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How Our Thought Life Can Effect Our Physical Body (Part 2 of 2)

August 15, 2015

You may recall the last Fast and Curious newsletter regarding how your thought life may be causing or contributing to physical symptoms that you are currently experiencing. In case you missed it, make sure you check it out here.

In this newsletter, we are going to briefly outline things you can try to help regain control of your thought life as well as provide you unique but not novel ideas regarding exercise.  This is because the mind-body connection needs to be addressed together rather than as separate entities.  We will even touch on how to improve and MAXIMIZE your performance regarding exercise/training.

Dr. John E. Sarno is a professor of Rehabilitation Medicine at NYU.  Prior to his retirement in 2012, he was the attending physician at the Howard Rusk Institute of Physical Medicine in NY.  Of his many books, he wrote the ground breaking The Divided Mind: The Epidemic of Mindbody Disorders.  In this book, he states that most back pain does not stem from physiological issues such as trauma and resultant tissue damage, rather it stems from psychological problems.  Dr. Caroline Leaf takes this a step further stating that, “If our thoughts and thought processes are powerful enough to make us sick, they are powerful enough to make us well.” 1

According to Dr Candace Pert (credited with discovering the opioid receptor), all of us have our own, endogenous, inner pharmacy that will produce all of the chemicals/drugs we will ever need.  In fact, she was one of the first of many researchers to show that exogenous (coming from outside of your body) drugs may be harmful to our system.  This is because they disrupt the natural feedback loops you have in place and cause changes down to the cellular level.1 Please understand that prescription drugs have their place and that they save lives, but is it possible that there may be safer, potentially effective alternatives out there?    Take the following for example:

A local doctor who will remain anonymous was recently at a continuing education Trigger Point Dry Needling course.  During the course, he volunteered to be the subject in the small group while we instructed the other health care providers on how to perform dry needling of the shoulder.  He immediately had improved active range of motion and significant reduction in pain.  He was surprised as he told us that this shoulder had been ailing him for years.   His response was this:

“I can definitely see a place for this in managing a lot of my patients and their pain.  I would much rather have them try this first than to prescribe a powerful anti-inflammatory with a whole host of potential side effects like tearing up their stomach and GI tract or prescribing other medications that actually could end up effecting their balance.”

So if all of this is true, how do we tap in to our own endogenous pharmacy?  How do we begin doing so by controlling our thought life?  Below is going to be a brief list of things that you can try to start taking back the battle for your mind as well as physical activities you can engage in.

Consciously Control Your Thoughts

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Ask yourself the following:

  1. How many “if only” statements were part of your internal and external dialogue today?
  2. How many times have you said a “could have,” “would have,” or “should have” statement today?
  3. How many times have you replayed a painful situation or conversation in your mind?
  4. How many different scenarios of the unpredictable future have you played out in your head today?
  5. Are you honest with yourself?
  6. Do you go through the day without being committed to a goal but rather just going through the motions?
  7. Are you creating a personal identity around a disease? E.g. “My multiple sclerosis,” “My low back pain,” “My neck pain,” “My hip pain,” etc.

The latter is prevalent in health care offices because this is a verbal manifestation of your thought processes.  We can hear your words, not your thoughts.   Dr. Sarno states that harmful thoughts are what can harm the body and cause pain.  Remember; an illness is only psychosomatic when a team of health care professionals are unable to find a cause.  A study by Cohen et al demonstrated in their research that mental health and physical health are closely linked.2 People with poorer mental health report more physical and somatic complaints/limitations such as low back pain and neck pain.3  In actuality, none of the above 7 are helpful and may lead to negative affective states, which ultimately do you harm rather than good.  Number 5 is particularly an issue when it comes to exercise in today’s day and age.  Did you know that a 30 minute workout comprises only 2% of your day?  Who honestly cannot afford to put aside 2% of their day to better themselves, mind and body?  Are you being honest with yourself?

