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This is the introduction to my pamphlet entitled Doing -Thinking -Feeling- In the World and serves as an introduction to this blog. You migh...

Psychology blogs & blog posts

Thursday, April 15, 2010

“Back Pain”

“Back Pain”



Brian Lynch

This is pretty dangerous territory. Back pain is a problem for many people including doctors. The good news is that nine out of ten people do get over back pain. Besides doing psychotherapy I do, do general medicine and there is a lot of back pain in general medicine. There is just a lot of pain in medicine. 


One reason I do psychotherapy and general medicine is that I do not believe that there is a great difference between the mind and the body. Some people say “Oh the pain is in your head” meaning it is not “real.” Well, where is your head? Where is your brain? Is it not part of your body? 


We now know that our emotional pain and what we call physical pain or “ouch” pain come from much the same places in the brain. Back pain has to do with a lot with the spinal column. Where does the spine start? It starts in the brain. Back pain also has to do a lot with muscle pain.


We have known, for a very long time, that if we take 200 people and take all their X-rays, cat scans, and MRIs we find that we cannot tell who has pain and who does not have pain based on their studies. We find 100 of people that do not have back pain and 100 that do have back pain, but all of them have things out of place on their studies that look like they should have pain and mix all their studies and give them to radiologists to read. The experts cannot tell who has pain and who does not have pain.


Now this is very interesting. One hundred have pain and one hundred do not, but their studies are the same.


This is where people will get upset and I do not want people to get upset. I believe people have pain. They do have pain. Maybe their pain is not caused by what we see in the studies. Maybe the pain is much more complex. Maybe we should think differently?


When people go to surgery for these conditions only about one in three get better, but often not completely better, what is going on? 


In this short space, I want to suggest Dr. John Sarno of Columbia University. After studying many patients he has discovered that the patterns of the pain of many people just do not fit what is seen on their MRIs and x-rays. He, again, is not saying they do not have pain. He is suggesting that since our emotional and other nervous systems are so intertwined, and so connected that we channel our negative emotions into, mostly our muscles, and this usually is in our upper back and upper hips. I think it is a bit more complex than Sarno is suggesting but he is on the right track. He talks mostly of our problems with anger. I think our problems are with a more broad range of feelings such as distress, fear, shame, and disgust but it is a start. I would suggest any of his books such as “The Mindbody Prescription.”




Tuesday, April 13, 2010

"Accept the things I cannot change and change the things I can."

"Accept the things I cannot change and change the things I can."


Brian Lynch

This is a short version of Reinhold  Niebuhr’s prayer that is used in the “AA” or alcoholics Anonymous movement.

The other day the meaning of the prayer became much clearer to me in terms of how I try and help people go about clarifying their daily lives.

It seems that many of the serious problems people have are precisely because of issues in their life that cannot be solved. We all have them. We all, for example, know we are going to die. We all know we have to pay taxes. We all know others will die. What we are not fully aware of is how we handle this knowledge. We do not realize that we might be wasting our lives trying to avoid death and not living. We might not realize that because we lost, for example, a parent when we were eight years old that we are still trying to “solve” that problem and that is  taking up almost every moment of our life even though we are fifty.  Since the problems are unsolvable it is “beating ones head against the wall” and yet we just do not realize what we are doing and since it is unsolvable we do something else: we  get angry at the world, destroy our business, family, take drugs, just “give up.”

So the point is the “prayer” points out a very important truth. What can we do? I think it begs us to work very hard to see our lives in a new light; that which is possible and that which is not.

Sometimes something can be done. A toxic relationship with a parent or sibling just might be able to be healed. If things have gone on for years and they have consumed your life take steps to test the waters. If, however, the other party is unable to respond, and continues to hurt you, evaluate. There are two ways to go. You can now go back to old habits which will continue to magnify. Things will get worse as things feed on themselves or through a window of opportunity, that you are now creating, one might realize that we can change albeit the other might not be ready to. Is all hope lost for the other? No. Why? Because often, when we really change others often change but this takes time and commitment. This becomes a new life of sorts, not the “old life” not the old dynamic.

Brian Lynch


“Testing Those We Love”

“Testing Those We Love”




2010

“We read the world wrong and say it deceives us.” Togare



Have you ever told your child to do something and they have not done it? Likewise, have you ever told a loved one, an adult that you could not do something for them, and yet they somehow do not hear you? They come back to you in some way asking you to do the very same thing. Is there any difference? In the end, I think not. 


 They are both quite obviously “tests” of our commitment and love. Or to put it in very personal terms, and from another perspective, it is a need to be taken care of. That is, either way, you put it, it is not a healthy love or need as the emphasis is all on “my need.” I immediately say that that said we all have times of great need. We all need to be needed and comforted and we all will test others at some time or other and that is all right.


So a few examples: You ask your child to please brush their teeth and ten minutes later they are still playing around. Asking three more times still does not get results. What is going on and what is your response? It is a test is it not? First, the child is not “evil” or bad. The child is in some great confusion. They do need order and consistency in their life, but how to do it? They may say I am doing it “because I can” meaning “I know you love me.” Meaning I need you now to figure out how to show me to love me and figure out this problem. “How do you get me to brush my teeth without hurting me!” Of course, they don’t realize this on this level but it must be this.


This is not the only reason. Very much of what we do is a type of “play” as we “feel” at a subconscious level many “feelings” as children and indeed as adults out of the blue that surprise us. We feel fear and anger in an instant towards someone and act on these feelings. Indeed, we have to “play” with the feeling to manage them at the moment to figure and figure them out. But our point is that much of the time we are “testing” others.


