Really need help to find a book

If a placebo effect is required to recover, I can see why I haven't recovered: I generally distrust doctors (having encountered so many of them who lord it over their patients and have treated me like a piece of sh*t on their shoe) and I'm otherwise quite guarded and suspicious of other 'professionals' who profess to have the answers, plus I'm quite mistrustful of people generally (having been badly let down in childhood etc etc etc).

In my desperation to get rid of my severe pain, I once (many moons ago) saw a self-styled 'practitioner' who had been recommended to me as he had apparently 'cured' so many people of their physical ills. He walked into the 'treatment' room sporting a waxed moustache and an ankle length black cape with a purple silk lining (no kidding!) and smelled of extremely strong, stale aftershave. I sobbed in despair in the car coming home afterwards thinking: 'oh, my god, what have things come to that I've just resorted to consulting and paying ££ to charlatan like that!'. I felt foolish and I didn't understand how anyone could be taken in by him. (Now I kind of wish I had been taken in by him!)

 

Bless you, that sounds like quite an experience but you must take heart from the fact that most of us have been equally desperate and have subsequently tried things that seem ridiculous with hindsight.

In my 20’s I was plagued by chronic thrush. For seven years I was in hell. After exhausting the medical route, I forayed into the Wild West of alternative cures including Colonic Irrigation (and an insanely restricted diet) through to Past Life Regression (where I was a slave girl at the mercy of marauding Vikings).

At least your charlatan had a theatrical edge!
It sounds like a bad Derren Brown episode.

 

Oh plum, you made me laugh out loud and made my day!

Btw I used to get thrush a lot and tried all sorts of things to combat it; turned out that in my case I was soaking my private parts in the bath too often, flushing out the majority of the good 'flora' down there.

 

Hi Bloodmoon. I have not been ignoring your questions. A windstorm knocked out my internet service for two days. I'll try to answer them now.

Before experiencing your cure, had you already assessed that a cure would be due to the placebo effect?

No. I was unaware of modern placebo research until I read Jo Marchant's Science of Mind over Body book a few years ago. I did not appreciate that my use of Sarno's approach was explainable in terms of the placebo effect until I heard Schubiner's Commonwealth Club lecture.

What specifically did you 'accept' and 'believe without reservation' was actually 'wrong' with you that was causing your pain and/or other symptoms [1]?

I had been suffering from episodes of low back pain for more than two decades when Sarno published Healing Back Pain in 1991. I bought the book as soon as I saw him promoting it on a morning talk show on TV. I memorized his Twelve Daily Reminders in the book and repeated them to myself not by rote but slowly, paying attention to the content of each one. I did this scores of times every day, sometimes probably hundreds of times a day. I think that played a big role in my acceptance of his explanation and technique to use, but there might have been other things involved as well. I think it was JanA who said that Sarno is easier to believe if you are desperate. I was desperate. Nothing else had relieved my back pain over the years, so I just knew I had to believe him if I was going to get better. Beyond that, I realize now that I grew up in a family where anger was taboo. Perhaps that explains why Sarno’s approach resonated with me, though I have no recollection of it being a factor in back in 1991.

What technique(s) did you use and believe would work [2]?

One of Sarno's Daily Reminders is to think psychological, not physical. Healing Back Pain contains a passage where Sarno discussed how he treated his TMS equivalent of heartburn that was particularly valuable to me. He wrote: "I have learned that heartburn means that I am angry about something and don't know it. So I think about what might be causing the condition, and when I come up with the answer the heartburn disappears. Generally for me it is something about which I am annoyed but have no idea how much it has angered me." When a back pain episode hit me, I would ask myself, "What am I annoyed about?" When I got the correct answer, my back pain would disappear. It generally turned out to be something my wife did, or did not do, that annoyed/angered me. In 2010, Sarno wrote the Foreword to a book published by two psychologists to whom he referred his patients who were not making good progress in getting in touch with their repressed emotions. He said: "In about one quarter of our patients, psychotherapy is essential for success. These patients harbor feelings that are deeply repressed in the unconscious and can only be brought to consciousness with the help of appropriately trained psychotherapists." I am fortunate I was not in that one quarter. I have no idea why I was in the 75% rather than the 25%.

