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Connect to Your Dark Side and Heal – Joy will Emerge

Overview Your survival reactions are meant to be deeply unpleasant, since they are protective danger signals. You have absolutely no ...

“Ride It Out!” Thriving After a Back-Breaking Horse Fall

Rachel is a therapist, specializing in trauma. She reached out to me a couple of years ago to learn more ...

“She Just Let Go”

My migraine headaches began on the Fourth of July when I was five years old. By age fifty, I had ...

Anger and Workers’ Comp Webinar

Our medical and political system has failed. Employers have abused workers as long as there have been employers and workers ...

Degenerative Disc Disease Isn’t a Disease

Surgeries being performed for axial neck, thoracic, and low back pain on normally aging spines was a major reason I ...

Physical versus Emotional Pain

The Swerve, by Steven Greenblatt is a historical account of a papal scribe’s discovery in the 1400’s of a poem, The ...

“The Journey of 1000 Moons”

“The Journey of 1000 Moons” by Ernesto Sanchez If you count the moon cycles you will experience in your lifetime, by ...

Permanent Disability – Needless??

Please do not let this happen to you, your family, or friends. The downside of failed spine surgery can be ...

Stay Out of the Surgical Scrap Heap

Objectives: Although there is no question about the dedication of physicians to providing excellent care, the rigors of training, the ...

Optimizing (Avoiding) Spine Surgery

About three years ago, my staff noticed that our surgical patients who participated in The DOC Journey principles were doing ...

Comprehending the Downside of Spine Surgery

Deciding whether to undergo spine surgery is one of the most important choices you will ever make. Currently, failed spine ...

The Myth of MUS (Medically Unexplained Symptoms) – It’s MES

There is a deadly diagnosis that has evolved and become increasingly embedded in chronic pain terminology – Medically Unexplained Symptoms ...

Stage 1 - Lay the Foundation

Select a step from the dropdown menu below to view the posts in that step. The steps are:

Step 1 - Learn About Your Pain
Step 2 - Expressive Writing
Step 3 - Active Meditation
Step 4 - Sleep
Step 5 - Don't Share Your Pain

Not Sharing Your Pain – Omega

I have held several three and five-day workshops in Rhinebeck, NY at the Omega Institute with Dr. Fred Luskin, a ...

Sharing My Pain

One of the tenets of successfully solving chronic pain is to stop discussing your pain with others. Dwelling on your ...

“This is going to hurt”

Your experience of pain depends on many parts of your brain receiving a signal, and comparing it to your expectations ...

Solve Chronic Pain – Listen

You must understand the nature of a problem before you can solve it. It is well-publicized that over 100 million ...

Neurophysiologic Disorder

There have been numerous terms used to describe the body’s response to chronic stress and the physiological response. The original ...

Anxiety

The ability to process anxiety in a healthy way is critical to maintaining your quality of life. It is even ...

Understand Chronic Pain

There are two fundamental aspects to the perception of pain: The source: Three Sources of Chronic Pain Possible structural problem ...

C – Neurophysiologic Disorder (NPD)

There have been numerous terms used to describe the body’s response to chronic stress and the physiological response. The original ...

Back in Control – Second Edition

The second edition of Back in Control: A Surgeon’s Roadmap Out of Chronic Pain will be available November 17th, 2016 ...

Systematic Approach to Sleep

Objectives: Adequate sleep is a necessary requirement for healing. Insomnia is a cause of chronic pain, and it is not ...

Neurophysiological Basis of Pain

To say that the wave of mass shootings over the last few years is disturbing would be grossly understating how ...

Taking Charge of Your Care

I want to share an email I received from a colleague regarding the effect of the DOC (Direct your Own ...

Fighting a Forest Fire – Address All Aspects of Your Pain

Objectives: Chronic pain is a complex multi-organ disease. It is reason why there are so many different symptoms. It cannot ...

Introductory DOC Concepts

DOC (Direct your Own Care) is a framework that breaks down chronic pain into basic parts that will enable you ...

