Pain - Unconscious Rage and Unbearable Feeling

Excerpted from
The Mindbody Prescription: Healing the Body, Healing the Pain
By John E. Sarno, M.D.

In reality, we have three minds: the conscious, the unconscious and the subconscious. This book is concerned primarily with the first two. The third, the subconscious, is the realm of perception, cognition, language production and comprehension, reason, judgment, physical and instrumental skill and the wellspring of creativity. It is a fascinating area but is relevant here only to the extent that learning takes place in the subconscious, and learning is the foundation of the therapeutic process.

Understanding the mindbody process requires some knowledge of the unconscious mind. I have laid some of the groundwork in the description of the parent, adult and child that reside in the unconscious.

The unconscious is not all negative, as the table might suggest. We are merely drawing attention to those qualities of the unconscious that lead to physical symptoms. The conscious mind copes very well with personality-imposed pressures and the pressures of daily life. It is the internal reactions to these pressures that lead to accumulated rage, and the threat that the rage will erupt into consciousness that necessitates a physical ailment as a distraction. Rage in the unconscious is perceived as dangerous and threatening by the unconscious, hence the dramatic overreaction in the form of pain and other physical symptoms.

To avoid any confusion it is essential to clarify the important difference between anger or rage we feel consciously and the repressed emotion referred to here.

Contemporary medical research on the relationship of emotions to pain, particularly chronic pain, focuses exclusively on what can be called perceived emotions. This includes such feelings as anger, anxiety, fear and depression. The person who suffers these feelings is aware of them; they are not repressed in the unconscious.

In my experience these may aggravate but they do not cause pain. TMS teaches us that only feelings that the mind perceives as dangerous, and therefore represses, induce physical reactions.

The Suppression of Conscious Anger

A very important book, The Rage Within, was published in 1984 by the noted psychoanalyst and author Willard Gaylin. It is a scholarly and insightful account of the causes and universal effects of anger and rage in the modern era. Dr. Gaylin makes it clear that suppressing anger is a fact of everyday life and, therefore, a psychosocial problem of great magnitude.

Inhibited or consciously suppressed anger contributes to the reservoir of rage in the unconscious. My work has dealt with pain disorders that are the direct result of anger-rage repressed (unconscious) and suppressed (conscious). While anger that is known to a person plays a role in the genesis of TMS when it is suppressed, it is not nearly as important as anger that is generated in the unconscious as a result of:

1. Internal conflict
2. Stresses and strains of daily life
3. The residue of anger from infancy and childhood

Moreover, people treated for TMS consistently get better; the same cannot be said for those treated for chronic pain in the medical community at large.

Rage-Not Anger

The intensity of the anger, to the point of rage, determines the necessity for physical symptoms as a diversion. The threat of rage to explode into consciousness must be of sufficient magnitude to warrant the production of TMS or one of its equivalents.

How Do You Know Rage Is the Culprit?

Throughout my experience with mindbody disorders, patients have been my source of information. I have learned by observing. Further, our psychologists repeatedly find evidence of repressed sadness and rage, and unconscious fear of these feelings. Helen is a prime example.

Examples abound, such as the man whose family sold, over his objection, a business that was his pride and joy; the man who felt compelled to participate in activity he dislikes to please his wife; the dozens of men and women looking after elderly parents, not objecting consciously, but seething inwardly; the young men and women who, like Helen, were sexually abused as children; the woman with six children who loves being a mother but is unaware of her inner anger at all that motherhood entails; the mother who invariably has a pain attack after holidays because of the enormous amount of work she had to do for the family, taken for granted by everyone; the fifty-five-year-old man who has been angry at his mother or father since childhood.

To varying degrees, I believe we all harbor repressed rage, that to do so is normal for our time and culture. We are all under pressure of one kind or another. Though it is well to be aware of this unconscious rage, it is equally important to focus on the sources of the rage. Before we do, a word about avoidance.