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The Mindbody Prescription: Healing the Body, Healing the Pain

John E. Sarno M.D. · 14 HN comments
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Amazon Summary
The New York Times bestselling guide to a healthy and pain-free life. Musculoskeletal pain disorders have reached epidemic proportions in the United States, with most doctors failing to recognize their underlying cause. In this acclaimed volume, Dr. Sarno reveals how many painful conditions-including most neck and back pain, migraine, repetitive stress injuries, whiplash, and tendonitises-are rooted in repressed emotions, and shows how they can be successfully treated without drugs, physical measures, or surgery. "My life was filled with excruciating back and shoulder pain until I applied Dr. Sarno's principles, and in a matter of weeks my back pain disappeared. I never suffered a single symptom again...I owe Dr. Sarno my life." - Howard Stern
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I share with you a bit about what I have learned. I've struggled a lot. Everything is like broken. I'm still struggling right now. However, I'm still working on something to make our situation better. I do several research and experiments on Happiness, psychology, neuroscience and here are something I'm want to share.

+ Hedonic adaption: Hedonic adaption is special psychological effects that explains about how we perceive about happiness. Even after a big happy moment, our level of happiness do down quickly. We adapt our perception to our current situations. So it's like nothing will last forever. Hedonic adaption is both good and bad. It makes us adapt quickly with any situations. It keeps us safe. So we should appreciate it and learn how to make use of this effect rather than blaming it. Learns to attend with everything you do even it's bad, explore something news. It will help you deal with bad effects of hedonic adaptation.

+ Mindfulness: Do some mindfulness exercise. We feel stress because our mind think we're having problems. Our mind made up our feelings to keep us safe [7]. It's good for us. Mindfulness help us understand more about feeling and more enjoy the moment.

+ Mind body connection: Your health affects your mental, and your mental will affect your health. To me, it's not because some spiritual belief, but it's how systems work [3] [4]. Our body, our mind are systems. They are part of bigger system. They connect each others and interact with each other, sending some feedback. So try to improve both your health and your mental. Try to improve your health diet, do exercises and taking care of our thoughts and feelings.

+ We aren't rational. Our thinking system is optimal but it has limitations [3]. It has a lot of problems (cognitive biases). Learn to appreciate and find a way to make it better. For example, we can adapt. We update our belief overtime. Try to make new better habits[5]. Make small steps.

+ There isn't perfect things. Every systems aren't perfect. Our immune system, our cognitive system, organizations, data structures, design patterns,... Appreciate what works, what not and improve it.

Some interesting books, articles you might interest:

[1] https://www.plantinghappiness.co.uk/hedonic-adaptation/

[2] https://www.amazon.com/Thinking-Fast-Slow-Daniel-Kahneman/dp...

[3] https://www.amazon.com/Thinking-Systems-Donella-H-Meadows/dp...

[4] https://www.amazon.com/Mindbody-Prescription-Healing-Body-Pa...

[5] https://jamesclear.com/atomic-habits

[6] https://www.coursera.org/learn/the-science-of-well-being

[7] https://www.amazon.com/Wisdom-Insecurity-Message-Age-Anxiety...

Yeah, I was in a similar place at one point. Check out the book in this thread: https://news.ycombinator.com/item?id=6099623. The book is: https://www.amazon.com/Mindbody-Prescription-Healing-Body-Pa...

I don't know if it was the book, a placebo effect, or something else, but I got better after reading that.

Feb 24, 2020 · mfrye0 on On Voice Coding
I went through a similar situation and ended up using https://voicecode.io for a few years. It worked well enough for me, but I always found it hard using it in a public setting.

Ironically, I solved my RSI issue after coming across a book on HN. Everyone seemed to recommend the Mind Body Prescription, and after trying it, it did the trick.

https://www.amazon.com/Mindbody-Prescription-Healing-Body-Pa...

Edit: I've been wanting to try this project for several years now: https://www.ctrl-labs.com. I think something like this is the solution moving forward vs voice coding.

I left a recent comment on HN about this[0], and at the risk of sounding like a shill I'll share it again as it helped at least one person :) My experience tracks with yours, and it really does seem like modern medicine is missing something important.

