Emotions or Pain Pathways? Help! I am losing hope.

TMS & chronic pain community, I desperately need your help! 2 years of chronic low back pain. Never gets better. In fact, it seems to just get worse. After months of trying all of the traditional physical approaches (MRIs, 30+ docs, procedures, injections, lumbar devices, Rx medications, physical therapy, acupuncture, chiropractic, exercise/gym, psychotherapy, meditation, yoga, herbs, supplements, CBD, kratom, medical marijuana, etc), I then spent a year and half dedicated and committed to the TMS/Mind Body approach. I was convinced it had to be TMS. It made 100% sense to me. I did months of daily journaling, trying to feel my repressed emotions, and telling myself it was just TMS and not physical. Multiple times each I have watched every YouTube video, read every book, listened to every audiobook, read every forum, facebook group, apps, etc. I fit the TMS mold 100%- perfectionist, people pleaser, worrier, hard on myself, etc. I am 44 with at least 20 years of severe chronic anxiety, bouts of severe clinical depression, and various forms of unexplained chronic pain. I see myself in every TMS story I read. However, no matter what I do, I just continue to hurt and NEVER feel the slightest improvement. I go to bed every night being positive and telling myself that tomorrow is the day I start to feel better, but it is the same thing every day when I wake up. I feel like I can’t break the cycle and see no end in sight and have just about lost hope. I hurt from the moment I wake up until the moment I fall asleep. On top of the back pain, I have minor sciatic pain sensations in my left butt, hamstring, calf, and foot, and some docs told me that the nerve is not properly functioning, but nobody can even directly correlate it to a pinched nerve or anything on the MRI (just some slight bulging)- and I know, that doesn’t indicate pain anyway!


I dont “fear” the pain. I just can’t take the pain. I am sure I have repressed anger and sadness and other emotions that my brain doesn’t want me to deal with, but yet I cant seem to uncover it despite many reputable psychotherapists working on it. I had a happy childhood and family with no memorable traumatic experiences growing up. I have considered a TMS Doctor, but I feel like they are just going to tell me the same things I have read daily for 2 years (I could practically recite every Sarno and Steve O book at this point!), so I don’t know what that would do for me at this point.


I am torn now between believing this is caused by repressed emotions (TMS) and wondering if this has now evolved into pain pathways that have become so strong. I really wonder now if dealing with emotions will solve my pain? Couldn’t it be that it is all neurological at this point and my brain and nerves are just signaling pain or interpreting signals as pain? How do you undo that? I believe Dr. Schubiner’s explanation of pain pathways, and I really wonder if that is my problem at this point, and if feeling my emotions can fix that? I don’t know what to believe anymore.


I am really out of ideas and hope. I haven’t experienced any joy in any moment of my life now for 2 years, and there are no signs of anything changing based on the fact that I feel the same every single day now. What do I do? I don’t want to accept a life of chronic pain and misery. I’d rather not live at that point, but I have kids and a family who loves me. Your insights and advice would be so appreciated. Thank you so much.

 

Sweetness, you'd be amazed at how many people have reached this wretched impasse and then gone on to ease their pain or rid themselves of it entirely. I was one of them. The bind you have gotten yourself into is believing there are emotions that must be felt/uncovered. This is not the case and it is a tragic flaw in Sarno's otherwise brilliant work. Even writers like SteveO acknowledge this (if you have not read his post on 'The Grail' let me know and I shall provide a link).

You also don't need to worry about "pain pathways". Essentially the different theories are explaining the same thing. They are different fingers pointing at the same moon. You need to stop looking at the fingers (the theories) and begin to look at the moon (your healing/healing in general).

In trying so hard to heal you generate HUGE amounts of tension. And tension is the problem. We tms'ers generate tension by being so damn hard on ourselves. We do it life, in relationships, at work...and then we bring the exact same strategy to bear in healing. *That* intensity is the problem.

At this point it sounds like you need a ton of love and support because this stuff is too much for any soul to bear alone. While we here at the forum gladly help where we can it may be worthwhile reaching out to someone like Alan Gordon. Lots of people here have felt utterly hopeless but have been helped by him and his people. It won't hurt to PM him and have the benefit of his wisdom.

Be of brave heart my darling.

Sending you love,

Plum

 

Thanks plum!!! I really appreciate the insights.

 

I as far as I have read CBT may be the most beneficial, and I think your learned pathways might have been become too strong. As far as I read your story there is a lot of personality traits that are disfunctional in your case. I think you are really hard for yourself and the way you formulate it also suggest you want it to be fixed quickly (goal setting mentality).

 

Thanks. Yeah I suppose now I want it to be fixed quickly because patiently trying to heal for 20 months hasn’t worked.

 

The key is to find how this applies to you and discovering ways of implementing those insights. It may be that you do need to spend some time calming your nervous system down a bit. This was absolutely essential for me. This calming of over-sensitisation is the very first step in Dr. David Hanscom's approach to chronic pain. He focuses on encouraging deep and replenishing sleep which serves to settle the stress response and ease the pain. Sleep was the single biggest factor that started my recovery.

