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Hi Balto and thanks for posting this. Anything that helps people heal is great in my book and there is some great advice in here.

When I think of this list, I think of the very first letter in TMS: the T for Tension. Way back in the 70s, when Dr. Sarno first coined the term TMS, he had the tremendous wisdom to see straight to the heart of the condition and see that it fundamentally came from tension. Not physical tension, but rather mental tension, and specifically unconscious tension.

Childhood experiences are clearly an important part of TMS for many or even most people, but that doesn't mean that the tension is necessarily about something that happened way back in childhood. On the contrary, it could be that experiences from childhood formed our personality and that aspects of our personality are what are creating our current unconscious tension. For example, a lack of secure attachment (loving relationships that make you feel safe) could lead to someone becoming a perfectionist or a goodist because they feel like they have to be perfect and good in order to feel safe. However, when, as an adult, we always feel like we have to be perfect and good, that creates a great deal of tension for us. It is, in fact, enraging. However, while our tension may be indirectly caused by the past (our childhood), it is just as influenced by the present. Sometimes people make terrific strides in their healing by focusing on their tension in the present. I call these approaches "Present-based approaches," and for a lot of people, I think that that can be a very good thing. Ace's list does a great job of communicating a very helpful present-based approach, and I'd encourage anyone to give it a read and think deeply about it.

Balto, tonight at 6PM PST, we are having a call in discussion group to discuss Steve Ozanich's chapter on how to heal. If Herbie doesn't mind, perhaps we could talk a little bit about this post as well and think about how the two relate to each other. Tennis Tom, njoy, Eric "Herbie" Watson, and myself are all regular callers, so there will quite a few "familiar faces." You probably don't have time and I wouldn't want to impose, but if you are at all interested, I'd be more than happy to help you connect.

If anyone else is interested in learning more about the Present Based Approach, I wrote the following which might also help:

Living Tension Free

Tension fuels our Tension Myositis Syndrome, and for many people, learning how to decrease their emotional tension is key to their recovery. You may not be consciously aware of all of the tension that you carry around on a day to day basis. So how do we identify our hidden emotional tension and learn to manage it?

Increase your emotional intelligence
Living tension free involves increasing your emotional intelligence and developing skills at reducing emotional tension. Emotional intelligence simply refers to becoming aware of your emotional and physical reactions each day. When and why do you generate anxiety? What do you ruminate on? What are the situations when your internal bully comes out? By being more aware some people have found that they were able to gain true control over the part of their symptoms that they could control. This is not about identifying repressed emotions. Instead it focuses on present emotions that affect your thoughts and well being minute by minute.

Letting our internal bully get out of control

“You are not good enough,” “No one will ever like you,” “You are ugly,” “You don’t deserve happiness.”
These may seem like very mean things to say, but they are exactly what we tell ourselves every single day. Everyone has a little voice in their head telling them all sorts of things. Sometimes this voice can be uplifting and encouraging, but other times this voice can seem more like an internal bully. This internal bully creates all sorts of negative thoughts and generates an extremely large amount of tension. When you notice your internal bully getting out of control, it is important to stand up to it and tell yourself that you are worthy.

First, learn to identify where this inner bully is coming from. When did you learn to treat yourself so badly? Who is the inner critic? Once you recognize the root of this criticism, you can stand up to it, by changing your thoughts. Tell yourself that you are good enough, and recognize how angry you are. Comfort and sooth your inner child who is being tormented. If you allow your emotions to be present at these moments, you will reduce your inner bully and increase your emotional intelligence.

Obsessing over recovering the right way
No one wants to be in chronic pain, so of course you want to recover as soon as possible. You want to do everything you can to make sure that you do everything exactly right, and that is the problem. The more you try to do something perfect, the more pressure you put on yourself, which creates more tension. Remember the key to recovery is to decrease your emotional tension .This can not be achieved if you are obsessing over doing everything right. By focusing on doing something the right way, you are distracting yourself from your emotions.

In the end, there is no right or wrong way to recover, because with TMS there is nothing that you do not need to fix yourself, only realize that your symptoms are benign.

