Month: August 2016

Relax and be gentle for your brain health

In the course of their normal duties, every cell in our body creates waste byproducts. Just left-over bits of molecules that have been partly used and then discarded. Like microscopic bread crusts. One of the purposes of the white blood system (also known as lymph) is to remove these waste byproducts — just like stormwater drains in a city.

Revealed: The brain’s sewage system

Did you know that this white blood aka lymph has it’s own vessels, similar to veins and arteries, that carry it around the body? Among other jobs, lymph percolates through our tissues and then collects in tiny vessels (like gutters) where it is channeled into larger ducts and eventually joins up with the red bloodstream.

Every part of the body has lymph vessels, except the brain. Curiously enough, until recently no one knew how, or even whether, the brain could get rid of the waste that it creates every day. This is important because the build up of waste products in the brain is known to be the primary cause of degenerative diseases like Alzheimer’s and possibly Parkinson’s.

Now we’re coming to it.

In 2012, scientists discovered that our brains do have a waste-removal system, but it’s entirely different than the rest of our body. Instead of using separate lymph vessels, the brain trickles its waste metabolites along the outside of tiny blood vessels in the brain.

That’s just weird if you ask me. But even stranger, some other scientists have now discovered that what drains the brain of waste is not just a passive trickling effect. It turns out that tiny “smooth” muscles in the brain’s blood vessels help to squeeze the lymph along. Also, the pulse of tension and release while we breathe acts like a pump to shift the brain’s white blood, or “glymph” as it’s now being called, along the tiny blood vessels of the brain to sites where it can be returned to the (red) bloodstream. [2]

Now here’s where gentleness comes in: both of these forces (smooth muscle contractions and breathing) involve a complex dance between parts of our involuntary nervous system — the part of our brain, spinal cord and nervous system that we don’t consciously control.

Fight or Flight vs Rest and Digest

You’ve probably heard of the “fight or flight” reaction — a state of high alert that we all can access in the presence of danger. That fight or flight reaction is initiated by our involuntary nervous system. But the involuntary nervous system also has another trick it can play: what is often called “rest and digest”, the opposite of the fight or flight response.

Now say you are biking to work when the car next to you swerves to avoid an obstacle and is now encroaching on the bike lane, directly threatening to knock you over. The fight or flight reaction is important in times of emergency like this. However Stephen Porges, PhD, in his breakthrough work, has shown that despite these kind of emergency situations being pretty rare in our lives, many of us are actually in a state of ongoing fight or flight for most of every day. Some of us are even in this state from the moment we wake up to the minute we try to sleep. [1]

Adapting ourselves to avoid the fight or flight instinct is perhaps the best way to improve the “tone” of our involuntary (aka “autonomic”) nervous system. When we are able to be gentle, the smooth muscle contractions in our brain’s blood supply can function more effectively to remove waste. It also allows our breathing to slow and become more subtle, removing the knots of tension that interfere with the pumping action of breath on our brain’s waste system. We are not talking about deep breaths or even slow breaths. Maybe you already have noticed the natural breathing that you have on waking, but if not then try tomorrow morning — that will give you a taste of the brain-health-promoting nervous system state of rest and digest that we are aiming for here.

As the video explains, improving the tone of our involuntary nervous system just turned out to be crucially important in our efforts to stay healthy and mentally alert as we age. We can thus add brain health as another benefit of gentle, non-striving yoga, meditation and short moments of rest throughout the day.

Far from making us “weak”, softness builds strength and the ability to remain pliable, not just in body but in our brain and mind as we age, adapting quickly when faced with trouble. The science behind this just got a bit more solid.

[1] Stephen Porges, The Poly-Vagal Theory, http://stephenporges.com
[2] New Scientist, Best Look Yet at How our Brain’s Sewage System Flushes Out Waste, https://www.newscientist.com/article/mg23130864-200-best-look-yet-at-how-our-brains-sewage-system-flushes-out-waste/

Last of the Dailies: Neuroplastic Brain Hacking for Persistent Pain Day 34

Because the visualisation is now an integrated part of my day, I have less need of a ritual around composing a daily blog post on the subject. The main purpose of these posts (as I mentioned a while ago) was to serve as a social hack that helped me build a habit of visualising relentlessly. But I’m starting to feel established in the technique now. So, thirty days of blogging later, I feel like I’m coming to the end of these daily updates.

