Heal2BHuman

“True stability results when presumed order and presumed disorder are in balance. A truly stable system expects the unexpected, is prepared to be disrupted, waits to be transformed.”

Tom Robbins (American Novelist, b. 1936)

When I was in high school I was a pretty destructive and law defying young lad. I remember waking up each day for school thinking of ways I could break the rules just a little bit to generate some type of controlled rebellion against “the system.” If you remember being a teenager or are fortunate enough to be a parent, you can understand exactly what I am talking about here.

I have many memories from high school- Jnco jeans, dickies, Blink-182, and how in the world to talk to girls. Out of everything I learned from high school, one specific memory took place during a public speaking class at the ripe age of 17. Most people hate public speaking, and I was no different.

The last thing on planet earth I wanted to do was speak in front of a crowd of my peers. My teacher challenged us to create a speech on something that really interested us- and somehow I convinced my teacher to let me put together a speech on peeps. If you aren’t familiar with these things, they are essentially terribly shaped ducks that are sugary and full of marshmallow goodness. To this day, I have no clue what inspired my neurons to spend any time, effort, or energy on this topic- but somehow I pulled it off and pitched an entire 10 minute speech about peeps to a classroom of 20 students.

^Peeps anyone?

Back to the destressing and balancing part-

Among the other students in class, there was on whose name was Wayne Dean- an unexpecting, relatively calm kid for his age. He said something so profound that the statement buried itself deep within my neurons for 15+ years, and I am sure it will continue to do so until I am old and gray.

After some horsing around, some discussion about jnco jeans, and some friendly gossip, I finally listened to Wayne’s presentation and all I remember from this experience was him repeating the statement “everything in balance.” 

Honestly, at the time, I had no clue what he was talking about- all I wanted at that age is “everything, all the time, whenever I wanted. Little did I know this was not a sustainable way to go through life.

• What would your life look like if you held this concept in your mind every time you made a decision?
• Heck, what would my life look like if I took this into consideration a few times a month?

Wayne, in all of his 17 y/o wisdom, knew more than most of us adults do when we hum and drum along at our busy lifestyles- many times not stopping to decompress, unwind, and find balance.

Discovering Homeostasis and Equilibrium

According to our good friends at Dictionary.com, homeostasis is defined as “the tendency toward a relatively stable equilibrium between interdependent elements, especially as maintained by physiological processes.”

The body and brain are remarkable living organisms- they have the capability to “ramp up” physiological processes such as blood pressure, and heart rate and call on regions such as the endocrine system to produce adrenaline and push motor commands to our muscles in order to generate tension, contraction, or complicated whole body movements.

Do We Undervalue Homeostasis?

According to a recent article titled “Homeostasis: The Underappreciated and Far Too Often Ignored Central Organizing Principle of Physiology” from the Frontiers of Psychology, the authors state-

“A greater emphasis must be placed on the traditional integrated and more holistic approaches developed by the scientists who gave birth to physiology as an intellectual discipline.”

If you want a deep dive into this article, it really underscores the crucial role that homeostasis plays in all aspects of physical and mental health. To quote the article directly- “health and vitality of an organism can be said to be the end result of homeostatic regulation, and understanding normal physiology is not possible without an appreciation of this concept.

A Real Life Example

I remember having a tough day at work- quickly running to my car through the concrete jungle of downtown, racing to the highway, slamming the gas-pedal, just to find it packed full of other motorists, brake lights, and angry emotions. 

We have all experienced some version of a stressor- traffic, wasting time, and the overall experience of STRESS. Stress in itself is not a particularly bad thing, in fact many stressors in life lead to positive benefits both physical and psychologically.

But in this case, my brain viewed this event as “BAD” stress, and I quickly felt the urge to rebalance. Shortly after I got home, I quickly ate dinner and immediately indulged in a bowl of sweet and chocolatey ice cream. As every sugary bite hit the “pleasure button” on my taste bud’s neurons, I began to feel more and more elated and full of sugary goodness.

Here is where I made the mistake- After my 1st bowl, I attacked the freezer and scooped up another bowl of sweet, glucose-raising goodness…. This whole time, I had zero guilt, and honestly looking back at it I still don’t, what I felt directly after that second bowl was the complete opposite of homeostasis.

