Ever feel completely lost in thought? Almost like you’re addicted to something that’s on your mind? I mean I feel that way a lot. We are humans, after all, and we have thousands upon thousands of thoughts per day. The exact number isn’t really clear but Kahneman (Nobel Prize winner) says we have 600k “psychological presents” per month (20k per day). That is a lot of thoughts.
Ever notice yourself holding your breath or crushing the steering wheel without even thinking about it? Do you have receding gums or exposed enamel because you keep smashing your toothbrush into your teeth while brushing? I am sometimes guilty of clenching my jaw when concentrating hard on something or when I find myself getting upset - or am I getting angry because I’m clenching my jaw?.
Imagine walking across a narrow, one-foot-wide plank on the floor of your living room. Knowing that any misstep will allow you to safely step onto the floor in the comfort of your own home, how stressed would you be to perform this task? Would you be physically tense or anxious if you raised the board half a foot? Probably not much, six inches is pretty manageable. You still have some options.
But what if you raised it fifteen feet?
The interesting thing about beliefs is that they are merely opinions, convictions. Not immutable facts. A belief is a learned habit of mind, a perception of our own reality. Yet many people hold these "facts" about the function of their body, their abilities, or their structure as unchangeable. But in reality we are a highly adaptable species and thru exploratory movement we can shed some of these distorted beliefs.
In Part I of this series on Spatial Perception and Self-Ownership, we introduced the concept of reference frames and described how those who don't know where they are in space may struggle with knowing who they are. So if our body is the reference frame for how we see the world and interpret reality, as I posited in Part I, how might altered perceptions change the way we feel and move? On to Part Deux!
How do you know who you are? That's a heavy question to start off this article and one that I certainly cannot answer. But I've been struck lately with how many of the clients I work with are uncomfortable in their own bodies, often reporting they feel 'phony' or otherwise physically insecure - unsure of who they are. I wonder if this is because many people don't accurately know where they are in space. If you don't know where you are, do you know who you are? In order to understand this better, we have to dig a bit deeper into spatial references and thus Part I!
Something I find interesting is that if an output doesn't feel challenging and full of psychosomatic tension, it must not be hard enough; we must not be putting forth enough effort. In my previous post, I discussed how the space between our self-image and our perception of environmental demands may often be the source of tension and rigidity. Taking this a step further, I wonder how many times we only feel "right" when moving or emoting with heightened tension - particularly the things we perform automatically that should be effortless: walking, bending forward, even swallowing. Is this the most efficient way to move and perform within the environment?
How are we aware of the space between what we want or need to do and what we think we are able to do? It's a feeling, isn't it? An underlying sense of tension, resistance, and insecurity if the space is wide enough. It seems that when there's a discord between our self-image and the perceived demands of the environment — whether social, athletic, functional, or a combination thereof — we begin to feel and express tension and rigidity. These are the manifestations of insecurity. This tension is not only physical, that of the neuromuscular system, but also cognitive such that thoughts become repetitive and lack flexibility. When the gap between our self-image and our perception of the environment is large and pervasive enough across several domains, we experience these tensions in a way that is difficult to relieve and affects both function and performance.
Our habits define us more than our anatomy. Form follows function. Moshe Feldenkrais wrote in Body & Mature Behavior that anatomical peculiarities only partially explain our behavior. It is our repeated output patterns - movements, thoughts, emotions - that become our state of being, bringing our anatomy along with them. Our structure is the carrier and executor of our behavior and is formed and re-formed by the stresses of our habits. Yet most clinicians are obsessed with finding the exact structure involved in a client's current state of misfortune with little attention paid to the outputs that brought about the structural changes in the first place.
"The idea that faulty behavior is a personal misfortune often leads to the conclusion that it must be covered up." Feldenkrais
Let's take, for example, pes planus. This unfortunate collapsing of the arch is almost always an acquired anatomic deformity from years of postural habits causing maladaptation in the rear- and mid-foot. If this collapse were to occur acutely from an accident, the pain would likely be severe and an emergency room visit would certainly beckon.
However, most flat-feet are painless and are only seen clinically once the sequelae of the faulty behavioral patterns have reached critical mass. Why is this? Because the mode of doing has become so habitual, and has been given repeated approval with every step, that it feels "right". The means of sensing any other mode of doing have been lost, along with movement variability, so with each step that collapses the arch becomes the "right one". So is this an anatomical problem as it ostensibly appears?
We keep striving forward with precise tools and techniques to identify the exact anatomical lesion or abnormality — in my mind, this is misplaced precision. Don't get me wrong anatomy absolutely matters, but mostly in the context of behavioral patterns which, in the majority of clinicians and coaches, is only superficially addressed. In the example I discussed above, does correcting the deformity automatically change behavior? I would argue no, unless we have made the client intellectually aware of a better way of doing along with ample opportunity to learn the difference. This is likely partly the cause (along with neural sensitization) of why so many surgeries and other tissue-based interventions fail over time. They have not been sufficient to alter behavior in a way that modifies tissue load.
Our neurological wiring has evolved into networks of patterned behavior designed to efficiently complete tasks mandated by the environment. Anatomy provides the frame to carry out these behaviors; the changes to structure are the tangible result of our habits. But once we open up some behavioral options for new habit formation, anatomical abnormalities don't seem quite so concrete and problematic.
