Monday, March 4, 2019

A Change of Name…

I am happy to announce that my groups for people living with chronic pain, anxiety, depression, and chronic illness have a new name: 

Stop Your Pain! Groups: Learn Powerful Tools that Work

These groups were formerly called “A Change of Mind: Neuroplastic Tools for Healing,” to highlight the importance of using neuroplasticity (the way the brain changes itself) to decrease symptoms. The impetus for the name change is to make it easier for people living with physical and emotional pain to find us. We all want to stop our pain, we all want to feel powerful again, and above all we want it to work.  

Changing the name of the groups reminds me that the nature of life is change, that change is inevitable, that change is the most constant experience that we all share. The brain itself changes constantly throughout our entire lives, and does so according to specific principles of how that change occurs. The neuroplastic method taught in the groups helps us to direct the change we want to see in our own brains: a decrease in our symptoms.

See these other blog articles to find out more about the neuroplastic method:

New sessions start soon — register here:

Online group:
Wednesdays 3:30–5:30 p.m. Pacific Time 

In-person groups:
Mondays 6:00–8:00 p.m. Pacific Time
Tuesdays 11:00 a.m.–1:00 p.m. Pacific Time

Saturday, January 5, 2019

A New Year: Reflection

2018 out, 2019 in illustration of Dr. Rosenman's blog related to reducing pain, reducing anxiety
Illustration by Mohamed Hassan
Reflection, looking inside ourselves to find a clear image, gives us the information that we need to decide where we want to go from here. It is the necessary prequel to making conscious choices about the next part of our lives and involves noticing who we are in the present moment. Reflection is often associated with particular calendar events, which can include a birthday, a religious or secular holiday, other events with individual meaning, and January 1.
Runner representing New Year's resolutions -- Danielle Rosenman, MD Neuroplasticity blog
Illustration by intographics
The new year has arrived, and there is a tradition at this time of making a set of personal “New Year’s resolutions.” These resolutions are promises that we make to ourselves, often about changes that we want to make related to our own habits. Two of the most common resolutions are to “eat healthier” and “get more exercise.” A large percentage of these promises are broken before the end of January, however if we choose simple goals, create action plans, take small steps, tolerate some inconsistency, and stay positive, we can feel good about our progress.
While reflection is the first necessary step into the possibility of change, it is the next steps that can help us most in choosing and creating what we want for ourselves. It begins with deciding on goals. It can be as simple as deciding on one goal for the immediate future. It can be as complex as creating a list of short term, intermediate term, and long-term goals. The first part of choosing goals is to give ourselves enough time and space to think carefully about what is most important to us at this time. Be sure to write down and save these goals in whatever format works for you. Possibilities include keeping a list in a notebook, on paper or 3 x 5 cards in a folder, on an app or your calendar on your phone or computer, or posted where you can see it.
While some think of long lists of goals to accomplish, in making an action plan it is important to decide on individual small steps toward each goal to avoid becoming overwhelmed. If you have 10 goals, it may work best to prioritize them and start with one step toward one goal. Each step should be small enough that it seems almost “too easy.” If you have not been exercising and want to begin, start walking a distance that is very easy at least three times a week. Slowly and gradually, the distance and frequency can be increased. Support this process by noticing and appreciating each step (and yourself!), no matter how small.
The most important personal qualities to cultivate while making change in support of goals are self-compassion, the ability to notice and release self-judgment, and positive outlook. When we are judgmental and have negative feelings about ourselves, it is harder to sustain the desire for change, and we are more likely to give up and fail to accomplish our goals. We are most able to create change and accomplish goals when we maintain self-kindness and focus on the positive.
Brain word cloud representing meditating and applying neuroplastic methods to change our feelings
Illustration by John Hain
In order to engage in this process of reflection, notice our current state, and choose a path to the future we want to see, we must feel that we have personal power and the ability to go through this process. Living with symptoms of chronic pain, anxiety, depression, chronic illness, and other conditions can lead to feeling powerless. It may be hard to imagine having enough energy to consider taking steps to have a better life. Here too, it works best to focus on one step at a time: learning to cultivate a sense of personal power. The first step is noticing the feeling of being powerless and interrupting that feeling, the same way we interrupt symptoms such as pain or anxiety. The Neuroplastic Method teaches us to interrupt our symptoms by using a Tool every time we notice them. One example uses words and language as a neuroplastic tool. We start by noticing the desire to change something in our lives, and the feeling of being too overwhelmed to even think about it. The minute we notice this feeling, we “catch it in the act” and say out loud “this is a feeling of being powerless and it’s NOT TRUE! I can take one small step at a time and eventually change will come.”
In this way we can recapture a sense of personal power and ability that will allow us to take steps toward achieving our goals.