Our body is an incredibly designed organism, and I think the nervous system takes the cake as one of the most intricate, highly adaptable systems in the human body. The entirety of our nervous system can be broken into two divisions-

1) The Central Nervous System- This is your brain and spinal cord, 

2) The Peripheral Nervous System- Everything outside of the brain and spinal cord.

The Autonomic Nervous System– This is the “automatic” section of the brain that responds and acts without direct voluntary commands- such as increasing heart rate, blood pressure, respiration rate, and the release of neurochemicals. Within this “ANS,” two primary systems emerge- the sympathetic and parasympathetic system.

Sympathetic Branch– All but sympathetic, this branch  plays a critical role in mobilizing the body’s response to stress and perceived threats. When activated, the innate stress response kicks in and sends “little packets” of information in the form of electrical signals to the body which-

• Increase heart rate and blood pressure
• Releases “stress hormones” such as adrenaline and cortisol
• Ramps up our skeletal muscles to prepare to fight against a threat or run away to safety.

During sympathetic activation, non-essential bodily functions, like digestion, are temporarily suppressed. While this response is vital for survival in immediate danger, prolonged or chronic stress can have detrimental effects on our physical and mental well-being.

Parasympathetic Branch– This system helps us conserve and restore energy by decreasing our heart rate, reducing blood pressure, and promoting digestion and elimination. This system releases a neurotransmitter known as acetylcholine and is responsible for turning the volume down on our nervous system which aids in the mind and body’s ability to rest, recover, and feel balanced.

Think about what examples demand performance but also require rest and refueling?

• Would your car accelerate without gas or charging? 
• Could you retire if you never never limited your spending?
• Working 70 hours/week on 3 hours of sleep?

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The Vagus Nerve- According to an article titled “Autonomic and endocrine control of cardiovascular function,” the fibers that innervate the organs of the thorax and upper abdomen belong to the vagus nerve. This “calming nerve” carries approximately 75% of all “calming” nerve fibers that pass to the heart, lungs, stomach, and many other visceral organs. (More on this later)

Sympathetic System- A Perceived Stress Response: Have you ever drove down the highway or local road and noticed police lights behind you?

Many of us have experienced this and immediately experience the impact of the body’s stress response in action-

• A progressive narrowing of the field of vision
• Rapid increase in heart rate
• Rising body temperature
• Profuse sweating

Have you ever had this “fight or flight” reaction and the police simply drive right on by you?

The perception that you were in “trouble” or under threat created an experience that forced the body to respond by cranking up “the protection responses of the body.”

This example is but one of many, that help us understand that our stress response is not solely dictated by the outside world, and in-fact each one of us commonly encounter the same “obvious” stressor but present with wildly different interpretations of the situation.

Same stressor- Wildly different reactions.

The evidence on stress, and other complex conditions such as chronic pain is so strong, that scientific literature suggests that shifting the mind and body’s worldly perception is critical to modulate and change the stress response.

^An example of perception: how many legs does the elephant have?

Homeostasis and Perception

Do you want an actionable tool that helps you explore what may contribute to your stress, pain, and overall distress?

Throughout my career as a physical therapist, the diagram below has received the most amount of positive feedback from patients and other clinicians. I owe credit to Dr. Benjamin Boyd, of the NOI Group who first introduced this concept to me in a masterclass about pain.

In those with chronic pain, such as chronic low back pain, Fibromyalgia, or persistent headaches- this “fire/danger scale” depicted above can be very helpful to understand and slowly become mindful of “our risk of a fire.” In our case, the risk of fire could be a flare up of pain, an overly reactive or angry comment to a friend or loved one, or an overwhelming sensation that our body is chronically exhausted.

Here are some examples of an “extreme chance of fire”

• Negative self talk
• Poor communication in relationships
• Poor job satisfactions
• Unrealistic self expectations
• Acute, physical injury

Examples of a “low chance of fire”

• Feeling loved
• Physical activity
• Healthy relationships
• Active relaxation
• Self love

When we use a tool like the fire/danger scale it, it helps us begin to observe what sets us off, what we find comfort in, and most importantly- it helps us to simply observe.

