Ankylosing Spondylitis and Why You Might Need a Psychotherapist

Disclaimer: This post is for information use only. It is not intended to treat, diagnose, cure or alter any medical health condition you may or may not have. For medical advice and treatment please speak to your doctor.
Ankylosing Spondylitis and Why You Might Need a Psychotherapist
The Mind-Body Connection
When I first started coaching people with Ankylosing Spondylitis I was helping them find relief using a holistic approach which consisted of diet, exercise and meditation. I wrote a blog post called “How I Healed from Ankylosing Spondylitis Symptoms” telling the story of how I transitioned from managing my own Ankylosing Spondylitis pain and into finding a solution without the need of special diets, exercises and meditation rituals. Apparently, the mind body connection didn’t just work well for me. It also worked well for more than 80% of people I coached during their healing. The amazing part is that when there were people who had multiple diseases happening at once, their other symptoms faded away as well. It didn’t matter if the person was dealing with undiagnosed mystery pain or they had physical pain together with Crohn’s disease. The mind body connection was clearly doing something for these people simply by them understanding what they were going through and how it was affecting their body.
The mind body connection is something that you will rarely consider and barely understand if you grew up in a culture that beliefs that the mind and the body are two separate things. Unless you happen to have an interest in psychology and mind body medicine, mind body healing sounds too good to be true and a little unscientific. What the public doesn’t know is that the mind body connection is a major problem in medical research. When a new drug is being developed, there are medical trials that must be done over and over. Mainly because the placebo effect gets in the way of the researchers being able to distinguish if the drug is working or not. Usually because the results that the new drug is getting are very close to the results of the placebo. Unfortunately the majority of the public thinks that placebo is just placebo. When in reality the placebo effect is the ability to heal your body with nothing more than your WILL to be healthy. THAT is how amazing we are! We can literally heal our body with nothing but pure will power and faith. Of course, faith healing is something that will never be prescribed by a doctor. I myself would not be satisfied if my doctor told me to use faith healing. The beauty of the mind body connection is that it is not faith healing. There is a history and a science behind it.
Science vs. Faith Healing
In the past when great minds like Sigmund Freud, Carl G. Jung and Karen Horney were roaming the earth it was widely known that unresolved internal conflicts can create not just mental illnesses but also physical illness. Sigmund Freud developed a method of psychoanalysis called “The Talking Cure”. He would do exactly what it sounds like. He would talk to patients and cure them by making them aware of the internal conflict that they were too afraid to look at. This was one of the greatest things that happened to humanity in the last 150 years. We finally understood that the mind and the body were so closely connected that unresolved fear can potentially harm our physical health. The talking cure suggests that by exploring our inner fears and getting to know ourselves a little better we can potentially set ourselves free from chronic diseases.
Why didn’t this become mainstream? There are many factors for this but there are three that I personally suspect are the most responsible for this not becoming common knowledge. The first is that humans like to pretend that we are always thriving and doing well, even when things are falling apart. We’ve learned to hide our most vulnerable parts to the world for the sole purpose of fitting in with social norms. This is human nature and it’s only getting worse with the use of social media. While most people are currently struggling with something in their lives. Social media allows them to pretend that they are living the perfect life.
The second reason is the inconvenience of psychoanalysis. Mental exploration was and still is a slow and unpredictable process that could take anywhere from a few minutes to a few years to heal the person. The third reason is that psychoanalysis was unscientific. In order for something to be considered a science we must be able to test and replicate the same results over and over in a controlled environment. Unfortunately we cannot yet measure thoughts, nor can we measure emotions. When we say that chronic pain is the result of too much anger. We cannot measure the anger in a lab experiment to scientifically determine just how much anger is too much anger. Think about it, how much anger does it take to start having chronic pain? Currently we don’t have an answer to that question, and neither can we test the hypothesis in a controlled lab environment.
The point is, that any person who understands the workings of the mind and its connection to the body. Can tell you that the mind body connection is not about faith, and neither is it a clear-cut science. Even with numbers and stats on human behavioral tendencies, working with the mind is still partially an art that unfortunately brings the practice of psychoanalysis a little too close to pseudoscience. For that reason it is much more practical and convenient to control what we can measure using western medicine and pharmaceuticals, such as biologics for inflammation in the joints and other parts of the body.
The Science in The Numbers
The closest way to make a science out of something that cannot be measured such as the mind, thoughts and emotions. Is to observe and keep stats on what is consistent under certain conditions and circumstances. The science of human behavior is currently at a point that some experts can predict how a person is going to behave under certain circumstances with 95% accuracy. Take voting for instance, when placing hand sanitizer near voting booths, a subtle change that consciously goes unnoticed. Voters will vote conservative 95% of the time. This, and many other things on the science of human behavior has been observed and documented over the past 100 years. Including what seems to happen when a human being grows up in a hostile environment during childhood. Sure, no one has a perfect childhood but research heavily suggest that the chances of developing chronic diseases in life are significantly increased when facing early life adversity. To learn about the statistics behind childhood trauma and its link to autoimmune diseases please read about the ACE project and explore what it means to you.
The Adverse Childhood Experiences (ACE) Project
The adverse childhood experiences project is a research project that focuses on exploring how childhood trauma can affect the health and well-being of a person throughout their life. Remember that science is all about numbers, what can be consistently observed and repeatedly replicated in a controlled environment. Apparently 90% of people with Ankylosing Spondylitis are positive for the genetic marker HLAB27. However, when it comes to adverse childhood experiences, ACEs seem to be present as well almost 90% of the time in people with Ankylosing Spondylitis. Many of them don’t even know it until they take the ACE quiz. Some experienced minor but consistent stress and others experienced major and unexpected stress. So, which one of these numbers do we go with? If you want to believe that you are hopeless and a victim to your genetics, the first number is appealing. If you want to take control of your inner world and have a fighting chance at recovery the second number can be healed with the help of a trained mental health professional. If you do not know what your ACE score is you can take the quiz and see what you discover for yourself. You can also research the ACE project and see what the numbers mean and how it can be contributing to your physical health. (How Childhood Trauma Affects Health Across a Lifetime)
Image Source: NPR.org

