The origins of psychosomatic medicine were concerned with the relationship between one's method of anger expression and resultant blood pressure change. This literature has been controversial: some theorists proposed that expression of anger will relieve psychodynamic tensions, and possibly help the person gain insight; others have posited, in contrast, that such expression will tend to promote social discord. Both pathways are thought to affect autonomic arousal, which may lead to sustained blood pressure elevation. The literature suggests that an “anger-in” style tends to characterize persons with hypertension; however, the mechanisms by which such this may occur may lead to hypertension remain unclear. We have theorized that rumination about trauma-related events leads to sustained blood pressure elevations, and have supported this hypothesis in a series of empirical studies.
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