Dangerous Names

One of the key elements of Dr. John E. Sarno’s work is an understanding of the basic context of Dr. Sigmund Freud’s work. In an early interview that we did with Dr. Sarno he pointed out that in the 19th century mental illness was seen as a disease of the brain. It was only when Freud came along, and postulated that the repression of emotions was central to many aspects of mental illness, that this view began to shift.

Describing mental illness as a disease process taking place in the brain frames the problem from a physical perspective. However, it should be clear to everyone that the brain is as much metaphysical as it is physical. The memory-based contents of the brain, both on a cellular and linguistic level, create the framework of response to every situation. While social psychology can help us to find clues as to how people might react, it would require impossibly complex sets of data to accurately predict an individual’s physical and emotional response to a given situation.

Freud, and those who where influenced his work, acknowledged this complexity. However by the mid 20th century, his theories began to fall out of favor as an increasingly “mechanistic” model of medicine came into vogue. In this construct, proving cause and effect became the main focus of medicine. As such, complex processes were left unexamined. Science relies on limiting factors in order to assign clear causal relationships. It is much more difficult to design studies that can process complex interactions involving multiple factors. As such, research money, and researchers gravitate towards designing studies that show clear and repeatable results. Emotions are not so easy to study.

As late as the early 50’s, many health problems were generally understood to have a mind body connection. This is to say doctors practiced with the understanding that a person’s emotional state affected their physical state and vice versa. Health issues, like asthma and headaches, were understood to have stress as a causative factor. It was understood that in order to heal, people needed to find ways of managing their stress and their emotions. Increasingly the focus of medicine shifted towards giving the power of healing to the doctors. People didn’t want to figure out how to handle their stress, but instead wanted a pill to get rid of its effects. Over time, the idea that one’s emotional health affected their physical health came to be seen as “blaming the victim”. In fact, one of the greatest difficulties in moving forward with our film has been that many people respond with anger when presented with the idea that the repression of their emotions might play a role in their illness.

As medicine became increasingly specialized, doctors ceased to treat people in a holistic way. Instead people went to one doctor for their eyes and another for their feet. This specialization led to a much greater understanding of the different systems within the body. However, the ways in which these systems interact was not focused on as heavily.

Words work in tandem with specialization. Words are like prisons for ideas. The more specific they are they smaller the cell they provide for thoughts. Once we name these things, describe them, birth them, they begin to die. The reason that it is forbidden to say the name of god in many religions is because to name this presence is to make it “of this world” These are lofty philosophical ideas that don’t seem to have much connection to the “real world”. However, on closer inspection they have powerful implications regarding our relationship to ourselves, and others.

Dr. Nortin Hadler, a rheumatologist, based in North Carolina traces the back pain epidemic back to a word. He believes that the introduction of the word “herniation”, meaning a rip or a tear, in regards to the soft discs of tissue between the cervical bones in our spines, created the basis for “medicalizing” a “normal” condition of life. Once it became a medical problem it became harder to overcome.

While naming an illness often gives a sense of relief to those who have unexplainable symptoms, names can also lead to unintended negative consequences. As Dr. Sarno points out in his lectures, whiplash is one such condition. The idea that one might get whiplash, which refers to a chronic pain condition after an accident, vastly increases one’s chance of getting it. Dr. Hadler points out a similar situation in relation to railway spine after the introduction of the railroad. It was postulated that the human body wasn’t built to withstand the bumping and shaking of the railway. There was an epidemic of pain in Britain. It then fell out of vogue.

One of the most vexing problems that doctors now face is auto-immune diseases like MS, lupus, rheumatoid arthritis, and alzheimers disease. In his book, “When the Body Says No”, Gabor Mate points out that all of these conditions share a common thread. They have no known etiology; we don’t know what causes them. However, he argues that a mounting body of evidence points to the repression of our emotions as a causative factor. He does not argue that they are the only cause, but that without the repression of our emotions, which knocks our autonomic nervous system out of whack, we are exponentially less likely to fall prey to these conditions.

Unfortunately, this knowledge does not provide a pathway to simple mechanistic cures. I’d like to say that we can simply meditate our way out of the problem. However, the issues are so deeply systemic that they require complex solutions. In much the same way that poverty is correlated with low performance in schools, it is also correlated with poor health. This is not because poor people are less intelligent, or because they live less healthy lifestyles, nor in “less healthy” environments, but instead because poverty creates constant and inordinate stress. Clearly, alleviating the social conditions that lead to poverty will help improve student performance more than merit pay for teachers. The kind of stress that coexists with poverty makes it hard to learn, and it makes it hard to be healthy.

Acknowledgement of this problem is not a panacea, but without acknowledging it we have almost no chance of fixing the situation. This is not to say that it is only impoverished people who suffer the ill effects of stress. In fact, almost everyone suffers due to stress to some degree. There is a lot that we can do to limit these problems. While acknowledgement of the things that stress us out isn’t a magic bullet, it certainly puts us on the right path. Dr. Sarno’s very successful treatment method involves acknowledging our repressed emotions as the causative factor in many pain syndromes.

In 2011 the National Institute of Health declared chronic pain a disease in and of itself. Faced with exponentially rising costs, and no explanation for the explosion in chronic pain, they felt that naming the condition was akin to declaring war on it. However, the unintended consequence is that many people now identify themselves as “people with chronic pain”. As Dr. Hadler points out, once people identify themselves as having a condition, it is much harder for them to get over that condition. In fact, many people who accept Dr. Sarno’s diagnosis of TMS (Tension Myosits Syndrome) become so involved with their identification as someone with TMS that they have a hard time moving past it.

As someone who has spent a good deal of my adult life struggling with these issues, I am the first to say that it is not easy to fully move past them. Dr. Sarno himself has such insight into these ideas because he too often struggled with stress related illness (as did Dr. Freud). However, the process of understanding the problem from both a physical and emotional perspective has been invaluable to me. I have learned a great deal about myself from listening to my body. I just wish I understood a little bit more of what it was trying to tell me.

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