In his book ‘When the body says no’ Dr. Gabor Maté proposes seven A’s of healing trauma: Acceptance, Awareness, Anger, Autonomy, Attachment, Assertion, Affirmation.
Acceptance
Acceptance means accepting all part of ourselves
When healing trauma we need to show compassion and curiousity towards ourselves. Especially when we are struggling. It does not mean liking everything we find, only that we look at it without judgement. Healing means becoming whole and so we need to accept all parts of ourselves. We want to meet ourselves with care and empathy.
Awareness
Being aware of what is going on inside physically and emotionally
If we want to be healthy we need to have awareness of our inner selves. That way we can protect from intrusion and stress. Unfortunately, many of us learn to detach from feeling our sensations in the body. Western society favors cognitive and verbal intelligence so body and emotions are often neglected.
Therefore, to heal from trauma we have to (re)gain awareness of our body and emotions. How does my body feel? What does it tell me? What are my signs of stress and exhaustion?
Emotional awareness means feeling what is going on inside and in our relationships. So we need to ask: How are my relationships on a deeper level?
Our body and our emotions have their own awareness of what is good for us. In order to become whole we must become aware of our own emotional truth.
Anger
The ability to feel and process anger in our body and being able to express it in a healthy way
Repressed anger is a risk factor for developing disease. Anger is an important emotion because it tells us when our boundaries have been violated or something feels uncomfortable. Anger helps us step up and communicate our needs and boundaries.
Many of us have never learned how to express anger in a healthy way. We either repress it or flare up with rage. But both repression and explosion are unhealthy ways of expressing anger that can damage our health and relationships. How, then, do we express anger in a healthy way?
We need to feel the anger in our body and acknowledge its existence. Then we can think about what has caused the anger. A boundary may have been violated or feelings may have been hurt. If we want, we can manifest the anger by confrontation or dialogue. We can also choose to let it go. The important part is that we have not repressed the emotion.
Autonomy
Development of an internal locus of control
If we want to become healthy we need to become an autonomous person. Illness, physical or mental, is a lifelong history of struggle for self, for individuation. Disease is a question of boundaries. People with the greatest risk of illness are the ones who experienced the most severe intrusion on their boundaries at a young age. This often happens because parents have not been taught healthy boundaries themselves and therefore struggle to establish them with their child.
Without boundaries the parent-child relationship becomes enmeshed. The child has a hard time establishing a sense of self and will likely experience boundary intrusion in their life. This can result in physical or mental health problems.
Boundaries are invisible. They are an internal sense of ‘me’ as an entity separate from others. When healing trauma we need to become autonomous individuals who know what we value, what we want and do not want.
Attachment
The ability to connect with others in a nurturing way
Many people grow up without healthy connections and without the feeling of being loved unconditionally. Lack of connection causes us to shut down and emotionally distance ourselves from others. This has a great cost on our health. We therefore need to regain the ability to be open and vulnerable with others. If we can closely connect to others we are on a good path to healing.
Assertion
The ability to BE without having to do or prove anything
Assertion means being ourselves without feeling that we have to justify our existence. We do not need to prove anything or have others validate us. We do not need to DO in order to BE. Assertion is a positive valuation of our self regardless of our achievements or our history. Every human being has value irrespective of their actions, personality or accomplishments.
Affirmation
Making a positive statement, moving towards something we value
If we want to heal we need to strive for something we value. Two basic values are important to help us heal and remain whole: Our creative self and universe itself.
Our creative self is the part of us that creates something new. That could be anything: art, music, writing, inventions at work, cooking, gardening or crafting something with our hands. The urge to create is part of every human being. Honoring that urge is a healing process in itself. Repressing it deadens our soul.
The second affirmation is our connection with the universe itself. To avoid feeling lonely and cut off we need to feel in contact with the world and with others. Connecting to the universe is a spiritual experience. It is a reminder that we are all part of the universe.
❤️
We hope you found this helpful. To learn more about healing from trauma read our full article on Dr. Gabor Matés book When the body says no
Learn the key information from Gabor Matés book ‘When the body says no’ about the hidden stresses of trauma.
Introducing the mindbody
“When we have been prevented from learning to say no’…‘our bodies may end up saying it for us.” (p 3, When the body says no, Penguin Random House, 2019)
So Gabor Maté writes in the beginning of his book. As a doctor he worked with patients with various mental and physical illnesses. Many of them could be traced back to childhood stresses and trauma.
