Moving Forward with Your Pain

posted in: Stage 3, Stage 3: Step 5

Moving Forward with Your Pain


  • Most of us are under the impression that you must first solve your chronic pain before you can move forward and enjoy your life.
  • It is actually the opposite scenario. You have to fully engage in life in order to move away from your pain.
  • Fully engaging in today, with or without the pain, is your only option. To change your brain, you have to direct your attention to where you want to go and keep doing it.
  • You also must use tools to lessen the impact of mental and physical pain. These are critical in that you can’t move forward without letting go.
  • To have a good life, you have to live a good life; It requires practice.


“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 rid yourself of your pain. In fact, there is no goal because there is no beginning or end to it. The only “goal” is to live your life fully today with the deck of cards you have been dealt – with or without your pain. You must keep moving forward to move through and past your pain.



Understandably, everyone wants to be free of pain. But that isn’t life. The brain treats emotional and physical pain in a similar manner and the body’s physiological response is the same. So, even you were to be rid of your physical symptoms the quality of your life would not change as much as you might think. The emotional circuits will keep firing in response to day-to-day stresses.

Historically, I felt if I surgically relieved a specific symptom caused an identifiable structural problem, the degree of relief would be so compelling that it would propel him or her out of chronic pain and back into a full life. I could not have been more wrong. Unrelenting anxiety, which essentially is the pain, was intolerable and it didn’t improve with surgery. I was shocked as normally the pain should have been easily relieved with the operation. What was also disturbing was that even if the pain resolved with surgery, another body part would frequently light up.

I now understand that research has documented that if you have surgery in the presence of untreated chronic pain, you can induce pain at the new site between 40-60% percent of the time. Five to ten percent of the time it will be a permanent problem.1 Of course, you can worsen the original pain.

Moving on

So, if you can’t fix yourself and there is no “goal”, what can you do? The patients who were successful in regaining their lives just moved on – with or without their pain. Paradoxically, there was a much higher chance they would leave it behind. Your incredibly adaptable brain develops wherever you place your attention. One metaphor is that of diverting a river into a different channel. There is initially a small amount of water flowing in the new direction, but eventually the volume of water will create its own channel. There are many ways to re-direct. Some include:


 A friend of mine, who may have been the first DOC success in 2006 sent me this email that suggested a different take on visualization. My take on the following quote is that people age because their dreams are crushed by anxiety. You will note that this quote has been used several times in The DOC Journey.

Hi David,

Great quote from your latest post:

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

Gabriel Garcia Marquez

To your quote about anxiety crushing dreams and the ability of dreamers therein, I’d add that pushing through the anxiety and daring to dream, regardless of how you feel, creates an inverse effect of calming the anxiety, because sometimes, just having something to believe in, as simple as that, takes us out of our anxiety momentarily enough to see clearly, and thus move forward to a better place.

It works for me as a visualization tool to break the “anxiety cycle” as I call it. And if someone doubts this protocol, they only need to buy a lottery ticket. For the cost of $1, you walk out of that store and start visualizing what you’ll do with the money, and in that very moment, you’re not anxious. Instead, you find yourself, calming, your breathing slows, as you really indulge, if for only a few moments, how you’d be with all that extra cash on hand. It’s an amazing, albeit temporary salve, a balm to the anxious heart. And here’s the trick: We can recall that feeling over and over again and build on it, finding new ways to create the lives we want, just by using this tool of positive visualization. As our mind uses this, our thinking becomes stronger and we can begin to avert the waves of anxiety and in the spaces between, create constructive, positive events, in which to build the life of our dreams. Ironic that what starts with a fantasy – a one-dollar lotto ticket – can actually become reality, with positive visualization techniques tasked toward constructive events in real life context. And hey, we can use every tool we can find along the way, as I see it! Even for a buck!




Play circuits are also permanent and are present to a greater of lesser degree in everyone. Re-connecting with them, with or without your pain, is a powerful way out of pain. These circuits do get buried under the weight of life stresses, but you can create a shift back onto them with specific tools and repetition. This does not mean obsessively engaging in play to distract yourself. Rather, it is a mindset of wonderment and curiosity. Your body chemistry will shift to safety hormones and an anti-inflammatory state, your brain will be less sensitized, nerve conduction improves, and your pain can dramatically decrease or resolve.

It is not logical to think that if your pain was gone that you could enjoy your life. There are too many ways to experience pain. You have to first learn to enjoy life regardless of its challenges, understanding there are days that you will enjoy it more than others. A positive outlook, which has been shown to lower inflammation, with a sense of play will move you moving forward.2

An old song returns

One example I often used in clinic is that any time you do not spend time practicing a skill, you will eventually lose it. My wife played guitar in her 20’s and became proficient in a picking style of performing. Two years ago, she began to take lessons from an extraordinary Bay Area guitar teacher. About six months into her lessons, parts of some old songs began to return in her head. One day she sat down and played a complete piece that she had not thought about for decades. The memory was still there. Pain, anxiety and anger circuits will atrophy, if you turn your attention elsewhere. But they will never completely disappear since these are also necessary survival emotions.


Nurturing the part of your brain that enjoys life is a learned skill. That is why it is so critical what you choose to program it with. If your default state of mind is that of being agitated and upset, that is what will evolve. As you trigger the same response in those close to you, then there is no end to this universal ping pong game. Conversely, if you choose gratitude and joy, the same phenomenon will lift you upward.

There is a lot to be angry about and also much to enjoy. What is your choice? How and when are you going to move forward?

Two Wolves

Questions and considerations

  1. Life is challenging in many ways for all of us. It never stops and solving problems tends to be the default program of our brain. Consider how much of your life is spent solving or thinking about problems compared to purposefully enjoying yourself.
  2. It would be great not to have pain, but how long would you survive without its protection. People born without pain sensors don’t live past 10 – 15 years of age.
  3. When pain becomes chronic, it is permanent and memorized and does not serve a protective function. The more you try to get rid of it, the stronger it will become.
  4. It is by separating from it, moving on, connecting with enjoyable circuits, and leaving it behind that allows your brain to heal.


  1. Perkins FM and H Kehlet. Chronic pain as an outcome of surgery. Anesthesiology (2000); 93:123-33.
  2. Dantzer R, et al. Resilience and immunity. Brain Behav Immun (2018); 74:28-42. doi: 10.1016/j.bbi.2018.08.010



Listen to the Back in Control Radio podcast Moving Forward with Your Pain.