| T O P I C R E V I E W |
| n/a |
Posted - 01/14/2006 : 20:03:06
This Section Is Constantly Being Updated
Starting today (Jan 13, 2006) I am going to begin posting some important excerpts from Dr. Sarno's work. These will be passages which I feel are most important in order to place TMS sufferers on the road to recovery. I am doing this with the suspicion that many people on this forum are either mis-reading Dr. Sarno's work or are trying to seek other treatment modalities, which are mostly bogus, and in the process prolonging their suffering. I am beginning with the treatment section in "Healing Back Pain," and will then proceed to chapter 1 of the book, The Manifestations of TMS, and then the psychology section of HPB before proceeding to "The MindBody Prescription." Over time I will be adding more quotes to this section so please be patient as this section is a work in progress. I am not adding any of my comments, except in any discussions that may come up on the board, but merely posting what Dr. Sarno has written based on his many years experience working with TMS patients. It is also important, as Dr. Sarno so firmly emphasizes, that readers move beyond a mere intellectual understanding of what is taking place and begin to incorporate in themselves a firm belief in the diagnosis and what it takes to get better. Dr. Sarno says in Healing Back Pain that "mere intellectual appreciation of the process is not enough." Dr. Sarno also states that "One has to confront TMS, fight it, or the symptoms will continue. Losing one's fear and resuming normal physical activity is possibly the most important part of the therapeutic process."(HBP page 81) I hope this section will prove to be useful as you read the passages over and over. Please do inform me of any typos. Let's begin:
Excerpts from treatment section (chapter 4) of Dr. Sarno's "Healing Back Pain."
"I found that most of the patients who got better were those who accepted the idea that their pain was the result of emotional factors." (HBP - page 70)
........
"Based on these observations, two therapeutic conclusions were reached:
"1. The most important factor in recovery is that the person must be made aware of what is going on; in other words, that the information provided is the "penicillin" for this disorder.
"2. Some patients will respond to physical therapy and/or the physical therapist with a placebo reaction. As has been said earlier a placebo reaction is fine, but usually temporary. Our goal was to effect a complete and permanent cure." (pg 70-71)
........
"From a strictly physical point of view, TMS is harmless; therefore, they had nothing to worry about physically. All the prohibitions and admonitions were unnecessary. Indeed, they actually contributed to the problem by creating fear where none was appropriate." (page 72)
"If the purpose of the pain is to make one focus on the body, and through these lectures the patient can be convinced to ignore the bodily symptoms and think about psychological things instead, haven't we made the pain syndrome useless?"
"It is a bit like blowing the cover on a covert operation. As long as the person remains unaware that the pain is serving as a distraction, it will continue to do so, undisturbed. But the moment the realization sinks in (and it must sink in, for mere intellectual appreciation of the process is not enough), then the deception does not work anymore; pain stops, for there is no further need for the pain. And it's the information that gets the job done." (page 72-73)
.........
"If I can convince the conscious mind that TMS is not serious and not worthy of its attention, better yet that it is a phony, a charade, an that rather than fear it one should ridicule it, that most of the structural diagnoses are not valid and that the only things worthy of one's attention are the repressed feelings, what has been accomplished? We will have made the TMS useless; it will no longer have the ability to attract the attention of the conscious mind; the defense is a failure (the cover is blown, the camouflage is removed), which means the pain ceases." (page 73)
..........
"The occurrence of pain in TMS always signifies the presence of repressed bad feelings, like anxiety and anger." (page 75)
..........
"...there are clearly opposing forces in the mind as to what will be the ultimate fate of these repressed emotions. There must be a force (I can't find a better word) which is trying to bring these feelings to consciousness, despite their unpleasant content. If they were subconscious and destined to remain so there would be no need for a diversionary process like TMS. The existence of TMS suggests that something is trying to bring these bad feelings to light." (page 76)
..........
"TMS serves the same purpose by keeping one's attention focused on the body, as do a variety of other physical disorders like tension headache, migraine, hayfever, eczema, and heart palpitation, to name a few." (page 76)
..........
"The treatment program rests on two pillars:
1. the acquisition of knowledge, of insight into the nature of the disorder.
2. the ability to act on that knowledge and thereby change the brain's behavior." (page 77)
"What one must then do is develop the habit of "thinking psychological" instead of physical. In other words, I suggest to patients that when they find themselves aware of the pain, they must consciously and forcefully shift their attention to something psychological like something they are worried about, a chronic family or financial problem, a recurrent source of irritation, anything in the psychological realm, for that sends a message to the brain that they're no longer deceived by the pain. When that message reaches the depths of the mind, the subconscious, the pains ceases." (page 77)
.........
