| T O P I C R E V I E W |
| vikki |
Posted - 06/30/2005 : 18:00:30
Hi,
I posted here a couple of weeks ago. I went to see Dr. Schechter about my numerous pain problems, and he agreed that it was TMS. I've been doing his workbook and listening to the CDs. The things I'm struggling with are doubt and impatience. I do think TMS is the most likely explanation for my pain. But I keep thinking that I should keep doing the stretching and other exercises "just in case," and that I should keep resting "just in case." I also keep obsessing about my symptoms and whether they are improving, worrying that if they aren't then I must not have TMS. (I've heard a lot of instant cure stories and keep comparing my situation to them.) I know this is probably hindering my progress. How do you guys deal with these issues?
I am also wondering about the use of meditation or biofeedback to improve awareness of the mind-body connection. Has anyone tried these things?
Thanks!
- Vikki |
| 11 L A T E S T R E P L I E S (Newest First) |
| Fox |
Posted - 07/11/2005 : 14:27:42
Vikki -- I've just started back running again, too, because it's such a stress reliever. I hadn't run in 5 years (except for a few one day attempts) because of pain and fear. I had been walking 45 minutes a day during that time. I'm happy to report that I've run 2 miles 3 times this week. The first day, I was hit with severe sciatica AFTER the run - which was suspicious because I had no pain during the run. I told my brain that I wouldn't tolerate that BS. Although I was extremely fearful, I pushed myself to run the same distance at the same pace the next day, and I had no leg or butt pain during the run or afterwards -- unless I mentally focused on my leg for too long (you know - checking your body for pain). Of course, my brain started looking for a new body site for pain - that it might sucker me into believing was due to structural damage/overuse - after I'd blown the cover on the sciatica charade. So, my left knee got so painful after the second run that I could hardly walk up steps. But the next day, with great fear but even greater resolve, I did the third 2 mile run and the knee problem disappeared within the first block of the run.... I hope to get back up to my 6 miles a day schedule from years ago. I miss those runner highs and that relaxation that comes with adding more distance to the run and the accompanying increase in creativity and problem solving skills. |
| n/a |
Posted - 07/01/2005 : 19:27:28
Here is chapter 30 from Dr. Marc Sopher's book "To Be or Not To Be... Pain-Free." I think it applies to this thread:
Chapter 30
SO WHAT DO I DO NOW? (OR, LET’S GET PSYCHOLOGICAL)
OK. You’ve read this far and now are wondering, “what now?”
It is surprisingly simple, even deceptively so, yet it can be very hard
work. The first thing you have to do is forget everything you have
ever been told about your body. Forget whatever diagnosis you have
been given before. Forget all of the well-meaning advice you’ve been
given by physicians, other practitioners, friends and family. Forget
what you’ve read in magazines, newspapers and other self-help
books. Put all of it aside. See, it’s not so easy, but it is essential to
getting better. You must undo all of the conditioning that has you
believing in a physical or structural process responsible for your
symptoms.
While you are contemplating the previous paragraph and before I
go any further, another point bears mentioning. This is integral to reprogramming your mind, to thinking differently. Attacking your
TMS symptoms does not require positive thinking. While it is good
to think positively and have an optimistic outlook with regard to your
self and life in general, it is not positive thinking that will cause
symptom resolution. If so, most of you would not be reading this. If
so, there would not be an epidemic of mindbody disorders. How do I
know this? Virtually everyone wants to be well. It is the rare
individual who wishes to experience pain and suffering. Most people
try very hard to ignore their symptoms, to soldier on. They try to
think positively; they try to put “mind over matter.” In one form or
another, this is what most self-help books promote. Think positively,
just do it, mind over matter are common themes. Others focus on
stress management, behavioral modification and relaxation
techniques. Don’t get me wrong; these are great skills to have.
Undoubtedly we could all do better with stress management and could
benefit from honing these skills. However, this is not what will
eliminate your pain. It doesn’t require positive thinking. It requires
ACCURATE THINKING. Accurate thinking means understanding
how psychological factors affect our physiology. Only when this
exists can we truly heal ourselves.
Forgetting all that you have been told, in essence creating a new
belief system, is extremely difficult. There are many obstacles, both
within and without. Many people speak to me about fear. Invariably
each has undergone a comprehensive evaluation by their physician (or
multiple physicians). They may have been told they have one of the
diagnoses that I have mentioned here. Very possibly they have been
told that they must avoid certain activities or they will risk further
damage or escalation of symptoms. For many this can be devastating,
particularly if they have been advised to give up or curtail an activity
that has brought them much pleasure. I have dealt with runners,
cyclists, tennis players, hikers, etc., who were despondent about
giving up or reducing their form of exercise. Even when they say
they believe TMS is their problem and I’ve told them to resume
exercise, they admit to being fearful that their symptoms will recur or
increase. Fear is powerful and it is part of the conditioning that has
occurred over time. It takes courage to put aside the fear.
