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Special Gift(s)

In the MindBody Workbook, Volume Two, we describe an Emergency Note.

I have found that when a pain flareup occurs, it is often impossible to think rationally, plan, and escape the pain.

By writing a note, in advance, you have what you need to calmly work your way out of severe pain or a flareup.

see below:

The Emergency Plan Note: Dealing with Flare-ups

©David Schechter MD


One of the most common questions people have when healing from TMS/chronic pain is what to do when the pain significantly flares up. When dealing with a lot of pain, it becomes very difficult to think, in the moment, of what you are supposed to do. Therefore, we recommend creating an emergency note (on your phone), which forms the basis for an “emotional safety plan”. Create this in advance, so that if you have a pain flare-up, you know exactly what to do. 


The Note should remind you to do some or all of the following:


Breathing: take a deep breath and exhale slowly, repeat for a minute.. This can help your nervous system to calm down even if your thoughts don’t change. 


Self-Soothing Statement: what can you say to yourself that is soothing? Example: I’m safe and this is just TMS. This will end. 


Remind Yourself of the Top 2 Reasons You have TMS: 1) 



3 Positive Distractions: what can you do to help your mind focus less on the pain?   a.               b.               c.


3 Activities that Help Calm You Down: what can you do to calm down and increase your emotional safety?

           a.               b.               c.


A Statement of Hope: draft a statement you can read to yourself

– you are going to be alright.  This will end.

Reminder it’s TMS– there is nothing structurally wrong causing this.

Reminder you’re not damaged!  I'm going to be okay. I've gotten thru this before.  This will pass.


Breathe and try not to catastrophize. Even intense pain will not stay forever. Acknowledge to yourself that you are having a flare-up and that it is very unpleasant. Have compassion for the fact that you are really suffering. Remind yourself that this too shall pass. It is just TMS and you are not damaged. 


Try to identify any underlying emotional trigger for the pain (in other words, practice thinking psychologically). If you can identify a strong feeling, work on addressing it through journaling, self-talk, or speaking with a friend, family member, or therapist. 


Sometimes, processing the underlying emotion brings relief. However, sometimes it does not, and sometimes you may also not be able to identify a strong feeling. In other words, the pain feels “random.” Once you have tried to think psychologically for 5-10 minutes, you don’t need to endlessly grasp for the emotional “answer” to the pain.


Type this into your phone, keep it where it can be easily found in a crisis. Read it to yourself when an intense flareup happens to it should help you calm down and get through the experience.

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