| T O P I C R E V I E W |
| windy |
Posted - 09/23/2005 : 09:47:25
Hi Everyone,
The foot pain that I posted about in July is still on me and feeling worse. I've used TMS protocol in the past successfully but this time I'm having a hard time veering away from structural stuff. I have not gone to a doc b/c I suspect they'll say:
1. you have flat feet and need orthotics
2. this muscle is weak - you need physical therapy for your feet
3. you need orthotics and physical therapy.
I've gone thru a major life change over the past few months (leaving a job I head for 12 years to go back to school full time for a career change, the pressures of grad school after being out of school for so long). In fact, when I think back, I started having sporadic foot pain beginning when I got my acceptance letter to grad school, but somehow I wonder if that's just coincidental.
I feel I've been dealing with this whole changeover without my usual level of obvious stress, which I realize in and of itself can be the problem. Basically, I'm not sure what to do.....I'm well aware of tms and how it works. Not sure why I can't make it work here & now.
Thanks,
Windy |
| 16 L A T E S T R E P L I E S (Newest First) |
| Stryder |
Posted - 10/16/2005 : 19:03:25
quote:
Originally posted by drziggles
So, yes, the unconscious causing physical symptoms so severe they could cause one to commit suicide just to avoid dealing with uncomfortable emotions does seem like killing a fly with a sledgehammer....
This line says it all...
"TMSers think and live in the extreme." -- floridaboy |
| barbara |
Posted - 10/16/2005 : 17:44:28
Windy,
I am keen to hear how you are progressing with the foot pain. I am also interested in how successful Sarno is in this area. I too have foot pain - tendinitis of some sort - and if I accept the worst prognosis my tendon could actually snap and I would then have posterior tibial dysfunction. Or, adult acquired flatfoot. That seems pretty physical (and painful!) to me. I seem to have had one tear - and although it was just one instance of sharp shooting pain I have developed ongoing tendon pain and discomfort, worse when I carry heavy things. I am really struggling with the idea it is TMS and I have regularly noted that Sarno obviously has a bit of difficulty persuading people that foot pain is not somehow structural.All the best to you - you have come so far I can imagine how frustrating this thing is!
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| PeterW |
Posted - 10/15/2005 : 11:06:18
Thanks Dave and Dr Ziggles. Yes it does seem irrational and completely self destructive, creating symptoms and disability that invariably will add mountains more pain, anger, anguish, frustration, sadness guilt etc on top of what was already there, or burying it all even further. Just digging an even deeper pit for itself. But you're absolutely right, who knows how that bleeping unconcious works anyway? When you think about it, we humans never evolved for this high stress, high expectation, be perfect, gotta scheme for a better future, gotta be nice to everyone, gotta do this gotta be that kind of culture that we live in today. Through most of human evolution it was either kill what is necessary to survive in this moment or perish. So little wonder that in the highly evolved new paradigm of Western Civilization, the least evolved part of our brain gets all messed up. It just doesn't know what to do with all the pressures, worries and fears.
So I think it is (finally) making sense to me that it DOESN"T make any sense. But I agree that getting all hung up trying to figure out the details of the TMS process is a futile exercise. Just a habitual overthinker here I'm afraid. Part of my battle . . . |
| Dave |
Posted - 10/14/2005 : 08:20:18
quote:
Originally posted by PeterW
...I have to wonder whether there's not something else going on, at least in some of the severe cases, something at an even deeper level...
It is futile to attempt to figure out the details of the TMS process. Most likely it is beyond our current comprehension. Dr. Sarno has formulated the "symptoms as a distraction" theory based on his many years of experience with thousands of patients. I'm sure even he would not be shocked if his theory was proved incorrect, or at least incomplete. But in our lifetimes, all we will have are unproven theories.
It is not surprising that TMS is an irrational process. It comes from the part of the human brain that is least evolved; the part that distinguishes us from the other creatures on this planet.
