Fear & Loathing & Lower Back Pain

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My computer’s wallpaper is a picture of a smiling Buddha, cherubic and childlike. Above his head is the quote:

All that we are is the result of what we have thought. The mind is everything. What we think we become.

Before my recent transformation explained below, I would have read this quote in the abstract. Now I experience its truth at bone level – however my version is slightly tweaked. In my case it’s not what I have thought, but rather what my brain was thinking without my conscious knowledge or consent. Let me explain.

About seven years ago, I awoke in the middle of the night convulsing from white-hot searing pain shooting up and down my spinal column. I jolted out of bed and stumbled as far as the living room rug, where I collapsed and spent several hours writhing in agony. Every breath sent excruciating waves of sharp pain through my nerves like shattered glass. I sobbed and panicked. Without provocation, I had entered an entirely uncharted territory of true chronic pain that would last for years to come.

In the ensuing days I dragged myself to a handful of chiropractors and massage therapists – not because of their reputations but rather their proximity, since traveling any distance only brought more pain. The one time I tried to drive myself to an appointment farther away, the pain prevented me from being able to hoist myself out of the car. Of all the scores of therapists I visited, some could alleviate the pain for a short time, and others actually made it worse. I will never forget the chiropractor with the towering stature and tough demeanor of a football coach. He walked into the examination room and, without so much as a pleasantry, proceeded to violently contort my body in an effort to make a quick fix. I hobbled out of his office barely able to walk.

In the process of being treated by a seemingly endless merry-go-round of well-intentioned healers, I discovered some theories common among them. One: my pain was the result of the degeneration of a disk in the lumbar region of my spine, which was somehow affecting the nerves that passed around it. Two: according to x-rays, my L5 vertebrae had sustained a nearly imperceptible compression fracture, even though I could not for the life of me recall what accident could have caused such an injury. The doctor who diagnosed the fracture recommended that I immediately cease any yoga, and he offhandedly dismissed asana practice as “5,000 year-old voodoo cooked up by a bunch of old men in caves”. He then prescribed a very expensive brace that looked like a medieval corset, which would essentially prevent me from being able to move my lower back at all. Confusingly, his advice conflicted with many other experts who promoted regular spinal movement to manage chronic back pain.

The gruesome parade of therapies continued. A napropath with an alarmingly deep year-round tan would regularly inject an experimental homeopathic serum directly into my back. It could have been a placebo injection, for all I know. A Transylvanian acupuncturist named Kinga Van Brundt would tap hot needles into me as I lay in a warm, candlelit room. While she worked in her delicate way, she would whisper in her exotic accent things like, “total recovery seems like an impossibility for you, as I’m sure you realize by now”. A Chinese massage therapist and former MMA fighter with self-described “elbows of cast iron” would regularly knead me into a whimpering puddle of a man. I even became so desperate that I visited a fringy punk rolfer who worked in his tiny, cramped apartment and only accepted cash. He adamantly insisted that my pain originated in the hip flexor, and his manipulation of that tender spot would caused me so much shockingly intense pain that he had to establish a ground rule: I was not permitted to bite or punch him, although screaming and swearing were both perfectly within bounds. After “treatment” he offered me homemade medicinal tea with the consistency and flavor profile of vermouth and motor oil.

Finally this futile search left me so broke and dejected that I quit seeing any therapists and stuck to hot baths and daily sessions on my living room rug, stretching or simply staring at the ceiling. At work I must have been viewed as a freak. I would often stand during meetings since sitting caused more pain. At the farm I would purposely never leave anything on the ground because I wasn’t sure I would be able to pick it up again (a losing battle since, of course, everything grows on the ground).  I began to quietly idolize an old farmer that my dad had taken me to visit in Oklahoma, not only for his skills with raising vegetables but also for his limp when he walked, the effect of years of toiling on hard dusty soil. He was obviously in pain but carried himself with incredibly jolly spirits. That’s my fate, I would say to myself. Farming is hard. Life is suffering. The end. Deal with it. At least you’re married to a nurse, so there’s some hope.

I had finally arrived at a state of self-loathing that became my identity, much like this commenter on the website Tiny Buddha:

All of my self-imposed labels gave me a strange kind of soothing feeling. They affirmed something I already believed, deeply, within me: I was broken. I was in a state of disorder. There was something wrong with me.