Not that the visualisations have run their full course. Far from it. Although I see promising signs every day now that the technique is starting to work (especially on Friday when I was completely pain-free for two hours), still the full benefits won’t be known for months yet, possibly even a year or two. I have a long way to go yet, and plenty of content in mind on this topic and others, so you’ll continue to hear from me fairly frequently I’d say.

I’ve had contact lately with a few people who are working with this technique. Some of our chats have made it into articles here on the site, in some form or other. I hope this diary can continue to serve as a resource for others who are putting neuroplastic visualisation into practice, or at least as a starting point for conversations.

In the meantime, why not get in touch at my Facebook page or on my blog (links below)? Let’s hack our brains together 🙂

Pain Trivia Learned from Neuroplastic Brain Hacking for Persistent Pain

Unlike a simple sense impression such as taste or smell, pain seems to be a fully-fledged, mind-body experience. We don’t just feel pain — we are gripped by it almost like an emotion or mood. How does that happen? Does pain always correlate with injury in the body? I’ll try and keep this short, and as jargon-free as possible!

Fancy a warm day at an idyllic beach. Wading towards the shore after a long leisurely swim, gazing around at the sunlight on the waves, you unexpectedly stub your toe on a submerged rock. Let’s use that example to analyze what’s going on as you suddenly find yourself dealing with a flurry of unpleasant feelings.

Nociception

I know, you’re like noci… wha?? Jargon straight up! Don’t stress — I never heard this word until a couple months ago either. But this is the only jargon for the whole article, ok? Bear with me …

Roughly speaking, nociception is the name for the pain signal before it reaches the brain. Interestingly enough, nociception itself does not cause much of a reaction in the area where the injury happens.

In the case of your accident at the beach, it is not until your brain receives a signal from the toe, that any kind of response begins to take place.

Nociception vs Pain

When we get a signal that “something hurts”, how does that expand into such a rich experience that all or most of our concentration and our emotions are suddenly turned towards it?

Well, as soon as your brain receives the nociception signal it does some trickery to figure out how bad the damage is (if you just scratched yourself or if you cut yourself deeply). It also looks into where the signal is coming from and how easily damaged that area tends to be (if you stub your toe it hurts more than if you hit your arm).

You’re already starting to feel things in a context that is more than just simple nociception. Next up perhaps memories will crop up of the last time you stubbed your toe, you’ll lift your foot out of the water and examine it closely. Your eyes and visual parts of your brain will be processing all those images. If you’re like me you’ll be wondering if anyone has noticed and if you perhaps look a trifle silly standing on one leg in the water with your other foot held up in front of you. You’ll be trying not to topple over.

Our mind has gone from soaking up the summery day, to a more active state. After the initial fast signals, the toe is now sending slow throbbing nociception signals to our brain, and every time a new throb reaches our brain, it goes through that whole activation state again. It returns our focus to our foot from whatever else might be going on. Now we are experiencing pain.

What’s interesting is that nociception and pain can be experienced separately. While normally of course, nociception does lead directly to an experience of pain, in some cases it is possible to experience great amounts of nociception but to be in an entirely pain-free state. This is sometimes noticed in cases of “massive trauma” [2] by paramedics in victims at the site of a car crash.

The opposite is also possible, for example when “individuals with functional pain syndromes report considerable anguish in spite of having [no measurable -nociceptive activity]”. [2]

Pain as a Perception

These understandings and many more led Ronald Melzack, a Canadian who studied phantom limbs and pain, to refer to pain as an “output of the central nervous system”. (Ok, a tad more jargon. “Central nervous system” is a medical term for the brain and spinal cord.)

What Melzack is saying here is that although pain does start starts in the site of injury, it is not until it is taken into the central nervous system and evaluated as being important enough to warrant attention, that the pain begins to intrude on our thoughts and emotions. This is more like a perception, where we are not just receiving sensory input but thinking about it and evaluating it.

Although this may seem quite obvious, you can see that rolling all of this together and calling it “pain” turns pain from being a simple realisation that “something hurts” to being the full mind-body response to an incident of nociception, and not just the nociception itself. Linking it all together like this is the only way to explain complex pain syndromes like those outlined above, or in the case of a phantom limb causing pain, where the pain persists in the brain long after the nociception has ceased.

