Culture, Society and Trauma – Dr. Gabor Maté – HPP 77

SPEAKERS

Keith Kurlander, Dr. Will Van Derveer, Dr. Gabor Maté

 

Dr. Gabor Maté  00:00

So if I’m depressed and then I look at the word depression, what does that mean? It means pushing down. So what am I pushing down when I’m depressed? Well, I’m pushing down my anger. But maybe I have a good reason why I’m pushing down my anger because in childhood, my parents were too threatened by the anger and I couldn’t really express it. So I learned to push it down. That becomes my dynamic, 30 years later, I’m diagnosed with depression.

 

Dr. Will Van Derveer  00:30

Thank you for joining us for the higher practice podcast. I’m Dr. Will Van Derveer, with Keith Kurlander. And this is the podcast where we explore what it takes to achieve optimal mental health. I’m especially delighted to introduce today’s guest, a fellow physician on the path of knowledge, I would say on the path of truth, a real seeker of truth, Gabor Maté, as you’ll enjoy hearing about in this episode. He needs no introduction. He has written a number of best-selling books in Canada; books that have been incredibly important and meaningful for me in my journey, as a physician who works with people with a lot of trauma. The books that I would highly recommend of Gabor Maté include, “In the realm of the hungry ghosts”, and “When the body says no”, there are a number of other great ones too. He has a new book coming out, which I’ll talk about in this interview. And Gabor Mate is really an expansive thinker who likes to think about culture, and cultural themes. He was born in Hungary, you’re going to hear about his experience of communism and capitalism and structures of racial inequity. One of my favorite things about Gabor is how open he is about his own journey to get well, to become whole, to face and work through his own trauma. And I think we need more leaders like Gabor who are willing to talk about their own journey that way. So without further ado, please enjoy this episode with Gabor Maté. We’re delighted to welcome Gabor Maté back to our show. Welcome Gabor.

 

Dr. Gabor Maté  02:13

Nice to be with you guys.

 

Dr. Will Van Derveer  02:15

Great to see you. We thought that we would talk with you today a little bit more about your own personal journey as a human being. And you know, you’ve dedicated most of your life in your professional world anyway to trauma and elucidating the underlying causes of things from autoimmune disease to other physical illnesses to manifestations of trauma and psychology. How would you connect your earliest experiences to your lifelong interest in trauma?

 

Dr. Gabor Maté  02:44

Well, the first thing I have to say is that it’s not quite accurate to say that I’ve dedicated my life to trauma. It’s more like I just want to figure out why things are the way they are. It’s not like I said, well, let’s look at trauma as a physician, as a family practitioner, but also in my personal life. I just want to know, why are things the way they are. And so if trauma then arises as a significant part of the answer, that’s in the nature of the inquiry. It’s not that it’s a decision that I made. And that’s an important distinction. Because I think, in life in general, and in medicine specifically, I think the big question is just why are things the way they are, and without that, we can’t get to any sort of answers as to what to do about things. So that’s a long way of answering your question, but in my own life, with my particular history of being an Eastern European Jew who was born into the Second World War and its traumas. And then my family has been devastated by the genocide, and then growing up in communist Hungary, as a child. And I have to say that the communist system was brutal and dictatorial as it was, on the ideological level, taught social caring and social justice at its ideals. So you had a system that inculcated a certain sense of social justice, at the same time is trampling all over it, then real practice. So the question, Why are things the way they are? And why do people do these terrible things to each other? And why do people have to suffer but don’t deserve to suffer? These questions have been agitating me ever since I was a child. And of course, that naturally extends into the types of medicines. Why do people suffer? And what are the sources of suffering? Then I’ve had to deal with my own challenges. You know, my default baseline is depression, you know, so that’s why I automatically go to a default network in the brain. Mine is organized around sort of a negative view of life, and kind of it can never get better. Not ideology, but mindset. Now, I happen to know that’s not accurate. I’m just talking about the default setting. So I had to ask what set me that way? And why did I keep going back to it, this way what I know? Then the answer that emerges to all these questions happens to be trauma. That’s how I got to my trauma perspective.

