10 ms·

People are incredibly reluctant to believe that ailments might actually be partly or mainly psychological. Chronic fatigue, fibromyalgia, chronic lyme disease,

by patmcc 5y ago

People are incredibly reluctant to believe that ailments might actually be partly or mainly psychological. Chronic fatigue, fibromyalgia, chronic lyme disease, back pain, are all things that sincere people truly are suffering from...that may be mainly psychological/psychosomatic but lots of people refuse to consider it. Probably due to the general dismissal of mental illnesses and being told for years "it's all in your head". I think partly, people with these conditions are sometimes accused (or think they're being accused) of malingering; I don't think that's the case very often, I think they legitimately feel the symptoms they report, but the root cause may be in the mind/brain rather than the rest of the body. Yes, some back pain is due to repetitive stress injuries or physical structures out of place or whatever. But as this study shows, looks like it has a strong psychological component as well. I suspect we'll (some day) get better treatments for all the things I mention, if mental illness stigma ends and they can be honestly considered from all possible causes. Edit: to be clear, I'm not saying that all cases of back pain or CFS or whatever are psychosomatic - just that it shouldn't be dismissed, especially when the treatments are relatively low-risk.

pfortuny 5y ago
Also, being psychosomatic does NOT mean they are ficticious, which is a widespread opinion.
playpause 5y ago
It’s odd that “all in your head” means “not a serious problem” or “you can fix it by yourself”. It seems to me that a problem being located in the head/brain/mind is, almost by definition, particularly difficult to fix, let alone to fix without external guidance.
casion 5y ago
However, quite dangerously, those ailments are also often misdiagnosis's. Fibro was a misdiagnosis for me, and I nearly died because I accepted it and worked on a psychological and rehab program rather than continue to pursue symptoms.
- cpncrunch 5y ago
  What was your eventual diagnosis?
  - casion 5y ago
    Autonomic neuropathy.
    - cpncrunch 5y ago
      So how was that diagnosed, and what is the treatment that saved your life?
      - casion 5y ago
        Saw a neurologist who ran a QSART, which I failed spectacularly. Treatment is supportive (vasodilators, beta-blockers, anticholinergic). I was at extremely high risk of stroke or dangerous fall until appropriately treated.
giantDinosaur 5y ago
You couldn't have picked a worse example than CFS to include in that list - a syndrome that for decades was dismissed as psychosomatic, and that many people (read: most notably medical professionals) today still dismiss as such, despite the evidence that no, actually there's some kind of physical dysregulation going on (probably triggered in many cases by a viral infection.)
- ianai 5y ago
  Few things are worse than a doctor denying care because of such denialism.
- cpncrunch 5y ago
  I managed to recover from ME/CFS 20 years ago (with no symptoms since). It was entirely through psychological/behavioural changes that I was able to recover. >actually there's some kind of physical dysregulation going on The only replicated findings are with the HPA axis (the stress system). There are some studies pointing towards impaired mitochondrial respiration due to reduction in the link step between pyruvate and the TCA cycle. However, if you take a quick look on google scholar, you'll see that that link step is downregulated by the glucocorticoid receptor (the stress system again), so that would seem to be the likely cause. There are also some studies showing reduced work capacity after repeat CPET. But again, the HPA axis influences CPET performance, so that is a possibility there as well. The point is: just because there is "physical dysregulation" doesn't mean it can't be caused by stress or psychology. That is literally how the brain works (if it didn't, we wouldn't be alive and conscious). Psychology is intrinsically linked to the immune system, HPA axis, autonomic nervous system. Psychological stress has been repeatedly shown to cause neuroinflammation, cyyokine release, impairment of the parasympaethetic nervous system, to name a few.
  - tomByrer 5y ago
    Good info! + Bruce Lipton's "Cell membranes are brains" theory. https://youtu.be/3tZ513NeSIc?list=PL2S-_LNXy9Vx24_o9zSTF6MADGr_4upKN&t=210 https://youtu.be/3tZ513NeSIc?list=PL2S-_LNXy9Vx24_o9zSTF6MAD... Also noteworthy: one of the top co-morbidities for COVID-19 is anxiety. https://youtu.be/iY98nuD3Bco?list=PL2S-_LNXy9Vx24_o9zSTF6MADGr_4upKN https://youtu.be/iY98nuD3Bco?list=PL2S-_LNXy9Vx24_o9zSTF6MAD...
glasscannon 5y ago
Something I only discovered recently is how much of an impact sustained mental stress/anxiety can have on your body. It puts your body into a state of fight or flight, which eventually wears you down. It's a very valid root cause to look for in diagnosis.
Klinky 5y ago
Sample size of 35 and mindfulness is not novel or new. It probably does help some people. However, a huge grain of salt should be taken with any diagnosis illness/disease being due to stress or psychosomatic. Some doctors immediately jump to this after doing very little due diligence and diagnostics. It should be a diagnosis of absolute last resort. Stanford does have a CFS clinic investigating pathogen-related causes[1]. 1. https://med.stanford.edu/chronicfatiguesyndrome.html https://med.stanford.edu/chronicfatiguesyndrome.html
- cpncrunch 5y ago
  >It should be a diagnosis of absolute last resort. No, it should be equal. >Stanford does have a CFS clinic investigating pathogen-related causes[1]. They haven't come up with anything, and their scientists are problematic: Montoya getting fired for sexual harassment, and Davis saying that anyone who doesn't think CFS has a molecular basis is a fool.
