Does Anyone Else Feel Like Everything Has Changed? (Unhappy, Lost, Addicted, Stressed) | Gabor Maté

Dr. Rangan Chatterjee 0:00 "I wish I'd let myself be happier."

Gabor Maté 0:02 Yeah.

Dr. Rangan Chatterjee 0:03 What does that say?

Gabor Maté 0:05 Well, that always reminds me of... Because I mentioned Dr. Panksepp and his concept of the brain circuits.

Dr. Rangan Chatterjee 0:11 Yeah.

Gabor Maté 0:12 One of them is for play and joyfulness, and, um, do you know Winnie-the-Pooh?

Dr. Rangan Chatterjee 0:21 Yeah.

Gabor Maté 0:22 Okay.

Dr. Rangan Chatterjee 0:22 Not personally.

Gabor Maté 0:23 No, no. [laughs] The book. Uh, and, uh, it's, it's always been one of my favorite books, and, uh, I've talked about this before. The end of that book would bring tears to my eyes for years, 'cause how it ends is Christopher Robin... By the way, that's a whole other thing. The relationship between A. A. Milne and his son Christopher-

Dr. Rangan Chatterjee 0:46 Mm

Gabor Maté 0:46 ... was a very fraught and difficult one.

Dr. Rangan Chatterjee 0:48 Right.

Gabor Maté 0:48 And, and Christopher actually resented the books, 'cause he felt that his father was buying these toys to write about rather than for his own benefit.

Dr. Rangan Chatterjee 0:57 Wow.

Gabor Maté 0:58 Well, they had a very diff- There's a photograph of the two of them, and the kid is looking so alienated. He had a tough life.

Dr. Rangan Chatterjee 1:03 Mm.

Gabor Maté 1:04 And... But that's a whole other story. But the book, in the, in the book, Christopher Robin, the little boy, now has to go to school.

Dr. Rangan Chatterjee 1:11 Yeah.

Gabor Maté 1:11 And he has to learn about history, and factors, and mathematics, and so on, and he's telling his friends, the toy animals, that he won't be able to play with them so much anymore. And in the end, Christopher and Winnie, the bear of little brain, uh, who's the smartest of the whole lot, and they walk off together, and the, the book ends with the statement, something like, "And whatever they do or wherever they go in the Enchanted Forest, the little boy and his bear will always be playing together." And that phrase would bring tears to my eyes for years. Because play is so important, and joy is so important, and that's what these people are talking about, and they didn't allow themselves to experience it. They sacrificed the play and the joy for all these other things. You know, and so, um, the good thing is, you know, um, I mean, my marriage, the best thing... And you know what the best thing in my marriage is? The way we play together.

Dr. Rangan Chatterjee 2:17 Mm-hmm.

Gabor Maté 2:17 The first time I dated my wife, Ray, I knocked on the parents' door and I said, "Can Ray come out and play?" [laughs]

Dr. Rangan Chatterjee 2:24 [laughs]

Gabor Maté 2:25 And we've been doing it ever since. And so, um, I believe what's being described in that last regret is people sacrifice their playfulness-

Dr. Rangan Chatterjee 2:36 Yeah

Gabor Maté 2:37 ... their joyfulness for the sake of being accepted, and being successful, and all that. It's a huge one. But play is built into our brains. Kids play spontaneously. Infants play.

Dr. Rangan Chatterjee 2:50 Mm-hmm.

Gabor Maté 2:51 And, um, in that sense, w- we can all be Winnie-the-Pooh and, and Christopher. We, we can always keep playing in the Enchanted Forest, and that's just essential, I think.

Dr. Rangan Chatterjee 3:06 In that final regret is the word happier.

Gabor Maté 3:09 Yeah.

Dr. Rangan Chatterjee 3:10 What does happiness mean to you?

Gabor Maté 3:13 Um, really it means the capacity to play and to be in the present moment. And, and, and, and, and, you know, the kids when they... When kids play, they don't worry about the, the, the, the... Appropriately, they don't worry about the war or wherever, or the, or climate change. They're just playing in the moment. They're fully present-

Dr. Rangan Chatterjee 3:32 Mm

Gabor Maté 3:32 ... to themselves in imaginative, almost hypnotically imaginative states. So happiness just means being in the present and being allowed to be, uh, no matter what, to have the capacity to play.

Dr. Rangan Chatterjee 3:45 A lot of people today, Gabor, and I, I think you have struggled with this as well-

Gabor Maté 3:49 Yeah

Dr. Rangan Chatterjee 3:49 ... from what I know, feel with so much heartache and suffering in the world-

Gabor Maté 3:55 Yeah

Dr. Rangan Chatterjee 3:56 ... they feel that they have no right to be happy. What's your take on that?

Gabor Maté 4:01 Well, um, first of all, Bob Dylan said somewhere that it's difficult to be completely happy when other people are suffering, and it's true. So whether... This, this is a time of terrible suffering. You know how I feel about Gaza and the terrible things that are happening there. How can I be completely happy? I can't be completely happy. I can't, 'cause I can't not think about that, the horror of it. Um, but at the same time, and this is where I... People might start get weirded out, but I'm talking about a psychedelic experience. This is three or four years ago. I did, uh... I've worked with psychedelics both as a healer, but also as a subject, and I was having a mushroom experience, and the same thing would happen with ayahuasca once. And I've always been one that felt that, how could I be happy when Auschwitz is possible? When Auschwitz happened? When my grandparents perished there? How can I be happy? What right do I have to be happy if that can happen in the world? And that did happen in the world. And both the plants showed me at some point that happened, and yes, you can be happy.

Dr. Rangan Chatterjee 5:26 Mm-hmm.

Gabor Maté 5:26 That the one doesn't detract from the other.

Dr. Rangan Chatterjee 5:29 Yeah.

Gabor Maté 5:29 That, that the capacity to be empathetic, and to recognize the grief, and to hold the grief does not obviate the capacity to be happy. And one doesn't... One does not... One is not disloyal to the suffering in the world by allowing myself to be happy.

Dr. Rangan Chatterjee 5:48 Yeah.

Gabor Maté 5:48 So there's no necessary contradiction.

Dr. Rangan Chatterjee 5:50 Yeah.

Gabor Maté 5:50 And I've, I've seen people on death row who, if they win their appeal, the best thing they can hope for is life in jail without... Life in prison without parole, but they're happy. And how do they become happy? Meditation, working through their traumas, having remorse for what they did, connecting with other people, and just connecting with the present moment.

Dr. Rangan Chatterjee 6:23 Mm.

Gabor Maté 6:23 And I'm thinking, my God, if people in that situation can be genuinely happy, which I've seen, I've, I've had contact-

Dr. Rangan Chatterjee 6:31 Yeah

Gabor Maté 6:31 ... with the people, then who am I to say that I can't be happy?

Dr. Rangan Chatterjee 6:35 Yeah.

Gabor Maté 6:35 So the, so there's, ultimately there's no contradiction.

Dr. Rangan Chatterjee 6:38 Yeah.

Gabor Maté 6:38 Now, in this society, there's way too much emphasis on, you know, don't worry, be happy, let's ignore all the bad stuff that's going on, let's just concentrate on how we can make ourselves pleased or, or, or pleasured or whatever. I'm not talking about that.

Dr. Rangan Chatterjee 6:52 No.

Gabor Maté 6:52 I'm talking about being able to hold both at the same time.

Dr. Rangan Chatterjee 6:55 Yeah, you have to. And, uh, this is something I feel I've really grown into over the last years, that I actually can be very happy and content-

Gabor Maté 7:02 Yeah

Dr. Rangan Chatterjee 7:04 ... whilst there is heartache in the world.

Gabor Maté 7:06 Yeah.

Dr. Rangan Chatterjee 7:06 It doesn't mean I don't care. I actually deeply care.

Gabor Maté 7:10 Yeah.

Dr. Rangan Chatterjee 7:11 But I've realized that it's a real skill, it's an evolution of the self to be able to hold those two.

Gabor Maté 7:17 Yeah.

Dr. Rangan Chatterjee 7:17 I, I really do think that. I think-

Gabor Maté 7:19 Yeah

Dr. Rangan Chatterjee 7:19 ... it's growth.

Gabor Maté 7:20 That's right.

Dr. Rangan Chatterjee 7:21 I very much love the phrase, uh, that's attributed to Gandhi, "Be the change you want to see in the world."

Gabor Maté 7:29 Yeah.

Dr. Rangan Chatterjee 7:31 I, I li- I try my best to live my life by that. And why that's relevant to this part of the conversation is, I said this once at a live event, I said, "Listen, if you watch the news and you allo- ... This is a few years ago. Allow the heartache that's going on in, name the country, right?

Gabor Maté 7:47 Yeah.

Dr. Rangan Chatterjee 7:48 To affect you so much so that you develop apathy, you can't interact with your husband, with your children.

Gabor Maté 7:56 Yeah.

Dr. Rangan Chatterjee 7:56 You, you, you just drink more and more alcohol in the evening to numb your pain.

Gabor Maté 8:00 Yeah.

Dr. Rangan Chatterjee 8:01 What does that do?

Gabor Maté 8:02 Yeah.

Dr. Rangan Chatterjee 8:03 Right? You're no good to the people-

Gabor Maté 8:05 Yeah

Dr. Rangan Chatterjee 8:05 ... uh, who are suffering.

Gabor Maté 8:06 Yeah.

Dr. Rangan Chatterjee 8:06 You're no good to those people around you, and that then ripples to everyone around you. Whereas if you can learn to be content where you're at-

Gabor Maté 8:16 Yeah

Dr. Rangan Chatterjee 8:16 ... if you then do wanna go and help-

Gabor Maté 8:18 Yeah

Dr. Rangan Chatterjee 8:18 ... in whatever way, you're much more able to, you know, volunteer, send money, whatever it might be.

Gabor Maté 8:23 Yeah.

Dr. Rangan Chatterjee 8:24 So I, I think this is, I think this is a really important point for people, especially the way things are in the world at the moment.

Gabor Maté 8:30 Yeah.

Dr. Rangan Chatterjee 8:30 A lot of people feel, "I've got no right to be happy."

Gabor Maté 8:33 Yeah. Well, I, I no longer believe... I used to believe that, and somebody once said to be- said to me, "Don't be so loyal to your suffering." And, um, that's a lesson I've had to learn fairly late in life.

Dr. Rangan Chatterjee 8:45 Yeah.

Gabor Maté 8:46 Um, and as I quote in The Myth of Normal, my friend Bessel van der Kolk, the trauma, uh, psychiatrist, looked at me once, this is what, 10, 12 years ago, we were having lunch, and he said, "Gabor, you don't have to drag Auschwitz around everywhere you go." And what he meant by, uh, that is that you don't have to let that affect your present moment. That you can be aware of it, hold a memory of it, but not let it determine your internal states. You know? And, and it's true. And I, I understood intellectually at that time what he meant, but it was only later that I was actually-

Dr. Rangan Chatterjee 9:23 Yeah

Gabor Maté 9:23 ... able to emotionally let go.

Dr. Rangan Chatterjee 9:26 Let's just talk about forgiveness then, because-

Gabor Maté 9:29 Yeah

Dr. Rangan Chatterjee 9:29 ... a lot of the time people say, you know, "I just can't forgive."

Gabor Maté 9:34 Yeah.

Dr. Rangan Chatterjee 9:34 "What, what happened to me was wrong."

Gabor Maté 9:36 Yeah.

Dr. Rangan Chatterjee 9:37 Now, I accept what happened to someone could, can be wrong-

Gabor Maté 9:41 Yeah

Dr. Rangan Chatterjee 9:41 ... but it doesn't necessarily follow that you can't forgive.

Gabor Maté 9:46 Yeah.

Dr. Rangan Chatterjee 9:47 What's your take on forgiveness?

Gabor Maté 9:48 Well, you and I last night were talking about a, a w- woman that we both met and, uh, admire tremendously, Edith Eger.

Dr. Rangan Chatterjee 9:55 Yeah.

Gabor Maté 9:55 And Edith, as I told you, was, uh, 16 years old when I was 1 year old. She lived in a town in what is now southern Slovakia, then was northern Hungary, called Kashar or Košice, and her family were taken to Auschwitz.

Dr. Rangan Chatterjee 10:12 Mm-hmm.

Gabor Maté 10:13 And, um, my grandparents would've been either on the same shipment to Auschwitz or within the next day or so. And her parents perished, and she survived with her sister. And she's become a psychotherapist. She's written a couple of wonderful books.

Dr. Rangan Chatterjee 10:31 Yeah.

Gabor Maté 10:31 That I know you've met her and interviewed her. And in one of her books, she describes going to the Berghof in Bavarian Alps, where Hitler used to have his lair, and he went there, she went there to forgive Hitler. And, um, it doesn't mean that it was okay what he did. She did that to liberate herself. She didn't... She said, "I don't wanna keep him in this prison in my heart for the rest of my life. I've worked too hard to attain happiness and joy to let this tension and this constriction control me." So the forgiveness wasn't making okay or, or pardoning Hitler for his, for all the evil that he perpetrated in the world, but it's of her letting go of the emotions around it and of the tension-

Dr. Rangan Chatterjee 11:23 Mm

Gabor Maté 11:23 ... and the tightness around it. So forgiveness is not for the other person. It's for yourself. Now, when I work with forgiveness, I don't advise people to forgive. I- i- i- in fa- as a matter of fact, I do the opposite. I say to people, "Before you forgive, allow yourself to feel the full anger that's in you. Let y- let yourself fully experience the anger that's there. 'Cause once you do, it'll dissipate."

Dr. Rangan Chatterjee 11:58 Mm.

Gabor Maté 11:58 "You'll let go of it. So don't do it in order to forgive. Do it in order to liberate yourself." Now, let's say I was abused as a child. But what, let's say I find myself a fully liberated, present-oriented, in contact with myself human being, then what does that mean? It means nothing was taken away from me. It means that whatever happened caused me a lot of pain over the years, but it didn't limit my capacity. I wasn't robbed of anything. So what's there to forgive?

Dr. Rangan Chatterjee 12:36 Mm.

Gabor Maté 12:37 So, uh-

Dr. Rangan Chatterjee 12:38 Yeah

Gabor Maté 12:38 ... and, and, and you can also ask yourself or anybody, when you haven't forgiven, what's in your heart? What's in your body? Do you like that state that you're in? Uh, the tension, do you like that? Is that how you wanna be? Do you think that's really helping you? So I don't go out of my way to teach... Now, I know that in a lot of spiritual practices, there are f- forgiveness practices, and I know in Buddhist practice and a lot of spiritual practices, there are forgiveness meditations and prayers.

Dr. Rangan Chatterjee 13:10 Yeah.

Gabor Maté 13:10 My mind doesn't go there, but my mind does say, oh, yes, oh, you also have to experience all the rage, all the hatred, all the anger that's in you, and be with it and see what happens to it.

Dr. Rangan Chatterjee 13:22 Yeah.

Gabor Maté 13:23 And what happens to it, once you pay attention to it, it actually dissipates. And so when E- Edith goes to the Berghof to for- forgive Hitler, she's just saying, "I don't wanna hold onto this stuff anymore."

Dr. Rangan Chatterjee 13:38 Yeah.

Gabor Maté 13:38 "It's not okay what you did, but I don't wanna hold onto this stuff anymore."

Dr. Rangan Chatterjee 13:42 Yeah.

Gabor Maté 13:43 Yeah.

Dr. Rangan Chatterjee 13:43 It's, it's fascinating. I think curiosity is, is often a very helpful pathway to forgiveness.

Gabor Maté 13:52 Mm.

Dr. Rangan Chatterjee 13:52 'Cause if you get curious about that other person as to why did they act that way-

Gabor Maté 13:58 Mm-hmm

Dr. Rangan Chatterjee 13:58 ... you know, I'm not talking about Hitler here, I'm talking about-

Gabor Maté 14:01 Yeah

Dr. Rangan Chatterjee 14:01 ... anyone.

Gabor Maté 14:01 But even with Hitler.

Dr. Rangan Chatterjee 14:03 Yeah. What, what were the conditions-

Gabor Maté 14:05 Yeah

Dr. Rangan Chatterjee 14:05 ... in that person's life that led to that?

Gabor Maté 14:08 Yeah.

Dr. Rangan Chatterjee 14:08 If I was that person, I'd be behaving in exactly the same way-

Gabor Maté 14:12 Yeah

Dr. Rangan Chatterjee 14:12 ... because I would've had their parents and their childhood experiences and their-

Gabor Maté 14:15 Fair

Dr. Rangan Chatterjee 14:15 ... bullying, et cetera, et cetera.

Gabor Maté 14:17 Exactly.

Dr. Rangan Chatterjee 14:18 Once you look at the world through that lens, your initial approach becomes compassion. Forgiveness comes as a side effect of getting curious.

Gabor Maté 14:31 That's totally right. And there's an expression that you may be familiar with, it goes, "To understand is to forgive."

Dr. Rangan Chatterjee 14:38 Yeah.

Gabor Maté 14:38 And, uh, it begins with curiosity.

Dr. Rangan Chatterjee 14:40 Yeah.

Gabor Maté 14:41 So I, and I think that, that curiosity is the essential quality-

Dr. Rangan Chatterjee 14:46 Yeah

Gabor Maté 14:46 ... that actually leads to compassion in the end. Now, compassion doesn't mean tolerance of bad behavior.

Dr. Rangan Chatterjee 14:52 No.

Gabor Maté 14:52 It doesn't mean validating or justifying crimes against, um, nature or crimes against other human beings. But it takes away that quality of tension where you make yourself superior to reality, and you ma- and you put yourself in a position to judge reality.