Unrelenting Stress Is “Bad” For Us Right?

Many articles, including this one, explores how chronic stress without an equalizing force to drive homeostasis makes us feel “unbalanced” and is where we tend to see negative health consequences arise. In fact, in an article titled “The effects of chronic stress on health,” the authors mention that “not all stimuli that elicit a strong neuroendocrine response are real stressors, but only those that exceed the individual’s ability to change and adapt.

I think we can interpret this statement by understanding that chronic stress can be responsible for negative health consequences, but of vital importance- is our ability to adapt in the moment, change, and move forward.

Is All Stress “Bad?”

Dr. Alia Crumb, assistant professor of psychology at Stanford has published many studies examining the effect of how we interpret stress. This “interpretation of stress” is what psychologist refer to as “stress appraisal.” This process describes how our mindset impacts how we  interpret incoming data and how we respond.

To quote Dr. Crumb-

“Stress is natural and inevitable when you’re living a life that’s connected with the things you care about. Learning how to embrace it, and work with it is really what helps us thrive, grow and perform at our highest level.”

According to Dr. Crumb, “We define mindsets as core assumptions about domains or categories of things that orient us to a particular set of expectations, explanations, and goals. So to put that a little bit more simply- mindsets are ways of viewing reality that shape what we expect, understand, and what we do.

Sounds a lot like perception right?

Stress Appraisal

Appraisal of Stress– Richard Lazarus was the pioneer in the field of psychology when it comes to the theory of stress appraisal in the 1950s. Scientists have been studying stress, demands, and anxiety for centuries, and the primary theme that evolves from much of the psychological literature is known as “Appraisal Theory.” This theory is broken down into the two following phases-

Primary Appraisal- At this stage, we are determining whether a situation, event, or set of behaviors are stressful and relevant to our lives. We take into account the demands and available resources in order to determine if the stress is a threat to our safety.

Secondary Appraisal- This occurs when we determine that an event is stressful and threatening to our health, safety, or well-being. During this process we start to explore methods of coping by asking ourselves “how are we going to be OK during this event?” It is vitally important to understand that our current situation, prior experiences and beliefs associated with stress create a frame of reference for how we cope, live, and survive.

The simple act of reading this section on stress appraisal can create a cascade of events that enable us to observe our belief patterns and begin to make a slow and progressive shift towards equilibrium.

Both stress appraisals and reactions contribute to the role that stress plays in our life, but what happens when we feel out of control and stress is wildly “out of check?”

When exposed to prolonged stress, the body releases stress hormones such as cortisol, which can sometimes disrupt the normal functioning of the brain. 

Although cortisol is not all bad, unchecked levels can lead to structural and functional changes in the brain and body over time. According to an article titled “The effects of chronic stress on health,” regions including the hippocampus, prefrontal cortex, and amygdala are negatively impacted in the presence of unrelenting stress. These regions of the brain are typically involved in memory, decision making, and how we interact and regulate our emotions.

For example, have you ever felt deep, unrelenting pressure because of a new life demand?

How do these new demands make you feel? 

• Emotional? 
• Physically weak?
• Poor thinking?
• Poor logic? 
• Fearful? 
• Worried about the future? 
• Challenged?

Chronic Stress & Chronic Pain

We know that chronically elevated stress responses heighten our body’s protection response and is well known to contribute to physical pain and tissue sensitivity. For example, a chronic state of stress creates an increase in our sympathetic activity, which in turn pumps out hormones and chemicals that “land” on receptors located throughout the body. This leads to a process known as peripheral sensitization which creates a heightened state of nerve activity in our joints, muscles, and ligaments. During this process, our cells are “more likely to fire” and generate pain during touch, movement, or thermal stimuli when they really shouldn’t.

When we view stress under a negative lens it impairs our cognitive abilities, increases the risk of mental health disorders such as anxiety and depression, and negatively impacts learning and memory processing. Additionally, chronic stress can contribute to systemic inflammation, cardiovascular disease or compromise, weakened immune function, and metabolic disorders.

Additional scientific papers on this topic can be found below-

McEwen, B. S. (2006). Protective and damaging effects of stress mediators. New England Journal of Medicine, 338(3), 171-179.

