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Hillbilly
USA
385 Posts |
 Posted - 03/05/2008 : 11:34:41
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quote:
Lastly, I have an assignment for someone who talks to Dr. Sarno. Please ask the man himself why he thinks that TMS operates outside the world of anxiety disorders (again, not the emotion anxiety, but the identified, accepted labels in the DSM-IV, just to make it easier for understanding). What research has he done to reject that explanation? Ask him why Dr. Brady and Dr. Schubiner are explaining the physiological aspects differently and if he has seen their research and to give his opinion. Why the change to myoneural in the syndrome name after all these years of amazing success? Why does he now think the nerves are the primary tissue? Ask him if he can record your conversation to be played here or on your website so that the presumptive bias is not at play. Others may add to this list. This would be a very good use of this forum in my opinion. The goal is healing for sufferers, not defense of theories. I would love to hear his reactions. If Dr. Sarno won't cooperate, perhaps one of the others will. I would love to hear it.
I asked some very pointed questions about theoretical stuff that in my opinion would be of use to many who visit here and flounder for months or even years due to their confusion. Confusion simply adds up to more stress and is a large obstacle on the road to accepting the diagnosis, which, I think nearly everyone would agree is essential to recovery. These are by no means the only questions out there, so perhaps people can add to the thread for a week or so, let one of Dr. Sarno's patients call him up and ask them and post or otherwise publish the results.
After all, the vast, vast majority of his patients will never see him or any other TMS doc. They have to rely on books and this forum and a few other scant resources. See if he'll cooperate. Shouldn't take more than 15 minutes or so. There are even people who visit this forum who understand all the technology about websites and such, so perhaps the material could be published there in word form or an audio file. Maybe Ken at the office who sells the DVD's could do this since he sees him frequently. Here's to your health! |
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stanfr
USA
268 Posts |
Posted - 03/06/2008 : 16:52:25
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| Hillbilly: ill take a stab. I dont plan on talking to Sarno in the near future, but my guess is that he will simply reject any criticism and rely on his experience with thousands of patients. He frequently brings up the fact that many are immediately cured upon learning of the TMS theory, and that does not necessarily gel with anxiety as a source. Ive asked Sarno similar questions and that's how he usually responds--with conviction and no room for doubt. When i asked him how dermatologic conditions that are non-symptomatic could serve as a distraction, his response was "Well, these things operate at numerous levels--it is a very complex phenomena (paraphrased)" And bravo, since if he had any doubts probably none of us would ever read his books! At 80+ years old, you aint gonna get any great discussion form Sarno, i hate to break the news to you. I would suggest you pose your question to one of the 'newer generation'. |
Edited by - stanfr on 03/06/2008 16:53:14 |
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mk6283
USA
272 Posts |
Posted - 03/06/2008 : 19:40:32
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You need to understand that Sarno's cockiness, confidence, and no-holes theory are a major part of his success with so many patients. The history of medicine is essentially the history of the placebo effect. 50 years ago, doctors armed in their white coats (and maybe a few vaccines) were all we had, yet people still seemed to get better. I am in no way implying that TMS is a placebo, as it is clearly NOT (and probably is one of the few true cures that we have in medicine today). I am just trying to say that Dr. Sarno's persuasive demeanor plays a large role in his success as a TMS doctor. I'm sure deep inside Dr. Sarno has SOME doubts about some MINOR details of his theory, but he realizes that it is more important that his patients BELIEVE in TMS, and that is a lot easier if they have a fully coherent picture of the process so that they can "understand what is truly going on." The details are simply not important.
Best,
MK |
Edited by - mk6283 on 03/06/2008 19:56:57 |
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Hillbilly
USA
385 Posts |
Posted - 03/07/2008 : 07:36:54
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Stanfr,
Thanks for taking this on. It is important. There are more than 20 million people in the US alone who have been diagnosed with various anxiety disorders. That's just less than one in 10. Just like back pain, some have severe problems that keep them housebound, others just feel uneasy and insecure and basically live in a shell created by their fear of embarrassment, success, failure, or whatever.
