Sarno emphasized repressed emotions, especially anger, while Alan emphasizes the role of fear. I will argue first that this difference is less than might appear and second that Sarno and Alan actually agree on the bedrock principle regarding what is required to stop TMS/neuroplastic pain--and that is what’s important.
I became a follower of Sarno in 1991 when he published
Healing Back Pain. By doing what he prescribed, I was able within six weeks to end more than two decades of chronic low back pain
. What did he prescribe? Two elements as I saw it. The first is to buy into his succinct “list of twelve key thoughts,” which he also called “the Daily Reminders.” The second is not stated as succinctly in
Healing Back Pain as Sarno would put it three years later in an interview, so I will use that formulation: "Know about the anger [you are repressing], and know why it’s there. And if you do those two things, your pain will go away.”
It is notable that no less than five of Sarno’s twelve Daily Reminders concern the role of fear in causing TMS pain:
- The pain is due to TMS, not to a structural abnormality. (Meaning don’t fear you have damaged or defective body tissue that will get worse if you are physically active.)
- TMS is a harmless condition, caused by my repressed emotions. (Meaning don’t fear you have damaged or defective body tissue that will get worse if you are physically active.)
- Since my back is basically normal there is nothing to fear. (“Nothing” means don’t fear you have damaged or defective body tissue that will get worse if you are physically active, and don’t have any subsidiary fears that the pain will prevent you from earning a living, from being a good parent to your children, from having a good social life, and so on and on and on.)
- Therefore physical activity is not dangerous. (Meaning there is no reason to fear physical activity.)
- I will not be concerned or intimidated by the pain. (Meaning don’t fear the pain or any subsidiary adverse consequences of being in pain like not being able to earn a living, etc.)
What I see as Sarno’s bedrock principle is implicit in the Daily Reminders, but he made it explicit in his later two books. In
The Mindbody Prescription, he wrote: “The pain will not stop
unless you are able to say, ‘I have normal back; I now know that the pain is due to a basically harmless condition, initiated by the brain to serve a pychological purpose, and that the structural abnormalities that have been found on X-ray, CT scam or MRI are normal changes associated with activity and aging.” (Emphasis by me.) In
The Divided Mind, he wrote that to recover “the person must not only understand the [TMS] process but be able to fully accept it as well. . . . This was clear in the early days [of his TMS practice] since
only the patients who understood and accepted got better . . . .” (Emphasis by me.)
Turning now to Alan Gordon’s new book,
The Way Out, he wrote on on page 51 about being in a car accident:
“After the accident I developed pain . . . which led to fear, which led to more pain. . . . But I didn’t just have fear of the pain. I had a very specific fear--that the pain was caused by a physical problem in my back. I was scared of the pain because I thought it meant that something was broken, or ruptured, or otherwise damaged in my body. And this is the exact fear that fuels neuroplastic pain."
Alan calls his therapy model Pain Reprocessing Therapy. What has to be reprocessed? The pain, of course. How does it have to be reprocessed? You have to quit viewing it as being caused by damaged or defective body tissue and instead view it as created by your brain by mistake, i.e., as being only what he calls neuroplastic pain.
Alan’s bedrock principle is essentially the same as Sarno’s. It is true that they rely on different theoretical explanations of why you can have pain that feels exactly like it is due to damaged or defective body tissue but in fact is not. Sarno’s explanation was Freudian; Alan’s is not. But it makes no difference which theory, or something else entirely, helps you to quit viewing your pain as caused by damaged or defective body tissue. The whole focus has to be on rejecting the notion that the cause is damaged or defective body tissue. (I’m not sure somatic tracking, a technique Alan highlights in his book, is necessarily the best way to get there, but that’s a topic for another time.)
