Ashley, I have read both of your posts today (this one and the one about the New York Times story regarding Sarno and modern pain science moving beyond him in some respects). That prompts me to write what follows.
I’ll begin with Sarno. In
Healing Back Pain, he wrote (with emphasis by me):
“I remember a mother telling me proudly how she had stopped the temper tantrums in her little fifteen month old. The ‘wise’ family doctor suggested that she splash ice water in the child’s face when he started to have a tantrum. It worked beautifully—he never had another tantrum. At the ripe age of fifteen months he had learned the technique of repression. He had been programmed to repress anger because it produced very unpleasant consequences, and he would carry that dubious talent with him throughout his life. Now when confronted with the multitude of frustrating, annoying, sometimes enraging things that happen to people every day, this man automatically internalizes his natural anger, and when that anger collects and builds up, he will have TMS or some such physical reaction in response to it.”
In short, the man learned at a young age to associate experiencing anger with danger to his well-being, so he learned to repress it. And Sarno said he would carry that learning with him for the rest of his life.
You wrote: "the fact that your brain and nervous system can generate pain strictly off emotions is frightening for me. It feels as if I have no control over it." Anger at times toward family members, other people we are close to, people we work with, etc. is a normal human reaction. We have no control over the autonomic physiological response that leads to what we call anger, but we can learn the skill of being aware of the anger and deciding whether to express it and, if so, how to express it in a way that is not dangerous. Sarno said in a 1994 interview that the solution to TMS due to repressed anger was this: "Know about the anger, and know why it’s there. And if you do those two things, your pain will go away.” Once you know about the anger, i.e., quit repressing it, then you can figure out why it's there, and then you can cognitively assess how dangerous it really is. From a modern pain science perspective, repressed anger itself is not what causes chronic pain. Instead, the problem is the learned association of anger with danger to one's well-being.
This brings me to modern pain science. Alan Gordon’s Pain Recovery Program, which is available on this tms.wiki website, is based on that. I urge you to take a look at his Day 2 lesson. The essence of it is this: Pain = Danger. You brain will create pain when it concludes you are in danger. He explains this by noting two facts. Fact 1 is that if your brain determines you are in danger of tissue damage, it will create pain to protect you. He asks you to imagine you are out for a run and sprain your ankle. You now have tissue damage, but if you resume running, you are in danger of suffering more tissue damage. You brain protects you by creating pain that induces you to limp home so you do not cause more damage and then induces you to take it easy on your ankle for a while so you do not interrupt the healing process.
Fact 2 is that your brain is not perfect. The human central nervous system did not develop in a way that is able distinguish between danger to your physical well-being, e.g., tissue damage, and danger to your nonphysical well-being, e.g., very unpleasant emotional or psychological consequences. Your brain will create pain to protect you not only when the danger that you face is to your physical well-being but also when the danger is to your non-physical well-being. Your brain blunders in the latter case because its creation of pain does not protect your nonphysical well-being, but the problem is that the human brain in not perfect.
In recent years, Dr. Howard Schubiner and Alan Gordon have been emphasizing that danger in the form of fear of your chronic pain—e.g., you fear it will damage your social life or prevent you from holding a job and you fear you will never overcome it—can play a big role in perpetuating and increasing your pain. I think Sarno appreciated this way back in
Healing Back Pain because two of his Twelve Daily Reminders were “Since my back is basically normal there is nothing to fear,” and “I will not be concerned or intimidated by the pain."
Recently Alan Gordon has modified his “Pain Recovery Program” a bit and calls his new approach “Pain Reprocessing Therapy.” His point is that to recover from chronic pain you need to change how you process your pain. Specifically, you need to (1) quit viewing your pain as an indication you have present or potential tissue damage and (2) quit fearing your pain. So how do you do that? His new book, titled
The Way Out, is devoted to telling you how. I have a few quibbles about the book, mainly because of what is not in it. But I surmise from an interview of him I saw recently that the omissions were deliberate in order to make the book more user friendly. A clear strength of the book is that it is easy to read and user friendly.
The International Association for the Study of Pain, which has thousands of members worldwide, defines pain as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.” There is no denying that pain is an unpleasant sensory and emotional experience. But that does not necessarily mean it is associated with actual or potential tissue damage, and usually chronic pain is not so associated. To recover, you need to persuade yourself that your pain only
resembles the unpleasant sensory and emotional experience associated with actual or potential tissue damage, and you need to develop hope and optimism that you will be able to overcome the pain. I detect a lack of optimism in your post above. I urge you to read
The Way Out. I think it could help you reprocess your pain if you study it carefully, buy into it, and apply it to your day-to-day life.
The hardest part is buying into it. Alan Gordon and a former colleague at his Pain Psychology Center had tremendous success with pain reprocessing therapy as reported in the recently published Boulder Back Pain Study, which also involved neuroscientist Tor Wager who is quoted extensively in the New York Times article. Buying into pain reprocessing is one thing when you meet face-to-face multiple times with a pain therapy expert like Alan Gordon, whom you come to trust and who repeatedly tells you that your pain is not due to actual or potential tissue damage, gives you reasons why, and tells you that you will be able to fix your pain problem. Buying in is quite another thing when you have no personal interaction with an expert and you are only reading a book he wrote. But it can be done. I completely recovered from more than two decades of low back pain by reading, buying into, and applying Sarno's
Healing Back Pain. That was shortly after the book was published in 1991. I have since gotten into modern pain science in a big way and have had complete success with other forms of chronic pain that I had previously thought impossible to get rid of, and I did this without having any interpersonal relationship with a professional. I did it by reading, digesting, and applying what I learned from scientific literature about pain biology.
