Welcome to Healing From Inside. Our mission is to share stories about psychosomatic illness. Psychosomatic (or Mind-Body) illness is an epidemic in North America, and learning about it is the first step to recovery. If you would like to contribute your story about healing from psychosomatic illness, please click on "Submit" below.
Story #1 - How I Overcame Back Pain Through Self-Reflection
Following years of mis-diagnosis I finally found the correct diagnosis and got well. In this post I’m going to tell my entire story of back pain from the beginning. Despite ruthless editing, it’s a bit long. I’m including the whole thing because I think it will be useful for people going through the same thing. Here goes:
Back Problems Episode One: 1994 – 1999
My “back problems” started in 1994 when I heard some crackling noises coming from my thoracic vertebrae while being crushed in a rugby maul in a high-school rugby match. It wasn’t serious and the only sign something wasn’t right was occasional upper back pain when I would stand for long periods. In 1998 I moved to Whistler B.C. for a couple months to work as a ski instructor. It was super fun, but after a while I developed some lower back pain. The pain got progressively worse over a couple of weeks and continued even when the snow melted and I began working as a cleaner. I moved back home to Toronto. The plane ride back was tough because sitting had begun to be painful in my back, and pain had started to shoot down my left leg along the top of my thigh and over my shin. Within a week of arriving home my leg pain intensified and my body tightened up so that any position other than lying down was painful. I was 19 years old and it was June 1999.
In August my friends went off to university and I stayed home because of the pain. I was unable to sit for longer than an hour without leg pain and therefore not able to attend university. My doctors did something called the “straight leg raise test” and told me that I might have a herniated disk in my spine. I had an MRI that summer and it showed a moderately-sized left-central herniation at my L5-S1 spinal disk. The doctors and I had suspected a herniation at L4-L5 (instead of L5-S1) because pain down the front of the left thigh doesn’t correlate with an L5-S1 herniation (Each herniation presses on a specific nerve which should produce a specific radiculopathy, that is, pain in only the area served by the nerve being compressed). Nevertheless the herniated disk on the MRI was diagnosed as the cause of my pain.
I saw a couple of surgeons in Toronto who suggested I wait a couple months to see if the pain and my function improved. So I waited and spent a lot of time in bed. I spent the fall recuperating and the pain gradually receded. I started swimming three times a week. I went back to see the surgeon in November and explained that my pain was still annoying, but that I could live a quasi- normal life. The surgeon tested my reflexes (all normal) and said I had the symptoms of somebody following a successful surgery. He told me to keep doing what I was doing.
By January I felt sufficiently improved to head off to university. I took 60% of a normal course load. The pain in my back and my legs continued but it was a mild annoyance, and over the next year and half I started playing sports again and eventually more or less forgot about my herniated disk. During the summer of 2001 I worked as a tennis instructor and didn’t have any pain or functional problems. End Episode One.
Back Problems Episode Two: 2005 – 2006
In 2004 I spent the year in Australia. I rode my bike everywhere and worked as a tennis instructor. I felt in the best shape of my life.
However, I was also in school and it was (at times) a stressful period. One day I hit a forehand and felt a pinch in my lower spine. Some pain appeared and started to radiate across my back and down my left leg. I went home and called my girlfriend at the time, distraught about how I had injured my back again and would have to quit my job and maybe even return to Canada to live in my parents basement (since I wouldn’t be able to work). I did some stretching and went to bed feeling very depressed.
The next morning I woke up feeling fine. I was amazed.
Start Episode Two:
Back from Australia in 2005 I finished University in Montreal and invited my Australian girlfriend at the time to come live with me in Toronto. She agreed. I started to think about how I was going to:
1. Move to Toronto,
2. Re-unite with my girlfriend,
3. Find a job, and
4. Find an apartment
All within a week and a half. Looking back, it was stressful, but consciously I didn’t feel stressed. I felt happy.
My girlfriend arrived and my back started to hurt again. One day after a steamy night with my girlfriend, I went to play tennis with my friend on a sunny July day. I hit a forehand and I felt a stabbing pain in my lower back. I tried to stretch it out, but my second forehand was just as bad - again a stabbing pain in my low back. Over the next couple weeks the pain spread across my back and into my left leg. The same pain appeared across the top of my thigh and knee, sometimes radiating into my shin and foot. Thinking (but more hoping) that it would just get better, I proceeded to get an apartment and a job - even though within about 2 weeks I couldn’t stand up without pain in my back and legs. I think I was in denial.
