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Daniel L. Question on acceptance

Discussion in 'Ask a TMS Therapist' started by driffy, Jan 22, 2016.

  1. driffy

    driffy New Member

    This question was submitted via our Ask a TMS Therapist program. To submit your question, click here.

    Hi i have a question on acceptance. Im really struggling with my understanding of acceptance, to me acceptance means giving up and not trying to change anything for the better because if im trying to change something then surely that means im not accepting it .

    is it possible to accept the present moment but still work to change future moments from a place of peace rather than inner struggle? surely trying to impact / change future moments means im not accepting this current moment of pain or distress.

    eg i read something that said the dalia lama is accepting , peacefully so that china occupies tibet but that he is still actively working towards this changing. I dont get this if he was accepting of it surely he would just put up with it ??

    Any analogies or insight would be much appreciated! thank you

    Last edited by a moderator: Jan 30, 2016
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  2. Daniel G Lyman LCSW

    Daniel G Lyman LCSW TMS Therapist

    Good question! While reading it, I’m curious, however, as to what it is that you are referring that you are working to accept. In the TMS world, we encourage acceptance of pain/symptoms, and my hunch is that you are referring to just that. I’ll try my best to answer it specifically and then more broadly.

    Regarding pain/symptoms: It is imperative to understand why acceptance is important to eventually become symptom free. When you are positive that your symptoms are TMS, it then becomes much easier to accept that you are in pain, but that pain is not indicative of something larger and scarier. The acceptance of your symptoms tells your brain that you are no longer frightened or worried by them. Your brain no longer sees a threat in the symptoms, and in turn, the symptoms reduce. The fear and preoccupation of your symptoms are keeping them alive. By accepting our symptoms, we understand that we know longer need to fear them.

    This is an important idea: Acceptance means that fear is no longer present.

    On a macro level, the Dali Llama accepts the reality of the Chinese occupation of Tibet. He does not fear or preoccupy about it. It is his lack of fear of the occupation that allows him to be present to many other things in his life. In this way, he can accept what is happening and still continue to work and hope for a better outcome.

    Let’s talk about acceptance on a micro level: when you feel an itch, you have a desire to scratch it. Acceptance that the itch is there, but will go away (as they always do) yields an undisturbed mind free from the desire to scratch it. I wrote about this previously, so forgive me for reposting that section:

    Next time you have an itch that you are consciously aware of – don’t scratch it. That’s right – don’t scratch it at all. Notice it, and then move on with whatever you’re doing. Don’t judge it – don’t think about it again, just observe it and move on. It’s harder than it sounds, but it’s possible. Do this every single time an itch shows up. Itches go away on their own (try it – they always do), but we’re unconsciously used to responding to an itch with a negative reaction:

    “Let me scratch this immediately so the unpleasant feeling goes away as soon as possible.”

    Okay, I know nobody consciously thinks like that, but that is exactly what is happening in your unconscious every time you scratch an itch.

    Instead, we want to rewire your unconscious brain so that it says:

    “I notice that I have an itch, but I am 100% positive that it will not last because all sensations (both positive and negative) go away, so I won’t spend my time, energy, and feelings responding to that itch.”

    Think of acceptance as a mind at peace. Free from fear. We scratch an itch because we are fearful that it won’t go away. But it always does, because it has to. Change is the only constant in the world. It’s imperative to understand this to have a mind at peace. Everything changes. Everything. Accept that, and you’ll be a few steps closer to becoming a Buddha!

    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.

    Questions may be edited for brevity and/or readability.

  3. Forest

    Forest Beloved Grand Eagle

    Thanks for this great answer, Daniel. I think this question is a challenge for many people learning mindfulness. I remember puzzling over it myself.

    This is a vitally important issue for people in pain. The most important thing that you can do when recovering from TMS is to change how you respond to the symptoms. Alan Gordon calls this Symptom Response Modification (SRM) and it is key for healing TMS. The issue is that the TMS wants your attention because attention feeds the TMS monster. I often write about this in terms of neuroscience using the metaphor of "two wolves." The more attention way pay to our TMS, the stronger those neural pathways get.

    The most important thing to do, then, is to not care about your TMS. You accept that the symptom is there, and then mindfully bring your attention back to the things that matter to you in your life. You focus on resolving the things that bug you and appreciating the things that bring you deep joy. One of the many reasons why a steady ongoing practice of mindfulness meditation is so helpful to TMS is that it allows us to do this.

