Gabor Maté, M.D.: When Stress Becomes Illness
Dr. Gabor Maté is a renowned physician and four-time bestselling author. His latest book, The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture is inarguably, a masterpiece. With over four decades of clinical experience, Gabor is a sought after expert on addiction, trauma, childhood development, and unraveling the relationship between stress and illness. In his new book, he brilliantly dissects our understanding of “normal,” exploring the role of trauma, stress, and societal pressures play in our mental and physical well-being.
Chronic diseases are not interruptions to our lives, but rather manifestations of how we live, Dr. Maté tells us. Very few diseases are genetically predetermined, he says, emphasizing that it is our environment that brings any genetic predispositions we may have to fruition. Starting in childhood, when we begin to disconnect from our authentic selves in order to maintain attachment relationships, most of us live a life where some combination of trauma, emotional pain, and separation from self play a major, yet unexplored, role in our health. Without a grounding in trauma-informed study, western medicine often fails to treat the core wounds that make us sick, leaving us vulnerable to mental illness, auto-immune disease, and addiction. When we recognize our maladies not as independent identities but as bodily expressions of mental suppressions, we can become empowered adults who choose to rediscover an authentic self we lost somewhere along the way. It is only through self-retrieval, Dr. Maté shares, that we can truly begin healing. I loved our conversation.
EPISODE HIGHLIGHTS:
Chronic illnesses are representations of our lives…10:00
Childhood wounds…21:00
Addiction as a coping mechanism is response to trauma…42:00
Soul retrieval…48:00
MORE FROM DR. GABOR MATÈ:
Read The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture as well as other books by Gabor Maté
Explore Dr. Maté's Website
TRANSCRIPT:
(Edited slightly for clarity.)
ELISE LOEHNEN:
Wow. What an amazing offering this book is. Wow. Thank you for doing it.
GABOR MATE, M.D.:
I tell you, it means a lot to hear you say so because, well, it just does. Here's what I wanna ask you. I know the ideas that I present, I'm a thousand percent confident about, but how is it as a read?
ELISE:
I thought, and this is why I think it's such an incredible gift, well you're beautiful writer. I know that's a natural skill for you and an adept storyteller, so it really moves with a lot of pace. It's a big book, but I read it on a beach, which is not where you would think about reading a book like that.
GABOR:
Hey folks, typical summer reading!
ELISE:
But it speaks to the fact that it was riveting, and I could completely follow all of your arguments. And I think you did an exceptional job of layering in the research, and your anecdotal experience, and your own story in a way that's very consumable, compelling. And I made 15 pages of notes. So I feel like I almost retyped the whole book.
GABOR:
Thank you. That's that's so great to hear.
ELISE:
I think I've read all of your books, including your book with Gordon on parenting. And so it was also really amazing to how you built on all of it was an aggregation of all of your work and the building on it with while not repeating yourself.
But you could just tell that you had also spent a lot of time going through it, that it had been well-edited and revised and clarified and clarified and clarified.
GABOR:
That's exactly what happened. Do you know that originally we, we turned in a manuscript of twice as long as this one?
ELISE:
Oh, wow.
GABOR:
And then we had to not just cut, but move, and rewrite, and rewrite, and clarify and rewrite and edit and rewrite. We went to quite a few layers. So from that point of view, it's our work, but it does also reflect the wonderful editing that we got, which originally, my tendency is to resent it, you know, like what, you know, but, but then, you know, they were right. 95% of the time.
ELISE:
Oh yeah. So I don't know if you remember this, but I emailed you last summer. Maybe this is a good place to start. I emailed you last summer to check in and tell you I was gonna do a podcast and to ask you to come on and you told me about this book, and then you said, how are you? And I responded,
GABOR:
I know you told me all about your husband.
ELISE:
I responded. He's doing really well.
GABOR:
I remember. So did you learn anything? Did you learn anything?
ELISE:
Well, you did a gentle intervention on me. And then I did it like two more times.
GABOR:
I know, I remember.
ELISE:
That has stuck with me. And as you say, that is maybe an excellent articulation of, of what happens to a lot of women socially where our immediate impact is to talk about everyone else, and how they're doing rather than the vulnerability of answering that question for ourselves.
GABOR:
That's right. It's not just the vulnerability it's also the culturally entrained, and then self-assumed responsibility not even to go there.
I mean, because ironically women are far more open about talking about their feelings than men are. It's only that culturally, whether they talk about their feelings or whether they don't, their duties is first of all, to attend to the feelings of others.
And that takes, as the book shows, that takes a heavy toll in both in terms of what we call mental illness and also in physical health.
ELISE:
Yeah. I let's start there. I think, you know, you presented this list, early on in the book where I think this is a list of maybe personality or behavior traits that you observe in the chronically ill. I don't know if it's people or women, but it's an automatic and compulsive concern for the emotional needs of others while ignoring one's own. Rigid identification with social role duty and responsibility over driven, externally focused, multitasking, hyper responsibility based on the conviction that one must justify one's existence by doing and giving repression of healthy self aggression and anger and harboring and compulsively acting out two beliefs. I am responsible for how other people feel. And I must never disappoint anyone.
GABOR:
Yes.
ELISE:
Oh Gabor. I feel like I read that list. I might have cried. It’s such a stunning and sad encapsulation. And is this gender, does this primarily women, or do you see this with anyone who assumes that caretaking role?
