The Treatment of TMS and Best Approaches to Manage it

Healing Back Pain Dr. Sarno

We will continue our reading of healing back pain written by who I like to call the legendary Dr John E Sarno.

Just for you if you are new to it, this book is focused on healing chronic pain treatment using the mind-body connection and we are up to almost the last two pages of the introduction.

We read about one important observation that 88 of the people seen had histories of such things as tension or migraine headache, heartburnhiatushernia,  stomach ulcercolitisirritable bowel syndromehay feverasthma eczema and a variety of other disorders.

All of which were strongly suspected of being related to tension.

It seemed logical to conclude that their painful muscle condition might also be induced by tension, hence the Tension Myositis Syndrome – TMS – means muscle tension.

Myositis syndrome is defined here as a change of state in the muscle that is painful.

When the theory was put to the test and patients were treated accordingly, there was an improvement in treatment results in fact.

It was then possible to predict with some accuracy which patients would do well and which would probably fail. That was the beginning of the diagnostic and therapeutic program described in this book.

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The Treatment Method of TMS?

Treatment Method of TMS

It should be emphasized that this book does not describe a new approach to the treatment of back pain.

TMS is a new diagnosis and therefore must be treated in a manner appropriate to the diagnosis when medicine learned that bacteria were the cause of many infections and looked for ways to deal with germs.

Hence the antibiotics of emotional factors are responsible for someone’s back pain.

One must look for a proper therapeutic technique.

Clearly there is no logic to traditional physical treatment instead experience has shown that the only successful and permanent way to treating the problem is by teaching patients to understand what they have, okay.

So here we have it again and I’ll repeat it so you can hear it a little more clearly it says that the only successful and permanent way to treat the problem is by teaching patients to understand what they have to.

Holistic Approach?

Unfortunately, what has come to be known as holistic medicine is a jumble of science, pseudoscience and folklore.

Anything which is outside mainstream medicine may be accepted as holistic but more accurately described the predominant idea is that one must treat the whole person, a wise concept that is generally neglected by contemporary medicine, but that should not give license to identify anything as holistic that defies medical convention.

Perhaps holistic should be defined as that which includes consideration of both the emotional and structural aspects of health and illness in accepting this definition.

One does not reject the scientific method; on the contrary, it becomes increasingly important to require proof and replication of results when one adds the very difficult emotional dimension to the medical equation.

Therefore this is not holistic medicine as it is popularly conceived.

I hope it is an example of good medicine, accurate diagnosis and effective treatment and good science conclusions based on observation verified by experience.

Understanding both Physical and Psychological Dimensions of TMS

Though the cause of TMS is tension, the diagnosis is made on physical and psychological grounds. In the tradition of clinical medicine all physicians should be practitioners of quote-unquote holistic pain management and its medicine in the sense that they recognize the interaction between mind and body.

To leave the emotional dimension out of the study of health and illness is for medicine and poor science.

There is an important point to be emphasized though TMS is induced by emotional phenomena, it is a physical disorder.

So I’ll read it again though TMS is induced by emotional phenomena, it is a physical disorder it must be diagnosed by a physician, someone who is capable of recognizing both the physical and physiological dimensions of the condition psychologists may suspect that patient symptoms are emotionally induced but not trained in physical diagnosis cannot say with certainty that they have TMS since very few physicians are trained to recognize a disorder whose roots are psychological.

TMS falls between the cracks as it were and patients go undiagnosed it is particularly important that the diagnosis be made by a physician to avoid the pejorative conclusion that the pain is all in the head.

All right so Dr Sarno is making it clear that he is not saying that the pain is all in the head, he’s not saying it’s imaginary.

Also Check: TMS for Panic Disorder

We clarify this in the first post; it was where we defined what the word psychosomatic meant.

It is a physical manifestation of any emotional phenomena that doctors think of the diagnosis.

It is unlikely that most physicians are aware of it I have written a number of medical papers and chapters for textbooks on the subject but they have reached a limited medical audience primarily physicians working in the field of physical medicine and rehabilitation in recent years it has become impossible to have medical papers on TMS except for publication undoubtedly because these concepts fly in the face of contemporary medical dogma for those physicians who might see this book.

