Intro: Classic TMS case, feeling stuck.

[ayalitta]

Thank you so much for creating this forum for peer support!
And thank you in advance for reading, listening and commenting...
This is a bit long, so I hope you'll bear with me:

I am 37 year old business owner, mother to a wonderfully lovable teen with permanent disability, whom I raise alone. I've been living abroad, far away from my family, for many years. I think in that alone lie the majority of my "life pressures". Add to that my abusive childhood, and high expectations of myself - and it's the classic recipe to TMS.

Up until 3 weeks ago (July 8th), I could not walk for more than 5 minutes at a time (and even then, it was using a cane!). I spent the entire spring 2013 in excruciating sciatica and lower back pain on my right, as well as sharp knee pain on my left. I was diagnosed with a herniated disc, protruding to the right, between L4 and L5. The knee got very little attention (physiotherapy did not work, and neither did the antiinflammatories I was on for 7 weeks; the spine doctor does not know anything about knees so it was quite the mystery how this knee thing happened, not to mention how to get rid of it). Between the left knee and the right leg/lower back pain I was heading downhill fast towards the operating table, from which I was extremely scared of.

3 weeks ago, I was exposed for the first time to the concept of TMS and quickly realized that I've been living with TMS probably all my life unknowingly. I have to first thank my brother, who called me 3 weeks ago on a Friday night, and told me about a family friend who was like me facing a surgery for herniated disc, and came across Dr. Sarno's books and healed completely. It was 10pm, I was very skeptic (my brother loves "spiritual gurus" LOL), and I was already in bed after a very rough day following my 2nd visit to the spinal clinic (aka hearing from the spine doctor that I really should do a surgery for my herniated disc). I listened to some interviews on YouTube with Dr. Sarno, I can't begin to describe the RELIEF at the thought that my back is healthy and strong and that I will not need a surgery! I decided I must get that book the next day, and put it to work when I was on my way, walking slowly (still with a cane) downhill to catch the bus (instead of taking a taxi, which I was forced to do for months). As I walked downhill the pain began to "act out", but I kept reassuring myself that my knee pain is psychological as I walked towards the book store to get "Healing Back Pain". I literally talked out loud to my knee and the sharp pain stopped, within minutes. I haven't even opened the book yet...

I returned home and read the book to the week hours of the night. I felt as if it was written about me: My early manifestations of TMS were mysterious skin conditions between ages 4-6. I've developed lower back pain at the ripe age of 10 (That adds up to 27 years of back pain... OUCH!). This constant pain is so deeply engrained into me that I've developed a high pain tolerance and can't even imagine my life without that constant pain/pressure/stiffness in my lower back). In addition, I "enjoyed" countless headaches through my teen years till the present days (usually they come in when I'm very stressed about school or work). I had all kinds of other mysterious physical symptoms before the "herniated disc" episode, such as waking up at night from unexplainable cough or from a numb hand or pinky finger. So I had no difficulty convincing myself that "it's not physical, it's psychological". To top it off, as I was reading the book, the pain shifter dramatically from the right lower back to the left lower back and the pain was turning on and off at random. Within 48 hours the sciatica went away. Needless to say I stopped using the cane; but I also stopped taking the Gabapentin (which was useless anyway), and cancelled my physiotherapy appointment that Monday. I also made an appointment with my family doctor so that she can refer me to a psychotherapist and started treatment last week.

The sciatica disappeared for most of the time, and whenever it came up (sometimes in my left leg, just for fun and for proving me the "symptom imperative" - so I knew Dr. Sarno was right. Similar things happened when I experienced headache the following week as I finally returned to work after 2 months of absence. I thought about what made me angry that day, and the headache disappared.

