I think this author/doctor has come to his conclusions quite out of the loop of Sarno and his research lineage. He simply states that symptoms must not be feared in order to overcome them. This finding is the foundation of Dr. Low and Dr. Weekes' treatment of nervous patients earlier in this century. It is odd that none of their books specifically lists persistant muscular pains as anxiety and anger induced, but then again, as Dr. Sarno points out, back pain was not epidemic in the 1950's and 60's when the aforementioned authors were sharing their findings. This makes Dr. Sarno all the more remarkable for caring enough and being aware enough of his patients' history to notice that they also suffered from a number of maladies that were stress-related and begin to create a diagnosis that he probably knew would be rejected.
Oddly enough, Dr. Weekes and Dr. Low were the first two authors to be recommended to me when my anxiety began. That means that their teachings were seen as mainstream in the early 2000's, but I suspect that they were renegades and held in low esteem by classically trained psychotherapists and the doctors they influenced. They preached simplicity and common sense and 110% trust in their expertise as the guideposts to recovery. Their approaches are not identical, but very similar.
Reading this has had two effects on me, one positive and one negative. The good part is that the pain syndrome fibromyalgia appears to be successfully treated as an amalgamation of anxiety symptoms. But the emphasis Dr .Sarno places on Freudian psychoanalysis is a stark contrast to this approach. And some confusion might result, which is not my intention at all. Oh, and make certain you read the postscript for a laugh.
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THE CAUSE AND CURE OF NERVOUS SYMPTOMS
Preface
The findings described here were originally discovered Dr. Abraham Low1,2 , an American psychiatrist (1891-1954), and Dr Claire Weekes8, an Australian physician, who died approx. 10 years ago. I was able to confirm their discoveries and additionally I incorporated in my manuscript some discoveries from the field of Objectivism3. The ideas expressed by the above two investigators were largely the result of introspection, i.e. cognition directed inward. I have been engaged in introspection such a long time that it has become almost second nature to me.
Please note that I use the terms anxiety, fear and stress interchangegeably. The same also applies to thethree adjectives nrvous, functional and emotional when pplied to illness, symptoms or disorders. The article can be found at the link below:
INTRODUCTION
"I have gathered a bouquet of flowers from other men’s gardens, naught but the string that binds them is my own"
---- Michel de Montaigne
Over fifty percent of patients who visit their physicians daily have symptoms for which no physical cause can be found. Doctors refer to these patients as having a functional illness, as distinquished from patients who have an organic cause for their symptoms. The cause of functional symptoms is not adequately understood by most physicians and it is managed poorly in a great many instances.
Other names for functional illness are: nervous illness, emotional illness, anxiety disorder, psychosomatic illness, emotional disorder, psychoneurosis, nervous ailment, minor mental disorder, and just plain "nerves." I shall regard all these terms synonymously and interchangeably because their symptoms are all anxiety-induced. Some examples of functional illnesses are: psychosomatic disorders, general anxiety disorders, posttraumatic stress disorders, simple phobias, panic attacks, fibromyalgia, obsessive-compulsive disorders, anxiety and depression, social phobia.
I am excluding from consideration psychoses, manic-depressive illnesses, schizophrenia, and major depressions. All these may have a genetic component and are possibly biologically triggered.
My position is that Functional Illness or Disorder is a definite clinical entity, with a specific cause. Just as tuberculosis is caused specifically by the tubercle bacillus, so functional illness is caused specifically by anxiety or stress. If anxiety is removed, functional symptoms disappear. I have reached this conclusion not only as a result of extensive experience in clinical practice, but also as a result of having personally experienced panic attacks, agoraphobia and other functional symptoms.
I have discovered that Functional illness is caused by our emotions, mostly fear (anxiety) and anger, and is largely self-induced and self-generated, without conscious awareness on our part. This may at first sound unbelievable. However, you can prove this to yourself by examining your own inner-life, your own emotions. This is called introspection, a process of cognition directed inward (Ayn Rand). Functional illness is logically best studied by introspection, because the cause, the symptoms and the cure of functional symptoms are all essentially subjective events.
HOW I GAINED INTELLECTUAL UNDERSTANDING INTO THE CAUSE OF FUNCTIONAL (EMOTIONAL) ILLNESS
I graduated from Case Western Reserve University Medical School in 1935. After three years of hospital training, I was engaged in a Family Practice for 50 years. The first 10 years in practice I found rather difficult because too many of my patients had symptoms without evidence of organic disease. I did not understand what caused my patients functional symptoms, and realized I managed them poorly. This caused me great stress in my practice. I took numerous postgraduate courses in Psychology and Psychiatry, hoping I would find the cause of functional symptoms, and learn how to manage these patients more successfully. At the end of ten years of intensive study of Psychology and Psychiatry, careful listening to my patients, and as a result of my own introspection I reached the conclusion that anxiety and stress were the cause of my patients’ functional symptoms. Once I had arrived at this conviction, I was able to manage most of these patients successfully, and I came to love the practice of Medicine.
