How to deal with uncertainty

[Time2be]

My problem seems to be how to deal with uncertainty. There is so much uncertainty connected to my symptoms: right now tooth pain and gum pain, I had surgery and I have a deep bite, missing teeth change the bite, probably therefore I have inflammation of the gum. But that’s not the important part. The important part is that I want to have certainty, if possible immediately. People saying : “wait and see, the pain will go away, you need some time after surgery”, this freaks me out. And then I get uncertain about every little symptom. What is it a sign for? The tooth needed to go, it was diseased. But you can react in a TMS like fashion to what happens afterwards, amplifying the pain. And creating new symptoms.
Now, I found out that I have huge problems dealing with uncertainty. I am constantly surveying: is this a symptom for something serious? How many experts should I ask? This is exhausting and keeps the anxiety running. The anxiety wants to control things, but more control feeds anxiety. And the uncertainty that is a necessary part of life feels then unbearable. There are of course realms in my life where I can deal with uncertainty. Just not with physical symptoms of the body. I am not sure about emotions.
How do you process uncertainty?

 

[Cactusflower]

Consider that it actually might not be uncertainty you are afraid of, but the fear itself.
Fear is a double edged sword, and some of us feel it, some of us THINK it. The ultimate goal is to allow ourselves to feel it as an emotion and let it pass through us.
If we hang on and cling to the fear and the fear thoughts which is what fuels the fear, we can get stuck in more of a state of fear which doesn't pass like it would emotionally. It can take a little time to let go of this fear, but in general letting go is what leads to reducing symptoms. Letting go of the things we tell ourselves as truths, and recognizing thoughts that are distractions to living our lives now (eg. want certainty NOW).
Let's break it down a little bit: "I have huge problems dealing with uncertainty". Uncertainty isn't a problem, it's a fact of life. When our minds are stuck in this kind of little phase (it IS just a phase, and knowing that is reassuring) even if we were offered certainty, our mind would find something else to cling on to and you would react the same way...because it's the REACTION (which is kind of dramatic, knee jerk, running from screaming and gut level) that is what you want to soften. The idea is to learn to RESPOND (slowly turning toward, taking a breath even if it's after a reaction (OH NO!) and lessening the judgement on ourselves that how we are thinking, or feeling or even reacting is "wrong" or "a problem". How about it's just were you are at now as you learn a new way to be. That is a LOT less pressure, it's a lot less judgy, and a lot kinder to yourself.
We understand you want to be out of pain, but as you've clearly illustrated above, the suffering isn't really the physical symptom, it's the rumination, anxiety and worry that goes along with it and this takes time and patience to flip that little switch. You also don't need to flip the switch with heavy determination, with a strong will....all it takes is being able to flip the switch gently, and sometimes. Not every time. This is SUCCESS.
You don't need to process a single thing. You don't need to "deal" with anything. If learning about emotions seem too overwhelming right now, then back off a bit. Not fully, just a bit.
Think about what being successful means to you now and how that manifested in your life?
How successful are you feeling about learning these skills?
Think about responsibility and those that you like or feel confident with and those that make you a bit jittery or you tend to want to push away. Do you feel responsibility in doing this work?

You simply need to face your fears by allowing them to hang out and not believe every single nasty negative thing your mind says about your pain or about you or about how you are "dealing" with it. This is a judgement towards yourself that you are not dealing with it well enough. We aren't perfect as we learn. We are messy and that's OK. That's how we learn. It's actually a lot easier than it sounds and Claire Weekes breaks it all down.

Claire Weekes has 4 steps to learn to deal with fear and anxiety. All uncertainty is is fear and anxiety. Try practicing these steps, and see if over the next few weeks you can teach yourself a way to respond that serves you better: https://www.claireweekespublications.com/the-4-steps.html?srsltid=AU7gw4VKZlzht5Jlu4XPA7cvd-CpyUgbhcTUiJ9VqQ8lpZvV9WlIFd39 (The 4 Steps)

 

[Adam Coloretti (coach)]

How do you process uncertainty?

My first thought is that you firstly make sure to validate that experience and appreciate that it is fully normal as part of the TMS process. Often the biggest reason why someone can't process any emotion is because there's the additional guilt and shame for having it in the first place, basically saying "I shouldn't feel this way".

