The Dr Sarno Back Pain Relief Method,
The Mind-Body Connection in Healing Back
Pain & Many or ALL Other Body Pains …
My (DSL’s) Comments on
The Mind-Body Connection
— Healing Back Pain —
— Mind Over Back Pain —
The Dr Sarno Method as Presented
in the I Love Marketing Podcast:
We’ll be looking at some background of the teachings of Doctor John Sarno’s books:
Mind-Body Connection, Healing Back Pain & Mind Over Back Pain, utilizing the
Dr Sarno Back Pain Relief Method, General Body Pain, and Chronic Pain Relief.
CAUTION: I took a re-read of this document. It is kind of long, and it was written in Stream Of Consciousness. So I noticed some areas it really needs to be edited some, especially point #3, below. There is some background information, background to the background, I find interesting. Maybe you will too? Yet there IS a lot of very good perspective presented as well. Hopefully, I’ll have time to do a thorough editing of it soon.
SPECIAL NOTE: Though written for any interested audience, my main focus is on Education & Mentoring / Consulting with Therapists & Physicians wanting to understand and utilize Soft Tissue Therapies similar to the way I developed and applied my system, DSL Edgework: My Method of Mindful Medical Massage, Bio-Structural Balancing & Yoga Therapy. It is an open-ended system, and the Principles & Techniques can be applied to or merged with, for the most part, any other existing modality or system. I’m not attempting to create a bunch of DSL clones.
If there are people who DO want to practice close to the way I do, that’s fine, but not required.
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. The more they know, the more it contributes to their skills, knowledge, and insights BOTH in the delivery of treatment and also in their marketing. …
And Marketing is how “The Right People” find out who their “Right Practitioners” with the “Right Methods” are …
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 deepest knowledge and experiences of others, by way of studying & understanding what they do and how they think, are both ways to become superior practitioners. …
Doctor John Sarno, M.D.
Even if their conclusions were not correct, understanding their observations and thinking process can teach you much about how to process information and come up with better ideas.
And this is only a VERY small sample of what I have available.
The following “tutorial” assumes you have read my previous 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.
A Deeper Look at the Mind-Body Connection,
Healing Back Pain, Mind Over Back Pain and
the Dr Sarno Back Pain Relief Method …
And Applications to Body & Musculo-Fascial Pain
in General and Chronic Pain Relief
1.) The Key Point, I think, the Dr Sarno Technique is revealed in his own discovery of his own self-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. They said he should try to figure out what he was angry about.
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 happen. …
THIS got his Attention!
The Critical Point, then, was not “getting in touch” with the *content* or memories of his thinking or “figuring out” or “remembering” his emotions from the past that were central to his healing process. It was the Act of Paying Attention in the current moment to the thoughts and feelings emerging at the time when he was paying attention. … That was, is, Mindfulness, or Meditation!
From my point of view, Mindfulness is a Subset of Meditation.
We will discuss that later on.
Thought Keeps Us Connected to the Past, Both Good & Bad
Neurological Engrams — Memory Traces
The Simple Lesson about Mindfulness leading to the Dr Sarno Philosophy is that being focused on the present moment tends to disconnect or dissolve our connections to past events, even if temporarily. That’s because memories live in great part in thought ( which is itself partly neurological or physical in nature — called Engrams ) and “neuro-physiological leftovers” from past events, injuries, or trauma. Those “events” can be physical, mental, emotional, metabolic, neuro-musculo-fascial, or relational in nature.
They are, to a 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 neurophysiological phenomena.
From a “psycho-physical meditation” or “mindfulness” point-of-view, the trick is in “getting in touch” with the current structure of mind 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 FEEL your current perceptions rather than remembering details of past events.
But Thought Is NOT “The Bad Guy”
Finding the Ever-Shifting Balance
Yet, remembering ( thinking about ) past events CAN help you figure out where to focus your attention. 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. Neurologically, the very act of focusing attention can activate neurological processes that slow down or reduce — inhibit — the engram’s memory traces.
The nervous system has unique paradoxes where certain things get activated in order to DE-activate other processes.
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, present moment “feeling” and in-the-moment awareness.
NOTE: Having started doing meditation when I was only 13 years old ( in Martial Arts ), and having a lifelong commitment to the inner explorations of body, mind, and emotions, I was often amazed at how the thinking mind could, 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 was helped by doing a LOT of yoga.
And, you can suppress ( temporarily ) things only so often before they become repression (more or less permanent without intervention).