Maté treated patients with all sorts of illnesses: multiple sclerosis, cancer, chronic fatigue syndrome, fibromyalgia, migraine, skin disorders, ailments of the bowel, endometriosis and many others.
Although their diseases and life circumstances seemed very different he found that none of his patients had ever learned to say no. Inability to say no and repression of emotions proved to be a key issue for most of his patients.
Maté realized that the approach to human health of Western medicine is deficient. It focuses on the physical body and its symptoms but if we want to understand our health we need to work with our WHOLE entity. Mind, body and emotions cannot be separated and should be conceived as one; a mindbody.
The PNI super system
How is the mind connected to the body? The immune system, nervous system, hormonal system and emotional centres in the brain are part of the same system, the PNI super system.
PNI super system: PNI means psycho-neuro-immuno-endocrine. The centres interact to protect the body against intrusion or imbalance. What affects one system affects them all. The task of the PNI super system is to recognize threats from within or without and mount biochemical or behavioral response to restore balance.
Since our emotions are part of this system experiencing and expressing them is vital to our health.
Emotional competence
We tend to undervalue emotional competence in our society. We do not grow up learning how to feel, express and regulate ourselves. More likely we are told to pull ourselves together, stick it out or stop being too sensitive. But emotional competence is important for a healthy life.
Emotional competence: The capacity to feel and express our emotions and to assert our needs and boundaries. Distinguishing between psychological reactions that respond to the present and those that represent issues from the past. Understanding which needs require satisfaction and seeking to fulfill those important needs instead of repressing them.
The less emotionally competent we are the more likely we are to feel stress. We have a harder time setting boundaries and creating emotionally fulfilling relationships.
The role of emotions is to let in what is healthy and nurturing and to keep out what is not. The role of the immune system is the same. Both systems are part of the PNI super system or the mindbody. So when you repress your emotions you also repress your immune system. Your defense against disease goes down and your immune system no longer recognizes what is dangerous and toxic.
We see this in autoimmune disease. According to Maté people with autoimmune disease often have imbalanced stress-regulation with a big release of cortisol. Psychologically, they tend to be emotionally repressed and serve the needs of others before their own. Boundaries between themselves and others are blurred, a blurring that is believed to happen physiologically as well. The immune system cannot separate self from other and starts attacking itself.
Emotional repression and cancer
Cancer occurs if there is failure of DNA repair and impairment of the normal cell death in the body. Emotional repression and chronic stress have a negative impact on both of these processes.
Gabor Maté mentions several studies in which researchers have predicted the occurrence of cancer based on factors of emotional repression alone:
“In one study, psychologists interviewed patients admitted to hospital for breast biopsy, without knowing the pathology result. Researchers were able to predict the presence of cancer in up to 94 per cent of cases judging by such psychological factors alone.” (p 62, When the body says no, Penguin Random House, 2019)
If we take a disease like lung cancer, smoking is one of the greatest risk factors. But smoking itself does not cause cancer. Other risk factors have to be present – otherwise every smoker would get lung cancer. A big risk factor is emotional repression.
A group of international researchers did a study on the psychological risk factors for cancer mortality. They picked the city Cvrenka for the study because it had a high mortality rate and because the stable population made it easy to follow up. The researchers picked about 1400 healthy adults and interviewed them with a questionnaire. It was about adverse life events, feelings of hopelessness and a hyper-rational, non-emotional coping style. They also recorded physical parameters like height, weight, blood pressure and smoking history.
Ten years later they did a follow-up on the study. They learned that 600 people had died of cancer, strokes, heart disease and other causes. The common denominator among the people who had died – especially of cancer – was a hyper rational, anti-emotional coping style, also called R/A.
Cancer incidence was 40 times higher in those who answered positively to 10 or 11 of the questions for anti-emotional coping style compared to the rest who answered positively to about 3 questions on average. Smokers had no incidence of lung cancer unless they also scored 10 or 11 on anti-emotional coping style.
The study shows that smoking works together with emotional repression to cause lung cancer. Still, all the thirty-eight people in Cvrenka who died of lung cancer were smokers. But for lung cancer to occur, tobacco alone was not enough.
Repression of emotions increases the likelihood for cancer because it exposes the person to more stress. Stress can potentiate cancer by harming the immune system and inner balance of the body.
The researchers of the Cvrenka study had also predicted who among their nearly fourteen hundred subjects would develop cancer and die of it. They based their predictions on characteristics of rationality/anti-emotionality and a long-lasting sense of hopelessness. Checking the death records ten years later, they had been right in 78 per cent of cases.
