Abdominophrenic Dyssynergia and Pelvic Floor Dysfunction

I've been told the reason why I feel it hard to breathe when I inhale is because I have dyssynergia of breathing (APD/PFD). Basically, from what I understand, instead of my diaphragm moving directly down it's pushing on my abdominal wall and isn't relaxing. It's a horrid feeling and I can't relax; I feel suffocation when I breathe. I previously had an ultrasound and I've been told my diaphragm is 'functionally' fine i.e. no issue with the organ. I've been told I need physio sessions to train my diaphragm to move correctly and, although rare, this usually happens after a period of stress/trauma. I understand the need for physio but the way I see it is that the signals for diaphragm movement comes from the brain so ADP/PFD is in fact TMS/MBS. I have not seen Sarno et. al. or any reference to dyssynergia on TMS Wiki so I do wonder if anyone else on this forum has this symptom.

Has anyone here had/has dyssynergia and resolved it as purely a psychological issue? I feel physical therapy may help facilitate symptomatic improvement so healing from both angles seems like the logical way forward.

 

Hi, Mike,

This is from page 51 of Hope and Help for Your Nerves, by Claire Weekes. This book is PHENOMENAL! It explains so much. I like to read it over and over.

INABILITY TO TAKE A DEEP BREATH
Just as tension causes scalp muscles to spasm and pain, so does it cause chest and lung muscles to spasm and the patient to complain that he cannot expand his chest sufficiently to take in a deep breath. He may walk around the house sighing until asked by an exasperated relative to “Please stop those lamentations.” The effect of such spasm is temporary and is released with relief from tension. It does not harm your chest. Your chest is not diseased. You will always get enough breath, although sometimes perhaps not as freely as you would like.

LET YOUR “BREATHING CENTER” DO THE WORK Some patients are so afraid they will suffocate that they struggle and fight for breath, believing that unless they win the battle the end is near. I explain to these people that nature was not so careless as to put such a responsibility in their hands. How do they think they breathe while asleep? This question never fails to surprise them. We have a “breathing center” in our brain which automatically regulates our breathing by responding to changing levels of carbon dioxide in our blood. To illustrate how this center works, I ask one of these apprehensive people to see how long he can hold his breath, how long he can actually stop breathing. To his surprise he finds that after about half a minute he is forced to breathe again. When he realizes that there is a control beyond his control waiting to protect him, he begins to see the folly of struggling so desperately to “take a deep breath.” He should breathe as shallowly as he feels he must and not be so concerned with what will happen. He can safely rely on his respiratory center to cope with the difficulty in its own way. It will not fail him.

Here’s the whole book:


My opinion is you don’t need physio. You just need to heal your anxiety.

 

Thanks, Diana. I did listen to that audio book. It’s a good one. I’ve listened and read so many books lately that I’ve got information overload. The symptom I’m feeling doesn’t feel like anxiety. I feel very bloated in my abdomen and each breath is restricted. I know I won’t suffocate and die. It’s just that every time I inhale the diaphragm feels very restricted in movement. It’s very uncomfortable but I don’t fear the sensation. It won’t kill me it’s just so distressing as I can’t relax. That sensation makes me feel very irritable but I am not anxious. I think, perhaps, it’s to do with my body being in freeze mode ie danger, danger, danger. From a TMS perspective I think the symptom will go away once the brain feels safe.

 

This is one of my symptoms.
The "bloating" as my physio explains it, is simply gravity, so don't worry much about it. My own stomach is relatively flat when I wake up, and by the end of the evening I look fat.

Claire Weekes is absolutely right: and @Diana-M is correct to point this out - this is anxiety breathing and part of the fight/flight mechanism. You are stuck in fight/flight which is absolutely part of TMS. This is way your own nervous system is trying to keep you safe. It's very similar to the startle reflex in infants.

I know you don't feel anxious, but I guarantee, you are anxious and stressed. That's what TMS is all about. You are simply not aware of this state because it has become the normal default for you and you've probably been here for a very long time.
As part of my own healing, I utilize a specific form of physio therapy that recognizes this type of breathing. I'll offer you their very first technique to begin to be aware and be able to drop into your body and simply breathe.

Sit in a chair, with upright posture. Not stiff, but similar to the posture prompted in meditation. Relaxed but upright.
Close your eyes and simply breathe. Notice the cool air going in, warm air going out. Notice if you breathe through your noise or mouth. Slowly focus on nasal breathing if you use your mouth.
No forcing, no worrying if it's right or wrong. You are noticing which is a passive state.
Keep this breathing up for 10 or more breaths, and see if your exhale naturally slows down. Don't change or force it purposefully. Keep breathing.
Now put your attention on the top of your head, and simply notice the skin of your scalp. Can you sense that it is alive? Maybe you sense a tingle, or the air around you, or the temperature. Breathe 3-4 more breaths without counting. The number of breaths doesn't matter. Slowly.
Now notice your eyes. Can you make slow and gentle mental circles around your eyes - almost like a mental massage. Breathe 3-4 more times, slowly. Don't try to relax, don't try anything except to gently follow instructions. Now move this method to your mouth and then jaw.

