Endless Cycle of Symptom Imperative

Hi all,

This forum is amazing. I'm a new member but have been browsing for awhile!

I'm a 25-year-old female and classic TMS personality. I discovered Dr. Sarno and this theory last year while suffering from sudden onset and debilitating RSI in my hands; my work in digital marketing is 100% at a computer, so it definitely hit me where it hurts.

Learning more about TMS, I realized that I've been cycling through symptoms for much of my life. I suffered from severe anorexia for years, coming close to death from malnutrition twice and necessitating inpatient treatment for a total of 8 months over two sessions. I'm also diagnosed with depression and anxiety. Thankfully, this all means I've been in therapy for about a decade and have a pretty good understanding of myself and my emotions.

After reading all the Sarno books, perusing this forum, and doing a lot of work - I'm thrilled to say my RSI is 99% GONE! I'm typing this right now. However, I know that the RSI was in fact the symptom imperative showing up as other things faded (a knee injury, a rib injury, lasting pain from a root canal, etc). Sure enough, the emotions are STRONG and now that the RSI is gone, I'm dealing with headaches, shoulder pain, hip pain, foot pain, and intensive circulation issues. I do have Ehlers-Danlos syndrome, a connective tissue disorder - like Dorado, if you're a regular on this forum! - that "can" explain some of these things, but it's clear my emotions are powerful.

Essentially: I can't stop the cycle of the symptom imperative. It's gone from anorexia to RSI to knee pain and shoulder pain and autonomic nervous system dysfunction, with clinically-recognized depression and anxiety hanging in there throughout. As soon as I get rid of one symptom, another pops up. I go to therapy and have doctors that help me manage my EDS (the genetic disorder that is not TMS as it's congenital). Curious if anyone has successfully stopped the endless cycle of the symptom imperative!

 

Hey Kelliwheatz,

I am starting to realize that stopping the symptom imperative is one of our biggest challenges, and that it might require continuous work. But that's not to say that it's impossible.

Essentially, the symptom imperative kicks in once we start fearing our symptoms less - for instance, we stop fearing our back pain, our back gets better, then something else pops up because the back pain is no longer having the desired effect. Unfortunately, sometimes some of the symptoms that come up as symptom imperative are worse than the original and very hard to ignore, especially if they have to do with anxiety and depression, or even something that visibly threatening like a rash or eczema.

Although I am pain free and I've overcome many symptoms, I cannot say for sure that I've overcome the symptom imperative 'forever'. By this I mean that if I am going through a stressful period, something inevitably comes up. Since I am not so fearful of pain anymore, it usually isn't pain - I've had anxiety, catastrophic thinking, and unexplained cravings, insomnia and hormonal imbalance - all of these symptoms coincide with stressful periods in my life. I try and apply a similar approach that I've applied to my pain with success - try not to give the new symptoms much attention, try to react to the symptoms or feelings in a more neutral manner, accept them, meditate, and believe in the possibility of healing or feeling better.

Although this may seem like constant work, I do believe that the symptom imperative can be overcome. To be honest, I have overcome it a number of times whenever I stayed true to myself - when I tackled an issue that has bothered me, and when I put myself first. Some symptoms return during stressful periods when I start putting too much pressure on myself or when I get stuck thinking about something that bothered me and not doing anything about it. Therefore, the best way to overcome it I'd say is by staying in tune with your emotions and learning to put yourself and your health first. If there is something that bothers you (toxic relationship, stressful job, etc), you have to be brave and try and change the situation. Some people argue that you cannot change everything - this is true, but it's amazing how many possibilities there are, and how blind we are to them sometimes.

I hope this helps just a bit X

Miriam

 

This is unbelievable, Miriam - thank you so much! Your thoughts make perfect sense, and I think it was exactly what I needed to hear. Time for me to keep doing the hard work. Much appreciation and many thanks

 

Like Miriam, I've put my SI away in a box for several periods but it does seem to still come back when something happens in my life...I'll get frustrated at one of my teens or feel guilty for something, or just go too hard at something stressful, and a week will follow where I will have rashing, itching or pain in one spot etc. I have considered myself "already healed" as I see that is how eastern medicine treats these things, but when I'm being honest, the SI stuff is well-engrained and difficult to get out of entirely. I do think it can happen over time, and does for many, when they put a lot of consistent work into journaling etc. Best wishes!