  - Klinky 5y ago
    >No, it should be equal. Okay, what is the consistent testing/diagnostic methodology that accurately measures stress and psychosomatic impact across patients? Typically it is going to be a diagnosis of exclusion. If you think you're diagnosing someone with stress/psychosomatic causes before comprehensive testing, imaging and/or specialists visit have been done, then you're jumping the gun, and potentially adding further stress to the patient as they try to follow a regimen that has little effect at helping their condition. I was not aware of the Stanford CFS clinic drama.
    - cpncrunch 5y ago
      Yes, the doctor should explore all possible causes with the patient. Tests can be done, and the doctor can also discuss stress. That is generally how it is done. Quite often in these cases there will be no final diagnosis.
      - Klinky 5y ago
silisili 5y ago
I was one of them. I thought panic attacks were some stupid made up thing for weak people, same with anxiety and the rest of them. Then it happened to me. And it affected so many things you wouldn't believe, from chest pains to fatigue to brain zaps to esophogal tremors to stool color even. I will gladly eat crow, I'm only admitting as much because I understand how easy it is to dismiss psychosomatic ailments. When you don't have any to worry about, it's nearly impossible to begin to comprehend. I liken it to ghosts...some folks swear they've seen or experienced them, but I don't see how it's possible. I half expect to be proven wrong on that, also.
- fsloth 5y ago
  I believe ghost sightings are real - but caused by visual system trying to map inconclusive/limited information to something it already has a pattern for, and once a pattern (no matter how absurd) is found, it latches onto it. AFAIK what we "percieve" of the world is anyway a hallucination produces by our brain based on sensory input. And particular conditions can mess this up briefly. I've seen things twice that weren't there and realized what was going on only when got closer. First was when in the middle of the night I saw through a half open door my son (1 y at the time) walking in a room - I entered the room, and realized it was not plausible he could have been where I saw him a second a go. I backtracked what I saw and realized there was play carpet with road patterning on the floor, plus miscellanious kids stuff on the background. It was nearly pitch black. From my pov the scene mapped to my son in my visual system, and then it maintained this pattern just long enough for me to "see him walking". Second was when I during a normal day observed what only could be two crows fighting or mating on a small tree. I got close. Really close. Then it suddenly 'stopped' being two crows and I realized it was just a black plastic bag fluttering in the wind. I have no idea how to teach people of the fragility of our cognition in a way that would not involve a pathology as you had - realizing fragility of psyche is real similarly as death is real - but I feel realizing this would make people more emphatic towards all sorts of problems our fellow humans have.
  - jwally 5y ago
    This? Pareidolia (/ˌpærɪˈdoʊliə, ˌpɛər-/;[1] also US: /ˌpɛəraɪ-/)[2] is the tendency for perception to impose a meaningful interpretation on a nebulous stimulus, usually visual, so that one sees an object, pattern, or meaning where there is none. https://en.m.wikipedia.org/wiki/Pareidolia https://en.m.wikipedia.org/wiki/Pareidolia
deleted 5y ago
[deleted]
denvaar 5y ago
My dad has been fighting cancer for the past 13-ish years. He recently told me that he's expected to live another six months or so because he has ran out of treatment options. Though we've known for most of these past years that his cancer is terminal, I feel like him telling me the news set something off inside of me. Starting shortly after the time of hearing this news, I started to feel subtle, hard-to-pinpoint discomfort near my tailbone & perineum (sorry, TMI). I went to the doctor multiple times, had all types of exams and scans, but everything was coming back as "normal". My symptoms got worse as weeks went on, and I became incredibly anxious, though I was not able to recognize it as "anxiety". At the peak of all this I found myself having what I would assume was an anxiety or panic attack. I could not control my breathing, started sweating, feeling like I was about to pass out. My wife was able to calm me down by helping me breath. I would break down crying on the phone trying to schedule doctors appointments (I'm 30 years old). I was unable to sleep at all for several days in a row even though I felt completely exhausted. Had to take time off (Incredibly thankful for coworkers/managers who were understanding) Chest pain, digestive issues, etc. It's been a weird few months, but I finally think (hopefully) I am starting to get back to my "normal" self. The experience has taught me at least a couple things: - Mental / emotional heath is something that is taken for granted. Now I have a new perspective on the importance of trying to maintain it and want to be understanding toward others. - I think some (all?) of my symptoms were definitely related to what was going on in my life, and how things played out as I tried to fix them. This is hard for me to wrap my head around, but really I have found no other logical explanation.
- mmaunder 5y ago
  That’s a powerful story. I’d encourage you to try yoga. Do the Beachbody 3 week yoga retreat. Then continue doing one of the final “flow” routines every day. It’s 30 mins and is very accessible. It cured my chronic back pain and has eliminated anxiety about a range of things. After 4 years of doing this its also left me with an insanely strong core and great flexibility.
- seer 5y ago