"...experience has shown that the majority will have resolution of most of their symptoms in two to six weeks after the lectures. Patients are warned, however, that the time may be prolonged if they count the days or weeks or become discouraged if the pain isn't gone when they think it should be gone. Human beings are not machines and there are many factors tending to vary the time of resolution. How strong are the repressed emotions? How much fear has the person built up over the years? How readily can he or she repudiate the structural diagnosis with which they came?" (page 78)
......
Patients are encourage to talk to their brains......What one is doing is consciously taking charge instead of feeling helpless, intimated victim, which is so common in people with this syndrome. The person is asserting himself, telling the brain that he is not going to put up with this state of affairs - and it works. Patients report that they can actually abort an episode of pain by doing this." (Page 78-79)
......
Perhaps the most important (but most difficult) thing that patients must do is to resume all physical activity, including the most vigorous. This means overcoming the fear of bending, lifting, jogging, playing tennis or any other sport, and a hundred other common physical things." (page 79)
.....
"Though is is often difficult, every patient has to work through his or her fear and return to full normal activity......That is the purpose of TMS, to keep the mind from attending to emotional things." (Page 79)
............
"I now believe that the physical restrictions imposed by TMS are much more important than the pain, thus making it imperative that the patient gradually overcome them. If patients cannot do this they are doomed to have recurrences of pain." (page 79-80)
"It should be noted, parenthetically, that the advice to resume normal physical activity, including the most vigorous, has been given to a very large number of patients over the past seventeen years. I cannot recall one person who has subsequently said that this advice caused him or her to have further back trouble." (page 80)
...........
"One has to confront TMS, fight it, or the symptoms will continue. Losing one's fear and resuming normal physical activity is possibly the most important part of the therapeutic process."(page 81)
..........
"Another essential for full recovery is that all forms of physical treatment or therapy must be abandoned.
...conceptually, prescribing physical therapy contradicts what we have found to be the only rational way to treat the problem; that is, by teaching, and thereby invalidating, the process where it begins - in the mind.
...the principle is that one must renounce any structural explanation either for the pain or its cure, or the symptoms will continue. Manipulation, heat, massage, exercise, and acupuncture all presuppose a physical disorder that can be treated by some physical means. Unless that whole concept is repudiated, the pain and other symptoms continue." (page 81)
..........
Review the daily reminders
"This is an important strategy but one must be careful that is does not become a ritual. Patients are given a list of twelve key thoughts, and it is suggested that at least once a day they set aside fifteen minutes or so when they can relax and quietly review them. The are called the daily reminders.
-The pain is due to TMS, not a structural abnormality
-The direct reason for the pain is mild oxygen deprivation
-TMS is a harmless condition, caused by my repressed emotions
-The principal emotion is my repressed anger
-TMS exists only to distract my attention from the emotions
-Since my back is basically normal there is nothing to fear
-Therefore, physical activity is not dangerous
-And I must resume all normal physical activity
-I will not be concerned or intimidated by the pain
-I will shift my attention from the pain to emotional issues
-I intend to be in control - not my unconscious mind
-I must think psychological at all times, not physical" (Source: Sarno, John E. "Healing Back Pain" - Page 82)
.......
"As long as he is in any way pre-occupied with what his body is doing, the pain will continue. His confidence in the diagnosis needs to be built up so that he can accept the fact he has TMS." (page 83)
......
"It is pointed out to her that she will never cease being a perfectionist, that she will always have too much to do, but that the secret of getting over TMS is not changing oneself but simply recognizing that the combination of the realities of her life and personality cause he to generate an enormous amount of anxiety and anger.......
"When she grasps the idea that the cure is the acknowledgement of such unacceptable subsconcious feelings the pain will cease." (page 83-84)
...........
"There is always emotional activity going on below the level of consciousness and we have no way of knowing about it, unless from experience we learn to suspect it and anticipate it." (Page 84)
............
"When someone tells me he is having trouble accepting the diagnosis, I suspect that there is resistance in the subconscious to giving up the TMS." (page 85)
........
One of the biggest problems for patients is developing confidence that they can banish this physical disorder with a learning program. That kind of thing is completely outside of people's medical experience. It is my job to convince them it can be done." (page 86)
..........
