A few questions about fear and stress from someone who is new to TMS

I have three TMS-related questions and was hoping someone might be able to help me out. I'm new to the concepts of TMS (some backstory is here) so apologies if these are already covered elsewhere on this site.

I believe there are two main factors underlying my TMS symptoms: fear and stress. I also believe I can identify my fear as being centered around athletic performance and injury, and my stress as being centered around my kids.

Here is my question regarding the fear part: when training is going well I am confident in my abilities to run, bike, and swim, and that confidence enables me to train for triathlon carefree. It's a reinforcing cycle – the more I'm able to train the more I'm confident in my ability to train. However, when running, biking, or swimming causes pain then I start down a cycle of fear, frustration, and panic that I now realize is also a reinforcing cycle that feeds the pain. The trouble is, I only learned about TMS about two months ago while already in an episode of pain (plus the associated fear and frustration). So I feel I have a chicken-and-egg problem: I can't be confident that running won't hurt until it doesn't actually hurt to run. I am trying to be outcome independent, and I'm largely successful when going about my daily life. However I love running, and running currently hurts, and it's very hard to be indifferent about the pain when the thing I love is both causing the pain and preventing me from gaining the confidence I need to get out of pain. It's like every run is a setback rather than a corrective experience. Does anyone have any suggestions?

For the stress, I do believe that my pain is my brain's way of trying to distract me from uncomfortable feelings. This most recent episode of pain began a little over 4 months ago, right when my wife and I had our fourth child. My wife and I talked for a long, long time before having a fourth kid. She really wanted another, I really didn't (it already required a lot of convincing before I agreed to kid number three). I don't generally see myself as a people pleaser but in this case I could see how much my wife wanted another child and I went along with it. Having learned recently about TMS I can now recognize the birth of our fourth kid as a likely trigger for this recent flare up of pain. I imagine my inner child lashing out and being angry with me. But what do I do now? I can recognize this increased stress and subconscious anger as likely causes of the pain, but acknowledging and talking about it with my wife hasn't helped with the pain. I still have four kids to take care of and I certainly don't want to take any anger out on them! Any suggestions for how to approach this situation would be greatly appreciated.

Lastly, I'm interested in speaking with a TMS doctor or therapist. I reached out to a practitioner in the directory who is local to me but they aren't taking any new patients. Would it be better to see someone who is local but not familiar with TMS, or to work remotely with someone in the practitioner directory who has a history of helping people with TMS?

 

Lots of us had that dilemma when we got here.

What I did was reprogram my conditioned responses because that was what was telling me that stuff like swing a baseball bat was painful... why I thought running made my sciatic worse. It didn't...conditioning made it that way.

After I had thoroughly digested the material, I went back to those activities like "in focus" on the rage makers and stuff I had learned. I kept up a steady dialogue. If a symptom showed I kept going but began TALKING to it.... yes, you read that right. I would talk to the sciatica, or shin splints or plantar fasciitis. "Hey.. You need to shut up... I am not going to listen to you and you are only here to distract me and make me scared and I don't believe in you anymore so you are wasting my time....I knwo your afraid but you don't get to be in charge you M--thrF--r!"

Yes, I swore at it, and a lot of people at the park probably thought i had tourettes, but as silly as it sounds, it worked and it still works....

But before that, make sure you have fully digested and processed the educational material. Even Sarno said that someone with the knowledge, but hadn't given it time to sink it, might be a little premature....2 weeks is a good "sink in' time...that is the minimum most shrink agree it takes a message to get to the unconscious (if they ever really get there at all, right?)

 

Thanks for sharing your experience. I've tried talking to my pain while running. Rarely out loud though, so I'll give that a try. I've oscillated between getting forceful and angry at my pain (like you describe, "you need to shut up, I know who you are, get out!"), trying to sooth the pain and let my brain know it's safe (e.g. "this is just a sensation, it's no different than the right side, you're just over sensitized to it, you're safe and strong"), and trying to be indifferent and laugh it off (e.g. "well that's interesting, where are you moving to today?, well aren't you tricky, etc.").

I think indifference may have been the most helpful for me so far but it's hard to tell because the pain intensity varies in general day to day. Either way, it is surprisingly hard to be indifferent to the pain when it's jolting me with every step. This is despite the fact that I know nothing is physically wrong with me (the pain moves locations, waxes/wanes, I now realize I've had this exact TMS symptom before as well as multiple other TMS pains before in my life).