GABOR:
Well, it's not purely gender determined, but at the same time, there's a reason why 80% of the people with autoimmune disease are women. There's a reason why women get more non-smoking related cancers than men do. There's a reason why woman who smokes has doubled the risk of lung cancer than a man who smokes. And it's because those characteristics that are not itself, they're not biologically determined. They're not as such gender determined, but in this patriarchal society, that's thrust upon one gender more than others. And therefore that's why women take twice as much antidepressants and anxiety pills. And that's why they end up with more chronic illness. Now men have their own way of suffering. But you can talk of about, but these characteristics normally describe the disease prone personality, which by the way, we'll have to talk about, cause it's not, anybody's real self we're talking about every we're talking about their assumed personality, but they also describe, how women are acculturated in society.
ELISE:
Let's talk about this idea of disease and, you’re very sort of humanistic or this very systems wide approach, this venn diagram that you see around, certainly there's biology and maybe there's a genetic predetermination for a lot of these things that we pathologize.
GABOR:
No, no. Let's make, let's make a distinction. There are very few diseases for, for which there's a genetic predetermination.
So one of them runs in my family, muscular dystrophy. It's genetically pass on. If you have the gene, you're gonna have the disease. My brother, I'm sorry, my mother had it. My aunt had it. Relatives of mine who have it, the gene, they have the disease, a predisposition, however, is not the same as a predetermination.
A predisposition doesn't have to turn into disease. It depends on the circumstances, right? So there are very few diseases that are genetically predetermined. No mental illness is, is amongst them. And no autoimmune disease is amongst them.
So even when there are predispositions, which only mean that it's more likely that something will happen, it still depends on the environment to turn those genes on or off, or to activate them or inactivate them.
ELISE:
And in your model, there's clearly layer, huge environmental factors, social factors that are affecting our health. I mean, that seems to be the predominant muscle right in your model. And that many times things that we call quote or unquote disease or pathologize are actually completely understandable and reasonable responses to what's happened to us in our lives, like addiction or other things that we would call mental disease.
GABOR:
Addiction or multiple sclerosis for that matter, or rheumatoid arthritis, or any of the conditions that we call mental illness. And when we talk about disease, a kind of interesting language that itself betrays an ideological bias. So I can talk about somebody having multiple sclerosis or in my case, I've been diagnosed with, therefore I can say I have ADHD, attention deficit hyperactive disorder, or I have had depression, or I have arthritis, or somebody has cancer, or so they have it. Now there's a hidden assumption in that way of languaging things. And this is a subtle one, but it's a crucial one to recognize. So here's my cell phone. I have my cell phone. You and I are on video. So you can see the, I have a cell phone. I can put the cell phone down, I can pick it up. I can sell it. I can destroy it. I have it. It's not me. When I say I have depression, or I have ADHD, or I have multiple sclerosis. The assumption is that there's disease entity. Then there is me. And the me that exists has that the disease, represents just like I have a cell phone. In other words, the disease is an independent existence. For me.
It's not how it works. How it works is, is I show extensively in this book, that diseases are processes that manifest what happens in our life. We don't have them. There's no separation between our lives and chronic illness, but the chronic illness represents our lives. It doesn't interrupt our lives. It manifests our lives. It manifests what happened to us in the uterus, in early childhood, and how we've lived our life ever since. Which also means that if we recognize that whether we are talking about depression or ADHD or multiple sclerosis, if we recognize that these are not independent entities, but processes that reflect how we live lives. It also means if we start living our lives differently, that is to say, if we understand ourselves, and we transform our relationship to ourselves, that process can change, which gives the individual a much more agency, because the average person that goes toa physician with depression, they'll say, you've got this thing called depression.
And here's a pill. That's gonna change the biology of your brain. That may or may not work in itself, not a bad thing, but you're not affecting the process as such. You go to a neurologist with multiple sclerosis, now umpteen study after study has shown that multiple sclerosis is much more likely in people who are childhood trauma, who live stressed lives, who have difficulties saying no, who are faced with challenges they can't handle. I can go on and on and on, multiple research on this. But the average neurologist will not actually ask: Any trauma in your children? Any stress in your life right now? How do you feel about yourself as a human being? How well do you take care of your emotional needs? What's your relationship to your partner, spouse, friend? How do you feel about your work? What is your boss like to work with? These are essential questions when it comes to the answer in multiple sclerosis shown in multiple studies, and yet these questions are not asked. In other words, the MS, or the ADHD, or the depression are manifestations of life events, and their processes that are not independent things. Nobody has them. People manifest them.
ELISE:
So what would be you the right language, because then there's sort of the other extreme, which is I am an addict or I am autistic. I think now the languaging on that has changed.
It's like saying I am cancer, right? So what is the appropriate way to relate, relate yourself to the stage or process?
GABOR:
So I'm an addict is useful as shorthand, but it's not useful to understand anything. Shorthand doesn't express the richness of reality. So I'm an addict means that I'm a human being who suffered a lot in life. And I carry a lot of emotional pain, from which I try to escape in certain behaviors that are compulsive. That cause me harm. But I can't give them up. Because I have so much pain. I keep looking for relief. Now what if you outlawed the word addict and every time you spoke about a person, who's quote unquote an addict, you have to say that whole sentence. So and so is a human being who suffers so much in life that they believe they need to escape into this behavior or substance in order to soothe their pain. That change of language would change the whole conversation. But it goes beyond. And this is where it's so frustrating. I'm not talking theory here. I'm talking about science. So both when it comes to multiple sclerosis and when it, for example, or when it comes to, um, addiction, science has amply shown the truth of what I'm talking about. So when I talk about the medical practice, it's not that it's not scientific. It's that ignores the important aspect of the science that we already have.
