It Works in Practice but Does it Work in Theory OR The Fairy Tale of John Sarno and The Miracle Cure

Once upon a time, there lived two brothers, John and Steve. John was a television reporter for ABC’s 20/20. Steve was on the faculty of Harvard Medical school. They both had horrible back pain.

They’d searched far and wide for a magical solution to cure their back pain.  They tried every contraption and theory supplied by doctors. Unfortunately, nothing helped.

One Contraption That Steve Is Using to Ease His Neck Pain 

One day John met a shaman (doctor) named John Sarno. John Sarno had a magical cure for back pain. If you just said the magic words and believed them, your back pain would be cured. You had to say:

  1. There is nothing wrong with my back.
  2. The pain is all being generated by my head. It’s my brain trying to distract me from the emotional rage that’s I’m feeling based on repressed Freudian memories.

When John woke up the next morning his back pain was cured.

“Steve!” said John, “I have the most amazing news! I found the miracle cure. You just have to say the magic words.”

“John, you know I can’t do that,” said Steve. I’m a doctor and don’t believe in magic. Besides, Freud’s theories on repressed emotions were discredited long ago.”

So John lived happily ever after while Steve stayed in back pain.

(End of fairy tale)

This story is a close adaptation of reporter John Stossel’s segment about John Sarno on 20/20  from 1999. His brother Steve was teaching at Harvard Medical School at the time.

When I first heard the story, I remember thinking that Steve was right. John Sarno was obviously blowing smoke. In the years since then, I’ve realized that it’s not quite so simple.

The basic problem here was that what Sarno said seemed to work even though his theory was tragically flawed. Sarno theory involved Freudian repressed rage — a theory that was discredited a century ago. He was clearly grasping at straws.

But the part that made sense was that the pain wasn’t anatomical. It was coming from your head. This article from Vox does a good job summarizing Sarno. In the article, Cathryn Jakobson Ramin, author of the book Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery says, “What he recommended as treatment was essentially cognitive behavioral therapy — elimination of fear avoidant behavior and catastrophizing — before anyone had ever heard of it and it’s exactly what is being used now to treat patients with central sensitization.”

My experience with chronic pain started around 2000. I had horrible wrist pain that wouldn’t go away. Luckily all my doctors told me that I didn’t need surgery. Though they didn’t give me any options of what I should do. Luckily I found Lisa Sattler who is one of the world’s best physical therapists for carpal tunnel. After a year of physical therapy with her, the pain went away.

Though the pain came back, as back pain, a few years later. I found the book Back RX to be very helpful. But as the back pain persisted, I got an X-Ray that showed a bone spur in my hip, “Aha!” I thought, “I’ll have surgery and pain will go away.”

“Not so fast,” said the surgeon. “Why don’t we inject some strong painkiller right into your hip. If the pain goes away we’ll do the surgery. If it doesn’t go away, the surgery won’t help.”

So I went into the doctor’s office and lo and behold, the pain didn’t go away with the painkiller. That got me thinking about Doctor Sarno again. I started to realize that the more stressed I became, the more my back hurt. Also, the pain would move around a lot which doesn’t make a lot of sense from an anatomical perspective. At this point in my life, I still don’t think Sarno’s theory makes sense; however, if I sit down and meditate, I can make most of my soft tissue pains go away.

A Better Way to Write OR Why You Don’t Need to Write About the iPhone 5

There’s an old saying that the best way to learn something is to teach it. That’s certainly true when working with Blake on a school project. Blake is writing a chapter book at school. At most, it’s going to be 20 pages long. In Blake’s mind this is huge. Like infinitely large.

Blake‘s topic is Apple — a topic that he’s passionate about. He wants to write everything in the world about Apple in his up to 20 pages. He wants to explain all the iPhones, iPods, iPads, Macs and everything else that’s ever existed within the Apple oeuvre. I thought it might be more useful to take a historical perspective and highlight the important parts of Apple history. He wanted to stick with his original plan of writing the encyclopedia of Apple.

So I tried to prune some of the low hanging fruit.  “What about the iPhone 5?”

“Of course we have to write about the iPhone 5,” Blake said.

“Why?” I said.

“Because it’s important. That’s where Apple started using Touch ID.”

“No,” I reminded him, “that didn’t happen until the iPhone 5s.”

So we got rid of one Apple product. But the real question here is how to make writing the most productive and fun, While Blake is working on his writing project, I was trying to think about how to optimize my own writing.

