“I never get angry,” a Woody Allen character says in one of his movies, “I grow a tumour instead.” (1)

In his book, When the Body Says No, physician Gabor Maté presents a clear case for a strong relationship between serious illnesses such as cancer, multiple sclerosis, rheumatoid arthritis, ALS (Lou Gehrig’s disease), and other slow killers that strike in mid-life, and the dynamics that shape our behavioral patterns as small children. Being the smallest and most dependent members of the family system, we shape ourselves to fit the needs of our older siblings, parents, grandparents. For instance, take the case of a mother who suffers the loss of her own parent while still in the hospital giving birth to her child. This child learns not to challenge or threaten an already stressed and depressed mother in order to stay close to her mother. The child learns to stifle her own desires and needs, in this case, finding freedom of expression only through her music. The young musician in this case was the famous cellist, Jacqueline du Pré who died of MS at age 42.

What does this have to do with what you don’t say, or, not speaking up? A palliative care physician, Gabor makes a compelling argument for archetypal patterns of repression lying at the heart of many degenerative illnesses such as multiple sclerosis, Lou Gehrig’s disease, cancer. As family constellation facilitators know only too well, children will accommodate and adapt themselves to be what the family, especially the parents, need them to be, even at the cost of their own well-being and health.

Now, as Dr. Maté shows, we have identified some of the emotional and physiological culprits that grind away at the basic foundation of health when we are forced to distort our basic nature in order to find belonging in our family. “The repression of anger and the unregulated acting-out of it are both examples of the abnormal release of emotions that is at the root of disease.” Both repression of appropriate anger, i.e., completely swallowing one’s feelings, or stuffing feelings then erupting in unregulated violent outbursts, trigger our physical and emotional stress systems. In either case, our nervous system’s fight-or-flight response is running amok. When the natural burst of anger – energy that would enable the child to take action to defend itself – is overrun, the hypothalamus-pituitary-adrenal series of glands the regulate our sympathetic nervous system and active our stress response remain switched on. Like a steady drip of water on a rock over time will wear away the stone, the stress hormones released by this natural stress response system wear down the physical basis for our long-term health. In both cases, repression and out-bursts of excessive rage, this stress system is left on. The normal release that follows anger and appropriate action never happens. The “tap” gets left on.

Maté makes a fascinating and astute observation when he points out that “the real experience of anger is a sense of empowerment and [then] relaxation.” That is, when anger does what it is supposed to, give us the necessary burst of energy to protect ourselves from intrusion or move us to safety, the natural consequence is relaxation. The anger did what it was supposed to do, get us to safety. What we often define as anger, however, a tightening of the voice, shallow, high breathing, an increase in muscle tension, are more accurately physiologically defined as anxiety, not anger. Maté points out that what people are experiencing when they say they are angry is actually rage.

Acting out through bursts of rage is a defence against the anxiety that invariably accompanies anger in a child. Anger triggers anxiety because it coexists with positive feelings…the desire for contact [with the adult caregiver]…[anger] threatens attachment…. It is incredibly anxiety-provoking and guilt producing for a person to experience aggressive feelings toward a loved one. (Maté, 2003, p. 271-272).

This double-bind, needing to protect oneself, yet not wanting to threaten the relationship with the care-giver is what teaching people to stuff their anger.

Making this point in a less dramatic, but still convincing fashion, is the research of a young woman Don and I met at the Connecting Fields conference this May in Copenhagen. Doctoral candidate and biosemiotic researcher, Mette Boll, studied clerks in the grocery store. She was curious whether maintaining a pleasant demeanor in spite rude or surly customers would be less stressful for the clerks than being affected by the customer and grumbling back at them. She expected to find that the clerks who found a way to remain pleasant in the face of an angry or rude customer would have lower physiological stress markers than the clerks who felt the customers surly behavior and responded accordingly rather than remaining pleasant. In fact, she found the opposite. The clerks who managed a “nice” response to the rude customers showed high physiological markers of stress. The clerks who grumbled or snapped right back at the customers showed no stress! (This being the case, we now know that the happiest waiters in the world must be those in the pubs in Cologne who are renown for telling their customers exactly what they think of their customers, including changing their order if they think the customers make the wrong choice!)

So, keeping quiet doesn’t necessarily make us feel better. But sometimes speaking out can be dangerous, especially if we express our aggression directly to someone bigger and stronger! That’s where non-violent communication (NVC) can be a literal life-saver. NVC combined with MindSight, a mindful awareness of our own feelings, can provide clear steps that will enable us to express our needs clearly, yet without aggression. In simple form (apologies to NVC experts!), here are basic steps that enabling our anger to serve its protective function in our adult relationships.

  1. I notice that I am having a feeling. This is where mindfulness practices are helpful.
  2. I notice/observe (without judgment and with self-compassion) what is happening that might be related to this feeling.
  3. I feel/sense (without adding a story) specifically what that feeling is and name it.
  4. I notice what I need (without resorting to manipulation), and finally
  5. I make a request of the other in clear, positive, actionable language to see if I can get my needs met.

Recently, a colleague I admire greatly, took a very difficult situation and explored how positive, compassionate communication in difficult circumstances could fundamentally change relationships. Kim Pearce, the wife of my dissertation chair, Barnett Pearce, and the co-founder of the CMM Institute, describes a conversation between Barnett and his father when Barnett told his dad that he’d been diagnosed with stage four cancer. His father’s strong religious beliefs made it hard for the father to hear his son’s need to connect and “feel felt” by someone dear and important to him in this critical moment. The father’s brusque response was painful and upsetting to both Barnett and Kim. Rather than stuff his feelings of anger and grief, Barnett made some difficult choices in that moment that allowed him to take a compassionate stance both towards his father and himself. This created an opening, whereas the unskilled expression of anger might have closed the door between them and made further connection even more difficult. Over time, this opening allowed father and son to transform their relationship, so that before he died, Barnett was able to connect with his father in a loving and meaningful way. I highly recommend Kim’s book, Compassionate Communication, for an inspiring view into how to accept, allow, and transform our powerful emotions into new opportunities for relationship.

Next time you think of stuffing your anger, or rage, for all those “right” reasons, take an inner step back. Exhale, allow yourself to take a full breath. Apply the NVC guidelines, and see how you can act into that situation with respect for the other while also getting your needs addressed.

For more information:


(1)  page 269, MatĂ©, G. (2003). When the body says no: Exploring the stress-disease connection. Wiley:Hoboken, NJ

(2) page 270, ibid.

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