Neuroplastix

Change the Brain; Relieve the Pain; Transform the Person

Mood and Pain


Wiring New Connections


Shared Circuits


Look at the graphic on page 54 of the workbook and compare it to the Key Graphic on page 13. You will notice that six of the areas (the amygdala, insula, prefrontal cortex, anterior cingulate cortex, posterior cingulate cortex and posterior parietal cortex) are involved in both the perception and regulation of mood and pain. This common circuit explains a lot about the direct relationship between persistent depression and stress with persistent pain. In fact chronic mood problems are not so much a risk factor for persistent pain as they are another manifestation of the same illness. Treating one without treating the other becomes an exercise in futility.

When nerve cells used to regulate mood are stolen by pain processing circuits, emotional regulation, calming and self-soothing are negatively affected. The ability to stay motivated and solve problems becomes impaired and people live with fear. Poor problem-solving and decision making leads to a further erosion of self-esteem and people often become less active because they are in more pain and lose the confidence to deal with life. As activity decreases more inflammatory molecules are released in both brain and body and the brain-body loop of chronic inflammation, chronic pain and chronic mood disturbance is reinforced. People become traumatized by their pain and fight-flight centers are activated. The fear of pain looms so large that people become frightened of challenging and opposing it, seeking increased passive treatment modes and less active lifestyles.

Shared Neurotransmitters

The brain uses molecules in different ways for different circumstances. Neurotransmitters are located at nerve endings and are released into synapses when an electrical signal is sent to these nerve endings. The gap between nerves, known as a synapse is too wide for the electrical signal to cross. Instead packets of molecules are released into these synaptic spaces between cells and cross these spaces to connect to specific receptors on the cell membranes on the far side of the synapse. This causes an electrical signal to be generated and sent down nerve shafts (axons and dendrites) to keep this process going.

There are multiple types of neurotransmitters with many of them serving more than one purpose. There are neurotransmitters that speed things up and those that slow things down. There are neurotransmitters that affect movement and those involved in sleep. There are neurotransmitters involved in pain and in mood, as well.

Many of the neurotransmitters involved in pain and mood are shared. The most important ones are Substance-P, norepinephrine and serotonin, but also may include GABA and Glutamate, dopamine and histamine. With all of these neurotransmitters in common, it makes sense that pain and mood are regulated together by the brain. Furthermore, these neurotransmitters have effects upon the cells, hormones and even genes. They cause further neuroplastic changes in the brain that can keep a pain state going or resolve it.

Neuroplastic Treatment of Pain and Mood


Look at the graphic on page 57 of the Neuroplastic Transformation workbook and read the text on “Limbic Deactivation.” It is important to fight the messages to give up and become more and more passive. Reject fear, self-loathing and self-hate. Get out of bed. Shower and dress every day. Leave your room. Get out of your home. Be as active as possible and increase that activity over time. Pay attention to the things that you can do and don’t accept the limitations of today. Push beyond these in small increments. If you experience a pain increase, back off, but pay attention to the pain, do not try to just cover it up. What brought it on? What can you do to get around it? What emotions did it bring up or what emotions were present when it started to become worse? What techniques that you have already learned can you use to bring it under control. Soothe and calm yourself. Do not let the fear of your pain overwhelm you. When the pain is under better control, get up and start moving again. Keep active, plan new approaches. Make controlling this pain your job, until you have it under better control.

Shift your point of view. Be curious about your pain. Pay attention to it. Are there feelings that the pain causes? Do these emotions remind you of anything else in your life? Do they relate to other problems that you haven’t yet resolved? Can you see the pain as a limit that can be respected, but challenged? How does the pain reduce your function and what can you do about that? Does experiencing your pain bring you to emotional places that are too frightening or overwhelming to bear?
Recall the emotions and the sense of fear, anger, loss disappointment and sorrow. What are the feelings that occur when you let yourself think about what has happened? Can you think of ways you have had to defend your pain and have felt under attack by others. Tell your brain it is time to move on. Forgive yourself and anyone else involved. Acknowledge the emotional wounds and let them heal. Allow your pain to become part of your life story, rather than something that controls your whole life . Acknowledge what you have lost, but recognize that your losses often provide new opportunities.

