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The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture

Chris Hedges interviews Dr. Gabor Maté | Oct 13, 2022

Dr. Gabor Maté in his new book “The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture,” which he wrote with his son Daniel, argues that what is defined as normal in a consumer society is at war with basic human needs.

The engine of capitalism, defined by the cult of the self, thrives on the fostering of psychological and physical chronic disorders, including high blood pressure, diabetes, anxiety, depression, addictions and suicide. It rewards the core traits of psychopaths: superficial charm, grandiosity, and self-importance; a need for constant stimulation, a penchant for lying, deception, and manipulation, and the inability to feel remorse or guilt.

Personal style and personal advancement are mistaken for individualism, equated falsely with democratic equality. We have a right, in the cult of the self, to get whatever we desire. We can do anything, even belittle and destroy those around us, including our friends, to make money, to be happy, and to become famous.

Once fame and wealth are achieved, they become their own justification, their own morality. How one gets there is irrelevant. The consequence of this dark ethic, Dr. Maté illustrates, plays out on our bodies, severely damaging our psyches, and pushing us towards individual and social self-annihilation. Joining me to discuss his new book is Dr. Gabor Maté who has written several best-selling books, including In the Realm of Hungry Ghosts: Close Encounters with Addiction, When the Body Says No: Exploring the Stress-Disease Connection and Scattered Minds: The Origins and Healing of Attention Deficit Disorder.

Transcript

Chris Hedges:  Dr. Gabor Maté in his new book The Myth of Normal: Trauma, Illness & Healing in a Toxic Culture, which he wrote with his son Daniel, argues that what is defined as normal in a consumer society is at war with basic human needs. The engine of capitalism, defined by the cult of the self, thrives on the fostering of psychological and physical chronic disorders, including high blood pressure, diabetes, anxiety, depression, addictions, and suicide. It rewards the core traits of psychopaths: superficial charm, grandiosity and self-importance, a need for constant stimulation, a penchant for lying, deception, and manipulation, and the inability to feel remorse or guilt.

Personal style and personal advancement are mistaken for individualism, equated falsely with democratic equality. We have a right in the cult of the self to get whatever we desire. We can do anything, even belittle and destroy those around us, including our friends, to make money, to be happy and to become famous. Once fame and wealth are achieved, they become their own justification, their own morality. How one gets there is irrelevant. The consequence of this dark ethic Dr. Mate illustrates plays out on our bodies, severely damaging our psyches and pushing us towards individual and social self-annihilation.

Joining me to discuss his new book is Dr. Gabor Maté, who has written several bestselling books including In The Realm of Hungry Ghosts: Close Encounters with Addiction, When the Body Says No: Exploring the Stress-Disease Connection, and Scattered Minds: The Origins and Healing of Attention Deficit Disorder.

So I said before we went on the air, this is a book that could have easily been three or four books, so your readers are rewarded. You write that most of us are in the grip of what you call a distant past, a psycho emotional time warp that prevents us from inhabiting the present moment. This is what the psychotherapist Peter Levine calls the tyranny of the past. Can you explain this process?

Gabor Maté:  Yes. First of all, thank you for having me on your broadcast. In my own life, coming to reflect on many of my behaviors, I’ve had to realize that often I wasn’t reacting to the present, I was reacting to some interpretation of the present based on old traumatic programming for my early childhood. So often when I get upset, say in my relationship with my spouse, the degree of upset is not related to anything that’s occurring right now, but it’s some dark pain or wound, which is what trauma means, based on a sense of me being rejected or not being loved or not being accepted when I was a very young infant.

And so that’s what Peter means by the tyranny of the past, that the past colors are… the Buddha said once that with our minds we basically create the world. But what it didn’t say is that before with our minds we create the world, the world creates our minds. So that the mind, in fact the very brain itself, including the physiology of the brain, is programmed very early in childhood by our earliest relationships with our caregivers beginning in utero, and those imprints govern a lot of our behaviors even into adulthood.

