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Advice Columns:
I'm mostly better, but I still sometimes have doubts
I'm suffering, should I keep seeing doctors, should I exercise, should I take medication?
Dear Rachel,

How are you today? I have not contacted you in a long
time and thought that I would take a minute to update
you on my status. And I also have a couple of
questions for you. I hope that you dont mind answering
them for me. I have begun winning in my battle with
the TMS, it is still not 100 percent there but I am
getting there. My anxiety has shifted and is almost
negible anymore and that is a great thing. I have
really done some digging into my past and found things
that I did not even no that I have that made me
stressed and angry. SO that is going well. I am doing
better all concerned.

I am back in school and now I am doing some computer
stuff from time to time. I am finding that as I am
increasing my activities on the computer that I am
going about it in the right fashion and no longer
worrying as much as I used to. But I still have doubts
from time to time. Do you have any helpful hints on
getting over the top to completely pain free and
worrying free or is this just part of the process and
I need to keep working on what I am doing and keep on
typing in unergonommic conditions. I even have the
little feet up on the keyboards these days to try and
force my mind into accepting that I can't hurt myself
by typing. SO I am getting there.

Also on your recovery do you find that you still have
to work on the little things that stress you out and
hinder your improvement or do you have it to the point
where you are completely conditioned in a TMS mindset
that you cant hurt yourself by doing things such as
typing.

On a side note, my psychial activies have increased
and I find that I am doing more things now like
running and doing sit ups and things like that.


That's great to hear that your recovery is going well. Congratulations!!!
It sounds like things are going just fine. I
had a similar experience, it kept concerning me for a
while. I think it's a matter of time. You'll get used to
it. Keep doing what you're doing, remind yourself it's a
trick of your mind. Your thoughts come to you
involuntarily, and eventually the worries will decrease to
a negligible amount. So keep at it! I mean, after the
progress that you've seen, do you really think it's
physical? No way. So just keep reminding yourself of that.
Your worries will keep decreasing with time.

Every once in a while, because I'm a bit of an anxious and
obsessive person, like a lot of TMS people, something might
hurt and a little part of me gets scared. But then I remind
myself and the worry goes away - either instantly, or in a
few days' time. The important thing is not that I have
those worries every once in a while - the important thing
is that I don't have pain all the time and I can do
whatever I want with my arms.

Getting better from TMS is really a learning process. It
might be the case that 2 years from now, when your arms are
all better, your knee starts hurting and you get confused:
is this TMS? Is something injured? I've had a situation
like that in my own life. And I had to ask myself, OK, how
do I make sure I'm not getting caught in the same trap? I'm
not going to go into that in detail right now, because you
can cross that bridge when you come to it. And I've had
some worrisome days being afraid "maybe it'll happen
again!". But I think that once you come through this TMS
process, you look at pain in your body differently, and
you're more aware of the importance of not focusing
obsessively on something to the extent that it then doesn't
go away.

I hope this was helpful, and it sounds like you're doing
wonderfully, so keep it up! Without even trying, you'll
learn with time new things about your TMS. Keep telling
yourself your arms are OK, keep expanding your activities
and challenging yourself, and I think these concerns you
have will answer themselves.

best wishes,
Rachel
Dear Rachel,

I lost the power in my right arm (I am right-handed) 2 years ago and while I
do have most of the power back in it, it does get worse at times, and also as each
day and week moves on I feel the strain increase.  Also, about a year ago 
my lower back started to bother me.  It is continually sore and I haven't been able to 
go for a decent walk since.  I have had back trouble for about 4 years prior to this in 
both areas.  My left arm is fine.

I was off work for 10 months and have been back for over a year now.  I work 
sitting at a computer at a desk.

I had all the conventional medicine tests as in x-rays and an MRI scan on the neck and
saw 3 types of specialists.  The only thing anyone had to say was that it was tight
muscles.  I attended regularly a chiropractor and a physiotherapist.

I had read John Sarno's book about five years ago and only came across it again a few
months ago.  I fully agree with his theory.  I knew from the time my arm went  that it 
was to do with an emotional issue.  It lost its power at the same time as my brother
admitted that he had sexually abused me.  It was far too coincidental not to be
related.  However, I had a lot of anger to deal with and I know at this stage that I still
haven't fully let go.  I would also be a perfectionist, always feeling that there should be
something better that I could be doing with my life.  

I gave up on the chiropractor in early 2004.  It was pointless.  My body was clicking out
the exact same way again every time.  I also gave up on the physio.  I
was just making myself sore for 2 days.  But I did start going to an Amatsu 
osteopath who works on straightening the ligaments.  I have felt some benefit, but
again I've come to a point where things should be staying in place but are not.

In the last few weeks I have gone through a lot of different things, starting off 
with a few days of panic/anxiety, then my right arm's muscles being tight one week
and the following week the power being gone, with a sore throat in between, then
week 3 my lower back was in pain and now in week 4 the pain in the arm/shoulder
is moving about continuously.  There was another couple of periods of anxiety in
there too.

