(Brought to you by Dr. David Alter)

As the huge baby boomer generation ages, the attention being paid to age-related challenges is growing, too.  I can’t tell you how often I receive requests for evaluations from people in their 60s, 50s and even 40s, worried and sometimes terrified that their memory lapses signal the emergence of that dark shadow we call Alzheimer’s dementia.  Thankfully, the vast majority of the times, those evaluations yield explanations for the problem that are fully reversible, highly treatable, and ultimately totally reassuring to the client!

One of the oldest and most effective treatments for our fears is humor.  Facing our darkest fears with laughter and levity takes the edge off our fears and helps build resilience in the face of life’s ups and downs.  As our gift to you, here is a prescription for facing aging-related worries.  Take this remedy once a day between meals and see whether the urge to call me in the morning passes.  (Of course, should you have any concerns, that persist, give us a call!) 

By Dr. David Alter in MindMatters

Do you believe that simple problems can be solved with simple solutions but that complex problems require complex solutions?  When it comes to the brain, neuroscience suggests that relatively simple solutions are quite capable of producing dramatic change.  The secret lies with the brain’s ability to reorganize itself on a moment-to-moment basis.

The brain is made up of 100 billion neurons that form more than 100 trillion inter-connections to other neurons.  That level of “connectivity” makes the human brain one of the most complex structures in the known universe!  Out of that degree of complexity emerges the brain’s ability to safely smoothly bring a mug of hot aromatic coffee to your lips and to compose an hour-long symphony orchestra’s score that coordinates the movements of 100 musicians playing 25 types of instruments at the same time. 

The brain wires some neurons to other neighboring neurons, and wires others to far-away neurons.  This wired network allows the brain to exercise incredibly fine-tuned regulation of sensation, emotion, thought and action.  Limited inputs have far-reaching effects.  The key is that the brain is also a creature of habit: its firing patterns don’t change unless we deliberately and consistently work to change them.

What effort is required to take advantage of the brain’s ability to reorganize itself on a moment-to-moment basis?  The brain appears to be eager to learn.  It is designed to take in new experience.  New experience is assimilated into the brain’s complex neural circuitry. With repeated practice what was new and challenging becomes routine and effortless.  For example, within three weeks of practicing juggling skills an hour a day, brain imaging studies showed that people with no prior juggling experience had expanded the complexity and activity of the neuron firing patterns in brain areas that regulate fine motor movements needed for juggling.  Just three weeks!

What is the lesson for us?
• Visualize a change you want to make
•Identify the elements of the change in behavioral terms (e.g., what do people do who act in the way you are seeking to develop)
•Focus on consistently practicing one or two elements for three weeks
•Observe the changes that result

Congratulate yourself on using the simple steps to reorganize and transform your brain’s complexity to help you  achieve your goals.

Authored by Dr. David Alter in Dr. Alter's MindMatters

The experience of pain is something with which everyone is familiar.  The experience of chronic pain is something else entirely.  Chronic pain is constructed out of many different components or elements that reinforce each other.  With chronic pain, the whole really is greater than the sum of the parts.  The good news is that the different elements of the overall pain experience can be treated separately.  When this is done, the overall experience of chronic pain can change.  For example, clinical hypnosis, a powerful tool woven into many different pain treatment approaches, can focus on:

• physical aspects of pain (e.g., the location, intensity or other sensory qualities)

• emotional aspects of pain (e.g., the fear that no one can help reduce the pain)

• cognitive aspects of pain (e.g., the belief that limitations in functioning levels make you worthless)

• spiritual aspects of pain (e.g., the conviction that the pain persists because of some past wrong the person committed)

• or the narrative aspects of pain (e.g., the interconnected memories from our past that become the on-going “story” of our lives, that contributes to self-fulfilling patterns of functioning in our lives)

For chronic pain treatment to be effective, each of these different elements has to be examined.  Each of these elements contributes to the overall experience of pain for each person.  Our culture tends to have a hard time considering a problem as caused by many different elements.  That is, perhaps, a major reason that when it comes to pain (a universal experience that creates untold misery for so many) the search for a magical cure is so strong.

Too often, the search for a solution begins and ends with prescription medications, often painkillers of one sort or another.  While moderate and focused use of such medicine can be helpful, it cannot treat all the different elements that make up the experience of chronic pain.  Not surprisingly, when pills are used to treat something for which they are not designed or intended, huge problems with dependence or addiction to pain medications arise.  This only complicates efforts to help people learn to manage the pain. 

If you are suffering from chronic pain, or if painkillers have become the primary tool you use in your efforts to manage pain, consider having a comprehensive holistic evaluation of your pain condition.  Learn what the building blocks are for your pain experience.  Learn how to change some of those building blocks and discover the power you have to change your pain experience. 

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.