How SOCIETY & CULTURE Leads Us Down A Path Of TRAUMA & ADDICTION | Dr. Gabor Maté

Dr. Gabor Maté 0:00 Addiction is the most human thing there is. All addictions, they're attempts to gain pain relief, emotional pain relief for something or another. Then this whole society is so expert at selling us stuff to fill those holes temporarily. This is the whole ethic of this culture. [upbeat music]

Dr. Rangan Chatterjee 0:18 Would you go as far as to say that pretty much all of us in Western society are addicted to something?

Dr. Gabor Maté 0:26 Well, your words about what it means to be a human being really speak to me because addiction is the most human thing there is. And, uh, when you understand it-- When you don't understand it, it looks like an aberration and an abnormality and some kind of a, a moral deviation. But when you understand it, it's a very human thing. So let's just define addiction as, um, manifested in any behavior that a person finds temporary pleasure or relief in, and therefore craves, and continues with it despite negative consequences. So the definition then involves pleasure, relief, craving in the short term, harm in the long term, inability to give it up despite the harm. Now, by that definition, of course, we're not just talking about drugs. We're talking about all manner of behaviors, from, uh, sex to pornography to gambling to eating to shopping to the internet to, to gaming, um, to self-cutting, uh, to work, as probably as a physician you know, and, and to any number of other activities. And my contention is that all addictions, they're not primary problems, they're not inherited diseases, they're not aberrations, they're not moral failures. They're attempts to gain pain relief, emotional pain relief for something or another. And so the first question in addiction for me is not why the addiction, but why the pain? And so if you have to look at why the pain, we have to look at people's lives, their life experience, their traumas, their, um, their adversity, their, their suffering. And so that's why I say that now when you talk to other people, "What did you get from your addiction?" They'll say, "Peace of mind." They'll say, "Connection with other people." They say, "Sense of control." They say, "Stress relief." Um, they say, "Sense of purpose." Those are all supremely human qualities. In fact, they're qualities that we all want-

Dr. Rangan Chatterjee 2:21 Yeah

Dr. Gabor Maté 2:21 ... in fact, have every right to expect. So that's why I say there's nothing more human than addiction. Now, problem of course is it creates more pain. But the, but the impulse is simply the addict just wants to feel like a normal human being. That's all.

Dr. Rangan Chatterjee 2:40 Yeah. It's such a profoundly different way of looking at addiction compared to, I think, the norm in society. Certainly the way many people view, you know, addicts.

Dr. Gabor Maté 2:55 Yeah.

Dr. Rangan Chatterjee 2:55 There, there's a, there's a certain view, isn't there, the, the, the addict is on the street corner, is homeless, is destitute.

Dr. Gabor Maté 3:01 Yeah.

Dr. Rangan Chatterjee 3:02 Yet we often don't want to put that mirror up and look at our own lives and go, oh, wow, you know, by your definition-

Dr. Gabor Maté 3:08 Yeah

Dr. Rangan Chatterjee 3:08 ... by that definition, there's probably very few of us who can honestly hold our hands up and say, at some point in our life we weren't addicted to something.

Dr. Gabor Maté 3:17 I think in this society, hardly anybody. Hence, in part, hence the title of my book, The Myth of Normal. Like, we think that so many things are normal, then there's the abnormal people-

Dr. Rangan Chatterjee 3:27 Yeah

Dr. Gabor Maté 3:27 ... who are different from us. I'm saying that that's a myth. That, that, that from the m-m-- from the most abject and most dependent and most ill drug addicted people that I worked with in Vancouver, Canada, to the most elevated segments of society, addictions are just rife.

Dr. Rangan Chatterjee 3:49 Yeah.

Dr. Gabor Maté 3:49 And, and, and we're completely are blind when we choose one segment of the population to ostracize and to punish and to feel superior to. And what we're really doing is denying our own humanity-

Dr. Rangan Chatterjee 4:02 Yeah

Dr. Gabor Maté 4:03 ... when we do that.

Dr. Rangan Chatterjee 4:05 There's all manner of different things that people can be addicted to.

Dr. Gabor Maté 4:09 Yeah.

Dr. Rangan Chatterjee 4:10 I want to talk about one which I don't think is spoken about enough, and that's online pornography.

Dr. Gabor Maté 4:16 Yeah.

Dr. Rangan Chatterjee 4:17 It is something that I think is-- it's just seeping there underneath. People aren't talking about it. I remember one of my patients, uh, not that long ago, this young man, he couldn't look at me, Gabor.

Dr. Gabor Maté 4:31 Mm.

Dr. Rangan Chatterjee 4:31 He couldn't look at me in the eye.

Dr. Gabor Maté 4:32 So ashamed?

Dr. Rangan Chatterjee 4:33 So ashamed.

Dr. Gabor Maté 4:35 Yeah.

Dr. Rangan Chatterjee 4:35 And he was just sharing with me how he was addicted to online pornography.

Dr. Gabor Maté 4:39 Yeah.

Dr. Rangan Chatterjee 4:40 And, um, when I asked him, has he opened up with anyone? Has he shared with anyone? No. Hasn't told a single person.

Dr. Gabor Maté 4:46 Yeah.

Dr. Rangan Chatterjee 4:46 I was the first person he told. And what was really interesting, as I got to know him and I built up trust with him and rapport, and he knew that he could open up with me, and I wasn't gonna judge him or invalidate him or look down on him-

Dr. Gabor Maté 5:01 Yeah

Dr. Rangan Chatterjee 5:01 ... actually, for this particular chap in his life, he was very isolated. He didn't have a tribe. He didn't have a community. There was no part of his life where he felt like he belonged. And for him, the ultimate solution was actually joining a boxing club. It, it wasn't just the physical activity. It was the tribe he got.

Dr. Gabor Maté 5:21 Yeah.

Dr. Rangan Chatterjee 5:21 I remember he said to me, Gabor, he says-

Dr. Gabor Maté 5:22 Yeah

Dr. Rangan Chatterjee 5:23 ... "You know, before I joined the boxing club, if someone said to me, 'Do 10 press-ups,' I wouldn't do a single one. But in a boxing gym, 10 means 10."

Dr. Gabor Maté 5:31 Yeah.

Dr. Rangan Chatterjee 5:32 And my conclusion with him was simply that he was missing a tribe. He was missing community. So in the, the hole that left inside him, he decided to fill that hole with online pornography.

Dr. Gabor Maté 5:45 Yeah.

Dr. Rangan Chatterjee 5:46 It was a symptom-

Dr. Gabor Maté 5:47 Absolutely

Dr. Rangan Chatterjee 5:47 ... of the problem, which really speaks to what you just said.

Dr. Gabor Maté 5:50 Well, a number of things come up as I listen to this anecdote. One is, um, the compassion that's required for people to open up and to actually heal. And so one of my teachers says, "Only when compassion is present will people allow themself to see the truth." And so I, I know that one of your three core values that you often talk about is compassion, and that's what this man needed to be able to open up and share and to look at himself honestly. That's the first thing. The second thing is when you study, um, p- People addicted to pornography, they're not actually after the pornography. It's not about sex. It's about, um, it's about a temporary spike of dopamine in their brain.

Dr. Rangan Chatterjee 6:30 Yeah.

Dr. Gabor Maté 6:30 Dopamine being the brain chemical that makes us feel alive and vital and present and excited and curious. Now, so then it was something happened to this man to shut down that mechanism, so he needed the extreme stimulation and titillation of pornography to, to get that dopamine spike so he can feel really alive. He just wanted to feel alive.

Dr. Rangan Chatterjee 6:50 Yeah.

Dr. Gabor Maté 6:51 That's all he wanted. Then he connects with the boxing community, and he gets himself going physically, and e- he gets this engagement with the group. All of a sudden he gets his needs met in a much healthier way. So again, uh, to, to, to, to, to criticize him and ostracize him and to shame him as he shamed himself, he just wanted to feel like a normal human being.

Dr. Rangan Chatterjee 7:13 Yeah.

Dr. Gabor Maté 7:14 That's all he wanted.

Dr. Rangan Chatterjee 7:15 And that's the thing with addictions. There's a, a certain hierarchical kind of preference we give to them. You know, certain things are a- acceptable addictions.

Dr. Gabor Maté 7:25 Mm-hmm.

Dr. Rangan Chatterjee 7:25 Certain things are not. You know-

Dr. Gabor Maté 7:26 Mm

Dr. Rangan Chatterjee 7:26 ... pornography is not an acceptable addiction.

Dr. Gabor Maté 7:28 Yeah.

