Derek S. What's the real cause of TMS?

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

Question

I need a clarification regarding the cause of TMS pain. Dr. Sarno says the purpose of the pain is to repress unconscious rage that threatens to become conscious. Others say the pain is more a physical expression of these inner feelings, and others that the pain is a form of abuse caused by "the bully within." So I'm confused by all these explanations. Since Dr. Sarno's books healed me for many years, I lean more toward pain being generated to repress unconscious rage. Can someone please clarify these seemingly very difference approaches to what causes the physical pain of TMS?

 

Answer

Thanks for your question. This is an important concept that many people have differing opinions on.

Here are my thoughts on the subject:

In order to answer the question about the purpose of TMS pain, it is first important to consider what the purpose of pain is in general.

Pain is an evolutionary advantage and it plays a crucial role in survival. Without pain, we would not last very long as individuals or as a species. That is one of the reasons that conditions such as leprosy and severe diabetes can be so dangerous. Both conditions can lead to nerve damage in certain parts of the body which leads to all kinds of injuries and infections going unnoticed and thus worsening. Pain tells you that something is wrong and needs to be tended to, with the purpose of increasing your odds of surviving a threat.

I would argue that TMS pain is really not all that different. The purpose of the pain is to scare you and to create fear and preoccupation. The symptoms exist to warn you against a perceived threat.

The distinction is that most people who develop chronic psychogenic pain have had their relationship with fear corrupted. In other words, there was likely a time in their lives (usually childhood) during which they did not feel safe; physically, emotionally, or both. This type of experience sometimes has the effect of causing the brain's threat detection system to go a bit haywire. When psychogenic pain becomes chronic, everything can become a threat; emotions, financial stability, intimacy, social interactions, bending down, sitting, typing, public speaking, certain foods, certain chairs, etc. You get the idea.

Most people who have TMS perceive threats everywhere. Being in a constant state of fight-or-flight can lead to the pain mechanism becoming hijacked.

Pain is not the problem. Fear is the problem. Pain is just a consequence of being in a perpetual state of hypervigilance, anxiety, and/or fear.

This is why we therapists tell you to not focus on your symptoms and to tend to your anxiety and feelings instead. If you are able to get your brain out of a state of perpetual fight-or-flight, the symptoms will no longer serve a purpose and will recede.

The good news is that it doesn't really matter which theory you choose to explain the purpose of TMS symptoms. You can still get better.

In other words, do not allow "not knowing the true purpose of TMS symptoms" to become another perceived threat.

-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.

 

thats a very clear explanation i was wondering the same myself

 

Yeah, great response by Derek!

 

I totally agree with Derek. I've always been a worrier, fearing this or that is going to happen.
The bad never does happen, but I have worried myself sick sometimes over the negative thoughts.

It isn't easy to break a long-held bad habit like worrying, but TMS knowledge is helping me a lot.

 

Great answer! Great last sentence.

 

I'm late on this thread, but this is a brilliant response Derek. I've bookmarked it.