Perhaps the most important part of Dr. Sarno's theory is that it doesn't matter! We do not need to comprehend the details of how TMS works. We just need to accept that the symptoms are psychogenic. The biggest part of recovery is reconditioning ourselves to think and react differently whenever we are aware of the symptoms. It is not necessary to delve into our unconscious and try to resolve all of our deep emotional problems. |
| drziggles |
Posted - 10/13/2005 : 19:40:41
When you think about it, I think everyone with TMS, regardless of the manifestation, would rather deal with their underlying emotional problems than have the pain they endure. However, it isn't our decision to develop this problem, but that of our unconscious mind, which is very irrational. So, yes, the unconscious causing physical symptoms so severe they could cause one to commit suicide just to avoid dealing with uncomfortable emotions does seem like killing a fly with a sledgehammer....but that still doesn't mean it isn't true. It's just not rational. |
| PeterW |
Posted - 10/13/2005 : 14:20:58
" ..For people to be driven to suicide because the pain is so bad ...that's one heck of a psychosomatic illness.. "
I hear you on that one Art. It doesn't seem to add up, at least at first glance, not with the 'symptoms as a distraction' theory. This is a difficult topic and probably deserving of its own thread. But it does brings up something I've been grappling with for awhile, since discovering Sarno, that I am convinced that there's gotta be more going on for some than a defense mechanism.
I personally knew a suicide victim (Chronic Fatigue Syndrome) and have heard of numerous other people who did, or tried, or considered it at one point due to intractable pain, CFS, or fibromyalgia. Having personally suffered severely (and now largely recovered) from CFS I can readily understand the motivation. I mean, full blown CFS is BAD. Every horror story you've ever heard doesn't even come close to capturing the misery. And personally, the stress, emotional toll and eroded self esteem produced from just HAVING this devastating illness was beyong enormous.
This is why I somehow have difficulty with the concept that the subconscious creates all these TMS equivalent symptoms, for everyone, as a distraction. I mean, would the subconcious really create something as a defense mechanism that was so emotionally traumatic in itself, so unbearably awful and crippling (physically, mentally and emotionally), that its own survival would be threatened? I have to wonder whether there's not something else going on, at least in some of the severe cases, something at an even deeper level.
Sarno says in Healing Back Pain "For many years I was under the impression that TMS was some kind of physical expression or discharge of the repressed emotions". It was a psychoanalyst colleague of his (Stanley Coen) who first suggested the defense rational after Sarno's first book, and it seems to have become unquestioned gospel. But to me, the earler interpretation makes more intuitive sense, at least for some of the really bad stuff. In other recent TMS type books, neither Seigel (Back Sense) or Selfridge (Freedom from Fibromyalgia) follow the defense or distraction explanation. Selfridge follows the Candace Pert concept of molecules of emotion flooding the body with pain signals. But it's still subconcious, psychosomatic, Mindbody, whatever you call it, just more of a repressed emotional flood or an emotional blockage trapped in the body than a clever distracting ploy.
No, maybe it doesn't really matter how you conceptualize it, and the distraction theory does work for most. And yes, some will say that I'm thinking too much or that my subconcious is playing tricks on me or protecting itself even by suggesting other alternatives. But for anyone any plan has gotta make intuitive sense to really believe and follow. And something that is suicidal bad as a defense mechanism really doesn't to me, having been there, knowing others who have been there, and I just know that to keep it simple and believable I have to follow another interpretation regardless if anyone else thinks otherwise.
And I also know that digging for and truly feeling a lifetime of repressed feelings remains critical for recovery, regardless of 'concept'. So back to the emotions . . . |
| n/a |
Posted - 10/13/2005 : 08:11:55
As long as you talk about and concentrate on the physcial pain it will remain with you. It is a sad reality and a hard lesson to learn but it is true. Pain is a distraction to keep you away from what is taking place on the inside, and a powerful one at that, and talking about it or focusing on it will ensure the perpetuation of physical symptoms. |
| altherunner |
Posted - 10/12/2005 : 20:14:06
I had lingering foot pain, after my neck and back pain left. I had to run with orthotics, etc. One day at the lake, my teenage daughter was lost with her cousin. I ran 7 miles around the lake in sandals, which would usually cause a lot of pain. When I got back to the picnic grounds, and they were back, I realized I had not had any foot pain. I was distracted by fear. I have not had foot pain since. |
| n/a |
Posted - 10/12/2005 : 09:32:19
The link does not seem to work. Hoping that the moderators do not object, but here is the full text of the article:
The Big Hurt
Issue of 2005-10-10
Posted 2005-10-03 - New Yorker
http://www.newyorker.com/online/content/articles/051010on_onlineonly01
This week in the magazine, Jerome Groopman writes about reflex sympathetic dystrophy, a type of intense chronic pain, and how a better understanding of R.S.D. might help to explain certain fundamental aspects of the nervous system. Here, with Ben Greenman, he discusses the topic.
BEN GREENMAN: What first interested you in R.S.D.?
