Could Therapy Help High Blood Pressure?
Other studies have revealed another mind-body connection to high blood pressure, so well-known that it has a nickname: white-coat hypertension. "These are people who are really scared about blood pressure," Mann says. "In the moment at the doctor's office when it's being measured, the pressure goes up."
But the link between childhood experiences and adult high blood pressure has been "amazingly neglected" in research, he says.
After 20 years as a hypertension specialist, Mann says, "my clinical observations have led me to believe that depression, anxiety, anger ... those are not the cause of hypertension. I am convinced that for many hypertensives -- those with hard-to-control or severe hypertension -- there will be a history of emotional, physical or sexual abuse in childhood," he tells WebMD. And when these people also have a genetic predisposition, they are that much more at risk, he says.
"I suspect that nearly 25% of those unexplained cases are due to repressed emotions," Mann says.
While memory repression allows people to survive childhood ordeals, protecting them psychologically and allowing many to grow into highly functioning adults, there's a cost, says Mann: "All this emotion that's been repressed -- and the repression goes on for so long -- puts people more at risk for ... physical consequences such as hypertension."
His theory, as revolutionary as it may be, is "perfectly consistent with psychoanalytic theory" that many people deal with traumatic childhood experiences by blocking certain emotions from their conscious awareness, he says.
Though there's been little research into the connection between repressed emotions and hypertension, studies have shown that people with unexplained pelvic pain are more likely to have been sexually abused as children, he says. "There are so many medical conditions where there's a suspected mind-body connection, where we've made very little progress in understanding the psychological connection and doing something about it," Mann says. "You can talk about migraine, asthma, fibromyalgia, chronic fatigue syndrome, colitis, where looking at the day-to-day stress people feel has not led to any answers."
Mann says that many of his hypertensive patients "grab the theory and run with it." Like Turner, many seek psychotherapy to deal with the experiences they have repressed -- and find that the episodes stop once they uncover the memories.
For others, "the impact is almost instantaneous," Mann says. "Just introducing the concept that past experience could be affecting their blood pressure, ... it is something that has never occurred to them. ... They're not psychologically healed, but just that shift in awareness can bring a dramatic improvement in their condition ... within hours, within days."
But not everyone with high blood pressure is open to a suggestion that repressed emotions may be causing the problem, says Mann. "It's too threatening, they're too resistant, and they won't even recognize that there is an emotional issue," he says. "Particularly if they went through a horrible childhood experience, I don't think they could deal with it. And if a couple of pills can cure their blood-pressure problem, why should they deal with it?"