Authored by Dr. David Alter

In the movie musical My Fair Lady made famous by Audrey Hepburn, she sings a song whose words begin, “The Rain in Spain Falls Mainly in the Plain.”  Her song signals her growing ability to achieve her full but untapped potential.  Every day, millions of people struggle to overcome the limitations imposed by their personal histories.  These are individuals who face the misery and despair that all too often arises with chronic pain.

Chronic pain has bedeviled healers for thousands of years.  Invisible, untouchable, and yet so many are touched by it – more than 70 million Americans per year!  A key aspect of chronic pain that makes its successful management so challenging is its disconnection from obvious tissue injury.  Typically, as the physical body heals, the process of healing turns off the nerve signals that generated the pain sensations in response to the original injury. 

What is difficult to understand is that over time pain signals become disconnected from actual tissue damage.  This involves a modification to the body’s pain signaling process.  Pain is an experience that is encoded in the brain in through state dependent learning experiences.  In other words, the experience we call pain is a type of memory that is encoded into the neural circuits of the brain, ready to be reactivated when any of the other elements that were present at the time of the original injury are once again present.  For example, when my young adult son was injured playing his favorite sport he needed stitches that were sown into his mouth without sufficient anesthetic.  When he began to anticipate going to have the stitches removed, he began to hurt again.  The hurt he felt involved reactivation of the state dependent learning that linked together the memory of stitches with the memory of pain.  The anticipation of going to have stitches removed reactivated pain!  The original emotional state (scared), the physical context (doctor’s office), the sensory cues (white coat, hospital smell, overhead paging, etc.) also served to reactive the pain because they were encoded as part of the original state dependent pain experience.

While this example involves an acute pain experience, you can appreciate the relevance to chronic pain conditions, where the encoded emotional, contextual, sensory, and cognitive cues linked to pain are more common and have been reactivated so much more powerfully over a longer period of time.  Still, the implication is clear: As hard as it is to accept, the fact of the matter is that chronic pain really is “in your head!”  It is wired into the brain’s network of nerves, ready to “fire” in response to so many different triggers. 

That the pain is in the head makes it no less real!  In fact, it allows a whole new approach to managing it: learning ways to re-program pain program wired into the brain.  To return to our theme, the key to management of chronic pain involves learning to change the “remembered pain,” the memory pattern that gets established in the brain and which is responsible for the activation, maintenance and exacerbations of chronic pain conditions.  If Audrey Hepburn were to star in a pain management movie, perhaps she would sing, “The Pain, its Plain, Stems Mainly from the Brain!”

There are a number of ways to modify chronic pain memories: the pain-maintaining signaling patterns that are at the core of chronic pain conditions.  In the next entry to this blog, six suggestions for modifying pain maintaining memory circuits will be introduced to you.  Each of the pattern-modifying techniques is useful precisely because of its proven capacity to alter the ways in which remembered pain signals are generated. 

Authored by Dr. David Alter

In the last blog I introduced the idea of adaptive flexibility as a core skill to restoring health.  Learning to be adaptive allows you to adjust to life’s challenges in ways that keep symptom patterns from getting to firmly established.  Where can you turn to learn about revving up your adaptive flexibility?

My patients and I have found it helpful to draw upon the “wisdom of the body.”  Look at how the wisdom of your cells can be tapped to improve your health by adopting the four questions that each cell in our body uses to maintain its health.  We are made up of several trillion cells that are interconnected with one another.  The patterns of interaction among and within these cells are unimaginably complex.  And yet, the vast majority of the time, this vast network of interconnected cells hums along in ways that allow you to smoothly carry out the activities of your daily life.  Cells actively regulate their boundary (i.e., the cellular membrane) with the world around them by asking four basic questions that you can learn to apply to yourself as you regulate your relationship to yourself and to the world around you.

The Four Basic Health Restoring Questions – Brought to you courtesy of your Cellular Mind!

1. Cell: What is in my external environment that is toxic to my health and well-being that I need to keep out?  You: Am I engaging in relationships or situations that hurt me, that drain my energy, that put me down, that make me sick?  What are they?
   
   
2. Cell: What is within my internal environment that is toxic to my health and well-being that I need to release and let go of?  You: Am I carrying around expectations, beliefs, attitudes, or memories of events from my past that are poisoning me?  What are they?
   
   
3. Cell: What is in my external environment that is essential to my health and well-being that I need to absorb to nourish me?  You: Are there resources, hopes, aspirations, opportunities, or activities that would be supportive of my health and well-being that are available but that I have not risked seeking out?  What are they?
   
