| T O P I C R E V I E W |
| art |
Posted - 09/02/2005 : 11:23:41
I have no way of knowing whether fibromyalgia is an extreme form of TMS or something else entirely. Nor does Dr. Sarno. He has an opinion, but that's all when you come right down to it. I have a "weird" illness myself that most mainstream doctors do not accept as a "legitimate" malady, whatever that means, characterized by hypoglycemia, food sensitivities, and chronic fatigue. Dr. Sarno would also say this is nothing more than an extreme form of TMS. I'd like to believe that, but I'm simply not smart enough to figure it all out yet.
I think you're all way too hard on Mary. I agree with her that there's often secondary gain issues in these illnesses...This is an old Freudian concept and it's just as valid today as it was 75 years ago. Most of us consciously want to recover, but as we TMS'ers know, that's far form the whole story. I don't think any of us are particularly well-served in being defensive about this issue..I personally can point to half a dozen "advantages" to my being ill, one of them being that I don't have to eat dinner anymore with my parents given my food issues, which if you knew my parents you'd immediately agree was not a bad secondary gain right there. 
Mainly, I think the less defensive we are, and the more we're willing to explore the complicated terrain of our own minds, and our own emotions, the better off we are. No one is saying that our suffering isn't real, but it seems to me that beyond that, everything else is or should be fair game for discussion.
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| 20 L A T E S T R E P L I E S (Newest First) |
| JohnD |
Posted - 09/08/2005 : 08:52:08
well i think the original point being made was that secondary gain could play a part in some but not all. I agree with all the people who said that the people who are trying to get well for the most part don't have significant secondary gain issues. I do think there is a point where secondary gain can be considered, maybe after someone is applying Sarno's techniques for an extended period of time (over a year) with minimal results. At that point it is only wise to look at what else could be going on, and address those issues as well. the bottom line is that we all to get rid of our own pain, and if considering a certain issue can help with that then why not just allow for it to be a remote possibility. i was talking to a friend last week about the topic of healing and jokingly said "if i had a case of chronic hemorrhoids and somebody told me that peanut butter and jelly worked for them, you can bet your bottom dollar that atleast once i'm going to stick that PB&J where the sun don't shine" |
| Fox |
Posted - 09/07/2005 : 12:33:53
On the topic of secondary gain (the avoidance of responsibility and work as a reinforcing byproduct of a pain syndrome), Sarno, at least in his CD, states that secondary gain is not a significant factor in the lives of TMSers. He states that either secondary gain is not an issue at all with the individual TMSer, or if it is an issue with an individual TMSer, it's only a minor component of the TMS syndrome. Sarno says that the behaviorists who try to treat the pain syndrome from the viewpoint of secondary pain philosophy are "singularly ineffective". That's good enough for me. |
| n/a |
Posted - 09/05/2005 : 20:05:09
Does not make any difference as to the exact how, even Dr. Sarno does not know why people recover or why his methods work, they just do. He has a hypothesis but he cannot prove it in a lab or under a microscope (which is a very narrow view of science in the first place). These patients tried many things and then tried Sarno and recovered. Can't argue with success. All they know is that once they had pain and now they are pain free thanks to Dr. Sarno. Bias or not, it works and has worked for many many people. Contact Dr. Schechter, Dr. Sopher, Dr. Schubner. Dr. Selfridge, Dr. Sopher, all who have treated people with the horrid condition with great success.
The thing with the chiropractor you will be back, as this is merely - for the most part - a placebo. These people are 100% crackpots with no science to back up their claims. |
| art |
Posted - 09/05/2005 : 18:16:37
quote:
If even one recovered that is enough proof for me-
This to me reveals a pretty strong bias.
One problem, scientifically speaking, is that you can't say exactly why they recovered, or even exactly what they recovered from...This isn't something you can see under a microscope. These processes are all invisible.
To simplify things, let's talk about back pain. Suppose I have lower back pain and go to the neighborhood chiro and get "cracked." Two days later I'm better. According to your methodology, that would be sufficient "proof" that the chiropractor healed me. But we know that's probably not true. For one thing, we're not even sure what "healing" means in this case, in large part because we're not even sure of the exact nature of the problem...
