Overcoming Chronic Pain

Introduction
This document describes a technique I developed to help people overcome chronic pain. It
is based almost entirely on concepts developed by John Sarno, M.D., author of numerous
popular books on the subject of the mental or emotional causes of chronic pain.

Sarno’s thesis, briefly stated, is that most chronic pain is a result of small and large
traumas we have experienced throughout our lives. Most of us do not deal with these traumas
directly; we bury them, ignore them, expecting they will go away. The saying “Time heals all
wounds” is really not true. Better stated, “Time buries all wounds”. But time does not really
bury the wounds, because the wounds present themselves in back pain, neck pain, skin
rashes, tiredness, and a whole host of other chronic ailments.

Sarno’s treatment involves bringing the traumas to the surface by examining significant
emotional events detail. Sarno likens the mind to a reservoir filling up with emotional events
over time. At some point the reservoir overflows as a result of some kind of trigger. The
trigger is a present time event which result in the pain or some other physical manifestation.

That trigger is no more the cause of the problem than any other life event from your past.
Examples of triggers include: a fight with your spouse, a layoff, a death in the family or simply
lifting a box. You get a sudden pain, which you attribute to a torn tendon or muscle or a spinal
herniation (etc.). You may get an x-ray or an MRI and the physician will insist you have a
physical injury, but chances are that herniation (or whatever) has been there all along, and so
is a post hoc explanation for your condition. What is really going on is TMS (Sarno's term).
TMS is simply inflammation that can occur anywhere in the body.

I discovered the technique you are about to learn as a result of researching a severe
sciatica condition. I tried every conceivable remedy until I cracked open Sarno’s “Healing
Back Pain,” hunting for a specific technique. I even went so far as to visit Dr. Sarno at his
office at NYU Medical Center for an examination where he was a professor of medicine. I soon
discovered that, while Sarno does a terrific job explaining his theories, his books and articles
fall short on the practical. I wanted to give his ideas a shot, but I just didn’t know where to
begin. My breakthrough came when I attended one of Sarno’s free workshops at NYU. Sarno
hosts the workshops but does not speak much. Instead he has a panel consisting of folks who
have overcome their physical issues using Sarno’s techniques, each telling their own story.
One of the panelists had my exact sciatica symptoms and he happened to be my age and
build. He described a method that I have adapted as the template that follows. I am
eternally grateful to that one person (and to Sarno of course) for allowing me to be pain free
for ten years now, with no surgery, no drugs, no other treatment whatsoever.

The objective of these exercises is to probe into the events in your life that filled the
reservoir. Your unconscious mind has buried these events very deep.

A word of caution. While this is a very simple technique, not everyone has the
wherewithall to follow through with these exercises. There is a reason our unconscious mind
buries these traumas: they are very difficult to face. For those people who have trouble
following this guide, I recommend locating a therapist trained in the Sarno technique.

A second cautionary note is that you may actually have a real physical injury that requires
conventional treatment. As Sarno puts it, the body is very capable of healing itself and
healing generally ensues in a few weeks after an injury. Virtually all injuries will self-heal,
assuming conventional treatments have been applied (the broken bone is set, the sprained
ankle is iced, the torn meniscus is stitched up, etc.).

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 Overcoming Chronic Pain
Most are skeptical that their chronic pain or other chronic condition could be
psychomsomatic in origin. They assume that their case is different, that they really need
surgery, anti-inflammatory medicine, an epidural steroid injection or some other conventional
treatment. But chances are, if you’re reading this paper, you’ve probably tried one or more of
these treatments with only temporary or no relief. Unlike conventional treatments, this one is
free, so why not try it out?

Please read the simple instructions carefully and avoid taking shortcuts. There is a lot of
very hard work ahead of you, but it should pay off in a dramatic reduction or elimination in
pain.

Technique Overview
There are two stages to the process: both require writing. Both stages involve reaching
back into your past to expose emotional traumas. Stage One is your laundry list and Stage
Two is the drill down into what you believe to be the most significant events contributing to
your current issues.

