Sunday, June 25, 2017
Time for a New Prescription
Dr. John Sarno died on June 22, 2017, at the age of 93. He was a physician who observed that much pain was psychosomatic in origin. As American medicine has largely rejected the idea that feelings can cause sensations in the body, he was ostracized by the profession. Happily, his books – including Healing Back Pain: The Mind-Body Connection – reached millions of people in many countries and helped them heal themselves.
“All the Rage,” a documentary about his work collectively directed by Michael Galinsky, Suky Hawley, and David Beilinson, has just been released by RUMUR. It arrives at a moment when the medically preferred method of pain treatment has triggered an epidemic of opioid addiction that is estimated to have taken 59,000 lives in 2016 alone.
It is time for humility.
As physicians, we swore the Hippocratic Oath, to “first do no harm.” It seems to me a reasonable corollary when we have done harm is “to admit harm and change course.”
But, some will say, Dr. Sarno’s ideas are not supported by data. That is a red herring. The data about opioids have not been as thorough as one might presume, especially given the frequency with which they’ve been prescribed. Indeed, one widely cited study of the safety of opioids for pain turns out to be a letter to the editor published in a medical journal, not the hallowed randomized controlled clinical trial one would have expected. At this point, new findings are emerging every week, shedding light on the ways in which opioids work to produce dependence and addiction. The evolving story suggests we must use these drugs with great caution.
By contrast, there is more than enough data about the reality of the mind-body connection and the effectiveness and safety of the mind-body interventions for us to move forward with confidence. However, as is often the case, sound “data” are ignored. This has been true for a long time: scientific breakthroughs are resisted for reasons that have nothing to do with the soundness of the intervention. The British Navy, for example, ignored for 50 years the advice that limes could prevent scurvy among seamen. Many suffered unnecessary death and disability during that period.
The opioid epidemic offers a remarkable opportunity to go in a new direction in the treatment of pain and in the embrace of the mind-body connection. State legislatures are busy restricting opioid prescribing. Change must happen, but what? What a perfect moment to go see “All the Rage,” pick up one of Dr. Sarno’s books, and try a new prescription!