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When the Body Says No by Gabor Maté.
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When the Body Says No is Dr. Gabor Maté’s exploration of the connection between stress and disease.

Disease, Maté says, is the body’s way of saying “no” to the stress placed on it by our lifestyles. Published in 2019, this book takes a biopsychosocial approach, arguing that biological, psychological, social, and environmental factors are inseparable for a holistic understanding of illness. Maté argues that modern medicine fails to recognize the devastating effects of chronic stress on our health, in part because of misunderstandings about what stress is and what causes it. (Shortform note: The biopsychosocial model is the primary approach to illness taken by health psychologists, whereas medical doctors tend to take a biomedical approach. Health psychologists argue that as the leading causes of illness shift from infectious diseases to chronic diseases, the biopsychosocial model is more important than ever.)

Rather than periodic external stress events, Maté says humans in modern society tend to experience chronic stress. He says...

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When the Body Says No Summary Part 1: The Mind-Body Relationship

Chronic stress is a psychological condition. But, according to Dr. Maté, modern medical practice is rooted in mind-body dualism, meaning that the body and mind are treated as separate entities with medical doctors treating only the body. He argues that thinking of the mind and body as two separate entities disguises the connection between chronic stress and disease. Researchers tend to miss those connections because of the way they’re defining and understanding stress, as well as their lack of attention to human psychology.

In this section we’ll discuss the problems with mind-body dualism and the predominant definition of stress. We’ll then look at how Maté understands stress and his explanation of what it actually does to our bodies.

Cartesian Philosophy and Medicine

Although the concept of mind-body dualism can be traced back to ancient Greece, much of modern Western medical thought has its roots in Cartesian philosophy of the 17th century. Descartes’ ideas about the mind and body as distinct entities have been regarded by many as a positive historical turn in medicine, because they challenged the...

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When the Body Says No Summary Part 2: The Stress-Disease Connection

Now that you understand how Maté defines stress, and what chronic stress does to the body, you may see why understanding psychology is so important for making the connection between stress and disease. Next, we’ll take a look at some of the research Maté cites, in which connections have been made between peoples’ life histories, psychological profiles, and specific diseases.

Diseases of the Nervous System

MS (multiple sclerosis) and ALS (amyotrophic lateral sclerosis, or “Lou Gehrig's Disease”) are both diseases of the nervous system that can cause wide varieties of symptoms. According to Maté, both have also been associated with specific kinds of life experiences and personality characteristics.

It’s well known that MS flare-ups can be correlated with stress. But according to the research cited by Maté, doctors as far back as the late 1800s have also suggested a connection between life stressors and onset of the disease. Many studies since have found that **people with MS are far more likely than average to have experienced trauma early in their lives, to have dysfunctional emotional issues relating to their parents, and to have other acute stressors....

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When the Body Says No Summary Part 3: Ultimate Causes of Disease

Considering the links that have been observed between these diseases and stress, personality, and life experiences, Maté argues that there are clearly contributing causes beyond the biological. He says that doctors often look primarily for “proximate” causes but fail to look for “ultimate” causes. Proximate causes include the immediate observable causes, while ultimate causes are the bigger-picture explanations.

With all the diseases discussed, Maté is looking for the ultimate cause in the psychology of the human host. In this section, we’ll look at how chronic stress is ultimately caused by childhood experiences of perceived threat that go unresolved. You’ll learn what kinds of parent-child relationships contribute to these experiences in children, and how modern society creates the conditions for these parenting patterns. You’ll also see why Maté says that nobody is to blame for this, so assigning blame is meaningless.

Integration of Traditional and Modern Medicine

Anthropologist Hank Wesselman says that within shamanic traditions, physical illnesses are the effects of disease, while “[the ultimate causes of virtually all illnesses are to be found...

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When the Body Says No Summary Part 4: Prescription for Healing

So, now that we’ve examined the multifaceted “ultimate causes” of chronic stress, and therefore disease, you may be tempted to feel resigned, knowing these patterns are embedded in your psyche from early childhood. However, Maté emphasizes that at any point in your life, you can take control of your chronic stress and cultivate a healthier disposition and lifestyle. In this final section, we’ll take a look at Maté’s advice for developing emotional competence as a way to counteract and alleviate the effects of chronic stress on your mind and body.

Avoid Toxic Positivity

The first piece of advice Maté offers for counteracting the effects of chronic stress on our bodies is to reject the common overemphasis on “positive thinking.” He says this approach to dealing with negative emotions only makes people repress them. Maté says healthy thinking includes acknowledging all of our genuine feelings. Focusing on only the positive and denying the negative is a defense mechanism developed by those who are hurt. But it doesn’t fix it.

In his suggestion to embrace “the power of negative thinking,” Maté doesn’t mean to dwell; he means be willing to look at what’s wrong. Pay...

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Shortform Exercise: Explore Your Anger

Now that we know repressed anger is possibly the biggest risk factor for disease, getting in touch with any anger you’re repressing is your first step in preventing and healing illness.


Start an anger exploration journal. Begin by freewriting your life story—just write anything that feels significant in your life, focusing on your relationships from as early as you can remember up to now.

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