Alex B. What are barriers to getting better?

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Question

Hi,
What is it that prevents someone from getting better from TMS (assuming they have it for sure)? What are some of the main barriers to someone getting better?

 

Answer

Hi there, thanks for the question.

So this a pretty broad one. I can give you some idea of what barriers I see my clients encounter most frequently. I would start by stating that first and foremost, the primary barrier is truly accepting the TMS diagnosis. So many of the people I work with come to me and say that they are "100% sure" that they are dealing with a mind-body issue. However, when we begin to confront and examine symptoms and try to reframe the meaning of the pain, they continually get stuck with the anxiety and fear that they are going to make things worse or that they can't get better. These fears will continue to plague you as long as there is a potent part of your mind that is thinking structurally. Now, it must be said that I think this is the most challenging aspect of TMS treatment. And it makes sense that it is; thinking of your pain as a non-structural issue goes directly against millions of years of evolution! We are hard-wired to associate pain with damage, injury and vulnerability. I understand how difficult this can be. I don't think I've encountered a single person who wasn't skeptical when first exposed to the concept of TMS. This doesn't mean you can't overcome it. What it means is that the most important thing you can do for yourself is to accumulate as much evidence as you possibly can that what you are dealing with is a mind-body issue. Create and evidence sheet, see a TMS doctor, whatever it takes to help you become convinced that the symptoms you are feeling just aren't congruent with a structural problem.

The second barrier is directly related to this: the continuing capacity for the symptoms to generate fear and anxiety. The reason it is so important for you to gather evidence and foster certainty that you are dealing with TMS is so that you truly believe that when you experience symptoms they can't actually hurt you. Yes, they may be painful. Yes, they may be annoying. But when you realize that they aren't structural and can't cause long-term damage, you have the opportunity to overcome the fear that they generate. It is this fear and anxiety that fuels TMS and keeps it relevant. The concept is that your pain is there for a reason and it's goal is to keep you fearful and preoccupied. The more you buy into this fear, the more it reinforces the purpose of the pain. People get hung up on the fear and it keeps them in this cycle.

So, to summarise the above: The first barrier is overcoming the built-in skepticism of TMS. This is done by accumulating evidence and conditioning yourself to accept that your pain isn't structural. Overcoming this first barrier allows you to overcome the second barrier, fear. Once you have accepted that the pain isn't structural, you can put aside the fear that it will hurt you.

The next major issues is outcome independence. The process I have outlined above is all well and good, but people still have difficulty with it because they become totally focused on using it simply to banish symptoms. This approach won't really work because the symptoms will still remain the focus of their efforts. Remember when I said the pain has a purpose, that it's there to keep you preoccupied? Well by having the symptom be the focus of your efforts, you are once again reinforcing that purpose. Monitoring constantly pressuring yourself to take on the techniques the "correct" way so that the pain disappears is still keeping you just as preoccupied as the fear did. The goal is to change the way you relate to the symptoms a the most basic level. Once you have accepted that they can't hurt you, it becomes about dismissing them as best you can. Again, it may still be very uncomfortable, but it doesn't need to have power over you. The goal of outcome independence is to change the way you relate to yourself, your process and your symptoms. The goal of your efforts becomes the abandonment of fear and anxiety not the banishment of your symptoms. Ideally you can get to the point where it doesn't matter if they are there or not: they can't hurt you so they no longer have the potential to keep you feeling powerless and afraid.

No this is also a difficult thing to do, and it won't always work. There will be times when the pain is too uncomfortable, the ringing in your ears to intense, your neck too stiff or whatever symptom it is you're experiencing. But this is paramount: that's ok! It's ok that this doesn't "work" every time. You don't have to completely banish fear and anxiety to be effective, just like you don't need to banish pain to make progress. This is about cultivating a different, more patient and caring perspective with yourself. Ideally you will be able to abandon the fear that accompanies your symptoms, but if you can't, simply observe what is happening, acknowledge that you're trying and keep at it. I can tell you with confidence that the less you let it scare and demoralize you, the sooner you get the long-term results that you want.

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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.

 

My list:
1 - We still fear our symptoms.
2 - the sum of our negative emotions is greater than the sum of our positive emotions. (we have no life outside of tms)
3 - Our body is still conditioned to produce symptoms. (bent down, go over high bridge, using keyboard, bright light...)

 

Barriers to getting better? I think Alex Bloom and Balto have given some excellent replies.

Fearing our symptoms or that they will get worse is futile. That is called, in TMS language, catastrophizing.
Thiking the worst will happen. It rarely does, so why worry about it? Worry and fear only keep the pain in place.

