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tms in a nutshell-

Discussion in 'General Discussion Subforum' started by Eric "Herbie" Watson, Dec 3, 2012.

  1. Eric "Herbie" Watson

    Eric "Herbie" Watson Beloved Grand Eagle

    Evelyn had been irritable, restless and tense for the past ten
    years. Sleep was poor. Appetite had declined to the point
    of making a meal an ordeal. There was a constant tightness
    of the throat, pressure in the head, palpitations and gastric discomfort.
    Overshadowing all complaints in importance and intensity
    was "an awful fatigue, an exhaustion that starts right
    when I get up in the morning and continues without letup
    till late afternoon. Then it eases up and in the evening I feel
    almost well."
    In spite of this sustained suffering, "without letup/' Evelyn
    managed to keep her job for years, supplementing her husband's
    income. It was only in the past two years that the fatigue and
    exhaustion became "unbearable." She resigned her position and
    tended to her household and her young son. "But in taking care
    of my home I have to drag myself all morning and the greater
    part of the afternoon. I am exhausted most of the day.**
    E Examiner
    P Patient
    E: You have attended classes for several months. Has your
    condition improved during these months?
    P: It has. I sleep well, and my appetite is much better. The
    pressure in the head has hardly bothered me lately, and the
    pain in the abdomen is getting less and less. But I am still
    fatigued. In the morning I have to drag myself and can hardly
    keep on my feet. Then I take lunch, and right after I have finished
    eating I am all exhausted, my eyes droop and I have to
    lie down for an hour or so.
    E: You say that you are "all exhausted/' May I ask you what
    precisely you mean when you use the word "exhaustion?"

    P: Why, I am all in. I have no pep and must force myself
    to do the simplest thing.
    E: Look here, Evelyn, an exhaustion that has lasted for years,
    day after day, even hour after hour, ought to have finally reduced
    you to a physical wreck. Your muscles should have
    shrunk, your face should by now look gaunt and haggard.
    Instead, you maintained your weight, your complexion is blooming,
    and your capacity for working is equal to the task of taking
    care of house, family and social activities. Several months ago
    when sleep was poor and appetite scant your claim to be exhausted
    might have been logical. But with a good appetite
    and sound sleep it is difficult to think that you are suffering
    from a state of exhaustion.
    P: I don't understand it myself, but it is a fact that I feel
    tired and weary all the time, except in late afternoon and evening.
    E: You say you "feel tired and weary all the time." I do not
    deny that. You alone are competent to state how you feel. What
    interests rne is whether your so-called fatigue is a mere subjective
    feeling or an actual and objective condition, whether you
    merely feel tired or actually are tired. You seem to be puzzled
    by the sharp distinction and I shall try to be more specific.
    You understand that if somebody says he feels guilty that does
    not necessarily mean he is guilty. And if somebody feels feverish
    that does by no means establish the objective fact that he
    has fever. These examples will prove to you that a subjective
    feeling does not necessarily point to an objective condition. And
    if you say you "feel tired and weary all the time," I shall ask
    you whether you consider your tiredness a subjective feeling or
    an objective condition?
    P: All I know is I am miserable all day. I wake up in the
    morning, and the fatigue is there the moment I open my eyes.
    E: You told me, Evelyn, that for the past few months your
    sleep has been good. Suppose you awoke this morning after a
    good night's rest. Would you nevertheless have felt fatigued
    immediately after awakening?

