The Childhood Lie That’s Ruining All Of Our Lives: Gabor Mate (Transcript)

How we relate to other people. And that really template is our earliest months, even in utero, already in a womb, we’re being affected by the environment. But certainly in the early years when our brain is being formed and our personality is taking shape. And so that forms our worldview.

Now my worldview was, in my sense of self, was shaped by the fact that at two months of age, when I was two months of age, the German army occupied Hungary. Hungary was the last country in Eastern Europe where the Jewish population had not been exterminated. And that was our turn. The day after the German army marched into Budapest, which was March 19th, 1944, the day after my mother called the pediatrician to say, would you please come and see Gabor because he’s crying all the time. And the doctor said, of course I’ll come, but all my Jewish babies are crying.

And so the fact is that when mothers are stressed or in pain, the infant feels all that and takes it personally. And it becomes part of their template for how they view the world. So that’s when that year began in which my grandparents were killed in Auschwitz and my father was away in forced labor. And my mother and I barely survived. And it’s a story I’ve told many times, but that’s when my brain is developing and that’s when I’m forming my sense of myself.

And then my mother, to save my life, gives me to a stranger and I don’t see her for six weeks. The sense I get is that I’m not wanted and I’m being rejected and abandoned because I’m not good enough. That’s how my life began.

STEVEN BARTLETT: So your mother gives you away for five to six weeks in order to sort of save you from starvation in a ghetto that she was going to, right?

GABOR MATE: That’s right.

STEVEN BARTLETT: This is after your grandparents were killed in Auschwitz by the Nazis. How do you know, in hindsight, that that moment of those six weeks created that sense of abandonment in you?

GABOR MATE: I wouldn’t say it’s just about that one moment. Children very much view themselves through their interactions with their parents. Now, first of all, I had no father because he was gone. I hadn’t seen him, except very briefly when I was a month old. But there was no father in the picture.

My mother was grief-stricken and terrorized and full of woe and worry about what’s going to happen to us and just the task of surviving each day. She’s not playful with me. She’s not smiling at me very much. She’s worried-looking. She’s stressed-looking. The infant takes everything personally. That’s just the nature of the infant. As infants, we’re narcissists. We think it’s all about us.

So when things are great, hey, we’re great. But when my mother’s unhappy, it’s because she doesn’t want me or I can’t make her happy or I’m inadequate. So that separation from my mother certainly set a template for some of my relationship interactions with my spouse decades later. But the sense of not being good enough and being responsible, that was inculcated in me throughout that whole first year of life. So much so that in this book, The Myth of Normal, I actually talk about an experience with the psychedelic mushrooms with a therapist. This was not that long ago, seven years ago maybe, when I’m at least 70 years old.

And I’m in this therapeutic session with the psilocybin, the medicine, and the therapist. And I know that I’m 70 years old, and I know this is a therapy session, and I know her name, and I know who I am in the world. But at the same time, I’m experiencing myself as a one-year-old baby, and she’s my mother. And I start crying. Tears come down to my face, and I say, ‘I’m so sorry I made your life so difficult.’

Now that was an unconscious memory of my sense of myself as a one-year-old, that I made my mother’s life so difficult. Because that’s the way the baby interprets it. So even if your mother loves you, which mine did infinitely, not that she always treated me the best way possible, but she did love me. And can you imagine what a great act of love even giving me to a stranger in the street would have been for her? But because of her own unhappiness, I can only conclude that I’m not good enough, and it’s my fault.

STEVEN BARTLETT: At 70 years old, having that psilocybin experience, coming to that realization, or having that response to your therapist, where they take the role of your mother and you’re a one-year-old, how does somebody at 70 years old go about correcting that sort of interpretation you had of that traumatic early event?

GABOR MATE: Well, by bringing it up to the conscious level. Then when I notice that sense of guilt or responsibility in me, I say, oh, that’s what it’s about. So it’s a meaning.

See, trauma, as I define it, is not about what happens to us. It’s about what happens inside of us as a result of what happens to us. And trauma means wound. So the wound in this case is my sense of deficiency or not being good enough, not being worthy enough. Once I realize that, oh, this has got nothing to do with anything except this interpretation that I made of my own experience all those years ago, then when I notice it, I can no longer believe it. I don’t have to any longer be a subject to that interpretation of myself in the world.

So awareness is one step. It’s not adequate, but it’s an essential step towards letting go.

STEVEN BARTLETT: But that one belief that you weren’t good enough, how did that rear its ugly head throughout your life?

GABOR MATE: It made me a workaholic physician because I had to keep proving my worth. And it doesn’t matter. Now, I don’t know if you ever had an addiction, but the nature of it is that we’re trying to get from the outside something that only can arise and fulfill us from the inside. So when you’re looking at it from the outside, it’s addictive because you get it temporarily, but then that internal emptiness, that hole, never goes away. So it has to be filled over and over and over again. It can only be done so temporarily.

So it becomes runaway addictive. So then work becomes an addiction because I keep trying to prove my worth. And it doesn’t matter how many times I may show up in a positive way at the beginning of someone’s life, at the end of somebody else’s life, or any time in between. It never fills that emptiness that my sense of lack of worthiness creates. So that’s one way it shows up.

Another way it shows up is if in my relationship I don’t feel as satisfied, my wife doesn’t please me the way I like her to, then I get angry. But why am I getting angry? I’m getting angry because it’s my sense of not being good enough that’s being now revealed. It gets uncovered, this self-accusation. But I get angry at her because her job is to make me not feel that. We get into this relationship for all kinds of reasons. Some of them are conscious, some are not. Some are positive, some come out of trauma. In my case, I want that relationship to prove to me how good I am. So when it isn’t proving that, then I get upset with my partner.

Well, except the gap is inside me, not inside. It’s not coming from her. So it shows up in my parenting. It shows up all over the place.

STEVEN BARTLETT: I mean, I think both of those examples sound a lot like me, especially the first one. The second one as well.

GABOR MATE: In what sense?

STEVEN BARTLETT: In the sense that I’m definitely a workaholic. And I thought, I think, in the earlier phases of my life, I sacrificed everything in this pursuit of becoming a millionaire and having all this stuff and really getting this validation. Sacrificed meaningful connections, everything in the pursuit of this one thing.

GABOR MATE: Well, part of the toxicity of the culture that I talk about in this book is that it actually rewards that kind of emptiness or that desperate seeking to fill that emptiness. Because, you know, you get rewarded. You make a lot of money. A lot of people admire you. You get to feel good about yourself. Mind you, my guess is that good feeling is only temporary, at least if my example is any guide. You know, that feeling good because somebody from the outside values you is only a temporary style for the wound that’s inside. But the world actually rewards it.

You know, so you’re a workaholic doctor. Great, you make more money and all these people respect you. Meanwhile, you’re hollowing yourself from the inside and you’re not available for your family. You know, so that’s part of the craziness of this culture.

STEVEN BARTLETT: And it’s like the hedonistic treadmill in a sense because you just never, enough is never enough, as you say. So the last achievement needs to be surpassed by a greater achievement for me to get an applaud or a clap. I’ve never really made the connection that the reason why I’m a workaholic is because I am trying to prove to the world that I’m enough. But I think that it’s highly true.

GABOR MATE: Yeah. So in your place, like race and class in this society of inequality are certainly traumatic, potentially traumatic inputs, as I pointed in this book. And, you know, to the degree that it affects people’s physiology, you know. But also then, I don’t know your family origin or what kind of relationship you have with your parents. But there also may have been a sense, like I got with my mom for, you know, reasons and for whatever might have happened in your family. Maybe you got the sense as well that even in your family origin, you weren’t good enough somehow.

STEVEN BARTLETT: So my mom would scream at my dad for like seven hours a day. My dad would just sit there. And so my early memories of like looking at my mom and dad are this kind of violent verbally, not like physically, this incredibly stressful screaming, one person screaming at the other. That’s what I remember. But from reading what you’ve written in this book and from what you said now, I actually might have learned — sort of learned that I was the problem to some degree.

GABOR MATE: Children interpret it that way. That’s just the whole point. That’s what I mean about kids being narcissists. I don’t mean that in a negative sense. I just mean actually they think it’s all about them. So if your mother is unhappy, it’s your fault, you know, and you’re not good enough. So then you have to go out there and work to prove yourself, to prove to the world and to yourself that you’re good enough. So that going back to your first question about how these things show up in our lives, that’s how they show up.

STEVEN BARTLETT: And so 12 years old, you emigrate to Vancouver. By 28, you join the medical profession. And you spend the next 32 years roughly working in…

GABOR MATE: Well, at 28, I went back to medical school. Actually, I took a detour. I was a high school teacher for a while. And then I was 27, 28 when I started medical school. At age 33, I think I began my medical career of 32 years.

STEVEN BARTLETT: And in those 33 years, what was your practice? What did you specialize in? What did you focus on?

GABOR MATE: So I was a family physician, which meant I delivered a lot of babies and I looked after people’s problems from beginning to the end of life. I also worked in palliative care. I was the director of a unit at the hospital, which looked after people with terminal disease. And I did – that was 22 years or so of my practice, 20, 22 years. And then I switched gears altogether and I went to work in the downtown east side of Vancouver, British Columbia, which is North America’s most concentrated area of drug use. People coming from anywhere in the world are shocked by what they see. There are thousands of people in the streets injecting, selling, using, inhaling, ingesting drugs of all kinds.

And people have suffered the consequences of drug use in a society that doesn’t understand drug use. So it punishes it, excludes it, ostracizes it. So people get HIV from dirty needles and hepatitis C. So this is the population. Often they’re homeless. So that’s the population I worked with for 12 years until the end of my medical work.

STEVEN BARTLETT: That experience working with patients that were in palliative care. So that’s – for anybody that doesn’t know, that’s patients that are approaching the end of their life. That have terminal illnesses and that are aware that they’re going to die. What did that experience teach you?

GABOR MATE: It took an acceptance of one’s lack of omnipotence as a physician. Because you want to cure people. You want people to heal. And now it takes tremendous acceptance to say, you know, we’ve reached the limit of our knowledge. And that doesn’t mean we can’t help people, but we certainly can’t cure them. And so it taught me how to be with the inevitable. And you’re working with people who are in the process of dying. I mean, by the way, who isn’t in the process of dying? But people whose time is more limited than the rest of us. Acceptance. You learn a lot of acceptance.

It challenges you to do your best when you know your best isn’t going to be saving anybody’s lives. But it’s to help people live a life of as little suffering as possible and as much dignity as possible. So it really challenges the best parts of you to show up. Patience, acceptance, intuition. Personally, it taught me a lot to listen to people.

