Push Through Significant Pain or Not?

In The Divided Mind, Sarno says, “With respect to physical activity, while some of our patients never cease being physically active, the majority are intimidated by their pain and are fearful of most physical activities. This fear must be overcome, and I tell them that for years we have been advising our patients to engage in unrestricted physical activities when the pain is gone and that there has never been a report of physical trouble as a consequence.” (p. 141). He also says, “When the pain is gone, or almost gone, start to do physical things you have been afraid to do.” (p. 145).

I interpret these statements to mean that one should resume activities as much as possible up to the limits of significant pain. I do not interpret them to mean that one should “push through,” or do activities that produce, significant pain.

In the Great Pain Deception, Steven Ozanich describes a process in which he repeatedly forced himself to engage in activities, such as running or hitting golf balls, that caused him excruciating, knee-buckling pain. (“I knew that I loved golf and that it hurt very much to twist and turn when I swung the club. So, I decided to begin hitting 500 golf balls each day. I didn’t care how much it was going to hurt, I would “just do it.”) (p. 105.)

Alan Gordon, in his Pain Recovery Program, says that “Graded exposure is a technique that can help us unpair pain and fear in a safe and gradual way,“ and that the goal is to “let your brain know that it’s safe through multiple channels simultaneously.” (Day 11.). But then, somewhat inconsistently, he tells a story about forcing himself to go for a walk despite significant heel pain: "I invited the pain in. I said with a positive feeling of enthusiasm “Bring it on, ramp up the pain as much as you want.” And I meant it. I was enjoying taking such a defiant stance. I was excited that the pain wasn’t dictating my mood - let it increase, let it decrease, let it do what it wants. I was feeling empowered, and when you’re empowered, there’s no room for fear." (Day 14.)

It seems to me that Sarno (and the gentler side of Gordon) has the better approach here, and Ozanich may have delayed his recovery by punishing himself in the manner that he did. From my perspective, pushing oneself into activities that cause significant pain most likely will (1) strengthen the mind’s association between motion, pain, and fear; (2) punish the id in favor of the ego, which is the opposite of what Sarno recommends; and (3) put oneself into a further state of inner conflict.

My question is this: does anyone on the TMS Forum know, definitively, if Sarno ever recommended engaging in activity despite significant or excruciating pain, or did he only recommend engaging in activity up to the point of significant pain?

Thanks.

 

I remember in my early days of learning about TMS that I scoured all the writings about it I could find with the hope of finding some definitive steps to take to ease my pain. But I think there comes a time in the recovery process when we just have to rely on our inner wisdom and knowledge about our own issues and struggles. Ultimately, you're the only one who can determine how much fear occurs in your mind when you attempt activities that cause pain. Only some trial and error can let you know if doing these activities propels you forward or sets you back in your recovery. This determination will change over time and is often not a linear process.

TMS occurs in the mind with its infinite complexity and individualization. TMS authors and scientists can provide us with a general road map based on their knowledge and experience, but we ultimately have to take over navigation and find our own path through our unique landscape. TMS recovery is a journey of self-discovery.

 

I think you have kind of answered your question with the Sarno quote ("when the pain is gone or almost gone, start to do , physical things again.."). He never said to go out and start doing things regardless of how bad it was. Although he apparently had some patients who just pushed through it - there is at least one story I can recall of some lawyer who started running again and it hurt pretty bad but he just kept doing it and after a short time (a few days?) he woke up to find the pain had shifted completely. I forget which book that is in.

Ozanich's period of punishing himself also lasted a loooong time it seems (many months) and I agree with you that doing it that way instead of graded exposure may have made his recovery slower (would love to ask him the question if he would do it like that all over again).

I personally babied myself for 9 months thinking I had a "bad SI joint" or some other kind of back or pelvis problem, but in the last 2 months I have just said f*** it and increased my exercise a lot, maybe even to the point of what Ozanich did (although not running, but bike/exercycle riding and rowing machine, lifting weights). It doesn't make it worse (although to date has also not made it significantly better), and at least I feel good for a little while after the intense aerobic exercise, so it helps in that way and makes me feel human again, stronger. So it makes me feel at least that I am moving in the right direction.

 

I would think pushing through would be counterproductive if the mind does not have a full understanding/acceptance of TMS. One could not really put through it anyway if one lack the faith in TMS. Otherwise, it should be fine for no doubters of TMS.

I am 63 years old. I am on my 4th days of TMS recovery after the sudden lower back injury from lifting the 25 lbs propane tank. Had to crawl to the bathroom the first two days. I have intended to push through it mentally and physically this time for a quick recovery. I have refreshed/immersed myself with all the TMS success stories and with some of my regular physical exercise. It has been working very well. No problem with doing some squats, sit-ups, and lying down dumbbell exercises tonight.