Paying such close attention to the Inner Self on a frequent and ongoing 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 of money or winning a sports competition.
Making Money, the Arts, Athletics, and so on generally require a lot of future-based and somewhat narrowly focused THINKING. Thinking is the very thing keeping us focused on future-oriented ambitions, processes, and perspectives. That hopefully leads to 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.
Yet this is quite Paradoxical because the very best artists and athletes will say they do their best performances when they are “In The Zone,” a state of “in-the-present-moment” Mindfulness, or Meditative in nature. When they are actually performing, they need to switch to a state of in-the-moment awareness, of mindfulness, where thinking slows down, almost to stillness.
Yet it is also well known that people who 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. Monks in a Monastery, for example.
The “trick,’ of course, is finding the right balance between future-focused Reflective Thinking versus in-the-moment Mindfulness, where the future and past tend to fall way for a time. And that “balance” will constantly shift given whatever your current situation, condition, or objective is.
Steve Ozanich ( the man interviewed in the Podcast in the previous article about Dr. John Sarno ) says this in his book regarding the background of 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]
~ Steve Ozanich © 2014
Top 10 Mistakes Made in Healing from TMS
The primary role of conscious thought is to rationalize mood-induced imperatives.
Robert Prechter, Elliott Wave Theorist,
May 2011, page 7
(Robert Prechter is known mostly as a VERY deep financial & economic analyst. Yet his studies, discoveries & teachings
on the nature of the mind and Socionomics and the wide ranging social implications are more than profound.)From the Homepage of Robert Prechter’s Socionomics:
What is Socionomics?
It starts with a simple observation:
How people FEEL influences how they ACT.We look at how society is feeling today –
so you can anticipate how society will behave tomorrow.
We track social mood in real time across the globe.
You’ll see how changes in social mood shift everything from the
songs people want to hear to the leaders they elect; from people’s
desire for peace to their hunger for scandals. Learn more.
Thinking About NOT Thinking Is An Interesting Thought
All this leads to a discussion of why it’s so hard for people to “stop their thinking,” as in the more common ideas about how meditation is “supposed to work.”
But thinking that 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 This Link ( on this website ) to 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, in the Dr. Sarno Method, he clearly stated he had specific criteria for choosing his patients, much as how surgeons decide which patients they’ll accept for surgery.
Like MOST surgeons and physicians, if a potential patient, in the initial interview, was NOT amenable to Dr. Sarno’s assessment that TMS ( Tension Myoneural Syndrome, formerly known as tension myositis 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 from Dr. 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. That is, even if that repression is in the unconscious part of their minds.
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 Dr. Sarno was employed by prestigious medical institutions probably helped his credibility quite a lot. So some Patients who might otherwise be skeptical might have been more trusting of DR. Sarno’s assessment, even if they were not really sure.
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 whose pain issues were NOT likely caused by repressed emotion. OR, that the patient might be too stubborn to perform the processes Dr. Sarno taught. This filtering would, of course, be a good thing as far as his results for a particular patient’s success were concerned, as well as the overall statistics.
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, even if that result is not 100% reliable.
There is no reliably objective test that we know of for such subjective phenomena as repressed thoughts, feelings, and emotions.
Although there are some people out there who have 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 is it appropriate for a client or patient to pursue such modalities as Sarno’s work versus other therapies such as soft tissue (medical massage, structural bodywork, or yoga therapy) 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.
However, while a lot of people get the desired result just by reading his books ( !!! ), some people take a LONG time to get the results.
Patients of Sarno, like the infamous 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 Episode with the Dr Sarno Howard Stern Interview:
Very Sorry — There WAS a Vidoe Interview by Howard Stern of Dr. Sarno.
It is now Private, for some reason. But if you do a Web-Search for:
“howard stern interviews dr john sarno” you will get some material,
such as Stern’s Eulogy of Sarno.
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” and Positive Engrams 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, psychological “map” assembled by the cerebral cortex (upper layers of the brain) and only the best approximation of what’s going on “out there” in the BodyMind and The World.
Yet, it is not a perfect representation. Our internal maps are often not, to varying degrees, not in accord with how reality really is. This can make our perceptions out of synch with reality, and the people in it, and can lead to discorant responses or reactions TO reality.
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 VERY high-level neuroscience & philosophy-based audience. Yet it sure is interesting!) The point is, they explain well how the cerebral cortex of the brain assembles a “map” of the outside world.
