Advice Request / Complex PTSD & Chronic Pain

Hi all!

I have CPTSD, am a huge Pete Walker fan, and my body hurts ALL THE TIME.

I'm hoping to get some guidance from all of you kind people!

backstory:

I have had chronic neck pain for 12 years. It was off and on for many years - mostly kept under control by oral steroids. Since 2019 the pain has been non-stop. I had cervical fusion neck surgery in 2020 but the pain has not gone away. It's mostly in my neck, right shoulder, right arm etc. I now have new issues with my lower back, hips. I am in PT and once the exercises started helping my lower back, my neck got worse and my knee started to hurt. MRIs show spondylolisthesis and other such issues in both neck and lumbar spine, nerve conduction test showed chronic C7 issues and carpal tunnel in both wrists. Oh and now I get stress rashes on stomach and back every so often. I have tried PT, massage, acupuncture, epsom salt baths, nutritionist, TMS (Transcranial magnetic stimulation), OTC drugs, aromatherapy, millions of lidocaine patches....

I have had chronic mental health issues for most of my life. I was severely neglected from the time I was born, growin up in a house with substance abuse and violence. I had new traumas in 2018, 2019 and within the last 9 months I have lost my brother, father and mother. Because my neglect was pre-verbal (in utero) and lasted for years, it's been very difficult to "process" my trauma. I am currently working on Internal Family Systems and EMDR with my therapist. I hold my breath, clench my teeth and fists, pull my shoulders up - rarely ever relaxing.​

I'm now to the point where all movement hurts, foam rolling and certain PT stretches/exercises make me feel overwhelmed with upsetting emotions.

SO when I read about "body armouring" in the book Complex PTSD by Pete Walker it really resonated with me. (That book has been life changing!) I then read The Body Keeps the Score by Dr. Bessel van der Kolk which was very informative.

Long story short, I feel like was already on board with the general concept of TMS prior to ever finding this website.

I got the audiobook version of Dr Sarno'a The Divided Mind and although it was helpful, I found it to be a bit too simplistic and did not seem evidence based. I thought the distraction idea was interesting. There were a few things that I'm probably not going to buy into like "The principal emotion is my repressed ANGER" and stopping all medical care. I had read a review saying that it contained actual steps for what to do but I only heard a few tips and one basic list. Apparently the audio book is missing a fair amount of content so maybe I missed some good stuff. Overall I think what Dr Sarno is saying fits in really well with all the other stuff I have been learning about the relationship between the brain and body.

Whenever my therapist recommends a book/article/resource etc she says "take what you like, leave the rest." Dr Sarno seems to be saying that for his program to work, you have to take it ALL.

I purchased the Unlearn Your Pain workbook by Howard Schubiner and *really* like his approach BUT OMG, that workbook was NOT made for someone with ADD. I found the "workbook" sections to be very non-linear to the point of being disorganized. My reading comprehension is crap right now and I find myself completely overwhelmed with things like the long text digressions within the daily exercises, instructions for things to do every day AFTER the entire week of day 1-7 worksheets, and descriptions of daily activities and then saying "you don't have to do everything"

I have SO many things to address and am getting so overwhelmed with all the different approaches. I am putting so much pressure on myself to pick the "right" course of action that I get fully immobilized.

SO these are the options I'm considering:

• keep trying with Unlearn Your Pain and sort out that program
• OR are there any better organized versions of Unlearn Your Pain out there?
• i could do the Structured Educational Program but, again, Dr Sarno isn't my fav
• forget the pain aspect and go all in on Internal Family Systems, EMDR and reducing my inner critic and pain will reduce --- this is what one trauma specialist told me would happen - but I can't even imagine healing my heart and my mind when I feel so old and disabled.
• look into something more somatic therapy?

caveats:
must be evidence based
room for skeptics or "take what you like, leave the rest"

What do you think? Any input would be greatly appreciated!

Hope you are all feeling good and sleeping well

 

I have tried Unlearn Your Pain and found it super overwhelming. Personally I like the SEP much more, but I have dine the entire program over 3 months because some days are LONG.
I think if you are doing EMDR or Internal Family Systems and have done the SEP then you are doing well for your internal investigations. Both address the mind-body connection, both will address your self-critic and help you recognize thought patterns which can create tension, if this is difficult to do on your own.

To help yourself unwind, you might try revisiting days 39-42 of the SEP where there are explorations of mindfulness in various ways, learning to slowly find time to do things without purpose that are meant to be relaxing (even if they initially are not).
To ease you mind about choices; none of the things you mention are inherently “bad” or “right” choices. They can be what you are going to try, stick with for a time and leave behind if they don’t or no longer serve you. Either type of therapy can be helpful depending on how open and vulnerable you can allow yourself to be with the therapist and yourself. Go slow. You don’t have to make all decisions now. Either choose a self method lime SEP again or Schubiner OR one or the other therapies. I was super overwhelmed, but making one decision at a time was helpful. Realizing that my fears of right and wrong choices were part of that super legalistic black/white TMS thought pattern helped free me of those worries. It also helped me see that doing “everything” to heal in a rushed manner was also a personality aspect (with everything I do!) so I intentionally slowed my TMS work down, less “doing” and more utilizing the skills learned each day - noticing emotions, noticing thought patterns, feeling in my body.
I think doing the physical to teach your brain to feel safe doing so is fine, Sarno said to get back to doing.. but if PT isn’t working for you know you don’t have to go now. You can go for walks, or ride a stationary bike, or do yoga or whatever you feel safe doing until you feel comfortable doing more. The idea is that you do these things not to heal TMS but to to move and exercise.
As your anxiety lowers and your nervous system begins to regulate you should feel less overwhelm and find making decisions a bit less stressful.
Good luck!

 

It sounds like you have a great deal of self awareness but the info. in the mind body world can be quite overwhelming! Based on everything you wrote, I'd suggest a combination of an emotions/trauma based therapy like IFS, ISTDP or EMDR (the most important factor is that you click with the therapist and feel safe with them etc.) and then some tms coaching to help you organize a program that is specifically customized for you. They can cut to the chase basically and assess the areas in which you need help. Another option I highly recommend is Dr. Dan Ratner's group seminars....It's part educational, part an organizing system, and part group support. If you suffer from any kind of doubt, he is the best with that. Try to keep things as simple as possible for yourself, find what speaks to you, and just stick with it. You will definitely make progress that way.

 

"I hold my breath, clench my teeth and fists, pull my shoulders up - rarely ever relaxing."

Learning how to restore belly breathing, unclenching and relaxing the jaw, and relaxing the shoulders down in real time can quickly bring down a flare. A TMS pain almost kept me in bed this morning but I recognized the signs and responded with a somatic + TMS combo and felt relief.

The stresses and worries are the most pervasive and the physical stuff is pretty unpredictable and frustrating. Keeping tabs on the stressors helps you and your body feel safer together and more connected.

 

Don't be so sure there is no hidden anger involved. I'm new to this as well and I denied that. I thought, well, Ok, mine is fear not anger.
But on my second day of journaling (yesterday), I decided I'd write about what I'm angry about (which I didn't think was anything) and omg, it evidently was so hidden that even writing, "I'm angry about _____. " caused massive rapid heart beat. So badly I had to stop after 5 minutes.
It was so overwhelming that I said "give me my symptoms back. If they are protecting me I rather have them."
I swear to you I was sure I had no anger.

So who knows?