| T O P I C R E V I E W |
| Dr Dave |
Posted - 05/07/2012 : 18:03:21
Hello,
The Psychophysiologic Disorders Association (PPDA) has launched ppdassociation.org to support our mission of educating health care professionals and the public about PPD (our preferred term for TMS). In the coming months and years, as resources permit, we plan to add much educational material to the site, start an e-newsletter and expand our Practitioner Directory which will list clinicians who know how to help.
By the way, if you missed the posts about the PPD term early last year, our Board chose it to maximize the chance for acceptance by medical clinicians. Without their buy-in and understanding, a large majority of patients with this condition will continue to face big challenges getting the help they deserve. The meaning of PPD is only that the brain and the body interact to produce the (very real) symptoms.
We certainly welcome thoughts about our work by contributors to this forum.
David Clarke, MD
President, PPDA |
| 12 L A T E S T R E P L I E S (Newest First) |
| Stryder |
Posted - 06/18/2012 : 17:25:50
It is awesome that PPD now has an professinal grade organization to start the march forward. However I remain concerned that yet another acronym has been invented to further confuse the topic. Since treating PPD is not going to make physicians a lot of money, I don't see them buying into a grass roots effort in a big way. I do see a core cadre of very committed physicians both inside and outside of the PPDA trying their very best to change the course of decades of misdiagnosis and incorrect treatment. For this they are to be commended, and supported going forward.
Unfortunately I don't have a solution to the TMS -> MBS -> PPD transition, I wish I did. If you want to call it "anxiety" to the patient, and "PPD" in DX codes to the insurance providers, that's great. But having a lay term (not scary) and a proper term (scary) is not going to fool anybody, sooner or later in the process the patient is going to make the connection to the PPD term. This isn't 1960, its takes virtually no effort in the internet age to figure out that "heart attack" is "myocardial infarction" just like "anxiety pain" is "psychophysiologic disorder". Try to say "psychophysiologic" five times fast, its hard to say, and doesn't flow well in conversation.
I hope the PPDA is successful in their strategy. If not we may have to wait for the eventual shift in our culture to a different lifestyle and way of thinking about the mindbody. How long might that be? Hard to say, possibly a few decades or more.
Do not fear the pain, resume normal activity !
Take care, -Stryder
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| SteveO |
Posted - 05/10/2012 : 11:49:02
It will be tough to get away from the past and the psycho-terminology. Dr. Sarno wants TMS to eventually become PNPS, psychogenic neural pain syndrome, but he's been using what he calls a transitional term from TMS to TPS, tension psychoneural syndrome. So he too knows the significance of psycho.
I know from my own experience in lecturing on TMS that as soon as I mention "psycho" anywhere, that people shut off and shake their heads from side to side as I'm speaking. For some reason they will listen to the word mindbody without a knee jerk reaction--even though they are the same thing.
The phrase "psychological disorders" may be a tougher sell than something like "mindbody disorders." Plus using mindbody disorders allows for the inclusion of TMS somewhere in the phrasing and still does great honor to the good doctor.
But that might not be possible. Just my own opinion. I do think the PPDA is doing a great thing here no matter what name they choose. The psycho-TMS message will not permeate the collective unconscious without the professionals leading the charge--or planting the memes. It has to become generally accepted by society and the most efficient way is to get the healers on board.
I hope the PPDA takes off and makes some powerful waves,
Good luck,
SteveO |
| Hillbilly |
Posted - 05/10/2012 : 08:41:52
quote:
Should we in the PPDA hold on to the "TMS" terminology in some way? What do people feel?
I believe it depends upon which terminology you reference. People here on the forum readily use terms from the books as means of communicating, which serves them well, but I don't believe it serves them to the uninitiated and, quite frankly, sounds absurd at times. I see it all the time that posters say things like, "Boy, my unconscious really is tricky." In my opinion, this cannot be taken seriously outside this small group, but it makes perfect sense that someone might think that after reading Sarno. Have a few medical students read this forum and get their feedback, not as a criticism of the patients, but to judge whether they could use such language and feel confident and credible expressing it.
This is why Part II of the treatment outline might be useful only to those whose initial entry to the field of mindbody conditions was generally pain-related and hence, they became aware of Dr. Sarno's work prior to anyone else's. There are hundreds of authors of books on anxiety that cover many different physical conditions, but most of them focus on panic attacks, GI problems, and not back pain. So there is the disconnect.
I suppose there are many here who believe they have more than one condition because they have more than one symptom. They might think they have anxiety because of conscious stress, but back pain because of things they've repressed. This is logical based upon reading different experts in the field. But if we bring back pain, or more specifically, chronic, idiopathic soft tissue pain of any site, under the rubrics of conditions like anxiety disorders that already exist and are accepted by medical and psychological professionals the world over, we don't have to re-invent the wheel.
