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Mal de dos : Attention, un mal peut en cacher un autre (Back pain: When your mind uses physical pain to protect you from psychic pain)

Posté le mardi 8 septembre 2015 par Admini

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Attention: un mal peut en cacher un autre !

« Dorsalgies », « lombalgies », « lumbago », « mal de reins », « tour de rein », « sciatiques » …

Alors qu’en ce meilleur des mondes où les bébés se vendent désormais sur catalogue …

Et où même les bâtiments tombent malades …

Nos thérapeutes et nos médias multiplient, sur fond de victimisation devenue folle, les appellations et les spécialités médicales comme les thérapies et les formules pharmacologiques censées y remédier …

Comment ne pas s’étonner de l’étrange consensus autour de cette quasi-épidémie qu’il est devenu normal d’appeler mal du siècle ?

Et du tout autant singulier silence sur les travaux du Dr Sarno (seulement traduit en français l’an dernier) …

Qui, remarquant le fréquent décalage entre les anormalités anatomiques et les douleurs ressenties ou la tendance desdites douleurs à se déplacer à mesure qu’elles étaient « guéries » ..

A depuis longtemps montré que nombre de nos douleurs physiques chroniques …

Ne sont souvent qu’une manière pour notre cerveau de nous détourner de douleurs psychiques plus profondes ou plus anciennes ?

Admini @ 10:32
Catégorie(s): Généralités


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5 réponses à “Mal de dos : Attention, un mal peut en cacher un autre (Back pain: When your mind uses physical pain to protect you from psychic pain)”

  • 5
    jc durbant:

    AMERICA’S MOST BRILLIANT AND NEGLECTED NATIONAL TREASURE

    Revered by some as a saint and dismissed by others as a quack, Dr. Sarno maintained that most nontraumatic instances of chronic pain — including back pain, gastrointestinal disorders, headaches and fibromyalgia — are physical manifestations of deep-seated psychological anxieties.

    Financial writer and Wall Street trader Edward Siedle described Dr, Sarno in a Forbes column as “the most brilliant doctor in America and unfortunately, a largely neglected national treasure.”

    The mainstream medical community, however, generally dismissed his theories as simplistic and unscientific, and thought he went too far in saying that emotional factors not only worsen chronic pain, but also directly cause it.

    “His views are definitely considered on the fringe,” said Dr. Christopher Gharibo, a pain management specialist at the Langone Medical Center at New York University. “His position was that almost all chronic pain is purely psychological and ‘all in the head,’ which I certainly disagree with.”

    Eric Sherman, a psychotherapist who worked with Dr. Sarno for many years, recalled how Dr. Sarno’s colleagues would belittle him behind his back in lunchtime conversations at NYU, even as some would visit him privately for their ailments…

    http://www.bostonglobe.com/metro/obituaries/2017/06/28/john-sarno-author-who-tied-pain-anxieties-dies/sI4FFULOTxQLCBR3jnLuKM/story.html

  • 4
    Vautrin:

    Hystérie collective ? Ou psychose collective ? Il est vrai que certains symptômes ressemblent à des névroses -précisément à l’hystérie de conduction. Mais si le phénomène prend une ampleur collective, il est bien possible que cela mette en cause un rapport sociologique, plutôt qu’axiologique. Une de mes thésardes avait noté dans plusieurs établissements (EHPAD) une sorte d’épidémie de « burn-out » parmi les soignants, avec des complications somatiques. Il semblerait que certaines organisations gérées avec des techniques de « management » trop rigoureuses engendrent ce type de réaction. On peut faire l’hypothèse qu’un certain degré de violence sociale -et nos sociétés de « bisounours » sont extrêmement violentes- a pour conséquence une défense impliquant des syndromes psychosomatiques. Mais ce n’est qu’une hypothèse !

