Mindfulness resources

There are traditionally trained physicians who believe that mindfulness is a form of neuromodulation and is the least invasive from of deep brain stimulation. Since there is not much profit in this approach, it is not utilized much here in the west. There are many books on the topic of mindfulness. Here are some that have recently been recommended to me:

• Nobel nominee, Vietnamese Buddhist monk, Thich Nhat Hanh.
• Will Johnson also has a great book on the Posture of Meditation.
• www.mindandlife.org
• TNH www.plumvillage.org
• Harvard's Mind Body medicine program, www.mbmi.org
• the growing field of non-invasive neuromodulation: TMS/tDCS
• Harvard’s CNBS (center for noninvasive brain stim)

If you find any of these resources to be helpful, or have already used them, please let me know!

Post by Dr. Howard Schubiner

I wanted to call attention to a comment posted by Dr. Schubiner. Here it is:

"I was referred to this blog by a friend who is interested in my work using Dr. Sarno's concepts. I have treated a young man with very severe spasmodic dystonia, not spasmodic dysphonia I realize, but related, I believe. Anyway, he had incredibly severe and frequently occurring symptoms. I have a 4 week program based on Dr. Sarno's concepts, but utilizing a variety of cutting edge techniques (including mindfulness meditation, and therapeutic writing exercises) to help people overcome syndromes such as this. If you're interested, please visit my web site: www.yourpainisreal.com or my blog: www.yourpainisreal.com/blog
Good luck, everyone.
Howard Schubiner, MDClinical Professor, Wayne State University, Detroit, MIFaculty Internist, Providence Hospital, Southfield, MI
June 11, 2008 5:07 PM"

I don't know Dr. Schubiner, but I applaud any attempts by practitioners of mainstream medicine who are open to alternative perspectives. It appears to me that Dr. Schubiner has integrated Dr. Sarno's approach into his medical practice. Be aware that he charges a fee to enroll in his program. If anyone with SD has or does enroll, please let us know how it went!

What progess are you making?

About a dozen people have contacted me since I posted about SD as a mind-body syndrome on the NSDA support bulletin board and then started this blog. So I was wondering what kind of progress anyone is making? It might be helpful to all of us to share.

And by way of reinforcement, last week, the NY Times had a front page article on the back pain epidemic in the U.S. that begins 'Americans are spending more money than ever to treat spine problems, but their backs are not getting any better' ... 'and that many popular treatments may be ineffective or overused.'

This is exactly as Dr. Sarno describes it in his books. As long as the medical community (and patients) continues to 'compartmentalize' the mind and body in their thinking and treatments, no one is getting better. So let this be a sign of encouragement that at least there is acknowlegement that something is not working here. For those of us who have/had SD, this is kind of like getting to the point where we acknowledge that no matter what we do, our voice is not getting better. Now it's time to break out of 'status quo' thinking and consider the possibility that the mind and body interact as one. When this happens, all sorts of new possibilities for healing will occur!

A new consciousness, a new earth

For those of you saturated with Dr. Sarno and ready to move to another level, I recommend picking up Oprah Winfrey's book club selection, Eckhart Tolle's, 'A New Earth, Awakening to Your Life's Purpose'. This book is not about healing pain per se, but rather about healing your life. Like Sarno, he makes reference to the 'Ego' but Eckhart's concept is that the essence of who we are is not defined by the 'Ego'. Our essence is our 'consciousness'...the observer to who can see the Ego within us at work, as it desparately trys to reinforce and sustain itself at the expense of ourselves and others.

This is some heavy thinking and consciousness 'shifting', so you might also want to sign up for the 10 week online class conducted by Oprah and Eckhart starting March 10. Just go to her website and sign up...then read the book in advance. I am going to be there!

From my perspective, here is what Eckhart's ideas has to do with SD...once again, it is about what we focus on (the constant internal dialogue) and how this impacts our emotions and our bodies. There was a time when I identified myself as a person with SD. This 'SD identity' defined who I was, how I interacted with people, decisions I made, etc. Every time my internal dialoge reinforced this SD identity, it reverberated throughout my body and 'like a ripple of water' throughout the universe. This self perpetuating story about who I am is generated by the Ego. But I am not my Ego. I am my consciousness and am aware of the Ego and what is going on.

