Diagnosis and Treatment For TMS
Step 1: Accept The Diagnosis
A key to getting well from TMS is understanding and believing the diagnosis! The TMS pain process occurs, we believe, in order for the unconscious mind to hide "unacceptable" emotions. It is a form of distraction.
When this TMS process is exposed, the symptoms begin to resolve. Accepting the diagnosis also pushes aside fears of a damaging structural condition that may reside in your belief system.
The treatment program begins with the diagnosis, which is typically made at the time of the initial consultation. The diagnosis is crucial and there are too few physicians who can make the diagnosis. This initial visit (in-person ideal, or telemedicine) leads to a series of recommendations and referrals as appropriate for your individual problem.
Patients are typically seen for a 45 minute initial consultation. Usually a follow-up visit at 3-4 weeks is advised and additional follow-up is scheduled as required. Follow-up visits may be appropriate for telemedicine. For initial visits in person or for telemedicine in California, contact the office; many visits are PPO insurance eligible. You must be in California or in-office as of April 2023.
The program of treatment is about empowering people to get well (not to become dependent on the practitioner) and therefore involves fewer visits than other approaches to chronic pain. Homework is essential and psychotherapy is often very important, as well. (Group and individual options)
Step 2: Think Psychologically
The second part of the treatment process is learning to think psychologically, not physically. By this we mean focusing on emotional tension and your internal response to external events and not on prior, conventional, mechanical or so-called structural explanations for your pain. We also teach a cognitive system of blocking, then shifting attention that is very effective. (a form of self-talk)
It then becomes crucial to gradually become more physically active; this further causes the apprehension and fear to diminish.
Patients with intense, long-lasting, or debilitating symptoms benefit from TMS psychotherapy. Both in the LA area and beyond I am fortunate to have developed professional relationships with psychotherapists who are accomplished "TMS Therapists". More than one has successfully treated his own pain via a TMS model. All of these therapists are skilled in telephone or Zoom therapy. They utilize elements of PRT (pain reprocessing therapy), EAET (emotional awareness expression therapy), CBT (cognitive therapy), psychodynamic therapy (deeper therapy), and other methods that are individualized for you.
I am able to do telemedicine visits some international patients.
We are now offering a weekly Zoom TMS Healing Group** where 6-9 patients get to interact with other people with TMS, learn from one another and from me and my co-leader, a TMS psychotherapist (Justin Barker, Psy.D.). Feedback has been excellent about this group, which has entered its 3rd year. The group is for diagnosed patients; contact the office for a diagnosis or if you have one, or for a reservation. Typically I advise patients to commit to a four week block of meetings in order to make significant progress. Meetings are 6 pm Tuesdays, Pacific Time on Zoom. **
While not every patient needs to see a psychotherapist as part of their TMS treatment, I find that the percentage of those that benefit from therapy is quite high. In my experience, I use this collaborative treatment model more than is cited in earlier books. (e.g. Dr. Sarno's) I try to tailor my referrals to an individual patient's personality and circumstances, which I learn during the initial consultation. Most therapists work virtually, so proximity is less of an issue.
If you see a psychotherapist in your area who is not familiar with TMS, suggest they learn more about this disorder via the web site, written materials, podcasts, and videos.
For most of our patients, daily journaling is a key part of the treatment program and recovery process. The MindBody Workbook offers a structured approach to therapeutic journaling. Challenging but rewarding!
** Comments on Group:
"Doctor Schechter's TMS Group saved my life! I am a classic TMS patient and his group therapy was the most helpful thing I have done and was able to get me 100% pain free. He is simply one of the best doctors in Los Angeles. He goes the extra mile for his patients. I am grateful to have met him!"
Nadia B. Agoura Hills, CA
"One of the most valuable aspects of the group sessions is being able to listen to and speak with others who have TMS. For those who are a little skeptical of the diagnosis, this gives them the opportunity to hear what others think. What initially appears to be a group of strangers quickly evolves into the feeling of talking with old friends who happen to have the same problem. I would suggest that anyone who is newly diagnosed attend some sessions."
Lori F. West Los Angeles
Some Concepts to Clarify:
What is Mind-Body?: Mind-Body is a term that tries to capture the true holistic element of the human experience. We are both a mind and a body. They are linked and connected. What influences one influences the other.
The Cartesian Split: Western medicine has unfortunately, for hundreds of years, de-linked the mind/brain and body. However, both modern scientific research, clinical insights, the pioneering work of John Sarno MD, and others, have begun to correct this error..
Reconnection: By understanding mind-body and utilizing the mind-body linkage, conditions that were otherwise untreatable by both conventional and alternative practitioners can be understood and solved!
Due Diligence: We always ensure appropriate work-up and testing is done. Some people suffer from both a structural issue and a mind-body issue. While we have advanced so much technologically in medicine, somewhere the human element was lost. Age-old wisdom combined with the scientific evidence from functional brain imaging (f-MRI) and other types of research have redefined our understanding of pain.
Chronification: I discuss the chronification process in more detail in Think Away Your Pain. But chronic pain is a different condition than acute pain. Chronic is localized more in the 'emotional brain'-- the prefrontal cortex, amygdala, etc. Acute pain is more of a sensory-motor experience.
updated Feb 2024
