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The pain is real, and it is physical. The majority of women I spoke to were able to describe how silencing impacted them physically. Before everyone begins to assume that silencing and disease in some regions of the body are directly correlated, let me clarify that I never had two participants explain their physical symptoms in the same way. Instead, I saw patterns. The pattern was breath, digestion, and overall body pain.

I did not lead women to these answers. As a researcher, my job is to ask open-ended questions and see what emerges. So, for instance, I asked, “How did feeling silenced impact you physically?” Here are some of the things I heard that were specific to breathing or the throat.

“My throat would constrict in situations like that. That’s a real interesting physical response to silencing when your voice doesn’t come out,” said an education executive.

A highly accomplished attorney told me, “I hold the pain in my throat, right here [pointing to her voice box], and I try to keep my voice even; I try not to cry.”

Another executive in healthcare said, “[gasp] Oh, I get that Globus Hystericus. It is painful—it is chest and throat. I mean, it just hurts. It’s funny that it hurts physically. It’s the weirdest thing.”

Let me pause here and talk about this Globus Hystericus, which is the medical definition of having a lump in your throat. The “lump” in most cases is not physical; it feels like a lump, but there is nothing actually there. If there is a palpable lump, it is often mucus that is cleared with coughing. The fake lump is emotion causing a genuine impression of physical swelling or tightening in the throat or chest. Romance authors love to describe the groom as having this sensation. He waits for his bride to walk down the aisle, and his eyes well with tears as he swallows the lump in his throat upon seeing his soulmate make her way toward him. I have never read a book that said the groom had to gulp his Globus Hystericus, or if we are literal—his glob of snot.

This Globus, otherwise known as a globe or sphere, can be painful. It can sit precisely in the spot that our vocal cords reside and if we feel psychologically silenced, it makes sense that this part of the body might experience a physical manifestation. However, this is not the romantic phenomenon we experience at weddings. For some women, this can be a painfully regular and consistent occurrence in the body.

If an aching lump in the throat is at one spectrum, the other end holds things such as severe bronchitis, pneumonia, mononucleosis, tracheal stenosis, thyroid disease, and various respiratory ailments. We have to remember that two essential bodily functions are reliant on the small channels in our neck. We swallow food, and we breathe air. If we hold stress in that part of the body, we are likely to experience some adverse impact with those functions. Another participant, who is a hospital CEO, shared this regarding her issues with breath.

I still get it; it’s when I’m stressed. And I have asthma, so I always wonder when I lay in bed, is this asthma? I can’t take a deep inhale, and so I went in to see my physician, and he said it was stress. When I felt trapped in that [silencing], one of the physical manifestations was my body just wasn’t even functioning right.

I had one particular participant who was an executive in finance talk to me about how silencing would literally take her breath away. It was incomprehensible that her peers could treat her with such disdain or with such marginalizing behavior. She explained that not only did it feel like a punch to the gut, it also often felt hard to breathe. She would catch herself engaging in shallow breathing and had to remind herself to breathe deeply. “I always felt winded.”

As I author this book, I am cautious about sharing too much of my own story because I want it to be about the research. However, as a leader, I also wrestled with breathing when I was in the height of my silencing experience. At the time, I did not have the label for “silencing.” I just knew I was suffering from a lot of psychological stress and did not feel I had a voice that was valued. The specifics of my story are not necessary; in many ways, they are similar to the women I interviewed and will be comparable to my readers. I had a professional relationship that silenced me.

Amid that silencing, I found myself constantly breathless. At times, I literally could not catch my breath to speak, and I was not exercising at these moments to explain the sensation, nor was I overweight or diagnosed with anything specific to explain it. This breathlessness became difficult for me as I was in a position that required public speaking and the ability to project my voice. However, I could not do it without severe pain in my trachea or chest, and taking a deep breath was an effort—it was hard to get air in and even harder to exhale it out.

I was misdiagnosed three times. First, I had an allergist tell me it was seasonal allergies and to take a pill. Second, I had a different physician hypothesize that I had most likely developed adult asthma and to use an inhaler. Last, and my favorite, I had a primary care doctor tell me I was probably suffering from anxiety and to take a different medication. I knew in my gut that none of those things seemed accurate, but to be honest, I felt ashamed to keep pressing for answers. What if the physical pain was just pretended? I honestly did not know what to do with myself.

After almost two years of this, I finally had a conversation with an emergency room doctor, who was also a colleague and he ordered a CT scan. It took me using my privilege in a system that is not always designed to work on behalf of people who cannot quite explain their pain or symptoms in textbook terms. I had to call in favors and leverage relationships. I realize now that without relying on those connections, I have no idea what might have happened.

