Pathways to Pain Relief, available in print and in Kindle format,
is an extension of the pioneering work of John E. Sarno, M.D., Professor of Rehabilitation Medicine,
New York University School of Medicine. Dr. Sarno wrote the Foreword to this text.
The authors, Dr. Frances Sommer Anderson & Dr. Eric Sherman, present clinical case material to
illustrate how musculoskeletal pain and other psychophysiological disorders can originate from
psychological experiences as a means to protect an individual from unbearable emotional distress.
Tension Myoneural Syndrome (TMS)
The cornerstone of Dr. Sarno’s theoretical and clinical
approach to treating psychophysiological pain disorders is
that physical pain can develop as a distraction from
emotional distress, even without permanent alterations in
the structure or functioning of the affected part of the
body. Dr. Sarno has identified Tension Myoneural Syndrome
(TMS) as a psychophysiological pain disorder in which
emotional experiences, which may be partially or completely
out of a person’s awareness, produce ischemia or reduced
blood flow to the postural muscles, resulting in mild oxygen
deprivation and pain.
Dr. Sarno describes TMS, which he initially referred to
as Tension Myositis Syndrome, as a physical disorder
characterized by pain and/or other neural symptoms affecting
a variety of musculoskeletal locations. He emphasizes that
the pain is real; it is not imaginary or “in the patient’s
head” as sometimes misconstrued by physicians and
analytically-oriented clinicians. Because TMS is a physical
disorder, the subjective experience of pain is
indistinguishable from pain originating from organic
conditions such as injuries, tumors, and infections, even
though the physical mechanism responsible for the syndrome
is psychologically induced.
TMS is a physical disorder that can only be diagnosed by a physician.
Once the diagnosis of TMS has been established, Dr. Anderson and Dr.
Sherman use an analytically-oriented treatment approach.
Dr. Sarno conceptualizes the pain symptomatology as a
self-protective reaction or a psychological defense against
recognizing and experiencing intolerable emotions, not the
result of structural damage or disease. For example, when a
herniated disc is diagnosed as the cause of the patient’s
pain and disability, a psychophysiological disorder can be
misdiagnosed and physical treatments not only fail but may
also serve to intensify the symptomatology. Appropriate
treatment is delayed or denied, and iatrogenic or
medically-induced debility develops. Often the patient
becomes increasingly preoccupied with the pain
symptomatology. Now every bodily sensation echoes and
confirms the doctor’s dire assessment, reinforcing the
patient’s own sense of being permanently damaged.
Because of our work with Dr. Sarno, our treatment of
patients, in contrast to mainstream thinking about the
diagnosis and treatment of musculoskeletal pain and
psychophysiological disorders, is guided by the idea that
pain symptomatology develops in response to intolerable
emotional experiences, not the other way around. Pain
functions as a compelling distraction, deflecting an
individual’s attention away from unbearably frightening or
disruptive internal experiences.
Obviously, the profound way our thinking about pain
symptomatology differs from the mainstream influences the
development and application of techniques for treating
patients with psychophysiological disorders, including
musculoskeletal pain. Many clinicians will pay lip service
to the notion that psychological factors influence an
individual’s experience of pain, both favorably and
unfavorably. What distinguishes Pathways to Pain Relief is
that it embraces the position that musculoskeletal pain and
other psychophysiological disorders can originate from
psychological experiences as a means to protect an
individual from unbearable emotional distress.
Psychotherapeutic techniques based on the medicalization of
musculoskeletal pain foreclose the possibility of
approaching these conditions as a psychophysiological
disorder. The medicalization paradigm prevents many
clinicians from recognizing that the same emotional
conflicts which lead to psychological symptoms can initiate
the development of physical symptoms as well.
Pathways to Pain Relief
We invite everyone who is interested in psychophysiological pain
disorders to read our recently published book, "Pathways to Pain Relief",
which provides details on how treatment has worked from the patient's and the
therapist's point-of-view. The book is now available on
Amazon as an ebook and in print.
We also encourage you to read
Dr. Sarno's and
Dr. Anderson's previously published
works on psychophysiological disorders and mindbody medicine.