I would point out that it is more complete than any of the papers I have published and will be useful to them despite the fact that it is written for a general audience judging by the reaction of doctors in my immediate environment.

Most physicians will either ignore or reject the diagnosis.

A few doctors in my own specialty say that they see the validity of the diagnosis but find it difficult to treat such patients.

One hopes that the younger generation of physicians will be more capable of dealing with this kind of problem.

It is one of the intentions of this book

To reach those young doctors, what of those readers who are having neck, shoulder back or buttock pain and think they have TMS a book cannot substitute for a doctor and it is not my intention to diagnose and treat through this book.

I consider it unethical and immoral to hold oneself out as a physician through a book or a video cassette.

Pain syndromes must always be properly studied to rule out serious disorders such as cancer tumors bone disease and many other conditions.

If one has persistent pain anywhere it is imperative to see a doctor so that appropriate examinations and tests can be done.

The primary purpose of this book is to raise consciousness both inside and outside of field of medicine.

Because these common pain syndromes represent a major public health problem that will not be solved until there is a change in the medical perception of their cause.

Having stated the purpose of the book I would be less than candid if I did not report that many readers of its predecessor, Mind Over Back Pain, reported amelioration or complete resolution of symptoms.

This substantiates the idea that it is identification with and knowledge of the disorder which are the critical therapeutic factors.

Science requires that all new ideas be validated by experience and replication before new concepts can be generally accepted.

They must be proven beyond all doubt. It is essential that the ideas advanced in this book be subjected to research study in the tradition of scientific medicine.

The manifestation of TMS I never saw a patient with pain in the neck shoulders back or buttocks who didn’t believe that the pain was due to an injury or a hurt brought on by some physical activity.

I hurt myself while running, playing basketball or tennis bowling.

The pain started after I lifted my little girl or when i tried to open a stuck window 10 years ago I was involved in a hit from behind auto accident and I have had recurrent pain recurrent back pain ever since.

The idea that pain means injury or damage is deeply ingrained in the American consciousness of course If the pain starts while one is engaged in a physical activity it’s difficult not to attribute the pain to the activity.

As we shall see later that is often deceiving but this pervasive concept of the vulnerability of the back of ease of injury is nothing less than a medical catastrophe for the American public, which now has an army of semi-disabled men and women whose lives are significantly restricted by the fear of doing further damage or bringing on the dreaded pain again.

One often hears I’m afraid of hurting myself again so I’m going to be very careful of what I do. In good faith this idea has been fostered by the medical profession and other healers for years.

It has been assumed that neck shoulder back and buttock pain is due to injury or disease of the spine and associated structures or incompetence of muscles and ligaments surrounding these structures without scientific validation of these diagnostic concepts.

On the other hand I have had gratifying success in the treatment of these disorders for 17 years based on a very different diagnosis.

It has been my observation that the majority of these pain syndromes are the results of a condition in the muscles nerves tendons and ligaments brought on by tension and the points has been proven by the very high rate of success achieved with a treatment program that is simple rapid and thorough medicine’s preoccupation with the spine draws on fundamentals and training.

Modern medicine has been primarily mechanical and structural in orientation.

The body is viewed as an exceedingly complex machine and illness as a malfunction in the machine brought about by infection, trauma inherited defects degeneration and of course cancer at the same time.

Medical science has had a love affair with the laboratory believing that nothing is valid unless it can be demonstrated in that arena.

No one would dispute the essential role the laboratory has played in the medical progress witness penicillin and insulin, for example.

Unfortunately some things are difficult to study in the laboratory.

One of these is the mind and its organ the brain; the emotions do not lend themselves to test tube experiments and measurement and so modern medical science has chosen to ignore them.

The emotions have little to do with health and illness anyway hence the majority of practicing physicians do not consider the emotions that emotions play a significant role in causing physical disorders though many would acknowledge that they might aggravate a physically caused illness.

In general physicians feel uncomfortable in dealing with a problem that is related to the emotions they tend to make a sharp division between the things of the mind and body.

