HERE are My (DSL’s) Comments on
The Dr. Sarno Back Pain Relief Method as
Presented in the I Love Marketing Podcast:

[CLICK HERE for the Webpage with My Article on the Sarno Podcast
with Joe Polish and Steve Ozanich]

SPECIAL NOTE: Though written for any interested audience, my main focus is on Training & Consulting with Therapists and Physicians wanting to understand and practice Soft Tissue Therapies the way I developed and apply my system, The DSL Method. My writings and Tutorials are, admittedly, on the long side. Yet, as the great Marketing Guru, Dan Kennedy (who helped many chiropractors and many other therapists develop their business and marketing systems) once said, the truly best practitioners have a very deep knowledge of both the inner workings AND the history of their profession. This helps contribute to their skills and knowledge BOTH in delivery of treatment but also in their marketing. …

SO if you want to be a Leading Edge Master at what you do, I suggest taking Dan Kennedy’s advice. … Being widely experienced, and accessing the knowledge and experiences of others through studying what they do and how they think, are both ways to become superior practitioners. … And this is only a small sample of what I have available.

The following tutorial assumes you have read my page discussing the Podcast on the Dr. Sarno Back Pain Relief Method. HOWEVER, if you’ve not, you can read that later if you prefer. And PLEASE don’t forget to listen to the Podcast! … Yet this page is written, if only in part, to clear up some of the questions and controversies as to why I recommend therapists study Sarno’s work. … This page can stand on its own, though.

1.) The Key Point, I think, in Dr. Sarno’s work is revealed in his own discovery of his own healing process.

As he described in his book The Mindbody Prescription (Warner Books, 1998, page xviii) he used to have “regular migraine headaches.” Eventually, someone suggested to him they were caused by repressed anger. Next time his migraines started coming on, he sat down and tried to think of what anger he might be repressing. He says he never figured that out.

Yet for the first time in his life, the headache did not come on. THIS got his Attention!

The Critical Point, then, is it was not “getting in touch” with the *content* of his thinking or “figuring out” or “remembering” his emotions that was central to the healing process. It was the Act of Paying Attention in the current moment to the thoughts and feelings emerging when paying attention. …

The Simple Lesson is that being focused on the present moment tends to disconnect or dissolve our connection to past events. That’s because memories lives in thought (which is itself neurological in nature) and “neuro-physiological leftovers” from past events, injury, or trauma. Those “events” can be physical, mental, emotional, metabolic, or relational in nature. They are in great degree moderated and modified by the nervous system, even if mental or emotional in nature.

Focusing on the present moment tends to “inhibit” (reduce or turn off) such neuro-physiological phenomena.

From a “psycho-physical meditation” or “mindfulness” point-of-view, the trick is in getting “in touch” with the current structure and present moment sensations of feelings and thoughts rather than being too focused on the content of thought. It’s more about experiencing HOW you think and feeling your current feelings, rather than remembering details of past events.

Remembering past events can help you figure out where to focus you attention.

Although in some cases, remembering past traumatic events CAN help access or “unlock” otherwise inaccessible content of mind and related feelings. This is usually when such thoughts are more thoroughly repressed.

Or rather, you can use the content of thought as a way to focus your attention down into your psycho-emotional and related physical structures. Yet too much “thinking” (the words, sounds, feelings, and pictures — the chatter — in your mind) can block a direct “feeling” and in-the-moment awareness.

NOTE: Having started doing meditation when I was only 13 years old, and having a life long commitment to the inner explorations of body, mind, and emotions, I was often amazed at how the thinking mind could literally, instantly, and easily over-ride and bury sensations and feelings happening in the moment. If I was not paying VERY close attention, the instant and nearly invisible suppression of what I was feeling, and sometimes thinking, would happen without even noticing. … Until I really started to focus on it, which helped by doing a LOT of yoga.

And you can suppress things only so often before they become repression.

Paying such close attention on an on-going basis, of course, requires a VERY different orientation than usual about what life is all about and what’s important, or not. That’s not exactly a Great Formula for certain other aspects of life, such as staying very focused on making a lot money or winning a sports competition.

Money making, the arts, athletics, and so on generally require a lot of future-based and somewhat narrowly focused THINKING. Thinking being the very thing keeping us focused on future orientated ambitions, processes, and perspectives leading to the actions leading to money production or other desired results, such as raising children, being a musician or artist, an athlete, and so on. Or forcing one’s self to “gut through” grueling workouts to become a pro football player or boxer, or whatever.

This is quite Paradoxical because the very best artists and athletes will say they do their best performances when they are “In The Zone,” which is a state of in-the-present-moment Mindfulness, or Meditative in nature.

