TMS enthusiast stuck in mainstream medical practice

MindBodyPT

MindBodyPT

Beloved Grand Eagle
Hi all,

Wanted to put a question out there to those of you using TMS in practice, share some of my recent experience trying this stuff out as a practitioner. As many of you know i'm a PT who found TMS last year after my own episode of chronic back pain (and a few other things) and had a transformative experience. Like so many of us on here, it changed the way I see myself, others and drastically altered my view of the body and brain. So many little aches and pains I had before are gone and I am so grateful to be where I am now.

I feel forever changed by TMS and am having more and more difficulty as time goes on continuing to practice in mainstream medicine. I work in a large hospital system that is quite conservative, i'm pretty sure no one I work with would accept TMS as a valid idea. I haven't spoken about it to anyone at work because it would unfortunately be so controversial. It can be so lonely!

I have used TMS ideas with a small handful of patients. I tend to bring it up casually when I evaluate someone I am pretty sure is there for TMS (other things ruled out) and see how they react. Most of the time there isn't much interest but there has been from a few people that i've been able to make strides with and that is always wonderful. Usually if they aren't interested I just go the conventional route and all is fine.

However, I have had the experience of people (occasionally) becoming very upset about the mere suggestion of stress/emotions contributing to pain...the gentlest of suggestions! It doesn't bother me at all, i'm happy to refer them to a different therapist... though i've even had one person make a complaint. It can be tough. Have others had this experience? How have you handled it?

I just keep feeling like my days of working in a big hospital system are numbered, that I can't be "out" about my TMS practice without being thought to be totally crazy or possibly even fired if I laid out this theory to anyone, it would create so many arguments and disagreements with co-workers. It is endlessly frustrating to me that it feels like such a secret when it could help so many people.

Has anyone else dealt with something like this? Other medical professionals frustrated with the system and feel you're nearing the end of your ability to deal with it on a day to day basis? A lot of days I just want to leave, go rogue and start my own thing! It's a goal for me but hard to know how to start, it feels scary but I think about it every day.

Any advice, commiseration, similar experiences you have had is appreciated :)
 
I can imagine how difficult and frustrating this must be. I know some of the MDs in the TMS field have been through similar experiences, and likely too that the TMS psychotherapists have also. I think your idea of going into private practice is an excellent one. But I know that is full of challenges and hurdles to overcome. Maybe outline a step by step plan and gradually work toward it.

Have you contacted @Georgie in the UK? She's the only PT who practices the TMS approach that I know of. Though the UK health system is very different from the US one, she may have some ideas and support for you.

Hang in there. It's hard to be on the cutting edge. Your expertise and posts on this Forum are invaluable. You are helping people here everyday avoid unnecessary PT services and medical interventions.
 
I sometime volunteered with a group of Buddhist monks who specialize in treating people's illness using the old traditional Asian med. They very often deal with people who have tms/ mind body syndromes. They never come straight out and tell people that their ills were caused by a negative mind/emotion. They just tell people whatever illness you have a negative mind will intensify and multiply and prolong it. They advice people to do thing to improve their state of mind. And then slowly with a program of relaxation, meditation, praying, living in the now mindfully, often the patient will have an "enlightens" moment and will recognize on their own that a negative mind is the cause of their illness.
 
balto said:
I sometime volunteered with a group of Buddhist monks who specialize in treating people's illness using the old traditional Asian med. They very often deal with people who have tms/ mind body syndromes. They never come straight out and tell people that their ills were caused by a negative mind/emotion. They just tell people whatever illness you have a negative mind will intensify and multiply and prolong it. They advice people to do thing to improve their state of mind. And then slowly with a program of relaxation, meditation, praying, living in the now mindfully, often the patient will have an "enlightens" moment and will recognize on their own that a negative mind is the cause of their illness.
Click to expand...
Brilliant!
 
MindBodyPT said:
Hi all,

Wanted to put a question out there to those of you using TMS in practice, share some of my recent experience trying this stuff out as a practitioner. As many of you know i'm a PT who found TMS last year after my own episode of chronic back pain (and a few other things) and had a transformative experience. Like so many of us on here, it changed the way I see myself, others and drastically altered my view of the body and brain. So many little aches and pains I had before are gone and I am so grateful to be where I am now.

