Alex B. 5 questions

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Question

1. Is Dr. Ramirez the key Boston specialist in TMS?
2. Is it important to have a formal diagnosis, or is my sense in the rightness of TMS enough?
3. Structurally, my scoliosis leans toward the left, and is mild. For three years, my pain has taken turns occupying my right lower lumbar, my right toe, mid back, my right trapezius area, sciatica on the right side, neck pain on the right, right thumb joint. Any significance to right side manifestation of pain?
4. Isn't lowering anxiety the critical task?
5. What do you think about the multi-generational transmission of TMS? is it like multi-generational transmission of trauma? I believe can trace TMS back for 3 known familial generations.

The pain travels- packs up from one area, pitches its tent in the next.

 

Answer

Hi Riv, thanks for the question.

Firstly, I'm not familiar with the Boston area as I am located in Los Angeles, but perhaps someone else on the forums can speak more accurately about Dr. Ramirez. I'll ask around with some of my colleagues.

I believe that having a formal diagnosis is an important element in treating TMS. Accumulating evidence is key to being able to confront the part of your unconscious mind that will always attribute your symptoms to physical factors. By getting a diagnosis and understanding the details of your symptoms you can begin to confront them from a place of empowerment. Furthermore, it is important to be sure that you are indeed dealing with TMS. If you do have a structural issue then it needs to be treated as such.

As far as significance to right vs. left I haven't encountered that specifically, but I think this illustrates why it is important to get a diagnosis. While it sounds as though the symptoms are independent of the mild scoliosis, as long as there is ambiguity, the anxiety and fear have a solid base to go back to. By getting clarity on what is a reasonable amount of pain to expect and if your symptoms are inconsistent with that you give yourself the opportunity to reframe the meaning of the pain when it arises. Lowering anxiety is a very important component, and this is what can help you do it.

We are all influenced by the circumstances of our upbringing and while the factors that cause some to experience TMS while others do not are still not fully understood, long-standing familial patterns of relating to pain and physical awareness are definitely something that can be learned. The underlying causes of people's symptoms are almost always learned behaviors or ways of relating to themselves so it stands to reason that if your family has this established way of relating to pain and anxiety, you could learn it as well.

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This is not a question; it is a response to you as clinicians.
I have seen Dr. Martinez and the diagnosis is confirmed. I liked him and would refer people to him. Indeed, I have come a long way.

I am inquiring my psychotherapy patients about their physical symptoms in a more attentive way, much as I do regarding their substance use. My practice is subtly yet dramatically changing, as I think that there can be recovery for people who are defeated by their DSM diagnoses.

I have a psychiatrist who prescribes for "OCD" and depression/anxiety and is very experienced, but of course never heard of Sarno. Unfortunately, qualified and experienced M.D.s often can't see the forest for the trees. I understand that my symptoms, i.e. anxiety and insomnia, are also MBS. I feel that I have to teach my treatment providers, which is I suppose OK.

I am educated and articulate (though also anxious and obsessive) and even so, I am intimidated by the medical profession.