- When people try to understand illness or trauma as an individual event, they miss out on the possibility of healing.
- Trauma is not what happens to a person, but what happens inside them as a result.
- People can change their lives by freeing themselves from narratives that are making them sick.
Dr. Gabor Maté is the bestselling author of four books published in over 25 languages, and an internationally renowned speaker on the topics of addiction, trauma, childhood development, and the relationship between stress and illness. He received the Order of Canada for his groundbreaking medical work, his country’s highest civilian distinction, and is the author of In the Realm of Hungry Ghosts: Close Encounters With Addiction, When the Body Says No, and most recently, The Myth of Normal: Illness and Health in an Insane Culture.
Born in Hungary in 1944, he lost his maternal grandparents in the Holocaust and has lived in British Columbia for most of his life. Maté ran a private family practice in East Vancouver for over 20 years, was the medical coordinator of the palliative care unit at Vancouver Hospital, and served as the staff physician at Portland Hotel, a residence and resource centre located in downtown Vancouver, where many of his patients suffered from a combination of mental illness, drug addiction, and HIV.
He is also the subject of the film, The Wisdom of Trauma, which was released last year, and is the co-developer of a therapeutic approach, Compassionate Inquiry, now studied by hundreds of therapists, physicians, counselors, and others internationally.
We caught up on Zoom to talk about the film, his latest book, and what Maté thinks about the myth of normal in a crazy world.
Mark Matousek: You’ve said that passion is a divine spark and that addiction is a flame that incinerates. How do you define passion?
Gabor Mate: Passion heats, illuminates, and guides. Passion enhances you, without enhancing the ego—in fact, the ego may not even like it. Passion is beyond the narrow self. Look at the activity of writing, for example. We don’t usually write just for ourselves. There's a passion to communicate, to teach, inspire, invite, engage with. This passion goes beyond the self.
MM: What's the difference between workaholism and healthy passion?
GM: The Eightfold Path of Buddhism talks about right work or right livelihood, which doesn’t hurt people and doesn’t hurt the world. It's wonderful to be passionate about your work without being so attached to it that you give up your personal life, your important relationships, and spiritual goals. If you engage with it in such a way that you become unavailable, with your mind always on work, you harm yourself and those around you. If you can’t dare to step away from your work, then you’ve got an addiction problem.
MM: It comes down to over-attachment?
GM: Well, attachment has two meanings. There is the connection with another human being, the gravitational drive to connect with somebody else for the sake of taking care of them or for the sake of being taken care of. We don’t survive otherwise. Then there is the Buddhist sense of attachment which points toward a type of clinging that creates negative consequences. The first kind of attachment is simply how human beings are. The second is what happens when those needs are not met. Being left with an emptiness and insatiable craving creates addiction in the personal sense, and capitalism in the social sense.
MM: Say more about the connection between capitalism and unmet attachment needs.
GM: One of the points I’m making in my latest book is that this society places stress on families, tears communities apart, and isolates individuals. This leaves us with parenting situations where children’s attachment needs are not met. They’re left empty and hungry and seeking stuff from the outside. This book is about our individual health not being an isolated biological phenomenon. It reflects our relationships from conception onward, our community, and the entire culture.
We have an economy based on meeting our false needs because our real needs were not met as children. Whole industries are based on selling us products and activities that have no other purpose than to temporarily satiate that need for completion. The whole system is based on the idea that the more you get, the happier you’ll be. It’s based on exciting a person, but not on meeting that hunger, which is how it becomes addictive. For that reason, when we try to understand the illness or trauma as an individual event, we miss out on the possibility of healing.
MM: It becomes a vicious cycle of hunger and feeling let down?
GM: That’s capitalism. Every year, air pollution kills more than double the number of people internationally than died of COVID. But no one is doing anything about that because air pollution is profitable, while COVID threatens the economy.
The Canadian philosopher John McMurtry coined the phrase “life capital” to describe anything that enhances life. In this society, life capital doesn’t matter. Instead, we are sold unhealthy food and products that kill us. These foster addictions, and all for the sake of profit.
MM: What about healthy capitalism?
GM: I’ve yet to see it. Even the concept of racial inequality was a capitalist invention. It came along when it became necessary to enslave people. This was done with the 'explanation' that one race was inferior to another. From the very beginning, this system was based on severe exploitation. It had a grace period after the Second World War, when there were more social services, corporations were reined in a little bit in their capacity to extort profits, and there were strong unions. But that 30-year period was torn asunder through neoliberalism in Margaret Thatcher’s Britain and by Ronald Reagan’s reign in the US. Now we’re back to extremes of inequality. If you look at the American population, something like 70% are on at least one medication for some chronic condition. Now, is that an accident or an outcome of the system?
