When the Body Says No: Exploring the Stress-Disease Connection [Paperback]

Life and society put an endless series of demands and requests on us. If we can't or won't say "no" to some of them, our bodies may say no for us, by getting sick or even dying. This is not a new idea. Many healers have taught it, and many books, including my own "Art of Getting Well" have described it.

But Gabor Mate explains it better than anyone, with powerful scientific evidence and moving stories to back it up. This Vancouver physician and health writer gives us the latest research on how emotions, thoughts, the nervous system, immune system and hormones work together to create health or illness. He interviewed more than 100 patients with various conditions, and he shows how always giving in to others and denying our own wants and needs makes us vulnerable to a wide variety of illness.

If you or someone you love is living with an autoimmune disease, an inflammatory condition, or cancer, you may find this book powerful and healing. If you are a health professional looking for better ways to help people with these "incurable" illnesses, you may find it here. If you just want to know more about body and mind and how they work, if you want to be entertained and moved, this book is for you. I wouldn't necessarily say buy it INSTEAD of Art of Getting Well, but they're complementary, and they're both great reading.

At times, I felt that Dr. Mate must have read my diary. The stories he tells of people with multiple sclerosis, ALS and other autoimmune diseases all sounded familiar. I'm pretty sure that my own inability to say no - to be open about my own fears and desires - contributed to my MS, although there were many other causes.

Gabor Mate sees the big picture-the combination of genes, physical and social environment, stresses and behaviors that lead to health problems. He doesn't blame us for not standing up for ourselves. He understands and explains the family dynamics and social forces that make it hard to say "No," even when our lives depend on it. He says, "Personality does not cause disease. Stress does. If we speak of a disease-prone personality, it is only in the sense that certain traits - in particular, the repression of anger - increase the amount of stress."

He knows, for example, that many of us feel guilty when we say no to others' demands, and he wants us get over it. He says, "For many people, guilt is a signal that they have chosen to do something for themselves. If you face a choice between feeling guilt and feeling resentful, choose the guilt every time. Resentment is soul suicide."

I had read a lot on PNI, or psychoneuroimmunology, the science of mindbody medicine. But I never understood exactly how these organs and cells all communicated and worked together until I read When The Body Says No. Mate has a gift for explaining difficult concepts in simple language. You will learn a lot, even if you don't completely buy the central idea.

A couple of criticisms - I wish he had written more about economic and political factors that make saying no difficult. The less power you have, the harder it is to protect yourself. Obviously, you can't say no if you're a slave. I write about the power aspects of disease in my new book, The Politics of Diabetes (out in 2006).

But a lot of people have lost their power not by being severely oppressed, but by things that happened to them in their childhood, even their infancy. There may be things we can do to reclaim some of our power and regain the freedom to say no. We may help ourselves heal in this way.

"When the Body Says No" is strong on these issues but doesn't give a lot of advice on what to do about them. The last chapter, the 7 A's of healing, provides some hints. The A's are Acceptance, Awareness, Anger, Autonomy, Attachment, Assertion, and Affirmation. Most of these get fairly short introductions, but I found the section on anger extremely valuable. Anger can be a life-giving force, or it can be a killer if suppressed or acted out as rage. We need to get in touch with the energy of anger and use it to empower ourselves and make needed changes. The other A's could have used some fleshing out, in my opinion.

As someone who has been immersed in mindbody medicine personally and professionally for 20 years, I recommend this book to all of you. It has meant more to me than anything I have read in this area for a long time.

David Spero RN. www.davidsperorn.com

I agree with the many positive comments made by other reviewers. This is not a self-help book, it's a discussion of the ramifications of stress (as a physiological phenomenon with distinct patterns within the body) for the lay person. The author discusses his experiences and observations with his patients as well offering a highly readable survey of the current research in psychoneuroimmunology.

I think that one of the reasons the author does not offer solutions to the reader is that he's well aware that there are no easy solutions. To change unconscious patterning that's been in place since childhood requires a great deal of motivation and an excellent therapist, or perhaps powerful spiritual guidance. No one is going to be able to shift their own patterns of stress just by reading a book.

But it's a fascinating view of how our environment as children becomes a part of us. The more people who understand the true extent of a child's vulnerability, the better chance any individual child has of getting at least some of what they need to develop a strong, healthy psyche (and body).

I disagree with the reviewer who said that this book does not offer solutions. Again and again the author reports that people need to be heard, and need to stop repressing emotions to get well. As a counselor working with battered women, I was amazed at the number of them who also had auto-immune disorders such as fibromyalgia. This book is a must read.