Day 1

I know the structured education program encourages us to make a short post but I’m finding it really difficult to hold back on letting it all come out since I can’t really discuss this with the people closest to me. I encountered Dr Sarno’s work on Christmas Day (a Christmas miracle?) last year after another desperate search for a solution in response to a particularly severe episode of debilitating back pain which came on quite suddenly the day after I decided to take time off from work and training (I’m a semi-professional rugby player).

The pain had persisted everyday for about 6 months prior to that point, and although it never left it had improved to the point I was able to train (which involved sprinting, tackling, lifting weights etc.) whilst working a very physical job. This involved a considerable amount of pushing through some pain and fear/anxiety but overall things were getting better. About a week before I originally hurt my back, a friend of mine had injured his in a similar way (lifting weights). He had an MRI immediately which showed a bulging disc, so when I hurt my back that’s where my mind went immediately. Even though I knew that MRI’s for spinal injuries were of little predictive value, I still treated my injury as if it was a bulging disc, and spent hours on YouTube looking up exercises that would supposedly help “move the disc jelly back into the centre”. In my search for a solution I discovered Dr Stuart McGill and his book The Back Mechanic. At the time Dr McGill’s words were what I wanted to hear. I had been to physiotherapists, chiropractors, doctors and felt that they weren’t really listening to me, that they were failing to realise that I was going through something extremely unique and concerning that demanded their utmost attention. I had heard the idea of “non-specific low back pain” and the biopsychosocial model of pain and found the ideas frankly insulting. You’re telling me that there’s nothing really wrong with me and I’m experiencing this much pain, for this long? I couldn’t come to terms with it. Now here was Dr McGill telling me there’s no such thing as non-specific low back pain, there is always a structural cause. I felt that I’d finally found the solution to my problem, it was incredibly validating to read these words. I did the McGill exercises everyday, several times a day but never really saw any improvement outside of my ability to do those specific exercises. McGill talks about the idea of spinal hygiene and pain sensitisation. Essentially, according to McGill, every time I allowed my spine to go into flexion (as i was supposedly flexion intolerant), I was improving my body’s ability to experience pain. So I became terrified of sitting down to eat my breakfast or catch the train to work, terrified of getting into the car and going for a drive that was longer than 5 minutes, terrified of putting my shoes and socks on. I began to live in constant fear of allowing my back to round at all, meanwhile I was still working a manual labour job and was getting back into training so I believed I was doing significant and permanent damage to myself everyday for months on end.

In order to stop “sensitising the pain” I informed my work and my rugby team that I needed to take some time off. It was at this point that my pain went to another level. As soon as I really gave into the idea that I was incapable of maintaining my normal activities, my pain became extremely debilitating. Suddenly I was struggling to walk, I couldn’t bend from the hips at the slightest, I couldn’t tolerate sitting. It didn’t make any sense to me, and it was at this point that I was finally ready to entertain some of those ideas I’d previously dismissed. It suddenly seemed not only possible but probable that my pain had a strong psychological component if it could get so much worse from doing nothing. My MRI (I eventually caved about 5 months in and needed to make sure that there was nothing seriously wrong with me) did indeed show a small protrusion at L4-L5 on the left side where I was experiencing symptoms, but it also showed another bulge at L5-S1 on the right side where I have no symptoms whatsoever. I felt this was further evidence that I wasn’t suffering from something structural any longer. I watched a few lectures from the Barbell Medicine YouTube channel on low back pain, which eventually led me to Dr Sarno. I quickly consumed all of his work, and while I did improve considerably over the last month, I have recently suffered a relapse, and the last few days have been amongst the most painful I’ve experienced throughout this entire journey. I’ve realised now that I’ve tried too hard to force it, and put too much pressure on myself to be completely pain free as soon as possible, and so I’m going to give this program a go, to help me take it one day at a time. I haven’t had trouble accepting the TMS diagnosis on an intellectual level, I see myself clearly in Sarno’s description of the perfectionist and the goodist and there’s so much evidence that points to my pain being psychological and conditioned (like the fact I can sprint with almost no pain but struggle to put my socks on or that I have squatted 200kg post “injury” but struggle to sit down). However, I’ve never been encouraged to express emotion and I sometimes feel incapable of truly experiencing my emotions, so I’m having a really difficult time being able to feel any of my repressed emotions as I keep trying to think about what’s bothering me as if there’s one right answer and once I find it this pain will immediately dissipate.

Another issue I’m really struggling with is relating my pain to others in my life. I get so frustrated with everyone constantly suggesting a panacea to me, and I want to get better so badly as if I’m carrying Sarno’s legacy on my back so I can prove to everyone I know what I’m doing, but it’s hard to tell my parents and other people close to me that I’m in control and on the right track when I’m spending so much time lying on the floor in agony. My pain has become so much a part of my identity that everyone who sees me asks how my back is and it is driving me crazy to have these same interactions over and over again. How do you deal with people asking about your progress and suggesting remedies that you know will only reinforce the idea that the pain is structural?

