PhD defence Boukje Yentl Nass

Keywords: Trauma, Selfhood, Agency, Gastrointestinal health

"Understanding the patient in situation. Environmental stressors, agency and healthy interdependence, unpacking their relevance to human resilience and (gastrointestinal) health"

Chronic stress, abuse, and dehumanization are not merely psychological phenomena; they reach deep into the body. In her dissertation Understanding the Patient in Situation, Boukje Nass shows—based on research involving hundreds of patients with inflammatory bowel disease and irritable bowel syndrome—that such experiences are linked to measurable physiological dysregulation.

For Nass, resilience is not an individual trait but emerges from the dynamic interplay between person and environment. When stress and trauma erode a person’s sense of self, experienced agency, and relational connectedness, the impact extends beyond psychological distress. The body becomes dysregulated, resulting in chronic tension, immune imbalance, inflammatory activity, and growing physiological vulnerability. As Nass notes, “Where people are isolated or reduced to objects, their sense of self and agency erode — and the body loses its regulatory capacity.”

Health thus emerges as a relational and situational process in which biology, life history, and socio-material context are closely intertwined. Nass challenges the traditional divide between body-mind, and between individual-environment. Health cannot be reduced to personal responsibility alone; biological resilience is shaped by social and relational conditions. In an era marked by #MeToo, polarization, and mounting pressure on individuals, debates about autonomy and vulnerability take on urgent biological significance.

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