What Are You Afraid Of?

Categories: Blog, Fear Avoidance, Vestibular, Nervous System, Pressing RESET Sep 26, 2022

And now, a guest article from OS Professional Dr. Kurt Brooks...

We all have fear of ‘something.’  I’m afraid of spiders! (Yes… they are vile creatures, and they will take your soul if you do not eradicate them as soon as they are spotted… preferably with fire!).  That fear changes what I do and how I do it.  While walking through the woods, I am hyper-vigilant about spider webs.  And if I do walk through a spider web, I will get 30 minutes of cardio squeezed into 60 seconds while I jump and spin and make sure there is no spider on my person trying to suck out my soul.

The science behind Fear Avoidance and its Beliefs and Behaviors has progressed rapidly in the past few years.  So let’s turn my fear into clinical speak.  With the example above, my particular Fear Avoidance Beliefs include the belief that if I see a spider (or God forbid that one is on me!)… It will be aggressive.  It will attack me.  It will kill me and take my soul.  This leads to my associated Fear Avoidance Behaviors… I am hyper-vigilant for spiders.  I will attack them first (violently!!).  I will walk a mile out of the way if I see a spider web before me, but not before hyperventilating, tensing up from head to toe in preparation for battle, and checking to see if one is already on me!

Yes.  It’s silly.  But the fear is real, and I must work on controlling my body’s response. I have to deal with my spider-related Fear Avoidance Beliefs and my Fear Avoidance Behaviors.  I have learned that if I just calm myself down, breathe deep into my belly and relax, I can pick up a stick, knock the spider web down, and move on. And no, I have yet to lose my soul to a spider.

For so many, though, the fear they live with is based on something that has happened to them, such as a physical injury. For example, I once treated a lady who came into the clinic with “low back pain.”  She described having an episode of severe/ debilitating lower back pain while bending forward to lift a box off the floor.  It was the single most painful thing she had ever felt, and now she was afraid of bending forward because she did not want that to happen again.  As she told me this story, she started crying and said she was missing out on her grandchildren’s lives (as she could not get on the ground to play with them or lift them up from the floor and hold them).  

I was beside myself when she told me her injury was 25 years ago. I quickly realized, though, that her fear of pain was just as debilitating as the original injury.  Her Fear Avoidance Belief that if she bent forward or tried to lift anything off the ground, she would re-injure her back had led to her Fear Avoidance Behaviors.  She had avoided bending forward and had avoided lifting anything (groceries, grandchildren, etc.) for decades!  And it was now coming to a head, as she felt she was missing out on her grandchildren’s lives.

We see this often in the gym and in the clinic with people who have hurt their shoulder reaching overhead to get something off a shelf and now avoid reaching overhead because “it’s GOING to hurt.”  Or the person who had knee surgery and has avoided getting on the floor for years because “it’s GOING to hurt.”

How can OS principles help?  We spend a lot of time in OS trying to control our body’s fight or flight response (calming down the sympathetic nervous system through engaging the vestibular system).  We work on diaphragmatic breathing, eye movements, head movements, and rocking/ rolling/ reciprocal movements.  We do this to improve input into the vestibular system so that the parasympathetic system will kick in and decrease the sympathetic system’s dominance (which includes increased muscular tension, altered body mechanics, elevated blood pressure, increased cortisol production, etc.). Or put in layman’s terms: we calm the body’s fight or flight system through movement to help the body relax, feel less pain and move even better.

Using OS principles with the back pain patient above, I started her with diaphragmatic breathing and head nods/ rotations in supine to get her parasympathetics to turn on.  Then we performed the same activities sitting on the edge of the exam table with her feet on the floor.  As she became more comfortable with the position, she slowly slid her hands over her knees and down her shins. As soon as she felt any sort of pain or sympathetic response (like making a fist, clenching her jaw, holding her breath, shaking and quivering in her trunk), she would back away from that position and focus on her diaphragmatic breathing, head nods, etc. to encourage her body to stop engaging the sympathetic nervous system.  

This gradual approach of confronting her fear while keeping her body in a state of relaxation took a while.  It was slow and occasionally took a step backward, but that was needed to keep her fear under control and her body and nervous system feeling safe. When she could finally go through a full range of motion with her back and hips and was able to reach the floor, she started the process of adding load.  She started with picking up a shoe, then a 2-pound weight, and so on until she was lifting a box with weight in it.  She would vary the size and shape of the things she lifted and the speed of her movement while focusing on breathing and staying relaxed.  

The day came when I had her bring in her daughter and her grandkids. Lifting them in the clinic gave her a sense of being in a safe environment.  She lifted her grandkids without pain and without any of those fear-driven responses.  Then she started to cry… joyfully.

We can do the same thing with many of our patients and clients. The slow, gradual process of confronting a fearful movement or activity and focusing on parasympathetic activation can work for many of our clients who are afraid of moving and can help get them back to living their best lives.

Give it a try!  And if you need encouragement or ideas or are struggling with a client, try attending an OS Pressing Reset or OS Pro/ Clinical certification course.  You can also reach out to me at drkurt@os-institute.com or drop us a note on Facebook.

 

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