Two blogs ago I looked at the issue of medically unexplained symptoms. Linked to this is the issue of pain. Pain can, of course, be caused by structural damage (such as a broken bone). Often it has a psychological basis, there is no physical reason; it is driven by emotions. The jargon for this kind of pain is tension myoneural syndrome or TMS.

This raises two important issues for the person experiencing pain: the need to rule out a physical cause (so do consult your GP) and then to accept the diagnosis. For many, dealing with a diagnosis of TMS is extremely challenging because it often strikes people who feel emotionally well and who, because of the way they feel, are convinced that the pain has a physiological cause. Furthermore, research shows that people with TMS focus so much on the physical pain that it stops them from focusing on the psychological pain. In effect, the pain is a way of drawing their attention away from their difficult emotions. It’s not that different from people who comfort-eat when angry, the eating distracts them from their anger, but a long-term solution is to work out the cause of the anger and how to manage it.

So, in answer to the question in the heading of this blog: no, pain caused by TMS is not all in the mind.The pain is real.Nor is its strength an indication of the severity of the emotional cause.We all respond differently and the real issue is the effect of the pain – whether intensely strong, stabbingly intermittent or nagging away in the background – on you.

If an inexplicable pain is affecting your life, psychotherapeutic treatment could well sweep it away by helping you understand and deal with its emotional cause.