3. Can you work too hard at overcoming TMS?

[Forest]

Hi everyone,

I am really interested in your feedback on this one. I've been thinking a lot over the last week or so, and tried to make this video blog as thought provoking as I could. The hope is to jump start an interesting discussion that we can all learn from.

Links:​

• Breaking the Pain Cycle, by Alan Gordon
• Structured Educational Program

Update: TMS practitioner Georgie Oldfield, MCSP has written an article on why it's important to stop trying so hard to get better, which she donated to the TMS Wiki:
http://www.tmswiki.org/ppd/Why_you_need_to_stop_trying_so_hard_to_get_better

 

[Beach-Girl]

Great video Forest:

Anyone who is still struggling (hand in the air) should watch this and think about what Forest is saying.

I got to a point where I simply burned out on everything. My life. Its challenges. The work I did for two months straight on ridding myself of TMS. I crashed. So I stopped all my "deep" journaling, daily lessons etc. And what happened? My pain moved. No longer do I have pain I notice in my lower back. Now it's in my arm and neck. I am miserable, but I look at it as progress.

An interesting side note: Maybe I was used to the pain in my lower back, but this much harder to live with. I am constantly aware of the pain. And I'm constantly aware of all the things I've put on hold - that need to be done for our business and our lives. I simply have been putting out fires. Thought there was a knot back there, but discovered there isn't. This is TMS for sure since I woke up with it one day.

Yesterday I finally got moving again and spent a better part of the day doing the grunt work I've put off. Then I went to the beach. There was no beach, a very high tide, and I (as usual) chose to play on the tide line, dodging waves and collecting agates thrown up onto the rocks. I love this. Makes me feel like a kid when I'm out there playing a dangerous game with Mother Nature. No worries - there are plenty of escape routes and having grown up here, I have a sense or rhythm about the surf. I know how far it's going to come in, and rarely get wet. I got wet yesterday on a few sneaker waves, but splashed, not "caught".

Anyway - I noticed that the whole time I was on the beach, I had no pain at all. I was "in the moment" as you talk about Forest, and there is no time to think about your body when you are dodging the surf and focused on finding that Perfect Agate. I am always heading out when there is a spare hour. But now I think I need to simply get out there to counteract all the hard work I'm doing. It's happened before. No pain! I wish the connection would stay with me when I'm doing other things. It's a sing of things to come.

I have always placed a cut-off for my day at 5:00. I'm home, not typically online or answering the phone. I watch a few news shows, cook dinner, and basically try and get away from it all. But I always have a running dialog about the "shoulds" and ways to beat myself around the head and ears if I have forgotten something. I know this is the root of where I need to start. Get rid of that dialog. Becoming present with my family. Loving the time we have together in the evenings.

Another helpful thing for me is sitting outdoors. I have a wonderful back yard. I live in a rain forest (it's not global warming) and we have a lot of rain. But watching the green reappear in our back 40 and listening to the birds is really relaxing. Today on top of our "mini canopy" I saw a Hummingbird making the rounds. What a thrill! Yesterday while driving I saw many eagles!!

I think you are right on. If I start focusing on the present moment, and not live in the future in my head, things could improve. I have already proved it to myself by being next to a pounding surf. Each wave is different. Each carries its own power and each retreats. There's a life lesson in there in a few ways.

Would love to hear how others are coping - the ones who haven't crossed the finish line. I'm patiently waiting for the time when it dissipates. When that wave comes in and my pain is gone on the outgoing tide.

BG

 

[Shanshu Vampyr]

Hi guys,

Fantastic video! Fantastic response by BG. And I couldn't agree more. It's why, in the past few days, I'm coming to be OKAY with the idea of doing nothing. I developed my current TMS symptoms in 1/11. Inadvertently; I was reading idly on the Internet and I was munching on those big sourdough pretzels that come in a giant bag from Snyder's of Hanover and all of the sudden I stumbled onto a website where someone was asking for career advice. "Will I make it into residency after having being let go once?" The consensus was uniformly negative--and my life, which I was currently spending on the interview trail, screeched to a halt with TMJ. That would only become the first symptom of many; and my life quickly became about "beating this thing before I start residency in July" since I had just matched.

Did the sourdough pretzels cause me to have TMS? I doubt it.

