Why I Became a Pain Coach

It all started with a shoulder injury, attributed to an intense rock climbing session. The pain was dull, at times intense, at other times barely noticeable. I wasn’t at all worried. In fact, I was rather intrigued about going to physiotherapy for the first time in my life, especially since the therapist turned out to be extremely charismatic.

Woman climbing

But two months down the line, my shoulder still hadn’t improved. The therapist hinted at a tear, and expressed his doubts about my ever being able to climb again. That’s when things started to turn sour. I tried to climb anyway, but my shoulder felt blocked and it hurt – a lot. It continued to radiate pain at random intervals throughout the day and night. Months later, I paid over $800 to have an MRI, so that I could get diagnosed with a HAGL lesion – a type of ligament rupture that can only be fixed through surgery.

Surgery booked, I saw another physiotherapist for a change of scene. She, as well as my appointed surgeon – reputedly the best in the country – expressed doubts as to whether my HAGL lesion was the real cause of pain. The surgeon said he could indeed fix it, but it would not guarantee that I’d be rid of the pain. What he meant was that the tear may have been an incidental finding – an ‘imperfection’ in my body which in itself, does not cause pain. That drained most of my remaining hope away, yet today I am very grateful for that surgeon’s honesty!

And then, a week before the surgery, I woke up with an intense pain in my legs. So intense, I could barely walk. It was as if all my leg muscles were in spasm. Panicked, I cancelled the surgery because I felt I couldn’t handle both problems at once (and because a small voice inside myself had started whispering to me that surgery was not the solution!).

The pain in my legs did not subside, despite a steroid injection and an intense physiotherapy regime (with a different, equally charismatic, physiotherapist). Instead, a few weeks later, nerve pain in both hands and arms was added to the mix. I stopped working and applied for a disability benefit because I couldn’t even type or sit down without intense pain, and started to despair and believe that there was something more serious.

But I also started to ask questions. Such as, why did the physiotherapist blame my leg pain on lack of flexibility, muscle weakness and a flat foot, when in reality, there were so many people out there who were much less fit than me, who didn’t do any exercise at all, ate whatever they liked, weighed triple my weight, and yet, were completely pain free? I put this question to the therapist, and he admitted that he did not know.

Tension Myositis Syndrome

It was a very lucky coincidence that I discovered TMS – Tension Myositis Syndrome – via a frantic google search, at a moment when I had decided that my life wasn’t worth living anymore, unless I could one day have my old self back. The condition, discovered by the American Professor of Rehabilitation Medicine Dr John Sarno back in the 70s, presupposes that various forms of chronic pain can manifest due to emotional repression or anxiety, and can than be exacerbated by fear, frustration, rage, powerlessness and a host of negative emotions that are all but natural in people who have found no solution to chronic pain, and whose doctors have either told them that they have a condition that is to blame for the pain, or have admitted that they have no clue what’s causing it.

I read up as much as I could about the subject of TMS, and followed a 40-day program, which included educating myself on the science of pain, journalling, meditating and working on radical mindset changes. I learnt how to make sense of my pain, and to identify it for what it really was – a physical, yet conditioned response fuelled by fear, rage, and general dissatisfaction with my present life. And then the magic happened. As I started to respond differently to pain and to strengthen my belief that what I had was only TMS, every single symptom began to subside. Within 5 weeks of starting my TMS program, I was back to rock climbing. I was one of the thousands of people to benefit from Sarno’s discovery, a discovery which had been discredited by the general medical community, but which today is gaining more credibility thanks to the latest discoveries in neuroscience.

What I learned

Along the way I learnt that ‘being over-careful’ and hyper-vigilant does not help at all in the case of chronic pain – avoiding activities that I believed would worsen pain was only strengthening the connection between the activity and pain, as this reinforced the false belief that there was something structurally wrong with my body. Instead, I needed to build up confidence in my body’s ability to be limitless and strong, and to resume all normal activities without fear or doubt. This is a way of countering the Nocebo effect that is so pervasive in chronic pain sufferers – the belief that the slightest movement or activity (or lack of medication) may make their pain worse, and which ends up being a self-fulfilling prophecy because fear and negative expectations are the worst reactions one can have in relation to pain.

