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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
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Stuffing It: The Culture of Not Speaking

Allan Schwartz, LCSW, Ph.D. Updated: Oct 27th 2006

Research during the past thirty to forty years points to the fact that mind and body are not separate. While the brain resides in, and is protected by the skull, its neurons reach down throughout the entire body.  A vast neurological network carries messages to and from every nook, cranny, and corner of the body.  What this means is that outside or environmental stimuli which impinge on the external body deeply affect the internal organs, including the brain. The messages sent from the brain in reaction to the external stimuli then affect those same organs. We now know that stress, anger, aggravation, nutrition, exercise, and other factors profoundly the way we feel. Consequently, the immune system is affected, making us more vulnerable to cold viruses.  Constant anger and conflict lead to high blood pressure, strokes, heart attacks, and even diabetes.  It is now a proven fact that depression resulting from a heart attack, if left untreated, shortens the life span of the recovering patient. In other words, there is more to recovering from a physical illness than restoring good health. Mood, environment, aggravation, and depression, have a negative impact on the ability of a person to return to health.  What has this to do with the "culture of not speaking?"



There are many families whose systematic way of functioning is to not speak about issues, emotions, and opinions. In such families when there is any sign of disagreement everyone "shuts down" or "stuffs it." What is "stuffing it" you ask? "Stuffing it" has to do with keeping thoughts and feelings to oneself so as not to hurt the feelings of other people in the family. In these "stuffy families," conflict is labeled as dangerous and harmful. Emphasis and value is placed on silence about anything that might be deemed controversial. Each family member works hard to protect the feelings and well-being of the other members. However, this comes at a great cost to everyone in the group.


Case Examples:

(Each case is a composite of many cases and not one person)


A. A woman underwent quadruple bypass surgery after she collapsed in the street. She lived a life of constant tragedy and disappointment. Her only child, a daughter who was now adult, would have nothing to do with her. The reason for the breach was never made clear except that the patient had a long history of being emotionally distant and aloof. Her father, mother, husband, and family had all died leaving her alone and isolated. Tragically, she had miscarried eight times before the birth of her daughter.  In a very real sense, this woman was dying of a broken heart. Yet, in therapy after surviving her bypass surgery, she denied feeling depressed and denied feeling sad or disappointed about her daughter. This woman lived alone, isolated herself, and continued to keep her feelings and thoughts to herself both after her surgery as she had prior to the near fatal incident. She never confronted her daughter about her failure to call or visit her mother.


B. Another man, always healthy, energetic, and vibrant began experiencing serious physical symptoms when he moved to another part of the country. While the MD's could find nothing wrong with him he complained he could not breathe, experienced numbness in his hands and arms, and could no longer work out in the gym. Having moved and given up his career, he could not seem to determine how he wanted to spend the rest of his life. While he had a career in the health industry, he never felt respected by his father, mother, and siblings for what he did. Worse, he devalued his profession. Anger and outrage were often and easily expressed by this explosive person. Yet, he could not verbalize or understand the full spectrum of what he felt. For one thing, as the only fully educated individual in the family, it was difficult for him to surpass his blue collar father. Prior to moving to another part of the country, he could not admit to himself how much he would miss his parents. His family, always protective of this man, regularly failed to inform him of any type of health problems family members experienced. They feared he would become too emotional. As a result, he worried about everyone, including his parents, even more because he could not trust that they were being honest with him. Now that he moved, he worried even more than before.


C. A woman whose father died of a heart attack when she was a teenager was left at the mercy of her alcoholic and abusive mother. Filled with rage at her mother, she could never settle into an intimate relationship which was both calm and reassuring. She fought with each of the men she with whom she had relationships, until they left her out of complete frustration. Although she was highly educated and extremely bright, her work relationships were marked by constant conflict and quarrelling. When she finally did meet a man she fell in love with and married, she was unable to become pregnant. Her doctors, including fertility specialists, were unable to find anything medically wrong with her. They were unaware of her stormy, explosive, and angry nature. Research has shown how this type of emotionality and storminess can contribute to fertility problems.


