My brother is a retired pediatrician. During his career he was often asked, “Are you nervous, Doc?” “Nah. It’s called familial tremor,” he’d say, his hands shaking as he placed the stethoscope over the child’s heart. No doubt his tremor was a source of embarrassment, as he weathered the odd glances and false assumptions even from his medical school instructors. He laughs about it now, but underneath his upbeat attitude, I sense his years of struggle in living with this visible condition.

Each medical condition or illness has its own set of challenges, including the visibility or invisibility of what the body must deal with. As someone who developed an autoimmune disorder, I became acutely aware of the challenges of a mostly invisible illness. I felt ill, but looked great! In cases like mine, it can take years for doctors to take a person’s symptoms seriously and begin to investigate.

For those with tremors, though, the condition is visible, and one must repeatedly experience the suppositions of others. They may make interpretations and assumptions about visible tremors — wondering if the person is “nervous” or even a drug addict — which can create more stress than the actual condition. From mainstream medical journals to patient support groups, it is understood that while stress is not the primary cause of many medical conditions, it often makes symptoms much worse.

For this reason, it’s important to realize that self-judgments and perceived judgments of others generate stress and can be detrimental to your health. Self-judgments can include thinking that you are “damaged goods,” “not good enough,” or “a loser.” When chronically present, these beliefs are especially potent in their toxicity. Those who work in the field of psychoneuroimmunology and its practical application, Mind-Body Medicine, know that such negative beliefs generate pro-inflammatory biochemical reactions that affect the nervous and immune systems, often making the illness worse.

Each one of us inherits a set of genes through our biological parents, making us prone to specific diseases and medical conditions. We cannot change our DNA, but what we can change is our environment, both internal and external. In this way, the expression of disease-causing genes has the potential to be altered. Mind-Body Medicine helps people evaluate what is possible to change and gives them tools to do it. It also challenges people to think differently, find their strengths and lead empowered lives.

A competent and compassionate mind-body medicine physician, healing practitioner or psychotherapist, trained in mind-body interventions and energy psychology, is a wonderful resource. Everyone with a chronic medical condition or illness needs to be proactive in creating their own internal healing environment.