Effects of stress throughout the lifespan on the brain, behaviour and cognition. 

The brain on stress: vulnerability and plasticity of the prefrontal cortex over the life course

Revisiting Alia Crumb’s work-

If we revisit our assumptions associated with stress, we begin to realize that most people have the mindset that stressful situations are inherently debilitating. This, in turn contributes to physical illness, creates psychological struggle, and makes us crumble under pressure. Dr. Crum’s words “But when you look at the truth about stress which is like most things very complicated, you realize that this understanding is a simplified assumption. It’s not necessarily wrong, but it’s only one way of viewing stress and you start to realize that the true nature of stress is more complex.”

Physiological Effects of Deep Breathing On The Body

How does breathing work?

The air which surrounds us is made of oxygen molecules, or “O2.” Active respiration, or how we breathe at rest is highly efficient and is primarily driven by the diaphragm. This HUGE dome-shaped muscle  sits just under the lungs and creates a “vacuum” effect by moving down towards the belly with an inhalation and returns to it’s resting position by the lungs at rest.

Why is this important?

Humans were designed to be efficient, and respiration itself is a fantastic marker for human metabolism, thus it was VERY smart to create a physiological process that gives us life and requires very little energy, or “ATP” to generate the act of inhalation and exhalation when we are at rest.

Intercostal muscles

These muscles contract during an active inhalation, which moves the chest upward, increasing the space in the lungs which allows more physical volume in the lungs and creation of negative pressure. This negative pressure allows oxygen in our environment to flow passively into the lungs which creates another mode of efficiency in the body.

“This is great and all, but how does breathwork relate to our mood, health and emotions?“

There is a renewing interest in how deep breathing can create the foundation of destressing, and has emerged as a critical tool for improving and understanding our emotional state. According to a study titled “Brief structured respiration practices enhance mood and reduce physiological arousal.” they found these 3 amazing points:

• Daily 5-minute breathwork and mindfulness meditation improves mood and reduces anxiety

• Breathwork improves mood and physiological arousal more than mindfulness meditation

• Cyclic sighing is most effective at improving mood and reducing respiratory rate

What I’ve found very interesting as I grow older (and hopefully wiser) is that I learn more from the things and people I don’t understand than I do from those who share a similar viewpoint as my own.

Let’s Take A Look At Depression

According to The Pharmaceutical Journal, “The latest data on depression suggests that the number of antidepressant items prescribed over the past six years have increased by 34.8%, from 61.9 million items in 2015/2016 to 83.4 million items in 2021/2022.

According to a recent article by British Journal of General Practice, “The number of antidepressant items prescribed per year more than tripled over the past two decades, from 18.4 million in 1998 to 70.9 million in 2018.”

Every case of depression is HIGHLY specific to the individual- some have trauma, others have struggled it for their entire life, and by no means is this discrediting anybody’s thoughts or opinions on their own condition.

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But I have to really step back and wonder if my colleague was right about the ancient Egyptians and our ancestors.

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Although this article is primarily about de stressing the nervous system, conditions such as depression play an intimate role in the choices we make, how we interact with the world, and how we form internal and external narratives about the world and society as a whole.

So how can deep breathing allow us to relax, reconnect, and perhaps even help with something as significant as depression?

Understanding Deep Breathing As A Relaxation Technique

Many cultures have used deep breathing to destress, unwind, and restore balance throughout human history. But what if focused breathwork and meditation can offer us something more powerful and potent than simply “destressing?”

For example, in ancient India, yogic traditions emphasized pranayama, a breathing practice aimed at controlling and expanding the life force energy known as prana. Through deep and intentional breathwork, individuals sought to harmonize the mind, body, and spirit by fostering a sense of inner peace and tranquility.

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“We can’t always change what’s happening around us, but we can change what happens within us.” -Andy Puddicombe, Headspace co-founder

Ancient Chinese practices like qigong and tai chi incorporated deep breathing as a means to cultivate and balance the body’s vital energy, known as qi. Deep and mindful breathing was believed to enhance the flow of qi, as well as promote physical health and mental well-being. These ancient traditions recognized that deep breathing techniques not only calmed the mind and reduced stress but also helped individuals become more present, attuned to their inner selves, and connected to the world around them.

