The Mindbody Prescription: Healing the Body, Healing the Pain Paperback – October 1, 1999

Background: I've had headaches most of my life, and remember them becoming a bit more consistent/intense around age 25 (I'm currently 35). I had a deviated septum and a lot of sinus issues and thought those might be a cause. Around age 31 my headaches were probably 1-1.5x weekly and quite strong, and I was determined to find the cause and do whatever I could to rid myself of them.I asked my ENT about my "sinus headaches" and he told me that these are probably tension headaches. "Do you work at a desk sitting like this all day?", "Yes", "Yeah those are tension headaches, I'll give you some exercises and also prescribe some sumatriptan for the ones that are migraines." (Important disclaimer: see a doctor and rule out serious physical causes. If your doctor diagnoses you with tension/migraine/sinus headaches, then this book might help you).Over the next 1.5 years I try everything, exercise, yoga, foam-rolling/lacrosse ball work, standing desk, special glasses, improving posture, tracking my diet for potential triggers...etc. Most of these things don't work, some, like yoga and lacrosse ball provide temporary relief, but my headaches keep getting worse. At this point they're 2-3x weekly and bad, sometimes im in bed with an eyemask on for the whole day or more, taking lots of ibuprofen, caffeine pills, excedrine migraine and occasional sumatriptan. I use mentholated pain patches on my neck/back and even temples, and I have 5+ other remedies I use. I have some form of pain or shoulder tension that precedes a headache every single day, and every single day I fear it will turn into a full blown headache. At this point it is affecting every aspect of my life.I decide to seek out a book, and come across "Heal your Headache" on Amazon as the top rated headache book. I pick up a copy and read it, cliffs are "Quit caffeine, red wine, and dark chocolate, plus a huge list of 'triggering foods', and cold turkey off medications because they do more harm than good". I read it in 2 days and find that my headaches improve somewhat just reading this book, and the stories of people who had similar or worse headache patterns being cured. This is my first clue that the condition isn't 100% physical. I also find myself reassured that the amazon 4-5 star reviews say it helped them immensely, but the 1-2 star reviews don't say "I tried this the best I could and it didn't work" but just generally say "this is too restrictive" or "this book is pseudoscience with no RCTs". I decide I'm going to try the diet and other advice of this book (I never actually tried it, due to discovering MindBody Prescription and trying that instead to great effect).It's around this time I come across a twitter thread from a guy named Josh W. Comeau, talking about his experience using Dr. Sarno's method to cure his elbow pain and avoid an extreme surgery (google 'josh w comeau personal experience with RSI'). I find the story incredibly interesting and I pick up a copy of MBP just out of pure curiosity, not even thinking that it could potentially be applied to headaches. In the book, like many people it helped, I see myself on every page. I also notice he briefly mentions headaches as a form of TMS, so I say screw it, I'll give it a shot. I start out still very skeptical that this can be applied to headaches, but I commit to at least pretending I believe it (this is essential, give yourself permission to believe). One other thing that helped me is that the skeptic in me decided to check Amazon reviews, and I found nobody who gave a 1-2 star review says "you know, I was skeptical but I gave it my best shot, and after 4 weeks it just didn't work for me". They all call it junk science, say it lacks evidence, or that Sarno doesn't tell you what to do.The first thing I do while reading the book is I stop doing any type of physical practice to try to reduce tension or improve my headaches. I even take it to the point that if I'm on the couch or seated at a desk typing, and I feel that familiar tension start to creep into my neck/shoulder, instead of adjusting or shaking it out, I intentionally remain in that position and remind myself that this isn't the cause.As I'm reading I go ahead and buy Schacter's MindBody Workbook and I make a few notion docs with Sarno's affirmations, and the stories of every person I can find who claims their headaches were improved by treating it as TMS I do the journal daily, reread the book a few more times, read the success stories every few days, reading guides and stories on tmswiki, and start doing all the things I had been avoiding for fear of causing a headache.I had stopped swimming, because getting water in my ear/nose "caused my sinuses to seal up". On flights I used special earplugs so the sudden pressure change wouldn't mess up my sinuses. Also my wife is from Mexico and, while there, if we spent too long in the 90 degree sun, I'd get a headache/migraine, so I started pushing back on that idea as well. All of these headache triggers were confirmed as valid by my ENT who advised I avoid those activities. I had