Chris Hedges:  Well, you write about it. One of the things I liked about the book was its honesty. You give voice to your wife and your son, and are quite frank and, I think, courageous about your own failings as a father. We all have them. It’s painful to confront that we failed, in some way, those we love, and I wondered if you could, for people who don’t know your story, just tell us quickly what that trauma – It is in the book – But what that trauma that you endured was.

Gabor Maté:  So, in a large historical context, the trauma was that I was born in January 1944 in Budapest, two months before the Nazis occupied Hungary, which is when the genocide began, two months after I was born. Now, the day after the Germans marched into Budapest, my mother phoned a pediatrician, I was two months of age, and she said, would you please come and see Gabor, because he’s crying all the time? And the doctor said, of course I will come, but I should tell you, all my Jewish babies are crying. And this is true, you don’t have to have war and genocide for this, infants absorb the stresses of their parents, and that has an impact on their nervous systems.

So I spent the first year under predictably difficult, even life-threatening circumstances, which culminated with my mother giving me to a total stranger in the street in Budapest, because where we were living, I would not have survived. So I didn’t see her for five or six weeks. Of course, an infant can only experience that as an abandonment, and who gets abandoned? Somebody who’s not lovable, somebody who’s not wanted. So my sense of self, on a deep unconscious level, was somebody who’s not lovable, who’s not wanted. And that then leads to all kinds of behaviors in adulthood. Not to mention that, for the whole year, I’m absorbing the stresses and terrors of my mother, which, infants and children being narcissistic in the sense that they think it’s all about them, naturally I think, she’s suffering so much, it must be my fault.

So this tremendous sense of guilt and shame that comes with trauma. It does not take historical trauma of those proportions. It doesn’t take war or genocide. In a diary entry, my mother described, when I’m two weeks old, before they were Nazis, before the Germans occupied Hungary, just how she was following doctor’s orders not to pick me up and feed me when I was asking for it because then the ethic was you feed on schedule, not on the child’s demand. That itself is a trauma, because what message do I get as a two-week-old? That my needs aren’t important, that I’m alone, that the person who loves me doesn’t care enough about me to pick me up. And that kind of trauma is very common in all societies, so I don’t want to create the impression that trauma is only under dramatic circumstances such as I endured as an infant.

Chris Hedges:  Well, you’re writing the book about your mother’s instincts and that she didn’t like it, and of course, I think much of your book is a celebration or holding up those instincts against modern medicine or modern psychotherapy. The psychiatrist, Basil van der Kolk –

Gabor Maté:  Bessel, if I may say.

Chris Hedges:  Bessel. Excuse me, yes. Bessel van der Kolk in The Body Keeps the Score, he writes that trauma is when we are not seen and known, and you build on this idea that trauma is a fracturing of the self, of one’s relationship to the world. You define this fracturing as the essence of trauma. What do you mean by fracturing of the self, and how does this fracturing work?

Gabor Maté:  Well, so trauma means a wound, wounding, a psychic wound, and you can wound people in two major ways, you might say. By doing terrible things to them, such as the abuse that many people endure in childhood, whether at home or in school, but the other way you can hurt people is just not to meet their needs. Now, one of the essential needs of human children – I’m talking about essential needs in a sense that if it’s not met the child suffers – Is to be seen and accepted for exactly who they are. Now, in Bessel’s words, if you’re not seen, that hurts you, because a child develops their self-image, their self-concept based on how he’s seen and treated by the adults around them. If the adults themselves are too limited, too stressed, too traumatized, too preoccupied to see the child in their child’s fullness, with all their emotions, the child will develop a very limited sense of themselves. So that’s part of that fracturing, first of all.

Secondly, when you’re not being seen, or worse, if you’re being hurt or abused, it’s just too painful to be in your own body and to experience your own emotions. So literally, as a survival adaptation, quite unconsciously, the child will cut off their sense of feeling, their gut feelings, and they even disconnect from their bodies. So that disconnection then fracturing the self, which is the essence of trauma, happens if you’re not seen and accepted just who you are, even more so if you’re hurt.