"It should be emphasized I don't consider someone to have been successfully treated unless he or she is free of significant pain (everybody is entitled to a little bit of pain from time to time) as is able to engage in unrestricted physical activity without fear. As I said before, the fear of physical activity may be more disabling than the pain for someone with a chronic pain problem. As said before, the fear of physical activity may be more disabling than the pain for someone with a chronic pain problem. Virtually everyone I have seen has been a prisoner of fear (of hurting himself, of bringing on an attack) and that works even better than the pain to keep the attention focused on the body instead of the emotions. It is our job to liberate them from this pervasive fear." (page 89)
......
I encourage patients to develop an attitude of disdain toward the pain to replace their strong feelings of intimidation. This sends a message to the subconscious that the strategy of keeping attention focused on the body is about to fail - which means the cessation of pain." (page 91)
..........
"One of the more difficult concepts to grasp is the fact that one does not have to eliminate tension from one's life.
"People ask, "How do I change my personality and how do I stop generating anxiety and anger?"
"If these were the prerequisites for recovery my cure rate would be zero. It is not changing one's emotions; it is recognizing that they exist and that the brain is trying to keep one from being aware of their existence through the mechanism of the pain syndrome. That is the key point in understanding why the knowledge is the effective cure." (page 91)
........
"Why have you stopped using physical therapy as part of your treatment program?
"This was touched on before but it bears repeating. As has just been said, any physical treatment can be a placebo, including physical therapy, and we strive to avoid this because the result is temporary. But there is another, more subtle reason. If I am trying to get people to stop thinking psychologically about their pain, am I not contradicting my own therapeutic strategy if I prescribe physical therapy?" (page 92-93)
"During the early phases of the treatment program the brain my try to locate the TMS somewhere else in the neck, shoulders, back or buttocks. It is reluctant to give up this convenient strategy for diverting attention away from the emotions. Patients must be warned that this may occur, that they must not panic or get discouraged, but merely apply the same principles to the new location." (page 94)
.....
"But I tell my patients, with considerable agitation, that I don't treat pain! That would be symptomatic treatment and it's poor medicine. I treat the disorder that is at the root cause of the pain." (Page 95)]
...............
The following are excerpts from chapter 1 (The Manifestations of TMS) of Dr. Sarno's "Healing Back Pain."
"I have never seen a patient with pain in the neck, sholders, back and buttocks who didn't believe that the pain was due to an injury, a "hurt" brought on by some physical activity." (HPB page 1)
......
"It has been assumed that neck, shoulder, back and buttock pain is due to injury or disease of the spine and associated structures or incompetence of muscles and ligaments surrounding these structures - without scientific validation of these diagnostic concepts.....
"It has been my observation that the majority of these pain syndromes are the result of a condition in the muscles, nerves, tendons and ligaments brought on by tension.....
".....the majority of practicing physicians do not consider the emotions play a significant role in causing physical disorders, though many would acknowledge that they might aggravate a "physically" caused illness." (page 2)
................
"So the answer to the question "Who gets TMS?" is "Anybody." But it is certainly most common in the middle years of life, the years of responsibility." (page 5)
.....
"TMS can manifest itself in a variety of locations and it tends to move around, particularly if something is being done to combat the disorder. Patients often report pain in a new location as the old one gets better. It is as though the brain is unwilling to give up this convenient strategy for diverting attention away from the realm of the emotions. It is, therefore, particularly important for the patient to know where all the possible locations of pain are." (Page 11)
......
This idea [that the pain has a physical cause] is one of the great impediments in the way of recovery. It must be resolved in the patient's mind or the pain will persist. Gradually, patients need to begin to think psychologically; and, indeed, one the diagnosis of TMS is made, it is common for patients to begin to recall all the psychological things that were going on in their lives when the acute attacks occurred, like starting a new job, getting married, and illness in the family, a financial crisis and so on. Or the patient will acknowledge that he or she has always been a worrier, overly conscientious and responsible, compulsive and perfectionistic. This is the beginning of wisdom, the start of the process of putting things into proper perspective. In this case, it is the recognition that are physical disorders that play a psychological role in human biology. Not to be aware of that fact is to doom oneself to perpetual pain and disability." (page 13-14)
.......
"It is not occasion itself but he degree of anxiety or anger which generates that determines if there will be a physical reaction. The important thing is the emotion generated and repressed, for we all have a built-in tendency to repress undesirable emotions that we would rather not be aware of, and so the mind keeps them in the subterranean precincts of the subconscious if it possibly can. All of this is discussed in the psychology chapter." (Page 17)
....
"The process of conditioning, or programming, seems to be very important in determining when the person with TMS will have pain." (page 21)
......
The conditioning is broken by the educational process." (page 22)
.....
