I am excited about my recent insights that have emerged from writing my new book on RUTs. It will be released in June 2026. The title is Calm Your Body Heal Your Mind: Transcend Pain, Anxiety, Anger, and Repetitive Unwanted Thoughts. I have seen some remarkable turnarounds that I never would have witnessed a few years ago. I have long seen chronic physical pain diminish or resolve. I am also aware that mental pain is less tolerated the physical pain. What I did not realize is that there are additional dimensions to consider concerning ruminating thoughts.
I presented a comprehensive overview of the physiological nature of RUTs, as well as the principles behind the solutions, to a group at the University of Denver. This is the most in-depth present I have given, and it is a good introduction. It is a long talk, but I encourage you to set aside time to have a good, leisurely listen. Understanding the problem is a significant aspect of healing.
Those who have been persistently spending time on the The DOC Journey course have often had a significant lessening of these thoughts. The Q&A sessions have also been helpful. I am personally committed to learn what concepts and tools help people out of the hole and move forward. Everyone is unique, but some common principles are emerging.
This is a detailed overview of the presentation. Again, this is detailed, but give yourself half an hour to digest and revisit it. It will help you move forward quickly. I am as excited to keep learning as you are wanting to heal. Use this material as a reference and template for practicing.
Unified Synthesis: Physiological Nature of Repetitive Unpleasant Thoughts (RUTs)
Dr. David Hanscom – OLLI Webinar – 10.31.25
Link to presentation: https://mediaspace.du.edu/media/Connect+to+Your+Pain+to+Launch+Your+New+Life+-+David+Hanscom/1_mey5o9j6
Executive Summary
Dr. David Hanscom’s presentation offers a paradigm-shifting approach to chronic pain that challenges conventional medical thinking. He argues that most chronic pain is neuroplastic—generated by the brain’s threat response system rather than structural tissue damage—and that healing requires fundamentally different strategies than traditional pain management. Central to his approach is the counterintuitive concept of “connecting to your pain” rather than fighting it, understanding that the unconscious brain’s survival mechanisms drive pain, and using specific tools to create safety and reduce threat perception. The presentation synthesizes neuroscience, psychology, and practical healing techniques into a comprehensive framework that addresses not just physical pain but the broader human experience of suffering.
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THE PARADIGM SHIFT: FROM STRUCTURAL TO NEUROPLASTIC PAIN
Redefining Chronic Pain
Hanscom begins with a fundamental reconceptualization: chronic pain is not primarily a structural problem but a neurological one. The brain creates pain as a protective response to perceived threat, independent of actual tissue damage.
Key Distinctions:
- Acute pain: Real tissue damage requiring immediate response
- Chronic pain: Brain-generated pain persisting beyond tissue healing
- Neuroplastic pain: Pain created by neural pathways embedded through repetition and threat perception
The 85% That Medicine Misses
Traditional medicine focuses almost exclusively on structural explanations—identifying anatomical abnormalities on imaging studies. However, Hanscom emphasizes that most people with structural findings on MRI have no pain, while many with severe chronic pain show minimal or no structural abnormalities.
The medical system’s structural bias creates several problems:
- Unnecessary surgeries that don’t address the actual pain generator
- Focus on “fixing” problems rather than understanding pain mechanisms
- Patient disempowerment through dependence on external interventions
- Escalation of treatments when initial approaches fail
The Brain as Pain Generator
The brain creates pain through:
- Threat perception: The unconscious brain interprets danger signals
- Neural pathway reinforcement: Repeated pain signals strengthen neural circuits
- Emotional amplification: Anxiety, fear, and frustration intensify pain
- Attention focusing: Hypervigilance to symptoms increases their salience
Hanscom emphasizes: “Pain is an output of the brain, not an input. The brain decides how much pain you’re going to have based on how much danger it perceives you’re in.”
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THE UNCONSCIOUS BRAIN: THE REAL DECISION MAKER
Consciousness as the Tip of the Iceberg
A central theme is that the unconscious brain processes one billion bits of information per second, while the conscious brain handles only 40-50 bits. This means:
- Most decisions happen below conscious awareness
- The unconscious brain prioritizes survival above all else
- Conscious intentions have limited power over unconscious processes
- Understanding this power imbalance is essential for healing
The Survival Imperative
The unconscious brain’s primary function is keeping you alive, not keeping you happy or pain-free. It operates through:
Threat Assessment
- Constantly scanning for danger (physical, emotional, social)
- Interpreting ambiguous signals conservatively (better safe than sorry)
- Creating pain as a warning system
Pattern Recognition
- Associating situations, people, or sensations with past threats
- Generalizing from single incidents to broader categories
- Maintaining hypervigilance in any context resembling past danger
Survival Prioritization
- Overriding conscious desires when perceiving threat
- Sacrificing long-term well-being for immediate survival
- Resisting changes that might increase vulnerability
Why Willpower Fails
Understanding the unconscious brain’s dominance explains why:
- “Just think positive” doesn’t work
- Willpower and determination often backfire
- Trying harder increases frustration and threat perception
- Fighting pain strengthens pain pathways
Hanscom states, “You cannot control chronic pain. The harder you try to control it, the worse it gets because you’re creating more threat.”
