The Jaw
Jaw clenching, grinding, throat tightness, and TMJ symptoms deserve appropriate dental and medical care. This essay also explores how the jaw can become a familiar holding place for what has felt unsafe to say, and how noticing that protective work can open a gentler relationship with the body.
Your dentist mentioned it again. The grinding. The wear on the molars that has been progressing since your last appointment and the one before that and the one before that, a slow erosion that happens while you sleep, or maybe while you don’t quite sleep, the jaw working through the night on something it can’t finish by morning. She suggested a night guard. You have a night guard. You mostly remember to wear it.
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Or maybe you don’t grind. Maybe for you it’s the clenching. The specific effort of releasing the jaw in the car, in meetings, at the end of a difficult conversation, and then noticing, twenty minutes later, or ten, or five, that it has returned to exactly where it was. As if the jaw has a resting position it finds more natural than the loose one your dentist keeps asking for. As if relaxation requires more maintenance than tension.
Or maybe it’s the throat. The permanent mild tightness there, not quite painful, not quite not, the thing you’d describe as difficulty swallowing if it were worse than it is. The sentence you felt forming at the meeting that you smoothed into something else before it reached your mouth. The way your voice sometimes goes to a particular pitch that you recognize as the managed version, the professional version, the version that doesn’t scare anyone, and you spend the rest of the conversation wondering where the real one went.
It isn’t dental. It isn’t TMJ in the mechanistic sense that your dentist is treating it. It isn’t caused by stress in the generic way that word gets deployed. It isn’t a tension headache issue or a posture issue or a night guard compliance issue.
Your jaw knows something. It has been holding it for a very long time. And it is keeping the word between your teeth until someone offers it a reason to let go.
“This jawline remembers winding the words in;maybe the skin knows something about silence,see how it has turned from itself.”
Taylor, Joelle. (2021). “iv.” C_nto. The Westbourne Press.
The proverbial house of the body we inhabit as adults was built on a foundation of early experience, the specific lessons absorbed, before we had language for them, about what was safe to feel and safer not to say. For many of us who grew up in households where the emotional climate required management, where a raised voice was a threat or a silence was a punishment or love arrived with the specific condition that we not be too much, the jaw learned a job. An old job. A job it learned before it had any choice in the matter. And it has been performing that job, every night and every meeting and every difficult conversation, with the fidelity of a body that was told, implicitly and early, that this was survival.
The jaw is where we hold what we cannot say. This isn’t metaphor. The muscles of the jaw and throat are among the body’s primary storage sites for incomplete speech, for the sentences that formed and didn’t arrive, the words that were determined, by the governing logic of the original household, to be too risky to release. The night guard treats the outcome. It doesn’t address the storage.
A Body That Learned to Hold
Her dentist had mentioned it at two consecutive appointments before she finally looked up from the chair and asked what could be done about it.
(Names and all identifying details have been changed for confidentiality.)
What she’d almost not said in our first session was that the jaw pain had woken her twice in the previous month. Not grinding pain, something more acute than that, a sharpness that seemed to originate somewhere she couldn’t locate, as if the jaw were processing something that had been waiting longer than sleep to be processed.
Charlotte was forty-four, a family law attorney in Richmond who had spent twelve years advocating fiercely, articulately, and precisely for her clients in the most emotionally volatile rooms that most legal proceedings create. She was known, within her firm, for her composure. She was the attorney other attorneys sent their most difficult clients to, because Charlotte could hold a difficult room without anything showing on her face.
Her mother, she told me in our third session, had been a woman who did not raise her voice. This was said as a compliment, her mother’s composure was the thing Charlotte had admired most about her. What she’d taken years to understand was that her mother’s composure wasn’t ease. It was effort. The specific, sustained, daily effort of a woman who had grown up in a household where raising her voice had consequences, and who had passed on not only the value of composure but the particular muscular technique of it, the jaw, the throat, the face arranged for the room even when the room was only her kitchen and her family.
“I’m very good at not reacting,” Charlotte said. She said it the way you say something you’ve been proud of and are newly uncertain about. “Like, professionally, that’s… that’s the whole job, basically. And I’m genuinely good at it. But.” She stopped. Picked up the water bottle on the table beside her, set it down again without opening it. “My jaw is… my jaw is always doing something. Even when I’m not in a hard room. Even when I’m just… home.” She looked at me. “Why does it do that when I’m home?”