listened to that point, but now I decided to try Sarno's advice and not limit myself physically. We went swimming with our nieces and I dove in the pool, did flips without holding my nose, and was intentionally reckless with ingesting water, and my sinuses stayed completely clear. In fact my sinuses stopped sealing up, and since then I've been able to breathe better than any point in my life.The experience that really sealed it for me though, was about 5 days in, I started to have a headache near my right temple. I did as advised and focused on my thoughts/emotions rather than anything physical, and I also said to my brain 'I know what you're doing and it's not going to work, now give me oxygen and open up my blood vessels near my temple', and the headache went away. Not two minutes later, I had a headache start forming at the back of my head. This is something that had never happened, my headaches didn't move, unless it was gradually over hours. I had read about this kind of transfer happening in other people's experiences, and I, now feeling more empowered, repeated the same process, and the pain dissipated. Unbelievably, five minutes later, I felt a gastritis pain in my stomach. Gastritis is something I had had 3-4 bouts of over the previous 3 years, and had treated with omeprazole. Before that point, I had never considered it as a possible manifestation of TMS, but I repeated the process and it went away. Finally, a few minutes later, I rotated my head and my neck popped and got stiff. This had happened to me roughly every other month for around 5 years, and I thought it was some form of pinched nerve or muscle injury, and would leave me unable to fully rotate my head on one side. It was super annoying and would last 1-3 days. I also hadnt consider that this could possibly be TMS. This time the pop didn't cause the full pinched nerve sensation, it was very mild, but since that moment I've never had that crick in my neck, nor have I had any type of gastritis pain.Anyways, after that extremely strange experience, I had little doubt that, if I kept journaling, believing and following the process, that I could minimize the role of headaches in my life. I had maybe 1 headache that week, and then from that point forward, roughly 1 mild headache per month (the type that I could take 2 advil for, or sleep and it would go away, not the debilitating ones I'd had in the past). Eventually, I stopped doing any kind of journaling or reading and, during a period of stress, my headaches increased to around 3x monthly. I reread the book and I added the question "Did you do anything yesterday that might cause head pain?" to a bullet journal I do most mornings, and my headaches decreased back to once a month or less.I know reading other peoples' success stories was something that helped me immensely, so I hope that reading this might help you with your headaches. You might be caught in a fear-pain cycle and be digging yourself in deeper looking for a physical solution. It scares me to think that I could have gone on for years like that! If you've seen a doctor, ruled out any serious physical cause, and been diagnosed with tension headaches, sinus headaches or migraines, then please consider giving this book a shot. If you have any questions feel free to write me at my g mail address which is "my first name + my last name + 1" (without the + of course).

If you have suffered from back or neck pain, then this book is a must read. Dr. Sarno has practiced at NYU for many years and has helped numerous patients overcome these physical ailments. The book is clearly written with many examples, which helps the reader to understand the principles and identify whether these apply to him/her. Dr. Sarno works with the concept TMS, tension myositis syndrome, which is used to explain how pain (or other sensory problems) can occur in various parts of the body for no clear (conscious) reasons. He reviews the details of TMS repeatedly throughout the book, again using many examples from actual patients.Dr. Sarno explains that many people experience relief of the pain through insight and coming to understand that their mind (brain) is responsible for the pain. Essentially, unconscious anger (and other emotions) create the physical response by decreasing blood flow and oxygen to the painful areas of the body. As the mind heals, so does the body. Dr. Sarno helps to heal the mind through this book by educating the reader about TMS and this process. Furthermore, he helps the reader understand that the pain is real (not imagined) and has an actual physical cause (i.e., reduction of oxygen) which is not dangerous or permanent. By reading the book, the mind's process for causing the pain is exposed and now rendered useless in distracting the patient from the underlying causes (i.e., anger). Therefore, the pain should decrease and stop altogether once this genuine insight is gained by the reader.In summary, Dr. Sarno's book is extremely helpful for those experiencing real day-to-day pain. He provides hope for those who have suffered from pain, in some cases for years, and he helps to end the pain where others have failed.

