WALKING THROUGH CENTRAL PARK in New York City, I passed two men sitting at opposite ends of a table nervously facing each other.
With their fists tightly clenched, you could see the steadfast expression in their faces, the desperate look in their eyes, the sweat on their brow and the obvious veins protruding from the musculature in their necks.
My curiosity was peaked as I stepped up my pace and cautiously walked by.
As I glanced discreetly to my right as I was passing this seemingly scary scene, I realized that these two adversaries were doing nothing more physical than moving little pieces of wood on a board.
Although not physically demanding, the emotional strain of a competitive chess
match can be a vigorous experience. Chess masters, during intense tournaments have been known to undergo nearly the same metabolic physiological demands on their bodies as high-level competitors during an athletic event.
While not physically demanding, the emotional strain characteristic of a competitive chess match is mirrored in many of our routine personal and occupational tasks. I vividly remember the trepidation of signing my name to a document, which obligated me to a mortgage of over $115,000. It was the contract to purchase my first home.
Where was I going to get $1,500 a month to pay for a mortgage and still be able to afford to put food on the table?
Our lives are filled with stressful moments and whether we are confronted with marital strife, health challenges, wedding plans or career instability, they may contribute to unresolved stress disturbing our physiological homeostasis.
These events may rival the anticipatory stress response of the world-class sprinter prior to his first heat at the summer Olympic games. The difference is that the sprinter
is about to work off that nervous energy with an intense 100-meter dash.
When unmitigated stress is allowed to proliferate for months on end twisting in our guts, inciting anxiety, anger and nervous tension, we may increase the probability of a serious illness and exacerbate pain.
While stress cannot be avoided, we possess the ability to control our reaction to
it. This article is about taking responsibility for our lives and developing an active consciousness in regard to our own ability to modulate pain and discomfort.
While using the mind to dissolve pain is just one component of an integrated system of wellness, it may be the most powerful element in managing pain syndromes.
Furthermore, a sense of worthiness is an essential component of sustained health management. One must feel an intrinsic justification to be pain-free. As a Naturopathic doctor, sometimes my biggest challenge is inspiring my patients to recognize their entitlement to living a pain-free existence.
The Mind Body Connection
Adherence to a sound nutritional program, a consistent exercise schedule, consumption of vital nutrients and therapeutic botanicals are essential components to optimum physical and psychological health. A positive self-esteem, however, is the adhesive that encourages sustenance and a positive expectancy. It is also an important prognosticator toward enabling one to mediate uncontrolled stress.
As we will discover, self-esteem is not a product of status, wealth or level of education, but a state of being. An attitude of gratitude is an important step in establishing personal fulfillment.
Most traditional medical systems acknowledge and make use of the extraordinary interconnectedness of the mind and the body and the power of each to affect the other. In contrast, conventional Western medicine has regarded these connections as of secondary importance, thus treating the body and the mind as separate and distinct entities.
This narrow focus, however, has also tended to obscure the importance of the interactions between mind and body and to overshadow the possible importance of the mind in producing and alleviating disease. The focus of medical research has been on the biology of the body and of the brain that is part of the body.
Concern with the mind has been left to non-biologically-oriented psychiatrists, other mental health professionals, philosophers and theologians.
Psychosomatic medicine, the discipline that has addressed mind/body connections, is a subspecialty within the specialty of psychiatry. During the past 30 years, there has been a powerful scientific movement to explore the mind’s capacity to affect the body and to rediscover the ways in which it permeates and is affected by all of the body’s functions.
This movement has received its impetus from several sources. The rise in incidence of chronic pain and illnesses appear to be related to environmental and emotional stresses.
The prevalence, destructiveness, and cost of these illnesses have set the stage for the exploration of therapies that can help individuals appreciate the sources of their stress and reduce that stress by quieting the mind and using it to mobilize the body to heal.
During the same time, medical researchers have discovered other cultures had utilized healing systems, such as meditation, yoga and tai chi, which are grounded in an understanding of the power of mind and body to affect one another.
