Tag Archives: mind

Brain with symptoms of Dementia (Image by Natasha Connell from Unsplash)

Are Amma’s Memory Lapses Normal?

Sukham Blog – A monthly column focused on South Asian health and wellbeing.

Amma is fiercely independent. “I’ll take care of myself as long as I can,” she insists. Living by herself, she manages all her needs. Not being a burden on others is a matter of pride for her, and we, her children, are really proud of her. A couple of months ago, however, we began to notice changes that made us uneasy. On a shopping trip one day, she couldn’t recollect why she’d come after we got to the store. Last month, after dinner at her home, she wondered aloud if she had taken her medicines, although we had seen her do so just fifteen minutes earlier. She asked me over a few days ago to help move some boxes but didn’t remember that when I got there. Were her memory lapses normal? She seemed just fine otherwise! 

We all forget things.  I thought I left the car keys right here, but I don’t see them now.  Did I lock the front door?  Did I turn off the stove?  It was really embarrassing – not remembering her name when she came up to say hello at the party last night. Memory lapses are commonplace, and we generally brush them off casually – even jokingly sometimes, saying “I had a senior moment,” implying that such behavior is associated with aging. However, it’s really important we learn to recognize when such incidents are not normal memory lapses, but signs of something more serious – signs of dementia.

Forgetfulness is often caused by normal, age-related memory loss. It can also result from lack of sleep, or be induced by stress or depression, even in younger people.  When it is part of a larger pattern, however, it could be a warning sign of dementia; an umbrella term that describes a collection of symptoms including changes in thinking, memory, or other cognitive functions. Dementia can be caused by a number of disorders that affect the brain such as Alzheimer’s disease, vascular dementia, or Lewy Body disease – to name a few. People with dementia have significantly impaired intellectual functioning that interferes with normal activities and relationships.   

The Alzheimer’s Association provides a very useful guide to recognizing the 10 early signs or symptoms of dementia:

  1. Memory loss that disrupts daily life.
  2. Challenges in planning or solving problems.         
  3. Difficulty completing familiar tasks.
  4. Confusion with time or place.
  5. Trouble understanding visual images and spatial relationships.
  6. New problems with words in speaking or writing.
  7. Misplacing things and losing the ability to retrace steps.
  8. Decreased or poor judgment.
  9. Withdrawal from work or social activities.
  10. Changes in mood and personality.

Here are some examples of such behavior:  Trouble balancing a checkbook. Forgetting dates and events. Repeating the same questions over again. Trouble following a recipe they’ve used for years. Difficulty concentrating or taking longer to do things than before. Remembering directions to a place they have visited often. Forgetting where they are or how they got there. Inability to keep up with a group conversation. Losing things and/or accusing others of stealing. Giving up hobbies and other regular activities. Losing interest in social activity. Experiencing sudden mood swings, or easily getting fearful or anxious. If you begin to see repeated patterns of these kinds of behavior in yourself, a family member, or a friend, do not ignore them!

A slight, but noticeable and measurable decline in cognitive abilities, including memory and thinking skills is called mild cognitive impairment or MCI. MCI usually does not significantly affect a person’s ability to carry out his or her daily activities, although you can usually spot its symptoms if you know what you are looking for.  An early diagnosis of MCI and identification of possible causes – such as the side effects of medication – is very important. People with MCI (this includes about 15-20% of seniors over 65) are more likely to develop Alzheimer’s or other dementia-related diseases. Some in this population remain stable or get back to normal cognition if the underlying cause can be removed. In many cases, however, MCI is an early stage in the onset of Alzheimer’s or other dementia-related diseases. 

Alzheimer’s disease is one of several terminal, progressive brain disorders with no known cause or cure.  The Food and Drug Administration (FDA) has approved a few drugs for the treatment of its symptoms. However, memory, cognitive functions, and the ability to care for oneself continue to decline, until the individual has little awareness of his or her surroundings and requires round-the-clock supervision and care, including help with personal care and all other activities of daily living.

