Dr James Alexander, PhD- Psychologist

TMS is a term coined by Dr. John Sarno (Professor of Rehabilitation Medicine at New York University Hospital 1962-2012). In the past, it referred to Tension Myositis Syndrome- tension (referring to both emotional and physical tension); myositis (refers to the muscles, particularly vulnerable to pain associated with emotional tension); syndrome (refers to the collection symptoms which people can suffer). More lately, TMS has come to refer to 'The Mind/Body Syndrome', in recognition that other aspects of the body, such as nerves, tendons and ligaments, can also suffer pain as a result of emotional tension- it is not confined to muscles. The terms psycho-physiological disorders (PPD), mind/body disorders, psychogenic pain, and psychosomatic pain are all referring to the same phenomenon.

The assumption behind the TMS model is that, despite having a large psychological component, the pain is entirely real and is a genuine physical experience. The division between body and mind is a completely arbitrary distinction which does not reflect reality- it is merely the way our culture has viewed the human organism for the last several hundred years, while other cultures never developed this split between mind and body. It has not all been a waste of time, however, as Western culture has developed some remarkable medical advances with the aid of technology, despite having got it wrong with dividing mind from body. But the problem where this all falls down, and in fact results in a crisis of epidemic proportions, is with chronic pain.

As long as we as a culture continue to treat the human organism as though it is a sophisticated piece of machinery (machines have no minds- feelings or thoughts), then we will continue to look for physical solutions to chronic pain, and most people will be doomed to continue suffering. If we want to overcome chronic pain (either as individuals, or as a society) then we need to re-introduce psychology into the equation. Ironically, health professionals in the 1940s and 50s were far more aware of the powerful role of emotions in a whole range of health issues than is common today. We have all been seduced into the 'mechanistic bias' by incredible advances in medical technology, so the view that we are essentially machine like has become more dominant (even though it is demonstrably wrong).

With between 1/5 to 1/3 of all Australians (1/3 of Amercians, & 1/6 British and Europeans) suffering from this condition, chronic pain is the mind/body health issue of this era. As discussed in great detail in 'The Hidden Psychology of Pain', there are biological pathways which produce very real physical pain in the body. These pathways can be activated by strong distressed emotions, such as trauma, dilemmas, threats, etc. It is perplexing to most of us as these distressed emotions are generally operating at an unconscious level. If you think that references to the 'unconscious mind' reflect outdated Freudianisms, think again- it is impossible to read cutting edge neuroscience without seeing repeated references to unconscious neuropsychological processes. In fact, most of what goes on in the mind/brain is unconscious. and we are only aware of very little on a conscious level. As such, contemporary neuroscience is in fact validating many of the 'depth-psychology' notions which for several decades have been viewed as anachronisms from a long-gone era.

The TMS model suggests that powerful forms of emotional distress which are operating at an unconscious level are able to trigger biological pathways to produce very real physical pain. By definition of them being unconscious, we are unaware of them. While this may sound pretty wild, I know this proposition to be true from my own experience of 18 years of chronic pain, and then my recovery from it within a very short time- just from the introduction of psychological notions. I also know it to be true from having seen this occur repeatedly with many clients over the years. There are no other possible explanations for these types of recoveries other than to point the finger at psychology.

Rather than suggesting that recovery is to do with 'mind over matter', or 'rising above' the pain, this approach is suggesting that we can learn what unconscious emotional issues (sorry folks- we've all got 'em!) are related to our physical experience. For me, it was the trauma from being nearly killed in a car accident as an 18 year old. Other types of experiences (often less dramatic and overtly traumatic) can be responsible as well.

Plenty of research has demonstrated that for mild to moderate problems, self-help books can be as effective as face -to-face therapy. 'The Hidden Psychology of Pain' is one such self-help book. We need to get a completely different picture on what is causing chronic pain, and we need to apply this to our own life experiences to see what unconscious factors could be causing problems. The book has a couple of chapters purely dedicated to self-analysis to help the reader work these out for themselves. For those who require more than merely processing information and self-analysis to overcome their chronic pain, face-to-face therapy may be needed. The types of therapies which have been demonstrated to work with chronic pain include (but are probably not restricted to):- brief psychoanalytic therapy; Eye Movement Desensitization and Reprocessing (EMDR); and Coherence Therapy. Other forms of psychotherapy are likely to be helpful for a range of other problems, but when it comes to chronic pain, a depth-psychology approach is the most helpful.