I don't have statistics on this one, but I have known personally, many, many people whose experience with anxiety always ends up with bodily discomfort in the neck, shoulders, back, feet, anywhere. And they can also have trouble sleeping, GI upsets, shake all over, have glandular swelling all at the same time. So how do we explain all these away as a simple distraction? If you only need one distraction (back pain), why did I and many others need 47? Wouldn't one suffice? Please try to approach this objectively. You were a lawyer. Rely on evidence. I've given you plenty. Ask Sarno to shepherdize his case.
Please ask the questions and don't couch it in terms of criticism, but in the spirit of improving recovery rates for this and all somatization problems. I think you may be right in that the new generation would be more open to this type of question and seek out information. I also asked if someone who has the ear of Brady or Schubiner to do the same. |
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Dave
USA
1864 Posts |
Posted - 03/07/2008 : 08:17:56
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I suggest you write a letter to Dr. Sarno and ask him yourself. It's not very fair to ask his patients to do your dirty work.
In any case I doubt you'll get the answers you are looking for, and as I've said before, I think all this misses the point of Dr. Sarno's work.
Dr. Sarno has positioned himself outside of the community that insists on applying "accepted labels" to disorders for a reason. Whether or not the medical community at large accepts his theory is of little concern to him. If it was, then he would have spent the better part of his life trying to prove it with research, rather than helping patients get better. |
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Hillbilly
USA
385 Posts |
Posted - 03/07/2008 : 08:39:47
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Dave, why do you characterize this as dirty work? If he responded to me, what would I do with the information? If he agreed with me 100% and I published it word for word, I would be dismissed as a heretic here anyway, so my suggestion was for one of you who believe the distraction theory is the answer, let them do the asking. This eliminates my less-than-hidden bias away from his explanation.
The goal is to clarify these things to improve healing rates. Are you satisfied knowing that less than half of his own patients who enter psychotherapy are helped? If so, let your indifference be noted. Remember these people are screened ahead of time. What about the unscreened? Where would they be? Where are they now?
Finally, I would like to hear from the neurologist who pops up on this board occasionally (Ziggles) how many people enter his office every day who have some benign symptom and think they have MS or ALS, request many tests, all normal, but still can't believe their own catastrophic thinking is feeding the beast they feel in their bodies? Does he tell them they have anxiety or TMS? Recommend psychotherapy or CBT? Meds or thought restructuring? How do you differentiate? If it's pain then TMS, if tingling, anxiety? |
Edited by - Hillbilly on 03/07/2008 11:36:48 |
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stanfr
USA
268 Posts |
Posted - 03/07/2008 : 13:46:43
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Dave (and MK) where i completely disagree with you is your statement of "understanding the scientific details of how TMS works is not important" (in response to the original thread)
I not only think it's important, i think it's essential. If more work were done "proving it through research" we might be reaching millions of people rather than thousands. MK, the reason i was drawn to Sarno's theory in the first place is because there was a scientific logic to it, that is what differentiated it from the countless other "alternative" remedies that were presented to me at the time. Granted, that's my bias as someone who is skeptical and a scientist, but im not the only one! You cannot claim "the details are not important" and simultaneously proclaim that the cure works because people "understand what is truly going on/fully coherent picture" That is a direct contadiction!! How the process works is absolutely essential for determining how best to attack and treat the problem. It may take beyond our lifetime to figure out the details, but that shouldnt be an excuse for not making the effort. My own experience and many others on this board bears that out, and i thank Hillbilly for again giving this issue the attention it deserves!
Note, I wholeheartedly agree that Sarno should be canonized for his contributions to this problem, and i fully credit him with helping me overcome my own symptoms!
Hillbilly, I obviously don't think it is "a simple distraction". I certainly dont have the answers, my only point to you from day one is that neither do you. In my case, i noticed that only one symptom can dominate at any given time, which is consistent with a distraction theory. I also gave you a clear example of how the simple act of recalling my dreams was able to rid myself of CTS, which to me personally certainly suggested that distraction from subconcious thoughts was a distinct possibility. We all have different experiences and so its tough and foolhardy to generalize when there is a lack of research on the subject. |
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Dave
USA
1864 Posts |
Posted - 03/07/2008 : 14:17:21
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I just think this exercise is irrelevant. What exactly does it mean: "TMS operates outside the world of anxiety disorders?"