Chris Hedges:  You’ve long argued that addiction is an outcome of childhood trauma. You say this is based on shame, a shame-based view of ourselves, negative self-perception, a loss of compassion for one’s self. You write, “The more severe the trauma, the more total that loss.” Can you talk about the loss and its effects?

Gabor Maté:  Sure. So for 12 years I worked as a physician in Vancouver’s Downtown Eastside, which, I don’t know if you’ve ever been here, Chris.

Chris Hedges:  I have. I have. And I have gone down to the Eastside.

Gabor Maté:  It’s shocking for people coming even from the ghettos in the United States. It’s North America’s most concentrated area of drug use. And in 12 years I worked down there, I never met a single female patient who had not been sexually abused as a child, and all the men had been severely abused, sometimes sexually, sometimes in other ways, neglected and so on. Not by accident, 30% of our clients down there were Indigenous First Nations Canadians. They make up 5% of the population. They’re also the most traumatized segment of the Canadian population. A shocking 50% of the women in jail in our country are Indigenous. They make up 5% of the female population. So what that trauma does is it hollows out the self because, again, it’s too painful to be connected to the self, and that pain will break through. And there’s a sense of emptiness, because the sense of fulfillment as a human being needs to come from within.

It needs to come from an embrace of one’s self as one is. But when it’s treated that badly, one ends up rejecting one’s self as not hurt, as a flawed, deficient individual. So underneath all trauma is a shame-based view of oneself, and that shame is searing. Now, all addictions are an attempt to escape from pain. So I don’t care if you’re addicted to gambling or sex or shopping or the internet or self-cutting or eating or drugs or alcohol, it’s all about soothing the pain of that shame, soothing the pain of what you endured. And when that pain breaks through, you have to soothe the pain by some addictive behavior. So that’s what I meant there. So underneath addiction – People think that they’re ashamed of themselves because they’re addicted, it’s as least as much the other way around. They’re addicted because they’re so ashamed of themselves.

Chris Hedges:  Well, you write about how consumer society plays on this. You say that if trauma entails a disconnection from the self, then it makes sense to say that we are being collectively flooded with influences that both exploit and reinforce this trauma.

These are your words, “Work pressures, multitasking, social media news updates, multiplicities of entertainment sources, these all induce us to become lost in our thoughts. Frantic activities, gadgets, meaningless conversations. We’re caught up in pursuits of all kinds that draw us on, not because they are necessary or inspiring or uplifting or because they enrich or add meaning to our lives, but simply because they obliterate the present.” Those are your words.

So that passage reminded me of the lines from W.H. Auden’s poem “September 1st, 1939”. “Faces along the bar, clinging to the average day. The lights must never go out, the music must always play. All the conventions conspire to make this ford assume the furniture of home. Least we should see where we are, lost in a haunted wood, children afraid of the night who have never been happy or good.”

Gabor Maté:  I should have just published a book with that poem and forgot everything else, because he says it all. Well, there are two large classes of people who confuse their desires with their needs. One of them is young children. When they want something, they think they need it, and they’re desperate if they don’t get it. In the hands of healthy adults, one learns that needs are not the same as desires. The other class of people who confuse their desires with their needs, of course, are addicts of all kinds. I need to go shopping, I need to have a drink. These aren’t needs, these are desires, but consumer society is based on making addicts out of everybody, to confuse our desires with our needs.

As the Catholic monk, whose work I’m sure you’re familiar with, Thomas Merton, said, the whole society is geared to raising our desires to this fever pitch so that we can be consuming the products of the film studios and all the factories. And so our whole consumerism is based on creating false needs. And if we weren’t at this fever pitch of desire all the time, we wouldn’t buy all the stuff that we buy, nor would we be coasting on the internet to fill every moment because we’re so empty and we’re so afraid of ourselves that we have to distract ourselves from our own presence by whatever means. Now, if you look on the internet, on YouTube for example, what gets seen by millions?