"They have learned to associate activity with pain; they expect it, so it happens. That is conditioning.
The specific posture or activity that brings on the pain is not important per se. What is essential is to know that it has been programmed in as a part of the TMS and is, therefore, of psychological rather than physical significance." (page 23)
.....
"In my view physical restrictions and the fear of physical activity represent the worst aspect of these pain syndromes. They are ever present, though the pain may come and go." (page 24)
.....
"Though we must indentify the structures involved in each case, this is the least important part of the consultation. Each encounter with a patient is an excursion into that person's life. After we have established which body parts are involved that information must be put aside for we do not work on the muscles, nerves and ligaments directly. Something in that person's emotional life that might have played a role in producing the symptoms must be addressed." (page 26)
......
"Recurrent attacks, fear of recurrence and physical activity, and failure to find successful treatment characterize TMS." (page 27)
........
"The net effect of symptoms, fears and alterations in the life-style and daily activities is to produce someone whose attention is strongly focused on the body. As shall be seen in succeeding chapters, that is the purpose of the syndrome - to create a distraction so that undesirable emotions can be avoided. It seems a heavy price to pay , but then the inner workings of the mind are not really known, and we can only suspect its deep aversion to frightening, painful feelings." (page 28)
The following are excerpts from chapter 2 (The Psychology of TMS) of Dr. Sarno's "Healing Back Pain." |
| 13 L A T E S T R E P L I E S (Newest First) |
| Saf |
Posted - 03/03/2006 : 15:26:00
I get you Peter, so what should we be doing?
Saf |
| n/a |
Posted - 03/02/2006 : 16:22:40
Trust me, I understand. In a sense trying to understand it intellectually can be a hinderence. You have to begin to establish the link between what is taking place inside of you and your physical symptoms. The source of your pain is not physical, it is something generated by your brain to distract you. The physical symptoms are so real, intense and keep you so distracted it is hard to think of anything else. This is exactly the role of the pain - keep you focused on your body so that you will not think about what is taking place on the inside. Angry outbursts, over eating, obsessions with sex (such as hard porn), etc. can serve the same function, ie they are all defense mechanisms to keep you away from concentrating on your inner self.....
I know it does not seem logical from our understanding of what causes pain, but the solid evidence can be found in Dr. Sarno's books and several other writers also.... |
| Saf |
Posted - 03/02/2006 : 15:19:13
Wonderful, even though I have read both books, very helpful.
BUT, what exactly is the treatment. neither me nor my back pain well educated intelligent husband can suss it.
Book makes wonderful sense, but then what...
No I am not being sarcastic, I we really cant fathom it...
Saf |
| Kajsa |
Posted - 02/17/2006 : 06:13:15
Haven’t been here for a while but when I log in I can see that you take
your mission serious indeed Peter.
It is of course kind of you to quote Sarno - but believe me - there will always be
people who misread him – or simply him the way they like. (And some of them will
benefit from it also...)
I think you should stop for a while and think WHY this bugs you so? Why you put so much energy in that?
I am finally doing fine. The fibromyalgia is almost gone and the fatigue is so much better.
I can often function like a normal person – do things with no pain and with energy.
“Letting go” was important for me. Not trying to hard, not being rigorous.
Live a normal and active life DESPITE the fatigue (not wait for it to go away). I am now
planning to start to work full time again.
Listen to your “inner voice” and don’t let the method become “a religion” in that sense that it occupies
your mind to much. The important thing is to LIVE your life among other people – with the joy and
problems that comes along with that.
All the best
Kajsa
|
| gevorgyan |
Posted - 02/17/2006 : 02:30:32
Thank You Peter,
due to my job, recently I travel a lot, thanks to you I can keep
Sarno's words on me all the time in spite of fact that HBP is already not translated on my mother language.
but figure out, you are the greatest goodist among us 
dying to hear you are totally cured,
Monika |
| almost there |
Posted - 01/21/2006 : 13:47:59
PeterMcKay,
This is wonderful....thank you so much for taking the time to select and type all these passages from Dr. Sarno's two books...what I am taking away from your entries thus far is... "fear is what is keeping us prisoners of our pain"....not that I didn't know this...but it always needs repeating!
I agree that MBP is more inclusive of many other manisfestations of TMS....but I will always love HBP because it was my first introduction to the idea of a mindbody connection and my first freeing from pain....I can't wait for Dr. Sarno's new book due out this spring!