What I suspect is happening largely is that people are trying very hard to be respectful of a pioneer such as Dr. Sarno, which is commendable. His work has no doubt brought many to at least suspect that stress plays a role in many pain syndromes. But it is far more important that patients are educated properly with sound, scientific, evidence-based reasons for why they have symptoms and what to do about them. I suspect this also varies broadly, even among the members of the board.
I don't see the same respect for the behavioral approaches of Claire Weekes or Abraham Low or Edmund Bourne or David Barlow or David Burns. These people were both practitioners and authors and have all influenced millions and been as influential in the cure of these conditions as Dr. Sarno, but they did not emphasize back pain as part of the broad ANS condition. Offending a few to broaden the audience might be necessary, but shouldn't be a cause of concern.
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"Failures do what is tension relieving, while winners do what is goal achieving."
Dennis Waitley
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| Back2-It |
Posted - 05/10/2012 : 07:25:41
Nothing made any sense to me until I read Dr. Sarno and understood that his description of TMS (in my mind) is the result of anxiety. TMS as a term did not seem to fully explain all the various symptoms experienced by so many, including me.
Most people can understand that anxiety causes physical problems. In fact, if I recall, that is how Dr. Sarno went about early on explaining the reasons for back problems might be "stress", and then started to see more "cures".
Dr. Sarno explained that TMS is the reason for the epidemic of back pain, where previous writers, such as Low, Weekes, Hanna, published mostly prior to the popularization of the MRI and other scans. After further reading of the above, as mentioned by several posters here, I understood what anxiety does to a body, specifically, and hence what it will do to back muscles.
What many do not understand, and even aware medical practitioners do not explain, is that the damned pain is real, not conjured in the head. If people were told why by enlightened practitioners -- that muscles tense, etc. -- or offered a more detailed explanation with a few graphics they might be more accepting of the idea that the brain causes the pain. In fact, in today's interactive world, it should be readily possible to make a display of physical symptoms that can be accessed and fully described.
Most people have trouble initially accepting that anxiety/TMS/depression can do what it does to a body.
When they have reached the end of the rope they either accept the dx or they continue to doctor surf and stay in pain.
Getting more doctors to engage will be difficult, because that is not their training, and new training will take generations. In a sense, for anxiety to be accepted as a cause of pain and other issues, the medical community must wed the twenty-first century with the nineteenth century. Ain't gonna happen soon.
"Bridges Freeze Before Roads" |
| Fox |
Posted - 05/10/2012 : 06:41:08
Agnes - I totally agree. To me, mindbody has the hippie, crystal, new age, alternative medicine (in other words, no empirical evidence) connotation. Using the term mindbody to sell Sarno's ideas is a mistake as it might repel as many people as it might attract. |
| ozagnes |
Posted - 05/09/2012 : 19:36:56
Actually, as a patient, I prefer the terms PPD or TMS to mindbody syndrome BECAUSE it sounds more medical/professional... If psycho can scare off people, I think mindbody can also as it is used in a very wide array of disciplines and beliefs, some of them clearly on the more "hippy science" spectrum. Look for "mind, body (and soul)" and you may find everything including crystal healing etc.
Now, I realise it is only my own reaction and that I am probably narrow-minded on this, but I would not have read about TMS if I had heard about it as "mindbody", because I simply did not beleive in most alternative medecins and that is what mindbody meant to me . I realise now what mindbody really means and that there is indeed a connection between what we think and what we are (physically), but looking back I would probably have simply NOT looked into it, thinking this is one more "rubish hippy healing" (sorry, I don't want to offend anyone here, I am not trying to say that these alternative medecines are rubish, I am just explaining how I thought and reacted at the time, after being told for years I had a medical problem, and after tried everything including briefly accupuncture and naturopathy...).
So as far as I am concerned, I would say use TMS and/or PPD for professionals, and for patients that look like they may accept it better than mindbody. Use mindbody for patients that are likelly to be scared by the term psycho.
Cheers
Agnes |
| Fox |
Posted - 05/09/2012 : 06:50:05
I definitely support the PPD designation. It's a perfectly logical and necessary diagnostic name change in order to win over the medical community - so that more lives can be touched by Sarno's concepts. Also, if the patient doesn't accept the "psycho" component, they are going to be resistant to Sarno's concepts anyway (that this is a brain generated disorder). |
| Dr Dave |
Posted - 05/08/2012 : 19:26:20
The Board of the PPDA would be the first to acknowledge that a term including the prefix Psycho will never be accepted easily by patients, even though in this context psycho refers only to the brain as a bodily organ.
