Thursday, September 24, 2015

Fight or Flight – Demonstrated!


I was giving what I considered to be a rather important lecture.  We were seated around a table and a soldier was sitting next to me.  With no advance warning I let my hand lash out into a karate chop intentionally aimed directly at his throat.

The soldier instinctively jumped in his seat and leaned as far back as possible with his eyes wide and his breathing pattern now rapid.  Thus began my lecture on fight or flight.  I needed a demonstration and the unsuspecting soldier was just perfect for my purpose.

The soldier had 3 options to deal with my surprise attack.  He could very well have come back at me and fought to protect himself.  I might have been in trouble if he had chosen that option.  He could have frozen like a deer in my headlights.  I pulled my chop just in case he reacted in that manner.  He actually chose door number 3 - to withdraw from the danger.

This is all in accord with what Walter Bradford Cannon told us to expect when we perceive an actual or even just a perceived threat.  He wrote of this in the early part of the last century.  We now know that we have 3 options:  Freeze, Fight,or Flight.  Most of us are familiar with the second 2 but number 1 is rarely mentioned.  It too, is very important.

This also agrees with the more recent work of Patrick Wall who in his book, “Pain: The Science of Suffering,” spoke of 3 stages of pain.  First, We withdraw from the threat.  Second we guard ourselves from further danger.  Third, we resolve the situation.  This usually involves movement.

The soldier is a great example of this.  We saw him withdraw.  He stayed back for a few minutes in a guarded position.  He did finally resolve the issue by going back into his original position.

Explanations are very important for people who experience chronic pain.  They can be useful in making sense of the many symptoms that are frequently reported.  They can also point in the direction of what might be a useful intervention.  Just having this knowledge can often be helpful!

The presence or even just the perception of a threat is sufficient to activate this process.   It is how we were created to deal with danger.  It is hardwired into us by our Creator.  We rarely experience the life threatening situations that we would expect to cause this activity.  Instead we experience…..STRESS!

We all seem to instinctively know what stress is.  It is something we routinely talk and think about.  In spite of this when we turn to scripture there is no mention of the term.  We have other terms, doctrines, and concepts that God has seen fit to have us use to structure our thoughts about what we now call “STRESS.”  Let’s look at a few of the words used in scripture.

Anxiety or Worry – Is something we are familiar with.  Both words are used when translating the same Greek word.  There are many good books written on this subject.  I especially appreciate the words of Jesus (MT 6:26-34) in the Sermon on the Mount:

     "Therefore I say to you, do not worry about your life, what you will eat or what you will drink; nor about your body, what you will put on. Is not life more than food and the body more than clothing? Look at the birds of the air, for they neither sow nor reap nor gather into barns; yet your heavenly Father feeds them. Are you not of more value than they?

     Which of you by worrying can add one cubit to his stature?  So why do you worry about clothing? Consider the lilies of the field, how they grow: they neither toil nor spin; and yet I say to you that even Solomon in all his glory was not arrayed like one of these.

Now if God so clothes the grass of the field, which today is, and tomorrow is thrown into the oven, will He not much more clothe you, O you of little faith? Therefore do not worry, saying, 'What shall we eat?' or 'What shall we drink?' or 'What shall we wear?' For after all these things the Gentiles seek. For your heavenly Father knows that you need all these things.  But seek first the kingdom of God and His righteousness, and all these things shall be added to you.  Therefore do not worry about tomorrow, for tomorrow will worry about its own things. Sufficient for the day is its own trouble.”

Much has been written on this topic but simply meditating on this passage can be of immense help.  It may come off as trite without the meditation aspect.  Think deeply about the truths expressed here.  It is God the Son speaking.  It is truth being spoken by him who is called the Way, the TRUTH, and the Life.  It is important and has specific application to you as a believer in the one who died in your place.  If worry and anxiety have overtaken you then these words are a great place to start.  Spending time with other believers and meeting with you pastor or elders may be of tremendous benefit in finding exactly how you are worrying and what part of scripture touches you in your pain.

Trouble – Now there is a word that has a good many uses.  Jesus uses it in the following passage in a way that is even stronger than worry.  It is more like stirring up or agitation.  Listen to what he says about trouble and dealing with it in John 14:1-4:

 "Let not your heart be troubled; you believe in God, believe also in Me.

