Success with ideas of John Sarno
Posted: Fri Sep 23, 2005 10:25 am
Received by email from Manuel Perez-Victoria today:
COMPLETE RECOVERY WITH DR. SARNO
Hello everybody. I would like to share with you the story of how I fully recovered from chronic pelvic pain (CPP) following the revolutionary ideas developed by Dr. John E. Sarno, who is a professor of Clinical Rehabilitation Medicine at the New York University School of Medicine. I am convinced that these ideas can help many of you. I must say that I am not a medical doctor and speak out of my personal experience only: I got rid of my pain following a program which is extremely simple, almost costless, painless and with no unhealthy side effects (it does have positive side effects).
Now, you are probably thinking that this is too good to be true and you will be even more skeptical when you learn that Dr. Sarno's methods fall within the slippery field of mind-body medicine. So, before getting to my story, let me tell you that I have a ph.D in physics and work as a researcher in particle physics. Therefore, I can say that I have a scientific attitude, which means that I'm quite skeptic myself, but also that I am open to new ideas if they explain facts well. The research of Dr. Sarno is not cheap new-age stuff but serious science. Just in case, I also state that I have no personal interest in advertising his methods. Actually, I haven't even met him personally. Finally, I should say that there is some overlap between the approach I will describe here and the methods of Dr. Anderson and Dr. Wise at Stanford.
My first CPP symptoms started suddenly in October 2002. My GP diagnosed an UTI but the subsequent analysis showed no trace of infection. Basically my problem then was only a general discomfort (something like a mild burning sensation) in the penis and testicles and an anomalous frequency of urination. In Christmas I visited an urologist, who diagnosed non-bacterial prostatitis and prescribed saw palmetto (serenoa repens). I was quite afraid to learn that something in my prostate was wrong and thought it uncommon for my age (32 at that time). I had the saw palmetto for two months, but my condition got worse. The frequency had increased and now I had pain all over the perineum when sitting for longer than half an hour. I explained this to the urologist and he said that this was logical since sitting puts pressure on the prostate. He recommended that I should keep on taking the herb. I did, with no positive result. At the same time started to learn about the disease with the help of internet. In particular, I found the very helpful resource https://ucpps.men. It was kind of nice to know that I was not alone with this thing and that there were different possible diagnosis and, maybe, solutions. But time went by and I was feeling worse and worse. I had several of the symptoms associated to chronic prostatitis which unfortunately you are familiar with. The one that bothered me the most was that I couldn't sit longer than 5 minutes without feeling an excruciating pain in the pelvic area. Of course, my quality of life went down dramatically. Above all, my work required reading, writing and being in front of a computer, and it is hard to do all this if you cannot sit. Moreover, I could not drive at all, and could hardly sit to have lunch or read or watch tv, etc. In my case, the worst aspect of this disease was how it was changing my everyday life. And I couldn't help spending most of the day and part of the night worrying about it. In those days I met one person who had almost recovered following the "broccoli treatment". I spent four months eating broccoli and drinking broccoli juice but things didn't improve. It is a miracle I still like it!
I was determined to find out the origin of the illness and had hopes of recovering some day. Since the pattern "sitting <-> pain" was so obvious, I concluded that the problem had to be mechanical rather than chemical, so I concentrated on diagnosis of a "physical" character. I began visiting a traumatologist, who said that pressure on spinal nerves from a disk herniation could indeed bring about the symptoms I reported. I had some MRI done but no anomaly showed up. Later, surfing the internet, I discovered a very convincing site on pudendal nerve entrapment. (For objective information on it, please see the corresponding section in this site; by the way, I agree with the webmaster's note.) This theory explained very well the symptoms I had and I took this possibility very seriously for a long time. The origin of it could have been a bad fall while skating in September 2002. I had had a lot of pain at first, but then it had subsided quickly and I had forgotten it. I even thought of surgery, which was suggested by some experts in this syndrome. To check out this possibility I visited a couple of neurologists, who said that an accurate diagnosis was almost impossible (and very painful in any case), that there were other nerves which might be involved, and that surgery in that area is very dangerous and typically results in extremely serious problems. So, I was very disappointed because I believed I had discovered the evil but had no reasonable remedy. At least, I thought, I would be better off if I managed to minimize the pressure on the trapped nerves. So I ordered and tried a couple of special cushions designed to lower pressure in the perineum. They worked for a while, but then I started having a lot of pain in the zones in contact with the cushion. After a month, they were useless.