Yet it is well known that people whom are are focused more on their emotional — in-the-moment — content of life, often have a very different orientation to life than what it takes to achieve such other objectives or purposes.

As Steve Ozanich (the man interviewed in the Podcast) says in his book on Dr. Sarno’s work:

The brilliant Swiss psychiatrist, Carl Jung, stated that “nothing inhibits feeling like thinking.” Thinking blocks the dreaded emotional experience, and it so happens that people in pain are living their lives in their head. The body matters in life, so healing must include becoming more physical, and living with less negative chatter. … [emphasis added ~DSL]

Top 10 Mistakes Made in Healing from TMS Steve Ozanich © 2014

The primary role of conscious thought is to rationalize mood-induced imperatives.

Robert Prechter, Elliott Wave Theorist, May 2011, page 7

This leads to a discussion of why it’s so hard for people to “stop their thinking,” as in the more common ideas about meditation. But thinking you have to actually stop thinking to benefit from meditation gets WAY ahead of the game and can actually be VERY counter-productive. The act of attempting to “stop thinking” usually produces more thinking, even if at a more subtle level. … But that’s a discussion for another time and place.

Please see an early draft of my thoughts on and quotes from experts on:

The Nature of Thought, Mindfulness & Meditation.

.2.) The 2nd Critical Point is, the Dr. Sarno Back Pain Relief Method (and for many other parts of the body) had and has a very high success rate (the statistics vary depending on how each study was done). Yet he clearly stated he had a specific criteria for choosing his patients, much as how surgeons decide which patients they’ll accept for surgery.

If a potential patient, in the initial interview, was NOT amenable to Dr. Sarno’s assessment that TMS (Tension Myoneural Syndrome, caused by repressed emotional stress) was a possible cause of their pain, he did not take them as a patient.

While it is certainly possible that many potentially successful patients “slipped through the cracks” and did not receive treatment form Sarno, it is also possible that enough people are reasonably self-aware enough to have some sense of whether repressed emotional experience was really their issue or not.

So to a degree, his patients were self-selecting based on how they answered the question as to whether they thought TMS was a possible cause of their pain. (The fact that Sarno was employed by prestigious medical institutions probably helped his credibility quite a lot.)

Therefore, it is certainly possible that Dr. Sarno’s high success rate included the factor that his protocols were reasonably efficient at filtering out people who’s pain issues were NOT likely caused by repressed emotion. This filtering would, of course, be a good thing as far as his results for a particular patient’s success were concerned.

Yes, there are some people who are under so much repression of their feelings, and quite defensive about it (which itself increases the repressed emotional load) that they cannot even acknowledge the possibility. Yet in such subjective matters, we need to trust the Client or Patient to at least some degree. That we know of, there is no reliably, objective test for such phenomena as repressed thoughts, feelings, and emotions.

Although there are some people out there who’ve a gift for spotting such things in other human beings. Some of them are therapists and a few are physicians, if you can find them.

And, obviously, this leads to a discussion and analysis of when it’s appropriate for a client or patient to pursue such modalities as Sarno’s work versus other therapies such as soft tissue or metabolic therapies. … Given that Sarno’s work is about as non-invasive as you can get, and very “low-tech,” it would seem like a good place to start for many, if not most, people.

Patients of Sarno, like the famous radio personality, Howard Stern, who could afford ANY treatment, ANYWHERE in the World, said things like this:

“I know that to people who listen to this conversation, they’re saying ‘Oh gee, this must be a placebo, this sounds like a cult or something.’ This is just – when you read this book, there is such medical evidence supporting Dr. John Sarno that I just – I guess I kind of feel like wow, this guy could really save the world.”

~ Howard Stern on a Larry King Live show devoted to Dr. Sarno.
Dr. Sarno cured Stern of back pain and OCD.

Here’s the Interview with Dr. John Sarno on The Howard Stern Show:

Dr. Sarno Back Pain Relief &
Perspectives on The Mind

3.) Sarno confirms what so many “alternative-healers” have stated repeatedly about chronic pain: all the “content” (historical sensory events and inputs of physical, mental, & emotional nature) was accumulated in the past from earlier events and is being recirculated in-this-present-moment via the way the brain and CNS (central nervous system) are structured and store their history, both good and bad.

(“Good History” would be the positive and useful skills and knowledge you’ve accumulated since conception, even including remembering your own name.)

