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According to the National Science Foundation, the average person has about 12,000 thoughts per day, or 4.4 million thoughts per year.

I wager that writers are well above the average because we read more and writing causes us to think more than the average.

Who’s In Charge?

I had known for a long time that our thoughts affect our emotions, and that toxic “stinking thinking” could derail our writing dreams and health faster than almost anything. You are the only one who can decide whether to reject or accept a thought, which thoughts to dwell on, and which thoughts will become actions.

But sometimes–a lot of the time–I felt powerless to actually do anything about it on a consistent basis. Sometimes I simply felt unfocused and overwhelmed.

Need a Brain Detox?

I’ve been reading a “scientific brain studies” book for non-science types like me called Who Switched Off My Brain? by Dr. Caroline Leaf Ph.D. which has fascinated me. With scientific studies to back it up, it shows that thoughts are measurable and actually occupy mental “real estate.” Thoughts are active; they grow and change, influencing every decision we make and physical reaction we have.

“Every time you have a thought, it is actively changing your brain and your body–for better or for worse.” The author talks about the “Dirty Dozen”–which can be as harmful as poison in our minds and our bodies.

Killing Our Creativity

Among this dozen deadly areas of toxic thinking are toxic emotions, toxic words, toxic seriousness, toxic health, and toxic schedules.

If you want to delve into the 350+ scientific references and pages of end notes in the back of the book, you can look up the studies. But basically it targets the twelve toxic areas of our lives that produce 80% of the physical, emotional and mental health issues today. And trust me. Those issues have a great deal to do with you achieving your goals and dreams.

There Is Hope!

According to Dr. Leaf, scientists no longer believe that the brain is hardwired from birth with a fixed destiny to wear out with age, a fate predetermined by our genes. Instead there is scientific proof now for what the Bible has always taught: you can renew your minds and heal. Your brain really can change!

Old brain patterns can be altered, and new patterns can be implemented. In the coming days, I’ll share some more about the author’s ”Brain Sweep” five-step strategy for detoxing your thoughts associated with the “dirty dozen.”

But right now I’m going to read about the symptoms of a toxic schedule. I have a suspicion…

My preference is usually for "uplifting" poetry, that which (along with everything it does for cognition and imagination by sounding good to your ears and feeling good in your mouth) leaves me with a reverberating sense of wonder at the goodnesses of this world, kind of like the ones I posted back in January that suggested some animal spirituality.

I'm having trouble therefore understanding why the poem below keeps me coming back to it. I received it courtesy of The Academy of American Poets' Poem-a-Day service. The pain barely contained in it is enormous and frightening and wonderful.

Prayer for the Man Who Mugged My Father, 72
by Charles Harper Webb

May there be an afterlife.

May you meet him there, the same age as you.
May the meeting take place in a small, locked room.

May the bushes where you hid be there again, leaves tipped with razor-
blades and acid.
May the rifle butt you bashed him with be in his hands.
May the glass in his car window, which you smashed as he sat stopped
at a red light, spike the rifle butt, and the concrete on which you'll
fall.

May the needles the doctors used to close his eye, stab your pupils
every time you hit the wall and then the floor, which will be often.
May my father let you cower for a while, whimpering, "Please don't
shoot me. Please."
May he laugh, unload your gun, toss it away;
Then may he take you with bare hands.

May those hands, which taught his son to throw a curve and drive a nail
and hold a frog, feel like cannonballs against your jaw....

Take a deep breath and read the complete poem here. Poetry Friday is hosted today by Breanne at Language, Literacy, Love.

Monday at work I was taking the copy paper from the box and putting it away on the shelf, when my back decided it didn't like what I was doing. It's been stiff and sore since then. That's happened a few times before, so I'm hoping it's just a strain.

This kind of aggravation reminds me of when a character gets hurt in a book or movie. Sometimes it's almost miraculous how that person can heal so instantly, run around and do all sorts of heroic actions. In real life, it's not usually the case.

