Dr. Hanscom's Blog Principles of Solving Chronic Pain

All symptoms, physical and mental, result from your body gathering data from your surroundings through multiple sensors, your brain interpreting them as safe, neutral, or threatening, and then your body responding in a manner to ensure survival. The reactions can be dictated by signals sent out directly through the nervous system, hormonal changes (also directed by the nervous system), or tissues responding locally to signals from small communicating proteins called cytokines.

Safety

With cues of safety from your environment, your response will consist of hormones such as serotonin (anti-depressant), dopamine (rewards), oxytocin (bonding), growth hormone (regeneration), and GABA chemicals (calming, anti-anxiety). The immune response stimulates anti-inflammatory cytokines. Metabolism will be lower and the whole scenario allows the body to rest and regenerate.

Physically, the result is feeling relaxed, slower heart rate and breathing, muscle relaxation, and reduced speed of nerve conduction, which decreases pain. The more time that can be spent in this regenerative state the better.

Most of the time, your body’s goal is to maintain equilibrium (homeostasis) and keep your range of behaviors and chemistry in a stable zone. For example, the nociceptive (pain) system unconsciously guides you to avoid actions that would cause harm. When you experience an uncomfortable or unpleasant sensation from any source, it is simply signaling danger and then you are compelled to take action to remain safe.

Threat

Environmental cues of threat are met with mobilization of all of your body’s resources in order to defend yourself. It includes your immune system with elevations of inflammatory cytokines, elevated metabolism to provide fuel, and the secretion of stress hormones such as cortisol, adrenaline, noradrenaline, histamines, and endorphins.

Physically and mentally, you are on “high alert” with numerous bodily responses. The basic ones include an increased heart rate, rapid breathing, increased speed of nerve conduction (increases pain), elevated blood pressure, sweating, muscle tension, and a sense of danger that we call anxiety. There also numerous symptoms created by this physiological state. They include tension and migraine headaches, neck and low back pain, skin rashes, stomach cramps, depression, bipolar, burning sensations in various parts of your body, and over 30 additional responses. Although the chemical environment encompasses your whole body, each organ and organ system will manifest its unique response.

Symptoms, illness, and disease

Balance is needed between your stresses and your capacity to deal with them. When you processing your circumstances well, you’ll feel connected to what you are doing and often will feel contented and safe. When your coping mechanisms are overwhelmed, your whole body will rise to the occasion to defend you, and every cell in your body goes into different levels of high alert. You will experience the above-mentioned threat symptoms.

When the threat is transient or resolvable, the symptoms will quickly abate. When it is more prolonged, you may develop an illness(es) that are reversible with appropriate treatments or when the stress has been resolved. When threat is sustained, people will eventually develop serious illness and diseases that cause permanent tissue damage and create mental havoc. Diseases don’t “just happen.” What would happen to your car if you were driving a long distance down the freeway at 70 mph in second gear. The engine would be running at a very high speed and will break down quickly.







There are two aspects of the situation that affect the quality of your life.

• The state of your nervous system:
  • Your inherent coping skills
  • Your current degree of neurological reactivity
• Your circumstances including:
  • The magnitude and duration of mental and/or physical threat
    • Note the human inability to escape from unpleasant thoughts and emotions.

Solving/ Preventing chronic disease

The core principles in solving/preventing chronic diseases with chronic pain being just one of many, are centered around the following 1) developing and nurturing a more resilient nervous system (processing center) 2) learning methods to process your stressors so they have less of an impact on your nervous system.

Examples of approaches to increase your nervous system’s coping capacity:

• Restful sleep
• Exercise
• Acceptance Commitment Therapy (ACT)
  • Learning to feel threatening mental or physical sensations and training yourself “to be with them.”
• Education – understanding the nature of chronic pain allows you to choose your own way of escape.
• Addressing childhood trauma
• Meditation practices

Some methods that lessen the impact of your threat:

• Cognitive behavioral therapy (changing thought patterns)
• Not discussing your pain
• Mindfulness/ active meditation – changes sensory input
• Forgiveness
• Awareness – can be used as its own tool
• Getting organized
• Expressive writing – separates you from your thoughts

Safety vs. threat

Modern medicine has nullified these aspects of care in that we are not given the time nor are we encouraged to talk to our patients. From the beginning, we are not providing cues of safety. Consequently, we don’t know our patients and their coping capacity and really don’t know much about their circumstances. We are given only the time to treat symptoms. We are ignoring the root cause of the problem. It is similar to trying to put out an oil well fire with a garden hose. It can’t and doesn’t work. Indeed, there is an ongoing and growing epidemic of chronic disease – both mental and physical.







A general overview of the mechanisms of how you will effectively be approaching chronic disease involves:

• Lowering inflammation (output) – calming techniques
• Increasing the resiliency of the nervous system – neuroplasticity
• Input – choosing what data to download

There is a marked amount of overlap and these three categories are artificial designations. They are intended to create a framework for discussion around developing and applying various interventions. You will learn tools to stimulate your brain to change and also calm down your nervous system. There will be a major shift in your body’s neurochemical profile. You can program your brain around most anything. Remember, this is not, “mind over matter.” You will lose that battle. Think of it more like a sculpting process and you have the power to create whatever reality you choose. The DOC Journey will guide you through this healing process at whatever pace you are comfortable with.







In summary, the root cause of chronic disease states is unrelenting exposure to threat and the solution is learning methods to create safety.

Related posts:

1. Essence of Illness
2. Anxiety is the Correct Name for Pain
3. Clarifying the New IASP Definition of Chronic Pain