Interestingly enough, people really want to be heard when they’re dying. They want to make sense of their lives. They want to tell their stories and they want their stories to be heard. And so I listened a lot. I just sat by the bedside and I listened. All that.

STEVEN BARTLETT: When you listened, did you hear any themes relating to regret or things that actually mattered? Because I always imagine if I was given such news that my life was coming to an end and there was an approximate date, it would be quite a powerful way of finally realizing what truly matters and what never did.

GABOR MATE: People react to their impending death in different ways. So there were some people who just fought it to the end. They didn’t really want to accept it. But most people were more along the lines that you described where they really get to see what’s important. And so I mentioned this a number of times. It sounds strange and I don’t recommend it.

But I’ve had patients say to me, ‘Doctor, I don’t know how to tell you this and I can’t even explain it perhaps. But this illness that’s going to take my life is the best thing that ever happened to me.’ And they meant a couple of things by it. They meant what you just said about finding out what’s really important in life. In this book, The Myth of Normal, I interview a young man called Will Pye who wrote a book called ‘Blessed with a Brain Tumor.’ What kind of blessing is that?

So I asked ‘Will, what’s the blessing?’ And he said, it made me appreciate every moment. It meant every time I talked to somebody, I knew this might be the last conversation I’m going to have with them. So it better be a human, genuine interaction. So that was that aspect of it.

The other aspect of it was that, again, my view is as I pointed in this book and in previous works, who gets sick and who doesn’t isn’t exactly accidental. There are certainly personality patterns based on traumatic experiences in childhood that make disease more likely. And people very often realize that throughout their lives, they had abandoned who they were. They lived a life that wasn’t meaningful for them. And on death, they reconnected with themselves in an authentic way. And that seemed to be worth a lot to people.

Again, I don’t recommend that way of going to reconnect with yourself. But people have certainly, I certainly saw it. So those are the two big lessons.

STEVEN BARTLETT: After your 33 years in medical practice, you described that you had a bit of a — you kind of tuned into a creative calling, which was writing.

GABOR MATE: Well, I began to write when I was a physician. So my first book on ADHD after I was diagnosed with it was published in 1999 now. So that was 23 years ago now. So I began to write. And even before then, I wrote because I wrote columns for newspapers. But yes, there was a time in my life where the writing impulse, which had been with me all my life, was stifled and stymied. And so was I because I had this frustration. In fact, I had this sense that there’s something I needed to express. But I didn’t know what and I didn’t know how. And at some point I realized, oh, yeah, I need to write.

So that began before I finished medical practice. But it certainly has been essential to my ongoing unfolding as a human being.

STEVEN BARTLETT: I was so compelled by that when I read about that, because I started to really understand the value of creativity in all of our lives, regardless of whether we have the luxury of being called an artist or not. And so what, in your view, is the importance of?

GABOR MATE: Well, you’re singing my tune here, if I may say it that way, because I quote in this book, there’s a great Hungarian-Canadian stress researcher called János Selye, S-E-L-Y-E. Selye is the one who actually coined the word stress in the sense that we use it today. And he’s the one that showed in the laboratory how stress diminishes the immune system and disorganizes the hormones and ulcerates the stomach and all this kind of stuff.

But Selye also said, and I quote him here, ‘What is in us must out.’ What is in us must out. That we all have to follow our creative urges in a way that nature prepared for us, otherwise we can be hopelessly hemmed in by frustration. I’m paraphrasing him very closely. So, we are created in the image of God. I mean, you know, whatever your religious views are, but that sense that we’re created in the image of God means that we are creators, because the essence of God is creation. In fact, we call God the creator and we call the result of that creation.

If we’re created and if we’re offshoots of that creative dynamic in the universe, then it means that it’s in us to create. And whatever form that takes, I mean, you know, you don’t want to see me do art, you know, unless you… I can do a pretty good stick figure, you know, but I’m married to an artist. So that creativity doesn’t have to take the form of formal art, but it does have to take some flow of something that’s inside you that needs to come out. Otherwise, as Selye says, you get hopelessly hemmed in by frustration.

And so in that sense, everybody’s got that creative urge, and that may take the form of social intercourse, it might take the form of gardening, I don’t care, communion with nature, athletic expression, I don’t care what. But everybody’s got it. And if people don’t realize they have it, it’s only because life has hemmed them in and they’re too busy. Sometimes they are trying to make a living or trying to survive or too disconnected from themselves. But it’s in all of us. And to the extent that we don’t give it expression, we suffer.

STEVEN BARTLETT: One of the things that really hems it in is the prospect that we might not be good at it because we think to express ourselves creatively, we kind of join a competition of sorts. And that’s a trap we can fall into. So if I’m going to DJ, I need to become a good DJ, but in social comparison what I’ve come to learn is, in fact, the act of DJing alone in my kitchen at midnight is the reward, regardless of outcome or whether there’s a crowd there, it’s just me and my dog listening. The expression is the reward, not the achievement or the medal that I might get.

GABOR MATE: Yeah, not the external.`Well, look, I went through that in the writing of this book. So here I am, this writer who writes about trauma and healing, and all of a sudden I’m in a panic because I’m writing a book. And I realized that the problem was that you talked about identifying with your work. So I had identified with this book. So the problem wasn’t the book. Because let’s say I write the book and it’s not a success. I mean, okay, big headline in the Sunday Times, book, not a big success. How big a big deal is that in the history of the universe?

But if I identify with the book and it’s not going well, then if the book fails, then I’m failing as a person, which then goes back to my very earliest concern about not being worth it. So once I disidentified, once I said, no, this is just a book. It may be a good book, it may be an important book, it may be a book that doesn’t hit the mark. But it’s only a book. And how it goes says nothing about me or my worth.

Once I could decouple that, then I could confidently and much more comfortably go back to the writing of it. But I went through that crisis.

STEVEN BARTLETT: It seems like a bit of a paradox that the lack of self-worth would motivate someone to create great things because they want the approval, but at the same time make the process so agonizing because their self-esteem seems to be on the line. Or their sense of self-worth is on the line.

GABOR MATE: Well, that dynamic was in me. Once I realized it, I let go of it. So it didn’t dominate me in the end. And honest to God, by the time I finished the book, I’m not just saying this in retrospect. It’s a bestseller now in several countries. I actually said to myself, and I meant it, now I’ve done the book, that’s what matters. I’ve said what was in me to say. How the world reacts, I can’t control. And it doesn’t actually matter. On a fundamental level, it’s not that I don’t want this book to be a success. I mean, success, of course I wanted to sell 10 zillion copies. But that doesn’t define my self-worth or how I function in the world or how I feel about myself. Honestly, it does not.

And I understood that by the time I finished working on it. So once it’s done, it’s out there doing its work or not doing its work. But I don’t have to hang my own sense of self on how the book does.

STEVEN BARTLETT: Because at that point, that’s an outcome you can’t control, right? So trying to control that would be anxiety.

GABOR MATE: Well, you can’t control it, no.

STEVEN BARTLETT: 10 years this book took you to write.

GABOR MATE: Took me to prepare. It took about 3 years to write.

STEVEN BARTLETT: You describe it as a calling. The Myth of Normal. Four words to sort of pull people in and in some way summarize a 550-odd page book. Why those four words? Why that phrase?

GABOR MATE: Can I pause for a moment to find a quote on my cell phone?

STEVEN BARTLETT: 100%

GABOR MATE: Yeah, yeah. So this is, are you familiar with the work of Eckhart Tolle?

STEVEN BARTLETT: Eckhart Tolle, yes.

GABOR MATE: Okay, yeah. So Tolle lives in Vancouver like I do. And in one of his books he says, the normal state of mind of most human beings contains a strong element of what we might call dysfunction or even madness, you know? So in medical parlance, normal means healthy and natural. So there’s a normal range of blood pressure, normal temperature. It’s a range. Outside that range there’s no life, there’s no health. Either too high or too low, you’re gone.

So normal means it’s equivalent with, synonymous with healthy and natural. However, we make that same assumption that in society what we use to, what we call normal, is also healthy and natural, which is a myth. Because I’m saying that in this society, what we consider to be normal is neither healthy nor natural. In fact, it’s hurtful to us. So that using the word normal in a way that doesn’t apply, in a narrow medical sense, it’s accurate. But in a broader sense, that which we use to in this society, we consider normal, is just not good for us. And norm is kind of a statistic or it’s a kind of an average.

So if everybody, you have a dog. If everybody in London mistreated their dogs, and if you didn’t, then you’d be abnormal. So it’s a myth to say that what is normal is healthy and natural. That’s what I mean by the myth of normal. That’s one thing I mean.

The other thing I mean is, if we understand the actual science of the unity of everything, I’m not talking about spiritual insight here. I’m talking about physiological science. I think that our physiology and psychology is very much affected by our life experiences, beginning in utero, childbirth, early childhood, and throughout the lifetime. It also follows that illness and health are not individual attributes. They are actually manifestations of our relationships and our situation in the world and our history. That also means when the circumstances are abnormal, you expect people to be sick. Just as if you gave animals something that wasn’t healthy for them, they’d be sick. That’d be what you’d expect.

So this idea that the people who are ill are either physically or mentally abnormal, I say no. These are normal responses to an abnormal set of circumstances. And rather than being sort of those abnormal ones and the rest of us, it’s really a spectrum that we’re all pretty much all on it. So in those three senses, this idea of normal is a myth, and it’s one that keeps us from seeing reality.

STEVEN BARTLETT: And we’re all abnormal in some way. So maybe my attention is different, maybe my interpersonal relationships are abnormal, but in some way I’m going to be abnormal. As it relates to treatments, how do you think that the medical profession and the psychological profession would respond differently if we removed this idea that there is a normal? How would our approaches change to treating people?

GABOR MATE: Well, that’s a multi-layered answer. First of all, we would recognize that our diagnoses are not explanations for anything. So I’ve been diagnosed with ADD, legitimately so. My first book was on it. But it doesn’t explain anything. So I tune out easily, very easily. And often when I don’t want to, but unless I’m highly motivated.

So you might say, this person has ADD. How do we know? Because he tunes out a lot. Why does he tune out a lot? He’s got ADD. How do we know he’s got ADD? Because he tunes out a lot. So first of all, we have to understand that our understanding of normal and what’s outside the normal, it doesn’t explain anything. They can describe, if you describe my mental functioning as that of somebody who’s got an automatic tendency to tune out, you’d be accurate.