Dr. Rangan Chatterjee 7:28 Heroin, uh, is not an acceptable addiction, but it's okay to be addicted to Instagram. It's okay to be addicted to consumption shopping.

Dr. Gabor Maté 7:38 Or power.

Dr. Rangan Chatterjee 7:39 Or power.

Dr. Gabor Maté 7:40 Yeah.

Dr. Rangan Chatterjee 7:41 One of the big messages I feel the new book really makes a strong case for is that we're living in a society that has as, as its core some values that are not conducive to good physical, mental, and emotional health.

Dr. Gabor Maté 7:55 Right.

Dr. Rangan Chatterjee 7:56 And it takes a lot of pressure off the individual.

Dr. Gabor Maté 7:59 Yeah.

Dr. Rangan Chatterjee 7:59 It doesn't mean that the individual can do nothing about it, but I think it helps people realize why they're struggling so much.

Dr. Gabor Maté 8:07 Well, w- w- I know that a, a real core value for you is authenticity. You know, and then being oneself, being truly oneself. And I know that you've been some, some struggle in your own life to become yourself or to realize who you were and to let go what wasn't. And certainly that's been my pattern and struggle and, and commitment as well. This is a society that fundamentally demands of people that they be other than who they are. Because the demand, the expectations that we fit in into structures and workplaces and education institutions and families and, mm, social settings, where if we ourselves, we risk being rejected. So that there's almost a universal demand for self suppression, which as we both, you and I know, uh, creates both mental and physical health problems. So that the, the core values of the society, which are fundamentally materialistic, individualistic, aggressive, and competitive, they go against what it really means to be a human being. And when you look at how we've evolved as human beings, like if you want to study a zebra, where would you study him if you want to understand his true nature? Would you study him in the London Zoo, or would you study him out in the savanna or wherever he-

Dr. Rangan Chatterjee 9:24 Yeah

Dr. Gabor Maté 9:24 ... you know, he, he or she lives? Well, you'd have to study him in their natural environment. In our natural environment, I'm talking about eons and millions and hundreds of thousands of years of evolution, and even about 90% of our own existence as a species, we lived out in nature in small band hunter gatherer groups.

Dr. Rangan Chatterjee 9:43 Yeah.

Dr. Gabor Maté 9:43 Connected, engaged, belonging, connected to nature, connected to our gut feelings. We had to be, otherwise we wouldn't survive.

Dr. Rangan Chatterjee 9:50 Yeah.

Dr. Gabor Maté 9:52 Th- that's what it means to be a human being. Now we can adapt to other, other environments, but that doesn't mean that we can thrive in them as well. And so that in a sense what I'm saying about our species, really we- we're like zoo creatures right now.

Dr. Rangan Chatterjee 10:06 Yeah.

Dr. Gabor Maté 10:07 We're living in an unnatural environment. I'm not suggesting we go back to being hunter gatherers, but I am suggesting we realize what we've lost, and how the particular social system in which we live right now demands that we stay lost.

Dr. Rangan Chatterjee 10:19 Yeah.

Dr. Gabor Maté 10:20 That's my whole point.

Dr. Rangan Chatterjee 10:21 Once our eyes get open to this-

Dr. Gabor Maté 10:24 Yeah

Dr. Rangan Chatterjee 10:24 ... because as, as you mentioned, for much of my life, I've been blind to this.

Dr. Gabor Maté 10:28 Yeah.

Dr. Rangan Chatterjee 10:28 You know, I, I felt that success was important. Being competitive was important. Being a winner-

Dr. Gabor Maté 10:35 Yeah

Dr. Rangan Chatterjee 10:35 ... was important. And-

Dr. Gabor Maté 10:36 Yeah

Dr. Rangan Chatterjee 10:37 ... as I've shed a lot of these behavioral adaptations to my own childhood, I find an inner sense of peace and contentment-

Dr. Gabor Maté 10:47 Mm

Dr. Rangan Chatterjee 10:47 ... and calm that I never had before.

Dr. Gabor Maté 10:50 Yeah.

Dr. Rangan Chatterjee 10:51 And actually, what's really interesting is as you do that, a lot of the addictive tendencies I had, which-

Dr. Gabor Maté 10:57 They fall away

Dr. Rangan Chatterjee 10:57 ... they fall away.

Dr. Gabor Maté 10:58 Yeah.

Dr. Rangan Chatterjee 10:58 Not because you're trying to.

Dr. Gabor Maté 10:59 That's right.

Dr. Rangan Chatterjee 11:00 You're not trying to stop the addiction. This is kind of what I feel a lot of the time with, let's say something like alcohol. And as medical doctors, we say, you know, this is the limits. You know, you should drink under 14 units of alcohol a week or whatever it is, which frankly, I find a lot of public health guidance quite unhelpful. I understand the need for it, but A, it's dry. B, there's no understanding within that-

Dr. Gabor Maté 11:25 Yeah

Dr. Rangan Chatterjee 11:25 ... of what role does the alcohol play in that person's life. And-

Dr. Gabor Maté 11:29 Yeah

Dr. Rangan Chatterjee 11:29 ... I feel the classic case of something like alcohol is New Year. You know, people decide on January the 1st that this year's gonna be different. I'm... Right, I'm not gonna fall into the trap I fell in before. I'm gonna cut down my intake. And you know, they do for the first week-

Dr. Gabor Maté 11:43 Yeah

Dr. Rangan Chatterjee 11:43 ... and the second week.

Dr. Gabor Maté 11:44 Yeah.

Dr. Rangan Chatterjee 11:44 And they, they, they c- they're not drinking at all, but by the third week, you know-

Dr. Gabor Maté 11:47 Mm

Dr. Rangan Chatterjee 11:47 ... when the stress of work is still there-

Dr. Gabor Maté 11:50 Yeah

Dr. Rangan Chatterjee 11:50 ... when the toxic relationship that they're in is still there, when the boss that doesn't value them is still there, it starts to creep in because the alcohol is playing a role, right? Serving a need. And coming back to this cultural point, you mentioned where would you study a, a zebra.

Dr. Gabor Maté 12:06 Yeah.

Dr. Rangan Chatterjee 12:07 Right? I think there's a key point here. You know, who are we as humans?

Dr. Gabor Maté 12:10 Yeah.

Dr. Rangan Chatterjee 12:10 Many of us feel that we are competitive, right? And competition is something I think a lot about.

Dr. Gabor Maté 12:18 Yeah.

Dr. Rangan Chatterjee 12:18 Right? As someone who used to be competitive-

Dr. Gabor Maté 12:20 Yeah

Dr. Rangan Chatterjee 12:20 ... who is no longer competitive.

Dr. Gabor Maté 12:22 Yeah.

Dr. Rangan Chatterjee 12:22 Really, I can put my hand on my heart and say-

Dr. Gabor Maté 12:24 Yeah

Dr. Rangan Chatterjee 12:24 ... I'm not competitive anymore.

Dr. Gabor Maté 12:26 Yeah.

Dr. Rangan Chatterjee 12:26 That was a, that was a trait I developed.

Dr. Gabor Maté 12:28 That's right.

Dr. Rangan Chatterjee 12:29 But some people say competition is natural, and I, I guess- And my view is that it's, it comes down to the relationship you have with that competition. So can you speak a little bit to competition?

Dr. Gabor Maté 12:40 Well, yeah. Well, first of all, I know something about your personal history, which is that, you know, being, um, immigrants from the subcontinent here to, to the UK, and your parents, with all their goodwill, they put this pressure on you to excel.

Dr. Rangan Chatterjee 12:55 Yeah.

Dr. Gabor Maté 12:55 That, that if you were... I think I heard you say once that if you only got 99% on a test, your mother would say, "What's wrong? What did you... How come you can't get 100?"

Dr. Rangan Chatterjee 13:03 Yeah.

Dr. Gabor Maté 13:03 You have to be the best.

Dr. Rangan Chatterjee 13:04 Had to be the best.

Dr. Gabor Maté 13:05 Yeah. Now, they did that out of their anxiety that you just succeed in this world in which you came with some disadvantage, being immigrants and maybe people of color as well, you know? But as a result, you become competitive. That's not your nature. That's just your second nature. But even in the phrase second nature, there's an implication that there's a first nature. And, and, and the first nature is you just are a human being. You wanna belong. Now com- competition, it depends what the intention is. If it's a competition in the sense that you wanna manifest your best, and in a sense you're competing with yourself-

Dr. Rangan Chatterjee 13:50 Yeah

Dr. Gabor Maté 13:50 ... not to be better than anybody else, not to beat or to dominate or to subjugate or exclude somebody else, but just because you just wanna be your best, well, that's, that's great. The idea that we're individually competitive creatures really comes along with the rise of capitalism, which is a system based on competition, where it is dog eat dog, and where the bigger fish do swallow the smaller ones. And as we can see this happening right now with the tremendous rise of inequality in the last decades. You know, eight people in the world now control as much wealth as the bottom 50% of humanity.

