Categories of Back in Control posts:

  • Important and most recent posts
  • DOC Roadmap posts organized by stage
  • Stories of Hope
  • Expressive Arts Gallery
  • The blog index.

 

Important Posts

Anxiety is a Symptom – Not a Diagnosis
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Every living creature on this planet survives by avoiding threats and gravitating towards rewards. The driving force is staying alive and survival of the species. This is accomplished by the nervous system taking in data... Read More

Do You Really Need Spine Surgery?
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Do You Really Need Spine Surgery? Take Control with Advice from a Surgeon considers all factors affecting your perception of pain and organizes them into a treatment grid that allows you to make a good... Read More

Anxiety Basics
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Anxiety is the body’s neurochemical reaction to a mental or physical threat. Without it you can’t survive.     It’s the sensation created by elevated levels of stress chemicals. Adrenaline – increases sensitivity and alertness... Read More

Recent Posts

Pain: the Gift Nobody Wants
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I have felt that it is important to pick out heroes to emulate. One person that I have greatly admired is an orthopedic surgeon, Paul Brand. He is the co-author of his autobiography, Pain, the... Read More

A Physician’s Story of Healing
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The solutions to breaking free from the grip of chronic pain have become increasingly clear. The answers are coming from several different sources that include the research on patterns of brain activity, the role of... Read More

The 8–Week Course of The DOC Journey
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Chronic pain is a complex problem consisting of many variables that affect your perception of it. Additionally, we now know that unpleasant mental input is processed in a similar manner as physical pain. Applying simple... Read More

 

Stage 1 – Laying the Foundation

A Physician’s Story of Healing
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The solutions to breaking free from the grip of chronic pain have become increasingly clear. The answers are coming from several different sources that include the research on patterns of brain activity, the role of... Read More

Anxiety is the Correct Name for Pain
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Every living creature on this planet survives by processing sensory input from all of the body’s different sensors and automatically causes you to behave in a manner that keeps you safe. Secondarily, they are motivated... Read More

Reprogram your Brain Around Pain
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One reason that chronic pain, mental or physical is consistently solvable is the brain’s property of neuroplasticity. Your brain physically constantly changes based on the nature of the sensory input. Every second, neurons, glial cells,... Read More

Smell the Peppermint–Safe or Unsafe
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Humans survive on this planet by the brain receiving ongoing sensory input from the environment and interpreting it as safe, neutral or unsafe. You will act accordingly to live another day. For pain, the brain... Read More

This COVID-19 Pandemic is Solvable–NOW
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Modern medicine has the capacity to halt this pandemic now. COVID-19 is a complex problem affecting the immune, metabolic, endocrine, nervous system, and the inflammatory response. The end result is death when there is severe... Read More

Evolution of the DOC Project
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I developed the DOC (Direct your Own Care) program after discovering that by providing a systematic approach to dealing with all aspects of a pain problem, I could almost always help patients become more functional.... Read More

Anxiety is a Symptom – Not a Diagnosis
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Every living creature on this planet survives by avoiding threats and gravitating towards rewards. The driving force is staying alive and survival of the species. This is accomplished by the nervous system taking in data... Read More

Depression is Anxiety
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Depression is anxiety. It is the constellation of symptoms caused by relentless anxiety. This is critical to understand because anxiety is simply the sensation you feel when your body is full of stress chemicals, such... Read More

Pain Sensitization – A Frayed Wire
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Research has demonstrated what all of us already know. Repetition of unpleasant sensations worsens over time and becomes intolerable. This is particularly true with pain and the classic example is that of water torture. Although... Read More

Anxiety Basics
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Anxiety is the body’s neurochemical reaction to a mental or physical threat. Without it you can’t survive.     It’s the sensation created by elevated levels of stress chemicals. Adrenaline – increases sensitivity and alertness... Read More

A Viable Solution for the Opioid Epidemic
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  The solution to the opioid epidemic is to solve chronic pain. 87% of patients on opioids have chronic pain (1), which is both driven by and results in severe anxiety. The second aspect of dealing with... Read More

Married 40 years – What Worked?
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My brother and I attended a small private college in England in 1975. Over the last 43 years, about 25 of us have enjoyed getting together for reunions. This weekend we had our eighth one.... Read More

Darkness – “The Abyss”
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When you’re suffering from chronic pain, your nervous system is ablaze. The medical term for this is “central sensitization syndrome” (CSS). Indeed, animal research has shown that when your body is full of adrenaline and... Read More

The Magic of Medical Hypnosis
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A few years ago, I attended a four-day workshop held by Dr. David Burns, who is a Stanford psychiatrist and the author of Feeling Good. It was his book that was the first step in... Read More

My Story of Hope
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I had a rough start living in a chaotic household with an angry mother who suffered from chronic pain. I did not figure out for 50 years that the migraine headache I suffered at age... Read More

Verbal “Expressive Writing”
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Freely writing your thoughts and immediately destroying them has been the starting point for almost every person I have seen heal. My concept of why it is effective is because humans cannot escape their thoughts,... Read More

Begin Your Healing Journey at Home
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It has become increasingly apparent to me that chronic pain is a family issue. Your deepest human interactions happen at home and members trigger each other. These powerful reactions have severe consequences. Partners and parents... Read More

More on Expressive Writing
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“I am the biggest ever skeptic. But I thought what the heck. My lower back pain has been very bad and persistent whenever I stand or walk for more than a minute. I read the... Read More

Not Sharing Your Pain – Omega
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I have held several three and five-day workshops in Rhinebeck, NY at the Omega Institute with Dr. Fred Luskin, a Stanford psychologist and author of Forgive for Good, my wife, Babs Yohai, a professional tap dancer, and... Read More

Sharing My Pain
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One of the tenets of successfully solving chronic pain is to stop discussing your pain with others. Dwelling on your pain only strengthens those neural pathways and therefore reinforces your perception of pain. Over the... Read More

“This is going to hurt”
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Your experience of pain depends on many parts of your brain receiving a signal, and comparing it to your expectations based on past experience. Recent research is confirming this on functional MRI (fMRI) scans that... Read More

Solve Chronic Pain – Listen
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You must understand the nature of a problem before you can solve it. It is well-publicized that over 100 million people suffer from varying degrees of chronic pain in the US alone. As I talk... Read More

Neurophysiologic Disorder
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There have been numerous terms used to describe the body’s response to chronic stress and the physiological response. The original descriptor was Tension Myositis Syndrome (TMS) coined by Dr. John Sarno in the 1970’s. Other... Read More

