Alan G. How do I turn off the "danger signal" of the pain?

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Question

Hello,
Dr. Schubiner told me that:

"It is almost the norm for TMS to start as a physical injury. Then the danger signal in the brain is set off and pain occurs. Then the brain/body learns that pain as a neural pathway. Then the injury heals, and then either the danger signal turns off or it doesn't. If the danger signal is still "on", then pain continues and/or migrates.

In people who have sensitized brains from trauma, any physical (or emotional) injury can activate the danger signal and cause persistent pain."

My question is:

How do I turn off the danger signal associated with the pain?

 

Answer

Good question. The part of the brain that generates psychogenic pain is the same part of the brain that generates fear (amygdala). So it stands to reason that the experience of pain becomes correlated with fear. The way to shut off this danger switch is simply to neutralize the fear associated with the pain.

For many TMS sufferers, being afraid of doing physical damage is one of the primary sources of fear around the pain. We're evolutionarily wired to associate pain with physical injury, so it makes sense that pain would elicit fear of doing structural damage.

I had a friend who had knee pain that ended up being TMS. Whenever she would go running, she'd have physical symptoms. She has so much fear that pain = damage that it became a constant source of preoccupation. When she finally gathered enough evidence that it was in fact TMS, it neutralized the fear associated with the pain and the symptoms eventually went away.

When you can change your interpretation of the pain from pain = damage to pain = brain's tricky way of trying to keep you in a state of preoccupation, it can become a lot less scary, thus neutralizing the fear associated with the symptom, thus turning off the danger signal associated with the pain.

Here's an example. I had a patient who had groin pain. It was clearly TMS, but because she'd had a previous (probably unnecessary) surgery on her right groin, every time she had pain, she had this image of cartilage tearing. Nothing I could do could shake this belief, so I suggested she get an x-ray. Her doc did the x-ray, and told her that her right groin (the bad one) looked even better than her left one.

X-rays don't even show cartilage, so I don't even know what that means, but just hearing that was enough for her. By the next day she was out of pain.

In her case, she needed a diagnostic test and her physician's positive feedback to help her neutralize the fear. That's why getting a diagnosis of TMS from a TMS physician can be so powerful, it can help to neutralize the fear associated with the pain.

If you already believe 100% that there's nothing structurally wrong with you, then it's just a matter of reemphasizing this to yourself (and your primitive brain) :

"I know it hurts, and even though my primitive brain is telling me that I'm doing damage, I know that because of x,y, and z that this is just learned neural pathway pain from a previous injury that has already healed. I'm not doing any damage, my back/neck/wrist/knee is healthy. I'm strong and I'm safe."

Or something along those lines.

Eventually the message starts to sink in, you become more confident, engage in more activities, continue to reinforce that message, continue to gather even more evidence as you go, and after a day or a week or a month the danger signal turns off.

Hope that helps.

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.

The general advice and information provided in this format is for informational purposes only and cannot serve as a way to screen for, identify, or diagnose depression, anxiety, or other psychological conditions. If you feel you may be suffering from any of these conditions please contact a licensed mental health practitioner for an in-person consultation.

Questions may be edited for brevity and/or readability.

 

Hi, Guest. Alan Gordon's reply should encourage you that you can condition your mind not to fear pain. Fight that danger signal by knowing it is just your subconscious or Inner Bully telling you to expect pain when you do anything physical, whether it is walking, bending, standing, sitting, or doing normal daily activities. Life is to be lived and enjoyed. If you keep your thoughts positive, that you don't even care if there is some pain, it won't get worse and will go away. This isn't Mary Poppins or Pollyanna. It's just healthy mind control. We can control our mind to be gloomy or happy. I choose happy and hope you will, too.

 

Hi Alan,

I wanted to ask about cartilage injury in the knee.
I have had MRI that shows a small tear and ulcere, and I have had numerous episodes after physical activity like biking and so on.
The last time it was after doing some soft squats, something that the doctor told me to avoid.

My knee feels sore at walking, and I can feel like some craking on it that the doctor said that the damaged cartilage adheres to the bone so it feels like having suckers inside of it.

After giving it some due time to heal and release inflammation.. would you suggest to treat it like TMS?

Thanks in advance!
Sienna

j

 

Hi Again, Sienna! I'm glad you were able to ask Alan about your knee issue. One thing I didn't mention in today's chat - I had a pretty good knee injury a few years ago...complete with dramatic swelling. My first PT told me not to worry that it would be fine.

We then moved a great distance. The knee didn't get better. (Hello, stress!) I went and saw another Orthopedic and he ordered an MRI. The results (yawn) showed minor tears. My second PT told me that what she saw was just typical wear and tear. Everyone has this, she said.

I had several PT sessions - nothing helped. Treating it as TMS was the only effective treatment. Hope that encourages you.

 

Hello North Star,

It was great to catch up on the live chat yesterday.
Thanks a tone for your answer and support. Your message helps to reinforce the TMS approach. I will try to think positive and rewire my thougts that there is real damage in my knee, but at the moment I must confess that I am still thinking "physical" as you know after you have had an injury.

Have a great Sunday
Best,
Sienna

 

Hi Sienna,

Yes, the great @North Star gave some fabulous advice in yesterday sessions.

Try looking up body scan meditations and loving kindness meditations. There's a tone available on you tube. I think they will be very helpful in your healing.

Regardless of the outcome of your conversations with Dr's etc, I'd still use the TMS modalities such as journalling, meditation because they can have profound effects on ones physiology, particularly healing times, or the prevention of other more serious illnesses.

All the best,

Mike

 

4

Thanks so much Mike,

I have started meditating, journaling and tapping too (I find this last very effective and helps to give a wellbeing feeling)- I recommend to follow Brad Yates videos on Youtube.

As for meditations, you can download great ones for free at:
dharma.org

Best,
Sienna

 

i could do with some advice on this - for me when i get pain its like this

pain = brain tricky way of distracting = oh my gosh what is it distracting me from = i need to work this out in order to heal = fear and panic


hmmmm x

 

Hi driffy,
Saw your thought process and will make a response. Alan often does not come back to these posts, I believe.

Alan is suggesting that you just "stop" the cascading thoughts at "tricky way of distracting." Full stop. What is it distracting me from? might be a parallel inquiry or a parallel approach. That is, a separate approach. Reading your thought process, it seems you get caught trying to fix the pain, vs just observing it and connecting it with "tricky way of distracting." You're trying to fix it, even though you are using a Sarno method.

This is very common, to end up using the "work against ourselves." If you are trying to make the symptom go away, you are already caught, and the symptom continues. Thinking psychologically then, has to be used while invoking the more basic attitude that Alan is suggesting here: see the symptom for what it really is (harmless), and don't fear it. And, you can also inquire into the probable causes, knowing you have TMS and it is not a physical condition.

The more you find the psychological connections, the more the mind-body gives up distracting through pain. Or, even if you don't find huge specific reasons and events, to me, it is this psychological inquiry which opens the mind-body to more flow of feelings, release, and alignment. Hence there will be less reason to be in pain in order to distract from feelings. And this process can be more ongoing, and longer term. Alan's stance is right in the moment.

Also, you can use Thinking Psychological in the moment, just knowing the root cause is psychological, acknowledging this to yourself, without knowing the reason, or pulling up a common reason you know exists in you, or just being gently curious, can also be in the moment, not about fixing. If a "reason" or connection immediately comes to you, great.

It is the fixing and struggling that cements us into the familiar relationship with the pain, so your train of thought is great to read, and really elucidates this...very common in our minds. Alan's advice takes practice, must be practiced repeatedly, and it is very effective.

Andy B