Okay, you've got to understand: I'm no fan of "woo" or new-agey alternative medicine, and this book is not that. I'm a diehard empiricist. Even so, what I'm going to tell you might sound weird.Everyone, EVERYONE, who has had long-term back pain needs to read this book and try it out.I had a back injury in 1993. It hurt off and on ever since. It disrupted my life and cost me a lot -- in stress, in worry, in wasted time, not to mention in money (for doctors, pain meds, massage therapists, etc.). This pain was a significant part of my life -- will I make it through okay on a long plane trip? Will it be okay to mop the floor? If I lie on my back to read a book for half an hour in bed, will I be miserable all day tomorrow? It affected my decisions every day.A friend mentioned this book to me, and said she totally got rid of excruciating back pain. She is not a fan of "woo" either, so I took her seriously -- and well, I'd tried everything else already. What would it hurt to buy a $10 book?As it turns out, I'm one of those people -- a not insignificant minority, it seems -- who read the book and their back pain goes away (my friend said it took her a few months of dedicated work, and that's pretty common too--but 80-some percent of people seem to get significant, lasting relief).I read the book about three weeks ago, and have been pain-free ever since. You might be saying "big deal" ...but I haven't had a three-week pain-free stretch in 20 years. Also, even on days when my back didn't actively hurt, certain places -- such as my shoulders -- were always stiff and sore if you touched them. That's gone too. I keep pressing on my shoulders to show myself, "Wow this doesn't hurt a bit." This thing that plagued me for 20 years is gone.Here's what I think is good in the book:1. Everyone knows that "stress" can affect you negatively. For example, people who suffer from chronic back pain or headaches often feel worse under stress. What I never considered, however, is that your own nervous system _creates_ physical responses. For example, when some people are embarrassed, they blush. Their blush is real -- it's not "in their head" -- and they're not blushing deliberately or in order to gain anything. Chronic back pain -- real pain, which is not "in your head" and not something you're exaggerating or fabricating -- can arise from your nervous system in the same way as a blush, whether or not there's anything "wrong" with your back. Just as a blush can arise in some people when they're embarrassed, back pain can arise in some people when they're "stressed" -- and everyone is stressed every day. If you're not stressed, you're dead, right? Not everyone blushes, and not everyone has back pain, but people's nervous systems can create physical responses from emotions.2. Sarno points out that injuries do heal. People break a bone, it heals, and they're fine. People sprain an ankle, it heals and they're fine. Once my back injury healed (20 years or so ago), there was no reason for it to hurt anymore, other than my own nervous system using a familiar "route" to cause pain. Then the question is, Why?3. The author points out that many people with chronic back pain are the "nice guys" of the world. People with chronic pain are often very conscientious, do-gooder, perfectionistic, or self-sacrificing types. If it's associated with a certain type of personality, that's a red flag right there that something other than an "injury" is going on. A lot of people with chronic back pain also have a history of having been abused as children. What do these two types of people have in common? They tend to deny or minimize or not notice their own feelings. They are the types to say, "Sure I'll help you move a piano at two a.m. on Christmas in a blizzard." They don't even notice that maybe a small part of themselves would rather not move the piano.4. The author speculates that all this do-gooding and self-denial and ignoring-of-one's-own-feelings and needs (whether it's your personality type, or whether you were raised in an abusive home, or both) also creates a constant pool of underlying "rage" (his word, which he uses a lot) from the part of ourselves that doesn't want to move pianos. Here's where it gets speculative. Somehow your body transforms this unacknowledged feeling into pain (just as "somehow" the body transforms someone's embarrassment into a blush).5. The author also speculates that the pain serves as a distractor. Of COURSE you aren't wild about moving the piano! Your back is killing you! That's a socially acceptable reason to admit to yourself that you don't want to move the piano. Of course, you'll probably move it anyway. (By the way, the author rejects the notion of "secondary gain" -- i.e., the idea that people with chronic pain use it to get certain benefits like attention or sympathy. He believes the pain serves both as a distraction from emotional pain, and an