OK...after re-reading this post I think it best to leave it for now and simply encourage you to read his book. He does a much better job explaining his concepts than I can. But I will post any insights I gain as I continue reading and attend the online class.

Recently in the news

Now that I view things through the lens of the 'mindbody' connection, I can see the futility of our current health care approach. For example, have you noticed the new ad for a drug to manage Fibromyalgia? Like 'Restless Leg Syndrome' (RLS) we have a condition that is of 'unknown' origin and cause where all of the research focuses on how to alleviate the symptoms. And as with most drugs, there is the heavy price of 'side effects'. One of the side effects for the RLS drug is 'having thoughts of gambling'. Jon Stewart on 'The Daily Show' joked that maybe it would be better to have a drug that cures gambling with the side effect of restless legs!

The medical establishment (and our general culture) is so biased away from any consideration of mind-body connection. And when people do talk about the possibility of a mind-body connection, they tend to 'simplify' it to mean 'mind over matter' or the idea that you can 'think' or 'rationalize' your way out of an illness. It is not quite that simple.

Sarno's treatment for these conditions is education. According to him, knowledge of how the mindbody interacts to create these symptoms is the cure. But as I have said before, it is not quite that simple. It is not enough to 'know' intellectually. You have to really accept his premise. For me, this took about 6 weeks or so for it to become so engrained that I no longer 'defaulted' to the 'old' way of thinking. And one of the things I continue to guard against is the temptation to obsess about my physical conditions. When I start to pay attention to my voice quality, I ask myself 'What would I be doing right now if I wasn't concerned about my voice?' And then I go do that!

How to experience the mindbody as integrated

In Sarno's latest book, The Divided Mind, he includes stories from some of his pyschotherapists. In one story, the therapist is seeking to help the patient experience the mindbody as integrated. This seems so elusive to me...so I have been pondering it in the hope of making progress along these lines. One thing this therapist listens for from his patients are defenses that protect the patient from feeling uncomfortable, painful emotions. Here are examples of some of those defenses:

1. After describing a painful event or emotion, the person chuckles as if to brush it off.
2. When describing painful events or emotions, the person uses buffer words or phrases (probably, maybe, sort of, etc.).
3. And again, when describing painful events or emotions, reverting to the third person. ('One would feel angry when such a thing happens')

First of all, I know that I have done and continue to do all three. Many times I put a humorous twist to emotionally wrenching stories. And I know I am full of buffer words. But here is what the therapist says he does when he hears such a defense. He gently stops the person and points it out...and allows the person to fully feel whatever emotion s/he was describing in the moment. It is at this moment, when the defenses are down and the person can feel fully that there is the possiblity of mindbody integration.

So I have started paying attention to my defenses and buffers. I started by rereading my journal and circling all of the buffer words. I also pay attention to my 'self talk'. I'm not perfect, but this is start in the right direction.

Where to find Sarno books/DVD

The website with Dr. Sarno's books and DVD can be found at: www.healingbackpain.com

Here are the books to read:

1. Healing Back Pain – The Mind-Body Connection

2. The Mindbody Prescription (I believe Sarno specifically mentions SD as an 'equivalent' in this book)

3. A more recent book, The Divided Mind is good too, but it is written for medical practitioners. I found it to be a good 'reinforcement'.

I suggest reading The Mindbody Prescription first and if it resonates for you, read one or both of his other books plus view the video. You don't have to read more than one book, but I found it helpful as a way to reinforce his concepts.

You can also order his books at Amazon.com, but the DVD is only available at his site. The DVD includes a workbook which you might find helpful too. Also note that you can get his lecture in VHS format for much less than the DVD.

Fluctuations of symptoms

Something important to keep in mind is that the symptoms (back pain or SD) will fluctuate over time. In other words, one day I would wake up with minimal pain or my voice would sound wonderful, and then the next day one or both would be worse! So don't be deterred by 'bad days'.

Use the symptom as a 'cue' to focus on the emotional and don't get caught up in the fluctuations. Know that over time, they will subside. Also know that this process is something that is a part of you and you will always be vulnerable to feeling these symptoms. I look at them as a 'gift' because they are signals to me to pay attention to my emotions.

