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Ah, the setback. Is there anything more frustrating than thinking you having your TMS symptoms on the run, and then having them come back with a vengeance? This probably happens with 90% of the clients I work with. As strange as this sounds, it’s actually good news. Those 3 good weeks you had is the experiential evidence you need to know that this is in fact TMS, as opposed to some structural problem.

So why did the pain come back? Debbie, you just had your first extinction burst. This is common, and in many cases expected.

The extinction burst is a phenomenon in behaviorism. When you stop reinforcing a behavior, you’d think that the behavior would just immediately stop. But they’ve found that that isn’t the case. When you stop giving a rat a food pellet every time he runs on the wheel, he actually runs harder and faster at first, before he stops running altogether. When you stop giving a two-year-old child candy every time he throws a tantrum, his tantrums actually get worse before they go away. No one likes to lose a behavior that’s working, so there’s a little resistance once the reinforcement is taken away.

How is this relevant to the pain? The purpose of the pain is to scare you, to bring you to a state of fear. When you take away the pain’s reinforcement (fear), the pain can come back even worse before it goes away. The mind does not like to lose a defense mechanism any more than a toddler likes to lose his candy-getting behavior.

So the real question is, how do you respond when the pain comes back? Do you resort to fear, dread, and preoccupation, or do you say, “Ha, I know what you are! You’re trying to bring me back to this state of fear. Give me your worst…I’m on to you!”

I used to teach parenting classes. I would tell the parents of tantruming toddlers to stop reinforcing the tantrum with candy or attention. They would, and as expected, after a little while the tantrums would get worse. Most of the parents would give in, and resort back to giving the kid candy. They got sucked in by the extinction burst, not realizing that they just had to hold out a little longer.

Most TMSers are absolutely beset by fear and preoccupation about their symptoms. This reaction, difficult as it is to resist, actually serves to reinforce the symptoms (see the article, Breaking the Pain Cycle for a more thorough explanation: http://www.tmswiki.org/ppd/Breaking_the_Pain_Cycle,_by_Alan_Gordon,_LCSW)

If after a successful break from your pain, you view your symptoms getting worse as nothing more than your mind desperately trying to bring you back to a fear state, like a two year old desperately trying to get that candy again, it's a lot easier to laugh it off and resist the fear. You know what it's doing, you're on to it's strategy.

We can either go through life scared, or go through life empowered. You can’t feel empowered when you’re in a state of fear, and you can’t be scared when you’re in a state of empowerment.

If you work toward honing a stance of empowerment, and work toward standing up to/not buying in to the fear, the dominos will start to fall. The purpose of the pain is to scare you, if you undermine that purpose by developing an empowered stance, the pain won’t have a leg to stand on.

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