 In My Father's house are many mansions; if it were not so, I would have told you. I go to prepare a place for you.  And if I go and prepare a place for you, I will come again and receive you to Myself; that where I am, there you may be also.   And where I go you know, and the way you know."

We all have trouble.  We have things that agitate and stir us up.  In the passage above Jesus is speaking to the disciples just before his arrest.  He was about to die and they – his sheep were about to be scattered.  That could well be troubling.  Notice how Jesus speaks to them about dealing with it.  He says do not be troubled. 

I have to admit that when I am all stirred up and someone tells me to just stop it that I do not always respond in ways that I am proud of.  You can’t replace something with nothing and a simple command to just stop it does not work particularly well.  That is why Jesus prepares them with what to do when the time comes.

They had a concrete concern.  Jesus had just announced that there was a betrayer in the midst and that he would be leaving.  They had been with him for 3 years and now it was about to end. 

He did not simply say, “Don’t worry, Be Happy.”  He explained to them that he was to be the object of their trust – “you believe in God, believe also in Me.” Now – because of who he is, they needed to understand that he was going to prepare a place where they would share eternity with him.

Think about it.  He was about to be arrested and crucified.  They were to be scattered and persecuted.  All except John would die as martyrs and they would try to kill John.  Jesus lets them know that instead of being troubled they are to look forward to the promise of eternity with him.

We are heirs with the disciples of that same promise!  We can stop and think about that promise – let it consume our mind and set our minds like those in Hebrews chapter11.  It will transform us.  Romans 12:1-2 assures us of that.

Of course this is difficult.  We need to turn off the radio and television.  We need to make time in our life to seriously look to Jesus.  We need to take our problems to him and then meditate on him and his word.  A simple prayer and turning the TV on will simply not do.  We must seek Jesus and make him our treasure.  There is no other way to not be troubled.  It requires effort on our part.

…And then there was Fear. Talk about Freeze, Fight, or Flight – when you have fear you are definitely in the place where this modern explanation easily dovetails with Biblical terminology.  This word is used when people see Angels, armies , and death.  People run, fall down, and often experience sheer terror.  There seems to be an aspect of something horrible happening when this word is used in scripture.

These are fiery furnace times.  Something horrible is about to happen.  What do we do?  Daniel’s friends show us how it ought to be done:

      Shadrach, Meshach, and Abed-Nego answered and said to the king, "O Nebuchadnezzar, we have no need to answer you in this matter.
If that is the case, our God whom we serve is able to deliver us from the burning fiery furnace, and He will deliver us from your hand, O king.
But if not, let it be known to you, O king, that we do not serve your gods, nor will we worship the gold image which you have set up."

Daniel 3:16-17

These guys look like it was done with no fear.  They knew clearly what God required of them and knew that the King could indeed kill them but choose obedience to the one who had the power to deliver them.  There were many believers living in the kingdom at that time.  We do not know their stories.  What would you have done?

Some of us already live in fear.  How do we develop a more believing response?  The 3 young men above give us a very good indication.  They believed in God and…wait for it – they served him! 

The word has the connotation of hard work involved in worship. We don’t usually think of worship as hard work but that is exactly the word used here.  I can’t help but think of Jacob’s wrestling with the angel and my favorite:

“Epaphras, who is one of you and a servant of Christ Jesus, sends greetings. He is always wrestling in prayer for you, that you may stand firm in all the will of God, mature and fully assured.” Col. 4:12

And in the context of putting on the armor of God - there is this:

     Eph 6:12  For we do not wrestle against flesh and blood, but against principalities, against powers, against the rulers of the darkness of this age, against spiritual hosts of wickedness in the heavenly places.

Serving God is never said to be an easy thing.  It is something we need to be focused on and dedicated to.  These passages describe it as wrestling.  I used to wrestle – it was very hard work.  I sweat and I hurt.  I prepared so that I was ready.  We serve God both individually and corporately.  When we cause ourselves to live in a life whose context is Biblical we can begin to develop into people who do not fear.  We cling to Christ individually and as his Church.  Neither is sufficient alone. 