Remember, if you include an injury in the plot, give your character time to suffer instead of making everything all right real fast. And if the hero or heroine has to ignore the pain to reach a goal, at least include some references to the fact it's there, like sweat on the brow, bruises, gouges, swellings or some other kind of evidence that all is not perfect.

Rising above difficulties is always a good way to heighten tension in a story, so don't make everything seem too easy. Pain is part of the human condition, unfortunately, so think about including it in when you write.

Morgan Mandel
http://morganmandel.blogspot.com/

This post is Part 5 in a 5-part series on Pain.

• Part 1: An Introduction to the Subject of Pain
• Part 2: My Personal Pain Story: The Pink Porcupine
• Part 3: Creativity in the Midst of Pain
• Part 4: What Others Have Written on Pain and Suffering
• Part 5: Resources Related to Pain Management

Thank you for going with me on this journey to learn more about how we can cope with pain, if and when it does appear in our lives. Here are some resources you might find helpful.

Pain Management Resources on the Web


The American Academy of Pain Management

American Academy of Pain Medicine

American Chronic Pain Association

Various conditions related to pain

American Pain Foundation

Pain: Chatrooms and Discussion Boards

American Pain Society

Guides for Persons with Pain

The Journal of Pain

Chronic Pain Information Page

Counseling / Pain Management Centers by State

International Association for the Study of Pain

Global Year Against Acute Pain: Oct. 2010 - Oct. 2011

Pain (Journal)

National Pain Foundation

National Institutes of Neurological Disorders and Stroke

How is pain treated?

Pain Connection: Helping People with Chronic Pain and Their Families

Pain Recovery Online

Partners against Pain (for Patients and Caregivers)

StopPain.org: Dept. of Pain Medicine and Palliative Care, Beth Israel Medical Center

Physical Medicine and Rehabilitation (Physiatry) is a specialty of medicine concerned with the diagnosis and treatment of aches and pains and other disabling conditions. Board-certified physiatrists complete four years of medical school as well as a four-year residency program, and many physiatrists also do fellowships in specialized areas of rehabilitation medicine. This training develops skills in the areas of orthopedics, neurology, and rheumatology. Physiatrists are therefore skilled in determining the cause of a patient's symptoms—nerve, muscle, joint, bone, ligament, etc.—and treating the patient’s condition. In addition to the conventional use of medications, physiatrists have expertise in the use of modalities (hydrotherapy, ultrasound, transcutaneous electrical nerve stimulation, etc.), exercise programs, manual techniques, equipment (splints, corsets, braces), and coordination of therapy programs. Source: http://www.rehabmed.net/patient_ed/physiatry1.html

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One of my health goals is to stop taking so much aspirin and other painkillers. It causes more problems than it helps. This has been an ongoing goal for years, and recently I found something amazingly simple that is really helping!

The Painful Side of Writing

When I started writing, I don’t recall ever reading anything about health problems associated with writing. But sitting for hours, especially at a computer, takes a toll on your neck, back, wrists, and hands. The associated headaches and back pain keep many writers on painkillers of one sort or another.

Then my daughter suggested that I get some yoga DVDs. My initial reaction was negative. My mental image of yoga was of some spaced-out chanting person twisted into an inhuman pretzel. Not for me!

Yoga for Writers (and other stiff people)

I quickly learned that my ideas were outdated. From my library, I checked out “Healing Yoga for Aches & Pains,” which was as soothing as a massage (and got rid of my headache!) I have yet to try “Yoga for Inflexible People.” My favorite DVD so far is Yoga: Sitting Fit Anytime, which has nine separate 3-5 minute segments addressing individual needs of people who sit at computers for hours.

It’s easy to follow, you do it sitting, and it targets neck and shoulder tension, lower back pain, upper back pain, tight hamstrings, headaches, and carpal tunnel problems. There was even a segment for stiff hands and fingers. There was no chanting. (FYI: I skip the New Agey intro–not for me! Just want the stretches.)

