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 had studied hernia 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 realised 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 will move to a new spot in the body. A new weak spot where pain symptoms will be formed. By studying this phenomenon he discovered that something else is 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. TMS now stands for The Mind Body Syndrome.


When Dr Sarno was examining patients with pain complaints, he discovered that all people had the same personality. They were all perfectionistic, goodist, analytical and responsable. People with these tendencies have what is called in psychotherapy, a dominant inner-parent. The inner-parent has won the battle from the inner-child and as a result the inner-child of this person will develop rage. When this rage is buried, it will come out as physical complaints to distract the person from his or her own feelings.

When we deal in life with difficulties we can either face our emotions and the problems or deny them. A denial is often caused by society’s pressures and judgement 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 via others by being a goodist and a perfectionist. In the long term this doesn’t work and it enrages the inner-child inside of us. The rage must remain hidden as our ego would see an outburst of rage as a 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 wants you to obsess about it.

Self study

In the self-study section on this website, you can download some of the books written by Dr Sarno. ‘The Mindbody prescription’ is a great starting book to understand his conclusions. Steve Ozanich continued his work and has written ‘The Great Pain Deception’. I recommend people to 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 it affected 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 learnt to maintain my boundaries as a child.  The house I grew up in was not safe enough to express myself that way.

I was scared but did not want to admit to it. I felt helpless but did not want to experience helplessness. I was humiliated but 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 since I was a small boy. It was a feeling I hated and I did everything to not feel this. I was ashamed of my feelings of loneliness and unworthiness. In 2015 I had reached a very respectable place, for the first time in 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. I even took an MDMA pill a few days before I started being fatigued. MDMA is known to release traumas.

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 even tired enough to go to sleep. When the fatigue hit me during some sort of flue, 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, I had now completely drained my adrenals as well. Instead of calming down however I was now studying my emotions in the state of complete exhaustion. I was in the ‘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 everyday 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 in 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 it 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 did Dr Sarno discover that we don’t always have to process our traumas to stop TMS from making 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 would maybe be able to digest this information easier. If you understand your body and its protection mechanism, it might be enough to heal.

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

Update december 2020:

TMS 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 TMS to be the only solution and explanation for chronic fatigue. You can find a very practical approach containing multiple holistic practises in The Alignment Recovery Program.


Check out the Mindbody precription from Dr John Sarno 

Check out the Great pain deception by Steve Ozanich