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T O P I C    R E V I E W
Sean Posted - 07/06/2006 : 08:53:01
I have been at this for over 9 months now and have seen no improvement, so I am getting a little frustrated and am starting to question whether I have TMS. I was in full belief for most of the time, but as of late my faith has wavered. I have done the reading and thinking psychologically, but to no avail.
Most of my faith has been diminished by my lack of progress, but some doubt has been introduced by reading The Divided Mind. I have read Healing Back Pain several times and I have read The Mindbody Prescription once and just recently finished The Divided Mind.

In the past many have questioned the fact that they did not have tender points in the 3 locations Dr. Sarno mentions. There were replies written that these tender points do not have to exist and maybe someone even quoted a TMS doctor to that fact. So until recently I was ok with these responses. Well, as many of you know The Divided Mind has many chapters written by others doctors that treat TMS patients, most of which mention they look for tender points on physical examination. They explaining that tender points are “universal” or occur in “virtually all” cases of TMS patients.

So question #1 is, what is the truth? Do you need these tender points or not? I would think that if they were not needed to prove a patient has TMS someone would at least mention that in the book.

My second concern is all the examples of “cured” TMS cases mention that the person is healed in less than a month. Maybe there were a couple of cases where it took 2 or 3 months, but even for these examples the author mentioned “most of the pain was gone in a month and then the person was pain free within 3 months”. I know everyone says don’t put a timeline on it, but if it were common to take 6 month, a year, 2 years why is there NO examples like this given or any type of reassurance in the books?

Am I to believe that of the dozens of examples given, 85% of people are cured in 2 weeks, 15% take less than 2 months, but 95% of the people on this forum take longer than 2 months? The books even give examples of people who just read the books without having an examination, and were relieved of their pain in 2 weeks. So that brings me to question #2, if it is common for people to take longer than 2 months to cure themselves why do they never give examples as such?

My third question is that if you don’t need to know what is causing your rage, but merely acknowledge that it exists then how do you think psychologically? If I think my tension comes from problems at work and when I am experience pain I think of these problems, but actually my problems stem from something else, how will that teach my brain to stop its distraction?

Question #4. All of my pain comes from what is considered a conditioned response. My back never hurts out of the blue. It hurts from sitting too long or standing more than 10 minutes. So should I think psychologically during a conditioned response and push through it? I tried that this weekend and am really paying the price for it.

I could probably write more, but this is already too long. Thanks.
20   L A T E S T    R E P L I E S    (Newest First)
vegomatic Posted - 07/11/2006 : 09:14:36
quote:
Originally posted by Sean


My second concern is all the examples of “cured” TMS cases mention that the person is healed in less than a month. Maybe there were a couple of cases where it took 2 or 3 months, but even for these examples the author mentioned “most of the pain was gone in a month and then the person was pain free within 3 months”. I know everyone says don’t put a timeline on it, but if it were common to take 6 month, a year, 2 years why is there NO examples like this given or any type of reassurance in the books?



This is from page 168 of The Divided Mind:
"Liam entered psychotherapy. It wasn't until the better part of a year had elapsed that he enjoyed any improvement in his pain symptomatology"
PeterW Posted - 07/10/2006 : 08:16:07

I'd agree with Hillary and of course Dr. Sarno about gently increasing activity, or waiting for improvement before increasing activity. Lord knows how many setbacks I've had trying to 'challenge' the pain. Fred Amir's tackle it by challenging it philosophy might work for some but it could backfire for others, and it's interesting how specific Dr Sarno is in The Divided Mind about waiting for pain to subside first. "When the pain is gone, or almost gone, start to do physical things you have been afraid to do" .

Of course this is dependant on the patient doing the TMS work diligently every day.

Regarding tender points and low back pain, from James Rochelle's chapter in TDM:

"Dr Sarno's physical examination was instructive. He did a complete musculoskeletal examination, with emphasis on findings of tenderness. I never realized how frequent the findings of tenderness on the outside of the thigh is in patients who have chronic low back pain. In Dr Sarno's experience, the correlation is approximately 80 percent. Tenderness in the gluteal and lower lumbar regions is almost universal in TMS, as is tenderness at the top of both shoulders. Many patients have paraspinal tenderness throughout the lumbar spine, extending sometimes into the thoraccic areas as well.

The tenderness people have with chronic low back pain is usually present over a very widespread area. Palpation requires a light to moderate amount of pressure in strategic locations, indicating that the pain is usually in the muscles and tendons just below the skin. This superficial tenderness indicates that deeper structures, such as invertebral disks, are not producing the pain".

