Doubts all of a sudden

I just endured an incredibly long and stressful (72 hr) travel sequence with missed flights trying to get home after the new year and now I have an increase in symptoms (of course). I think together with the lack of sleep and being unable to keep up with meditating, journaling, the SEP etc the past few days have thrown me out of my new rhythm. I'm also of course coming back from the "vacation effect" to some extent where I haven't had to worry about a lot of my usual life stressors for a couple of weeks.

All of the above has conspired to put me in a place of catastrophizing and doubt in the TMS diagnosis that I'm struggling to get out of and make my way back to the gentler mindset I was just starting to have more regularly.

Would appreciate if anyone has thoughts on how to keep from spiraling when your nervous system is kind of fried?

I think adding to my current anxiety is that I'm finally seeing a provider trained in PRT tomorrow, which is great, but I'm of course going through the "what-ifs" if they don't think they can help me/don't believe it's TMS/etc. I don't know why I'm thinking that way. I honestly have been in a much better place the past few weeks, just can't seem to get my head on straight today.

 

I think what you've done above by writing it all out is really great. Your logical, rational mind is explaining it all to your unconscious, emotional mind. This is how you take control. Just don't obsess about it all. Shift your mind to something neutral, relaxing, enjoyable that has nothing to do with TMS until it's time to see your new PRT provider tomorrow.

 

Ha, I didn't realize it but you're absolutely right. I posted this, then got on with my day, did the things I needed to do and then shifted focus to some more enjoyable activities and I'm already feeling a bit more grounded. Maybe next time I can remember that writing it out helps me. Thanks.

 

Evidence lists help me, and you’ve written some here! Symptoms increasing due to psychological factors, that’s the key keep a list of evidence and when I’m in doubt I look at the list

 

That's a really good point. I had sort of slowed down with the evidence list, thinking it was long enough already. But I've just been keeping it on my phone and sometimes I forget about its existence, maybe I should actually write it out and tack it up somewhere.

I have seen so much symptom increase due to psychological factors and yet some part of me won't let go of the idea that something's irreparably damaged. Which feels like it's hitting on some deeper psychological fear of always thinking there's something deeply wrong or deficient with me long before I started to have pain. Just need to keep on with the work I guess.

 

I agree with the comment about an evidence list - also, if anything this experience should confirm the TMS diagnosis and give you confidence (even though it sucks), because the pain is increasing in reaction to emotional stimulus! What are the reasons that you still go back to it potentially being physical? I would focus on addressing that doubt with your logic and evidence - argue against it if the evidence supports TMS

 

Hey Adam, thank you for responding. I read/watched your success story a couple of weeks ago and found it very encouraging!

I think the main doubt I'm having is the idea that there's something going wrong with muscle coordination that needs to be worked out in physical therapy. The symptoms can be so convincing—it feels like I just have this terrible muscle cramp in my lower abdomen, but nothing I do except for meditation/breathwork actually has an effect on it. I've been trying to convince myself that there's no difference between this and any other kind of TMS—Steve Ozanich literally describes TMS as the "cramp from hell"—but at times of greater stress I keep thinking what if I'm missing something in treating it solely with the mind-body approach.

I also have some emotional attachment to the fact that this started with an injury, and I still feel a sense of guilt and shame around the fact that I accidentally hurt myself in a way that started off this whole thing—even if it's just TMS and there's no damage, it's still hard to get out of and totally sucks as you say. It's hard to stop ruminating on what life would be like if this simply hadn't happened. I realize a better perspective would be something along the lines of, the injury was just a trigger and some version of this would probably have shown up sooner or later no matter what, but I still find it hard to accept.

I guess I should clarify - neither of these are things that I actually believe, in my rational mind. It's more like I keep having intrusive thoughts along these lines that don't make sense but drive me crazy all the same.

 

That's a great reflection and great to hear because the wheels are turning for me as to what to work on and I also relate a lot to what you said.

At the risk of sounding clever and challenging you, I don't think it's beneficial to you to differentiate between believing it in the rational mind and in the subconscious. If you really believed it, then either the thoughts wouldn't come or if they did you'd laugh them off and you wouldn't get dragged down into catastrophising. You need to expose the subconscious beliefs that are wrong/aren't serving you and bring them into the light of the conscious mind, then destroy them with evidence and logic. Once I truly believed that it was TMS the catastrophising stopped (that didn't mean I didn't have pain but it did lower it quite significantly).

In terms of the first paragraph, I think it's a matter of making a final decision and really putting your foot down with yourself, assuming that the evidence of TMS is very strong. The truth is that no matter how much evidence you have (you could have absolutely no evidence that it is structural and everything points to TMS), you theoretically can never fully eliminate the idea of "what if I'm missing something". I would actually take solace in this fact and be empowered in a sense to know that it's your decision, you'll never have enough evidence to eliminate this possibility if you decide that it isn't enough. There's always a perspective that exists that says "what if I missed something" but if you entertain the idea then that won't help at all.

