When the Body Says No: The Cost of Hidden Stress
(U.S. Title: When the Body Says No: Exploring the Stress-Disease Connection)
- Explores the role of the mind-body link in conditions and diseases such as arthritis, cancer, diabetes, heart disease, IBS, and multiple sclerosis
- Draws on medical research and the author’s clinical experience as a family physician
- Shares dozens of enlightening case studies and stories, including those of people such as Lou Gehrig (ALS), Betty Ford (breast cancer), Ronald Reagan (Alzheimer’s), Gilda Radner (ovarian cancer), and Lance Armstrong (testicular cancer)
- Includes The Seven A’s of Healing: principles of healing and the prevention of illness from hidden stress
An international bestseller translated into fifteen languages, When the Body Says No promotes learning and healing, providing transformative insights into how disease can be the body’s way of saying no to what the mind cannot or will not acknowledge.
Can a person literally die of loneliness? Is there a connection between the ability to express emotions and Alzheimer’s disease? Is there such a thing as a “cancer personality”?
Drawing on scientific research and the author’s decades of experience as a practicing physician, When the Body Says No: The Cost of Hidden Stress — published in the U.S. with the subtitle Exploring the Stress-Disease Connection — provides answers to these and other important questions about the effect of the mind-body link on illness and health and the role that stress and one’s individual emotional makeup play in an array of common diseases.
I want everyone to read this book. It’s remarkable. In its pages, the author draws two lines: one connecting chronic illness in adults to childhood trauma – and a second connecting body to mind. When the Body Says No: The cost of Hidden Stress can be found at the point where those two lines meet. I’m not sure I’ve read anything like it before.
Here comes a long review. Feel free to drop out now – but I hope you won’t and I hope you stay the course. This is a book that’s changed a lot of lives. I
I want everyone to read this book. It’s remarkable. In its pages, the author draws two lines: one connecting chronic illness in adults to childhood trauma – and a second connecting body to mind. When the Body Says No: The cost of Hidden Stress can be found at the point where those two lines meet. I’m not sure I’ve read anything like it before.
Here comes a long review. Feel free to drop out now – but I hope you won’t and I hope you stay the course. This is a book that’s changed a lot of lives. I’m not sure if mine isn’t one of them. Yours could be too.
A few words first on the author. Gabor Maté is a Hungarian Jewish holocaust survivor, born in Budpest in 1944. He emigrated to Canada in his early teens and later trained as an MD. After 25 years of clinical practice, he published this book in the early Noughties. When the Body Says No is thus informed by a quarter of a century of clinical practice, but also by the research literature. The book is steeped in the scientific method.
Now to the basic thesis of the book. Let’s start with a question that Maté would ask his patients:
“‘When, as a child, you felt sad, upset or angry, was there anyone you could talk to – even when he or she was the one who triggered your negative emotions?’
In a quarter century of clinical practice, including a decade of palliative work, I have never heard anyone with cancer or with any chronic illness or condition say Yes to that question. Many children are conditioned in this manner not because of any intended harm or abuse, but because the parents themselves are too threatened by the anxiety, anger or sadness in their child – or are simply too busy or harassed themselves to pay attention.”
The core thesis of this book is that emotional pathologies in childhood lead to physical pathologies in adulthood. Firstly, what does childhood look like when things are working well? A child needs to be free to explore and to express their emotions. When they’re angry or upset, as inevitably children will be, it’s crucial that someone (ideally their mother) is there to listen to that anger or upset, to allow it to play out and resolve itself. By these means, a child grows up secure in the knowledge it’s being look after and that its needs will be met: the child will develop a clear sense of self and of the boundaries between itself and those around him/her. The mother of course has the primary nurturing role. The role of the father is to contribute to this emotional security – but above all is to create the space for the mother to get on with her job. To support and not to distract.
Things go wrong if the child isn’t able to freely express those emotions. This will typically happen because either the mother is absent – or she is present with her child but not fully ‘attuned’ (to use Maté’s term). This might be because she is stressed and distracted herself – or has chosen to be emotionally remote – or is preoccupied with a difficult partner. At all events, if the child finds that his/her anger or upset isn’t listened to, they will quickly learn coping strategies. This will generally involve repressing their emotions. No longer free to explore and express their emotions, the child grows up insecure – uncertain that their needs will be met, uncertain of the boundaries around themselves, and with a poorly defined sense of self.
And so to adulthood.
Insecurity in the child leads to certain pathologies of personality (my phrase) including low self-esteem and frequently also perfectionism and control-freakery. Maté is particularly eloquent on the latter:
“In a ‘controlling’ personality, [there] is deep anxiety. The infant and child who perceives that their needs are unmet may develop an obsessive coping style, anxious about each detail… They believe that only by controlling every aspect of life and environment will they be able to ensure the satisfaction of their needs… The drive to control is not an innate trait but a coping style.” [Author’s italics.]
Another classic personality trait stemming from a dysfunctional childhood is excessive care-giving. In other words, the inability to say No. Maté links this trait in adults to children (most often, girls) who have inadvertently had to assume the role of parent. Remember: it is the mother’s role to listen to their child’s emotions and to help the child resolve them*. But in a dysfunctional household, it’s all too often the child who ends up listening to the mother’s problems. The mother will often come to regard their child as a ‘best friend’, unaware of the harm they’re causing. That child will then grow up conditioned to suppress their own needs and tend to others’ needs before their own.
*[I for one found this seemingly simple truism fascinating to read. I grew up thinking that it was the child’s job to listen to their mother’s issues – endlessly (sorry, mum, but it’s probably time we cleared the air.)]