Anxiety
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  The ability to process anxiety in a healthy way is critical to maintaining your quality of life. It is even more important for someone who is experiencing chronic pain. Anxiety is a reflection of... Read More

Understand Chronic Pain
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There are two fundamental aspects to the perception of pain: The source: Three Sources of Chronic Pain Possible structural problem Inflammation of soft tissues Neurophysiological Disorder – “short circuits” The receptor—your brain Three additional variables... Read More

C – Neurophysiologic Disorder (NPD)
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There have been numerous terms used to describe the body’s response to chronic stress and the physiological response. The original descriptor was Tension Myositis Syndrome (TMS) coined by Dr. John Sarno in the 1970’s. Other... Read More

Back in Control – Second Edition
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The second edition of Back in Control: A Surgeon’s Roadmap Out of Chronic Pain will be available November 17th, 2016. Why did I write a second edition? The first book was based on my personal... Read More

Systematic Approach to Sleep
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Get some sleep – NOW Sleep is number one and I ask all my patients with insomnia to work with their primary care doctors to find a solution – and quickly. There are many ways... Read More

Societal Disintegration – Untreated Anxiety
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Relentless untreated anxiety is the core driver of destructive human behavior. Anxiety is simply the sensation generated by your body’s stress chemicals in response to a mental or physical threat. It is not primarily a... Read More

Neurophysiological Basis of Pain
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To say that the wave of mass shootings over the last few years is disturbing would be grossly understating how most of us feel. One of the most basic of human needs is to feel... Read More

Taking Charge of Your Care
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I want to share an email I received from a colleague regarding the effect of the DOC (Direct your Own Care) process in his practice. He is a retired orthopedic surgeon who is currently practicing... Read More

The Pain of Social Isolation
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Many people suffering from chronic pain are socially isolated. When you are trapped in pain you have a difficult time reaching out. Others do not necessarily want to interact with angry people. The problem becomes... Read More

Fighting a Forest Fire – Your Pain
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The negative impact of chronic pain on quality of life is more severe than heart failure, renal failure, or major depression and comparable to terminal cancer (2,3). Failing to adequately manage chronic pain has additional... Read More

Solving the Unsolvable
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Chronic pain is a complex situation with multiple factors affecting your perception of it. Regardless of the source of the pain, your brain is being rapidly bombarded with unpleasant sensations that become magnified and memorized... Read More

Introductory DOC Concepts
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DOC (Direct your Own Care) is a framework that breaks down chronic pain into basic parts that will enable you to discover your own solution. It evolved from my own 15-year experience suffering from chronic... Read More

Anxiety, Anger, and Adrenaline
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All living creatures survive and flourish by avoiding threats and gravitating towards rewards. Humans have language and consciousness, which creates some problems with this avoidance response. Thoughts create that same chemical reaction as a physical... Read More

Write Your Way Out of Chronic Pain
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Watch the latest video at video.foxnews.com Chronic pain is at an epidemic level, affecting about a third of the adult population. In adolescents, the number of in-patient admissions rose 831 percent over a seven-year period.... Read More

Stress, Illness, and Photovoltaic Cells
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Photovoltaic cells The photovoltaic cell is a solar technology that converts sunlight directly into electrical current.     Your nervous system “on the prowl” Your nervous system is designed to process all external stimuli and... Read More

Embracing Adversity – Tinnitus
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Tinnitus is an annoying (miserable) symptom that I had experienced since 1985. In another website post, The Ringing in My Ears, I tell my story about how it has all but disappeared. I was being... Read More

Physical versus Emotional Pain
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The Swerve, by Steven Greenblatt is a historical account of a papal scribe’s discovery in the 1400’s of a poem, The Nature of Things. Lucretius had written it almost 1000 years earlier. He makes a case... Read More

Healing Power Within—Warts
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I had a lot going on during my junior year in high school. I had left home to attend a boarding school and was free from a chaotic household. It was also incredibly stressful trying... Read More

The Ringing in My Ears – Tinnitus
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Posted in: Stage 1: Step 1 The old saying, “Youth is wasted on the young,” is true—especially in my case. Many of the physical issues of my adulthood resulted from a perceived invincibility during my teenage... Read More

Mold Your Brain: Neuroplasticity
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STOMP Dr. Gordon Irving was the medical director of the Pain center at Swedish Hospital in Seattle, WA. He developed a wonderful set of resources for dealing with chronic pain. His version of a structured... Read More

Unhooking from the Train
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Neurophysiological Disorder? The multiple manifestations of the Neurophysiologic Disorder (NPD) endlessly fascinates me. With engagement of the principles that treat it, the improvement in my patients’ quality of life is consistent and frequently dramatic. The foundation of... Read More

My Feet on Fire
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I began my orthopedic surgery residency in 1981. I had an unusual path into this specialty in that I had completed two years of internal medicine residency in Spokane, WA prior to moving to Hawaii.... Read More

My Midnight Trip to the Dentist
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My dentist is a great guy. Our children played sports together in elementary school. Still, I tend to skip going to the dentist. I had been quite diligent for years getting my teeth checked and... Read More

My Battle with NPD
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The concept that stress can create physical symptoms has been around for centuries. In modern times we have become enamored with technology and have lost sight of the fact that multiple different physical symptoms will... Read More

Your Hand Stuck Over the Stove
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I often encounter a perplexing situation: A patient experiencing severe chronic pain on my spine intake questionnaire rates him or herself as a zero on a 10-point scale with regards to anxiety, depression, and anger.... Read More

Freed by a Pen
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I was running an hour late in clinic and was trying to get through my last patient before my already abbreviated lunch. A young Spanish-speaking woman from Puerto Rico was lying on the table moaning.... Read More

A – Structural Sources of Pain
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It is an almost universally held belief among surgeons and patients that a specific structural lesion is usually the cause of pain. If that lesion can be identified and repaired, the pain will abate. This... Read More

You are Not a Machine
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Pain is a perception that is affected by many factors. Our western medical culture has focused on the idea that there is always a direct physical source or “pain generator” that can be identified and... Read More

Unlearning How to Ride Your Bicycle
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I don’t recall much about learning how to ride a bicycle. I remember the training wheels and taking a few nasty falls. I do know that my father wasn’t there to help me or witness... Read More