JEROME GROOPMAN: Several people I know developed it, and they saw a number of physicians until the correct diagnosis was made. Along the way, they were given a lot of misinformation and misdiagnoses. I became intrigued. I didn’t know much about it myself. And, the more I looked into it, the more I realized that it was important. It was not that rare a condition. And thinking about pain in this new way had the potential to give us a window into a new understanding of the central nervous system.
How much is known about pain in general? In medicine, obviously, it’s managed all the time, for surgical procedures and terminal illnesses and everything in between. But pain itself seems poorly understood. Why is one of the most common conditions also one of the most elusive?
I think that, in classic medical education, pain has either been overlooked or disliked. It’s the kind of situation that is often very frustrating to doctors. The therapies are not easy or pleasing. Until recently, it did not have its own specialty. In the past, physicians would just write a prescription for a narcotic and hope that the patient found enough relief not to come back and bother them. A lot of the patients in my article, the ones suffering from R.S.D., would have entered a medical purgatory, where they were largely shunned by the medical establishment. More recently, two things have happened. There’s been increased understanding of the biology of pain, and I talk about that in the article. Also, there are very committed physicians who believe that this is an important clinical issue, and they have begun to devote themselves to the care of these patients.
One of the things about pain that you mention in the article, and that people intuitively understand, is that it’s subjective. When you take a history of a patient’s pain, you have an essentially subjective complaint. Thresholds are different, and there aren’t always visible or measurable symptoms—although, in R.S.D., there is skin-temperature increase and inflammation. The subjectivity of pain must be something that thwarts and frustrates physicians.
I just got off the phone with a close friend who fell yesterday and smashed her arm. Luckily, nothing’s broken, but she has an extraordinary pain threshold. She does not take Novocain when she goes to the dentist, and it’s not because she’s a masochist; it just doesn’t bother her that much.
So is that the kind of person who might, in theory, have a low-lying case of chronic pain?
Well, there are some pains that wouldn’t register with her. But I think that what’s interesting about R.S.D.—and what distinguishes it from any other pain syndromes—is that it can affect anyone. It’s not predicted based on people’s prior pain thresholds. For example, the woman who is the main figure in this week’s piece, whom I call Barbara, is someone who’s very athletic and active. She doesn’t have the “classic pain personality,” which physicians have portrayed in the literature: people who don’t want to work, people who are not motivated, people who are terrible complainers, people who have a little bump and think it’s the end of the world. This is a woman who has been thrown from a horse, fallen down a flight of stairs, torn her hamstring, and hardly complained about any of her injuries. Then R.S.D. came along and affected her the same way it affects everyone—it’s debilitating. So the mystery of this is that the psychological predisposition to reacting to pain doesn’t seem to be determinative.
Can you explain the difference between adaptive and maladaptive pain?
Adaptive pain is pain that assists the body in healing or protects the body. So, classically, you’ll withdraw your hand from a flame, or you’ll have surgery and the area will become inflamed and swollen and painful, and you’ll be forced to rest it, so that healing can occur. It’s either protective or it fosters the natural healing process. Maladaptive pain—and R.S.D. is a severe version of it—is essentially a neurological disease. You develop circuits in the spinal cord and in the brain which are signalling continual pain, despite the fact that there is no painful stimulus. Or you develop circuits in the spinal cord and in the brain in which peripheral nerves—nerves from your fingers or feet or legs, which normally carry innocuous or even pleasant sensations, like a breeze fluttering or a soft touch—now send signals that are interpreted in the brain as being painful. That’s maladaptive. It gives no benefit to you, and actually is extremely destructive.
What are the effects of defining something like R.S.D. as a disease, as a neurological condition in which signals are crossed or distorted?
By focussing on the authentic biology and casting it as a neurological disease, it takes away the negative stigma and elicits not only sympathy but concentrated clinical attention.
The cases cited in the article seem to involve truly excruciating pain. One woman who was a friend of Barbara’s has committed suicide, and Barbara admits that she has considered it. If someone is afflicted with R.S.D. in a foot, would amputating the foot help?
The stump would still be excruciatingly painful.
So the pain remains whether or not the limb does?
Correct.
And the effect seems to be to drive people out of their minds, and out of their lives.
That’s exactly what it does. The only analogy that I can think of is being under constant torture. For people who were in concentration camps or at prisons under Saddam—those kinds of places where every day you are subjected to excruciating pain, with no guarantee that it is ever going to be alleviated—their lives would have become empty, and not only empty but torture.
