Gabor Maté

"(about Occupy Wall Street) among the many inequities in a society are the ones that this protest has brought to light, the inequitable distribution of wealth and power. But what is not so generally realized, that this society also makes people sick. Fifty percent of American adults have a chronic medical illness, and much of that has to do with stress. And if you look at the literature on what causes stress, it’s uncertainty and lack of information and loss of control and lack of expression of self. And the uncertainty that has been forced upon the American population by the recent economic crisis, the loss of control as power has flown into the hands of very, very few people, and the absolute powerlessness of the many in the face of all that, and the lack of expression through the ordinary political process, people are totally disempowered and deprived of their voice. This protest addresses all those issues. So I can only say that this is an extraordinarily healthy thing to happen. People who participate here will be healthier for it as a result, and maybe society, in general, as well. And one more thing, as well. There was a study just this morning that parents who are stressed, they’re not as tuned in to their kids. They’re not as connected to their kids. So when society stresses people, like the current economic uncertainty and crisis does, children are not getting what they need. So this protest, as well, speaks to the needs of children as much as to the needs of adults in general. So that’s why I’m so gratified to see all this."

"Physical well-being depends on more than keeping our bodies fit. Emotions and the people who come into our lives matter just as much... “‘I never get angry,’ says a character in one of Woody Allen’s movies. ‘I grow a tumor instead.’ Much more scientific truth is captured in that droll remark than many doctors would recognize. Mainstream medical practice largely ignores the role of emotions in the physiological functioning of the human organism. Yet the scientific evidence abundantly shows that people’s lifetime emotional experiences profoundly influence health and illness."

"The separation of mind and body is an erroneous view, incompatible with science. Personality traits—that is, psychological patterns—conduce to disease because the brain circuits and systems that process emotions not only exert a profound influence on our autonomic nerves, as well as our cardiovascular, hormonal, and immune systems: In reality, they are all conjoined... Most medical students never hear the word ‘trauma’ in all their years of training, except in the the sense of physical injury. ‘The medical profession is traumaphobic,’ a well-known colleague in San Francisco once told me. The results for patient care are devastating, whether in the treatment of physical or psychiatric conditions—a distinction that, given the mind/body unity, is in itself misleading.”"

"People far-flung have told me that it saved their lives, it changed their view of addiction or it made a big difference to their families... the book addresses — the origins of addiction and a sane and humane way of treating addiction of all kinds — has not become mainstream practice or awareness yet... When the book came out, we still had a federal government that was completely against supervised injection sites, for example, or the provision under observed circumstances of prescribed heroin to dependence users who needed it. We had a completely retrograde federal policy which has opened up quite a bit under the current administration."

"I think we live in an insane culture. By insane, I mean a culture that does not meet real human needs. It meets our physical and economic needs, for the most part, for many people — at least in the privileged West. But at the same time, it alienates people. It cuts people off from themselves, from their gut feelings, from nature [and] from other people. It sets people against each other. We're destroying the earth. It's a very unhealthy system that we're living in right now. So where's hope in that? Hope in that is people realizing that we live in troubled times, to look for solutions within themselves and within their communities and ... recognizing our spiritual nature, that we have needs beyond the physical ones. We have to look at the other needs we have that this way of life just does not satisfy."

"In our society, we tend to look at people's behaviours, rather than ask what is behind the behaviour... Kids are considered to be bad or good, but nobody's asking what is making the child behave a certain way... I've never met a single person who ever chose to be a drug addict... It's easy to focus on how someone is different from you than recognize what you share... That tendency is magnified when the person doesn't resemble you. Consider the "stereotyped image" of a drug user one may pass on the street... We see them as something other than ourselves... And it's hard for us to recognize our common humanity... In reality, most people have more in common with drug users than they'd like to admit... Virtually everybody's got some kind of an addiction. Maybe not to drugs, but to some behaviour that they crave that gives them relief. Whether it's video games, sex, work or shopping, addictions to any of these activities tap into the same brain circuits that drug users activate with intoxicating substances."