I feel forever changed by TMS and am having more and more difficulty as time goes on continuing to practice in mainstream medicine. I work in a large hospital system that is quite conservative, i'm pretty sure no one I work with would accept TMS as a valid idea. I haven't spoken about it to anyone at work because it would unfortunately be so controversial. It can be so lonely!

I have used TMS ideas with a small handful of patients. I tend to bring it up casually when I evaluate someone I am pretty sure is there for TMS (other things ruled out) and see how they react. Most of the time there isn't much interest but there has been from a few people that i've been able to make strides with and that is always wonderful. Usually if they aren't interested I just go the conventional route and all is fine.

However, I have had the experience of people (occasionally) becoming very upset about the mere suggestion of stress/emotions contributing to pain...the gentlest of suggestions! It doesn't bother me at all, i'm happy to refer them to a different therapist... though i've even had one person make a complaint. It can be tough. Have others had this experience? How have you handled it?

I just keep feeling like my days of working in a big hospital system are numbered, that I can't be "out" about my TMS practice without being thought to be totally crazy or possibly even fired if I laid out this theory to anyone, it would create so many arguments and disagreements with co-workers. It is endlessly frustrating to me that it feels like such a secret when it could help so many people.

Has anyone else dealt with something like this? Other medical professionals frustrated with the system and feel you're nearing the end of your ability to deal with it on a day to day basis? A lot of days I just want to leave, go rogue and start my own thing! It's a goal for me but hard to know how to start, it feels scary but I think about it every day.

Any advice, commiseration, similar experiences you have had is appreciated :)
Click to expand...

People (both medical staff and the lay public) are infinitely more receptive to neurological/neuropsychological explanations. They have the massive advantage of being science-backed, and are increasingly being accepted in the mainstream.

I see evidence of this in the many and varied people (across many disciplines) who are involved in treating my husband's Parkinson's.

Keep the faith and maybe seriously consider 'going rogue ;)
 
[
MindBody
I recently retired from a long career as a psychotherapist in charge of a group of therapists within a public agency. I entered this work environment with a history of working in healing practices, including many mind-body therapies, but could not implement most of these practices. The expectations of the public we served and the entity that employed me was that our agency would use standard procedures such as counseling and group work, including family counseling. I was skilled in many modalities but could not practice these various techniques. However, over time, I was able to begin to interest the staff in learning some of the more mainstream skills and convinced the hierarchy (those who controlled the money for training, etc.) that it would be money well spent to begin to train the counseling staff (LCSWs, MFTs, LCPC's) in certain skills. All were eventually trained in EMDR, and many began to take trainings in other skillsets that were more esoteric. So, I guess I would suggest that sometimes changes just take time. It can be done in increments. The larger the change the more time it may take. People are sometimes slow to change. The medical establishment has vested interests in not changing BUT there are some docs and medical professionals that are willing to look at a different picture of healing and how change occurs. I think balto said it well in talking about his/her work with the Buddhist monks. Keep that candle lit and others will too begin to see the light.

Having said this, I also understand the frustration you must feel. I too was deeply frustrated at times and believe some of this frustration created certain physical problems (TMS symptoms) in myself. I could say I sold out for the money, but in the long run I felt good about what I accomplished in moving such a public agency forward.
Whatever you decide should be best for you. Good luck in your decision.
Lainey
 
Thank you all for the words of encouragement! It has helped immensely. I have goals of establishing a true TMS practice eventually, maybe in conjunction with someone else in my area if possible...but I know i'm at the beginning of my journey and have to find the right place for myself. The place I currently work is ok right now but very conservative and I feel certain I can find a workplace where people are a little more open to newer ideas at some point. I get frustrated frequently at how slow people are to change (not just TMS related)...the place I worked before was more innovative and experimental with medicine in general so I probably need to find a place more like that.

Ellen- Yes i've talked to Georgie! She is amazing. Things in the UK work a little differently but she had some good advice, she has a wonderful program.

