 Welcome to coronavirus in our mental health. Today is November 9th, 2022. And I'm Ken Burtness, coming to you from Haleva on the North Shore. Got a good program for you today. The joy of relief from pain, which I'm sure you'll enjoy, because if you're like me, you've got little parts of pain all with you all the time, not to mention the pain of what's going on in the world. So we'll have a good time talking about that. I'm with my good friend, Daniel Lev, and I'll introduce him later. But first, I want to do a coronavirus update to bring everybody up to date. As far as Hawaii goes, we're looking better. We're continuing to go down. We only had an average of 142 cases, new cases, every day this week. Now, that's down from 188 two weeks ago in the last program. So we're getting there. We're not to our bottom yet, but we're getting there and we're doing well. The big problem and the bad news is that we've got the holidays coming up. And the holidays are dangerous with a capital D. And let me review that for you. Let's go back to the beginning of the pandemic. Let's go back to November of 2020 and look at the national statistics. In November of 2020, we saw our new cases every day nationwide start to rise. It was getting up to 100,000 new cases per day in America. Now, that was the beginning of the holiday season. When we reached the end of the holiday season, after Thanksgiving, Christmas, and New Years, and all the other holidays, we were up to 250,000 new cases a day. Now, go ahead a year. Let's go to November of 2021. Again, we start rising up in early November. We're rising up to 90,000 cases, 100,000 cases again. But by the time January of 2022 rolls around, we're at 800,000 new cases per day in this country. It was astounding. Now, we're at November of 2022, looking at the holidays that will run through January 2023. So how are we going to deal with this? Well, there's difficulty. Yes, the numbers are going down. We're looking better. People are feeling more comfortable. But our safeguards are disappearing. Mask requirements are practically non-existent. We're gathering in groups. Everybody feels comfortable. Feels like we've beaten the coronavirus. But we haven't. It's still here, and new cases are coming up every day. And if this increases like it did the first two years, we're going to be looking at a big spike at the end of the holidays in early January, just like the first two years. So we have to be real careful. Now, the only thing that we really have got going for us right now is vaccinations, since our other safeguards are sort of down. Vaccinations in Hawaii are going well. We've got 82% of the people in Hawaii vaccinated, which is one of the best among all the states. So, yeah, give yourself a pat on the back. But, and here's the big but, we've only had 47% of people in Hawaii who have had a booster shot. And even less who had that second booster shot, which is a bivariant booster shot, which really deals with what we're really most concerned about nowadays is the Omicron variants, B5 and B4. So if you take away anything from this program, please take away the fact that get vaccinated, be safe. We don't want to be on that bad end of a big surge from January 2023. Now, one of the big problems we face that I've mentioned this before with coronavirus is the fact that coronavirus so dominated us from the beginning that it was very hard to concentrate on anything else. So if you had a problem, an existing problem, or a problem that comes up that wasn't coronavirus, you found it difficult to get to the hospitals because they were full and they were getting short-staffed because everybody was dealing with coronavirus. So it was a very difficult time. So people just stayed home. They didn't get help for these other problems, including pain that they were in. Now that's where our guest, my good friend Daniel Lev, the great psychologist who's into pain relief, that is his specialty. And I want to welcome him to this show to talk about this topic. Welcome, Daniel. Hey there, good to see you, Ken. Now Daniel's got a new book out. It's on pain relief. And he's going to talk to us about that. So where should we start, Daniel? Where would you like to start? I guess, let's start here. Just let me give you this cue. This is the thing that Daniel really emphasized to me when we were talking about. It was the fact that most people who are dealing with pain relief focus on pain. They focus on what it is, where it is, where it's coming from, what we can do about it, how we can fix it. Daniel's focus, wonderful focus, I think, is on comfort. So maybe we should start there, Daniel. Yeah, absolutely. And it might seem a little bit like quibbling about language, pain relief. Who doesn't want pain relief? I mean, it's true. But I've found that if you focus on the pain, even trying to do things about it, too often it gets larger. And that's because of the way, especially chronic pain works. It's not about the injury as much as it is about the nervous system. So the nervous system has learned