It’s therefore even more important to contact a doctor as early as possible for a thorough examination if a parent or other family member shows signs of cognitive impairment or dementia. A specialist in cognitive function can conduct a thorough examination and evaluation that includes physical exams, diagnostic imaging, and neuropsychological testing, to determine whether these are symptoms of normal aging, of MCI that is potentially reversible, or of a condition that will eventually progress to dementia.  There is no single definitive test; neurologists, geriatricians, and psychiatrists typically use a combination of tests and assessments in their diagnosis.

The statistics on dementia and Alzheimer’s disease are grim. Around 50 million people live worldwide today with dementia-related disorders. Alzheimer’s Association estimates that six million Americans currently live with Alzheimer’s, increasing to 13 million by 2050.  Dementia and Alzheimer’s related deaths increased by 16% during the current COVID pandemic.  The Centers for Disease Control and Prevention ranks it the sixth leading cause of death in the United States; it kills more than breast and prostate cancers combined. Between 2000 and 2019, deaths from heart disease decreased by 7.3%, while Alzheimer’s related deaths increased by 145%. 15% of the population 70 and older has dementia. 1 in 3 seniors dies with Alzheimer’s or another dementia. Dementias will cost the US an estimated $355 billion this year, not accounting for more than 11 million people who provide unpaid care for family members or friends. 

This is a national and worldwide crisis, and we need to learn to recognize potential signs of dementia and act early if we see them.  We also need to learn how to deal with dementia.  A subsequent article will discuss what to do if Amma receives a dementia diagnosis.


Mukund Acharya is a regular columnist for India Currents. He is also President and a co-founder of Sukham, an all-volunteer non-profit organization in the Bay Area that advocates for healthy aging within the South Asian community. Sukham provides curated information and resources on health and well-being, aging, and life’s transitions, including serious illness, palliative and hospice care, death, and bereavement. Contact the author at sukhaminfo@gmail.com


 

Happiness Beyond Mind: An Individual Experience

Simplicity is not simple. It takes a lot of thought and effort to condense complex concepts to a simple, practical, and easy to follow recipe for getting to “contentment” or “happiness”. By distilling the essence of ancient Indian philosophy, practicing it himself, and sharing his experiences as he travels the path of dharma (good life conduct), Rajesh Sengamedu has created a forehead-slapping page-turner of a book.

Happiness Beyond Mind gives us a clear path to rethink, structure, and execute our entire life in “thought, word, and deed” to journey to a state of contentment and happiness. As Gandhi once said “the path is the goal”, Rajesh’s book is the path.

As soon as I flipped through Rajesh’s acknowledgments, I found it thoroughly engrossing as he takes us on a journey of deep thought and introspection on why, with all worldly accomplishments and success we still feel empty and conflicted, with examples from his own life. It is this trait of personal experience that immediately sucks you into his journey into spiritual realization — you can connect with him as you look back on your own life. His language is simple for us to understand and relate to. He does revert to colloquialisms which really help emphasize and drive his points home. You really get it.

The stories and anecdotes deserve special attention. Rajesh beautifully blends quite complex analogies from the ancient Upanishads and the Bhagavad Gita with his own experiences with family, friends, and colleagues — and I found myself with a big lump in my throat or nodding or simply going “now I’ve never thought of it that way!” This is not an easy thing to achieve.

Author, Rajesh Sengamedu

Rajesh also makes it clear that Indian thought and philosophy are monotheistic, contrary to lots of misconceptions promulgated by iconoclasts. The key is to follow dharma in thought, word, and deed and ultimately merge with the Absolute Reality, the one Supreme Being.

The ratha kalpana analogy from the Kathopanishad was what I would call mind-blasting (no pun intended). It would take a lot to erase the characters from memory; the passenger (ego), the charioteer (intellect), the reins (emotional mind), and the horses (five sense organs). This analogy and the function of how the entire chariot (human body) functions may appear so obvious AFTER you’ve heard Rajesh describe it. And of course, great examples are the letters to his daughter and son actually at the end of the book in three Appendices, but they’re like The Gita (the core essence) of the book! You could just read those and consider them a synopsis of the entire 185 pages preceding them.