Types of Breathing Exercises

There are literally countless “types” of ways to breathe, and we incorporate many types of these practices on our free Heal2BHuman Spotify podcast to make it easy to simply follow along, breathe, and get lost in the moment (shameless plug, I know). The beautiful part of breathing and meditation is that although there is some inherent structure to the many types of breathing- beginning the journey without any expectation is often the best way to experience the many cognitive, emotional, and physical benefits of this practice.

We are seeing an unprecedented surge in the interest surrounding breathwork within the scientific community, health providers, and the general public. We are beginning to understand what our ancient ancestors knew for years- breathwork and meditation play a crucial role in modulating our mental health and perception of well being.

For a deep dive into breathwork and mental health, check out this article titled “Effect of breathwork on stress and mental health.”

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Nasal Breathing

This breathing technique as the name implies uses only the nose as a method for inspiring oxygen and expelling Co2. The nose plays a critical role in the regulation of our physiology to relax, and stay calm in stressful events or athletic performance.

Physiology of Breathing

Humidifies air: The nasal passages help to warm up the oxygen traveling into the lungs and changes the temperature so your lungs can more readily harness the oxygen for energy, breathing, and metabolism.

Filters toxins: The “cilia” in the nose allows it to filter any toxins (pollens, dust, dirt) or particulates in the air which delivers more pure oxygen to the lungs.

Nitric oxide: Nasal breathing allows the body to release nitric oxide which is a potent vasodilator and creates nutrient rich oxygenated blood to reach your lungs and other vital organs.

Diaphragmatic Breathing

Also known as belly breathing or deep breathing, this technique involves focusing on expanding the diaphragm while inhaling and allowing the belly to rise. It promotes relaxation by activating the parasympathetic nervous system, which impacts the vagus nerve and can changes the body’s stress response.

Boxed Breathing

This technique involves inhaling, holding the breath, exhaling, and holding the breath again, each for an equal count of time. The structured pattern of box breathing can help to regulate breathing and our emotional state by inducing a sense of calm and balance in the nervous system.

4-7-8 Breathing

In this pattern, you inhale quietly through your nose to a count of 4, hold your breath for a count of 7, and exhale slowly through your mouth to a count of 8. It is thought to calm the nervous system, reduce anxiety, and promote better sleep.

Each technique has specific scientific advantages, but I find that the simple act of spending time on yourself, and getting curious about what truly fulfills your life is the true power of a consistent breathwork practice.

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What the **&$$ does Fran have to do with the brain, stress, and relaxation?

As I got to know Fran I realized that she was carrying around a lot of “negative energy” in the form of medically diagnosed anxiety. Her body language was rigid, she spoke sporadically in segments, and acknowledged that her anxiety was a maladaptive habit she formed over the last few years. I was very thankful to meet Fran, because with her permission we explored how she could support her mental health through breathwork. This experience positively impacted her ability to challenge her thought process and offered a different perspective of how she viewed the world. 

Oh yeah, and we also did some fantastically amazing physical movements that reduced her immediate neck and upper back pain (I am a physical therapist after all!) 🙂

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Unchecked Stress & Anxiety

Many of us fail miserably at outwardly acknowledging how stressors and persistent worrying thoughts impact our life and the decisions we make throughout the day. Through these experiences, the brain adapts, changes and learns how to to act and behave- and not always for the better. This “learning effect” is classically known as neuroplasticity and can be directly related to our experience of stress.

We are all familiar with stress- we often think about it as a negative but necessary part of our life. Although we already have some insight into how stress doesn’t always have to be “bad,” what happens in our brain and body when our perception of stress is outweighed by our available resources?

In section II, we went through a crash course about the 2 primary branches of the nervous system- parasympathetic and sympathetic. Think of these two systems as representing the ancient, but highly relevant of “yine and yang.” 

This ancient Chinese belief commonly talks about opposite but interconnected forces in the world that collide to create a sense of balance, homeostasis, and equilibrium. 

“Can we attach some mechanistic data to breathing and stress?“

Knowing what brain centers control breathing and the famous phrenic nerve that innervates the diaphragm can really help us understand a little bit about the science behind foundational health and balance.

