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Dr. Sarno |
Dr Sarno: Healing back pain - The mind-body connectionDr Sarno has found out that a greater part of the diseases of the back have psychical causes. The conventional understanding is that the greater part of the diseases of the back is of physical nature and therefore should be cured by physical means. Read his books: The Mindbody Prescription, John E. Sarno ISBN 0-446-52076-4, The Mindbody Prescription, Healing the body, healing the pain ISBN 0-446-67515-6. You will recognize Émile Coue´s "conscious autosuggestion" applied to the back pain.
The most fantastic in the metod of Dr Sarno is the insight that the source of the back pain often lies in the psyche. The difficulty of the method lies with the patient, the ability or unability to accept this truth. It is difficult for many patients to accept the psychical cause. The result is that they not even try the method of autosuggestion. Many associate the psyche, psychical sickness with madness - something much worse than physical sickness. I use to speak of a psychical-mental insufficiency or lack of mental development. Sometimes I tell the client/patient that he/she lacks the ability to think his/her own thoughts, that he/she on the whole isn´t free or acts freely (to take his/her own decisions), but only through programmed habits. Unfortunately nothing works if I aim directly at the goal. Often many interviews (See: The Correctus Method) are needed to bring the client to insight. After the insight it´s relatively easy to to on. It´s only to follow the prescribed way, that I and my former patients have experiences of. The same phenomena are valid for smokers, alcohol- and drugabusers. The first phase is to realize and accept: I am an alcoholic, a smoker, a drug abuser - I want to get rid of my vice.
The Correctus Method is an universal instrument, tool for your own good, that you can practise where it´s best suited, for your own good. Here follows a short summing up of Dr John E. Sarno´s theory and treatment of back pains:
During the last 20-30 years problems and pains in the back have increased greatly and are one of the most common causes of sick leave, and they are not only a difficult pain for the sufferer but also a great cost for society. The diagnosis of patients with back pains is very difficult, you often don´t exactly know what causes the different symtoms and difficulties. The common beliefe is that the pain is caused by different structural problems i the back, for instance intervertebral disc herniation, degenerated and protruding discs, spinous stenosis, spondylosis, skolios, bad carriage and musculature and so on. The treatment given is based on the understanding that the pain is caused by some of these physical defects, and it may be practices to strenghten the musculature of the stomach and the back to give "support" to the spinal column to reduce the weight on it, also antiinflammationary medicines, injections of cortison, massage, ultrasound and so on. Many operations are also carried out, but you can´t for sure tell if this will really help the patient or not.
Dr Sarno holds the opposite of this, namely that most back pains are not causes by a physical injury or a degenerative process. The different structural problems that are said to cause the pain, have according to Sarno no possibility to give as serious a pain as the patients apparently have, and they are really just normal abnormities. In an investigation made 1994 it was found that 52 % of individuals with changes such as intervertebral disc herniation and degeneration had no pains or problems from the back. Dr Sarno means instead that the pain is caused by tension, not physical tension but emotional tension: suppressed disagreeable feelings like anger, worry, fear, feelings of inferiority, guilt and sorrow, and the most important of these use to be suppressed anger.
During the last 20-30 years problems and pains in the back have increased greatly and are one of the most common causes of sick leave, and they are not only a difficult pain for the sufferer but also a great cost for society. The diagnosis of patients with back pains is very difficult, you often don´t exactly know what causes the different symtoms and difficulties. The common beliefe is that the pain is caused by different structural problems i the back, for instance intervertebral disc herniation, degenerated and protruding discs, spinous stenosis, spondylosis, skolios, bad carriage and musculature and so on. The treatment given is based on the understanding that the pain is caused by some of these physical defects, and it may be practices to strenghten the musculature of the stomach and the back to give "support" to the spinal column to reduce the weight on it, also antiinflammationary medicines, injections of cortison, massage, ultrasound and so on. Many operations are also carried out, but you can´t for sure tell if this will really help the patient or not.
Dr Sarno holds the opposite of this, namely that most back pains are not causes by a physical injury or a degenerative process. The different structural problems that are said to cause the pain, have according to Sarno no possibility to give as serious a pain as the patients apparently have, and they are really just normal abnormities. In an investigation made 1994 it was found that 52 % of individuals with changes such as intervertebral disc herniation and degeneration had no pains or problems from the back. Dr Sarno means instead that the pain is caused by tension, not physical tension but emotional tension: suppressed disagreeable feelings like anger, worry, fear, feelings of inferiority, guilt and sorrow, and the most important of these use to be suppressed anger.
Tension, stress and the will to do good things in our life can give inner reactions, which we are totally unaware of, but in our unconscious we are very afraid of them. Unconsciously we get very angry, and this can be raised to rage. This is universal, and we all do this to a less or greater degree. There are many different ways in which this can show itself in physical reactions in our bodies, and of which different pain syndroms for the time being have an almost epidemic expansion. What the brain does is to create symtoms that draw the attention from what goes on in the psyche. The brain makes sure that the anger or other unpleasant and unacceptable feelings can´t come to the front. The brain thinks that it does us a service through this, it protects us from acting out of this anger or getting destroyed by it through distracting us from the anger through a socially accepted disease, the back pain. "It seems a heavy price to pay, but the inner workings of the mind are not really known, and we can only suspect its deep aversion to frightening, painful feelings".