to become sensitized to pain. And a lot of that comes from our naturally focusing on it. So if we can reduce the focus on it, not, you know, we can't say, oh, it's not there. Obviously it's there. It's very loud. It's very annoying. But if we can do something else while the pain is there, that might help us calm the nervous system. Then people who do that find that they feel more comfortable. So I call that comfort. So it's essentially instead of focusing on pain, you focus on comfort. And that is, the way I define it is a feeling of confidence, relative calm, positivity, things of that sort. It almost sounds impossible like I'm saying it because people who are in pain is like, what are you talking about? But I've seen it again and again, 25 years of doing this with people. Kaiser Hospital pain programs and other pain programs and my practice here in Oahu that people, as they start to allow the pain to be there, but do things to increase their comfort. And that's what the book's about. Numbers of skills you can use to increase the comfort that helps. One last thing on this is that often people in pain get overly dependent on doctors because where do we go? We go to the doctor because it's a medical problem. But when it comes to chronic conditions too often, once it's established what it is, they can't do very much. And people feel like, oh my God, and some doctors even say, I'm sorry, can't do anything, you have to live with it. And most people in pain, here's that is, you're doomed. But you're not because they're wrong. You have one more option that option is you. And using the right kinds of skills, along with whatever medical treatment's helpful, you can get more comfortable than you are right now. Well, let's talk about those skills. Now, your book starts off, well, even B-Port starts off, on the cover we see a set of six comfort skills. And you know, let's start with those. Oh, here's the picture of the book and you can see those comfort skills all starting with the middle of it, which is noticing. So Daniel, maybe you can take us through these skills starting at noticing and run down what people can do to deal with these pain. Absolutely, and just the language I use, these are strategies, like categories, and they each contain a certain number of skills. So I wanted something pretty to kind of display it and here you are. Noticing skills are basically people will get pain flares and it's almost like it comes out of nowhere, they get so upset and get uncomfortable. So noticing is starting to notice positives and negatives. So notice the negatives that are important to see, like triggers or what I call first signs, the first sign in your body or your mind that you're heading for a pain flare, because if you can catch it early, then you can use the other skills that you see around that graphic, the other categories of skills to actually make shifts in your body to get more comfortable around the pain. So people will say either the pain's gone down or they'll say, you know, it's still there, but it doesn't bother me the same way. And that's another sign of being more comfortable around the pain. So noticing is a very important first step. Okay, take us to the second step. Let's talk about the second step. And I think I told you this, made you laugh that there are numbers of skills, this is not a rigid program you may find in certain other kinds of self-help books. There's a short and a long training in here, but even then you can use it any way you want. And same thing with the skills. Some people need certain kinds of skills and they don't need others, okay? So for example, I often go to refocusing skills and that's my name for things like relaxation, meditation, hypnosis, imagery, various things like that. That do affect that high level of stress in the nervous system and calms it down. It's called basically you have a hypersensitivity to the pain in the nervous system. So if you can start shifting your nervous system a little bit, that can help. So the refocusing skills do that. No, you can't meditate the pain away, but if you practice or a good amount of time regularly, you will start to notice some shifts that in time you will start feeling more comfortable. I never claim that this gets rid of all the pain, but what it does do is it increases your comfort level so you can tolerate it much better. So the focusing skills is a good place I start. Then actually it's almost like going around this, but not always the moving skills, that's how you move through certain things like sleep or how you move through activities or planning for pain flares or making goals in your life, which often all these things get disrupted when the pain comes along. You can't sleep as you usually do, you can't do the same activities. And so these kinds of skills help you to engage in these things in ways that can make a big difference. Like sleep is one of those, if you're not getting enough sleep, it affects your sensitivity, your nervous system, you feel more uncomfortable or just, we all feel lousy