When the Body Says No: The Cost of Hidden Stress

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In this accessible and groundbreaking book -- filled with the moving stories of real people -- medical doctor and bestselling author of Scattered Minds, Gabor Maté, shows that emotion and psychological stress play a powerful role in the onset of chronic illness.

Western medicine achieves spectacular triumphs when dealing with acute conditions such as fractured bones or life-threatening infections. It is less successful against ailments not ...
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Overview

In this accessible and groundbreaking book -- filled with the moving stories of real people -- medical doctor and bestselling author of Scattered Minds, Gabor Maté, shows that emotion and psychological stress play a powerful role in the onset of chronic illness.

Western medicine achieves spectacular triumphs when dealing with acute conditions such as fractured bones or life-threatening infections. It is less successful against ailments not susceptible to the quick ministrations of scalpel, antibiotic or miracle drug. Trained to consider mind and body separately, physicians are often helpless in arresting the advance of most of the chronic diseases, such as breast cancer, rheumatoid arthritis, Crohn's disease, multiple sclerosis, fibromyalgia, and even Alzheimer's disease.

Gabor Maté has found that in all of these chronic conditions, there is a common thread: people afflicted by these diseases have led lives of excessive stress, often invisible to the individuals themselves. From an early age, many of us develop a psychological coping style that keeps us out of touch with the signs of stress. So-called negative emotions, particularly anger, are suppressed. Dr. Maté writes with great conviction that knowledge of how stress and disease are connected is essential to prevent illness in the first place, or to facilitate healing.

When the Body Says No is an impressive contribution to current research on the physiological connection between life's stresses and emotions and the body systems governing nerves, immune apparatus and hormones. With great compassion and erudition, Gabor Maté demystifies medical science and, as he did inScattered Minds, invites us all to be our own health advocates.

Excerpt from When the Body Says No
"Only an intellectual luddite would deny the enormous benefits that have accrued to humankind from the scrupulous application of scientific methods. But not all aspects of illness can be reduced to facts verified by double-blind studies and by the strictest scientific techniques. We confine ourselves to a narrow realm indeed if we exclude from accepted knowledge the contributions of human experience and insight. . . .

"In 1892 William Osler, one of the greatest physicians of all time, suspected rheumatoid arthritis to be a stress-related disorder. Today rheumatology all but ignores that wisdom, despite the supporting scientific evidence that has accumulated in the 110 years since Osler first published his text. That is where the narrow scientific approach has brought the practice of medicine. Elevating modern science to be the final arbiter of our sufferings, we have been too eager to discard the insights of previous ages."
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Editorial Reviews

From the Publisher
“His medical background and lucid writing style make complex biological processes accessible to non-scientific readers.” — The Gazette (Montreal)

“Maté carefully explains the biological mechanisms that are activated when stress and trauma exert a powerful influence on the body, and he backs up his claims with compelling evidence from the field…. Both the lay and specialist reader will be grateful for the final chapter, “The Seven A’s of Healing,” in which Maté presents an open formula for healing and the prevention of illness resulting from hidden stress.” — Quill & Quire

“[An] enthralling exploration of the relationship between stress and disease. . . Maté probes deeply into the life histories and psyches of [his] many patients. . . . What emerges is nothing short of a revelation. . . . When the Body Says No has the power to change medical thinking.” — The Edmonton Journal

Praise for Scattered Minds:
“Rare and refreshing. . . . Here you will find family stories, an accessible description of brain development and sound information. You will also find hope.” — The Globe and Mail

“Maté has done us a great service. . . . People who do not yet know they have [ADD] will have their lives transformed.” — Canadian Medical Association Journal

“An utterly sensible and deeply moving book written for a general audience.” — The Vancouver Sun

“One of the most comprehensive and accessible books about Attention Deficit Disorder.” — Publishers Weekly (starred review)

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Product Details

  • ISBN-13: 9780676973112
  • Publisher: Knopf Canada
  • Publication date: 3/11/2003
  • Pages: 320
  • Product dimensions: 6.28 (w) x 9.26 (h) x 1.03 (d)

Meet the Author

Gabor Maté, a Vancouver physician, is the author of the bestselling book about attention deficit disorder, Scattered Minds. He has been a family physician for over twenty years, a palliative care specialist and a psychotherapist; he is also staff physician at a facility for street people in Vancouver’s downtown eastside. He was a long-time columnist for The Vancouver Sun and The Globe and Mail.

