The Ultimate Victim Role – Perfectionism
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Objectives Perfectionism is felt by many of us to be a virtue. It is reflected in terms of, “high standards,” “excellent quality,” and “strong work ethic.” It is actually a disguised version of anger directed at yourself. These ideas actually become translated our minds as, “not good enough,” “imposter syndrome,” … Read More

The Impact of Anger on Your Life – and Pain
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Objectives Most patients in chronic pain are frustrated and angry, whether they recognize it or not. Why wouldn’t they be? They are trapped by unpleasant sensory input. Unresolved anxiety is the driving force behind anger. Anger is your body’s concerted neurochemical last ditch effort to regain control. Being chronically angry … Read More

The Gift of Anxiety – Your Bodyguard or Prison Guard?
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Objectives: Since the body’s response to threats affects every cell in your body, it feels like part of who you are. We spend a lot of time attempting to avoid this intentionally unpleasant sensation when it is necessary for life and also overpowering. We are trapped in life by our … Read More

“The Curse of Consciousness” – Trapped by Your Thoughts
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Objectives: Unpleasant thoughts are impossible to avoid and can significantly impact your quality of life. They are a “neurological trick” created by your unconscious brain. They are not subject to rational interventions. The root cause of the problem is the human need for mental control. It sets off two different … Read More

Anxiety is the  Pain
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Objectives: Anxiety is the sensation generated when you feel unsafe, and your body’s chemistry is stimulated into a fight or flight state. It is physiological state and not primarily a psychological one. It is not subject to rational control. Anxiety indicates danger and is the pain. It is intended to … Read More

Mortal Combat – These People are Hurting Each Other
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In The DOC Journey, we have observed that the “shortcut” to healing is letting go of anger. You are then able to place your attention on what you want and your brain through the process of neuroplasticity, will respond with structural changes. You brain will develop wherever you place your … Read More

Solving/ Preventing Chronic Disease – Mental and Physical
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Objectives: Understanding the nature of chronic disease and the principles behind the solutions, allows you to fully engage in your care. Characteristics that keep us alive are what also create disease states. Chronic pain is a neurological diagnosis that has profound effects on your body’s physiological state. Existing in flight … Read More

Taking Control – The Eye of the Storm
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Objectives: It is a common perception that if we could manage our stresses better, we’d have a better life. That is true on one level, except that the stresses that are the most damaging are the ones we can’t control. Ongoing exposure to threats creates an adverse physiology that is … Read More

Stay Out of the Surgical Scrap Heap
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Objectives: Although there is no question about the dedication of physicians to providing excellent care, the rigors of training, the demands of practice, and the business of medicine have made it increasingly difficult to treat you – a person. A major factor is doctors are not allowed the time it … Read More

My Descent Into The Abyss
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Objectives There are many different physical and mental symptoms that are possible when you are in sustained flight or fight physiology. At my lowest point, I was experiencing 17 of them. No one could tell me what was happening despite seeing many physicians. I suffered for over 15 years. The … Read More

Dynamic Healing
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A new, data-based dynamic approach is needed for medicine to successfully deal with our epidemic of chronic disease. It must acknowledge the interaction between circumstances and your body’s capacity to process them, which determines the makeup of your body’s neurochemistry. Hormones and signaling cells create mental and physical reactions to … Read More

Stress Kills – Threat versus Safety
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Lesson Objectives Consider ongoing environmental input separately from your body’s responses. Understand the essence of illness/ disease is sustained exposure to real or perceived threats. It creates an adverse chemical profile that increases metabolism (your rate of fuel consumption) and causes inflammation. Your tissues will be physically damaged over time. … Read More

Experiencing Safety: Solving Chronic Pain: An Immersive Weekend Retreat
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We are holding a weekend retreat on May 21-23, 2021 based on our past experiences at the Omega institute in Rhinebeck, NY and Talaris in Seattle, WA. These workshops continue to be the highlight of The DOC Journey experience for us. This will be a virtual workshop with a special … Read More

The Bidirectional Interaction between Resilience and Your Immune System
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This blog is based on a review paper written by Dr. Robert Dantzer that discusses how resilience and immunity influence each other. (1) It is a bi-directional relationship in that poor adaptive skills stimulate the immune system; and a fired up immune system makes it harder to deal with stress. … Read More

Let’s Start Now and Learn the Details Later
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Lesson Objectives There is deep basic science research that has revealed the nature of chronic pain and this understanding will allow you to discover your version of a solution. The essence of the problem is sustained exposure to threat and the core of the solution lies in finding safety. Create … Read More

Anger and Illness–Cause and Effect
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Tom’s original story was one that I never thought was possible. He recounts his journey of undergoing 28 surgeries over 22 years in this blog. His is among many stories that has shown me that the body has a powerful capacity to heal if we can just get out of … Read More

The Myth of MUS (Medically Unexplained Symptoms) – It’s MES
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There is a deadly diagnosis that has evolved and become increasingly embedded in chronic pain terminology – Medically Unexplained Symptoms (MUS). (1) It means that you are suffering with symptoms, but we physicians don’t know the cause. Therefore, the solution is unclear, and you are going to have to do … Read More

Shadows Dancing in the Fire
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  Dancing through the ring of fire.                           Dancing through the ring of fire.  