   
4. Cell: What is in my internal environment that is essential to my health and well-being that I need to learn to keep in because it nourishes me in fundamental ways?  You: Are there resources, qualities, desires, preferences and practices that I know are self-nurturing that I overlook, defer, or minimize the importance of, to the detriment of my overall health?  What are they?

This coming month, take the time to ask yourself these four questions.  Set aside 20 minutes several times per week, morning or evening, at a time when you will be free from interruptions, to consider the four basic questions and record your responses.  The responses you obtain may be verbal, they may be feelings or they may be bodily sensations.  After you discover initial answers to these core questions, use them as a blue print sent to you courtesy of your body’s wisdom.  Recognizing that initial answers to the questions arose from within you can be a sign that you have the internal resources needed to begin to implement the changes suggested by your body’s wisdom.  The prize is a healthier and balanced YOU.  Let me know what you find!

Authored by Dr. David Alter

Chronic pain. Depression. Gut dysfunction. Anxiety.  Relationship discord. Sleep disturbance.  Post-traumatic difficulties.  Energetic imbalances.  When people begin to describe their difficulties, they often use these labels.  Each of these labels is a blend of sensations, thoughts, feelings, emotions and behaviors that persist over time.  It is the fact that they repeat over time that makes them into symptom patterns.  I am going to offer four important questions that will help you learn to alter these symptom patterns.  By changing the symptom pattern, you can change your illness process – almost always for the better!

At first, the symptom pattern of chronic pain may seem unrelated to a pattern involving gut dysfunction, (Irritable Bowel Syndrome, for example), but all symptom patterns represent a loss of adaptive flexibility of the mind and body.  Adaptive flexibility involves the capacity to adjust to the ever-changing circumstances of your life while maintaining a steady sense of balance and control in your life.  The greater your ability to adjust and adapt to the circumstances of your life the greater the likelihood that you would describe yourself as healthy.  And the more you can learn to increase your adaptive flexibility, the more likely you are to regain or restore your health. 

The idea that we are designed to seek healthy balance is not new.  Ancient traditions described health in terms of the capacity to maintain balance among competing urges, functions, energies, or qualities (e.g., warm-cold; wet-dry; optimistic-guarded; active-sedentary; spicy-bland; thin-heavy; fast-slow; fiery-calm; stoic-vulnerable; thoughtful-emotional, etc.).  Sounds strange?  Think for a few moments about the kinds of suggestions we hear or give ourselves each day and you’ll recognize they are still suggestions about improving our ability to adjust and adapt in ways that are not all that different from what Hippocrates might have advised a patient in Greece 2500 years ago:  “I’ve got to stop burning the candle at both ends;” “I should eat less and exercise more;” “I’ve got to stop picking the same type of relationship partner over and over again;” “I have to take some risks if my situation is ever going to change;” “I have to get ‘in touch’ with my feelings;” “I have to give more and expect less;” “I have to over-extend less and take better care of myself.” “I have to live my life with integrity that is consistent with my basic values.”  Each statement reflects the recognition that you have gotten stuck in a repeating pattern of functioning that is negatively affecting your health.  Repeating unhealthy patterns of living is the primary sign of the loss of adaptive flexibility, and often predicts that a loss of physical, emotional or mental health will soon follow. 

Most of the time, our deeply wired ability to maintain balance in the face of constant change is something that occurs automatically (e.g., we don’t have to think about how heal a paper cut to a finger or how to walk, even though walking involves controlled falling!).  Sometimes, we have to make conscious decisions to maintain healthy balance (e.g., “Even though I want another helping of my dinner, I will listen to my body’s signals and push myself away from the table now.”).  And then there are times when we need to seek the help of a professional who is trained to identify what accounts for our imbalance and the symptom pattern the imbalance is generating. So, where to begin your efforts to alter the pattern of your symptoms?  In the next entry to this blog I will introduce you to what your own cells have to teach you about restoring your health.

