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4 The Mind-Body-Headache Connection

In his writings, seventeenth-century French philosopher René Descartes assigned the flesh and blood of humans to medicine and their spiritual side to the church, and it stuck. In Western culture, we tend to move through life as if our bodies are simply vehicles on which to carry our heads around — just well-oiled machines unrelated to our thoughts, aspirations, and behaviors.

In the 1960s, Eastern spiritual philosophies and practices began flooding into Western culture. Over the next forty years, a large variety of meditation, yoga, tai chi, martial arts, and bodywork disciplines became widely available, and new forms were created and adopted. Classes were offered at medical centers and sports clubs; doctors referred patients to complementary medicine practitioners; and the National Institutes of Health (NIH) began researching alternative therapies in medicine. People who practiced these disciplines and received these therapies found that relaxing their bodies calmed their minds, and calming their minds relaxed their bodies.

What Is the Mind-Body Connection?

The term mind-body (or body-mind) is used in conjunction with health and healing. For nearly a century, researchers have been trying to prove what Eastern and indigenous cultures have known and practiced for millennia (and what Descartes had wrong): People are more than their flesh and blood. Rather than being purely mechanical operating systems, living beings have intuitive intelligence, from the cellular to the cosmic level.

The mind-body connection means that your body and mind are one; they are inextricably connected and constantly interacting. But what is this connection, why is it significant, and what does it have to do with headaches?

The Biofeedback Revolution

At about the same time mind-body approaches were growing in popularity, biofeedback therapy created a revolution in the scientific world when it showed that people could exert voluntary control over their own nervous system functions that were previously thought to be involuntary. The central nervous system, made of the brain and spinal cord, sends and receives information to and from the body via the peripheral nervous system, which has two branches: (1) The somatic nervous system controls conscious, voluntary functions, like skeletal and muscular systems, and general senses, like pain, temperature, touch, vision, hearing, and joint position. (2) The autonomic nervous system controls unconscious, involuntary actions — like heart rate, respiration, skin temperature, blood flow, and digestion — and cardiac and smooth muscle (blood vessel) tissue.¹

The two branches of the autonomic nervous system govern the body at rest and in action: (1) the parasympathetic nervous system (PNS), which is the body in balance, or homeostasis, governs the body at rest, and (2) the sympathetic nervous system (SNS), which mobilizes the fight-or-flight response, governs the body during activity.

In biofeedback training, a patient, who is fitted with sensors and hooked up to an electronic device, learns relaxation techniques, then receives instant feedback of the results through the device via sound or visual cues. Researchers showed that trainees could engage their PNS, slowing heart rate and respiration and aiding digestion, and override their SNS. The goal of the training is to reproduce those relaxed states using mind-body cues in lieu of the device’s feedback.

Biofeedback Pioneers

In the 1930s, German psychiatrist Johannes Heinrich Schultz developed autogenic training, where people are taught to use mental visualizations, passive concentration, and verbal commands to induce a relaxation response (“Now my hands are heavy and warm”). In 1958, psychologist Joe Kamiya, PhD, experimented with electroencephalography (EEG), or brain-wave biofeedback, now known as neurofeedback, at the University of Chicago. Dr. Kamiya demonstrated that test subjects could learn to recognize when they were in relaxed, intuitive, alert mental states, called alpha, and control their brain waves to produce these states.²

In the 1970s, Joseph Sargent, Elmer Green, and Dale Walters of the Menninger Foundation began investigating the use of autogenic feedback training to control migraine and tension headache. By combining autogenic training and biofeedback, subjects were able to control heart rate, blood pressure, and extremities temperature.³

More research followed: In 1976, researchers Jose Medina, Seymour Diamond, and Mary Franklin showed that with skin-temperature and electromyographic biofeedback training, or EMG biofeedback, headache severity and frequency as well as medication usage decreased significantly.⁴ Turin found that finger-temperature warming alone was effective in reducing migraine activity;⁵ Sargent’s study showed nondrug treatments for migraine decreased headache frequency;⁶ and Mitchell and Mitchell combined relaxation, awareness, assertiveness, and desensitization trainings, resulting in markedly reduced headache frequency.⁷

Collectively, the research shows that you can learn to change your stress, tension, headaches, and pain with your mind.

Passive and Active Volition

Interestingly, biofeedback therapy makes a distinction between two mental states of volition, or exerting the will. In biofeedback, the patient does not attempt to actively will a state of homeostasis and calmness, which is called active volition (“I must relax!”). Instead, the patient produces relaxation using passive volition, which is an open and allowing awareness of one’s inner world.⁸

Always versus Never

The most effective way to understand the mind-body connection and how it relates to your headaches is to experience it firsthand.