The convergence of a potentially wide range of current sensory inputs with an even wider range of historical physical and mental memories project from the unconscious parts of the brain out onto the body and up into the conscious part of the brain. They project an internal “sensory map” of what the body is feeling and doing. Yet this is a highly subjective “map” assembled by the cerebral cortex (upper layers of the brain) and only a best approximation of what’s going on “out there” in the body.

Some of the best early and readable descriptions of the sciences behind our perceptions and how the brain creates them are from Humberto Maturana and Francesco Varela, authors of the book Tree of Knowledge and Autopoiesis & Cognition. (Well, Autopoiesis is actually pretty UN-readable, given it’s written for a high level neuroscience & philosophy based audience.) They participated in one of the largest psycho-cybernetic projects ever undertaken. It was performed in Chile, in part under the supervision of Fernando Flores, a minister of finance and economics in Chile under the Allende government at the time.

After being released from prison after the Chilean coup d’etat, Flores went to America and studied philosophy, linguistics, and computer science. He was pretty good at investing, as well. … More on him in a minute.)

Maturana and Varela became involved with Naropa Institute in Boulder Colorado. Here, primarily Varela, worked diligently to bridge the gap between neuroscience and meditation. They worked extensively with Buddhist meditators, including the Dalai Lama. The idea was that Buddhists were students of the mind, neuroscientists studied brain & nervous system.

They were both looking for the place, function, or field where brain and mind met or intersected.

For an interesting history of one slice of the development of the merging of science and meditation (or mindfulness) an interesting, in depth article appears here:

Two Sciences of Mind

One great quote from the article is this:

“Matthieu Ricard [a central figure discussed in the article ~DSL] started his professional life as a molecular biologist. Now, after many decades as a monk, his molecules have become the subject of study for biologists. His discussions with physicist Trinh Xuan Thuan, published as The Quantum and the Lotus, and his vigorous give-and-take with his father, the renowned philosopher Jean-François Revel, published as The Monk and the Philosopher (a best-seller in France) demonstrate his ability to discuss Buddhist understanding deftly outside the context of Buddhism. This has made him an ideal participant in Mind and Life dialogues and a laboratory subject who can report his subjective experience with scalpel-like precision. …

“Ricard is concerned that the average person is afraid of the mind, and that this fear is taking a great social toll. If you ask someone to look into their mind, he says, “A surprisingly common reaction is ‘I don’t want to look into my mind. I’m afraid of what I’m going to find there.’”

Back to Fernando Flores, whom in some ways a genius in developmental psychology & philosophy, was strongly influenced by Maturana (a Chilean professor), eventually becoming involved with Werner Erhard and the est Training. The est Training was, among other things, all about observing one’s self from an internal focus and the changes that could or would bring. The Training was very effective — for many, but not all — people, in part getting in touch with repressed aspects of theirselves, often leading to profoundly positive changes in their lives. (And some not so good changes.)

Flores eventually coached Erhard in converting the est Training to The Forum and Communication Workshops. Later The Forum became, and is currently known as, Landmark Education.

Flores on some occasions brought Maturana to the states, and they produced programs at places like Harvard University, where they taught rooms full of medical researchers and doctors about how, for instance, pain was a “conversation” between mind and body. …

Flores was a client of mine [DSL[ for the better part of a year. I was a participant in some of those workshops at Harvard and other locales, and I was very involved in providing therapy and logistics for Flore’s personal health program while he was traveling, including doing structural bodywork therapy and macrobiotic food preparation for his medically required diet. My work with him included performing my form of myo-structural bodywork which he said was right in line with his vision of how to “modify” the human nervous system for better results.

Flores had, apparently, studied and applied the work of Alfred Korzybski and his General Semantics, and was an advocate of the idea one could change the way a human nervous system functioned by treating the fascial (or colloidal*) structures of the body. Not surprisingly, Ida P. Rolf, founder or Structural Integration (also known as Rolfing®), studied with Korzybski as well. I had several disagreements with Flores (and Ida’s writings) on how it all works, but we were never able to come to resolution on our differences.

Ironically, our REAL disagreements were more about politics and society. But that’s a whole story on it’s own.

* COLLOIDAL: From Wikipedia: “A colloid, in chemistry, is a mixture in which one substance of microscopically dispersed insoluble particles is suspended throughout another substance.” … Fascia is a colloidal substance, described very well and extensively in Job’s Body by Deane Juhan, Station Hill Press, 3rd Edition, Chapter 3.

Here is an article on my views of Ida Rolf, Korzybski, Fascia and the Nervous System.

For those interested in the Medical Sciences behind how Muscles and Fascia work together (rather than independently):

Please Read, What Ever Happened to the MYO in Myofascial Release?

And Facts & Fallacies on Myofascial Release.