Why is this diagnosis so difficult to accept?

In one of his books, Sarno states that only about 10 to 15% of people with a mind-body related disorder can actually accept this as the diagnosis. On the face of it, the diagnosis seems so simple and people should be glad to know there is a 'cure'. But there is a strong, deeply embedded need to believe that external factors cause pain or SD. External factors are out of our control...in other words, it's not my fault.

If we are to accept the mind-body diagnosis, then we have, in a sense, 'done it to ourselves'. But that conclusion would be a misperception of how the mind-body syndrome works. We don't make ourselves sick or disabled. Everything is happening in the unconscious and the symptoms are induced by the autonomic system...it's automatic and not under our conscious control. Yet, paradoxically, just having this knowledge and understanding of the mind-body process is enough to stop the symptoms!

Let me tell you a story about the difficulty of accepting this diagnosis. A few years back I went to an NSDA conference to hear Diane Rehm speak. While there, I connected with another woman who told me how SD had totally changed her life. She told me that she used to be a sales person under a lot of stress having to make sales calls and meet her quota. After she developed SD, she could no longer present herself in a confident enough manner to make sales calls. So she became a librarian.

As I listened to her story, I could hear that she hated her sales job and was really happy now as a librarian. At the same time, however, she felt guilty because you don't make as much money as a librarian. In a flash of insight, I saw that she 'needed' SD in order to make a life choice that otherwise she would not have been able to justify. It was more acceptable and less threatening to blame SD for having to make this choice.

I don't intend to be harsh and judgmental here...I'll be the first to acknowledge that I let SD be my excuse for doing or not doing a lot of things. But my point here is that 'blaming the symptoms' is no longer viable if one accepts that SD is a mind-body condition and that we can overcome it. If I overcome SD, what is my excuse for choosing not to speak up? For withdrawing from dialogue and interactions with others? Maybe the answers to those questions are harder to face than an injection of Botox.

Let me assure you...the answers to those questions are hard. I had and continue to come face to face with deep feelings of inferiority which result in a compulsive need to be competent (perfect) and 'right' all the time. I had and continue to manage the anger, rage, and defensiveness that threaten to boil over when I am challenged. But this is the path of adulthood, enlightenment and wisdom. And as the commercial for Strivectin states, it's 'Better than Botox'!

Some helpful tips!

Buying into Sarno's approach requires 'reprogramming' of how one thinks about illness, health, and the relationship between the mind and the body. There is no other way to put it. We have been and continue to be 'programmed' by the medical establishment and by everything around us. Just watch the commericals about 'Requip' for restless leg syndrome and the latest drug for fybromyalgia (both of which are probably 'equivalents' to use Sarno's term). We are bombarded constantly with images that promote a 'mechanical' view of our bodies with parts that need to be fixed. This mechanical view leads us to define depression as a chemical imbalance without asking what causes the chemical imbalance in the first place?

So here are some things that have helped me to really integrate and reinforce Sarno's approach into the way I think.

1. I did purchase his video which is a recording of his 2-hour lecture that he calls the 'treatment'. While it is not much more than him standing at a screen lecturing to a group of people with back pain...it is very effective in communicating and educating. If you are a visual learner, watching this video is a must.

2. I watched this video the first time in 30 minute 'chunks' while I was on the treadmill (killing 2 birds with one stone!). I also watch it again every few weeks or whenever I feel like I'm losing the 'heart' of what he is saying.

3. I downloaded three of his books onto my Sony e-Reader and I read some portion of one of these books every day. Yes...every day. Let's face it, the commercials on TV, the ads in newspapers, the way people talk to you about their illnesses...all of these tend to reinforce the 'mechanistic' way of thinking. Re-reading his book helps to keep perspective.

4. Writing this blog is another way to help me. It is an opportunity (and a challenge) for me translate what he is saying into my own words.

5. And finally, I journal everyday about emotional triggers. There is something about putting pen to paper that also has value.