Dr Sarno calls this TMS, Tension Myositis Syndrom, and it includes muscles, nerves, tendrons and liagaments in the neck, shoulder and the back. The autonomous nervous system cuts off the blood flow in the tissues involved and this ischemi gives pain. Dr Sarno says of the acute attack: "It is the most painful thing I know of in clinical medicine, which is ironic because it is completely harmless". A patient with malignant TMS may because of the pain be more handicapped and get a much more changed situation in life than a person with amputated legs in a wheel-chair. The life of the TMS patient becomes dominated by the pain, and everything circles around it. Because the pain can start or grow worse through the most common and normal situations, for example sitting, standing, lifting and carrying. The patient can´t work, have a functio- ning family life or leisure, while a wheel-chair bound can cope with all this and have control over his life, which the TMS patient has not, because the back pain dominates. The pain is real, physical, but the cause is psychical. That the mind can control our body so drastically and give results, which for example in difficult cases of TMS can lead to total confinement to the bed, is hard to accept. The pain is experienced as physical and it´s also created through a physical process, and it´s therefore natural to seek the cause in the physical, but the foundation really lies in the psychical. By instinct we read pain as if something is hurt, and we must be very careful not to hurt ourselves further to give the injury a chance to heal. Characteristic for TMS is recurrent attacks, fear of these attacks and of physical activity, and the failure to find a functioning and tenable treatment. Treatments given are usually directed towards the physical, they treat the pain and therefore only the symtoms and not the real, fundamental cause to the pain, which is only a symtom of the problem. Because of this prejudice that physical pain must have a physical cause, these patients often get the wrong treatment.
The most important thing in the treatment is that the patient is aware of the real cause of the pain, that nothing is hurt in the back, and accepts that the brain tries to protect him/her from the anger and other disagreeable and unacceptable feelings. Because nothing is hurt in the back, all normal activities should be resumed and all kinds of treatment should be suspended. When the pain starts, you should talk to your brain, show that you know what goes on and immediately turn your mental activity from the pain to the psyche. By doing this over and over the brain will finally understand that the distraction doesn´t work any longer, the pain will finally stop, and the patient is permanently cured. Sometimes the patient will have a return of the pain later in life, but because he then knows what really happens, it will pass away quickly. He doesn´t react as earlier on the pain, doesn´t let it control his life and at once directs his awareness to the mental. More than 95 % of the patients of Dr. Sarno were cured or got much better. About 2 % with more difficult cases of TMS needed psycho- analysis. For the large majority the knowledge and understanding were enough to cure a many times 10-20 years long history of pain and functional obstacles - the knowledge has a strong therapeutic effect. This also means that you don´t have to change yourself to get well, and you don´t have to the bottom of the primary problem, it´s enough to think psychologically, and later on the inner knots can be untied by themselves with most patients.
There are all degrees of TMS, from an occasional reaction to stress to total functional obstacles with grave chronic pain. It is a certain kind of personality who experiences TMS. They often have a strong wish or need to be good, capable, fine and nice, obliging and willing to help. It is also important to be popular and very revolting to feel that somebody is dissatisfied with them. They often are very intelligent and highly educated, ambitious, very conscientious and skilful. But even if success in work and progress are very important to them, they don´t strive as intense to reach their goals as type A personalities, and they often have very little aggressivity in their personality, which is one of the strongest traits in an A type. Interesting is, that it´s very unusual for a TMS patient to develop heart problems. The need to reach a high ideal and perfectionism are common, as are a low self- confidence and, paradoxically, farthest in at the same time narcissism, in the TMS patients.
Patients with TMS often also have a history of other related syndroms, such as
tension headache, migraine, stomach problems, eczema.
Other personality types have other physical reactions, which have the same goal as TMS, e. g. gastric ulcer, asthma, migraine, eczema, psoriasis, prostatit, irritabel bowel syndrom, spastic colon.
It is difficult for most people to accept a diagnosis like TMS, to accept that the pain is caused by a psychical problem, and what makes it even more difficult is, that doctors have difficulties to make a diagnosis because of its psychological and physiological coupling together, and even worse is it to treat the patient, because the treatment must be contrary to the physical, which is the sphere the doctors feel most at home with and are trained in. Unfortunately many who suffer from TMS can´t accept this, and some accept it only when they are in complete desperation. That most people aren´t responsive depends very much on the fact that either the medical science or the society at large are open to these lines of thought. The wish of Dr Sarno is, that TMS should be studied and examined clinically, so that patients can get help and be cured faster. This page in pdf.
Summarized by Stephan Tomac
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