4.5 Years of Chronic Pain Resolved in 2 Months

The discussion on this thread reminded me of the old parable "The Ship Repair Man."

The story:

A ship's engine dies at sea. Top engineers try for days—nothing. They bring in an old pro who's spent his life fixing ships. He inspects quietly for a while, taps one spot with a hammer, and it roars back to life. The bill arrives: $10,000. The outraged owners demand a breakdown, and he amends it:

• Hammer tap: $2
  
  
• Knowing where to tap: $9,998

How it fits coaching:

• Ship = your nervous system stuck in symptom mode (pain, fatigue, IBS, whatever).
  
  
• Failed fixes = generic tips or treatments that miss your wiring.
  
  
• Old pro = a coach who spots your patterns—triggers, buried feelings, safety gaps—and "taps" precisely (a reframe, expression tool, or habit shift).

The irony? The ship owners complained about the "simple" job.... But if someone nailed your headspace like that?... Well, many of us would endeavour to pay $4,000—or maybe more—in a heartbeat to get back to fully functioning.

The real difficulty though: No guarantee any coach will be that ship repair man for you personally—they might inspect and tap the wrong spot. That's why I've never tried expensive one-to-one coaching; too much risk of costly dead ends.

 

I agree. I would find 4K in a heartbeat from somewhere if the healing could be guaranteed. However one cant keep paying that out over and over again when results are then lacking.

Anyway I believe this conversation has probably reached its limits of productivity.

I asked about men because the Instagram account says women. That is all.

And I think one will stop trying to get an answer to the graded exposure question.

Infact perhaps graded exposure is not a requirement at all.

 

Interesting and I've never heard that one before!

I would look at it slightly differently (hopefully I don't have too much fun with this to the point that it makes no sense):

- Whilst the coach can spot where to tap, it is only the client (ship's owner) who can use and strike with the hammer (this differs from a surgeon for example, who actually does the fix for the patient irrespective of their understanding or knowledge of their own body (ship)). It is in a sense irresponsible for the coach to even touch the hammer, as self-led and self-informed healing is the only thing that will stick long term and prevent future ship issues (give a man a fish.... teach a man to fish...). The ship also usually requires 24/7 maintenance and care to fix, something which can only be achieved by the owner. They (the coach) can, however, be stern as to their recommendations for where to strike the blows.

- Some issues are obvious, external problems which the coach can easily spot and direct the client to hammer (e.g. claiming belief in TMS yet still engaging in practices that treat the structural, like seeing a physiotherapist) - these are very common ship problems that are seen every day (and can fix the ship completely in minority cases). However, some issues (more of the deeper emotional side) are deep, complex intricacies which are unique to every single different ship in the world (even the exact same model of ship made by the same engineers). Whilst they may have similarities to other ships (and the more seasoned the pro the more they will be able to spot these), the owner is always in the best position to understand/inspect these intricacies, as they are the only ones who have experienced all the waves that have led to the concerns. The pro can point towards general parts of the ship and suggest to inspect those regions (and can assist the client by holding the flashlight + can give recommendations for how others have fixed issues in similar parts of the ship), but they ultimately aren't the ones who go all the way down there and fix it.

I think it's wrong then to treat a coach as your ship repair man - only you can repair the ship. The coach can spot issues, support and guide the ship-owner, but like Emily said it takes a certain amount of dedication and self-drive. You could have the best coach in the world (and they could be 100% correct with what is wrong with the ship and how to fix it), but (and this is evident of the fact that the coach isn't the ship repair man) if the shipowner doesn't want to go into the bowels of the ship where the smoke and fumes are in order to fix the ship, then there's nothing the coach can do (they can't take the hammer and do it themselves unfortunately).

As I said in a previous comment, a TMS coach is far more like a therapist than a surgeon most often. Are we concerned about expensive dead-ends with a therapist or do we have a greater understanding of what they are really there to do? I think the latter, and I think that's a more realistic view of what TMS coaching (and coaching in general) is

Ps: That's not to say that you can't have 3 sessions with a coach and heal (it's rare but I have had such clients), but given the unpredictable nature of emotions and trauma (as a therapist faces), expectations need to be managed.

 

I think you're right re this thread.

If you want to make a new post with your story and your questions repeated there I'm happy to answer/help as specifically as I can

 

I agree Adam, both analogies actually work wonderfully.

I am more than happy to go into my ship and do the required repair work. Infact I keep going in there but feel as though all my previous coaches have been telling me to whack everything with the hammer with no real accuracy.

Much love to everyone.

 

Yep, I agree, that was exactly one of the points I made.

