How do you explain TMS to someone simply?

What is the simplest/shortest way to explain TMS to someone?

 

In my workshops I ask people to close their eyes and imagine their favorite dessert.

Soon their mouths begin to water.

Then I tell them that even though there is no dessert here just thinking about it made a physiological change in their body. In the same manner, if they are thinking about negative things they too create physiological changes, like reduction of blood flow, in their body.

This reduction of blood flow cause their pain and/or numbness.

It usually helps people to make the connection.

 

@Penny2007

It really depends on whether the individual is willing to open themselves to the possibility of PPD derived pain processes. I've found that if you explain to them that if no physical cause can absolutely be identified as the culprit that there's a strongly probability it is something more psychological. Again though, the audience needs to be more willing to accept this probability.

I have had this discussion with my wife. She has suffered from shoulder and neck pain since she was 15; she's 33 now. It all started with a doctor simply stating that she has a bundle of nerve tissue in her shoulder that looked abnormal and that she would suffer for the rest of her life. She is the type unwilling to consider the pain as PPD thus complaining near daily of the discomfort but still managing to battle through it with virtually no issues.

Some people will never consider the idea.

 

@RichieRich

True - many people are totally unwilling to accept it or they understand it but it doesn't apply to them. That's my husband. He can see how my pain is psychologically caused but his pain is "real".

But for people who are open, how do you explain it? I don't like saying the pain is psychologically caused. That makes it sound like it's in their head. What is another simple way of explaining it? I find I get into too much detail and that isn't an effective way to explain it. Maybe I don't understand it well enough myself otherwise I'd be able to explain it in a couple of sentences

 

@Penny2007

I guess another way of explaining it is to simply ask, do you feel bothered if not preoccupied by the pain when it pops up? In this case there's an emotional component that amplifies the sensation. I think with this in [mind] it can be safely deduced that the issue is grounded partially in the mind. It's that component that's hardest to overcome. The pain is real, but the sufferer has to come to grips with the reality that there can be a mental component.

My wife insists she has fibromyalgia, and I've supported her with the thought of going to see a doctor and getting medication. I think she's deathly afraid of the issue spiraling out of control and into a cycle of pain management drugs. We have a 2 - 1/2 year old son whom she's home with all day everyday as I work. I think she's worried she'll be zonked while taking care of him.

Having GAD, I've learned to manage my own problems as they arise through a combination of mindfullness and distraction. It's an awful feeling watching someone else beat themselves relentlessly because they can't understand how to manage similar issues.

 

@RichieRich - what's GAD?

Would like to hear more of your combination of mindfulness and distraction. I've been trying that recently but I believe the mindfulness takes a lot of practice because you need to break your old thinking habits. I also feel better when distracted but then I think, isn't that just treating the symptoms and not solving the problem?

 

Not that I've had a lot success converting people ...

I think it's very important to point out early in the discussion that the pain is very real and not imagined. But the pain IS generated by the brain and not caused by some physical abnormality in the body. The great news is the brain can be trained to stop generating this pain.

 

@Penny2007

Generalized Anxiety Disorder (GAD). I'm not a diehard TMS'er but I do respect its tenets. I use a combination of things learned over the years to ground myself. I should clarify mindfullness as it applies to myself. I recognize when there is a symptom and I'm starting to slip. Rather than run from it, I run towards it. I recognize the issue for what it is, allow it to simmer a minute or two, then try to move on with what it was I was doing. It eventually abates. You just have to give it some room.

Understand that I've been through hell over the years. Tremors, depersonalization, heart palpitations, breathing difficulties, night terrors, sleep paralysis. You name it, I've just about experienced and overcame it. I've seen counselors over the years that helped me gather my thoughts. This site has been more instrumental in me overcoming my issues than all the therapy and useless gimmicks combined.

Feel free to peruse my history for some of my responses on the issue of anxiety and it's management.

 

I tell them : "It's psychosomatic, caused by stress--the pain is excruciatingly real, but benign. Which would you rather do, have surgery--or have a change mind?"

 

For the most part, it's a fool's errand to try to explain TMS to others. As I have posted here previously, the two people who independently told me about Dr. Sarno's work and TMS, claim that it makes good sense; however, it doesn't apply to them, as they needed surgery.