Best to write in the first language of your childhood, or the language you were most
comfortable speaking when the event occurred. I have provided templates for each stage with
sufficient examples to get you started.

Stage One
Stage One takes about one to two days to complete. It takes this much time because you
need to revisit your list frequently, with time to reflect quietly. You are not actually writing for
this long. If you have already done some soul searching about your past and present you may
be able to get through this faster. But in general I find it useful to work through the Stage One
exercises on day one, and then put down your pen for 24 hours or so. Then revisit Stage One
and flesh it out more, or edit what you’ve already written. In Stage One you will list out all
the events of your past and present that your conscious mind tells you may be contributing to
your physical problem. You begin with your earliest memories.

This is a simple listing process, and is NOT intended to be a narrative. In fact, writing a
narrative will defeat the entire purpose of the stage one exercise. The next, and critical step is
the ranking. After you make your list, preferably a day later, you should rank all the items in
your list by severity. Stage Two follows with a detail probe of your small handful of highly
ranked events. You may be lucky and not need to progress to Stage Two.

Best to use pen and paper, not a computer. The computer is somehow too analytical and
cold of a tool for this process. The process needs to be organic and low tech. And make sure
your documents are kept safe, away from prying eyes at all times. The traumas in your list
may involve someone in your household. You need to be honest with yourself, holding back
nothing, so you need to feel comfortable putting anything down on paper. If you are unsure
whether a past event was significant enough to record, put it down anyway. You can always
give it a low ranking. Upon reflection later you may discover that the seemingly trivial event
was really significant.

To summarize Step One:

1. Make your initial list and then pause for 24 hours
2. Revisit and augment the list
3. Apply a ranking for each listed item

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 Overcoming Chronic Pain

Stage Two
Stage two is a detailed probing of each of the highly ranked items from your Stage One list.
It is amazing how many details can emerge when you start to probe. This probing does not
have to be accurate, and will likely not be, as our memories are colored by stories from family
and friends, by photos, and our own faulty memories. For those events for which you just
cannot dredge up details, you should feel free to reach out to family or friends for details if you
feel comfortable doing so. Having such conversations may also trigger your own memories.

By the time you’ve probed each of your highly ranked items, most likely you will start to
feel some relief. If you have not, revisit the Stage One list and start on the next ranking level.
If you still have no benefit, revisit the Stage One list. You most likely have left out some highly
ranked key events from your past. This is quite normal. You may try consulting with family
members for help in uncovering events you have suppressed completely. If you are still not
making any progress at this point, you may want to consult with a therapist to help guide you
through Stage One. There are therapists who specialize in TMS (Sarno) therapy.

To summarize Stage Two:

1. Select a high ranked item from your Stage 1 list

2. Follow the template guide to describe each item in detail
3. Ask family or friends for help in recovering memory if you need to
4. Repeat with the next high ranked item
5. If you obtain little or no relief, revisit your Stage One list

Remember, this is very hard work, and takes courage to complete.

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 Overcoming Chronic Pain
STAGE ONE: Create and rank your life event list
Instructions
1. List events from your past that could possibly be contributing to your physical problem.
 Use a pen and paper, and make sure no one can find your list.
 You can go forward from early childhood or backward from the present.
Better to start with your earlier memories.
 Be brutally honest.
 Be specific. Don’t use phrases like “I never…” or “I always” or “my whole life”.
 You should have at least 20 items. More if you are over 40.
 NO LENGTHY NARRATIVE.
 Revisit the list a day later. Feel free to edit and add items any time.
2. When you have completed your list, read it over a few times. Try reading it out loud when you
are alone. This is a very private list you should not share with anyone.
3. Rank your list on a scale of 1-5, using the column in the template. 5 is high. You can use stars
or numbers.
A note about your list before you get started. Most life events are things that happened to you, in
which you were not instrumental in the playing out of the events.
There are major exceptions to this.
Some events may have been initiated by you. You may have severe guilt related to the event. This
could include cheating someone, commission of a felony, lying, etc. These types of events are at least
as significant as the other type, so please don’t omit them from your list, no matter how hard it may be
to face them. All the more reason to keep your list safe from prying eyes.