The prescriptive part of the book where Rajesh insists that we follow the path of dharma (right life conduct) dives deep into how to think, how to handle day-to-day life situations with words, and of course action — with yoga and meditation, and finally how to approach the goal of understanding oneself and that we are part of the larger whole. “Do try it!” goes his persuasive, characteristic nudge throughout the book, you can almost picture him smiling benevolently over you. I personally found this portion extremely helpful. This will be a practical takeaway for me for years to come. This is the enduring portion and can only be realized through action. You know the author is already on the path and is speaking from his personal experience and transformation. You also realize the importance and reverence Rajesh gives his Gurus, showing a deep sense of learning, understanding, and gratitude.

I strongly urge all readers, young, old, innocent, not so innocent, brash, arrogant, big-hearted, small-hearted — to read Rajesh’s work. For each one of us reading will walk away with our individual experience and messages, and it automatically becomes The Happiness Beyond the Mind WE know for ourselves.


 Raj Gopalaswamy has over 18 years’ leadership in innovation, business strategy, account management, and new product development. 

Sushant Singh Rajput Jolts Global Mental Health Dialogues

Trigger warning regarding mental health and suicide.

Sushant Singh Rajput, Disha Salian, Sudha Devi lost to mental health

Mental health has been exacerbated during the COVID-19 pandemic. Headlines relating to suicide have sent shock waves through the community. A successful tinsel star, Sushant Singh Rajput and his former manager, Disha Salian, succumbed to their mental health within one week of each other. And in a tragically poetic fashion, as Sushant Singh Rajput’s last rites were performed, his sister-in-law, Sudha Devi, passed away, who had allegedly stopped eating upon learning of his death. The rippling effect of mental health ran its course.

Popular for his acting in both TV and film, the 34-year-old actor, delivered a strong anti-suicide message in his last seen 2019 film ‘Chhichhore’. On June 14, 2020, the actor was found in his Mumbai home. He was reportedly suffering from depression. A week earlier, he had written a heartbroken Instagram story addressing the suicide of his 28-year-old former manager, Disha Salian.

Is it the lockdown and the resulting loneliness or is it the disease itself?

“It is both,” said Dr. Farida Sohrabji, Regents Professor and Interim Head, Department of Neuroscience and Experimental Therapeutics, Texas A&M College of Medicine, at a webinar organized by Ethnic Media Services, June 12, 2020. Both the molecular impacts of the virus and the pandemic-related isolation leads to depression,” she said.

The impact of social isolation can be quite devastating in many ways. Social isolation increases the risk of cardiovascular ailment, heightens the symptoms of autoimmune disease, and increases mental health issues. Not interacting with people increases the stress hormone cortisol and weakens the immune system. People who don’t have the virus but are being socially isolated slip into depression. The senior population, or those with comorbidities like diabetes, hypertension, etc., are isolated for their own good. They are entrapped by voluntary confinement and fall prey to depression.

And then there are those that are infected by the virus.“The virus enters the body through the nose,” says Dr. Sohrabji, “The nose is somewhat exposed to the brain and the virus can end up in the brain in the olfactory system (how we smell things). This area is strongly implicated with depression.”

Additionally, the full-blown inflammation caused by the virus has an effect on the brain and mood of the patient. “The proteins that fight the virus slash and burn cells in the war against the virus and the resulting inflammation can lead to depression,” she said. “ The medical community’s first thought was that the virus is akin to a respiratory disease but it has been noticed to be more than that. A broad basket of mental issues has been caused by it.”

Social distancing to prevent the spread of the virus can lead to depression and anxiety, while those infected with COVID-19 can experience mental health issues, including depression. Being cognizant of the dangers caused by the lockdown can help us help each other stay sane and safe. 

What can help?

A study by Harvard Medical School has a unique solution. Foster a pet. Pets have a calming effect. Dogs’ calming effect on humans appears to help people handle stress, the study says. Research suggests that people with dogs experience less cardiovascular reactivity during times of stress. That means that their heart rate and blood pressure go up less and return to normal more quickly, dampening the effects of stress on the body.