I take your point, so no need to - and I'm not expecting you to - respond to me at all, but I just wanted to reply to Adam's response to my posting above...

@Adam Coloretti (coach) I agree—the coach isn't the repair man... that's why I put "taps" in inverted commas. As I said, the "tap" might be something like a reframe, expression tool, or habit shift (or similar)—which it's obvious the client has to be willing to implement to recover and stay recovered.

The point I was making is that the coach may spot what the client needs to do—like spotting someone claiming TMS but still chasing physio (your example)—whereas the client is at a loss to see it themselves.

I surmise you have seen cases where clients missed their own "spot" until you pointed it out?

 

I got you, and yes definitely!

Most of those cases are people failing to align their thoughts and behaviours with the TMS belief (the physio example, but there are countless more and they can be subtle).

I've inferred it's complicated too (and I guess that's more to do with implementation on an individual level), but really to me the formula is quite simple.

If someone truly believes it is TMS and acts accordingly + treats themselves in a self compassionate way - the pain will go (with the exception of cases where the person is still in genuine danger, then that needs to be resolved).

Perfectionism, people-pleasing, self-criticism, poor boundaries etc can all be placed under the umbrella of self-compassion deficiency. So too is emotional repression because you aren't giving yourself the self-compassion to experience all of your emotions and have them be acceptable (without shame and guilt). Now saying how many ways/strategies there are to develop self-compassion is like saying how long a piece of string is (you would get millions of ideas on social media alone). And it would be nice if it was easy as just telling someone to treat themselves better (it can be - but it's very entrenched), but experiences/trauma have led to that so that's where the delving into the past comes in. I think a lot of people have it wrong as to why we actually look into the past. It's largely beneficial to the extent that it helps us do differently going forward (there can be a release, but we need to learn from that to stop future repression).

Now some people could take my very basic formula above and work it out themselves and heal. Similarly, the coach can get the "taps" all right and say to someone "this is why you treat yourself poorly" - the client could even say "yes that makes so much sense and I've accepted that, now what?". There can be strategies, but at the end of the day a big part of it is just a decision - we know intuitively whether we are treating ourselves well or not - and it's our responsibility. Also, most people with TMS know they treat themselves poorly and put too much pressure on themselves (they know they have the TMS personality), so on the emotional side they know what they need to do in a sense (they are just looking for the how).

I'll finish by responding to this and hopefully tying it together (I may have gone off on a slight tangent - and I did that on purpose in a sense because I thought this might help others reading anyway + I get carried away due to passion for this) - you're right in that it's obvious if it's a reframe or a tool etc that implementation is needed, but the overall and more major decision of dedicating yourself to treating yourself better (and one cannot hide behind a tool or a strategy to avoid this) is bloody hard/scary for most (and takes a lot of consistent work) and makes the coach powerless in a sense because that's a deeply personal decision.

That's also why pretty much everyone I see heal (myself included) realises that it's so much bigger than the pain. Because, ironically, treating yourself with more self-compassion for any other reason other than you deserve it (i.e. just to heal the pain), is the opposite of self-compassion.

So in summary, the "spot" often has to do with not acting in alignment with the TMS belief (or still having doubts in the TMS diagnosis overall) - it's usually self-evident both the fact that someone treats themselves poorly and what may need to be done to fix this (assuming they understand the TMS personality and have read a bit of Sarno) - so a coach is more of a support/strategist here rather than a "spot" spotter (maybe if there's something in someone's past that is making the person act a certain way that the coach can see, but usually the client knows this and a connection made by them is going to be more powerful).

 

I am not a coach, and I have never received one-to-one coaching, so I respect your professional take and experience of this. However, my own experience of what has helped me the most has been when I've watched, say, a coach's YouTube video and something they've said hits the spot... it might be an 'aha' moment or something that I find I keep thinking about and take on board and implement. So, I guess that's why the repair man parable came into my mind.

Something I think coaching may be good for is possibly stopping the client from wriggling out of or running away from what they need to recognise about themselves and what they likely need to do to recover. I say this because what I notice on these forums is that when people who have recovered or are near to full recovery - or coaches for that matter - offer poignant and constructive advice to those asking for help they are so very often totally ignored, whereas 'tea and sympathy' type postings, which are all very 'nice' but don't imo tend to progress anyone's recovery other than to feel that they are not alone and some camaraderie, are met with great enthusiasm. And I think that happens because their brain doesn't want to hear the stuff that may be getting to the nub of the problem... because the work can be hard and the brain wants the status quo. But paying for someone's services can sometimes, let's say, 'focus' the mind too, I surmise, whereas freely given advice on the forums may not be valued.

