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Psychophysiological Disorders

Working with repressed emotions.

“The sorrow which has no vent in tears may make other organs weep.” —Henry Maudsley

Last week, I attended the first Psychophysiological Disorders Association 2021 conference with over 400 participants. I have long been a proponent of the mind-body paradigm for healing which has been around for well over 2,000 years. One of the conference presenters was Nicole Sachs, LMSW, who talked about her work based on her experience as a patient with John E. Sarno, M.D.

One of my patients recently experimented with Nicole’s expressive writing protocol, which she adapted from Dr. Sarno. Much has been written and researched about the power of expressive writing and the therapeutic benefits are empirically well established.

Nicole’s protocol is two parts. For twenty minutes a day, get out a piece of paper and write out the darkest, most forbidden feelings/emotions from your childhood and/or from your current life, then tear it up and totally destroy what you have written. Do not read it, do not share it, just let it go through destruction.

Once the paper is destroyed, spend ten minutes engaging in some form of self-care. It could be listening to a positive guided meditation or affirmations of self-love on YouTube, taking a walk with your dog, or taking a bubble bath.

How This Helped My Patient

One frequently encountered psychophysiological disorder symptom is chest pain. With any pain symptom in the body, it’s important to first rule out the possibility of a biological medical condition. After ruling out a heart condition, my patient discovered that the chest pains he had been experiencing were related to the emotional trigger of staying at the home of his deceased parents. His experience of pain was triggered by moments of profound sadness and grief. Many of my patients report feeling chest pains brought on by anxiety and stress, an experience a great number of us can relate to.

While staying at his late parents’ home, my patient discovered that it was time to demolish the decaying tree house his father had built for his children. He mentioned that it had become a safety hazard for anyone who approached it and required a debris removal service. As his father had constructed the treehouse to withstand tornado force winds, he knew it would not be an easy task to pull down. He had to make use of extremely heavy metal chains attached to a motorized vehicle, as well as large hammers and prier bars.

The whole experience became extraordinarily symbolic for the patient. He felt that the chains represented the bonds to his parents and his childhood, as well as his attachment to his children as he mourned the passing of their childhoods. Despite the tremendous physical exertion of tearing down the treehouse, he experienced no chest pain at all, which he attributed to completing the expressive writing exercise and self-love exercise earlier that day.

He felt that each tug on the chains brought him one step closer to letting go of his past and any negative emotions that surfaced. He remarked that he was unable to cry during the experience but was able to vocalize sounds like a wounded animal, which he found cathartic.

Many years have passed since my first investigations into Gestalt psychotherapy and psychoanalytic psychotherapy. Both have elements that lean towards the psychophysiological disorders model. The core idea is that the mind and body are interdependent and intricately attached. I recently heard someone say that emotions are the main ingredient of neuroplasticity, and brain rewiring to which I concur. I expect as we continue to understand the immensely powerful connection between our emotions and the pathology of pain and illness, traditional Western medicine will further embrace more holistic healing modalities.


Suggested Reading and Resources

Nicole Sachs, LMSW, (2016). The Meaning of Truth. Lewes, DE: Safe Harbor Press.

James F. Zender, PhD (2020). Recovering from Your Car Accident: The Complete Guide to Reclaiming Your Life. New York: Rowman & Littlefield.

Psychophysiological Disorders Association,