Archive for the ‘Patient stories’ Category
The relationship between OCD and MBS: Jacob’s story
I have learned so many things about the mind and the body over the past 5 years of working with patients with Mind Body syndrome. One of the most interesting things is that disorders that we considered psychological, such as anxiety, depression, PTSD (post-traumatic stress disorder), and OCD (obsessive-compulsive disorder) actually are similar to (dare I say identical to?) Mind Body syndrome. In other words, these disorders are caused by patterns of neurological response to stress and emotional reactions to stressful situations. This leads to two conclusions: 1) that psychological disorders such as these occur as part of MBS and typically are exchanged (substituted) with pain and other typical MBS symptoms and 2) we can treat these disorders effectively using the same methods as we use for MBS.
Read the story of Jacob, who had OCD, which morphed into chronic pain. He learned that he had to deal with the OCD and the pain, but that they were connected by being components of Mind Body syndrome.
“About 10 years ago I had back pain for 2-3 years and read Dr Sarno’s book and also had a MRI which showed no problems and my back pain went away. A couple years ago when having my second child I started getting high anxiety and really bad obsessive-compulsive disorder (OCD) about things like locking doors, chemicals around house and just about anything else. Then about a year ago, I had surgery, and the pain after surgery started going away but lingered and then after taking numerous tests and seeing specialists and searching the internet about why the pain was not going away it started getting worse and worse. Soon I was taking Vicodin for pain and searching for any cure I could find. I even tried a pain clinic and had a nerve block which did not work and even made my back hurt for a few weeks (the doctor warned me that it was a possible side effect). I was getting pretty desperate and depressed. The pain was nearly unbearable. I was taking sleeping pills at night to sleep and pain killers during the day.
The “disease” of TMS/MBS: Lori’s story
The last two blogs have dealt with the issue of fear and how fear can often derail the recovery process from TMS/MBS. I thought it would be helpful to read the story of a brave woman who is confronting her fears head on. Here is Lori’s story:
“Fear is a big issue for me right now, but I am making some progress in dealing with it. In the blog entry titled “A rose by any other name…” it says people can see themselves as having a disease called “TMS” and see themselves as a victim of their life events, their stressors, or their mind. It goes on to say that people with TMS/MBS do not have a diseased autonomic nervous system (ANS). Until I read that, I hadn’t had the specific thought, “I have a diseased ANS”, at least not consciously. But when I thought about it, I realized that I really did fear that I had a disease or syndrome or chronic problem called “TMS” or “MBS”. I thought that since my physical symptoms were caused by emotional triggers, then those emotional triggers would always cause physical symptoms. I worried that whenever I was stressed, anxious, angry, guilty, or in a confrontation, I’d start to have physical symptoms. And since I often did have physical symptoms in those cases, that reinforced my fear of the emotional triggers.
“I read that blog entry over and over again, several times a day. I started to realize that when I did have physical symptoms, I had been thinking I had done something “wrong” to have caused them. I figured I shouldn’t have put myself in a stressful situation, or gotten angry and not calmed down quickly enough, or felt guilty and not figured out how to stop feeling guilty. Since I knew the physical symptom was due to an emotional trigger, I blamed myself for putting myself in the situation that caused the emotional trigger, or not controlling it well enough. Then I feared encountering future emotional triggers, thinking it was inevitable that they would lead to physical symptoms because I “had” MBS.
Many people find that fear of not being able to recover from MBS and fear of pain are major factors preventing their recovery. In order to address these issues, I offer the courageous story of Brad in his own words. Following that (in the next blog), you will find my comments on dealing with fear and several methods that can help.