Become a Genius at Not Feeling Pain
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I always wanted to play golf at a level where I could consistently shoot in the 70’s. I began to play when I was 14 but I never took lessons and didn’t practice much. Then in college I subscribed to Golf Digest and read about a dozen golf instruction books. … Read More

Directly Calming Your Body’s Threat Response
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Your capacity to enjoy your life, feel safe and content is dependent on your body’s neurochemical profile. When you are stressed you don’t feel good. There are methods to regulate your body’s stress reaction and inflammatory response. The gift of life Every living creature, from one-celled organisms to mammals, have … Read More

Principles of Solving Chronic Pain
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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 … Read More

“Anger Academy”
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The only way to stop the anger connected with chronic pain from dominating your life is to look at it with an unflinching eye and separately examine its three aspects: 1) output–final reaction 2) the nervous system–processing mechanism 3) input–the fuel. Defining the parameters It is most desirable on a … Read More

Three Aspects of Processing Anger
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This aspect of The DOC (Direct your Own Care) Journey is by far and away the most critical leg. I hear a similar story over and over and over again, “”Who would have thought it was the anger?”, or “I didn’t realize I was so angry.” Then it is inspiring … Read More

Plan A–Lowering Inflammation Lengthens Life
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The COVID-19 virus is a member of the Corona virus family that usually just causes the common cold. The problem is that we now have a strain that is potentially fatal. However, there are some strong hints of how to survive it and it revolves around learning strategies to regulate … Read More

Essence of Illness
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The burden of chronic disease is crushing us while we have the answers right in front of us. A recent summary reported that the total cost of chronic disease in the US is 3.7 trillion dollars a year, which is approximately 19.6 percent of the country’s gross domestic product. (1) … Read More

Navigating the Entire Circle of Your Life
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The DOC (Direct your Own Care) Journey is a collection of resources that reflect the ones many people have used to escape from the grip of chronic mental and physical pain, It includes: A guided course of six legs and rest stops Video tutuorials Webinars Weekly group Q&A sessions Weekly … Read More

Negative Messages to Your Brain
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I spent a day with Bruce Lipton, a cell biologist and author of a best-selling book, The Biology of Belief. One of his major points regarding the function of the nervous system is that 95% of our nervous system is functioning from the unconscious aspect of it and only 5% … Read More

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 Gift that Nobody Wants. (1) I knew him personally and he was as gracious a … Read More

The Need to be Vulnerable and the Irony of It
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There is no reward for being vulnerable for any species of life from one-celled organisms to homo sapiens. Consequences are severe and often swift. On the other hand, it is necessary to create space to experience safety and regenerate. Creatures exposed to sustained threat do not thrive or live as … Read More

People – The Most Powerful Part of The DOC Journey
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It has become apparent that one of the most important factors in people moving away from their pain is our weekly Question and Answer sessions that we hold every Tuesday and Thursday at noon Pacific Time. We have about 25-35 participants in each session and most are present on both … 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 the autonomic nervous system, fluctuations in inflammatory markers, changes in metabolism, and the collective experience … Read More

Clarifying the New IASP Definition of Chronic Pain
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The International Association for the Study of Pain (IASP) is highly regarded international society committed to research and education about pain. It was founded by one of the most prominent pioneers in pain, Dr. John Bonica. Conceptualizing pain What is pain? We toss the word around a lot without really … Read More

Forgiveness–The Continental Divide of Freedom and Hell
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There is an intense relationship between anxiety and anger. Understanding this interaction is one of the most important concepts that will have a major impact in calming down your nervous system. They are, first of all, the same entity. Anxiety is the sensation generated by your autonomic nervous system’s response … Read More

The Guided 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 solutions to such a multi-layered problem can’t be and isn’t effective. Through many years of … Read More

Bullying is Assault and Should be treated as Such
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There are serious mental and physical consequences from being bullied. What would be the outcome of a scenario where a stranger or acquaintance walked up to you and began to call you names and shove you. Maybe they even hit you? What would you do? You would call the authorities … 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 to seek reward to allow the body to regenerate and propagate the species. Humans at … Read More

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.

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, and intracellular connections are formed and destroyed. These changes occur based on blood flow, metabolism … 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 foundation for moving forward with your life. There are four patterns of awareness that work … Read More

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 you will by instinct lay your fingers in the earth, find its root, and set … Read More

“Play 20” – Create Your Life at Any Age
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Maurice is someone who I recently met and immediately was intrigued by his demeanor and outlook. My wife and I recently spent a few hours with him and his partner and had a wonderful afternoon. I was aware of his skills as an artist but had not understood that he … 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 “switch” has to be on in order to feel it. Acute pain is protective and … 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 tissue destruction. To solve the problem, every aspect of it must be systematically and simultaneously … 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 expressive somatic energy.

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 he had experienced for over 15 years that The workshop was based on Awareness, Hope, … 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 system is critical for survival and this inflammatory process is supposed to destroy invaders and … Read More

Expanding Your Horizon–Your New Life
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The DOC process evolved from my own, mostly futile, attempts to both figure out how I fell off a cliff into the Abyss of pain within a matter of 10 minutes and then how to get back out. I tried everything, talked to anyone, had medical workups, and eventually gave … Read More

Thrive and Survive COVID-19: The Polyvagal Approach
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The main problem with the COVID-19 virus is not that we catch it, but that that it can kill you. There are two ways of stopping a deadly pandemic. One is through developing immunity, either by exposure to the virus or by inoculation with a vaccine. The other is 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 With connection I live With full acceptance I live With freedom to exude in open … 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 and kindness into the relationship with her body. In the glowing light of the setting … Read More

