The Connection Prescription: Part 3 of 3 of OCD and Pain

The Connection Prescription:

How to Plug into a Person in Pain without Shorting Out

One of the most challenging situations in the human condition unfolds when someone you love is in pain. Whether it’s physical, emotional or even financial pain, you might have a deep longing to fix things and make their pain go away. 

But not all problems can be fixed. This is especially true when the source of the pain is tied to unmanaged OCD. 

What do you do when you cannot fix things?

As adults witnessing a person in pain, we choose between the same three basic responses: turn away, observe from the sidelines or reach out.

Here’s the main message: You are a force for healing by calmly saying with words and actions, “You are not alone in your pain.  I’m here, and we’ll get through this together.”

Human connection is powerful medicine.

I’ve helped many, many families with the ideas I’m about to share with you, and the improvements occur quickly.

What helped when YOU were in pain?

Your own experiences can inform what you say and do when someone you love is in pain.

Reflect on a specific situation in which you were in pain. Maybe it was an episode during your childhood. 

The adults in your life may have genuinely wanted to make things better. However, their actions made things worse.

Let me give you an example. I’ve always loved animals, and I was particularly attached to my pet hamster. I would laugh every time I gave him a cracker with cream cheese and watched him fill the pouch in his mouth with the treat. 

One morning I went to his cage and found him lifeless. I’m going to guess that I was about 6 years old, and I was drowning in the pain of my own grief. 

My mother responded to me the best way she knew how. Unfortunately, almost everything she said and did made things worse rather than better for me.

I’m not trying to throw my mother under the bus. I know she did her very best. She was reacting my pain in the same way her parents reacted to her pain. She learned that certain feelings like sadness or anger were dangerous. If you plugged into a person in pain you could short out. She learned to get back to safety by minimizing her exposure to the pain of others. 

Ways to make things WORSE for a person in pain

Think about your own experience as a person in pain. Maybe you, too, were in pain when a pet died. Here are some things that may have made things worse for you, too.

Your parent became the judge and ruled that you were wrong for having the pain. ” Why are you making such a big deal about this? You feel sad when people die, not when animals die.”

Your parent tried to distract you from the pain. “How about if we go out for ice cream”

Your parent may have reached for the quick fix. “I’ll tell you what we’ll do. Let’s go buy you another hamster.”

Your parent may have physically separated from you and your pain. “If you’re going to cry, go do it in your room.” 

Your parent may have reached for ABC solutions—accuse, blame a and criticize. ” I told you this would happen.” Or, “What’s wrong with you!” Or, “You know better.” Or,  “You know that you get like this when you’re hungry. Why don’t you just pay more attention to your diet?”

Your parent became the timekeeper. “You’ve been sad long enough. Stop already.” 

Your parent became the philosopher. “Animals die. If you have animals, this is what happens.”

Your parent may have gotten angry, “Enough, already. Snap put of it!” In fact, you may have learned that it’s too dangerous to go to your parent with your pain. 

What do all of these action have in common? They all communicate:

• You shouldn’t have those feelings. 
• You’re wrong for having painful feelings. 
• It’s not as bad as you think and . 
• Get over yourself.

All of these approaches built walls between the two of you. They make you feel alone in your pain. 

The Important Pain Formula

Here’s a very simple formula. Pain plus isolation leads to suffering.

Most people can manage tremendous amounts of pain. What’s intolerable is to be alone in your pain. Many of my patients on whom I operated said they had the most physical pain in the wee hours of the morning. While some of that may have to do with medication dosing, it may have to do with the fact that the people who love them were usually asleep. They felt alone. 

People with neurodivergent brains often feel alone in their pain. Neurotypical people simply don’t understand OCD or autism or ADHD. Further, their source of pain is not something that can be fixed.

People can be scared of a person in pain. They don’t know what to say or what to do. They worry they will make things worse.

The safe choice, our brain tells us, is to withdraw from the person in pain. You might think, “My job is to get my loved one into the hands of a trained professional.” 

Mommy Magic

You don’t have to be a trained professional to make a positive difference to a person  in pain.