Living in Crisis Mode


Read the text on page 55 of the Neuroplastic Transformation workbook. The crisis mode can easily become a way of life. Pain, depression, anxiety, emotional trauma, stress and fear reorganize the brain. Processes are set in motion that establish a constant state of agitation. The persistence of these symptoms, occurring separately or together, shuts down the brain’s self-soothing responses. The ability to detect conflict, problems solve it and respond appropriately are lost. The brain’s ability to make decisions based upon order of importance is diminished. Choices are made out of a sense of desperation. The wisdom of experience becomes inaccessible. The brain releases more glutamate, the main excitatory neurotransmitter. Review the graphic on page 56 of the Neuroplastic Transformation workbook. When more glutamate is released into mood and pain pathways, the brain becomes too excited. Long-term nerve firing in pain and mood circuits increases and more Substance-P is released expanding the pain map. The person experiencing these changes feels unrelenting pain and a constant state of dread. Expectations of more pain and more depression take over.

Recognizing crisis mode living is the first step to bringing it under control. Counter-stimulate this with soothing, calming and effective problem solving. Do not allow fear to color your decisions. Do everything you can to turn on higher brain functions and modify the crisis mode input. Remember who you really are and tell your brain to be calm. Look at the graphic on page 55 of the Neuroplastic Transformation Workbook. Now look at this animation. Picture the insula in your own brain releasing soothing, calming GABA into the Amygdala. Look at this animation of the same process. Feel the relief in your own brain of agitation, fear, anxiety and pain.

Soothing with GABA


GABA is the the main inhibitory neurotransmitter used throughout the body. Look at the graphic on page 56 of the Neuroplastic Transformation workbook. It shows two nerve endings and a synapse. GABA in one nerve ending attaches to receptors in the next nerve ending and holds back the release of Glutamate. Read the text under the graphic. The two main neurotransmitters in the brain are glutamate and GABA. Glutamate causes nerves to fire and GABA causes them to stop firing. The body manufactures these substances in a typically economical fashion, creating most of the GABA in the brain from glutamate. This ensures a balance between these two neurotransmitters. In depression, anxiety, panic and pain states the brain releases more glutamate than GABA. It fires more easily and this can lead to other problems, such as creation of long-term potentiation, disruption of the Default Mode Network and wiring of unpleasant mood and pain circuits. Nerve cells produce more excitatory neurotransmitters and glial cells produce more inflammatory cytokines. Substance-P production goes up and expands pain circuitry in the brain, while causing more inflammatory release in injured parts of the body. The brain-body loop is stimulated by more pain input and output. GABA release is too limited to overcome these runaway processes.

People are the least soothed when these runaway processes are going on, but this is precisely the time the brain needs soothing. Conscious effort to counter-stimulate by soothing releases GABA all over the brain.

Self-Soothing Strategies


The limbic system is critically involved in pain processing and soothing. Page 57 of the Neuroplastic Transformation workbook describes the limbic system and it’s cross connections with pain circuitry. Likewise, pain and emotional experience are intimately connected. Pain produces anxiety, depressed mood and fear. Conversely, depression, anxiety and fear augment pain. The good news is that by employing self-soothing strategies people can interrupt those connections. The result is less pain and more positive outlook.

Each person can find a way to soothe themselves. Self soothing strategies come in many forms and are unique to each individual. They are based on personal experience. A nearly infinite number of self-soothing strategies can be created using thoughts, images, sensations, memories, soothing emotions, movement and beliefs. The Neuroplastic Tips pages at the end of each section provide suggestions for self-soothing strategies. A more portable tool is the R.A.F.T. card deck. Each card contains a strategy to counteract pain and lift mood. Rubbing on raw cacao butter can be very soothing. Try something comfortable and then try something different. Change is the way we grow and learn. Keep trying new things. There are ways for everyone to self-soothe. Unrelenting persistence is the key.

Stimulating and Soothing


Soothing calms the brain. It can be as simple as a thought or as complex as competing in a triathlon. We are soothed by others and learn to self-soothe over time. The range and variety of soothing behaviors is nearly infinite. People soothe themselves in positive ways and in negative ways. Regardless, the act of soothing requires activation of circuits extending from deep brain centers into higher brain centers in the limbic system, an important part of the Associational Cortices (see pages 35 and 46 of the Neuroplastic Transformation workbook). The limbic cortex is responsible for regulating mood, autobiographical memory and problem solving. A description of the limbic cortex and its ability to disrupt or calm pain and mood circuits is mapped out on page 57 of the Neuroplastic Transformation workbook. Soothing activities allow for the proper balance of neurotransmitters, electrical circuits and resting networks.

Stimulating the brain results in the release of excitatory neurotransmitters, honing focus, sharpening memory and unleashing creativity. Too much stimulation can lead to runaway anxiety and pain. Too little stimulation causes depression and fatigue. Staying in the zone requires that stimulation of the brain is balanced by soothing. Being in the flow of an experience is achieved when a perfect balance is reached reached between the two and a person merges with the activity being performed. The peak moments of life are the times we are in the flow.