Anxiety, Anger, and Adrenaline

All living creatures survive and flourish by avoiding threats and gravitating towards rewards. Humans have language and consciousness, which creates ...

Write Your Way Out of Chronic Pain

Watch the latest video at video.foxnews.com Chronic pain is at an epidemic level, affecting about a third of the adult ...

Stage 2 - Forgive and Play

Select a step from the dropdown menu below to view the posts in that step. The steps are:

Step 1 - Understand the Impact of Anger on Your Life
Step 2 - Acknowledge Your Disguises
Step 3 - Admit Your Victimhood
Step 4 - Choose Not to Remain a Victim
Step 5 - Forgive
Step 6 - Play

Awareness, Hope, Forgiveness and Play

These four elements form a powerful alliance to connect to your own capacity to heal, which is the essence of ...

The “Benefits” of Becoming Disabled

I have always enjoyed hard work. I began working in heavy construction at age fourteen during the remodeling of our ...

Rigid Thinking – “Make America Great Again”

Anxiety is the sensation created by elevated levels of stress hormones in response to a threat. It is intended to ...

Stress and Getting Sick – Howard’s Golf Story

For those of you who are golfers, you know that golf is a great metaphor for life. It is both ...

Changing Your Story – Reframing

Neuroplasticity is the term for the brain’s capacity to physically adapt to the environment. This is modulated by sensory input ...

Aced Out

I received an email from an orthopedic colleague who I have never personally met. We are both part of an ...

Your Personal Brain Scanner

Every second of your life depends on your brain scanning your surroundings for trouble. This unconscious process guides your behavior ...

The Power of Pain

Recent world events have raised a lot of questions about why would people dedicate their lives to the pursuit of ...

Rewire Your Brain – Omega 2015

Omega Institute, July 2015 Dr. Fred Luskin, author of Forgive for Good, my wife Babs Yohai, a professional tap dancer, and ...

“The Unenforceable Rules”

I was in Italy grabbing a ride to my hotel from the Florence train station. While waiting in line I ...

Ready to Blossom – Omega 13

The Omega Institute In August of 2013 I put on a 5-day workshop at the Omega institute in Rhinebeck, NY ...

“But You are Still Angry”

The DOC project is not a formula. You are not going to read my book and experience healing. My book ...

Destroyed by Bullies

Despair I will never forget a 40 year-old woman I met in the office a few years ago. She had ...

Your Book is Bullshit – The Encompassing Power of Anger

This is a recent post that was on my Back in Control Facebook site. I was well-aware that I would ...

Violence and Love

Power Many patients have no interest in giving up their pain. Being a victim is a powerful role – and ...

Nick’s Winning Run – Off of the Hill

My son, Nick, has been a competitive freestyle mogul skier since he was 14 years-old. He is an extraordinary athlete ...

Stage 3 - Move Forward

Select a step from the dropdown menu below to view the posts in that step. The steps are:

Step 1 - Commit to a Daily Practice
Step 2 - Create a Safe Haven - Family
Step 3 - Get Organized
Step 4 - Connect with the Life You Want
Step 5 - Create Your Vision

Listen to Your Family–No Advice or Criticism

“I am asking you to not give ANY advice to any member of your family for the next month and ...

A Safe Haven – Omega 2018

Our next weekend workshop will be held this summer at the Omega Institute in Rhinebeck, NY. The dates are Friday ...

Why are New Year’s Resolutions So Hard to Keep?

Each new year, many of us spend time figuring out how we’ll make it better and also to really complete ...

Happily Ever After

My wife and I were at a wedding this weekend. The bride was the daughter of some of our closest ...

The Impact of Mirror Neurons on Your Family

It is becoming increasingly clear that chronic pain has a tremendous impact on your immediate family. One of the more ...

The Taste of Freedom – Omega 2017

Becoming socially isolated often occurs when suffering in pain. Additionally, the area of the brain that lights up is similar ...

Your “Identity” Can Destroy You

Humans spend a good part of their life energy creating and maintaining something called “self-image.” Thanks to parents, peers, and ...