Dr. Rangan Chatterjee 15:09 Mm-hmm.

Gabor Maté 15:09 You know, and I'm above it, and I'm in a position to judge.

Dr. Rangan Chatterjee 15:12 Yeah.

Gabor Maté 15:12 That's not a comfortable... I mean, actually, it is comfortable for a lot of people to be there, but it's a way of not dealing with their own stuff.

Dr. Rangan Chatterjee 15:19 Yeah.

Gabor Maté 15:19 So I do think that curiosity is the key.

Dr. Rangan Chatterjee 15:23 Just to wrap this conversation up, Gabor, we've been talking a lot about these regrets-

Gabor Maté 15:27 Yeah

Dr. Rangan Chatterjee 15:27 ... the regrets of the dying.

Gabor Maté 15:29 Yeah.

Dr. Rangan Chatterjee 15:30 And the final question I wanna put to you is about the word regret.

Gabor Maté 15:38 Mm.

Dr. Rangan Chatterjee 15:40 I have been playing with the idea over the last 12 months or so that regret is actually a form of perfectionism.

Gabor Maté 15:47 Mm-hmm.

Dr. Rangan Chatterjee 15:49 So I actually now very much subscribe to the philosophy of no regrets, but not in the, not in the kind of derogatory way.

Gabor Maté 15:55 Yeah.

Dr. Rangan Chatterjee 15:55 You know, I'm gonna live my life my way.

Gabor Maté 15:57 Yeah.

Dr. Rangan Chatterjee 15:57 It doesn't matter who comes to my way.

Gabor Maté 15:58 Yeah, yeah.

Dr. Rangan Chatterjee 15:59 No, with this really compassionate understanding that I've always done the best that I can-

Gabor Maté 16:03 Yeah

Dr. Rangan Chatterjee 16:04 ... based upon where I was in life-

Gabor Maté 16:06 Yeah

Dr. Rangan Chatterjee 16:06 ... at that time.

Gabor Maté 16:08 Yeah.

Dr. Rangan Chatterjee 16:08 So even the things that I look back on and go, "Actually, you know what? If I was in that situation again today, I would act differently," I don't see them as regrets. I see them as situations that happened that have taught me something, which is allowing me to be a better version of myself today.

Gabor Maté 16:27 Exactly.

Dr. Rangan Chatterjee 16:27 So in my life today, there's, there is no room for regret anymore.

Gabor Maté 16:32 Mm-hmm. Mm-hmm.

Dr. Rangan Chatterjee 16:33 And I guess I would love to know, you know, right at the end here, what's your perspective on the word regret?

Gabor Maté 16:39 Um, I think, um, chronic regret is debilitating.

Dr. Rangan Chatterjee 16:44 Mm.

Gabor Maté 16:44 Um, it's a lack of self-forgiveness. It's, um, also kind of egotism of that, that, that, that, that somehow I'm that important. Um, it's quite something to recogni- I do recognize that some of the way I parented my kids, the way I showed up, I've often talked about this on your program too, wasn't the best for them, but it was the best I could do at the time. So it's not the que- ju- question of justifying anything, but it's also not dwelling on the past.

Dr. Rangan Chatterjee 17:14 Mm-hmm.

Gabor Maté 17:15 Regret is to dwell on the past, and what's the point? It's quite something to recognize that I did things that, had I known differently, I would not have done the same way. That's just learning. Um, em- regret is an emotional state of, that values the past more than the present, and it, uh, accuses yourself of doing things for which you had no consciousness to do otherwise.

Dr. Rangan Chatterjee 17:51 Yeah.

Gabor Maté 17:51 So that's where I stand with regret.

Dr. Rangan Chatterjee 17:53 Yeah. Gabor, you know what a big fan I am of your work.

Gabor Maté 17:57 Ah.

Dr. Rangan Chatterjee 17:57 Um, it's just incredible to see the impact you're having on so many people around the world.

Gabor Maté 18:03 Mm.

Dr. Rangan Chatterjee 18:03 I'm very lucky to consider you a friend these days.

Gabor Maté 18:05 Likewise.

Dr. Rangan Chatterjee 18:06 It's been great to get to know you over the last few years. Um, for someone who has heard us speak today- And something connected with them.

Gabor Maté 18:17 Mm.

Dr. Rangan Chatterjee 18:17 Something you said spoke to them, and they thought, "Wow, yeah. You know what? I'm carrying around old stuff with me today. I don't express my emotions."

Gabor Maté 18:27 Mm.

Dr. Rangan Chatterjee 18:27 "I'm not living a life that is true to me."

Gabor Maté 18:30 Yeah, yeah.

Dr. Rangan Chatterjee 18:32 What are some of your final words for them?

Gabor Maté 18:34 Well, it's the word that you used, curiosity. So not why am I living this way, but, hmm, why am I living this way? You know, what happened to me? What am I carrying here? So, uh, the key phrase is precisely the one that you introduced, uh, uh, the necessity to be curious-

Dr. Rangan Chatterjee 18:55 Yeah

Gabor Maté 18:55 ... um, in a compassionate way. So you don't do an interrogation of yourself like you're a, um, prosecuting detective. Why did you, or why did you not?

Dr. Rangan Chatterjee 19:05 Mm-hmm.

Gabor Maté 19:07 But compassionately. Why did you not?

Dr. Rangan Chatterjee 19:09 Yeah.

Gabor Maté 19:10 Why did you? And if you ask these questions compassionately, um, and with curiosity, the answers will emerge, as will the capacity for you make yourself f- for you to make different choices as you move forward. So where there wasn't choice before 'cause you were compelled or, or, or driven, now you can have some freedom if you're willing to be curious.

Dr. Rangan Chatterjee 19:35 All behaviors of addiction, substance dependent or not, whether gambling, sex, the internet or cocaine, all of them either soothe pain directly or distracts from it. Hence your mantra, "The first question is not why the addiction, but why the pain?" Uh, and I think that beautifully sums it up.

Gabor Maté 19:55 Mm.

Dr. Rangan Chatterjee 19:56 Um, you know, in, in, in that you, you're liking... You're likening addiction to drugs, potentially to, you know, sex, gambling, alcohol, maybe shopping. Um-

Gabor Maté 20:10 Well, so I've had my own shopping addiction, and I can tell you that the... What happens in my brain when I'm indulging in my shopping addiction is exactly the same that happens in the brain of the cocaine addict.

Dr. Rangan Chatterjee 20:21 Yeah.

Gabor Maté 20:21 In other words, there's an excitation of the reward incentive and motivation circuitry, and what the addict is after is that temporary change in brain status. Really what it is, all addictions are an attempt to regulate an unbearable emotional state internally, but you're trying to regulate your internal state through external means, and that's what an addiction is. So temporarily you get a change in the state of your brain and a change of your physiology. You can do that through drugs. You can also do it through gambling or internet or sex or shopping. But essentially you're after that same revitalization of your i- incentive and motivation circuitry of your brain. And so from my perspective, there's only one universal addiction process that dominates all addicted people. The targets of addiction may be different. The internal effects are much the same.

Dr. Rangan Chatterjee 21:15 Yeah.

Gabor Maté 21:17 And, and I'm sorry, I should add, when you look at the c- the, the, the sources of it, the states that people are trying to escape are states of emotional distress, states of emotional pain, and hence why the addiction. Not why the addiction, but why the pain.

Dr. Rangan Chatterjee 21:32 So some people who are listening to this or, or watching this right now might be thinking, "Yeah, I get that. That, that all sounds fine, um, for those people who are addicted, but I of course am not addicted to anything." So you've g- you've got a rather beautiful definition, I think, of addiction, which I think will be really helpful to sort of-

Gabor Maté 21:49 Mm

Dr. Rangan Chatterjee 21:49 ... go through at the start here so that people listening can actually figure out if it does relate to them or not.

Gabor Maté 21:56 Well, when I speak to a room of people, and I ask them, "How many are addicted?" Most people will only think of drugs, so some people put their hand up. Then I give them my broader definition of addiction, and now everybody puts their hand up. And that definition is that an addiction is manifested in any behavior that a person finds temporary pleasure or relief in and therefore craves but suffers negative consequences in the long term and isn't able to give it up. So any behavior, not just drugs. The key hallmarks are craving pleasure or relief in the short term, negative outcomes in the long term, inability to d- to give it up. That's what an addiction is, and that could be to drugs, uh, nicotine, caffeine, alcohol, the legal... the lethal and legal substances, or it could be to heroin, cocaine, crystal meth, fentanyl, cannabis, any number of other substances. But it could also be to sex, to gambling, to shopping, to eating, to work, to exercise, to the internet, to gaming, to pornography, to political power, to the acquisition of wealth, to the hoarding of objects. Anything. And by... And when you give that definition, and you ask people, "How many here would acknowledge some addiction in their life?" sometimes the vast majority of people would put their hands up. Which means to say that addictions are on a continuum, it's on a spectrum, and they're distributed, dispersed throughout all of our society, and so that the identified drug addicts make up only a small, narrow segment of our addicted population.

Dr. Rangan Chatterjee 23:35 So really the whole way we, we think about addiction, the way we criminalize various forms of addiction really needs to change to a much more, a more compassionate way of dealing with it, but also really trying to understand what's the root cause. 'Cause if... You know, I s- totally subscribe to your theories, and I, I, I... and I think that ultimately if the root cause of all addiction or all addictive behavior is the same, how do we tackle that? And where does that come from? What is that root cause?

Gabor Maté 24:05 So once you're asking not why the addiction but why the pain, now you have to forget that it's a choice 'cause nobody chooses to be in pain, and you also have to forget the medical idea that it's an inherited brain disease. You actually have to look at people's lives. Now, in Vancouver's downtown east side in Canada where I worked for 12 years with a highly addicted population, these people had, uh, multiple addictions: cocaine, alcohol, cannabis, uh, opiates of all kinds, cigarettes in every case. They suffered with HIV, with Hepatitis C. They would die of overdoses, suicide, um, infections of all kinds. And these people, every single one of them had been heavily traumatized in childhood. All the women I worked with over 12 years had been sexually abused. All the men had been neglected or beaten or emotionally abused. I'm talking about now the severely addicted population. Which is also what the large scale study shows, that the, the greater the childhood adversity, the greater risk for addiction in adulthood. Now, the more severe the childhood adversity, the greater the risk of substance addiction and injection use. However, if you look at my own case, um, I wasn't beaten. I wasn't abused in my family of origin. Um, I wasn't neglected, but I was a Jewish infant boy during the war in Hungary, um, and spent my first year under the Nazi re- Nazi regime, you can imagine under what circumstances. So I had a very unhappy, stressed, terrorized mother. And children can be hurt in two ways. Children can get, children can be hurt when bad things happen to them that shouldn't happen. That's the abuse, that's the violence in the family, that's the parental addiction. But children can also be hurt when their needs are not met. Now, I had this need for an attuned, empathetic, emotionally responsive mother. She couldn't be that. Not because she didn't love me, not because she didn't do her best, but simply she was too terrorized. She was too depressed. The lack of that joyful, attuned, loving mother who ... I, I shouldn't say loving because she loved me tremendously, but her love couldn't be translated into responsive behavior. That alone was enough to hurt me. So in other words, the source of addiction is always some kind of a childhood hurt, either because bad things happened that shouldn't have or because the good things that should have happened couldn't happen 'cause of the parents' emotional states. Both of these are enough to hurt the child, uh, in a way to driving them to self-soothe through addictions.

Dr. Rangan Chatterjee 26:55 So, so do you think your own experience of trauma really-

Gabor Maté 27:00 Yeah

Dr. Rangan Chatterjee 27:00 ... uh, uh, as a, as a young baby-

Gabor Maté 27:02 Yeah

Dr. Rangan Chatterjee 27:02 ... not even a child, as a young baby-

Gabor Maté 27:04 Yeah

Dr. Rangan Chatterjee 27:04 ... has impacted your own health, your own behaviors, and therefore ultimately where you are today, which is one of the world's leading voices on trauma and addiction. Do you think that has been instrumental in you getting to where you are today?

Gabor Maté 27:19 Having to deal with the impacts of that has been instrumental. I mean, I really, uh, as an adult, uh, I was a successful physician. You know, I was much in demand, uh, family practitioner. I was head of a palliative care department at a major hospital. I was a national medical columnist for a Canadian newspaper in my 50s, and internally I was driven, workaholic, depressed, uh, affected by ADHD, um, anxious, and unfulfilled and unsatisfied. And it's when looking at those dynamics and wondering, "Well, what the heck has happened to me here, and w- what is the gap between my external persona and my internal experience of myself?" That's when I began to deal with trauma. Not to mention as a family physician, and you and I were talking about this before, we get to see patients before they get sick. The specialists only see them after the illness has been diagnosed. I get to see people before they get ill. I get to see people in their context of their multi-generational family background. So I, we have a much broader view of who gets sick and why. And so both through my medical work and having to deal with my own stuff, I began to realize the central role of trauma in shaping people health or illness.

Dr. Rangan Chatterjee 28:35 Yeah, since I've, since I've been studying trauma myself, um, both with the work that you do, but just other things that I'm reading around it, it really helps me understand my patients.

Gabor Maté 28:46 Mm-hmm.

Dr. Rangan Chatterjee 28:47 And their behavior is much better. I really start to ... You can start to tap in now as to what they're coming in with more. You think, "Oh, that's ... What's going on behind that?" Not the symptom they're describing, but, but why are they making those choices? And something you may not know, Gabor, I, I, a few years ago I did, um, a series of documentaries on BBC One called Doctor in the House. And what I would do on that is I went to live alongside families who had health problems.

Gabor Maté 29:14 Mm.

Dr. Rangan Chatterjee 29:14 They were already under GPs. They were already under specialists. They were all taking medication pretty much already, and they still weren't getting better, and they were still struggling. So I went in to ... Sometimes I'd stay the night in their houses. I'd live-

Gabor Maté 29:27 Mm

Dr. Rangan Chatterjee 29:27 ... alongside them, really get to understand, you know, what choices they were making with their lifestyle, sure. But also I'd get to see, you know, various dynamics in the family, the sort of thing that would never come up in the consultation room. Even if you asked that question, they would never even think to bring those things up. But you would just start to spot things and, and little dynamics. And I found that with every single family pretty much now, if I f- if I reflect back on all those families I stayed alongside, I was very fortunate to get really good health outcomes with them all after about six weeks.

Gabor Maté 30:00 Mm.

Dr. Rangan Chatterjee 30:01 Sorry to interrupt. If you're enjoying this video and want to learn more, you can download my free special guide containing six simple breathing practices that will help you calm your mind, lower stress, and improve your energy. To get ahold of this guide, all you have to do is click on the link in the description box below. But- There was a huge emotional component behind a lot of the illness.

Gabor Maté 30:27 Yeah.

Dr. Rangan Chatterjee 30:28 Um, now, just to be clear, I'm not saying that it was in their head at all. They had proper physical symptoms that were, that they were struggling with. And obviously that in some ways can make people feel down a little bit about themselves because they're not feeling so good. But I really got the strong sense that when you start to look at their lives and their upbringing and how they saw themselves, it, it was just... It was uncanny how many times their emotional health was absolutely tied into their physical health.

Gabor Maté 30:57 Well, so one of the books I've written, which will be published and written in a few months, is entitled When the Body Says No: The Cost of Hidden Stress. And I'm making the case precisely as I heard you articulate just now, is that when it comes to chronic illness, and whether it's colitis or Crohn's disease, multiple sclerosis, ALS, or motor neuron disease in, in England, uh, malignancy, um, chronic psoriasis, eczema, chronic fatigue syndrome, the physiological symptoms, which are not in people's heads in the sense that they're imagining them, but it very much originates in people's heads in that it has a lot to do with certain relational and emotional patterns that they adopted in childhood. In other words, what I'm saying is that because of childhood programming, people impose certain unconscious stresses on themselves, and those stresses, because of the unity of mind and body, which unfortunately is not taught or recognized in the medical schools, but which scientifically is not even vaguely controversial. Because the immune system and the emotional apparatus and the hormonal apparatus and the nervous system are part and parcel of the same system. So when something occurs emotionally, which it does on a chronic basis, that has an impact of undermining people's physiology, turning their immune system against themselves or suppressing the immune system. So I absolutely agree that people's emotional patterns, which reflect not individual choices or mistakes, but multi-generational patterns in the family, those emotional patterns translate into physical illness. And, and, and, and, and if we can address those emotional dynamics, we can actually have an impact on the physiological course of their illness, which is again, not something that anybody in medical school will ever tell you because there's this unfortunate separation of mind and body that you and I are trained in.

Dr. Rangan Chatterjee 32:46 Yeah, absolutely. And I think the key, one of the key things there for me was that you're s- you're not putting blame on people.

Gabor Maté 32:51 There's no blame.

Dr. Rangan Chatterjee 32:52 Yeah. And I think that's really, really a key point to, that maybe we can discuss now, because a lot of people may be hearing that feeling, you know, "Maybe I've done this to myself," or, "My mother did this to me," for example. Uh, and that's not what you're saying at all, is it?

Gabor Maté 33:08 Well, um, th- this is an interesting conversation. I make the distinction between blame and responsibility.

Dr. Rangan Chatterjee 33:17 Okay.

