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Discussion: A common physiology?
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ForestForTreesTMS |
A common physiology?
Nov 12 2009, 9:01 PM EST
I just found a very interesting post in another thread, but I'm worried that that post might change the topic of the original thread. I think that it is important to keep that thread on topic and to have the new discussion, so I'm starting this thread for the new discussion.Here's a link to the original thread: http://tmswiki.wetpaint.com/thread/3370924/Another+syndrome+name In that thread, Dave.Clarke wrote: "By the way, Dr Sarno claimed that muscles and nerves were deprived of oxygen in TMS but there is no evidence to support this (and no evidence of myoneuritis) which caused most health care professionals to dismiss even the good parts of his work. This is why Dr Sarno no longer uses the TMS term (he now calls it Psychophysiologic Disorder)." TordH responded: "No oxygen deprivation, no myoneuritis... So what is the common physiology of these conditions then? Best regards, Tord" What do you all think? I'll add my thoughts in another post. 1 out of 1 found this valuable. Do you?
Keyword tags:
Dr. Sarno
oxygen deprivation
RSI
success stories
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ForestForTreesTMS |
1. RE: A common physiology?
Nov 12 2009, 9:54 PM EST
"No oxygen deprivation, no myoneuritis... So what is the common physiology of these conditions then?Yeah, I think that Dr. Schubiner is also skeptical of the oxygen deprivation theory. Having talked with him about TMS a number of times, I definitely get the impression that he is someone who cares an awful lot about science, so I tend to trust his skepticism. The fact that he is on the editorial board of 2 academic journals and has over 60 scholarly publication only confirms the impression. When I think about why I believe in TMS, the two things which has always been the most convincing thing to me are the success stories that people have written and the clinical experience of experts like Dr Sarno and Dr. Clarke who have been brave enough to buck medical orthodoxy and take the time to be true healers, recognizing that mind and body are connected. Reading success stories that people diagnosed with RSI had posted online (including HilaryN's, I think!) gave me a huge amount of faith that I could heal. I'm a huge skeptic by nature and believe that people are terrible observers of themselves. However, the transformations that people described were not anything that could be explained by biases in observation. I encourage anyone reading this to track down success stories of people whose symptoms and diagnoses are similar to their own; read those success stories; and then draw their own conclusions. Likewise, both Dr. Clarke and Dr. Sarno have literally seen thousands of patients, so when they say that this methodology works, I would really tend to believe them. On the other hand, my experience and the experience of other people whose lives have been transformed by these diagnoses don't tell me anything (in my opinion) about the underlying physiology. (continued...) Do you find this valuable? |
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ForestForTreesTMS |
2. RE: A common physiology?
Nov 12 2009, 10:19 PM EST
"(continued...)"I can't look at my hands and figure out why the pain levels don't go up like they used to. All I know is that it happened. Likewise, as far as I can tell, science just hasn't given a definitive answer regarding the physiology of TMS. As Dr. Sarno wrote in Divided Mind, "One of the dirty little secrets of the medical community is that clinical medicine is clearly not always as scientific as many would like to think." My impression is that the more we learn about biology and medicine, the more we learn how little we already know. I have to admit that I've always been a little uncomfortable about Dr. Sarno's treatment of oxygen deprivation. I've simply never felt like he offered very much evidence to support the theory. For example, I just went through every mention of oxygen deprivation in his most recent book (using the index), and only found one reference to a piece of published evidence in support of the oxygen deprivation theory. I probably missed something, but I found it quite disappointing. And, to be honest, I don't find that one reference to two papers to be that convincing. You can find 2 published research papers that will support just about any crazy position you want to take (research is my job; trust me on this... :-) ). 2 research papers really aren't enough to mean very much. You really need a larger collection of evidence before you can really be convinced. Hence, when I hear that Dr. Clarke and Dr. Schubiner are skeptical of that part of the theory, I'm skeptical too. I think that the only responsible thing is to say that we simply don't know. The bottom line is that these are very complicated biological systems and we just don't know much about them at this point. (continued...) Do you find this valuable? |
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ForestForTreesTMS |
3. RE: A common physiology?
Nov 12 2009, 10:28 PM EST
| Post edited: Nov 12 2009, 10:30 PM EST
"(continued...)"But the bottom line, for me, is that I just don't care. I've been working on my computer for over five hours now, with only a couple short breaks for snacks or thinking. In past years, I could only have worked on a computer for a couple of minutes at time. I'm starting to take up sports again and I simply feel free. My life is *so* *different* *now*. ...So I don't really care what the physiology is. All I know is that I've read enough stories to believe that Dr. Sarno's books (and presumably books by other authors) transform lives. It's just my personal belief and I might be wrong, but it is what I believe. Sharing that belief was the reason that I started the wiki. In 200 years, we'll probably understand TMS completely. However, in the mean time, people are suffering, so just knowing that it works is enough for me. Do you find this valuable? |
