Wow Blake, that is a great question and not the easiest to answer! When we sit with our pain in awareness and ask ourselves what it means, what it might be connected or related to, we are thinking psychologically. This is always productive and a good thing when we are working on TMS recovery. The difficulty arises when we are monitoring this work expecting immediate pain reduction as a result. It is wonderfully reaffirming and confidence building when it comes, and any of those experiences should go down on an evidence sheet for future reference. They are not exclusive to therapy. In the beginning of my recovery I was so wrapped up and distracted by the pain, that experiencing some relief from the pain tended to happen most frequently with therapy. At first I was seeing a TMS therapist via skype. I can remember one day in particular I was feeling so awful, neck pain, headache, stomach upset... that I almost canceled my therapy last minute. I decided to go through with it anyway and then I noticed after the hour long session, I felt pretty good. That experience really bolstered my belief and confidence in my TMS diagnosis. But then I would go into therapy hoping and expecting that kind of relief and when it didn't happen, I was disappointed. Then I would start beating myself, wondering what I was doing wrong etc. These habits can be deeply ingrained in some of us and that is where the mindfulness can be especially helpful. Just noticing now is usually enough for me to stop doing it, beating myself up for instance. But I used to notice I was beating myself up and then beat myself up for that. I am sure that it very common. It is great to explore images behind the pain and ask what it is trying to tell you. This is not the same as being distracted by the pain. Anytime you are worrying, in a state of fear over the pain, trying to figure out a structural diagnosis or remedy for some physical relief, you are being distracted by the pain. In this sense the pain is an abstraction, there are no boundaries to it. The pain is so effective at distracting that we become the pain, what we can and cannot do is dictated by the pain and there seems to be no control over it. It is a self perpetuating negative cycle. We can notice what our mind is doing and redirect our thoughts. The more we do this, the less the pain dictates our lives. I don't think that exploring what the pain means is counter productive or the same as being distracted by the pain. Its the monitoring and hoping for immediate results that is the problem. I know how frustrating that is but it does get easier. The fact that you had these positive experiences in therapy gives you a really good sense how much the psychological does effect your physical well being. Therapy is just about assisting us in making those connections. Journaling, mindful meditation, and working on our own can be just as effective.