making them feel more comfortable and more safe. But I frequently see people who are told they can't eat all these foods and then they get more stressed. The symptoms get worse because they're more afraid and they're more fearful of food, just like they're more afraid of so many things in their life. And that's counterproductive, in my opinion
obsession about diets will not heal chronic pain
I'm not saying those new diets are bad. You may live longer if you want to prevent diabetes and heart disease, maybe you can prevent cancer. I have no idea. I don't know that that's been shown, but you may live longer with healthier diets. I have no problem with that idea. I'm not arguing that what I'm arguing is that those diets are not going to cure your back pain or your headaches or your irritable bowel or your fibromyalgia. Those are not inflammatory conditions
about safety:
There's no question that our childhood experiences, all of our life experiences, are imprinted on our brains. We have memory. We have explicit and implicit memory. We have subconscious memory. We have emotional memory, and all those memories can make one feel safer or less safe. It can make one feel more trusting or less trusting. the people who have disruptive childhoods are much more likely to develop mind body syndromes are much more likely to develop physical ailments as well later in life. that's been shown very clearly in the adverse childhood event studies and many other studies. However, we exist in our past and we exist in our presence.
what we found is that you can help people heal and recover in their present and in their past. modern medicine hasn't really understood or taken on this. a lot of psychological therapies I would also suggest have not taken on because it's not just cognitive processes that are necessary to heal people. It is also emotional processes.
many ways of helping people feel safe
there's many ways of helping people feel safe, cognitively in their lives in the present, but it's often necessary to help them feel safer in their past by using emotional processes such as memory reconsolidation processes to help people heal some of the hurts from their past.
What do you mean?
Well, memory reconsolidation. The idea is that we can't change our past, obviously. But how do we know what our past is? We only know our past because of our memories of it and memory is constantly changing. This is a scientific fact. We don't have memory like some video camera. We have memory pockets and emotional pockets of information.
Go back to the past and heal it
There's ways of helping people in fantasy go back in time to visit their younger selves, or express feelings from their younger selves, or ways of imagining changing the situation, changing the memories purposely to help them feel more empowered, help them feel safer, help them to express feelings that they couldn't express then, help them deal with the anger that they felt, the guilt that they felt, the sadness that they felt and help them move move through those feelings, to have compassion for themselves, caring for themselves, letting go and forgiveness. And when you do those things, they're healing their past, which helps them to heal their presence.
it is a visualization technique
yes but you applied it on the past, not on the future. It's the idea that we hold our whole life is held within us. so our child is held within us, and that's healing the child that was within us and the parts of us that are child parts, the parts of us that are parental parts. so everyone has different parts of themselves. sometimes those parts feel like they're at war or they're fighting with us or they're betraying us. But the idea is to move toward integrating those parts and being at peace with our past with ourselves and with the different parts of us that we carry with us.
Question: Let's take an example, a concrete example. If a child back then had a critical caregiver and he lived a normal childhood, no abuse, no physical, no sexual abuse, nothing big, not a big trauma. But he lives with criticism because this was the way of his parents to show love and to Hone the child for life challenges to come. practically. How would such a child go back to his past and heal this?
create a new experience your younger version
You can simply ask the person to summon the parts of themselves currently that are caring and kind and loving and strong and courageous and then mentally go back in time and visit their self when they were eight years old or twelve years old or whatever. And they imagine meeting that person who's themselves and they can feel what that person was feeling, what their younger self was feeling, the emotions that they were feeling, the hurt, the sadness, the anger, the depression, the fear. then they can empathize with that person and then give that person in this imaginary scenario what they needed, which was love and caring and compassion and give them the opportunity to express their feelings. they can help them imagine doing whatever it is they need to do so they can create a new experience for that person that younger version of themselves, who is empowered, who cares for themselves, who can stand up for themselves. Maybe the person wants to talk back to their parents or scream at their parents or tie their parents up or make their mouth shut or push them out of the house or whatever. it is that they need to imagine doing. Or maybe they need to ask their parents to just love them and hold them and hug them. then your adult self is hugging that person and caring for that person and letting them cry scream or do whatever they need to do. maybe you take them to a beach and you laugh and you give them space and you ask if they can let go of their hurts. it's a variety of things that people have learned over the years to help heal the big trauma.
you carry all this hurt from childhood in your body
when you take away some of the hurt and guilt and anger from the child and the adult who's in current life in present times can also feel relief and begin to realize that they're okay in the present that they are safe now. They don't have to carry around all this hurt and mistrust as much, and they can practice as I mentioned before self compassion now- in the present. they're healing their past and they're healing their present at the same time
immersed in the fight flight freeze
question : how would you approach such a person who is so immersed in the fight flight freeze and he's kind of hooked in this emergency state of being? How would you access his brain and train it and reprogram his brain to feel safe again?