“It seems to us’, they commented, ‘that the importance of psychosomatic risk factors is likely to have been grossly underestimated in many studies.” (p 99, When the body says no)
What is stress?
Stress can be many things. It can be obvious stressors such as war, job loss or death in the family. But it can also be more subtle stressors that can be hard to detect.
Violation of boundaries and over-adjusting yourself to other people’s expectations causes internal stress. So does having a poor sense of yourself as an independent person. If you have a hard time sensing who you are it is difficult to get your needs met and set boundaries. It can also be difficult to form meaningful, supportive relationships, leading to loneliness, anxiety and overwhelm.
Healthy relationships and self-differentiation
In order to thrive we need healthy relationships with others. Emotionally fulfilling relationships in adult life require the ability to self-differentiate.
Self-differentiation: Self-differentiation is the ability to define yourself as separate from others and autonomous in your emotions, whilst remaining in emotional contact with others. You are able to express your needs and emotions without tailoring them to fit other people’s needs. You neither repress emotions nor act them out impulsively.
A self-differentiated person is better able to self-regulate and self-soothe in case of stress or conflict. Suffice to say self-differentiated people are less stressed out and enjoy better overall health.
The less self-differentiated we are the more likely we are to experience stress in relationships. Conflict or separation can be very stressfull to a less self-differentiated person.
Lack of self-differentiation can lead to co-dependent relationships with others. These relationships lack boundaries and each person subconsciously wants the other to fulfill their needs without asking for it directly. It might even be difficult for each individual to know what they want.
Less self-differentiated individuals often have a great dependence on others for emotional regulation. The greater the dependence the greater the fear to lose someone or to make them upset. Therefore a person might try to please others to avoid stress and lose some of his autonomy in the process. But loss of autonomy is itself a source of stress and does not create healthy relationships. You will even have increased risk of illness due to the constant repressing of emotions and over-adapting to others.
Becoming independent and self-differentiated is a natural and important process. It is the process of becoming a healthy adult able to look after himself in a mature, confident way.
Childhood development sets the stage
Learning self-differentiation occurs – or fails to occur – during childhood.
The human brain develops in the earliest years of childhood. By reading and interpreting the parents the child learns how safe or unsafe, how relaxed or stressful the world is. They carry that template with them into their life. The child ‘downloads’ the circuit of his parents into his own nervous system. If a child downloads a stressed out and dysregulated circuit, then that becomes the template of their own nervous system.
Vital for the healthy connection between parent and child is the process of attunement.
Attunement: A process in which the parent ‘tunes in’ to the child’s emotional needs. It is an instinctual emotional connection where the parents read the signals of the child and respond to them adequately. Attunement regulates the nervous system of the child, signaling safety and connection.
If a parent cannot adequately attune to the child it can have long-term consequences such as attachment issues or heightened stress responses. This can bring about physical and mental illness. In fact, much childhood trauma comes not from hardcore abuse but from lack of attunement during those formative years.
Most parents do what they can to care for their child in a loving way. But they might be unable to attune to the child because of their own stresses or because they themselves were never attuned to by their parents. You cannot teach something you do not know. If you have never felt safe and relaxed in the world, you can unknowingly pass stress and attachment issues on to your children.
The family system
Many of Gabor Matés patients had a family history with generations of disease and of members of the same generation suffering from disparate illnesses. A primary cause is stress and trauma passed down through the generations.
Physical and mental illnesses can be seen as disorders of the family emotional system. That system includes past and present generations. Each member of the family system has its own way of managing the disorder and hence its own disease: some suffer from autoimmune disease, others from cancer, another from alcoholism, some from depression and other mental health issues.
Disordered or dysfunctional family systems often have four characteristics: enmeshment, overprotectiveness or control, rigidity and lack of conflict resolution.
Enmeshment: Enmeshment means weak boundaries between individuals or a lack of appreciation of individuality itself. Needs are met through control or manipulation instead of open communication
An enmeshed family coerces each member to give up their own individual needs and preferences in order to ‘serve’ the family system. The family system controls the individual and decides what is good and bad and which values you should live by. This happens in subtle, often subconscious, ways and can be hard to detect.
Consequently, individuals in enmeshed families mostly have poor self-differentiation. It can be hard for them to lead emotionally fulfilling lives causing increased risk of stress and disease.