HOW I GAINED EMOTIONAL INSIGHT INTO THE CAUSE OF FUNCTIONAL ILLNESS
I gained emotional insight, a deeper understanding of functional illness, by experiencing severe functional symptoms myself. My first panic attack occurred suddenly on February 21,1998. First, I felt three bizarre heat waves sweeping across my upper back. Then came a feeling of severe anxiety. Next, I thought I was about to die by suffocation. As I looked around me to see if opening a door or window might help, I saw there really was no danger present, and my intense anxiety subsided immediately. However a low-grade anxiety lingered on, and I could not get free of it. I recognized immediately that I had just experienced a severe panic attack.
I consulted my family physician and described my unusual experience. He performed a complete physical examination and prescribed 0.25-mg aprazolam (xanax) tablets, an anti-anxiety medication. With half of an aprazolam tablet, my anxiety vanished completely, but the effect only lasted four hours. I realized that this was only treating my symptom. It did not treat the cause. A low-grade anxiety continued to follow me like a shadow, in anticipation of getting future panics. Next, my fears multiplied, and I developed other functional symptoms. I woke up on three separate nights with racing, obsessive thoughts, which I was unable to control. An anti-anxiety pill was necessary for sleep on each occasion. Additionally, I felt increasingly uneasy as dusk approached each day, and I experienced slight fear on entering my bedroom at night. Being alone at night became somewhat distressful, and I felt much more comfortable during daylight hours. In retrospect, I was on the road to developing agoraphobia, because my fears multiplied and I was unable to "let go of my fear" of getting future panic attacks.
At this point, I realized I needed additional help, so I joined a "self-help" lay support group, named Recovery-Inc. Dr. Abraham Low, who founded this group in 1937, was a Psychiatrist and Psychoanalyst who practiced in Chicago, Ill. He was Associate Director of the Illinois Psychiatric Institute, and Assistant Forensic Physician to all the State Mental Hospitals. Reading Dr. Low’s books, and especially listening to his 70 audiotapes, was a great educational experience for me. Most of Dr. Low’s keen insight and understanding of functional illness was gained by introspection. His philosophic principles and techniques of therapy are described in his many books, some of them listed in the bibliography.1, 2
Dr. Low said, there would be very little nervous illness without fear. And to overcome nervous symptoms one has to be willing to do the things one fears to do, and be willing to endure some discomfort. I carefully thought about this advice, and after my third weekly Recovery-Inc. session, I experienced symptoms that I recognized as the onset of a second panic attack. Again I felt three bizarre heat waves sweeping across my upper back, followed by severe anxiety. Before the latter reached its maximum intensity, I said to myself, "I am going to endure this, even if it kills me." As I did so and confronted my anxiety directly, it vanished instantly, completely and magically. I became immediately elated as I experienced sudden insight on an emotional level, that my panic attack had been self-induced by fear. I became so exhilarated that my fear of another panic attack vanished instantly. I learned that anxiety, in the absence of physical danger is reversible, when you face it without fear. The expression "There is nothing to fear but fear itself" now gained a new vital meaning for me.
My panic attacks stopped immediately, and the remainig fear-generated agoraphobia-like symptoms I overcame more gradually in a matter of four or five weeks. My mental health in the past five years has been so splendid, that I am eager to share my personal discoveries in functional illness with all others.
EMOTIONS ARE THE RESULT OF OUR AUTOMATIZED VALUES
On the subject of emotions, my greatest mentors were Ayn Rand and her Associates, Leonard Peikoff and Harry Binswanger. Ayn Rand was the founder of a monumental philosophy called Objectivism. Objectivism holds that man has a cognitive mechanism and an emotional mechanism. Both are blank slates at birth, and both are controlled by man’s conscious mind. Man’s subconscious mind (subconscious) can be likened to a computer that is programmed by our conscious mind, by our own value judgments. All this takes place mostly without conscious awareness. We say our values become automatized, and the resultant "printout" from the subconscious is the emotions. Both the storage and retrieval takes place with lightning rapidity. All the above explanation is highly abstract, but is clearly presented by Leonard Peikoff3 and Harry Binswanger.4.5
Since all the above ideas are abstract concepts, let me illustrate by giving you some concrete examples. First, on how the cognitive mechanism works: if I say to you, "Five times eight is ____", what come to your mind instantly is 40. If I say to you "In God we --------", what comes to your mind instantly is "trust." In each instance, the information was previously automatized (programmed) into the subconscious, and was instantly available to your conscious mind, when triggered.
Now, some examples to illustrate how the emotional mechanism works. If the person driving behind your car unexpectedly blows his horn, your instant reaction is emotional, perhaps a combination of fear and anger. This would be the result of a previous evaluation that was automatized, and its resultant emotions (fear and anger) were now triggered. Another example: A 3-year old child might be found playing fearlessly with a loaded handgun, not realizing it is a lethal weapon. This same child later in life, having learned that a loaded handgun is dangerous and can kill, would now react with great fear. Here again, a previous evaluation was automatized, and the sight of the handgun triggered the emotion of fear. A third example: when we are introduced to someone for the first time, we usually measure each other subliminally. Each might observe and evaluate the other on such things as personal appearance, level of intelligence, sense of self-confidence, degree of relaxation, skill in self-expression, sense of empathy. All this complex evaluation is done by our conscious mind, automatized in our subconscious and is instantly available, on a cognitive as well as an emotional level, on demand.