The Chronic Pain Marriage-Go-Round

I have long asked the spouses/ partners of my chronic pain patients to participate in the DOC project (“Direct your ...

The Two Faces of Christmas

Louis Cozolino, in his exhaustive book The Neuroscience of Human Relationships, points out that that human consciousness developed through interacting ...

Moving Forward with Your Pain

Moving Forward with Your Pain Objectives Most of us are under the impression that you must first solve your chronic ...

Be All that You Can Be – or Just Be

Objectives Modern civilization offers more opportunities than any other era of human history. Yet our mental health is declining. We ...

The Essence of the DOC Process

“The essence of the DOC process is simply chilling out and moving on. One cannot happen without the other. This ...

Take Back Your Life

Whenever your peace of mind is at the mercy of your external circumstances, you are at the mercy of them ...

Happy Father’s Day – Not

I was landing in Salt Lake City to spend Father’s Day weekend with my son and daughter-in-law. While standing at ...

Pain Rules the Roost

I am noticing a pattern that seems to be quite common. People in pain control others around them – especially ...

The Power of Love – Anthony

Anthony was a patient who I saw just a couple of times in his early 20’s. He was experiencing low ...

Stage 4 Posts - Expand Your Consciousness

Select a step from the dropdown menu below to view the posts in that step. The steps are:

Step 1 - Pass Through the "Ring of Fire"
Step 2 - Step Into Your New Life
Step 3 - "Failing" Well
Step 4 - Look Up - Your Spiritual Journey
Step 5 - Giving Back is Healing

The First and Last Day of School

“It is not true that people stop pursuing dreams because they grow old. They grow old because they stop pursuing ...

Video: Standard Stress Skills Inadequate

I talk about how the DOC Project can relate to other aspects of our everyday life, including everyday stressors and ...

Plugging the Negative Drain

Picture yourself in a tub trying to fill it to take warm, relaxing bath. The drain is not only wide ...

My Hoffman Experience

Hoffman is a seven-day residential personal growth experience where you are able to become aware of your family patterns of ...

Hoffman Process

Hoffman Institute The headquarters of the Hoffman Process is located in Rafael, CA. They offer the process in the US ...

Stage 5 - Decision-making

Select a step from the dropdown menu below to view the posts in that step. The steps are:

Step 1 - General Principles - The Grid
Step 2 - The Source of Your Pain
Step 3 - The Impact of Stress on Your Pain and Decision-making
Step 4 - Understanding the Magnitude of the Surgery
Step 5 - Making the Final Surgical Decision
Step 6 - Stories of Surgical Despair

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Stage 6 Posts - Procedures

Select a step from the dropdown menu below to view the posts in that step. The steps are:

Step 1 - General Considerations: Magnitude vs. Benefit
Step 2 - Decompressions
Step 3 - Lumbar Fusions
Step 4 - Deformity Surgery
Step 5 - Other Spine Surgeries
Step 6 - Stories of Surgical Despair

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Important Posts

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Stories of Hope

My Feet on Fire

I began my orthopedic surgery residency in 1981. I had an unusual path into this specialty in that I had ...

“I Am Not Letting Yesterday Ruin Today”

I had been working with Anne for a while and she had been experiencing chronic pain throughout her body for ...

Ron Salvages His Own Spine Surgery

A letter from a case manager Dear Dr. Hanscom: You may not receive these kinds of letters from nurse case ...

A New Life at 72

Crystal is a woman from the southern part of Washington. When I first met her, she was over 70 years-old ...

Bipolar Disorder Broken

Debbie was a 45 y/o woman who I had been working with for about four years. She was diagnosed with ...

Expressive Arts Gallery

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Other Posts

Repetitive Unpleasant Thoughts

Click a Show Section button below to view the posts in that section.

Section 1 - Overview of RUTs

Overview of RUTs

RUTs - Defining the Problem

“The Curse of Consciousness” – Trapped by Your Thoughts

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 ...

