Cognitive Behavioral Therapy (CBT) is therapy in its most vanilla form, you could say. This is not to disparage it, because it’s something like a systematic analysis of thinking errors that most of us do, and that really can get us into trouble. It’s a nice, organized approach.
But in the same way that Physics is sometimes explained to poets in a … different way, let’s say … I thought that haikus might be a good way to explain a number of mistakes we often make, for the poets among us.
No middle ground exists, Only hero or villain’s mask. Shades fade in stark light.
Alice is running for student council. Her opponent, Ben, is either a “brilliant leader” or a “total disaster.” There’s no room for the possibility that both have strengths and weaknesses.
Yesterday’s lens, Rewinds perfect the unseen play. Tomorrow’s script ignored.
After a failed presentation, Sarah berates herself for “not practicing enough” and “being so nervous.” She ignores the positive feedback and focuses solely on what could have been done differently.
Their actions mirrored, My thoughts paint their unseen intent. Guesswork binds like chains.
David sees his coworker, Emily, laughing with someone and assumes she’s making fun of him. He never asks her about it, letting the imagined negativity fester.
Tiny flaw giants, Shrinking mountains to dust mites. Truth lost in perception.
Maria tells her friend about a fight with her parents. The friend brushes it off as “just a typical teenage disagreement,” dismissing the emotional impact.
Only fitting parts, Filtered scenes create the truth. Blind to what’s unseen.
A newspaper only reports on crimes committed by immigrants, leading readers to believe all immigrants are criminals, ignoring the vast majority who are law-abiding.
Self the center stage, Events revolve around their role. The world watches, unseen.
Lisa receives a critical work email and assumes it’s because her boss doesn’t like her personally, ignoring the possibility of it being objective feedback.
Feeling paints the world, Logic drowns in passion’s tide. Reason takes the back seat.
Feeling angry after an argument, Liam decides to stop talking to his friend because he is illogical, ignoring the need for rational communication to resolve the issue.
Rigid rules dictate, No room for nuance or change. Life cracks through the mold.
Clara believes she “shouldn’t eat dessert” after dinner, based on a rigid diet rule, even though she’s already achieved her fitness goals and feels like a treat.
Would you like to take a cyberdelic to enter a special trance within a brilliant, virtual world, in which your pain can’t find a foothold? No doubt many would. Soon you might be able to.
As they say, the world is large. One might argue about which type of treatment is better and for whom, yet I suspect that as with all treatments, it depends on the patient. I’m intrigued about the powers and limits of this new technology.
A Brief History of Pain Management
The Times article by Dr. Ouyang is well-written and does an excellent job of quickly detailing how we arrived at our present understanding of chronic pain:
We have, at least, come to recognize that acute pain resulting from damage to tissues is not the same as chronic pain, which is now considered a distinct disease. How we came to this understanding can be traced back to a serendipitous experiment in London in the early 1980s. Before then, scientists knew that the brain has some control over pain, but that insight was mostly confined to the situations described by Patrick Wall’s and Ronald Melzack’s gate-control theory, which helps explain why, say, a person running from a house on fire may not realize that she sprained her ankle until she is a safe distance away. The brain, so intent on escaping the fire, shuts the gate, blocking pain signals coming up the spinal cord from the ankle. “You could close the gate,” says Clifford Woolf, a neurobiology professor at Harvard Medical School who worked in Wall’s lab, but “essentially there was nothing about the opposite possibility — which is that the brain, independent of the periphery, could be a generator of pain.”
Woolf was conducting his own experiment in Wall’s lab, applying painful stimuli to rats’ hind legs. The animals developed large “fields” of pain that could easily be activated months later with a light tap or gentle warmth, even in spots that weren’t being touched directly. “I was changing the function of the nervous system, such that its properties were altered,” Woolf says. “Pain was not simply a measure of some peripheral pathology,” he concluded; it “could also be the consequence of abnormal amplification within the nervous system — this was the phenomenon of central sensitization.” Before this discovery, he says, “the feeling was always pain is a symptom that reflects a disease, and now we know that pain often is a consequence of a disease state of the nervous system itself.” Some ailments, like rheumatoid arthritis, can exhibit both peripheral pathology and central sensitization. Others, like fibromyalgia, characterized by pain throughout the body, are considered solely a problem of the central nervous system itself.
