Happiness when in Pain is a Perspective - Part 1

Dr. Lisa Holland PT, DPT, ERYT-200, PRYT has been a licensed Physical Therapist for close to two decades with a personal yoga practice since 2000.  Lisa is one of the many, generous YogaFest NC 2014 instructors, and she will be leading the Conscious Surrender of Suffering : Yoga for Chronic Pain. This workshop will teach participants about their body through awareness of the Koshas and experience of various physical forms intertwining with these levels in gentle asana , pranayama and concentration exercises. Register for YFNC 2014

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It seems, according the book Hardwiring Happiness:  The new Brain Science of Contentment, Calm and Confidence by Rick Hanson, PhD (2013) our brains are wired to remember trauma as if it were in the present. It is the subconscious that knows the information obtained surrounding those moments may be very important to our future survival so it guards them as skeletons in the closets of the mind.  The uglier, the more loss, the more sorrow we perceived at the time, the more pre- programmed we are not to forget them.  This feedback loop was intelligently designed by Mother Nature to help her children avoid past real dangers. The problem is that we now tend to magnify the threat of everything that is not pleasurable.  The more and more comforts we have, the more and more uncomfortable normal aches and pains of living become. 

Mental stress has been linked with physical disease (Melville et al., 2012).  Research on brain lesions by Starr et al. (2009) proposed how we process a stimulant that evokes a response by the insular cortex, a deep lobe that research has found to be a place where we cognitively recognize threats as well as the main relay point within a multisystem way we process pain. Thanks to that insular cortex, one may extrapolate that if you are constantly feeling threatened by your life, your interactions or your injury you might just have an overstimulated insula to begin with. From there, it is not hard to assume that anxiety may actually make up or manifest a future or present reality of danger.

Imagine, what if engaging in motions or activities that reminded you of a trauma had a chance to come to the insular cortex in only a reactive way? You cannot be mindful of the present reality if your perception is dominated by your past experience. This is why just the thought of a future interaction or challenge with a difficult person can evoke a present reality of abdominal pain. An anxious thought begins a reactive protective response of the body and that loops back to the mind.  The key is to quiet the reactive “monkey mind” anticipating threats at a very subconscious level.   

You are wired that way but there is a spot, an energy I have coined “the mindfulness potential” that can be evoked at a conscious level so that the brain fires and reroutes the true (present, real-time) experience to optimize a certain stress or non- stressful reaction. This is especially the case in chronic pain because the insula is a major relay point for the pain tracts to decide how they will react to the experience of a pain. Therefore  you really need to replace the experience of physical pain with a consciously evoked potential of happiness. 

If you want guaranteed success, find an uncomfortable but healthy discipline to be grateful for the courage to experience this year.

Much of my lifestyle therapy is based on disarming my clients’ and patients’ perception of pain by having them look at all of life’s discomforts from the perspective of being a witness. For my clients and patients, engaging in their prescribed daily mindfulness of “yoga off the mat” is a useful tool for surrendering pain -- an approach inherent in Belly Guru Yoga and supported by recent research (Teper and Inzincht, 2013).

In their 2013 study, Teper and Inzincht summarize the possible mechanisms mindfulness plays on executive control of the brain and propose that learning to be open minded to subtle changes of emotions evoked by an experience may affect our need to act and control the situation. As a clinician it appears pain is very much tied to the emotional state.  A chronically inflamed body eventually presents as an angry one to therapy, especially if there is continual anger and blame placed upon another which evokes victimization.

In that way I can prescribe yoga to support being a warrior and survivor of the initial and subsequent traumas.  A practice that enable the surrendering of control over pain can be quite liberating.  My best support as a therapist can then be in allowing for an experience of initial discomforts as a safe and guided process. When the experience of pain becomes a mentally tolerable process, healing is expedited and the subjective experience quickly improves. But how can I evoke a sense of peace while I am asking my clients and patients to experience pain as they practice yoga?

In Part 2 I will share how I can create this with the clinical offering of Integrative Physical Therapy.


About the Author:

Dr. Lisa Holland PT, DPT, ERYT-200, PRYT has been a licensed Physical Therapist for close to two decades with a personal yoga practice since 2000.  An active member of the International Association of Yoga Therapists, The American Physical Therapy Association and the Charlotte coordinator for the Yoga Alliance community initiative, Lisa’s main objective is to foster safe and effective public well care models by bridging yoga with healthcare. Since 2009 she has studied yoga as a lifestyle with her beloved teacher Sri Dharma Mittra and is working towards her 500 hour Dharma Yoga certification.

Originally from the NYC area, Lisa obtained her bachelor in Athletic Training at Hofstra University and practiced in the field of sports medicine and orthopedics for over a decade before moving to Charlotte in 2004.  She is a licensed therapist in both North and South Carolina and has completed thousands of hours of post professional clinical trainings including a clinical doctorate in Physical Therapy, women’s health, pediatric development and integrative orthopedic care. To learn more about her wellness mentorships and integrative courses visit @ www.OmHealing.net and www.Bellyguru.com