Tuesday, 3 June 2014

Chronic Pain and TMS – the hidden cause

When, in my mid-thirties I became struck by a mystery illness which rendered me incapable of more than 3 hours work a day, I feared the worst. The symptoms were very varied but began with incredible fatigue. Then my joints swelled up so that walking became painful. I had unexplained rashes and itching, dizziness and headaches, it went on and on. I went back and forth from the GP and various hospital and blood tests. They could find nothing organically wrong with me and left me with a 6 months prescription for painkillers telling me it would probably get better of its own accord!

So, I determined I would find out more about chronic pain and fatigue and see if I could unlock whatever it was with alternative methods. I tried acupuncture (which was helpful), homeopathy (which was not – for me anyway). Then I tried massage and chiropractic and finally some Chinese herbs which were incredibly effective as they detoxified my body and enabled it to begin to heal. I started to see that health and wellbeing was more than curing myself of disease. It was about bringing my body back into balance.

Fast forward 15 years and I am now a fully qualified therapist specialising in Chronic pain, specifically TMS or Tension Myositis Syndrome (which is closely related to Chronic Fatigue syndrome although they may manifest differently). It is a stress-related illness – by which I don’t mean necessarily due to an obvious stressor but it can be accumulated, low-level stress like being in the wrong job, relationship for you, or by burying your emotions of loss, grief or anger. Men and women are different in this respect as their emotional landscapes are different which may explain the huge preponderance of women with CFS/ME as compared to men. Men on the other hand may get unexplained back pain, or auto-immune diseases. Modern medicine calls these conditions different illnesses, and attempts to treat them symptomatically. This doesn’t work as the central cause isn’t in the affected part but in the brain.

Now, here’s where this gets tricky as people in pain do not like being told ‘it’s all in the mind’. That isn’t what I’m saying at all. The pain is very real and there is real physical disturbance in the tissue causing that pain. However, the ultimate causation is in the imbalance in the nervous system which comes from undischarged emotion. It is a simple biological fact that we are hardwired for emotion – the two most primitive are fear and defensive anger (rage). In the animal kingdom (of which we are part from an evolutionary perspective) animals will display these emotions as a survival tactic. If we didn’t have fear we would be incautious and perhaps get eaten, if we didn’t have rage we couldn’t stand up to our attackers with the same result. The part of the nervous system that controls this is the autonomic nervous system and it is composed of two parts; the sympathetic and the para-sympathetic. They are like the accelerator and brakes respectively that modulate the body’s responses to outside stimulus. But they also response to internal stimuli – our feelings and emotions.

So, if we are afraid, our heart rate increases, our breathing is rapid, we are geared to the so-called  ‘fight or flight’ response which involves the brain and endocrine (hormone) system. If we have a situation where neither of these is possible we can exhibit a freeze response where our body is in perpetual slow motion – lacking energy and vitality. This is probably the basis for Chronic Fatigue syndromes – much more common in women whose nervous systems tend to freeze more than they fight. [i]That our mind can create this may seem nonsensical until you begin to understand our evolutionary heritage. As animals, our mind is incredibly complex and designed to deal with threat- it cannot differentiate between real threat and perceived threat – perception is everything! So, for instance we can get anxiety because our mind is interpreting a situation as threatening even when it is relatively innocuous. This is because the brain is a pattern recognition machine and it links certain events together by their associated senses or emotions. So, for instance a certain smell will evoke a memory as will feeling fearful – but the associations may be unconscious, so for instance your boss may remind you of someone you once feared so they trigger that response in you causing unconscious stress.
TMS is the physical response of the body to that cumulative, low-grade stress. It inhibits blood flow to the tissues casuing local ischaemia (or oxygen deprivation). The tissues become hypoxic, lactic acid builds up and pain and fatigue is the result – especially in muscles and tendons. There only needs to be a small amount of reduction too to have serious effects. If the nerves are affected then the pain may be accompanied/replaced by tingling or odd feeling sensations. But because the root cause – stress – is never addressed all physical approaches be they massage, physio, pain killers and surgery will never work. It has been noticed of instance that in people with Fibromyalgia most pain killers are ineffective.
There has been a lot of research into TMS but the main author who first coined the term was Dr john Sarno[ii]. He was in rehabilitation medicine for 30+ years and began to notice patterns of trauma in his patients that, if he encourage them to highlight and address their unprocessed emotions, they were able to reduce or remove their pain altogether. He hypothesised that the mind was creating pain as a diversion to these uncomfortable emotions – in the mind’s view physical pain is less damaging! He also noticed  that the pain could shift and move around when these feelings were addressed. Combined with his research into normal pathology of the spine and tissues with ageing, he came to the conclusion that the root cause was not physical but emotional.his work has since been furthered by clinicians such as Dr James Alexander[iii] who being a psychologist, was able to hypothersise how this mechanism might be mediated.

I have written extensively on this in other blogs and won’t repeat here, but mindbody medicine which acknowledges that we are both mind AND body is really the only logical way forward to solve the epidemic of mindbody disorders that we are currently seeing. These include in no particular order; CFS/ME, auto-immune disease, IBS, anxiety/panic disorders, headaches/migraines, insomnia, etc. In my practice I work with people on a mindbody level - we investigate the whole person not just the physical symptoms.  I use massage and Reiki to stimulate the body and rebalance the energy system, and then various psycho-somatic techniques such as EFT (tapping ) and EMDR within a hypnotherapeutic framework (which emphasises safety and self-empowerment).

[i] Peter Levine:  ‘In unspoken voice- how the body releases trauma
[ii]Dr john Sarno: ‘The Mindbody Prescription’ and ‘Healing Back Pain’
[iii] Dr James Alexander; The hidden Psychology of Pain’

No comments:

Post a Comment