Structured Program

[Shanshu Vampyr]

Educational Program Day # 9 Question To Ponder (Have you been overly critical of yourself lately? How and why have you done this?)

"Up until today's meeting with [Boss], I continued to worry about OB. Intellectually I know that I've given this program my all, despite (sometimes) very severe pain; other times, chronic, naggy aching pain. And yet my thoughts are always about hot to do better even when I'm doing well so I can continue to give 110%. I am always critical when I don't feel like I'm the superstar of the program. I know all my other resident colleagues are just trying to get by. I feel so burdened by trying to be not only "better", so to speak, than anyone else (which given my time away from "traditional" medicine in Psychiatry isn't a fair competition), but better than "failure Phil" who is a ghost of the victimized medical student I was and no longer exists except deep in my head/heart."

 

[Beach-Girl]

Phil:

Confession time. I don't work for a group of people I need to please and insure that I'm ready to call my own shots. I own a business that's 40 years old and been seeing some really tough times. I'm married but It's up to me to figure our way out of a lot of debt. I have always "had the answers" but now? I sit in fear of the next steps that should have been taken weeks ago.I'm on total burn out.

I also have a passion I told you about where I work with animals. I'm an animal communicator. Belief system aside, I'm actually quite good. Anyway - blew a job (in my mind) the other day. First time in ages my clients weren't happy. That kinda did it. And I went into a hole for three days. Who knew there were so many interesting shows on TV?

I'm also struggling with anger and fear. I want to be happy. Isn't that the bottom line? We want to be happy? You AND me? I think this is why your frustration (and I applaud your rants - I typically do them in my head) is so palpable. You want to be happy. End of story. You've worked hard to be where you are yet you still meet with what you perceive as resistance to how "good you are." I have no doubt that on a good day you and leave your 35 hour shift with a smile on your face. Job well done. And if you don't have any days like that, well then it's time to reconsider.

What happens at the next level? Will you have more control over your days and in turn your life? The bottom line is: we get one shot at this and I believe TMS is a great gift to help us understand there needs to be a change. I am still trying to figure out how I'm going to start up again, new projects I should have started a month ago, but collapsed in exhaustion instead. I know the feeling only from a totally different perspective. I'm exhausted from anxiety and stress. And I've been running on high alert for too many years. Like 10 of them to say the least.

There is surrender. That is a tough one for me. Surrender to the fact, we're never going to be perfect and as long as we struggle to - we shall both be less than happy. So I'm working on surrender each day. Do what I can for now, love myself, my husband, and be happy we do have a business and we still have our home. But it so sucks to work there anymore - I've had it with retail.

I've got some years on you and I still envision a life without pain and with happiness and joy of every moment, not just one moment of joy in each day.

Think about it Phil. Is this really where you want to be? Or it it someone's "per-destined" idea of where you should be?

In my case, I put myself in this life and now it needs to morph. Not easy with the untold parts of my story. But this is about you and I'm sharing a bit about me - to help you in your process. I'm writing. You're ranting. We're both going to get there with some reorganization.

Surrender. It's all about this (or a lot) in the end. The means to health and the means to happiness. And the means to no more pain.

Let me know what you think

BG

 

[Beach-Girl]

"Up until today's meeting with [Boss], I continued to worry about OB. Intellectually I know that I've given this program my all, despite (sometimes) very severe pain; other times, chronic, naggy aching pain. And yet my thoughts are always about hot to do better even when I'm doing well so I can continue to give 110%.

Perhaps it's time to give it less than your typical 110%. That's what I'm finding. You are I are good at what we do. Yet we're still in pain. Something isn't right I'd say. Like maybe we expect too much too fast? And we're not making all the changes we need to make? I know it's true for me - just throwing it out there.

I am always critical when I don't feel like I'm the superstar of the program.

Ditto. But this is not a program of superstars. It's an individual journey towards health and well being.

I know all my other resident colleagues are just trying to get by. I feel so burdened by trying to be not only "better", so to speak, than anyone else (which given my time away from "traditional" medicine in Psychiatry isn't a fair competition), but better than "failure Phil" who is a ghost of the victimized medical student I was and no longer exists except deep in my head/heart."

