Even Sigmund Freud participated Essay

Today the checkup sphere whitethorn offer us good examples of how the existing diversification of approaches and methods towards the give-and- mystify of plurality is related to the primordial shifts in our perception of the old problem of pay backing the connection in the midst of the serviceman body and the mind. In situation, on one hand c atomic number 18 for as such(prenominal) is on the fill up fundamental take an inherently conservative filed of knowledge and practice be elbow grease what is at billet for a doctor is often the real tender life, the value of which overthrows all manageable dubious methods of manipulation that may lead to the lack of supreme results, or stock-still to shun ones.On the other hand, as we atomic number 18 constantly learning new things close towhat such an intricate complex body mapping as the human body is, it becomes clear that phenomena that had been thought under(a)standable in concreteity have a much more comp licated nature, which dominates en large-scalement of existing scientific approaches, or nonetheless demands refusal from roughly of the handed-down medical examination examination postulates.To grasp challenges that arise from such shifts in our correspondence of mind-body connection we may consider perhaps besides extreme examples many a nonher(prenominal)(prenominal) schools of the alleged(prenominal) new-fangled Age medicinal drug which under the pretence of the break- by dint of knowledge all besides often advance simply untenable and absurd claims establish on mere speculations (Reisser, Reisser, and Wel gull, 1988, pp. 147-52), and the overly sceptical defenders of the traditional Western medicament who may tend to be too inflexible in their admission of the severity of alternative approaches to medical treatment of mass.More specifically, the matter of the influence of human mental processes on what has traditionally been considered stringently physiologi c dis ordinations is one of the virtually inflaming arouses of dis takements among the mentioned approaches. This tension that in one form or a nonher is ongoing between representatives of different medical camps to a large degree defines the new discourse of approaches to the medical treatment (Miller, 2003, pp. 185-187).In this regard, it would be interesting to virtually investigate the existing literature that represents the current adduce of affairs in the perception of the connection between the mind and the body. As a suitable object of our analysis may serve the take for written by Doctor of Medicine John E. Sarno, a professor of Clinical Rehabilitation Medicine at the New York University School of Medicine, and go to physician at the Howard A. Rusk Institute of Rehabilitation Medicine at the New York University Medical Center.His best-selling work The Mindbody Prescription better the Body, Healing the Pain belongs to the list of the most popular makes that highli ght begetternish and applicatory achievements in the field of psychoneurotic medicinal drug, a school of medicine which is based on the principle of unity of the mind and the body, and which aims to examine the weapons of the interdependency between emotions and corporeal functions and to promote psychological methods of medical c atomic number 18 (L howeverson, 2004, pp. 3-66).The combination of the academic approaches of the spring to the support of his material and the popularity of the book among lay people to whom it is for the most small-arm addressed suggests that on the example of this work we may judge the level of perceptivity of what could unanimously be perceived alternative medicine not long time ago into the modern medical discourse. With all this in mind, let us examine the volume of John E. Sarno in the scope of its connection as of a textbook of utilise psychoneurotic medicine with the modern medical paradigms.For this purpose, we leave briefly outline the history of psychosomatic medicine, then will try to link it with the book of Sarno, and in the chief(prenominal) body of the paper will provide the book accounting with germane(predicate) comments on the books contents. Background on psychosomatic medicine The origins of the psychosomatic medicine can be found in the teachings of primeval Western philosophers and physicians who acknowledge that emotions played an important role for the human headness (Cacioppo, 1989, p. 589).Still, the Western medicine has traditionally been more inclined towards the national of the moment of incarnate functions (Loudon, 1997, p. 238). However, by the middle of the nineteenth century the level of charge to the involvement of emotions in complaints development grew as the observational evidence was accumulating that had suggested that some disorders were not al commissions accompanied by organic affections (U. S. National depository library of Medicine, 2005).For example, and since the seventeenth and the eighteenth centuries such a neurosis as hysteria began to be linked with turned on(p) agentive roles and the nervous system in general. until now Sigmund Freud participated in the study of symptoms of hysteria, and one of his conclusions was that they atomic number 18 based on memories linked to mental traumas which under certain mark offs may intrude in the processes of somatic innervation. In this way, a possible mechanism for the interaction between mind and body was offered that was reminiscent of mechanisms that Sarno would be describing in his book.The German psychoanalysts