Other developed techniques such as botanical therapies, nutritional interventions, biofeedback, hypnosis, sound therapy and visual imagery have demonstrated the ability of facilitating specific links between the body and mental processes, stimulating immune, endocrine and nervous system functioning. The growth of a new discipline was born called psychoneuroimmunology.
The Classifications of Stress in Your Life
Stress management can be complicated and confusing because we experience acute, chain acute, and chronic stress — each with its own characteristics, symptoms, duration, and treatment approaches. Let’s look at each one:
1. Acute Stress
Acute stress is the most common form of stress. It comes from demands and pressures of the recent past and anticipated demands and pressures of the near future. Acute stress may be thrilling and exciting in small doses, but too much is more likely to be exhausting.
A ride on a roller coaster or a run down a challenging ski slope, for example, can be exhilarating. That same activities taken to extremes could be taxing and wearing. By the same token, overdoing any short-term stress can lead to psychological distress, tension headaches, upset stomach, and other symptoms.
On the flip side, acute stresses may be attributable to a laundry list of what has gone awry in your life: an auto accident, losing a job, the loss of an important contract, a deadline they’re rushing to meet, your child’s occasional problems at school, and so on.
Acute stresses, generally, are short-term and may not generate the sustained
harm associated with long-term stress. The most common symptoms are:
- emotional distress — some combination of anger or irritability, anxiety, and depression, the three stress emotions;
- muscular problems — including tension headache, back pain, jaw pain, and the muscular tensions that lead to pulled muscles and tendon and ligament problems;
- stomach, gut and bowel problems — such as heartburn, acid stomach,
flatulence, diarrhea, constipation, and irritable bowel syndrome;
- transient over arousal — leading to elevation in blood pressure, rapid
heartbeat, sweaty palms, heart palpitations, dizziness, migraine
headaches, cold hands or feet, shortness of breath, and chest pain.
Acute stress can crop up in anyone’s life, and it is highly treatable and manageable.
2. Chain-acute Stress (Castastrophizing)
Many people create a never-ending chain of stresses, thereby going from one acute episode to the next without resolving any of the previous stressors, hence creating an overwhelming snowball effect.
They become so encumbered by their inability to find resolution that they feel imprisoned with no hope for escape. They are so disordered that they’ve created a sense of chaos, anxiety, panic, depression and crisis. They are trapped in their own mind. They are often the ones that are always in a rush, but always late.
If something can go wrong, it will. They take on too much, have too many irons in the fire, and can’t organize the slew of self-inflicted demands and pressures clamoring for their attention.
They seem perpetually in the clutches of going from one acute stress to another. It is common for those with chain-acute stress reactions to be over aroused, short-tempered, irritable, anxious, and tense.
Often, they describe themselves as having “a lot of nervous energy.” Always in a hurry, they tend to be abrupt, and sometimes their irritability comes across as hostility. Interpersonal relationships deteriorate rapidly when others respond with real hostility. Their work becomes a very stressful place for them.
Another form of chain-acute stress comes from ceaseless worry. They are often catastrophizers, predicting disaster around every corner and pessimistically forecasting an ominous outcome in every situation. The symptoms of chain-acute stress may include:
- persistent tension headaches
- chest pain
- heart disease
Treating chain-acute stress may require a multi-interventional approach, which may take many months to correct. Usually these lifestyle and personality issues are so ingrained and habitual with these individuals that they neglect to see anything wrong with the way they conduct their lives.
They are more likely to blame their problems on family, friends, co-workers, bosses and external events beyond their control. Those sufferers can be fiercely resistant to change. Only the imminent promise of relief from pain and discomfort may sustain their treatment and recovery program.
In an office setting, chronic pain patients who catastrophize “display more pain behavior such as holding, rubbing as well as vocalizations such as moans and sighs,” was stated at a meeting, sponsored by the International Association for the Study of Pain.
Research has shown that catastrophizers are going to have more difficulty in pain situations and are less likely to respond to appropriate remediation compared with non-catastrophizers. Catastrophizers are at greater risk of chronic pain.
3. Chronic Stress
Chronic stress is exhausting. It is the type of stress that progressively creates deterioration, pain, depression, anxiety and apathy. It can destroy our body, our mind and ultimately our life. It wreaks havoc through long-term attrition.