When I retired in 2010, I decided to use my newly abundant free time to pursue a new hobby: to learn everything I could about what Sarno called TMS and others like Schubiner and Abbass now call PPD. I knew that by "appropriately trained psychotherapists" Sarno meant ISTDP. So I spent many hours studying ISTD literature. I learned that a key part of ISTDP is that the therapist helps patients become aware of defense mechanisms that they use automatically, habitually, and unconsciously to repress core emotions like anger and then helps them stop using those defense mechanisms so they can become aware of what they were repressing. I also learned that ISTDP regards "annoyed" and similar words like "irritated" "aggravated" and "pissed off" that patients use with therapists as tactical defense mechanisms to cover up what is really anger. So now I understand why Sarno was on the the right track to focus on what annoyed him, and I was on the right track in doing the same. In ISTDP therapy, when a patient uses a cover word, the therapist will hone in on it and try to help the patient uncover his or her repressed anger, e.g., by asking questions like "How do you experience that annoyance?" or "'Irritated' is just a word. How do you experience your feeling?" and continuing to press in that manner.

To sum up in terms of Schubiner's placebo model, I accepted fully and without reservation that the explanation for my back pain was repressed anger rather than something physical and that the technique I needed to use to fix it was to become aware of the repressed anger. I never had another episode of back pain after 1991. I did have TMS in other forms (what Sarno called the symptom imperative). Once I accepted that the explanation for the new pain was repressed anger and I used the technique of becoming aware that I was angry and what triggered my anger, I succeeded in stopping the new pain.

Although Sarno regarded repressed anger as the major cause of TMS, he recognized TMS could also be caused by Pavlovian conditioning. For example, if you believe your back is so damaged or fragile that sleeping on a soft mattress will make it hurt, then your brain will create back pain when you sleep on a soft mattress. I have had a few kinds of pain that did not respond to emotional work, e.g., neck pain. Through practice I've gotten quite good an uncovering repressed anger, so when emotional inquiry did not work, I concluded the cause of the pain must be conditioning. Sarno says little about how to fix conditioning. One way to do it is to use what psychologists call graded exposure, but I have just used what Schubiner calls affirmations. I kept telling myself there was nothing physically wrong, e.g., with my neck, and the pain was just conditioning. The difficulty with affirmations is that you must truly believe what you are telling yourself. This can take resolve, persistence, and mental grit. If any doubt creeps back in, affirmations don't work.

And what gave you hope and optimism [4]?

I think if one truly has the other three elements necessary for the placebo effect in place, hope and optimism naturally follow.

 

Hi @Duggit,

Thank you so much for your detailed reply to my questions - I appreciate all the time and effort you put into answering them.

ISTDP was something I wanted to try but none of the therapists listed on the UK ISTDP website practice near me so it's helpful, from your description, to know what ISTDP therapists actually do...so that I can work on myself in this vein. I think it's the next best thing for me to do - that is, to notice when I feel 'just' irritated or such like, and then delve down deeper about it. Journaling and reviewing what I've written might help me recognise when I'm operating a 'tactical defence mechanism'. The trouble though has been that I am already well aware of generally how very pissed off / angry I get, but that awareness hasn't realized any profound recovery in me...but maybe there's something buried that needs unearthing (even though Sarno said that you don't necessarily have to exhume all anger to get better...but, if one is one of the unlucky 25%, I guess, for some reason, it becomes necessary).

Also, I found you mentioning Pavlovian (classical) conditioning helpful. I'm becoming more and more convinced that I'm a 'victim' (for want of a better word) of this. I understand that such 'conditioned responses' are created through the making of neural pathways in the brain. And that this forming of neural pathways works through the process of neuroplasticity, with different areas of the brain being involved in different kinds of conditioning, which would explain why one has to be so persistent in counteracting them. I have been telling my brain that there's nothing physically wrong when my symptoms pop up in various parts of my body and thanking those parts of my body for doing their job now and over the years, which does sometimes work for me to alleviate the pain and/or stiffness or whatever, but so far it's only worked for new symptoms. (A general, throughout the day, 'attitude of gratitude' is also helping me too; over the years I have become generally more and more pissed off at and critical of all sorts of things and I believe I need to unlearn it as it has become an automatic reaction to life's difficulties.) Buoyed by hearing of your success in relation to defeating/overcoming conditioned responses I shall continue using affirmations, talking to my brain.

Thanks again, @Duggit.

 

This is an amazing thread! How did I miss this one lol! Will read more carefully later....