“Always versus Never” is an exercise I’ve adapted from the work of Clyde W. Ford, DC,⁹ to demonstrate your mind-body connection in real time. It is based on working with two sets of thoughts, or inner dialogues. In my adaptation, each dialogue represents a way of thinking about your headaches — one negative, and one positive.

To do this exercise, first follow the setup instructions. Then read the scripts, do the exercise, and at the end do the check-in and debriefing.

If you are reading this book to support someone else, you can do the exercise too. Simply use a concern from any area of your life for your inner dialogue. Find something that is real for you right now and substitute your concern for the words headaches, migraines, or pain in the scripts.

Setup

First, stand in an area with enough space around you to extend your arms to the front, sides, back, and above your head. Then give yourself a good base: Place your feet hip-distance apart (about twelve inches) with your feet parallel, toes pointed forward or turned slightly in, knees soft and unlocked. This will give you good balance as you do the exercise with your eyes closed.

Scripts

Now read over the following two scripts of internal dialogue to familiarize yourself with them. During the actual exercise, your eyes will be closed as you repeat in your mind each set of thoughts. Don’t worry about memorizing all the words — it’s the thought that counts!

The first set of thoughts is called “Always”:

SCRIPT 1: ALWAYS

“I’m always going to have these headaches (or these migraines). I’m always going to have this pain. I’m always going to feel sick. I thought this program would give me the answers, but now I have doubts. It’s just another dead end. I feel lousy. I’m afraid I’ll always be stuck here. There’s no way out. No matter what I do, nothing ever changes; it’s always the same. I hate this pain!”

Got that? Good. I know it can be hard to go there!

Now, read over the second set of thoughts, called “Never”:

SCRIPT 2: NEVER

“I will never again have these headaches (or these migraines)! I will never again have this pain and disability. I will not suffer like this again. I’ve finally found the answers I’ve been looking for, and I’m never turning back. I feel so much better now. I see more possibilities. After all this time, I’m actually hopeful. I can live my life free of pain. I feel great! Yay! I’m free!”

Move to Match the Thought

Now that you know the thought scripts, it’s time to add the special sauce. During the exercise, while you’re saying each thought in your mind, move your body to match the thought. In whatever way feels right, allow your body to move in a way that expresses what you are thinking.

For example, when you say to yourself you’ll always be in pain, do you tighten your shoulders and lower your head? What does your body do when you say you’ll never be in pain? Whatever feels right for you, move to express each thought.

Always versus Never Exercise

Now read over the numbered steps that follow, glance at the scripts one more time if needed, and then put the book down. When you are ready to begin the exercise, return to your stance with feet hip-distance apart and knees soft, close your eyes, and proceed. When you finish the exercise, open your eyes and do the check-in and debriefing.

1. For about thirty seconds, repeat in your mind the “Always” script, or your version of “I am always going to have these headaches (or migraines). I am always going to be in pain. I am always going to have to curb my activities,” and all the negative thoughts that go with it. Allow your body to move to match the thought “I always will have this pain.”

2. Then switch to the “Never” script and repeat it in your mind for thirty seconds: “I am never again going to have these headaches (or migraines). I feel so much better! I am free! Yay!” and all the positive thoughts that go with it. Allow your body to move to match and express the thought of “Never again will I have this pain.”

3. When you’re done, open your eyes, sit down, and do the check-in and debriefing that follows.

Check-In and Debriefing

1. What happened in your body during the exercise when thinking you would always have headaches, migraines, and pain?

• What happened to your tension or relaxation overall? In specific areas?

• What happened with your posture and breathing? How about your mood?

2. What happened to your body, posture, breathing, mood, tension, and relaxation when you thought you would never again have headaches, migraines, and pain?

3. Were your two responses different?

• For always, did your body contract, shoulders raise, neck stiffen, and head pull in? Did you hold your breath? Was your mood fearful, hopeless, angry, sad?

• For never, what happened? Did you feel a sense of relief, take a breath, let out a sigh, or smile? Could you let your body go, lift your head, and see beyond your pain? How did that feel?

You might have had the responses listed here, or others. During the Always exercise, some people grip their temples as if in pain, whereas others get completely still and don’t want to move at all. Some follow their urge to self-soothe and simply hug themselves while standing, while others curl up in a fetal position. And while imagining being free from pain, some people extend their arms in the air in joy!

You might not have had the responses you expected. Some headache sufferers report they simply “can’t go there” — meaning, they can’t imagine always having pain — for fear of actually bringing on a headache. On the flipside, even never can be difficult for those who cannot imagine their world as pain-free. They are unable to get there mentally for fear of being disappointed again.