Tuesday, August 21, 2018

Training the Puppy in Your Brain: “Catch It in the Act”

The brain changes itself constantly throughout our entire lives. All of our experience changes the brain. Symptoms such as pain, discomforts of illness, anxiety, and depression also change the brain — because they are part of our experience. The brain “learns” those symptoms, and builds them into pathways that stay in the brain. These pathways become stronger and stronger with repetition.

How can we “unlearn” symptoms? I remember learning trigonometry in high school, and then never used it again. Eventually, I forgot how to do it — I “unlearned” trigonometry.

If we want to “unlearn” pain, we have to stop “using” it. To understand how, it helps to know something about dog training.

How is the brain like a puppy dog?

If you’ve ever trained a dog, you know that it takes a lot of time, patience, and repetition.
The trainer also needs to have three very important qualities:
  • Stay positive
  • Be consistent
  • Always “catch it in the act”

Puppy on floor, looking up with sad eyes, symbolizing the brain's bad habits before being retrained with neuroplasticity
When I walk in the house and see my dog with her nose in the garbage, I want to interrupt that behavior as fast as I can (in a neutral way) and then immediately get my dog to demonstrate a positive behavior so I can praise her: “good dog!” It looks like this:
    • Stop! (Catch it in the act)
    • Come, sit! (Be consistent)
    • Good dog! (Stay positive)
    On the other hand, if I come home and see garbage on the kitchen floor, with the dog happily lying on her bed in the other room, I’ve lost my opportunity for training. If I call her into the room and show her the garbage, she doesn’t understand. There is no perceived connection between the garbage and her doggy brain. That is why I have to “catch her in the act”!

    Similarly, if I want to extinguish a symptom (remember that symptoms are reinforced by connections and pathways in the brain) I can “catch it in the act” by
    • immediately noticing that I have pain, or anxiety, or depression (whatever symptom I have) stopping the experience of the symptom right now by taking my attention away from the symptom itself and
    • quickly counter-stimulating the brain using one of many positive attention-grabbing techniques, such as telling my brain to stop! the symptom, and remembering a fun activity, thus
    • helping my brain feel like my dog, “wonderful, good, happy brain!”


    We learn from dog training that when the trainer makes a mistake (gets tired, overworked, doesn’t feel well) and does not immediately stop the unwanted behavior, the training itself will ultimately be more challenging and take longer, leading to more garbage on the floor!

    Training the brain (unlearning symptom-related pathways) requires
    • interrupting the experience of the symptom every time we notice it
    • developing many techniques (tools) — immediate positive and engaging experiences — to counter-stimulate the brain (like singing, looking at photos of vacations, or viewing pet videos!)
    • patience and persistence — changing the brain is a slow process!

    Why is it so important to interrupt the symptom as soon as we notice it?

    The answer has to do with the rules of Neuroplasticity — how it works in the brain:

      Happy dog (chocolate lab Grace) symbolizing a brain retrained with neuroplastic tools to stop repeating pain
    • What is fired is wired (and nerves that fire together wire together): When brain cells (nerves) are activated, cell by cell, it makes a pathway (set of connections between nerves) that stays in the brain. Repetition strengthens the connections/pathways.
    • Nerves that are activated at the same time in the same place make connections and pathways together
    • Use it or lose it: The pathways that have been created in the brain disappear if you don’t keep using them!
    • When you make them you break them; when you break them you make them: In order to make new connections (pathways) in the brain, existing connections are broken; in order to break existing connections (pathways) in the brain, new connections must be made. This way the brain conserves its resources.