Eventually, based on my initial diagnosis in 1999, I became certain I had re-herniated my L5-S1 disk again, although I hoped that it wasn’t as serious as before. Within a month or two, it became clear that it was MORE serious than before. I had an MRI which showed a “large central” herniation at L5-S1. You can see the herniation below (the black blob), pressing into the nerves (white) running down my spinal canal.
I brought a bench into my job so I could lie down and work with a laptop on my chest. I brought crutches into work so I could prop myself up at my chair. I cut back to working half-time in the hopes that my pain would recede as before.
I remember I found the patterns of pain strange. On some days I felt pretty much OK. I was able to work from 9-5 (sitting some of the time) with only occasional back pain. On these days I would go home thinking I was getting better and be happy that maybe I wouldn’t need to quit my job after-all.
On other days I was in pain from 9 am right through to 5 pm. These days were a struggle. Even while working half time, swimming on my days off, stretching for 30 minutes every morning, and doing abdominal strengthening exercises every night, I was still having more bad days than good days. Eventually I decided to quit my job (which I loved by the way). I resigned on November 30th 2005.
During this time I saw two Toronto surgeons. One was an orthopod (Dr. Kremer at Western General in Toronto) the other a neurosurgeon (Dr. Mueller at St. Mikes in Toronto). Both seemed unimpressed with my normal reflexes (meaning they didn’t think I was a surgical candidate) and said I would probably do well to wait. Remember this is in Canada, where surgeons do not try to push surgery on you - Very different than in the US. They didn’t seem to want to operate on me, and said I should wait to see if it got better on it’s own.
One reason they didn’t want to operate was that my pain was not severe. On a scale of 1-10 (ten being total agony) I would rate it a 3 – very real and annoying, but not severe. Also, the pain moved around. Sometimes it was in my low back, sometimes on the top of one or both of my thighs, sometimes just in my shins, and sometimes just in my left foot. Or it could be a combination of these. Sometimes the pain was gone completely. I noticed that it intensified in certain situations and positions. I remember noting that I felt better when I returned home everyday from work, but I attributed this to the anticipation of seeing my wonderful girlfriend at the time who would greet me when I arrived home.
I also went to physiotherapy where they assigned me lumbo-sacral stabilization exercises, various other strengthening exercises, and stretches to do every day. I did these religiously but I didn’t see many results.
So the Canadian surgeons didn’t want to operate, and physio wasn’t working. I bought and read a number of back pain books and some helped more than others, but the long and short of my situation was that I was in daily pain, I was constantly scared of doing things that might make my injury and the pain worse, and I was limited in my enjoyment of life. After seeing the surgeons and physios, I felt that “Western Medicine” didn’t have an answer for me, and as a result I might be one of those poor patients left visiting “pain management” clinics, destined to live a life that included daily pain and disability.
Looking back I think I had a lot of fear and depression that I repressed and wasn’t facing.
It was around January 2006 when I was trawling the internet for answers one day that I found the website of an American surgeon offering an endoscopic micro-discectomy: a different approach to treating my herniated disk that was much less invasive than anything available in Canada. I had researched the open micro-diskectomy available in Canada and didn’t want this operation. It had a success rate in the 80% range, and involved removing spinal muscles and ligaments that I preferred to keep. I spoke to the American surgeon and he sold me on his operation. Looking back I was naive of the differences between talking to surgeons in the US and talking to surgeons in Canada. Canada’s public system has long wait lines for most operations, so the surgeons only want to operate on the best candidates. In America’s for-profit system, surgeons will operate on much more marginal candidates as their incomes are at stake.
In April of 2006 I felt good about the operation I had decided to have. In contrast to the Canadian medical system, I had found an accomplished doctor (the leader in his field I was told) who was confident about getting rid of my pain. I spoke to some references from the surgeon – patients who had had the same operation I was considering. I spoke to one man from Florida who bragged that the day of the operation he walked a quarter mile (which although it was great news for him, I could already walk a quarter mile and so I wondered if my condition was serious enough to be helped by this surgery.) The Florida man said he still had the occasional ache or pain, but that the surgery for him had been “night and day”. This was heartening to hear.
So I traveled outside Canada and had the surgery on May 17 th 2006. The day after the surgery I was supposed to be nearly pain-free, but instead the pain was worse. I had pain in my left shin and a new burning pain in my right thigh, in addition to the pain in my back. When I asked the surgeon why I wasn’t better, he said he didn’t know why the pain wasn’t gone, that my current pain level was “Acceptable” and that I should be able to live a “Reasonable” life-style moving forward. This was enraging and depressing to hear. He said he was sorry that I wasn’t better and that I should wait at least 6 weeks before making any conclusions on the surgery. Before the surgery he had promised instant relief and so I was very skeptical. Surgery was a last resort for me after trying a dozen other treatments, and the possibility that it hadn’t worked was terrifying, since conventional western medicine didn’t have any other treatments for me except a life-long relationship with pain-killers.