There are no right or wrong reactions, only what happens to you. Your palpable, felt responses — whether positive, negative, or reluctant — are what matter. It’s okay if your responses are so subtle that an outside observer couldn’t tell anything was happening. What matters is that you feel something happen and are aware of it.

Survival and Wonder Vision

We now return to the point of the Always versus Never exercise: to have an experience of your mind-body connection and understand how it relates to your headaches.

In the exercise, you spent a minute or so working with two types of thoughts, and you likely noticed that something happened in your body as a result. Did you contract or feel fear with the negative and expand and feel joy with the positive?

Of course, the directions were to move your body to match your thoughts. But I’m pretty sure that you didn’t take a deep breath, lift your head, and raise your arms to the sky when imagining yourself stuck in pain — or tighten your body when imagining that you were free of it. We naturally contract when under stress and expand when feeling safe.

Here’s the point. Your body responded to two types of thoughts in the period of just a minute. How many thoughts do you have in ten minutes, a half-hour, an hour, a day, a week? A lot! And your body is reacting to each one.

In fact, every thought has a bodily response. I repeat: there is no thinking without your body responding. If you are thinking angry or hopeless thoughts, what happens to your shoulders, jaw, posture, and mood? Your body responds. Every thought — happy, sad, angry, fearful, hopeful — has the potential to affect your headaches because it’s affecting your body.

Body-centered psychotherapists Gay and Kathlyn Hendricks say that people view the world with either survival vision or wonder vision.¹⁰ In survival mode we see the world through fear-tinted glasses, and those filters limit our choices. We feel like we’re struggling tooth and nail just to make it. However, in wonder mode, we see the world through curiosity-tinted glasses. We allow ourselves to wonder about a problem and consider possible solutions instead of worrying about it.

Drawing from the Always versus Never exercise, thinking that you will always be in pain is like seeing the world with survival vision. It looks like there’s no hope — your possibilities are limited and you’re barely scraping by. In contrast, thinking that you can be over your headaches is like viewing the world with wonder vision. You can be hopeful and see a future filled with possibilities.

From Expert to Beginner

Why is it important to be open to new possibilities? By the time I meet my clients, most of them have tried many therapies and are skeptical after repeatedly chasing hope that ends in defeat. They have become experts at knowing what does or doesn’t work for them, but they can be closed to exploring new avenues. They think they’ve already tried everything, and they don’t want to put out the effort and risk more pain and disappointment. They’ve tried alternative therapies and wonder how somatic self-care is different.

In his classic book Zen Mind, Beginner’s Mind, Zen master Shunryu Suzuki Roshi writes, “In the beginner’s mind there are many possibilities, but in the expert’s there are few.”¹¹ Zen philosophy teaches us to live life in each moment — savoring, appreciating, and learning from it. That’s beginner’s mind. Having beginner’s mind is like having wonder vision. Like a new puppy or kitten, we are open, inquisitive, and unjaded, and we want to explore everything. Beginner’s mind is that willingness to begin again and again.

The first step in the Mundo Program is being willing to enter into a new inquiry process with fresh eyes despite what you have already tried. You might discover something that you missed previously — which is, after all, why we get second opinions about our health, our fashion choices, or anything else.

This process of looking at your headaches in new and different ways is more than a one-time exercise. You have to keep refreshing your vision if you get stuck and can’t find answers. If you’re in a negative mood and feel as if nothing is working, if you’re questioning why you’re putting yourself through this again, that means you’re squarely in survival mode. It’s time to re-up, find your bearings, move forward, and return to wonder mode. To do so, stop, acknowledge your mood, take a breath, and find center.

In chapters 11 and 12 you will learn meditation and breathing practices to help you to feel more calm and open.

Becoming a Headache Detective

Why do we love the image of a detective? Because detectives are dedicated to the case and intent on solving the mystery at hand. Using their wits, curiosity, and perseverance, they uncover clues and reveal possibilities that ultimately lead them to the culprit.

The beloved fictional detectives Sherlock Holmes and Lieutenant Columbo embody the energetic perseverance that is needed to crack difficult cases. They’re the epitome of living in wonder mode — always poking and prodding what is hidden and what is obvious, plumbing the depths of the mystery, and searching for clues, for “just one more thing.”

If you wanted a detective to solve your headache mystery, whom would you hire? If a detective said, “You know, I’m not sure I can help you. I’ve seen cases like yours before, and I’m not hopeful. But I can take your case anyway and see what I can do,” would you hire that person? Me, I would turn around and walk away; I wouldn’t even consider hiring someone who wasn’t hopeful, open, and gung ho about my case.

