Written by on September 16, 2008 MBS Blog 13 The layers of wellness: levels of coping with TMS/MBS I have spoken to so many people who are frustrated that their TMS symptoms have not gotten better yet. They have read so many accounts of people who have read Dr. Sarno's books and immediately gotten better. They wonder why they haven't had the same response. This can lead to increased worrying: worrying about what's wrong with them, if they really have TMS or not, if they are making themselves sicker by worrying, and this vicious cycle can go on and on. On the TMS Help Forum and other web sites, there are many excellent suggestions about methods of self-help and books that people have used to vanquish their TMS symptoms. Most of these are great resources and can be helpful to many. I was talking about this the other day with a good friend and excellent psychologist, Mark Lumley from Wayne State University. He and I actually ended up writing a little poem about the layers of work that many people may need to do to get better. I must warn you, neither of us are poets, so the so-called poem isn't very poetic. But we like it because it means something important to us. Here it is. Things to do: Notice what has been hidden; Understand what has been a mystery. Speak what has been unspoken; Confront what has been avoided. Accept what needs to be accepted; Forgive what needs to be forgiven. Change what needs to be changed. Howard Schubiner, MD and Mark Lumley, Ph.D. It is truly amazing that some people can simply read The Mindbody Prescription and get better. I had a patient who only read the first 20 pages and his fibromyalgia symptoms disappeared. However, when the source of a great deal of tension in his life, his college aged son, came home for the holidays, his pain returned immediately. For most of us though, it takes more, often much more. There can be several levels of ways of coping with our emotional issues. I have designed my TMS/MBS program to gradually urge people to understand and address any issues in their life more deeply and begin to cope with them more actively. In fact, I am adding some new material to the fourth week of the course soon. Here are some of the levels (as I currently see them): 1. Learning that TMS exists, that emotions can cause pain 2. Understanding one's own emotions, prior stressors, core issues that have lead to the physical and emotional symptoms 3. Starting to uncover these core issues and emotions in writing 4. Speaking the truth to oneself, through writing, meditating, reprogramming the mind 5. Recognizing hidden barriers in our own mind that may prevent us from getting better (see week 3 of the program); honestly asking ourselves the question: Why might my mind prefer to hang on to these symptoms? 6. Speaking the truth to others, telling others what you need, expressing anger or apology or forgiveness 7. Accepting what needs to be accepted; forgiving what needs to be forgiven 8. Doing things that we need to do, physical things (activities), but also things we want to do, and most importantly, figuring out what things need changing in our lives and actively working on those 9. Letting go of past issues, recognizing that what has happened “should” have happened and that fighting reality is a horrible way to live (see the work of Bryon Katie in week 4 of the program) 10. Creating our new self, deciding who we want to be and making that a reality, deciding how we will respond to issues and making that happen There are many steps and each person may need more of one or more of another. It's your job to figure out what you need to do. Fortunately, you have a great teacher in this process: yourself, i.e. your mind and your body. It will very clearly tell you when you are doing what you need to do and it will tell you when you still have more work to do. Our bodies talk to us in their language. It's up to us to decode it. Unfortunately, it's language is the only one it knows and it if often the language of pain. But pain is nature's way of alerting us to the fact that there is something wrong. It may be that we just stubbed our toe or placed a finger on a hot frying pan, or it may be that we are stuck in a difficult situation at work or in a relationship. There is a recent research study done by Naomi Eisenberger at UCLA in which they showed that the pathways in the brain that are activated by emotional distress (in this case, a game where the person is excluded; i.e. social exclusion) are the same pathways that are activated by physical pain (i.e. the anterior cingulated cortex). This shows clearly that there is really no difference between emotional pain and physical pain. They are one and the same and the mindbody (as Dr. Sarno calls it) will decide which one (or both) we feel. Our job is to listen. Our job is to pay attention to our bodies. They are trying to help us by being our teacher. Learn to see what events, emotions, and thoughts occur with increased and decreased pain. Be kind to yourself and to your mind and to your body. Start doing the work of healing yourself. There can be several steps as outlined above. And there is much work to be done for most of us, but this is the essence of being human. Our highest level of accomplishment is in seeing ourselves clearly, in taking control and making changes that need to be made with honesty and with kindness. It's a fantastic journey that most people never approach. We are fortunate to be making this journey and we are doing it together. It isn't an easy or simple journey, but the rewards are great. In truth and kindness, Howard Disclaimer: It is important to recognize that the information contained in this blog, whether posted by me or anyone else, cannot be considered to be specific medical diagnoses, medical treatment, or medical advice. General information about MBS/TMS will be posted in response to questions, but you will need to decide if this information is relevant to your situation and, as always, you should consult with your physicians and counselors regarding new symptoms and any changes that you might make in medications or activities.