Video: Anxiety and It’s Demons
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I talk about how anxiety and stress can lead to certain obsessive tendencies. Some of the tools from the DOCC project are laid out, specifically those that can help break down the circuits that fuel... Read More

Video 16/19: “White Bears”
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I talk about how the suppression of negative thoughts associated with chronic pain can really fire up the nervous system.  Dr. Daniel Wegner from Harvard published an elegant paper in 1987 demonstratng the impossibity of... Read More

Back Pain vs. Mouth Pain
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I am a busy spine surgeon, yet I spend most of my time talking my patients out of surgery. When I do recommend surgical treatment, many, if not most, become apprehensive. They have heard that... Read More

Video: Memorizing the Circuits: Phantom Pain
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Our brain has neurological circuits that can become memorized. In this video I discuss phantom pain, which is more the rule than the exception with amputations. This factor is a significant problem with any chronic pain... Read More

Video: Your Brain Becomes Sensitized
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I discuss how the brain becomes more sensitive to pain with repetition. I also introduce the first 3 “E’s” of the 5 “E’s” of chronic pain as well as the evolution of pain. The 5... Read More

Video: Is Your Pain Structural or Not?
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I look at the source of the pain and it’s receptors in reference to back pain and one’s spine. I also discuss the difference between a structural and non-structural source of the pain. Read more... Read More

A Bunch of Balloons
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Much, if not most, of what the DOC project presents about creating a central nervous shift is 180 degrees different than how most of us are taught to deal with our conscious mind. One of... Read More

Video: Introduction of David Hanscom
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In this introductory clip, I lay out my novel approach to chronic pain. In addition to sharing some of my personal experience in spine surgery, I give insight into how my approach to spine surgery... Read More

David Burn’s Letter
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In the beginning of the DOC Project, the only resource that I had for my patients to deal with the stress of pain was the Feeling Good book. I discovered that patients would often notice... Read More

Motivated by “The Talent Code”
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Dear Dr Hanscom, Having read (devoured actually) The Talent Code by Daniel Coyle, I can now share with others the benefits I received through reading this book. The author demystified that very mysterious quality of... Read More

The Terrifying Triad
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When a basic human need such as air, food, or water is not met, we experience a deep feeling of anxiety.  We then take directed action to meet the need, which allays our anxiety. When... Read More

Write and Don’t Stop!
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  There are over 1000 research papers that document that expressive writing in some form is effective for improving both your mental and physical health. I have been adamant for a long time that you... Read More

Your Demons are Robots
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It is critical to understand how deeply negative anxiety-producing thoughts are etched into your nervous system. A 1987 Harvard experiment (1) documented that when you suppress unpleasant thoughts, they become more powerful. Unfortunately, they documented a... Read More

Normal Arms Amputated
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It’s important for you to understand how powerfully and quickly pain circuits are embedded into the nervous system. It’s accomplished in the same way one learns anything—by repetition. Pain impulses flood your brain much faster... Read More

Degenerative Disc Disease Isn’t a Disease
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I regularly see patients who’ve been told that they have “arthritis, bulging discs, herniated discs, bone on bone, ruptured discs or degenerated discs”. They are terrified that they will become increasingly disabled and need to... Read More

Decreasing Anxiety with Control
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Anxiety is the basis for most of our behavior and ability to stay alive. We have many cues around us that govern our actions so as to avoid danger. The essence of this sequence is:... Read More

Sleep Disorders
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Only five percent of patients have an adequate evaluation of their sleep issues by any physician. (1) This is unfortunate, because lack of sleep is such a common problem. The term commonly applied to trouble... Read More

Writing at Bedtime
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When you are under stress, your brain is on a Formula One racetrack.  Being in chronic pain is one of the most miserable experiences of the human existence. There is hardly any strategy that will... Read More

Sleep Meds
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Nothing can really happen in the context of the DOC Project until you are regularly getting a full night’s sleep. Exhaustion makes it impossible for anyone to concentrate long enough to engage in the program.... Read More

Sleep Hygiene
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Sleep hygiene is a term that’s used to describe a group of strategies that will improve your ability to get a restful night’s sleep. In the context of chronic pain, these strategies often need to... Read More

B – Non-Structural Pain
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Patients often wonder how soft tissues can be so painful. It’s because they have a high density of pain receptors arranged in a spider web type pattern. These irritated soft tissues give rise to some... Read More

“Feeling Good” format
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After you have become comfortable with writing down and immediately destroying your thoughts, the next phase involves the “three-column technique that Dr. David Burns outlines in his book, Feeling Good. It provides an excellent format in... Read More

Anger
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Anger is as important as anxiety when it comes to chronic pain management. Some people are able to come to grips with anger and process it in a healthy way. For others, a lack of... Read More

Sleep
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Understanding the importance of sleep and its effect on the perception of pain was my initial insight into the neurological nature of chronic pain. Incorporating adequate sleep into my treatment of pain was my first... Read More

4 – The “Modifiers”
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There is a sequence of events that results in chronic pain. It is complex and not linear. The first step is to acknowledge a source that can originate from soft tissues, a structural abnormality, or... Read More

Masking
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Masking your reaction to stress is a way of dealing with repetitive racing thoughts. Masking is behavior that’s used to cover up uncomfortable emotions. Driven by anxiety, you do something to get you mind off... Read More

Suffering
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  Repetitive thoughts When you suffer, you have the same set of thoughts over and over; a process that clearly reinforces a given neurological circuit. Suffering takes many forms. Ways it is manifested include complaining,... Read More

3 – Memorization of Neurological Circuits
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Memorization of neurological circuits is the another phase of the chronic pain experience in addition to pain sensitization. The way you learn any skill, such as a sport or musical instrument is repetition. It takes... Read More

Early Sleep Concepts
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I learned about the importance of sleep somewhat by chance. It was covered in my medical training. I read a book, The Promise of Sleep.  It was an autobiography of William Dement, who started the... Read More

DOC – A Framework of Care
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Chronic pain is a complex problem consisting of many variables that affect your perception of it. Additionally, we now know that unpleasant mental input is processed in a similar manner as physical pain. Applying simple... Read More

2 – Sensitization to Pain
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I frequently encounter patients who feel that there must be an anatomical problem that is progressing as their pain is getting worse.  There has been no further injury.  Nonetheless, these patients become even more focused... Read More

Four Steps in the Evolution of Chronic Pain
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There are four phases in the evolution of chronic pain: (1) There is a potential source for pain, which may or may not be readily identifiable Structural–identifiable lesion with MATCHING symptoms Non-structural–inflammation or irritation of the soft... Read More