This sounds like you are still not quite on board with TMS and its demands on us to change. First and foremost - you need to work though this idea of "Failure Phil". You need a way to build self confidence and do some things you enjoy. This will begin your journey.

Keep writing Phil, this is helping me too.

BG

 

[Shanshu Vampyr]

Hi Beach-Girl,

The conundrum you propose is one that I've been (acutely) struggling with for many, many months (ever since I got here, basically), if not years. Which is, do I need to quit this job, paddle my own canoe, hitch my wagon to different stars, and follow the beat of a different drummer even though it will go against what most people think is right in order to heal TMS? Or will it in fact, actually be HEALTHIER to bear the short term pain (another 2 years and 3 months of residency) and keep living the insights I'm making? (I've never undergone as intense a period of self-scrutiny as now, and for that I THANK TMS). In other words, is it easier (and healthier) to become an actor, architect, playwright or follow my own muse; or stick out the conventional job (with its practical benefits of a steady paycheck and a traditional career) for the short term until I become an attending, established and secure while battling back TMS by learning how to be a more assertive, less people-pleasing, less anxious, fearful, and worried wreck of a person with a perpetually sensitized nervous system? While I don't enjoy the daily grind of residency, at least I have a steady training job and money in the bank to where I can actually sit at home at night and THINK about deliberate next steps of healing TMS (instead of busting my ass at a menial job to pay the bills in order to follow a pipe dream?) My non-TMS therapist (I still haven't decided whether or not to seek out a TMS one) is pretty convinced that the internal war I've been waging can only be won in the day to day of mindfulness, and that some day I will look back as an attending and reflect on my angst, and my pain will disappear somewhere along the line...I'm not good at being patient!

Long story short...I don't LOVE Medicine 100% and I don't HATE it 100%...but I've taken far too many lumps along the way. Perhaps it's time to forgive myself? I know that doesn't come overnight...

And yet, if I quit a "good thing" now, won't "Failure Phil" have won?

The war continues.

 

[Shanshu Vampyr]

I am unhappy because I sense that anyone with compassion for me would say, "Take a stand NOW, it's OK not to succeed at everything," and yet Insecure Phil doesn't feel like he's succeeded at anything yet. And I don't really feel I have the courage to take that stand, when so much is on the line.

 

[Beach-Girl]

, do I need to quit this job, paddle my own canoe, hitch my wagon to different stars, and follow the beat of a different drummer even though it will go against what most people think is right in order to heal TMS?

Don't know where you got this idea Phil. The idea is - becoming pain free for you - not others. If you start some other reading and really look at who you are - really delve into "that guy" - you will get the concept of TMS - and it won't matter one bit what others think. You have to live your authentic self. You can't people please your whole life. Are we "most people" here on this board?? If you stay in the job and continue to get better - great. But others who have kicked this went back to their work - after being cured - seem to love what they do. They were temporarily invalids, but found a way to make peace with themselves.

Or will it in fact, actually be HEALTHIER to bear the short term pain (another 2 years and 3 months of residency) and keep living the insights I'm making? (I've never undergone as intense a period of self-scrutiny as now, and for that I THANK TMS).

But same as me, you aren't "there" yet. You need to dig deeper my friend.

I already know that I do things day in and out I don't enjoy any longer. We have a retail shop and I want (most days) to be away from the kind of people we attract! I hate it! After close to 20 years of answering the same questions - I'm done. But I can't just quit because my husband needs my help there. So on I go. I know that and I am taking steps to get out of this for the summer. That is our busiest time. I'll oversee and spend my time (I hope) doing more of the things that are me. Not who people want me to be. You think my family and friends accept me as an animal communicator? I've lost more "friends" than I care to recount because 1) I stopped drinking when I learned I could do this and 2) I am good at what I do and it's my life's passion.

