A link between TMS and hyperawareness OCD?

[Skylark7]

Has anyone else observed a sort of "Venn diagram" overlap between chronic pain and hyperawareness/somatic OCD? I'm talking about the factors and causes common to both, as well as "exposure" treatments common to both.

With "pure O" hyperawareness/somatic OCD, you're acutely aware of some physical sensation and can't disengage from it. Your constant fear that the sensation will last forever limits your life and causes you great distress.

With chronic pain, you're also acutely aware of a physical sensation. In cases without nerve or tissue damage and few effective treatments (fibromyalgia, lower back pain, TMJ, headaches etc), your constant fear that the pain will last forever limits your life and causes you great distress.

But it seems possible that ONE sensation can cause both conditions in one person at the same time: You have a chronic pain, numbness, burning, tingling etc. (Man, my ________ is bugging me!) AND a somatic hyperawareness of that sensation (What if it never goes away? I can't stand it. What if it never goes away?? I can't stand it!!)

Both chronic pain and OCD involve interplays between biology/genetics and life experiences such as trauma. Both worsen with stress. And both can improve with cognitive therapies that lessen the brain's fear response.

The fact that psychotherapy can help with chronic pain doesn't mean pain isn't "real." It just recognizes that anxiety, grief and anger make the subconscious brain hypersensitive, reinforcing its need to "protect" you by hijacking your attention.

Common psychological techniques for pain and OCD include exposure therapies. Yes, you're ALREADY "exposed" to these sensations constantly — that's the problem! But the trick is to make the brain indifferent to the exposure. The less your brain cares about a sensation (or anything, really), the less attention it will give it and the less severe the discomfort will be.

Of course, we've known for decades that one's emotional state can aggravate or minimize chronic pain and OCD/anxiety/depression. That's nothing new.

But after spending years seeking help for a chronic neuropathic pain condition so intrusive in my mind that I can barely function, I realize there's lots of parallel information on both conditions separately but nothing that combines them. And I feel like combining the treatment for both — since it's pretty similar — could be really helpful for someone like me.

Am I alone?

TL;DR: Can we kill two birds with one stone by using the same cognitive treatments for hyperawareness/somatic OCD and chronic pain?

Some articles to illustrate what I mean:

https://ocdspecialists.net/ocd-themes/hyperawareness-ocd-somatosensory-ocd

https://iocdf.org/about-ocd/treatment/erp/

https://www.treatmyocd.com/blog/somatic-ocd-exposures-explanation-examples (What Are Somatic OCD Exposures? Explanation and Examples)

https://uspainfoundation.org/blog/six-emotions-that-drive-chronic-pain/

Apologies for the weird formatting of links.

 

[JanAtheCPA]

TL;DR: Can we kill two birds with one stone by using the same cognitive treatments for hyperawareness/somatic OCD and chronic pain?

In short, yes. there have been multiple forum discussions in the past which consider OCD, from mild to extreme, to be a form of TMS, or what Dr. Sarno termed "a TMS equivalent" along with anxiety and depression. Although when it comes to anxiety, we've also had many chicken vs. egg discussions, but I won't digress.

TL;DR: - I did not link through to any of those articles, because for what we try to accomplish here, I feel like you're overthinking it. Which, let's be fair, is kind of an OCD thing, right?

Both chronic pain and OCD involve interplays between biology/genetics and life experiences such as trauma. Both worsen with stress. And both can improve with cognitive therapies that lessen the brain's fear response.

On this forum we reject any arguments that consider genetics or biology to be a factor in chronic pain, with ONE exception, which applies to ALL humans, which is that the TMS brain mechanism exists in all humans.

The TMS mechanism evolved eons ago as a survival mechanism which worked well for most of those eons, because the world was still very primitive for most of that time. The problem is that the TMS mechanism does not work at all well in today's modern world. And don't forget, even if we define "modern" as going back to the advent of what we now call "ancient civilizations" which, one might argue, brought about the initial stresses of having to conform to increasingly complex rules, and to learn increasingly complex technologies, and to deal with the fact that humans congregating together in large numbers invariably ruin the environment they are in.... even if we go back, say, 6 or even 8 thousand years ago, this is still a microscopic blip on the timeline of the development of homo sapiens. Bottom line: biologically, or physiologically and neuroscientifically, we are still dealing with an ancient brain mechanism that still thinks we live in a physically dangerous wilderness. This essential disconnect underpins the conditions that we describe as TMS. Today's TMS is simply our ancient survival mechanism gone haywire.

