Book SummaryThe Mindbody Prescription, by John Sarno

1-Page Summary1-Page Book Summary of The Mindbody Prescription

In The Mindbody Prescription (1998), John Sarno explains that the Western world is experiencing an epidemic of disorders characterized by chronic pain with no clear physical cause. However, he explains that these disorders—while genuinely physically painful, and sometimes disabling—are harmless and result from the repression of emotions, particularly rage. He refers to these pain disorders as tension myositis syndrome (TMS). Doctors try to treat these pain disorders as physical problems, but often, their treatments don’t provide any relief. Sarno explains that this is because **the problem isn’t physical, it’s...

The Mindbody Prescription Summary A Chronic Pain Epidemic

According to Sarno, doctors have been diagnosing patients with conditions characterized by seemingly inexplicable muscle pain for over a century. This pain tends to be centered in the back, neck, and shoulders, and it seems to lack a clear physical cause. Because of its prevalence, an entire industry has formed in the United States devoted to diagnosing these disorders—usually as fibromyalgia, myofascial pain syndrome, and fibrositis—and their treatment. Sarno estimates that these issues cost the United States over $100 billion annually.

(Shortform note: Sarno doesn’t specify where these costs come from, but research conducted since the book’s publication suggests that they come from several factors, including the cost of the healthcare itself, missing work, and reduced wages. This research also suggests a much higher total cost than Sarno’s estimate: Based on data from 2008, experts suggest that the total cost of chronic pain in the United States was more than $500 billion. Experts estimate that over 51 million Americans suffer from chronic pain. However,...

The Mindbody Prescription Summary Mindbody (Psychosomatic) Conditions: How the Brain Interacts With the Body

Seeing how patients improved in response to his TMS diagnoses, Sarno now had an explanation for these pain syndromes: psychological tension. The pain involved was psychosomatic.

Sarno explains that the term “psychosomatic” has some negative connotations, which is why he uses the synonym “mindbody.” Both terms refer to physical symptoms that are real and result from emotional or psychological factors. The “psych” in “psychosomatic” (and the “mind” in “mindbody”) doesn’t mean a patient is faking or imagining their physical symptoms.

(Shortform note: Some experts agree with Sarno’s objection to the term “psychosomatic,” for several reasons. First is the stigma that Sarno describes. Second is that it paints the body and mind as entirely separate. In reality, they argue, everything the body does and experiences involves the brain—meaning that every physical ailment could be described as somewhat psychosomatic. This takes Sarno’s concept of the mindbody connection a step further to suggest that the mind and body aren’t just connected in cases of chronic...

The Mindbody Prescription Summary Why Emotions Manifest as Physical Symptoms

Sarno now understood that the epidemic of chronic pain conditions he’d been seeing was the result of psychological tension manifesting as physical symptoms. However, there was still the question of why emotional difficulties would manifest physically. The answer, according to Sarno, lies in Freudian psychoanalytic theory.

Freud’s Three Components of the Mind: The Parent, the Adult, and the Child

To understand why emotions manifest themselves as physical symptoms, we have to understand the nature of the psyche, or the emotional mind. Sigmund Freud identified three parts of the psyche, which go by different names in different contexts. Freud referred to them as the superego, the ego, and the id. Sarno uses the terms parent, adult, and child respectively because these terms make more sense in the context of mindbody disorders. Only the parent and the child are relevant to Sarno’s theory.

The parent is the part of our mind that serves as our moral compass and pushes us to be “good.” This is what drives us to work hard and be thoughtful toward others, but it also gives us perfectionist tendencies and makes us worry about not being good enough or successful enough. The...

The Mindbody Prescription Summary Personality Traits: Who Is Predisposed to TMS?

Psychoanalytic theory helps explain why the mind represses some emotions and why the body translates those emotions into physical pain. However, everyone has repressed emotions, but not everyone suffers from TMS. According to Sarno, some personality traits are especially associated with TMS. These tend to relate to feelings of inadequacy and the need for approval from others. They include perfectionism, self-criticism, low self-esteem, conscientiousness, ambitiousness, and the desire to be a good person and to please others (which leads to guilt when these desires aren’t met).

These traits are characterized by pressure on oneself, explains Sarno, and this pressure enrages the child part of the mind because the child wants to be free of responsibilities and expectations. Because rage is the primary emotion these traits engender, and because these traits are practically universal in people suffering from TMS, Sarno concludes that rage is the primary repressed emotion that causes TMS.

The Role of Rage, and Character Traits That Make It Easier to Cope With Pain

Some experts suggest that [anger is the primary emotion associated with...

The Mindbody Prescription Summary What Does TMS Look Like?

So far we’ve explained that pressure results in undesirable emotions like rage, that the unconscious mind represses these emotions, and that the brain distracts the conscious mind from these emotions by creating physical symptoms. These symptoms tend to include pain in the neck, shoulders, back, or legs. However, TMS can manifest in many different ways, all of which appear to be different conditions but which arise from the same source.

The symptoms of TMS can include nerve pain, joint pain, muscle weakness, inflammation, temporomandibular joint dysfunction, tendonitis, and chronic fatigue, all of which tend to be diagnosed as their own discrete disorders. Sarno also explains that TMS can manifest itself as seemingly unrelated but ultimately equivalent conditions such as tinnitus, dizziness, anxiety and depression, gastrointestinal disorders, circulatory and cardiac disorders, skin disorders, and genitourinary disorders (related to the genitals and urinary tract). Many of these symptoms can occur as a result of non-TMS conditions, but in those cases, treating the underlying condition should resolve the pain. Pain that has resisted multiple treatments is a strong indicator of...

The Mindbody Prescription Summary How to Treat TMS

According to Sarno’s theory, chronic unexplained pain is a harmless physical manifestation of repressed emotions. Therefore, physical treatments won’t cure TMS. Instead, Sarno explains that the most effective treatment for TMS starts with knowledge: You have to understand mindbody disorders and where the pain is actually coming from in order to treat it. This is why, according to Sarno, many people can cure their pain simply by reading his books or attending his lectures. However, Sarno emphasizes heavily that patients should only take on this diagnosis and treatment after doctors have effectively ruled out the chances of a serious illness.

(Shortform note: Testimonials from people who’ve found success with Sarno’s method support his statement that knowledge is the key to treatment. Prominent media figures like Howard Stern and Larry David have praised Sarno’s method, and there’s a website called thankyoudrsarno.org featuring over 100 success stories and thank you notes to the late doctor.)

Once the patient understands the source of their pain and how the...

Shortform Exercise: Overcome Your TMS Symptoms

Consider how TMS might be manifesting in your life, and how you could use Sarno’s advice to treat their effects.

Identify a symptom you’ve been experiencing that doesn’t seem to have a clear cause. How does this symptom manifest? This might include pain, gastrointestinal issues, allergies, dizziness, and so on.