Balto- The volunteering is such a good idea! I'll have to look into something like that in my area.

Plum- Yes I definitely always use the neurological explanation :) I specialize in neuro PT so i'm always talking about this sort of stuff...though you'd be amazed how some people get upset when the brain is mentioned at all in relation to pain! But yea I agree overall people are most receptive to the neural pathways theory.

Lainey- great advice, thanks for reminding me to take the long road...I get impatient sometimes and I know its a marathon journey to change minds.
 
Hmmm... I have never been where you are BUT I did have an illumination/epiphany of sorts regarding my career after My TMS symptoms went away. I worked as a scenic artist/set painter in the film business. From Inventory/journaling it became clear I only pursued that profession because it was the most money I could make consistently in my trade... BUT I realized I was working for the 'bad guys'. I loved the actual work... but I absolutely Loathe Hollywood, Television and the low-brow bovine-mass appeal of the absolute CRAP we were guilty of producing...meaningless,pointless,destructive fodder.

So... I left LA and moved to Tennessee. I knew I was going to have to live on a fraction of my old income but I was OK with it. My wife was NOT! I became a meat and potato construction worker while she maintained our LA Lifestyle.(consume,consume,consume) That brought out all of the shortcomings in our marriage, which soon disintegrated. So, I went through a drawn out painful divorce... not fighting over anything other than money and it's importance (or lack of), just reluctant to 'give up'. Finally surrendered in 2011..went through a depression, pulled my head out of my arse and now I have been the happiest I have ever been in my life. I have great relationships with everybody (even my ex) a beautiful family and a simple life.

But it was all triggered by realizing my Job in Hollywood was a huge piece of my anger reservoir. 15 years of making a product you think shouldn't be made . I can now honestly and freely tell the world that Hollywood is a great big lie... the only thing they care about is ratings and they are the most environmentally CRIMINAL and mismanaged industry I have ever been involved with. They make the federal government look like a well oiled streamlined machine (LOL)

If you aren't lying to yourself, you can only be a part of someone else'e lie for X amount of time and stay sane.

Who would have known? I sure didn't.... but I am glad now

Hope you figure that out. You could be a huge catalyst for change helping people
 
Baseball65 said:
Hmmm... I have never been where you are BUT I did have an illumination/epiphany of sorts regarding my career after My TMS symptoms went away. I worked as a scenic artist/set painter in the film business. From Inventory/journaling it became clear I only pursued that profession because it was the most money I could make consistently in my trade... BUT I realized I was working for the 'bad guys'. I loved the actual work... but I absolutely Loathe Hollywood, Television and the low-brow bovine-mass appeal of the absolute CRAP we were guilty of producing...meaningless,pointless,destructive fodder.

So... I left LA and moved to Tennessee. I knew I was going to have to live on a fraction of my old income but I was OK with it. My wife was NOT! I became a meat and potato construction worker while she maintained our LA Lifestyle.(consume,consume,consume) That brought out all of the shortcomings in our marriage, which soon disintegrated. So, I went through a drawn out painful divorce... not fighting over anything other than money and it's importance (or lack of), just reluctant to 'give up'. Finally surrendered in 2011..went through a depression, pulled my head out of my arse and now I have been the happiest I have ever been in my life. I have great relationships with everybody (even my ex) a beautiful family and a simple life.

But it was all triggered by realizing my Job in Hollywood was a huge piece of my anger reservoir. 15 years of making a product you think shouldn't be made . I can now honestly and freely tell the world that Hollywood is a great big lie... the only thing they care about is ratings and they are the most environmentally CRIMINAL and mismanaged industry I have ever been involved with. They make the federal government look like a well oiled streamlined machine (LOL)

If you aren't lying to yourself, you can only be a part of someone else'e lie for X amount of time and stay sane.

Who would have known? I sure didn't.... but I am glad now

Hope you figure that out. You could be a huge catalyst for change helping people
Click to expand...