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Read an Excerpt

A Note to the Reader

People have always understood intuitively that mind and body are not separable. 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. Of these two kinds of knowledge the latter, narrower, kind most often wins out, to our loss.

It is a pleasure and a privilege, therefore, to bring in front of the reader the findings of modern science that reaffirm the intuitions of age-old wisdom. That was my primary goal in writing this book. My other purpose was to hold up a mirror to our stress-driven society so that we may recognize how, in myriad unconscious ways, we help generate the illnesses that plague us.

This is not a book of prescriptions, but I do hope it will serve its readers as a catalyst for personal transformation. Prescriptions come from the outside, transformation occurs within. There are many books of simple prescriptions of one sort or another — physical, emotional, spiritual — that appear each year. It was not my intention to write yet one more. Prescriptions assume that something needs to be fixed; transformation brings forth the healing — the coming to integrity, to wholeness — of what is already there. While advice and prescriptions may be useful, even more valuable to us is insight into ourselves and the workings of our minds and bodies. Insight, when inspired by the quest for truth, can promote transformation. For those seeking a healing message here, that message begins on page one with the very first case study. As the great physiologist Walter Cannon suggested, there is a wisdom in our bodies. I hope When the Body Says No will help people align with the inner wisdom we all possess.

Some of the case examples in this book are derived from published biographies or autobiographies of well-known persons. The majority are taken from my clinical experience or from taped discussions with people who agreed to be interviewed and quoted regarding their medical and personal histories. For privacy reasons, names (and, in some instances, other circumstances) have been changed.

To avoid making this work prohibitively academic for the lay reader, notes have been used only sparingly. References are provided for each chapter at the end of the book.
Italics, unless otherwise noted, are mine.

I welcome comments at my e-mail address: gmate@telus.net.

1
The Bermuda Triangle

Mary was a native woman in her early forties, slight of stature, gentle and deferential in manner. She had been my patient for eight years, along with her husband and three children. There was a shyness in her smile, a touch of self-deprecation. She laughed easily. When her ever-youthful face brightened, it was impossible not to respond in kind. My heart still warms — and constricts with sorrow — when I think of Mary.

Mary and I had never talked much until the illness that was to take her life gave its first signals. The beginning seemed innocent enough: a sewing-needle puncture wound on a fingertip failed over several months to heal. The problem was traced to Raynaud’s phenomenon, in which the small arteries supplying the fingers are narrowed, depriving the tissues of oxygen. Gangrene can set in, and unfortunately this was the case for Mary. Despite several hospitalizations and surgical procedures, she was within a year begging for an amputation to rid her of the throbbing ache in her finger. By the time she got her wish the disease was rampant, and powerful narcotics were inadequate in the face of her constant pain.

Raynaud’s can occur independently or in the wake of other disorders. Smokers are at greater risk, and Mary had been a heavy smoker since her teenage years. I hoped that if she quit, normal blood flow might return to her fingers. After many relapses she finally succeeded. Unfortunately, the Raynaud’s proved to be the harbinger of something far worse: Mary was diagnosed with scleroderma, one of the autoimmune diseases, which include rheumatoid arthritis, ulcerative colitis, systemic lupus erythematosus (SLE) and many other conditions that are not always recognized to be autoimmune in origin, such as diabetes, multiple sclerosis and possibly even Alzheimer’s disease. Common to them all is an attack by one’s own immune system against the body, causing damage to joints, connective tissue or to almost any organ, whether it be the eyes, the nerves, the skin, the intestines, the liver or the brain. In scleroderma (from the Greek word meaning “hardened skin” ), the immune system’s suicidal assault results in a stiffening of the skin, esophagus, heart and tissues in the lungs and elsewhere.