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Joseph Campbell teaches that the hero’s journey is often aided by the sudden appearance of a supernatural figure, to offer a clue or to light the way to salvation. My supernatural savior appeared in the form of Dr. John E. Sarno, M.D, a professor of rehabilitative medicine and veteran physician in New York. After hearing about his bestselling book Healing Back Pain: The Mind-Body Connection, I bought it the next day. How could I resist the allure of a promise that “without drugs, without surgery, without exercise, back pain can be stopped forever”? All I had to lose was $7.95 and a few hours. I finished the book over a weekend, and for the first time in over seven years, moved through a glorious day of unfettered, fully mobile painlessness.

Dr. Sarno had returned me to my previous healthy self that I had believed long lost. I found myself alone in my apartment laughing out loud at my new found freedom to perform the most mundane tasks like flushing the toilet simply by bending at the waist instead of resorting to my usual stiff-backed ballet move I liked to call les plié de la toillette. Tying my shoes had never brought so much overwhelming joy. I danced like a crazy person to no music at all, while the cats watched sceptically.

So, how did the good doctor do it, without even meeting me for a consultation? He did it simply by shining a light on the mind-body connection that traditional Eastern medicine has been aware of for thousands of years. The idea is so simple that conventional Western medicine dismisses it as new-age psuedo science. And yet, in doing so millions of Americans continue to miss work because of chronic back pain (more than any other reason), continue to ingest toxic painkillers with serious side effects, and continue to endure terribly invasive spinal surgeries that often backfire.  We can edit the Buddha’s quote to explain how it works:

Most of our back pain is the result of how our minds misdirect our unconscious anxieties. The mind is everything. What we repress in our unconscious, we manifest in our physiology.

Or, to quote Dr. Sarno:

…we all tend to generate anger and anxiety in this culture, and that the more compulsive and perfectionist of us generate a lot. What one must then do is develop the habit of “thinking psychological” instead of physical. In other words, I suggest to patients that when they find themselves being aware of the pain, they must consciously and forcefully shift their attention to something psychological, like something they are worried about, a chronic family or financial problem, a recurrent source of irritation, anything in the psychological realm, for that sends a message to the brain that they’re no longer deceived by the pain. When that message reaches the depths of the mind, the subconscious, the pain ceases.

Sarno makes this central point midway through the book, prefacing the theory with chapters on the psychology, physiology, and manifestations of what he calls Tension Myositis Syndrome or TMS. For balance, he follows with more chapters on the traditional (conventional) diagnosis and treatments, allowing the reader to reach his own opinion and try the treatment, which consists of simply absorbing the material as well as actually talking, out loud, to your his own mind. The doctor encourages each person to come up with their own unique way of this self-mind-talk. I’ve done this many times and it works, as silly as it must look if anyone were to eavesdrop.

The book’s final chapter on Mind and Body references everyone from Hippocrates to Freud but never evokes Buddhism or other spiritual philosophies. Still, a comparison can be made between his holistic approach and the discipline of meditation. The meditator practices the technique of noticing. Noticing when thoughts arrive, how they come and go like clouds in the sky, how they are separate from our true selves, never defining us. By noticing and labeling thoughts as fearful, angry, or anxious, we can then release them categorically as only thoughts. Through this release our minds and by association our physiology are able to find stillness, and through stillness we can find a respite from pain. Sarno’s method is to recognize that underneath our conscious mind lies an underground reservoir of memories and dreams, some of them from early childhood and many of them traumatic. However a release through inward-turning practices like meditation, these upsetting fantasies find refuge in our pain centers and exploit those centers in a kind of feedback loop of chronic dis-ease.

To say that I’m ecstatic about finding this book and arriving at true relief through its teachings is an understatement. I evangelize on Sarno’s behalf to anyone who mentions having chronic back pain. That isn’t to say I’m one hundred percent without pain – the familiar aches do return from time to time, usually when I’m stressed. For example, just today I was at the farm with a group of twelve to fourteen-year-olds who were mostly goofing around while only two of them were focused on the task at hand (the much needed repair of a broken gate). Their obnoxious behavior combined with the bitter cold started to get the best of my patience, and I felt the muscles around my sacral vertebra spasm. The pre-Sarno me would have succumbed to the pain blindly, blaming myself for lifting something incorrectly or not working out enough. Today though, on the return walk I gave my mind a stern talking to (silently this time), and by the time we got back to school I was able to focus on life outside of my own problems.

For years, when my chronic pain was the first thing I thought of when I awoke and the last thing when I retired, I would chant the following mantra:

Om Shri Dhanvantre Namaha (salutations the celestial healer).

I still chant the mantra, but now instead of getting lost in the depths of my own navel (or more precisely the vertebrae just behind it), I can share the good news: suffering is universal, but doesn’t need to be everlasting.

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