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New Program Day 4: Breaking the Pain Cycle

I get the whole TMS thing, I know I have it, but what in the world do you do with the intense pain while it's happening? I'm not having much luck talking myself out of it, even though I go right to the "okay brain, what the hell is bothering you?"
 
Nele, Fearing certain foods is very common for TMS. I'm going to talk more about overcoming fearful associations in the associate learning section. Sometimes it's helpful to try and challenge these fears gradually, as opposed to all at once.

Ellen, that was a beautiful post. Buddha talks about resistance as the source of all suffering. All resistance is actually driven by fear, the fear of sitting with what is.

Lily Rose, that is a great point. Overcoming fear is a process. I'll be focusing a lot on how to go about achieving this goal.
 
Alan, thank you for sharing this programme with us all. It is helping me enormously and I am so grateful to you and Forest and everyone who has helped build this website - it is an invaluable support network.

I found this video moving and it really resonated with me too. I have been struggling with RSI in both arms for over a year. The pain turned my life on its head - I've been on sick leave on and off for a total of 4 months since and I became fearful that I would need to change careers because I couldn't type without being in pain.

Since discovering Sarno's books and this website about 3 months ago I have turned a corner. I am now coming to understand how fear drove my pain over the first 10 months or so, when I was being misinformed about the cause of the pain (I was told my back muscles needed strengthening and that it was the repetitive nature of my typing which I now understand is false). I still feel pain when I type but it does not rule my life anymore and I know I can get rid of it over time.

Thank you so much again
 
Now I'm beginning to believe that repressed, unbearable emotions was what first set off my pain, but is not what has sustained it. I believe that was just the catalyst. Now, it is my fear that keeps the pain perpetuated.

That may be true for me, too. My initial neck pain that started me off on this 12-year nightmare started at the same time as the strangest emotional experience of my life. In an attempt to cure the neck pain I worked with (among others) a Feldenkrais practitioner who proceeded to "train my brain" to sit, lie down, and move the "right" way to avoid pain. The process involved constant mental monitoring of my position, balance, and which muscles I was using.

Before I started the Feldenkrais program I could plop myself down in a chair or on the bed any old way and be comfortable. A couple weeks into the program my mental monitoring had me constantly wondering if I was sitting, lying, or moving in a "balanced" way. I started to notice subtle "imbalances" I would have overlooked before and that would make me fidget and adjust myself to find the "right" balance. The more I did this the more difficult it became to sit, lie down, or move comfortably. Now I can't get comfortable no matter what I do. I think this process locked in a fear of sitting, lying down, or moving the "wrong" way and trained my brain to avoid pretty much every position because I can't label it as the "right" way.

I feel a little like Anakin Skywalker who turned to the dark side to prevent a certain bad result only to find that by turning to the dark side I brought upon myself the very result I was trying to avoid.
 
to the woman who talked about Tinnitus. I had that for two years. First, it drove me mad, because i'm prone to insomnia, and you cant sleep with that ringing in your ears! eventually i got used to it, and with that, i stopped caring. That's when it faded. it comes back sometimes, but i just dont care about it, so it doesnt stick around.

To the last comment about negative feelings, feeling victimized, I too feel that. Usually it's "i was born broken. i'm useless, i shouldnt even be on this earth because i'm a useless broken human. i should just fade out or die in my sleep". It's awful. i have to stop that. I also noticed that living in my moment cuts the pain drastically. When i go for hikes with my dog, i'm nearly pain free. I used to think it was because i was standing, and therefore not hurting the nerve. i'm sure some of it is that, but most of it is because i'm not laying around and stewing about my awful life. Even on the bike, when i had only bladder pain (not pudendal pain YET) i'd be pain free on the bike. I never knew why. i'd have pain before, and after i got off the bike. But while on it, it was like taking a pain pill, yet i didn't take anything. I now believe it was because i was living in the moment. On a mountain bike, you have to concentrate on the trail ahead of you or else you'll crash. You cant really let your mind wander and start worrying about the future. I think that's what took the pain away. I'm all about catastrophizing and when something can distract me from that, my pain lessens. I just havent been able to apply these things to every day life yet. I cant always be hiking or sleeping or crying (another thing that lessens my pain temporarily). i need to apply these techniques 24/7.
Helpful! Me too. Was wondering why I can climb a mountain but can't sit for too long....the more involved, present I am the less I fear. You can't worry about the future and be present at the same time.
 
Day 4: Breaking the Pain Cycle

In The Wizard of Oz, Dorothy and her friends were standing before the great and powerful wizard. His enormous, hovering head and booming voice terrified them.

And then Toto pulled the curtain back; it was just a man in a sound booth. Dorothy and her friends were no long afraid, not even the cowardly lion. The only thing that scared them about the wizard was their belief that he was dangerous. Once that belief was gone, so was the fear.

Overcoming TMS

Pain is a danger signal, and in the case of TMS, the belief that the pain is dangerous is the only thing keeping it going. If you can truly embrace that this pain is not dangerous, it deactivates your danger signal and the pain stops.

