Tamara’s Blog

My Posts

• Eye-Opener May 2021
• Five Stages Of Mindbody Healing July 2021
• Anxiety October 2021
• No Longer A Victim! December 2021
• Cure vs. Healing February 2022
• Cognitive-behavioral Therapy and TMS Therapy April 2022
• Hostages Of Pain June 2022
• The Myth Of The Diagnosis And Symptoms August 2022
• Magic Pill October 2022
• Self-compassion December 2022
• Dealing With Emotional Trauma February 2023
• Purpose In Life April 2023

Eye-Opener

Somebody asked me recently: how did you feel when you first learned about mind-body approach to CRPS? It has been over 5 years, but I still vividly remember that day when I finished reading Dr. Sarno’s book Mindbody Prescription. At first, it was absolute, total disbelief. No, my mind was telling me, it cannot be that simple!!! Why all other doctors have not arrived on the same idea? Why was I told to subject myself to all kinds of invasive treatments when result can be achieved by simply adjusting the way you think about your pain? But the book was so logical, persuasive and straightforward! It also had thousands of extremely positive reviews written by grateful readers, and it was obvious that those reviews were sincere, truthful and by no means fake.

My head was spinning. On one hand, the book promised a miracle. On the other hand, I knew darn well that miracles did not exist. On one hand, the book put the control over recovery from chronic pain squarely in the hands of a patient, which was so much better than dealing with the maze of the healthcare system. On the other hand, it left me with a full responsibility for my recovery. It made me feel equally liberated by putting power in my hands (no pun intended), and burdened with the work of healing, which, looking back, was much harder than I initially thought it would be. I soon learned that my brain was much more stubborn than I could expect, but still trainable!

Looking back, I can tell that my newly acquired knowledge changed my life forever. It made me a stronger, more confident and more compassionate person. Not only I understand myself much better now, I am better equipped to handle my relationships with other people, I am more open to new experiences and new ideas. But most importantly, I am healthy and I know how to manage daily stresses of my life so inevitable occasional pains caused by stress heal quickly.

Five Stages Of Mindbody Healing

Mindbody healing is not a simple or linear process. Mind does not work like a switch. It takes time and effort to re-wire your brain and un-learn the information that was being imprinted in your brain for years. Once people learn that there is a mind-body path to healing from any chronic pain, most of them go through five stages. I call them five Ds of TMS healing.  

Stage 1. Disbelief. Almost everybody starts with disbelief, because it is very hard for them to accept the fact that their pain is induced by the brain. Their brain, trained in the opposing theories, offers many ways to go back to convenient knowledge:

1. My pain feels so physical, it must be structural. 
2. I have a herniated disk, and I have my MRI to prove it.
3. My EMG shows that I have a carpal tunnel syndrome, there is a structural damage to the nerve
4. Doctor such-and-such told me that I have a pinched nerve
5. Swelling or skin changes cannot be induced by the brain

I am sure, this list can continue forever.

Well, multiple studies were done to show that back pain is not a result of a herniated disk, but rather a coincidence. Study after study show that spine deformities are equally present in those with chronic pain as they are in those without chronic pain. Here is one of them, from the United States, and another one, from Japan. Orthopedic surgeon Dr. Bruce Moseley conducted a clinical study comparing an arthroscopic knee surgery for osteoarthritis to a placebo one.  He found no difference in the outcome.  Now, for those who are still stuck on skin changes: it has long been a well-accepted notion that acne and rosacea are known to be triggered by stress.  

Disbelief is normal. Every revolutionary idea starts with disbelief. And that’s OK. What makes a productive revolutionary idea different from an unproductive revolutionary idea is that it stands the trial by practice. Thousands of people around the world have proven Dr. Sarno and the mind-body method right by simply using it and healing. If you are in disbelief, you are welcome to continue questioning this theory. However, keep your mind and eyes open to the facts and try to accept them instead of resisting or ignoring them. Only then you will progress to the next stage of healing.

