Official Thread Section 2.2 Reframe the Meaning of the Pain

This is the official thread for Section 2.2 of the TMS Recovery Program donated by Alan Gordon of the Pain Psychology Center (PPC). This section is entitled "Reframe the Meaning of the Pain." Neither Alan nor the PPC necessarily endorses this thread or any of the viewpoints presented in it.

Please keep these official threads on topic and put your best thoughts down, as these threads will be read by many people. All posts in this thread should all relate to section 2.2 of the TMS Recovery Program:
http://www.tmswiki.org/ppd/TMS_Recovery_Program#Reframe_the_Meaning_of_the_Pain

In section 2.2, Alan writes the following:

Reframe the Meaning of the Pain

One of the ways that you may be able to reduce your symptoms is by changing the way you think about the pain. Many TMS sufferers think about their pain all the time; mostly from a perspective of fear: “I’m not in pain right now, when’s it going to come?” “I’ve had it for so long now, is it ever going to go away?” “Nothing else has worked so far, will this recovery program be any different?”

This very common type of thinking can actually perpetuate the pain. The following article, Breaking the Pain Cycle, explains the concept of reinforcement, how you may be reinforcing your symptoms without realizing it, and what steps you can take to break this cycle.

To emphasize, your TMS symptoms themselves aren’t serving as a distraction from painful unconscious emotions, it’s the fear and preoccupation around the pain that is serving as this distraction. That’s the purpose of the pain in most cases, to generate fear. It’s for this reason that runners often get leg pain and screenwriters often get wrist pain (and not the other way around.) It’s for this reason that pain often manifests in a place where you know you’re structurally vulnerable. And it’s for this reason that some TMSers can eliminate their symptoms simply by reading one of Dr. Sarno’s books (as it can neutralize the fear associated with the pain).

Consequently, every one of those pain-themed fear thoughts is actually serving to reinforce the pain. (Perhaps you may have just had the thought, “Oh man, I’m never going to be able to overcome those thoughts. I’m doomed.” That’s another one right there. See how prevalent they are?)

Familiarize yourself with these thoughts. Spend some time watching how frequently your mind goes in that direction. Shining a light on this type of thinking brings it to conscious awareness, and it is the first step to diminishing the power of these thoughts.

In Part II, I talk more specifically about how this type of fear-thinking develops, and how to best respond when it rears its head.​

Alan Gordon says that a good way to reduce the severity of our symptoms is to change the way we think about the pain. We may work ourselves into a fear that the pain will never go away if we think about the pain all the time. This just keeps the pain coming and can even make it worse.

This can be changed by “breaking the pain cycle” which is explained in an article Gordon posts. It offers steps in breaking this vicious cycle of pain.

Often, pain shows up in part of the body that is structurally vulnerable. For instance, a runner may get leg pain or a writer may get wrist pain. This can cause a conditioning that perpetuates the pain. But the pain can stop if we stop associating it with an activity such as running, walking, sitting.

A member on this forum posted an example of breaking the pain cycle. She wrote that she had been bedridden for weeks, afraid to get up and walk because she associated back pain with walking. She made up her mind to stop thinking that, got up, and walked half a block outdoors. She had a little back pain, but next day walked a full block and felt less back pain. She no longer associates walking with back pain and posts that she is walking farther every day with little or no pain.

 

Walt, thanks for this: We may work ourselves into a fear that the pain will never go away if we think about the pain all the time. This just keeps the pain coming and can even make it worse.


I think that learning a new relationship with pain, so that the pain is not re-enforced has taken me a lot of time. I try to be patient with this process. I think “Oh, there is fear of this discomfort that is arising in my foot. Oh, oh, everyone says 'don't fear the pain,' I must be screwing up right now. I'm going to make it worse.”


Then I think how many times this “nerve pathway” of fear about pain has been activated. How many years did I recoil in fear of the pain? How many times was I afraid about diagnosis, afraid of treatments, afraid of lack of improvement, afraid of pain worsening, ----afraid of just getting out of bed to stand up?


And I try to have some compassion for myself. I allow that fear of pain, and observe it, and let it dissolve on its own, without rejection. This is my approach, because I don't want to reject my experience. Rejecting what I am experiencing causes its own set of deep pain, in my emotions. I am not willing to pile on myself about being “wrong for feeling and fearing pain.”


Have you seen that bumper sticker that says “Don't believe everything you think”? To me that is the challenge: to not let fear run me ---and also to not be afraid of my fear. About anything. And when the fear arises, allow it with compassion, and with patience.


I am very curious about how others work this fine line in themselves.

 

My initial reaction to a recent relapse of TMS was of overwhelming frustration, fear, sadness and outrage: "how can this be happening"!! Of course my TMS was having a party on all this tension. It took me several weeks to let these feelings subside, and for me to reluctantly accept that this pain was here to stay for a while.

As the weeks past I found myself watching the calendar anxiously thinking, "okay pain, yeah I get it, so how long are you going to hang around for"?