 

Image Source: NPR.org

 

Childhood Trauma and Ankylosing Spondylitis
Since the day that I understood the link between childhood trauma and Ankylosing Spondylitis I began to ask everyone I was working with if they knew their ACE score. Surprisingly none of them knew what that was and upon taking the quiz they were surprised at their findings. I myself was even more surprised to see that all 15 people I was coaching on diet, exercise and meditation had multiple adverse childhood experiences. At the time I believed that I was the only one who was possibly mis-diagnosed with Ankylosing Spondylitis when I was really suffering from what is known as complex PTSD. Now this doesn’t mean that everyone with Ankylosing Spondylitis is mis-diagnosed. What this means is that childhood adversity seems to be way too common in the AS community. Until this day after a couple of years of speaking to hundreds of Ankylosing Spondylitis sufferers the ACEs are still too common and too high. For that reason when I am interviewing someone with Ankylosing Spondylitis for my life coaching program I ask them to find a psychotherapist to work with while we work together. Working with a therapist doesn’t mean that your physical pain is imaginary and it’s all in your head. According to Donna Nakazawa, author of the book “Childhood Disrupted”. Childhood trauma can not only be the trigger of autoimmune diseases, chronic pain, anxiety, depression, gastrointestinal pain, cancer  and mental disorders in adults. It can also cause physical inflammation in the joints and major organs including the brain. Therefore the pain is not imaginary, and according to Donna it is the result of something much deeper than genetics.
What Happens in The Mind of a Childhood Trauma Survivor
According to Sigmund Freud when a person experiences early trauma in their life they stay fixated and stuck in the mindset that they were in during that time in their life. Most childhood trauma survivors develop coping mechanisms to help them cope with the feelings that we’re left from their childhood adversity. Apparently when it comes to childhood trauma the coping mechanism(s) usually also shapes their personality. This is one of the things that makes it so difficult for therapists to work with childhood trauma survivors. Their personalities do not allow them to seek the help they need. Especially if the person believes that their personality is helping them survive, get through life and avoid potential danger. Whether they are aware of it or not, the childhood trauma survivor is constantly anticipating and trying to avoid physical, social and emotional threats (pain). While also being unsure of what their basic human needs are and how they can get them met effectively.
What Needs?
All humans have multiple basic needs. According to Dr. Matthew Lieberman, one of those needs is the need for deep meaningful relationships. As much as humans tend to deny it nowadays, it is a biological need to have other humans around you that care for you and your well-being. Take the prison system for example. When a prisoner misbehaves in prison the corrections officers put him in solitary confinement as punishment. Solitary confinement is a form of social isolation. This suggests that humans much rather be surrounded by murderers and dangerous people than be alone for a couple of days. Dr. Lieberman’s research suggests that isolation activates the amygdala. The part of the brain that regulates fear and the stress response. Isolation also triggers the ACC (The Anterior Cingulate Cortex). The part of the brain that regulates emotional pain as well as physical pain. An even more interesting finding in Dr. Lieberman’s research is that when you take pain killers for emotional pain. You get relief the same way you do when you take pain killers for physical pain (Dr. Lieberman on The Social Brain). Apparently the mind doesn’t know the difference between physical pain and emotional pain. In the mind pain is pain and emotional pain can in fact be experienced as physical pain as well.
As we all know, prolonged stress can be both emotionally and physically painful. Now here is the kicker, in humans, it doesn’t matter if the isolation is physical or purely imaginary. Isolation is isolation, you can be surrounded by millions of loving people but if you feel lonely inside you are still isolated. In the chronic pain community the chronic pain sufferer usually seems to have a very hard time feeling connected to others. Even when they pretend to do so. If it’s not trust issues keeping them isolated, it is a deep feeling of awkwardness and feeling like an outcast. It is a feeling that is constantly telling you that you are different and that you don’t belong. This is one way in which one of many basic needs is not being met, the need for meaningful connection.
Learned Trauma & Lack of Adversity 
According to Donna Nakazawa many people may have experienced what seemed like a perfect childhood. However, upon further research it was noticed that they may have acquired behaviors from parents who may themselves be traumatized. Children who grew up with traumatized or overly protective parents. Were shown in research to be in as much risk for developing physical and emotional pain as the group who faced too much adversity early in life. It is suspected that this may be due to the idea that children who face too little adversity grow up with low resilience. Lacking the ability to effectively cope with challenges in adulthood. Leaving them overwhelmed, over challenged, anxious and depressed by the stresses of daily life. In essence, too much adversity as well as too little adversity early in life can result in a lifetime of emotional and physical health challenges. I personally believe that those who face too little adversity can benefit from learning new life skills just as much as those who faced too much adversity.
Personality Types at High Risk of Developing Chronic Pain
According to Dr. Gabor Mate the author of the book “When The Body Says No”. There are certain personality types that are at high risk for developing specific diseases. When it comes to chronic pain and autoimmune diseases the personality types at high risk are the following:
On the “up side”
1. People Pleaser
2. Goodist
3. Perfectionist
5. High Achiever
6. Strong Desire to Always be Productive
7. Deep Thinker/ Over Analyzer
On the “down side”

