Q & A with an Expert

This question was submitted to Dr. Eric Sherman as part of the wiki's Q&A with an Expert program, and I have included his response below. This thread is the source of the wiki page: Q&A: I've just read Sarno's books. Now what should I do?

Dr. Sherman has extensive experience treating patients with TMS/PPD and is one of Dr. Sarno's most trusted psychologists. Feel free to write your own response about your thoughts on Dr. Sherman's response.

Dr. Sherman Wrote:

There are several possible factors related to your unrelieved pain. First, I am assuming that you've been thoroughly evaluated by a physician who ruled out the presence of any serious problems. The diagnosis of PPD must always be established by a physician, even though many patients accurately self-diagnose the condition.

Although the acquisition of knowledge is therapeutic for many patients (that's why Dr. Sarno originally described his approach to treating PPD as psycho-educational), there are certain life events that are so traumatic in their impact that no amount of knowledge can counteract their harmful effects. If someone is a victim of domestic abuse, for example, or is the parent of a seriously ill or disabled child, all the knowledge in the world will not help the pain symptomatology unless certain concrete steps are taken to ameliorate the problem. Unfortunately, your situation falls under this category. One of the worst situations anyone can ever experience is feeling helpless to protect someone you love. When someone is dealing with a spouse's serious illness, overpowering feelings of helplessness, fear, sadness, frustration, loss of control, and anger predominate. In fact, these very emotional reactions are inevitable, given the circumstances. If someone was going through the situation you describe and didn't experience these feelings, I would not be impressed with the person's strength or resilience. Rather, I would be dismayed at how disconnected the person was from his or her own feelings. The first step for you to take is to develop compassion for yourself.

Drs. Thomas Holmes and Richard Rahe are psychiatrists who developed the Holmes and Rahe Stress Scale. Essentially, someone tallies up the stressful events he or she has experienced within the last 24 months. The events range from trivial, for example, getting a parking ticket, to catastrophic--divorce, death of a loved one, serious illness, etc. These events are weighted so getting a parking ticket earns l point whereas life threatening circumstances earn 50 or more points. If someone's total exceeds 300 points, then he or she is at a statistically increased risk to develop physical or emotional problems. Not only do you mention your husband's illness but you also refer to financial problems and increased responsibilities. I wouldn't be surprised that if you took the Holmes and Rahe Stress Scale, your score would exceed 300 points, or hover close to that number! Knowledge alone is just no match against such powerful forces.

Another possible and often overlooked explanation for the persistence of your pain is it's adaptive value in a crisis. Although you suffer tremendously, your mind remains very clear and focused with respect to cognitive functioning. Imagine if you were to experience the full brunt of your emotions, without any filters or distractions. Under such circumstances, it would be highly unlikely that you would be able to think clearly enough to troubleshoot problems and help your husband. Therefore, pain functions like a brownout which averts a blackout. The ability to preserve your cognitive efficiency at your body's expense can occur when someone is deeply devoted to protecting someone he or she loves.

Another aspect of this complicated situation is how you feel about yourself when you experience certain feelings. Even though you describe being aware of your anger, often people feel selfish and petty for experiencing anger towards people who are victimized by cruel diseases or circumstances. Even when these feelings are experienced exclusively as private, internal, emotional events, and the person's behavior is beyond reproach, many people still hate themselves for having such uncharitable thoughts.

Good people always experience anti-social thoughts and feelings. However, good people generally do not act on these feelings. Also, people in your situation typically resent the additional responsibilities imposed upon them by a loved one's illness. Or, people worry about their own well-being when they feel they should be exclusively concerned with the other person's needs. So even if you are aware of experiencing these kinds of feelings, you might feel guilty and ashamed for even having such reactions in the first place. I can emphatically reassure you that such reactions are universal under the circumstances you find yourself in. Perhaps dealing with how you feel about these feelings can become a focus of your treatment.

When there is serious illness in a family, the family is the patient as well as the family member whose body is affected. Therefore, in your own way, you too are suffering from prostate cancer. It might be worth your while to seek out a support group in addition to your individual therapy to help you manage your overwhelming feelings of distress.

 

I couldn't be happier for you, BG - and in your turnaround, you are giving back - you are already an amazing resource for the work here.

It's a beautiful thing.

Jan

 

Congratulations, Beach Girl, on the courage and hard work that kept you going and got you on the right track. I'm so proud and happy for what you've accomplished!