Even when someone tells me they have gone ahead and done their
activity with minimal or no pain, they may admit that they remain
nervous or fearful about the next time. In many cases this may be a
reflection of personality, as well as previous conditioning that needs
to be undone. Remember, many with TMS are prone to worrying –
they may be perfectionists, placing much pressure on themselves to
do well, succeed or be well thought of, or they may be concerned
about their ability to care for, or do for others. They may also have a
more simple fear that their symptoms represent a physical decline or
deterioration that heralds future morbidity or mortality.
So, when someone confronts their fear, does the activity and feels
fine, I tell them to celebrate. CELEBRATE! I tell them to talk to
their brain – tell themselves that they are fine! There cannot be a
physical problem if they were able to do the activity without
difficulty. Celebrating is an important way to re-program the mind.
It is conditioning yourself to think differently about your body and
will help you immeasurably to undo the old conditioning. It will help
you to forget all that came before.
On the flip side, it is important not to be discouraged if symptoms
arise during the course of an activity. It simply means that more
mental work must be done. It is easy for fear and its compatriot,
doubt, to creep in. “Maybe it isn’t TMS, maybe I do have a physical
problem” are common thoughts. The best advice is to simply
acknowledge this fear as part of the old conditioning, of the brain’s
strategy to have you believe there is a physical problem.
A common question I hear daily is, “What should I do when I
have pain, especially a lot of pain?” Here people acknowledge that it
can be very difficult to ignore it and carry on. First, you must talk to
your brain and remind yourself that you are physically fine! Tell your
brain that you are on to its game, that you know about the reservoir of
rage. Like Dorothy discovering the Wizard of Oz behind the curtain,
you won’t be fooled! The pain is not because you’ve done something
that you are incapable of or that you are so feeble or fragile. Try to
pay it as little attention as possible; the goal is for it to distract you
and keep your attention and focus on pain, rather than on what may be
in the unconscious. Many become obsessed with their pain—they
must learn to shift their focus (this is the re-programming, or reconditioning
process). Try not to give in! Try to remain active, doing
the activities that you enjoy.
What about medication? As medication is a physical modality, it
cannot fix the problem. This fact is essential to assimilate. As I’ve
stated earlier, use of medications can, in some circumstances,
exacerbate the problem. Having said this, I do believe there are
certain occasions when use of over-the-counter pain medications may
be done without adding fuel to the fire. It is acceptable to take
medications like acetaminophen, aspirin, ibuprofen and naproxen if
you tell yourself, “This is not fixing the problem. This may take the
edge off or ease some of my discomfort while I continue to do battle
with my brain.” Again, remember that frequent use of even these
medications can worsen the situation, but used appropriately may be
acceptable.
For reasons that are not entirely clear to both Dr. Sarno and
myself, there is great variability in the time required for symptom
resolution. This gets back to the notion of doubt. If someone states
they truly believe that TMS is the problem, that they have been doing
the mental homework and yet are distressed that their symptoms
persist, they may question whether they have TMS. This has the
elements of a catch-22. If you begin to doubt there is a psychological
cause, that there could be a physical cause, then the work is undone
and the brain’s strategy of creating a physical distraction will triumph.
This is part of what I refer to as The Calendar Phenomenon. By this
time, everyone may know of someone whose symptoms vanished
immediately after reading the book or shortly after seeing a physician
trained in TMS treatment. So, an expectation is created in their mind
that their symptoms should recede soon after incorporating this
philosophy. They look at the calendar and become upset as days and
weeks go by. This is where I tell people to look back at their
personalities. The calendar phenomenon is another manifestation of
perfectionist tendencies – it is self-imposed pressure to succeed and
succeed quickly. If they can recognize this aspect of their personality
and add it to their “list” of sources of stress, relief will be on the way.
Fear, doubt, the calendar phenomenon and the failure to think
accurately are examples of some of the internal obstacles to healing.
Several external obstacles bear mention.
#1 You have read this book and become convinced that this
approach makes sense. When you mention it to your physician,
he/she either dismisses it out of hand or nods indulgently, and advises
a traditional regimen including medication, physical therapy, etc.
#2 You have read this book and become convinced that this
approach makes sense. When you mention it to your friends, family
and/or co-workers, they look at you as if you have lost your mind.
They, too, may nod indulgently and then recommend a physician,
practitioner, medication, herb, etc.
