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Derek S. Is this the symptom imperative?

Discussion in 'Ask a TMS Therapist' started by stayfit65, Aug 9, 2015.

  1. stayfit65

    stayfit65 Peer Supporter

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    Question
    Hello,
    I recently saw a TMS physician about my back pain and diagnosis of TMS was confirmed. Back pain this past week was minimal or gone! But yesterday I went out to do some running and I had terrible pain in the back of both knees (felt like hamstring tendinitis). I've had no problems until now with this. I also had some terrible waves if anxiety while trying to sleep. Would it seem that this is the symptom imperative? I am thinking of making an appointment with a sports physician, and if he says it's tendinitis should I treat it as TMS?
    Thanks
    Stayfit
     
    Last edited by a moderator: Aug 15, 2015
  2. Derek Sapico MFT

    Derek Sapico MFT TMS Therapist

    Answer
    Hey Stayfit,

    This one feels like a symptom imperative slam dunk. Your longstanding back pain goes away and, lo and behold, up pops the hamstring pain, anxiety, and sleep problems. That would be one amazing coincidence to all of a sudden develop three new symptom presentations in one week. Your TMS appears to be giving you more rabbits to chase down holes.

    If possible, schedule a follow-up appointment with your TMS physician to give you that extra bit of certainty. If that is not logistically possible, I think that you can operate on the premise that these are just symptoms popping up trying to put you back into a state of fear/preoccupation and get you back into that old familiar problem-solving mentality. See your sports doc only if you absolutely must but I worry that this will put the focus back on a "structural pathology" mindset which seems dubious given the fact that you just got cleared by a TMS doc and have your diagnosis. The symptom imperative showing up just as your primary symptom disappears is classic TMS behavior and is to be expected.

    Don't let the symptoms scare you or become a focus of fear or concern. Reinforce your tremendous progress and be proud of yourself for getting to this point in your recovery. Every time a symptom pops up, new or old, utilize it as an opportunity to practice outcome independence and to reinforce your shiny new pain-free neural pathways

    Good luck and keep up the good work!

    -Derek


    Any advice or information provided here does not and is not intended to be and should not be taken to constitute specific professional or psychological advice given to any group or individual. This general advice is provided with the guidance that any person who believes that they may be suffering from any medical, psychological, or mindbody condition should seek professional advice from a qualified, registered/licensed physician and/or psychotherapist who has the opportunity to meet with the patient, take a history, possibly examine the patient, review medical and/or mental health records, and provide specific advice and/or treatment based on their experience diagnosing and treating that condition or range of conditions. No general advice provided here should be taken to replace or in any way contradict advice provided by a qualified, registered/licensed physician and/or psychotherapist who has the opportunity to meet with the patient, take a history, possibly examine the patient, review medical and/or mental health records, and provide specific advice and/or treatment based on their experience diagnosing and treating that condition or range of conditions.

    The general advice and information provided in this format is for informational purposes only and cannot serve as a way to screen for, identify, or diagnose depression, anxiety, or other psychological conditions. If you feel you may be suffering from any of these conditions please contact a licensed mental health practitioner for an in-person consultation.

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    clairem and Grateful17 like this.
  3. stayfit65

    stayfit65 Peer Supporter

    So in the last week I had hamstring pain one day, then got better and back spasms came back, then went away a again, then hamstrings flared again, with moderate anxiety. Right now I've got no anxiety but still mild back pain and Hammies are feeling some better. This is the first time I've ever seen this much shifting in 3 years. Is this a good sign? Still working on embracing outcome independence but I'll admit sometimes it's hard being a fitness instructor and ignoring these flares.
     

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