Is your Recreation “Wreck Creation?” 
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There is a basic dividing line in life that influences the development of your brain. Is your overall life outlook based on love or fear? For many of us that were raised in a less than nurturing environment, being afraid is the norm and dictates the way we respond to a … 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 & handling them I feel very connected to this organic plant. I dye the gourds with … Read More

28 Surgeries–”I elected to not be in pain”
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For many years, I thought that for many patients there was a point of no return because the sheer magnitude of both physical and emotional trauma. I particularly felt this way with people who had undergone many failed surgeries. I was wrong and continue to hear stories of healing in … 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 alone. We are relational beings after all…I’m hoping we can shift out of our paradigm … 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 face is one so a recent collage series and the wire piece was found in … 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, mirrors and walls… an expressive vocabulary of remembrance , metaphors and metamorphosis. Will post more … 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 that is simply a structure that presents well-established documented treatments. Once a person understands the … 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 writing & exploring emotions I decided to do a series of paintings documenting the unfamiliar … Read More

Wear A Mask!
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We have protected all our outside art as a reminder … This is serious!

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 passionate about sharing it with others. I have found music to be a wonderful pain … 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 business is that of marriage or being legally bound together defined by time. It is … 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 mask when out in public, but the metaphor is not lost upon me. 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 of seeking balance in a world pandemic crisis. I may look calm in the outside, … 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 focus An old mosaic completes itself Myself As I stay with the names new memories … Read More

Me
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Becoming myself through Balinese masks, rhythm tap and rumba. (Click the mask to see the video.)

What Makes Your Book Different?
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This is a followup letter from a woman who emailed me about four years ago. I had never met her and she shared a remarkable story of recovery. Her story is one that has led me to believe that essentially anyone can learn to rewire their brain around any pain … Read More

Your Home–Oak Tree or Military Barrack
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One of the most  basic human needs in addition to survival is to feel safe. Of course, the two go hand-in-hand. But how often in our lives do we really feel safe? Feeling safe There are many benefits of feeling safe and secure, with the first one being your body’s … 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 over 20,000 people over the age of 18.  They found that over 50% of Americans … Read More

Moving Forward by Being with her Anxiety
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Lisa is a 58 year old high-level professional who developed chronic neck pain about 5 years ago. It began around the time she was facing some major career challenges. The pain became severe enough that she couldn’t work. She came across the DOC project a couple of years ago, and … Read More

Forgiveness is a Learned Skill–and a Power Move
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Forgiveness is both a learned skill and an ongoing daily process without a beginning or end. It is a statement that you are going to live your life on your terms, and no one person or situation is going to take that away from you. It is the tipping point of … Read More

Beyond Forgiveness–Compassion for Those Who Hurt You
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Ongoing anger is an absolute block to moving forward and living a truly enjoyable life. You are stuck to past. As anger is a reflection of higher elevations of stress hormones, sustained levels of them will also make you sick. The list of stress-related diseases is long and they are serious. … Read More

Meditation versus Medicating for Life
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This is a letter from someone who I have never met. I would encourage you to read it carefully for several reasons. The first being that this is a person who was been beaten up badly by the medical system and somehow emerged out the other side doing better. Anything … Read More

“Un-screwed”–Yoga Healing Back Pain
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This is a piece submitted by a reader, who has done well. It illustrates several aspects of the healing journey. The structure presented by the DOC process is a framework that organizes your thinking so you are able to discover your own solution. Everyone is unique and finds his or … 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 life span is shortened by seven years (1) Increased heart disease (2) Depression/ anxiety/suicide Autoimmune … 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. But more surprising to me was that not only would they improve, many would experience … 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 of my annual spine society meetings, I became involved in a conversation with three colleagues … 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, the journey out of suffering is always enhanced by a coach who can help you … Read More

The Gift of Hope – “This Might Hurt”
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One of the worst aspects of being trapped in chronic pain is losing hope. No one can give you a diagnosis or explain why you are so miserable, multiple ineffective treatments are failing to provide lasting relief, you are being bounced around the medical system, the pain is often unbearable … 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 from the environment through each body sensor and analyzing it every millisecond. All of the … 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 include: Body image disorders Eating disorders Crohn’s Disease and Ulcerative Colitis Irritable Bowel and Spastic … 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 as cortisol, adrenaline and histamines. It is the essence of your body’s neurochemical unconscious survival … 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 decision regarding having spine surgery. Spine surgery is out of control. I am not against … 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 the drop of water is inherently painless, it eventually is perceived by the poor prisoner … 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 want it to look like. As you pursue your vision, your nervous system will respond … Read More

Trapped – I Know How Gulliver Must Have Felt
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I have been organizing an annual guy’s ski trip for over 30 years. Anywhere from 20-30 of us head to the Peruvian Lodge located at the base of the Alta Ski Resort in Utah. This year (2019), we had 30 people, with several fathers bringing their sons who are in … 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 histamines you are on high alert and you’ll feel agitated and anxious. When this state … Read More

My Cat has Irritable Bowel Syndrome?
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We have a cat, Sophia, who is remarkably attached to my wife. She may pay some attention to me when my wife isn’t around. She rolls over multiple times when my wife comes home. She will come on command to lie on my wife’s chest when we are watching TV. … 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 to bring the DOC (Direct your Own Care) principles into mainstream consciousness. It has become … 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. If this describes your experience with the holidays, then this article is for you. I’ll … 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 an enraged state of mind, you’ll do whatever it takes to take care of yourself. … 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 Cortisol – mobilizes energy stores/ inflammation Histamines – immune system/ inflammation Endorphins – modulates the … 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 those close to them. Conversely, the family is often worn out from being around someone … 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 while vacationing in Florence, Italy. Many of the cobblestone streets are narrow and the sidewalks … Read More