What creates this civil war inside the body?

Medical textbooks take an exclusively biological view. In a few isolated cases, toxins are mentioned as causative factors, but for the most part a genetic predisposition is assumed to be largely responsible. Medical practice reflects this narrowly physical mindset. Neither the specialists nor I as her family doctor had ever thought to consider what in Mary’s particular experiences might also have contributed to her illness. None of us expressed curiosity about her psychological state before the onset of the disease, or how this influenced its course and final outcome. We simply treated each of her physical symptoms as they presented themselves: medications for inflammation and pain, operations to remove gangrenous tissue and to improve blood supply, physiotherapy to restore mobility.

One day, almost on a whim, in response to a whisper of intuition that she needed to be heard, I invited Mary to make an hour-long appointment so that she would have the opportunity to tell me something about herself and her life. When she began to talk, it was a revelation. Beneath her meek and diffident manner was a vast store of repressed emotion. Mary had been abused as a child, abandoned and shuttled from one foster home to another. She recalled huddling in the attic at the age of seven, cradling her younger sisters in her arms, while her drunken foster parents fought and yelled below. “I was so scared all the time,” she said, “but as a seven-year-old I had to protect my sisters. And no one protected me.” She had never revealed these traumas before, not even to her husband of twenty years. She had learned not to express her feelings about anything to anyone, including herself. To be self-expressive, vulnerable and questioning in her childhood would have put her at risk. Her security lay in considering other people’s feelings, never her own. She was trapped in the role forced on her as a child, unaware that she herself had the right to be taken care of, to be listened to, to be thought worthy of attention.

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Table of Contents

A Note to the Reader
1. The Bermuda Triangle
2. The Little Girl Too Good to Be True
3. Stress and Emotional Competence
4. Buried Alive
5. Never Good Enough
6. You Are Part of This Too, Mom
7. Stress, Hormones, Repression and Cancer
8. Something Good Comes Out of This
9. Is There a "Cancer Personality"?
10 The 55 Per Cent Solution
11. It's All in Her Head
12. I Shall Die First from the Top
13. Self or Non-Self: The Immune System Confused
14. A Fine Balance: The Biology of Relationships
15. The Biology of Loss
16. The Dance of Generations
17. The Biology of Belief
18. The Power of Negative Thinking
19. The Seven A's of Healing
Notes
Resources
Acknowledgments
Index
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First Chapter

A Note to the Reader

People have always understood intuitively that mind and body are not separable. 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. Of these two kinds of knowledge the latter, narrower, kind most often wins out, to our loss.

It is a pleasure and a privilege, therefore, to bring in front of the reader the findings of modern science that reaffirm the intuitions of age-old wisdom. That was my primary goal in writing this book. My other purpose was to hold up a mirror to our stress-driven society so that we may recognize how, in myriad unconscious ways, we help generate the illnesses that plague us.

This is not a book of prescriptions, but I do hope it will serve its readers as a catalyst for personal transformation. Prescriptions come from the outside, transformation occurs within. There are many books of simple prescriptions of one sort or another -- physical, emotional, spiritual -- that appear each year. It was not my intention to write yet one more. Prescriptions assume that something needs to be fixed; transformation brings forth the healing -- the coming to integrity, to wholeness -- of what is already there. While advice and prescriptions may be useful, even more valuable to us is insight into ourselves and the workings of our minds and bodies. Insight, when inspired by the quest for truth, can promote transformation. For those seeking a healing message here, that message begins on page one with the very first case study. As the great physiologist Walter Cannon suggested, there is a wisdom in our bodies. I hope When the Body SaysNo will help people align with the inner wisdom we all possess.

