Dr. Zafirides The Role of Existential Anxiety in TMS Pain

Peter Zafirides

Peter Zafirides

Physician
Hi everyone,

I had received some email requests for further information regarding my existential therapy approach to - and interpretation of - PPD/TMS pain. As a result, I decided to dedicate this week's podcast to explaining the role of existential anxiety in the development of PPD/TMS symptoms.

You can find the podcast here:
http://www.thehealthymind.com/2012/04/18/existential-therapy-how-anxiety-leads-to-physical-pain/

I hope you find it helpful. I look forward to your comments!!

- Dr. Zafirides
 
Dr. Zafirides - Thanks so much for letting us know about this. I just listened to it and it was really interesting. It seems like you expanded from Sarno's idea that PPD is caused by rage to something more broad. Bringing in the core humanity issues seems like it would be more acceptal then main Sarno take. Personally, I think there is more to it then just rage or being angry about something. I loved that you mentioned, several times, that the anxieties, fear, worry that people have is complete normal and just part of humanity. I find that to be a great way to look at PPD. Having these symptoms doesn't mean someone is a failure, crazy, or anything else. It's just a normal part of life.

It sounds like the first step in the existential approach is to figure which core issue (meaning, death, freedom, and isolation) is the main cause of the symptoms. Once this is identified how should a person, if its needed, go about addressing these issues. Do they need to change their lifesytle or how they react to certain situations?
 
Thanks Dr. Zafirides for posting this and continuing to explore MBS symptoms on your podcast. I enjoy listening to these things and I hope you continue doing them because they keep my train of thought on the right path. I find that I need to reaffirm to myself every day the causes of MBS symptoms otherwise my brain wants to go backwards instead of forwards in thinking.
 
Chuck said:
Dr. Zafirides - Thanks so much for letting us know about this. I just listened to it and it was really interesting. It seems like you expanded from Sarno's idea that PPD is caused by rage to something more broad. Bringing in the core humanity issues seems like it would be more acceptal then main Sarno take. Personally, I think there is more to it then just rage or being angry about something. I loved that you mentioned, several times, that the anxieties, fear, worry that people have is complete normal and just part of humanity. I find that to be a great way to look at PPD. Having these symptoms doesn't mean someone is a failure, crazy, or anything else. It's just a normal part of life.

It sounds like the first step in the existential approach is to figure which core issue (meaning, death, freedom, and isolation) is the main cause of the symptoms. Once this is identified how should a person, if its needed, go about addressing these issues. Do they need to change their lifesytle or how they react to certain situations?
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Chuck,

Thanks for listening to the podcast! I sincerely appreciate it.

I don't think one needs to identify the core issue, as they are all core issues! Over the years though, it seems to me that issues of isolation and freedom tend to be more dominant. The core concern of isolation seems to be a major source of stress. It can be activated by an infinite number of stressors - a bad relationship, an unfulfilling job, financial debt, bad health (personal and of family members), etc. Those stressors remind us - consciously or unconsciously - that no matter how close our relationships are, there is still an unbridgeable gap of aloneness all of us have to reconcile. This can be very anxiety-ridden. As a result, TMS pain may be activated.

Dr. Z
 
dabatross said:
Thanks Dr. Zafirides for posting this and continuing to explore MBS symptoms on your podcast. I enjoy listening to these things and I hope you continue doing them because they keep my train of thought on the right path. I find that I need to reaffirm to myself every day the causes of MBS symptoms otherwise my brain wants to go backwards instead of forwards in thinking.
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Dabatross,

Thank you for your kind words as well as taking the time to listen to the program. I really do appreciate it.

Never doubt how powerful you are, Dabatross! I know you will succeed because you are already putting in the effort and daring to challenge your mind. It takes a little bit of practice and work, but it is very doable. Have compassion and forgiveness for yourself.

For all of us, our thought patterns and coping skills - both healthy and unhealthy - have been reinforced by a lifetime of experience. But none of these behaviors are fixed in stone. That is the great irony. That is the secret. The truth is, we are always changing - or capable of it. The reason so many people don't change is that they do not believe they can. This is the power of our thoughts and beliefs. But all of us are capable of so much change for the better as well through our attitude, our thoughts, our beliefs.

This includes YOU!!! :) :) :)

Don't ever doubt yourself and your ability to get past the pain of PPD/TMS.

YOU CAN DO IT!!