Once the body is rested and at peace it is much easier to move onto the next stage of healing. I also found it easier to re-engage with the emotional/psychological aspect of healing with greater success.

Remember that the healing path is unique for us all so don't worry about the time it takes to find what works for you. You will get there.

Plum x

 

TH

I saw the Mark Owen story posted on youtube by Dr. Hanscum the most uplifting story yet posted by anyone. Mark had 2-3 spinal fusions I think. Was in severe pain for 9 years. He now rides horses etc. Since I watched that I have been journalling everyday 2x/day and meditating religiously. I also read a story about a guy who had nerve damage after a hernia operation. This also went on for years. The guy had repeat surgeries to release the nerve and the pain went on and on. He finally let go and one day the pain melted away. This guy spent years trying to figure out what the problem was and actually lectured to doctors on nerve damage related to hernia surgery ! He is pain free today. I tried looking for his story and couldn't find it (if anyone knows please let me know), but these 2 fellows were the most beautiful stories that prove healing is possible no matter what the issue is.

 

Thanks for this angel. I didn't realise Dr. Hanscom had a YouTube channel so I have happily subbed.

Is this the Mark Owens story you refer to?

 

yes

 

Kerrj74, have you tried yelling at your brain and telling it to knock it off? After suffering from chronic back pain for years, I stopped it in less than 24 hours after reading Sarno's book about it. This was back in the 1990s and I really didn't think it would work but I had tried everything else and was desperate. So I just started yelling and cursing at my brain and soon the pain stopped. Just like that. Of course, a short while later it moved to my neck but since Sarno warned that can happen I wasn't concerned and laughed at it until that pain went away too. And I still do this today because apparently this condition is a chronic one for me--but it's one I can usually control quite well now. I've also found that yelling at my brain has worked wonders for eliminating feelings of anxiety and depression.

 

was there anything structurally wrong with you back ?

 

Thanks plum. Yeah I’m trying not to compare myself. It am just getting frustrated from seeing zero improvement in almost 2 years of religiously doing everything everyone says to do. By the way, I read Dr Hanscom’s book a few times, but I don’t recall what his recommendation was for sleep? I don’t sleep too bad. Probably 6-8 hours of sleep where I wake up a few times a night. I feel like that isn’t bad for a 44 year old? I listen to relaxing music and meditation before sleep, and I take melatonin. Not sure what else I could do in that area to calm and rest the nerves?

 

Thanks! I will look for those too.

 

None that any docs could definitively say. MRI’s showed two mildly bulging discs. No sign of a pinched nerve to correlate to the left leg sciatica.
However, it didn’t stop them from recommending: decompression treatments, medial branch blocks and nerve ablations for “facet joint arthritis”, epidural injections, fusions. I didn’t get them! Actually, i did get the diagnostic medial branch blocks which if they helped would lead to a nerve ablation, but they didn’t help (thank god).
It was shocking to have highly reputable doctors (i.e., from U. Penn Medicine) suggest epidural injections and fusions, but could not tell me what exactly either was going to fix!

 

Thanks, yeah I do that almost every day! In my 1 hour commute to work alone, I yell and scream at my brain. I had hoped that would help, but it never has.

 

When I was in my 40's I had sciatic leg, low back pain plus pain in my feet that made it impossible to work. I lost 25 lbs. My MRI was perfect. I was hospitalized for the symptoms and given IV steroids. Finally after 18 months the symptoms went away. Nobody could figure it out. This was b4 I knew about TMS. 18 years later symptoms back with a gray haired spine. Had surgery and made it worse. It's been 3 years and it's getting better, but slowly. Sometimes James I think you have to just believe, let go and wait it out. The mind is strange.

 

I think I was in the almost same situation, Kerrj74. Only in my case the pain sometimes went away but always came back (for 20 years!). What I learned now is that you really need to be totally cool about the pain, the symptoms etc. And concentrate on things you like! Maybe you are doing too much? And I think Plum is right, there either might not be hidden emotions or the hidden emotions cannot be felt, but in both cases, this is not really relevant. Just deal with what you actually feel. I found it hard to experience the tension and the nervous feelings directly in the body. Calming down the nervous system happens by letting things be. I tried to meditate but I couldn’t really. I found it very difficult. Now I am just sitting in my rocking chair and watch the garden, letting my thoughts wander wherever they want to go. Though not to thoughts about my symptoms. If this happens I tell myself: oh no, not again! It’s boring, stop it! In a more humorous inner voice. And don’t believe that your pain pathways are too strong or whatever. They can switch to another mode in a second.
I once told this experience in another thread, but I think little story could be useful to see that every moment can be the moment of change. Three years ago I had a pain period for about a year or so, bladder and pelvic pain. I was in a different town for work and was invited for dinner at a colleague’s house. I was in pain when I arrived. I entered the house, it was a house with lots of wood and books, in the fire place a fire was burning and it was a cosy atmosphere. I felt like something light and warm touched me and then, suddendly the pain was gone. Just like that. The pain was there again the next morning. But this experience told me that the pathways can change in a second.
And so can your’s!!

