Doctor, back pain has been, is and probably will be a widespread problem. What causes them? Why did you get out of the system and open your own private practice?
Actually, today I regret getting out of the system so late. For years I toiled in the clinic, my job could be compared to working in a factory on the line. Crowds of patients came to see me and I did what I learned in medical school. Prescribing drugs, electrotherapy, writing sick notes, giving injections... I treated, treated, but they kept coming back. I inherited a filing cabinet of people who had been coming in with sore backs for maybe twenty years. They were still being treated, they were still sick. I was fed up, I was racking my brain, "where the comrades went wrong." Then I accidentally met my colleague Dr. Šavlík, the founder of Czech psychosomatics. He told me a memorable sentence:
"Illness is information that one is making a mistake in life."
It is not possible to look for an explanation of the disease only in X-rays, CT scans, MRIs or blood tests. It is equally important to get to know the patient personally, to find out what his character is like, how he lives, how he works, how he rests, what his joys and worries are... Only in this holistic or complex context can you understand the causes of his illness. It's incredibly simple. Patients are amazed.
Are you a psychologist in a way?
I am not a qualified psychologist, I try to approach the patient in a psychotherapeutic way. Communicate with him sensitively but effectively. A lot of colleagues complain that patients don't confide in them about their personal problems. I have the opposite problem. They want to tell me everything. I have to hold them back. At the beginning of the consultation, I tell them: "In order to quickly find my way around your problems, I always ask you a simple question and ask for a simple answer." I need to find out how he's doing physically so I can "didn't miss" some organic problem. I'll examine the patient carefully. I'll strip him down, assess his musculoskeletal system, take his blood pressure, listen to his heart, lungs... just like a regular doctor. If I find an organic problem, I'll refer him to an associate specialist. Even though we don't sit in one place, we work as a team. Then I have to find out how he's doing mentally so I don't miss a serious psychological problem (psychosis, depression, panic attack...). If psychopharmaceuticals need to be put in place, I'll put you in touch with an experienced psychiatrist. If psychotherapy is appropriate, I find out if the patient would accept it, or what kind. At the Nest of Health we have two psychotherapists and three psychotherapists, each offering something different: coaching, psychoanalysis, KBT, psychorelaxation techniques, autogenic training... I give the patient a choice. In addition to the state of the body and soul, I am interested in how he is doing in life, how he works, how he rests, what are his joys, worries, family relationships... It's actually a simple puzzle. Most of the time, I'm clear in half an hour. How a person lives is also how they moan, if they don't change the way they live, they can heal, but it's hard to heal.
Let's go back to backs - you mentioned that you once inherited a file of these patients. Do clients seek you out with these problems?
Patients with back and joint pain are probably the most numerous. But the psychosomatic approach is effective for any health problem: not only eczema, stomach ulcers, anxiety, depression, but also severe autoimmune or oncological diseases. It works regardless of age, gender, diagnosis. Psychosomatics has only one limit: it is for people who are willing and able to take responsibility for their health. They just come to me for advice on how to do it. That doesn't mean I don't use medication at all. If I find that a patient is down and couldn't manage the illness on his own, I prescribe them - analgesics, antibiotics, antidepressants... But I try to prescribe them only temporarily, to help the patient bounce back from the bottom and use their effect to change his life.
Does this approach lead to a higher success rate?
It's not just up to me. I'm not promising or working any miracles. I explain and advise patients how to help themselves. Well, when a patient comes in and says: "Doctor, only you, you will save me, you can do it!", it's clear that his expectations are completely unrealistic. So I'll tell him: "No, no, no - you are wrong here, you must go to the Most High."
I make no promises, I don't work miracles, I just explain clearly and calmly where the patient is making a mistake.
For example, in relationships, in exercise, in diet... I identify the fault, I advise him what he should change in his life to get better. Then it's up to him. Sometimes they're disappointed, expecting at least a homeopathic ball or an acupuncture needle. But I don't need a mediator. For me, it's up to "fair and square". Illness is actually a set mirror. The question is whether one dares to look into it, or whether one prefers "obscure" pills.
Is there any way to generalize somatization to a specific part of the body? If someone says - my cervical spine hurts and my hip hurts. Is the message always the same?
Somatization in Czech means the embodiment of an unresolved life situation. A person has a problem in life - family, relationship, stress - and does not know how to deal with it.
What a person is not able to change in his life consciously, over time the body starts to do on an unconscious level for him.
My head hurts - I'm full of it. My back hurts - I've packed more than I can carry. I have heartburn - it's crawling up my throat... These are typical manifestations of somatization, information that one is making a mistake, that one is not solving the problem of life.