    Of course doing all of this is impossible if you are all wrapped up in thinking about whether you are going to get better. If that is what is going on deep in your mind, then the TMS has you, and you'll never break free. That's why you need to focus on getting your head in the right place. Once you learn to love life and find joy in life, independent of the ups and downs in your symptoms, that is when you will start to get better.

    Alan Gordon calls this Outcome Independence, and I think of him as the first person to heavily emphasize the importance of it. He certainly single-handedly brought the term, "outcome independence," into the TMS lexicon. The best explanation of it is his original writeup:
    With 20 likes, it is clearly one of the most beloved pieces of content on the forum.

    It is particularly relevant now because Alan has let me know that he's recently recorded an amazing session with one of his interns in which he worked on outcome independence. He says he'll be posting it here and I think it's set for tomorrow morning, so if you haven't read the original article for a while, now might be a good time.
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  4. Huckleberry

    Huckleberry Well known member

    This is interesting to me as well. I have spent so long caught up in the internal structural v TMS debate that in reality the whole period has been a state of limbo that has generated more frustration and anxiety. Some things that have occurred to me recently is that all the traits that Sarno picked up on as indicative of those who are likely to be suffering from TMS may not necessarily be responsible for the pain but they may actually be responsible for the pain becoming ingrained and chronic. Secondly, it may just be that the acceptance of the TMS dx is the tipping point in the removal of the fear in relation to the symptoms...I'm not saying that the TMS dx is placebo as such but rather that the 'active element' of the recovery process is the removal of fear and probably just as importantly the removal of the fear of future damage particularly as regards to exercise and activity. Just a thought anyways.
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  5. Huckleberry

    Huckleberry Well known member

    Just wanted to add a brief aside about outcome independence as well. To me this really is a crucial mindset to cultivate. When we have chronic pain it is all too easy to fall into the trap of putting our lives on hold for that mystical future date when we are pain free and can finally go after the job of our dreams and start training for that Ironman Triathlon. Of course the stark reality is that regardless of causation we may possibly be living with the pain for all our lives so it is incredibly short sighted to hold this mindset as it is incredibly self limiting on a day to day basis.

    I have come round to the idea that all the thoughts and actions we hold and conduct should really be carried out for our enjoyment and self development to our needs in that moment in time and not as a means to an end that may or may not happen. Yes, I think we certainly have it within our means to limit the volume of our pain at a given moment but we should really learn to accept that this is possibly all we have and that we have to get back into our lives with that knowledge. I don't think this is giving in or surrendering to the pain but rather I see it more as being aware of our current limitations and being kind to ourselves but NOT giving ourselves permission to step out of our lives.

    I am a runner and hiker and have been incredibly frustrated and fearful of my pain and whilst I haven't let it stop me from my activities totally I have fallen into the trap of allowing my enjoyment to be sucked from it by constantly comparing and contrasting to how I used to be able to perform and how I envisage I may be performing in the future. I am aware this sounds incredibly trite but the bottom line is that if I had a serious accident 5 years ago and had limited mobility I would give serious money to be able to do what I can do today...I know this sounds like the typical 'look on the bright side' trash that chronic pain sufferers dread hearing so much but for me it really is true.

    I suppose it does come down to the idea of mindfulness and living in present without seeing it in relation to a judgement of future outcome. As I've got older I've realised that not everything can be perfect at every given moment but that doesn't mean the whole experience should be tainted or discounted. I'm reminded of a bit in the book Zen and the Art of Motorcycle Maintenance in which the main character becomes increasingly annoyed at a noise coming from his motorbike that he is unable to locate...this noise gets worse and worse and finally his travelling companion locates the cause of the noise as coming from his bike's handlebars. The companion fashions a shim out of an old Coke can that he paces around the handlebar...it fits perfectly and the noise is totally eradicated. The guys continue on their journey but it starts eating away at the guy that the shim is not an official BMW (or whatever) component and is actually just an old bit of tin. The chap finally orders an official part to pick up and fit which costs about £100 even though his bike is working fine...the whole journey until he gets to the dealer for the new part is tainted by the knowledge that at that moment in time his bike isn't perfect. That pretty much sums up the mindset I'm now trying to escape from.
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