You said: "The cure lies in acceptance and understanding that the symptoms are just everyday symptoms of stress exaggerated by fixation and sensitization, and calming your system down by dropping the fixation and responding to life's challenges instead of shrinking away from them because you fear failure, embarrassment, or not living up to some perfectionistic standard." Is this so different from what Dr. Sarno is saying? I would say it is quite consistent. Is "responding to life's challenges" different from exploring sources of repressed emotions? Isn't "shrinking away from them" repression? Fear of failure and living up to perfectionistic standards is completely consistent with TMS-prone personalities.
As I said before, I prefer to think of all this metaphorically. I do not believe humans have the capability to comprehend the complexities of how the brain works. All we can do is formulate theories that resonate with us on a level that we can understand.
Is every detail of Dr. Sarno's theory completely accurate? Probably not. Is every scientific research study done on anxiety disorders completely accurate? Probably not.
Physical symptoms can be caused by psychological factors. This is the key piece of knowledge that we need to learn and accept. Next we have to recondition ourselves to think differently about the symptoms and modify our responses to them, as well as to become more aware of the emotional conflicts within us that we are avoiding.
The "cure" lies in what we think, what we do, what we feel. A part of it is understanding, on some level, the scientfic explanation for the physiological responses to emotional factors. When I say the details are "not important" I mean the precise nature of how these physiological responses occur. I believe these details may be far more complex than Dr. Sarno theorizes, even to the point of being incomprehensible to us based on our current knowledge of the brain. |
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Hillbilly
USA
385 Posts |
Posted - 03/07/2008 : 15:59:50
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Dave,
What that statement means is this: why does Dr. Sarno think he discovered something new? He evidently thinks he has found something like a new element to put on the periodic table, when in fact a very effective method existed long before he got out of med school to deal with nervous condtions like anxiety disorders and all forms of somatization, regardless of the label attached. Again, as I stated, these labels serve no purpose to patients, only to the labelers as they attempt to formulate a treatment program. Symptoms overlap. Insomnia can be present with anything from plain old back pain to dementia. My whole point was to cast off the labels entirely and deal head-on with the issues and sensitivities that lead to pain and illness, the essence of cognitive therapy.
To use his own words: Insight therapy is clearly the choice for patients with this syndrome. This statement was first made in Healing Back Pain. OK, so let's look at the outcome studies of this VERY STRONG statement: Page 180 of TDM for those following along in their hymnals. The outcome study of 1999 had WORSE results than the one in Mind Over Back Pain. So, far all the warp and woof about distraction theory (which came after the first book's publication, also statements about the brain picking muscles near herniated discs that the patient could not possibly know about if it weren't for imaging studies that came about long after back pain started happening in the world, could not possibly know if the doctor would order one or if the insurance company would pay for it) the results were worse. Bottom line: the theory expanded and the results contracted. This is the fairy tale trip I would like people to avoid if they are struggling to see their problem through this theory.
So again, I ask the question, why did he not simply stick with his early theory of anxiety and anger causing the whole problem and attempt to treat it according to well-established counseling techniques that were available at the time? He needs to answer this question for his patients, most of whom are book readers who've made the rounds of doctors and even therapists, yet their suffering continues.
Dave, you have stated repeatedly that we don't know much about how the brain works. This is a cop-out statement. There IS much known about the brain's role in symptom creation. A simple blood test can check for elevated stress hormones. The rest can be readily gleaned through public sources. And constantly insisting that it doesn't matter or is irrelevant means that YOU find it so, not that others who are desperately trying to puzzle their way through this thing do. So it is here for anyone interested. Thanks again for allowing a quasi-intellectual discussion to take place that didn't involve politics, global warming or someone's boyfriend problems or trouble with their dogs — all hot topics in former, sadder times here.
