Book Review: “When the Body Says No: Understanding the Stress-Disease Connection”

Since losing my mom to a very aggressive cancer a little more than a year ago I’ve been really interested in reading books about the disease and what western doctors do and don’t really know about it. A friend recently loaned me this excellent book When the Body Says No: Understanding the Stress-Disease Connection by Dr. Gabor Mate, which as the title implies looks at the connection between stress and disease.

One of my concerns when I started reading this book was whether he would adequately address the idea of personal blame and how people are shamed into feeling like it is their fault for being sick. I was pleasantly surprised on his clear distinction between blaming someone for their illness versus looking at larger dynamics that can add an increased risk to autoimmune disorders. He is fully in the latter category, not at all the former. In other words, he’s not simplistic in his approach and does not say just “If this, then that.” I appreciated how he walks the reader through the various connections and humanizes it with personal stories of his patients. I learned a lot about the role of cortisol production in our bodies and want to read more on this now.  I’ve been left with many questions about why my mother had such an intense cancer despite her her great health (balanced diet, regular exercise, etc) and this is the first book that has given me even a crumb of solid scientific explanation for other emotional dynamics that might have contributed.

His writing on anger was particularly poignant for me–so much of what he said resonated with me and provided a really fresh perspective. He also blew a lot of the conventional “Just think positive” mentality out of the water. I’ve never been able to articulate why I don’t agree with people in my life who are insistent on repeating that they just need to “stay positive” and then this passage totally nailed it and gave me the language:

. . .compulsive optimism is one of the ways we bind our anxiety to avoid confronting it. That form of positive thinking is the coping mechanism of the hurt child. The adult who remains hurt without being aware of it makes this residual defense of the child into a life principle.

The onset of symptoms or the diagnosis of a disease should prompt a two prong inquiry: what is this illness saying about the past and present, and what will help in the future? Many approaches focus only on the second half of that healing dyad without considering fully what led to the manifestation of illness in the first place. Such ‘positive’ methods fill the bookshelves and the airwaves.

In order to heal, it is essential to gather the strength to think negatively. Negative thinking is not a doleful, pessimistic view that masquerades as ‘realism.’ Rather, it is a willingness to consider what is not working. What is not in balance? What have I ignored? What is my body saying no to? Without these questions the stresses responsible for our lack of balance will remain hidden.

Even more fundamentally,not posing the questions is itself a source of stress. ‘Positive thinking’ is based on an unconscious belief that we are not strong enough to handle reality. Allowing this fear to dominate engenders a state of childhood apprehension. Whether or not the apprehension is conscious, it is a state of stress.

All in all a great read, interesting concepts, and left me wanting to learn more.


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  1. I am so glad that the importance of “negative thinking” is finally being talked about or recognized in this culture. In this culture, we are always told to stay positive. People tend to think that they always need to smile, even though the smile may be forced and artifcial. If you don’t smile all the time, you become an outcast and people are “scared” of you or think you are mad at them or something. Yes, it is nice to smile and be positive, but we have to acknowledge the importance of our negative thoughts and feelings and not run away from them, sweep them under the carpet or sugar coat them. I always try to expect and be prepared for the worst and hope for the best. That way, when the outcome is just good enough, not so good, mediocre or even disappointing, I won’t be terribly disapponted, sad or stressed. If the outcome is perfect, very good or just as I had hoped for, I will be at least doubly as happy as I would have been if I were a “positive thinker.”
    Thank you for a great book review, Sara. It is comforting and reassuring to see that a doctor agrees with what has been my philosophy and way of life.

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