The book The Mind-Body Prescription[1] by Dr. Sarno covers this exact topic, and made a huge impact on my life and the life of a friend of mine. It's a worthwhile read for scientifically-minded skeptics who are feeling frustrated that doctors seem stumped by their chronic pain/illness. I had a worsening pain that jeopardized my ability to work a desk job, and that book resolved it in a matter of weeks.

[0] https://news.ycombinator.com/item?id=17899992

[1] https://www.amazon.com/Mindbody-Prescription-Healing-Body-Pa...

bornon5
I've seen this book recommended from time to time. I have a condition that falls within the book's purported domain, but when I read the synopsis, it raised all kinds of red flags. As a skeptic, what about this book let it through your filters? I really want to be open to it.
evmar
The pattern of "I am a skeptic, eventually I was desperate enough to read the book despite that, and it genuinely helped me" has happened to more than one person I know. The standard testimonials is of the form "I thought it was magic crystal BS but it's actually pretty sensible". I find it a bit amusing that each person thinks they're somehow even more of a skeptic in the face of of the previous people who themselves tried to disclaim their skepticism.

But ultimately you have very little to lose beyond a bit of time to just give it a shot. It very well may not help, too.

md224
I'm not the person you're replying to, but I'm curious about the other side of this: what were the red flags you found, and why do you consider them red flags?

I find that open-mindedness can be as simple as questioning and rethinking one's heuristics for detecting bullshit. These heuristics are useful for keeping us sane, but we should recognize them for what they are: epistemic shortcuts that allow us to dismiss something as false without really investigating it. What we gain in efficiency we lose in accuracy, and sometimes we end up missing out on something potentially useful.

bornon5
I agree with you on this. Ultimately I think there's an element of pride ("I don't get taken in by scams!") that I would do well to shed. But looking at the vague list of attributes:

  - celebrity doctor  
  - passionate followers  
  - findings not accepted by mainstream medicine
  - touts a worldview I want to be true
I have trouble seeing what's qualitatively different from your average daytime TV doctor selling supplements. The big distinction is almost certainly that people who seem smart recommend it, which as I mentioned to the poster above, may now be enough.
ceras
What let it through my filter was:

(1) I'd already spent time and money on traditional treatments with neutral or even negative results. So $11 and a few hours reading wasn't that hard to stomach

(2) I heard it recommended by others who were similarly skeptical, which put it on my radar. Otherwise I may have just given up.

(3) I felt confident I could read the whole book with a truly open mind. I told myself before starting that I'd suspend any disbelief for the duration of reading the book and implementing its practices, and only critically re-engage after that period ended. I.e. I felt I could read it as a practitioner and not a theoretician.

To elaborate on #3, this may sound very uncomfortable, but the book's value is not in accuracy but in efficacy. It's an open question to me if the author's explanation as to why the system works is 100% "true" in a physical sense, but he explains it very well to an audience that is unsure. Regardless, whether it's "true" is ultimately an academic concern compared to the book clicking with a (possibly less rational :)) subconscious part of your mind in a way that resolves your very real chronic pain/illness.

bornon5
Thanks for this. I've struggled with the effective-vs-true question, even to the point of panicking that I had read too much about the placebo effect for it to work on me. I like your #3 - I'll give it a real shot.
I bought my then-girlfriend/now-wife a copy of Sarno's Mindbody Prescription a few years ago on the recommendation of someone on HN to help her with chronic back pain. It did her a world of good. Didn't fix everything, but definitely helped out quite a bit.

https://www.amazon.com/Mindbody-Prescription-Healing-Body-Pa...