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THE CENTRAL PARADOX: CONNECTING INSTEAD OF FIGHTING
The Counterintuitive Core Principle
The presentation’s most radical idea: Healing requires connecting to your pain rather than fighting it. This appears paradoxical to people who’ve spent years trying to eliminate pain.
Why Fighting Fails:
- Resistance creates tension and amplifies threat perception
- The brain interprets fighting as evidence that danger remains
- Avoidance prevents the nervous system from learning safety
- Each battle lost strengthens helplessness and frustration
Why Connection Works:
- Acknowledgment reduces the threat response
- Observation without judgment allows habituation
- Acceptance creates space for other life experiences
- Connection provides information the brain needs to recalibrate
What “Connection” Actually Means
Hanscom carefully defines this often-misunderstood concept:
Connection is NOT:
- Resignation or giving up
- Passive acceptance of suffering
- Liking or wanting the pain
- Stopping efforts to improve your life
Connection IS:
- Acknowledging what is actually present
- Observing without immediately reacting
- Being with discomfort without adding struggle
- Creating space between sensation and response
The metaphor he uses: “It’s like turning on the light in a dark room. The monsters disappear not because you fought them, but because you saw what was actually there.”
The Three Words of Healing: Connection
Hanscom emphasizes that “connection” applies to multiple domains:
- Connect to your pain: Be present with physical sensations without fighting
- Connect to your skepticism: Acknowledge doubts rather than forcing belief
- Connect to your emotions: Feel what’s actually there, not what you think should be there
- Connect to what is: Accept reality rather than insisting it be different
- Connect to others: Build genuine relationships that create safety
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THE DOC FRAMEWORK: DEFINE, OBSERVE, CONTEXTUALIZE
A Structured Approach to Working with Pain
Hanscom provides a practical three-step process for dealing with pain episodes:
Define: Getting Specific
Most people say “I hurt all over” or describe pain vaguely. Defining requires:
- Precise location: Where exactly is the sensation?
- Quality description: Sharp, dull, burning, tingling, pressure?
- Intensity specifics: Rate it, but recognize the rating changes
- Duration pattern: Constant, intermittent, triggered?
Why this matters: The unconscious brain responds to specificity. Vague threats keep the alarm system activated. Clear definition paradoxically reduces threat.
Observe: Curiosity Without Judgment
Observation involves:
- Noticing changes: Pain fluctuates constantly; paying attention reveals variability
- Identifying triggers: What makes it better or worse?
- Recognizing patterns: Time of day, activities, emotional states
- Suspending conclusions: Watch without immediately interpreting
Critical point: Observation is not analysis. It’s simply witnessing what’s present without the story about what it means.
Contextualize: Understanding the Whole Picture
Context considers:
- Life circumstances: What else is happening in your life?
- Emotional state: What feelings are present beyond pain?
- Social environment: What are your relationship dynamics?
- Historical patterns: Have you experienced this before in different circumstances?
Hanscom emphasizes that pain rarely exists in isolation—it’s almost always embedded in a larger life context involving stress, unmet needs, or unresolved conflicts.
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EXPRESSIVE WRITING: THE FOUNDATIONAL TOOL
Why Writing Transforms
Expressive writing emerges as the foundational and necessary effective tool in Hanscom’s approach. The research supporting it is compelling:
Pennebaker’s Research:
- 15-20 minutes daily writing about difficult experiences
- Documented improvements in immune function
- Reduced doctor visits and medication use
- Enhanced psychological well-being
Mechanisms of Action:
- Externalization
- Thoughts on paper become objects to observe
- Creates distance between self and thought
- Reduces rumination cycles
- Pattern Recognition
- Writing reveals repetitive thoughts (circular thinking)
- Exposes cognitive distortions
- Identifies core beliefs driving behavior
- Emotional Processing
- Activates different brain regions than thinking
- Accesses unconscious material
- Facilitates integration of fragmented experiences
- Narrative Reorganization
- Transforms chaotic experience into a coherent story
- Creates meaning from suffering
- Allows revision of self-concept
The Critical Writing Guideline: Destroy It Immediately
Hanscom emphasizes one non-negotiable rule: Write with the intention that no one will ever read it, including your future self.
Why this matters:
- Eliminates self-censorship
- Allows complete honesty
- Prevents performance (writing to impress)
- Removes fear of judgment
The method: Write by hand, then immediately tear it up and throw it away. This act of destruction is therapeutic—it symbolizes letting go.