The power of touch appears to be an important part of this “pet effect.” Several studies show that blood pressure goes down when a person pets a dog. Having a dog is good for your heart too, says the study. Besides, dog owners tend to get more exercise as well. As coronavirus spreads across the US, Americans have stepped up to foster and adopt animals, keeping them out of shelters.

Contextualizing

”We come up with our sort-of explanations, even if they are not particularly persuasive, and then file the event away,” says Malcolm Gladwell on suicide. “I keep coming back to how important context is in understanding behavior.” 

The incontrovertible fact is that Sushant Singh Rajput, Sudha Devi, and Disha Salian were casualties of mental anguish during the lockdown. Rest in peace to all the lives that have been lost due to mental health.

Ritu Marwah is an award-winning author whose interest in history has led her to chronicle our life in times of COVID. How many more must we lose?

Five Reasons to do Yoga this Holiday Season

Holidays can be a busy time to say the least; in spite of the joy surrounding it, you are pulled in different directions physically, emotionally and financially. For me, every year when the holidays come around, I resort to yoga. Yoga has been a constant thread in my life, one that I seek especially when my cup is overflowing.

The term yoga comes from the Sanskrit word Yujir which means ‘to yoke.’ The Bhagavad Gita says, “Yoga is said to be equanimity” (2.48); “Yoga is skill in action” (2.50). The Yoga Sutras of Patanjali say, “Yoga is the suppression of the activities of the mind.” An asana practice helps us achieve the higher goal of yoga. For me, asanas create equanimity which furthers my intention and understanding of utilizing that skill in all action that Lord Krishna is talking about. Asanas help calm the mind to take on the world a little better everyday. So if you are overwhelmed with love, joy, stress, foodlists, shopping lists or just too much on your plate, consider yoga this holiday season. 

Here are five reasons to give yoga a chance.

Stillness

What I crave most is silence when I’m consistently going to holiday parties and hosting guests. Carving out a few minutes for silence can really reset the body and mind’s rhythm and re-center me so I can face life’s busy-ness again.

Poses I love: Balasana ( Child’s pose), Viparita Karani (Legs up the Wall), Shavasana(Corpse Pose), Surya Bhedana (Sun-Piercing Breath) and Chandra Bhedana (Moon-Piercing Breath).

Detox

Who does not need a mind and body detox after the holidays? Inversion poses are really helpful for blood circulation and thus promoting detoxification and moving fluid to the lymph nodes.

Poses I love: Adho Mukha Svanasana (Downdog), Eka Pada Adho Mukha Svanasana (One leg dog), Salamba Sirsasana(Headstand), Dolphin pose

Digestion

All that turkey and stuffing along with endless gingerbread men keeping you bloated all holiday season? I find that my digestion is sluggish, especially paired with the colder temperatures. A few simple poses that aid digestion can go a long way. 

Poses I love: Bharadvajasana (Seated twist), Pavanmuktasana (Wind Relieving Pose), Salabhasana (Locust) and Agni Sara.

Gratitude

The economic commercialization of the holidays makes us forget the true reason for their existence. Yoga makes me stop to give thanks for the opportunity to have and love family, community and God in my life. Giving thanks makes the chaos of my life worthwhile.

Poses I love: Apanasana (Knees to chest), Malasana( Yogic Squat), Ustarasana (Camel Pose), Balasana (Child’s pose), Padmasana (Lotus Pose).

Burning Calories

Okay let’s get real, everyone puts on those extra pounds during the holidays and everyone is seeking to burn calories. No time to go to gym? Yes yoga can help burn calories too! A vinyasa flow including the following poses can help tone and strengthen.

Poses I love: Plank pose, Utkanasana (Chair pose), Surya Namskar (Sun Salutation), Chattaranga Dandasana (Four Limbed Staff Pose), Navasana (Boat pose), and Agni Sara.