    We want the brain’s “use it or lose it” principle to break up connections and pathways that reinforce symptoms of chronic pain/discomfort, anxiety, and depression.
    • The brain will do this only when symptom-related connections and pathways are not being “used.”
    • Therefore, we must interrupt the experience of the symptoms as quickly as possible to stop “using” those pathways.

    The brain keeps changing – we can do it!

    When we consistently interrupt the experience of our symptoms, eventually the brain will decide that the symptom-related pathways are no longer being “used.” That is when the “use it or lose it” principle will be activated. Pathways associated with pain, anxiety, depression, and other symptoms will be broken up to help the brain make new positive connections and pathways. As pathways are broken up, symptoms reduce more and more. I’ve been using this practice for almost six years, and experience vastly reduced pain and greatly expanded energy and abilities. The puppy dog in my brain is as happy and well-trained as my wonderful dog Grace.

    Learn how to do it for yourself in my group:
    A Change of Mind: Neuroplastic Tools for Healing

    Monday evenings 6:00–8:00 p.m.
    Starts October 8, 2018
    Tuesday mornings 11 a.m.–1:00 p.m.
    Starts October 9, 2018

    Wednesdays 3:30–5:30 p.m. PDT
    Starts October 17, 2018

    For information and to apply, please see:  
    Individual Appointments Available

    Wednesday, January 10, 2018

    How an Online Group Can Help You

    I’ve lived with chronic pain myself for 28 years, and for the last 5 years, since I’ve been practicing the neuroplastic method, it’s gotten better and better – and I’m able to be active from morning until night!

    You may have looked at my website, thought about your symptoms, and wished that you lived in the San Francisco Bay Area, where my Medical Counseling practice is located. Or perhaps you live with chronic pain and read Norman Doidge’s book, The Brain’s Way of Healing, and wanted to learn the neuroplastic method developed by Drs. Moskowitz and Golden — but you live in the Midwest, or the East Coast, or the South, or Canada. Maybe you have a friend who was in one of my groups, “A Change of Mind: Neuroplastic Tools for Healing,” and who already has less anxiety, more energy, or less pain, but it’s simply too far for you to drive to Berkeley.

    If so, you are the person who inspired me to take my group to the Internet. My first online session of “A Change of Mind: Neuroplastic Tools for Healing” was held in autumn 2017, with participants from many different places. Using Zoom videoconferencing technology, and with the help of “Steve the Tech Guy,” every participant was able to connect with me and with each other, support and be supported, and learn about the brain, neuroplasticity, the neuroplastic method I adapted from Drs. Moskowitz and Golden, as well as many techniques, all of which help us (yes, me too!) change brain pathways associated with symptoms of chronic pain, anxiety, depression, negative/unhelpful thought patterns, and symptoms of chronic illness. By doing so, over time, we begin to rewire our own brains so our symptoms can gradually be reduced, and some can even be eliminated.
    The new online session of “A Change of Mind: Neuroplastic Tools for Healing” will begin February 7, 2018 — Wednesdays 3:30 to 5:30 PM PST
    There will be eight meetings of two hours each. It’s easy to use the technology, and the Tech Guy will be there each time to help anyone as needed. You can be in your own home, in any position that’s comfortable, and you have a choice each time of being seen by video or simply heard by audio (you can participate even if it’s a “bad hair day!”).

    The cost is $500, and if you are experiencing financial limitations, there is a sliding scale available. I want you to feel better!