  So sorry to hear what you were going through. My partner had something similar due to the stress from the pandemic. What helped her the most was actually a regular psychiatrist appointment. Did you do something specific when you took your time off and saw your symptoms disappear? Curious what helped you the most.
xwowsersx 5y ago
Yeah, part of the problem is in the wording too. It's incorrect to say "it's all in your head" because this makes it sound like the person experiencing the pain is just imagining it or that it's entirely a construct of their mind. What Sarno points out is that there might be some underlying physical issue at play, but it's the extent of the pain that has a psychological component to it. As an example, two people can have the same exact x-ray of their back showing some alignment or other issue. One person will experience extraordinary pain and the other barely any at all. The fact that this is left unexplained by chiropractors (who are mostly kooks IMO), for example, should be a big red flag. How can it be that people who are supposedly experts in this field cannot explain for a basic a discrepancy like this? I think the right way to open people up to this is to acknowledge and validate their pain, that it's real (not "in your head"), but have them consider that the mind-body connection could explain more than perhaps they had previously realized. If you start out the gate with "it's all in your head", not only in this not correct, but it turns the person off because it sounds dismissive and pseudo-scientific.
- codingdave 5y ago
  Except that it is all in our heads, ultimately. Pain is a sensation in our brains, based on inputs from everything else. That "everything else" is often our physical nerves, but can also be everything else going on in our heads. If someone needs to meld the idea of psych-driven pain with physical pain, trying to deny that they come together in our heads can backfire. It is more important to focus on what we even mean by pain being "real", and that it being in our heads does not invalidate it in the slightest. It is real, and there are more paths to recovery to explore.
- tsol 5y ago
  >One person will experience extraordinary pain and the other barely any at all. The fact that this is left unexplained by chiropractors (who are mostly kooks IMO), for example, should be a big red flag. How can it be that people who are supposedly experts in this field cannot explain for a basic a discrepancy like this? Not sure what chiropractors have to do with this, you can see an MD for your back pain too but they'll be equally hard pressed to find the reason for the difference. And that's simply because there are countless variables-- x-rays don't show you cell level differences between the patients, central sensitization in the brain plays a part, different pain tolerance(ie something as simple as being a redhead is associated with increased pain), the level to which a certain amount of pain causes psychological distress can also change, coping mechanisms used, etc
bserge 5y ago
I mean, technically all pain is in your head. Because the brain processes it. If one can learn to ignore it, well... Good? Just go on until you literally become disabled, I guess. I ignored the ridiculous fatigue from hypothyroidism for years. It was my hands looking like someone slashed them a dozen times with a knife, bleeding to the point of having to wear gloves in late spring that led me to finally get medication.
lostdog 5y ago
> People are incredibly reluctant to believe that ailments might actually be partly or mainly psychological. There are two simple reasons why people don't want their ailments to be psychological. First, there are no real tests for determining if something is psychological or physical. Doctors just test for some stuff, and if the tests come back negative or inconclusive, they just explain it away as "psychological." You can never be sure whether you have a physical problem or whether your doctor is just lazy. Second, the medical system just gives up on you if the issue is psychosomatic. There are no treatment protocols that work, so agreeing that something is psychological is just having your case tossed on the trash heap to be ignored. Modern medicine does have a light side and a dark side. On the light side are known ailments with known tests and treatments. On the dark side is everything fuzzy and uncertain. Doctors HATE being faced with ambiguity, and patients know that if their case falls into the dark side that treatment and recovery are hopeless.
- amelius 5y ago
  > There are two simple reasons why people don't want their ailments to be psychological. Another reason is that most people find it scary if someone starts tinkering with their psyche. I honestly think that every therapy should start with strategies to overcome this fear.
- hdjjhhvvhga 5y ago
  > Second, the medical system just gives up on you if the issue is psychosomatic. There are no treatment protocols that work, so agreeing that something is psychological is just having your case tossed on the trash heap to be ignored. Maybe it's because we need to change our approach to psychotherapies in general. The reason psychology as a whole is not considered hard science is because replication is hard and in some cases impossible (good luck finding subjects who haven't heard about the Stanford prison experiment today). Why don't we accept this is just the way it works. That some therapies will work for some people and won't work at all for others (or might even make their symptoms worse). That therapy needs much more time than a pill to work - instead of hours, we're talking weeks and months, possibly years. That the evaluation of the results always has an element of subjectivity: sure, you can measure some physiological aspects, but there is always the internal component of well-being.
watwut 5y ago