Gabor Maté 33:17 Blame says that you did something that you could have done otherwise, and so you're, therefore, you're at fault. That's what blame says. Responsibility says, yes, you did this to yourself, but not consciously or deliberately. You did it because you're programmed to do it by your own childhood experience, which in turn was, uh, um, mm, programmed by your parents' childhood experience. So there's nobody at fault. Everybody does their best. But we do pass these unconscious patterns on. And you don't blame people for having unconscious patterns. You try to make them conscious of it so they can take responsibility for it. So there's no con- there's no responsibility without consciousness.

Dr. Rangan Chatterjee 33:58 Yeah.

Gabor Maté 33:58 And so... And, and there's no blame. So I don't blame anybody for their illness. I don't blame their parents either. But I do say these unconscious patterns have been passed on, and these unconscious emotional dynamics have an impact on your physiology. That's all. And if you want to have an impact on your physiology, you gotta get conscious. You have to realize what have you been doing unconsciously so you can stop doing it or do it differently. So it's a matter of liberating people from these ingrained patterns for which they're not to be blamed. So in my world, there's no room for blame whatsoever, but there is room for helping people become responsible, for helping people being response able, being able to respond to their circumstances. And without awareness, none of us are response able.

Dr. Rangan Chatterjee 34:43 Yeah, I think, i- if I think to my own life and my own health journey over the last few years, and I guess what's really changed for me over the last few years, you know, I've done a lot with my lifestyle.

Gabor Maté 34:54 Yeah.

Dr. Rangan Chatterjee 34:54 I've done a lot with my nutrition, my sleep, and, and those things have been great, and they've really helped me. But over the last few years, I've really been focused on my emotional health. You know?

Gabor Maté 35:02 Okay.

Dr. Rangan Chatterjee 35:02 I, I, I see a therapist pretty regularly. Um, and I can always feel when I've got something new, some, some deeper layer that's starting to come out. You know, I, I have a, I have a session, or I, I go through some sort of therapy, and I, I feel good. I feel, "Oh, yeah, you know, I've, I've got it now. I get it. I get it why I do this." And, and it changes your behavior certainly. But it's almost as a, a, as if you, as you do that, th- there's multiple layers. It's like peeling back a layer of the, you know, it's peeling back layers of the onion, and newer things keep coming out, um, which has been really rewarding for me because, you know, you talk about addiction, and I, I think back to my, my own life and various things that I've done at certain points. You know, I don't think anyone who knows me well, uh, maybe my close friends [laughs] but-

Gabor Maté 35:47 Yeah

Dr. Rangan Chatterjee 35:47 ... most people probably wouldn't think that I've ever had an addiction-

Gabor Maté 35:51 Yeah

Dr. Rangan Chatterjee 35:51 ... because we have all these connotations about addiction, you know. You know, it's like, you know, being at a, being on a street corner-

Gabor Maté 35:57 Yeah. Yeah

Dr. Rangan Chatterjee 35:57 ... or being a drug addict or something.

Gabor Maté 35:59 Yeah.

Dr. Rangan Chatterjee 35:59 But, but everyone around me would know that I've got an addictive personality.

Gabor Maté 36:03 Yeah.

Dr. Rangan Chatterjee 36:03 And I used to think that that was my personality. That's the way I was born.

Gabor Maté 36:08 Yeah.

Dr. Rangan Chatterjee 36:08 What's weird, that as I start to process my own emotional baggage and I start to clear it, I'm no longer as an addictive person as I used to be. And, and that's why really I kind of feel, I feel so strongly about the work that you're doing because I kind of feel that- That wasn't my personality. That was the behavior I had chosen to soothe something that I was missing. And-

Gabor Maté 36:34 Well, so what I- how would I would put it, I, I mean, I, I agree with your concept. I would use, use a different language around it.

Dr. Rangan Chatterjee 36:39 Sure.

Gabor Maté 36:40 That was your personality, but it wasn't your person. It wasn't who you were. The personality itself is a defensive structure that we develop as a way of dealing with our pain. So much of what we consider to be our personality is actually, um, an overlay, uh, upon our true selves. And so these are in choices in childhood. For example, um, with my ADD, the tuning out, I never chose to tune out. But when I was an infant, under the conditions that I've described, of being a Jewish infant under the Nazis, I had plenty of stress on me. And how does an infant deal with stress that they can't change? They tune out, and then the tuning out becomes programmed into my brain. And then so many years later, I'm diagnosed with ADD. It wasn't a choice that I made. It was an adaptation. So I would... What I would say about the personality, including what you describe as your addictive personality, it wasn't you. It was an adaptation that you took on as a way of surviving your childhood, as a way of soothing your pain. It's when we got older that we realized that there's something more to us than a personality, that the personality is actually a defensive cover for who we truly are. And as we start, like as you describe your own process, you go through therapy, and you go through layers, and then you realize, oh, that's not actually me.

Dr. Rangan Chatterjee 38:03 Yeah.

Gabor Maté 38:03 And, and I'm freer without it. Then you realize that what we thought was the personality was actually just a defensive cover. Uh, and, and once we strip that defense off, and we find it no longer necessary, we become much more truer ourselves, more, much more true to ourselves, so become much more balanced and happier in our lives. So yes, it was the personality, but you are not your personality.

Dr. Rangan Chatterjee 38:29 Yeah.

Gabor Maté 38:29 That's, that's how I would formulate it.

Dr. Rangan Chatterjee 38:31 Yeah, no, I, I lo- I love the way you put that, actually. It really, [laughs] really helps me think about it in a slightly different way. Um, I think something came into my mind there, which is, you know... And we were chatting a little bit about this before we got on air, um, about medicine and how in, how reductionist it has become, the practice of medicine. And I think, like, something like high blood pressure, for example-

Gabor Maté 38:53 Mm-hmm

Dr. Rangan Chatterjee 38:53 ... I think of as an appropriate response from the body to the signals that it's been given.

Gabor Maté 39:00 Absolutely.

Dr. Rangan Chatterjee 39:02 And I think there's an analogy there with what you're saying, which is if you, if you're surrounded by stress as a young baby, whatever that stress is, your brain is gonna adapt to that. It's an appropriate response to the signals that your brain is getting. Is that fair to say?

Gabor Maté 39:20 That's right. So, so my next book is gonna be entitled The Myth of Normal: Illness and Health in an Insane Culture. And when I say in culture, insane culture, I mean a culture that doesn't meet human needs. So if you take a, a condition like high blood pressure, for which, what's the medical term for high blood pressure?

Dr. Rangan Chatterjee 39:42 Hypertension.

Gabor Maté 39:42 Hypertension. Okay. And, and, and doctors, of course, say, our colleagues say, "Well, there's a few types of hypertension for which there's a cause, like kidney disease or some kind of hormonal disorder." But for most part, we don't know what causes high blood pressure.

Dr. Rangan Chatterjee 39:57 Essential hypertension.

Gabor Maté 39:58 Essential. We call it essential, which basically is we don't know what the heck we're talking about. That's what that means. Just take the word hypertension and slow it down a bit. Hypertension. Hypertension. Hypertension. Maybe there's too much tension in people's lives, you know? And if you actually look at the, the rising rates of, of, of hypertension, it's got to do with social pressure and social stresses. And I know that b- usually, when I take care of myself, I have the blood pressure of a, of a young person. But there's been times in my life when I've been driven by stress, and I've had, uh, blood pressure ranges in the, in the, in the risky, uh, end of the scale. So for, so for me, when my blood pressure goes up, it's a real warning. "Buddy, you've got too much tension in your life. You better do something about it." All we do in medicine is we hand out pills, or we tell people to lose weight, but we never address the sources of real tension in their lives. And I'd say that most hypertension... A- a- and so for example, if you look at, uh, Black, Black American males, they have much higher risk of hypertension than, say, white American males. What we say is genetic, no it isn't. Their biological relatives in Africa do not have high blood pressure.

Dr. Rangan Chatterjee 41:09 Right.

Gabor Maté 41:10 So it's an artifact of being a Black male in essentially a racist society. And, uh, James Baldwin, the American writer, once said that being a Black American male is to live in a condition of suppressed rage all the time.

Dr. Rangan Chatterjee 41:23 Yeah.

Gabor Maté 41:24 Well, that suppressed rage will drive your blood pressure. So hypertension-

Dr. Rangan Chatterjee 41:27 And drive other ill health.

Gabor Maté 41:29 Yeah.

Dr. Rangan Chatterjee 41:29 Yeah.

Gabor Maté 41:30 So, so high blood pressure is a great example of a, a, a socially induced physiological, physiological condition which is mediated through our emotions and the impact of our emotions on our autonomic nervous system and on our hormones.

Dr. Rangan Chatterjee 41:45 Yeah. It's, uh, I mean, I've never really thought about the term hypertension like that before.

Gabor Maté 41:51 Yeah.

Dr. Rangan Chatterjee 41:51 You know, hypertension. And it, and it makes such sense-

Gabor Maté 41:54 Yeah

Dr. Rangan Chatterjee 41:54 ... when we think about it like that.

Dr. Rangan Chatterjee 41:56 You, you mentioned this, this new book you're writing, talking about how we've got a, I think you... Is it an insane society around us?

Gabor Maté 42:02 Yeah, yeah.

Dr. Rangan Chatterjee 42:02 And I think of, I think of stress, you know, as, as I've mentioned to you, I've, I've just spent a few months locked away writing a new book on stress called The Stress Solution.

Gabor Maté 42:13 Yeah.

Dr. Rangan Chatterjee 42:13 And I, I, I feel strongly that when we talk about making changes, so a lot of people, when they try and improve their health, they try and improve their lifestyle, okay? Which is a pretty reasonable start.

Gabor Maté 42:28 Mm-hmm.

Dr. Rangan Chatterjee 42:29 But many people, I find ... can't do that, or they do it temporarily for a few weeks, a few days, a few months maybe, but then they revert back. And as a doctor, I've always been intrigued as to why do some patients keep coming back, and why do some patients with the same so-called problem get better with the-

Gabor Maté 42:49 Mm

Dr. Rangan Chatterjee 42:49 ... with the same course of, of-

Gabor Maté 42:50 Right

Dr. Rangan Chatterjee 42:50 ... treatments?

Gabor Maté 42:51 Right.

Dr. Rangan Chatterjee 42:52 And I, and I always think, well, if they keep coming back, I'm clearly not getting to the root cause of the problem. And the more I think about your work, although people talk about you in the, in the realm of addiction and trauma, I think your work doesn't only explain addiction and trauma, it explains all human behavior, and therefore has profound implications, not only for trauma, not only for pain, not only for addiction, but actually the whole of the health landscape.

Gabor Maté 43:25 Well, thank you. And I, again, in my various books, I've written about that. Um, it just so happens that it's my addiction book that's being published right now, first in England. Um, when you get down to it, it's very simple. Either you raise human beings who- whose n- needs are met, or you raise human beings in a way that you don't meet their needs. When you don't meet people's needs, they have to adapt in, uh, artificial ways. Those adaptations become a source of illness later on. There was a very interesting article in the journal Pediatrics, which is the official journal of the American Academy of Pediatrics, published in January 2012. It was an article on childhood development generated by the Harvard Center on the Developing Child, so as prestigious as you get. And in the abstract, they say that human environments that because of scarcity or stress, uh, trouble young children, cause these children to make adaptations which are ne- psychological and physiological adjustments that are necessary for immediate survival and adaptation, but which may come at a long-term cost to health, behavior, uh, and longevity. In other words, the way that young children adapt to, um, to stress early on helps them survive that early stress. But in the long term, those same adaptations become sources of pathology. So if you, if you look at my own tuning out, so the, the tuning out that I did as an infant under conditions of severe psychological strain is an adaptation. It helped me as an infant survive a year where the situation was utterly impossible. But that same tuning out gets programmed into my brain, and now I'm diagnosed with a medical condition, ADHD, decades later. So what was ad- was adaptive in one circumstance becomes maladaptive later on. I'm suggesting that much of illness, uh, begins with that, that, that these are necessary personally adaptations, however, which then stress us later on. And so that is a real... So, so what's common to my work is that I look at the sources of adult function or dysfunction in our formative experiences. And, you know, that's not controversial if you look at a gardener. I mean, if a gardener looks at their plants, they know that how they treat that young plant will have a huge impact on the, on the adult plant. Uh, anybody who is in animal husbandry will realize that how you treat the young, whether it's a dog or a horse, will have huge impact on the personality and behavior of that animal later on. Why don't we get the same thing in human beings? It's the same principle. So it's essentially very simple.

Dr. Rangan Chatterjee 46:21 Yeah, it really is, isn't it? When you, when you break it down to the-

Gabor Maté 46:24 Yeah

Dr. Rangan Chatterjee 46:24 ... like that, it, it, it's super simple. We need to, we need a society that really supports children-

Gabor Maté 46:30 Absolutely

Dr. Rangan Chatterjee 46:30 ... and babies and mothers and, and parents at a young age.

Gabor Maté 46:33 Absolutely.

Dr. Rangan Chatterjee 46:34 And then w- I guess what comes to my mind is, and you may know the stats on this, I don't, but we here in the UK, we always are talking about Scandinavia, and we talk about how they are really, uh, prioritizing those early years. You know, they give a lot of maternity leave, a lot of paternity leave. Um, you know, yes, they may have high taxes, but it seems to me that their society there has prioritized family and bringing up children, whereas I don't think we're quite as good here, and I... but I don't think we're as bad as the, the US.

Gabor Maté 47:06 Mm-hmm.

Dr. Rangan Chatterjee 47:06 Um, when I... A really good friend of mine, he married an American girl, and she... Uh, I can't remember, but maybe after she gave birth to her first child, she might have been back at work, it might have been something like four weeks or something-

Gabor Maté 47:21 Yeah

Dr. Rangan Chatterjee 47:21 ... something obscene. Like, to me, or it sounds obscene to me.

Gabor Maté 47:24 Absolutely.

Dr. Rangan Chatterjee 47:25 And the child's in daycare.

Gabor Maté 47:27 Yeah.

Dr. Rangan Chatterjee 47:27 And I wonder, I wonder if you could talk about that a little bit, how society is set up now, and then what that is doing. Because you mentioned your mum's... Clearly, that's a huge trauma. I mean, that's-

Gabor Maté 47:39 Yeah

Dr. Rangan Chatterjee 47:39 ... hopefully the sort of trauma that most of us aren't experiencing. But are there similarities in terms of what that's doing to the child?

Gabor Maté 47:47 Oh, absolutely. Um, so the United States, uh, [laughs] which, uh, to hear their politicians, is the best and most glorious country in the world. Which itself, by the way, is interesting. Like, if you met a person, if, if your neighbor was always telling you how great he was and how he's the best and everybody wants to be like him, what would you think of him?

Dr. Rangan Chatterjee 48:08 [laughs] Yeah.

Gabor Maté 48:10 You'd think he's got a grandiose personality disorder, and he's compensating for his real sense of deficiency. Well, that's the United States, and they've a lot to compensate for. And what you say about childcare is absolutely true, is that they've a barbaric childcare system and a barbaric maternity leave system, where women, and often poor women on welfare, have to go back to work after a few weeks of, of, of giving birth. Now, if you look at human evolution- Or, or look at an ape culture. The ape mothers hold their babies for months. There's no separation. The child actually develops by, through being held by the mother. And human be- societies until very recently were organized around children being around their parents really all their lives, certainly through a childhood and adolescence. There was just no separation. What we do in our culture, more in the States than elsewhere, but increasingly elsewhere as well, we separate children from their parents. In other words, we're depriving them from the natural conditions for healthy development. Now, there was a study last year or two years ago comparing the crying of British, German, Canadian, and Danish children. Lo and behold, Danish kids cried much less than these others. What was the difference? The parents were around much more, and the parents were much more likely to pick up the kids when they were crying. That's what made the difference. Now, that crying child is an anxious child. When a child is crying, it's not just a benign thing. The child is crying because they're stressed. When they're stressed, their brains are suffused by stress hormones, adrenaline and cortisol. Adrenaline and cortisol interfere with your physiology, interfere with healthy brain development. So just the fact of holding a child, which was historically and prehistorically the standard, um, is, is, is an essential aspect of child-rearing, which modern societies have denied. And as a matter of fact, I don't know what it's like in England, but in North America, we actually advise parents not to pick up their kids. When they're crying at night, we tell them not to pick them up. Help ... We sleep train the kid by not picking them up. In other words, we're denying the child's needs for connection.

Dr. Rangan Chatterjee 50:32 And what's that doing to the child, do you think?

Gabor Maté 50:35 Well, it does a, a number of things. Uh, one is it gives the child the message that his emotions don't matter, and, and children take everything personally. It's not true that babies don't have emotions, and it's not true that babies are tabula rasa where you can write anything you want. Babies have certain defined emotional needs, and when they get the message that they're not important, that's the message they're gonna imbibe unconsciously, non-verbally, and you can see that behavior in the adults. You know the person who comes into your office and says, uh, "Doc, I'm sorry to bother you. I'm sure you have many people much more important than me, but I have this little problem," you know what kind of a childhood they had.

Dr. Rangan Chatterjee 51:14 Yeah.

Gabor Maté 51:15 Um, number one, so it gives them-

Dr. Rangan Chatterjee 51:17 That would be me going into the doctor-

Gabor Maté 51:19 Okay

Dr. Rangan Chatterjee 51:19 ... or in, in just various aspects of my life and, you know, the people pleaser.

Gabor Maté 51:25 Yeah.