It could be the stress of poverty, of being a member of a dysfunctional family, the feeling of being trapped in an unhappy marriage, an unfulfilling job or career or the fear of being unemployed.
It’s the stress of seemingly is a never-ending dilemma with no resolution in sight.
Chronic stress comes when a one believes that they are unable escape from a
dire situation. It’s the stress of unrelenting demands and pressures for seemingly
interminable periods of time.
With no hope, many individuals give up searching for solutions.
Some chronic stresses stem from traumatic, early childhood experiences that become internalized and remain forever painful and present. Some experiences profoundly affect personality. A view of the world, or a belief system, is created that causes unending stress for the individual (e.g., the world is a threatening place, people will find out you are a pretender, you must be perfect at all times).
When personality or deep-seated convictions and beliefs must be reformulated, recovery requires active self-examination, often with professional help.
The worst aspect of chronic stress is that people get used to it. They forget it’s there. People are immediately aware of acute stress because it is new; they ignore chronic stress because it is old, familiar, and sometimes, almost comfortable.
Chronic stress kills through suicide, violence, heart attack, stroke, and, perhaps, even cancer. People wear down to a final, fatal breakdown. Because physical and mental resources are depleted through long-term attrition, the symptoms of chronic stress are difficult to treat and may require extended medical as well as behavioral treatment and stress management.
Adapted with permission from The Stress Solution by Lyle H. Miller, Ph.D., and
Alma Dell Smith, Ph.D.
Fibromyalgia and Stress
Fibromyalgia is the second most common diagnosis made in rheumatology clinics, yet its cause is quite controversial. It has been suggested that those afflicted with fibromyalgia have sustained a significant physical or psychological event, which precipitated the initial onset of symptoms.
In support of this theory, there is definite evidence from population-based studies that psychological distress, particularly early-life trauma such as death of a close family member, physical, emotional or sexual abuse, serious illness, or traumatic injury, may be able to predict the future development of chronic widespread pain and fibromyalgia.
However, there are still uncertainties of the mechanism of how psychological stressors are attributable to chronic physical pain.
Regardless of the pathway, however, the links between fibromyalgia and unresolved chronic stress have now been well established. While the exact relationship is not fully understood, the research has made clear that chronic stress influences, exacerbates and/or aggravates the development or progression of fibromyalgia.
We could perceive our resilience to stress in the same terms as our checking account. Nutrients, exercise, joy, laughter, vitality and personal fulfillment would be our deposits and unresolved stress, anxiety, unhappiness, obsessive behavior, selflessness, worry, illnesses, malnutrition and environmental toxins would be our withdrawals.
Those individuals who have exhausted their assets in lieu of over whelming deficits (withdrawals) are more apt to suffer symptoms of fatigue, pain, sleeplessness, weakness and cognitive decline. All of which are commensurate with fibromyalgia.
Habitual Stress Patterns and Fibromyalgia Susceptibility
Many researchers believe that the inability to manage stress is a major factor in
the susceptibility to fibromyalgia. Fibromyalgia patients frequently possess habitual patterns of anxiety, feelings of powerlessness, repressed anger and poor stress management.
This is often due to the inability to say “no,” overloading their schedules and taking on too much responsibility for other people such as family, friends and co-workers and neglecting their personal health and self-interests.
Event Triggered Stress and the Onset of Fibromyalgia
There is some evidence that the onset of fibromyalgia may be triggered by an extremely stressful experience. While this stress may be associated with physical trauma, such as an auto accident, illness or surgical procedure, it also may be associa
ted with psychological stress, such as emotional or physical abuse.
Most scientists believe that stress is probably not the primary cause of fibromyalgia, however, there is evidence to suggest that both chronic stress and post-traumatic stress disorders may be instrumental catalysts in the onset of fibromyalgia.
How Stress Can Aggravate Fibromyalgia
For fibromyalgia patients, chronic stress can also make the condition worse and can trigger particular physical symptoms. People who suffer from fibromyalgia often have trouble knowing their personal limitations, which can make it hard for them to know when they are in danger of overexerting themselves.