I didn’t say anything right away.
There was a quality in that last question that I’ve been thinking about since. Not frustration, something more precise than frustration. The quality of someone who has just noticed that the skill and the symptom have the same source, and isn’t sure yet what to do with that.
you pull the lump in your throat out with your teeth
and say
fine
numb
really, Kaur, Rupi. (n.d.). Milk and Honey. Andrews McMeel Publishing.
Why the Jaw Keeps Working
I found something in Pat Ogden and Janina Fisher’s work on sensorimotor psychotherapy that I return to constantly with clients like Charlotte: the observation that tension in the jaw contributes to bouts of anger, that shoulders hiked up reflect and sustain fear states, and that if we are scared or suppressed often enough, these tensions turn into enduring physical habits. It takes a long time, they write, but eventually the body’s repeated reactions become automatic, long-lasting patterns that carry the memory of a past the mind may have forgotten, dissociated, or suppressed. The jaw doesn’t know the room has changed. It’s still doing its job in the original room. It will keep doing it until someone tells it the old room is over.
Christine Courtois and Julian Ford’s clinical work on complex trauma lists the specific physical effects: gastrointestinal disturbance, respiratory distress, muscular tension, migraine headaches, and, specifically, temporomandibular joint pain, high blood pressure, frozen joints. Ringing in the ears. Inability to physically relax due to hyperalertness. The TMJ is not listed as a psychological symptom. It’s listed as a physiological one. A measurable, documentable consequence of a nervous system that has been running hypervigilance past the point the tissues can sustain it.
A sustained state of scanning and bodily readiness for possible danger, often shaped by environments where the emotional climate felt unpredictable.
In plain terms: The jaw may stay braced even in a safe room because the body has learned that relaxing too soon could be risky.
I also found a passage in the EMDR clinical literature that stopped me: that the need to inquire about unspoken words can be identified by visible clenching of the jaw, a band of white or red coloration around the throat, or verbal reports of tightness in the throat. That the invitation for unspoken words asks what someone wishes they had said, or now wishes to say, even if they would not actually say them out loud. The jaw is holding the unspoken words. This is not a therapeutic metaphor. This is the clinical observation of what the jaw is doing when it won’t release.
A clinical observation used in trauma-informed work to explore speech, needs, or reactions that were inhibited because expression once felt unsafe.
In plain terms: The question is not whether you must say every held sentence out loud, but what changes when you notice the jaw may be guarding something real.
Don’t tell me about the dead leaves littering the gutters,
your fists & jaw clenched at the impossibility of order.
Don’t tell me a name can be buried in the skin
when the sky is suffering again., Dingman, Chelsea. (2020). “Instructions for Resurrection [of Our Marriage, if Nothing Else].” Through a Small Ghost.
A Different Relationship to Release
Here’s the structural argument we need to make.
TMJ diagnoses are estimated to affect women at significantly higher rates than men, by some estimates, three to four times as frequently. This is not because women’s jaw joints are structurally different. It is because women have been taught, across centuries and in individual households across those centuries, a specific muscular technique: the smile that is trained, the voice that is softened, the face that is arranged for the room even when the room has given us something to say. We learned to hold it. We were rewarded for holding it. We were called composed and professional and mature and easy and pleasant. We received the message, early and consistently, that the words that most needed to be said were often the words we were least permitted to say. And the jaw stored them.
Charlotte’s jaw was doing her mother’s work and her grandmother’s work and the work of every woman in her line who had learned that composure was safety. It wasn’t personal pathology. It was the physiological inheritance of a specific gendered instruction that has been operating for so long it no longer requires repetition. It simply runs.
I’m not saying the composure was wrong. I’m not saying the jaw has been malfunctioning. I’m not saying you should have said all the things you held. I’m not saying the night guard is useless. I’m not saying this resolves before the next appointment.
What I am saying: the jaw has been doing a job it was given before you were old enough to decline it. AND, it has been doing that job in rooms that no longer require it. AND, the unspoken words are real, and they’re still there, and the jaw has been their faithful guardian for a very long time. AND, Charlotte has spent twelve years in rooms full of difficult things being said and has been professionally celebrated for not letting any of them show on her face, while her jaw worked through the nights trying to finish what the face hadn’t been allowed to start.
