Are secretive people more or less healthy?

Also in this week's column:

• What is Alice in Wonderland syndrome?
• Can you really see the Great Wall of China from the Moon?
• How far can the naked eye see?

Are secretive people more or less healthy?

Psychological research shows that keeping secrets, especially distressing ones, can make the secret keeper sick. But we do not know if keeping a secret per se causes more illness symptoms or if it is something about the type of person who is secretive that tends to make them sicker.

For a century, psychiatrists, psychologists, and other clinicians have noted that patients often hold back important information from their therapist. This is so even if they want to get better and they know the therapist wants them to get better too.

This is called "self-concealment". The "self-concealer" keeps secrets that are perhaps too painful to recall, too stressful to reveal, or even too frightening to describe.

In On the Beginning of Treatment (1913), Sigmund Freud described the physical and psychological consequences of patients concealing information from the analyst.

It is now known that patients "self-conceal" in both long-term and short term therapeutic situations. And they keep both large secrets as well as small ones. Secrets seem to be of all kinds too. Judging from what patients do, more people are "self-concealers" than not. So it appears we humans are a very secretive lot - even with our own therapist.

Researchers have only recently begun to investigate how secrecy and nondisclosure can influence the therapeutic process and affect the patient’s physical and mental health. In 1990, psychologists Dr Dale Larson from Santa Clara University and Dr R L Chastain from Samuel Merritt College, both in California, reported in the Journal of Social and Clinical Pshychology evidence showing that "people who are high in self-concealment (i.e., the predisposition to keep secrets), as compared to those who are low in self-concealment, report having more physical and psychological symptoms".

Dr J W Pennebaker, a psychologist at the University of Texas at Austin and author of Opening Up: The Healing Power of Expressing Emotions (1997) proposed a three part theory for why secrecy seems to be harmful.

First, keeping a secret takes effort. Such inhibiting of behaviour requires the brain and body to work harder than it otherwise would. Second, when people cannot or otherwise do not reveal themselves, there is an increased probability of having obsessive thoughts developing around the secret. This also requires the brain and body to work harder. Third, conversely, the act of revealing "reduces autonomic activity".

So, the theory goes, telling a secret lifts a burden from mind, heart, and soul. Life is easier and the patient becomes healthier.

In 2000, Dr C E Hill and psychology colleagues from the University of Maryland at College Park observed in Psychological Bulletin that "secrecy may require considerable psychic energy which can leave the person with less energy to deal with other important issues". They also argued that secretive people "come to feel inauthentic, fearing that they are accepted only for the social mask they wear for their therapist". This too causes stress and stress causes illness.

But what of the question, is it keeping a secret per se or something about the type of person who is secretive that tends to make people sicker?

In the October 2006 Journal of Personality, Drs Anita Kelly and Jonathan Yip from the Department of Psychology at the University of Notre Dame in South Bend, Indiana, presented evidence showing that the process of keeping a secret predicts fewer symptoms, whereas the personality trait of "high self-concealment" predicted more symptoms. They put 86 volunteers through a battery of tests and arrived at this conclusion.

The next step for researchers is to tease out what is the personality trait of secretive people that tends to maker them sicker. In any case, Grandma was right. Make a clean breast of it to your therapist. It is good for you - and that’s no secret.

Stephen Juan, Ph.D. is an anthropologist at the University of Sydney. Email your Odd Body questions to s.juan@edfac.usyd.edu.au