Stage 2. Doubt. Regardless of how much or how little time you spent on stage 1 – a year or just one minute, you will inevitably enter stage 2, which is doubt. If you have not sufficiently disposed of your disbelief, with every spike in pain your mind will continue going back to the concept of structural damage. Why? Because your mind is searching for easy solutions: a pill, a surgery, an injection. Because the advances of our modern medicine in fighting bacterial and viral infections, in developing amazing surgical techniques and painkillers or amazing diagnostic technologies conditioned us to believe that there is an instant solution for every illness. Well, mind-body healing is hard work, and it is slow, especially for CRPS, which manifests itself with very complex and widespread symptoms. Usually, there is no instant relief and no instant gratification. But eventually you will convince yourself that slow but successful healing is better than an endless search for a magic pill. Sometimes people even accept that some of your mind-body symptoms (for example, pain) are psychosomatic, but the rest of them (swelling, rash or spasms) are not. Acceptance is often a gradual and painful process.

Still, once you get over those doubts and firmly convince yourself that your pain is, in fact, of psychosomatic origin and can only be defeated by a mind-body approach, there is another doubt waiting for you. You begin to doubt yourself and your ability to beat your pain. This one is the biggest obstacle on your path to recovery. This doubt comes in different shapes and shades. You may be worrying that you are not going through the right steps, or that your choice of the methodology is wrong. It may be that you decide that you are lacking skills or even capacity to re-wire your brain. My advice to you is very simple: as long as you understand that everybody has doubts but most of us succeed with enough effort – you will eventually overcome your doubts and move on to the next stage.

Stage 3. Disappointment. This is another likely period for those who made it past doubts. You have done all the work understanding the mind-body connection with regards to pain, you are now diving deep into your emotions, you are working through your childhood traumas, you are meditating every day, but your pain is not going away. Or maybe your original pain is down, but your anxiety is now through the roof. This is the time when you start wondering whether you wasted all of your time on this Dr. Sarno mind-body business and you would be much better off by just getting a prescription for an opioid painkiller or look for a good surgeon to fix your problems.

However, I have very good news for you: you are closer to success than you think. Increase in the levels of anxiety, depression or OCD is in fact a very good sign. It indicates that your pain has psychosomatic origin.  The same applies if your pain moved to a different location. Everybody goes through this period. Why? Because good things never come soon enough and because there are no free lunches. People who developed CRPS often have a long history of stress, difficult life situations and even tragedies. It takes a lot of damage to make the nervous system fall apart to the point that it creates symptoms of such intensity in different parts of the body. But that also means that you must put a lot of time, effort, and patience into climbing back to normal. And with time, patience, and effort, you will get to the next stage, Determination. But for now, keep working!   

Stage 4. Determination. This stage, when I switched from despair and anxiety caused by my CRPS to hope and determination, was maybe the most exciting time of my life. My hard work was paying off and the sense of personal achievement in beating this officially incurable illness was exhilarating. I felt like a mountain climber feels being a hundred feet away from the peak of Mount Everest.  So, what one should expect at this stage? By now, you have seen small improvements. You were able to achieve occasional reduction of some or maybe even all of your symptoms. You are no longer fearful of pain because you know that you can improve. At this point, you are working on your healing with renewed energy. Congratulations! You should be very proud of yourself! Still, I have a word of warning for you: do not get overconfident or easily discouraged. Your success may still be temporary, with setbacks and long plateaus when you seem to be stuck without any progress. Continue your work. You will know when you are fully healed. It may not happen overnight, but it will happen.  Keep working!

Stage 5. Defiance. At this point, you are symptom-free. You are walking on clouds and confident that your pain and the rest of your symptoms will never return. Life is great and you regained your normal lifestyle. Enjoy your victory but be mindful that pain may still come back if your emotional problems reoccur under pressures of life and stress, and it would be more than you can successfully cope with. Don’t be defiant, be vigilant instead. You have a playbook at your fingertips, try it again, and you will be fine!

Anxiety

Many chronic pain patients who start on the path of mind-body healing soon discover that, as their pain level goes down, something happens to their mental health. They often report increase in anxiety, depression, mood swings or obsessive behaviors. They get frustrated and scared because they view these emotional issues as a new set of symptoms, often more unpleasant than their physical pain.

