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As therapists, we are trained to look for the psychological roots of distress—but what if the symptoms our clients bring into the therapy room are also speaking through their bodies?

The Hidden Costs of “Niceness”

Certain personality traits can increase susceptibility to illness. These include compulsive caretaking, the inability to say no, repression of healthy anger, and the belief that one must never disappoint others. Many of these patterns take root in early childhood, when authenticity is sacrificed for attachment. Children learn to suppress their true feelings to maintain connection with caregivers. This necessary adaptation, while helpful in the short term, can later manifest as chronic physiological stress.

And it’s not just theoretical. There are studies showing that women with PTSD have double the risk of ovarian cancer, while men with histories of childhood abuse are significantly more likely to suffer heart disease. In both animals and humans, sustained stress has been shown to accelerate the progression of disease and weaken immune resilience.

Stress is Not Just in the Mind

We must challenge the medical field’s siloed view of illness by emphasizing that there is no real separation between psychological and physiological processes. Emotions influence the immune system, hormone production, inflammation, and even gene expression. The vagus nerve, for example, connects the brain’s emotional centers to the heart, lungs, and gut. When healthy emotional expression is stifled, that suppression shows up in the body—sometimes as eczema, chronic pain, irritable bowel, or much worse.

Questions That Transform

Below is a set of questions you can bring into your sessions with clients who suffer from chronic illness or burnout:

1. Where in your life are you not saying no?
2. What is the impact on you of not saying no?
3. What belief keeps you from saying no?
4. Who might you become if you could say a healthy no?
5. Where are you not saying yes—to your own needs, your creativity, your authentic desires?

These aren’t just questions for clients, though. They're worth considering as clinicians, too. Many therapists enter the profession with strong caregiving identities, and we want to be cautions that our compulsions to help, give, and fix can also come at a personal cost when rooted in unresolved trauma or unmet early needs.

No Blame, Just Insight

Crucially, we’re not advocating for patient-blaming. Instead, we’re inviting you to help clients reconnect with the parts of themselves they’ve had to suppress. When someone develops an illness after decades of self-silencing, the task is not to judge, but to listen—both to the story they’re telling and the one their body may be trying to speak.

Healing isn’t just about symptom management. It’s about creating the internal safety to reclaim agency, assert boundaries, and express the truths long buried.

Reclaiming Authenticity in the Therapy Room

As a therapist, you are in a powerful position to help clients make connections between emotional patterns and physical symptoms. By attending not just to what clients say, but to the ways they sacrifice themselves in relationships or abandon their needs in the service of others, we can support a more holistic path to healing.

Whether a client presents with depression or fibromyalgia, chronic fatigue or panic attacks, we must begin to ask not only “what happened to you?” but also, “what have you been unable to say no to?” and “what has your body been trying to communicate all along?”

In a world that praises self-sacrifice and over-functioning, helping clients listen to their bodies may be one of the most radical and restorative acts we can offer.