 

Not everyone is closed to the idea of TMS. I find that men are a harder nut to crack then women for sure. I was trying to explain it to someone the other day (a woman who is likely suffering from TMS) and she was very receptive, I just feel like I may have inundated her with too many details.

 

Sometimes I introduce it very gently to patients to see if they might be interested in learning more. I think this works best. I say that often times pain and sensations in the body are caused by stress and emotions in the absence of any true damage to the body and cite a study or two if I think the patient would connect (the more scientifically minded like these). I usually explain it with the neural pathways model since I connect to that best and feel there is more evidence for it, plus the fact that it is consistent with modern neuroscience. I use myself and my back pain story as an example if they're interested. Sometimes they don't bite at all, sometimes they do! I've had a couple more people recently interested and have been talking them through it in their PT sessions.

 

I had one man who was off work for disability due to carpal tunnel syndrome tell me that he agreed 100% that it was TMS but hated his job so much that he was going to have the surgery as a means of staying off work longer!

So there are many reasons why people may or may not accept TMS.

 

There is no easy way of doing it, and its also depends upon the level of interest and suffering other person is going through that make things a lot easier to grasp.

 

Thanks for the candor about why some people don't have the incentive to heal due to receiving primary and secondary gain from having an "injury". I'm seeing more people everyday who are not working but seem able to play tennis and go to the beach just fine. They run to get one surgery after another, I believe much of this is to get the strong pain killers that come with post surgery.

A quote from comedian Maria Bamford previously quoted at the TMS Help site comes to mind :

"All my friends in Los Angeles are the sensitive type. They all have like all the diseases like Chronic Fatigue, Epstien Barr, Fibromyalgia. Like all the diseases where the only symptoms seem to be you had a really crappy childhood and at the prospect of full time work ya feel kinda achy and tired."
Comedian Maria Bamford
​

 

I hope nobody gets offended...but here is what I said the other day when describing it to some friends:
"The mind causes your pain in the same way that it causes your erection."
Probably better to use a different approach if you are talking to women, though.

 

Actually, come to think of it, my own reaction was not all that receptive either. Here's how I describe it in Rapid Recovery from Back and Neck Pain:

FINALLY, AN ANSWER​

About a month before I returned to work, we received a flyer in the mail about a book published by Boardroom Classics giving inside information on money, travel, health, and more. By now, experience had taught me how important every bit of information could be in saving time, money, health—even one’s life. Since the book offer included a fourteen-day free trial period, I had nothing to lose by ordering the book. It arrived on the day I returned to work.

TENSION MYOSITIS SYNDROME​

I began by reading the section on health. Under the topic of back pain, the book mentioned Dr. John Sarno's discovery, as set out in his book Mind over Back Pain. Dr. Sarno, a professor of clinical rehabilitation medicine at the New York University School of Medicine, discovered that back pain is almost always caused by anger, anxiety, worries, frustration, and tension—not some physical abnormality. He calls this phenomenon tension myositis syndrome (TMS). TMS is the result of reduced blood flow to affected soft tissues. Although extremely painful, the condition is harmless; what is going on is that the subconscious mind is creating pain to distract the person’s attention from a stressful relationship or situation.

Once the patient is aware that back pain results from repressed anger and anxiety, the subconscious mind will discontinue its trick, and the pain will stop. TMS sufferers are usually perfectionists who want to be the best in whatever they do and are their own worst critics.

Not Me!​

I saw myself as a very calm, positive, easygoing person with a sense of humor, who rarely became angry. Of course, like anyone with chronic back pain I had experienced more pain during or after a stressful period, but was it reasonable to believe that repressed anger and tension could really cause all my pain and disability? And what about my degenerated discs? The medical establishment considers anger and anxiety aggravating factors for existing physical problems, but could tension actually cause these physical problems?


None of my doctors or therapists, nor any of the many books I had read, had yet been able to provide me with a clear explanation, diagnosis, or treatment for back pain and its chronicity. I knew that successful problem solving requires being open-minded and examining all possible solutions.

Considering that this concept of tension myositis syndrome was the observation of a professor of clinical rehabilitation medicine at a major university, I decided to study it further. After all, what could I lose by gaining more knowledge? Even if my pain was not caused by tension, maybe I could help others by learning about it.

