How to identify triggers?

[Wings313]

I joined this forum a couple months ago and while I haven't been officially diagnosed with TMS, I'm pretty sure I have it. My symptoms are bladder-related - feeling of needing to urinate and some pelvic/bladder pain. Basically, the symptoms of interstitial cystitis (IC) which I know is a TMS equivalent. Anyway, I started the structured educational program on here, which was great, but due to some life circumstances, took a break from it. I was distracted by other things going on in life, and my symptoms basically disappeared. I do think the journaling and all helped. But, just today, the symptoms came back in a way they hadn't had for a while. I tell myself to "think psychologically." I was trying to think of what could have triggered this...so I'm just looking for insight from you more experienced TMS-ers. I did have a voicemail from my mom today which brought up slight feelings of what I think is a root of my TMS - feeling like I disappointed her, I'm not a good daughter because I haven't talked to her in a while, I'm not living up to her expectations, etc. I didn't have ALL those thoughts, but it was a general feeling that I've had MANY times in my life before. But before, it didn't cause me physical symptoms. Could it just now in my life (I'm 33 years old) cause physical symptoms whereas it didn't before? Or maybe different symptoms?

I have been eating/drinking the "forbidden" IC foods, which haven't caused me problems bladder-wise lately, but my mind goes there - what if it's the food or the wine, etc etc? I know that's dangerous thinking because it makes it focused on the physical.

Last question: a while back, I made an appointment with an IC specialist (urologist) that is coming up on the 18th. I'm thinking I shouldn't even go to the appt now, because it could actually make things worse. I'm sure he doesn't know anything about TMS and might make me think my issues are physical (which clearly they're not because they went away with no change in my eating/drinking or anything). Thoughts?

 

[Leslie]

The only advice I can offer regarding whether or not to keep the appointment would be this: If your symptoms have already been thoroughly checked out by a medical doctor you might want to go with your instinct. If you haven't seen a doctor about the symptoms yet, I would highly encourage you to keep the appointment to rule out anything more serious.

As for the voicemail, for me personally, sometimes that's all it takes (even perfectly pleasant - just called to say "hi" messages can do it for me)- especially if the voicemail is being left by a prominent life-long figure like Mom. Certain email addresses popping up in my inbox can have the same effect before I even open them to see what the message is. You may not have consciously had all those thoughts when you listened to the voicemail, but you've had them before and they're never far from the surface. I have had very similar thoughts related to my own parents. Prior to almost 2 years ago when my TMS pain began, my "pain" manifested itself as anxiety and depression mostly. I guess I had maxed out the capacity that my brain could handle using depression or anxiety as it's distraction methods so it moved on to physical pain. As I've taken a closer look at things in my life, previous "health" experiences, even in childhood, I have discovered that 2 years ago was not truly my first time to the TMS rodeo, it was just the first one I was aware of as TMS. The earliest "physical" issues were actually headaches that started early on in grade school, followed by an "ankle" incident when I was 12, and a "pseudo-seizure" incident in my late teens. With the exception of the headaches (because my early grade school memories are not that good), I have identified some serious (given my maturity level at the times of the incidents) stresses occurring in my life with each incident. I think that for a lot of goodists (definitely true for me) Mom and or Dad are hard-wired into our brains. We've spent most, if not all, of our lives desperately trying to please them, and often that meant using a lot of "intuition". We focus so closely on them that we "know" what they're thinking, even when the words don't come out of their mouths. I think many of us could get as much (or more) information from a passing glance from one of our parents than if we sat down and had a conversation with them for 10 minutes.

Final thought here, have you tried re-framing your "what if" thoughts about food and wine to a positive thought like "what if the food or the wine is the cure for the pain?" I know my "what if" thoughts were a major culprit for my negative, or self-defeating thoughts. I actually play a game of "positive 'what if' tag" with my sister each day to make sure I am held accountable for having at least ONE positive "what if" thought each day. It was REALLY REALLY hard at first. In fact there was at least one day when I had to do a google search for positive "what if" thoughts and borrow one from someone else when I could not think of my own. Positive thoughts are just as contagious as negative ones, they just don't come as naturally to those of us who are always on high alert to please others.

 

[Wings313]

Thank you, Leslie! Your response was very helpful. I have actually already been to one urologist who doesn't think there is anything physically wrong with me. It was my fear that made me make an appt with a supposed "specialist" (even though the first urologist is a specialist in urinary stuff anyway). So, my thoughts are to cancel the appt.

It is interesting that even seemingly small things like a voicemail can cause symptoms to flare. And I was like you in that I have felt these emotions before, but they've come out more as anxiety and depression in the past (they still do). I like your re-framing ideas too!