In dealing with stress there are also particular doctrines that can provide the context to our thought life that really prepare us to deal better with the situations in which we are prone to anxiety and fear (notice how I switched from a modern to a biblical word to describe our situation – do that).  One such doctrine is Providence.  Here is a description taken from the Westminster Shorter Catechism:

Q. 11. What are God's works of providence?
A. God's works of providence are his most holy, wise and powerful preserving and governing all his creatures, and all their actions.

You might recognize this from scripture – it is intensely personal:

     "Therefore I say to you, do not worry about your life, what you will eat or what you will drink; nor about your body, what you will put on. Is not life more than food and the body more than clothing? Look at the birds of the air, for they neither sow nor reap nor gather into barns; yet your heavenly Father feeds them. Are you not of more value than they?

     Which of you by worrying can add one cubit to his stature?  So why do you worry about clothing? Consider the lilies of the field, how they grow: they neither toil nor spin; and yet I say to you that even Solomon in all his glory was not arrayed like one of these.

Now if God so clothes the grass of the field, which today is, and tomorrow is thrown into the oven, will He not much more clothe you, O you of little faith? Therefore do not worry, saying, 'What shall we eat?' or 'What shall we drink?' or 'What shall we wear?' For after all these things the Gentiles seek. For your heavenly Father knows that you need all these things.

     MT 6:26-34

If you are God’s – He is taking care of you.  In Romans 8 we even learn that he has a plan to do so:

And we know that all things work together for good to those who love God, to those who are the called according to His purpose.  For whom He foreknew, He also predestined to be conformed to the image of His Son, that He might be the firstborn among many brethren. Moreover whom He predestined, these He also called; whom He called, these He also justified; and whom He justified, these He also glorified. 

Romans 8:28-30

Not only was there a plan – there was a purpose behind the plan:

Eph 2:10 For we are His workmanship, created in Christ Jesus for good works, which God prepared beforehand that we should walk in them.

We were created to do good works.  It is interesting that we are not saved by the works – yet the works accompany salvation.  We do them because of what Christ has done for us.  True belief, trust, or reliance upon Jesus, results in a life of good works.  We will in this life struggle with sin in general and with particular sins, but we will grow in grace as we seek the face of our great God and Savior, Jesus Christ.

This particular doctrine of providence then teaches us that God has a plan and that he is controlling everything in our situation at every moment to fulfill that plan.  We will someday be presented as his Bride.  In the mean time He is chipping away at our rocks that we are and creating something beautiful in His eyes that he desires to spend eternity with.

The very works we do minister to His Body, the Church.  Think about it.  In Freeze, Fight, or Flight – or Biblically – Worry, Anxiety, and Fear, We are putting a real narrow focus on ourselves.   Yet when we do good works to edify or build up others the focus is off of us.  We stop thinking about ourselves and focus on others.  Others do the same for us and so we all carry each other’s burdens – thus lightening the load.  This can be very important in dealing with what we have fallen into calling stress.

Many of us have particular passages that seen to speak to our lives in many varied circumstances.  Here is one of mine:

     For the weapons of our warfare are not carnal but mighty in God for pulling down strongholds, casting down arguments and every high thing that exalts itself against the knowledge of God, bringing every thought into captivity to the obedience of Christ, and being ready to punish all disobedience when your obedience is fulfilled.   2Co 10:4-6 

The contest is Paul coming to Corinth to deal with some issues in the congregation.  He is about to apply scripture to the problems.  He thinks and reasons as a believer and so he frames his thinking according to reality – that is- scripture is his interpretive grid.  He sees all things in light of how God has revealed himself in scripture and casts down arguments on that basis.

Taking our thoughts captive in this manner is a mighty weapon against worry, fear, and anxiety.  Bringing these same issues to the Church is one of the tools spoken of in scripture to deal with things in a Biblical manner.  We were never intended to be alone.  My next post will go into some of the physical tools that are of help in dealing with these same issues.  I leave you with this:

     Rom 12:2  And do not be conformed to this world, but be transformed by the renewing of your mind, that you may prove what is that good and acceptable and perfect will of God.

Thursday, April 23, 2015

Science Says I May Not Be Crazy!

Many people have the experience of going to the doctor with some type of pain.  The doctor often orders tests to try to make sense of the complaint.  We want that.  At least we want that until we have been to doctor after doctor and they can’t seem to find a problem.  That is when we get the psych referral and are told that the problem must be in our head.