The human body and brain is truly a unique and wonderful biological machine. Two primary regions of the brain control our breathing, and in turn help us regulate our emotions and internal physiology.

Pre-Botzinger Complex: With all credit owed to (Jack Feldman,) University of California, Los Angeles. This region of the brain controls all types of breathing that follows a “rhythmic” and fluid pattern of breathing. This subset of neurons control inhibitory neurons that change our heart’s parasympathetic activity whilst other neurons modulate sympathetic neuron activity, generating heart rate and blood pressure oscillations in phase with respiration.

Rhythmic Breathing Anyone?

Parafacial Nucleus: This region of the brain is responsible for breathing whenever we take active control of our breathing. Although this is not 100% straight forward, we are going to stick with these divisions of the brain for simplicity’s sake.

Voluntary control– I’ve worked with many people who have simply had enough- they feel overwhelmed with the demands of life, and have finally reached a point where demands outweigh available resources and they desperately need control and balance to move forward. In the practice of all types of medicine, this “realizing we need to take control” is often referred to as self-efficacy, which is defined as our own internal ability to know that we can impact both our situation, our life, as well as how we feel physically and emotionally.

“The Brain Controls The Brain“

“The breath is the connection between the conscious and unconscious mind.”- Dr. Andrew Huberman

^Damn that is deep, but what the hell does this actually mean?

I’ve worked with many patients in my career who start their session with a little small talk about the weather, work, or the weekend, but very quickly begin to reveal that they are really suffering. Suffering from the loss of a loved one, excessive worrying thoughts about the future, negative relationships, or the ever compounding pressure of self expectations in their professional career.

Deep breathing is thought to stimulate the vagus nerve, a key neural structure of the parasympathetic nervous system that is responsible for promoting a state of calm, relaxation, and an overall sense that it will simply “all be ok.” As we take slow, rhythmical deep breaths, our heart rate slows down, blood pressure decreases, and muscle tension releases. This triggers a cascade of physiological changes that reduce anxiety, and restore a balanced state within the body and mind.

Vibes On The Vagus Nerve

If we focus on elongating our exhalations, the body sends electrical signals to the heart to slow down and promote a state of rest, digestion, and safety. Oftentimes, when I’m working with patients through progressive rehab or strength training, I always coach them to perform better- faster – and stronger. But here’s the secret of performance- in order to really achieve and perform, we must first learn how to down-regulate and feel at peace. 

In the physical rehab space, we see this all the time with athletes- when they give themselves permission to truly rest- they return to training fully recovered and their performance skyrockets. 

Practical advice for physical exercise: Between sets of strength training, jump training, running, or any set of physical tasks- we should pay special attention to extending our exhalations by “taking conscious control of the breath.”

By consciously elongating our exhalations, we encourage the parasympathetic nervous system to engage, which, in turn reduces the activity of the sympathetic nervous system associated with performance, movement, and “fight or flight.”

Our friend “Fran” was like many of us- trying to make it in a chaotic world- many internal narratives, self-expectations, and prior beliefs and experiences that shaped her reality. She felt anxious all the time, had a measurably high heart rate(~120bpm), and most importantly she felt trapped by her internal story of what she thought about herself. This story creates a perception of reality and how she fits into the world.

^Look Familiar?

When we control our breathing, we can get curious about our perception of reality. 

Deep breathing and meditation can foster a systemic sense of tranquility and overall well-being. For example, incorporating long exhalations into our breathing practices can be a simple yet effective technique for managing stress and promoting heart health.

Still Skeptical?

Scientists explored how deep breathing and mental imagery impact physiologic recovery in an article titled “The combination of deep breathing and mental imagery promotes cardiovascular recovery in firefighters,” 

Here is the consensus statement: Firefighters’ activities involve intense physical activities associated with a high level of psychological stress. Enhancing their recovery after each rescue intervention appears crucial. The results of this study showed that a recovery protocol combining deep breathing and mental imagery promotes heart rate recovery and better maintenance of physical fitness.

A progressive wave of change is rushing over health care. The way we view mental health and how it intertwines with conditions such as anxiety and depression is starting to shift. We are beginning to understand that sometimes the way in which we engage in our “normal” chaotic world can often create a continuous stream of worrying, negative self-talk, and a progressive path towards a feeling of systemic depression.

