Through the power of the pen, Vancouver-based physician and bestselling author Gabor Maté has explored how stress manifests in the body, the role one’s environment plays in the cause and treatment of ADHD, and the root causes of addiction.
Maté’s fifth book, The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture, which came out in September from Penguin Random House, was co-written with his son Daniel. In the book, the father-son duo say our society is built on systems which have fostered the perfect conditions for high rates of chronic and mental illness. The book is the product of the seventy-eight-year-old’s long career and promises clear-eyed truths at a moment of confusion and despair for many.
Maté spoke with The Walrus about society’s major challenges and why he remains optimistic that healing is possible for all of us.
This conversation has been edited and condensed for length and clarity.
In all of your books, you weave in your personal story and share the stories of your patients. What do you love about the power of storytelling?
Our psychology and our biology are shaped by our life experiences, and through telling stories, we come to understand ourselves. By listening to stories, we come to understand others. Modern medicine is too much about the symptoms and narrow medical histories that do not include the whole person. Yet the whole person is shaped by their story. Storytelling is an obvious healing modality when you understand how you can’t separate people’s lives and biology from their histories. When I think of storytelling, whether in a folktale or a good novel, the basic teaching is the commonality of existence in human life. That none of us are isolated, idiosyncratic manifestations of existence, but that we’re all part of the human journey. Storytelling invites people to be part of that common journey that we all share.
Isolation and loneliness are so prevalent in our society today. A fundamental argument in your book is that this is toxic, leaving us traumatized, disconnected, and ashamed, which you have long claimed is the root cause of most chronic illnesses.
We’ve evolved in communal settings for millions of years. Our prehominid and our hominid ancestors and our species lived in a community in close, cooperative, collaborative contact with others. The hypercapitalist ideology of people being competitive, aggressive, selfish, individualistic creatures is almost guaranteed to isolate people.
In the UK, they had to appoint a minister of loneliness. Loneliness is as much of a health risk as smoking fifteen cigarettes a day, and the number of lonely people is going up all the time, significantly in the last several decades, particularly under neoliberalism. So, when I talk about society being toxic, I literally mean that it actually undermines human health by the very assumptions that it makes about what’s necessary for human life.
How is the nature of our current system connected to rates of illness in our society?
If you look at the research on stress, the commonest triggers for stress response are lack of information, uncertainty, loss of control, and conflict. There is uncertainty, with an 8 percent inflation rate in a relatively rich country like Canada. What control do you have when some corporations thousands of miles away decide your fate or politicians far away decide your fate?
Inequality creates stresses on people, and the more the burden of inequality on somebody, the greater the risk of illness. That’s why Indigenous women face much more stress than the average person. Inequality itself is a stress because, in a society that values people according to economic achievement, those with less are made to feel inferior. Even if people who are making an adequate living feel themselves to be inferior, that’s a stress in itself. Then there is the totally unresolved issue of racism in our society, of which the health impacts are tremendous. Then there’s the gender gap; women account for 80 percent of autoimmune disease diagnoses. Stress isn’t just an abstract psychological event; it translates into physiology in the endocrine system, which organizes the hormonal apparatus, burdens the nervous system, taxes the heart.
What have you noticed about how health and wellness have been marketed?
Everything has become a product, so stress reduction and wellness have become products rather than basic conditions of life. At best, the wellness industry deals with effects rather than causes. So it’s fine to do yoga and meditation. I do that myself. But if you don’t get to the cause of the stress, you’re not dealing with the fundamentals. It’s not just the wellness industry that becomes commodified and marketed, but the medical profession itself is trained only to affect symptoms or diseases that themselves are symptoms of an unhealthy way of life.
What is the source of the medical world’s resistance?
People who go into medicine are very driven and willing to put up with really difficult conditions like lack of sleep, being talked to by authoritarian leaders like you are a small child, being shamed, being stressed, and being overworked. Why would you want to put up with that? Because you so badly want to become a doctor. Students are poised already to ignore their own stresses and traumas just to get through medical school, so this is a very stressed cohort that we’re talking about. For them to look at trauma in their clients would mean acknowledging the trauma in themselves, and that’s very painful.
If you’ve been practising medicine a certain way for twenty years, to recognize the role of trauma and stress would mean to question and reevaluate everything you’ve done. It’s much easier to just carry on with the same old, same old.
The fee-for-service health care doesn’t reward physicians for spending time with people. If you come to see me for depression, it takes me five minutes to give you a prescription for a pill. To discuss why you started to push down your emotions, what happened in your life, and what circumstances caused you to adapt to the self-suppression of emotion, which then becomes depression, takes a conversation which physicians are not trained in. Even if they do think of it, maybe they won’t have the time. So there are powerful reasons keeping things the way they are.
What is the largest misconception about trauma?
Trauma is woefully underrecognized, and the misconception is that there’s a small proportion of really traumatized people and that the rest of us are free of it. The legal profession has virtually no concept of trauma even though the majority of the people they deal with in our criminal courts are traumatized people, demonstratively and documentatively so. Politicians haven’t got the vaguest clue about it, otherwise they would pursue policies very different than the ones they do now.