Back to Sarno. His contributions to the mind-body problem applies mostly to those whose initiating and perpetuating factors of pain are primarily mental and emotional in nature.

However, the overall PRINCIPLE of getting in touch with — of directly feeling — “the present moment” versus “digging around in the past” with purely thought-based experience, applies to chronic pain regardless of the Original Source or First Cause, be it emotional, mental, physical, structural, or even spiritual.

From a mindfulness point-of-view, it’s possible that some of the people who are NOT helped by Sarno’s approach is because they are stuck in THINKING about their feelings, rather than FEELING their feelings. As mentioned above, thinking tends to distance ourselves from and recirculate the past. Yet ATTENTION in-the-moment (the opposite of “thinking about”) tends to dissolve the past.

Yet if the primary inputs are more physical in nature, such as in a car accident or a fall, then the emotional component might not be as or very important, if at all.

Yet it is dissolving the memories keeping us inappropriately connected to past events that are much of the problem — and memories can be very physical, or very emotional, or in nature.

Metabolic / nutritional sources of pain and other dysfunction also have a multitude of possible inputs, sometimes significant. Many of them have no “sensory feedback loops” a human being can directly perceive or feel. Or at least not until it’s very developed and in some cases way too late.

In such metabolic cases, we are in need of indirect methods of determining our internal chemical state like blood tests and other bodily fluid & substance tests, or thermography, Doppler imaging, and a wide variety of other possible tests. Many of the internal processes affecting our health and function do not have nerve pathways to the conscious part of the brain, therefore it is far less likely we can “get in touch” with and feel what’s going on with some of these non-conscious processes.

One danger is a particular pain or dysfunction might have several or many inputs to it. It’s very possible to relieve the body and mind of obvious manifestations of pain and dysfunction through mental / emotional and / or soft tissue / structural means. Yet when pain is gone, this does NOT mean ALL problems are necessarily ALL gone. …

This is the domain of the true Whole Health Healer, of the Elegant Aging Physician or Therapist. Their job is to find ALL the “negative stuff” going on even when you are “feeling fine,” because a lot of things can be happening without the sensory information making its way to the conscious part of the brain and mind.

4.) For those committed to a deep understanding of how people get the way they are, delving into the factors of early childhood and personality development has many rewards. Many people can just not figure out why they have certain repetitive behaviors often working against them.

A great starting point for this is the writings of Harville Hendrix. He wrote the books :

  • Getting the Love You Want: A Guide for Couples, Henry Holt and Company, 1988
  • Keeping the Love You Find, Atria, 1993


Though mostly focused on romantic aspects of life, the fundamentals of how our personalities develop based on our experiences of our primary care givers early in life are profoundly insightful.

Hendrix’s idea of the Imago — the psycho-sensory self-image we develop in our younger years — helps us understand many of our drives and preferences literally buried in the deeper structures of the brain. These structures do not “talk’ to the cerebral cortex, as there are few or no nerve endings connecting the brain centers. So he cannot actually “feel” what’s going on “in there.” We can only deduce what MIGHT be happening “in there” based on what we keep doing, usually over and over again. Even when it makes NO sense at all.

The short story is we are attracted to people who will fulfill both our positive and negative impressions of our primary care givers in early life. We seek people who have the positive characteristics for obvious reasons. Yet we also seek people with the negative characteristics in attempts to “go back” and heal upsets caused by — or at least associated with — our care givers in early life.

Yet we are generally not conscious that we are intentionally attracting these “negative” people. So when their negative behavior begins to arise, we are taken by surprise. Sometimes its a BIG — as well as painful and costly — surprise!

Additionally, early in life, we learn to modify our various behaviors to attract and encourage, or appease or deflect, the behaviors of our primary care givers. This usually unconscious behavior usually manifests in ways not to our best advantage, producing emotional, and sometimes physical, stresses and strains we do not consciously acknowledge let along know how to deal with.

This can lead to repression of the feelings and thoughts producing the desired or feared interactions with other human beings. And the closer they are to us, or the more important they are to our survival, the more those repressed feelings will affect our body and mind.

My main point here is I believe the very same internal dynamics are at play with much or all of our adult life. We are affected by many inputs in early life, from many people, and they “make their mark” on the physiology of the unconscious brain and mind, and can be very difficult to even realize they’re there, let alone “fix” them.

It is such phenomena that make certain Clients and Patients that much more difficult to “figure out.”

5.) YET … as J. Krishnamurti, the late, great anti-guru of East Indian descent said, it is not the past that gives meaning to the present moment. It is in the present moment, we give meaning to the past.