Dr. Rangan Chatterjee 14:30 Hmm.

Dr. Gabor Maté 14:32 Now, the interesting thing about human nature is that when people do something selfish or aggressive or competitive, what do we say? "Well, that's just human nature." But when people do something s- uh, selfless and generous and kind, nobody says, "Oh, that's just human nature."

Dr. Rangan Chatterjee 14:47 Yeah.

Dr. Gabor Maté 14:48 So there's an assumption in this culture, and what we do is we take the core values of a particular materialistic culture, and we project them onto human beings as if that was our true nature. It isn't. And to the extent that we try to conform to it, we create suffering for ourselves and for others. You know? Now, competition as between Liverpool and Manchester City, i- in this capitalist world, even that gets pretty vicious, not in the sense of the players being vicious, but in the sense of how can we get the best players in the world, and who can pay the most money for the-

Dr. Rangan Chatterjee 15:27 Yeah

Dr. Gabor Maté 15:27 ... best striker, and where will Haaland go? Will he go to Manchester City or Arsenal, you know? E- even on that level, what is meant to be play, we talk about playing football, but it's no longer a play. Becomes a business of dominating others. So whereas it could be just play, which is... And in play, there's no consequences to who wins and who doesn't.

Dr. Rangan Chatterjee 15:51 Yeah.

Dr. Gabor Maté 15:51 It's just for the process. It's just for the enjoyment. It's just for the sheer pleasure of the activity. The human beings are meant to play. There's a circuit in our brain that's designated to play. Play is essential for human development, for human child development, for the brain development. But even the play we've made into a competitive cutthroat-

Dr. Rangan Chatterjee 16:12 Yeah

Dr. Gabor Maté 16:12 ... endeavor.

Dr. Rangan Chatterjee 16:13 Yeah.

Dr. Gabor Maté 16:14 That's how far denatured we've become.

Dr. Rangan Chatterjee 16:17 I don't know if you are familiar with Jonny Wilkinson, probably one of the world's, certainly one of England's most famous rugby players ever. When Jonny was a little boy-

Dr. Gabor Maté 16:24 Yeah

Dr. Rangan Chatterjee 16:24 ... he wrote down his dreams on a piece of paper. He said, "I wanna play for England. I wanna win the World Cup."

Dr. Gabor Maté 16:31 Hmm.

Dr. Rangan Chatterjee 16:32 Now, the problem for Jonny is that by the age of 24, he'd achieved his dreams.

Dr. Gabor Maté 16:37 Hmm.

Dr. Rangan Chatterjee 16:38 Right? So yes, he plays for England, and then he helps England win the World Cup in the most fairy tale-

Dr. Gabor Maté 16:45 Hmm

Dr. Rangan Chatterjee 16:45 ... situation. He kicks the winning goal in the final minutes-

Dr. Gabor Maté 16:49 Oh

Dr. Rangan Chatterjee 16:49 ... of the World Cup final.

Dr. Gabor Maté 16:51 Wow.

Dr. Rangan Chatterjee 16:51 The sort of thing that kids all over the world now would dream about doing. He did it-

Dr. Gabor Maté 16:56 Absolutely

Dr. Rangan Chatterjee 16:56 ... at the age of 24.

Dr. Gabor Maté 16:57 Yeah.

Dr. Rangan Chatterjee 16:57 The problem is, is that he said, as the ball left his boot, even before it had gone through the goals, he started to go down-

Dr. Gabor Maté 17:07 I get it

Dr. Rangan Chatterjee 17:07 ... in his mind. The following morning-

Dr. Gabor Maté 17:09 Hmm

Dr. Rangan Chatterjee 17:09 ... this is after they'd won the World Cup, first time in years, national hero, he can't get out of bed.

Dr. Gabor Maté 17:15 Hmm.

Dr. Rangan Chatterjee 17:16 Lonely, depressed.

Dr. Gabor Maté 17:17 Hmm.

Dr. Rangan Chatterjee 17:18 I, I find his story-

Dr. Gabor Maté 17:19 Hmm

Dr. Rangan Chatterjee 17:19 ... incredibly fascinating because he ticked the boxes of what society says you need to do to be happy and successful, yet it left him with this inner turmoil. And he said something to me, Gabor. He said many things, but one thing in particular I remember is he said, "I used to play rugby for the joy of the game."

Dr. Gabor Maté 17:36 Used to play.

Dr. Rangan Chatterjee 17:37 At some point, it changed from being joyful and playful to being something that said something about who I was.

Dr. Gabor Maté 17:44 Yeah.

Dr. Rangan Chatterjee 17:45 And he thought winning would say something about him, and his relationship to rugby changed.

Dr. Gabor Maté 17:53 Yeah. It's a v- incredibly powerful story, and it illustrates a point that I've often made, is that there's two common ways to wake up. One of them is to fail, but an even more dramatic way is to succeed, because then you realize that you've got what you wanted, and it's empty-

Dr. Rangan Chatterjee 18:10 Yeah

Dr. Gabor Maté 18:10 ... 'cause it's all been external. And so in a certain sense, people who are succeeding, they're, they're, they're fortunate 'cause they have a... Uh, uh, 'cause as long as you're failing, you might keep thinking, "If only I succeeded, I'd be happy," you know? But the people who succeed, and then they realize, they, they have a much, mm, more rapid opportunity to wake up, 'cause now I've got what I wanted, and I d- And it's nothing

Dr. Rangan Chatterjee 18:37 That's still the whole science

Dr. Gabor Maté 18:38 Yeah. I mean, you and I both know this. I mean, I- we both have been successful physicians, and a- as a child, or as if your parent could have pictured your future or my future, you know, famous and physician and successful-

Dr. Rangan Chatterjee 18:53 Yeah

Dr. Gabor Maté 18:53 ... and all this kind of stuff. But we both know empty it is in itself.

Dr. Rangan Chatterjee 18:58 Yeah.

Dr. Gabor Maté 18:58 No, it doesn't need to be. If it's fulfilling, if it expresses who we are, if it's aligned, as you say, if we're in alignment, then it's great. But it's precisely when we succeed that we find out, was this in alignment-

Dr. Rangan Chatterjee 19:15 Yeah

Dr. Gabor Maté 19:16 ... or was it not? And often it isn't.

Dr. Rangan Chatterjee 19:18 I guess there's that wider point there, which is success, right?

Dr. Gabor Maté 19:23 Yeah.

Dr. Rangan Chatterjee 19:23 What, what is that definition of success?

Dr. Gabor Maté 19:26 Yeah.

Dr. Rangan Chatterjee 19:27 Because if we talk about the toxic culture in which we live, many of us around the world live-

Dr. Gabor Maté 19:33 Yeah

Dr. Rangan Chatterjee 19:34 ... actually, you know, by its metrics, success, society is successful. You know, making a load of money, people consuming lots of different things. You know, new fashion every three months, people buying clothes they don't need, endlessly consuming things that they don't want. Even, you know, I was thinking the other day about sustainability-

Dr. Gabor Maté 19:52 Mm-hmm

Dr. Rangan Chatterjee 19:52 ... and the environment, and even the word sustainable and then sustainable products. I was thinking, yeah, the elephant in the room here is that we... Sure, there's, there's a value to sustainable products, [laughs] but if we're still over-consuming sustainable products, it's not that sustainable.

Dr. Gabor Maté 20:08 Mm-hmm. And what it ignores is that, like, if everybody in what we call the Third World, or the, what we euphemistically call the developing world, consumed at the same level as we do in this world, it would take several Earths to support the population. So even the s- so-called sustainability is only sustainability so far as it's restricted to a fairly small proportion of the Earth's population. And so that, uh, in, in a global sense, there's nothing sustainable about it whatsoever.

Dr. Rangan Chatterjee 20:41 People often hear this, Gabor. They hear you speaking or me speaking or whoever saying, you know, "These things don't make us happy."

Dr. Gabor Maté 20:50 Yeah.

Dr. Rangan Chatterjee 20:51 Jim Carrey, I think, was once quoted as saying, "I wish everyone would become rich and famous so they could realize it doesn't make you happy."

