Emotional Health

Dealing With Emotional Distress and Its Physical Effects
By Suzanne Scott and Lynne M. Constantine

Medical science is only beginning to understand the relationship between physical health and emotional well-being. The “Type A” personality — highly driven, constantly anxious, often combative, and prone to overwork — has been linked to heart disease, reduced immune-system function, and altered hormonal patterns.

There is increasing evidence, however, that an even more lethal force than high anxiety is high hostility — especially when that hostility is strongly repressed. According to Daniel Wineberger, Ph.D., a practicing psychotherapist and professor at Ohio’s Case Western Reserve University who presented a paper at the recent Centennial Convention of the American Psychological Association (APA), people who repress their anger and anxiety may be more prone to getting sick than those who worry a lot and seem to be off the scale on stress levels.

Outer Calm Versus Inner Storm

The typical repressed person usually describes himself or herself as restrained, likely to think before acting, and not at all prone to depression or anxiety. Even in the most provoking situation, he or she appears to remain completely in control. But Wineberger and his colleagues found that these people had all the physiological responses characteristic of anger — raci g heart, rapid pulse, and biochemical changes — even when they said they felt nothing.

“In every single case we looked at closely, it was not worrying that made people sick, rather than anxiety,” Wineberger said. “Extreme control of hostility is linked to high heart rate and blood pressure, high levels of LDL cholesterol — all coronary risk factors.” Finding a means to express emotion safely and nondestructively is a key means of dissipating stress, breaking through repression, and improving health. Dean Ornish, M.D., a cardiologist who discovered that a program including an extremely low-fat diet, moderate daily exercise, and other lifestyle changes may reverse coronary artery disease, requires participants to join a support group to help them learn to express their emotions. Its research suggests that without the group, the other changes won’t make a long-term difference in cardiac health.

Reclaiming Emotions

For survivors of childhood abuse, recognizing the potential dangers of repressed emotion underscores the importance of the work done in therapy and in other activities focused on recovery. Typically, survivors have lived with years of severe stress and have learned to repress their hostility against their abusers as a survival skill. Even a single event may lead to traumatic stress, chronic anxiety, and repressed age that persists for years. A major part of the recovery process involves reclaiming emotions, particularly anger.

As the work of reclaiming emotions proceeds, most survivors need a way to ventilate the new-found hostility that comes to the surface. The most common, but least effective, way that repressed people ventilate hostility is to have periodic “blowups,” in which the person temporarily loses control and says everything that’s bothering him or her.

Writing about emotions is a more effective way to buffer hostility and open up memories and emotions safely and nondestructively. According to James Pennybaker, Ph.D., professor at Southern Methodist University (SMU) and author of Opening Up: The Healing Power of Confiding in Others, there is an unmistakable connection between emotions and immune system and endocrine activity. Words, he says, and particularly the written word, have an enormous power to heal.

In a talk at the recent APA convention, Pennybaker described research in which he found that the ability to express emotions in writing bore a direct relationship to people’s health and self-esteem. In one experiment, for example, Pennybaker and his colleagues found that SMU students who could write about traumatic experiences with signs of emotional engagement were likely to make fewer visits to the doctor and to have higher grade point averages than students who wrote about the same type of experiences in a more detached way, as if they were observers rather than participants.

Bargaining with the Internal Censor

Some survivors report that their writing is plagued by either an internal censor, who cleans up the emotions before they can spin out of the pen onto the page, or by an internal critic, who dismisses their writing as worthless. The censor and the critic interfere with the free flow of words because they view being in control as a critical survival skill. They may not easily give up that control.

Clarissa Pinkola Estes, Ph.D., a noted Jungian analyst who studies the creative process, suggests that it may be far more helpful to make an alliance with these inner forces than to fight with them. On an audiotape program called “Journey to Creativity,” she suggests that would-be writers visualize the internal critic and find out what he or she is trying to protect them from. Similarly, she suggests bargaining with the internal censors, giving them a limited but definite role in the inner process of creativity, such as allowing them to say whether a piece works or doesn’t work for them but not allowing them to say anything judgmental.

Nonverbal Methods of Releasing Emotions

Some survivors find that nonverbal methods of releasing emotions are the best means of evading the restrictions of censor and critic. One man reported playing the piano all night during the period of acute stress that he experienced following the death of his abuser. After several hours of playing, he achieved an almost meditative state. The next day, he was more able to express the mix of emotions he felt about the death of someone with whom he had a love-hate relationship.

One woman survivor reported spending whole days in her studio drawing early in her recovery process. Although she was not an artist, the shapes she drew with colored pencils helped her unlock years of pent-up emotions.

It’s important for survivors not to fall into the trap of thinking that they ‘bring on” physical illnesses by not being “perfect” and able to handle their emotions just right. Learning to undo the patterns of repression fostered by childhood abuse is a lifelong pursuit for most survivors. Because of the intricate connections between body and psyche, survivors may gain unexpected rewards if they persist in the therapeutic process. As they find psychological and spiritual healing, they may also discover that greater sense of physical well-being that comes when the fullness of emotional life is restored.

Suzanne Scott and Lynne M. Constantine are health and
behavioral sciences writers in Northern Virginia.

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