The Mindbody Prescription

1. Pain is often psychological, not structural

Statistically, TMS occurs most commonly in the low back; one or both legs may be involved at the same time.

Structural abnormalities mislead. Many patients with back pain are diagnosed with herniated discs, spinal stenosis, or degenerative changes. However, these structural abnormalities are often incidental and not the true cause of pain. Studies have shown that a significant percentage of people without pain have these same abnormalities visible on imaging.

Pain patterns defy structural explanations. TMS pain often shifts location, varies in intensity, and occurs at illogical times. This variability is better explained by psychological factors than by fixed structural issues. The mind can induce pain in any part of the body, regardless of physical findings.

Common misdiagnoses:

• Herniated discs
• Spinal stenosis
• Degenerative disc disease
• Fibromyalgia
• Carpal tunnel syndrome

2. TMS: The mind's strategy to distract from emotional pain

The purpose of symptoms, physical or emotional, is to prevent repressed feelings from becoming conscious by diverting attention from the realm of the emotions to that of the physical.

Distraction mechanism. TMS (Tension Myositis Syndrome) is a strategy employed by the brain to divert attention away from threatening emotions by creating physical pain. This pain serves as a powerful distraction, keeping the individual focused on bodily sensations rather than confronting difficult emotional issues.

Protective function. The mind perceives certain emotions as dangerous or unacceptable. To protect the individual from these threatening feelings, it creates physical symptoms. While this may seem counterintuitive, the unconscious mind considers physical pain preferable to emotional distress.

Common TMS symptoms:

• Back pain
• Neck pain
• Shoulder pain
• Gastrointestinal issues
• Headaches
• Skin disorders

3. Unconscious rage fuels physical symptoms

Rage in the unconscious is perceived as dangerous and threatening by the unconscious, hence the dramatic overreaction in the form of pain and other physical symptoms.

Repressed emotions. Many individuals, particularly those with a tendency towards perfectionism or people-pleasing, accumulate significant unconscious rage. This rage stems from various sources, including childhood experiences, self-imposed pressures, and the stresses of daily life.

Rage as a catalyst. The intensity of repressed rage often determines the severity of physical symptoms. As unconscious anger builds, the mind becomes increasingly desperate to keep it hidden, leading to more severe or persistent pain. This explains why some individuals experience debilitating symptoms while others have milder manifestations.

Sources of unconscious rage:

• Childhood trauma or neglect
• Perfectionism and self-criticism
• Suppressed anger in relationships
• Unmet emotional needs
• Stress from work or personal life

4. Personality traits contribute to TMS development

People with TMS have a strong need to seek approval, whether it is love, admiration or respect.

Perfectionism and goodism. Individuals prone to TMS often exhibit personality traits such as perfectionism, people-pleasing, and a strong sense of responsibility. These traits, while often socially valued, can create significant internal pressure and contribute to the accumulation of unconscious rage.

Low self-esteem paradox. Despite outward appearances of competence and success, many TMS sufferers harbor deep-seated feelings of inadequacy. This internal conflict between high standards and low self-worth creates a fertile ground for the development of physical symptoms as a distraction mechanism.

Common personality traits in TMS sufferers:

• Perfectionism
• People-pleasing tendencies
• High sense of responsibility
• Difficulty expressing anger
• Suppressed emotional needs

5. Equivalents of TMS: When pain shifts location

TMS is one of a group of interchangeable physical disorders. They all serve the same mindbody purpose and are, therefore, equivalents of each other.

Symptom substitution. When one physical symptom is resolved, the mind may create another to maintain its distraction strategy. This explains why individuals may experience a shift in pain location or develop new symptoms after successful treatment of the original complaint.

Diverse manifestations. TMS equivalents can manifest in various systems of the body, including the gastrointestinal tract, skin, and immune system. Understanding this concept helps patients recognize that seemingly unrelated symptoms may have a common psychological origin.

