What Is The Symptom Imperative? And Why It's An Empowering Way To Heal Chronic Pain

I speak a lot on this blog about Dr John Sarno, and his revolutionary acknowledgment of TMS. Amongst the many discoveries Dr Sarno made in the treatment of TMS, none are more empowering than a recognition of the symptom imperative. 

Healing TMS usually starts with reflecting on:  

  • Your personality traits, 

  • Present day stress 

  • Past day stress 

Once you begin to see correlations with these things and your pain, you can begin the process of healing. This process is usually filled with epiphanies, emotional releasing and a new empowering relationship with your body.

And at some point during this process something remarkable may happen, the symptoms in your body start to get weird. 

Mainly your symptoms either change location or intensify, a phenomenon which Dr Sarno called the symptom imperative. Your lower back pain becomes upper back pain, your left knee pain goes to your right knee, your stomach aches become tinnitus. 

Dr google will always have a diagnostic reason for your new pain, but once you understand the nature of the symptom imperative you begin to realise that your body is just doing what it’s always done: distract you with physical pain to protect you from emotions it thinks are dangerous for you to feel. 

As Dr Sarno put it in his ground-breaking book, Healing Back Pain: The Mind-Body Connection

“Patients often report pain in a new location as the old one gets better. It is as though the brain is unwilling to give up this convenient strategy for diverting attention away from the realm of the emotions.”

Why is understanding the ‘symptom imperative’ empowering? 

The conventional more mainstream approach to dealing with pain, is a diagnosis and a pill. 

Have heart burn? Here’s a rennie

Have bodily pain? Here’s nurofen 

Have stomach aches? Here’s a laxative or a diarrhoea pill

Have a cold? Here’s lemsip 

Have neck pain? You slept wrong and left the window open.. 

Have back pain? You’re sitting wrong..


However once you understand TMS it becomes a choice, either continue to take a new pill for a ‘new pain’ or start to do the work of understanding what needs resolving and how you’re going to resolve it.   

Once you get into the habit of turning towards emotions, the new symptoms disappear as quickly as they arose. So imagine this, at some point in the future you’ll feel a pain in the body and know exactly what emotion has been coming up for you and how to resolve it. Plus you’ll confidently know that doing this will heal the pain. How empowering is that! 

This process may initially seem to take time, you’re learning a new skill after all. However, if you were to ask me whether I want to spend:  


A lifetime reliant on pills and spending lots of money and time on people who don’t know what’s wrong with me. 

Or 

A couple of months of learning to be emotionally intelligent, and cultivating a new empowering relationship with my mind and body. I’d make the same choice every time. It worked for me, it’s worked for tons of other people and it can work for you. 

I offer a COMPLIMENTARY CALL for anyone wanting to speak to me about their pain and how they can also heal.

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Why Your Inner Critic Needs Your Support, Not Constant Positive Thinking

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Are You Constantly Pre-empting Pain Even When It’s Not There? How To Break Pre-emption Loops To Heal Chronic Pain