 

Keith Kurlander  05:04

Did that, you know, you obviously were born into a very, extremely challenging climate at the time. And they hear you basically asking these questions of why do we suffer this way? I mean, I’m assuming were you also sort of asking the questions why don’t people treat each other this way? Is that a question you’ve been asking yourself in your lifetime?

 

Dr. Gabor Maté  05:24

Yes, why do people do it to each other what they do? Why do people impose suffering on themselves and then on one another? Yeah. And again, the answer I come to is trauma.

 

Keith Kurlander  05:36

You know, with the way the world is right now, there’s kind of a heightened moment, a lot of tension, a lot of social unrest and is you’re kind of understanding that people are acting out of trauma, basically, when they’re just treating people poorly, and that it really all stems from trauma. Is that kind of your conclusion?

 

Dr. Gabor Maté  05:55

Well, yeah, that’s a really important question, Keith. And this is where I need to be careful, because there’s a kind of danger of reductionism in narrowing down to individual psychology. But it’s not that simple. There’s also a system in place here. So just to look at COVID, what do we see? We see, first of all that it doesn’t destroy, it curses equally on the population, that certain people are more vulnerable, not that anybody is immune to the possibility of getting COVID. But it’s not striking the population equally is it? It has to be striking people who are politically the least powerful, economically the most exploited, and racially the most oppressed. So that’s not just a question of individual trauma, that’s a question of our whole system set up. And economically speaking against devastating the most vulnerable, and the richest are actually getting richer, so that the most wealthy people have actually reaped major benefits under the COVID system. So Jeff Bezos is multiple billions of dollars richer now than he was in March. And he’s not the only one so that, in addition to individual trauma, we also have to look at the system in which the trauma operates. If you take someone like Donald Trump, who I’ve been saying for years publicly that he is a highly traumatized man, you can just tell his trauma is, all you do is look at him for five seconds, turn the sound off and just look at his face, you see a traumatized person. But because of his class background, and the fact that he comes from a wealthy family, his particular trauma results in me being elected to the most powerful office in the country. Somebody else with his level of trauma, from a lower class background ends up in jail, so that there’s also a system in place here, and so that the individual trauma, and you know, this is the subject of my next book, but the individual trauma manifests itself in a social, economic, political context. And so it’s not just individual psychology that explains why things are the way they are, but also how the system is set up, who rules and who benefits and who suffers and who makes decisions and who doesn’t. These also have huge implications on why and who suffers.

 

Dr. Will Van Derveer  08:10

Right we have these intergenerational structures that have evolved for the concentration of power over and you know, it’s been 1000s of years, this has been growing and building. And we recently interviewed Resmaa Menakem, who talks about structural racism. He’s an African American Somatic Experiencing practitioner in Minneapolis and he was talking about how people with white bodies were beheading each other and traumatizing each other and killing and maiming and subordinating each other in Europe for hundreds of years before white people started dominating African descent people in this continent, and his work has me thinking about your work and his work. And it reminds me of not just the personal journey of healing trauma, but also what can we do on this more structural level? What are your thoughts about that?

 

