Dr. John Sarno and TMS: Similarities and Differences with Our Work

by Jessica Shahinian, PPDA Outreach Director and creator of GotPainCure

Most people who have heard about the mindbody connection are familiar with Dr. John Sarno and his work with Tension Myoneural Syndrome (TMS) and may be wondering why we at the PPDA prefer the term Psychophysiologic Disorder (PPD). You may be wondering what our thoughts are on Dr. Sarno, if our approach to treating mindbody symptoms differ, and generally why there have been so many terms to describe the mindbody connection over the years.

As Outreach Director for the PPDA, and a recovered PPD patient myself, I wanted to set the record straight.

Why does the PPDA use the term PPD instead of TMS?

Tension Myositis Syndrome (TMS) was the first term that Dr. John E Sarno used in his 1986 book “Mind Over Back Pain.” TMS later became Tension Myoneural Syndrome, and then referred to as The Mindbody Syndrome in his later work. Dr. Sarno theorized that mild oxygen deprivation caused pain and other TMS symptoms, and that this was likely a distraction from unpleasant emotions that our mind would rather repress than express.

It was very hard to study the mindbody connection, or the neuroscience of pain in general before the use of functional magnetic resonance imaging tests (fMRI). As fMRI became available for randomized controlled trials (the gold standard of medicine) it was discovered that learned neural pathways, NOT mild oxygen deprivation, was the cause of these symptoms. This also advanced the understanding on why Dr. Sarno’s emphasis of educating patients was so useful because learned neural pathways can become “unlearned” - a concept that scientists refer to as neural plasticity.

Dr. Sarno faced a lot of skepticism by the medical community, and even though he did amazing work and helped tens of thousands of patients around the world recover by making the mindbody connection easy to understand, TMS is still thought of to be “quackery” by many in the medical field.

To combat this stigma, the health practitioners at the PPDA, including several who studied directly with Dr. Sarno, came up with the term Psychophysiologic Disorder (PPD). The PPD term has been used in published clinical research and continues to be the preferred term among clinicians.

Have any other health professionals discovered an effective treatment for TMS/PPD on their own?

Yes! While many mindbody health practitioners were inspired by or studied directly with Dr. John Sarno (including PPDA Board members Dr. Howard Schubiner and Dr. David Schechter, as well as PPDA Co-Founders Dr. Frances Sommer Anderson and Dr. Eric Sherman) other health practitioners happened upon the mindbody connection by keenly observing what happens when patients are treated with a different approach.

PPDA President & Co-Founder, Dr. David Clarke, is a perfect example. Early in his Gastroenterology/Internal Medicine career, Dr. Clarke discovered that stress, trauma and repressed emotions could cause real physical symptoms that could be treated without surgery or medication. After treating over 7000 patients with this approach he wrote “They Can’t Find Anything Wrong!” and continues to educate health professionals around the world on how to better diagnose and treat medically unexplained symptoms and chronic functional syndromes.

Dr. Sarno was definitely a trailblazer in the mindbody medicine field, and one of the most famous doctors for his work with chronic pain. The PPDA continues his work by advancing the diagnosis and treatment of stress-induced medical conditions in order to one day be able to end the chronic pain epidemic and opioid crisis.

Why all the skepticism?

Science is skeptical by design, always testing theories through peer review to remove any bias and potential flaws. It’s very important not to conflate coincidence with causation. If you removed the skepticism from science, what you’d have left would be the opposite of science - faith, which is the belief in something without any need for demonstrable evidence.

The PPDA’s approach is evidence-based, and this means that the terms and treatments may change as our tools for observing the complexity of pain and neuroscience become better. This is the main reason why there have been some differences between Dr. Sarno’s initial TMS theories and what we now refer to as PPD.

That being said, much of what Dr. Sarno claimed in the 70s and 80s still holds true today:

  • The mind and body are ultimately connected

  • Stress, trauma, and repressed emotions can cause real physical symptoms

  • Education is a key component in relieving symptoms of TMS/PPD.

For more info, watch my animated explainer video Dr Sarno’s TMS Research: Addressing the Skepticism and explore the rest of our website for information about the symptoms, diagnosis and treatment for TMS/PPD.