-Dr. Z
 
Peter Zafirides said:
The reason so many people don't change is that they do not believe they can.
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This is why accepting the diagnosis is so important. Recovery is all about believing that we can become pain free. When you are in pain for such a long time (for me it was 17+ years) you almost just accept the pain as part of your life and who you are. When we first learn about TMS, it can be hard for us to believe that we can actually become pain free. But we can break these deep ingrained thoughts and feelings. The main force that can break our conditioning is simply believing that we can get better and accepting the TMS diagnosis.
 
Thanks, this was really interesting. I really related to all four areas, especially the last one of freedom, wanting it but then having the repsponsibility of so many choices. My life to the extreme. Thanks for speaking,
D
 
This may be a late post, but I just listened to this podcast, and it really resonated with me. I'm going to listen to it again, and probably again, until it really sinks in and becomes a part of my daily awareness, because I think it's vitally important to my TMS.

Thank you, Dr. Z - I'm looking forward to receiving your email newsletters, and I've already sent links to friends.

Jan
 
Just got through listening to your pod cast, Dr. Zafirides, and I must say it answered some of the questions I've had about the onset of my TMS symptoms, which occurred in the form of a so-called "herniated disk" leading to a major back pain attack, about 6 months after my mother died when I inherited her house (a house incidentally where my parents had fought incessantly for 40 years, driving me out on my own). Well, my mother had dementia, so caring for her was a sudden full-time burden that nothing before in my life had prepared me for. Well, after her death, when I'd be out running alone in a nature park, I started getting sciatica, which just kept increasing until my back attack. I can see now that it wasn't repressed rage a la Dr. Sarno that I was confronting so much as major existential choices that manifested for me following my mother's death. I always wondered why the very air at night as I ran out there alone seemed pregnant with all kinds of life questions like: What to do next? What does life mean now that I was isolated from my mother's protection and love? Big stuff, not just repressed rage left over from childhood directed against an absent parent. My mother's death had made me confront life's ultimate core issues (like Oedipus when he couldn't answer the Sphinx's riddle on the road to Thebes?) and instead of answering the very difficult questions they posed, I found it was "easier" to develop TMS symptoms in my back and left leg. I realize now that when my mother died, it was probably the first time in my life that I hadn't either been dominated by my parents or else resisting their domination. IOWs: Your existential approach to TMS seems consistent with my own experience and answers a lot of questions I've had about the reasons behind the onset of my symptoms. Thanks a lot!
 
Your existential approach to TMS seems consistent with my own experience and answers a lot of questions I've had about the reasons behind the onset of my symptoms. Thanks a lot!
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You said it better than I did, MorComm. I think this is something that Dr. Sarno only hints at, whereas I think it's really important - those life and death issues. I may have had TMS all my life, but this explains much better why it became a crisis for me when it did (the last few years). I am happy being single again, but living alone at age 60 has its own special set of fears. My mother at age 90 is exhibiting all the obvious signs of anxiety and panic about her future, and that really affects me.
 
Yes, Jan, freedom is very, very difficult.

PS- That's why democracy isn't the easiest way to run things.
 
I'm happy to report that Dr. Zafirides just posted on Facebook that he is revisiting Existential therapy. He wrote,
Can our search for meaning heal us?
Welcome to Episode #91 of The Healthy Mind with Dr. Zafirides podcast. Because you asked for it, Dr. Zafirides begins a multi-episode series this week on his specific area of interest and expertise – Existential Psychotherapy. If you are a regular listener to the podcast, you have heard Dr. Z refer to existential therapy and how our behavior is shaped by the big questions of our existence – Meaning, Freedom, Isolation and Death. He’ll discuss all of these issues over the next few weeks.

Just FYI: this is not going to be a “heavy discussion” of philosophy. With practical, everyday examples and healthy tips, Dr. Z keeps everything lively and upbeat. These issues are part of the human condition. We all face them – everyone of us. Join us for an enlightening discussion and learn how our individual search for meaning can truly heal us. Welcome!!
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Here is the link to the next podcast: http://www.thehealthymind.com/2013/10/30/091-existential-therapy-part-1-introduction/

It is my pleasure to consider Dr. Zafirides a friend of mine. We have served together on the board of the Psychophysiologic Disorders Association since the second TMS conference in Los Angeles. I think that his site and podcast are important because they blend cutting edge science with important Mind-Body concepts, all from the perspective of a compassionate physician. We also did a webinar with him that was very well regarded.

