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Alan has completed the new Pain Recovery Program. To read or share it, use this updated link: https://www.tmswiki.org/forum/painrecovery/
David Hanscom MD
- Thread starter Jacqui9
- Start date
IrishSceptic
Podcast Visionary
yes Dr Hanscom contributes to the forum, try searching for his tag
Since we are entrenched in "Politics" right now I would say Sarno = Conservative and Hanscom = Moderate when it comes to their approach and mythology TMS.
For example, Sarno believes that surgery for almost all structural spine issues are NOT needed whereas I believe Hanscom is a little more liberal in his thinking. Also Sarno believes in permanent healing from TMS whereas Hanscom believes most people will have reoccurrences.
For example, Sarno believes that surgery for almost all structural spine issues are NOT needed whereas I believe Hanscom is a little more liberal in his thinking. Also Sarno believes in permanent healing from TMS whereas Hanscom believes most people will have reoccurrences.
Hi Jacqui,
I saw Dr. Hanscom a month or two ago. I think Jrid sums it up pretty well. I was very pleased with my visit and found Dr. Hanscom to be very insightful and compassionate. The impression that I got from him was that whether there is a physical source of pain or not it simply doesn't matter. Since all pain comes from the brain he believes it can be treated with a multidisciplinary approach including, what we would call tms work. For me, he felt that my treatment should involve physical treatment and as Jrid said he is much more "liberal" in how he approaches chronich pain/tms. He gave me a lot of confidence that I could get better regardless of the source of my pain. I have since given up physical treatment as I found myself getting discouraged when treatment didn't work, but that is not to say that is the case with everyone. Clearly, Dr. Hanscom's approach works for many.
I saw Dr. Hanscom a month or two ago. I think Jrid sums it up pretty well. I was very pleased with my visit and found Dr. Hanscom to be very insightful and compassionate. The impression that I got from him was that whether there is a physical source of pain or not it simply doesn't matter. Since all pain comes from the brain he believes it can be treated with a multidisciplinary approach including, what we would call tms work. For me, he felt that my treatment should involve physical treatment and as Jrid said he is much more "liberal" in how he approaches chronich pain/tms. He gave me a lot of confidence that I could get better regardless of the source of my pain. I have since given up physical treatment as I found myself getting discouraged when treatment didn't work, but that is not to say that is the case with everyone. Clearly, Dr. Hanscom's approach works for many.
Jacqui9
Peer Supporter
Hi mc,
Thanks very much for your response. I'm glad you had such a good experience with Dr. Hanscom. I understand about getting discouraged when treatments don't work. For me, I was discouraged every time I had a doctor's appointment (many specialties) which all ended with them telling they had no idea what was causing my pain. That led me to start to learn about TMS which has helped me immensely. After reading your post about Dr. Hanscom I am feeling better about him. I don't know if you read his Blog "Failing Well" in the Mindbody Blogs. His first paragraph, last two sentences seem quite harsh and discouraging. If you read the whole Blog I think he is indicating ways to deal with reoccurrences which is helpful but he seems to indicate there always will be reoccurrences and I don't think all agree with that. I'm certainly not an expert on TMS but appears that many people have healed permanently.
I want to thank you for the work you do as a firefighter. My husband was a police officer in Tucson for 26 years and worked at scenes with firefighters there until we retired to Sequim 3 years ago.
I read some of your other posts and I'm glad that you are confident that you can get rid of your pain and hope that you have achieved that or are very close to it.
Thanks very much for your response. I'm glad you had such a good experience with Dr. Hanscom. I understand about getting discouraged when treatments don't work. For me, I was discouraged every time I had a doctor's appointment (many specialties) which all ended with them telling they had no idea what was causing my pain. That led me to start to learn about TMS which has helped me immensely. After reading your post about Dr. Hanscom I am feeling better about him. I don't know if you read his Blog "Failing Well" in the Mindbody Blogs. His first paragraph, last two sentences seem quite harsh and discouraging. If you read the whole Blog I think he is indicating ways to deal with reoccurrences which is helpful but he seems to indicate there always will be reoccurrences and I don't think all agree with that. I'm certainly not an expert on TMS but appears that many people have healed permanently.
