Updated: Jun 18
Before jumping into a brief origin story of the syndrome commonly known as TMS, The Mindbody Syndrome, I want to make it clear that at its essence, the theory of TMS states that the mind and body are deeply connected, so much so that it is a fallacy to even refer to them as if they are/were separate entities. What happens in the mind directly influences the body, plain and simple. This is far from a new insight, other cultures throughout history have been well aware of this and the fact that our current medical system pays no tribute to this, or at most gives it a small nod, is completely absurd. Now, when referring to TMS we are looking at an extreme example of this connection, one in which the affected individual experiences drastic, as well as chronic, physical symptoms.
In the 1970's, Professor of Rehabilitation Medicine at the New York University School of Medicine and attending physician at the Howard A. Rusk Institute of Rehabilitation Medicine, Dr. John E. Sarno, discovered the true cause of his chronic pain patients' symptoms. Through experience and honest observation, he found that their symptoms were almost never caused by anything physical, meaning that the pain was not the result of structural or pathological abnormalities. This proved to be the reason why the traditional forms of treatment (surgery, medication, physical therapy, chiropractic, etc.) he was prescribing were not providing lasting results, and certainly were not curing anybody. What he discovered was that the physical symptoms were a result and manifestation of repressed emotions and the elevated stress/tension levels that accompany them. These repressed (unfelt) emotions consist of shame, guilt, apathy, grief, fear, and anger, with all the varying shades, depth, and complexity within our emotional apparatus. He found that all of his chronic pain patients had very similar personality characteristics, mainly that they were "people pleasers" and perfectionistic, which was causing enormous amounts of stress and tension. More often than not, the patients he saw were suffering with multiple mind-body symptoms, for example, the back pain sufferers also had frequent urination, the knee pain sufferer also had migraines, and the foot pain sufferer also had insomnia and occasional eczema. This all began to reveal that there was something deeper at play. Sarno was old school in that he was still in the business of talking with his patients and building relationships, because of this, he also found that frequently the patients had recently experienced a major life crisis of some sort or another (divorce, loss of job, death in the family).
In the early days he found that this elevated tension was affecting muscle tissue, causing back pain, etc.. At this point he named the syndrome Tension Myositis (Muscle) Syndrome. He soon found that not only was this elevated tension affecting muscle, but also the nervous system and nerves within, which lead him to rename the syndrome Tension Myoneural (Muscle and Nerves) Syndrome. It was not long before he became aware that repressed emotions and the accompanying elevated tension/stress levels, were capable of affecting any and every system within the body. This is because what is primarily affected is the autonomic nervous system, which has implications throughout our bodies. The autonomic nervous system (ANS) controls breathing rate, blood pressure, internal organ function, digestion, smooth muscle activity, body temperature, heartbeat, and the distribution of the blood supply within the musculoskeletal system (Ozanich, 2011). In regards to chronic pain, simply put, the ANS controls blood flow, which dictates the oxygen delivery to nerves and muscles. When this is altered, and even slightly changes the oxygen supply to a nerve or muscle, it can cause extraordinary amounts of pain. Nerves being deprived of oxygen creates many different sensations of pain, this why when someone has back pain it can radiate down the entire leg, neck pain often radiates down an entire arm, and pelvic pain is felt in many areas of the region. Similarly, disturbances within the ANS can wreak havoc on and cause dysfunction within any of the many organs of our bodies, which provides insight into the variety of other uncomfortable symptoms a person experiencing TMS often feels. This being said it is important to note that in the majority of TMS cases, the pain is not representative of any real, life-threatening danger within the body. This is evidenced by the many sufferers who repeatedly and unsuccessfully seek out new and different doctors and specialists hoping to finally find the "real" reason for their pain...
And thus, we arrive at The Mindbody Syndrome. In my personal experience, learning that the cause of chronic back pain, plantar fasciitis, pelvic pain, as well as a host of other distressing symptoms was TMS, and acting upon this knowledge, has allowed me to heal. I no longer suffer with these conditions that plagued me for years.
Steve Ozanich writes in the opening pages of his seminal work on TMS entitled The Great Pain Deception: Faulty Medical Advice is Making Us Worse, "TMS is the cause of the current pandemic of back pain, neck pain, shoulder pain, migraine, hip pain, knee pain, wrist and hand pain, carpal tunnel pain, pelvic pain, mouth and jaw pain, foot pain, fibromyalgia, chronic fatigue, so-called repetitive stress "injuries", GERD and other stomach disorders, skin disorders, allergies, many eye problems, ulcerative colitis—and an infinite variety of other pain equivalents. TMS is also the major cause of non-physical phenomena such as anxiety, addictions, and depression. The roots of our health problems are most often planted in childhood, through early separation anxiety—tension from trauma causing lack of connection or attunement—forming a specific personality that is more conducive to these disorders."
