Whenever I have a flare up I think I messed up my back inspite of knowing that flareups are normal.

I've been dealing with chronic back pain for 5 years now . Recently all my MRIS (3) , NCS , PET scan and all my reports are normal . My doctors confirmed I dont have any physical problem . So I discovered TMS and have already completed reading The Way Out and I am half way through completing Crushing doubt by Dr.Ratner

From the past few weeks I'm working with a PT who is trying to get me back to physical activities which I am afraid of . Everytime I have a flareup I think I either messed up my back at the gym or doing some activity . Is this normal and how do I deal with it whenever I get these thoughts

 

Yes, it's normal to think physically again and to have an increase in fear. Look at it this way, if you didn't have these episodes of feeling these sensations, you'd never have the opportunity to realize that they are painful, but you are not damaged - you're OK, just feeling sensations. The cruix is the anxiety. The sensations you fear are not just the sensations of pain you might feel but also the sensations you feel of anxiety, which can create a lot of thoughts that make us think things aren't OK. We catastrophize or we beat ourselves up.

One of the biggest parts of this work is the mindset. In The Way Out, there's a passage where Alan Gordon writes about starting to drive again, and his fears and anxieties, and how he works with that...by allowing it to just be there. He has physical sensations of fear and anxiety but responds to them calmly and they dissipate pretty quickly. Along with the sensations you'll probably get those annoying thoughts, but they are simply thoughts - just let them float on by. Claire Weekes has written a few books about anxiety that are the TMS go-to books. She is old fashioned but has very explicit directions on what to do with anxiety and her suggestions work if you use them regularly and over time.

As you are working with your PT - think about your relationship with them. How do you feel like it is going with that relationship? Do you feel pushed? Would you like to continue but perhaps slow down or have each part broken up into smaller segments? I too use a PT - I went to a few of them, but this is the one I trust. We go VERY SLOW - I see him only once every 6 weeks and do the PT at home (it's a unique method) on my own. This is very helpful because I can utilize much of the TMS mindset work as I do these movements. Now, the movements are not going to "cure" my TMS and I am very well aware of it. I use them to help break my mind of the fear and encourage me to do other movement every day and get my nervous system to accept the fact that the movements are absolutely safe. That can be a challenge when fear creeps up..brain senses danger and sends that message to your nervous system but over time you'll break this cycle and it's really what Alan Gordon's book is all about.

Time and practice is the way to get a handle on these things. It might take you 10 times, it might take you a thousand times. You just have to have faith (or crush your doubt) that you will eventually master the mindset.

 

Thank you so much for the clarification . I have one more question . During a flare up is it normal to have pain/extra sensitivity with movements which were not previously a problem . For eg I don't have a problem with extensions when I am not in a flare up . But during flare up I get a lot of pain or sensations with extensions

 

My body is what physical therapists might call “stuck in extension”. My pt explained that our bodies can react to being in fight, flight or freeze…when I used a traditional pt method used for “back pain” I felt all kinds of things new and old. I did not yet understand how TMS works - which is a combination of repressed emotions and fear/anxiety (and pain) being distracting symptoms from the internal (subconcious) rage. These are things that Alan Gordon doesn’t quite explain but Dr. Sarno does which is why we recommend reading a book by Dr. Sarno.
I asked how you felt about your current situation because a lot from both your past and present can fuel this subconscious rage - and in general TMS-ers are really good, kind folks who don’t want to think they have any rageful parts of themselves.
Now think about physical extension: one might be in that position with dukes up fighting, or running and stumbling backwards loosing that fight. RAGE! You want to WIN! What you don’t want to do is feel that rage or any of the internal pains and thoughts that make you feel that way. This is the parts that I believe you’ll read much more about in Crushing Doubt.
In the end, physically.. does it matter much?
No.
Because your pain feels very physical but it is not. It’s tension.
So what do you think about your pt? What fears do you have as you feel sensations when you do the movements?
How do you feel about “having” to do pt?
What thoughts do you think about yourself when you have flair ups?
These are good things to write down and think about. To utilize and look at your personality traits eg perfectionism, goodist, people pleaser etc that are common in TMS folks (Sarno goes into this a bit).

When utilizing a PT and doing this work you’ll need to understand that it is not going to “fix” you. The work is what will help you understand that TMS mechanism but the PT is just to encourage movement. We don’t talk about the physical stuff on this forum, we just focus on the TMS work and will bring you back to it every time because worries about the physical is really just a distraction.