YOUR MIND CAN KEEP YOU WELL IF YOU HAVE FUNCTIONAL SYMPTOMS
Most patients are not aware that their panic attack or other functional symptoms are due to anxiety or stress. It is essential that this information is conveyed to them. Otherwise, they might forever look for a physical cause for their symptoms, or even imagine that they are "going crazy." Faison Covington consulted 30 physicians over a period of 13 years, looking for a physical cause for her symptoms, before recovering from a severe functional illness.6
Taking pills only treats symptoms. Taking pills in the hope that they will magically cure a "neurotransmitter imbalance" is an idle hope.
Once the patient understands and is able to accept the fact that his symptoms are functional in nature, and caused by anxiety and stress, the patient is immedialy relieved and his symptoms disappear shortly thereafter, in most instances. This has been my experience repeatedly in clinical practice, and was one reason why I found the practice of Medicine so enjoyable and fulfilling. Many patients are aware on a subliminal level that their symptoms are related to stress, and only need to hear this from a trusted physician or other authority figure.
The treatment of patients with long-standing functional symptoms can be more difficult, especially if they have consulted numerous health professionals in the past. When these patients have been referred to many specialists previously, and have been subjected to numerous sophisticated tests, this experience itself can serve to frighten some patients. Often times, patients may become confused when different physicians and therapists offer different explanations for their functional symptoms. These patients need the care of an understaning physician and the duration of treatment may take a longer time. A few patients are unable or unwilling to accept the fact that their functional symptoms are due to anxiety and stress, and may continue to search for someone who will find a physical cause for their illness.
All the above observations serve to indicate that the treatment of patients with functional symptoms can at times be complex and difficult. A physician who understands the cause of functional symptoms, and who at the same time understands and practices the "Art of Medicine" will have the greatest success in helping patients with functional symptoms. The subject of treatment of severe chronic anxiety, panic and agoraphobia is well presented in the books by Seagrave and Covington6, Paul Foxman,7 Claire Weekes,8 and Lucinda Basset.10
SUMMARY
A functional illness or disorder is a distinct clinical entity, and is caused by our emotions (fear, anxiety, and anger). Emotions are the result of the "printout" from our subconscious computer that we ourselves programmed, mostly without conscious awareness. Automatized emotions erupt into our conscious mind instantly when triggered. This instant appearance of fear or anxiety, out of nowhere so to speak, can trigger our biological "fight or flight" reaction and thus cause our functional symptoms. Only someone who is willing to engage in minute self-observation (introspection) will discover and be convinced of the fact that functional symptoms are caused by our emotions.
Intellectual understanding of the cause of functional symptoms on the part of the patient may at times not be enough to cure a patient’s functional illness, but understanding the cause can be the forerunner to prevention and cure. If a patient overcomes his irrational fears, anxiety and anger, where no physical danger is present, he will lose his functional symptoms, and find himself on the road to high-quality mental health.
BIBLIOGRAPHY
(1) Low AA, Mental Health through Will Training. Glencoe (Ill): Willett Publishing Co.; 1950.
2) Low AA, Manage Your Fears Manage Your Anger. Glencoe (Ill): Willett Publishing Co.; 1995.
(3) Peikoff L, Objectivism the Philosophy of Ayn Rand. New York: Penguin Books USA Inc.; 1991: 153-158.
(4) Binswanger H, The Ayn Rand Lexicon, Objectivism From A to Z. New York: New American \\\\ Library; 1986:141-144.
(5) Binswanger H, Psycho-Epistemology ll. (Two audiotapes). New Milford (CT): Second Renaissance Books; 1998: 2(b).
(6) Seagrave A, Covington F, Free From Fears, New Help for Anxiety, Panic and Agoraphobia. New York: Pocket Books; 1987.
(7) Foxman P, Dancing with Fear, Overcoming Anxiety in a World of Stress and Uncertainty. Northvale (NJ): Jason Aronson Inc.; 1996.
(8) Weekes C, A Simple and Effective Treatment of Agoraphobia. New York: Hawthorn Books, Inc.; 1976.
(9) Binswanger H, The Ayn Rand Lexicon. New American Library; 1986.
(10) Bassett, L. Attacking Anxiety. Center for Anxiety and Stress, 1984.
POSTSCRIPT: The above manuscript was not accepted for publication in the medical journals, perhaps because its concepts are almost completely psychologically oriented, and at the present time Academic Psychiatry is principally biologically oriented. If the ideas expressed in my manuscript were confirmed, validated and accepted by the Academic Medical Centers and other leaders in the mental health field, it would give Functional Illness and Psychiatry a more scientific base. Psychiatry today, is the only branch of Medicine that has no strictly scientific base.
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Interesting article mentioning fibromyalgia
Posted - 09/18/2007 : 19:32:07