 

[Leslie]

Happy to help any way I can. If you've already seen one specialist and you're inclined to agree with the assessment then your instincts are probably right on as far as canceling the appointment. One expert has already told you there's nothing "physically" wrong so TMS is very possibly your culprit. You can always reschedule the appointment later on if you change your mind and in the mean time you aren't draining your bank account feeding into your pain with the search for the culprit.

Really small things can definitely trigger me. If I know there is something going on that someone in my family might consider the tiniest bit stressful, just the "ring" of the phone can do it before I even look at the caller id. How silly I feel when my shoulder is throbbing because some telemarketer chose that time to disregard my "do not call" request!

I love the positive what if game. I really struggled to come up with them the past couple days but that's exactly the reason I play it with my sister - she keeps me accountable when I might be inclined to let myself off the hook. If you'd like to play, you can send me a private message (so I don't drive everyone on the forum bonkers with some of the wild what if thoughts that enter my mind sometimes) by clicking on "inbox" at the top right of your screen (next to your name) and then click on "start a conversation".

 

[Wings313]

Leslie - thank you! I did keep the appt with the specialist doctor. but I presented my case very carefully, making sure he knew I thought it was psychosomatic and how I have a lot of anxiety, it seems to be related to that, etc. He did ask some medical questions but at the end of it he basically said he didn't think anything was physically wrong with me. But I immediately started wondering if he only said that because of how I presented it? Maybe I biased him because I talked about it being psychosomatic? You can see my neurotic obsessiveness/overanalyzing here!

I did find it interesting that he was very uncomfortable with the term "psychosomatic" - like he didn't want to say he thought that was it (he termed it more as an anxiety problem). I was fine with the term, but he was a typical medical doctor within the medical establishment and thought that was a bad word to use.

 

[Leslie]

Leslie - thank you! I did keep the appt with the specialist doctor. but I presented my case very carefully, making sure he knew I thought it was psychosomatic and how I have a lot of anxiety, it seems to be related to that, etc. He did ask some medical questions but at the end of it he basically said he didn't think anything was physically wrong with me. But I immediately started wondering if he only said that because of how I presented it? Maybe I biased him because I talked about it being psychosomatic? You can see my neurotic obsessiveness/overanalyzing here!

Sounds like you did a great job presenting your case to the specialist. I think that as humans, our tendency is often to assume other humans think and act as we do, so possibly that might have been what was triggering the wondering if he only said what he said because of how you presented yourself - possibly subconsciously you were assuming the doctor was a people-pleaser too? In your previous post you said that you've already seen one specialist who didn't think there was anything physically wrong with you. Now you've seen another one who agrees. I'm assuming that as specialists in this area either or both has run some type of testing as well as the physical exam to back up their findings? I would think that if anything, you probably reduced his anxiety a bit by talking about it being psychosomatic - you proactively neutralized any concerns he might have had regarding how you would react if he told you he didn't think there was anything physically wrong.

I did find it interesting that he was very uncomfortable with the term "psychosomatic" - like he didn't want to say he thought that was it (he termed it more as an anxiety problem). I was fine with the term, but he was a typical medical doctor within the medical establishment and thought that was a bad word to use.

I don't have any medical training to know whether or not this might actually be true, but I wonder if the discomfort with the word "psychosomatic" could be the result of the type of medical training "body medicine" doctors receive - especially specialists. Possibly they receive such extensive training in their area of expertise that they are uncomfortable with anything pertaining to the psychological, not necessarily because they disagree with the idea, but simply because it takes them out of their specific area of expertise and leaves them vulnerable to questioning (maybe it's their malpractice insurance guiding their reactions?). An anxiety problem is definitely "psychosomatic" in origin so it is interesting that he would be comfortable agreeing with that. Regardless of the reason, I'm thrilled that you have another expert opinion confirming that there is nothing physically wrong! Now you can focus all your efforts on curing yourself psychologically!

 

[Wings313]

Just want to touch back to all my old posts because it's always nice to hear how things worked out. I am doing MUCH better. My urinary stuff was and is completely TMS/mind-body stuff. I am convinced of that. Not even physical therapy helped. What I've found helped the most is not fearing the symptom, and not changing anything physically because of the symptom (I would walk differently, clench, cut out foods/drink, etc...but now I try not to). Take away the power of the symptom by not being afraid of it! Tell yourself - oh well, even if I have this symptom forever, it's going to be okay, it won't ruin my life, etc. Even the typical TMS/Freudian anger work didn't really help, although it can be a good exercise to do. For me it's all about dismissing it (the TMS symptom), not giving it power, not giving it attention.