 

Bloodmoon, below is a hyperlink to a video by ISTDP therapist Angela Cooper Ph.D. about treating medically unexplained symptoms, i.e., what Drs. Schubiner and Abbass call psychophysiologic disorders (PPD). She works with Abbass, whose book on ISTDP (titled Reaching Through Resistance) Dr. Sarno endorsed. I hope you will find the video interesting and informative:​

https://videos.files.wordpress.com/OOk9yY2p/sirpa-video-presentation-small_dvd.mp4

 

Thanks, @Duggit. The video is really enlightening: particularly striking was about 'Sympathy Symptoms', e.g. (for those who haven't watched the video but are reading this post) the TMS-er wants to, let's say, strangle someone who has upset them but as they can't strangle that person (as it's against the law and they may also actually love the person) they 'strangle' themselves, they suppress their hot murderous anger and suffer the unprocessed guilt (love + anger) which manifests in their bodies as feelings of choking and difficulty breathing etc. This has inspired me to look at some more videos about ISTDP that are on YouTube...And I'm now also wondering if I might be able to get an ISTDP therapist to help me virtually or over the phone as they might be up for that now what with covid-19...I think that it might be worth contacting a few to see. It has also struck me that, although I have been back over the past, my childhood etc., and recognised when I felt sad, angry etc., I didn't close my eyes and think about and endeavour to relive the events to feel those emotions physically in my body, viscerally. I'm going to try to do that now and see what happens.

 

Bloodmoon, a fully trained, true blue ISTDP therapist insists on seeing patients in person. In part this is so the therapist can observe the patient's body throughout therapy sessions in order to determine when the patient's anxiety is manifesting itself in his or her striated muscles (as distinguished from in smooth muscles or in cognitive perceptual disruption) because only then can the therapist use the ISTDP techniques to help the patient uncover his or her repressed emotions. There are exceptions to in-office therapy, but they are rare. For example, Arlene Feinblatt was Sarno's chief psychologist and reportedly was trained by the founder of ISDPD, Dr. Habib Davanloo. The tmswiki website says she is available via phone but "[o]nly if I have met with the patient and they are then able to do the work of therapy to ethical and professional standards."

I don't know where you are in England, but Georgie Oldfield, who introduced Angela Cooper in the video I recommended, is in Halifax, West Yorkshire and Huddersfield. She is a physiotherapist who trained briefly with Sarno, and she founded SIRPA (the Stress Illness Recovery Practitioners Association), which organized the program at which Cooper spoke. Oldfield obviously has some familiarity with ISTDP but, as far a I know has no formal training in it and is not authorized to practice it. She offers an online treatment program that I am not familiar with. Based on a chapter she wrote in a book published by the Psychophysiologic Disorders Association, I would say her approach is a Sarno-like and emotion-based but not ISTDP. Of course, this was true of Sarno; he referred patients to ISTDP psychologists if they needed it. Nat Kuhn, a prominent ISTDP psychiatrist, has said Schubiner has referred some patients of his that need ISTDP to him. If you cannot find an ISTDP practitioner who is accessible to you, seeing Oldfield if she is near where you live or doing her online program might be worth a try. At least that might enable you to find out if you are in Sarno's 25% who need ISTDP and, if so, Oldfield might be able to tell you if there is a fully trained ISTDP practitioner near where you live.

Finally, I would not be intellectually honest if I did not say again what I said in my earlier post: ISTDP is only one way to get the four-factor dependent placebo effect that calms down neural pathways in your brain. There are other ways. You just need to find an explanation for your PPD that you accept fully and without reservation and find a technique to use that you accept fully and without reservation will get the job done for you and that you can then implement.

 

Hi @Duggit,

I spent yesterday afternoon looking at YouTube videos re ISTDP (Jon Frederickson et al) and I had started to gather that a pukka ISTDP therapist would really need and want to view a patient's reactions - something which you've now confirmed for me. I did find one UK ISTDP practitioner's website on which they say they offer Skype sessions if the patient can't attend, but that doesn't appeal to me - I've used Skype a few times and the connection kept dropping. There's a list of fully qualified ISTDP practitioners in the UK on both the official ISTDP American and British websites but, unfortunately, the nearest is too far. Watching the ISTDP videos has been interesting for me though, as I now realise that with regard to a long, significant past relationship, I used the defence of 'denial in fantasy'. Knowing about the various defence mechanisms is also going to be useful and enlightening for understanding the 'mechanics' of present and future relationships.

