11/01/2026
The Double Bind: Choosing Between Stability Or Equality In Your Relationship
Why the โBe A Bitch Or Get An Autoimmune Diseaseโ meme went viralโand why it might not have to be so binary
After presenting Friday and Saturday at Mile Hi Church in Denver, Jeff and I are returning home from the first leg of our book tour for RELATIONSICK: Why Putting Yourself Last Is Destroying Your Health-And How To Heal. I was just sitting down at the Denver airport to write about one of the clinical case studies from our book when I laughed out loud while reading the title of Celeste Davisโs latest Substack essay: โBe a bitch or get an autoimmune disease.โ Thems the choices ladies. Celeste writes heartbreakingly about the countless ways women twist ourselves in knots to figure out how to get our own needs met without upsetting everyone else. Yet, there can be a physical and psychological toll for women who try that hard to be that nice.
I so appreciate the work of Celeste Davis. Celeste, Terry Real and I were scheduled to do a webinar together right after I wrote the viral essay about Deepak Chopra in the Epstein files. But it got cancelled when Terry got sick and was never rescheduled, which bummed me out, because I was really looking forward to hashing out some of the issues around patriarchy, relationships, and abuses of power with two badasses who both teach about deconstructing patriarchy. Because, from my OB/GYN physician point of view, deconstructing patriarchy is an absolutely essential aspect of womenโs health.
While โBe a bitch or get an autoimmune diseaseโ might not be entirely scientifically or psychologically accurate, letting a man walk all over you, pretzeling yourself to please a man, silencing yourself when heโs upset you, suppressing your anger rather than using it to fuel healthy boundary-setting, saying yes when you mean no, forgiving him even when heโs not remorseful or planning to stop, and letting him off the hook in the name of โunconditional loveโ is very likely to chronically dysregulate your nervous system, interfere with immune function, activate your hypothalamic-pituitary-adrenal (HPA) axis, and lead to chronic inflammation. And when you marry that with other predisposing factors, like genetic susceptibility, environmental factors, nutritional influences, and social determinants of health, relationsickness is a real medical risk.
After listening to a Mormon life coach respond to countless ways women seek advice about how to solve their own problems without upsetting anyone else, Celeste wrote about the kinds of questions she heard these well-intentioned Mormon women asking:
โHOW DO I FIX MY PROBLEM WITHOUT INCONVENIENCING ANYONE?
โ> How do I ask my husband to help more without making him mad?
โ> How do I deal with my mom hurting my feelings without hurting her feelings?
โ> How do I decline going on the family vacation without disappointing everyone?
โ> How do I limit my teenโs phone usage without them fuming at me?
โ> How do I get the support I desperately need without inconveniencing anyone?
And I get it. Trust me, I get it.
Iโve been these women. I AM these women. They are me and I am them. I so want for there to be a way for me to honor my own desires without anyone being mad at me.
Wouldnโt that be amazing? A world where I can stand up for myself and everyone still likes me and no one judges my decisions or is inconvenienced, disappointed, or upset?
A gal can dream.โ
She also quotes an article from Nod Mag.
โWhy do women need a medical justification to advocate for themselves in the first place? Why is โset boundaries because you deserve respectโ somehow less persuasive than โset boundaries or your immune system will attack your thyroidโ? The internet has wrapped a fairly ordinary piece of life advice in the language of disease because, consciously or not, many women still feel more comfortable defending their needs when they come with a doctorโs note.โ - Sheya Kurian, The Nod Mag
An Unsolvable Bind
A part of me felt my heart sink reading those questions and Celesteโs take on how the life coach makes millions by telling these women they just need to change their perception of these situations, rather than changing their circumstances. Those questions reminded me of all the questions people have asked me in LOVE SCHOOL and other relationship programs Iโve taught over the years. Now that Iโm on a book tour, women continue to ask questions just like this.