when we don't get enough sleep, that plus chronic pain is not a great combination. So moving skills are another one of those areas. Enjoying skills is another, but did you wanna break in here for a minute? Well, I was just gonna say, sleeping is one of the big complaints I always hear from patients, I can't sleep. And the typical response for that is to try to force it. You sit there and say, I'm gonna get to sleep, I'm gonna get to sleep, I'm gonna count a thousand sheep, I'm gonna do all this, I'm gonna get this, and the more they try to force sleep, the further it is away from them. And the nice thing about your procedure is that it gets them refocused and not getting hooked on that, I've gotta get to sleep, I've gotta get to sleep, but doing other things so that it takes their mind off of this, terrible fear they have of staying awake and for being in, not functioning the next day. It's a big challenge. Same thing with, I gotta get the pain down, but you try too hard and you just get more stress. So stress and sleep don't work together, but for example, one little technique based on some research is you don't have to always sleep but you do need to rest. And so one very simple thing you can do, which of course takes practice, is if you're not asleep in 20 minutes, you can do what I call rest in bed. Give up sleep that night, don't try to go to sleep, but instead rest. That means to get your body in as comfortable position as you can and use one of the refocusing skills, follow your breathing, do some, what I call head trips, it's like daydreaming on purpose, go enjoy a little fantasies in your mind or do your best to relax parts of your body all night long. And trust me, you won't get through the whole night because you'll probably fall asleep. But even if you don't, your brain goes into a sleep pattern and you get a lot of the benefits of sleep even though you don't formally go to sleep. You've got to go into a sleeping mode. Yeah, I certainly discovered that when I was studying altered states of consciousness. You know, when you're under hypnosis, when you're in a sleep deprivation tank, for instance, our sensory deprivation tank, you feel so relaxed. And when you finish with that, when you come out, it's like you waking up from a sleep and you just feel the same way, you feel refreshed, you feel energized. And I try to pass that on, but that's a little hard for them to understand until they actually experience it. If they can get to that part like you're taking them so that they actually feel the benefits of just resting. And they're not so obsessed with going to sleep so they can get refreshed. I was talking with one of my clients about this and it's a common pattern. People are so uncomfortable, they want relief as soon as possible. And the challenge is that you take a pill, oh, it helps right away. But then over time, it goes down and you need more of it to make it work better and it still go down. With skills, they move slowly, but the longer you practice them, the stronger they get. So for example, what we've been talking about, the more you consistently practice focusing your attention, it's just three simple things as meditation as one example. You let go and relax and put your body as comfortable as place, let your thoughts come and go as best you can. They'll be buzzing there. Number two, you focus on something. Like let's say you're breathing, going in and out. And number three, every time you get distracted by thoughts or feelings or anything, that's okay, let it go and come right back to focus. You do that over and over, it gets easier to focus. The more you focus, the calmer your nervous system gets and the more comfortable you can get, including comfortable enough to fall asleep. Absolutely. But you won't have immediate results, it takes practice. So there's an old Hebrew word called emuna, means faith. You gotta have a little faith and patience that as you practice the skill and do it consistently, like a lot of the clients I've worked with, they feel better and do better. Absolutely. And we're in a society which instant gratification is sort of the byword. We want things and we want it now and we want it fast and we want it to do exactly what we want it to do. And with most things that's just not possible. And you have to contribute to that, whatever it is that you're striving for, you have to contribute to that and that's hard for people. But I was gonna ask you about the six strategy that you have. I was wondering of the six, is there anyone that you find is helpful to most people? So to your go-to strength and if something's gonna work, maybe this is it for many people. On a certain level, it depends. Everybody's different. Everybody needs something more. Some people need to have more pacing in their life. So how to do activity without getting a pain flare. And there's ways to do that. But I find often the refocusing types of skills where people can do something to calm their nervous system down. Now it doesn't have to be watching your navel or even watching