"If you look at the origin of the word ‘trauma’, it’s simply the Greek word for wounding. Trauma is a wound. You can think of a wound in two ways. One is that it doesn’t heal, and every time you touch it, it really hurts. Or it’s a wound that’s healed, leaving scar tissue... Trauma is a process, a part of your life, and therefore you have agency, you can do something about it... The word for healing comes from the Anglo-Saxon word for wholeness, and the essential nature of trauma is that it’s a loss of wholeness..."

"If you come to me and say, ‘I’ve got an addiction to… whatever,’ I could say three things to you. One is that you have a genetic disease, which is the mantra in most of the medical world. Or I could tell you, ‘You are an idiot, you made a bad choice, you are morally degenerate, you are lacking will power,’ or I could say, ‘Hmm, what is that addiction doing for you? Oh, it’s soothing your pain, is it? So how did you develop that pain? What happened to you? And how can we help you heal that pain and handle it in ways that are not self-destructive?’ So, the role of the therapist is in helping people understand that what happened to them has a role in what happens inside them, so they don’t see themselves as deficit, bad or stupid, or as diseased; they see that how they are functioning is actually a fairly reasonable and understandable response to what happened to them."

"It is time to realize, then, addiction is neither a choice nor an inherited disease, but a psychological and physiological response to painful life experiences. It can take many forms, but whatever form it takes: • it employs the same neurological pathways and emotional patterns; • the damage it does extends well beyond the suffering imposed by drug use specifically; • to ostracize the drug addict as somehow different from the rest of us is arrogant and arbitrary; • to criminalize certain substances, say heroin, while allowing the profitable distribution of more deadly products such as cigarettes is irrational and harmful—yes, though it may be a startling assertion it is medically a simple fact: heroin use, short of overdose, is far less lethal than cigarette smoke; •to treat the addiction, which is a symptom, without treating the pain that underlies it is to deal in effects rather than in causes, and therefore dooms many to ongoing cycles of suffering."

"Capitalism is the system that we live under... and for all its economic achievements and scientific breakthroughs — which are very unevenly distributed, with a lot of inequality, which itself is a source of illness — it’s a system that’s based on fundamental assumptions... that people are individualistic and competitive... In fact, from an evolutionary point of view, had we been individualistic and competitive, we never would have evolved. We evolved as communal creatures in close contact with each other, with a lot of mutual support. Now, if you develop a system that’s based on the opposite perspective... then you’re running roughshod over human needs. And so to understand what’s happening on an individual level, you really have to look at what’s happening on a macro level. And this trauma shows up, not only in the personalized, but of course in politics and other areas of our culture. So we really have to look at the larger picture, and not just think that illness is somehow an individual aberration. It’s really a manifestation of a system that is a toxic culture."

"Trauma and stress are so normal in society that we take them to be almost natural occurrences... We think this is normal. But actually, from the point of view of human needs and human evolution, the current way of living that we pursue is actually abnormal and is the cause of a lot of ailments of body and mind... a lot can be done as long as we recognize the problem. The issue is that my own profession, the medical profession, despite all the science that links the mind and body, emotions and physiology, doesn’t link them... physicians are not trained in understanding the whole human being and the unshakeable oneness of our existence."

"The average physician, when they do their prenatal visit, they don’t ask about the woman’s emotional state or the stress in their lives... In British Columbia, the Caesarean section rate is almost 40 per cent now, which is incredibly high... that degree of intervention actually interferes with the natural bonding between mother and infant. So right from the beginning, we just don’t get it... At the University of British Columbia, where I was trained 40 years ago, the average medical student still doesn’t get a single, coherent lecture on the impact of emotional trauma on physical health, even though we know... that people with stress and trauma in their lives have an increased risk of rheumatoid arthritis, multiple sclerosis, depression, psychosis, ADHD, and so on. So, the first thing has to be at least the training of physicians in the unshakable unity of mind and body, of educators as well, because many of the troubled kids that educators are helpless to know what to do with are actually traumatized kids. And politicians, if their policies are trauma informed, are going to have a totally different legal system, we’d have a totally different approach to addiction and so on."