Georg Groddeck even went as far as claiming that psychological mechanisms engendering hysteria can be applied to all somatic diseases which from this target of thinking are the embodied manifestations of unconscious(p) mind mind psychological processes. In the 1930s psychoanalyst Franz Alexander assay to find a compromise between the Freudian supposition, such views as those of Groddeck, and existing knowledge of physiology.He was against overweeningly psychological interpretations that ignored the automaton worry mechanisms in the body that to a large degree directed aflame expressions. The theoretical basis developed by Alexander contri saveed in the fall in States to the invigorated extensive research of psychosomatic mechanisms, and psychosomatic medicine as a separate field of study was formed in 1939 when the medical journal dedicated to this branch of medicine was published. subsequently that time, psychosomatic medicine was only gaining momentum. For example, World War II spurred the interest to it referable to numerous manifestations of psychosomatic symptoms in soldiers. Eventually, by the 1950s interest to psychosomatic medicine and its scientific sufferground grew so much that its concepts entered the popular culture as media started to publish numerous articles and thus popularized psychosomatic theories (U.S. National Library o f Medicine, 2005). Now, truehearted forward to today, and we can witness that many of the postulates of psychosomatic medicine are already among the undisputed popular opinions of many people, and for instance the maxim that in order to stay healthy a person should avoid excessive stresses and worrisome emotional states is among the most frequently heard ones in twain media sources and in our everyday interaction.However, aft(prenominal) the surge of academic interest to it half(prenominal) a century ago, psychosomatic medicine, in contrast to its successful penetration into the public perception, somewhat lost momentum within scientific circles in the second half of the twentieth century (Kennedy, 2004, p. 400). So, it is in such chance that the book of John E. Sarno The Mindbody Prescription Healing the Body, Healing the Pain dictum the light of the day. The book of John E. Sarno in the larger social and historic contextThe Mindbody Prescription Healing the Body, Healing th e Pain builds upon themes from Sarnos preceding book Healing Back Pain The Mind-Body Connection that march on the liking that the seduce of back distress, business concern, slipped discs, and other inveterate forms of torture is real root in our psychology (Sarno, 1991). In The Mindbody Prescription Sarno adds new knowledge or so the psychology of emotionally stimulated physiologic manifestations, and elucidates how such emotions as raise, anxiety, guilt, and other negatively charged mental states can cause mental stimulation of negative somatogenic symptoms.Thus, in both of those books the precedent touches upon very urgent topics for the modern American society in which an increasing number of people are plagued by back, neck, or limb offend. In fact, this is a serious stinting problem as well, as industries in which large percentage of people are working at computers bear significant health damages burden due to a variety of similar disorders causing suffering, l ike fibromyalgia or repetitive stress injury (Sarno, 2005). More generally, suffer as such in its different forms is a crippling problem for many individuals in both their professional and private lives (Margoles, 1998, pp.9-32). So, The Mindbody Prescription addresses precisely this disturbing epidemic as it analyses clinical data to find the master(prenominal) cause of the pain disorders, and elaborates methods to treat those disorders. Importantly, in doing so the compose tries to fill the opening night existing in the traditional methods of continuing pain treatment that are apparently unable to stop this pain epidemic. From the very counterbalance of the primary(prenominal) body of the volume it becomes clear for a reader that the author adopts a holistic approach to his subject.More specifically, Sarno opens the beginning chapter of the book with construction of heterogeneous typical and stressful scenarios that in one form or another take place in lives of many of us and contrisolelye to chronic somatogenic pain that people experience. What is untypical, though, is that Sarno from the very beginning of the book begins to embroil our wariness to what could be considered as a minor fragment of those scenarios, scarcely what in reality, fit to the author, underlies the different manifestation of the pain disorders.This significant element is the factor of unconscious raise or outright rage that Sarno envisions as inevitably accompanying all of the scenarios that he delves in, like our troubles with private life, or within family, or career-related frustration, and many other different or that Sarno repeats in succession to bring home to us his case of unconscious mechanisms that pay off anger in so many people.Now, this initial attention to the emotional side of our life is in a good agreement with our above observations about the widely acknowledged role that our mind plays in our health, and the author as if resumes that the existence o f the definite connection between our emotional experiences and our bodily health is factual. But, judging from the way he begins his work, what we can expect from Sarno is the participation on the admit mechanisms that keep the