In case you haven't been following this blog (looking at you, people of Mongolia), the last few posts have centered on the appraisal of threat by the limbic system of the brain, the resting tone of the nervous system based upon said threat, and how consistency and security provide an environment for better learning. Light reading, no doubt. As I've alluded to in those writings, learning is optimized when resting tone of the nervous system is low and attention can be sufficiently diverted to the task at hand.
A question we must ask ourselves as coaches/clinicians is are we truly teaching a new skill versus further engraining a conditioned response that has been adapted for survival? Without a knowledge of what we're actually affecting, improvements are more random and less reproducible. So here's a brief discourse on conditioning and how attention is a valuable resource in altering habits.
But first, a quick definition: Learning as I'm operationalizing it here, is the state in which novel skills or neural patterns are developed. Novel learning requires prefrontal cortex activity, attention (mediated thru the nucleus basalis), and mild transient stress to capture the pathways. As I've stated previously, mild stress/arousal is necessary for a baseline of attention but needs to come from a place of underlying security to allow errors to occur without threat that sends the nervous system into freakout and repeating conditioned responses.
Conditioning is the automatizing of habitual, previously learned patterns that are reinforced by the immediate environment. Novel learning can eventually become a conditioned response (or is it a conditioned prediction?) provided the stimulus and repetition are sufficient, however a conditioned response cannot become novel learning. The same machinery that allows for psychomotor variability can also make conditioned responses "deeper" and more conditioned, this is the plastic paradox discussed below.
So when we are working on changing a movement pattern, or changing perceptions, we need to be acutely aware of one's current state. Are we teaching a new skill or are we further engraining a habit? My position is that those who are locked in a neurologic state of being — as measured by loss of HRV, loss of triplanar movement, persistent apical breathing, or whatever measures you use — are likely to further engrain their conditioned responses rather than novel learning unless we give them a reason not to. This is because we do what we know, particularly when under duress. We have to be given a reason to produce a different output.
It should be mentioned that I don't think conditioned patterns (aka habits) are inherently "bad". Like everything in life, it is context that gives them value. Conditioned patterns provide efficiency in neural processing. Patterns are what allow high-level performers to function in flow states and for Average Joes to streamline their morning routines and drive to work whilst thinking about their day.
In an example of stress and survival, someone under acute duress will typically hyperinflate and extend the spine in an attempt to improve oxygenation - this is an adaptive response to modify respiration in a sympathetic state. This is a good thing and highly effective to maintain survival for the organism but may make us more rigid when stressors are no longer present. From Stress Signaling Pathways That Impair Prefrontal Cortex Structure and Function:
high levels of dopamine release in corticobasal ganglia circuits during stress serve to capture whatever successful behaviour has just rescued subjects from danger and engrain this pattern as a habit. But this same evolutionary solution could make humans vulnerable to maladaptive behaviours
So when stressors are not present such as in what should be a low tone position like laying down trying to sleep, these folks will often continue to extend and hyperinflate literally driving their backs into the mattress. Seriously, palpate a stressed client's paraspinals while they're supposedly "relaxed" on your treatment table. No wonder the neurotag associated with back pain or fatigue is continuously facilitated. The chronic facilitation of a habitual pattern then makes that pattern more likely to be called upon in less and less stressful situations. This is the definition of classical conditioning - the innate response to a potent stimulus comes to be elicited in response to a previously neutral stimulus. Now you have a habit on your hands.
The Plastic Paradox
The problem with conditioned patterns lies in the inability to get out of them when the task/environment requires it. The neuroimmune process of neuroplasticity is inherent to the system and this machinery can allow for novel learning or the further conditioning of a response. This is the plastic paradox as defined by Norman Doidge in The Brain That Changes Itself.
The same neuroplastic properties that allow us to change our brains and produce more flexible behavior can also allow us to produce more rigid ones
The more practiced a pattern becomes, the deeper and deeper the subcortical groove, increasing the demand of attentional resources to unlock the pattern and learn something new. The conditioned response is therefore self-sustaining without a significant redirection because they are subconscious, occurring without our attention (see pictograph above). And our addition of stressors, whether purposeful or not, only serve to drive that further because conditioned responses are what's easy for a stressed organism.
So, first we calm them through parasympathetics which we've discussed at length on this here blog, then we redirect.
Attention and Redirection
Regulation from the prefrontal cortex (PFC) as well as the anterior cingulate cortex and insula (the executive homeostatic network) allows us to respond to numerous inputs and cues and assign meaning to them - this is essentially the explicit learning of a new skill. And it requires attention. Redirecting our attention is what breaks the habitual cycle, opens valuable cortical real estate for novel learning, and changes our perception of reality.
So, HOW do you redirect attention? That depends on the individual and their particular conditioned response. Sounds like a cop-out I know but n=1, bro. Respiration, interoception, therapeutic neuroscience education, altering sensory stimuli (visual, auditory, and stomatognathic have a lot of receptors devoted to them if you're looking for a place to start). This will probably require several future posts so stay tuned.
I am big fan of internal cues, particularly early in this process of novel learning, and my friend Dr. Aaron Swanson has a fantastic piece on it that brings the information in this post full circle. James Clear also has an interesting post on habit stacking - a technique I use often in those with persistent pain or fatigue syndromes in order to change the nervous system's appraisal of threat.
Ultimately, an awareness of the difference between novel learning and conditioning of a previously learned response is critical because when we allow a previously facilitated behavioral output to persist, we are only serving to perpetuate that response - context will provide whether or not that's valuable for the client's goals.