Why you should look into Dr Sarno’s TMS

Bodymind symptoms

Dr. Sarno spent his life trying to help people with chronic pain. Dr. Sarno was a professor of rehabilitation medicine and an attending physician. In his years as a physician, he studied hernia and spine problems. He had found that many people have a hernia condition without experiencing any pain. By taking scans of people without back problems, he realized that the hernia itself is not the cause of back pain.

Surgery on people with a hernia and back pain did often resolve chronic pain on the particular spot, but it wouldn’t take too long before the complaints would move to a new spot in the body. A new weak spot where pain symptoms will form. By studying this phenomenon, he discovered that something else was responsible for the pain complaints. This is what he originally called Tension Myoneural Syndrome, or TMS.

His theory suggests that the unconscious mind uses the autonomic nervous system to decrease blood flow to muscles, nerves, or tendons, resulting in oxygen deprivation (temporary micro-ischemia) and metabolite accumulation, experienced as pain in the affected tissues. Later in life, he added many ‘bodymind’ symptoms to the list of potential sensations: fatigue, nausea, dizziness, anxiety, migraines, headaches, and so on. Dr. Sarno’s TMS now stands for The Mind Body Syndrome.

Personality traits of someone with TMS

When Dr. Sarno was examining patients with pain complaints, he discovered that all people had the same personality. They were all perfectionists, goodists, analytical, and responsible. People with these tendencies have what is called, in psychotherapy, a dominant inner parent. The inner parent has won the battle with the inner child, and as a result, the inner child of this person will develop rage. Buried rage manifests as physical complaints to divert the person’s attention from their own emotions.

When we deal with difficulties in life, we can either face our emotions and the problems or deny them. Denial is often caused by society’s pressures and judgments towards the so-called negative emotions. A person then swallows their own emotions. To deal with this unease, we then look for a way to cope. In this case, the inner parent has come up with lots of long-term strategies to create happiness in the future.

We expected to get the love and acceptance we needed from others by being goodists and perfectionists. In the long term, this doesn’t work, and it enrages the inner child inside of us. The rage must remain hidden, as our egos would see an outburst of rage as the death of the fake personality based on the inner-parent strategies. As long as we see this rage as an (egoic) death threat, the bodymind hides the rage for you by creating symptoms to distract you.

TMS and diversion pain syndrome

One condition for it to be a ‘bodymind’ symptom is to exclude a normal medical explanation. If you have made sure that conventional medicine has no explanation for your sensations, it is most likely a ‘bodymind’ symptom. Many people have built on Dr. Sarno’s work, and another often-used name is Diversion Pain Syndrome, or DPS. The theory is that the ‘bodymind’ creates symptoms to distract you from an emotion that you are very good at burying. It will find the symptom that you are most afraid of and want you to obsess about it.

Self study

In the self-study section of this website, you can download some of the books written by Dr. Sarno. ‘The Mindbody Prescription’ is a great starting point to understand his conclusions. Steve Ozanich continued his work and has written ‘The Great Pain Deception’. I recommend people take the time to absorb this material. The books are mostly written for chronic pain patients, but when you read fatigue instead of pain, I am sure it can help you.

How did it affect me?

Due to a rough childhood, I have not been able to develop a healthy ‘bodymind’ relationship. There was physical and mental abuse in my family. I have not grown up in a safe place, and my emotions were not tolerated unless I was happy. Anger is an emotion that comes with boundaries. By not allowing myself to experience anger, I have not learned to maintain my boundaries as a child. The house I grew up in was not safe enough for me to express myself that way.

I was scared but did not want to admit it. I felt helpless, but I didn’t want to experience it. I was humiliated, but I did not allow anyone to see that. For everyone, it seemed I was doing okay. Later in life, I was a driven and successful person, and people envied me. I made things look very simple, and I often heard that I could have only achieved those things because I probably had a perfect childhood.

