| T O P I C R E V I E W |
| susan828 |
Posted - 01/31/2010 : 12:12:21
I keep reading about this but haven't found a physiological explanation. If this is caused by not enough oxygen to the muscles, what is the process that's causing it? If someone is an avid aerobic exerciser, why do they still suffer with this? It seems to me that the oxygen would be delivered well throughout the body. |
| 17 L A T E S T R E P L I E S (Newest First) |
| catspine |
Posted - 02/04/2010 : 14:54:32
Hi Susan
At the time of the migraines I as mostly living in Europe and was lucky to be able to benefit from the great health care system it has to offer so I didn't have to think twice about seeking help I could go see any doctor or specialist and not have to worry about cost or insurance permission and preferences. I spared myself no expenses and had all the possible tests done. All the physicians I saw confirmed the vascular neuralgia at the time except for the one who came up with the trigeminal neuralgia( the literary translation may not be accurate since you describe something more generic). This is how it was supposed to work:
It was often sparked by cold temperatures I was exposed to regularly and by my life style merciless to my body although I took good care of it.
Under the constant control of the autonomic part of the brain the blood vessels in the body expend or shrink to meet the need . i was told that the migraines were set on by the factors listed above because the thermostatic system in the autonomic brain was not responding appropriately but there was no cure for it really except avoiding the cold and stop burning the candle by both ends... pain killers didn't do anything except for Sumatriptan toward the end.
Years later when my life changed the migraines disappeared. Although hard to achieve that was a very simple and efficient solution compared to the the medical approach ...I do not like mind altering drugs either our thoughts are enough already.
It is interesting to notice that TMS and the autonomic system are working tightly together. At the time of the migraines I never knew anything about TMS or the influence of psychological factors... It was not even remotely an option in my head. Back then I believed in medicine with doctors, plain and simple.
To make long story short the pain was unbearable, doctors could only help me within the limits of their knowledge then and the cause of it was obviously emotionally related although I did not know this and it took me years to figure it out so I suffered for a while. I wish I knew then what i know now...
As always in such case when the reason for the pain either physical or psychological is found and a treatment exists all is well so to speak but if we do not have that it causes a lot of distress while going around in circles.
Being accustomed to the rewards for the effort we make we start to feel like we do not have control over our own destiny anymore when a solution to the problem can not be found. That alone can generate unconscious anxiety and the very conscious chain reaction it creates.
I can not tell you what is best for you of course but if you're not decided about the cause of what is bothering you and how to proceed with it (There also can be two different problems at the same time in the same area andnothing stops you from treating it accordingly) you may have a better chance to fix the problem by using what you can first:
if you think (or even better feel) that TMS is lurking in the back ground for all the previous reasons that you mentioned besides the medical ones then chances are it's probably there so you can already act on that and commit entirely to treating it as such and see how that serves your need. The nice thing about it is that it is not counter productive.
Experimenting with it will also makes it easier.
You can always return to the other options if it doesn't work for you but this knowledge will never be lost.
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| susan828 |
Posted - 02/03/2010 : 16:37:53
Thank you very much, Winnie. I actually have most of those books. You really went through a horrible time, I am sorry. I am curious as to which stretch you used for the face. Did you ever use heat or ice and if so, which helped? I am glad that you never had to use the drugs. At one time, I was given Elavil for that pain, a low dose but still, my mouth was so dry and I would be absent minded, putting the wrong key in the door. I don't like any mind altering drugs.
No worry about being long winded. I really appreciate your taking the time to elaborate as you did. |
| winnieboo |
Posted - 02/03/2010 : 09:01:39
Hi Susan,
There are a whole bunch of neck, shoulder and facial muscles that can tense up and wreck havoc on your mouth, jaw and face. You can help yourself with some stretching! Yes, all of your mouth, teeth, dental, and facial pain can be caused by tense muscles. Mine was. Look at the books at the bottom of my post if you don't want to read my long story, but I'm offering what I've been going through in hopes it might help you, if you're interested. It sounds like our experiences are similar. By the way, the oxygen deprivation remains, even if you're exercising, if the muscles stay tight. If you're exercising with tight muscles, you'll of course still have pain and be more prone to injury. Somehow, you have to get the muscles to release, whether it's through releasing psychological tension, stretching, or a combo of both.
