Dr. Sarno's theory posits that certain types of chronic back, neck and limb pain, as well as some gastrointestinal issues, which are not relieved by standard medical treatments are largely psychosomatic in nature. Dr. Sarno's belief is that while the pain is certainly felt in the body and physical examination will confirm corresponding areas of tightness, the root cause of the perseverance of the pain stems from one's psychological and/or emotional functioning. The reason for the pain, according to Dr. Sarno, is that this physical pain acts as a type of distraction from the more systemic and less easily identifiable repressed psychological, emotional and oftentimes unconscious issues.
The treatment for this type of pain (Tension Myositis Syndrome) involves verifying the TMS diagnosis (thus ruling out any abnormal structural causes for the pain), thorough patient education about the way that TMS works, and perhaps most importantly, getting in touch with whatever conscious and unconscious emotional material may be causing discomfort and distress. Many TMS sufferers will attest that once their distressing repressed issues have been adequately addressed, the physical pain no longer has the purpose to distract from the underlying emotional pain and begins to subside.
To put it another way, with psychogenic pain it is not necessarily one's body that is hurt, although that is certainly where the pain is felt, but rather one's emotional and psychological state has been in some way troubled, hurt or disregarded. Unfortunately most people can go a long time repressing their hurt feelings, often not wanting to or not being able to identify the true source of the pain. However, trying to identify and treat physical pain, particularly in our highly medicalized society, is less stigmatizing, more widely accepted, and appears, at least on the surface, easier to achieve. It is not surprising then that some of us tend to experience our internal distress in a physical form!
While this type of chronic pain is likely not uncommon, before assuming that one is suffering from such psychogenic pain, it is important to first rule out any structural physical causes of the pain by a qualified medical professional. Here is a list of physicians and therapists who often work with TMS and other mind-body disorders who can help in establishing a diagnosis. Additionally, this TMS forum is a wonderful online community established specifically to support and educate those who may be suffering from TMS.