Spastic Bladder Resolved – Being with Anger
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This is a letter I recently received from a young woman with interstitial cystitis or spastic bladder. It is a common condition that creates a lot of misery. I don’t have much experience treating patients with this problem, but it’s felt to be one of the symptoms of the Neurophysiologic … 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 rest of the protocols. I define a structural problem as one that can be identified … 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 it was my baseline environment, I didn’t define it as anger. I didn’t enjoy the … 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 it involves recognizing that what drives most people to use opioids is mental pain and … Read More

Learn Another Language – “An Enjoyable Life”
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    To master a new language requires a focused commitment for an extended period of time. Say you wanted to become fluent in French. It would take years of reading books, attending classes, listening to audio tapes and probably immersing yourself in the culture for a period of time. … 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. We always have a wonderful time and it’s remarkable how we still think we all … Read More

Avoided a 12-hour Spine Fusion and is Free from Chronic Pain
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Mark Owens’ Story This is a video that we shot of Mark Owens, who wrote the Forward of my book. I’d like to give you some additional background to his story, both from his and my perspective. He is a PhD scientist who has spent his life addressing environmental issues. … 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 have been proven to be effective, such as ACT (acceptance commitment therapy) (1), mindfulness-based stress … 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 money,  a happier family, better athletic skills and the list was endless. In retrospect, it’s … Read More

How I Cured my Migraine Headaches
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Migraine headaches are brutal and often incapacitating. They are also one of the symptoms of a chronically stressed nervous system. Adrenaline decreases the blood supply to the frontal lobe of the brain and when you relax the vessels re-expand and then you have a screaming headache. Often it’s accompanied the … 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 solve it that I’ve seen in my lifetime. Maybe one of the reasons is 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 has documented for decades that arthritis, bone spurs, disc degeneration, disc bulges and herniations are … Read More

Listen to Your Family–No Advice or Criticism
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“I am asking you to not give ANY advice to any member of your family for the next month and hopefully indefinitely; especially your children.” This is the foundation of creating functional family dynamic, especially with those dealing with chronic pain. Chronic pain takes a terrible toll on families. People … Read More

Darkness – “The Abyss”
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Objectives: Appreciating the depth of suffering experienced when trapped by chronic mental or physical pain is an important early awareness that will allow you to begin to move forward. You feel extremely isolated but everyone in this hole is also suffering badly. You are not alone. The factors that make … 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 pulling me out of tailspin into The Abyss of pain. I wanted to meet him … Read More

Chronic Neck Pain Gone – DOC Prevents Relapse
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This story is from a woman, who I met at our first Omega workshop in 2013. I was holding the workshop with Dr. Fred Luskin, who is a Stanford psychologist and author of Forgive for Good and also my wife, Babs Yohai, who is a professional dancer and taught rhythm to the … 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 create a structured safe environment where you can connect to your capacity to heal through … Read More

 “Our envy of others devours us most of all”
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What about the main thing in life, all its riddles? If you want, I’ll spell it out for you right now. Do not pursue what is illusionary – property and position: all that is gained at the expense of your nerves decade after decade, and is confiscated in one fell … Read More

Positive Thinking vs. Real-time Reprogramming
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This email was sent to me by a person that I have never met. A high percent of people find relief on their own with the medical system becoming a resource instead of a place to fixed. This letter illustrates a problem that created my original suffering–positive thinking. It seemed … Read More

Using New Tools to Reclaim My Life
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    Beginning in 2003, I suffered low back pain in the L4-5 region. I saw a chiropractor from time to time but in 2009 my treatments began to be on a regular basis and he advised that as long as I stayed at my current desk job and it … Read More

Why are New Year’s Resolutions So Hard to Keep?
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  Each new year, many of us spend time figuring out how we’ll make it better and also to really complete some projects that we have been putting off, maybe for decades. Few of us are able to accomplish a fraction of what we envision. Why? It’s because our unconscious … Read More

A Little Merrier Christmas – Letting Go of Blame
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People trigger each other and the closer the relationship, the stronger the reactions. When you become anxious or frustrated, you’re in a survival mode that’s impossible to control. It’s ironic that our most important relationships are also often a source of frustration. You can undergo many medical treatments for your … Read More

From Would Like to Should – The Unenforceable Rules
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I was asking a friend of mine about what I could write about this week. He suggested, “What about resentment?” I hadn’t thought about this for a while but it’s a significant problem that does wear us down. Should There are many reasons for resentment. I think the essence of … Read More

Healing Begins at Home – The DOC Journey Starting Point
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The DOC Journey began to evolve in 2003, as I emerged from my own 15-year struggle with chronic pain. It took me a long time to figure out how I ended up being in this state and even longer to understand what had allowed me to escape. Then I was … 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 musical about the Motown group, The Temptations, and finally a movie, The Florida Project. I … Read More

Life Sentence
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  After my fourth L3-L4 surgery the neurosurgeon sat me down and said “…you are not going to get better but rather worse as you grow older. You have a life sentence of pain.” I’ve had 6 spinal surgeries and 20 additional surgeries. I know chronic pain intimately. After 25 … 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 undergoing a procedure with significant risks. Chronic pain infiltrates every aspect of life. You have … Read More

Romanticizing Pirates – Normalizing Suffering and Abuse
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Each year we return to Italy to spend time with some of our close friends. My wife lived there for seven years and is fluent in Italian. For me, it is a wonderful experience, as we get to enjoy Italian culture at the ground level. One trip was to the … 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 are upset they show it. They are completely connected to what is right in front … 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 supporting them in their new venture together was electric. Their commitment to each other was … Read More