Dr. Gabor Maté  09:00

Well, yeah, so again, this is something I’ve been thinking about, the last time there was really quality on Earth, when we were living in small band hunter gatherer groups of 50, 80 to a 100 people before the accumulation of private property and power and gender control, now that’s most of human existence, by the way. This is how we evolved. So that I think hominids have been on earth for so many years or so I think, in our physical species, Homo sapiens has been around for 150,000 years, give or take, and for 90% of that time, we live in small band hunter gatherer together that’s entirely different ethic, communal sense of oneself, relationship with nature, relationship with each other, relationship with childhood, relationship with child rearing, relationship with authority, all that was completely different. And then with agriculture, this is generally acknowledged now. And then the agriculture of revolution, you get the accumulation of private property and with the condition of private property, now you have variations of wealth and power, and you have the rise of the patriarchy. And so ever since the onset of urban life called class society where people started to divide into classes, some with more, some with less, some with absolute and some with absolutely no control whatsoever. Then you have the phenomenon that you described. But racism is such really becomes prevalent with the rise of capitalism, when under slavery before but slavery wasn’t based on race, in the Roman Empire, you could be a white person becomes a slave, for what that’s worth. So then in Europe, Western Europe, capitalism arises, and then the search for raw materials and the expansion begins with the Spanish and Dutch and British empires, French empires, then all of a sudden, and especially So let me start dominating me. I mean, the Caucasians start dominating other races, and especially consigning into slavery. Now you have to have an ideology that explains to you why we have the right to do this. And the ideology is both religious and now we have the right religion, so we can slaughter them in the name of Jesus. And literally, if you read the histories of Latin America, you can’t kill people if they don’t know about Jesus. But if you tell them about Jesus and they don’t succumb, then you have pagans. And now you can kill them. So literally, the Spanish would arrive in some coastal village, read out in Latin, or Spanish, some Christian doctrine, if the natives didn’t agree, now, you could slaughter them, literally, this is how they saw it. So those are religious superiority, and then the racial one that we have because they are inferior we have the right to control them dominate and kill them or enslave so that the concept of race was a fairly recent development in tandem with the rise of capitalism and its need to dominate other nations internationally, in other people. By the way, if you look at the history of American policing, you know about the policing roles? I don’t want to talk about the racial bias in police practice, but policing in the states started off as slave patrols to capture and control escaped slaves, that was its origin. So these things that we take for granted, they all have historical origin, which relate to the nature of the system, as structural as your friend said.

 

Dr. Will Van Derveer  12:33

Structural, yeah. And obviously, from your experience in Hungary, this kind of gaslighting or disingenuous concern about social equity, which in practice was not happening from what I’m understanding, and having experienced the Canadian political environment. After that, I mean, are you observing, you know, the American nightmare over here? What do you think about how humans organize and structure themselves in a culture? Is there a possibility that’s not just a utopian fantasy for all of us to have opportunity and care for each other?

 

Dr. Gabor Maté  13:11

It’s interesting. I grew up as a fervent proponent so that in school assemblies, when the principal would mention the party leader, there’s like a cue, and they would all stand up and clap. Long live Mátyás Rákosi, Rákosi was the name of the Hungarian mini Stalin that ruled the country and long lived the party and I was fully enthusiastic about it. And then I remember in 1955 when I was 11 years old, there’s a block meeting organized by the party. And I was given this poem to recite, and I did recite it with my fist raised in the air, chanting or trembling you lords of Wall Street, now, I had no idea what Wall Street was or where it was. So then comes the Hungarian revolution in 1956, where the country rolls against the communist system, the dictatorial nature of the inequality, the brutality of it, and against the Soviet occupation. And all of a sudden, I realized that what I believed in was a total illusion that I bought into some kind of a dream, you know, when I was 13. And so the Soviets who had saved my life as an infant in defeating the Germans, now and who I had idolized all my life as a child, now becomes the enemy and the oppressor. So they come to the west, and the Americans become the heroes. And I remember traveling to Germany, seeing these khaki clothes, the neck and servicing them, seeing them as the protectors and the heroes, that was the 1950s, early 1957. And then Wall Street becomes the symbol of prosperity. And American capitalism becomes the symbol of democracy, freedom and protection. That’s 1957. And then, by the early 60s, 5, 6, 7 years later I was at the Vietnam War. And I thought, I see these American heroes democracy slaughtering millions of Asians in the name of a complete lie. And then I started looking at history. And I started looking at how virtually every single one of American wars there were wars of expansion and aggression, starting with the Mexican-American war. And then the annexation of Texas and then the Spanish-American War and the war in the Philippines and extermination of local resistance, the multiple interventions in Latin American ever since in the name of freedom, is support of the dictatorships like Somoza, Nicaragua, and Battista in Juba. And this continues, I’m gonna give you guys a fact and easy to look this up. You don’t have to take my word for it. But if I asked you, you guys, progressive, open minded people aware Americans, how many people were slaughtered in Guatemala in the 1990s? Not that long ago. with American support? Could you tell me a figure?    A 100,000, and you don’t even nobody, you know, you don’t have to take my word for it. You can really look this up in research. And if I’m wrong, let me know. But I know I’m not wrong. Between 80,000 to 100,000, mostly indigenous presence. I could go on and on and on. And so what I came to realize is that everything that the Soviets had said about Americans was true. Not Americans as the people but the American system as racists, as imperialists, and so on. And everything that the Americans said about the Soviets was also true, brutal, dictatorship, exploitative, dishonest, everything they said about each other was true. And everything they said about themselves was a lie. That’s what I found out. So then the question becomes, is there some way out? Well, I happen to think there is not that I’m here to describe it, but that the very fight that we’re talking about, and people are always interested in the truth. And there’s an innate desire in people for freedom, whether they know it or not, there’s an innate desire for freedom and for truth. So I believe in it. And I also don’t believe that any system is foolish to think that any system is permanent, I mean if you look at history, systems change and empires fall and new things arise. And you might say, well, what rules are equally as bad and some are worse than before. And that’s often true. But the point is that nothing is permanent. But what I think is permanent is the human desire for truth, justice and freedom. I think that’s permanent. It doesn’t always manifest itself. And it’s often beaten down, but it’s never destroyed. So I believe in that.