It took many years of communicating with hundreds of sufferers, but most importantly my own experience, to fully understand that it was the loss of awareness of negative emotions that was the culprit behind pain and most ill-health. - Steve Ozanich
Many of us are aware of the connection between body and mind to some degree or another, we understand that stress plays a role in many of the ailments we experience. For example, it is now common knowledge that stress can cause headaches/migraines and stomach ulcers. Over the course of the last two years, since learning about The Mindbody Syndrome, I have come to realize that the effects of the mind on the body are much more far reaching, and extreme, than what I could have previously fathomed. In the years prior to my chronic pain hitting peak levels—and thus becoming intolerable—I had read a good deal about the mind-body connection, I had even accepted its assertions on some level, but when it came down to it, I was a long ways from fully understanding the implications involved. Throughout my life and experience with physical pain, I have done what everyone does, for back pain I would head off to a chiropractor, and when it got really bad, it was on to the physical therapist, surgeon, and "one-who-gives-steroid-injections"; when plantar fasciitis made it so I could no longer run or walk without severe pain, it was off to get the perfect shoes, a special roller for the feet, constant calf stretches, and shoe insertions; when pelvic pain made life unbearable, it was off to the hospital, physical therapist, urologist, and once again, surgeon. The common denominator in all of this is that not one of these conditions ever fully healed, actually, they continually got worse, and I lived a good fifteen years of my life with some combination of these. This doesn't even mention the other conditions that come and go throughout ones' life, allergies, hernias, ulcers, frozen shoulders, insomnia, ad nauseum...
Before my encounter with, and acceptance of TMS, I truly believed that the cause of my pain was something physical: a structural abnormality, a bacteria, a tight muscle, poor nutrition, not enough of the right exercise or stretching, etc., and that the only way I could manage it was to continue pursuing physical remedies. If I could only stretch enough, drink enough spinach and kale, find the right specialist, I would be ok. Well, as it turns out, none of this was true. The true cause, and proper diagnosis for everything I had experienced, turned out to be TMS, The Mindbody Syndrome. This may sound wild, and I assure you it is, it is a daunting and chilling fact, but one that provides hope and a confidence that one can actually heal permanently from chronic pain.
It should be emphasized that this book (Healing Back Pain) does not describe a new approach to the treatment of back pain. TMS is a new diagnosis and, therefore, must be treated in a manner appropriate to the diagnosis... clearly there is no logic to traditional physical treatment. Instead experience has shown that the only successful and permanent way to treat the problem is by teaching patients to understand what they have. - Dr. John E. Sarno
So what does this all mean? Let's assume you are like I was when I finally came across the TMS diagnosis, you have tried everything and nothing has worked, you are suffering intensely and TMS makes complete sense to you. But then, invariably the next question is, ok well what the hell do I do now? As stated by Dr. Sarno in the documentary film about TMS entitled All the Rage, "you need to get out of the physical ball park and into the psychological one." This is a topic I would like to elaborate more on in another blog, but I want to make it clear what acceptance of the TMS diagnosis implies. What does it actually mean, in practice, to accept that repressed emotions, tension, and stress are the root causes of your physical symptoms? How would your behaviors and actions change if you were to accept that TMS is your proper diagnosis? It means that you are now beginning to understand that treating the physical symptoms themselves, is never going to work. So the logical next step would be to stop physical treatment. If you are not in any life threatening danger, then you are completely ok to do this. For me, this meant that the endless doctors appointments and hospital visits came to an end, I cancelled all future physical therapy sessions, I got rid of the shoe inserts, the special cushions, no more excessive stretching exercises, and disposed of all other "crutches" that were perpetuating the myth that I had a physical problem. I started doing any physical activity I felt inclined to do, without reservation, without fear, or in spite of the reservation and fear. The latter being more often the case as reality would have it. I began looking at my life through a new lens, how stressed out and tense am I?! What traumas have I experienced that have gone unrecognized?! Which relationships need healed, and which ones need to be forgiven and let go of?
It is important to understand that when you are busy seeking physical treatments, you are necessarily not attending to—nor are you even likely aware of—the true causes of the pain. For me, this meant that prior to the acquiring of the knowledge that TMS was my correct diagnosis, I wasn't addressing my relationship issues, I wasn't being honest with myself about the fact that my career no longer aligned with my core values, I could let my excessive drinking go unrecognized for what it had become, and I could continue grinding through grad school in pursuit of a career that did not suit me. These are just a couple examples of how the true root causes of chronic pain go unaddressed while we endlessly chase quick fixes in the form of physical treatments. It is vital to note that the specific events that change throughout the healing process are unique to the individual, and therefore are not as important as the recognition that each of these events is connected with underlying, dormant emotions. It is the guilt and resentment lurking in our relationships, the fear of finding a new career that aligns with who we are, and the shame, guilt, and fear of not yet being honest with the world about who we truly are, along with the ever-mounting rage inherent in being continually stifled in the truest expression of ourselves.
Healing is often slow, and it involves dealing, revealing, expressing, and understanding. -Steve Ozanich
If you are ready to begin healing from TMS, it is time to take a deep, long look inside and to start asking yourself the difficult questions of life. Time to start feeling your emotions again and become honest with yourself and others. Time to start saying no. Time to stop pretending that everything is ok. Time to start taking care of yourself and facing the aspects of your life that have been allowed to fester and go unaddressed. It's time to learn to forgive and start showing yourself some love again.
Love your struggle and remain free!
Ozanich, S. (2011). The Great Pain Deception: Faulty Medical Advice Is Making Us Worse. Silver Cord Records Inc.
If you are interested in getting fully acquainted with TMS, The Mindbody Syndrome, I cannot recommend the work of Steve Ozanich enough. He has writtin three books on the subject, The Great Pain Deception: Faulty Medical Advice Is Making Us Worse, Back Pain Permanent Healing: Understanding the Myths, Lies, and Confusion, & Dr. Sarno's Top 10 Healing Discoveries. These books provide every aspect of the knowledge necessary to heal from chronic pain and illness.