Let's say that fibromyalgia is indeed psychosomatic...Isn't it just as possible that the "cure" in this case is some sort of placebo effect? Dr Sarno says it's a manifestation of TMS which he posits is a slight deprivation of oxygen due to emotional conflict. He might be right...God knows I've had wonderful success applying that model to my own case, but ultimately it's just very hard to know exactly what's going on...form a scientific point of view, a lot of work is yet to be done.. |
| n/a |
Posted - 09/05/2005 : 17:18:38
If even one recovered that is enough proof for me- but there were hundreds. |
| art |
Posted - 09/05/2005 : 12:08:55
quote:
Yes, there is a "way of knowing" with 100% proof. Dr. John E. Sarno, and a number of TMS health providers, have concretely established that fibromyalgia IS TMS in the extreme form. The proof? Their fibromyalgia patients get better when using Dr. Sarno's TMS treatments. It has happened over and over and over again. Just ask Dr. Nancy Selfridge who was a fibromyalgia but is now fully recovered. She, along with a co-author who also had (and yes that is the PAST tense) fibromyalgia, wrote a book with the title "Freedom From Fibromyalgia." She used Dr. Sarno's methods as outlined in Dr. Sarno's "Healing Back Pain." Dr. Sarno did admit they are harder patients to treat, but he has had success nonetheless. Best wishes....
I'm as big a fan of Dr. Sarno and his TMS theory as anyone I think. And yet this is really not "proof" of anything. This is anectodal evidence only. Compelling enough certainly, but far from settled.. |
| n/a |
Posted - 09/05/2005 : 11:37:16
quote:
Originally posted by art
I have no way of knowing whether fibromyalgia is an extreme form of TMS or something else entirely. Nor does Dr. Sarno.
Yes, there is a "way of knowing" with 100% proof. Dr. John E. Sarno, and a number of TMS health providers, have concretely established that fibromyalgia IS TMS in the extreme form. The proof? Their fibromyalgia patients get better when using Dr. Sarno's TMS treatments. It has happened over and over and over again. Just ask Dr. Nancy Selfridge who was a fibromyalgia but is now fully recovered. She, along with a co-author who also had (and yes that is the PAST tense) fibromyalgia, wrote a book with the title "Freedom From Fibromyalgia." She used Dr. Sarno's methods as outlined in Dr. Sarno's "Healing Back Pain." Dr. Sarno did admit they are harder patients to treat, but he has had success nonetheless. Best wishes.... |
| art |
Posted - 09/05/2005 : 10:18:52
I'm a little surprised at the intensity of some of the reactions to the idea of secondary gain. We're quite complex organisms and few things are straight forward when it comes to the human mind. If you accept the premise that a particular illness has psychosomatic components, you open the door to all sorts of complicating factors.
There's a Freudian concept called "over-determination" and it simply means that what we dream, and what we do in life, often has more than one meaning, more than one underlying impulse.
I've been as beaten up as anyone on this board in terms of not getting any respect for my pain and suffering. Family members treat my food allergies for example with utter comtempt. And yet, the honest truth is, I do not understand my illness, even after all these years it's utterly baffling to me. If it turned out that on some level I've "chosen" this illness, then by definition I must be deriving some sort of at least subconscious benefit. It certainly wouldn't tell the whole story, but it might be a small but important piece of the puzzle.
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| n/a |
Posted - 09/05/2005 : 02:37:58
I'm not saying that people deriving secondary gain from a pain, or other condition, do not exist. but for the people who post here, I don't think it's applicable. OK - I'm generalising, but when you read the histories of most of us, nothing could be further from the truth. Stories of years and shedloads of money spent trying to get better; that doesn't suggest any secondary gain to me.
It did wind me up when the assumption was made that it might be a factor in my condition. The CBT therapist suggested it to me on our very first meeting - she had had no opportunity to get to know me at that point. She is a fully trained therapist working within the system, so I can only assume that bringing up secondary gain so early in my treatment is something that she has been trained to do, and that in my opinion, is plain wrong.
I suppose it all depends how we define secondary gain. If we use the term to describe a person who is lazy and is fabricating or exaggerating their symptoms, then fair enough. However, if we define it as something more in line with TMS - where the pain is a substitution for repressed negative emotions, then I don't think it applies. Given that most people, including health professionals do not accept that TMS exists, that distinction is not often made.