 

Good realization! Start practicing being kind to yourself in your inner dialogue and thoughts. You are worth being treated nicely and comforting by yourself, and not being pressured. Usually when you so something this way instead (with joy and excitement rather than pressure), you actually perform better (!).

There you go! Find a safe space to journal and rip the pages apart so there is no risk someone can read them. You would be amazed of all the hateful, ragefully words got written during my journaling... And all the crying and rage fantasies I had... Now when I have gotten a lot of things out, the need for this outlet has gone down dramatically. But it is extremely tough so break through your own walls if you are not used to tapping into these feelings. For me it helped to listen to all the therapy-in-action recordings here: https://www.tmswiki.org/ppd/TMS_Recovery_Program (TMS Recovery Program)

Don't be afraid to express your emotions to them regarding this. Or simply say "I don't want to talk about my pain" and carry on talking about something else. It´s perfectly fine to ask people to respect that wish.

I understand this completely, it´s very irritating.

 

There's this thing in yoga where you give your lower back a little massage by rolling on it. It's a nice self love thing.

 

kindersurprise: Hang in there, you are not alone. I can relate to a good bit of what you say. I too got very excited about the Stu McGill book "Back Mechanic", particularly after reading the many positive reviews on Amazon. I don't doubt he has legitimately helped many people, but everybody's back problem, not to mention mental/emotional makeup, is unique. Not everyone is going to get better just by religiously doing bird dogs and side planks every day. In the time I did his exercises I got worse. Go figure. Even worse, the "spine hygiene", while all possibly good advice, may or may not apply the same to everyone, and just made me terrified to move my back in any way ("NO YOU ARE BENDING ALL WRONG", "NEVER EVER SIT ON A COMFY COUCH", etc.). I think there are some personality types, like me, who having someone tell you to think about your back all the time, had the exact opposite effect of my mind increasing the pain.

I am actually totally new to this forum (Day 2) but I am totally convinced that 90% of my discomfort is self-induced and psychosomatic.

I saw an extremely helpful YouTube video blog today that was super encouraging. Search "TMS Success Story (Dr. Sarno)" - it is in seven parts. It is a youngish guy, maybe late 20s, who does a really great job in chronicling his years-long journey, then finding his way. Very compelling. He talks about some of the issues you talk about, e.g. how to deal with talking to people asking how you are doing, plus some very practical steps he took to get to where he is, which is in a good place. Check it out.

 

I’ve seen that video series and found it very helpful too but I might even watch it again. I’m glad to have someone going through the journey with a similar backstory. I also agree that McGill has obviously helped a lot of people but it just absolutely messed me up at the time to as you say have to constantly be thinking about whether I was doing more damage to my back every moment of the day. I can tell you now that I’m already feeling a lot better now on Day 6 than I was when I wrote this post. I think that having this structure and especially the requirement to journal really consistently is helping a lot. I know there are conflicting views about how “mandatory” journaling is in this process but I know that when I first started looking to this stuff a month ago as soon as I heard the argument that journaling isn’t entirely necessary and that for some people feeling the need to keep up with anything can feed into their stress producing perfectionist tendencies, I took that and ran with it because it gave me an excuse to avoid really digging down and uncovering these emotions which I’m starting to scratch the surface of. Good luck on your journey and I hope to hear that you’re feeling better soon

 

That is great to hear that you are feeling better. So you are finding journaling helpful? What are you recording, are you following the suggestions from the day-by-day Structured Educational Program, or more free form?

 

The structured education program is my starting point most days but it usually branches out into different areas depending on if I’ve really tapped into something that runs deep. My biggest difficulty with journaling, which is also my biggest impediment from actually feeling and experiencing my emotions, is that I tend to create narratives about the reasons for or implications of what I feel. I’m too focused on explaining, intellectualising and rationalising the feelings that it’s stopping me from really getting to relive the experiences that I’m journaling about in a way that I think would be the healthiest for me. I’ve also read the Scott Brady book which has a lot of prompts for journaling which I’ll go to if I feel the SEP’s topics of the day didn’t really produce anything substantial.

EDIT: I forgot to mention that I went back and watched that video you suggested. Thank you again, it was really helpful and put me in a much better place. When he said he had to tell his parents, “healthy people don’t talk about their backs” it really struck me. I was listening to it in the car and saw that my Aunty was over when I pulled up to my house. Even though she’s read Sarno, she claims, she is always suggesting I get acupuncture or tape two tennis balls together and place it at the bottom of my back when I sit or to see her energy healer or to try some stretches and so on. It usually drives me mad and even seeing her car out the front would have sparked a bit of pain and anxiety but I felt empowered to handle that situation.