A related pathology (seen more often in men) stems from a household with a disapproving father. A child who constantly performed chores to please a demanding parent becomes an adult who’s constantly being helpful to others – who’s pathologically unable to say No.
And so to the meat of the book: the physical illnesses of adulthood brought about by dysfunction in childhood.
Maté draws on peer-reviewed scientific research to explain the physical mechanisms by which repressed emotion and childhood trauma lead to chronic physical illnesses in adulthood. I won’t try to get into the detail (I have no expertise in this field) but suffice to say that Maté does. He makes the case convincingly that the nervous system, the endocrine system (hormones), and the immune system should really be thought of as one single ‘super-system’. This of course runs counter to modern medical education, which is constantly seeking to shoehorn expertise into artificially tight disciplines – neurologists, endocrinologists, immunologists, etc.
But anyway…
When one does see these disciplines holistically, it becomes much easier to see how our thoughts and feelings (nervous system) get spread through the body by our hormones (endocrine system) and end up impacting on our health (primarily, immune system – but with frequent impacts on the digestive system and elsewhere). In other words, how our feelings shape our body. How thoughts become things.
Studded through the book are about a half-dozen references to some quite remarkable studies. These peer-reviewed studies demonstrated that it is statistically possible to predict the course of a person’s illness based on a simple analysis of their childhood experiences. This is pretty alarming stuff and very striking. Take this example on breast cancer:
“Research has suggested for decades that women are more prone to develop breast cancer if their childhoods were characterized by emotional disconnection from their parents or other disturbances in their upbringing; if they tend to repress emotions, particularly anger; if they lack nurturing social relationships in adulthood; and if they are the compulsive, caregiving types. In one study, psychologists interviewed patients admitted to hospital for breast biopsy, without knowing the pathology results. Researchers were able to predict the presence of cancer in up to 94% of cases judging by such psychological factors alone.”
Where next? Case studies.
Having established a causal link between trauma in childhood and chronic illness in adults, the book descends into a plethora of case studies as Maté shows how different emotional pathologies manifest in physical illness. I found him particularly illuminating in the realm of autoimmune disorders. These are disorders such as rheumatoid arthritis – where the patient’s own immune system attacks parts of their own body. Autoimmune conditions are becoming increasingly common while remaining (to conventional medicine at least) frustratingly inexplicable. Why would our own body attack our own body? To Maté, however, there is no mystery. Remember how one aspect of a dysfunctional childhood is that the individual develops a poorly defined sense of self? Maté shows how this translates across to the immune system. Just as the individual, emotionally, is unable to distinguish the boundaries around their own self, so also does their immune system become confused. The immune system confuses ‘self’ with ‘other’ – and attacks it.
This book is both light and darkness. The light: Maté’s extraordinary humanity. When you enter this book (…and, believe me, you don’t start reading this book, you enter it…), you find yourself in a judgement-free space. Maté teaches you to listen to all the self-criticism in your own head… And turn it off. This book is not written as a self-help manual; it isn’t specifically addressing me – or you. But read it, and you’ll inevitably find yourself looking at your own past, personality, and present – and doing so without judgement or criticism. It’s amazing.
But then the darkness. You’ll be shown case study after case study, each one presenting and diagnosing human misery and human illness in its many, many forms. You could be forgiven for thinking yourself Dante, being taken by Vergil on a tour of the underworld. All thirteen circles are there. First you pass the asthmatics and allergy-sufferers and the more modest autoimmune disorders. From there, you travel lower, heading past chronic fatigue to rheumatoid arthritis, motor neurone disease, and ailments you’ve never heard of and sincerely hope you don’t catch. Until finally, in the lowest circles of the inferno, cancer.
Prepare to have your preconceptions subverted. Prepare to re-think your own past. Prepare to have your understanding of life and illness challenged – and changed. I can lay my hand on my heart and say I learnt more about the human condition from reading this book than from reading (…forgive the heresy…) the complete works of Shakespeare. Yes, the bard does better poetry – and expresses seeming truisms about life in colourful, isolated fragments. But what Maté presents is a complete system: a complete system for understanding what makes a well-adjusted adult and what doesn’t. And of course in doing that, he helps define what a well-adjusted adult actually is. Not an insignificant task.
A couple of parting observations.
The penultimate chapter of the book had a foreboding title: “The Power of Negative Thinking”. At this point in my reading, I wasn’t sure how much more negativity I could take. I needn’t have worried, the chapter was a joyous and thoroughly cathartic takedown of the ‘positive thinking industry’. Maté’s view in a nutshell: you can’t resolve your issues merely by resolving to think positively – no matter how many overpriced books or videos or podcasts tell you that you can. It is necessary first to uncover the pain in your past that is holding you back, to feel angry – yes, angry – about it. And then to move on. Positive thinking, yes – but only after some healthy and well directed negative thinking.
After reading this book, I have no doubts – none at all – that the medicine of tomorrow will involve an investigation of someone’s emotional health just as much as it involves a thermometer and blood pressure gauge today. Our descendants will look back at the crude simplicities of modern medicine – with its monomaniacal focus on physical symptoms – and see it as being every bit as barbaric as we consider medieval medicine to be. At that point, Maté and his ilk will be seen as the brave pioneers they undoubtedly are.
Read this book. Please. Read it if you suffer from a chronic illness you can’t shake. Or read it if you’re close to someone who suffers from a chronic illness that they can’t shake. And if – by some unfathomable miracle – you and everyone else you know live in the light of perfect health, read it anyway – so you know what the rest of us are going through.
…more