So far so good - this looks like it can be a "success story". And I realize I am being harsh on myself as I'm only 3 weeks into the process. However, these are my concerns and I hope you can help me:
1) While I'm easily able to put the TMS approach to work on all the "new pain" - i.e. symptoms that were onset in the last episode (knee pain, sciatica, etc.) - I have no success whatsoever in getting rid of my so-called "normal" back pain in my lower left back. I've had it for years and I'm not feeling any improvement. Every time I get up after sitting or bending, it feels very stiff and hurts.
2) For years I've been practicing Pilates and enjoying it a lot. It also felt as if it was helping me with my back pain (though my initial interest in it was more for overall fitness and vanity...). Should I continue with that? Or should I stop any sports that might be considered "physical therapy"?
3) Ditto regarding swimming. I just love water, and enjoy outdoors swimming. I think the reason it always helped with my pain is because swimming brings me to an almost-meditative state, and really relaxes me while helping to sort out my thoughts.
4) Regarding running: I used to hate running, but it grew on me when I started running on the sand by the beach (did I mention I love water)? I went on my first run last week, all enthusiastic, and my pain got worse. I was not pain free when I started to run, but things certainly got worse after - and I tried to deal with it emotional, but since then I'm feeling even more "stuck" in my inability to release or get rid of any of my back pain.

 

[AngK]

Hi, ayalitta!
I am new to this so you're not talking to a success story... yet! So, take my advice for what's it's worth. Answering you point by point:

1) I too have some TMS symptoms that just hang on... some move, some refuse to move (but HAVE lessened). But, especially since I'm early in treatment, I don't get discouraged. My subconscious senses that it's job is not done yet (or so I take it).

2 & 3) I do the exercise and physical activity that I WANT to do. I don't refrain from anything due to fear OR due to me wanting to prove something to myself. Earlier in the program I denied myself things I wanted to do b/c I thought I was giving in to the TMS. For instance, getting a massage. Now I get a massage if I want one. The work to be done on TMS is mental, psychological. So that's where my focus is: on getting better psychologically. I'm now learning not to focus on the pain one way or another. Beating myself up & thinking I'm a failure b/c I want a massage is just as bad as refraining from bending over b/c I fear hurting my back. There's a lot of information & prior posts on here re: self compassion and it's very helpful. You cannot have self compassion when you're expecting yourself to be the perfect TMS patient There's a balance there that I think each person needs to find. Just yesterday I had sort of an "a-ha" moment and a good deal of pain disappeared. "A good deal" but not all. It's complicated. I've determined that there is no Holy Grail... no ONE reason why my subconscious feels TMS is needed. It's truly a journey, not a destination.

4) RE: exercise... you are human! If you have not been running then taking up running should be a slow process. I am not a runner myself so I don't have any specific advice for you. I do a lot of boot camp type classes & when I started back I started off wimpy. There were days when muscle fatigue & soreness seemed to exacerbate my symptoms temporarily. I am out of shape. So that is never an easy thing to overcome. But, I'm noticing it less and less now.

 

[trypp]

Welcome, ayalitta,

You do indeed sound like a classic case of TMS, and I think you are exactly on the right track. The fact that you saw yourself so much in the book is a great sign, and you clearly are under a lot of stress. I wouldn't worry at all about the back pain. It's completely normal for different symptoms to take different amounts of time to die down. In some sense, it is just another trick of the TMS, trying to wear you down. You can do it, though, as many have before.

AngK's advice sounds great to m. If you like Pilates and Swimming, then, by all means, do them! The key is recognizing that the TMS is nothing, that it doesn't mean anything to you. Then it will slowly fade away.

For running, it's also very common for symptoms to increase before they decrease. However, this doesn't mean that you should go all out immediately, because this might just frighten you. Dr. Sarno provided some great advice about this in Healing Back Pain coincidentally illustrating it with a runner:

It should be noted, parenthetically, that the advice to resume normal physical activity, including the most vigorous, has been given to a very large number of patients over the past seventeen years. I cannot recall one person who has subsequently said that this advice caused him or her to have further back trouble. ​

​

I suggest to patients that they begin the process of resuming physical activity when they experience a significant reduction in pain and when they are feeling confident about the diagnosis. To start prematurely only means that they will probably induce pain, frighten themselves and retard the recovery process. Patients are usually conditioned to expect pain with physical activity and so must not challenge the established programmed patterns until they have developed a fair degree of confidence in the diagnosis. ​