In that whole process, and beyond, it is our thinking, with it’s historically based filters, messing with how we remember and unconsciously recirculate the past (even if the “thinking” is happening unconsciously), and therefore how we’re perceiving the present moment. That’s what prevents us from easily changing it.

What the unconscious mind wants to see, it will, much or most of the time, see.

“Thought is so cunning, so clever, that it distorts everything for its own convenience.” ~ J. Krishnamurti

One profound example of this is a person trying to edit their own writings. No matter how many times they re-read their work, they’ll very often not see errors that are present. (Just ask ME! … It takes three times longer to edit these articles than it does to originally write them!)

The mind “knows” what’s supposed to be on the page; so that’s what it sees.

The Great Guy Kawasaki, the Original Apple Computer Evangelist, has written several very successful books. In discussing the editing of the books we write, he says:

It is essential to have a professional copy editor work on your book before you publish it, … No matter how careful you think you were, you will have made mistakes. Even though APE [his book titled “Author, Publisher, Entrepreneur”] had two detail-oriented authors and 60 volunteer editors, [a] professional copy editor still found 1,400 errors in the manuscript. [!!! ~DSL]


1,400 errors is a LOT of errors. … That’s why we need proof readers. … Or one reason, anyway. … But the lesson is, what our mind wants or is conditioned to see via repetition or intention often overrides what’s really there to see.

The point here is, while delving into memories of the past might have great benefits in discovering unresolved emotions and unraveling and resolving various issues including chronic pain, memory is so unreliable, it’s far more effective if one is actually and directly “getting in touch” with present moment reality.

The reason is that, in one world view, the past no longer exists, at all. It only “exists” to the degree we (usually sub- or un-consciously) hold past memories in place in the present moment. And our “view” of our memories is often quite distorted.

For example, we get into a car accident. The nerves sense stresses and strains to the system as the accident unfolds in-the-moment. The nerves instantly react (most reactions NOT originating in the conscious part of the brain but in lower parts of the brain and locally at the level of spinal cord and peripheral nerves) by turning on certain motor nerves to muscles. The muscles instantly contract, protecting the bones, joints and other body parts, such as organs, from too much damage. …

This was an in-the-moment survival tactic the body performed to save it’s own life and well-being … or at least, in minor events, stability.

Yet it all happens so fast, with so many inputs happening simultaneously, the idea it was all a precisely orchestrated event with perfect memory of what happened is a real stretch of the imagination. That is, I believe, one reason people develop persistent pain patterns even long after the tissues have healed. Their “bodymind” cannot find it’s way back to “normal,” it cannot relax, because the nerve reactions were too extreme, too fast, too confused, and too “burned into the memory banks” for the body or mind to find its way back to normal.

That is one thing the therapist or physician does, help the psycho-neuro-musculo-fascial system “find its way back to normal.”

One of the great values of “structural bodywork” is you can SEE, in the present moment, which muscles are most over-shortened, and therefore over-contracted. These are, most likely, where the nervous system initiated and now perpetuates psycho-neuro-muscular tension patterns that cause pain.

(The “psycho” part refers primarily to the brain, and possibly the mind, depending on the Client or Patient’s unique situation. It does NOT [necessarily] refer to “needing a psychiatrist”!)

“Tracking” Trauma Events & Injuries in the Bodymind

5.) Just to reinforce that last point, when many events occur simultaneously, with a lot of intensity, confusion, and fear involved, the body or mind cannot necessarily “track” the patterns of reaction to what happened. If the bodymind goes too far “out of whack” in an un-trackable moment, the mind cannot “track BACK” to normal. It gets “lost” in a “neuromuscular no-man’s land,” without an internal map to get back to normal.

Or, this “out-of-whackness” develops over time, so gradually, the client doesn’t even notice. It’s difficult to “track” what you don’t notice.

So we get stuck in that Emergency — or Chronic — Pattern of psycho-neuro-musculo-fascial reaction that was initially a life saver, but is now a distraction, burden, or worse. This manifests as mostly C.E.M.&.N.T. or Chronic, Excess Muscle & Nerve Tension & Stress. These are the “tight muscles” that, activated by their respective nerves, irritate other nerves, restrict blood flow, get in fights with other muscles, and so on.

These are the kinds of events producing bodymind reactions we sometimes cannot resolve without outside help. Or we need a VERY rational and sensitive “sense of self” allowing us to feel and evaluate, then respond to, those destabilizing reactions. But since the resulting pain is often felt in opposite or distant locations from it’s actual cause, this is not always an easy task.