flutterby2 |
4. RE: A common physiology?
Nov 13 2009, 4:52 AM EST
| Post edited: Nov 13 2009, 8:55 AM EST
Forest, it is great that for many people, like yourself, anecdotal evidence is sufficient to free them from their symptoms. But maybe more people would be convinced, and therefore benefit, if they could understand the physiology behind their suffering? I haven't read the book but maybe Candace Pert's 'Molecules of Emotion' has some answers. Maybe someone who has read it could jump in here? I also wonder what explanation is given in 'Back Sense' (mentioned in another thread). Do you find this valuable? |
pandamonium09 |
5. RE: A common physiology?
Nov 13 2009, 7:28 AM EST
"But the bottom line, for me, is that I just don't care. "Forest, you sum up exactly how I feel. Sometimes I feel a little bit of an oustider on this forum and on tmshelp.com, because I'm too simple. I believed what Sarno wrote, ok, maybe I wasn't 100% convinced of the oxygen deprivation stuff, but it didn't matter. I fitted his profile to a tee I was afraid, he showed me I had nothing to fear I was conditioned, he showed me how, and what to do about it. I wasn't expressing my emotions, he made me see that. It was enough I don't spend hours wondering about "what to do or what am I doing WRONG?" or "whether there is a physical sub-component STILL?" or "what is the EXACT physiology of my pain?". I accepted the diagnosis on the simplest terms, and my life improved beyond my wildest dreams. I'm not trying to be perfect any more, I'm living in the now, and I feel great. Do you find this valuable? |
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Noraloui |
6. RE: A common physiology?
Nov 13 2009, 8:36 AM EST
I just finished reading Who Switched Off My Brain by Dr. Leaf. She gives a rather lengthy explanation as to how "toxic" thoughts affect all of the bodily systems. She does attempt to try to make it easy to understand even if biology is not your strong suit. But, I, like others am really not that interested in that aspect. I believe strongly in a mind body connection and that is sufficient for me. I'm trying not to try too hard.
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flutterby2 |
7. RE: A common physiology?
Nov 13 2009, 8:54 AM EST
For those who DO need a physiological explanation to be convinced - and I think it is vital for some people! - here is the transcript of an interview with Candace Pert in which she explains her theory:http://primal-page.com/pert.htm The interview was conducted some years ago now and I don't know whether there has been any follow-up research but in the meantime but would be interesting to know whether other TMS 'experts' would agree with her? 1 out of 1 found this valuable. Do you? |
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pandamonium09 |
8. RE: A common physiology?
Nov 13 2009, 3:37 PM EST
That interview is a great find Flutterby, well done.I loved Molecules of Emotion on so many levels, it's a great read. Do you find this valuable? |
MatthewNJ |
9. RE: A common physiology?
Nov 13 2009, 5:18 PM EST
I am not sure if there is a common physiology? Does there need to be one? Could there be more than one? I have read Dr. Sarno's works and I am his patient. I have listened to an interview with Dr. Schubiner and he takes a different approach to the physiology. I have read Dr. Candice Pert (both the interview above) and the book "Molecules of Emotion". She takes a different approach to the physiology. For me, what comes down to is that I continue to read whatever I can find, and follow the paths that work. Regardless of the actual physiology (and I think this will be argued for many , many years to come) I have found relief with my current methodology which is endorsed by both Dr. Sarno and Dr. Schubiner (and I think it still fits under Dr. Pert's ideas) and that is being mindful and living in the moment. Do you find this valuable? |
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flutterby2 |
10. RE: A common physiology?
Nov 13 2009, 6:24 PM EST
I think an important reason for establishing the physiological cause of the symptoms is, as Dave Clarke said on another thread, that some (he says 'most') health professionals will dismiss the whole idea of TMS (or whatever we call it!) as long as there is no solid evidence of what is happening to cause the symptoms. Anecdotal evidence, even circumstantial evidence is not enough for many people - and it is then all too easy for them to 'throw the baby out with the bath water'!I also think that when people are faltering in their progress it is often because they begin to wonder whether there actually is a structural/physical cause and telling them they must believe there isn't doesn't help if we can't explain what is really going on. I, personally, would feel very uncomfortable promoting questionable science. Do you find this valuable? |