Understanding the family system is not about placing blame. It is about understanding ourselves as part of a larger whole. Only then can we have a full picture of why we are struggling. The main goal is to create balance and understanding so that we can help ourselves in the best way possible.
The power of (negative) thinking
According to Maté thinking negatively is an important part of healing. If we want to heal we need to look at the parts of our lives that are not working.
Positive thinking has a tendency to exclude the negative and unwanted. But genuine positivity needs to include our WHOLE being – including the difficult and the messy. So negative thinking is actually just thinking – without the adjective ‘positive’ in front.
Thinking negatively is not about being a pessimist or an eternal complainer. It means having the courage to look at every part of who we are. Negative thinking helps us understand how our life circumstances have shaped us.
One of the main aspects we need to look at is our relationships. This can be difficult because there can be conflicting emotions at play. We love our family but what if some of our family dynamics are unhealthy or downright abusive? How do we set boundaries with our loved ones while staying in a loving connection with them?
In his medical practice Gabor Maté has seen how emotionally draining family relationships are a primary risk factor in most major illnesses. As part of a healing process it is therefore important to examine our close relationships of the past and the present. Not to blame our family members but to recognize unhealthy patterns in our relationships that are damaging to our health.
The dilemma of anger
If we start to look at our close relationships we will encounter feelings of anger and aggression. Anger is a normal human emotion necessary to protect our boundaries. But the expression of anger towards loved ones can fill us with guilt and anxiety because it co-exists with feelings of love and the desire to stay connected. That is the big dilemma of anger. Perhaps it is the reason why so many people struggle to express it.
But it is very important to be in touch with anger. If you cannot react when your boundaries are violated, you will likely experience a lot of stress over the years. On the other hand, you can do much damage to others by exploding with uncontrolled rage in moments of stress or conflict.
But what are we supposed to do then? How to resolve the dilemma of anger?
We need to find healthy ways to cope with anger. Repression of anger and the uncontrolled acting out are both imbalanced release of emotions. They represent the same thing: a fear of the genuine experience of anger.
Healthy anger is an experience of power and a mobilization to attack. It is a necessary experience that tells you that something is off. A boundary may have been violated or there may be some other threat. Allowing yourself to experience the anger gives you a chance to think: What has triggered the anger? How should I react?
You can choose to display the anger in some way or you can choose not to. The importance of healthy anger is that it leaves the individual – not the emotion – in charge.
Anger is an important tool in the toolbox of being a human. It is a friend not an enemy, as this quote beautifully expresses it:
“‘Anger is the energy Mother Nature gives us as little kids to stand forward on our own behalf and say I MATTER,’…. ‘The difference between the healthy energy of anger and the hurtful energy of emotional and physical violence is that anger respects boundaries. Standing forward on your own behalf does not invade anyone else’s boundaries.” (p 274, When the body says no)
The path to healing
Many factors work together in the causation of disease. Even when there are risk factors like biological heredity or unhealthy habits, no disease happens in isolation from its environment. Disease is a dynamic process between biological, psychological and social factors. We all live in an interchange of energy between these factors. If we want to heal we need to find new and healthier ways to relate to our environment and to others.
According to Gabor Maté healing is about creating balance and becoming more whole. It is a holistic process that takes into account our whole life history and our life circumstances.
Healing can only happen as a free and informed choice and cannot be forced or pressured. We can choose the treatments we prefer. It can be conventional medicine, complementary healing, alternative methods like mind-body techniques, ancient Eastern practices like Ayurvedic medicine, yoga or acupuncture, meditation techniques, psychotherapy – the list could go on.
Ultimately, the wish to heal and the ability to change comes from within:
“Whatever external treatment is administered, the healing agent lies within. The internal milieu must be changed. To find health, and to know it fully, necessitates a quest, a journey to the centre of our own biology of belief. That means rethinking and recognizing – re– cognizing: literally, to ‘know again’ – our lives.” (p 238, When the body says no)
Put in the time and effort to really get to know yourself. It enriches your life and helps you choose wisely to support a holistic life
Do it in a thorough manner. Seek depth and understanding instead of quick fixes
Don’t feel responsible for other people’s emotions (unless you are a parent to small children)
Be bored and inactive regularly. It rests your brain, fuels your creativity and can offer you your best insights. To live a holistic life remember to prioritize boredom and relaxedness
Be silent regularly. Be without music, conversation or other audible stimulation. Good for balancing the nervous system and for checking in with yourself
Create a connection with your body. Your body can tell you a lot about your current state of mind, how you really are and what you need. Your body is like a good friend you need to have a conversation with on a regular basis – just to check in and see what’s up.