Therefore - trying to apply "biology" as a distinction between individuals regarding chronic pain is not relevant.

Genetics is also irrelevant when it comes to the brain's use of chronic pain or other chronic symptoms as a fear-based survival mechanism. (I refer you to Nicole Sach's personal story about her genetic condition- just do a web search on "nicole sachs spondylolisthesis"). What we DO see for sure is that the personality characteristics of perfectionism, goodism, self-judgement, and anxiety can all be "inherited" from our families. Generational trauma is recent terminology, but the first time I saw it explained in professional terms, it made total sense to me from our TMS point of view. Social justice has an enormous component of generational trauma which demands recognition and mitigation, but oops - that's another digression.

But after spending years seeking help for a chronic neuropathic pain condition so intrusive in my mind that I can barely function, I realize there's lots of parallel information on both conditions separately but nothing that combines them. And I feel like combining the treatment for both — since it's pretty similar — could be really helpful for someone like me.

Okay, so I get this, and intellectually I agree with your premise. I also see that intellectually you completely understand the mechanism and how it works. The missing element is any sign of understanding that the way out is to give in to emotional vulnerability. And here is where it gets tough.

I've been doing this for 13 years, and the most emotionally resistant folks I've met are the ones with significant OCD. Intellectual understanding just ain't gonna do it. But emotional vulnerability is a completely alien concept to someone who is suffering from a past experience of severe trauma, especially if that trauma was laid down in childhood. Tragically, the severely traumatized brain is highly skilled at deflecting emotional vulnerability, which is why psychotherapy ends up being an exercise in frustration for both the patient and the therapist.

I believe it can be done, but the magic bullet to initialize the essential emotional breakthrough is as yet unknown. It seems that recent research into therapeutically supervised microdose psychedelics is is an attempt to find this breakthrough. And when I say "breakthrough" I refer only to the initial breaking down of the old walls. I firmly believe that intensive emotionally-based therapy MUST follow.

Mind you, like the vast majority of individuals participating on this forum, I have no professional certification for stating my beliefs. Just a dozen years of observations and participation and constant non-professional study on the topic.

 

[Baseball65]

TL;DR: - I did not link through to any of those articles, because for what we try to accomplish here, I feel like you're overthinking it. Which, let's be fair, is kind of an OCD thing, right?

Yep. I have had both. No amount of renaming and relabeling with new therapeutic terms can minimize the Hellish circular thinking of OCD, but I could see it making it worse. ...making 'special versions' reminds me of the people who show up on the forum with new fancy diagnoses.

There's really only two things going on with OCD... Intrusive thoughts and ritualized actions. Doing MORE of either will only make it worse, like pouring gas on a fire.
The Thoughts trigger the actions....the sufferer thinks that going through the ritual will somehow minimize their anxiety..it is called 'binding the anxiety' but it doesn't...It just keeps you distracted, like the pain in TMS.

In fact, they are using the same exact mechanism. Different symptom, same outcome.

And just like when we recover from TMS we have an overwhelming sense of freedom and joy, realizing that we don't have to respond to 'the voice' or 'the tyrant' is liberating. I actually joined an OCD support group, but all they seemed to do was TALK about OCD..when I mentioned a very quick and thorough recovery method, I got zero replies or interest. Therapists are making a fortune! It WAS sponsored by a for-profit organization...who you gonna believe? The crusty old constuction worker or a slick young PhD.

We all know what B.S. is ?
Well an M.S. is 'more of the same'
and a PhD? 'Piled Higher and Deeper'

OCD is mental TMS and TMS is OCD of the Body.

anybody tired of their OCD can read my post on 'Stop Therapy' by searching it here on the forum...works like a charm to banish OCD