A word about outcome independence

One of the clearest paths to eliminating your symptoms is to take away the pain's power by overcoming your preoccupation with it.

Easier said than done, right?

Shifting to an attitude of outcome independence is a great technique to help achieve that.

Outcome independence means your definition of success is independent of a specific outcome.

My favorite example of this comes from the movie, "Dead Poet Society."

One of the students has a huge crush on a girl from a nearby school, but is terrified to ask her out. Finally, with a burst of courage, he rides out to a party she's attending.

Later that night, he returns to his school with a black eye, and beaming with joy. His friends ask him what happened.

"I asked her out," he replied with a huge grin.

"And she said yes?" They asked.

"No," he said, "and her boyfriend punched me in face."

"Then why are you so happy??" His friends inquired.

"Because I asked."

He wasn't pleased by the outcome, he was pleased in spite of the outcome.

Think how outcome dependent you tend to be with the pain. Assume you have back pain when you take a walk (or some comparable situation.) Every time you take a walk, you monitor it. "Okay, today the pain started after a block. Yesterday it started after a block and a half." "Today it was a 3 out of 10 when I returned home. Last week it was a 7 out of 10 after the same distance."

When you have a good walk, you feel happy, optimistic, feeling like you're on the right track. When you have a bad walk, you feel down, defeated, bad about yourself and your prospect of ever getting rid of the pain.

This attitude, this outcome dependence is feeding the pain cycle. It's reinforcing its very purpose.

Change your definition of success. Work on it. Success is no longer measured by whether or not you have a good walk. Success is measured by how little you care.

At the beginning of your walk, tell yourself, "It doesn't matter how much it hurts afterward. That isn't an accurate measure of monitoring my progress with PPD anyway. What matters is how little I let it affect me; how I refuse to let my mood, my self-perception, my feelings about the future be determined by how much pain I'm in afterward."

This is not an easy transition, and you'll revert back to outcome dependence plenty of times. But if you keep at it, and continue to work toward altering your definition of success, you will strip the pain of its power, and it will likely lose its hold on you.

 

Thanks Alan.

This makes so much sense. I am looking forward to my next walk (to a lunch appmt in 2 hrs) to see how effectively I can utilise this technique.

In order to better manage exercise when symptoms flare, I keep reminding myself " I am not reinforcing this pain loop any more with negativity". Pain Loop, your days of control are OVER!

 

thanks alan another great article. im going to try this out it resonates with me just like that video Forest posted about not caring whether you're in pain or not. I think thats the key

 

Good stuff!

 

Thank you for this. One of the most helpful articles I have EVER read.

 

Thanks a million, Alan. I have to agree with ashcatash that this has been a most helpful article. "Outcome independence" is as simple as taking a walk without monitoring whether the pain level is improving or worsening. It's a matter of just taking a walk and enjoying it as an end in itself. It's really an important perceptual shift that's necessary to short-circuit the TMS pain process. Of course, it's easier said than done!

 

Now I need to apply this to how much I sleep. I need to NOT look at the clock and NOT count how many hours I got to see if I will be able to function.

I need to say "it does not matter how much sleep I get. It is not a measure of my progress. I refuse to allow my lack of sleep to impact my mood, self-perception and my feelings about the future."

Yeah

 

Hi. I had tremendous success with getting rid of my pain this way, 1. knowing that my pain is TMS 2. Knowing that it is harmless and 3. Not caring if I have pain or not. So I don't have pain now - I had a lot of the "symptom switch" for awhile, but just kept doing the same thing. However, I have not been successful with sleep, which I believe is part of my TMS strategy also. I have issues with childhood trauma and this is where the sleep problem may have begun. If I could lick this, I think I could declare myself cured. Somehow I can't seem to believe that I don't care if I sleep or not because I feel so awful and bored when I cannot get to sleep and often don't feel well the following day. I have tried everything under the sun. I also have used low doses of meds to sleep for many years. I seem to have the problems more when I don't take the meds. Am I missing something?

 

Mindfulness. When people do mindfulness exercises, one of the most difficult barriers is not falling asleep. Mindfulness is so phenomenal that it literally changes the structure of the brain for the better. Try practicing mindfulness when you're attempting to fall asleep. You win either way: either you fall asleep or you're healing your brain.

Here's a great introduction to how to practice mindfulness.
Click on the five minute breathing meditation at this link:

http://marc.ucla.edu/body.cfm?id=22

Alan

 

Alan, thanks so much for your response and the link for the meditation. I am going to try to learn this the best I can. I also owe you a lot because your "outcome independence" really helped me to get over my sciatic pain. That seemed to be the missing link and so as soon as I mastered that attitude, the pain disappeared. It also worked well, and still works well, for those annoying substitute symptoms.

 

Thank you Allan for your insights,
Since the beginning of my tms journey I have had problems with this. After I read the books and I did the structured program I had expectations of healing soon and I did not. Intellectually I knew I should not compare myself with others or pressure myself into healing but emotionally I could not stop. I keep disappointing myself and your program is being very helpful. I definitely discovered that I am not good to myself and my whole family has this tendency.

 

Last night my friend drug me to a concert (New Kids on the Block, ha!) and I did not want to go. Not only was I worried that hearing music from my childhood would surface traumatic memories, I didn't feel good. My legs were tingly/buzzy and I just wanted to stay home. I got to a point that I said to myself, my legs are going to tingle/buzz whether I stay home or not. I might as well get out and do something different, make new memories and live a little. So I did! And as I was dancing/singing, legs tingling, I just thought to myself, "I don't care." And I'm actually feeling a little better this morning. Babying myself clearly doesn't help me get better, but getting on with my life does.

