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Dr Dave
USA
53 Posts |
 Posted - 01/29/2011 : 15:29:04
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Thanks, Skizzik, appreciate the kind words. Not to worry about my being labeled a "quack." As long as we stick to evidence-based practice and our patients have decent outcomes we'll be fine.
In my department (Gastroenterology) of a dozen traditionally trained MDs and PAs, they were confident enough to send me 85-90% of the patients who needed a second opinion. I also had many patients referred from primary care, GYN, Pain Clinic, ENT, neurology, psychiatry and occasionally even from the hospital chaplain. |
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forestfortrees
393 Posts |
Posted - 01/29/2011 : 15:40:28
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Hi everyone,
Many thanks to everyone for their feedback. As Dr. Clarke mentioned, they strongly resemble many of the arguments that were made during our teleconferences in the fall. So many different positions and so many compelling arguments!
I remember the first conference about TMS/PPD in Ann Arbor. It was so exciting to have around 50 practitioners in a room who were all strong believers in the idea of TMS. You could tell that a movement was forming, driven by caring and passionate practitioners who believed in PPD and wanted to share that information with others. It was truly inspiring, and during the brainstorming session about what we can do to help more people, one of the things that participants thought we should work on first was finding a new name for the condition.
I put several hours of work into the TMS Wiki every day, and the reason why I do it is that I suffered terribly from my PPD for 18 years, and I want to help others avoid what I went through. In my mind, the Ann Arbor meeting shows that a movement of doctors and therapists is forming.
To me, this is the only way forward. We may be disillusioned by people we have dealt with in the past, but at the beginning of a movement like this, we simply have to believe that there is a better way. What would have happened if, for example, at the beginning of the civil rights movement, people had decided that the economic forces arrayed against them were too strong? PPD is an idea whose time, I think, has come. If we organize, our stories are too powerful not to be listened to.
Forest (My story at tmswiki.org) |
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suegr98
USA
39 Posts |
Posted - 01/29/2011 : 23:24:10
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I personally do not care what it is called. Anything beats hypochondria, but that word was once used for the same thing. Hysteria was too.
The gift Sarno gave me was to explain it in such a way that it could both come from my mind and hurt like hell, though it is a very difficult concept to explain to most people. They still hear "It's all in your mind, therefore not real. In fact, you might actually be crazy." (Those words do not have to be said to be heard!)
To me, the name of it doesn't matter nearly as much as the understanding that an actual process of pain and illness can be triggered by the mind.
take good care,
Sue
http://www.facebook.com/suegr98
http://healingwithfeelings.wordpress.com
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suegr98
USA
39 Posts |
Posted - 01/29/2011 : 23:35:52
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PS I wonder how psychophysiologic is better than the more traditional term psychosomatic, which is a word I am very familiar with as a nurse. Not that it is popular with patients to be told their pain is psychosomatic. Again, we get stuck in the mire of people thinking we are saying the pain is not real. And many practitioners are less likely to respect peoples' complaints when they are considered to be psychosomatic. It's quite the negative feedback loop.
take good care,
Sue
http://www.facebook.com/suegr98
http://healingwithfeelings.wordpress.com
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art
1903 Posts |
Posted - 01/30/2011 : 05:53:08
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I'd say you answered your own question Sue, and quite ably at that.
For that matter, why not call it somatization disorder? Same deal.
These things have long been recognized, going back at least as far as Freud. In those days, "hysterical blindness" was all the rage... |
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skizzik
USA
783 Posts |
Posted - 01/30/2011 : 06:47:25
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************** PSYCHO ******************
What came to your mind? Someone who's well adjusted? Someone normal?
Perhaps......................CRAZY...............?
Yeah. You Dr.'s have spent so much time in the vacum of medical school (and thank you for that) that you forget how real society works.
Am I supposed to spread the word of Psycho whatever? I was just getting good at baiting and hooking people into tension disorders. And now this?
I was just a psycho? Everyone I feel who should hear how tension works will now be googling psycho whatever?
I'm grateful it was'nt called that when I was introduced to it, I'd have ran from any doc implying psycho whatever and found (easily) a doc who'd have shoved titanium screws in my back to prove I was'nt crazy, postal, or planning to shoot a congress woman.
