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The Link Between Emotions and Physiology

I would like to offer my review of a book that I think would be very useful for RMTs.

January 4, 2012  By Don Quinn Dillon

I would like to offer my review of a book that I think would be very useful for RMTs. When the Body Says No provides numerous case studies of how repressed emotions contribute to chronic and difficult-to-treat illnesses via the stress response. Actual stories are shared about people experiencing scleroderma, SLE (systemic lupus erythematosus), multiple sclerosis, ALS (Lou Gehrig’s disease), cancer, breast cancer, Alzheimer’s disease, irritable bowel syndrome and other pathologies.

Author and Vancouver physician Gabor Maté states, “Stress is a complicated cascade of physical and biochemical responses to powerful emotional stimuli.” He elaborates: “Disease is disharmony. More accurately, it is an expression of an internal disharmony.” The new science of psycho-neuro-immunology (PNI) draws the relationship of distant and sometimes unconscious repressed feelings to physiological manifestations of disease.

Medical texts maintain a biological cause of illness, despite extensive research implicating emotions in the causation of many diseases.

Autoimmune disorders are a type of civil war, ravaging the body’s own tissues. In one case, Maté shares, “Perhaps her body was doing what her mind could not: throwing off the relentless expectation that had been first imposed on the child and now was self-imposed in the adult ­– placing others above herself.”


To punctuate his point, Maté states, “When we have been prevented from learning how to say no, our bodies may end up saying it for us.”

Borrowing from Hans Selye’s research, Maté outlines the stress response. Stress contains three elements: the stressor, interpretation of the stressor by the organism and the response. In lab studies with rats exposed to stress, Selye found enlarged adrenals, shrunken lymph organs and ulcerated intestines. The literature identifies stress facilitated by feelings of: i) uncertainty; ii) lack of information; and iii) loss of control.

Maté describes common beliefs shared in people with chronic illness, such as “It’s not right for me to be angry,” “If I’m angry, I will not be loved,” “I’m responsible for the whole world,” and “I must justify my existence/I must do something.” He describes the development of “emotional competence,” which outlines the capacity to feel, the ability to express, the facility to distinguish (current from past) and the awareness of the genuine need to address emotions to one’s satisfaction.

When the organism perceives a threat – real, exaggerated or imagined – the hypothalamus in the brainstem releases corticotrophin-releasing hormone (CRH). This hormone travels a short distance to the pituitary gland to stimulate the release of adrenocorticotropic hormone (ACTH). Adrenocorticotropic hormone travels via the blood to the adrenal glands, affecting the adrenal cortex. This functional nexus of the hypothalamus, pituitary gland and adrenal cortex is called the HPA axis, and is the “hub of the body’s stress mechanism.”

Once stimulated by ACTH, the adrenal cortex acts like an endocrine gland and releases corticoid hormones, including the oft-referenced cortisol. Cortisol acts on almost every tissue in the body and is key in the body’s response to stress, dampening the body’s stress reaction and, consequently, the immune system. Cortisol has an ulcerating effect on the intestines and a thinning effect on bone tissue. The alarm response, in addition to the taxation on the hormone, immune and intestinal systems, affects the heart, lungs, skeletal muscle and emotional centres.
The hypothalamus maintains two-way communication with the brain centres that process emotion; therefore, it is via the HPA axis that emotions exert their influence on the immune system.

In the chapter entitled “Power of Negative Thinking,” Maté presents, surprisingly that a positive continence may actually shorten life span and a self-reflective examination of our dark feelings can be helpful and healing. In his chapter, “Dance of Generations,” he describes how illness may originate from the behaviours and repressions of generations before, filtering down and impacting subsequent generations. Proximate abandonment describes the physically present but emotionally absent parent.

However, Maté is careful not to unload blame on parents or the patient, and describes how to do so is both unhelpful and inaccurate. “The dynamics of repression operate in all of us. We are all self-deniers and self-betrayers . . . when it comes to health or illness, it is only a matter of degree and, too, a matter of the presence or absence of other factors – such as heredity or environmental hazards, for example – that also predispose to disease.”

“So in demonstrating that repression is a major cause of stress and a significant contributor to illness, I do not point fingers at others for ‘making themselves sick.’ My purpose in this book is to promote learning and healing, not to add to the quotient of blame and shame, both of which already exist in overabundance in our culture.”

The book is poignantly, tenderly, written, using case studies and physiological concepts – written in layperson’s terms to avoid being prohibitively academic – to tie together the causal relationship between emotional repression and disease.

With liberal use of case studies to provide a “real face” to the personal impact of stress, Maté recognizes his book may be dismissed as largely anecdotal. However, he backs up the case studies with a thorough and comprehensive explanation of the response to chronic stress, and how it may proliferate in a variety of pathological (disease-causing) guises.

“If a link exists between emotions and physiology, not to inform people of it will deprive them of a powerful tool,” notes Maté.

Dr. Maté ends the book with seven points to help us in becoming emotionally aware, self-compassionate and effective at expressing our emotions. I hope you will give this wonderful and insightful book a read.

Don Dillon, RMT is the author of Massage Therapist Practice: Start. Sustain. Succeed. and the self-study workbook Charting Skills for Massage Therapists. Don has lectured in seven Canadian provinces and over 60 of his articles have appeared in massage industry publications in Canada, the United States and Australia. Don is the recipient of several awards from the Ontario Massage Therapist Association, and is one of the founding members of Massage Therapy Radio His website, , provides a variety of resources for massage therapists.

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