Day 7 1 week of TMS Education

jarditti

Newcomer
What's been illuminated to me more than anything in my first week of learning about TMS and reading Dr. Sarno's books is the element of scanning for pain. I think I mask this with scanning, and I Have yet to figure out how to stop my brain from scanning for pain. For example, when I wake up in the morning, the first moment of my eyes opening, I'm thinking about: Am I feeling tingling in my right elbow and fingers? The answer typically is no. However, lying in bed for a few minutes, by the fifth minute, my arm will be tingling/throbbing/in pain.. I'm at the point where I truly believe I am manufacturing this but have yet to figure out mechanisms for preventing myself from scanning and searching for this pain. I essentially feel like every morning I am voluntarily opening up the floodgates for these neuropathways that are bringing pain to my arm because it is such an embedded habitual pattern.

What are everyone's thoughts on scanning for pain in your body? It feels like if my mind is not distracted with something, it is constantly returning to scanning for pain.
 
One thing you could experiment with is gently lengthening your out-breath for a few breaths when you wake up—or when you notice the urge to check. There’s no need to do this perfectly or to use it to force the sensation away. Then get up and engage with something ordinary rather than repeatedly testing your elbow and fingers.

If the symptom appears, you might acknowledge it without analysing it: “This is uncomfortable, but there's no need to investigate it right now. I’m going to carry on with my day.” Repeating this can gradually weaken the checking habit and teach your nervous system that a sensation does not always require an alarm response.

The aim isn’t to stop every thought or sensation, but to respond to them with less fear and less checking. If you miss the opportunity, that’s fine—you can simply begin again the next time you notice.
 
Hello New Friend! Welcome! Glad you are here.
I'm on day 13, I had a very similar experience with the morning scanning routine. I learned that for me, the pain gradually increased as I woke up because I feared the pain, which made the pain come, which increases the fear... it became a closed feedback loop that kept me in pain. The fear created anxiety. The anxiety of needing to be functional and fearing that I wouldn't be able to. My brain would take that narrative to a place where I lose my job and become homeless! That is so far from the reality. By the time I would get going, the burning pain in my thigh and hip would have me in tears.
One of the first things that got better for me was the morning pain. I read Dr. Sarnos mind body prescription before I started in the forum. Rejecting the fibromyalgia diagnosis I was given made a big difference. The SEP lessons in the first few days were everything. The testimonials, the examples of people doing the work, listening to experts walk people through investigating what the pain had to say. Listening to any of the experts talk about TMS helped. I started to notice patterns or themes. For me, I noticed I have a lot of fear and anxiety around losing function due to a flare up or losing my independence permanently. Why is your brain scanning for pain?
 
One thing you could experiment with is gently lengthening your out-breath for a few breaths when you wake up—or when you notice the urge to check. There’s no need to do this perfectly or to use it to force the sensation away. Then get up and engage with something ordinary rather than repeatedly testing your elbow and fingers.

If the symptom appears, you might acknowledge it without analysing it: “This is uncomfortable, but there's no need to investigate it right now. I’m going to carry on with my day.” Repeating this can gradually weaken the checking habit and teach your nervous system that a sensation does not always require an alarm response.

The aim isn’t to stop every thought or sensation, but to respond to them with less fear and less checking. If you miss the opportunity, that’s fine—you can simply begin again the next time you notice.
Thank you! I will definitely try the breathing technique. I agree that one of the most important things is just to simply get up and start doing something ordinary with your day. I also like the "carry on with my day" mantra. Both of these things can be effective in preventing your mind from going to the alarm response.
 
Hello New Friend! Welcome! Glad you are here.
I'm on day 13, I had a very similar experience with the morning scanning routine. I learned that for me, the pain gradually increased as I woke up because I feared the pain, which made the pain come, which increases the fear... it became a closed feedback loop that kept me in pain. The fear created anxiety. The anxiety of needing to be functional and fearing that I wouldn't be able to. My brain would take that narrative to a place where I lose my job and become homeless! That is so far from the reality. By the time I would get going, the burning pain in my thigh and hip would have me in tears.
One of the first things that got better for me was the morning pain. I read Dr. Sarnos mind body prescription before I started in the forum. Rejecting the fibromyalgia diagnosis I was given made a big difference. The SEP lessons in the first few days were everything. The testimonials, the examples of people doing the work, listening to experts walk people through investigating what the pain had to say. Listening to any of the experts talk about TMS helped. I started to notice patterns or themes. For me, I noticed I have a lot of fear and anxiety around losing function due to a flare up or losing my independence permanently. Why is your brain scanning for pain?
Thank you, Margot! You and me really are on the same page. I know the closed feedback loop of fear, then pain, then anxiety, then thoughts outside of reality, all too well. I'm still trying to understand why my brain is scanning for pain. I've started to journal and acknowledge lots of repressed emotions, and even have had one or two therapy sessions. However, I feel like I'm not truly feeling these emotions. Maybe it's my all-too-pragmatic and practical approach, where I'm still guarding myself somehow.
 
