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Medicine Without Medicine: The Radical Cure of a Cult Doctor

From high school until my mid-20s, I lived with debilitating stomach issues that controlled my life. Every decision revolved around a simple question: Would a bathroom be nearby? Could I manage a 45-minute subway ride to have dinner with my dad?

My primary care doctor dismissed my concerns with a wave of his hand. "It's all in your head," he said. "This happens to girls in their 20s."

At 25, weighing less than 100 pounds and still losing weight, I finally received a diagnosis: panic disorder. When I started antidepressants, my stomach problems vanished. Forever.

So were my stomach problems "all in my head"?

Yes—but they were also in my body, because the two systems are one.

Traditional medicine often fails to recognize this connection, dismissing anything without a visible physical source as medically illegitimate. The term used to describe such illnesses—psychosomatic—has become pejorative, conjuring images of "made up" or "imaginary" ailments.

When applied to women, it often carries the additional stigma of "hysteria."

The mind-body disconnect in medicine has deep historical roots.

Hippocrates's misunderstanding of female anatomy led to theories about wandering wombs. Later, despite his problematic views, Freud made a groundbreaking observation: the mind and body are in constant conversation. When we repress trauma or psychological pain, it can manifest in physical symptoms.

It wasn't until decades later that the medical community began taking these mind-body connections seriously. The cost of this delay has been steep, contributing to today's chronic illness epidemic in America.

Enter Dr. John Sarno.

The late Dr. John Sarno, a professor of rehabilitation medicine at New York University Medical School, challenged conventional wisdom about chronic pain.

Though small at five feet three, his impact on medicine was enormous. His discoveries, while controversial at the time, offered hope to thousands of chronic pain sufferers.

As director of the Outpatient Department at the Rusk Institute in 1965, Sarno noticed a pattern: more than half his patients complained of chronic back pain. Traditional medical training attributed this to structural spine abnormalities or injury, but treatment results were inconsistent.

Most puzzling were the frequent mismatches between pain patterns and physical examination findings.

This led to Sarno's first breakthrough: structural abnormalities rarely seemed to cause pain. 

If we did an MRI of our entire body, we’d find a handful of structural anomalies, random nodules, cysts, and maybe even that house key we thought we lost. Things that are amiss, but don’t cause us any pain at all.

Sarno wondered why chronic back pain had only become epidemic in the 1960s, when spinal degeneration had always been common in humans by age 20. Sarno realized that the rise in chronic back pain coincided with increasing social pressures and psychological stress in post-war America.

Goddamn post-war America.

He recognized that the 1960s were marked by significant societal change, rising economic pressures, and increasing perfectionism in the workplace. More people worked desk jobs, there were higher expectations for career success, and pressure mounted to maintain a particular lifestyle, but emotions? Those needed to be suppressed to maintain a professional demeanor.

A sudden change in human anatomy didn't cause the epidemic of chronic back pain; it was triggered by mounting psychological pressure in an increasingly demanding society.

Sarno noticed something about his patients: those who trusted him tended to improve, while skeptics often remained in pain. This insight led him to explore psychological factors in chronic pain.

His research revealed a striking pattern: most of his back-pain patients were perfectionists or people-pleasers, highly self-critical individuals who internally punished themselves for perceived failures. This recurring personality profile suggested that psychological tension might be creating physical symptoms—a revelation that led Sarno to investigate how emotions could trigger real physical pain.

After years of clinical observation and research, he developed his theory of Tension Myositis Syndrome (TMS), a groundbreaking framework for understanding how emotional stress manifests as physical pain. He later refined the name to "Myoneural" as he discovered the crucial role of nerve pathways in this mind-body connection.

According to TMS theory, when the brain becomes emotionally distressed, it activates the sympathetic nervous system, reducing blood flow to muscles and nerves. This oxygen deprivation creates physical pain, not imaginary pain, but real physical symptoms triggered by emotional states.

Sarno developed a detailed treatment protocol that goes far beyond traditional pain management. His approach requires active participation and patient commitment, focusing on educational and psychological components.

There is no shortage of people who credit Sarno with saving their lives. 

Lucky for us, he developed a treatment protocol we can all follow. 👇

You’ll find the full John Sarno Protocol behind the paywall. The more intricate, longform pieces are there, quietly waiting. Subscribe if that’s your pace.

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