When The Body Says No - The Hidden Cost of Stress

EDMONTON JOURNAL
March 15, 2003

Review by Margaret Gunning
“People have always understood intuitively that mind and body are not separable,” writes Vancouver physician Gabor Maté in his enthralling exploration of the relationship between stress and disease, WHEN THE BODY SAYS NO. “Modernity has brought with it an unfortunate dissociation, a split between what we know with our whole being and what our thinking mind accepts as truth.”

The author of a previous best-seller on ADHD, SCATTERED MINDS, Maté argues with passionate conviction that mind and body are not just connected, but inseparably intertwined. He believes certain chronic diseases (ALS, MS, rheumatoid arthritis, breast cancer) are at least in part “an expression of an internal disharmony” driven by the abrasive effects of stress.

The significance of the mind-body connection is hardly new. An entire field of research (psychoneuroimmunology) is devoted to it, exploring “how the mind. . . profoundly interacts with the body’s nervous system and how both of them, in turn, form an essential link with our immune defenses.” And it is not such a stretch to see the connection between organic disease and “stress”, a relentless pressure that can twist around the immune system’s protective powers into a “suicidal assault”: what Maté calls “a civil war inside the body”.

But how he defines stress is so different from mainstream interpretations as to be practically revolutionary. Maté probes deeply into the life histories and psyches of the many patients he treated during his years as a palliative care physician. What emerges is nothing short of a revelation.

He could not help but notice the excessive “niceness” of people suffering from ALS (Lou Gehrig’s disease), along with “rigidly competent behaviour” and “chronic exclusion of negative feelings”. Women with breast cancer revealed their lifelong “difficulty saying no and expressing anger”. Many terminally-ill patients had both an indistinct sense of self with poorly-defined boundaries, and a compulsion to look after everyone else’s needs ahead of their own.

But Maté was not content to stop there. Probing more deeply into his patients’ family histories, he found dysfunctional emotional patterns going back for generations. Chronic disease existed cheek-by-jowl with such phenomena as alcoholism, severe depression, and parental neglect. Repression of emotion, particularly anger, became a coping device to avoid intolerable psychic pain. But as Maté points out, when you repress anger, you repress the immune system too, often with tragic results.

I was deeply drawn into this compelling and meticulously researched book, particularly by the transcribed interviews in which patients are allowed to speak in their own voices. If you have ever doubted the link between childhood pain and organic disease, these deeply poignant stories might just convince you. There is something about Maté, perhaps his ability to listen respectfully and react compassionately, that makes his patients open up their souls to him. What he hears is a cri du coeur, a lifetime of unexpressed psychic pain erupting through the body in fatal disease.

Despite what some of his detractors think, Maté does not “blame” people for getting cancer: “I do not point fingers at others for ‘making themselves sick’”. His book is a plea for understanding of the deeper dynamics that contribute to disease. His “seven A’s of healing” (acceptance, awareness, anger, autonomy, attachment, assertion, affirmation) provide a blueprint for greater emotional and bodily health. Full of complex and powerful truths, WHEN THE BODY SAYS NO has the potential to change medical thinking – and perhaps even save lives.

BACK

Now comes Gabor Maté , an insightful, no-nonsense, and thoroughly compassionate physician who provides an overview of all these perspectives and comes to the marvelously humane conclusion that ADD/ADHD is neither nature (genetics) nor nurture (parenting/environment) but, rather, the result of the collision of a predisposing nature with an ADD-hostile life situation, family, school, or job. How refreshing!

-Thom Hartman, author of ADD: A Different Perception and many other books about ADD