Healing through Play – It is Safety Physiology

posted in: Recent, Stage 2, Stage 2: Step 6


  • Connecting with your sense of play is one of the most powerful ways of shifting your physiology from threat to safety.
  • Play circuits are also simply more pleasant.
  • Everyone has some level of play in their life, although for some, it is quite limited.
  • The interactions created while at play is one of the basic ways humans learn to cooperate with each other, including reading body language, interpreting tone of voice, and negotiating boundaries.
  • When suffering from chronic anxiety and other symptoms, play circuits are used less and don’t evolve.
  • Nurturing a sense of play and joy is a learned skill that requires thoughtful repetitions. These are not usually taught to us throughout our life experience,
  • The benefits of reconnecting with play are healing and have a significant impact on your health and quality of life.


This is the real secret of life –

to be completely engaged with what you are doing

in the here and now.

And instead of calling it work,

realize it is play.

~Alan W. Watts

Play is a physiological state that reflects a sense of safety. You cannot play or feel playful if you are in a survival mode. The essence of escaping from the grip of crippling anxiety is feeling safe. In this state your body is full of relaxing chemicals such as oxytocin (love/bonding drug), serotonin (antidepressant), GABA hormones (anti-anxiety), dopamine (rewards), and small anti-inflammatory proteins called cytokines. Your metabolic rate (fuel consumption) also drops, which allows your energy reserves to be replenished. This scenario not only creates a deep sense of well-being, but it is also healing.



The data regarding the devastating effects of chronic stress on your mental and physical health is extensive and deep. Prolonged exposure to the body’s neurochemical survival response predictably causes illness and disease and shortens life.1,2,3

Research also shows that cultivating optimism, having a sense of purpose, and feeling hopeful has the opposite effect. When people learned how to skillfully process their stress and nurture joy, they experienced an improvement in anxiety and many other symptoms.4 One paper had participants visualizing their best self for five minutes a day over a course of two weeks. They all noted significant improvements in anxiety.5


In our workshops, we discovered that shared play is a powerful force and most of the participants had a significant improvement in their anxiety and pain during the three or five – day events. It happened after people began to relax, share, let go, and laugh together. We initially didn’t understand reasons why people could shift so quickly after being so miserable for years. I now understand that anxiety reflects a sustained inflammatory state that also causes many other symptoms. Feeling connected to others in a relaxing environment stimulates the release of oxytocin. Oxytocin is a hormone that is critical for social bonding and is also powerfully anti-inflammatory. The participants felt safe in this setting and several people commented that they felt like they were in an “adult summer camp.”

Of course, when they returned home to their triggers, their anxiety and pain would reappear. But now they not only possessed new knowledge and tools, but they had reconnected to feeling playful, and relaxed. Many had not felt that way for years. Now they had a memory that they could return to and over time, and they became skilled at it. Years later, many have continued to thrive.

The basis of The DOC Journey is learning how to re-program your brain away from embedded anxiety circuits by stimulating neuroplastic changes in the brain. This requires repetition and eventually it becomes automatic. However, you can make this change happen even faster by shifting onto pre-existing play circuits.



All mammals have play as a part of their development. It is a multi-dimensional experience that processes many environmental cues and reactions are learned that are appropriate to the situation. Play is a core step in how we developed language and consciousness. Even if they feel deeply buried or almost non-existent, your play circuits are there, waiting to be accessed.6 Any skill that is not practiced will fade, but those neural circuits can be re-awakened.

As you use the playful part of your brain more and spend less time feeling anxious, your brain’s structure and neurological activity physically changes and grows . Conversely, when you experience chronic stress, your brain physically shrinks. Fortunately, as you heal and create more connections, it re-expands.7

I used to play trumpet in high school

An example of how this works is to consider a skill you had in middle or high school. Without practice, it has faded, but the memory is still there. I played trumpet in high school and a little bit in college as well. I could play reasonably well through medical school, but it all disappeared in the midst of the rigors of residencies and fellowships. I recently picked it back up, and although I have no lip strength or dexterity, I still remember the basic techniques and hope to re-connect with them quickly. It is doable, whereas if I were to try to learn a completely new instrument, it would take much longer.

My wife started playing the guitar again after a 30-year hiatus, and within a few weeks, was able to finger-pick like the old days. One day, it just all came back to her, and she  quickly progressed beyond where she left off.

The same is true for you – your play circuits are still there, waiting to be re-vitalized.