Some of the case examples in this book are derived from published biographies or autobiographies of well-known persons. The majority are taken from my clinical experience or from taped discussions with people who agreed to be interviewed and quoted regarding their medical and personal histories. For privacy reasons, names (and, in some instances, other circumstances) have been changed.

To avoid making this work prohibitively academic for the lay reader, notes have been used only sparingly. References are provided for each chapter at the end of the book.
Italics, unless otherwise noted, are mine.

1
The Bermuda Triangle

Mary was a native woman in her early forties, slight of stature, gentle and deferential in manner. She had been my patient for eight years, along with her husband and three children. There was a shyness in her smile, a touch of self-deprecation. She laughed easily. When her ever-youthful face brightened, it was impossible not to respond in kind. My heart still warms -- and constricts with sorrow -- when I think of Mary.

Mary and I had never talked much until the illness that was to take her life gave its first signals. The beginning seemed innocent enough: a sewing-needle puncture wound on a fingertip failed over several months to heal. The problem was traced to Raynaud's phenomenon, in which the small arteries supplying the fingers are narrowed, depriving the tissues of oxygen. Gangrene can set in, and unfortunately this was the case for Mary. Despite several hospitalizations and surgical procedures, she was within a year begging for an amputation to rid her of the throbbing ache in her finger. By the time she got her wish the disease was rampant, and powerful narcotics were inadequate in the face of her constant pain.

Raynaud's can occur independently or in the wake of other disorders. Smokers are at greater risk, and Mary had been a heavy smoker since her teenage years. I hoped that if she quit, normal blood flow might return to her fingers. After many relapses she finally succeeded. Unfortunately, the Raynaud's proved to be the harbinger of something far worse: Mary was diagnosed with scleroderma, one of the autoimmune diseases, which include rheumatoid arthritis, ulcerative colitis, systemic lupus erythematosus (SLE) and many other conditions that are not always recognized to be autoimmune in origin, such as diabetes, multiple sclerosis and possibly even Alzheimer's disease. Common to them all is an attack by one's own immune system against the body, causing damage to joints, connective tissue or to almost any organ, whether it be the eyes, the nerves, the skin, the intestines, the liver or the brain. In scleroderma (from the Greek word meaning "hardened skin" ), the immune system's suicidal assault results in a stiffening of the skin, esophagus, heart and tissues in the lungs and elsewhere.

What creates this civil war inside the body?

Medical textbooks take an exclusively biological view. In a few isolated cases, toxins are mentioned as causative factors, but for the most part a genetic predisposition is assumed to be largely responsible. Medical practice reflects this narrowly physical mindset. Neither the specialists nor I as her family doctor had ever thought to consider what in Mary's particular experiences might also have contributed to her illness. None of us expressed curiosity about her psychological state before the onset of the disease, or how this influenced its course and final outcome. We simply treated each of her physical symptoms as they presented themselves: medications for inflammation and pain, operations to remove gangrenous tissue and to improve blood supply, physiotherapy to restore mobility.

One day, almost on a whim, in response to a whisper of intuition that she needed to be heard, I invited Mary to make an hour-long appointment so that she would have the opportunity to tell me something about herself and her life. When she began to talk, it was a revelation. Beneath her meek and diffident manner was a vast store of repressed emotion. Mary had been abused as a child, abandoned and shuttled from one foster home to another. She recalled huddling in the attic at the age of seven, cradling her younger sisters in her arms, while her drunken foster parents fought and yelled below. "I was so scared all the time," she said, "but as a seven-year-old I had to protect my sisters. And no one protected me." She had never revealed these traumas before, not even to her husband of twenty years. She had learned not to express her feelings about anything to anyone, including herself. To be self-expressive, vulnerable and questioning in her childhood would have put her at risk. Her security lay in considering other people's feelings, never her own. She was trapped in the role forced on her as a child, unaware that she herself had the right to be taken care of, to be listened to, to be thought worthy of attention.
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