 

Dr. Will Van Derveer  16:09

I couldn’t tell you.

 

Keith Kurlander  17:41

Yeah. You reminded me I had a conversation in Israel, I don’t know, maybe 20 years ago with a rabbi. And I said, I asked him a question, is life on Earth right now as good as it’s gonna get? Like, is this sort of, is this gonna be as sort of skillful as we get as nations interacting with each other? And he said to me, you’re not really grasping that. When you look at the span of how long nations have been around, that we’re really just children still, as nations. We’re not even teenagers or adults yet at all around long enough to claim that and he said, hopefully, we make it through adolescence. Don’t kill each other along the way. So yeah, I’m just curious, like, do you feel like we’re hopeful that you know, human beings are on a quest for truth. What do you feel like needs to change here on a more global level in terms of how we’re going to get along? Is it just personal work, more personal work has to happen for people to grow up and learn how to be together? Is it something else?

 

Dr. Gabor Maté  18:42

Well, history does have a logic of its own. So when systems begin to fail, I mean I know things that are happening now in the Western world, there’s a lot of people starting to question the system. 10 years ago, if you use the word capitalism, you’ll be seen as a raving lunatic Marxist. But now the New York Times’ editorials about capitalism says we’ll be saved from itself. Now there is, when things lead to crisis, people start questioning things. And so if you look at the French Revolution, which was very much inspired by the American Revolution, by the way. When things begin to fail, then people start developing new ideologies and new ways of looking at the world. So the French slogan of equality and solidarity, and freedom wouldn’t have made sense in the 15th century, although it did make sense to some people, because there was peasant rebellion in Europe, where the slogan was. Well, the peasant rebellion in England was in the 15th century, and the slogan was Adam rolls and Eva Spann, who was then the gentleman, in other words, at the beginnings of humanity, where were the class distinctions? So people had sensed that this wasn’t right. So as systems begin to fail, people start asking questions, and out of those questions will come the answers. So as the French feudal system began to totter, and fail and that didn’t happen overnight. But all of a sudden, we call it the Liberty fraternity becomes slogans. Now, the revolution very quickly betrayed its own slogans. Just as the Russian Revolution very quickly betrayed its own slogans. But the very fact that these slogans arise and repeatedly speaks to what I mean about the human drive for freedom and for truth, and for justice. So, yeah, I think that’s going to continue. I think that’s eternal. And I once spoke with Noam Chomsky, no actually Chomsky interviewed. And he was asked, Is he a pessimist or an optimist? And he said, strategically, I’m an optimist. And tactically I’m a pessimist, which means that in the long term, I believe in positive change in the short term, things might get worse before they get better. And that’s how I see the situation right now. So yeah, I’m an optimist in the long term. But I think, well, this brings you back to medicine, the reclaimer, right escalates, and it’s play the Agamemnon, he has the course to say that the way the gods created us, we have to suffer in truth. Now, I’m sure you’ve both seen this in your clinical practice, as something terrible happens to somebody, and then they start learning the truth. And they actually become transformed by their suffering in positive ways, I mean, maybe all three of us have experienced this in less dramatic ways, but I certainly had to suffer a lot of truth in my own life. Now the same thing is true of people on a social level. So sometimes we have to go through some very difficult times before we grasp the truth.  I no longer remember what the question I just answered. I hope it was a good answer.