Back in Canada, my pain continued to be worse than before the operation and I called the surgeon’s office to ask what to do. At this point there was a mental battle being waged in my head between hope and despair. The hope had its foundation in my surgeon’s experience and his re-assurance to me that I would get better and that my pain would go away. The despair was based on all the inconsistencies between what I was feeling and what I had been told before the operation. The surgeon and his staff had all said I would experience immediate relief, and here I was 3 weeks later in more pain than before. This was a really hard period. Some days I would feel improved and think that the surgery was finally taking hold. And then the next day I would feel terrible and be unable to shake from my mind the vision of the rest of my life spent in bed and in pain.
Every once in a while I would write a “where I’m at” post in my journal so I would be able to go back and compare later.
From June 8 th 2006: “Where I’m at: I have a more-or-less constant tingling in my left shin and burning in my left foot and ankle. It goes away from time to time if I am swimming or lying down reading, and sometimes when I am sitting, but I am aware of it about 2/3rds of the time. Sometimes it is very mild; sometimes it becomes intense and is quite painful. It’s worse in the mornings when I wake up and at the end of the day. On a scale of 1 to 10 it goes from zero to 4 whereas 3 weeks ago it was never more than a 2.5. My low back feels weak and unstable whenever it is loaded, and especially while walking. Sometimes there is pain, but it is dwarfed by pain in my left leg. There is occasional pain in my right foot, the same burning sensation as in the left but less intense. It seems to come and go randomly. My sitting capacity is probably 1-3 hours before I’m in considerable pain. I’ve been taking Tylenol 3’s about every 2nd day, about 5 per week. ”
In the weeks that followed I started getting some really weird symptoms. One day I woke up and my RIGHT foot was on fire. It got intense and then faded away, and a few hours later my LEFT foot was hurting
My physiotherapist evaluated me and checked my reflexes. It turned out that my left Planar/Achilles reflex was gone, which is sometimes a sign of nerve damage. This wasn’t encouraging as both my reflexes were normal before the operation. My physio also told me that in every successful diskectomy he had seen, the patient had showed an immediate improvement within a couple weeks. This was very discouraging to me. I asked him what was causing my pain and he didn’t know. I couldn’t figure it out either - since the operation was supposed to remove the herniation, how could I still have pain?
At this point I was seeing three physiotherapists in Toronto in the hopes that one would have an answer for me. I went to Ethel Wilson who is a very experienced and knowledgeable physio in Eastern Toronto. She keeps up on current research and you can tell she is committed to finding answers for people. She thought I was suffering from inflammation and told me about the specifics of how the annulus of the disk heals slowly after the incision is made to extract the herniated nucleus material. She said the wound in the annulus takes 6 weeks to heal and that she just saw a presentation from a spine surgeon who showed slides of the healing process. Ethel was very enthusiastic about lumbo-sacral stabilization exercises, I told her all about my research and she agreed with me that they are likely the “missing link” in back pain.
Her admission that there is a “missing link” in back pain is interesting. I think this refers to the subset of back pain that remains untreatable by physiotherapists like Ethel - a strong sign that something is wrong with the conventional diagnosis.
The end of June was encouraging, and I seemed to be making some slight progress. My pain was reduced and I was having some success in the pool with aqua-fit routines and an aqua-jogger. But to put it in perspective I was still in more pain and had less functionality than before I had the operation.
My journal from Jun 26 th. “Woke up today frustrated and angry. Angry at the fact that 6 weeks after surgery, I’m still so much worse off that before I went to Russia. I never thought this was a possibility, based on what my doctor told me. I feel I was either misled or the doctor made a mistake in my back, or the disk herniation was not causing my pain…I’m lying here with my left shin tingling, and my right foot on fire, also my thighs don’t feel great…it’s so hard using pain as a motivator to get better when I don’t know what I have to do to get better.”
