A 'silent blockade': a hidden barrier that stops mind/body approaches from working effectively

I have been trying to help someone who has a family history of what can be a variable but sometimes seriously debilitating medical condition. They have some severe symptoms that fit with that particular medical condition, but they won't get themselves checked out to get the all clear and I know that they live in an underlying fear of having the same condition as their family member. I also know that they haven't been checked out but they are avoiding admitting that they haven't to other people (who think they have been checked out).

The person concerned has been endeavouring to do mind/body/TMS work to not much, if any, avail and they have wanted my advice. I'm going to do my best to point out to them that this could well be the 'elephant in the room' that is stopping them from losing their mind/body/TMS symptoms albeit I don't think they will listen and they will 'shoot the messenger'. I really do understand that they don't want to go down a 'medical rabbit hole' and why, but it goes against Dr Sarno's advice and I more than suspect that the issue is really holding them back.

I'm posting up about this (with the following, below) because personally, I think that this issue may be more prevalent than one might think, and in case it might help someone get to where they need to be in order to lose their mind/body/TMS symptoms.

The psychological Consequences of Skipping Medical Checks:

If a medical cause is feared but never properly excluded through an evaluation, underlying anxiety and doubt persist. This leaves the nervous system in a state of hypervigilance—constantly scanning for evidence of physical danger, which undermines the mind/body approach. Unchecked fear means:

• The brain does not receive the reassurance needed to shift its attention away from symptoms.
  
  
• Mind/body strategies (such as reframing pain and reducing fear) struggle to work because threat perception remains unresolved.
  
  
• The person may engage in contradictory behavior, trying to convince themselves of a psychological cause while secretly fearing something catastrophic.

Expert Consensus
Mind/body specialists like Dr. Sarno and leading TMS authors explicitly recommend that chronic pain sufferers rule out serious medical conditions first. Only once confident in benign findings should mind/body treatments begin. Avoiding this step is a “silent blockade”—the mind/body approach cannot produce calm, safety, or symptom reduction if the brain is still in protective mode.

Summary
Failing to get fully checked out when medical fear is high blocks mind/body recovery because doubt, anxiety, and unaddressed threat signals remain active in the brain, making it impossible for psychological re-education and symptom reduction strategies to be effective. Proper medical reassurance is foundational for successful mind/body work.

Footnote:

I do of course appreciate that an extremely common barrier to doing mind/body/TMS work is that the TMSer doesn't accept that their symptoms are created by the brain and so very often they go for medical opinion after medical opinion, essentially 'down the medical rabbit hole' looking for the disease/medical condition that is causing their pain or other symptoms... and just can't stop.

I do also appreciate TMSers can also experience numerous symptoms and become overwhelmed by the amount of opinion, medical tests etc., that they would need to have to get checked out medically for every symptom they experience, so it's difficult for them to know where to draw the line.

There are, however, numerous postings about the above difficulties, so I've not attempted to deal with those issues in this posting/thread.

 

My Mum had a combination of TMS and serious physical issues (perhaps caused by lifelong anxiety, perhaps not). My MIL also had TMS which nobody in the family (including herself) believed was TMS and she also had some serious medical conditions caused by lifestyle which eventually where her very quick demise. I had to let it all go. She had very strong beliefs that were not healthy nor in her best interest to her mental health, and I had to recognize that she was choosing her own path. Even when she occasionally asked for help or even considered getting help and we'd offer her the tools she would not follow through. So I just let it go. Luckily she didn't complain much about her situation because she'd then have to admit to the health issues which she denied (but we found clearly stated on her medical records which were in her possession).
It was sad to see it happen. I think she simply believed it "wouldn't happen to her". We just supported her, and praised her for actually choosing not to do the work and get well and get treatment when she decided she simply didn't want to and she chose to peacefully pass away. The situation has been incredibly hard on the family, (this was very recent) but we all realize that you can "lead a horse to water, but you can't make them drink".