 

I have this problem with nearly every activity where friends and other people are involved.
A concert would be one of these activities, but also smaller ones, for example having a barbecue dinner with friends
or just watching a movie together. Obviously there's no physical action involved, and yet somehow my
arms start hurting.
This "I don't care" or "So what" may be worth a shot and seems very powerful to me,
if properly used.

 

Still keeping this concept top of mind and I'm getting some relief. I've pulled my daughters in the bike trailer 1-2 times a day since Saturday. Riding a bike alone is tough at this point, but it's more enjoyable with my babies along for the ride. My symptoms are a little crazy immediately after, but by the time I go to sleep at night, they are lessened. I may have TMS, but I don't have to be out of shape and have TMS!

 

Pandagirl, I had a similar experience yesterday. My shoulder was giving me more pain than usual and it was the day of my swim workout. I was almost convinced not to go through with it, but I thought about being more outcome independent. So I went and I was ok with the thought that I might have pain after the workout. I did do a relatively easy workout, but at the end of the day, I didn't experience any pain at all in the water or even afterward. Today it feels pretty good, too.

 

I learned this valuable tool as I went along trying to figure out the ins and outs
like this morning when I got up I had a twinge of pain shooting in my right shoulder
now I have done defeated this supposed rotator cuff tear or frozen shoulder/ its according to which Doc you ask
anyways it had been about a month since I had my last talk/ ignore/ no thought- to it
think it would start to listen, hum? well it does , when I first started my fight to win id ignore the pain and work out anyway
well that only seemed to give it more strength at the beginning-
then I learned not only to ignore but to just not acknowledge it at all
even while I was In the ignoring stage I was still wondering when was it gonna stop
and it just seemed to stay there- so I took any thoughts I was giving to that shoulder and dropped them- decided to study more on other things
I mean after all if im gonna be outcome dependent I might as well know its gonna heal without me trying to force it to heal huh
so when I did this approach the pain did leave ....
now back to this morning, I told it to stop and it stayed
I then knew id just have to forget it and not acknowledge it- knowing that's how I work it
and now im setting here getting ready to move up to a new benching record for my chest
in the past every time id bench press or throw a football or just about anything,
that shoulder then the other would flair up and the more id focus and fear
the more it would stay, well as I became outcome independent it try's to come on
like this morning but I just give no thought to it and soon within minutes its gone
as we say its not linear and it was there a long time before I knew tms healing- now anytime I just feel a twinge , I really don't think about it to much
I just use the outcome independent method and within minutes its gone

 

Hi Alan, and Others,
Thanks for the article, which combined with the other two in Part I of the Recovery Program really put a magnifying glass on the concept of "think psychological." Each article adds a specificity to the concept, with real tools!!

You say:
At the beginning of your walk, tell yourself, "It doesn't matter how much it hurts afterward. That isn't an accurate measure of monitoring my progress with PPD anyway. What matters is how little I let it affect me; how I refuse to let my mood, my self-perception, my feelings about the future be determined by how much pain I'm in afterward."

I agree with all that, and I also think there can be more subtle ways of using outcome independence in your example: "I am taking a stand with all of my TMS practices to help myself, including going for a walk. That in itself is the most powerful outcome." "I am out walking. That in itself is an outcome."

For me "how little I let it affect me" or "my feelings about the future" etc. are not in complete control, and they are ideals I may not meet. And these attitudes may not be needed in order to judge the success of my endeavor. There are more basic truths, such as "I"m out walking." So what if I have fears about the future? What else is new? This is perhaps even more independent...??

 

Andy, I love this. It reminds me of something called Radical Acceptance, a method I've found really helpful over the years. It helps me deal with things I have no control over (but would very much like to). The way this works is, you accept the situation for what it is, and you accept that you cannot change that situation (in this scenario, you accept the fact that you will have fears about the future, and you accept that these fears may emerge whether you want them to or not). From there, though, you can move forward to what factors you can control -- like your reaction to it. ("OK, I could focus on all the terrifying things that could possibly happen, or I could enjoy this walk that I'm on right this very moment.") I've found that in identifying those things I have little to no influence over, I am able to see more clearly those things I am able to influence. Interesting, how giving up control sometimes can give you some control back...

 

First, thank you Allan for putting together such a great Recover Program. So many aspects and deep insights...

I have a question about the outcome independence, because I find myself applying it to not the physical but psychological challenges. Is it ever a good life choice or just a form of self-bullying? What I mean, when I'm in a situation that upsets me and I expect it will cause me more pain afterwards, I tend to push through it anyway and ignore the fear of pain. I know I should prioritize my inner state in each given moment but I also think it's sometimes wiser to endure"short-term pain for long-term gain", like not estranging all my friends or people in authority whom I depend on in a spur of a moment and irreversibly damaging my relationships. It is a voice of fear protecting me from a later regret, a lose-lose scenario...
I'm referring to situations which I can't easily remove myself from and the only choice is to suck up my feelings and comply/please someone, or to stand up for myself by expressing my anger (because it's hard to be calm and assertive when emotions are already high).
Any tips on how to handle such inner conflicts?