mind-body connection running, especially as the author immediately claims that the disorders that he is about to discuss . . .are neither illnesses nor diseases, alone rather symptomatic states induced by the forefront to serve a psychological purpose (Sarno, 1998, p. 3). After all, while general public does not always bother to verify its views, practitioners of classical pathophysiology would surely expect unassailable support of any claim related to the emotional aspects of diseases and illnesses and to the connection between pain problems and stress. At the said(prenominal) time, having chosen the non-technical elbow room of presentation Sarno attaind the easiness of reading for common people whose pain-related problems are the actual target of the book.The building and the contents of the book The Mindbody Prescription consists of three move preceded by an protracted preface and an introduction that deals with a historical perspective of the books theme. The preface and the introduction of the book summarize theories and experience of Sarno with treatment of back pain and other types of musculoskeletal disturbances. Naturally, already in the opening parts of the work the emotional foundation of the pain is emphasized.In the end of the book we can find a positive appendix, which provides supportive citations for conclusions of Sarno, and a bibliography which refers to articles that covering fire physical and psychoanalytic issues related to chronic pain and its treatment. In the first part of the book Sarno reflects upon concepts underlying mind-body medicine, and exemplifies influences that physical stress and such psychological states as feeling of guilt, anxiety, depression, or personalizedity disorders have on th e meander of symptoms manifested in perseverings.Sarno categorizes the range of terrible symptoms that may arise due to psychological processes as belonging to what he terms Tension Myositis Syndrome (TMS), which is a painful condition that develops in the back, shoulders, neck, or buttocks, and may equally arise in other parts of the body, and which throughout the whole book would be the main object of study for the author.But before shifting to investigation of concrete instances of TMS-related maladies, in order to justify his principal claim that chronic pain symptoms are in reality a kind of a falsifying mechanism used by our brain to distract our attention from our unconscious emotions of anger, Sarno copiously refers to the prominent figures whom we have discussed Sigmund Freud, Franz Alexander, and some other defenders of the theory of psychoanalysis like Stanley Coen and Heinz Kohut.I gestate that this approach is beneficial as it helps readers assess the historical inheritance that underlies basic conceptions of the psychosomatic medicine, and thus provides a firmer pay for beliefs held by many people who have had successful experiences with psychosomatic approaches to treatment of illnesses. Aside from the references to important figures in the history of psychosomatic medicine, the first part of the book also elaborates a distinct and well-structured rendering of the concepts constituting the basic principles of mind-body interaction.In the process of such explanation the author mentions such fields of study and such medical and psychological notions as neurophysiology of psychogenic disturbances, problems of psychosomatic origin, and reactions of renewal (which is one of the types of interaction between the mind and the body when unconscious elements of human psyche intrude into somatic processes) (Sarno, 1998, pp. 173-174).Sarno also mentions the findings of Candace Pert, a neuroscientist who found opiate receptors in the human brain, and who greatly contributed to the growth of our knowledge of links between biochemical processes in the brain and physiological phenomena. In this way, Sarno anchors the theme of his book in the history of psychosomatic medicine, and, even though he is mentioning some composition concepts that may be critically perceived by adherents of traditional pathophysiology, the style of Sarongs presentation is lucid and definitely absorbing.All in all, the first part of the book serves as a bridge between the general reciprocation of the psychological mechanisms of emotional influence on physical disorders and more expatiate investigation of psychoneurophysiology that underlies psychogenic processes. In the second part of the book Sarno closely examines his clinical experience with emotionally caused physical disorders, and is primarily partakeed with various(a) manifestations of TMS and with the possibility to extend his theory of the mechanisms of TMS emergence to other diseases and illnesses.In fact, many of the clinical problems that he examines have already been known to have a connection to stress, which either produces them, or aggravates their effects. However, what makes the work of Sarno special is his approach to explanation of these disease states from the point of view of unconscious working of suppress anger and rage. To prove his case, Sarno has combined physical medicine with psychoanalytic theory in order to give what he believes is a prudish draw for TMS, which, harmonize to his practice, is the main cause of musculoskeletal and back pain.For Sarno, the origin of painful manifestations of TMS lies in keep down emotions. And the pain in various parts of body as such is theorized by the author as existence caused by a diminution of filiation point to the corresponding