Pain, disability, misinformation, fear-that quartet has plagued the
Western world for decades and the plague shows no sign of abating. Back,
neck and limb pain are rampant, and statistics indicate that the
epidemic is spreading. Disability in American industry from low back
pain continues to increase year by year.
Industries that employ large numbers of people working at computers are
experiencing great disability and health insurance problems because of a
new pain disorder known as repetitive stress injury (RSI).
Millions of Americans, mostly women, suffer from a painful malady of
unknown cause called fibromyalgia. While gigantic medical industries
have arisen to diagnose and treat these conditions, the plague
This book is about that epidemic. It describes both a clinical
experience that has identified the cause of the pain disorders and a
method of treating them. Sadly, mainstream medicine rejects the
diagnosis because it is based on the theory that the physical symptoms
are initiated by emotional phenomena. Intelligent laymen in large
numbers have embraced the concept, however, no doubt because they are
not burdened by the bias imposed by a traditional medical education.
As if the pain epidemic were not of sufficient magnitude, a large group
of physical disorders have been identified as equivalents of the
pain syndrome, since they appear to stem from the same psychological
process. These maladies have occurred commonly for years and, taken
together with the widespread pain maladies, are universal in Western
society. I refer to many of the headaches, gastrointestinal symptoms and
allergies, as well as respiratory, dermatologic, genitourinary and
gynecologic conditions that are the stuff of everyday life.
If most of these are psychogenic-that is, they originate in the mind
(and it is my goal to demonstrate that they are)-we have a public health
problem of staggering proportions. The medical, humanitarian and
economic implications are obvious and will be enumerated.
This book is about emotions, illness and wellness, how they are related
and what one can do to enhance good health and combat certain physical
conditions. The ideas are based on twenty-four years of successfully
treating an emotionally induced physical disorder known as the Tension
Myositis Syndrome (TMS). Although I will provide an up-to-date
description of that condition, my major focus is the impact of the
emotions on bodily function.
That connection came close to being accepted by Western medicine in the
first half of the twentieth century and then fell into almost total
disrepute. Repudiation of psychoanalytic theory, increased interest in
laboratory research and the tendency of doctors to shy away from
psychological matters (they see themselves as engineers to the human
body) are the likely reasons for this historical trend. As the century
draws to a close, few practitioners, either in physical or psychological
medicine, believe that unconscious, repressed emotions initiate physical
illness. Psychoanalysts are the only clinicians who have held to that
concept, but their influence in the larger fields of psychiatry and
general medicine is limited. In the physical medicine specialties
virtually no one adheres to the idea.
Despite the lack of interest of mainstream medicine, much has been
written on the "mind-body connection." Careful studies have been
conducted that relate psychological factors to pathological conditions
such as coronary artery diseases and hypertension. I know of only one
investigator outside the field of psychoanalysis who has identified
unconscious emotions as the cause of a physical illness. One reads of
stress, anger, anxiety, loneliness, depression, but they are discussed
as conscious, perceived emotions. In many instances these feelings are
thought to aggravate underlying structural pathological processes, such
as herniated discs, fibromyalgia or repetitive stress injury.
In view of the widespread Freud bashing of recent years I may be
courting disapproval to state that my concepts descend from Freud's
clinical observations and theories. But I know this only in retrospect,
for I did not set out to prove Freud right. My developing ideas were the
consequence of clinical observations; they were not based on
preconceived notions about the mindbody connection. As with Freud's
patients, I found that my patients' physical symptoms were the direct
result of strong feelings repressed in the unconscious. In addition, I
have drawn on the concepts of three other psychoanalysts: Franz
Alexander, founder of the Chicago Institute for Psychoanalysis, did
pioneer work in mindbody medicine in this century; Heinz Kohut
conceptualized what is known as Self Psychology and pointed out the
importance of narcissistic rage; Stanley Coen suggested the crucial idea
that the mindbody disorder I was studying (TMS) was a defense, an
avoidance strategy designed to turn attention away from frightening
This book addresses physical disorders that are caused by repressed,
unconscious feelings. Because these disorders are very specific, they
can be accurately diagnosed and successfully treated.
The Tension Myositis Syndrome is currently the most common emotionally
induced disorder in the United States, and probably in the Western
world. Since the publication of Healing Back Pain, other painful
conditions of significant public health importance have emerged. They,
too, are manifestations of TMS.
The book is laid out in three parts. Part I is a discussion of the
psychology that induces these physical maladies, and it includes a
chapter that might be called a bridge, for it describes the
psychoneurophysiology of psychogenic processes: in other words, how
emotions stimulate the brain to produce physical symptoms. After
traversing this bridge (which sounds more formidable than it is), Part
II takes up the various emotionally induced physical maladies, beginning
with TMS, the disorder that introduced me to the world of mindbody
medicine, and including such ailments as the common disturbances of the
gastrointestinal tract, headaches, allergies and skin disorders.
Part III discusses treatment for these disorders.
For those who are interested, an appendix covers the more academic
aspects of the mindbody (psychosomatic) process.
A word of caution to the reader: What follows is a description of my
clinical experience and the theories derived from my work. No one should
assume that his or her symptoms are psychologically caused until a
physician has ruled out the possibility of serious disease.
Excerpted from "The Mindbody Prescription: Healing the Body, Healing the Pain" by John E. Sarno M.D.. Copyright © 1998 by John E. Sarno M.D.. Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher. Excerpts are provided solely for the personal use of visitors to this web site.