Dave.Clarke |
11. RE: A common physiology?
Nov 14 2009, 3:41 PM EST
| Post edited: Nov 14 2009, 3:42 PM EST
Wow, good thing Forest set up a thread for this topic, it certainly attracted a lot of posts. I appreciate the care taken in assessing this important issue.Dr Schubiner, Dr Schechter, myself and others take care not to overstep the bounds of what is scientifically documented. This approach is essential if we are ever to gain broad acceptance for what I refer to as the 8-word mantra: Stress Causes Real Symptoms, Effective Treatment Is Available. Stress-related symptoms are not imagined and therefore they must result from a physiologic process. This process, and there may be more than one, is not fully understood but inflammation does not appear to be involved and, again, there is no consistent evidence for oxygen deprivation. Intriguing clues are emerging from fMRI imaging of the brain that the cause may be increased sensitivity to pain in the brain. One study showed that pain signals from the bowel travel up to one set of brain circuits if you grew up in a healthy home but use a different set of circuits if you grew up in an abusive home. The adults abused as children are more sensitive to these pain signals. For me there is no question that physical symptoms that improve in response to stress reduction developed due to a physiologic process and improve due to changes in that process. To gain acceptance by the medical profession we should insist on evidence before making any claims about physiology while simultaneously pointing out that we already know how to help people with this condition, even without fully understanding it. By the way, for those interested, I have started a blog called The Stress Check-Up on www.stressillness.com. 2 out of 2 found this valuable. Do you? |
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MatthewNJ |
12. RE: A common physiology?
Nov 14 2009, 5:26 PM EST
| Post edited: Nov 14 2009, 5:31 PM EST
Flutterby,While I agree with you that a known physiological cause helps many folks accept TMS, we are currently stuck without that "definition". I know that when I had my most recent relapse, I saw a physical medicine doc who did an MRI. He wanted to do all kinds of treatments. I called Dr. Sarno and he looked at the MRI report. He compared it to the one 4 years ago, claimed it "unchanged" and said "Matt, you still have TMS, you have more work to do" (eg: with Dr. Evans). This confirmation of TMS (regardless of physiological cause) helped me immensly in not going back down the physical path. So I am completely sympathetic to you any many others who need a "cause" for acceptance. And remember, this physical med doc I mentioned above would loose about 90 % of his business if the mindbody connection was totally accepted by the medical community. Also the drug companies and most of the orthopedists, etc. So even as we get more and more data to prove our case, there is a MAJOR denial factor on the part of the medical community because it means that most of them would have to go back to school and get counseling degrees. Also, denial plays a role in non acceptance for the patient as well. So This is what we do have: -1- What David said "….while simultaneously pointing out that we already know how to help people with this condition, even without fully understanding it" -2- Dr. Sarno does provide a method of diagnosing TMS (regardless of discussing the physiological cause). So If you have a practitioner who is at least open to the mindbody connection, he/she simple needs to read the section in Dr. Sarno’s MBP. I am glad I am where I am with TMS. That is where I think the success stories come in. This allows people to see others have succeeded. And Everything we do is non invassive, so we are doing no harm, as the Hippocratic oath says. Do you find this valuable? |
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ForestForTreesTMS |
13. RE: A common physiology?
Nov 14 2009, 6:24 PM EST
"Pandamonium wrote:Hi Panda, It sounds like you are a natural for the Mindfulness stuff. :-) Perhaps the reason why you don't spend hours worrying about it is that a laid back approach just came naturally to you. More power to you! Do you find this valuable? |
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ForestForTreesTMS |
14. RE: A common physiology?
Nov 14 2009, 6:52 PM EST
"Flutterby wrote:Hi Flutterby, I am sure that every single TMS physician agrees with you completely that it would be incredibly helpful in convincing the medical establishment about TMS if we better understood it's physiology. I'm sure that they all agree that there should be more research done into the physiological basis, so that we figure that basis out sooner rather than later. What do we do now, though? The bottom line is that it appears that we don't have such a basis. At this point, scientists *just* *don't* *know* how it works, except in the most broad terms. I think that good science is careful science. It doesn't pretend to know things that it doesn't know. For example, I love reading Dr. Clarke's posts. His definition of what is now called TMS is so incredibly *humble* from a scientific perspective. I would paraphrase it as, "we can't find anything physical wrong, but the patient gets better when we identify and treat their stress." There is no fancy scientific terminology in there, nor is there any reference to fancy diagnostic tests. He isn't pretending to know more than we actually know. Rather, he starts with what he does know: (continued) Do you find this valuable? |