In any case, I've been going through hell with mouth, teeth and facial symptoms for six months. It started with a bad sinus infection, which led to three courses of antibiotics, and then a sore mouth and fungal infection. During that time, I also had three amalgam fillings replaced. On one dental visit, I asked about a small pinkish, white bump on the inner part of my cheek that I'd noticed and long story short, I had it removed a few weeks later by an oral surgeon. Turned out it was a benign fibroma, but after the surgery (four stitches, the surgeon had to dig it out of my inner cheek), I was left with nagging pain in the area, and a numb and burning sensation on the side of my tongue, near the site.
Then the floodgates of pain, TMS, whatever opened: The tongue symptoms led to multiple doctor and dentist appointments, migraines, pain in all of my teeth that led to a root canal in one of them, a new crown which threw off my bite. All of the muscles in my neck shoulder, jaw and cheeks were tense. My diagnoses: chronic migraine, TMJ, trigeminal neuralgia, fibromyalgia (have heard this one before) and lingual nerve damage (to explain the tongue issue). Oh yeah, probably depression and anxiety, too (LOL).
I believe I hit rock bottom recently when I landed in the ER for something new, abdominal symptoms that my GP uncovered while giving me a neurological check during a 5-day migraine. Since none of my meds were killing the headache and I was miserable, I went to her office and next, burned up eight hours in Emergency because she thought I might have appendicitis, in addition to the migraine. It was a long day of IV fluids, drugs, tests and an abdominal CT scan (and I'm still so damn mad about the hit of radiation that I didn't need)!!
Of course, all the tests were normal...It wasn't exactly an "Ah-ha!" day, it was more like a "DUUUHHHH" day. I have been meditating and thinking psychological and reading self-help books and have been coming back to the Forum every day, but the problem is, I haven't been moving physically, nor have I moved to change bad habits. I know that's what's supposed to be done for TMS, but I wasn't complying. I went to Pilates once a week and usually got a headache right after. I've been wrapped up in fear and tension.
So, post ER, I felt like something had to give. I had done psychotherapy for two years and all this mouth stuff came on when I started thinking about firing my therapist. It took me three months of thinking about it before I finally did, and the last thing I feel like doing is going back to into the chair. But I was thinking that might be the answer. Instead however, and almost as a last resort, I grabbed my self-help books. I extracted about 20 easy stretches and started doing them gently every day. What I found was that EVERY muscle in my body was tight. My husband kept telling me "Rome wasn't built in a day. Keep going!"
While I was at it, I gave up my wine every night at dinner (my only way of self-medicating). I changed my diet, stopped eating junk, have thrown sweets out the window for now. I love to sing and have always been in a choir, but I stopped last Fall because my mouth hurt. Last night, I forced myself to go out in the snow after dinner to audition for a big professional choir (They took me!). Wagged my tongue around like crazy singing and the pain went away!
The next thing is to lose my current job, which feels like a cement block on my shoulders.
Now I feel like I have some control. Foreign feeling for sure.
All of these really little changes have made a huge difference in less than two weeks. The stretches for neck, shoulder and facial muscles have melted 95% of the intense and migrating pain in my mouth, face and upper body. I'm sleeping better (b/c no wine?). No drugs (I have neurotin, elavil, topamax and fiorcet in my cabinet! Scared to take any of them!), no surgery and no doctor told me to it. A big part of the SARNO theory is to MOVE.
It helped that I have a compassionate dentist who several months ago told me (while he was fitting me for a TMJ splint) that HE had chronic neck, shoulder, and TMJ pain and that his docs told him he had fibro. He read Sarno and did PT and is FINE!!! By the way, I will not go to PT, or even get a massage, because they invariably tell me that things are out of alignment or injured or abnormal, which invariably sends me back into a negative tailspin.
In any case, as usual, I've been super long-winded and I apologize.
Here are books with stretches and info that are helping me:
Taking Control of TMJ Robert O. Uppgaard, DDS
The Migraine Brain Carolyn Bernstein, M.D.
The Trigger Point Therapy Workbook Clair Davies
Trigger Point Therapy for Myofascial Pain Donna Finando and Steven Finando.
WB |
| susan828 |
Posted - 02/02/2010 : 22:22:08
Hi catspine. Facial vascular neuralgia...ok, how do they know that's what you had? I think they just say neuralgia when they are stymied. Neuralgia is what our grandmas had, everyone seemed to have it, it's just nerve pain. Did they actually find something inflamed with a test, a scan of any kind? I didn't explore the possibilities of allergies. Try to tell a dentist that...they just don't get into this kind of stuff.