Beyond that, gain as much certainty as you can based on the situation. It's true that time will provide that as if the pain disappears shortly then it was likely just normal post-surgery pain. If it doesn't, then it's highly likely to be TMS. That's just the way it is. You can also gain certainty through what the medical professionals/dentists are telling you - based on their experience and medical expertise. If they start getting confused, then that's a great sign that it is TMS (as they very likely aren't versed in it). The fact that you've been told it's atypical odontalgia is basically the same thing as being told you have TMS, as that "diagnosis" (it's not really a diagnosis to me) is a fancy way of saying we don't know why you're in pain. Finally, if the big fear is that something is wrong, Dr Schubiner's FIT criteria can also give potentially give you some comfort there

 

[JanAtheCPA]

I also like to ask myself if what I'm feeling can be linked to the evolutionary purpose of our survival mechanisms - never forgetting that the brain process that we call TMS is a natural, evolutionarily-developed function of that mechanism. But it's also quite primitive, not having had a chance to catch up with the completely different stressors of the modern world.

Our brains naturally dislike uncertainty, because it could lead to a failure to survive in the primitive world, where dangers were fairly obvious and immediate, and were usually quickly resolved one way or another. This is not the case in the modern world, and we need to readjust our outlook accordingly, since our survival brains can't do that.

The mental health toll of world-wide uncertainty became a hot topic in 2020 as the pandemic ramped up and showed no signs of resolution - and honestly, looking around, it's kind of been one thing after another ever since. You can't do much about the existential uncertainties out in the world, but you can help yourself by looking at the things you can control and one of those is to be rational about your health care, and to visualize the outcome you want, in accordance with normal expectations, for whatever treatments you agree to, rather than catastrophizing over every little post-treatment symptom.

Ask yourself whether the catastrophizing and ruminating are serving you in your recovery? It is a well-known observation that patients who are proactive, engaged, and positive about their prognosis have the best outcomes! Make that your goal.

 

[Time2be]

Consider that it actually might not be uncertainty you are afraid of, but the fear itself.
Fear is a double edged sword, and some of us feel it, some of us THINK it. The ultimate goal is to allow ourselves to feel it as an emotion and let it pass through us.
If we hang on and cling to the fear and the fear thoughts which is what fuels the fear, we can get stuck in more of a state of fear which doesn't pass like it would emotionally. It can take a little time to let go of this fear, but in general letting go is what leads to reducing symptoms. Letting go of the things we tell ourselves as truths, and recognizing thoughts that are distractions to living our lives now (eg. want certainty NOW).
Let's break it down a little bit: "I have huge problems dealing with uncertainty". Uncertainty isn't a problem, it's a fact of life. When our minds are stuck in this kind of little phase (it IS just a phase, and knowing that is reassuring) even if we were offered certainty, our mind would find something else to cling on to and you would react the same way...because it's the REACTION (which is kind of dramatic, knee jerk, running from screaming and gut level) that is what you want to soften. The idea is to learn to RESPOND (slowly turning toward, taking a breath even if it's after a reaction (OH NO!) and lessening the judgement on ourselves that how we are thinking, or feeling or even reacting is "wrong" or "a problem". How about it's just were you are at now as you learn a new way to be. That is a LOT less pressure, it's a lot less judgy, and a lot kinder to yourself.
We understand you want to be out of pain, but as you've clearly illustrated above, the suffering isn't really the physical symptom, it's the rumination, anxiety and worry that goes along with it and this takes time and patience to flip that little switch. You also don't need to flip the switch with heavy determination, with a strong will....all it takes is being able to flip the switch gently, and sometimes. Not every time. This is SUCCESS.
You don't need to process a single thing. You don't need to "deal" with anything. If learning about emotions seem too overwhelming right now, then back off a bit. Not fully, just a bit.
Think about what being successful means to you now and how that manifested in your life?
How successful are you feeling about learning these skills?
Think about responsibility and those that you like or feel confident with and those that make you a bit jittery or you tend to want to push away. Do you feel responsibility in doing this work?

You simply need to face your fears by allowing them to hang out and not believe every single nasty negative thing your mind says about your pain or about you or about how you are "dealing" with it. This is a judgement towards yourself that you are not dealing with it well enough. We aren't perfect as we learn. We are messy and that's OK. That's how we learn. It's actually a lot easier than it sounds and Claire Weekes breaks it all down.