My journal from June 27th 2006: “this morning I felt like rolling up in a ball with my pain and crying, but that seems like giving up…It’s 1:48 AM. Both my feet are on fire and I can’t sleep. I realized that I’m really angry with Dr. <name removed> and Dr. <name removed>. I haven’t received what I bargained for at all. I’m in so much more pain now and it’s been 6 weeks since the operation. How/why does my nerve hurt when I lying in bed. What the Heck is Going on. I’m having a hard time. I feel lonely and useless … I’m jealous of everyone on the subway who isn’t in constant pain. … I feel a bit like I’m cracking up. … These setbacks are like a kick in the stomach”
I was petrified that I was going to be in constant pain for the rest of my life like so many of the people whose posts I had read on the back-pain newsgroups. Most days were not fun and I was depressed. But occasionally I would start to feel better and each time I would become optimistic that maybe my healing process had reached a new stage and my pain would slowly drain away to nothing over the weeks to come.
On July 4th: “I felt better this weekend and I’m not sure why. I went up to Dave’s cottage with Laura and Orfeo. So nice to be in nature up there. The wind was blowing through the trees and the birds were talking to each other. I love being outside in the summer, it just makes me feel at peace. But anyways, I sat quite a bit on Saturday and Sunday and Monday and I didn’t gat a lot of leg pain at all. I was actually impressed….I was thinking that when I took my mind off my leg pain it went away. So maybe there is a mental component to this pain. I need to watch it as I run the risk of assuming the pain will be there, and then it will be.”
I wrote some conclusions for June:
“1. I’m in a cycle of chronic inflammation and have been since February 2006
2. It’s been so long my brain has built a pathway (expressway!) for the pain response. I gotta demolish this somehow.”
The frustration went on and on for the next month. I felt like I was on a roller coaster. When I was pain free I felt hope and optimism for the future. When the pain inevitably returned my anger and frustration welled up and I felt ready to explode. I was able to get out of the house a little bit and visit my friends that summer, but I still felt like my life was on hold. I didn’t know what to do.
Finally: The Correct Diagnosis
My life changed on July 18th. I came upstairs and met my mom’s contractor who asked me about my back. I told him the situation was grim. He told me that his wife had read a book that really helped her get rid of her back pain, by Dr. John Sarno, I thanked him for the suggestion and mentally added it to my list of back self-help books to buy. I also mentally dismissed this book as probably a waste of time, since it sounded like a bunch of new-wave mumbo jumbo.
As luck would have it, my mother overhead the conversation and handed me the book a few minutes later. She said she had bought a copy when I first hurt my back in 1999 and had it sitting in the bookshelf. It was a nice summer day and I lay down on the couch in the front room of the house and started to read.
Here’s the amazing part of the story: Within 3 weeks of reading Healing Back Pain by Dr. Sarno and applying the treatment method outlined in the book, I was back playing sports (soccer, swimming, climbing trees, basketball). Within 3 months I was totally pain-free.
In three weeks I went from being despondent about living my whole life with daily pain to believing that there was nothing wrong with my back at all and expecting to live the rest of my life pain free. It was an amazing transformation and I’m so thankful to Dr. Sarno for making it possible.
In Healing Back Pain, Dr. Sarno makes a number of controversial statements. Firstly, he says that herniated disks can be present without causing pain. Secondly, he says that back pain can be caused by repressed emotions in what he calls Tension Myositis Syndrome (TMS). Thirdly he says that most patients with TMS can recover in a matter of weeks by applying a few simple psychological treatment techniques.
I was skeptical at first, but as I read Healing Back Pain I began to see an opportunity for myself. If Dr. Sarno was right that my herniated disk wasn’t the cause of my pain, it perfectly explained why so many months of physical therapy and an eventual surgery had done nothing. It explained why my pain didn’t correspond to the L5-S1 nerve dermatome. It explained why my pain varied from one day to the next.
As I read on, I saw myself in the personality type Dr. Sarno describes as prone to developing TMS: Perfectionistic people-pleasers with a strong urge to be good. I finished the book ready to consider that repressed emotions were the cause of my pain.
How TMS Works
Dr. Sarno explains in his book that TMS, or psychogenic pain, or psychosomatic pain can act as a distraction mechanism from emotions the conscious mind does not want to experience. Instead of experiencing these repressed emotions, the brain creates a physical distraction to occupy the mind and save it from experiencing emotions that are threatening to bubble up to the surface.
Sarno uses psychology to explain in more detail the reason people develop TMS. He cites Freud to explain that inside each of us is a child, a parent, and an adult.
The child is impulsive and gets angry when things don’t go how the child wants.
The adult is our conscious thinking mind.
The parent is our conscience, constantly telling us what we ‘should’ and ‘should not’ do.