Although some physicians would dispute the idea there is fairly wide acceptance among practicing doctors that ulcers are caused primarily by tension contrary to logic however the major focus in treatment is medical not psychological and drugs are prescribed to neutralize or prevent the secretion of acid but failure to treat the primary cause of the disorder is poor medicine.

It is symptomatic treatment something we were warned about in medical school but since most physicians see their role only as treating the body

the psychological part of the problem is neglected even though it’s the basic cause in fairness.

Some physicians make an attempt to say something about tension myositis syndrome treatment but it’s often of a superficial nature like you ought to take it easy you’re working

too hard pain syndromes look so physical. It is particularly difficult for doctors to consider the possibility that they might be caused by psychological factors and so they cling to the structural explanation in doing so however they are chiefly responsible for the pain epidemic that now exists in this country.

If structural abnormalities don’t cause pain in the neck shoulder back and buttocks what does studies and clinical experience of many years suggest that these common pain syndromes are the result of a physiologic alteration in certain muscles nerves tendons and ligaments

which is called the tension myositis syndrome.

Psychology of TMS

It is a harmless but potentially very painful disorder that is the result of specific common emotional situations. It is the purpose of this book to describe TMS in detail.

It discusses who gets it and what parts of the body it occurs the various patterns of pain and the overall impact of TMS on people’s health and daily lives. We’ll talk about the psychology of TMS which is where it all begins its physiology and how it is treated conventional diagnosis and treatment will be reviewed and I will conclude with a chapter on the important interaction between mind and body and matters of health and illness any questions comments concerns before we get into the next section which is who gets TMS.

The Occurrence of TMS in Different Age Groups?

One might also say that TMS is a cradle to grave disorder since it does occur in children though probably not until the age of five or six. In children, of course, it’s different from what occurs in adults.

I am convinced that what are referred to as growing pains in children are manifestations of TMS.

The cause of growing pains has never been identified but physicians have always been comfortable in reassuring mothers that the condition is harmless. It occurred to me one day while

listening to a young mother described her daughter’s severe leg pain in the middle of the night that what the child had experienced was very much like an adult attack of sciatica and since this was clearly one of the most common manifestations of TMS.

Growing pains might very well represent TMS in children. Little wonder that no one has been able to explain the nature of growing pain since tms is a condition that usually leaves no physical evidence of its presence.

There is a temporary constriction of blood vessels bringing on the symptoms and then all returns to normal the emotional stimulus for the attack in children is no different than that in adults anxiety.

Emotional stimulus for the attack in children is no different from that in adults. 

The better you get at recognizing your anxiety I’m not saying getting rid of it, I’m not saying meditating through it, I’m not saying doing special exercise routines.

I mean just recognizing it; the moment you recognize that you’re anxious is almost like the body just goes oh wow so I’ve been

lost in my thoughts for how long now because I am anxious oh okay. And then the body follows okay so that’s the key; recognizing that state.

One might say the attack in a child is a para nightmare; it is a substitute for a nightmare, a command decision by the mind to produce a physical reaction rather than have the individual experience, a painful emotion, which is what happens in adults as well at the other end of the spectrum.

What Does Studies and Surveys Show?

I have seen the syndrome in men and women in their 80s there appears to be no age limit why would there be as long as one can generate emotions one is susceptible to the disorder.

What are the ages when it is most common and can we learn anything from these from those statistics in a follow-up survey carried out in 1982, 177 patients were interviewed as to their then current status following treatment for TMS.

The results of the survey showed that 77 of the patients fell between the ages of 30 and 69 percent were in their twenties and they were only four teenagers, two percent at the other end of the spectrum, only seven percent were in their sixties and four percent in their seventies.

These statistics suggest very strongly that the cause of most back pain is emotional for the years between 30 and 60. These are the ages that fall into what I would call the years of responsibility.

This is the period in one’s life when one is under the most strain to succeed.

It is logical that this is when one would experience the highest incidence of TMS; further if degenerative changes in the spine osteoarthritis,  degeneration facet on thoracic and spinal stenosis, for instance, that’s in the parentheses or a primary cause of back pain.

