My aching mind
Back pain guru John Sarno touted the mind-body connection as the root of chronic aches
A physiotherapist once told me I’d be a “train wreck” by 40.
I was a 19-year-old with chronic back pain and no one knew what to do. I stopped running, stopped lifting weights and could hardly sit in a chair for more than 30 minutes. My preferred position was horizontal, a heating pad hugging my lumbar.
Nothing showed up on X-rays, bone scans, MRIs. I tried chiropractic adjustments, deep tissue massage, hot yoga, acupuncture, shiatsu and some more eccentric treatments including one where a woman gently prodded “pressure points” on my body and insisted I’d feel better in a week.
I did not feel better. Not until I read a book called Healing Back Pain by a New York University doctor named John E. Sarno.
Sarno, considered a hero by thousands of patients and readers he never met, died June 22 from cardiac failure, a day before his 94th birthday.
He claimed for decades that most chronic pain is psychosomatic, a mindbody process called tension myoneural syndrome (TMS) caused by repressed emotions. He wrote three controversial bestselling books — Healing Back Pain, The Mindbody Prescription and The Divided Mind — and won the powerful endorsement of celebrities including Seinfeld co- creator Larry David and radio personality Howard Stern, who aired a tribute to the doctor last month.
“He was an amazing man,” Stern said, according to his website. He suffered from debilitating back pain that had him on the floor for years until he read Sarno’s books. “I got a note from his wife . . . I wrote her back. I said, ‘I can’t tell you how sad I am that my hero is gone.’ ”
Sarno remained a pariah in the medical community despite thousands of success stories and a growing lack of evidence for conventional diagnoses and treatments that North Americans spend billions of dollars on annually. But recognition for his work has grown in recent years. In 2012, Sarno testified in Washington before a U.S. Senate committee called “Pain in America: Exploring Challenges to Relief.” He has been characterized as “the rock star of the back world” in the new bestselling book Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery by investigative journalist Cathryn Jakobson Ramin.
“The legacy that (Sarno) leaves is an understanding of the relationship between the mind and the body,” says Jakobson Ramin, who doesn’t buy into Sarno’s theory that most chronic pain is caused by emotional phenomena. “He continued to insist that the mind and the body were one, they couldn’t be separated and that the mind was perfectly capable of generating physical symptoms. I think that that is accurate. But it’s not the whole story.”
I didn’t buy it at first, either. I thought he was a Freudian quack when I read about him in a desperate Google search for back pain treatments. He claimed to have helped thousands relieve pain without surgery, drugs or physical intervention. His only prescription was knowl- edge: read his books, journal about your emotions, ignore the pain and resume physical activity.
Unconscious emotions like repressed rage are the true cause of chronic pain, he said, once serious illness like cancer and infection are ruled out by a physician. You can “think away” the pain because it is a trick of the mind, a distraction from emotions that the brain has deemed too intense to experience. But that doesn’t mean the pain isn’t real, or that it’s all in your head.
“The pain is always real,” he told the Senate committee in 2012. “In medicine in general, there’s a tendency to look at things from the anatomical and physiologic point of view and perhaps not recognize the impact of emotions on the physiology.”
But what about those scary abnormalities doctors point out on X-rays and MRIs? Normal, he said. Indeed, scientific evidence backed up some of his claims over the years. A 1994 study published in the New England Journal of Medicine showed that 64 of 98 men and women had lumbar disc bulges and protrusions, but no back pain. Research continued to dispel years of diagnoses, including a 2014 Mayo Clinic literature review of more than 3,000 people published in the American Journal of Neuroradiology that found “degenerative disc disease” is common in all ages and can be asymptomatic.
For years, those frightening abnormalities led most physicians to prescribe rest and a “stop if it hurts” philosophy. Those approaches are now out of style, experts say.
“Sitting and doing nothing is not the proper way to deal with back pain,” says University of Toronto professor Angela Mailis, founder of the Pain & Wellness Centre in Vaughan and author of Beyond Pain: Making the Mind-Body Connection.
But Sarno’s journaling might not be the proper way for many either. Mailis says every chronic pain sufferer falls somewhere on a spect r um: Sarno’s psychological factors at one end and biomedical reasoning at the other.
“When it comes to chronic pain, you can’t have a one-size-fits-all,” she says. That’s why an integrated painmanagement program is employed at her Pain & Wellness Centre in Vaughan, where dietitians, chiropractors and massage therapists work with psychologists and mindfulness experts to provide interdisciplinary treatment.
While Sarno never led formal studies of his theory, much to the derision of his colleagues, University of Southern California research by one of his protégés, David Schechter, showed that patients with chronic pain symptoms who were treated with a mind-body technique experienced pain reduction of 52 per cent on average.
Sarno didn’t care much for labs and numbers and long maintained that the proof was in reader and patient testimony. Michael Galinsky began working on documentary All the Rage, opening in Toronto at the Hot Docs Cinema July 28, in 2004 when he first met Sarno, but set it aside for other projects. Then, he says, his back pain came back “with a vengeance.” He was on the floor, in excruciating pain. So he turned the camera on himself.
He reconnected with Sarno, underwent mind-body treatment and realized that his struggles with family, home ownership, and difficulty promoting a previous film were becoming too much to bear, causing him emotional and physical pain. Making the film “enormously” helped him recover.
“It really forced me to confront these things and really deal with it,” he tells the Star.
But it doesn’t work for everyone, including Crooked author Jakobson Ramin. She found relief through physical therapies like those advised by University of Waterloo professor of spine biomechanics Stuart McGill. His regimen of strengthening exercises helped her overcome much of her back pain and get back to an active life. She even climbed Machu Picchu with a friend.
As Jakobson Ramin puts it, “For some people, Sarno is not enough.”
For me and thousands of others, Sarno provided a way back to an active life. Until I read Healing Back Pain, I was afraid to move. I sat stiffly in chairs or on stability balls until I couldn’t stand it anymore. I always bent my knees and feared any wrong twist could put me out.
Sarno took that fear away. I remember the moment I decided I could slouch back in my chair if I wanted to. I fell back, allowed my muscles to relax and let the chair support me. It was oddly exhilarating to take control of my body again.
I got back to running, lifting weights and was living normally within weeks.
I still get back and neck pain sometimes, but I don’t stop exercising, endure drawn-out medical treatment and look in horror at unsettling MRIs. When my back pain came back recently, I treated it as no coincidence that it was timed perfectly with the end of an employment contract and a rent increase from my landlord. I began journaling and kept lifting weights. In a matter of weeks the pain dissipated.
When I learned of Sarno’s death in June, I shouldn’t have been surprised that I felt it deeply even though I never met him. He’s the man who from afar managed to steer me away from being that “train wreck” I was told my body — and so many others’ bodies — might have become.