Sarno explains that while we experience the adult every day, the child and the parent reside
mostly in our unconscious. We are mostly unaware of them but they are as real and as much a part of us as the adult. In TMS prone personality types, it is the unconscious interplay of the parent and the child that eventually results in a pain syndrome. TMS-prone people are usually perfectionistic and “goodist”. This means their inner parent is very strong-willed and demanding with very high standards. Standards so high they can’t ever be met.
I know this accurately describes me growing up: I always expected a lot of myself, and rarely gave myself credit for anything. In one way, this is a useful trait because it allowed me to get good grades in school, and succeed at many things. But there is also a negative side, which is that I can never live up to my own expectations.
Sarno explains that in general, the overbearing parent is constantly telling people how to act: For example “be a better father”, “you should help out more with the kids”, “you should make more money”, “you should spend more time with your family/friends”, “don’t be immoral or evil”, etc. This can be a good trait, keeing people on a path towards morality and self-expression.
But to the inner child, the over-bearing parent causes much anger and frustration. Dr. Sarno uses the word RAGE, to describe the emotion involved. The child does not like being told what to do constantly, especially if the instructions are impossible to follow (ex. “be a better person”). This rage builds up in the unconscious and threatens to erupt into the conscious, which for most people would be a traumatic experience.
Instead of letting repressed feelings of anger, inadequacy, shame and whatever else into the conscious mind, the brain engineers a simple yet effective trick - it uses the autonomic nervous system to cause illness in the body. The illness could be back pain, neck pain, leg pain, tinnitus, conjunctivitis, irritable bowel syndrome, and many others, even depression. All of these illnesses are created by the sub-conscious mind to distract the conscious mind from thinking about or experiencing the repressed rage. This is TMS and I agree with Dr. Sarno that it is rampant in our society and almost totally undiagnosed.
Diagnosing Myself With TMS
After I read Healing Back Pain twice, I decided there was something important for me in that book. It explained why my pain persisted despite surgery and years of physical therapy. It explained why my pain didn’t correspond to the dermatome of my disk herniation. And most importantly it gave me hope that I would be able to live a pain-free life.
At this point I had tried everything the traditional medical establishment had to offer. I had also tried osteopathy, massage, reiki, and other alternative therapies with little success. I didn’t have many options left and after finishing Dr. Sarno’s book, I remember hoping that I did indeed have TMS, because it seemed relatively easy to treat.
To diagnose myself with TMS, I first had to reject the assumption that my herniated disk was that cause of my back pain. I didn’t find this easy because it meant rejecting the conclusions of all my physiotherapists and surgeons – who in total probably had over 100 years of medical training. And ALL of them thought my herniated disk was causing my pain. It was the base assumption upon which they had all been treating me since 1999.
Secondly, I had to reject the assumption that there was anything at all wrong with my back. This was difficult because everyone had been telling me that my disk was ruptured and pushing on my spinal cord, and that any false move could cause it to rupture some more and result in more pain and disability. I had been living in fear of injuring myself further, so to decide that there was nothing at all wrong with my back was a complete reversal of thinking that I found difficult at first.
Lastly, I had to accept that I had repressed emotions that the pain was distracting me from, and I had to accept this in the face of the social stigma that currently exists around psychosomatic pain. Following the treatment method outlined in “Healing Back Pain” I looked into my subconscious and found unresolved anger at my father, personal feelings of insecurity, and a fearful unwillingness to take responsibility for myself and my life.
The more I thought about it, the more Dr. Sarno’s diagnosis of TMS made sense to me. I noticed that both episodes of back pain started during periods of transition in my life. The first time I “hurt my back” was when I finished high-school and went away to British Columbia to be a ski bum. It was the first time I was totally on my own financially and I felt isolated, insecure, and scared. The second time I “hurt my back” I had just finished university and I was trying to strike out on my own in the world. Again I was trying to break away from my family and become financially independent and an independent person. So in examining the pattern of onset of my back pain, I came face to face with my repressed issues of dependency. My inner child didn’t want to leave the nest, and my back pain was the perfect excuse to keep me from taking responsibility for my life.
Making the Diagnosis “Stick”
I had decided I had TMS. But how to use this diagnosis to get rid of the pain? Here’s how the process went for me:
Dr. Sarno explains that to get rid of TMS symptoms (my back pain), I would have to remove the effectiveness of the distraction mechanism. This meant repudiating the physical diagnosis, telling myself there is nothing wrong with my back, and returning to full physical activity while at the same time facing any repressed emotions whenever the pain appeared. This was a terrifying prospect for me. I was terrified of injuring myself further, and ending up with more sever pain and disability.
