Psychophysiologic Disorders (PPD) occur when our minds, under stress, create real pain in our bodies through learned neural pathways.

While medical practitioners have been aware of this process for thousands of years, in the past few decades, we have set aside this knowledge and instead, focused on research and treatments on the amazing pharmaceuticals and procedures which the Cartesian model of scientific study has brought us. These discoveries have been truly amazing – antibiotics, transplant surgery, imaging studies that have allowed us to see inside the body and medications that can take away auditory hallucinations and stabilize mania. We are fortunate to live in this time of life-saving discoveries.

However, in our well-intentioned efforts to view all illness as being caused by tissue damage or physiologic processes gone awry, we have overlooked the power of our own thoughts and emotions to affect our health outcomes. We have forgotten that internal stress can actually cause dis-ease.

During this time, some physicians, such as John Sarno MD, Howard Schubiner MD, David E. Clarke MD, David Hanscom MD, and David Schecter MD, have continued to successfully treat patients who have unexplained and treatment-resistant medical conditions such as chronic back and neck pain, fibromyalgia and irritable bowel syndrome by using a mind-body approach to healing. Such an approach addresses the role of unresolved stressors, both past and present, in the creation of learned neural pain pathways. Dr. Sarno called this phenomenon Tension Myositis Syndrome (TMS). Others have called it Psychophysiologic Disorders (PPD), Mind Body Syndrome (MBS) or simply, Stress Illness.

We have all had a psychophysiologic response to internal stress at some point in our lives – the time your face turned red when you felt embarrassed? Or, the time you experienced “butterflies” in your stomach before that lecture or performance? This physiologic reaction is a result of stress-inducing thoughts and emotions in our mind creating a physical symptom in our body. This human experience is universal.

Sometimes, this universal response to stress can become severe enough to cause debilitating pain that interferes with one’s ability to fully live one’s life.

How does PPD work? Early childhood trauma, recurrent adult traumas and/or current stressors trigger a danger response in the brain’s amygdala. This activates our body’s fight or flight response via our autonomic nervous system (ANS). The ANS triggers a cascade of neurotransmitters in our brain and hormones in our body which prepare us to defend ourselves from the danger. We develop shortness of breath, a fast heart rate, sweating, and muscle tension. This system works perfectly for acute, time-limited danger, but when these traumas are ongoing or occur repeatedly over the course of one’s life, chronic ANS activation can cause health problems. The chronic ANS activation, when combined with specific personality traits (which affect how you respond to the stress and the pressures you put yourself under), creates conditioned pain responses via learned neural pathways. The chronic pain leads to fear which causes heightened attention, and a vicious cycle ensues of more pain, more fear, more attention, more pain, etc. The original traumas are often associated with unresolved emotions which we would prefer not to feel – in fact, we will avoid feeling these feelings of anger, sadness, guilt or shame at all cost. But, the emotions are still there in our subconscious, signaling danger and activating the ANS. This is all occurring at a subconscious level and we have no more control over it than we do our dreams.

A mind-body treatment approach to pain views chronic, non-malignant pain as a dynamic process which can be unlearned. With appropriate treatment, we learn that our bodies are not broken which breaks the fear response, we unlearn our conditioned responses to the pain, we learn to respond to life’s stressors in healthier ways and we learn to attend to our internal states in ways that promote well-being. A different message is then sent to our brain – that we are safe and the danger has passed. We are now in control of how stressors affect us – allowing our ANS to turn off.

Treating neural pathway pain as if it were the result of tissue damage typically will not work and often can create more pain via complications of treatment and increased fear from the patient receiving direct and indirect messages that their bodies are broken and need to be fixed or can’t be fixed. The pain of PPD is not due to damaged tissue or damaged nerves, but occurs in normal nerves conducting pain responses.

Some of the health conditions which have been responsive to this treatment include chronic neck and back pain, migraine headaches, fibromyalgia, irritable bowel syndrome, gastroesophageal reflux disease, interstitial cystitis, pelvic pain, hyperacusis, as well as many conditions viewed as “pain equivalents” such as dizziness, chronic fatigue, tinnitus, insomnia, anxiety and depression. There are many more. In fact, our minds have the capacity to create any type of pain which can be imagined.

If you would like to learn more about the effects of unresolved stress on health or refer someone for treatment, please contact me.

Please note that it is critical to first rule out life-threatening and other serious health conditions through appropriate testing before considering a diagnosis of a psychophysiologic disorder and before referral.