A deliberate decision

Many years ago, I was pondering my own journey out of The Abyss and considering some additional approaches. It hit me that the words “work” and “play” are somewhat arbitrary. I realized that my vacations were spent largely with trying to recover from the rigors of work. I didn’t have the energy to fully engage in enjoying my time off.

Much of the problem had to do with how I viewed work and my strong reactions in dealing with the challenges of being a spine surgeon. I decided that I would work on removing those labels from my life.

If I loved my work, and spent most of my waking hours doing it, why call it work? I decided to just embrace the whole experience. My entire team relaxed, and I enjoyed my patients, fellows, and colleagues a lot more. We had fun to the point where sometimes we would have to work on toning it down while we were in clinic.

At the same time, one of my mentors told me, “Challenges are an opportunity to practice your stress-coping skills and are part of any endeavor.” I began to embrace challenges head on and my reactions to stress dropped dramatically. By seeing problems as opportunities, I was both more effective and engaged with the difficult aspects of my job. This simple paradigm shift created a world of difference.



Play is a mindset

A word of caution – I am not referring to play as a way to distract yourself from your suffering. You can’t outrun your mind. Rather, it is mindset of curiosity, deep gratitude, listening, anticipation, awareness, and improving your skills to calm your nervous system. Nothing initially has to change in your life. My work environment was unchanged. It was my attitude that changed. I chose different words every day to reflect a sense of play. The result was a sense of contentment and peace.

Remember, nurturing joy is a learned skill along with processing  stress. You will eventually become an expert. At some tipping point, you’ll simply refuse to let people or situations ruin your day. You’ll also progress to being a source of peace and vitality. That is a long way from being trapped by anxiety and pain,

Recap – Moving forward

Play is one of the most effective ways to give your nervous system cues of safety. However, in the presence of relentless anxiety and pain, this probably seems impossible, and it is without effective tools and an approach that works well for you. You must simultaneously learn to de-energize anxiety and anger while nurturing safety.

Play to distract yourself from unpleasant feelings doesn’t work and is actually counterproductive. You cannot outrun your mind and your inflammatory markers go straight up. Conversely, living life with connection and purpose causes them to plummet.8

Choose play –  every day and watch your life transform.

Questions and considerations

  1. Have you noticed that much of your vacation is spent trying to recuperate from work? By viewing work as play, you may have more energy to enjoy your time off.
  2. You have heard the phrase, “don’t sweat the small stuff.” This is another way of letting go and simply enjoying your day.
  3. There are many ways to connect with play. They include deep gratitude, a sense of curiosity, cultivating a sense of humor, and consistently choosing joy as opposed to complaining or feeling like a victim. When where you taught to nurture these traits?
  4. As you continue to make these choices, your brain will begin to move in this direction automatically. Consider how much your brain is being programmed with negative self-talk and external messaging.
  5. Notice how your mood affects those close to you. A good mood is contagious because it directly stimulates a similar area of the other person’s brain through “mirror neurons.” Conversely, a negative mindset is also having a ripple effect.


  1. Tennant F. The physiologic effects of pain on the endocrine system. Pain Ther. 2013;2(2):75-86.
  2. Torrance N, Elliott AM, Lee AJ, Smith BH. Severe chronic pain is associated with increased 10-year mortality: a cohort record linkage study. Eur J Pain. 2010;14(4):380-386.
  3. Rahe R, et al. “Social stress and illness onset.” J Psychosomatic Research (1964); 8: 35.
  4. Hausmann, LRM, et al. Reduction of bodily pain in response to an online positive activities intervention. Jrn of Pain (2014); 15: 560-567.
  5. Meevissen,YMC, et al. Become more optimistic by imagining a best possible self: Effects of a two-week intervention. Jrn of Behavior Therapy and Experimental Psychiatry (2011); 42: 371-378.
  6. Brown, Stuart, and Christopher Vaughan. Play: How it Shapes the Brain, Opens the Imagination, and Invigorates the Soul. Penguin Group, New York, NY, 2009.
  7. Seminowicz, David A., et al. “Effective Treatment of Chronic Low Back Pain in Humans Reverses Abnormal Brain Anatomy and Function.” The Journal of Neuroscience (2011); 31: 7540-7550.
  8. Cole SW, et al. Social Regulation of gene expression in human leukocytes. Genome Biology (200); 8:R189. doi: 10.1186/gb-2007-8-9-r189