 

Dr. Will Van Derveer  21:40

It was a great answer. Inside of the chaos and the unrest and the questioning of the patriarchal structure, it seems like to me that there must be opportunities , huge opportunities for change and transformation inside of the decline or the opening up of this structure. And I’m wondering if you have any ideas about what some of those opportunities are right now?

 

Dr. Gabor Maté  22:05

Well, so you had the horrible case of George Lloyd. Now that opened a lot of people’s eyes to systemic and structural racism. So for example, the support for Black Lives Matter amongst non black people went into quite a bit in the immediate aftermath. That’s an interesting question to ask is, where were these people before, like police brutality against black people, nothing about it. It’s only been going on for 400 years, and has been numerous examples of it every year in the States. This has happened to go viral. That’s the only reason you know about it. Because there was a 17 year old young woman there with the presence of mind and the courage to film. But nevertheless, it happened. And all of a sudden, there was a huge opportunity to ask some questions. But before then you couldn’t have asked or have people listening. In Canada, it’s the same thing. You can’t grow up in Canada and have your eyes opened and not recognize what a racist system is because when I worked in addictions in Vancouver’s Downtown Eastside, 30% of my clients were First Nation Aboriginal origin, they make up 5% of the population. For the Canadian jails, 30% of the jail population are First Nation Aboriginal origin, they make up 5% of the population. You have to believe one of two things, there’s something inherently wrong with these people. In other words, you can make a racist out of that or the system is doing something to them. And of course, what it’s doing is traumatizing them. Which means they are a bit more with their addictions and do more and less functional, violent, and addiction related behaviors that land them in jail, which this system, what we do is we punish people of lower class who get traumatized. We reward people, very often people of higher class get traumatized like Harvey Weinstein, who clearly to me, is a highly traumatized person, from what little I know about his history, you can just see him, but he gets to be powerful, and wreak all kinds of damage before he’s brought down. And in another, they’re in an era 10 years ago, he might not have been brought, or as I mentioned earlier, with Donald Trump. So the possibility when these crises happen is when people see the truth. So I think what we can do right now is start really asking why, what’s going on, and not be satisfied with superficial answers. I mean, from a medical point of view, well, I was speaking to do you know who Lewis Mehl Madrona is? He’s an American physician, psychiatrist. He’s also partly of Cherokee and Lakota origin. So he’s worked in high tech emergency medicine, but he’s also knowledgeable of native ways. He was telling me that in the Lakota tradition, when somebody gets sick, they’re seen as canary in the mind. they’re seen as manifesting the illness. So this function of the Vols system for the group that they’re a part in, so to actually be honored for manifesting the dysfunction of the system, and so that everybody gathers on to help heal them, because in doing so, he is healing the whole group. Now, it so happens, that’s also the physiological side effects of the illness in general. But most physicians are not aware of it. So that when somebody develops an addiction in the family, or mental illness in the family, or in my view, and I can show this, physiological inside a family, then it’s not just an individual claim. Their manifesting in their relationships with the whole system that they’re a part of. So Dan Siegel, the psychiatrist talks about interpersonal neurobiology, but our nervous systems are locked into each other, and they affect each other, that faces other meetings as well. But that’s one. So that I spoke to you and what tone I speak to you, and with what body language I speak, and what our power relationships are has an impact on your physiology and your nervousness. Now I take as a medical doctor, I take that a step further. And I take Dan’s concepts of interpersonal neurophysiology, interpersonal neurobiology. And I say, all of the budge isn’t the person to the stressor apparatus, to the hormonal apparatus, the nervous system, that we affect each other, which means that the manifestation of the illness in an individual is actually speaking to the system that they’re a part of. As you mentioned earlier, the multi-generational system, and the current founding system, and the community and so on. And we can see this in COVID. Because, again, who gets sick and who doesn’t isn’t totally accidental. It’s a systemic manifestation. And so again, the healing has to begin with asking, well, what is it about the system that we’re all a part of that these illnesses are manifesting, and COVID for one is a lot of lessons to teach. And so maybe, I mean, the biggest tragedy apart from the individual and community tragedies of people getting sick and dying. But the biggest long term tragedy of COVID would be if we didn’t learn the lessons, because