  • 3
    jc durbant:

    Oui, ce serait intétessant de voir si, comme pour les bâtiments qui tombent malades, on a affaire à une forme d’hystérie collective au niveau de nations entières …

  • 2
    Vautrin:

    Je pense, selon mon expérience, que nombre de troubles apparemment physiques comme des dorsalgies, lombalgies etc… ne résultent pas systématiquement de distorsions osseuses ou musculaires. Certains résistent, sans que l’on sache pourquoi, aux étirements thérapeutiques, infiltrations etc… Je connais au moins deux cas dont je m’occupe. Le premier est celui d’un homme psychiquement déstabilisé par un environnement professionnel harassant l’ayant conduit au « burn-out ». Il a développé une sciatique chronique qui étonne les médecins. Le second est celui d’une femme, ayant développé le même symptôme récurrent de sciatique. Il est vrai qu’elle exerce une profession physiquement difficile, mais je constate qu’en même temps elle subit la tyrannie d’un époux hypocondriaque présentant une note psychotique indéniable. Assez curieusement, le symptôme physique, chez cette dame, s’atténue lorsque le mari s’éloigne quelques jours du domicile. Dans ces deux cas, on ne peut pas conclure de manière certaine à une relation de cause à effet, mais il y a tout de même suspicion de syndrome psychosomatique. Du reste, la littérature sur le « burn-out » évoque fréquemment des symptômes physiques associés.

  • 1
    jc durbant:

    Morceaux choisis:

    Un coeur joyeux est un bon remède, Mais un esprit abattu dessèche les os.

    Proverbes 17: 22

    L’opprobre me brise le coeur et je suis malade.

    Psaumes 69: 21

    Plus d’un siècle après que Charcot a démontré que les hystériques n’étaient pas des simulateurs et que Freud a découvert l’inconscient, il nous est difficile d’accepter que nos souffrances puissent être à la fois réelles et sans cause matérielle. Georges Saline (responsable du département santé environnement de l’INVS)

    Chacun a bien compris que « syndrome du bâtiment malsain » est la traduction politiquement correcte d’ »hystérie collective ».

    Le Monde

    Musculoskeletal pain is very common. A review of prevalence studies indicated that in adult populations almost one fifth reported widespread pain, one third shoulder pain, and up to
    one half reported low back pain in a 1-month period.

    McBeth & Jones (2007)

    Les muscles sont riches en terminaisons nerveuses, et lorsque le cerveau «en situation de stress», transmet trop d’informations aux nerfs, ils se trouvent alors saturés. Le muscle va y répondre par une crispation, une contraction musculaire, qui peut être la cause d’une douleur locale ou d’une douleur projetée. Et l’état de stress chronique favorise les poussées inflammatoires sur les articulations par la libération dans le sang de substances inflammatoires. Il suffit d’avoir un peu d’arthrose et d’être stressé pour que les articulations se mettent à exprimer une souffrance.

    Dr Gilles Mondoloni

    We have incredible healing mechanisms that have evolved over millions of years. No matter how severe, injuries heal. Continuing pain is always the signal that TMS has begun. Consider that a fracture of the largest bone in the body, the femur (thigh bone), takes only six weeks to heal and will be stronger at the fracture site than it was before the break. Strong support that whiplash is part of TMS came to my attention in the Medical Science section of the New York Times from a piece published in the May 7, 1996, issue titled « In One Country, Chronic Whiplash Is Uncompensated (and Unknown).