I then went to Alan Gordon for help, and this pearl of wisdom jumped out and hit me:

When you go for a walk, tell yourself "it doesn't matter how much it hurts afterward. That isn't an accurate measure of monitoring my progress with TMS. What matters is how little I let it affect me; how I refuse to let my mood, my self perception and my feelings about the future be determined by how much pain I'm in afterward".

Success is no longer measured by whether or not you have a good walk. Success is measured by how little you care.

Continue to work towards altering your definition of success, you will strip the pain of its power, and it will likely lose its hold on you.

I then found Ace1 on the other TMShelp forum. In his post " Repeating the keys to healing" he states:

"The primary problem (with TMS pain) is the mental strain, therefore your goal is to be at peace with everything and do things with ease. If you begin to get the start of a symptom, don't strain into it more. Be still and accept the symptoms, and work on the mental strain. You will think that the way you react/feel is normal (and that you are not in a hyped up mode) because it is so habitual, but if you have symptoms, it is there. Your goal is to prevent the strain, because after you strain the resultant pain/symptoms do linger for a bit before they dissipate, even if you try to relax."

Ace1's post along with Alan Gordon and Claire Weekes have helped me reframe the meaning of my pain.

I had a few twinges this week, but instead of my previous default reaction, I thought "ah yes, I WAS tense about so and so", and I worked on changing my reaction to a situation that was causing tension.

 

"Have you seen that bumper sticker that says “Don't believe everything you think”? To me that is the challenge: to not let fear run me ---and also to not be afraid of my fear. About anything. And when the fear arises, allow it with compassion, and with patience."
I LOVE that saying! and just as I was typing this - a bird flew in the open door and then flew out again! another hint to take things more lightly...?!

 

With 'reframing the meaning of the pain' I found I got it and did it, then as I was not in pain and got involved more in life - I then sort of forgot. So it does go back to that repetition that Forest was on about. Sometimes it is so simple - but life's busy detail can blindside me...

 

Pain is a powerful generator of fear. The incredible thing about chronic pain is that it hurts every day. I often felt angry with those close to me because it seemed like they thought that just because I had been in pain for a long time it didn't really hurt anymore. But it hurts each and every moment and the fact that it didn't make sense, made it so much worse at times. Survival for me was about distraction from the pain, from the angst and panic I felt inside that I didn't know why it was happening and when it would ever get better. Reframing the meaning of pain is about consciously reminding ourselves why the pain is there. It is not a big mystery, it is not there to punish us, it is not a signal that there is some terrible diagnosis lurking...the pain is there to keep us preoccupied with it rather than something else. We may not know exactly what that something else is, but allowing the pain to scare and preoccupy us only perpetuates the pain. I currently have some of my old right sided head, neck and shoulder pain. I have had a mild headache on the right side for two days. There have been moments when I have fallen back into the fear generating cycle. I catch myself jumping on the "what if" train. I don't even want to write out examples because I don't want to go down that track. I think we have all been there. Last night I went out and enjoyed a pop show my daughter was in. I didn't think about the pain at all. I have plans for getting some things done around the house today. I am not running and distracting myself out of fear, I am consciously deciding that I am not going to think about the pain in such a way that I allow it to scare me. I will take some time today and try to connect with some of the things that are going on in my life.

 

Familiarize yourself with these thoughts. Spend some time watching how frequently your mind goes in that direction. Shining a light on this type of thinking brings it to conscious awareness, and it is the first step to diminishing the power of these thoughts.
This has been the game changer for me and the one I keep working on. I have been shocked to discover the path of my thoughts - the ones that pop up first thing in the morning when I wake up - I am grateful to keep broadening my awareness to catch thoughts, to observe. My latest has been to let my TMS know that it can come with me on my training run or not because I was going to keep running no matter what. The pain would pop up and I would talk to it with those sentences, it would go away, them come back but I stayed steady with my message. I'm convinced that this is working for me. As a result of doing this work, I've discovered I'm quite pessimistic about a lot of things and I ALWAYS thought of myself as an optimist! I don't know if its the years of chronic pain that has turned me this way or if this is the repressed part now being exposed - asking to be loved up instead of shoved aside for the sake of being a Goodist.

 

When I first read Breaking the Pain Cycle it explained where I was stuck and sometimes still get stuck with TMS. In seeing that fear and preoccupation are traits that feed TMS as much as repressed emotions, it allowed me to start addressing those issues.

In my case my symptoms threaten my ability to make a living and my ability to play music, so when I go to play my solo guitar gig on weekends I'm an easy target for my subconscious. I have journaled and let go of some of my obsessive qualities about playing music, and examined how my whole identity has been caught up in being a musician. I do feel at this point I see myself in a more well rounded way and realize some of the obsessive qualities go back to when I was a very wounded child.

What's helped me the most to look at my pain differently is a variation on what Alan talks about. I found I couldn't very easily ignore or not pay attention to my symptoms so out of frustration I turned it around and actually welcomed the TMS. I also challenged it to give me it's best shot, if it could stop me from playing music, fine. If it never goes away, so be it. I was just sick of being afraid. As part of this I've also been gradually increasing normal activities and not backing off of doing things because of TMS. If pain or fear is there it's ok, but I need to get back to doing things I enjoy in life, as best I can.

