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Title: The Nature Of Reality: Exploding The Mind Body Spirit Myth
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Item Number: 9781450555326
Number: 1
Product Description: Full Name: The Nature Of Reality: Exploding The Mind Body Spirit Myth; Short Name:The Nature Of Reality
Universal Product Code (UPC): 9781450555326
WonderClub Stock Keeping Unit (WSKU): 9781450555326
Rating: 5/5 based on 2 Reviews
Image Location: https://wonderclub.com/images/covers/53/26/9781450555326.jpg
Weight: 0.200 kg (0.44 lbs)
Width: 0.000 cm (0.00 inches)
Heigh : 0.000 cm (0.00 inches)
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Date Added: August 25, 2020, Added By: Ross
Date Last Edited: August 25, 2020, Edited By: Ross
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$99.99 | Digital |
| WonderClub (9294 total ratings) |
Anton Siluianov
reviewed The Nature Of Reality: Exploding The Mind Body Spirit Myth on April 10, 2014The premise of this book is all right there in the title. There is a mind-body connection and recognizing it you can heal your back pain. At it's core I believe this premise. Unfortunately I did not like this book for a variety of reasons. As has been stated in other reviews, it is repetitive and doesn't actually explain the process of healing. The author is dismissive of others and arrogant. The research cited is old. I read the 2016 reprint of the 1991 version of this book. I think the only thing newer than 1991 in this version is the preface, the chapters themselves seem unchanged.
I am going to break down my impression of the book for you chapter by chapter.
1. The Manifestation of TMS
Sarno uses the term Tension Myositis Syndrome (TMS) to describe the compilation of painful symptoms that he believes are a result of emotional situations. This chapter describes those symptoms, which can be anything, and their onset, which can be acute or slow-onset. He also proposes that these symptoms are related to specific emotional situations and can occur during or after these situations. He explains that TMS is characterized by recurrent acute attacks, by limited activity due to fear, and by fear of never getting better.
2. The Psychology of TMS
Sarno believes that stressors cause tension which is really "repressed, unacceptable emotions" (p35) which then cause physical symptoms. Despite not being a psychologist, he throws around a lot of diagnostic terminology and Freud. But the take-home from this chapter is that your back pain is probably due to repressed anger, because the mind would rather deal with physical symptoms than unpleasant emotions.
3. The Physiology of TMS
This chapter explains Sarno's hypothesis that TMS is due to poor oxygenation due to an autonomic nervous system response to a psychological need. This chapter is the first place he dismisses the role of inflammation in back pain. (Even though he used the suffix -"itis" which literally means inflammation when naming this syndrome.) But don't worry too much about this chapter, "focusing on the physiology and symptomatology of TMS is actually counterproductive, tending to perpetuate rather than alleviate the problem." (p82)
4. The Treatment of TMS
Finally, yes, what we are all waiting for. This is why we started reading this book in the first place. He explains that this pain exists to distract the brain from the repressed unpleasant emotions. The treatment is two-fold. First understand what is going on, acquire information, "the information provided is the "penicillin" for the disorder" (p84). Second, act on this information to change the brain's behavior. These actions include a. Thinking psychological. When your back hurts think about an emotion that you are repressing. b. Talk to your brain. Tell it to quit repressing that emotion. c. Resume physical activity. In the next chapter he explains that most of the abnormalities that might be seen on imaging, possibly aren't causing any symptoms. But a more striking argument I think is that a lot of people without symptoms might have the same physical abnormalities. (Of course, be cautious here. I believe there are plenty of physical reasons that folks should limit physical activity.) d. Discontinue all physical treatment. This must be done to fully convince your brain that the pain is emotional and not physical. Oh, and on page 101 he mentions about 5% of people might need psychotherapy to deal with all these repressed emotions.
