When Nothing Feels Urgent, But Everything is Changing

Name: The Body Keeps the Score
Author: Bessel van der Kolk

Dominique Paquet
May 1
6 min read

You already know when something isn’t quite right. Not enough to panic, not enough to call it a problem, but enough to notice. Energy is lower than it used to be, sleep feels lighter or less restorative, digestion becomes inconsistent, focus drifts more easily, and small discomforts begin to appear without clear cause or urgency. Nothing is dramatic, nothing is alarming, and because nothing has been named, nothing is addressed.

This stage does not feel like illness. It feels like inconvenience, like a series of minor disruptions that can be postponed, explained away by stress, age, a busy schedule, or the assumption that fluctuations are normal and self-correcting. It is here, in this quiet and often prolonged interval, that the direction of health is most decisively shaped, not through acute events or diagnoses, but through the accumulation of responses that favour delay over engagement. The body continues to function, often remarkably well, adapting in ways that allow daily life to proceed uninterrupted, and it is precisely this capacity for adaptation that makes the early phase so easy to overlook.

From a physiological standpoint, the absence of a diagnosis does not imply the absence of change. The human body is not a system that moves abruptly from health to disease; it is a dynamic network that continuously adjusts to internal and external inputs, modulating function in response to nutrition, activity, sleep, stress, and environmental exposures. When these inputs become inconsistent or insufficient over time, the body does not immediately fail. It compensates. Hormonal pathways recalibrate, inflammatory processes fluctuate, metabolic flexibility narrows, and organ systems redistribute effort in ways that preserve short-term stability at the expense of long-term efficiency. These adjustments are not inherently problematic; they are, in fact, evidence of resilience. The issue lies in the duration and repetition of the conditions that necessitate them.

Research from the Public Health Agency of Canada continues to show that many chronic conditions develop over extended periods, influenced by behavioural patterns that precede clinical recognition by years or even decades. Cardiovascular disease, type 2 diabetes, and inflammatory disorders evolve through stages of metabolic and physiological changes that are often detectable only through subtle shifts in function rather than overt symptoms (Public Health Agency of Canada, 2022). Data from Statistics Canada further indicate that a large proportion of Canadian adults live with one or more risk factors—physical inactivity, suboptimal nutrition, and elevated stress—long before any formal diagnosis is made (Statistics Canada, 2023). These findings point to a disconnect between what is experienced and what is acted upon, a gap that is not rooted in ignorance, but in how early signals are interpreted.

Part of the difficulty lies in the nature of those signals. Early physiological changes are rarely specific; they are intermittent, diffuse, and often reversible in the short term, which reinforces the belief that they are not significant. A few nights of poor sleep can be recovered, digestive discomfort can pass, and periods of low energy can be attributed to external demands. Each instance appears manageable, and in isolation, it often is. The challenge emerges when these instances begin to form a pattern, when the baseline shifts incrementally without crossing a threshold that would trigger concern. It is similar to being in a room where the light gradually fades; because the change is continuous rather than abrupt, the adjustment happens without conscious awareness, and what would have been immediately noticeable in a sudden shift becomes part of the new normal. The body adapts to that new baseline, and what once felt like a deviation becomes normalized.

What is less often considered is why some individuals remain in this state of subtle dysfunction longer than others, why their baseline does not fully return, and why certain patterns persist even when there is a general awareness that something is off. This is where the conversation extends beyond lifestyle in the conventional sense and into regulation, specifically the regulation of the nervous system and the cumulative effects of what has not been processed over time.

The work of Bessel van der Kolk, particularly in The Body Keeps the Score, has contributed to a broader understanding of how the nervous system responds to sustained or unresolved stress. His research illustrates that the body does not simply “move on” from experiences that overwhelm its capacity to process them; instead, it adapts by altering patterns of reactivity. This can present as a system that is persistently activated, where stress responses are easily triggered, or as a system that is blunted, where energy, motivation, and responsiveness are reduced. Neither state is inherently pathological in the short term, but over time, both influence physiological processes that extend well beyond mood or perception, including sleep architecture, immune function, and inflammatory regulation.

A complementary perspective is offered by Gabor Maté in When the Body Says No, where the focus shifts toward behavioural patterns that develop in response to early conditioning. Chronic suppression of emotional responses, difficulty expressing needs, and a tendency to prioritize external expectations over internal signals are not uncommon, particularly in individuals who have learned to remain functional under pressure. Over time, these patterns contribute to a form of sustained physiological stress, not because of acute events, but because the system is rarely given the conditions required for recovery.

Within this framework, the delay between awareness and action takes on a different dimension. It is not simply a matter of ignoring symptoms or lacking discipline; it is often the result of a system that has adapted to operate within a narrower range of regulation. Signals of discomfort are minimized, overridden, or reinterpreted, not out of neglect, but out of familiarity. Many individuals have learned, explicitly or implicitly, to move through discomfort, to remain productive, and to interpret both emotional and physical cues as something to manage rather than something to understand. In this context, the absence of acute symptoms becomes the benchmark for health, even as underlying processes continue to shift.

The assumption that significant health issues will present clearly and unmistakably further reinforces this pattern. There is a prevailing belief that if something were truly wrong, it would be obvious, that the body would signal distress in a way that compels action. While this may hold true in acute scenarios, it is less applicable to the development of chronic conditions, where progression is gradual and often silent.

At the same time, the structure of healthcare systems, including Canada’s publicly funded model, is primarily oriented toward identifiable conditions that meet specific diagnostic criteria. This does not reflect a failure of care, but it does mean that individuals in the early stages of physiological change may not encounter interventions that address the patterns underlying those changes.

From a metabolic perspective, prolonged exposure to suboptimal conditions, whether nutritional, behavioural, or regulatory, can lead to measurable changes in insulin sensitivity, lipid metabolism, inflammatory markers, and hormonal balance, even in the absence of overt symptoms. Research supported by the Canadian Institutes of Health Research continues to demonstrate the cumulative impact of lifestyle and stress-related factors on these early markers of dysfunction (CIHR, 2021).

Health is rarely lost in a way that feels sudden. It erodes in small, repeated moments that are easy to dismiss and easier to postpone. Most people notice the changes—fatigue that lingers, digestion that shifts, and sleep that no longer restores—but nothing about them feels urgent enough to act on. So they wait. They adjust. They move around it. And when the body eventually forces the issue, the response is no longer reflection but resolution, often in the form of a prescription intended to manage what has been building for years. By that point, the question is no longer whether something changed, but how long it has been changing without being addressed. The body does not suddenly fail; it eventually stops compensating.

From a TRIVENA perspective, this stage is not defined by urgency, but by direction. The body is not waiting for confirmation; it is already adapting to what is repeated, tolerated, and overlooked. What follows is rarely the result of a single turning point, but of whether those early shifts continue to be absorbed into routine or used as a point of recalibration. Most people don’t make that decision consciously. They adjust, they carry on, and they revisit it later, when it is no longer optional. By then, the question is not what changed, but how long it has been changing without interruption.