> are all things that sincere people truly are suffering from...that may be mainly psychological/psychosomatic The back pain being cause by physical issues is not exception. The doctors and physiotherapists that wrote articles I read, had talks I has seen and the ones people I know visited never mentioned that. Instead, they recommended to fix the posture a set of "exercise" routines for rehabilitation. They also explained back damage as a mechanism. And those actually worked. Back pain can be very often helped, if you fix posture and do rehabilitation. It is not exception for it to be purely physical. The moment you claim it is psychological, the people who have fixable mechanical issue, won't get any help. And that help, quite apparently, actually makes difference. And not just with back pain.
- BeetleB 5y ago
  There are different kinds of back pains, and for a few years I had them on and off, and it very likely was posture related. The first time I tried a good lumbar support my pain almost disappeared while using it. It was such a relief that even now, a decade later, I have that lumbar support for all the chairs I sit in - home or work - even when I'm pain free. However, my pain was unusual (did not fit the usual symptoms people normally have). There are other types of back pains. Sarno was always insistent that a physiological cause always be investigated, and if one is found, to treat it accordingly. Absent that, he would recommend a psychological approach. One thing he highlighted that I've anecdotally found to be true when discussing with others[1]: The pain often disappears near/after retirement. And almost all physiological problems get worse with age - not better. Me personally: Sarno's approach didn't work with other pains (ones he claims are within the scope of this type of pain). I don't know what the cause is - doctors never found anything and physical therapists have told me they've never dealt with my types of pains. Maybe it is psychological, but I must emphasize: Sarno's approach didn't work for me. [1] A former boss is an example. He said he had severe back pain on and off for so many years - had to take time off from work, etc. Nothing really worked. But eventually, in his mid 50's it went away and he doesn't know why. He's near retirement (senior guy with money), kids all grown up and graduated from college (or near graduating). Once a lot of his life worries got resolved, so did his pain. His story is fairly common.
andy_ppp 5y ago
I knew a guy who had an extremely stressful job and a bad skin condition, it cleared up as soon as he left. The brain and body are extremely connected.
atom_arranger 5y ago
All pain is psychological. I imagine for most people with back pain there is a physical component, they didn’t have back pain as children, but if we had full control of the brain we could turn off the pain sensation if it’s not useful.
asadkn 5y ago
There can also be physical issues that can be masked psychologically. You can train your brain to ignore and mask many pains and aches and dull them down. IMHO, managing pain can definitely be done psychologically, at least to some extent. Being too aware of the pains, obsessing over them, and being anxious and stressed definitely aggravate the conditions in my experience. Having an otherwise healthy balanced life in terms of work, relationships etc. with healthy amount of stress, makes some of the ailments very manageable or a non-issue.
cameronh90 5y ago
I agree with all of this but just to add, the pain can indeed be a real physical issue directly caused by mental health. For example, anxiety often causes muscle tension and bad posture which can lead to real mechanical pain causing issues. I suffer from panic attacks and they are a very physical experience. My temperature stops regulating itself properly and I get GI problems. This is likely an indirect consequence of the adrenaline surge, but there are other known and theorised ways that your mental state can influence your body.
gameswithgo 5y ago
You are unwittingly just promoting yet another form of back pain snake oil and there is already plenty. If I had fallen into the idea that my back pain was “just in my head” I would have gotten no where. I encourage anyone suffering to get an MRI as early as possible so at least you know what is wrong. Doctors and chiropractors will regularly misdiagnose you. There are lots of ways a back can go bad and everyone has their pet advice which probably doesn’t apply to you.
- ethanbond 5y ago
  Get an MRI and consider that psychological stress can have physiological or physiological-seeming consequences.
- lukas099 5y ago
  > I encourage anyone suffering to get an MRI as early as possible Tons of people will have worse outcomes after getting an MRI, as it will reveal a physical abnormality that would have been symptomless otherwise.
intricatedetail 5y ago
Many doctors believe what you say and dismiss patients as psychosomatic if they can't find anything obvious. Sometimes they refer them to psychiatrists or insinuate they are drug seeking. It's a disgrace. This treatment from health "professionals" almost drove me to suicide. Actually my own research got me into a path of finding out I have a rare disease and I had to pay private consultants to help with diagnosis. Only then and a threat of lawsuit got the doctors treat me seriously and I actually got help.
- cpncrunch 5y ago
  What is the disease?
jfengel 5y ago
The brain is involved in all pain. The fact that the brain can help fix it doesn't mean it's psychosomatic. It just means you can interrupt the process at some place other than where the damage is. Chronic pain is aggravatingly hard to trace to the source. Maybe it's psychosomatic, maybe it's not. Calling it psychosomatic causes stigma -- it implies that it's fake and their choice. But they do want to get better. It's more than just thinking yourself healthy. It requires some counterintuitive ways to create new pathways. It's great that there is more research showing an improved way.