    P: I feel fatigued immediately after I wake up in the morning
    regardless of whether sleep was good or poor.
    E: If this is true then it is established that you suffer from
    the subjective feeling of tiredness and weariness, and not from
    the objective condition of fatigue. I shall tell you why I can afford
    to be so positive about my statement. You see, Evelyn,
    soldiers after a long march, athletes after an exhausting race,
    laborers after a strenuous effort, may sometimes be too tired to
    fall asleep. But once they lapse into a sound sleep they invariably
    and inevitably feel refreshed after awakening. These are examples
    of extreme fatigue. Even in these utmost exertions sleep
    eliminates fatigue with unquestioned certainty. In minor exertions,
    mere rest without sleep will have the same effect. The
    only exception to this rule is physical ailment, like an anemia or
    tuberculosis. In these conditions, even a sound sleep may not do
    away with fatigue. But with physically healthy persons, sleep
    never fails to remove fatigue. If it is true that for several
    months past you have enjoyed good sleep you have no reason
    for being tired in the morning. To sleep means to rest the
    muscles. How can your muscles be fatigued if they are rested?
    P: I don't know what to say. The fact is that I am all in
    no matter how well I slept. If you call that a subjective feeling
    you must think it is mental. But I didn't even have time to
    think about it. It is there the moment I wake up.
    E: I do not know what precisely you mean when you use the
    word "mental." Presumably you refer to the possibility that
    you may have the thought of fatigue in your mind and instantly
    feel the fatigue in your muscles* This instantaneous response
    of the muscles to a thought seems to puzzle you. I do not see
    why it should. You have certainly gone through similar experiences
    hundreds of times. Remember the occasion, for instance,
    when you were at a meeting and were called upon to make a
    speech. Instantly, your heart began to palpitate, your face reddened,
    your abdomen trembled and the knees shook. To use
    your own words, you "didn't even have time to think" of the
    speech; you merely heard your name called, and the muscles of

    your heart, abdomen and legs were thrown into violent tremors
    "in no time." In the instance which I quoted the thought in
    your mind which caused your muscles to shake was the fear of
    not being able to deliver a well constructed address. It was a
    fear, or you may call it a fear idea, or the idea of danger. Do
    you understand now that if an idea strikes or occupies your
    mind the muscles may respond with a violent reaction in a
    fraction of a second?
    P: I understand that. But when I get up in the morning
    there is no idea of danger in my head.
    E: The question is what you mean by danger. If you wish to
    indicate that, in the morning, you are not trembling with the
    fear of being killed or trapped or burned I shall fully agree
    with you that no such idea may occupy your brain immediately
    after awakening. But there are subtler forms of fears and
    dangers. These subtle anxieties and apprehensions go by the
    name of preoccupations. I happen to know from your own
    account how readily you fall victim to such preoccupations. Let
    me remind you, for instance, of the anguish you experience
    whenever you expect visitors for the afternoon or the evening.
    You fret and worry days in advance, anticipating some bungling
    or clumsiness while performing the part of the hostess. You
    know that when finally the much dreaded day arrives you feel
    troubled and helpless "the very minute" you awaken. The day
    stares you in the face as a threat, as an event fraught with
    heavy responsibilities. You are without pep or zest. Your vitality
    is at a low ebb. A heaviness seems to descend on your
    limbs. Everything is done with effort. You have to drag yourself,
    feel "all in," exhausted, lifeless, fatigued. Do you understand
    that all of this is caused by your preoccupation, and that
    the preoccupation is based on the idea of danger ?
    P: It is true I am worrying my head off when I expect
    guests. People are critical, and it is not easy to please them and
    make them feel at home. But we don't have visitors every day,
    and there is not a day when I feel relaxed. I am always tired.
    E: I mentioned your preoccupation with your guests as an example
    only. The example will demonstrate to you that a pre

    occupation of this kind is apt to produce, in a split second, a
    condition in which you feel "all in," dragging, exhausted and listless.
    Being a nervous patient you are always preoccupied with
    your disability. This preoccupation is a kind of worry which
    hardly ever leaves you. You are always on guard against something
    untoward happening in some part of your body. Looking
    back on your unhappy experiences of the past ten years you can
    recall numerous instances in which you planned a social engagement,
    a card game, a show, a trip and were stricken with
    a severe head pressure or palpitations or abdominal pain or
    numbness. The card game had to be interrupted, or you managed
    painfully to go through with it in wretched agony. You
    remember the frequent occasions when dinner parties had to
    be cancelled because your throat suddenly "locked," and you
    were afraid you might not be able to swallow or speak; or the
    dances that had to be called off because a heaviness settled on
    your legs so that you could hardly walk. It was observations
    of this character that in time suggested to you that it was no use
    planning. The unpredictable suddenness with which your symptoms
    could make their appearance gave you no guarantee that
    if you made a plan you could go through with it. Gradually the
    inability to plan spread to the trivial chores of everyday life. You
    set out to prepare a meal, and your eyes blurred. Or you decided
    to darn your husband's socks, and the hands trembled. The
    symptoms came without warning. They shot through your
    body without cause, without provocation. To use your own
    words, you "didn't even have time to think about them." I
    may tell you that symptoms which shoot up so unexpectedly,
    in a mere fraction of a second, are called "trigger symptoms."
    They shoot forth with the rapidity of a bullet after the trigger
    has been pulled. Their trigger character makes them appear
    weird, mysterious, threatening. In essence, they suggest to you
    that you have utterly lost control of your primitive bodily functions.
    Having noticed time and again that your organs may go
    on a rampage without warning you feel you cannot trust your
    body. You must always be on the alert for some sudden disturbance.
    You cannot plan with any assurance of carrying out