So the description, it’s helpful as an explanation as to why this person isn’t behaving quote-unquote normally. It doesn’t explain a thing. Now if you understood that I spent my infancy under very difficult circumstances, where I was very stressed because of all the stuff I already talked about, and that tuning out was a normal response to those circumstances as a way of protecting myself from the stress of it all. And this was happening when my brain was developing. Then you’d understand there’s nothing abnormal about my, by tuning out. In fact, it is the normal response to a set of abnormal circumstances. So that’s the first point. And I could go through the same kind of dialectic with all manner of physical and mental diseases, by the way, so-called.

The second point is…

STEVEN BARTLETT: Why do you say so-called?

GABOR MATE: Well, look, the disease model is, as long as you understand it’s a model, it’s okay. When you think it describes reality fully, it doesn’t. So, for example, we talk about mental illnesses. And we’re assuming that there’s a kind of definite pathology there. Just as in rheumatoid arthritis, you can describe the inflammation of the joints, and the blood levels of certain antibodies being abnormal, and hormonal levels being disturbed. You know, we’re making the same assumption in mental illness. There’s no such evidence in mental illness. There’s no physiological parameters that you can say somebody’s got mental illness.

There’s just been a study a few months ago of thousands of brain scans of people with mental illness diagnosis. There’s nothing diagnostic about the brain scans. It’s not like I can take an x-ray of a lung and say that this lung has got what we call consolidation or fluid indicating inflammation. There’s nothing like that in mental diagnosis. There’s no blood test you can do and so on. So, illness is a model. I mean, it might. Somebody’s really depressed, even suicidal perhaps, and they might need pharmacological intervention which will really save their lives. That may be true.

And in that sense, you may say that they’re ill. As long as we realize that this is a construct that we’re applying here, but that there’s no actual measurement of that that’s at all similar to what we call physical disease. But even in physical disease, we make certain assumptions. For example, somebody has rheumatoid arthritis. Now, nothing wrong with that statement on the face of it, but there’s an assumption there. The assumption is that there’s this thing called rheumatoid arthritis. And there’s this person called me. And this person has this thing.

Now, the example I often give, here’s my cell phone. I’m holding it in my hand. I have a cell phone. It’s not part of me. It says nothing about me. It’s a discrete object. Its nature doesn’t depend on my nature. Nothing.

Is that true about rheumatoid arthritis? Or is it more true to say, as I found out, that this is a condition that shows up in people with certain life experiences and certain ways of functioning in the world. And that because of the science document, the unity of mind and body, and the impossibility of separating the activity or emotional apparatus from our immune system, because it’s all one organismic unit, therefore, when the immune system turns against the body, as it does in rheumatoid arthritis, the immune system actually attacks the body. Is that a thing that’s got a life of its own? Or is there a process that’s happening inside that person because of certain aspects of their lives?

Now, if I say it’s a thing that happens to you, then that thing has got a life of its own. And that’s how most doctors see it. They see somebody with rheumatoid arthritis. They say, okay, this is the kind you’ve got. This is what’s going to happen. This is the only thing we can do is to mitigate the symptoms. I find that’s not true. I find that the rheumatoid arthritis, not just I find it, the science finds it, that rheumatoid arthritis is very much related to stress and trauma. And the more stressed there is, the more likely it is to flare up. And if people deal with that stress, if they know how to prevent it, their illness abates, which means that it’s not a thing that’s separate. It’s a process that happens inside them. This is a subtle concept.

I’m wondering if I’m explaining it clearly.

STEVEN BARTLETT: No, you are. And it’s really making me question how much we misunderstand the relationship between the mind and the immune system because that’s the important connection to understand if you are to accept all the things you’ve just said, which we don’t understand. I don’t think typically we understand that my mind and my immune system have such a close relationship.

GABOR MATE: Well, there’s a whole new science that studies those relationships. It’s called psychoneuroimmunology, which studies the interlinked unity of the emotional apparatus of our brain and body with the immune system, with the nervous system, and with the hormonal apparatus. I mean, it’s just so obvious. I could change your hormonal state in a split second right now without touching you just by screaming at you and threatening you. That would necessarily create a change. I mean, it’s just clear that our emotions are inseparable.

And the other funny thing is, well, several funny things. How do we treat most conditions in medicine right away? Inflammations. If you go to a dermatologist with inflamed skin, if you go to a rheumatologist with inflamed joints, if you go to a gastroenterologist with inflamed intestines, if you go to a respiratologist with inflamed lungs, if you go to a neurologist with inflamed nervous system, as in multiple sclerosis, they’re going to give you steroids to settle the inflammation.

Now, what are steroids? They are stress hormones. And you would think that as physicians, we would ask ourselves, gosh, we’re treating everything with stress hormones. Does stress maybe have something to do with this condition? Now, when you look at the scientific literature, yes, yes, yes, and yes. So there’s a great Canadian physician, actually knighted by Queen Victoria, one of the great medical teachers of all kinds, Sir William Osler, and he said in 1890 that rheumatoid arthritis is a stress-driven disease.

The French neurologist Jean-Martin Charcot, who first described multiple sclerosis, he said this is a stress-driven condition. And since then, there’s been so much research. So what I’m saying is that this way of looking at what we call disease as a process is so much more accurate scientifically, actually, in understanding the mind-body unity. And then, you know, naturally when people are traumatized, that has a huge impact on their physiology. Their psychological trauma has a huge impact on their physiology. It’s just science. But it’s science that’s not taught to medical doctors. For some strange reason, well, the average physician never hears a single lecture about, say, trauma and its relationship to illness. And yet there’s studies internationally, thousands of them, showing those relationships.

So there’s this strange gap between science and medical practice. But it would change medical practice for the better. Because what would happen if you went to a physician and you presented with your symptom, and they’d say, okay, look, we’ll give you such and such medication to deal with your symptoms, and then let’s look at your life in the context that you live it and see how the stresses that you may be taking on, the traumas you may be carrying, might be affecting the physiology of your body.

No, they don’t have to be all trauma therapists to do that. They just have to raise the question and to begin the inquiry. And that’ll make a huge change to that person’s life and to their disease process.

HOW PARENTS’ BEHAVIOUR CAN IMPACT A CHILD

STEVEN BARTLETT: And clearly to their kids’ lives as well. Because I remember reading in your book about the study with the rats. Could you tell me about that study, the stress study with the rats, and how the parents’ treatment of a child impacted their stress response, and then also they passed that on?

GABOR MATE: Yeah, that was a very interesting study. It was done in Canada at McGill University. I think maybe something in the last 20 years, early 2000s I think. And they looked at how mother rats interacted with their infants, their newborns. And there’s this process called grooming in which the mother rat licks the infant or in the perineal area, you know, in the genitalia. This is shortly after birth. These mother rats just start licking their infant. Some of the rats did it in a more efficient and caring kind of way than other mother rats. Those that had the better kind of caring, the better kind of grooming, grew to be calmer and responded to stress in more functional ways than those little rats who, as neonates, had not been given that same kind of efficient and quite as caring grooming.

And what they found that in the brains of those adult rats who had been groomed one way or the other as infants, the stress apparatus was different. Certain receptors were the stress hormones. So one of them could calm themselves more easily than the other. What was interesting is you might say, well, so what? This is genetic. The calmer mothers passed on their genes to their infants. No, they didn’t. Because if you took the infants of mothers who groomed beautifully and put them with mothers who didn’t, and conversely you took the infant rats of mothers who didn’t groom so well, but you put them with mothers who did, it changed the brain for the adult.

STEVEN BARTLETT: It changed the brain?

GABOR MATE: It changed the genetic functioning. Not the genes, but the genetic functioning. This is called epigenetics, how genes are turned on and off by the environment. And then those rats who were groomed well as infants, it doesn’t matter what their original mother was, but those rats who were groomed well, they went on to groom their infants in exactly the way they had been groomed. So this is how we pass on our parenting stuff from one generation to the next, both behaviorally but also through the turning on or off of certain genes.

STEVEN BARTLETT: So in essence, how nurturing our parents were, has a big impact on our own ability to handle stress positively or negatively.

GABOR MATE: Oh, absolutely.

STEVEN BARTLETT: And then we pass that down.

GABOR MATE: How stressed our parents were, how they reacted to our own stress as infants, that has everything to do with how our brains handle stress later on. And so some people just don’t handle stress very well. They don’t handle frustration very well. You should have seen me this morning at the hotel when the swimming pool didn’t open in time. But I was a lot better than I might have been years ago.

But yeah, our stress responses are very much programmed by our early developmental experiences.

STEVEN BARTLETT: Speaking about our early experiences, the first word in the subtitle of your book is the word trauma. It’s a word that I’ve talked about a lot on this podcast, and I’ve had a lot of people here that have opened up about their traumas. How do you define trauma? I know society has defined it in its own way, but how do you define it?

GABOR MATE: I define it very specifically. It’s not something bad that happens to you. It’s not that, you know, I went to this movie last night and I was traumatized. No, you weren’t. You were just sad or you had some emotional pain, but you weren’t traumatized. Trauma means a wound. That’s the literal meaning of the word. It’s a Greek word for wounding. So trauma is a psychological wound that you sustain, and it behaves like a wound.

So on the one hand, a wound, if it’s very raw, if you touch it, it just really hurts. So if I have a wound around not being wanted, or the belief that I’m not, then decades later, if anything reminds me of that, it hurts as much as it did when I originally incurred the wound. So in one sense, trauma is an unhealed wound. That touch, we get triggered. That’s what triggering means, by the way. Some old wound gets activated or touched.

And the other thing that happens to wounds is that they scar over. And scar tissue has certain characteristics. It’s thick. It has no nerve endings, so there’s no feeling in it. So people traumatize disconnected from their feelings. Scar tissue is rigid. It’s not flexible. So we lose kind of response flexibility. So when something happens, we tend to react in typical, stereotypical, predictable, dysfunctional ways because of the rigidity. And scar tissue doesn’t grow like healthy flesh.

So people who are traumatized tend to be stuck in emotional states that characterized their development when they were traumatized. So when somebody says to you, don’t be such a baby, it doesn’t sound very pleasant, but there’s some truth to it. It means that you’re probably reacting according to the lines of some wound that you sustained as an infant. And now you’re reacting as if that wound was happening all over again. This is what one of my friends in the trauma world, Peter Levine, calls the tyranny of the past. So something happens in the present, and we react as if we’re back there in the past when this first happened. And we’re not in the present moment at all.

STEVEN BARTLETT: I was trying to figure out how many people, as a percentage of the population, have trauma. But then I read this stat that 60% of adults say that they’ve had sort of a traumatic early upbringing or whatever, or traumatic events from their childhood. But then I thought maybe everybody has trauma.

