How Does Self Image Affect Your Pain?

How Does Self Image Affect Your Pain?

An excerpt from my book as seen over at InnerSelf Publications website.

Timely for the season of self reflection and internal work.

 “by Ya-Ling Liou, D.C. If you’ve only ever seen yourself as unsure and perhaps your self-esteem is not strong, you may be more vulnerable to becoming overwhelmed by fear—stressed by the worry that your pain might devolve into a worst case scenario of unknown proportions.”





Taking My Own “Medicine”

Taking My Own “Medicine”

Dobbins'_medicated_toilet_soap,_advertising,_1869When you’re a chiropractor, what does it mean to “take your own medicine” ?

“Walking my own talk” consists of more than just making sure I receive chiropractic care myself.  It’s about seeking balance in all areas of health.  With balance in sight, the need for professional treatment decreases.

My motivation is maybe a bit more intensely fueled than for most people because my body is my essential work tool.  If mechanical, biochemical or emotional balance is off, it directly affects the ability to fulfill my commitment to patients which in turn could potentially risk my livelihood.  This is an intense interdependence that I would never trade for anything but it can be more than stressful to be even just a little bit laid-up.

In last week’s post I alluded to a recently renewed return to health by restoring balance to my own life, after a year of pushing to get my book out, followed by the release and adventures in promotion.

Block Quote 4I cannot emphasize enough how much this pursuit of balance can differ from person to person.  I am taking a moment to briefly outline what this looked like for me at this particular juncture, to give you a very general idea of the factors to consider when thinking about your own balance in wellness.  In particular I want to illustrate some of the principles outlined in my book (Every Body’s Guide to Everyday Pain, Volume One – Put Out the Fire). Don’t wait until you’re in pain to find your true healthy balance. The everyday variety of pain is always a sign that something has fallen by the wayside in one of the three main categories (mechanical, biochemical or emotional) but things can be “off” long before pain strikes.

In my case, this time I needed first to focus on returning to a more regimented sleep/wake schedule.  I’ve learned that my body and mind operate optimally with 6,1/2 – 7 hours of sleep per night and this means I need to exercise a little discipline about getting to bed on time because I am not willing to get up late.  The morning hours are treasured time and important to my emotional well-being.  I’m very lucky to have good sleep hygiene and my body cooperates well when put to bed.  For times when that’s not the case (as everything ebbs and flows), I reach for homeopathic remedies, herbal teas or magnesium to calm the nervous system before bed.  A controversial trick that isn’t advisable for everyone but that works well for me, is to have a small bite to eat before bedtime as well.

Test tubes science backgroundRe-balancing my biochemistry is something that I dedicated the better part of two consecutive months to. Resetting my organ systems and aiding the natural detoxification, involved some herbal and food therapy.  I returned to eating simply by avoiding my known sensitivities: dairy, all animal protein, simple starches (sugar), nightshades and a few other specifics that I’ve come to recognize over the years as taxing to my system.  I’ve since then slowly returned to more variety based on what my appetite dictates.

Block Quote 2Some signs that will tell you about your sensitivities can be as subtle as an increase in heart rate within 1/2 hour of eating. Sometimes it’s just a little tickle in the back of the throat that passes quickly but is still a significant sign of intolerance.  Other times it can be a generalized increase in mucous production and that might be harder to spot.  The need to clear your throat or blow your nose in the morning might be signs of excess mucous production in response to a food trigger from the day before.  The point is that foods (sometimes very delicious food), not overtly considered as “allergenic” like peanuts, can still be considered by your body as a burden for your biochemistry.  So, it’s always important to pay attention to subtle reactions.

When I commit to helping my body unload excess waste, I also utilize dry sauna sweats, infrared if possible and pay extra attention to optimizing kidney and bowel function.  This makes a big difference in the associated discomfort of “detox”-related headaches and body aches that can happen when large amounts of waste are mobilized throughout the body for elimination.

My herbal and nutrient based regimen was also targeted, in part to facilitate elimination via the kidneys, liver and colon.  There are many different philosophies on which herbs are most appropriate and this is something that is best done with the advice of a natural health care doctor.  Focusing on aiding natural elimination is the best way to help decrease your body’s chemical burden from exposure to complex molecules in our air, food and water.

Balancing RocksFor me, restoring mechanical balance can’t happen without first adequate rest and attention to nutrition.  After re-setting sleep and nutrition I found my energy returning and started to increase activity based on that, but not until then.  If fuel or rest and recovery are lacking, then the exercise output ends up adding stress to the system instead of strengthening it.  This is why sleep and nutrient intake is first priority. It sets the stage for successful return to exercise.  Without this in place, workouts are pointless and counterproductive, potentially resulting in inflammation-causing stress.

