What are different mindbody syndrome symptoms? Can high blood pressure be caused by a psychological condition?
The Divided Mind by John E. Sarno consists of a series of essays by other doctors about their experiences with mindbody disorders. This includes learning about their symptoms, treating them, and in some cases, recovering from such disorders themselves.
Let’s look at real-life stories of mindbody syndrome to get a sense of the different kinds of symptoms patients experience.
High Blood Pressure as a Mindbody Disorder
Samuel J. Mann teaches clinical medicine at Weill Cornell Medical College and treats patients at NewYork-Presbyterian Hospital. He specializes in treating hypertension, and is particularly interested in the connection between repressed emotions and hypertension, one of the many mindbody syndrome symptoms.
Most people believe that constantly feeling stressed raises the risk of developing high blood pressure. However, Mann argues that research and treatments focusing on feelings of stress have failed to support this theory; the link between stress and hypertension remains tenuous, and stress-reduction techniques don’t reliably reduce blood pressure.
In contrast to that common belief, Mann says that repressed emotions—the stresses people don’t feel—are the real link between stress and high blood pressure.
He writes that keeping upsetting feelings at bay requires the sympathetic nervous system (SNS) to stay constantly active. The SNS controls the body’s threat response, part of which is to increase heart rate and blood pressure. In the short term, this ensures that the body’s muscles are well-supplied with oxygen, so they’re ready to fight or to run at a moment’s notice. However, if the SNS is always engaged, then the person’s blood pressure is constantly elevated; in other words, they have hypertension.
Therefore, uncovering repressed emotions and helping the patient to resolve them is an effective way to treat high blood pressure; much more so than stress-reduction techniques like muscle relaxation and deep breathing exercises. Alternatively, drugs that interfere with the SNS’s ability to affect blood pressure also show promising results in treating this type of hypertension.
Joint and Back Pain as Mindbody Disorders
Andrea Leonard-Segal is a rheumatologist and a clinical associate professor of medicine at George Washington University. She specializes in treating chronic pain and takes a holistic approach that addresses both physical and psychological causes of pain.
When Leonard-Segal herself developed back pain that didn’t go away with standard treatments, she went to Sarno as a patient. That was when she learned about mindbody disorders and the psychological causes of pain. Sarno’s treatment cured her, and she’s been using his principles of mindbody medicine in her practice ever since, with a particular focus on treating TMS.
TMS Patients Think They “Should” Be in Pain
Leonard-Segal says that the only common thread between many of her patients is the belief that they’ve seriously hurt themselves. Their injuries—if they have any—are often minor and would normally heal on their own. However, because the patient thinks they’re hurt, the pain continues.
Furthermore, the mindbody disorder often compounds itself because the patient comes to believe that the chronic pain means they’re frail and weak. As a result of that belief, they actually start to feel even minor pains more severely and struggle to recover from injuries and illnesses that should pose no threat at all.
Leonard-Segal’s treatment for TMS is similar to Sarno’s, but she adds that her goal is to give her patients the benefit of an outside perspective. In other words, Leonard-Segal helps her patients to see themselves as she sees them: healthy, strong, and capable. She says that, once her patients internalize that new self-image, they usually make full recoveries.
Diagnosing Physical Versus Psychosomatic Disorders
Douglas Hoffman is an orthopedist with decades of experience in sports medicine. He takes a particular interest in how psychological and social factors lead to mindbody disorders in otherwise healthy people.
Hoffman makes two important observations about mindbody disorders:
1. Even when a condition is psychosomatic, it often has a physical trigger. For example, someone who twisted their ankle while running might still feel pain in that ankle years later. This makes it difficult to diagnose a mindbody disorder because it seems obvious that the cause is physical: In this case, the ankle must not have healed properly.
2. Physiological conditions and psychosomatic conditions aren’t a simple binary, but instead exist on a spectrum. In other words, chronic conditions often have both physical and psychological causes. Therefore, the doctor must determine on a case-by-case basis how much the patient’s psychology is contributing to their condition.
Hoffman says that the best way to diagnose a patient is to get a thorough history and conduct a complete physical exam. From there, the doctor can create a differential diagnosis: a list of conditions, both physical and psychosomatic, that could explain the patient’s symptoms. The patient’s medical history is crucial because it will include psychological conditions such as depression and anxiety that would make psychosomatic disorders more likely. It will also note if they’ve ever been diagnosed with a psychosomatic condition before.
Hoffman adds that traditional treatments for pain like painkillers and physical therapy reinforce the idea that there’s something wrong with the patient’s body. This makes it harder for them to recover from their mindbody disorder. Therefore, it’s crucial to identify whether the patient’s condition is physical or psychosomatic because the wrong treatment plan could prevent their recovery or make their condition worse.
