Healing Pain Class: Stress And Pain: How To Change Our Reactions

Presented by Dr. Bruce Eisendorf (Family Medicine)

[This article also includes information from the Holistic Health SMA series Dr. Eisendorf offers – this particular class reviewing “The Last Best Cure” by Donna Jackson Nakazawa]

Both stress and pain are inevitable, but we have some control over our reactions to them.

Some strategies for change: Meditation and mindfulness, loving kindness and compassion meditation, yoga, spending time in nature

Psychoneuroimmunology: aka PIN (psycho-immu-neurology): the study of how our mental and emotional states influence our overall physical health and our ability to heal. It also studies the “floating brain”, which includes the chemical and hormonal messengers that are triggered by stress and our mental and emotional reactions (adrenaline, noradrenaline and cortisol).

Stress: Any threat to our physical or psychological well-being, real, perceived or imagined. Stress leads to stimulation of the sympathetic nervous system and the activation of the hypothalamus, pituitary and adrenal glands. This process is what is called our “flight/fight” reaction.

ACE: Adverse Childhood Experiences: emotional/physical neglect, physical/emotional/sexual abuse, having lived with someone with depression/substance abuse, having lived with only one parent, having lived in home where someone else was being abused.

A 1997 study with 17,000 patients showed that 2/3 of them experienced at least 1 ACE by age 18. ACEs correlated to higher risk of chronic illness (independent of other factors), such as cardiovascular disease, cancer, lung disease, diabetes, autoimmune disease, chronic pain, depression, ulcers. The younger the age of the ACE, the greater the impact. All the ACEs seem to have similar impact. The study also found that the more ACEs a patient had, the smaller the hippocampus. The hippocampus is part of the brain that processes memories, emotions and stress.

MBSR: Mindfulness-based Stress Reduction. Developed by Jon Kabat-Zinn, Center for Mindfulness in Medicine, U of Mass Medical Center. Most studies show a 35-65% reduction in chronic pain, depression, and anxiety.

MBSR and Chronic Pain: At a pain clinic, an eight week study involving an MBSR class with daily practice showed 88% of participants had more than 50% reduction in their pain and achieved better pain relief than from morphine or other drugs. 44% reduced there analgesic pain meds. Without MBSR, there was no improvement in overall pain nor reduction in medication. MRI’s showed regions of the brain, normally active when in pain, were much less active. There was an increase in grey matter in the hippocampus.

Wandering Mind: We spend more than 50% of our time thinking about something other than what we’re doing. Though 70% of our day is relatively “good”, 28% is neutral, only 2% “bad”, but we spend most of the time thinking about the 2% “bad”. PET scans show that the more we ruminate or replay negative memories, the more we reinforce the synapses and the more these synapses fire habitually.

MEDITATION: Increases telomerase (RNP – ribonucleoprotein that contain RNA) and increase the length of telomeres (the end of certain chromosomes), which in turn is connected to reduced cellular aging. Meditation has also been shown to reduce the tendency to ruminate on negative emotions, contribute to a greater sense of control and purpose in life, reduce cognitive aging, and increase in grey matter and size of the hippocampus.

AMYGDALA: The “reptilian” or “lizard” part of our brain, the “alarm center”. About 66% of the cells in the amygdala are dedicated to processing negative information. We are “hardwired” to focus on negative information so that we can respond rapidly to life threatening situations. “Our brain is like Velcro for negative events and Teflon for positive ones” (Rick Hanson, PhD http://www.wisebrain.org/BuddhasBrainArticle.pdf).

Naming Feelings: UCLA Brain Mapping Center research shows that when people identify their emotion (viewers identified faces which were angry/fearful…) then the amygdala (fight/flight) response decreased (compare to just identifying the person’s name). Meditators who more often identify and label their emotions had less activation of the amygdala and reduced stress reactions.

Compassion Meditation: AKA Loving Kindness Meditation has been shown to reduce stress reduced cytokine activity and lower stress levels. Cytokine are small proteins that signal immune system responses including inflammation, similar to infection. Research shows that feeling love for another activates the same area of the brain that is activated by opioids or by winning a lottery.

Loving Kindness Meditation: Here are some examples of words to say or think, like a mantra: “Be grateful to everyone” (one of the 59 slogans in the Tibetan Lojong tradition). “May you be happy, healthy, and whole”. “May you abide in the peace, freedom, and equanimity that you deserve”. “May you be filled with love and kindness”. “May you be safe and protected”. “May you love and be loved”. “May you be happy and contented”. “May you be healthy and strong”. “May your life unfold with ease”. “May you be a person of joy.”

Yoga and Pain: Certain regions of the brain respond the same to physical as well as to emotional pain. Regular practice of yoga helps to dampen the reaction to both and reduce inflammatory cytokines. Regular yoga has been shown to improved mood, decrease pain and and fatigue in people with fibromyalgia and other chronic illnesses.

Shinrin-yoku: “Forest bathing” often prescribed as therapy by Japanese physicians. It’s a practice of spending time in nature, It has been shown to increase the activity parasympathetic nervous system (controls relaxation) and suppresses sympathetic activation, and improves memory and attention. In a study of hospitalized patients, those with a view of nature from their rooms recovered more quickly and used less analgesics than those patients without a view of nature.

“The Last Best Cure, My Quest to Awaken the Healing Parts of My Brain and Get Back My Body, My Joy, and My Life” by Donna Jackson Nakazawa, chronicles her recovery from severe auto-immune disease and chronic pain.

Chronic Disease: affects 50% of adults (chronic pain, migraines, autoimmune disease, chronic fatigue, depression, cancer IBS).

GABA: low levels of this brain chemical are associated with depression and anxiety. A study involving 3 months of yoga class vs. the same amount of time walking showed that those doing yoga had significantly higher GABA levels, as well as decreased brain activity in the amygdala, which is the part of the brain which detects fear and prepares for emergency events, and increased activity in the frontal lobe, which is associated with emotional clarity and problem solving.

Parasympathetic Nervous System: many anti anxiety and antidepressant meds dampen the sympathetic nervous system. Yoga coordinated with slow breathing activates the parasympathetic system, helps immune system, blood pressure, breathing, digestive and cardiovascular systems.

Exercise: Increases new neurons and nerve connections in the brain and is show to reduce depression and anxiety. Exercise has also been shown to increase telomeres and less memory and cognitive decline. 15 minutes of exercise per day increases life expectancy by 3 years.

“Sitting is the new Smoking”: for each hour of sitting and watching TV there is an 11% increased risk of dying. Having a sitting job results in twice the rate of cardiovascular disease as a person with a standing job. Sitting for 2 hours creates a marked drop in electrical activity in the legs, a 90% reduction of lipoprotein lipase (which breaks down fat), and increases CRP (a marker of inflammation). Regular exercise doesn’t undo all these effects.

Mirror Neurons: mirror neurons are brain cells that receive signals from those in proximity to us and trigger similar reactions with us. Woman have more than men. Mirror neurons explain why we’re more likely to laugh, cry or yawn when someone with us does this. Thus, there a benefit of being in a group for doing yoga, meditation, exercise.

Set a Goal – meditation and mindfulness, yoga and exercise, loving kindness and compassion meditation, psychotherapy, group support, spend time in nature

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