Stanfr, your last post was much more ecumenical, so thank you. I didn't claim to have invented this stuff. It's all out there for anyone looking for it. I just put it together here in a way that other people can look at and either reject outright or look for themselves. I post this anonymously and have nothing to gain from it, not glory, not money, nothing.
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Edited by - Hillbilly on 03/07/2008 16:02:59 |
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golden_girl
United Kingdom
128 Posts |
Posted - 03/07/2008 : 19:40:37
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I find this all very interesting as I have, first and foremost, an anxiety disorder - the physical symptoms came later. However, I had about 2 years of CBT with a psychiatrist at the age of 18-19 and felt it pointless and patronising throughout. How does scoring out of 10 on a bit of paper how much you really believe some crazy fearful thought of the day help? Maybe I missed the point? What about coming to some sort of resolution with a childhood of middle-class domestic violence, personality-forming bad family dynamics and a myriad of wrong personal lifestyle choices? Oh no - "Don't worry, this isn't a Woody Allen film, I won't make you lie on a couch and talk about your fears - I'll just get you to write down a four-way circle of feelings-thoughts-worry-actions and call it A HOT CROSS BUN".  (At least I managed to avoid bloody anti-depressants in my teenage years and thus avoided selfharming and suicide and all the other things the lovely pharmaceutical companies knew increased in teens.)
My point being - the only thing you get offered (in the UK at least) is CBT, and therefore you have no way of getting any other sort of psychotherapy on the NHS (and seemingly privately either). And what help is that?
By the way, politics, global warming or someone's boyfriend problems or trouble with their dogs may not sound very intellectual to some - but could cause severe stress for others...
"F.E.A.R.
Forgive Everyone And Remember
For Everything A Reason"
Ian Brown |
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Hillbilly
USA
385 Posts |
Posted - 03/08/2008 : 07:43:53
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GG,
I am sorry that this is your impression of CBT, but it isn't mine. There are good and bad counselors everywhere, and my first experience was less than wonderful, so I sought someone who lived it. I actually saw a lady who not only used CBT, but she was a drill sergeant about thinking patterns. She forced me to provide evidence of truth about all the thoughts that were causing me strain, and cast them off as nonsense without supporting facts. This was a key. If you even suspect that you have something physically wrong with your body after all these years, seeing doctor after doctor, you are commiting the cardinal sin of recovery.
Nervous people don't fear anything except their inner life. They think they fear situations that bring on their symptoms, but they don't. They avoid the situations BECAUSE of the symptoms. Banishing the symptoms certainly makes life more comfortable, but implicit in the definition of anxiety disorder and in TMS is the most important word and most powerful word that we don't latch onto and give enough credit: harmless. There is nothing wrong with your body. Do you believe that? I hope so.
The last quip may sound crass, but for those who remember some of the stuff that was argued about here about 18 months ago, it will give them a laugh. Cheers, GG! You can get better. |
Edited by - Hillbilly on 03/08/2008 08:37:53 |
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Dave
USA
1864 Posts |
Posted - 03/08/2008 : 10:52:27
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quote:
Originally posted by Hillbilly
What that statement means is this: why does Dr. Sarno think he discovered something new?
And here is precisely why I called it "dirty work."
You seem to imply that Dr. Sarno is somehow feeding his ego and demanding sole credit for some new discovery. I prefer to see him as a medical practitioner who has helped thousands of people recover from their symptoms, and who is trying to spread the word.
If you really think Dr. Sarno is ignoring all prior research on the subject then all you have to do is look at the tremendous list of references he credits in his writings. Not to mention, the entire basis of his theory originates in Dr. Freud's work, who coincidentally has had his own theories discredited as the psychology profession has evolved.
If your intention is to discredit Dr. Sarno then please do not use this forum to further this goal. |
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Hillbilly
USA
385 Posts |
Posted - 03/08/2008 : 11:55:29
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So Dave, what exactly is the purpose of this forum?
Is it aimed at expanding or adding to the healing process of psychosomatic illness or is it a place to train people to think inside a box, the bounds of which are defined by three books, all of which say essentially the same thing (discounting the first book, of course, which he himself no longer recommends)?