Writing vs. Journaling
An important distinction:
Journaling (keeping records to review later):
- Can reinforce rumination
- Creates performance pressure
- May strengthen negative patterns through review
Expressive writing (immediate destruction):
- Purely cathartic
- No audience, no performance
- Freedom to express anything
- Energy release without reinforcement
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THE THREAT RESPONSE SYSTEM AND NEUROPLASTICITY
How the Brain Embeds Pain
The neuroplasticity discussion centers on how neural pathways strengthen through repetition:
The Learning Process:
- Pain signals travel through specific neural pathways
- Each repetition strengthens those connections
- Eventually, the pathway becomes a “highway” rather than a “dirt road”
- The brain defaults to familiar patterns (even painful ones)
Factors That Strengthen Pain Pathways:
- Attention: Focusing on pain reinforces it
- Emotion: Fear and anxiety amplify signals
- Repetition: Each pain episode strengthens the circuit
- Meaning: Catastrophic interpretations increase salience
- Avoidance: Trying not to think about it paradoxically increases mental activity
The Threat Threshold Concept
Hanscom introduces the idea of a threat threshold—the accumulated stress load that triggers pain:
Components of Total Threat Load:
- Physical stressors (injury, illness, sleep deprivation)
- Emotional stressors (anxiety, depression, anger)
- Social stressors (relationship conflicts, isolation)
- Environmental stressors (noise, chaos, unpredictability)
- Cognitive stressors (rumination, worry, perfectionism)
Key insight: Pain often emerges not from a single cause but from accumulated threats exceeding the threshold. Reducing any component of the total load can bring pain below the threshold.
Neuroplastic Reversal
The hopeful message: What the brain learns, it cannot unlearn. New neural circuits can be created through:
Creating Safety
- Consistent experiences of security reduce baseline threat
- Predictability lowers nervous system activation
- Social connection signals survival enhancement
Attention Redirection
- Deliberately focusing on non-pain experiences
- Engaging in absorbing activities
- Cultivating awareness of moments without pain
Pattern Interruption
- Doing things differently when pain arises
- Breaking stimulus-response chains
- Introducing novelty and play
Play as Fundamental to Healing
Hanscom devotes significant attention to play as a therapeutic modality, drawing on Stuart Brown’s research from the National Institute for Play:
Why Play Matters:
- Signals safety to the unconscious brain (animals only play when safe)
- Activates different neural circuits than survival mode
- Reduces baseline threat perception
- Facilitates neuroplasticity and learning
- Creates positive emotional states
Play Characteristics:
- Done for its own sake (not to achieve goals)
- Absorbing and timeless
- Reduces self-consciousness
- Increases creativity and flexibility
- Generates positive emotions
The Play Deficit Crisis
Hanscom argues we have a societal crisis around play:
- Children have lost unstructured playtime
- Adults view play as frivolous or childish
- Educational systems prioritize performance over exploration
- Technology replaces embodied, imaginative play
Connection to Chronic Pain: Without play, the nervous system lacks the primary signal that life is safe. This maintains elevated baseline threat, lowering the threshold for pain.
Creating Safety Conditions
Beyond play, safety requires:
Physical Safety
- Stable environment
- Basic needs met (food, shelter, rest)
- Freedom from immediate threats
Emotional Safety
- Relationships where authentic expression is welcomed
- Absence of criticism and judgment
- Permission to have all feelings
Social Safety
- Belonging to supportive communities
- Predictable social interactions
- Acceptance rather than performance demands
Cognitive Safety
- Permission to not know
- Freedom from perfectionism
- Ability to make mistakes without catastrophic consequences
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THE EGO PROBLEM: IDENTITY AND SUFFERING
Ego as Source of Threat
Hanscom presents a sophisticated analysis of how ego and identity creation contribute to suffering:
The Ego Structure:
- Collection of self-concepts and stories about who we are
- Social comparisons and competitive positioning
- Need to be “right” or maintain a specific self-image
- Protection of identity against perceived threats
Why Ego Creates Suffering:
- Constant vulnerability (identity can be threatened)
- Need for external validation
- Comparison generating dissatisfaction
- Rigidity preventing adaptation
The Holiday Example
Hanscom uses holidays as a powerful illustration:
“Holidays actually are a huge problem for people in chronic pain. When I was in chronic pain, I became obsessed with what everybody else had, including, first of all, not being in pain. They had families, they had friends, they had all these wonderful things around them. That was one of my worst parts of my obsessive thinking—what everybody else had that I didn’t have.”
This reveals how comparison thinking (a core ego function) intensifies suffering.
Killing Your Ego (The Disarming Technique)
Drawing on David Burns’ work, Hanscom describes the disarming technique:
When criticized or attacked:
- Don’t defend: The moment you get defensive, you’ve given them fuel
- Agree with them: Find something in the criticism to acknowledge
- Remove ego investment: Recognize these are just thoughts, just stories
Why this works:
- Eliminates the threat to the ego
- Defuses the attacker (nothing to push against)
- Reduces your own stress response
- Reveals the impermanence and unreality of concepts
Concepts Becoming as Real as Tigers
A profound insight: “The problem is the ego or concepts become as real as a tiger or lion. Our brain has not learned how to process all the sensory input.”
