How to tell someone they have TMS?

I am almost 100% sure a colleague of mine has TMS. The problem: she is a physician and I fell weird telling her about TMS since her training always taught her that pain is a result of a physical problem.

How can I approach her with this?

Thanks!

 

Ask your colleague to chart out her symptoms on a time-line and correlate them with emotional events in her life on another parallel time-line. Once she notices the obvious relationship between her physical symptoms and events in her emotional life, then you can talk turkey with her about TMS. It seems as though that's a necessary first step in the process of talking about PPD symptoms. Before the patient has that perception, he/she will always be coming up with structural, biochemical or genetic arguments to explain his/her symptoms. But once a patient sees, for example, that losing a job or a divorce preceded the onset of TMS symptoms, then you can speak to them about the process that generates PPD symptoms logically and rationally.

I think that Dr Sarno is right again when he observes that TMS is a process going on all around us in Western culture and that 95% of the aches and pains that people are going to chiros and PTs for are in fact psychological in origin and triggered by repressed emotions. Huge numbers, yes! I remember when I was in PT for a so-called 'herniated disk' ten years ago or so, that all of my fellow sufferers also had just underwent some emotionally traumatic event in their lives. One woman had just lost her job at the same time her husband lost his and at the same time her mother (with the beginning stages of dementia) moved in with them in the upscale house they could no longer afford. Bingo! CTS in her hands and wrists, which, not surprisingly, she used in her work as a technical writer. Another woman, who had double spinal fusion following a total collapse out running, had just been divorced not long after her father died. She'd also lost all her money in the stock market and was obviously "mad as hell" but had been taught by her religion to be good and charitable. There was another woman in there who was trying to be a "perfect mother" for her teenage children and was constantly on the cell phone talking to them morning, noon, and night. She had chronic back pain and had to do Pilates on the reformer day after day, all with no measurable improvement. She just kept talking to (and monitoring) her kids on the cell phone while doing her exercises. And then there was the technician who had found his mother dead in her cubicle at work who also had an alcoholic abusive dad. He was also a perenial nice guy forever doing chores assigned to him by his stay-at-home obese wife. He had two herniated disks! I never noticed these little clues until years later because I thought if I kept working and working at PT I would cure the underlying structural cause of my own condition. I think if you look around you, you'll start to see many, many people with TMS who are unconscious about what's really going on.

 

In my experience, unasked for advice often backfires. You could try mentioning that you personally have had similar problems, and explain what you have been doing to address them. Even so, don't be too surprised at a defensive reaction, or one that indicates you are a likely TMS candidate, but her case is certainly not. I would think it's worth a try since not many people are aware of TMS, but saving other people from their suffering is often surprisingly hopeless.

 

I hear you, I've wondered this too.

I back up and ask myself, why do I need to help this person? Is it to avoid working on my own stuff or to make things perfect (yet again). TMS/perfectionist mindset is pretty insidious so I find myself getting hung on perfection even with my own recovery and that over others.

I tell some people about my own recovery from TMS, everyone has been somewhat receptive. Some people don't want to believe this could be their issue too...in which case, nothing I say would make a difference. Some people have told me flat out they wouldn't want to do all the work I have done. And they have the right to make that choice. If someone had told me about TMS a few years ago I probably would have blown up at them. I had to get hit rock bottom with pain before I would have been open to something like this.

 

That was me exactly, Veronica. I read Sarno years ago, but somehow the pain was not quite bad enough to go to such lengths. When I read what you said about people not wanting to do the work I thought, "how shortsighted," then realized that is what I did. When I added shoulder pain and headaches to sciatica, desperation made me willing.

It's true too that we can never really know another's path, and what is best for them in the long run. I know in my case at least, my desire to help is often more about me than about the other person. I'm not sure I have heard the term "rescuer" in connection with TMS personalities, but it is a definite part of my goodist, perfectionist way of being.

