Dr.Wise on Sarno

Male pelvic pain, prostatitis, IC
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MB
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Dr.Wise on Sarno

Post by MB »

This was posted on the Sarno forum:
http://tmshelp.com/forum/topic.asp?TOPIC_ID=1811
"Thank you for your email and attachment. I appreciate John Sarno's work on back pain. I was going to have breakfast with him the last time I was in New York. That being said I am a psychologist and understand the process of the somatic transfer of anxiety. I wish the person well who described his strategy with pelvic pain in your attachment. In my experience of treating thousands of patients with prostatitis/chronic pelvic pain syndrome, this strategy mentioned in your attachment is not useful however theoretically viable it is. You cannot talk yourself out of trigger points in your quadratus lumborum that are causing severe testicular pain or trigger points in your anterior levator ani which are causing penile pain and post ejaculatory discomfort. In a way it is not helpful to tell people with pelvic pain to just get over it and focus on their psychological problems. Prostatitis/CPPS is a psychosomatic problem involving psyche and soma... both must be addressed. I say this as someone who had pelvic pain for over 20 years, who has been symptom free for many years and who tried everything. I know the problem from the inside as well as someone who deals with many people every day from all over the world who are desperate. This idea of telling people to treat their pelvic pain as TMS as John does with people with back pain in my opintion is not a service to people suffering from pelvic pain because when they fail to do be able to help themselves, they can blame themselves for their condition.... which I don't think is kind or helpful. If you have pelvic pain, try this method yourself and let me know honestly how it works for you."

David Wise, Ph.D.
[email protected]
Age:46 | Onset Age: 43 | Symptoms: Burning | Helped By: Sleep/Ultram | Worsened By: As the day goes by
texas2006
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Let the battle begin

Post by texas2006 »

Just kidding. But I'm sure the battle lines are being drawn. I'm freshly back from the SP clinic, so I'm knee deep in trigger points, stretches, and paradoxical relaxation. But one thing Dr. Wise says in his note is the gospel, as far as I am concerned. If you buy into the existence of trigger points (and some, i.e. most MDs don't), you have to see at least the PT of the SP as being mandatory. Sarno's stuff doesn't address that at all, from what I gather. Now, I suffer from back pain also. I have a protruding disc. I've seen the MRI films myself. I don't know how I can talk myself out of the pain, right now. Howard Stern famously esposed the Sarno stuff as helping his back pain. I am happy for him and the others Sarno has helped. But until Sarno starts really discussing CPPS, and not just his supporters suggesting we read his book and replace the word back with pelvis, let's trust Wise on this topic.

My two cents worth, now back to my stretches and tapes.
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MB
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Post by MB »

I am not sure. I go back and forth on the subject. I have days here and there where the pain completely vanishes. Not a trace. If those trigger points were really the culprit, then why would the pain just go away?
Age:46 | Onset Age: 43 | Symptoms: Burning | Helped By: Sleep/Ultram | Worsened By: As the day goes by
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Post by alprost »

Firstly, thanks to Dr Wise for taking the time to post his comments. I agree 100% with the points he makes.

I also stand by the comments I made on this issue in a previous thread:
viewtopic.php?t=3594
MB wrote:I am not sure. I go back and forth on the subject. I have days here and there where the pain completely vanishes. Not a trace. If those trigger points were really the culprit, then why would the pain just go away?
Because how symptomatic trigger points are at a given point in time depends on many factors, e.g. posture, temperature, exercise and especially stress. If you completely avoid the factor/s which worsen your symptoms, you become less symptomatic, only for symptoms to worsen if the impact of these factors is increased at a later time.

Check out the video clips on this page - http://www.pelvicpainhelp.com/videos.html

Compare the video clip where the patient is put in a stressful situation with the one where she is practising a relaxation technique - the electrical activity in the trigger point (and hence how symptomatic the TP is) is increased in the stressful situation and decreased when she practices a relaxation technique. This is a key part of the answer to your question above.
This is not Medical advice - Consult your Doctor!

Age:39. Age at onset:31. Symptoms prior to treatment: Golf ball in rectum, severe urinary frequency (2-3x/hr; 5-10x/night); weak stream; painful ejaculation; coccygeal pain; tip of penis pain; general pelvic pain on left; testicular pain; supra-pubic pain. Current | Symptoms: Urinary frequency 1x every 2-3 hrs and 1-2 x a night; mild pelvic pain on left hand side (all symptoms still improving!)
Helped by: Trigger point release; avoiding exercise; pelvic floor relaxation; Neurontin decreased bladder sensitivity somewhat. Worsened by: Exercise; frequent ejaculation; ibuprofen irritates bladder. Made no difference: Diet; biofeedback; quercetin; Steroid anti-inflammatories; Elavil.