Block Quote 3What my body and mind are willing and able to do changes with the seasons, years and stages in life.  This Spring, yoga was the doorway back to physical empowerment.  It helped me begin to feel able to return to swimming and weightlifting.  Now, my routine includes one yoga class per week and two other days of gym workouts which consist of a warm-up swim followed by an upper body or lower body weight resistance workout.  That’s three days a week of 1-2 hours of exercise. They are strategically spaced from my days with patients so that I am not too sore to be effective in the office, but also to avoid muscle fatigue related injuries.

There’s nothing rigorous about this current exercise schedule which is what makes it completely sustainable.  When starting a new routine, being consistent is more important than making a huge impact.  Come wintertime, it’s possible that my needs will change and I will change my exercise accordingly.  Perhaps in a future post I will take some time to address the how of tuning in to your own changing needs from season to season or depending on life and work situations.  It’s mostly a lifelong process of trial and error.

It can be tricky to walk the fine line between the intended exertion of exercise and inescapable demands of work life. But as you slowly increase physical activity, what always holds true is that you increase your body’s capacity for emotional, chemical and physical stress to keep from rebounding into exhausted inactivity.  It must be done in a loving way. Self-care routines are best implemented with gentle caring instead of harsh reprimands.  If you’re someone who thrives on hard line tactics for motivation – find a trainer or someone outside of yourself to play that role.

Even though it’s not an easy daily practice for many, being loving and yes even permissive with yourself makes room for healthy choices.  Remember real health can and does exist in imperfect bodies everywhere.  It’s about balance, not perfection.

Block Quote 1Lastly, you should know that it takes at least two full months – often three months – of consistent activity in order to surpass the “transition reaction” of new exercise.  When introducing a change in routine or physical demands, the brain and body will express themselves by exhibiting physical sensations that aren’t always 100% comfortable.

Sometimes the transition to a better balance in life includes re-visiting old pain that might feel like re-injury as we work to strengthen around these old vulnerabilities.  This is why it’s important to line up some outside help during these transitions either via massage, acupuncture, or chiropractic.  It’s the time when I see the greatest need for support in my patients.

Food for thought while you consider your own healthy balancing act: When we act in reaction or opposition to an idea or a feeling, we set the stage for inevitable failure. When we act out of caring and acceptance for the imperfection that is, we make good and sustainable choices.

Image Credits: Wikimedia Commons, Fotolia

















Your Effort IS the Accomplishment

VrksasanaOccasionally before a patient can be fully pain free I find myself teaching them one or two key “proprioceptive rehabilitation” activities.  These are home exercises designed to help them restore proper body function, so it’s not about strength or speed at this stage.  The intention is to re-train the brain and body for better collaboration between the two. Proprioceptive retraining leads to more efficient and safer motion. It’s an important part of injury rehabilitation because of how it will buffer against future re-injury, by breaking patterns and learning new ones or re-learning old ones.

Often these types of exercises are very subtle activities that some people might not even think of as exercise. They tend to involve coordination and balance of some sort.   Sometimes for example, it involves making a small circle with the leg in a specific position.  The interesting thing is that very often no matter how hard we try, the desired outcome of an actual smooth circular motion is not possible.  But exactly therein lies the benefit!

Proprioceptive retraining demands that we set goals that will never be fully realized. You see, it’s the action itself that triggers the desired neurological re-organization.  Striving to reach that ideal mythical outcome is exactly what provides the appropriate “re-education” of the structures in question.  How these structures re-configure their dialogue with the brain is where the true benefit lies.  Refining the call and response-like relationship between body and brain is not an activity that can have an endpoint.  These relationships are constantly changing and adapting for variations in body, circumstance and environment all of which are ever changing of course.

My instructions to patients generally goes something like this:

“Notice that your leg is not actually making a smooth round shape but don’t worry about it.  That’s not the point.  It’s by you trying to get your leg to move in that smooth circle which will make you start using muscles that you normally don’t or have forgotten how to.”

So your success is not in making a smooth circle, because you probably never will. You succeed simply by trying to make that smooth circle.

Don’t Succeed. Strive

Buddhist_monk_meditationWhat occurred to me this week is what a fitting metaphor this is for how effort – not unlike the therapeutic effort of a proprioceptive rehabilitation exercise – is what deeply matters most in just about every aspect of life.  Effort is what creates change and drives life.