I thought about some of the principles we’re using in Agile software development at work and how they could help when writing:

  • Limiting the work in progress  (WIP). It’s much easier to start things than to finish them. I remember someone at Google once told me that “If you have 10 apples, don’t take one bite from each of them.” And it’s the same thing with writing. I only want to have 3 items in progress at any given point. That gives me some flexibility on what to work on but any more than that I start to feel overwhelmed with the work I need to finish.
  • Develop iteratively and refine. Jeff Patton gives a great example of this when thinking about the creation of the Mona Lisa. Da Vinci didn’t sit down and start drawing pieces of the Mona Lisa.
    Tbe Mona Lisa Wasn’t Put Together Piece by Piece…

    …It Was Refined in an Iterative Fashion
  • He drew the basics. Then he drew the outline. Then he made refinements.
  • Do the most important thing first. In order to develop iteratively, I need to prioritize. By prioritizing the work, it breaks things up into manageable chunks. I’ve also done the biggest things first so I can stop much earlier and still have something that holds together. Then I can edit and refine only the parts I really want to. 
  • Time Box. I give myself a certain amount of time upfront to finish something. If I say I’m going to finish this piece in 2 hours it really helps me prioritize and make sure I’m focused.
  • Split up the planning and the doing. Most people don’t like planning so they mix up their planning and their actual writing. It’s much easier to split up the work into multiple bite-sized chunks. This relieves a lot of the cognitive stress and makes the writing more fun.

Here are the steps I use to implement these principles:

  1. Topics. This is really just the very high level of topics that I want to write about. I keep a list in Evernote. It’s good to try to keep this list prioritized because the items on the top become the most exciting ones that I want to tackle. Possibly I might put in a very high-level outline at this point.
  2. Story Bits. This is when I start to flesh out the idea. This can be done on index cards, post it’s, or just a piece of paper. My favorite way of brainstorming is Mind Mapping. There’s a great book that taught me how.
  3. Organizing. Then it’s time to create a broad outline. Some good ways of building the outline are user story mapping and the pyramid principle (summary here). These days when I’m writing a blog post I just write out my the paragraph order and my topic sentences.
  4. Write. Once I’ve done he organizing, the writing is fairly easy. It’s just fleshing out the idea. Each paragraph really should only be one idea and I’ve already written that idea down in the last step.
  5. Refinement. This is where I go in and make sure that spelling is correct and that everything makes sense. This is best to do once I’ve had some time to rest and take a look at it. There’s normally some silly mistakes but in general I’m happily surprised with what I wrote.

By following these steps I’ve been able to write a lot more and have a lot more fun doing it. Give it a try!

Tips Not Answers

From Lewis Menand’s review of Smart, Faster, Better, I learned that all self help books have the same goal — to get us to be the people we know we should be. These books don’t have have any new solutions — they just reiterate common sense through the current cultural or businesses lenses. Menand points out that Dale Carnegie’s famous book How to Win Friends and Influence People (which I love) could be summed up in the sentence “If you are nice to people, they will like you.” But, he continues, the purpose of these books is not “What would Jesus do? but How, exactly, would He do it?” Carnegie’s book has some great tips on how to be nice to people like, “Be a good listener and focus on what the other person is interested in.” To me, it’s a fundamental point that none of these books, as much as they try, have the answer — we already know the answer. But they do have some good tips and tricks on how help us anyway.

Stop The Things That We Own From Owning Us

Reduce Stress

According to Robert Sapolsky, research says that the following things lower our stress and make us happy. As a side fact, you get a lot more benefits if you enjoy doing these things and aren’t forced to do them:

  • Exercise: Do 20-30 minutes of cardiovascular exercise. It’ll make your heart and brain work better as well as reduce your stress levels.
  • Meditate: Meditation lowers your blood pressure, heart rate and cholesterol levels. It also lets you put stressors in perspective.
  • Friends and Family: Having friends and family you love and trust helps keep us calm.
  • Sleep: The human body needs 7-9 hours of sleep. Less than this causes significant stress on the body.

Wishing Others Well is a Quick Happiness Fix

I’ve always heard that the best way to make yourself happy is to focus on making other people happy — but I’ve found it hard to put into practice. Then I found the meditation app Buddify. It has a “Walking in the City” meditation they call “Zap” where you wish everyone well that you pass on the street. Give it a try because it’s amazing. It’s hard for me to find a quicker happiness fix.

Trigger Yourself to Stay on Track

Marshall Goldsmith wrote a great book called Triggers: Creating Behavior That Lasts — Becoming the Person You Want to Be. He talks about how we react to our environment more frequently and powerfully than we’d like to admit. So Goldsmith places triggers in the environment each day to help drive progress on key goals. I’ve been doing this for about a year and it’s really life changing. If you’d like to try it yourself you can take his basic survey at Ask Me Every.

Be Vulnerable to Build Stronger Connections with Friends

Brene Brown has a great recording of her seminar The Power of Vulnerability: Teachings of Authenticity, Connection, and Courage. It’s a great follow up to her other work that I love. First you might want to check out her animated shorts on Empathy and Blame that are taken from her presentation at the Royal Society of the Arts. She also gave some great TED talks on The Power of Vulnerability and Listening to Shame.

Asking vs. Guessing

Asking vs Guessing. I never realized that there are two different types of people and they ask for things in two very different ways. If you don’t realize these two different frames, you could end up misunderstanding what’s expected of you. The Guardian had a nice overview of this idea that was first described on a Metafilter post that then went viral. In short:

  • In Ask culture, people grow up believing they can ask for anything – a favor, a pay raise – fully realizing the answer may be no.
  • In Guess culture, by contrast, you avoid putting a request into words unless you’re pretty sure the answer will be yes.