ELISE:
Why do you think that that happens? Is it just we’re not trauma-informed, even though it's such a buzzword now, or there's an intentional disavowal?
GABOR:
It's much more complex than that. First of all, the average physician doesn't hear a single lecture on trauma throughout the years of education. Even though trauma shows up in virtually every chronic conditions they have to deal with whether malignant cancer, or autoimmune disease or so-called mental illnesses, they don't get a single lecture, right. Or if they're lucky, they'll get a single lecture where they need where they, where they need to be grounded in it thoroughly. Number one. But why is that? Well for one thing, the mind-body unity, in other words, the inextricable oneness of mind and body that you can't separate the two, has been more than adequately abundantly demonstrated scientifically, but the average physician doesn't hear a word about it.
Now. Why is that? Number of reasons. Number one, we live in a society that is materialistic, whose view of human beings is basically materialistic, whose view of human beings is that we're really after is material goods. And the more we produce and the more consumed, the happier we are. Furthermore, the intention of the economies to and make a profit. Now, no matter how you do it. So it doesn't matter what kind of poisonous product you sell people. If you make a profit you're genius.
So if I deliberately go out and con to junk foods in order to make people addicted, which people do, this is documented. It’s not conspiracy, it's reality. Or if I sell pharmaceuticals that I know are harmful, but will make me a huge profit. Or if I create products that will degrade the environment, what would make a huge profit, I'm a marketing or corporate genius. But in order to do that, I have to forget that people are not just material beings, they're spiritual beings, they're emotional beings. And when I treat them as material beings, I'm trampling on their true nature. Now that's the dominant ethic in this society. That's why I call it a toxic culture. The major institutions of any society would reflect the ruling ideology. Therefore medicine, medicine reflects the ruling ideology.
Then there's the fact that doctors are traumatized people. Medical training for a lot of people is very traumatic, and you can talk to any number of conscious physicians who'll tell you how they suffer through medical school, and how they had to suppress their authentic feelings, and selves in order to get through. Well, if that's how you're trained, that's how you're gonna treat people. That's how you're gonna see people.
Then there is the overweening influence of the pharmaceutical companies who drive most of the research. They're not interested in the mind body entity. They're interested in the biology that they can manipulate through pharmaceuticals, which sometimes can be miraculously good. But at the same time they are very one track way of looking at human beings. Then there's the fact that if you average ego-bound physician, when you spend 30 years practicing one way, you are not gonna all of a sudden wake up to the fact that my God, I got the whole thing wrong. Or my God, my vision has been narrow and there’s much more to this. There's much more this heaven and earth, than our philosophy dreams of, as Hamlet said and, and their Shakespeare play. So people are just defending their turf. So there's, there's all kinds of reasons.
ELISE:
No, and it's so nebulous, it's difficult to fix. And going to, you know, medical school being traumatizing, but also it's traumatic to be the end of the book when the Shaman, when you are in Peru and the shaman is like the, the darkness you're with a bunch of doctors and the energy that you guys all carry. I mean, my dad's a doctor, an intensivist, he's retired now, but like he was present for a lot of death, you know, and a lot of physical trauma. Right. Which is how I think, you know, car accidents, et cetera. And so that's hard particularly because culturally we don't have a process at all on any level of society for emotional hygiene or yeah. Processing what we experience.And the cumulative effects of that have to be deadening and numbing, I would imagine.
GABOR:
Well, they are. And, and so physicians, once they undergo some kind of a wake up experience, whether emotionally or spiritually, they will say how numb they had been before, and how much better it feels not to be numb anymore. And how much more satisfying and, and meaningful their interactions with their patients become.
But very little in medical school prepares you for that.
ELISE:
No, I'm sure. None of it. So trauma, obviously it's become a common word. Which is probably good. I'm curious if there are any, do you have any concerns about people not understanding it, but you make the point throughout the book that you write, “Children, especially highly sensitive children can be wounded in multiple ways by bad things happening, yes. But also by good things, not happening such as their emotional needs for attunement not being met, not being seen or accepted, et cetera.”
GABOR:
For, for example, there's a book, Cribsheet. So she's an economist and a young mother who looks at all the research. Now she's got no psychological insight whatsoever. No training in developmental psychology. She's an economist. She looks at the statistics and she understands studies through statistics. So that's what the book is called Cribsheet. And this is a book for parenting, a bestseller, highly touted in the New York Times and a New Yorker. It's a textbook for traumatizing children Because it recommends parenting practices that ignore the actual needs of the child. It's all about how to make parenting more minion for parents in a toxic culture. But if you don't recognize the toxic nature of the culture, then fitting in with the toxic cultures is self toxic.
So her advice is all about how to make parenting easierin a culture that doesn't support parenting that's understand the basic needs of the mother and has no idea what the basic needs of the child are.
So full of goodwill and well-meaning intention. She promotes parenting practices and practices, parenting practices that actually traumatized the child. And this is mainstream parenting advice. And these are the books that get touted and lionized and endlessly podcasted and written about it in the major media. And in a book I gave a, a very specific example of this kind of traumatization being depicted on public television and celebrated. So during the 2016 democratic convention where Hillary Clinton is nominated for the presidency, there's a movie narrated by the Voice of God, the Morgan Freeman, you know, about her life. And Hillary says that my parents brought me up to be self-reliant and resilient and so on. You know, what happened in reality? Her father beat the shit out of her kids. You know, that wasn't talked about, but that's not the worst case scenario. The worst case scenario is then she tells an incident that says, this gave me resilience. And you're a mom. The story is that four-year-old Hillary is bullied by neighborhood kids. And she runs into the family home to seek protection from her mother. And her mother says, you get outta here and deal with those kids. There's no room for cowards in his house.