 

Yes, tarala, most people (at least those who are passive-aggressive) would rather be "fixed" by a doctor or physical therapist, rather than doing the deep psychological work required to "fix" themselves. As you point out, it has to get really bad (i.e. insufferable) before a TMSer will adopt a proactive approach and work on the underlying psychological issues behind their symptoms. The big advantage, as I see it, of graphing a time-line of traumatic emotional events and a parallel time-line of physical symptoms is that then the pain patient cannot deny the obvious connection between these events and the appearance of pain symptoms. Doing such a simple exercise plants the first seeds of doubt about what they believe are physical symptoms caused by structural abnormalities. Of course, they always can tell you to go shove it. But they may return later and begin adopting a psychological approach to their TMS.

 

MorComm, I think you are right about making that connection. Journaling is making me do that, since I'm writing about what's happening in my life, my flare ups, and with a focus on my feelings. It kind of stares you in the face and the aha! moment stills amazes me.

 

When I noticed that my major back attack in 2002 occurred approximately six months after my mother died at the very moment I inherited her house, that was my aha! moment. Abandoned by mom at the very moment I took on new fully adult responsibilities was probably too much stress for my essentially selfish inner child to handle and my body sent me a strong message to let me know how much my dependent self didn't like this new arrangement. Mom had been dependent on me as a care giver for over five years, but that doesn't mean that I still wasn't holding on to the same dependency models I'd been using as common currency since infancy, childhood and adolescence. But you're right about well-intentioned advice often backfiring and making the person you were trying to help pull away. "You can lead a horse to water, but you can't make him drink!" as the old proverb says. However, having someone draw up a time-line of traumatic events and pain symptoms is so graphically compelling that if you can get them to do it, it'll be hard for them to evade what's staring them in the face. Now getting them to do that, I must admit, can be extremely difficult. Repressing emotions and having physical symptoms may be characteristic of our whole society at large, but so is relying on pseudo-scientific materialist explanation for pain and other physical symptoms that are, too often, not due to tissue damage, genetics or biochemistry.

 

Well, I first got my sciatica whilst pregnant with an unplanned child with someone I really did not want to be with. What a surprise.....

 

It's those often shocking unplanned events (like my mother's death or your unplanned pregnancy) that call into question all your old psychological assumptions and often enough precede and precipitate the onset of TMS symptoms. Looking back, though, it's easier to see what was going on than when you're in the midst of the process. It's easier to understand the origins of your pain condition by looking honestly at what was going on in your emotional life at the time of the onset of your symptoms in a real graphical, chart-like, x-y axis fashion. Our first inclination, I know, is to seek physical relief for what we assume are physical symptoms brought on by physical abnormalities such as 'spinal degeneration', 'herniated disk', 'scoliosis' . . . . etc etc etc (the list is nearly endless). But if pain continues when all physical treatment modalities have been exhausted, you might start considering psychological explanations. An outsider observer may help steer you on the right path, but the point is that you have to finally do it yourself. Like so many other things requiring real 'WORK'!

 

It's tricky, but...if someone didn't take a chance on me, I wouldn't be here healing

 

Good point Jilly. There's a saying, "Once is communication, twice is control." Maybe that works here; take a chance and tell them but if they are not receptive, let it go.

 

Wow thanks for the great answers everyone!
Veronica73 when you said "TMS/perfectionist mindset is pretty insidious so I find myself getting hung on perfection even with my own recovery and that over others." you have it right on the nose! I think I'll just tell her about my recovery and see from there.

 

Yes, Jullemire, people learn more from your own example than from precepts.

 

That's a great question, jullemire. People can often get defensive if someone tells them that their pain is psychologically caused, especially if it contradicts their training.

I have a lot of clients who told me that someone gave them one of Dr. Sarno's books ten years ago, but it sat on their shelves for years before they looked at it.

In addition to discussing your own experiences, one way to go about it is to pass along resources that involve minimal time investment, yet are convincing. One of the best resources you can pass along is the ABC 20/20 special on Dr. Sarno ().

It's only 10-12 minutes (thus involves a low time investment) and carries a great deal of credibility since the source is an established news program.

Another resource that could be helpful is this article (I've included it as an attachment) which was written in a psych journal and goes over the history of, physiology of, evidence for, and treatment for TMS. Some folks are more willing to spend a few minutes reading an article than read an entire book.

Good luck,
Derek