GABOR MATE: It depends on how we understand trauma. So if we understand trauma, it’s only the really terrible things that happen to people, which do happen to people. In the book I talk about a British friend of mine living in Canada. They are a yoga teacher and a meditation teacher and a psychologist and an artist, actually. And they grew up in some orphanage here in Britain where they were racially taunted every morning. Words that are in the book, by your permission, which I’m not going to cite here publicly. And that gave her a sense of division, a sense of self, that I’m just not good enough, that I don’t belong, and so on. There’s those obvious traumas, or the obvious trauma of being sexually abused.

So men who are sexually abused, according to a Canadian study, have tripled the rate of heart attacks as adults, and all kinds of physiological reasons why that should be the case. So there’s those self-evident, big T traumas that we call big T trauma, with a capital T. Trauma with a capital T. There’s a certain percentage of the population, much larger than we think, subject to that. If you include all the known factors, such as physical, sexual, emotional abuse, spanking, by the way, has not been shown to be as traumatic as harsher forms of physical abuse. Spanking, which is still recommended by so-called experts, which will remain unnamed for the moment. The death of a parent, violence in a family, parental violence against each other. A parent being jailed. A parent being mentally ill. Did I say a parent being addicted? A ranker’s divorce. These are the identified big T traumas, not to mention poverty, not to mention extreme inequality, war, and so on.

But then, if you remember that trauma is not what happens to you, but what happens inside you. It’s the wound. People can be wounded not just by bad things happening to them, but small children can be wounded in loving families where they don’t get their needs met. I mean, that’s obvious in the physical sense. If a child doesn’t get proper nutrition, their body will suffer. Their mind will suffer. We’re also creatures with emotional needs as important as our physical needs. So when a child’s emotional needs are not met, that child is wounded. And that’s what we call small T trauma, which is not the big ticket events such as I described, but just a child’s need to be loved unconditionally, to be held when distressed, to be responded to, to be seen, to be heard, to be allowed their full range of emotion without them being stamped on in the name of so-called discipline. The right to play creatively, spontaneously, out there in nature, not with these damn digital gadgets that subvert and hijack the child’s imagination, but spontaneous play that’s essential for brain development.

So what I’m saying is that when these needs are not for the unconditional loving attachment relationship, when those needs are frustrated, children are also hurt. And I call that trauma as well because it shows up later in life as the impact of painful wounds. So trauma in this society for all kinds of reasons is far more common than we imagine.

STEVEN BARTLETT: From sitting here and speaking to, I don’t know, somewhere over a hundred different people that come from all walks of life, but specifically people that are successful in their industries, and you talked about, you know, how an anomalous early upbringing can create sort of abnormality in an adult. A lot of people I sit here are successful because of some kind of abnormality, or at least their interpretation of some kind of early event that caused them to have some sort of abnormal belief about themselves, that they’re not enough, so they become a billionaire or a gold medalist or whatever it might be.

One of the things that I thought I could predict is, I thought I could, if they told me, I thought after doing a hundred episodes, if they told me the traumatic event they’d been through, I could predict the outcome in them. But there’s a disconnect there because, you know, I sit here with a guest who went through one of your capital T traumas, like domestic violence, and one of them might become incredibly angry, and one of them might become the most peaceful, loving person I’ve ever met. And that taught me that there’s this thing in between the event, which is what you call interpretation.

And I found that as, that kind of makes it really difficult to diagnose.

GABOR MATE: Well, now look, so the two examples you gave, that really peaceful person may be really peaceful for genuinely good reasons, such as they found the milk of human love flowing through their veins, and they’ve had some spiritual reconciliation with the world, or they may have genuinely learned compassion for themselves and others. But they could also be very nice and peaceful because they’re suppressing their healthy anger, because they’re actually sitting on their rage unconsciously, which is going to show up in the form of some kind of health manifestation, I guarantee you, later on.

So you can’t tell from the outside without asking some questions. Or I can give you the example of a Donald Trump who had a really traumatic childhood. I mean, his father was, as described by his psychologist niece, Mary Trump, his father, Trump’s father, who is Mary’s grandfather, was a psychopath, and who really demeaned and harshly treated their children. So Trump decides, unconsciously, that, by the way, I’m not talking about his policies here, this is not a political debate, and in the book I point out that his opponent was also traumatized, Hillary Clinton. This is an ecumenical view of trauma and politics. I’m not choosing sides.

I’m just saying that you can see his trauma, and every moment he opens his mouth. His grandiosities need to make himself bigger, more powerful, aggressive, and he’s, as much is said in his autobiography, that the world is a horrible place, a dog-eat-dog place, where everybody is after you. Everybody wants your wife and your house and your wealth, and this is your friends, never mind your enemies. That’s the world he lives in. That world that he lives in reflects his childhood home. He developed that worldview. He came to it honestly, you might say, because that’s the world that he lived in. And he gets to be really successful in this crazy world. Financially, although people question, was he really as big a success as he says he was, but he certainly was successful politically, if by success you mean the attainment of power.

His brother, on the other hand, Mary Trump’s father, Trump’s niece’s father, drank himself to death. And they were both responses to the same… You can never say it’s exactly the same for two kids, but there was a toxic home environment. One ends up dead as an alcoholic. The other ends up at the pinnacle of power. And when I look at them both, I see dysfunction there, significant dysfunction there.

STEVEN BARTLETT: So one of the consequences of that early upbringing was it materialized itself as sort of addiction, and the other got the same psychological reinforcement or the thing missing from power and work and money.

GABOR MATE: Well, Donald Trump learned that the way to survive is to be aggressive and harsh and competitive and to get the other before they get to you, which is a faithful reproduction of his early childhood experiences. So for him these were not choices so much as survival techniques. And when they talk about his lying, well, I don’t know when he’s lying and when he’s not, but my sense is that often he actually believes what he’s saying. And actually his biographer or the person who co-wrote his quasi-autobiography called The Art of the Deal, this writer says that he’s never met anybody who’s so capable of believing something that’s not true to be true if he wants it to be true. Now that’s the mark of a traumatized child, you know, a denial of reality.

It is an inauguration. There were a certain number of people that came to the – he couldn’t stand it that there weren’t as many people there as came to Barack Obama’s inauguration. There were a much smaller number of people there. He created this reality where many more people came to his inauguration. Now what age behavior is that? That’s a four-year-old where more kids came to his party than my party. That can’t be true. But that’s Donald’s way of dealing with reality. It’s not a moral failing as such. That’s how you survive. And these survival mechanisms then begin to form our personalities. And again in this world, sometimes they pay off in certain ways.

STEVEN BARTLETT: Is that often the case with pathological lies? They’ve learned to lie as a way to survive.

GABOR MATE: Oh, absolutely. The German philosopher, writer Nietzsche, Friedrich Nietzsche said, people lie their way out of reality who have been hurt by reality. And so I’ve lied. Like when I had my shopping addiction, I lied every day to my wife. And even afterwards when she stopped trying to change my behavior, I said, just tell me. If you’re going to shop, you’re going to spend another $1,000 on music. Just tell me. And I still couldn’t because I was so ashamed of it. And so the lying became like a way of survival for me.

STEVEN BARTLETT: Defense against reality.

GABOR MATE: It’s a defense against reality and it’s a defense against being judged. Well, that says something about my childhood. Nobody is born a liar. As we say in this book, there are congenial liars but there are no congenital liars. No one little baby tells any lies. No one little baby pretends anything. If we end up pretending in any way at all to the extent that we do, it’s because we have to learn that’s what we must do to survive.

STEVEN BARTLETT: You said something at the start when I gave the example that I have this. I sat with a guest here who went through domestic abuse and they are the calmest person. And then you said, well, maybe they’re suppressing it. And in fact, the minute you said that, it reminded me of something they said, which is they said to me on this podcast that they had angry outbursts all the time. So sometimes their child will come up to them and want to play when they’re working and they’ll snap. And they’re trying to deal with that.

GABOR MATE: That’s what I meant, that they’re sitting on this crater, volcanic crater of anger, which sometimes bursts out of them. So their demeanor is like a really developed, suppressed way of handling rage, which rage, when they were children, had they expressed, would have got them into more trouble. So suppressing it, repressing it became their survival. It’s all about survival, you see. So it became their survival mechanism.

Now, that person, as long as they keep it that way, they’re at risk. They’re at risk for mental health diagnosis like depression. Because what is depression? It means you’re pushing something down. That’s what it means. What do we push down? Our natural emotions. Why do we push them down? Because we have to, to survive. So that person, I don’t know, I can’t prognosticate what’s going to happen to them. If they don’t work it out, in general, they’re at risk for some kind of mental or physical manifestation. That’s my experience.

STEVEN BARTLETT: You talked about expressing one’s emotions. And something you’ve talked about in this book, but also previously, is this idea that there is such a thing as healthy anger. It’s one of the seven A’s of healing, as you say. The first being a topic we’ve talked about already, which is acceptance. The next being awareness.

GABOR MATE: Well, awareness, I wish we had put into this book, but we didn’t. Not into this book. In this book, I put four A’s, and I left out awareness, and that was an omission on my part.

STEVEN BARTLETT: Really?

GABOR MATE: Yeah, it was. I’m sorry, but it was.

STEVEN BARTLETT: So in the book, you have authenticity, anger, autonomy.

GABOR MATE: Authenticity and agency, yeah.

STEVEN BARTLETT: Yeah, acceptance. So awareness, you said before, before this book, that awareness is the starting point. I found that to be so true in my life, but it’s not very easy. I feel like awareness is a luxury or a privilege that is very hard fought. Because you’re guessing. You’re guessing based on pattern recognition. So I was guessing, 25 years old, I can’t get into a relationship. Any time a girl comes near me, even if I’ve pursued her, I run off. And to figure out why I was doing that, to even identify the behavior pattern and go, that’s not helpful. That’s not going to lead me to feeling whole. Where does that come from? It took 25 years and a lot of introspection. But most people, they’re living unaware of the puppet master of trauma that is driving their life.

GABOR MATE: That’s a really good analogy. The trauma really is like a puppet master behind the scenes and the unconscious pulling your strings, and you’re not aware of it. Do you remember Pinocchio?

STEVEN BARTLETT: Yeah.

GABOR MATE: So you remember what Pinocchio says at the end when he finally becomes a real boy? He says, how foolish I was when I was a puppet. And to the extent that we’re being activated by these unconscious strings that our trauma is pulling behind the scenes, and we’re acting in our lives and we think we’re autonomous, free beings, but we’re actually being controlled by something in the past that we haven’t worked out, we’re puppets. We’re actually puppets. And there’s not much freedom in that. There’s no freedom in it at all.

So, I mean, I suppose the opposite of trauma, if you want to revisit that question, is liberation.

STEVEN BARTLETT: Interesting. Liberation by reconnection.