The second paragraph is almost identical to my experience, in that I felt a lot of guilt and shame too - if only I hadn't have been so stupid to squat without warming up (in my case). That guilt and shame was a major contributor to my symptoms upon reflection, and like you mentioned it was only through an understanding of TMS and the fact that if it wasn't this it would have been something else (which is completely true) - that I was able to let that go. My straight answer to you is why don't you believe it? This potentially tells me that you are too focused on the symptoms and don't have an understanding of just how much stress, emotions and personality contribute to symptoms. Once I realised that the symptoms were a message to tell me that I needed to change on a personal level (things like perfectionism, people pleasing etc), then the initial injury lost relevance to me and there was no need for guilt and shame. If it hadn't happened now at least for me, then in a way the rest of my life would have been miserable and a lot less rich as I wouldn't have been forced to be kinder to myself and grow personally. The pain sucks and you can reflect on time lost, but it is worth it for a better life going forward.

Let me know what you think but I'm excited for you because I think you're just a few mental shifts away from breaking this open

 

What's happening is that your brain’s own danger system is doing its job a bit too well. Doubts and catastrophizing subsided for me when I accepted the fact that in my brain is the amygdala, the primitive part that’s always on the lookout for danger and threats to my wellbeing. This small almond-shaped structure deep in the emotional system acts like an internal alarm, constantly scanning and triggering fight-or-flight responses to protect us. When it becomes over-sensitive it can leave us feeling hyper-vigilant, convinced there must be hidden damage, a new physical disease or injury; it can be a complete and utter worry wort.

The solution for me was to use techniques that made my amygdala feel safer—like gentle grounding exercises and sensory soothing—which has helped and continues to help rewire that hypervigilance over time. This article by Martha Beck encapsulates the situation perfectly imo https://marthabeck.com/2023/02/meet-your-creature/ (Meet Your Creature - Martha Beck) In the article she says that the amygdala can't:

• Talk
• Calculate
• Analyze
• Ponder all possible interpretations of events
• Care what your life coach (or anyone else) thinks it should do

The harder you try to push logic and reason on a scared amygdala, the more anxious it becomes—and the less it understands, but it does respond to:

• Slow, relaxed breathing
• Physical stillness or slow, fluid, gentle movements
• A soft voice, pitched low
• Simple, reassuring words (more the sound than the meaning)
• The energy of kindness

In a further article Martha suggests how to do this https://marthabeck.com/2023/03/calming-your-creature/ (Calming Your Creature - Martha Beck)

Alan Gordon (author of The Way Out) once mentioned that during his recovery he carried around with him a brain-shaped stress ball and regularly looked at it kindly, thinking, ‘This poor little primitive brain,’ to help calm the fear response behind his chronic pain. He’s also described the primitive brain as a scared kitten that just needs reassurance.

 

Love all these suggestions to soothe a primitive brain — bookmarking.

When my physical symptoms disappeared, my compulsions and ruminations jacked up. Everything made me anxious. Even having anxious thoughts made me anxious which is kind of ridiculous.

Claire Weekes book was really helpful for me and it still is when I get into that weird funny brain loop. I highly recommend.

 

I hear this and empathise completely. I hold so much anger and blame at myself for the injury, and I don’t think I realised that until I’m writing this now. I’m furious I could have been so stupid… if you’re anything like me you punish yourself for simple honest mistakes and maybe that’s a good journalling exercise

 

These are great insights, thank you.

I just went to see my new provider, who is a PT trained in pain reprocessing therapy. This was actually incredibly useful to me because she did a quick assessment of my muscles and immediately determined that they're perfectly fine and strong in fact, but also they are in a lot of tension. So we will NOT be treating them with any physical modalities. That's what I was hoping was the case, but it is fantastic to get this confirmation and I'm feeling a lot of relief actually. I like your idea of empowering myself to decide definitively—I remember reading that in Dan Buglio's book a few months ago, but at the time I was still divided because I was well within an injury healing timeline. Now I'm far outside of that timeline and it's high time I accepted the TMS diagnosis.

Yes! It has been staring me in the face that things need to change. It feels daunting but I'm trying to not tackle everything all at once and recognize when it's actually my perfectionism telling me "you need to change everything RIGHT NOW." I'm lucky to have a great therapist who is encouraging me to make small shifts like trying new things or taking a different walk somewhere rather than trying to change everything all at once.

It's true that even while I've been in pain my life has actually been more rich in many ways as it's forced me to slow down and notice things more, and as a result I've found myself being more kind and sympathetic to other people. It has been painful, physically and emotionally, to go through this but on some larger more spiritual level it seems like it's a force for good, or at least greater connection.

Thank you @BloodMoon and @HealingMe and @HealingNow for your replies as well, I actually saw the post sharing Martha Beck's articles and have found that helpful to think about. I just started Claire Weekes' book on the plane!

Yes, exactly—I am relentlessly, almost masochistically self-punishing to a ridiculous degree. A professor of mine once called it self-flagellating. Something to work on. I think this injury just really hit on that emotional response in a huge way during a stressful time for me and everything has just spiraled out from there. But I'm in a better place now and I know things can change—they have already.

 

This is a great suggestion. I encourage you to try this, @cafe_bustelo, and then any then any time you catch yourself talking to yourself unkindly, shift the attitude and become protective over yourself. Perhaps firmly say, “I’m allowed to be human.” Some phrase that resonates with you and don't worry if nothing resonates at the moment, as with repetition it will sink in. There is so much power in how we treat ourselves.

 

That all sounds excellent @cafe_bustelo - you sound well on your way and I am excited for you!