What becomes possible, when the jaw begins to understand the room has changed: the release that happens in your car after a hard meeting might come a little sooner. The throat might soften slightly during the phone call you’ve been dreading. The sentence that forms in the meeting might arrive, not always, not all of them, but sometimes, in something closer to your actual voice rather than the managed one. Charlotte’s jaw, she told me eight months in, still clenches in hard rooms. But she notices it now. And sometimes, when she notices it, she lets it drop. Just slightly. Just one inch. Just enough to feel the difference between holding and not holding. That inch, she said, is different from anything she’d had before.
and i said to my body. softly.
i want to be your friend.
it took a long breath.
and replied
i have been waiting my whole life for this., Waheed, Nayyirah. (n.d.). “Three.” The Body Is Not an Apology: The Power of Radical Self-Love. Berrett-Koehler Publishers. Chapter 3.
The next time you feel the jaw do what it does, in the meeting, in the car, in the middle of the night, try this:
Before the night guard. Before the magnesium. Before you tell yourself to relax. Place one hand along your jaw. Cup it gently, the way you’d hold something you’d been carrying for a very long time.
Then: let it drop one inch. Just one. Just enough to feel that the drop is possible. Then take one breath into the space that opens when it does.
You don’t have to say the words tonight. You don’t have to decide anything. You just have to let your jaw know that you know it’s been keeping them, and that you’re beginning to think it might not have to keep them alone anymore.
Q: Why do I clench my jaw without noticing?
A: The essay describes clenching as a possible long-standing protective habit, especially for people who learned that managing expression or staying composed was necessary.
Q: Is jaw pain only a stress problem?
You've been holding everything together. You're allowed to put some down.
A focused self-paced course on overfunctioning, achievement-first self-concept, and the trauma response that masquerades as a personality. Not a productivity problem. Not a boundary problem. A nervous system that learned competence was the only safety.
A: No. Jaw pain and TMJ symptoms deserve dental and medical attention. The essay adds a trauma-informed lens without replacing that care.
Q: What is hypervigilance?
A: It is a state of ongoing readiness and threat-scanning that can remain active after the environment that required it has changed.
Q: What are unspoken words in this context?
A: They refer to needs, reactions, or sentences that felt too risky to express and may still be held with physical tension.
Q: What is a small practice for jaw tension?
A: Gently cup the jaw, let it drop only a little, and breathe into the space, without forcing relaxation or requiring yourself to speak everything at once.
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Annie Wright, LMFT
Licensed Marriage & Family Therapist · Relational Trauma Specialist · Author, W.W. Norton 2027
“Helping driven women finally feel as good as their résumé looks.”
Annie Wright is a licensed psychotherapist with 15,000+ clinical hours since 2013 and an EMDRIA Certified Therapist. She’s the founder and former CEO of Evergreen Counseling, a multimillion-dollar trauma-informed therapy center she successfully exited. She’s currently writing her first book, The Everything Years: Navigating the Pressure and Promise of Your Thirties, with W.W. Norton (2027). Her expert commentary has appeared in Psychology Today, Forbes, Business Insider, NBC News, and The Information.
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Annie Wright, LMFT
LMFT · Relational Trauma Specialist · Author, W.W. Norton 2027
Helping driven women finally feel as good as their résumé looks.
Annie Wright is an EMDR-certified licensed psychotherapist and relational trauma specialist with over 15,000 clinical hours, and she's been in practice since 2013. Trained in EMDR, psychodynamic, and somatic modalities, she is licensed in 14 U.S. jurisdictions and registered to provide telehealth in Florida (California, Colorado (telehealth only), Connecticut, the District of Columbia, Florida, Illinois, Maine, Maryland, New Hampshire, New Jersey, New York, Texas, Utah, Virginia, and Washington). Annie works with driven and ambitious women from relational trauma backgrounds, and everything she writes about is field-tested across thousands of clinical sessions. She is the founder and former CEO of Evergreen Counseling, a multimillion-dollar trauma-informed therapy center she built, scaled, and successfully exited, and is currently writing her first book, The Everything Years: Navigating the Pressure and Promise of Your Thirties, with W.W. Norton (2027). A regular contributor to Psychology Today, her expert commentary has appeared in USA Today, Forbes, Business Insider, Inc., NBC, and The Information.
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