This explains why:
- Political beliefs create genuine physical threat responses
- Social rejection activates pain pathways
- Identity threats generate survival-level reactions
- Abstract concepts trigger concrete physiological changes
The societal implication: Much suffering (including violence and discrimination) stems from treating concepts as concrete realities.
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PRACTICAL TOOLS FOR NERVOUS SYSTEM REGULATION
Direct Vagal Stimulation
Hanscom provides specific techniques for immediately calming the nervous system:
Breathing Techniques
- Breathe through nose (stimulates nitric oxide, anti-inflammatory)
- Slow exhalation (longer exhale than inhale activates parasympathetic)
- Deep diaphragmatic breathing
- Breath awareness without forcing
Physical Techniques
- Forehead rubbing: Stimulates the fifth cranial nerve, which activates the vagus nerve
- Humming: Light humming stimulates the seventh cranial nerve, also vagus-connected
- Shoulder dropping: Releases muscular tension, signals safety
- Progressive relaxation: Systematic tension-release through the body
Sensory Regulation
- Music: Quiet, lullaby-type music calms the nervous system
- Temperature: Warm baths, cool compresses
- Touch: Self-massage, gentle pressure
- Visual: Nature images, calming colors
The Present Moment Practice
Repeatedly returning to direct sensory experience in the present moment:
- What do you actually see, hear, and feel right now?
- Distinguish between sensation and interpretation
- Notice moments between thoughts
- Recognize that suffering exists in past/future thinking, not present sensation
Reframing Techniques
The “And” Practice Instead of “but” which negates what came before, use “and” which allows both truths:
- “I’m in pain AND I can still enjoy this sunset”
- “This is difficult AND I’m learning”
- “I’m scared AND I’m safe right now”
Cognitive Restructuring
- Identify catastrophic thoughts
- Question their validity
- Seek alternative explanations
- Practice realistic optimism
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THE REJECTION OF “FIXING” AND CONTROL
The Paradox of Control
A central theme: The attempt to control pain makes it worse.
Why Control Strategies Fail:
- Implies the current state is unacceptable (increases threat)
- Creates success/failure dichotomy (failure intensifies suffering)
- Puts you in opposition to your own experience
- Exhausts mental and emotional resources
- Maintains hypervigilance
The Liberation of Giving Up Control:
- “Just turn on the light,” rather than fighting the darkness
- Accept that you cannot control pain directly
- Focus on what you can control (responses, actions, attention)
- Paradoxically, giving up control often reduces pain
The Problem with “Healing” as a Goal
Hanscom makes a subtle but important distinction:
Traditional approach: Use techniques to eliminate pain (pain elimination as a success metric)
His approach: Use techniques to engage with life (life engagement as a success metric)
Why this matters:
- When pain reduction is the goal, persistence of pain means failure
- When life engagement is the goal, progress is possible regardless of pain
- The first keeps attention on pain; the second redirects attention to living
- The first creates pressure; the second creates possibility
Learning to Be With Pain
“You have to learn to be with your pain. People don’t want to be with their pain. They don’t like it. But it’s a learned skill set to quit fighting it.”
This represents a profound shift:
- From pain as an enemy to pain as information
- From elimination as a goal to coexistence as a strategy
- From control as a method to acceptance as a path
- From fighting to dancing with discomfort
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THE EDUCATIONAL AND SOCIAL IMPLICATIONS
The Human Species Problem
Hanscom briefly touches on what he calls “a major human species problem that’s actually solvable through the school system.”
The Core Issue:
- Humans develop concepts and identities
- These concepts become as threatening as physical danger
- Social divisions, violence, and suffering follow from concept-based threats
- Education currently reinforces competitive, ego-based thinking
What Schools Should Teach
Essential Life Skills Missing from Curriculum:
- Emotional regulation and nervous system awareness
- Play and creativity as fundamental to wellbeing
- Connection and authentic relating
- Present-moment awareness
- Distinguishing thoughts from reality
- Dealing with uncertainty and discomfort
The Play Foundation Connection
Hanscom’s collaboration with Lauren Sundstrom (daughter of Stuart Brown) and Lonnie Zeltzer’s Creative Health for Youth in Pain program represents attempts to:
- Bring evidence-based approaches to children
- Prevent chronic pain patterns from forming
- Create resilient, emotionally intelligent generations
- Transform educational philosophy
The Vision: International collaboration around play, connection, and nervous system regulation as foundational to human flourishing.
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PERSONAL STORY: FROM SURGEON TO HEALER
Hanscom’s Journey
The presentation is interwoven with Hanscom’s personal narrative:
Professional Crisis:
- Successful spine surgeon
- Developed severe chronic pain himself (back, neck, burning sensations)
- Anxiety, depression, and insomnia
- Considered suicide
- Realized surgery couldn’t solve his problem
The Turning Point:
- Discovered neuroplasticity research
- Implemented expressive writing
- Learned to stop fighting his symptoms
- Gradually recovered completely
Career Transformation:
- Stopped performing elective spine surgery
- Developed the “Back in Control” program
- Now dedicates work to helping others understand neuroplastic pain
- Advocates for system-wide changes in pain treatment
The Credibility of Lived Experience
Hanscom’s story provides crucial credibility:
- He’s not a theorist but someone who lived the nightmare
- He understands the desperation and skepticism
- His medical background allows him to bridge conventional and alternative approaches
- His recovery demonstrates the principles work
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ADDRESSING SKEPTICISM AND RESISTANCE
Why People Resist This Approach
Hanscom explicitly addresses common objections:
“My pain is real!”