1 – Three Sources of Chronic Pain
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Dr. Howard Schubiner Dr. Schubiner is a pain physician practicing in Detroit, MI. He approaches pain from a whole body perspective. I consider him one of my major mentors and was the one who unlocked... Read More

Stage 2 – Forgive and Play

Forgiveness as a Habit
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Once is not enough in forgiveness Perhaps this game is like weeding. The trick is to become so practiced that you can sing while you do it, that when you see one beginning to sprout... Read More

When I Dance – Omega 2019
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Your brain changes every second and will evolve in whatever direction you choose. The term for this phenomenon is called, “neuroplasticity.” It is important to decide what you want in your life and what you... Read More

No Action in a Reaction – Part 2
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The essence of solving chronic pain and also creating a life that you enjoy is learning how to regulate your body’s chemistry. When you are full of stress hormones such as adrenaline, cortisol, endorphins and... Read More

No Action in a Reaction
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Anger is the body’s effort to regain control of a situation that you perceive as threat. It’s the most basic of survival reactions. It is only about your survival and by definition is destructive. In... Read More

“But I’m Not Angry”
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One of the most sobering aspects of my journey in and out of chronic pain was my lack of awareness of my emotional state. My childhood wasn’t nurturing and I was surrounded by anger. Since... Read More

Bullying is Good for Your Health
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Bullying is maybe one of the most irrational and unacceptable aspects of the human experience. Everyone at every age, including the bullies, knows it’s wrong. Yet there doesn’t seem to be an effective way to... Read More

Escaping the Abyss – Which One??
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I saw two movies and a show this month that highlighted many issues about the human condition and pain. I first saw the 2015 movie, Cinderella, then a show, Ain’t Too Proud, which was a... Read More

Wake the Fun up!!
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Watching a baby take in every aspect of his or her surroundings with curiosity and awe is wonderful, delightful and inspiring. The capacity to learn is almost infinite. Their laughter is contagious and when they... Read More

She Just Let Go
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My migraine headaches began on the Fourth of July when I was five years old. By age fifty I had over fifteen physical symptoms of an over-adrenalized nervous system. The last five years were extreme.... Read More

Your Unconscious Brain
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Your body is a lean and mean fighting machine. That is all it is designed for and intended to do. We somewhat cheated nature in that we possess consciousness and language so we are able... Read More

Society’s Pain and World Peace
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We live in an era of unprecedented comfort and freedom. A recent experience that drove this home was spending a few days in New Orleans. As my wife and I were on a walking tour... Read More

Out of the Valley, with Dolls
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When I first met Sarah, she was close to 75 and had been experiencing debilitating pain for decades. But, since her spine x-rays revealed only normal degeneration consistent with her age, I set her to... Read More

Awareness, Hope, Forgiveness and Play
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These four elements form a powerful alliance to connect to your own capacity to heal, which is the essence of the solution to chronic pain. The DOC program is a framework that allows you to... Read More

Taking on the World’s Suffering
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The tipping point in successfully solving  chronic pain is becoming aware of your anger and processing it. When you are upset your body is full of stress hormone and as each organ system responds, you... Read More

Perfectionism—The Ultimate Victim Role
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Perfectionism is an additional—and perhaps less examined— way that people play the victim. Many view perfection as the standard that must be reached in order to be successful. It’s held up as a virtue in... Read More

Changing Your Story – Reframing
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Neuroplasticity is the term for the brain’s capacity to physically adapt to the environment. This is modulated by sensory input and chemical changes. It has been well-documented that prolonged exposure to stress hormones adversely affects... Read More

Aced Out
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I received an email from an orthopedic colleague who I have never personally met. We are both part of an Internet discussion group about chronic pain and disability. His observations were very succinct and I... Read More

Your Personal Brain Scanner
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Every second of your life depends on your brain scanning your surroundings for trouble. This unconscious process guides your behavior so as to avoid danger and maximize your chances of survival. You will become conscious... Read More

The Power of Pain
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Recent world events have raised a lot of questions about why would people dedicate their lives to the pursuit of destruction? My observation is that this unspeakable behavior is one of the expressions of what... Read More

Rewire Your Brain – Omega 2015
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Omega Institute, July 2015 Dr. Fred Luskin, author of Forgive for Good, my wife Babs Yohai, a professional tap dancer, and I will hold a five-day workshop at the Omega Institute in Rhinebeck, NY. The course... Read More

“The Unenforceable Rules”
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I was in Italy grabbing a ride to my hotel from the Florence train station. While waiting in line I noticed a slightly older taxi driver standing by his cab in the middle of the... Read More

Ready to Blossom – Omega 13
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The Omega Institute In August of 2013 I put on a 5-day workshop at the Omega institute in Rhinebeck, NY with 11 participants. The other two faculty were Dr. Fred Luskin from Stanford and my... Read More

“But You are Still Angry”
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The DOC project is not a formula. You are not going to read my book and experience healing. My book is a framework that will organize your thinking. You can then systematically address all the... Read More

Destroyed by Bullies
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Despair I will never forget a 40 year-old woman I met in the office a few years ago. She had suffered from chronic pain that enveloped almost her entire body since her late teenage years.... Read More

Violence and Love
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Power Many patients have no interest in giving up their pain. Being a victim is a powerful role – and for many is synonymous with love. Some of the reasons to remain a victim and angry... Read More

“The Cup Song”
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Omega Institute – June 7 – 9, 2019 – Relief from Chronic Pain The essence of curing chronic pain is connecting to your own body’s capacity to heal. When you are trapped by any circumstance, especially chronic... Read More

To Become Strong – “ILOHLA”
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My creative artist friend, Ernesto, endured a rough couple of years and for a while he “disappeared”. The details are not important. What is important is that he is back and thriving. This piece is... Read More

Ugolino
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Neurological circuits are permanent Pain pathways are permanent. So are the intertwined anxiety and anger circuits. I am personally reminded of this fact on a daily basis. It happened in a particularly dramatic fashion while... Read More

“Self-Esteem” Must Die
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In our society today, it’s commonly believed that the higher the opinion you have of yourself, the more confident, happy, and successful you’ll be; high self-esteem is held up as the ultimate goal. In actuality,... Read More

The Angry Meditator
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Meditation is a powerful tool in calming down your nervous system, and is a skill that everyone should be taught in elementary school and continue to hone throughout a lifetime. Think what we are not... Read More