    your decisions. But if you are deprived of the power to plan,
    your day is carried on without accomplishment. Moreover, without
    planning, you miss that singular joy of looking ahead to
    accomplishments. The joyous trembling of watchful anticipation is
    taken from your daily routine. Life becomes a never-ending
    drabness and drudgery. It is this type of life that you look forward
    to when you awaken in the morning. In a flash, before
    you had "time to think about it," the dismal dreariness of your
    existence stares at you. Again one of those empty days with
    no plans, no decisions, no accomplishments. You become
    discouraged, disgusted with the dead monotony that is in store
    for you, and it is the self-disgust that robs your tissues of their
    vitality. There is no vigor, zest or incentive with which to
    start out on the daily routine. Your body is devoid of stimulation;
    it feels uninspired, flabby, limp. This feeling of limpness
    you call "fatigue." You will now understand why towards
    evening your vitality returns and why, after supper, you "feel
    almost well." There is nothing left for planning after supper,
    no drabness to be anticipated, no drudgery to be performed in
    self-disgust. The dreadful day is gone or going. Nothing is
    expected of you any more. You breathe freely now, and your
    vitality returns. Do you realize now that what you call "fatigue"
    is nothing but a psychological reaction to the anticipated and
    dreaded boredom of daily existence? Do you understand that
    the tiredness of which you complain is not in your muscles but
    in your mind?
    P: You are right, doctor. I realize now that everything you
    say is exactly as I feel it. My mornings are dreadful. I have
    nothing to look forward to. I can't plan; I am afraid to plan.
    You are right, doctor, but why was I never told what is wrong
    with me? I have seen all kinds of physicians, and the one
    told me I was suffering from nervous exhaustion, another said
    my energy was running down, and I should take it easy. One
    blamed it on my thyroid gland; another told me I had a poor
    constitution and he couldn't do anything about it. I was warned
    not to overwork, was told to take long periods of rest, to go on
    trips and vacations. If you say that my trouble is nothing but

    boredom and disgust why did nobody tell me that before?
    It would have spared me ten years suffering, and I could have
    saved thousands of dollars spent on cures, sanitariums and trips.
    E: It is painful for me to answer this question. I do not
    like to be critical of what other men think or believe. Unfortunately,
    there are superstitions that refuse to die. One of them,
    very preposterous and pernicious, is the myth of nervous fatigue
    or nervous exhaustion. All I can tell you is that, in 1880, a New
    York physician formulated the absurd theory that a group
    of patients whom he called "neurasthenics" suffered from a state
    of nervous exhaustion.* How uncritical this man was is evident
    from the fact that he did not hesitate to make unwarranted and
    extravagant claims, for instance, that the "disease runs in families,"
    that it is due to inheritance, that it has its origin in the
    spine, that it is typically American and, hence, proposed to call
    it "American Nervousness." Somehow this fanciful idea spread
    all over the globe and is still widely accepted today as a message
    of scientific truth. I cannot tell why a theory of this kind has
    been permitted to figure in textbooks and to be practiced on
    hapless sufferers. All I can state is that superstitions are born
    easily but die with difficulty. I do not blame you for feeling
    resentful of the unnecessary hardship that was imposed on you
    during ten long years of anguish. But resentment will not help
    you. It will only serve to whip up your emotions and throw
    an additional load on your nervous system. What you need is
    re-education. You must learn to reject as untrue all the silly
    notions that were crammed into your head and to accept the
    explanation which I gave you. Up to now, with the thought of
    exhaustion in your brain, you were afraid to move, to work,
    to tax your "weak" muscles. I take it for granted that henceforth
    you will throw to the winds all this drivel about nerve
    exhaustion and will not hesitate to tax your muscles to your
    heart's delight.
    P: You told me that before, and I made every effort to accept
    your view. On many mornings I jumped out of bed with-
    *George M. Beard, A Practical Treatise on Nervous Exhaustion
    (Neurasthenia), New York, 1880, William Wood.

