Ep 29: How negative beliefs can torpedo your pain reduction efforts in fibromyalgia

Episode 29: why losing hope can torpedo your efforts at reducing pain from fibromyalgia

Well hello there my friends!

It has been a few weeks since I talked to you from my office in person  I brought several guests to you and I hope you loved the episodes.

Today I want to touch upon something that has been weighing on my mind last few days. I had a patient told me recently: “Doctor Z, I already DID ALL OF THAT. I tried EVERYTHING. I already did meditation, physical therapy, and more meditation and I am not better!”. This happened when I explained the neuroplasticity concept and how nervous system and our magnificent brain can produce pain. She has had fibromyalgia for over 25 years and also suffers from chronic low back pain.

I know it was frustration speaking. And also – to me anyway, it sounded like she may have started losing hope. Hope that her pain can get better. She had already tried all of the meds that are out there for fibromyalgia. Many of you may have already. They gave her side effects or did not help. Water aerobics have been beneficial but her pool is currently closed so she did not feel she could do that.

Here is what I want to tell you. The words matter. Language we talk to ourselves matters. And I have a science-y explanation for you, it is not just motivational speak that I am here to tell you 

There is a small structure, or should I say, a conglomerate of cells in the brain stem/right underneath the brain and at the top of the spinal cord referred to as RETICULAR ACTIVATION SYSTEM. Its sole job is to filter through millions bites of information our nervous system registers every second and only deliver to our cortex of our brain the relevant “stuff”. And how is it related to what I am talking here?

The cells of this reticular activation system (or simply RAS) comb through an ocean of information our nervous system is flood with. And by nervous system I mean input from eyes, mouth, touch and ears (the input from our smell goes somewhere else). What information gets to our conscious mind rests solely on this RAS guy! RAS regulates our wakefulness, flight or fight AND focus.

If the message we send to our brain (aka, the thought we think and words we say) is: I have already tried everything, this is pointless, nothing is working”, the RAS will look for information that confirms this thought. It will find all the ways we have already tried and failed in our efforts. It will emphasize how our pool is closed and will not let us think about other options. It will allow us to think that not moving is the best course of action, day after day, because what’s the point.

Please know I do not argue resting when it is warranted and when the body needs it. I do just that when I need it, when my body needs it. I absolutely 100 percent endorse the idea of listening to our body. What I am talking about here is indulging our primitive brain into thinking that we cannot do something or should not do something because it is not safe.

Our brains want to keep us safe. That’s their primary role. So if we feel we already tried everything, movement is not safe, there is no point in not trying anything else, the brain will say of course, don’t do anything new, stay where you are because you already know it is safe (eventhough you are miserable). A good day in the office, from brain perspective, is to stay dormant, and save energy.

If on the other hand, our thought is: ”Well this sounds weird and interesting at the same time, I wonder what is up with this neuroplasticity theory”, or “well this sounds interesting, I am not super excited but I am curious”, the RAS will filter through and lets in information that allows your curiosity and willingness to learn be satisfied.

So, to go along with the scenario I presented, the patient might say to herself: ”let me read the book the Dr. Recommended or let me try this somatic tracking thing – I am going to give it a try, it can’t hurt since I already tired other things!”.

Basically when the predominant feeling is curiosity, chemical and electrical changes happen in the brain, starting at the RAS level, that lead to different actions than the I give up approach. In our patient’s scenario, she might consider other pools acceptable options, or might try tai-chi and yoga instead.

One way how to get to change the default reaction of our brain, is to try the approach championed by Katie Byron. If you have a thought that suggests you already tried everything, you can ask ‘is it true” and answer it. Then ask “is it really true”? I don’t know about you but when the question is like that, I almost always say, well maybe not, maybe there are some holes in my theory. Next up is: ‘if you had a stroke and only the part of your brain with that though would be removed, who would you be without that thought?”. When I first heard that question as I was working with my limiting belief (of not being good enough), I literally cried, because if the negative belief is eliminated, we can be almost limitless. So who are you without the thought that everything was already tried?

And the last piece of tackling unhelpful thoughts is: how can you turn it around?

SO in this case, we could say: the pain has already tried everything. Now let me see what I can do to pain 