When I had a tooth diagnosed with an abscess that I could not yet feel, I started having pains all over my mouth. The day before my x-rays, I had no pain!! from that day on, I have pains in every corner of my mouth. It stops for months, starts again, on and off for almost 20 years now. So I know that thinking about it brought it on. However, I get some pains that are so very real..as most of us can say. Burning on the roof of my mouth, also get herpes inside my mouth when I am stressed so it may be somewhat related...just like shingles can leave one with post-herpetic neuralgia, I have very bad shooting pains following an outbreak for a couple of weeks. This is real physiological stuff, not TMS. So my problem is complex, I don't know the root of it.
I do know that I had fibromyalgia for years that stopped when I ended a relationship. I mentioned that before. I also get stabbing temple pain when I have stress. I went to the dr to have them rule out temporal arteritis, had bloodwork. The more I worried, the worse the pain got. I get the bloodwork back, guess what? No more pain.
I think WalMart has a sale on new bodies this week. 99 cents, LOL. |
| catspine |
Posted - 02/02/2010 : 21:41:34
Beleive me Susan trigeminal neuralgia is beyond belief AWFUL! the epicenter of the pain is located between the temple and the ear it goes behind the eye and radiates on the side of you face all the way down your neck and to the top of your head and you want to kill yourself when it happens.
I had 30 years of migraines and at the peak of that era I was mistakenly diagnosed with trigeminal neuralgia and the doctor wanted me operated. Tegretol didn't even make a dent in it. I never tried the other one. It turned out it was facial vascular neuralgia, the symptoms are hard to discern from one another and the intensity or the pain is similar. I never got the operation. Years later all the symptoms disappeared when my life changed. I let you decide if that was TMS or not... all 30 years of it all gone like by magic!
Some components or compounds used in dental work can create chemical reaction one can be allergic to sometimes did you explore that possibility ? |
| susan828 |
Posted - 02/02/2010 : 20:31:03
Thanks, catspine. I do have an appointment with a neurologist in a month (they're so busy here) and after that, I am going to see what happens. I truly don't know what tests can be done to find out why I have chronic tooth pain (x-rays are negative although they can't se everything under crowned teeth)...just maddening. The treatment for neuropathic pain like this is anti-epileptic drugs like Tegretol and Neurontin that make you like a zombie. That would be my absolute last resort.
I sent for Sopher's book and got it today. He says that trigeminal neuralgia, referred to as the most painful condition known to man, could be TMS. That doesn't sound so believable. While I have had some terrible lightning pains, I don't think I have that. I wish I knew the answer but in the meantime am reading all I can and trying to do this regime. |
| forestfortrees |
Posted - 02/02/2010 : 20:27:30
quote:
Originally posted by HellNY
There are other possible mechanisms. The strength of TMS theory, however, is not so much in its postulated mechanisms but the success in the treatment using TMS principles.
I've also wondered a bit about the hypoxia theory, but I came to this exact same conclusion. The bottom line is that I don't really care how TMS works as long as I know that this treatment approach changes lives (like mine!). I wrote my thoughts out pretty carefully in this thread (click here). I thought the resulting discussion was pretty interesting... you might want to check it out. Even Dr. Clarke weighed in to share his thoughts on the issue (he's also skeptical of hypoxia).
Forest
My story at tmswiki.org |
| catspine |
Posted - 02/02/2010 : 16:25:39
quote:
Originally posted by susan828
Catspine, I will google it but sure, I'd love to hear about the B.E.S.T technique, never heard of that one.
Susan
Before I found out about TMS I was seeing a chiropractor when I could afford it to try to fix my back problems but I also had loss of balance issues and he fixed it every time. My choice was guided by the fact that he had been officially voted best chiropractor by the local news paper readers for several years in a row. It turned out he was pretty good. He combined kinesy therapy with the B.E.S.T technique and I got better for a while. I know that whatever he did during the sessions effected my nervous system from day one because I could clearly feel the effect of it on it. How it works was beyond me then but I was able to function after the sessions whereas I couldn't otherwise.
One day I was there and his secretary told him she had extra sensitive teeth and sometimes a painful jaw on one side although there was nothing wrong with her teeth or jaw. He gave her a free session and she never had a pain again after that so I guess the method can apply to different ailments. This is why I mentioned it.