#3 You have read this book and become convinced that this
approach makes sense. When you pick up a magazine and read an
article discussing symptoms like yours, there is no mention of TMS as
a possible cause. Or maybe, just maybe, there is a brief mention of
Dr. Sarno’s work with TMS, but other quoted sources dismiss it out
of hand. As you trust the members of the media to do their homework
and provide accurate, complete information, you begin to wonder
whether TMS is for real.
These scenarios occur every day. They may contribute to the
conditioning that allows the pain to persist. Even in my own office,
when I am introducing one of my established patients to TMS
concepts, they may get angry or look at me as if I have two heads.
You see, they have come in unsuspecting. They have come in to see
me for evaluation of some physical symptom and did not expect to
hear that it may have a psychological cause. Some are delighted,
enthusiastic and quite willing to think outside of the box. To the
others I explain that I can only expose them to this different way of
thinking, that I cannot make them believe it. I will certainly try to
make my case and be convincing, but it is ultimately up to them to
decide.
Perhaps when TMS theory and treatment becomes embraced by
the medical mainstream, more people will be open to this way of
thinking about themselves. For those that do, it is extremely
gratifying to see them succeed at getting rid of their pain and
improving their quality of life. Trite as it sounds, I became a
physician to help others, to help them when they are ill and keep them
well. I am saddened when people refuse to accept the possibility of a
psychological cause and so continue to suffer. |
| mala |
Posted - 07/01/2005 : 18:16:22
Vikki,
It seems to me after reading your posts including the ones on the other thread that you are having doubts. Instead of totally accepting the fact that you and have tms (which is essential for recovery) and working 100% on getting better you are focusing on how long it's going to take and saying that you are annoyed with Sarno etc. If there is anyone you should be annoyed with it's yourself for being a tad too impatient. Also, don't try to place your annoyance on someone else. Rather, find the source of your annoyance and rage and work on it. Use examples from this forum of people who have taken longer to get better rather than focusing on those from his book. Also most importantly, do not be afraid.
I had pain so bad for 4 years that I could'nt sit for more than 10 mins at a time. Slowly, I gave up things that I enjoyed. I couldn't go to the cinema, I couldn't sit and chat with my friends, couldn't sit on a plane, go dancing. I used to lie in bed and cry. I went to every doctor, tried every treatment in the book and nothing changed. I even stopped working for a year.
The first time I tried Sarno, I did it halfheartedly and gave up after a few months. The second time round I did it seriously and it has taken me over a year. I can now do almost anything. I wear high heels, I go dancing . This year I have been on 4 holidays already. I go to the cinema, I work. From time to time the pain tries to grab a foothold.(the mind doesn't want to give up easily.) I know that it IS TMS and I deal with it according. In other words I ignore it.
If you believe in it, be patient, do the work seriously, ignore the pain and most importantly be fearless there is no doubt in my mind that you will get better.
Good Luck & Good Health
Mala |
| n/a |
Posted - 07/01/2005 : 13:06:38
I am on day seven and am going through it for the first time. I havbe read Dr. Sarno's books and some other TMS material also so I read quite a bit. My problems began about a year ago but I only read Dr. Sarno's work about 5 months ago also. |
| vikki |
Posted - 07/01/2005 : 12:17:43
Thanks, everyone, for your replies. Yeah, having the pain move made me feel happy that maybe I was finally onto something. I am totally ignorning the knee pain and keeping on running ...
Peter, I am on day 8 of the workbook. Are you going through it for the first time too? I would like to compare notes sometime if you're willing.
BTW, I've had all this pain for about 5 months. Never had any problems like this before, though I did have some TMS equivalents (mild IBS). I know I need to be patient, but it's hard when it's completely turned my life upside down -- not being able to sit has really messed up my career and social life. |
| Dave |
Posted - 07/01/2005 : 08:57:46
quote:
Originally posted by vikki
I do think TMS is the most likely explanation for my pain. But I keep thinking that I should keep doing the stretching and other exercises "just in case," and that I should keep resting "just in case." I also keep obsessing about my symptoms and whether they are improving, worrying that if they aren't then I must not have TMS.
This basically says that you have not yet accepted the TMS diagnosis.
If you accept that it is TMS, then you must stop any physical stretching or exercise designed to alleviate the pain. Meditation can be a useful exercise, but should not be viewed as a remedy.