I still am not sure about the tender point thing either. Even though I have severe low back pain, when I prod myself in the lumbar area, the tenderness and pain seems to come from deeper, not from the surface muscles, which is the opposite of what Dr. Rochelle says. And I've never done a friendly massage on anyone whose upper shoulder and neck areas weren't stiff or tender to some degree.

Another question, for anyone out there who has been examined by Sarno or another TMS trained doctor: Do the docs tell from their own prodding that you have the tenderness, or is it up to the patient to say 'Owch, that's tender in there'. Experienced bodyworkers can usually tell just from touching.

I know, thinking too much again . . . Mr. Objective here, just wondering how objective the tender point examination is . . . ;-)


HilaryN Posted - 07/09/2006 : 10:18:39
I think Sarno’s advice is to tackle that first (i.e. wait for an improvement) before starting the activity which you believe causes the pain or make it worse. But it’s up to the individual: whatever you think you can handle.

If I were in a lot of pain I’d be very reluctant to do anything which could make it worse, even if the connection were psychological rather than physical. Pain is exhausting and you might not have the mental energy to challenge your thoughts if you’re in pain before you start the activity.

I’m a complete coward when it comes to pain, so I took it gradually. I took 6 months to increase my typing from 5 minutes a day to stopping the voice recognition completely. I might have been able to do it more quickly, but I was happy to take it slowly. (I didn’t have pain when I kept my typing below a certain level and I was able to do my work by using voice recognition, so there was no hurry for me.)

Hilary N
FlyByNight Posted - 07/09/2006 : 09:56:08
HillARY,
what if pain is not necessarly associated to an activity but is always present ?
HilaryN Posted - 07/09/2006 : 09:25:59
Hi Sean,

Sorry you’re not making the progress you’d like.

Q1: It’s funny you should say that in The Divided Mind it says the tender points occur in all patients. I could have sworn I’d read in there that they don’t, and aren’t necessary to diagnose TMS. I don’t have the book to hand at the moment.

Q2: When I read The Mindbody Prescription, I thought everyone was cured more or less immediately and I gave up when I didn’t have an immediate cure. But if you look carefully, there are actually examples of people who take longer. Either their cure time isn’t emphasised or we gloss over it ourselves. Perhaps we only see what we want to.
Don’t take people on this forum as a representative sample. People who cure quickly are unlikely to visit this forum.

Q3: I can’t remember if you said before whether you’re having psychotherapy? Dr Sarno does say that if there is no improvement after (I think) a couple of months then it’s advisable to have psychotherapy (with a TMS psychotherapist or an analytically-trained one). I don’t think you should worry about whether it’s “normal” or not, or whether you’re “abnormal”, which you seem to be worrying about.

Q4: You might prefer to take a gradual approach to the activities which you think cause your pain. If 10 minutes cause pain, try 5 minutess, or 2 minutes, or an amount you can handle. Then increase very slowly.

Hilary N
Scottydog Posted - 07/08/2006 : 14:24:59
I have the 3 tender points despite back ache not being my main tms problem.

Probably many of Sarno's patients ARE cured in a matter of weeks but they're the ones who never get as far as using this messageboard and of those that do appear here many many must have moved on - look at the total number of names of users.

Thinking psychologically may not be reaching your true feelings. Remember the anger/emotions causing your back problems are suppressed, so being annoyed that your wife makes demands on you or that you don't have enough time to play with your child are probaby not it.

Try journalling every day - things that upset you in the past, childhood etc etc. That way you can go back over stuff until you have really got to the truth of the matter.

Anne
armchairlinguist Posted - 07/08/2006 : 03:23:10
Sean,

Sorry, but I have to tell you I have no way of knowing if you need to find a specific problem or not, especially since you did not give any details about psychology. When I say the real problem, I'm referring to a constellation of real emotional issues (vs the fake ones of the pain) that have come up for me, mainly to do with the typical perfectionism and goodism. Not that exciting on the TMS scale! There's quite a bit in TDM, as you probably know, about how for different people, the contributions of the different factors is different. For some, it's more about childhood, some more about real life pressures, and some more the internal pressures of p&gisms. If you covered all that stuff, then you've exhausted the sources Sarno mentions.

It sounds like you would be better off seeking advice from a TMS doctor or therapist, perhaps one of those who will answer email or do phone consults if you can't see one in person. It could lessen your doubts, since the forum does not seem to.