The good news?

This “progressive wave” is strengthening public interest in ancient practices such as deep breathing, sound healing, meditation, and overall mind-body downregulation. In an article titled Effect of breathwork on stress and mental health: A meta-analysis of randomised-controlled trials, results suggest that “breathwork may be effective for improving stress and mental health.”

Whether we thins concept rationally and scientifically using brain centers, neurons, and science, or by firsthand experience, the results are quite clear. 

Our mind, body, and soul needs a reason to feel balanced, re-energized, and more homeostatic.

How this applies to physical pain– Finding balance is critical for those with chronic pain conditions such as persistent migraines, headaches, and persistent lower back pain.

Think about it- Pain is often a result from an imbalance between excessive threats and not enough safety. Over time, existing and new threats become amplified and the result is often an over-protective and maladaptive nervous system. Put another way- for many people the “default path,” when left unchecked leaves many of us feeling chronic pain, anxiety, depression, and with low energy.

This “overprotective nervous system” is what many scientists and various health care providers refer to as “neuroplasticity” (more on that in another set of articles). Neuroplasticity is defined as the brain’s ability to change both adaptively and maladaptively based on experience, but the question is-

Which Path Will You Choose?

If you are still following this article- hats off to you for being an astute follower of all things text, learning, and neuroscience!

Let’s recap what we’ve covered so far-

• To feel “balance” the body and mind must reach equilibrium
• Chronic fight or flight mode is detrimental
• The fire/danger scale helps us understand what “ramps us up” and what ramps us “down”
• The brain changes the brain
• Our thoughts and emotions about stress matter
• Neuroplasticity is the brain’s ability to change

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This article is about destressing right?

Yes! and we are discussing how breathing practicing help us understand how thoughts and emotions control our physical and mental well-being.

Here is an example-

I want you to imagine for a moment that you are trapped inside of a wild jungle… It’s dark, it’s beginning to rain, and you hear a pack of fierce lions in the distance.

But do you know what you wouldn’t be feeling?

A sense of safety.

In the rehabilitation process of those with pain, much of the advanced literature discusses engaging patients in behavioral learning as one of the primary therapeutic tools for progressing away from pain and towards recovery.

What is behavioral learning?

This is a school of thought that believes humans learn through experiences by associating a stimulus with either a reward or a punishment.

Put another way, humans learn by going through the experience first hand and deciding how their actions and behaviors create consequences.

Physical Pain & Behavioral Learning: In a recent article titled “From Fear to Safety: A Roadmap to Recovery From Musculoskeletal Pain,” some of the top pain researchers in the world discuss how rehabilitation must be designed to create a learning environment that fosters biological change. For example, in those with chronic lower back pain, behavioral learning offers us the ability to identify exercises that create a positive experience with movement which generates brain “errors” that eventually lead to less pain.

Over time, we expand our interventions to include more complex exercises or discussions to help create errors which are mismatches between their expectations with movement and their current experience. This- in turn violates patient’s expectations surrounding pain and forces them to rewire the brain and decrease the volume of protection within their body.

This type of recovery is not found solely in musculoskeletal conditions, but is observed in much of the psychology associated with depression, anxiety, and physical or emotional trauma.

The Cool Thing About Errors

Errors, or “mismatches” between our current experience and expectations of movement is exactly what our nervous system needs to stimulate genuine change in our lives.  In order to shift the mind and “change the brain” a fundamental step of creating “errors” must occur in order to create a new skill, rewire the mind, and change the body.

For example- When I learned how to ride a bike, I was upset, probably cried, and wanted to master the skill immediately. But what I didn’t know is that I had to fail repeatedly to learn the skill and succeed. (You can read all about it and emotional health HERE).

To further explore the “making errors” rabbit hole, as it turns out, according to an article titled “Neuroplasticity Promoted by Task Complexity”, the difficultly of the task is directly proportionate to the ability to learn, evolve, and generate change in the nervous system.

Here are a few ways to create errors-

• Bodily movements
• Challenge your thought processes
• Explore cognitive biases
• Explore and confronting prior trauma
• Learn a new sport
• Challenging your assumptions

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This Again.

