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Hi Peter,

First of all, it's important to get physical causes ruled out. It's best to have this done by a TMS physician, as non-TMS physicians can sometimes attribute pain to incidental disc bulges or herniations.

Getting a TMS diagnosis from a physician can also be a great psychological intervention. Accepting that the pain is psychologically generated is an important component of recovery, and getting a diagnosis of TMS from a physician can help with that.

Now, I'm going to get a little deep with you. I'm questioning whether you truly believe 100% that your symptoms are TMS. In your question, you state, "which I know is TMS" and "I know this is conditioning." Sometimes when we have ambivalence about something, we overcompensate by expressing things with complete certainty. (This is a defense mechanism known as reaction formation. Isn't learning fun?)

Ambivalence can be a difficult thing to consciously tolerate, but it's important to be honest with ourselves. Work toward accepting that there's probably a part of you that questions whether your pain is TMS (it's hard not to have doubts when you're in a pain state), and continue gathering and focusing on the evidence that it is TMS.

Now to answer your question. The single greatest weapon in overcoming conditioned responses is genuine, authentic indifference. The harder you try to get rid of the pain and the more you monitor it, the more power you're giving it.

Of course, it's hard to be indifferent toward something that matters so much to you. Sometimes it can help to change your habitual response to the onset of the symptoms.

Right now, I can guess how you respond each time the conditioned response comes on: disappointment, fear, hopelessness. As natural as these responses are, they are destructive and serve to perpetuate symptoms.

Try working toward developing a new automatic response to the onset of symptoms. Something along the lines of "I know what you are, and I know you're trying to bring me to a state of disappointment, fear, and hopelessness. I'm not going there. You're safe, and it's going to be okay." And be genuinely proud of yourself for responding in such a healthy way. Then take three deep breaths to help bring you out of a fight or flight state.

Eventually, you can shorten it to, "You're safe." Reward yourself with a feeling of pride for responding in such a nice way, and take a few breaths.

Altering your reaction to the conditioned response changes the pattern of reinforcement, and over time, the symptom will lose it's power over you.

Alan

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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.

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