I want to thank you for the work you do as a firefighter. My husband was a police officer in Tucson for 26 years and worked at scenes with firefighters there until we retired to Sequim 3 years ago.
I read some of your other posts and I'm glad that you are confident that you can get rid of your pain and hope that you have achieved that or are very close to it.
Jacqui9
Peer Supporter
Hi mc,
My husband grew up near San Francisco (Bay Area) and missed the Ocean the whole time we lived in Tucson. It is so expensive to live in the Bay Area and San Francisco now so we chose the Olympic Peninsula because of the Ocean and we also wanted some acreage. We are about 3 minutes from the Ocean. If our neighbor hadn't planted trees we would be able to see the Ocean from our windows. But the trees are pretty also. Also it was 110 degrees the day we left Tucson. Much nicer weather here even though the winter cold gets to me sometimes.
I appreciate you mentioning my husband. I will tell him.
My husband grew up near San Francisco (Bay Area) and missed the Ocean the whole time we lived in Tucson. It is so expensive to live in the Bay Area and San Francisco now so we chose the Olympic Peninsula because of the Ocean and we also wanted some acreage. We are about 3 minutes from the Ocean. If our neighbor hadn't planted trees we would be able to see the Ocean from our windows. But the trees are pretty also. Also it was 110 degrees the day we left Tucson. Much nicer weather here even though the winter cold gets to me sometimes.
I appreciate you mentioning my husband. I will tell him.
Steve Ozanich
TMS Consultant
This is an interesting thread. I assume the one person meant "methodology" and not mythology, but that could be a Freudian slip. It's good insight to say Dr. Sarno is more conservative and Dr. Hanscom more liberal, when it comes to procedures. Very observant, and I agree. I would also clarify that by saying Dr. Sarno is more "right." There are people I talk to a few times per year who were told they needed surgery, by "mindbody" doctors. But they did not need it. The industry still hasn't caught up to where Dr. Sarno led them. They just can't stop recommending surgery to sufferers. And yet when they return to Dr. Sarno's work they heal (I keep all communication as proof).
The temptation to utilize the medical training is too much, and of course for the sufferer, the desire for a quick fix becomes the linchpin that leads to the unnecessary. But as the great doctor noted, the surgery did not work, it simply shifted forms. So those rare few who feel their surgery worked are not aware of the symptom imperative.
Also, the pain does not return in most people. It can. But it is not a foregone conclusion. TMS is not a life sentence. There are many other examples of how Dr. Sarno is more conservative, in a right way.
SteveO
The temptation to utilize the medical training is too much, and of course for the sufferer, the desire for a quick fix becomes the linchpin that leads to the unnecessary. But as the great doctor noted, the surgery did not work, it simply shifted forms. So those rare few who feel their surgery worked are not aware of the symptom imperative.
Also, the pain does not return in most people. It can. But it is not a foregone conclusion. TMS is not a life sentence. There are many other examples of how Dr. Sarno is more conservative, in a right way.
SteveO
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I did mean methodology! I have never been known for my spelling... 
Did you mean "Also, the pain does "not" return in most people."?
Did you mean "Also, the pain does "not" return in most people."?
Steve Ozanich
TMS Consultant
Good catch jrid, that made the whole point contradictory unto itself. "Not" withstanding. And the point still remains, Dr. Sarno's work is at the cutting edge. All "new techniques" and "Sarno advancements" have taken his work backwards. He knows it, and the people he worked with and trained know it. It's a shame because people are increasingly more confused. For, ex., TMS is "not" a neurological disorder. It is a state of being, a tool. There are others as well, but the solution has been revealed. And it's working elegantly every day in every way.
giantsfan
Well known member
Thank you for posting that, Steve. I hope more people will read that and realize the reality of it. I know there are some "conservative" TMS practitioners out there who are similar to Dr. Sarno, but I do agree that the more "moderate" one's can make for quite some confusion.