We find that a structural approach, combined with the historical picture (a “video,” actually) of past events, gives a properly trained therapist more insights they need to help figure out the client’s situation and bring their bodymind back on a “normal track.”

6.) Problem is, in many cases, that neuro-muscular reaction to the accident gets, in relative terms, more-or-less permanently recorded and remembered as a “life-long survival tactic.” The body-mind facilitates (makes habitual) such reactions of the nervous system and brain.

This facilitation occurs by modifying the chemical bath at each synapse* located in the relevant nerve pathways. Many times, there are many thousands of nerves and synapses involved. Some motor pathways have as many as 10,000 neurons converging on ONE motor unit.

A motor unit turns a muscle, or a part of a muscle, on or off.

Though it might fade substantially into the background to varying degrees, quickly or slowly, the neuromuscular system tends to retain a memory of that stabilizing or protective reaction for later use. It literally becomes facilitated into the structure of the nervous system by way of changes in the chemistry at the synapses.

In every present moment, repeated moment-to-moment, the bodymind tends to retain this protective action as a newly acquired survival tactic, and to varying degrees, never lets it go. The bodymind utilizes this action, perceiving that it needs to hold onto this pattern of reaction to survive, to protect itself from life itself and future accidents.

* Synapse: these are the “switches” in nerve pathways determining whether a particular nerve will fire … or not. Their ease of firing is modified by changes in the chemistry at the synaptic cleft, the space between the pre- and post-synaptic cell. If the chemistry has changed sufficiently, synapses can become less resistant to firing to the point where they become “stuck” in the ON position, and cannot turn OFF. The attached muscle or organ, therefore, cannot turn off, and soon goes into over-activity, dysfunction, or burnout.

Much of myo-structural, soft tissue therapy is in reality about modifying the chemical bath at the synapses back to a more normal state. This is done by DE-facilitating the nerve pathway and synapses by means that inhibit the firing of the involved nerve(s). In those moments of inhibition, that gives the chemical bath a chance to return back to a more normal, less facilitated state

There are several ways to “inhibit” (reduce or stop) the firing of a synapse and it’s nerve. It appears that focused attention is a neurologically “inhibitory” activity, which might well explain why attention — also known as mindfulness or meditation — can in many cases turn stress, tension, and resulting pain OFF.

Various forms of bodywork, yoga, and other therapies also tend to inhibit nerves and synapses as long as they are not applied with too high an intensity of stimulation or sensation. Lower intensity therapy is better for inhibiting C.E.M.&.N.T.

This is why I started calling my Yoga Therapy “Let-Go Yoga. It’s about “letting go” of tension, stress and habit patterns with relatively low intensity yoga postures.

Such “facilitated behaviors” can in some cases be overridden by the person by their own efforts. Sometimes, this requires a fairly high level of self-awareness and willpower to achieve. In other, less intense cases, less ability to focus attention is needed. Either way, if not consciously defused, in many chronic cases, the “facilitated synapse” will just not “go away” of its own accord, as some tensions do.

7.) Even if mostly physical, the reaction to a car accident (for example), if intense enough, instantly becomes integrated as part of The Self, as a sensory self image, which is the more physical aspect of what some call *ego” or self-identity. If nothing is done to DE-facilitate the reaction patterns, the person can instantly or eventually become “stuck” with that sensory–action pattern, sometimes for life, as an element of their very self-identity. Self Identity is not easy to let go of, even if self destructive.

Here is where the idea of Pattern Interrupts come in. This means providing the psycho-neuro-musculo-fascial unit an opportunity to “feel something different.” In those moments when it “feels something different,” the “attachment” the bodymind has to the memory pattern is reduced or even stopped. It is in those moments the bodymind can sometimes begin to find its way back to “normal.”

The Big Question is, for how long, and how often, does the pattern need to be interrupted for some change to occur? ANSWER? Like all too many things, *IT DEPENDS* on a multitude of possible factors!

Further complicating the tissue issue, there are the people who tend to identify with their afflictions, and they literally become “attached” to them. This is the same way an addict can soon identify with all aspects of their addiction, even if it has unpleasant or self destructive elements.

Eastern psychological thought tends to classify “ego” as the Bad Guy. Yet Western psychological thought says we NEED a Self-Identity to survive and prosper. Western thought does not treat “ego” as the bad guy, but calls the “bad” aspect of ego as “the ID.”

The more *foundational* the neuro-muscular event was, the more all the attendant images, sounds, and sensations occurring at the time of the accident or incident become more deeply facilitated (habitual). In the case of a car accident or fall, it all happens pretty much instantaneously. Other, longer term “events” unfold over months or years, affecting the individual in a variety of ways. These could, for example, be the repetition of an action over and over again for long periods of time, leading to repetitive strain injuries. Or they might be a series of emotional events over a long period of time, as well.