These statistics would fit at well.

These statistics wouldn’t fit at all in that case a gradual increase in incidence from the 20s on would occur with the highest incidence in the oldest people.

To be sure this is only circumstantial evidence but it is highly suggestive so the answer to the question who gets TMS is anybody but it is certainly most common in the middle years of life, the years of responsibilities.

The Fear of Returning Pain

What happens the majority of the time at least to people who have a high chance of relapsing the first thing that happens is that they start to worry that it might come back.

So the pain disappears and then about a few days go by and they start to worry that it might come back.

The act of worrying in of itself is in fact a panic attack.

Only thing is that most people think anxiety is that feeling you know that whoa my god, oh I’m gonna die, but no the moment your mind goes, oh I got rid of my pain.

This is great, oh my god, I can go out and play. I can live, I can do what I’ve always wanted to do and then you start making that plan, you start writing in your calendar and your daily planner.

Every Monday at three o’clock in the afternoon I’m gonna go play tennis with my friends.

The moment you do that and your mind goes what if I flare up it’s gotcha okay and I want you to remember that it’s gotcha and I mean the anxiety and it’s only a matter of time before it manifests itself physically once again.

Be Fearless of It And Welcome If the Pain Comes Back

So just remember that worry that it might come back is the main reason why it does come back.

For some people for me personally I’ve been in remission for over six years now and every time somebody asked me Ralph, don’t you ever worry that it might come back, my answer is no, I don’t worry that it will come back and if it ever comes back I welcome it with open arms because I guarantee you that if that back pain ever comes back is because there is something that I really cannot take.

So I consider it a superpower, if at any point I am on the edge of losing my freaking mind I have a mechanism sitting in my unconscious mind that it’s just going to save me from doing that.

And, I  think that’s fantastic so that’s one of my secrets to my success with my health. I’m not afraid of it, I’m not afraid of back pain, I’m not afraid of.

Yes, I’m not afraid of ending up in a wheelchair, I’m not afraid of any of that stuff. And, I say yeah it’s probably why it never comes back because I’m not afraid of it and when I get those thoughts hey what if it coming back doesn’t mean anything to me.

Shift your perspective on the entire experience of going in and out of remission even this part that we just read about the years of responsibility

a lot of people don’t realize how the pain is directly connected to what’s happening in their life. Fear is the fuel. Fear is another name for anxiety.

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Where does TMS manifest itself?

Where does TMS manifest itself?

The primary tissue involved in TMS is muscle; hence the original name myositis as mentioned myo stands for the only muscles in the body that are susceptible to TMS are those in the back of the neck, the entire back and the buttocks known collectively as postural muscles.

They are so named because they maintain the correct posture of the head and structure and contribute to the effective use of the arms.

Postural muscles have a higher proportion of slow twitch muscle fibers than limb muscles making them more efficient for endurance activity

which is what is required of them whether or not this is the reason why

tms is restricted to this group of muscles we do not know.

It is possible though since the muscles most frequently involved have the most important jobs.

These are the buttock muscles known anatomically as gluteal muscles.

Their job is to keep the trunk upright on the legs to prevent it from falling forward or to either side statistically.

The low back buttock area is the most common location for tms so when we see that postural um deformity where the person just hunches forward just leans forward what muscle according to Dr. Sarno here what muscle is responsible for keeping you upright and that’ll be the butt muscles.

And if you’re having pain and weakness in the butt muscles it’s only a matter of time before your posture starts to lose its alignment now it doesn’t mean that the posture is causing the pain.

It seems more plausible for it to be the other way around so the pain and weakness of the butt leads to that postural change.

The buttocks are the lumbar muscles in the small of the back often involved simultaneously with buttock muscles occasionally. The gluteal or lumbar muscles are affected separately roughly two-thirds of TMS patients have.

The pain is usually in the side of the neck and the top of the shoulder in the upper trapezius muscle.

TMS can occur anywhere else in the back between the shoulders and low back but does so far less frequently than in the other two areas mentioned generally a patient will complain of pain.