    John E. Sarno

    In a survey done in 1975 it was found that 88 per cent of patients with TMS had histories of up to five common mindbody disorders, including a variety of stomach symptoms, such as, heartburn, acid indigestion, gastritis and hiatal hernia; problems lower in the intestinal tract, such as spastic colon, irritable bowel syndrome and chronic constipation; common allergic conditions, such as hay fever and asthma; a variety of skin disorders, such as ecema, acne, hives and psoriasis; tension or migraine headache; frequent urinary tract or respiratory infections; and dizziness or ringing in the ears. . . . » (…) Even when there are structural abnormalities found in the back and in arthritic joints, many with such pathology have no symptoms; others have pain symptoms disproportionate to the actual pathology of the normal aging process. Even after surgeries to correct these « abnormalities » the pain continues. (…) . . . insight oriented therapy is the choice for people with TMS or its equivalents. The therapists to whom I refer patients are trained to help them explore the unconscious and become aware of feelings that are buried there, usually because they are frightening, embarrassing or in some way unacceptable. These feelings, and the rage to which they often give rise, are responsible for the many mindbody symptoms I have described. When we become aware of these feelings, in some cases by gradually becoming able to feel them, the physical symptoms because unnecessary and go away. (…) . . . insight oriented therapy is the choice for people with TMS or its equivalents. The therapists to whom I refer patients are trained to help them explore the unconscious and become aware of feelings that are buried there, usually because they are frightening, embarrassing or in some way unacceptable. These feelings, and the rage to which they often give rise, are responsible for the many mindbody symptoms I have described. When we become aware of these feelings, in some cases by gradually becoming able to feel them, the physical symptoms because unnecessary and go away. John Sarno (…) The pain will not stop unless you are able to say, « I have a normal back; I now know that the pain is due to a basically harmless condition, initiated by my brain to serve a psychological purpose. (…) The brain tries desperately to divert our attention from rage in the unconscious. . . . So we must bring reason to the process! This is the heart of the very important concept. . . . (…) Remember, the purpose of the pain is to divert attention from what’s going on emotionally and to keep you focused on the body. (…) For some people simply shifting attention from the physical to the psychological will do the trick. Others need more information on how the strategy works, and still others require psychotherapy.

    John Sarno

    Our results suggest that chronic symptoms were not usually caused by the car accident. Expectation of disability, a family history, and attribution of pre-existing symptoms to the trauma may be more important determinants for the evolution of the late whiplash syndrome.

    Dr. Harald Schrader et al

    The study in Lithuania provides a healthy reminder to Western societies that a heavy price is paid when a culture of self-imposed victimhood and self-serving litigation develops. One part of that price appears in impersonal numbers: lost efficiency, soaring costs, unfair usurpation of health-care resources. But a far more tragic cost is personal: individuals shackled for years by their belief that inescapable pain rules their lives day after day.

    Christian Science Monitor

    I’ve seen patients 25 years down the road still having problems. The condition can become chronic, he said, when people alter their posture to relieve the pain of injured tendons and muscles. « They begin to compensate. and these compensations also cause problems. Dr. Barry August (New York University Medical Center)
    And then, in an instant, I started to cry. Not little tears, not sad, quiet oh-my-back-hurts-so-much tears, but the deepest, hardest tears I’ve ever cried. Out of control tears, anger, rage, desperate tears. And I heard myself saying things like, Please take care of me, I don’t ever want to have to come out from under the covers, I’m so afraid, please take care of me, don’t hurt me, I want to cut my wrists, please let me die, I have to run away, I feel sick-and on and on, I couldn’t stop and R–, bless him, just held me. And as I cried, and as I voiced these feelings, it was, literally, as if there was a channel, a pipeline, from my back and out through my eyes. I FELT the pain almost pour out as I cried. It was weird and strange and transfixing. I knew–really knew–that what I was feeling at that moment was what I felt as a child, when no one would or could take care of me, the scaredness, the grief, the loneliness, the shame, the horror. As I cried, I was that child again and I recognized the feelings I have felt all my life which I thought were crazy or at the very best, bizarre. Maybe I removed myself from my body and never even allowed myself to feel when I was young. But the feelings were there and they poured over me and out of me.

