Book Spotlight: Autoimmunity and the Good Girls by Sara Hirsh Bordo
If you've spent your life being "the good one,” the responsible one, the one who keeps everyone else okay, the one who doesn't make waves, you may already sense, on some level, that this role has cost you something. Filmmaker and author Sara Hirsh Bordo's new book, Autoimmunity and the Good Girls: How Permission to Put Ourselves First Has the Power to Keep Us Well, makes the case that this cost isn't just emotional. For many women, it shows up in the body, as autoimmune disease.
We wanted to spotlight this book because it sits right at the intersection of so much of what we see in our practice: the link between self-silencing, chronic caretaking, nervous system dysregulation, and physical illness.
On a personal note, this book found me at exactly the right moment. I've been navigating my own health journey this past year, and somewhere in the middle of researching root causes, I came across Bordo's work I immediately resonated. I grew up with five brothers, the only daughter. That was quite the environment for a sensitive being to arrive into, and the role established early on as a caregiver (no wonder I became a therapist). Reading this book, I started connecting some dots about my own health and history. Many of the ideas and concepts in this book, have become part of my own healing work.
A Quick Note on the Author
Sara Hirsh Bordo is an award-winning documentary filmmaker, activist, and founder of the production company Women Rising. She was one of the estimated 80% of autoimmune disease patients who are women, and her own diagnosis became the starting point for this book. Raised in a large Texas-Lebanese family as the eldest and only daughter, Bordo grew up caring for everyone else's needs at the expense of her own, and later, as an acclaimed director who spent years lifting up other women's stories, watched her own body collapse under the weight of autoimmune disease and cancer. She writes that it was only when she reclaimed sovereignty over her own voice that she began to heal.
The Core Idea: The "Good Girl" Role Has a Physical Cost
Bordo's central argument is that for generations, women have been raised to be "good,” to put others first, silence their own voices, and neglect their own needs, and that a growing body of evidence suggests this comes at a real cost: when our lives are compromised, our immune systems are too.
What sets this book apart from a purely anecdotal wellness narrative is that Bordo went on to fund the first quantitative research examining the intersection of female empowerment and autoimmunity. The findings suggested that women raised in caretaker roles, especially eldest and only daughters, are disproportionately likely to develop autoimmune conditions such as Hashimoto's, lupus, multiple sclerosis, fibromyalgia, and inflammatory bowel diseases. This research was made publicly available for free and has since been downloaded across more than 18 countries.
Why This Resonates With So Many Women
In Bordo's own words, drawn from an interview about the book, she spent most of her life putting others first to her own detriment, both physically and emotionally, always playing "the good girl" or "the people pleaser" at home and at work, and the more she abandoned herself, the more her body seemed to follow suit.
This is a pattern we see often in our work with clients, particularly women who were praised, implicitly or explicitly, for being easygoing, accommodating, endlessly capable, or "low-maintenance." Over time, the nervous system can begin to treat self-suppression as the norm: swallowing anger, minimizing needs, staying calm for everyone else's sake, even when the body is signaling that something is wrong.
When this pattern goes on long enough, the body doesn't just "get over it." For some women, as Bordo's work suggests, it can show up as chronic illness, a kind of physiological consequence of years spent overriding one's own needs and emotions in service of others.
A Memoir Woven With Research and Other Women's Stories
The book weaves together memoir, expert interviews, evidence-based findings, and other women's personal stories, which gives it a dual quality: deeply personal, but also grounded in something larger than one woman's individual experience. Bordo has described the pattern she's writing about as a "climate crisis of women's health," and her hope is that the book moves the conversation about women's health beyond purely biological explanations and into the social and relational factors that shape how girls and women are raised.
Why This Matters for Our Clients
We share this book because it offers language and validation that can be incredibly meaningful, especially for clients who:
Have a long history of people-pleasing, caretaking, or being "the responsible one" in their family
Are the eldest daughter, or grew up taking on a parental role for siblings or even parents
Have an autoimmune diagnosis (or unexplained chronic symptoms) alongside a lifelong pattern of self-silencing or self-sacrifice
Notice that asserting a need or boundary brings up disproportionate guilt, anxiety, or shame
Are curious about the connection between identity, voice, and physical health
This is also closely connected to the work we do around repressed core emotions: when anger, need, or even simple preferences were never safe to express, especially in childhood, those emotions don't just vanish. They often get rerouted into anxiety, shame, or, as Bordo's research suggests, into the body itself.
An Invitation, Not a Verdict
It's worth saying clearly: this book isn't suggesting that autoimmune disease is "caused" by personality, or that women are to blame for their own illness. Autoimmune conditions are complex and multifactorial, involving genetics, environment, and many other variables. What Bordo's work adds to the conversation is a missing piece, the role that chronic self-silencing and identity suppression may play alongside everything else, and the possibility that reclaiming one's voice can be part of the healing process.
A Closing Reflection
For me, the most useful part of this book wasn't a single insight, it was permission. Permission to look at my own patterns not as personality quirks but as something my body has been holding for a long time. I'm still in the middle of this work myself, learning to notice when I'm about to override a need out of habit, practicing saying things out loud that I would have swallowed even a year ago. It's slow, and it's not linear, but I can genuinely say it's changed how I think about my own healing, not just how I show up for clients navigating similar territory.
I share this not because I think everyone's path looks like mine, but because I know how isolating it can feel to wonder if your health and your history are connected, with no doctors or specialists, quite making that link. If any part of this resonates, you're not imagining it, and you're not alone in it.
Want to Go Deeper?
If you've spent your life managing everyone else's needs, swallowing your own feelings, keeping the peace, Autoimmunity and the Good Girls may offer both validation and a new lens for understanding your own health story.
And if you're noticing that your body has been carrying the weight of a role you never quite chose, that's exactly the kind of pattern experiential, nervous-system-informed therapy is designed to help untangle.
At Allison Grubbs and Associates in Raleigh, NC, our therapists work with many people navigating the link between chronic self-suppression, people-pleasing, and physical health, using approaches including AEDP, IFS, and nervous system-informed somatic work. We offer in-person sessions in Raleigh and virtual sessions throughout North Carolina.
Curious if this kind of work could help you? Reach out to schedule a consultation, we'd love to talk it through.