Are You in Pain?

by Dharma Singh Khalsa, M.D.

continued from page 3

The Brain Can Stop Pain: Testimonials

As I've indicated, one of the best ways to stop pain is simply to increase the power of the brain. This simple principle was portrayed dramatically to me shortly after the publication of my first book, Brain Longevity. In that book, I told readers how to optimize their brain power—but I said almost nothing in it about using the brain to defeat pain. Nonetheless, please note the following exchange of letters.

August 20, 1998
Hartford, CT
Dear Dr. Khalsa,

I have recently finished reading your book Brain Longevity. It has given me some hope. Recently I was diagnosed as having a form of dystonia called spasmodic torticollis, a condition that causes severe twisting of the neck, and great pain.

I was given two injections of botulinum toxin, which failed to make a difference. My neurologist has now put me on Tetrabenazine, which also does not seem to be helping. I am 38 years old, very active, and have two daughters. My neurologist has given me these medications—the only ones available to help me. A cure is not known.

I have started your brain longevity program. It seems to my unscientific mind that it makes sense to try to improve the working order of my brain. The nutritional side is something I can easily handle, but exercise is difficult, since I can't hold my head straight.

Anyway, I am forging ahead, and would love to hear if you think I have any real chance of helping my condition.

Sincerely,
J.M.

I wrote back to this woman—who had a severe neurological disease that is generally unresponsive to treatment—encouraging her to persevere with her brain longevity program. I recommended that she do mind/body exercises and see an acupuncturist, in addition to following a comprehensive program that boosts the power of the brain.

A few months later I received another letter from her.

October 19, 1998
Hartford, CT
Dear Dr. Khalsa,

All of my symptoms are gone! My neurologist had given up on me when the drugs didn't have any effect. I then decided to work on my own, in a holistic mode. I have been successful, and my inspiration came from you. Thank you very much. I continue to take all of the vitamins and supplements you suggested. I also continue with my mind/body exercises, meditation, yoga, good nutrition, and exercise.

Thank you again.
Sincerely,
J.M.

This case clearly illustrates that the brain can have a profound effect upon a supposedly intractable pain condition—even in the absence of a full-fledged pain program.

Furthermore, when the power of the brain is allied with the power of the body, and the power of the spirit—in a comprehensive pain program—almost anything is possible!

Now you have a basic understanding of how pain works, and how chronic pain can begin.

Therefore, you already understand—probably better than some doctors do—why the traits of chronic pain syndrome are so devastating to people with chronic pain.

As you'll recall, chronic pain syndrome is characterized by physical inactivity, inadequate sleep, depression, poor nutrition, fear, anxiety, reliance on medications, and mental lethargy. As you now know, these traits are almost certain to lock in—and amplify—pain signals that have become engraved upon the nervous system.

If you are now suffering from chronic pain, I can certainly see why you might have fallen victim to these traits. After all, pain wears you down, and eats away at your strength and your zest for life.

But now that you have a better grasp of how chronic pain gets started, and keeps going, you can probably see that these characteristics of chronic pain syndrome are literally poison for the nervous system. They reduce the natural ability of the nervous system to resist pain. And they allow the brain to focus on pain, and thereby increase the intensity and frequency of pain signals. Besides being "poisonous" to the nervous system, these characteristics also rob life of its most basic sources of joy: the pleasure of play, the satisfaction of work, and the love of other people.

This loss of joy is not only horrible in itself, but it, too, contributes to the cycle of pain. The less joy, satisfaction, and love you feel, the more you will indulge in harmful habits, and the more you'll focus on the only thing that's left in your life: pain. The end result is suffering.

If you have been suffering for a long time, you may have come to believe that your only escape from suffering will be through death.

That's what my patient Scott thought. But he was wrong.

Scott Fights Back

As I described the physiology of chronic pain to Scott, we talked about the particular cause of his own pain.

His immune system, for unknown reasons, had turned against his own body, in an "autoimmune" disorder; it was destroying his muscles, and causing him terrible pain. Shortly after his disease had begun, the pain from his muscle deterioration had become engraved upon his nervous system. It had caused him to suffer almost constant, knifelike jabs of pain. His muscles were disintegrating. He was very thin.

Scott was adamant, though, about discontinuing the use of his medications, including prednisone, a steroid that depresses the immune system and slows the autoimmune attack. He loathed prednisone's side effects of acne, bloating, insomnia, and emotional agitation. He hated these side effects as much as he hated his pain.

But if he did stop taking prednisone, a specialist had told him, the disease might intensify, and cause even more agony. It might also kill him sooner than expected. I asked him how he felt about that, during our first meeting.

"I'll take that chance," he said. His eyes looked watery and regretful. His skin was the color of skim milk, and his body seemed to be a shriveled version of what it once had been. He looked physically and emotionally exhausted.

"How is your doctor monitoring the progress of your disease?" I asked.