 

1. Avoidant
2. Ambivalent
3. Overly Self Dependent
4. Hostile/ Aggressive
5. Anxious/ Fearful
Those first four traits on the up side may seem like highly sought out virtues, but when they are coming from a place of fear it might be nothing more than an attempt to cope with repressed negative emotions. I suspect that some of those repressed emotions are triggered when I suggest to a potential client to seek help from a mental health professional. Some get upset, others take action and proceed to seek the help of a therapist when they start to see the pattern in their life. Another reason why some get upset may be the social stigma of seeking psychotherapy. Especially when the pain they feel is physical and they don’t recognize nor understand how their mind might be involved. The chronic pain sufferer may also act out and adapt hostile, stoic, and legalist (always right) personality traits to cope with the same exact repressed emotions that the goodist and the people pleaser is dealing with. When this is present it is usually very unlikely that the pain sufferer will ever seek the help of a therapist. Unless they eventually start to understand how their behavior might be linked to inner conflicts.
My Dance With The Designated Issue
It is human nature to focus on a problem that we feel we can control when we are facing problems in our lives that we believe we cannot handle. In my personal experience growing up in an environment that left me with 9 out of 10 adverse childhood experiences (not including some that were not on the ACE Quiz). I learned how to hide from my emotional pain by adapting many coping mechanisms. The most effective one for me was over thinking and over analyzing everything. When things got way too difficult for me I would turn my attention to my body. In my teen years I was very physically active, competitive, and focused on my looks. At some point my fixation on my physical features turned into anxious bouts of picking at every pimple, scab or injury that I experienced. Then it turned into an obsession of constantly checking to see if I was ok. Something had changed in me and I couldn’t stop asking myself “what is wrong with me?!” In psychology, it is known that when a person survives high levels of stress it can take anywhere from a few days to 20+ years before the feelings of that experience start to manifest. This is called a delayed onset of symptoms. According to Donna Nakazawa in her book “Childhood Disrupted”, the delayed onset can be passed down through genetics onto the children of the trauma survivors. Leaving the child to deal with fears and emotions that aren’t even theirs to begin with.
One day to another my childhood and possibly my family’s history started to come up to the surface. I intuitively knew that there was something wrong with me I just couldn’t pin point exactly what it was. The threat(s) was not there in front of me anymore but the feelings were rising more and more each day. Eventually I started to feel physical pain which then turned into the reason for my emotional pain. At the time it made perfect sense to me that the way I felt emotionally was a result of the physical pain. I convinced myself that my emotions would stabilize themselves if only there was no physical pain. A difficult thing to imagine when the doctors told me that the pain will never leave. The physical pain became the new coping mechanism for me. It became the designated issue, the thing that I blamed constantly for feeling the way I felt. When I woke up In the morning the first thing I would look for was pain. Constantly asking myself if it was gone yet. All day long it was obsessing with the pain. I couldn’t focus on anything else other than the pain. To overcome this, the person who helped me during my healing made me aware of the possibility that it was the other way around. The feelings were the cause of the pain and not the result of it. To heal the physical pain I had to release the emotional pain and let it go. All the fear, hopelessness and shame I felt from those nine adverse childhood experiences continued to bubble up. All I had to do was learn how to let it pass and develop a new way to cope with the feelings whenever they came up. This meant not focusing on my pain whenever my separation anxiety was triggered. Something that happened automatically whenever I found myself all alone. The flare ups always seemed random to me until I started to pay very close attention to the pattern. Ultimately I learned how to accept the physical pain and experience what was underneath it. Slowly at my own pace I learned to feel and release those feelings.
What I believe in