Not one mention of The Mindbody Prescription (if only to dismiss it)? If you're suffering from back pain, or carpal tunnel syndrome, or such ailments, read this book, it might change your life! (and if it doesn't it can't harm)

https://www.amazon.com/dp/0446675156/

HillaryBriss
IIRC one of Sarno's central ideas is that, sometimes, when a person is undergoing an intensely painful psychological experience, the brain creates some physical pain in order to distract the person from that, original, intense psychological pain.

i.e. the chronic physical pain is manufactured by the brain as a means to cope with (avoid awareness of) another type of pain.

so, if the person (somehow) becomes consciously aware of that original psychological pain, the brain stops creating the physical pain. the physical pain no longer serves a purpose at that point.

bambax
Yes. The other insight is that the physical pain is located somewhere likely, somewhere where things already aren't optimal and where you're ready to accept there's a problem. I found that part really fascinating.
justanotheratom
I had excruciating upper back pain as well as wrist pain. I had tried an insane number of things. Read the book. Cured.
chrismealy
I read about three chapters of this and it cured my wrist pain. Never would have believed it possible if it hadn't happened to me.
eric_b
Yep, exactly the same for me as well. I finally tried his "treatment" after everything else I tried failed, and was shocked to find it worked.
KGIII
I am skeptical. What about those three chapters resolved your physiological ailment?
tomohawk
Think about pain as a feedback loop between your brain and the pain site. The feedback loop itself is a thing, and can cause additional pain if not interrupted. It can cause your muscles to tense up, etc. If left untreated too long, it can continue on despite the initial cause no longer being a factor.
chrismealy
It sounds impossible but it actually happened - just acknowledging the stress I was under made the pain go away (it's not like you have to solve anything). I think it only took about four days. The crazy thing is it was actually visible. The throbbing swollen veins in my forearms receded. I was receptive to the idea because the pain was the worst the summer my dad was dying in a hospice and I wasn't working at all.

The bummer is there's no way to know if it's stress or not, but it doesn't hurt to give it a try.

KGIII
I don't have any specific reason to try it personally but I do know that the mind is a very powerful thing.

In hindsight, I don't think I presented my question as accurately as I could. I wasn't skeptical of you, and your story, so much as I am skeptical of the results being broad, repeatable, and not due to something unknown. In other words, I am still a bit skeptical of this being viable for most folks,or even many folks.

You mention that you were receptive to the idea, and that makes some more sense. If I understand correctly, you did this by identifying and reducing your stress?

I don't want to ask medical questions, as I have no right to the answers nor do I wish to pressure you into disclosing things you may wish to keep private. The brain is a very powerful thing (though I remind myself of which specific organ it is that tells me that) and it is great that you found a solution.

I guess, I'm curious if there was more to it than being receptive at a specific time and having access to the book. I'm reminded of similar claims about religion and religious texts? That's not meant as a slight, it's just that I wonder if the mechanism is the same, if it's using the same parts of the brain, and things of that nature.

Alas, I am entirely unqualified to speculate, it's just curiosity on my part. It also makes me curious about myself. I'm in remarkably good health, more so if one considers my age and history. I sometimes attribute that to living a life that is virtually free of stress.

So, I wonder if there is more to it. I know low-stress is linked to certain health benefits, though I'm not sure of the rapidity or physiological mechanisms. I believe I read a study that correlated the placebo effect with a reduction in stress. I'm unable to find it, at the moment.

Either way, thank you for your answer and sorry for the novella reply. If you're curious, my low-stress life is due, in part, to being mindful. It works for me.

Again, thank you. I have some free time later today, I am going to do some reading to satisfy my curiosity. I am a doctor, but not that kind of doctor. It's just intellectual curiosity, though it may answer some of my questions for myself.

Do you have any online resources that you might recommend? I'm going to hit up Google Scholar.

phlillip
This; when my Father was diagnosed with cancer I was under a lot of stress but acting like everything was fine. Pretty soon I got alopecia, in my beard not my head. The body communicates with you in very different ways and it can be overlooked. Finding the root cause of pain in your life is the key. Not always, but often.
kxs
Did it resolve your Alopecia?
Oh man, do I feel you on that. Doctors are fairly worthless in my opinion for these issues. I say this having dealt with various RSI/nerve pain issues for over 6 years, and tens of thousands of dollars in out of pocket medical bills. They'll pretty much always be like "just take an Aleve", or "I don't know, do some physical therapy or wait and see if it gets better. Next patient please!". Your health and getting better will be on your shoulders.

With that in mind, I'd like to preface all of the following by saying: I am not a doctor. This information is for educational purposes only, and is not meant to be a substitute for professional medical advice.

