I find this concept helpful for understanding and healing from chronic pain and other stress-related symptoms, but I want to propose an additional layer of nuance.

Fear, like pain, is something that we need for survival. Without fear, we wouldn’t run for cover when a tornado is coming. Without pain, we wouldn’t pull our hand away from the stove when we get burned.

So, it wouldn’t be accurate to say that all fear is undesirable or that all fear leads to chronic pain. And it’s certainly impossible to get rid of fear or to never feel afraid again.

But there’s one type of fear in particular that I find most often in clients who struggle with chronic symptoms, and that is the fear of social rejection. This fear can trigger self-abandoning thoughts and behaviors, and habitual self-abandonment leaves us feeling helpless and hopeless. It can put our nervous system into a state of chronic stress that manifests in chronic symptoms.

Here are some anecdotal examples:

I’ve seen folks who are afraid to sit, stand or walk because it hurts, and the more they fear these activities, the more the pain persists. But what really escalates their pain levels is the fear that they will be rejected by their family, their job, their partner and friends for not being able to “keep up.” This social fear preoccupies them so greatly that they spend most of their energy trying to please others rather than prioritizing their own feelings, needs, desires and pleasures. And this habit of self-abandonment puts them in a chronic state of stress.

I’ve seen folks who are afraid to go out for a night on the town for fear that it will trigger a migraine attack. And the more they fear and predict pain, the more the pain persists. But what really escalates their attacks is the fear that friends and loved ones will see them as weak or pathetic or uncool for not being able to “keep up.” And again, it’s that social pressure that triggers self-abandoning habits which in turn leads their body to feel like it can’t trust them. And when our body feels like it can’t trust us, it freaks out and pulls the emergency alarm: symptoms.

If any of this is resonating with you, you might be wondering: OK now what? Now that I’ve recognized this pattern of fear of rejection and self-abandonment that exacerbates my stress levels and symptoms, what the heck can I do about it?

And my answer might not be what you want to hear, because when we’re feeling fearful, we want quick solutions and certainty. And as far as I know, the antidote to self-abandonment is something far more complex than that: it’s the gradual journey of developing self-compassion.

Developing self-compassion is slow work. It’s gentle work. It’s asking ourse in each moment, “what is the simplest, easiest, most doable step I can take right now to be just a little bit gentler and kinder toward myself?”

We can’t develop self-compassion with harsh expectations or by pressuring ourselves to transform our self-relationship overnight. We have to give ourselves the grace to do it one baby step at a time.

So, keep it simple and ask yourself, “what is the simplest, easiest doable step I can take — from exactly where I am right now — to bring just a tiny bit more kindness and gentleness into the way I treat myself?”

I’d love to hear what you come up with!

➡️ If you need support with chronic pain and anxiety, take my FREE QUIZ called “Why the *bleep* am I still in pain?!” so I can help you get some clarity.

And follow me on Instagram for healing tips, inspiration and encouragement.

The post The Role of Fear and Self-Abandonment in Chronic Symptoms appeared first on Medika Life.

As humans, we are instinctively drawn to ourselves. It’s an inherent trait that defines our existence and makes us who we are. However, as technology advances and becomes increasingly sophisticated, we begin to question whether we can embrace it as am intimate part of ourselves. This is the Scorpion Effect.

The story goes that a scorpion stings because it’s in its nature to do so. Similarly, as humans, we struggle to embrace technology because it goes against our very nature. While technology may be incredibly useful and powerful, it’s also foreign to us. We simply can’t relate to it in the same way that we can relate to other humans.

Perhaps the biggest reason for our reluctance to embrace technology is the belief that it represents an existential threat. Many people fear that technology—particularly AI—will eventually replace humans, making us obsolete or subservient. And others feel that technology robs us of some fundamental aspect of ourselves that historically is the domain of humanity. This can include qualities and emotions such as creativity, musical virtuosity and even love. The rise of artificial intelligence in lens of Hollywood and its dystopian perspective has only fueled these fears.

The emergence of GPT technology, such as GPT-3, exacerbates the problem of the Scorpion Effect by blurring the lines between what is human-generated and what is machine-generated. GPT technology is a form of artificial intelligence that is capable of generating human-like language and responses to various prompts. It’s captured the world’s imagination—for better or worse.

GPT technology can be incredibly useful in a variety of applications, from chatbots to content generation. However, the fact that machines are now able to generate language that is nearly indistinguishable from that of humans raises questions about what it means to be human and how we interact with technology.

