How does your mind affect your body’s health? What does it mean when a medical condition is “psychogenic?”
John E. Sarno says that many painful medical conditions are psychogenic, meaning “created by the mind.” He refers to such conditions as mindbody disorders, emphasizing that they are mental as well as physical.
Let’s look at how the mind-body connection affects health below.
The Mind and Body Connection
When it comes to the mind-body connection, health is a big consideration because some medical conditions are psychologically created. These disorders exist because of the deep connection between your mind and your body. In simple terms, your mental health and physical health are intrinsically linked—therefore, if one suffers, the other will too.
(Shortform note: Sarno’s assertion that there’s a connection between your mind and your body is not a new idea. For example, mindfulness practitioners teach that every emotion creates certain physical responses, like how anger makes you tense your muscles and joy causes you to smile. In many cases, by carefully observing what your body is doing at a particular moment, you can identify thoughts and feelings that you weren’t consciously aware of. Also, the mind-body connection works both ways, meaning you can also change your emotions (to an extent) through physical actions; for instance, you can genuinely improve your mood by faking laughter.)
We’ll discuss Sarno’s theory of how mindbody disorders develop, and how Sigmund Freud’s ideas laid the foundation for Sarno’s work today.
How Mindbody Disorders Develop
According to Sarno, repressed stress and unconscious emotional factors like anger, anxiety, or trauma can lead to physical symptoms through the following process:
First, the mind tries to repress or suppress deep-seated emotional issues and stressors that are difficult to face consciously, which creates a state of unconscious emotional tension. In fact, that’s why Sarno titled this book The Divided Mind: He says that mindbody disorders originate from the conscious and unconscious parts of your mind working against each other.
To distract from this underlying tension, the brain produces physiological symptoms—for example, reduced blood flow, oxygen deprivation, or muscle spasms. These physiological changes manifest as pain, headaches, gastrointestinal problems, fatigue, and other symptoms.
According to Sarno, when you suffer from these symptoms and seek medical help, you’re usually diagnosed with some kind of physical illness and treated accordingly. However, since the root cause is psychological, such treatment doesn’t solve the underlying problem, and the symptoms inevitably come back.
Therefore, Sarno criticizes contemporary medicine for overemphasizing physical abnormalities as the root causes of pain. He argues that neglecting people’s underlying psychology often leads to unnecessary medical treatments and surgeries, which could be avoided with a better understanding of mindbody disorders.
The Freudian Roots of Mindbody Theory: Hysterical Disorders
Sarno credits Freud, the founder of psychoanalysis, as one of the earliest thinkers to recognize the connection between the mind and physical symptoms that had no discernible structural or biological cause.
Freud believed that many of his patients’ complaints like paralysis, pain, and sensory loss were actually “conversion symptoms,” meaning psychological distress converted into physical symptoms. He labeled these conditions as hysterical disorders, and theorized that they stemmed from subconscious psychological conflicts and repressed emotions.
(Shortform note: Though he may have been the first to connect it to physical symptoms, Freud didn’t coin the term “hysterical disorder.” In fact, the word hysteria appears in medical texts dating back to the early 19th century, describing a neurotic condition that was believed to be unique to women (it comes from the Greek hystera, meaning womb). However, by the mid-19th century the definition of hysteria had broadened to mean a sense of overexcitement, losing its gendered subtext.)
In Freud’s work, Sarno saw parallels with his own theory of how repressed emotions can unconsciously trigger physiological changes and pain. He built upon Freud’s early insights about psychosomatic disorders and applied them specifically to chronic pain issues like back problems, migraines, and repetitive strain injuries. This culminated in Sarno’s concept of Tension Myositis Syndrome, which we’ll discuss in the next section.