I first learned about TMS in early October and then got and read Sarno's The Mindbody Prescription, must have been late October/early November. So I've had more than 2 weeks for things to "sink in" but I'm still new. Despite knowing and accepting TMS I still fell into an old trap of believing my most recent flare up of shin and hip/glute pain were do to banging my shin on a table (physical, would've gone away within a day) and in the case of my hip/glute I believed it was ankylosing spondylitis. I even started a Medrol steroid pack believing ankylosing inflammation was the cause, but a few days into the steroid pack the pain was worse! That's when I went back, re-read some Sarno, read some of the information on this site, and realized I was letting myself be tricked by TMS. That was about two weeks ago. The shin pain went away pretty much instantly. The hip/glute pain has been very stubborn. I initially interpreted it as an extinction burst and therefore a good sign, but it's persisted and can vary from annoying to bad to very bad.

Was talking to and getting angry at the pain the only thing you needed to reprogram your conditioned response? Thanks again for your help.

 

Yes and No.. it is part of a larger strategy.

Far and away the most effective tool for me in beating TMS fast and thoroughly was Sarno's recommendation ; "If you notice yourself paying attention to the symptoms, Turn your mind to a source of recurrent irritation"

I am 20 plus years into this deal and that is STILL the best therapy. That is where the 'Rubber meets the road' with TMS recovery.

This is first and foremost and education program...but just like in the world of academics, Merely having the information is not enough to do a job..at some point hammers hit nails, typewriters fill out forms, products are sold, boxes get moved, things get delivered, wires are connected... The job begins with education and is followed by action .

To forcefully think of a Recurrent irritation OR pondering the potential anger maker I am not yet aware of... That action when confronted by a symptom is the key reconditioning tool....I might be running...or climbing a ladder...or carrying heavy 5 gallon buckets. I consciously and forcefully think of a problem with someone at work, or a bad dating thing. I allow myself to think the meanest basest most selfish thought I can get to, in context of the problem. "I need to fire that guy... I am not going to go out with her anymore...here's how and why". 15 minutes might elapse. Of a sudden I realize i am no longer thinking of my leg, my hip, my foot, my wrist.....and now as I think about them, the pain sneaks back "Oh no you don't!"...and I go back down the rabbit hole. This time I don't notice it for 10 minutes... I do it again...an hour.... I do it again...all night pain free...again...days.

Some times during some of these sessions I will have an 'Aha!' moment. I will realize there is something else i have been totally overlooking, or overlooked that was operative at the time the symptom began. I can tell when I am right because as the thought blossoms the symptoms fade entirely or immediately move to another location. ...and sometimes it just take a little time, but I am talking hours and days, not weeks and months.

I have read of Non-Sarno techniques on this forum, like 'going in to the pain and telling yourself it is OK, or You are OK"... that it is exactly the opposite of what Sarno taught. Anything that draws my attention towards the physical will exacerbate the conditioning and reinforce it, while I want that bastard GONE! It is not 'ok'. I don't need to 'feel' it anymore. All pain is scary and sucks..why do I need to learn more about that? How many lifetimes would that take. I want results now. The 'turning your mind to an irritation" is the fast track

Being a Sarno purest, I have gotten the results I wanted...Fast, 100% recovery...and it builds confidence, because as each one goes away it also builds confidence in the simplicity and efficacy of his advice. Anger, Rage and a few other unconscious embarrassing things made it, going down there and playing in the mud and slime ends it. Fire v Fire

 

Some of us simply don’t realize the source of our “recurrent irritation”. I try but clearly that’s what I’m repressing. I don’t get angry, and can not reach into those selfish and childish thoughts without feeling more guilt and shame and then my brain just sort of switches off of those thoughts. I wish this process was as fast and straight forward for me as Baseball65 describes it has been for him. Frankly, someone saying there is only one way to do things or you are doing them wrong feeds into my “do it right” personality. It brings up more fear and frustration and major anxiety because if I’ve not found success that way I must be doing it all wrong (beat myself up for failing once again!).
The key is to find one method that resonates with you and follow it. That can be 100% Sarno, and/or needing a psychologist or using the Pain Recovery Program on this wiki (now pretty much called pain reprocessing in Alan’s book The Way Out” or Dr. Schubiners’ book.. be consistent and try not to focus on anyone else's recovery times or their “book cure” or whatever. Just deal with you and your chosen program. Fear and stress are the TMS drivers in my opinion. Focus on what you can reduce; eg stress by facing your stressors and feeling the emotions created by them. This will reduce fears. Some folks go straight into fear, face it head on and find it dramatically reduces stress.

It will get better, it will get better in your own time. People have had lasting success by a variety of methods.

 

Recurrent Irritation is CONSCIOUS.
Obviously if I am aware of it, it is not the anger at the core of my TMS.(Which is UNconscious) If that was the case, everyone of my angry psycho political ranting fellows would be pain free . They are not. They tend to be the most in pain of my friends.