Further, GPT technology can be used to generate content at a massive scale, potentially leading to the creation of vast amounts of low-quality, machine-generated content. This could ultimately devalue the role of human creativity and expertise in content creation, as more and more tasks are handed over to machines. And the use of GPT technology in social media and other platforms could lead to the spread of misinformation and fake news. If machines are able to generate convincing language and responses, it becomes more difficult to distinguish between what is real and what is fake.

Another concern is the potential loss of privacy and personalization in our interactions with technology. As machines become more sophisticated at generating human-like responses, it becomes easier to forget that we are interacting with a machine rather than a human. This could lead to a loss of trust and transparency in our interactions with technology.

In addition to the fear of being replaced or subordinated, there is also the issue of the fundamental differences between humans and machines. We are made of flesh and blood, while machines are made of silicon and carbon. While we can certainly create machines that mimic our behavior and thought processes, they will remain different, in both structure and function. This fundamental difference between humans and machines creates a deep chasm that can be difficult to bridge. We may be able to program machines to do certain tasks or behave in certain ways, but will they truly understand what it means to be human?

Moreover, some argue that there is a “spark of life” that separates humans from machines. This spark is what makes us unique and gives us our humanity. It’s what enables us to feel emotions, experience the world around us, and form connections with other people.

Of course, this isn’t a uniform consensus. Many people embrace technology and see it as a powerful tool that can help us improve our lives and make the world a better place. The Scorpion Effect is a reminder that our relationship with technology is complicated and multifaceted. While we may be attracted to technology for its power and utility, we also have a deep-seated fear of what it represents. And the sting of technology—particularly as it advances as a cognitive tool—can be deadly. But the realistic and unrealistic fears that it congers can be even worse.

The post The Scorpion Effect: Why People Struggle To Embrace Technology appeared first on Medika Life.

Suffering happens when our protective mechanisms become chronic. Protective mechanisms like: Hyper-vigilance, anxiety, physical pain… These are all “danger” alarms that our nervous system sets into motion to protect us. But when our protective mechanisms become chronic, they start to smother us.⁠

Protective mechanisms are triggered by fear. Chronic protective mechanisms are held in place by chronic fear.

To heal the symptoms, we need to address the fear.⁠

But if we address the fear as a problem to be solved or an unwanted part to be exiled, guess what happens?⁠

Fear freaks out. Wouldn’t you freak out if you were treated as a problem or an undesirable?⁠

Trying to fix fear won’t fix fear. Fear doesn’t need to be fixed. Fear needs these three simple things in order to feel safe again:⁠

1️⃣ Fear needs to be 𝗮𝗰𝗸𝗻𝗼𝘄𝗹𝗲𝗱𝗴𝗲𝗱. Name the fear.⁠

2️⃣ Fear needs to be 𝗲𝗺𝗽𝗮𝘁𝗵𝗶𝘇𝗲𝗱 with. Tell fear you get it. You’ve been afraid before. You know what that feels like, and it’s a difficult thing to experience.⁠

3️⃣ Fear needs to be 𝗹𝗼𝘃𝗲𝗱. Tell fear, “I’m here for you. I care about you. I’m your biggest supporter and I will take care of you. I’ve got you. I love you.”⁠

But what if you’re afraid to try this approach? Then start by acknowledging, empathizing with and loving 𝘵𝘩𝘢𝘵 fear. 💖⁠

With total and infinte belief in you,

Anna

The post What To Do When You Feel Afraid appeared first on Medika Life.

The answer is… it really depends.

Pain is a danger signal that your nervous system sends when it feels unsafe. So should you obey the danger signal and stop what you’re doing? Or should you ignore it and keep going on with your life?

Or… could there be a different path altogether?

Consider this metaphor…

Imagine that your nervous system is a child and your mind is the parent. While playing, the child falls, scrapes their knee and starts crying in pain and fear.

What parenting style will help the child to reestablish a sense of safety?

👉 Would it be a pushy, tough-love parenting style — telling the child to “just get over it” and push through the pain? Probably not.

👉 Would it be a coddling, over-protective parenting style — telling the child to lie down in bed and sleep for the rest of the day every time they feel fear and pain? Probably not that either.

➡️ How about a style of loving acknowledgment and gentle encouragement?

If pain is mild…

That means the child is only a little unsettled. Offer them warmth and kindness — and then encourage them to shake it off. Reassure them that they’re okay and remind them that they’re strong and capable.

