Alan G. Tried everything...what now?

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Question

My husband has been in severe pain for almost 2 years now. He has pain on the left side of his face with constant pressure, pain on the left side of his neck, and pain in his upper left side of his back. The pain is constant. It doesn't ever get better or worse. He has had x-rays, CT scan, MRI, injections, physical therapy, massage therapy, seen a chiropractor, stopped playing sports, gone back to playing sports, taken muscle relaxers, been on anti depressants, had his wisdom teeth pulled, worn a mouth guard, and... there is probably other things his done and other doctors he has seen but I'm sure you get the idea.

He heard about TMS back in November and read a book by a Dr. Brady that someone gave him. Just after Thanksgiving he decided to read a book by Dr. Schecter and tried following the book along with the journaling. That did not work for him. He seemed to believe that he might have TMS but couldn't 100% accept it. Since then he has tried following Schecter's journaling plan and read Sarno books. He even listened to Schecter's cds for a week. He was still in the same constant pain in the same areas throughout all of this.

I found a doctor experienced in diagnosing TMS that was almost 5 hrs away from where we live since there is no one else near by. I suggested he talk to her. She was great at first and took her time with my husband. She diagnosed him as having TMS. That was at the beginning of June. Since then he has still had some doubts but had started to accept the diagnoses more and more. His pain is still the same and never eases off and he says its still incredibly painful. He called the TMS doctor. He NEVER said that he thought that he should get another examination by any other doctor about any other possible illness, BUT she told him that maybe he should go see a Neurologist and that might help ease his doubt and fears to rule something else out!

She also told him not to go on the TMS wiki website and only read Sarno books. She says she knows Dr. Sarno and this is the route she would take. He is so angry, frustrated, confused, and ready to give up. Is this normal? Is what she told my husband right?

He does not want to cycle through doctors again! He went ahead and left a message with his general practitioner to refer him to a Neurologist. He is very discouraged. I want him to not do this and seek out a new TMS doc. He seemed hopeful for at least a few days until this...

 

[Alan Gordon LCSW]

Answer

If I understand correctly, the referral to a neurologist was simply to help him increase his confidence in the diagnosis. I don't really see how that can help, given the fact that he's already had physical causes ruled out and had the diagnosis confirmed by a TMS physician.

It's hard to accept the diagnosis when there is never any change in the symptom. It's hard to accept the diagnosis when there isn't improvement after taking a TMS approach. The mind tends to gravitate back toward, "What if they missed something?" Or, "How could there be nothing wrong with me if it hurts this badly?"

Even confirmation from this neurologist will likely help for only a few days, but without further improvement, his mind will probably resort back toward thinking physically.

There are essentially three components to getting better: accepting the diagnosis, fundamentally altering your relationship with the fear and preoccupation around the symptom, and getting to what's going on beneath the surface generating the pain in the first place (living in a constant state of fight or flight, putting excessive pressure on yourself, repressing certain emotions, a feeling of deserving punishment, etc.)

Sometimes symptom improvement comes just with acceptance, most often it comes with altering your relationship with the fear/preoccupation around the pain, and the improvement is often sustained by getting beneath the pain.

Given everything your husband has tried, I get the sense that he needs some help with these interventions. There's one TMS therapist in particular that I work with who specializes in Skype, that has had a lot of success with such stubborn symptoms. If you think your husband would benefit from with someone, I'd be happy to introduce you to him. Often it can take several months to fundamentally alter the neural pathways necessary to reduce or eliminate symptoms, but the results are generally long-lasting.

Alan

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