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  • Heidi Alexander, LAc

Can Emotions Make Chronic Pain Worse? Book Review For The Mindbody Prescription by Dr. John Sarno

Updated: Jul 19




Does your pain flare when you are upset with a spouse, friend or co-worker? Or, when an aggressive driver cuts you off in traffic? Conversely, does it ease when you laugh with friends or enjoy a beautiful walk? If your pain is influenced by mood and emotional circumstances, the good news is that your pain can get much, much better. The Mind Body Prescription by John Sarno is a book designed to eliminate the pain by working constructively with the emotions that create it.


Chinese Medicine recognizes the link between mind and body. When we include acupuncture points and/or herbal formulas to ease emotional distress as part of a pain reduction treatment, we achieve far greater and lasting results.


What if, however, emotional distress continues unresolved? This is where the late Dr. John Sarno’s work comes in. Dr. Sarno wondered if repressed emotions play a role in chronic back pain. This exploration led to a hypothesis that the mind can induce pain to distract from unwanted emotions. His idea is that when we repress anger, our brain sends signals to restrict blood flow, and hence oxygen supply, to a given area. This causes very real pain. This pain serves as a distraction from the uncomfortable truth that we are angry with our spouse, boss, parent or child. Unless we find a constructive way to deal with undesired emotions, we hold them in. We may even berate ourselves for even having them at all. He labels this dynamic as Tension Myositis Syndrome, or TMS.

He identifies do-gooders, perfectionists, nice guys and people pleasers as being more prone to this mind-body dynamic. It makes sense. People who recognize themselves as fundamentally "nice" are ill-prepared to deal with thoughts that are in deep conflict with their core values.


Sarno developed techniques to relieve pain by processing unpleasant emotions. One strategy is journaling. This is not beautiful and grammatically correct prose. It's the place to unleash raw emotions, as fast and furious as they come (have a paper shredder at the ready).

Sarno's work is not for all cases of pain. Though he achieved an impressive clinical success rate of 80%, he screened prospective patients to ensure they had high likelihood of this mind-body pattern. It's not for acute injuries or pain that is only worse with specific movements and positions.


I have two perspectives that vary from Dr. Sarno:


1) Sarno cites anger as the repressed emotion. Chinese Medicine recognizes that excess grief, fear, anxiety or worry also wreak havoc on the physical body. My suggestion is that while reading this book, you substitute the emotion(s) you experience in place of or in addition to anger.

2) He advises not to use other therapies, such as acupuncture and massage, during this process. Respectfully I disagree based on witnessing quicker results using the book and acupuncture together, as shown in the following case study.


Case study – surgery cancelled!


In late October of 2012, a pleasant 70 year old woman came for acupuncture on the recommendation of her physical therapist. She had severe sciatic pain and hoped acupuncture would provide relief until she had low back surgery. She had tried physical therapy, massage and steroid injections without lasting improvement. Three surgeons concurred surgery was the only choice. She rated her pain as debilitating, at 8 of 10 on the pain scale.


My examination found, unsurprisingly, that she had extremely tight low back, hip and leg muscles. In Chinese Medicine we feel the pulse for various qualities. I was surprised to feel a large, tight raging pulse that did not match her gentle demeanor.


Cautiously, I inquired, “I could be misinterpreting due to a medication or transient stressor, but is there something that’s been bothering you for a long time?” Her face suddenly became red. She commenced spilling her intense frustrations with her husband and stepdaughter. The stepdaughter called shots for the entire extended family and her husband “always took her side”. My patient had felt powerless and resigned for several years. Inside she was filled with long term anger and resentment.


I recommended John Sarno’s book and acupuncture twice a week for 3 weeks. She quickly agreed to both. Her treatments included acupuncture protocols to relieve anger as well as muscle tension. By the end of the first treatment, her pain was down by more than 50%. Her pulse was flowing like a gentle river. By the end of the 6th treatment, her pain was 80% gone. She postponed, and eventually cancelled her surgery. A couple years later, she stopped by the office. She reported that she maintained 90-100% pain relief. She noticed that even the slightest of aggravations set off her back pain. She viewed it as biofeedback that she had emotions to deal with. Using Sarno’s techniques, she was able to reduce the pain within minutes.




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