If pain is high…

That means the child is quite shaken up and may need time to reestablish equilibrium. Offer them warmth and kindness while they feel their feelings. Give them the time they need to settle. Sit with them and sooth them. And then…

Once they’ve settled enough that their distress and pain levels have decreased to mild — encourage them to get back in the game!

If the child resists, do NOT push them.

The goal is to help the child regain a feeling of safety. Pushing them and overriding their feelings will not accomplish that — it will only increase distress. Instead, honor their feelings and alternate soothing with gentle encouragement.

Translating the metaphor…

When you feel pain, what would feel kind and loving to your nervous system? Because kind and loving is what helps the nervous system feel safe. Safe enough to turn down the danger signal (i.e. pain.)

Treat your nervous system the way you would treat a beloved child — honoring the child’s vulnerable feelings with empathy, expressing confidence in their strength and capability, and encouraging them to re-engage in activities that bring them joy — and little by little, feelings of safety will return.

It may take time and patience. But your nervous system is worth it! 💖

With loads of warmth, empathy and confidence in you,

Anna

➡️ If you need support with chronic pain and anxiety, take my FREE QUIZ called “Why the *bleep* am I still in pain?!” so I can help you get some clarity.

And follow me on instagram for healing tips, inspiration and encouragement.

The post Should You Rest or Keep Going When You Have Chronic Pain? appeared first on Medika Life.

It’s also not a new idea that stress causes heart disease. Cardiac patients have been told to lower their stress levels for decades by avoiding strenuous activity — but unfortunately, they haven’t been told much more than that. Healthcare providers tend to focus more on things that are easily measurable like medication adherence, blood pressure, smoking, and cholesterol. Stress seems like a slippery, messy, wishy-washy concept that we are not well equipped to address. But some recent science suggests the role of mental stress in cardiovascular disease might be more significant than previously understood. In light of this evidence, a deeper dive into the concept of stress is warranted.

Stress: what it does to the body

Stress is the body’s physical and mental response to changes and challenges (stressors). The stressors themselves can be physical, like hard exercise or injury, or mental, like emotional upset or trauma. Some of the body’s responses are helpful, especially in the short term.

Increased alertness, heightened perception, increased blood flow to muscles, and increased energy availability can help you respond to a stressor. Appropriate levels of stress can also lead to adaptation over time. However, when stress is chronically high, these mechanisms can become maladaptive, and without time to rest and recuperate, adaptation doesn’t occur.

In mental stress, the brain responds to fear (processed in the amygdala) by activating the sympathetic nervous system (that’s the fight-or-flight response). This sets off a cascade of hormones that can serve to protect the body from danger acutely, but chronic activation can result in increased body fat, insulin resistance, hypertension, vascular inflammation, and atherosclerosis.

Chronic systemic inflammation created through these mechanisms is also a potential consequence of ongoing stress. A chronic inflammatory state is associated with a host of chronic illnesses. This is one likely mechanism for how poverty, racism, abuse, and other so-called social determinants of health are major contributors to observed health disparities.

So what does the evidence say?

A large (n=24,767) case-control study published in the journal Lancet in 2004 reported that psychological stress was an independent predictor of later heart attacks. A more recent study published in JAMA late last year (including 918 patients over nine years) reiterates this finding with more specificity. Not only can mental stress lead to cardiac ischemia (reduced blood flow to the heart), but patients who develop mental stress-induced ischemia are more likely to experience heart attacks and to die over the next four to eight years. These findings tell us clearly that in people with any degree of underlying heart disease, mental stress is strongly associated with heart attacks and death. This isn’t a negligible effect or a questionable outcome. These are meaningful, relevant endpoints, and we should care about them.

Is there a prescription for stress?

Perhaps you work in, or get care in, a patient-centered medical home with an integrated behavioral health team that has the training and resources to coach people through long-term, evidence-based stress management programs. But probably not. Absent a perfect solution, what tools do healthcare providers and patients have at their disposal? Physical exercise is one tool that can reliably modulate the body’s stress responses, including inflammation. Others include consistent, high-quality sleep, mindfulness practices, and an anti-inflammatory diet pattern. For some, medication to treat anxiety or depression can lessen activation of the stress response.

Exercise, get good sleep, eat well, meditate, and take your medication? This list reads like a who’s who of behaviors that are hard to change. For people who are used to getting simple prescriptions from their healthcare providers, advice to make changes to their lives and habits is often ineffective. Most people don’t have experience with positive goal setting and behavior change, and most clinicians think they lack the expertise and/or time to counsel them. There are promising models to address these challenges, including group visits, behavior change specialists embedded into primary care, integrative medicine practices, and health coaching. For many, though, these services are not available, too expensive, or otherwise out of reach.