Restoring Balance


The goal is to restore the balance between soothing and stimulating. Every process in the body is set up to have it’s own regulation, it’s own check and balance system. In any disease, the balance in one or many systems is disrupted. This leads to pain and dysfunction. In order to work properly, the body has to right itself. It has to work it’s way back to a place where the paired processes function as they should. This is known as homeostasis and it exists as a wide range, rather than a precise target.

Review the text on page 57 of the Neuroplastic Transformation workbook. It addresses the issue of release of calming neurotransmitters to restore balance in the limbic emotional and pain processing region of the brain. Using pain, anxiety and depression as signals to consciously self-soothe is an important strategy to restore balance to the brain and to a person’s life.

Brain Rhythms


Large networks in the brain influence each other by using waves of electricity in slow rhythms. These oscillating signals are measured in fractions of a cycle per second, with the optimal rhythms being 1 cycle every 10 seconds. To put this into perspective the lowest sound that is audible to the human ear is 20 cycles a second. Even through these rhythms are slow, they are the fastest processes to make neuroplastic change. Making and breaking synapses takes minutes to hours, but changing these network influences only takes a matter of seconds. While these network rhythms cause rapid change in brain function, they also make it harder for the brain to re-establish old patterns. Capturing these rhythms and restoring them to normal is an excellent strategy for restoring normal brain processes and function.

Pain and the Default Mode Network


Neuroplasticity is an essential activity of the brain associated with new learning. It involves constant changing of the ways that nerve cells connect to each other and organize networks dedicated to many different functions. Larger networks of cells in the brain connect to each other by electromagnetic waves that fire in slow rhythms and are called Resting State Networks. These networks rhythmically activate one another when we are at rest. One of the most studied of these Resting State Networks is the Default Mode Network (DMN). Under normal conditions the DMN fires every 10 seconds and is related to consciousness and our sense of self. Essentially, the DMN tells us who we are. The network is activated when people daydream, meditate, or are being introspective.

The DMN is scattered throughout the thinking part of the brain. Another Resting State Network is the Frontoinsular Network (FIN). This network tells the brain what current information is the most important to attend to. It is called a Salience network and helps the brain decide how to deal with the massive amount of information presented to it in an order of greatest to least importance. In persistent pain states, depression, anxiety and post-traumatic stress disorders, the 1 cycle every 10 second rhythm that exists between the DMN and FIN is disrupted and changes to 1 cycle every 4.5 to 5 seconds. When pain stimuli ramp up frequencies between the Fronto Insular Network (FIN) and the anterior DMN a disruption of one’s sense of self occurs. This is worsened further when FIN pain signals increase frequencies in the posterior DMN. The result is that the person experiencing this starts to experience them self through their pain and the neuroplastically disrupted background rhythms of the brain perpetuate persistent pain. Resolution of persistent pain results in a return of the DMN/FIN rhythm to 1 cycle every 10 seconds. A similar pattern of disruption and resolution occurs with depression, anxiety and emotional trauma, presenting another link between persistent pain and emotional disturbance.

The Ripple Effect of Calming


Just as anxiety, pain and depression cause more of themselves, so does soothing create more calm. Self-soothing activities and soothing to and from others causes a release of calming and pleasure neurotransimitters, harmoniously resets the rhythm of the Default Mode Network and the Frontoinsular Network, and slows down long term potentiation of nerve cells. This takes counter-stimulation and shifts it to multi-dimensional neuroplastic change. Experiencing calm and soothing becomes the norm. The Default Mode Network shifts a person’s sense of self from being agitated to being calm.

The Brain in 3-D


This section of the Neuroplastic Transformation Workbook takes the key graphic on page 13 and gives it a 3 D perspective on page 58 through 62. Starting with the intact brain as viewed from above on page 58 the personal access to the brain that each of us has is described using thoughts, images, sensations, memories, soothing emotions, movement and beliefs. On page 59, with the upper part of the brain removed, the two insulas are visible and their function is described in detail. On page 60, the insulas are removed to reveal the two almond shaped amygdalas below. Their functions are also listed. On page 61, we see the brain from the left side, showing the primary somatosensory cortex, the primary motor cortex, the orbital frontal cortex and their functions. Finally on page 62 we see the brain’s central structures, the prefrontal cortex, anterior cingulate cortex, posterior cingulate cortex, posterior parietal cortex and the primary and secondary somatosensory cortex and the supplementary motor area. The functions of these areas are, once again, listed.

The 3 dimensional view shows the anatomical layout of the brain. This allows us to see the spatial relationship between the various brain regions that make up the circuit responsible for pain perception. It’s easy to see how stimulating other functions directly and purposefully can counteract the constant stimulation of persistent pain.