Frame Your World With Your Words

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This is more than just positive thinking, which is tremendously important.  Your actions MUST be congruent with your thoughts.  What you say and do must be congruent with what you are thinking, if not, this creates stress and interferes with how information is processed and memories are built.  Negative thoughts and statements release “negative” chemicals.  The words that echo throughout most medical offices treating pain are “my (fill in the blank) is/are killing me.”  Saying that your “back is killing you” is actually an example of catastrophizing.

“Pain catastrophizing is defined as a tendency to misinterpret and exaggerate situations that may be threatening.4   Individuals who are found to catastrophize about pain find it difficult to shift their focus of attention away from painful or threatening stimuli, and attach more threat or harm to non-painful stimuli.   Catastrophizing influences pain perception through altering attention and anticipation and heightening emotional responses to pain.”5   That means the pain you feel in actuality may not be all that bad, however, due to your mental/cognitive state, it is amplified.  Think of it this way:  It’s as if somebody went inside your brain and found the physical sensation amplifier.   Once they found this physical sensation amplifier, particularly for pain, they cranked it way up.  Now, seemingly normally non-painful stimuli are painful, maybe even excruciating.

According to a new study as of July 2015, patients who catastrophize and demonstrate lower moods or negative affective states were shown to “not perceive the biopsychosocial messages” provided by the physical therapists.  These messages included that their back pain was benign and that physical activity was pertinent and essential to recovery.  These patients who didn’t perceive these biopsychosocial messages were also at a higher risk for disability.6 

Therefore, WATCH WHAT YOU SAY!  Believe it or not, it has consequences.  Cut out the negative proclamations that you make about yourself like “my back is killing me,” or “my neck is killing me,” or “my knees are killing me,” or “my shoulder is killing me.”   It may seem like such a simple harmless statement, but according to research, you are actually doing yourself more harm than good by saying these things.  Instead, have a positive attitude about your symptoms.  Make some POSITIVE proclamations about your back, neck, knees, shoulders or whatever it is that is ailing you!

Lastly, don’t build an identity about your symptoms or condition.  Don’t wear your surgical history or diagnosis like a badge of honor as if it is something to be proud of.  It is easy to get caught up in telling your friends, family and health care providers about how limited you are with a certain activity.  Consider the following examples:
“Doctor /Physical therapist _____, I can’t even walk my dog anymore.  It just hurts too bad.”
“Doctor /Physical therapist _____, I can walk my dog for 10 minutes before it really hurts and then I have to stop.”
Now, both of these things mean the same thing, but it all goes back to catastrophizing.  You previously were able to walk your dog for 60 minutes uninterrupted due to pain.  However, since the onset of pain, you can take one of the two above examples in how to express it.  It isn’t that you physically cannot walk your dog anymore, it just means that you CURRENTLY are unable to walk the dog as long as you used to or as long as you’d like.  Again, this goes back to FRAMING YOUR LIFE WITH YOUR WORDS.  If you have to choose, pick the latter because it is a much more positive affirmation. Positive thoughts equal positive, mood boosting chemicals circulating in your body.

Power of Touch…hug it out

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Research shows that endorphins and enkephalins (the feel good chemicals) are released from an area of your brain called the periaqueductal gray area (PAG) just by touch (Leaf)!  This is likely the very reason why physical therapy, chiropractic and therapeutic massage can be so effective in providing pain relief.   In the 1950s, a Wisconsin University psychologist deprived baby rhesus monkeys of touch.  They were raised by fake mothers who were comprised of wire, cloth and bottles rather than breasts.  Therefore they were fed but never hugged, held or touched.  Before long, these baby monkeys showed signs of trauma, stress and depression.  The intervention was simple; they brought in an older monkey that held/cuddled them, and the signs of trauma, stress and depression vanished.1 

Don’t Be Afraid to Laugh

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Did you know that simply laughing reduces stress hormones, instantly?  A good belly laugh can drop adrenaline by 70%, cortisol by 39% and increase endorphins (“feel-good hormone”) by 29%!!  Growth hormone can increase 87%!! Laughing 100-200 times/day is equivalent to rowing or jogging for 10 minutes.1

So next time you pick a movie to watch, ditch the horror films, suspense movies, etc.  Later in this article, you will read about how just imagining certain scenarios can result in a cascade of chemical pathways that will kick start your sympathetic nervous system. (See Training With a Purpose section)  Instead, pick a comedy.  One of my personal favorites is “Impractical Jokers” which airs on TruTV.   You will have a good laugh, even if you don’t “want” to!