So you tell your 28-year-old son you cannot help him out when he gets out of the army or when he returns from overseas or in whatever situation. You name the situation, but he seems to not hear you. You state emphatically your situation and your budget. You do not have the money. And comes the refrain “Dad, you don’t understand what am I supposed to do! I need 800 dollars.” Yet, it seems to you that six-eight weeks prior some steps could have been taken and on the other hand maybe nothing could have been done. The point is that there is an unconscious engine of need just like the child’s “How do you get me to brush my teeth without hurting me!” Those things were not done or he is just not hearing you and being empathetic with you because your son needs you the father to take care of him.


I am never saying that there is some other solution to getting the 800 dollars and a tragedy may ensue.


Brian Lynch, M.D.





















Monday, April 12, 2010

"Cognition"

 "Cognition"



Brian Lynch

The other day I was explaining to someone how we could now see emotional expressions on babies’ faces before they were born. Some might think this is not news, but it is. We have been able to see the fetus for years, but not clear facial images until only a few years ago. So now we can see that a fetus can smile (I then note that after birth it is several months before the baby then has a full smile again. Which I think is a testament to how rough life is.). I off handily said that we are feeling and not “thinking” and the person said, “How do you know we are not thinking?” My heart sank and I paused.


The cognitive monster raises its head. Why on earth would we presume that we are thinking before we are born? It is because as humans cognition is what makes us human. Without cognition, humans are nothing more than other mammals.  Cognition gives us control. We intuitively know when anyone says anything along the lines that is going to remove “thinking” from the equation we panic and put it back in. We are unable to learn a new system of thought.


This summarizes the entire problem I and all my colleagues have in explaining what we think is the most important psychology information available. In our essence “thinking” is not the most important part of being human. What is “feeling’ or “emotion” or whatever you want to call it is the most important. We conclude that reason and emotion have to be handmaidens but it seems almost no one can put down the gun of reason even long enough so that they do not stop shooting themselves in their foot and listen not to us necessarily but to their own emotions.


So back to the fetus, if anyone is going to make the statement “How do you know we are not thinking before we are born?” My retort is, my default position is, it is a moot question until someone proves to me that they remember thinking before they were born or it is a meaningful statement for the average person. The default or meaningful statement is that we all can agree that none of us remember anything until our first memory and that, on average, is somewhere about two years of age. What we do have is proof of feeling and that is plentiful and it is demonstrated in the face.


I am not saying we do not think before we remember. This is not so as we clearly behave logically early on and talk long before we have memory.


The point is thinking takes learning. We have to build on concepts and relationships. We feel the very basic building blocks are the biological “feeling” building blocks. We are stimulated and our feeling centers are stimulated. This is how we feel alive. This is how we begin to “know” the world first. 


Brian Lynch

"Brian chemistry"

Brian chemistry



Brian Lynch

It is certainly not uncommon for me to run across people who will express a desire to understand the “chemical” nature of their mental problems or likewise see the problem as being fixable purely or solely based on mediation.


This is a tragic situation.


Even as a doctor knowing what goes on inside the brain in terms of the chemical workings rarely helps me help you. We have to understand that we are nowhere near the sophistication in brain science that we are in other areas of medicine. We can, for example, test for a specific infection and give a specific drug for that infection. We are not so lucky to do much of any kind of tests on our brains.


For sure we know when someone has a seizure to give anti-seizure medication. But that is a “physical problem” that has to do with the physical brain. That has to do with the “physical” electrical network of the brain. And we have learned that anti-seizure medication often helps with more “mental” problems to calm people down yet exactly how and when to give them is not exact and certainly it is very individual how they affect an individual life.


My point is more with many a patient and doctor’s fascination with the thinking that knowing about serotonin, dopamine, and norepinephrine will somehow help them feel much better. I ask you, do you experience these chemicals directly? No, you don’t. Can you have any idea that you are affecting the levels of these chemicals? I say not by much. And I as a doctor cannot measure them. Again, I can give you medication that we believe alters these chemical levels and that we believe logically end in affecting certain pathways that end in making you feel different. There is an important point. You feel differently. 


If both doctor and patient would focus more on specific feelings I think we would make much more progress. And note I say feelings and not acting or behavior. Specific feelings like anger, fear, shame, disgust, interest, and joy and forgo the more diffuse and imprecise words such as “depression” and “anxiety” or “panic.” These are being called into question by more and more professionals. Just tell yourself how you are feeling today. Then, if you are taking a medication which of these specific bottoms did it push? Is the medication, making you less angry? Less afraid or is it making things worse?


We live in a world of “feeling”, we do not live inside our brain. We will never be able to experience our brains. We experience what those chemicals in our brains produce. They produce in some miraculous way our feelings. If we want to affect those chemicals the road is a direct one, but one that shifts focus to something right under our noses, something palpable and real, our feelings. Work on our feelings and there will be feedback to our chemicals that will then, in turn, feedback to our feelings and help us out.


Now a final thought. Focusing on the “chimerical” seems to presume, most of the time, that the reason we feel bad is due to an ad hoc imbalance in the chemicals. Something is wrong in my head. Fix it doc! Give me some medicine. I have a cold in my head. Well, we believe that the chemicals are being stimulated by something, by what? By the world. Anger, fear, distress, disgust, and shame have their chemical equivalents in the brain. We “get our buttons pushed!” We live in a world that can push our buttons. We need to work. We need to work with the environment and do also what we can to remove the button pushers and thus the stimulus that is causing the pain and causing, yes, that neuro-electrochemical imbalance. Not easy I know.