- Response: Absolutely, it is. Neuroplastic pain is real pain. The brain creates it, so it’s genuine.
“But I have structural problems on my MRI!”
- Response: Most people with the same findings have no pain. The structure isn’t the primary driver.
“I’ve tried everything; nothing works!”
- Response: That’s precisely why this might work—because it’s fundamentally different from everything else.
“This sounds too simple/too hard”
- Response: Simple concept, challenging implementation. It requires patience and practice.
“I can’t just accept pain; that’s giving up.”
- Response: Acceptance isn’t resignation. It’s acknowledging reality so you can work with it effectively.
The Importance of Connecting to Skepticism
“Connect with your skepticism. Don’t believe a word I said. I’m serious. Because you’ve tried everything, nothing’s worked. Why should you believe David Hanscom?”
This validates rather than dismisses doubt, which:
- Reduces resistance
- Acknowledges the legitimate reasons for skepticism
- Invites experimentation rather than demanding belief
- Respects autonomy and intelligence
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THE ROLE OF RELATIONSHIPS AND SOCIAL CONNECTION
Relationships as Safety or Threat
The quality of relationships profoundly impacts chronic pain:
Threatening Relationships Create:
- Constant vigilance and defensiveness
- Suppression of authentic needs and feelings
- Accumulation of resentment and hurt
- Increased baseline threat load
Safe Relationships Provide:
- Validation and emotional support
- Permission to be authentic
- Reduction in threat perception
- Buffering against stress
The Narcissistic Pairing
Though not explicitly detailed in this transcript, Hanscom references dynamics where:
- People with poor boundaries attract controlling partners
- Chronic self-suppression leads to physical symptoms
- Leaving toxic relationships often precedes pain improvement
- Setting boundaries can be physically healing
Social Connection as Biological Necessity
Humans are fundamentally social creatures:
- Isolation registers as a life threat to the unconscious brain
- Belonging signals safety and survival enhancement
- Quality matters more than quantity of connections
- Authentic relating (not performing) provides benefit
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CONSCIOUSNESS, THE UNCONSCIOUS, AND IDENTITY
The Nature of Consciousness
Hanscom explores deeper philosophical territory:
Consciousness Characteristics:
- Processes minimal information (40-50 bits/second)
- Creates narrative continuity (sense of self over time)
- Generates meaning and interpretation
- Produces the illusion of control
The Problem:
- We identify with consciousness as “me”
- We believe our conscious thoughts define reality
- We trust conscious interpretation over unconscious wisdom
- We fight unconscious processes with conscious will
The Unconscious as Ally, Not Enemy
A key reframing: The unconscious brain is trying to protect you, not torture you.
Shifting the Relationship:
- From “my brain is broken” to “my brain is over-protective”
- From “I need to fix this” to “I need to show my brain I’m safe”
- From opposition to cooperation
- From control to communication
Identity and Suffering
The Buddhist Influence (though not explicitly named):
- Suffering comes from attachment to concepts of self
- Fixed identity creates vulnerability and rigidity
- Letting go of ego reduces suffering
- Present-moment awareness transcends identity concerns
Application to Pain:
- “I am someone in pain” locks in the experience
- “Pain is something I’m experiencing” creates space
- Identity with pain strengthens pain pathways
- Flexible self-concept allows change
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INTEGRATION: THE BIOPSYCHOSOCIAL MODEL REALIZED
Moving Beyond Mind-Body Dualism
Hanscom’s approach dissolves traditional boundaries:
Not Mind OR Body:
- Mind-body dualism is a false dichotomy
- The brain generates both psychological and physical experiences
- The same mechanisms create mental and physical pain
- Interventions work at the level where the mind and body interface
Not Psychology OR Medicine:
- Medical interventions (surgery, medication) have their place
- Psychological understanding is also medical understanding
- Effective treatment requires both perspectives
- Most chronic pain requires more psychology, less surgery
The Biopsychosocial Reality
Every pain experience involves:
Biological Factors:
- Neural pathways and neurotransmitters
- Inflammatory processes
- Hormonal influences
- Genetic predispositions
Psychological Factors:
- Beliefs and expectations
- Emotional states
- Attention and interpretation
- Coping strategies
Social Factors:
- Relationship quality
- Cultural meanings of pain
- Social support availability
- Economic stressors
The Integration: These factors don’t just correlate—they causally influence each other through feedback loops. Changing any level affects all levels.