Steve Ozanich
TMS Consultant
Hi Giants Fan, I'm a lifelong Indians and Browns fan so you know my true pain, but I love the Buckeyes so there is statewide sports recompense.
The confusion over pain and ill health doesn't come from professionals who don't believe in TMS. They alone marginalize themselves through their misguided beliefs. The confusion comes from those who claim to be "TMS" practitioners and then state opposing views to Dr. Sarno's work. Every day the TMS professionals have to answer questions from sufferers who have been confused over this vs. that. It is now tiresome.
My position is to keep the true message going, as it continues to work every day, in every way. But there is the occasional, "Dr. Sarno isn't the only way!" That's true... and it isn't. The placebo is the most powerful mechanism in all of healing. "Ways and methods" may work occasionally, but as long as the cause remains, suffering is on the next horizon. This is why Dr. Sarno is still the latest and greatest.
He found the cause.
Whichever path anyone may choose may take them to interesting destinations, but what they don't want will return when they need it most. At that point it's back to the basics again, and TMS: the revolutionary discovery.
Be aware of people saying that TMS is a neurological disorder, it is not.
Be aware of people saying you have to journal to heal, you do not.
Be aware of anything not referred to as TMS, it isn't.
And then rest easy, because anyone can heal. I've seen some amazing healings that I would enjoy sharing with everyone some day.
Steve
The confusion over pain and ill health doesn't come from professionals who don't believe in TMS. They alone marginalize themselves through their misguided beliefs. The confusion comes from those who claim to be "TMS" practitioners and then state opposing views to Dr. Sarno's work. Every day the TMS professionals have to answer questions from sufferers who have been confused over this vs. that. It is now tiresome.
My position is to keep the true message going, as it continues to work every day, in every way. But there is the occasional, "Dr. Sarno isn't the only way!" That's true... and it isn't. The placebo is the most powerful mechanism in all of healing. "Ways and methods" may work occasionally, but as long as the cause remains, suffering is on the next horizon. This is why Dr. Sarno is still the latest and greatest.
He found the cause.
Whichever path anyone may choose may take them to interesting destinations, but what they don't want will return when they need it most. At that point it's back to the basics again, and TMS: the revolutionary discovery.
Be aware of people saying that TMS is a neurological disorder, it is not.
Be aware of people saying you have to journal to heal, you do not.
Be aware of anything not referred to as TMS, it isn't.
And then rest easy, because anyone can heal. I've seen some amazing healings that I would enjoy sharing with everyone some day.
Steve
Misha
Peer Supporter
A book of healing stories would be an inspirational read. Maybe book number four??
Just about journalling - I know you talk about reflecting on events/issues in GPD. Do you think that is better than journalling? Is journalling unnecessary and just mulling things over in your mind is a better approach?
tgirl
Well known member
I love your responses Steve. Hearing some of your examples of people healing would definitely be a welcome read because all this pain stuff can get a bit discouraging when it lingers, as it is in my case.
I've had a prickly sensation in the skin of both legs for a long time and i want it to leave. Over the last year it hasn't seemed as bad. There are actually times I feel it may have disappeared but alas, no. I experience it at least part of everyday. No rhyme nor reason as to when. I do get relief when lying in bed reading though.
I've been tested extensively by the medical community, so that route is closed. I've read a few books on TMS which give hope, but I am still saddled with this nasty pain.
So again, positive comments are certainly welcome.
I've had a prickly sensation in the skin of both legs for a long time and i want it to leave. Over the last year it hasn't seemed as bad. There are actually times I feel it may have disappeared but alas, no. I experience it at least part of everyday. No rhyme nor reason as to when. I do get relief when lying in bed reading though.