On the other hand, the word “trauma” is used too loosely, and there’s this conception that everything stressful is traumatic. Every trauma is stressful, but not every stress is traumatic. The loose, unscientific employment of the terminology trivializes the real meaning of trauma.
An increasing number of people on social media are sharing videos unpacking their trauma, even spurring lucrative careers for some. What do you make of the rise of the influencer economy and how enticing this career is to young people?
The thing about being an influencer is: What does it actually mean? It means a lot of people are paying attention to you and buying not who you are but the image that you project. Well, who needs that? The people who need it are people who are desperate to be noticed. Why are people desperate to be noticed? Because they haven’t been seen for who they are. That’s a marker of trauma. So, in a sense, the influencer phenomenon is a marker of social trauma on a huge scale, because one of the biggest traumas in children is not being seen for who they actually are. Influencers have to concoct an image that they hope will be noticed by others. When one becomes an influencer, the hope is that various companies selling useless products will then seek you out so you can monetize your image. So it’s the ultimate capitalist dream of selling people useless stuff without having to actually produce any value.
This all represents a draining of actual meaning from people’s lives because meaning doesn’t come from other people’s attention or anything from the outside. It comes from your relationship to your life. It comes from having a purpose in life that has to do not with getting but being in communion and giving.
As part of the healing process, you noted in the book that the daily practice of yoga and meditation, along with the occasional psychedelic experience, has really helped you.
Before we go there, yoga and meditation are practices that I pursue and recommend, but most of the healing is about working through your trauma. You can’t just do yoga and meditation on top of unresolved trauma. Of the chapters on healing in my book, I have one on psychedelics, so let’s put this proportionately. In the appropriate context, with the right leadership and intention, psychedelics can really help you work through the trauma.
What excites you about how psychedelics can work together with modern psychology?
I know people find this absurd to hear, but so many of our decisions or emotions around politics or personal relationships, even our career paths, are often driven as much by unconscious choices as rational considerations. Certainly, our dysfunctions, if not our functions, are largely driven by unconscious traumatic imprints. Psychedelics can really lift the veil over what is driving us so we get to know ourselves in a very deep way. We get to become conscious of the unconscious, so that’s why psychedelics are a promising modality in the right hands.
Mental disorders have become a major health challenge, and health care systems around the world are collapsing. What is a holistic solution to this crisis?
What we call a mental illness often begins with an adaptation to abnormal circumstances. We have to see that what people with mental illness are manifesting are normal responses to these abnormal circumstances. One of the irreducible needs of the child for healthy development is the capacity and the freedom to experience all their feelings as they arise, whether that be joy or sadness, grief, fear, or anger. But the child needs to be held safely in an environment that can welcome all their emotions. If parents—because of their own fear or anger or because they listen to the child-raising advice of famous psychologists—think their child should be punished for being angry, the lesson that child gets is that their anger is not acceptable to the people on whom their life depends. I was diagnosed, amongst other things, with Attention Deficit Hyperactivity Disorder, the hallmark of which is tuning out and absentmindedness. Given the circumstances of my infancy as a Jewish baby under the Nazis, my brain coped with all of the stress around by tuning it out. I’m not saying these things are not biological. What I am saying is that it’s the environment that shapes the biology of the brain and your interactions with the genes. So, if the environment is stressful for young children, which it increasingly is for a lot of parents, some young kids will have to adapt by tuning out, which gets wired into their brain. Then, years later, that child is diagnosed with ADHD. That’s why the rate of ADHD is going up.
Medical diagnoses are useful descriptions as long as we don’t confuse the description for an explanation. The problem with the profession, and the public in general, is they think these descriptions—which are fairly apt—are also explanations, when they’re not.
Do you think humanity can heal from all of this within a capitalist system?
Those who believe that it can, I would like them to show how it’s possible. I think no human system is meant to be eternal, and no human system ever has been. Again, one doesn’t denigrate the great achievements of capitalism and industrialization. Nor should we ignore their great depredations and the harm that they have done to the world and to human beings amidst great achievements.
So, do I personally think that humanity can heal its trauma socially and personally? Yes. Can it do so under a system that imposes traumas on it? I don’t personally believe so. But, for those that disagree with me, I’m happy to be proven wrong.
What informs your optimism as we head into a turbulent future?
Most people I meet on a personal level are very good people. Fundamentally, I believe in human goodness. When given the right environment, human beings turn out to be good, giving, generous creatures.
There’s something in us that wants healing, and I’ve seen healing on so many levels, in so many people whom we would have written off as hopeless. I’ve seen murderers without any hope of parole become warm-hearted, sweet people once they’ve dealt with their trauma. I’ve seen abjectly addicted people overcome their addiction. I’ve seen people with terminal illnesses find their true selves and express real joy in life even as their joy was ebbing away. I’ve experienced my own healing to a significant degree, and I believe what’s possible for individual human beings is also possible for aggregations of human beings, including society as a whole. It takes a lot of courage and a lot of willingness to get through the illusions. But human society—and human history—is a record of not just all kinds of crimes and misdemeanours but also a lot of transformations.