PDF Summary:Mind Your Body, by Nichole J. Sachs

Do you suffer from chronic physical ailments like pain, long Covid, or autoimmune conditions? Have you exhausted every avenue of treatment and had no success? What if you could resolve your symptoms not through pills, surgeries, or procedures, but by treating your mind? In Mind Your Body, psychotherapist and podcaster Nicole J. Sachs argues that repressed emotions and trauma are at the root of many people’s chronic physical conditions, a theory rooted in mindbody medicine. She elaborates on how and why this transference happens and provides a guide for how to resolve your physical symptoms through mindbody treatments.

In our guide, we’ll explain what mindbody medicine is, as well as how and why mental and emotional difficulties manifest as physical symptoms. Then we’ll explore the solution to mindbody symptoms and outline the steps for following Sachs’s mindbody journaling practice. We’ll also discuss the history of some key concepts, add research to support Sachs’s ideas, and compare Sachs’s methods to other therapies and theories.

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Choose to Believe

Sachs acknowledges that this mindset shift can be challenging. It may seem illogical to attribute physical symptoms to emotional causes. But what you see as logical is biased by your knowledge and your experiences, which form your assumptions about the world. The only way to access greater possibilities is to challenge these assumptions. So, Sachs advises, choose to believe in the illogical. Just as you suspend your disbelief when you read a fantasy story, suspend your disbelief of mindbody medicine so you can open yourself up to the benefits it offers.

(Shortform note: Challenging your assumptions about the world can be difficult if you aren’t sure what those assumptions are. In Deviate, Lotto says you can identify your assumptions by paying attention to your emotional reactions when your expectations are met or unmet. He also recommends you embrace uncertainty: When you face something you don’t understand, admit you don’t understand it instead of rejecting it at face value. This is uncomfortable, but it may help you suspend your disbelief as Sachs advises.)

Challenge Your Brain: Understand Your Habits

Sachs explains that your brain has to keep up with an immense amount of information. To make this easier, it forms shortcuts in the form of habits. It automates behaviors that you engage in regularly so you can spend its energy on things that require focus. This prevents you from having to devote conscious energy to regular behaviors—you don’t have to remind yourself to shower every evening or consciously go through every step of driving (opening the door, buckling your seatbelt, starting the car, and so on) every time you do it because these actions have become habitual.

(Shortform note: The brain’s need for shortcuts isn’t just a matter of mental space, but also physical space: In The Brain That Changes Itself, Doidge explains that the brain has limited mass, which results in competition for that limited space (or competitive neuroplasticity). Once a behavior pattern is established, we continue to rely on it even if it’s not optimal, as de Bono argues in Lateral Thinking. In the context of mindbody medicine, this means your brain has found patterns that get you through life but may not provide optimal (pain-free) results.)

However, while these habits take a huge load off your brain, they’re not always beneficial. You also develop habits to help you cope with stress, often in the form of avoidance behaviors. These are activities that help you avoid thinking about what’s stressing you out—for example, eating or drinking, watching television, exercising, or scrolling on social media. You’re drawn to these behaviors because they’re familiar, which causes the brain to perceive them as safe—or at least, safer than the unknown, which the brain is naturally averse to.

These behaviors aren’t inherently bad (exercise, for example, can benefit your health). But Sachs says they can become obstacles to doing mindbody work, because this work requires you to remain in a state of discomfort and uncertainty until you can convince your brain that what you’re feeling isn’t dangerous. However, this state of uncertainty itself feels dangerous because of the brain’s aversion to the unknown. To protect you from this perceived danger, your brain will try to distract you from this work with the aforementioned avoidance behaviors, so you need to be prepared to deal with these distractions. We’ll explain how to do this next.

(Shortform note: For some people, the fear of the unknown can be so paralyzing that they're unable to make any changes at all—this is called metathesiophobia. It prevents them from making changes that could improve their lives. This can help explain why some people remain in dangerous situations even when a better option is available. However, one of the benefits of Sachs’s mindbody method is that it doesn’t require you to make major changes to your behavior—so while you’ll need to challenge your brain’s habits and establish one important new habit (as we’ll see next), you don’t have to stop doing the familiar things that bring you comfort and joy.)