In one of these prime areas as, for example, in the left buttock or the right shoulder but the physical examination will reveal something else of great interest and importance in virtually every patient with TMS one finds tenderness

when pressure is applied palpation to muscles in three parts of the neck

the outer aspect of both buttocks and sometimes to the entire body.

The muscles in the lumbar area in both upper trapezius shoulder muscles are important because it supports the hypothesis that the pain syndrome originates in the brain rather than in some structural abnormality of the spine or incompetence of muscle.

The Role of Nerve in TMS

Nerve, the second type of issue to be implicated in this syndrome, is specifically what are known as peripheral nerves.

Those most frequently affected are located as my as might be expected in close proximity to the muscles that are involved most often.

The sciatic nerve is located deep in the buttock muscle. One on each side lumbar spinal nerves are under the lumbar paraspinal muscles.

The cervical spinal nerves and brachial plexus are under the upper trapezius shoulder muscles.

These are the nerves most frequently affected in TMS.

In fact, TMS looks like a regional process rather than one aimed at specific structures so when it affects a given area all the tissues suffer oxygen deprivation.

So that one may experience both muscle and nerve pain.

The Lack of Oxygen in Tissues

When it affects a given area, all the tissues suffer oxygen deprivation. So that one may experience both muscle and nerve pain. There’s a person that I worked with years ago and who lived in Toronto, Canada.

As a hobby, his thing was riding dirt bikes and he was diagnosed with AES not TMS, and he went into full remission and he decided to do what any other human would do which is go back to doing what he loves.

He went to do motocross on hills and ramps. It’s literally like hopping these motorcycles for a few feet and then landing them and It’s pretty cool well on one of those um ramps where you jump from one ramp to the other, he landed and he fell and the motorcycle that was coming behind him landed right on top of him and broke his back.

I gave him a call. He said he was worried because you know he did all that work he went into remission and now he literally broke his back and there’s one thing that he shared with me that I would never forget, he said Ralph,  I did learn something from this. I said what’d you learn.

He said, well I learned that I wanted to kill the guy that’s one but the second thing was that the pain of a broken back is nowhere near as bad as the pain of an AES flare-up, I was like yeah I believe you I never had a broken back but I could only imagine so this is a gentleman who experienced the pain of a flare-up and the pain of a broken back.

He says the pain of a broken back is nowhere near as bad as a flare-up and here in this small piece right here that Dr. Sarno wrote we can get an idea of why you know because the muscle suffers oxygen deprivation so that one may experience both muscle and nerve pain.

That’s the physical response so he’s not saying that it’s imaginary. It’s this what happens.

Varying kinds of pain may result when muscle or nerve are affected. It may be sharp aching burning shock like or it may feel like pressure in addition to pain, nerve involvement may produce feelings of pins and needles tingling or numbness and sometimes sensations of weakness in the legs or arms. In some cases there is a measurable muscle weakness the latter can be documented with electromyographic studies.

Short EMG abnormalities are often cited as evidence of nerve damage due to structural compression but in fact EMG changes are very common.

In TMS and usually reveal involvement of many more nerves than could be explained by a structural abnormality. Lumbar spinal and sciatic nerve symptoms are in the legs for that is where those nerves are going involvement of and brachial plexus cause symptoms in the arms and hands.

Traditional diagnosis attributes leg pain to herniated discs and arm pain to a pinched nerve.

TMS may involve any of the nerves in the neck, shoulders, back and buttocks sometimes producing unusual pain patterns.

One of the most frightening is chest pain one immediately thinks of the heart when there is chest pain and indeed it is always important to be sure that there is nothing wrong with that organ once having done so one should keep in mind that the spinal nerves in the upper back may be suffering mild oxygen deprivation because of TMS and that is and that this may be the source of the pain.

These nerves serve the front of the trunk as well as the back hence the chest pain sternum pain in a sternum that’s one of the symptoms that I used to have and it’s literally a chest right in the heart.

Remember, always consult a regular physician in order to rule out serious disorders.  So make sure you speak to your doctor this book is not intended as a guide to self-diagnose. Its purpose is to describe a clinical entity, TMS.

