Tension Myositis Syndrome and Repression - the unbroken link

“There's nothing like a little physical pain to keep your mind off your emotional problems.”
― John E. Sarno, Healing Back Pain: The Mind-Body Connection

The subject of emotional repression is widely discussed among TMS sufferers, mainly because Dr Sarno identified it as the main cause of chronic pain. Although repression is not the only thing that keeps TMS pain alive, in this article I shall attempt to discuss the issue very briefly, so you can get the general idea of how emotions, especially repressed emotions, can cause TMS.

How repressed emotions cause TMS

Sometimes, we do not acknowledge how stressful a situation is to us, because our ego or sense of responsibility demand otherwise. For this reason, we cannot vent our anger, we refrain from complaining, and sometimes, we’re not even aware of the toll something is taking on us. To alert us to this, the brain is compelled to send a powerful signal. And what better way to capture our attention than by creating pain, in the body? That almost always works.

Let’s take one typical example:

Jane has just given birth. Suddenly, she’s got this beautiful baby to take care of, a baby she loves and adores. However, taking care of a newborn is no easy task, and Jane feels constantly exhausted.

As the baby wakes her up crying every single night, frustration starts building up inside her, but Jane doesn’t acknowledge it. She doesn’t express much frustration or anger in relation to her daughter, because, of course, she loves her daughter and thinks that these feelings are not acceptable. So Jane starts experiencing back pain, which she blames on the fact that she has to pick up and walk around with her daughter all the time. It is more acceptable for Jane to blame the pain on a structural reason than on the fact that she is feeling angry at her daughter.

The subject of emotional repression is extensive; someone could be in pain because of frustration about a present situation (like our friend Jane), while somebody else could experience pain because he still feels angry at someone who has deeply hurt him in the past (or because he/she regrets not acting differently).

Someone else can simply be angry at himself, because of a lack of self-love, while others may simply be unable to express grief after a loved one passes away, because crying or opening up is only for the ‘faint-hearted’. This person may therefore go about his life trying to look and sound fine, smiling when he or she should be crying. I hope you get the gist of it from these examples.

Repression and Western culture

How many times has someone told us to simply ‘get over something’ or ‘man-up’, even as we were growing up? Parents and teachers alike have passed on the belief to their children that crying should be avoided, that they should simply man-up and keep going. Unfortunately, a lot of parents and teachers are not qualified to teach kids how to express themselves and then let go. They do not realise that the first step in letting go is actually acknowledging and getting comfortable with one’s emotions.

And even worse, in situations when kids experience real traumatic events, such as accidents, abuse or the loss of a loved one, the kids themselves will believe that talking about or expressing their emotions is a behaviour that only weak kids indulge in. Some do not even talk about their problems to anyone, only realising how much a trauma has affected them when they grow older.

So how does this repression cause chronic pain?

The above are all classic examples of emotional repression. When we repress very strong emotions, we may develop a build up of anger, or, what Sarno likes to call Rage. The theory goes that it’s the rage inside of us, caused by all these unacknowledged emotions that eventually builds up to a point that causes pain.

If you think back to the fight or flight response, you would remember that when a person’s sense of security feels threatened, then pain is one of the alarm signals that the neural pathways may send to the body. When we have so much frustration, helplessness and anger stored inside of us which our conscious mind is reluctant to acknowledge, I would say that that’s a big enough threat to our well-being, and so the body has to find a way to alert us!

But how does the pain become chronic?

Although emotional repression or unacknowledged stress may be sources/triggers of pain, neuroscience has now shown that it is not what actually causes pain to become chronic. Chronic pain is almost always due to a process called conditioning, which means that it is always part of a program that our mind/body has learnt to run. Think of TMS as a cause and effect:

Emotional repression or unacknowledged stress causes a buildup of anger and frustration. When this reaches a certain point (the boiling point in the images), it needs an outlet. The outlet can either be in the form of chronic pain or illness, if we don’t want to acknowledge our emotions. But pain causes fear, and even more anger and frustration (the stress response is kept alive). The only consequence is therefore more pain, as the person starts to anticipate the pain outcome in his/her thinking patterns, repressing the original emotions (the actual trigger) further.*

If you keep creating the same feelings (anger), which lead to pain, and this leads to more of the same feelings (anger), then you’ve entered a vicious cycle of conditioning, which we shall tackle in more detail in the next lesson.

*Sometimes, in the case of an injury that doesn’t seem to be healing, the cycle can start below the red (boiling point) line in the image. In this case there may be no deeper layer of emotion, but it is simply the fear of more pain, and frustration at the injury/pain that keeps it alive.