My own Mum clearly had TMS and serious medical issues for many years. She could not grasp the idea behind TMS - she was not an very emotionally mature person, and asking her to get in touch with her mind and body was asking a lot of her. She at least tried and "got" mindfulness a bit more and her care facility really tried to work on that with her (they learned about TMS from me and talk to their clients about it) but again, she was only willing to do so much, and that's as far as they got. So we just keep going with what she was comfortable with (which was avoiding any emotional discussions at all cost

My take on it, you can only do so much. You need to take into consideration that the other person is 100% responsible for their actions and if they can't or won't, there isn't anything you can do but be kind and supportive without feeding "the beast". You're a good kind soul, @BloodMoon

 

@Cactusflower With my sincere condolences, I thank you for sharing your experiences regarding your MIL and Mum and thank you too for your kind words and advice. I consider the person I am going to try and help to be a friend and to alienate them will be a considerable loss to me if they should 'shoot the messenger' and want to avoid me afterwards or otherwise alter our relationship, but I'm going to imagine being 'surrounded by a bubble of protection' and know that I can better live with myself having tried my best to gently explain what I think is going on. As you say, 'you can lead a horse to water...' One of the things that you've made me see is some black and white thinking on my part, which I am pleased to have realised before I discuss this issue with them... that is, they may be experiencing a combination of TMS and suffering a health condition, not necessarily one or the other. (I guess that was because I am obviously wanting them to 'only' be experiencing TMS.)

Thank you too, @JanAtheCPA for your supportive words on this topic.

My father had late onset RA (his mother had it too) and they both were on meds for it, but neither of them were seriously debilitated by it and I'm convinced that, as with you, their mindset had such a lot to do with it, to include an approach to life of moderation in all things. My father, for instance, lived till he was almost 95. (By choice) he was living on his own, enjoying watching his beloved sport on TV, reading and memorising poetry, eating healthily and generally looking after himself, driving his little car, popping out for a walk everyday to his local shops to buy his daily newspaper and get a few groceries, etc., right up until having to suddenly go into hospital for other reasons that were nothing to do with his RA... and his eventual death in hospital wasn't due to those reasons but due to the covid-19 that he contracted there.

 

@BloodMoon,
You are always so helpful and you look out for everybody. I’m sure if you really are friends with this person they would love to hear your thoughts.

 

Thank you for your kind words, @Diana-M.

Well, from my side we're friends and I guess I shall learn whether it's the same from their side. That said, however, I think it's rare to find a friendship that isn't pretty conditional. With 'friendships' I've found that even when asked for help, if you don't mirror what they are wanting you to say, then you're liable to be toast (particularly when it's concerning an emotive issue such as this) and toast for good (because even if they may at some point come round to your way of thinking and/or recognise that you meant well, they can't lose face and apologise and that, of course, may also be because you didn't really matter to them much, if at all). I know I sound cynical, but imo I'm just a realist. Anyway, we shall see... I don't believe that they are going to love hearing my thoughts, but, you never know, I might find myself flabbergasted (gobsmacked) by a somewhat receptive response.

 

There is a lot going on here with you and friendship. Maybe you shouldn’t assume all friendships are conditional? At any rate, if this were my friend, I’d just have a heart to heart private discussion with them about your concerns. But even after you discuss it, it’s possible your friend might not want to follow your advice. But at least you got it off your mind. I think any true friend of yours would know you have the best intentions. That’s pretty obvious about you.

I think after an initial visit with a primary care provider to clear for disease or cancer, etc., I don’t know if pursuing via specialists in today’s western medicine—especially with neurologists, has been helpful to many of the people I’ve read about on the forum. I think neurologists can tell people some scary things that the person then has to overcome to get back on track with a TMS healing. Many people here on the forum have defied what doctors have sworn was true. I was cleared by a primary doctor, but elected not to go to a neurologist for that reason. And as time went on, my list of evidence grew and my symptoms proved to me they were TMS. I had one of my numb cramped hands randomly get completely better for a few weeks, then return to cramped. I’ve had all sorts of things happen that have taken my fear away of my symptoms—especially reading all the stories here and realizing that TMS can, in fact, create some pretty drastic symptoms—especially with hypersensitive nervous systems. Many of my neurological symptoms have slowly been subsiding, like burning and buzzing, etc. This has also really helped prove to me I’m on the right track, and wouldn’t be true of a progressive disease.