I would want to hire the detective who greeted me with this:

After you made your appointment, I did some initial legwork, and I’ve identified four doors worth exploring. In fact, I looked behind one of them, found a hallway, followed it to the end, found two more doors, looked behind each of them, found several clues, came back out, and am ready to explore what’s behind the three other doors. What do you think?

When it comes to hiring the best person to solve your headaches, that detective is you! Be the detective you’d want to hire.

Placebo: Your Inner Warrior

The state of inner knowing and confidence, the belief that you can do something, is palpable in wonder mode. The power of belief is so real that it has a name in medical research: the placebo effect. The placebo effect is a beneficial result in a patient that is due not just to the treatment, but to the patient’s expectations about the treatment.¹²

Blinded, controlled studies are the most reliable way to avoid bias in human medical research. Blinded means that patients won’t know which treatment they’ll be getting. The participants are split into groups, with all of them receiving a regimen — for example, a medication. But whereas one group receives the treatment that’s being tested, the other group receives a sugar pill, or sham treatment, called a placebo.

This protocol helps determine how well a drug works and how much the patients’ thoughts and beliefs (that they are taking a real drug) affect the treatment outcome. Researchers have to gauge to what degree the real treatment works because the subjects think that it will. As it turns out, our thoughts influence the treatment a lot. Brain imaging studies show that the placebo effect is physical. It changes bioneurological pathways in the brain, causing release of the reward and pain-relieving neurotransmitters, dopamine and endorphins.¹³ Because this response is so consistent, research studies commonly factor it into their baselines. A fascinating study that looked at migraine and the triptan Maxalt found that pain intensity decreased when the drug was expected, even when participants received placebo. When Maxalt was administered but placebo was expected, the actual drug was not as effective.¹⁴

Even the people who administer a treatment can bias the results if they know who gets the real treatment and who gets the placebo. For that reason, double-blinded studies, in which neither patients nor researchers know who is getting what, are considered to be the most reliable. However, in a stunning 2011 randomized, controlled trial of irritable bowel syndrome by Harvard Medical School Professor of Medicine Ted J. Kaptchuk and colleagues, both researchers and participants actually knew if they were getting the real therapy or the placebo.¹⁵ Remarkably, the placebo still worked to treat subjects’ IBS, even though everyone knew they were getting a sham treatment!

We humans are very hopeful and imaginative creatures; our minds and beliefs can make us feel sick, or well. It’s amazing how powerful the mind is!

Mind of a Champion

If thinking about a good outcome results in improvement, then can’t we just think it without undergoing the treatment? Consider the true story of champion platform diver Laura Wilkinson.

Wilkinson had been a ten-time U.S. National Champion in women’s ten-meter platform diving. Unfortunately, she suffered a serious injury during training six months before qualification rounds, downgrading her chances to make it to the 2000 Olympic Games in Sydney, Australia. She broke three bones in her foot and was unable to dive for two months during her recovery. A layoff this long can spell the end for athletes, who need to keep their muscles and form in top condition. Laura’s sport required her to use her feet to push off from a three-story-high platform and flawlessly complete a dive. And it was her feet that were injured. Her chances didn’t look good.

Cleverly, instead of physically practicing her dives during her recovery, Laura did the next best thing: she used mental imagery to practice her dives. In other words, she ran through them in her mind’s eye and felt the action of diving in her body. Remarkably, she recovered in time to qualify for the Olympic team.

Maybe you watched the 2000 Olympics on television and remember watching her dive. China’s team had won the event at seven of the last eight Olympics and was heavily favored to win the gold medal. No pressure there! But Laura Wilkinson won — the first American in thirty-six years to do so.

Laura’s mental training helped her accomplish what she could not do physically when injured, and it propelled her to victory. Like a champion, you too can use your mental focus and the power of thought and belief to help your body relax and relieve your pain.

In Greek mythology, the warrior goddess Athena was most known for her wisdom and practical sense. Born wielding a sword, straight out of her father Zeus’s headache, she had an independent spirit, was a fair and compassionate mediator, and tried to prevent war whenever possible. When necessary she fought bravely, assuming disguises and devising the Trojan Horse in opposition to a provocation to war. Athena never lost a battle.

I encourage you to be a warrior like Athena — a headache warrior — and pursue and attack your headaches, determined to win each battle and the larger war. If you lose your way, get right back on track and conquer your headaches with passion, creativity, and cunning. Be willing to do whatever it takes to be a warrior for your own health, and along the way, combat the inner and outer forces that seek to deter you from claiming your power to heal your headaches. It is the hero’s journey.