by patmcc 5y ago

pfortuny 5y ago

Also, being psychosomatic does NOT mean they are ficticious, which is a widespread opinion.

playpause 5y ago

It’s odd that “all in your head” means “not a serious problem” or “you can fix it by yourself”. It seems to me that a problem being located in the head/brain/mind is, almost by definition, particularly difficult to fix, let alone to fix without external guidance.

casion 5y ago

However, quite dangerously, those ailments are also often misdiagnosis's. Fibro was a misdiagnosis for me, and I nearly died because I accepted it and worked on a psychological and rehab program rather than continue to pursue symptoms.

cpncrunch 5y ago
What was your eventual diagnosis?
- casion 5y ago
  Autonomic neuropathy.
  - cpncrunch 5y ago
    So how was that diagnosed, and what is the treatment that saved your life?
    - casion 5y ago
      Saw a neurologist who ran a QSART, which I failed spectacularly. Treatment is supportive (vasodilators, beta-blockers, anticholinergic). I was at extremely high risk of stroke or dangerous fall until appropriately treated.

giantDinosaur 5y ago

You couldn't have picked a worse example than CFS to include in that list - a syndrome that for decades was dismissed as psychosomatic, and that many people (read: most notably medical professionals) today still dismiss as such, despite the evidence that no, actually there's some kind of physical dysregulation going on (probably triggered in many cases by a viral infection.)

ianai 5y ago
Few things are worse than a doctor denying care because of such denialism.
cpncrunch 5y ago
I managed to recover from ME/CFS 20 years ago (with no symptoms since). It was entirely through psychological/behavioural changes that I was able to recover. >actually there's some kind of physical dysregulation going on The only replicated findings are with the HPA axis (the stress system). There are some studies pointing towards impaired mitochondrial respiration due to reduction in the link step between pyruvate and the TCA cycle. However, if you take a quick look on google scholar, you'll see that that link step is downregulated by the glucocorticoid receptor (the stress system again), so that would seem to be the likely cause. There are also some studies showing reduced work capacity after repeat CPET. But again, the HPA axis influences CPET performance, so that is a possibility there as well. The point is: just because there is "physical dysregulation" doesn't mean it can't be caused by stress or psychology. That is literally how the brain works (if it didn't, we wouldn't be alive and conscious). Psychology is intrinsically linked to the immune system, HPA axis, autonomic nervous system. Psychological stress has been repeatedly shown to cause neuroinflammation, cyyokine release, impairment of the parasympaethetic nervous system, to name a few.
- tomByrer 5y ago
  Good info! + Bruce Lipton's "Cell membranes are brains" theory. https://youtu.be/3tZ513NeSIc?list=PL2S-_LNXy9Vx24_o9zSTF6MADGr_4upKN&t=210 https://youtu.be/3tZ513NeSIc?list=PL2S-_LNXy9Vx24_o9zSTF6MAD... Also noteworthy: one of the top co-morbidities for COVID-19 is anxiety. https://youtu.be/iY98nuD3Bco?list=PL2S-_LNXy9Vx24_o9zSTF6MADGr_4upKN https://youtu.be/iY98nuD3Bco?list=PL2S-_LNXy9Vx24_o9zSTF6MAD...

glasscannon 5y ago

Something I only discovered recently is how much of an impact sustained mental stress/anxiety can have on your body. It puts your body into a state of fight or flight, which eventually wears you down. It's a very valid root cause to look for in diagnosis.