Quit Fighting Darkness and Turn on the Light

Objectives We are trained that if we can solve enough of our problems, we’ll have an “enjoyable life.” Life’s challenges never stop, and we may slowly sink into darkness, “The Abyss.” We become desperate trying to escape; especially from our ...

Am I Operating on Your Pain or Anxiety?

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 ...

My Descent Into The Abyss

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 ...

Section 2 - Solving RUTs

Solving RUTs

Separating Your Identity from Your Physiology

The Gift of Anxiety – Your Bodyguard or Prison Guard?

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 ...

Four Aspects of Solving RUTs

Objectives Mental and physical pain are processed in similar regions of the brain. Our inability to escape from RUTs relentlessly drives flight or fight physiology, and people may become ill. There is a healing sequence for solving them: separation of ...

The Popcorn Machine – Healing RUTS

Objectives Repetitive Unpleasant Thoughts (RUTs) are solvable with a multi-pronged self-directed approach. Consider the four aspects in the metaphor of a popcorn machine. They are 1) the kernels 2) the cooking pot 3) the storage compartment 4) the power source ...

Write and Don’t Stop!

There are over 2200 research papers that document that expressive writing in some form is effective for improving both your mental and physical health. I have been adamant for a long time that you should write down just negative ...

Unhooking from the Train

Your body under chronic stress There are multiple physical and mental manifestations of a chronically fired up nervous system. With engagement of the principles that calm it down, the improvements in my patients’ quality of life are consistent and frequently ...

The Three Column Technique

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

Active Meditation

A basic tenet of many Eastern philosophies is that worrying about the future and thinking about the past causes internal unrest. There is anxiety around the future and many regrets and frustrations about the past. By staying only in the ...

Anger Academy

Objectives Processing anger is more doable if it is broken down into its components. Anger is a powerful, necessary, and hard wired survival reflex. You cannot tame it with the conscious brain. It is an acquired skill that requires ongoing ...

Directly Calming the Threat Response

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 ...

“5–3–2” – Processing Anger in Three Steps

Objectives Anxiety is an unpleasant sensation generated by your body’s physiological response to real or perceived danger. It compels you to take action to resolve the threat and live another day. If you cannot escape or solve the threat, your ...

RUTs – Can’t Take Your Hand Off the Stove? Turn Down the Heat

Holding your hand over a hot burner triggers an immediate threat response (anxiety) and prompts action to address that threat. This sequence is part of the protective pain response known as the nociceptive pain system. Numerous danger cues activate this ...

Quit Fighting Darkness and Turn on the Light

Section 3 - The Evolution of RUTs

The Evolution of RUTs

The Need for Mental Control – The “Ironic Effect”

Your Demons are Robots

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

Your “Authentic Self”

The only “authentic self” that exists is the one who is present today – right this very second. Your actions and reactions reflect your entire lifetime of programming. Much of our programming is less than ideal but it is what ...

Your Personal Brain Scanner

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 ...

Threat versus Safety Physiology

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 ...

Common Links to Chronic Disease – RUTs are Relentless

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 ...

We have no protection from mental pain

Objectives: Pain from any body part is a protective danger signal that guides our behavior and physical responses to avoid danger and remain safe. This system is called the nociceptive system, which guides behaviors to not exceed the limits of ...

Section 4 - Consequences of RUTs

Consequences of RUTs

Clinical Manifestations / illnesses/ Diseases

Extreme Mental Pain – OCD

Obsessive Compulsive Disorder (OCD) is an extreme form of anxiety. A relentless assault of unwelcome intrusive thoughts characterizes it. I suffered from OCD for several decades, well before I knew what OCD meant. It is becoming increasingly apparent that many ...

School or Prison – What’s the Difference?

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 ...

Threat Physiology Can’t be Controlled with Behavioral Approaches

Objectives Many people are focused on controlling anger and anxiety with behavioural approaches. These powerful reactions are not controllable and suppressing them increases threat physiology. We all need to be heard, supported, and taught methods to regulate and lower these ...