Secrets Keep You Sick: A Conversation with My Dad on 45+ Years of Being an LCSW

The conversation we won’t have is the progress we won’t make. 

It was a chilly, fall Sunday afternoon.  I was sitting in our family room, talking with my dad, Jim Schroeder, as he reflected on over 45 years as a licensed clinical social worker (LCSW).  With his Bachelor’s from Ball State University in 1975 and Master’s in Social Work in 1978 from IUPUI, he began his first job in Lebanon, Indiana before our family moved back to Evansville in 1980 when he took a position at the Southwestern Mental Health Center. 

Years later, still practicing in the field, he was working with a client who had been in therapy for over 16 years.  He asked her what was the most important thing she had learned from all this time in treatment.  She replied “Secrets keep you sick.” 

It was a moment he still recalls to this day, as those four words reverberated through decades of his own experience and insight.  He began to recognize the high price of keeping secrets, especially regarding chronic or intense circumstances.  Whether it involved trauma or pertained to difficulties in relationships or various types of insecurities, it seemed that in well over four decades of practice, the outcomes looked eerily similar.  The dis-ease stemming from a lack of effective communication regarding critical, life changing matters was, as he noted, creating just that:  disease.

For decades, research has indicated a clear link between adverse childhood events (ACES) and later medical conditions of various kinds.  Beyond just anxiety, depression, PTSD, and other psychological disorders, ACES have been linked to heart disease, diabetes, and cancer as well as smoking and alcohol/drug use.  Beyond the ACES themselves, certain features create added risk, two of which are the absence of transparency and effective treatment.  Said another way, when a person experiences painful, divisive circumstances, and healthy, collaborative means of healing aren’t utilized, mind and body often suffer in the process. 

The suffering isn’t exclusive to trauma.  As we talked more, Dad reflected on his own life, and the ways various factors, such as power differentials, personality, and family dynamics, often served to restrict an individual’s ability (or desire) to interact around issues that became the seed of lifelong insecurities.  The further an individual gets from authentic communication, and becomes committed to keeping a façade alive, the worse outcomes are.  Keeping a false image alive requires a lot of energy and focus—energy and focus that is not available for the pursuit of joy and fulfillment. 

Working in the chronic pain field since 2001, Dad noted the link between various types of pain, including stomach pain, and toxic environments that were often shrouded in secrecy.  He recalled a previous client who experienced severe digestive issues, which appeared linked to her experience as a young child growing up with a harsh, unforgiving father.  Sometimes, he noted, the most impactful secrets involve the environment in which someone lives, where three unwritten laws abide 1) Don’t talk about it 2) Don’t trust 3) Don’t feel.  Countless people find themselves in toxic circumstances that are not approachable. 

“Guilt, shame, and embarrassment are powerful emotions.” 

Over time, living and breathing a facade carries serious costs.  One of the biggest costs is a learned helplessness that develops from a simple, but powerful reality.  As Dad stated “The longer a person feels [something] without being able to act on it, the more likely action will never occur.”  The longer I go without being honest, the more stuck in a pattern I become. 

Discussing this further, Dad noted that the more the same events are recreated where there is a lack of communication and action, and a person’s authenticity is stifled, then the more likely this person is to develop serious psychological conditions (e.g., anxiety, depressive disorders), and chronic fatigue, tension, distraction, and sleep problems will set in.  This also becomes a primary driver of many unhealthy behaviors, such as substance abuse, overeating, pathological gambling, and pornography. 

All of this increases risk for two ultimate outcomes:  the loss of fulfillment and peace. 

As Dad and I wrapped up our conversation, he passed along a document highlighting 9 key lessons that he had learned in working with almost 1,500 chronic pain patients.  At the top of the document in bold, it read what had become a mantra for his work:  Therapy is a process of discovering ourselves and finding healthier tools for life. 

Contained in the document were 8 lessons and one final unfortunate realization for those who were never able to discover an authenticity that we all desire.  In reading the list below, I thought of the countless ways that we’ve all, including Dad, been impacted by these hidden but very real patterns in our lives.  It’s what makes mental health so challenging and yet so important.  There’s a home that lives inside of us, not unlike the one where we reside, which is in constant need of maintenance, repair, and updating.  It’s easy to see the walls, floors and windows that make up our exterior home, but it’s no less important to consider the interior abode that often has an even greater influence on our lives. 

1. Rejection/abandonment → leads to pain → feeling unwanted; thought of as unacceptable
2. When I ignore my emotions (e.g., disappointments), I feel more pain in my body.
3. Hidden confusions and uncertainties increase anxiety and lead to less sleep and more isolation.
4. Damaging selfless loyalty is a major factor to pain.
5. Relationships cause pain without communication, cooperation, compromise, commitment, and consideration.
6. Be true to yourself, or anxiety will overwhelm you and you will not get well.
7. A lack of understanding leads to tension, which leads to pain and other bodily dysfunction.
8. “If I don’t focus on my own emotional truths, my pain will increase.  And I will act old.”
9. “My whole life is a contradiction.”

Forty-five years since Dad began working, now in my own career as a psychologist, it is clear that there is no such thing as a disconnect between mind and body.  Just as a knee joint limited by movement and flexibility only increases the possibility of pain, so it is for our emotional state.  The more we find ourselves in rigid circumstances, where movement forward, or of any kind, is not occurring, the more likely distress, and dis-ease of all kinds will set in.