The particular brain regions that are involved in taking up the call of pain, on behalf of the nociception from the site of injury, in order to generate this “output” are many. Moskowitz identifies no fewer than sixteen different brain regions! [3] and [4] Many of these are connected with our emotions and our thinking patterns, and others are connected with our body’s most basic self-monitoring and survival systems.

This explains why pain can be such a distressing experience, and why we sometimes shrink away even from the thought of hurting ourselves. The emotional centres of our brain are anticipating our potential distress and creating aversive reactions before the pain has even happened, by simulating the pain independently of receiving any actual nociception.

Conclusion

I’ve found this knowledge to be the start of a whole investigation into the nature of pain. Knowing that pain is partly to do with how I evaluate it, and not just a result of being told “something hurts” by my body, has been quite an eye-opener for me.

I hope you’ve found it interesting too. If so be sure to like my Facebook page or follow my blog for more updates. I write about wellbeing and mindfulness, with a few creative pieces thrown in from time to time.

Further Reading

Here are some useful links I’ve found while reading about pain theory.

How do our brains process pain? contains a good introduction with some diagrams.

And there’s way more to be learned from this How Pain Works at HowStuffWorks.

[1] Melzack, Ronald. “Gate control theory: On the evolution of pain concepts.” Pain forum. Vol. 5. No. 2. Churchill Livingstone, 1996.

[2] Garland EL. Pain Processing in the Human Nervous System: A Selective Review of Nociceptive and Biobehavioral Pathways. Primary care. 2012;39(3):561-571. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3438523/

[3] Moskowitz, Michael MD and Golden, Marla. Neuroplastic Transformation Workbook. pg10-13. https://www.amazon.com/Neuroplastic-Transformation-Workbook-Michael-Moskowitz/dp/0615814654

[4] Doidge, Norman. The Brain’s Way of Healing. Penguin Books 2016. pg 13-14.

Two Hours Completely Pain Free: Neuroplastic Brain Hacking Day 32

When you’ve been in constant pain for a long time, it’s pretty weird when the pain suddenly disappears. It’s like when snow begins falling after promising all day to do so … there’s no fanfare, no flashing lights. Occupied with walking, soft whispers of cold touch your cheeks, your throat. Whirl into your eyelashes. You pause transfixed and watch the motes appear from grey-brown sky.

alone-in-the-snow

I who had forgotten wonder, only to have it fall in countless drifts, each tiny moment fresh and precious. Gone, but followed by a million, a trillion more, endless snow descending with silent life to Earth.

Great soul of the sky, lend me strength through thrill of your touch but lead me not to clutch your wonder too tight. Let me be afraid not of snow nor summer sun but free to spin instead with every gust of air that fills your gulf.

Beyond Visualisation: On To Section Two of the Neuroplastic Transformation Workbook

Section Two of Moskowitz’s book[1] goes beyond visualisation to the sense of touch. This is particularly helpful when the pain is long-running. Sometimes, I’ll do visualisation and that pain is gone by the end of it. Was it the visualisation that caused the pain to diminish? Impossible to say really. But when the pain doesn’t decrease, I’m using some of the techniques in Section Two as a way of flooding the brain with other input.

Some of the suggestions are very simple. Rub your thumb-pad with your forefinger to stimulate touch sensations in the brain that are not painful. He also advocates brushing the skin over a painful area very lightly with a finger, or a cold glass, or even things like feathers and shaving brushes! All to stimulate nerves in the area other than pain receptors. Some of these suggestions are more in the realms of traditional advice you’d receive from your friend. You have a back ache or a “crick in your neck”? Take a warm bath.

Gently rubbing an area where there has been almost constant pain is not a small deal. In fact, when I take two fingers and just rest them lightly on the skin in my left-hand-side clavicular fossa[4], I feel a high-pitched throbbing down the underside of my left arm, through my elbow into my little finger, and a circle on the top of my head and the orbit of my left eye both set up sympathetic aches. In this case, Moskowitz recommends placing your fingers just to the side of the painful area, as near as possible without firing off the nerve that is hypersensitised.