So the question is to me as I read this: Are you making strides? You are doing some great rants. Are they helping? Do you turn off the computer and say "there! I let it out! Now I can get to work tomorrow and feel great and less pain."

In other words, is it easier (and healthier) to become an actor, architect, playwright or follow my own muse;

Follow your muse. Ultimately it will bring you peace of mind and happiness. This in turn will lead to a pain free life. Playing devil's advocate here: How do you answer that question? Just changing your life goal will not stop the pain Phil. There is more to Phil. And perhaps staying in medicine IS the best thing for you. You do need to work through the anger. Trust me. I'm full of anger myself.

and yet, if I quit a "good thing" now, won't "Failure Phil" have won? The war continues.

This is the war inside you Phil. Years of hearing (I'm guessing) your "fate" as being a doctor has put you in a place you don't love at all - right now. Do you get breaks? Like vacations? Can you take some time to figure this out? I can tell you one thing. As long as you walk around with that moniker, you will continue to see yourself in that light and you're not going to improve much. I don't know that for sure. But isn't the goal for you to rid yourself of TMS? Then love yourself first and foremost.

I can see it Phil, hear it in your voice. You're Unhappy. You've got some heavy stuff to work through and you might as well start now.


BG

 

[Beach-Girl]

I am unhappy because I sense that anyone with compassion for me would say, "Take a stand NOW, it's OK not to succeed at everything," and yet Insecure Phil doesn't feel like he's succeeded at anything yet. And I don't really feel I have the courage to take that stand, when so much is on the line.

Well write some letters to Insecure Phil. See what he has to say. I found that doing dialogs with myself were some of the best ways to find the root cause of things. Pen was flying off the page and I was talking to myself. Try it. You be "Phil" and then set up "speaker #2" as "Insecure Phil. See what happens. You're going to like this way of writing.

BG

 

[Shanshu Vampyr]

Thanks Beach-Girl,

Maybe I've ended up framing this issue all wrong. I developed TMS because I was so stressed out about getting into a program after three years. All the symptoms started in 1/11 when I read a message board that dashed my hopes of getting into a program again. Yet, here I am today.

If I understand you correctly, the war isn't about staying in medicine or leaving, but whether or not I can find my muse in it or not, or if it becomes just a job. If I understand you correctly, I can become a Broadway star and still be unhappy if I haven't resolved some issues, or I can become an attending and be perfectly happy if I DO resolve issues. Or the converse might be true. If I understand you correctly, I am unhappy but not necessarily because I was denied a choice (or so it feels) when I was 18 and I chose "the path of least resistance"--not medical school itself, but to please my parents by choosing what they would. If I understand you correctly, I need to find happiness independent of career path. Happiness for Phil. Resolution of "Insecure Phil" and "Failure Phil". Who might be present even if I were in my dream job.

Is this the correct read?

Thanks,

Phil.

 

[Beach-Girl]

Maybe I've ended up framing this issue all wrong. I developed TMS because I was so stressed out about getting into a program after three years. All the symptoms started in 1/11 when I read a message board that dashed my hopes of getting into a program again. Yet, here I am today.

I hear you. Mine started when I heard my husband had cancer. And here *I* am 11 years later. (He's doing fine btw) but it so threw me out of anything *I* could control, I understand now, that my back began to hurt. And I kept running. Every morning. Jogging my 2 miles a day. And through holding my body wrong (Stress) - in addition to my back pain, I pulled out my SI joint. So I get this. One too many things and we're in the TMS loop - so to speak.

If I understand you correctly, the war isn't about staying in medicine or leaving, but whether or not I can find my muse in it or not, or if it becomes just a job. If I understand you correctly, I can become a Broadway star and still be unhappy if I haven't resolved some issues, or I can become an attending and be perfectly happy if I DO resolve issues.

This is for you to decide - but yes. You must find the peace and happiness inside yourself in order to never please anyone but yourself again. You might be loving it in an ER? Or be on burnout from too many nights on Broadway. But if you're doing what you love, then it doesn't matter. Because you're doing what you love.