A few months later, in dire straits with jaw pain, neck pain, shoulder pain, back pain, ankle pain, and a recurrence of my IBS, my therapist looked me in the eye and asked me to consider if I was having psychosomatic symptoms. The idea of Sarno was introduced.

Every moment in my life since 1/11 has revolved around pain, fear, and an obsessive focus on "fixing" things (first physical stuff, then Sarno stuff when I came here last July). And so it is that I am stuck, after journalling hundreds of pages.

So yes, one can absolutely work TOO HARD.

Phil Chow

 

[BruceMC]

Yes, Forest, I find my perfectionism finds an immediate outlet in turning whatever I do into a "Big Project". But this week I noticed yesterday that my sciatica was going down after I took a long bike ride that forced me to concentrate on just spinning the wheels without thinking too hard about TMS theory. Then, after a recovery day while my muscles came back, I sensed that as I walked around the old pain nerve pathways weren't firing off anymore. No journaling. No meditation. No psychotherapy. Just letting go and spinning the wheels for 30 miles had broken the programmed pain pathways. So it is a matter of letting go and not bearing down intellectually that shifts the focus in your brain from the paleomammalian mind to the neocortex. IOWs: Just cranking hard for 30 miles made my brain let go of its old conditioned bad habits long enough to break the TMS programming. But of course I had already gone through the SP and had journaled before when I first encountered Sarno's books three years ago. But it's really hard to tell someone to "just let go" and "leave it be" when they want to achieve an instant solution to their TMS pain problems. That's like my late father screaming at me to "just relax" when all his screaming and yelling did was frighten me into a catatonic trance! I think a lot of us TMS patient with those kinds of family backgrounds have a really hard time letting go of our programmed responses because their based on fear and our primordial survival instincts.

 

[veronica73]

Great video, Forest! I kind of stepped back from the really intense journaling after the first few weeks and I think my next step is probably going to be doing some kind of therapy. I'm a naturally extroverted person and I think I tend to process some things better with another person/people. Also, like many of us, I can be an obsesser and I think journaling was starting to be another avenue for that.

 

[Forest]

Thanks so much for all of your wonderful comments! I've really been thinking about all of this a lot recently, so it's great to see such a positive response.

This video was largely dedicated to Beach-Girl. I think it will take a while, but I'm going to be so happy to see you gradually get better. Since the video was largely dedicated to you (and a couple of other people), I'm going to make sure to respond to a couple of points in your post.

First...

I am constantly aware of the pain.

Ouch. That's what the pain syndrome wants because the pain is distracting you from whatever else might come up. It sounds like it's got you in its grip, which only reinforces its power.

Anyway - I noticed that the whole time I was on the beach, I had no pain at all. I was "in the moment" as you talk about Forest, and there is no time to think about your body when you are dodging the surf and focused on finding that Perfect Agate.

That used to happen with me with, of all things, computer games. Don't laugh, but I used to absolutely LOVE this one computer game called Unreal Tournament. I got completely absorbed when I played it. Of course, this was at a time when I had pain most of the time and any sort of computer use would bring it on. According to my conditioning, it was computer use that actually caused all of it. And here I was, absolutely mashing the keys on my keyboard, completely caught up in the game, my fingers a blur and my pain level actually DECREASING.

It turns out that this type of thing is very common. It's so common, in fact, that it's one of the questions on Dr. Schechter's TMS questionnaire because it can be used to diagnose TMS. The questionnaire's final question is, "10. Has the pain significantly changed or gone away while on vacation, away from home, or while distracted?"
https://docs.google.com/viewer?url=http://www.mindbodymedicine.com/TMS%20Quest%20pdf.pdf

But I always have a running dialog about the "shoulds" and ways to beat myself around the head and ears if I have forgotten something. I know this is the root of where I need to start. Get rid of that dialog.

I'm glad you're aware of this. But make sure to cut yourself some slack on this. Rome wasn't built in a day, and you're only human, so it will take some time to quiet down that running dialog. I know that my own personal running dialogs have taken a long time to quiet down and I still definitely hear them in the background, just much quieter than before.

 

[Forest]

my life quickly became about "beating this thing before I start residency in July" since I had just matched.

