When the Body Says No: The Cost of Hidden Stress (43 page)

“Now, I need lots of people in my life. Cancer people support each other. And that’s what we
need
—to talk about it. The rest of my life we will all be talking about it. It seems to be something that you have to do.”

“Don’t human beings in general need support and the opportunity to share emotions, and to talk about their difficulties, cancer or no cancer? Why do you think cancer would have to teach you this?”

“I wondered that myself. When I was first diagnosed, I built a wall around me, and I didn’t let anybody in because I felt safe inside there. That was a mistake I made. I put all my energies into fighting the cancer, for eleven months. When I finally thought that the cancer was gone, I started to let this wall down, I started telling people about my experience, that I had cancer and that I had got rid of it. I was quite proud of the fact.”

“You were able to share once you defeated the thing, but not while you were fighting it, when you most needed support. Why did you keep your wife out?”

“I never felt that she supported me … and yet … I know she was supporting me … but I wouldn’t let her into my life. I had this wall around me, and I wouldn’t let anybody in.”

We sometimes find it easier to feel bitterness or rage than to allow ourselves to experience that aching desire for contact that, when disappointed, originally engendered the anger. Behind all our anger lies a deeply frustrated need for truly intimate contact. Healing both requires and implies regaining the vulnerability that made us shut down emotionally in the first place. We are no longer helplessly dependent children; we no longer need fear emotional vulnerability. We can permit ourselves to honour the universally reciprocal human need for connection and to challenge the ingrained belief that unconsciously burdens so many people with chronic illness: that we are not lovable. Seeking connections is a necessity for healing.

Beyond acceptance and awareness, beyond the experience of anger and the unfolding of autonomy, along with the celebration of our capacity for attachment and the conscious search for contact, comes assertion: it is the declaration to ourselves and to the world that
we are
and that
we are who we are
.

Many times throughout this book we have witnessed people expressing the belief that if they do not act, they experience only emptiness, a frightening void. In our fear we falsely equate reality with tumult, being with activity, meaning with achievement. We think autonomy and freedom mean the liberty to do, to act or react as we wish. Assertion in the sense of self-declaration is deeper than the limited autonomy of action. It is the statement of our being, a positive valuation of ourselves independent of our history, personality, abilities or the world’s perceptions of us. Assertion challenges the core belief that we must somehow justify our existence.

It demands neither acting nor reacting. It is
being
, irrespective of action.

Thus, assertion may be the very oppositive of action, not only in the narrow sense of refusing to do something we do not wish to do but
letting go of the very need to act
.

When we affirm, we make a positive statement; we move toward something of value. There are two basic values that can assist us to heal and to remain whole, if we honour them.

The first value is our own creative self. For many years after becoming a doctor, I was too caught up in my workaholism to pay attention to myself or to my deepest urges. In the rare moments I permitted any stillness, I noted a small fluttering at the pit of my belly, a barely perceptible disturbance. The faint whisper of a word would sound in my head:
writing
. At first I could not say whether it was heartburn or inspiration. The more I listened, the louder the message became: I needed to write, to express myself through written language not only so that others might hear me but so that I could hear myself.

The gods, we are taught, created humankind in their own image. Everyone has an urge to create. Its expression may flow through many channels: through writing, art or music, through the inventiveness of work or in any number of ways unique to all of us, whether it be cooking, gardening or the art of social discourse. The point is to honour the urge. To do so is healing for ourselves and for others; not to do so deadens our bodies and our spirits. When I did not write, I suffocated in silence.

“What is in us must out,” wrote Hans Selye, “otherwise we may explode at the wrong places or become hopelessly hemmed in by frustrations.
The great art is to express our vitality through the particular channels and at the particular speed Nature foresaw for us.”

The second great affirmation is of the universe itself—our connection with all that is. The assumption that we are cut off, alone and without contact is toxic, but—no matter how cruelly and how consistently life has shown us this dark shadow—it is no more than a bitter illusion. It forms part of the pathological biology of belief.

Physically it is easy to see that our sense of separateness from the universe is false: we do not go “from dust to dust,” we are dust enlivened. We are a part of the universe with temporary consciousness, but never apart from it. Not by coincidence is the word
seeking
so frequently employed in relation to spiritual work.