Trying to verbally explain this to other people is also a good way to reinforce this learning. However, I haven't yet figured out how to explain it without people looking at me like I have lost my mind ... which is ironic since in reality, I have found my mind!

The post that gets no respect!

Following is the post that I put on the SD online support group bulletin board. While a lot of people have contacted me 'offline', everyone on the BB dismisses it.

Hi All,
This is a post for those of you who are open to the possibility that SD has a psychological facet. Here is my story. I was diagnosed with AD SD in 2002 (by a well known SD physician in NY) after struggling with a strangled voice since 1995. After the diagnosis I had several injections of Botox and while I found some relief, the loss of voice at the beginning and end of the 'bell curve' was more than I could handle given my profession (consultant and facilitator for Fortune 100 companies). I also saw how I was becoming obessesed with the condition (on the BB for hours, searching the web for alternatives, paying for and practicing relaxation, breathing, and vocal techniques for hours...)so I decided I would just live with it (hey, Diane Rehm and Robert Kennedy Jr can do it! Why not me?). In fact, I was inspired to make this shift after hearing Diane Rehm speak at the SD Symposium in Washington DC. She said 'You are not your voice'. I strongly disagreed at the time, but came to realize that I couldn't let this condition rule my life.

Shortly after I decided to 'just live with it', I developed severe carpal tunnel and then back and shoulder pain. In retrospect, I see how I simply shifted my obsession with my SD to these maladies in the exact same way (physical therapy, acupuncture, yoga, Alexander Technique, pilates, etc....). All of these approaches treat the symptoms. And I was never convinced that stress caused any of the symptoms (SD, Carpal tunnel, and back pain included). Like a lot of you, I could be on vacation, not working at the computer for days, or have a non stressful day and find my back in pain and my voice strangled.

In my quest for back pain relief, I came across a school of thought that suggests all of these 'symptoms' (SD included) can be psychosomatic. Not in the sense that it is all in your head...the pain and the strangled voice are indeed real! But in the same way our 'autonomic' brain sends adrenalin during a 'fight or flight' situation, so does the autonomic brain, when it senses a psychological threat (eg: situations that trigger emotions that threaten our very self image) send signals to diminish blood flow to muscles, tendons and nerves thereby causing these symptoms. This process is the 'minds' way of distracting and thereby protecing us from having to consciously deal with the unconscious emotions that have been triggered. The good news is that knowledge of this process and believing that the symptoms are psychosomatic is enough to end it. Sounds kind of weird...but no more weird than being told my strangled voice was a neurological problem (medicine speak for we don't know what causes it...but here, inject this Botox into your vocal cords and it will stop it temporarily).

I consider myself living proof that SD can be psychosomatic. I have no back pain and do not consider myself as having SD anymore. I would be happy to share more if anyone is interested.

Best regards and a Happy and Healthy New Year to all.

How long it took to overcome SD

Although it was really a 'process' not an 'event', I would say it took between 4 to 6 weeks for me to overcome SD. I initially started using Dr. Sarno's approach for back pain. So I wasn't really focused on my voice. My back pain started to melt away almost immediately...but there was still deep muscle soreness that eventually and slowly diminished a little each day. I would just notice that the pain was less and as it did I became more confident doing Yoga and other physical things. During this time I started to notice my voice would sound 'normal' for extended conversation. So I made the connection that SD was an equivalent for me as are my migraines and GERD.

I was and still am diligent in focusing on emotions when any of this physical stuff comes up for me (e.g. I pull out a sheet of paper and start writing about what things trigger rage for me). Let me point out here that over the years I have been to numerous doctors for all of my physical ailments and 'menopausal' symptoms. There is nothing wrong with me. Period. And I encourage anyone reading this to make sure beyond a shadow of a doubt that there is nothing wrong with you either before using Dr. Sarno's approach. He explains it much better than I can, so please read one of his books! Meanwhile, I can also include insomnia, night sweats, and carpal tunnel on my list of physical equivalents. All of these problems have and continue to get better. I wish this for you too!

Physical symptoms that can be emotionally induced

In the course of his medical experience, Dr. Sarno realized that TMS is not just limited to musculoskeletal manifestations. Following is a list of conditions which Dr. Sarno believes commonly serve the same purpose. They are conditions which, emotionally induced, can work as a distraction and can be cured through education and awareness. The very last item on this list is Spasmodic Dysphonia.