If you stop the TMS stuff, will you have other options? If you don't have other options, besides just being in pain, then maybe trying to think TMS is the best course even if you remain unsure...

--
Wherever you go, there you are.
Jim1999 Posted - 07/07/2006 : 23:13:03
quote:
Originally posted by Sean

In the past many have questioned the fact that they did not have tender points in the 3 locations Dr. Sarno mentions. There were replies written that these tender points do not have to exist and maybe someone even quoted a TMS doctor to that fact. So until recently I was ok with these responses. Well, as many of you know The Divided Mind has many chapters written by others doctors that treat TMS patients, most of which mention they look for tender points on physical examination. They explaining that tender points are “universal” or occur in “virtually all” cases of TMS patients.

So question #1 is, what is the truth? Do you need these tender points or not? I would think that if they were not needed to prove a patient has TMS someone would at least mention that in the book.

...

Question #4. All of my pain comes from what is considered a conditioned response. My back never hurts out of the blue. It hurts from sitting too long or standing more than 10 minutes. So should I think psychologically during a conditioned response and push through it? I tried that this weekend and am really paying the price for it.

Sean,

Your first and last questions made me think of a chronic pain patient I met on the Internet before coming to TMSHelp. He had none of the 18 fibromyalgia tender points. (He hadn't seen a TMS doctor, so I don't know if this patient had any of Dr. Sarno's tender points, but there is some overlap between the two sets of tender points.) This made me wonder whether he had TMS, but he was convinced that he had TMS.

He was first drawn to Dr. Sarno's approach by the concept of conditioning. He tried pushing through pain, although that backfired sometimes. He had to accept that there was more to his pain than conditioning and deal with unconscious emotions.

He did eventually make a full recovery, but it took him several months. (I guess that touches on your second question.)

I hope this example helps,
Jim
tennis tom Posted - 07/07/2006 : 21:57:13
quote:
Originally posted by Sean

I never once mentioned my butt hurting... you did. Frankly what you do in your personal life is non of my business.

You must have a very unsatisfying life you spend your day (all day) on this forum.

See that's the thing, you know nothing about me...you just assume I'm fat and lazy and you pass judgment. You can't give tough love to someone who you have no background information on. In my book that's called rudeness.

Tell you what Tom, as long as you stay out of my posts I'll stay out of yours. I don't appreciate you assuming right off the bat that I am too stupid to understand the concepts of TMS. If you disagree that's fine, you don't have to post. Posting just to make ignorant comments to me is not helping anyone.





NO DEAL


Nor Posted - 07/07/2006 : 20:00:25
What's going on w/this forum? Why is everyone so sensitive? Sean, Tennis Tom likes to use sarcastic humor, its not personal! If you get over feeling attacked about how you are approaching TMS, you could actually learn from him and others on this forum. I believe nobody is trying to be critical or harsh on this forum - its just that advice is coming without sugar-coating. Its okay, haven't we all wasted enough time w/our pains that we can handle some directness?

Regarding the time factor, I have to jump on the wagon w/the others. The book "cures" are a "results not typical" situation....I've been getting better slowly and my shrink believes that TMS is a lifelong journey.
Nor
Sean Posted - 07/07/2006 : 15:16:10
Jay, I hear you, I look at those things you mention. And while I don't think I spread myself too thin, when I do have free time I feel like I should be getting something done. I have noticed that when I have an extended weekend (like the 4th of July) I have more pain. I thought that it may be my brain trying harder to distact me since I don't have my job to think about.

Hillbilly, I think for the most part I want things done right for me. I have done many jobs that would have been easier with 2 people, but I do want anyone's help (or put anyone out {more TMS}). I see your point though.

Michele Posted - 07/07/2006 : 14:01:13
Well if you have doubts after only 9 months, then I should be throwing my books out the window. I've been at it for 2 YEARS. I'm still in pain. Occasionally I have a good day where the pain isn't so bad and it hurts but not "screaming" hurt, but it has not gone away.

I thought maybe this weekend I would shelve all of my TMS books, pull out one journal, and try to forget about TMS for a while. If I'm lucky, I'll have a good cry and perhaps be a little pain free in the morning.

I know exactly how you're feeling Sean, but I don't have any answers for you. I simply go day to day.

Hillbilly Posted - 07/07/2006 : 13:53:55
Sean,
Just this weekend I put the finishing touches on a bunk bed I built for a friend. I caught myself in pain several times and realized that it was when I was pressing to do things more quickly, more efficiently, and more perfectly. This is a disease that we share. I have also remodeled houses that should've taken a few weeks and stretched into months. I would get angry when my wife would ask about completion and it would stir my ire. When I realized that she cared about the project only from a practical standpoint and not from an "Oh my gosh, who did this work, it's so beautiful?!" standpoint, I got 'r' done, to quote my compatriot Larry the Cable Guy.

