Book Review: "When the Body Says No: The Cost of Hidden Stress"

Author: Dr Gabor Mate, M.D.

Overview

I highly recommend everyone read this empowering and enlightening, if at times somewhat disturbing*, book, at least once. The author takes an interdisciplinary approach, incorporating psychology, neuroscience, immunology, physiology, genetics, pharmacology, molecular biology, psychiatry, behavioral medicine, infectious diseases, endocrinology, and rheumatology. Whilst the findings of the book are all supported by lots of hard science and peer reviewed scientific and clinical studies from many disciplines, the story is told in a highly accessible way, and illustrated not only by case studies from the author's own patient files, but also by exploring cases of famous people who became chronically ill.

The book especially focuses on how relationships and emotional problems, especially those which affected childhood, can result in certain inappropriate (according to the modern society in which we live) coping styles or behaviours. The author details how these self-stressing, emotionally repressive coping "strategies" can and do affect the hormonal/neurotransmitters of our brain and body, causing chronic imbalances in our chemistry. These chemical imbalances in turn disrupt the normal operation of our Nervous System and impact on the immune system, so when sustained over many years, those negative coping behaviours can and do make us prone to chronic diseases.

The understanding the author brings to the subject also provides us with the ability to identify and address our own possibly negative patterns, which may be driving us towards or keeping us in chronic disease, and help to understand the emotional origins of own personal unhealthy coping styles. A number of practical steps towards remedies are provided in the final chapters.

If you have a chronic illness, or know a close friend or family who does, this book is an absolute, if harrowing and upsetting*, "must read", and after reading, "must action".

If you are a parent or are thinking of becoming a parent, this is also a must read, albeit a uncomfortable one, as it could help to break the invisible cycle of emotional trauma which may have passed down to our own parents from our grandparents.

*How the Book Impacted Me

I first began to understand the role of Adverse Childhood Experiences (ACEs) in my own case, when I began to explore the work of Dr Gabor Mate, starting with his book, "When the Body Says No".

Like many, I found reading this book very difficult, very triggering and very disturbing, but it was the revelation I needed. This introduction to the research area of ACEs gave me the certain knowledge that the brain and body, and hence mental and physical health, are absolutely non-separable, and that long term effects of emotional trauma on the body, and of physical trauma on the mind, are now very well established by a mature, robust and hard science. Starting from Dr Mate's work, I researched further and found that, indeed, such mind-body-emotions connectivity concepts are not just some alternative or eastern philosophy, but are absolutely proven in traditional, mainstream western science too.

In "When the Body Says No", Dr Mate uses a series of cases studies from his clinical practice, as well as those of the lives of famous people, supported by the scientific research, in order to demonstrate that many idiopathic chronic illnesses can be directly linked to specific lifelong modes of behaviours, thought processes and relationship styles.

Where this becomes very difficult for those of us with such chronic illnesses is the dawning realization that, through his illustrative case notes, Dr Mate is describing ourselves: in parts it can seem that he is writing the story of our own lives. Moreover, the book uncovers a very hard truth. The very parts of ourselves we consider so strongly to be our "self-identity" are not inherent personality traits at all, but what Dr Mate refers to as "inappropriate coping styles".

These coping strategies are actually patterns of responses learned through emotional or physical trauma, especially in early life, which at the time did exactly the job they were designed to do, and allowed us to survive. However, because we humans tend to get stuck in the events of the traumas and can't move forwards, we also got stuck in these high stress patterns of behaviour.

Continued onwards into adult or later life, these trauma induced coping style become inappropriate to the context of the modern world [or, as I now prefer to think of it, our modern society is not well adapted for us to thrive], causing us to live our lives almost perpetually in fight-flight-or-freeze stressed states. These coping styles are what make us lose connection with the present, have little sense joy or aliveness in the now, turn our relationships toxic, cause addictive and obsessive-compulsive behaviours, feelings of shame and guilt, etc., thus contributing greatly to our susceptibility to “idiopathic” chronic illnesses.