start with listening to the little child in you
start with compassion. You start with compassion and caring and love for that person. You start with understanding. You start with listening to them and allowing them to talk and tell their story, and you listen to that story and you help them see the issues that have occurred and are occurring in their life. And you help them to begin to be compassionate to themselves. as you do that, you can then help them understand what the story means and change the story. Help them change the narrative from one of fear and mistrust to understanding and caring and help them see that of course, their brain is going to be afraid. Of course they're going to not be trusting. Of course they're going to be living in fight or flight because of what happened to them and then help them see that their current diagnoses are not dangerous. If that's the case, if they don't have clear structural problems, then you can help reassure them currently that their body is not damaged. then you give them techniques and help them to reduce the fear of the pain or of their symptoms. And then you help them to see what they can do in their lives to help them be connected and safer and happier now in their lives.
it all starts with listening
gradually over time, you can help them to heal, heal emotionally they have to re conceptualize their story as one which makes sense and to help empower them that they can do something about it. And it all starts with listening. It all starts with understanding. It all starts with compassion.
about bracing:
bracing
There are people who are bracing their bodies. it is transparent. It is unconscious. They live like this in a clenched mode and it is not necessarily the muscles. Sometimes blood vessels are constricting and creating symptoms like raynaud's disease. Or sometimes it might be the tendons or the fascia. What's your take on the bracing pattern of the body?
the constriction is caused by the brain
Well, first of all, the bracing and the constriction is caused by the brain. So our brain creates what we experience and the muscle tension and the bracing that people have and the vasoconstriction of the arteries with Raynauds. Those are all under control of the brain, the autonomic nervous system of the brain and all the neural circuitry of the brain. Now how to access that? You can intervene in what we call top down and bottom up.
you can intervene using physical techniques. And there's a lot of people working in somatic therapies and a lot of great physical therapists or physiotherapists and body workers and acupunctures and massage therapists all can work to help calm the body as a way of calming the brain. What I think is important to understand is those bottom up techniques should not be designed to fix the body or change the body because the body is not broken. The changes in the body are reversible. They're under control of reversible. remind yourself that you're doing these modalities for training the brain. That is critical because it can be frustrating and annoying.
about diseases:
spasms, muscle knots, and chronic pain
I saw a woman who had very severe big muscle knots in her back and the muscle was very tense and all knotted up. she kept having these hundred dozens of treatments to fix the muscles with needling massage and cupping and all sorts of things. But the muscles kept bracing. they would relax temporarily. Then they've been tight again. They were relaxed and get tight again.
everything really comes down to the brain
We have to treat the brain saying : There's nothing wrong with the muscles. We're teaching your muscles to relax so we can train your brain to relax the muscles. So everything really comes down to the brain.
severe eczema and severe skin rash
I had a patient with severe eczema, severe skin rash. She had it since she was really an infant, and everyone had told her she was allergic and it was not under control of the brain, that there was something wrong with her body. she had a big eczema outbreak when she came to see me as an adult a few years ago. she told me that a few years earlier, she had had a very severe bout of eczema all over her body, she got a few acupuncture treatments and it completely disappeared. why? Because acupuncture is changing the brain. It's a brain treatment, even though it's based on the body. that one little fact, that one historical fact gave me the confidence and understanding to tell her that this is rash under control of the brain. that gave her the understanding and the confidence. she went out and just changed her brain. She just relaxed her mindabout the eczema. she told herself she was fine and calmed her brain. the eczema disappeared in a week. this was top down. The extra punch is bottom up, but it's still starting from the brain.
Raynaud – constriction of the blood vessels
is it a TMS issue?
Raynnauds phenomenon is not poor circulation. Poor circulation can be a medical problem if there's blockage of the arteries. Here it is not blockage of the the vessels. The constriction turns on and off because it's under control of the autonomic nervous system of the brain.
it can be treated up down as well
you're seeing this on and off phenomenon. This turning on and off phenomenon within seconds, within minutes it means it is a tms issue.
how would you access the blood vessels by visualization?
Just calm the brain. Calm the brain. you calm the brain. How do you calm the brain? You breathe, you calm yourself. You tell yourself you're okay. You look at your finger and say, oh, it's all red and funny or it's all white and it has a funny sensation and you just smile at it and you just allow the sensations to be there without reacting without fearing them, without freaking out.
about acceptance:
So now you're talking about acceptance and embracing any sensation that comes. how acceptance is so connected to healing?
because You're accepting that you're okay, that the sensations are not dangerous. You're not reacting to them with fear or frustration. You're not trying to fix them because you're not actually broken. All of these things are decreasing the threat detection system, the danger system in the brain. And when the brain feels safer, it will relax and it will relax the body. It will relax the muscles, it'll relax the blood vessels. It will go back to this resting and healing state, and the body knows how to do this. The brain knows how to do that. And the brain knows how to turn the body back to that resting state. Now, in some people, as you pointed out, they've been living in fight or flight for so long all the time that they don't come back to quite as low level as somebody who's very calm and composed. But everybody has their ability to modulate this up and down, more tense, less tense, more danger versus more safety. And over time, we can train ourselves. We can train our brain to be live more in safety because the brain is neuroplastic.
Your brain is still neuroplastic in old age
This is true at all ages. You can be 105 years old. Your brain is still neuroplastic.