    out paying attention to my fears. I ignored the heaviness in my
    muscles and did my work, but it was certainly difficult. Your
    assurance that the fatigue is in the brain and not in the muscles
    helps me at times. But after I continue with my work for
    awhile the thought strikes me that maybe the other doctors
    were right when they warned me not to strain my muscles.
    After ten years it seems not easy to shake off the fears.
    E: You said you made every effort to accept my views about
    fatigue. This is, of course, an exaggerated claim. I do not
    expect anybody to make "every" effort in any endeavor. What
    you mean is that you tried hard but did not succeed. But remember,
    Evelyn, I never asked you to "accept my views." I
    asked you to practice them. My view with regard to "nervous
    fatigue" is that you can safely ignore it, that it is a bugaboo
    and not a real danger. This view cannot be "accepted" and,
    as it were, placed in your brain there to preside over your
    actions. In order to make a view direct your action it must
    be acquired, digested and absorbed through patient practice.
    This is true of every sphere of life in which you wish to plant
    views into the thoughts and brains of a person. In bringing
    up your children you did not merely present them with lovely
    notions and lofty principles, asking them to accept them. These
    views had to be practiced, again and again, till finally they
    were incorporated and lived and experienced and acted out
    spontaneously. When you intended to make your boy adopt
    the view of group responsibility you did not tell him to accept
    your principle of group behavior. Instead, you told him not
    to make noise in the presence of people. You urged him to
    say "thank you" and "please." This you did for months and
    years until finally the new habits took root. After ceaseless
    practice your boy finally incorporated the view in his system,
    made it part of his organism. The practice made the view
    "sink in" and take its firm place in the brain from where it
    then directed action. In this process of child training you influenced
    your boy's muscles and through them established a
    firm structure of habits. It was these good habits that represented
    your view. You understand now that I asked you to

    practice my view, not merely to accept it. The continued practice
    would have brought acceptance in its train. You will perhaps
    remember what precisely I asked you to do. I told you
    to jump out of bed and to go about your work, fatigue or no
    fatigue. But I also warned you to avoid all actions that embody
    the view of danger, I specifically instructed you not to look in
    the mirror to watch your so-called fatigue in your anxious
    features. I asked you to avoid the practice of touching the
    muscles of your arms and legs to investigate the degree of
    their flabbiness. I cautioned you not to sit down after a few
    steps or a few manipulations. Most important, I enjoined you
    not to complain about your fatigue, not to moan or sob, not
    to ask for help or sympathy. If you had complied with these
    instructions you would have established a new set of habits
    of how to deal with this legendary thought of nervous fatigue.
    The old habits of fear would have been crowded out of your
    mind, and a new set of constructive trends would have settled
    down or sunk into your brain. My view would then have
    occupied and taken possession of your brain without any effort
    on your part to accept or adopt it. If you say that "after ten
    years it is not easy to shake off the fears" I shall advise you
    that you had no business assuming that it might be easy. Mere
    acceptance of a view is easy, but practicing it means sustained
    application with endless trials and endless failures till finally
    you score the ultimate success. You thought of merely accepting
    a view. That would have been easy but ineffectual. What
    I wanted you to do was to practice, i.e., to direct your muscles
    to carry out my view. I presume that after tonight's interview
    you will no longer entertain the unrealistic notion that mere
    lip-service to a principle -will reestablish a new set of habits.
    Practice alone will do that.
    Leslie and Forest like this.
  2. Endless luke

    Endless luke Well known member

    Very interesting- I think this style of dialog where you root out the patients misconceptions can be very helpful.
  3. Eric "Herbie" Watson

    Eric "Herbie" Watson Beloved Grand Eagle

    this is awesome endless luke-i love the dialouge -
    its like it spoke right to my sub-conscious and it did.
    also i love the way he explains the objective and subjective minds -
    and at the end where he tells her of the practice and dedication
    so much more to talk about
    thanks-if ya need any answers or get stuck any where hit me back-im
    right here-or if ya just want to talk psycholgical-thats always fun
  4. Endless luke

    Endless luke Well known member

    I think I'd like to take you up on your offer. So was this dialog from *George M. Beard, A Practical Treatise on Nervous Exhaustion
    (Neurasthenia), New York, 1880, William Wood. ?