In a popular self help psychology book entitled, “I Don't Want To Talk About It,” psychotherapist Terence Real discusses what he refers to as the secret legacy of male depression. Of course, the secret legacy refers to the male value of hiding feelings and appearing strong and masculine. With verbal and emotional pathways of expression closed to them, many men turn to alcohol and/or drug abuse to attempt to defuse their problems. Unfortunately, this too often leads to suicide. What types of emotions are these men hiding? They are hiding feelings of: 1. Shame, 2. Anger, 3. Rage, 4. Embarrassment, 5. Sadness, 6. Love and affection for their children, and these are a but a few among many others.


Words are symbolic representations for how we feel, what we think and what we are experiencing. Many great psychologists and psychiatrists have written about their observations that verbal communication is a way for people to mitigate the impact of the stresses to which life subjects them. The failure to communicate with loved ones and the need to avoid discussing anything emotional lead to the types of somatic symptoms experienced in the cases cited above.


What to Do About Verbal Communication for You and Your Family:


1. It is important to understand that anger can be expressed without tempers flaring. The purpose of words is to express feelings and thoughts in ways that are controlled but effective. The most effective way to express anger and disappointment is to lower one's voice and to carefully explain the reasons for the anger.


2. It has often been said by many family therapist that when expressing anger and disappointment an individual should avoid using the pronoun "you." "You" carries with it a tone of accusation which makes other people defensive. Instead, the preferred pronoun in the parlance of family therapy is the pronoun "I."


3. The purpose of using the pronoun "I" when expressing feelings is to state one's own thoughts and feelings without accusing the other. For example, I may feel angry that my daughter broke her curfew and came in late. I want to tell her that when she is late "I feel" worried about her. Or, if a husband or wife has spent too much money on clothing "I feel" worried about money and I need your help in controlling the budget. If I state something like "You are always late," or, "You are a spend thrift" the ground work is being laid for a gigantic quarrel.


4. Our colleagues in Family Therapy also tell us that adjectives such as: always and never are more exaggerated than can actually be true. Teenagers do not always break their curfew. Instead, my teenage son broke his curfew this evening. Also, my spouse does not always spend too much money. Instead, she spent more than I wanted on this occasion.


5. It is essential for everyone to understand that there is nothing weak or helpless about discussing all types of feelings from those that are painful and sad to those that are angry.

Controversies, fears, disappointments, passions, and other emotionally laden issues can be discussed in ways that express emotions while protecting the dignity of others in the family.


6. It is vitally important for children to be told, by both of their parents that they are loved. One parent actually asked me if he loved his son and daughter too much. He feared that too much love would spoil them!! How can love ruin, harm or spoil anyone.


In other words, it is not only anger, depression and other negative feelings that many people have difficulty expressing. It is also difficult for many people to express love, affection and tenderness.


What If We Cannot Discuss Feelings or Issues?


There are many modes of psychotherapy available to help individuals and/or families and couples learn how to improve communication:


Types of Psychotherapy:


  1. Family therapy can be extremely helpful in helping families identify and change their patterns of communication. Rather than focus on changing the behavior of a single person, the family therapist concentrates on how the entire family system functions with the purpose of enabling that system to learn healthier and more adaptive ways of communicating and relating to one another.
  2. Psychodynamic individual therapy can be geared towards the family or the individual. In working with the individual, patient and therapist uncover the unconscious conflicts that prevent the patient from being spontaneous about the way in which they communicate.


  1. Cognitive-Behavioral therapy, in this case, for individuals, centers on the automatic or distorted thinking patterns that keep the patient from improved functioning and communication. Once the patient is able to identify their automatic thoughts they can learn new and more realistic ways of thinking that will improve their mood, self esteem and how they interact with other people.


What If I Do Not Know What I Feel?


There is a psychological condition, referred to as alexithymia that means a person does not know what they are feeling. Also, they are unable to use words to describe what they are feeling. For these types of people, many of whom suffered severe traumas during their lives, long term individual therapy is used to help them learn to express their feelings and thoughts.


Your opinions and experiences with these types of problems are welcome.




Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at for details.

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