I've been tested extensively by the medical community, so that route is closed. I've read a few books on TMS which give hope, but I am still saddled with this nasty pain.
So again, positive comments are certainly welcome.
Walt Oleksy (RIP 2021)
Beloved Grand Eagle
Dr. Hanscomb has some good videos on Youtube, like this one...
http://www.tmswiki.org/forum/threads/david-hanscom-md.12178/ (David Hanscom MD)
http://www.tmswiki.org/forum/threads/david-hanscom-md.12178/ (David Hanscom MD)
I am not SteveO but I did stay at a Holiday Inn Express last night... I believe what Steve is saying is that journaling, itself, will never "heal" you from TMS but it "can" get the proper juices flowing. For instance, healing from TMS involves blowing the cover of your unconscious mind's scheme and recognizing exactly what TMS is... a distraction caused by your unconscious mind. Journaling can help but is not the healing "cure".
Steve Ozanich
TMS Consultant
Sara, I don't want to think of a book 4 right now, but I've learned to never say never. I'm burned out from creating, even though I really enjoy the process. If I did #4 it would probably move away from TMS into the larger life, the consciousness-realm where everything "matters." There is also a paradox to the healing stories. If one story isn't enough, normally, a hundred more stories won't be either. The desire for more stories indicates resistance to healing. But there are always exceptions.
As far as journaling, as Forest knows from the beginning, I've always been against things like structured healing programs, and anything designed to heal. Trying to heal is the biggest mistake I see, and it continues to be on a daily basis. I recently listened to an interview with Dr. Hanscom in which he said that journaling was necessary to heal. But it isn't. I never journaled to heal, and I went 10 years before I ran into anyone who had to. It's more rare that you have to journal, for the reasons that I don't believe in healing programs. In that same note, and same interview, Dr. Hanscom admitted that he's seeing a new problem with journaling, an that is, the people are journaling too much, trying to get it perfect by journaling all day, and that the idea is to let go of more control, not to seek more control. I think he's seeing the mistakes I saw early on. To write out your feelings and observations can be a stabilizing force. It allows you to see your life more clearly. The lucky ones may have an ah ah moment of clarity.
The same is true for healing programs. Take another listen to Dr. Sarno in the good news interview, when he says, 'take note of that, it is the self imposed demands that are causing the problems.' If the demands on your life are causing the TMS then why add more demands with journaling and daily work programs? Unstructure your life, free yourself from yourself. Since there are few absolutes, there are times when these things have helped people. I have seen on rare occasion journaling and daily programs have positive effects. It seems like they work best when the sufferer is lost. They provide a direction, and the journaling of course works best when the person doesn't see herself as she is, and needs to express something she has strongly disowned. In my case, I saw my flaws well, too well, and I expressed myself fairly well (not as well as now though). I didn't need to see more bad aspects of myself, or to hear my inner self complaining.
So I didn't need to journal, and it's wrong to say that people have to journal to heal. They do not. But it can help in some cases. There are other things being stated that are not correct either like that the pain will return. It does not always. But we build our own temple of healing based on our own beliefs. Be careful of who you attach your beliefs to, and be aware of the placebo phenomenon. I see people following people who don't understand TMS at all, as defined by Dr. Sarno. And when their symptoms return in another form they suddenly realize what true healing means. Healing isn't just comprised of getting rid of current symptoms.
TGirl, is that for Toronto girl? I remember my adventures on Yonge St. well. I also remember those fasciculations you're experiencing. That's fear. So when you lay down to read you feel safe, your amygdala isn't on high alert. You aren't making current demands of yourself. People often get those sensations when they move, or go on vacation: they're out of their comfort zone.