Because it is adopted as a protective pattern, the bodymind cannot easily “let go” of the embodied pattern of response because of its fear of instability, damage, or death. And that fear “lives” in the body, not just the mind. The reactive pattern becomes integrated as an element of physical/mental self-identity, and, more-or-less, assessed to be indispensable. To “let go” of this pattern is unconsciously experienced as a partial “death” of the self, and therefore subconsciously resisted, sometimes to the actual death of the self.

You can observe this phenomena while driving with someone (or some of them, anyway) who’s been in a severe car accident, even many years past. You can see their body is held “on guard,” and every move by another driver or car is reacted to in a far more magnified way than “normal.”

“Outside In” versus “Inside Out”
Stress, Trauma, & Injury

8.) I think reactions occurring from “the outside in,” toward the spinal cord from the outside of the body, or the peripheral tissues of the body — those NOT originating within the brain and from “the inside out” — are more likely to require external, manual therapy to manage or alleviate. This could be massage or bodywork techniques, yoga therapy, Tai Chi, various other exercise forms, and a near endless list of possibilities.

“Outside In” might be a car accident or falling down the stairs. The physical body is impacted from outside forces, and automatic, reflexive actions — usually showing up as hyper-contracted muscles —  stabilizing or protecting the bodymind from these outside forces. These are the kinds of issues dealt with very well by properly trained soft tissue therapists. (See, for example, my article on LinkedIn Pulse: 2nd Hip Replacement)

“Inside Out” issues are, for example, the psycho-emotional forces — fear, anger, rage, guilt, and so on — generated internally by the mind and emotions. Emotions are primarily in the body, but partially “in” the mind, as well. Sometimes, however, the mind identifies with the emotion so much that it “remembers” and “replays” the feeling(s) even if the original source is no longer present in the body. But it “feels” real!

The mental / emotional “stuff” can end up expressing as muscle tension. The result can be Dr. Sarno’s TMS or Tension Myoneural Syndrome*. These are the internally generated forces Dr. Sarno deals with so well.

* The term I use is C.E.M.&.N.T. … That’s short for Chronic, Excess Muscle & Nerve Tension & Stress. I use that term because it is more descriptive for the layperson. … And for many clients, cement is what their muscles almost feel like.

Once Again, the link to the Podcast with Joe Polish & Steve Ozanich on Dr. Sarno’s work is HERE.

Generally speaking about “outside in” issues, although there are probably various residual, emotional after effects, the initial reactions were most likely, at the outset, primarily physical. An emotional response tends to come a little or a lot later, to varying degrees, depending on various circumstances. Yet some trauma is far worse than others. Not too many people have developed a capacity to use their mind to “reach down into their nerves & muscles” at a deeper level of integral neurological phenomena, and voluntarily defuse those more traumatically programmed reactions. …

Yet this approach is much closer to the “whole health” or “wholistic” ideal so many modern practitioners subscribe to because it involves, as much as possible, the “whole system.”

I’ve got about an 80% or more success rate in using my manual therapy method with clients who’ve pretty much been given up on by a wide range of physicians or therapists, a few of them having tried the Sarno Method. Yet I always try to let people know about the Sarno method, just in case their issues are primarily in the range of root causes Sarno deals with. …

Basically, I subscribe to the idea that there are three main domains of body function that a wide ranging Whole Health Healer will deal with — the physical / structural, the physical / metabolic, and the mental / emotional. And, of course, there’s a LOT of overlap between them.

And there’s also the personal / interpersonal, the social / cultural, how we function and relate to other human beings, animals, and our environment. That’s more the domain of professions like psychotherapy and personal coaching, or ecological studies, however …

How we relate to other beings and our environment can have dramatic impacts on our internal physical, mental and emotional self.

These are three (or four, including that last one) vastly different areas requiring vastly different therapeutic skill sets, whether you’re doing self-healing or being treated by another person. Yet a Really Good Practitioner, while more likely highly competent in one of these areas, should have enough understanding of the other two (or three, if you’ve got a lot of time!) to be able to guide a Client or Patient to an appropriate practitioner, if there’s one around.

Hopefully, more practitioners will take it upon themselves to embrace all three areas, becoming more able to provide an integrated package of structural, metabolic and mental/emotional therapy to Clients.