In fact, they are still dealing with the same problem. Physical and emotional pains are connected vessels. Remember, your physical pain is a result of a suppressed emotional pain. Your pain began when you started repressing the feeling of negative emotions because those emotions were too painful. Eventually avoidance became habitual, and your brain re-routed emotional pain into a physical circuit. Fast forward to today. You stopped hiding from your emotions and the pain went down, but all those bottled-up emotions are now staring into your face.

Does it mean that you are now forever stuck between the rock of pain and a hard place of anxiety? Not at all. This is your opportunity to finally address your underlying problems. I will walk you through the steps.

Let’s first understand what anxiety is. Emotions exist in our nervous system for a reason. Anxiety is an evolutionary mechanism that helped humans avoid dangers: tigers, falling rocks, lightnings etc. Before we can see a tiger hiding in the bushes, we are likely to hear a sound of a movement or notice a faint shadow on the ground. We don’t know what it is, but our brain generates suggestions that we may be facing a danger. That sense of an unspecified danger is anxiety, and it is, in a way, a good emotion. However, it becomes a negative emotion when it starts dominating your life.  

You don’t believe me? Watch this presentation by Dr. David Hanscom, a renown orthopedic surgeon, who explains the mechanism of anxiety-generated pain. It is a bit detailed, but what matters is what you do after you are done watching.

So, what do you do now, how can you tame the beast of anxiety? There are three actions that you can take:

1. Acknowledge that your previous life experiences led you to the elevated sense of anxiety. Continue re-examining your life and connecting past life events with your current emotional state. Remember that by now you were able to reduce your physical pain by doing so, therefore, your emotional pain will eventually go the same way.
2. Use mind-body approaches to reduce anxiety. Read books and listen audios by Dr. Claire Weekes, the world-renown anxiety specialist. You can find her work here.
3. Start meditating. If done right, meditation stabilizes central nervous system and normalizes emotional response. Multiple studies were down showing positive impact of meditation on patients with anxiety and depression. 

Each one of these actions works on different aspects of mind-body, but all three get you to the goal of getting your life back.  Remember, until you learn to recognize your emotions for what they are, accept them as part of your nature and learn how to handle them as they come along, you will be in this ping-pong between the emotional and physical pain, so get to work!

No Longer A Victim!

CRPS is brutal. The pain is so extreme, it robs its victims of will power and desire to fight. Prescription opioids routinely prescribed for CRPS often come with serious side effects, causing drug dependency, reduced inflow of oxygen into the brain, confusion, and drowsiness. Each one of those side effects alone can kill any desire to make any effort, but those side effects usually come on top of the pain that may have been reduced by the drugs, but always present.

What does it do to the CRPS patients? They stop believing that their condition can be reversed, and they give up. Slowly, patients get used to being disabled and they surrender to a victim mentality. They know their pain is forever and they are skeptical of anything that may bring the ultimate end to their suffering.

But something amazing happens when people learn that they can take their life back and overcome their pain. Slowly, day by day, they learn how to change their way of thinking about their illness and to re-wire the brain to respond differently to events of life. The power of positive thinking and the power of determination produces amazing results!

I am deeply inspired by Kay, whose success story you can read here:

She was beaten down by the relentless onslaught of CRPS and the understanding that she would have to live with it forever. A chance encounter brought her knowledge that pain signals were generated by her brain. That was enough for her to start on the path of improvement. Empowered by knowledge and knowledge only, she was able to overcome CRPS by way of mindfulness and meditation. She still has occasional relapses, but she knows how to bounce back through meditation, and she knows that relapses are getting shorter and less painful.

This is from Kay: “entered 2022 in a better place than 2020 or 2021!”. If you are just starting on the path to end CRPS, I wish you all to say the same a year later!

Cure vs Healing

Generally, people don’t distinguish between cure and healing. For example, when you injure your finger, you apply a medication, so your finger is cured. You can also say that it healed. Does not look like there is much difference between curing and healing, right?