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armchairlinguist
USA
1397 Posts |
Posted - 03/08/2008 : 13:04:19
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quote:
these labels serve no purpose to patients, only to the labelers as they attempt to formulate a treatment program.
Strange that you would say this, since you constantly mention the category of DSM-IV "anxiety disorders" -- which, I would note, many people with TMS pain symptoms do not have as far as the DSM-IV is concerned. Not everyone with TMS is a "worrier" type.
I would call your "request" dirty work because you are not willing to undertake the debate with Dr. Sarno yourself (instead asking others to do it), and you are going about it antagonistically. You have decided that you are opposed to Dr. Sarno and I don't believe you will change your mind. You have so far been unwilling to recognize the similarity between what you think the answer is and what Dr. Sarno says, so I don't see why you imagine hearing from the man himself would make any difference.
Why are you insistent that it has to be your way or the highway? You are just as dogmatic as anyone else on this board in this regard.
TMS very clearly is not stated to operate outside the world of anxiety disorders. And to call anxiety an equivalent is not to diminish it -- it indicates it's a different syndrome with similar psychological causes. I don't see how what you are saying conflicts with this, except that you might identify different emotions as the primary causes (fear vs. rage). But basically your treatment suggestions are the same -- restore normalcy to the nervous system (similar to training the brain to stop pain by repeatedly focusing on the psychological), and return to normal life by ceasing to shrink away from challenges & anxious situations (like returning to normal physical activity).
Dr. Sarno's work was with pain patients, so he formulated a theory and treatment for those who are having pain. The same techniques can work for anxiety, but the syndrome, strictly speaking, is different, and he was focused on solving that single syndrome. I don't think this singular focus benefited his work, and his work is ripe for extension and cross-connection, but the good doctor is in his eighties and he worked at a pain clinic; he wasn't trained as a psychologist or psychiatrist. Other people may be better suited to carry forward and synthesize the varying theories.
What he was saying about pain was not at all accepted in the environment in which he worked (and still largely is not). It was quite new in that regard (though he does not say it is new in general, as he explores its expression to past literature in psychology in A Divided Mind), and it's still extremely unorthodox in its belief that the pain can be dealt with without therapy for many people. I frankly think this is a very valuable part of his theory, because while it is not true for everyone (which he acknowledges), it allows many people to quickly feel better and see success without the time- and money-intensive activity of therapy. I don't tink I would have ever attempted to practice the theory if I'd had to start out with therapy, instead of starting out by retraining my thinking and reclaiming my life.
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It's not 100% belief that's required, but 100% commitment. |
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Wavy Soul
USA
779 Posts |
Posted - 03/08/2008 : 13:54:29
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Don't want to jump into the underlying vibes/ debate here, but I will say that the ONLY thing about this whole Sarno deal that actually worked for me was...
drum roll...
DISTRACTION THEORY!!
Everything else I already knew and had been practicing diligently for decades.
xx
Love is the answer, whatever the question |
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Hillbilly
USA
385 Posts |
Posted - 03/08/2008 : 17:24:33
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ACL,
Please reread the previous thread and see that I am only referring to the DSM-IV to find common language that nearly anyone in medicine or psychology would recognize for the purpose of having a discussion. Otherwise, as it says in the pullout, labels are useless.
Please also see that I said that OTHER prevailing thoughts and emotions can trigger the symptoms in people. So no, not everyone with this kind of pain is a worrier before the onset of symptoms, but they sure are once the symptoms appear. Else, what is "physicophobia?"
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Allan
USA
226 Posts |
Posted - 03/08/2008 : 18:48:25
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Talk about the Tower of Babel.
This is the most ridiculous thread that I have ever read.
Time to move on.
Allan |
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mk6283
USA
272 Posts |
Posted - 03/08/2008 : 19:16:40
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Hillbilly, I'm sorry but in my opinion your arguments are simply a combination of semantics and nonsense. No one is denying the role that anxiety can play in TMS. Likewise, no one is implying that Dr. Sarno invented the concept of somatization (nor would Dr. Sarno himself). You keep saying "why does Dr. Sarno think he discovered something new?" Well, for starters, I don't know of a single physician who ever diagnosed a patient presenting with excruciating back pain and multiple disc herniations with a psychosomatic illness before Dr. Sarno did. He was the first to postulate that such pain was still (despite overwhelming radiologic evidence to the contrary) psychogenic in origin. For the record, he proposed and stood by his theory long before the Jensen study (NEJM), or other comparable studies, ever corroborated his suspicions.