The Impact of Mirror Neurons on Your Family
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It is becoming increasingly clear that chronic pain has a tremendous impact on your immediate family. One of the more direct ways is through mirror neurons. I frequently tell my patients that when you smile at a baby the reason the baby smiles back is not because the baby is … Read More

Chronic Pain is Solvable -Take Back Your Life
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It has been my observation that suffering from chronic pain affects almost every aspect of your life, especially trying to enjoy yourself. Every enjoyable experience is lessened in the context of pain. You may be able to successfully distract yourself for a bit and not even experience the pain, but … 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 five would be the beginning of a lifetime filled with chronic pain. I eventually experienced … 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 will play off of each other and you can spiral downward quickly. Loneliness There is … Read More

Comprehending the Downside of Spine Surgery
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Deciding whether to undergo spine surgery is one of the most important choices you will ever make. Currently, failed spine surgery is so common there is even a separate diagnosis for it – “Failed Back Surgery Syndrome.” You do not want to become one of these people, as it usually … 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, this process allows you to separate from them. The reason to destroy them is be … Read More

It is Becoming Harder to Make a Living as a Surgeon………
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In late March this year I received this email from an educator in the South. I don’t recall how he found me. Dear Dr. Hanscom, Is there a doctor or clinic in the Nashville, TN area that you would recommend? I have ordered your book and look forward to the … 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 often end up acting in ways that they would not tolerate in their children. How … 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 this conditioning is well-intentioned, it can wreak havoc in our lives. It is only about … Read More

Omega 2017: Awareness, Hope, Forgiveness and Play
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I will be holding a weekend workshop this July at the Omega Institute in Rhinebeck, NY. This will be my fourth workshop at Omega. The results have been overwhelmingly satisfying. As in the past, joining me will be my wife, Babs Yohai, who is a professional dancer; and my daughter … Read More

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 patient, the more successful the surgical outcome.  Patients undergoing this procedure most commonly ask the … 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 back pain–at least in my case. After following the physiological recommendations and taking the various … 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 she came to me for a second opinion. Dorothy was a retired National Guard armed … 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 others. So, when we judge people around us—either positively or negatively—we are projecting aspects of … 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 forward and immediately began using the ‘expressive writing.’ You take paper and pen/pencil and write, … Read More

OCD is No Fun and Not Funny – Extreme Mental Pain
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Neil Hilborn – “OCD” Obsessive Compulsive Disorder (OCD) is an extreme of form of anxiety. It is characterized by a relentless assault of unwelcome intrusive thoughts. I suffered from OCD for several decades well before I knew what OCD meant. The beginning My anxiety became disruptive one night in 1990 … 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 reason is that partners of chronic pain patients also experience suffering—they have their own broken … 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 my daughter, Jasmine Yohai-Rifkin who is an expressive arts therapist. The tightly-structured seminar is based … 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 last couple of years, I have seen evidence that has made this notion clearer to … 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 and inflamed nervous system. The last five years were extreme. After trying almost everything, I had completely lost hope of ever regaining any … Read More

Compassion
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Compassion: Empathy in the Face of Chronic Pain Empathy is an inherent part of the human experience.     Being labeled as a “chronic pain patient” is one of the worst aspects of an already terrible problem. It’s impossible to be truly seen or heard if you are viewed in … 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 of it develop significant health problems. We will do almost anything to stay connected. It … 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 look at what part of the brain lights up in response to sensory input. Pain … Read More

Harnessing the Body’s Healing Power
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The most powerful treatment for any disorder is engaging in practices that calm your nervous system and allows your body to heal itself. Each person has his or her unique way of accomplishing this. I was introduced to this concept in the 1980’s by Dr. Bernie Siegel’s book, Love, Medicine … 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 I did not dream possible. The article talked about about the Quintuple Anvil Triathlon held … 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 to control and manipulate our environment to our advantage. Human consciousness is a recent development. … 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 to colleagues around the world, it is clear that it an international problem. So whatever … 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 through the French Quarter, our guide pointed out that it was not until 1890 that … 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 terms have included Stress Illness Syndrome, Psychosomatic Disorders, Central Sensitization Syndrome (CSS), and Mind Body … 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 your body chemistry changes when you are in an arousal state. Your senses are heightened … 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 affect your perception of pain: Sensitization Memorization The “Modifiers” –1) anxiety 2) anger 3) sleep … 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 terms have included Stress Illness Syndrome Psychosomatic Disorders Central Sensitization Syndrome (CSS) Mind Body Syndrome … 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 Journey is not to get rid of your pain. In fact, there is no goal at all. There is no beginning or end to it. The only intention … 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 cause of the symptoms could not be found. I gave a talk at a high … 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 work on the DOC process. After about a year of working diligently through the tools, … 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 thanks for the opportunity to help so many patients during the week, be grateful for … 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 organize your thinking around these age-old concepts. Awareness You cannot successfully address any problem without … 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 with your life with or without your pain. If you are waiting for your pain … 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 experience and observing the successes with my patients. A great deal of new neuroscience research … 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 levels and ways of doing this. Some of them include: Forgiveness – is a selfish … Read More

Systematic Approach to Sleep
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Objectives: Adequate sleep is a necessary requirement for healing. Insomnia is a cause of chronic pain, and it is not the other way around. It is almost always possible to experience a consistently good night’s sleep using a combination of approaches. Do not undergo any major invasive interventions until you … Read More