Or the converse might be true. If I understand you correctly, I am unhappy but not necessarily because I was denied a choice (or so it feels) when I was 18 and I chose "the path of least resistance"--not medical school itself, but to please my parents by choosing what they would.

This has been a harping point I admit. Does it fit? Try it on with some writing. Why did they decide? And did they choose correctly for you?

If I understand you correctly, I need to find happiness independent of career path. Happiness for Phil. Resolution of "Insecure Phil" and "Failure Phil". Who might be present even if I were in my dream job.

That is exactly what I'm talking about Fearless Phil.

BG

 

[Shanshu Vampyr]

Dear Beach-Girl,

Thank you. You have helped me reframe the question and helped me immensely otherwise. For that, thank you. I will continue to post updates here as I progress through the journey. Sort of my blog, I guess.

By the way I'm on weekend call here on this chilly Pennsylvania day. And I may have just saved a woman's life.

I rock.

Working-On-Being-Fearless Phil.

 

[Beach-Girl]

Phil:

You DO rock. Just keep that in mind as you roll through your day. The right thing will present itself, and you'll know what to do.

Thank you for the kind words. You have helped me too on a long road to recovery.

And I can't imagine the rush of saving a life. Just think what you did for that family?

That is in no way...a guy who fails.

BG

 

[Shanshu Vampyr]

Thanks Beach-Girl,

I have been working the program quite intensely lately. Including writing letters to people from my past like my dad. I can share excerpts from them if you like. I've come to realize that part of the problem is that I find myself incapable of feeling emotion (suppression or repression), unless I'm completely overwhelmed by them. Journalling has given me insight, and it often makes me sad, but it never makes me SAD, or ANGRY, or HURT or anything. I don't feel it.

TMS therapist?

 

[Beach-Girl]

I have been working the program quite intensely lately. Including writing letters to people from my past like my dad. I can share excerpts from them if you like. I've come to realize that part of the problem is that I find myself incapable of feeling emotion (suppression or repression), unless I'm completely overwhelmed by them.

Interesting. You could share them here, or start a blog. You could share in your blog only what you want, and others will respond. It's with the Structured Program section. Started one myself. Just a little about my journey. But yes! By all means I want to read what you want to share.

Journalling has given me insight, and it often makes me sad, but it never makes me SAD, or ANGRY, or HURT or anything. I don't feel it.

Well you're gaining insight. That's a huge first step. You don't have to get all those other things (sad, angry or hurt) unless you feel them but can't express them in your writing. Then maybe a TMS therapist could guide you on your way. Are you still working the program here? Do you have Dr. Schubiner's book? I had to take a break from Schubiner's book. But I think I'm going to get back at it starting tomorrow. There are layers to this and when I least expect it, something will come out of left field. So keep at it Phil. Even though we aren't aware we're working on this stuff - we are. And it's working on us too, through our subconscious.

The other day, for example, out of nowhere I started to retell a story to my cousin that happened when we were in high school. Another grand injustice that was perpetrated by my mother.

So yes, please write excerpts here, create a blog, whatever you want.

Glad you're checking in Phil.

BG

 

[Shanshu Vampyr]

Hi,

I am indeed working the Structured Educational Program. I just finished Day # 11. I do indeed have Schubie's book but I'm already overwhelmed with fear. Shortly after my diagnosis from Dr. Schechter, as I've mentioned, I completed HIS workbook on top of all the months of journalling that I've done beforehand. And it's not that my journalling doesn't sometimes turn up gold; it's just that I feel that I should have seen results sooner. I started getting symptoms in 1/11. I started the Sarno process in 7/11. I got diagnosed by Dr. Schechter in 12/11. Now it's 4/12 and I've covered hundreds of pages in my journal. Maybe journalling is not the right modality for me. Maybe I need something other than that. I have a fear of starting TMS therapy (on top of my regular therapy) despite Dr. Schechter's encouragement. Will it work? What if it's a dead end? What about the cost? Am I digging myself deeper into a psychological ditch?

