John E. Sarno said:
Fear is another important equivalent of pain that may be more effective than the pain itself to achieve the mind's goal of distracting attention from repressed rage. The fear of pain, physical activity, injury, or spinal abnormality is enough to perpetuate TMS, even in the absence of pain. The mind is interested only in keeping our attention on the body; the fera of any of the phenomena will accomplish that as well as the reality of pain itself.
-The Mindbody Prescription, page 31-32