outlet for / substitute for emotional pain you're not feeling.)6. Something I found interesting is that people in certain times and places seem to have certain mindbody disorders that are approved by their society as being "real" things with physical causes. In Victorian times there was a lot of mysterious paralysis, but it went out of fashion once people knew more about the body and that it didn't "really" work that way. In the 1990s there was a lot of carpal tunnel, even though computers were probably easier to use (easier on the wrists) than, say, old manual typewriters where you had to bang the keys. There's a whole lot of back pain today, which often lasts years beyond an injury, and which is remarkably unresponsive to treatments and surgeries, but the medical community supports the idea that an injury you sustained 20 years ago can be hurting you today, so everyone believes that chronic back pain has a physical cause, just as everyone once believed in the paralysis in Victorian times. Almost everyone (like me) can point to an "injury" that triggered their back pain, but unlike ever other injury we've ever had, it doesn't get better. It's pretty odd, once you think about it, but everyone -- from doctors to physical therapists to chiropractors to massage therapists to other people with back pain -- reinforce the idea that it's related to a physical injury and there's very little you can do about it. This belief is extremely powerful and helps perpetuate the pain.7. What I like most of all: I read the book, I thought about all this stuff, I decided his description fit me perfectly (my personality, the type of pain, the length of time, etc. etc.), and once I knew there was likely nothing actually "wrong" with my back, it's like the game was up. My brain gave up trying to use that as a strategy. The back pain went away, including the permanent tightness in my neck and shoulders, including the shooting excruciating nerve pain down my leg for which I was being medicated.It. Went. Away. I'm off the medication. I'm doing whatever I want. I'm lying on my back for hours every night reading my books. I'm bending however I want. Etc. No problem.I can never do this book justice. There's a lot more, about MRIs, about people with and without bulging discs, arthritis etc., about people who are told they have to do this or that with physical therapy, "or else" (which is pretty much reinforcing the notion that there's something terribly wrong, although plenty of people have bulging discs and arthritic changes and never have a day of back pain). You just have to read it, to see whether it fits you too. If you've had back pain for years, it probably does.Here's what I'm not wild about.1. The book seems very psychoanalytic to me -- to me, needlessly so. It talks a lot about "rage" and you might not be a person who really perceives that you're feeling "rage" (I'm not). But on the other hand, the book "works" so I'm not sure that anyone necessarily needs to accept a psycholanalytic explanation. I'm a nice-guy self-denier who probably, if I'm really honest with myself, truly loves to help people but doesn't enjoy moving pianos at 2 a.m.For me, all I had to do is, every time my back started to twinge, ask myself to think hard about what I'm feeling, what's bothering me. I say it to myself -- I don't even have to go around refusing to move people's pianos. I just have to say to myself something like "I really don't like getting up at 2 a.m. to move pianos. I would rather stay in bed. I wish there was some other time -- not on Christmas, not during a blizzard -- when we could move the damn piano." I just acknowledge to myself that a part of me feels that way. I also ask my brain to stop my back from hurting, and it does. Then I go about my business. But there's no need for a psychoanalytic explanation, in my opinion, any more than there's a need for a psychoanalytic explanation for a blush or a phantom limb pain.We don't have to understand it for it to work. Gravity always "worked" whether or not we understood it. Apparently checking in with your own emotions, acknowledging them, and asking your brain to stop sending pain messages also works. I don't quite understand it, but -- like gravity -- it's very powerful.So -- like every other idea you encounter in life: Take what works for you, and leave the rest. I've read a bunch of other good books on this topic now too, by this author and others. My favorite so far is Unlearn Your Pain by Howard Schubiner. Only the first five chapters is available on Kindle, though, and I've ordered a hard copy of the rest of the book, so I can't review the whole thing yet.I wish every doctor who sees patients with back pain would read this book. I wish everyone with persistent back pain would read this book and give the ideas a try. I wish tons of research were being done on this phenomenon. I wish I had come across this book 20 years ago.