Runner’s High: Don’t quit too soon!

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Have you ever heard of that “runner’s high” that many runners will speak of–an almost euphoric feeling that they experience well into their run?  Research has shown that cortisol, the main stress hormone, actually increases for the first 29 minutes of running.7   It is only after 29 minutes that cortisol levels begin to come down.  Endorphins, or “feel-good” molecules are also released with prolonged exercise.  This is likely why runners must run for an extended period of time before they start to experience what they call the “runner’s high.”  Therefore, if you are running, make sure that your physical activity times are sufficient.  Those endorphins can actually block the feeling of pain, minimize the discomfort of exercise and again give that “euphoric-like” sensation.  Also know this:  Running is not the only physical activity that brings down cortisol levels.  So a “runner’s high” is misleading in that people may think that only running can bring about this feeling of euphoria.  That is inaccurate. See below to understand this concept further.

Easy Does It

There may be more to your doctor or physical therapist telling you to “take it easy” than you realize.  Did you know that just 20 minutes of light to moderate intensity exercise is effective in reducing depression/anxiety?  The thought here is decreasing levels of circulating cortisol.  Remember, high circulating levels of cortisol are associated with negative affective states while reduced circulating levels of cortisol are associated with positive emotional states.2   Look at the difference between our brains during sitting vs after a 20 min walk!

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Clanging and banging the weights should help boost my mood because I am blowing off steam, right?  Not so fast…..

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We’ve all heard it before.  Sometimes it is good to blow off a little steam when you are stressed or mad, right?  Some may take to the weight room to lift weights, performing high intensity anaerobic activity to help aid them in this.   This can be effective for some but there is a caveat.  Did you know that high intensity workouts have been shown to increase anxiety?8  In order for anaerobic exercises to have mood boosting effects, they must be performed continuously for 1 hour or more.  Unfortunately, this may discourage some of those interested.  Some examples of high intensity anaerobic exercises are:

-strength training
-power lifting
-cross fit
-high intensity interval training or HIIT
-sprinting

Spirituality and Forgiveness…

spirituality

LouiseHay_forgiveness

I know.  You don’t want to be lectured about spirituality or forgiveness.  However, you may find it interesting that studies have shown higher cortisol levels (the main stress hormone) in those who considered themselves not spiritual at all.  Studies have also shown that participants who reported a higher frequency of prayer and/or forgiveness showed decreased cortisol levels during tasks.  Cortisol levels on average were increased in those participants who reported never praying OR were low on forgiveness.9   Pretty fascinating that being forgiving is beneficial for your health.

Meditation…

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Regardless of how you meditate, it may affect how much of the main stress hormone, cortisol, circulates in your body.  In a study by Tartaro et al, they sampled circulating cortisol levels during a procedure where they punctured a participant’s vein with a large needle.  They then took continuous samples of circulating cortisol levels for a period of time.  The meditation group showed a decrease in plasma cortisol vs the control group which were the non-meditators.  The non-meditators showed a consistent rise in plasma cortisol following venipuncture, where the meditators did not.9   Remember this for a later illustration.

You don’t need to take classes about meditation.  Instead, think of a time/experience in your life that made you really happy.  This is considered a form of meditation.  If you are religious or spiritual, meditate on a scripture or teaching that you like or find peace in.  If you are spiritual but are not religious, meditate on something that brings you peace when you think about it.  If none of those apply to you, close your eyes and clear your mind.  Focus on your breathing.  Take note of any areas of body where you feel you are tense.  Tense those areas further and then actively relax them.  Again, there are several ways in which you can meditate.  It is all about what works best for you!

