The first stage of any new field of science is observation.  The books listed below describe clinical experience with thousands of PPD patients.  Though written by clinicians from diverse training and practice backgrounds, these thoughtful summaries are an essential foundation for hypotheses that can be tested by randomized clinical trials, which are currently underway.

These observations also inform study of the physiology of PPD.  With fMRI scanning of the central nervous system, we at last have a tool that is beginning to unravel the anatomic and physiologic basis of PPD symptoms.

We expect scientific understanding of PPD to continue its growth.  As new research is published, we will add to the scientific reports listed below.


Files you can download:

Hidden Stress Screening Test



Blog post titled Medical Myopia and Common Sense by Howard Schubiner, MD commenting on several recent publications in the news media and scientific journals.



Books:  (alphabetical by author)

The Hidden Psychology of Pain by James Alexander PhD.  (2012).                               The author's life was redefined by a tragic car accident followed by chronic physical and emotional trauma. Now pain-free, Dr Alexander has dedicated the last three decades of his life to helping others overcome similar challenges. His success is proof that recovery from chronic pain is possible.

Pathways to Pain Relief by Frances Sommer Anderson PhD and Eric Sherman PsyD.  (2013)                    A book for therapists and the public summarizing decades of experience diagnosing and treating PPD.  Available in paperback or for the Amazon Kindle (or Kindle app).

They Can't Find Anything Wrong! by David Clarke, MD. (2007)
Uses dozens of case histories to illustrate the many hidden life stresses that can cause physical symptoms. Discusses effective treatment techniques in detail.  All author profits are donated to the PPD Association.

Back in Control by David Hanscom, MD.  (2012).     Focuses on an aspect of chronic pain that the medical world has largely overlooked: you must calm your nervous system in order to get better. Has helped hundreds of patients.

Childhood Disrupted by Donna Jackson Nakazawa (2015.)  Shows the link between Adverse Childhood Experiences (ACEs) and adult illnesses such as PPD, heart disease, autoimmune disease, and cancer—Childhood Disrupted also explains how to cope with these emotional traumas and even heal from them.

Chronic Pain: Your Key to Recovery by Georgie Oldfield. (2014)  Reveals how very real, and even debilitating pain, can frequently be caused by our brain in response to repressed emotions as a result of current and even past experiences.

The Mindbody Prescription by John Sarno, MD.  (1999)                                                                Reveals how many painful conditions- including most neck and back pain, migraine, repetitive stress injuries, whiplash and tendonitis- are rooted in repressed emotions and shows how they can be successfully treated without drugs, physical measures or surgery.

Think Away Your Pain by David Schechter MD. (2014)  You will learn how chronic pain becomes a condition of the brain as much as the body. Shows you how to use the immense power of your thoughts and beliefs to literally change the neural circuitry of your brain.

Unlearn Your Pain by Howard Schubiner, MD.  (3rd Edition 2015)
Reversing chronic pain is possible by understanding its underlying cause. This book explains that most pain is due to learned nerve pathways. It helps you determine if you have PPD and how to cure your pain with a revolutionary step-by-step process.


Research Journal Articles (briefly annotated)

Clarke DD. (2016). Diagnosis and Treatment of Medically Unexplained Symptoms and Chronic Functional Syndromes.  Families, Systems, & Health, Vol 34(4), Dec 2016, 309-316.   Review of an approach to patients with PPD based on detailed interviews with over 7000 patients.

Christensen, et. al. Eur J Pain, 2012, 16: 921–933.  This study demonstrated cross-sectional and prospective factors linked to severity of back pain. The most robust predictors were decision control, empowering leadership and fair leadership.  Physical workload, using one’s arms at or above the shoulders, and chronicity of physical work were not connected to the development of back pain at a 2-year follow up.

Chou, et. al., Spine, 2009, 34: 1078–1093.  Evidence on the efficacy of epidural injections specifically for spinal stenosis, low back pain without radiculopathy, or failed back surgery syndrome is sparse and inconclusive, but showed no clear benefit.

Schofferman, et. al. Spine, 1992, 17:S138-44.  Success in lumbar spine surgery is based upon the degree of childhood trauma.  In those with no childhood trauma, 95% were successful; in those with mild childhood trauma, 73% were successful; and in those with significant to severe childhood trauma, only 15% were successful.

Malik, Spine, 2004, 29:E315–E317. Of people who sustained severe injuries after motor vehicle accidents, only 5% ( 2 of 36) developed a whiplash-type pain disorder in a British study.

Uomoto JM, et. al. Arch Phy Med Rehabil. 1993, 74: 61-64.  Headache in those with moderate to severe head injury was 18%, compared to 89% in mild head injury.  Neck and shoulder pain was 4% versus 51%; back pain was 2% versus 45%, and other pain was 2% versus 20%.  Why should this be?  The next study in our list provides a possible explanation.

Kross, E., et. al. Proceedings of the National Academy of Sciences.  2011, 108:6270-6275.  On functional MRI imaging, these researchers found that emotional pain and physical pain activate the same brain regions.  This suggests that physical pain can cause emotional pain and vice versa.

Goodwin, Hoven, Murison, & Hotopf, 2003; Sumanen, Rantala, & Sillanmäki, 2007; Latthe, Mignini, Gray, Hills, & Khan, 2006; Meltzer-Brody et al., 2007; Mayer, Naliboff, Chang, & Coutinho, 2001.  Childhood adversities (divorce, family conflict, sexual abuse, physical abuse, etc.) and adulthood experience of conflict and victimization are elevated in people with migraine headaches, interstitial cystitis (painful bladder), pelvic pain and irritable bowel syndrome.

Burns JW. Emotion, 2006, Vol.6, 309–319.  Changes in muscle activity in the back occur with anger recall in those with chronic back pain.

Baliki, et. al. Nature Neuroscience, July 1, 2012. doi:10.1038/nn.3153.  People with an acute back injury had brain imaging.  Activation of areas associated with emotional reactivity predicted those who were more likely to develop chronic back pain.

Hsu, Schubiner, et. al. J Gen Int Med. 2010; 25: 1064-1070.  Randomized, controlled trial of affective self-awareness for fibromyalgia.  Individuals with fibromyalgia were treated with PPD methods and had lower rates of pain after a 6-month follow up than a wait-list control group.