Taking on the World’s Suffering
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Anger is a powerful force and intended to keep you safe. It is a basic reaction and necessary to stay alive. Every living creature exhibits some version of it. Humans are different only in they uniquely possess language and a consciousness. We have to navigate a whole different level of … Read More

The “Benefits” of Becoming Disabled
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I have always enjoyed hard work. I began working in heavy construction at age fourteen during the remodeling of our house. I fell in love with it and kept working at it for another 18 years. I poured concrete slabs, framed, did some finish work, plumbing, and spent three summers … Read More

Rigid Thinking – “Make America Great Again”
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Anxiety is the sensation created by elevated levels of stress hormones in response to a threat. It is intended to be unpleasant enough to compel you to take action to resolve the situation. We will do anything to avoid it. The expected and required response is to take control. However, … 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 psychological issue and is the mechanism that permits survival of any living creature. Species that … 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 safe and we largely depend on our society being reasonably civilized. We count on our … Read More

Stress and Getting Sick – Howard’s Golf Story
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For those of you who are golfers, you know that golf is a great metaphor for life. It is both challenging and social. I think the bonding is a result of such deeply shared suffering. What is fascinating is that it really is just a game. This is a story … 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 down and saw a remarkably cute five-year-old little girl with curly hair being stopped in … 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 addiction medicine. He and I had been in touch and I was helping him bring … 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 filled with fluid surrounding the spinal cord and nerves and the back part of the … 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. We have found that the more knowledgeable you are, the better you’ll be able to … 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 only will you think about it more, there is a trampoline effect and you will … 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 greatly magnified in that it has been shown that social rejection shares the same neurological … 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 had been fused from L4 to the sacrum. Additionally, he now had severe leg pain … Read More

Out of the Abyss After 25 Years
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I received this email from someone that I had never met. I’ve now gotten to know her and she is delightful. A physician had recommended my book and here is her story. A rough road I have read your book Back in Control many times (which I refer to as … 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 the brain structure in addition to causing it to physically shrink.(1) Having a chronically negative … Read More

Remarkable Healing Stories – Dr. Bernie Siegel
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I have had the distinct privilege of getting to know Dr. Bernie Siegel, who is a retired pediatric general surgeon and author of several books, including Love, Medicine and Miracles. He has looked extensively at the stories of patients who are survivors of advanced cancer and documenting common traits in … Read More

Fighting a Forest Fire – Address All Aspects of Your Pain
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Objectives: Chronic pain is a complex multi-organ disease. It is reason why there are so many different symptoms. It cannot be successfully solved with random simplistic treatments directed at just the symptoms. Addressing the root cause of stresses overwhelming your nervous system’s coping capacity requires a multi-pronged self-directed approach. It … Read More

Mental or physical health – Which is more Critical?
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I have been considering this question since I was eight years old. For some reason it was a subject that my father felt was important. It was his contention that mental health was more important. I have historically felt that physical health was the foundation of a productive life. Since … 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 think summarizes the problem of physicians not being adequately trained in chronic pain. Here is … 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 who were on a path to hell. His father was also incredibly critical of every … 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 of this ongoing interaction with the environment only when a given need is unmet. This … 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 is learned in school that we call, “socialization”. The First Day of School Every child … 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 through different strategies to pull out of it and he is slowly coming out of … 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 to flying into a rage. The circumstance may be real or perceived. Either way the … 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 seemed less and more easily controlled. Patients were moving forward quickly with rehab while re-entering … Read More

 Are You Kidding Me? – ILL Advised Spine Surgery
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Patients and physicians are frequently making illogical decisions regarding spine surgery. I have watched this phenomenon steadily worsen for over 30 years. One of the core problems is that there is little accountability. You would expect your surgeon to do everything he or she could do to optimize your chances … 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 is structured around education, hope, forgiveness, and play. It is based on the concepts presented … 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 taxi stand while three or four drivers took off ahead of him. He seemed slightly … 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 pain with the last seven being extreme. I was fortunate to work my way back … 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 threat and we can’t escape our thoughts. Emotional pain is processed in a similar manner … 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. The reason? Many of these patients are treated for acute pain, when they are really … Read More

The Enlightenment Light and Judgment Mirror
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I had a patient come into my office recently who represents one of the most remarkable turnarounds I have witnessed and she definitely has the record of being in pain for the longest time before she pulled out of it. She had been in pain for over 55 years when … 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 wife, Babs Yohai, who is a professional performer (tap dancer). We designed it to address … 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 it is becoming increasingly clear how devastating chronic pain is not only to the patient … 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 variables that are affecting your pain. Unless you are actively learning and using the tools … 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. She was anxious, depressed, and would barely lift her head to talk to me. The … Read More

Your Book is Bullshit – The Encompassing Power of Anger
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This is a recent post that was on my Back in Control Facebook site.  I was well-aware that I would be on the receiving end of this type of feedback before I published the book. I deal with variations of this energy weekly. An unhappy reader “Your book about back … Read More

Trapped for 18 Years from Scoliosis Surgery
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I first met Georgia when she was 15 years-old. She had undergone a fusion for adolescent scoliosis at another hospital. Her post-op pain was much worse than usual and nine months after the surgery she was still experiencing severe pain. Normally, pain from a fusion such as hers is gone … 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 are: It is a familiar pattern You are not aware or connected to your anger … 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 some mild degeneration at L4-5 and was not a problem that would respond to surgery. … 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 source of the pain, surgery was the best option and the sooner the better. Then … 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 a problem for about six months. It was consistently more severe with standing and walking, … Read More