Here is a quick way to decrease activation of your “fight or flight” system, also known as your sympathetic nervous system that we spent quite a bit talking about in the last newsletter.  It is called Box Breathing.  Box breathing is a way to slow your respiration down, considerably.  Stress can bring about hyperventilation or rapid, shallow breathing.  Your brain is very sensitive to the concentration of carbon dioxide in your blood.  The second you deviate from this, you can experience very strange sensations, including shortness of breath, numbness, tingling, and dizziness/lightheadedness to name a few.  When we hyperventilate, oxygen concentration in our blood increases and the carbon dioxide concentration decreases, which is what can cause these symptoms.   To counteract this, you can try some box breathing.

Follow these steps in succession.  Make sure that you are sitting down when you try these for the first time until you know how you will react/feel.

Inhale for 4 seconds…..

Hold your breath for 4 seconds……

Exhale for 4 seconds…..

Hold your breath for 4 seconds…..

It’s ok if you can’t do the whole 4 seconds when you first start out.  If you can’t hold for the 4”, try 3” and work your way up to 4”.

Another alternative you can try is the following:

Inhale for 5 seconds through your nose….

Exhale through pursed lips for 10 seconds….

What these do is slow your respiration down to about 4 breaths per minute, which can help relax you by helping activate your parasympathetic nervous system, often referred to as “rest and digest.”  It is a way of telling your brain and ultimately your body that there is no threat detected and you are relaxed.  Try these when you are not stressed as well as when you are stressed.

Shrinking brain….

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If you recall back from the previous newsletter, chronically stressed brains can result in dendritic shrinking in some areas of the brain by up to 20%!!!   There is good news, however.  In 2006, a study was performed on older adults.  After only 6 months of aerobic training, they showed a significant increase in regional brain volume.  The areas that were diminished initially have been linked to devastating clinical syndromes such as Schizophrenia and Alzheimer’s disease.10  The exercise consisted of aerobics and stretching which lasted 60 min for 3 times/week.  They attended these classes for 6 months.  Another group that participated in non-aerobic stretching, tone and balance exercises showed improved functional connectivity in the brain’s default networking, which resulted in greater executive function and behavior normalization.11

Training with a purpose…

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You may think that training with a purpose means preparing for the upcoming 5k, ½ marathon or triathlon.  Not really.  What is the one main difference between you and a child running outside?  First of all, most children aren’t usually outside running for exercise, they are usually playing and having fun.  If you foresee exercising as daunting and just something else you have to get done, maybe you’re not enjoying it and chances are you may skip out some days or altogether.  If a child is outside running, they are running with a purpose, their imagination is engaged.  They are running from monsters, robots or maybe a “bad guy.”  Maybe they are playing with friends and they are running from each other during a game of tag.  When you get outside to start your run, is your imagination engaged or are you thinking about everything else you should be doing instead of running–grocery shopping, work projects, picking up the kids, dropping the kids off, taking the car to the shop, etc.?  Are you finding yourself engaged in the type of thinking that was outlined in the very first section of this newsletter?  Do you put your earphones in and drown out the environment trying to escape it all, only to have a nice soundtrack in the background while the problems of life start going through your mind like a movie?

Skeletal muscle activity during childhood produces greater adult-like recruitment of a region of your brain called the anterior prefrontal brain regions, which are critical for maintenance and goal-oriented cognitive control.12   In fact, regularly exercise-trained children learn better to stay focused on a sustained task, which demands selective attention and distraction suppression.  This actually demonstrates a more mature brain function when compared to adults!  Exercise may also allow PROTECTION from the NEGATIVE cognitive and emotional consequences of INEVITABLE stress.13   Selective attention and distraction suppression; did you read that?  Have you ever tried to stop a child from playing or investigating something?  It can be quite a challenge!  They are very engaged in what they are doing!  According to this article, children and adults utilize their brains very differently.  That is; they demonstrate a MORE MATURE brain function!

