Excerpt
Mind Your Body
My trip into the fire began young. At nineteen years old, I lay on the orthopedic surgeon's table in mind-numbing pain and fear. The X-ray glowed on the screen while my mother wrung her hands beside me. We were awaiting a second opinion to explain my symptoms. My parents had taken me home from college a week before final exams when excruciating lower back pain prevented me from even walking to the bathroom, much less finishing my semester.
"I'm in agreement," the doctor said. "The diagnosis is spondylolisthesis, a degenerative condition of the lower spine. To avoid being in a wheelchair by forty, you will need to immediately stop several activities and accept certain realities. We will have to reevaluate what exercise looks like, and you certainly won't be rollerblading."
Rollerblading was a daily form of transportation that was integral to my joy and mental wellness. It was the nineties, after all. At that moment, his words directly called into question my entire sense of identity as strong, fit, and free to do as I pleased.
He went on. "It's ill-advised to lift anything over twenty pounds or ride in a car for more than an hour. You'll have to sleep in very specific positions to avoid pain and stabilize your back. Travel of any kind will need to be carefully considered from a risk/benefit analysis. Most importantly, you should come to terms with the fact that it's unlikely you will carry a biological child. The weight of the baby could strain your back to the point of irreparable harm." This last piece of news was too much to process. A life without the vibrant family I'd envisioned? Was that any life at all?
Based on what he saw on my films, the doctor explained that spinal fusion surgery was the standard protocol. But since I was young and otherwise healthy, it could wait. If I was willing to follow the strict guidelines for sleeping, travel, and exercise, I could put off the surgery as long as possible. Recovery would entail weeks of downtime and decreased mobility for life. Awash in the overwhelm of this dark prognosis, I felt that only the present seemed real. Yet what mattered most in that moment was not being addressed.
"Will the surgery eliminate my pain?" I asked in desperation. The tenor of the doctor's energy shifted as he explained that the surgery carried no guarantee of pain cessation.
For the first time in my life I realized that though they were well-versed in reading films and reporting results-and certainly wanted to help-the doctors didn't have solutions for what was most urgent: curing my pain. This was an inflection point for me. A quiet skepticism of their power to fix me, paired with the unimaginable vision of the future they were painting, became the seeds that would later grow into my desire to understand human pain more deeply. I needed to believe that there was a better way. I had no choice but to turn my attention to finding it.
Fast-forward thirty years: I am fifty-two years old, a mother of three almost-adults, and a barefoot beach runner. I travel the world, drive cross-country regularly to take my kids back and forth to college, and sleep any way I please. It turns out that this doctor, along with the many others who conferred over my diagnostic tests, was wrong. They saw an abnormality on a film and assumed, however understandably, that the finding was the cause of my pain. It was not.
First driven by desperation, then fueled by curiosity, I began a surprising and ultimately rewarding journey to discover all I could about the nature, cause, and treatment of pain and chronic suffering. It started with earning my undergraduate degree in psychology, followed by a master's in clinical social work, and culminated in the practice of Mindbody medicine in association with Dr. John Sarno's office at the Rusk Center for Rehabilitation/NYU Langone Medical Center. For over twenty years, I have been guiding people once mired in seemingly endless chronic pain, conditions, illness, and anxiety to total freedom through my private practice, podcast, retreats, and online offerings.
Pain Seen Through a New LensFor those who might not be familiar with Dr. Sarno, he was a pioneer in Mindbody medicine, a paradigm that questions long-held assumptions of the medical establishment. Simply defined, Mindbody medicine recognizes the influence that our stored trauma and repressed emotions have on the brain science behind bodily health. When an individual is experiencing a physical illness-particularly a chronic one-the Mindbody approach looks at the issue through a wider lens, seeking to understand how our physical, mental, and emotional systems are working together to keep us safe and alive.
Dr. Sarno's model challenged the traditional Western view that pain or discomfort is directly correlated with the affected part of the body and should be treated as such. His remarkable scientific work uncovered that real physical symptoms, including chronic pain and anxiety, gastrointestinal issues, autoimmune flares, and even dermatological problems, were not always tied to pathology or structural abnormalities in the body. Rather, unprocessed trauma, psychosocial stressors, and repressed emotions, over time, could build up and trigger the brain to send signals of illness or the sensation of injury. He referred to this condition as tension myoneural syndrome (TMS)-and discussed its impact in his groundbreaking 1984 book,
Mind over Back Pain: A Radically New Approach to the Diagnosis and Treatment of Back Pain.
Sarno defined TMS as the process that is activated when acute symptoms like tension headaches or strained muscles morph into a chronic condition or diagnosis. In the Mindbody community, you will often hear people refer to themselves as "TMSers" or exclaim, "My TMS is acting up today!" The acronym is an umbrella term under which myriad chronic conditions reside. It includes muscular pain/spasm/inflammation of all kinds, chronic anxiety, long COVID, panic disorders, IBS, sciatica, psoriasis, pelvic pain, fibromyalgia, migraines, skin disorders, the symptoms of autoimmune disease, and many, many more. This is far from an exhaustive list-which is why, as I mentioned in the Author's Note, I will often simply refer to chronic pain or chronic conditions in our discussions. As you'll learn, it doesn't necessarily matter what specific symptoms you may be battling. The key is to understand that just as we look to the body when trying to explain why you are experiencing these sensations, we must also look to the brain science behind them.