Nick’s Winning Run – Off of the Hill
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My son, Nick, has been a competitive freestyle mogul skier since he was 14 years-old. He is an extraordinary athlete and within three years of beginning his skiing career he won the Duals event at Junior Nationals. He was focused, passionate and it appeared that he was well on his … 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 GI service. Diabetics don’t take their insulin and their sugars go out of control. Cardiac … Read More

“I’m Paying You to Inflict Pain??”
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  This is Scott, who is a personal trainer that I work out with on Tuesdays and Thursdays at 6 am. This is his picture at the gym one memorable Halloween. He’s a little unusual in that he laughs at us – the whole time we are working out. He pushes … Read More

The Gift of Pain – Thanksgiving 2013
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Pain, The Gift That Nobody Wants is a book written by an orthopedic hand surgeon, Paul Brand. Through his work in India with lepers he discovered that the reason why they had such severe hand, facial, and foot deformities was that the bacteria resided in sensory nerves and destroyed protective … 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 was always looking for a surgical lesion that I could “fix”. In the first edition … Read More

Never Give Up – Breaking Through After Six Years
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Terry was a middle-aged mother of two children whom I met many years ago. For reasons that are unclear, her spine just tipped forward in her lumbar area. She came into my office severely bent forward and tipped to the left side. She had understandably developed chronic pain over 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 of you really are. Being around your family usually will precipitate a massive resurgence of … 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 that centers around embedded family patterns. The initial download to your brain There are many … 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 pain, first your anxiety escalates and then you become angry. Your body is full of … 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 a statement of his time in the “Abyss.” I spend over eight years in darkness. … 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 on vacation in Italy. Florence My wife lived in Florence, Italy from 1983 to 1990. … Read More

My Migraines
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Fourth of July fireworks I was 5 years old and lived in a small town in New Hampshire. Our house was right across the street from the town common. I was so excited in that the fourth of July fireworks were going to be launched in the common within just … 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 direct the musculoskeletal and various organ systems to respond in specific ways to maximize your … 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 that it becomes a bigger problem after 12 months (1). The brain activity switches from … Read More

Thought Suppression and Chronic Pain – White Bears and ANTS
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  Trying not to think about something will cause you to think about it more. All of us know this phenomenon but we don’t know how to deal with it. The deadliest emotion we suppress is anxiety. It is a survival response and our whole being is repulsed by it. … 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 interviewed on a radio program and somehow the topic of tinnitus came up. The host … 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, however, this couldn’t be further from the truth: the pursuit of self-esteem is a destructive … Read More

STOMP – Structuring Your Own Management of Pain
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Structuring the Own Management of Your Pain (STOMP) is a program that was developed by Dr. Gordon Irving and his staff at the Swedish Medical Center Pain and Headache Center. They have a wonderful set of resources that has greatly enhanced my patient’s capacity to become pain free. They also … Read More

Avoid Surgery by Raising the Pain Threshold
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A friend of mine asked me for an opinion a couple of years ago about his back. I was giving him advice as a friend, not as a surgeon. He was having some pain and numbness down the side of his leg. It was down the distribution of his 5th … 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 taught about stress, anxiety, and frustration at an early age. A child has little control … Read More

Can Your Body Language Change Chronic Pain?
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Dr. Gordon Irving was in charge of Swedish Medical Center Chronic Pain Program for many years. His group has embraced the treatment principles of the Neurophysiologic Disorder (NPD. Although each of us have different tools and styles, the essence of our approaches is similar. One of them being you cannot … 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 treatment of NPD. Most of them are physical. The most difficult concept for many patients … 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 is one letter. What a difference a letter makes.  

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 that it was the discovery of this poem that ushered the human race out of … 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 to figure out what was going on and how I fit in. In the midst … Read More

Leg Pain Gone with NPD Principles-Carol’s Story
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Carol is one of my favorite patients and success stories. It is one that surprised both of us. Her turnaround occurred a while back but I wanted to make sure she was stable and ready to relate her experience. Background She is a middle-aged mother. She historically had been very … 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 years, combined with my refusal to heed adult advice. Protecting my ears was one of … 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 us forgiveness involves somewhat of an intellectual process and is focused on many small “wrongs”. … 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 very small, they train them to stay in one place by tying one foot to … 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 program was STOMP (Structuring Your Own Management of Pain). He and I co-edited this guide … 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 brain contains mirror neurons, which are cells that fire in response to the observation of … 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 success continues to be the writing exercises. I don’t know the reasons why it is … 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. Most orthopedic residents have had one or two years of general surgical training prior to … Read More

School or Prison-What’s the Difference? Bullying
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Bullying bothers me–a lot. When I was in middle school and high school, I was very fortunate in that I was not a target of bullying. However, I have watched dozens of friends and family come under attack from bullies. The results are often devastating. No part of bullying is … Read More

Charley’s Story: Pain Free After 17 Doctors
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This is a story of a middle-aged gentleman who became pain free using DOC Process principles. Although, he saw me primarily for back pain, it turned out that lack of sleep and anxiety were the more pressing issues. He had already seen 16 doctors in a span of eighteen months … 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 cleaned every six months until I got too busy and slid past a few visits. … 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 be caused by changes in the body’s chemistry because each organ system responds in its … 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 can no longer see the needs of those around you, much less respond to them. … Read More