Anne
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| Jim1999 |
Posted - 09/04/2005 : 22:55:44
Curiosity18,
Thanks for posting what your professional experience shows: fibromyalgia patients are not more prone to secondary gain than other TMS patients.
Anne,
I appreciate most of what you've written. However, I must point out that secondary gain is always used to imply a pay-off, such as getting out of work commitments. Even Dr. Sarno himself uses the term that way. On pages 104-106 of The Mindbody Prescription, Sarno writes that he had previously tried treating patients based on the assumption of secondary. This approach failed to help the patients, and he discovered that secondary gain was not primarily responsible for his patients' symptoms.
Again, other than this terminology issue, I think that your last posting was very good.
Jim |
| art |
Posted - 09/04/2005 : 22:05:33
Hi Suz,
God,I wish I had osme words of wisdom for you. My illness has baffled me for years now. One minute I was healthy and strong, and seemingly the next I was not. Needless to say, I did not lead a very wise life as an active alcoholic...didn't eat well etc. And I just assumed that that had all caught up to me...As I wrote in a recent essay, it was as if after years of physical self abuse, my health just suddenly flew off one day like some startled bird.
I liked this image because it underscores what I had begun to think of as health's precious fragility, and how we take it for granted at our peril. It also felt right to me as I was terribly discouraged and pessimistic when I wrote it. It seemed to me that the chances of my recovering my health after being ill all those years were on a par with that bird somehow deciding to return...in other words virtually impossible...
Lately though, I've begun to change my thinking a little..For one thing, I'd rather focus on the body's amazing resilience and recuperative powers instead of any perceieved fragility...And in the face of some real improvement in my condition recently, I'm less apt to think of regaining my health as some sort of next to impossible dream...For the first time in years and years I think perhaps that I might get well..
My best recommendation I think is to always challenge your assumptions...If you assume you can't do this, try it anyway. If you assume you must do that, see if maybe you actually don't..As a hypoglycemic for example, my standard operating assumption was that I needed to eat lots of meals and could not fast..It turns out that was wrong, that I could fast, and in doing so I began to get a little better...
And of course there are the whole mind/body assumptions that we discuss on this wonderful forum. There's no doubt in my mind that there are some aspects of my illness at least that are psychosomatic. And it wouldn't bowl me over if the whole thing were, that's for sure.
A.
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| Suz |
Posted - 09/04/2005 : 18:33:48
Art,
I am so glad you brought up the topic of food allergies. I often scan the topics for this one as I cannot seem to get rid of my food issues. I am torn between them being TMS or legitimate genetic problems. I wish I had never found out about the blood type diet - I am an O blood and supposedly cannot eat grains, dairy or sugar. I started this diet 12 years ago - around the time I had chronic fatigue and back pain. When I avoid these foods, I have lots of energy, have totally clear skin and feel great. Historically, when I have eaten those foods, i feel like I have a hangover. If I overdo the grains, milk or sugar - my skin breaks out as well.
This is a very hard pattern to break. But it does seem strangely coincidental that many people with TMS have these food issues too. I know Sarno did. Mine have gone on for a long time so I think may take a long time to break.
I also wonder why so many people seem able to eat these foods without any of my issues. I avoid eating lots of sugar and bread now as I don't want to get fat. But in the back of my mind - I think I have a problem with them.
My approach right now - I occasionally eat some of these foods - usually when I am feeling really relaxed and happy. I took a week off and ate some chocolate brownies - with no ill effects at all. I really wonder if the whole thing is due to stress. Why can I eat these foods on vacation but not during my very busy, stressful work week.
Art - have you tried any different methods of introducing these foods? I have to share with you that I am also a recovered addict and alcoholic - I didn't drink for very long - only a year but I did a lot of other toxic things for longer. However, my food issues started way before that - 12 years ago. Hm - strange. |
| n/a |
Posted - 09/04/2005 : 02:04:32
I think, maybe, the term 'secondary gain' is an unfortunate one. The word gain suggests a pay-off: ie - a person gains from maximising how they perceive their symptoms. It suggests a deliberate effort to get more attention or an effort to get out of work commitments: maybe to acquire state benefits or pension rights.