Ouch. I think that that might be setting you up for some pain. In one of my absolute favorite essays about TMS, Alan Gordon explains how this works and gives some techniques for beating it:
http://www.tmswiki.org/ppd/Breaking_the_Pain_Cycle,_by_Alan_Gordon_LCSW

Do you think those ideas might help you?

Thanks for your comments Veronica and MC. I'll definitely respond to them tomorrow, but for now, it's off to bed after a very long day.

 

[BruceMC]

Thanks so much for all of your wonderful comments! I've really been thinking about all of this a lot recently, so it's great to see such a positive response.

This video was largely dedicated to Beach-Girl. I think it will take a while, but I'm going to be so happy to see you gradually get better. Since the video was largely dedicated to you (and a couple of other people), I'm going to make sure to respond to a couple of points in your post.

First...


Ouch. That's what the pain syndrome wants because the pain is distracting you from whatever else might come up. It sounds like it's got you in its grip, which only reinforces its power.


That used to happen with me with, of all things, computer games. Don't laugh, but I used to absolutely LOVE this one computer game called Unreal Tournament. I got completely absorbed when I played it. Of course, this was at a time when I had pain most of the time and any sort of computer use would bring it on. According to my conditioning, it was computer use that actually caused all of it. And here I was, absolutely mashing the keys on my keyboard, completely caught up in the game, my fingers a blur and my pain level actually DECREASING.

It turns out that this type of thing is very common. It's so common, in fact, that it's one of the questions on Dr. Schechter's TMS questionnaire because it can be used to diagnose TMS. The questionnaire's final question is, "10. Has the pain significantly changed or gone away while on vacation, away from home, or while distracted?"
https://docs.google.com/viewer?url=http://www.mindbodymedicine.com/TMS%20Quest%20pdf.pdf


I'm glad you're aware of this. But make sure to cut yourself some slack on this. Rome wasn't built in a day, and you're only human, so it will take some time to quiet down that running dialog. I know that my own personal running dialogs have taken a long time to quiet down and I still definitely hear them in the background, just much quieter than before.

"10. Has the pain significantly changed or gone away while on vacation, away from home, or while distracted?"

Oh, yes, for certain. I first noticed this three years ago when I was really "hurting" with sciatica and lower-back pain. If I hiked on a trail, the jarring of walking would really make the pain go up a notch. However, if I carried along my Nikon D90, the moment I set the DSLR up on a tripod and started accessing the menus and submenus to define the variables for the shot, the pain would all go away. But it lasted after taking the picture too. When I walked away from the place where I had taken the picture, the sciatica and lower-back pain would have disappeared, as if concentrating on the camera and setting it up for a shot had distracted my attention away from the TMS pain, broken my programmed response. I would be willing to bet a dollar to a donut that you use the neocortex to adjust the menu settings on the camera and that gets you out of the unconscious process that triggers the pain and weakness.

 

[yb44]

Well, I am certainly not one who overdoes the journalling but I overdo the procrastinating! I am taking the long route. I have been crawling forward on all fours for about a year now just taking my time, not rushing. I expect some days will be better than others but recently there have been more good days than bad days. I can appreciate why people rush head long into this. I know myself enough to recognise this would stress me out no end and worsen my pain. So I'll just tag along with the rest of you. You go ahead. I'll get there when I get there.

 

[Forest]

"10. Has the pain significantly changed or gone away while on vacation, away from home, or while distracted?"

Oh, yes, for certain. I first noticed this three years ago when I was really "hurting" with sciatica and lower-back pain. If I hiked on a trail, the jarring of walking would really make the pain go up a notch. However, if I carried along my Nikon D90, the moment I set the DSLR up on a tripod and started accessing the menus and submenus to define the variables for the shot, the pain would all go away. But it lasted after taking the picture too. When I walked away from the place where I had taken the picture, the sciatica and lower-back pain would have disappeared, as if concentrating on the camera and setting it up for a shot had distracted my attention away from the TMS pain, broken my programmed response. I would be willing to bet that you use the neocortex to adjust the menu settings on the camera and that gets you out of the unconscious process that triggers the pain and weakness.

