Interview with Dr. Schechter about Dr. Sarno and TMS
Q: I understand you have known Dr. Sarno for many years.
Dr. Schechter: I first met him in 1981. I was a first year medical student at NYU. Dr. Sarno had lectured to us in anatomy class about the musculoskeletal system and I remembered that he was a Rehabilitation Doctor. I was having knee pain at the time and I was frustrated at its persistence despite medication, x-rays, and strengthening exercises. I had even been referred to an orthopedic surgeon, who was also the team physician for the New York Yankees at the time. He had me obtain an arthrogram, a special test that involves a dye injection into the knee joint—this was in the days before MRI—and it showed no evidence of a tear that would require surgery. So I went to see Dr. Sarno to see if he could recommend a special physical therapy program for me. Little did I know…
Q: What did he recommend?
Dr. Schechter: He looked at me in the eye and said the following. I remember it quite well. “I believe 95% of these chronic pain conditions are psycho-somatic.” I was a bit shaken. I responded, “I know migraine headaches can be stress-related, but knee pain?” Dr. Sarno invited me to come to his lecture that week—a teaching session for his TMS patients—and if I was interested, he offered to then see me as a patient and confirm the TMS diagnosis. I decided to go to the seminar.
Q: What was it like?
Dr. Schechter: I was probably the youngest one there. Well-dressed people, many from the upper East Side, New Yorkers. They seemed “normal” which was reassuring. The lecture consisted of Dr. Sarno teaching us, via his words and slides, about the “true cause” of back pain and many other painful disorders. I found the presentation very convincing. He laid out a thoughtful, clear, step-by-step explanation of how emotions and the unconscious could impact, via the hypothalamus and limbic system, the autonomic nervous system and cause physical pain in the back, neck, and other areas such as the knee(via peripheral nerves such as the sciatic nerve).
Q: What happened next?
Dr. Schechter: I went home that night and thought about the lecture. I felt hope and I felt “lighter” than I had in some time. I dreamed again of returning to the basketball and running that I missed so much since I had been forced to curtail these activities due to the pain. I felt a weight “lifting” off my shoulders when I went to bed that night. The following morning the pain had eased and by later that same day, I felt essentially no pain in the knees. I resumed basketball and running and felt occasional twinges, ignored them, and gradually resumed my activities. It was wonderful.
Q: Did you see him as a patient?
Dr. Schechter: I did make an appointment and saw him. He was pleased at my progress and I was very excited at the results. He did confirm that I had the characteristic personality and tender points of TMS and agreed that I was heading in the right direction.
Q: Did you stay in touch with him while you were in school?
A: I shared my continued excitement with him during the upcoming year, my second year of medical school. The following spring I was able to obtain a grant that enabled me to spend the summer in his office. During that time, I observed while he saw dozens of patients. I attended his lecture series several times, and most importantly, I performed the first follow-up study on his TMS program, under his supervision.
Q: Tell me about the study.
Dr Schechter: I developed a questionnaire to assess pain levels and response to treatment. I telephoned 177 patients of Dr. Sarno. I analyzed the data and determined that he had a 77% success rate with the diagnosis and treatment of TMS. Again and again, I heard similar experiences to my own. I spoke to patients with years of back pain who were cured by the education/insight program of Dr. Sarno.
Q: Were there any other details of the study that are especially relevant?
Dr. Schechter: I found that those patients who accepted the diagnosis got better. Some who failed the program had problems with the diagnosis and what it meant.
Q: How did this impact your career in your final two years of medical school?
Dr. Schechter: I strongly considered going into Rehabilitation Medicine, Dr. Sarno’s field. However, I wished to bring this psycho-social, wholistic perspective to all kinds of patients and I chose to enter Family Medicine Training.
Q: Did you stay in touch with Dr. Sarno?
Dr. Schechter: I did my residency in California so we spoke and saw each other only rarely. However, I do value those dinners with him and also spending time with his wife, Martha Taylor Sarno, herself an esteemed professor of speech therapy at the Rusk Institute.
Q: When did you begin a TMS program of your own for patients?
Dr. Schechter: During my training in Family Medicine, and my subsequent training in Sports Medicine, I was always acutely aware of the mindbody connection. I can think of many individual cases where this made a huge difference in the diagnosis and treatment of particular patients. However, it was not until the mid 1990’s, about 1995 or so, when I spent a few days in New York, seeing patients with Dr. Sarno, attending his lectures, and socializing that my program began to formalize itself.
Q: What happened next?
Dr. Schechter: When I returned to my practice in California in 1995, Dr. Sarno began referring me some of the many “out-of-town” patients who called or wrote his office seeking a doctor (link) who treats TMS. At that time, it was pretty much him and me who did this, perhaps a couple of others. I was actually surprised at how many patients began to call my office in Beverly Hills and lived in LA, even San Francisco, Arizona, Utah, and Colorado. Given the level of interest, I was able to offer once monthly TMS seminars in the evening, following a day of seeing TMS patients for consultations.
Q. How did these sessions go?
Dr. Schechter: There’s definitely a power to the group process of getting together, teaching about the diagnosis, and hearing the patients’ stories of improvement. Over time I had requests for recordings of my talks and hence the audio program developed—first one hour of tapes, now three CD’s, a total of almost three hours of materials. Due to scheduling and logistical issues—many of my patients come from quite far away for a TMS consultation—I have chosen, of late, to focus on the office visit, home program, workbook, and follow-up (in office, by email, or telephone/Skype), rather than offering a seminar on a regular basis.
Q: Why did you write the MindBody Workbook?
Dr. Schechter: I heard from patients that Dr. Sarno’s books outlined the diagnosis extremely well but were skimpier on treatment. I had been using journaling in my practice as a therapeutic tool and found that some patients loved it and others had trouble figuring out what to write each night. So I combined these two components: a program of guided journaling to help patients through the weeks after the diagnosis is made or after they have learned about TMS and want to apply it to themselves. Hence, The MindBody Workbook…a thirty day program… The key is that it teaches people through practice to “think psychologically”.
Q: What else are you doing with TMS?
A: I have been fortunate to have been able to do part time research on TMS which led to publications in the area.
Q: And Dr. Sarno?
Dr. Schechter: He is now retired, but in my opinion, is a legend in this field whose work is unfortunately known by more patients than practitioners!
Q: Thank you for your time.
A: You are most welcome.
(Interview done ca. 2008. Dr. John E. Sarno died in 2017)
Picture is ca. 2006.
Dr. John Sarno
Dr. David Schechter