Up until now, I was on board with the book. I have had back pain for a year and a half. I have done six months of physical therapy and three months of chiropractic posture adjustments. I have had lab work and imaging. I have changed my exercise routine and tried massage and acupuncture. The last two years have been the most stressful of my life and I am sure that I am repressing some emotions about that. Sure, I can even trace back some specific situations around the time the back pain began and intensified. I began to lose faith though after reading about the treatment. I wish there were more details. Does he really mean, ignore the pain and acknowledge the emotions. That's it!?
But the dismissive arrogance of the next two chapters is what really turned the tide for me.
5. The Traditional (Conventional) Diagnosis
This chapter was very frustrating to read. He went through common back pain diagnoses and dismissed them one at a time. "Most disc herniations are harmless" (p 120). Of pinched nerves, "to attribute symptoms to a physical abnormality is a sad diagnostic error" (p128). Of arthritis, "I have not found that this is pathological" (p129). Of spondylolysis, "rarely responsible for back pain in my experience" (p129). And on and on. Every (conventional) diagnosis is dismissed as not causing symptoms in his experience. He again dismisses inflammation as important in back pain. He cites only the definition of acute inflammation "an autonomic reaction to disease or injury" (p140) and denies that TMS is either of those things, completely disregarding all the possible causes of chronic inflammation that could relate to back pain.
6. The Traditional (Conventional) Treatment
This was another frustrating chapter to read. First he says "therapeutic eclectism is a sign of diagnostic incompetence" (p142) meaning that because there are many different treatment options for back pain (surgery, medication, manipulation, acupuncture, massage, etc), and because one size doesn't fit all, obviously these treatments must all be wrong. He doesn't acknowledge that different treatments work for different people for a multitude of reasons: different anatomy, different physiology, different medical and injury histories, different approaches to health care, different expectations, etc. He describes the placebo response as one that only works for a short time. And then he lists many different (conventional) treatment options and says they only work because of the placebo effect. "When someone reports feeling better... (of resting an injured part), I think placebo" (p145). "Surgery may sometimes produce a desirable result because of the placebo effect" (p148). Muscle strengthening: "placebo effect" (p149). Manipulation: "On occasion, dramatic relief of pain follows a manipulation, suggesting that the person is having a good placebo response" (p147). He completely misrepresents acupuncture, describing it as similar to a nerve block (p145) which might treat pain but not the cause. He also misrepresents meditation, relaxation and biofeedback, saying there is "considerable fuzziness about this subject", despite the entire premise of his syndrome is the presence of stressors. For the third time he dismisses inflammation as playing a role in chronic back pain.
7. Mind and Body
Well, this book continues to be frustrating to read. Two of the chapter subheadings use the word "current" despite, as I previously mentioned, that the information is 25 years old. But the laugh out loud moment is found here. After dismissing every (conventional) treatment as a placebo effect, on page 170 he has the audacity to say "The best evidence of the validity of this concept is the fact that patients are able to stop the process simply by learning about it.... Many people have reported resolution of their back pain syndromes after reading my first book, making it quite clear that they were "cured" by the acquired information. This could not be a placebo." First of all "best evidence" but not evidence-based, since all of the data in this books seems to come from follow-up surveys with his own patients. Secondly, I don't even know how to describe how ridiculous it is to believe that being cured of a syndrome through acquisition of information couldn't possibly be a placebo!?
In the next edition, I would like to see the research significantly updated. We've come a long way since 1984 (first ed) and 1991 (second ed) in our understanding of the mind-body connection and this outdated book should not be taking any credit for those advances. I would like the racism on page 68 removed. (He cites a doctor who said in 1988 that Africans don't get back pain because they don't "seem to generate anxiety as we do. Entirely logical.") I would also like the inherently misogynistic discussion of hysterical symptoms that starts on page 170 to be removed. In fact, I think the whole premise of the book that the pain is all in our head, is a dangerous concept that has historically been used to disadvantage people.
In conclusion: Since starting this book, the back pain that has been bothering me for the past year has much improved.
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