“None of us expressed curiosity about her psychological state before the onset of the disease, or how this influenced its course and final outcome. We simply treated each of her physical symptoms as they presented themselves: medications for inflammation and pain, operations to remove gangrenous tissue and to improve blood supply, physiotherapy to restore mobility.”

Maté critiques the normalized medical model of diagnosing and treating only physical symptoms rather than considering the lived experience and mental state of the patient. Maté believes that in ignoring the qualitative data of a patient’s state of mind (in favor of purely verifiable, quantitative data), doctors deprive themselves of important information that might inform their understanding of disease onset and treatment. This is part of the broader theme The Shortcomings of Western Medicine: Mindbody Dichotomizing and Rejection of Anecdotal Evidence.

“Mary described herself as being incapable of saying no, compulsively taking responsibility for the needs of others. Was the scleroderma her body’s way of finally rejecting this all-encompassing dutifulness?”

Through Mary’s case study, Maté highlights The Relationship Between Chronic Stress and Disease as well as The Power of Early Conditioning in Forming Coping Mechanisms. Mary internalized the need to care for others as a very young child. As part of this caretaking, she repressed her own needs. Maté suggests that this caused chronic stress in Mary’s physiology, which eventually expressed itself via scleroderma, an autoimmune disorder.

“Repression—dissociating emotions from awareness and relegating them to the unconscious realm—disorganizes and confuses our physiological defenses so that in some people these defenses go awry, becoming the destroyers of health rather than its protectors.”

Maté continues to explore the relationship between chronic stress and disease in his explanation of the physiological effect of