Claire Weekes has 4 steps to learn to deal with fear and anxiety. All uncertainty is is fear and anxiety. Try practicing these steps, and see if over the next few weeks you can teach yourself a way to respond that serves you better: https://www.claireweekespublications.com/the-4-steps.html?srsltid=AU7gw4VKZlzht5Jlu4XPA7cvd-CpyUgbhcTUiJ9VqQ8lpZvV9WlIFd39 (The 4 Steps)

Wow, thanks @Cactusflower! Sure, uncertainty is a fact of life. And I am a control freak who wants to get rid of it as much as possible. Sometimes helpful, when it comes to medicine, diagnoses and pain often not so helpful. Maybe it is fear all along, yes. Absolutely possible. I know that uncertainty triggers fear and anxiety. There is a lot of fear in my life, I found out that it followed me, often quiet as a bystander, sometimes loud and active, since I am a little child. I know why, my parents dysfunctional and not able to provide emotional stability. Knowing this can turn into a narrative of excuse. Instead it could be a simple explanation and helping me to feel better about myself, not blaming me, but also not making me the helpless victim.
What I like most is your advice not to "believe every single nasty negative thing your mind says about your pain ...." Indeed, that and all the other advices what I should do or not should do this little voice gives me. To lessen the judgement on ourselves, as you say. That doesn't come easy for me. But I am willing to go there, I know Claire Weekes work, I listened to the videos and read the four steps years ago. I will incorporate the four steps. I do not know quite how to specifically, but in situations where the anxiety is present I will use these four steps and then I will see what happens. Thank you!

 

[Time2be]

My first thought is that you firstly make sure to validate that experience and appreciate that it is fully normal as part of the TMS process. Often the biggest reason why someone can't process any emotion is because there's the additional guilt and shame for having it in the first place, basically saying "I shouldn't feel this way".

Beyond that, gain as much certainty as you can based on the situation. It's true that time will provide that as if the pain disappears shortly then it was likely just normal post-surgery pain. If it doesn't, then it's highly likely to be TMS. That's just the way it is. You can also gain certainty through what the medical professionals/dentists are telling you - based on their experience and medical expertise. If they start getting confused, then that's a great sign that it is TMS (as they very likely aren't versed in it). The fact that you've been told it's atypical odontalgia is basically the same thing as being told you have TMS, as that "diagnosis" (it's not really a diagnosis to me) is a fancy way of saying we don't know why you're in pain. Finally, if the big fear is that something is wrong, Dr Schubiner's FIT criteria can also give potentially give you some comfort there

Thank you @Adam Coloretti (coach)! The dentist just mentioned neuropathic pain to me, he does not really know anything about it. It is me that is going down the rabbit hole of finding out if this is what I have, besides the fact that there are valid explanations for the pain I have post surgery. And even if this is neuropathic pain, then as you say it is a fancy name for TMS.
Having pain and not knowing the cause properly, that has become an obsession for me. I had that with bladder pain for decades, until I found proper medical treatment. And even with the treatment there is a grey zone where I would say there is a part TMS involved. It is the way I react to symptoms and diseases, not calm and looking at the facts. Instead I panic, google widely, use AI, gather information that often is contradictory. That opens for even more symptom checks and then I am totally confused and exhausted. Writing it down like this it is clear to me that the first thing I have to stop is to google information and have these conversations with AI!!!

 

[Time2be]

I also like to ask myself if what I'm feeling can be linked to the evolutionary purpose of our survival mechanisms - never forgetting that the brain process that we call TMS is a natural, evolutionarily-developed function of that mechanism. But it's also quite primitive, not having had a chance to catch up with the completely different stressors of the modern world.

Our brains naturally dislike uncertainty, because it could lead to a failure to survive in the primitive world, where dangers were fairly obvious and immediate, and were usually quickly resolved one way or another. This is not the case in the modern world, and we need to readjust our outlook accordingly, since our survival brains can't do that.

The mental health toll of world-wide uncertainty became a hot topic in 2020 as the pandemic ramped up and showed no signs of resolution - and honestly, looking around, it's kind of been one thing after another ever since. You can't do much about the existential uncertainties out in the world, but you can help yourself by looking at the things you can control and one of those is to be rational about your health care, and to visualize the outcome you want, in accordance with normal expectations, for whatever treatments you agree to, rather than catastrophizing over every little post-treatment symptom.