I would also add, that when you say "and I want it to leave" that you should switch your perception. "It" is being created by you. So you have to let it go, it isn't something that has you, like an outside entity. It's you doing it to you. Relax. All the information in the world won't help unless you act on it. Fear indicates that you don't have a clear path in your life, yet. But you will. Find it.
Good job jrid, that's pretty much what I meant. I should have simply copied your answer and saved some time. But I slept at a Motel 6, and my self esteem hurts today. Journaling helps purge, gets the juices flowing, and most importantly, it begins to focus the mind into concentration. With TMS there is great confusion.
Mind = many thoughts (hi Beta = high tension)
Concentration = one or two thoughts (lowered Beta)
Yoga = no thoughts
You can see where it's all going, or should be going. The T in TMS means tension. The mind is usually in one of 2 states, it's either confused or it's comparing two things. In severe TMS it's massively confused within many thoughts, so if someone starts journaling they begin to feel better because the mind is now focused and brain activity slows. The person isn't being healed, they just feel better. It's a great start. Permanent healing occurs when they alter their reaction to life. Resistance is a big problem in TMS.
Onward and sideways!
SteveO
As far as journaling, as Forest knows from the beginning, I've always been against things like structured healing programs, and anything designed to heal. Trying to heal is the biggest mistake I see, and it continues to be on a daily basis. I recently listened to an interview with Dr. Hanscom in which he said that journaling was necessary to heal. But it isn't. I never journaled to heal, and I went 10 years before I ran into anyone who had to. It's more rare that you have to journal, for the reasons that I don't believe in healing programs. In that same note, and same interview, Dr. Hanscom admitted that he's seeing a new problem with journaling, an that is, the people are journaling too much, trying to get it perfect by journaling all day, and that the idea is to let go of more control, not to seek more control. I think he's seeing the mistakes I saw early on. To write out your feelings and observations can be a stabilizing force. It allows you to see your life more clearly. The lucky ones may have an ah ah moment of clarity.
The same is true for healing programs. Take another listen to Dr. Sarno in the good news interview, when he says, 'take note of that, it is the self imposed demands that are causing the problems.' If the demands on your life are causing the TMS then why add more demands with journaling and daily work programs? Unstructure your life, free yourself from yourself. Since there are few absolutes, there are times when these things have helped people. I have seen on rare occasion journaling and daily programs have positive effects. It seems like they work best when the sufferer is lost. They provide a direction, and the journaling of course works best when the person doesn't see herself as she is, and needs to express something she has strongly disowned. In my case, I saw my flaws well, too well, and I expressed myself fairly well (not as well as now though). I didn't need to see more bad aspects of myself, or to hear my inner self complaining.
So I didn't need to journal, and it's wrong to say that people have to journal to heal. They do not. But it can help in some cases. There are other things being stated that are not correct either like that the pain will return. It does not always. But we build our own temple of healing based on our own beliefs. Be careful of who you attach your beliefs to, and be aware of the placebo phenomenon. I see people following people who don't understand TMS at all, as defined by Dr. Sarno. And when their symptoms return in another form they suddenly realize what true healing means. Healing isn't just comprised of getting rid of current symptoms.
TGirl, is that for Toronto girl? I remember my adventures on Yonge St. well. I also remember those fasciculations you're experiencing. That's fear. So when you lay down to read you feel safe, your amygdala isn't on high alert. You aren't making current demands of yourself. People often get those sensations when they move, or go on vacation: they're out of their comfort zone.
I would also add, that when you say "and I want it to leave" that you should switch your perception. "It" is being created by you. So you have to let it go, it isn't something that has you, like an outside entity. It's you doing it to you. Relax. All the information in the world won't help unless you act on it. Fear indicates that you don't have a clear path in your life, yet. But you will. Find it.
Good job jrid, that's pretty much what I meant. I should have simply copied your answer and saved some time. But I slept at a Motel 6, and my self esteem hurts today. Journaling helps purge, gets the juices flowing, and most importantly, it begins to focus the mind into concentration. With TMS there is great confusion.