The Pros and Cons of Avoidance Behaviors

Behaviors you engage in to deal with or avoid stress (such as the avoidance behaviors Sachs describes) are known as coping behaviors. Coping behaviors are often divided into two categories: adaptive and maladaptive. Adaptive behaviors tend to promote growth, be geared toward a solution, and involve creativity and flexibility. They provide both immediate and long-term relief from stress. Maladaptive behaviors provide temporary relief from stress but ultimately fail to address the source of the stress, so they’re harmful in the long term.

The same behavior can be adaptive in one context and maladaptive in another. So while, as Sachs notes, a behavior like exercise can provide benefits, if you use it to distract yourself from your emotions, then it’s maladaptive in the context of mindbody work: It fails to address the source of your stress.

This also means behaviors we might assume are always maladaptive can be adaptive. For example, we often think of scrolling on social media as a bad habit, but it can be a means of social connection. So if the stressor you’re dealing with is social isolation, using social media can be an adaptive behavior. Distraction can also be beneficial in some situations as long as it’s paired with acceptance rather than avoidance—but again, in the context of mindbody work, any behavior that distracts you from the work is an obstacle.

Mindbody Medicine Techniques

Now we’ll explain how you can put Sachs’s principles into practice, using mental work to treat your body’s symptoms. As you start this process, keep in mind that the only way to make it work is to do it consistently. It needs to become a habit in order to unseat the maladaptive habits your brain has formed to protect you. Sachs says it should take around three weeks to make this practice a habit. So, pick out a conducive space and a convenient time to do it every day. Prioritize yourself during this time, even if that means setting strict boundaries with others who demand your attention when you’re trying to work on yourself.

You’ll begin by completing an inventory exercise to understand what’s currently happening in your brain. Then you’ll start a daily practice: mindbody journaling (a method that Sachs calls JournalSpeak).

The Placebo Effect and Its Implications for Mindbody Treatment

The principles of mindbody medicine may help explain the placebo effect, which is when a treatment with no active therapeutic effects provides a positive health benefit. While some may think of placebos as “useless,” the placebo effect can actually be a powerful source of healing. It happens because of your brain’s interpretation of various contextual cues: External cues (like physically being in a doctor’s office, being told a treatment will help you, speaking with medical practitioners, and being administered shots) combine with internal cues (like your expectation that a treatment will work, your memories of things that have helped in the past, and the sense of being cared for) to create a positive health effect, such as reduced pain.

When you follow a daily practice like the one Sachs describes, you’re cultivating a particular informational context for your brain. Over time, your brain will become conditioned to respond to that context in a way that results in therapeutic effects. Additionally, research suggests that the placebo effect isn’t dependent on deception—that is, you can get therapeutic benefits from a placebo even if you know it’s a placebo. You just need to condition your brain with consistent external and internal cues, like doing it in a specific space at a specific time every day, and devoting your attention entirely to yourself during that time.

However, while Sachs suggests a timeline of around three weeks for her techniques to become a habit, other research indicates that forming a new habit can take an average of 66 days. So, if you’ve been following Sachs’s techniques for a month and still don’t feel like it’s a habit, don’t give up—you may just need more time to effectively condition your brain.

Inventory Exercise

The first step to beginning mindbody work is to create an inventory of your current avoidance behaviors, Sachs explains. This will help you understand what your brain is doing to distract you from “dangerous” emotions, which is necessary for uncovering and identifying those emotions. As you do this exercise, refrain from judging yourself in any way. This exercise isn’t about putting yourself down or shaming yourself for past or current behaviors, nor is it a list of things you need to stop doing; it’s simply an exploration of where you are now so you can see how to get to where you want to go next.

(Shortform note: In Lateral Thinking, Edward de Bono explains why judgment can be such a problem in mental and cognitive exercises. He suggests that judgment prevents you from using certain ideas in your reasoning. Applying this to the inventory exercise, judging yourself as you compile your list of behaviors might lead you to exclude things you should include because you have too much shame associated with them. Suspending your self-judgment during this work will help you open your mind to both the present reality and what you can accomplish.)