Of course, this is easier said than done. Having had 22 different TMS symptoms myself, I can tell you it’s hard not to be afraid of something that is so inherently scary. But that’s the goal, and it’s one of the things we’re going to be working toward for the next few weeks.

A couple months ago, Howard Schubiner and I did a training in Michigan. We wanted to do a live demonstration with someone to show the relationship between pain and fear. A nurse practitioner named Felicia volunteered. Felicia had had chronic neck pain for 20 years, and for 20 years she’d interpreted that pain as dangerous. Over the course of several minutes, Felicia was able to eliminate her fear around her pain, and the pain went away.

Here’s a video of the live demo:


The Fear Behind the Pain

If a fire alarm goes off, you’re not focused on turning off the alarm, you’re focused on putting out the fire. The alarm is just the signal.

Likewise, TMS is a danger signal. You don’t need to get rid of the pain, you simply need to address the fear.

Fear is the fuel for the pain.

fearpump.png


If you overcome your fear, the pain will follow. So in truth, this is not a pain problem you have, it’s a fear problem. The pain is just the consequence.

Outcome Independence

In the earlier clip, Felicia was able to eliminate her fear around the pain by being outcome independent. Outcome independence means your definition of success is independent of a specific outcome.

I came upon outcome independence by accident. In 2004, I had chronic back pain, and I would take long walks every night.

I would constantly monitor my symptoms: How soon would the pain start? How quickly would it intensify? How bad was it when I got home?

If I had a “good” walk, I’d feel confident, hopeful, and good about myself. If I had a “bad” walk, I’d feel scared, hopeless and despairing. This went on for two years.

Finally one day, I’d had enough. I was sick and tired of my mood, my outlook on life, and my feelings about the future being so dependent on the pain.

And I was done.

I changed my definition of success. A “good” walk was no longer one with less pain, it was one where I felt okay regardless of the pain. I took pride in my growing ability to determine my own mood. I celebrated the accomplishment of feeling good about myself even when the pain was bad. I broke free from the prison of fear, hopelessness, and despair.

And much to my surprise, within a month, my walks were pain-free. Without even knowing what I was doing, I undermined the pain’s fuel source: fear.

Outcome independence is not something that comes easily. It’s hard to change deeply ingrained habits, and you’ll falter often. But with practice and discipline, with exposure and repetition, you can get there.

And it all starts with a single decision: I’m done being afraid.

[​IMG]
Hi
One question please :
Are we trying to live a pain-free life, or "fear of pain"-free life??
 
Great post ! I am however confused at the mechanics behind TMS. Is it :
  • A danger signal mistakenly activated in response to a psychological threat ;
  • A mistaken assumption that there is a structural damage ;
  • A diversion from strong, hidden emotions.
On another subject, I think labelling this a syndrome or giving it a name does as much damage as saying it's structural. I don't know but I believe it's just how the brain works and everyone of us at one point in his life experienced some of the symptoms. It's just that others have been lucky enough to not overthink/fear it.
Good questions indeed?
I am confused as why is it that our fear of pain causes pain?
 
The symptoms are a vicious circle for me. I have no fear that there is nothing physically wrong with me but fear the symptoms when they come on. Like my mind becomes preoccupied by them and i worry how long they are going to persist.

I realise this is the minds strategy.

I will be giving Outcome Independence a good try and focus on the present.
 
Great post ! I am however confused at the mechanics behind TMS. Is it :
  • A danger signal mistakenly activated in response to a psychological threat ;
  • A mistaken assumption that there is a structural damage ;
  • A diversion from strong, hidden emotions.
On another subject, I think labelling this a syndrome or giving it a name does as much damage as saying it's structural. I don't know but I believe it's just how the brain works and everyone of us at one point in his life experienced some of the symptoms. It's just that others have been lucky enough to not overthink/fear it.

I think TMS is all of the above! It is most certainly a warning signal that something is going on emotionally for you. It can, as a result, provide a distraction from those emotions while you worry about the pain (though this might be something of a side effect of it). It can also be fueled by anxiety and fear over the pain itself or fear of structural damage. Multiple factors contribute to persistent pain...TMS is not one thing.
 
Yes there are quite a few people here that went the "repressed emotion route" rather than the fear route to get better. There seems to be a few different schools of thought to TMS. Either way, the fear thing really speaks to me. My whole life revolves around "what if?"
I wake up every morning wondering "will this be one of my better days, or a terrible day?" and your walks are the same as my bike rides (yes i try to ride bikes with pudendal neuragia, a big no-no). i'm so obsessed with good ride/ bad ride and how TMS will affect my future. I also have constant fear like "will anyone ever love somebody with pelvic pain? i'll never have a normal relationship, i'm broken" This is my life.
You are perfect just as you are. I am perfect despite my pain. Will you start being compassionate to yourself? When? How can you show loving kindness to yourself?
 
That may be true for me, too. My initial neck pain that started me off on this 12-year nightmare started at the same time as the strangest emotional experience of my life. In an attempt to cure the neck pain I worked with (among others) a Feldenkrais practitioner who proceeded to "train my brain" to sit, lie down, and move the "right" way to avoid pain. The process involved constant mental monitoring of my position, balance, and which muscles I was using.