That's a great story. It does seem like our level of activation can wax and wane, as if the brain chemical associated with pain or anxiety can build up and then persist, or other parts of our brain (Schubiner mentions the DLPC) can calm them down. At it's simplest level, this is what I imagine a mood to be: you feel some emotions, either good or bad, and those emotions stick around for a while afterward. Sometimes I wonder if depression or generalized anxiety disorder may be like this, where sadness or anxiety just builds up and sticks around until it gets to such a level that it disrupts your life and a self-reinforcing cycle begins. Why can't the same thing happen with pain and the attention that we pay to it?

 

[Forest]

Well, I am certainly not one who overdoes the journalling but I overdo the procrastinating! I am taking the long route. I have been crawling forward on all fours for about a year now just taking my time, not rushing. I expect some days will be better than others but recently there have been more good days than bad days. I can appreciate why people rush head long into this. I know myself enough to recognise this would stress me out no end and worsen my pain. So I'll just tag along with the rest of you. You go ahead. I'll get there when I get there.

And maybe this laid back approach is actually helping you! Worry is one of the number one causes of TMS, and your ability to slow down and moderate the level of your activation could be a huge help in the progress that you've been seeing (or not, everyone is different, and it's always best to just go with your gut and trust your intuition). I trust that each and every one of us will eventually find what is best for us.

 

[Forest]

Great video, Forest! I kind of stepped back from the really intense journaling after the first few weeks and I think my next step is probably going to be doing some kind of therapy. I'm a naturally extroverted person and I think I tend to process some things better with another person/people. Also, like many of us, I can be an obsesser and I think journaling was starting to be another avenue for that.

I think that there is a real art with TMS in learning to listen to what our bodies are telling us about our emotions. I'm sure that what you've learned about yourself and about journaling will stick with you for the rest of your life and that the right balance of personal work and talk therapy will change over time.

To some degree, that is what this entire video blog was about - learning to listen to what our feelings and our mindbodies are telling us so that we keep healing, keep learning more about works for us, and keep growing. The key then is to come back to the forum and share with everyone what works best for you so that we can all benefit from it (as you do ).

 

[Ollin]

Forest, all I can say: this is spot on! Thanks for posting it. I think what all TMS-ers have in common is their history of perseverance to get rid of their symptoms. After finally learning about the right diagnosis with its groundbreaking treatment approach, we put all our hopes and energy to make it work. But striving hard towards a goal creates some dose of fear based on the vague doubt "what if it doesn't work for me?" And out of faith we tend to suppress this fearful voice. We hope we're on the right path, think about it a lot, constantly observe our symptoms and how they respond to the psychological thinking, we focus on our past only in relation to our symptoms, and whether we realize it or not, this is a form of attachment to the idea of TMS. In other words, we're stuck.

Another thing: Affirmations are aimed to reprogram our subconscious mind. Therefore, we need to be careful how we phrase them. Our subconscious is simple and direct, it doesn't understand intellectual or abstract concepts, not even words such as "don't", "no", "never". But it knows what "pain" means and instantly reacts to it with tension. So repeating to ourselves things like "My pain is going away" (without proper visualization), can be actually counterproductive, as it focuses us on what we DON'T want. May be better to say: "I'm feeling good and healthy", "my body is strong, fit, and moves with ease".

I read somewhere that habitually formed neural pathways, i.e. everything we learnt, don't disappear from our brains in our lifetimes. They may get weaker as we lose some habit or skill during not using it, but it takes a long time. That's why past addicts are always more susceptible to triggers of their past behaviours than those who never had given addictions. TMS is also a collection of learn responses to triggers (either emotional or physical). The best way to deal with unhelpful neural pathways is to override them with new, more useful ones. Dr. Schubiner's program and book address this issue well by decoupling triggers from pain response.
But by extension, one could also work in a more general way by 'crowding out' the pain from their life with other things to occupy their mind with. Experience the world, open up to our environment, other people, open up to own ideas and feelings.

I feel best in a role of an observer: perfectly safe in my detachment, when I know nothing can hurt me in a given moment (of meditation).

