Written by Dr. Schubiner on June 3, 2008 It is important to realize that Mind Body Syndrome is not a new diagnosis. When Dr. Sarno described Tension Myositis Syndrome (TMS) in the 1970's, he created a new name for a syndrome that has actually been known for hundreds of years. I agree with Dr. Sarno that we do need a name for this syndrome (and I will explain why in future blogs). However, when you look at the history of medicine you will find many examples of MBS. I highly recommend the book by the University of Toronto historian, Edward Shorter, From Paralysis to Fatigue: A History of Psychosomatic Medicine. Dr. Shorter uses the term psychosomatic, which is commonly used in medicine, but a term that I do not prefer to use because it has a connotation of being unkind to the patients, implying that they are somehow less than normal, or somewhat “crazy.” As I often say, I know that people with MBS are not crazy because I have MBS and I know I'm not crazy. In any case, the reason people get MBS, or physical (or psychological symptoms) due to emotions which are often unconscious, is that they are human. They have a human brain that processes emotions in certain ways and they have human existences that often cause great stress in our lives. That is why there has always been MBS and there will always be MBS. However, the type of symptoms that the brain creates in our bodies does change over time. For example, we know (courtesy of Dr. Shorter) that a common manifestation of great stress and emotions in the 1600's and 1700's was the development of paralysis. A story that captures this is about a young man who was beaten, abused, and berated his whole life by his father. When he was approximately 25 years old, while being berated once again, he had a great surge of energy and suddenly went to hit his father with his fist. At that very moment, his arm became paralyzed and he couldn't move it at all. We know that he didn't suddenly have a stroke because he regained use of the arm fully within a short time. And therefore we know that the cause of the paralysis was a combination of emotions, which were all unconscious (i.e. he was unaware that he was feeling them), and the main emotions were anger, fear and guilt. In those centuries, doctors did not consider this type of reaction to be caused by psychological factors, but rather some kind of physical condition. In the 1900's, doctors learned how to tap on the tendons of an arm or leg and determine immediately if there was a stroke or some other severe neurologic condition. We now call these reflexes, the deep tendon reflexes, and use them all the time. When they are normal, in someone with sudden paralysis, we know that there is no neurologic condition and that the cause of the paralysis is due to MBS. Since doctors have been able to use deep tendon reflexes, the number of people with paralysis due to stress and emotions has dropped drastically so that it's relatively rare. Why? The cause of MBS is in the mind, in our unconscious mind that is trying to help us cope with great stress. The unconscious mind will find some physical symptoms to use when necessary and it will choose a physical symptom that makes some kind of sense. And typically, it will choose a physical symptom that will not be seen as “psychological.” Since paralysis is now seen as psychological, it is rarely used by the unconscious mind. We are more likely now to get Back Pain, headaches, fatigue, and stomach pains, which are more likely to be seen as physical conditions and therefore more acceptable to our self and to the doctors. This is one reason why there are so many people today with these chronic symptoms and often they do not respond to biomedical treatments. Since so few doctors are aware of MBS, they often are not treating the underlying cause of the symptoms and therefore the treatment is trying to cope with the symptoms of the problem and is less likely to be successful. 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.