----------------------------------------------------------------------------------

Here is a long, varied guide on everything I've learned and things that have helped. Most of my knowledge has come from trial and error, and reading books and medical papers.

I have had tingling, burning pain throughout my arms and hands for many years. I also had several bouts of nerve pain in my legs. RSI and nerve pain stuff seem to go hand in hand. A lot of this advice ties into reducing nerve pain as well. I've had three surgeries total to move my ulnar nerves out of their ulnar tunnel so they would stop snapping over the bone and causing me pain. This wasn't the only cause of my issues though.

A lot of pain in your arms actually originates in your neck/shoulder area. There is an issue called Thoracic Outlet Syndrome that is suspected to be the cause of most of this kind of arm/hand pain. Chances are, you have bad posture.

Things that helped:

- Using a macbook pro for all computer use. Using a mouse or raised keyboard is awful for your hands. The trackpad placement with the keyboard, and the fact you can set the trackpad to register a touch (without pushing down) as a click are very helpful. Make sure you're not bending your wrists to the left or right when typing. It's a hard habit to break, and you're probably doing it now, but ideally you want your hands to be straight in line with your arm. Wrong - https://ehs.okstate.edu/modules/ergo/hand4.gif. Right - https://ehs.okstate.edu/modules/ergo/hand3.gif. Also, don't raise up your hands when typing or using a mouse, it stresses out your forearm muscles.

- No keyboard or mousepad wrist pads, they just constrict the nerve pathways in your wrists.

- You want to make sure your posture is good. When working at a desk, you actually should be sitting back against the seat, with your arms supported by the arm rests. You shouldn't be sitting straight up 90 degrees, but leaning back a little, with your back supported against the chair. This picture kind of shows it - http://cdn.makeuseof.com/wp-content/uploads/2013/06/computer... - though I would say you should be a bit less far back than the 135, maybe like 110.

- General posture stuff: when walking make sure your hips aren't tilted forward or backwards, make sure your shoulders are slouched forward, make sure your head isn't tilted forward (99% chance you do this one and don't even realize). Make sure your shoes' soles aren't worn down - if you see they look uneven buy new shoes.

- TMS (Tension Mytostis Syndrome) - basically is stress and anxiety making your brain subconsciously cause your body pain. Really helpful with me way after my surgeries in getting from 3-4 pain level to 0-1. I read this one - http://www.amazon.com/gp/product/0446675156/ref=pd_lpo_sbs_d....

- The Trigger point therapy workbook - http://www.amazon.com/Trigger-Point-Therapy-Workbook-Self-Tr.... Your muscles get tight and get these things called trigger points. This causes them to tense up and pull on other muscles, starting a bad chain reaction causing pain all over. This will teach you not only how to do trigger point self massage, but how groups of muscles can affect other parts of the body far away from them. You’ll also want to pick up a pair of lacrosse balls, they’re super helpful for self massage.

- OTC pain pills – this I discovered recently – NSAID’s like Aleve work by reducing inflammation, while Tylenol works more on your Central Nervous System by increasing your pain threshold so it takes higher levels of pain before you can feel them. Also way gentler on your stomach than Aleve. Aleve can also cause some damage to your digestive system, making it harder to absorb…

- B12 vitamins – a deficiency of b vitamins, especially 12 can cause neuropathy (nerve pain). This b vitamin combo is really good, has all the best options for each one inside of it - http://www.swansonvitamins.com/swanson-ultra-high-potency-ac...

- Sleep – I find that if I get less than 8 hours of sleep over a period of a few days my nerves start to light up a bit (not sure how else to describe it). Sleep is super important, it’s when your body does most of its repairing and healing.

- Anti anxiety meds – klonopin, xanax, etc - if you can get prescribed these, I’ve found them more helpful than painkillers sometimes, they definitely take the edge off. From what I've read they can be very addictive though, so watch out for that.