Tip: If you simply cannot remember early memories, try consulting with friends or family members if
you feel comfortable doing so. Keep in mind “memory transference.” Other’s memories can be
adopted by you and become false memories. Best to use their recollections as triggers rather than
delving into details.

Three more approaches to recall early memories:

(1) Work with a therapist trained in early childhood memory recovery
(2) Work with a hypnotherapist trained in memory regression therapy
(3) Listen to guided meditations and self-hypnosis audios:
Some examples: Hypnotic regression audio, Guided Meditation

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 Overcoming Chronic Pain
A Sample Stage One List
Age of 1st Impact Rating
Occurrence (5 is high, 1 is low)

1. Illness or accident (self or family member)

My father had a severe heart attack and I was the
7 4
first to find him

2. Death of a friend or family member

My grandmother died suddenly 6 5

3. Financial Loss

I had to declare bankruptcy 46 4

4. Non-financial loss (job, relationship, home)

I've been out of work for 8 months 41 3

5. Guilt event (failure to act, commission of a bad deed)

I shoplifted some candy 6 2

6. Other trauma (major embarrassment, robbery, fire, nightmare, job

failure, school failure, major move, 9/11, major argument, etc.)

I was sexually abused by my uncle 13 5

An SUV cut me off this week on the highway 49 1

I was held up at gunpoint 12 3

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 Overcoming Chronic Pain
Stage One
Empty Template for you to Complete
Age of 1st Impact Rating
Occurrence (5 is high, 1 is low)

1. Illness or accident (self or family member)

2. Death of a friend or family member

3. Financial Loss

4. Non-financial loss (job, relationship, home)

5. Guilt event (failure to act, commission of a bad deed)

6. Other trauma (major embarrassment, robbery, fire, nightmare, job

failure, school failure, major move, 9/11, major argument, etc.)

Consider printing this page or just use a notebook and write free-hand Don't forget to leave
space for numbering, event age and ranking (1 – 5). If you are over 30 you may easily have a lot more
than the 24 slots provided by this template.
A note on ranking: ranking your life events is a tricky exercise, usually requiring several passes.
You can use whatever ranking scheme you feel comfortable with. Some people prefer 1 to 3 ranking.
Most likely your inflammation is due to only one or two life events and so you should have only a few
ranked at 5. As you walk through your list, ask yourself “is this event causing my inflammation?”.

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 Overcoming Chronic Pain

When Will it Start to Work?

If you have read this far you may be wondering when the pain will start to go away, and how does this
process even work?

This treatment method works for differently for everyone. Much depends on identifying the one or two
events that were the most signficant or the events that were not well processed. For most pain
sufferers, the events are probably not occuring right now unless you’ve received an injury (in which
case you should be treated by a physician). And it is generally not suffiicent just to remember the event
superficially, which is why we have Stage 2, in which you go much deeper into event details.

Some people will see benefit from just Stage One, and may see benefit within a few hours or days.
Others need to revisit the list and recover more memories and dig much deeper into the most impactful
memories.

You should keep revisiting your list and revisit the ranking if you are not obtaining any relief or if the
relief is minimal. Continue to engage in normal activities to the extent that are able, as Sarno has
instructed in his writings. If after a few weeks you are not achieving pain reduction, consider getting
help with recovering early memories and going deeper into those memories.

We really don’t understand the physiological mechanism that causes the mind to influence
inflammation occurrence in the body. Science has only begun to explore the mind-body connection in
the past few decades. We just know that this technique works.