 

Completely agree - and it might even just take someone explaining the same thing a different way to click.

100% - and this is why the idea before about paying someone after one heals - I like the idea - but taking the financial side out of it you get this problem. It's like everything in that when you have financial skin in the game you're going to focus more and take it more seriously (even subconsciously) - because if it's free then there's no consequence and one is less likely to take responsibility (and that's important because as we've discussed, this is self-led and isn't like getting surgery in that nothing you do in the moment contributes to success).

 

I myself have paid several coaches and none of them have actually helped me work out the problem. They have just said try staring out the window, count how many red things you can see, hum, meditate.
But when one asks what the issue is, they can not answer me.
It is very much a sense of throw everything at it and see what sticks.

This is very annoying.

 

Absolutely! My late mother was a junior school teacher and I remember her saying how explaining things in a number of different ways to the kids in her class was key to helping them all understand the lesson. In that sense, a great coach is also liable to be a great teacher.

 

I’m really sorry that you’ve spent money without getting the help you hoped for. Like I say, I’ve never had one-to-one coaching, but if I were to contemplate it now, it would only be after seeing something of them first and really liking what I saw — their personality, the way they put things over, and, especially, their views on the causes of mind/body symptoms. I’d want that to chime with my own thoughts about what might be going on with me personally.

I recently came across a mind/body coach (who is medical doctor) on YouTube (thanks to a mention from @Cactusflower) whose approach really resonated with me. I liked his suggestions for their simplicity, quickness, and practicality, and how he always says that if something doesn’t feel right for you, don’t do it. How refreshing that he recognises it’s a case of “horses for courses”! That really appealed to me.

My approach now is simple: if what someone says makes sense to me personally, I’ll give it a try. At the moment, I’m content just practising some of his suggestions from his videos. What he talks about in the video below (starting around 4 minutes in) was new to me, and I’ve been enjoying experimenting with it — and I’m optimistic that it’s likely to help. He also has some imo helpful video shorts you might want to explore, though of course, he may not gel with you.

My suggestion would be to watch one mind/body YouTube video a day and gather the bits that resonate. I also really appreciate most of Raelan Agle’s interviews, for instance — I’ve cherry-picked a few ideas from her guests that have helped them to recover and made my own ‘recipe’ for recovery. Personally, I’ve gone from being bedridden and housebound to functioning really well by comparison, and I continue to improve a little week by week.

You’re not giving up — that’s clear from your continuing to post on these forums — and that’s good. Never, ever give up!

 

Lately I've been reading a lot about the negative bias of our brains and minds, and that it can be one of the biggest things that will hold us back from being able to do this work. I think that without discussing it much, this is absolutely what Dr. Fantasil brings to the table. When you watch his videos, pretty much the first steps he mentions talking to his patients about is mindset, and how to begin to turn it around gently but firmly. How to stop believing the stories and untruths we've told ourselves and how to let go of the stuff we hang on to (eg. anger and blame towards those who "won't" fix us). There have been several studies that show how this negative bias (of which a symptom is anger) can shape our health and our pain levels. Without explicitly saying or focusing of this concept, it's very much the center of Dr. Fantasil's work - he talks kindly and gently but firmly about the need to have a change in mindset to heal and that someone like himself who assists and coaches patients are only guides. He does not do the healing. He can't force a mindset on you, but he offers a variety of things to try over time (and time being variable from days to weeks to months or even years) to see what might work for you, and that it may take others (mental health professionals eg. psychologists or psychiatrists) to assist you over time, or it may simply be that you just need to go live life and let things settle. I love his open mindedness about the process.

 

I think my core issue is I want things to make sense to ME.

I have had a few coaches say to me that yes within 6 to 8 sessions they will be able to get me improvement. Yet they seem to always fail.

I am not expecting them to heal me. Only i myself can heal me. However I do expect a coach to give me clarity and give me the confidence in the approach i am using.

I do not wish to pay someone to just guess.

Dr Dan ratner says "you make sense and your symptoms make sense".
Well if that is the case how can nobody help me understand.

I think perhaps the books by Schubiner, sarno, sachs all made it sound to simple. They would have a chat with someone in chronic pain. Explain to them why. Give them clarity and instruction and they would heal.

Either that or it has been made far too complicated by all these so called experts.

For me it makes no logical sense when your think about it. There is a girl who healed in 6 weeks after being in a hospice. 6 weeks! Yet there can be someone who has say wrist pain that stays in pain for 5 or more years.

Logically that makes zero sense.