Here’s the proof.

Do you remember when your kids were young, or you were young and you skinned your knee? You went to your mom, who cleaned up the injury, put on a bandage, kissed it and said, 

“There. All better!” And it really was.

I call this “Mommy Magic” 

And what the key to Mommy Magic? It’s the human connection. I ofter wonder if bandaides work as a reminder of Mommy Magic even when Mommy is not there.

Mommy magic demonstrates the power of human connection. 

The alleviation of suffering is like making a fire. You can’t make a fire with just one log. The fuel for the fire is the gas released between two logs. 

Your goal is creating this space between the two of you for this “all better” magic to happen.

Human connection is powerful medicine.

Ways to make things BETTER for a person in pain

Psychiatrist, ADHD expert and friend Dr. Ned Hallowell says, “We all need one person who gets us and believes in us. They are there when things get tough. It can make all the difference in the world.” He says that one person for him was his first grade teacher. 

When someone you love has a neurodiverse brain, you can be that one person. 

Exactly what can you do when someone with a neurodivergent brain is in pain? 

It’s to say with words and actions, “I see you. I hear you. You are not alone. You’re not broken. I’m here with you and I trust that you can get through this.” 

In my house, we had a saying, “To every problem there is a solution.” Sometimes in the thick of it, we couldn’t find the solution. We moved forward with the trust that when we kept looking, we’d find it.

The Connection Prescription©️ 

I would like to share with you the Connection Prescription. It’s what to say and what to do when you come across someone in pain.

You don’t have to be a healthcare professional to learn the skills and tools to do this. People with no formal medical training can make a positive difference to a person in pain. AND you can do it without shorting out.

What’s the evidence that you CAN make a difference? You may be certified in CPR. We know that in cities in which people are trained in CPR, the outcomes after a heart attack is better.

About a decade ago—long before my son was diagnosed with OCD —I challenged myself. Could I create a simple set of instructions that helps people with no formal medical training to make a positive difference to a person in pain?

I came up with the Connection Prescription©️.  It’s what to say and what to do when you come across someone in pain. Think of it as emotional and verbal CPR. You can trust that you are equipped to make a positive difference to a person in pain.

OCD Champions can make a huge difference in the lives of OCD Warriors by saying with their physical presence, words and actions, “You are not alone. I’m here. I see you. I see your pain. Together, we’ll get through this.”  

You don’t have to be a physician or a therapist or a nurse to make a positive difference to a person in pain.

Human connection is powerful medicine.

The Challenge with OCD and Pain

The Connection Prescription©️ is especially helpful when a person with OCD is in pain. Here’s why.

The obsession themes of OCD represent different forms of danger. You’ll get contaminated and die. You’ll hurt someone else or yourself. You’ll engage in taboo sexual behavior. No one will like you.

When we sense that we are in danger, our bodies prepare to fight, flee or freeze. This happens without a single conscious thought on your part. It’s mediated through the autonomic nervous system.

Sometimes false alarms trigger this danger response. 

Whether or not it’s a false alarm, the brain witnesses the rapid heart rate and the shallow breathing and says, “My body’s reacting to danger. This is proof that there really is danger out there.”

When you’re in this physiologic state, you don’t have access to the part of the brain that’s best at solving hard problems. That would be your prefrontal cortex. In order to access it, you must first calm the nervous system. 

For people with OCD, the compulsions become the path back to safety. It becomes the way out.

However, in the end, compulsions make OCD worse.

Further, many people with OCD believe, “I can’t trust myself. I can’t believe what I see or hear. I can’t trust my memory. I can’t distinguish between what’s real and true and what is not. ”  this makes it difficult to discern between a real threat and a false alarm. 

The challenge of responding to a person with OCD in pain

Let’s say this person with OCD is someone you love. Maybe it’s your adult child or your partner or your friend.

You have a special challenge, too. When we humans are in the presence of someone in danger, our own autonomic nervous systems prepare us to fight, flee or freeze, too. This happens automatically. Remember, the autonomic nervous system responds without any conscious thought on your part. 

