Wendy was sent to see me because for the previous three years she had been suffering from a disfiguring rash over the left side of her face.  The dermatologists had diagnosed eczema, but the rash  didn’t respond to the usual creams.  Even steroids had failed to resolve it and make up didn’t conceal it.  It was particularly embarrassing because Wendy had been working as a beautician in the cosmetics department of a big store.  Her employers were understanding but she eventually lost her job. 

I asked what was happening in her life when the symptoms first came on. Wendy looked down in embarrassment and told me they had started around the time her sisteen year old daughter, Jane, became pregnant.  Wendy had felt angry and deeply ashamed.    To Wendy, this was history repeating itself.  She had become pregnant with Jane at around the same age. Her mother had been furious when she had found out and had slapped her so hard across the cheek, the mark did not not go for months.  This was the first time, her mother had ever hit her.  It was she said, her stigma; the sign of her shame. That night, she left home to live in her boyfriend’s flat.

Unexplained symptoms often seem to represent what is going on in a person’s life.  They are the feeling or reaction to what has happened.  We all know how the loss of someone close to us causes a lump in our throats and a pricking and watering of our eyes,  how we feel a rising burning sensation in our chest when someone ignores us or is rude and how we feel an urge to go the toilet before an important interview.  These are familiar.  We take them for granted.  But they are usually short lived.  We realise why we are getting these sensations.  We recognise the emotion; sadness, anger, fear or guilt.  We resolve the situation that caused the emotion by thought, action or words. action .  For example,  the fear we feel in our bladder or bowel is resolved as soon  as we start to engage in the interview.  But if what has happened is so severe, we don’t want to think about it or if we cannot, or don’t want to resolve the situation, then the symptoms are likely to remain. 

Women suffer more unexplained illness than men and their symptoms tend to be more severe.  More women than men suffer from Irritable Bowel Syndrome,  Chronic fatigue Syndrome, Fibromyalgia Syndrome,  Food Intolerance and Functional Dyspepsia.  Constipation and Anorexia Nervosa are almost entirely diseases of women.  So what is it about women or their  roles in society that makes them disproportionately susceptible to unexplained illness? 

Sociologists will argue that despite greater equality in the workplace or perhaps because of it, life for women is much harder than it is for men.  Women still undertake more responsibility for running the home, for rearing the children, looking after parents than their husbands and yet many of them have to go to work as well.  Single parent families are ten times more likely to be headed by women than men.  Much is made of a woman’s ability to carry out several different roles at the same time; mother, wife, lover, housekeeper and employee, but this emotional balancing act can only be achieved at the cost of secrecy, guilt or frustration, which is often played out in the body.  

But it’s not just that women have things harder than men, they are also more sensitive.   Woman have a more acute sense of smell, they have greater discrimination of taste, their hearing is more acute, they have a wider range of vision, their skin is more sensitive,  their gut is more sensitive to distension and to nutrients, their bladder is more sensitive.  By any measure, the same principle applies.  Women are not only the secretive sex; they are also the sensitive sex.  Endocrinologists have suggested this sensitivity may be caused by the balance between oestrogen and progesterone and their effects on modulating responses to other transmitters such as serotonin;  psychologists suggest it might be due to a woman’s greater emotional capacity.    

Lord Byron probably had a point when he wrote, ‘Man’s love is a thing apart – ‘tis a woman’s whole existence, but perhaps his masculine view was a little constricted.  But physiologists have shown that when rat pups are separated from their dams, it is the females that show the more drastic rise in stress hormones and changes in behaviour. 

Brain scans have demonstrated that, compared with men,  women are more likely to engage both sides of the brain when exposed to painful stimuli or distressing situations.  In women, the connection between the more analytical left brain and the more emotional right brain is like a six lane highway.  In a man it is a rope bridge over a chasm.  This means that women are more apt to react emotionally and engage bodily responses through activation of the sympathetic and parasympathetic nervous systems.  And in the face of severe distress, they are more readily overwhelmed with feeling.   

Men tend to react more analytically; left brain stuff.  It is not surprising that more men tend to be scientists and mathematicians and more women are counsellors, nurses and write novels. Men can read maps upside down.  Women can read people.   

Men and women are different; thank God!  No better or worse than each other; just different and when they get on, complementary.  But in a climate of stress and loneliness, a woman’s greater sensitivity and intuition comes at the cost of irritated bowels, tender muscles, eating disorders, pain and fatigue.     

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