For well over a year, I struggled with chronic pain in both my arms. At one point, even simple things like stirring food or applying mascara made my arms burn. The pain was all I could think about for a long time, and I tried everything in my power to get rid of it. But the dozens of physical treatments didn’t save me. Psychology did.
I’m telling my story here in the hope that it will help others who are going through the same thing, and to spread the message that physical symptoms aren’t always physically caused.
Life with RSI
Like many chronic pain conditions, RSI (repetitive strain injury) is debilitating. For over a year, I was unable to work at the computer for more than 2 hours a day, and using my phone hurt just as much. I had to make serious lifestyle changes. I gave up many of my hobbies, mostly quit social media, and put what little computer work I could do towards my studies.
During this time, I saw four different physiotherapists. All of them diagnosed me with the same thing — RSI — but all of them gave me conflicting advice. I tried stretches, strengthening exercises, modified workouts, improving my posture, and took up tai chi. I was prescribed massages, shockwave therapy (yes, it’s as painful as it sounds), and dry needling. I spent a lot of money on an ergonomic chair, monitor, keyboard and mouse. I even took a break from using the computer over an entire summer.
Some of it helped a little. Most of it didn’t help at all. Nobody really seemed to know where my pain was coming from or how to make it go away. At this point, I was nearing the end of my university program, and I knew I’d have to start looking for a job soon. But if I couldn’t work a full-time desk job, my chances of finding work in my field would be slim to none. I was getting desperate.
A New Diagnosis: TMS
Surprisingly, it was actually that desperation which ended up being my saviour. Over time, whenever I’d research RSI, I’d find a bunch of success stories on the internet of people who’d been cured after reading a book. It sounded wildly implausible, and I initially wrote the success stories off as a marketing ploy. But as I said, I was desperate. And I kept seeing more and more of these success stories, in more and more different places. I figured, what have I got to lose but a few euros? So I ordered the book.
I’ll give it to you straight: reading the book alone did not cure me. But the ideas presented by the author, John Sarno, and expanded upon by a number of other medical professionals, eventually got me to where I am today: mostly pain-free, and living a normal, healthy life.
In a nutshell, John Sarno claims that many chronic pain conditions, including RSI, most cases of back pain, and fibromyalgia, have their origins in your mind. That’s not to say the pain is in your head — on the contrary, it’s very real. But it’s ultimately caused by the brain, and not by any sort of physical abnormality.
According to Sarno’s theory, our brains are capable of producing physical pain in order to distract us from emotional turmoil. In other words, our brain wants to protect us from having to deal with extreme feelings, and creates pain instead. Once you are in pain, you become afraid of engaging in specific activities (like using the computer) because you think they will make the pain worse. Your brain will then start to associate these “dangerous” activities with pain, and you’re stuck in a downward spiral of fear and pain. It will be on your mind all day, every day, and your brain will have successfully focused your attention on the physical, distracting you from the psychological. Sarno calls this Tension Myositis Syndrome (TMS). It’s also known as Tension Myoneural Syndrome, Mindbody Syndrome (MBS), or Psychogenic Pain Disorder (PPD).
If you think it sounds far-fetched, I’m with you. I’ve always been naturally sceptical — possibly to a fault — of any theories that are not part of mainstream medicine. But nowadays the fact that our brain can affect our body is widely accepted (take, for example, the placebo effect) and there is a growing amount of scientific evidence supporting Sarno’s theory. If you’re interested, this article presents some of that evidence. The article is focused on back pain, but it does a very good job at explaining TMS, and how psychological interventions can heal physical pain. Along with the overwhelming number of success stories I mentioned earlier, it showed me that TMS is not just speculation. It is very real, and it can be cured.
So I decided to give this theory a try. As I said, because I was desperate, but also because I had always suspected there to be a psychological component to my RSI. I’d always had mild RSI symptoms, even as a teenager, but they had never really bothered me. When I went to see a physio for unrelated pain, she asked me to track when and where I felt sore. That’s when I suddenly realized my RSI was really, really bad. And literally overnight, the pain in my arms became all I could think about. So either my pain skyrocketed overnight (unlikely), or I had been blissfully ignoring the pain before, and this had made it less intrusive and ultimately less painful. That would suggest that the way you respond to pain can change the way you experience pain. And that’s exactly how TMS treatment works.
TMS Treatment in a Nutshell
The first crucial step in TMS treatment is accepting that your pain is not physical, but psychological in origin. Then, you can reprogram your mind to recognize the pain as safe, not scary, and take away the fear-pain cycle that is your brain’s distraction technique. That’s why many people who have read one of Sarno’s books report that they were cured just by reading it: they accepted the diagnosis and instantly got better.
I wasn’t quite so lucky. I became convinced that TMS may be what I had, but I was wondering why my brain would generate so much pain. I didn’t think I was going through any kind of emotional turmoil — what would my pain be distracting me from?
It turns out that identifying those (hidden) emotions is another crucial aspect of TMS treatment. Once you become aware of those emotions, you will have taken away the reason for your pain: your brain can no longer distract you from your emotions if you’re actively aware of them. For many people, though, this isn’t an easy process. As a starting point, Sarno states that childhood trauma, personality traits like perfectionism, and current life stresses can all cause the oppression of emotions. What emotions they are and how difficult it will be to uncover them, differs between people.
To identify which experiences or characteristics may be at the root of your symptoms, journaling is a typical ingredient of TMS treatment. Writing about your experiences and how they make you feel can help you get to the underlying emotions. Personally, journaling helped me discover the extent to which my perfectionism and experiences from the past have shaped my current way of thinking, which is cultivating negative feelings. It is an ongoing journey to deal with those feelings, but the most important thing for TMS treatment is to simply be aware of them; you don’t need to change them in order to achieve your goal.