Traditionally, as you say, pain has been treated with narcotics, and there are often side effects—addiction to painkillers being the most obvious. As you point out in the piece, therapies like nerve blocks are used to treat R.S.D. as it becomes better understood. Are there also cases where old, blunt, and not so efficient therapies are being abused? Or, for that matter, are there crank therapies?
It’s interesting. These people generally don’t have a very high addiction problem, because they don’t have what’s called an “addictive personality.” They have terrible pain, and they use their medicines very judiciously. In fact, a lot of them don’t even want to use their medicines, because they don’t like the side effects. So they’re not psychologically predisposed to addiction. I think there is still a tremendous need for better therapies. As the biology has become better understood, there are drugs emerging that target specific neurotransmitters, specific channels, and so on, which can help these people. The more extreme interventions, with nerve stimulators, for example, are a relatively recent development—in some cases the results are tremendous, and in others the technique doesn’t succeed. I haven’t seen a lot of crank therapies, because there is not much placebo effect here. You tend to see crank therapies proliferate where the placebo effect is profound. But the kind of pain that these patients are having is not amenable to suggestion or emotional state.
Do you have any sense of how common something like R.S.D. is? There seem to be diseases that crop up more and more often—because of the way people live now, or because of environmental conditions. Carpal tunnel is one. Is there any sense of whether R.S.D. belongs in this category?
I wrote a piece for The New Yorker a while ago about fibromyalgia, and how, historically, there have been poorly understood pain syndromes that were related to the introduction of new technology. For example, there was something called railway spine, chronic and disabling injuries sustained as a result of minor railway accidents, often, when railroads were first introduced, in the nineteenth century, and clearly that’s gone. This is different. To me, it was fascinating to trace this back to the Civil War. And I’m sure it antedated that as well. This doesn’t, to my knowledge, have any cultural or sociological overlay.
So this has probably existed with the same prevalence as long as there have been people but has only recently been better classified and understood?
That’s right. And I think there are large numbers of people who aren’t diagnosed. Some of them are fortunate, because in the acute setting, in the initial setting, if you can tolerate the pain to some degree and keep functioning, the nervous system may be able to rewire itself. Other people, unfortunately, who are not diagnosed, who have chronic R.S.D., just go from pillar to post, basically, and suffer terribly.
As this particular syndrome is better understood, is it likely that the medical community will develop a deeper understanding of larger neurological issues?
If you’re asking whether more attention to this will lead to a proliferation of diagnoses, what distinguishes this from other pain syndromes is that there are objective findings. If you look at the limb of a person with R.S.D., it’s not as though someone has carpal tunnel or someone has railway spine and they’re complaining of pain and there are no objective clinical findings. Here, there are really impressive and bizarre clinical findings. You touch the person with cotton and they’re on the ceiling. I hope that one of the consequences of the article will be that people who have this will realize they have it, and physicians like myself, and even specialists who were never formally schooled in this, will be more alert to it. It’ll be on the radar screen, so that patients can be referred to get help by specialists, and also so that the research that’s done on this condition may lead to better treatments. |
| art |
Posted - 10/07/2005 : 17:20:37
Hi Holly,
I know, and I had that bias of course as I read through the article..but bottom line is nobody really knows..For people to be driven to suicide because the pain is so bad ...that's one heck of a psychosomatic illness.. I was very interested to read that the affected limb is given to temperature swings...One woman's arm swelled up so badly she was afraid that it would literally explode..
Yikes. |
| holly |
Posted - 10/07/2005 : 15:45:12
Art,
Interesting article. In SarnoLand RSD is hogwash. It would be great if they came up with a medication to reverse this.
thanks for the article.
~Holly~ |
| art |
Posted - 10/07/2005 : 14:41:04
Holly,
There's an interesting and sympathetic article in this week's New Yorker on RSD.
Also an online interview that you might find helpful
www.newyorker.com/online/content/articles/051010on_onlineonly01+RSD+new+yorker+magazine&hl=en" target="_blank">http://64.233.167.104/search?q=cache:6CzuQ_xvRD0J:www.newyorker.com/online/content/articles/051010on_onlineonly01+RSD+new+yorker+magazine&hl=en
A. |
| holly |
Posted - 10/07/2005 : 06:46:15
Hi Windy,
I too have been experiencing long term foot problems. (3 years now of constant pain in my pinky toes). I too had major life changing sucess from practicing Sarno's TMS theory many many years ago.
