When the Body Says No: The Cost of Hidden Stress

Attunement is the process whereby parents are attentive or “tuned in” to the emotional experiences and needs of their children. Attunement allows parents to soothe or support children as the child needs, creating the conditions that promote secure attachment to this parent and, eventually, healthy self-regulation of their emotions.

Stress is a physiological reaction to pressure or threats in one’s environment. Citing Hans Selye, Maté notes that stress has three elements: the stressful event itself, the processing of the stressful event, and the response to the event. When the Body Says No focuses on the “response” component, which involves the activation of the central nervous system and the HPA axis, which is responsible for the secretion of hormones like cortisol and adrenaline. While stress serves an important evolutionary role in protecting people from life-threatening situations, a state of chronic stress—such as through the repression of emotion—can impact the body’s stress-response systems. For instance, people who experience chronic stress release less cortisol. Maté establishes The Relationship Between Chronic Stress and Disease by highlighting the ways that chronic stress impacts the immune system and other bodily systems.

Differentiation is the process by which individuals can have an independent and authentic emotional experience that is unaffected by the experiences or emotions of others around them. Differentiation is particularly difficult for children or adults whose parents were (or are) chronically enmeshed in their lives; these children were inhibited from achieving independent self-regulation, as they learned to understand their experiences through the prism of their parents’ interpretation and emotions. Differentiation is a vital first step in achieving self-recognition and self-acceptance.

The hypothalamic-pituitary-adrenal axis is a neuroendocrine mechanism that regulates physiological processes such as immune response, metabolism, and the autonomic nervous system. Activation of the HPA axis releases glucocorticoids, namely cortisol, which act on numerous organ systems to prepare the body to appropriately react to perceived stressors. Maté suggests that the function of the HPA axis can be disrupted by chronic stress, which can lead to illness or disease.

The premise of When the Body Says No is that one’s mind and body are not only connected but are inextricably linked. Maté suggests the term “mindbody,” written as a single word, to represent the concept of a body and mind that function as a whole, unified entity, noting that one can never really be separated from the other.

Proximate abandonment describes the feeling of unmet needs experienced by a child whose parents were present but not attuned to their needs. This creates an experience for the child of being alone with their emotions. Children will then intentionally suppress the expression of and eventually the internal registering of their emotional states (in a process called repression), in order to avoid presenting needs that will not be met. Children who experience proximate abandonment often experience chronic stress as adults; they will often suppress their own needs and desires in favor of caring for the comfort of others, mimicking ways of being that were established in childhood.