“Finding Health by Letting Go of Hate”
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The common thread of those who successfully heal from chronic pain and other symptoms of Neurophysiologic Disorder (NPD) is letting go of anger through deep forgiveness. Anger and pain are inextricably linked. For many of... Read More

The Elephant’s Noose
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The Elephant’s Noose If you are angry, in a reactive mode, it’s difficult to develop a plan. A metaphor showing the impact of anger is how they handle elephants in India. When the elephants are... Read More

Anger and Workers’ Comp Webinar
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Our medical and political system has failed. Employers have abused workers as long as there have been employers and workers. The intent of worker’s comp’s no-fault system was to both provide excellent medical care as... Read More

Anger Simplified
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  Anxiety creates the need for control Anger = loss of control More stress chemicals are secreted in an effort to regain control Therefore Anger = anxiety + adrenaline Related posts: Anger = Loss of... Read More

Taking Back Your Spirit-Caroline Myss
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Caroline Myss-Taking Back Your Spirit Anger and chronic pain are linked pathways. It is not possible to release yourself from your pain and move foward with your life until you can experience true forgiveness for... Read More

Labeled “Drug Seeker” and Almost Died
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One of the core concepts of the human condition is labeling experiences, trends, groups or people. It comes along with having the capacity to communicate through language. Yuval Noah Harari in his book, Sapiens, pointed out that... Read More

Anger-The Absolute Block
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It has become clear that if a given patient engages in the principles outlined in this book, he or she has a high chance of experiencing a dramatic decrease in pain and improved quality of... Read More

Maslow’s Miss
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  Abraham Maslow Abraham Maslow (1908-1970) was a brilliant professor of psychology. He founded a branch of psychology known as “Humanistic Psychology,” which focuses more on psychological virtues or excellences rather than on psychological disorders.... Read More

Video: The Myth of Self Esteem
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Self esteem involves endless judgment of comparing yourself to others around you. I discuss the negative impact that this concept has on us. For more, see The Myth of Self Esteem. Related posts: Video 15/19:... Read More

Reactive to Creative
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Hard work and creativity are equally important to successfully developing and implementing new ideas, both personally and in the business world. It can be argued that insanity is the antithesis of creativity. Consider Albert Einstein’s... Read More

“C”ing Clearly
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All of us know we can’t think clearly when we’re upset. There’s a physiological reason why. Adrenaline and other stress hormones will diminish the blood supply to the frontal lobes of your brain.The flight or... Read More

Enjoy Your Day-Today
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  “Happy” We all want to become better, happier people, and we work pretty hard at it. The marketing world keeps reminding us that we are not even close to our potential and holds up... Read More

Video 3/19: Completely Trapped
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I talk about the frustration and the feeling of being trapped by chronic pain and how using the DOC Project will help get your pain “Back in Control”. Remember: Anger = Loss of Control.  Related... Read More

Video 2/19: Your Hand Over the Stove
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Consider a situation where you are forced to hold your hand next to the hot burner of a stove.  What would happen to your anxiety?  What would be your next response?  In chronic pain, you... Read More

Depression Masking as Pain
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Patient’s Letter Hi Dr Hanscom, I have been meaning to check in with you for a while now and let you know that the DOC program seems to have worked for me. My lower back... Read More

“Call Things by Their Right Names”
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The culture of medicine is immersed in high standards, ideals, and perfections. Society demands perfection from physicians.  It is manifested in many ways. The legal system, hospital staff privileging, no mercy for personal mental health... Read More

“The Journey of 1000 Moons”
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“The Journey of 1000 Moons” by Ernesto Sanchez If you count the moon cycles you will experience in your lifetime, by the time you reach 77 years of age, you will have experienced one thousand. As... Read More

A Tale of Two Golf Holes
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I love golf. I love the social aspect of it. I love to hit a great golf shot. There is nothing quite like hitting the “sweet spot” and feeling the ball take off like a... Read More

My Victimhood
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I was raised in an abusive household and living that life seemed normal because it was all that I knew. I was truly a victim, but I didn’t know it at the time. It was only... Read More

Anger = Loss of Control
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Anxiety is the feeling generated by your body in response to a threat. When a situation causes a feeling of anxiety, we exert some type of control to diminish it. When you lose or don’t... Read More

Anger and the Continental Divide
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Playing the victim role is a universal part of the human experience. The word ‘victim’ does not sound very pleasing. However, it may be the one most important words affecting the quality of your life.... Read More

The Myth of Self-Esteem
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Self-esteem is one of the worst concepts ever propagated. While the definition itself appears harmless enough on its surface, “confidence in one’s own worth or abilities,” the ideas surrounding self-esteem implies that if I had... Read More

Anger/Victim with Worker’s Comp
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There is a “genealogy” of frustration/anger. It is: Circumstance Blame Victim Frustration/Anger There are two types of “victimhood”: Perceived                                ... Read More

Suppressing
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We frequently deal with negative thoughts by suppressing them. We don’t want to feel negative, so we don’t. We think that we have no alternative to a difficult situation, so we just move on.  ... Read More

Anger and Anxiety–Highway to Hell
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  There is an intense relationship between anxiety and anger. Understanding this interaction is perhaps one of the most important concepts that will have a major impact in calming down your nervous system. The are... Read More

Stage 3 – Move Forward

The 8–Week Course of The DOC Journey
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Chronic pain is a complex problem consisting of many variables that affect your perception of it. Additionally, we now know that unpleasant mental input is processed in a similar manner as physical pain. Applying simple... Read More

Awareness–Ingrained Patterns
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    Awareness is the essence of healing in that you cannot stimulate your brain to develop in a given direction, unless you know where you are starting from. Awareness is both a tool and... Read More

Develop a “Family Business” Business Plan
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Any business of that consists of more than one person involves creating a legally binding contract that spells out the expected responsibilities of each party, distribution of the rewards, and assumption of liabilities. The ultimate... Read More

Decreasing Your Stress Chemicals (Anxiety)
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Chronic stress can be deadly. People experiencing chronic elevations of stress hormones such as adrenaline, noradrenaline, cytokines, histamines, and cortisol mentally and physically suffer. Some of the problems include the following: Early mortality – average... Read More

Relationships and Rock Tumblers
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Over the last several years, it has become apparent that family dynamics are a major factor in perpetuating or solving chronic pain. I am on a continual journey to learn more about these forces. At one... Read More

