John E. Sarno, M.D. is Professor of Clinical Rehabilitation Medicine at the New York University School of Medicine and attending physician at the Howard A. Rusk Institute of Rehabilitation Medicine at New York University Medical Center. Over the past 25 years, he has treated many thousands of patients with disabling back pain through educational lectures and claims a 90-plus percent success rate. He has written extensively on the subject, including his two most recent books, Healing Back Pain (Warner 1991) and The Mindbody Prescription (Warner 1998).
According to Sarno, most back pain is caused by tension myositis syndrome (TMS), a condition in which repressed rage causes the brain to select certain parts of the body for mild oxygen deprivation. The most frequently targeted areas are the neck, shoulders, and middle and lower back. Although "myo" means muscle, Sarno notes that nerves and tendons can also be involved.
Sarno's theory, which draws heavily on psychoanalytic concepts, posits that the driving force behind back pain is unconscious or repressed rage. The pain serves as a distraction to prevent the sufferer from dealing with terrifying thoughts. According to Sarno, the rage is comparable to dangerous criminals in a maximum security prison. Unacceptably frightening thoughts exist below the level of consciousness but are constantly struggling to reach awareness.
Sarno says that there are three sources for the rage: past anger; a sense of inferiority; and daily life pressures. Past anger may involve childhood traumas such as sexual or extreme emotional abuse. Daily life pressures include work deadlines, taking care of children, and even positive life events such as getting pregnant or married.
One of the most interesting parts of the theory involves the sense of inferiority. It is more fully described in The Mindbody Prescription. According to Sarno, the "child," what Freud called the "id," is an illogical, narcissistic part of the unconscious that is easily angered. A desire to be perfect, to do "good," and other self-imposed pressures enrages the "child," adding to the reservoir of anger.
So what does all this have to do with anorexia nervosa?