Dr. Rangan Chatterjee 51:25 Always doing, you know, always, "Yeah, yeah, no problem." You know, the amount of times I think just on a social thing you'd be like, "Oh, where do you wanna go, guys?" "Yeah, yeah, no worries. Wherever, wherever." You end up somewhere you just don't wanna be in. You're in a restaurant you hate the food in, but-

Gabor Maté 51:36 Yeah

Dr. Rangan Chatterjee 51:36 ... "Hey, yeah, it's cool, guys. No problem." And it's ... Sorry, I don't mean to trivialize what you're saying. It's, it's-

Gabor Maté 51:41 No, you're not trivializing it. What you're actually illustrating, you're telling me exactly what kind of infancy you had.

Dr. Rangan Chatterjee 51:47 Yeah.

Gabor Maté 51:48 And, um, physiologically what does it do? The baby's crying, and again, these stress hormones. Now, one of the things that aboriginal peoples don't do is let their babies cry. When I say it's not that they forbid them to cry, they pick them up. They don't even put them down, to tell you the truth, but should they cry, they pick them up immediately. We, in our society, we actually advise people let the babies cry. When a baby's crying, it's 'cause they're stressed. When they're stressed, again, their brains are suffused by stress hormones. That interferes with healthy brain development.

Dr. Rangan Chatterjee 52:22 You used to work in palliative care.

Gabor Maté 52:25 Yeah.

Dr. Rangan Chatterjee 52:26 And I think you're familiar with the book by Bronnie Ware, the palliative care nurse-

Gabor Maté 52:31 Yeah

Dr. Rangan Chatterjee 52:31 ... The Five Regrets of the Dying.

Gabor Maté 52:32 Yeah.

Dr. Rangan Chatterjee 52:34 What I thought would be interesting today for our fourth conversation on my podcast together-

Gabor Maté 52:40 Yeah

Dr. Rangan Chatterjee 52:40 ... is to maybe go through each of those five regrets, because I'd, I just ... I'd love to know from your perspective what each of these regrets says-

Gabor Maté 52:51 Yeah

Dr. Rangan Chatterjee 52:52 ... about where we are, who we are-

Gabor Maté 52:54 Yeah

Dr. Rangan Chatterjee 52:54 ... what things are important to us.

Gabor Maté 52:57 Yeah.

Dr. Rangan Chatterjee 52:58 And so the first of those five regrets is, "I wish I had the courage to live a life true to myself, not the life others expected of me."

Gabor Maté 53:07 Yeah. And so l- let's keep in mind that, l- like when I used to work in palliative care, which I did for seven years, and this nurse who wrote the book, she's Australian, and she wrote the book about 12 years ago now.

Dr. Rangan Chatterjee 53:22 Mm.

Gabor Maté 53:23 They weren't talking about people dying at old age. They were mostly it's about people dying before their time.

Dr. Rangan Chatterjee 53:28 Mm.

Gabor Maté 53:29 And so the regrets that they had, um, as their terminal illness, usually malignancy or perhaps chronic autoimmune disease, um, brought them to the end of their physical existence, what did they regret? And the top one was, "I wish I had the courage to live my own life rather than the one that people expected of me." I would reframe that, because th- there's a deep truth in it. And as you know, and perhaps we've talked about, from my point of view, very often the people that do develop chronic illness are people that have suppressed their own true selves for the sake of being accepted to others. And that self-suppression has deep physiological consequences on the immune system-

Dr. Rangan Chatterjee 54:16 Mm

Gabor Maté 54:16 ... on the nervous system, on the heart, and so on. So that, that self-suppression is also physiological self-annihilation in some ways. But when she talks about courage, this is self-judgment. They're saying to themselves, "I wish I'd had the courage," as if it was a question of cowardice. It isn't. It's a question of programming. Like w- you and I are both parents. We know this. No infant is born suppressing themselves. No infant enters the first day On this earth trying to please anybody.

Dr. Rangan Chatterjee 54:51 Mm-hmm.

Gabor Maté 54:52 They're just being purely themselves.

Dr. Rangan Chatterjee 54:54 Yeah.

Gabor Maté 54:55 Expressing their joy when it's there, expressing their upset, their distress when that's dominant, but they're purely themselves. So that what she calls courage or what these people call courage of being myself is actually a trauma imprint that for some reason they learned early in life that to be themselves is to court rejection by their environment. So it's not a lack of courage. You can't talk about a one-year-old lacking courage or a two-year-old. It's simply an adaptation. Now, lo- later on they say courage, but really that's, uh, that courage is, i- uh, the lack of it is a shorthand for something happened to me that I gave up my true self for the sake of being accepted.

Dr. Rangan Chatterjee 55:42 Yeah.

Gabor Maté 55:42 And that cost me. Uh, first of all, it cost them in terms of physical illness, but also cost them in terms of self-respect and, and dignity. It's a major one.

Dr. Rangan Chatterjee 55:54 Yeah. Are you living a life at the moment that's true to yourself?

Gabor Maté 56:00 I am now. Um, uh, I, I sense that I am. I believe that I am. Um, that doesn't mean every second I do, you know, but on the whole I do and it feels really good. And I know, you know, I had dinner last night and, and, and you were telling me that you're finding yourself far more self-expressed and, and, and comfortable with who you are-

Dr. Rangan Chatterjee 56:29 Yeah

Gabor Maté 56:29 ... than you used to. So that's the good news people, is that this is a process that can continue for a lifetime.

Dr. Rangan Chatterjee 56:36 Yeah.

Gabor Maté 56:36 But yeah, um, I, I really see that people who suppress themselves really suffer.

Dr. Rangan Chatterjee 56:45 Yeah. So that first regret, I wish I had the courage to live a life true to myself. Um, I'm really glad you picked out the word courage-

Gabor Maté 56:54 Yeah

Dr. Rangan Chatterjee 56:54 ... because that word also stands out to me.

Gabor Maté 56:57 Yeah.

Dr. Rangan Chatterjee 56:57 It's very interesting to use that word.

Gabor Maté 56:59 Yeah.

Dr. Rangan Chatterjee 57:00 Um-

Gabor Maté 57:00 Well, it's, it's a self-judgment, isn't it?

Dr. Rangan Chatterjee 57:02 It is.

Gabor Maté 57:03 Yeah.

Dr. Rangan Chatterjee 57:03 You know, I, I could have done better.

Gabor Maté 57:05 Yeah.

Dr. Rangan Chatterjee 57:05 I should have had the courage-

Gabor Maté 57:07 That's right

Dr. Rangan Chatterjee 57:07 ... is what that kind of says.

Gabor Maté 57:08 Yeah.

Dr. Rangan Chatterjee 57:10 It's interesting, Gabor, you said when, when you turned 80 or as a consequence of you turning 80, you realized that while 13 years ago you gave it your medical practice-

Gabor Maté 57:20 Yeah

Dr. Rangan Chatterjee 57:20 ... will you be alive in 13 years? That's, that's very-

Gabor Maté 57:24 Yeah

Dr. Rangan Chatterjee 57:24 ... striking.

Gabor Maté 57:25 Yeah.

Dr. Rangan Chatterjee 57:26 Are you afraid of death?

Gabor Maté 57:28 Um, in principle I'm not, you know. Um, but I don't really know till I have to face it. I won't know how afraid I am until it confronts me, you know? At this point I feel healthy and I get to do what I want to do and I, I have vigor and I have interests and excitement and, and love and, and, um, likes and dislikes and I'm, I'm quite alive, you know? What happens when I have to confront the actuality of it, I have no idea how I'm gonna respond. So at sometimes I get fear around it. I mean, there's, I don't want to give this up. I don't want to give up this life. But other times I say, "Well, if I do, I've lived and, and it's been good and there's not much to regret," you know? So yes and no-

Dr. Rangan Chatterjee 58:22 Yeah

Gabor Maté 58:22 ... but I won't really know until I'm up against it.

Dr. Rangan Chatterjee 58:26 You've spoken publicly before about your, um, your journeys with plant medicine.

Gabor Maté 58:35 Yeah.

Dr. Rangan Chatterjee 58:36 Does that change anything in s- for you, I guess, or has that changed anything in terms of how you may view what happens at the end of-

Gabor Maté 58:45 Ah

Dr. Rangan Chatterjee 58:46 ... human life? Because people, many people will say for them it does change how they perceive themselves, how they perceive death, how they perceive what this experience of life actually really is.

Gabor Maté 58:57 Well, specifically, as you're probably aware, they've done studies on end of life anxiety-

Dr. Rangan Chatterjee 59:03 Mm-hmm

Gabor Maté 59:03 ... with psilocybin, so-called magic mushrooms. And, um, people report spiritual experiences.

Dr. Rangan Chatterjee 59:12 Yeah.

Gabor Maté 59:12 And people report a significant abatement of anxiety they had around dying. These are people who are terminally ill.

Dr. Rangan Chatterjee 59:19 Mm-hmm.

Gabor Maté 59:20 And, uh, nothing that the medical profession could offer to reverse the course of their fatal illness, but they had much less anxiety about dying as a result of those spiritual experiences-

Dr. Rangan Chatterjee 59:35 Mm-hmm

Gabor Maté 59:36 ... that were induced by taking the mushroom.

Dr. Rangan Chatterjee 59:38 Yeah.

Gabor Maté 59:39 Uh, for me, I've never faced death in that sense. When I think of some of my psychedelic experiences, and if in retrospect I allow myself to sink into them, I can say in that state I would not be afraid of death. I'd say that there's a larger reality than the-

Dr. Rangan Chatterjee 1:00:03 Sorry to interrupt. If you're enjoying this video and you want to learn more, then do check out my free special guide which contains the six crucial steps you need to take in your life to not only build healthy habits, but also to make them stick. If you wanna get a hold of this free guide, all you have to do is click on the link in the description box below

Gabor Maté 1:00:24 ... persistence or cessation of this particular lung-

Dr. Rangan Chatterjee 1:00:30 Mm-hmm

Gabor Maté 1:00:30 ... uh, represents, you know.

Dr. Rangan Chatterjee 1:00:32 Yeah.

Gabor Maté 1:00:32 I would say that if I project myself back into those experiences. Again, how I will face it when it happens or when it becomes inevitable, um, I don't know.

Dr. Rangan Chatterjee 1:00:44 Yeah. Society's view or this society's view of people getting older-

Gabor Maté 1:00:53 Yeah

Dr. Rangan Chatterjee 1:00:53 ... 80 seems to be The age where we often expect people to be doing less.

Gabor Maté 1:01:00 Oh.

Dr. Rangan Chatterjee 1:01:00 You know? Being less mobile-

Gabor Maté 1:01:03 Mm

Dr. Rangan Chatterjee 1:01:03 ... less vital. Not everyone-

Gabor Maté 1:01:05 Mm

Dr. Rangan Chatterjee 1:01:05 ... of course, but-

Gabor Maté 1:01:06 Yeah

Dr. Rangan Chatterjee 1:01:06 ... but many.

Gabor Maté 1:01:07 Yeah.

Dr. Rangan Chatterjee 1:01:07 You seem to be someone who has this love of life-

Gabor Maté 1:01:13 Yeah

Dr. Rangan Chatterjee 1:01:13 ... this vigor, this message you want to share.

Gabor Maté 1:01:15 Mm.

Dr. Rangan Chatterjee 1:01:15 You seem to be traveling all over the globe at, you know, pretty regular intervals. You've-

Gabor Maté 1:01:22 Yeah

Dr. Rangan Chatterjee 1:01:22 ... you've come into London for four days.

Gabor Maté 1:01:24 Yeah.

Dr. Rangan Chatterjee 1:01:24 You're gonna help me do some teaching with doctors tomorrow, which is-

Gabor Maté 1:01:26 Yeah

Dr. Rangan Chatterjee 1:01:26 ... incredible. But a lot of 80-year-olds are not doing that.

Gabor Maté 1:01:30 Yeah.

Dr. Rangan Chatterjee 1:01:31 Right? And the longevity space within medicine has really exploded over the last few years. People love talking about longevity.

Gabor Maté 1:01:41 Mm.

Dr. Rangan Chatterjee 1:01:42 Right? And I think we're missing something in our discussions about longevity. Well, I think there's a couple things, but-

Gabor Maté 1:01:50 What, what do, what do you think we're missing?

Dr. Rangan Chatterjee 1:01:52 I think it depends what you mean by longevity, first of all, right?

Gabor Maté 1:01:56 Yeah.

Dr. Rangan Chatterjee 1:01:56 So yes, some people want to know how can I, not necessarily live longer, but be independent, mobile, vital as long as I live? So health span versus-

Gabor Maté 1:02:07 Mm

Dr. Rangan Chatterjee 1:02:07 ... lifespan.

Gabor Maté 1:02:08 Yeah.

Dr. Rangan Chatterjee 1:02:08 And I get that.

Gabor Maté 1:02:09 Yeah.

Dr. Rangan Chatterjee 1:02:10 But there's a lot of talk these days about extending lifespan-

Gabor Maté 1:02:14 Yeah

Dr. Rangan Chatterjee 1:02:14 ... living to 150 and beyond and all-

Gabor Maté 1:02:16 Yeah

Dr. Rangan Chatterjee 1:02:16 ... kinds of-

Gabor Maté 1:02:17 Yeah

Dr. Rangan Chatterjee 1:02:17 ... crazy stuff, right? And I don't wanna be the, uh, I don't wanna stand in the way of human progress at all. My, one of my fears is that in pursuit of living longer, are we missing something about the beauty and the essence of what life really is? Life is finite. The fact that it's finite is what makes it so beautiful.

Gabor Maté 1:02:42 Yeah.

Dr. Rangan Chatterjee 1:02:42 If we could live to 200-

Gabor Maté 1:02:45 Yeah

Dr. Rangan Chatterjee 1:02:45 ... would we have even more of these regrets because we'd keep taking life for granted?

Gabor Maté 1:02:50 You know what? I, you're talking my language because to tell you the truth [laughs] , to coin a phrase, all this stuff about longevity bores me to death. You know? Um, I just don't care, you know? What really matters is w- what does this moment bring us? Or what can we bring to this moment, you know? Let the future take care of itself. You know, like Jesus says-

Dr. Rangan Chatterjee 1:03:14 Mm

Gabor Maté 1:03:14 ... take no thought for tomorrow, you know?

Dr. Rangan Chatterjee 1:03:16 Yeah.

Gabor Maté 1:03:17 And, um, I really think that this longevity movement is a sign of deep social anxiety. When especially you get these rich people in California with their cryo technology of freezing the, the body hoping that 100 years from now they'll be able to unfrozen and there'll be treatments for the d- ... You know, it bores me, you know? What really matters is, for me, is what makes life meaningful and active and engaged in the present moment. And, um, it's interesting, in English we talk about growing older. Now, that's a very telling phrase because in significant ways when we get older we shrink.

Dr. Rangan Chatterjee 1:04:04 Mm.

Gabor Maté 1:04:04 You know? Like our bodies, our skin starts to sag, our muscles are no longer as, you know-

Dr. Rangan Chatterjee 1:04:11 Mm

Gabor Maté 1:04:13 ... supple and strong as they used to be. So what does it mean to grow older? W- we could just say, like you said earlier, get older, which is just a chronological progression. But growing older implies that the growth is actually possible.

Dr. Rangan Chatterjee 1:04:27 Mm.

Gabor Maté 1:04:28 So in what sense can we actually grow? And I think actually we can actually grow into the present moment and, and, and, and growing in our, growing our appreciation for life and what matters and, and knowing what doesn't matter and growing in wisdom. Indigenous cultures, they don't talk about elderly, they talk about elders.

Dr. Rangan Chatterjee 1:04:49 Yeah.

Gabor Maté 1:04:49 There's a huge difference.

Dr. Rangan Chatterjee 1:04:51 Yeah.

Gabor Maté 1:04:52 So, um, I think there's a natural reverence for age that senior cultures would respect and modern society kinda, um, dismisses, you know? Now, do I wish that my hair was blacker and-

Dr. Rangan Chatterjee 1:05:09 [laughs]

Gabor Maté 1:05:10 ... more curly the way it used to be? Yeah, I do. You know? And it wasn't gray and my hair wasn't thinning at the top and I, sure, I wish that, but [sighs] at the same time I would not wanna be as unconscious as I was-

Dr. Rangan Chatterjee 1:05:26 Yeah

Gabor Maté 1:05:27 ... when my hair was blacker and curlier, you know?

Dr. Rangan Chatterjee 1:05:30 Yeah, this is such an interesting point. I've spoken to several menopause experts on this show-

Gabor Maté 1:05:38 Oh, yeah

Dr. Rangan Chatterjee 1:05:38 ... over the past few years. And I remember when doing some research on one of the conversations, I came across research showing that in cultures where women are revered as they get older-

Gabor Maté 1:05:51 Yeah

Dr. Rangan Chatterjee 1:05:51 ... their wisdom is respected, they're seen as really important parts of the community.

Gabor Maté 1:05:56 Right.

Dr. Rangan Chatterjee 1:05:57 Those cultures report less menopausal symptoms.

Gabor Maté 1:06:01 Isn't that interesting?

Dr. Rangan Chatterjee 1:06:02 I j- just so I'm not misinterpreted, I wanna be really clear, I'm not saying that that means that all menopausal symptoms would go away if that was the case.

Gabor Maté 1:06:11 Yeah, yeah, yeah.

Dr. Rangan Chatterjee 1:06:12 I just find it interesting that when the cultural view of growing old is different-

Gabor Maté 1:06:19 Yeah

Dr. Rangan Chatterjee 1:06:19 ... we perceive ourselves as having, I don't know, a different symptom profile i- if I, if I can put it like that.

Gabor Maté 1:06:27 Yeah. And, and, and, and the degree of suffering is different so that maybe they have symptoms or maybe they have certain features, but the suffering-

Dr. Rangan Chatterjee 1:06:36 Mm

Gabor Maté 1:06:36 ... is not experienced the same way.