Mind = many thoughts (hi Beta = high tension)
Concentration = one or two thoughts (lowered Beta)
Yoga = no thoughts
You can see where it's all going, or should be going. The T in TMS means tension. The mind is usually in one of 2 states, it's either confused or it's comparing two things. In severe TMS it's massively confused within many thoughts, so if someone starts journaling they begin to feel better because the mind is now focused and brain activity slows. The person isn't being healed, they just feel better. It's a great start. Permanent healing occurs when they alter their reaction to life. Resistance is a big problem in TMS.
Onward and sideways!
SteveO
tgirl
Well known member
Steve, thanks for your reply, much appreciated. And yes, tgirl stands for torontogirl. It can be a very fun city - a little cold right now, but still fun Glad you had a good time here.
Not that this makes much difference, but I don't really have fasciculations, instead my leg skin feels prickly and sore; kind of sensitive to clothes etc. (And have been checked out thoroughly by the medical community- can't find a thing wrong). The sensations are so >#%^|#% annoying! I think you are right about the 'high alert' stuff. During the day I am always monitoring how I feel- not a good thing to do. I am working on acceptance and letting go right now. This stuff doesn't always come easy to me.
By the way, I am half way through your book and am really enjoying it. This TMS stuff isn't for the faint hearted that's for sure. Hope you are well.
Glad you had a good time here.Not that this makes much difference, but I don't really have fasciculations, instead my leg skin feels prickly and sore; kind of sensitive to clothes etc. (And have been checked out thoroughly by the medical community- can't find a thing wrong). The sensations are so >#%^|#% annoying! I think you are right about the 'high alert' stuff. During the day I am always monitoring how I feel- not a good thing to do. I am working on acceptance and letting go right now. This stuff doesn't always come easy to me.
By the way, I am half way through your book and am really enjoying it. This TMS stuff isn't for the faint hearted that's for sure. Hope you are well.
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Forest
Beloved Grand Eagle
This is turning into a thought provoking thread. Thanks, everyone for the interesting discussions.
I'm actually on the journaling-skeptic side of things as well. However, there is no denying that Dr. Sarno had his patients do a bunch of writing in his program at NYU Rusk. This journaling helped support the "think psychological" work that they had to do later. Further, if people didn't start healing after four weeks he started referring them to depth psychotherapy that, simply put, helped them explore and accept their unconscious feelings. This is similar in spirit to what many people are attempting to do with their journaling.
As background, Dr. Sarno explains that "thinking psychologically" is one of the most important things we can do to heal from TMS. He explains this clearly in The Mindbody Prescription on page 144:
I'm a bit of a journaling-skeptic like Steve, but I think that the reason why people do journal is because it is right there in black and white on the page. Journaling is just people's way of thinking "about repressed rage and the reasons for it" whenever they are aware of the pain. Dr. Sarno tells them that "it is essential to focus on unpleasant, threatening thoughts and feelings," and many people find that journaling is the best way to do that.
In terms of Dr. Sarno's own treatment program, he also sets them up to do journaling as homework. He had patients write a list of all of the things that may be contributing to their unconscious tension. Then, he had them write an essay, the longer the better, about each item on their list.
He pursued an educational approach for 3-4 weeks, and if the patient didn't have adequate progress he suggested either group meetings or psychotherapy. In Dr. Sarno's words, therapy is "indicated" when patients don't improve. ("Failure to improve is the indication for therapy")
According to the outcome study in The Divided Mind, Dr. Sarno said that 24% of a sample of his patients did individual psychotherapy. Elsewhere in the book he said that 20% are referred to therapy. Either way, after a relatively short period of time, Dr. Sarno starts referring his patients to highly trained (doctorate level + psychoanalytic or other credential) psychologists, preferrably trained in the psychoanalystic or ISTDP approaches. This type of therapy is considered "depth" therapy because it goes "deep" into our unconscious depths, helping us come to peace with the sources of our tension.