Here's an exercise that I found very useful and enlightening. Try to see how much the voice of perfection is yours and how much is someone else's (a demanding father, perhaps, or your wife). Perfectionism is never about our opinion. It is our projection of someone else's thinking. Our need to please and be good. Tell me your thoughts.
wolf29 Posted - 07/07/2006 : 13:45:35
quote:
Originally posted by Sean

I try to do as much as I can every day. When I am not working I am usually doing many home improvement projects; I recently tried to get back into lifting weights; and I have a 2 year old that keeps me busy.


Sean, maybe that's part of the "problem".. trying to do as much as you can every day. I have 2 jobs and 6 year old which keep me very busy. I also try to get my weight training in and all that can add up to a lot of stress and anxiety. Am I doing enough here, and I doing enough there, am I giving myself enough time. Do I deserve time to myself and so on. Not saying that's what goes through your mind, but I can see how it could for many of us.

My 6 year old demands a lot of my time and keeps me busy. I wouldn't trade it for anything in the world but subconsciously I think I may have anger towards the fact that I don't have time to myself or as much as I would like. My wife puts demands on my time as well or at least I see it as such. It's all about how we percieve situations and can cause us the pain.

So perhaps you need to examine, if you haven't, how doing as much as you can really makes you feel. The conscious side of me feels proud to do as much as I can for my family. The subconsious side might be angry as hell for the demands it puts on me. I don't like to think I may feel that way, but if I'm going to beat TMS I have to be open to that possibility.

Jay
Sean Posted - 07/07/2006 : 13:36:45
Hillbilly, Thanks so much for the response. I do not try to play the victim, I try to do as much as I can every day. When I am not working I am usually doing many home improvement projects; I recently tried to get back into lifting weights; and I have a 2 year old that keeps me busy. In fact (since you asked) the activity that caused me great pain this weekend was scraping my house (I'm going to start painting). I was out there for about 30 minutes and my back really started hurting so I decided I would totally ignore it and focus on psychological issues. Well after about 20 more minutes I was in much more pain so I went in to rest and the next 3 days I was hobbling around the house.

I can relate to the catastrophizing, when I get the acute symptoms I usually end up to the point where I can't walk. I think what will happen if I can't work? Luckily it didn't get that bad.

To tell you the truth I have never thought the disc degeneration was an accurate diagnosis (even before I heard of TMS). I know I'm not a doctor, but by looking at my x-ray or MRI I just can't believe that the small amount of degeneration can cause so much pain. And the there are many things about my situation that support the TMS theory that keep me hanging in there. You haven't seen perfectionism until you've seen me doing the finish work on some crown molding.

Thanks again for the helpful comments. I'm going home in a bit and get a little more scraping done.
h2oskier25 Posted - 07/07/2006 : 13:00:32
It seems the "Tender Points" aren't just physical any more . . .

[Just Kidding].

We could all use to laugh more on this site . . .

Beth
Hillbilly Posted - 07/07/2006 : 12:33:08
Sean,
For what it's worth, I don't think Sarno's theory is dead-on accurate either, but I don't think it matters to your healing. I realize also that there are many here that take offense that people don’t consider the theory 100% accurate, and ultimately it doesn’t matter what they think, right? What does matter vitally is what you think. This condition is not so much a condition of how you feel as it is a condition of what you THINK. I can't (and won’t) argue with the results of so many who claim to have healed using only information and their thought processes, but here is what I have used so far to help myself, a fellow doubting Thomas.

I have had the dubious honor of suffering from panic disorder and TMS simultaneously. If you read the archives you will find many who fall into this category. Ron Siegel's book also mentions this extraordinary link. Sarno gives mention to anxiety disorders as being equivalents, but doesn't say he thinks the back pain is just a symptom of anxiety state (those with this problem will recognize the more common as dizziness, trembling hands, churning stomach, depersonalization/realization, and shoulder, neck and back stiffness and pain).

The cure for panic disorder is to not focus on the body and its sensations and fear them. We should let them come and go without being too impressed with them, realize they go away in time if we wait, and that no death will follow. There has never been a case of a death from panic attack, nor, I suppose from TMS spasm. Permanence of that cure typically takes going thorough panic attack after panic attack until you no longer fear the symptoms. Sound familiar? Isn’t that exactly the same thing that Sarno says? Think about something other than your pain (think psychological) and don’t respond with conscious fear.