Tens of millions of people watch this. All kinds of commentators watched it. Nobody said that was being celebrated here is the traumatization of the child. There's a four-year-old little girl who runs the money for protection. Is she a coward? Is that what she is?
What the, what's the message to the child. I'm asking you. What's the message.
ELISE:
Oh, the message. Is your feelings. Aren't valid. You have no right to be scared, and you're an adult. Go handle it.
GABOR:
And you're on your own.
ELISE:
Yeah.
GABOR:
Okay. Now that's traumatizing. That’s wounding a child. Now trauma means wound by the way, this wounding of a child is celebrated as something as a wonderful example of parenting. 60 odd years later, that four year old now, 64 or whatever, how old she was develops pneumonia.
During the election campaign, you remember what she did with that.
ELISE:
She kept going until she collapsed.
GABOR:
She collapsed publicly in the street. Suck it up. You're on your own. You have no right to be vulnerable. Is that you don't want any friend of yours to do?
ELISE:
No, certainly not my child.
GABOR:
Not your child or any of your friends. You got pneumonia. Keep going.
So I'm not blaming the individual I'm describing here. I'm talking about a toxic culture. So yeah. Children can be wounded in multiple ways. They can be hit like she was. But even if she'd never been hit, it's enough that she had that experience.
ELISE:
Right. Can you tell us that poignant question that you ask everyone about, where they went when they felt certain ways as a child?
GABOR:
Well, it relates to the incident I just related. Sometimes people tell me they had this happy childhood and one of your friends, I went through that process with her once, you know, Stephanie, and then I issue what I call the happy childhood challenge, which means let's talk about it for three minutes. Shall we? And it doesn't take long. And the key question is, if Elise was sad or alone, scared,pain in emotional pain as a child. Who did you talk to? Oh, I talked to my dog. I talked to my, I talked to my Dolly. Maybe I talked to my brother if you're lucky.
ELISE:
Right.
GABOR:
But you didn't talk to your parent. And then I asked people, well, if you, if your child felt that way, who would you want them to talk to? Oh, I'd want them to talk to me.
And if they didn't, if they felt that way and they didn't talk to you, how would you understand that? Oh, I’d feel terrible. I'm not asking you how you feel. I'm asking you, how would you explain why my child isn't talking to me? Oh, they felt I wasn't there for them. They felt scared. What's it like for a child to have no one to talk to? We are not, we're not talking about severe trauma, big T trauma, abuse, sexual exploitation, violence, anything. We're just talking about being emotionally wounded, bereft. That's enough to traumatize the child, And the more sensitive the child greater the trauma, of course.
Because when I talk about, I lay out in one of the chapters, what are the core irre reducible needs of children? One of them is the full of experience of all their emotions, and that being received and understood by adults. Short of that, the child starts to repress their feelings, disconnect from themselves. And now you get into the realm of dysfunction and pathology.
ELISE:
I want to talk about anger and aggression in a minute, but before we get to that, can you talk about sort of this, the essential need for both attachment and authenticity and how those can sometimes seem to be mutually exclusive for children?
GABOR:
Sure. So the need for attachment, which means the closeness proximity with somebody who you take care of, or who takes care of you, that's self evident need of the human infant, and fortunately, of the human parent as well. Because parents do have this system in their brains that makes them want to take care of the vulnerable little one. So do orangutans and and cats have that system in their brains. Thank God. Otherwise babies would die. So there's that attachment drive on the part of the parent, which is instinct, which built in by nature, by the way. But like anything else it can be turned on or turned off. For example, the parent has this to take care of the child and it's a logical need actually. So as somebody says, when the baby's born, a mother is born.
But then what happens when you listen to one of these sleep training experts who tell you that's six months of age, your kid should be able to sleep through the night. So next time they cry, don't pick them up. Have you ever done that by the way?
ELISE:
No. I fortunately had amazing sleepers, but no, never. I never had to let them cry.
GABOR:
But you, but you've heard about it, right?
ELISE:
Oh yeah, yeah, yeah.
GABOR:
You talk to moms and dads who tried to do that, who, who did do it? And you asked them, what did you feel as your child was screaming for you? My heart was breaking. My own mother writes that in her diary, Gabor, or my poor little Gabi, and my heart is breaking for you. You've been crying to be fed for the last hour and a half. But I promised the doctor I wouldn't pick you up till two o'clock in the morning. So it goes against the parenting instinct, but the depending instinct has to be evoked by the environment. And we're actually telling people in this culture is to shut down their parenting instincts. Then there's the attachment need of the child to be taken care of. And that's an obvious one, because we thought that not just in the physical sense of being fed, but also being held emotionally and physically. That's why the baby's crying.
Because they're expressing their biological need. The bio-psychological need to be held. So that need for attachment, for connection, closeness. That's clear. Then this other need, which I already talked about, which is the, the need to be able to feel what we feel. So I call that authenticity, being able to feel and experience what's happening for us. Now why is that a need as well? Where did we evolve? We evolved out in nature millions of years. We lived there out there in nature until a blink of an eye ago. We lived out there in nature. Just how long do we survive if we're not in touch with our gut feelings out in nature?