Back in Control Coaching
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I would like to introduce you to Kendra Bloom, who is a somatic psychotherapist. She has been a wonderful resource for my patients for many years in Seattle. Although, the DOC process is largely self-directed,... Read More

Holiday Landmines – Your Family
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  For some, the holidays are synonymous with a strong sense of familial closeness and love. However, this is not the case with many family gatherings, where relatives trigger each other, and chaos quickly ensues.... Read More

A Couple Re-united
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Our team has become extremely aware of the effect of chronic pain on the family and the family dynamics around pain. The patient is in a survival mode and loses awareness of the needs of... Read More

A Safe Haven – Omega 2018
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Our next weekend workshop will be held this summer at the Omega Institute in Rhinebeck, NY. The dates are Friday evening, June 29th until Sunday noon, July 1st. The intent of the program is to... Read More

Happily Ever After
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My wife and I were at a wedding this weekend. The bride was the daughter of some of our closest friends. She and her new husband are a wonderful couple. The excitement and energy around... Read More

The Taste of Freedom – Omega 2017
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Becoming socially isolated often occurs when suffering in pain. Additionally, the area of the brain that lights up is similar to the same circuits that are active in chronic pain. The effects of being isolated... Read More

Your “Identity” Can Destroy You
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Humans spend a good part of their life energy creating and maintaining something called “self-image.” Thanks to parents, peers, and the socialization process, we are conditioned to identify with an “image” of our “selves.” While... Read More

The Chronic Pain Marriage-Go-Round
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I have long asked the spouses/ partners of my chronic pain patients to participate in the DOC project (“Direct your Own Care”—my step-by-step method that allows patients to take control of their treatment plan). One... Read More

The Two Faces of Christmas
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Louis Cozolino, in his exhaustive book The Neuroscience of Human Relationships, points out that that human consciousness developed through interacting with other humans. We all know that people seek connection with others and when deprived... Read More

Moving Forward with Your Pain
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“Life is like riding a bicycle. To keep your balance, you must keep moving forward.” Albert Einstein The goal of the DOC process is not to get rid of your pain. In fact, there is... Read More

Be All that You Can Be – or Just Be
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Chronic disease is rampant amongst teenagers. A 2014 paper out of Indianapolis demonstrated an 830 percent increase in hospital admissions for pain in adolescents over a seven-year span. In the vast majority of patients, a... Read More

Who Do You Choose to be Today?
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One morning I woke up feeling low, having just completed eight straight 15-hour workdays. As I lay there exhausted, I reviewed my choices: either (1) stay in bed feeling sorry for myself; or (2) give... Read More

The Essence of the DOC Process
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“The essence of the DOC process is simply chilling out and moving on. One cannot happen without the other. This is a corollary of the other basic principle that it is important to move forward... Read More

Take Back Your Life
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Whenever your peace of mind is at the mercy of your external circumstances, you are at the mercy of them. The essence of taking your life back is disconnecting from this energy. There are many... Read More

Happy Father’s Day – Not
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I was landing in Salt Lake City to spend Father’s Day weekend with my son and daughter-in-law. While standing at baggage claim I heard a father yelling at his daughter to hold still. I looked... Read More

“Stars Through the Bars”
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Many years ago I was involved with helping a young friend, Larry, in his 20’s deal with a difficult legal situation involving drugs. He was a great kid and had ended up associating with friends... Read More

Pain Rules the Roost
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I am noticing a pattern that seems to be quite common. People in pain control others around them – especially their close family members. I have not had the chance to research the literature but... Read More

The Power of Love – Anthony
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  Anthony was a patient who I saw just a couple of times in his early 20’s. He was experiencing low back pain that was significantly impacting his quality of life. His MRI scan showed... Read More

Happy Holidays – Not
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My first year in training I will never forget my first holiday season as an internal medicine resident in Spokane, WA. I learned that the holidays are a nightmare for the medicine service, especially the... Read More

Breaking Loose – Not Quite
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Family Patterns Behavioral patterns laid into your nervous system are the essence of your life view. Until you become aware of them and their effect on your day-to-day life you cannot connect with the core... Read More

Escaping Your Family – The Crab Bucket
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Having a family member on disability is a significant risk factor for becoming disabled. For years, I was puzzled by this connection, but I saw it frequently. I learned that it is a powerful influence... Read More

Mastering Pain – Shuhari
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The foundation of the DOC project is understanding that pain circuits are permanently laid down in your brain quickly. It is unclear in a given person when acute pain becomes chronic, but we do know... Read More

Mirror Neurons—Family Healing
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I always ask family members or close friends to fully engage in the DOC project. It is not just for support, which is important. People exert a direct neurological effect on each other’s brains. The... Read More

Protect Your Family from Your Pain
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Chronic pain is dangerous Chronic pain is dangerous. When you are trapped by anything in life, especially pain, you’ll become angry. When you’re angry, everything is completely about you and your efforts to escape. You... Read More

Staying in the Storm
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Almost every patient of mine who is in chronic pain is also experiencing much adversity in the rest of his or her life. Chronic pain rips through every aspect of your life and there is... Read More

Breaking Loose – NOT
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Behavioral patterns laid into your nervous system are the essence of your life view. Until you become aware of them and their effect on your day-to-day life you cannot connect with the core of you... Read More

Visualization – Holt’s Winning Run
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Stimulating your brain to form new circuits first involves awareness of what already is, separating or creating some space between the stimulus and response and then redirecting your attention. Visualization is an effective method to... Read More

Pain = Anger = Abuse
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I was raised in a chaotic household. My mother was physically and emotionally abusive. It was confusing for me to feel like I had a mother who would do anything for her family and then,... Read More

The Eye of the Storm
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Any time your sense of well-being or peace of mind is dependent on external factors, you are at the mercy of those circumstances. For instance, if you feel the need for approval from your boss... Read More

“The Pit of Despair”
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Modern medicine is evolving in a dangerous direction with regards to your care. The major factor in deciding to offer a procedure or treatment is often whether it’s covered by insurance and how well it... Read More

Stage 4 – Expand Your Consciousness

Pain: the Gift Nobody Wants
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I have felt that it is important to pick out heroes to emulate. One person that I have greatly admired is an orthopedic surgeon, Paul Brand. He is the co-author of his autobiography, Pain, the... Read More

Thrive and Survive–The Movement
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      I have launched a major effort to change the way we think about disease; whether it is mental for physical. EVERY chronic disease state exhibits elevated levels of inflammatory markers. The immune... Read More