So, I really thought hard about when I got the shoulder blade area pain originally and when it started to get worse, and sure enough, it was when I started to get despondent about the pain not going away that I got panic attacks. Concomitantly, I was beginning to feel the strain of the homelife with two little kids, financial pressures, a job I hated, and soon I cooked up a recipe for suffering. Then the pain REAALLLLLY pushed on me hard.

I then began to catastrophize about my life situation with work, finances, being pushed too hard to perform at work and at home. I didn't sleep through the night for 10 weeks. I was suffering from strange neurological symptoms in my legs, and the constant back pain between the blades was horrifying. I went through several diagnostics and nothing was found. My GP put me on Zoloft and I nearly lost my mind. I was convinced I was dying, and there was no treatment because docs couldn't figure it out. But I really never lost hope that if it wasn’t an organic process that I could heal.

Today I am not healed. I deal daily with the pain in my right shoulder blade area and sometimes in my low back on the right side. I also have plantar fasciitis pain. But none of it matters. It only matters if I LET it. I too only feel severe pain when standing or sitting. But I can lift weights, jog, throw baseball, anything I choose. The pain I can’t control; the suffering I can. It is an operation of will. I suppose the conditioned response I have to sitting and standing is similar to yours. Have you tried seeing what happens if you let the pain be there and don’t shrink away from it? You said you tried ignoring it recently while standing and paid dearly. In what way? Did something clinically significant happen or were you just upset greatly by it? I used to have panic attacks from the pain until I lost my fear of them. Haven’t had one since January.

I know I’m on the right track because I feel so much better and I am not allowing myself the self-pity trips. I did three sets of thirty push-ups this morning just to punch the fear in the face before I left for work. This pain is really a joke and cannot stand up to your will. Get inspired for accomplishing something in spite of the pain and see if you don’t do it. A journey with pain is just as successful as a journey without, right? You’ll get there. Read Back Sense. It is great for those of us who have to dissect things and get hung up on the theoretical stuff.

One last thing: I don’t know if I have tender points in the three areas either and never bothered to see. If you know that what you have only bothers you in certain circumstances, that it can’t harm you and is wholly, completely clinically benign, what else do you need to know to get better? Best of luck.
Sean Posted - 07/07/2006 : 11:15:04
I never once mentioned my butt hurting... you did. Frankly what you do in your personal life is non of my business.

You must have a very unsatisfying life you spend your day (all day) on this forum.

See that's the thing, you know nothing about me...you just assume I'm fat and lazy and you pass judgment. You can't give tough love to someone who you have no background information on. In my book that's called rudeness.

Tell you what Tom, as long as you stay out of my posts I'll stay out of yours. I don't appreciate you assuming right off the bat that I am too stupid to understand the concepts of TMS. If you disagree that's fine, you don't have to post. Posting just to make ignorant comments to me is not helping anyone.

tennis tom Posted - 07/07/2006 : 11:01:35
quote:
Originally posted by Sean

Tom, it is smart A$$ know it alls like you that make this forum bad. Let me get out my calculator...No one forced you to reply or give any feed back...if you don't want to respond DON'T.

If you feel you have to put your 2 cents in to everything when you don't have anything of value to add that = Jacka$$.




---------------------------------------------------------------------------------------

Your welcome Mrs. McKay,

You are absolutely right, no one forced me to respond. I did it all by myself. If you want to talk to someone who has spoken directly with Dr. Sarno, call Don Dubin. That's what I did. He charges $150 per session.

Have a nice day,
The Bad Forum Person, smartA$$, JackA$$


p.s.,

If your butt hurts from sitting to long then get off your fat a$$ and get a real job instead of pushing pencils and counting beans for the man. Try doing something usefull that helps humanity like hammering nails, flipping burgers at IN & OUT, (my favorite fast food), or pumping gas in Oregon. If your back hurts when you stand for ten minutes try moving your feet.
Sean Posted - 07/07/2006 : 10:26:41
Jay (wolf29),

Thanks for the response. I have many things similar to what you posted that make me believe I have TMS too. That is what keeps me going, but as you see with no results I have been losing faith.

If I could get answers from someone who may have heard it from Sarno or another credited TMS doc then maybe I wouldn't feel like I'm wasting my time.

Some people feel as though if they have been cured, everyone else who hasn't is ignorant or doesn't know what they are doing. I think that is a poor attitude.

Thanks.

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