In fact that's it, in a nutshell. While physical treatments haven't helped, neither has digging into the psychological well-spring. Can psychological progress be THIS slow? Is the stress of work daily "undoing" any gains I have made? I cannot remember the last time I have woken up unburdened. It was close to a year and a half ago.

In fact maybe it's some aspect of subconscious resistance that's preventing me from scheduling a TMS therapy appointment. Could be just the thing I need, and my subconscious knows it, and is running interference because it doesn't want to part from the TMS. I am so dejected, fearful and confused sometimes. So I do the work, but I have trouble pushing past the fear.

BTW I met again with my advisor two days ago (the meeting last week was more an informal, "What's going on with you and can we help you" meeting). My track record here has been pretty good when my demons don't get the better of me and cause me to tune out during the day (with fear and worry in the back of my mind). I was explicitly told, "We'd be having a conversation with a distinctly different tone" if I was in danger academically. I was told that I've got "it", when I'm mentally present, and am capable of giving gold.

That felt nice but I still worry.

 

[Shanshu Vampyr]

My sister, who has been my sounding board, just texted me, "You are full of spiritual growth."

Excerpts:

"Dear Dad,

I never felt like I was good enough for you.

Why did you make me feel like I could only earn your love by being good at school? Why did you equate my masculine identity with academic success? Children need their fathers. Yet I only felt like you were available to me at all when I did well at school. If I didn't do well, or at least AS well as you would have me do, I felt like I was letting down "Professor Peter Chow." Do you know how much that sucks? I felt like I was raised by "Professor Peter Chow" and not my father!

I am 31 years old and I don't know if my father loves me. I don't "feel" it. I can recount few episodes where I "felt" your love. One was recently, the day we took a walk...just before I moved here. The day when you told me it was OK if I didn't succeed at residency here. Otherwise I sense a dearth of experiences where I felt your love.

Do you love me? :'("

"Dear Dad,

I really wish you had been more emotionally available to me as a child. I feel like I got the short end of the stick with you. I didn't know how to approach you on advice on anything as a child, and it was the same when I became a young man. I think I never admitted to myself how much I hated you for being just out of reach. Even when you were at home, you were never emotionally or really even physically available to me as a father. You were always in your role as a working Professor, even at home. I hate that. Even worse, you'd sometimes leave on business trips as a means, I felt, of getting away from us. Work has always been your primary focus, and your family second. Having a meal on the table while you were downstairs writing manuscripts is NOT good parenting! And so, to get some modicum of respect from you, I became an academic, just like you.
Sometimes a child needs a dad. In particular, sometimes a young man needs a father figure. I know you TRIED to spend time with me, but it was always in a way that YOU preferred. Taking me to rigidly play basketball at Upland Park at exactly 5:30 every evening so I could go home and take a shower and you could prepare the evening meal while watching the Nightly News wasn't a fun, father-son bonding activity; it was another chore to be done to please you. And it seems that I couldn't please you. Maybe it was your veneer, your definition of manhood to always to be stoic, but you always seemed to be mad at me. Always pissed off."

 

[Forest]

Hiya Phil,

I know that you've been "doing the work" for a while now, and it can be frustrating to not be progressing as quickly as you hoped. It can be very easy to journal and journal and journal with the hopes that we will have a"a-ha" moment and just get it. Like if we keep journaling at some point everything will make sense and our symptoms will go away. But I'm not entirely sure how accurate that is. When I hear of people doing intense journaling I always wonder if they are obsessing a bit too much about their symptoms and treatment. I think this is why Sarno primarily focused on writing lists. The most important thing to do is connect the emotions that attribute to our symptoms. Once this is done, we need to learn to accept that these emotions exist. Then get back to doing whatever we love to do. I've mentioned this before, but the biggest factor of my recovery was starting up physical activity again. I told myself that even if I have some pain, it's just TMS, and I'm not going to let it control my life.

We repress the emotions that we do not accept or cannot tolerate. Journaling can help doing this, but so can therapy. Seeing a therapist can really help you make those connections and learn to accept the emotions. Dr. Schechter is great at what he does, so it would be wise to consider his advice.

