Is physical illness in our communities the dark side of our ‘perfect’ appearance?

Firstly, what is psychosomatic illness? Psychosomatic refers to the relationship between our mind, emotions, and body. Where psychological (mind, emotion) factors influence physiological (somatic) states. When your emotional and psychological experiences are repressed this can lead to biological dis-ease. It’s your body communicating to you.

Some research has suggested that psychosomatic illness and symptoms are common amongst South Asian women (Hussain & Cochrane, 2004; Patel, et, al. 2008). A wider look at mental health literature amongst ethnic minority and south Asian populations paints a picture of great stigma around emotional and psychological distress, leading to isolation, shame and delays in seeking support (Patel, at, al. 2000; Moller et, al, 2016; Sadiq, 2019).

We could speculate that these aspects may be related to a cultural shadow.
What do I mean by ‘shadow’? The shadow is a concept from Jungian psychology. Like a human shadow, it is a darkened version of a person (institute/ group)  that lays opposite to the outward, visible entity. The shadow is always present but not really acknowledged. In our psyche, the shadow is largely unconscious and consists of all the parts of ourselves that are deemed unacceptable. They are parts that we, and others, would ordinarily feel ashamed of. But the more we ostracize these parts, the more fragmented we become because we are essentially denying a part (or parts) inherent to our self.

In the book ‘owning your own shadow’, Johnson (1991) talks about collective shadows and shadows of faith communities. As a Pakistani, Muslim woman, it got me thinking about the shadows of South Asian cultures and Muslim communities. A culture is made up of many individuals, each operating to some degree on the norms of that culture. Anything that falls outside of cultural norms is usually considered odd, strange, wrong or bad. Often resulting in shame.

In this view then, repression and suppression of emotions can be seen as a shadow of a culture that shuns emotional experiences. A culture that shuns emotional experiences, always gazing into a direction of positivity and gratitude, will create a shadow. And the more the shadow is ignored, the bigger it becomes. Suppressing emotions has an impact on the immune system, increasing vulnerability to ill health (Coughlin, 2007). The longer we continue to deny abuse, inequality, oppression and negative emotions that we experience, the more distance we create between our conscious and subconscious and increase our vulnerability to psychosomatic illness.

Let’s think about the ideologies of our communities. Although our belief systems and principles are there to provide a moral code, often stemming from a religious basis, the systems can be enforced in a very rigid way. Beliefs and ideas around being a ‘good Muslim’ or the ‘perfect Muslim’, ‘perfect child’, ‘perfect parent’, ‘perfect spouse’ etc. Beliefs and ideas around being strong, grateful and self- sufficient (except with God’s help). Within these narratives then, falling short of perfection, or not being seen as a strong person, a good Muslim etc. can create a sense of shame, disappointment, guilt, amongst other things. Rather than challenging these rigid ideals, it is more common for people to hide their shortcomings, to dismiss their struggles, to soldier on and pretend everything is good. All the while, underneath, the reality could be creating something sinister.

It is not the emotions themselves that put us at risk, but our defensive responses toward them (Coughlin, 2006). Our shadow will protect itself from being exposed, employing defences like projection, blame, judgement, abuse of power and adopting the victim role. All of these hide the root emotions as the shadow engages in self- preservation. It is a noble and courageous thing to begin facing yourself, peeling back the layers and really exposing the nasties that have been hidden away. But without engaging in this transformative process, the dark side continues to breed. We need to ask ourselves what are we keeping in the dark? What can we start facing and stop avoiding? What can we address in our lives that will break the cycle of suppression + shame <->  psychosomatic illness and lead to greater acceptance and healing.


Coughlin, D. S. P. (2006). Emotional processing in the treatment of psychosomatic disorders. Journal of Clinical Psychology, 62, 539- 550.

Hussain, F. & Cochrane, R. (2004). Depression in South Asian women living in the UK: a review of the literature with implications for service provision. Transcultural Psychiatry, 41, 253- 70.

Moller, N., Burgess, V., & Jogiyat, Z. (2016). Barriers to counselling experienced by British south Asian women: A thematic analysis exploration. Counselling and Psychotherapy Research, 16:3, 201-210.

Patel, S., Peacock, M. S., McKinley, K. R., Carter, C. D. & Watson, J. P. (2008). GP’s experiences of managing chronic pain in a South Asian community- a qualitative study of the consultation process. Family Practice, 25:2, 71- 77.

Patel, N., Bennett, E., Dennis, M., Dosanjh, N., Matitani, A., Miller, A., & Nadirshaw, Z. (2000). Clinical Psychology: ‘Race’ and ‘Culture’: A training manual. Leicester: The British Psychological Society

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