Chapter 8 of The Great Pain Deception

Hello, everyone...

Steve Ozanich's The Great Pain Deception is a great read, and I take notes for my own use as I read in order to get as much as I can from it. Since the book group is doing the chapter today, I thought I'd share my notes with the group. They are, of course, just my personal thoughts. I added some discussion questions at the end. Feel free to comment!


Summary
On my second reading of this chapter I see it playing more off of Ch. 7’s discussion of the Placebo and Nocebo effect, which, I believe, is Steve’s main goal with this chapter. More specifically, Steve uses Jungian Psychological concepts, archetypes, collective unconscious, to demonstrate how physicians can influence our placebo/nocebo reaction so much. These concepts have a profound impact on how seeing physicians and receiving PT treatments (massage, physical therapy, orthopedics) will keep us in pain. It is our belief, implanted by physicians unaware of TMS, that makes us susceptible to developing chronic conditions, and why TMS moves around.

Notes from earlier read through
The main goal of this chapter is to show the role placebos and the power of suggestion play in medicine. He begins by discussing archetypes and collective unconscious. There are two main archetypes in play the Healer, which places doctors in authority positions, and the fool, which is accepting that certain activities can create chronic pain. He tries to show that authority figures, especially doctors, influence if we have pain or not. He criticizes doctors for only looking at what they expect to see, and can’t think of new ideas. The Fool Archetype may be the reason that if a co-worker has back pain, you will develop back pain.

Goodism and Timing are critical in accepting a belief and “periods of isolation, tension, and stress are open wounds awaiting the emergence of the next suggestion. He provides an example from Amir’s book, where Fred started having back pain when he sneezed because his coworker commented one day that sneezing must really hurt. He suggests that it was Fred’s need to be good and do what is right that led him to having pain when he sneezed. He goes on to argue that we have pain because we want to avoid conflict and be part of the collective pack.

In the next section he begins discussion placebos and argues that “if belief can improve and even heal, it’s logical to assume that the mind can even create the disorder.”

Quotes
“normally believe what the physician tells them, especially if it allows them to opt out of things they don’t want to do—avoid places they don’t want to be. Even if the physician is wrong, most people will believe him or her because of their position of influence. If your doctor doesn’t believe Dr. Sarno, and you believe in your doctor, then that’s it—your healing has been negated.”

When a physician tells the patient he has bad knees or feet, or back or neck, he believes the healer at a deeper level of consciousness—filling the patient’s dry river bed, helping to form his personal unconscious.

How do people interpret Steve’s idea of the dry river bed. He mentions that it has something to do with archetypes, but only says that filling it sort of creates a person’s unconscious.

“A good person tries to avoid conflict, and will often do so by accommodating others’ realities at the expense of self. We live in a society that celebrates individual achievement; but regarding our health, we allow ourselves to be pulled into the collective pack.”

Steve believe we get symptoms because we see them in other people. It is an epidemic. We get chronic conditions “if the individual can be persuaded to focus on them—to fear them.”

He discusses quite a bit the role of placebos in medicine and the power of suggestion

“This is why identifying a sense of purpose in life, and refusing to feel like a victim, eases pain. Find a way to turn your obsession toward an activity that you love and focus on it, and the pain will slowly leave, as this new, more productive obsession becomes the competing stimulus.”

Questions:
Steve believes we get symptoms because we see them in other people. Have you ever had a symptom someone close to you has had? Is there a sort of contagion connected to TMS?

I tend to think, and Steve writes about this, that a lot of the standard medical approaches people receive, especially surgery for pain, is just a placebo. They may relieve symptoms temporarily, but after a while it will come back in the same location or a new one. Have any of you ever experienced a placebo? Can TMS have a placebo effect?

How do commercials for Fibromyalgia drugs or Shingles Shots affect the number of people who get those conditions?

 

Hi Deborah,

Did you mean to leave a comment on my post? I'd love to read your thoughts, but I can't see them at the moment!

 

I think there is really something to this, and compare it to research on whiplash. One study in particular (The best approach to the problem of whiplash? One ticket to Lithuania, please) shows how the expectations of having an injury can influence if a person experiences pain or not. Due to a variety of factors (mostly that people don’t carry personal-injury insurance) Lithuanians have little awareness of the potential consequences of whiplash injuries. In this study 202 people, who experienced car accidents, were interviewed and not one person reported any neck pain or other whiplash symptoms. The study found that because Lithuanians do not expect whiplash to occur in car accidents, it never does.

This study has always been at the heart of my own interpretation of TMS and how I read this chapter. Our culture and collective unconscious shapes how we react to pain conditions and which symptoms we are susceptible to. It is our expectation, worry, and fear of having a symptom that can lead to us developing that symptom. As Gail mentioned, it is the thought that having foot pain will prevent us from doing what we love that, in part, leads to us developing foot pain over another condition.

A similar idea comes up often in Sarno’s books when he describes how ulcers used to be “in vogue” during the 70s but faded away once people knew they were caused by stress. Our unconscious sees other people having certain symptoms, missing work, or unable to do certain things, and sure enough when we are really stressed out, all of a sudden our backs hurt.

To some degree I was playing devil’s advocate with this question, but Steve actually has two paragraphs that touch upon what I was thinking. At the start of Chapter 7 he writes:

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"The placebo was a powerful tool by which the individual could mobilize his own internal healing resources. He could transform his own power of will (hope) into physiological healing. Nature has given the body what it needs to heal; the body is its own apothecary. But the patient needs to tap into these inner healing forces - and the mechanism is always belief. Sadly, people have lost faith in their own healing powers - clinging to healers as guiding compasses"​

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He continues to write

"With the placebo it’s the belief in the drug - or act - that ratifies the body’s constitution to free itself. The belief rallies the will to change, which in turn transforms the body. If anything can be taken away from Anatomy of an Illness, it’s the notion that we are as strong as we believe ourselves to be - no more and no less. The placebo effect pulls people toward their higher potential - but not as high as truth itself. With TMS healing, the actual truth activates those very same healing mechanisms, but TMS healing has been shown to be more permanent. The truth wins out in the end. But this doesn’t understate the necessity of the placebo. Who cares how it goes away if it is so painful that it devastates life?"​

Healing from TMS involves believing that you can heal yourself, because you understand the truth that you do not suffer from a physical problem, but a psychological one. We use the placebo as a way to mobilize our own healing. The idea here is that you are gaining confidence in yourself and no longer viewing yourself as fragile or broken, but as strong and healthy. If you have doubt, and think that you can’t heal or that you have a permanent chronic problem, then you will not be able to make progress. The way you view your symptoms affects the progress you will make. In my own recovery, I found that the more confidence I had in myself, and the more I believed this approach would work for me, the more progress I made.