Dr. Sarno posited a much broader explanation of the genesis of pain and other chronic symptoms. Instead of a direct link between the aching body part and a related physical origin or abnormality, he suggested that a person's psychological processes and underlying nervous system dysregulation were the catalysts for chronic conditions. When seeking a reason for pain, inflammation, immune system suppression, or any of the other many manifestations of human illness and discomfort, he explained that we need to look beyond the afflicted part of the body to the origin of the pain: the brain's attempt to protect us from difficult emotions and stored trauma.
People often laugh when I tell them that I found Dr. Sarno thanks to Rosie O'Donnell. But after my mother watched an episode of The Rosie Show where Dr. Sarno helped one of her producers, Janette Barber, overcome leg and ankle pain so severe that she had to use a motorized wheelchair, she told me to check him out. After reading Healing Back Pain, I was astonished when my own back pain began to abate.
I later became Dr. Sarno's patient, open and willing to think in new and innovative ways, and grew into a student of his work, evolving his theories and practices into ones that delivered me from chronic pain to the life I live today. Over time, I also became his colleague as he referred patients into my psychotherapy practice. It was my honor to be regularly chosen to lecture beside him at NYU, and at the end of his life, our conversations turned entirely to extending his work to a growing global audience. Dr. Sarno was keenly aware that the combination of my background in psychotherapy and my personal success story in the face of a grim diagnosis brought a powerful voice to his work-one I know he was heartened would outlive him.
The Pain Is Not in Your HeadI've often found that clients initially misunderstand the concepts behind Mindbody medicine. The primary reason is that when people are suffering, they can misinterpret its message to mean The pain is in your head. This understandably can make ailing people quite resistant, as they've endured physical, often excruciating, pain and chronic symptoms that limit their lives. Additionally, because of its necessary emphasis on emotional experience, people erroneously infer that Mindbody medicine is suggesting that they are mentally unstable, making up their symptoms, or somehow to blame for them.
This is not the case.
Adding insult to injury is the negative association around the term psychosomatic, used throughout years of literature to describe how emotional and mental pain are channeled into the body. Despite the fact that scientific studies have proved, time and time again, that our stress and emotional experiences can influence our experience of pain, the term has come to be confused with hypochondria, which, once again, wrongly calls into question the real pain and suffering of the patient. Today, most scientists avoid the term. Instead, they refer to psychophysiological symptoms-or physical symptoms that are the result of psychological processes.
Knowing how prevalent this confusion is, I want to emphasize from the start that the pain is not in your head, but the solution is not in altering your physical body. As I will explain throughout our time together, the genesis of most chronic conditions can be explained when you understand the way a fight-or-flight-motivated nervous system sends signals of distress to divert us from the perceived "predators" causing our suffering. You will hear me repeat this idea in many ways, as I have discovered over years of practice that this is what's required to rewire your thinking. As soon as a profound mindset shift occurs, healing is significantly accelerated.
Let's talk about fight or flight. There is no cure for the human condition, and pain of all varieties is part of it. As inconvenient as it is to be such deeply feeling beings, here we are. Intense emotional experiences are both the most joyful and most daunting realities of human life, and our health and happiness depend on being aware of their power. When we don't know how to feel our "unacceptable" emotional reactions to life (shame, despair, rage, grief, and terror), we are diverted from these challenging feelings by something that our nervous systems deem safer: physical pain and anxiety. This diversion process launches us into the brain's default mode when we are faced with danger: the fight-or-flight response.
You've likely heard of this phenomenon. The primogenital parts of your brain have one vital task: keeping you alive. When you encounter a dangerous situation, the amygdala, a small almond-shaped region nestled deep in the brain, is there to help you respond in a way that will increase the likelihood of survival. It signals your adrenal glands, part of the endocrine system, to start churning out adrenaline, cortisol, and other hormones. These chemicals raise both your respiratory and heart rates, ensuring that your now-tensed muscles have the energy they need to make their next move. You might get only one chance to save your own skin, so you have to be ready!
Depending on the situation, you may run from the danger-flee. If there's nowhere to go, you can stand ready for battle-fight. But while we often talk about fight or flight as if there are only two options with the power to save us, there are two other states you might inhabit when faced with perceived danger. You can freeze and hope the predator doesn't notice you blending into the woodwork. Or you can fawn-say or do whatever comes to mind to appease the threat. Moving forward, I'll refer to this response as simply fight or flight for brevity's sake-but it's important to keep in mind that the amygdala can help ready the body for a few different responses to tension or peril.
Whether your amygdala directs you to fight, flee, freeze, or fawn, this well-documented physiological reaction is meant to last for only a short time-just long enough to get you out of danger. But when the predator you face is the repressed emotional energy inside you, you can end up stuck in this state for the long term. This is what causes chronic symptoms-because your pain or infirmity is seen as "protection" from further damage.
Think of it this way: If you broke your ankle and kept running, you might damage your bones and ligaments to the point where you'd never walk again. A broken bone causes pain as protection, so you can slow down and take the steps to heal. The same is true for myriad chronic conditions-since your brain and nervous system interpret your rising dark and traumatic emotions as a threat to your life, they will slow you down to give you time to attend to yourself and escape. A blinding migraine slows you down pretty damn quick. So does an IBS attack or excruciating knee pain. But when you train your system to safely and systematically allow these presumably threatening emotions to rise, this ancient protective response is disabled. Consequently, the corresponding chronic issues abate. It's the most astonishing and exhilarating experience. This is how I have guided people to full-body health for over twenty years, and what we will do here together.
