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Comment by makmanalp | Hacker News Reader

Every time I see Sarno's book recommended, it's always controversial, with the "woo-woo" camp and the "it worked for me so I don't care" camp, though I think the people-who-I-respect-who-recommend-this ratio is way higher than most crank books, so it's interesting in that regard. Thoughts? (I haven't read it)

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It always surprises me that people find the concept of the brain being connected to the body to be "woo-woo". The objections are very unscientific. Biology is incredibly complex, and our understanding of it is very shallow, yet people scornfully dismiss the idea that the brain could in any way cause sensation in the body. I think the key to their misunderstanding is the tendency to imagine the brain as a completely separate thing, like the driver of an automobile, rather than a deeply integrated and intertwined system, which science shows it to be.

Phantom limb syndrome is in many ways similar -- do these same people consider that "woo-woo"?

My one issue with Sarno is that he's a little light on detail in terms of what exactly I need to do to get rid of the pain. For that, I've found this organization/program to be helpful: http://www.tmswiki.org/forum/pages/overcomingpain/

Speaking only for myself: I consider it woo-woo because there's no real set of steps which makes it repeatable for a majority of people. What works for one person works for one person, but it's sold like it works for everybody.

I've heard of folks who are capable of meditating their way through a root canal. Should we stop offering Novocain to patients? Should we start actively discouraging dental patients from getting Novocain?

To me (dons flameproof suit), it's a lot like Homeopathy - another attempt to sell the placebo effect.

> It always surprises me that people find the concept of the brain being connected to the body to be "woo-woo"

I don't think it's an objection to psychosomatic phenomena as much as just skepticism towards Sarno's work specifically, lack of support from other MDs, lack of strong peer reviewed evidence, etc.

https://en.wikipedia.org/wiki/Tension_myositis_syndrome#Cont...

IMHO we're fairly likely to eventually find that what he calls TMS is an early precursor / catch-all to a larger class of health issues (like "cancer"), and as we find better ways to classify, distinguish and diagnose these, we're also going to be able to run better studies and come up with more specific treatments that satisfy the medical community's standards of proof.

Would you have been likely to recommend this book if your pain didn't resolve after trying it? I'm skeptical of this specific theory of how the mind and body are interacting to cause pain and what he thinks is the proper way to treat it. First of all, on the back cover a 2-6 week period is given. A lot of back pain resolves itself within this time frame so without a proper study done there is no telling how many of his "success" stories are just back pain taking it's usual course. He relies a lot on testimonials. That is never a good proof of a treatment's efficacy. Why not do a proper study and not push the treatment until the results are in? We see this a lot in the medical field where some doctor has convinced themselves they have found the key to treating something yet never actually bothers to do a proper study of it. I can understand that, studies are expensive and it's much easier to live in the world where you think you are helping people and the self-selecting testimonials reinforce this. On the flip side I see a lot of people who are convinced that some "alternative" therapy works for them simply because they tried it and got some relief but are convinced others are BS because it didn't "work" for them. The problem here isn't people not believing in the mind-body connection.

Edit: there may be some slight truth to why his treatment seems to work for some in that if you can mentally reframe your pain you are more likely to get better but that nugget seems to be buried in the fluff of his TMS theory: (https://sciencebasedmedicine.org/chronic-pain-a-disease-in-i...)

I'm in the "it worked for me so I don't care camp".

I can't believe people think it's woo-woo or anti-scientific, though, after reading it. Sarno's thesis is basically "we haven't found a physical cause for most chronic pain conditions, so why not the brain?".

Anxiety sufferers can fool themselves into thinking they're having a heart attack and hyperventilate. Why is it crazy or anti-scientific to think that the same can cause other symptoms?

> "we haven't found a physical cause for most chronic pain conditions, so why not the brain?"

That makes more sense than I was expecting. In particular, pain must be felt in the brain. That is, my body can be suffering some trauma, but if the nerve signals don't make it to the brain, or the brain doesn't interpret them as pain, then I don't feel pain. (This is true of third-degree burns - they don't hurt very much, because the nerves got destroyed, so you don't feel how bad the burn is.)

But if the body isn't under (known) trauma, but the patient is experiencing pain, maybe the brain is a reasonable place to look...

I tried to read it. If you don't have much patience for being preached antiscientific garbage, you won't get through it. I'm not saying that it can't work, or that there isn't some usable knowledge in there, but just that it's based off of idiocy.

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