Dr. Rangan Chatterjee 1:06:39 Please expand on that 'cause I think some people will go, w- what do you mean? If you're either getting symptoms or you're not getting symptoms.

Gabor Maté 1:06:44 Yeah.

Dr. Rangan Chatterjee 1:06:44 Explain what you mean by perception of, you know, the, the suffering essentially.

Gabor Maté 1:06:49 Well, I was talking to somebody else about this today. So, uh, in w- uh, uh, as you, as you and I know, in Western medicine we kind of medicalize everything. And so we talk about premenstrual syndrome. Now d- Which PMS is a syndrome. It's a medical entity.

Dr. Rangan Chatterjee 1:07:08 Mm-hmm.

Gabor Maté 1:07:08 What is it really is that under the impact of hormonal changes, women get more sensitized, so they might have more physical pain and more upset. But we could see that as pathological, or we could actually say that it's a time of truth-telling-

Dr. Rangan Chatterjee 1:07:27 Mm-hmm

Gabor Maté 1:07:27 ... that the hormones do sensitize them to things that are not functioning in their lives, which the rest of the time they're acculturated to acquiesce with and to put up with.

Dr. Rangan Chatterjee 1:07:38 Yeah.

Gabor Maté 1:07:38 But the menstrual ferment in their bodies makes it less tolerable. So instead of seeing it as a pathology, we could see it as a time of insight. And what if they actually listen to their bodies and listen to what their body's saying no to, that the rest of the month they kind of-

Dr. Rangan Chatterjee 1:07:57 Mm

Gabor Maté 1:07:57 ... suppress? Then that could be seen as a time of wisdom rather than a time of suffering. So the s- the physical things are there, but it, but it doesn't have to be experienced as suffering.

Dr. Rangan Chatterjee 1:08:10 Right.

Gabor Maté 1:08:10 It could be experienced as a time of truth-telling. And actually, a lot of women have told me that once they become aware of that, their relationship to menstruation is-

Dr. Rangan Chatterjee 1:08:18 Yeah

Gabor Maté 1:08:18 ... totally different. And I think that's what you're saying about menopause as well.

Dr. Rangan Chatterjee 1:08:21 Yeah.

Dr. Rangan Chatterjee 1:08:22 This kind of speaks to the second regret, which is I wish I hadn't worked so hard.

Gabor Maté 1:08:26 Yeah.

Dr. Rangan Chatterjee 1:08:27 And what I mean by that is I agree that for many women-

Gabor Maté 1:08:37 Yeah

Dr. Rangan Chatterjee 1:08:39 ... and I can think of so many patients like this, their, their hormonal symptoms were actually showing them that the way you're currently living-

Gabor Maté 1:08:50 Yeah

Dr. Rangan Chatterjee 1:08:50 ... is not in harmony with your body.

Gabor Maté 1:08:52 Exactly.

Dr. Rangan Chatterjee 1:08:53 Now, of course, sometimes people struggle to make change. It's hard to make change. Maybe their life is mega stressful and, and at that moment they can't change it for whatever reason.

Gabor Maté 1:09:01 Yeah.

Dr. Rangan Chatterjee 1:09:01 And I totally, I empathize with that. I, I understand.

Gabor Maté 1:09:05 Yeah.

Dr. Rangan Chatterjee 1:09:06 But for some people who are able to, it's in- sometimes it's one of the best things that has happened to them.

Gabor Maté 1:09:12 Yeah. Now, this thing of, I wish I hadn't worked so hard, that's an interesting one, because I wish I hadn't worked so hard. And what do I mean by that? Like, like, uh, speaking for myself, and I don't know if this is true for you, but I became a physician for some really good reasons. One of them was I genuinely wanted to help suffering humanity, and I thought medicine is a perfect, mm, pathway through which I could help people. That's genuine, and I meant it. I also chose a profession where I was fairly confident of making a decent living so I could support a-

Dr. Rangan Chatterjee 1:09:54 Mm-hmm

Gabor Maté 1:09:55 ... a life for myself and my family. That's legitimate. But those reasons don't make you work too hard. They make you work hard, but they don't make you work too hard. What makes you work too hard, and that's what these people are saying, is you're driven by something that you're not even aware of. And what I wasn't aware of when I went to medical school and when I was a physician for decades is how driven I was to justify my existence in the world and to prove that I was important and worthwhile-

Dr. Rangan Chatterjee 1:10:30 Yeah

Gabor Maté 1:10:30 ... and so on, and that had to do with the loss of those, that confidence owing to early childhood trauma. And so there w- it's not a question of... Nobody says, I wish I wouldn't h- hadn't worked hard. To achieve something in life, you have to work hard. They're saying, I wish I wouldn't worked too hard. And that too part, the T-O-O part, comes from being driven by unconscious needs to validate your existence, where why should any human being have to validate their existence, you know? And so that's what they're saying. And when you're driven to work too hard, you actually ignore what matters. And what matters is, um, what you were telling me last night about how much it matters for you to spend time with your family. So every summer you take a num- a bunch of weeks away from your podcast, and you just spend time enjoying your kids and, and your, and your wife and your family. And I didn't do that. I... For me, it was very hard to even take holidays. I always felt I had to keep working. If somebody was, um, pregnant, oh my God, what if I would miss their delivery? Like the baby couldn't enter the world without me, you know? So that drivenness is what makes people work too hard. And so not a matter of working hard, it's a matter of working too hard. And where does that come from? Again, that comes from childhood trauma.

Dr. Rangan Chatterjee 1:11:52 A lot of doctors, and I have several friends like this, they don't take their full allowance of annual leave.

Gabor Maté 1:12:00 Mm.

Dr. Rangan Chatterjee 1:12:01 Sounds like you may have been similar.

Gabor Maté 1:12:04 I had that tendency, yeah.

Dr. Rangan Chatterjee 1:12:05 Yeah. And often people will say, and I have a friend who says this, "Yeah, but my patients need me."

Gabor Maté 1:12:12 No, they don't need them. They need medical help.

Dr. Rangan Chatterjee 1:12:15 Yeah. [laughs] But I think we have to ask ourselves, and this is very, very common in medicine, actually. I'm sure it's common in other, um, professions as well.

Gabor Maté 1:12:24 Yeah.

Dr. Rangan Chatterjee 1:12:25 It's interesting when you don't take your full allowance of annual leave-

Gabor Maté 1:12:28 Yeah

Dr. Rangan Chatterjee 1:12:28 ... that your contract entitles you to. It's-

Gabor Maté 1:12:31 Yeah

Dr. Rangan Chatterjee 1:12:31 ... often paid time off, right?

Gabor Maté 1:12:33 Yeah.

Dr. Rangan Chatterjee 1:12:33 It's part of your job.

Gabor Maté 1:12:35 Yeah.

Dr. Rangan Chatterjee 1:12:35 When you're not taking it, of course, there can be reasons for that. There can be reasonable reasons. There can be work reasons. But if you're not, I think you... I think it may be worth reflecting on some of those underlying, you know, th- those real drivers of that.

Gabor Maté 1:12:51 Well, it occurs to me that what your friend is actually saying is not that my patients need me, but I need my patients-

Dr. Rangan Chatterjee 1:12:59 Yeah

Gabor Maté 1:12:59 ... to feel okay. And when I'm not working to help them- I don't know who I am and I don't feel comfortable-

Dr. Rangan Chatterjee 1:13:06 Yeah

Gabor Maté 1:13:06 ... myself so I need them. Now that means get thee to a therapist and deal with it. And n- and not only that, even though your capacity to help your patients over time will be eroded-

Dr. Rangan Chatterjee 1:13:18 Totally

Gabor Maté 1:13:18 ... by the way you're stressing yourself and you're not taking care of yourself. And physicians are notoriously programmed to ignore themselves, and there was a very interesting study that I mention in the book The Myth of Normal. They looked at the fraying of the chromosomes, um, of people and, you know, uh, when we're born we're born with certain structures called telomeres-

Dr. Rangan Chatterjee 1:13:43 Mm

Gabor Maté 1:13:43 ... and telomeres are DNA structures at the end of our chromosomes, and their fraying and their shortening is a mark of aging and of stress. And they looked at the, the telomeres of medical residents compared to other people their age. They age faster. They fray faster.

Dr. Rangan Chatterjee 1:14:02 Yeah.

Gabor Maté 1:14:02 And so physicians are driven to actually, um, not spare themselves and to literally consume themselves in the work. Now in the long term that may make you a very popular and very successful doctor, but in the long term it's gonna be at the expense of your marriage and of your children and of your own mental and physical health.

Dr. Rangan Chatterjee 1:14:26 Yeah. F- for me if I look at that situation and I reflect on society a- and culture, what I see these days is a very, this very me focused culture where-

Gabor Maté 1:14:41 Yeah

Dr. Rangan Chatterjee 1:14:41 ... community has been gradually eroded out.

Gabor Maté 1:14:45 Yeah.

Dr. Rangan Chatterjee 1:14:47 And therefore if we think about a human being, a human being needs to feel that they're of value to other people.

Gabor Maté 1:14:53 Yeah.

Dr. Rangan Chatterjee 1:14:53 We, we, we need that.

Gabor Maté 1:14:54 Yeah.

Dr. Rangan Chatterjee 1:14:56 In our tribes, you know, 50,000 years ago we would have felt of value-

Gabor Maté 1:15:04 Yeah

Dr. Rangan Chatterjee 1:15:04 ... because we would have a role, and other people would see that role. They would benefit from it, and we would benefit from the things-

Gabor Maté 1:15:11 Yeah

Dr. Rangan Chatterjee 1:15:11 ... they were doing.

Gabor Maté 1:15:11 Yeah.

Dr. Rangan Chatterjee 1:15:11 You know, whether it's someone's hunting, someone's gathering, someone's putting the fire on, whatever it might be. In this me focused culture where it's all me, me, me and what are my needs and what do I need to do and how can I better myself, I feel that we often don't feel of value to others. We don't feel important, and so it makes sense that in that culture you might overwork.

Gabor Maté 1:15:36 Mm.

Dr. Rangan Chatterjee 1:15:36 You might keep pushing yourself because if you're not working and feeling important there, then actually you may not have that sensation in any other aspects of your life.

Gabor Maté 1:15:48 Well if, well if you weren't given the, um... It's very simple. If in early childhood you're given the sense that you're valued just 'cause you existed, your parents welcome you and validate you and value you and, and celebrate you just 'cause you are, then you don't have to keep proving it afterwards.

Dr. Rangan Chatterjee 1:16:08 Mm-hmm.

Gabor Maté 1:16:08 But if you don't get that sense, then you have to be important.

Dr. Rangan Chatterjee 1:16:12 Yeah.

Gabor Maté 1:16:12 So that sense of needing to be important has to come from missing out on being valued for who you are or being only valued for your achievements. You know, you're valued-

Dr. Rangan Chatterjee 1:16:21 Mm.

Gabor Maté 1:16:22 Like, look, my parents, bless their souls, but they valued my intelligence, you know? And so a lot of my persona was caught up in being smart and, and proving my value that way. Well, it's good to be intelligent, but your value should... doesn't depend on-

Dr. Rangan Chatterjee 1:16:43 Mm

Gabor Maté 1:16:43 ... or shouldn't depend on any one quality, whether you're cute or cuddly or handsome or-

Dr. Rangan Chatterjee 1:16:49 Mm

Gabor Maté 1:16:49 ... successful or good at sports or smart in school, any of that, is y- your value is intrinsic-

Dr. Rangan Chatterjee 1:16:56 Mm

Gabor Maté 1:16:56 ... or g- innate, inherent 'cause you're a human being. In this society, as you say, it tends to value people for what they do, and so that can become very, very addictive. But again, going back to your friend who says, "My parent, my f- my patients need me," and you think about it, and I'm not accusing them of anything, but they're not realizing just how egotistical that statement is. It's as if it dependent on them.

Dr. Rangan Chatterjee 1:17:23 Mm-hmm.

Gabor Maté 1:17:23 Their patients need good medical care, but they don't need him or her-

Dr. Rangan Chatterjee 1:17:30 Mm

Gabor Maté 1:17:30 ... or them specifically, which means that they should be able to take care of themselves as long as they make sure that when they're not there-

Dr. Rangan Chatterjee 1:17:39 Mm-hmm

Gabor Maté 1:17:39 ... their patients are receiving-

Dr. Rangan Chatterjee 1:17:42 Mm

Gabor Maté 1:17:42 ... the care that they need. So it's not about us, and I used to think it was always about me.

Dr. Rangan Chatterjee 1:17:46 Mm.

Gabor Maté 1:17:47 If I'm not there for the delivery of this [laughs] you know? Yeah.

Dr. Rangan Chatterjee 1:18:14 As I was walking to the studio this morning thinking about our conversation, the word impressive kept coming up for me.

Gabor Maté 1:18:23 Mm.

Dr. Rangan Chatterjee 1:18:25 And I've been reflecting on the word impressive because, again, I think culturally we, we think it's a good thing to impress others.

Gabor Maté 1:18:33 Mm-hmm.

Dr. Rangan Chatterjee 1:18:33 Like, "That bit of work you did is impressive."

Gabor Maté 1:18:36 Mm-hmm.

Dr. Rangan Chatterjee 1:18:38 But actually if you, if you really unpick impressive, or certainly if I do it, it implies to me, and maybe this is my own bias because this is what I have done for much of my life-

Gabor Maté 1:18:52 Yeah

Dr. Rangan Chatterjee 1:18:53 ... I've changed who I am in order to impress others.

Gabor Maté 1:18:59 Yeah.

Dr. Rangan Chatterjee 1:19:00 I didn't feel I impressed others by being myself.

Gabor Maté 1:19:03 Yeah.

Dr. Rangan Chatterjee 1:19:03 I impressed them by changing.

Gabor Maté 1:19:06 Yeah.

Dr. Rangan Chatterjee 1:19:06 So- What comes up for you when you hear the word impressive? Have we got it wrong? Has it been, you know, has it been taken to mean something it's not? Like, how, how do you see the word impressive?

Gabor Maté 1:19:19 Hmm. Well, um, impressive, first of all, has to do with what? It has to do with our impact on other people, how others see us. So if I can just be myself and express my own truth, and not drive myself into activities that are not good for me, and people are impressed, well, that's great. But if my intention is to impress other people, if I need for me to make a certain impression in somebody else's mind, then where am I living? Then I'm living in their minds rather than in myself.

Dr. Rangan Chatterjee 1:20:04 [sniffs]

Gabor Maté 1:20:05 So the question is, where do I wanna live? Here or in your mind, you know? And, uh, our society is so, um, addicted to people being impressive in the minds of others. That means that we live in the minds of others though m- more than we live-

Dr. Rangan Chatterjee 1:20:23 Mm-hmm

Gabor Maté 1:20:24 ... in ourselves. So if I c- if you can be yourself, and if find that imp- if I find that impressive, that's great. But you're not doing it to impress me.

Dr. Rangan Chatterjee 1:20:33 No.

Gabor Maté 1:20:33 You're just doing it 'cause that's, you're expressing who you are. If I'm impressed, great. If I'm not impressed, that doesn't take anything away from you. But to the degree that we're dependent on impressing others, we're robbing ourselves. So that's how I see that word.

Dr. Rangan Chatterjee 1:20:51 You know,

Dr. Rangan Chatterjee 1:20:51 we're quite isolated now. You know, many of us have moved away from where we grew up.

Gabor Maté 1:20:55 Yeah.

Dr. Rangan Chatterjee 1:20:55 We don't have friends, we don't have a family network around us, so... And often two parents are working.

Gabor Maté 1:21:02 Yep.

Dr. Rangan Chatterjee 1:21:02 So you've got this really stressful situation where everyone's trying to do the best that they can.

Gabor Maté 1:21:08 Yeah.

Dr. Rangan Chatterjee 1:21:08 They're trying to, you know, make enough money to feed themselves, to house themselves. They're also trying to spend enough time with their children, yet they have no support. So there's a huge amount of pressure then that goes onto the kids, but also on the parents.

Gabor Maté 1:21:21 Yes.

Dr. Rangan Chatterjee 1:21:22 And I think, I, I saw you talk last night, um, at the Tabernacle in London. It was a, it was a, you know, an amazing talk. And you mentioned a little bit about hunter-gatherer societies, and how for the bulk of human evolution we have lived and raised our children a certain way.

Gabor Maté 1:21:38 Yeah.

Dr. Rangan Chatterjee 1:21:38 I wonder if you could expand on that.

Gabor Maté 1:21:40 Well, a- again, human beings, some version of human beings have been on the Earth for millions of years. There've been hominids for millions of years. There have been human species for hundreds of thousands of years, and our own particular species probably for about 100,000 years, uh, Homo sapiens, which is the latest and the only current human species that's extant. For all of that prehistory, until about 9,000 years ago, virtually all human beings lived in small hunter-gatherer bands. This is our evolution. This is how we became human beings. So to think that, uh, now, now you might liken modern society to a zoo, where you take an animal from a natural habitat and you put them in a completely artificial restricted situation, and you expect him to stay as normal as he was out there in the wild. Essentially, that's what's happened to human beings, in that in a very short space of time, in the blink of an eye from the perspective of evolution, we've been, we've gone from the hunter-gatherer, small band, communal, attachment-based group to a society which is alienated, disconnected. And that disconnection is, m- uh, is, is, um, accelerating at a tremendous rate throughout the world. Um, urbanization, it's taking people out of their villages and into the big cities where they're alone. Uh, here in Britain, uh, there was quite a deliberate assault on community under the Thatcher regime, with the destruction of neighborhoods and communities and so on. And, uh, that trend has continued. So what we're having in is societies that are less and less natural to the actual makeup of human beings from the evolutionary perspective. And which means that children are being brought up under increasingly artificial and disconnected circumstances. And, uh, you know, m- Johann Hari, who's written a book recently on the d-

Dr. Rangan Chatterjee 1:23:44 Yeah

Gabor Maté 1:23:44 ... uh, uh, on, on, on depression called Lost Connections, is pointing exactly at what's happening in modern society, so that these lost connections characterize the modern world. And as they do, you're getting the spread of autoimmune disease into countries-

Dr. Rangan Chatterjee 1:24:00 Yeah

Gabor Maté 1:24:00 ... that never used to have it before.