“In the late 1980s, I became totally crippled with back pain shortly after an incredibly stressful four-month period. I couldn’t do much besides lie around. I saw several doctors, who gave me a variety of diagnoses, and I realized they were just guessing, so I went to the library do some research. By chance (thank God!) I saw Dr. Sarno’s first book, Mind Over Back Pain, on the shelf. I took it out, and after reading it I knew that my pain had been caused by my recent psychological tensions. I also concluded that I had become literally phobic about many movements and decided that the only way to break the phobia was to challenge it with graduated exercise. So I began to exercise and lift weights. However, I was very timid and therefore didn’t exercise as aggressively as I could have. Read more »
Understanding the depth and breadth of The Mindbody Syndrome (TMS)
It is clear to most people that emotions can cause physical reactions in the body. When someone gets embarrassed, their face will turn red. When standing up to speak before a large audience, many people would have physical reactions such as sweaty palms, churning stomach, a more rapid heart rate or a dry mouth. These are physiologic reactions obviously caused by activation of the autonomic nervous system that are reversible and do not indicate that there is a pathological or tissue breakdown condition in the body.
Most people also recognize that they can get a headache or a stomach ache after a stressful day. Therefore pain can also be caused by stress and emotions. These immediate reactions are relatively easy to discern as being connected to stress and emotions. Among people who are afflicted with TMS however, the time lapse between when the stress that is responsible for the symptoms may be years or decades. And the symptoms of TMS can be amazingly varied and severe. Common symptoms of TMS include back and neck pain, headaches, abdominal or pelvic pain, TMJ pain, or widespread pain now known as fibromyalgia. TMS symptoms can also be related to ANS activity such as is the case with IBS and IC. Neurologic symptoms of burning, tingling, itching, and other paresthesias may occur. Generalized symptoms such as fatigue are common. Psychological symptoms such as anxiety, OCD, PTSD, and depression are very common manifestations of TMS. And insomnia is very common as well. How can we understand the great depth and breath of these varied symptoms and how can we figure out what precise events and emotions are the causative factors in the life of an individual with TMS?
After conducting hundreds of detailed interviews with TMS sufferers, it is my firm belief that we can determine what has lead to TMS in the vast majority of patients. However, in order to truly understand these individuals with TMS, it is critical to learn to dig deeply in the history and the minds of our patients.
If we are patient and take the time to listen, patients will lead us to an understanding of the source of their pain and other TMS symptoms. We need to learn how to take these sensitive histories and learn what clues to attend to in order to help patients gain the insight into the key issues they will need to cope with in their lives. Certain patients have such overwhelming histories of childhood abuse or neglect, which when coupled with additional trauma in adulthood, gives an obvious explanation of the emotional sources of TMS. However, in other patients, it is necessary to listen for more subtle clues to explain how and why TMS developed.
I have compiled a number of examples to illustrate the thesis that childhood events create specific emotional memories that when triggered later in life cause the onset of TMS symptoms. Typically, there are two other psychological factors in the development of TMS: One is a strong sense of obligation, high expectations, perfectionism, desire to be good, guilt, low self-esteem, and self-blame. The other is a suppression of lack of awareness of the emotions that are reactions to life stressors or the internal pressures that patients put upon themselves.
Dear Dr. Schubiner,
For so many years, I have been taught and “programmed” to please others and basically ignore what I was feeling; because I didn’t matter. I denied myself things such as food (anorexia), pain medications and even rest. I even felt that I didn’t deserve to have feelings and lived with tremendous guilt.
I started to have pain at the age of 13 and I am now 49 years old. I had a very difficult childhood with severe abuse and neglect and it has been reflected in pain for all these years. I now understand that my subconscious mind caused me to have severe headaches. They began gradually and occurred about twice a month. But they were severe and forced me to lie in bed and cry. The headaches started to occur more often, until they came daily and lasted for the next 20 years! I forged on with my life; marrying, working and starting a family. The pain finally got so horrible that I had to quit a job that I loved and held for 21 years.
I was devastated, but I decided to become the best wife possible. I was determined to be the best coupon shopper to find sales on all items, sometimes dragging two toddlers with me across town just to save 50 cents. I tried to be the best housekeeper and stay at home Mom. I was obsessive about everything, to the point of exhaustion. Finally, I had a nervous breakdown and was hospitalized for three weeks.
Since taking your workshop and beginning therapy, I have come to an amazing revelation. My internal child was telling me, “Hey, I matter and if you won’t listen to me, then I’ll just have to force you to pay attention. I want some nurturing too. Quit trying to please everyone else and be kind to me. I deserve it.”