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flutterby2 |
15. RE: A common physiology?
Nov 14 2009, 6:55 PM EST
Matthew - I'd just like to comment on a couple of the points you made.You mention the doctor losing 90% of his business if the mindbody connection was totally accepted. As far as I understand it, this wouldn't be the case in the UK as the system of remuneration for GPs (family doctors?) is different. They are paid according to how many patients they have on their lists, regardless of whether they ever visit their surgery or not. So, in theory at least, they would be motivated to do whatever it takes to keep their patients well as they'd then have less work for the same remuneration. But the more important point that I think we should address is that people are different. While some people benefit from hearing/reading about success stories, and they can be a great motivator to get people interested in investigating whether stress may be causing their symptoms, there are others who get frustrated and depressed when they hear of other people's 'cures' if they don't seem to be making progress themselves. So they try even harder and put themselves under even more pressure, which is counterproductive, as we have seen on another thread. 1 out of 1 found this valuable. Do you? |
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flutterby2 |
16. RE: A common physiology?
Nov 14 2009, 7:00 PM EST
| Post edited: Nov 15 2009, 4:42 AM EST
Dave, the 'clues' you mention that are emerging from brain imaging are certainly intriguing! I think I read something similar recently but seem to have lost the link. Could you, by any chance, point us in the direction of anything on this subject, possibly to add to the 'research' page? And does it tie in at all to Candace Pert's theory?
Do you find this valuable?
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ForestForTreesTMS |
17. RE: A common physiology?
Nov 14 2009, 7:14 PM EST
(continued)having treated about 8000 patients whose physical symptoms had no medical explanation, he knows that some patients for whom no organic problems have been identified get better when their stress is identified as the cause of their symptoms and then treated. In comparison, I think that questionable science is pretending to know more than we actually know--pretending that we understand a common physiological basis when indeed we don't. Again, I think that there is 100% agreement that more research is needed about a physiological basis. But what should a doctor do when she sees a patient who fits this profile? Should she just let the patient suffer because the physiological basis of TMS isn't adequately understood? No, she applies a therapy that seems to have worked in the past. I think that most doctors are very aware of this. My bet is that science doesn't adequately understand most medical conditions that doctors are faced with. For example, I think that good doctors know that we don't adequately understand the physiological basis of Alzheimer's, fibromyalgia, chronic fatigue syndrome, Parkinson's, autism, depression, or bipolar. Does this just mean that we don't treat these patients? No, we apply treatments that are known to work, and barely even stop to think about how well the conditions are understood. Given this, I think that the type of research that will speed up the acceptance of TMS the most does not cover physiological basis, but rather the effectiveness of the treatment approach that we advocate. This research is happening, but it is happening slowly, because there isn't much funding yet and because it can be dangerous to research a condition that is outside of the medical mainstream. My bet, also, is that TMS is simply difficult to research, but that's another post. :-) Do you find this valuable? |
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flutterby2 |
18. RE: A common physiology?
Nov 14 2009, 8:02 PM EST
There is quite a lot of interesting information in this article on the 'psychology of pain', though I doubt whether much of it will be new to TMSers -http://bja.oxfordjournals.org/cgi/content/full/87/1/144 There's an interesting passage about chronic pain and depression from the 'chicken and egg' point of view. And this paragraph refers to the negative effects of not knowing what is causing the pain: "Making sense of the pain People are intrinsically motivated to make sense of experience. Except in extreme cases of depression or in specific circumstances of prolonged restriction or incarceration, people are motivated to reach an understanding of personal events. Until a pain is understood within a system of knowledge, it will interrupt current thinking and promote worry and concern. Knowing what has caused a pain and what it may mean and does not mean is critical for effective coping. Those patients who are most difficult to help are those who repeatedly present with problems that have no known aetiology. Not knowing compounds distress and an uncertain diagnosis leads to an increased belief in illness." I realise that 'TMS' is a 'diagnosis' but as it is now acknowledged that there is no evidence to support Dr Sarno's theories about the causes, even though his treatment works for some people, I believe that a far greater number of people could be helped if there were greater understanding of the physiology - and if a a new, more accurate name were adopted! 1 out of 1 found this valuable. Do you? |
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Dave.Clarke |
19. RE: A common physiology?
Nov 15 2009, 5:40 PM EST
"Dave, the 'clues' you mention that are emerging from brain imaging are certainly intriguing! I think I read something similar recently but seem to have lost the link. Could you, by any chance, point us in the direction of anything on this subject, possibly to add to the 'research' page? And does it tie in at all to Candace Pert's theory?"I don't have the reference for the brain imaging study, sorry. Also, I'm not familiar enough with Dr Pert's work to comment fully on its validity. However, what I have read from Dr Pert seems mostly self-promotion as a "new age diva" and her advocacy of T-peptide therapy for HIV has never gained scientific acceptance so I would approach her work with extreme caution. I do agree with you that better understanding of Somatic Stress Disorder physiology (and there definitely is a physiology), would help clinicians to accept the whole concept, would support patients self-image as strong people coping with a medical problem and would lead to better treatments. Do you find this valuable? |
