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Recently Scott Alexander and a few others have been talking more about the idea of a social contagion, one which spreads real physical problems.
As I’ve argued in previous posts, this social contagion likely causes a number of what we see as purely physical injuries. Many feel that their body is injured. They deal with diagnoses from the medical community such as:
Chronic pain
Fibromyalgia
TMJ
Joint Hypermobility
Some doctors, like John Sarno, have even argued that far more injuries are based on psychological harm, rather than physical, such as:
Hives
Eczema
IBS
Gluten sensitivity/Celiacs
Herniated Discs
The list goes on. These are extraordinary claims, which Sarno backs up with impressive statistics in his book.. Unfortunately I can’t find his paper online, would be curious to take a look if anyone has a link. What Sarno calls the issue, and what other doctors or medical writers such as have supported him in, is a disorder called Tension Myositis Syndrome (TMS.)
The basic mechanism he posits is that our mind uses defense mechanisms to prevent us from thinking certain thoughts. We distract ourselves with drugs, alcohol, fast food, and many other addictions. He thinks that in the modern world, due to our views on physical injury, some people deal with their mind creating physical pain to distract them from emotional issues. This distraction comes out in certain nerves being deoxygenated, which he claims to have proven.
Much of this stress comes from trauma due to unresolved emotional issues, which is pretty standard accepted literature in psychology nowadays. Sarno specifically calls out “anxiety, anger, and feelings of inferiority” as the big culprits, citing that modern life causes many of us to have a lot of anger boiling under the surface. Constraints from work, relationships, illness, loss of loved ones, and in extreme cases childhood neglect or abuse.
To use a more rationalist lens, you could say the most stressor would be status anxiety. Many on the motte have argued that status anxiety is an incredibly common and hidden force that generates massive emotional problems, since the Western world is so hypercompetitive, and it’s difficult to measure up in any walk of life, let alone most. When you don’t feel you're at the top in your work life, social life, or family structure, people get frustrated.
What makes this problem worse is that due to the way modern society operates, we can’t express anger frequently depending on our situation. For those in the PMC, or the business world more generally, it’s considered almost unthinkable to yell at a boss or a client. The whole microaggression concept exacerbates the issue.
Some believe this is a recent phenomena due to stresses of modern life, but I’d argue that the connection between mind and body is far more complicated and older. Writers throughout history would cite feelings of pride which make your chest well, or having your hands tremble with rage. Our minds and bodies are inextricably linked, so it stands to reason that if we have rampant neuroses in our society, some of it would express itself physically.
I’m sure many of those reading this who are more physically active may have an instinctual response of “duh, of course the mind and body are one, it’s the most obvious thing ever.” I’d argue that the inferential distance around this issue opens a vast gulf which is difficult to imagine. If you have not experienced chronic pain, I don’t think it’s something one can confidently model with any real accuracy.
To some degree, patterns of behavior also must matter. A common response to an injury is to exercise, and for most generalized chronic pain issues, this seems to work. The issue arises when someone creates a trapped prior. Basically the idea that they have some condition is so deeply ingrained that the typical fixes don’t work. Many sufferers of chronic pain even admit they think it’s psychosomatic, but still struggle to deal with it. Ultimately Sarno’s method seems to work for them over time. Point is, our modern medical fixation on mechanical causology for injury seems, if not totally wrong, at least to be missing a big piece of the puzzle.
This idea may already swim in the water all around us. After all, we have plenty of colloquialisms such as “trust your gut” or “follow your heart” that suggest a connection. However, the common idea that injuries are almost entirely physical persists.
If true, this hypothesis could be one the discovery of which would shake our society to its roots. Long-lasting physical injuries being caused by emotional pain would alter our entire approach to medicine, let alone overall health or the pursuit of virtue.
It’s important to note that depending on your values, you may prefer the current state of events. If subjecting the emotionally damaged in Western society (most of us) to self-caused physical pain is worth preventing large amounts of anger and other negative emotions from boiling over, that is not necessarily an irrational choice. I’d certainly prefer dealing with one of these issues than living through a revolution or large war.
That being said, it’s a choice we must make without blinders. To ignore the issue entirely is to prevent us from solving it.
Something interesting is that Sarno’s treatment is not merely “let out anger/stress”. It is specifically to delegitimize a “physical origin” of the pain, and to believe that the body is pretending to be in pain in order to prevent you from thinking about psychological/emotional concerns which are in turn solved chiefly by the emotion of anger. Some quotes from when I read his book years ago:
“ In other words, I suggest to patients that when they find themselves being aware of the pain, they must consciously and forcefully shift their attention to something psychological, like something they are worried about, a chronic family or financial problem, a recurrent source of irritation, anything in the psychological realm, for that sends a message to the brain that they’re no longer deceived by the pain. When that message reaches the depths of the mind, the subconscious, the pain ceases.”
“Another useful strategy sounds silly at first but has great merit. Patients are encouraged to talk to their brains. So many patients reported having done this on their own with good results that I now routinely suggest it, despite lingering feelings of foolishness. What one is doing is consciously taking charge instead of feeling the helpless, intimidated victim, which is so common in people with this syndrome. The person is asserting himself, telling the brain that he is not going to put up with this state of affairs—and it works. Patients report that they can actually abort an episode of pain by doing this. The woman whose case was described here did just that and experienced an immediate cessation of pain. It’s a very useful strategy”
We must say to ourselves, “It’s all right to be the way we are: illogical, unconsciously enraged, like a child having a temper tantrum. That’s part of being human and it is universal.”
I have enunciated three principles of treatment: repudiate the physical, acknowledge and accept the psychological.”
I tell my patients that they must consciously think about repressed rage and the reasons for it whenever they are aware of the pain. This is in contradiction to what the brain is trying to do. This effort is a counterattack, an attempt to undo the brain’s strategy. It is essential to focus on unpleasant, threatening thoughts and feelings to deny the pain its purpose—to divert your attention from those feelings.
I’m interested in why it works. I think it has to be one or a combination of these: (1) the pain is due to a social stress which the human mind may instinctively process as physical, and assertive anger directed toward this pain fixes it because anger is a high status dominant emotion; (2) an ultra-negative association is being made involving the pain, making one’s mind flee from pain signaling, so perhaps the pain victim inadvertently reinforced pain sensitivity by associating it with the relief of some even more painful and intense stressor; (3) it is simply a matter of sensitizing the person to something other than their physical pain but which uses roughly the same pathway such as general life stressors.
It's interesting how this is almost the opposite of mental health therapies that use body scanning, or focusing on the body to try to resolve mental issues.
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