****UPDATE*** I am now able to sit again at work all day, and can perform moderate aerobic exersise again for the first time in 8 years!!!

Please read:
viewtopic.php?f=37&t=808&p=3954
viewtopic.php?f=7&t=239&p=1158
viewtopic.php?f=37&t=248&p=1214
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MB
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Post by MB »

Alprost,
I think Dr.Wise makes very good points and I agree with him.
That said, I tend to disagree that stress is the major culprit of pelvic floor dysfunction.
I am usually pain free when I experience a different type of stress. A distracting stress I may say.
I went to India for a business trip earlier this year and I was pain free for the entire time until I got back in my car at the airport.
The trip was very stressful but it was a break from my everyday life. So my brain is perfectly able to release that tension down there without the manual intervention of a physical therapist. The problem is how...
Last edited by MB on Wed Jul 12, 2006 7:34 am, edited 1 time in total.
Age:46 | Onset Age: 43 | Symptoms: Burning | Helped By: Sleep/Ultram | Worsened By: As the day goes by
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Post by HelpADude »

MB wrote:I am not sure. I go back and forth on the subject. I have days here and there where the pain completely vanishes. Not a trace. If those trigger points were really the culprit, then why would the pain just go away?
A newbie here.

I am finishing up AHIP and Dr. Sarno's "Mind Body Prescription" and I also feel that I'm at a cossroad on which way to go. Dr.Sarno said he used to prescribe PT in his early days but stopped doing it because it reminds the patient that a physical cause might be at work.

I just returned from a weekend trip to the Southwest, my first "vacation" since this thing started and I felt fine the whole time dispite all the Mexican foods and I slept great! Kinda makes me say "HUH!" I did do some PT on myself during the vacation but stopped doing Brocolli Treatment during these times. I don't think I will continue with that... after this.

I'm seriously thinking of talking with a Psychoanalyst instead of going with a PT...
Age: 38 Onset: April 2006 Current | Symptoms: Update, doctor found no hemorroid but pruritus ani. Was doing very good for a while but lately are having more flares. | Symptoms: raw, irrated feeling, spams in balls and bladder area. Drugs: Omega 3 oil only and just started Prosta-Q in Feb 2008, currently not taking Prosta-Q. Treatment: relaxation, AHIP stretches, the book EVERYDAY ZEN, Worsened by: Coffee (not 100% sure)
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There is merit

Post by texas2006 »

There is merit in seeing both a PT, and a psychologist. Yes, at the same time. My counselor is reading parts of AHIP, and after having been to the Stanford clinic, I see her as a local "coach," when I cannot seek Dr. Wise for guidance.
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Re: There is merit

Post by Sleeper Service »

texas2006 wrote:There is merit in seeing both a PT, and a psychologist. Yes, at the same time. My counselor is reading parts of AHIP, and after having been to the Stanford clinic, I see her as a local "coach," when I cannot seek Dr. Wise for guidance.
An extremely sensible approach, Ryan. I think we need to realise that this condition has to be attacked on all fronts and, let's be honest, we know that:

1) If muscles are chronically shortened/tightened then there are physical causes.
2) Stress can make things worse both psychologically and physiologically.

I would strongly advise everyone to explore all avenues and not just focus on one.

Mark A.
Age 56: Onset 2006 and bouts on and off since then. See posts for details.
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Post by LightningTree »

I basically agree with Wise, and so does my psychologist.

You have to treat Soma and Psyche.
It is VERY VERY true that stress makes this problem much worse. I have tons of personal eveidence of that.

But I find the stretching and TP release to be just as important.

I'm now back to sitting at a desk, I'm only midly achey after a few hours of sitting (I adjust positions constantly and get up to walk around eveyr hour or so.) I stretch 3 times a day.

I was going to post on here about how some new stretches are getting to problems with my iliopsoas and levitar ani, and have allowed me to sit, but it has only been 2 weeks of success and I want to wait a few more weeks.

The point is, in my experience with this problem, PSYCHE and SOMA.
Address both every day.