Preeti Hay has been a lifelong student of yoga. She has written for Yoga International, Yogi Times, India Currents and Khabar Magazine among others.

Building Resilience

In this fast-paced society, we are increasingly stressed for longer periods of time. Dr. Sanjay Gupta – neurosurgeon and Chief Medical Correspondent for CNN – describes an epidemic of chronic stress in the HBO documentary “One Nation Under Stress, with 8 in 10 Americans experiencing stress daily. Stanford neuroscientist Dr. Robert Sapolsky explains that while stress response originally evolved as a life-saving and coping mechanism to deal with external threats or dangers, we now generate stress responses to non-life-threatening situations including interpersonal conflict, deadlines, health concerns, jobs and finances. The United States of Stress 2019 reports that chronic stress affects people of all gender and ages, particularly younger people, exacting a stunningly toxic toll on the body, brain, mind, and soul. Its ongoing assault wears us down, measurably aging — or “weathering” — our insides, for some of us much more than others. Chronic stress zaps brainpower by damaging neural pathways and skewing judgment. It compromises the immune system. It taxes the heart, kidneys, liver, and brain. Multiple studies show that high stress adversely impacts physical and mental health leading to higher levels of chronic pain, addiction and suicide. Learning to deal with stress can be a powerful addition to our personal-wellbeing arsenal.  

The American Psychological Association defines Resilience as the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress … It means “bouncing back” from difficult experiences. This article explores the relationship between stress and how your brain functions, and simple techniques to “bounce back” to – to build Resilience.  

Dr. Amit Sood tells us how. As a physician and professor of medicine at Mayo Clinic he created their Resilient Mind Program. Now executive director of the Global Center for Resiliency and Well-Being, he’s an internationally recognized expert on proven resilience techniques. “Cognitive and emotional loads we carry have increased progressively over the past two decades” he says; our brains possess a finite ability to lift these loads and get overloaded, “just as our ancestors’ backs were when manual labor was predominant.” This excessive load decreases quality of life, so we have to find ways to increase our lifting capacity if we don’t have ways to reduce it. “Resilience is our capacity – the core strength – to lift the load of life,” he says. It has several components: physical, spiritual, cognitive and emotional. Cognitive resilience relates to the amount a person can remember and handle, while emotional resilience measures the amount of negative emotion one can manage before getting stressed. Research led by Dr. Sood and several others shows that higher resilience correlates with better emotional and physical health, better relationships, success at work and the ability to handle adversity and grow despite downturns.

Our body hosts resilience in the brain and heart, our two main active organs. Heart health impacts physical resilience while cognitive, emotional and spiritual resilience are centered in the brain. “We understand how exercise, diet, sleep and sometimes medications keep the heart healthy and strong,” Dr. Sood explains, “with recent advances in neuroscience we are just learning that how the brain operates is critical to cultivating resilience.”

The evolution of the human brain has given it some operational vulnerabilities which predispose us to chronic illness and premature death. These can be traced back to the instinctive suspicion about everything around them that our ancestors developed in a quest for survival. Suspicion was their means to deploy attention, and is the genesis of our negativity bias today. Their need to constantly scan their environment for external threats has led to our wandering, jumpy attention. Although we have since collectively created a completely different world where the cause of death has shifted from external injury to heart disease and cancer, these brain vulnerabilities persist. Dr. Sood points out that while our brains tire after 90 minutes of cognitive work, we work 12-14-hour days, enabling emotional and cognitive vulnerabilities to manifest and influence our actions. “Nature gives us ‘baseline’ brains and hearts, and we have to keep ‘upgrading’ them through training,” he says, “resilience boils down to becoming aware of how our brain operates – particularly its vulnerabilities – and learning how to overcome them.”  