We are not taking a warm bath or rubbing a painful area to achieve temporary relief but in order to reduce the dominance of pain processing in our brain. The idea again is to approach it with the MIRROR acronym in mind:

The key is to stay Motivated. Have the Intention of changing your brain. Be Relentless in opposing any and every pain intrusion into your consciousness. Rely upon your brain’s ability to adapt and make considerable initial efforts automatic and seamless. Approach each pain intrusion as an Opportunity to hone and master this proactice and make it automatic and effortless. Expect your brain to Restore itself and work on these approaches until it does so.
Michael Moskowitz MD [2]

So we don’t need to be discouraged when the pain doesn’t go away, or returns immediately. We weren’t expecting any relief in the first place, necessarily. Just as in the visualisation we used imagery to “access” the pain centres and direct them to process other input, so now with the sense of touch we are starting to use the nerves outside of the brain and spinal cord (the peripheral nerves) to access the brain for the same purposes.

A further suggestion that Moskowitz makes is to receive regular gentle massage from a skilled therapist [3]. As a trained massage therapist myself, you’d think this would have been obvious!

[1] Moskowtiz, Michael MD and Golden, Marla. Neuroplastic Transformation Workbook.
[2] ibid, pg 1
[3] ibid, pg 21
[4] The supraclavicular fossa is roughly speaking the area where your neck joins your torso just above your collarbone.

My Visual Imagery: Neuroplastic Brain Hacking for Persistent Pain Day 30

Visualisation now is more refined again; colours fade gradually through all the colours of the rainbow including indigo, violet to black. I’ve two versions. One of these versions — we’ll call it the “full-cream” version — I use just for the more focussed sessions (when I stop what I’m doing and close my eyes). It has a lot more detail, eight different regions of colour fading through all colours of the rainbow and each colour in between to black. Whereas when I’m more active and moving around, I go for a more “lite” version. I mentally zoom in on just one of these regions and fade it through as many colours as I can before distraction sets in. Often that’s just red through orange to yellow. Or sometimes I start with violet and just let it fade from there to nothing.

I’m writing absent-mindedly at present because I’m visualising at the same time.

Another setback today, which I’m using as an opportunity to practice my visualising “in anger” as they say — in the extremity of a strong flare up of pain, after an awful gapping sensation in C3-C4 region on the left-hand side of my neck.

Was all chill, sitting before the fire, warm as, reached up with right hand to adjust my hairtie and turned my head as I did so to provide more leverage. As you do. Weird graunchy clunk that my son heard from across the room and zing, pain in the origin of my left-hand anterior scalene over Rib 1 and 2 and sudden body bracing from top of torso to bottom. Last night and all today — drop everything and visualise, constantly. Takes an hour to wash a small load of dishes because I keep pausing to hallucinate haha.

I’m not sure if it’s recommended to visualise so intensely as I’m doing, it takes 2-3 minutes each time I do it if I go the full version. Perhaps it’s better to have a lean, quick little visualisation more often, than less frequent visualising for a longer duration? A bit of both perhaps — I guess that’s what I’m doing with my “lite” version and my “full-cream”.

But when I do the lite version, I don’t get the same level of pain relief — often, pain is still intruding on consciousness. So by Moskowitz’s “Relentlessness” rule, I should visualise again… That kind of repeated visualising eventually uses as much time as the “full-cream” practice. But the difference is, I can get things done at the same time, albeit slowly.

I stopped for a couple of minutes for every line of the last paragraph. Just did it again.

I’ve noticed lately that there’s a rhythm that the colours emerge to — sometimes the colours cycle rapidly, other times it’s slow. Until now I’ve always tried to slow that down so I can get more high-resolution in the fades, but just now I went with the natural pacing and it felt more calm, relaxing, helped with the pain and went more quickly too. So I’ll go with the rhythm it seems to want from now on.

I just did some trigger pointing of my upper trapezius – often the only thing that gives me relief during a flare up of this magnitude. Usually when I have acute LHS neck pain they’ll be eye-watering to the touch. Today, hardly noticeable when I pincer-grip them.

Trigger points work by being adjacent to pain signalling neurons within the “body maps” of our somatosensory cortex. And they’re often firing due to neuronal spillover from the “neuroplasticity gone wild” of chronic pain. I they’re not online today, especially given how much pain I’m feeling just in general, could that indicate I am slowly shrinking the spillover?