Speaking for myself, when I lecture to medical clinicians, I encourage them to use PPD primarily for interprofessional communication. For communication with patients, it makes more sense to me that they use a term that relates best to specific symptoms like IBS, fibromyalgia, chronic pelvic pain, interstitial cystitis, TMJ pain, low back pain and so on. If you like, you can add the prefix stress-related to those syndrome names. Along those lines, the PPDA is encouraging use of the term "Stress Check-Up" to describe the diagnostic process for PPD, rather than "mental health evaluation" or "psychological assessment."
My personal opinion is that after 30 years TMS has failed to catch on with most medical clinicians because the "M" originally stood for myositis which means muscle inflammation. Because there is no muscle inflammation in TMS (even though it feels like it), most physicians dismissed the entire concept (baby and bathwater) as lacking evidence.
If we are ever to bring effective diagnosis and treatment to the millions who suffer from PPD, we simply must acquire the understanding and support of the medical community. Fundamental to that process is using a term among healthcare professionals that is consistent with science and to which physicians can relate. Our Board, which collectively has over a century of experience in this field, debated for months in 2010 before reaching consensus on PPD. But non-professional users of this forum don't have to use it at all.
Thank you.
Dr Dave
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| mk6283 |
Posted - 05/08/2012 : 11:13:13
I prefer psychosomatic medicine or psychosomatic disorders. Call it what it is I say. It seems like people just love renaming this condition, but I don't view that as a solution to the biggest challenge at hand: increasing acceptance for the diagnosis on the part of both patients and physicians. I think that problem is mainly two fold: psychosomatic medicine doesn't make doctors any money and it requires patients to take responsibility for their own recovery. I'm not sure the constant renaming (TMS, AOS, MBS, PPD, stress illness, etc.) is the right approach to a solution. There is a rich history to psychosomatic medicine, a subject once widely studied and respected. In my opinion, most effort should be focused on reigniting that passion instead of trying to reincarnate it under a new umbrella term.
That said, it seems like the PPDA has the best of intentions and strong leadership to help carry forward this important work. As such, I support the PPDA in their efforts. The website looks great!
Best,
MK |
| Dr. Zafirides |
Posted - 05/08/2012 : 10:46:45
quote:
Originally posted by balto
I like mind & body syndromes more. Name that sounded too technical or psycho scare people and usually put them in a defensive and denial mode. I wish we can have some everyday English term for it like we call a cold, Cold.
Should we in the PPDA hold on to the "TMS" terminology in some way? What do people feel?
One of the hesitations in doing so is that there are multiple approaches represented there in trying to help people. It is not strictly TMS in the tradition of Dr. Sarno, per se, although clinicians like me (and many others in the PPDA) have been heavily influenced by Dr. Sarno and TMS.
Your thoughts are greatly appreciated!
Dr. Zafirides
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| balto |
Posted - 05/08/2012 : 09:22:34
I like mind & body syndromes more. Name that sounded too technical or psycho scare people and usually put them in a defensive and denial mode. I wish we can have some everyday English term for it like we call a cold, Cold. |
| SteveO |
Posted - 05/07/2012 : 23:40:16
Like many people who are emailing me daily about this PPDA, I'm torn.
But this is the first time I've heard a great explanation of "why" the term was chosen. It was the medical industry that got us into this healthcare disaster, and as Dr. Clark just said, the medical clinicians have to buy-in if they are to get us out of this mess. I couldn't agree more.
There is no way that TMS, or this new term PPD, will ever win over the suffering public directly. I've been trying for over 10 years and people are simply too brainwashed by their physicians into believing they have something physically wrong with them to look deeper. But, if these doctors and healthcare professionals in the PPDA, begin a grassroots effort to educate the patients from the top, then I think it's a fantastic idea and is the only way to expand the message.
Only the healthcare professionals themselves can reverse the current downward spiral. But like Dr. Sarno, I never liked the word "psycho" involved in my view of myself and my healthcare, even though he has used it in referring to the psychology involved in our physical problems. The word mindbody is much less offensive and avoids the pejorative that I've found leads more people to reject the notion of TMS than anything else. I'm so tired of explaining "it's not all in your head" because these people hear..."psycho" first; and then shut down listening.
But if the phrase was chosen for a strategic purpose then I hope it works. It's not intended to be pedantic, but that phrase these professionals have chosen is vital, and I think they know it. You can only make a first impression once and you can't put an ego back into its holster once it has been offended. I've learned the hard way.
I just looked at the new PPD website and it is very interesting. I hope to learn more.
Good luck Dr. Clarke, this is a good concept,
Steve |
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