Callie K. The Hope-Disappointment Cycle

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Question

So I have been doing the SEP for the past 31 days and in the beginning, I felt hopeful and felt that my pain was a bit more manageable(primarily hip and low back.) I walked with intention and even try jogging a bit. Now for the past couple of days, I have been working up to a full blown back spasm, and today, I am doubled over. I tend to be pretty analytical and have fully embraced the concept of TMS; I am also a chronic Lymie so moving targets is something that I am all too familiar with. Since all movement is excruciating, I just took an advil to see if I can cut the intensity.

Granted, I was sleeping on a bed that was harder than my usual bed and wondering, was I waiting for this to happen? Has my previous success irritated my mind into making me really re-think that it is actually physical? I am open to all ideas and am sure that I am going to nail this; I just feel someone defeated today and wonder how long this will take. With others who have had spontaneous healing, I think that they haven't really looked at their issues before. I have been in therapy many times and know that this is most likely the reason for my chasing down every doctor in town to see if they can help me. This is the first time I am actually doing something on my own.

Thank you for any wisdom you can share.

 

Answer

Thank you for your post. The experience of fluctuating between hopefulness and defeat in the process of recovering from TMS/ psychogenic pain is incredibly common within the TMS community.

If you have TMS, there is a good chance you have spent months, years and even decades trying to figure out what is wrong with you and desperately trying to resolve your pain. This process is often marked by an overwhelming sense of uncertainty, confusion, and fear of whether or not you are going down the right path and whether or not each thing you are doing or not doing is ‘right’. As such, every step of your journey with pain thus far has included you measuring and monitoring your symptoms in hopes of giving yourself the best chance of success.

Often when people learn about TMS, they are relieved and hopeful that they have finally found an answer and a pathway to resolution. You start to engage in the treatment and symptoms may start to feel more manageable, you’re feeling excited, even hopeful. And you may even start to feel a bit better, emotionally and physically. Then boom, your back spasms, the pain is full force. The pain may have come back even stronger or it may have just stayed the same, but either way it’s seeming relentlessness has stripped away the hope and excitement and transformed back into that familiar place of uncertainty and disappointment.

“What did I do wrong?” “Is this working” “Did I sleep on a weird bed?” “Is it better or worse than it was yesterday?” I knew this wouldn’t work” “Maybe there is something structurally wrong with me?” “Should I really have stopped doing physical therapy?”

Do these fear thoughts sound familiar?

Psychogenic pain is fueled and reinforced by fear. Disappointment, despair, frustration etc. and the accompanying thoughts of such are all forms of fear. So, in your attempt to give yourself the best chance of success by monitoring the fluctuations in your pain, you are engaging in thoughts that may have got you into this mess in the first place. You are searching and scanning for any measurement of your pain to give you insight and guidance. What you end up finding is more pain.

So here’s the thing- it’s normal to get push back from your brain and body when you start engaging in activities that your brain has conditioned itself to perceive as unsafe, but it doesn’t mean that it is! Pain has a way of scaring us, pushing us back into this state of fear, which in turn, reinforces the pain- it’s a vicious cycle. Plus, we are evolutionarily conditioned to associate physical pain with physical injury, which makes it harder to refrain from thinking the pain is a result of something we have done physically. Taken together, fundamental parts of the process of overcoming pain are teaching our brains that the painful sensations we are feeling are not physically dangerous to us and also, working to neutralize the fear, disappointment and impatience when pain increases.

It sounds like you have already done the work to know on an intellectual level that you are not doing anything to hurt yourself, but it also sounds like there is still a part of you that gets stuck in the idea that some of the actions you are taking may be impacting your process of healing. Keep in mind, the goal is not to immediately get out of pain, but to change your relationship with fear. This can take time and patience. Your pain is going to test you and it’s an important part of the journey because each time you are able to respond to your pain without fear, you are breaking the reinforcement of the pain and eventually your pain will have nothing to hold on to. I know this is not as easy as it sounds- pain hurts and sometimes it is hard not be afraid of it. Hope in itself can feel dangerous when you have been disappointed so many times before. You have spent time and energy trying to take care of yourself and at a certain point your pain not only feels like another defeat, but it feels like a betrayal. So now the work is to build trust with yourself by knowing you are not hurting yourself and being compassionate with yourself by exercising patience throughout the process and noticing small victories. Your motivation to work through your pain is wonderful and it is very difficult to strike a balance between being mindful of doing all the right things and not putting pressure on yourself to do everything perfectly. This is an opportunity to step back from the impatience of getting a certain outcome and understanding that your fluctuations in pain and hopefulness are a part of a larger journey.

Working through your pain can be very challenging and it’s a process! Keeping in mind that pain is part of this process of healing can help to neutralize your disappointment when it comes up. You’re exactly where you are supposed to be right now, just continue engaging in the treatment and trying to flex the muscles of stepping back from the ledge of fear.

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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.

 

Extremely well written and many statements here worth remembering and journaling for encouragement for those of us on this journey.
Especially to me, "the immediate goal is not to eliminate all pain but to change the relationship with FEAR ".
Fear has increasingly become a keyword on this forum I have learned. I get that part, especially because each time pain hits, fear always ensues within me, as described, in the form of frustration, disappointment, and hopelessness.
Also an important part of this article to me ironically, is that pain, even extreme pain, is a very normal part of the journey for most all of us and can serve as a guidepost to combat our inner struggles, as stated, likely how we got started with this mess in the first place. This is encouraging to me to as I experience it daily, like right now with the pain

 

Very well said! Needed this reminder. Thanks callie!

 

I know how debilitating fear can be. It 's every bit as difficult to deal with as the pain. I do a fair amount of fluctuating back and forth between hope and despair as well but over the past few days I've been better at keeping the hope alive. I have read a few of the TMS books and found them very helpful but I think the blogs by Dr. Schubiner have given me more hope and reassurance. The books talk a lot about people who have healed fairly quickly and I was starting to feel like a failure because after 6 weeks the pain is still miserable. After reading some of Dr. Schubiner's blog I'm feeling more hopeful again. This post by Callie has also been very encouraging. Thank you.

 

It is very common for those new to the idea of TMS to make a lot of progress and then boom, the pain hits really hard. This is because the mindbody is not willing to give up the strategy that has worked so well for so long. This is actually good news! It means that you are actually doing very well. It is not unusual for new clients to experience greater than usual pain after our first session. This happens so often, that I will actually tell the client in advance not to worry if this should occur. Have a list of helpful hints to tell yourself when the pain hits. This will keep you in the psychological and not the physical.

 

Thank you Callie for your thoughtful response. I am still struggling with the same hip pain and now have acid reflux, which I have not had for years. After seeing many doctors for that, I landed in a Lyme doctor's office and it was diagnosed there. I was treated for this and have not had it in several years. I know that many folks on this site feel as though acid reflux and for that matter, chronic Lyme are both just TMS, but for people who have had chronic Lyme, it may be a different story. Lyme acts a bit like TMS, as it often goes from site to site in the body, and is very opportunistic, going where there are weaknesses.
If all of this is TMS, the struggle that I continue to have is identifying what issue causes this and making the connection.