Remember this diagram?

I challenge you to use this in order to start thinking about what thoughts, actions, or behaviors in your life move you towards an “extreme” chance of fire and pain and what things create a sense of safety and low chance of fire.

• Perhaps it is deep breathing
• Maybe you dislike your job
• What about how you think about your body?
• Prior beliefs about others and yourself

Find your (-) stressors, observe and create your own evidence for safety, and start to get curious about the interplay between physical and emotional health.

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1. Seek Equilibrium

Equilibrium is balance, yin and yang, performance and rest. Homeostasis is the scientific term that is fundamental to our understanding of human physiology, and how we understand and treat disease. Challenge yourself to write down what actions, thoughts, or behaviors pull you too far in one direction. Over time, you may find that not only does your performance in life increase, but your ability to feel connected, satisfied, and energized will be at an all time high.

2. Understand The Stress Response

Stress is our reaction to what we perceive as threats to our safety. We now understand that the body will shift into fight or flight mode when we need it to- but in our modern world, our perception, and what we understand as negative stressors to our safety is the direct trigger to activate this system of defense.

“Understanding stress begins with getting curious.”

Take a few moments and think about, or better yet- write down what factors, behaviors, and actions “stress you out.” From there, think about what assumptions and prior beliefs contribute to why you think a particular stressor is bad for you. 

Getting curious about this process can often be the first and the last step towards shifting our perceptions. This, in-turn, changes our mindset about how we directly interact and respond to stressors throughout our day.

3. Use The Fire/Danger Scale

At the risk of sounding repetitive, this exercise has been the most useful tool for myself and my patients throughout my career. This is a “tool” that you can use to take a step back from the complexities of life and become inquisitive about what sets us off, what calms us down, and every detail in between. Feel free to write down your thoughts, other people’s actions, beliefs about others and the world, and anything that you feel applies to your sense of balance and equilibrium.

4. Understand That Stress Isn’t Always “Bad”

Negative health consequences associated with stress typically stem from a mismatch between our demands and our available resources. Much of the scientific literature, such as the work from Alia Crumb’s lab identifies that our core assumptions related to stress is what really matters.

We can start to get curious about our core assumptions related to stress by leaning into the process of stress “appraisal.” 

Remember that each one of us appraises stress differently, but we have the ability to change how we evaluate our stressors, and ultimately how we react and cope with these demands.

For example, have you ever felt “stressed out” when something in the workplace doesn’t go your way?

• Is the stress you experience directly linked to the situation?
• Or is it sourced from how your prior beliefs, current mindset, and past experience shape how you think and respond in a given situation?

The term “stress” gets thrown around entirely too much for my liking. It carries a broad assumption that all demands on the humans are “bad” and must be avoided at all costs…. By now we’ve realized that this is not true. If all stressors tore us down- exercise, learning, cold exposure, and cognitive challenges would degrade us rather than build us up.

5. Intentional Breathwork Is Critical

The primary physiological advantages that occur with a breathwork or meditation practice are well documented to improve biomarkers of health such as blood pressure, heart rate, and serum levels of adrenaline. When we widen our scope of what can make us “feel safe” and out of danger, breathwork is one of the easiest and most accessible forms of down-regulation available. It decreases our autonomic nervous system’s level of arousal, creates intentional time to ourselves, and it can be an effective tool for depression and anxiety.

6. Find Your Evidence For Safety

I’ve had this conversation many times with patients and I find that the majority of us have a very difficult time finding what actions, behaviors, and people in our lives create our unique evidence for safety. Start to explore this through intentional down-regulation practices such as NSDR, breathwork, or meditation. If you need a little extra help (who doesn’t?), phone a friend or work with a health professional who understands the intersection between physical and emotional health.

7. Neuroplasticity Is Key

Sometimes shit goes well, and sometimes it doesn’t. Failure is no fun and it creates a systemic sense of frustration and irritation that can directly impact how we interact with the world and those around us.

But failure and errors are the key to unlocking your greatest potential in life- we may not see it now, but if we keep striving and embracing failure, we can surprise ourselves on what we can accomplish.

Cheers,

-Dr. Chad Shafer, Physical Therapist

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