notes-books-mindbodyPrescription

This is a book by a doctor about various types of chronic pain (although he seems to use the phrase 'chronic pain' for something different than i mean here?). The author thinks that a lot of chronic pain (~80%?) is psychogenic. Note that he doesn't believe that the symptoms are imaginary; rather, he thinks that the brain unconsciously instructs the autonomic nervous system to do something that causes actual (although not permanent) damage to muscles and tendons. He is not completely sure of the nature of the damage but his hypothesis is that it is mild local ischemia, eg he thinks the autonomic nervous system is being programmed by the unconscious to restrict the blood supply in some location, depriving the tissues in that location of sufficient oxygen. He notes that there anecdotally appears to be a correlation with certain personality types (perfectionists, and also people who try to be very nice to others) and the symptoms.

He believes that what is usually going on is that there is unconscious rage at life's various disappointments, that this unconscious rage is blocked from consciousness because it isn't socially acceptable, and that the unconscious is intentionally causing these pathologies in order to distract the attention of the conscious, so that it doesn't notice the rage.

As evidence, he notes various anecdotes in which patients who accepted this hypothesis, and then introspected upon the emotional cause of their pain, found that the pain went away (even in some cases if they introspection yielded no culprit). He notes an various anecdote in which a person who had a sudden breakthrough of apparently repressed emotion found the pain suddenly go away. He attributes these things to the unconscious no longer being interested in diverting the attention of the patient, because it has already lost the battle to try and keep the patient from noticing the undesirable emotion. He also notes anecdotes in which someone who has one pain condition gets a different one after the first one goes away; his theory explains this by saying that the unconscious is just using all of these to try and distract the person, so when one distraction stops another one must be found.

He claims that he has a lot of anecdotal evidence in the form of successfully treating many pain patients with these methods. So far he hasn't presented any controlled statistical studies but i hope that he will later. I note that he says that his treatment has a very high probability of success, conditional upon the patient accepting his basic hypothesis that the pain is psychogenic; he presents this as if the patients who reject this hypothesis aren't facing the truth, but it seems to me that another possibility is that there are some patients in whom the pain is psychogenic and some in whom it is not, and that whether this is the case in a given patient is correlated to whether they accept this hypothesis.