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Answer

Hi Eskimo, thanks for the great question. This is an important topic with a lot of varying perspectives. I can offer up my interpretation, which is based on my own practice and experience.

I think that we have to start by differentiating between fear and anxiety. Fear is the unconscious detection of a threat that triggers an activation of the somatic and autonomic nervous systems. This is a fancy way of describing symptoms such as sweaty palms or pounding heart, etc. When these symptoms are triggered by our feelings we call them anxiety. Anxiety tells us that the feelings inside of us are being interpreted as a threat. So in summary, fear is brought about from external threats or danger (like a tiger in the jungle – this a very ancient mechanism) and anxiety is a product of internal emotion and feeling.

Okay, so now that we understand that, what’s the deal with TMS? When you have symptoms is that fear or anxiety? Surely the symptoms pose an existential threat, I mean if your back hurts it must mean there is something wrong with it and you could be permanently injured, etc. This is exactly the purpose of TMS: to conflate internal emotional distress with real threats, thereby distracting you from the actual source of anxiety. The physical symptoms are the mind’s way of keeping you distracted from the actual issue: while it may be hard to believe, it is easier (unconsciously) for you to face the fear of pain than to face and experience the underlying feelings and the accompanying anxiety.

So the goal here is not to “repress” your fear by ignoring but rather understand the underlying process that is occurring when are experiencing the fear of symptoms. This is why it is so very important to accept the TMS diagnosis and reframe the meaning of the pain; once you realize that your symptoms are not existential threats but a distraction, you can begin to confront the underlying issues and the anxiety they provoke.

As I said above, this is a fairly complex issue with a variety of opinions. I encourage people to offer up what they think about this explanation, brief as is it, so that a larger discussion on the nature of fear and anxiety can continue. I hope this is somewhat useful.

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