Dr. Sarno's Treatment Plan

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Dr. Sarno's current treatment program for TMS sufferers is detailed on pages 134-183 of The Divided Mind. As you read the following, you'll want to know that the program is being used by a growing number of practitioners in the U.S. and abroad who are following Dr. Sarno's work, and you can find out about many of them through this site.

The structure of the program involves an individual consultation followed by a lecture, with the possibility of further group meetings and, in some cases, psychotherapy. First contact with Dr. Sarno will be a phone screening so he can determine if he believes the TMS program can work for them. One thing he asks is if you believe things going on in your life could be causing you pain. If he feels the patient can be helped, he schedules an appointment.


During the 45-minute consultation, Dr. Sarno will gather information about the patient's pain symptoms and medical history. The patient's psychological history is also discussed, since the circumstances of their life, including personality, stressors, and relationships, impact the diagnosis of TMS as a psychosomatic condition. A physical exam is also performed.


Next, patients come together to attend a lecture, since understanding TMS is the key to overcoming it. The lecture reviews the recent history of musculoskeletal disorders with respect to psychosomatic epidemics. The main point is that physical abnormalities may not be the source of pain, as is commonly concluded by doctors. Also discussed are myriad other psychosomatic disorders, to show that TMS is just one of many that are already recognized.

The lecture then goes on to discuss the psychology of the disorder. One important note is that patients may condition themselves to feel the pain during certain physical activities, such as sitting or walking, and that these activities really have nothing to do with the pain. Furthermore, patients are advised not to fear the disorder, since there is no possibility of permanent damage as other doctors may have mistakenly informed them. Finally, the lecture discusses sources of unconscious anger and the role that psychosomatic pain plays in keeping that anger from coming to the surface.

After the lecture, patients continue to work on a study program for several weeks. The program involves rereading one of Dr. Sarno's books, with daily attention given to the chapters on psychology and treatment (especially pages 142-146 in The Divided Mind). Patients are instructed to list things that may contribute to their painful and threatening feelings, then write an essay about each of those things. These can be issues from childhood, current stressors, etc. Many patients report significant progress after following this regimen for three to four weeks.

Further Treatment

Patients who do not feel any progress may join a weekly group conducted by Dr. Sarno, or begin group or individual psychotherapy. The purpose of Dr. Sarno's group is to correct misconceptions about the program itself. For instance, a patient may want an instant cure for his pain without understanding that he needs a fundamental change in attitude; this patient would attend one of Dr. Sarno's meetings. Dr. Sarno also has a monthly forum where several patients share their personal experiences of pain and recovery with a group, which motivates others who continue to struggle.

The purpose of psychotherapy, recommended for approximately 20 percent of those in the program, is to make the patient more aware of their emotions, especially any defensive structures holding back unconscious anger. The process starts with a consultation to determine whether the patient would best fit into group or individual therapy.

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