Dr. Sarno's Treatment PlanThis is a featured page

Like all pages on TMS Wiki, this page has been written by TMS sufferers. It has not been reviewed by Dr. Sarno.

Introduction

Dr. Sarno's current treatment program for TMS sufferers is detailed on pages 134-183 of The Divided Mind. The structure of the program involves an individual consultation followed by a lecture, with the possibility of further group meetings and, in some cases, psychotherapy. First contact with Dr. Sarno will be a phone screening so he can determine if he believes the TMS program can work for them. One thing he asks is if you believe things going on in your life could be causing you pain. If he feels the patient can be helped, he schedules an appointment.

Consultation

During the 45-minute consultation, Dr. Sarno will gather information about the patient's pain symptoms and medical history. The patient's psychological history is also discussed, since the circumstances of their life, including personality, stressors, and relationships, impact the diagnosis of TMS as a psychosomatic condition. A physical exam is also performed.

Lecture

Next, patients come together to attend a lecture, since understanding TMS is the key to overcoming it. The lecture reviews the recent history of musculoskeletal disorders with respect to psychosomatic epidemics. The main point is that physical abnormalities may not be the source of pain, as is commonly concluded by doctors. Also discussed are myriad other psychosomatic disorders, to show that TMS is just one of many that are already recognized.

The lecture then goes on to discuss the psychology of the disorder. One important note is that patients may condition themselves to feel the pain during certain physical activities, such as sitting or walking, and that these activities really have nothing to do with the pain. Furthermore, patients are advised not to fear the disorder, since there is no possibility of permanent damage as other doctors may have mistakenly informed them. Finally, the lecture discusses sources of unconscious anger and the role that psychosomatic pain plays in keeping that anger from coming to the surface.

After the lecture, patients continue to work on a study program for several weeks. The program involves rereading one of Dr. Sarno's books, with daily attention given to the chapters on psychology and treatment (especially pages 142-146 in The Divided Mind). Patients are instructed to list things that may contribute to their painful and threatening feelings, then write an essay about each of those things. These can be issues from childhood, current stressors, etc. Many patients report significant progress after following this regimen for three to four weeks.

Further Treatment

Patients who do not feel any progress may join a weekly group conducted by Dr. Sarno, or begin group or individual psychotherapy. The purpose of Dr. Sarno's group is to correct misconceptions about the program itself. For instance, a patient may want an instant cure for his pain without understanding that he needs a fundamental change in attitude; this patient would attend one of Dr. Sarno's meetings. Dr. Sarno also has a monthly forum where several patients share their personal experiences of pain and recovery with a group, which motivates others who continue to struggle.

The purpose of psychotherapy, recommended for approximately 20 percent of those in the program, is to make the patient more aware of their emotions, especially any defensive structures holding back unconscious anger. The process starts with a consultation to determine whether the patient would best fit into group or individual therapy.


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Latest page update: made by mizlorinj , Sep 30 2009, 7:17 PM EDT (about this update About This Update mizlorinj Edited by mizlorinj

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DrNord Dr Sarno's treatment plan 6 Sep 30 2009, 3:03 PM EDT by flutterby2
Thread started: Apr 16 2009, 11:17 PM EDT  Watch
This plan is very successful and interesting. I have personally had back pain for over 25 years. It started during my orthopedic residency. I read Dr Sarnos' "Healing Back Pain" in the early 80's. It made sense, sounded like me and I managed OK but far from normal. When I had back pain enough with a "herniate disc" to warrant surgery in 1997 I reconnected with his teachings. Soon came symptom imperatives Tennis elbow ( I play a lot, have a court at my house play local tournaments and never had TE before age 50 ) shoulder pain. neck pain,and allergies. I made a personal appointment with Dr Sarno in 2006 when I got stuck one morning with such severe Low back pain and sciatica that I was stuped over with on one leg in my pants and couldn't put the other on. I had to telephone my medical office on my cell from my closet and tell them i wasn't coming in. I read "The Divided Mind" which had just come out. I Called Dr S. Passed his phone screening and went in for the $$ appointment. Was diagnosed as the poster boy for TMS. Went to the lecture. Went back 2 weeks later for a Small group session which I affectionetley call "AA for back pain". Got basically cured. I then visited with him to observe him seeing other patients in his apprentice type teaching that he does. It all clicked. I began incorporating it in my life and my Practice. As an Orthopedic surgeon people come to me 90% of the time because they have pain. The other main reasons are deformity or loss of function. I still believe in severe true arthritis that I can help with a total joint replacement. Or busted up knees that have mechanical meniscal tears or ACL tears which I can fix or reconstruct. These get great results. However the diffuse pains, nonspecific, chronic neck and backs (with no proven pathology on workup except some bulging or even herniated discs) are perfect to treat with the TMS protocals.
The treatment plan details to follow
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DrNord Dr Sarnos Treatment plan 2 Apr 18 2009, 7:37 AM EDT by Peghanson
Thread started: Apr 16 2009, 11:50 PM EDT  Watch
Sorry got long winded like forest.
Treatment starts with a correct diagnosis. Major Key.
#1 A detailed History LISTENING to the patient ( most doctors will interrupt you the patient within 15 seconds, watch for yourself next time in). A detailed social history including family upbringing, relationships , parents , siblings etc. trying to unearth the subconscious stresses that occur .The doctor needs to learn how to ask the right questions. Many patients wont volunteer that they had "issues" some because it is in the subconscious don't recall them initially until probed beneath the surface. 90% of doctors don't do this for various reasons. A review of prior symptoms diagnosis , tests result xrays, MRI etc. medication taken now and prior (could be extensive, yesterday I had one patient on methadone for 2 years)
#2 then a detailed Physical exam of all body parts looking at gait stance balance, neurological tests reflexes and a musculoskeletal exam checking Range of motion strength and especially specific points of tenderness. Classic TMS trigger points are para spinal muscle low back, neck by the trapezius towards the should blade top and lateral thigh area called the trochanteric bursa or a little lower the ilio- tibial band. (very similar to Fibro so don't get confused).
after the history and PE you discuss the findings with the doctor and develope the plan. It is very standardized yet at the same time personalized. I tell patients it starts on Page 142 in the Divided Mind and you start writing. Buy a spiral binder or journal and begin you cure. Let it flow stream on consciousness writing no editing no spell correction just let it flow. It's cathartic in itself. This wiki has great info on journalling. Dr Schechter's workbook which I bought is very good and really walks you through a 30 day step by step process. If you need more hand holding and directions it is worth the $18 BIG TIME .

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