We so desperately want to believe that someone has a way to resolve this double bind, that someoneโs advice will finally give us the golden ticket so we can have both equality in our relationships with men and also stability, happiness, and love.
Wouldnโt it be nice if every request for equality in domestic or emotional labor, for mental load and the tedium of managing daily life outside of our workplaces didnโt result in a fight? If we could just respectfully ask for what we need and have our requests at least respectfully heard, without a fight, and negotiated if need be. If we didnโt feel like we have to mother our adult partners like theyโre entitled, rebellious teenage boys? Wouldnโt it be nice if our partners understood the need for equality as much as we do and actually wanted to do the hard work of figuring out how to create equal relationships where power, labor, and responsibilities are divided fairly? Wouldnโt it be nice if we didnโt think of ourselves as selfish bi***es when we do what we need to do in order to heal from the chronic nervous system dysregulation caused by unequal, unbalanced, or narcissistic relationships?
A gal can dream.
The Double Bind Women Face
Yet as Celeste so eloquently (and painfully) point out, women are faced with an impossible bind. Celeste writes:
โThe truth is the answer to these daily decisions of โwhen do I accommodate myself and my desires and when do I prioritize those of others?โ are not easy or clear cut. There are no solutions, there are only trade offs. We must proceed with a great deal of self-compassion for the double-bind we are in.โ
Ouch. Ouch that so many of us have to choose between marital stability and relational equality. I have refused to give up on my fight for equality in my own romantic relationship, and what that means, in actuality, is a lot of fighting and weekly couples therapy for the past five years. To his credit, itโs also required Jeff to be willing to go to the mat on the regular to hash out what equality actually requires, even though he doesnโt always like it. Thank God for our Terry Real-trained RLT therapist who goes to the mat with us and fights for us, relationally. We wouldnโt have been able to write the book without that weekly battle between stability and equality.
I get why some feminists quit fighting for actual equality. Itโs exhausting. The emotional labor it takes to keep fighting for equality takes a toll. But not fighting may take an even more devastating toll. Not fighting for equality could contribute to a cancer diagnosis. Or an autoimmune disease. We could get relationsick.
Iโm very familiar with the medical reasons women would relate to the โBe a bitch or get an autoimmune diseaseโ meme, and Jeff and I have written a whole book about how this can actually happen, not just with autoimmune conditions, but with many different kinds of medical illness, including cancer. Still, reading Celesteโs essay felt validating because it points out why nobody, including all the therapists and experts, can solve this dilemma: because itโs a double bind women faceโbecause of patriarchy.
Itโs not actually possible to resolve the double bind when patriarchy requires us to choose between self-sacrificing (and therefore making our partners happy) and advocating for our own needs and boundaries (and therefore getting perceived as bitchy, demanding, controlling, entitled, and unduly privileged in their eyes.) Yet, as we wrote about in RELATIONSICK, itโs not possible to stay physically or psychologically healthy if weโre stuck in impossible to resolve double binds, forced to choose between self-protection and being liked.
As we write about in RELATIONSICK, women shouldnโt have to get cancer or an autoimmune disease to justify standing up for themselves. Nobody should need a doctorโs note to feel entitled to self-advocacy, yet thereโs a very real risk that if you do stand up for yourself, youโll be less liked, less popular, and less attractive to men who prefer submissive women. and find women with boundaries bitchy.
Am I A Bitch Because I Fight For Equality In My Romantic Relationships? Would I Be Sick If I Didnโt?
I might write about this stuff professionally, but that doesnโt mean Iโve resolved it at the personal level. As I read Celesteโs essay, I thought about the seven different therapists Iโve dragged my infinitely willing partner Jeff to as a way of trying to figure out how to get my own needs met and my own boundaries respected without triggering Jeff. (For those of you who worry about Jeff, he read this essay and granted his consent to talk about our personal life here. He even said, โI agree with what youโre writing,โ which shows the progress weโve made in couples therapy.)
*You can read the rest on Substack at no cost. I'll post the link in the comments below.
