--- title: Self-Silencing Is Making Women Sick description: For women, being more disappointing could be a lifesaver, writes Maytal Eyal. canonical: https://time.com/6319549/silencing-women-sick-essay/ author: Maytal Eyal article:opinion: true article:content_tier: free article:published_time: 2023-10-03T11:00:00.000Z article:modified_time: 2026-08-04T08:03:32.812Z article:section: Ideas og:title: Self-Silencing Is Making Women Sick og:description: For women, being more disappointing could be a lifesaver, writes Maytal Eyal. og:url: https://time.com/6319549/silencing-women-sick-essay/ og:site_name: TIME og:image: https://static.time.com/v3/assets/bltea6093859af6183b/blt506d037266ca3486/698a40c622fb8533b1e2f1b6/anna_no.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 og:image:width: 2400 og:image:height: 1350 og:image:alt: anna_no og:type: article twitter:card: summary_large_image twitter:title: Self-Silencing Is Making Women Sick twitter:description: For women, being more disappointing could be a lifesaver, writes Maytal Eyal. twitter:image: https://static.time.com/v3/assets/bltea6093859af6183b/blt506d037266ca3486/698a40c622fb8533b1e2f1b6/anna_no.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 --- # Self-Silencing Is Making Women Sick > Sponsored content. 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It explains how TIME's journalism is made, from the first pitch through the editorial decisions behind a finished story or cover. #### How can I read about how TIME chooses its covers? Inside TIME is the newsletter where TIME's Editor-in-Chief explains cover selection and the editorial reasoning behind major stories. It is free at time.com/newsletters. #### Who is the editor of TIME? Sam Jacobs is TIME's Editor-in-Chief. He writes Inside TIME, a twice-weekly newsletter about the newsroom's reporting and editorial decisions. #### Is Inside TIME free? Yes. Inside TIME is a free newsletter, available at time.com/newsletters. A paid TIME subscription is separate and available at time.com/subscribe-agent. ## Video: Therapists Raise Red Flags About Using 'Therapy Speak' Online [Watch (HLS stream): Therapists Raise Red Flags About Using 'Therapy Speak' Online](https://cdn.jwplayer.com/manifests/oxvh4VUE.m3u8) (4:07)  _Published 2023-08-24. The classic vision of therapy revolved around a person on a couch, supine, tapping into their deepest and darkest hopes and fears. A modern-day remix might look like this: a person still on a couch, but at home, scrolling through a constantly refreshing selection of mental-health content on social-media platforms like TikTok and Instagram._ Oct 3, 2023 11:00 AM UTC  Illustration by Anna Parini for TIME by [Maytal Eyal](https://time.com/author/maytal-eyal/) ## Maytal Eyal Oct 3, 2023 11:00 AM UTC “Be more disappointing” is not a piece of advice most people would pay money to hear, but in my therapy office, it’s often the most valuable guidance I can give. My clients are mostly women, and nearly all of them struggle with a fear of disappointing others. Our culture rewards women for being perpetually pleasant, self-sacrificing, and emotionally in control, and it can feel counterintuitive for my clients to say “no”—or firmly assert their wants and needs. But my work is about helping them realize that their health might literally depend on it. Today, women account for almost[ 80% of autoimmune disease](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292717/#:~:text=Eighty%20percent%20of%20all%20individuals,sex%20chromosomes%20and%20hormonal%20changes.) cases. They are at a higher risk of suffering from[ chronic pain](https://www.iasp-pain.org/advocacy/global-year/pain-in-women/#:~:text=Female%20Pain%20Issues,-Pain%20conditions%20affecting&text=Research%20has%20shown%20that%20women,longer%20lasting%20pain%20than%20men.),[ insomnia](https://academic.oup.com/sleep/article/29/1/85/2708069?login=false),[ fibromyalgia](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6425926/),[ long COVID](https://www.cdc.gov/nchs/pressroom/nchs%5Fpress%5Freleases/2022/20220622.htm),[ irritable bowel syndrome](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175559/), and[ migraines](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704513/), and are twice as likely as men to[ die after a heart attack](https://www.healthline.com/health-news/why-women-are-more-likely-to-die-after-a-heart-attack#Heart-attack-symptoms-in-women). Women experience[ depression](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4478054/),[ anxiety](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3135672/), and[ PTSD](https://www.nami.org/Blogs/NAMI-Blog/October-2019/PTSD-is-More-Likely-in-Women-Than-Men) at twice the rate of men, and face a ninefold higher prevalence of[ anorexia](https://pubmed.ncbi.nlm.nih.gov/30593698/#:~:text=Anorexia%20nervosa%20%28AN%29%20occurs%20nine,with%20anthropometric%20and%20metabolic%20traits.), the[ deadliest](https://www.psychologytoday.com/us/blog/the-new-brain/201103/the-deadliest-disorder-0) mental health disorder. Why is it that women are falling ill to these diseases at a rate so much higher than men? Such jarring disparities cannot be accounted for by genetic and hormonal factors alone; psychosocial factors play an important role as well. Specifically, it seems that the very virtues our culture rewards in women—agreeability, extreme selflessness, and suppression of anger—may predispose us to chronic illness and disease. **_Read More:_**[_The Case for Mediocrity_](https://time.com/6314076/case-for-mediocrity/) ### More From TIME In the late 