Well, in the mindbody world, the difference is significantly more pronounced. Your chronic pain is generated not by a physical injury, but by an emotional trauma to your brain. Often chronic pain remains in the body after the physical trauma is already cured and there is no reason for the injured organ to remain in pain. The emotional trauma that caused chronic pain can be new or very old, it can be associated with the physical injury or can be completely unrelated or be lurking in your brain until it cannot cope anymore. It can be a single event or accumulation of multiple events. Human beings are resilient creatures, they have many evolutionary mechanisms to cope with emotional and physical traumas, so to penetrate that coping mechanism and cause physical pain, your emotional trauma must be deep.

And this is where the difference between cure and healing becomes clear. Cure comes from outside, through a pill, a surgery, an organ transplant. Unfortunately, there is no magic pill to cure deep emotional traumas, the only way out of such pain is to embark on a difficult journey of healing.  And mindbody healing must come from inside, through the emotional work that often challenges your habits and your beliefs but helps to re-wire your brain and cause a different response to those once unbearable emotional burdens.

There are many methods that are designed to help you with that. Check out our Resources page to learn about those.  

Cognitive-behavioral therapy vs TMS therapy

Often, people are asking an important question: cognitive-behavioral therapy is often used for pain management and seem to produce some results, why TMS therapy is better?

The answer to this question is very simple. CBT is a supporting therapy, it was designed that way and is being used that way. It is meant to help people cope with pain – that’s it. At least some clinical studies do not find significant positive impact of CBT on pain levels

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5999451/.

TMS therapy, on the other hand, is a very different animal. All various types of TMS therapies are based on doctor Sarno’s theory of chronic pain. All of them have a goal to eliminate chronic pain and associated with it other symptoms. The first clinical study conducted on one of the TMS therapies, Pain Reprocessing Therapy (PRT), showed significant improvements not only in the level of pain, but also in the mental health of the patients. Those improvements largely remained at a 1 year follow-up.

https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2784694

As someone who tried both, CBT and TMS therapies, I can tell that the difference is significant from day one. Without going into many technical details, I will focus on one. When you enter CBT, you are told that CBT will help you better handle the pain, so you still believe that your disease is with you forever. Just knowing that you are doing all the work to finally be pain-free sets the patient on a very optimistic course. The best component of TMS therapies is hope for the better future!  

Hostages Of Pain

In my book Defying The Verdict, I write about my experience with the CRPS forums. I was new to the CRPS world and was looking for the support and encouragement in fighting the disease. Instead, I found a community of people completely absorbed by their illness, for whom their illness became their identity, something that made them stand apart from the rest of the world. I got a feeling that, even if offered a path to a complete recovery, they would be reluctant to step on it. My suspicions were confirmed few years later, when I tried to reach out to CRPS patients and tell them that they can heal without paying thousands of dollars for risky treatments with little chance of success. Out of a half a dozen of people who I spoke to, only one became interested. Believe it or not, she succeeded, even quicker than I expected!

Today, I came across the article that goes deeper into the phenomenon of a Stockholm Syndrome of chronic pain. I highly recommend that you read it. It quotes Alan Gordon, one of the most prominent practitioners in the world of mindbody method. Here is the link: When Chronic Pain Becomes Who You Are.

The Myth Of The Diagnosis And Symptoms. 

CRPS is labeled as COMPLEX for a reason.  The sheer variety of symptoms that fall under the definition of CRPS can be overwhelming. They may appear in hands, or feet, or spread to the entire body. Often,  people have some initial diagnosis that is different from CRPS, and it would be specific to a hand, like RSI, or to a foot, like  foot drop.  

Well, your nervous system is deeply involved in every part of your body, and when it is generating pain signals, those signals may show up in any part of your body, including skin, vascular system, digestive system and so on. At the same time, each person is unique. We have unique genetic makeup, environment we grow up in, set of psychological factors that impact us – and so are the symptoms.

 Unfortunately, we are trained by our increasingly specialized medical system to look at individual body parts instead of the entire person, and we rarely trace our illnesses to the actual cause, which is more often resides in our stressed-out nervous system than we think.