If someone could come up with another description of what Sarno knew was actually the substitution of physical symptoms for repressed emotional issues over which the sufferer has no control, that sounds less like a person is feinging symptoms; probably people would not get annoyed when this is suggested. No control that is, until they begin to explore Dr Sarno's (and, as I'm finding out, a number of other writers on psychosomatic pain) ideas.
Something else that winds me up - in the media the idea of people feigning symptoms for 'secondary gain' is often used - generally in comedy situations.
In Britain - we have a long running soap called 'Coronation Street' which is a national iinstitution. One long standing character - a work shy, stupid guy, is always trying the 'back pain' excuse to get out of work.
Bonnie, what you say is so very true. I've had cancer - people could not have been kinder. I was lucky, it was caught very early and I made a full recovery. This will sound bad, I know, because many people do not recover as easily, but TMS brought much more anguish to my life than that cancer did.
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| Curiosity18 |
Posted - 09/03/2005 : 22:29:02
This debate over whether or not Fibro sufferers have more secondary gain issues than other TMS folks is getting old. As a therapist who works with TMS,as well as with those diagnosed with "fibromyalgia" I have not found any difference in the presence of secondary gain issues between the 2 groups. I also believe strongly that Fibro IS TMS, as evidenced by personality and stress factors. Most importantly, when they are opened to Sarno's stuff, and do the work- they start getting better. It's awsome! I mostly recommend Selfridge's book to them, and recently I've gotten into Howard Schubiner's (TMS physician in Michigan)work. I think is very comprehensive with some really good strategies on dealing with emotions.
Curiosity18 |
| LuvtoSew |
Posted - 09/03/2005 : 20:43:42
Well I'm a very painful person. I haven't been able to enjoy myself the last week seeing whats going on on Tv in New Orleans. I'm a Nurse and I can just feel other people's pain. While working as a Nurse I came down with MS- with physical findings- but I really think thats because I wasn't taking care of myself and I let the stress take over me. People think I'm nuts but I feel so bad the pain that other people are going through and it just kills me. I should of never became a Nurse, but if I ever got the chance to go
back to work I'd be a nurse. Sad but true. I wish I knew the answer. |
| JohnD |
Posted - 09/03/2005 : 13:48:54
I think there are times when we do consciously want to get better, but still could have an unconscious secondary gain. For some people, their pain does say something for them that for whatever reason they can't say for themself. Now this is very different from pain not being real. Of course the pain is real, but that doesn't mean that it doesn't serve a purpose. If it didn't serve any purpose then it wouldn't exist. Think about that for a second. If we understand the true cause of the pain, and the pain still exists (assuming we've given ourselves time to overcome the associated conditioning of the pain)....then we are holding onto it for some reason or some need that we have. Everything we do as human beings has some sort of payoff, either conscious or unconscious, or else we wouldn't be doing it. |
| Bonnie |
Posted - 09/03/2005 : 12:48:30
Anne, I agree wholeheartedly with you about those looks from people who thought I was a fraud, I can't count how many times I saw that look on a doctor's face, that look that said I was just another hypochondriac female looking for attention or trying to get out of work or taking care of my family or whatever. And I'd leave the office either in tears or so angry I couldn't breathe. I ached all over, from my feet to the top of head and I could never perdict when or where it was going to start or stop and I knew darned well I didn't want or deserve this stuff but no one would help me get rid of it or even understand it because none of them understood it either.
Some Doctors or Rheumatologists would say it's Fibro and you'll have it for the rest of your life and you'll always be in pain, they stuck me on antidepressants and pain killers, some of which are now implicated in heart attacks and how do I know if that wasn't what caused mine?
And other Doctor's just sent me to the psychologists who also put me on pills and none of them did me any good. I was on my own and frightened and ashamed and had no one to turn to, even my family felt I was just being too sensitive and making most of it up.
How do you defend yourself against that? What do you do with all those emotions when there is no outlet and no one will listen or even try to hear or understand you?
When I read Sarno's book and found that all those bloody emotions I'd been shoving down inside for so many years were the cause of my very real pain I burst into tears, but tears of relief this time.