The other theory which caught my attention was that of muscular tension. It also seemed plausible, and furthermore the therapy of Dr. Wise and Dr. Anderson at Stanford was apparently pretty successful. I got my copy of the 1st edition of "A headache in the pelvis" and learned all I could about trigger points (I recommend the book by Claire Davis "The trigger point therapy workbook). In the summer of 2003 I was treated by a physical therapist every day for a couple of months (external massage only). This didn't improve things but had a very interesting effect: during this period the pain moved around, from the perineum to the abdomen, to the upper leg, to the coccyx, and back to the perineum. I also did the stretching exercises recommended in the book at home, which usually increased the pain or changed its location. But the fact that the massage and the stretching had an effect was in agreement with the hypothesis of muscular tension. Sometimes I even noticed changes when stretching muscles which apparently had nothing to do with the pelvis. Those days I managed to speak to Dr. Wise on the phone and exchanged several emails with him. He was extremely kind and supportive. My main concern was that I couldn't find anyone doing the right deep tissue massage in my country. He explained to me that I could try with relaxation alone, without the trigger-point physical treatment, even though this was like fighting with one hand tied against a powerful opponent. He also told me that his own symptoms had been very much like mine and discouraged me from having pudendal nerve surgery.
So, I was quite reassured and ready to fight with only one hand. I tried to learn paradoxical relaxation from his book. I also learned and practised other relaxation techniques. It helped only during the moments I was relaxing (lying on my back). Otherwise things were as bad as usual, but this experience helped me sense how my state of mind could have an impact on my condition and I had the feeling that I was starting to have some control over my body.
It was also that summer that, while browsing Amazon.com, I came across a book titled "Healing Back Pain: The Mind-Body Connection" by Dr. John E. Sarno. At first I thought it was just one more book trying to make money out of desperate people who believe that all problems in the world come from stress. But fortunately I noticed that it had lots of positive reviews. I was curious and read all the reviews, which were very enthusiastic. Many people even claimed to have cured themselves simply by reading the book! And apparently the same method could work for other chronic illnesses. I started to have some hope that it could work for me as well. After all, I was also desperate... Of course, the reviews in Amazon are not always impartial, but I found in the web several reasonable people who claimed to have healed using Sarno's approach. One had a Ph.D in robotics at MIT, another was a computer scientist and then there was a Harvard group of sufferers of RSI ("repetitive stress injury, which affects wrists, hands and arms, check http://www.rsi.deas.harvard.edu/mb_what_is.html). Since the standard theory explaining RSI is carpal tunnel syndrome, there was a direct connection to chronic prostatitis and the hypothesis of pudendal nerve entrapment. So, I ordered "Healing Back Pain" and also "The Mindbody Prescription: Healing the Body, Healing the Pain", which discusses a number of different pathologies having the same psychological origin. At this point I make a parenthesis to explain my understanding of Sarno's theory.
According to Dr. Sarno, many chronic painful conditions- including most neck and back pain, RSI, tendonitises, etc- are not produced by some structural problem, but rather have an emotional origin. This doesn't mean at all that the pain or the symptoms are imaginary: they as real as a bacterial infections, but the root of the problem is psychological and, at such, can be treated successfully using psychological methods only. Basically, the pain is produced by the subconscious mind (or autonomic nervous system, if you prefer) by a local restriction of blood supply. This immediately affects the muscles or nerves with lack of blood flow, giving rise to a large class of symptoms and, often, to a very acute pain. The reason for your subconscious playing this ugly trick on you is not, in my opinion, rigorously established. According to Sarno, its purpose is to distract your attention from some emotional hidden problems such as repressed rage or anxiety. This sounds a bit like old psychoanalysis, and there may be a better or more accurate explanation, but you have to admit that chronic prostatitis is a very efficient distraction. In fact, the theory of distraction explains very well several features of this syndrome. The second key idea is that of conditioning (very much like the salivation of Pavlov's dog). Let me explain it with one example: One day you sit and feel pain down there for whatever reason. Then, the subconscious mind associates sitting with pain. The next time you sit down it sends the pain again, so the association is reinforced. If your doctor tells you that your prostate is not OK, you accept this as an explanation, and the association is made much stronger. As you can understand, it is difficult to escape from this vicious circle. Note that this mechanism can work at the subconscious level even without the aid of your well-intentioned doctor, but it is more efficient when the beliefs of the concious mind support it.