Convincing yourself you have TMS (and not for example a herniated disk, carpel tunnel syndrome, repetitive stress injury, Frozen shoulder, etc.) can be difficult for the following reasons:
i) Your brain is trying to trick you into thinking you have a physical problem, and will focus in on sites of previous injury or weakness, and
ii) You most likely have medical test results that 'prove’ your pain has a physical cause, and
iii) Most likely your doctors and physiotherapists have discussed this physical cause at length with you, and have successfully treated many other people with the same problem, and
iv) Most likely your doctors and physiotherapists will scoff at an alternative diagnosis for your pain, and point to the test results which are “conclusive” (see my MRI), and
v) Most likely your friends and family will not believe in TMS and think you are losing your mind (note: my own mother still does not believe I had TMS), and
vi) Most likely, you will have a great deal of fear about injuring yourself further if you don’t follow your Doctor’s and Physiotherapists advice, and
vii) You could have difficulty in even explaining the diagnosis to co-workers, colleagues, and anyone but your closest family and/or friends, since psychosomatic pain is subject to a powerful stigma in our society and is seen as shameful and a sign of mental instability.
All this could make you feel like maybe you are losing your mind. I came to a point where I had to choose between believing one of two stories. It was either:
1. I have a serious and long-standing back injury confirmed by multiple MRIs that compromises the structure of my spine and is causing pain in my back and legs. Physiotherapy and surgery have failed and I have no further medical options other than drugs and reduced activity to deal with the daily pain. I will listen to my doctors and friends and limit my future activity in order to limit the pain and risk of further injury.
2. There is nothing wrong with my back. All my doctors have mis-diagnosed me for the last 7 years. All my doctors and friends are wrong about my back. My pain is psychosomatic in nature and is serving as a distraction from painful emotional issues that I haven’t dealt with. To remove the distraction, I will return to full physical activity (despite any pain) and consciously deal with the emotional issues so that the distraction is no longer effective. I can live a full, pain-free life doing all the things I love.
I imagine that for most people getting from 1 to 2 can involve lots of episodes of fear, denial, confusion, and anger. It did for me. And I have to admit that even sitting here writing this after playing a season of soccer, volleyball, going to yoga twice a week, lifting couches, etc. I still have moments when my back starts to hurt, and a vision of an exploding spinal disk fills my mind, and I have to remind myself that I have TMS, that there is nothing wrong with my back, and that there is some emotional cause for the pain.
Everybody will have a different path to becoming confident in the diagnosis. For me it was anatomy.
I have a couple friends who are doctors and while I was out of commission with my “herniated disk” I borrowed their text books and learned as much as I could about spinal anatomy. After my operation I still had leg and back pain. This to me didn’t make any sense. I had seen the MRI of my herniation, I had had the operation, which removed 25% of my disk, and yet I still had leg pain. If the herniation was the cause of the pain: remove the herniation, remove the pain. Since the pain was still there, something was fishy.
The pain I was feeling was attributed to swelling, but this didn’t pass muster either for the following reason: The pain would shift from my right leg to my left depending on my position, or sometimes it would just shift spontaneously while I was sitting or lying down in a chair. One day in late July my pain went from my right foot, to my left foot, and back to my right shin within 20 minutes. This was after I read Healing Back Pain and in that moment I knew I had TMS. There was simply no anatomical explanation for this pain shifting around like that. If there was swelling in my spinal canal, the process would at least take hours to shift pressure from one nerve to another. Swelling doesn’t change minute to minute. So there it was, I broke through my brain’s distraction technique. In that moment, something new opened up for me.
I had always asked my doctors why my pain didn’t correspond to the correct “dermatome” for the L5-S1 joint; they had always replied that every patient is different. I was never fully satisfied with this answer, but took it at face value until Dr. Sarno provided me with an alternative explanation. Also I didn’t understand how my pain would get better and worse from day to day, but I never had a reason to question it. While the mind is good at making you think TMS symptoms are physical, it isn’t perfect. Pay attention and you will find clues to help you start thinking in terms of TMS.
Other people will just have to 'believe’. You will find yourself with an intuitive sense that TMS is the correct diagnosis, or you will be willing to give it a try rather than remain in pain.
Treating My TMS
Dr. Sarno outlines his treatment method in Healing Back Pain and his second book The Mindbody Prescription. The main point to realize is that the pain is a distraction from emotionally painful thoughts and feelings that have been repressed and are threatening to become conscious. If you can figure out what these thoughts and feeling are, and actively think about them, the distraction mechanism no longer works. In other words, if your head is constantly filled with the thoughts your brain is trying to distract you from with the pain, the pain no longer serves any function, and it slowly dissipates.
