My time with John Sarno

I am an osteopathic physician and surgeon who has seen thousands of people in the last 30 years. One day, many years ago, I had a dance teacher come to me as a patient. She happened to mention that for many years she had debilitating low back pain. 

“Do you still have it?” I asked. 

“No, I haven’t had it for years thanks to John Sarno.”

I had never heard of him so I asked her to explain further.

“Well, I had heard that he helped people like me just by talking so I took the train from Washington, DC to NYC and went to one of his public lectures.”

“I never had any more back pain since.”

As a doctor I found this story unbelievable but since I respected her I decided to investigate further.

I learned that Sarno, a former GP from upstate New York, decided in the early 70s to get trained in Physical Medicine and Rehabilitation at the Rusk Institute for Rehabilitation at New York University. One day, while working in the out patient pain clinic, it dawned on him that many of the same patients were coming back again and again for the same complaint.

What was going on?

If they were correctly diagnosed and the treatment (physical therapy) was effective then why were they returning with the same complaints?

It turns out, as he discovered, they were not being correctly diagnosed. They were being diagnosed with physical problems when, in fact, they had psychosomatic problems.

Even though their pain was real, and for such patients it is real including muscle spasm and other physical symptoms, the cause was not physical. The cause was from the mind, not the body.

For many years physicians have known that the mind has an effect on the physical body but they really had no idea how to help such patients. There are many textbooks and articles on these things but as far as I know no medical school teaches what to do with these people when training doctors.

Sarno, who had lifelong headaches, worked with psychologists and therapists at NYU to learn about the mind and its effect on the body. What he finally emerged with not only cured his own headaches but also made him famous with patients with such symptoms.

He calls these problems TMS (tension myoneural syndrome). I read his books (5) and researched him. Then I wrote him a letter and he said that I could spend time with him seeing patients.

So I got on a train and went to NYC where I subsequently spent a day seeing patients with him.

Sarno was a very small man. He wore a white doctor’s coat and had a tiny office in the NYU Rehabilitation Institute. When I came there he told me, Well, I have to get permission from the patients for you to come in. You know, these people are paying a lot of money to see me.

At the time he was on a salary but NYU charged $1,400 for a consultation with him. 

I noticed that the patients varied from those who were very quiet and reserved to one man who angrily said, “Who made you and expert? You are not a psychologist. You have no academic training in these matters.”

He was very hostile.

Sarno just pulled himself up and looked directly into his eyes and said, “I have a brain and I can read.”

That shut the patient up.

Then Dr. Sarno told him, I have looked at your records and examined you. There is nothing physically causing your pain symptoms. Here is the program I advise. When you feel the pain, which you will, you must tell yourself: “There is nothing wrong with my body. All of these symptoms are being caused by my unconscious mind which is trying to send me a message. It believes that I need the message because it is afraid that I haven’t realized that my way of being with stress is making my life hell. It is using my body to get my attention.”

“You are not crazy. You are simply one of a subset of people who has these psychosomatic reactions to internalized stress and refusal to recognize your feelings and to do something about them.”

I went back to my practice in Maryland and began to apply these teachings to my own TMS patients and got success. Over the years I have learned a lot more from helping these patients and gotten even greater success.

One of the most important things I have learned, which I want to share with you, is that without a thorough physical examination done by a physician who can actually put their hands on the patient and figure out the difference between normal tissue (musculoskeletal) findings and those which indicate a physical origin, we cannot ever know if indeed the patient has TMS.

I am an osteopathic physician who went to medical school, took years of courses designed to help me make such a exam, and who has treated thousands of people over the years who indeed do and did have pain caused by physical problems. I treat them and their pain goes away.

Most DOs (osteopathic physicians) do not have such a practice. They are family doctors, internists, surgeons, obstetricians and do not specialize in these types of exams. I do and have for 30 years. I know very soon whether a patient has a physical or a non-physical cause of their pain.

Most of my patients do not have TMS but some do and with them I must use Dr. Sarno’s approach to get results.

Incidentally, and this is written with great respect, few physicians especially MDs like Sarno have these skills.

Sarno did the same exam with the same result on every patient during the time I spent with him. I asked him why he did this sham exam. He told me, I have already figured out they have TMS from the interview (he would interview new patients by phone before the consultation) so the exam is simply to let them know that I have examined them.

As an osteopathic physician who regularly makes such exams I understood that we had very different training and that it was useless to mention this to him. There was no way he could relate and, honestly, what he was doing worked well for him so why would I want to upset the apple cart.

Dr. Sarno was well known in the TMS community to not welcome challenges of any type. One MD told me that he was aware of another physician who was permanently on Sarno’s list of those whom he wouldn’t talk to because this man had questioned him in a way that he didn’t welcome.

So I kept my peace and went home.

Many practitioners in the TMS  community do not touch patients at all. Some who do, physicians, cannot do the exam which I have used on all my patients.

I believe that without such exam validation one cannot have a confirmed TMS diagnosis.

A possible cure for macular degeneration.

Macular degeneration is a very common condition which in many cases may lead to partial or complete vision loss and blindness. According to the  National Eye Institute, NIH there is no cure.

Recently I met with Richard Niemtzow, MD, a radiation oncologist who currently serves as the head of all acupuncture-related services for the Armed Forces. He has devoted much of his life to pioneering new approaches to curing such conditions as dry mouth, battlefield acupuncture for pain , and other areas of medicine. Dr. Niemtzow has a PhD in electronics and is a prolific researcher and writer in the field of medical applications of acupuncture.

Dr. Niemtzow has made a discovery that may change the way in which the medical profession helps people with blindness and vision loss from macular degeneration.