“The Bottom”
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Generation Z and Millennials as a group are struggling. In spite of living in an era of unprecedented opportunities, they are the loneliest groups. Cigna Insurance company conducted an online survey in 2018 (1) on... Read More

Anxiety – Bodyguard or Prison Guard
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Imagine yourself on the fourth day of your Hawaiian vacation, lying on a tropical beach in the sun. You are full of oxytocin, dopamine, and a few other chemicals that make you feel relaxed. Now... Read More

Success is a “Story”
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There is currently an epidemic of pain in our country, and chronic pain is increasing especially rapidly in people under 40. Teen anxiety, with its many physical manifestations is particularly problematic. A few of them... Read More

Moving Forward – A New Horizon
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I have stopped doing spine surgery and active clinical care to pursue the Back in Control project full time. This link explains my position: Why I am Leaving My Spine Surgery Practice. My vision is... Read More

“Dying” Before Living
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  Florence, Italy, 2013 On vacation We all intellectually know that life is short and somehow we spend a lot of energy avoiding that thought. I was reminded of the frailty of life this week... Read More

Anxiety with Success
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No matter how many parts of my life were good, I was stuck in thinking about what I didn’t have and what could be better. It seemed to me that almost everyone else had more... Read More

Healing With Support from her Community
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Hi Dr. Hanscom, It’s Donna, a former patient. I just wanted to write and tell you some good news regarding my back situation. You were right about forgiveness as well as the emotional aspects of... Read More

Trying Not to Be Judgmental
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The psychological process of projection is a defense mechanism that allows us to transfer our unwanted feelings or behavior onto another person. For example, a person who is highly self-critical may constantly feel (or fear) criticism from... Read More

Compassion
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A Course on Compassion: Empathy in the Face of Chronic Pain Click to view “A Course on Compassion” lecture videos Empathy is an inherent part of the human experience.   Being labeled as a “chronic... Read More

How Much Suffering Can You Take?
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This was the highlighted title of an article in the Sports Sunday section of the NY Times a few weeks ago. Of course, it tweaked my interest and I was introduced to an event that... Read More

“Better Not Look Down”
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A recent study demonstrated that thought suppression damages the hippocampus of your brain, which processes short and long-term memory. (1) It is also been well-documented that when you try not to think of something, not... Read More

Anger: Damage Control
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There is a “genealogy”  of anger. It begins with a person or situation that you blame for upsetting you. You then go into a victim role and become upset. “Upset” can range from being irritated... Read More

Anger versus Angel
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ANGER ANGEL   Love and rage are both four-letter words. A N G E   R  A  G  E A N G E L O V E The difference between the words anger and angel... Read More

The KKK and a Spiritual Journey
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I am a strong supporter of psychology, psychiatry, and any mental health profession that can provide insight into how to live a full and productive life. However, I want you to think differently about mental... Read More

The First and Last Day of School
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“It is not true that people stop pursuing dreams because they grow old.  They grow old because they stop pursuing dreams.” Gabriel Garcia Marquez “It is not true that people stop pursuing dreams because they... Read More

Video: Standard Stress Skills Inadequate
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I talk about how the DOC Project can relate to other aspects of our everyday life, including everyday stressors and suppression. This is related to some of what I talk about in “Memorization of Neurological... Read More

Plugging the Negative Drain
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Picture yourself in a tub trying to fill it to take warm, relaxing bath. The drain is not only wide open, but it is a foot in diameter. No matter how long you try to... Read More

My Hoffman Experience
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Hoffman is a seven-day residential personal growth experience where you are able to become aware of your family patterns of behavior that are playing out in your own life. You’ll learn techniques to calm down... Read More

Hoffman Process
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Hoffman Institute The headquarters of the Hoffman Process is located in Rafael, CA. They offer the process in the US in two locations–one in California and the other in Massachusetts. There are thirteen centers around... Read More

Stage 5 – Decision Making

Never Too Late for Hope
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This letter was sent to me by a woman that I have corresponded with a few times but I have never met or worked with. One of most powerful aspects of the DOC process is... Read More

The Surgical Scrap Heap
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Modern medicine has forgotten its foundational mission – to take care of you – all of you. The capacity to deliver high-level services for a given challenging situation is commendable and beyond reproach. Physicians’ commitment... Read More

Do You Really Need Spine Surgery?
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Do You Really Need Spine Surgery? Take Control with Advice from a Surgeon considers all factors affecting your perception of pain and organizes them into a treatment grid that allows you to make a good... Read More

Know Your Surgeon – Well
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When the DOC project began to evolve in 1999 it was my feeling that if there was a structural problem that it first needed to be dealt with surgically and then we could move ahead with the... Read More

Dashed Hopes
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Mainstream medicine is frequently not offering you effective care. Many procedures performed for spinal problems have been documented to be ineffective. Much of the problem stems from the corporatization of medicine where the interventions that... Read More

Avoids a Five-level Neck Fusion
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I received this email from a physical therapist on the East Coast, who I’ve never met. He’d heard about my work on a podcast. Before you read this letter, I’d like to emphasize that research... Read More

Prehab – Optimizing Surgical Outcomes
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“Prehab” is refers to a patient engaging in a rehabilitation process before surgery. There are well-documented factors that affect pain and surgical outcomes. It’s important to implement treatments to address all of them prior to... Read More

Eight-Level Spine Fusion? No!
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A seventy-three-year-old woman—let’s call her Dorothy for the sake of this story—was understandably apprehensive. She had just been told that she needed an eight-level spine fusion from her tenth thoracic vertebra to her pelvis, so... Read More

Surgery is the Definitive Solution?
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Ernie presented to me a few years ago with severe back and leg pain. He had undergone two spine fusions for LBP about 10 years earlier that had not been helpful. His three lowest vertebra... Read More

When will the Pain Stop?
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Mike is a local physical therapist who is a friend of mine. He has been interested in the DOC project and, like me, has struggled with severe chronic pain. I have been helping him work... Read More

Optimizing (Avoiding) Spine Surgery
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About three years ago my staff noticed that our surgical patients who participated in the DOC project principles were doing much better. The outcomes were better and we were having fewer failures. The postoperative pain... Read More

Are You Kidding Me?
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Patients and physicians are often making illogical decisions regarding spine surgery. I have watched this phenomenon steadily worsen for over 30 years,     To solve a problem in the mechanical realm you must specifically... Read More