Dr. Gabor Maté 20:57 Ah.

Dr. Rangan Chatterjee 20:58 But the common view from people is, "Yes, it's okay for you, Jim, to say that."

Dr. Gabor Maté 21:03 Yeah.

Dr. Rangan Chatterjee 21:03 "You've had all that success. Gabor, it's okay for you."

Dr. Gabor Maté 21:06 Yeah.

Dr. Rangan Chatterjee 21:06 "You've got all these successful books. Millions of people around the world watch your talks. It's okay for you." Or, or the same thing to me, right? So I guess the question is, how do we help people [laughs] see this without having to go to that extreme first? Is it possible?

Dr. Gabor Maté 21:22 Well, y- y- you know, and those people who point that out to us, they're making a valid-

Dr. Rangan Chatterjee 21:27 Yeah

Dr. Gabor Maté 21:27 ... statement, you know?

Dr. Rangan Chatterjee 21:29 I agree.

Dr. Gabor Maté 21:30 Uh, it is easy for you, and I do this at this point. All I can say to people is you have to find out for yourself. You know, w- w- when do you feel good about yourself? When you're straining for something external, or when you're aligned with yourself? When you've have got other people's approval, even on a limited basis? I mean, not e- not e- not everybody's gonna be famous, not everybody's gonna be, you know, in the public eye. But everybody has a certain circle of be- of belonging and a certain circle of engagement. When in that world you get ap- approbation from others, but you're denying yourself, how do you feel? When you are being yourself, even if others don't approve, how do you feel? When I say, how do you feel, what's happening in your body? And most people, most of the time, if they paid close attention, they'd realize that when they're being authentic is when they feel really good about themselves, even if it means... And let's face it, I mean, but to be, but to be fair to you and I, we didn't exactly make it because we tried to fit in.

Dr. Rangan Chatterjee 22:43 Yeah.

Dr. Gabor Maté 22:44 We made it because we, at some point, decided that we're just gonna speak our truth.

Dr. Rangan Chatterjee 22:48 Yeah.

Dr. Gabor Maté 22:48 And especially as physicians, you don't immediately get a lot of brownie points for pointing out the shallowness and just limited worldview and, and actually harmful binary division of mind and body. You don't get a lot of, uh, accolades within the profession-

Dr. Rangan Chatterjee 23:08 Yeah

Dr. Gabor Maté 23:08 ... for pointing these things out. So it's not like I didn't set out for success. Honest to God, I didn't. I wanted it. I'm not denying it, you know? And I had a lot of ego investment in whatever I did, I did. But fundamentally, that wasn't what was driving me-

Dr. Rangan Chatterjee 23:23 Yeah

Dr. Gabor Maté 23:23 ... or, or calling, what was calling me. It's like, just once that you start seeing certain things-

Dr. Rangan Chatterjee 23:27 Yeah

Dr. Gabor Maté 23:28 ... you just wanna speak them, and it was that desire to speak my truth that led to whatever success I've had.

Dr. Rangan Chatterjee 23:35 Yeah.

Dr. Gabor Maté 23:35 And I would guess that something similar is true for you as well.

Dr. Rangan Chatterjee 23:39 Yeah, 100%. A- a- and I think what's so powerful about that is that these things can coexist, right?

Dr. Gabor Maté 23:45 Yeah.

Dr. Rangan Chatterjee 23:45 You can be speaking your truth. You can feel compelled to write a book that the world needs, but you need to write.

Dr. Gabor Maté 23:52 That's right.

Dr. Rangan Chatterjee 23:53 And also like the success that comes with it.

Dr. Gabor Maté 23:56 Yeah.

Dr. Rangan Chatterjee 23:56 It's not either/or. It's not either it's-

Dr. Gabor Maté 23:58 No

Dr. Rangan Chatterjee 23:58 ... completely selfless. You know, maybe there is a selfish component to these things as well, at least at the start.

Dr. Gabor Maté 24:04 At the start, yes.

Dr. Rangan Chatterjee 24:05 At least at the start. That's certainly been my experience. You know, I felt compelled to speak the truth as I saw it, the frustrations I had within medicine that for so many patients, I think we're underserving them with our reductionist-

Dr. Gabor Maté 24:18 Yeah

Dr. Rangan Chatterjee 24:18 ... simplistic biomedical model without taking into consideration all the other aspects that drive health.

Dr. Gabor Maté 24:25 Yeah.

Dr. Rangan Chatterjee 24:25 But yes, it was, you know, my son nearly dying when he was six months old that-

Dr. Gabor Maté 24:28 Oh, gosh

Dr. Rangan Chatterjee 24:29 ... um, really drove me. It's completely changed my worldview on what is important. You know, I, I had to speak up.

Dr. Gabor Maté 24:37 Yeah.

Dr. Rangan Chatterjee 24:37 I, I felt I had no choice-

Dr. Gabor Maté 24:38 That's right

Dr. Rangan Chatterjee 24:39 ... but to speak up.

Dr. Gabor Maté 24:40 That's right.

Dr. Rangan Chatterjee 24:41 And yes, over the last years, I've had a high degree of success, whether it's with this podcast or my books for sure. But over the last two or three years, I've really I've really gone deep, Gabor

Dr. Gabor Maté 24:52 Yeah

Dr. Rangan Chatterjee 24:52 Your work's helped me hugely with that-

Dr. Gabor Maté 24:54 Yeah

Dr. Rangan Chatterjee 24:54 ... for sure, but also the work of, you know, Dick Schwartz and-

Dr. Gabor Maté 24:57 I know, yeah

Dr. Rangan Chatterjee 24:57 ... IFS

Dr. Gabor Maté 24:58 Yeah, I know

Dr. Rangan Chatterjee 24:59 Internal Family Systems has been transformative for me in terms of making peace with various parts of myself.

Dr. Gabor Maté 25:05 Yeah

Dr. Rangan Chatterjee 25:05 And it's-

Dr. Gabor Maté 25:06 Yeah

Dr. Rangan Chatterjee 25:06 ... now, honestly, I sit here before you like a different person to when I first met you three or four years ago.

Dr. Gabor Maté 25:13 Mm.

Dr. Rangan Chatterjee 25:13 Like, I, I feel when I, when I met you last time face to face, I feel I had multiple holes in my soul

Dr. Gabor Maté 25:22 Mm. Mm

Dr. Rangan Chatterjee 25:22 And, you know, we had a great conversation that people enjoyed for sure, but I feel I sit alongside you today complete and whole-

Dr. Gabor Maté 25:32 Mm

Dr. Rangan Chatterjee 25:32 ... and I've never felt this deep sense of-

Dr. Gabor Maté 25:35 Mm

Dr. Rangan Chatterjee 25:35 ... contentment and happiness.

Dr. Gabor Maté 25:37 Mm. Well, I'm so happy for you. Um, when you talk about holes, there's a, a teacher of mine that I quote often, A.H. Almaas, and, uh, he, he says that we're born with these, um, innate essential qualities. As the world doesn't recognize them or discourages them, we shut them off and we develop holes instead. Then we spend all our lives trying to fill these holes until we realize that as, as soon as, you know, like self-love or, you know, self-acceptance or clarity or courage or love for others or sense of belonging or sense of unity, uh, these get shut down. We develop these holes instead. Then this whole society is so expert at selling us stuff to fill those holes temporarily, but only temporarily, so you have to get getting more and more and more, and the whole society lives on trying to fill people's holes that can never be filled from the outside. This is the whole ethic of this culture. In terms of the, writing the book, I was sharing with you before, and then in writing this one, um, it, it, it, it really wasn't, "Okay, I'm gonna write this book and become even more famous." Uh, honest to God, because, uh, I suffered writing this book. I mean, I, I, I'm not saying this self-pityingly. I'm just telling you what happened. 10 years, I collected 25,000 articles f- uh, of newspaper reports, scientific papers, medical journals, and so on, a couple hundred books, uh, 300 interviews, and then three years of writing, like every day. And at times I sat there, had nothing to say. I didn't know... There's nothing was coming out of, flowing from the tips of my fingers, and I thought, "I can't do this." I talked to Russell Brand once, and Russell said, "Remember something. You're not doing this for yourself. You're doing this for the world." And that really helped. Get over your own ego. Just do what you need to do. And at some point, I actually weekly talked to a therapist for a couple of months. I was so despondent about this feeling that I had. I went, "There's so much I want to say, and then what I want to say is, at least I think, is so important, and I'm not finding the way to, to get it out of me." So that wasn't done for my pleasure, believe me.