GABOR MATE: By reconnection, but liberation from the inexorable power of the unconscious.

STEVEN BARTLETT: Which is like cutting the strings in a way. Kind of brings me to, there’s kind of two ways I want to go with that. The first question I have about trauma and the puppet master analogy is, do we ever really cut the strings? Or do we just kind of learn to pull against them when they try and tell us to do something with more force than they’re exerting in the opposite direction?

GABOR MATE: That doesn’t work very well, pushing against it, because it’s still reactive. You’re still not in charge. You’re just in automatic resistance mode to something. There’s no freedom in that either. So, yeah. But awareness, that you mentioned, is huge, because once you’re aware that there’s this, see, the thing about, these strings may not fray right away, but once you’re aware that, ah, this reaction of mine, it’s not about what’s going on right now. There’s something all being activated here. That awareness alone weakens the, it slackens the strings a bit. They’re no longer as taught. They’re no longer as automatically capable of pulling on you. So it does have to begin with awareness of them.

Ultimately, if we realize that this puppet master is just a desperate little person trying to get you to survive, the only way he, she, they knew how when they were small, if you make friends with it, but we relieve it of its duties, say, thanks very much, but I can handle it now, it eventually becomes a friend rather than sort of our master.

STEVEN BARTLETT: On that first step of just acknowledging, just understanding that there is a puppet master there controlling us, and exactly which strings that puppet master is pulling in our lives, how does one go about awareness, the process of awareness? Is that, I mean, is it introspection, keeping a diary, therapy? What is it?

GABOR MATE: Well, all that. I mean, all or any. But even when you ask how you go about it, what is the it? For you to say how to go about it, you already must have some degree of awareness. If you didn’t, you wouldn’t even be asking the question. So that’s the very first step of realizing that there’s something here to work on. There’s something here to work through. It does not need to be the way it is. That already is the biggest step. The Buddha said that to recognize the source of your suffering is the first step towards relieving the suffering. And so as soon as you ask how you go about it, you’ve already taken a huge step. Because a lot of people don’t even know that there’s an it. They just think this is a reality, that this is life. So realizing that this it doesn’t have to be the way it is, that’s already a huge step.

Now, beyond that, yoga, meditation, nature, therapy of all kinds, body work of all kinds, like somatic experiencing, or cranial sacral treatments, or even massage therapy. It’s incredible what can be revealed just through body work like that. Then all kinds of forms of therapy, the ones I teach, the ones other people teach. Journaling, certain exercises in this book that we recommend. Like just ask yourself where you have trouble saying no in life to things you don’t really want to do. And working that through on a regular basis.

So there’s lots of ways once you open the door. You know, I have a chapter on psychedelics here which is, again it’s not like a panacea or for everyone, but certainly it’s a helpful modality for a lot of people. So some people may actually benefit from taking pharmaceutical medications if their situation is dire enough. But not as the final answer, but as a way of getting respite that allows them to go to work on the real issues that cause them to be depressed, or anxious, or tuning out. You know, so any and all of these things.

STEVEN BARTLETT: A lot of people don’t even want to open those doors though. Because there’s so much pain associated with maybe going back or revisiting an early experience that they just think it’s better to keep the doors shut and get to tomorrow.

ADDITIONS AND HOW WE DEVELOP THEM

GABOR MATE: That’s true. To which I have two answers. One is, it’s true, it’s painful. Because all the pain you didn’t want to feel and you’ve been running away from through your compensatory behaviors like your addictions are nothing but an attempt to escape from pain. That’s all they are. They’re not a disease, they’re not genetic, whatever it is. Addictions are very simply an attempt to escape pain. Which creates more pain. But that’s what they are.

And so we get addicted to work, to sex, to pornography, to gambling, to the internet, to shopping, to eating, to power.

STEVEN BARTLETT: On that point, I find it so fascinating. When you mentioned in your previous book that you classified things like food, social media, shopping, porn, and work as types of addiction. That in and of itself was a bit of a revelation for me because I never saw work as an addiction. The minute you said it was, and I kind of link it to heroin addiction, which is providing a certain psychological, physiological benefit to me. Temporarily, of course it’s a fucking addiction. Of course work is an addiction.

GABOR MATE: Work can be an addiction. Work can also be sacred. It can also be fulfilling and a manifestation of your creative urges. But it’s strange to say, not that I recommend it, but it’s possible even to use heroin in a non-addictive way. I don’t personally get it and I would never want to. But the addiction is never in the behavior itself, it’s in your relationship to the behavior.

So if the particular activity gives you temporary relief or pleasure and therefore you crave it, but it causes harm in the long term and you can’t give it up, you’ve got an addiction. And I don’t care what the activity is. It could be drugs and all the other things that we mentioned. And it employs the same brain surface, by the way. The workaholic is after the same brain chemical that the cocaine addict is after. Dopamine. And people can be even addicted to their own stress hormones, like adrenaline. The so-called adrenaline junkies. There’s such a thing. So almost anything can be addictive if it serves the purpose of temporarily easing some distress but causing harm in the long term.

STEVEN BARTLETT: Is escapism the right word to use, Werner Frey? Because it doesn’t sound as much like we’re escaping rather than we are seeking something.

GABOR MATE: We’re seeking relief from a certain mental state. Like I just gave you the definition of addiction, so I don’t know what addictions you’ve had or haven’t, but what did that do for you temporarily? Did it give you something?

STEVEN BARTLETT: It made me feel like I was valid and I was pursuing a sense of accomplishment and validation.

GABOR MATE: It gave you a sense of worth.

STEVEN BARTLETT: Yeah, it was worthy.

GABOR MATE: Is that something that people need or not?

STEVEN BARTLETT: Yes.

GABOR MATE: Yeah, that’s a good thing. But the real question is, why did you ever get the idea that you didn’t have the worth? Why did I get the idea that I didn’t have the worth? That’s where trauma comes from.

STEVEN BARTLETT: Because I was called the N-word when I was eight by a kid in school.

GABOR MATE: Exactly. And because your mother screamed at your father.

STEVEN BARTLETT: Yeah, yeah, yeah.

GABOR MATE: All that together. And that’s emotionally painful. What’s it feel like to not have a sense of worth? That’s painful. And so that’s why my mantra is, don’t ask why the addiction, ask why the pain. And if you want to understand why the pain, you have to look at that person’s life.

STEVEN BARTLETT: And what the benefit of the addiction is. That’s something that you say in a previous book that I found, it’s a flipping of narrative where you say, we should be asking what the benefit of the addiction is.

GABOR MATE: Yeah, like in your case. It gives you a sense of worth. And you say, well, okay, I’ll say to you, if you come to me, because you say, I work hard, it’s causing some harm in my life, it’s keeping me from intimate relationships, it makes me stressed and tired, whatever it is. The first thing I would ask you of you is, what is it doing for you? And you say a sense of worth. And I’d say, you know what? You deserve to have a sense of worth. You understand why you’d want to engage in an activity that gives it to you. But given that it’s causing you harm, let’s look at why you don’t have a sense of worth and how else you might develop it that isn’t harmful to you. But you start with what’s right about it. What are you looking for? And what you’re looking for is always valid.

STEVEN BARTLETT: And how would one go about getting that sense of worth? I’m asking for a friend.

GABOR MATE: Well, that would be a matter of some form of work. People who meditate often deal with that issue through the meditation. Not always. Certainly therapy. By recognising also that what you’re doing to get the sense of worth doesn’t really do it for you, just by getting honest about it. So there’s all kinds of ways, but the first step is the recognition.

STEVEN BARTLETT: That’s the first step that you say is missing from the book, which is that sort of awareness. The next thing which has been really front of mind in my life recently, because I’ve been asked this a few times on stage and I’ve been trying to find the words to really articulate the importance of it, and this is one of your forays in this book about how to heal, is authenticity. Really interesting concept, because I’ve been trying to articulate why the fact that I’ve just shared all this stuff with you and the fact that I do this every week, I’m getting closer and closer to that sort of authentic self where the mask is kind of dropping on me. Why that’s been so healing for me. Why is authenticity such an important way for us to heal?

GABOR MATE: It’s much more than a way for us to heal. It’s actually who we are. What you’re really asking is why it is important for a creature to be true to its own nature, because that’s what we’re meant to do. We’re meant to be here as ourselves. And when we’re not ourselves because we had to abandon ourselves or betray ourselves, disconnect from ourselves in order to survive, we lost connections with our essence. And I mean, how does it feel to be a successful CEO and more than realizing your financial dreams, but to be a workaholic and not to be available to yourself in areas of your life that really matter to you, as opposed to being honest about your stuff, sharing it with other people, dropping the veil, dropping the…

I mean, to answer your question, what does it feel like? I mean, can you sense the difference in your body?

STEVEN BARTLETT: I feel lighter.

GABOR MATE: Well, yeah.

STEVEN BARTLETT: Expansive.

GABOR MATE: Well, that’s the answer. That’s why it’s so important.

STEVEN BARTLETT: So many of us live inauthentic lives because, as you said, it’s either because from an early age we were escaping some kind of reality in order to help us to survive, or then the other thing that happens a bit later on in life is we develop an identity, which becomes a career, which becomes a social circle, which becomes a prison of our inauthentic selves. We get trapped in there because I was good at something or because I felt accepted in this job as a lawyer, so I am now living inauthentically as this robot in this prison.

And there’s often a real perception of risk and loss and danger of trying to get out of that prison, of trying to get close to our authentic selves. We feel like we’ll lose our friendship circle. We’ll feel like we’ll let our parents down who wanted us to become a lawyer. All of these things. I guess you see that a lot in your work.

GABOR MATE: Well, there is that risk, but here’s the issue. As a child, you had no choice but to go for acceptance and being approved of and being received under any conditions. No matter what, you had to give up your authenticity. You had to give up your authenticity. You had no choice in the matter. At a certain point as adults, we learn that this lack of authenticity, this disconnection from ourselves, this separation from our gut feelings, is costing us. It’s costing us in terms of our physical health, our peace of mind, our relationship, our mental health, and so on. You’ll never be as vulnerable again as you were when you were a child. You’ll never be as helpless, as dependent, as resourceless.

No, it’s true that if you develop the whole set of relationships based on your inauthentic persona, some people in your life may not like it if you gradually move towards authenticity. They may not like it. It’s not what they wanted from you. You’re going to find out who your friends are. You’re really going to find out. Because your real friends will say, Oh, I’m so happy for you. We were waiting for this. Other friends will say, It’s not what I signed up for. The question is, you still have to decide. As an infant, as a young child, I had no agency in the choice of authenticity and attachment. No, I do. Which one do I want to go with? What is the cost of being inauthentic? I can’t make that decision for anybody else. Nobody can’t make that decision for anybody else. But most people will find that choosing authenticity has benefits way beyond whatever they might lose. That’s what I find.