At any rate, when it’s all said and done, we each have to make our own best calculated decisions about how to heal. Maybe your friend isn’t getting better fast for a bunch of reasons, some that you don’t even know about. Who knows? Also, like Cactus said elsewhere on the forum recently, a longer journey is beneficial in a lot of ways. Your life just gets better and better, despite remaining symptoms. I know that’s true for me.

 

Yep, it probably goes with the territory of being let down a lot in my life by others.

Maybe I shouldn't but, sadly for me, that's been my experience. But strangely enough I always have some hope that I'll find people to be different to that.

Indeed, that's what I've said I'm going to do.

Yes, exactly.

Of course! They probably won't.

True, and maybe they will choose to share something in our discussion when we have it, but maybe not. I appreciate we're all entitled to keep stuff private.

Well, I'm afraid, I'm one of those that it has helped. Having done so might actually end up saving my life, depending on how things progress.

I've never written about this on the forums before (for one thing because I knew that it would just be pointed out by some that I'm a rare case and 'scaremongering' or whatever, and so I didn't want to get embroiled), but a neurologist I was referred to sent me for an MRI and it was discovered that I have a fairly rare tumour (a schwannoma) on a nerve on my spine that needs to be regularly monitored because it could turn cancerous and cause me other problems.

I appreciate that that may have been your and/or others' experience with them, but my personal experience is that out of all the medical specialists I have been referred to over the years, I have found that they are the most likely to tell a patient that their symptoms are 'psychogenic'. I have experience of them due to another fairly rare neurological condition that I have that affects my eyes.

Certainly over here in the UK neurologists are notorious generally for 'thinking psychological'. Indeed, an ex-colleague of mine whose husband was a GP said in conversation with me at an office 'get together' that he had found that to be the case.

To be clear, I am not saying any of the above to try and convince you personally to seek the opinion of a neurologist. And, tbh up until now I had thought that you had been to see one, and I appreciate that it's actually none of my business whether you've seen a neurologist or not. You haven't asked me for my help, unlike my friend that I mentioned about in my opening posting.

Anyway, what I was saying in my original posting is that with some people it might be that not getting themselves checked out medically may be acting as a barrier. I think if I were out of order about that Jan would have put me straight, but she's written that she agrees with me 1000%. I just wanted to shine a light of awareness, that's all.

Yes, of course, I agree mind/body/TMS can create some pretty drastic symptoms. I often say this to people on the forums. As you know, I was bed ridden for a total of circa 18 months with neurological-like symptoms plus severe pain and severe muscle spasms, unable to stand or walk because of them, and virtually housebound for many years. To go out I needed to use a combination of a wheelchair and a rollator/walker.

And, I am genuinely glad to hear that your symptoms have been subsiding.

I agree.

Yes, I'm one of them; amongst a myriad of symptoms, I was told by a back specialist that my lower back pain, radiating buttock pain and sciatica-like pain were due to narrowed, dried out discs and bone spurs, when they were not.

My journey out of TMS also certainly hasn't been short (though like most people I would like it to be). I am a proponent of taking baby steps and have often talked about the merits of the 'scenic route' on these forums, so no convincing needed here; I am in agreement with Cactus.

 

@BloodMoon
I totally understand your skepticism about people and their friendship. I’ve been mostly let down, too. And like you— I always have a secret hope that people will surprise me. But, usually they don’t. I wish I could get better at picking them.

I know you’ve had quite the journey through the medical gauntlet. (And that’s such a blessing it saved your life.) You had my total respect as a brave soul and warrior before, and even more so now. That’s scary about the schwannoma! I hope it stays controllable. As well as the Ocular Myasthenia Gravis. You have really been through some hard things! And still are. I’m so sorry to hear it.

I wish you the best on this circumstance with your friend. That’s a hard position to be in. I hope your friend doesn’t toast you. That would be really unfair.

 

@Diana-M thank you for your good wishes. I have altered my last reply above just to take out some of the graphic details of my medical situation (and to cut things down as I tend to be far too verbose). I don't mind that forum members will have been able to see them, but I don't want them there permanently. Talking of deleting postings, I deleted the one to you on Rusty Red's 'Those constant symptoms...' thread because I went off topic. I'm pleased though that you saw it and it was helpful and of some comfort. You said that you might start a new thread about the topic of 'disappointment'; if you do, I expect I will contribute.