there’s a lot to teach us. So I think what we can do to start with, is educate ourselves and keep asking questions. And by the way, you guys might ask yourselves as two Americans, how come you didn’t know about Guatemala? And not as that you should have known, and as a critical or an accusatory question, but it is a question of inquiry. How can we live in, we have this screaming news in the media, and the screens and ads and all kinds of information is available? What kind of a bubble do we live in that we’re not aware of what’s happening next door as a result of our own policies, and all these people that are coming from Central America, to the States, these refugees that Trump wants to build the wall against, in which Obama deported in higher numbers than any president before him? Where are they coming from? There’s a new book called “The unforgetting” by Roberto Lovato. He was an Ecuadorian American journalist. He was reviewed in the New York Times this last weekend. In his country in Ecuador. 10s of people are slaughtered by the army, and by right-wing death squads with American support and American weaponry and American leadership. Do Americans even know about it? Do they realize that these refugees that are coming from those countries are coming from dire situations created by American domination and foreign policy? And the same questions can be asked you know, internally, how can such a high proportion of the prison population be minority of origin? Same as in my country. I’m not saying Canada’s better than the States. I’m saying that these systemic questions need to be asked and we have to break through the wall of denial, and it’s bubbled up. We all live in places where we’re not seeing the whole of reality. So I think the biggest question is are we willing to break through the bubble? Just as I lived in this bubble, as this idealistic little communist, you know, but I was talking to Noam Chomsky once and they both agreed that the propaganda system here in North America is far more sophisticated and effective than the crude propaganda of communism was in Eastern Europe. Because they had the adults who mostly knew that it was all nonsense. They didn’t say so. I remember because I have to say as a kid it will be to risk dire consequences. I remember one t-shirt of mine when I was in grade three, which would have been what 1953 maybe 1952. It was an all boys class where we were gender differentiated schools. And this guy said, on the winter solstice, he said, boys, this is the darkest day of the year. And it also happens to be Stalin’s birthday. But don’t tell anybody I said so. And it is only in retrospect, they realize what a slight courage it took for him to say that. I didn’t know what he meant at the time but I never forgot it, and I only realized only later that I became like, wow, this guy was really putting his neck on the head anyway. But the point is, so what I’m saying is that the adults knew what was going on. They couldn’t say so. Here, people actually think they’re living in liberty and freedom, and they have free press and they’re getting the truth. And they don’t know anything. The simplest facts are eluding most people’s consciousness. And I have to say, again, the same thing is true in the medical world, because my knock against our profession, my profession, Will’s profession is, they keep talking about evidence based practice. And if there was one phase I would forbid, from anybody that says ever again, is evidence based, I would think anybody who said evidence base, they immediately should lose their medical license. Because this is not basing my practice on this evidence. We live in a bubble, every profession as a whole society lives in an ideological bubble, the medical profession lives in an ideological bubble. So that all the stuff about interpersonal biology that I told you about, I could go on forever, or interpersonal neurobiology. The evidence is there. 10s of 1000s of papers published in major journals, the average physician hasn’t got a clue. Now, if I could tell you something. Somebody sent me photographs, two days ago. This is a woman I met in London, I gave a talk there. SLE – systemic lupus erythematosus, a serious debilitating and potentially fatal autoimmune disease, for some reason, which we’ll go into, women are much more likely to get it than men, and for some other reason, but you might guess minority of women are even more likely to get it. What a surprise. Because it has to do with stress in life. You know, the average physician doesn’t get a clue about that, because they haven’t looked at the scientific evidence. They just see the disease as an isolated event that happens in a body for who knows what reason? Well, it’s according to its context. It has to do with stress, and emotional depression, and childhood trauma. And the physiological pathways are really clearly laid out. It’s not conjecture. So I met this woman in London, she came to a vlog of mine, and all sudden she realized these questions about what trauma I had endured as a child. What stresses am I under now? How do I relate to myself? What do I feel about myself? Why do I behave in the world? These may have something to do with my illness. She sent me photographs two days ago, two years ago, when I met her, her fingers were white.

