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TitleThe Divided Mind: The Epidemic of Mindbody Disorders
LanguageEnglish
File Size1.3 MB
Total Pages402
Table of Contents
                            Cover Image
Title Page
Contents
	Introduction
	Chapter One: What is Psychosomatic Medicine?
	Chapter Two: A Brief History of Psychosomatic Medicine
	Chapter Three: The Psychology of Psychosomatic Disorders
	Chapter Four: Treatment
	Chapter Five: Hypertension and the Mindbody Connection: A New Paradigm Samuel J. Mann, M.D.
	Chapter Six: My Experience with Tension Myositis Syndrome Ira Rashbaum, M.D.
	Chapter Seven: A Rheumatologist’s Experience with Psychosomatic Disorders Andrea Leonard-Segal, M.D.
	Chapter Eight: My Perspective on Psychosomatic Medicine James R. Rochelle M.D.
	Chapter Nine: Structural Pain or Psychosomatic Pain? Douglas Hoffman, M.D.
	Chapter Ten: A Family Doctor’s Experience with Mindbody Medicine Marc Sopher, M.D.
	References
	Index
	About the Author
	Also by John E. Sarno, M.D.
	Credits
	Copyright Notice
	About the Publisher
                        
Document Text Contents
Page 2

THE DIVIDED

THE EPIDEMIC OF MINDBODY DISORDERSMIND MIND
THE DIVIDED

JOHN E. SARNO, M.D.
WITH CONTRIBUTIONS FROM SAMUEL J. MANN, M.D., IRA RASHBAUM,

M.D., ANDREA LEONARD-SEGAL, M.D., JAMES R. ROCHELLE, M.D.,
AND DOUGLAS HOFFMAN, M.D.

Page 201

196 THE DIVIDED MIND

scendental meditation lowered home blood pressure by 10 millime-

ters (Alexander et al., 1996). However, in a more recent study by the

same researchers, the observed effect on blood pressure was much

weaker (Schneider et al., 2005).

WORRYING AND BLOOD PRESSURE ELEVATION: MOVING AWAY
FROM THE OLD PARADIGM

Before moving on to the new paradigm, I first want to reiterate a

harmful misconception promoted by the old paradigm. It bears re-

peating that worriers who worry about their blood pressure are not

causing their hypertension. In many cases, their worrying is elevat-

ing their blood pressure while it is being measured, even if their

blood pressure is otherwise normal. The consequence, though, is that

the high reading leads to treatment that in many cases is not neces-

sary.

In my experience, worriers often have “white coat hypertension”

rather than true essential hypertension. That’s why it is essential to

measure the blood pressure outside the doctor’s office, with an easy-

to-use digital home blood pressure monitor or an ambulatory moni-

tor worn for twenty-four hours.

Many doctors instill the fear of stroke in their patients, feeding

both the patient’s fear and the misleading elevation of the blood

pressure at the time of its measurement. This is where a dash of re-

assurance goes a long way. When I suggest to a worried patient with

a high reading that she, in fact, might not have hypertension, the

surprise and relief often results in lower readings, sometimes imme-

diately and sometimes after a few weeks. I am not curing her hyper-

tension because she doesn’t really have hypertension in the first

place. This is perfectly analogous to telling a patient with back pain

Page 202

197 HYPERTENSION AND THE MINDBODY CONNECTION

that there is nothing wrong with his back. That knowledge can have

an immediate and profound effect.

I also find, ironically, that people with the mildest hypertension

seem to worry more about it than those with severe hypertension,

rather than the other way around. Although concern about hyperten-

sion is appropriate and helpful, extreme worry about mild hyperten-

sion is inappropriate since the risk of stroke is low, may take effect

only after many years or decades, and can be minimized with treat-

ment. Sometimes excessive worrying about mild hypertension reflects

a tendency to worry about everything. Or the worrying may divert

the person’s attention from other issues, as back pain often does.

Should worriers with elevated blood pressure consider psy-

chotherapy? Not if the goal is treatment of hypertension. If the wor-

rying affects quality of life or is diverting attention from other

issues, then psychotherapy or relaxation or stress-reduction or anger

management techniques my have a role. These interventions are use-

ful for controlling tension, not hypertension.

THE NEW PARADIGM

It is not the emotional distress that we feel, but those emotions we have re-

pressed and are unaware of, that leads to hypertension. The process by

which we unknowingly keep distressful and threatening emotions from

awareness causes persisting stimulation of the sympathetic nervous system

(SNS), resulting in persisting elevation of blood pressure. A shift in our

awareness, or use of antihypertensive drugs that block the effects of the

SNS on blood pressure, or, in the case of episodic hypertension, drugs that

help maintain repression, provide the best results in treating this type of

hypertension.

The new paradigm is virtually the opposite of the old. Instead

Page 401

Also by John E. Sarno, M.D.:

Mind Over Back Pain: A Radically New Approach

to the Diagnosis and Treatment of Back Pain

The Mindbody Prescription: Healing the Body, Healing the Pain

Healing Back Pain: The Mind-Body Connection

Stroke: The Condition and the Patient

coauthored with Martha Taylor Sarno

Stroke: A Guide for Patients and Their Families

coauthored with Martha Taylor Sarno

Page 402

Credits

Designed by Kris Tobiassen

Cover design by Richard Ljoenes

Front cover photograph of figure with Vitruvian Man by Geoffrey Gove /

Getty Images

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