Preventive and Restorative

If you don’t have aches and pains from writing, thank heaven. But also consider doing some routine stretching to prevent developing such problems. If you already suffer from head, back and/or arm pain, consider yoga as a drug-free solution. Your body–AND creative mind–will thank you.

[P.S. If you long-time faithful readers thought this sounded like a repeat, you're right. Had a ripping headache today that I finally got rid of with the DVD stretches! Thought you all might need the same reminder I did.]

I just put down a big YA bestseller with only 100 pages to go. Why? Because I realized I no longer cared.

Oddly enough, the reason I no longer cared is that none of the characters I loved were in danger.

You would think that such a situation would be ideal. After all, I don’t enjoy it when characters are hurt or killed. I actually cried when one of the characters in The Hunger Games died. (Full on tears.)

And this book had plenty of scrapes. The main character is kidnapped. She’s forced to fight in a ring. (And if you lose three times, you are thrown to the crowd which rips you to pieces.) She falls into a river and nearly goes over a waterfall that would mean her certain death. She and her friends fight off giant clawed worms. (Those of you who have read this book will have guessed what it is by now.)

But you know what? Not one important character had died at the point I stopped reading. (Her father dies at the beginning, in the inciting incident, but you haven’t gotten to know him yet.) Not even an important animal. No character is even badly damaged. I started having a hard time paying attention to the latest adventure, because I knew they would find a way out a page or two later.

Life is precious because we know it is short. If we could all live forever, would we care about life as much? I think the very best books are willing to show us that it could all be on the line, and that sometimes the good guys lose (at least one battle, if not the war).

Mother's Day had its beauty--sunshine, a lovely church service, my daughter's original poem. I prepared a scrumptious brunch and the world seemed totally right. I even got to take a nap. And then the downside of life started--a slow slide into unexpected pain. My left hip started twinging, and by evening, I couldn't walk without excruciating pain.

I went to the ER, where everyone wished me a Happy Mother's Day. Better yet, I got a painkiller so I could at least answer questions, and after two hours, I had a diagnosis (nothing serious), a prescription for painkillers and muscle relaxants, and a wheel chair ride back to the car for the trip home.

It's amazing how I take everything for granted but as soon as it's gone (even temporarily), I suddenly realize just how valuable it is--like walking, bending, sitting, even rolling over in bed--when you can't do those basic things they suddenly seem like the most important things in the world. They aren't, of course--to my daughter, my friends and my co-workers who all pitched in to help me through Sunday and the next two days--thanks. People are the most important. Still, I'm glad that I can now sit down and stand up (even if there's still pain, it's not the excruciating, can't do it kind of pain, just the unpleasant, discomfort, occasional-twinge kind of pain.

And I'm hoping to go back to work tomorrow. It's no fun to be home when all you can do is hope to lie down and be able to get back up again!

In Fibromyalgia: An Essential Guide for Patients and Their Families, Daniel J. Wallace M.D. and Janice Brock Wallace, provide advice for the nearly six million Americans who suffer from fibromyalgia. The book explains all the symptoms, signs and treatments in accessible language and offers accessible guidance for living with this syndrome. Below is some advice about exercise.

What Is the Best Kind of Exercise for Fibromyalgia? (more…)

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The Oxford American Pain Library provides practical guides that cover current approaches and new developments in the assessment and management of pain. The Diagnosis and Treatment of Breakthrough Pain is meant for doctors and nurses but can also provide some insight into treatment options for patients suffering from uncontrolled pain flares. In the excerpt below we learn what breakthrough pain really is.

The term “breakthrough pain” began appearing in the medical literature in the 1980s on the heels of the increased attention, brought about by the World Health Organization, to the global problem of undertreated cancer pain. During that time, it became apparent that cancer patients commonly experience intermittent exacerbations of severe pain against a background of continuous, or baseline, pain. Episodic pains that would “break through” during the treatment of background pain that was otherwise well controlled through the use of around-the-clock opioid therapy were catergorized by Portenoy and Hagen (1990) in a seminal work titled “Breakthrough pain: Definition, prevalence and characteristics.” The definition of breakthrough pain proffered in that article took root and has been used in pain management parlance ever since.