Klinky 5y ago

Sample size of 35 and mindfulness is not novel or new. It probably does help some people. However, a huge grain of salt should be taken with any diagnosis illness/disease being due to stress or psychosomatic. Some doctors immediately jump to this after doing very little due diligence and diagnostics. It should be a diagnosis of absolute last resort. Stanford does have a CFS clinic investigating pathogen-related causes[1]. 1. https://med.stanford.edu/chronicfatiguesyndrome.html https://med.stanford.edu/chronicfatiguesyndrome.html

cpncrunch 5y ago
>It should be a diagnosis of absolute last resort. No, it should be equal. >Stanford does have a CFS clinic investigating pathogen-related causes[1]. They haven't come up with anything, and their scientists are problematic: Montoya getting fired for sexual harassment, and Davis saying that anyone who doesn't think CFS has a molecular basis is a fool.
- Klinky 5y ago
  >No, it should be equal. Okay, what is the consistent testing/diagnostic methodology that accurately measures stress and psychosomatic impact across patients? Typically it is going to be a diagnosis of exclusion. If you think you're diagnosing someone with stress/psychosomatic causes before comprehensive testing, imaging and/or specialists visit have been done, then you're jumping the gun, and potentially adding further stress to the patient as they try to follow a regimen that has little effect at helping their condition. I was not aware of the Stanford CFS clinic drama.
  - cpncrunch 5y ago
    Yes, the doctor should explore all possible causes with the patient. Tests can be done, and the doctor can also discuss stress. That is generally how it is done. Quite often in these cases there will be no final diagnosis.
    - Klinky 5y ago

silisili 5y ago

I was one of them. I thought panic attacks were some stupid made up thing for weak people, same with anxiety and the rest of them. Then it happened to me. And it affected so many things you wouldn't believe, from chest pains to fatigue to brain zaps to esophogal tremors to stool color even. I will gladly eat crow, I'm only admitting as much because I understand how easy it is to dismiss psychosomatic ailments. When you don't have any to worry about, it's nearly impossible to begin to comprehend. I liken it to ghosts...some folks swear they've seen or experienced them, but I don't see how it's possible. I half expect to be proven wrong on that, also.

fsloth 5y ago
I believe ghost sightings are real - but caused by visual system trying to map inconclusive/limited information to something it already has a pattern for, and once a pattern (no matter how absurd) is found, it latches onto it. AFAIK what we "percieve" of the world is anyway a hallucination produces by our brain based on sensory input. And particular conditions can mess this up briefly. I've seen things twice that weren't there and realized what was going on only when got closer. First was when in the middle of the night I saw through a half open door my son (1 y at the time) walking in a room - I entered the room, and realized it was not plausible he could have been where I saw him a second a go. I backtracked what I saw and realized there was play carpet with road patterning on the floor, plus miscellanious kids stuff on the background. It was nearly pitch black. From my pov the scene mapped to my son in my visual system, and then it maintained this pattern just long enough for me to "see him walking". Second was when I during a normal day observed what only could be two crows fighting or mating on a small tree. I got close. Really close. Then it suddenly 'stopped' being two crows and I realized it was just a black plastic bag fluttering in the wind. I have no idea how to teach people of the fragility of our cognition in a way that would not involve a pathology as you had - realizing fragility of psyche is real similarly as death is real - but I feel realizing this would make people more emphatic towards all sorts of problems our fellow humans have.
- jwally 5y ago
  This? Pareidolia (/ˌpærɪˈdoʊliə, ˌpɛər-/;[1] also US: /ˌpɛəraɪ-/)[2] is the tendency for perception to impose a meaningful interpretation on a nebulous stimulus, usually visual, so that one sees an object, pattern, or meaning where there is none. https://en.m.wikipedia.org/wiki/Pareidolia https://en.m.wikipedia.org/wiki/Pareidolia

deleted 5y ago

[deleted]

denvaar 5y ago

My dad has been fighting cancer for the past 13-ish years. He recently told me that he's expected to live another six months or so because he has ran out of treatment options. Though we've known for most of these past years that his cancer is terminal, I feel like him telling me the news set something off inside of me. Starting shortly after the time of hearing this news, I started to feel subtle, hard-to-pinpoint discomfort near my tailbone & perineum (sorry, TMI). I went to the doctor multiple times, had all types of exams and scans, but everything was coming back as "normal". My symptoms got worse as weeks went on, and I became incredibly anxious, though I was not able to recognize it as "anxiety". At the peak of all this I found myself having what I would assume was an anxiety or panic attack. I could not control my breathing, started sweating, feeling like I was about to pass out. My wife was able to calm me down by helping me breath. I would break down crying on the phone trying to schedule doctors appointments (I'm 30 years old). I was unable to sleep at all for several days in a row even though I felt completely exhausted. Had to take time off (Incredibly thankful for coworkers/managers who were understanding) Chest pain, digestive issues, etc. It's been a weird few months, but I finally think (hopefully) I am starting to get back to my "normal" self. The experience has taught me at least a couple things: - Mental / emotional heath is something that is taken for granted. Now I have a new perspective on the importance of trying to maintain it and want to be understanding toward others. - I think some (all?) of my symptoms were definitely related to what was going on in my life, and how things played out as I tried to fix them. This is hard for me to wrap my head around, but really I have found no other logical explanation.

