Do I have to stop acupuncture in order to heal from TMS?

If you have read any of Dr. Sarno’s books, you will know that he categorizes acupuncture among the body-focused treatment modalities that must be stopped in order for TMS healing to be achieved. Given this, it might seem strange that I (as a licensed acupuncturist) would be such an advocate of Dr. Sarno’s teachings.

I agree with Dr. Sarno that acupuncture, if it is understood solely as a method of healing injured tissues, reducing inflammation, or altering the function of nerves, could be an impediment to recovery from TMS because it keeps the conscious mind focused on the body, which only serves to reinforce the TMS process.

As long as he is in any way preoccupied with what his body is doing, the pain will continue. – John E. Sarno, Healing Back Pain

Nothing new under the sun — not even Dr. Sarno’s “discovery” of TMS

Unfortunately, however, Dr. Sarno (and other TMS authors, including the most vocally anti-acupuncture of which is “TMS Whisperer” Steven Ray Ozanich) have thrown the proverbial baby out with the bathwater. With its rich and nuanced understanding of the psyche, Chinese medicine (including acupuncture) can be an invaluable aid to authentic recovery from TMS.

Though he does not seem to realize it, Dr. Sarno’s theory of TMS corresponds very closely with Chinese medicine concepts which date back over 2000 years. The Inner Classic of the Yellow Emperor (written around 200 BCE) says “bu tong ze tong, tong ze bu tong” which translates roughly to “if there is no free [blood] flow, there is pain; if there is free [blood] flow there is no pain”. There has long been an awareness among the sages of Chinese medicine that unresolved emotions are a primary cause of this lack of free flow. According to ancient medical texts, chronic pain is often caused not by a physical problem but by “crystalized emotion”, which results from familial issues that have been swept under the rug, early childhood abuse forgotten by the conscious mind but remembered by the body, and/or refusal to face one’s own shadow side and trying to be “all goodness and light” while denying deeper layers of emotion. In these cases, the treatment is to “dare to shine the light of awareness into the dark death sleep of a denied truth” (Lorie Eve Dechar, in her book Five Spirits: Alchemical Acupuncture for Psychological and Spiritual Healing). Does this sound familiar? It should, because this is almost exactly what Dr. Sarno says about the cause and cure of TMS.

What purpose can acupuncture serve in the TMS healing process?

Healing from TMS is a DIY project — no doctor or acupuncturist or counselor can do it for you — but that doesn’t mean that you have to go at it completely alone. Over and over again I have seen even complicated tangles of “physical” maladies unwind and patients take huge strides forward in recovering from TMS when they are treated using emotionally-focused acupuncture techniques. Dr. Sarno acknowledges that some patients need to work with a counselor or psychologist in order to recover from TMS. In my opinion acupuncture can serve a similar role by giving a person a leg up as they untangle the knots that unconscious and conscious negative emotions create in the body.

I know that I would not have made it through the very difficult early days of my healing process if it weren’t for acupuncture. As I was discontinuing my pain medications (the key to my recovery), my pain and emotional distress was overwhelming. I didn’t have attention to spare for reading Dr. Sarno’s books, writing in my journal, or finding insight into the role my emotions were playing in my pain. Instead, all I could think about was that I felt like I was going to jump out of my own skin. Until I gave myself acupuncture. Each treatment gave me a priceless window of calm. The needles quieted my sympathetic nervous system, dilated my blood vessels, and eased my pain. Acupuncture gave me the relief that I needed in order to stay present in my body and mindful enough of the relationship between my emotions and my pain to become convinced that the cause of my problem was psychological, not physical. Even just the rudimentary treatment that I am capable of giving myself was enough to help a lot (I have always been jealous that my patients get much more sophisticated and nuanced acupuncture treatment, which would have been even more helpful to me).

Real relief requires attention to the mind AND the body

Although I have a very high regard for Dr. Sarno and his work, his theory is not perfect. Physicians have erred by focusing only on the body and ignoring the role of the mind and the emotions. In an attempt to correct this error, Dr. Sarno’s theory swings to the far opposite extreme and focuses exclusively on the mind. This leads Dr. Sarno to classify any therapy involving the body as a distraction (at best) or impediment to healing (at worst). It seems to me that the truth lies somewhere between these two extremes. In my opinion, the ideal therapy treats the body and mind as two ends of a single continuum (as opposed to separate entities).

According to Taoist philosophy and Chinese medicine, each of the internal organs houses a different aspect of the psyche. This gives each organ a set of mental and emotional functions in addition to its physical ones. When the organs are functioning optimally, the result is mental, emotional, and spiritual harmony (in addition to physical health). In contrast, when the function of the organs is compromised, then mental and emotional health suffers in ways that are specific to each organ.