Direct simultaneous stimulation of muscle and brain TOGETHER enhances the brain-muscle communication system and therefore this style of training is absolutely necessary to produce a superior effect on cognitive benefits!!11   Again, the cognitive benefits means that this style of exercise with purpose can help to protect you from the negative cognitive and emotional effects of stress.  This is a pretty neat strategy to help you manage those toxic thoughts and emotions and you can do it without making an appointment to see anybody!  Next time you go for a run or pick up some weights, why not use your imagination with them?  Take a trip back to childhood.  Next time you go swimming, jog your memory and ask yourself a few questions like “What would I have been swimming to/through or swimming from before I swim across the pool?”   Running or swimming merely for the sake of running/swimming is not natural to our species/being.  Remember this statement for the next section below.

Use Your Imagination!

child-imagination

Some patients with motor neuron disease/injury due to ALS (Lou Gehrig’s disease) or trauma, can stimulate exercise-sensitive brain networks without any motor activity.  That means parts of their brain are activated without physically doing the activity.  Hypnotic suggestion of uphill running causes increased breathing response and minute ventilation in these patients.  In fact, imaginary exercise activated the dorsal lateral prefrontal cortex (DLPFC), superolateral sensorimotor cortex (SLSMC), lateral sensorimotor cortex (LSMC) and supplementary motor area (SMA).  Voluntary breathing alone produced the activation of the SLSMC, LSMC and SMA, ONLY.  Therefore, it is showing that using your imagination for imaginary training is the ONLY way you can activate the DLPFC, which is a very important area of your brain involved in executive function and working memory.11

Why is this important and what does all of this mean?  Well, the DLPFC sends neuronal tracts out to a very important area of the brain that was discussed earlier in the Healing Power of Touch section.  This area is called the Lateral Periaqueductal Gray (LPAG or PAG), which is also known as the “central command” of brain networking.11   It should not be surprising then that the PAG receives input from the hypothalamus and the amygdala.  If you remember from the first newsletter, the hypothalamus has been termed the “brain of your endocrine (hormone) system.”  You also should recall from Part 1 of this newsletter that the amygdala is the “seat of your emotions.”

So, now you have the “central command” of brain networking, the “brain of your hormone system” and the “seat of your emotions” all intricately tied together with neuronal tracts within your brain.  It is not a one-way street, however.  The “central command of brain networking” (PAG) also sends multiple projections back to the “brain of your hormone system” (hypothalamus). The reason for this 2 way street is the following.  Information coming from the “seat of your emotions” (amygdala) to your “central command” (PAG) is telling your cortex (brain) what kind of mental/cognitive state you are in.  This is why the PAG is sometimes also referred to as the “cognitive integrator.”  The PAG, or “command center” synthesizes this information coming in whether you are happy, sad, angry, full of rage, full or depression or whatever mental state you are in and then sends information to the hypothalamus or the “brain of your hormone system” so that it can secrete the appropriate chemicals based on these emotions.  These projections coming from the PAG into the hypothalamus are what kick start the sympathetic nervous system response.  Increases in sympathetic nervous system activity, such as an increase in heart rate, arterial blood pressure, and respiration, are due to the activation of this pathway just discussed.  Remember, the only way your body can be fully prepped for exercise is imagining what you are about to do.  As previously mentioned, meditation can be effective and has several uses. Meditation can also help prepare you for an event or exercise, as demonstrated above. Simply breathing alone never activates the DLPFC or the area that is needed to start this cascade of reactions in this neuronal feedback loop.  Therefore the PAG never activates and your HR, breathing and blood pressure never elevate, which are NECESSARY for optimal physical performance. These individuals must meditate or imagine themselves walking uphill in order to reap the benefits of the sympathetic nervous system activation.

Remember when you read that thoughts are not just abstract things but actual chemical and electrical processes?  Well this just goes to show you the physical power of your thoughts!