Don't you get it????? Thats what TMS is about. It's a distraction to the rage so that we can all get along in a western society. Labeling anyone in chronic pain as psycho alienates them. No if's and's or buts.
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art
1903 Posts |
Posted - 01/30/2011 : 09:18:01
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I think the above comment is way over done. I understood that TMS referred to PSYCHOsomatic processes and I wasn't in the least put off.
When you see the word "psychology" do you feel some sort of fear and loathing?
How about psychometrics?
How about psychoanalytic?
Psychodynamic?
It's all about context, and by using only the root prefix in isolation to make a point you're stripping it of that very thing.
This wouldn't have been my first choice either, but I don't think it's nearly the problem you do.
EDIT: I'm gong to amend that. I think I very well might have chosen this. it's pithy, and it says what it is, yet without the preconceived baggage of psychosomatic..The physiologic really works much better than "somatic" (bias aside), because it's a word people understand for the most part. It gives a sense of something real, that is something bodily in a way somatic does not to the unschooled.
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Edited by - art on 01/30/2011 10:32:35 |
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Dr Dave
USA
53 Posts |
Posted - 01/30/2011 : 12:40:58
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In my lectures to health care professionals I encourage using the term Stress Illness when communicating with patients and using the term Psycho-Physiologic Disorder when communicating with other clinicians. Some day Stress Illness may take over and the PPDA can become the SIA. That will likely be decades from now, if ever.
I also use the term Stress Check-Up (rather than psychological evaluation or similar term) to describe the process of evaluating someone for the largely hidden stresses that are the cause of Stress Illness.
Words matter. The problem is that they matter in different ways to different groups. The PPDA couldn't find one term that worked for all of our stakeholders. |
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art
1903 Posts |
Posted - 01/30/2011 : 12:51:15
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Part of me wants to argue that's patronizing to the patient, Dr.Dave. And strictly speaking, stress illness is not completely accurate as you know. Everyone suffers from stress, and TMS can arise in people who aren't even particularly aware of being stressed in any unusual way.
If you buy Dr. Sarno's theory of unconscious processes this is especially so..
And yet, I get your intent and I'm sure for some who might otherwise head for the hills, it's the right approach... |
Edited by - art on 01/30/2011 12:52:21 |
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suegr98
USA
39 Posts |
Posted - 01/30/2011 : 13:02:27
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Dr Dave, which stakeholders is the term PPDA directed at? If it is directed at clinicians and to be used in research I would say drop all hyphens and caps. For patients, hyphens and caps might clarify it a little more. But I don't think what matters for patients is the word used, it is more about the presentation.
I like Stress Illness. I have seen stress tests and stress management outcomes addressed in a lot of patient literature. But seldom if ever have I seen it associated with back pain.
take good care,
Sue
http://www.facebook.com/suegr98
http://healingwithfeelings.wordpress.com
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forestfortrees
393 Posts |
Posted - 01/30/2011 : 13:07:23
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quote:
Originally posted by suegr98
If it is directed at clinicians and to be used in research I would say drop all hyphens and caps. For patients, hyphens and caps might clarify it a little more. But I don't think what matters for patients is the word used, it is more about the presentation.
For what it is worth, this is my personal opinion as well. I think that strange capitalization and hyphens make it look like a brand rather than a scientific term, and think that practitioners are quite wary of anything that looks like a brand.
Forest (My story at tmswiki.org) |
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susan828
USA
291 Posts |
Posted - 01/30/2011 : 14:40:45
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@skizzik re your question:
************** PSYCHO *****************
What came to your mind? Someone who's well adjusted? Someone normal?
Me: The shower scene in "Psycho"?
Just a joke, guys!
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art
1903 Posts |
Posted - 01/30/2011 : 15:16:27
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quote:
Originally posted by forestfortrees
quote:
Originally posted by suegr98
If it is directed at clinicians and to be used in research I would say drop all hyphens and caps. For patients, hyphens and caps might clarify it a little more. But I don't think what matters for patients is the word used, it is more about the presentation.