I hear you. We've endured a similar experience with the music industry: key word industry. It's such a corrosive business jam-packed full of people who know fuck all about music (i.e. Making a nice sound) and care only about 'making it' and making money. Most dangerous of all are what I call the fortune and glory seekers. In the 80's we called them users but these types seem to have become ubiquitous and accepted. All they want is a free ride on the gravy train. We've been out of the business for years so we are less exposed to it but every now and then a user pops up, odious with desperation and fawning, and it fires up the most immense gratitude in me. Thank the gods I am well out of it.

You are so right, being a part of the lie is profoundly detrimental to health. At some point you have to jump ship in favour of the good life. Thanks for your post and words of encouragement for @MindBodyPT with which I agree completely. There is a life beyond the leap of faith required to leave the system, a simple life well-lived with integrity. Not always easy, and oftentimes rather challenging but grounded as it is in peace, love and healing, it can take you far. All the way to being yourself and doing the work you were born to do.
 
Baseball65 and Plum, et al
Your past work experiences seem to have been much more corrosive (Plum's descriptor) than my past work experience in a clinical setting. I could never have imagined working in either of your industries. Too big, too many overlarge egos it seems. Mindbody will need to determine if she is living her own truth in staying in her hospital setting, working with incremental changes or should move on to another place. I believe that the work she is doing already offers hope to many patients, yet hospitals are not built for TMS treatments, at least not yet. Maybe Mindbody can be the catalyst for change, or maybe it is best she move on. I know we all wish her well in whatever way she chooses to make her way as a TMS counselor.
 
Lainey said:
Baseball65 and Plum, et al
Your past work experiences seem to have been much more corrosive (Plum's descriptor) than my past work experience in a clinical setting. I could never have imagined working in either of your industries. Too big, too many overlarge egos it seems. Mindbody will need to determine if she is living her own truth in staying in her hospital setting, working with incremental changes or should move on to another place. I believe that the work she is doing already offers hope to many patients, yet hospitals are not built for TMS treatments, at least not yet. Maybe Mindbody can be the catalyst for change, or maybe it is best she move on. I know we all wish her well in whatever way she chooses to make her way as a TMS counselor.
Click to expand...

Great response. I'm indebted to various therapists who work within the NHS yet manage to integrate more insightful care within the constrains of their practice. They really make the world of difference to the people they care for. My role as a carer has been transformed by such good people. So @MindBodyPT do find great solace in the lives of others that your passion reaches. You may not even realise how much so.

It's not an either/or situation, there is much compromise and balance to be found. Freelance is a whole different kettle of fish to being employed and is not for everyone. It can be as immensely stressful as it is liberating.

Life eh? :)
 
Thanks, everyone, seems like I have a lot to think about!

There are definitely two sides to the coin...on one hand, I currently work in a super traditional setting but have reached a handful of people on TMS issues (under the radar of course!) but made a big difference. They are people who are lower income and might not find a private TMS clinic normally due to needing to use Medicaid or Medicare to pay for their sessions. So the change is already happening very slowly...can be frustrating but wonderful when it works out. My workplace certainly isn't as toxic as what some of you described above, just conservative and some clinicians have a tendency to fear-monger about pain, posture and the like, but this is true of most PTs anyways, I don't really fit in with those types and never have. I try to empower my clients and not warn them about things they can't really control anyhow.

On the other hand I know I could make a big difference doing my own path at some point, advocating more for TMS than I can now and providing community education and services in my area. I happen to live in an area with no TMS practitioners that i'm aware of so I could be the first! I saw a person recently who wished there were Sarno-style TMS classes somewhere around here and i'd love to do that.

Being relatively early in my career i'm not ready to take the plunge into solo practice yet but I think its coming. I have a lot of other things changing in my life right now (all good things!) so i'm hesitant to make another big change at the moment.

Thanks again for all the advice and helping me see both sides of the dilemma!
 
MindBodyPT, in an earlier private message I called your attention to the Explain Pain approach to chronic pain by physical therapists David Butler and Lorimer Moseley. Butler is the director of the NOIgroup in Australia. (NOI = Neuro Orthopaedic Institute.) The group has an outpost in Pennsylvania called NOI US that does educational programs for physical therapists in the United States and Canada. The NOI US web page lists seven faculty practicing in the United States. You might consider contacting some of them to see if they have any advice for you.
 
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