What really made me respond was that your post reminded me of another TMSer, Skizzik. He has a great story on the wiki called Relapser's curse-there is hope. I've always felt that it did a great job at talking about how to find the balance between doing TMS work and just living our lives. There is also a blog post by Howard Schubiner on the bottom of the page, which I will go ahead and post in another thread.

 

[Beach-Girl]

Phil:

Thank you for posting some of your writing. It's clear to me that you have very specific issues when it comes to your dad. You sound like a "tender soul" which is an awesome trait - only not "manly" like your father wants. And he doesn't see who you are at all. But that aside.

My mom was the same way. I was supposed to be a boy so I was a disappointment from the get go. We battled our way through my child and adulthood. We never saw things the same way, we never really liked each other. I didn't turn out like she had hoped and I fought it every step of the way. I think it's different for guys. They have the need somehow, through our society to please their fathers in particular and let their own dreams stay on the sidelines.

But you've added a component I hadn't known before - that your dad is a doctor too? Or a Professor where you're struggling to get through this program? No pressure. You walk around with that last name - same as his? That has to be rough. So how does that really make you feel? Are you trying to do ALL this to please your dad? Won't work Phil. We're here to please ourselves. Or we'll never be happy.

I know there has been time, money, and attention into your adventure in doctoring. I call it that since you seem to be on a daily routine of pins and needles. Not a great way to live. Neither is being in pain. And you are most likely right. The pain is caused from being an over-achiever at people pleasing.

I read your timeline. I started the program in December as well. I have noticed that my pain has now traveled into my neck and arm. Very distracting, but possibly a good sign. I did nothing physical to cause this. I've been journaling a lot too, but what Forest says is really interesting. Lists. Dr. Sarno suggests we make lists of things that connect our emotions with our symptoms. It's probably right under your nose. I see it in you. But then I've been talking with you awhile.And I see it in me, only my solutions run deep.

A therapist (and preferably a TMS therapist) could really get you on your way. You will have all these thoughts fresh in your mind from all the writing. You can reel them off to me, you can reel them off to a therapist. They have a wonderful way (if you have a good one) of just setting it out in a new way for you to examine. It could really help you in more ways than one. Because I see now that you truly are stuck. I'd be scared all the time too. Lots of pressure, trying harder than your hardest, and waiting to see if you are "accepted". Whew!Too much!

Yes Phil. A therapist - and if you can find one a TMS therapist is going to help you wade through all this. And I'm right here listening. So if you aren't ready, keep writing. Or keep writing anyway.

BG

 

[Shanshu Vampyr]

Thanks all.

Beach-Girl, my father isn't a doctor. At least, not a physician. nobody in my immediate family is in Medicine--my mom did payroll taxes and my sister's in biotech consulting. But he is a high-powered Professor of Economics at a university where I also did my pre-medical training. He has nothing to do with my current residency program. It's ironic. I never picked up on that before, but at 18 my dad "suggested" I apply to his University which has an accelerated biomedical program for "forward thinking" high school graduates who want to go to med school directly. 5+2 years instead of the usual 4 of college and 4 of med school.

I guess I have to admit I'm stuck, and therefore seek help. Doesn't feel good to have "failed" at curing myself. Part of the problem is that I'm so self-critical. The Psychologist/Behaviorist/Sister at the Catholic hospital that I work at just told me "I carry the weight of the world on my shoulders"--why???

Wish me luck.

 

[Beach-Girl]

I guess I have to admit I'm stuck, and therefore seek help. Doesn't feel good to have "failed" at curing myself. Part of the problem is that I'm so self-critical. The Psychologist/Behaviorist/Sister at the Catholic hospital that I work at just told me "I carry the weight of the world on my shoulders"--why???

This is awesome Phil. Therapy can really help. I hope you'll keep checking in now and then. After all, you're a doctor and I have this pain in my lower back......

(kidding)

You're on the right path. I hope you find the pain-free, angst-free life you seek.

BG

 

[Shanshu Vampyr]

Thanks. I will check in from time to time. I am scared.