Back to the Sarno Technique. His contributions to the mind-body problem apply mostly to those whose initiating and perpetuating factors of pain & pathology 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 Dr Sarno’s philosophy & approach are because they are stuck in THINKING about their feelings, rather than FEELING their feelings.
As mentioned above, thinking tends to distance ourselves from the present moment and recirculates the past. Yet mindful attention in the moment (the opposite of “thinking about” the moment) tends to dissolve the residue or remnants of the past, the engrams.
My view is that while many people “THINK” they are in a “state of feeling,” they are actually running an “instant replay” of their feelings in their thinking mind. While almost imperceptibly instantaneous, this quickness of present moemtn feelings being converted into engrams or memories allows the Thinking Mind to evaluate, modify, & regulate the incoming feelings to make sure they FIT with their existing self-image. Otherwise, if the effects of the feelings are too challenging, cognitive dissonance comes into play and modifies or rejects the experience.
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.
And it is dissolving the memories keeping us inappropriately connected to past events that are much of the challenge — and memories can be very physical, or very emotional, or both, 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. Rather than feeling them happening, you experience their results. Or at least not until it’s very developed and in some cases way too late.
In such metabolic cases, we are often in need of indirect methods of determining our internal chemical state like blood tests and other bodily fluid & substance tests, such as 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 Anti-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 negative 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 following 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 with our primary caregivers early in life are profoundly insightful with, potentially, applications to all aspects of our lives.
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 buried in the deeper structures of the brain and nervous system. There are also widely variable hormones and neurotransmitters producing vast variabilities in how we process our experiences. These structures do not “talk’ to the cerebral cortex, as there are few or no nerve endings connecting the upper and lower brain centers.
The excellent book Molecules Of Emotion by Candáce Pert does a deep dive into the biochemistry of emotion. She talks about numerous neurotransmitters and peptides coursing through our bloodstreams and adding a VAST range of nuance to the sensations and responses we generate. She gets a little too New Agey or solipsistic for me in one chapter, but most of her book is very scientifically based and informative.
So, to a great degree, we cannot directly “feel” what’s going on “in there.” We can only deduce what MIGHT or MUST be happening “in there” based on what we keep doing & seeing, usually over and over again. Even when it makes NO sense at all.
We extrapolate what “must be going on” inside our “old” or primitive part of our brain by what it does, or does not, do.
The short story from Harville Hendrix & Imago Theory is that we are attracted to people who will fulfill both our positive and negative impressions of our primary caregivers in early life. We seek people who have positive characteristics for obvious reasons. Yet we also seek people with negative characteristics in attempts to “go back” and heal upsets caused by — or at least associated with — our caregivers in earlier life.
Yet, we are generally not conscious that we are intentionally attracting these “negative” people. Mostly because we are “blinded” by the good things about them.
So when their negative behavior begins to arise, we are taken by surprise. Sometimes, it’s 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 caregivers. This very often unconscious behavior often manifests in ways not to our best advantage, producing emotional, and sometimes physical, stresses and strains we do not consciously acknowledge let alone know how to deal with.
Therein might be the source of much of the sub- or unconscious anger and/or rage some of us feel. We attract people who are prone to letting us down, to not providing what we need in a partner. And we “simmer” along in life, with the negative emotions building or boiling up, often without our even knowing it.
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 be, and will affect our body-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 out 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.” And why methods such as the Dr. Sarno Method are important for some of us to confront our REAL problems and then, hopefully, heal.
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 that we give meaning to the past.
In that whole process and beyond, it is our current thinking, with its 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 see, much or most of the time.
“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, such as a long article or a book. No matter how many times they re-read their work, they’ll very often not see errors that are clearly present. (Just ask ME! … It takes three or four times longer to edit these articles than it does to originally write them!)
In many cases, 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 proofreaders. … 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 worldview, the past no longer exists at all. It only “exists” to the degree we (usually sub- or unconsciously) hold past memories in place — REMEMBERING the Past — 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* by turning on certain motor nerves in the muscles. The muscles instantly contract, protecting the bones, joints, and other body parts, such as organs, from, hopefully, too much damage. …
* Most reactions do NOT originate in the conscious part of the brain but in lower parts of the brain and locally at the level of the spinal cord and peripheral nerves distributed throughout the body. By the time you notice it, it is already history!
This was an in-the-moment survival tactic the body performed to save its own life and well-being … or at least, in minor events, maintain 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 its way back” to “normal.” It cannot relax, because the nerve reactions are too extreme, too fast, too confused, too disjointed, and too “burned into the memory banks” for the body or mind to find its way back to “normal.”