As opioid therapy has become more commonly used in the treatment of chronic noncancer pain over the last decade, it have become equally apparent that similar patern of supervening severe pain episodes can confound otherwise well-managed chronic pain (Seppetella et al., 2001). Recognizing the similarities of sympotms, independent of underlying pathophysiology, a group of pain managment experts came together in 2006 to create a unifying definition, based on a review of all the literature on the subject in all populations studied to date. The more generalized definition incorporates the additional observation that breathrough pain seriously disrupts the quality of patients lives. Therefore, the term breakthrough pain is now categorically determined to define the particular clinical circumstance wherein patients who have controlled baseline pain experience severe episodes of pain that breaks through the medical therapy (usually opioids) that has relieved the baseline pain.

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In 2001, my first book, Circles of Confusion, was chosen for the Oregonian’s Book Club. The paper sent a photographer to take a picture of me at my local bookstore, Annie Blooms. The photographer liked the store’s black cat and asked me to pose with it on my lap.

While I’m a cat-person, that cat is not a people-cat, not at all. In the photograph, I’m wearing the strangest expression, a pained smile that’s on its way to just plain pain. It’s because the cat has sunk his claws deep into my thigh.

On Sunday, the Oregonian published an essay I wrote about what it’s really like to quit your day job. They also used that photo from so long ago. Today when I was out for a run, a couple walking a dog stopped me and congratulated me. I kept trying to place them, but couldn’t. Did my kid go to school with theirs? Were they neighbors? It was only after I started running again that I realized they must have recognized me from that photo. Maybe I wear the same pained expression as I stagger up the hill.

You can read the essay here. No photo, though.

Dr. John D. Otis is the Director of Medical Psychology at Boston University School of Medicine and the director of the Pain Management Psychology Services at the VA Boston Healthcare System.  He is also Associate Professor of Psychology and Psychiatry at Boston University.  In his newest book, Managing Chronic Pain: A Cognitive-Behavioral Therapy Approach, Workbook, which is part of our Treatments That Work Series, Otis provides a guide to increasing productivity in the face of chronic pain.  Below are some tips, excerpted from the book, which will help you decrease the stress in your life, which in turn decreases your pain.

Stress and pain reinforce each other. You may have noticed that when you are stressed out, your pain gets worse. On the other hand, chronic pain is often a source of stress. This can result in a cycle of pain and stress…

Ways to Decrease Stress:

Given the relationship between stress and pain, it is important to learn how to manage stress. The good news is that there are things you can do to decrease your stress….

Change Lifestyle Habits:
-Decrease caffeine intake (coffee, tea, colas, chocolate)
-Maintain a balanced diet and decrease consumption of junk food
-Eat Slowly and at regular intervals
-Exercise regularly (at least 30 minutes three times per week)
-Get adequate sleep (figure out how much you need)
-Take time-outs and leisure time (do something for yourself every day)
-Do relaxation exercises (e.g., breathing, imagery, PMR)

Change How you Approach Situations:
-Time and money management
-Assertiveness
-Problem-solving coping skills

Change your Thinking:
-Have realistic expectations (when expectations are more realistic, life seems more manageable)
-Keep a sense of humor (being able to see the humor in the things helps o lighten the situation)
-Have a support system (speak with someone or write down your thoughts)
-Focus on the positive (think half-full versus half-empty)
-Challenge negative thinking using cognitive restructuring skills

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Paul G. Kreis, MD, is the Medical Director, Division of Pain Medicine, Professor of Anesthesiology and Pain Medicine, Department of Anesthesiology and Pain Medicine, University of California, Davis.  Scott M. Fishman, MD, is Chief, Division of Pain Medicine, Professor of Anesthesiology, Department of Anesthesiology and Pain Medicine, University of California, Davis.  Together they wrote, Spinal Cord Stimulation: Percutaneous Implantation Techniques, which looks at the basic multidisciplinary information necessary for understanding SCS and pursing safe and effective implantation.  In the excerpt below we look at the origins of sensory stimulation.