This means not only physical stress, but also worry. I explain to patients that if a person has worries and takes them too much, then it weighs on him. It causes tension, not only psychological, but also muscular tension. To carry the weight, to get everything done and to cope. Muscle tension itself uses up a lot of energy, and then you get tired just from being tense. However, they also say "tired of worrying." If it lasts for a long time, fatigue, neck and back pain, dizziness, shortness of breath, heart palpitations appear... Physical manifestations are functional at the beginning, usually nothing is found in X-rays, CT scans, blood tests. But if the functional problems last for a long time, they become organic problems: arthrosis, stomach ulcers, asthma, hypertension, heart attacks... These are irreversible, they cannot be cured completely. Ideally, the patient and the doctor catch the warning signs at the stage of functional problems. That's why I write books, give lectures, give interviews. So that people understand what their body is telling them through illness and don't have to go to the doctor. I ask patients in my office 15 simple questions to help them find the key to their health problems. (You can find them at the end of the interview, editor's note). Everyone can ask them themselves. After the consultation, patients usually say: "Doctor, I knew it, I suspected it, you just confirmed it."
I have an hour for each patient. That's plenty. My approach is different from that of a regular doctor, who usually does not deal with the patient's psyche and life situation. He is usually interested only in the part of the body he is dealing with, guided by attitude: "Don't bring psyche and personal worries here, I'm interested in heart, lungs, stomach, pressure..." Yet people who somatise are the vast majority. They don't go to a psychiatrist or a psychologist who is interested in their psyche and stresses. They're not "Crazy." What they need is a comprehensive psychosomatic approach. Psychosomatics is nothing new. It is a return to the experience and wisdom of family physicians. Such a doctor knew the family, the children, the grandparents, he knew how things worked in the family, and when someone from the family came to him, he was able very quickly, without complex investigation, to put the health problems into the context of his life. That is what we miss most today.
What role does genetics play?
There are very few truly hereditary diseases.
What is inherited are the behaviours that lead to disease.
The patient complains of hip pain, arthrosis, she says - it's hereditary... both her mother and grandmother had an endoprosthesis. Then we talk for half an hour and it turns out that the lady lives a similar lifestyle - overweight, heavy physical work, sedentary job, lack of proper exercise, stress. There's a pattern of behaviour that leads to illness. Character also plays an important role. Not only weight, height, physical parameters, but also personality traits are inherited. If I have brought anything new to medicine that patients are confused about, it is that I am interested in the character of the parents, the relationships of the original family. That's terribly important. You find out that Daddy is a choleric, Mommy is a hysteric, there are disputes at home, the children don't get along, they have lived in tension since they were little... These emotional traces and tensions are then carried into adulthood, causing them health problems: dizziness, heart palpitations, respiratory distress... The objective findings are normal. There's nothing physically wrong with them. The problem is that they've been there since they were young. "put on guard" and there's no one to tell them "at ease, at ease!"
How do you take a break?
The first step is to become aware of the problem, to admit it. Not to look for explanations only in objective findings, to balance also the psyche and interpersonal relationships. But most patients prefer a biological explanation, preferring to hide behind a diagnosis of arthritis, disc prolapse, hypertension, depression, autoimmunity... rather than admit their own failure. It is more comfortable to make yourself a patient, to be cared for, treated... than to accept responsibility and take care of yourself. I don't give patients diagnoses. I take them away. I turn them over to the problems of their lives.
I won't make you a patient, I will explain what you need to do to be healthy and not a patient.
In a conventional doctor's office, the most they will ask you is about your parents' illnesses, but not about their character and what kind of relationship you have with them. Sometimes patients are not able to describe the nature of their parents at all. For example, a top manager comes in and you find out that he has no relationship with his parents at all. This is typical of psychopaths (I write about this in detail in my book They're all psychopaths, but I'm an airplane.). In their original family, the relationships didn't work, the father was a choleric, the mother was cold, they didn't know compassion, they couldn't accept or give love. They are reckless, heartless, predatory, crippled in character. This is the problem of many high-ranking managers and politicians. A social system based on predation, ruthlessness and individualism attracts them like wasps to honey. They continue to develop it. We live in an era of psychopaths.
Advice in conclusion - how to maintain your health?
I've been advising people how to do this my entire medical life for years. I tell them: You need to play sports, relax, do breathing exercises, sing, cultivate relationships, get together, don't sit in front of the computer all day...
Article published with kind permission of the magazine Sphere
casopis-sfera.cz / gnews.cz-HeK
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