Taking Charge of Your Care

posted in: Stage 1, Stage 1: Step 1

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 the Back in Control concepts to his patients. It has always been my intention that my book, this website, and now The DOC Journey be used as an adjunct to medical and non-medical providers who treat any aspect of chronic mental and physical pain, since it is a largely self-directed program.



“Do it Yourself”

His Letter

Greetings David,

“First, let me say how grateful I am to be able to provide a copy of Back in Control to each and every one of my addiction, chronic pain, and or PTSD patients on their first visit.

Due to the drug-induced disruption of communication between frontal cortex and emotional brain, I’ve come to realize that many are functionally teenagers, which has modified my presentation of your book. I now present this as a gift, appealing to either the emotional teenager or to the rational adult, depending on the severity of drug effect (which improves with Suboxone). I’ve now started them out at Chapter 9 with writing exercises, which I often have them do while I’m writing on their chart.

They are usually quite amazed at how easy and calming free writing is. I have them visualizing the disruptive thoughts flowing from their brain, down their arm and hand, onto the paper to be destroyed, along with discussion of the unlearning process. They then become interested enough to go to the beginning of the book and learn the theory. This presentation varies from one individual to another.

Now that I’m further along the learning curve, I am seeing some really amazing results, much of which I attribute to your book. I almost never have to use antidepressants, am having good results weaning off benzos (Valium-type meds), the bipolar mood disturbance screen often reverts to normal.

ACE issues (Adverse Childhood Experiences) are common, especially when chronic pain is involved, including some patients who do not meet the criteria for addiction. This is broached by asking if there are nightmares. The pain drawings and word descriptors are a big tipoff. The response to Prazosin (PTSD and sleep medication), usually just 1 mg at night is amazing. For most of my patients, it is the only sleep med needed.”

Many thanks for your generosity and please be assured that the book has been extremely beneficial to a lot of folks who need all the help they can get.


Finding Your Own Solution

Chronic pain is solvable by engaging in three phases:

  • Understanding the nature of chronic pain
  • Addressing every aspect of it simultaneously – similar to fighting a forest fire
  • The patient takes control of his or her own care.

Back in Control provides a framework that breaks down chronic pain into its component parts. The patient is able to figure out his or her own solution. There are so many factors that affect pain and with each individual’s life being unique, the only possibility of solving pain would have to come from the patient.

I frequently saw patients in clinic who had broken free from the grip of chronic pain. Each story and journey out of pain is unique. The one common tool is the expressive free writing, which is combined with the active meditation. The writing accomplishes the awareness and separation phases of the neuroplasticity process and the active meditation then re-directs attention to a different sensation. The writing is immediately destroyed so you can write with freedom and also to NOT analyze the thoughts. Otherwise your attention is still on the thoughts and you are reinforcing them.

My approach for the first month consists of five suggestions outlined in Stage 1 of the DOC Process. It the “homework” phase of learning how to take back your life.

My intention is to slow down every aspect of your life, especially the frenzied of search for a solution. I understand the desperate need to escape the pain. When I was in the midst of my ordeal, I became an “epiphany addict”. I was on a relentless quest to find the answer to my suffering and my efforts intensified over 15 years. Towards the end, almost every minute was spent on trying to escape my pain. Somehow, I was able to wake up enough to realize that this course of action wasn’t working and I realized that there was not one solution. Until you can calm down a bit, you will continue to have elevated stress chemicals in your body, which directly sensitizes the nervous system and increases the pain. They also slow the blood supply to the frontal lobes of your brain, so you aren’t able to think as clearly.




Expressive Writing

I don’t know why the expressive writing is so powerful. The effects are rapid and consistent. It was the one tool that began my path to healing and maybe it broke up my racing neurological circuits. I have used Gene’s approach for a while and ask my patients to begin the expressive writing combined with the active meditation before they begin reading the book.  Nothing of substance occurs until the writing begins. There are over 1000 research papers documenting its effectiveness. The question is not if it works but why and how it does. You can’t re-direct your nervous system until you separate from the past.

I saw a patient who had escaped chronic pain after suffering for over 40 years. Her journey began with the expressive writing about a year earlier and she was diligent in addressing all of her issues, especially anger. Her entire appearance and demeanor was transformed. She was animated and excited about possibilities. It was an incredibly rewarding and energizing experience to share her excitement. I felt privileged to have been able to share my journey that had also freed me from my pain.

I also think that the expressing writing is symbolic of being proactive and taking charge, which is the essence of healing.