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Dr. Schechter's Blog Blog 9: TMS/Chronic Pain as an Attention SURPLUS Disorder

Think Away Your Pain Blog

Automated blog by David Schechter, MD
Originally posted: January 4, 2015

TMS, an Attention Surplus Disorder?

ADD or attention deficit disorder is a medical term for individuals who have an inability to focus or remain focused on a task for a period of time.

This got me to thinking: TMS, in a sense is a surplus of attention, or an ASD (Attention Surplus Disorder). This can be seen on several levels. People with TMS are VERY focused on the disorder, looking for a solution, focusing on symptoms, obsessing, if you will. At the brain level, f-MRI (Functional MRI) imaging studies suggest that chronic pain has a component of overuse or hyperfunction of the anterior cingulate cortex and medial front cortex and associated structures... areas that are related to attention. Yes, the attention is to the pain, and it's a vicious feedback neural loop that has developed.

So what's the answer?: It's to lower the attention-- as Dr. Sarno first said 30+ years ago, "Think Psychological, not Physical"... The consequence of this is a change of focus. I might say, it's not bio-mechanical, it's bio-psycho-social. I might describe a block and shift technique to focus away from pain sensations and towards other aspects of one's life. You can't just 'turn it off'. It gets turned off because of new understanding and lowering anxiety and fear about the significance of the physical sensation.

The result is the same-- successful treatment involves a person focusing LESS on the pain, the TMS, and more on his/her life. This does involve managing stress and emotions better, processing tension, just living more fully for those that have retreated into a shell of their former selves

The attention levels return to normal, rebalance, and the patient is improved.

Ref: http://www.rsds.org/pdfsall/confere...r evoked by cognitive and emotional tasks.pdf
 
I love this because its so true. Attention Surplus Disorder - I can apply that to all sorts of things - like when I'm overcome with fear or pessimism. Pain has its own roar of demand. But I found out how to shift my attention in very small increments so I could feel some success in NOT paying attention to the pain and eventually I was able to build up more sustainability of having my attention go elsewhere.
Thanks for the post!
 
A friend came here for dinner last night and we shifted our attention from his personal problems by
watching a Monty Python movie, The Life of Brian. He just began divorce proceedings after 25 year of marriage
and they have a son of high school age. He finds relief in laughing and that film made us both laugh a lot.

It looks like the marriage was in trouble from the start and the reason seems to be that the wife wants to
dominate him. He's an easy-going guy so the relationship is not easy. They disagree on how to raise their son
and the boy began beating up my friend. The boy is twice my friend's size so he tried defending himself
and the wife called the cops. My friend was arrested for suspicion of child abuse and goes to court next week for that.

I only mention all this because I think many marriages and other relationships are problems for people posting with
TMS symptoms can be traced to the dominance issue. I'm single but believe marriage should be a "give-give" thing,
and one person should not try to dominate the other. Another friend's father escaped being dominated by his wife
by joining Chenault's Flying Tigers before the US entered World War II. He'd rather face the Japanese than face his
domineering wife.

Back to the posts, shifting our attention from pain and other symptoms by finding things to laugh about
can be very helpful.
 
Really good, common sense, bread and butter advice from Dr. Schechter. Also a nice explanation of the reasons why NOT focusing on the pain, helps us get better.
 
I've been doing this block/shift technique and it's been interesting. I really recognize how often I think of the pain. A LOT. But I also have large spans of time where I don't feel it (notice it) at all.
 
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