Using just two points on the body and a very low level electrical current between the points, he has shown that macular degeneration vision loss can be rapidly eliminated. He has just returned from Vietnam where a research trial of this approach was conducted with patients at an ophthalmology center in Saigon ( Ho Chi Minh City). The results were astounding with all the patients experiencing immediate return of vision. He told me that several treatments may be required for long term benefit but even the limited results are impressive considering that there is currently no cure for this ailment.

The procedure takes little time, may be done in an outpatient setting, is cost effective, involves no drugs, surgery or injections into the eyes, all of which are mentioned by NIH as current approaches, none of which seem truly helpful, to this problem.

I hope to be working with Dr Niemtzow to offer this treatment to patients in the near future. He told me that when the data from the work in Vietnam has been received and processed, he will publish it.

Osteopathic diagnosis and treatment also has much to offer in restoration of normal function, physiology to the eye and we hope to add this as well to make the treatment even more effective.


Expert in concussion. Maryland

Dr Goodman has been treating concussions for over 25 years.

He is a residency-trained specialist in Physical Medicine and Rehabilitation, having done a three year residency at the National Rehabilitation Hospital, Washington, DC. There he was taught state of the art approaches to the diagnosis and management of concussions.

What is especially unique in his approach to this increasingly common issue is that he uses osteopathic diagnosis and treatment as well as other non-drug approaches to support patients.

At the time of this writing, he is working with many young people who, besides needing to be cleared for school, camp, sports activities, and other things, require care so that they will have zero carry over effects from their injuries.

Most patients for these problems will see neurologists or other physicians who lack the hands-on background for diagnosing and treating these conditions. They may, indeed, clear a patient to return to school, work or other activities based on an imaging study ( MRI, CT, etc.) but do not actually put their hands on the patient to examine in real time what is going on.

This is critical for not only full recovery but also for identifying and treating the many things that happen with closed head injury, head injury, traumatic brain injury, concussion and do not show up on the MRI, CT studies.

Dr Goodman is a recognized expert in the evaluation and treatment of concussions.

His results with patients who were told that nothing more could be done for them and who today are back to leading a full life speak for themselves.

Osteopathic treatment of the common cold

Most colds are caused by viruses. I was trained in conventional medicine, having worked in two hospitals for a period of four years, and am  familiar with the allopathic or symptom- oriented treatment for most disease conditions.

Basically, physicians will treat the manifestations of the cold. The person who actually has the cold is ignored to the extent that there is minimal attempt made by the physician to check the function or working of the actual body.The physician speaks briefly with the patient, may look in their throat, nose, ears, auscultate their lungs but that is about it if even that is done. The diagnosis, common cold, is rapidly established and the patient given symptomatic treatments and told to take clear liquids, etc. etc.

But what about the person who has the cold? The critical elements that will help them recover are largely ignored. The lymphatic system, the circulatory system, the drainage from the sinuses and working of the various organs concerned with respiration, the rib cage, the clavicle which often prevents good drainage from the head and also makes it hard for the lymphatics to drain into the venous system, their final point of release are not examined. The spleen, which removes old red blood cells, and is vital in the function of the immune system  is critical in fighting off any infection is overlooked. In fact, one authority has described the spleen as one enormous lymph node. The diaphragm, the muscle of respiration, is also what is responsible for the movement of lymph in the entire body. It also has a tendency to spasm with any trauma, physical and emotional, which leaves the patient compromised in many ways. These and many more aspects of a living, functional whole might as well not even exist as far as most physicians are concerned.  There are so many important and vital structures and functions which the well trained osteopathic physician must examine in real time and treat until they are functioning as close to normal as possible, that truly help the patient to return to not only a state of health, which few people as they age ever again experience, but a glowing state of health.

The osteopathic treatment for the common cold, for which allopathic medicine has no specific treatment since antibiotics are not helpful in a viral infection, can have immediate and powerful benefits to the patient with this condition.

There may be general guidelines of which I have mentioned only a few above, but the reality is that every patient is totally different. So there is no cookie-cutter recipe for treating the cold. We must meticulously examine and treat the patient who presents with the condition which is usually labeled the common cold. In actuality, a lot more is going on with these patients than the symptoms of a cold. Each one must be evaluated and treated from a functional perspective with a hands-on exam and osteopathic treatment.

And this need not be a long, drawn out affair. The well trained, experienced osteopathic physician can accomplish the actual exam in a matter of minutes. The treatment will take longer but all of this can be done in less than 30 minutes with excellent and immediate results.

Today I treated a 55 year old man who had developed a bad cold which left him sounding horrible when he spoke. He felt lethargic and was going from bad to worse. He had already taken large doses of time release vitamin C, echinacea, and I gave him a homeopathic remedy, Ferrum phosphoricum, to further help. Following the osteopathic treatment his voice had returned to normal, his color was back to normal, he mentioned that he could finally take a deep breath and his entire system was functioning as it was meant to function in its healthy state. He felt truly healed in many ways. And, of course, his cold was now almost an after thought.

Osteopathy is not manipulation.

Very few DOs practice any hands-on osteopathy. The vast majority practice as any MD would.  Most have the attitude that, as one of my students told me ( I taught osteopathic manipulation in the 80s in a DO school), ” You wasted a spot that could have gone to someone who really wanted to be a doctor.”

But I love my work and my patients seem very grateful for what I do for them.

Every year there are fewer and fewer DOs who do what I do. Most of them are truly ignorant of what osteopathy is all about. It is not about manipulation at all. That is simply a tool we use to improve the physiology  (functioning) of our patients. The essence of osteopathy is philosophy and it is this that is overlooked and not taught at any of the schools. The philosophy of osteopathy is truly profound and guides me in my interactions with patients, my examination and treatment of them.

And this unique view of life and how to use it to help people who are suffering makes all the difference in the world for our patients.