And I've said it before and I will say it again: Ritual healing through things such as stretching, which provides positive feedback to the mind, is just as good for the psyche as it is for the soma. So even if you take Sarno's approach, don't think of stretching as a conscious reinforcement of the subconscious's tricks. Think of it as positive affirmation of your commitment to total health. I would think that could be middle ground we could meet at.

This is not medical advice, and I am NOT a doctor of medicine or a related field.
* Age:33 Onset: February 2004.
* 99.9% IMPROVEMENT in 2.5 Years with the first year being the really hard part
* Current Symptoms: Mild irritation of perineal muscles on occasion. Relieved for days at a time by a specific stretch (see below).
* Initial Symptoms: Terrible penile, urethral, rectal, and perineal burning/aching with addition afferent sensations.
* Current Treatments: Deep stretching of the legs and pelvis. Most effective: Deep psoas and levitar ani stretch using the first phase of the "pigeon pose" from Yoga. When a deep pulling is felt in the middle of the pelvis next to the upper rectum, symptoms are completely alleviated for several days.
* Past Treatments Hyperprotection of the perineum for 1.7 years, Walking, Rectal biofeedback, Stanford/Wise-Anderson Protocol, Conditioned deep relaxation practice, Men's Multi-Vitamin and an Extra B-complex pill, all seemed to help.
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Post by HelpADude »

I agree with everything LightningTree just said.

I also had a long conversation with a friend who had dealt with IC/CPPS for the last five years. We come to the conclusion that some people with milder symptoms (like me) may able to recover with just Dr. Sarno's method. However, for him, who would be disabled if he just drink a cup of coffee, that's just not possible. Therefore, I recommend he try the protocal on this website (Quercetin, SP)

And if you read some of the other discussions on TMShelp.com, it seesm for chronic prostatitis / chronic pelvic pain syndrome folks it's very tough to do with just Dr. Sarno approach even though they accept the TMS concept.

As for me, I decided to go 100% Sarno for now and see what happens.

(and if you are wondering, yes, one of my best friend got IC/CPPS as well, he's a classic type-A person. I can't help wondering what the chance of that is :sad: )
Age: 38 Onset: April 2006 Current | Symptoms: Update, doctor found no hemorroid but pruritus ani. Was doing very good for a while but lately are having more flares. | Symptoms: raw, irrated feeling, spams in balls and bladder area. Drugs: Omega 3 oil only and just started Prosta-Q in Feb 2008, currently not taking Prosta-Q. Treatment: relaxation, AHIP stretches, the book EVERYDAY ZEN, Worsened by: Coffee (not 100% sure)
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Post by Astrotitan »

HelpAdude wrote:
and if you are wondering, yes, one of my best friend got IC/CPPS as well, he's a classic type-A person. I can't help wondering what the chance of that is
I think the chances are higher than expected. My brother-in-law has problems, has had for 15 years and has learnt to live with it. I think there are a lot of men who just don't talk about it and keep it to themselves. Two of my co-workers have/have had problems and get them from time to time. I guess it depends on the severity of the symptoms before one speaks up.
Age 43: Onset June 2005, Initially: perineal pain, discomfort in penis, very sensitive, sometimes burning. Red around the urethra on penis. Increased urination during night, problems with stream, sometimes constant urge to urinate. Exercise and moving around and laying down helps. Sitting down and squatting makes it worse. Improved to about 85-95%. Symptoms usually mild pain near belly button and slight urge to urinate.
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Post by LightningTree »

My twin and I are both internalizing personalities with the same body morphology and the same type of computer programming (sit a lot) job. I think those three things combined will really set this off.

This is not medical advice, and I am NOT a doctor of medicine or a related field.
* Age:33 Onset: February 2004.
* 99.9% IMPROVEMENT in 2.5 Years with the first year being the really hard part
* Current Symptoms: Mild irritation of perineal muscles on occasion. Relieved for days at a time by a specific stretch (see below).
* Initial Symptoms: Terrible penile, urethral, rectal, and perineal burning/aching with addition afferent sensations.
* Current Treatments: Deep stretching of the legs and pelvis. Most effective: Deep psoas and levitar ani stretch using the first phase of the "pigeon pose" from Yoga. When a deep pulling is felt in the middle of the pelvis next to the upper rectum, symptoms are completely alleviated for several days.
* Past Treatments Hyperprotection of the perineum for 1.7 years, Walking, Rectal biofeedback, Stanford/Wise-Anderson Protocol, Conditioned deep relaxation practice, Men's Multi-Vitamin and an Extra B-complex pill, all seemed to help.