The Perfect Blend of East and West

The MindBody Syndrome TMS - Description and Equivalences - by Marc Sopher, MD  - Modified by Marion Bachra, MS, RD, LN a Nutritionist in Bozeman, MT, latest modification was on 11/04/2021

Much of the chronic and recurrent pain and discomfort we all experience is either psychologically induced, psychologically aggravated, or if a physical incident did occur, psychologically perpetuated. This is the premise of Dr. John Sarno, who has helped thousands of people in his own practice and reached thousands more with his books. TMS, or tension myositis syndrome, is the term he has coined to describe this pain that often appears in the back, neck, knees, or legs but can affect any part of the body or organ system. Having realized in recent years that nerves, tendons and other body systems could be targeted by the brain in the disorder that he has described, Dr. Sarno and Dr. Sopher have decided that another term would be a more accurate designation for the entire process. After much thought and discussion, they agreed that the term The Mindbody Syndrome would be a better choice and would be used henceforth in place of tension myositis syndrome. This has the virtue of retaining the acronym, TMS, which has become familiar to many who have read Dr. Sarno's work.

Some common conditions that can involve TMS include headaches, irritable bowel syndrome, dyspepsia, gastroesophageal reflux disorder (GERD), carpal tunnel syndrome (CTS), plantar fasciitis, tendonitis of shoulder, elbows, temporomandibular joint syndrome (TMJ), knees pain and fibromyalgia. Using today's popular lingo, TMS is a Mindbody disorder because the symptoms arise from the mind and are experienced by the body. The body has certain physical vulnerabilities or imperfections and the mind will use these vulnerabilities to its advantage.  Hence, The Mindbody Syndrome is an appropriate title.

TMS is a strategy of the brain to keep unpleasant thoughts and emotions from rising from the unconscious into the conscious mind. The brain, through established physiologic pathways, creates pain as a distraction. By focusing our attention on physical symptoms, we keep these painful thoughts and emotions repressed although not always perfectly, but the pain is used as a form of coping mechanism, no matter how excruciating this pain can be, it is still preferred by the brain than these painful emotions and feeling in the unadulterated form. TMS than serves as a very effective strategy even though at first we might think that is an absurd concept.

Dr. Soper and Dr. Sarno state that eliminating the pain is startlingly simple. We can banish the pain and thwart the brain’s strategy by simply understanding and accepting that the pain has a psychological origin that it is not physically based but that the brain merely uses our physical imperfection to its advantage.

(NOTE: For this to work, you must read one of the books listed later!)

While much of the pain we experience has a psychological basis, it is essential first to be evaluated by your physician to determine that there is not a significant disease process. Unfortunately, if your physician does not consider TMS in the process of generating a differential diagnosis of your symptoms, it is possible that he or she will give an incorrect diagnosis. This occurs all too frequently as a physical cause is mistakenly offered. This results in a treatment plan that is often unsuccessful. As an example, many people with back pain are told that their symptoms are due to a herniated disc or disc degeneration, when in fact these findings are often incidental and normal. This helps to explain why physical therapy, medications and surgery are often unsuccessful.

Dr. Sarno and Sopher have been treating patients from all over the US and Canada using Dr. Sarno's approach since early in 1999. A patient of Sopher's asked him to read Healing Back Pain and offer his opinion on its value. Unbeknownst to the patient, Sopher had low back pain for nearly two years and intermittent sciatica for more than fifteen years. This all vanished after reading the book. Intrigued, he contacted Dr. Sarno who graciously invited him to The Rusk Institute of Rehabilitation Medicine at New York University to train with him. After seeing patients with him and attending his lectures, Sopher decided to offer TMS treatment. With Sarno's support and encouragement, Sopher has attempted to follow his approach faithfully. Like him, Sopher screens all potential patients by phone or email. If their symptoms appear consistent with TMS and their mind is open to this way of viewing their health, an appointment for a forty-five minute consultation is offered. Following that, Sopher follows up with all patients with additional office visits (if necessary) or by phone or email. Results have been excellent. Dr. Sarno and Sopher have remained in regular contact, reviewing cases and theory.

