Cutting Taxes

Cutting Taxes

The few times I’ve posted anything vaguely political on the All The Rage Facebook page, it has sparked outrage from Dr. Sarno fans who support Donald Trump. This includes simply posting articles about Trump’s response to the opioid crisis with no comment whatsoever. While Dr. Sarno did not write about political issues in his books, when he appeared before the Senate Panel that Senator Harkin convened in 2012 to discuss the IOM report on “Pain In America,” the interaction with Senator Bernie Sanders made it clear that Dr. Sarno saw a direct connection between the stresses of poverty and the pain crisis. Bernie Sanders asked,

“The Institute of Medicine Report found that a person with lower educational level – and presumably also lower income people – are more prone to suffer pain. I guess if you’re poor and you’re uneducated you’re more likely to become ill, you’re more likely to experience pain. Could someone speak to that?”

After one other expert had spoken, Dr. Sarno replied,

I would like to suggest a more Freudian, if you will, or psychodynamic explanation. And that is that poor people are angry. They’re furious, as a matter of fact, at what society has allowed to happen. And that fury will evoke physical symptomatology, believe it or not, as a defense against the rage. They can’t enrage, and so what happens is they get sick, and I believe this is an extremely common phenomenon.

Sanders replied, “You mean rather than burning down the Capital they are turning that anger against themselves.” To which Dr Sarno retorted, “Exactly”


While the tax bill that just passed both houses of Congress might put a small amount of money in people’s pockets this year, Speaker Paul Ryan has made it clear that the next thing on his agenda is to cut the budget in direct response to the lowered tax revenue. These cuts will have a profound effect on the people who struggle with poverty. As citizens, we can disagree about the amount of taxes we should pay as well as about the role government should play in our lives. However, when one looks at data about the rising level of inequality as well as the data about the pain crisis, it is difficult to deny that there is a connection between the two. This is not to say that poverty is the only causal factor in regard to pain, but instead, that is part of a complex set of factors. In “All The Rage,” there is a short section well before the aforementioned Senate scene that makes this connection quite clear. When one looks at a chart detailing the rise in the cost of dealing with pain in America and then lays it on top of a chart dealing with the rate of the increase in the wealth gap, the charts move at almost exactly the same rate. In other words, when the rise in the wealth gap that many economists connect to Ronald Regan’s tax plan began to take off, so did the rise in the cost of dealing with chronic pain. This wealth gap, which already is at historically high levels, will be exacerbated by a tax cut plan that gives the majority of the benefits to the wealthy and to corporations.

Dr. Sarno’s prescription is knowledge. He teaches patients that by understanding that our unconscious response to the “stresses and strains of life” can cause pain, we can respond to the problem. In some sense, his teaching involves a “Republican”-oriented focus on personal agency in regards to how we might shift our conscious response to these stresses. However, there is also a lot of data to support the idea that the stresses and strains of poverty, of not being able to take care of one’s family, can be overwhelming to such a degree that we quite literally cannot think rationally. Further, these stresses carry over to children which put them at a greater disadvantage when it comes to learning. An NIH funded study found that,

The stresses of poverty — such as crowded conditions, financial worry, and lack of adequate child care — lead to impaired learning ability in children from impoverished backgrounds, according to a theory by a researcher funded by the National Institutes of Health. The theory is based on several years of studies matching stress hormone levels to behavioral and school readiness test results in young children from impoverished backgrounds.

Further, the theory holds, finding ways to reduce stress in the home and school environment could improve children’s well being and allow them to be more successful academically.

High levels of stress hormones influence the developing circuitry of children’s brains, inhibiting such higher cognitive functions such as planning, impulse and emotional control, and attention. Known collectively as executive functions, these mental abilities are important for academic success.

In his work, Dr. Sarno focused on how individuals often respond to their home environment and the expectation of their parents and peers, by unconsciously repressing socially “unacceptable” emotions. A complex bio-psycho-social response to these factors can lead to all kinds of pain syndromes. At the same time, conscious stresses can also have a powerful effect on our body. Frankly, Dr. Sarno’s patients tended to be more affluent, but he understood the connection between stress, fear, unconscious rage, and how these factors affect the body. A Gallup poll that came out today, Dec 20, 2017, states that 8 in 10 Americans feel stressed out on a daily basis. This level of stress isn’t wildly higher than it was a decade ago, but daily anxiety has increased in the past year. This conscious anxiety is just the tip of the iceberg.

There is no doubt that financial stress and anxiety have played a role in the rise of the opioid crisis. It is a complex problem with multifactorial causes. In some sense, it is a perfect storm. When we look at the role government and pharmaceutical companies have played in the rise of the opioid crisis, it is clear that both are at fault to some degree. This comes on top of the fact that most of the crisis is playing out in places where the industry has left gaping holes in local economies. Some of us want the government to support business so that we can have jobs- so that these economic woes don’t lead to this kind of poverty. Others focus on the role of government in protecting people from the power of corporations. The New Yorker recently published a trenchant piece on how business, government, and medicine helped create the crisis we now have. There’s plenty of blame to go around. Donald Trump’s stated response to the crisis was that people simply shouldn’t start doing drugs in the first place. However, vast numbers of people have become addicted to opioids through a confluence of medical, government, and business influence. Again, there is plenty of blame to go around, but what we need to focus on is how to deal with this problem. “Just say No!” is not the answer.

In order to combat the problem, we need to reduce stress in people’s lives, we need to create jobs that allow people to take care of their families, we need to provide support for families who have addiction problems, and we need to address the way that our emotions affect our health. While some people might argue that cutting taxes on corporations will free up money to create jobs, most economists don’t think this will be the case. However, Congress didn’t ask any economists this question. In fact, as they rushed to pass this massive, economy-changing bill, they didn’t hold a single hearing or secure expert testimony. The entire bill was constructed behind closed doors and most everyone who was asked to vote on it did not have a chance to read it. All of the evidence points to the fact that this tax cut will not help solve the pain crisis in America. In fact, it is very likely to exacerbate it.

  • Theresa Lode
    Posted at 18:30h, 20 December Reply

    Totally, agree! I think the wave of anger that’s coming when loyal Trump supporters realize that he is really only for himself, is going to be a tsunami. Thanks for raising your voice on these things.

  • John Sklar
    Posted at 04:57h, 21 December Reply

    Lots of holes in your thinking my friend! The opioid crisis is due to the rising wealth gap? I don’t buy that for a second. I don’t think tms hits people of lower socioeconomic status more so than people who are wealthier(or the opioid crisis either). The groups have different stresses and both have levels of stress that generate tms symptoms(and addictive behaviors). And I might suggest that wealthier people have more to lose and on that basis possibly even more stress than the less wealthy. Freedom is just another word for nothin left to lose as Janis sang! Also people in lower socioeconomic groups may have better community support amongst each other. So there is more to this discussion than your argument suggests. Just not that simple. What I see here is your disdain for Trump and his agenda being linked to your disdain for the medical profession in an illogical way that serves your antiTrump agenda.

    • Michael Galinsky
      Posted at 05:38h, 21 December Reply

      Thanks for the thoughtful response. You’ll get no argument from me about the idea that everyone, regardless of their social or class position will have stresses and respond to them in different ways. In the piece I linked to an article about how the stresses of poverty lead to increased levels of stress hormones that affect people’s ability to think rationally. The opioid crisis clearly affects people of all classes, however there is also a clear connection between a lack of living wage jobs and drug abuse. A quick search on google will bring up reams of articles including this one I don’t have a disdain for the medical profession, but I am troubled by the ways in which government, business, and health care interact in ways that often cause more harm than good- as with the opioid crisis.

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