Striving is the Goal: How Hard work and Dopamine are fueled by Intrinsic rewarding
Traditional goal setting in short are powerless in our assessment and plans for persistent pain conditions.
"Everything in your life is a reflection of a choice you have made. If you want a different result, make a different choice"
Can you remember what percentage of your goals were met on time, or how many times an amendment or an extension was necessary to merit continued therapy?
A subjective balance on one end and an objective analysis come together on our best guess.
We cannot account for one’s unique human condition.
Should there be no goal settings when working in chronic pain scenarios?
In my mind it is nonsensical and anti-ethical.
Considering the nurturance of navigating the internal world of one’s subjective experiencing in the movement from pain to a state of ease has an argument on why we feel it necessary ( Medicare comppliance, good QA practices). The PT slash Practitioner in us thinks “oh horrors” no goals!!
May we at least have an alternative pathway to setting and realizing more grounded and self supporting goals.
Lets dig in a little on a possible neuro-scientific reason for minimizing or amending our goal setting process.
When “reward” is not asked or given as a reinforcement we tend to associate less pleasure with an activity we engage in.
In essence, it is itself the activity that evokes the reward state: completion, accomplishment, satisfaction. It is driven intrinsically.
time rolls on time lapse over the San Francisco Bay, Winter 2023
Dopamine controls our perception of time. It is involved in reward ( pleasure), motivation, attention, memory and coordination of our bodily movements. When we engage in hard work or exercise with the notions of a reward at the outset by allowances, we are extending the time over which we are analyzing or perceiving that experience.
Essentially our watching ourselves strive with an outcome extends this illusion of time space by its mere observance. Watching the seconds count down, we insist to persevere from an extrinsic stimulus.
Because the reward comes at the end ( a sense of accomplishment) we dissociate the dopamine neural circuits for reward that would have been normally active during the activity. Because it all arrives at the end, over time we have less and less pleasure while doing it in the future.
We derive pleasure in peak form in the present moment of the activity and Dopamine drives this in the background… We do not force. We avail ourselves to the task at hand without any other motivator other than to improve range, strength, flexibility or balance.
In other words do not look to be rewarded. (Not the ice cream sundae or banana split or sweet mojito at the end of the rep’d out rainbow)
Striving is the Goal
According to Andrew Huberman a neuroscientist at Stanford University striving is the Goal and not the extrinsic reward of hitting a target or allowing oneself to indulge. (the blue ribbon syndrome). When we strive we are originating this effort from with-in.
He calls it the Growth Mindset: striving to be better. “I am not there yet”. Striving itself is the end “goal”.
I will perform well because I am focused on the effort itself and ability to access the reward from the effort itself.
So we might begin to re work our goal setting as adding to our functional outcomes coupled with how hard they perceived their work effort, in this case striving goal?
“Percy will climb his stairs with high intrinsic effort and minimal extrinsic rewards manifested in normalizing gait mechanics over two flights in 2 weeks time. His success will be measured by his “Yahoo” at completing this.”
It will take more creativity to manage how to write up a well balanced targetable pain outcome in goal setting for functional attitudes. I would posit the better more inclusive the goal setting that has an intrinsic mindset for the patient re-minds them of their pace and control over how much true involvement and autonomy they have over their healing pathway.
Learning to access the rewards from effort and doing.
The passion for stretching yourself and sticking to it, even (or especially) when it’s not going well, is the hallmark of the growth mindset. This is the mindset that allows people to thrive during some of the most challenging times in their lives. carol dweck: mindset, the new psychology of success.
When we engage intrinsically, we are utilizing the prefrontal cortex ( PFC) in concert with our meso-limbic system ( emotion-feeling center). We are cognitively saying to ourselves this effort is detached within us from the external world. This may evoke dopamine release from what is called Limbic Friction. When we are utilizing both our conscious executive processes system with our feeling systems we can eliminate the ability to generate those circuits and extrinsic processes by rewarding this internal friction-efforting.
This limbic friction can be washed out if you are only focused on the reward at the end.
If we are pushing for the reward at the end we make it more painful. It is less efficient as we are not driving up this pleasurable neuro-modulatory molecule. We enjoy the process less and rely on our capacity to overcome without greasing the rails with a DOPA fix in our ask to make it easier, less uncomfortable in short order.
Consider the addiction to time organizing or the 6:30 am caffeine shot to make life more temporarily “awake”……..DOPA hit… to be motivated to succeed in pursuit of an extrinsic reward. It is time bound…. Healing is not time bound in the meta and existential realms. The healing is forming into completion before we conjure the path when we understand that how we can co witness our own cranial stellar observatory in our heads. That aspect that holds the images of our suffering and our traumatic experiences. Healing is awakening to absolute sovereignty. With the growth mindset in full gear this is pathway becomes untouchable and irreducible by any one or any thing. This brings one onto the healing pathway as a resource for vitality.
Hare and Hound Motif
If we focus on the reward at the end then we undermine the entire process and we will need to double down on the secretion of dopamine to remain motivated if our reward is with-out and not with-in. At some point there is a waning of a want to continue… the hare continues to out run the hound and the hound gives up and the hare escapes. He loses interests for he is looking for the capture, the end and not the process.
Here is a bio hack and potential solution for healing chronic pain
Intrinsic Efforting.
In the moments of most intense friction note that this is painful-hard and because it is it will evoke a DOPAMINE release later and increase baseline sensation of accomplishment.
Tell yourself that “I am doing it by Choice and I LOVE IT.” If you don’t believe in it, Start.
Feel it feeling better. Believe in it whole heartedly, whole body.
See yourself moving with more coordination and easing effort.
Find the pleasurable in the effort and struggle.
Willingly embrace the effort-activity as pleasurable in the moment and this pathway will strengthen, your baseline will be raised up and will need less Dopamine to motivate the self. Other neurochemistry will stabilize and act as effort upregulators and brakes as prn in the whole cycle such as Serotonin and Cortisol, E and NE. Consider that even in the stretch Oxytocin and Vasopressin will enter the fray in relationship to another as we heal ourselves we may find pathways in healing and regeneration of loving relationships.
Access pleasure from effort is the most efficient manner in which to use our Dopamineric pathways for the overall good in adding to the healing trajectory. It Just works. Like a Dividend reinvestment plan it pays handsomely with consistent and reproducible deposits into the account of healing.. Compounding baby!
A LESSON FOR YOUR PATIENTS AND CLIENTS
Take them through a set of movement practices-lessons that they have found unable to obtain.
When it is difficult offer this lesson:
Preload the exercise with a mindful exercise to build on the intrinsic reward pathway.
“I am doing this by my choice and I love it! I am seeing the movement now as real and complete and then let it go. Do not hold onto the energy of the end point now… The Brain now has it… Make your way to it with good efforting.
(This is preceded by the initial conversation on how to identify the boundaries with discomfort, compassionate edging and pain that may be injurious. in relationship to movement practice)
BON COURAGE, a tous!!