The bottom line is that the first four weeks of Dr. Sarno's treatment plan was a mixture of learning and journaling. The journaling provided a foundation for the "think psychological" work that they had to do later. If people didn't start healing after four weeks he started referring them to intensive analytic psychotherapy.
His program may have changed over time, but I'm basically paraphrasing from the treatment chapter of The Divided Mind. This is his most recent book and, more importantly, it was how he chose to present his work to the world. I'm curious, though, so I'll check with some of the psychologists he trained and who worked with him up until the end to see if there were any changes.
The point is that most people are buying Dr. Sarno's books and trying to replicate what he wrote about in his books. Certainly, a moderate amount of journaling and then working with a therapist is about as close as anyone can get to what Dr. Sarno actually did with his own patients.
Anyway, despite all of that, I actually agree with Steve that people do journal more than they should.
It's true, Steve, that I don't know the details of how you work now that you have "hung out a shingle" and are treating people for money, but the sense that I get is that unlike Dr. Sarno you don't give them a writing program from day 1 or refer them to analytic or ISTDP psychologists when they don't get better. Despite these things that strike me as differences from Dr. Sarno and while I haven't heard many reports back yet, but my bet is that you are terrific and offer a wonderful service that is very much worth the money.
What this means is that while you don't like our approach, which is similar to Dr. Sarno's approach in that it does have structured writing, I actually think your approach, with apparently less writing, is probably also quite good. I think that people need to be reminded that TMS recovery is about how you live your life, and I think that you are quite good at that. Your chapter on Dr. Sarno's concept of the Rage/Soothe Ratio came up in another thread and I thought you did a great job with it.
In terms of how much journaling is too much, here is my perspective. In the end, I recovered from my TMS through the online community, and I'm passionately devoted to it. It feels like I've read a million success stories; each one seems to be different, and every person is different. What I've always found striking is that not many of those success stories had an a-ha moment, when someone did some journaling and suddenly got better.
In other words, a certain amount of journaling, like Dr. Sarno had his patients do, is probably great. If you aren't working with a therapist or if you are and just want to make faster progress, then doing additional journaling is probably also good. But watch out for the point of diminishing returns.
Specifically:
I'm actually on the journaling-skeptic side of things as well. However, there is no denying that Dr. Sarno had his patients do a bunch of writing in his program at NYU Rusk. This journaling helped support the "think psychological" work that they had to do later. Further, if people didn't start healing after four weeks he started referring them to depth psychotherapy that, simply put, helped them explore and accept their unconscious feelings. This is similar in spirit to what many people are attempting to do with their journaling.
As background, Dr. Sarno explains that "thinking psychologically" is one of the most important things we can do to heal from TMS. He explains this clearly in The Mindbody Prescription on page 144:
Think Psychological
I tell my patients that they must consciously think about repressed rage and the reasons for it whenever they are aware of the pain. This is in contradiction to what the brain is trying to do. This effort is a counterattack, an attempt to undo the brain’s strategy. It is essential to focus on unpleasant, threatening thoughts and feelings to deny the pain its purpose—to divert your attention from those feelings.
When the pain is severe, it is difficult to concentrate on feelings, but you must regard the process as a contest in which your conscious will is pitted against the unconscious, automatic reactions of the brain.
I tell my patients that they must consciously think about repressed rage and the reasons for it whenever they are aware of the pain. This is in contradiction to what the brain is trying to do. This effort is a counterattack, an attempt to undo the brain’s strategy. It is essential to focus on unpleasant, threatening thoughts and feelings to deny the pain its purpose—to divert your attention from those feelings.
When the pain is severe, it is difficult to concentrate on feelings, but you must regard the process as a contest in which your conscious will is pitted against the unconscious, automatic reactions of the brain.