Faced with illness, many people seek their spiritual selves almost instinctively, often in surprising ways. Anna, with breast cancer, was born
Jewish and was brought up in her ancestral religion. She now goes to a Catholic cathedral for spiritual sustenance. “My beloved is God, and that’s why I stay strong. I go to church, and I take Communion; I know that I am beloved of God. I serve at the altar. The first time I did it, I held the crucifix and two candles, and the priest said to me, ‘You are the altar.’ I’ve been saying that to myself, especially when I feel really awful:
I’m the altar
. And the priest said to me, ‘If you’re the altar of God there in the cathedral, you are the altar of God all the time. You are … beloved.’”

On the other hand, Lillian, a woman with arthritis I interviewed, has turned from Presbyterianism to Judaism. She grew up in a highly controlling and repressed home in her native Scotland. In her Jewish faith she finds a freedom to be herself, an acceptance and a joy of life long denied to her. She is still not quite liberated: when her brother comes to visit, she hides the menorah and the Sabbath candles. But she is more at peace than ever before. “I felt if I was going to heal, I would have to throw off spiritual bondage,” she says.

Others I have spoken with have reaffirmed their confidence in their traditional faith, or they meditate, or they commune with nature. Each seeks his or her own way to the light within and without. For many it is not an easy search. No matter where we may have lost the key, like Nasruddin, we all prefer to begin under the street light where we can see.

“Seek and ye shall find,” one of the great teachers said. The seeking itself is the finding, since one can fervently seek only what one already knows to exist.

Many people have done psychological work without ever opening to their own spiritual needs. Others have looked for healing only in the spiritual ways—in the search of God or universal Self—without ever realizing the importance of finding and developing the personal self. Health rests on three pillars: the body, the psyche and the spiritual connection. To ignore any one of them is to invite imbalance and dis-ease.

When it comes to healing, if we look only in the easy places, we usually find what Nasruddin and his neighbours found under the street light:
nothing
. Nasruddin, in his role as fool, did not know that. In his role as sage and teacher, he did.

Nasruddin, fool and sage, exists in all of us.

1: The Bermuda Triangle

1.
Hans Selye,
The Stress of Life, rev
. ed. (New York: McGraw-Hill, 1978), 4.

2.
M. Angell, “Disease as a Reflection of the Psyche,”
New England Journal of Medicine
, 13 June 1985.

3.
Interview with Dr. Robert Maunder.

4. Plato,
Charmides
, quoted in A. A. Brill,
Freud’s Contribution to Psychiatry
, (New York, W.W. Norton, 1944), 233.

2: The Little Girl Too Good to Be True

1.
G. M. Franklin, “Stress and Its Relationship to Acute Exacerbations in Multiple Sclerosis,”
Journal of Neurological Rehabilitation
2, no. 1 (1988).

2.
I. Grant, “Psychosomatic-Somatopsychic Aspects of Multiple Sclerosis,” in U. Halbriech, ed.,
Multiple Sclerosis: A Neuropsychiatric Disorder
, no. 37,
Progress in Psychiatry
series (Washington/London: American Psychiatric Press).

3.
V. Mei-Tal, “The Role of Psychological Process in a Somatic Disorder: Multiple Sclerosis,”
Psychosomatic Medicine
32, no. 1 (1970), 68.

4.
G. S. Philippopoulous, “The Etiologic Significance of Emotional Factors in Onset and Exacerbations of Multiple Sclerosis,”
Psychosomatic Medicine
20 (1958): 458–74.

5.
Mei-Tal, “The Role of Psychological Process …,” 73.

6.
I. Grant, “Severely Threatening Events and Marked Life Difficulties Preceding Onset or Exacerbation of Multiple Sclerosis,”
Journal of Neurology, Neurosurgery and Psychiatry
52 (1989): 8–13. Seventy-seven per cent of the MS group, but only 35 per cent of the control group, experienced marked life adversity in the year prior to the appearance of disease. “The excess in marked life stress was most evident in the 6 months before onset…. 24 of 39 multiple sclerosis patients (62 per cent) reported a severely threatening event, as compared with six of 40 controls (15 per cent)…. Significantly more patients than controls experienced marital difficulties (49 per cent vs. 10 per cent)…. Eighteen of 23 first cases and 12 of 16 relapsing cases reported marked adversity.”