A better grasp of how chronic pain changes the central nervous system has emerged since Woolf’s experiment. A. Vania Apkarian’s pain lab at Northwestern University found that when back pain persists, the activity in the brain shifts from the sensory and motor regions to the areas associated with emotion, which include the amygdala and the hippocampus. “It’s now part of the internal psychology,” Apkarian says, “a negative emotional cloud that takes hold.”
Photo by M. Voss
My clients, of course, know this emotional cloud very well. It’s this cloud, like a set of glasses that have become dirty, that we target in Pain Reprocessing Therapy. We transform that lens into a “lens of safety”.
For us as conscious beings, becoming habituated to pain is a mental and emotional, psychological process. But part of the substrate beneath those thoughts and feelings is an organic brain process that is now much better understood. As the article further explains:
The brain itself morphs. Patients with chronic pain can show a significant loss of gray matter in the prefrontal cortex, the attention and decision-making region of the brain that sits behind our foreheads, as well as in the thalamus, which relays sensory signals; both areas are important in processing pain. Excitatory neurotransmitters increase, and inhibitory ones decrease, while glial and other immune cells drive inflammation; the nervous system, unbalanced, magnifies and prolongs the pain. The system goes haywire, like an alarm that keeps blaring even when there’s no threat, even when the pain isn’t protective anymore. Instead, it just begets more pain — and the longer it lasts, the more deeply systemic it becomes and the harder it is to resolve.
There’s a popular saying in neuroscience that as neurons fire together, they begin to wire together, an example of neuroplasticity in action. But if our brains really are plastic, what is shaped there can be reshaped. Therapies that target the brain instead of the aching back or the sore knee — whether through psychology, drugs, direct stimulation of the brain or virtual reality — in theory could undo chronic pain.
Psychedelic vs. Cyberdelic
The pace of the use of psychedelics to treat mental illnesses such as depression and PTSD has been quickening; people can find that even a single experience, if it’s the right one, can be life-changing. The psychedelic experience itself can, in the best case, provide people with insights into their lives and concerns that last and change the nature of how they see themselves. One interesting question that arises here is whether these VR systems provide an experience, like psychedelic, or a training, or both?
Photo by M. Voss
The article presents a client, Julia Monterroso, with chronic back pain. She slips on a headset and as the author describes it,
Monterroso sat in a plastic chair under fluorescent lights, but in virtual reality she stood on a footbridge in a lush forest. As she looked around at the giant trees, she trembled, and tears suddenly started streaming down her face. Her cognitive load, shown as a pink line on the computer, started to increase.
“I feel like I’m there with my son,” she said in Spanish. Her 21-year-old son died in a car accident in June. They loved visiting Yosemite together, and in these virtual woods, she felt as if she were hiking with him again. [Dr.] Spiegel reassured her that such intense reactions are very common, then leaned over to whisper to me, “She’s doing her own therapy right now.”
In this case the experience helped her process her grief, regardless of the initial intent of the session. And that — according to PRT principles — will most definitely decrease the latent distress in her nervous system that can spark and contribute to chronic pain. We also know that the brain is extraordinarily visually dominated — almost 50 percent of the cortex is involved in visual processing. So if we can commandeer the brain’s computer time with something other than pain, this is, at the very least, an extraordinary distraction technique. Which is a very necessary and useful tool in your toolbox. In some sense, VR replaces the previously conditioned production of pain sensations with new sensations related to the immersive world being experienced. That’s great, but what might the patient learn in that new space, if they were to engage in a training?
What Principles are Behind VR Pain Management Therapy ?
The virtual reality field in mental health is just on the cusp of widespread offerings. One leading company is called AppliedVR. To date they’ve raised more than $70 million in funding. Their product, RelieVRx, is soon to be on the market.
Photo by M. Voss
Patients’ breathing patterns can by tracked by the device in real time and the patient is given immediate feedback. The Times article quotes Todd Maddox, a cognitive neuroscientist and AppliedVR’s vice president for research and development. “I am rewarding you with a tree that flourishes for generating an appropriate breathing pattern. I didn’t tell you to read a PDF or count in your head.” But by using VR to engage the brain in experiential learning, he says, “I have just set you on a path for behavioral change.”
So this is real-time learning spiced with a feeling of reward. It’s basically operant conditioning, following principles developed by B. F. Skinner in the 1950s, but with an interesting biofeedback twist.
My initial response to reading this is: “Wonderful, this stuff will work!” But I had the same concern as expressed in the article by University of Washington professor Hunter Hoffman, who noted, “We can definitely reduce your pain while you’re in the helmet, but you can’t stay in there all day.”