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PRACTICAL APPLICATION SYNTHESIS
The Core Protocol
Distilling Hanscom’s approach into essential steps:
- Understanding Phase
- Learn about neuroplastic pain
- Recognize your pain may be brain-generated
- Understand the threat response system
- Connect to your skepticism
- Writing Practice
- 15-20 minutes daily expressive writing
- Write about difficult experiences and emotions
- Destroy immediately (no re-reading)
- Continue for weeks to months
- DOC Practice
- Define pain specifically when it occurs
- Observe without judgment or story
- Contextualize within whole life situation
- Use as meditation practice
- Nervous System Regulation
- Daily breathwork and vagal stimulation
- Create conditions of safety
- Incorporate play and pleasurable activities
- Maintain sleep hygiene
- Relationship Work
- Identify and address boundary violations
- Practice authentic expression
- Build genuine connections
- Consider leaving toxic situations if necessary
- Life Engagement
- Redirect attention to valued activities
- Do things you love despite pain
- Measure success by life quality, not pain reduction
- Allow pain to exist while living fully
Timeline Expectations
Realistic Progression:
- Initial weeks: Learning, skepticism, little change
- 1-3 months: Glimpses of improvement, increased understanding
- 3-6 months: Noticeable changes, more consistent application
- 6-12 months: Significant transformation possible
- Ongoing: Continued practice and life engagement
Important Note: This is not a quick fix. It requires sustained commitment and patience.
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KEY DISTINCTIONS AND CLARIFICATIONS
What This Approach Is NOT
Not Positive Thinking
- Doesn’t deny reality
- Doesn’t require forcing optimism
- Doesn’t blame you for negative thoughts
- Acknowledges suffering is real
Not Mind Over Matter
- Doesn’t rely on willpower
- Doesn’t demand you “think away” pain
- Doesn’t imply pain is “all in your head” (dismissively)
- Recognizes brain generates real physical experiences
Not Anti-Medical
- Doesn’t reject appropriate medical intervention
- Doesn’t tell people to stop medications irresponsibly
- Doesn’t claim all pain is neuroplastic
- Works alongside medical care when needed
Not a Cure
- Doesn’t promise pain elimination
- Doesn’t work for everyone identically
- Doesn’t happen quickly or easily
- Requires ongoing practice
What This Approach IS
A Different Framework
- Understands pain through a neuroscience lens
- Addresses root causes (threat perception)
- Empowers rather than creates dependence
- Focuses on life engagement over symptom elimination
A Skill Set
- Teachable and learnable
- Improves with practice
- Applies to many life challenges beyond pain
- Builds resilience and adaptability
A Way of Being
- Cultivates present-moment awareness
- Reduces suffering through acceptance
- Emphasizes connection over control
- Integrates multiple dimensions of experience
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SYNTHESIS OF SHARED IDEAS
Convergent Themes Across the Presentation
The Primacy of Safety Repeatedly emphasized: The nervous system must feel safe for healing to occur. Every technique aims to reduce threat perception.
Connection as Central Healing Mechanism: Whether connecting to pain, emotions, skepticism, or others, connection reduces resistance and allows natural regulation.
The Limitation of Conscious Control The unconscious brain’s dominance means traditional willpower-based approaches fail. Working with (not against) unconscious processes is essential.
Suffering from Resistance Fighting reality (whether pain, emotions, or circumstances) amplifies suffering. Acceptance creates space for change.
The Social Nature of Healing. Isolation intensifies all forms of suffering. An authentic connection with others provides profound therapeutic benefit.
Play as Medicine Playfulness signals safety, facilitates neuroplasticity, and provides direct nervous system regulation.
Identity as Source of Vulnerability. Fixed self-concepts create suffering when threatened. Flexible, process-oriented self-view reduces suffering.
Emotion as Information: Feelings provide crucial data about needs and threats. Suppressing them removes essential feedback.
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CONTRADICTIONS AND TENSIONS
Apparent Paradoxes Resolved
“Connect to pain” vs. “Redirect attention”
- Resolution: Both are true at different times. Connection means not avoiding; redirection means not obsessing. It’s about balanced awareness.
“Accept pain” vs. “Pain can resolve”
- Resolution: Acceptance doesn’t mean resignation. Accepting current reality allows the nervous system to recalibrate, which may reduce or eliminate pain.
“Give up control” vs. “Take control of your life”
- Resolution: Give up direct control over pain sensation; take control over responses, attention, and life choices. Paradoxically, releasing control over pain often reduces it.
“It’s neuroplastic” vs. “But there’s real structural damage”
- Resolution: Both can be true. Structural findings don’t necessarily cause pain. The brain’s interpretation determines pain experience.
Unresolved Tensions
Individual Healing vs. Systemic Change Hanscom advocates both personal healing practices and educational/societal transformation, but the relationship between these levels remains underdeveloped in this presentation.
The Role of Medical Intervention. While acknowledging that surgery and medication have appropriate uses, the specific criteria for when these are beneficial versus harmful could be more clearly articulated.
The Timeline Problem: Encouraging patience with healing while people are suffering significantly creates tension. How long is reasonable to try before seeking other approaches?
