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One of the things any ethical therapist needs to consider carefully is the amount of hope one gives to clients. Some conditions can be completely cured, some can be helped and with some there isn’t much that can be done. Not giving people enough hope, where hope is justified, is in my view not providing proper service. And at the other end of the spectrum, providing false hope is unethical as it can add to the suffering of an already vulnerable person.
In chronic pain conditions where a known organic (i.e. physical) cause is absent, many in mainstream medicine and allied health are happy to accept an important role for psychosocial factors. Few believe however that debilitating chronic pain conditions such as fibromyalgia can be cured completely by a mindbody approach. So as ethical practitioners, doctors making this diagnosis will tend to tell clients that there isn’t a known cure, so as to not provide false hope. Clients are referred to various forms of pain management strategies which may involve drugs or cognitive therapeutic interventions, with the worthy goals of maximising the persons ability to function with pain and reduction of the associated distress and dysfunction. What often tends to happen however is that pain sufferers fall into a downward spiral (or at least a holding pattern) of disability and feelings of hopelessness about their situation.
After reading Sarno and curing my own fibromyalgia / CFS I realised that there is in fact both a cause and a cure for many forms of chronic pain and fatigue. After training in psychology and somatic psychotherapy and reading the published research I came to see a growing evidence base for the mind-body cure. So I have come to view the conventional medical practice of referring clients to pain management as unnecessarily prolonging the suffering of many pain sufferers.
It must be acknowledged that the mind-body approach doesn’t work for everyone. After known medical causes have been excluded, the client needs to able to accept the mind-body diagnosis. Not everyone is happy to accept that pain could be caused by psychological or emotional factors, and some even feel demeaned by such a diagnosis (despite this never being the intention of mindbody approaches). But then again, few medical or psychotherapeutic treatments can claim a 100% success rate.
But getting back to the question of healing versus pain management, is it ethical to not refer clients to a completely natural treatment that has demonstrated benefit and the power to cure or substantially alleviate suffering? In my view it is not.
So why is it that Sarno as a professor of medicine for many years has been unable to achieve broader acceptance of the mind-body cure for pain? The answer probably lies in his personal preference towards being a clinician rather than a researcher. He has helped thousands of clients in his decades in medicine, some of whom have been completely cured of pain that other doctors had recommended surgery for. But in the scientific method “case studies” are considered the poor cousin of randomised controlled trials, and skeptics will discount such evidence as inadequate.
In evidence based practice the weight of published data in controlled experiments allows the scientist-practitioner to make inferences about how the world is, and which treatments work. Hsu and Schubiner’s recent randomised controlled trial of a mindbody approach to fibromyalgia treatment is an exciting step in the direction of broader understanding of the healing power of accepting the deeper aspects of our self.
It is frustrating though that still, in 2011, large numbers of pain sufferers are being directed towards pain management approaches which are expensive to the public purse and won’t assist people in making a full recovery. In pain conditions where a cure is possible, and fibromyalgia is only one of those, healing should be the goal.
Other pages which may be of interest
Important: always work with your doctor to exclude other serious illnesses before concluding that your illness is the result of a mindbody process.
"Since I've started seeing Hal, I've quit drinking and smoking, gone off my antidepressants, stopped feeling shy, dramatically improved my relationships with my partner and with my mother, and largely gotten over my RSI issues.
Its been a transformational few months. I have to give credit to myself and to a course that I'm doing at the moment as well, but seeing Hal has really helped me get in touch with my emotions and given me the capacity to deal with life, rather than avoiding ... >>read more >>
"Seeing Hal changed my life. After 4 years of strong chronic pain I now experience minimal pain and have no restrictions in doing all the activities I love in life. Here is my story.
I initially developed RSI type pain in my wrists from typing and computer use while writing up my PhD. It manifested as strong pain right through both my wrists whenever I typed or used my wrists for normal activities. It eventually got so bad ... >>read more >>