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Alan G. Overcoming the symptom imperative

Discussion in 'Ask a TMS Therapist' started by Guest, Mar 7, 2015.

  1. Guest

    Guest Guest

    This question was submitted via our Ask a TMS Therapist program. To submit your question, click here.

    Question
    I have a question that sounds like criticism of Sarno’s theory, but honestly it’s not. I genuinely want to know the answer so that I can heal and I hope your replies help others who may struggle with this.

    I’m re-listening to The Divided Mind right now, and I guess I’m not listening well enough, because I still have one seemingly fundamental question that I can’t understand. Dr. Sarno says that some of his patients get better just by acquiring the knowledge that the thing that ails them is originated in the mind, rather than a pathological problem. So if the brain is trying to protect us from unwanted feelings, why would it just stop producing symptoms in that case? Doesn’t it still have something it wants to hide from us? Why wouldn’t the symptom imperative start happening?

    Contrast that with a situation like mine, where I do have symptom imperative going on; After each symptom crops up, I have a brief period of worry, but then I realize that the symptom is mind-body in origin, and it loses its power – but instead of being completely healed, it just produces a symptom somewhere else.

    I don’t understand why when I pull the curtain back on what my brain is trying to do, it just keeps going. And yet others, it knows the jig is up?
     
  2. Alan Gordon LCSW

    Alan Gordon LCSW TMS Therapist

    Answer
    Great question! The symptom imperative is often sneaky, and can occur even without being recognized.

    Psychogenic pain is serving a purpose. The purpose of the pain for most people is to serve as a vessel of preoccupation, primarily in the form of fear. So put more directly, the purpose of the pain is to scare you (ultimately with the unconscious motive of helping to protect you...)

    So when you neutralize the fear associated with one symptom, it usually subsides, as it's no longer serving its purpose. But the pain came up for a reason. Maybe there are emotions that you're not consciously able to tolerate, or maybe you treat yourself poorly (criticism, pressure, etc.)

    If you plug up a leak in a dam, it'll be fine for awhile, but if you don't address the water pressure, it'll just spring another leak. This is why people have symptoms crop up in other areas.

    But it doesn't have to be replaced with another physical symptom, any vessel of fear will do. I've had patients where the pain went away, and several weeks later it was replaced with OCD, or body dysmorphic disorder, or specific phobias, or generalized anxiety, or even obsessing about their job or relationship.

    Many people categorize overcoming TMS as just getting rid of their physical symptoms, but often the new "leaks" in the dam can just as uncomfortable, even if they're less obvious.

    I look at beating this thing as getting to the root of what's going on so that you no longer need the defense mechanism; you're not just neutralizing the fear associated with one symptom, but you're eliminating (or significantly reducing ) your overall need to exist in a state of preoccupation and fear.

    When you've achieved this, the mind no longer has a need to elicit new symptoms - physically or psychologically. It's like achieving TMS enlightenment.

    Alan


    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.

     
    Last edited: Mar 7, 2015
    Lynn S likes this.
  3. chickenbone

    chickenbone Well known member

    This is an excellent explanation of the symptom imperative - the best I have seen yet - Thank-you, Alan. This helped me also. Even though I am mostly recovered from TMS, the symptom imperative still follows me around. It seems like each time my mind needs some outlet for anxiety, I get one of my many TMS symptoms, but usually for short periods because I know why this is happening. However, I don't believe this is because of things that have happened in the past. I tend to be a non-stop worrier. When I can't find anything personal to worry about, I tend to worry about existential stuff.
     
  4. colls100

    colls100 Well known member

    This explanation is super helpful!
     
  5. Buckster

    Buckster New Member

    100% agree colls100!
     

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