That is one thing the Whole Health Therapist or Physician does, finding and providing the sensory inputs necessary to help the Client’s psycho-neuro-musculo-fascial system “find its way back to normal.”
One of the great values of “structural bodywork” is you can, in many cases, SEE, in the present moment, which muscles are most over-shortened and, therefore, over-contracted. These are, most likely, where the nervous system most initiated and now perpetuates psycho*-neuro-muscular hyper-tension patterns causing pain.
* The “psycho-“ part refers primarily to the breath, soul, mind or psychology. The functions of the brain, and possibly the mind, depend on the Client’s or Patient’s unique situation. It does NOT [necessarily] mean you are crazy or “needing a psychiatrist”!)
This evaluation and resulting treatment strategy makes things more efficient because you devote the most therapy time to the muscles, or even PARTS of muscles, most likely to be causing the most trouble for the body.
“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 just happened. If the bodymind goes too far “out of whack” in an untrackable 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. This might be much of the source of what Sarno calls the Divided Mind.
So we get stuck in that Emergency — or Chronic — Pattern of psycho-neuro-musculo-fascial reaction that was initially a lifesaver, but is now a distraction, burden, or worse. This manifests as mostly C.E.M.&.N.T. or Chronic, Excess Musculo-Fascial & 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 opposing or compensating muscles, and so on. … So called “compesations” are the unconscious or unconscious actions, very often minute, of muscles to stabilize, protect, or otherwise manage the various challenges of navigating our way though the physical world.
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. However, since the resulting pain is often felt in opposite or distant locations from its actual cause, this is not always an easy task.
We find that a structural approach, combined with the historical picture (an “inner recurring video,” actually) of past events, gives properly trained therapists more insights they need to help figure out the Client’s situation and bring their bodymind back on a “normal track.”
One Big Challenge is the Descending Sensory Pathways. Most of us have heard of Ascending Sensory Pathways delivering sensations to the CNS & Brain. We’ve also heard of Descending Motor Pathways sending instructions to turn various muscles and organs on or off. But I was not aware of the Descending SENSORY Pathways (DSPs) until I read Job’s Body by Deane Juhan in 1989. It was a real revelation for me. That little section on DSPs was worth about ten times the price of the book, or MORE!
The DSPs are tiny nerve pathways in the lower part of the brain selectively filtering or even BLOCKING incoming sensory information. This happens in order to filter out low-level and redundant information, which is a very useful function. The cerebral cortex can only process a VERY tiny portion of the data flowing through the nervous system. If you had to consciously process ALL stimulations entering the brain, you would be instantly overwhelmed.
The Problem IS, WHO or WHAT decides which sensations to block? Deprived of the data, the causes of those sensations can live in the background, gradually building up over time until they become a big problem; yet we cannot FEEL them. What you cannot feel, you cannot respond to. So you might not feel anything until it gets so bad it’s a much bigger problem than when the source of the sensation happened.
One of the Challenges for a Therapist is to work with the Client in such a way that the DSPs reduce or eliminate their filtering so the Client can restore their ability to more deeply FEEL what is really happening in their body. DSL Edgework is specifically designed to produce the effect of restoring DSPs back to a more normal state.
6.) Another problem is, in many cases, that neuro-muscular reaction to an accident gets, in relative terms, more-or-less permanently recorded and remembered as a “life-long survival tactic.” The body-mind facilitates (makes habitual or “burns in”) 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 rather a small part of a muscle, on or off.
* Synapse: these are the “switches” in nerve pathways determining whether a particular nerve will fire (transit a signal) … 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 (meaning they fire VERY easily) to the point where they eventually 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. Then, they’ll spend more time in the OFF position, keeping the nerves, muscles, & organs in a more calm, relaxed state.
Paradoxically, this is done by DE-facilitating the nerve pathways and synapses 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. This turns off the nerve change to the muscles or organs, allowing them to return to a more normal state.
There are several ways to “inhibit” (reduce or stop) the firing of a synapse and its nerve. It appears that focused attention — mindfulness — is a neurologically “inhibitory” activity, which might well explain why attention — also related to mindfulness or meditation — can in many cases spontaneously turn stress, tension, and resulting pain OFF.
Attention can be focused on one point, object, sound, or other such “thing-ness.” That is concentration. … OR, attention can be completely UN-focused, in a “state” of “full spectrum” or global or universal awareness. Here, the mind is not focused at all on any one thing. THAT is the fully meditative state, which is the OPPOSITE of concentration.