Dr. Rangan Chatterjee 1:24:02 Yeah.

Gabor Maté 1:24:02 So we think autoimmune disease is one of these, uh, or addictions for that matter. So if you look at the rate of addiction now in, in countries like, uh, China and India, it's going up exponentially precisely because of the, uh... And it's, and it's not a question of idealizing the old way of life.

Dr. Rangan Chatterjee 1:24:18 No.

Gabor Maté 1:24:18 We, we can't go back. And, and, and of course, there's all kinds of benefits to, to progress and industrialization. Trouble is that as we progress, we forget the benefits of, uh, we forget what we've lost. So instead of combining progress with trying to hold onto what was best about some of the old ways, we just throw everything out, and, and we think we can reinvent ourselves. And as we do, we're making ourselves sick.

Dr. Rangan Chatterjee 1:24:42 Yeah. You're right, and I think it's a really great point to, to, to, to sort of bring up. We're not saying we need to go back to hunter-gatherer tribes.

Gabor Maté 1:24:49 We can't.

Dr. Rangan Chatterjee 1:24:50 We, yeah, n- not only should we not, we can't.

Gabor Maté 1:24:52 Yeah.

Dr. Rangan Chatterjee 1:24:52 And there, there are so many great benefits of the modern world, and-

Gabor Maté 1:24:55 Yeah

Dr. Rangan Chatterjee 1:24:55 ... as you say, industrialization. I guess it's, it's how do we learn from the past? How do we learn from our evolutionary heritage, and what can we implement from that within the constraints of the modern world? That, certainly that's how I see it. And you mentioned, uh, Johann Hari's new book, and, you know, I, I write, a huge quarter of my book on stress is about this. Um, is about relationships-

Gabor Maté 1:25:17 Yeah, yeah

Dr. Rangan Chatterjee 1:25:18 ... and our, our, our lack of connection these days. You know, one, on one level we are- We- we're being told anyway that we're more connected than we've ever been before. And-

Gabor Maté 1:25:30 Mm-hmm

Dr. Rangan Chatterjee 1:25:30 ... certainly in a digital sense that may be the case, but, you know, when we talk about real human meaningful connection, what I see around me with the public, but what I also see in my practice as a doctor is I don't think we've ever been this disconnected and lonely. And-

Gabor Maté 1:25:47 Well, we're more wired, but we're less connected is, is how I would put it. Uh, because genuine connection happens between people, not between pieces of technology. So as you and I are talking to each other, there's a real interaction.

Dr. Rangan Chatterjee 1:26:00 Yeah.

Gabor Maté 1:26:01 When you speak, I'm looking at you, I'm listening to the modulation of your voice. I may nod in agreement or shake my head in disagreement, vice versa, but the communication is taking place on many different levels. That's a connection. If you and I were having the same conversation online, it'd be a whole different, um, ballgame, and I'd have no idea actually who I'm talking to. They'd just be exchanging words. So we're wired together, but we're not actually connected. We're actually disconnected in this world 'cause people are isolated modules sending out messages via the, uh, ethernet or the internet.

Dr. Rangan Chatterjee 1:26:36 Yeah.

Gabor Maté 1:26:36 Um, when it comes to addictions, it, it, it's, it, it's that disconnection again, um, that, that leaves us so alone. So we're traumatized in the first place. We are then, um, develop, we then develop behaviors that soothe our pain, but which actually keeps us more isolated from other people 'cause we're ashamed of ourselves, and we hide it, and, and we, uh, furtively seek out our addictive pleasures. And that disconnection then furthers our sense of isolation. That isolation furthers our pain, and that pain further drives our addiction. So we live in a society that actually generates addiction in many of its members.

Dr. Rangan Chatterjee 1:27:20 Yeah. It really does, doesn't it? I, I, I did a, um, I did a post on my social media channels I think just yesterday actually-

Gabor Maté 1:27:28 Yeah

Dr. Rangan Chatterjee 1:27:28 ... about, uh, friendship.

Gabor Maté 1:27:31 Mm-hmm.

Dr. Rangan Chatterjee 1:27:31 And I was saying that, "Look, s- seeing your friends in real life-

Gabor Maté 1:27:36 Mm-hmm

Dr. Rangan Chatterjee 1:27:36 ... so not over the internet, in real life, is, um, a necessity for human health, not a luxury." And I know myself, I've neglected some of the friendships closest to me over the last few years-

Gabor Maté 1:27:47 Mm

Dr. Rangan Chatterjee 1:27:47 ... 'cause I've been busy with my career and my family, and so that, you know. And you sort of see on social media what your friends are doing, so you feel less of a need-

Gabor Maté 1:27:54 Mm-hmm

Dr. Rangan Chatterjee 1:27:55 ... to actually see them in, in real life. And I was, uh, really surprised with how, how, how much that post on social media resonated with people.

Gabor Maté 1:28:04 Yeah.

Dr. Rangan Chatterjee 1:28:05 So many people started interacting and saying, "Yeah, you know what? I've not seen my friends in months."

Gabor Maté 1:28:10 Hmm.

Dr. Rangan Chatterjee 1:28:10 You know? "Yes, I've, I've maybe had a, a bit of a text con- conversation with them, but I've not seen them in real life." And-

Gabor Maté 1:28:14 Yeah

Dr. Rangan Chatterjee 1:28:15 ... this was me trying to sort of challenge everyone to say, "Hey, look, get a date in the diary now, even if it's in two months' time, with one of your friends. Email them, call them, text them, whatever, but put a date in the diary where you're going to see your friends-

Gabor Maté 1:28:27 Absolutely

Dr. Rangan Chatterjee 1:28:27 ... in real life." And, and it's crazy, isn't it? That we need to, to say these things when these things have always been there in human culture, yet we're now having to talk about them and remind, remind us what has, what has just been our norm for so many thousands, millions of years.

Gabor Maté 1:28:44 And what's interesting, of course, is that on Facebook we use the same language as we would in real life. So on Facebook, people have friends.

Dr. Rangan Chatterjee 1:28:52 [laughs]

Gabor Maté 1:28:53 But these friends that we have, these are people we don't know, we have nothing necessarily in common with except maybe certain cultural ideas or interests. And so these friendships aren't genuinely supportive relationships. They're pseudo friendships, and we actually substitute the one for the other. And then on Facebook, people like each other, but, but, but, but, but which are, again, is a substitute for genuine contact. But it's not that they like each other. They don't, they don't even know each other. You don't know somebody until you've hung out with them. And, and so we substitute the language of friendship, and we substitute the language of connection for genuine friendship and genuine connection. And then we wonder why we feel so lonely and why we, we're so dissatisfied.

Dr. Rangan Chatterjee 1:29:33 And why we are seeking pleasure or seeking to numb that discomfort with the choices we're making, whether it is-

Gabor Maté 1:29:43 Yeah

Dr. Rangan Chatterjee 1:29:43 ... heroin, cocaine, or shopping and sugar.

Gabor Maté 1:29:48 Yeah. Yeah.

Dr. Rangan Chatterjee 1:29:49 Because I guess, you know, a lot of people who listen to my podcast are trying to make lifestyle change, and a lot of them feel inspired to do so by what they hear. But some of them, um, I know are, are struggling. Sorry to interrupt. If you're enjoying this video and want to dive deeper into the topic of nutrition, I have created a free special guide which contains the five most important changes I think we all need to make when it comes to our diet. If you wanna get hold of this free guide, all you have to do is click on the link in the description box below.

Gabor Maté 1:30:24 Well, you know, I'm very interested in language and, and even the phrase lifestyle change. It's not lifestyle changes people need to make. It's life changes people need to make.

Dr. Rangan Chatterjee 1:30:34 Yeah.

Gabor Maté 1:30:34 You can change the style.

Dr. Rangan Chatterjee 1:30:35 [laughs]

Gabor Maté 1:30:36 But style is a rather superficial thing. You know? The style of clothing, you know? Uh, it's the life changes that people need, and, and, and we need to p- help people see the life changes that are required, not the lifestyle changes they need to acquire. It, it's, it's the fundamental life that's being lived that needs to change, not, not the external behaviors. And lifestyle largely refers to behaviors, but not necessarily a transformation within. And really, to deal with addiction, um, it's not a question of dealing with the lifestyle. It's a question of dealing with the life, and it's a question of really owning the life, that this is my life, and I'm the one who needs to be, uh, the agent of my own life. And here are the reasons why the, the, the wound or... Trauma is another word for wound, actually. So the wounding that I received as a child has had me behave in certain ways. It's not those behaviors I need to change. I need to heal that wound. I need to change my life, and then the, the, the, the, the life behavior changes will automatically follow.

Dr. Rangan Chatterjee 1:31:41 Yeah, you br- you really, you, you really got me thinking about language actually because two terms that I use very commonly in my work, whether it's hypertension or lifestyle, you've, you've just, you know, in seconds-

Gabor Maté 1:31:53 Yeah

Dr. Rangan Chatterjee 1:31:53 ... reframed what those words actually mean. Uh, and I wonder where that comes from. You know, you're an immigrant to North America. Where has this fascination with language come from?

Gabor Maté 1:32:04 Well, I- I think as an immigrant you get to see the language a bit more clearly than the people-

Dr. Rangan Chatterjee 1:32:08 Yeah, that's true

Gabor Maté 1:32:09 ... who are, who are actually in it, and you get to see the construction of language. And, and by the way, you know, in my secret life I used to be an English teacher, so I, I, I did that be- before I went to medical school. So I've always paid a lot of attention to language. And language very often unconsciously expresses realities and truths that when you pay attention to it are, are revealing.

Dr. Rangan Chatterjee 1:32:30 Yeah.

Gabor Maté 1:32:30 And, uh, so words should never... Even the word addict. The word addiction actually comes from a Latin phrase for slavery.

Dr. Rangan Chatterjee 1:32:38 Wow.

Gabor Maté 1:32:38 S- so, a, a, a, a, a, a, a, a-

Dr. Rangan Chatterjee 1:32:41 A slave to the pain

Gabor Maté 1:32:42 ... well, uh, the-

Dr. Rangan Chatterjee 1:32:43 Right

Gabor Maté 1:32:43 ... the original meaning was an addictus, i- i- i- it comes from the word to assign. Now, in, in, in, in, in the Roman world when you couldn't pay a debt, you would be assigned as a slave to somebody until you worked off the debt. So you'd be an addictus, somebody who was assigned to somebody. So that's the origin of the word. So, so it implies slavery. So if we actually understand that, that addict refers or originates in a word for slavery, we realize that it's not a choice. 'Cause who would, uh, who would ever choose to be a slave, you know? So I think language is absolutely revelatory if you understand the sources and meanings of words.

Dr. Rangan Chatterjee 1:33:24 Yeah. Yeah, very much so.

Dr. Rangan Chatterjee 1:33:27 Gabor, I wanna go to, um, something you, you did last night in, in your talk, which-

Gabor Maté 1:33:33 Yeah

Dr. Rangan Chatterjee 1:33:33 ... you know, I went out for dinner with my friends afterwards, we all attended it, and we were all talking about it.

Gabor Maté 1:33:38 Mm.

Dr. Rangan Chatterjee 1:33:38 Um, which was you, you, you peppered throughout the evening, you said, "I... If there is anyone in here who feels they have some form of addiction-"

Gabor Maté 1:33:48 Yeah

Dr. Rangan Chatterjee 1:33:48 ... "without childhood trauma-"

Gabor Maté 1:33:50 Yeah

Dr. Rangan Chatterjee 1:33:51 ... "and you're happy to talk about it, please raise your hand." And, um, you know, at the end you, you actually found someone who, you know, quite confidently, uh, put their hand up and was, you know, pretty nonchalant that they had a, you know-

Gabor Maté 1:34:02 Happy childhood

Dr. Rangan Chatterjee 1:34:03 ... happy childhood. And-

Gabor Maté 1:34:04 Yeah

Dr. Rangan Chatterjee 1:34:04 ... so you started, uh, inquiring into her childhood. And I remember the tone of her voice initially was very much, you said, you know, "You have a happy childhood?" "Yes, happy childhood." Parents said, yeah. Parents absolutely loved me. You know, really sort of very vocal about how great her childhood was, and then it wasn't long before it became clear that actually she felt that her parents really loved each other and sometimes she was intruding on them.

Gabor Maté 1:34:28 That's right.

Dr. Rangan Chatterjee 1:34:29 And I think it was really powerful for the whole audience of 300 to see how, you know, how we all potentially tell ourselves a certain narrative, stories that we continue telling ourselves. And, you know, she obviously maybe is a fan of your work. She's come here, she, she's come to watch you speak, but hadn't reflected on her own experience. And I, I wonder, you know, what's going on there?

Gabor Maté 1:34:59 So what's happened here is that this woman says she had this happy childhood, but within a couple of minutes... And, and, you know, my mantra is wide, not wide addiction, but wide the pain. And so the, I, I always say that there's pain underneath it, and, uh, I said to the audience, "It never takes me more than three minutes to drill down to where the pain is. You just have to ask the right questions." So this-

Dr. Rangan Chatterjee 1:35:18 I, and I've gotta say, about a minute in-

Gabor Maté 1:35:20 Yeah

Dr. Rangan Chatterjee 1:35:20 ... I thought, "Oh, maybe this is the first one who Gabor won't get to." [laughs]

Gabor Maté 1:35:23 Yeah.

Dr. Rangan Chatterjee 1:35:23 You know? I, I actually thought, 'cause she was so confident in her answers.

Gabor Maté 1:35:26 Yeah.

Dr. Rangan Chatterjee 1:35:26 So anyway, please continue.

Gabor Maté 1:35:27 Well, well, that confidence itself is a giveaway-

Dr. Rangan Chatterjee 1:35:29 Yeah

Gabor Maté 1:35:29 ... because it's an assumed stance to protect herself from the pain that she doesn't want to feel or she's afraid to feel. So she said, "Well, maybe I felt I was intruding on my parents." And in other words, really what she felt was that she wasn't accepted and loved for who she was. And, and when she felt unhappy, there was nobody for her to be talk to, to talk to. And all you have to do is ask that person, "If your own child did the same thing, how would you understand it?" And they totally get it. So w- what's going on there, she's not lying.

Dr. Rangan Chatterjee 1:35:58 Yeah.

Gabor Maté 1:35:58 But believing that she had a happy childhood was her way of dealing with her pain, because if she dropped that idea, she'd have to realize that she suffered and she actually, as much as her parents did their best and loved her, we're not blaming the parents, but she herself got the impression that she was alone and unsupported and unloved for who she was. Now, that's very painful.

Dr. Rangan Chatterjee 1:36:18 Yeah.

Gabor Maté 1:36:18 So we defend against the pain by suppressing those emotions and developing this, this ideology of the happy childhood. And so that's just another form of self-defense. And then given her ideology that she had a happy childhood, she can't understand why she turned to an addiction. But once she gets that, yeah, okay, that belief that I was happy denies the fact that I was feeling isolated and alone, and I felt myself as an ex- as an intrusion on my parents.

Dr. Rangan Chatterjee 1:36:52 Yeah.

Gabor Maté 1:36:53 Now she can understand what her pain was. But, but not feeling that pain was how she survived her childhood, because as a child, how would she survive if she believed that she wasn't loved for who she was? Life would be intolerable for her, so she has to deny and suppress that.

Dr. Rangan Chatterjee 1:37:09 So she had an appropriate response to-

Gabor Maté 1:37:11 Or, or she-

Dr. Rangan Chatterjee 1:37:12 ... the signals that were given to her.

Gabor Maté 1:37:13 That's exactly what you said before, and that's exactly what happened with her. So that-

Dr. Rangan Chatterjee 1:37:17 Yeah

Gabor Maté 1:37:17 ... that suppression of her pain and denial of it is a completely appropriate defensive response.

Dr. Rangan Chatterjee 1:37:22 Yeah.

Gabor Maté 1:37:23 These are not mistakes that we make. These are, these are essential survival adaptations. The problem is then we spend a whole... Because we learned how to ignore our feelings as children, now we learn to ignore them for the rest of our lives, and that then creates problems for us. So again, it's that whole idea of an early adaptation, essential adaptation, brilliant adaptation, but because it's unconscious it stays with us, and now it limits our lives. So we become imprisoned with our own adaptations. Our, our, our, our childhood patterns become the prison through which we live our lives.

Dr. Rangan Chatterjee 1:38:01 So hopefully last night for her might have been a, a key step potentially in her now being able to really go out and seek real healing, transformative healing. Uh, hopefully, touch wood. Um-

Gabor Maté 1:38:14 Touch wood. But I would say that the very fact that she came to the talk, and the very fact that she raised her hand, she was already working at it.

Dr. Rangan Chatterjee 1:38:22 Yeah.

Gabor Maté 1:38:23 Because she didn't have to raise her hand.

Dr. Rangan Chatterjee 1:38:25 Yeah.