tissues. This process of blood flow reduction is mediated via the autonomic system as a stressful reaction of brain to repressed emotions. We may chart the TMS pathophysiolog y in the avocation way The formation of unconscious repressed emotions (anger/rage) ? Abnormal patterns of autonomic systems activity ? Decrease of the level of local blood circulation ? maturement of mild oxygen deprivation ? The resulting pain in vigours and other possible symptoms (for example pain in tendons, tingling, numbness, weakness). Having established such a mechanism of the emergence of pain, Sarno surmises that this approach from the TMS formation theory can as well be applied not only for the fixed number of cases of muscle and back pain, but to a wider range of physical disturbances. In this light, Sarno in front pointed out that in a 1975 survey it had been found that 88 per cent of patients with TMS had histories of up to five common mindbody disorders (Sarno, 1998, p.29). And, indeed, Sarno manages to extend his theory of the emergence of pain disorders to megrim, to such various conditions as carpal tunnel syndrome, fibromyalgia, colitis, peptic ulcer, post-po lio syndrome, infections, scrape up disorders, and even to more unusual instances like the chronic pain that accompanies Lyme disease, which is caused by bacteria transmitted through ticks. The author also mentions disorders in which emotions world power be involved, among which are atherosclerosis, hypertension, one of the most common heart problems termed mitral valve prolapse, and even cancer.Of course, with such a broad scope of concern at hand Sarno has to offer an adequate methodology for unambiguous diagnosing of emotionally induced pain. For this purpose, his requirement is that the TMS diagnosis can be ascribed to a patient only if traditional physical exam failed to uncover existing abnormalities. However, gibe to the author, even in the forepart of an abnormality TMS still can be working in a patient and exasperate the pain to the high level than the found abnormality itself would be capable of.In the leash part of the book Sarno discusses approaches that may effect ively treat TMS and related physical disturbances. From what we have observed before it should already become clear that Sarno fundamentally assigns to the pain the function of a defense reaction that aims to run around our pick uping from the need to face repressed anger or other impossible forms of emotional strain. On ground of this, as the only possible way of treatment of the real cause of TMS symptoms Sarno postulates the examination of the physical origins of repressed negative emotions as the way for the deliverance from pain.Generally speaking, a person has to find ways to virtuoso out those harmful emotions and roots of the unconscious anger that are undermining his or her psychological well-being. And what also makes the theory of Sarno special is that, according to him, the mere acknowledgement of certain emotional concerns, and not of any bodily abnormalities, as the ground of the deteriorated physical state is in many cases already a sufficient condition for heali ng.One may not even have to remove the psychological problem itself in order to procure a visible clinical improvement. This contrasts with some of the New Age schools of psychotherapeutics that also associate unconscious repressed emotions with various maladies, but which require that before the healing can take place such unconscious problem spots must be dissolved, like is proposed, for instance, by the so-called primal therapy, a school of psychotherapy elaborated by psychologist Arthur Janov (Janov, 1999).For Sarno, the denomination of a problem is the main task for people suffering from emotionally induced physical disorders, and such identification can normally be implemented by means of an insightful self-examination, perhaps with the help of such techniques as meditation or self-affirmation (a method of compensation for the lowered self-consciousness in one area by consideration of ones proficiency in other areas (Sarno, 1998, p.22 Nezu and Nezu, 2004, pp. 182-188). In t his regard, from the point of view of Sarno it is also very important that a patient should have no doubts about the correctness of the TMS diagnosis, and that he or she fully realizes the exclusively psychosomatic origin of pain.To bolster this indispensable perception in patients, after the mentioned thorough physical examination needed for the elimination of possibility of the presence of real physical problems, Sarno accentuates the need to educate people and to assure them that the influence of repressed emotions is a sufficient condition for the reduction of the flow of blood to the touch on areas of the body which leads to the pain and other troublesome symptoms, which nevertheless should not be viewed by people as those inflicting permanent damage to the body.Even if some morphological abnormalities related to ordinary changes due to physical activity or aging are found, the patient should have a clear understanding of their nature. Basically, what is demanded from a patie nt is in no way the denial of the presence of the pain but rather the acceptance of its genuine origin. To help allege such an attitude to chronic pain, Sarno recommends to patients who know that they have no physiological abnormalities to suspend physical therapy and to return to normal physical activity.In appendix to that, patients should on the daily basis remind themselves the following points I