Here are some excerpts from the book.
According to Gabor Mate, one of the key areas needing attention in the stress-disease connection is in the area of emotions. Emotional competence is sorely lacking in modern society and is often the root cause for the development of a number of diseases.
[quote author=When the Body Says No]
Emotional competence requires
• the capacity to feel our emotions, so that we are aware when we are experiencing stress;
• the ability to express our emotions effectively and thereby to assert our needs and to maintain the integrity of our emotional boundaries;
• the facility to distinguish between psychological reactions that are pertinent to the present situation and those that represent residue from the past. What we want and demand from the world needs to conform to our present needs, not to unconscious, unsatisfied needs from childhood. If distinctions between past and present blur, we will perceive loss or the threat of loss where none exists; and
• the awareness of those genuine needs that do require satisfaction, rather than their repression for the sake of gaining the acceptance or approval of others.
Stress occurs in the absence of these criteria, and it leads to the disruption of homeostasis. Chronic disruption results in ill health. In each of the individual histories of illness in this book, one or more aspect of emotional competence was significantly compromised, usually in ways entirely unknown to the person involved. Emotional competence is what we need to develop if we are to protect ourselves from the hidden stresses that create a risk to health, and it is what we need to regain if we are to heal. We need to foster emotional competence in our children, as the best preventive medicine.
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He talks about a certain psychological profile seen with ALS (Amyotrophic Lateral Sclerosis) patients in the video. The chapter in the book dealing with case studies of ALS patients is titled Buried Alive
[quote author=When the Body Says No]
In ALS the motor neurons, nerve cells that initiate and control muscle movement, gradually die. Without electical discharges from the nerves, the muscles wither. As the Web site of the ALS Society explains:
"A-myo- trophic comes from the Greek language. `A' means no or negative. `Myo' refers to muscle, and `trophic' means nourishment-No muscle nourishment.' When a muscle has no nourishment, it `atrophies' or wastes away. `Lateral' identifies the areas in a person's spinal cord where portions of the nerve cells that nourish the muscles are located. As this area degenerates it leads to scarring or hardening ('sclerosis') in the region."
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"Why Are Patients with ALS So Nice?" was the title of an intriguing paper presented by neurologists from the Cleveland Clinic at an international symposium in Munich a few years ago.' It discussed the impression of many clinicians that people with Lou Gehrig's disease nearly all seem to "cluster at the MOST PLEASANT end" of the personality spectrum, in contrast to persons with other diseases.
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The life histories of people with ALS invariably tell of emotional deprivation or loss in childhood. Characterizing the personalities of ALS patients are relentless self-drive, reluctance to acknowledge the need for help and the denial of pain whether physical or emotional. All these behaviours and psychological coping mechanisms far predate the onset of illness. The conspicuous niceness of most, but not all, persons with ALS is an expression of a self-imposed image that needs to conform to the individual's (and the world's) expectations. Unlike someone whose human characteristics emerge spontaneously, the individual seems trapped in a role, even when the role causes further harm. It is adopted where a strong sense of self should be-a strong sense of self that could not develop under early childhood conditions of emotional barrenness.
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ALS sufferers often tend to be energetic overachievers or chronic workaholics. Famous theoretical physicist Stephen Hawking suffers from ALS. Former baseball star Lou Gehrig is another example of a high achiever. Canadian Sue Rodriguez became famous for fighting for her legal right to assisted suicide as sufferer of ALS.
[quote author=When the Body Says No]
The biographer believes Sue Rodriguez was "a woman of strong convictions and a powerful sense of self. She had control over her life and preferred to have control over her death" As with all ALS patients, the reality was rather more contradictory. Strong convictions do not necessarily signal a powerful sense of self. very often quite the opposite. Intensely held beliefs may be no more than a person's unconscious effort to build a sense of self to fill what, underneath, is experienced as a vacuum.
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And this trend applies not just for ALS, but for many other afflictions as well.
[quote author=When the Body Says No]
The nature of stress is not always the usual stuff that people think of. It's not the external stress of war or money loss or somebody dying, it is actually the internal stress of having to adjust oneself to somebody else. 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.
