Thanks so much for posting this. Feinblatt’s talk about the early days of helping Sarno work out his TMS approach and about the disdain of Sarno’s NYU medical school colleagues toward him and his patients were interesting. What stood out to me the most, though, was her emphasis on the role of goodism in generating unconscious anger that produces TMS. I say this for three reasons.
First, I have been a regular reader of tms.wiki for the better part of a decade. Over this time, I have seen a number of posters say Sarno’s book(s) resonate with them because of their perfectionism, and yet they wonder why they are not getting any better. It is rare indeed when a poster says his or her problematic personality trait is goodism. I wonder if goodism might be an underappreciated cause of TMS.
Second, one of the things in
The Divided Mind that stood out to me was Sarno’s discussion of his goodism as the cause of his persistent heartburn, or as he also called it esophageal reflux. On pages 125-26 (of my hardcover first printing), he talked about going on a long trip with his wife during which he suffered from that. He said that with his wife’s help, “we tried to figure out what was making me unconsciously angry.” He reported they came up with four reasons: (1) he disliked the discomfort and inconvenience if traveling, (2) he found some of the places they visited disagreeable, (3) he wished he was home working, and (4) the trip was too long. He then said:
“We obviously didn’t hit on the right answer, because my symptoms continued unabated for the entire trip. It wasn’t until we got home that I realized what had been going on. I had promised the long trip to my wife, who loves to travel. I was being a good guy. [In short, it was his goodism.] I was unconsciously furious for having to do something I really didn’t want to do. My psyche wouldn’t permit me to be consciously furious at my wife, and neither would my reasonable self—so to be absolutely sure the rage remained unconscious, the brain dished up the severe gastrointestinal symptoms.”
This strikes me as odd because Sarno wrote in
The Mindbody Presciption about the need to be wary of displaced anger in trying to uncover one’s unconscious anger. He explained that displaced anger is when “you become overtly angry at something relatively unimportant, like a traffic tie-up or poor service in a restaurant, instead of at your spouse or a parent, because the latter is simply not allowed by your psyche.” The four reasons that he and his wife came up with regarding the trip were all displaced anger. If there is any possibility that you might be unconsciously angry at your spouse, why would you seek her help in uncovering the anger? That would virtually guarantee you will waste your time in the minefield of displaced anger.
But there is a bigger oddity. Sarno was being most unSarno-like when he concluded his discussion of the long trip as follows:
"Earlier in this chapter I suggested that reasonable people might prefer to deal with the unconscious rage rather than the pain and discomfort of a psychosomatic symptom, if the brain’s decisionmaker would only give them the opportunity to choose. My gastroesophageal reflux prompts me to rethink my position. Rage at my wife would have been inappropriate and unfair—better to suffer gastroesophageal reflux.”
I have sometimes wondered about these oddities. If I were interviewing Arlene Feinblatt, I would want to ask her if she could shed any light on them.
Third, by the time Sarno published
Healing Back Pain in 1991, I had been suffering from chronic low back pain for 24 years. My wife saw Sarno on a morning talk show promoting the book, and as soon as he came on she called me in to watch. I immediately bought the book, and six weeks later my low back pain ended and never returned. I realized right away that I was a perfectionist regarding what I expected from myself, but it took a while for me to realize my perfectionism extended to what I also expected from people in my life. A critical clue regarding my low back pain was that it started a week after I got married. Beyond that, I had grown up in a family where anger was regarded as a taboo emotion, and it took me about six weeks to become attuned to when I was repressing anger at my wife for not meeting my unrealistic, and hence unfair, vision of how a wife should be.
In the 30 years since 1991, I have dealt with some other forms of TMS—always with complete success once I realized the pain was not structural and instead was just a case of what Sarno called the symptom imperative. I have also, in recent years, developed a strong interest in modern pain science (mainly but not entirely neuroscience); it is my hobby in retirement. I no longer buy into Sarno’s reliance on Freudian theory, but I still think he got the core stuff right. I generally view myself as one hundred percent perfectionist and zero percent goodist. But now that I am in the role of being a caregiver to a wife with Alzheimer’s, I am starting to try to become attuned to possibility of goodism-generated unconscious anger. Hence the reason why Fleinblatt’s references to that stood out to me.