Then in 2002 I went thru a very tramatic 4 month incident involving my perfectly healthy, active 69yr. old mother having a huge cerebral bleed in her brain one night at dinner at my home. Knowbody even knew it was happening. Then having to make a decision to withhold putting in a feeding tube in her and then visiting her daily while waiting for her to die. I could of let her live but she would have been paralized down her whole left side. She had also developed a bed saw on her back in the hospital the size of a basketball and I was told her bones were comming thru her skin (I never looked) It just went on and on........(she did have a living will but that really didn't help much in this case)
I have been diagnosed with RSD and more recently Polyneurophathy. I really thought it was TMS in the beginning as it made so much sense. I clearly remember walking in the cementary, one year after to her grave for the unvieling of her stone. My pinky toe was rubbing so bad against the inside of my shoe. It started before that but was "peaking" that day!
It just made sense that it was from TMS. Now 3 years have come and gone and I am not so sure anymore. I have yet to find anyone on this board with this same problem. I do know that feet can be a target zone. I don't know anymore except that I am just so frustrated with this too! Cold weather is coming and I can never find a pair of shoes that don't bother my pinky toes except Puma Mostro sneakers. I know I am running on and on so I will cut it here. Good luck. I hope you find an answer as I certianly haven't. |
| windy |
Posted - 10/03/2005 : 14:06:33
Well, I emailed Dr. Sarno because my foot pain is worsening still. Even though I can logically list all the reasons why tms would be active now I'm apparently not getting to the heart of the matter. Anyone have good ideas on emoting better, or should I say accessing emotions better? I'd like to avoid therapy because a) I didn't seem to need it the first go round a few years ago. In fact I had picture perfect results within a few weeks and was ecstatic b) now I'm a full-time student with no income. no stress there.  |
| art |
Posted - 09/23/2005 : 15:49:41
Windy,
Me too. And Andrew has it right. Because it seems to make sense when our feet hurt..after all we're always on them....it's hard to fully accept the pain is TMS.
I had a very painful case of metatarsalgia. I'm a runner, had just got new and poorly fitted orthotics which pressed right on the spot where the injury appeared, plus I'd ben increasing my mileage. Talk about a great disguise for an injury.
But I just decided to believe. Every other injury I'd applied the TMS approach to went away, so why not this one too? Lo and behold, it got slowly better and not because I laid off in any way. In fact, I did more. I also own a kickbike which before I accepted the TMS diagnosis really seemed to aggravate the thing, and I increased my mileage with that too.
Foot problems go away slowly, but they do go away. And the good news is the pain's benign. So no worries there.
There's always a counter-argument whenever you start to try apply the TMS model. I call them "yes, buts." Yes, but this. Yes, but that. So I've learned just to stop debating whtehr it is or is not. Or try to anyway. So far I haven't been sorry. |
| Andrew2000 |
Posted - 09/23/2005 : 11:12:39
Hi Windy,
I can totally relate to your foot problem -- have been battling the same kind of problem since April (so it's been about 5 months now)... and prior to reading or hearing about TMS, went to see a Dr., who as predicted, prescribed expensive orthotics, exercises, etc.
I wore the orthotics, did the exercises, and no improvement. Then about two weeks ago, I started hearing/reading about TMS ...
I'm now convinced beyond a shadow of a doubt that it's TMS-related. There was no physical incident that explains why the problem began (although the Dr. said it was from 'overuse') - I'm pretty athletic, work out a lot, and never had a foot problem before -- so why now?
After hearing about TMS, I realized that my problem began just after a very intense period for me on the job, dealing with a boss who was really demanding and tough -- I had to hold in my anger and frustration a lot. Ironically, now the boss is gone, and they've put me in charge, which on a different level has created even more fear! ... So I can understand for me why the problem has been persisting awhile on an emotional level ...
TMS experts say that problems with the feet can be difficult - they can linger - because it is hard to totally accept that there is no structural problem ...
Slowly I'm starting to see some improvment as I face my fears and accept 100% that this is a TMS problem, not structural ... I went back to doing some of the exercises I had been avoiding out of fear of making the problem worse; took the orthodics out of my shoes; have been writing my thoughts down every night in a journal; and reading the books on TMS ...
Am now having good days and bad days with the pain (as opposed to every day and every moment being painful like before). A few weeks ago. I never would have imagined that emotional tension could cause pain in the feet (of all places!), but I think you have to believe it 100% in order for the pain to fade away ... keeping a sense of humor about yourself and the problem you're facing helps, at least for me.
Hope you feel better.
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