Unexpressed feelings may produce physical tensions that cause or contribute to headaches, backaches, migraines, irritable bowel syndromes, chronic fatigue syndrome, allergic diseases (asthma,

Respants may feel unhappy or upset with doctors' interventions. For instance, respants often complain that doctors take too little time to listen to respants’ explanations of their problems, don’t actually listen to hear what might lie behind the problems, and prescribe treatments without adequate explanations. This is often experienced as an expression of uncaring on the part of the doctor. Respants may reject medical advice and ignore recommendations for treatment. It is estimated that half of medical prescription written go unfilled - a reflection of these sorts of problems.

Many people who come to doctors are not looking for treatment. They want to share their anxieties and learn whether a pain or other symptom is serious. As often as not, if they are simply asked, "What is your body saying with these symptoms?" they will be able to identify the underlying stresses that are contributing to or actually producing physical symptoms. Joe, who had severe migraines, responded, "My headaches come on towards the end of the weekend, as I start to think of going to work on Monday." Frieda, who had been suffering excruciating stomach aches for years, with occasional bloody stools, was scheduled for surgery to remove part of her bowel. She was startled to be questioned about why her guts were in such an uproar. No one had ever asked her to consider the stressors in her life and how she was swallowing down her feelings. Psychotherapy, relaxation and imagery exercises, and careful attention to her diet relieved her pains and made surgery unnecessary.

When frustration and anger is stirred and not resolved between caregivers on a therapeutic team, treatment also suffers. At the physical level, adrenaline levels rise when we are upset. While this is helpful if a tiger is attacking, it has negative consequences in a therapeutic setting. Adrenaline makes us more alert to deal with attack, but at the same time makes us more distractible, so that we can focus on any shift in the attack. In an office, anger can lead to unhelpful distractibility. Where emotions are unexpressed, staff get distracted more easily. This is when phone messages and medical records go astray. Psychological mischief may also intrude, with unexpressed feelings leading to unconscious or conscious manifestations of anger that are expressed through irritating behaviors, ranging from brusque or negative verbal and non-verbal interactions between staff, through passive-aggressive behaviors that release angers indirectly, and displacement of anger towards other staff and respants.

In a film featuring Danny Kaye, The Inspector General, there is a classic portrayal of such interactions. In the first scene of the sequence, the wife of the police chief berates and belittles him and stalks angrily out of his office. He chews out the first sergeant, who reams out the corporal on duty, who shouts at the patrolman who is leaving his office. This unfortunate officer, having no one lower on the totem pole to vent his angers on, storms down the stairs of the police station. Danny Kaye, an innocent bypasser, happens to be walking in front of the station at just that moment. The patrolman bumps into him and angrily shoves him into the gutter. Kaye, angered at his mistreatment, kicks at a passing dog.