           Authored by Dr. David Alter

Welcome! Thank you for taking the time to explore this site. I developed this blog to share with you practical, usable and effective suggestions for addressing specific health problems based upon what I have learned from my clinical work over the past quarter century.  In other words, what I share with you has successfully been put into practice with the patients I have worked with, and is solidly grounded in discoveries from fields of learning that span modern science, timeless spiritual traditions, western medicine, eastern healing practices, and developmental psychology.  My particular focus throughout my career has involved ways to apply mind and body resources to improve your health and enhance your life.  I will offer you condition-specific suggestions.  At other times, I will offer more basic strategies and techniques to improve your health that are useful no matter the particular condition(s) with which you wrestle.  I think of these basic strategies as a blue print for health that is not necessarily associated with any specific health problem.  They represent building blocks upon which a solid foundation for your future health can be built.  In the future, I intend to make down-loadable teleseminars or webinars available, which will provide you with opportunities to learn about various mind-body subjects in much greater depth.  At the same time, such programs will help you to develop essential health enhancing skills as you apply what you will learn to your own life.  

An ancient saying described a good teacher as someone who was forever learning from his students.  In that sense, I am a good teacher, since I have been learning from my “students” – the patients with whom I have had the privilege to work – since I first began my psychology practice in the mid-80s.  I am a clinical health psychologist and a clinical neuropsychologist in an integrative, holistic health center.  In 1999, after 15 years of working in a large health care organization, I left to form a smaller and more intimate center, which became Partners in Healing of Minneapolis (www.pih-mpls.com), the holistic health center where I have worked for the past 11 years.    

In my practice I have paid attention to how the mind, brain and body interact to generate symptoms.  Without exception, symptoms represent recurring patterns of interactions.  Sometimes those interactions are within the patient (e.g., dysregulation of muscle tone in blood vessels in the head that becomes the pattern we call “migraine”).  Sometimes the patterns involve anticipations of interactions with others (e.g., the sense of anxiety and dread that takes the form of stomach pain and nausea as a child waits and wonders whether her father will come home drunk tonight).  Sometimes the patterns represent the way in which biological, psychological, social, genetic, behavioral, and even spiritual factors interact with one another to form a condition such as irritable bowel syndrome.  And sometimes, the patterns represent the way in which past history has been encoded in a person’s mind and body to produce patterns we call post-traumatic stress disorder or dissociative identity disorder.  

By helping patients discover and modify their mind-brain-body interaction patterns, I’ve helped them to discover that once you change the recurring pattern in important ways, the symptoms can no longer show up in their usual way.  In effect, change the pattern and the illness process changes – almost always for the better! Now, I intend to bring what I have learned to a new “audience”: you, the readers of this blog.  It may be useful for you to read and apply what I offer.  It will be that much more useful if the communication flows in both directions.  Therefore, the blog will offer a comment board where your questions, ideas, and reactions to postings can be featured.  

I am looking forward to opportunities to interact with you as we go forward together.  Most of all, I am excited about continuing to learn from my “students,” which will now, hopefully, include you.

Do you want personal attention from highly-skilled health care professionals who know and care about you?  Partners in Healing of Minneapolis (PIH) is a holistic health center located in Minnetonka, Minnesota, serving people throughout the Twin Cities (Minneapolis and St. Paul). We integrate the best of Western and Eastern healing systems to meet your unique health care needs. We address the physical, mental/emotional, and social aspects of your health care. Here at PIH we respect your inner wisdom and partner with you to find what you need to be healthy. Working with individuals, couples and families, PIH addresses a wide array of health concerns. We can work with you one-on-one or as a team of health care professionals. Services include cutting-edge best practices in:

• Mental health care for adults and children
• Holistic medical care for adults and children
• Acupuncture and Traditional Chinese Medicine
• A variety of massage traditions
• Energetic approaches to healing

We also offer classes and workshops for healing and personal growth.

Regardless of the presenting concerns, our services emphasize helping our clients to:

• Increase their natural resilience" or "stress hardiness" by strengthening self-regulation abilities
• Re-write their life story by altering patterns of perception and teaching them to take healthy perspectives on their circumstances

For any treatment to be helpful it has to be accessible. For many people this involves using their health insurance benefits. At PIH, each clinician is associated with several insurance plans, although many individual clients choose to pay privately for reasons of or covered by, their health insurance plan. If you choose to go through your insurance we will process insurance claims for you and help you decipher what is or is not covered through your insurance. Please contact our office with questions related to insurance issues and the particular coverage options available when working with any of our clinicians or participating in any of our clinical programs.

We are conveniently located in Minnetonka on the south frontage road of Interstate 394 and just west of Highway 169. A map and written directions to our clinic is available through our web site, emailing us at info@pih-mpls.com , or by calling the clinic at 763-546-5797.
At PIH, "the art and science of healing" are put to work for you in a comfortable and collaborative environment.