When I say that I feel lost, it’s not because of TMS. I’m 100% convinced that I have TMS, and I have plenty of evidence right in front of me every day.
Excellent!
I feel lost when it comes to emotions, stress, and anxiety.
It’s as if I have a number of suspects standing in front of me, and I feel like I need to identify the culprit.
I feel like I don’t know which lock to open to get directly to the root of the problem.
Two things I would say to this. Firstly, does the evidence that you have already compiled give you a clue? Surely you've already seen some evidence of how your stress links to symptoms, so this can help to distinguish what's really going on - e.g. if there's a pattern of perfectionism in it all, whenever you feel pressure to be perfect there's an uptick - then that can help you to determine what is currently triggering you.
Secondly though, these links are much more important to me in order to establish belief in the TMS diagnosis. Once you already have, then yes they can help to point you in the right direction, but to me it all comes down to self-compassion. If you have a number of suspects in front of you, then don't you have motivation to address them one by one for your own sake? It's like if two suspects were 1. self-criticism and 2. putting needs of others first above my own - if I'm trying to decide which one it is then what I'm really saying is I only care about them for the purposes of recovering from chronic pain, otherwise I'm not bothered (so I find the one that's causing this, and the other one who cares basically). That's the opposite of self-compassion. I would say the vast majority of people who recover (myself included) do so because it clicks that this is about so much more than just the pain. It's about self-compassion and self-worth. This is obviously true because if it was just about belief for you then you would have healed by now.
When I take the time to think about it, seeing all of this come back reminds me of the terrible months I went through before getting that much-needed break for almost two months this summer.
I’m afraid of falling back into that situation, afraid that it will last a long time, afraid that I won’t find the right way to overcome this TMS.
I appreciate that - and I also appreciate the challenge of having seen what's possible only to seemingly be dragged back into it (that is its own unique challenge separate to being in pain all the time and not having any periods of respite/not knowing any better). You can't fall back into the same situation though, because a big part of why it became chronic in the first place was because you thought something was wrong with you/because you didn't know about TMS. Those longer exists, so there's no real reason to believe that it will last a long time, you're in the peaks and troughs phase of TMS recovery - but you can't ever be where you were because a big fuel source (thinking it's physical and not understanding TMS) is gone.
I would encourage you to potentially keep it broader (that's perfectly fine, it doesn't always need to exactly make sense in connection with the symptoms - appreciating what I said above) and give yourself that self-compassion to say that (although I know that in a way you are doing it to recover and that's unavoidable) you're doing this emotional work for your own happiness and because you deserve it. Additionally, if you're only doing it for the pain then that just puts way more attention on the pain, you're going to be checking it all the time as if to say "did the emotional work work?" That only heightens hyper vigilance and gives the pain unnecessary importance. The pain isn't really the problem (I appreciate the challenges it provides), it's the messenger for a larger problem (you don't need to define this super specifically, overall treating yourself poorly or something like putting too much pressure on yourself is enough).
I've never seen anyone who believed in the diagnosis and improved their self-compassion (whether that be through lowering people-pleasing, perfectionism, taking care of their needs more etc.) for its own purpose (not just to heal the pain) not at least significantly improve their TMS symptoms.
@cafe_bustelo made a great post recently expressing a similar sentiment, as it clicked for him that this was about so much more than the pain.
As for me, after reading your thoughts about stress and a possible emotional trigger, it’s possible that this could be one.
I like your analysis and I think that's very possible. If you're prone to putting too much pressure on yourself, then there could be a lot of unnecessary guilt here which is triggering your alarm system. I appreciate that you don't want to disappoint her, and that is compassionate of you, but what's the fear? You're well within your rights not to be ready, you've already shown great improvement and you're on the correct path clearly. It all comes back to self-judgment, self-pressure (to heal quickly in this instance - which will never help when it comes to symptoms) and self-compassion to me (see how we can look at it broadly? You don't need to get overly specific) - if you addressed those here it would mean less guilt, less self-judgment and less fear - you can still be disappointed at potentially disappointing her - but you've got to take care of yourself and anyone would appreciate your desire to feel your best for the specific moment. That's an example of how a specific situation applies to more broad things to work on - pretty much any potential trigger can be linked back to self-compassion - as long as you're working on self-compassion, then that's always regulating to the nervous system and will always help pain