MIND OVER BACK PAIN​

The local library had a copy of Dr. Sarno’s book Mind over Back Pain. In this book Dr. Sarno attributed the cause of back pain to reduced blood flow to certain muscle groups as a result of tension. He described back-pain sufferers as conscientious, responsible individuals who are in touch with their feelings (unlike the Type A, aggressive, and competitive personality) and who try to be the best in what they do. They are also their own worst critics. As a result of subconsciously repressing their anger and anxiety, they create a great deal of tension and develop certain physical symptoms, such as back, neck, or shoulder pain. Some individuals even developed sciatica and knee and elbow pain.

Dr. Sarno explained that, unfortunately, the present medical approach to diagnosing back pain is to look only for a structural disorder such as a herniated disc, arthritis, or other physical problems. Such a diagnosis increases the patient's tension level, which causes more pain, and the individual's mobility is restricted by a long list of dos and don'ts that are supposed to prevent further damage to the back.

According to the book, most TMS sufferers are very calm and in control on the conscious level. But their subconscious reacts to repressed anger or tension and causes physical pain. I had always been a fairly calm person who rarely got angry. Even when I did, my anger was usually under control. I wondered how Dr. Sarno's diagnosis could apply to me.

I had also trained myself, since my first course in psychology, to be as free of worry and anxiety as possible. I was taught that people with type A personalities, who get angry easily and are tense, can suffer heart attacks, ulcers, and other ailments. To avoid such ailments, if I could do something about a problem, I would do it. If not, I would be concerned about it and pray about it, but never worry about it or allow it to dominate my thoughts or my life.

When I read about a young girl with chronic back pain who dealt with problems in the same manner I did, though, I became more interested. I also remembered from my course in psychology that one of Freud's patients was a young woman who experienced pain in her right arm. The pain had developed after she failed to write to a loved one before he died. Her subconscious focused the guilt and anger at her right arm, where she experienced pain.

Dr. Sarno gave many examples of patients who had back pain and related problems for years. Many had been diagnosed with structural abnormalities such as herniated disc, and some had had surgery but were never able to recover completely and lead normal, productive lives until they were treated for TMS. These examples gave me the hope that it might be possible for me to lead a normal life again.

Dr. Sarno wrote that reduced blood flow caused the pain. So after I read the book, I lay down, closed my eyes, and imagined an increase in blood flow to my elbows. Strangely enough, the pain in my elbows decreased, but my right triceps muscle began to twitch. It was such a strong twitch that even my wife could see the muscle twitching! This interesting phenomenon indicated to me that what goes on in my mind might affect my painful condition.

But I was not convinced yet. I needed to have a number of questions answered: Do I need to change my personality and show my anger and discontent? How is TMS treated? Are there any doctors in California who diagnose and treat TMS? What is the role of physical therapy and the treatments therapists use to increase blood flow to affected areas? How soon after one realizes that the pain is caused by tension does recovery begin?

HEALING BACK PAIN​

After two weeks of calling New York University, I was finally able to talk with Dr. Sarno. He kindly suggested that I read his latest book, Healing Back Pain, for answers to my questions. To my amazement, only one copy of this book was to be found in all of the Silicon Valley library system. I placed an immediate request for the book. I also called a bookstore and ordered a copy.

Three days later, I checked out the book from the library. I began by reading the appendix, which contained letters from patients who had recovered from chronic back pain simply by reading Dr. Sarno's first book, Mind over Back Pain. The success stories contained in those letters-some of whose writers had been in worse condition than I was-gave me more hope for a complete recovery and prepared my mind to be more receptive to the ideas presented in the book. In particular, a letter from a woman who suffered disabling pain similar to mine for seven years and eventually regained complete health represented a clear sign that I could expect the same results.

Therefore, I eagerly began reading the book.

 

What sorts of things did you do to ground yourself?

 

Caulfield

 

I heavily suspect that in order to get fully understanding and total acceptation of the TMS concept you have to be simultaneosly very naive .... and very clever. Yes, simultaneously!
You have to posses some kind of common sense and emotional (not intellectual, beware) intelligence in order to grasp the trap that our brain is hatching.... trying to protect/distract us from menacing/dangerous emotions (mainly colossal unconscious rage generated by our inner child by the exigences, responsabilities, frustrations and failures corresponding to an adult existence).