Various forms of bodywork, yoga, and other low-intensity 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.
Anytime more mindfulness can be brought into any process, it has a higher potential to facilitate healing processes.
Though it might fade substantially into the background to varying degrees, quickly or slowly, the neuromuscular system tends to automatically retain a memory of that stabilizing or protective reaction for later use. It becomes facilitated into the structure of the nervous system by way of changes in the chemistry at the synapses. Since the body survived whatever put that reaction in place, the body retains it as necessary.
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, to even exist.
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 cases, it is the complete letting go of willpower that does the trick. No small feat for most people. That’s one reason working with a Therapist can make the process more effective and efficient for them, or even easier.
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 a self-destructive one.
The letting go of any part of a self-identity might be perceived BY the self-identity as a form of ego death. Like most living things, the impulse to survive is an imperative, and survival of the self-identity, the ego, is, for many people, at least as strong, if not more so, as for the physical existence of the body.
Here is one place Pattern Interrupts come in. This means providing the psycho-neuro-musculo-fascial unit an opportunity to FEEL or DO “something different.” In those moments when it “feels something different,” the “attachment” the bodymind has to a memory pattern is slightly reduced or even stopped, even if only momentarily. Yet sometimes those short “breaks in the force field” are enough to start a “Reset Process.” 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 soft tissue issue, there are people who tend to self-identify with their afflictions, and they become “attached” to them. This is the same way an addict can soon identify with many or 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 “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 or stabilizing 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 phenomenon 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 constantly held “on guard,” and every move by another driver or car is reacted to in a far more magnified way than “normal.”
When talking with someone who is highly identified with their self-perceived “sense of self” or “self-identity,” they will often say something like “that’s just me” or “that’s just who I am.”
The implication is that it’s rigidly established with NO possibility of change.
That, of course, is just another defense mechanism to protect the Self-Identity. For some people, having a BAD Self-Identity FEELS safer than the uncertainty of attempting to modify or heal the self-identity that is getting in the way of their own self and relationships with other human beings.
Some people are so internally conflicted they start projecting their stress, anger, or rage onto inanimate objects or other people, which sometimes turns to violence in extreme cases.
OR, they internalize it and “dump” the stress, anger & rage into their own nerves, muscles, & organs. Then, they start developing physical health issues, as Dr. Sarno asserts.
“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 internal feeling states, 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 nearly endless list of possibilities.
“Outside In” might be a car accident or falling down the stairs. The physical body is impacted by 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: Prevent 2nd Hip Replacement on Same Hip)
“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, actually, primarily in the physical body, but partially “in” the mind, as well. Sometimes, however, the mind identifies with the physical 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!
Even mental/emotional “stuff” can end up expressing as muscle tension. The result can be Dr. Sarno’s TMS (Tension Myoneural Syndrome.*) These are the internally generated forces Dr. Sarno deals with so well.
* The term I use instead of TMS is C.E.M.&.N.T. … That’s short for Chronic, Excess Musculo-Fascial & 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 traumas are far worse than others. Not too many people have developed the 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, soft tissue therapy method with Clients who’ve pretty much been given up on by a wide range of physicians or therapists, a few of them have 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. … (If what you have is what Dr. Sarno works with, then his approach is a LOT LESS expensive or time-consuming than working with me. Like I said, SOME people get the results of Dr. Sarno’s Method JUST by reading one or more of his books, which I believe are less than $20 each!)
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. They’re all three connected via the nervous system as well as hormones and neurotransmitters coursing through the bloodstream. 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 is, however, more the domain of professions like psychotherapy and personal coaching, or ecological studies …
How we relate to other beings and our environment can have dramatic impacts on our internal physical, mental, and emotional Selves.
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 RGP (Really Good Practitioner), while more likely highly competent in one of these areas, should have enough understanding of the other two (or three, if they’ve got a lot of time to study!) 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 for Clients.
9.) In the case of a car accident, it is the sensory inputs stimulated by events in the physical world and body the CNS & Brain inputs converge to produce, or not, in the cerebral cortex ( thinking mind ). Here, conscious experiences are produced based on inputs converging on the cortex from the CNS, lower brain centers, and body.
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, except in the most extreme situations.
Yet there are significant limits on what the cerebral cortex can process. First, there are many incoming, sensory nerve pathways not traveling all the way to the cortex. Therefore they cannot be consciously felt.
Second, according to medical research, the cortex can only handle somewhere between 4 and 9 bits of data out of every 100,000 bits passing through the cortex at any moment! … THAT is a tiny amount. 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, prescribing drugs and surgery, with some physical therapy and occasional bed rest.
