Trauma Education Essentials

Book Reviews

Monthly Book Reviews

Book reviews written by Dana Ross, MD, MSc, FRCPC. 

'When the Body Says No: The Cost of Hidden Stress' by Gabor Maté, M.D.

'The Cost of Hidden Stress' by Gabor Maté, M.D.

Lately, I’ve been thinking a lot about the idea of ‘health’ and how our treatment approaches are influenced by our conceptualization of what it means to be healthy. Words like ‘mental health, trauma-informed care, attachment trauma, relationship-centered care, adverse-childhood experiences and physical health outcomes” are swirling around in my mind. I alternate between feeling excited about the possibilities that these concepts hold, and also, overwhelmed by an emerging, but not quite formed, kaleidoscope of ideas and hopes.
There really couldn’t be a better time for me to have come across Dr. Gabor Maté’s book “When the Body Says No: The Cost of Hidden Stress”. This book is about the relationship between stress and health outcomes. He includes research to support his viewpoint, but people’s stories are just as important to him as the facts and figures.

The over-arching theme in the book is the importance of recognizing that there is no separation between the psychological and the physical, and that they both play an integral role in health and disease. Though in some ways this seems rather obvious, treatment approaches in western medicine are often still underpinned by a belief in the duality of mind and body. Dr. Maté challenges the duality theory and writes about a super-system composed of our emotions, hormones, immune system, and nervous system. He explains that these are not isolated systems, but rather they work in concert. When we think about our mental and physical health, we must check-in with every component of our own super-system in order to understand cause, treatment, and ultimately, prevention.
According to Maté, we need to think about health and disease as occurring within a social and cultural context. We tend to see a disease, or a disorder, as solely a problem of the individual and tend to ignore the fact that individuals are embedded within a societal system. Of course, acknowledging this means we need to take a look at how our society complicates, or outright antagonizes, our individual and collective health and wellness. Not an easy or a small task.
He points out that our health is also influenced by our more immediate interpersonal relationships, and through legacies of intergenerational trauma, and familial patterns of coping. One example involves a wife picking up on her husband’s work-related stress and developing headaches of her own as a result. For those of us who work directly with people who have experienced interpersonal trauma, the idea that healing also takes place in relationships, therapeutic or otherwise, is not surprising. Maté is essentially expanding on this by saying that there is a relational component to all aspects of health and disease.
Throughout the book, Maté underscores that thinking about how our emotional responses are connected to our health issues is not about blame. It is not about saying ‘you didn’t deal with your stress properly so that’s why you got x disease.’ Rather, it is about being honest with oneself from a lens of compassionate curiosity. It’s about understanding that our physical health is intimately influenced by the level of health or stress within our psychological and social domains.

Holding a deep understanding of the oneness of our brains, bodies and spirits, and a respect for the power of our internal and external relationships could lead to powerful paradigm shifts in our healthcare system. I imagine that in Maté’s ideal world, the next time we go to a clinic to see a healthcare provider, along with a physical exam, we’ll also receive a psychological and relational health check-up. I’m all in with Mate’s viewpoint, and all I can add is…I hope that clinic is taking new patients.

Dana Ross