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 optimize your chances of surviving and then thriving. When your stresses overwhelm your coping capacity, your body will go into an “fight or flight” mode, and you’ll experience many different mental and physical symptoms created by this imbalance. Addressing only symptoms cannot, has not, and will not solve the burden of chronic disease.1 “Dynamic Healing” is a term that captures this approach.
The root cause of disease
Two aspects of this sequence determine the expression of symptoms. One is the magnitude and duration of your stresses (input), and the other is the reactivity of your nervous system. There are three possible outcomes (output) – safe, neutral, or threat. Living creatures are in the neutral zone most of the time and gravitate to safety whenever possible to rest and regenerate.
The perception of danger (threat) causes the nervous system to send signals to prepare for battle and wage it if necessary. The common term is, “fight or flight,” and your body’s response (activated) is intended to feel unpleasant enough (anxiety) to compel you to take action to resolve the situation. The goal is to remain in this agitated state for as short a time as possible. But what if you cannot solve the problem and you’re chronically fired up? Your body stimulates even more of a response to regain control, and you are hyperactivated (angry). Unpleasant sensory input progressively impacts your body at three levels.
- Illness/ Diseases
When the threat is short-lived your response will be appropriate to the situation and quickly disappears when it has passed or resolved. Almost every internal and external action of your body is automatically directing you in a manner, so you don’t feel many unpleasant sensations. It is called the nociceptive system. If you do sense danger, you are programmed to resolve it immediately. Examples are looking away from the sun, spitting out rancid food, pulling your bare foot back from hot pavement, frequently shifting in your chair to avoid skin breakdown, and avoiding predators.
When threats are prolonged, you will experience symptoms such as back pain, tension headaches, anxiety, poor appetite, nausea, urge to urinate, sexual dysfunction, burning sensations, skin rashes, dizziness, ringing in your ears, and insomnia. There are over 30 different physical and mental symptoms that can occur.2
When threats are sustained, you have a significant chance of becoming seriously ill or developing a disease. It is well-documented that chronic stress kills people and unfortunately the symptoms of an illness or disease also add to the threat load. This is particularly true in chronic pain.3
Dynamic Healing Overview
The nature of your body’s physiology under threat
Environmental cues of threat set off a defensive response. Immediately, before you are even aware, your immune system girds for the possibility of injury by initiating inflammation (to protect cells against invaders (bacteria, viruses, cancer cells), elevates metabolism to provide fuel for defense, increases the speed of nerve conduction–which increases your alertness but also your pain sensitivity, and elevates the levels stress hormones (cortisol, adrenaline, noradrenaline, histamines). Much of this defensive state is modulated by small signaling proteins called inflammatory cytokines.
So how do you think you feel when you are in this physiological state? Your heart is racing, you are sweaty, tired, anxious, overwhelmed, nervous, stomach feels tight, blood pressure is elevated, pain is worse, and your breathing is rapid. The bottom line is that you don’t feel great when your body is in this heightened neurochemical state. Are these symptoms imaginary? Not a chance. None of them.
Examples of physical threats include viruses, bacteria, being attacked by a predator – human or animal, hunger, lack of shelter, poverty, lack of opportunity, being bullied at work or school, racism, authoritarianism, trapped in a difficult living or family situation, and physical maladies.
Mental threats are processed in a similar manner as physical ones with the same physiological response.4 They are more problematic in that humans have consciousness, many of our thoughts and emotions are unpleasant, and unlike visible threats like tigers or a severe storm, we cannot escape our thoughts. Repressed thoughts and emotions are even more impactable on your body’s neurochemical state. Many of our unpleasant thoughts are based on cognitive distortions or “stories” about our lives. Unfortunately, whether the threat is real or perceived it has the same deleterious effect.5
Systematically addressing the root cause – circumstances versus coping capacity
First, it is always important to undergo a medical workup to make sure there is not a structural issue such as vascular disease, pinched nerve, tumor, or an infection.