One day this week during yoga class I found myself in Eagle pose with both arms and legs wrapped and on one foot – balancing, wobbling, focusing and sweating when it occurred to me that the entire practice of yoga is exactly like that proprioceptive retraining: effort is the goal. We’re all striving for what we think that yoga pose or sequence should look like or feel like yet none of us are actually there.  The whole hour of class time is about trying to get there – wherever “there” is for each of us.  It’s easy and natural to get lost in the externals and become disappointed or frustrated by not attaining, measuring up or “succeeding”.

This further brought to mind a parallel in human relationship. We strive to be known and to know, to be seen and to see, to be heard and to hear and yet none of us can truly do that for another human being.  We think we can and we hope others will and so we do often spend a lifetime making the effort – we try. And we hope that others make the effort for us.  I propose that it is inside these efforts of others where we feel the closest to being seen and heard and loved.  Making that effort for another is the closest we can come to doing that in return. Our effort at love does not bring us the desired ultimate outcome.  No one can truly know another human the way that person may crave to be known.  We can only see and understand from the context of our own experiences and so we make assumptions about how others are either like us or different from us and we try to listen with the template of our own lives guiding the way, doing the best we can at making sense of it all.

Learning how to try for love and how to welcome someone else’s effort at loving us, is the closest we come to the fantasy of truly knowing others and being known and seen for who we are.

In our effort lies success.

Meditation_Harmony_Peace_CrystalWhile our limbs are clumsily making the effort to trace smooth circles our brain is remembering muscles we’d forgotten.

While we make the effort to breathe while faltering and sweating in our yoga poses, our minds reach for that smooth circle and are reminded to let it go.

While our hearts are trying hard to make that smooth circle for love and acceptance, we are actually learning to love deeply and in ways we would never have been able to without the giving and receiving of  effort… and yet that smooth circle will still always be just ever so slightly out of reach…

(Don’t!) Watch Where You’re Walking!

caida resbaladaAs toddlers we’ve probably all heard “Watch were you’re walking!”.  But as adults this can be a very dangerous thing to do and here’s why.

First of all falling as a grownup is extremely weird and a much bigger deal than all those times we landed on our butts and tumbled around as kids.  Luckily falling is quite rare as we get older but when it does happen it can be very jarring and disorienting (if we’re sober).  Other than feeling embarrassed, we’re just not as good at it anymore as we used to be.  The ground is much farther away and we don’t bounce nearly as well now.

It’s bad enough that falling down as grownups is so weird but the older we get, the more emotionally vulnerable a fall can make us feel.  There’s something that happens for older adults as we get farther into our second half of life.  Falling now becomes high stakes – a threat to our freedom.  Locomotion is the single most important thing for the human body and as we age that becomes wildly apparent.  Studies show that there is an extremely strong correlation between ambulation (being able to walk around) and the survival rates through illness and old age.

With this all looming.  A mere stumble up some stairs or stubbing a foot on an uneven part of the sidewalk, can really throw someone’s psyche for a loop.  It’s only natural after something like that to start to become concerned about sureness of footing.  The next most natural thing is to start becoming more likely to look down at your feet when you’re walking or stepping, to make sure you don’t have another fall.

Well, watching your feet by looking down at them while you’re moving is guaranteed to cause you to fall again.  The habit of watching your feet is disabling your brain.  The part of your brain responsible for predicting where your body is in space and where it is going, depends on you to look in the direction of the horizon or at least several steps ahead of your feet while moving.  If we look down and watch our feet as we walk, we’re actually turning off the part of the brain that handles this sense of where we are in space – our ability to balance upright against gravity at all moments depends on the system of proprioception inside the brain and spinal cord.  You do not want this part of your brain to get lazy! Again the saying: “Use it or lose it!” applies all too well.

If you’re an older adult and you’ve had some falls and you’re worried about your sureness of step, it’s more important than ever for you to NOT watch where you’re walking – at least not directly by looking down at your feet.

Have you had falls that make you feel insecure? Share your story in the comments section.



Journal of Intellectual Disability Research.Volume 32, Issue 3, pages 203–213, June 1988,Prediction of mortality in community and institutional setting, R. K. EYMAN1,*, S. A. BORTHWICK-DUFFY1,T. L. CALL1 andJ. F. WHITE2

I Do Hot Yoga and Love It. I Do NOT Recommend It. 3 Reasons Why:

sweaty face w smileThe hot yoga I do is not Bikram.  It’s an offshoot and it’s offered in a room heated with infrared heat.  This is a large part of why I decided to try it.  Infrared heat has detoxifying effects on the body that surpass any other form of heat.  My logic went something like this: It doesn’t even matter if I do any of the poses – I’ll be getting a health benefit simply by being in the room.  It worked.  It got me in the door to try something new.