only have a mild oxygen deprivation and not structural abnormalities my condition stems from repressed negative emotions and is not physically harmful TMS exists to divert my attention from emotions there is nothing to be afraid of for me the physical pain is not dangerous I will not allow pain to trouble and intimidated me I will change the object of my concern from pain to emotional experiences it is my conscious part that will have control, and not my subconscious mind I have to think about psychological aspects of my life, and not so much about physical. When such a situate of at titudes towards the role of ones unconscious emotional experiences and towards ones own body is obtained, Sarno believes that the brain that aims to contain the repressed emotions will no longer be able to fool us by drafting our attention to body. To illustrate how psychological relief may have a radical influence on the chronic pain, the author offers examples of some realistic cases. In one of such cases a patient knew about the most probable origin of her back pain but still did not have an improvement, and even had increased level of pain.According to Sarno, the worsening of the pain was brought about by the last efforts of the brain to keep hidden emotions unconscious, but when the feelings finally burst into the patients consciousness the pain, as if miraculously, went away. Sarno documents the account of this patient . . . in an instant, I started to cry. . . Out of control tears, anger, rage, desperate tears. And I heard myself saying things like, Please take care of me, I dont ever want to have to come out from under the covers, Im so afraid, please take care of me, dont hurt me, I want to cut my wrists, please let me die, I have to run away, I feel sick-and on and on, I couldnt stop . . . And as I cried, and as I verbalize these feelings, it was, literally, as if there was a channel, a pipeline, from my back and out through my eyes.I felt the pain almost pour out as I cried . . . I knew . . . that what I was feeling at that moment was what I felt as a child, when no one would or could take care of me . . . the feelings were there and they poured over me and out of me (Sarno, 1998, p. 13). However, as in order to get rid of pain we have to use our insight to understand its foundation, one may wonder that if the real cause of the pain is the repressed anger, how helpful psychotherapy may be in the healing of TMS symptoms? The author says The therapists to whom I refer patients are trained to help them explore the unconscious and become sensitive o f feelings that are buried there . . .When we become aware of these feelings . . . the physical symptoms . . . go away (Sarno, 1998, p. 161). Still, according to Sarno, the need for psychotherapy should not arise too often. The author reports numerous cases when people did away with pain simply after having read the book and having followed suggestions contained there. In fact, Sarno claims that the percentage of those who report the improvement of their condition is as high as 90-95 percent, and that many of his patients had been backup with physical disorders and pain for a large part of their lives and could not be treated by the traditional medical approaches. General critical observationsEven though the belief that emotions and stressful circumstances are related to physical conditions of people is today generally accepted, the extent to which Sarno emphasizes the role of psychological factors will nevertheless surely seem too extreme for many clinicians. Indeed, formally spea king, the author of The Mindbody Prescription gives some reasons to relate him to those practitioners who denounce the traditional medical approaches as outdated ones, as he says that . . . poor medical advice . . . keeps your attention riveted on your body, which is your brains intention (Sarno, 1998, p. 147), or that Modern medical science studies the details of maladies but rejects unconscious emotional processes as the cause (Sarno, 1998, p. 117).On the other hand, the effort of the author to extend the validity of his TMS theory to a range of disorders which in combination are shared by significant fractions of Western societies populations may also seem to be too ambitious and at the same time not sufficiently support according to strict scientific standards (Wilson, 1991). In this light, while Sarno rightfully remarks that . . . proper management of TMS and related disorders would alleviate much suffering and reduce the big cost of medical care that now burdens modern soci ety (Sarno, 1998, p. 126), he perhaps should also pay more attention to the fact that the mass of physicians still have doubts about the ability of psychological processes to cause chronic pain in the first place, and are more ready to agree that emotions may only aggravate physiological problems, but still in most cases should not be considered as their primary causes.In his turn, Sarno disputes that such processes as osteoarthritic changes and herniated vertebral discs are always the immediate sources of the pain and suggests that very often they may just be coincidentally present close to affected areas that due to emotional causes are deprived of oxygen. Such views pull ahead distantiate him from the conventional approaches to treatment of these disturbances. Moreover, Sarno insists that traditional medicine has no valid methods of TMS treatment because If you thwart that purpose by taking away the symptoms without dealing with its cause, the brain will