Thanks for mentioning Georgie. (Unfortunately, she is at the other end of England, but she does list her SIRA trained practitioners on her website with one of them being not too far away.) I've read Georgie's book, but none of the suggestions therein 'hit the spot' for me, but maybe face-to-face sessions might work, although I wouldn't go at present what with the Covid-19 R rate having shot up recently...So, I'm pleased that you reminded me that "ISTDP is only one way to get the four-factor placebo effect"....I was brought up by overly critical parents which made me into a 'glass half empty' sort of a person. Recently, using gratitude techniques throughout the day and adopting a general 'attitude of gratitude' as I go about things, has started to profoundly combat this, so I'm beginning to believe that this is the way to go for me. (The only thing that's missing to complete the 4 elements for a placebo effect is [3] - a 'guru' that I can believe in, to endorsing this 'method'/approach - Although I take on board that [1], [2] and [4] can be enough if one's read an inspiring book or article re the 'healing' effects that an 'attitude of gratitude' can have on the mind/body.)

You're one of the treasures on this forum, @Duggit - I'm taking the liberty of gradually reading through all of your past postings and all of the ones I've read are well considered and very informative.

 

I agree completely. Duggit’s posts are immensely generous, considered and grounded. Invariably they encourage reflection and a deeper understanding.

 

Hi again, Bloodmoon. I have not read Georgie's book, but I understand why it did not "hit the spot" for you. I thought her chapter in the PPD book that I read was okay, but it did not hit the spot for me either.

Turning to something that did hit the spot for me, I will mention Dr. Gabor Maté's book When the Body Says No in case you have not seen it. It is is not about PPD but rather is about how one's emotional unawareness adversely affects his or her health in numerous ways. After explaining the biology of that at some length, Maté discusses "The Seven A's of Healing" in chapter 19. The first A is Awareness, i.e., learning to become aware of emotions that we habitually ignore. Unsurprisingly, another A is the emotion of Anger. Much of Maté's discussion of anger is based on what he learned from Canadian ISTDP psychiatrist Allen Kalpin. Another A is Attachment, the cornerstone of ISTDP. I think Maté's discussion of healthy anger versus unhealthy anger is really valuable. We repress anger at people we are attached to because we learned in childhood that it was too dangerous to experience consciously because it adversely affected our relationship with one or both parents. Maté's discussion of healthy anger can help a person to realize, deep down where it counts, that anger need not be dangerous to our relationships and therefore need not be repressed. Perhaps you would find it helpful to read chapter 19 if you have not done so, or reread it now that you are aware of the role of anger in ISTDP. Also, Maté's chapter 15 discussion of "attunement" in attachment relationships is really astute (at least it really resonated with me).

You mention gratitude. I think its cousin, forgiveness, can be even more important. Schubiner recognized the importance of forgiveness in Hidden from View:

"Forgiveness does not imply forgetting what happened. It simply asserts that the issue will not continue to dominate one's life and one's mind, preventing one from being emotionally 'hijacked' by past events. It has often been said that maintaining a grudge is like 'swallowing poison and expecting the other person to die.' It [forgiveness] is letting go of anger and hurt."​

Restated in terms of what Schubiner said about the placebo effect in his Commonwealth Club video, one might say that forgiveness calms the brain down. (I do not mean to imply that gratitude doesn't.) Similarly, Abbass has said the following about overcoming anxiety and somatic symptoms: "Emotions that can be helpful are self-acceptance, positive regard for oneself and other people, and forgiveness for oneself and other people. So it involves getting back to basic love and attachment for others. " If you are interested in learning more about forgiveness, I think the best book is psychologist Fred Luskin's Forgive for Good. He makes the point, among others, that forgiveness does not condone what happened and is not for the benefit of the person who wronged you. It is for your own benefit.

​

 

Hi @Duggit,

Blimey, I think you must know me! I say this because I have an addiction (comfort/binge eating since at least the age 7, which I now control pretty well, but the tendency is always there) and I also have difficulties with regard to forgiveness – in as much as my trains of thought often hark back to people who ‘did me wrong’ and how they ‘did me wrong’ when something in daily life reminds my brain/mind of them.

I will therefore definitely read Fred Luskin’s book.

With Maté's book, I borrowed it from the library probably about 9 years or so ago (before I'd heard of Sarno) and all I can remember is that I was disappointed that there were no tangible techniques to follow for recovery but, from what you've said, that's not actually the case – it might therefore have been that I just wasn’t ready at that time to take up any suggestions in the book. I’m going to buy it on Kindle, but straight after I read your post, I did a quick surf and found an article about Maté's ‘attunement’ ideas. I hadn’t remembered about that at all and it explains why it has been so difficult for me to control my addiction, how it what boils down to being a development issue and therefore why I couldn't help it.

Thank you for all of your help and advice.