Make a list of everything you do to get away from feelings you don’t want to feel. Then, says Sachs, “interview” each behavior one at a time. Place it at the top of a page and ask it why it’s there and what it does to help you. For example, let’s say you’ve written “reading books” on your list of avoidance behaviors. You ask this behavior how it helps you, and it explains that it keeps you entertained and helps you learn new information. It allows you to imagine novel experiences and helps you better understand how to relate to people with different perspectives. But as you continue your interview, it also reveals that it helps you focus on other people’s problems instead of your own and that it helps you procrastinate on unpleasant tasks like washing dishes.

Next, if you can, dig deeper. Why is washing dishes so unpleasant to you? Maybe as a child, your parents were always dissatisfied with how you’d washed the dishes. They’d criticize you and re-do it, leaving you feeling inadequate and humiliated. Now, as an adult, washing dishes brings up those awful feelings, so you put it off as long as you can, even though that results in unpleasant things like clutter, bad odors from the sink, and a lack of clean dishes.

Sachs cautions that this exercise will bring up painful memories and feelings. It may also cause a temporary but sudden uptick in your physical symptoms, because you’re closely examining the exact emotions your brain works so hard to keep you safe from. However, it’s necessary to guide you in your next stage of mindbody work.

(Shortform note: While it’s normal for this exercise to unearth painful feelings, some caution that you should avoid digging too deeply into your trauma if your nervous system isn’t yet ready to do so. Sachs’s work can help with a dysregulated nervous system (an imbalance between the two parts of your nervous system that we discussed earlier: the sympathetic and the parasympathetic systems). However, if your systems are so imbalanced that you’re in a perpetual state of very high arousal—what some term a sensitized nervous system—then digging up trauma may make you feel worse. If you think your nervous system may be sensitized, consider taking time to desensitize it before excavating your deeper traumas.)

Mindbody Journaling

Mindbody journaling is a 30-minute daily practice you’ll use to reprogram your nervous system. According to Sachs, it will allow you to uncover the deeper, more unpleasant emotions underlying your surface emotions, signal to your brain that these emotions aren’t dangerous, and thus circumvent the threat response that creates pain and other physical symptoms. The practice consists of 20 minutes of writing followed by 10 minutes of meditation. We’ll break this practice down into four steps: 1) creating (or reviewing) three lists, 2) stream-of-consciousness writing, 3) meditation, and 4) disposing of your writing.

(Shortform note: Another type of journaling practice focused on healing is writing therapy. It can include things like expressive writing (which resembles Sachs’s mindbody journaling method), gratitude journaling, reflective journaling, and trauma-informed writing. While expressive writing is more freeform, other types are often more structured, focused on answering specific questions or completing certain exercises. Writing therapy is also usually guided by a mental health professional, who ensures that the journaling is helpful and that the patient doesn’t get overwhelmed by the thoughts and feelings they uncover. If you need more structure or guidance than Sachs’s method provides, you may prefer to begin with writing therapy.)

Step #1: Start With Three Lists

Create three bulleted lists: one for your past experiences, one for your current life, and one for your personality. These will serve as living documents that you can refer back to every day and update as needed. They’re for your purposes and no one else’s, so include everything you can think of, and don’t worry about thoroughly explaining the details of events. Just write in whatever way you’ll best understand.

Past Experiences List

List every experience you’ve had in your life that you have negative associations with. This may include traumatic experiences, conflicted relationships, personal losses, or troubling events. Sachs suggests thinking of this as a sort of montage of formative moments in your life.

Current Life List

Here, you’ll list all the stressors you experience today. Other people are often the greatest sources of friction in our lives, so think about the people close to you and what stressors you associate with them. There may be overlap between this list and your past experiences list, as some of the things you struggled with in the past may continue to pose a problem for you today.

