There is something interesting that happens when we start paying attention to the relationship between our emotional and physical health. We often talk about them as though they are two completely separate things. We have our physical health, which belongs to the doctor, and our mental health, which belongs to the therapist. But our bodies don't really work that way.
The mind and body are communicating with each other all the time.
I see this connection often in my work with clients. Someone may come into therapy because they are struggling with anxiety, grief, anger, relationship stress, or simply feeling overwhelmed by life. As we talk, they may also mention that their neck has been stiff for months, their shoulders constantly hurt, they have frequent headaches, or they wake up feeling exhausted and sore. Sometimes they have already seen their doctor and had bloodwork or other testing done, but nothing has provided a clear explanation for what they are experiencing.
That can be incredibly frustrating. It can also leave people wondering if they are somehow imagining what they are feeling.
They aren't.
Pain can be very real even when there isn't an obvious physical cause showing up on a test. That is one of the reasons the relationship between emotional health, the nervous system, and physical pain is so important to understand.
The body responds to what we experience
Our bodies are designed to respond to stress. When we feel threatened, our nervous system helps prepare us to respond. Our muscles may tense, our heart rate can increase, our breathing can change, and our attention becomes more focused on whatever feels important or dangerous.
That response is helpful when we actually need to react to something in front of us. The problem is that our bodies can remain in this state when the stressor isn't something we can simply run away from.
Relationship problems, financial stress, parenting exhaustion, grief, unresolved trauma, work stress, and anxiety can all keep our nervous systems working overtime. We may not consciously feel like we are in a constant state of stress, but our bodies can still reflect it.
Over time, that can look like chronic muscle tension, disrupted sleep, fatigue, headaches, digestive symptoms, or increased sensitivity to pain.
This doesn't mean that every physical symptom is caused by stress. It doesn't mean that someone with chronic pain simply needs to "relax." Physical causes still need to be taken seriously and evaluated appropriately. But it does mean that our emotional experiences can influence the way we experience our bodies, and that physical symptoms deserve to be considered within the context of the whole person.
This is part of what makes chronic pain so complicated. Pain isn't simply a signal coming from an injured body part. The nervous system, brain, emotions, attention, previous experiences, and environment can all influence how pain is processed and experienced.
What does grief have to do with your shoulders?
Think about the way your body feels when you are grieving.
You may lose your appetite. You may sleep too much or not sleep at all. Your chest may feel heavy. You may feel completely drained of energy. Even simple things can feel physically exhausting.
We tend to describe grief as an emotional experience, but grief can affect us physically as well.
The same thing can happen with anxiety. Someone may know intellectually that they are safe while their body is telling them otherwise. Their heart races. Their stomach turns. Their breathing becomes shallow. Their jaw tightens. Their shoulders creep toward their ears without them even realizing it.
Anger can look similar. Some people clench their jaw or fists. Others notice tension across their shoulders and upper back. Some people feel restless and unable to sit still.
None of this means there is one specific place in the body where a particular emotion is "stored." You may have heard statements about anger living in your shoulders or grief being stored in your chest, but the science is more complicated than that.
What we do know is that our bodies learn from our experiences.
Our nervous systems learn what to pay attention to. They learn what feels threatening. They learn how to brace and protect us. And when those responses are repeated often enough, they can begin to feel almost automatic.
This is one of the ideas explored in Bessel van der Kolk's The Body Keeps the Score, which examines the ways trauma and overwhelming experiences can affect the brain and body. The book has helped bring greater attention to the physical side of psychological experiences, particularly the ways trauma can influence nervous system functioning, bodily awareness, and responses to stress.
I think there is something especially meaningful about that idea when we take it less literally. Rather than thinking of our bodies as a place where emotions are physically stored, we can think about them as a place where our experiences leave patterns.
Our bodies remember how to brace.
They remember how to stay alert.
They remember what it feels like to hold tension.
And sometimes, even when circumstances have changed, those patterns don't automatically disappear.
Your body may need something different from your mind
This is where I think mental health treatment and physical wellness can meet in a really meaningful way.
Talking about something can be incredibly helpful. Understanding where a pattern came from can change the way we relate to ourselves. Learning to identify emotions, process grief, work through trauma, improve relationships, or establish boundaries can all create meaningful changes in our emotional lives.
But sometimes our bodies need an opportunity to participate in that process too.
That might mean walking regularly. It might mean stretching before bed or taking a yoga class. It could mean working with a physical therapist, getting a massage, or finding another form of movement that feels good in your body. For some people, strength training or dancing may be what helps them reconnect with their body. For someone else, it may simply be taking a slow walk outside without a podcast, phone call, or list of things to accomplish.
Movement doesn't have to be another thing you have to be "good" at.
It doesn't have to be punishment for what you ate or something you do because you are unhappy with your body.
Sometimes movement is simply a way of reminding your body that it is allowed to move, stretch, breathe, and take up space.
Research supports a number of movement and mind-body approaches for certain chronic pain conditions, including exercise and yoga, while approaches such as massage may also provide relief for some people depending on the type and cause of their pain. These approaches aren't replacements for appropriate medical care, but they can be valuable pieces of a broader approach to wellness.
What if we became curious instead of frustrated?
When we have a physical symptom that doesn't seem to have an explanation, it is understandable to become frustrated with our bodies. We want an answer. We want to know what is wrong so that we can fix it.
But sometimes another question can be useful alongside What is wrong with me?
What is happening around me?
When did I first notice this?
Does it get worse when I am stressed?
What does my body feel like when I finally have a chance to rest?
Do I notice myself clenching my jaw when I'm angry?
Do my shoulders tense when I feel anxious?
What happens when I move?
What happens when I slow down?
These questions aren't meant to convince you that your symptoms are "all in your head." They are an invitation to become curious about the relationship between your emotional and physical experiences.
That curiosity is something I encourage in therapy as well.
We spend so much time trying to understand our thoughts and behaviors that it can be easy to overlook what our bodies are doing. Sometimes your body notices something before your conscious mind has words for it. You may notice your stomach drop before you realize that something made you uncomfortable. You may find yourself holding your breath when you're anxious. You may notice your shoulders tense every time a certain topic comes up.
Those physical reactions can become another piece of information that helps us understand ourselves.
Taking care of your mental health can include taking care of your body
I don't think the answer to chronic pain is as simple as "go to therapy."
I also don't think the answer is always "go exercise."
Sometimes there is a medical explanation that needs to be addressed. Sometimes physical therapy is appropriate. Sometimes medication is helpful. Sometimes massage or yoga provides relief. Sometimes therapy helps someone finally process the stress, grief, anger, or trauma that their nervous system has been carrying for years.
Often, there isn't one single answer.
There are pieces.
The more I do this work, the more I believe that mental health isn't something that happens separately from the rest of us. We don't leave our bodies at the door when we walk into therapy.
Our bodies come with us.
The tension comes with us. The exhaustion comes with us. The racing heart, clenched jaw, restless energy, headaches, and heaviness come with us.
And maybe instead of treating those things as annoyances we simply need to get rid of, we can become a little more curious about what they are telling us.
Your body isn't your enemy.
It isn't failing you because you haven't figured out how to make the pain disappear.
And experiencing physical symptoms without an obvious explanation doesn't make those symptoms any less real.
Sometimes your body is simply communicating in a language you haven't learned to listen to yet.
And learning that language may be another part of taking care of yourself.