As it turns out, the average session lasts only seven minutes, and patients are directed to do just one a day for eight weeks. This is an interesting bit of information. In a short part of a session, a psychotherapist can play a role analogous to a VR headset by engaging the client’s imagination, rather than vision, during a meditative exercise. This may require a little more effort for the client and therapist initially, but the possibilities of tailoring the “imaginal world” to the client’s needs are fascinating.
How Did We Get Here?
You’ve no doubt heard about phantom-limb pain, the phenomenon in which someone who has lost a leg or an arm still feels pain in the missing limb, because the brain continues to perceive it as being present, but in an injured or abnormal state. The abnormality registers as dangerous — painful.
The famous neurologist V.S. Ramachandran invented “mirror therapy” in the 1990s by placing the arm of an amputee or stroke patient into an open box with a mirror down the middle so that the patient, peering down through the top, saw the reflection of an intact, functioning arm on the affected side.
The brain was trained to see that missing limb as a healthy limb. And this — if we use the PRT understanding that pain is a danger signal sustained by fear and distress — might be why the pain could be trained away.
From Mirror Therapy to Virtual Reality Therapy
Photo by M. Voss
Now what if you could play a movie in the mirror, in which the patient could begin to exhibit what are, for them, special powers? With the same effort, for example, they could move much further. They could bend and twist in exquisite ways and feel no pain. They would be able to watch themselves do this, feel that they were doing this, and yet, because of the immersive power of the virtual environment they were in, where all their normal queues for pain are absent—that dreaded work chair, those familiar steps, that particular keyboard—they could have entirely new, pain-free experiences.
This is imaginal therapy based on graded motor imagery and currently being offered by San Francisco’s Karuna Labs. According to the article, Karuna’s VR program “exaggerates bodily movements, so patients see themselves moving more extensively in the virtual world than in actuality; this further disrupts their brains’ predictive coding — or what they expect to happen when they move.” The brain makes pain by predicting that an action will be painful, and according to CEO Lincoln Nguyen, if the brain predicts that an action will be painful, then “it’s going to send that threat signal out ahead of time.” The article concludes, “But if people experience themselves maneuvering more easily and with greater range in VR, then their brains may begin to recognize that increased movement as safe — and, Nguyen hopes, eventually pleasurable. To that end, patients also score points, accompanied by lights and dings, as in video games, in order to activate the reward centers in their brains.”
These are fascinating new technologies, and in the times we live in, solutions like pills, magic mushrooms, or VR headsets often garner more interest and dollars than a talking cure — regardless of what the science shows. It seems to me that these will be part of the future of treatment for pain. For some, the “talk” alone in the talking cure can itself melt pain away. But for most, there are skills — like somatic tracking or leaning in to positive sensations — to learn and train. These are wonderful life skills whose effects can reach far beyond merely curing pain. Some people are naturally attracted to such a path, but it’s a little like learning meditation. Some would like to learn, but others would rather take a pill if they could — and that is also fine! We will see mixes of approaches as well. Karuna Labs adds health coaches as part of their program.
Photo by M. Voss
There’s one other point to consider regarding virtual reality. In 2022 some may believe that people “can’t stay in there all day,” but many suspect that this is a future we are heading towards. I think it’s wise to consider our roles in encouraging and shaping that future.
My hope is that as we use these devices, they will, like cameras or musical instruments, help us to develop our own curative powers, imaginal qualities and aesthetic interests as we experiment with them. Many of us have already experienced that light and color, the imagination, as well as music, can be exceptionally soothing, even healing. What if we used these tools like training wheels to discover what is most effective for us, not only to de-condition pain, but to further explore conscious and aesthetic experience itself?
Chronic pain is not like normal pain. It is trained in. It’s a groove in the brain.
Strangely enough, the brain couldn’t care less whether it makes pain or not. The brain doesn’t care about anything; it’s just an organ in the body that generates cells, chemicals, and electrical signals. Only YOU care if the brain makes pain or not. Only you can care.
Therefore, you are the key to the process of retraining your brain so that it doesn’t make unnecessary pain. It can’t be done for you or to you—but you really can do it.
That’s what I’m going to talk about here.
