In theory, I understand the importance of managed care. I am aware of the abuses that have been perpetuated in my field, and the escalating costs to the consumer that have accompanied this abuse. However, operating within the constraints of various managed care companies was becoming increasingly overwhelming. Not only was I repeatedly confused and frustrated, but worse, I believed the treatment that clients received was too often compromised by clinicians (including myself) responding to the requirements of Managed Care companies. I avoided looking at this for as long as possible. Managed Care was definitely not going to disappear, and so for a long time (too long), my only alternative appeared to be to adapt and adjust. And that is exactly what I did. Consequently, I became so adept at jumping through the various hoops that my practice thrived. I was seeing more people than I had ever planned to see. At the same time my back started hurting, and the tremendous satisfaction I once experienced from my work was diminished by my ongoing sense of frustration and concern regarding the direction in which my profession was being led. I felt trapped.

As I began to face my anger regarding the profound effects of managed care on my practice, while continuing to work on attending to my body's needs, I began to experience relief. The pain became less frequent and was far less intense. I was able to work in relative comfort for longer and longer periods of time. Finally, it seemed that my long and traumatic bout with chronic pain was behind me. I celebrated in a thousand small ways. I danced with my daughter. I sang loudly in the shower. I smiled again at strangers. I found myself being silly a great deal with friends and family. I collected jokes. When you have been ill, the absence of pain (which the healthy take for granted) is no longer simply a normal condition. It can become a metamorphosis calling for commemoration and celebration. I became a true believer in the profound effect of the mind over the functioning of the rest of the body, and my work as a therapist began to reflect this conviction more and more. I'm absolutely convinced that my effectiveness as a clinician grew tremendously as my knowledge of new ways to integrate mind and body were incorporated into my treatment methods. I'll always be appreciative of how my own personal suffering led me in directions professionally that continue to enhance my skills and have led me on a quest to further understand the phenomenal healing processes of the body/mind.

Much later, while reading "What Really Matters: Searching For Wisdom in America," I was struck by how similar Schwartz's account of his experience with back pain was to my own. Like myself, Schwartz made the rounds to various medical professionals seeking relief. His pursuit of a cure was far more ambitious than my own however. He met with an orthopedist, a neurologist, a chiropractor, and an osteopath. He tried acupuncture, physical therapy, yoga, exercise, and spent two weeks at a pain clinic, all to no avail.

After 18 months of continuous pain, he met with John Sarno at New York University's Rusk Institute of Rehabilitation Medicine. Sarno convinced him that there was no structural damage to his back. Further, he informed Schwartz that his physical symptoms were actually precipitated by unconscious emotions that he was refusing to acknowledge, and that his fear was perpetuating the pain.

From Sarno, Schwartz learned that many individuals suffer from tension myotis syndrome (TMJ), a condition triggered by emotional factors such as fear, anxiety and anger. Sarno went on to explain that in over 95% of the patients he sees, no structural damage can be found to account for the pain, including those cases where symptoms associated with herniated disks and scoliosis are present. Over the past twenty years, Sarno has treated more than 10,000 individuals suffering from back pain with extraordinarily impressive results. Treatment primarily consists of classroom lectures focusing on the emotional origin of back pain. Sarno believes that anger is the emotion most commonly responsible for back pain.

After only three weeks, and attending two classroom lectures by Sarno, Schwartz's back stopped hurting and with a few short-lived exceptions, Schwartz reports that it hasn't hurt since then. I found Schwartz's story to be extremely gratifying, as it validated the significance of my belief that my own discomfort had been linked to my anger, and then aggravated by my fear of the pain.

"Every man has the right to risk his own life in order to save it." Jean Jaques Rousseau

The rumblings of my own personal "Quake" began years before building into the life crisis which would eventually confront me. While it may have began with a tortured back and the invasion of managed care, events continued to occur in my life which contributed to the dramatic change in life style my husband and I would later make.

My maternal grandmother, a woman whom I dearly loved, was diagnosed with an extremely rare and deadly form of cancer. At the same time, my paternal grandfather, a man who had been a significant role model for me while growing up, was dying. While my grandmother was in critical condition, I was informed that my grandfather would probably not last more than a few days. Torn between them both, I opted to stay at my grandmother's side in Bangor, while Grampy was fading fast over three hours away in Caribou. He died without me having the opportunity to say good-bye. I felt a tremendous amount of guilt as well as grief when I learned of his death. I had had an opportunity to be with a man whom I loved and whom I knew would not be on this earth for much longer, I chose to take the chance that he would hang on. He didn't and I missed the opportunity. There would be no second chances. Shortly after his death, and while my grandmother remained seriously ill, I discovered that I had a tumor. Although it proved to be benign, the fear and anxiety were very intense during the days that I waited for the verdict. What overwhelmed me the most during that time were the people who'd come to count on me who would be significantly effected if I became disabled or died. How would they manage? I found myself acknowledging how burdened I had often felt.