“It’s All in Your Head”

Barker rides Sarlat

Is this preacher heading for mass?

OK, I’ll admit it – at the very least for the benefit of all six of my regular readers. In the past few weeks, I have become an evangelist for Dr. John Sarno, who has been swimming against the current on U.S. back pain treatment for years.  

I’ll try not to bore you with the background (again), but he believes most chronic back pain is related to emotions and fear surrounding injuries – not the result of some “structural” problem like a ruptured disk (my 1990 diagnosis).

I believe him because my back has gotten progressively better since I began reading his books – a result many others have reported. It’s called “Knowledge Therapy” because simply making the connection between stressful thoughts that trigger back pain and the pain itself relieves suffering.

But back to the reason for this post. Several people – including my wife and my mother – are skeptical of my conversion. My wife was particularly so because I told her of Sarno’s suspicion that many other ailments, including ulcers, colitis and hay fever (my wife suffers from allergies) are the result of the same mind-body connection that leads to lower back pain.

The nature of their skepticism can be boiled down to this paraphrase: “You’re saying it’s all in your/my head? I’m just not buying it.”

Just to clarify, Sarno and a bunch of his followers actually are saying the opposite: “It starts in your head, but the pain is actually the result of a physical process.”

It’s call Tension Myositis Syndrome, or TMS. Sarno theorizes that negative subconscious thoughts manifest in a physical way by constricting blood flow to muscles, ligaments and nerves – most often in the back or neck area. This causes pain because there is not enough blood, i.e. oxygen, to carry waste away and allow the tissue to function properly.

Over the course of thousands of disagnoses, Sarno determined that a certain type of personality is predisposed to TMS – we are perfectionists who are generally harder on ourselves than anyone else. He says the syndrome is characterized by the body generating physical pain to distract the sufferer from dealing with the negative emotions they’re feeling (classic avoidance behavior – another bulleye on my persona).

Fixing this problem is a matter of understanding where it’s coming from and acknowledging that your emotions are being manifested in a physical way. But another very important factor in my ongoing recovery has been separating myself from the fear of my diagnosis (this may be the most powerful medicine of all, for me).

It’s powerful because for 20 years I’ve defined myself as having “a bad back”. In doing so, I’ve protected it by limiting certain activities and exercising religiously but I still have always thought of myself as seriously injured for life. By thinking of my problem as a minor, fixable circulatory problem instead (and beginning to run again and carry myself differently, as if I’m not injured), I have addressed a huge subconscious fear of disability and begun healing my back in the process.

In fact, I ran more than a mile today – with the strong support of my enthusiastic wife, I might add.

So maybe you’re still thinking, “He’s giving too much credence to the effects of these ‘negative’ emotions, and not acknowledging that there are physical reasons behind pain and illness.”

My reponse is, despite what I see as a wrongheaded tendency by U.S. medicine to separate the mind and body when it comes to diagnosing and treating pain, there is nevertheless plenty of evidence-based proof that displays the power and breadth of the mind-body connection.

 Take the placebo effect, for instance –  which proves clinically, time and time again, that patients feel better because they think they’re being treated by a certain drug or procedure, even though they’re actually not.

Other examples abound – such as the much-documented (harmful) effect of stress on cardiovascular disease and this recent study, which demonstrated that health care workers who fear job-related medical pain may actually be more predisposed to experience it.

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3 responses to ““It’s All in Your Head”

  1. It strikes me that this is a bit like the nature vs. nurture debate. Both are critical to how a creature develops and that it will always be impossible to tease out which predominates. I’m sure you would agree that some people do actually suffer injuries–for which they need treatment, whether it be rest or pt or meds. And maybe even occasionally surgery. But I agree that we don’t remotely understand how powerful our minds are. I just don’t think it’s an either/or. It’s both–more of one for some people perhaps.

  2. Matt, I think your analogy is correct. Several people I know who’ve had back surgery told me their he pain was instantly gone when they woke up in the recovery room. While that could because the pressure of the impinging disk against the sciatic nerve has been relieved, I suspect there is a powerful mind-body effect at work. Simply because by placing their trust and confidence in the surgeon, people are expecting to get better, which actually makes them better.

  3. Hold on. Barker? Stress? I must be on the wrong blog.

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