There’s, recently, Eli Manning, the former New York Jets, was it? No, Giants quarterback went to this college, and he pretended to be somebody he wasn’t. It doesn’t matter, it’s trivial. 11 million views in three weeks. So the average person in America knows a whole lot about what quarterbacking strategy the Denver Broncos or the Tampa Bay Buccaneers should be pursuing, and then there’s big discussions about this. What does it matter to anybody? But ask the average American or Canadian to string two intelligent sentences together about the history of Afghanistan, or the history of Ukraine, or even about climate change, they’re not able to do it. So the whole society is designed, the whole culture is designed to draw our attention away from what’s important and make us believe that what’s trivial is actually essential. And that’s both a consumer strategy, but it’s also a propaganda imperative.

Chris Hedges:  Well, you’re right about the dopamine hits, and a constant need because you get a high, but then you fall into a low and you need another hit, and that consumer society depends on this pleasure principle, if we want to quote Freud. But in fact, of course, what makes us content, what provides joy, is outside of that self-destructive behavior.

Gabor Maté:  Absolutely. And this society is perfectly, I would say designed, but it’s not actually designed. As you and I know, it’s not that there aren’t conspiracies at the top and in all aspects of corporate life, but the whole thing is not a conspiracy as such. It’s almost a self-organizing organism that, on the one hand, deprives us of our genuine needs as children and as young people so that we create false needs to which you can cater. So society both creates these false needs and then creates an economy that caters to them. In fact, the economy couldn’t survive the way it is if it wasn’t based on false needs. So it’s a perfect mechanism, and it couldn’t have been designed better to sustain itself, at the cost of human health, of course, and human life even.

Chris Hedges:  I want to talk about passing on trauma. That’s something that I’ve had to deal with, that when we don’t resolve that trauma, you write in Ourselves, you say, “The home becomes a place where we unwittingly recreate scenarios reminiscent of those that wounded us when we were small.” Can you talk about how this trauma is passed down?

Gabor Maté:  I’m reminded of a statement of Primo Levi. I don’t know if you’ve read Primo Levi, but –

Chris Hedges:  Oh, of course.

Gabor Maté:  …He’s one of the great writers, one of the very few great writers, actually, on the genocide. He wasn’t somebody who sentimentalized anything. And he said at some point in one of his books that let’s not recreate in our homes the same conditions that existed in the camps. And that may seem like a shocking statement, because how can you possibly compare the two? But in terms of wounding children, again, you don’t need those dramatic historical circumstances. So I talked about my own formative year, the first year of my life, in the sense that I thought I wasn’t lovable and wanted.

Well, the way I compensated for that, in part, was to go to medical school, because when you go to medical school, you get a sense of self-importance. And it’s very traumatic to go to medical school, but you come out of it with a lot of power and a lot of knowledge that makes you indispensable to the world, and now they’re going to want you all the time. And the beeper’s always going. Every time the beeper goes, you get a dopamine hit. Oh, they want me. I’m so important. But it’s addictive, because it never fills the emptiness inside. So I’m a workaholic physician and I’m carrying my depressions and anxieties and so on, but not on the job. They come out at home.

Now, what message do my kids get when daddy’s not around because he’s always busy looking after other people, or when he is home, he’s kind of depressed and morose? Same message I got: that they’re not wanted. And this is a middle class Vancouver, British Columbia, home in a leafy, lovely neighborhood, no circumstances of abuse or deprivation or war, and yet my children are getting the same message I got. So this is how we pass it on unwittingly. And not because we don’t love our kids, and not because we don’t do our best, but simply because our best is constrained and informed by our own unresolved trauma. And most of us, or many of us have children when we’re very young, before we actually have resolved or even recognized our traumas.

Chris Hedges:  Yes. That was something I’ve dealt with. I remember helping my kids build a gingerbread house when they were little and then just without thinking, I said, let’s play Bosnia and burn it down.