Also @Margot!! Acknowledging that you have a lot of fear and anxiety around losing function... How did you address this in your mind? How do you stop yourself from going deeper down the wrong path?
 
Why is your brain scanning for pain?

Nailed it!

So, reasons can include (this is not exhaustive - just off the top of my head - and it can be a mix):

- Still doubt in the TMS diagnosis - so scanning for it is fuelled by the fear of structural damage.
- Fear of what the pain means to life, which often involves putting too much pressure on ourselves and finding our self-worth outside of ourselves (represented by people-pleasing and perfectionism) - how Margot talked about the spiral of losing her job is an example of this - now this can differ person to person because for some the risks and consequences of the pain could be a lot more realistic, so it's about self-reflecting on whether these consequences are imminent or whether it is being fuelled by self-pressure and perfectionism. The fear results in scanning as we want to wish it away.
- A distraction from things we don't want to deal with or emotions we don't want to feel - this does tie into the last point because it can also be fuelled by self-pressure and by not feeling worthy of being ourselves. An example could be that you may have been taught that anger wasn't okay (you don't feel entitled to it and think that it reflects poorly on you), so your brain may be trying to distract you from this so that you don't feel it, so before seeing someone who you have a lot of repressed anger towards this loop of scanning goes into overdrive (this might not always be obvious, but often there are clues as to what the pattern is protecting you from). It could be as simple as you don't enjoy work very much because you don't enjoy the pressure that comes with it (which may be largely self-driven), so it's a distraction from this feeling and from the idea of work itself.

Those are the main ones I think - you could even just not be comfortable with sitting with yourself without distraction (as you said, unless your mind is occupied by something, then it uses this to fill the space) - I like the way you are thinking about it though :)
 
Also @Margot!! Acknowledging that you have a lot of fear and anxiety around losing function... How did you address this in your mind? How do you stop yourself from going deeper down the wrong path?
In my experience, I needed to acknowledge that my brain was creating alarms that did not match the level danger that existed,in reality. My alarm system is overactive and responds in ways that are inaccurate to my current state of being. Ive been in therapy off and on for years and I learned some cognitive behavioral techniques that help me alot. Knowing when I am stuck in cognitive distortions, like the anxiety of losing everything. Self talk is the tool I use the most I have phrases I say that help me. Like " I am safe. it doesnt hurt to stand it doesnt hurt to walk" and I repeat this until my brain catches on. When I start to feel pain I will say " I am Safe, please increase the oxygen to my hips and quads and repeat this until the pain fades." When managing the pain gets really hard, I tell my brain FACTS like " there is no structual reason for this pain" I also highly recommend useing Dr. Sarnos 12 daily reminders when things get tough. Belief is the key for me. I want to be at 100% but some days are hard and I may only be at 90% belief in the TMS dx. I am a work in progress. I understand the desperation. When I found this program I was so desperate to find relief and put so much pressure on myself that I actually made it worse. Have patience with your brain, it takes time to reprogram these things. Self compassion and giving yourself grace goes along way. I learned that through this program. Learning to be with the pain instead of being IN the pain and thinking psychologically was a big step for me. Asking my brain why it is sounding the alarm helps me to get in touch with the emotion underneath. For me, Perfectionism lurks under the surface and my harsh inner critic can get in the way.... ie Im not doing this right, or I need to do this perfectly to heal. Adam helped me understand that sometimes the pain is conditioned response. No emotional cause. The brain creates the pain because that is what it has always done. Neuroplastisity tells us that our brains CAN be retrained. I am glad you are here<3
 
Adam helped me understand that sometimes the pain is conditioned response. No emotional cause. The brain creates the pain because that is what it has always done. Neuroplastisity tells us that our brains CAN be retrained. I am glad you are here<3

Just to clarify this - in specific moments yes - like in my case my brain associated sitting with danger (because of the prior belief in structural damage), so that was the reason why it really hurt and flared when I sat (conditioned response). My overall pain experience did still have emotional causes though in this respect (self-pressure, rejection of my emotions, people-pleasing - they were always operating in the background) - so technically in that case it's a mix and both were at play when I was sitting (and in other cases, it won't be a conditioned response to an activity or position but rather it will be flared by strong stress or a ramping up of one of the emotional causes listed before like people-pleasing - like when I was in social settings it would flare, regardless of whether I was sitting or not) - hopefully that makes sense :)
 
Nailed it!