My understanding now is that whatever he did helped the body to fix itself by 'rearranging the nerves response" kind of what thinking psychological does with TMS but it’s not clear to me which part of the techniques kinesy therapy or Best was used for what.
I felt uncomfortable at first because he was not able to answer my practical questions (his explanation was that he was a holistic doctor and not an MD) but decided to try anyway as I did not have another option at the time and after a while I started improving…
My spine was completely out of alignment and at least it fixed that problem over a few weeks. The pain became proportional to how well the spine was aligned. The treatment involved a degree of verbal communication about the physical condition and conflicting thoughts and included a recommended diet. There was no hands on massages although he was a certified Shiatsu massage therapist as well, this was not part of the treatment.
When I finally heard about TMS my previous experience with him made the psychological theory much easier to accept. Even as helpful as the Chiropractor was Sarno was right: it was a placebo and I got stuck again ...By then I couldn't afford his help anyway but he did offer couple of free sessions. Nice the guy.
Hope you find something in there for you.
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| catspine |
Posted - 02/02/2010 : 15:16:50
From Malaquote:
What I would like to understand is whether it is the subconscious mind that creates the injury/hurt or does the subconscious wait for something physical to happen to happen before it seizes the opportunity to perpetuate the symptoms.
Why should it be one or the other Mala ? Once you know it is TMS it doesn't make much difference.
I suppose we all would like to have an answer to your question just in order to know but I can only refer you to what the experts have to say and illustrate some of it with my own experience for now.
I watched Sarno's DVD recently. He says in it that the subconscious mind takes care of the involuntary functions only and the unconscious mind is where the emotions are repressed and want to escape from.
Supposedly there is a chain reaction involving the different functions of the brain when there is a strong emotion that wants to come out which in turn creates pain in an area chosen by the brain in a surreptitious way, in this case the problem seems to originate from the brain .
If you had an injury or an illness with painful symptoms that left a trace in your memory the brain can probably use that as the shortest way to creating symptoms with an excellent cover to mask the origin of it . All it wants is pain somewhere to keep you busy dwelling on it after all...
This is exactly what happened to me after a fall where my fingers and wrist were badly sprained and biceps had been bruised. The trauma healed on time but the pain remained making me think there was something drastically wrong for as long as the reason for the pain was misdiagnosed. This is why it is also important to acquire some basic medical knowledge (like healing time frame for a sprain in this case) so that your mind doesn't wander endlessly thinking of the worst case scenario helped by the fear to perpetuate unnecessary pain and anxiety.
The doubt creates the fear the fear creates the pain etc etc... once I found what it really was it started to go away or somewhere else.
Speaking of '' I believe that once the pain in one area is diagnosed and treated as TMS successfully meaning it doesn't return to the same spot a reason for the pain to reappear somewhere else later could be that the next pain is due to a different emotion taking over and so on. Of course it also means that if it comes back to the same spot the emotion responsible could be the same as before but stronger. Maybe I'm wrong but emotions need to be sorted out apparently...
You see what I'm interested in is to find why the mind can not repress without risking an overflow of emotion. Is it because of their nature or because of the multitude or both? or because we don't have what it takes to deal with it? Anyways...
In this forum I see people from all over the world and it makes me think of this:
Remember that in our culture strong Cartesian ideas still prevail: We need to have an explanation before we even get a chance to accepting something (as for the cause of our pain) and it applies to many different issues as well such as what type of emotions prevail in our society. Often the intellect rules and the heart fights for its own sake.
In some other cultures people don't even need to know why/because, for it may accepting things as they are that prevails (as with a different philosophy), I imagine they have other problems of course but maybe they don't have as much TMS related symptoms or the mechanism varies and they call it something else.
Our pattern of thinking has a lot to do with how we get sick or how we heal.
All cultures are very strongly influenced by religious beliefs that sunk in it over milleniums and are now built in the way of thinking buried in the unconscious even if one is not religious.
I often wonder if people with a different cultural heritage such as oriental or East Indian for example work on TMS from a different angle? or for those who live in our society for a long time already if it could be one of the reasons why a western psychological approach to get rid of tms doesn't work for them sometimes.
If I were from a different cultural group it would make sense to me if need be to choose a therapist who masters an understanding of that particular culture and the western one as well.
Comments welcome.