"A nurse comes to my house and checks my CPK levels," he said. He was talking about his levels of a chemical called creatine phosphokinase, an enzyme that breaks down muscle tissue. The higher the levels got, the closer he would be to death. "My nurse is part of the hospice program," he said sadly. The hospice program was an in-home service for terminal patients who had only weeks or months to live.

"You'll need to taper off on the prednisone gradually," I said, "because you can die from sudden withdrawal. And when you start tapering off on the prednisone, you're going to need an aggressive anti-pain program, because your pain may increase dramatically."

He nodded calmly.

I scanned his medical records. "You're also taking some tranquilizers?" "Xanax, Lithium, and Ambien," he said.

Xanax is a minor tranquilizer, much like Valium, and Ambien is a sleeping pill. Lithium is generally used only for bipolar disorder, or manic depression, which Scott did not have. Xanax and lithium did not seem appropriate for a patient with chronic pain. With Scott's concurrence, I discontinued those two medications and placed him on a full pain program immediately. He began to institute major changes in his life. Even though he had been told he was dying, he participated in his program enthusiastically. I really admired that. In some people the human spirit is just unbeatable.

Here's a brief outline of the four levels of Scott's program:

Nutritional therapy.

Scott began to force himself to eat regularly, and carefully. His diet—which I changed to one composed primarily of grains, vegetables, high-protein soy products, and fish—was designed not only to give his nervous system abundant nutritional support, but also to improve his general health. He ate foods that stimulated production of nerve-calming serotonin, and he took the supplements that his brain and nerves needed to achieve regeneration. In addition, he regularly ate nutrients that have anti-inflammatory properties.

Physical therapies.

Scott engaged primarily in massage therapy, and yogic mind/body exercises. He also did light work around his house, and a bit of walking, which helped him begin his cardiovascular rehabilitation.

The mild cardiovascular exercise he did stimulated his production of endorphins, and also provided his beleaguered muscles with a much-needed infusion of blood-borne oxygen and nutrients. The stretching and massage soothed his muscle pain, and helped his nervous system to "unlearn" its patterns of circulating, engraved pain. The mind/body exercises stimulated his brain, and brought energy to the areas of his nervous system that help control pain.

Medication.

This was probably the most important component of Scott's program, since his primary goal had been to stop taking pharmaceutical drugs. Scott's desire to overcome his reliance upon powerful pharmaceutical drugs, though, was not at all uncommon. In fact, at the most prominent pain clinics in America, the first goal of the attending physicians is usually to eliminate their patients' reliance upon drugs. Pharmaceutical drugs can play a very positive role in pain management. But they are not panaceas—even though many general practitioners seem to believe they are.

Over the next eighteen months, Scott gradually stopped taking prednisone, and eliminated his use of tranquilizers. He replaced those pharmaceutical medications with milder natural medications, including homeopathic remedies and analgesic herbs.

I'd feared that his pain might become unmanageable after he discontinued prednisone, but this didn't happen. The natural medications—combined with the other elements of his pain program—more than compensated.

Mental and spiritual pain control.

To heighten his ability to cognitively reduce his pain signals, Scott began to confront his feelings of anger and worthlessness. These negative emotions increased his perception of pain, and reduced his brain's ability to "dampen" pain signals.

Scott had been reared by a difficult father who had convinced him that he didn't deserve to be happy, and never would be. Scott had internalized this neurotic outlook, but was seething with anger toward his dad. To overcome his self-hatred and anger, he used several of the methods of "cognitive therapy," a rationality-based form of psychotherapy that's often quite beneficial for pain patients. As Scott began to shed his sense of self-loathing and his anger, he became much more relaxed, physically as well as emotionally. This reduced his perception of pain, increased his ability to accept pain, and heightened his ability to cognitively distract himself from pain.

Having a more positive outlook also helped Scott implement the other self-help measures in his program. It made it much easier for him to rise above his chronic pain syndrome, and to do good things for himself.

I also taught Scott an advanced meditation technique, and his meditation helped him to achieve deep personal insights, and to release much of the negative emotional energy that was heightening his pain.

In addition to his psychological therapy, Scott also began an earnest search for spiritual peace. He started his search the same way many patients do—by asking himself, "Why me?" This in one of the most fundamental of all spiritual questions about suffering, because spirituality is, essentially, the search for meaning.

When patients first ask this question, they usually assume the answer to it will be negative; they assume that they must have been doing something wrong, or that there is something intrinsically wrong with them. Often this is true, and whatever it is that's wrong must be corrected. But the negative answer is almost never the complete answer. Usually there is also a positive element to pain. For example, for many people, pain is the only force strong enough to make them back away from the "rat race" and really live.

When patients find a positive meaning for their pain, it invariably helps them recover. It reduces their stress response, and heightens the pain-fighting power of their minds. Often it enables them to perceive their pain as less threatening, and helps them forget about it.

Scott found a positive meaning for his pain. He found he could use his pain as a path to universal truths, and to greater understanding. From intense study of spiritual literature, he learned that many great holy men had experienced terrible suffering—but had needed this suffering to reach enlightenment. Those spiritually advanced people became Scott's role models.