“Many Italians Choose Suicide” – People Need to Work
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Few physicians have sufficient training in the nuances of occupational medicine, yet all of us have the capacity to completely remove a patient from the work force. It has been my observation that when a person is sitting at home, his or her pain usually worsens. Without the distractions of … 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. They may have even undergone multiple failed spine surgeries. Yet upon further, almost intrusive, questioning … 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 well as improve worker safety. Although workplace safety has dramatically improved since the early 1900’s, … 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. Her husband, who was sitting motionless across the room, could speak limited English, and there … 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

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 the people who have wronged you the most. This remarkable video was passed on to … Read More

“I Am Not Letting Yesterday Ruin Today”
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I had been working with Anne for a while and she had been experiencing chronic pain throughout her body for a many years. Her once productive life had fallen apart and she now depended on welfare for her sustenance. She had undergone a lumbar disc surgery a couple years earlier … 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 the cognitive revolution for Homo Sapiens occurred about 70,000 years ago with the advent of … Read More

Marsha’s Three Unnecessary Spine Surgeries
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Marsha was a 36 year-old businesswoman with two young children. She was referred to me by another patient and came to see me from the east coast. She had a spontaneous onset of back pain about eight years ago. Everything possible had been tried, but she continued to spiral downward … Read More

Neurophysiological Disorder -“Short Circuits”
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Dr. Howard Schubiner is board-certified in pediatrics, adolescent medicine, and internal medicine. He was a full time professor at Wayne State University for 18 years and now works at Providence Hospital in Southfield, MI. He is the founder of the Mind Body Clinic and the co-author of several of my … 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 health for a moment. Consider it not in terms of talk therapy but in terms … 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 no apparent escape. The stories I hear each day are mind-boggling. They include abuse, murder, … 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 seems plausible. A diagnostic test ought to be able to identify the source of intense … 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 fixed. You are Not a Machine “Pain-Generator” thinking takes the human body to be like … 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 it. He was a small town family doctor who routinely worked over a hundred hours … Read More

Ron Salvages His Own Spine Surgery
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A letter from a case manager Dear Dr. Hanscom: You may not receive these kinds of letters from nurse case managers very often. I thought I would advise you of the above captioned patient that you performed a redo L5-S1 microdiscectomy about a year ago.  Ron got quite discouraged when … Read More

Pain to Pleasure-Pavlov’s Dogs
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When I began to witness patients becoming pain free, I thought that it would happen only for patients with diffuse pain, such as neck or back pain. I felt that more focal symptoms like arm and leg pain would not respond as well. I was wrong. I now have many … 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 multiple levels. Stenosis is a condition where bone and ligaments grow around the spinal canal … 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 life at some point in time. The richness of this new life often exceeds anything … Read More

Everyone Needs Support
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Mental Health Every injured worker should have access to some level of mental health support. I work with a veteran pain psychologist who is wonderful. 90% of her practice is caring for my patients. If she feels it is necessary, she will refer a patient to one of several psychiatrists … 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. Maslow is best known for his conceptualization of “man’s hierarchy of needs.” This hierarchy is … 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.

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 anxious and stressful thoughts and behaviors. For more, see Your Demons are Robots. BF

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 really are. Being around your family usually will precipitate a massive resurgence of these patterns. … Read More

The “Five E’s” of Chronic Pain
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A few weeks ago, I sent the roundtable a short article I put together called “Ability and Motivation.”  These are the two key ingredients necessary to create true change. My point was that the current state of the worker’s comp system destroys both of these attributes.  The only logical choice … 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 thoughts on what constitutes insane behavior? Insanity is Doing the same thing Over and over … 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 flight response is ONLY about survival and that’s it.   REACTIVE CREATIVE If you can … 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 create new pathways around your embedded pain pathways. Part of the chronic pain experience is … 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 trying to suppress thoughts. I’ve talked about it before in White Bears and ANTS.   BF

“The Talent Code” – Forming Neurological Pathways
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All pain is “in your head.” Every pain impulse has to be interpreted by your brain as pleasant, neutral or unpleasant. It is a complex process that involves comparing present with past experiences. There are millions of bits of information being processed every second. Although your emotions do affect the … 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, in addition to a history and diagram of the pain. She was a healthy physically active … 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.  

Video 15/19: Anger Fueled Anxiety-“The Highway to Hell”
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I discuss how anger is the turbocharger that keeps anxiety both covered up and fired up. Until you turn off anger you won’t be able to get a handle on your anxiety or your pain.  

Template for Your “Personal Business Plan”
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About once every one to two years, I go through a process that helps me organize my thinking about my own life. It is the norm for most of us to run our lives by continually fixing problems. We not only get worn down, but we don’t have the pleasure … Read More

Video 14/19: Chronic Pain: Pain Free is Not Only Possible, it’s Probable.
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I talk about how powerful the DOCC Project can be and how it can break down the doors of years of chronic pain. Through patient’s stories, the DOCC project is showing that pain free is not only possible, it’s probable. For more on this, check out Reversing Chronic Pain with … 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 spine surgery never works and will relate stories to me about their friends, family, or … 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 situation.

Compassion and an Italian Dinner
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Compassion—First and foremost I am on a much-needed vacation this week in Italy.  From 1980 until 1990, my wife lived in Florence.  We have many friends in Italy we like to visit as much as we can.  It is a unique opportunity for me in that she is fluent in … 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 “E’s” are Empathy, Evaluation, Education, Encouragement and Engagement. For more on this, check out Sensitization … 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 least 10 additional NPD symptoms of burning, aching, stabbing, and tingling that would migrate throughout … Read More