The Next Chapter·Q&A

Are we mislabeling our trauma? Why Dr. Gabor Maté believes we need to change the way we think about pain

The Canadian physician and author spoke to Shelagh Rogers about his nonfiction book The Myth of Normal and rethinking healing and pain management.

'Trauma is not what happens to is what happens inside you as a result of what happened to you'

The Myth of Normal is a book by Gabor Maté and Daniel Maté. (Knopf Canada, Ken Wilkinson)
Shelagh Rogers spoke with Dr. Gabor Maté about The Myth of Normal, in front of a live audience in Victoria in 2022.

"In the most health-obsessed society ever, all is not well." 

This is the first line of Dr. Gabor Maté's new book, The Myth of Normal. Spanning over 500 pages, Maté and his son Daniel Maté document the rise of chronic mental and physical illnesses as a response to trauma — and trauma as a product of our culture. 

In addition to The Myth of Normal, he has also written three bestselling nonfiction books that combine personal experiences with scientific research to explore the state of healthcare in Canada. 

Scattered Minds is a book about attention deficit disorder; In the Realm of Hungry Ghosts tackles addiction; and When the Body Says No is a book about the onset of chronic illnesses like Alzheimer's, breast cancer and multiple sclerosis.

LISTEN | Dr. Gabor Maté on The Realm of Hungry Ghosts: 

The Next Chapter replays Shelagh's interview with Dr. Gabor Maté about his book In the Realm of Hungry Ghosts to celebrate the books' 10th anniversary edition.

In 2018, he was appointed to the Order of Canada, in part, because Dr. Maté has spent his career challenging commonly held notions about health. The Myth of Normal is no exception. 

In front of a live audience in Victoria last month, he spoke to The Next Chapter's Shelagh Rogers about why we need to change the way we think about trauma and his book, The Myth of Normal

Trauma, defined

"Trauma is a Greek word for wound. Literally that's what it means. So when you understand that, then you realize...trauma is not what happens to you. Trauma is what happens inside you as a result of what happened to you. 

"Trauma is not the event that inflicted the wound. So, the trauma is not the sexual abuse, the trauma is not the war. Trauma is not the abandonment. The trauma is not the inability of your parents to see you for who you were. Trauma is the wound that you sustained as a result.

Trauma is not what happens to you. Trauma is what happens inside you as a result of what happens to you.

"So my wound wasn't that my mother gave me [away temporarily] to a stranger [when I was a child]. My wound was that I made that mean that I wasn't lovable and I wasn't wanted and I was being abandoned, which is a good thing. Because if the trauma was what happened to you, guess what? It' ll never unhappen.

"But if the trauma wound happens inside you, the wound that you're carrying? That can heal at any time."

LISTEN | Dr. Gabor Maté and Daniel Maté on how our toxic culture harms our health: 

Canadian physician Dr. Gabor Maté says our overall health is on the decline — and he blames the society we live in. He and his son Daniel Maté discuss trauma, the power of a good walk for our mental health, and their new book The Myth of Normal: Trauma, Illness and Healing in a Toxic Culture.

How we mislabel trauma

"It's strange: we use the word trauma because a bit promiscuously. People say, 'I went to a movie last night. I was traumatized.'

"No, you weren't. You were just upset. It's not the same thing.

"Or, 'We had a big fight at the family dinner last night and I was traumatized.' No, you weren't. You were just angry, you know?

"Trauma is when you are actually wounded and as a result, you're constricted and limited and constrained by what happened. On the other hand, where it matters, we don't use it at all.

Every traumatic event is stressful, but not every stressful event is traumatic.

"As I show in this book — and there's a vast literature, for example, linking childhood trauma and adult physical illness. As British psychologist Richard Bentall said, the link between childhood adversity and mental illness is as strongly proven as the link between cigarette smoking and lung cancer. But the average medical student at the University of British Columbia or any university in Canada never hears the word trauma.

In all their education, except in a very narrow sense —. maybe of PTSD  —. they never get a glimpse at the vast literature linking physical illness and trauma or mental illness and trauma or addictions and trauma.

"On the one hand, we might use the word a bit loosely. Where it really matters, it doesn't even exist."

What Dr. Gabor Maté would change about the school system 

"I'm going to tell you a big secret. It's such a big secret that on the one hand, it's printed in all those scientific journals, and on the other hand, no medical student ever hears about it.

"The most important influence on the biological development of the human brain is the quality of adult-child relationships, particularly in the early childhood years.

"If in our society, most kids are going to spend most of their time away from their parents in daycares, in kindergarten, preschools, and finally in schools, and if we understand that these are years of brain development, then the question the school will be asking themselves is not how to drive algebra into the kids' heads or how to teach them computer skills, but what conditions will promote the development of healthy brain circuits?

We'd have a totally different school system if we had a brain-based school system.​​​​​​

"The healthy brain has certain qualities: social connectivity, caring, seeking curiosity, play. All mammals play. Why? Play is one of the most important drivers of healthy brain development.

"What if the schools understood that the human brain needs warm, nurturing human interactions with trusting and trustworthy adults? That play is essential? That curiosity is a natural circuit in the human brain and it needs to be fostered rather than squashed?

"We'd have a totally different school system if we had a brain-based school system."

What earlier generations got wrong 

"We were raised in the 'cry it out' era. So if you were a baby and you were crying and you wanted your parents attention, you just let them cry it out and they'll learn not to cry.

"What's the impact? On the psychological level, this sends the message that their needs don't matter. They also learn that they're alone and that the world is untrustworthy.

When the child is crying, it's expressing a great need for connection. When the need is not met, the child is stressed and the brain is suffused with cortisol, which interferes with brain development.

"There's nothing more natural than for an infant to cry and want to be picked up. In fact, Indigenous people around the world don't let their babies cry. It's not that they're forbidden to cry; it's that they carry them everywhere they go. As soon as the child is in any distress, they pick them right up.

"When the child is crying, it's expressing a great need for connection. When the need is not met, the child is stressed and the brain is suffused with cortisol, which interferes with brain development.

"We were talking about trauma before. We tend to think of the big ticket things: sexual, physical, and emotional abuse, which happen a lot. But you can wound the child if you understand that trauma means a wound just by not picking them up when they're crying and they need your attention and you don't give it to them."

Dr. Gabor Maté's comments have been edited for length and clarity. 

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