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| mala |
Posted - 02/02/2010 : 05:58:29
It could be that when we hurt ourselves in a particular place like the lower back or neck that there is a physiological response to the injury or pulled muscle or whatever. There is then a tendency for the muscles around the area to get tight usually initially in order to protect that part of the body .
Normally in such acute traumas the muscle tightness should resolve within a few days or at most a few weeks. In some cases the muscle does not relax. This could be due to the fact that we tense up so much that we perpetuate the tightness simply because we are tms prone type personalities . Now begins the vicious cycle of fear which in return causes more muscle soreness which in turn makes us more fearful.
Now physiologically,there is a build up of toxic & waste matter around that area which then does lead to reduced oxygen flow and the next thing you know nerves, ligaments, other muscles are involved.
What I would like to understand is whether it is the subconscious mind that creates the injury/hurt or does the subconscious wait for something physical to happen to happen before it seizes the opportunity to perpetuate the symptoms.
Good Luck & Good Health
Mala |
| susan828 |
Posted - 02/01/2010 : 19:17:23
Catspine, I will google it but sure, I'd love to hear about the B.E.S.T technique, never heard of that one. |
| catspine |
Posted - 02/01/2010 : 17:27:57
Thanks Hellny
All of these make sense to me. I just couldn't put a name on it and as you say it doesn't really matter. I never had the money for doctors and tests to have these elements checked out when the symptoms imperatives were at their worst and neither could I have found the quality of help needed for that over here anyway so for a year I clenched my teeth and rode the storm and it went away. In fact it is because I never had access to the usual medical help and did nothing that I finally thought : well what if it is TMS equivalents? and right on! from then on things started to improve using a TMS approach. I just never thought of it as a possibility while focusing on the symptoms that I must say were so severe my wife and I often thought I wouldn't make it. Since I recovered completely from the lower back problems w/o a glitch ever before that it never occurred to me it could be it .Isn't that ironic?
Susan828,
I still have to find a dentist or oral surgeon or the like I'm happy with since I moved back to the US compared to what I was used to in Europe. I had implants and plenty other dental work done there w/o a ghost of a problem and as soon as I started seeing dentists here problems from treatments began to appear. All this to say I wouldn't be surprised if there was a physiological base to your problem on top of the emotional ones. The body knows more than the mind does.
The fact that physicians in the US withhold information from their patients mostly because they are so afraid of being sued which is never so much an issue over there is kind of scary because you never know what they are really doing and if what they do is in your best interest first. I was told a few times already that they are not there to educate the patients, how strange!
Dental problems even minor can quickly generate silent tension all around the area and beyond like on the skull and on the sides of the face. it may drive you to clench your teeth for no other reason and the muscles involved are permanently tense becoming a fertile ground for TMS symptoms. The only time I had a migraine reappear was when I had to have a root canal and waited for the money to proceed. There was no pain but the slight constant tension in the area was enough to trigger the old symptoms because the body also has a memory of these things, kind of like weak links... I bet that was it was got the RC done and no more migraines.
I would definitely have a close look at the teeth previous work. An other option is to see someone who specializes in B.E.S.T technique. In short the nerves responses to stimulation can be re-programmed . Let me know if you wish to hear more about it. I've had success with this before. |
| susan828 |
Posted - 02/01/2010 : 15:51:06
Thank you catspine and hellny. It's so good to get replies where people elaborate as well and caring as you both do. i will go back and look for the part you mentioned. I want to mention that many years ago, I went to a well known oral pain specialist/dentist at NYU Medical Center. Chronic pain after an extraction (still have it 15 years later on and off, that's my particular pain these days)...and he said "Walk, just walk as much as you can". He recommended this along the endorphins line but I wonder if it had something to do with oxygen, however we can get it be it autonomic or otherwise. Maybe he knew something that he just didn't explain but even when I had active fibromyalgia (it stopped petty much in 2001), my rheumatologist told me keep active.
I noticed in my fibro chat room that the people who just gave up and stayed home became worse or stayed the same. I started walking my tail off and I think that may have helped. I also want to throw in a comment about what I read here about people feeling fragile. I also thought I would break, I really thought my muscles would crack and was scared to do much at the beginning. It's crazy how we can talk ourselves into being so fragile. People started telling me the old saying "Use it or lose it" and I'd tell them "you don't understand" but decided to do exactly that. Now I walk like an athlete but this darn mouth pain is driving me crazy and I don't even know if it IS TMS but without boring you regarding how it started, I am pretty sure it is emotionally caused with some physiological base.