You say that all illnesses, if not psychosomatic in origin, have psychosomatic components, and there are long passages in the book where you tie trauma of individuals, often childhood trauma, to a variety of diseases. You argue that confronting the underlying trauma often mitigates and even, at times, eradicates the disease. Stress, you say, may disable our immune system’s capacity to control and eliminate malignancy. That’s a big topic, and people are going to have to buy the book, which they should do, but can you touch on that?

Gabor Maté:  Yeah. I’ve discussed this in a previous book of mine which you mentioned, When the Body Says No. But this is what’s so frustrating, Chris, is that I’m talking here not about conjecture or intuition, I’m talking about science. So in the 1860s or ’70s, whenever it was, Jean Martin-Charcot, the French neurologist who first described multiple sclerosis, said that this is a stress-driven disease. James Paget, a British surgeon around the same time, talked about breast cancer in women and how it’s inescapable to link between emotions and breast cancer. Sir William Osler, one of the founding physicians at John Hopkins in Baltimore, said in the 1890s, I think, that rheumatoid arthritis was a stress-driven disease.

Without going into, in 1938, a great lecturer at Harvard, a physician whose name is still honored at Harvard in a research day named after him, Dr. Soma Weiss, like myself from Hungary, he said that emotional factors are at least as important in the causation of illness as physical elements and should be at least as important in the treatment. This lecture was published in the Journal of the American Medical Association. Now, they had no science to back it up, they just had their intuition. Since then, we’ve had 80 years of science showing the relationship between emotions and physiology, because you can’t separate the mind from the body. Scientifically speaking, you cannot separate the mind from the body, and the emotional apparatus is part and parcel of the same system that runs the immune apparatus as well. So when I say psychosomatic, I’m not meaning imagined, I’m meaning literally the oneness of psyche and soma, the mind and the emotional circuits of the body and the brain with the physiology of the rest of the body.

Chris Hedges:  Is this what you mean by neurogenic inflammation?

Gabor Maté:  Well, neurogenic inflammation simply means that the nervous system can trigger inflammation in the body, and of course the nervous system, as easy to demonstrate, is very much influenced by emotions. You have a certain emotional state, your nervous system changes by definition, and that can initiate inflammation in a body. A recent study three weeks ago showed that a single episode of racism will instigate inflammation in the body and suppress the immune system. So everything is psychosomatic in that sense, not in the sense of imagined, but that the psyche is influencing the soma because they’re one system.

Long-term stress, long-term release of stress hormones like cortisol, suppresses the immune system and makes it less able to resist malignant transformation, and also can turn the immune system against oneself so that one has more of a chance of developing autoimmune disease, which not surprisingly, who’s most prone for? Women of color. Because A, they’re women, so they’re more stressed over gender reasons, and of color because they’re more stressed because of racist reasons. So the more intersection there is of gender and race, the more autoimmune disease you have. It’s strict science. And the frustrating part of it is the average medical student doesn’t get a single lecture on any of this stuff despite the voluminous science. It’s incredible, the gap between science and medical practice.

Chris Hedges:  On pages 101 and 102, you drop a list of personality features that you say are most often present in people with chronic illnesses. What are the traits, and why do so many chronically ill people have those traits?

Gabor Maté:  Yes. So in family practice, which I pursued for 22 years, I think, some of which I also was the medical coordinator of the palliative care unit at Vancouver Hospital, I noticed that who got sick and who didn’t wasn’t accidental. And as a family physician, I did have an advantage over my specialist colleagues in that I knew my patients as people. I knew them before they got sick. I knew them in their families of origin. I knew them in their multi-generational family context, so I began to notice that people that developed chronic illness had certain character traits. These were an automatic regard for the emotional needs of others while ignoring their own, rigid identification with duty, role, and responsibilities. So in other words, their duty out in the world, their responsibility out there rather than who they were as individuals, a repression of healthy anger.