After this, move your attention to your chest.
Can you notice without changing anything at all, that the muscles of your chest almost imperceptibly move when you breathe. Keep breathing, keep noticing. Notice now the sides of your chest. Then notice your upper back and see if you feel anything at all move or have any sensation at all. Just breathe slowly in and out. Change nothing, no forcing. Notice gently.

Now drop your attention to the bottom of the rib cage and do the same exercise, now drop it to your belly. When focusing in the belly do not force any air into the belly. Just notice. Nothing more.

This takes 10-20 minutes to complete. Do it sitting for a week or two then try different positions like laying with knees up and small pillow under head, or knees over the side of bed or sofa...

If you desire to change anything, force anything etc. that is anxiety. Notice if your mind worries if you are doing this "right", or wants wander or anything else. All of this is OK, but signs of anxiety and that is perfectly fine. You can be anxious, it's no big deal.

This exercise is nothing but a form of gentle brain retraining through noticing.

 

It’s weird all the things that anxiety can do. People don’t realize! If somebody gets TMS, it’s actually a pretty advanced form of anxiety that has built up for a long time. That’s why everyone preaches Claire Weekes. She’s probably the only book you need at first. Because you won’t get anywhere until your nervous system calms down. And that takes some time.

 

I really wanted to like Claire Weekes with all the recommendations here. I tried to read her book. Maybe it was the outdated language, I'm not sure, but I did okay with Sarno. I'm going to try again with the audio and see if it helps.

 

I agree and perhaps I missed something. I thought it was okay but didn’t really tell me something I didn’t already know. I was already well versed in mindfulness and I felt that her book is based on that ie float through your emotions, don’t resist them and allow them to pass in a nonjudgmental way.

 

Makes so much sense that different individuals resonate with different approaches and also dependent on how much you have already been exposed to material on the topic.
There are so many books out there and of course a number of them suggesting similar techniques.

A lot of people seem to like the Dare approach -- “Dare: The New Way to End Anxiety and Stop Panic Attacks” by Barry McDonagh

I've had so much exposure to all kinds of techniques/books/theories through years of academic study/degrees in psych, so all of it makes so much sense theoretically....
alas it is the actual integration and consistent practice that seems to be the area where I have to keep reminding myself to refocus.

Oh, also it seems a lot of people have really loved the Dare app -- anyone tried it?

 

@Rusty Red @mikeinlondon
Hmmm. You guys have got me thinking. I know she is really old-fashioned even for someone like me. lol And I have battled anxiety for my whole life — And have studied a lot about it— but somehow her book seemed to help me realize just how advanced my anxiety had become. It helped me give myself a break. She made me realize I’m going to need a lot of patience and I’m going to need to wait until this adrenaline stops surging. For several months, I listened to her every day. Now I read her about once a week. So, I’ve been reading her book(s) for a year. I don’t think I’m the only one who has really benefited from her.

If she doesn’t appeal to you, she doesn’t. Have you looked into the DARE method? It has an app and a book. The book is: DARE, the new way to stop anxiety, by Barry McDonagh.

I guess the bottom line thing to know is that every time you’re afraid or worried about your symptoms (or anything), you’re pumping yourself full of adrenaline. And, you’re already overloaded.

 

Diana - Don’t get me wrong, I think her book is golden. However, many years ago I had a severe stammer (which I know now believe to be TMS). It was debilitating and couldn’t express myself. I resolved it on my own by learning how the mind works. I read a lot of books on the mind and so I already resonated with what she said because, it seems, her book has been used as the basis for updated books on anxiety etc. Now, when I look back on my life, I’m astounded just how many TMS symptoms I experienced. I had no idea of TMS and this journey I’m on now makes so much sense to me. Sarno says that for severe cases of TMS he would refer them to psychotherapy. I’m doing exactly that and due to start EMDR this weekend.

 

@JanAtheCPA Mind Your Body was one of the first TMS books I bought! I really like Nicole.

@Diana-M I did start DARE. I've been bouncing around through different books lately, non-fiction and fiction. I think I might try Claire Weekes again in audio, I feel like I've seen a lot of people have benefited from her audio tapes.

 

That's great, @mikeinlondon! Will be eager to hear how your experience goes with EMDR.

 

Mike,

Me too! When I started my TMS journey about a year ago, I wrote down all of my incidents of TMS, and I realized they were pretty much back-to-back my whole life with only sometimes a year in between each one! I think I’ve had 15 episodes.

That’s exciting you are starting therapy! With what you’ve shared about your life I know that therapy will help you— but just like anything it’s not a quick fix. Although EMDR is probably the quickest. It can be. I’ve had about 10 years of therapy all different kinds. My most recent was three years of Internal Family Systems, which supposedly is very useful for healing from TMS. It was the deepest therapy I’ve ever done and it was very painful, draining, I think it contributed to my anxiety level. But I am using what I learned from it now and I think it was beneficial. I tried EMDR once briefly. I kind of wish I could try it again. It helped! Please let us know how it’s going— if you feel like it.