Derek S. Some concrete goals

This question was submitted via our Ask a TMS Therapist program. To submit your question, click here.

Question

Hi can you recommend some daily physical goals to get me out of bed please? Day 4 of spectacular relapse that nearly had my husband calling for an ambulance on the first evening. I am doing the emotional work but need some goals for getting moving. My fear is holding me back. I feel as if now I am getting to my really repressed emotions I should be doing a Lazurus type trick physically. Then it's disappointing when going to the toilet is agony and 10 minutes on my feet feels like I ran a marathon. I had previously spent 6 weeks getting over first episode but was never bed bound! Thanks so much.
Lexington

 

Answer

Thanks for your question, Lexington.

Without knowing the details of your physical situation, it's difficult for me to formulate specific physical goals for you. Plus I'm a therapist so thoughts and feelings are more my bag.

I don't think the physical part is nearly as critical as the thoughts and behavior accompanying the activity. You mention fear and disappointment being big parts of your day to day life. I would first focus on the fear by challenging yourself to walk to the bathroom while soothing your primitive brain using breathing techniques and self talk. Remind yourself that there is nothing wrong with you physically and that if you do not reinforce the symptoms with fear and attention, they will recede. Do this relentlessly but be kind and understanding with yourself. It's ok if this takes some time because you are doing something very important.

Do not fall into the trap of making symptom reduction your primary goal. You are not trying to change the symptoms, you are trying to change your response to them. If you focus on the symptom, you reinforce the pain mechanism. The symptoms will go when your response to them changes.

Also, try not to get deflated, discouraged, or disempowered by the presence of symptoms. Expect the symptoms to come and view each symptom as an opportunity to practice outcome independence and to create shiny new neural pathways.

Be patient with yourself and patient with this process.

Good luck!

-Derek

---

Any advice or information provided here does not and is not intended to be and should not be taken to constitute specific professional or psychological advice given to any group or individual. This general advice is provided with the guidance that any person who believes that they may be suffering from any medical, psychological, or mindbody condition should seek professional advice from a qualified, registered/licensed physician and/or psychotherapist who has the opportunity to meet with the patient, take a history, possibly examine the patient, review medical and/or mental health records, and provide specific advice and/or treatment based on their experience diagnosing and treating that condition or range of conditions. No general advice provided here should be taken to replace or in any way contradict advice provided by a qualified, registered/licensed physician and/or psychotherapist who has the opportunity to meet with the patient, take a history, possibly examine the patient, review medical and/or mental health records, and provide specific advice and/or treatment based on their experience diagnosing and treating that condition or range of conditions.

The general advice and information provided in this format is for informational purposes only and cannot serve as a way to screen for, identify, or diagnose depression, anxiety, or other psychological conditions. If you feel you may be suffering from any of these conditions please contact a licensed mental health practitioner for an in-person consultation.

Questions may be edited for brevity and/or readability.