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IMPLICATIONS FOR DIFFERENT AUDIENCES
For Chronic Pain Sufferers
Core Message: Your pain is real, but it may be primarily neuroplastic. There’s hope, but it requires a fundamentally different approach than what you’ve tried.
Action Steps:
- Start expressive writing today
- Learn about neuroplasticity
- Begin practicing connection to pain using DOC
- Consider whether your life circumstances increase threat
- Experiment with play and nervous system regulation
Warning: Don’t use these tools to “fix yourself.” That perpetuates the problem. Use them to learn to be with your experience differently.
For Healthcare Providers
Core Message: Most chronic pain involves neuroplastic mechanisms that surgery and medication cannot address. Understanding these mechanisms should transform treatment approaches.
Action Steps:
- Screen for neuroplastic pain indicators
- Educate patients about pain neuroscience
- Refer to neuroplasticity-informed practitioners
- Reduce unnecessary imaging and procedures
- Validate suffering while reframing causes
Challenge: Current healthcare economics and training don’t support this approach. Systemic change is needed.
For Educators and Parents
Core Message: Children need to learn emotional regulation, play, and nervous system awareness as foundational life skills to prevent chronic pain and suffering.
Action Steps:
- Prioritize unstructured play
- Teach children about emotions and the nervous system
- Model healthy boundaries and authentic expression
- Create environments of safety, not performance pressure
- Integrate these concepts into curriculum
Vision: Transform education to develop emotionally intelligent, resilient individuals.
For Society
Core Message: Much human suffering stems from treating concepts as concrete threats and from educational systems that prioritize ego-development over well-being.
Action Steps:
- Recognize how identity-based thinking creates conflict
- Value connection and authenticity over competition
- Create social structures supporting safety and play
- Transform healthcare to address whole-person needs
- Invest in prevention through education
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THE NEW BOOK AND EVOLVING UNDERSTANDING
Consciousness and the Unconscious Brain
Hanscom references his forthcoming book that explores:
- The physiology of consciousness
- Interaction between the conscious and unconscious brain
- How concepts become as real as physical threats
- The evolutionary roots of current dysfunction
Key Insight: “Our brain has not learned how to process all the sensory input it has—personal and societal, certainly social and subgroup impact in a huge way.”
The Evolutionary Mismatch
Humans evolved for:
- Small social groups
- Physical threats requiring immediate response
- Limited sensory input
- Concrete dangers
Now we face:
- Complex social structures
- Abstract threats (concepts, identity threats)
- Overwhelming sensory input
- Symbolic dangers our brains process as real
The Result: Chronic activation of threat responses to non-life-threatening situations, creating epidemic chronic pain and mental health problems.
The Competitive Species Problem
As competitive animals, humans naturally:
- Compare and rank
- Create in-groups and out-groups
- Defend territory and resources
- Seek dominance
When applied to concepts:
- Political/religious beliefs become “territory” to defend
- Identity differences trigger survival responses
- Symbolic threats feel literally life-threatening
- Violence and discrimination result from treating concepts as concrete
The Challenge: How do we honor our nature while not letting it destroy us?
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RESOURCES AND NEXT STEPS
Hanscom’s Recommended Approach
Primary Resource: Read “Back in Control” – A relatively quick read providing the foundational framework. All of his resources are on www.backincontrol.com.
Implementation: Engage in the DOC Journey course 10-20 minutes daily over 3-6 months. It is accessed at www.thedocjourney.com
Progression: As changes occur, select additional resources that resonate
Warning: Don’t do multiple programs simultaneously. Master one approach first, and then move on as seems appropriate.
Other Practitioners Mentioned
Dr. Howard Schubiner – Hanscom’s mentor, another leader in neuroplastic pain treatment
Dr. Brad Fanestil – Boulder, Colorado practitioner
Lynn Health (L-I-N Health) – Organization working in this area
Dutch Thompson – Denver-based practitioner who spoke on neuroplasticity
Each has their own approach, but all share core principles.
The Foundational Nature of Hanscom’s Work
He emphasizes his work is foundational rather than comprehensive:
- Provides understanding of mechanisms
- Teaches core skills (especially writing and connection)
- Creates a platform for additional growth
- Allows people to then explore other modalities
Philosophy: Learn to be with pain first, then pursue other healing modalities from that foundation.