 

Hi @kelliwheatz,

Curious how you are doing now? some of your story is similar to mine. I see the great advice above and wondering how implementing things has gone? Hope you are doing well!

 

i've had pretty much the same experience with the same results. thanks for posting this.
i would say stay the course and always aim at regulating your nervous system.

 

Great to read this thread, guys! I started mind body work about 1.5 years ago for IBS. I have gone from daily pain and symptoms to long periods of pain free days, flaring only when mega stressed. These flares last less time too, so all good on that score. The SI is a pesky thing though. In hindsight, I realise that the IBS was just taking the place of previous chronic symptoms once I’d become less afraid of them, sometimes because of seeing a therapist (reflux, tingling, headaches… you know how it is, the list goes on!). Anyway, I can see what my brain is doing now the IBS is on the run… it’s trying out different things… old symptoms and new ones. Once my brain gets the message that they’re not stopping me in my tracks, another one pops up… throwing mud at the wall to see what sticks! Most of the time I can laugh when a new one shows up, but the longer they go on, the more they test me. I’m currently on week two of neck tension and headaches, and managing really well to crack on anyway.

I am a little confused though. Listening to Nicole Sachs, Dan Buglio, Alan Gordon etc… they imply the SI goes round and round in circles and you have to learn to live within it. That’s fine and is what I’m doing. But are they saying that the SI will eventually go, because it seems like something always has to occupy that space for me! Or are they saying you just have to eliminate the fear around them??

 

You could try reading Dan Buglio's book. I really like how he frames TMS as caused by perceived danger. I have a somewhat more expansive opinion of what is a symptom of TMS than does Dan but that's a minor detail, I still think the perceived danger understanding is very helpful. It has helped me knock down the SI to nothing, the lowest it's ever been. It may come back briefly if I get stressed, but the critical thing is not to fear it and to pay it little attention.

 

I also have questions about symptom imperatives. They seem to stem from the emotions reacting to stressful situations, relationships, etc. my hypothesis is that if there are elements in life situations or personal relationships that repeatedly trigger the unsafe emotions, symptom imperatives would occur repeatedly. Examples includes work stress, family stress, kids, social stress (massive bad breaking news everywhere), daily life frustrations, on and on.

Sometimes one may wonder what would have happened if all these external triggers are removed from one's life, would they be symptom free forever? Would that lead to blaming certain people or situations for causing one's symptom imperatives? And if people know or feel that they or their behavior are the triggers of their loved ones' TMS, how does that work? I tried to look for answers in the book The Myth of Normal, but the healing part is kind of vague. With all the internal work, would we eventually make peace of our life and feel safe even with triggers? Then symptom imperatives could come and go, right?

 

"They seem to stem from the emotions reacting to stressful situations" "Sometimes one may wonder what would have happened if all these external triggers are removed from one's life"

OK, two things to unpack here and are general for many people dealing with symptom imperatives.
1) They are not CHRONIC - these are symptoms that come up and you use the skills you've learned to deal with your REACTION to them. It's not the emotions reacting to anything..it's you reacting to the emotions.
2) Removing the external stressors is not guarantee you won't continue to generate internal stressors. This is a mindset issue, and I think it is the crux of many people who feel weighed down by symptom imperatives, (always important to note there are people who are exceptions: folks dealing with massive traumas etc) - it's the concept of how you see yourself within the stressors and you actual attitude to the "stress". Personally I think glass half empty mentality and/or folks that sort of dwell in a level of anger and angst will continually suffer symptom imperatives (physical or mental/emotional) because they can't find personal peace and reduce the activity of their nervous system. Their brain is constantly viewing things as a threat because they haven't been willing to change their internal narrative - and their place in the narrative. You can find more information about this idea by searching on "thinking clean" in these forum. In the past there was quite a bit of talk about this idea, and it's really helped me.
I have setbacks and symptom imperatives - sometimes attempts at multiple symptom imperatives a day right now - but using the "think clean" strategy has nipped them in the bud quickly - from things lasting a few days, to mere seconds. I don't even have to go very far to get to the source: I react to any stressor or stressful thought associated with the stressor and just go to the emotion automatically - even if I don't feel it, I know it's upset my equilibrium. I acknowledge this and move on with my day. If the external stress is large and looming or there are many elements, I break it down into manageable pieces. What I can deal with and what I don't want my brain to constantly chew on and try to "solve" - sometimes you can solve external stressors and sometimes you just need to take a breath and deal with the emotion and FEEL the emotion surrounding them. Later on, when I have a moment I look at how I am viewing my position with this thing in my life. Do I feel it's my fault, do I feel I am the only one who can or must deal with it? (goodist/hard on self). Is it really even a "thing" I need to add to my stress bucket - is it really a stressor or am I making it one (perfectionism) And lastly, do I view this stress as a horrible thing that has come down on me (self-victimizing) and blame others for it. And sometimes horribly stressful situations happen and you really need to give yourself huge blankets of self-love and compassion to get through it, knowing that symptoms may arise but you have the skills to deal with it.