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In the video Gabor Mate talks about the connection between the functioning of the immune system with the emotions. A basic hypothesis about the working of our immune system is based on the "self- non-self" identification.
[quote author=When the Body Says No]
With immune cells found in the bloodstream and in all tissues and spaces of the body, we may think of the immune system as a "floating brain" equipped to detect the non-self. The sensory apparatus-the eyes and ears and taste buds-serving. this "floating brain" are receptors on the surfaces of immune cells, configured to know benign from noxious.
The self is identified by means of so-called self antigens on the membranes of the body's normal cells, molecules that the immune receptors infallibly recognize. Self-antigens are proteins found on every cell type. Foreign organisms and substances lack such self-markers, making them targets for attack by the immune system.
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The point to grasp here is the shared functions of immunity and emotion:
first, the "awareness" of self accompanied by an awareness of non-self,
second, the appreciation of nourishing inputs and the recognition of threats;
finally, the acceptance of life-enhancing influences paralleled by a capacity to limit or eliminate danger.
When our psychological capacity to distinguish the self from non-self is disabled, the impairment is bound to extend to our physiology as well. Repressed anger will lead to disordered immunity.The inability to process and express feelings effectively, and the tendency to serve the needs of others before even considering one's own, are common patterns in people who develop chronic illness. These coping styles represent a blurring of boundaries, a confusion of self and non-self on the psychological level.The same confusion will follow on the level of cells, tissues and body organs.
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The fundamental conflict between developing an individual self along with maintaining social relationships is the challenge that needs to be addressed. In Jungian psychology this is called the "tension of the opposites" and as adults striving for individuation, we are constantly "put on the cross" between the needs of the collective and need for individuation. Both physical and psychological health critically depends on how we adapt ourselves to this challenge.
[quote author=When the Body Says No]
Development requires a gradual and age-appropriate shift from security needs toward the drive for autonomy, from attachment to individuation. Neither is ever completely lost, and neither is meant to predominate at the expense of the other. With an increased capacity for self-regulation in adulthood comes also a heightened need for autonomy-for the freedom to make genuine choices. Whatever undermines autonomy will be experienced as a source of stress.
Stress is magnified whenever the power to respond effectively to the social or physical environment is lacking or when the tested animal or human being feels helpless, without meaningful choices-in other words, when autonomy is undermined.
Autonomy, however, needs to be exercised in a way that does not disrupt the social relationships on which survival also depends, whether with emotional intimates or with important others-employers, fellow workers, social authority figures. The less the emotional capacity for self-regulation develops during infancy and childhood, the more the adult depends on relationships to maintain homeostasis. The greater the dependence, the greater the threat when those relationships are lost or become insecure. Thus, the vulnerability to subjective and physiological stress will be proportionate to the degree of emotional dependence.
To minimize the stress from threatened relationships, a person may give up some part of his autonomy. However, this is not a formula for health, since the loss of autonomy is itself a cause of stress. The surrender of autonomy raises the stress level, even if on the surface it appears to be necessary for the sake of "security" in a relationship, and even if we subjectively feel relief when we gain "security" in this manner. If I chronically repress my emotional needs in order to make myself "acceptable" to other people, I increase my risks of having to pay the price in the form of illness.
The other way of protecting oneself from the stress of threatened relationships is emotional shutdown. To feel safe, the vulnerable person withdraws from others and closes against intimacy. This coping style may avoid anxiety and block the subjective experience of stress but not the physiology of it. Emotional intimacy is a psychological and biological necessity. Those who build walls against intimacy are not self-regulated, just emotionally frozen.Their stress from having unmet needs will be high.
Social support helps to ameliorate physiological stress. The close links between health and the social environment have been amply demonstrated. .......
"Social ties and support," a group of researchers concluded," remain powerful predictors of morbidity and mortality in their own right, independent of any associations with other risk factors."
For the adult, therefore, biological stress regulation depends on a delicate balance between social and relationship security on the one hand, and genuine autonomy on the other. Whatever upsets that balance, whether or not the individual is consciously aware of it, is a source of stress.
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