Pavlov’s Dogs
You’ve heard of Pavlov’s dogs. There were perhaps hundreds of them, dogs like Arleekin (clown), Genghis Kahn, Barbus (big dog), Jack, Krasavietz (beauty), Mikah (nice girl), Moladietz (good boy), and Murashka (cute little thing). The psychologist’s favorite, apparently, was Druzhok (buddy).
Some of Pavlov’s Dogs
These dogs were individuals, just like us, with preferences and far more varied responses to their situation than the schoolbooks tell us. We owe them a considerable debt, because they assisted Pavlov in teaching us that we animals have the capacity to be programmed, almost like robots, but by environmental cues.
Mikah (Nice Girl)
When Mikah’s master rang a bell each time he put down Mikah’s supper dish, Mikah’s brain paired the sound of the bell with food. Thus Pavlov found he could make Mikah salivate whenever he rang a bell. Of course, the sound of a bell has nothing, in principle, to do with a tasty meal; from the point of view of cause and effect, it’s a miswiring. But Mikah’s brain had been so altered.
As you might imagine, evolution has an inbuilt solution for when cause and effect is mis-wired in animals. Food should cause salivation, but bells shouldn’t. So eventually, if you keep ringing a bell but never present food, the dog will stop salivating. Pavlov discovered this as well. Take away the evolutionarily wired cause (here, food) but leave the conditioned one (the bell) and the evolutionarily wired effect (salivation) eventually goes away, because its real cause has ceased. This is called the extinction of the conditioned behavior—the inappropriate response to the bell.
The Bell of Chronic Pain
Why then would evolution allow pain in humans to persist chronically, if there is no good (true) reason for it? Is chronic pain more like a true signal (food) or a false one (the bell)? Should it cause fear or not? You first have to think about Mikah to answer this.
She keeps hearing a bell, and she anticipates food, but it never comes. Gradually the bell loses its interest for her. She doesn’t care about the bell.
But if we have chronic pain, we’re not like that. Even though the danger never comes. I know this from my own body. I had chronic neck pain—danger signal—for 30 years. But the danger never came. The shoe never dropped, the catastrophe did not arrive. Just more and more pain and fear, so intertwined I could hardly disentangle them. More and more bell, no food.
Pain is a signal, like a bell. It makes us do things, like move or stop moving, but the associated feeling is negative. We don’t like it, we don’t want it. We are super-interested in the bell stopping. And that’s not how the extinction of behavior happens. It comes from not caring anymore, like Mikah felt about the bell. So we’re in a fix—we care about pain and we can’t imagine not caring. Could evolution still have a hidden trick up its sleeve for us?
The Tool of Introspection
Dogs are intelligent, but not psychologically self-aware. They lack a well-developed-enough pre-frontal cortex to support self-reflection. So when they feel something, they are already in response; they cannot simultaneously reflect on their response. Much less can they analyze why they are responding in the way that they do.
As humans, we have greater capacities than dogs—for heightened experiences of both pain, pleasure and everything in between. Since we are—or at least can be—self-consciously aware of our responses, we can actually train these responses ourselves, unlike dogs. We don’t have to rely only on the instincts provided us by evolution. In fact evolution bestowed on us an additional option, a very special tool: the experience of open, unbiased introspection.
A Little Gap as Big as the Universe
Viktor Frankl, the reknowned neurologist and Holocaust survivor, famously wrote:
Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.
I’ve loved this quote from the moment I first heard it, because it’s so true to experience. But I want to add a little something to it that pain has taught me, if I may be so bold.
This is that, it’s not just that there is a tiny space inside for decision-making, like the gap between dominoes, but rather, this space is you. The stimulus (e.g., pain) and the response (e.g., fear) actually occur in the space of you, isn’t it so? You’re the one who feels and knows them. The space is an entry point to connect to yourself—to however you are actually feeling in this moment. What is that space actually like? What does it feel like?
The message here is that that “little” space, which for a chronic pain sufferer can feel so constricted by tension and fear, can grow over time. With practice, you can become more and more spacious. It’s something you do step by little step, literally rewiring your brain each time you introspect in the right way.
The Peace of Not Caring
The type of introspection we are encouraging carries the feeling tone of safety. What is the feeling of safety? Spaciousness and peace, gifted with a little vibration of happy, satisfied pleasure. A shark’s tooth is sharp; a hawk’s stare or a stone is hard; a rose is soft; water is fluid. What is the feeling tone of you? THAT is what we are interested in here. We want to notice that tone, and we want to allow any unnecessary disturbances created by pain and fear to settle themselves out.