Life is Stressful  Even if we are happy and feel good about our families, jobs and finances, we all experience stress. Stress, anger, conflict arise from three main sources. There are everyday issues such as: our home and work responsibilities, worrying about our children, worrying about our parents, the inconsiderate drivers, the long line at the market, etc. Some of us have experienced much emotional distress in childhood. Even if we have made peace with it, it is still there, a potential source of unpleasant feelings. Our personalities also predispose us to these emotions. If we have high expectations for ourselves, if we are ambitious and place great demands on ourselves, if we are very conscientious about our performance, then these perfectionist traits are causes of stress. If we go out of our way to help and care for others, even to the point of self-sacrifice, then these "goodist" traits also create stress as we make our needs subordinate to those around us.

These personality traits are not undesirable—they make us successful, kind and considerate. But it is essential to understand how these very qualities can contribute to the accumulation of stress, anger and conflict. The way our brains work, we repress unpleasant thoughts and emotions. They find a home in the unconscious. This is a very good defense mechanism—it allows us to move on and take care of our responsibilities and be nice people that others like and respect. Unfortunately, we can only hold so much of these unpleasant thoughts and emotions in the unconscious. Accumulated anger, stress and conflict become RAGE. This RAGE wants to rise to consciousness, but we usually do not let this happen. If it were to happen, we might rant and rave and do things which would not be acceptable--things that would make others not think well of us. To distract us from these unpleasant thoughts and emotions, our brain creates pain, real physical pain. In our society it is acceptable, even "in vogue", to have certain symptoms, like back pain, knee pain, headaches and reflux. When we focus on our pain, we are distracted from these causes of RAGE. A brilliant strategy on the part of the brain. Why does this occur? No one can know for sure, but we know this happens because by learning about it, we can stop it. We can stop it and thereby eliminate the pain.

Dr. Sarno has pioneered this approach to the evaluation and treatment of a variety of pain syndromes. His treatment program involves education only--no medications, no special exercises, no injections, no surgery and no manipulation or massage. His results and those of the physicians, like  Dr. Sopher, who embrace his theories, are outstanding, far exceeding any other modality.

TMS is the name Dr. Sarno has given to describe the chronic and recurrent syndromes of pain and discomfort. The pain, wherever it occurs, is very real. However, it does not have a physical cause exclusively, but a psychological cause. Getting better involves acceptance of this. It is not necessary to change our personalities to get better and we could not, anyway. Unfortunately, most physicians are not familiar with Dr. Sarno’s work or do not accept his theories. The traditional medical training seeks to explain most symptoms as having only a physical cause. While this may be true in some cases, it does not explain much of the pain and discomfort that we all experience. Most physicians do not consider the possibility of a psychological cause for the pain. As a result, they will prescribe medication, special exercises, physical therapy, injections or even surgery to address what they believe is a physical problem. When this is not successful, people seek alternative remedies, such as chiropractic, craniosacral therapy, prolotherapy, etc. in an effort to relieve their discomfort with varying levels of results.

What does work is Dr. Sarno’s approach--the acquisition of knowledge. Put aside the notion that there is only a physical problem, accept that there is a psychological cause and understand how and why the brain does this. I recommend that all people read and re-read my book and/or Dr. Sarno’s books to fully integrate this information. Some will benefit from seeing Dr. Sopher or a TMS-based  counselor for a consultation or counseling. You can thwart the brain’s strategy and get rid of your pain. When you do, you will truly feel empowered!

A Key Quotation from the book Healing back pain: the Mind-body Connection: "One of the more difficult concepts to grasp is the fact that one does not have to eliminate tension from one's life. People ask: How do I change my personality and how do I stop generating anxiety and anger?  If these were the prerequisites for recovery, my cure rate would be zero. It is not changing one's emotions; it is recognizing that they exist and that the brain is trying to keep one from being aware of their existence through the mechanism of the pain syndrome, this can include numbness, weakness as well as pain which Dr. Sarno states can also be used by the unconscious to generate and/or perpetuate TMS symptoms. Dr. Sarno states that is the key point in understanding why knowledge is the effective cure."

