In his final phase of gastroenterology training at UCLA Harbor Medical Center, a 37-year-old woman was referred to him for specialized testing after other universities had found no cause for her ailment of a single bowel movement per month.  Their test also found no cause and he was designated to do her exit interview.  He had never encountered anything like her situation.

He asked about stress in her life, expecting all prior doctors had also inquired, and she revealed her father molested her hundreds of times up to age 12, but she was otherwise happily married with two children.  It seemed improbable that stress 25 years prior could be a factor in her ailment, but he referred her to Dr. Kaplan, a psychiatrist he heard might be interested in this unusual mind and body problem.

Two and a half months later he inquired about the patient and Dr. Kaplan said she had met with the patient one hour a week for 8 or 10 weeks and she was cured with her bowels back to normal.  Thinking he might encounter a few such cases in his career he asked her to train him on her framework for evaluating and treating patients, i.e. the questions to ask patients to uncover the stress in their lives.  With that background he planned to send any similar unsolvable cases to a local mental health provider where he was practicing.

He actually encountered 5 – 6 such cases per week (7000 in his career) but only Cognitive Behavioral Therapy was available in Portland, Oregon. So, to serve his patients, he eventually learned how to uncover the stresses that caused ailments in patients referred to him with various illnesses that had no structural or disease cause.  He published a book in 2007 titled “They Can’t Find Anything Wrong” describing his approach and the key factors in about four dozen widely varying cases.

In 2011 he co-founded the PsychoPhysiologic Disorders Association and has served as President of the Association since then.  He refers to the illness as a PPD and shows statistics that 20% of the population suffers from the disorder, or about 20% of the adult population. The PPD population is 80% larger than the diabetic population and absolutely can be diagnosed.  PPD symptoms range from dizziness, to coughing, rashes, irritable bowel, migraine and a long list of both pains and non-pain symptoms.

He shows results of a randomized controlled trial, the Boulder chronic back pain study (published in 2021) where 150 patients with an average of 10 years of chronic pain, responded to 8 hours of Pain Relief Psychology with a 75% reduction in pain scores which was far better than standard treatment or placebos, and was sustained for the 1-year duration of the study.

He then describes how a disorder is diagnosed, citing blushing, physical discomfort prior to public speaking, and phantom limb pain as common examples of physical changes produced by emotions.   Adding an example of a nail in a worker’s boot that produced agonizing pain, but no tissue damage because the nail passed between his toes.

His 6-step evaluation process attempts to: discover the chronological relationship between stress experiences and ailments in a patient’s life story; then explore current stresses in their life; possible stress from adverse childhood experiences; and finally, three mental health factors; depression, post-traumatic stress, and anxiety.

Having patients make a list of all stresses in their lives, past and present, is a very useful technique.  Then start working to reduce some of the stresses on the list to discover those that relate to their symptoms.  When symptoms change that is encouragement to continue the process.  Reduction of current stress may yield to changes in personal boundaries or improving self-care like adequate sleep, nutrition, and personal time.

For previous stress experiences, revealing past emotions in secret, through writing or verbally   recording, elevates the emotion that causes a symptom into consciousness which relieves the brain from producing the symptom as a protective notice.

He recommends reading the resources available in the PPDA website, including a self-assessment questionnaire and his 2007 book ‘They Can’t Find Anything Wrong!’

He cites studies from Harvard, the Boulder Back Pain study and a West Los Angeles VA study, that all showed so much more long-term improvement in pain compared to normal treatment or Mindfulness practice that there is ‘nothing comparable in pain relief literature’.

Three doctors in a medium-sized city in New York were so enthusiastic they said the insights put the joy back into their practice and it then spread to 72 doctors in the community.