    TMS patient

    Dr. Sarno’s theory can be stated simply: Most muscular/ skeletal pain is usually the result of early infantile and childhood trauma which has been repressed. The emotion involved is invariably that of profound anger and rage. Our mind plays tricks and confuses us into focusing our attention on physical pain while the real problem is in our not facing and uncovering our repressed emotions, particular deep rage. Sarno’s thesis is quite different from Janov’s in that the cure to Sarno’s Tension Myositis Syndrome (TMS) is simply to come to realize that the origin of the pain is from the unconscious mind and not from any bodily abnormality. Janov’s primal theory, on the other hand, emphasizes that this insightful knowledge is not curative; that what is needed for cure is a full re-living of the original repressed trauma. The disorders which are encompassed by this syndrome include, low back and leg pain, most neck and shoulder pain, fibromyalgia, and chronic fatigue syndrome. The author believes that anxiety and depression are both TMS equivalents. (…) The author surmises that the source of the pain in TMS is mild oxygen deprivation to the involved tissues and organ systems. At a very deep unconscious level repressed rage is the cause of the pain. Sarno takes issue with the medical profession since most physicians do not accept that the primary cause of many such chronic pain syndromes are psychological problems. Most physicians recognize that emotions play a role in such problems but are quick to find an inconsequential abnormality which they believe to be the cause of the TMS symptoms. (…) Unless the patient can become convinced that his back or neck is normal, the pain will continue. They must be reassured and then really come to believe that « . . . structural abnormalities that have been found on X ray, CT scan or MRI are normal changes associated with activity and aging. » This newly acquired belief, Dr. Sarno writes, will thwart the strategy of the brain to make one become fixated on the body and instead begin to understand that the problem is an unfelt trauma stored in one’s unconscious. It is as though the mind fears the release of the repressed rage. To make the pain go away the patient must acknowledge and accept the true basis of the pain. Think psychologically and talk to your brain! This will divert attention from the body. Insight, knowledge, and understanding are the cures for the TMS symdrome. (…) This was a patient, who at first despite knowing and accepting the source of her back pain, did not improve. Instead, the author writes, this patient’s pain became worse. He believes that her symptoms were exacerbated in a desperate attempt by the body to prevent their being released into consciousness — into her knowing their actual source. « The feelings would not be denied expression, » he wrote, « and when they exploded into consciousness the pain disappeared. It no longer had a purpose; it had failed in its mission. » (…) It is the unconscious repressed rage which is the source of the chronic pain, not the anger and rage which is consciously known by the patient. (…) There is an inexorable press by the unconscious to release and reveal its past traumas. When the patient understands the repressed presence of rage the feelings will stop trying to become conscious and « removal of that threat eliminates the need for physical distraction, and the pain stops. »

    John A. Speyrer

    Quand un patient arrive dans une consultation d’hopital, la routine est de faire un scanner IRM. Invariablement, on observe une quelconque anormalité anatomique comme un disque déplacé, une sténose spinale, ou de l’arthrite spinale. Alors le docteur déclare quelque chose comme : « C’est à cause du disque que vous avez mal » et dirige le patient vers la thérapie physiologique destinée à traiter le disque, avec de faibles résultats à long terme. En étudiant la littérature médicale, le Dr Sarno avait remarqué que si vous prenez une centaine de patients entre 40 et 60 ans ne présentant aucune douleur du dos et que vous leur faites passer un scanner IRM, dans 65% des cas vous constatez qu’il existe un disque déplacé ou une sténose spinale SANS douleur (New England Journal of Medicine, article 1994). Alors il s’est posé la question : « Si ce n’est pas le disque qui cause la douleur, alors c’est quoi ? » Il a découvert que les gens qui souffraient avaient des tensions chroniques et des spasmes musculaires dans le cou, le dos, les épaules ou les fessiers. Il affirme que lorsqu’un muscle est tendu de façon chronique, le sang ne peut pas circuler normalement à cet endroit ; il y a un manque d’oxygène et cela cause une douleur sévère. Vous pouvez aussi imaginer un muscle tendu enserrant un nerf et provoquant les symptômes de la sciatique. L’important ici, c’est que le Dr Sarno ne dit pas à ses patients que la douleur est dans leur tête. Il leur donne une véritable explication physiologique. Et nous allons bientôt voir la connexion logique avec les émotions. Le Dr Sarno s’est demandé : « Et d’abord, pourquoi est-ce que les gens ont les muscles tendus de façon chronique ? » Il a trouvé l’explication suivante. C’est que nombre de nos concitoyens grandissent dans des familles dans lesquelles ils apprennent, à un certain niveau (inconscient), que ce n’est pas bien d’exprimer sa colère ou sa peur. C’est un problème parce qu’en grandissant nous traversons des événements spécifiques ou des traumatismes qui suscitent la colère ou la peur. Et dès que ces émotions émergent dans le corps, notre inconscient dit en substance : « Ce n’est pas bien ni sécurisant de ressentir ces choses ». Alors, selon Sarno, l’inconscient provoque la crispation et le raidissement des muscles afin que la douleur nous détourne de ce qui nous met en colère ou nous fait peur. Quelquefois, ce processus de douleur peut continuer pendant des dizaines d’années.

    Dr Eric Robins
















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