A tip for those who obsess about all the "do's" and "dont's". Make a list of all the things that don't serve you, or perpetuate your TMS, and burn it. Let it all go. Focus on what's good for you, for your mind, body, your creativity, your hobbies, engage your mind and body in what grabs your passion and lifts your spirits. Connect with the real you, the person you would be if you never had TMS, you'll soon realize you are still this person. Can you let go of the fear of pain getting worse from not journaling, or self-judgment about being lazy? The world won't end and the symptoms will not get worse if you take a break, just be nice to your inner child for a while, it should stop screaming. When you find your peaceful ground, go back to journaling but with a different intention: to learn more about yourself, about the world, to see what it can teach you how to manage your stress response, your relationships, what you can learn about other people, their similarities and differences and find some compassion. Get interested again in the world and your place in it. When there's love there is no room for fear.

Just a few thoughs on this Friday, the 13th...

 

[dabatross]

this is a great post forest the same thing has happened to me in the past.. when i stopped caring about a pain i was having it eventually went away on its own without my intervention. it was funny because i was working really hard to try and get rid of the pain and was focusing on it a lot and then one day for some reason i just stopped trying to cure it and didn't care. before i knew it the pain was gone. i actually talked to Dr. Clarke about this as well and I told him that when I stopped caring about the pain it went away and he said that probably has more to do with the obsessive compulsive disorder and focusing on it too much/trying to get rid of it. So yes I definitely believe that you can work the program too hard especially if thats all you think about is fixing your pain. If thats the only thing on your mind you're actually perpetuating the pain not getting rid of it faster. I know that sounds like an oxymoron but when you dont let it consume every waking minute of your life thinking about it, it will go away on its own. I think this also plays back into the thoughts about mindfulness and "allowing" versus fighting off the pain all the time. If you're constantly thinking about it you're not allowing you're fighting which just keeps the pain around.

In my opinion you dont want to do the program and make it the only thing you think about but just do the program and move on with your life as best as you can. I've learned this as well and you will burnout eventually if you go to work, come home and do nothing but work on TMS or whatver you're doing to fix the pain until you go to bed and then repeat day after day this same cycle. This feeds the pain and makes it stick around. It's when you stop caring either way, do the program and then move on from it that the pain dissipates. So yeah I definitely think this should be included in the TMS structured program and should have more discussion on this forum as well. I like many others have thought that the harder you try to fix it, the faster the results are going to come but its exactly the opposite. The more you fight it the more it fights you back so try to be allowing instead of resistant to it. Sounds counterproductive but that is the best way I can think of getting rid of the obsession with the pain which is for sure a hard thing to break.

Forest I thought it was interesting that you made a video on this because I've had the same train of thought for a few months now on this. I've noticed that the harder I try to fix pain the more it fights me back which creates a cycle of disappointment, fear, anxiety, and negativity when you don't see results quickly. I also think a lot of people with TMS have a certain amount of obsessiveness with their personality which makes it difficult for them to focus on other things than the pain. This is essential though to move on from it because if all you can think about is the pain it fills up your entire mental awareness and makes it feel much worse than it really is.

 

[Beach-Girl]

So yeah I definitely think this should be included in the TMS structured program and should have more discussion on this forum as well.

Agreed.

Forest I thought it was interesting that you made a video on this because I've had the same train of thought for a few months now on this. I've noticed that the harder I try to fix pain the more it fights me back which creates a cycle of disappointment, fear, anxiety, and negativity when you don't see results quickly.

It's the fear and anxiety that are your biggest hurdles Dabatross. I devote some time in the mornings to TMS therapy. But I don't spend all day on it. Still I suffer pain.

I also think a lot of people with TMS have a certain amount of obsessiveness with their personality which makes it difficult for them to focus on other things than the pain.

I have to politely disagree here. I don't think it's really an obsession, I think it's more of a "perfectionist" thing. We do the reading. We do the work. We write till our hands our numb. Why? So we can get it down perfectly. Perhaps this is obsessive, but I see it more as trying to get it down "perfectly" so that we can overcome pain.

This is essential though to move on from it because if all you can think about is the pain it fills up your entire mental awareness and makes it feel much worse than it really is.

Again - I have to disagree. I think people focus on the pain - because it hurts. I try and ignore mine, but it has taken over my shoulder and arm making a lot of things more difficult. That is different than obsession. I'm trying not to care. But I can't help it when I constantly hurt!