Dr. Rangan Chatterjee 27:53 No.

Dr. Gabor Maté 27:53 That, that, that was really done because there's something in me that just wanted to be said.

Dr. Rangan Chatterjee 27:57 You know, that's so powerful, Gabor, because I think for people to hear that-

Dr. Gabor Maté 28:01 Yeah

Dr. Rangan Chatterjee 28:02 ... that you, this esteemed, globally respected physician, when writing this latest book, and you've written many fantastic books already, right?

Dr. Gabor Maté 28:10 Yes. Yeah.

Dr. Rangan Chatterjee 28:10 That you are getting consumed with self-doubt and insecurity about, you know, have I got anything worthwhile-

Dr. Gabor Maté 28:18 Yeah, my, my b- my blood pressure, which is usually that of a baby's, was going up.

Dr. Rangan Chatterjee 28:23 Yeah.

Dr. Gabor Maté 28:23 I was getting concerned. I would... Did I have to go on blood pressure? No, of course I didn't have to go on medication, but it was just the... Uh, finally somebody, you know, somebody said to me, a very wise therapist, uh, she said, "Your problem is not the book. Your problem is your relationship to the book." And just that, that, that rugby player that you mentioned, I'd allowed myself to be totally identified with the book.

Dr. Rangan Chatterjee 28:44 Yeah.

Dr. Gabor Maté 28:44 So my success or my validation as a human being depended on how well this book was doing. Well, actually, what's the reality? Let's see if I had written a lousy book and nobody wanted it, and it's not the end of the world. It doesn't change who I am. It just means that for once I didn't succeed, you know? But it's the identification that had me so anxious.

Dr. Rangan Chatterjee 29:09 As we have this conversation, you are maybe two months out from publication.

Dr. Gabor Maté 29:15 Three.

Dr. Rangan Chatterjee 29:16 It's okay. Three months.

Dr. Gabor Maté 29:17 [laughs]

Dr. Rangan Chatterjee 29:17 Okay. But this is gonna come out-

Dr. Gabor Maté 29:19 Yeah

Dr. Rangan Chatterjee 29:19 ... when the book's out.

Dr. Gabor Maté 29:20 Yeah.

Dr. Rangan Chatterjee 29:22 A lot of us, we know the right things to say, you know? You know, we, we've studied this. We know what we should value.

Dr. Gabor Maté 29:31 Yeah.

Dr. Rangan Chatterjee 29:31 Yet we still can't help falling into traps, these, these traps I think [laughs] society lays out for us. At this stage in your life, you've heard me say that I think your new book is a masterpiece.

Dr. Gabor Maté 29:43 Yeah.

Dr. Rangan Chatterjee 29:44 Um, and I, and I genuinely mean it from the bottom of my heart.

Dr. Gabor Maté 29:46 Mm.

Dr. Rangan Chatterjee 29:48 Let's say the book comes out and it's not as successful as I think it's gonna be-

Dr. Gabor Maté 29:53 Yeah

Dr. Rangan Chatterjee 29:53 ... as maybe you think it's gonna be, or maybe your publishers think it's gonna be.

Dr. Gabor Maté 29:58 Or as I think it should be. [laughs]

Dr. Rangan Chatterjee 29:59 Well, yeah. Right.

Dr. Gabor Maté 30:00 Yeah.

Dr. Rangan Chatterjee 30:01 What, what is... As honestly as you can, w- what would you say is your relationship with that now? If this book tanks when it comes out-

Dr. Gabor Maté 30:10 Yeah

Dr. Rangan Chatterjee 30:10 ... what does that say about you?

Dr. Gabor Maté 30:13 You know something? That's something I've engaged with over time. Now, whether I'm fooling myself or whether I'm being authentic here, what comes out of me is, you know what? This is the book I wanted to write.

Dr. Rangan Chatterjee 30:26 Yeah.

Dr. Gabor Maté 30:27 At, after all that struggle and all that, this book, it's a long book, but it was double as long when I first finished writing it, my son and, and I, who helped me write it, and we had to cut it and trim it and rewrite it and rewrite, rewrite it. But now you know what? This is the book I had envisioned 10 years ago when it first occurred to me. So you know what? Now it's out in the world, not up to me anymore. S- but I'm ha- but I'm satisfied-

Dr. Rangan Chatterjee 30:57 Yeah

Dr. Gabor Maté 30:57 ... that I said what I needed to say. Now- Talk to me four months from now. If the book tanks, how will I be feeling? Probably pretty lousy in some ways. But it's not gonna fundamentally affect who I am, and it's not gonna really affect my core happiness, uh, my core sense of what my life is about, uh, m- my sense of myself. It is not going to affect that.

Dr. Rangan Chatterjee 31:21 Yeah.

Dr. Gabor Maté 31:21 It's gonna be okay regardless.

Dr. Rangan Chatterjee 31:24 I, I believe you.

Dr. Gabor Maté 31:25 Yeah.

Dr. Rangan Chatterjee 31:25 I, I honestly believe you. Um, I happen to think it will be a big international bestseller.

Dr. Gabor Maté 31:31 Yeah. From your mouth to God's ears, as they say.

Dr. Rangan Chatterjee 31:34 I, I think it's a must-read book for everyone. But if I may, I, I'm, I'm gonna share my own experience with that-

Dr. Gabor Maté 31:39 Mm

Dr. Rangan Chatterjee 31:39 ... which, again, you know, the Rangan of even five years ago would've felt too shy and, um-

Dr. Gabor Maté 31:45 Mm

Dr. Rangan Chatterjee 31:46 ... insecure about sharing, right?

Dr. Gabor Maté 31:48 Mm-hmm, mm-hmm.

Dr. Rangan Chatterjee 31:49 Um, you've touched on some of my childhood story. I know you've read my latest book. You've heard a lot about how I saw myself when I grew up-

Dr. Gabor Maté 31:56 Yeah

Dr. Rangan Chatterjee 31:56 ... which was very much I felt loved and validated when I had high levels of success. It's nobody's fault.

Dr. Gabor Maté 32:03 Yeah.

Dr. Rangan Chatterjee 32:03 My parents did the best that they could. They wanted the best for me.

Dr. Gabor Maté 32:06 Yeah.

Dr. Rangan Chatterjee 32:06 But little Rangan took on this very, very toxic idea that has led to a very lonely place inside me for much of my life.

Dr. Gabor Maté 32:12 Mm. Yeah.

Dr. Rangan Chatterjee 32:13 Now, like you, I'm, I'm someone who has ticked a lot of these societal boxes of success.

Dr. Gabor Maté 32:19 Yeah.

Dr. Rangan Chatterjee 32:19 You know, this is a... You know, millions listen to this podcast each week. A lot of people buy my books. They've all been Sunday Times bestsellers, right?

Dr. Gabor Maté 32:27 Yeah, yeah.

Dr. Rangan Chatterjee 32:27 And what was interesting is my latest book, Happy Mind Happy Life, came out, I dunno, two months ago, two and a half months ago in the UK.

Dr. Gabor Maté 32:35 Yeah.

Dr. Rangan Chatterjee 32:37 And you can't write a book like this without doing [laughs] a lot of self-reflection on yourself. And I remember the week or two before it came out, I was just chatting with people close to me, and I was thinking about it, and I genuinely thought, like you've said, Gabor, "This book is the best that I can do at this moment in time. It's exactly what I want it to be."

Dr. Gabor Maté 32:55 Mm.

Dr. Rangan Chatterjee 32:55 I've, I've really tried to distill a lot of complex ideas down, make it really simple, very readable, very practical, which was my goal when writing it. How this book does in the world-

Dr. Gabor Maté 33:05 Yeah

Dr. Rangan Chatterjee 33:06 ... is no reflection of who I am as a human being.

Dr. Gabor Maté 33:09 Yeah.

Dr. Rangan Chatterjee 33:10 If nobody buys this book, it is still a great book.

Dr. Gabor Maté 33:13 Mm.

Dr. Rangan Chatterjee 33:14 I'm still incredibly proud of it, and it says nothing about who I am. Now, it... I was pretty convinced that I honestly believe that, but as you've hinted to, we're pretty good as humans at kidding ourselves as well.

Dr. Gabor Maté 33:24 Yeah, yeah, yeah.

Dr. Rangan Chatterjee 33:25 Now, here's the reality. The book comes out.

Dr. Gabor Maté 33:28 It's a success.

Dr. Rangan Chatterjee 33:30 It's the most successful of any book I've ever published.