I hated those looks, I hated those people who made fun of or discounted what I was feeling and I hated myself for not being strong enough or smart enough to fix what was happening to me. If you have cancer or some other tangible disease at least there's a concrete cause, a diagnosis that you can understand and there is no stigma attached to that, but I felt like I was locked in limbo with no way out.
I'm still shaky, there are days when I doubt my own perceptions and what I'm trying to do and I tend to obessess about every little twinge at times, but it's only been six months and a bit since I started this and I know this diagnosis is right, I've proved it to myself and I will keep doing the work until I'm back to normal.
Bonnie |
| n/a |
Posted - 09/03/2005 : 08:14:58
It's fair and right to discuss the secondary gain idea - one thing I know, however, those of us who post here have not gone down that road. Over and over again I've read accounts of what people here have gone through before they twigged that something psychological was going on - stories with which I can empathise, every time. People desperate to be well and leading the life they want to live.
One reason why some people react badly to the suggestion of secondary gain is that to have that suggested to you when you are trying everthing possible to be well, is that it is so wide of the mark and hurtful.
I undertook a course of CBT (no use whatsoever) prior to finding out about TMS. On my very first meeting with the therapist, she suggested this and had I not been such a goodist, I'd have got up and left, there and then. Every time I saw her, I couldn't get it out of my head that she thought that I was a bit of a fraud. |
| art |
Posted - 09/02/2005 : 17:56:32
Hey Doc,
Thanks for the interest. I've been baffled by my own symptoms from day one, more than fifteen years ago now. It took me years to even accept that I was ill. I fought it tooth and and nail. It just struck me as so absurd that all of a sudden I couldn't eat say, pie or ice cream, or anything with lots of sugar in it. So I'd eat this stuff anyway, absolutely daring my body not to accept what I was putting into it. So you see that on some level anyway I smelled some sort of psychosomatic rat right away. But all that determination notwithstanding, I just continued to get desperately ill any time I'd eat this stuff..
A few years later the food allergies started. This struck me as even more ridiculous, and I fought this tooth and nail as well. What finally convinced me that something all too real was going on was how terribly sick I would get. Eyes red, desperately hungover, utterly drained of any semblance of strength and vitality, I finally gave up and altered my diet.
I guess one thing that confuses me is that if the illness is indeed psychosomatic in origin, it is nonetheless real enough in effect, So for example, I get sick form certain additives, whether or not I know the additive is in whatever I'm eating. So for example, if I eat soup that has msg, I'll get sick even if I didn't know the soup had it.
Also, the intensity of my reactions is so extreme. I honestly believe that if I'd continued to refuse to accept what was happening to me and continued to eat the way I wanted to, I would have died. That's one heck of a psychosomatic illness.
Incidentally, this all started when I was under a tremendous amount of stress...I'd been an alcoholic and tranqulizer addict, and kicking those two habits, especially the xanax, was absolutely devastating. It's known that hypoglycemia sometimes manifests after periods of stress, so I gradually came to believe that I'd somehow messed up my endocrine system, perhaps by way of my adrenal glands..
I would love to believe that this is all a TMS type deal, and in fact have made some effort to do that...but so far I've been unable to convince myself...Much easier for me to believe that my back is TMS say, or my knee, or my elbow, or whatever the overuse syndrome du jour might be...I've had great success on that score...But as to the other thing, that's a bigger kettle of fish I'm afraid... |
| drziggles |
Posted - 09/02/2005 : 16:44:21
I agree about trying to be nonjudgmental, especially as some people are new to the idea when they come to the forum. That being said, the problem you have is very likely to be part of TMS (as long as you have had a thorough medical work-up).
The symptoms you mention are exceedingly common in people with other TMS equivalents, and usually never have any discoverable medical cause. Sure, there could be something that we don't know about yet (there usually is...), but I suspect otherwise. Hell, there's no PROOF for TMS, strictly speaking, beyond anectodal experience and the complete lack of efficacy of the standard medical treatments for things like back pain.
If you believe the TMS concept and have had other TMS symptoms, I'm curious as to what difficulties you are having specifically in buying that the others might be? Sometimes examining those reasons can be helpful in determining how this "defense mechanism" is working for you...
Oh, and I agree that secondary gain DEFINITELY plays a role in some, but certainly not all, people with TMS... |
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