your breath. You could put on a really soothing piece of music and totally focus on that. So those three things I told you about that you do in meditation, the second one focusing on something could be a piece of music and just focus on it as best you can. But when you do that consistently, you build up to at least 20 minutes, at least once or twice a day. Over time, it makes a change. Some people with chronic pain or illness have a lot of anxiety. This helps calm the anxiety. It also strangely helps raise up positive mood in some people who are depressed. Although they may need to do some walking meditation where you just do some kind of physical activity for a period of time that doesn't hurt, doesn't add to the pain, but you focus on the feeling of that movement. Any of these kinds of things can be quite helpful. And another one, of course, is they're enjoying skills, which is do things that are enjoyable. Oh, let's talk about that, because that was one that caught my eye really quickly. I'm into enjoying things and I'm into enjoying life. So tell us a little bit about enjoying strategy. And some of this might sound like, oh, I'm just giving you wonderful, fabulous advice and interesting little sayings, but these all have scientific backing, everything, every skill has been studied and found to be very helpful for people with a lot of different problems. Enjoying skill comes from a field called positive psychology where they studied what makes people happy and how our happy people functioning so well in life. Instead of just studying people that are having a hard time, people that are not having a hard time, they found a number of principles and practices, a simple one, it may sound simple for some people as a challenge, is to start doing some positive activity, some enjoyable activity that fits your body. So you don't wanna go hiking if your body can't handle that, but maybe taking a walk or maybe going to the beach and sitting there and enjoying the scene. Whatever that enjoyable thing is, that can lower the sensitivity and the nervous system that helps you then feel more comfortable around the pain. Some people to the point, everybody's different, but some people to the point that the pain disappears temporarily, that's how they describe it. I'm not into trying to get rid of pain because it focuses people on it, rather doing skills to help them get more comfortable and that often helps people feel much better. Terrific. What about, let's go to the other side. And again, like you're saying, and I think this is really important in every aspect of psychology and that is that everybody who comes to you has a different story, has a different problem and needs a unique response to that and that's something that I firmly believe in. So given the fact that everybody reacts differently, again, sort of looking at all over the umpteen years that you've been doing this, if a patient is gonna have trouble with one of these strategies, find one of these strategies maybe the most difficult. Which one is that likely to be? And whatever that strategy is, how do you help them with that, getting over that difficult hurdle? You know, it's hard to pick one. Now, the relating skills, some people have challenges with either not having people in their lives, good people or people that are really stressing them out, but probably one that comes to mind. And this is the thing about Americans, we're hardworking people. We'll work ourselves to death. That's why unfortunately, it's like stress psychologists like myself will be in business for too long. But people that have a hard time pacing their activity or what I like to call accepting you have a new body. The old body can do the kind of work schedule you did. The new body can't do that. And so some people who do push themselves through work, they come home and they're exhausted and they barely eat and they sleep and the weekends they're just trying to catch up but the quality of life is down. So how can you engage in activity and not overdo? Similarly, people who underdo activity. It creates the same amount of pain in a way because you're just laying around not doing anything, not just physical pain, but emotional pain. You feel terrible. You feel there's no meaning in life. A lot of folks go through that. So helping people figure out how to do activity in a way that fits their body and get back to some of that, that is huge. That is huge. And what do I do is, again, it depends on the person, the person who wants to work hard. I usually say something like this. There are two pains. The pain in your body and the pain of change. And change is kind of a pain. I gotta do things differently, whatever. So the pain in your body is there, it's annoying but maybe it's gonna be annoying to start going on walks. Even two minute walks, which by the way, I recommend a two minute walk, nothing bigger than that to start and see how you can build up. Just using activity is one thing. But I ask them, which is the bigger pain? If the pain in your body is bigger, then