Dr. Gabor Maté 33:32 Yeah, yeah.

Dr. Rangan Chatterjee 33:33 And about a week after it came out, like, I got a text from my senior editor saying, "Hey, Rangan, can you give me a call, please?" I thought, "This is-

Dr. Gabor Maté 33:41 Mm

Dr. Rangan Chatterjee 33:41 ... this is weird. I, I, [laughs] I never get texts like this." So I said, "Sure." So I, so I called her, and she goes, "Hey, Rangan, we just found out this Sunday you're gonna be the number one Sunday Times paperback bestseller in the country."

Dr. Gabor Maté 33:51 Wow.

Dr. Rangan Chatterjee 33:51 "Congratulations."

Dr. Gabor Maté 33:52 Yeah.

Dr. Rangan Chatterjee 33:53 Now, the point in me sharing this, and this is where my insecurities come for sharing something like this, you know, will people think I'm being arrogant? Will they think I'm boasting? I, I promise from all my heart and soul this is not the purpose of sharing this.

Dr. Gabor Maté 34:06 Yeah.

Dr. Rangan Chatterjee 34:06 The purpose of sharing this is in that moment, Gabor, I didn't feel this artificial ego elevation.

Dr. Gabor Maté 34:12 Yeah.

Dr. Rangan Chatterjee 34:12 I really didn't.

Dr. Gabor Maté 34:13 Yeah.

Dr. Rangan Chatterjee 34:14 I, I was just quietly content.

Dr. Gabor Maté 34:16 Mm-hmm.

Dr. Rangan Chatterjee 34:16 I could hear her excitement and the team's excitement in the background.

Dr. Gabor Maté 34:20 Yeah.

Dr. Rangan Chatterjee 34:21 I didn't feel it. I know for a fact that five years ago I would've been jumping through the ceiling.

Dr. Gabor Maté 34:26 Yeah.

Dr. Rangan Chatterjee 34:26 I would've phoned all my friends. But honestly, I thought, "Okay, this is awesome. This, my message is gonna get out there to more people. Fantastic." But my wife's out. I still need to wash my daughter's, uh, sports clothing before school tomorrow.

Dr. Gabor Maté 34:39 Yeah.

Dr. Rangan Chatterjee 34:39 Still need to cook the kids dinner.

Dr. Gabor Maté 34:40 Yeah.

Dr. Rangan Chatterjee 34:41 And for me, it was a real-life test where I thought, "You're saying the right things."

Dr. Gabor Maté 34:47 Yeah.

Dr. Rangan Chatterjee 34:47 "You think this is happening." Now, in the actual reality... Now, look, what would've happened had the book tanked? I, I, I don't know-

Dr. Gabor Maté 34:54 Yeah, yeah

Dr. Rangan Chatterjee 34:54 ... because that didn't happen. But I, for me, that was a really powerful real-life scenario where I thought, "Hey, hey, buddy, maybe you have actually healed [laughs] these, these holes inside yourself because actually you didn't feel it."

Dr. Gabor Maté 35:06 Uh-huh.

Dr. Rangan Chatterjee 35:07 You didn't feel it like you used to.

Dr. Gabor Maté 35:08 Well, it's wonderful. I... You mentioned your wife, um, when you were talking. It made me think of my wife because she has never wanted my success. She wanted me, the real person. And, um, so she, as much as she appreciates the success and celebrates it, if I get too caught up in it, if I start identifying myself with it, I have somebody to come home to who will knock me off my pedestal [laughs] pretty quickly, you know, which is great, you know? You know, and, uh, uh, you know, her, uh... my relationship with, with Ray is woven throughout the book 'cause it shows up in so many areas of parenting and male-female relationships and why women get chronic illnesses more than men do, and so that we've sort of lived the whole thing. And, uh, I, I have to say, left on my own, uh, my head would be a whole lot bigger than it is.

Dr. Rangan Chatterjee 36:12 Yeah.

Dr. Gabor Maté 36:12 But, but, but thanks to... No, of course, I give myself credit. I chose that relationship.

Dr. Rangan Chatterjee 36:18 Yeah.

Dr. Gabor Maté 36:18 And I chose to stay in it. I, I, I'd rather have the truth than whatever simulacrum of truth I could sort of project and blow a balloon like out there in the world. But it, it, it, it's, it's essential because... [sighs] You know, I'm... And, and I came to success rather late, late in life. I mean, you're a younger whippersnapper compared to me, you know? Um, but here I'm 78, and it... I can handle it now.

Dr. Rangan Chatterjee 36:49 Yeah.

Dr. Gabor Maté 36:49 I, I, honest to God, 10 years ago it would've blown me away.

Dr. Rangan Chatterjee 36:54 Yeah. It's interesting 'cause I think all these things are relative, right? 'Cause you're saying 10 years ago you would've struggled.

Dr. Gabor Maté 36:59 Yeah.

Dr. Rangan Chatterjee 36:59 But 10 years ago you were still You know, pretty experienced in life, right?

Dr. Gabor Maté 37:03 I was.

Dr. Rangan Chatterjee 37:04 You know? And, and I say, and because where I think these things all become relative is my first appearance on the public stage was in, I don't know, 2015, where-

Dr. Gabor Maté 37:16 Oh

Dr. Rangan Chatterjee 37:16 ... I get my own prime time BBC One series called Doctor in the House, where I go and live alongside families who are struggling with their health for four to six weeks. They've all been under GPs and specialists before.

Dr. Gabor Maté 37:27 Mm.

Dr. Rangan Chatterjee 37:27 They're all struggling. And without fail, every single family, after six weeks, either their conditions were fully reversed or they were significantly better. Whether it's, you know, type two diabetes has been put into remission, fibromyalgia pains gone in six weeks-

Dr. Gabor Maté 37:43 Yeah

Dr. Rangan Chatterjee 37:43 ... uh, panic attacks down by... All through helping them understand the various drivers in their life that were influencing their health.

Dr. Gabor Maté 37:51 What does that say about the actual practice of medicine? Because you take something like fibromyalgia, which most physicians, if they know anything about it at all, they just throw up their hands in frustration.

Dr. Rangan Chatterjee 38:01 Yeah.

Dr. Gabor Maté 38:02 Uh, whereas what I imagine what happened was that the presence of a compassionate, um, witness and physician and guide changed those people's relationship to themselves.

Dr. Rangan Chatterjee 38:15 Yeah.

Dr. Gabor Maté 38:16 And is that whatever lifestyle choices they may have made that have been more healthier, fundamentally what happened is the transformation of the relationship to themselves.

Dr. Rangan Chatterjee 38:25 Right.

Dr. Gabor Maté 38:25 And, and, and that's the key to healing, um, not just in fibromyalgia, but in a whole lot of other conditions as well, and that's something I explore quite a bit. But it's... That, that's the part that Western medicine doesn't get. And, and so these so-called miracles turn out not to be miracles at all. They're only what you'd expect if you understand the mind-body unity and its scientifically demonstrated physiological, psychophysiological unity. You'd expect somebody to get better once they get into a healthier relationship with themselves, for which they need somebody with compassion and some insight to, to guide them and to reflect their process. You must be frustrated as I am sometimes, and I, and, and I know some colleagues of our- ours are as well, just how much more we could achieve as physicians if we just understood these basic principles.

Dr. Rangan Chatterjee 39:18 Yeah. I am. I've gone through various emotions over my career. You know, I'm pretty much 21 years in-

Dr. Gabor Maté 39:25 Yeah

Dr. Rangan Chatterjee 39:25 ... to my practice as we speak. Um-

Dr. Gabor Maté 39:29 Yeah

Dr. Rangan Chatterjee 39:29 ... and I used to get frustrated, and I guess I went through a phase of anger.

Dr. Gabor Maté 39:34 Yeah.

Dr. Rangan Chatterjee 39:34 Um, but I'm a lot more at peace with things now. I, I... It doesn't really rile me up in the way that it used to. I feel a lot calmer about it.

Dr. Gabor Maté 39:43 Mm-hmm.

Dr. Rangan Chatterjee 39:43 Um, I, I want to talk about some of the problems with Western medicine-

Dr. Gabor Maté 39:48 Yeah

Dr. Rangan Chatterjee 39:48 ... because I think, you know, we're both physicians. We both practiced for many years within that system.

Dr. Gabor Maté 39:53 Yeah.