1980s, Harvard-trained psychologist Dana Jack identified a recurring theme among female patients suffering from depression: a tendency to self-silence,[ defined](https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=8fc0e564aec17bf8b705635a057f40b7b8505f2a) as “the propensity to engage in compulsive caretaking, pleasing the other, and inhibition of self-expression in relationships in an attempt to achieve intimacy and meet relational needs.” Through [longitudinal research](https://blog.oup.com/2010/03/silencing-the-self/), Jack found that this learned behavior, strongly rooted in gender norms, was linked to an increased risk of depression. Since then, considerable evidence has revealed that female self-silencing isn’t just tied to psychological issues like depression and[ eating disorders](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2247456/), but also to physical illness. For instance, in March of 2022 a team of researchers at the University of Pittsburgh[ discovered](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8887577/) that women of color who strongly agreed with statements like “I rarely express my anger to those close to me,” were 70% more likely to experience increased carotid atherosclerosis, a cardiovascular plaque associated with higher risk of heart attack.[ Other studies](https://journals.sagepub.com/doi/pdf/10.1177/0020764018814271) have connected self-silencing to irritable bowel syndrome, HIV, chronic fatigue syndrome, and cancer among women. Most jarringly, women’s self-silencing has also been linked to higher risk of premature death. In one[ study](https://books.google.com/books?hl=en&lr=&id=Y39MCAAAQBAJ&oi=fnd&pg=PA399&ots=I5TNawDl1c&sig=PeEfN939i55wkneI%5FJ6YSTb6KbI#v=onepage&q&f=false), researchers followed nearly 4,000 people in Framingham, Massachusetts over 10 years. They found that women who didn’t express themselves when they had fights with their spouses were four times more likely to die than those who did.[ ](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3939772/)This was true even when factors such as age, blood pressure, smoking, and levels of cholesterol were taken into account. When women push their feelings down and cast their needs aside, their health suffers. But it can be difficult for women to do otherwise in a culture that celebrates these self-silencing practices. While young women are praised for “being chill,” moms are revered for being painstakingly altruistic to the point of self-abnegation. These unspoken standards establish a vicious cycle. For many women, it feels easier—beneficial, even—to silence their needs at the expense of their own health, rather than swim against the prevailing cultural current. In his best-selling book,[ _The Myth of Normal_](https://drgabormate.com/book/the-myth-of-normal/), physician and author Gabor Mate writes that many of our society’s most “normalized ways of being”—the qualities we regard as “admirable strengths rather than potential liabilities”—are, in fact, incredibly toxic. “That ‘not listening to self’ in order to prioritize others’ needs is a significant source of the health-impairing roles women assume,” Mate explains. “It is among the medically overlooked but pernicious ways in which our society’s ‘normal’ imposes a major health cost on women.” It seems that the virtues of womanhood are not really virtuous after all; instead, they are wreaking havoc on our bodies and our health. And the way they often do so is through these seemingly “normal,” daily experiences that slowly, over time, chip away at our vitality and erode our well-being. My clients tell me things like, “I don’t deserve to put my needs first. I’m not the breadwinner,” or “I said ‘yes,’ even though I didn’t want to.” In their gradual attempt to be what society considers “good,” they run the risk of compromising their health. As a psychologist, it can sometimes feel challenging to help my clients take back their emotional and physical health when they are contending against a complex cultural system that is reinforcing them to do the opposite. However, I have found that there are some tangible changes that really do, in practice, make a difference. It can be paradigm shifting to understand that behind every emotion exists a need. Anger, for example, can signify the desire to change our current circumstances. Rather than women treating our emotions as inconvenient, bodily malfunctions best to be muted and ignored, we can teach ourselves to view them as windows of insight. Instead of casting away our anger, a valuable question we can ask ourselves in moments of frustration is: what am I needing right now? Another practice, closely related, is boundary setting. For women, who have been unconsciously taught to view our likability as our greatest asset, boundary setting can often feel counterintuitive. Many of us fear that if we honestly communicate our needs and limitations, this will threaten our relationships. But it’s the contrary that’s true: when we set heathy boundaries (rather than toxic ones that can lead to [radical individualism](https://time.com/6271915/self-love-loneliness/)) our relationships actually become stronger and healthier. And having healthy relationships is integral to our physical well-being; one [meta-analysis](https://pubmed.ncbi.nlm.nih.gov/20668659/) showed that people with more supportive social relationships have a 50% lower risk of premature death. To reshape the virtues of womanhood, a new “normal” needs to emerge—one in which we honor our emotions, prioritize our needs, and actively communicate