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.
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.