The books most disturbing revelation is that people with such illnesses actually tend to have a super-strong, rigid sense of self, that we feel pride in and hold dear. However, according to Dr Mate, the very "personality traits" by which we define our prideful strong sense of self, are actually, precisely, the behaviour patterns of the inappropriate coping strategies or maladaptive survival styles we learned through getting stuck in trauma, and are causal of our suffering!

From here, I turned once more to my network and gently probed other people with chronic illnesses as to whether they would describe their personality traits and patterns of behaviour, prior to diagnosis, in ways which matches up with what Dr Mate outlines. Indeed, the similarities to what the book describes and the real lives and case histories of people with chronic illness I found was startling in the similarities.

Based on this research, I started to explore my own early years could be relevant in my own case. Indeed, after my mother asked me once "why do you think you were always so sensitive?", we were able to have a full, frank and open discussion about events around my own birth and early upbringing. I won't go in to details here, but suffice it to say we discovered that I ticked very many of the extended ACE boxes, including being born premature, Caesarean, separated mother-and-child after birth in the hospital, poor feeder, not breast fed.

I was now back to the beginning of my own story, but also just beginning to understand how the trauma perspective of idiopathic chronic disease now gave me renewed hope. Through my ongoing networking and research, I had found a myriad of methods which can heal our traumas, but moreover, a vast array of people around the world, who, through applying various trauma healing modalities, had indeed managed to significantly reduce their own symptoms, recover or partially recover from many conditions. This included illnesses which some medical doctors believe to be "incurable" or "degenerative" or "hopeless cases".

Quotes

Here, I’ve included a quote from the book, and some quotes from other sources by Dr Mate, to help illustrate what his work is all about.

Firstly, here are some quotes from the show notes of a podcast interview with Tom Bilyeu.

“When people are just trying to survive it's hard for them to consider transformation, so people that are under economic pressure, or racially oppressed, or under economic threat, political conflict these make it difficult for people because people are just in survival mode.” [11:43​]

“Then there’s another way to isolate yourself which is a defensive one, which is ‘the world is so awful, the heck with them all, I don’t need anybody,’ that will protect you from some kinds of hurt, cause if you withdraw from relationships you’ll never be betrayed, so that’s true, on the other hand, that itself is a state of pain” 23:49​

“Survival and fully being alive and fully living are not the same thing” [25:39​]

“There’s lots of facts out there, but truth is much larger than facts, it’s integrating the facts in a picture of reality.” [1:00:05​]

“A life without truth is not a meaningful life” [1:04:46​]

“You have to have the compassion to look at yourself not through the voice that tells you you’re worthless, but to say if I reacted that way it must be a good reason for it. Something in me, there’s something that happened to me that made me react that way at some point” [1:39:35​]

“There’s all kinds of memory and the body carries memory even if it doesn’t carry recall” [1:41:45​]

Excerpt from Chapter 14 of the book:

“Nature's ultimate goal is to foster the growth of the individual from absolute dependence to independence - or, more exactly, to the independence of mature adults living in communities. Development is a process of moving from complete external regulation to self-regulation. Well self-regulated people are capable of interacting fruitfully with others in a community and of nurturing children who will also grow into self-regulated adults. Development requires a gradual age-appropriate shift from security needs to autonomy, from attachment to individuation. Neither is ever completely lost, and neither is meant to predominate at the expense of the other”.

Quote from Dr Mate’s new book “The Myth of Normal”, which I haven’t personally read yet, but will reviewing in the near future:

“If we could begin to see much illness itself not as a cruel twist of fate or some nefarious mystery but rather an expected and therefore normal, consequence of abnormal, unnatural circumstances, it would have revolutionary implications for how we approach everything health-related.”

To dig deeper into the connections between chronic stress and chronic disease, and to onboard lots of tools to help reduce symptoms, take my online course “Nervous System in Chronic Illness”.