Site news

TMS and Central Sensitization

TMS and Central Sensitization

by Bryan Nagle -
Number of replies: 5

I have a question regarding TMS and its relationship to central sensitization.


First, let me say that I find Sarno’s refutation of structural “flaws” to be entirely convincing. The studies demonstrating no correlation between MRI findings and the experience of pain is very strong evidence against structural explanations for pain.


I also find the whiplash study in Denmark to be very strong evidence demonstrating that the origin of persistent pain can be entirely emotional.


I find the idea of central sensitization to be of a hindrance in completely accepting that I am experiencing TMS (it nags in the back of my mind). The concept of central sensitization was beaten into me years ago. I doubt that I am the only one that has had neurological reasons (rather than structural ones) explained to them for the continuation of pain. I am only in week two of this program but I’m not sure if this has been addressed, especially considering the popularity that central sensitization has gained in recent years.


It seems to me that the argument against its importance is the high recovery rate reported my Sarno and others treating TMS. This would imply that central sensitization, which I have been “educated” is present in many experiencers of persistent pain, must be reversible or not the actual cause of the pain itself (I know Sarno talks about oxygen deprivation). And obviously this a very strong argument. But it’s kind of a roundabout way to think about it.


My question is: Did Sarno or any further TMS theory ever directly talk about the problem of central sensitization?


Thank you.


In reply to Bryan Nagle

Re: TMS and Central Sensitization

by Howard Schubiner -

Yes, you are asking an important question.

I have been vexed by all the focus on central sensitization. It has been good to put more focus on the brain in chronic pain, rather than the body. But it has gone overboard by suggesting that there is actually something wrong with the brain; that the brain is damaged in some way.

Nothing could be further from the truth. Central sensitization should be understood as simply TMS. Nothing more.

Does that help?

Best, Howard

In reply to Bryan Nagle

Re: TMS and Central Sensitization

by Erin Kershaw -

Hi Bryan!

I study the physiology of the body for a living and I also have TMS, which can be tricky! Recently, in an attempt to better understand the physiological changes I was having and also to answer some questions that some of my physical therapist colleagues had about TMS, I went very deep into Central Sensitization, as well as some other related concepts. 

I have to tell you that this put me in a black hole, as I then began to feel like I was, well... f**cked. My brain was damaged, my nervous system was damaged and stuck on ON, etc. This made me feel a lot of fear, and my symptoms increased.

What I have learned as someone who studies the body and also who has a lot of incredible colleagues who study the body, is that we are desperately trying to make sense and "science" this phenomena, but we can really only make our best educated hypothesis. The incredible healing process of TMS can sometimes be dramatically quick or instantaneous for people, which shows that while Central Sensitization is an excellent hypothesis to explain this phenomena, it actually falls very short. 

You are spot on to see this! How aware you are! Follow that intuition and stick to your guns!! Nothing about any of us is damaged! You are powerful to realize this. Very powerful.

Kindly,
Erin 

In reply to Erin Kershaw

Re: TMS and Central Sensitization

by Bryan Nagle -

Thank you for the responses.


I find myself moving beyond the concept of central sensitization. It is a concept that has not served me well. 


I don’t even remember the details of it very well anymore. I just remember how terrifying the whole thing sounded when I read this abysmal book by the NOI group called “Explain Pain” or something. I even remember thinking this really isn’t explaining much of anything—that no one really seems to understand what actually causes pain. Nonetheless, at the same time, I seemed to accept CS as at least perpetuating the pain. But no objective tests were ever performed on me. There was no evidence at all that this was my fundamental problem.


The potential neurophysiological effects of TMS seem rather unimportant given that people seem to regularly overcome them when applying Sarno’s ideas to their life. My fear of CS seems trauma-based rather than factually based. It seems I have some unconscious resistance to fully accepting TMS, an idea that actually makes a lot of sense considering my life experience. My unconscious is grasping at straws trying to keep me believing in CS and focused on the pain. This strikes me as (typically) irrational of the unconscious to cling to CS when many people are healing only after rejecting these types of explanations and focusing on the idea of emotionally-induced pain. 