• Low back pain, diagnosed with one or more of the following: Sciatica, Osteoarthritis, Spinal stenosis, Herniated/bulging/degenerated lumbar disc, Scoliosis, Spondylolysthesis, Piriformis syndrome, Weak/inflexible torso or hip muscles, Spina bifida occulta, Spondylolysis, Transitional vertebra.
• Neck/shoulder pain, diagnosed with one or more of the following: Osteoarthritis, Pinched nerve, Herniated/bulging/degenerated cervical disc, Whiplash, Thoracic outlet syndrome, Weak/inflexible neck, shoulder girdle, or rotator cuff muscles, Rotator cuff tears, Bursitis, Tendonitis.
• Knee pain, diagnosed with one or more of the following: Tendonitis, Torn meniscus, Chondromalacia, Unstable patella, Muscular imbalances around the knee joint, Osteoarthritis
• Elbow pain, diagnosed with one or more of the following: Tennis elbow, Tendonitis, Muscular imbalances around the elbow joint, Osteoarthritis
• Foot/lower leg pain, diagnosed with one or more of the following: Tendonitis, Plantar fasciitis, Plantar metatarsalgia, Neuroma, Flat feet, Calcium deposit/heel spur, Shin splints, Muscular imbalances around the ankle or foot joints, Osteoarthritis
• Wrist/hand pain, diagnosed with one or more of the following: Carpal tunnel syndrome/repetitive stress injury, Tendonitis, Muscular imbalances around the wrist or hand joints, Osteoarthritis
• Nerve dysfunction, diagnosed with one or more of the following: Sciatica, Carpal tunnel syndrome/repetitive stress injury, Trigeminal neuralgia/tic douloureux, Bell's palsy
• Temporal mandibular joint syndrome (TMJ)
• Fibromyalgia
• Myofascial pain syndrome
• Tension myalgia
• Chronic pain
• Gastrointestinal disorders: Heartburn/acid reflux, Hiatus hernia, Gastritis, Ulcer, Nervous stomach, Spastic colon, Irritable bowel syndrome, Colitis
• Circulatory disorders: Tension headache, Migraine, Raynaud's phenomenon (excessively cold hands/feet)
• Genitourinary disorders: Frequent urination, Urinary tract infections, Prostatitis
• Cardiac disorders: Rapid pounding heartbeat (paroxysmal auricular tachycardia), Extra (ectopic) heartbeats
• Immune system disorders: Allergies, Asthma attacks, Frequent infections, Skin disorders, Epstein-Barr syndrome
• Psychological disorders: Depression, Anxiety, Panic attacks, Obsessive-compulsive disorder
• Miscellaneous disorders: Dizziness/vertigo, Tinnitus (ringing in the ears), Chronic fatigue syndrome, Laryngitis/spasmodic dysphonia

Summary of Dr. Sarno's approach

Copied below is some helpful information that I found on the web in a handout created by some students at Harvard and Radcliffe with Repetitive Strain Injuries (RSI). While the focus of this summary is on 'pain' or what he calls TMS (Tension Myositis Syndrome), the same principles apply to other physical manifestations that he calls 'equivalents' such as Spasmodic Dysphonia.

The basic premise of Dr. Sarno’s TMS diagnosis is that the unconscious fear and anger can actually induce physiological changes. Every single person on earth experiences unpleasant emotions such as fear, anger, guilt, anxiety, shame, sexuality conflicts, identity problems, and dependency needs. We all have a self-image that we try to protect. We all want to think of ourselves as intelligent, successful, independent, strong, likable, sexy, invincible, immortal, patient, loyal, loving, a good husband or wife, a good son or daughter, a good mother or father. When situations arise that seem to threaten that self-image, our minds do everything possible to keep us from having to face that threat. It's a built-in defense mechanism.

Your brain tries to shove any threatening emotions into your unconscious so you don't have to become aware of them. Most of the time, when the feelings aren't all that intense or threatening, your brain manages to keep them repressed. However, when the emotions are particularly strong, it's harder to keep them tucked away, so your brain needs to create a distraction. It creates real physiological changes in your body, which in turn create real symptoms. These symptoms are painful or distressing enough to take your attention away from the threatening, unacceptable feelings.

