Dr Gabor Maté is on Zoom warning me that my inability to say ‘no’ will kill me, if I’m not careful.
Let’s say you and I were friends and you had no capacity to say no,” says the expert on addiction, mental health and childhood development. “Say whenever you are tired or don’t feel like it, or have many other things to do, I came to you with some kind of expectation, request or demand. And you said, ‘Yes, that’s fine.’ What would that mean for your system?”
“Well, you’re describing my life,” I tell him. “And I’m exhausted.”
“And that has an effect on your immune system,” he says. Again, I agree. I get every bug going.
“You’ll be stressed and resentful,” he adds. Yes and yes.
“Emotional resentment… when you feel it in your body, what’s going on in your chest and your belly?”
“My chest is tight and my tummy has a kind of clenching,” I reply.
“So you’re blocking blood flow — we’re not talking about abstract dynamics here,” he says, explaining one of the central theses that underpin all his work: our body and mind are inextricably linked. Feelings we suppress in the mind will show up in our body — either through chronic physical or mental illness, or addiction.
“But when I say ‘no’, I feel guilty,” I say. “Next time you feel guilty, celebrate it. Instead of a pity party, throw a guilt party because it means you’ve done something for yourself. My advice to people is if you are choosing between guilt and resentment, choose the guilt every time. The resentment will kill you.”
And I believe him.
The 78-year-old Hungarian-Canadian doctor is the author of several bestselling books, including the award-winning In The Realm Of Hungry Ghosts (about addiction); When The Body Says No (about chronic illness) and Scattered Minds (about ADHD). He has been telling me about his early years in medicine, when he worked in family practice and palliative care. In his daily practice and sitting by the bed of dying people, he noticed that there were patterns with patients with chronic illness, in particular those with autoimmune diseases.
“There were certain character traits that I couldn’t help notice. And these are: a compulsive concern for the emotional needs of others, while ignoring their own; a strong identification with the roles in the world rather than who they were as a person; a repression of healthy anger and, number four, they believe they are responsible for how people feel and have a fear of disappointing anyone.
“I have never met anyone with an autoimmune disease that does not meet these characteristics. All these traits represent self-repression. When you repress emotion, you’re also repressing the immune system.”
Far from being a New Age concept, he says this is a fact supported by medical literature. This repressed people-pleaser has been warned.
I ask him about depression, something else I experience regularly. Depression, he believes, is not an inherited brain disease, but rather a result of having to push down one’s emotions as a child. It’s a controversial stance, and one that other medics disagree with.
Dr Maté claims that, when we are children, we have two primal needs: to express ourselves authentically and to be attached to caregivers. When authenticity in the form of crying, anger or saying ‘no’ is not welcome in the family, you will suppress your authenticity in favour of being attached and this starts a lifelong pattern of pushing feelings down.
“What does it mean to depress something? It means to push it down.” Though he has taken and prescribed antidepressants — more on which later — he doesn’t consider depression to be a disease but rather a coping mechanism — as is all mental illness and addiction in his view. Again, it’s a controversial viewpoint.
With my therapy done, it’s time to talk about his new book — a telephone-book-sized offering called The Myth Of Normal: Trauma, Illness And Healing In A Toxic Culture. It’s about why the modern world is making so many of us sick. Western countries invest billions into healthcare, yet mental illness and chronic diseases are on the rise. Why?
Dr Maté believes that what we think of as normal in society from the point of view of human needs and evolution is absolutely abnormal.
His book outlines the stresses of modern life, starting with the damage done by books which tell parents to let their infants scream without picking them up. He talks about a school system that is about competition and evaluation rather than relaxation and learning. Then, we grow up and we are judged by how we look, what we achieve, how smart we are, how rich. We are taught to see other people as competition and wonder why we are so lonely. We are sold things that are supposed to make us feel better — new cars, artificial food, Botox, social media — but which only make us feel worse.
There is one word that describes what happens to us in these situations: trauma. “The essence of trauma is that you lose contact with yourself,” he says.
So when people are traumatised they don’t feel their real pain any more. They shut down and separate from themselves and their feelings, but the trauma will surface somehow, whether through illness, relationship issues, addiction, anger, depression…
Dr Maté speaks from personal experience. In the opening chapter, he shares a moment when his wife doesn’t pick him up from the airport and he goes into a rage. It takes a while for him to realise it had brought up feelings of being abandoned by his mother as a baby in Budapest in 1944.
Two months after he was born, the Nazis occupied Hungary and his mother, who had already lost both her parents in concentration camps, gave him to a stranger on the street, thinking it would save her baby’s life. He was only away from her for a few weeks but it had a lasting effect, which came to light when Dr Maté was in his 50s and a depressed workaholic diagnosed with ADHD.
“I was diagnosed in my late 50s and within a few months, two of my kids were diagnosed as well. But I never bought into this idea that this is a genetic disease or that it’s a disease at all. Tuning out is the hallmark of ADHD — why do we do that? Look at my own infancy. How does an infant deal with all that? Can it fight back? Escape the situation? Can I bear that much stress? No. So I tune out.
“When do I tune out? When my brain is developing. The brain develops in interaction with its environment. The most salient feature of this is our emotional relationship with our caregivers. In my relationship with my mother I had to tune out quite a bit, as did my kids, because they grew up in a very stressed home as well. So it began as a coping mechanism, just like depression.”