 

Hi @Duggit, it's me again

I just thought that I'd let you know that in reading through your past posts, I came across your mentioning about ISTDP therapist Kristian Nibe's book 'Reconnect to your Core: A practical guide on how to feel good and be happy' and I went to the link you gave to the webpage on his website which gives excerpts from his book (https://kristiannibe.com/reconnect-to-your-core-content/the-real-cause-of-psychological-problems/ (The real cause of psychological problems - Kristian Nibe)). I went to the excerpt regarding overcoming anxiety (https://kristiannibe.com/reconnect-to-your-core-content/how-to-overcome-anxiety/ (How to overcome anxiety - Kristian Nibe)) and did the 4 steps that he describes and, as he suggests, I did them a number of times. In response, I felt a little bit of a shift (bodily and mentally) of 'relief' (for want of a better word/description) so I've bought the book on Kindle. I can believe what Nibe says: that there is an automatic mechanism inside our brain that doesn’t allow feelings to be felt and instead, what many feel when a feeling arises in them is anxiety in the form of (muscle) tension, nervousness, stress, nausea, pain, dizziness, or other symptoms...And this unconscious anxiety mechanism does one thing most people are not aware of: it transforms a feeling into anxiety in around 12 milliseconds...And then in turn immediately after our brain detects anxiety it invents subtle tactics and strategies so that we won’t have to feel this anxiety. This is a 'light bulb' moment for me as I hadn't comprehended that anxiety acts as a 'layer'/'barrier' to prevent one from feeling one's feelings and that we put yet another 'layer' on top of that to stop ourselves feeling our anxiety!

 

Could not agree more! I did read the first post on this thread a while ago and thought it was a yes-no question. Today I noticed the thread grew to dozens of posts - gootta be something interesting, and yes, indeed, it is!

 

@BloodMoon , I think what you just described is the key to your struggles. I had similar experiences going to various healers, not as dramatic as yours, but at a minimum disappointing. The worst practitioners were the ones that insisted that, if given yet another 3 more sessions, they would cure me 100% (like the previous disastrous 3 were not a proof of the opposite :=).

This is what I learned.

1. Looking to somebody else to cure oneself is not likely to work with psycosomatic conditions, unless you recruit your main therapist - yourself. Your brain is so powerful in generating pain that unless you start believing in your own ability to calm it down you would not succeed. Until I came to the firm conclusion that my role in my healing is preeminent and all the therapists, specialists and doctors I am seeing are my consultants for hire, I was not healing. No offense to my wonderful, competent, caring and outstanding in every way GP, but I am the one who have known myself from my childhood and throughout my all life experiences and who could connect the dots. She became my close partner in my healing process, but I was the one taking the lead. People are different, not everyone was born a leader willing to take charge at any life circumstances. But I still believe that even most the timid personality type can grow that quiet confidence in their own abilities to talk their own brain out of the downward spiral. This is what Albert Schweitzer said: "Each patient carries his own doctor inside him. We are at our best when we give that doctor who resides in us a chance to work".
2. Desperation can be a good thing. It was at the angst of the utmost desperation that I decided that I needed to stop going around in hope for cure and turned inward for healing.
3. Regardless of a specialist's outstanding qualifications, you need to have a trust in them. Just because somebody worked well for number of people, they may not be a good fit for you. Don't be afraid to run your own lithmus test on the personal compatibility. Not all the people can be a great match for your unique personality and life circumstances.
4. Faith in oneself is not a linear ascend, it is not even a constant. You will go through ups and downs, but you need to look for those little stepping stones to bring it back. I can't well describe this, but I look for hope in places that I would never expect to find it. Sometimes I can't find it, sometimes I can. What I also noticed is that the benefits of every meditative activity (meditation, yoga, swim, run) show up with a delay. For me, it is usually a day or two. But they alsmost always lead to resumption of hope.
5. This is the one that @miffybunny talked about in her posts, very eloquently. You need to have something to live for. Without life purpose and meaning, whatever it is for you, healing is very hard to achieve.

 

Thank you for your advice and reassurance to trust and have faith in myself, @TG957. I shall particularly bear in mind about the benefits of meditative activity showing up with a delay. (It figures that it would work like that as I have noticed that, on the other side of the coin, when I've experienced a stressful event there's often a similar delay before I've noticed a physical symptom in response.) Point [5] is a hard one for me. All the major things I used to live for went out of the window and out of my life years ago when I became virtually housebound. I have a few scraps of things in my life that keep me going though so, hopefully, they are enough for healing. Also, fairly recently adopting an 'attitude of gratitude' is gradually helping me appreciate things that I wouldn't normally take any notice of or interest in, so the ground is being laid for change.