All beginnings are difficult.

I began to realize that a doctor had to be more than an engineer to the body, that feelings and who we are had an enormous amount to do with human illness.

If instead we look at repressed emotions, at the emotions that we don’t feel or complain about or even know we harbor, we have a very different approach that can finally make sense of the mindbody connection in hypertension, and offer new approaches to treatment. This understanding identifies the individual who feels the least emotion as the most

It is normal for blood pressure to fluctuate. No one’s blood pressure is perfectly steady. It is also clear that blood pressure can vary with stress, rising in tense moments and then settling. We do not treat those transient elevations because they are part of the normal physiology of blood pressure.

The new paradigm tells me exactly the opposite—that it is the nonreaction that is more likely to lead to psychologically mediated neurogenic hypertension,

the more a trauma survivor insists that the past has had no lingering impact, indicating that major issues have been repressed, the more likely it is that the hypertension is related to it, but the less likely it is that such an individual will be amenable to, or helped by, psychotherapy.

Patients whose hypertension is related to repression usually do not complain of emotional distress, do not feel any need for psychotherapy, and are not interested in it. And they are coming to me not because they want to explore old trauma, but because they want to bring their blood pressure under control. Also, if someone has successfully

if a patient is uninterested, I do not coerce him to embark on psychotherapy.

The patient who tells me he is worried about this or angry about that, or that he or she feels down or depressed from time to time, is not likely to be a repressor. The patient who tells me he is very even keeled, or is always up, or has never ever been depressed no matter what has happened, is likely a repressor.