Every day I would write in a journal about what emotional rage could be contained in my unconscious. I found some underlying anger at my father, I found anger at myself for not living up to my own expectations, I found insecurity, I found fear of responsibility, it was a rewarding experience to look inside and see what I had been ignoring for years.
Once I had pinpointed what I thought were the causes of my TMS, I wrote them down into a list. Every time I felt pain, I would actively think about the items on my list, and talk to my brain inside my head whenever I felt pain. “You can’t distract me from my insecurity” I would say, and I would try to feel the repressed insecurity. At the same time I would say to myself “brain, stop trying to make me think I have a physical problem, I know you are just manifesting this pain as a distraction, so STOP IT!” For about 3 weeks I did this everyday, and tried to be more active each day than the day before.
I decided if I could run around my block it would prove to myself that I had TMS and that there was nothing wrong with my back. It took me 3 days to work up the courage to actually do it since I was petrified of hurting myself. On the first two nights I chickened out. On the third night I mustered the courage to start running. I almost didn’t get past the first 30 feet: As soon as I started running I felt an acute stabbing pain in my lower back right above my disk. It was my brain with another offensive! I thought to myself “oh no, what if I’m wrong about my TMS and I really hurt myself badly?” I almost stopped running and started to feel the same hopelessness related to my “incurable physical back pain”.
But then in a moment I made a decision. I decided to keep running. I thought “brain, it’s just you again isn’t it? well it won’t work!” and I kept running and finally made it around the block. The elation I felt coming down the home stretch back to my house was intense. I hadn’t run in a year and I was totally out of breath, hacking up phlegm like crazy, but the sense of accomplishment brought a huge smile to my face! I said to myself “a guy with a bad back injury can’t run around the block!”. All of a sudden I had hope! I could see a way to become pain-free.
Running around the block was a victory. I kept a record of all my victories so I could think back to them whenever doubts rose up in my mind, which was often. If I was sitting on the bus, and my back started to hurt, I would think about playing sports, or sitting all day some other day, and this gave me the confidence to believe I had TMS, and to get rid of the pain by thinking psychologically, instead of worrying about further injury.
I realized that every time I was worrying about further injury, or even when I doubted some new pain was TMS, I was falling into the TMS trap. And so I developed an internal mechanism to get out of the trap. I just kept reminding myself that I have TMS, that I KNOW I have TMS, and that there is nothing physically wrong with me. This is effective and I still use it today.
As I got more and more active, and had more and more victories over my TMS, and as I thought more and more about what psychological rage I was repressing, my back and leg pain slowly faded away.
It was at this point that I got to experience the phenomenon of symptom substitution. Dr. Sarno and others talk about symptom substitution as a frequent occurrence in their TMS patients. When the brain’s distraction mechanism has been undermined and discovered, the brain doesn’t give up so easy. Instead, when you have realized there is nothing wrong with your back, knee, or legs, your brain will move the pain to other parts of your body. Maybe you had an old neck injury, and so as your leg pain fades, your neck will begin to hurt and you will think “oh no, I’ve cured myself of TMS, but now there’s something wrong with my neck!” Not so fast. Your brain is just using a trick to continue the distraction.
Maybe your knee pain will fade, but you will get terrible exema, or your irritable bowel syndrome will go away, but you will develop tinnitus, or your conjunctivitis will go away only to be replaced by 'frozen’ shoulder. All of these are examples of symptom substitution. Luckily once you have been warned about this phenomenon it’s easy to spot your brain’s little trick. Just remind yourself not to be worried, remember that the new symptoms are a continuation of TMS, and you will be able to make them go away following the same treatment method.
I had symptom substitution big-time, with a shopping list of other health complaints that arose after my back pain started to go away. First I had exema on my ankles, then I had arm and hand pain, then my abdomen hurt for a day or two, then I developed knee pain that was quite severe at times and lasted for a couple weeks, then my ears rung for two days, then my eyes hurt. Each time I noticed a new symptom my first reaction was fear, my second reaction was to recognize it as TMS and start to think psychologically. They all went away eventually. I still have mystery pain in my body from time to time and it’s almost always psychosomatic or TMS.
