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Life is full of stress. We are fortunate in having powerful and necessary tools to support our emotional resilience. and help us cope with severe emotional stress. At times of severe stress, we have the ability, when needed, to focus on other things. We can seek comfort from those close to us. And faith is a powerful force. However, severe or prolonged stress or truly traumatic events truly challenge our coping ability. Here, our most powerful means of coping, ironically, is one that few are aware of: our ability, without any conscious effort or awareness, to repress, and not feel, potentially overwhelming emotions.

In my new book ‘Hidden Within Us’, I discuss how our ability to repress emotions is a gift of evolution that often is a cornerstone of resilience. However, my clinical experience teaches me that there is also a downside that needs to be recognized and studied; Those powerful but unfelt emotions, though we don’t realize it, do linger within us and, though unrecognized among both patients and physicians, can affect our health. This blog highlights a new understanding of the role of repression in both our resilience and in medical illness, and how it offers new pathways to understanding and treating medical illnesses.

The Gift of Repression

Although repression of emotion is often considered and can be a psychological problem, it actually is a built-in defense mechanism that is crucial to our resilience. We would be emotionally naked without the cocoon of resilience it provides.

As I discuss in Hidden Within Us, a past history of severe or prolonged stress, or of abuse or trauma, whether during childhood or adulthood, is not uncommon, and clearly can be associated with psychological problems in adulthood. However, although many survivors of severe stress or trauma suffer emotional consequences, many don’t and can be considered to be resilient. In my clinical practice, I was surprised by how many patients had moved on in life without overt psychological sequellae, whose emotional survival was largely attributable to the blessing of repression. And they didn’t just survive; they thrived.

In this era of the ascendance of psychology, we are taught to feel our feelings. However, some events, depending on their severity and the circumstances in our life, can be too painful to deal with and at the same time function normally. This is particularly true in childhood and in the absence of emotional support. Here, repression is crucial and is a true gift to so many.

In dealing with extremely stressful events, being “tough,” and being resilient, can be understood in two very different ways. It can mean experiencing and dealing with severely painful emotions and eventually healing and moving on. Or it can mean exactly the opposite, repressing, not feeling, and moving on!

It is optimal if we can confront those emotions and heal. However, my patients’ stories have conveyed to me that in dealing with potentially overwhelming stress or trauma, with emotional distress that could challenge our capacity to consciously cope, the best option often lies in our ability to repress, to not feel. The patients who repressed those emotions didn’t consciously “decide” to block off that emotion; it is their unconscious mind that remarkably, without conscious effort or awareness, kept those emotions from awareness.

Ideally, at a later time, when the threat to emotional and/or physical survival has passed, conscious emotional healing is still possible. However, there are barriers that stand in the way of healing. In many, the opportunity for healing goes unnoticed because of the absence of awareness of the burden of repressed emotions. And in many others, the lifelong partitioning through repression of severely painful emotion often is the best path. The reaction of the patient, or reader, is perhaps the best guide of the path to be taken.

Given our ability to repress, why then do so many suffer psychologically? Clearly we do not repress all emotion. We consciously deal with emotions in our day-to-day life. Being able to repress does not provide an emotion-free life. And in many, severely painful emotion is not repressed. Or repression fails and repressed emotions surface. The ability to repress differs from person to person, due to many factors such as genetics, childhood experience, connectedness and emotional support and the events that we encounter. Nevertheless, the ability to repress plays a key protective role in the resilience of many.

The Downside of Repression

Repression clearly serves us. However, few realize that it also has a downside. My clinical experience, and evidence from published studies, have taught me that the lingering burden of repressed emotions is associated with an increased risk of medical consequences. In this way our genetically-favored ability to repress emotions is a mixed blessing.

The ability to repress emotions can and should be viewed as a survival advantage in a world where so many face overwhelming emotional challenges. It is associated with a reduction in psychological distress and prevention of psychiatric illness. However, few realize that the burden of repressed emotions, though unfelt, persists within us. And that our repressed emotions, though we are unaware of them and legitimately insist that we don’t feel them, can be far more powerful and long-lived than the emotions we experience and focus on, and can ultimately affect our health. They can manifest with physical manifestations that medical science cannot otherwise fully explain. That cost, however, remains hidden from the annals of medicine as mind-body research has focused almost exclusively on the day-to-day stress and emotional distress that we experience.

My clinical experience strongly indicates that the burden of repressed emotion, though unfelt, leaves a legacy as an unsuspected factor in medical and emotional conditions whose cause is otherwise unclear. And ironically, those adverse effects on health can become evident even at times when life circumstances are very stable when one would least suspect a mind-body link.

Decades of mind-body research have focused almost entirely on the link between medical illness and the day-to-day emotional distress we feel and acknowledge; emotions such as anger, anxiety, and depression that are quantifiable by questionnaires. Unfortunately, the impact of that research on our understanding or treatment of medical conditions has been limited. In contrast, there is a paucity of awareness of, or studies concerning, the link between repressed emotions and medical illness. Further challenging such research, research questionnaires cannot readily quantify emotions that we don’t feel.

Few realize that we can be affected more by the burden of repressed emotions than by the distressful emotions that monopolize our attention. What needs to be examined is its role in the genesis of many common, incompletely understood medical conditions.

In Hidden Within Us I present this understanding as it unfolded to me.  I start with observations involving patients with forms of hypertension that opened my eyes to the silent role of repressed emotions, and subsequently to their unnoticed role in many other common yet still inadequately explained medical conditions such as chronic fatigue syndrome, colitis, migraine, autoimmune diseases, chronic pain disorders and others.

I also present published evidence that support this understanding. Studies report an association between adverse childhood events and an increased incidence in adults of hypertension, autoimmune diseases, chronic fatigue syndrome, chronic pain syndromes, cancer and others. Studies similarly link a repressive coping style to an increased likelihood of developing hypertension, coronary heart disease, asthma and cancer.

And the question that also needs to be asked and addressed is whether this understanding offers new pathways for medical healing. My clinical experience and published reports indicate that it does.

Clinical psychologists regularly interact with patients who are suffering from emotional distress. However, it is important to recognize that patients who by virtue of repression are not experiencing psychological distress do not tend to see psychologists. Clinical psychologists, therefore, are less likely to write about the unexplored link between the burden of repressed emotions and subsequent development of many prevalent medical conditions whose cause remains inadequately explained.

The following should be introductory content at the top of the Blog Page:

In my new blog series, entitled Beyond Mainstream Medical Thinking, I present down-to-earth, valuable information that moves beyond the limitations of standard guidelines. It reflects the art of practicing medicine, incorporating what we know about physiology and pharmacology, lessons derived from decades of clinical experience, logic and common sense. I offer valuable suggestions that are very sensible yet rarely incorporated in standard medical care. Some of the insights are discussed in 2 of my books, Hidden Within Us; a Radical New Understanding of the Mind-Body Connection, and Hypertension and You; Old Drugs, New Drugs, and the Right Drugs for your High Blood Pressure.

The advice offered will be very practical, and moves beyond the limitations of standardized treatment guidelines. I am confident that you will enjoy reading these articles and find them relevant to your health.

Beyond Mainstream Medical Thinking

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