The impact of emotions and emotional avoidance is commonly associated with the development and maintenance of mental health illness.
However, the link between emotion avoidance and physical illness is generally less commonly known and accepted.
This is very interesting given the robust evidence demonstrating a relationship between emotional avoidance and the development of physical illness.
How is emotion avoidance related to physical illness?
When we experience an emotion such as sadness, anger or fear, our body releases hormones. These hormones let us know that something in our environment is not right and orients us to do something in order to ‘feel better’. If we don’t listen to our emotions but rather ignore and suppress them, our body continues to release these hormones and remains in this aroused state rather than returning to baseline. After time this chronically heightened state can deplete our body’s immune system. As a result our immune systems can become weak and defenseless against disease invasion and/or can become confused and begin attacking the body instead of foreign invaders.
Below are just a few studies that highlight the link between emotion avoidance and physical illness.
Autoimmune Disease
Rheumatoid Arthritis.
Shochet and colleagues conducted a medical-psychiatric study on patients with Rheumatoid Arthritis. They concluded that the patients demonstrated remarkably consistent psychological traits. One common characteristic was compensating hyper-independence – that is the belief that one must get through everything by oneself. This is believed to be due to unmet childhood emotional needs through which the child learns that they must act as though they do not to have needs and as such must take care of themselves. In adulthood this translates into someone who commonly presents as ‘everything is ok’ and will endure all of life’s challenges on their own, never wanting to burden or rely on others for help or support. (7)
In 1965 Solomon and Moos conducted a study investigating the relationship between emotional suppression and immune mutiny by examining healthy relatives of women suffering from rheumatoid arthritis.
In order to understand the results of this study one must first understand the significance of the RF antibody commonly present in patients with Rheumatoid Arthritis (RA). Antibodies are typically only developed when the body must fend off an invasion of harmful molecules. However, a trademark of RA is the presence of an antibody called the rheumatoid factor (RF), which is an antibody that mistakenly attacks the self, due to a confused immune system.
The researchers sought to examine whether certain personality characteristics were associated with the presence of the RF antibody, in the absence of the disease. Therefore, none of the participants in this study had Rheumatoid Arthritis, however they were all related to a woman with the disease.
The results showed that the participants with the RF antibody suppressed anger and expressed higher concern about the social acceptability of their behaviours significantly more than the participants without the RF antibody. They were also significantly more shy, compliant and conscientious. These findings suggest that emotional suppression initiates immune attack against the self. (8)
In 1967 Feigenbaum and colleagues conducted a 5-year study on 50 adults with RA. Psychosocial stress was assessed at the beginning of the study. At the end of the study participants were placed in category 1, 2 or 3 according to their symptom severity. Those with the least severe symptoms were placed in category 1 and those with the most severe symptoms – tissue swelling and bone erosion – were placed in category 3. Participants who were placed in category 3 had, upon entry into the study, significantly more psychosocial stress factors related to the onset of disease compared to participants placed in either of the other two categories. (9)
Cancer
Breast Cancer.
Wirsching and colleagues ran a study with 56 women who were admitted to hospital for a breast biopsy. Without knowledge of the pathology reports, the researchers were able to predict which tumors were cancerous in 94% of the women based solely upon psychological factors that included emotional suppression and avoidance of conflicts. (1)
Greer and Morris conducted a study with 160 women who were admitted to hospital to for a breast lump biopsy. The researchers found that the presence of cancer was significantly associated with extreme suppression of anger. (2)
Prince and colleagues conducted a study on the relationship between stressful life events and emotional support in the development of breast cancer. Their study consisted of 514 women, all of whom required breast biopsies. The results indicated that there was a significant association between severe life stressors and emotional support. More specifically, the results showed that women who experienced events that they considered to be highly stressful and lacked emotional support were nine times more likely to have developed breast cancer. (3)
Lung Cancer.
Dr. David Kissen conducted a study on the risk of lung cancer in men. The results showed that risk of lung cancer was five times higher in men who were unable to effectively express emotion. (4)
Grossarth-Maticek and colleagues conducted a 10-year study with 1,400 participants on risk factors for death due to lung cancer. The researchers found that the greatest risk factor for death, especially mortality due to cancer, was repression of anger. Furthermore, the researchers found that smokers had no incidence of lung cancer unless they also reported repressing their anger. This finding suggests that, despite commonly held beliefs that smoking ’causes’ lung cancer, repression of anger is actually a crucial risk factor for lung cancer, in smokers and non-smokers alike. (5)
Colon and Rectal Cancer.
Kune and colleagues conducted a study investigating whether personality traits were risk factors for colon or rectal cancer. They compared over 600 patients diagnosed with colon or rectal cancer with matched individuals who were cancer free. The researchers found that the patients with cancer were significantly more likely to repress anger and other negative emotions, display an external impression of a “nice” person, suppress a reaction that might offend others, and avoid conflict. These risks factors for colorectal cancer were still significant after controlling for diet, beer intake, and family history. (6)
Written by, Dr. Amanda Stillar
Registered Psychologist
References
1. Wirschin, M. (1982). Psychological identification of breast cancer patients before biopsy. Journal of Psychosomatic Research, 26, 1-10.
2. Greer, S. & Morris, T. (1975) Psychological attribute of women who develop breast cancer: A controlled study. Journal of Psychosomatic Research,19, 147-53.
3. Prince et al., (2001). The role of psychosocial factors in the development of breast carcinoma. Part II: Life event stressors, social support, defense style and emotional control and their interactions. Cancer, 91(4), 686-97.
4. Cox, T. & MacKay, C. (1982). Psychosocial Factors and Psychophysiological Mechanisms in the Aetiology and Development of Cancers. Social Science and Medicine, 16, 385.
5. Grossarth-Maticek, R et al. (1985). Psychosocial factors as strong predictors of morality from cancer, ischemic heart disease and stroke: The Yugoslav prospective study. Journal of Psychosomatic Research, 29(2), 167.76.
6. Kune, G.A et al. (1991). Personality as a risk factor in large bowel cancer: Data from the Melbourne colorectal cancer study. Psychological Medicine, 21, 29-41.
7. B.R. Shochet et al., (1969). A medical-psychiatric study of patients with rheumatoid arthritis. Psychsomatics, 10(5), p. 274.
8. Solomon GF., Moos, RH (1965). The relationship of personality to the presence of rheumatoid factor in asymptomatic relatives of patients with rheumatoid arthritics. Journal of Abnormal Psychology, 103, 2, 251-8.
9. Feigenbaum et al. (1967). Prognosis of rheumatoid arthritis: A longitudinal study of newly diagnosed adult patients. The American Journal of Medicine, 66.