Examples of TMS equivalents:

• Irritable bowel syndrome
• Fibromyalgia
• Chronic fatigue syndrome
• Tension headaches
• Skin conditions (e.g., eczema, psoriasis)
• Allergies

6. Knowledge is the cure: Understanding breaks the cycle

Merely acknowledging that a symptom may be emotional in origin is enough to stop it.

Education as treatment. The primary treatment for TMS involves educating patients about the true nature of their symptoms. By understanding the psychological origins of their pain, individuals can begin to break the cycle of fear and avoidance that perpetuates the condition.

Conscious awareness. As patients become aware of the mind's strategy, they can consciously redirect their attention to emotional issues rather than physical sensations. This awareness often leads to a reduction or elimination of symptoms, even without addressing the underlying emotional conflicts directly.

Key components of TMS education:

• Understanding the mind-body connection
• Recognizing the role of unconscious emotions
• Learning to identify symptom patterns
• Challenging fear-based beliefs about pain
• Resuming normal physical activities

7. Mindbody connection: Emotions influence physical health

The body is intimately connected to the mind, and particularly to emotions. How could it be otherwise?

Holistic perspective. The mind and body are inextricably linked, with emotions playing a crucial role in physical health. This connection extends beyond TMS to a wide range of health conditions, including cardiovascular diseases, autoimmune disorders, and even cancer.

Emotional impact on physiology. Emotions can directly influence physiological processes through the autonomic nervous system and immune function. Understanding this connection opens up new avenues for treatment and prevention of various health issues.

Areas influenced by emotions:

• Immune system function
• Cardiovascular health
• Gastrointestinal processes
• Hormonal balance
• Pain perception
• Healing and recovery

8. Fear and misinformation perpetuate chronic pain

Our greatest enemies are fear and misinformation.

Nocebo effect. Negative beliefs and expectations about pain can actually intensify and prolong symptoms. When patients are given dire prognoses or told their condition is structural and irreversible, it can create a self-fulfilling prophecy of chronic pain.

Breaking the cycle. Overcoming fear and challenging misinformation are crucial steps in recovery from TMS. Patients must learn to trust their bodies again and resume normal activities without fear of causing damage or exacerbating their condition.

Common fears in chronic pain:

• Fear of movement
• Fear of permanent damage
• Fear of pain worsening
• Fear of inability to work or function normally
• Fear of failed treatments

9. Alternative treatments may provide temporary relief

Most alternative medical treatments achieve whatever success they enjoy through the placebo effect.

Temporary benefits. Many alternative treatments for pain, such as acupuncture, chiropractic care, or massage therapy, may provide temporary relief. However, these approaches often fail to address the underlying psychological factors driving TMS.

Focusing on the body. While alternative treatments can offer short-term pain relief, they may inadvertently reinforce the mind's strategy of focusing on physical symptoms rather than emotional issues. This can prolong the cycle of TMS and prevent true healing.

Limitations of alternative treatments:

• Temporary relief without addressing root causes
• Potential reinforcement of body focus
• Variability in effectiveness
• Lack of scientific evidence for long-term benefits
• Potential delay in addressing psychological factors

10. Psychotherapy: Exploring the unconscious for lasting healing

Since the therapeutic process takes time, you must look on it as an exercise in preventive medicine.

Insight-oriented approach. For some individuals, particularly those with deeply ingrained patterns or severe symptoms, psychotherapy may be necessary to explore and resolve unconscious conflicts. This process can lead to more lasting relief and personal growth.

Addressing root causes. Psychotherapy allows patients to confront and process the emotional issues that drive their physical symptoms. By working through repressed feelings and developing healthier coping mechanisms, individuals can achieve long-term freedom from TMS.

Benefits of psychotherapy for TMS:

• Exploration of unconscious emotions
• Development of emotional awareness
• Improvement in stress management
• Resolution of interpersonal conflicts
• Enhancement of self-esteem
• Long-term prevention of symptom recurrence

Last updated: January 24, 2025