ELISE:
Not long.
GABOR:
Not very long. And that's what I call authenticity. The capacity to feel what we feel, which is I said is an essential need of the child. Now. Great. But what happens when an infant feels the need for attachment, and is crying to get the attachment, which if you're a mother cat or mother orangatan, you'll immediately run to the infant and comfort them. But if you're a human mother or father, and you listen to the stupid experts, you won't. Now, what does the child learn? That my feelings don't matter. And it's so painful not to be picked up and to be connected with that they start disconnecting from their authentic feelings. So that in order to maintain their attachment relationships, they have to disconnect from authenticity. Or if a two-year-old is told over and over again and punished for having anger, which is a healthy emotion. It it's just a basic emotion. But if they're given the message that they're not acceptable, because they're given a time out, you know. You're not acceptable to me if you're angry, you're only acceptable to me when you're not angry. The child, to maintain the attachment, will sacrifice the authenticity. And then we spend our lives not being ourselves, not even knowing who we are until life starts. Just knocking and through the relationships that don't work or, or through physical illness or through mental illness.
ELISE:
And then there's this splitting that can often happen right? Maybe extreme disconnection where, rather than a child perceiving that their parent might be failing or might be bad or might also be traumatized and incapable of connecting to their feelings, the child assumes that responsibility.
GABOR:
Well, no two-year-old can possibly understand the parent's state of mind. The capacity to understand and empathize with, let alone to have compassion for the state of another’s mind, that takes maturation and development. It just doesn't happen in early age. So in early childhood, the child can recognize, theoretically that my parents just are incapable of loving me the way I need to be loved. Poor people. They're just limited by their own trauma Or the child can assume, but basically they're not available.
The child can assume that unconsciously, but the child can assume there's something wrong with me. I'm flawed. And maybe if I work hard enough, I can fix it. Now, which is the safer belief for the child?
ELISE:
The latter, unfortunately.
GABOR:
Yeah, the, the first one is an endurable. So the latter, the latter, the belief in our own unworthiness becomes the defense mechanism.
And then we carry it throughout our whole lives. And this society is brilliant at exploiting people's sense of insufficiency, hence the $50 billion or whatever, billion dollar plastic surgery industry, all the products that are designed to enhance our image, all the products that are designed to make us feel more in control, more powerful: Buy this car, buy that dress, get this Botox injection, and then you'll be acceptable, and you'll be powerful and whatever. All because long ago we gave her sense of self worth.
ELISE:
And it also seems to particularly, maybe for women instill this idea of over-responsibility and hyper-vigilance, that you can somehow guard against disconnection, you’re responsible for how your mother feels it's you.
GABOR:
And later on, you're respons for how your spouse feels.
ELISE:
It hurts!
GABOR:
Not to make the conversation too personal. We're talking, not of anybody in particular here, we're talking about a general dynamic, but you know, during the COVID crisis, the new times that an article, I quote this article, it's called “Society Shock Sbsorbers.” And how women took on the stress of the COVID. And they took on the responsibility of keeping their husbands and their children happy. And if it wasn't going well, they blamed themselves.
So this role is deeply ingrained in women, in particular.
ELISE:
Let's change gears a little bit, and talk about addiction because your reframe of addiction, not as a disease really, is so powerful. I think, it's so humane. And as you say, ask not why the addiction, but why the pain. And that addiction is really like a very, very helpful device for people who cannot function.
GABOR:
By definition, any addiction is helpful in the short term and harmful and long term. So to give you my definition of addiction, it's manifested in any behavior, a person finds temporary pleasure or relief in, and therefore craves, but suffers negative consequences, a result out and cannot give up. So short term pleasure, relief, craving long term harm, inability to give it up. That's what addiction is. That could be to substances. It could also be to relationships. It could be to work, to gambling, to eating, to shopping, to gaming, to any number of human activities.
ELISE:
It's a big tent, as you say.
GABOR:
It's a huge tent. And in this society, there's a book called When Society is an Addict, you know, published in the 1990s. I think when 1980s in this society, it's you right with addiction. It's not, then the next question is not, what's wrong with the addiction, but what's right about it. So this whole idea that addiction is a choice that people make, which is utter nonsense. You just say no. I don't even have contempt to even expend a minute on that idea, but it's but the whole legal system is based on it. The legal system is based on the stupidity that people are choosing to be addicted. And I can tell you no addict I've ever worked with. And I've worked with many. That was my work as a medical doctor for years ever chose to become an addict. Nobody chose it. Number one. Number two, that it's inherited brain disease as well. Let's just look at it. So at least I gave you this definition of addiction. Just tell me if according to that definition, I'm not gonna ask for what, when or how long, according to that division, have you ever had an addictive pattern in your life?
Okay. Again, I'm not, I'm not gonna ask you what it was. I'm just gonna ask you what was right about it. What did it do for you? What give you a short term?
ELISE:
It calmed me down.
GABOR:
It calmed me down. Okay.
ELISE:
Distracted me.
GABOR:
So it distracted you from what?
ELISE:
From whatever I was feeling from my feelings.
GATOR:
So some painful feeling states.
ELISE:
Yeah.
GABOR:
Okay. So is inner peace and pain relief, a good thing or a bad thing?
ELISE:
A wonderful thing.
GABOR:
Yes. In other words, the addiction, wasn't your primary problem. It wasn't any kind of a brain disease. What it was, was your attempt to solve the problem of emotional pain.