 

Dr. Will Van Derveer  32:56

From Raynaud’s phenomenon,

 

Dr. Gabor Maté  32:58

Raynaud’s Yeah. fingers were white. Her face displayed the typical butterfly rash, it’s SLEs, it’s the redness of the face over the cheeks. And it looks like a butterfly, that’s why It’s called the butterfly rash, it’s pathognomonic of SLE. Her face is clear and beautiful, her hands, colors perfectly normal. This is without medication. She went over core emotions, and her trauma. But none of her physicians had ever asked her what anything that happened to her childhood. In other words, we have this bubble, biological bubble about living. We’re not putting in people’s lives in context. So that I’m saying that we live in a system that whether politically or medically or legalistically it always ignores context.

 

Keith Kurlander  33:50

I’m really curious about how you are framing the conversation of trauma and whatever you would frame as the opposite of trauma? I don’t know what you would frame that as presence through, like, how are you seeing basically the scope of like the human experience through a day? And what is health in a given moment? And what is trauma in a given moment? And is this just a continuum we’re all moving in and out of throughout a day, which is like, what we’re calling trauma is actually some kind of experiential, phenomenological experience where we’re dissociated, we’re not present and then we move back into presence, like how you framing all that in your head these days?

 

Dr. Gabor Maté  34:33

Well, first of all, it is a continuum and I think that, in my next book is called “The myth of normal”. Almost an elephant in an insane culture, and normal is a myth in this society. We are all on this spectrum. I mean, you talk about Spectrum Disorders, guess what, for all the different degrees, but the differences are more quantitative than qualitative. So yes, we’re on a continuum and certainly, look, if you had spoken to me yesterday, yesterday, I went back to the baseline. I was reading the dollar embittered mood yesterday. And there was no particular reason for it. It’s just where my nervous system was. Not there today. So yeah, I do move in and out of it. Although if I look at my trajectory, compare myself in my 40s, really far more healthy now than I was then. And so if you look at the origin of the word health, it has to do with wholeness. So trauma is the loss of that wholeness, as you say, Keith, the loss about presence, loss of connection. So trauma is not what happens to us. Like, I can show my hand here, you can see it on my forearm here, you see a kind of a wound, right? So what happened I happened to pass my forearm over the water heater, so I was boiling water for coffee or tea the other day, and the steam just blasted my arm, and I had this burn, the trauma wasn’t the steam. The trauma is the wound that I sustained. So trauma is not what happens to us and what happens inside of us and essentially, so what happens is that the word origin of trauma is wound. So trauma is the wound that we sustain, the psychic wounds we sustain, where if this one doesn’t heal, if I touch it right now sensitivity hurts. If I touch myself here, no pain, here, yeah, there’s a bit of pain there now, even though it’s been a week of healing. So trauma, these wounds that haven’t healed, and so they hurt. Or on the other hand, it might be a wound that scarred over and what is the nature of a scar? It protects the hurt tissue, but it’s also inflexible and rigid, and it doesn’t have nerve endings, so it doesn’t feel. That’s what trauma is sort of psychiatrically speaking. So trauma is a place where there’s an unhealed wound, but it’s raw or on the other hand where there’s a scar that’s rigid and unfeeling. And a primal trauma is disconnection from ourselves, because it’s too painful to be ourselves. So develop all these coping mechanisms not to be ourselves. And then the healing is then becoming whole again, reconnecting, reintegrating. And you both know this from your clinical work that traumas help people reintegrate them, which means also accepting and knowing these painful parts of ourselves and not rejecting them, and not trying to run away from them, but learning how to be with them. For sure, that’s what your work is all about.