How can you do this? Dr. Sood has developed a structured approach in the Resilient Option. At its core is an integrated three-step process to develop awareness, attention and attitude (positive mindset). First, become aware of the brain’s vulnerabilities and take charge to train its attention and attitude. Second, develop an intentional attention that is strong, focused and immersive. Third, cultivate a resilient mindset or attitude through practices that best resonate with you such as meditation, prayer, music, or working out. This approach enables you to view your world in a broad context instead of a short-term one that could frighten or stress you. The resilient mindset is built around five guiding principles: gratitude, compassion, acceptance, meaning and forgiveness that reframe your perspective, integrating teachings of several disciplines including psychology, cosmology, spirituality to develop your unique model of self, life and fulfilment. You start by assigning one day in the week to each principle, and develop short specific practices that are emotion- and relationship-centric. Short practices are key for success – Dr. Sood refers to the ‘two-minute rule.’ We all struggle to sustain lengthy practices because of inherent weak attention and the tugs and pulls of our daily lives. In time, you integrate the three steps and five practices into your daily life, pre-emptively experience more joy by the practice of gratitude and compassion, and recover quickly from negative experiences or moments of negative emotion because you are able to more easily find gratitude or compassion through that experience and have learned to accept, find meaning and forgive. You live a life of your choosing, and are not reactive but responsive and intentional. Your energy increases and you develop better relationships. Fifteen years of research and over 30 clinical trials have proven that this approach is easy and powerful, enabling positive changes with little time investment. Find out how resilient you are.  Get your resiliency score, and start building it with these tips from Dr. Sood.

With sincere thanks to Simon Matzinger at Unsplash for the use of his beautiful photograph.

Sukham Blog – This is a monthly column focused on health and wellbeing.  

Mukund Acharya is a co-founder of Sukham, an all-volunteer non-profit organization in the Bay Area established to advocate for healthy aging within the South Asian community.  Sukham provides information, and access to resources on matters related to health and well-being, aging, life’s transitions including serious illness, palliative and hospice care, death in the family and bereavement. If you feel overcome by a crisis and are overwhelmed by Google searches, Sukham can provide curated resource help. To find out more, visit https://www.sukham.org, or contact the author at sukhaminfo@gmail.com.  

 

Think Away Your Chronic Pain

Think Away Your Chronic Pain

In his book, The Divided Mind, John Sarno describes the case of a young engineer who was suffering from severe back and leg pain for over eight months. He had tried conventional treatments, but to no avail. His MRI showed a herniated disk for which he had been advised surgery. Hoping to avoid this, he came to Dr. Sarno, a pioneer in treating mind-body disorders.

On the day of his appointment, his leg pain was especially severe. During the consultation, he described how his job, in which he supervised four people, was very stressful and burdensome. Then, as the conversation continued, he suddenly realized something and said, “I don’t want that job of mine. It’s too hard and there’s too much responsibility. I want a job where someone will tell me what to do.” And as this revelation flashed in his mind, his severe leg pain simply disappeared.

If this anecdote about the healing power of the mind seems incredible, you can find other similar, albeit less dramatic stories when you read the numerous online reviews for the books mentioned later. Many people have cured their refractory chronic pain of decades by simply reading a book!

Mind Over Body
There is little doubt that our mind affects our body in myriad ways. We blush when we are embarrassed, our blood pressure increases when we visit a doctor’s office, and our heart races when we are frightened. In these examples, the association between the psychological cause and the physiological effect is easy to see because both are acute (short-lived). However, when certain negative emotions such as anger or anxiety become chronic, they often lead to physiological effects or disorders that are also chronic. This makes it harder to determine the root cause of such disorders.

Examples of such chronic or recurrent disorders include musculoskeletal disorders such as back pain, neck and shoulder pain, sciatica, carpal tunnel syndrome, as well as other disorders like migraine headaches. Although these disorders may be simply referred to as psychosomatic disorders or mind-body disorders, they are also known by a more distinctive name: Tension Myositis (or myoneural) Syndrome or TMS.

Psychological Origins of TMS
Many people experience negative emotions, such as anger, anxiety, fear, or guilt in their lives. These emotions may arise from a traumatic episode in the past, or from a current situation such as a difficult boss, family conflict, or serious health issue. Such emotions are often short-lived, but when they become chronic, they become unbearable. Moreover, open venting of such emotions may be socially unacceptable. Consequently, they get buried or repressed in the subconscious recesses of the mind where they start producing TMS symptoms such as chronic muscle pain.