7.
J. D. Wilson., ed.,
Harrison’s Principles of Internal Medicine
, 12th ed. (New York: McGraw-Hill, 1999), 2039.

8.
L. J. Rosner
, Multiple Sclerosis: New Hope and Practical Advice for People with MS and Their Families
(New York: Fireside Publishers, 1992), 15.

9.
E. Chelmicka-Schorr and B. G. Arnason, “Nervous System–Immune System
Interactions and Their Role in Multiple Sclerosis,”
Annals of Neurology
, supplement to vol. 36 (1994), S29-S32.

10.
Elizabeth Wilson,
Jacqueline du Pré
(London: Faber and Faber, 1999), 160.

11.
Hilary du Pré and Piers du Pré,
A Genius in the Family: An Intimate Memoir of Jacqueline du Pré
(New York: Vintage, 1998).

12.
Wilson,
Jacqueline du Pré
.

3: Stress and Emotional Competence

1.
Selye,
The Stress of Life, xv
.

2.
Ibid., 414.

3.
Ibid., 62.

4.
Ibid., 150.

5.
E. M. Sternberg (moderator), “The Stress Response and the Regulation of Inflammatory Disease,”
Annals of Internal Medicine
17, no. 10 (15 November 1992), 855.

6.
A. Kusnecov and B. S. Rabin, “Stressor-Induced Alterations of Immune Function: Mechanisms and Issues,”
International Archives of Allergy and Immunology
105 (1994), 108.

7.
Selye,
The Stress of Life
, 370.

8.
S. Levine and H. Ursin, “What Is Stress?” in S. Levine and H. Ursin, eds.,
Psychobiology of Stress
(New York: Academic Press), 17.

9.
W. R. Malarkey, “Behavior: The Endocrine-Immune Interface and Health Outcomes,” in T. Theorell, ed.,
Everyday Biological Stress Mechanisms
, vol. 22, (Basel: Karger, 2001), 104–115.

10.
M. A. Hofer, “Relationships as Regulators: A Psychobiologic Perspective on Bereavement,”
Psychosomatic Medicine
46, no. 3 (May–June 1984), 194.

11.
Ross Buck, “Emotional Communication, Emotional Competence, and Physical Illness: A Developmental-Interactionist View,” in J. Pennebaker and H. Treve, eds.,
Emotional Expressiveness, Inhibition and Health
(Seattle: Hogrefe and Huber, 1993), 38.

12.
Ibid.

4: Buried Alive

1.
Suzannah Horgan,
Communication Issues and ALS: A Collaborative Exploration
(Thesis submitted to the Division of Applied Psychology, University of Alberta, Calgary, 2001).

2.
Wolfgang J. Streit and Carol A. Kincaid-Colton, “The Brain’s Immune System,”
Scientific American
273, no. 5 (November 1995).

3.
W. A. Brown and P. S. Mueller, “Psychological Function in Individuals with Amyotrophic Lateral Sclerosis,”
Psychosomatic Medicine
32, no. 2 (March–April 1970), 141–52. The countervailing study is by J. L. Houpt
et al.
, “Psychological Characteristics of Patients with Amyotrophic Lateral Sclerosis,”
Psychosomatic Medicine
39, no. 5, 299–303.

4.
A. J. Wilbourn and H. Mitsumoto, “Why Are Patients with ALS So Nice?” presented at the ninth International ALS Symposium on ALS/MND, Munich, 1998.

5.
Ray Robinson,
Iron Horse: Lou Gehrig in His Time
(New York: W. W. Norton & Company, 1990).

6.
Michael White and John Gribbin,
Stephen Hawking: A Life in Science
(London: Viking, 1992).

7.
Dennis Kaye,
Laugh, I Thought I’d Die
(Toronto: Penguin Putnam, 1994).

8.
Evelyn Bell,
Cries of the Silent
(Calgary: ALS Society of Alberta, 1999), 12.

9.
Lisa Hobbs-Birnie,
Uncommon Will: The Death and Life of Sue Rodriguez
(Toronto: Macmillan Canada, 1994).

10.
Jane Hawking,
Music to Move the Stars
(London: Pan/Macmillan, 1993).