Tension Myoneural Syndrome (TMS), (previously known as Tension Myositis Syndome) refers to a group of emotionally-induced conditions which include chronic or recurring back, neck, limb and leg pain, carpel tunnel syndrome and fibromyalgia. The pioneer of this work is Dr John Sarno, Professor of Clinical Rehabilitation Medicine at New York University Hospital Medical School and author of the books Healing Chronic Back Pain, The Mindbody Prescription and The Divided Mind.

PSYCHOLOGICAL TENSION

Dr John Sarno proposes that throughout life we accumulate psychological tension – in the form of grief, anger, anxiety, emotional pain and rage within our unconscious mind in response to pressures placed upon us. These pressures are from three places

1.       stresses and strains of everyday issues such as home and work responsibilities

2.       childhood experiences and

3    self-imposed pressures resulting from certain personality traits such as being a perfectionist, highly sensitive, overly nice, self-sacrificing, a people-pleaser and/or   self-critical.

Because we are afraid to feel these emotions, they are repressed and placed out of awareness in the unconscious mind. This at the time seems like a good idea as it allows us to survive the situation, maintain an outward calmness and get on with life. However the accumulated emotional upset, conflicts and anger build’s up and becomes rage, which seeks to come through into our awareness. Fearing being overwhelmed by this reservoir of rage our subconscious mind, via the brain, restricts blood flow to various muscles and nerves. This lack of oxygen and build up of waste materials results in muscle pain, tension and spasms. According to TMS theory, this very real physical pain, is designed to distract our attention and keep unpleasant thoughts and feelings from rising into the conscious mind. Although the pain can be very debilitating, it does not cause any permanent damage and can disappear quickly without any lasting effects.

DO YOU HAVE TMS?

The diagnosis of TMS must be made by a health professional that is trained in its diagnosis. The following questionanire is designed to provide an indication as to whether TMS is a possible cause of your chronic back/neck pain, fibromyalgia or RSI and whether you would benefit from consulting with a health professional.

If the answer is yes to any of these following questions score yourself: 3

• Have you noticed a relationship between your pain and your emotional state/stress level just prior to the onset/flare up of pain?                                                               
• Are you overly conscientious; highly driven; self-critical; a people-pleaser; an overly nice/helpful/non-confrontational person and/or a perfectionist? 
• Do you have pain that has been thoroughly investigated, but for which they have been unable to provide you with a definitive diagnosis?       
• Do you have a history of irritable bowel syndrome, migraines, tension headaches, heart-burn, carpel tunnel syndrome, repetitive strain injury, peptic ulcers, hives, raynaud’s phenomenon, teeth grinding, frequent urination (not related to any medical condition) or tinnitus/ dizziness not related to neurological disease?            
• Does the pain persist and/or recur despite treatment with conventional and complementary therapy treatment approaches?                
  

If the answer is yes to any of these following questions score yourself: 1

• Does your pain shift around your body and/or tend to hurt more at night, first thing in the morning or on the weekends ?                                                                   
• Did the pain come on during or just after a psychologically traumatic event/s?     
• Have you found that massage helps your pain significantly or that you are quite sensitive to massage in certain areas of your neck and back?                                        
• When you get upset or stressed does the pain significantly increase in intensity?              
• Have you noticed the pain improving when you have another stress-related problem?        
• Does the pain improve with distraction or when on holiday?                                   
• Do you have a history of physical, emotional and/or sexual abuse?                                         
• Do you tend to suppress your anger?                                                                                           

A total score of 12 or more indicates a possibility that the pain you are experiencing is emotionally-induced.

THE FREEDOM PROCESS FOR TMS

 
To eliminate the pain associated with TMS, the solution is to thwart the brains strategy by understanding and accepting completely that the pain has a psychological causation and that the recovery therefore needs to be psychologically and emotionally based.

I’m now going to briefly outline my treatment programme for Tension Myoneural Syndrome. It’s based on the work of Dr John Sarno and also my experiences in treating patients with TMS to date.

Step One

The first step is to have an assessment by a TMS trained practitioner. This will include you filling in a comprehensive questionnaire, having your medical and personal history taken and undergoing a physical examination. It is essential that other causes of chronic pain are excluded prior to receiving a diagnosis of TMS, these causes include: fractures, tumours, infections, rheumatoid arthritis, cancer, severe disc herniations and other major structural problems. If necessary you might be referred back to your GP for further testing and assessment.

Step Two

Once the diagnosis has been confirmed, the next step is to start studying TMS. According to Dr Sarno, to get the brain to stop the emotionalky-indiced pain process, you must fully understand what Tension Myoneural Syndrome is and to acknowledge that TMS, and nothing else is the cause of your pain (or equivalent symptoms). To start this process I encourage you to read his book The Divided Mind.

Step Three

Now its time to do the work of recovery. Whilst the insight that the pain is completely related to repressed emotions can sometimes result in a complete cessation of the pain, the majority of TMS sufferers need to commitment to a minimum 6-week daily study programme. I offer this to my patients through The Freedom Process for TMS consultation, workbook and audio programme. For details click here

I also run a three-day workshop called The Freedom Process that teaches many of the skills and tools featured in the workbook. For more information visit www.thefreedomprocess.com