Before I started the Feldenkrais program I could plop myself down in a chair or on the bed any old way and be comfortable. A couple weeks into the program my mental monitoring had me constantly wondering if I was sitting, lying, or moving in a "balanced" way. I started to notice subtle "imbalances" I would have overlooked before and that would make me fidget and adjust myself to find the "right" balance. The more I did this the more difficult it became to sit, lie down, or move comfortably. Now I can't get comfortable no matter what I do. I think this process locked in a fear of sitting, lying down, or moving the "wrong" way and trained my brain to avoid pretty much every position because I can't label it as the "right" way.

I feel a little like Anakin Skywalker who turned to the dark side to prevent a certain bad result only to find that by turning to the dark side I brought upon myself the very result I was trying to avoid.

Actually I feel similarly (though I think of the analogy more like jumping out of the frying pan, into the fire) as I had a back operation because I couldn't handle the pain, and then the back operation made my back about 100x worse than it was before the operation! I wish there was a one-use time machine in life, where we could retract a decision - just once! But maybe all this suffering is here to lead us on a particular journey – I can think that on the good days. Your Feldenkrais experience reminded me a bit of my experience in a pain management group, where they taught us the concept of 'pacing', which is was I use now for sitting, standing and walking, but before I did this, I used to be able to sit for much longer. It wasn't until we were told to pay attention to the pain and note the time when it starts to hurt (so as to change position before this), that my sitting time went down by quite a lot, and now if I go over that time, I get a lot worse for a few days. It seems very easy to make our bodies more sensitive, especially having a highly strung nervous system. But pacing can be a good way to get going again, if you are finding it hart to sit at all.
 
You are perfect just as you are. I am perfect despite my pain. Will you start being compassionate to yourself? When? How can you show loving kindness to yourself?
These posts make me cry in a good way. Since learning about all this, i've been crying at the smallest things. When something resonates with me, i instantly well up. I think i'm purging all these repressed feelings
 
As
i dont have IBS but i had interstitial cystitis (now in remission) but i was always told to eat a bland diet because acidic foods would harm the inflamed bladder lining. I never really tried the diet other than a few half hearted attempts. I occasionally took special antacids with foods just in case, but they never worked. part of me thinks that because i never feared the acidic food, i never developed the "these foods kill my bladder" symptom. I always ate and drank whatever i wanted because early on, i realized it didnt matter what i did. i imagine if i psyched myself out about the "IC diet" i might have become food sensitive.
I have been diagnosed with IC since it was "discovered" or "invented".
I feel tremendous sadness that I still fear tomatoes. I did the IC diet perfectly. Fear of those razor blades in the bladder terrified me.
I now eat tangerines and have lemon water. That took years to trust.
My vision is to be off the 20mg baclofen that has been part of my life for 25 years. Slowly, slowly.
Maybe this workshop I will have a piece of pizza?!
 
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These posts make me cry in a good way. Since learning about all this, i've been crying at the smallest things. When something resonates with me, i instantly well up. I think i'm purging all these repressed feelings

I totally relate to this so you're not on your own. Heck, we went to see the musical Buddy last week and I was seriously welling up when it announced his death. And I'm a guy so crying at the theatre isn't the done thing :-)
 
"Change your definition of success. Work on it. Success is no longer measured by whether or not you have a good walk. Success is measured by how little you care." --Alan Gordon
I loved this. I call it "failing up" but it's the same thing. It's the try that counts, that helps continuing the retiring of our brain's pathways.
Discouragement was one of my favorite drugs for a long time. Defeated by anxiety, depression and somatic complaints I could finally rest.
Now I Just Rest. Whether I need to or not.
 
My conception of IBS is, that my thougths/ my fears weaken my bowels. Additionally I am afraid that my bowels got accustomed to that poor behavior. Is that a thought of structural cause?

Outcome independence would mean for me: eat all you want, and don't mind bowel symptoms. Is that the right approach?
I am trying it cautiously, so far not convincing. You see, I fear to try it courageously. Vicious circle? How to overcome my fear?

Please excuse my poor English.

For me, this brings up that for one person, IBS is TMS, and for another, it is not. Most of my pain issues are TMS. But not all. This is true for a great many people. Nothing in life is 'absolute'.

I have spent nearly ten years experimenting with my IBS. I have had it most of my life, but only in the last ten years did I begin actively seeking 'natural' solutions. For the last year or so I have been symptom free. I am a vegetarian, but most raw vegetables (which I really really really really really really love) tear through me. Some cooked vegetables do not. Root vegetables are fine. All fruit is perfect, especially apples. Rice and yogurt are good. Beans in any form are agony.

My method was to try eliminations first. Once I found this 'safe place' where pain was not going to overwhelm me, I now sometimes venture outside of my safe zone to see if some other vegetables are available to me. Broccoli persists in causing pain, but broccolini, which is like broccoli does not hurt me at all.

As for "poor English", if English is not your primary language, my view is that you are far ahead of me, as I can only speak one language :)

Be patient, and most of all, be compassionate towards yourself.
You can do anything you set your mind to do.

.... with Love and Gratitude <3
 
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