That, that you had not been given the resources to deal with as a child. Therefore the question, not why the addiction by the pain? And for that, you have to look at people's lives. And as I've pointed out, it's always rooted in childhood experience. So the addiction comes along as an attempted solution that creates more problems in its wake, but it's primary rule is to solve a problem. So what kind of a disease solves the problem?
ELISE:
Not a disease.
GABOR:
It's not a disease folks. It's a coping mechanism in response to trauma. That's what it is.
ELISE:
And it has, we look at the people with substance abuse who are on streets and we wag our fingers, and shake our heads. And then we celebrate the addicts who are more like me, where I use work to avoid and numb. I know you suffer from workaholism, workaholic tendencies. And yet I'm supported for that celebrated for it.
GABOR:
And if you addicted to power and self aggrandized, man, you'll become president of the United States. And you can't give it up, even when you lose it, you believe that they stole it from you. You know, because, because really you need it. And, uh, I'm not making fun of you, anybody here, I'm saying that's a traumatic imprint is what we're seeing.
ELISE:
Oh, yes. For sure. So having worked with, you know, in, in deeply addicted and traumatized populations throughout your career, and really I think understanding, and then also the sort of going back to how we opened the conversation, this idea that there's a gene, right. And aggressively dispute this idea that we'll ever find a gene for addiction. I mean, I think we could all say we're all addicted, right? So we all have the same gene.
GABOR:
Yeah. And the question is?
ELISE:
The question is how, how do we, besides trauma-informing an entire culture and prison system, et cetera? Is that the antidote?
GABOR:
Well? So first of all, it's the genes simply stating a scientific fact. Nobody has any ever identified any particular gene that causes any particular mental health condition, right? Nobody's ever identified any group of genes that taken together will necessarily cause any mental health conditions. Nobody's identified any group of genes that if you don't have them, you cannot have a mental health condition. What they have discovered at best is a large nebulous group of genes that the more you have them, the more likely you have to have any number of mental health conditions, but nothing specific. Some people with the same set of genes, will I be disease, somebody else with schizophrenia, which means diseases aren't inherited, what's inherited or sensitivities. And the more sensitive you are, the more hurt you're gonna be when things go wrong in the environment. So it's the environment that determines how any set of genes will declare itself.
ELISE:
And we know in trauma is an inherited in some ways, an inherited disease, right?
GABOR:
Trauma's not a disease at all. If you cut yourself with the knife. You can't say that the knife cut is a disease, right? It's an effect of being cut with a knife. So the trauma is the wound that you sustain. Now, trauma can be passed on from one generation to the next, partly through epigenetic activity, not genetics, but how the genes are activated or not. Part of that can be passed on, but mostly it's passed on through, but repeating traumatizing patterns from one generation to the next. So the next generation grows up traumatized. Now, in terms of addressing it, let's take the prison population, which many, many studies have shown is a high traumatized population. Extremely so. Traumatized, not only in the individual, personal, and multi-generational sense. Traumatized racially, traumatized through poverty, throw all that together. You've got the template for drug related activity and violence and so on.
Now, you have, what's called a correctional system. We have what's called the criminal justice system. Well, there's nothing correctional about the system. It doesn't correct anything. It makes things worse. By the way we treat people. If the original problem was that as children were badly treated, now we treat them badly as adults. Why do we expect that to come out with some corrective result. But the name criminal justice system is very accurate. It's a criminal justice system because it hurts people. It hurts people who have already been hurt terribly. Now what we know from my limited work in prisons, that's very limited, but other people who have done extensive work with even so-called hardened criminals lifers. You give them a compassionate circle. I could name you several of such projects. You give them some self-understanding. You give them group connection. These people open up like flowers. They become some of the loveliest people you've ever met. And this is hard for anybody who hasn't been there to see it, but I've been with lifers who were some of the best people I've ever met. And they're not pretending, you know, I'm not that stupid.
Not that they have much of a reason, many of them to pretend, because they're not gonna get outta jail anyway, many of them. Because the system doesn't believe in these things anyhow, but, but other people who have worked with them extensively, will tell you the same thing so that yes, trauma informed, compassionate, humane approach can actually rehabilitated people, rehabilitated people. And you know, I, um, well, if I can find this quote from this particular person at San Quentin, is that okay if I take a minute to do it?
So there's a man in San Quentin. Who's a lifer. Okay. And he is a typical template of multiple traumas upon traumas. So on ends up using drugs, ends up killing somebody at age 19. And so I interviewed him, Atan at San Quentin and he says, this group made me think about my actions and helped me to start running, to stand up and face those inner demons. I had always run a away from, I've learned to love myself. And to know that there are people who care about them. Now he grew up in a world where nobody cared about it.
So I asked him, what would you want the parole board to know about you? And he says, well, at that time of my life, I was separated from me. I didn't even know who I was. I didn't respect myself, so I couldn't respect no one else. But after doing this time really stopping and looking at my life as a genuine thing, imagine that looking at my life as a genuine thing,
Imagine growing up, not seeing your life is genuine. But he says, and with the love for myself and understanding that for me, love is everything. Love is opening me up to everything outside of me. What I'm doing for myself, learning about me. I'm learning about everyone else too. I'm not different from everybody else. If I touch spirit, I'm not separated from everyone else. If you do let me out of here. This is the kind of work I want to do. When I get out, I'm ready. I wanna go home. But even if they don't let me go home, I already know who I am and what I want to do. He is either is an incredibly good actor and a wonderful poet, or he is speaking from his heart and yeah. So that’s what's possible. That's what's possible.
