Gabor Maté, MD
"I never get angry," says a character in one of Woody Allen's movies, "I grow a tumour instead."
“I never get angry,” says a character in one of Woody Allen’s movies, “I grow a tumour instead.” In over two decades of family medicine, including seven years of palliative care work, I have been struck by how consistently the lives of people with chronic illness are characterized by emotional shutdown: the paralysis of “negative” emotions - in particular, anger.
his pattern holds true in a wide range of diseases from cancer, rheumatoid arthritis and multiple sclerosis to inflammatory bowel disorder, chronic fatigue syndrome, and amyotrophic lateral sclerosis (ALS). Patients I’ve observed with these illnesses seem incapable of considering their own emotional needs and are driven by a compulsive sense of responsibility for the needs of others. They all have difficulty saying no. Many studies, in several continents, confirm the prevalence of these patterns in people with chronic conditions.
The suppression of anger contributes to the onset of cancer and other diseases because the mind and body cannot be separated. The brain’s emotional centres are directly and powerfully linked with the immune centres throughout the body. Emotions such as anger serve exactly the same defensive role as the immune system: to protect our boundaries and to keep us from being overwhelmed by external forces. Similarly, both emotions and the immune system, when healthy, also serve a repair function: they help us to heal when we have sustained some trauma or when something has gone wrong internally.
Emotions and immunity are interconnected, part and parcel of the same system of defense and repair, so when we suppress any aspect of that system, other parts will be suppressed as well. Thus, in one well-known study, women with breast cancer who had difficulty expressing anger toward their physicians also had diminished activity of a group of immune cells called natural killer (NK) cells. They had a poorer survival rate than did women whose anger was more clearly expressed and whose NK cells were better able to attack the tumour.
It follows that an essential preventive measure against cancer and other diseases is an awareness of what emotions we are experiencing, and the healthy expression of these emotions. These same qualities are also important to the healing of those who have been diagnosed with illness.
There is no quick route to emotional awareness because many of us have lost that capacity in early childhood. We must begin by practising paying close attention to the body: tension in the neck, a flutter in the abdomen, a headache, a sudden hoarseness of voice, unexplained muscle pain, the outbreak of a rash, poor sleep, disturbed bowel habits - these and many other phenomena can be symptomatic of some underlying emotional disturbance. We must at such times ask what in our lives - in our work, in our relationships - we have not been paying attention to. Why, and to what, is our body saying no?