A Fable

Imagine for a moment that you move to a place where you don’t know the customs, or speak the language. It feels like you are living in a dream most of the time, and things don’t make sense in ways that you can’t put into words. While you can quietly observe what’s going on, when you try to speak or communicate, it causes problems. As such you largely stick to observing rather than interacting, and you notice a great deal. Soon you come to understand the customs so well that you begin to forget the customs and ideas that you came with.

After a while you notice that people are getting sick from something that seems like dysentery. You observe that their religious ceremonies involve drinking from a still pond in the center of town. Knowing what you know about biology you can infer that they people are likely getting sick from drinking this water. They perform many rituals to get rid of the illness, but nothing seems to make much difference. Some people recover but many die.

You try to let people know that the pond might be part of the problem, which draws unwanted attention. In fact, you are so passionate at first that you scare people. Since you can’t speak the language no one can really understand what you are saying. People stop listening to you all together.

Still, you are able to drag a few people away to a nearby spring where they drink the fresh water and their condition improves. They try to drag a few others to the spring because it worked for them. This runs counter to their culture, and the people whom you have helped, who have deviated from custom, are looked upon negatively. A few people are able to see the results of your help. They listen and others start to see that they are healthier and less prone to the sickness, and they try it too.

However, they are very quiet about their knowledge because they can see how deeply the rest of their community is invested in their rituals. They stay healthy themselves, but they are careful about who they tell.

At a certain point enough people can see that the standing water might be the problem, and almost en masse they break with tradition and move their ceremony to the clear running spring. Unfortunately, by the time they begin to listen, you are forgotten.

Dr. Sarno’s experience with mind body medicine is a bit like this scenario. When he began to study medicine, people incorporated the work of Sigmund Freud into their practice. They understood that the mind affected the body, and vice versa. However, by the time he was firmly ensconced in his practice, medicine was on its way to becoming almost entirely mechanistic.

A few years after founding the first group practice in New York State, he moved to the Rusk Institute of rehabilitative medicine at NYU medical center. At the time they were doing a great deal of work with injured soldiers, and patients who had suffered strokes. He worked in orthopedic medicine and following standard care protocol of the time in regards to back pain, he often prescribed physical therapy to strengthen the muscles, which were presumed to be the cause of the pain. Over time though, as more and more people came to him with x-ray’s and later MRI’s that didn’t match up with the pain they were having, he began to question this mechanistic model of medicine that he had been trained in.

He looked at his patient’s charts and he saw that the majority of them, 88%, had a history of ailments that were known to have a psychosomatic connection; excema, colitis, ulcers, migranies, etc. When he began talking with the patients about their lives he found that many of them were perfectionists, who tried to do as much as they could for others, often to such a degree that their own needs were not met. For the most part, they weren’t even conscious of this pattern. They just wanted to be good people, and Dr. Sarno dubbed them “goodists”. Remarkably, when he was able to get some of these patients to recognize the connection between the suppression of their needs, as well as their emotions, they got better.

His practice began to grow rapidly through word of mouth, and as he worked with patients he refined his treatment methods. At the same time he became increasingly ostracized by the other doctors he worked with.

He struggled to figure out the physiology of the mind body interaction that was causing the pain. He eventually postulated that the subconscious, was coordinating with the autonomic nervous system to lessen the flow of blood to crucial nerves and muscles, causing the pain in order to make sure the difficult memories would not surface to the conscious mind. He theorized that the decreased blood flow to key nerves was causing them to spasm.

While he had increasing levels of success treating his patients, his colleagues were less enthusiastic about his work. They pointed out that he had not done any scientific trials to prove his claims. In the early 80’s he published his first book and he began to get great feedback about the efficacy of his work in healing people simply by reading the book. His book “Healing Back Pain” became a major best seller, and yet there was almost no promotion or media about it.

While his books were distributed in a dozen countries, he quietly worked at his practice, and became increasingly ostracized by his peers. In 2012, when he was 91, he was forced to retire when his building at NYU medical center was torn down to build a more hi-tech facility. Not only did he not get a gold watch or a party; he didn’t even get a thank you note for his 50 plus years of service. We hope the movie will change that.

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