Stress is the least controllable source of our pain - you can avoid the physical triggers but you can't control those things that lead to stress - and it can be either emotional stresses or the pressure that comes from trying to do too much, work too hard, keep going too long, eating improperly, dealing with other pain or physical problem. I too find that breathing exercises and imagery are helpful. And my "places to go" are also quiet and peaceful spots by ponds or streams or the bay (water seems to be important), often I visualize slowly placing pillows in a canoe and then resting myself comfortably nestled in the pile of pillows while the canoe glides over the water. I think perhaps some of the tapes or cds that are available would help if you haven't ever tried this.

As for the capsaicin, I used a lot of it to bridge between the pain breaks that I had when my tn was younger. You just apply it to your face - very carefully, you don't want it in your eyes or mouth or the inside of your nose - and be careful to wash your hands after applying it. I do think it helps. Yes, it burns, but that is something I found less painful than tn jolts, and you get used to it. You have to apply it often enough, and stick with it - one dose won't do it. But since it can't do any harm and might do some good, why not put up with the sting and burn. Be prepared though, after you have it on the burn fades and you'll be surprised when you get near heat, like a hot shower or a hot stove to find that it begins to burn all over again. Maybe some people are more sensitive to this than I am but it never bothered me much.

Learning to manage stress is helpful whether you have tn or not. I'm impressed with the results that they have in teaching stress reduction techniques to patients with everything from cancer to psychological problems, it would be helpful if there were more medical centers that offered classes. I hope that things get better for you whatever you try. Nancy