The test results showed it was not allergies, asthma, or anxiety. I had idiopathic subglottic stenosis (I.S.S.). In standard terms—my trachea was filled with scar tissue for no darn good reason. I had never had a breathing tube or a tracheotomy, two things most likely to cause the severe scar tissue found in my throat. When I met with the surgeon who would perform several of the needed surgeries to open up my airway, he said to me, “Girlie, I’ve got good news and bad news. The good news, God gave you an hourglass figure. The bad news, he stuck it in your trachea.”

My condition is so rare, it is almost always misdiagnosed. Also, interesting to note, it is scarce for a man to have this same condition. It is primarily something that only women over the age of forty experience. The most recent statistics I have seen suggest 1 in 500,000 women are diagnosed with I.S.S. each year. There is no cure for this condition, just surgical interventions to maintain the airway.

There is not a correlation I can declare between I.S.S. and feeling silenced, and yet I cannot help but wonder about my silencing and my physical condition. I have had seven surgeries since I was diagnosed. Despite having a healthy voice and a complete recovery from feeling silenced, my body has not fully recovered, and I will most likely experience regular surgeries for the rest of my life. Cheryl Glenn’s words in her book Unspoken, as haunting and accurate as they are, continue to remind me: “The relationship of language—and silence—to deprivation is profound. What happens when one needs to—or should—speak and is cut off from the possibility of speaking? What kind of deprivation does the silenced body experience?”^[3]

Aside from the respiratory issues that women may experience when they feel silenced, another large group of participants explained how their digestive tracts were severely challenged as well. On one end, I heard things like weight gain, stress eating, or loss of appetite. On the other severe side, I heard things like ulcers, acid reflux, stomach tears, reconstructive surgeries, and heavy doses of medication.

A professor at a private college said, “I feel [silencing] in my gut. I feel it from my solar plexus down to my intestinal tract, and I can feel it tighten up.”

An executive who performed professional services for the education industry stated,

I started having really severe stomach pains, to the point that they were running all sorts of different tests, and it ended up primarily being just really, really, really severe acid reflux, and a couple of other things that I was able to get under control. But just so much constant pain in my stomach.

An attorney told me, “I was having physical problems. I had ulcers. I was a wreck.”

We have all had those moments in life when our systems do not operate correctly. Sometimes we literally lose our shit! However, when women are consistently and severely silenced over a period, the stomach and intestines can become permanently damaged. We can easily explain away our symptoms as part of growing old or repercussions of poor food choices, or we can begin to recognize correlations between when we feel we have agency and voice versus when we do not. Often women described shifts happening in the body during the same period they began to feel silenced in their leadership. In some cases, they recover their voice and body. In other cases, the physical problems continue long after the silencing ceases.

The last category of physical pain is what I am calling overall body stress. Women described a tightness or heaviness in the body. If they were carrying a heavy psychological load, their bodies, shoulders, necks, and feet felt it as well. Sometimes it was an unusual but specific symptom, such as an eye twitch that never healed requiring a new eye prescription. Or a stutter they developed in their speech during times of silencing. One even talked about grinding her teeth so hard, she broke three and needed a night guard. Other times, women described the pain in generic ways such as how they were in constant need of a massage because their shoulders were always scrunched up next to their earlobes or they would have chronic tension headaches and migraines. One participant said this:

At one point I had to go to the doctor because I was having trouble concentrating and focusing, and I had headaches, and don’t laugh, but I had to hold my head up when I talked to people because I was so stressed out, and that’s when I went to the physician, who said, “You are suffering from major stress,” and of course he told me to get another job, which wasn’t possible. I’m the support for my family—financial support.

An executive director in nonprofit gave this specific example when I asked her to tell me how feeling silenced impacted her in a physical way.

“Very stressful. Very stressful. I manifest my stress by overeating, and I feel it. . . . I see a chiropractor three times a week. A lot of pinched nerves, a lot of joint issues. Those sorts of things.”

I then asked, “Where in your body, were you most impacted?”

She replied, “Probably in the nerves here in my neck through my hands. I was fighting numbness in my hands a lot. During that period.” She went on to tell me the pain lasted a good eighteen months.

Over 75 percent of the women I spoke to describe changes to their bodies during episodes of feeling silenced. There are too many examples or specifics to list in this chapter. However, the primary categories of physical pain manifested in the respiratory and digestive system, along with full-body stress.

It is essential to not just focus on the physical pain that the silencing virus can cause. There is also the issue of psychological illness. Chapter 2 covered some of the emotional issues a silenced woman may live with, but the summary may not do justice to the things I heard women say. They suffered, and still suffer, forms of extreme exhaustion and emotional distress. This is often the hidden pain no one sees.