17 Mar Bigger Than Life

For the last two weeks, Suki has been going through our older footage of Dr. Sarno. We only have about 8 hours of tape from our early shoots, but the majority of it is strong, and the passage of time makes it more powerful. Yesterday she showed me a clip from 2004 of Dr. Sarno saying in French, “The more things change, the more they stay the same.” He is referring to how, in the late 19th century, mental illness was thought about in terms of diseases of the brain. While current doctors may be more sophisticated about how they talk about mental illness, referring to a chemical aberration instead of a disease of the brain, it’s the same idea.

Freud challenged these ideas, placing a strong emphasis on the role of the unconscious, and the idea of psychosomatic illness came to hold a powerful sway on medicine through the 1940’s and into the 1950’s. In fact, as we do more research, we are finding that many studies about the relationship between mind and body were being done in the 1950’s. These then tapered off as the standardization and mechanization of medicine swung solidly into vogue, severely diminishing the acknowledgement of the complex relationship between mind and body.

This evening, Suki and I received an unexpected lesson in the cultural mindset of the 1950’s. We sat down to watch Nicholas Ray’s 1956 film “Bigger Than Life”. Having no idea what the film was about, we were amazed to see that it focused on the beginning of the 20th Century Pain Epidemic. The main character, Ed Avery, played by a brilliant James Mason, is a classic Sarno goodist. He’s a teacher that works a second job as a cab dispatcher. Hiding this job from his wife because he believes she’ll think it’s beneath him, he tries to carry more than his fair share of the weight in the relationship both physically and emotionally. He puts himself under extreme pressure to be perfect and good, and struggles to protect his wife from any unpleasantness, to the point that he begins to lose his sense of himself and his own desires. Most of the pressure he is under centers on cultural expectations of what it meant to be middle class in the new post war suburbs of the 1950’s, hence the need to secretly supplement his teacher’s salary.

Early on, after having just lied to his wife about staying late at school, he rushes to his second job where one of the cabbies begs Avery not to send him near the racetrack. He explains that if he ends up near it, he won’t be able to keep himself from gambling. Avery laughingly agrees and then inexplicably doubles over in pain. Later that evening while hosting a bridge party at his house, Avery sneaks off to the kitchen to drink milk because of apparent stomach pain. It seems that he has an ulcer. Back at the bridge table one woman complains that she’s having to make a hard choice; between a vacuum cleaner and going to the doctor. Her child has asthma, which the doctor thinks is psychosomatic. She wants to get the vacuum because she believes dust makes his asthma worse. It was shocking to hear of a doctor viewing asthma as being psychosomatic. However, in the mid 1950’s, one can imagine doctors coming of age when the thinking of Freud and Jung were still in vogue, who would view the unconscious as a powerful force in matters of medicine. This was only a minor aside in the film, but details like these were small clues as to what was going on in the culture at large. It is interesting to note the skepticism of the patient’s mother, who doesn’t want to hear that gobbledy gook, just wants a machine that will make things better for her son, pre-figuring an important role the modern patient plays in matters of medicine.

Back in Avery’s home after the party has ended, he and his wife reflect on their dull suburban lives. Their home is filled with maps and posters of European monuments, creating a sense of an unfulfilled wish for worldliness. His wife fears he’s cheating on her because of all the late afternoons at work, so the tension is thick, but Avery doesn’t understand the sublimated anger coming from his wife. He feels it though, and is struck by the most severe attack of pain yet. He collapses and passes out. The doctor is called and he recovers enough to go to the hospital.

Once there, he’s subjected to a brutal battery of tests. The doctors share little or no information with him, pushing, prodding, and taking biopsies at will. They never talk to him about what’s going on in life. They simply measure things, treating him as an object to be studies. Eventually, after days of testing, they tell him the bad news. He has a new and rare pain disease of the arteries. They’ve only seen a few cases, they tell him, but all have been fatal within the year. However, there’s a new drug that might just help. “A miracle drug?” queries James Mason in his best James Mason voice. “Kind of, “ he’s told. The drug is cortisone.

Dr. Gabor Mate, and others, point out that when people repress their emotions over the long term, they are often unconsciously in a constant state of fight or flight response. This process burns through the body’s natural stress hormones (including cortisone). Dr. David Clarke who wrote the book “They Can’t find Anything Wrong” likens this to a body builder who can successfully lift 250 pounds. However, when it comes to 255 pounds, he collapses under the weight. When people surpass their capacity for managing unconscious stress, their body begins to break down. For some people this might manifest as a bad back, for others a gut problem like an ulcer, and others might get an auto-immune disease.

This idea is a possible explanation for the relationship between stress and asthma. People with asthma often have an attack when under duress. At this moment, when they need their body’s stress hormones to kick in, they have nothing left. Dr. Mate sees a connection between this process and auto-immune diseases. When the body’s systems get out of balance, they begin to attack themselves.

It’s doubtful that Ray set out to make a film about pain and repressed emotions. Instead, he was making a film about the crushing emotional weight of suburban expectations. However, clearly the two are connected. In post war America, millions of men coming home from the horrors of war wanted to put it all behind them. This process of denying emotions, coupled with a cultural need to live up to new stereotypes, facilitated medicine’s march toward reductionist, data-driven beliefs. While there were small rebellions against Western Medicine in the 60’s and 70’s, the path of the technology, testing, and pills continued to take on an ever more powerful hold. The body was seen as a machine and the emotions were regarded as irrelevant. The orthodoxy of scientific testing, which primarily works in situations where complexity is limited or denied, gained an absolute prominence.

According to Sarno’s understanding of pain syndromes, the pain is a distraction device designed by the subconscious to keep repressed emotions from escaping. Through the admonitions and unspoken communications of socialization, the small child is taught that left to his own devices, dreadful emotions might emerge from his being. They must be pushed down in a deep place and closed with a tight lid. If we actively focus on a physical problem which takes most of our attention, these emotions will be kept properly sealed off.

When Mason’s character starts taking the steroids, his pain disappears, and he has a new lease on life. He’s focused, strong, and rested after a week in the hospital. Despite clear instructions to take only one pill every 6 hours, Avery begins to take more and more. Without the pain to distract him, and the cortisone increasingly coursing through his blood, his id takes control. He ceases to be the wondrous do-gooder, and instead becomes an increasingly self-focused tyrant. Demanding and petulant, like a child, while at the same time dismissive of others for being childlike, he becomes a psychotic Nietziean Superman.

The psychosis escalates to the point where Avery lands again in the hospital, restrained and sedated. The doctors are not sure if, when he wakes, he will be the old Ed Avery his family knew, or lost to the psychosis. Eventually he wakes up and begins to remember what happened. “That’s the way it should be,” the doctor crows, “It’s important to remember.”

While those sentiments from the medical community waned over the next six decades, Bigger Than Life reveals in 1956 an example of cultural attitudes that bend more toward acceptance of a mind body connection. As Avery remembers what happened, he regains his sense of his self. He pulls his family close and the film ends. It’s unclear whether or not he will survive without the drugs, or if he will be able to take them without going insane. From the perspective of Sarno, Mate, and others, perhaps if he comes to accept his feelings, rather them repress them, it seems likely that he will thrive without the cortisone, which seemed to only mask the symptoms rather than cure the cause.