​

One of my patients, an attorney in his midthirties, had an interesting experience in this regard. He went through the program uneventfully and in a few weeks was free of pain and doing everything— except one thing. He was afraid to run. He explained to me later that it had been drummed into his head for so many years that running was bad for your back that he simply couldn’t get up the courage to try, though he could do many things more strenuous than running. After almost a year he decided that this was silly and he was going to run. He did, and his pain returned. Now he was at a crossroad; should he continue to run or back off? He called for my advice but unfortunately I was on vacation and he had to make his own decision. Wisely, he decided to bull it through. He continued to run and he continued to hurt. Then one night he was awakened from sleep with a very sharp pain in the upper back, but his low back pain was gone. Knowing that TMS often moves to different places during the process of recovery, he decided that he had probably won, and he had. Within a couple of days the upper back pain was gone too and he has not had a recurrence of either upper or lower back pain since that time. One has to confront TMS, fight it, or the symptoms will continue. Losing one’s fear and resuming normal physical activity is possibly the most important part of the therapeutic process.​

I think the goal is to feel the fear and the pain, allow them to pass right through you, and then let them go. The feelings may very well stay around, but they don't need to and you can move on if you like. It can be scary, but it works.

 

[Mtngal]

I am too, "stuck" in a second bout of what I think is TMS, since no doctor has actually ever been able to give me a definitive diagnosis, other than "some mildly degenerated discs" in 1995 - and I was 41 then.. a neurosurgeon suggested surgery, which I'm glad to say I declined. I was actually healed that time by quite a miraculous "incident" that occured and was quite "spiritual" in nature - and of course was due to a change in the way I thought about my back.. had 6 years of being pain-free and unlimited physical activity.. then one short lasting recurrence in 2001, then another 1.5 years ago that also got better by realizing that I really had no structural reason for the pain. However, I'm in a doozy of a recurrence now, going on about 1 month.. in between the last recurrence and this one, I was regularly jogging up to 30 some miles per week and playing very competitive racquetball.. now I'm just in pain standing and moving about at work.. for some reason I'm stuck.. I know the last months had lots of stresses in my life.. but try as I might, I am now doubting the TMS diagnosis because it feels so darn "structural".. I have been trying to jog a bit, but after about 15 minutes the pain increases .. so I stop. Can do weights and Yoga with no or minimal pain.. so go figure how I can be in so much pain at work...

My question is - should I "just do it" like Steve Ozanich did when he was healing.. ? To just go out and run for an hour like I used to? I'm afraid to do that, honestly. I can't believe that 2 months ago I ran 10 miles, now I'm back in this mess. I stopped apts. with chiro - weren't helping and reinforced the idea of structural problems. But I'm seeing an orthopod in about 2 weeks.. one I saw last time who really said there wasn't much wrong - except a thoracic kyphosis, which is where I get most of my pain (as well as low back).. should I keep my appt.? Now I'm having to take pain meds and it seems a worse "flare" than the previous one.

Thanks all, you guys are great, prayers and good thoughts to you all.

 

[North Star]

Hi Ayalitta, I'm fairly new too. I'm on day seven of the SEP and am finding it very helpful. I'm about 2 weeks into my recovery...a few dramatic leaps forward and other areas that I know I've got some brain training to do. My TMS start about 30 years ago but really picked up speed the last 10 years or so...times of intense stress on many sides. (Surprise!) And like you, I saw myself on the pages of Dr. Sarno's book. I keep re-reading it; it is so encouraging, isn't it?

I've been enjoying my re-entry into exercise. It's been really weird, the shin splint pain has large subsided but has been replace by some pretty miserable tightness. Ah! The symptom imperative! It could switch locations or even change it's face in the same place. Tricky little devil!

I hope you are gaining as much encouragement and friendship as I am here in this forum. I look forward to hearing your success story unfold!

 

[Stella]

As MontanaMom says the 42 day Structured Education Program on this site on the main page down the left hand side is the best. Plus it is free. I learned more about myself in 42 days then all my years of living. Check it out.

 

[nancy]

As MontanaMom says the 42 day Structured Education Program on this site on the main page down the left hand side is the best. Plus it is free. I learned more about myself in 42 days then all my years of living. Check it out.

 

[nancy]

I hope I am doing this right, this note is to Stella. I am going to start the 43 day SEP tomorrow. I did receive your
post this am. Thank you Stella. Will talk to you soon, Nancy

 

[Forest]

I do the exercise and physical activity that I WANT to do. I don't refrain from anything due to fear OR due to me wanting to prove something to myself.

This is great advice for you Mtngal. Running should be something you do because you truly want to and when you no longer fear what may happen. If you are afraid to run at this point, then don't. This is not about proving something to yourself, and doing so will only create an immense amount of pressure. When we pressure ourselves to succeed we are fueling our TMS. Recovering happens when we reduce the pressure we put on ourselves to succeed and be perfect at everything we do.

