ABSTRACT
Musculoskeletal back pain brings the body into the consulting room in an unavoidable, compelling way. Consider Mr. H, age 59, who was a vigorous, physically active executive until six weeks ago, when he developed acute musculoskeletal back pain due to Tension Myositis Syndrome (TMS). 1 Our initial session was on the phone because he is immobilized by severe pain. When I enter my waiting room to meet him for our second session, he is lying on the floor with his wife at his side. He needs her assistance to enter my office. Once we are inside, Mrs. H and I use all my pillows to support him in a semireclining position on my analytic couch so that he and I can face each other during the session. He asks that his wife remain with him during the consultation. Fully aware that Mr. H is in great physical discomfort, I nonetheless press forward with the psychoanalytic inquiry that I began in the phone session. 2