Practical tips for providers & patients to try

So what CAN you do, as a clinician or a patient seeking to encourage stress reduction as a means to reduce cardiac risk? First, acknowledge that this is a different kind of prescription — not everyone will be game for it. Ask your patient (or yourself) if they’re willing to try this approach. If they are, here are some tips to guide you.

• Make it meaningful. Scare tactics don’t work. Tying change to individual values does. Try asking an open-ended question like “what do you want to be in good health for?”.
• Make it personal. Consider offering some possible directions and seeing which one sounds most interesting, doable, or important. For some, increasing physical activity will be appealing; for others, it may seem impossible. Explore what will work best for each individual.
• Make it specific. Trying to make huge, sweeping changes is overwhelming. Advice to “eat better” or “exercise more” doesn’t create a path forward. Offer targeted information and encourage identifying small, manageable actions steps, one at a time.
• Offer affirmation & accountability. Believe in each person’s strengths, acknowledge their skills and successes, and help them stay connected to their intention to change. For some people, a reminder letter or a quick question at a follow-up visit will do the trick. Others might find keeping a log or looping in a loved one helps.

This process, believe it or not, can be accomplished in just a few minutes if that’s all you have. If you don’t believe me, give it a try! With a little practice, I’ve been able to implement this style of counseling into routine primary care visits without getting behind. As an added bonus, most people really value being listened to in this way.

Clearly, brief counseling in medical visits is not a panacea and won’t undo stress, especially chronic stress from poverty or racism. But it is an inexpensive, empowering, and science-based risk reduction strategy that anyone can implement in any setting — and that’s a great place to start. Are you ready to add stress reduction to your cardiac risk management toolkit?

Elizabeth Knight is a scientist, nurse practitioner, educator, and coach. You can find her at www.flowerpower.health.

The post The Latest Science on Stress appeared first on Medika Life.

“You gain strength, courage and confidence by every experience in which you really stop to look fear in the face. You are able to say to yourself, ‘I have lived through this horror. I can take the next thing that comes along.’ You must do the thing you think you cannot do.”
— Eleanor Roosevelt

Fear is one of our most resistant emotions, and it refuses to be erased quickly, despite Eleanor Roosevelt’s advice. She faced fears which would have traumatized any child, e.g., shipwreck, father’s attempted suicide, and loss of parents to diphtheria.

In addition to her losses, Eleanor was shy due to her mother constantly referring to her as an ugly child she called “Granny.” Unfortunately, her mother was one of the desirable beauties of her age.

Eleanor did manage to conquer her fears, but childhood fears, especially of medical and dental settings, stay with us for too long — into our adult lives. These fears pose threats to our health in their potency to inhibit actions that would save us from illness. How do we tackle this thorny emotion? First, a bit of history on my personal experiences with medical misdiagnosis and fear.

A Child’s Trauma

When I was a young child, a trip to the hospital emergency room felt like I was being led to a torture chamber, which it invariably proved to be. The smell of antiseptic filled the air in the gloom of the old city hospital.

I would be deposited with my mother on a long wooden bench in a hallway waiting to be called in. It always seemed that we were the only ones waiting there. The waiting was as though the torturers were preparing their tools to provide the ultimate in my painful experience.

One experience stands out among all the others. I had a toothache and, since we could not go to a dentist because we had no money, the dental clinic was a trip I was soon to make.

Today, it would be right out of Dustin Hoffman’s “Marathon Man” or “A Clockwork Orange,” maybe even “The Boys From Brazil.” Would the dentist have uttered Robert Duvall’s famous line from “Apocalypse Now” (with a slight change), “I love the smell of antiseptic in the morning.”

After a long wait in the hallway, I was called in, alone, seated in a large chair and surrounded by three nurses and a dentist. The torture was about to begin.

I received a minuscule shot of Novocain, and the dentist proceeded with enthusiasm and a pair of pliers to pull at my tooth. The anesthetic hadn’t yet taken effect, but they weren’t going to wait. As I pleaded, they refused to believe me that it was painful.

Three nurses grabbed me and held me down as the dentist pulled at my tooth until it plopped out. The fear I felt was extraordinary, and they acted as though I were being an unruly child, not one in pain and frightened out of my wits.