ELISE:
You have this great line. Um, you say, nor is healing synonymous with self-improvement closer to the mark would be to say it is self-retrieval. Yeah. That's so beautiful.
GABOR:
Well, thank you. Although the indigenous people talk about soul-retrieval.
That's one of their healing practices is soul-retrieval. Cause you know, we lose contact with our souls. We lose contact with ourselves. And so healing is all about which means wholeness, by the way, it's all about connecting with ourselves.
ELISE:
Can we talk a little bit about sort of the spiritual dimension and your work, the with Ayahuasca and shamans and sort of this other element of understanding who we are and how that has changed or impacted the way you move to the world.
GABOR:
Sure. Although I don't want to restrict the spiritual dimension to the psychedelic realm. So those are two separate chapters. Actually I do have a chapter on the psychedelic healing, but also another one on, on the spiritual aspects of healing and for the spiritual healing, psychedelics can be helpful, but they're hardly necessary. Nor are they're accessible to most people. Fortunately they don't need to be. So spiritually healing, that sense of belonging to something greater than a little legal. The seeing beyond, beyond the lie of the separate solo self as Dan Siegal says are oneness with nature. These are Indigenous ways that people have always being steeped in part of the toxicity of this culture is that they cut us off from traditional knowledge. So we're not necessarily talking about psychedelics. However, having said that psychedelics because of their capacity to get the egoic mind out of the way, at least temporarily do all us to glimpse deeper aspects of ourselves and beyond ourselves. So they can be a powerful ally, in the right environment with the right guidance, with the right holding. Or they can be terribly disconcerting used in the wrong ways with the wrong people.
Because if you can open up your soul, and make your psyche more permeable, you better be in a safe environment.
But they can be powerful and I've experienced them that way. And I'm very grateful for that, that I was led to that work quite some years ago now. And I continue to cherish those experiences.
Having said that, cherishing the experiences and then integrating them integrating into your life. They're not exactly the same thing. And the integration is more important than charging.
ELISE:
I watched The Wisdom of Trauma which was beautiful and people can find that on the Wisdom of Trauma website. And I thought that that scene, and I like thought it was stunning that 2 million people have watched that documentary. I think you mentioned probably more…
GABOR:
That was in the first week. No, that's been about by now. It's last time I was told it was about 7 million.
ELISE:
That's amazing. Yeah. So everyone should watch it. And I thought the scene with you and I cannot remember his name, but he has the stage four cancer diagnosis. It's going through the process of cancer, Tim.
GABOR:
Tim.
ELISE:
And the way that you held him as he was, you did a psychedelic session with him and the latent, and you could tell, like I knew watching him in the car before he went, did through this experience with you, that he had a lot of, he was so kind so nice. And then in that experience, sort of the latent rage and anger was allowed to come up. It's really beautiful to watch that. And can you talk a little bit about how that's connected to likethe study that you cited about ALS and the nurses was staggering, and the type C cancer personality. Can you talk about like what anger, when suppressed, does to our health?
GABOR:
Well, so let's do an experiment here. So if you're willing to be a participant, okay. We're just play acting of course. But, let's say I were to become abusive, verbally abusive to right now, or inappropriate. What could you do in this setting right now in the present setting where you talk to each other on Zoom, what would you do?
ELISE:
I would be very nice about it. And I would try…
GABOR:
I'm asking what you would do. I'm asking what you could do.
ELISE:
Oh, I mean, theoretically, I could exit the zoom.
GABOR:
Could you not?
ELISE:
I could. Yeah,
GABOR:
No, theoretically, practically you could exit the zoom. You could just say that's called flight. I'm outta here. Right?
ELISE:
Right. Okay.
GABOR:
What else? What else could you do?
ELISE:
I could, theoretically, this is would not be my inclination. Get aggressive with you back.
GABOR:
Couldn't you, you can say stop it, you know, to talk to me that way.
ELISE:
Yes. Theoretically.
GABOR:
You and I better do some constantly sessions after this is over. Okay. Okay. So, but you could, you can see that you could do those things, right? Yes. When you were telling me, stop it and you can't talk to me that way. What emotion would you be generating? Do you think?
ELISE:
Anger.
GABOR:
Anger. In other words, anger, healthy anger is nothing but a boundary defense.
It says you've crossed a boundary that you're not allowed to. You're in my space. Get out. Either physically or emotionally, but you're in my space. Get up healthy. Anger is a boundary defense. Okay. Now, in fact, the role of the emotional system is to set up a boundary against that which is dangerous and unwelcome and to allow, and that which is nurturing.
Some people you're gonna set up a boundary with. Other people, the boundary will be much more permeable. You want them close. You want them in. know, So the emotional system is to distinguish that which is healthy and nurturing and welcome from that, which is toxic and day. Right? Is that clear enough?
Now a trick question. What's the role of the immune system?
ELISE:
The same.
GABOR:
Exactly. The same. To keep up what's unhealthy and toxic and to allow in which is nurturing and life sustaining. Now it's so happen is the two systems and not two systems. It's one system that scientifically speaking, they're part of the same apparatus, different aspects of the same apparatus. And there's myriad ways in which physiologically they're connected to the nervous system to hormones, chemicals, and so on and so forth. Therefore, when you're repressing the healthy anger, you're also disabling the immune system.