Even today, if I were to ever suggest to an attending that a patient's back pain was due to anxiety or psychosomatics or somatization or TMS ["what the hell is TMS???"], I would be laughed at, ignored, ridiculed, and my evaluation would probably suffer for it. Dr. Sarno was, and still is, a pioneer whose work still has a long ways to go before it receives the attention and credit that it deserves. I, like thousands of other PATIENTS who have been CURED by Dr. Sarno's work, think that he is far more worthy of the Nobel Prize in Medicine than many other physicians who have ever received that honor. Yet, for some reason, you're still stuck trying to figure out "what exactly new" he has discovered.
As for your assertion that his success rate has gone down through the years, you are probably right! You need realize that when Dr. Sarno started out he was treating refractory cases of back pain with enormous success. Now, thanks mostly to the popularity of his books that have cured thousands, he probably finds himself more often treating refractory cases of TMS. There is a huge difference in these 2 patient populations. Some patients simply are not amenable to the TMS approach, and seeing Dr. Sarno probably won't make any difference (although I'm sure it sometimes does). TMS may not be for everyone, but millions of people around the world can still benefit from the brilliance of Dr. Sarno's work, and if you disagree, or you think there is nothing "novel" to his approach, then I think we have all heard your opinion and are content enough to move forward anyway. I think this whole topic is overkill already, but as I've said before, for some reason I'm addicted to this forum...
Long live Dr. Sarno!!!
Best,
MK |
Edited by - mk6283 on 03/08/2008 19:47:40 |
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Scottydog
United Kingdom
330 Posts |
Posted - 03/09/2008 : 04:31:04
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quote:
that in my opinion would be of use to many who visit here and flounder for months or even years due to their confusion
As a long term flounderer (though I don't really consider myself one, more someone with too much time on their hands) I have been visiting this site for over 3 years and would dispute that many linger for months or years. I don't think anyone posts here who was around when I first found the site. So many have come and gone.
I think that recovery comes in fits and starts and some may post a desperate post after much TMS work but then never reappear. Look how big the member list is. |
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Hillbilly
USA
385 Posts |
Posted - 03/09/2008 : 09:47:15
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MK,
It appears that you are in the medical field, though by your reference to "attending," still in school. I hope you learn as much as you can about the mind and its workings and from listening to your patients.
Here is a link to such a story written by a doctor that was posted right here on this forum that received almost no attention. It deals with fibromyalgia and all other functional illness from a medical perspective, and the doctor even recounts his own experience. I couldn't find his name anywhere, but he's an oldster, in the same generation as Dr. Sarno. It's worth a read and underscores everything I have written here in two threads.
http://hometown.aol.com/__121b_MmE2aDSyPLnwjZn8RXgoc9PPbGarPLw+
I agree that refuting the radiologic evidence took some gonads, and I have given Dr. Sarno much applause for his successes. It is the failures that I targeted by arriving back here at all. You made a point about refractory cases of TMS, as opposed to refractory back pain, as though it matters where the pain or symptoms are, they are somehow easier to dismiss by patients as harmless if it is in their back as opposed to their fingers? And you completely ignored the fact that the results went down despite the fact that he started screening his patients to discover their openness to his theory AFTER the publication of his first book.
Perhaps you can be the voice of synthesis among the many out there in treating these things. But I can tell from empty statements like my arguments are nothing but semantics and nonsense (so support that statement with evidence of semantics OR nonsense, which you don't attempt to do), that you have a long way to go. |
Edited by - Hillbilly on 03/09/2008 14:13:13 |
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Hillbilly
USA
385 Posts |
Posted - 10/06/2009 : 08:58:48
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| deleted |
Edited by - Hillbilly on 10/06/2009 08:59:37 |
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Any takers?