The Second Fearful Experience

My next childhood experience in a charity hospital emergency room, as a six-year-old child, was also traumatic and almost catastrophic. I had a leg injury, which was misdiagnosed and, as a result, I was later rushed into surgery.

The surgeon told my parents that they didn’t know if they’d be able to save my leg. They’d waited too long to come in; they hadn’t. The intern they saw earlier in the day sent us home after their first visit to the ER.

As I was wheeled up to surgery, my parents were accused of child abuse by an over-enthusiastic social worker who refused to believe the intern misdiagnosed the injury. I, even as a young child, heard the comments and yelled to support my parents.

I recall blurting out that they did not injure me and that they followed the doctor’s instructions. I have no idea if they believed me or thought I was being a loyal child. We know that abused children generally protect abusers.

I almost lost my leg at the hip because of that misdiagnosis, and my parents were nearly arrested for child abuse. It was all the result of inadequate medical training.

Of course, the fact that we were poor added to the problem. How many poor kids have gone through the same experience and will experience this type of treatment in the future? The thought is more than distressing.

It took a long time, but, as an adult, I overcame my fear and managed to go to the dentist as I would go to any other appointment. I never expected pain, nor did I ever experience it because all the dentists I saw waited for the anesthetic to work.

Stress and Fear Resistance to Extinction

Stress has a critical role in the development and expression of many psychiatric disorders, and is a defining feature of posttraumatic stress disorder (PTSD). Stress also limits the efficacy of behavioral therapies aimed at limiting pathological fear, such as exposure therapy.

Early childhood stress, therefore, plays a central role in the development of stress-related disorders such as dental phobias. But is it solely learning to be fearful in a specific environment, or is there a biological involvement?

Dr. David Barlow theorized three specific types of anxiety-related behavioral outcomes:
1. generalized biological vulnerability, mainly of genetic origin
2. generalized psychological vulnerability, resulting in particular from early life experiences
3. a specific psychological vulnerability focused on particular events or circumstances

Therefore, early childhood experiences, together with a genetic component, are actively responsible for phobic anxiety. While they may be confined to specific places or events, Barlow never delved into the question of biological brain area and structural changes that would embed fear-related memories. The physiological changes in the brain seemed unreasonable. But research provided new clues to early fear imprinting.

The biology of fear and anxiety has now been explored and it has been found that specific areas of the brain are where fear resides.

Vulnerability to psychopathology appears to be a consequence of predisposing factors (or traits), which result from numerous gene-environment interactions during development (particularly during the perinatal period) and experience (life events), (and) the biology of fear and anxiety (is a) systemic brain-behavior relationships, neuronal circuitry, … functional neuroanatomy and cellular/molecular (neurotransmitters, hormones, and other biochemical factors…

Multiple brain structures involved in fear work in an interplay of swift reactions meant to preserve and protect life, usually from saber-tooth tigers, but today real or imagined threats.

The fear response starts in a region of the brain called the amygdala. This almond-shaped set of nuclei in the temporal lobe of the brain is dedicated to detecting the emotional salience of the stimuli — how much something stands out to us.

From the amygdala and other brain structures, e.g., the prefrontal cortex and the hippocampus, the cascade of hormones and neurotransmitters begin to wash the brain in a reaction to danger.

Fear is being laid down in the brain, which will incorporate it into its memory banks in the hippocampus. But the memory of fear is not restricted to the brain alone. All the five senses of sight, olfaction, audition, touch, and taste record their memory in a somewhat dissimilar fashion and save it for later use.

Every physical reaction to fear is mustered during this time as blood pressure rises, the heart beats in an ever-increasing cadence, sweat is produced, and even the intestinal tract works overtime.

Despite all this disturbing activity, abused children, who fear their abusers, protect them. Why? Imaging of these children’s brains shows abnormal portions of their brains, which is believed to be related to the abuse.

The brain, in fact, in fearful children shows areas that are smaller. Fear has hampered and impeded development which then manifests in unexpected, protective behavior of the children toward their abusers.

So, early fearful experiences are not solely learned; they are laid down in neurology in the person in fear. Can this be changed later in life?

Research on brain development and early fear would require something equivalent to the 40-year-study of Donald Super and his colleagues related to school children and career choices. It would be nearly impossible today because of the needed funding and maintaining a dedicated and willing database of participants.

But we march on with various forms of therapy in the belief that we will be able to conquer fear and we do. Does the brain recognize these new and acceptable experiences and respond physically to them? Maybe someday we’ll know the answer to that question.

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