mmaunder 5y ago
That’s a powerful story. I’d encourage you to try yoga. Do the Beachbody 3 week yoga retreat. Then continue doing one of the final “flow” routines every day. It’s 30 mins and is very accessible. It cured my chronic back pain and has eliminated anxiety about a range of things. After 4 years of doing this its also left me with an insanely strong core and great flexibility.
seer 5y ago
So sorry to hear what you were going through. My partner had something similar due to the stress from the pandemic. What helped her the most was actually a regular psychiatrist appointment. Did you do something specific when you took your time off and saw your symptoms disappear? Curious what helped you the most.

xwowsersx 5y ago

Yeah, part of the problem is in the wording too. It's incorrect to say "it's all in your head" because this makes it sound like the person experiencing the pain is just imagining it or that it's entirely a construct of their mind. What Sarno points out is that there might be some underlying physical issue at play, but it's the extent of the pain that has a psychological component to it. As an example, two people can have the same exact x-ray of their back showing some alignment or other issue. One person will experience extraordinary pain and the other barely any at all. The fact that this is left unexplained by chiropractors (who are mostly kooks IMO), for example, should be a big red flag. How can it be that people who are supposedly experts in this field cannot explain for a basic a discrepancy like this? I think the right way to open people up to this is to acknowledge and validate their pain, that it's real (not "in your head"), but have them consider that the mind-body connection could explain more than perhaps they had previously realized. If you start out the gate with "it's all in your head", not only in this not correct, but it turns the person off because it sounds dismissive and pseudo-scientific.

codingdave 5y ago
Except that it is all in our heads, ultimately. Pain is a sensation in our brains, based on inputs from everything else. That "everything else" is often our physical nerves, but can also be everything else going on in our heads. If someone needs to meld the idea of psych-driven pain with physical pain, trying to deny that they come together in our heads can backfire. It is more important to focus on what we even mean by pain being "real", and that it being in our heads does not invalidate it in the slightest. It is real, and there are more paths to recovery to explore.
tsol 5y ago
>One person will experience extraordinary pain and the other barely any at all. The fact that this is left unexplained by chiropractors (who are mostly kooks IMO), for example, should be a big red flag. How can it be that people who are supposedly experts in this field cannot explain for a basic a discrepancy like this? Not sure what chiropractors have to do with this, you can see an MD for your back pain too but they'll be equally hard pressed to find the reason for the difference. And that's simply because there are countless variables-- x-rays don't show you cell level differences between the patients, central sensitization in the brain plays a part, different pain tolerance(ie something as simple as being a redhead is associated with increased pain), the level to which a certain amount of pain causes psychological distress can also change, coping mechanisms used, etc

bserge 5y ago

I mean, technically all pain is in your head. Because the brain processes it. If one can learn to ignore it, well... Good? Just go on until you literally become disabled, I guess. I ignored the ridiculous fatigue from hypothyroidism for years. It was my hands looking like someone slashed them a dozen times with a knife, bleeding to the point of having to wear gloves in late spring that led me to finally get medication.

lostdog 5y ago

> People are incredibly reluctant to believe that ailments might actually be partly or mainly psychological. There are two simple reasons why people don't want their ailments to be psychological. First, there are no real tests for determining if something is psychological or physical. Doctors just test for some stuff, and if the tests come back negative or inconclusive, they just explain it away as "psychological." You can never be sure whether you have a physical problem or whether your doctor is just lazy. Second, the medical system just gives up on you if the issue is psychosomatic. There are no treatment protocols that work, so agreeing that something is psychological is just having your case tossed on the trash heap to be ignored. Modern medicine does have a light side and a dark side. On the light side are known ailments with known tests and treatments. On the dark side is everything fuzzy and uncertain. Doctors HATE being faced with ambiguity, and patients know that if their case falls into the dark side that treatment and recovery are hopeless.

amelius 5y ago
> There are two simple reasons why people don't want their ailments to be psychological. Another reason is that most people find it scary if someone starts tinkering with their psyche. I honestly think that every therapy should start with strategies to overcome this fear.
hdjjhhvvhga 5y ago
> Second, the medical system just gives up on you if the issue is psychosomatic. There are no treatment protocols that work, so agreeing that something is psychological is just having your case tossed on the trash heap to be ignored. Maybe it's because we need to change our approach to psychotherapies in general. The reason psychology as a whole is not considered hard science is because replication is hard and in some cases impossible (good luck finding subjects who haven't heard about the Stanford prison experiment today). Why don't we accept this is just the way it works. That some therapies will work for some people and won't work at all for others (or might even make their symptoms worse). That therapy needs much more time than a pill to work - instead of hours, we're talking weeks and months, possibly years. That the evaluation of the results always has an element of subjectivity: sure, you can measure some physiological aspects, but there is always the internal component of well-being.

watwut 5y ago

> are all things that sincere people truly are suffering from...that may be mainly psychological/psychosomatic The back pain being cause by physical issues is not exception. The doctors and physiotherapists that wrote articles I read, had talks I has seen and the ones people I know visited never mentioned that. Instead, they recommended to fix the posture a set of "exercise" routines for rehabilitation. They also explained back damage as a mechanism. And those actually worked. Back pain can be very often helped, if you fix posture and do rehabilitation. It is not exception for it to be purely physical. The moment you claim it is psychological, the people who have fixable mechanical issue, won't get any help. And that help, quite apparently, actually makes difference. And not just with back pain.