We resent this.  We feel the pain.  We know that we have a problem and that if we just see the right person – they will listen to us, run the right test, and finally fix our problem.
It really starts getting to us.  We have bad feelings toward our caregivers.  Many of us begin to mistrust the medical profession.  We blame big pharma, the insurance company, and the government.

Our life begins falling apart.  No one sees any blood, cast, or wheel chair and they too often begin to wonder – is it all in their head?  The saddest part of this is that deep down – we often begin to wonder about that as well.

A Way Out – Understanding!

 I would like to offer a way out of this mess.  It is only possible to do this by helping you to understand what we now know about both you – and your pain.  I will start with a definition.

An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.

This definition comes from International Association for the Study of Pain. [i] It is the definition that is followed by most health care practitioners.  It is really good to have a definition like this because in its absence we really have no accepted way to have a discussion about it.  We are simply left with opinions.  This is a helpful definition.
Tissue damage is not a requirement for a person to have pain!  This is very important because all of those tests that get used to find out what is wrong with the tissue are looking for – you guessed it – TISSUE DAMAGE!

This means that just because the tests are negative that you can still have a legitimate pain problem.  If you are complaining about pain or experiencing it – you probably actually have it regardless of the outcome of any number of tests.

This became clear when people began complaining of phantom limb pain.  There was no limb to have pain in and yet many people in the absence of those limbs consistently complain about pain.  One of my favorites is the rubber hand illusion  where a person can be taught that a rubber hand belongs to them and they can actually feel pain when it is struck with a hammer!  People did not even have to believe the hand was theirs in order to be benefit from acupuncture or TENS in this abstract at the World Confederation of Physical Therapy.

This may all sound a bit strange.  We have pretty much assumed that pain is an input from our tissues since the time of Descartes.  Yet the science seems to be pointing in an altogether different direction. 

In the picture above we see the view of Descartes in the left hand corner that we have nerve receptors in our skin that go directly to the brain and carry pain signals.  The problem with this traditional view is that there is no such thing as pain to sense. 

Think about it.  If you get a cut - did pain leak in?  Did you put some pain on a slide in high school and view it under a microscope?  Have you ever seen, heard, or tasted pain?  If you answered no you are in good company.  We are all in the same boat!

The reason the rubber hand illusion works and why people who have lost limbs can feel pain is that you don’t need a body to feel pain.  You just need a BRAIN!  The big finding of modern neuroscience is that pain is actually an output rather than an input of the brain.  Let me explain.

Pain researchers have found that the brain takes everything into account regarding our beliefs and attitudes as well as the sensory input from the surface of the body when a potentially bad issue exists.  It asks the question, “How dangerous is this?”  The answer to that question determines what you are going to feel.

Here is how this looks in real life.  You have a minor fender bender.  There is a slight scratch on your bumper.  No big deal.  It was low impact.  The complicating feature may well be the emotional attachment you have to the idea of an accident.  If you know someone who suffered serious pain from an accident and that influenced you a good deal – you may be set up for a pain experience.  If you have been studying disability statistics for a paper and have really focused on the bad outcomes you may well have set your thought processes up to cause a pain experience.  Your brain takes all of this information and if it answers the “How dangerous is this?” with – dude, you are in big time danger – then you may well have a horrible pain experience.  This could be in the absence of any tissue damage and a minor scrape on your bumper.

All of this gets registered in various portions of your brain.  Related pieces of information are stored all over in your cranium.  As you go through life you create these connections and reinforce them.  In any situation the activation of a number of these pieces of information (called neurotags) may lead you to experience pain – even in the absence of tissue damage.  

My favorite is the memory I get when walking through the mall and I smell cinnamon.  I immediately see the living room from when I was a kid waiting for my mother to bring her newly made cinnamon rolls.  Some people drive by where they had an injury and can feel the pain – even after the tissues have healed.

At This Point Things Get Really Interesting

 If you are having a pain experience and your tissues are healed why would you be continually treating your soft tissues?  Most scar tissue is formed by 2 months. At this point the issue is pretty much a brain issue.  People often continue to get expensive treatments for pain.   These are based on the idea of fixing issues in the tissues that have healed long ago.

What really needs to happen is to realize that a more effective and sensible approach is to deal with the sensitization of the nerves that has occurred.  You need to deal with the neurotags.  Your nervous system can change.  That will soon be the subject of another post!