We should not let TMS pan obsess us. We need to find a life outside of it and TMS. I think pain remains with
a lot of people because they are spending too much time thinking about themselves and their pain.
They need to share their lives with others, get involved in their lives, but not over-involved.
In helping others, we help ourselves.

Many people say they feel pain when sitting, standing, walking, or being on the computer.
They may have conditioned themselves to expect pain in those situations.
Positive mantras are very important. A favorite of mine came from my best friend who said,
"I can do this. It's a piece of cake."

And be happy. Laugh as much and as often as you can.

 

This is currently one of my biggest barriers. Usually situations where I feel stuck in, unable to get out of either for external or social reasons. Do you suggest de-conditioning the pain response by reciting positive mantras? Telling myself I am free and can do whatever I want produces more resistance in me, like "I am kidding myself... If I do this I will lose my job... Or all my friends. Or everyone will think I'm weird". Perhaps I need to mindfully test these situations, learn to set boundaries...
Or there is this pain that when I put pressure on my right knee e.g. kneeling, it produces nervy pain on the side of the knee. Obviously some learnt response. How can I decondition it if it happens whenever I press on my knee, whether or not I expect the pain?

Does anyone have tips on unlearning conditioned pain response?

 

This is what worked for me:


Use the logic and reasoning of your conscious brain to override the unconscious. For example, I was conditioned to get migraines when the barometric pressure changed. When I could feel those beginning twinges of a migraine in response to weather changes, I told myself repeatedly, "There is no reason that a change in barometric pressure should cause a migraine. So stop it brain!." This eventually worked.

For some reason that I don't understand, talking to your own brain is an effective strategy.

Best wishes......

 

I can't find where to start my own post, so I am just going to post it here, as I really need some help:
I am a brand new member, although I have been using this website to assist me when I begin to have flare ups and it has been very helpful.
To keep it brief, I am a 30 year old female who has been dealing with 'fibromyalgia' for about 10 years now following a couple car accidents. I've lived with chronic pain for some time and have tried almost everything (they even discovered I have 'short leg syndrome' last month). I am also a recovering addict and since getting clean, I've tried even more avenues to cure myself or at least relieve/ manage the symptoms that have been destroying my life. I seem to always think I found a cure and then the pain returns.
I believe I have TMS and when I first found out about the concept, I jumped right in and after reading Healing Back Pain, I was 95% better for about 2 weeks. Since that time, I have begun to have flare ups again (although much less than before) that I can't seem to defuse. I ask myself what I could be repressing/ what is really going on and I can't seem to have anything come up that relieves the pain. I started journaling yesterday and felt a great relief mentally but today I'm in pain again and its very persistent. I try to tell myself its TMS and all of that but I guess my head is messing with me telling me I can never do anything right anyway, so of course I won't be able to do this right and I won't have any freedom from pain and I can't cure myself because I've tried so many things that helped for two weeks and then it returned and that maybe it's not only TMS therefore it's not going to work for me or that I am missing something in the solution so I won't get better. I recognize all of this as fear and intellectually, I think I know all those statements are wrong, but they keep coming up. I am clearly very hard on myself and am definitely aware of that and working on in it in the 12 steps. I also tend to over-complicate/ over think everything so this is no different and becoming detrimental.
I know conditioning is a huge barrier for me and I've been trying to break through them but I'm just having some trouble. Thankfully, I do have a friend who is in this with me and so I do have that as a support/ someone to relate to and a supportive boyfriend who shares the mindset.
I would love to be able to see a TMS doctor or therapist, however money is super tight and I don't think I can afford it.
Any help would be greatly appreciated, as I am open to all suggestions and advice.
Thank you!

 

Hi Jezmika,

Welcome to the Forum! Your story is very familiar to most of here. I had fibromyalgia for 20 years and overcame it by using TMS healing strategies. However, I do still have the occasional relapse, though they usually don't last for more than a few days now. You can read my story on my profile page in the Success Stories sub-forum.

Other than reading Sarno, you don't mention what you've done to address your TMS. There are two wonderful free resources on this site that are a good place to start. Alan Gordon's Recovery Program and the Structured Educational Program (SEP). I highly recommend these, as they address the issues you've raised in your post.

Keep us posted on how you're doing and feel free to ask questions or for support at any time. The more specific you are in your requests, the better able we are to assist you. You are in the right place and on the right path. Recovery is possible.

Best wishes.....

 

I'm curious, Alex, about the power of suggestibility. I hesitate to read other's posts sometimes because I will feel those symptoms often the next day. Why do our minds want to lock down on negativity like this? As ridiculous as this sounds, I was reading about FDR's polio in the 1940's and started feeling numbness in my legs. I know it's unreal, but it seems like my brain will latch onto possibilities of symptoms. Frustrated.