Dr. Rangan Chatterjee 39:53 So I think we, we have a perspective that's useful for people, I'm sure. I think there's a whole multitude of problems. I'd love your view on that. One of the things I've been thinking a lot about recently is... In fact, I was on the Tube last night. I normally only record podcasts now in my studio, but I knew you were in London. I, I had to speak to you, so I came down to London.

Dr. Gabor Maté 40:11 Hmm.

Dr. Rangan Chatterjee 40:12 I got the Tube to my hotel, and a chap stopped me on, on the Tube to talk to me, which is very rare in London. He'd heard me on a podcast. He, he's a psychologist. He, he loved the sort of content he was hearing, and he said something to me, which is, "It's interesting that you guys as doctors, you seem to know a lot about psychology and yourself." But actually, most doctors he meets and works with, he says he doesn't have that perception of them.

Dr. Gabor Maté 40:37 Oh, yeah right.

Dr. Rangan Chatterjee 40:38 And he said to be a clinical psychologist, you have to demonstrate that you have done a lot of self-reflection.

Dr. Gabor Maté 40:45 That's right.

Dr. Rangan Chatterjee 40:46 I found this fascinating. I thought, wow.

Dr. Gabor Maté 40:48 Mm.

Dr. Rangan Chatterjee 40:48 And I said, "What's the average age when someone becomes a clinical psychologist?" And I think what he said to me was around 27.

Dr. Gabor Maté 40:54 Mm.

Dr. Rangan Chatterjee 40:55 And I thought, well, it's really interesting. In the UK, you can go to medical school when you're 17-

Dr. Gabor Maté 40:59 Mm-hmm

Dr. Rangan Chatterjee 41:00 ... straight out of s-

Dr. Gabor Maté 41:01 Really?

Dr. Rangan Chatterjee 41:01 ... high school. Yeah.

Dr. Gabor Maté 41:01 Really?

Dr. Rangan Chatterjee 41:02 Uh, you can, depending on where your birthday is in the year, 17 or you've just... I mean, I, I had literally just turned 18 when I went to medical school. So I was actually-

Dr. Gabor Maté 41:12 So you didn't have to do, uh, four years of pre-med?

Dr. Rangan Chatterjee 41:14 No, no.

Dr. Gabor Maté 41:15 Okay.

Dr. Rangan Chatterjee 41:15 You go straight into medical school-

Dr. Gabor Maté 41:16 I see

Dr. Rangan Chatterjee 41:16 ... which means you could potentially-

Dr. Gabor Maté 41:17 Oh, God

Dr. Rangan Chatterjee 41:17 ... be a practicing doctor at 22 or 23.

Dr. Gabor Maté 41:20 Frightening [laughs] .

Dr. Rangan Chatterjee 41:21 It is frightening because what... You know, of course everyone's different, but what life experience-

Dr. Gabor Maté 41:27 Yeah

Dr. Rangan Chatterjee 41:28 ... do you have? But I find that really interesting how many doctors have never been through a period of self-reflection and therefore potentially can't help their patients with that.

Dr. Gabor Maté 41:38 It's even worse than that. Uh, I don't know what the quality of medical, or the experience of medical school here is in Britain, but when you talk to fellow physicians, when I talk to fellow physicians in writing this book and reflecting on my own experience, there's a lot of pressure, stress, and even trauma in medical training. And there's one particular study, uh, [laughs] that's rather alarming. You know what telomeres are, telomeres being the, these chromosomal structures or DNA structures at the end of our chromosomes that are meant to keep our chromosomes healthy. Let me just put it in shorthand like that. The length of our telomeres are some markers of biological aging and stress, so that the more stress, the more aged we get, the shorter our telomeres get. The telomeres of medical residents, medical students f- fray more rapidly than those of other people their age. In other words, the, the stress of training. So, so not only are we callow and inexperienced and without a broader vision when we enter medical school, the pressure that we're under further traumatizes us and makes us even more tight and less open-

Dr. Rangan Chatterjee 42:52 Hmm

Dr. Gabor Maté 42:52 ... so that, uh, when they've done studies on compassion, um, in medical students, some of the studies show that the highest level of compassion is at, is as they begin their studies. And after that, it diminishes

Dr. Rangan Chatterjee 43:08 Yeah

Dr. Gabor Maté 43:08 And n- not because they mean ill or anything like that, but because of the stress and pressure of the training itself, and because of the narrowness of the education.

Dr. Rangan Chatterjee 43:18 Yeah.

Dr. Gabor Maté 43:18 So that then the, then we get out there and we deal with people with complex life problems and all these chronic conditions that have huge emotional, um, scientifically demonstrated and demonstrable pathways where their emotions and their relationships and their social standing and their context has everything to do with their physical conditions. We're nowhere pe- nowhere prepared to recognize that. So we concentrate, as you said earlier in this conversation, on pretty, um, shallow symptom control at the very best.

Dr. Rangan Chatterjee 43:52 Yeah.

Dr. Gabor Maté 43:53 Now, you and I both know the miracles that Western medicine has also achieved.

Dr. Rangan Chatterjee 43:57 Yeah.

Dr. Gabor Maté 43:57 You know? As a... This is not in any way to dismiss the findings and brilliant achievements of our, our profession and, and the science that we follow. It's only if we could apply that science in a much more broader and humanly-

Dr. Rangan Chatterjee 44:13 Yeah

Dr. Gabor Maté 44:13 ... framed perspective, we could achieve so much more, and the population could be so much more healthy.

Dr. Rangan Chatterjee 44:18 Yeah. There's a couple of things there for me. Um, I just wanna echo what you said, that modern medicine has, you know, had so many phenomenal achievements and-

Dr. Gabor Maté 44:29 Yeah, yeah

Dr. Rangan Chatterjee 44:30 ... so many life-saving treatments and, and all kinds of things that it does. But I do certainly feel for much of chronic disease-

Dr. Gabor Maté 44:37 Exactly

Dr. Rangan Chatterjee 44:37 ... I would say much of modern medicine is broken, I think. I, I really do. Well, certainly parts of it. If we take the, I guess if we take Dick's, uh, IFS model and different parts within ourselves, I guess we could apply that same thing to mo- to modern medicine-

Dr. Gabor Maté 44:51 Mm

Dr. Rangan Chatterjee 44:51 ... and chronic disease management, that there are-

Dr. Gabor Maté 44:53 Mm

Dr. Rangan Chatterjee 44:53 ... certain parts within it that have been exiled. [laughs]

Dr. Gabor Maté 44:57 Well, let me... Exactly. So let me give you a, a really salient example. Take something like multiple sclerosis-

Dr. Rangan Chatterjee 45:04 Yeah

Dr. Gabor Maté 45:04 ... which is an autoimmune condition that affects the nervous system, results in weakness, paralysis, sometimes blindness, um, you know, balance issues. Um, can be very debilitating. Now, the multiple sclerosis was first described by a French physician called Jean-Martin Charcot in the ni- 1800s.

Dr. Rangan Chatterjee 45:25 Yeah.

Dr. Gabor Maté 45:25 Sometime in the mid-19th century. I forget exactly when. He said that this disease is caused by long-term vexation and grief. Now, since then, there's been dozens of studies showing a relationship between childhood trauma, multiple sclerosis, stress, and multiple sclerosis. Overwhelming evidence. And also that if we deal with these stresses or we have social support, the disease abates-

Dr. Rangan Chatterjee 45:57 Yeah

Dr. Gabor Maté 45:57 ... or becomes, you know. So, uh, uh, so what I'm saying is it's not, this is not fanciful. We also know the pathways, you know, because we know how stress can cause inflammation in the nervous system. You know, um, and despite this scientifically demonstrated relationship between stress and multiple sclerosis, the average neurologist will never ask their client about their childhood trauma or about what stresses are in their lives-

Dr. Rangan Chatterjee 46:24 Yeah

Dr. Gabor Maté 46:25 ... or about even helping them understand that the flare-up of the disease could be a teaching moment, and where the patient could investigate, "Well, how did I stress myself?" or, "What stress I was under, uh, before this flare-up?" In other words, the disease is assumed to have a life of its own.

Dr. Rangan Chatterjee 46:43 Yeah.

Dr. Gabor Maté 46:43 But, but it doesn't. The disease is a process-

Dr. Rangan Chatterjee 46:46 It's a process

Dr. Gabor Maté 46:47 ... that, that, that reflects a life experience, and if we can affect that life experience, we can affect that process.

Dr. Rangan Chatterjee 46:53 Yeah.

Dr. Gabor Maté 46:53 Now, I'm talking pure science here, but it's science that's completely eludes most people in our profession.