Healthy anger. There’s a distinction between rage and unhealthy and healthy anger. And finally, two fatal beliefs that one is responsible for how other people feel, and one must never disappoint anybody. Now, these traits, it’s not, again, fanciful they lead to illness because they all impose tremendous stress on the individual. If you’ve ever been angry and if you know what a perturbation of the nervous system and the visceral anger involves, imagine not feeling anger, what energetic demand it is to repress the anger so much so you don’t even feel it, so one of these really nice people that never gets angry. It’s a tremendous diversion of body energy. That wears on the immune system and the nervous system.

So it’s that long-term stress, then, that leads to the illness. Not these traits cause the illness, but these traits make you much more prone to be stressed without even you knowing it, and therefore you’re more prone to illness. It’s a very straightforward correlation.

Chris Hedges:  I see that play out in the prison, because my students in the prison cannot express anger to the guards, and it’s just an epidemic. Diabetes, hypertension, heart disease, everything because, of course, if they express that anger, they’re immediately punished.

Gabor Maté:  Yeah. And no wonder, you see, like James Baldwin once said, I think that to be an American Black is to be in a constant state of suppressed anger.

Chris Hedges:  Yes.

Gabor Maté:  And the question is what to do with that anger? It’s no wonder that Black American males have a much higher risk of high blood pressure. It’s got nothing to do with genetics. Their genetic relatives in Africa do not have the same risk. It has to do with the stress of being American and Black and not being allowed to be angry.

Chris Hedges:  I want to talk about the tension or the clash between what you call two essential needs: attachment and authenticity. You call this ground zero for the most widespread form of trauma in our society. Can you explain that idea?

Gabor Maté:  Sure. So attachment is simply the drive to be close to somebody. It’s a biological, instinctive, psychological drive that’s part of our evolutionary heritage. And we share that with other mammals, because without attachment, the drive to be close between parent and infant, no mammalian infant would survive. So we’re simply wired for it, and especially the young child is wired to attach because without that attachment, there’s just no life, period.

Now, we also have another need as well, which is what I call authenticity, and that comes from the word auto, for the self, and being in touch with our feelings, knowing what we feel and being able to act on that. Now, don’t forget, we evolved out there in nature for millions of years and for hundreds of thousands of years until a blink of an eye ago in humans, even in existence of our own species, we lived out in nature. How long does any creature survive in nature if they’re not in touch with their gut feelings? And that’s what I mean by authenticity, is being in connection with our bodies and our emotions.

However, according to much of the toxic parenting advice that is doled out, the tiger mom and Emily Oster’s Parenting by the Numbers, it is designed to teach parents to ignore their parenting instincts. And if a child shows up angry, for example, they should be made to sit by themselves until they come back to normal, according to a very famous psychologist who, blessedly, will remain unnamed in this program. But he’s Canadian –

Chris Hedges:  He’s named in your book, isn’t he?

Gabor Maté:  He’s named in my book. And he says that an angry child should be made to sit by themselves until they come back to normal. So anger in a child is not normal. I got news for that psychologist. Anger is built into our brain as one of our essential brain circuits because it’s an important boundary defense. Now, if a child gets the message, or Hillary Clinton, who I talk about, who runs into her mother’s home at age four seeking protection from bullies and she’s told there’s no room for cards in this house, that you get out there and deal with it, when a child’s natural fear is not acceptable and a child’s desire for help is not acceptable, when the child’s natural anger is not acceptable, the child has a decision to make.

Am I going to be authentic and be rejected by my parents, or should I reject myself and be accepted by my parents? Well, the tragic tension invariably gets resolved in favor of attachment, and a person adaptively suppresses their authenticity, but then that becomes a lifelong paradigm and we live out of a false sense of self. We don’t know what we feel, we dare not ask for help. We dare not say no at the demands of the world, and that makes us sick. So that’s what the tragic tension is. And a lot of people, when they get sick, they actually learn to be themselves. And when they do, not just as documented by myself but by others as well, there’s a much better chance for health.

Chris Hedges:  Yeah. I think this is why you write that the personality traits we come to believe are us, and perhaps even take pride and actually bear the scars of where we lost connection to ourselves.

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