My mind, however, started to become more and more restless. Despite all my accomplishments, I still experienced the loneliness that I had had since I was a small boy. It was a feeling I hated, and I did everything to not feel it. I was ashamed of my feelings of loneliness and unworthiness. In 2015, I had reached a very respectable place; for the first time in my life, I did not have any worries anymore. I had had financial issues since I was a child, and it was hard to leave that part of my identity behind. I started trying to relax for the first time in my life. A few days before I started feeling fatigued, I even took an MDMA pill. MDMA is known to release trauma.

My exhaustion

If there was one quality that I identified with, it was my ever-going energy. I had to exercise every day in order to be tired enough to go to sleep. When the fatigue hit me during some sort of flu, I listened to my body for the first time in years. When you listen to your body for the first time in years, it is not a pleasant experience.

According to the TMS theory, the fatigue distracted me from my emotional pain that was set free due to the calmer waters I was in at that time, plus the MDMA that had triggered my trauma. The ‘bodymind’ had successfully found and created a symptom that could make me obsess about it. I had had IBS for years by then, and I really didn’t care about it. This, however, was so extreme that I started to be very worried. Everything I had fought for was at stake. The fatigue caused me to feel even more stressed, and for a period of time, I just felt like I was Sherlock Holmes. The sharpness I had in my thinking is a side effect of being in the fight-or-flight mode of the nervous system.

After that period, I was so exhausted that my fatigue started to change. Not only was I fatigued, but I had also completely drained my adrenals. Instead of calming down, however, I was now studying my emotions in a state of complete exhaustion. I was in ‘fight or flight’ mode my entire life. Examining my emotional body was not something that would calm my nervous system down. Day after day, I was looking at my traumatic childhood. I cried daily for many hours. If you have ever done an EMDR session, you would understand how draining it is. After one session, you might be exhausted for a week. Doing this every day with the inability to relax due to the fight or flight stress response put the final pressure on my body, and it simply stopped working. I could not digest food anymore, I couldn’t sleep anymore, I couldn’t process information any longer, and so on.

Emotions like anger and fear

Even after all my emotional healing, I was still completely in the dark about my unconscious anger. I thought that anger was an emotion that I simply don’t have. This means that my ‘bodymind’ had done an excellent job hiding it for me. If I don’t experience anger, I will experience fatigue. Dr. Sarno says that of all emotions suppressed in the unconscious, anger affects TMS the most. If I now get tired, I can tell my unconscious mind that I know the emotions are there; it can stop hiding them from me. I will not obsess about my symptoms anymore. I know it is a harmless symptom created by slight oxygen deprivation and muscle tensions to distract me.

The easy way out

Luckily, Dr. Sarno discovered that we don’t always have to process our traumas to stop TMS from causing symptoms. Sometimes understanding TMS is enough to stop the ‘bodymind’ from making symptoms. This would mean that you have to read daily about this topic and how it works. Reading this blog is not enough; you will have to buy books on this topic. 75% of his patients have healed with understanding TMS and a 10–20 minute daily ‘bodymind’ awareness writing exercise. 23% healed after psychotherapy like EMDR. 2% of people did not heal.

Funny enough, many people will believe they belong to that 2% when they start. The idea that the mind can create these symptoms as a distraction for your emotional issues can be offensive if you don’t understand how it works. Almost everyone will deal with TMS symptoms at least once in their lifetime. When you add auto-immune diseases and more chronic and even worse conditions and diseases to the list of possible TMS symptoms, your ego may be able to digest this information easier. If you understand your body and its protection mechanisms, it might be enough to heal.

Don’t make a big deal about how to journal correctly in the beginning; you will eventually get the hang of it.

Update December 2020:

TMS is not the only approach.

Because the body of someone with ME/CFS has dealt with extreme stress over longer periods of time, I don’t believe Dr. Sarno’s TMS to be the only solution and explanation for chronic fatigue. You can find a very practical approach containing multiple holistic practices in the Release Program.


Check out the Mindbody transcript from Dr. John Sarno.

Check out The Great Pain Deception by Steve Ozanich.