TMS is unconscious rage... that means we can't get to it with journaling...or talking to a shrink, or maybe EVER. Those are all tools to maybe get a 'shadow off of the cave wall' like Socrates spoke of.

However there are irritations that all of us have that are conscious...Sarno is quite clear in explaining this in the text. I am adding nothing new. Finance. Bad relationships. Pressures we don't want.

The point of the 'recurrent irritation' therapy is to send a message to the unconscious that we know what it is up and that the strategy is failing , and like a 'blown undercover operation' the system ceases.

..and he also documented his cases and the majority of people get better in 2-5 weeks. Some people feel better about turning this into a months and years long process. I don't know why. Sarno said they were 5%. That means 95% of people got better in that time frame (2-5 weeks) . Why would we ever tell a person on this forum that they aren't extraordinarily likely to get over their pain quickly?

Every person (100%) I have ever known personally (not on this forum) who has done the work in his text has gotten better fast. Period. 100%. The only ones who didn't were the ones who were dismissive...and even Sarno said he screened his patients.

 

Thanks for your thoughts. I definitely agree with the "all roads lead to Rome" approach to TMS. I just need to find what works for me. Building off my earlier post I do think that being indifferent to the sensations and setting myself up with a positive mindset is proving helpful. For example, I was reading this reply of Baseball65 in a "really struggling with knee pain" thread:

I've noticed over the past couple days that if I fear, worry, or expect that something will cause pain then it almost invariably does. If I tell myself before hand that I will be fine, that activity does not have to hurt, and that all I'm feeling are normal sensations then I've been much better off. This has been helpful for both little things and bigger things. For example, I went out for a run on Friday and told myself beforehand "this run will be fine, you can run however you like, you're not injured, you can be indifferent to the sensations" and it went pretty well! Then a few hours later I felt a sneeze coming on and found myself worrying "oh boy this is gonna hurt" and sure enough it did. Later the same night I felt another sneeze coming on and preemptively told myself "you're going to be fine, this doesn't have to hurt" and it didn't hurt at all! It's been a kind of crazy and eye-opening exploration. Plus it confirms that the pain is TMS rather than something structural.

As I've been exploring these topics more I do believe that fear and stress are my two most significant TMS pain promoters. I had a happy, supportive, stable childhood. I've also enjoyed a lot of success and good fortune in my life. As I mentioned at the top I believe the majority of my fear comes from worry that essentially any uncomfortable or painful sensation is a sign that I've injured myself, a threat to my athletic goals, and I'm sent into a spiral of hyper vigilance and increased fear, worry, stress, and anxiety that all just feeds the fear/pain cycle. I think it's been so bad and so consistent over the past two years because I've jacked myself up into a state where my baseline is hyper vigilance and fear around a variety of physical activities (pandemic, work, and family stresses surely don't help). Good thing is, since learning about TMS, I now have at least some greater understanding of the pain itself, the reasons for pain, the comforting though still odd understanding that I haven't been injured all this time, and I'm starting to figure out how I might be able to address all this.

The general stress component of it is something I also need to work on a lot. I'm VERY interested in the whole repressed emotions and inner child part of this. I have recognized my perfectionist tendencies for a while, and have been realizing more places in my life where I am likely a people pleaser and I may avoid some kinds of emotions and conflicts. What's interesting to me is along the lines of what both of you have brought up – if they're truly repressed emotions and my subconscious then, by definition, I can't access them or know what those emotions are. I can explore and speculate, but only in my conscious mind. Is the general idea that exploring and feeling your emotions, perhaps being more present and aware, helps not only with general life stress but also serves as an outlet for repressed and subconscious feelings?

 

I would say the ability to look at yourself from the outsider's point of view aka mindfulness is the key. Whether it is getting to the bottom of your rage in a single shot like Baseball65 (pure Sarno's approach) or observing and understanding your own reactions/feelings towards daily life events and slowly correcting your own behavior (my approach) - it will all lead you to Rome. There is no ready answer, that's the puzzle you have to figure out on your own. Don't get frustrated or disappointed if it takes longer, because persistence pays off. I tried pure Sarno approach and could not find the rage itself, let alone the source of it. It has been 6 years, I still have not found it. But mindfulness and calming down my anxiety worked slowly, over a period of 2 years. I have been pain-free for 4 years now. It is trial and error, but conquering your fear is another key.

 

Thank you @TG957 for your words of wisdom.

@Baseball65, I re-read healing back pain and found this reference to ‘recurrent irritation’ - I can only find it mentioned once, so I missed or missed its importance.