So, reasons can include (this is not exhaustive - just off the top of my head - and it can be a mix):

- Still doubt in the TMS diagnosis - so scanning for it is fuelled by the fear of structural damage.
- Fear of what the pain means to life, which often involves putting too much pressure on ourselves and finding our self-worth outside of ourselves (represented by people-pleasing and perfectionism) - how Margot talked about the spiral of losing her job is an example of this - now this can differ person to person because for some the risks and consequences of the pain could be a lot more realistic, so it's about self-reflecting on whether these consequences are imminent or whether it is being fuelled by self-pressure and perfectionism. The fear results in scanning as we want to wish it away.
- A distraction from things we don't want to deal with or emotions we don't want to feel - this does tie into the last point because it can also be fuelled by self-pressure and by not feeling worthy of being ourselves. An example could be that you may have been taught that anger wasn't okay (you don't feel entitled to it and think that it reflects poorly on you), so your brain may be trying to distract you from this so that you don't feel it, so before seeing someone who you have a lot of repressed anger towards this loop of scanning goes into overdrive (this might not always be obvious, but often there are clues as to what the pattern is protecting you from). It could be as simple as you don't enjoy work very much because you don't enjoy the pressure that comes with it (which may be largely self-driven), so it's a distraction from this feeling and from the idea of work itself.

Those are the main ones I think - you could even just not be comfortable with sitting with yourself without distraction (as you said, unless your mind is occupied by something, then it uses this to fill the space) - I like the way you are thinking about it though :)
Incredibly insightful, thank you Adam. The biggest reflection in the last 24 to 48 hours from me has been self criticism. I found that I'm probably criticizing myself hundreds of times a day not more. I have a beautiful eight-month-old daughter and last night we were dancing and listening to music and I thought to myself, "we should be taking her to see real music somewhere but I'm recovering some surgery so we can't" and it totally ruined the moment for me. How messed up is that? I ruined a perfectly blissful moment comparing to what we should or could be doing but can't because of a perceived limitation that I have.

The self pressure gets worse. I'm constantly challenging myself to optimize my day - my mind is always running about how our garden should be better or how I should be in better shape or how my guitar playing isn't as good as it should be. Then there is criticism of myself because of the pain I'm in which is just a downward spiraling feedback loop.

I am also uncovering a lot of anger over the last few months. I finished MBA school, had a five month old at the time, got a new job, dealt with my twin brother's first manic episode, and completed a construction project during paternity leave with my father-in-law who is critical and a perfectionist. I felt incompetent on all fronts and know I was psychologically self abusing myself even though I was performing at extremely high-level. I'm learning to acknowledge these emotions of resentment and anger of having time taken away from being with my daughter, feeling like I was not competent enough, feeling like I was overworked and underappreciated. A big challenge for me is letting these emotions pass.

And what have I thought for the last three months every minute of every day since all of those events passed? Pain and the fear of more pain.
 
Just to clarify this - in specific moments yes - like in my case my brain associated sitting with danger (because of the prior belief in structural damage), so that was the reason why it really hurt and flared when I sat (conditioned response). My overall pain experience did still have emotional causes though in this respect (self-pressure, rejection of my emotions, people-pleasing - they were always operating in the background) - so technically in that case it's a mix and both were at play when I was sitting (and in other cases, it won't be a conditioned response to an activity or position but rather it will be flared by strong stress or a ramping up of one of the emotional causes listed before like people-pleasing - like when I was in social settings it would flare, regardless of whether I was sitting or not) - hopefully that makes sense :)
How did you challenge that conditioned response?
 
I ruined a perfectly blissful moment comparing to what we should or could be doing but can't because of a perceived limitation that I have.

It's a great insight about the self-pressure - and what that can do is easily lead to blame and guilt for having the symptoms in the first place, when they are never your fault and never anyone's fault for having them. This guilt (which is evident by this quote) is likely a huge contributor to the symptoms.

Then there is criticism of myself because of the pain I'm in which is just a downward spiraling feedback loop.