Structural Sciatica Resolved Without Surgery
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When I published the first edition of my book, Back in Control: A Spine Surgeon’s Surgeon’s Roadmap Out of Chronic Pain in 2012, I was still of the mind set that if the correct pathology could be identified as the... Read More

“My Son Just Died”
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George was a 78 year-old businessman who acted and looked about half his age. He was pleasant and talked freely about his LBP and pain down the side of his left leg, which had been... Read More

Am I Operating on Your Pain or Anxiety?
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My surgical decision-making dramatically changed over the last five years of my practice. In spite of watching so many successes of people healing from chronic pain without surgery, I still had a surgical mindset and... Read More

“The Doctor is Missing Something”
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The Neurophysiologic Disorder (NPD) describes the body’s memorized response to stress and also what occurs when your body has sustained elevated levels of adrenaline, cortisol and histamines. There are many symptoms that disappear with the successful... Read More

My Call to Action
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Jean was a 48 year-old woman who came to me from a neighboring state for a second opinion. She filled out an extensive spine pain questionnaire, which included many questions about her quality of life,... Read More

Think Twice About Spinal Surgery
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Roy Carey, a well respected spinal surgeon in Melbourne created this video highlighting the decision-making about undergoing spine surgery. It helped reduce the frequency of spinal surgery in Victoria, New Zealand.   Related posts: Indications... Read More

How Many More Neck Surgeries?
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One middle-aged patient sought me out in Seattle from the East Coast for a second opinion regarding his neck. He had been disabled since 2001 with chronic pain over most of his body. He had at... Read More

Video: I Can Only Fix What I Can See
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I discuss the cultural belief system about spine surgery and it’s impact on the treatment for chronic pain. It took me years to understand that performing fusions for LBP is based on unsubstantiated belief rather... Read More

Anger Altering Surgical Decision
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Imagine your life before the pain. Stop and visualize a day or period back then when you were just plain angry. What kind of a day was it? It wasn’t great. Now add the pain... Read More

My Early Surgical Philosophy
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I started my practice in Seattle in 1986.  I was feeling pretty beat up from my spine training. I felt well-trained and began to perform fusions for LBP with a zeal. It was what I... Read More

Stage 6 – Procedures

Posterior Lumbar Fusion
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Video animation of a lumbar fusion The purpose of this letter is to explain what is involved when a posterior fusion is performed on your lower back.  We have found that the more knowledgeable the... Read More

Lumbar Laminectomy/Laminotomy
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Print this letter Laminectomy: Video animation Laminotomy: Illustrations What is a laminae? The spinal column consists of vertebra and disc as the front part of the spine, the spinal canal which contains the dural sac... Read More

Lumbar Microdiscectomy
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Print this letter Video animation: Microdiscectomy The purpose of this letter is to explain the microdiscectomy procedure. A microdiscectomy is the removal of an intervertebral disc fragment next to a nerve in your lower back.... Read More

A New Life at 72
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Crystal is a woman from the southern part of Washington. When I first met her, she was over 70 years-old and lived on her own. She had severe spinal stenosis in her lumbar vertebrae at... Read More

My Low Back Surgery–and Infection
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I started my working life as a carpenter at age fourteen. I worked every summer and vacation doing residential construction. I did everything from heavy concrete slab work to finish interior work. The summer before... Read More

 

Expressive Arts Gallery

Emotional Turmoil
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A great life isn’t just about waiting for the storm to pass, It’s about learning to dance in the rain. Related posts: Physical versus Emotional Pain Read More

Somatic energy
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I am a Registered Art Therapist in Victoria, BC. My husband is your big fan and introduced me to your website. I wanted to send this image that I created using colors and symbols to... Read More

With or Without
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Without or With Without desire I die Without touch I die Without conversation I die Without inspiration I die Without passion I die Without worthiness I die Without listening I die Without song I die... Read More

“Compassion”
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As I grow through my journey of coming to peace with chronic pain, I see the need for deep self compassion. So this painting depicts a woman connecting her belly to her heart, bringing awareness... Read More

Autumn Leaves
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I find such tranquility in nature & creating these hidden lid gourd containers helps me feel that I am in harmony with my universe. Gourds are a living medium, and when I am touching &... Read More

Love
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I made this doodle at the beginning of quarantine. As a social person, it’s been hard to be isolated from those that I LOVE. I’ve realized that there is no way we can do this... Read More

A selection from my mask project
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The range of expressions tell the story. The wall in the studio is from 1972-72. They are collage friends. The found objects are photographed uncleaned or retouched just as they “spoke” to me. The blue... Read More

The Lone Ranger
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My Mask project is part of my fie art practice that began around 1970 and continues today. The series includes found objects that “speak to me” and numerous collage works. They are friends, protectors, moods,... Read More

Six Feet Apart
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“Six Feet Apart” Oil 9×12″ Currently in literal terms, this is the kind of mask that has center stage right now. When the pandemic began I hadn’t painted for quite a while. But through expressive... Read More

The Cellist
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When I saw this man playing on the street so he could make some money, I saw the expression on his face. He was in his own world and not only enjoying his music, but... Read More

Lost and Found
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I keep coming back to this idea that there are two sides to every coin. In this time of global pandemic, masks hold a duality of both safety and fear. I’m now used to wearing a... Read More

Caught in a Swirl of Change
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This mask represents the feeling of being separated from normal life. The Coronavirus has caused the government to close my studio/gallery in Pt Reyes. I now find my life cast adrift, in a constant state... Read More

Florentine Mosaic
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Mosaico Fiorentino Fragments like colored glass Segmented memories Names of streets Distant ricordi In a flash my thoughts translate into Florentine tongue Connecting chards of glass like dots on a page my memory comes into... Read More

Me
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Becoming myself through Balinese masks, rhythm tap and rumba. (Click the mask to see the video.) No related posts. Read More

Stories of Hope

A Physician’s Story of Healing
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The solutions to breaking free from the grip of chronic pain have become increasingly clear. The answers are coming from several different sources that include the research on patterns of brain activity, the role of... Read More

Freed by Persistence and Play
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I first met Mark at our 2017 three-day “Rewiring Your Brain” workshop at the Omega Institute in Rhinebeck, NY. He had flown in from the Netherlands. His main problem was chronic low back pain that... Read More

Never Too Late for Hope
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This letter was sent to me by a woman that I have corresponded with a few times but I have never met or worked with. One of most powerful aspects of the DOC process is... Read More