The reason we learn to “not care” about these disturbances is because we come to understand, as the truth, that the pain and fear cannot truly hurt us. They are just signals. The more deeply we understand and feel that, the more deeply we can “not care” in the way I describe it here. It’s not aggressively ignoring; it’s the “not caring” of not minding: “Ah, I see you, and I really don’t mind. You’re fine as you are.”
What is the feeling of safety? Spaciousness and peace, gifted with a little vibration of happy, satisfied pleasure.
Something subtle here: When you feel spaciousness and peace as an experience, you can also feel it as your own being, deep inside. Whenever you’re not disturbed, when the “waves of the lake of you” settle back down, you have an opportunity to contact peace, not just as an ephemeral experience, but as a deeper part of yourself. It’s like if you were to look outside and see a storm but glance inside and feel a calm lake. Not just “I know I’m safe” but “I am safe here, through and through”. This experience is possible, it’s enjoyable, and it can be cultivated.
Right now when you feel within you might feel just pain and tension. It can seem that way; I know that well. We want to look and feel a little further, until we start to feel the actual feeling of our inner being. I well understand that this can be challenging and may even sound absurd to someone in a lot of pain. And yet, somewhere in your experience, even if it’s just in one toe, there might be an experience of okay-ness, and that’s a start. The pain is simultaneously a big obstacle as well as a powerful spark to learn. You can let your pain make cultivating that feeling of safety be your highest priority, even if the starting point is no feeling of safety at all.
No doubt somewhere inside you are already open, loving, courageous, playful, interested, peaceful—many people who suffer from chronic pain have such inner qualities in spades—but such qualities need inner spaciousness in order to arise and show themselves.
With chronic pain, what has happened over time is that YOU (and therefore, your brain) have become caught in a pain-fear cycle. Stimulus and response start to act like a robotic cause-and-effect chain. Pain causes fear which causes pain which causes fear which causes … etc., etc. … you know it all too well. When that seemingly iron chain begins to loosen, stimulus and response begin to happen more and more within the spaciousness of your awareness. You can recognize this spaciousness, and begin to orient towards it.
Feel Your Own Being
As a human rather than a dog, you can consciously feel your own being, at any moment, and you can respond. Is it tense, closed, frightened, upset, irritated? What’s the quality of that space in which stimulus and response are occurring? You can know that, not just react to it. As you begin to notice that space, you embark on a journey that becomes less about changing the stimulus (pain) or the response (fear), but about noticing and attending to the overall quality of your being-space. You learn to make that space safer. Or even better: to find and feel the safety that is already there. Not a safe space somewhere, but an inner spaciousness that feels safe.
When you begin to get the hang of this, you begin not to care so much about the fear and pain that used to consume you. You trust that it’s being handled by the safe space inside of you—as you discover for yourself that it is indeed being handled. How strange and unexpected, for a chronic pain sufferer like me.
We are much bigger than we realize! Our body and brain can uncreate what they create. Like Mikah, we can help them by not caring about false bells.
You trust that it’s being handled by the safe space inside of you—as you discover for yourself that it is indeed being handled.
I hope that this is evocative rather than esoteric. There are specific tools that we can use to connect to and grow this space, beginning with mindfulness, somatic tracking, and positive affect induction. These are practical methods, and they work when done carefully, in the right spirit. You can learn, and you can’t help it—your brain is a learning machine!
Getting back to Pavlov and his dogs, the bell is like your amygdala ringing in pain and fear to sensations that are actually harmless. This method has the power to drive the response (fear-pain cycle) to extinction because it can remove the stimulus (also the fear-pain cycle) permanently. If you no longer respond to either pain or fear in the way you did before—by cultivating that spacious peace inside, one moment at a time—you will grasp the root of the problem. At that point, it’s game over, pain and fear.
I am fortunate to have training in the various disciplines of counselor, coach, and supervisor/mentor, and there are important distinctions. If we work together, it might help you to have clarity about the difference between coaching, counseling, and other types of professional services such as consulting and mentoring, so that you’re clearer about what you’re seeking.
By law, my work as a mental health counselor is currently limited to clients from the State of New Mexico and Florida, where I am a licensed professional clinical counselor (LPCC). Regardless, I still value the coaching model – and I also prefer to move to a coaching model as soon as the client is ready, in my psychotherapeutic practice.
What exactly is a coaching model?
