Alex B. Fibromyalgia, TMJ, myofascial pain, or TMS?

[Kez]

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Question

Hi there,

I think I may have TMS but not sure. I had a car accident 13 years ago, actually went through the windscreen. Since then I have been diagnosed with whiplash, TMJ, Myofascial pain and Fibromylgia. Most of the pain is in my jaw/face. I have had many MRI scans and show no abnormality. I do feel better when I am less stressed but I have had pain now all year with no let up. The pain is causing the stress and visa versa but I dont know how to get out of the cycle. I am still not convinced if I have TMS. I have had IBS and stress problems since I was a little girl but this is totally controlling my life. Im hoping its TMS but how do I know for sure? The Max Facial guys want to try me with BOTOX another hard splint? Should I try this. I have recently bought the Howard Schubiner "unlearn your pain" but something is stopping me from doing it completely....almost like I want to wallow in my own self pity. I have been in pain for so long, i guess I feel its a part of me and im scared what will happen if I am not in pain!!! I know how ridiculous that sounds. I guess im also scared I do it and it doesnt work. Thanks for any help in this and sorry to be a bother x

 

[Alex Bloom LCSW]

Answer

Hi Kez,

First of all, thank you for the excellent question. There's no need to apologize for being a "bother". A big part of confronting TMS involves empowering and prioritizing yourself and we can start with you legitimizing your own challenges and accepting you own needs. It sounds like you have a long history of feeling powerless, stressed and fearful and these are the conditions in which TMS thrives.

Two of the most important things for you to focus on moving forward are that a) your MRI shows no abnormalities and b) you have experienced a direct correlation between your stress levels and the intensity of your symptoms. These two facts are your most important tools for addressing the fear and preoccupation that the symptoms generate. I try to remind my clients that the goal of TMS treatment is NOT to make the pain go away but rather to address and soothe the stress and anxiety that arises. This is how you begin to change that cycle that you feel stuck in.

Now the second issue you raise is not ridiculous in the slightest, but rather is one of the core issues that many people with TMS must face. The fact that you are able to recognize this tendency and acknowledge it is really great and that capacity for self-reflection will serve you well. The issue here is pattern and habituation. Your unconscious mind has been using pain and powerlessness as a distractor, as a means of preoccupying you, for so long that it feels like who you are. It feels like the norm. So to deviate from that pattern, to challenge and confront in, is naturally going to make you somewhat uncomfortable. This is very normal. It's important for you to begin to see that this long-term pattern of self-intimidation and devaluation is not who you are, but rather, what you do to yourself. While it takes practice and effort, the good news here is that you can change it! By confronting the cycle that you wrote about, by seeing the patterned way of treating yourself and by standing up to it, recognizing that you don't deserve to keep yourself there you can begin to work towards an alternative way of treating yourself. My mentor, Alan Gordon, writes more extensively about this process in the TMS Recovery Program, which you can find on the TMS wiki. I recommend you check it out.

I hope this is somewhat helpful, thanks for the great question.

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