Same thing as above.

A big challenge for me is letting these emotions pass.

All of this awareness is brilliant - what I will say is that emotions naturally pass once we become fully accepting of them. If you feel like your anger is justified and you're able to truly let it out, then it will pass. All emotions are ok and you're entitled to all of your emotions, there is no justification needed. We treat them like actions when they are not, they are our own internal experiences and are no reflection on our character. Given your level of self-criticism and judgment, I would be shocked if this wasn't spilling over into the field of emotions - i.e. judging yourself for having specific emotions and trying to intellectually justify them. This judgment is mainly what prevents them from flowing and passing. Hopefully that makes sense :)
 
How did you challenge that conditioned response?

I'm a big believer in someone naturally pushing themselves (progressively) based on their belief in the TMS diagnosis. So that was what was first, I built the evidence up. Once I was confident enough that pain didn't mean damage and I wasn't going to further injure myself, then I challenged the conditioned response.

What causes a conditioned response? Fear (and by extension attention) and avoidance. So I had to start sitting and stop avoiding it (because avoiding something confirms it's dangerous), but I also had to catch and challenge my anxiety both before and after the activity.

So before I had to sit, the fear started swelling up and the dread started kicking in, in an attempt to stop me from sitting (which is normal). I would challenge it in the moment and say "There's nothing wrong with my body, I know this from the evidence, this is just a conditioned response. The sitting itself isn't actually causing the pain but rather it's the belief that the sitting is dangerous that is". That would calm me down and it's challenging that danger response to the activity which is fuelling the conditioned response. I would say the same thing during the sitting when in pain.

I think equally important is what happens afterwards. Before I knew about TMS, if I hurt more after sitting, then there would be tremendous guilt and fear, as if to say "why did you sit on that chair, look what you've done and now we are going to be in pain for a week". This only confirms to myself that I was wrong to sit, and therefore it must be dangerous. After I knew about TMS, if it hurt after sitting I would say to myself "Don't you dare blame it on the sitting and regret it, it's just a conditioned response and you were absolutely right to sit as there's nothing wrong with you, the only way to break the conditioned response is to sit without fear".

I did that enough times until my indifference to sitting built up - it hurt but I didn't care (or at least not as much as I used to). Because the main fuel for the conditioned response is fear, I was cutting this off and the conditioned response started to break up (it didn't disappear overnight). Once it started to break up, even more things that wouldn't make sense if it were structural started to happen, like one day it hurt more on a comfy couch than on a wooden stool - that only increased my confidence and improved my reactions. I began to be able to link my symptoms more to my emotions as the conditioned response was no longer distracting me (as it was breaking up) - so for example when I was more stressed I couldn't sit for 10 minutes vs when I wasn't as stressed I could sit for 40 minutes with a lot less pain. I knew at that stage. That's how I broke it, and even though I can still get minor symptoms from stress (which don't impact me), nothing physical (including sitting) triggers my pain at all - I can sit for 10 hours and have no change, whereas I used to not be able to sit for 10 minutes without it turning into agony. It's still hard to believe sometimes and feels like magic (because I haven't change anything physically), but conditioned responses can be broken no matter how real they seem :)
 
I'm a big believer in someone naturally pushing themselves (progressively) based on their belief in the TMS diagnosis. So that was what was first, I built the evidence up. Once I was confident enough that pain didn't mean damage and I wasn't going to further injure myself, then I challenged the conditioned response.

What causes a conditioned response? Fear (and by extension attention) and avoidance. So I had to start sitting and stop avoiding it (because avoiding something confirms it's dangerous), but I also had to catch and challenge my anxiety both before and after the activity.

So before I had to sit, the fear started swelling up and the dread started kicking in, in an attempt to stop me from sitting (which is normal). I would challenge it in the moment and say "There's nothing wrong with my body, I know this from the evidence, this is just a conditioned response. The sitting itself isn't actually causing the pain but rather it's the belief that the sitting is dangerous that is". That would calm me down and it's challenging that danger response to the activity which is fuelling the conditioned response. I would say the same thing during the sitting when in pain.

I think equally important is what happens afterwards. Before I knew about TMS, if I hurt more after sitting, then there would be tremendous guilt and fear, as if to say "why did you sit on that chair, look what you've done and now we are going to be in pain for a week". This only confirms to myself that I was wrong to sit, and therefore it must be dangerous. After I knew about TMS, if it hurt after sitting I would say to myself "Don't you dare blame it on the sitting and regret it, it's just a conditioned response and you were absolutely right to sit as there's nothing wrong with you, the only way to break the conditioned response is to sit without fear".

