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T O P I C    R E V I E W
shawnsmith Posted - 02/08/2007 : 08:59:50
Taking a mental approach to physical pain

Susan E. Lindt

27 September 2006
Lancaster New Era/Intelligencer Journal/Sunday News

Local doctor offers fibromyalgia program

If you suffer fibromyalgia's chronic pain, you've probably been told it's all in your head.

The mysterious syndrome is ill-defined, tough to diagnose and nearly impossible to cure, leaving patients frustrated and desperate to find an answer.

Physicians long have attempted to manage the physical discomfort associated with fibromyalgia, but as for what causes it, they're at a loss.

Now a New York University professor's theory about fibromyalgia's cause is the basis of a new six- to eight-week program offered by Dr. Randy A. Cohen of Mind Body Solutions on North Pointe Boulevard.

"It's a fairly novel approach," Cohen said. "To say that we know what causes fibromyalgia is an arrogant thing. But we believe it's a mind/body disorder. Although the symptoms are very real and the pain is not imagined, the trigger for this pain is emotional."

Before you shoot down Cohen's idea, think of other mind/body ailments we readily accept: Colitis, ulcers and irritable bowel syndrome are digestive problems triggered by stress. Acne can be triggered by stress. Addictions, weight gain and loss, migraine headaches and depression all can be stress-induced. Why not fibromyalgia?

For one thing, fibromyalgia as a diagnosis hasn't been embraced by all physicians. Diagnosis is typically a process of elimination - when tests for other maladies come up negative but the pain continues, some physicians reluctantly settle on fibromyalgia. Still, there is no cure or treatment and symptoms can only be partially controlled, so a fibromyalgia diagnosis offers patients little hope for relief.

"That's one reason why so many patients get a delayed diagnosis. There are so many uncertainties about it," Cohen said. "Physicians continue to want to find something they can put their hands on, so patients are sent from doctor to doctor for endless testing. Patients often have some associated symptoms: irritable bowel syndrome, insomnia, migraine headaches, fatigue. But unfortunately, there's no fix to the problem."

Cohen's program is based on Dr. John Sarno's theory that TMS, or tension myositis syndrome, is the root of fibromyalgia and dealing with emotional stress can relieve fibromyalgia pain.

"What's very unique is that Sarno's saying a lot of us tend to repress uncomfortable or dangerous emotions and stuff them into our subconscious," Cohen said. "The subconscious will then activate the autonomic nervous system and that results in tense muscles due to decreased blood flow, which causes the pain in the muscles."

Emotional pain has long been known to cause other psychological disorders - even some that result in physical pain. And what Cohen's program teaches isn't entirely different from how a therapist would help clients cope with other disorders.

Cohen's $450 program includes education via Sarno's book, "The Mindbody Prescription: Healing the Body, Healing the Pain," and another book by physician Scott Brady, "Pain Free for Life: The 6- Week Cure for Chronic Pain - Without Surgery or Drugs." Patients also are encouraged to watch videotapes about fibromyalgia and the mind/body connection and attend lectures.

The second component is focusing on the psychological aspects of fibromyalgia. The autonomic nervous system is our "fight or flight" system - the subconscious alarm that protects us from hurtful feelings and painful memories. So patients are encouraged to look for emotional triggers to physical pain that might be distracting them from hurtful emotions.

"The more a person focuses on the physical pain, the less someone will have success in this treatment," Cohen said. "When they have a flare of pain, they have to think about what emotion it was connected to, what kind of harmful emotions their subconscious is trying to protect them from."

Cohen's program also offers tools such as self-affirmation to help patients avoid pain by conquering the emotions that trigger it.

The program's last component teaches patients to keep a journal to help them work through emotions at a slower pace and vent them, even if it's only on paper. This is important because fibromyalgia sufferers are often perfectionists or people who repress negative emotions.

"They are people who are just better at repressing emotions than others and they're always nice and pleasant. But it takes a lot of pressure to always have a smile on your face when you aren't feeling that happy," Cohen said. "The perfectionists tend to have more negative thoughts and put more pressure on themselves. They set such high standards, it takes a tremendous amount of pressure to keep up."

Cohen said fibromyalgia patients often also experience anxiety, depression and chronic neck, shoulder and back pain.

In addition to personality types, Cohen's program looks at past trauma and experiences that may trigger pain, as well as current stresses, such as finances, relationships and job stress.

For about six years, Cohen has occasionally recommended similar programs to patients with scant success. He emphasizes the need for patients to be open-minded about the mind/body connection and strictly adhere to the program, which prescribes between 30 minutes and 60 minutes daily to meditate, fill in a journal entry and review the principles of psychological thinking.

Cohen first saw Sarno speak several years ago on "Larry King Live" and "20/20." ABC reporter John Stossel, radio personality Howard Stern, actress Anne Bancroft and other celebrities stumped for Sarno's theory after he successfully treated them for chronic pain. Cohen soon picked up Sarno's and Brady's books and liked what he read: Brady's 10-year success rate shows about 80 percent of his patients felt relief after six to eight weeks in a similar program.

That kind of success has pulled Cohen on board to design his own program based on Sarno and Brady's work. He's hoping he can sell it to some patients who have tried everything else and aren't afraid to draw the link between mind and body.

"It's hard for me not to tell patients about this approach because it has so much potential and can do so much good," Cohen said. "It's been the most rewarding thing that I've done."

Cohen will introduce his Mind Body Solutions program at two free seminars tonight at 7 and 8 at Eden Resort Inn & Suites, 222 Eden Road. For more information, call the Arthritis Foundation at 397- 6271.

4   L A T E S T    R E P L I E S    (Newest First)
shawnsmith Posted - 02/08/2007 : 13:06:12
there is not a link as I got it on a database via the local university that you have to be subscribed to in order to access
Nor Posted - 02/08/2007 : 12:52:56
Singer Artist - I'm thinking this might be a cheaper option for you instead of seeing Sarno. I'm not sure if you're still in NJ. Lancaster is a drive or a train ride away.
NL
ralphyde Posted - 02/08/2007 : 10:31:13
Here's more info on Dr. Cohen for those in Lancaster, PA area:

Randy Cohen, DO
Practicing Medicine & Teaching 17 yrs
Dr. Cohen is a board certified physical medicine, pain management and rehabilitation specialist. He has full privilages at all Lancaster County hospitals. During his career as a physician, Dr. Cohen realized his area of interest lay in the little understood field of chronic pain.

In 2000 he discovered the ground-breaking work of Dr. John E. Sarno. Dr. Cohen traveled to New York City to work with Dr. Sarno and intensely studied his teachings. Dr. Cohen is truly pleased to provide Dr. Sarno's program to the PA area and will be present an overview of Dr. Sarno's work here at Tranquility.

Cohen Randy A DO
160 N Pointe Blvd Ste 113, Lancaster, PA 17601 | 717-560-4480

I haven't been able to find the above article itself.
Ralph
ralphyde Posted - 02/08/2007 : 10:02:09
Very good. Thanks.
Is there an online link to this article?

Ralph

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