This is a metaphor I often use when explaining anger. It has a specific purpose and function for us, but there is almost always something beneath anger. I hope this piece of psychoeducation helps you to understand yourself better. Remember, the content on this blog does not replace seeking help from a licensed mental or other healthcare professional in your area.
For a meditation on working with anger, click this link.
I know this is a bold statement, but honestly it’s not one that I’ve come up with. It’s one that’s been studied, and it came to my knowledge through the form of a book – When the Body Says No by Gabor Mate. Now, I have done a whole post giving my review of that book awhile back, so that might be something you want to check out before or after reading this today.
First things first, I want to reflect on my own life. As an adult I wouldn’t say I repressed my emotions. Well, sometimes, when I was in my 20s, I would repress anger until it boiled over and spilled out like. Then I was accused of having ‘anger problems’ but really, looking back I was just not expressing it as it came about. On the other hand, sadness, joy, etc. all seemed to come out appropriately. Diving further back, I know there was a time between the ages of 8-13 that I repressed emotions – again, usually anger. Through those 5 years I had a group of friends at school, and one girl in particular was good at manipulating the others into not talking to me for periods of time. Like I mean I had no one to hang out with at school when they did this. It started as just being a day, then a few days, then a week, sometimes a month. It was honestly unpredictable of when it would happen and how long it would happen for. I never knew what ‘I was doing wrong’ and was always only told by them, “If you don’t know, then I’m not going to tell you.” I think this was actually a traumatic experience for me. Actually, my therapist told me it was. However, this post isn’t about that trauma, it’s about repressing me emotions. I think the only way I could get through 5 years of elementary and middle years schooling was to repress. Not show any emotion about it at school. I remember crying myself to sleep at night, but certainly not every night. Luckily, I was enrolled in a ton of extracurricular activities which probably helped me too.
What does repression of emotions have to do with chronic illness? Well, in When the Body Says No, Gabor Mate explains that repression of emotions – particularly anger – has been linked to several illnesses. These include autoimmune diseases, cancer, and ALS. Now, this doesn’t necessarily mean EVERYONE fits the bill, but certainly, in my conversations with others, people readily admit they have difficulty expressing anger in an appropriate and healthy way. Very interesting.
Why does repression of anger cause chronic illness? Well, in and of itself, it does not. However, when we look at illnesses from a biopsychosocial standpoint (this is the mostly widely accepted view in the medical community – both Western and holistic), it is a contributing factor stemming from the “psycho” portion. Bio stands for biological – so any genetic or epigenetic (meaning our genes were changed by our environment) – contributions to illness. Psycho stands for psychological contributors, which can also include personality, management of emotions, how we handle stress, and so on. Social usually relates to the environment, which often includes factors like traumatic events.
What can we do with this knowledge? For me, the best thing I’ve learned to do is appropriate and consistent expression of emotions. This means I don’t ‘boil over’ with rage but rather can notice and accept the feelings of anger, expressing them through words. This is sometimes referred to as emotional regulation, and in my practice it definitely falls under acceptance. There are many ways to learn to do this. The most effective would be going to see a therapist. There’s also the self-help section of the bookstore or library. The practice of mindfulness. Just to name a few. Will doing this help heal our illnesses? Well, not exactly, but it can help lessen the severity and impact of our symptoms on our lives. I think it is a part of the healing process we often neglect, but really shouldn’t. This week’s episode of the podcast talks about acceptance (find it here). If you have questions about it, feel free to DM me on Instagram (@chronically.living_)
Today I want to talk about some of the work of Dr. Gabor Mate, because, well, I find it quite interesting. Dr. Mate is an addictions specialist, who has also worked as a family physician and in palliative care. Much of his work and research has been on that body-mind connection between mental health and chronic illness and substance use. He has a lot to say about stress, trauma, and coping and their relationship to chronic illnesses ranging from autoimmune diseases to neurological conditions to skin disorders to cancer. While I’m not sure that I necessarily agree with everything he says, a lot of it does make sense.
The work of Dr. Mate I had heard of before but never looked much into. At my practicum, the other student at my site brought it up. She was interested in his work as someone who wants to work with people who use substances, and she thought I might also be interested as someone who is specializing in working with people with chronic illness (which is currently 40% of my case load!). She was correct that this would be interesting and helpful for my work as a psychotherapist. So let’s talk about some of this work. Dr. Mate asserts that there is a “pathway from stressful emotions, often unconscious, to physical disease” or to break it down slightly differently, “emotional stress if a major cause of physical illness.” Again, he’s talking about a wide range of illnesses, including autoimmune diseases and cancer. There are two parts of this that I found interesting doing some research (and there’s a lot more I want to do yet – there’s a whole book of his that’s on my to read list).
The first part is emotions themselves. For instance, Dr. Mate connects repressed anger to the development of autoimmune diseases. Basically, if you’re not letting your anger out (in an appropriate way of course) and instead, you’re holding it in, it bursts out, not in a fit of rage, but in a chronic illness such as RA or lupus and so on. Tied into this is emotional repression in general. So if you’re disregarding your emotions, whatever they may be, and holding them in, this can lead to illness as well. On his website Dr. Mate gives the example of Lou Gehrig and ALS (and according to Mate, every patient he has seen with ALS), who often disregarded both emotional and physical pain he was in throughout his life.
The second part is trauma and trauma response. It is pretty well documented that people who endure trauma, especially early in life, will make adaptive changes either physically or psychologically, in order to survive. Childhood abuse is one often cited with this. It is also well documented that childhood trauma has a huge impact on adult physical and mental health. Dr. Mate states that trauma in another cause of the range of chronic conditions I’ve mentioned.
So wait, does this mean that every person with pretty much any chronic conditions has either a history of trauma and/or a history of emotional repression? Not necessarily. I watched an interview with Dr. Mate, where the interviewer asked just that (because it’s a rather big claim). The response was that of course, this doesn’t apply to everyone, but it does apply to a large portion of this population. Interesting. So my thoughts on it are this: I have an autoimmune disease. I did not have any kind of significant childhood trauma (I have maybe what I’d call minor trauma) and I have usually been good at expressing my emotions (though I have gone through periods where I’ve been less likely to, those are usually short-lived). Basically, I’m not sure I fall into this category. I also know many other Spoonies who would not fall into this category. That being said, especially through my work as a therapist, there are many people who this does make sense for.
My main takeaway from this is that to help heal from chronic illness (and I’m not saying cure), one really has to take care of their emotional health. See a therapist. If there’s trauma in your background, that likely needs to be worked through (also just in general for your mental health). If it’s emotional repression, then you need to start to learn to open up (part of my work as an acceptance and commitment therapist is to get people to allow their emotions to be there). The body and mind are connected so we need to treat them as such.
That’s all for this week. Until next week, keep making the most of it.
Guided can be very relaxing and many people find it helps with anxiety. It is also helps for regulating emotions in general. I recommend it for anyone who is also struggling with chronic illness, because of the overlap of anxiety with chronic illness. I want to note that this particular guided imagery is not one I wrote myself. I found it mixed in with some paperwork on a CBT group therapy course as a skill that therapists teach to clients. There are lots of other guided imageries out there and I hope to do more in the future.