Personality List

Now, list as many aspects of your personality, or the self you present to the world, as you can. Our personalities develop throughout our lives to help us exist in this world and meet others’ expectations of us, and difficult emotions often arise from the conflict between how we truly feel and how we behave or want to be seen. These may include things like perfectionist tendencies, people pleasing, the need to be liked, or conflict aversion.

(Shortform note: In The Mindbody Prescription, Sarno explains that certain personality traits can predispose you to TMS. These traits tend to relate to feelings of inadequacy and the need for approval from others. They include perfectionism, self-criticism, low self-esteem, conscientiousness, ambitiousness, and the desire to be a good person and to please others (which leads to guilt when these desires aren’t met). However, your personality isn’t set in stone: Techniques like the ones Sachs recommends may help you cultivate traits that lead to greater self-efficacy, which can offset the effects of the traits that lead to TMS—and, consequently, reduce your pain.)

These lists will serve as your starting points for the writing process.

Step #2: Write for 20 Minutes

Now, pick one bullet point from your lists and put it on a new page. In a stream-of-consciousness style, journal for 20 minutes, writing everything you can about that item. Don’t censor yourself at all—you can use profanity, expressions of hatred, hopeless language, or anything else you’re feeling. This language helps teach your brain that sitting with these feelings isn’t dangerous.

During this writing process, you’ll likely start with the basic facts or surface-level thoughts and feelings, but as you go on you’ll start to uncover what’s at the root of your repressed emotions. Allow yourself to feel all of these, whether they’re good or bad, and don’t worry about whether they make sense. This is your inner child speaking, and their feelings won’t seem rational to your adult self, but they need to be heard. (We’ll discuss the inner child in greater detail later in the guide).

As you get more accustomed to the journaling process, you might no longer need your lists to get you started—instead, consider whatever thought or feeling your brain is currently preoccupied with, and write about that.

Will Thinking About Negative Emotions Make Them Worse?

One reason you may be reluctant to dig into our repressed emotions is because you don’t want to get into the habit of thinking about them all the time. After all, as discussed in earlier commentary, your brain changes in response to your thoughts, and thinking certain things repeatedly strengthens the neural pathways associated with those thoughts. Ruminating on your trauma or stress might lead you to think about those things more, not less.

However, on her podcast, Sachs clarifies that rumination is repetitive, unproductive thinking or dwelling on negative emotions. It’s also involuntary. In contrast, your goal in mindbody journaling is excavation: purposefully exploring your feelings and memories to gain greater clarity or healing. So if you simply rehash the same thoughts and feelings in your journaling, you might be ruminating and making your symptoms worse. If, on the other hand, you explore them deeply and without judgment, your brain won’t keep replaying them in your head, so you’ll ultimately end up thinking about them less.

The key, according to Sachs, is making the deliberate choice to dig these emotions up—with the goal of resolving them—rather than letting them crowd your mind. And while excavation can be painful in the short term, it prevents more pain in the future.

Step #3: Meditate for 10 Minutes

Sachs says that once your 20 minutes of writing is up, you’ll follow it up with 10 minutes of loving kindness meditation—a practice of cultivating goodwill and compassion toward yourself. This practice helps your body let go of the emotions you’ve just excavated, recenter, and regulate your nervous system. Focus on affirming and holding space for yourself: The writing process requires vulnerability, and the meditation process helps remind your brain that you’re still safe despite this feeling of vulnerability. Your inner child will feel uncertain and scared after journaling, so you—the responsible now-adult—need to reassure them that everything is OK.

(Shortform note: Loving kindness meditation is a practice focused on sending love to yourself and others—but with Sachs’s method, you’ll focus that love on yourself. It’s derived from Buddhist traditions and is also known as Maitri or Metta meditation. The goal of this type of meditation is to transform your relationship with yourself—starting by befriending yourself. This requires affirming yourself: expressing your authentic self, thinking positively about yourself, and doing things to meet your needs and desires. Similarly, holding space for yourself means being present and authentic, and validating who you are right now. You may think of this practice as giving your inner child a best friend (you) to comfort them when they’re feeling scared.)

