Q&A: Is it PPD/TMS or a real structural issue?
Answer by Alan Gordon, LCSW
I think that everyone who’s had PPD has waged this internal battle at some point.
There’s two ways to answer this. The more straightforward explanation is that our brains are wired to associate physical pain with physical injury. So even in the face of plenty of logical evidence to the contrary, our primitive brains think, “Sitting makes my back hurt. I better not sit because that might make my back worse.”
One of the best ways to overcome this is by bombarding your primitive brain with the opposite message. Write up an evidence sheet (MRI was clean, sat that one time for 2 hours without pain, history of other PPD symptoms, etc.) and throw it up on your refrigerator. Tell yourself daily, with confidence, “I know this is PPD, and here’s why...” With time, it’s possible to override this more primitive voice.
There’s a deeper answer to this question, though.
The pain isn’t the real distraction from painful unconscious emotions. The real distraction is the preoccupation around the pain: the fear of whether it will ever go away; the monitoring of whether it was better or worse than the day before; and the psychological struggle over whether or not it’s PPD.
This struggle, this back and forth between the PPD diagnosis and the structural diagnosis is actually part of the PPD. Your brilliant mind is keeping you preoccupied with the terrifying uncertainty of what to believe.
Tell me if this sounds familiar: “Wait, if it’s really PPD then why would it hurt more in hard chairs?” “Hold on a second, if it was structural then why would it move to different parts of my back?” “But then again, if there’s something wrong with my spine, it’d make sense for different parts of my back to hurt...”
This whole thing, this whole internal struggle is all part of the distraction. Your mind is keeping you preoccupied by pulling you back and forth, accumulating evidence on one side one day and the other side the next.
It’s like an evil genius, actually using thoughts about PPD as part of the PPD. You had no idea your unconscious was so clever.
So here’s what you do. See what’s going on. Recognize that your mind has an ulterior motive to pull you back and forth, and actively avoid engaging. Say to yourself, say out loud, “I know what you’re trying to do. You’re trying to pull me into a state of anxiety by making me stress over what’s causing my pain. I’m not going to buy in.”
To quote a 29 year old Matthew Broderick movie, “The only way to win is not to play the game.”
It is important to recognize that no information on this wiki can be considered a specific medical diagnosis, medical treatment, or medical advice. Reading information here does not create a doctor/patient or other professional relationship between you and the answering professional. As always, you should consult with your physicians and counselors regarding new symptoms and any changes that you might make in medications or activities.
- Breaking the Pain Cycle, by Alan Gordon LCSW
- Q&A with an Expert
- TMS/PPD Structured Educational Program
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