Sunday, December 6, 2009

Our tendency to make everything mechanical

I wanted to dialogue with anyone who's reading about our tendency to make our health entirely mechanical. We certainly have the capacity to invent amazing stories, so why don't we use some of our imagination to wonder why things like back pain could be more than just mechanical.

I was speaking this week to a woman with neck pain.  We discussed her orthopedic surgeon's ordering repeat X-rays every three months.  She didn't know that the research literature shows no correlation of X-ray findings with pain.  "Why would he order so many X-rays?" she wondered.

"He's looking for something he can treat." I answered.  "He's not actually treating you; he's treating your X-ray.  If it's bad enough, he can justify surgery in the hopes that it will make you better."

I told her about Dr. Sarno in New York City and his book on back pain. He is an orthopedic surgeon who wrote a book about back pain rarely being mechanical and much more often being related to how we live.  He helps people resolve their back pain with a process that looks very much like cognitive behavioral therapy.

My friend hadn't heard about him either. I suggested she see him the next time she was in New York since I suspected he would have more impact than a mere friend (his office is fancier, his furniture more designer; probably hangs his diplomas framed on the wall).  Eighty percent of his patients improved with CBT and many fewer with surgery.  I suggested to my friend that surgery could make her better, worse, or no different. I told her about the arthroscopic surgery study that was reported in the New York Times in which sham surgery (an incision only) was equal to arthroscopic knee surgery in outcome one year afterwards (all patients improved dramatically).  She remembered reading that story.


I asked her, "What do you tell yourself about your pain?"

WOMAN: I hace a twisted cervical spine. It happened at birth. I started dancing too young. I’m just getting old."

This answer implies that the issue is purely physical. Native healers can’t conceive this way. The body is not separately mechanically from evertyhing else.I iremember my friend who was asked how would you treat arthritis? I don’t know – I don’t know her bring her to see me!