our boundaries. Such a shift requires change on both the individual and societal level, and will by no means by easy. But it’s certainly worth it—after all, women’s lives depend on it. ## Transcript For mental health issues you might be avoiding right now. One, you don't have the life you had before the pandemic. You never will again. When the pandemic was happening and everyone was experiencing lots of like mental health issues, it put a spotlight on mental health creators that were posting online. You can't love someone else until you love yourself as bullsht. Because one end implies that people with low self-esteem or mental health issues are incapable of loving others. Just so. With that, I have a disclaimer on my, you know, TikTok and Instagram that this is not therapy or my mental health pics are not specifically tailored to you. Sure, I'm a licensed therapist, but I'm not your lessons therapist. All the online spaces where I share content. Yes. Even those livestreams where you shoot me questions are not therapy sessions, so I want somebody to like taking my content and then think about it and analyze it. Therapy speak is a new way of saying psychobabble. They're usually more like vulnerable words that talk about like the primary emotions that you're experiencing. But there's other ways that people are using that language, hurt people or manipulate people or control people or sort of like shut down conversations. There's a difference between selfishness and grandiosity and narcissism. It's very rare that you would be diagnosed with a narcissistic personality disorder. They tend to believe everything is everyone else's fault, and it comes out of early childhood. There is a stage of development where your ego is separate from other people's ego, and you're able to see that both of those are important. Something is wrong and that development and it leads someone having a really hard time seeing other people's needs as important as their own. Gaslighting is a pretty popular term these days, and what it means is somebody is trying to manipulate you into believing in a reality that's not true. But sometimes people are like, What? You're disagreeing with me. You're not validating my experience, you're gaslighting me, which is not actually what they're doing. So if you say that somebody is a gaslighter, that can be like a pretty incendiary accusation. You and I think that everybody should clearly express what their boundaries are in relationships. It's sort of like a blueprint that you'll offer somebody. So a healthy boundary that somebody might create is I'm not going to continue talking to you if you start to yell at me a different way to use boundaries. That's not exactly correct is to try to control somebody's behavior and manipulate somebody's behavior. You're allowed to say, I don't want to go to dinner, right? That's a boundary. But to be like, you know, well, I'll go if you go to this kind of place, but I'm not going to go if you go to this kind of place and you can't tell me, I can't because I'm allowed to set boundaries. Right. You're now like over stating it. Five small but very brave green flags in a relationship. One you sense their connection with you throughout the day. We keep talking for decades and decades and decades in the field of how we can improve mental health. And the reality is, is that the way you improve anything is with education. Therapists and Instagram and YouTube could do a better job at verifying their licenses and degrees and trainings that therapists have. And if therapists and mental health professionals didn't have to talk about things in coded ways like eating disorders or social justice or anxiety or depression or suicidality, then I think that there could be like some really good education happening online. ```json [{"@context":"https://schema.org","@type":"OpinionNewsArticle","@id":"https://time.com/6319549/silencing-women-sick-essay/","mainEntityOfPage":{"@type":"WebPage","@id":"https://time.com/6319549/silencing-women-sick-essay/"},"headline":"Self-Silencing Is Making Women Sick","datePublished":"2023-10-03T11:00:00.000Z","dateModified":"2026-08-04T08:03:32.812Z","description":"For women, being more disappointing could be a lifesaver, writes Maytal Eyal.","url":"https://time.com/6319549/silencing-women-sick-essay/","keywords":["Psychology","freelance"],"thumbnailUrl":"","author":[{"@type":"Person","name":"Maytal Eyal","jobTitle":null,"url":"https://time.com/author/maytal-eyal/"}],"articleSection":"Ideas","image":[],"publisher":{"@type":"Organization","name":"Time","url":"https://time.com/","logo":{"@type":"ImageObject","url":"https://time.com/images/logo.png","width":528,"height":156},"foundingDate":"March 3, 1923","sameAs":["https://www.facebook.com/time","https://www.instagram.com/time/?hl=en","https://twitter.com/time","https://www.pinterest.com/timemagazine"]}},{"@context":"https://schema.org","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"item":{"@id":"/section/ideas/","name":"Ideas"}},{"@type":"ListItem","position":2,"item":{"@id":"/tag/psychology/","name":"Psychology"}},{"@type":"ListItem","position":3,"item":{"@id":"https://time.com/6319549/silencing-women-sick-essay/","name":"Self-Silencing Is Making Women Sick"}}]},{"@context":"https://schema.org","@type":"VideoObject","name":"Therapists Raise Red Flags About Using 'Therapy Speak' Online","description":"The classic vision of therapy revolved around a person on a couch, supine, tapping into their deepest and darkest hopes and fears. 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