After Scott found a positive meaning for his pain, he never again suffered from it quite so much. When he realized that some good was coming from his pain, he began to see it more as a challenge than as a curse. Scott, who was a practical man, did not just sit down one day and contrive the meaning of his pain. Instead, he did a lot of hard work. Each day he meditated for a long time, and it helped him to make contact with his inner self. He told me that meditation also helped him to make contact with the realm of the divine spirit.

In addition, each day Scott read extensively in spiritual literature—everything from Buddhism to the Bible. He prayed with conviction and fervor.

He also began a powerful practice called naad yoga, which employs the chanting of particular mantras. These ancient mantras were devised centuries ago, not only for their literal meaning, but also for the particular vibrations they create in the head, chest, and throat. My own spiritual teacher, Yogi Bhajan, has said that these vibrations stimulate optimal function of the brain and the endocrine glands, which produce hormones. Scott's favorite mantra was Ra Ma Da Sa Sa Se So Hung, which means "The healing power of God is in every cell of my body."

For Scott, the turning point in his spiritual exploration was when he finally "gave up" and surrendered to the inescapable fact that sooner or later he would die. When this happened, he remarked to me, "Now that I've given up, I feel like I've received everything." By this, he did not mean that he had received some sort of "free pass" to immortality. He meant that each day, for at least several blissful moments, he had begun to experience his own infinity.

The net effect of Scott's spiritual growth was that he developed an unshakable inner peace. This inner condition was so profound that it had various physical manifestations. One of them was the raising of his pain threshold.

Another manifestation was Scott's physical appearance. After several months he began to look different. His skim-milk skin tone began to be replaced by the luminous, incandescent glow that you sometimes see surrounding holy men. Even the look in his eyes changed. They no longer looked tormented; instead they reflected great compassion, and a deep sense of self-knowledge. The change in Scott's appearance was very dramatic.

As you can see, there was nothing terribly exotic about his pain program; it was just a combination of good medicine, common sense, and Scott's own hard work.

After he had been on the program for about six months, I got a call from him. "My cardiologist just phoned me," he said. "It was about my CPK levels. We need to talk."

I felt a sick jolt in my stomach. If Scott's CPK levels were becoming dangerously high, his heart muscles might be in danger of immediate failure.

"What did your cardiologist say?" I asked.

"I'd rather talk in person."

Scott's Story: The Final Chapter

As soon as I saw Scott arrive, I blurted out, "What did he say?" I was nervous. I know that some doctors can remain detached and don't become emotionally involved in their patients' lives, but I've never really understood that.

"He said my CPK levels are going down," Scott said, flashing a smile as bright as lightning. "Way down. As in normal."

"Yes!" I jabbed my fist into the air.

"My cardiologist goes, 'I don't know what you're doing, but keep doing it!'" Scott said, beaming. "The cardiologist said, 'I've read some of that Deepak Chopra stuff, but frankly I just don't get it.' I told him, 'There's nothing to get. It's not an intellectual thing, it's an experiential thing. You've just got to do it.'"

"How's your pain?" I asked.

"Fine. I don't think about it all that much. Actually, now that I do think about it, it's not fine. My muscles still hurt some. But pain just isn't the be-all and end-all now. I'm working again. Did I tell you that?" Then he was off on a story about work, and I had to steer him back to his medical condition.

"So you still have some residual pain?" I asked.

"I do," he said, "but I know a bunch of ways to rise above it. I know every trick in the book."

"Has it been hard?" I asked.

"You bet. Sometimes it was even harder than being sick. I had to change so much—my habits, my diet, my psyche. I had to accept the fact that for forty-two years, most of what I'd been doing was wrong—because look where it got me.

"But having to make so many changes was a blessing," he said. "The greater the changes in your life, the greater your healing."

That was three years ago. Scott's disease is still in remission, as of publication.

Of course, it would be ludicrous of me to purport that my pain program is a miracle cure for polymyositis.

The fact is, Scott transformed his own life—body and soul. And when he did, his immune system stopped trying to destroy him, for reasons that are as mysterious as why the disease began in the first place.

As I have said, the body has an almost magical power for self-healing. But no one can control that power. It's a power that can only be served—not commanded.

When I saw Scott again recently, I told him, "I'm so proud of you."

He replied simply, "Thanks, Dharma."

He is very proud, too—that's quite obvious. But he is proud in a way that does not involve his ego. His pride is deeper than that, and more profound.

He loves life now, and his pride—like that of someone who is proud to be in a wonderful family—is the pride of a person who is proud to be a part of life.

© 1999 by Dharma Singh Khalsa, M.D

This article is excerpted from the book The PainCure by Dharma Singh Khalsa, M.D., ©1999. All rights reserved. Posted with permission from Time Warner Bookmark.

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About The Author

Dharma Singh Khalsa, M.D. is the founding director of the Acupuncture Stress medicine and Chronic Pain Program at the University of Arizona Teaching Hospital in Phoenix. He is the author of The Pain Cure as well as of Brain Longevity and Meditation As Medicine. Visit his website at www.meditation-as-medicine.com