My Progress and Personal Treatment
In many success stories I read, people simply wrote, “I applied Sarno’s techniques and got better!” That always left me wondering exactly what it was they did, and how long it took them to see results. So, I want to share with you the specific steps I took on the road to recovery (including all the resources I used), just because I would have found an overview like this helpful myself.
As I said, reading Sarno’s book didn’t cure me. But it’s what got me started. For me, the book I read — called The Mindbody Prescription — was a great and convincing introduction to TMS. (Sarno also wrote several other books on the topic which I did not read, but which you may find worth checking out, such as Healing Back Pain.)
After finishing the book, I was pretty convinced that my symptoms could be TMS. Still, while Sarno’s theory is intriguing, it’s not without flaws, and I had a lot of questions. Most importantly, what do I do now? In The Mindbody Prescription, Sarno advises you to make a list of all the current pressures in your life. He also suggests you take some time each day to think about what may be causing your symptoms. I did both of those things, but I felt unsatisfied. So I began to look for more resources.
I found a great treatment plan on The TMS Wiki, a forum for people with TMS. The plan was developed by Alan Gordon, a TMS therapist. It’s written with a healthy dose of humor, and includes many helpful videos and audio clips. You can find an overview here and a more structured program here. Where Sarno focuses mostly on oppressed emotions, Alan Gordon’s program puts the emphasis on how you respond to pain. It can help you reprogram your mind to stop thinking of your pain as frustrating and terrifying, and to stop thinking of physical activities as dangerous (which they are not, if the pain is psychologically caused).
While I was following this program, I also continued to journal for about 30 minutes each day. I tried to think of experiences from childhood and adolescence that may have caused strong negative emotions. I wasn’t only remembering, but also speculating about feelings I might be suppressing. I did the same for my current pressures and my personality traits: I asked myself, how are they affecting my life? How might they be affecting my feelings? This was, and still is, a pretty intense (at times) and interesting process, through which I’ve gotten to know myself a lot better.
As I later found out, journaling is actually an important part of another treatment plan on The TMS Wiki: the Structured Educational Program. This is a six-week program that I started after completing Alan Gordon’s program. Every day of the Structured Educational Program contains some new information on TMS, a journaling exercise, and a question to think about. I found it useful because it gave me some guidance for my journaling, and also because it includes a lot of information on TMS from therapists and doctors other than Sarno, which I hadn’t seen a lot of yet.
Throughout following Alan Gordon’s program and subsequently during the Structured Education Program, I became increasingly confident in the TMS diagnosis. I gradually started to increase my activity, which is the final important step in TMS treatment. Once you believe that your physical pain is actually harmless (because you know the underlying emotional causes, and because you’ve trained your mind to stop responding to pain with fear) you will start to believe that physical activities won’t hurt you. That will allow you to slowly start doing more and more things you would normally avoid. My first victory was when I spent an extra hour or so on the computer editing photos I took — one of the hobbies I had given up. My pain didn’t increase. One day the next week, I used my computer for four hours instead of two. I started using my phone more. My pain still didn’t increase. This started a new, positive spiral: one of motivation and successes.
Now, I’m writing this blog post without thinking twice about how much time it’s taking me to type it, how many breaks I should take, or how much pain I’ll be in later. My symptoms aren’t gone completely, but they’ve decreased to the point where I can live my life the way I used to. I can do what I want, when I want, without fear or pain getting in the way. And I’m grateful for that every day.
So You Think You Have TMS
If you’ve read this story and think you may have TMS, there are a few important pieces of information I’d like to pass on to you.
First off, there are many different pain characteristics that may point to TMS. My story is just one example. For many people, TMS pain first occurs during a particularly stressful time in life, for example when having a baby, starting a new job, or going through a divorce. TMS pain also tends to behave illogically. It can move around to different places, and it can get worse with stress. If your pain experience doesn’t seem similar to mine, that doesn’t mean it’s not TMS. I strongly recommend you read The Mindbody Prescription to find out more about whether or not your pain may be TMS.
Secondly, and most importantly, if you think TMS could explain your symptoms, always see a doctor first to rule out a physical cause for your pain. Otherwise, you may hurt yourself worse if you start to increase your physical activity. My last physio told me, “There is no reason for your body to be sending pain signals to your brain.” That allowed me to safely accept the TMS diagnosis. All that being said, Sarno states that some physical abnormalities (like herniated discs in people with back pain, or carpal tunnel syndrome in people with RSI) tend to be mistakenly identified as the source of chronic pain, when actually TMS is at work. It’s a good idea to keep that in mind; again, The Mindbody Prescription explains this in more detail.
Finally, if you’re considering starting TMS treatment, do realize it will take time and effort. Don’t get discouraged if you’re not seeing results right away; keep reminding yourself that you can be cured. Read others’ success stories to keep the faith. Dig deep when you journal. And routinely practice other techniques that you will pick up from the recovery programs, such as somatic tracking, cognitive soothing, and meditation.
All in all, it took me months (and yes, a lot of work) to get from first reading about TMS to being almost pain-free. Some people manage it in hours. Others may take years. All I know is that I am extremely thankful that I decided to read Sarno’s work. It saved my life in many ways. I hope whoever reads this will find their way to recovery as well.
📖 Further reading: Dealing With Chronic Pain — Can Psychotherapy Help With Chronic Pain? A short article on Psychology Today, explaining TMS and its causes and symptoms.
📷 Photos: John Lockwood, Rachel Lynette French, & JEShoots.