"For those habituated to high levels of internal stress since early childhood, it is the absence of stress that creates unease, evoking boredom and a sense of meaninglessness. (p28)"

"As Selye pointed out, the salient stressors in the lives of most human beings today — at least in the industrialized world — are emotional. Just like laboratory animals unable to escape, people find themselves trapped in lifestyles and emotional patterns inimical to their health. The higher the level of economic development, it seems, the more anaesthetized we have become to our emotional realities. We no longer sense what is happening in our bodies and cannot therefore act in self-preserving ways. The physiology of stress eats away at our bodies not because it has outlived its usefulness but because we may no longer have the competence to recognize its signals. (p36)"

"Emotional competence is what we need to develop if we are to protect ourselves from the hidden stresses that create a risk to health, and it is what we need to regain if we are to heal. We need to foster emotional competence in our children, as the best preventive medicine. (p38)"

"(Q: “Why can’t parents see their children’s pain?”) I’ve had to ask myself the same thing. It’s because we haven’t seen our own. (p80)"

"Much of what we call personality is not a fixed set of traits, only coping mechanisms a person acquired in childhood. (p127)"

"Emotions interpret the world for us. They have a signal function, telling us about our internal states as they are affected by input from the outside. Emotions are responses to present stimuli as filtered through the memory of past experience, and they anticipate the future based on our perception of the past. (p206)"

"Parenting, in short, is a dance of the generations. Whatever affected one generation but has not been fully resolved will be passed on to the next. (p216)"

"In order to heal, it is essential to gather the strength to think negatively. Negative thinking is not a doleful, pessimistic view that masquerades as “realism.” Rather, it is a willingness to consider what is not working. What is not in balance? What have I ignored? What is my body saying no to? Without these questions, the stresses responsible for our lack of balance will remain hidden. (p244)"

"Do I live my life according to my own deepest truths, or in order to fulfill someone else’s expectations? How much of what I have believed and done is actually my own and how much has been in service to a self-image I originally created in the belief it was necessary to please my parents? (p256)"

"Resentment is soul suicide. (p257)"

"We can learn to read symptoms not only as problems to be overcome but as messages to be heeded. (p268)"

"Healing both requires and implies regaining the vulnerability that made us shut down emotionally in the first place. We are no longer helplessly dependent children; we no longer need fear emotional vulnerability. We can permit ourselves to honour the universally reciprocal human need for connection and to challenge the ingrained belief that unconsciously burdens so many people with chronic illness: that we are not lovable. Seeking connections is a necessity for healing. (p279)"

"Everyone has an urge to create. Its expression may flow through many channels: through writing, art or music, through the inventiveness of work or in any number of ways unique to all of us, whether it be cooking, gardening or the art of social discourse. The point is to honour the urge. To do so is healing for ourselves and for others; not to do so deadens our bodies and our spirits. (p280)"

"chronic illness—mental or physical—is to a large extent a function or feature of the way things are and not a glitch; a consequence of how we live, not a mysterious aberration. (p16)"

"If we could begin to see much illness itself not as a cruel twist of fate or some nefarious mystery but rather as an expected and therefore normal consequence of abnormal, unnatural circumstances, it would have revolutionary implications for how we approach everything health related. (p22)"

"The meaning of the word "trauma," in its Greek origin is "wound." Whether we realize it or not, it is out woundedness, or how we cope with it, that dictates much of our behavior, shapes our social habits, and informs out ways of thinking about the world. It can even determine whether or not we are capable or rational thought at all in matters of the greatest importance to our lives. (p29)"

"What is trauma? As I use the word, "trauma" is an inner injury, a lasting rupture or split within the self due to difficult or hurtful events. By this definition, trauma is primarily what happens within someone as a result of the difficult or hurtful events that befall them; it is not the events themselves. "Trauma is not what happens to you but what happens inside you" is how I formulate it. (p33)"