9.) In the case of a car accident, it is the sensory inputs stimulated by events in the physical world that the CNS & brain converge to produce, or not, in the cerebral cortex. This produces certain conscious sensations. Sometimes the upper, newer brain (cerebral cortex) assembles and integrates the current sensory inputs with its historical data (memories) such that a pain pattern is created. In other cases, it does not. This is not highly predictable from person to person or situation to situation.

Yet there are significant limits on what the cerebral cortex can process. First, there are many incoming, sensory nerve pathways that do not travel all the way to the cortex. Therefore they cannot be consciously felt. Second, the cortex can only handle somewhere between 4 and 9 bits of data out of eery 100,000 bits passing though the cortex at any moment. Therefore, you cannot directly feel MOST of what goes on in the body anyway.

10.) As far back as 1982, I knew doctors who had seen the research (or experienced with their own patients) that joint degeneration, arthritic builds ups, misaligned vertebrae, etc., had NO reliable correlation with pain, lost range of motion, or other dysfunction. But they didn’t know what to do about that revelation. So a lot of them just avoided the issue and continued with business as usual.

Worse, the joints and discs have very few, or NO, pain sensitive nerves within them, so degeneration of those structures cannot, by themselves, generate pain. Sarno is right, that even in the most physical / structural areas of “structural damage,” it is far more likely the muscles are triggering pain by putting stress on, for example, tendons (with more sensory nerves than the muscle bellies), or nerves embedded in the periosteum (the “skin”) of the bones, or ischemia, as TMS (Dr. Sarno’s diagnosis) hypothesizes.

That is also why so much manual therapy mistakenly focuses on the tendons, joints, ligaments, or fascia rather than the muscle bellies. There are far more pain sensitive nerves in the tendons & periosteum (surface coating of the bones), rather than the muscle bellies. So the tendons, joints, ligaments, or fascia get most or all the attention. Yet it is the chronically contracted muscle fibers, located between the tendons, putting all the pressure on those tissues and nerves.

11.) Neuromuscular Discombobulation (Confusion) and Other Causes of Pain:

One of our hypotheses is that when adjacent or nearby musculo-fascial fibers get out of synchronization with adjacent or nearby fibers within the same muscle belly, a pain pattern is set up. The brain perceives “something is wrong,” and initiates the pain pattern. This can happen in many circumstances, for instance when falling over, or hit by a car, and things happen so fast the neuromuscular system cannot “track” what neurological actions occurred, and therefore cannot find a “pathway” of nerve normalization back to “normal” firing.

We believe this because many people have very specific pains located in very specific groups of muscle fibers, often of very small diameter. Those fibers groups are most often very much more tense — “tight” — then adjacent fibers. When the tension level in that excessively tense group of fibers is brought back into harmony with their neighboring fibers, the pain pattern often just goes away, sometimes instantly.

This requires the manual release technique to be very precise and held relatively steady, with very little motion, on the fibers until they release sufficiently.

PLEASE CLICK HERE to go to Web Page (on Discombobulation and other aspects of pain and therapy, on my Yoga Therapy website)

12.) Regarding Inflammation:

PLEASE CLICK HERE to the Web Page (in-depth discussion of Inflammation and its (alleged) relation to tendinitis and other factors, on THIS website)

13.) Bone-on-Bone Degeneration:

PLEASE CLICK HERE to the Web Page (on whether Bone-on-bone degeneration causes pain, dysfunction, and lost range-of-motion, on my Yoga Therapy website)

Thank You For Reading My Article On Dr. Sarno Back Pain Relief!

CLICK HERE to Read the Introduction and 1st Chapter in my 100-plus page e-Book on Tendinitis & RSI (Repetitive Strain Injury)

Books By Dr. John E. Sarno, M.D.
& Mr. Steve Ozanich

(NOTE: I make NO money off the sale of any of these books.)

Thanks for Reading,
David Scott Lynn (DSL*)
* DSL: Your Hi-Touch Up-Link to the Inner-Net
Inner-Net: Your Psycho-Neuro-Musculo-Fascial System


David Scott Lynn (DSL)

Beginning at 13 years of age, DSL's been involved with alternative philosophies & practices most of his life. Becoming a yoga teacher in 1976, then a hands-on bodyworker in 1981, he developed a unique & highly effective form of Yoga / Bodywork / Whole Health Fitness & Therapeutics. … David wrote the chapters on a wholistic philosophy & physiology of bodywork & stretching for the textbook Structural Balancing, published by McGraw-Hill, Inc. in 2010. … He is the author of Simple Steps to Let-Go Yoga, available at: … Several other e-books and e-courses are soon forthcoming at … David consults with Kyle C. Wright on massage school development at the Schools of Advanced Bodywork at

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