October 5, 2011

Coming Into My Own

The past two weeks have been a challenge because an old problem I thought I'd gotten rid of reared its ugly head. Since the night before my daughter's 1st birthday, I started having terrible lower back pain. Since the pain inevitably affects my life, I posted on my Facebook page that my back was out & what I thought was behind it—a psychogenic pain syndrome. Judging by the response (0 comments so far), either my friends and family think I'm loca, or this is too heavy of a topic for social networking.

But if I were crazy, so would be Jeannette Barber, John Stossel, Howard Stern, and Dr. John Sarno, M.D., as well thousands (if not millions) of people that this venerable but controversial NYU medical professor who developed the TMS theory believes the disorder affects every year. John Stossel, 20/20 correspondent, talks more about the pain syndrome here.

I've been having bouts of incapacitating back pain off and on since the spring of 2002. Back then, I thought my back pain was due to an on-the-job injury. I visited the doctor, who prescribed NSAIDs and bed rest. The pain became practically paralyzing. The MRI said I had bulging discs. The physical therapist prescribed exercises. The bodyworker helped me breathe deeper and visualize a protective shield. This went on for months. Then I saw an acupuncturist, who balanced my energy meridians. Ironically, the stress relief treatments worked better than the pain relief treatments. The massage therapist said I was tense. The chiropractor adjusted me and told me I had an instable SI joint. Still no long-term relief after four years. Finally in 2006, I read the book Healing Back Pain by Dr. John Sarno, which told me my back pain was psychogenic in origin: Tension Myoneural Syndrome.

Reading that book was the only thing that really reduced the length and frequency of my bouts of pain—once I really accepted its role in my life, I went an entire year without a major pain event, and when I did again it only lasted for days, when for the past four years, I'd have at least 3 bouts of pain that lasted from 1-2 weeks every year. To me, the book was the most powerful medicine I'd encountered so far.

On the TMS wikipedia site, TMS is summarized as "a condition in which unconscious emotional issues (primarily rage) initiate a process that causes physical pain and other symptoms. [The] theory suggests that the unconscious mind uses the autonomic nervous system to decreases blood flow to muscles, nerves or tendons, resulting in oxygen deprivation, experienced as pain in the affected tissues." According to Sarno, TMS manifests most commonly as back, leg, or neck pain, but can also lead to disorders such as Irritable Bowel Syndrome (IBS or colitis) and others. Sarno also considers fibromyalgia to be synonymous with TMS.  The personality characteristics of people who are most susceptible to TMS are, from the introduction to TMS wiki: perfectionists, people pleasers, very self critical, and very ambitious individuals.

This whole topic is both fascinating and embarrassing to me at the same time. Fascinating because although it's not the first instance where I've come in direct contact with the power of our mind, it's definitely the most in-my-face example of how my subconscious can control me, and how I can often take control of my own pain. Because of this, I've made great strides with this and other difficult aspects of my life.

However, telling people that I believe I "have this" condition can sometimes still be embarrassing for a couple reasons: One, there's still that stigma against mental disorders in both the United States where I'm from and in Mexico, where I live—in both countries a psychological condition is often seen as an imagined apparition (it's all in your head) or a personal debility. And there's a part of me, probably that very perfectionist, people-pleaser side, that doesn't want to appear weaker, or anything less than "on top of" my own issues, no matter how hard things get. I can remember a time in high school when we used to mock the concept of psychosomatic disorders, i.e. people who "do it to themselves" or "bring on their own problems." Kids are cruel, adults pretend not to be, but many of us hide our true feelings, which sometimes makes it harder for us to be genuine with each other (or even ourselves). But let's face it—all of us have struggled with unpleasant emotions—anger, jealousy, sadness, frustration, or worse— for our entire lives. To deny it would be ingenuous at best.

Second, I was trained as a biologist and a skeptic in the scientific tradition, and Dr. Sarno's TMS theory is more controversial—it smacks of pseudoscience. Although many prominent alternative physicians support his theory and believe it could relieve a large burden on the payout system for Workers Compensation (of which I was a part of, and back pain sufferers are a majority recipient), Sarno acknowledges that the vast majority of the medical community rejects his hypothesis. This is mainly because a major clinical trial has not been performed. Some researchers claim that his education program, which teaches people that their subconscious repression of unpleasant emotions leads to pain and that learning about the process can alleviate pain, is merely placebo effect.

On the other hand, I have a very open mind. It doesn't surprise me that it's not only hard to test for this effect, but that there's a lot of money to be lost on the chronic pain industry were this theory to be proven (for example I avoid long term use of painkillers).  Just because something hasn't yet been definitively proven through clinical trials doesn't mean it can't exist. Great strides are being taken to demonstrate through Western medicine what Eastern medical traditions have long since known—the intricate mind-body connection and the importance of approach to life in health issues. For example, Dr. Dean Ornish who showed that coronary artery disease could be reversed not only through a vegetarian diet, but also through meditation.

For many years I've self-diagnosed and treated with diet, herbs, and vitamins, and normally I've had a great track record—I'm usually in very good health. But when you're having a recurring problem and it comes down to the nitty-gritty of getting proper professional support with it, it can be a lot harder to heal when you're doing it on your own.

Which might be why, even though I haven't had a bout of back pain in almost two years, I'm coming to terms with the fact that I'm still struggling with this problem. August 2007, February 2008, and December 2009 were the last times I had TMS-type symptoms. In Dec. '09, I had a short-lived bout of back pain that both disappeared as soon as I figured out what was stressing me out. Since that was the last time I had actual back pain, I figured I was "cured."

But now I'm realizing that there were two other things that happened since then that very well could have been TMS in disguise: a brief bout of IBS in October '09, severe morning sickness in early '10, and hip pain that started five months after I gave birth and worsened daily until two weeks ago when it suddenly disappeared and the back pain started.

I'm going to save the story of how my hip pain progressed, how I thought it might be a degenerative joint problem, how it "coincidentally" morphed into back pain (and then back again a few times), why I became convinced that it was TMS after all, and what I think I need to do to get "back on track" for another time. But suffice it to say that I have my work cut out for me, in terms of coming into my own, yet again, and finding a way to heal myself.

Because I know I have something to learn from this struggle, and I don't want to needlessly miss out on another moment of enjoying my life.

1 comment:

  1. hope you are better...i understand sarno...many people don't get it...he helped me tremendously.


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