    A few representative comments from both online and in-person group participants:

    • This group was a great way to connect with others facing health challenges and to learn to use tools to improve symptoms. Overall, a high-quality group!
    • Being in a group of people who understand pain is a huge thing.
    • This group was very helpful to me as I struggled with illness.
    • Being part of an online community for 8 weeks, especially the check-in at the beginning, helped with motivation.
    • I use many of the tools to help me deal with symptoms and anxiety.
    • I am more cheerful and happier.
    • Wonderful. Inspiring and encouraging. Way more positivity with purposeful upbeat thoughts. Mood better. More hope.
    • Using these principles (MIRROR) to apply to other important life issues beside pain is also very life-changing; it opens to moving in another direction.
    • I have less pain already – a real breakthrough after 30 years of chronic back pain. It’s uneven, but to move and not have pain is amazing!
    • The facilitator is excellent – I don’t know where else I would get this process from someone who could present it so well for non-medical people.

    In addition to the online group, I have two in-person groups starting in early February. More information and sign-up form are on my website’s Change of Mind Groups page.

    Thursday, September 28, 2017

    Why Doesn't my Pain, Anxiety, Depression GO AWAY?

    We ask these questions again and again: Why doesn't my pain go away? Why do I still feel so much anxiety? Why can't I pull myself out of the dumps? How can I ever get better?

    Too often, our doctors and other health providers assume that chronic symptoms of pain, anxiety, depression, and illness are here to stay. We are told, “you just have to live with it.” Or “I’ve tried everything.” Or even, “there’s nothing I can do for you.” At best, we are prescribed medications that may give only partial relief, along with side effects, and are referred to programs, classes, or groups that help us “manage” our pain or other symptoms.

    The answers to these questions can actually be found by understanding the brain and how it changes. We used to think that after a certain age the brain never changes. We now know that the brain actually changes throughout our entire lives — until we take our last breath. The brain changes from every bit of experience we have, and it changes the most when we have repeated experiences.

    When we have persistent symptoms such as pain, anxiety, depression, and symptoms of chronic illness, this repeated experience creates changes in the brain that actually tend to perpetuate the symptoms themselves. Regardless of the original “cause,” which may have been healed or resolved, the brain itself now keeps us experiencing these symptoms.

    Once we understand how our persistent symptoms are related to the way the brain changes itself, we can learn how to induce changes in the brain that can eventually help us feel better. Because this understanding is based on relatively recent brain science, most doctors and health providers don’t know about it yet.

    Dr. Michael Moskowitz and Dr. Marla Golden are two pain specialists who developed a neuroplastic method, based on how the brain changes itself, that can change brain pathways and decrease or even eliminate symptoms of persistent pain. I have found that this method can be adapted to reduce other symptoms, such as anxiety, depression, and symptoms of chronic illness. This work is revolutionary in that it is about reducing or eliminating symptoms, rather than merely “managing” them.

    I have been using this method myself for my long-term chronic pain for more than five years, and have been teaching it to individuals and in my support and educational groups, A Change of Mind: Neuroplastic Tools for Healing, along with many techniques, or “tools,” that are important in changing the brain.

    What is my own experience? Life-changing! I feel unbelievably better. I keep doing more and more activities I hadn’t been able to do for years. I have energy all day long. When I have pain, it’s mild, temporary, and inconsequential to me.

    It’s important to understand that it takes time to change the brain. We need to persist in noticing every symptom in order to counteract it by creating new experiences in the brain. Each of us has had many experiences of learning something new that takes a long time to master. We can be experts at patiently practicing what we need to do in order to change our brains and change our lives.

    New sessions of the support and educational group A Change of Mind: Neuroplastic Tools for Healing are beginning in October 2017. Each group meets eight times, for two hours each.

    Group A – Monday evenings 6–8 p.m., starting October 2, 2017
    Group B – Tuesday mornings 11 a.m.–1 p.m., starting October 3, 2017

    Online Group – Sunday afternoons 4–6 p.m., Starting October 1, 2017

    For information and to apply, please see: 

    Contact me — I'd love to hear from you! 

    Danielle Rosenman