BG

 

[Enrique]

I think that what Ollin is saying about affirmations and neural pathways is correct. In my experience, PPD/TMS is about how we are being and thinking in the moment. It is less about our deeply repressed emotions. It is about understanding our personality trait that is being exhibited at that point in time. People pleasing, perfectionist, etc.

We can get too obsessed with trying to find the "answer" or find the person or procedure to fix us. I personally have had less success in digging up the past and more success in observing my current thought habits which cause the repression to occur. when I do that I find wrong thinking and I change my thought to something more productive, like what Ollin is mentioning. Or I allow myself to feel the emotion in that moment... Shame, guilt, anger, fear, worry, frustration... Whatever. I acknowledge it, observe it, then let it go or take some action on it. For example, I notice that I feel angry that my boss didn't tell me about budget cuts affecting my team. Rather that repress... Make a note to talk about it in our next one on one meeting.

The thing about pain, from my experience, is that it is distracting me from something... Something now. Not something from a long time ago. So the key for me has been to focus on the NOW in terms of my chronic thought patterns. What's going on now...... Journal about that.

These are my opinions from personal experience and from what i learned in my reading of PPD books. When I get off track.... I get pains and I'm reminded by the new pain experience to be mindful again.

 

[Forest]

I would probably call it more perfectionsim that makes people work too hard on their recovery, but obsession is sort of an underlying factor of perfectionsim. I almost see them as the same thing in terms of focusing on doing something exactly right. In the end, it doesn't matter what you call it, just how you handle it.

I think it is important to investigate our past, but recovery is much more then just that. I think looking in our past is important becuase it can give us insights into who we are today and why we have certain emotions today. Doing this can help us accept our present emotions more easily. But we still need to look at what present emotions are affecting us. As Enrique touched upon, we recover in the present. Past events can affect how we handle certain situations, but we also need to keep an eye on the present emotions/stresses/events that we may be repressing or avoiding.

One of the main points I wanted to make in my video is that it can be really easy to journal and journal and journal and dig up a whole bunch of emotions, but still be in pain. In situations like this, I think it is important to start to ask yourself if you are trying too hard and what role our perfectionist personality is playing. I'm not too sure if people will simply journal one day and be pain free. I see it more as a process where we change our focus from the physical to the psychological. If anyone is struggling with this, I highly recommend checking out some of Monte's Blog post. There really is something to the whole Thinking Clean idea.

 

[veronica73]

I'm sure there are a lot of different variations in TMS as with any condition...I definitely am an obsesser and a lot my issues do come from really old stuff that I'm still carrying around with me now. It's not so much the past experiences that get to me...these experiences were more like the beginnings of patterns that I still have today.

 

[Ollin]

I think that a lot of people who do the structured program expect things to change, beginning only a few days into it, and hope that they eventually disappear by the end of the program. So if this doesn't happen, they may get discouraged or wishing the program was longer, long enough for them to get to the "core issue" of their particular case. The instant-success stories are deffinitely good for giving beginners the much needed hope. But I wonder if, later in the program, it would be more beneficial to direct people towards embracing life rather than focusing on their TMS.

What it means to theWiki is that with such an approach we can expect some people to distance themselves from it as they let go of their TMS-sufferer identity and 'get on with life', which might for us look like we failed them, but in fact would be sign of a success. We could of course ask them to report back after a few weeks or months.

Although I absolutely love the wiki and its mission, I find lately that it triggers my preoccupation with TMS, and the more I think about everything related, the more often I experience symptoms. But overall I'm doing a lot better than when I first started 'my journey' over a year ago, and I know how much all the information and support helped me.

 

[Neo Veloci]

Hi Forest,
I definitely feel that there is room for improvement in the 'feeling your feelings' part of the program. I'm convinced it's useful to do it, because I think finding out the reason(s) for supressed anger is the first step to self-awaresness and recovery.
But I think there's a lack of psychological advice for what to do with these feelings and thoughts after discovering them. I can't seem to find a succesful way to deal with the inner child and parent, a big part of Sarno's theory.
I live in The Netherlands so there aren't any known TMS doctors or psychologists here to help me with this. Currently I'm reading Eckhart Tolle's 'The Power of Now' after finding this: http://tmshelp.com/forum/topic.asp?TOPIC_ID=7350 and it definitely helps me.
Marcus