I have come to enjoy these classes very much and every class I go to reinforces for me why I will never recommend hot yoga to any of my patients:

1. There is very little attention to form.

What mention there is on occasion is often misguided.  Many of the instructors are young and likely unfamiliar with injured and aging bodies. I spend much of my time focusing on pulling back – keeping my movements small and calculated and often doing something different from the rest of the class – something that I know is mechanically more sound for my body.

2. The heat is extremely seductive

It takes a very self aware person with much experience with biomechanics to know where the limits are to keep from pushing too far into the postures.  Not only does the body become more pliable but there is less feedback from the warmed muscles and tendons about what is truly safe.

3. Heat tolerance is simply very individual

Even people who like to be warm don’t necessarily take well to increasing their heart rate in 105 deg. Farenheit.  I am a good sweater.  The moisture on every inch of my skin helps keep me cool during these workouts.  Many people don’t have the same capacity for sweat over every inch of their body and people with that sort of constitution risk over heating.

I will continue to go to hot yoga when I can – it amounts to one day a week, two days at the most, and that’s interspersed with the mainstay of walks with my dog and visits to the gym where there’s swimming and resistance training…and only when the weather is perfect there’s a bicycle and a promise of wind on my face that calls my name.

For me it will always be about balance – whether that’s a one legged pose or juggling sufficient sleep with adequate nutrients with demands of life and the expectations or compassion we extend ourselves.


Yoga: The View From Inside

DSC03011The other morning I forgot to put in my contact lenses before going to yoga. I go to this hot yoga place where they keep the temperature at 105 deg. I don’t even want to know how hot it gets when the class is full with all those bodies generating even more heat… So, wearing glasses is really not an option for me in this situation because of how dripping wet my face gets about 5 minutes into the class — rendering the bridge of my nose a hostile environment for even my super lightweight titanium frames.

I started learning yoga almost 15 years ago in the traditional and more humanely temperature controlled studios around town. The first thing that struck me and bothered me a bit when I was still new at it, was the lack of mirrors. I was used to looking at myself while exercising which up until that point had usually been in a gym. I had always found it reassuring to check in with my form and was quite attached to that feedback for the sake of symmetry, and safe movement. But, it didn’t take long for me to realize and appreciate what this new absence of my own reflection was gifting me.

I was finding myself uncomfortably forced to appreciate and trust the watchful eyes of yoga instructors who came around to give gentle cues through touch about how to move further into or out of poses. But the other more yoga sutra or philosophical type of teaching that came from learning not to see my reflection, was an inward focus that filled a completely foreign set of senses with awareness, and questioning.

I’m no stranger to looking inward in order to quiet the mind. However, it’s quite another thing to use the mind’s eye for initiating and contemplating physical effort. Turning your “eyes” in to focus on sensation relies on, and therefore develops, confidence that intention is translating into execution effectively. It’s not only a good exercise for the brain by forcing you to access your inherent mechanisms of balance and flow, but it’s a great reminder of how to tap into what that balance and flow feels like on the inside. The sensations are what inform how you move through your day and if you want to do it well, it’s best to tune in regularly about how to let your sensations guide you. As with anything, practice makes perfect or at least leads to improvement and having the opportunity to practice with tuning in to your body from the inside rather than the outside, during yoga class, even just once a week, will make for a more accurate connection with your body — what you intend to do with it and how it actually performs.

The hot yoga world breaks this rule a little bit. The studio I’ve been frequenting has two walls of mirrors. I have to admit despite my previous enlightenment about tuning in and gazing inward during practice, I’ve been enjoying the external feedback of that image in the mirror, and that validation for my efforts. It’s very easy to be seduced and distracted by the visual. Even though I tell myself “So what if there are mirrors? I don’t need them.” But I’d be fibbing if I said I didn’t sneak a peek here and there either to smugly congratulate my efforts or remind myself I have a lot of work ahead of me — depending on the state of my self esteem that day.

One idea is that mirrors will help you face the truth about yourself and monitor improvement in order to motivate. Mirrors will help you watch for your mechanics and form. But what we perceive in the mirror is not nearly as accurate and truthful as how it feels inside. One huge problem with our preoccupation by the appearance of poses is that it can be extremely deceiving. What we think looks “beautiful” and “correct” for one body can be mechanically completely unsound for another. The only way to avert this pitfall is to look inside, listen and tune in.

Not wearing my contact lenses that day and not being able to keep my glasses on my face forced me back into that brief discomfort. Practicing without being able to see myself once again forced me to let go of my distraction with the externals and served as a rich reminder that the most truthful feedback about performance whether it’s physical, occupational, or in relationship, is how it feels.


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