Chronic Pain Relief

Dear Dr. Schubiner,

For so many years, I have been taught and “programmed” to please others and basically ignore what I was feeling; because I didn’t matter.  I denied myself things such as food (anorexia), pain medications and even rest.  I even felt that I didn’t deserve to have feelings and lived with tremendous guilt.

I started to have pain at the age of 13 and I am now 49 years old.  I had a very difficult childhood with severe abuse and neglect and it has been reflected in pain for all these years.  I now understand that my subconscious mind caused me to have severe headaches.  They began gradually and occurred about twice a month.  But they were severe and forced me to lie in bed and cry.  The headaches started to occur more often, until they came daily and lasted for the next 20 years!  I forged on with my life; marrying, working and starting a family.  The pain finally got so horrible that I had to quit a job that I loved and held for 21 years. 

I was devastated, but I decided to become the best wife possible.  I was determined to be the best coupon shopper to find sales on all items, sometimes dragging two toddlers with me across town just to save 50 cents.  I tried to be the best housekeeper and stay at home Mom.  I was obsessive about everything, to the point of exhaustion.  Finally, I had a nervous breakdown and was hospitalized for three weeks. 

Since taking your workshop and beginning therapy, I have come to an amazing revelation.  My internal child was telling me, “Hey, I matter and if you won’t listen to me, then I’ll just have to force you to pay attention.  I want some nurturing too.  Quit trying to please everyone else and be kind to me.  I deserve it.”

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MBS Blog –  #9 Mindfulness Meditation

I have been a devoted and passionate teacher of mindfulness meditation for about 15 years.  Many people have misconceptions about meditation.  The most common misperception is that meditation is about relaxing.  Of course, meditation may be relaxing at times, but not always and the intent is not relaxation, but obtaining a better understanding of yourself, and learning to respond to body sensations and thoughts/emotions more deliberately, and learning to live fully in the moments of our lives.  Mindfulness meditation is a form of meditation that asks people to simply pay very close attention to the here and now, to the present moment, to what is happening right now, whatever that may be.  One of the great things about mindfulness is that one can practice it at any moment, no mater what you are doing or what is going on.  That makes it quite useful as a way to cope with the ups and downs of life.

The reason to learn mindfulness meditation techniques for people with Mind Body syndrome is that it can help a great deal in learning to live fully in the present and to learn to let go of some of the things that tend to perpetuate MBS, such as fear, anxiety, sadness, issues from the past, or worries about the future. 

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MBS BLOG # 8

Genetics and Mind Body Syndrome

Everyone knows that genes “controls” our lives.  But how powerful an influence do our genes play in our lives?  Of course, these issues have been debated for many years since the discovery of genes and the classic experiments of Gregor Mendel in 1865 on pea plants genetics.  We wonder not only at the similarities of facial features of children and their parents, but also at their personality quirks that seem to be passed down through genes.  There have been many books that purported to show that genes control everything.  So, when we are told that a certain disease is genetic.  We often assume that we are destined to be affected and that treatment may have little effect.

First, you must realize that there are certain genes that do have powerful effects that will produce diseases if those genes are present.  For example, cystic fibrosis and sickle cell anemia are diseases produced by inherited genes.  If you have those genes, you will get the disease.  However, it is also clear that different people with the same genes can have differing levels of that disease, even in CF and sickle cell.

Other diseases have some contributions from genes, but these contributions are either minor or variable.  For example, breast cancer has been found to have genetic components, but most people with breast cancer do not have the breast cancer gene.  There are genetic contributions to asthma and migraine headaches, but these are relatively small contributions in comparison to the effects of genes on height, ADHD and schizophrenia, which have heritability factors of 0.8-0.9.  The heritability factors of asthma and migraine headaches are in the range of 0.4-0.5, i.e. much smaller effects. Read more »

#3—What is Mind Body Syndrome Part II

As I mentioned in the last post, MBS is not new.  As long as there have been humans, there have been physical symptoms caused by stress and emotions.  It is important to realize that physical symptoms, even very severe physical symptoms can be caused by stress and emotions.  In fact, the emotions that tend to have the largest effect on us are precisely those that we are unaware of.  There are two ways to think about how these symptoms can be produced. 

The first way is to understand how the neurologic system works.  Pain is a learned response, i.e. the body actually learns how to produce certain symptoms by experiencing them.  For example, I had a patient who fell and hurt her back as a teenager.  A decade later, she was in a very difficult situation in a job where she felt trapped and unable to get out of her problems there.  At that moment, suddenly her back seized up and she had tremendous pain.  The nerves that send signals from the back to the brain had been fired when she fell as a teenager and those nerve connections had been “learned” at that time.  When a significant emotional situation arose where she had no way out, her body responded in a way that it already knew, by producing the back pain it had learned 10 years earlier. 

A good way to understand how MBS works is by thinking about phantom limb syndrome.  In this syndrome, which is very common among amputees, pain or other sensations can be felt in the part of the body (arm or leg usually) that is missing.  There is obviously no disease in that area, yet we can feel pain (often severe) that appears to be coming from the missing body part.  What has happened is that the nerves that send signals to the brain have been sensitized and are continuing to fire and those signals are interpreted as pain by the brain.  A vicious cycle is formed of sensitized nerves that send signals to the brain, then those signals get amplified in the brain (by a structure called the anterior cingulated cortex; more about that area of the brain in upcoming posts), and then signals are sent out to the body by the autonomic nervous system (the fight, flight or freeze system).  This pain is real, very real.  However, there is no tissue breakdown, no tissue disease in the body.  This is exactly what happens in Mind Body Syndrome.  We may feel pain in an area of the body, for example, the head or back or stomach, yet there is no tissue breakdown, no tissue disease there.  Of course, pain can be caused by tissue breakdown or disease, such as occurs in cancer, infections, or fractures.  When the doctors are unable to find disease after a careful and thorough search, the diagnosis of MBS is usually correct.  It is important to realize that MBS is a physiologic process, i.e. a process that occurs due to normal reactions of the body.  When we get scared, our heart speeds up; when we get nervous, our stomach tightens up or we get clammy hands.  These are physiologic processes, normal reactions that are 100% reversible.  That is why MBS is curable.  It can be reversed by interrupting the vicious cycle.

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#2—What is Mind Body Syndrome?  Part I.
June 3, 2008

It is important to realize that Mind Body Syndrome is not a new diagnosis.  When Dr. Sarno described Tension Myositis Syndrome (TMS) in the 1970’s, he created a new name for a syndrome that has actually been known for hundreds of years.  I agree with Dr. Sarno that we do need a name for this syndrome (and I will explain why in future blogs).  However, when you look at the history of medicine you will find many examples of MBS.  I highly recommend the book by the University of Toronto historian, Edward Shorter, From Paralysis to Fatigue: A History of Psychosomatic Medicine.  Dr. Shorter uses the term psychosomatic, which is commonly used in medicine, but a term that I do not prefer to use because it has a connotation of being unkind to the patients, implying that they are somehow less than normal, or somewhat “crazy.”  As I often say, I know that people with MBS are not crazy because I have MBS and I know I’m not crazy.

In any case, the reason people get MBS, or physical (or psychological symptoms) due to emotions which are often unconscious, is that they are human.  They have a human brain that processes emotions in certain ways and they have human existences that often cause great stress in our lives.  That is why there has always been MBS and there will always be MBS.  However, the type of symptoms that the brain creates in our bodies does change over time. Read more »