Book Review: When the Body Says No

If you haven’t heard of this book and you have a chronic illness you need to get in the know. And to be fair, and I hadn’t heard of the book until about a year ago, and I didn’t actually read it until recently. The author I had heard of. Dr. Gabor Mate. He has written several books over the years on topics ranging from chronic illness to substance abuse to ADHD, and he’s quite well-known in both the self-help and medical communities. So, now that I’m done reading this (must-read) book, let me share some thoughts and opinions, and hopefully help encourage you to also give it a read.

It’s available at all major book sellers
(I got mine from Amazon)

First, for those of you unfamiliar with Gabor Mate, he is a Canadian (now retired) doctor who spent his career in family practice, palliative care, and working with people who use substances in Vancouver’s East End. And he’s touted as being an expert in these areas. The book, When the Body Says no is about how “stress” influences chronic illness. Now, stress encompasses a lot of things here, which is why I put it in quotations. It includes life stress, attachment, coping styles, trauma, adverse early childhood experiences, adult relationships, and so on. Basically a lot of stuff, though Dr. Mate posits that it’s our early life stresses that have the greatest impact on us. The book takes a biopsychosocial approach. This means it includes biological, psychological and sociocultural influences on health and illness. This is the approach that science is backing when it comes to both physical health and mental health (literally my first class in grad school was “A Biopsychosocial Approach to Mental Health”). What’s interesting, if you go online to research most illnesses (come on, we’ve all googled our actual illnesses, as well as other potential ones) usually only biological causes are listed. And I will agree with Dr. Mate, that biological causes don’t tell the whole story (and neither to strictly psychological or sociocultural). For example, he writes (based on scientific research) that some people with biological markers for illnesses never actually develop one. Why? If it was strictly biological then everyone with the biological markers would clearly develop it. Again, there is more to the picture.

Image from: https://www.physio-pedia.com/Biopsychosocial_Model

Like I said, I agree with a lot of the content in the book. I mean, many autoimmune diseases are diagnosed after a person has gone through a stressful experiences. It makes sense that the body would take on what our minds don’t want to – such as a repression of emotions. And clearly trauma can manifest in many, many ways (illness, substance use, psychiatric disorders, etc.). Many people will read the book and find themselves very well represented for whatever illness they have (and he covers a lot of illnesses from cancer to a variety of autoimmune diseases to Alzheimers and so on). My only problem with it is that he asserts that attachment issues (to parents) are the #1 determinant of illness, and that virtually all people with illnesses have more than one of these issues. And this is where I didn’t find myself represented. My attachment style with my parents has always been healthy. My early childhood experiences were really good. In fact, the first trauma I suffered was ongoing between the ages of 8-13 (being bullied at school). At the time, yes, I did probably repress a lot of my emotions, but as I got older, and certainly by the time I was diagnosed with my illnesses, and I was not repressing emotion (at least as often) anymore. Now, that being said, maybe all it took was that experience to account for the psychosocial part of my illness. I can’t say either way, but regardless I don’t feel I perfectly represent the picture Dr. Mate paints in his book, though I can appreciate that a lot of people do.

My brother and I, circa 1988-89.

All of that said, I do highly recommend reading this book if you have a chronic illness OR if you have a loved one with a chronic illness. It gives insight into the causes, which some people find helpful. And if you’d rather live in the here-and-now, rather than try to decipher what caused your illness, the last chapter is called the “Seven A’s of Healing” and it really resonated with me, because for the most part, it is exactly what I work on with clients, and it is strongly evidence-based. So, go read When the Body Says No, it’s definitely worth it.

My podcast episode this week is on Creative Hopelessness, so if you’re finding it difficult to make changes in your life and/or you’ve been feeling hopeless, please check it out. Until next week, keep making the most of it!

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Trauma and Chronic Illness

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.

Dr. Gabor Mate
Retrieved from: https://californiahealthline.org/news/addiction-rooted-in-childhood-trauma-says-prominent-specialist/

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).

Image from: https://agelessgrace.com/5-ways-improve-body-mind-connection/

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.

Image from: https://www.baseball-almanac.com/players/player.php?p=gehrilo01

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.

Image from: https://chronicillnesstraumastudies.com/chronic-illness-trauma-nervous-system/

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.

It’s not necessarily the case for everyone. Circa 1988/89.

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.

Image from: https://post.edu/blog/your-mind-matters-may-is-mental-health-awareness-month/

That’s all for this week. Until next week, keep making the most of it.

References:
https://drgabormate.com/culture-good-health/
https://drgabormate.com/topic/mindbody-health/