Howard Schubiner, MD opened this weekend's LA Mind-Body Conference at UCLA by laying out the premise that speakers would approach from different angles through two days of lectures and panel discussions: Much of the chronic physical pain that people experience is based not in bodily injury, but in psychophysiological processes--that is, chronic pain is often based in emotions. Schubiner surveyed the room, anticipating resistance: "Who's with me on this?" Just about every hand in the room went up. The Michigan-based doctor gave a surprised smile. "We're not in Kansas anymore."
The conference's 200-plus attendees were primarily LA-based psychotherapists, more than ready for the conference's message. Many were converts before arriving, having had personal experience of pain--fybromyalgia, IBS, back pain, and the like--lifted courtesy of their experience with a combination of psychotherapy, yoga, and mindfulness meditation.
The conference's speakers were by-and-large disciples of Dr. John Sarno, whose Healing Back Pain first popularized the notion that acknowledging intolerable, unwanted feelings--particularly anger and sadness--is how to get rid of chronic pain--not surgery, not medication. This stand has made Sarno and company less-than-popular with many in the medical establishment. But what he says are success stories (including, most famously, Sarno patient Howard Stern) may be shifting that antipathy.
Some consider Sarno's 1991 back book, and others on the subject, the first step in treatment when a diagnosis of stress-based pain (dubbed Tensions Myoneural Syndrome (TMS)) is made. Dr. David Schechter is L.A.'s preeminent TMS-wise doctor, often sought out after patients have already discovered Sarno's writing. At the conference, Schechter presented a ten-item questionnaire that he uses as a preliminary screening device for TMS pain. Have you been told there's nothing that can be done about your pain...? Do you obsess about your pain...? Have you sought a variety of treatments for your pain...? (The whole thing is posted on Schechter's website.) Several panelists reported that getting patients to accept the diagnosis is often the hardest part of treating it.
Portland, Oregon-based Gastrointerologist, David Clark, MD, uses the term "Stress Illness" to describe the TMS phenomenon. He gave conference-goers a simple way to introduce mind-body thinking to patients: "If you have too much stress or stress goes on for too long, your brain sends it down your spinal cord and into your body." He sends patients for a "stress check-up" with a therapist, a survey of current and past stress, particularly stress that occurred near the time the pain began. An example from Clark: A man feels unbearable back pain while driving--awful, debilitating, agonizing. A stress check-up finds a helpful clue: the back pain only flares up when the man is driving to work, never when he's driving home. Conclusion: The problem isn't the ride, it's the destination. And so, Clark says, the process of heeding the mind-body connection begins.
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