STEVEN BARTLETT: You said the word agency, which is the second of the four A’s on how to heal. Agency, when I read that word, I hear like personal responsibility, taking personal responsibility over my life.

GABOR MATE: Exactly. Which also means not letting, you don’t wear trauma as a badge. You don’t use it as a get-out-of-jail pass in a game of Monopoly. I was traumatized, so I can’t be any other way.

STEVEN BARTLETT: Giving all the power to the puppet master.

GABOR MATE: Yeah, exactly. Agency means actually I take responsibility, not for what happened to me, not even how I interpreted the world as a result, going backwards, but how I interpret the world from now on. Do I still want to interpret the world and my role in it based on some decision I made when I was a one-year-old? That’s where agency comes in.

Agency also means that if I have any kind of dysfunction or illness, it’s not just that I put my fate in the hands of a physician or a healer, but I make the decisions. I listen to your advice. I accept some, I don’t accept some, but I’m the one who’s making the decisions along with what seems right to me. So agency.

STEVEN BARTLETT: It’s interesting in your work, throughout your work, you use alliteration a lot as a way to kind of summarize and make ideas really memorable. It really helps.

GABOR MATE: It’s an old trick.

STEVEN BARTLETT: It’s a trick. It’s a writing trick, right?

GABOR MATE: Well, it also works, you know. The four A’s or…

STEVEN BARTLETT: The four R’s.

GABOR MATE: I don’t have to say, you know, I’m denigrating my work if I say it’s a trick. No, it’s just the way things occur to me. That’s all it is.

STEVEN BARTLETT: One of the alliteration devices you use also relates to limiting beliefs and how we can undo self-limiting beliefs with the five R’s. RELABEL, REATTRIBUTE, REFOCUS, REVALUE, and RECREATE. Now, from what I understood of those, relabeling is the story and the belief that is limiting to us.

GABOR MATE: Well, it takes something like your workholism. I need to go to work. I need to do this work. Relabeling is I don’t need to do this work. I just have a belief that I need to do this work. So that relabeling just takes a degree of separation from the behavior. And actually, it’s true. It’s not that you need to do all this work. You have this belief. So relabeling just says it for what it is.

By the way, I have to acknowledge that these five R’s, only one is mine. I stole the other four from a psychiatrist. I mentioned that in the book, but I find it a very helpful technique. But it was developed for people with obsessive-compulsive tendencies. So the relabel is not that I have to wash my hands a hundred times. I just have a belief that I have to wash my hands a hundred times. That’s the context in which it was developed. I think it works for all kinds of dynamics.

STEVEN BARTLETT: So I’ve relabeled it. I don’t have to work to feel a sense of validation, but I have a belief that I do.

GABOR MATE: That’s right.

STEVEN BARTLETT: And then I reattribute it, which is the second R, which means I get clear on where it’s come from.

GABOR MATE: Yeah. So let’s say you have the belief that you’re not worth it. It’s not true that I’m not worth it. I just have a belief that I’m not worth it. Okay. Or it may not be true that I’m not worth it. But I do have a belief that I’m not worth it. REATTRIBUTE means this is an old brain circuit sending me an old message. It’s got nothing to do with reality. It has to do with some experience that I had a long time ago. That’s the reattribute.

You just say, well, where is it actually coming from? There’s a circuit in your brain that’s wired with the message, you’re not worth it. And it’s going to keep repeating that message. Well, you say, okay, that’s where it’s coming from.

STEVEN BARTLETT: Until I refocus, which is the third R.

GABOR MATE: Yeah. So refocus is just to give yourself some space. So if you ever say, I need to go to work, okay, refocus means, well, for five minutes, maybe in five minutes I’ll go to work, but for five minutes I won’t. I’m going to put on some piece of music or go for a walk or meditate or whatever. So you refocus, you put the intention somewhere else. To prove to yourself that you actually have some agency over your brain. If only for five minutes. If you have this belief that I’m not worth it, well, you can go back to it in five minutes if you want. Just for five minutes though, consider all the ways that you made a contribution. Consider all the ways that people have acknowledged your benign presence in their lives. The times that people have told you that they’ve loved you or that you told somebody else. Just for five minutes, hang out with that. Five minutes later, you want to go back to this belief that, or if you can’t help going back to this belief that you’re not worth it, well, that’s okay. But at least create some space. It’s all about creating space between yourself and these beliefs or these behaviors.

STEVEN BARTLETT: And in that five minutes, you’re basically accepting new evidence to be true. You’re proving that other evidence is true. I didn’t need to go and work.

GABOR MATE: Well, you’re also proving that you don’t have to spend all your time subjected to those beliefs. You can take a hiatus from it, at least for a while.

STEVEN BARTLETT: And that they are not you.

GABOR MATE: They’re not you, yeah.

STEVEN BARTLETT: And then re-value.

GABOR MATE: Re-value is really what it should mean or maybe more accurately devalue because you say, what has been the actual value? This belief that I’m not worth it, what has been the actual value of it in my life? This tendency of mine to be a workaholic. What has been the actual value? Oh, it made me tired. It made me alienated. Or it keeps me depressed. It keeps me hopelessly trying to prove something which I can never prove to myself anyway, through external activity. So you actually look at what has been its actual impact on your life. What has been its real value?

STEVEN BARTLETT: Sometimes the value is positive though, right? I think about my own workaholism, if that’s the term. I think, oh, there’s some positives here. A lot of negatives.

GABOR MATE: Yeah. Well, is the positive due to workaholism or is it due to your capacity to work hard on behalf of a goal? They’re not the same. Your capacity to work hard to achieve a certain goal is simply a gift that you have and something that maybe takes some discipline and application on your part. That’s not workaholism. That’s just a strong positive work ethic. The workaholism is when you’re driven to work. You actually don’t need to.

STEVEN BARTLETT: It’s funny because it reminds me of an analogy I’ve been talking about in the last couple of episodes of this podcast. The distinction between being driven and being dragged. It’s like, which side of the lorry am I flying down the motorway? Am I tied to the front and am I running and pulling the lorry? Or am I just like my ankles attached to the back of the lorry as it flies down the motorway because I’m being dragged?

GABOR MATE: If I may, I would say that neither of those are particularly desirable. But it’s the distinction that I made before between being driven and being called. Because if you’re called… You see, if I call you and say, Steven, would you come and have dinner with me? You can say yes. You can say no. I just gave you a call and you can say… Literally, I’m talking about a call, a telephone call. You can say yes. You can say no.

STEVEN BARTLETT: It’s a decision, though.

GABOR MATE: But you’re the one who’s making the decision. When you’re dragged or pushed or pulled, you’re not making the decision.

STEVEN BARTLETT: I’m a slave to the decision, to that, to the activity. One of the really interesting things I wanted to talk to you about is ADHD. I’ve had a few of my friends in my close friendship circle diagnosed with ADHD recently. And then I looked into some of the statistics around ADHD. I found this statistic that said in the 1980s, one in 20 U.S. children were diagnosed with ADHD. Today, the number is roughly one in nine. And just generally, around me, it feels like, and this could just be because of my own little narrow circle, or it could be because of a wider thing happening in society, it feels like there’s been an increase in diagnosis of mental illness and things like ADHD. And the causes, when I spoke to my friend about what he believed the cause of his ADHD was, and he’s posted this on LinkedIn and talks about it very publicly now, it seemed to point to, he seemed to believe it was relating to some kind of genetic or heritable factor.

Now, the issue that I’ve sort of been contending with myself, and why I spoke to Johann Hari about this and others about this is, if I am to accept that, then I feel like I’m accepting that we’re being born somewhat broken. And this is almost what Johann Hari talked about in the early stages of his teenage years, where he was made to believe that there was a chemical imbalance in his brain, and therefore he was born broken, and here’s the medication to solve it.

So, but I don’t believe that. I don’t personally believe that we’re born broken.

GABOR MATE: Well, anybody interested in the subject might do what I think Johann actually did, is to read my book on ADHD, it’s called Scattered Minds. And I was diagnosed with it in my 50s, and so were a couple of my kids. But I never bought into the idea that this is a genetic disease, or that it’s a disease at all, genetic or otherwise.

Now, as for the rising number of people being diagnosed with it, there could be two reasons, at least. One is we’re better at diagnosis, so before we wouldn’t have noticed it, but now we are. Or genuinely, there’s more people who are having trouble in certain ways, such as with attention and impulse control and so on. But either way, the fact is that many more children are being diagnosed and medicated for this condition, particularly in the U.S., but also increasingly here in the U.K. as well, and in China and elsewhere.

Now, as I said earlier, the fact is, here’s the actual reality. Nobody’s ever found a gene for ADHD. Nobody’s ever found a gene that says, if you have this gene, you’re going to have ADHD. No such gene has ever been found. No group of genes has ever been found that says, if you’re going to have this gene, you’re going to have this condition. Nor ever will be. And no such gene or group of genes has ever been found that if you don’t have these genes, you will not have the condition.

Now, there are some diseases that are genetic. One runs in my family, muscular dystrophy. If you have the gene, you’re going to have the disease. My mother had it, my aunt had it. That’s a genetic condition. And if you have the gene, you’ll have the disease. Very rare, those kind of diseases.

Now, there are some genes that the more of them you have, the more likely you are to have any number of mental health diagnoses. ADHD, depression, anxiety, even psychosis, bipolar illness. But there’s no group of genes or set of genes or gene that themselves determine any one condition. As a matter of fact, you can have those same genes and not have any condition whatsoever. So something is being passed on, but it’s not any kind of condition that’s being passed on. What’s being passed on is sensitivity. And the more sensitive you are, the more you’re going to feel whatever’s going on in the environment. So you take the same sensitive kid with these genes that confer greater sensitivity of them. And sensitive means to feel, from the Latin word, to feel, sincere. The more sensitive you are, the more you’re going to feel. The more you feel, the more bad stuff happens, the more pain you’re going to be in. And the more compensating you’re going to have to do.

At the same time, with the same genes, if you treat it well and you grow up in a healthy environment, you’ll just be creative and happy and joyful and a leader or an artist or a shaman or a very creative CEO or whatever you’re going to be. So the genes don’t determine. They make you more sensitive to their environment.