Essentially, it entails a strength-based focus and values client autonomy right from the start. Like a psychologist or psychiatrist, a counselor is often seen as an “expert” to whom one goes for a “treatment”.
Coaching is not like that. You are the expert in coaching, and if I am your coach, I help to reveal your expertise. Coaching focuses especially on where you are presently and where you are headed. It has the goal of helping you gain clarity about your present and your vision for the future, eliminate obstacles to your success, accelerate the pace of personal growth, and achieve results that empower you to live your best life – professionally and personally.
Coaching vs. Counseling
While coaching is forward-focused, counseling tends to deal more with past issues in which you may find yourself stuck and struggling. It is more directly focused on past trauma and the unconscious, as it plays out in psychological defenses. This is important work and sometimes is necessary before progress can be made. But within the coaching model, while we might discuss something that has occurred in the past for the purpose of clarifying the present, coaching does not generally focus on resolving the past, as such. It takes the present as the path. For example, freedom from pain can involve training our brain now to work differently right now, and that can be our focus.
Clients often come to see me about chronic pain, but that issue tends to affect many others, so in addition to the presenting issue that brings you to me, we can also focus on other areas of your life: Relationships, Finances, Spiritual Life, Work and Business, or Physical Health and Environment. A satisfying life includes all areas of life.
A simple rule of thumb to know whether you should be in coaching or counseling: If your past is the main issue, counseling is your best option. If your past feels more like a fact (regardless of whether the circumstances were difficult or negative), you are probably ready for coaching. If it appears that there is an issue for which you may need counseling and you live in the State of New Mexico, we can work on it together, and also as a bridge to a coaching model. Otherwise, I am happy to discuss with you the forms of psychotherapy available, and what may benefit you.
Coaching vs. Consulting
A coach focuses on helping you walk your unique path to success. As the client, you are responsible for the results you receive as a result of coaching. I help you discover how to become more of who you need to be to achieve those results and identify what you may need to do differently. A consultant takes responsibility for a specific project, acting as a specialist, providing specific deliverables and knowledge. Although I do have knowledge to share, my goal is to bring out your inner expert regarding your situation and how to resolve it. I believe in your ability to fully experience your potential and will provide a safe, consistent space for you to develop your potential.
I have specialist knowledge in several areas. The first is my professional experience as a clinical counselor, including training specific to trauma (such as EMDR and The Flash Technique), addiction (e.g., Motivational Interviewing), anxiety (mindfulness-based methods), chronic pain (e.g., Pain Re-processing Therapy), and many others. These all naturally also inform my work as a coach, as a framework to understand what I’m seeing and what might benefit. In addition, my long-time experience as a student of Buddhism and a practitioner of meditation and yoga provides as much a theoretical and practical background for my work as does Western psychology. As it happens, I also have years of experience as a writer and editor in the software industry. None of this knowledge need come to the forefront, unless it becomes directly relevant, or you are personally interested. In that case, whether my knowledge has come personally or professionally, I will gladly share my understanding.
Coaching vs. Mentoring
Mentoring is very similar to coaching, but with a crucial difference. As a mentor (or supervisor) I guide you towards a specific path of development. For example, if I am supervising/mentoring a young counselor, I have an agenda that I need to follow to make sure my supervisee develops certain capacities. But as a personal coach, I focus on the development of people in general, and the development of your unique path in particular.
We are all different, and I am more interested in helping you onto the unique path that is meant for you—which may be quite different than the path I have taken, even though the purpose of our paths may be very similar. The job of a coach is not to tell you what to do, but rather to help you uncover the answers that lie within you, to be a catalyst for your success.
Sometimes we don’t know ourselves as well as we think, especially when it comes to our strengths. But it’s actually pretty easy to sort them out, and if we work together I will want to know your strengths, because they will tell me a lot where you’ll find energy and success.
Character strengths are stable aspects of our personality: positive traits. They are energizing for us; natural and authentic and so easy for us to use without even trying; and they are useable for us as leverage to do heavy lifting.
Although we don’t choose them, we can recognize them once they’re pointed out: “Yes, I’m like that, that’s me.”
They are what we rely on to get through challenges, what we often use as a basis for our work, as a basis for connection to others. They’re not merely our persona; they may have deeper roots even than personality, as an individual aspect in ourselves of a quality of life itself.
According to happiness researcher Dr. Sonja Lyubormirsky, celebrated author of The How of Happiness, three elements comprise the happiness pie.
