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 Doctor John Sarno's 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.
SPECIAL NOTE: Though written for any interested audience, my main focus is on Training & Consulting with Therapists and Physicians wanting to understand and utilize Soft Tissue Therapies similar to the way I developed and apply my system, The DSL Method. The principle and techniques can be applied to or merged with any other existing system. I'm not attempting to create a bunch of 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 contributes to their skills and knowledge BOTH in the delivery of treatment but also in their marketing. ...
And Marketing is how "The Right People" find out who their "Right Practitioners" 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. ...
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 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 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 were 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 leading to the Dr Sarno Philosophy is that being focused on the present moment tends to disconnect or dissolve our connection to past events. That's because memories live in thought (which is itself partly neurological or physical 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 neurophysiological 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.
Yet remembering 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.
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 lifelong 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 (temporary) things only so often before they become repression (more or less permanent without intervention).
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 of 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 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.
As Steve Ozanich (the man interviewed in the Podcast in the previous article) 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
(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.)
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 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:
.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 the Dr Sarno Method clearly stated he had 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, also 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 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 whose 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, even if that result is not 100% reliable.
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 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 it's appropriate for a client or patient to pursue such modalities as Sarno's work versus other therapies such as soft tissue (medical massage or structural bodywork) 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 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:
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, 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 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 VERY 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.
Of course, the Allende regime was, at the request of the Chilean Legislature, soon dismantled by General Pinochet. People like Flores went to jail.
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, the Buddhist school 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:
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. It was literally an attempt to bring a "modernized version" of some of Buddhist Perspective into America.
The Training was very effective for many — but certainly not all — people, in part getting in touch with repressed aspects of themselves, 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 now currently known as Landmark Education.
Flores on some occasions brought Maturana from Chile 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 is a "conversation" between mind and body. ...
DSL NOTE: Flores was a client of mine 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, prescribed by Michio Kushi. My work with Flores 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 other story on its own.
* COLLOIDAL: From Wikipedia: "A colloid, in chemistry, is a mixture in which one substance of microscopically dispersed insoluble particles are 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?
Back to the Sarno Technique. His contributions to the mind-body problem apply 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 the Dr Sarno 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 and recirculate the past. Yet mindful ATTENTION in-the-moment (the opposite of "thinking about") tends to dissolve the residue or remnants of 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 often 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 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 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 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 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 we cannot actually "feel" directly 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.
The short story is 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 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 caregivers 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 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 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.
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 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 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." And why such s 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, 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 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. 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 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 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 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* by turning on certain motor nerves to the muscles. The muscles instantly contract, protecting the bones, joints and other body parts, such as organs, from too much damage. ...
- Most reactions are NOT originating 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.
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, 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, 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 therapist or physician does, provide the sensory inputs necessary to 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 hyper-tension patterns causing 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 just 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. This might be much of the sources 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 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 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 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 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 a part of a muscle, on or off.
* 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. They'll spend more time in the OFF position, keeping the nerves in a more calm state.
This is done by DE-facilitating the nerve pathways 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 its nerve. It appears that focused attention — mindfulness — is a neurologically "inhibitory" activity, which might well explain why attention — also known as mindfulness or meditation — can in many cases spontaneously turn stress, tension, and resulting pain OFF.
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.
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, 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, 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 soft tissue issue, there are people who tend to self-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 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 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 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 tension myositis syndrome (TMS or Tension Myoneural Syndrome*). These are the internally generated forces Dr. Sarno deals with so well.
* The term I use instead TMS 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.
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, 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 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. They're all three connected via the nervous system 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'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 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 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 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. 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, 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. 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, in the muscle bellies, putting all the noxious 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 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 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 / myofascial 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 fiber groups are most often very much tenser — "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 (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)
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
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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