Now, if you go back to what I said about the tuning out, it’s simply a defense. So the more sensitive you are and the stress in the environment, the more you’re going to feel the stress, the more you’re going to need to escape from it by tuning out. So you didn’t inherit ADHD. You inherited a sensitivity that makes it more likely under stressful circumstances that you will revert to tuning out. When your brain is developing, which, by the way, is an organ that develops physiologically under the impact of the emotional environment. So if there’s a lot of stress in a child’s life, and what I’m saying is in this society, is that more and more parents are stressed, not because they don’t love their kids, not because they’re not doing their very utmost to provide for them, but because they’re more stressed for all kinds of social, political, economic reasons. If you look at inflation in Britain, which is a high risk right now, more people are going to be stressed financially.

Financial stress on the parents translates into physiological stress in the children. Those children may want to tune out because it’s too much to be in the present. Some of them will be diagnosed with ADHD. They didn’t inherit anything in terms of a disease. They’re just reacting to the environment. So if we’re diagnosing more and more kids these days, I think it’s because the parenting environment has become much more stressed.

STEVEN BARTLETT: And that’s backed up in this book where you mention that study of 65,000 parents and their children with ADHD, right?

GABOR MATE: There’s more trauma in their lives.

STEVEN BARTLETT: Yeah, so the children, they do a study with 65,000?

GABOR MATE: I forget, you’re better than I am.

STEVEN BARTLETT: 65,000, I read it.

GABOR MATE: You made notes, I did. Yeah, but many thousands of kids, yeah.

STEVEN BARTLETT: So because I found that to be really, really sort of supportive of what you just said where, again, I’m saying this from memory, but a study of 65,000 children and their parents, they found that those parents who had more adverse traumatic events in their lives ended up having a higher chance of having a child that had ADHD.

GABOR MATE: Well, look, if you look at the United States at least, poor kids and kids of so-called color are much more likely to be diagnosed with ADHD.

STEVEN BARTLETT: Interesting.

GABOR MATE: Now, why would that be the case? Because they’re living with so much more stress.

STEVEN BARTLETT: Men as well, right?

GABOR MATE: Men as well? Adults, you mean?

STEVEN BARTLETT: Men, yeah. So I read that more men, more boys.

GABOR MATE: Yeah, more men are diagnosed partly because in men, the symptom of hyperactivity seems to be there more often. So when a kid is sitting in school and the cancer is still, that’s obvious, the teacher will notice it. The girl who’s kind of dreamy and tunes out, kind of fades away at the back of the class, she doesn’t create any problems. So they don’t, that’s one of the reasons.

But also, funny to say, but young boys, infant boys are more sensitive to environmental pressure than girls are for some strange reason. So they’re more likely to be affected by these factors.

STEVEN BARTLETT: Seeing a boy like that in the class, that has a poor attention span, bad response to stress, we medicate. What is the impact of that approach to treatment, medicating super early?

GABOR MATE: I used to, when I worked as a physician, I would certainly prescribe medication sometimes. It’s a question of who’s prescribing it and what intention. If I understand that the real problem in this child is not that there’s anything intrinsically wrong with the child, but that they were developed in a stressed environment and those stresses are still acting on them. And one of the stresses is the parents don’t understand the kid’s behaviors and they tend to react rather harshly.

Then if I change, if I can help the parent understand the sensitive nature of their child, which also means that when positive changes occur in the environment, the kid will be very responsive to that as well. If the parents can create a positive, accepting, understanding atmosphere in the home and work on their own stresses, so they don’t unconsciously pass them on to their kids, that kid will change very quickly.

And I say, well, if in the short term the child wants the medication to function better, and no child should be forced to take medication, and medication are never the final answer. At the very most, they’re a stopgap. There’s no proof whatsoever that medications help anybody heal from ADHD. They simply suppress symptoms, which may be helpful in the short term, but for God’s sakes, go to work on the long term development of that child. And what does that mean? Create the conditions in which healthy development takes place. That child will do very, very well. If you think the problem is a disease, they’re just going to medicate away the symptoms of.

STEVEN BARTLETT: What about for adults? I’m thinking of my friend there. He’s in his 30s, and he got the diagnosis of ADHD in his 30s. He’s been given this medication, which he presumably has to take for life. He told me the medication has helped him focus.

GABOR MATE: Has helped him focus.

STEVEN BARTLETT: ‘It’s been a game changer, Steve.’

GABOR MATE: Yeah, yeah. I’ve taken medication myself for ADHD, and it helped me focus. It helped me write my first book. I didn’t take it for this one. As a matter of fact, more recently, when I was beginning to write the medication, I thought maybe I would take a bit of stimulant like I used to, and just to see if it helps me write the book better. All it did is give me side effects. My brain has changed. I don’t need it anymore.

So I would say to your friend, if the medication is helping you right now, and it’s not causing you side effects, I’ve got nothing against it. And you might want to give it a break every weekend. You might want to use it for when you’re having to work or having to really concentrate, but it’s up to you. If it helps you function, take it. But go to work on the traumas and stresses that are driving the ADHD going back to your childhood. And I may say in my book, my book on ADHD, Scattered Minds, does outline some ways to do that.

You might find that you don’t need the medication so much anymore, or not at all, perhaps. Number one. Number two, even if you do, your life will be so much fuller and so much less stressed if you deal with the underlying factors than if you simply medicate the symptom.

STEVEN BARTLETT: I always think in life there’s a cost for all these things we use to medicate and stimulate ourselves. So I always ask myself, there’s got to be a catch here. And even for coffee, I’m like, what’s the catch? We can’t just be all up and positive. And with my friend when he had the conversation with me about being on this medication for life, my first thought is like, okay, what’s the cost? It’s going to make you really focused and better at work. But what is the long-term cost?

GABOR MATE: I have to talk to your friend. Those are good questions to ask. When I took medication, it made me a much more efficient workaholic. It did nothing for my workaholism, just made me much better at it because I could stay up later now and I was more focused. I could get even more things done. So you’ve got to deal with these other issues.

STEVEN BARTLETT: Did you?

GABOR MATE: I did. Did I deal with them? Yes, I have. And there’s so much more, like dealing with the trauma. I’m telling you, if your friend’s got ADHD, I can tell you he had it stressed early for years and his parents were stressed. So deal with that. Deal with what conditions are you creating now in your life that create more stress for you. Are you taking care of your body? Are you exercising? Are you eating well? Do you get out there in nature? Nature has a certain kind of harmony to it which actually calms the mind. So are you doing all these things? If not, all you’re doing is medicating a symptom. If you are taking the medication specifically to help you focus but you’re working on these other issues, you’ll have a much fuller life and you may find you don’t need the medication after all.

STEVEN BARTLETT: You came off the medication for your ADD.

GABOR MATE: Yes.

STEVEN BARTLETT: Because I’m just not that medically well-versed, what’s the difference between ADD and ADHD?

GABOR MATE: It’s kind of a confusion. ADHD simply means that the hyperactivity is present. So you can have ADD with or without hyperactivity. So the actual proper way to write it is AD and in brackets HD indicating that the hyperactivity may or may not be there.

STEVEN BARTLETT: Got you. So you were on medication. You did the work. You’re now not on medication. Do you still have the symptoms of ADD?

GABOR MATE: To a certain degree but not in a way that anyway blights my life. Like one thing I can pretty be sure that when I go on a speaking trip, I’m going to lose something. I’m going to lose my portable electrical tooth cleaner. In this case, I left my rain jacket in Budapest when I came here. You can take it for granted that my attention will just not notice something that I haven’t packed yet. That’s okay. I’m going back to Budapest next week so I get to get my rain jacket back. Sometimes it’s the cost of being me. So what? So no, not in every way but that’s not the point. Nobody’s life has to be perfect. It just has to be a life that I want to live and I can enjoy living. That I have. So who cares if sometimes I forget something or I lose something or even if I’m listening to a symphony and I can’t keep my attention on it. Okay, so I can’t.

STEVEN BARTLETT: You talk about this toxic society. Do you think society is getting more toxic and if so, why?

GABOR MATE: What measure shall we use? If you use the measure of the number of kids being medicated, the number of adults having chronic illness or immune disease, the number of students, university students being depressed, contemplating suicide, the number of children in the United States killing themselves, the number of people on medications of all kinds, the degree of safety that people have in society, the rancor or peace that characterizes political discourse in this world, the intolerable fact that eight people in the world, I think, own as much as the bottom half, as the bottom 3.5 billion.

If I look at all those things, by those measures, if we look at what’s happening to the environment, if I look at the fact that the people who are the worst polluters in the environment also happen to be the most successful people by a certain measure of success, by any number of parameters, if I look at how racism still affects the lives of so many people, and not just affects it in an emotional sense but actually physiologically, then yeah, this is a toxic society and those measures are getting worse, they’re not getting better. And inequality is getting worse here in the UK and elsewhere. So yeah, I think it’s getting more toxic.

STEVEN BARTLETT: What’s the antidote?

GABOR MATE: What’s the antidote? Well, how about we go back to this word awareness. People just have to get that this is how it is. In the last chapter, I don’t lay out a political program. I don’t see that as my role to do that. I have my own political ideas and preferences, but I don’t want to impose them on the reader. But I do say, first of all, we have to lose our illusions that this normality is actually healthy or natural. We have to just get cognizant that what we consider to be normal is actually bad for us, number one.

Number two, just if we introduced the concept of trauma into healthcare, the average doctor, again, strange to say, doesn’t hear a single lecture in their medical training about the impact of trauma on physical or mental health, which is astonishing given that it was a British psychologist, Dr. Richard Bentall, who pointed out not that many years ago that the evidence linking what we call mental illness and childhood adversity is about as strong as the evidence linking smoking and lung cancer, and the average physician doesn’t hear a word about that. It’s astonishing.

Education, teachers, if they understood child development, brain development, the developmental factors that children need that I cite in this book, and if they understood how trauma affects kids’ capacity to learn, to pay attention, and to behave in functional ways, the Daily Telegraph here in London not that long ago was bemoaning the fact that kids aren’t caned anymore in schools. I mean, what they were moaning about is that we no longer traumatize kids quite as harshly as we used to. That’s all it does, caning.

So if teachers understood that the behaviors on the part of children are actually manifestations of emotional dynamics of frustration and needs not being met, and very often of trauma, that would change the educational system. If the legal system understood it, that most people facing the criminal justice system are actually traumatized people, they could actually be rehabilitated and healed if we understood that instead of just exposing them to harsh punishments. We actually treated them like human beings who may have done things that are unacceptable, but that came from traumas they couldn’t have helped, and that they can be helped back to healthy functioning, as we know from lots of experience.

Just that little trauma information would change society. So that’s what I can offer as a physician.

STEVEN BARTLETT: What about parents? What do they need to know?