 

Dr. Will Van Derveer  37:27

Absolutely, it’s a gathering of these fragmented parts of the self, so that the relationships between them can flow and dissociation between the fragments of the self don’t have to keep repeating themselves, and unconscious repetition of trauma. Which actually brings me to this other piece we wanted to hear more from you about, which is your self compassion project. And I’m wondering if you could tell us a little bit more about that, I’m guessing that it’s germane to what we’re talking about right now, in terms of applying presence to oneself.

 

Dr. Gabor Maté  38:05

So over the years, as a family physician, I’ve found that this physical illness like autoimmune disease, mental health conditions, like addictions, or depression, anxiety. Again, as I’ve been saying, These weren’t random events that have manifested a person’s life in a certain context of a multi generational family, society and culture and so on. Which meant that in addressing these conditions, it wasn’t enough to address the biological parameters. So if somebody was depressed, you couldn’t simply just say, well, you were lacking serotonin, take some Silexo or Prozac or Zoloft, or surgery, whatever, or when it comes to autoimmune disease. And sometimes a beneficiary has to look after the biology. But you don’t want to deal with the long term, how about looking at the long term emotional factors and stress factors that are discombobulating your system. The problem was that within the medical system, there’s nobody I could send people to for counseling, because the psychiatrists, present company excepted simply, for the most part don’t know a whole lot of counseling, they mostly deal with biological psychiatry and getting medications. That’s how they’re trained these days, these disease models. And the medical system in Canada pays for psychiatric visits. But I can never find, with rare exceptions, psychiatrists that knew how to counsel people. At the same time, the private counselor, who is a psychologist, is not paid for by the medical system. So in the part of Vancouver, I was working with people who couldn’t afford counselling. So I started bumbling my way into counseling. I set aside an hour a day. One or two people to come in and just talk for half an hour. So if I’m depressed and then I look at the word depression. What does that mean? It means pushing down. So what am I pushing down when I’m depressed? I’m pushing down my anger. But maybe I have a good reason why I’m pushing down my anger because in childhood. my parents were too threatened by the anger and I couldn’t really express it. So I learned to push it down. That becomes my dynamic. 30 years later, I’m diagnosed with depression. So this compassionate inquiry simply means a professional, or relating to oneself, asking questions to find out well, why? Again, this question of why we began the conversation. This phenomenon that you’re experiencing, what is the reason for it? Rather than rejecting it and making it bad, and calling it a disease, public looking at the function of it? And how about being compassionate towards yourself for having developed that particular way of coping? So in a nutshell, that’s what compassionate inquiry is all about. Now, it’s evolved into a psychotherapeutic method that actually I teach in several iterations and different forms, depending on who the students are. But it arose from my awareness that there’s more to us than meets the eye. Or as totally, the spiritual teacher says, there’s more to us than meets the I capital I. There’s more. There’s more to us than just the conditioned personality and egoic self.

 

Keith Kurlander  41:21

This is a good transition point as we wrap up. We’ve been asking every guest for a while the same question as we end, which is, if you had a billboard that everybody could see on the planet once in their life, there was a message you wanted to let them know, what would you want each person to know?

 

Dr. Gabor Maté  41:38

That your authentic self is the biggest gift to yourself and to the world. And to know that authenticity is in you. And if you’re not experiencing it, it’s only because at some point in your life, you were punished for being authentic, you were not accepted. But now you can really find your authenticity and make a contribution to yourself and to the world. So that billboard would have the words just be authentic.

 

Keith Kurlander  42:00

Thanks so much, Gabor.

 

Dr. Gabor Maté  42:02

It’s my pleasure. Thank you.

 

Dr. Will Van Derveer  42:06

Well, we hope that you enjoyed that conversation as much as we did. We obviously have our work cut out for us to address structural inequities in our culture, in our system, in our human evolution. And it’s daunting, but we have each other to move everything forward. So let’s do it, folks. We look forward to connecting with you again next time on the next episode of the higher practice podcast where we explore what it takes to achieve optimal mental health.