I know the structured education program encourages us to make a short post but I’m finding it really difficult to hold back on letting it all come out since I can’t really discuss this with the people closest to me. I encountered Dr Sarno’s work on Christmas Day (a Christmas miracle?) last year after another desperate search for a solution in response to a particularly severe episode of debilitating back pain which came on quite suddenly the day after I decided to take time off from work and training (I’m a semi-professional rugby player). The pain had persisted everyday for about 6 months prior to that point, and although it never left it had improved to the point I was able to train (which involved sprinting, tackling, lifting weights etc.) whilst working a very physical job. This involved a considerable amount of pushing through some pain and fear/anxiety but overall things were getting better. About a week before I originally hurt my back, a friend of mine had injured his in a similar way (lifting weights). He had an MRI immediately which showed a bulging disc, so when I hurt my back that’s where my mind went immediately. Even though I knew that MRI’s for spinal injuries were of little predictive value, I still treated my injury as if it was a bulging disc, and spent hours on YouTube looking up exercises that would supposedly help “move the disc jelly back into the centre”. In my search for a solution I discovered Dr Stuart McGill and his book The Back Mechanic. At the time Dr McGill’s words were what I wanted to hear. I had been to physiotherapists, chiropractors, doctors and felt that they weren’t really listening to me, that they were failing to realise that I was going through something extremely unique and concerning that demanded their utmost attention. I had heard the idea of “non-specific low back pain” and the biopsychosocial model of pain and found the ideas frankly insulting. You’re telling me that there’s nothing really wrong with me and I’m experiencing this much pain, for this long? I couldn’t come to terms with it. Now here was Dr McGill telling me there’s no such thing as non-specific low back pain, there is always a structural cause. I felt that I’d finally found the solution to my problem, it was incredibly validating to read these words. I did the McGill exercises everyday, several times a day but never really saw any improvement outside of my ability to do those specific exercises. McGill talks about the idea of spinal hygiene and pain sensitisation. Essentially, according to McGill, every time I allowed my spine to go into flexion (as i was supposedly flexion intolerant), I was improving my body’s ability to experience pain. So I became terrified of sitting down to eat my breakfast or catch the train to work, terrified of getting into the car and going for a drive that was longer than 5 minutes, terrified of putting my shoes and socks on. I began to live in constant fear of allowing my back to round at all, meanwhile I was still working a manual labour job and was getting back into training so I believed I was doing significant and permanent damage to myself everyday for months on end. In order to stop “sensitising the pain” I informed my work and my rugby team that I needed to take some time off. It was at this point that my pain went to another level. As soon as I really gave into the idea that I was incapable of maintaining my normal activities, my pain became extremely debilitating. Suddenly I was struggling to walk, I couldn’t bend from the hips at the slightest, I couldn’t tolerate sitting. It didn’t make any sense to me, and it was at this point that I was finally ready to entertain some of those ideas I’d previously dismissed. It suddenly seemed not only possible but probable that my pain had a strong psychological component if it could get so much worse from doing nothing. My MRI (I eventually caved about 5 months in and needed to make sure that there was nothing seriously wrong with me) did indeed show a small protrusion at L4-L5 on the left side where I was experiencing symptoms, but it also showed another bulge at L5-S1 on the right side where I have no symptoms whatsoever. I felt this was further evidence that I wasn’t suffering from something structural any longer. I watched a few lectures from the Barbell Medicine YouTube channel on low back pain, which eventually led me to Dr Sarno. I quickly consumed all of his work, and while I did improve considerably over the last month, I have recently suffered a relapse, and the last few days have been amongst the most painful I’ve experienced throughout this entire journey. I’ve realised now that I’ve tried too hard to force it, and put too much pressure on myself to be completely pain free as soon as possible, and so I’m going to give this program a go, to help me take it one day at a time. I haven’t had trouble accepting the TMS diagnosis on an intellectual level, I see myself clearly in Sarno’s description of the perfectionist and the goodist and there’s so much evidence that points to my pain being psychological and conditioned (like the fact I can sprint with almost no pain but struggle to put my socks on or that I have squatted 200kg post “injury” but struggle to sit down). However, I’ve never been encouraged to express emotion and I sometimes feel incapable of truly experiencing my emotions, so I’m having a really difficult time being able to feel any of my repressed emotions as I keep trying to think about what’s bothering me as if there’s one right answer and once I find it this pain will immediately dissipate. Another issue I’m really struggling with is relating my pain to others in my life. I get so frustrated with everyone constantly suggesting a panacea to me, and I want to get better so badly as if I’m carrying Sarno’s legacy on my back so I can prove to everyone I know what I’m doing, but it’s hard to tell my parents and other people close to me that I’m in control and on the right track when I’m spending so much time lying on the floor in agony. My pain has become so much a part of my identity that everyone who sees me asks how my back is and it is driving me crazy to have these same interactions over and over again. How do you deal with people asking about your progress and suggesting remedies that you know will only reinforce the idea that the pain is structural?