Worse, the joints and discs are a-neural, meaning they have very few, or NO, pain-sensitive nerves within them, so degeneration of those bony, hard structures cannot, by themselves, generate pain. The pain comes in great part from the hyper-tense muscles pulling, though their tendon, on the soft tissue surrounding the joints and bones. THIS is where the sensory nerve endings are being irritated by the constant pull of muscles. That is why REAL Relaxation & Lengthening of musculo-fascial units so often reduces or eliminates the joint-related pain people feel.
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, andirriating, for example, tendons (with more sensory nerves than the muscle bellies), or nerves embedded in the periosteum (the “skin”) of the bones, or causing ischemia, as TMS (Dr. Sarno’s diagnosis) hypothesizes. Periosteum is a very thin layer of fascia “shrink-wrapped” around bones and is what tendons attach to.
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) than in the muscle bellies. So the tendons, joints, ligaments, or fascia near the ends of the muscles near the bones get most or all the attention.
Yet it is the chronically contracted muscle fibers, located between the tendons, in the muscle bellies, putting all the noxious pressure on those tissues and nerves. So the cause of the problem is often felt in a very different location than where the cause is … but NOT always! Telling which is the challenge of evaluation the DSL Edgework system works with to locate the most likely culprits with a high degree of reliablity.
11.) Neuromuscular Discombobulation (Confusion) and Other Causes of Pain:
One of our hypotheses is that when adjacent or nearby musculo-fascial fibers get far enough out of synchronization with adjacent or nearby fibers within the same muscle belly, a “confusion” occurs, and a pain pattern is set up. With such confusing inputs, the brain perceives “something is wrong” and produces a pain pattern. … Even though there is NO real Damage!
This can happen in many circumstances, for instance, when falling over, or hit by a car, and things happen so fast the neuromuscular / myofascial system cannot “track” what neurological actions occurred and therefore cannot find a “pathway” of neuro-muscular normalization back to more “normal” firing.
We believe this is because many people have very specific pains located in very specific groups of muscle fibers, often of very small diameter or area. Those fiber groups are most often very much tenser — “tight” — than 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. This often takes MANY minutes. For some, it is HOURS spent on just one spot on one muscle.
Muscles can get SO overly contracted and “tight” they literally FEEL like BONES! That is NOT an exaggeration! Other muscles are of various textures and densities; some of them even feel like steel cable. And having been as Structural Steel Ironworker many years ago, I know EXACTLY what a steel cable feels like! Those take a LOT of time.
And just pressing harder on them, or “beating them up,” or “breaking them up,” does not usually work very well.
It is about Finesse, not Force.
PLEASE CLICK HERE to go to Web Page (on Discombobulation and other aspects of pain and therapy)
12.) Regarding Inflammation:
PLEASE CLICK HERE to the Web Page (an 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)
14.) Intersection Between Physical Bodywork and Emotional Work:
DSL Edgework, my method of therapy, attempts to engage the Client’s mind in the therapeutic process as much as possible. The more Awareness & Time that can be invested into the process of working with the physical body, the more effective the work can be. The DSL Therapist does NOT focus too much on the Tension Release Technique itself. They are more focused on the Clients responses.
NO Therapist has EVER Relaxed the Muscles of Another Human Being. What the Therapist offers is the environment, opportunity, & support for the Client to discover that the DEEP, Radical Relaxation happens in their own CNS & Brain when THEY discover their ability to Internally Relax those Muscles.
As said earlier, emotional stuff is mostly “physical” stuff, like the chemical in the bloodstream that add dimension to what the Human Being FEELS. The word emotion, broken down etymologically, is E = to bring forth, and motion = Action. To bring forth Action. And the sensations we feel are physical sensations associated with various actions and processes of the bodymind.
If we apply physical pressure to the skin & muscles, various sensations are invoked. focusing on those sensations brings us in closer contact with whatever is associated with those sensations. If it is true what I said in # 1 above, that it is the act of paying attention in the moment that dissolved the cause of Sarno’s headaches, then physical work can enhance & deepen that process of Self-Introspection.
Thank You For Reading My Article On Dr. Sarno Back Pain Relief, the Mind-Body Connection, Healing Back Pain & Mind Over Back Pain utilizing the Dr. Sarno Method!
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.)
Thank You for Learning More about the Dr Sarno Back Pain Relief Method,
the mind-body connection, and healing back pain.
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