simply find a substitut e symptom (Sarno, 1998, p. 39). In any case, despite the unconventional elements of his methods of treatment, Sarno has numerous adherents who attest to the practical pertinence and effectiveness of the theory of connection between psychological processes and manifestations of TMS.Therefore, I believe that even if Sarno is not able to provide a completely tried from the academic point of view account of the mind-body connection, he may be practically exploring the mechanisms of the human body that the fundamental science is only beginning to test experimentally (Brush, 2005, p. 259). For example, consider the recent finding related to the storied placebo effect in which it was again confirmed that such a purely psychological factor as our expectations has not only psychological but as well physical effects on health. But in this particular research a new variety of the placebo effect was found, actually a kind of an anti-placebo effect, as it turned out that . . .once Alzheimers d isease robs someone of the ability to expect that a proven painkiller will help them, it doesnt work nearly as well. . . (Neergaard, 2005). This fact testifies to the power of our psychology to intervene in the what might seem as purely physiological realm of our bodily functioning, and the data is being poised to prove that at least such a psychological factor as the placebo effect . . . actually is physical, and that expecting benefit can trigger the same neurological pathways of healing as real medication does (Neergaard, 2005). Now, this conclusion is in a perfect agreement with the principles underlying the theory of TMS origin advanced by Sarno.However, quite ironically, the specialists involved in the mentioned research were quick to point out that positive expectations arent a substitute for real medicine (Neergaard, 2005), which contradicts the reliance of Sarno on psychology as not only the cause of many physical disorders but at the same time as the only means of their healing. But I suppose that if Sarno produces an impression of being too confident in the self-sufficiency of his conclusions it could only mean that due to his extensive observational experience he may just be a little bit ahead of the vanguard of the mainstream medical science. And, after all, if we want to find what unites Sarno with the conservative part of the medical establishment it is his traditional recommendation for his patients to resume full activities of daily life, including physical exercises. Critical observations about Sarnos view of migraine as an equivalent of TMSWhile Sarno devotes a large portion of his book to back pain, among other painful physical disturbances related to mechanisms that lead to TMS he mentions migraine, which is a very common condition that causes headaches, and physiological mechanisms of which are currently quite poorly understood (Cochran, 2004, p. 156). Sarno confesses his personal experience with migraine as he had had this condition f or quite a long time before he was introduced to medical research which suggested that migraine headache was the result of repressed anger (Sarno, 1998, p. 111). As he was already amassing evidence in support of the significant influence of psychological factors on many widespread medical problems, he was inclined to test that idea.After trying to find out what anger that he could be reduce was causing his migraine, Sarno allegedly got rid of migraine headaches for the rest of his life. However, he himself acknowledged that some symptoms of migraine still continue to happen to him, which brings us to a question whether the method of the author of the book can be applied without reserve to all the types of chronic pains that seem to have no accompanying physical abnormalities. Indeed, it may be that our lack of understanding of the causes of migraine simply leaves us ignorant of possible physiological mechanisms that underlie it, and even though approaches borrowed from TMS treatmen t may often be effective for removal of painful symptoms, purely psychological vision of the migraine origins may continue from us its genuine cause.Besides, it may be somewhat alarming that the definition of migraine that Sarno advances is different from the one offered for example by the National megrim Association. Sarno says that migraine is supposed to arise from . . . sudden constriction of a single blood vessel within the substance of the brain (Sarno, 1999, p. 111), while on the website of the National hemicrania Association it is stated that Migraine is disease, a headache is only a symptom. Migraine pain is caused by vasodilation in the cranial blood vessels (expansion of the blood vessels), while headache pain is caused by vasoconstriction (narrowing of the blood vessels). During a migraine, inflammation of the tissue surrounding the brain, i. e., neurogenic inflammation, exacerbates the pain (Coleman and Burchfield, 2006). Therefore, at least in the case of migraines it seems warranted to say that physiological mechanisms may be working to produce migraine independently from psychological processes, and that without knowing the exact causes and possible consequences of migraine-related tissue inflammation it is perhaps risky to adopt a strategy of assuring oneself that the pain is not physically harmful. The National Migraine Association again confirms this worry by pointing out that The Migraine disease is a serious health and disability problem that affects approximately 11 to 18 million Americans .