Whenever you have a strong reaction to something, take it seriously. Your body and your emotions often know what’s up before the mind does. If something makes you angry, sad or stressed out it’s a clue that something needs to be addressed
Don’t run away from emotional pain. The more you avoid difficult feelings the more they subconsciously run you. Suppressed emotions cause more harm than emotions you are aware of, so you might as well deal with them.
Learn when to cut corners. You can’t give your all on every occasion. As part of a holistic life style, learn when it’s okay to take the easy way out
Don’t force yourself into a structure that doesn’t fit you. Life isn’t a ’one size fits all’ and everyone has their own version of a good and meaningful life.
Learn to speak up on issues that matter to you
Learn what matters to you
Choose your battles. Discern when to fight and when to back down
Be in touch with your sensuality. Smell, touch, move, dance, sing. It improves your quality of life and is an important indicator of what turns you on energetically
Be as honest as possible. To both yourself and to others
Communicate your needs and boundaries
Cultivate warmth and closeness in your relationships
Tend to your blindspots. Midlife is the time to become aware of your weaknesses. Whatever you’ve neglected during the first half of your life is probably causing you some problems by now. Get to know your blindspots so you can better integrate them in your life
Find out what your biggest strengths are and how you can best share them with the world
Appreciate your individuality and don’t water it down
Everything in life is energy. Be mindful of where you put yours.
Be passionate but don’t be fanatic
Have a holistic approach to your mental and physical health. Combine traditional western treatment with alternative treatment such as healing, psychotherapy, massage therapy, ayurvedic medicin, yoga, meditation or other alternative approaches. A holistic life style means exploring different approaches from time to time
Prioritize your mental health equally to your physical health. We should actually be able to take a sick day if our mental health needs it. Chances are stress, grief, anxiety, sadness etc is going to manifest in a physical form eventually anyway
Prioritize your mental and physical health over: your career, money, other people’s opinions and emotions, your social status, your family’s wishes.
Balance humility and self confidence. Stay connected to your achievements and talents in a healthy way. Don’t constantly brag about your accomplishments, but don’t hide them away either. Be proud of who you are and share yourself with the world in a balanced way
Avoid black-and-white thinking. Few things in life are black and white, so try to open up to all the nuances of grey. Even the ones you initially thought were dumb, weird, uncomfortable or uninteresting. Explore opinions that seem wrong or odd to you. Broadening your scope of perspectives matures your soul
Accept and love your scars and wounds, emotional as well as physical ones. They are part of you and deserve your respect and care
If you realize you’re on the wrong path –go back. No matter how far you’ve come, if it doesn’t feel right, if it’s not working: go back, undo it and start over
Don’t make unnecessary enemies. People you don’t like – avoid them, but also avoid unnecessary drama. Stirring things up is incredibly draining in the long run
Don’t try to rescue people. If they are adults they must rescue themselves
Be a giver – but a conscious one. Be generous towards people whenever you can. Be generous with what you have – time, presence, money, gifts, acts of service, affirmations. But: Don’t give more than you have and don’t deplete yourself
Avoid gossip, especially if it’s malicious. Practice speaking to the person directly if something is bothering you
Show your soft side as often as you can
Make space for pleasure in your life. Adulthood can be overwhelming, so never forget to prioritize pleasure and fun. It makes your life more enjoyable and you’ll probably be much nicer to be around
Strive for BALANCE in everything. Nothing is good or bad in itself, what’s good is the balance. Holistic life style is about striving for balance: passiveness vs assertiveness, activity vs rest, action vs contemplation, loud vs still, boldness vs restraint, open vs closed, control vs flexibility. You can find this represented in Taoism and the Yin/Yang balance
Find your individual balance points. Everyone needs both activity and rest, both control and flexibility, but some need more and others less to feel their best. Find your own personal sweet spots that work for you
Prioritize rest. Modern society tends to value constant productivity and competition, but good quality of life needs down time and relaxation, too. Be as productive as you can handle and prioritize down time
Try new things when you feel stuck or bored or just as a stimulating experience
Accept that you can’t have it all. Some things are not available to you in this life time and you have to go without. Find a purpose that is within your means and make the most of it ❤️
Read our review of Gabor Matés book When the body says no about the connection between body and mind and the importance of a holistic life
