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SYMPTOMS | PATHOMECHANISMS | HISTORY

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Author: Klaus Podoll, Markus Dahlem, Sofia Greene	19. January 2008
Edited by: Klaus Podoll, Markus Dahlem, Sofia Greene

Tension myositis syndrome

Tension myositis syndrome (abbreviated TMS) is a name given by Dr. John E. Sarno to a condition he describes as characterized by psychosomatic musculoskeletal and nerve symptoms, most notably back pain. According to Sarno, TMS is a condition in which emotional stress causes physical pain and other symptoms. Sarno states that the underlying cause of the TMS symptoms is the mind's defence mechanism against unconscious mental stress and emotions such as anger, anxiety and narcissistic rage. The conscious mind is distracted by the TMS symptoms, as the psychological repression process keeps the anger/rage contained in the unconscious and thereby prevented from entering conscious awareness.

In his books Healing Back Pain: The Mind-Body Connection (1991) and The Mindbody Prescription: Healing the Body (1998), Sarno talks "about these lights that he sees just before the onset of a migraine... Dr. Sarno sees this as a TMS equivalent and treats it the same way he would treat other TMS related pain symptoms" (shawnsmith, TMS Help forum, December 20, 2006). In fact, "that was Sarno's first personal experience with TMS that started him on his theory of TMS. He was able to stop the migraines it their tracks at their on-set of the visual snow stage, by shifting his thoughts, from physical to psychological" (tennis tom, TMS Help forum, December 20, 2006).

By analogy to Sarno's interpretation of his own transitory migraine aura symptoms as TMS equivalent, one user of the TMS help forum suggested persistent visual snow (of unspecified etiology) as representing another TMS equivalent, too. "SO I really think we can add this to the TMS equivalents and since we Snow vision people seem to become more and more everyday, maybe Sarno acknowledges it sometimes" (Alpha, TMS Help forum, December 20, 2006).

I am sure it is TMS, because it's VERY disturbing, it is 'strange'

"Hehe, I think you both have no idea what visual snow is. It's not 'just' a light you see sometimes like Sarno describes it (I have read it, he refers in Healing Back Pain and Mindbody Prescribtion to this experience). Visual Snow is a syndrome for its own.

1. I see television like static over my whole visual field, 24/7, since I'm 14. It began without warning, one day I woke up and it was there and never changed really in intensity. It's like a permanent flickering over everything I see.

2. Since this day I see floaters, MILLIONS of them. Like many different layers of floaters. It looks like germs in my eye, little pieces of glass, hard to describe and they swim on my vision, if I look to the side they slowly follow my focus.

3. If I look in light or daylight, I see light flashes all over my visual field which 'crawl' in a consistent pattern, its all very hard to describe.

I visited EVERY eye doctor and neurologist here in Germany and they found nothing, nothing nothing. I made acupuncture, drank disgusting Chinese herb teas, chiropractic, everything. Nothing made it better. Some years ago I found others in the net, they always had an odyssey of doctor visits behind them, and nobody had a clue what it could be. It seems to be a really unknown 'disease' because it's hard to find anything about it. I am sure it is TMS, because it's VERY disturbing, it is 'strange' and with massaging my neck and face muscles I produced a slight change in flickering pattern last month. I find out, that the muscles beyond my eyebrows, beyond my jaw, and around my ear and all over my neck are extremely painful to press, on my neck I have stone-hard knots all over it and so I think that this heavy tensions in head/neck created a oxygen deprivation in my eyes which creates these symptoms, along with mild tinnitus, acne (is gone, but few flare ups now and then), sensitive teeth, headaches sometimes.

But PLZ read this link for a explanation in better English: http://en.wikipedia.org/wiki/Visual_snow.

And more important, if you want get an idea HOW DISTRACTING this condition is, look at this very authentic Image of the three main symptoms in visual snow: href="http://en.wikipedia.org/wiki/Image:Visualsnow-80.jpg.

It's really like a bad TV picture, WITH strange creatures swimming in our TV and flashes all over it (at least, the last JUST if it's very bright), but it's ok. I have it for so long now, it's really not distracting anymore, I don't really see it. It had become normal, I think that's the reason why I developed CPPS as the new main syndrome, because before I get this, I was always afraid about my eyes, I mean REALLY afraid, like lying in my bed every night, sure that I get blind and die soon. After I became the visual snow my main thought was death, I don't know exactly why I was SO afraid, but I was constantly thinking about dying. Really scared to death. I think it was because I had the accident, where my lung collapses one year before and then this ****ing eye thing, it really grabbed me. But as soon as I lost my anxiety and accepted the diagnosis, that there was really nothing wrong I lost my anxiety and sooner or later now 'strange' diseases crawled in my life, always without anything structural.

SO i really think we can add this to the TMS equivalents and since we snow vision people, seem to become more and more everyday, maybe Sarno acknowledges it sometimes. I think I try to write him about it. It's really such a strange condition to have, I am so curios about how a clear and 'quiet' vision is like, I hope i will see it again."

(Alpha, TMS Help forum, December 20, 2006)

The TMS diagnosis and treatment protocol are not accepted by the mainstream medical community because they don't comply with the standards of evidence-based medicine. Critics in mainstream medicine state that neither the theory of TMS nor the effectiveness of the treatment has been proven in a properly controlled clinical trial. Considering the application of the TMS diagnosis to phenomena of migraine aura, more specific objections can be made. From a neuropsychiatric viewpoint, Sarno's notion of TMS is modelled after Sigmund Freud's doctrine of conversion, a defence mechanism whereby emotional stress is repressed and "converted" into physical symptoms (Freud and Breuer, 1895). However, in migraine with aura, stress just acts as trigger or precipitating factor, not as cause. Migraine is not a psychological or psychiatric disease but one which results from biological and physiological alterations. Therefore, Sarno's interpretation of migraine aura in terms of a conversion disorder, and its expansion to include persistent aura, have to be rejected from a neuropsychiatric point of view. Moreover, as Sarno has included lack of known physical cause among the diagnostic criteria of TMS, the making of this diagnosis to explain either transitory or persistent migraine aura phenomena can be rejected on the grounds of Sarno's own diagnostic criteria, as the neurological disorder migraine with aura has to be considered as a known physical cause which is an exclusion criterion for TMS.

References

Freud S, Breuer J. Studien über Hysterie. Franz Deuticke, Leipzig and Wien 1895.
Sarno JE. Mind Over Back Pain. Berkley Trade 1982.
Sarno JE. Healing Back Pain: The Mind-Body Connection. Grand Central Publishing 1991.
Sarno JE. The Mindbody Prescription: Healing the Body, Healing the Pain. Warner Books 1998.
Sarno JE. The Divided Mind: The Epidemic of Mindbody Disorders. Harper Paperbacks 2006.

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