RESOURCES: by Marc D. Sopher MD by David Schechter, MD by Howard Schubiner, MD by John Sarno, MD

Healing Back Pain: The Mind-Body Connection by John E. Sarno MD  (Paperback - Feb 1, 1991)

The Mindbody Prescription: Healing the Body, Healing the Pain by John E. Sarno M.D. (Paperback - Oct 1, 1999)

To Be or Not To Be... Pain-Free: The Mindbody Syndrome by Marc D. Sopher MD (Paperback - Feb 1, 2003)

The Divided Mind: The Epidemic of Mindbody Disorders by John E. Sarno MD (Paperback - Mar 27, 2007)

Marion Bachra, MS, RD, Lic. Clin. Nutritionist-Chinese Herbalist- A shift in my paradigm

For me, in 1996, the book: Healing Back Pain; The Mind Body Connection helped me resolve 6 years worth of chronic sciatica and low back pain ranging from almost unbearable to excruciating to intermittent chronic nagging sciatic and low back pain. I thought that I had only a physical problem as proven by me MRI! In 1991, my MRI showed a completely ruptured disc between L4 and L5 and two bulged discs above and below. The only option I was given was to have back surgery, namely a laminectomy, which I declined. I requested a prescription for massage and yoga therapy which helped me a lot during the acute phase, but did not resolve my intermittent chronic sciatica and low back pain. Because of my physical diagnosis, I experienced resistance to even consider reading this book which came highly recommended by Andrew Weil, MD. It was not until there were no other options left, since surgery was unaffordable (I was kicked out of workman's compensation and had no insurance), that I finally purchased the book.

The Mindbody Prescription: Healing the Body, Healing the Pain, published in 1999, describes how other body systems can be affected such as the immune system. This book for me was a stepping stone to reroute my overactive immune system and stop my allergic response to cats.

The Divided Mind; Epidemic of Mind Body Disorders, published in 2005, is an excellent book. I read it much later, after I had fully accepted that TMS played a crucial role in my sciatica, and after I had been pain-free for many years. The book includes six fascinating chapters outlining the experiences of six specialists in Family Practice, surgical/non-surgical Orthopedics, Rheumatology, Psychiatry, and Clinical Medicine research.

Now fast forward to 2016, after 20 years of being completely free of sciatica pain and without any type of physical limitations, my sciatica switched to the left and returned with a vengeance.  I was completely aware of the psychological trigger that I will not go into and I figured that I would shake it off, but I did not. So I went to see a non surgical orthopedist who gave me 3 steroidal epidurals two weeks spaced apart. These epidurals helped me for 7 or so months. Before this procedure I had another MRI and this time my MRI looked pretty bad and showed severe bilateral foraminal stenosis and what that means that I had severe narrowing on either side of the L4-L5 foramen or space between those 2 vertebrae through which the sciatic nerves run.  However, the MRI showed worse stenosis on the right side, the side were I had my original sciatica in 1991.  Yet all of my sciatica was now on my left side. So I thought that I had some wiggle room, no pun intended, which confirmed to me that the triggering event was the psychological event that took advantage of my ever so less than perfect back. But, I got so consumed with the horrible MRI image of my spine and I thought that it was now too late that my back was too far gone and too damaged. 

My non-surgical orthopedist ordered another MRI and it showed that the severe bilateral foraminal stenosis had worsened. I had another round steroidal epidurals but this time it worsened my sciatica. So he send me to a orthopedic surgeon who recommended a 2-level back fusion and he showed me the hardware that he would place in my back with this type of fusion. I told him that I would not want that and so then his second best option was to do a laminectomy. I declined both and I thought to myself: I will become pain-free without surgery.  And, so I did, but it was not easy. I reread Healing Back Pain the Mindbody connection, but to be honest I got mad at Dr. Sarno for many reasons I will not go into.  I still was able to use his Mindbody concepts along with reading the book: You are the Placebo by Dr. Joe Dispenza who had broken his back during a bicycle accident and had 6 severe vertebral compression fractures. Dr Joe was recommended a very invasive surgery called the Harington procedure by several different orthopedic surgeons, but Dr. Joe declined and through meditation and visualizing the rebuilding of his back Dr Joe turned his grim prediction around. I adopted some of Dr Joe's Mindbody rituals, including the Emotion Code, see entry page, and by the Grace of God, I turned the sciatica around without any surgical intervention despite my grim MRIs.  

Contact number: 1(406)586-1833