From what I have seen the pain explained programme says things like decide to heal. Its a little insulting to suggest we are deciding to stay in pain.

Anyway I digress.

 

This!

 

Perhaps if Dr Sarno had ended his book with a set of instructions and explicitly said do this and your pain is sure to go a lot of people would not have gone on to read 100 other books.

I appreciate he had his 12 daily reminders but I didnt find those packed the punch for me.

 

This post certaintly went off topic after one just wanted an explanation on graded exposure. Whoops!

 

Who needs a coach when you can ask ai?! lol The following (summarised by perplexity ai) is pretty much what I did from being bed bound for over 18 months and housebound for many years. When I first started I couldn't stand upright for more than 5 minutes and those 5 minutes were extremely painful. Now I can do moderate exercises in front of the TV for two sessions of 35 - 40 minutes each and walk a kilometre a day and potter about the house doing various chores. I call what I did 'taking baby steps' rather than 'graded exposure' because I never had a baseline of being pain free from which to work from.

"You can still use graded exposure when pain is present in every position, but you shift the focus from “no‑pain baseline” to “management of fear, over‑response, and nervous‑system reactivity.” The key is not to wait for a “neutral” state but to work within the pain you already have, while slowly changing how your brain and nervous system interpret it.

When there is no “neutral” position
In chronic‑pain or sensitised states, there often genuinely is no perfectly comfortable “base camp”; instead, you treat the current worst tolerated position or activity as your starting rung. For example:

• If sitting is always uncomfortable, you might start with a very short, supported sit (e.g., 1–2 minutes) and build up time or change how you sit (cushion, posture, movement breaks) rather than expecting comfort first.
• The “baseline” becomes “what I can actually tolerate for a short while without triggering a big flare‑up,” even if it is still painful.

How graded exposure still trains the brain
Graded exposure trains the brain by systematically proving that:

1. the activity or position is not dangerous (even if it’s unpleasant), and
2. your body can tolerate a bit more than you feared, without catastrophe.

This works through:

• Habituation: Daily exposure to a slightly challenging but non‑injuring task reduces the nervous system’s alarm over time.
• Extinction learning: The brain learns that “pain + doing X” does not automatically mean “damaged” or “worse,” so the pain‑fear loop weakens.
• Self‑efficacy: Successfully completing small, repeated exposures builds confidence that you can manage pain rather than be controlled by it.

You are not training the brain to “stop pain,” but to stop over‑reacting to it or to harmless sensations that it interprets as pain.

How to adapt graded exposure when pain is always there
If every position hurts, you can still apply graded exposure by:

• Choosing a hierarchy of “least worst” to “most worst” positions or actions (e.g., supported sitting → unsupported sitting → standing → walking).
• Grading by duration or intensity, not by comfort: e.g., 1 minute of sitting, then 1.5 minutes, then 2, rather than asking for comfort first.
• Adding “buffer” strategies into each exposure (breathing, grounding, gentle movement, self‑compassion) so your nervous system doesn’t spike even though pain is present.
• Treating “staying in it without escape” as the exposure: The work is learning to tolerate a known level of discomfort, break the fear‑avoidance cycle, and stay present.

When graded exposure might not be the only focus
If pain is truly constant and every position feels equally threatening, graded exposure may need to run alongside:

• Nervous‑system calming (breathing, mindfulness, gentle movement) to lower baseline sensitivity.
• Activity management so exposures don’t translate into massive flares that reinforce fear.

In this situation graded exposure is usually still appropriate, but it becomes “graded exposure within a constant pain environment,” not “graded exposure to reach a pain‑free state.”

A simple way to start (your “clear answer”)
A clear, practical starting point is:

1. Pick the least painful position or activity you can sustain for a short time (even if it still hurts).
2. Stay in it a tiny bit longer or repeat it slightly more often than usual, without trying to “win” or force comfort.
3. Use a calming anchor (breath, grounding, self‑compassion) while you do it.
4. Repeat this small step often enough that your nervous system starts to notice, “This isn’t catastrophe, just discomfort.”"

 

Thank you for that. I just think graded exposure cant really be applied in these situations.

I do not avoid becauae I can not avoid. I just have to put up with it.

My brain can not comprehend how it is graded exposure when theres no where safe to build up from.

Perhaps not everyone uses graded exposure.

 

Personally the threat of a setback makes 'safety' impossible to me. I can only somewhat fake it and do small baby steps but the pain isnt going just by itself. I'm afraid of getting worse. I can try not to think about it but i feel the threat of it all. My situation is paradoxical in nature and theres no solution to it. I need to accept setbacks but if only setbacks came from exposure, then what?