Does TMS get worse before it gets better?

Hi everyone

I have been experiencing reduction in symptoms for a month roughly. BUT now my symptoms are going "a little crazy" again. I think it is because I am better at feeling my negative emotions such as stress, anxiety and sadness.

Although, I think it is a "good thing" that I am letting myself feel negative emotions, my pain is getting worse as a result. My question is therefor:

Do some TMS "patients" get an increase in symptoms as a result of dealing with emotions and then feel relief after dealing with the negative emotions such as: rage, anxiety etc.? Does TMS get worse before it gets better?

 

hi Scott,
yes, it could be the «extintion burst», the (almost) last effort of your brain for trying to keep your attention away from your scary emotions. A second option for that is the «symptom imperative».
Two very decisive concepts: extintion burst and symptom imperative.

 

Hi, I am in exactly the same situation ☺ O think we're healing!

 

Yea! Good luck with your healing!

 

Thanks for your answer. I have heard of the symptom imperative, but never extinction burst. So, thanks a lot for bringing that to my attention. I will look in to it.

ur

 

Alan Gordon: "There’s a phenomenon in behaviorism known as an “extinction burst.” When you stop reinforcing a behavior, you’d think that the behavior would just immediately stop. But they’ve found that that isn’t the case. When you stop giving the rat food pellets for running on the wheel, it actually runs harder and faster at first before it stops running altogether. When you stop giving the two-year-old candy, his tantrums actually get worse before they go away. No one likes to lose a behavior that’s working, so there’s a little resistance once the reinforcement is taken away. How is this relevant to the pain? Often when you take away the pain’s reinforcement (fear, attention, etc.) the pain gets worse before it goes away. The mind does not like to lose a defense mechanism any more than a toddler likes to lose his candy-getting behavior. So just know that if you stop reinforcing the pain and it starts getting worse, don’t panic, that’s just an extinction burst; it means you’re on the right track."

 

Dr. Schubiner explains the extinction burst concept much like Alan Gordon, which is hardly surprising given that they collaborate regarding TMS pain. Schubiner has written:

When you ignore a child with a temper tantrum, it will go away; but before it goes away, that child will increase the ferocity of the tantrum to try to maintain control over you and to try to scare you. This is exactly what the TMS brain does. It is called "extinction burst" and it's caused by the brain realizing that it's losing control over you to frighten you. Your brain truly believes that it's "in danger" and that you are "in danger" and is acting like it; producing severe symptoms to relay this message to you.​

I am not sure I fully agree with all of this, but getting into that would be nitpicking. I am writing this post to call attention to the point Schubiner made right after the passage quoted above:

It is up to you to realize that you are NOT in danger and that this is just the brain. It is very important to realize this and know this at a 100% level!! You need to be able to separate from the pain and relax knowing that you are going to be fine; 100% chance that you are going to be fine. The fear and doubt get in the way of recovery.
​

I think this advice is right on the mark. It also fits totally with what Dr. Sarno wrote in The Divided Mind:

It soon became evident that knowledge was the key to treating TMS. . . . Another crucial therapeutic element became clear early on as well: the person must not only understand the nature of the process but be able to fully accept as well . . . . acceptance of the idea is essential."​

The italics are by Sarno. Maybe he should have italicized "fully," too.

It seems to me that Sarno's "fully accept" and Schubiner's "know this at a 100% level" are the same thing. You have to know at a 100% level that your chronic pain is just a false danger alarm created by your brain, not an indicator of present or potential damage to the part of your body that is hurting.

Almost 30 years ago, I was able to reach the necessary the 100% level and completely overcome more than 2 decades of chronic back pain by fully accepting Sarno's Twelve Daily Remainders in his book Healing Back Pain. Some of these are the following:

• The pain is due to TMS, not a structural abnormality;
• TMS is a harmless condition caused by my repressed emotions;
• The principal emotion is my repressed anger;
• Since my back is basically normal, there is nothing to fear;
  Therefore, physical activity is not dangerous;
• I will not be concerned or intimidated by the pain.
• I must think psychological at all times, not physical.

My back pain has never returned. Upon the infrequent occasion when a symptom imperative visits, I still benefit from Sarno's Twelve Daily Reminders. The last few years, my 100% level has been reinforced by learning about recent research by pain scientists unraveling how the brain creates false pain alarms. The gist of this ever-growing body of research was described in an article titled Glial Ties to Persistent Pain in The Scientist, January 2018.

Bottom line for success: You need to fully accept, i.e., know at a 100% level, that your chronic pain is just a false danger alarm created by your brain. That is necessary.

I will add, however, that it might or might not be sufficient. As another element of Sarno's prescription to think psychological, you also might need to identify exactly what repressed emotion (or other conditioned response) is involved. That has usually, though not always, been necessary for me over the decades in which I have dealt very successfully with TMS.

Here is my explanation of why it can be necessary to identify the repressed anger involved. Sarno explains in Healing Back Pain how a 15-month old learned to repress anger when his mother responded to his temper tantrum by splashing ice water in his face. He wrote:

It worked beautifully--he never had another tantrum. At the ripe age of 15 months he had learned the technique of repression. He had been programmed to repress anger [i.e., conditioned to repress it] because it produced very unpleasant consequences, and he would carry that dubious talent with him, throughout his life. Now when confronted with the multitude of frustrating, annoying, sometimes enraging things that happen to people every day, this man automatically internalizes his natural anger . . . .
​

The man in Sarno's story represses anger because he learned as a child that experiencing it would produce "very unpleasant consequences" because of the the way his mother responded. His brain was programed that anger is dangerous to his relationships with other people. As an adult, the man might not repress anger at the driver who cuts him off in traffic, but he will repress anger at someone who is important to his present being, much as his mother was important to his well being in childhood.

In my case, the key to overcoming decades of back pain was becoming aware of when I was repressing anger at my wife. By becoming aware of the anger and identifying why I was angry at her, I was able to process it cognitively, and my brain was able to determine it posed no relationship danger with my wife (because as an adult I had various ways to deal with it other than a temper tantrum, e.g., decide it is no big deal or if it is a big deal wait and find an opportune to broach the subject very diplomatically). But if one's anger remains repressed, the cognitive part of his brain cannot process it. As Sarno said in a 1994 interview: "Know about the anger, and know why it’s there. And if you do those two things, your pain will go away.” By "know about" and "know why," he was talking about cognitive awareness--which can't happen if you continue to repress the anger. And as long as the repressed anger continues, your programed unconscious brain will determine you are in danger and create pain.

Why does your brain create pain when you are not in physical danger? Alan Gordon uses the wonderful term "blunderous brain." Your brain is not able to distinguish between physical danger and emotional (i.e., relationship) danger. It blunderously creates physical pain for both dangers.

 

Thanks a lot for your amazing answer!