 

Such good advice, thank you @Time2be . It's about not getting in the way of the body's own innate healing processes. Just letting the body get on with what it knows how to do while I keep my mind occupied elsewhere so that it doesn't sabotage things. Simple but not at all easy to do when pain is involved (stomach and pelvic/rectal pain and bloating in my case). I am reassured by success stories here that it can be done but that it often takes time and recovery most definitely is not linear. In any case there seems to be no other soluation.

 

Even reading this made me feel good inside. It speaks of the power of home and hygge, of the natural elements, and of a cosy, caring mind. How beautifully these essentials create a safe place, something that our body immediately recognises and relaxes into.

Thanks for sharing this lovely experience. It truly endorses how vital the sense of safety is, and how generously we can bring it into our lives beyond simple brain-talk such as "I am safe". To be safe, to feel at home in our own body is the greatest healing of all.

 

This dovetails perfectly with the Butler & Moseley approach to treating pain. They say: "You will have pain when your brain concludes that there is more credible evidence of danger in me (DIM) than there is credible evidence of safety in me (SIM). Explain Pain Supercharged p. 17 (2017) (I added the italics). One problem is that your brain does not always regard simple brain talk like "I'm safe" as credible evidence.

More strikingly, they say: "[E]ven if problems do exist in your joints, muscles, ligaments, nerves, immune system or anywhere else, it won't hurt if your brain thinks you are not in danger. In exactly the same way, even if no problems whatsoever exist in your body tissues, nerves or immune system, it will hurt if your brain thinks you are in danger. It is as simple and as difficult as that." Explain Pain p. 8 (2nd ed. 2013). This accords in some respects with Alan Gordon's Pain Recovery Program. Alan's Day 2 lesson titled The Nature of Pain says Pain = Danger.

Butler and Moseley are not New Age mystics. They started out as physical therapists but Moseley then earned a Ph.D. in pain science, was a research fellow in neuroscience at Oxford in the UK, and is now a prominent researcher and prolific author of professional journal articles on the neuroscience of pain. Butler earned a Ph.D. in education "to further his professional love of devising ways to take the complex ‘gifts’ of neuroscience to students, clinicians and sufferers in ways that can change their lives." Without getting into all the complex "gifts" of the central and peripheral nervous systems, one example is that if your brain thinks you are safe, it triggers the production of endorphins, but if your brain thinks your are in danger, it does not. "Endorphin" is a clever amalgam of two words: ENDOgenous + mORPHINe. Endorphins shut down pain sensors as effectively as exogenous morphine, if not more so, but without any of the adverse side effects.

The task, as Butler & Moseley see it, is to maximize SIMs and minimize DIMs in your life. They define a DIM as "anything that is dangerous to your body tissues, life, lifestyle, job, happiness, your day to day function - a threat to who you are as as person." They define a SIM as "anything that makes you stronger, better, healthier, more confident, more sure and certain - within and about yourself." The Explain Pain Handbook: Protectometer p. 16 (2015). They identify seven categories of DIMs and SIMs, such as things you do, places you go, people in your life, what you think and believe, etc. They note that what is a SIM for one person might not be for another, e.g., doing yoga might be a SIM for some people but, I must say, is not a SIM for me; and they note that what might be a SIM for one person might even be a DIM for another person, e.g., going into the hospital.

I was able to overcome more than two decades of low back pain with the help of Sarno's Healing Back Pain by becoming aware of when I was angry but did not realize it. For Sarno, the major cause of TMS is repressed anger, and we repress anger (mainly anger at people we are close to) because we learned in childhood that it is a dangerous emotion to experience. After my success in eliminating low back pain, I had what Sarno calls the symptom imperative, i.e., other TMS symptoms. I was able to overcome those symptoms with the help of Butler & Moseley. Repressed anger is only one thing (one DIM) that can cause your brain to conclude you are in danger rather than safe. There are potentially many other things that can be DIMs, and as Butler & Moseley say, they can hide in hard to find places.

I think anyone not getting relief from Sarno's approach might consider giving Butler & Moseley a try (but without abandoning Sarno). Their books are not inexpensive but can pay big dividends, especially their first two books. Their Protectometer book is intended to help one minimize DIMs and maximize SIMs, but it is pretty short and, in my opinion, contains too little neuroscience information to stand alone and is best read together with Explain Pain (2nd. ed. 2013). Their third book, Explain Pain Supercharged, might also be of interest for its advice in chapters 8 and 9 (even though the advice is aimed at therapists), but I caution that it cannot be understood without reading their first two books and that chapter 3 is a daunting read that is definitely not for everyone.