I first learned about TMS and psychosomatic pain on July 19th 2006 when I read Healing Back Pain by Dr. John E. Sarna M.D. I had been in daily constant pain from July 2005 to July 2006, and previously from April 1999 – April 2000. I was very limited in what I could do: no sex, no sports, no sitting for long periods, no dancing. I was unable to work a job due to the pain. All these activities would cause lower back pain, and pain radiating down my legs, especially the left thigh, shin and foot. The pain was intense from time to time, for which I took some medium grade pain-killers like Tylenol 3’s. But most of the time, the pain was a moderate achiness and tingling sensation that competed with whatever I was doing for attention. Fear was a large part of my experience. I was constantly scared of doing something that would further injure my back and set me back in the healing process. Every time my friends convinced me to hang out with them, and I sat for too long causing pain, I worried that the pain I was feeling was indicative of further injury I had caused myself.
I read Dr. Sarno’s book on July 19 th 2006 while lying on a couch in pain. By August 16th I was frequently pain free and was able to play soccer, volleyball, sit for hours and hours, run, and bicycle. I even tested myself by doing the unthinkable for someone with a “bad back”: while building a sand castle at the beach I lifted and carried 40 lb. rocks from the dunes to our castle, I crouched and dug heavy sand while pulling up and rotating. All without pain to prove to myself that there was nothing wrong with my back. If anyone had said to me in mid-July that I would be pain free by mid-August, I would have been incredulous. But by applying the treatment method for TMS that I found in Dr. Sarno’s books and on the internet I was able to get rid of the pain that had stolen a year of my life. It’s the most unbelievable and wonderful thing that has ever happened to me.
I haven’t been able to totally rid myself of TMS pain. When I’m overworked, or when I don’t find time to think about what’s going on in my emotional life, or when I’m worried about something, I’ll notice my TMS pain come back, usually in my legs or back. It’s a bit annoying, but it’s also a kind of barometer that tells me when I need to set aside some time for myself. It’s now been over 3 years since my self-diagnosis with TMS and I am no longer in pain (other than the occasional TMS flare-up) and I’m not limited in any way in what I do. I play competitive ultimate frisbee, soccer, squash, and tennis. I do yoga, have sex, and I can sit for 12 hours straight, all pain free. I owe an incredible debt to Dr. Sarno and all those who helped me realize the true source of my pain.
The scariest thing about my experience is that had I never have stumbled across Healing Back Pain, I might have remained in pain and fear for years, or decades. Thank god I did find this work, and if this site helps one person recognize and treat his or her own TMS I’ll be elated! Please write me and tell me about it.
Will Sacks December 2006 (Edited May 2010)
Post-Script: Telling Others About TMS
I wanted to write a section on informing other people about the existence of psychosomatic illness. I’ve found over the years that it is not something that is well-understood, and that there is in-fact a significant social stigma against the word psychosomatic – which refers to diseases with a mental cause. This is a part of the larger stigma in our society around mental illness.
I’ve described this syndrome to many people since I diagnosed and cured myself. The reaction I get is varied. Some people are enthusiastic and believe what I tell them, others react with genuine disbelief and discount my experience. Others think I’m crazy.
I kept a detailed journal for the whole of 2006, so I know I’m describing events as they happened, and I’m equally sure that my recovery over 3 weeks in July is not a fluke. The reason people react with disbelief is because TMS rests on an assumption that has long been resisted in our western culture. The assumption is that that physical symptoms must have physical causes.
Sometimes when I mention physical symptoms having mental causes I’m met with eyes that are glazed over and begin to get the experience of being “humored”. This is changing however, as our society accepts that the body-mind is indeed one organism, and that the mind is capable of causing changes in the body. Some everyday examples of mind-body interaction are:
“I have a stress headache”
“I have butterflies in my stomach”
“We kissed and I felt all tingly ”
“I was sad and started to cry”
“He makes my skin crawl”
Despite the fact that we have all experienced the mind’s effects on the body, a sad statistic that Dr. Sarno presents in his book is that of people with TMS who are presented with the diagnosis, 80% will reject TMS and remain untreated and in pain. It’s sad that our social stigma against psychosomatic illness means some people are unwilling to accept the medicine that will get them well. I hope this site changes that.
All healthcare practitioners will agree that to offer the right treatment, the first step is a correct diagnosis. Without a correct diagnosis, successful treatment is unlikely. Some people don’t want to accept the diagnosis of TMS because they think it means they are crazy. The faster we dispel this myth, and show that psychosomatic illness is all around us, the sooner these people will feel comfortable exploring the real cause of their pain, and have a chance at a pain-free life.
Read this far and still have questions? call me: (416) 887 7084