Sensory stimulation has been used to treat pain since antiquity.  It is believed that anciet Egyptians may have used electrogenic fish to treat ailments 4,500 years ago.  One such fish, the black torpedo fish, was used for centuries by the ancient Greeks and Romans.

The live fish was placed over the painful site, and the patient endured the electrical discharge from the fish until the pain was relieved.  The Roman physician Scribonius Largus recorded the medical use of the torpedo fish in 46 CE, and Claudius Galen (131-201 CE) also described shocks from the torpedo fish to treat gout and headache.

An 1871 publication by Beard and Rockwell presented a case of “Faradization” and described the application of faradic current (i.e., discontinuous, asymmetric, alternating current) to stimulate muscles and nerves in a subject using a direct current inductorium device.  Units…were also used by early researchers, including Benjamin Franklin, for pain relief, as well as for treatment of other ailments.

The first modern attempt at electrical stimulation of the brain took place in a conscious patient in 1874.  The patient had ostemyelitis of the scalp, and the brain was exposed during debridgement.  Muscle contractions were apparent when the exposed motor cortex as subjected to electrical stimulation but not when it was mechanically stimulated.  Not until 1948, however, were electrodes successfully implanted in the brain, to treat a patient with psychiatric disorder.

The Electreat, the first electrical stimulator designed specifically for therapeutic use, was patented by Charles Willie Kent in 1919.  It appears to have been remarkably similar to transcutaneous electrical nerve stimulation units that wold appear later in the century.

Advertised to the public as a cure-all therapy, an estimated 250,000 Electreat stimulators were sold over the next 25 years.  Eventualy, Keat would be the first individual prosecuted under the new 1938 Food, Drug, and Cosmetic Act for making unsubstantiated medical claims for the device.  The Electreat Company was subsequently forced to limit its claims to pain relief alone.

Betrayal is the number one deal breaker, it is one of the most devastating experiences a person will ever endure. It is more than a psychologically damaging event, it is a physical insult to the deep limbic system. Betrayal inflicts wounds to our senses which are played out by the body's chemical response network. Neurotransmitters fall out of balance. Brain chemistry churns out feelings so painful, so devastating, it often seems as if we cannot possibly survive into a new moment because the one we are living in is so hurtful, so filled with suffering, we are too stuck to imagine a new door will ever open. I am dealing with this in my life today. I will have to deal with it for many tomorrows that come, because the injury caused by this kind of event requires an entire overhaul of ones personal life, including plans, dreams,hopes, goals, beliefs, trusts, reality. I will ache and I will heal. I will pause to learn, and I will move forward. I've endured similar pain before, yet never this much betrayal. But I will be okay.

Have you ever received messages, which were always delivered to you in a similar way, and which you were certain came from a person once in your family, who was now deceased? I have. In particular, I have received such messages from my brother approximately half a dozen times since he died. How do they begin? Always exactly the same way. I will be listening to a radio, usually in my car, and I hear a specific song twice in a row. When that happens my mind kicks in to high alert. I pay attention to every one and every thing around me. And I clear my mind of whatever I have been thinking, and I allow myself to be as open and receptive to what ever it is I need to discover or learn about. These occasions have always, one hundred percent of the time, proved pivotal in my life. Something always happens which is life changing. And when I say life changing, I mean just that. Old doors close, new doors open, insights sit on my porch, and I find myself on the path of new transformations. Such an event recently happened to me. I was driving through the nearby town of Belen, that song played, then when it finished, I changed the channel, and it played all over again. As in the past, I let the day play out, and I followed my senses. Today I am transforming pain into happiness. And without pain, there would be no happiness. Life is wonderful, but so is the ability to remain in communication with those who have left us. They do speak to us, I believe this with all my spirit and soul. If experience is proof, I do have proof. And when our departed loved ones find it important enough to speak to us, we are wise to pay attention and learn.