you're gonna start going on those walks or whatever the skill is you're gonna use, you're gonna make time in your life and you're gonna start doing it. However, if doing a bunch of skills and things, that's more of a hassle and I'll just deal with the pain. That's fine too. I am not here to tell everybody in pain exactly what they have to do. It's up to what they're up for doing. And some of the clients, we discover they really are fine. We're just dealing with the pain and turns out maybe someone told them to see me, they weren't even coming to see me because they wanted to, that's fine. Go and do your life. And then there are other people who say, no, the pain in my body is bigger. I wanna do something. And it's like this guy, Dan, who I work with, a lovely man in his fifties had five back surgeries. Just all kinds of things happened with him and he was having panic attacks and he started using a meditation and some of the hypnosis that I taught him. And it was like a big turnaround, but he took the time and still takes the time that he calls it dosing. He doses himself with minutes of practicing relaxation and his comfort level goes up and he's doing a lot better. So it just depends on the person. Yeah, and we're coming down to the end of the program, but I wanted to quickly throw in a mental pain that is associated with that overwork. We're in a society that dictates to us that if we're gonna be a good person, a good American or whoever, we do such and such. And if we're really a good person, we work overtime because it's needed. If we're really a good person, we gotta do those repairs on the house that we've been putting aside. And if you don't do those, you're not a good person and you're not taking care of your family and et cetera, et cetera. So guilt is sitting there driving this need to do things constantly and it gets in the way of relaxing because the guilt is always nagging at you saying, you gotta do this, you gotta do this, you know? Well, here's something about relaxing. Relaxing is work. Relaxation is the side effect. When you do some meditation, you're bouncing your attentions all over that you have to keep bringing your mind back, bringing your mind back, bringing your mind back. It's a lot of work. A lot of people don't realize they'll listen to a thought that says, you're just sitting around, but you're doing a lot of work internally. You're right though. People will say, I gotta do the laundry, I gotta do this. They don't give themselves time. And when you're dealing with chronic pain, if you don't give yourself time, you may end up with more flares. And the emotional stress too. That's a good way to put it. Like I said, we're running down a little bit. Let me just turn the last part over to you. And is there anything that you really would like to say to the audience who are sitting here and listening and feeling tense and need to relax and have that pain, either physical or mental or both, which is usually the case. Last but not least, words for them. This is a real challenge, but find somebody like me. Find some person who knows how to work with people in chronic pain. There are something called a chronic pain psychologist. I'm one of them on a walk who here. So finding somebody who knows not just any therapist, they don't all understand how to do this. You can get my book, there's many other books, my book's called, You're Bigger Than the Pain. It's on Amazon, you wanna check it out. When I see my clients, I all give them a copy of the book just because it's the program I do with them. It's the kinds of skills. It's just about the skills we've been talking about today. But seeing somebody doing that or taking some challenge of yourself to get out and start doing a little activity, do something different a little bit and that may start turning things around a little bit. Okay, and certainly using relaxation. Yeah, Daniel, I really appreciate you being here because a lot of people are in pain and it's hard for people to ask for help. And you've given them something to think about and some things that they can take control back and say, I can do something about this pain. And I much appreciate you doing that. I much appreciate you once again being on this program, always wonderful talking to you and thank you. Thank you so much, nice to be here. And thanks to everybody who's watching in. We appreciate the audience. If you have any questions of Daniel or myself about pain, please email us. And you can do that to Think Tech Hawaiian and we'll respond to that. Now, the other thing is I certainly want to thank all the people here at Think Tech Hawaii, Eric and Michael and Haley and Jay and everybody who helps put this together. But most of all, I thank you all for tuning in and listening. Aloha. Thank you so much for watching Think Tech Hawaii. If you like what we do, please like us and click the subscribe button on YouTube and the follow button on Vimeo. You can also follow us on Facebook, Instagram and LinkedIn and donate to us at ThinkTechHawaii.com. Mahalo.