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CRITICAL SUCCESS FACTORS
What Makes This Approach Work
Consistency Over Intensity
- Daily practice matters more than dramatic efforts
- Small, sustained actions accumulate
- Trust the process even when immediate results aren’t visible
Genuine Connection
- Can’t fake a connection to yourself
- Authenticity essential (hence the “destroy the writing” rule)
- Half-hearted engagement produces half-hearted results
Patience and Long-Term Commitment
- Expect months, not days or weeks
- Neural pathways took time to form; they take time to change
- Premature abandonment prevents success
Willingness to Challenge Beliefs
- About pain causes
- About control and willpower
- About what healing means
- About identity and self-concept
Life Changes May Be Necessary
- Sometimes relationships need to end
- Sometimes jobs need to change
- Sometimes boundaries need firm establishment
- This isn’t failure—it’s recognizing reality
What Undermines Success
Using Tools to Fix Yourself
- Creates pressure and expectation
- Maintains focus on eliminating pain
- Perpetuates control agenda
Inconsistent Practice
- Starting and stopping repeatedly
- Trying briefly, then abandoning
- Switching between multiple approaches
Remaining in Toxic Situations
- Chronic threat prevents nervous system regulation
- No amount of practice can overcome a continuously dangerous environment
- Boundaries and life changes may be prerequisites
Maintaining Victim Identity
- “I’m someone in chronic pain” asa core identity
- Makes healing threatening to the sense of self
- Secondary gains from the pain role
Isolation
- Healing without connection is incomplete
- Human nervous systems co-regulate
- Authentic relationships essential
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FINAL SYNTHESIS: THE COMPREHENSIVE PICTURE
The Core Understanding
Chronic pain is a threat response gone awry. The brain creates pain to protect you from perceived danger. When threat perception becomes chronic (through life circumstances, learned patterns, accumulated stress), pain becomes chronic. Healing requires:
- Understanding the mechanism (neuroplastic pain, unconscious brain dominance)
- Reducing threat perception (safety, connection, play)
- Changing relationship to pain (connection instead of fighting)
- Addressing life context (relationships, boundaries, meaningful engagement)
- Practicing consistently (writing, DOC, nervous system regulation)
- Engaging with life (regardless of pain presence)
The Revolutionary Shift
From: Pain as an enemy requiring elimination through control and medical intervention
To: Pain as information requiring understanding, acceptance, and life transformation
From: Success measured by pain reduction
To: Success is measured by life engagement and meaning
From: Passive recipient of medical treatment
To: Active participant in neural reprogramming
From: Fighting what is
To: Connecting with what is
The Broader Vision
Hanscom’s work points toward a comprehensive transformation in how we:
- Understand and treat chronic pain
- Educate children about emotions and nervous systems
- Structure healthcare systems
- Think about consciousness and identity
- Create societies that support human flourishing
The Ultimate Message: Most suffering is optional. Not easy to eliminate, but optional. It stems from resistance to reality, from treating concepts as concrete, from isolation, from fighting our experience. When we learn to connect—to pain, to emotions, to others, to what is—suffering diminishes even if circumstances don’t change.
The path forward isn’t through more control, more willpower, or more intervention. It’s through understanding, acceptance, connection, play, and engaging fully with life. The unconscious brain, given these signals of safety, can recalibrate. Neural pathways can change. Life can be reclaimed—not by fixing ourselves, but by learning to be with ourselves differently.
CONCLUSION: AN INTEGRATED APPROACH TO HUMAN SUFFERING
Dr. Hanscom’s presentation synthesizes neuroscience, psychology, and practical wisdom into a coherent framework for addressing not just chronic pain but the broader human experience of suffering. By understanding the unconscious brain’s threat-detection mechanisms, the neuroplastic nature of pain, and the profound importance of connection, safety, and play, individuals can fundamentally transform their relationship with pain and with life itself.
The approach challenges conventional assumptions about control, willpower, and medical intervention while offering hope grounded in science and validated by clinical outcomes. Most importantly, it empowers individuals to reclaim their lives not by fixing themselves but by learning to be with their experience differently—accepting what is while actively engaging with what could be.
The implications extend far beyond individual healing to educational reform, healthcare transformation, and even the way we structure society to support human flourishing rather than inadvertently creating the conditions for chronic suffering. As Hanscom notes, this is ultimately about solving “a major human species problem”—our evolutionary heritage colliding with modern life in ways that create epidemic levels of pain, anxiety, and disconnection.
The solution lies not in returning to some imagined past or in achieving perfect control over our experience, but in developing new skills for being human in the modern world: skills of emotional awareness, authentic connection, playful engagement, and compassionate presence with whatever arises. These skills, transmitted through education and modeled in relationships, could transform individual lives and, collectively, society itself.
Key Takeaways for Implementation
- Start with expressive writing – 5-10 minutes daily, destroyed immediately
- Practice DOC – Define, Observe, Contextualize when pain occurs – accessed at www.thedocjourney.com
- Connect rather than fight – deal with reality while actively engaging with life
- Create conditions of safety – Through play, relationships, and nervous system regulation
- Be patient – Neural change takes months, not weeks
- Don’t use tools to fix yourself – Use them to learn to be with yourself differently
- Address life context – Relationships, boundaries, and meaningful engagement matter
- Measure success by life quality – Not by pain reduction
- Stay connected to skepticism – Don’t force belief; experiment and observe
- Engage professional help when needed – Practitioners trained in neuroplastic approaches and self-calming methods.
Feel free to reach out with questions. This journey is complex, but not complicated. The idea is to spend only about 10-20 minutes per day with these concepts or the course. It should not be “work.” Enjoy!!