Thank you again! |
| art |
Posted - 01/15/2006 : 17:36:08
quote:
It appears from these words, if I am reading them correctly, one can be 100% free of pain and still not have recovered from TMS. It is the fear that is the most powerful weapon of the brain.
I agree with this. While I've thus far been able to put out all the brush fires, I've never considered myself cured, if such a thing is even possible.I know I have lots of work to do.... |
| n/a |
Posted - 01/15/2006 : 16:58:16
Scottydog,
I will be posting select quotes from "The MindBody Prescription" once I am done with "Healing Back Pain." This is a longer term project that may take a few weeks. Both books are filled with many nuggets of wisdom and insight. |
| Scottydog |
Posted - 01/15/2006 : 16:41:04
I much preferred MBP to HBP - it seemed much more relevant to my problems.
Anne |
| n/a |
Posted - 01/15/2006 : 16:17:08
Art, fear is certainly a powerful weapon that the mind uses and Dr. Sarno has a lot to say about this topic. For example, on page 89 of "Healing Back Pain" he writes: "It should be emphasized I don't consider someone to have been sucessfully treated unless he or she is free of significant pain (everybody is entitled to a little bit of pain from time to time) as is able to engage in unrestricted pyhsical activity without fear. As I said before, the fear of physical activity may be more disabling than the pain for someone with a chronic pain problem. As said before, the fear of physical activity may be more disabling than the pain for someone with a chronic pain problem. Virtually everyone I have seen has been a prisoner of fear (of hurting himself, of bringing on an attack) and that works even better than the pain to keep the attention focused on the body instead of the emotions. It is our job to liberate them from this pervasive fear." (page 89)
It appears from these words, if I am reading them correctly, one can be 100% free of pain and still not have recovered from TMS. It is the fear that is the most powerful weapon of the brain.
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| n/a |
Posted - 01/15/2006 : 15:57:49
Thank you Ralphyde, I am still typing the material in and will edit as I proceed. Please be patient as it takes a lot of time. If you see other mistakes please let me know. I never said I was a perfectionist, but even if I am that does not mean I am perfect:) |
| art |
Posted - 01/15/2006 : 15:23:35
quote:
"It should be noted, parenthetically, that the advice to resume normal physical activity, including the most vigorous, has been given to a very large number of patients over the past seventeen years. I cannot recall one person who has subsequently said that this advice caused him or her to have further back trouble." (page 80)
This was great idea, Peter. And your timing couldn't have been better for me as I'm struggling with a ton of "over-use" type things since we've arrived in Florida for the winter (I can hardly believe my good fortune). But that's just it. The perverseness of my TMS is that the better the time I'm having, the more sweet and enjoyable my work out sessions, whether biking or running or whatever, the greater the fear I have of injury. I fight this fear tooth and nail, but as we all know, it's not always easy.
I love that Sarno can make such an unequivocable claim. I believe him too. I kind of wish he'd extended it to any kind of injury, but I'm going to assume that any genuine physical set back, in other words someone assuming TMS and then turning out to seriously hurt themselves is quite rare.
Thanks again Peter. I'm sure Ralph is joking. I couldn't care less about a few typos myself.. |
| ralphyde |
Posted - 01/15/2006 : 13:48:43
Good Idea, Peter,
But there are a very few misspellings throughout which you may want to correct. They're getting much harder to find now. Good job! Here are a couple more:
quote:
"Patients are encourage to talk to their brains......What one is doing is consciously taking charge instead of feeling helpless, intimated victim, which is so common in people with this syndrome. The person is asserting himself, telling the brain that he is not going to put up with this state of affairs - and it works. Patients report that they can actually abort an episode of pain by doing this." (Page 78-79)
"
quote:
"It is pointed out to her that she will never cease being a perfectionist, that she will always have too much to do, but that the secret of getting over TMS is not changing oneself but simply recognizing that the combination of the realities of her life and personality cause he to generate an enormous amount of anxiety and anger....... 'her' instead of 'he'
"When she grasps the idea that the cure is the acknowledgement of such unacceptable subsconcious feelings the pain will cease." (page 83-84)
quote:
"It should be emphasized I don't consider someone to have been successfully treated unless he or she is free of significant pain (everybody is entitled to a little bit of pain from time to time) as is able to engage in unrestricted physical activity without fear. As I said before, the fear of physical activity may be more disabling ...
'and' instead of 'as'.
I think this is a great idea. I just think that when quoting someone else, one should be careful to get the quote right. So that others who use these quotes, as I intend to, can be confident they're correct.
So what's up, Peter, aren't you supposed to be a perfectionist? 
Great job, Peter.
Ralph |
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