I know that I basically need to start doing things again, that is things that I used to do
like swimming and walking, and other things just to keep myself occupied and 
distracted from my back.  And to fool my brain of course.

I have a few question which I would like to ask you if that's okay:

My main question would be about not going to the osteopath.  When I do something
that puts my back out and it hurts how can it not be damaging to use it to do physical
things like swimming which I haven't done for a while?  Or is it a case that when the
body relaxes enough things will fall back into place by themselves?  
What if you feel more sore after the exercise?

Walking - how much should I do and what if it hurts?
Pain killers - is it okay to take them sometimes?
How long does it take for things to change and does it go through different stages?
Is there anyone in England who deals with this, that you know of?
First of all, I'm sorry that you've gone through so much.
It sounds like the Sarno diagnosis is very probable for
you, especially since you've connected the arm pain to your
brother. With the panic and anxiety, which I can sympathize 
with, it sounds like you are really under a lot of emotional 
stress, at least in part from the experience of abuse and 
the feelings that go with that trauma. 

The first thing I want to point out about TMS is that it
involves pain but no structural damage correlating to that
pain. The idea is, there is something very disturbing to
you psychologically that you are dealing with inside, and
because it is so disturbing, your body creates something
else for you to focus your attention on, like arm pain or
back pain. Then, you spend a lot of time thinking about
your arm/back pain, visiting chiropractors and doctors, and
so on, and that is all something that you can do rather
than think about the terrible psychological pain that
exists inside. It's kind of like when someone plugs their
ears and closes their eyes and sings "LA LA LA LA LA!!" so
that they don't hear what another person is saying.

Then, the pain get associated with certain things (walking,
typing, etc) and that helps to keep your focus on it. Now,
you are afraid to do all sorts of activities because they
may cause the physical pain, and you have more reason to
focus your attention on external things, like your
activities and physical body, rather on the internal
trauma.

Getting better from TMS is about gradually (and I mean
gradually - for me it was a year in total) decreasing your
focus on your body, as you begin to realize that there is
nothing physically wrong with it, and that the pain is a
trick designed to keep you in a certain loop of thinking.
The thing is, doing this usually means that you are no
longer hiding yourself from the painful emotions that are
underneath the whole thing. In fact, one of Sarno's
suggestions is that every time you feel the pain, rather
than thinking about your body parts, shift your attention
to the psychological matter. Spend time exploring the
psychological matter and learning how it is that you are
avoiding dealing with that by obsesssing about your body.

For these reasons, I'd suggest that if you can afford it
you enlist the help of a therapist to help you work through
things, especially what your brother did to you. 

In answer to your questions, the point is that you are not
really "putting your back out" - the pain is real but it is
not tied to a physical dysfunction. That is the myth of
TMS, and it's that fear of damaging our bodies that keeps
us obsessively worried with our physical states. You
admitted yourself that the osteopath has not helped you.
The point is that if you start to work with the TMS
strategy, your pain will likely decrease *even though* you
are engaged in physical activities. Although you've built a
circle of expectation and pain, that doing certain
activities will cause resultant pain (just like I did with
typing), in reality there is nothing physically damaged
with your body, and over time when the expectation cycle
gets broken, you will be able to do those activities
without pain. I can't say this for you with certainty since
I don't know you, but everything you've said sounds very
much like TMS, and that's how TMS works.

I am not familiar with people in England, so just be
grateful for internet and telephones.

There's no point in forcing yourself to do physical
exercise just for the sake of forcing it and making
yourself miserable. The point is to explore how these
things might be an illusion, that perhaps there is nothing
wrong with your body and it is a big thing constructed to
keep your mind busy and avoiding the horrible things that
you've gone through in the past. Think about how many times
a day you think about your physical pain. A person who's
broken his leg will be unhappy about it and annoyed, but
will he spend his whole day thinking "Ow, my leg hurts. Oh
my god, I wonder if it will get better. It still hurts
today, is that normal? Maybe I should see a new doctor.
What if it never gets better? Maybe I'd better not walk for
the next week." and so on. It sounds like you are obsessed
with your injuries, which is THE defining characteristic of
TMS. Obsessing about your injuries, thinking about them all
the time, is what allows you to avoid the ugly
psychological stuff.

My advice to you is to reread Sarno (several times) and to
think about this proposition that perhaps this whole
physical nightmare is a big cloud around your head that is
keeping you busy with something to think about rather than
dealing with those awful, shameful-feeling emotions.
Perhaps there is nothing really wrong with your body, like
all those medical scans showed, and perhaps the pain does
not really correlate with any true physical breakdown.

I think you need to delve deeper into your emotional
issues, and because they sound so overwhelming (hence the
panic and anxiety) a therapist would probably be very
helpful. Try to find someone good, who has experience with
trauma and panic!