Don’t “Break” your Bad Habits: Neuroplastic Brain Hacking for Persistent Pain Day 29

Maybe I’m particularly prone, but to me it’s amazing how subconscious we can be in our routines. When I successfully gave up smoking fourteen years ago, it was only the last in a line of attempts, dozens-long. Each attempt on that line was a step towards the outcome I eventually crafted. I got discouraged after the early attempts were unsuccessful until I realised this.

Those first few attempts I tried to “break the bad habit”. But fighting with myself just lead to stress. What’s a common way to unwind when you’re stressed? Settle into something familiar like (for me) rolling a durry. Boom, smoking again. That’s what some of my early attempts looked like. I’d literally be sitting there smoking before I remembered how I was supposed to be quitting.

To an extent, life is about habits. They keep us alive and well (think of the many habits we use while driving, or the habits of hygiene). It’s useful to do things habitually. The problem is when we discover the need to change a behaviour pattern. Our brains are very good at forming, but not so good at “breaking” these routines.

I’ve learned from the smoking experience that it’s not helpful to create the intention to cease a habit. That just sets up internal conflict — a fight with yourself, resulting in stress. At the very least, stress saps motivation. If you’re unlucky, the habit will resurface as a coping mechanism for the stress that you’ve created by trying to get rid of it! Instead, much more helpful is to look at replacing that habit with another, beneficial one. [1]

When we replace an old habit with a new one, we are creating a competition between the two, and if we continually feed the desired habit, the undesired one will become weaker and weaker.

This is making use of competitive neuroplasticity. It applies equally well when working to unwind from persistent pain. We must replace the body’s neuro-inflammatory habit of wind-up pain with other habits and continually feed this habit until we weaken the pain pathways for good. Like an ex-smoker, we then need deal only with the occasional flare-up.

As a twenty-four-year-old, I somehow cottoned on to this. Once I reframed each “failed” attempt as actually a step on the path to being free of smoking, I started looking at these steps as crucial learning that I could take into the next time around the cycle. I was evolving a set of new habits like tools, that eventually did win out. Smoking was just smoking. It wasn’t evolving. There was no way I could lose — it was just a matter of time.

Today I’m digging deep, returning to the visualisation technique after three days in no-man’s-land due to gastro. I find that I’ve fallen behind by about a week from where I was in terms of motivation, clarity of visualisation, pain relief. All those are cloudy.

I just want to break the cycle. I want to work my body. I want to stretch myself to create things no one’s ever seen, to seek things I’ve never seen. But I know what happens when I follow those urges. If I ignore what’s wrong in my body, the flare ups return. There’s no escaping.

The frustration is real. I just want to break the cycle. But frustration leads to stress. Stress leads to tension. Tension leads to pain. Boom, back to square one, just like smoking.

So I regather myself, re-reading passages of neuro-biology to return a sense of motivation, visioning my particular imagery to activate networks only four weeks old in the competition vs those four years old. I remind myself that this is crucial learning. Resilience in the face of setbacks is how we effect lasting change.

Bene Gesserit Litany Against Fear by Frank Herbert in "Dune"
Bene Gesserit Litany Against Fear by Frank Herbert in “Dune”

[1] I just found that James Clear has talked about the same thing. I must say, I’m not a fan of that pop-psychology stuff that reduces all of these lessons to little flow charts and worksheets. It seems a bit sterile. But he does present a similar idea here, and it’s worth a read: http://jamesclear.com/how-to-break-a-bad-habit

Neuroplastic Brain Hacking for Persistent Pain: Day 28

Days 26 and 27 went by in an unfortunate episode of unwellness completely unrelated to whiplash or neurology but entirely to do with a bad choice of takeaways on Friday night! Amazing dreams, worthy of Salvador Dali. On speed. At a masquerade ball. I’m largely on the mend today, but let me just say there’s nothing like being under attack by truly vigorous bacteria to remind us how our mind is so much an embodied arising of consciousness. Change the body, and the mind changes drastically.

Needless to say, I don’t have a lot to report for today. Although I have dim memories of visualising while in the throes of gastro, it could have been I was merely dreaming about visualising. Or visualising my dreams. It all gets a bit blurry.

Just returning to the visualisations in earnest today, and expecting to have slipped backwards a bit. Nothing wrong there — further integration of the practice with daily life. Next time food poisoning strikes, it’ll be the second time it’s happened since I changed my brain’s wiring. I wonder if I’ll even be visualising still, then?