MM: What's the role of spirituality in countering cultural toxicity?
GM: I think of spirituality as the desire to recognize, and belong to, something greater than yourself. But spiritual growth needs to be combined with emotional growth. If it is not, pursuing beautiful mind states, meditating, and so on can become another addiction. Or worse, it can lead to abuses by people with the best credentials who have not done their own inner work. We have seen too much of that. One without the other is inadequate.
People who study human needs agree they include a sense of belonging, a sense of meaning, and a sense of transcendence. You can call that spiritual, but that’s part of our nature. When those needs are not met, we suffer. Noam Chomsky points out that all societies need to have a working theory of human nature. That theory will reflect the dominant structures of those societies. When people act selfishly, we say, 'Oh, that’s just human nature.' But when somebody does something selfless, or kind, or compassionate, nobody says, 'Oh, that’s just human nature.' Why is one human nature and not the other?
MM: Your work is the subject of a compelling new film, The Wisdom of Trauma. How does trauma differ from pain?
GM: On the one hand, the word trauma is used too loosely, but on the other hand, it’s not used nearly enough. Throughout our culture—in medicine, psychiatry, the law, the educational system—there’s an utter lack of trauma awareness.
Trauma and the pain of being upset are not synonymous. Trauma is a chronic wound that you sustained and still carry. The term refers not to what happens to you, but what happens inside you as a result. You retain the pain of trauma, and you retain your defense against the pain without actually being aware of its source. Trauma is like what happens to a wound when it forms scar tissue. What’s the nature of scar tissue? It’s protective, but it has no growth capacity. It doesn’t feel, there’s no nerve endings in it. It’s not flexible. When traumatized, we become limited, less flexible, and harder. Where we’re inflexible, we don’t feel as much because our hearts are shut down. Growth invites or demands being vulnerable and open and that’s very hard for people to do when they were hurt in their vulnerability when they were small.
MM: Why are some people traumatized by painful events while others seem to be more resilient?
GM: Fifteen to 20 percent of the population are born with genes that make them more sensitive, as in feeling more. That same sensitivity can make you more creative, alive, insightful, empathetic, and compassionate. You may become a leader. But it depends on how your sensitivity is responded to by the environment in which you grew up. If that environment was hurtful, you’re going to be more wounded than someone who grew up being supported through validation of your experience and emotions.
MM: Is it necessary to know specifically what happened to us in order to heal from trauma?
GM: It’s not necessary and impossible in some cases to know, because you can be traumatized in the womb before you have the awareness to form memory threads. On the other hand, trauma memories are a lot more accessible than most people think they are. I’ve yet to talk to anybody who says, “I don’t know how I was hurt.” You just have to ask the right questions.
MM: Does changing our story about trauma help to heal it?
GM: Dan Siegel says, “People can change their lives by freeing themselves from narratives that are literally making them sick.” I can’t change the fact that as a Jewish infant, I almost died in the genocide. I can’t change that fact, but I can change what I made it mean, rather than allow it to be limiting and constricting.
MM: This is not the same as "compulsive positive thinking" referred to in your work?
GM: Not at all. It’s good to be optimistic, to believe in possibility, your own and everybody else’s. But it’s not good to be unrealistic, and reality has to take in all aspects of human experience. I’ve known people to heal from severe conditions and it’s because they’ve looked directly at the suffering or so-called negative aspects of their condition. This has been well documented.
MM: You point out that attention deficit has an emotional meaning in people’s lives.
GM: As a physician who constantly reads research, I have found that all mental health conditions, or so-called mental diseases, and most chronic physical health conditions, are responses to unresolved pain. They are responses to life. What’s the hallmark of ADD? Tuning out, absent-mindedness. It’s a coping mechanism. Contrary to medical nonsense people put forward, it is not a genetically inherited disease, but a response to early stress. The more sensitive you are, the more difficult it can be to cope with your environment. Early coping mechanisms, however, can become sources of problems later.
MM: Many blame ADD on technology and smartphones.
GM: We had these problems before we had technology. Technology makes it worse because it’s addictive and it interferes with human relationships. It’s a double-edged sword because it allows a lot of information to be available to people, but it also makes available lies, disinformation, fantasy, and venom. Technology in itself is neutral. It’s how it’s used.
MM: One final question for this pandemic era. What gives you hope?
GM: Hope is about wishing for something to happen in the future. It is absconding from the present. Noam Chomsky was asked once if he was an optimist or a pessimist and he said, “Strategically, I’m an optimist, and tactically, I’m a pessimist.” Like him, in the long term, I see the possibilities of human beings. In the short term, I see all kinds of problems. I see the possibility of healing and transformation both on the social and the personal level, but I see that possibility in the present.