Thanks for the question, Jay1986.
The cycle that you describe is pretty classic behavior for TMS. The pain will reappear and will serve the purpose of either getting you back in the fear/preoccupation mindset OR it will put you back in a place of hopelessness/disempowerment. Both will try to convince you that you are "back to square one" and erase any progress that you have made (even if that progress is significant, which appears to be the case with you).
Feeling confident and empowered, even in the face of symptoms, is one of the most important skills that you can hone to make the symptoms go away. This is difficult because of the urgency that every person who is in pain feels to be free of their symptoms for good.
I want you to stop expecting yourself to be symptom-free. Focus on being outcome independent and if the fatigue and pain come back, don't allow that to be a determinant of whether or not you're making progress. Be patient with your personal recovery process and remind yourself how far you have come. Encourage yourself to continue all of the hard work that you have done to get to this place in your recovery. The symptoms will come and go but you will remain steadfast and determined in your process.
You just had a week with no symptoms! You deserve some credit for that and once this extinction burst fades away, you will be right back to where you were last week.
Don't impose timeframes on yourself or set symptom-focused conditions for progress. Practice this mindset and be there for yourself in a kind and compassionate way. Every time the symptoms come back, use that as an opportunity to practice honing your attitude of outcome independence. Reframe the entire experience for yourself and don't allow the symptoms to have that much power.
If you take away the purpose of the symptoms, they will not have a reason to keep coming back.
Keep at it and you will get there!
-Derek
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