Thanks for sharing, I believe that your experience is very common to those dealing with TMS, and you certainly have a lot of insight into how your activities affect your symptoms. You are working on preventing set-backs (or flare-ups), which is an essential part of any pain recovery program.
If by incremental training you refer to something akin to graded exposure therapy (a term I believe used in psychology for the purpose of desensitization), then it is very relevant to TMS recovery, but as you point out, life can throw triggering situations unexpectedly with which you need to deal in the moment. Unfortunately we can't 100% bulletproof ourselves to all potential challenges, but the key to recovering from TMS is "ALWAYS THINK PSYCHOLOGICAL".
In this case, you talk about (paraphrasing) a bag being too heavy and overloading your body which will cause you consequences. Sure, the body has its limits, but what also (and maybe more importantly) goes on is your nervous system going into a threat response and that escalates the symptoms. Physically: If a bag is too heavy you won't be able to lift it. You may have a lower physical endurance (weaker muscles) due to unuse - completely normal with chronic pain, but this is usually easy to recognize and stopping the physical strain is a normal response of selfcare. By all means, exercise, do strength training if you think it's below a normal level for your age/build etc, But this is the physical aspect, and if you end with this you are not addressing the psychological factors that fuel TMS.
To do this, I would suggest that in such moments of deciding whether or not to continue an activity: ask yourself how do you FEEL emotionally? Beyond wondering intellectually 'am I reinforcing the fear of activity by avoiding it?' are you feeling safe, excited, empowered about the activity itself, or do you fear that it can cause a real damage to your mind or body? See, there is a difference between fixation and mindfulness. As we learn about TMS we often fall into the trap of strategizing, rigidly following some structured program because we fear that any slip can undermine our healing potential. In the process, we abandon our own inner guidance - our moment-to-moment feelings. We can't think our way out of symptoms, but we can always honor our emotions, and feeling SAFE is essential to healing. That's what you need to work on - assessing risk to your wellbeing 'here and now', and decide accordingly whether to continue the activity or not. Never push through anything when your mind-body is screaming "Danger!" This is how we sensitize ourselves, reinforce the maladaptive neural pathways and escalate symptoms.
So, how can you prepare yourself for the unexpected situations? Without exposing yourself to them, establish your sense of safety through grounding in the current place and time. Once you determine you're not in danger - start imagining yourself in a potentially triggering situation, but go slowly, take small steps and the goal is to not overwhelm your nervous system with a fear response. This is the basis of graded exposure therapy, which I'm sure others can describe better and guide you through - check Alan Gordon's recovery program as suggested above. Also, Howard Schubiner's book is excellent. Your body responds to imaginary situations in the same way as real stimuli, so it can harm us but can also heal us.
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Alan has completed the new Pain Recovery Program. To read or share it, use this updated link: https://www.tmswiki.org/forum/painrecovery/Dismiss Notice