Fibromyalgia, Boundaries and the Body: A Somatic Therapy Perspective

“When we have been prevented from learning how to say no, our bodies may end up saying it for us.”

Gabor Maté, When the Body Says No

In the UK I often see women being handed a fibromyalgia diagnosis after years of unexplained pain, fatigue and exhaustion. In mainstream research, fibromyalgia is described as a chronic primary pain disorder with no single cause, only clusters of symptoms. Scientists tend to focus on what can be measured like changes in pain pathways, brain signalling or immune responses. Because emotions like grief, anger or suppressed needs can’t be put under a microscope in the same way, they are often overlooked or spoken of cautiously.

Yet many women describe their lived experience very differently - years of not being listened to, feeling dismissed, or being told “it’s all in your head.” When a fibromyalgia diagnosis finally comes, it can feel like both a relief and a dead end like a label, but no clear treatment. This is partly because the medical profession doesn’t know the exact cause and so care often focuses on managing symptoms rather than healing root patterns.

Research is beginning to shift. There is growing interest in the role of stress, trauma and emotional suppression in conditions like fibromyalgia. Central sensitisation is where the nervous system becomes highly reactive and is now widely accepted as part of the picture. What’s still catching up is how much emotional life and unprocessed stress feed into this sensitisation.

This is exactly where somatic therapy offers another lens: not instead of science, but alongside it. It doesn’t deny the biology, but it asks the deeper question: What story is the body carrying that hasn’t yet been heard?

Guidelines in the UK (such as NICE) recognise fibromyalgia as a chronic pain condition. There’s no single test, the cause isn’t fully understood and treatment often centres around education, gentle movement, psychological support and for some, specific medications. Unlike in the past, strong painkillers such as opioids are now discouraged, as they tend to mask symptoms rather than address underlying patterns. Still, many women describe a long, frustrating path to diagnosis, ineffective treatment options and too often a sense of not being believed.

What I notice in so many of these women is a common thread: a lifetime of putting others first. They are the ones who never say no, who keep giving long after their body is crying out for rest, who hold everything together but rarely turn that care inward.

Somatic therapy offers another way of looking at fibromyalgia, not as something to endure silently, but as the body’s own language, showing us where emotional life has been suppressed and where boundaries have been crossed again and again.

Emotional Suppression and the Cost of Never Saying No

Every emotion is an event in the body. Anger, grief, even joy - they create sensations, chemistry, energy that is meant to move through us. But what happens when there’s no space for that movement? When saying no feels dangerous, or selfish, or simply not an option?

The body finds a way to hold it. Muscles tighten, breath shortens, digestion falters. Over years, this holding can become chronic pain, fatigue, inflammation, whcih is the body trying to digest what the mind has pushed aside.

Emotional Digestion: What the Body Does with What We Can’t Express

Every emotion has a beginning, a middle and an end. It rises in the body, peaks and when fully felt, it eventually subsides. This is our natural rhythm of emotional digestion.

But when emotions are not given space, when anger is swallowed, grief is hidden, or needs go unspoken, the body is left holding what the mind has pushed aside. It’s as if the digestive system of our emotional life gets stuck and like indegestion, it cuasing pain and discomfort.

Over years, this can build into tension, chronic pain and exhaustion. Fibromyalgia, with its wide constellation of symptoms, can be seen not only as a condition of the body but also as the residue of all those unsaid “no’s” and unmet needs.

Somatic therapy approaches this not with blame or pressure, but with gentleness. By slowing down and listening, we create space for those unprocessed experiences to complete themselves in the body, sometimes as movement, sometimes as tears, sometimes as a deep sigh of relief.

What John Sarno Got Right (and Where Somatic Therapy Goes Further)

Dr John Sarno, in his work on mind-body connection and chronic pain, recognised that pain is often the body’s way of expressing unacknowledged emotion.