One may suspect the presence of nerve involvement in TMS through the patient’s history, the physical examination or both sciatic pain may affect any part of the leg except the upper front thigh.

There is considerable variability depending on how much of the nerve trunk is affected by oxygen death as noted above the person may also complain of other strange feelings and of weakness on physical examination the tendon reflexes and muscle strength are tested to determine whether oxygen deprivation has irritated the nerve significantly to interfere with the transmission of motor impulses.

Similarly sensory tests are done for example ability to feel a pinprick to determine the integrity of the sensory fibers in the involved nerve the major virtue of documenting sensory or motor deficit is to be able to discuss them with patients and reassure them that feelings of weakness, numbness or tingling are quite harmless.

The so-called straight leg raising test is also done when a patient is examined though for different reasons depending on the examiner if there is a great deal of soreness in the buttocks the patients will be able to elevate.

If there is a great deal of soreness in the buttocks the patients will be unable to elevate the straightened leg very far and then only with a great deal of pain the pain may be due to the muscle, the sciatic nerve or both.

In the majority of cases, there is a herniated disc air pressing on the sciatic nerve as patients are often told when there is a shoulder arm pain syndrome one does similar tests on the arm and hand; sometimes patients have pain on two sides this is of no particular significance.

People will also often report that in addition to having the major pain in the right buttock and the leg, for example, they have some intermittent pain in the neck or one of the shoulders. This is not unexpected since TMS may involve any or all of the postural muscles.

The variety of tendonalgias pain in the tendon or ligaments were probably part of the syndrome of tension myositis. The term myositis was fast becoming obsolete and having been determined many years before the nerves could be implicated in TMS as just described now.

I was beginning to realize that still another type of tissue might be part of the process and as time went by this conclusion became more and more inescapable what first attracted attention were reports from treated patients.

In addition to the disappearance of back pain, their tendon pain, for example, tennis elbow often left as well. The tennis elbow is one of the most common of the disorders called tendonitis. Generally, it is assumed that these painful tendons are inflamed presumably because of excessive activity. The routine treatment is anti-inflammatory medication and activity restriction.

You might be told to take some anti-inflammatories and not move so much. You might have been alerted to the possibility that these painful tendons might be part of TMS. I began to suggest to patients that their tendonitis might also disappear if they allowed it to occupy the same place in their thinking as the back pain.

The results were encouraging and over time my confidence in the diagnosis increased. I am now prepared to say that tendonalgia is often an integral part of TMS and in some cases it is its primary manifestation it has become apparent that the elbow is not the most common site of tendon nausea.

In my experience the knee has that distinction.

Some of the usual diagnosis for knee pain are chondromalacia. However, the examination disclosed that there is tenderness of one or more of the tendons and ligaments surrounding the knee joint and the pain usually disappears along with the back pain.

Another common place is the foot and ankle either the top or bottom of the foot or the Achilles tendon.

The shoulder is another location for TMS tendinosis.

The usual structure diagnosis is bursitis or rotator cuff disorder again. There is usually easily identified tenderness on palpation of a tendon in the shoulder wrist.

Tendons are not uncommonly involved. It is possible that what is known as carpal tunnel syndrome may also be part of TMS, but this cannot be stated without further observation and study.

Recently I saw a patient who had developed pain in a new location after a minor accident.

She said the pain was in her hip and that x-ray showed that there was arthritis of the hip joints more on the side where she was having pain and she had been told that this was the cause of her pain.

She had proven to be highly susceptible to TMS in the past. So I suggested she come in for an examination.

The x-ray showed a very modest amount of arthritic change in the joint in question about what would be expected in someone of her age. She had excellent range of motion of the joint and no pain on weight on weight bearing or movement of the leg.

When I asked her to touch the exact spot where she felt the pain she identified a small area with a tendon of a muscle attached to bone

well above the hip joint. I told her I thought she had TMS tendon nausea

and the pain left in a few days, not weeks or months, just a few days.