At this point, you goal needs to be to reach a point where you fully believe that your symptoms are benign. Creating an evidence sheet can help you reach this point. You mentioned that you can already do so many other activities without any symptoms. This is a sign that you do not have a structural problem. It sounds to me like you have a conditioning problem, which is why I would recommend running only when you are ready.

 

[Mtngal]

This is great advice for you Mtngal. Running should be something you do because you truly want to and when you no longer fear what may happen. If you are afraid to run at this point, then don't. This is not about proving something to yourself, and doing so will only create an immense amount of pressure. When we pressure ourselves to succeed we are fueling our TMS. Recovering happens when we reduce the pressure we put on ourselves to succeed and be perfect at everything we do.

At this point, you goal needs to be to reach a point where you fully believe that your symptoms are benign. Creating an evidence sheet can help you reach this point. You mentioned that you can already do so many other activities without any symptoms. This is a sign that you do not have a structural problem. It sounds to me like you have a conditioning problem, which is why I would recommend running only when you are ready.

Thank you Forest, your advice is very well put.. will work on some journaling and will do the evidence sheet as you suggest..

 

[ayalitta]

Thank you, everyone for your thoughtful and encouraging comments!
These have been very difficult few months, and I still don't feel like I've even scraped the surface of what I need to deal with to overcome the pain. I've been away on a family trip (which was not a good idea, btw, but I had to do and now I'm back). I was able to journal a little but not enough while away, and though I was hoping to do the 42 day program systematically when I was there - it did not work out the way I hoped (like so many other things on that trip...). Tough learning process.

I'm undergoing therapy with a counselor that does mind-body work. She is not a Dr. Sarno therapist, but then I don't live in New York either so access to practitioners of that specific approach is tricky. But I think she's the right person to go through this journey with me, now.

I'm reading the book "Women Who Run With The Wolves" by Clarissa Pinkola Estes, and this quote I found most inspiring and relevant (regardless if you're a woman or a man) - this is from page 83, which is in the chapeter that surrounds the interpretation to an ancient Russian/Eastern European fairytale about Vasilisa the Wise - and in reference to the heroine's evil stepfamily that constantly demands her to perform chores etc:
"To submit without complaint is heroic-seeming, but in fact causes more adn more pressure and conflict between the two oppositional natrues, one too-good and the other too-demanding. Like the conflict between being overadaptive and being oneself, this pressure builds to a good end. A woman who is torn between these two is in a good way, but she must take the next steps".

 

[ayalitta]

2 & 3) I do the exercise and physical activity that I WANT to do. I don't refrain from anything due to fear OR due to me wanting to prove something to myself. Earlier in the program I denied myself things I wanted to do b/c I thought I was giving in to the TMS. For instance, getting a massage. Now I get a massage if I want one. The work to be done on TMS is mental, psychological. So that's where my focus is: on getting better psychologically. I'm now learning not to focus on the pain one way or another. Beating myself up & thinking I'm a failure b/c I want a massage is just as bad as refraining from bending over b/c I fear hurting my back. There's a lot of information & prior posts on here re: self compassion and it's very helpful. You cannot have self compassion when you're expecting yourself to be the perfect TMS patient There's a balance there that I think each person needs to find. Just yesterday I had sort of an "a-ha" moment and a good deal of pain disappeared. "A good deal" but not all. It's complicated. I've determined that there is no Holy Grail... no ONE reason why my subconscious feels TMS is needed. It's truly a journey, not a destination.

Thank you, AngK for your encouraging words. I was trying to follow your advice, and it's good to come back to it, re-read and re-think.
I've been truly enjoying the freedom of knowing I'm capable of doing a lot more than I thought I could do physically - running, and other activities. Gone to Pilates teacher training program this fall, and am really enjoying getting back into a healthy and steady, fear-less exercise routine. Doing it for the sake of enjoying it, not to prevent back pain etc.
I'm rather sore now, be it TMS or just building up muscle - it's hard to tell. But I am going to follow your advice and go to massage just because I think it will help with releasing tension, in addition to therapy, journaling, mindfulness and all the other things I struggle to keep up with...
Is it just me, or does healing TMS is a full-time job?!