This makes sense from an evolutionary standpoint. If one person is in danger, it may represent a danger to a person near them. 

If you’re avoiding a saber toothed tiger’s dinner, this is a good thing.

However, when the perceived danger is amorphous or existential , this response harms you. The solutions to these threats reside in the prefrontal cortex. You don’t have access to that part of the brain unless and until you calm down your autonomic nervous system. 

You can learn the skills and tools to return your dysregulated nervous system to a state of regulation. Then you have access to your prefrontal cortex.

So, the way you show up to a person in pain matters. 

Your unmanaged human brain puts you in a state of compassion. You feel what the other person is feeling. You reflect their mood and emotional state.

You have the best chance of being helpful is when your nervous system remains regulated even when the person you’re helping is dysregulated. This is true empathy.

You’re not born with this skill. You can learn it, though. Firefighters and police officers and soldiers can learn to enter life and death circumstances while maintaining access to their prefrontal cortex.

Many people with neurodiverse brains find themselves in dysregulated states of their nervous system. aIf this is someone you love, your first step is understanding your own nervous system, and acquiring the tools to recognize and regulate your own nervous systems.

This is the foundational principle of the Connection Prescription. 

So, let’s go through the steps so you, too can respond to people in pain without shorting out.. 

1. Set the emotional thermostat. 

I remember my first day on the hospital wards when I was a medical student. Over the loud speaker, I heard “Code Blue.725. Repeat Code Blue. 725.” I knew what that meant. A patient in room 725 was facing a life-threatening situation. Maybe they stopped breathing. Maybe their heart stopped beating. The next 10 minutes mattered.

I rushed to the staircase and ran up 7 floors. When I arrived at room 725, the room was packed with people wearing white coats. I went to stand beside my resident instructor. He leaned toward me and asked, “What the very first thing you do at a code?”

I repeated what I had learned. “Airway, breathing circulation.” He said, “Wrong. The very first thing you do at a code is to take your own pulse.”

He way saying that in emergency situations, the first thing you want to do as a first responder is to calm your nervous system. 

When you set your own emotional thermostat to calm, you’re in a better position to help. You have access to your prefrontal cortex. You can help the person you love catch your calm rather than have you catch their chaos. 

People with OCD often believe they are in emergency situations. It’s just part of the condition of having OCD. 

When you have evidence that your OCD Warrior is in pain, take a moment to get to calm.

Keep the calm rather than catch the chaos

Take your own pulse first. 

When you set the emotional thermostat, you create a sense of safety.

2. Set your intention

As you connect with someone in pain, begin with clarity about your intention. This impacts how you show up. 

When someone you love is in pain, you will have a human desire to make the pain go away.

Efforts to fix things will usually backfire, as we discussed earlier.

The best way to make the biggest impact is to become an empathic witness. You say with your words and your actions, “ You are not alone in your pain. I’m here, no matter what.”

In order to do that, you can develop the skills to be present with feelings you might find frightening, like sadness, or anger.

3. Put the other person in center stage.

Imagine that your encounter is happening in a Broadway theater. There’s one chair in center stage under the limelight.

You get to decide whoo goes in the limelight: you or the person in pain.

We have a natural human tendency to put ourselves in the limelight and make it about us. You may be listening and think, “How did I contribute to this problem?” 

Instead, put the other person in the limelight. It’s about them. Watch and listen actively, just like you would if you went to see a play or a movie. 

A friend told me about a situation in which he took his wife info a doctor appointment. They got some very bad news. His wife had back pain, so on the way home she was lying in the back seat. Dave said that as he was driving he was thinking about what this wife’s diagnosis meant for HIM. His thoughts were interrupted when he heard the sounds of his wife crying. He knew right then and there that he needed to be there for her. Her illness impacted him, too, but he could deal with that later. 

A lot of time we listen long enough to figure out what to say. Instead, listen to hear. What is the other person saying and thinking

4. Access your own wisdom

As you are helping someone in pain, drop into your own body to gain insight about what’s happening.  How are you feeling? What are you noticing? 