Dr. Sarno has baptized this condition "tension myositis syndrome" (TMS). One of its main distinctive features is that the pain moves in time and space. I mean, it is intermittent and it can change location. Moreover, it is quite common that the same person has a sequence of different manifestations of TMS, for instance, she can suffer from back pain one year, then recover and soon after get tendonitis in the knee. As long as the patient believes that there is an structural cause for his problems, TMS will work fine as a distraction.
The great thing about this new diagnosis is that the treatment is extremely simple. It turns out that if your concious mind changes its beliefs, the subconscious reacts accordingly. So, the moment you accept and believe deep in your heart that there is nothing wrong with your back or your prostate or whatever, and that the pain has a psychological origin, you'll be almost cured (even if you don't identify the repressed emotions). The reason is that the pain has ceased to deceive you and it does not work as a good distraction. In practice, the main obstacle is that it is quite difficult to be completely convinced that your nasty physical problems originate in your brain. You also have to get rid of the conditioning. In my example, you would achieve this by sitting longer and longer without being afraid. There are many psychological techniques that can help you (more on that later).
You will get a better description of the TMS diagnosis and therapy in the references I'll give you at the end. Now let me carry on with my personal story. I started reading "The mindbody prescription" and was put off a bit by its Freudian content. I also thought that probably this diagnosis didn't apply to my problems. Nevertheless I found it interesting and read it with attention. At that moment I was concentrated on the relaxation program, so I decided to give Sarno an opportunity later, if I had nothing else to try.
The turning point arrived in October 2003, while I was attending a conference in Hamburg. I was having an awful time attending the seminars, because either I spent all the time suffering and changing position in the chair or I had to stand at the back of the room. I was feeling worse than ever. At one point, I thought that maybe my muscles would be less tense if I just tried to stay in the same position for a while. So, I decided to be still for 5-6 minutes in the next talk. Fortunately the talk was very interesting and I concentrated on it. After half an hour I suddenly realised that I had been sitting there for such a long time and yet felt no ache at all! Correct strategy, I thought, and turned my attention to the speaker again. When the seminar finished I was still feeling well. Wow, this was like a click inside my brain! I had been sitting for one hour without any pain! I could hardly believe it. It was clear that being distracted from my discomfort while sitting and the correct attitude had produced the miracle. And let me stress this: I was sure that if the pain had been there nothing in the world would have made me forget it, so it was not that I wasn't concious of it. For some reason the pain had faded away. In the remaining time of the conference I felt pretty well. I had some pain sometimes, but I was feeling at least 90% better than before.