I did that enough times until my indifference to sitting built up - it hurt but I didn't care (or at least not as much as I used to). Because the main fuel for the conditioned response is fear, I was cutting this off and the conditioned response started to break up (it didn't disappear overnight). Once it started to break up, even more things that wouldn't make sense if it were structural started to happen, like one day it hurt more on a comfy couch than on a wooden stool - that only increased my confidence and improved my reactions. I began to be able to link my symptoms more to my emotions as the conditioned response was no longer distracting me (as it was breaking up) - so for example when I was more stressed I couldn't sit for 10 minutes vs when I wasn't as stressed I could sit for 40 minutes with a lot less pain. I knew at that stage. That's how I broke it, and even though I can still get minor symptoms from stress (which don't impact me), nothing physical (including sitting) triggers my pain at all - I can sit for 10 hours and have no change, whereas I used to not be able to sit for 10 minutes without it turning into agony. It's still hard to believe sometimes and feels like magic (because I haven't change anything physically), but conditioned responses can be broken no matter how real they seem :)
Adam - really really appreciate all of your insight.

On conditioned responses, I will approach it like you recommend -- challenge the moment as fear/anxiety arise before you do the conditioned response activity, reinforce your decision/activity afterwards even if you feel pain, and link symptoms to emotions.

On the pressure/guilt, I'm working on acknowledging this self-pressure and guilt and countering them with self-compassion. Also recognizing that I'm not to blame for this nor are others.

I also hear you that I am trying too hard to justify my emotions instead of just acknowledging and letting them pass. And don't judge myself for having them! Just acknowledge and let pass. I will keep you updated.
 
Adam - really really appreciate all of your insight.

On conditioned responses, I will approach it like you recommend -- challenge the moment as fear/anxiety arise before you do the conditioned response activity, reinforce your decision/activity afterwards even if you feel pain, and link symptoms to emotions.

On the pressure/guilt, I'm working on acknowledging this self-pressure and guilt and countering them with self-compassion. Also recognizing that I'm not to blame for this nor are others.

I also hear you that I am trying too hard to justify my emotions instead of just acknowledging and letting them pass. And don't judge myself for having them! Just acknowledge and let pass. I will keep you updated.

Awesome - you got it! :)
 
In my experience, I needed to acknowledge that my brain was creating alarms that did not match the level danger that existed,in reality. My alarm system is overactive and responds in ways that are inaccurate to my current state of being. Ive been in therapy off and on for years and I learned some cognitive behavioral techniques that help me alot. Knowing when I am stuck in cognitive distortions, like the anxiety of losing everything. Self talk is the tool I use the most I have phrases I say that help me. Like " I am safe. it doesnt hurt to stand it doesnt hurt to walk" and I repeat this until my brain catches on. When I start to feel pain I will say " I am Safe, please increase the oxygen to my hips and quads and repeat this until the pain fades." When managing the pain gets really hard, I tell my brain FACTS like " there is no structual reason for this pain" I also highly recommend useing Dr. Sarnos 12 daily reminders when things get tough. Belief is the key for me. I want to be at 100% but some days are hard and I may only be at 90% belief in the TMS dx. I am a work in progress. I understand the desperation. When I found this program I was so desperate to find relief and put so much pressure on myself that I actually made it worse. Have patience with your brain, it takes time to reprogram these things. Self compassion and giving yourself grace goes along way. I learned that through this program. Learning to be with the pain instead of being IN the pain and thinking psychologically was a big step for me. Asking my brain why it is sounding the alarm helps me to get in touch with the emotion underneath. For me, Perfectionism lurks under the surface and my harsh inner critic can get in the way.... ie Im not doing this right, or I need to do this perfectly to heal. Adam helped me understand that sometimes the pain is conditioned response. No emotional cause. The brain creates the pain because that is what it has always done. Neuroplastisity tells us that our brains CAN be retrained. I am glad you are here<3
“I’m not doing this right” or “I have to be perfect to heal.” I can relate to that! I think I’m trying too hard and wanting fast results. That makes sense, that’s how I am. I need to work on that!

Jarditti - I feel like I am guarding myself too. That, plus my perfectionism, is definitely holding myself back. I, too, find myself constantly scanning for pain. I’m trying to see it as a sensation rather than pain. And I’ve started using more self-talk too, like Margot.
 
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