| T O P I C R E V I E W |
| Jeff |
Posted - 01/01/2007 : 11:25:54
I read with some interest the recent exchange of posts on the lack of scientific rigor with Sarno's TMS approach. I thought it might be useful to give my perspective on why this doesn't matter very much.
I went through 18 months of seeing doctors, taking tests, etc. for a series of pain and neurological symptoms. Every test came back normal. At that point, the doctors, purportedly applying "science," started the equivalent of throwing darts at a dartboard. I was given two weeks of cipro on the "suspicion" that I had some bacterial infection. I did not. I was given two weeks of Bactrim on the suspicion that it would help my prostatitis. It did not. I had one doctor tell me that my leg and ankle pains were caused by spinal stenosis. When I pressed him, he admitted the only reason was that all the other options had been ruled out, so it "must" be spinal stenosis (he had previously concluded after his initial reading of my MRI that my mild spinal stenosis was not the problem). Needless to say, I did not go through with any back surgery or other treatment for my spinal stenosis.
I am unlike those persons who have something identifiably wrong with them -- say, a herniated disk. They have the difficult problem of trying to convince their minds that it is TMS rather than the identified physical problem. I have no identified physical problem, but the pain and neurological symptoms persist.
For me the bottom line is that science has no answer for what ails me, and the doctors I have seen, in the guise of applying science, have really just been engaged in a sophisticated form of guesswork.
I agree that Sarno does not have the scientific rigor one might like. I think he acknowledges that in his books. In effect, he says the brain causes this but we don't really know why, even though he suspects ischemia is the mechanism in some cases. But TMS makes logical sense to me, which is more than I can say for the various diagnoses I have received from medical doctors.
I don't entirely blame Sarno -- how do you test something like TMS? And how do you test it when the entire established medical community is skeptical? At some point you just treat patients, and learn from your experiences, and that is what Sarno (and now various others) are doing.
My TMS symptoms have come and gone. I've had periods of remission, and then they come back again. If anything, that makes the Sarno approach seem more logical. If I really had some medical condition or illness, why would the pain move around, or vary in intensity from day to day?
My bottom line is that many pain and neurological conditions are still (unfortunately) well beyond what proven medical -- or scientific -- knowledge can reach. They occur, and no one knows why. Just look at the various conditions, ranging from prostatitis to restless leg syndrome to fibromyalgia, where the Internet medical sites say basically "we have no idea what causes this or why it happens."
In this milieu, Sarno offers a logical and, to my mind, defensible approach. I don't believe it will necessarily work for everyone, but what does? Despite what I agree is a lack of scientific rigor, I intend to stick with Sarno for the forseeable future because it still offers the most approachable solution for what ails me.
Jeff |
| 2 L A T E S T R E P L I E S (Newest First) |
| Wavy Soul |
Posted - 01/02/2007 : 00:56:23
Some thoughts about scientific approaches and faith and healing...
Actually a scientific approach in clinical medicine is usually statistical and I think that Sarno's approach satisfies this criterion - a huge percentage of those who accept his diagnosis get helped. There are many, many drugs and other treatments in medicine that work, but no one knows quite why and the exact mechanism hasn't been established.
The big bugaboo for the western rational scientific mind religion is that the diagnosis works for those who believe in it, as the last poster mentioned. This might make it seem a bit like faith healing.
Except I don't think it is, really. I have attempted all kinds of faith healing in my 30 years of fighting fibro (which have ended thanks to this approach, even though I began it before Sarno). I even went to Brazil for 2 months to spend time with John of God, and watched him in trance giving healings and cutting people open and operating, then smoothing his hands over the skin and it closed without a trace. I watched this right up close for weeks. It's real. (I didn't have this kind of healing from him, but the "psychic" kind as I didn't want to be cut open by dead doctors).
But even watching this undeniably miraculous process did not make me believe in it enough to be healed, although I met some people there for whom it had worked (hundreds of people go there and live in the town to get healings).
However, Sarno's approach appeals to my logic and my knowing of how things work inside me, and I think that's what ultimately has made it work. Since I was brought up with physicist parents (although I am totally on a spiritual path), I just have this very deep skepticism about lots of stuff. But I could accept the Sarno approach because it made sense. It isn't some miracle happening from the outside, and although it's near-miraculous after suffering for so long, it has plenty of real substance to me as a theory, just because it takes some time and fairly complex effort to work.
Not just a waving of a magic wand.
Sarno's approach is pretty scientific, to me.
xx
Love is the answer, whatever the question |
| ralphyde |
Posted - 01/01/2007 : 22:45:12
In the book, The Divided Mind, Andrea Leonard-Segal, MD, a Rheumatologist who was converted to Dr. Sarno's approach (by being cured by him), discusses the difficulty of applying ideal clinical methodology to TMS. She says on page 259:quote:
How can we conduct studies to see if psychological approaches can cure this condition? Patients with TMS must be psychologically open to the diagnosis to improve. They must be ready to renounce the idea that their cure is to be found in structural or chemical means. Thus, it would be exceedingly difficult, if not impossible, to conduct a study in which patients with the same condition are randomly assigned to different treatments, one of which is the TMS treatment. Because getting better depends on accepting the TMS diagnosis, most patients assigned to TMS treatment would not improve because they would not be able to accept the diagnosis.
I would add that not accepting the TMS diagnosis is the equivalent of not taking the prescribed medicine, or doing the prescribed exercises, in alternate treatments.
The bottom line is that the TMS treatment, which we know to be highly successful among those who can accept the diagnosis, is simply not amenable to the standard methods of evidence-based medical trials, which is probably why Dr. Sarno has not attempted to conduct such trials.
Ralph
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