As a life coach my job is to help people suffering from chronic pain reconnect with their greatness. Learn life skills that they usually don’t have such as setting healthy boundaries and building deep meaningful relationships. There is nothing more rewarding to me than seeing someone be able to trust again, love again, enjoy life again and pursue their passions with the heart of a child, fearless and confident in their abilities. Part of my journey also lies in educating the public on how unresolved issues can manifest into physical diseases. The challenge is that the public has been indoctrinated into believing that a pill is the only way to heal. Don’t get me wrong, western medicine is very useful but alternative and holistic approaches can be just as affective. Currently western medicine does not offer the chronic pain community a solution to their problems without the risk of potentially life threatening side effects. Therefore, until western medicine figures out a way to heal chronic pain with a pill. The best chance they have for recovery is to do it the old fashion way. Working with a psychotherapist, being brutally honest with themselves, self-reflecting and the courage to rebuild their life from the inside out. Learning to forgive the past and allowing old wounds to heal will give you the best chance of living a full meaningful life again. Regardless of how bad you think you have it.
As a past trauma survivor myself, recovering from chronic pain and resolving my past traumas is one of the greatest blessings in my life. healing created in me a will to live and enjoy life so much that I want to experience it all to the fullest. I don’t find myself living the way I used to live my life. Social media has lost its appeal to me and I don’t use it as often as I used to. I don’t I find myself being a workaholic like I used to be. Neither do I rush through everything in an anxious attempt to finish up quickly, only to pick up another task to rush through. Life is fun again, time goes by much slower and even the small things I once took for granted in my life are amazing. I no longer find myself seeking thrills, being fearful all the time or obsessing over things that I once thought would make me happy.
Reaching The Masses
Over the last couple of months I created a Facebook group for the Ankylosing Spondylitis community to support each other. I intended to share with them my experiences using the mind body connection for healing and encourage them to seek professional help. Many people got relief and improved just by understanding how to apply some techniques I shared with them. While some were improving rapidly, others struggled to comprehend how to apply the techniques. Not because the techniques were hard to comprehend, but because understanding any technique for healing requires a two way conversation. In addition to that it is extremely difficult to share information with hundreds of people at once. Without setting off a chain reaction in the ones that are not ready to learn about the possible connection between their pain and their past. For those that improved, my hope was for them to share with the group how they were doing it and what was working for them. That way we can encourage others struggling with Ankylosing Spondylitis to seek professional help. The group could have potentially served as a community of support for those who struggle with the social stigma of past painful experiences and psychotherapy.
The group members that are doing well are out enjoying life again, which is a very good thing. I’m assuming social media lost its appeal to them as well, which is great! That’s what is supposed to happen when you feel good enough to start living life again. I can continue to share my experiences as I always done, but at the moment I don’t feel that this is something to be discussed on a public forum without being able to see if all members are being properly supported. Especially when not everyone in the group is able to find a psychotherapist they feel comfortable working with. If you believe that the information in this post applies to you and you are ready to heal your past. Find a therapist and if you want my support as a life coach while you work with your therapist I would be more than happy to support you as a coach and a mentor.
How I help The Chronic Pain Community
If you are still seeking a solution to your pain and you believe you may be experiencing the results of a difficult childhood. Please seek the help of a mental health professional. One who works with chronic pain and/or childhood trauma. In addition to psychotherapy I can help you rebuild your life with life coaching by teaching you how to create the life you want to live. Acquiring the skills needed to improve your life from the inside out is as simple as making the decision to do so.
To get started with life coaching please visit my website and schedule an initial call with me.
Ralph Ruiz is a life and wellness coach who specializes in helping those living with autoimmune diseases live healthier and more prosperous lives.

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