On average I have seen people go into remission. On average about 6 weeks and usually by week 6 is where some of the anxiety starts to show

itself and going back to what I said earlier. If the person is having a hard time recognizing which natural supplements for anxiety, they can potentially relapse so that does not mean get anxious about your anxiety.

It does not mean you go on high alert and constantly be watching over whether or not you’re anxious.

Give Yourself Room to Manage it

We have to take a very compassionate approach to this. You have to give yourself the space to do what you do. Allow yourself to be anxious. Allow yourself to be panicky.

Allow yourself to have a flare-up.

This is very important. Don’t go out there doing this like it’s some type of task that needs to be done for the pain to go away.

This is for many people the beginning of learning how to love themselves and learning how to take care of themselves.

For now, let’s finish this part; hip tendon nausea is most commonly attributed to what content bursitis.

That diagnosis was not made on this occasion because the location of pain was above the trochanter, the bony prominence, that can be felt at the upper outer aspect of the hip.

TMS can manifest itself in a variety of locations and it tends to move around all right.

So, it tends to move around.

TMS tends to move around and I gotta read that several times because when you have lower back pain and it disappears and you feel good for two days and you start worrying again about crap what if it comes back and then you get a little pinch on your elbow.

That’s definitely gonna bring you back because at that point the anxiety just grabs you.

It says oh look now I have this new problem and sometimes it goes from pain to habits. Sometimes it goes from pain to habits but that’s all another topic.

Let’s move on and by habit I mean they can go from okay I don’t have pain anymore but now I can’t stop binge eating, I just can’t.

I’ve never been a big eater and all of a sudden I can’t stop eating and in some cases, it turns into other self-destructive habits but the point is that it moves around.

TMS can manifest itself in a variety of locations and it tends to move around particularly if something is being done to combat the anxiety disorder treatment particularly if something is being done to combat the disorder.

Patients often report pain in a new location as the old one gets better.

Though the brain is unwilling to give up the convenient strategy for divorce for diverting attention away from the realm of emotions.

It is therefore particularly important for the patient to know where all the possible locations of pain are.

My patients are routinely instructed to call me when they develop new pain so that we can determine whether it is part of TMS.

In summary, TMS involves three types of tissue muscle nerve and tendon ligaments. Let us now look at how TMS therapy for anxiety manifests itself.

This discussion helped me understand why symptoms jump around and how new ones were created. Absolutely new ones can be created.

The pain is created from bad posture always sitting at the computer.

I wouldn’t say always but it’s definitely a possibility that there are real things out there that can cause pain. Sitting in front of the computer is one of those things.

I am always open to other possibilities anyone else has; anything you’d like to share, any comments or concerns. Is there anything you’d like to share in a positive way? How is this helping you?

Relaxing Moments and Thoughts!

So, at the end, let’s take a moment to notice your breathing.

Notice where you are seated, Notice your body. Notice any sounds around you and just notice that space in the mind, when I say notice your breathing notice how silent the mind goes for just a few seconds.

That’s right and at this moment let’s take a deep breath down into the belly and exhale gently out the mouth. Notice how nice that feels one more time. Deep breath in through the nose and exhale gently out the mouth. Very good.

One more deep breath into the belly and exhale out the mouth.

Let’s take a moment our body and our mind to the sacred temple for protecting us even though some of us may be annoyed by it.

It’s important to be grateful for that. It’s important to let go of the act of demonizing your condition, blaming that your body is failing you, claiming that you know there’s something wrong with it.

Nothing is wrong with it. This is just your body and your mind protecting you the best way and knowing how and when the time comes where the protection is no longer needed, it will leave just as randomly as it showed up and then we can go play tennis.

It says a word of encouragement to continue to teach your brain you are safe yes and I would add a note to that telling your brain that you are safe.

The only thing I would add to that is let your brain know that it is safe to feel unsafe.

So let’s not try to push away what we call fear and worry which are just symptoms of anxiety. Let’s not push that away if we’re afraid. It’s safe

to feel afraid, it is safe to feel uncertainty, it is safe to feel like I might get covered whatever your anxiety tells you it’s safe to feel it.

At the end, I would like to thank you all for reading this post.

Enjoy the rest of your week wherever you are. 

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