- Actual nerve pain medicine – I learned about this reading Wolf of Wall Street. Turned out he had terrible, chronic nerve/back pain that drove him to do all those drugs. He was at the end of his rope, multiple surgeries and still a lot of pain. His doctor ends up prescribing him Lamictal, which at the time was a medicine for seizures, and it’s like a switch was flipped and he wasn’t in pain anymore. There are better options these days for that though, Lyrica is a popular, as is Neurontin. They can have some side effects, but apparently can be very effective (I’ve never tried them myself, was able to get my pain down to a manageable level for the most part, though I do have them in my mind as a back up if it gets really bad again) - http://www.mayoclinic.org/diseases-conditions/peripheral-neu...

If you would like to do more research on top of what I described above:

- If you want to go to a doctor, try a neurologist or a good physical therapist. Most doctors are infuriatingly ignorant and incompetent when it comes to these kinds of issues.

- Read about the nerves in the arm, and thoracic outlet syndrome

Good luck, and try not to lose hope, I know how being in pain every day can wear someone out. Remember that there’s a good chance you won’t be in pain or at least it will be manageable at some point in the future, even if that may be a while out. If you want to ask me any questions, I'd be happy to help.

mahyarm
Wow thank you! I'm not at that level of pain myself, but I've started to notice symptoms that started to worry me, one of them being that numbness you originally described. I want to prevent a disaster before it happens, since my livelihood depends on it.
kdamken
No problem, hope it helps!
Anyone who is interested in mind over matter should check out Dr. Sarno's work - http://www.amazon.com/The-Mindbody-Prescription-Healing-Body...

Similar to the vomiting poster, I had/have a longtime chronic nerve pain issue in my arms and legs that this book was tremendously helpful in managing. While fixing bad posture and a variety of other things helped, this book helped me get to the point where most days I'm in no pain.

fucsia
Did you read any of Dr. Sarno's other two books? I'm wondering how they compare.

http://www.amazon.com/Healing-Back-Pain-Mind-Body-Connection...

http://www.amazon.com/The-Divided-Mind-Epidemic-Disorders/dp...

Besides challenging the mind over matter, this work also challenges the idea of what to believe and pursue when scientific evidence is relatively lacking.

kdamken
I have not - once the pain subsided I decided to take a break from all the medical reading and research for a while. Still, I'd definitely be interested in checking those out when I have a bit more free time.
mgmeyers
I highly recommend Sarno's work as well. I had severe tendinitis in my wrists for about 4 years. I was only able to work about 3 hours a day and was getting pretty desperate, so I decided to give what I thought was Sarno's "crackpot theory" a try. 4 weeks later my tendinitis was completely gone.
drzaiusapelord
This is interesting. What kind of techniques does he advocate?
glibgil
http://www.amazon.com/The-Mindbody-Prescription-Healing-Body...
The most surprising information I discovered curing RSI is:

http://aaroniba.net/articles/tmp/how-i-cured-my-rsi-pain.htm...

which recommends

http://www.amazon.com/Mindbody-Prescription-Healing-Body-Pai...

pierrend
This book has been really helpful for me. I recommend it.
darkmighty
Pseudoscience? Here?

Placebo pills seem a lot less time consuming than the suggested above...

Have you read Mindbody Prescription by Dr. John E. Sarno?

It's the only thing that could cure my constant RSI/chronic pain after years of trying everything, and in the book he talks about fibromyalgia.

http://www.amazon.com/The-Mindbody-Prescription-Healing-Body...

The idea of psychogenic disorders would have normally have sounded like esoteric BS to me, but I ended up picking up the book at the recommendation of an ex-Google coder who went through all the same things that I did. I'm glad I did; for 15$, I completely cured myself after years of trying everything else (physiotherapy, standing desk, stretching exercises, working out, various books on RSI, ergonomic chairs, keyboards, mouses, trackpads, switching hands, etc, etc), and it turns out the book takes a very scientific approach to these conditions, even if it admits that there's a lot we still don't understand about exactly how our minds work and how they can affect our bodies (it's kind of an engineering approach -- we figured out something that works, now we need to figure out why).