I am encountering a lot of people caught up in the confusion over the exact nature of their symptoms, even if they are willing to accept a mindbody approach. Having a role model, a person who managed to recover from any chronic condition using mindbody approach, is very important. Unfortunately, the biggest mistake that chronic patients can make, is to start looking for the examples of recovery from the exactly identical symptoms. For example, I was asked by someone whether I had pain and swelling in the ring finger. When I responded that my pain originated in the middle finger, he dismissed all my experience as irrelevant, because it was not exactly the same finger.  By doing so, this person deprived himself of healing from chronic pain.

Remember: once you agree to accept the notion that your disease stems from an overstressed nervous system and resides in your brain rather than in your body, you need not to worry about the label of the diagnosis, because your diagnosis is often concerned with the symptoms, which are the result, but not the actual cause of the disease.

Focus on the root cause, which is your distressed or traumatized brain, look at the ways to normalize your nervous system!

Magic Pill

I remember very clearly the time when my CRPS was at the peak. I wanted to stop the pain right then, instantly. I would have given a lot for the chance to get that magic pill that would put the end to the relentless neuropathic pain that was present constantly, day or night, the worst pain I ever experienced in my life.

The sad truth is that there is no flip-of-a-switch cure for CRPS. There are plenty of expensive and potentially dangerous treatments, from opioids to amputations, that may stop the pain for a short period of time, only for it to return sooner or later. Those treatments often come with side effects that may be almost as bad as the pain itself.

As I learned from my own experience, the only “magic pill” that ultimately works is slow, it challenges your patience because the progress is often uneven, it is hard to use, but it works. It is called mindbody approach. The active ingredients of the pill are introspection, mindfulness, and patience.

People often ask why they have not seen any results after taking this pill for a week. Well, if it took your nervous system years to develop your symptoms, it may take a while for the pill to start working. All the impatient things I did during my recovery only slowed it down. Easier said than done but be prepared that your brain may need months of taking this pill before it starts giving up its habit of generating symptoms of distress, like pain, swelling, heart palpitations or whatever else ended up being your symptoms.

Self-compassion

When I first learned about mind-body healing, it immediately made sense to me. But I did not know how and where to start.

After about a month of trying my pain was still raging through my body, and I got very upset. Upset with myself, because I read in the Dr. Sarno’s book about all these people who listened to his lecture and were pain-free within days. I, on the contrary, didn’t seem to get anywhere. Something must be wrong with me, I thought, maybe, I need to try harder and work more on my healing!

Well, back then I did not realize that my habit of being tough on myself was one of the reasons why I got sick in the first place. As Dr. Sarno noticed, a lot of his chronic pain patients were what he called TMS personality: perfectionists, do-gooders, type A personalities often tough on themselves. As a result, they often end up with anxiety, depression, migraines, and wide variety of chronic pain.

What is a solution? Stop pushing yourself towards achieving your goals? Sit on the couch and do nothing? Not at all. The issue is not about what you do in your life, it is about how you go about doing it. Kristin Neff, PhD, the pioneer of the study of self-compassion, defines it in this way:

1. Being kind to yourself vs being judgmental. Take example of me being mad at myself for not healing fast enough. Was it helpful that I was upset? No, because by being angry I was increasing my anxiety, and instead of creatively looking for better ways to achieve my goal, I kept doing the same thing while hoping for better results. Would you be mad at your friend or your child when they are failing? No, you would rather encourage them and try to ease their anxiety. Why not do it for yourself?
2. Being mindful vs self-identifying with your lack of success. The more you dwell on your perceived failure, the more you get immersed in the loop of negativity. Result? Even less success and more negativity. Stepping back and rationally, mindfully assessing situation helps in finding a better path to success.
3. Common humanity vs self-isolation.  What would you tell your friend who struggles to pass a difficult exam? You would point out that others struggle too, that we all are human and can make mistakes while taking a hard test. Why not do it for yourself? It is not about finding an excuse to fail, it is about supporting yourself emotionally through the difficult times, just how you would do it for your friend.