In my trip home I thought hard about the implications of this amazing experience. It fitted well both with the theory of muscular tension being produced by stress (my muscles relaxed when I was distracted and not anxious about the fact of being seated) and with Sarno's theory of TMS. The latter emphasized even more the psychological connection and I realised that it explained accurately the progression of my CPP. In fact, it explained everything!! First, in the 2 years before developing pelvic pain I had had *sequentially* a number of strange problems with no apparent cause: intermittent acute pain in the index finger, two isolated episodes of acute back pain (I even fell down the second time), tendonitis in my right knee, a problem of lazy stomach (with difficult digestions and pain similar to the pelvic one but in the abdomen and only after eating) which lasted six months and tendonitis in my right Achilles tendon, plus numerous headaches and two weeks with torticollis. My wife even joked that I was under the curse of a former girlfriend, and when I recovered from the torticolis she said that she was scared of what would come next. It was chronic prostatitis. Now I understood that they could well be different manifestations of TMS. This diagnosis also explained why the pain had moved down to the perineum after the urologist brought my attention to the prostate, and that it had moved to my abdomen and to the coccyx after my physiotherapist mentioned tension in those two regions. Another example: I had found lately that I felt better in those simple plastic chairs that are used in summer terraces of pubs and cafeterias, and was even thinking of getting one for my office and one for home. I wondered what was so special about their shape which made me more comfortable. Now I knew: the special thing was not the chair but the atmosphere and the fact that in these places I was always relaxed and distracted by lively conversation with my friends. Also the claims of some people having recovered from chronic pelvic pain using crazy methods (broccoli being not the most absurd) made sense: these methods had been effective placebos for people who believed they could help them. Finally, my personality matched the one which was said to be most prone to developing TMS: a perfectionist guy who likes to control everything (that's why I hate flying) and tries to be good to everybody.
When I arrived home I read carefully both Sarno's books and every single piece of information I could find in the web. Everything fitted. As for many other people cured by Dr. Sarno, just understanding and believing that my pelvic pain had a psychological root produced the miracle and I felt 95% better. Some interesting effects occurred: As the pain in the pelvis subsided, I began to experience pain in my index finger, or in my right Achilles tendon. Of course, I had uncovered the trick of the subconscious and it was trying to send TMS to places where my concious mind could expect to have some problem. I recognized the mechanism, which was anticipated in Sarno's books, and the ache disappeared. The next day, the left Achilles tendon began to ache. I smiled at this bad move, and the pain vanished.
But I had not completely got rid of the conditioning which still associated some mild discomfort with sitting. I wanted to be 100% cured so I had to go further. Dr. Sarno suggests psychotherapy to uncover the repressed emotions but I was not completely convinced of the psychoanalytical methods, so I tried something else. I followed the suggestions in Fred Amir's book, listed below, and used simple affirmation and visualization techniques. In Christmas 2003 I was 99% cured, and in February 2004 I could say that I had completely recovered. One year and a half later I can drive for 8 hours without any problem. Not only have I recovered my health and my life, but I have learnt a lot about myself and have a nice feeling of power and control. Recognizing the root of the problem has prevented new or old manifestations of TMS from bothering me so far. In fact, once I experienced the old stomach ache after doing too many sit-ups, but I disregarded it and had a nice dinner with a pint of beer. The pain disappeared in one hour. I also had a couple of threats of tendonitis which were easily dismissed.
By the way, I think that the psychological problem that my mind had been trying to hide all the time was mostly anxiety related to my work. I try to take life more easily now and to enjoy it and not get too worried about the future.
Let me tell you about another direct experience I've had with TMS. My wife had had for four years a recurrent pain in the wrist with no clear cause. One event showed that she was suffering from TMS: she had had no pain for half a year when one evening she found in the bottom of a drawer the wrist bandage she had used before. That very night the pain came back. I told her that it was probably TMS. She had been close to me all this time and had suffered my nasty disease with me, so she was ready to accept that it was indeed TMS. But still she couldn't easily get rid of it. She said that her mind was not strong enough. Her problem was most likely that she was not convinced enough. Anyway, the pain disappeared as usual after one or two weeks. Half a year later, she had to fly alone with our baby to meet me in Switzerland. It was the first time she flew with the baby and there was a quick transit in Madrid, so she was quite worried and stressed. Two days before the trip her wrist ached again and she found it hard to package. The pain was very bad during the first flight and got even worse in Madrid airport. Then, after the second airplane had taken off, it became weaker and weaker, and when we met in Geneva she was perfectly well. She told me that now she had seen clearly that it was TMS, and she has been OK ever since (9 months now).
