Honoring The Original Mindfulness Guru

All we hear about today is mindfulness. And meditation. Breathing, observation, awareness. There is a reason that these concepts are rising to the top of our harried, overworked, physically suffering collective consciousness. It’s because we are out of options. The pills once deemed as the standard of care by hungry pharmaceutical companies looking for an analgesic solution aren’t doing the trick we’ve been promised. Opioid addiction and overdose are threatening to end the species. We are desperate. 

Chronic pain affects more people in the U.S. today than diabetes, heart disease, and cancer combined. It is an epidemic wildly out of control, costing the country upwards of 635 billion dollars a year.  If it’s not the backache which sends you home from work early, it’s that bout of IBS. Maybe the dreaded migraine strikes right at the worst moment. Your neck won’t turn to the left, your hip is screaming, you suffer from Fibromyalgia, your sciatica is shooting into your foot. Who could have predicted this devastation; this earth swallowing horror from which our escape is uncertain?

Dr. John Sarno. 

Dr. Sarno died in June, the day before his 94th birthday, almost 40 years after he had first predicted this catastrophic chronic pain explosion within which we now fester. For over half his life he practiced as an attending physician at the Rusk Center for Rehabilitation at NYU Medical Center, healing patients by helping them to understand that their minds were their most powerful tool in alleviating pain. Now, as we find ourselves at the point of surrender on the chronic pain battlefield, preeminent institutions like the Mayo Clinic’s Pain Rehabilitation Center are singing Dr. Sarno’s tune. Under their “Core Components of Pain Rehabilitation Center Programs,” the first bullet listed is Group Therapy stating that, “Skills such as relaxation, stress management and problem-solving are emphasized.” 

In the article The Secret Life of Pain in the New York Times on August 1st, 2017 David C. Roberts details his pain journey at Mayo as being “…treated as a malfunction in perception, whether or not an ongoing physical cause had been identified. The brain becomes addicted to dramatizing pain, and the more you feed it, the stronger the addiction.” He goes on to explain Mayo’s recommendation. “Don’t dwell on the pain, and don’t try to fix it — no props, no pills. Eventually the mind should let go.”

Here is where we could use the father of chronic pain mindfulness to sort out the details, and save our lives. Perhaps the mind should let go, but the mind doesn’t always listen to the shoulds. There is a specific science behind the reason we suffer and the ways in which to heal, and Dr. Sarno explained them in 1984 when he wrote Mind Over Back Pain, and again in The Mind/Body Prescription in 1999, and again in Healing Back Pain in 2001, and finally one more time in The Divided Mind in 2006. Society wasn’t ready to listen, and the precarious ground on which we stand (well, lay down) is the result. Luckily, it’s not too late.

Dr. Sarno was not saying that the pain is in your head any more than the Mayo Clinic is saying it now. The pain is not in your head, it is real and physical and it hurts like the scorcher it is. We certainly feel pain in our bodies, enough to land us in wheelchairs and hospitals and on disability, and begging for relief of any kind. What Dr. Sarno explained when the uproar over his theories calmed down enough for people to listen was: There is simply more than one way to reach the same conclusion. Although felt as symptoms which appear attached to certain muscle groups or bodily systems, the grips of chronic pain are in the mind, and can only be alleviated using the mechanism with which they are being sustained.

This is not to say that we do not experience pain connected to an immediate or logical injury which requires healing. The dark forest of chronic pain develops when, after a period of time or a completion of therapy indicated to relieve a particular problem, the pain sticks around. Or it moves. Or it worsens. Or perhaps it lessens just to be replaced by another syndrome. The back pain is less but now the headaches, the migraines seem manageable but now the stomach…

Dr. Sarno explained that pain is the result of the brain attempting to protect and divert us from feeling the dark, unpleasant and inconvenient emotions associated with being a human being. Once an area of weakness is uncovered, like an old sports injury or a condition one takes for granted as an achilles heel, the brain seizes on the opportunity to keep us in the physical - a safer spot, it posits, than dealing with the myriad life challenges which we feel are impossible to change or control. It is essentially a survival response, albeit a wildly misguided one. And it is the reason our society suffers with chronic conditions as never before. This makes sense, as our world is more complicated and our problems more overwhelming, and our primitive fight or flight systems are looking for a steam valve. Dealing with chronic pain is just that — as we busy ourselves with doctor’s appointments and second opinions, our systems find their way to a miserable yet stable equilibrium. If we are “handling” something we feel more powerful. 

The mindfulness mantra when it comes to chronic pain is missing a piece, and Dr. Sarno’s theories are holding it if we are finally ready to take a look. If we are simply willing to systematically take a look at our most difficult feelings, those of anger, rage, fear, terror, shame, despair, and regret among others, we can release our brain’s reflexive function of protecting us with physical pain. The work is simple, but it’s not easy. It takes an open mind, dedication, and bravery. This is no pill, or even a surgery where you can give away your power and wake up 5 hours later on the perceived road to transformation. This is a process which is as hard as it is rewarding. The results are the definition of the modern miracle.

Yes to mindfulness. Yes to breath work. Yes to yoga and meditation and affirmations and group therapy.  Yes, a thousand times yes. But without the integral piece of learning the language of communication between mind and body, all of these lovely modalities will have limited efficacy. Sarno’s theories and those which have been built upon them serve as a vehicle to relief. If we are to slay the Goliath of drug dependance and the panic of pain, this is the very David we need.

It is widely held that Dr. Sarno died never knowing the power of his legacy. The same is said of Hamilton. And Van Gogh, and Bach, and Thoreau. Time will tell. History will write the story of a society saved by the uncommon wisdom of a soft spoken man who once taught us how to properly feel.


Nicole J. Sachs, LCSW is a speaker, writer and psychotherapist who has dedicated her work and her practice to the treatment of chronic pain and conditions. She is the author of The Meaning of Truth, and the online course: FREEDOM FROM CHRONIC PAIN. Through her personal journey, as well working with hundreds of clients, she's shaped and evolved theories which serve to teach those suffering how to heal themselves, completely, with no medication or surgery. She lives and works in coastal Delaware with her wife and their five beautiful children.