Tag Archives: Dr. Sarno

MBS Blog #23: Understanding and Overcoming Fear

It has become very clear to me over the last year or so that one of the biggest impediments to recovery from Mind Body syndrome (MBS) is fear.  It seems to be a part of the experience of so many people that it should be considered as a normal part of the MBS experience and therefore everyone will probably need to deal with fear at some point in their recovery.  In this blog, I will take a stab at identifying the sources of fear, the meaning of fear and offer some thoughts and methods on dealing with fear.

Where does fear come from?  We should recognize that fear is part of the normal experience of life.  We are born with a brain system that is built to protect us from danger and harm, i.e. to help us survive in a dangerous world where we may become stalked by a predator or endangered by one of our own species; another human being.  This system resides in the deeper parts of the brain (sometimes called the “reptilian brain”), it operates all of the time by constantly scanning the environment for danger, and it is clearly in the subconscious (or unconscious) part of the brain, i.e. we are not aware of its actions until after it has acted.  When we sense danger, the brain sends immediate signals from the amygdala (the emotional center of the brain) to the hypothalamus (where the autonomic nervous system resides) to cause some kind of action in our bodies.  Again, this occur without conscious awareness and our bodies are programmed to react to danger by activating the fight or flight reaction pathways.  After our body reacts (with muscle tension, gut or bladder tension, and many other reactions), we THEN become aware of the sensation of fear.  Interestingly, studies have shown that people who are paralyzed have lesser degrees of the sensation of fear (and other emotions).  Continue reading

MBS Blog #22: Confronting Fear Head On: Brad’s Story

Many people find that fear of not being able to recover from MBS and fear of pain are major factors preventing their recovery.  In order to address these issues, I offer the courageous story of Brad in his own words.  Following that (in the next blog), you will find my comments on dealing with fear and several methods that can help.


“In the late 1980s, I became totally crippled with back pain shortly after an incredibly stressful four-month period. I couldn’t do much besides lie around. I saw several doctors, who gave me a variety of diagnoses, and I realized they were just guessing, so I went to the library do some research. By chance (thank God!) I saw Dr. Sarno’s first book, Mind Over Back Pain, on the shelf. I took it out, and after reading it I knew that my pain had been caused by my recent psychological tensions. I also concluded that I had become literally phobic about many movements and decided that the only way to break the phobia was to challenge it with graduated exercise. So I began to exercise and lift weights.  However, I was very timid and therefore didn’t exercise as aggressively as I could have. Continue reading

MBS#17–Why symptoms move and change? A look at symptom substitution

Symptom substitution:  Why do MBS symptoms move and change over time?

Everyone who has MBS/TMS or works with people who have this syndrome knows about symptom substitution, which Dr. Sarno calls the symptom imperative.  Freud wrote about it many years ago.  For the purposes of MBS/TMS, it basically means that the manifestations of MBS/TMS can vary over time.  They can move, shift or completely change within minutes, days or weeks.  I had a lady in one of my classes who came in with low back pain for seven years.  After two weeks in the class, her low back pain was completely gone, but she had developed a pain in her neck.  I had a 15 year old in one of my classes whose symptoms shifted over time from hip pain, to headaches, to chest pain, to loss of movement of his arm and leg (known as a conversion disorder in medical terminology, i.e. paralysis due to psychological, rather than physical, factors), to leg pain to fainting spells.  I know someone who had groin pain, which morphed into back pain, then shifted into anxiety and OCD symptoms and then back again to the pain.  It is amazing to watch MBS/TMS symptoms shift from day to day and week to week, even sometimes from minute to minute.  This is especially interesting to see that the symptoms often involve both “physical” and “psychological” symptoms.  This confirms that MBS/TMS can cause both sets of symptoms, such as pain and anxiety, diarrhea and OCD, urinary frequency and depression, rapid heart rate and fatigue.

When we see this kind of symptom substitution, we can usually easily confirm that the cause of this is truly MBS/TMS.  There are very few medical diseases that have this type of pattern and therefore when we see this we are confident that the correct diagnosis is MBS/TMS, once serious medical conditions are ruled out.  The reason symptoms can come and go, alter and change, or transform into new symptoms is that they are all caused by the same underlying physiological issues.  These pathways are described in earlier blogs and consist of activation of the amgydala (emotional memory center), the anterior portion of the cingulate cortex (amplifies pain due to fear, worry and frustration), and the autonomic nervous system (activates the fight, flight or freeze reaction).  These cause a variety of changes in the brain and body such as increase in muscle tension or muscle spasm, alteration or spasm of muscles in the bowel or urinary tract, activating or inhibiting nerve signals that control our activity and feelings.  Once these nerve pathways get activated, they tend to quickly become sensitized and then “wired” to produce learned connections that develop a life of their own and can persist for months, years or even decades unless they are stopped by MBS/TMS therapy.  Note that these are physiological changes, i.e. temporary alterations that do not produce tissue destruction or damage, as opposed to pathological changes, such as cancer or heart disease.

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MBS Blog #13: How deep have you gotten? Layers of health in coping with TMS/MBS

MBS Blog  13


The layers of wellness: levels of coping with TMS/MBS



I have spoken to so many people who are frustrated that their TMS symptoms have not gotten better yet.  They have read so many accounts of people who have read Dr. Sarno’s books and immediately gotten better.  They wonder why they haven’t had the same response.  This can lead to increased worrying: worrying about what’s wrong with them, if they really have TMS or not, if they are making themselves sicker by worrying, and this vicious cycle can go on and on.


On the TMS Help Forum and other web sites, there are many excellent suggestions about methods of self-help and books that people have used to vanquish their TMS symptoms.  Most of these are great resources and can be helpful to many.


I was talking about this the other day with a good friend and excellent psychologist, Mark Lumley from Wayne State University.  He and I actually ended up writing a little poem about the layers of work that many people may need to do to get better.  I must warn you, neither of us are poets, so the so-called poem isn’t very poetic.  But we like it because it means something important to us.  Here it is.


Things to do:


Notice what has been hidden;

Understand what has been a mystery.


Speak what has been unspoken;

Confront what has been avoided.


Accept what needs to be accepted;

Forgive what needs to be forgiven.


Change what needs to be changed.


Howard Schubiner, MD and Mark Lumley, Ph.D.

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#11–Back pain 101–How modern medicine gets it wrong…

Conventional “knowledge” tells us that we were not meant to walk upright and that backs typically degenerate over time which leads to chronic back pain.  If back pain was caused by degeneration of the back and the discs between the vertebrae, then it would make sense that back pain would increase with age.  This is not the case however.  Back pain actually drops a bit after age 65.  We have been told that back pain will occur more often in people who use their backs more often.  However, in studies from around the world, more people have back pain in industrialized, modern societies than in rural, agrarian societies. 


What is the cause of back pain?  There are several serious medical conditions that can cause back pain, such as a vertebral fracture (usually a compression fracture seen in the elderly or those with osteopenia), cancer of the vertebrae (seen in those with metastatic breast, lung or prostate cancer), serious abdominal conditions such as rupture of an abdominal aortic aneurysm, pancreatic cancer, rupture of a duodenal ulcer, or infections such as osteomyelitis, epidural abscess or diskitis.  Fortunately, these conditons are relatively rare and easy to diagnose with modern imaging techniques (X-ray, CT or MRI). 

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