-Right I've referenced a few times how if you're in a mode of perceiving threat, you're not gonna
all of a sudden start slow yogic breathing, unless you want to turn this off. So what I teach first
to every single person who walks in my door is slow your breathing. I teach diaphragmatic
breathing. Every single person that I work with must learn that. I was practicing that
with my daughter before I got up here by the way. The next thing I teach people once they've
practiced diaphragmatic breathing and have it mostly down is a relaxation strategy. Trying to
teach people to go from being like this to being like this. There's a lot of different
techniques for relaxation in psychology. They're all effective, guided muscle, guided
imagery, progressive muscle relaxation, autogenic relaxation. It doesn't matter so much what you do
it matters that you do one of them. Right because you're trying to tell your body there's nothing
to be afraid of here, it's okay. The breath does that very very effectively by the way.
Okay, the next thing I do is I try to teach people to divert their attention away from pain, and away
from avoiding pain. The best way I know how to do that is with mindfulness meditation. People
think, a lot of people think that meditation is relaxation, it's not. Meditation is a practice
of turning your attention to one thing over and over and over again, until you basically develop
a muscle in your mind that allows you to direct your attention where you want it to go. What people
report when they learn mindfulness meditation with pain - I'm separate from my pain. Okay, they
can turn their attention away from - I'm in pain I'm in pain, this is killing me to, I notice a feeling
of pain in my leg I notice a feeling of pain, I am separate from that. It's a really powerful
but subtle shift that happens. Then we have to talk about not avoiding painful activities. This
is always a touchy subject because where I start with is exercise, and most people with chronic pain
are very terrified of exercise for good reason, because it hurts. I also talk with them about
trying to stop guarding the painful area and sort of relax their posture and let that go a little
bit. Try to act in your body as though your body feels normal, instead of your body feeling hurt.
It's a tall order. So we talk a lot about how to resume exercise, and I'm not talking about going
and doing you know an hour of marathon running practice. I'm talking about getting up off the
couch and walking gently for five minutes a day. Something you can accomplish. You'll notice on here
that I skipped emotions. I find that if people manage to develop some skills and mastery over
the physical cognitive and behavioral elements of the sympathetic response, the emotions come
online on their own. Because in parasympathetic mode the emotions that go with that are - a sense
of peacefulness, sense of happiness, sense of thoughts sort of flowing. I can't get someone to
do that that. The emotions basically have to kind of flow from these other changes that people make.
you