Ruminating on Something
We have all been there: worrying about something that happened at work, thinking over and over about something that will happen later in the week. Some examples of this are:

• Replaying past events over and over again in your head
• Worrying about upcoming events
• Thinking about worst-case scenarios

What you don’t realize is that when you are in this state of rumination you are increasing tension in your body and fueling your symptoms. You are not focusing on the present and are not allowing your emotions.

Check in with your body. Notice how activated your body is: feel your heartbeat racing, are your eyes dilated, feel your breath quickening. These are all signs that you are hyperaroused. Use your body’s autonomic stress response to recognize when you need to take control over your thoughts and focus on the present. Gaining emotional intelligence means understanding what triggers you.

Take a breath and begin to bring your focus back to the present. Begin to think about what you are doing at that moment. What is the activity you are doing? How do you feel in the present moment?

When are your afraid of your symptoms
Fear is the fuel of TMS. It keeps you focused on your symptoms and prevents you from living your life. For many people, it can be difficult to fully understand the depths of their fear, but gaining this knowledge is one of the first steps to recovery. Most of this fear revolves around having a serious medical condition, however with TMS your symptoms are benign. Therefore, there is no need to fear your symptoms.

The first step to reduce your fear of your symptoms is to learn to recognize when their fear occurs or ramps up.

Rage
It may seem like a scary idea, but deep down we all have repressed rage. The more you investigate your emotions, the more in tune you will become with what this rage is about or towards. The closer you get to his rage, however, the more emotional tension you may develop, as you may fear what will happen when you discover it.

This rage is perfectly normal, and does not mean you love someone any less.


Learn to Soothe yourself
In the Mindbody Prescription, Dr. Sarno writes, “the occurrence of symptoms reflects too much rage and not enough counteracting soothing elements in one’s life.” pg. 29

The emotional tension you have been generating is the reason why your symptoms occurred when they did. Luckily, significant progress can be made by simply soothing yourself. The more relaxed you are and the more you are kind to yourself, the less tension you will generate on a day by day basis. The goal here is to develop skills at increasing positive thoughts and decreasing negative ones. By achieving the following goals, you will be able to combat your anxiety and successfully sooth yourself.

Find Joy and/or Relaxation
The more joy you have in your life, the more confidence you will gain in the TMS approach and yourself. This will go a long way in reducing overall tension in your life. Learn to take pleasure in the little things in life, and find time to relax throughout the day. Feeling like you have to be on the go all the time is what got you here in the first place. By finding small ways to create joy and relaxation in your life, you will balance the anxiety you generate on a day-to-day basis.

Meditate
Most of the TMS distraction involves worrying about the past or future and thinking about your symptoms. This increases tension and anxiety. Meditation will help you learn how to return your attention back to the present. It will also help you become more allowing and accepting of your emotions, which will help you limit the amount of emotions you repress moment to moment.

Increase your confidence
You are not good enough; You will never be happy; Your pain will never go away; You will never be able to play with your kids again.

We have all been there. That place where you feel like you can’t do anything, and where your self confidence is at an all time low. But you can stand up to your inner bully and find small ways to increase your confidence. To start, remind yourself that you do not have a physical problem. While your pain is present, it will go away, and does not have to limit your activity.

The more confidence you have in yourself, the more you will accept the diagnosis, which will lead to a reduction of your symptoms.

Begin doing activities you love to do
One of the more frustrating parts of having chronic pain is giving doing activities you love. When you begin to do some of these activities that you have been avoiding you will begin to feel like you have your life back. Joy leads to confidence, which reduces inner stress and tension.

Gain acceptance and equanimity
If you have TMS, you have difficulty accepting and allowing your emotions. Whenever you repress your emotions, you are building up emotional tension. The only way to decrease this tension is by learning to accept your emotions and gain mental calmness.