Second, regardless of the findings of the workup, maintaining your body’s metabolic, immune, and nervous system balance is important. If you require a procedure, your odds of a good outcome will be maximized.
Third, all three aspects of chronic illness must be addressed. Here are some examples of interventions for each one.
Input (what are you uploading into it and what are you holding onto?)
- Cognitive Behavioral Therapy
- Expressive writing
- Never discussing your pain or medical care
State of the nervous system (calm or hypervigilant)
- ACT (Acceptance Commitment Therapy)
- Processing prior trauma
Output (physiological profile – safe, neutral, threat)
- Breath work
- Mindfulness/ meditation
- Vagal stimulation
- Certain pitches of music
Finally, you must take charge of your own body and health. Chronic diseases are complex, and you are unique. You are the only one who can figure out a solution. The first step is understanding the nature of chronic disease. The solutions lie In implementing strategies that address the root cause of disease and lower inflammation,6 which destroys tissues throughout your body. It is more doable than you think. Not taking charge may have severe consequences.
Modern medicine is continuing down the wrong road
Modern medicine is mainly addressing symptoms (output). This approach works well when there is an identifiable structural problem that can be fixed. But the vast majority chronic illnesses/ diseases result from being in a prolonged fight of flight state and structural approaches cannot and do not work. The burden of chronic disease continues to rise without an end in sight.1 Why do we continue to travel down the same road?
The tragedy is that It is an eminently solvable problem at a fraction of the risk and cost. There is deep data revealing the common neurophysiological nature of chronic mental and physical diseases. Most of modern medicine is ignoring it.7 A significant percent of interventions have no supporting data. Integrative medicine and similar approaches are much better at systematically addressing the dynamic interaction between a person and his or her circumstances. Treating symptoms is necessary but won’t definitively heal you. The more accurate term for current “mainstream medicine” is “disintegrative medicine.”
Dynamic Healing Medicine
Dynamic healing medicine requires listening and knowing you. Feeling safe positively affects your neurochemical profile.6 It is important to understand both your circumstances (input) and your coping skills (nervous system resilience) to develop a healing relationship with your provider.
We are launching a movement, “Dynamic Healing.” Every weekday morning at 7 am PT, Dr. Les Aria, an experienced pain psychologist and I hold a 10-minute session called, “Dynamic Healing Moments”, discussing various aspects of chronic mental and physical disease. You can find it on Facebook at “drdavidhanscom.”
My book, Back in Control: A Surgeon’s Roadmap Out of Chronic Pain,7 provides a foundation and framework to understand and implement your own solution to chronic illness.
The DOC Journey is a program that reflects updated neuroscience research and includes a guided course, video tutorials, webinars, and access to supportive group sessions. We have been delighted that we have been able to provide clearer explanations for chronic mental and physical pain and allow patients to more quickly find their way out of The Abyss.
Join us in bringing Dynamic Healing into mainstream awareness.
- O’Neill Hayes, Tara, and Serena Gillian. Chronic disease in the United State: A worsening health and economic crisis. Americaactionforium.org; September 10th, 2020.
- Schubiner H and M Betzold. Unlearn Your Pain, 3rdMind Body Publishing, Pleasant Ridge, MI, 2016.
- Smyth J, et al. Stress and disease: A structural and functional analysis. Social and Personality Psychology Compass (2013);7/4:217-227. 10.1111/spc3.12020
- Eisenberger NI, et al. An experimental study of shared sensitivity to physical pain and social rejection. Pain (2006);126:132-138.
- Burns, David. Feeling Good. Harper Collins, New York, NY, 1980.
- Porges, Stephen. The Pocket Guide to the Polyvagal Theory: The Transformative Power of Feeling Safe. Norton and Co, New York, NY, 2017.
- Hanscom, David. Back in Control: A Surgeon’s Roadmap Out of Chronic Pain. Vertus Press, Seattle, WA. 2016.