For what it is worth, this is my personal opinion as well. I think that strange capitalization and hyphens make it look like a brand rather than a scientific term, and think that practitioners are quite wary of anything that looks like a brand.
Forest (My story at tmswiki.org)
I voted for the hyphen, but now that you mention it that's a good point about looking brand name-ish... |
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marjrc
Canada
19 Posts |
Posted - 01/30/2011 : 19:49:20
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Wow, this has been an informative and interesting thread! I don't at all see the word/term "psycho" in a negative way, such as "sick in the head" and I like the use of both psycho and physiologic because that is really what this syndrome is. I like the word "tension" as well and think it's very acceptable to most people. Everyone knows what kind of pain tensions can cause as they've no doubt experienced it for themselves, even if for a short time.
What I hadn't thought about, though, was how doctors and medical professionals see this and I agree that TMS may not be the most well-received term in that regard.
I loved reading about the conference in 2009, so thank you for posting that, Art! :) |
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art
1903 Posts |
Posted - 01/31/2011 : 06:02:23
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Thanks Marj...
It was apparent to me by some of the replies that some weren't aware of what these good folks are up to..
In the end, the thing becomes the name and the name becomes the thing. To most of us on the forum, we're so used to "TMS" that it might seem funny to start calling it something else. But I'm kind of looking forward to a brand new package all nicely wrapped and with a ribbon on top..
Kind of like Christmas :>)
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alexis
USA
596 Posts |
Posted - 01/31/2011 : 06:22:48
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| I don't think the public reception of words containing "psycho" is something that can be meaningfully debated here. The sentiments skizzik describes apply to a significant part of the US and world populations, and people who've accepted a TMS diagnosis are far from a target audience. If people really want to get a feel for this it will be a lot more worth while to read up on the numerous studies of public sentiment on psychiatric disorders or conduct a more scientific pole to determine whether we're looking at 20 or 80% type figures. The rest is just guesswork. |
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skizzik
USA
783 Posts |
Posted - 01/31/2011 : 08:00:08
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quote:
Originally posted by alexis
and people who've accepted a TMS diagnosis are far from a target audience.
I did'nt accept it at first, heck 2n or 3rd for that matter. I eventually did. So am I a "target audience"?
I think for me it was all about approach. When I heard Howard Stern (love or hate him he's no hippocrate) discussed how he healed, I was ready to give it a shot.
I think my little scenarios demonstrate that it's in the "approach." Therefore, you really can't have a "target audience" in my opinion. This board is full of men and woman of all ages, heights, sexual orientations etc.... Some were book cures, some were'nt, many remained skeptical and healed, and many haven't found relief even though they accepted the terms.
Like Susan said, when you think of psycho, you think shower scene.
When you hear or see the word idiot, what do you think? And yet it came from idiot savant. Which is now called autism.
Imagine if some forum came along with a group of doctors and went back to calling autism idiot savants again in the mainstream. |
Edited by - skizzik on 01/31/2011 08:02:28 |
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Dr Dave
USA
53 Posts |
Posted - 01/31/2011 : 08:49:23
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quote:
Originally posted by art
Part of me wants to argue that's patronizing to the patient, Dr.Dave. And strictly speaking, stress illness is not completely accurate as you know. Everyone suffers from stress, and TMS can arise in people who aren't even particularly aware of being stressed in any unusual way.
If you buy Dr. Sarno's theory of unconscious processes this is especially so..
And yet, I get your intent and I'm sure for some who might otherwise head for the hills, it's the right approach...
Art, no patronizing is intended with the Stress Illness term. I think of it as the plain English version of psychophysiologic. Sort of like converting "biliary obstruction due to choledocholithiasis" to "the main tube from your liver is plugged with a gallstone".
Stress Illness is an accurate term. Though it can arise, as you point out, in people who aren't aware of being particularly stressed, their stress is merely hidden and can be uncovered with appropriate questions from an empathetic practitioner. The four dozen stories in my book are all about people not fully aware of how stressed they were.
Please vote in Forest's poll! |
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art
1903 Posts |
Posted - 01/31/2011 : 08:59:32
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No argument Dr. Dave, I just thought it rather broad. Stress causes many things, far from all of them psychosomatic.
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Poll on new term for TMS