You will need to banish the "just in case" thinking in order to get relief. You must give yourself over to the diagnosis, even if you have lingering doubts. You must also accept that treatment is long-term. You cannot put a timetable on recovery. You are embarking on a life-long change in the way that you think about the symptoms. You are breaking conditioning that is deeply ingrained in your personality. This takes time ... weeks, months, maybe years. How long it takes is irrelevant. The important thing is acceptance and focus. |
| mala |
Posted - 07/01/2005 : 02:12:02
Vikki,
Congratulations. The shifting of the pain to different places is a precursor to the fact that you are progressing well and are on the right track. It is an excellent sign and means you are on the mend. I know it is hard to but don't get impatient. I don't know how long you have had the pain but it doesn't always go away soon. At first it gets worse, then it shifts here and there. As you get more and more brave and start to do more physically it may flare up and then get better. In the beginning you will have more bad days and less good days. Don't let it get you down. Then you will have more good days and less bad days. From time to time this b***** tms will try to come back and bite you on the bum. But by that time you will be such an expert in this that you will merely laugh it off.
It could take a few months. It could take a year. So stay in there and keep focussed. Using pain killers and Ben gay is fine so long as you know what the real cause is.
Good Luck & Good Health
Mala |
| n/a |
Posted - 06/30/2005 : 22:24:12
I am now going through Dr. Schechter's workbook also so if your would like to compare notes I am willing.
Dr. Sarno does mention on meditation in his book. Remember, as Dr. Sarno notes, that we have to "think" our way out of TMS so taking time to meditate over what it is going to take to get better and reflecting on our life situation is a step towards recovery. |
| altherunner |
Posted - 06/30/2005 : 22:14:47
I found that strong painkillers, and hard excercise helped me the most when I was really hurting, sometimes both at the same time.
hope this helps, al |
| vikki |
Posted - 06/30/2005 : 21:58:03
Thanks for the help. I've tried to ignore the pain as much as possible and focus on emotional issues. I've started running again (felt empowered to do so after reading Sarno's book). The sciatic pain going down my legs is actually quite a bit better (yay!). What I'm left with is intense pain on the inside of my sit bones, making it excruciatingly painful to sit. I also have awful pain in my neck and shoulders, which seems to have gotten worse now that the sciatica is improving. I'm also having all this new pain in my knees all of a sudden. Classic TMS, I know. I actually started laughing last night when I used my right arm to brush my teeth, and my LEFT arm started to hurt.
I'm writing every night about things in my life that bug me -- trying to uncover any hidden sources of rage or fear. I'm also writing down all my doubts about TMS and then using the various TMS books to respond to them. Before I learned about TMS, I spent WAY too much time researching my symptoms and have read all kinds of scary stuff about surgery and permanent nerve damage. All the specialists had given up on me and sent me to pain management, where I was told that I faced a lifetime of drugs and injections. I remember feeling totally liberated when I first read about TMS. I think I just need time to accept it 100%, especially given all the stuff I've read about structural problems.
What about using physical treatments to stop pain? Is it okay to do that? I find that rubbing on some Ben Gay or sitting on ice helps take my mind off the pain so I can concentrate on other things. But I know how important it is to stop physical treatments. |
| Fredarm57 |
Posted - 06/30/2005 : 19:47:07
Vikki:
As long as you are focused on your symptoms, it's going to be hard to get better. You have try to ignore them and keep going about your business as normally as possible. I know that this is easier said than done. Same with worrying about when they will go away. Everyone wants the pain to go away "now"! There are a lot of "instant cure stories" but there are also a lot of people like me. The first time through, it took me about a year to see significant progress and a couple of years to be really free of TMS. This is not to scare you or worry you (I was a real mess), everyone has their own pace of recovery. It is common to have relapses in the early stages too. It's kind of a "two steps forward, one step back" kind of process.
How to deal with it? Keep reading the books and listening to the CD's. Work on the workbook. Try to identify the things in your life, past or present, that might be bugging you. If Schechter isn't doing it for you, try Sarno, Siegel or Sopher (notice how these guys all start with "S"?). Know that the pain will eventually go away. Try to focus on the present and not worry about how long the pain will take to go away or whether it will come back at a crucial time (if you worry about that, it will). Mindfulness or meditation techniques can be helpful. Ron Siegel has some good ones in his book "Back Sense". Try to do some fun things in your life or things that you have given up because of your pain. Go see a movie, take a walk, read a book, go for a drive in the country. For me, it was getting back into community theatre, which I felt that I couldn't do becuase of the back pain.
Notice the pain-free moments, notice when you're in pain how it changes and moves around. Some people have success with fighting the pain, yelling at their brains to stop pulling this stupid stunt. For me, acceptance worked--"OK I have some pain, but it will go away, what's been bothering me lately?". Don't obsess about "fixing it". Keep posting on this board--everyone has to find the approach that works for them. There are good people with good advice here. You can do this!
Fred
Fred |
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