When fibromyalgia patients physically overexert themselves, this can often lead to
increased stress, which results in increased pain. A vicious cycle can easily develop, because the pain can lead to more stress, which, in turn, can lead to more pain. For this reason, learning to manage stress may have a profound effect on eliminating or reducing the pattern of pain.
The Story of Two Wolfs
One evening an old Cherokee told his grandson about a battle that goes on inside people. He said, “My son, the battle is between two wolves inside us all.
“One is Evil – It possesses anger, envy, jealousy, sorrow, regret, greed, arrogance, self-pity, guilt, resentment, inferiority, deception, false pride, self-rightousnesss and egotism.
“The other is Benevolent – It is joyful, peaceful, loving, hopeful, humble, kind, benevolent, serenity, empathetic, generous, truthful, compassionate and faithful.”
The grandson thought about it for a minute and then asked his grandfather: “Which wolf wins?”
The old Cherokee simply replied, “The one you feed.”
Managing Your Pain Through Mind Control
A fibromyalgia patient’s level of stress can directly influence their ability to deal with pain and other symptoms of the condition. In general, the more you are able to control your thoughts, emotions and feelings, the better you will be able to deal with the physical discomfort of fibromyalgia. Here are a few ways to ameliorate fibromyalgia symptoms:
- Physical Exercise – Regular aerobic exercise can make an enormous impact on managing your pain and controlling your stress level. Start an aerobics class, play tennis, do yoga, or just go for a nice, long, relaxing walk. You’ll find that it can elevate your mood, relax your muscles, and even give you a feeling of being in more control over your symptoms.
- Correct Sleep Disorders – Fibromyalgia and sleep disorders can go hand in hand. Resolving sleep problems can directly lead to a lessening of fibromyalgia symptoms.
- Practice Rational Selfishness – Do not over-commit yourself to work,
family, and friends. Finding balance in your life is key to overcoming fibromyalgia, and one of the best ways to do that is to make sure you take enough time for yourself.
- Tap the Mental Healer Within –
- Breathing and Pain
- Guided Imagery
- Mindfulness Meditation
- Emotional Freedom Technique (EFT)
- Neuro-linguistic Programming (NLP)
Physical Exercise and Fibromyalgia
While beyond the scope of this article, performing exercise can have profound benefits in helping to manage the symptoms of fibromyalgia. The problem is, if you are encumbered with deep muscle pain and chronic fatigue, exercise is probably not at the forefront of your mind.
Yet exercise may be just what the doctor ordered? Whether it’s daily walks, stretching, swimming, rowing , yoga, tai chi or Pilates, low-impact exercise programs can keep you fit in spite of your fibromyalgia and may help reduce pain as well.
Exercise helps by:
- Strengthening muscles
- Enhancing flexibility
- Increasing range of motion
- Controlling weight
- Increasing endurance
- Maintaining physical function
- Promoting an affirmative emotional state
- Reducing stress
- Stimulating circulation
- Inhibiting fatigue
- Balancing gastrointestinal function
- Optimizing metabolism
- Encouraging present-mindedness
Formerly, medical doctors had believed that physical exercise might have a
deleterious effect on fibromyalgia symptoms or hasten the progression of the
Current scientific studies have determined that those beliefs were unfounded and discovered for most patients receive tremendous benefit by strength and aerobic conditioning exercises.
How Does Exercise Reduce Pain and Stress?
Regular exercise slows down the heart-racing adrenaline associated with stress, but it also boosts levels of natural endorphins – the feel good, pain-fighting molecules that may be responsible for the well-known “runner’s high.”
Endorphins help to reduce pain, inhibit stress, anxiety and depression. It is further purported that exercise raises the brain chemical serotonin.
Serotonin is a neurotransmitter in the brain that scientists have found to be deficient in most of those afflicted with fibromyalgia. Neurotransmitters are brain chemicals that send specific messages from one brain cell to another. This neurotransmitter is believed to play a vital role in mediating moods.
Additionally, research has revealed that pain and depression share the same neural pathways, the same circuitry. Serotonin and the endorphins that modulate healthy brain functioning are the same ones that modulate depression and chronic pain. If exercise can increase serotonin production, it has the ability to modulate pain as well.