Going back to my own story, it took me a while to learn self-compassion, and eventually I healed from CRPS and moved on with my life.

I still occasionally fall into the trap of self-judgment, but not as hard or as frequent as before. And life became easier!

Dealing With Emotional Trauma

Occasionally, I get questions from the readers about past emotional trauma and benefits of digging into the traumatic past. Often people find that facing their painful past causes them even more pain, and they choose to shut the door on it again, thus pushing their emotional pain out of their conscious mind and finding themselves back with more physical pain. They may not realize that they are not mentally and emotionally ready to face the painful past yet – until they learn the art of forgiveness.

Forgiveness is often interpreted as forgiving those who hurt us for what they have done. It may work in some cases, as some people hurt us unintentionally, and would have themselves asked for forgiveness if they could. But often it is not the case. How do you forgive somebody who hurt you knowingly, would that mean releasing them of the responsibility for the pain they caused us and giving them permission to do the same again?

It took me years of going around in circles until I understood that forgiveness does not mean giving a permission to the person who hurt you to do what they have done, it is rather a permission you give to yourself to rise above the past hurt and leave it behind. It is a permission to yourself to no longer feel a victim and learn how not allow the hurt to happen to you again, how to stand up for yourself in the future. It is easier to do if the perpetrator is no longer part of your life, but if the person is still around and is continuing to hurt you, your task is harder, as you need to learn in real time how to set the boundaries so they would not hurt you again. To sum it up, the act of forgiveness is an act of self-compassion, not an act of letting the perpetrator off the hook.

Purpose in Life

One may ask, what is the connection between purpose in life and chronic pain? Well, chronic pain can easily become an all-consuming existence, a black hole of a kind – unless you find something that gives you purpose and takes you away from chronic pain.  

This point is supported by evidence from many of those who succeeded beating serious illnesses. If you have something to live for (other than your illness!), you have a much better chance to overcome your pain. As I struggled with my pain spreading rapidly from hands to other parts of my body, there was only one reason for me to continue my fight: my family needed me. I heard similar stories from others, for whom being relied upon by their family was a major stimulus to recover.

When my CRPS was at its worst, I came across the story of a cancer patient who was diagnosed with stage 4 cancer and was given 6 months to live. He returned to his childhood home in Greece to die, but every day he set a goal for himself, first to be able to walk to the church where his grandfather preached, then to be able to sit on the porch of the church and talk to his childhood friends, then to clear the weeds around the church and then – to move on with his life! 20 years later, still alive and well, he went back to the US to see those 6 doctors who independently of each other gave him 6 months to live and ask them about the diagnosis that proved to be wrong, but they were all dead. I re-read that story dozens of times, and it gave me hope, inspiration and purpose. I, too, wanted to prove my doctors wrong!

Another way to find purpose is to resume pursuing whatever goals you had before you became sick, despite the pain. There are numerous stories of athletes who overcame serious illnesses because they had a goal of a grand achievement motivating them. Take your long forgotten ambitious goals out of the dusty closet – and go for it!

Another thing that can get you out of the black hole of pain is helping others. Helping others had a very positive impact on me after I acquired some knowledge and experience in recovery from TMS and started answering questions at the TMS forum. I highly recommend volunteering to distract yourself from your unrelenting pain but also to experience a pure joy of knowing that somebody was helped by your advice or information you shared. Joy has a great healing power!

No matter how you find your purpose in life and what that purpose ends up being, grand or small, personal or socially oriented, make sure you have it!

Tamara Gurin

I was diagnosed with CRPS in 2016. By then, I suffered relentless neuropathic pain in my hands, loss of dexterity and was seriously considering disability. Thanks to the work of Dr. Sarno and his followers, I fully recovered.

As I overcame one challenge after another in my healing process, I promised myself that in case of a successful recovery I would write a book to help others defeat their chronic pain conditions.

After my book Defying The Verdict was published, I became an advocate for the chronic pain patients and created this website to promote mind-body healing to the CRPS patients.

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