I'm a bit of a journaling-skeptic like Steve, but I think that the reason why people do journal is because it is right there in black and white on the page. Journaling is just people's way of thinking "about repressed rage and the reasons for it" whenever they are aware of the pain. Dr. Sarno tells them that "it is essential to focus on unpleasant, threatening thoughts and feelings," and many people find that journaling is the best way to do that.
In terms of Dr. Sarno's own treatment program, he also sets them up to do journaling as homework. He had patients write a list of all of the things that may be contributing to their unconscious tension. Then, he had them write an essay, the longer the better, about each item on their list.
He pursued an educational approach for 3-4 weeks, and if the patient didn't have adequate progress he suggested either group meetings or psychotherapy. In Dr. Sarno's words, therapy is "indicated" when patients don't improve. ("Failure to improve is the indication for therapy")
According to the outcome study in The Divided Mind, Dr. Sarno said that 24% of a sample of his patients did individual psychotherapy. Elsewhere in the book he said that 20% are referred to therapy. Either way, after a relatively short period of time, Dr. Sarno starts referring his patients to highly trained (doctorate level + psychoanalytic or other credential) psychologists, preferrably trained in the psychoanalystic or ISTDP approaches. This type of therapy is considered "depth" therapy because it goes "deep" into our unconscious depths, helping us come to peace with the sources of our tension.
The bottom line is that the first four weeks of Dr. Sarno's treatment plan was a mixture of learning and journaling. The journaling provided a foundation for the "think psychological" work that they had to do later. If people didn't start healing after four weeks he started referring them to intensive analytic psychotherapy.
His program may have changed over time, but I'm basically paraphrasing from the treatment chapter of The Divided Mind. This is his most recent book and, more importantly, it was how he chose to present his work to the world. I'm curious, though, so I'll check with some of the psychologists he trained and who worked with him up until the end to see if there were any changes.
The point is that most people are buying Dr. Sarno's books and trying to replicate what he wrote about in his books. Certainly, a moderate amount of journaling and then working with a therapist is about as close as anyone can get to what Dr. Sarno actually did with his own patients.
Anyway, despite all of that, I actually agree with Steve that people do journal more than they should.
It's true, Steve, that I don't know the details of how you work now that you have "hung out a shingle" and are treating people for money, but the sense that I get is that unlike Dr. Sarno you don't give them a writing program from day 1 or refer them to analytic or ISTDP psychologists when they don't get better. Despite these things that strike me as differences from Dr. Sarno and while I haven't heard many reports back yet, but my bet is that you are terrific and offer a wonderful service that is very much worth the money.
What this means is that while you don't like our approach, which is similar to Dr. Sarno's approach in that it does have structured writing, I actually think your approach, with apparently less writing, is probably also quite good. I think that people need to be reminded that TMS recovery is about how you live your life, and I think that you are quite good at that. Your chapter on Dr. Sarno's concept of the Rage/Soothe Ratio came up in another thread and I thought you did a great job with it.
In terms of how much journaling is too much, here is my perspective. In the end, I recovered from my TMS through the online community, and I'm passionately devoted to it. It feels like I've read a million success stories; each one seems to be different, and every person is different. What I've always found striking is that not many of those success stories had an a-ha moment, when someone did some journaling and suddenly got better.
In other words, a certain amount of journaling, like Dr. Sarno had his patients do, is probably great. If you aren't working with a therapist or if you are and just want to make faster progress, then doing additional journaling is probably also good. But watch out for the point of diminishing returns.
Specifically:
- If you are journaling because you want to "cry your eyes out," and have been doing it for a while, perhaps there is a better way to find closure so you can focus on the things that bring you genuine joy.
- If you are digging and digging, trying to find some secret insight, ask yourself if you are still learning things about yourself that change the way that you see yourself, your life, and other people. If not, perhaps you have reached diminishing returns.
- If you are digging in the past to better understand it, a certain amount may help provide a great foundation, but then it is time to move on.