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 Overcoming Chronic Pain
STAGE TWO: In Depth Probing of High-Ranked Events
Instructions
Select the high-ranked events from Stage One. For each event, on a separate page, do the following:
1. Copy the text from the event to the space in the template
2. Explore the event in detail. Some suggested categories are contained in the template. Here are
some guidelines to get you started:
 Briefly describe what you were feeling at the time. Angry? Hurt? Sad?
 Who was with you?
 What were they saying, doing?
 What led up to the event? What happened after?
 Did you have nightmares afterward?
 Did your life change after the event? In what way?
 Describe anything you may have learned from the event.
 What would you tell your earlier self now, in hindsight?
Try to be very brief. This is not journaling in the typical sense. Don't worry about punctuation, spelling
or grammar. This is intended for your eyes only.
Be sure to keep your detailed worksheet or notebook in a safe place away from prying eyes.
Consider contacting friends or relatives if you cannot remember details about the event.
Understand that the categories listed on the following pages are only a guide. Feel free to add other
categories or omit categories.

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 Overcoming Chronic Pain
A Sample Stage Two In-Depth Probe

My grandmother died suddenly when I was nine .

(1) I learned about the event…. (8) My physical condition during the event was….
My father told my sister and I late one evening I contracted the flu about 2 weeks afterward

(2) During the event I felt… (9) Activities leading up to the event…
I was confused , sad , angry There was a lot of confusion and running around

Everyone spoke in hushed tones at the time

(3) After he event I was thinking or feeling (10) In hindsight, I would advise my earlier self with the following…
She seemed perfectly healthy It's okay to be very sad

I never knew anyone who died Write your grandmother a letter saying goodbye

(4) I was living in…. (11) Looking back on the event, I now feel…
Our apartment in NYC

(5) The weather was... (12) I learned these lessons about the event…
It was early autumn and the weather was cool

(6) The reaction of others to the event was …. (13) After the event, the following happened or did not happen…
My dad cries at the mention of her name I couldn’t sleep for 3 days

I had regular panic attacks shortly afterward

I missed 2 weeks of school

I cried every night for months

(7) When thinking about the event now, I…. (14) Other thoughts, feelings or incidents not covered above….
I never got to say goodbye We didn’t attend the funeral

I realized that everyone loved her

I miss her still

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 Overcoming Chronic Pain

Your Stage Two Template for You to Complete

My grandmother died suddenly when I was nine .
(1) I learned about the event…. (8) My physical condition during the event was….

(2) During the event I felt… (9) Activities leading up to the event…

(3) After he event I was thinking or feeling (10) In hindsight, I would advise my earlier self with the following…

(4) I was living in…. (11) Looking back on the event, I now feel…

(5) The weather was... (12) I learned these lessons about the event…

(6) The reaction of others to the event was …. (13) After the event, the following happened or did not happen…

(7) When thinking about the event now, I…. (14) Other thoughts, feelings or incidents not covered above….

Not all traumatic events are entirely negative experiences. Sometimes we learn from these
experiences and that can be very positive. If you have positive memories, include those in the
list. A typical example would be a relative who comforted you at the time.

Frequently we have feelings of guilt mixed in with traumatic events. These feelings can be
very confusing for a small child and are typically suppressed. Try to remember if guilt feelings
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 Overcoming Chronic Pain
were present, and list them, along with why you were feeling that way. An example is survivor
guilt: “Why did I survive the crash and no one else did?” Make sure to record any sort of guilt
feelings associated with each event.

When recalling your events in detail, consider your role in the event. Were you a willing or
active participant? Did you actively resist? If you feel like you were a victim of circumstances,
be sure to indicate that. If you were a witness to the event, consider the circumstances that
placed you in the situation; was there intentionality behind your placement at the scene?

Summary
We reviewed a technique for reducing inflammation that is the direct cause of chronic pain or other
chronic conditions. The technique involves a self-directed two stage process of journaling in which
you listed traumatic events in your past, ranked them in terms of severity and then drilled down
into details of that event.
I hope you are successful in your journey to eliminate your chronic pain. I would greatly appreciate
any and all feedback on this guide. Feel free to pass on this guide to anyone you think may
benefit.

Please send feedback to: Berl Kaufman at [email protected]

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