GABOR MATE: Well, if parents actually understood, first of all, that the first three years are everything, that if they get the template right in the first three years, they can hardly set a foot wrong afterwards. But on the other hand, if we’re not present for our kids emotionally, if we don’t understand them, if we don’t see them, if we don’t attune to their emotional states, we’re going to hurt them. And if they understood what the needs of children are, and I mentioned some of them, for play, for experience of all emotions, for unconditional loving attachment, for the child being able to rest from having to work to make the relationship work, so the child doesn’t have to be good or nice or beautiful or successful. They just have to be. So we don’t impose conditions on our approval and acceptance on them.

If parents just understood that, and if they understood how important it is that they take care of their own emotional needs, so that the child doesn’t have to take responsibility, like perhaps you did, for the parents’ stresses. If parents understood all that, and if society actually understood how important parenting was, and it supported parents who needed the support to be there for their kids, it wouldn’t be financially costly. It would save us a lot of money. Not to mention we’d have a lot more happier kids who don’t need to be on medications. So, yeah.

STEVEN BARTLETT: And lastly, schools.

GABOR MATE: Schools? Well, again, like I said about educators. Well, here’s the thing. If you look at how does the human brain develop, I quote an article from the Harvard Center on the Developing Child that appeared in the Journal of Pediatrics, the official journal of the American Pediatric Academy, in 2012, February. The article said that the human brain develops through a complex process that begins before birth and continues into adulthood.

Okay? Now that means, A, we take care of the emotional needs of pregnant women, number one. Number two, if it continues into adulthood, then the job of the schools, if they understand it right, is not to teach kids what year the Battle of Austerlitz took place or the Battle of Waterloo or, you know.

STEVEN BARTLETT: Algebra.

GABOR MATE: Any of that stuff. The most important job of the schools is to promote healthy brain development. Because a child with healthy brain development will actually be naturally curious. They’ll want to know about history. They’ll be keen to absorb the skills of algebra. They’ll want to know how to use a computer and they’ll want to know how to write properly. A kid will want to do that spontaneously because mastery and learning, these are human hungers. They’re human needs.

So, in other words, the most important job of the schools is not to cram the kids full of information but to help them develop healthy brains. What does that require? Safety, above all. Lack of pressure. Healthy relationship with nurturing adults. And if the kids are not going to spend their time with the parents, which they can’t in this society, like they used to through human evolution, let them spend their time with adults who are emotionally nurturing and emotionally penetratingly attentive to the child’s needs.

Now you’re going to have schools that are going to teach kids something and where kids will want to learn. And it’s very simple. It doesn’t take more training and it doesn’t take more… Well, it takes some training for us but not more than what teachers are getting now. So, that’s what it would take in education.

STEVEN BARTLETT: I was thinking there about the importance of doing certain psychological tests on certain teachers because if they are also passing on a generational cycle of their own at a time when my brain is still being developed, they can have a huge impact positively or negatively on my life in the same way that my parents could.

GABOR MATE: Absolutely. It’s quite remarkable. Teachers don’t know how much power they have because of the vulnerability of the young brain. And well-meaning teachers will sometimes behave in ways that are really hurtful to kids just because they don’t get it, not because they don’t mean well. So, I’ve had many adults sit in my office with tears in their eyes about something a teacher said to them three decades before. Like, the class will continue when Johnny comes back to earth. This kind of sarcastic little dig can undermine a child’s dignity and sense of self so easily.

So, if teachers just understood how powerful they are and how important they are in helping to promote healthy brain development, I think their profession would take on a whole new meaning that would be much more satisfying than it is right now. It’s not the fault of individual teachers. We’re talking about a system that is toxic.

STEVEN BARTLETT: Gabor, we have a closing tradition on this podcast where the previous guest asks a question for the next guest. I don’t get to see it until I open the book, so there’s a question written here for you. Before I ask you this question, I did have a question of my own, which was, you know, you’re in your 70s now. What are you still working on in terms of your own traumas? Is there anything, even though you’re in a later stage of your own life, that you’re still struggling with as it relates to that puppet master pulling on the strings and that kind of analogy that we gave earlier?

GABOR MATE: Yeah. It’s a sense of peace when I’m not doing anything. Just being. The capacity just to be. That’s something I’m still looking for. Well, not looking for, like, I was looking for a lost puppy, but I’m still searching myself for it.

STEVEN BARTLETT: And where exactly does that come from in your own diagnosis?

GABOR MATE: How about if I tell you when I find out? I mean, I can give you a textbook answer, but it wouldn’t be authentic.

STEVEN BARTLETT: Okay. So you don’t know entirely.

GABOR MATE: I have some senses, I have some ideas. It really means being okay with my mind the way it is and not needing it to be any different. That’s what it would mean. Which means if I’m sitting there for five minutes, I don’t have to reach for the cell phone to occupy my mind. Now, in the midst of this busy book tour and all the speaking I do, I don’t do enough to take care of that quiet little voice inside myself. I don’t. I think it would take some attention.

STEVEN BARTLETT: I can’t either, though. I can’t sit for five minutes. I couldn’t sit for five seconds without grabbing my phone. It’s weird, I noticed the other day that I was going to the toilet and I had no intention of using my phone in the toilet, but I went to get my phone to go to the toilet.

GABOR MATE: But you can’t be alone with yourself.

STEVEN BARTLETT: Yeah, I can’t be alone with myself. Sitting for 30 seconds, my brain… Is that because they’ve built these algorithms to stimulate my dopamine or is it because there’s something in me? I guess it goes back to your point about addiction.

GABOR MATE: Well, it’s both. They certainly create algorithms to stimulate your brain and get you hooked on that dopamine hit. They call that neuromarketing. Neuromarketing, can you get that? They work on your brain to get you addicted. But it also comes from an earlier discomfort with the self that predates any cell phone use. It goes back to the earliest childhood where you couldn’t have been comfortable to be just with yourself because of the circumstances.

STEVEN BARTLETT: Interesting. Yeah, because I’ve got friends that don’t have the same addiction with their cell phones that I do. They can take it or leave it. They’ve put it outside their bedroom when they go to bed, charging in the kitchen. I’m like, I have to hold mine like my pillow.

GABOR MATE: Well, like your little safety pillow. And what’s the first thing you do when you wake up in the morning?

STEVEN BARTLETT: I grab it with one eye open and all that gunk in my eye. I’m like, can I just…

GABOR MATE: How does both you and I work on not doing that so much?

STEVEN BARTLETT: Okay, I’ll give you my number. You shouldn’t discuss via phone how we’re getting on with this. That’s just another reason to use my phone. But next time I speak to you in person, you can update me on how you’re getting on with that. I am working on it. I’m working on it.

I think I’ve got to become more cognizant of the cost of that addiction. I know one of the costs is meaningful connections and presence with… and the cost of interpersonal relationships. But maybe I haven’t had the cost impact me enough yet. Maybe.

The question left for you, but I don’t know the signature, so I’ll have to figure that out later, but is what’s your selfish dream?

GABOR MATE: You know what? I’m not sure how to sit with that question because I’m not trying to get out of it. I’m just looking at my own reaction to it. You know, at this point, I don’t have too many… What does it mean selfish, by the way? Let me ask you that. What does that mean? Something that is for me at the expense of others? I don’t think I have any dreams like that left. I might have. Not might have. I did have at some point. If I had a dream for myself in that sense of self-enhancing dreams, something that enhances my ego or something, well, if this book sold a billion copies, well, that would be a nice selfish dream, you know?

But I don’t know how else to answer that. I do have dreams, but they’re more about the state of the world that I’d like to see, the world I’d like to see future generations inherit.

STEVEN BARTLETT: Selfless dreams.

GABOR MATE: Yeah. Well, I don’t know if they’re selfless, because it certainly involves my own history and certainly would make me feel better, you know? So in that sense, it’s selfish, you might say. But they don’t have to do with personal… I have enough. You know, I’ve done enough and I have enough. So I don’t have anything lacking that I need to dream about.

STEVEN BARTLETT: All of our selfless dreams are also very much selfish in that regard as well.

GABOR MATE: Selfless in a different sense. I mean, any dreams I have for a better world certainly have the function of making me feel better, of maybe even the stuff that happened to me or the stuff that happened to you. It would mean a lot to me if they didn’t happen to any more children, you know?

So in the sense that it would mean a lot to me, you might say it’s selfish. But it’s not purely about me. It’s about something larger. I don’t want to paint myself as some kind of an altruistic saint. I’m just saying that would make me feel better. If I really knew that kids in Gaza didn’t have to face any more bombings, if kids in Israel didn’t have to face any more dangerous terrorist attacks, not that I see inequality there, but I’d like that for both of them. If kids in Ukraine didn’t have to live under the threat of missiles falling, if people in Russia didn’t have to live with the fear of perhaps a nuclear conflict or young men being conscripted into a war, if kids in Britain didn’t have to live in poverty, wouldn’t that make you feel better?

So to the extent that it makes us feel better, you might say it’s selfish, but is it?

STEVEN BARTLETT: Gabor, thank you.

GABOR MATE: Well, my pleasure. Thank you so much.

STEVEN BARTLETT: Thank you so much for writing such an important book. I think my only wish is that I discovered this book sooner, because I think so many of my… I think it would have liberated, that’s a good word, liberated me from a series of things that would have helped me to live a much better life and to understand myself. That’s the point of awareness that we talked about.

GABOR MATE: I know that your advanced stage is over, isn’t it?

STEVEN BARTLETT: Yeah, but I think we all want the answers even sooner, because we reflect on some of the consequences or the mistakes that we made. Not that I’m imprisoned by any of those, but it’s so wonderful that this book now exists. You’re a name that I started to be peppered with by my audience over and over again, specifically in the last 12 months. People, really, really young people, were messaging me and asking me to have a conversation with you about the topics we’ve talked about today, things like ADHD and their trauma and so much.

I sit here every day talking to a lot of people on this podcast, and I think my understanding of trauma has forever been redefined by both this conversation today, but also by your book. I’m so thankful to you, because I think that will help me speak on the topic with more accuracy and, therefore, hopefully help other people understand their own trauma in a more meaningful way. It’s just such an important book.

GABOR MATE: Well, thank you so much. Thank you so much for giving me the platform to talk about my work and just the opportunity to meet you. Thanks a lot.

STEVEN BARTLETT: And it’s written in such an accessible way, which is so important, because that means it can reach even more people. Thank you so much.

GABOR MATE: Okay, thank you.

For Further Reading:

The Power of Addiction and The Addiction to Power: Gabor Maté Transcript

Everything You Think You Know About Addiction is Wrong by Johann Hari (Full Transcript)

America’s Invisible Crisis: Nicholas Eberstadt (Transcript)

(Through The Bible) – Book of Proverbs: Zac Poonen (Transcript)

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