This is a tough topic...I'm careful to distinguish between addiction & dependency because I very naturally ease off the pain meds the second my pain improves...though there are many days where I would be absolutely useless without it. When you combine the ferocious lower back pain & abdominal cramping from IBD, it can be too much to bear. There is however phenomena most patients with chronic pain on long-term opioid therapy are familiar with. After a certain period of time without the meds, long after any symptoms associated with acute withdrawal syndrome have dissipated, the brain will come up with all sorts of thinly veiled excuses & tricks to get more drugs.
In the absence of a clear-cut psychological dependency based on typical conditions usually associated with addiction (i.e. genetic predisposition, childhood trauma/abuse or neglect, etc. – I have none of these), the brain will create new pain or more likely exacerbate an existing pain syndrome, regardless of whether that syndrome is derived from a psychological cause.
The stress associated with the incredible hassle associated with the decision to include controlled substances as part of my treatment these days is enormous. Yet when faced with two options - take a couple of Vicodin and have a productive day, or spend it suffering in bed, it becomes an easy choice.
The relationship between IBD & TMS is still poorly understood. I recently had a consultation with Dr. Ira Rashbaum (Dr. Sarno’s successor), and while he agreed with me that emotional trauma could exacerbate the condition, it is only a small piece of the puzzle.
I guess the bottom line here is two main points/questions:
(a) What steps can I take to progress in treating the TMS – maintaining my focus on the pain my mind creates to distract me from the repressed stress instead of the pain it creates solely to satisfy a chemical need?
(b) How do I let myself off the hook for allowing myself to rely on the meds, and avoid beating myself up with the negative self-talk that perpetuates that vicious cycle of TMS? How to shut down the continuous internal narrative that views a dependence on medication as a sign of weakness, and blames that weakness for a dozen other things in my life that I’m unsatisfied with or pissed off about.
For my entire life, medications/conventional medical treatments have done more harm than any illness they intended to treat, but now I really feel trapped. I don’t have the wherewithal to abstain for a period of 6-8 months to allow my body’s natural pain relieving circuitry to repair itself. I therefore need to 1st resolve the psychological cause(s) of the back pain before I can even consider that step.
While I can see how addiction might be a TMS equivalent for some people, I really do not believe it is the case with me. There’s no chicken or egg question – the pain definitely came along first, and would persist without the meds. I have yet to encounter an analytical psychologist with the background to understand this process any better than I already do, so I am trying to read as many patient stories that I can find with the hopes of discovering some new angle by which I can approach this.
One interesting side note…I’ve recently begun reading Adam Heller’s “Zero Pain Now”, and experienced an immediate positive response by the time I reached chapter 4. I then stopped reading, and have found it extraordinarily difficult to start chapter 5. I do have a difficult time maintaining enough focus to read any book these days, even though I used to be an avid reader. My experience with this book is responsible for the first significant improvement (aside from Prednisone) I’ve seem in almost 7 years, and I will watch a rerun on Netflix before I will go back to reading it. Something in my psyche doesn’t want me to dig any deeper into what’s behind the TMS, so it must be some pretty horrible sh*t, right? Arg. I didn’t intend for this to become a novel, but if you’re still reading – THANK YOU for taking the time. I look forward to hearing some more thoughts on the topic.
TIA
I think addictions are tms - part and parcel of the same emotional/psychological problems...
My father was an alcoholic and over the years i could see his patterns of emotional behaviour - all go back to losing his mother's attention as a small child, all his life he was the he-man - but had to have successions of women jumping to 'look after him' - i had far more aunties than any one should...! I think many addictions come down to that tiny child inside - there is often (not always) a hugely selfish component. I have had addicted friends who have grossly neglected their kids but not themselves. Others who have brought their own parents to pernury, crime and death thru their selfishness - and not just for the substance of addiction - for everything they wanted. Callous use of others seems normal - but with every person i have known well with an addiction - they have all had abuse or issues with abandonment as a child. And all underneath had been or could be, incredibly sensitive people.
It is like TMS with a turbo attached!