By sustaining their belief that there must be something structurally wrong with them (most sufferers end up getting a diagnosis, such as disc herniation, arthritis, scoliosis or even fibromyalgia[1]), patients are simply unable to envision a pain-free life, and the conditioning in their bodies becomes stronger and stronger, like a well-coded program. Most of this takes place subconsciously, so that the pain becomes automatic, a physical response to a non-physical stimulus – just like the case of Pavlov’s dogs who always salivated at a sound of the bell, even when no food was present!


[1]Dr Sarno believed that fibromyalgia was an extreme form of TMS. Although deemed incurable, several fibromyalgics have managed to significantly reduce or overcome their symptoms altogether by adopting his approach and disowning their identity as ‘fibromyalgia sufferers’.

Becoming a Pain Coach

My recovery happened four years ago, and I am now completely free of pain (and if a new symptom does arise, due to a period of anxiety or stress, I am quick to identify it for what it really is, and stop it from the onset). Since then, I continued to study the mind body connection, and graduated as a Holistic Life Coach and MindBody Practitioner from the MindBodyFood Institute in Australia. My decision to become a Pain Coach was fuelled by the realisation of how little knowledge there is of the mind body connection in chronic pain patients and in Western medicine in general. Sufferers are prescribed drugs, physiotherapy, injections and a host of other treatments that may be excellent at treating acute pain (such as pain stemming from a recent injury), but not chronic pain.

My approach to chronic pain is entirely psychological and focuses on making clients aware of any triggers, emotions or personality traits that are contributing to chronic pain, and educating them on the mind body connection. Most importantly, the approach involves learning how to respond differently to pain, by substituting emotions like fear, anger, frustration, hopelessness and disappointment, with more neutral emotions, positive expectations, empowerment and trust in a better outcome. The more clients practise changing those old habitual emotions, the easier it gets, so that their altered response to pain becomes their new ‘habit’, and their brain no longer remains hard-wired for pain. All of this not only has the side-effect of reducing or eliminating pain, but also helps people develop healthier ways of thinking, build a self-care routine and reduce stress and anxiety in their lives.

If you are still doubtful, think about the below for a while:

If a broken bone can mend itself within 6 weeks, then why does chronic pain[1]* have to last forever?

Why are there so many people with conditions like disc herniations, arthritis and a host of other structural abnormalities, who are living a pain-free life? (lispinemed.com). What if these are simply ‘incidental’ findings that have nothing to do with your pain?

If there is something structurally wrong with you, then why does the pain come and go and vary so much in intensity, and even perhaps change location? It’s as if the pain has got a ‘mind’ of its own (maybe it has a mind!).

An injury would always hurt in exactly the same way, all the time, until it heals.

Despite the ‘dirty’ work of getting to terms with unpleasant emotions and having to challenge your body’s hard-wired responses, mind-body work for chronic pain can be the most rewarding and life-changing journey you can ever embark upon. Determination, honesty, and an open mind are all that’s needed. Oh, and a touch of bravery to challenge those thought patterns and beliefs that are not serving you.


[1] Not all chronic pain symptoms are due to Tension Myositis Syndrome – the TMS Wiki can help you figure this out. Sufferers should always exclude serious underlying conditions first, such as cancer, certain degenerative diseases or infection.

About the Author

Miriam is a Holistic Life Coach and MindBody Practitioner specialising in healing a range of chronic pain symptoms by combining psychology and neuroscience. She is the owner of the Blog PainOutsidetheBox.com, and although she is based in Malta, offers one-to-one virtual sessions as well as a 6-week program to clients from all over the world.

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