Who is Dr. John E. Sarno?
Dr. John Sarno was a Professor of Rehabilitation Medicine at New York University School of Medicine. He was a pioneer in treating psychosomatic pain, sometimes referred to as mind-body pain. Dr. John Sarno challenged the thinking of the medical community about Chronic pain, when his patients got better. His theory and concepts were developed in conjunction with Dr. Arlene Feinblatt Ph.D. They recognized repressed emotions, mental health and mood disorders had a significant impact on the treatment of chronic pain and other chronic medical conditions. In his lectures Sarno used a psychosocial approach, recognizing the internal stressors resulting from difficult relationships, self-esteem, Adverse Childhood experiences (ACES), etc were the root cause of chronic pain.
Patients who visited Dr. Sarno were often on high doses of opioids prescribed by their family doctor which they were able to wean off after attending his famous Monday night lectures or having ISTDP therapy.
Many called Dr. John Sarno, “the world’s most famous back doctor.” Conditions treated at Rusk Rehabilitation Clinic were most commonly low back pain, herniated disc, slipped disc (disc hernia), following spinal fusion and various back injuries that became chronic. Patients were then able to discontinue their NSAIDS medication and opioids when they no longer had any pain.
TMS is the term Dr. Sarno coined to explain these psychosomatic disorders and mind-body conditions. Tension Myoneural Syndrome or Tension Myositis Syndrome is explained as a condition that causes real physical symptoms, such as chronic pain, gastrointestinal issues, and fibromyalgia, migraine headaches to name a few disorders, that are not due to pathological or structural abnormalities and are not explained by diagnostic tests. The TMS theory proved true time and time again while improving thousands of patients with depression, anxiety, and stress. These repressed emotions and more are found hidden beneath many lower back pain, spinal discs and musculoskeletal neurological disorders.
How Does Dr. John Sarno Heal Back Pain?
1. He would perform a thorough case history and exam to rule out anything pathological or structural.
2. Using the TMS concepts, Dr. John Sarno would ask his patients;
“Do you remember what was happening in your life
when you first noticed the back pain?”
By asking this question, he encouraged the patient to self reflect on their own personal experience. Why and how disappointments or self-criticism, etc could affect the body's nervous, vaso-vagal system and immune response in the body. (Fight, Flight, Freeze) and help them overcome the resistance to self-reflection (intrapsychic conflict)
3. He clearly felt the knowledge of what was happening in the body of a TMS patient was of vital importance to recovery. This brought forth his weekly Monday night lectures where he explained in a slide show the physiology behind the symptoms.
4. He advised patients to return to their normal exercise routine or start a balanced exercise program. This was for the patients wellbeing, not symptom relief.
5. Dr. Sarno encouraged patients to journal about their life experiences to help them make sense of how the pain could be connected to an intrapsychic conflict (feelings/ emotions).
6. He suggested mediation and breathing exercises to calm the nervous system.
7. Dr. Sarno understood after many years of treating TMS that when the patient realised what had caused their pain, the pain would cease to exist. There were a number of patients who found it difficult to accept the psychosomatic diagnosis who were referred to Dr. Arlene Feinblatt’s ISTDP clinic.
With psychotherapy, the mind-body becomes integrated and the pain subsides; the patient can deeply connect and release the intrapsychic conflict within them.
Was Dr. John Sarno right about TMS
(Tension Myositis/Myoneural Syndrome)?
Dr. Sarno coined the term TMS, to refer to a broad range of problems including back pain which usually comes under the diagnosis of Medically Unexplained Symptoms. Before we had fMRI’s to confirm/ exclude the causes of symptoms, a lot of diagnoses were deemed as possible... All medical doctors are aware of the term Medically Unexplained Symptoms (MUS). But do not refer to the idea that the mind is an integral part of the body, so is therefore connected = mind-body connection.
In fact Dr. Sarno gave patients an option to have a Medical Condition that they could understand. (Patients often believe that the mind is the imagination) and from that position make the connection to anxiety, stress being a cause.
Concurrently, Dr. Malan at the Tavistock in London and Dr. Davenloo at McGill University in Montreal were becoming aware of the three anxiety pathways and were beginning to track them in the body to help patients become aware of how anxiety was manifested in the body and how it disrupted their wellbeing. This investigation also gave a clear understanding of defenses, and the reluctance and discomfort the patients experienced when reflecting on their emotional intrapsychic conflict.
Part of Dr. Sarno’s team at the Rusk Institute was Dr. Arlene Feinbatt who had studied ISTDP (Intensive Short-Term Dynamic Psychotherapy), under Dr. Davenoloo. With Dr. Feinbatt’s support patients could explore, face, and overcome their intrapsychic conflict and take charge of their own lives again.
Dr. Sarno's Method and Legacy
Dr. Davenloo a contemporary of Sarno, developed Intensive Short-term Dynamic Psychotherapy, which tracks anxiety pathways of striated muscle anxiety, smooth muscle anxiety, and cognitive-perceptual disruption. Including La-belle-indifference, a condition in which the patient shows no concern with symptoms caused by a conversion disorder. These anxiety pathways are also the pain pathways that patients experience. By tracking the type of anxiety patients can become aware of the actual connection between the mind and body. Prof Allan Abbass who studied under Dr. Davenloo from Dalhousie University now has a large outpatient clinic in Halifax specializing in treating patients with chronic pain.
Dr. Howard Schubiner, a colleague and protege of Dr. Sarno shares also sees that there is a universal problem that there are few medical doctors that know how to treat chronic pain. In the last 20 years, Dr. Schubiner has written many books on the topic of chronic pain, anxiety, and depression (Unlearn Your Pain: Unlearn Your Anxiety)
Dr. David Schecter also worked with Dr. Sarno during his medical internship and found himself in Sarno’s office with knee pain. Dr. Sarno quotes “ I don’t know if you will buy this son, but 95% of this chronic pain is psychosomatic.” Dr. David Schecters books on this topic include, “Think Away Your Pain”.
All the Rage: Saved by Sarno
Perhaps one of the most well-known introductory medias into Sarno's work, All the Rage is a documentary about Dr. John Sarno, by Film Director Michael Galinsky who also starred as one of Dr. Sarno patients. The movie includes some of the famous people whom Dr. Sarno healed, including Howard Stern, Anne Bancroft, and Larry David. Prince Ea, also gets a mention. It has now been shown in 80 countries worldwide and continues to be a source of education and healing for many doctors and patients.
Books Written by Dr. John Sarno
Dr. John Sarno's best-selling books include Healing Back Pain (translated to 32 languages), Mind Over Back Pain, The Mind-Body Prescription and The Divided Mind:The Epidemic of Mind Body Disorders. These books enabled many patients to become free of pain after their symptoms could not be explained and the medical community was unable to help treating medically unexplained symptoms (MUS).