Internal stressors, personality traits, emotion not allowed to be felt--that, of course, is Sarno, and maybe that is what is going on with you, magicjim. But often overlooked is what Sarno said about Pavlovian conditioning in his last three books. Here is how he put it in
The Divided Mind:
“One of the prime characteristics of TMS is that the pattern of symptoms will develop as a result of Pavlovian conditioning. People will experience the kind of symptoms they have learned to expect to experience, just as Pavlov’s dogs learned to associate the presentation of food with the ringing of a bell. Elizabeth von R had pain associated with standing and walking, though there was nothing neurologically wrong with her. Another patient with similar pain will say that it is sitting that brings on the pain, while walking relieves it. Experience with large numbers of patients in our clinic makes it clear that these are programmed responses having to relationship to anything beyond what the patient is conditioned to expect. That is why most common psychosomatic disorders are invariably the ones currently in vogue.” (The italicization is Sarno’s; the underlining is mine.)
Maybe the underlined language is a bit ambiguous, but I think “having no relationship to anything beyond what the patient is conditioned to expect” includes no relationship to internal stressors, personality traits, or repressed emotions. The sole cause is that the patient expects that if he or she does X (and X can be walking, can be sitting, can be sleeping, or whatever), then he or she will have pain.
This interpretation of Sarno is based partly on my own experience with TMS. I overcame more than two decades of chronic low back pain by getting in touch when with when I was repressing anger and didn’t realize it, so I fully appreciate what Sarno said about internal stressors, perfectionism and goodism, and repressed emotions. But years after I ended my chronic low back pain, I got neck pain that became chronic. No amount of focusing on stressors in my life, my perfectionism, or trying to uncover emotion that I was repressing made any difference. It was only after I realized and accepted that my pain was Pavlovian conditioning having no relationship to anything else that I stopped the pain. Another example is chronic right knee pain that began after I tore my medical meniscus in 1991. Over the next ten years, I had three surgeries to stop the pain. The first and third cut away parts of the meniscus, reducing cushioning in the joint. The second one was a crazy procedure intended to fill in divots in the cartilage covering the end of my femur due to wear and tear associated with diminished meniscal cushioning, and the third one included that procedure as well as more resection of the meniscus. None of the surgeries helped one bit. Over the last five years, however, I have had no knee pain at all. Why? I realized and accepted that the pain was just Pavlovian conditioning. (The details of my realization involve learning about molecular biology that would take too long to explain and nobody would have the patience to read because of the off-putting terminology.)
My interpretation of what Sarno wrote about Pavlovian conditioning is not based solely on my experience with TMS. A neuroscience-oriented version of Pavlovian conditioning called predictive processing, or predictive coding, is the new big thing in both cognitive brain science and pain science. Dr. Howard Schubiner has gotten into that in recent years, which is what stimulated my interest in it. Prominent pain neuroscientist Katja Weich has nicely condensed predictive processing: “what you get is what you expect” because that is just the way the (very complex) central nervous system works. So my question to you, magicjim, is have you become conditioned to expect that after sleeping you will wake up with an extremely stiff and sore upper back and become conditioned to expect the pain to go away after being up for an hour? If so, that is what you will get until you stop expecting that. Finally, don’t answer my question in the negative just because you do not remember ever having consciously and cognitively deduced that after you sleep, you will wake up with an extremely stiff and sore upper back. Pavlovian conditioning can occur unconsciously, so you don’t realize you have created a causal expectation in the unconscious part of your brain that has no basis in physical reality.
