By Moushumi Ghose, LMFT
In my years of working as a sex and relationship therapist, I have sat with a large number of people navigating chronic symptoms — fatigue with no explanation, pain that moves around and lingers years after an injury, libido that just disappeared, a brain that feels foggy.
These are not small complaints. They are life-altering. And what has struck me, again and again, is how often these symptoms arrive together in people who are also struggling to get some need met.
“When we consistently set aside our own needs — the body often begins speaking the words our voice could not.”
THE BODY SPEAKS THE TRUTH
This is not a new observation — though it is worth noting that some of the most important voices come from outside the mainstream.
Resmaa Menakem, a therapist and cultural practitioner whose work centers racism and intergenerational trauma, writes about how unprocessed pain does not stay in the mind. It settles into the body, into muscle and bone, and it can pass through generations. His framework reminds us suffering in the body is not just individual but something shaped by history, culture, and systems of oppression.
Joy DeGruy’s work on Post Traumatic Slave Syndrome— documents how the chronic stress of oppression, across generations, produces a specific set of physical and psychological symptoms in Black communities. The body, holds not just personal experience but inherited experience.
And adrienne maree brown, writes from a Black feminist framework, remind us to center pleasure, rest, and intuition as forms of resistance — and to ask why so many of us have been unable to access them.
What these thinkers share is an understanding that self-abandonment is not simply a personal psychological habit. It is something many people — women, queer and trans folks, black and brown specifically — have been structurally conditioned into for generations.
Conclsion: A body that cannot get what its needs did not arrive there on its own.
THE PATTERN I SEE
In my practice, I have observed a consistent theme: people who are highly attuned to their partner’s needs, who find themselves as peacemakers or accommodators, making concessions over and over and/or who have difficulty asking for and getting what they want — are also, often, experiencing persistent physical symptoms that medicine has struggled to explain or resolve.
I want to be careful here, because correlation is not causation, and bodies are complex. But I also think it is worth asking: what if some of what we feel or are calling chronic pain, or auto immune is the physiological expression of years spent running on empty? What if some of what we feel in our skin, muscle, bones is resentment that has never found a way out of the body? What if the libido that has “just disappeared” is actually just our inner self withdrawing from a situation it doesn’t feel truly unsafe in?
These are not rhetorical questions. They are clinical questions I find myself returning to and they continue to change how I view our work.
“What if the libido that has ‘just disappeared’ is actually just your inner self withdrawing from a situation it doesn’t feel truly safe in?”
GUILT, RESENTMENT, AND THE COST OF SELF ABANDONMENT
Two emotions show up in this work more than any others: guilt and resentment. They are often inverses of each other. Guilt says, I should not want this (thing I want.) Resentment says, I keep giving too much and receiving too little in return.
When neither can be expressed — because maybe the relationship does not feel safe enough, or because self-expression has simply never been practiced we experience what can be considered a form of self abandonment.
And, those emoions don’t just disappear, because we did not express them, they tend to go somewhere.
The body.
How does the body speak? Pain. Inflammation. Illness? Maybe so.
This is just an invitation to explore the relationship between what you hold in emotionally and where it goes.
THE METABOLIC LAYER
There is one more layer I want to add, because it shows up in my own life and because it has become increasingly relevant in my own understanding of how bodies work. Chronic emotional stress dysregulates cortisol. Dysregulated cortisol disrupts blood sugar. Disrupted blood sugar worsens systemic inflammation. Inflammation amplifies pain, fatigue, and cognitive fog.
In other words, the emotional and the metabolic are not separate systems. They are in constant collaboration. I have watched people do significant work in therapy — finding their voice, restructuring the terms of their relationships — and still feel stuck, because the body’s baseline state of inflammation can keep us stuck physically and make everything harder.
I know because I’ve struggled with inflammation and chronic pain myself.
And I have seen the opposite too: people who addressed their metabolic health finding that the emotional work became more accessible and sustainable.
Stewart Copeland, drummer for the band The Police once said, he was doing everything in his power to improve his life, his relationships, but nothing worked. It wasn’t until he quit the alcohol that things got better.
It’s kind of the same concept. If we’re not taking care of our physical health, but you’re just working on our mental health, we’re not looking at the whole picture.
And as I continue to work on healing my own chronic pain, inflammation and auto immune issues and experiencing more holistic healing, whole-body healing I’m now wanting to ask the questions for my clients.
Because. All parts matter and deserve our attention. And I truly believe that all of it is interconnected.
So here’s a prompt if you wish to explore this further for yourself.
Prompt: Is there something in my life that my body might be holding onto?
A note: I speak from part personal experience, part clinical observation and from existing literature in somatic psychology. None of this is meant to diagnose. I have watched myself and many clients spend years seeking answers from a medical system that was not asking the right questions. I encourage clients to get informed, so they can advocate for themselves and start asking more questions. I think we should all do the same.
Many of our sex therapists and relationship coaches also incorporate somatic work -integrating mind and body. Please inquire if this is of interest to you.
Mou (pronounced Mo) is licensed sex therapist, sex-positive advocate, the founder and clinical director at Los Angeles Sex Therapy (LAST Collective). She is also the creator of the Pleasure Psych Sexology Training Certification for aspiring sex educators, therapists and coaches.
Mou’s passion is around advocacy and change by breaking down barriers for better relationships and sex. Mou specializes in couples sex therapy that is trauma informed with an emphasis on emotion focused and somatic work and which integrates other modalities as needed which are tailored to her clients needs. She has extensive experience both personal and professional with LGBTQIA, Kink, Ethical Consensual Non Monogamy (ENM/CNM), Polyamory, BIPOC.
She is the author of several books, has appeared in the media and numerous publications. She is the creator of a documentary film series Temple and Brothels undoing harmful messages around sex, and sexuality.
Mou is currently accepting clients in her sexuality program: The Desire Formula, which is a group/team program spearheaded by Mou and includes wrap around services from her team.
You can learn more by watching Mou’s free training: Watch Mou’s Free Training on Sexuality in Relationships