When the Body Says No: The Cost of Hidden Stress

by Gabor Maté

The research literature has identified three factors that universally lead to stress: uncertainty, the lack of information and the loss of control.

Cancer and ALS and MS and rheumatoid arthritis and all these other conditions, it seems to me, happen to people who have a poor sense of themselves as independent persons. On the emotional level, that is—they can be highly accomplished in the arts or intellectually—but on an emotional level they have a poorly differentiated sense of self. They live in reaction to others without ever really sensing who they themselves are.

Habitual repression of emotion leaves a person in a situation of chronic stress, and chronic stress creates an unnatural biochemical milieu in the body. Perpetually abnormal steroid hormone levels can interfere with normal programmed cell death. Also participating in cell death are natural killer cells. Depression—a mental state in which repression of anger dominates emotional functioning—interacts with cigarette smoking to lower the activity of NK cells.

It is customary to conceive of cancer as an invader against whom the body—like a country under foreign attack—must wage war. Such a view, while perhaps comforting in its simplicity, is a distortion of reality. First, even when there is an external carcinogen like tobacco, the cancer itself is partially an outcome of internal processes gone wrong. And, of course, for most cancers there is no such identified carcinogen. Second, it is the internal environment, locally and throughout the entire organism, that plays the major role in deciding whether the malignancy will flourish or be eliminated. The malignant transformation of normal cells, in other words, is a process determined by many factors that have at least as much to do with the biopsychosocial state of the organism as with the type of cancer itself. Once a cancer reaches the stage where its cell surfaces display molecules different from the normal body proteins, it ought to be destroyed by immune responses of many different kinds. T-cells should attack it with noxious chemicals; antibodies should be formed against it; specialized blood cells should chew it up. Under conditions of chronic stress, the immune system may become either too confused to recognize the mutated cell clones that form the cancer or too debilitated to mount an effective attack against them.

There is a remarkable consistency in people’s coping styles across the many diseases we have considered: the repression of anger, the denial of vulnerability, the “compensatory hyperindependence.”

“If you face the choice between feeling guilt and resentment, choose the guilt every time.”

If a refusal saddles you with guilt, while consent leaves resentment in its wake, opt for the guilt. Resentment is soul suicide.

Emotional competence is the capacity that enables us to stand in a responsible, non-victimized, and non-self-harming relationship with our environment.

we do not go “from dust to dust,” we are dust enlivened.