Who should listen? Well, I think that people with TMS are so desperate to get out of pain that sometimes they go from book to book and idea to idea in a desperate search for something outside of themselves that will heal them. In contrast, Dr. Sarno taught us that for the vast majority of people, TMS healing is fairly basic. We just need to accept the diagnosis 100%, resume physical activities, and do the other steps he outlined in Healing Back Pain. However, TMS can sometimes be a message from our unconscious telling us that we have opportunities to heal, and I believe that those opportunities are worth taking for their own good.

So if we want to heal simply because healing is good, how do we do it? I think that there is part of us, deep inside of us, that knows what it is that we need to heal. And it tells us by, when we learn about something, such as what Dr. Zafirides is describing, by stimulating our curiosity. So if existential therapy resonates with you and you feel like it might hold some meaning for your life... well, that's a good sign. I'd take a listen. If you like what you hear, post here and let us know what you learned.
 
Forest,

Thank you for your kind words. I am privileged to call you a friend. Your tireless efforts and unwavering commitment - from the TMS Wiki to the forum to your personal story - is an inspiration to me. You motivate me to do a better job and work harder - and for that, I thank you.

I appreciate you posting the link to the first installment of my podcast series on existential psychotherapy. People have asked me to do it for some time now, so now was the right time - especially since I am teaching this exact material in a class to psychiatry residents at Ohio State University. It is my goal to make this topic as approachable as possible.

I hope all of you enjoy it and find it helpful and worthwhile.

Kindly,
Dr. Z
 
Hi Dr. Z,

Thanks so much for dropping by. I downloaded this podcast in iTunes and it was one of my favorites because you got right down to business and gave a well organized presentation while still going in to some depth. I was already familiar with many of the ideas that you described, but it was great to hear them re-summarized.

It's a bit off topic, but I was very impressed to hear that members of your practice see only 2 patients per hour. It came up in another thread about Lissa Rankin's TED talks that when she was a gynecologist, she had to see 40 patients a day, sometimes for as little as 7.5 minutes each. How can true listening and healing go on in a tiny little slot of time like that. So I salute you for making time to talk and listen and for looking just beyond medicine in your practice.

Best,
Forest
 
Forest,

Thanks again for your kind words.

With regards to our practice, I couldn't imagine doing it any other way. It's funny though, despite having 30 minutes to see my patients in follow-up, I am still routinely 30-90 minutes behind by the end of the day! Medicine has all but forgotten the healing power of the therapeutic relationship. But the pendulum will swing back. The reductionistic approach to medicine and human health is not living up to all the hype. That doesn't mean we abandon research and the scientific method, but let's not forget there is more to healing than just physiology.

Kindly,
Dr. Z
 
I listened to the first podcast yesterday. I was floored. So often (too often) there's a divide between the patient and the provider, an imbalance in who's "right" and who's "wrong" . The provider thinks he is the "expert" - he's the one with the degree. And after all, his patient is the "sick" one in the relationship. I can't begin to write out how many things are wrong with that statement. I was so, so, so pleased to hear you starting to discuss existential therapy - building on the foundation that both the patient and the provider are human beings . There is such power in having that sort of an equal relationship. Such power, and such unspoken respect. And respect, for me, is essential...it's essential to any relationship, really. I think that's why I like the existential therapy approach so much - it's not really about being in therapy. It's about being in a relationship -- a mutually respectful relationship -- with someone who, perhaps, can help you, and genuinely wants to help you.

I want to (and probably will) write more on this, but at the moment I have to wrap up since I have to catch a bus in a few minutes! I guess just wanted to post this first...and, I wanted to thank you, Dr. Z, for taking the time to really focus and honor this approach and the amazing results it can produce. I can't wait to listen to the other podcasts. For now, though, I'm off!
 
I studied German in college as a second language, since my mother was born in Austria, although she never spoke German at home and my father, born in America of Polish-Ukrainian parents, never spoke Polish at home.

My German teacher in college was a strong believer in existentialism. She talked about it to us all the time, but I at least never really understood it. I'll listen to your podcast, Dr. Z, and I'm sure it will clarify the subject for me.
 
Dr. Z it really made sense about how you mentioned when folks think about life and the end of that life. I know from all the people I've helped in the past and lately how much the existence of life means to them.

In the what am I here for department and being scared too. Its really hard to know what to say when folks ask about immortality. I think you really have some good insights and when I listened to your podcast it brought me to the thought of how do I look at this if im able to help someone.

I got from the podcast to live life to the full everyday. Fill it full of purpose and stop thinking we got forever but to know how strong you really are in your mind and go out there and really live, don't hold back. Do it for others that need you and for yourself too so you can be fulfilled.

Im really loking forward to your next podcast. This is something that's in all our minds and we need to know.
Bless You
 
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