Gabor Maté 1:38:25 So if she did, it meant that she already had a curiosity about it.

Dr. Rangan Chatterjee 1:38:29 Yeah, absolutely.

Gabor Maté 1:38:29 So she, so she'd already taken the first step.

Dr. Rangan Chatterjee 1:38:32 Yeah, absolutely. Okay, but in your, in your book, uh, In the Realm of Hungry Ghosts, I think... Is it the second chapter where you talk about, um, a funeral you go to-

Gabor Maté 1:38:41 Yeah

Dr. Rangan Chatterjee 1:38:42 ... of one of your, uh, someone you were looking after, an, an addict. And-

Gabor Maté 1:38:45 A thirty, a thirty-five-year-old who overdosed, yeah.

Dr. Rangan Chatterjee 1:38:48 And I'll let you tell the story, but-

Gabor Maté 1:38:50 [clears throat]

Dr. Rangan Chatterjee 1:38:51 ... one thing it really illustrates to me is how, how... You know, addiction is on a, on a, is on a spectrum, of course. But how powerful that addictive, that, that addictive drive is for some people. And, and I just wonder if you could expand on that, 'cause that was really, really interesting.

Gabor Maté 1:39:10 So this woman's real name was Shannon, which I can tell now, and she was 35. And she was a beautiful woman as a young woman. Uh, when I met her she was already fading. She was in her mid-30s, or early 30s when I met her. Um, she had, uh, severe, uh, opiate addiction. And because she injected, she had, um, blood-borne infection in her, one of her knees, so she had osteomyelitis, uh, a joint infection, um, or a bone infection in her knee bones. She needed to be hospitalized for intravenous antibiotic care, but she could never be hospitalized long enough, because she had to leave and use. And every time she left and used she was, uh, expelled from the hospital.

Dr. Rangan Chatterjee 1:39:56 Ah.

Gabor Maté 1:39:56 So her osteomyelitis was never treated.

Dr. Rangan Chatterjee 1:39:58 Expelled from the hospital?

Gabor Maté 1:39:59 E- expelled from the hospital because she-

Dr. Rangan Chatterjee 1:40:01 She wasn't engaging in treatments?

Gabor Maté 1:40:03 Well, she was leaving the hospital to use.

Dr. Rangan Chatterjee 1:40:05 Right.

Gabor Maté 1:40:06 And, uh-

Dr. Rangan Chatterjee 1:40:06 So therefore they wouldn't treat her?

Gabor Maté 1:40:08 So the... Yeah. So she wouldn't... The, the, the, so they, they didn't want her using her IV lines for shooting o- o-

Dr. Rangan Chatterjee 1:40:13 Sure

Gabor Maté 1:40:14 ... and what not. Now, since then, we've developed a facility where people can have intravenous antibiotics and use if they need to, but this is before the days of that particular facility.

Dr. Rangan Chatterjee 1:40:25 Yeah.

Gabor Maté 1:40:25 So out of the regular hospitals she'd be regularly kicked out before her six or eight weeks of antibiotics treatment was completed. So by the mid-30s... A- and they were actually talking about amputating the knee, 'cause there's nothing more they could do. And so by her mid-30s she was in a wheelchair, and she would quickly wheel her wheelchair down a street looking for her next hit. Now, she left the Downtown Eastside for six months, and she actually got clean. And, um, then she came back, and within three days was dea- dead of an overdose. Because what happened, of course, is that she used the same amount she had left be- she had used before she left the Downtown Eastside, but now she was detoxed, so she'd lost her tolerance. You would understand-

Dr. Rangan Chatterjee 1:41:10 Yeah

Gabor Maté 1:41:10 ... what I mean by that.

Dr. Rangan Chatterjee 1:41:11 Yeah.

Gabor Maté 1:41:11 So the same dose that she could tolerate prior to leaving the Downtown Eastside, now that she was free of drugs, that same dose killed her.

Dr. Rangan Chatterjee 1:41:19 Wow.

Gabor Maté 1:41:20 And so she, we, so we went to her funeral, and there's all these friends of hers, each of them with their HIV or their Hepatitis C or their chronic infections, and they're, uh, mourning their friend.

Dr. Rangan Chatterjee 1:41:33 Yeah.

Gabor Maté 1:41:33 And I'm thinking how powerful the drive of the addiction is that this young woman would, would, would, would shed her life for the sake of that next hit. And her friends, who are watching her being buried and memorialized, are gonna continue using despite this dire example.

Dr. Rangan Chatterjee 1:41:51 Yeah, they're gonna continue using despite seeing that, that-

Gabor Maté 1:41:53 Yeah

Dr. Rangan Chatterjee 1:41:53 ... just seeing that wasn't enough to go, "Right. We're gonna change our behavior now."

Gabor Maté 1:41:58 No. And which is why anybody who thinks this is a choice is out of their minds. Nobody would choose to, to, to blight and endanger their lives like that. And, and-

Dr. Rangan Chatterjee 1:42:10 Yeah

Gabor Maté 1:42:10 ... so this is what made me thinking, "Well, what is this powerful drive?" I mean, it must be really deeply built in to the human brain and the human soul for people to engage in this behavior despite all this, um, um, deterrence-

Dr. Rangan Chatterjee 1:42:26 Yeah

Gabor Maté 1:42:26 ... that they witness around them. And so what made that event powerful for me was the starkness of the experience of these people, and the social idea that somehow this is any kind of a choice.

Dr. Rangan Chatterjee 1:42:41 Yeah. Wow. I mean, it's incredible to hear that actually, and certainly me and, and maybe, maybe all the listeners, um, on some level in their lives may know, not, maybe not to the same degree as that, but may know what that drive feels like when you, when you know you shouldn't be doing something, but you choose to do it nonetheless.

Gabor Maté 1:43:03 Well, I know that. I mean, I, I've had that in my own life, and, and there's something in you that knows you shouldn't be doing it. It's almost... Recently I, I, I became aware of a form of therapy called internal family systems.

Dr. Rangan Chatterjee 1:43:16 Oh, my God. That's what I'm doing at the moment. [laughs]

Gabor Maté 1:43:18 IFS.

Dr. Rangan Chatterjee 1:43:19 Yeah. It's incredible.

Gabor Maté 1:43:20 Dick Schwartz's stuff. Yeah.

Dr. Rangan Chatterjee 1:43:21 Yeah. I've had a, two or three sessions, and it's, it's been brilliant for me so far.

Gabor Maté 1:43:25 Amazing.

Dr. Rangan Chatterjee 1:43:26 Yeah.

Gabor Maté 1:43:26 So I, I met the founder of it recently. We've become good friends, and, uh... But, but I've learned the technique to some degree. I'm, I'm not an official practitioner of it, but I, I'm quick to catch on. So in internal family systems, you realize there's these different parts of you, and these different parts form like a, a, a squabbling family. Like, some of them like each other, some of them don't like each other. So- There's a part of me that can watch the other part doing its thing, knowing that he shouldn't be doing it, but feels quite helpless to intervene. So I watch myself, like for example, when I am supposed to be working, looking after clients, but instead I watch myself go to the store to engage in my shopping addiction. I'm not unaware of what's happening. There's a part of me that's watching it, disapproving of it, wanting me not to do it, but that part is not strong enough to assert itself. The part that's driving the behavior is leading, is driving the boat.

Dr. Rangan Chatterjee 1:44:26 Yeah.

Gabor Maté 1:44:26 And, uh, so it, it, it's a question of becoming friendly with all these parts, finding out what is it they really want, what are they after? The part that's driving me to do the shopping when I should be looking after my patients-

Dr. Rangan Chatterjee 1:44:43 Yeah

Gabor Maté 1:44:43 ... is a part that really is desperate for, for me to, desperate for me to feel good for a moment. That's all it wants. It just wants me to be happy. It's not an evil part, it just wants me to be happy. And, and it's not a question of indulging it, but it's a question of really getting to know it.

Dr. Rangan Chatterjee 1:45:01 And understanding it.

Gabor Maté 1:45:03 Understanding it, and actually being compassionate with it. And, and then teaching it, "You know what? It's okay, but this guy can be happy without indulging in that behavior."

Dr. Rangan Chatterjee 1:45:14 Yeah.

Gabor Maté 1:45:14 "He doesn't need to do that. You may think he does, but he doesn't."

Dr. Rangan Chatterjee 1:45:18 I wish I had the courage to express my feelings.

Gabor Maté 1:45:21 My emotions, yeah.

Dr. Rangan Chatterjee 1:45:23 Which is, I guess, not dissimilar to the first one about living a life that's true to yourself.

Gabor Maté 1:45:28 No. And it, again, it again, is the word courage that shows up.

Dr. Rangan Chatterjee 1:45:32 Mm.

Gabor Maté 1:45:32 And these people are judging themselves. A more interesting way to put it is, why is it that I didn't express my feelings, you know?

Dr. Rangan Chatterjee 1:45:42 Mm.

Gabor Maté 1:45:42 Now, here's the thing. Um, again, in my writing, uh, in The Myth of Normal, I quote this great neuroscientist who died in his mid-70s of cancer a few years ago. Those of us who knew him still mourn him. His name was Dr. Jaak Panksepp, P-A-N-K-S-E-P-P. He was, uh, from the Baltic states, whether he was Estonian, I think he was, but maybe L-L-Latvian, you know. And he was an, uh, effective neuroscientist, so he studied the neurobiology of emotions, and he wrote a book called The Archeology of the Mind. It's among the seminal books-

Dr. Rangan Chatterjee 1:46:23 Mm

Gabor Maté 1:46:23 ... of modern science. And he pointed out that we share certain emotional circuits with other animals. So we have circuit- and he capitalized these circuits, these systems. So he, he, the C-A-R-E, the care system.

Dr. Rangan Chatterjee 1:46:38 Mm-hmm.

Gabor Maté 1:46:39 And there's a system for anger, system for fear, for lust, for playfulness, for joy, in other words, for seeking, which is curiosity, um, grief. And we share these brain circuits with other mammals. In other words, these emotions are not luxuries. They are emotionally, I should say, they are evolutionarily determined aspects of who we are. So if you take the care system, it's essential because without care, the mammalian infant doesn't survive.

Dr. Rangan Chatterjee 1:47:21 Mm.

Gabor Maté 1:47:22 There's gotta be something in the parent's brain that drives that parent to take care of the infant.

Dr. Rangan Chatterjee 1:47:27 Mm.

Gabor Maté 1:47:28 And something that's in the infant's brain that impels them to connect with the parent in order to be taken care of. That's just evolutionary biology. So we have all these emotional systems. Anger is one of them, um, as I mentioned, fear, grief are others. And children, one of the emotional needs of children, when I studied and invest- you know, and interviewed experts on child development, uh, one of the things I learned and write about is that one of the needs of children for healthy brain development is the freedom to experience and express all the emotions that come up for them.

Dr. Rangan Chatterjee 1:48:08 Mm.

Gabor Maté 1:48:08 That's just necessary for health. Um, now what happens in this society where a lot of parents get the message that certain emotions on the part of their kids are not acceptable. So, you know, a kid might experience a loss, like a dog might die or grandpa might die, and the child is upset, and the parent can't handle the child's grief. "So snap out of it, it's just a dog," or, or, "Yeah, get over it. People die." You know? Um, or a child experiences anger-

Dr. Rangan Chatterjee 1:48:43 Mm

Gabor Maté 1:48:43 ... uh, 'cause you didn't give them a cookie before dinner, you know, and a two-year-old throws a tantrum, and you can't handle it. Um, I think you and I have talked about this before.

Dr. Rangan Chatterjee 1:48:52 Yeah.

Gabor Maté 1:48:52 Then the child gets the message that in order to be acceptable to the parent, they have to suppress their emotions. So when these people talk about that, and that suppression of emotion, as I've often made the case with you and in my books, actually undermine health and, and, and our physiology and our immune system. So when these people, in their dying weeks regret not having had the courage to express their emotions, what they're really talking about is that long time before, when they were children, they were forced to suppress their emotions for the sake of being accepted.

Dr. Rangan Chatterjee 1:49:30 Yeah.

Gabor Maté 1:49:30 And now they regret it, 'cause they, they sense that they were forced to abandon themselves.

Dr. Rangan Chatterjee 1:49:37 Yeah.

Gabor Maté 1:49:37 And so, again, I would remove the word courage and ask, instead of judging them for lacking courage, I would say, "What happened to them?" Because again, no infant ha- lacks the capacity to express their emotions.

Dr. Rangan Chatterjee 1:49:53 Yeah.

Gabor Maté 1:49:55 So if they lose it, it's 'cause they learned that they had to

Dr. Rangan Chatterjee 1:50:00 In terms of something practical around this point, Gabor, if, if there's any parents listening and their kids, let's say, sometimes get angry or have a tantrum-

Gabor Maté 1:50:15 Yeah

Dr. Rangan Chatterjee 1:50:15 ... whatever it might be-

Gabor Maté 1:50:16 Yeah

Dr. Rangan Chatterjee 1:50:18 ... of course there is a, a certain conditioning in our modern, certainly in Western society, about what one should do about that.

Gabor Maté 1:50:25 Yeah.

Dr. Rangan Chatterjee 1:50:26 Given your view in terms of what is important for a child-

Gabor Maté 1:50:30 Yeah

Dr. Rangan Chatterjee 1:50:30 ... and what you've just said, what would you encourage a parent to do when their child is, I was gonna use the word playing up, but, but that's a ridiculous term because playing up is a societal construct-

Gabor Maté 1:50:43 Yeah

Dr. Rangan Chatterjee 1:50:43 ... the child is just expressing emotions and we're calling it playing up because we don't like, you know, what it's doing or-

Gabor Maté 1:50:50 Right

Dr. Rangan Chatterjee 1:50:50 ... what the people next door are thinking or whatever it might be, right? So-

Gabor Maté 1:50:53 The North American term is acting out.

Dr. Rangan Chatterjee 1:50:55 Acting out.

Gabor Maté 1:50:56 Yeah. Do they use that phrase here? Uh, uh-

Dr. Rangan Chatterjee 1:50:57 Yeah, they do

Gabor Maté 1:50:58 ... yeah.

Dr. Rangan Chatterjee 1:50:58 They, they use this phrase here.

Gabor Maté 1:50:59 Yeah. Yeah.

Dr. Rangan Chatterjee 1:51:00 So, so going back to that, um, the parent who may be struggling but wants to be a better parent, wants to go, "Actually, you know what, Gabor, I really want to make sure that I allow my child to express their emotions-

Gabor Maté 1:51:14 Yeah

Dr. Rangan Chatterjee 1:51:14 ... do you have any advice for me?"

Gabor Maté 1:51:16 Well, uh-

Dr. Rangan Chatterjee 1:51:16 What would you say to them?

Gabor Maté 1:51:17 No, I do. Well, so th- you know, there's, um, we can talk about three modes of parenting. One is the permissive parenting where you allow any behavior and you don't intervene or, you know, that's not... That's the worst thing you can do. Kids needs to-

Dr. Rangan Chatterjee 1:51:33 But that is allowing them to express themselves-

Gabor Maté 1:51:37 Yeah, but, uh-

Dr. Rangan Chatterjee 1:51:38 ... I think

Gabor Maté 1:51:38 ... uh, there's a difference. Uh-

Dr. Rangan Chatterjee 1:51:40 Okay

Gabor Maté 1:51:40 ... they might express themselves by hitting their sibling, for example, and you don't allow that. Parents need to f- kids need to feel that somebody's in charge.

Dr. Rangan Chatterjee 1:51:48 Yeah.

Gabor Maté 1:51:48 Parenting is not a democracy. It's a hierarchy. Um, in a hierarchy, there's a dominant force. The parent dominates the child, not to exploit or to suppress, but to nurture and to support, you know? So that, you know, you live in Manchester, and I don't know how cold it gets in Manchester, but if you have a one-year-old child, they don't get to vote on whether they get to crawl outside in the wintertime in Manchester, you know, naked, you know? The parent says, "No, you don't go outside naked, you know. You have got to put clothes on." That's just how it is. It's a hierarchy. It's not a democracy. The one-year-old doesn't get a vote-

Dr. Rangan Chatterjee 1:52:25 Okay

Gabor Maté 1:52:26 ... on g- being going into the, into the slush and the snow in the middle of December or whenever. Um, so that's permissive parenting. That's not very good. Uh, then there's repressive parenting, which some experts that we've talked about advocate. That's authoritarian parenting. In between them is the golden mean. So there's permissive parenting here, authoritarian parenting here, then there's authoritative parenting in the middle. Authoritative parenting is, "I'm in charge. I know what's good for you. Um, I'm the authority, um, so I know what to do with you." So if a child is upset, you say, "Oh, you're upset. You know, you're angry with Mommy. Mommy wouldn't let you have a cookie before dinner. Yeah. You're really upset about that. Yeah. Well, come here. I know how you feel." In other words, you validate the emotion, you don't punish the child for it, and you hold the child, 'cause the child needs to learn that they can go through these difficult emotions and get through them.

Dr. Rangan Chatterjee 1:53:26 And still be loved.

Gabor Maté 1:53:27 And still be loved, yeah. Now, that doesn't mean you let them pull the cat's tail or to break the, uh, break the glass, you know, or, uh, smash the furniture or hit their sibling. But it does mean you validate the emotions and you hold them, and then they learn, "Ah." And, and actually, and when they... And it's also age-specific.

Dr. Rangan Chatterjee 1:53:48 Mm.

Gabor Maté 1:53:49 Like, y- there's no point saying to an angry one-and-a-half-year-old, "Let's find... Let's express it through words." They don't have the words.