The emotions we’re talking about are unconscious. Lots of doctors and other health professionals say that stress can aggravate many medical conditions, but they're usually referring to conscious, perceived emotions such as getting a bad grade, having an argument with a close friend, losing a pet – obvious sources of stress. We're talking about the nasty, unconscious feelings that are simmering below the surface. These feelings are why even happy events like weddings and new jobs can cause the mindbody syndrome: seemingly happy events can often create pressure and fear (am I going to be a good husband, am I going to look fat in my wedding dress, am I going to be able to handle the responsibilities of my new job, etc.).

Dr. Sarno developed his theory as a result of working with patients suffering from back and joint pain. He noticed that a large majority of his patients had a previous history of tension-induced conditions such as heartburn, pre-ulcer symptoms, hiatus hernia, irritable bowel syndrome, colitis, spastic colon, tension headache, migraine, and eczema. Not all doctors agree that these disorders are emotionally-induced, but based on his own clinical observations at the time, Dr. Sarno felt confident that indeed they were. This correlation between back pain and tension-induced disorders, and the failure of conventional back pain treatments, led him to believe that back pain may be caused by emotional tension.

After noticing that heating pads, massage, and physical therapy (all of which increase circulation to the applied area) seemed to temporarily alleviate his patients’ pain, Sarno hypothesized that the real cause of the pain was a reduction of blood flow to the soft tissues in the affected area, initiated by emotional factors (his books go into greater detail as to how the limbic and autonomous nervous systems could be capable of producing such a change). In Sarno’s experience, although TMS is painful, it causes no permanent damage to the soft tissues involved. Once his patients understood and accepted the fact that they were suffering from a tension-induced disorder, their pain quickly went away and they were able to resume their activities without restriction.

To be perfectly clear: in this theory, the cause of pain is not the structural abnormalities (tendon or muscle tears, tissue inflammation, herniation, degeneration, decrepit muscles, etc) or behavioral “problems” (poor posture, a bad ergonomic setup, improper typing habits) typically identified by medical practitioners. None of them are responsible for the pain – none.

This is a tough idea for pain sufferers to swallow. People with these pain syndromes have usually been to at least one (and often several) practitioners and received structural diagnoses. However, Dr. Sarno contends that what is often diagnosed as tendonitis, bursitis, fasciitis, metatarsalgia, shin splints, tennis elbow, sciatica, carpal tunnel syndrome and so on is, in reality, just an area of soft tissues suffering from mild oxygen deprivation. Some people have structural abnormalities (such as herniated disks) which they think “prove” the structural diagnosis. You may have a structural abnormality – but abnormalities don't necessarily cause pain. Lots of people who have no pain at all have all kinds of structural irregularities. Lots of people who have excruciating pain have no structural irregularities.

How does your mind/body decide which physiological alterations to make in response to unacceptable emotions? You develop the symptoms that will work as the best distraction for you – the ones that you are least likely to attribute to emotional tension. As long as a patient believes that there is something "wrong" with their back or other joint, the pain will hang around. Why? Because it's still working as a distraction. It is still successfully keeping the focus away from the unpleasant emotions in the unconscious mind.

What I did to overcome SD

While the Botox did help my voice, the process of getting the injections began to outweigh the benefits. First, each injection was a serious disruption in my life, starting with coordinating the appointment (the Dr. has to have a 'group' of people to make it economically worthwhile for a vial of botox), the pain of the actual injection, the aftermath of the injection (nausea immediately following and no voice leading to a breathy voice for 3 to 4 weeks after the injection) and finally, it was treating the symptom not the cause...so I had to do it over and over again.

So around 2006, I decided to just live with the SD and put it out of my mind. I reminded myself that Robert Kennedy Jr. has untreated SD and continues to inspire groups through his public speaking. I didn’t let the SD distract me in anything I did. I stopped anticipating a bad voice and just plowed into whatever I needed to do (facilitate training programs, speak up in meetings, etc.) If anyone asked, I told them, and then changed the subject. During this time I even on occasion noticed that my voice sounded fine and people would tell me it sounded fine, but in the spirit of not being distracted, I didn’t dwell on it.

