Book Review: When the Body Says No: The Cost of Hidden Stress by Gabor Maté

Published by Vintage Canada 2004 ISBN 0-676-97312-4
Reviewed by Sarah Kay

‘When the Body Says No’ has been around now for a while and is on the reading list at the college where I teach. It’s a great book for students and teachers alike because it is not pedantic or preachy or unintelligible like some psychology tomes. Gabor Maté writes about his direct experience with people and his compassion for them permeates through his work.

Maté was born in Hungary to Jewish parents who survived the holocaust and he went to Canada in 1957. He trained as a medical doctor and psychotherapist and works in Vancouver at the coalface of addiction, ADHD and mental health.

Maté is despairing of the over-specialisation of doctors who fail to take personal histories into account when doing a diagnosis. As far back as 1892, William Osler, a Canadian physician, suspected that rheumatoid arthritis was a stress-related disorder. When, more recently, Maté published articles in the Canadian Globe and Mail newspaper on the relationship between disease and hidden stresses generated from early programming he was derided and the evidence was deemed to be merely ‘anecdotal’. However he did get support from Noel B. Hershfield, clinical professor of medicine at the University of Calgary, who backed Maté by saying there was compelling evidence for the link between stress and many diseases such as cancer, diabetes, multiple sclerosis, inflammatory bowel disorders and the rheumatic disorders. Maté claims that many of the above diseases are neither random nor genetic but result from suppressed emotions. People who are stress- absorbers, caregivers and who cannot say ‘No’ may find over time that their body says ‘No’ for them; hence the title of the book.

The book describes in great detail how emotional repression, especially at a young age over a long period of time, affects the immune system and in fact ends up working against the body rather than protecting it – creating a civil war within. Maté gives many moving examples of patients he has treated, some who were healed and others who sadly died. He also looks at some famous people, linking their life experiences to their illnesses. He traces the traumatic childhoods of Jonathan Swift and Ronald Reagan in relation to Alzheimer’s disease and Jacqueline du Pré, the cellist, in relation to multiple sclerosis.

Maté is clear that blaming someone for one’s disease is unfair and counterproductive, but he does wish we would take more responsibility for our health and lifestyle. He feels that the Western medical approach is in part to blame for this by making the doctor the ‘authority’ and the patient a recipient of the treatment. He also says you cannot take responsibility without awareness, so this book is also a wake-up call to both the medical profession and to ourselves to listen to our bodies.

This book has a lot of meat in it – plenty of psychology, reference to family systems, the biology of relationships, the biology of loss, repression and cancer and a surprising piece on the power of negative thinking. Maté quotes Candace Pert who says, “Health is not just a matter of thinking happy thoughts. Sometimes the biggest impetus to healing can come from jump-starting the immune system with a burst of suppressed anger.” The book ends with the seven A’s for healing: Acceptance, Awareness, Anger, Autonomy, Attachment, Assertion and Affirmation. The piece on anger developed by Allen Kalpin, physician and psychotherapist is one of the best analyses of the difference between anger and rage that I’ve come across.