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Perhaps your confusion arises from not understanding the difference between localized inflammation and systemic inflammation. An example of localized inflammation is a sprained ankle. Dr. Hanscom was talking about systemic inflammation. Systemic inflammation is about how protein molecules called cytokines regulate the working of the central nervous system, i.e., brain and spinal cord neurons.

The central nervous system works best when there is approximately a 50-50 balance between pro-inflammatory and anti-inflammatory cytokines. Why have any pro-inflammatory cytokines? One important reason is that they help us to learn. Learning requires the creation of new connections between neurons, and pro-inflammatory cytokines facilitate that. If the balance goes chronically awry in favor of too many pro-inflammatory cytokines and not enough anti-inflammatory ones, various chronic physical disorders can result, and so can chronic anxiety and TMS.

Below I will link to a monograph by Dr. Hanscom titled Plan A - Lowering Inflammation, Lengthening Life. In it, he talks about lowering systemic inflammation. He wrote the monograph during the height of the corona virus pandemic, so his focus was on surviving the pandemic. But what he wrote applies equally to anxiety and TMS. Below is some of what he wrote. I have added the italics.

Any mental or physical threat, perceived or real, is going to be met with a defensive response from your body. Much of this is mediated through the vagus nerve, at the core of the autonomic nervous system. The response is the well-known flight, fight, freeze, or faint reaction . . . .

Although threats come in many forms, they always activate pro-inflammatory (Pro-I) cytokines. Besides obvious physical threats, mental threats are even more inflammatory and harder to manage because we can’t physically escape them. They create a sustained inflammatory response that forms the basis for chronic mental and physical disease. Examples of mental threats are memories, negative thoughts, suppressions, repressions, insecurities (social, financial, health, etc.), cognitive distortions, loss of life perspective and purpose, and social isolation . . . .

Discovery and acknowledgement of all our threats – whether real, imagined, anticipated, or repressed – is the first step towards addressing them. The second is choosing an adaptive rather than a maladaptive escape to safety, whether the threat be physical or spiritual. We are better at physically escaping to safety than we are at dealing with spiritual crises . . . . If you don’t feel safe and peaceful, you are carrying elevated levels of inflammatory cytokines. . . .
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As Ellen wrote above: psychological conflicts --> physiological changes. Hanscom discusses 12 kinds of ways to lower one’s pro-inflammatory cytokines. Some of them are physical things, e.g., get adequate sleep, but most of them are in the psychological realm. Below are the psychological ones.

1. Understand and treat anxiety.
2. Employ expressive writing.
3. Calming techniques.
5. Address anger/Practice forgiveness.
6. Directly address family issues.
10. Play.
11. Giving back.
12. Regaining your life vision/Reconnecting with life.
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If you are interested in seeing what Hanscom says about these things, here is the link to his monograph: https://backincontrol.com/wp-content/uploads/2021/10/Plan-A-V4.pdf

I want to end by emphasizing that the essential first step is discovering and acknowledging all of your threats. Only then can you find an adaptive escape to safety. If repressed anger is your problem, you have to discover and acknowledge who you are angry at and why.

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