You can learn to soften many of the reactions you have to stressors, over time and with practice. Your mind will learn that your past associations that create such reactions are not in the present, and that you can take a breath, and choose how you are going to respond to the things that fall in your lap.

 

As a fellow TMS personality, I have bad news and good news for you. Bad news is that obsessive personality is part of who we are and even when we get rid of the last set of symptoms, the new set of symptoms is likely to roll in.

But here is good news, and it is much bigger than bad news. You and I, and thousands of people who were fortunate enough to learn about TMS (BTW, it recently acquired a more modern name Neuroplastic Symptoms), have knowledge to deal with those symptoms. I doubt we will ever be completely freed of our brain's ability to generate symptoms, but knowing about those symptoms, knowing how to face them and how to calm them down with the knowledge and techniques we have learned will help you to overcome each new round. It gets easier with the experience, just be patient.

Finally, you mentioned anxiety and depression. These are not new symptoms, these are the original symptoms. They are part of who you are, and they get converted into physical symptoms if not handled properly, it is called repression of emotions, more specifically repression of your anxiety. Depression is often the result of anxiety. When your physical symptoms get replaced by anxiety, it means that you actually made progress. Then your actual work begins, because that's when you finally are facing the source of your problems, which is repressed emotions. You need to start reading books by Dr. Claire Weekes (or even better listening to her audios).

Best of luck!

 

I think the bell finally went off for me when I realized that my problems really are internal problems (not the physical ones I came in here initially focused on.) I’ve had to learn what is churning up the volumes and volumes of Adrenaline in me on a daily basis. Most of it is caused by my THOUGHTS—not by my external environment, though there was plenty to sort out there. I’m allergic to me, is one way to look at it. I’m realizing that how I think is killing me. HUGE realization. And I’m only just now learning how to work on changing that. I have had TMS on and off my whole life—but then again, I’ve almost always been in tough situations, but I’ve also caused them or lengthened them with my way of living life and my THINKING. It’s all connected. My thoughts, my outlook, my self-abuse, my stress on myself— all make the brew I drink daily to keep this TMS rolling. Fixing this is my challenge. I’ve recently found some awesome tools to help, along with others I’ve learned here.

1. Slow down! Slow down my thinking. Slow down my driven insanity. Contemplate nature. Move at the speed of a snail. Seriously. Not kidding.

2. Be honest. (Super hard!) Do I really want to talk to this person? Why not? Believe myself. Trust myself. Listen to myself. Defend myself. (I had none of this a year ago!)

3. Lift your brain away from your body. Lift it out toward what you want. Fun! Picture fun and start having fun. Wake up in the morning and think of what you love about life.

4. Realize how you are a victim. Ugh! I didn’t want to admit this; But every time I’m angry at someone, I’m being a victim. They are who they are. I have POWER to choose a better way to respond than ruminating and staying angry. I can let it go. Release them in love. Forgive them and move on. I actually say out loud, “I love you. I forgive you. I release you,” out loud when I start obsessing on something someone has done “to” me.

 

So so much brilliant wisdom and deep insight from all of you. I will be re-reading daily for a while!
Thank you!