Ask yourself whether the catastrophizing and ruminating are serving you in your recovery? It is a well-known observation that patients who are proactive, engaged, and positive about their prognosis have the best outcomes! Make that your goal.

@JanAtheCPA thanks for you answer! What strikes me as most important:
You can't do much about the existential uncertainties out in the world, but you can help yourself by looking at the things you can control and one of those is to be rational about your health care, and to visualize the outcome you want, in accordance with normal expectations, for whatever treatments you agree to, rather than catastrophizing over every little post-treatment symptom.
That is exactly what I do, catastrophizing over every little post-treatment symptom! it is not good for recovery, it is not good for my life, not at all! The challenge for me is how to stop this!! Sometimes a doctor whom I trust is able to stop the ruminations and catastrophizing. Sometimes only for a short period, before it starts again. I feel shame for this, I do not want this and do not want to be that person. Sometimes medical treatment is absolutely unproblematic, I had surgery for the thyroid, three days afterwards I did not use pain killers and was doing quite well, one week after I started to work from home again. I was not concerned at all. And then there are other symptoms or conditions I cannot handle. That teeth are now also in this category astonishes me, because they were not before. Maybe symptom imperative, because I do not have bladder issues or stomach issues. Then something else comes up, in my case connected to necessary dental work.

 

[Time2be]

Thank you all of you again. Your replies gave me a lot of insights. Also answering your replies helps me to clarify a lot. I see a pattern of how I react, although I still do not really know how to change it. Not one big decision, I understand that @Cactusflower, little steps. Some will power is needed I think, e.g. to not google symptoms and treatments. I didn't mention that I am in therapy with a psychologist who uses ACT approach. I really thought I had learned something the last years, I overcome a big crisis in 2023 and felt like a different person after that. But this year it came back, first with vaginal infections and related bladder pain that took a long time to be resolved. And then about two month later suddenly a bridge became loose and two teeth had to be pulled out, leaving me without molars the lower right side. Then three week later, pain left upper side starts and a molar with a crown has to be pulled out because it was partly dead and there was decay into the root. It felt like a nightmare, because I clean my teeth and two times a year went to the dentist for control. It came so fast. But it is a fact of life, these things happen.

 

[Adam Coloretti (coach)]

It is the way I react to symptoms and diseases, not calm and looking at the facts. Instead I panic, google widely, use AI, gather information that often is contradictory.

I think that's a very good reflection and that makes all of these symptoms (past and present) more likely to all be TMS (either fully or in large part) - it's a big underlying factor to them all!

 

[Time2be]

Sorry for posting again, it's just like now something seems to configurate in my mind. Anyone also has a kind of magic thinking? Not that I believe in magic. But I have this feeling that if something goes well, that when my symptoms subside, then, something awful will happen. As if I am punished for feeling good, being happy, being optimistic. I do not think that most people who know me would call me a pessimistic person. And it is not really general pessimism. But it is a belief that obstructs healing. And fuels anxiety. In popular language we often say 'I do not want to jinx it' .. it is something like this ...

 

[Time2be]

@Adam Coloretti (coach) , you think that if it were a clear diagnosis, no googling is necessary, the facts would be clear. But if not, then the googling starts and this is a indication that it is TMS, very interesting. Sounds right to me!

 

[Adam Coloretti (coach)]

@Adam Coloretti (coach) , you think that if it were a clear diagnosis, no googling is necessary, the facts would be clear. But if not, then the googling starts and this is a indication that it is TMS, very interesting. Sounds right to me!

It's true that the more complicated and unclear things are medically the more likely it is to be TMS (but not necessarily) - what I meant was that in each case there you've freaked out and that symptom has become chronic - that is evidence that they are likely all TMS (because the freak out is present) - that's something to work on, this part:

It is the way I react to symptoms and diseases, not calm and looking at the facts.

I'd be addressing why that is from an emotional perspective - because that might just prevent future little things from becoming chronic, so you're addressing the root cause

 

[Time2be]

@Adam Coloretti (coach), thanks for the correction. I understand, things can become chronic because of the way I react. I am waiting for a second opinion of a specialist dentist. I hope that will clarify things. In the meanwhile I continue with my life and do not try to freak out.