    I was trying to work on connecting with my emotions but now I've gone back to working on believing 100% that my diagnosis is TMS. I was at about 70% last week. Then I read on one of the forums about "drop foot" which is one of my symptoms that I thought was unique to me. That definitely moved my belief up a bit. I'm also writing down the ten beliefs from http://www.tmswiki.org/ppd/So_You_Think_You_Might_Have_TMS here each day.

    I read this book called Intensive Short Term Dynamic Therapy that you might find interesting. I have a fair amount of experience with therapy and usually it seems meandering and not goal focused. This book is very different and includes much sample dialog- similar to what you posted. In the end I found it confusing because I couldn't tell which of the sample patients best matched up with me.
  5. Eric "Herbie" Watson

    Eric "Herbie" Watson Beloved Grand Eagle

    i think we as tms-ers match well with the dialouge above, were like lost at first -then we get it-its when the scales are re-moved from our eyes and we see the truth,and its only after we do what were taught to do-i see some friends that have been at this tms psychological thinking for a long time and i dont see them healed yet-even tho there much better -they have this 1 little issue that keeps them from the full 100% healing and that would be the defense mechanism-we have to know that these lessons are from real people that have really healed-and there really aint no short-cuts . we have to do the work as the therapist above stated-but you see we think were doing the work when in reality our short-cuts and hopes for a fast healing are helping the mechnism keep the pain there-then that becomes sub-conscious or natural to ya

    but onto your dialouge-i believe your right on the dialouge above -a lady named mala posted it on another site and i thought it explained perfect the way -we can be taught,but still have the scales or blinders over our eyes till we know that we do have subjective and objective thoughts-then when we break through that barrier-we start to heal-but if we go back to our ol patterns of thinking-which i wouldnt suggest-this is a lesson learned to live a better life -if ya want what ya never had -ya have to do what ya never done and keep doing it in tms healing-its awesome because we actually learn to walk in the law of attraction then and all aspects of our lives get better-

    now onto what works for you-you said when you read about the drop foot that it made you feel better-did your percentage to feeling better from the pain rise-
    and what of the ten beliefs is helping you most.
  6. Endless luke

    Endless luke Well known member

    Oh reading about the drop foot didn't make me feel better but it did increase my belief that TMS is the cause of my symptoms. Perhaps it did make me feel better but not immediately- I've had some relief this week.
    I'm bouncing around a little in terms of which ones seem the most important. The one I'm really responding to is MBS (or TMS) exists only to distract my attention from my emotions.
    I will shift my attention from pain to emotional issues
    I must think psychological at all times not physical
    MBS is a harmless condition caused by my repressed emotions

    I think it may be useful to think of MBS as an addiction. Of course we didn't choose this addiction and we can't quit as easily as an addict can but it is an addiction to avoiding emotions.
  7. Eric "Herbie" Watson

    Eric "Herbie" Watson Beloved Grand Eagle

    (Quote)-Endless luke -MBS (or TMS) exists only to distract my attention from my emotions.
    I will shift my attention from pain to emotional issues
    I must think psychological at all times not physical
    MBS is a harmless condition caused by my repressed emotions

    (Quote)-Eric -it will help you to keep going in the direction your in-
    i havent heard good talk like that in a minute-
    thats right-it is a dis-ease and its mechanism does distract your attention-
    a most powerful concept every time i think about it
    it was almost like i had so many daily reminders to think about that
    i didnt have time to think emotional-and i didnt want to-i wanted to heal -and i did
    -you will too-if you stay in this direction and never let the teachings go a day with-
    out practicing those keys you said-you should heal good-theres soooo much to learn
    -i say about 40 yrs and sarno was still learning -so tell me
    its good though.

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