That shooter couldn't repress the extra dose of rage originated by the failed surgery!
He (the shooter) doesn't know that his back pain was the consequence of his unknown rage previous to the surgery --rage repressed in his subconscious, against someone crucial in his life (his espouse, children, parents, boss, partner,....)--
Sadly not even the surgeon knew that the back pain of the shooter aren't linked to the physical condition of his back. Very probably the surgery was unnecessary.
The result: devastation and destruction, exactly that TMS pain is trying to prevent via "protective distraction".
The solution: to overcome IGNORANCE
Dr. Sarno says that in his whole life just 2 (two!) of his patients (thousands!) reacted violently after his dangerous rage emerged from the subconcious to the conscious, so that rage was felt and become a feeling.
Unfelt, unbearable, dangerous emotions (mainly rage) are "the core problem". Our brain detects our inner/ residual ENRAGED, DANGEROUS child and send us pain as effective lid that retains that rage in the subconscious.
Easy to say, difficult to communicate...and ---in my experience-- largely rejected.
Just my two cents.
M