Organ/
Aspect of Psyche
When Function is HarmoniousWhen Function is Disharmonious
Heart/
Mind
Joy, happiness, self-confidence, compassion.
A person has luminous vitality and a sparkle in their eye, they are inspired, creative, happy, self-confident, and compassionate.
There is congruence between a person's personality and the life they are living.
A person is authentic, which makes them compelling and inspiring to others.
Agitation, shock, hysteria.
A person is plagued by insomnia, timidity, and discouragement.
Maintaining authentic social connections feels exhausting.
A person lacks a clearly defined "center" so even a normal level of activity degenerates into restlessness, nervousness, and anxiety.
A person lacks inspiration and insight and their life feels (to them and others) like it lacks heart and soul.
Liver/
Ethereal Soul
Self-assertion, motivation, responsibility.
A person makes decisions and plans readily and is capable of translating insight into a course of action and a clearly defined set of priorities.
They have clarity about their direction and purpose in life.
A person has emotional resilience and flexibility in the face of obstacles, as well as the ability to identify what they are feeling, state their feelings clearly, and stand by their feelings and beliefs.
Frustration, anger.
A person is plagued by depression, erratic emotions, disorganization, and a lack of clear psychological vision.
They tend to wander aimlessly, they start projects and then move on before completing anything, they struggle with procrastination.
A person can develop an obsession with blaming others, rather than taking personal responsibility, which prevents them from moving ahead in life.
Spleen/
Intellect
Clarity, empathy/sympathy.
A person has a razor sharp intellect, they have clear cognitive function, they learn easily, and are able to digest and assimilate information readily.
A person is able to stay centered in the face of other people's problems, needs, demands, and opinions.
They are able to digest experiences and impressions and transform them into values, ideas, and actions. 
Worry, overthinking, mental fatigue.
A person experiences mental fatigue, foggy-headedness, and has difficulty making logical connections between ideas and ordering thoughts in logical patterns.
They are prone to obsessiveness, overthinking, and rumination.
A person finds themselves stuck in endless thought loops that never lead to insight, decision, or action and has difficulty turning ideas and thoughts into commitments and actions.
Lung/
Corporeal Soul
Openness, receptivity, letting come & letting go.
A person is open and receptive and has the ability to let new things come and let old things go.
A person is able to create and maintain healthy boundaries.
A person has a clear sense of their value and place in the world.
Grief, sorrow, anguish.
A person has a hard time letting go of unhealthy patterns and relationships and is unable to move on in life.
A person has physical pain that overtakes their life but has no discernible cause.
A person has extreme sensitivity to other people’s emotions and moods.
Kidney/
Will
Resolution, willpower, trust.
A person has ample initiative, motivation, and perseverance.
A person has a clear understanding of what matters to them. They are able to know and speak their authentic feelings.
They are able to stay with projects until they are complete.
A person has courage to face the unknown.
Apprehension, fear, phobia.
There is a lack of drive, motivation, and initiative.
There is a lack of willpower and a tendency to addiction.
A person is unable to face their fears, which interferes with expression of true self.
At the extreme, a person loses the ability to hold steady or face the challenge of day to day living (nervous breakdown).

A lack of harmony goes both ways

When problems arise, it is sometimes difficult to discern which came first, the chicken or the egg. For example, a person whose Spleen function is weak tends to worry and overthink. But overthinking and worry damage and weaken the Spleen…and a weak Spleen causes more worry…and more worry makes a weak Spleen even weaker…and round and round we go. Once this cycle gets established it quickly becomes vicious, resulting in patterns of thought and behavior that are very difficult to shift once they become established.

The good news is that acupuncture, acupressure, Chinese herbal medicine, and movement therapies like Qi Gong can effectively interrupt this stalemate. A skilled acupuncturist can create a window of opportunity for you to more readily move from obsessive worry to clarity and confidence, from anger to responsibility, from fearfulness to confidence, thus facilitating your recovery from TMS.

How to find the right practitioner

It is important, however, to find a professional who is willing to take an emotional focus in working with you. Many licensed acupuncturists are like most physicians in the sense that they view pain as a problem that is caused by inflammation, tissue damage, degenerative changes, and the like. You want to find someone who is willing to assist you in shifting mental and emotional (as opposed to physical) patterns. If one is available, a Five Element acupuncturist would be an excellent choice. If that is not an option, I would recommend contacting the acupuncturists in your area by telephone or email and explaining that you are seeking help with shifting some emotional patterns in your life and ask if they have done this type of work before. You could even send them a link to this article. Although you may need to contact a few people, eventually you will likely find someone who either has the appropriate experience or is open-minded enough to be wiling to learn more about Dr. Sarno’s theories so that they can help you.

If this doesn’t work, the other option is to obtain a copy of The Joy of Feeling by Iona Marsaa Teeguarden. Unfortunately this book is both out of print (but available used) and rather dense but, for a motivated reader, it will provide the guidance needed to use acupressure to facilitate your emotional healing.

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