"It doesn’t matter whether we can point to other people who seem more traumatized than we are, for there is no comparing suffering. Nor is it appropriate to use our own trauma as a way of placing ourselves above others—“You haven’t suffered like I have”—or as a cudgel to beat back others’ legitimate grievances when we behave destructively. We each carry our wounds in our own way; there is neither sense nor value in gauging them against those of others. (p36)"

"An event is traumatizing, or retraumatizing, only if it renders one diminished, which is to say psychically (or physically) more limited than before in a way that persists. (p37)"

"In the absence of relief, a young person’s natural response—their only response, really—is to repress and disconnect from the feeling-states associated with suffering. One no longer knows one’s body. Oddly, this self-estrangement can show up later in life in the form of an apparent strength, such as my ability to perform at a high level when hungry or stressed or fatigued, pushing on without awareness of my need for pause, nutrition, or rest. (p39)"

"Work pressures, multitasking, social media, news updates, multiplicities of entertainment sources—these all induce us to become lost in thoughts, frantic activities, gadgets, meaningless conversations. We are caught up in pursuits of all kinds that draw us on not because they are necessary or inspiring or uplifting, or because they enrich or add meaning to our lives, but simply because they obliterate the present. (p45)"

"Time after time it was the “nice” people, the ones who compulsively put other’s expectations and needs ahead of their own and who repressed their so-called negative emotions, who showed up with chronic illness in my family practice, or who came under my care at the hospital palliative ward I directed. (p110)"

"Our other core need is authenticity. Definitions vary, but here’s one that I think applies best to this discussion: the quality of being true to oneself, and the capacity to shape one’s own life from a deep knowledge of that self. (p116)"

"no emotional vulnerability, no growth. (p193)"

"A society that fails to value communality — our need to belong, to care for one another, and to feel caring energy flowing toward us — is a society facing away from the essence of what it means to be human. Pathology cannot but ensue. To say so is not a moral assertion but an objective assessment. (p288)"

"Whereas individual people can become dislocated by misfortunes in any society, only a free-market society produces mass dislocation as part of its normal functioning, even during periods of prosperity. (p288)"

"As materialism promises satisfaction but, instead, yields hollow dissatisfaction, it creates more craving. This massive and self-perpetuating addictive spiral is one of the mechanisms by which consumer society preserves itself by exploiting the very insecurities it generates. (p298)"

"Disconnection in all its guises — alienation, loneliness, loss of meaning, and dislocation — is becoming our culture's most plentiful product. No wonder we are more addicted, chronically ill, and mentally disordered than ever before, enfeebled as we are by such malnourishment of mind, body and soul. (p298)"

"Hungarian-born Canadian physician Dr. Gabor Maté also ascribes... widespread illnesses and lifestyle risks ─ our leading causes of death and disability ─ to “toxic societies.” ... Maté also cites Australian hospital records showing 9-times higher incidents of breast cancers among women who, after onset of lumps, were emotionally stressed and socially isolated during monitoring.... The proper way to look at [Earth] stewardship is the care and nurturing of other life, not its destruction and exploitation which, Maté explains, are earmarks of toxic societies and byproducts of materialism. Restoring planetary and national health calls for significant cultural and societal reformations... Maté calls it an ideology and way of looking at human beings (and nonhuman animals as well) through psychological connections to others."

"It is important to respect Maté's work with individuals living with addictions. For this reason, people who work with clients from a harm reduction perspective—that is, they accept people as they are, and seek to help those in need—deeply admire Maté. In addition, Maté's exploring the root causes of addiction may in some sense represent progress out of a deterministic disease concept of addiction because it broadens the range of experiences that can lead to addiction and through which addiction expresses itself. Unfortunately, however, Maté is fundamentally proposing a reductionist vision of addiction, where abuse history and posited biochemical changes are now the essential causes of people's self-destructive action. It is not enough to say that this model is highly conjectural. It also isn't true, that is, it makes little sense of the data...at the deepest level, Maté's views limit our approaches to, our understanding of, and even our respect for people living with addiction. Rather than expand our understanding of addiction, his views harm our ability to respond to it."