I also, through some guided meditations, got in the habit of offering myself compassion and love whenever the symptoms come up, or when I get into obsessive thinking, and can remember to do this. In other words my TMS is a reminder to offer myself more compassion. I may not be able to stop all the fear and anxiety thoughts or my pain, but I can offer myself compassion and nurturing when they happen.

As I've done these things I find I have much less pain, and when pain does return I'm not as upset. It will be there as long as it's there.

I think Steve O said "defeat it by allowing it" talking about pain. I think as I've challenged my TMS it's been a way to not keep feeding it by fighting, or looking for one more miracle technique to try on the forum etc.

I don't do any of this perfectly by the way, but gradually the things I've learned here and in in the TMS books I've read are sinking in and really working. It's nice to see the process works, even if slowly in my case.

 

On the last thread I left off stating that I needed to learn how to retrain my brain so that my triggers would no longer bring on pain, so it's really convenient that that is the topic of this discussion.

Colly, thanks for bringing up that great quote from Allan that I had forgotten about. Don't judge success by how much pain you feel, but by how little you care about it. I hate doing things that bring on my pain because I hate being in pain, obviously. Things usually go pretty well until the pain kicks in, then I just become so preoccupied by it that I really can't do anything until it wanes. Fatigue is a big part of it too. Even if my back isn't bothering me too bad once I get home from work I'm usually just too worn out to feel like doing anything. It's easy to feel trapped by your symptoms. The key may be to stop caring about the pain, but that is a very difficult thing to accomplish; it goes against your instincts. Another issue is, you're supposed to think psychologically when you feel pain. That's fine when I'm home and can relax, but what about at work when I have to concentrate on getting the job done? I try to talk to my brain, and reinforce that it is only TMS; that's about all I can do. Fortunately, the pain doesn't bother me at work too much anymore. Actually on most days my back doesn't hurt until I get home from work. So it seems that getting home and starting to relax is my trigger for pain, lol. On Friday I went to get something to eat with my brother after work and felt little to no pain. So, just changing my cycle helped to reprogram my mind.

If the theme of today's lesson is breaking the pain cycle by changing the way you think about pain, that will make a good goal for me this week. In order to do this, I'll try taking a negative thought about my pain and replacing it with a positive one.

Negative Thought: What if the severe pain comes back?

Positive Thought: The severe back pain was not caused by a physical problem. I had it looked at. It came on before I knew it was TMS and it went away the day I was determined I had TMS.

Negative Thought: What if the pain never goes away?

Positive Thought: The pain has come and gone several times in my life, so it's not a matter of whether the pain will go away or not, it's a matter of what level of pain I will be in each day. Some days it will be a 0, and maybe on others it will be a 5.

Negative: Pain at times when I can rest is okay, but I don't want to do this activity with may back hurting.

Positive: Usually the pain is at its worst when I'm resting because I'm doing nothing but concentrating on it. Odds are I won't even be thinking about my back during the activity, only when I get home and start resting.

 

I do something similar when my TMS pain demands my attention. I started challenging my TMS to "give me your best shot" because I was tired of being afraid of the pain. Now I challenge TMS and then let it go and consciously focus on something else.

I also like what you said about compassion Msunn. Sometimes TMS may be a signal that we need a little self-care.

 

I echo Msunn and Gigi's thoughts - welcoming the pain and telling my brain to give me its best shot has done wonders for me in my journey to healing. When you ACCEPT the pain and don't fight it, there is no challenge left for your id/ego/superego to fight out. When you ACCEPT, the fear will start to melt away. Will the fear keep trying to come back? Heck, yeah - the brain is constantly looking for a way to keep us distracted. So here's how I have diffused that:

I've stated this in other posts and I'll keep stating it because it is so helpful (at least for me!) - the best affirmation I have come across through this whole process is:

"THERE IS NOTHING PHYSICALLY WRONG WITH ME - AND THERE NEVER HAS BEEN. "

It's amazing how much confidence this affirmation can give you. It diffuses the pain and the fear. When you are hurting and you can keep repeating the above affirmation, watch how much better you are able to accept, push through and accomplish things. Watch how much 'easier' the pain becomes (however minuscule at first). Feel the fear lessen (however minuscule at first). Get glimpses of overcoming this TMS Beast (however minuscule at first). Just keep doing it. It will eventually start to snowball and you will have the tools needed to keep the healing going.

You can do this!!!!

 

I would love to reframe the way I think about pain, and I think I am doing better at this much of the time (although it's not making a lick of difference in the severity of the pain,) but sometimes it literally takes me down, as in I cannot stand up or the pain buckles me up and I fall. I'd love to see that as funny, but I'm not quite able. Any mind advice? Good jokes? And how do you deal with the people around you who see you fall or hear you gasp or yelp? They don't seem to buy, "There's nothing wrong with me! I'm perfectly normal!" as I'm unable to stand up and have involuntary tears running down my face.

 

[Deleted at BeWell's request]