The first step in this is to overcome your fear of your emotions. Don’t be afraid of the discomfort of feeling your emotions. Most of the time when a person pushes an emotion away it is because they feel discomfort in their body. Remember, the feeling is only temporary. Don’t resist emotions, be it anger, rage, anxiety, fear. Accept these emotions and they will fade away quickly. If you allow yourself to sit and experience the emotion, it will slowly go away. Experience your emotions, don’t think about your emotion. This is not about intellectualizing but about feeling.

As for your symptoms, try not to challenge them, as it will only draw your attention to your symptoms. Sometimes challenging them makes things better. Other times it makes them worse. You must learn to watch yourself to figure out which is which, and when to challenge yourself and when not to. Do not try to force your recovery. Any time you think you have to do xyz activity in order to get better, stop and ask yourself if you are trying to force it to much. Accepting the diagnosis means that you believe your symptoms are benign. Therefore, you do not need to challenge your symptoms, because there is nothing to challenge.



[the following is a second essay]
Self Monitor

Recovering from Tension Myositis Syndrome (TMS) involves learning to use your body as signal that something else is going on. This condition is caused by repressed emotions, which means that most of us are not skilled at knowing what we are feeling and, perhaps more importantly, why we feel they way we do. A useful technique to learn to think psychologically is to use your body to identify when you are activated and hyperaroused. Doing so will allow you to reduce your current emotional tension and therefore reduce your present symptoms.

What do you mean by Current Emotional Tension?

Emotional Tension refers to anytime we are acting in a repressing manner, and are not being in touch with our true emotions. This consists of having negative thoughts and focusing on the worse-case scenarios. Some examples of emotional tension are:

• anxiety
• worrying about the past and/or future
• rage
• ruminating on something
• Letting our internal bully get out of control
• Obsessing over recovering the right way
• Being afraid of our symptoms

Learn to Recognize Your Tension
All of these emotional states activate our Amygdala, an emotional center of our brain, which amplifies our symptoms and leads to more fear, anxiety, and worrying. In addition, the emotional tension we create, on a minute by minute basis, also engages our body’s physical stress response through the Autonomic Nervous System and the HPA axis. This is the reason your heart beats faster when you have anxiety. Our bodies react to our emotional states. If we have emotional tension, our bodies will reflect that.

By paying attention to the sensations in our bodies, we can use these physical signals to Think Psychologically and figure out what is generating our tension. This can help us better understand what we react to. This means that if we feel our bodies activating our stress response, we can identify when we have emotional tension building up inside us presently. If you feel your heart rate start to increase, your pupils dilate, your breathing accelerate, these are all signs that you need to get in touch with your present emotional state.

Use your body’s natural stress response to identify when you are repressing present emotions. From there, go back one to one of the most basic principles of Sarno’s work and Think Psychological. Ask yourself, “what am I thinking right now,” and “why do I feel this way right now.” If you can bring your focus back to the present and to what you are feeling in this moment, your symptoms will reduce.

1. Monitor Your Body
2. Think Psychological
3. Your symptoms will reduce

Where is Your Energy
A great deal of what drives our "Tension" Myoneural Syndrome is simply our own tension. There is a tremendous amount of value to be had in just watching where your energy goes on a day to day basis. One way to start with this is the following very simple classic exercise: get a blank piece of paper and draw a stick figure in the center. Now, around it, draw all of the sources of tension that are using your energy. Just write the words out like a spider diagram or word map. Use the insights that you have refined from journaling to understand the sources of that tension. Then ask yourself what you can do to be kind to yourself. What can you do to lessen that tension? Can you forgive? Can you accept? (It may take time, of course.) Can you make changes? Can you simply accept that some of the things will unavoidably cause tension and that while that is unpleasant, you can mindfully ignore that tension or feel it in your body and let it slip away? Can you use an affirmation to reduce the tension? Can you invent techniques of your own to manage it?

Healing from TMS is a great deal like meditation. Once you achieve peace with not yet being where you are going, that is when you will actually get there. This may seem paradoxical, but it can be done. Just watch your tension levels, and get drawn back into the life that your symptoms always distracted you from. Settle in to it a little and just focus on living (and enjoying) the best life that you can. (From the thread: Frustrated)