Thanks again, guys (or gals :-) |
| HellNY |
Posted - 02/01/2010 : 05:39:44
Catspine -
When I say other possible mechanisms, its really a very broad statement that leaves the door open to possibilities. For example, we often hear that "reduced blood flow and subsequent oxygen deprivation" is the cause of TMS pain. Now, lets think about that. What else are tissues deprived of, other than oxygen, when blood flow is reduced to them? One is probably glucose. Another is probably the ability to remove waste products. Another coud be sodiumj or potassium infiltration because that might come from the bloodstream. Another possible mechanisms could be "relaxation of muyscles" and have nothing to do with blood flow whatsoever.
Im just suggesting that "oxygen deprivation" hasnt been proven and there are other alternative hypotheses which could account for the pain.
I also think that it doesnt matter too much as long as we recognize that TMS is controlled by our own cognitive and emotional processes. |
| catspine |
Posted - 02/01/2010 : 03:59:10
quote:
There are other possible mechanisms. The strength of TMS theory, however, is not so much in its postulated mechanisms but the success in the treatment using TMS principles.
Hi Hellny
Could you tell us more about these other mechanisms and what they are please? I'm just curious to hear more about it. Thanks
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| HellNY |
Posted - 01/31/2010 : 16:25:28
Insufficient oxygen is an unproven mechanism. Its a possibility, a hypothesis. Basically one of many theoretical mechanisms of how TMS pain might work.
The application of heat (hot baths, etc etc) tends to relieve TMS pain. This is consistent with the oxygen theorry since blood flow is increased to teh area being heated. However, its probably much safer to say "reduced blood flow" since a lot more happens than just extra oxygen when heat is applied.
There are other possible mechanisms. The strength of TMS theory, however, is not so much in its postulated mechanisms but the success in the treatment using TMS principles. |
| catspine |
Posted - 01/31/2010 : 15:05:38
In Dr Sarno's Healing back pain he talks about how he came up with this conclusion: If I remember well a study revealed that there was always a slight oxygen deprivation (in real time observation ) in athletes who were in pain all cramped up after an effort.
It was also discovered that tms patient also showed such signs of oxygen deprivation in the affected tissues but for no apparent reason other than the autonomic brain restricting it.
Please read the book passage again to make sure I have it right as it's been a while.
While I'm at it I'd like to say this: my migraines disappeared before I heard of TMS but I'm certain now that it was mostly caused by it.
Oxygen is not part of any treatment against migraines but one day I got a huge one while I was at a car show for no obvious reason.
The only help present there was the Red Cross and all they could legally offer to help me was to put me under oxygen as I was going to faint from the pain while in their care.
I had never had oxygen before and was in no shape to argue about it so they just did it . I was laying down on a stretcher moaning on my way to hell when after a while the pain stabilized and gradually went away. I had the pain go away that fast before but very seldom.
I did not believe oxygen did it and decided to renew the experiment if the migraine would come again and I did a few times within the following months. To my surprise it worked again! This was quite a discovery but I moved back to Europe where laws are different and that was the end of my access to this form of help: If I went to the fire station for oxygen they had to take me to the ER over there and as it was not recognized as a migraine form of treatment they didn't want to do it. I later found that hyperventilation can achieve the same result but with unwanted side effects...don't know why.
In Healing back pain Sarno says that increasing the amount of oxygen you breathe does not make the pain go away (refering to back pain I presume) because it's controled by the autonomic brain and I believe that from my own experience but it certainly did work for my migraines so it is a bit confusing. A doctor explained to me that increasing the amount of oxygen makes the blood more fluid and that it could be the reason why the migraines went away then. Other factors such as being dehydrated or the heat or cold can also affect the blood flow in a healthy person. Many things must be taken into consideration which I also had no clue of at the time including of course the very important psychological aspect of it.
This is why even with other TMS symptoms I can not disagree with Hillbilly when he says that a purely psychological approach is not enough sometimes or not working for some people. It work for me for sure but the difficulty with it is to find what works for each different person .It must be very difficult to come up with a one size fits all theory under these conditions... it ain't perfect but at least we got one and it's based on experience as well.
I do not favor one technique over another particularly because I do what works when I need it so I can easily understand why you're looking for a physiological explanation but unfortunately TMS and it's equivalents requires a bit more. In a way it is a physical manifestation of the quote : We have no greater enemy than ourselves.
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