BeetleB 5y ago
There are different kinds of back pains, and for a few years I had them on and off, and it very likely was posture related. The first time I tried a good lumbar support my pain almost disappeared while using it. It was such a relief that even now, a decade later, I have that lumbar support for all the chairs I sit in - home or work - even when I'm pain free. However, my pain was unusual (did not fit the usual symptoms people normally have). There are other types of back pains. Sarno was always insistent that a physiological cause always be investigated, and if one is found, to treat it accordingly. Absent that, he would recommend a psychological approach. One thing he highlighted that I've anecdotally found to be true when discussing with others[1]: The pain often disappears near/after retirement. And almost all physiological problems get worse with age - not better. Me personally: Sarno's approach didn't work with other pains (ones he claims are within the scope of this type of pain). I don't know what the cause is - doctors never found anything and physical therapists have told me they've never dealt with my types of pains. Maybe it is psychological, but I must emphasize: Sarno's approach didn't work for me. [1] A former boss is an example. He said he had severe back pain on and off for so many years - had to take time off from work, etc. Nothing really worked. But eventually, in his mid 50's it went away and he doesn't know why. He's near retirement (senior guy with money), kids all grown up and graduated from college (or near graduating). Once a lot of his life worries got resolved, so did his pain. His story is fairly common.

andy_ppp 5y ago

I knew a guy who had an extremely stressful job and a bad skin condition, it cleared up as soon as he left. The brain and body are extremely connected.

atom_arranger 5y ago

All pain is psychological. I imagine for most people with back pain there is a physical component, they didn’t have back pain as children, but if we had full control of the brain we could turn off the pain sensation if it’s not useful.

asadkn 5y ago

There can also be physical issues that can be masked psychologically. You can train your brain to ignore and mask many pains and aches and dull them down. IMHO, managing pain can definitely be done psychologically, at least to some extent. Being too aware of the pains, obsessing over them, and being anxious and stressed definitely aggravate the conditions in my experience. Having an otherwise healthy balanced life in terms of work, relationships etc. with healthy amount of stress, makes some of the ailments very manageable or a non-issue.

cameronh90 5y ago

I agree with all of this but just to add, the pain can indeed be a real physical issue directly caused by mental health. For example, anxiety often causes muscle tension and bad posture which can lead to real mechanical pain causing issues. I suffer from panic attacks and they are a very physical experience. My temperature stops regulating itself properly and I get GI problems. This is likely an indirect consequence of the adrenaline surge, but there are other known and theorised ways that your mental state can influence your body.

gameswithgo 5y ago

You are unwittingly just promoting yet another form of back pain snake oil and there is already plenty. If I had fallen into the idea that my back pain was “just in my head” I would have gotten no where. I encourage anyone suffering to get an MRI as early as possible so at least you know what is wrong. Doctors and chiropractors will regularly misdiagnose you. There are lots of ways a back can go bad and everyone has their pet advice which probably doesn’t apply to you.

ethanbond 5y ago
Get an MRI and consider that psychological stress can have physiological or physiological-seeming consequences.
lukas099 5y ago
> I encourage anyone suffering to get an MRI as early as possible Tons of people will have worse outcomes after getting an MRI, as it will reveal a physical abnormality that would have been symptomless otherwise.

intricatedetail 5y ago

Many doctors believe what you say and dismiss patients as psychosomatic if they can't find anything obvious. Sometimes they refer them to psychiatrists or insinuate they are drug seeking. It's a disgrace. This treatment from health "professionals" almost drove me to suicide. Actually my own research got me into a path of finding out I have a rare disease and I had to pay private consultants to help with diagnosis. Only then and a threat of lawsuit got the doctors treat me seriously and I actually got help.

cpncrunch 5y ago
What is the disease?

jfengel 5y ago

The brain is involved in all pain. The fact that the brain can help fix it doesn't mean it's psychosomatic. It just means you can interrupt the process at some place other than where the damage is. Chronic pain is aggravatingly hard to trace to the source. Maybe it's psychosomatic, maybe it's not. Calling it psychosomatic causes stigma -- it implies that it's fake and their choice. But they do want to get better. It's more than just thinking yourself healthy. It requires some counterintuitive ways to create new pathways. It's great that there is more research showing an improved way.