I have a tightness I get in my gut when I’m talking with my son’s OCD monster and not my son. This is important information. 

Many political leaders say, “I don’t negotiate with terrorists.”  I see OCD Monsters as terrorists.

I don’t negotiate.

I can comment on it, though. I can say, “I think I’m talking to my son’s OCD Monster. Could I please speak with my son?”  

5. Return to the here and now.

As you listen to the person in pain, you might catastrophize about what will happen in the future. Will my child be able to work or love or find peace? 

Remind yourself to return to the present moment. Remind yourself that you are safe in this moment. The person you love is safe. Big feelings are not dangerous. You can live through them. 

Sometimes , especially as you parent, your child’s current circumstance may trigger unhealed episodes from your past. If your 6-year-old didn’t get invited to a birthday party, it reminds you of the time you were excluded when you were 6.

Here’s the interesting thing. When we stumble upon unhealed episodes, we become the person we were at the time of the initial event. You act as if you were 6 yourself.

This is a completely human experience. You can learn to identify time when you are responding to the past instead of the present. 

6. Play it safe

Think of yourself as a first responder. There are situations you can manage. There are other situations that are over your head.

We all have limits. 

Sometimes we’re not the right person to respond to a person in pain.

You best serve others when you know what your limits are. 

I remember a neighbor asking me to come take a look at her husband. He was describing a tight chest and problems breathing. If you’ve ever been with a person having a panic attack, it looks just like they’re having heart attack. I said to my neighbor, “I think you’re most likely having panic attack, However, I cannot say with certainty that you are not having a heart attack. Let’s err on the side of caution and call an ambulance and rule out a heart attack.” It’s safer to manage a panic attack as if it’s a heart attack that manage a heart attack as it it’’s a panic attack.

Play it safe. Put the decision in the hands of the experts who have access to the right tools. Getting the right help is an act of courage, and not a admission of weakness.

We know that when the pain is overwhelming, some people lose hope.  They may see suicide as an option. 

You can always ask, “Have you thoughts about ending your life” Do you have a plan?” 

You cannot plant this thought. 

It can be difficult is the person you love has OCD harm themes. Untrained therapists do not take the distinction. This is why it’s so important to create a dream team, and have ann OCD therapist on the team.

7. Know where you’re headed

I like playing Chinese Checkers. It’s fun to set up the board so I can do 7 jumps in a single move. However, when I do that lose sight of the bigger picture—getting all my marbles to the opposite side.

When you live with someone with unmanaged OCD, you and your family members make moves the OCD Monster commands. You get temporary peace in th house.

However, in the long run you are best served when you decide to be freed from OCD. You are willing to tolerate the anger directed at you when you decide you’re not longer going to participate in the compulsions. 

When you’re clear about where you’re headed it’s easier. Your commitment to helping yourself  and other family members be freed from OCD will inform your actions—even when the choices are hard. 

Remember, human connection is powerful medicine.

That’s why I have for you today.

I believe that the Connection Prescription is a powerful tool that will help you and your family be freed from OCD.

I am offering an entire online course called the Connection Prescription to help you learn the skills and tools to help you translate these ideas into action. You will take away:

A better understanding into how the nervous system works.

The tools to regulate the nervous system

Insights about how the nervous systems of people with neurodiverse brains are different than people with neurotypical pain

Ways to connect with yourself 

And ways to connect with people you love who are in pain.

You will develop more trust in your own ability about how to confidently respond to a person in pain.

You can reach out to a loved one in pain with:

• More confidence 
• More influence and impact
• More rewards

You have everything it takes to infuse your family with more love, more joy and more hope.  There may not be a magic wand to make pain disappear in a cloud of smoke.  However, human connection is powerful medicine. 

And if no one has told you yet today, I admire your courage. Managing OCD may be the hardest job I’ve. Whether you’re an OCD Warrior or and OCD Champion, you’re not alone. You have everything it takes to infuse your family with more love, more joy and more hope.  There’s hope for a better tomorrow. You got this!