Remember earlier that running for the sake of running isn’t natural to our species/being?  This should make a lot more sense now.  Simply put, if you are in a negative state when you are trying to run, the necessary regions of your brain that were discussed above will not be stimulated and your performance will not be optimal.   However, if you are running with a purpose, that necessary region of your brain will be stimulated so that the brain-muscle communication system is optimized for performance.  So next time you are running or exercising, exercise with PURPOSE!!   Don’t confuse purpose with an 8 minute mile pace, working out in your target heart rate zone, etc.  Instead, use your imagination!  It will work!  After all, research has validated this concept.  Nobody will know what you are running from but you. 

That was a lot of information.  It may take several re-reads to truly digest it all and get a grasp on all of what is in there.  But in summary, you need to have fun when you are exercising to get the maximum benefit; maximum benefit being not only the physical benefits but also the mental benefits and protection from inevitable stress.  Don’t be shy.  Exercise like a kid.  Play a little.  Also, remember this.

A 30 minute workout is only 2% of your day.  What is your excuse?  🙂

Bibliography

  1. Leaf, Caroline.  Who Switched Off My Brain?: Controlling Toxic Thoughts and Emotions. Switch on Your Brain International LLC.
  2. Cohen G, et al. Depressed, Low Self-Esteem: What can exercise do for you? The Internet Journal of Allied Health and Sciences Practice. April 2009, Volume 7 Number 2.
  3. Ruo B, Baker DW, Thompson JA, Murray PK, et al.  Patients with worse mental health report more physical limitations after adjustment for physical performance. Psychosom Med. 2008;70(4):417-421.
  4. Van Damme, S., Crombez, G., Bijttebier, P., Goubert, L., & Houdenhove, B. V. (2001). A confirmatory factor analysis of the Pain Catastrophizing Scale: invariant factor structure across clinical and non-clinical populations. International Association for the Study of Pain, 96(3), 319-324. Retrieved October 10, 2013, from www.sciencedirect.com/science/article/pii/S0304395901004638
  5. Gracely, R. H. “Pain Catastrophizing and Neural Responses to Pain among Persons with Fibromyalgia.” Brain 127.4 (2004): 835-43. Oxford Journals. Web
  6. Overmeer T.  What Messages Do Patients Remember?  Relationships Among Patient Perception of Physical Therapist’s Messages, Patient Characteristics, Satisfaction and Outcome.  Phys Ther. 2015 Jul 16.  [Epub Ahead of Print]
  7. Rudolph DL et al. Cortisol and affective response to exercise.  Journal of Sp Sciences  1998;16:121-128.
  8. Rendi M et al.  Acute Psychological benefits of aerobic exercise: a field study into the effects of exercise characteristics.  Psych Health Med. 2008;13(2):180-4.
  9. Tartaro J et al. Exploring Heart and Soul: Effects of Religiosity/Spriituality and Genderon Blood Pressure and Cortisol Stress Responses.  J Health Psychol 2005 10:753 http://hpq.sagepub.com/content/10/6/753
  10. Stanley J et al.  Aerobic Exercise Training Increases Brain Volume in Aging Humans.  Journal of Gerontology; Medical Sciences.  2006, Vol 61A, No 11, 1166-1170
  11. Foster P. Role of Physical and Mental Training in Brain Network Configuration. Frontiers in Aging 
  12. Chaddock-Heyman, L., Erickson, K. I., Voss, M. W., Knecht, A. M., Pontifex, M. B., Castelli, D. M., et al. (2013). The effects of physical activity on functional MRI activation associated with cognitive control in children: a randomized controlled intervention. Front. Hum. Neurosci. 7:72. doi: 10.3389/fnhum.2013.00072Overmeer T.  What Messages Do Patients Remember?  Relationships Among Patient Perception of Physical Therapist’s Messages, Patient Characteristics, Satisfaction and Outcome.  Phys Ther. 2015 Jul 16.  [Epub Ahead of Print]
  13. van Praag, H., Fleshner, M., Schwartz, M. W., and Mattson, M. P. (2014). Exercise, energyintake,glucosehomeostasis,andthebrain.J.Neurosci.34,15139–15149. doi: 10.1523/JNEUROSCI.2814-14.2014