Dr. Schubiner's Blog Psychological Aspects of MBS

Written by Dr. Schubiner on June 13, 2008

I have discussed the relationship between the mind and the body in prior blogs. Briefly, it is important to realize that they are essentially one, i.e. there is no separation between the mind and body in the sense that physical stimuli (e.g. an injury) immediately produce changes in our minds (emotions, reactions, etc.) and emotional stimuli (e.g. a scare, a verbal criticism, etc.) immediately produce physical reactions. The relationship between the mind and the body are immediate for survival. It would take too long for thought processes to engage prior to reacting if we happen upon an angry bear. Our survival instincts of an immediate reaction (running, freezing, etc.) are much quicker. William James, the father of psychology, noted that it is not true that first, you see a bear, then your feel fear, and then you run. He reasoned (and we now know he was correct) that you actually see a bear, then you run, and then you feel fear.

Our minds and bodies are constructed (through the process of evolution) to maximize survival. When an animal is frightened, it immediately goes into one of the survival reactions: fight, flight, freeze, or submit (play dead). When we get overwhelmed in our life, our body will react in a way that is designed to help us out of the situation. For example, I saw a woman who had a very difficult childhood with neglect and abuse. Her reaction to this was to look for love and attention whenever and wherever she could find it. She grew up and always attempted to appease others and tended to neglect her own needs. Like many people with MBS, she had a very strong dose of the “shoulds” (as Dr. Sarno often refers to Freud's superego or conscience). As her life became more complicated and busy, she tried to do more and more for everyone else. Finally, her body reacted by giving her severe migraine headaches and fatigue. These reactions were her body's way of trying to protect her, i.e. forcing her to rest, to lie down, to stop doing so much for everyone else and to do something for herself. Unfortunately, she there was a great cost to this response, i.e. severe pain and fatigue. I believe it is useful to view the body in this way, as trying to help us, to protect us, rather than as betraying us, which is a common thought that many people with MBS have.

Another thing to understand is that childhood memories are very powerful and are remembered in the unconscious mind forever. One of my patients had a father who used to yell and scream at her about the things she did incorrectly. Although she developed no MBS symptoms in childhood, she did develop severe headaches as an adult one day when she put on a new pair of prescription glasses. She had no idea why these headaches started and blamed the new glasses. Despite altering the glasses several times, the headaches did not abate and occurred daily for 17 years. During that time, she saw over 20 doctors, was placed on over 20 medications, and even had a surgical procedure to try to release pressure that was supposedly being applied to her facial nerve. None of these things helped. When I took her history, the onset of headaches began after she had gotten a new boss at work; a boss she described as “mean and nasty” and who yelled at her. The new glasses did not cause her headaches, but when she put the glasses on, her mind used that event as an opportunity to create the pain, which allowed her (forced her) to get away from the boss and the triggering of emotions from her childhood.

This is how our minds work. If you pay close attention to your body, you will find that you often have physical reactions (often very mild ones) to common emotions that occur. However, you will usually not be aware of the emotion, because most emotions are subconscious. In fact, about 95% of all of our thoughts and feelings are located in the unconscious mind. (more on this in the next blog) The other day, I saw a friend who had an earaches. He asked if I would look in his ear to see if there was an infection there. The pain had started when he was singing in his choir in the dress rehearsal for a concert. The man next to him was singing close to his ear when the pain started. His eardrum looked perfectly normal and as soon as he learned that there was no infection, the pain went away. This is a very simple and common story. He was nervous about performing in the concert and the singing in his ear gave his mind the opportunity (the idea?) of creating ear pain as a way of alerting him to the nervousness. Accidents and injuries often present the opportunity for the mind to create chronic pain, if there are particular stressful events occurring at the time of the accident. Whiplash is a good example of this; the strain on the neck from an accident would typically heal within a week or two, unless there is something causing the nerve connections to become chronic.

The brain is set up to help us survive. It has mechanisms for immediate reactions to avoid danger. And these mechanisms are intimately tied into the body. In the modern world, we rarely meet bears, but we are commonly confronted with acute emotions and stresses in our daily lives. These stresses frequently result in bodily responses, such as increased heart rate, changes in blood flow to our hands, tension in our stomachs, bladder reactions and muscle or nerve pain. When these stresses are linked to childhood emotions, the reactions are likely to be even greater. I teach all of my patients to pay attention to their bodies, because their bodies are a warning system and they will always alert us to ways that we are reacting to stress and emotions in our lives. The more this is understood, the better off we will be as a society, because people (and doctors) will appropriately recognize common physical symptoms as MBS, rather than as signs of a serious disease.

Much more on this in the future. If you pay close attention to the mind and the body and look for the connections between the two, you will typically learn a great deal about what affects you, what drives you, what scares you, and what makes you tick. This self-knowledge is a great reward for taking unconscious thoughts, feelings and reactions and looking at them with the conscious mind.

Bye for now.

To your health,

Howard Schubiner, MD

Disclaimer: It is important to recognize that the information contained in this blog, whether posted by me or anyone else, cannot be considered to be specific medical diagnoses, medical treatment, or medical advice. General information about MBS/TMS will be posted in response to questions, but you will need to decide if this information is relevant to your situation and, as always, you should consult with your physicians and counselors regarding new symptoms and any changes that you might make in medications or activities.