Dr Maté is honest about his own failings as a father: “I was a workaholic who defined his existence by how busy he was because the message I got as an infant was that I wasn’t wanted. My mom gave me to a stranger on the street. She did that to save my life, but what’s the message to me? I’m not wanted. If you’re not wanted, go to medical school — they’re gonna want you all the time. But what message did my kids get when I wasn’t around? That they’re not wanted. This is how we pass trauma on intergenerationally — it’s completely unintended. So I don’t blame any parents, nor should parents blame themselves — but the point is that we can reverse these patterns.”
I have no reason to feel unwanted because I was loved by both my parents. I was not given away as a child or brought up in the midst of Nazis — far from it! — but that’s Dr Maté’s point; we all pick up trauma along the way and it plays out in ways that we often don’t see until the behaviour we adopt causes us trouble.
As well as illness and mental disorders, he believes childhood trauma often leads to addiction. “The question is not why the addiction, but why the pain?” While he spent years working with drug addicts in Vancouver, he argues that most of us are addicted to something.
“Let me give you a definition of addiction. Addiction is manifested in any behaviour that a person finds temporary pleasure or relief in, and therefore craves but suffers negative consequences as a result and does not give up, despite the harm.
“It could be drugs or nicotine, caffeine, alcohol, opiates. It could also be sex, gambling, pornography, internet gaming, shopping, eating, work, extreme sports. I could go on… Let me ask you, do you have an addictive pattern?”
And we’re back to my personal therapy.
I could pick from several: hours of television, bottles of wine, online scrolling, but instead I tell him I overwork. “What do you get from it?” He asks. “What did you like about it in the short term?”
“A sense of importance and achievement, and working in newspapers you are very much needed.”
“So the feeling of being needed and important — is that a good thing or a bad thing?” he asks. “It’s a good thing,” I reply.
“The addiction is not your problem — it was an attempt to solve a problem. And the question is why on God’s green earth, did you not have a sense of importance just for your existence as a human? Why did you have to prove to yourself that people want you or that they should want you? Every infant needs to have that sense of being wanted and celebrated — that’s why my mantra on addiction is not why the addiction, but why the pain? The pain of not feeling wanted or needed? That’s painful. That means that in this society there are very few people who don’t have some kind of addiction.”
According to Dr Maté, the pain comes from not just our own experiences, but our parents and their parents’ experiences. “Fundamentally, when a child is conceived, they are already inheriting the trauma and joys their parents are carrying.”
They are also inheriting the pain of the culture around them and Ireland, he believes, is a deeply traumatised culture. “We’re talking about years of foreign occupation, and sometimes brutal occupation and also, of course, civil war of a murderous kind, then the potato Famine and the recent Troubles. And, of course, the longer story of the finally publicly acknowledged sexual abuse — and abuse in general — of children by religious authorities which are meant to represent God on earth. So the trauma and pain in Irish culture is immense. The resultant escape into alcoholism, which the Irish almost pride themselves on, is really a trauma response — a way of killing your pain.”
So what should we do with all this pain — both personal and collective? Self-awareness is the beginning, he says. It is painful to address past trauma, which is why so many of us don’t do it until we are forced to, with illness.
In The Myth Of Normal, Dr Maté shares several examples of profound healing that come from addressing long-suppressed feelings through therapy, creativity and, in some cases, psychedelics, which are being shown to help with PTSD and severe depression.
I ask him about the role of antidepressants, which he has taken himself. “They can be very beneficial sometimes, I found it that way. In some cases, they can be life-saving. My problem is not that they are used, but that they’re overused — that was my experience, I began to over-prescribe them, I was almost a Prozac evangelist for a while. It only addresses symptoms. That’s not a bad thing necessarily but it’s certainly not adequate. The average physician is not trained in looking at the source of depression so as to transform the person’s relationship to themselves. So I think they are over-prescribed.”
I ask him if the medical system is catching up to the idea that body and mind are one? He explains that while the scientific research is there to back up all of his beliefs, doctors are not trained to ask about emotions or childhood history, they don’t have the time or the skills to do so — “It’s not a lack of goodwill, for sure”. He says individual doctors get in touch thanking him for validating their own experience.
He also gets messages from people who have read his books and who say they changed their lives and their parenting. I saw that myself when I posted on Facebook that I was interviewing him. Dozens of comments came asking me to thank him for his work on ADHD, which transformed their understanding of their children, and for his work on childhood trauma. “Please tell him I love him,” said one friend.
He elicits devotion because his work rings true. When I read his 500-page book, so many of my own feelings and illnesses made sense. I turned each page thinking, ‘Of course! Of course we’re tired and stressed!’
“People get it, it makes sense to people. I sometimes laugh that if I said the same things that I’m saying but I didn’t have a MD behind my name, nobody would listen. I get paid big bucks to stand in a room and state the obvious. If the medical profession ever woke up, I’d be out of a job.”
And what he told me about the danger of repressing feelings hit home. In the week after we spoke, I cancelled two things I had said yes to but didn’t want to do. I felt guilty and threw a little party. Who knows, it might save my life.
If you are concerned about depression, speak to your GP
‘The Myth of Normal’, by Gabor Maté with Daniel Maté, is published by Vermillion at £20
https://www.independent.ie/life/health-wellbeing/dr-gabor-mate-when-a-child-is-conceived-they-inherit-the-trauma-and-joys-their-parents-are-carrying-42004014.html Dr Gabor Maté: ‘When a child is conceived, they inherit the trauma and joys their parents are carrying’