According to Sachs, many people have doubts about meditation because they tried it before and it didn’t seem to work. To help you set aside any skepticism, consider scientific evidence: Research shows that meditation can change your brain’s response to stress and enhance your emotional regulation skills—and since this mindbody treatment regimen is all about re-training your brain for exactly those purposes, it’s crucial not to skip this step.

(Shortform note: The research Sachs cites demonstrates the long-term benefits of a consistent meditation practice, but other studies suggest it can have immediate benefits as well: Even a single, 15-minute meditation can improve decision-making, and doing a 25-minute meditation three days in a row can reduce stress.)

Don’t worry about the specific format of your loving kindness meditation—use whatever methods and tools you’re comfortable with, whether that’s guided meditation, breathing meditation, mantras, or simply sitting and existing for 10 minutes. The point is just to sit with your feelings after you’ve stirred them up so your brain doesn’t immediately jump back to avoiding them.

Meditation: Challenges and Forms

While meditation’s benefits have been well documented, not everyone finds it easy or productive at first. You might struggle to slow your brain down, stay focused, or resist the urge to daydream—especially if daydreaming is one of your common avoidance behaviors. You may also feel bored or uncomfortable, have trouble staying awake, or get sudden ideas that you feel you must write down immediately—interrupting your meditation. And you may get frustrated if you don’t immediately see results or if you can’t do it perfectly right away.

Experts recommend giving yourself grace and continuing with your meditation practice even if it’s difficult. You can find ways to tweak it over time to better fit your needs and goals. For example, if you notice your mind wandering, just take a moment to refocus. (You could also consider padding time into your day, separate from your meditation time, to daydream.) If you feel uncomfortable or keep falling asleep during meditation, consider different body positions: You can sit on the floor or in a chair, lie down, stand, or even walk.

As for methods and tools, there are many resources for guided meditation, breathing meditation, mantra meditation, and resting awareness meditation (the sitting and existing form that Sachs describes). Other forms include visualization, in which you focus on a mental image—for this, you might choose to focus on an image of your inner child and imagine holding them or sending love directly to them. There’s also chakra meditation, which focuses on channeling your energy upward through the body.

Finally, there’s body scan meditation, where you focus on your body and notice every physical sensation you’re feeling—but if you find yourself fixating on your pain, choose a different form and reserve body scan meditation for another time of day.

Step #4: Dispose of Your Writing

After you’ve completed your writing and meditation, it’s time to get rid of what you wrote. You don’t need this writing anymore because it’s already served its purpose of helping you feel safe in your emotions. Additionally, since mindbody journaling is uncensored, you’ll be writing things that others might misunderstand, so get rid of it to avoid the risk of other people reading it. If you journaled by hand, rip up or burn the pages. If you journaled on a computer, delete the document.

(Shortform note: Research suggests that disposing of emotional writing can help manage difficult emotions. In one study, participants wrote down their thoughts about an insulting, anger-provoking event. Those who disposed of the writing in a trash can or shredder reported feeling less anger than those who held onto the writing. Researchers speculated that this has to do with the way we attach emotions to physical objects. When we throw those objects away, we may also throw away the emotions we associate with them.)

Differences Between Sachs’s and Sarno’s Methods

Sachs and Sarno worked closely together, so the methods they recommend for treating TMS bear many similarities. In The Mindbody Prescription, Sarno advises creating a list of your stressors from your past and present as Sachs suggests. However, Sarno also recommends assessing each stressor on your list to determine if it’s in your control or out of your control. He recommends taking action to resolve the ones that are in your control. In contrast, Sachs doesn’t explicitly recommend taking action (though she doesn’t advise against it either). Instead, her lists serve as the springboard for step 2 of her practice.

In The Divided Mind (published eight years after The Mindbody Prescription), Sarno recommends keeping a journal to keep track of your recurring thoughts, powerful emotions, or sudden insights, which you may find helpful if the structure of Sachs’s method feels too constricting. On the other hand, because neuroplastic change requires frequent use of the pathways you want to strengthen in order to build a habit, you may find Sarno’s journaling method less effective for long-term change than Sachs’s.