Highly recommended to all those of you suffering from constant back pain, neck pain, RSI, etc.

mikevm
I was thinking of buying that book, but he sounded like a typical wackaloon to me. I mean, just from reading the first few lines of the Amazon review:

> Dr. John Sarno caused quite a ruckus back in 1990 when he suggested that back pain is all in the head. In his bestselling book, Healing Back Pain: The Mind-Body Connection, he claimed that backaches, slipped discs, headaches, and other chronic pains are due to suppressed anger, and that once the cause of the anger is addressed, the pain will vanish.

Slipped discs are due to suppressed anger? What the fuck? I've been having back pain for a few years now (it returns whenever I slouch), but it started directly after a gym injury... what has that got to do with suppressed anger?

bithive123
I read his book (http://www.amazon.com/Healing-Back-Pain-Mind-Body-Connection...) expecting to have a similar reaction. While he doesn't make the strongest scientific case, you are not doing his proposition justice. It's more about people who injure themselves maintaining unconscious tension in areas which leads to stiffness and pain well after the physiological healing has finished, because they fear re-injury.

I found some of his advice helpful insofar as it suggests that mindfulness meditation can help ease tension-induced back pain (which I have found to be true for me) and that there is a mental component in overcoming the fear of re-injury and allowing yourself to resume your full range of motion without subconsciously tensing up.

As someone who struggles with anxiety from time to time, I can even believe his statement that he's referred some patients to therapy before attempting to treat their back pain.

MikeCapone
Invest a couple hours in reading a few chapters of the book and find out for yourself. I can't possibly summarize it all here without skipping important steps.

All your objections are addressed very well in the book. It's not like he hasn't thought about those things and how it sounds at first. He came to his conclusions empirically by treating his patients, not by dreaming up some theory out of the ether.

I'll just re-iterate my recommendation for the book. It doesn't cost much and you can always get it from the library if you really don't want to spend the money.

zwegner
I don't think he claims that, but rather that slipped discs being painful is.

Not really sure about this (I haven't read that particular book), but I will say that Sarno's theories cured my RSI pain, which crippled me for over a year. I'm not sure if his explanations of the mechanism for the pain are correct (they seem very hard to test), but I'm pretty sure the pain was all psychosomatic.

marincounty
I was in Chiropractic School and dropped out because I felt most patients got better by the placebo effect.

I once heard a Doctor describe psychosomatic pain. He believed the artierioles constricted with psychological stress. It's still real pain, but it will eventually go away.

I was deeply effected by nagging pain throughout my twenties. I went to Doctors, but since I knew where all the cranial nerves were(Chiro student), they didn't think it was psychological.

The American way to success(what ever that is) is Stressful. Especially, if you were the hard working type. Don't think you are invincible. The mind does break.

My use of weed has not worked. I used it for anxiety/depression but, it just made me feel anxious, and amplified any pain I had. But, everyone is different--try it--it just might work.

i_lift_bro
Suppressed anger because you don't even lift?
cooperadymas
Reading this currently, with a lot of similar skepticism, mostly because of this blog post: http://aaroniba.net/articles/tmp/how-i-cured-my-rsi-pain.htm...

I avoid books like this because they are almost all "wacakaloons" like you say. But this one seems to be much better. At least the entire first half of the book is the author making the medical case for his treatment. It is well cited, based on both his clinical experience and other studies.

Sarno doesn't claim that slipped discs are caused by suppressed anger. He never says that all backaches, headaches, slipped discs, and chronic pains are due to this and stresses the importance of getting examined before judging for yourself the cause of the pain. He believes that the pain from things like a slipped disc sometimes is, though. He cites a multitude of instances where people have slipped discs and aren't in pain.

Again, I'm not finished with it and am still a bit skeptical, but I would say it's probably worth a read.

Dec 22, 2012 · AhtiK on The Placebo Phenomenon
A rather deep research and clinical practice on working with the mind to cure the body has been conducted by John E Sarno.

The Mindbody Prescription [1] and The Divided Mind [2] are two of his books.

My interest in this started with the motivation to get some relief for the RSI-like symptoms and it's been part of my recovery for a few weeks together with the improved ergonomics.

[1] http://www.amazon.com/The-Mindbody-Prescription-Healing-Body...

[2] http://www.amazon.com/The-Divided-Mind-Epidemic-Disorders/dp...

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