His theory known as Tension Myoneural Syndrome (TMS) rests on the idea that much chronic pain is not caused by structural damage but by the mind-body connection:

• Repressed or unacknowledged emotions (especially anger, guilt, fear) create tension in the body.

• This tension leads to changes in blood flow and muscle activity, which then generate very real pain.

• In some cases, pain also functions as a distraction keeping difficult emotions out of conscious awareness.

Sarno saw conditions like fibromyalgia, back pain and tension headaches not as mechanical problems but as the nervous system’s response to hidden stress. As he wrote: “The unconscious mind would rather have us suffer with physical pain than experience emotional pain.”

Where somatic therapy differs is in the how. Rather than simply telling someone their pain is emotional, we invite the body to show us what has been suppressed. Through nervous system regulation, gentle awareness and emotional integration, protective patterns can begin to shift.

This isn’t about “thinking away” the pain, or about blaming the sufferer. It’s about giving the body the support it needs to release what it has been carrying — sometimes for decades.

“The unconscious mind would rather have us suffer with physical pain than experience emotional pain.” John E. Sarno

Somatic Therapy, Boundaries and Healing

Boundaries aren’t just about saying no to others, they are about saying yes to ourselves. They are how we honour our needs, our energy and our truth. For many women I meet, boundaries were never modelled as safe. Saying no might once have risked rejection, abandonment or even danger. So instead, the body learned to suppress and comply, even at great personal cost.

As Brené Brown writes “Daring to set boundaries is about having the courage to love ourselves, even when we risk disappointing others.”

This pattern reflects the a survival style when our earliest relationships didn’t feel safe or attuned, we adapted by disconnecting from our needs in order to stay connected to others. As adults, this can make boundaries feel unsafe, even though they are the very thing that allows for authentic connection.

Somatic therapy works gently with this history. It helps us notice the subtle signs of when our body is pushing past its limits, the tightening jaw, the shallow breath, the drop in energy when we say yes but mean no. These cues become invitations to respond differently, not with judgement, but with care.

Learning to set and hold boundaries is also nervous system work. When we can regulate, we feel safer to express ourselves. Over time, this restores a felt sense of choice and agency, qualities that fibromyalgia and chronic stress so often erode.

Self-healing doesn’t mean we never feel pain or stress again. It means the body no longer has to carry it all alone. With each small boundary honoured, each no spoken, each yes given to ourselves, the body softens and begins to trust that it no longer has to shout to be heard.

A Gentle Path Forward

If you live with fibromyalgia or chronic pain, it may be your body’s way of carrying stories and emotions that were never given space. It may be that your body has been carrying unspoken truths for years, holding the weight of every swallowed “no,” every silenced need, every moment where it wasn’t safe to be fully yourself.

Somatic therapy offers a way of listening to this language of the body without forcing or rushing. It’s not about erasing symptoms overnight, but about creating conditions where the nervous system can begin to trust safety again. Sometimes this looks like tears softening long-held tension. Sometimes it’s the quiet power of finally saying no. Sometimes it’s simply a breath that feels easier than the one before.

Healing is not linear, and it isn’t about perfection. It’s about restoring relationship - with your body, with your needs, with the truth that you matter.

If you’d like to explore this further, two books I often recommend are:

• When the Body Says No: The Cost of Hidden Stress by Gabor Maté

• The Body Keeps the Score by Bessel van der Kolk

  
  

Both are insightful reads that explore the intimate link between stress, trauma, the nervous system and the body’s symptoms.

So I invite you to pause for a moment and ask gently: Where might my body already be saying no, when I cannot?

If this resonates, you are warmly welcome to explore my work at HeartSomatics™, where together we can create a safe space for your body’s wisdom to be heard, honoured and supported.

Ready to go deeper on your journey?

Click here to Book a Cuppa (Free Connection Call) with Laura Starky

References:  NICE, Cornell Chiropractic, RACGP, ScienceDirect, PubMed