Listen to Your Inner Child

The last strategy Sachs shares is letting your inner child talk to you. This is a part of yourself that rarely gets heard, and as a result they’re angry and brimming with emotion. When your inner child feels unheard, they try to take over and control your behavior in the present. This is why you often have irrational, reflexive reactions to stressors that trigger difficult emotions or memories. Listening to your inner child prevents them from trying to take the wheel and allows you to help them heal. It also teaches them to trust you, so they’ll bring their feelings to you rather than holding onto them until they spill over. And it teaches you to notice when your inner child is feeling overwhelmed, so you can give them the loving care they need.

The Origins of Inner Child Theory

The concept of the inner child has its roots in psychoanalytic theory. The concept was originally introduced by Carl Jung, but it drew from Sigmund Freud’s theory of the three components of the psyche: the superego, ego, and id. Freud also proposed the idea that experiences in childhood have a lasting impact on our psyches.

In The Mindbody Prescription, Sarno adapts Freud’s terms (superego, ego, and id) to mindbody medicine, calling them the parent, adult, and child, respectively. He suggests that TMS is caused by the conflict between the parent (who acts as our moral compass and pushes us to be “good”), and the child (who is narcissistic and concerned only with pleasure). According to Sarno, the pressure the parent puts on the child to “behave” instead of doing whatever will bring them the most pleasure manifests as rage, which we’re ashamed of, so we repress it.

This doesn’t conflict with Sachs’s theories—in fact, in her podcast, Sachs emphasizes the importance of presence over pressure when dealing with your inner child (as well as your actual children). She cites research showing that children learn emotional regulation when adults are there for them without trying to take over or problem-solve.

However, Sachs’s use of the term “inner child” aligns more closely with Jung’s theories: Jung described the divine child archetype, and researchers have developed this concept to refer to the parts of our child selves that remain with us throughout our lives. The inner child retains memories with strong emotional associations, including both good and bad memories. In contrast to Freud’s theory, the focus of inner child theory is the wounds the inner child continues to hold (rather than the pressure the “parent” part of your mind currently places on the “child” part).

Sachs gives the following tips to help your inner child feel heard: Imagine your inner child in front of you. Notice how old they are and what they look like. Kindly and lovingly invite them to stand next to you or be held by you, tell them you love them, and then ask them how they are and if there’s anything they need to tell you. Then listen to everything they have to say. Give them the undivided, nonjudgmental attention you’ve always needed.

When they finish, ask them if there’s anything else, as they may have thought of something they want to talk about more or say in a different way. When they’ve finished, thank them—Sachs suggests that you’ve probably rarely, if ever, been thanked for sharing how you feel. Tell them you love them again, that they’re safe, and that you’re going to handle everything now. Then when you get a chance, write down everything they told you. This lets you mindfully sit with those emotions, which can lead to emotional breakthroughs.

Additional Inner Child Practices

Other theories focused on “inner child work” may complement mindbody work. In No Bad Parts, Richard C. Schwartz describes “Internal Family Systems,” (IFS) a framework he developed for understanding our inner selves. He suggests we all have a core Self, as well as a “multiplicity” of parts inside us. Each part is a piece of who we are, with their own goals and motivations and different levels of maturity. He refers to “inner children” parts as exiles. According to IFS theory, we “exile” versions of our child self because we or our caretakers or peers were bothered by our traits or behaviors. This aligns with the mindbody medicine concept that we repress the parts of ourselves that aren’t socially acceptable.

Schwartz’s solution for healing your “exiles” is to unburden them of the emotional weight that keeps them trapped in their role—similar to Sachs’s recommendation to connect with your inner child and let them know you’re going to handle everything from now on. However, in Healing the Shame That Binds You, John Bradshaw proposes a more external solution for healing the inner child. He argues that a crucial step in healing your wounds is to identify your unfulfilled childhood needs and determine how to fulfill them as an adult. This often requires you to build relationships with people who can help you fulfill these needs.

To supplement your internal mindbody work, consider your current relationships and determine whether increasing your external support system might clear the way for more effective inner child healing.