Factors influencing chronic happiness levels
These are setpoint or genetic tendencies, intentional activity, and circumstances.
The set point is your baseline happiness. Some people are normally relatively happy, some people less so; it’s part of temperament. According to this theory, the set point is said to make up 50% of one’s total happiness.
The next aspect is intentional activity—includes things like cultivating kindness and forgiveness, expressing gratitude, and other practices that specifically target our own and others’ well-being. This is said to comprise about 40% of one’s total happiness.
And finally, there is circumstances, and this includes all the sorts of stuff that happens to us as we go about seeking good conditions, from buying an ice cream cone to a new house. This is said to comprise about 10% of one’s total happiness.
The main message here is that circumstances account for far less than we normally suppose. So if we believe that we are going to increase our happiness by improving our circumstances, we may be in for a rude awakening.
But the takeaway is that working with our intentional activity is our best bet if we want to increase happiness. This has to do with changing our mindset (e.g., feeling more gratitude for what we have or how the world is); or increasing our experience of autonomy, self-efficacy, self-respect, satisfaction, etc., by setting intentions and then following through on them.
One way to think about the difference between coaching and counseling is that coaching is in the main is present- and future-focused, about achieving such goals, rather than addressing psychological disorders or past trauma. Positive before negative.
Researchers in the field of Positive Psychology have looked at the thoughts, emotions, and behaviors that create lasting happiness, and Coaching implements that research.
It focuses on the strengths that a person has rather than problems or weaknesses.
It focuses on what the person can do rather than what the person cannot do.
It forwards the view that human beings are basically healthy and good rather than ill or conflicted, and so the task is to help people find their way to their natural, innate strength and goodness, rather than to focus mainly on problems and negative emotions.
A wealth of research shows that being strength-based and strength-focused is a very effective means for helping people achieve their goals—which, when connected to their values and deepest sense of meaning, leads to a fulfilling experience of life. The research also explores how successful people operate—how they define goals and then achieve them.
Put simply: coaching is focused on what works.
Finally, positive psychology, in various ways, provides a way into implementing commitment. A coach provides feedback and accountability for the client, but this is in service of a learning process in which the client discovers how to create rituals and habits that serve his or her deepest values. Once these habits are in place, change happens as surely as compound interest accruing on a loan.
Life is almost overwhelmingly distracting, and interventions like committing to a daily gratitude prayer or some other practice—what in Buddhism is called “mind training”—is, according to my mind and experience, necessary if we are to have any chance at creating lasting well-being.
Pain Reprocessing is an elegantly designed intervention to retrain your brain.
Chronic pain is disrupted by interrupting the feedback loop which creates it. This loop is the way that you and your nervous system habitually respond to signals from your body.
The nervous systems responds unconsciously, and it is this fear-based habit that needs to change in order for chronic pain to resolve itself. The seeming miracle is that it will resolve itself, when you learn to stop the feedback loop. How?
Pain Reprocessing has five main components, and they involve changes in thinking and attention.
The first step involves learning about where chronic pain originates (in short: in your brain, not in the location it appears in your body), through which you can prove to yourself that it is reversible.
The second step involves your unique experience of pain, the gathering of evidence that will show you, in your direct experience, that pain is reversible.
The third and crucial piece is to retrain your way of attending and appraising pain sensations—literally to polish and refocus your lens of attention—so that you come to experience your body through a “lens of safety”.
The fourth is expanding the lens of safety so that you become resilient in the face of emotional threats.
And the fifth is to learn gradually to switch your polestar from negative to positive sensations, to seek out and find positive feelings and sensations and allow yourself to take them in. People who have been in pain a long time may forget that positive feelings even exist, but we will find them.
Pain Reprocessing has its roots in the pioneering work of Dr. John Sarno in the 1980s, but it has taken until 2021 for this method to be refined and truly gain traction as the most effective current treatment for chronic pain. Pain Reprocessing Therapy (PRT) has recently been validated by a randomized controlled study at the University of Colorado Boulder.
Polish and refocus your lens of attention … experience your body through a “lens of safety”
The Colorado study treated 100 chronic back pain patients for only four weeks. Half of them received PRT twice a week, and half of them received treatment as usual. The results? In the PRT group, 98% of patients improved and 66% of patients were pain-free or nearly pain-free at the end of treatment. Even more important, these outcomes were largely maintained one year later.
Let’s work together to find the same results for you.