According to Sarno, a key purpose of these TMS symptoms is to create a physical distraction for the mind to keep it focused away from the repressed emotions. Thus if you relieve a specific symptom of TMS, such as shoulder pain with drugs or surgery, without addressing its root cause (repressed emotions), the pain will move to another part of the body. This is called the “symptom imperative,” and ensures that physical pain is always present to distract the mind away from repressed emotions.

An alternative theory by Dr. Scott Brady posits that the continual stresses and negative emotions in our modern life overload our autonomic (involuntary) nervous system (ANS) which was designed to handle such stresses (requiring a fight-or-flight response) for short periods only. The perpetual overloading of ANS leads to what Brady calls the “autonomic overload syndrome (AOS).” Both TMS and AOS have similar symptoms and treatment options.

Physiology of TMS
The TMS pain isn’t “all in your mind.” It is a real pain caused by a physical dysfunction. However, the dysfunction itself is caused by the mind and not by a structural abnormality. The mind controls the involuntary functions of the body such as heart rate through the ANS. In particular, the ANS regulates the circulation of blood within the muscles through the widening and narrowing of tiny blood vessels called arterioles.

The TMS pain is caused by the narrowing of these blood vessels, which reduces blood and oxygen supply to muscles, leading to oxygen deprivation and pain. For example, studies show that chronic neck pain is associated with reduced blood flow to the upper trapezius muscle.

Diagnosing TMS
There is no single definitive test for TMS. However, a number of clues may point towards it. The failure of conventional treatments to control the chronic pain is a significant clue. The TMS pain also tends to increase during a stressful period and decrease during a relaxing activity or vacation. Moreover, the TMS pain may jump around in the body, i.e. when the pain in one area subsides, the pain in another area becomes more intense.

The personality of the patient may also provide some clues. People who are perfectionists, people-pleasers (who can’t say no), or stoics are more likely to get TMS. A good candidate for TMS is a traditional Indian woman who often says “yes” to her mother-in-law’s unreasonable requests with a smile, while building up deep resentment inside.

All these clues and pain symptoms may be weighted and combined using an online questionnaire (google for TMS Questionnaire). If the overall evidence is still inconclusive, a consultation with a psychotherapist may be helpful in making a final diagnosis.

Treatment of TMS
The TMS treatment begins with the education of the patients. For best results, the patients must sincerely believe that their pain is psychosomatic, not structural. This may involve attending some lectures on TMS or reading some books, such as The Divided Mind and Healing Back Pain by John Sarno, Pain Free For Life by Scott Brady, and Unlearn Your Pain by Howard Schubiner. Many patients heal by learning the true cause of their pain, namely, repressed negative emotions.

The next step in the treatment involves therapeutic writing, also called depth journaling. It is a form of self-discovery in which patients write a daily journal about their stresses and sources of negative emotions, both past and present.

In principle, TMS would disappear if patients could simply banish negative emotions from their lives. But this is usually impractical. For example, one may learn to control overt anger, but taming subconscious anger and resentment requires nothing short of a major spiritual transformation. As part of the treatment, patients are also encouraged to resume normal physical activities that may have been restricted to do earlier based on incorrect structural diagnoses. There is no drug, surgery, or physical therapy required at any stage of the treatment. However, in some cases, psychotherapy may be required to unearth deeply buried emotions.

This mind-body approach has been successfully used by Sarno, Brady, and others to treat thousands of TMS patients. Approximately 80% of these patients have achieved a remarkable 80-100% improvement in their pain within a few months.

If you are intrigued by the possibility that your chronic pain may be related to TMS, please read a TMS book and follow the steps suggested. As you think away (and write away) your chronic pain, you can thank Dr. Sarno for his path breaking research in this field.

See tmswiki.org for a list of TMS physicians and therapists in the United States.
Vijay Gupta studies and writes about health issues from a consumer’s perspective.