I find it very plausible that TMS is the cause of most CPP, including non-bacterial prostatitis (which is a very misleading name for a condition which in most cases has nothing to do with the prostate). Let me quote an extract form the definition of CP/CPPS in this website: "The condition is notorious for waxing and waning. The pain can recede for hours and even days, then return inexplicably with force. In addition, people experience remissions which can last months to years, then have another flare-up." This behaviour is so typical of TMS! It is the same that you find in other manifestations like back pain or RSI. Furthermore, the fact that no other theory can really explain CPP so well, and that there is no proof of any structural or chemical abnormality, should make you wonder. TMS is very close in spirit to the diagnosis of "a headache in the pelvis". In my humble opinion it has some advantages:Of course, both theories can be combined into one. Maybe the restriction of blood triggered by the subconscious mind gives rise to trigger points which in turn cause muscular tension and so on... I wrote to Dr. Wise telling him about my recovery and, once more, he was very kind. In his answer, he said that he had followed the research of Dr. Sarno and found it very interesting, but that his clinical experience had showed him that for some people the massage they practice was necessary for recovery. In milder cases like mine, he said, the right mental attitude can be sufficient. I'm not convinced that massage is really a must in some cases (it is not for back pain or RSI, why should it be for pelvic pain?), but of course I don't claim to have the experience and knowledge of Dr. Wise. At any rate, I think that you lose nothing if you try Sarno's approach first, before getting into the trigger point therapy.
- there's no need for painful trigger point release and you can cure yourself without direct external help, just thinking psychological.
- it explains better some patterns of pain, like the fact that it hurts when you are not under apparent stress, the fact that it moves around and waxes and wanes, or the sensitivity to your beliefs.
- it unifies many painful conditions in different parts of the body as having the same ultimate origin.
Let me stress one more thing about TMS. To heal, it does not matter if the precise mechanism involves blood shortage or trigger points or whatever, and it does not matter if the reason why your subconscious mind sends the pain can be explained with psychoanalysis or with some physiological theory of the brain. In practice the one important thing is to realise that you have no structural problem, that the pain has a psychological origin and that you can consciously control it and make it disappear.
If you have followed me to this point it means that you are, at least, open to the possibility that TMS is the cause of your pelvic pain. What can you do now? I suggest the following:
If you want to try this approach, you have to do it seriously! Otherwise it won't work. You have to believe that it is going to help you, think psychological, stop all medication and forget about all other chemical and physical explanations. And sure enough, if your prostatitis is indeed TMS, it is only psychological methods that can help you.
- Read carefully all the information in the following website: http://www.conquerrsi.com. It is about RSI but the translation to chronic prostatitis is obvious. I really like the description of the problem given there.
- Read Rachel's website http://podolsky.everybody.org/rsi Again, it is about RSI but everything can be applied to pelvic pain.
- Read all the reviews in Amazon to Sarno's books (including the very few negative ones)
- Read carefully "Healing back pain" keeping in mind the translation "back" -> "pelvis" and thinking about your own experience. I think this book is better written and more convincing that the other one.
- Read "The Mindbody prescription". This has the virtue of generalising back pain to other chronic pains. (CPP is only mentioned in passing.) On the other hand, it develops further his mind-body psychonalytical theory. I understand it as a model which explains facts very well, and has to be further studied.
- Read "Rapid Recovery from Back and Neck Pain", by Fred Amir, and follow its recommendations.
- Follow the suggestions in the two websites I mentioned.
I think that the discoveries of Dr. Sarno and other researchers in mind-body medicine are a great breakthrough in the history of medicine, and sooner or later they will be standard textbook subjects. They may also lead to a change of attitude in the medical practice, making it more human. Of course, these cheap and simple mind-body methods have to fight against the powerful pharmaceutical companies and against established "serious" specialists who may see them as an invasion of their territory, but in the era of the internet the truth cannot be hidden too long. Personally, I simply thank Dr. Sarno for having made my life worth living again. I am also indebted to Dr. Wise and to the internet, which has allowed me to carry out my research and to contact these people from old Europe.
So, this was really long! I do hope it will be helpful as well. If you want to ask me anything or make any comment, you can send me an email to [email protected]. I thank the administrator of the forum for posting this report and I ask him to include TMS both in the section of causes and in the one of treatments. Best wishes to everybody,
Manuel
He actually has courses for patients I found out, so it's not too far off. But then again, he also means that the knowledge he gives is the remedy in most cases, so from that perspective I guess it's understandable.