This has been shown scientifically. So the immune system can now fail to protect you against say, malignant transformation, or bacteria, or can actually turn against you, like suppressed anger turns against you. And now the immune system attacks you. Now, you got autoimmune disease. So the repression of healthy anger, which makes you this very nice personality, that has been studied up the ying yang as a risk factor of a disease, is that that extreme niceness is a risk factor. Not because it's bad to be nice, but because that extreme niceness very often represents the repression of healthy anger. And that increases the risk for prostate cancer, for breast cancer, for autoimmune disease, and so on and so on and so on. So that's how it works because it's the same system.
Which also means like the first chapter of the book opens with the story of this woman with breast cancer, who was told, that statistically, you got two years to live. And she had small children that she wanted to raise to be adults. And so she says to the doctor, she says, I was very rude to the doctor. I said, yeah, what did you say? She said, I said, fuck your statistics. I said that probably that probably helped to save your life. And she lived another two decades. Because for the first time she expressed healthy anger. She's been one of these really nice people accommodating to everybody else. So we are not talking theory here. We're actually talking about health. And what can make a difference.
ELISE:
Yeah. And that paper, that the Cleveland Clinic neurologist presented about ALS and the nurse's ability to write, they just talk to someone and be like, this person can't have ALS they're too mean. And this person is nice. I'm worried they have ALS. I mean, and their staggering, very unscientific method, but ability to identify…
GABOR:
The ALS risk is very high. And there's been more studies since then that show that most neurologists see the ALS patient is extraordinarily nice. They just don't make the connection. Now, what they're looking at is the rigid repression of anger, which contributes to the onset of the disease. ALS patients who learn how to express anger live longer, according to other studies. So we're not talking vague theory here. And then of course, when you look at ALS, there are people who actually, even after decades will have the disease completely go away.
ELISE:
Really?
GABOR:
Oh yeah. There’s been a number of such cases, but look at Steven Hawking, he was diagnosed at age 21. He was given two years to live. He died in his seventies. Not without the disease, but he sure had a much longer life than the doctors predicted from, because the disease, isn't a thing. It's a process. That's a process. And that process reflects how you live your life.
ELISE:
So I think we should close with your, your two question self-inquiry exercise because it's very much related.
GABOR:
If I remember, if I remember it, I'll I'll we can close it.
ELISE:
I have it if you forget it. But the, but yeah. One, in my life's areas, what am I not saying no to? And two, how does my inability to say no impact my life?
GABOR:
Yeah. So when you don't say, no, that's inability to set a boundary. That's your inauthenticity. That's when you surrendered your authenticity as a child, and by the way, we have emphasized over and over again, that these personality traits that you recounted. And there's not saying no, these are not faults. These are brilliant coping strategies as a child trouble is they outlive their use usefulness. And now they cause harm. And so where have you not said no? Where you not saying no in work, in personal relationships. And, and then what's the second question of where did
Well, what is the impact of you not saying, yeah, so this is part of an exercise in one of the chapters, but there's a number of questions. These are the first two. There's the third very important. There's three other questions. I'm not gonna go through them now, but oh yeah. But, but there's a, the final one is where in your life where you're not saying yes, but there's a, yes that wants to be said, where there's some desire for self expression or creativity or way of being that you're stifling because you're trying to stay in attachment relationship rather than being yourself. So where are you still choosing attachment over authenticity? If the two are in conflict now, ideally will form relationships with partners and spouses and, and families and friends where we can have both authenticity and attachment. But if that's not possible, this is the challenge for all of us. What are we gonna choose? Are we still gonna choose the attachment or we're gonna go for authenticity. And I'll tell you, health-wise, we pay a huge price if we go for the attachment by stranding authenticity. And so, as we say in the book, the loss of inauthenticity, it may not have been a choice to the child. It's not like they had a choice in a matter, but authenticity can be a choice to the adult.
ELISE:
So powerful. And it's as you write somewhere in the book, when I was citing those behavior characteristics, like no child is born perfectionistic and other-directed.
GABOR:
You've had children. No infant said one day of age, lighter thinking, gee, I'm hungry, and I'm tired, and I need to be held, but mommy must be so busy. And my God, I don't wanna bother her. So I think I'm not gonna cry right now. I mean, nobody's born like that. Right. You know? So these are compensatory coping mechanisms that develop to protect our attachments when those attachments can't accept us exactly the way we are.
ELISE:
Uh, thank you. Thank you. Thank you. This was amazing.
GABOR:
It's amazing to be, it's amazing to be interviewed by somebody who's read the book so closely, you know, that's your pleasure. Because I tell you it's really satisfying. Because I spent, I'm a breakdown cry here. I don't complain here, but I spent 10 years on this thing, you know? Yeah. And then,it is just a delight to speak to somebody like yourself, who's really done the work of reading the book and helping me to talk about the important points in it. So I'm very grateful.
ELISE:
If you can’t tell, I’m a huge Gabor fan. And he’s played a really important role in my life, and in my family’s life. And his book is such a gift and service. So I know I left everyone hanging with the self-inquiry exercise by only listing the first two questions, so I’m going to give you the rest. But again, this is sort of a healing bible that I think you’ll refer to again and again, so please pick up a copy.
1. In my life’s important areas, what am I not saying no to?
2. How does my inability to say no impact my life?
3. What bodily signals have I been overlooking? What symptoms have I been ignoring that could be warning signs, were I to pay conscious attention?
4. What is the hidden story behind my inability to say no?
5. Where did I learn these stories?
6. Where have I ignored or denied the “yes” that wanted to be said?