Sometimes it is difficult to see beyond the ideology of our time. But when I think of it now, it really seems that the “science” fails to take the big picture into account. It is obsessed (and trying to make me obsessed) at only looking at the nuts and bolts of the issue, like we’re machines. But we’re not. Machines cannot develop persistent pain. Only living beings can. Machines cannot experience trauma or rage. You need a mind to experience that. 


I may prefer to be a machine at times—that’s one reason that I have pain—but I must acknowledge that I am not. I have a mind whether I like it or not. It’s actually a good thing it is not a nuts and bolts issue because I’m not a mechanic. I am, however, a human being and therefore I know how to change my mind. Now I must continue on with the course work and engage in my emotions, trauma, and psychology. 



In reply to Bryan Nagle

Re: TMS and Central Sensitization

by Paul S -

Thank you for sharing those thoughts Bryan. They really resonated with me. I listened to the Explain Pain audiobook. At the time it gave me some comfort as it seemed to help make sense of the pain/discomfort that was constantly haunting me. It also seemed to do a good job of explaining why there was such a physical aspect.

On thinking through what you wrote I can see that my mind has a constant desire to find a reason for my pain/discomfort. This seems strange as I have so much faith in TMS, and like you it makes so much sense given my history/personality, etc. However, my rational brain is in the habit of constantly working at finding a solution. In my working life x+y=z (or whatever) and so my brain wants to find the x and y that are causing the pain, e.g. z. If that makes sense :-)

Maybe I am wishing I was the machine you spoke of as then maybe I'd be better able to figure out what the x and y are equal to and solve the problem.

Truth is, Dr Sarno and Dr Schubiner make so much more sense, but I just struggle to rationalize that the pain/discomfort is NOT caused by a physical issue.




In reply to Bryan Nagle

Re: TMS and Central Sensitization

by Erin Kershaw -

Bryan, 

This response is POWERFUL. So many incredible things in here. It is so extremely true that a lot of us think of the body like a machine, and treat it that way, rehab it that way, strengthen it that way... etc. I was once a coach that operated that way, until my entire life fell apart (actually, thank God)! In my experience, the body follows the brain/mind. The body believes the brain/mind. The body reacts to the brain/mind. However, at least in my experience in the fitness/rehab world, there is never a brain/mind component in our work. Never. As an exercise physiologist, we get one psych class in undergrad and one sports psych class in grad school, and then we are off to treat and strengthen our machines! NO! BIG BIG BIG problem here. Glad you see this! One day, and if enough pioneers like Dr. Schubiner, Dr. Sarno, Dr. Clarke, Dr. Hanscom, and many more keep pushing, this will change. This HAS to change. It is bound to change. I hope it changes sooner rather than later. 

One thing that has helped me immensely is studying Internal Family Systems by Dr. Richard Schwartz. It has allowed me to develop an entirely new relationship with my psyche, and has also made me look at the protective parts of the mind that send me symptoms, in an entirely new light. Actually, it has been a profound tool in my personal healing journey, as just like you, I have a trauma brain that is often very afraid to accept this condition, particularly when it gets triggered. I should add, I have even been diagnosed by Dr. Schubiner in person! However, in times of fear, my protective parts do what they think they need to do... OUCH. 

 A quick example of how I used to talk to this part of my mind and symptoms before IFS: "These symptoms are just Mind Body Syndrome! They are harmless, I am not hurting myself, so I am going to deadlift and run up this mountain and screw you brain! How could you do this to me? I will not let you do this! I will not let you stop my recovery! I am doing it my way!"

This Morning Deadlifting: "You are doing this perfectly. I know it is really tough, but just hang in there, do as much as you can do. Back off the resistance if you want, who cares! No pressure, Erin. You have nothing to prove. Thank you, protective part (of mind/brain/psyche) for protecting me."

This Morning Trail Running: "I know these symptoms are MBS. Thank you, protective part (of mind/brain/psyche) for protecting me. I am so sorry you feel so unsafe, but I understand why you do. I am here for you. I've got you. We don't have to go fast or push hard. Actually, we can just walk (walking now..). See? It's okay. There is no pressure. I've got you. We are okay, we are safe. Thank you for protecting me."


Kindly,
Erin