However, it was during this time period that I developed increasingly debilitating back, neck, shoulder and wrist pain. If you are familiar with Sarno's approach, you know that this is a classic response of the mindbody syndrome. If a physical malady ceases to provide distraction, then the mind will induce another malady! And so it did!

The back, neck, shoulder pain was getting worse and worse. Earlier in 2007, I said to my husband, ‘if this pain continues, I am going to eventually be disabled!’ Now I had heard of Dr. John Sarno years ago and while I believed his approach to healing back pain, I never connected it to SD. And quite frankly, I had forgotten all about his approach. But we were in the car (in NYC) when I said this to my husband and at about the same time, we turned the corner and there was the The Rusk Institute for Rehabilitative Medicine. And it just suddenly clicked… Sarno’s approach came back to me and I realized in that moment that everything happening to me was all a trick of my mind to keep me focused on the physical, not the emotional and boy was it working!

So here is what I did and continue to do:
1. Read and re-read everything he has written and watched his video lecture twice. I continue to do this. Every day I take time to read a couple of chapters or more from one of his books. All of this serves to ‘reinforce’ this new way of thinking about the process. It helps it to really ‘sink in’ instead of being an intellectual exercise.
2. I started a daily journal to record my emotional issues. All I can say about journaling is that it is a ‘must do’. There is something about the act of writing things out that really allows the ideas to sink in and for true understanding to occur.
3. Whenever I feel any sort of pain or something happening with my voice, I focus on my emotions…not the pain or my voice. I ask myself, what emotions have been coming up for me in the last 24 hours. Why? Where does it come from? And then I tell myself it’s OK to feel those emotions…that they won’t hurt me. Other times I lecture my mind saying, ‘OK, cut it out! I know what you are up to and it is not going to work. Whatever emotions are bubbling at the surface, I can handle. There is no need to distract me…in fact you will not distract me’. And then I think about the emotions.

Here are the things I write about:
1. What personality traits are causing my emotions right now (e.g. inferiority complex, narcissism, dependency)?
2. What unconscious, painful, threatening feelings do I have? What contributes to these feelings? Then I write an essay about each.
3. What are the sources of my feelings from a) my childhood/past, b) my personality traits, and c) life pressures?
4. What are the sources of my anger?
5. What events/people cause me to have an emotional response? Why?
6. What is my self-image (who do I want to be, how do I want people to describe or perceive me)? What unacceptable emotions threaten my self-image?
7. Free form rambling about whatever comes up for me!

Initially I spent a lot more time on this than I do now. I spend about 10 minutes a day re-reading selected portions of his books and another 10 minutes or so journaling. I squeeze it in when I have some down time (e.g. waiting for a plane, before I go to bed, while waiting for the dishwasher repair guy to appear!)

Believe me...it is that simple and it is that hard. Because you really have to believe in this diagnosis for it to work. You have to believe that there is nothing organically or structurally wrong with your back and voice. After visiting numorus doctors for both conditions, I knew there was nothing really wrong with me (e.g. I didn't have esophogeal cancer). I hope this story helps someone. There is no need to center your life around SD. Center it around something meaningful and life affirming...something that you enjoy and gives back to others.

Treating the Cause not the Symptoms

To continue with my story, I want to emphasize that Botox merely treats the symptoms of SD and does nothing to address the cause. All the other therapies I tried (Alexander Technique, acupuncture, voice therapy) focused on the symptoms too. There is nothing wrong with treating the symptoms. Sometimes that may be all you can do. In fact, Allergen who makes Botox would like all of us SD sufferers to believe that there is nothing else that can be done. They have no incentive to fund research or support discussion about other options.

So again, I encourage any one reading this post to educate yourself on the dynamics of mind-body syndromes. This is when the mind induces a physiologic response (throught the autonomic system) for psychologic reasons (which are at the unconcious level). The gold-standard for explaining these dynamics are the books by Dr. John Sarno.

In my next post, I'll explain how I used his approach...