Dr. Rangan Chatterjee 1:53:56 Mm-hmm.

Gabor Maté 1:53:57 But to a five-year-old you can say, "Can we find some words for your anger?" In other words, you can teach them to express their emotions in ways that are, um, socially appropriate.

Dr. Rangan Chatterjee 1:54:09 Yeah.

Gabor Maté 1:54:09 So at any age, you have to be age-appropriate, but fundamentally, you validate the emotions and you hold the child, and you make them feel that, "You can have these emotions. I don't want you behaving that way, but you can have the emotion, and I'm not gonna reject you for it." It's not that hard, and-

Dr. Rangan Chatterjee 1:54:25 No

Gabor Maté 1:54:25 ... people do it on- intuitively sometimes.

Dr. Rangan Chatterjee 1:54:28 Yeah. And the impact of parenting like that will be felt for the rest of that child's life.

Gabor Maté 1:54:37 Well, absolutely.

Dr. Rangan Chatterjee 1:54:38 And that's the key, isn't it? You look at, look around society. It's very, very hard to not make the case that we have to set up society so that those early years are where the kids get good nutrition, they have calm environments, they have present parents. You know, I'm always shocked at the amount of leave that, um, people in America-

Gabor Maté 1:55:03 Mm

Dr. Rangan Chatterjee 1:55:03 ... get or mothers get in jobs in America. I think one of my friend's partners in America got two weeks off.

Gabor Maté 1:55:10 Oh.

Dr. Rangan Chatterjee 1:55:11 Which, which I, I, I thought, what? Two weeks off after giving birth.

Gabor Maté 1:55:14 Well, when I researched The Myth of Normal, I found that 25% of women in the States go back to work within two weeks of giving birth, which 25% of women, now needless to say, this is both economically and racially determined. But it means that it's a massive abandonment of the child-

Dr. Rangan Chatterjee 1:55:33 Yeah

Gabor Maté 1:55:33 ... 'cause as, from the point of, of the development of enzymes in the child, the child's physiological unfoldment, psychological security, they need the mother for many, many, many, many months. And you try and take an infant away from a, an orangutan at two weeks and see what happens.

Dr. Rangan Chatterjee 1:55:52 Yeah.

Gabor Maté 1:55:52 You know? And, uh, in fact, I- They've done some very cruel studies with monkeys that shows the impact of maternal deprivation at those early ages. You know, studies that are terrible to read about.

Dr. Rangan Chatterjee 1:56:09 Yeah.

Gabor Maté 1:56:09 But... And they prove what? They prove that love and contact and connection is important, something we should've known all along.

Dr. Rangan Chatterjee 1:56:15 Yeah.

Gabor Maté 1:56:15 But the point is that the statistic that 25% of women have to go back to work within two weeks of work, within two weeks of giving birth, it's a massive abandonment of children, the s- the impact of which will show up in their mental and physical health decades on.

Dr. Rangan Chatterjee 1:56:31 Yeah.

Gabor Maté 1:56:32 And then they wonder why there's so many problems.

Dr. Rangan Chatterjee 1:56:38 Tomorrow is the yearly Prescribing Lifestyle Medicine course that I've been running, uh, with a colleague, Dr. AM Panja, since 2018. And-

Gabor Maté 1:56:46 Mm

Dr. Rangan Chatterjee 1:56:46 ... of course, you're gonna be the guest speaker tomorrow.

Gabor Maté 1:56:48 Mm.

Dr. Rangan Chatterjee 1:56:48 And I'm, I'm really excited that we're gonna be able to communicate with doctors and share your work and how they can bring your work into their practice. It's really, really exciting.

Gabor Maté 1:56:59 Mm.

Dr. Rangan Chatterjee 1:57:01 One of the things I'm hoping you're gonna be able to share with the audience tomorrow is what I think is the biggest hole in medical school training.

Gabor Maté 1:57:14 Mm-hmm.

Dr. Rangan Chatterjee 1:57:15 If you'd asked me five years ago, I may have said, "Oh, nutrition and sleep, and we need to teach doctors about the importance of this stuff," and we do.

Gabor Maté 1:57:22 Yeah.

Dr. Rangan Chatterjee 1:57:24 But if I had to choose one thing that I think is the biggest hole in medical training today, for me it's that doctors, a lot of doctors leave medical school without an understanding that our emotions-

Gabor Maté 1:57:41 Mm. Oh, I see what you're saying. Yeah

Dr. Rangan Chatterjee 1:57:42 ... that the way we think, holding on to anger, resentment, not being able to forgive and move on, I really don't feel within medicine there's an understanding that this can contribute to ill health.

Gabor Maté 1:57:58 Yeah. It's such a gap. And, um, I think both you and I have had to discover it, not as a consequence, but despite our medical education.

Dr. Rangan Chatterjee 1:58:08 Yeah.

Gabor Maté 1:58:09 And, uh, when you're in practice and you... I mean, as a family physician, um, we do have an advantage over specialist colleagues-

Dr. Rangan Chatterjee 1:58:17 Mm

Gabor Maté 1:58:17 ... in that we know people before they get sick.

Dr. Rangan Chatterjee 1:58:19 Yeah.

Gabor Maté 1:58:20 So we get to see who gets sick. And, uh, I couldn't help but notice that people's emotional lives are so intertwined with the physiological health. And a- as you suggest, nobody in medical school told me that. It's, it's a huge gap. Now, it, it, it also has to do with how we relate to ourselves, by the way, 'cause the way doctors are trained is very often very stressful and very, um, almost traumatic in significant ways. So that in... That's why I mentioned the word self-care, because in being trained to stoically ignore ourselves, we also are dismissing the importance of-

Dr. Rangan Chatterjee 1:58:59 Mm

Gabor Maté 1:58:59 ... emotions in our clients.

Dr. Rangan Chatterjee 1:59:01 Yeah.

Gabor Maté 1:59:01 So that I wish there was more emphasis in medical school on dealing with our own stuff.

Dr. Rangan Chatterjee 1:59:07 Yeah, for sure.

Gabor Maté 1:59:08 And in conjunction with that, therefore the awareness of the importance of people's emotional lives.

Dr. Rangan Chatterjee 1:59:15 Yeah.

Gabor Maté 1:59:16 And, and what's really interesting here is that some of the great pioneers of medicine have known this all-

Dr. Rangan Chatterjee 1:59:22 Yeah

Gabor Maté 1:59:22 ... along, and they've said it hundreds of years ago. Well, uh, Jean-Martin Charcot, who first described multiple sclerosis, said that this is related to stress and grief. And, uh, it is statistically and according to studies since then, but he just saw it. He didn't, you know... And, uh, there's a great British surgeon, James Paget.

Dr. Rangan Chatterjee 1:59:43 Yeah.

Gabor Maté 1:59:43 You know, Paget's disease, and he operated on, on women with breast cancer. And he said that breast cancer is indubitably related to emotional factors, that it's so evident that it's hard to ignore. And s- so these great pioneers said this, and their teachings have been completely ignored.

Dr. Rangan Chatterjee 2:00:00 Yeah. Let's be really clear. This is such a delicate area for people because many people perceive that as fault and as blame.

Gabor Maté 2:00:09 Yeah, yeah.

Dr. Rangan Chatterjee 2:00:09 I know you don't mean it like that. I don't mean it like that when I talk about it either.

Gabor Maté 2:00:13 Yeah.

Dr. Rangan Chatterjee 2:00:13 But often it's like, "What are you saying, that I did this to myself," right? You must have had that before. People must have said that.

Gabor Maté 2:00:20 Yeah, yeah. Yeah, yeah.

Dr. Rangan Chatterjee 2:00:21 Just s- just clarify that for them, please.

Gabor Maté 2:00:23 Well, really we've been talking about it, that the, um, suppression of emotion, nobody's born with it, and it's not a lack of courage or wisdom.

Dr. Rangan Chatterjee 2:00:36 Mm.

Gabor Maté 2:00:36 It's a programmed response to childhood experience.

Dr. Rangan Chatterjee 2:00:40 Mm.

Gabor Maté 2:00:41 So people have got the message bef- before they, uh, had any choice in the matter, that if they are truly themselves, if they express who they are, their emotions, just like we've been talking about, they won't be accepted. So that's a programming that people, um, are ingrained in in their early childhood. How is that their fault?

Dr. Rangan Chatterjee 2:01:02 Yeah.

Gabor Maté 2:01:02 It's just the way they ad- adapted to the environment necessarily. As a matter of fact, it was an inevitable and unavoidable adaptation, 'cause the alternative of being rejected by their families or their milieu was not acceptable-

Dr. Rangan Chatterjee 2:01:16 Mm

Gabor Maté 2:01:16 ... to a small child. So therefore, nobody does this to themselves in any conscious or deliberate sense. What I can tell you is that when people are diagnosed and they become aware of these dynamics, they find that liberating.

Dr. Rangan Chatterjee 2:01:32 Yeah.

Gabor Maté 2:01:33 So, uh, in The Myth of Normal, I quote the, um, the American singer Sheryl Crow, who was diagnosed with breast cancer, and she said that, "Before the diagnosis, I was always pleasing others and not expressing myself, and there was always a voice in my head that I'm wrong and I-" I have to adjust myself to other people's expectat-... I'm paraphrasing her, but she s- but she said, "I've learned differently now."

Dr. Rangan Chatterjee 2:01:57 Mm.

Gabor Maté 2:01:57 "And now I'm really paying attention to myself." So again, this, this idea of disease as teacher. Now, Sheryl Crow wasn't born like that-

Dr. Rangan Chatterjee 2:02:04 Yeah

Gabor Maté 2:02:04 ... and she didn't choose to be that way. That was her response to her upbringing. So nobody's being faulted here. But we are saying, people, if you allow that disease to wake you up and to teach you something, you might have a whole lot better life than you could have imagined.

Dr. Rangan Chatterjee 2:02:20 Yeah. Well, I think this is really, really interesting. We can, first of all, make the case to people that emotions matter. The express- the, the ability to express your emotions is important. If you repress them-

Gabor Maté 2:02:35 Yeah

Dr. Rangan Chatterjee 2:02:36 ... it may well have some quite severe physical consequences.

Gabor Maté 2:02:39 Yeah.

Dr. Rangan Chatterjee 2:02:40 So let's say that a doctor accepts that and goes, "Okay, so what do I do with that?"

Gabor Maté 2:02:47 Well, what do doctors do with it? Well, here's the thing. It depends how you're oriented. Like, I'm kind of psychologically oriented. I've always been inter-

Dr. Rangan Chatterjee 2:02:58 Me too

Gabor Maté 2:02:58 ... I've always been interested in it. Um, so for me, it was a natural movement from strictly f- focusing on the physical symptoms to dealing with the whole person. Another physician may recognize the value of this, but not have the orientation to deal with it.

Dr. Rangan Chatterjee 2:03:16 Mm.

Gabor Maté 2:03:16 But at least they can say to their clients, "Listen, there's a lot of information now. So when you come in with your rheumatoid arthritis, or your multiple sclerosis, or your chronic eczema, or chronic migraines, or irritable bowel syndrome, or inflammatory bowel disease, or whatever you happen to present with, there's a lot of information now, a lot of scientific information, information that, uh, shows the connection between... actually, in fact, the unity of mind and body, and the inextricable, mm, relationship between the immune system and emotions and so on. I'm not myself trained in that. I'm gonna deal with the physical aspects of the illness. I'm gonna prescribe for you the indent- anti-inflammatories-

Dr. Rangan Chatterjee 2:04:00 Mm

Gabor Maté 2:04:01 ... or the immune suppressants or the steroids or whatever you happen to need to mitigate the symptoms. But can I send you to somebody so you can talk about this stuff? Would that interest you?" You know?

Dr. Rangan Chatterjee 2:04:12 Yeah.

Gabor Maté 2:04:12 So you can do that. So we're not necessarily talking about every doctor having to become an expert on this, but at least they should be aware of it so they can steer people to a broader approach-

Dr. Rangan Chatterjee 2:04:24 Yeah

Gabor Maté 2:04:24 ... to their illness, number one. Number two, there's certain simple things any doctor can ask. Like one of my books, When the Body Says No, that's the title. Um, and in The Myth of Normal there's a chapter called When- Before the Body Says No. You can ask your client, it's a very simple question, "Where in your life are you not saying no?"

Dr. Rangan Chatterjee 2:04:44 Mm.

Gabor Maté 2:04:45 "Where there's a no that wants to be said, but you're not saying it for the sake of pleasing others?" Can you just consider that one?

Dr. Rangan Chatterjee 2:04:52 Mm-hmm.

Gabor Maté 2:04:52 Because that simple issue of not saying no can play havoc with your health.

Dr. Rangan Chatterjee 2:04:58 Mm-hmm.

Gabor Maté 2:04:58 'Cause if you're not saying no when they, when you're, when you're wanting to say no, you're actually suppressing yourself.

Dr. Rangan Chatterjee 2:05:06 Mm.

Gabor Maté 2:05:07 And then you're taking on more stress and more burden. So those simple questions any doctor can ask.

Dr. Rangan Chatterjee 2:05:13 Yeah.

Gabor Maté 2:05:13 So it's not as complicated as all that.

Dr. Rangan Chatterjee 2:05:15 Yeah.

Gabor Maté 2:05:15 But the point is, the first step is just to be aware of the connection that you mentioned between emotions-

Dr. Rangan Chatterjee 2:05:22 Yeah

Gabor Maté 2:05:22 ... and physiology. Then if the physician wants to take on a deeper study of it, they can. If they don't, at least they can guide people-

Dr. Rangan Chatterjee 2:05:31 Yeah

Gabor Maté 2:05:31 ... to, to, to, to, to explore that connection somewhere else.

Dr. Rangan Chatterjee 2:05:34 Yeah, completely agree. Thank you.

Gabor Maté 2:05:36 Yeah.

Dr. Rangan Chatterjee 2:05:37 Fourth regret, "I wish I stayed in touch with my friends."

Gabor Maté 2:05:41 Yeah. Well, what we're talking there is... a- and it goes back to the others about working too hard, you know? For example, um, what, what are, what are they discussing there is the need for attachment, for connection, for belonging. And what these people are saying is, "I was too driven by whatever factors impelled me to ignore my personal relationships and to port my attention on things that ultimately don't matter, my acquisition, my attainment, my achievement, uh, rather than the heart-to-heart human contact-

Dr. Rangan Chatterjee 2:06:21 Mm-hmm

Gabor Maté 2:06:21 ... with people that matter to me." And again, people are driven to be that way, and when they look back on their life, they regret it because nobody, as, as often is said, nobody ever on their deathbed regrets not going to the office often enough, you know [laughs] . But they do regret the heart connection-

Dr. Rangan Chatterjee 2:06:45 Yeah

Gabor Maté 2:06:46 ... that, that, that they've sacrificed.

Dr. Rangan Chatterjee 2:06:49 Have you stayed in touch with your friends?

Gabor Maté 2:06:52 Well, you know, uh, that's where you could say that I haven't. Um, I mean, I have more, much more recently. It, it matters to me much more now. But over the years, um, I put work and my busyness and my writing ahead of all that.

Dr. Rangan Chatterjee 2:07:11 Is it at all balanced out by the fact that your work and your writings-

Gabor Maté 2:07:17 Yeah

Dr. Rangan Chatterjee 2:07:17 ... have influenced the lives of millions of people? I guess what I'm trying to get at is, on a personal level, you may have sacrificed your friendships-

Gabor Maté 2:07:31 Yeah

Dr. Rangan Chatterjee 2:07:31 ... but perhaps the world has benefited from Dr. Maté doing that. Is, is that fair to say?

Gabor Maté 2:07:41 It's fair to say, and to some extent I accept that, that I've made certain decisions, and those decisions have benefited many, and it means that there's certain things I've missed out on. Um, but not completely, and, uh, I'm much more prone now to seek out those friendships and to strengthen them and to celebrate them and to value them. And I've, I've, I, I have some really good friends, you know, and, and the people that really care about me, and I care about them, and we're there for each other no matter what, you know? So that matters to me much more than it used to. And, uh, to put it to the real test, if I were to choose to live my life over again, I wouldn't live it in this way.

Dr. Rangan Chatterjee 2:08:26 Yeah.

Gabor Maté 2:08:27 I would say, yeah, I, I have some insights. I have some capacity to articulate some truths, uh, that are really important, and I'm not gonna let that dominate how I live my life.

Dr. Rangan Chatterjee 2:08:41 Mm.

Gabor Maté 2:08:42 Um, and I think it would've been possible for me to express that voice and, and, and, and to, mm, put those teachings out in the world, that I get the feeling, feedback that it does help a lot of people. But I could have done that without the drivenness-

Dr. Rangan Chatterjee 2:09:01 Mm

Gabor Maté 2:09:01 ... without the sacrificing of the heart, without the... and, and connection-

Dr. Rangan Chatterjee 2:09:07 Yeah

Gabor Maté 2:09:07 ... that sometimes that entails. So, you know, again, if I could live it, do it over again, I would do it differently, and I don't think in the end that would've detracted-

Dr. Rangan Chatterjee 2:09:17 Yeah

Gabor Maté 2:09:17 ... from my message. And if it did, I would accept that.

Dr. Rangan Chatterjee 2:09:20 Yeah. If that conversation resonated with you, here is another incredibly powerful one that I really think you're going to enjoy. Give it a click.

Host 2:09:28 If you actually went to the happiness gym several times a week, you will actually have a happier life, right? And the happiness gym is very straightforward. It's a set of skills, hm, that you need to practice