Tag Archives: pain

What is Mind Body Syndrome Part II

#3—What is Mind Body Syndrome Part II


As I mentioned in the last post, MBS is not new.  As long as there have been humans, there have been physical symptoms caused by stress and emotions.  It is important to realize that physical symptoms, even very severe physical symptoms can be caused by stress and emotions.  In fact, the emotions that tend to have the largest effect on us are precisely those that we are unaware of.  There are two ways to think about how these symptoms can be produced. 


The first way is to understand how the neurologic system works.  Pain is a learned response, i.e. the body actually learns how to produce certain symptoms by experiencing them.  For example, I had a patient who fell and hurt her back as a teenager.  A decade later, she was in a very difficult situation in a job where she felt trapped and unable to get out of her problems there.  At that moment, suddenly her back seized up and she had tremendous pain.  The nerves that send signals from the back to the brain had been fired when she fell as a teenager and those nerve connections had been “learned” at that time.  When a significant emotional situation arose where she had no way out, her body responded in a way that it already knew, by producing the back pain it had learned 10 years earlier. 


A good way to understand how MBS works is by thinking about phantom limb syndrome.  In this syndrome, which is very common among amputees, pain or other sensations can be felt in the part of the body (arm or leg usually) that is missing.  There is obviously no disease in that area, yet we can feel pain (often severe) that appears to be coming from the missing body part.  What has happened is that the nerves that send signals to the brain have been sensitized and are continuing to fire and those signals are interpreted as pain by the brain.  A vicious cycle is formed of sensitized nerves that send signals to the brain, then those signals get amplified in the brain (by a structure called the anterior cingulated cortex; more about that area of the brain in upcoming posts), and then signals are sent out to the body by the autonomic nervous system (the fight, flight or freeze system).  This pain is real, very real.  However, there is no tissue breakdown, no tissue disease in the body.  This is exactly what happens in Mind Body Syndrome.  We may feel pain in an area of the body, for example, the head or back or stomach, yet there is no tissue breakdown, no tissue disease there.  Of course, pain can be caused by tissue breakdown or disease, such as occurs in cancer, infections, or fractures.  When the doctors are unable to find disease after a careful and thorough search, the diagnosis of MBS is usually correct.  It is important to realize that MBS is a physiologic process, i.e. a process that occurs due to normal reactions of the body.  When we get scared, our heart speeds up; when we get nervous, our stomach tightens up or we get clammy hands.  These are physiologic processes, normal reactions that are 100% reversible.  That is why MBS is curable.  It can be reversed by interrupting the vicious cycle.

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What is Mind Body Syndrome? Part I

#2—What is Mind Body Syndrome?  Part I.
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. Continue reading