Somewhere doctor John E. Sarno is smiling.

In 1991, he published a book, Healing Back Pain, that I thought would revolutionize how the medical world treated that affliction. In it, he claims that the overwhelming majority of back pain (from which four out of five Americans will eventually suffer) has an emotional rather than a physical genesis although the subsequent pain is clearly physical.For instance, Sarno calls the diagnosis of a herniated disk as something "almost universal [in patients] beyond the age of twenty" and "a perfectly normal part of the aging process," similar to the graying of hair. The pain experienced by those who also have herniated disks results in his opinion from stress and other psychological factors; therefore, his treatment does not involve surgery.And his treatment is effective.In a 1987 follow-up survey randomly done with previous patients of Sarno's diagnosed with herniated disks, 88 percent were free of pain and engaging in unrestricted physical activity. In each case, these patients were told by other physicians that the herniated disk that Sarno left "untreated" was the source of their pain.In most cases, surgery was suggested by the first physician consulted.Why Sarno's work has not been taken more seriously remains a bit of a mystery. Could it simply be that both patient and doctor alike are more comfortable dealing with the physical rather than the emotional?What's not a mystery is why Sarno should now be smiling. There's been a recent rash of related research that clearly shows the brain/pain link.Take, for instance, a recent study performed at Ohio University. A total of 34 healthy young women gave speeches to researchers masquerading as job interviewers. The researchers wore white lab coats and kept their faces free of expression.Afterwards, half of the speech givers were told to think about their performance, but the other half, however, were asked to think about what a Medical News Today article characterized as "neutral images . . . such as sailing ships and grocery store trips."Blood samples were then taken from all subjects. Those who had been thinking about their speech had significantly higher levels of C-reative protein in the bloodstream.Since C-reactive protein is produced by the body to counteract inflammation, the higher levels of it meant something was creating inflammation in the tissues in the body.Both groups gave the same sort of speech, but only half had higher levels of C-reactive protein the half asked to keep thinking about the speech so that can mean only one thing: that it's the mental review of the speech not the speech itself causing the inflammation.Similarly, researchers at Tel Aviv University have linked mental burnout from a job previously seen as a mental ailment to a physical one.Heart disease.In a nearly three-and-a-half year study of almost 9,000 healthy male and female workers ranging in ages between 19 and 67, the subjects who recorded burnout scores found to be in the top 20 percent of the group carried a 79 percent higher rate of coronary heart disease than those who scored in the bottom 20 percent even when other facets that contribute to heart disease, such as age, gender, smoking, and family history were factored into the equation.While burnout comes from subjective factors some workers seemingly thrive on a heavy workload, long hours, and stressful situations, all the ingredients of burnout the manifestation of stress in this case is objective: the buildup of plaque in the coronary arteries that is often the harbinger of heart attacks.Plaque buildup, in fact, is a stronger predictor of potential heart attacks than many of the other well-known precursors, including high blood cholesterol levels, a lack of exercise, and cigarette smoking.After considering all subjects' results, the researchers estimated that job burnout increases the risk of heart disease by 40 percent, a figure that Sharon Toker, one of the authors of the study published in the journal Psychosomatic Medicine, called troubling and far higher than the percentage she and her colleagues were expecting.So what should you remember from this column? That your physical state may very well be a reflection of your mental one.I rarely get a cold, for instance, that lingers for more than a few days and keeps me from working out hard, but I had one that I couldn't shake for three weeks more than a dozen years ago, one that caused me to ride the bicycle poorly for twice that amount of time.What made this cold so much more severe?A year before, I had decided to take a half-year sabbatical from teaching to take writing courses, and as the day of my departure approached, I was feeling really conflicted about leaving a great group of seventh graders, a group that really seemed content to learn, and clearly let me know that they were not happy I was leaving.The school situation was so copacetic that I actually inquired into withdrawing from the writing class, but found my deposit to be nonrefundable.The fact that I felt so bad mentally about leaving those students, I believe, is why I felt so physically bad for so long.