Dr. Rangan Chatterjee 47:01 You've detailed, yes, in this book, but also [laughs] in your previous books as well, the detailed science behind this.

Dr. Gabor Maté 47:06 Yeah.

Dr. Rangan Chatterjee 47:07 And then when we talk about evidence-based medicine-

Dr. Gabor Maté 47:10 Yeah

Dr. Rangan Chatterjee 47:10 ... uh, you just think, "Well, you know, really are we practicing evidence-based medicine or are we practicing selective [laughs] evidence-based medicine?"

Dr. Gabor Maté 47:18 Well, you know what? Uh-

Dr. Rangan Chatterjee 47:19 Myopic evidence-based medicine.

Dr. Gabor Maté 47:21 Well, if there's one phrase I could delete from the medical dictionary, it would be evidence-based.

Dr. Rangan Chatterjee 47:26 Yeah, me too.

Dr. Gabor Maté 47:27 Be- be- because I only wish, you know? It's not evidence-based practice, it's practice-based evidence. And like we, we keep doing the same thing over and over again, and then we gather the evidence from what we do.

Dr. Rangan Chatterjee 47:38 Yeah. It's also, you know, this, this whole thing, you know, what is that, you know, holistic definition of evidence-based medicine? It's three things, isn't it? It's research evidence, it's clinical experience and expertise-

Dr. Gabor Maté 47:50 Yeah

Dr. Rangan Chatterjee 47:50 ... and patient preference. Whereas-

Dr. Gabor Maté 47:52 Yeah

Dr. Rangan Chatterjee 47:52 ... in this modern world now, it's just become one of those things. What's, what does the research show?

Dr. Gabor Maté 47:56 Yeah.

Dr. Rangan Chatterjee 47:56 As if our clinical expertise, as if seeing people, reading them, what a patient might want for their condition is, like, irrelevant. And, and so I, I have a real problem with that term as well. I do think all doctors, at their core, want to help.

Dr. Gabor Maté 48:11 Of course.

Dr. Rangan Chatterjee 48:12 Uh, I don't think the system is that helpful. You know, certainly 10-minute consultations, 15-minute consultations really are completely inadequate now to actually-

Dr. Gabor Maté 48:21 Yeah

Dr. Rangan Chatterjee 48:21 ... look at the various things that are influencing disease. And I guess one of the great things for Doctor in the House for me was that I would see things, Gabor-

Dr. Gabor Maté 48:30 Yeah

Dr. Rangan Chatterjee 48:30 ... that even if I had an hour with a patient in a consultation room-

Dr. Gabor Maté 48:32 Yeah

Dr. Rangan Chatterjee 48:32 ... I would never, they would never come up. I would see relationship dynamics.

Dr. Gabor Maté 48:36 Yeah, yeah.

Dr. Rangan Chatterjee 48:37 How would one party talk? How would a husband talk to a wife?

Dr. Gabor Maté 48:40 That's right.

Dr. Rangan Chatterjee 48:41 What was going on before bedtime?

Dr. Gabor Maté 48:43 Yeah.

Dr. Rangan Chatterjee 48:43 I was thinking, "Oh, this is interesting. Mm, I wonder if that's why she's sick at the moment." I want, you know, all these things-

Dr. Gabor Maté 48:49 Oh, yeah. Yeah, yeah

Dr. Rangan Chatterjee 48:49 ... started to go in my mind. I thought-

Dr. Gabor Maté 48:50 Right

Dr. Rangan Chatterjee 48:50 ... this is almost like, um, I feel so fortunate to have had that experience.

Dr. Gabor Maté 48:54 Well, you know, and this is where I think that family physicians, should they choose to use the opportunity, are in an advantageous position. Because as a family doc, I knew a lot more than my specialist colleagues did.

Dr. Rangan Chatterjee 49:05 100%.

Dr. Gabor Maté 49:06 Not about their particular field, about which they knew infinitely more than I did, but I knew the person before they got sick. I knew the family background. I knew the multigenerational family background. And so that to me, the person wasn't just a disease. It was th- Somebody manifesting a, a life pro- Not that I knew that right away.

Dr. Rangan Chatterjee 49:25 Right.

Dr. Gabor Maté 49:26 It, it took me some time to realize, what was I looking at? But in that-

Dr. Rangan Chatterjee 49:29 But you knew intuitively.

Dr. Gabor Maté 49:30 But intuitively I knew, and, and so, uh, [laughs] there's another phrase that might drive you as badly as it drives me. There's evidence-based practice, then there's anecdotal. That's anecdotal. Like, if you tell a story about a patient-

Dr. Rangan Chatterjee 49:43 I know [laughs]

Dr. Gabor Maté 49:44 ... that's anecdotal. For God's sakes, yes, it's anecdotal, and I pay attention to anecdotes. People's life experience matters to me.

Dr. Rangan Chatterjee 49:51 Yeah.

Dr. Gabor Maté 49:51 And, and, and how they s- how they view their life experience matters to me. It's part of the evidence.

Dr. Rangan Chatterjee 49:56 Yeah. One of the other things you mentioned before when talking about the medical school students fraying their telomeres and shortening them-

Dr. Gabor Maté 50:04 Yeah

Dr. Rangan Chatterjee 50:04 ... it just made me think, like an idea that I, I spend a lot of time sitting with these days, is that our experience of the world is dependent on the state of our nervous system.

Dr. Gabor Maté 50:17 Yes.

Dr. Rangan Chatterjee 50:18 So if we have a nice, calm, relaxed nervous system-

Dr. Gabor Maté 50:22 Yeah

Dr. Rangan Chatterjee 50:23 ... we can see things. Our, our, our vision is peripheral. We're open. It's outward.

Dr. Gabor Maté 50:28 Yeah.

Dr. Rangan Chatterjee 50:29 We can hear. Whereas when we have this stress, the tuning of your nervous system then i- is slightly higher, maybe significantly higher, and what happens when we're feeling stressed, our, our vision becomes narrow and focused, right?

Dr. Gabor Maté 50:43 Totally.

Dr. Rangan Chatterjee 50:43 So if we think about the profession as a whole, if there's a chronic state of stress, and you've only got 10 or 15-minute consultations, and you have patients coming in with chronic complex issues, your focus being narrow is a problem.

Dr. Gabor Maté 50:58 Yeah.

Dr. Rangan Chatterjee 50:58 You know, it's fundamentally built into the system, and do you know what I mean? It makes me think what-

Dr. Gabor Maté 51:04 Oh, oh, totally, and, and, and patients feel it.

Dr. Rangan Chatterjee 51:06 And patients feel it.

Dr. Gabor Maté 51:07 Because they come out of there thinking, or, "I wasn't heard, I wasn't seen," you know? And, um, it's certainly true that the, the, the state of our nervous system determines the state of the world as we perceive it.

Dr. Rangan Chatterjee 51:21 Yeah.

Dr. Gabor Maté 51:21 And going back to a point you made earlier, what if an essential aspect of medical training was actually self-awareness? Uh, and not just only self-awareness of the broad sense of who we are and all that, but just what am I experiencing at the moment? Because the energy that I'm experiencing at the moment is going to be felt by the patient. Now, I'm in a position of authority as a physician. Um, if I'm tense, there's no way that's not gonna affect-

Dr. Rangan Chatterjee 51:52 Yeah

Dr. Gabor Maté 51:52 ... the, the, the emotional and physiological state of the, of, of the patient. Now, in certain, in the more mechanical aspects of our profession, like an orthopedic surgeon, when the person, when the patient is asleep on the table, you know, I, I just want that guy to have good hands-

Dr. Rangan Chatterjee 52:14 Yeah. I get it

Dr. Gabor Maté 52:14 ... and, and/or that woman to have good hands and, and to be able to perform the technical aspect of the operation. So in that acute sense, it, it's not as important. Not that it isn't, but it's not a- not nearly as important. I'd rather have a technically skilled orthopedic surgeon who is an emotional idiot than, than somebody who's emotionally really sensitive and lousy hands, you know, if they're gonna operate on my femur, you know?

Dr. Rangan Chatterjee 52:41 Yeah.

Dr. Gabor Maté 52:42 But that's a rare example. When we talk about the chronic conditions of the mind, as in psychiatry, um, or in chronic conditions of the body, as in autoimmune disease and malignancy and, and, and, and, uh, uh, you know, chronic inflammations and, and, and so on-

Dr. Rangan Chatterjee 52:59 Yeah

Dr. Gabor Maté 52:59 ... um, this lack of awareness of self and of the client is a huge handicap, uh, that, that burdens our profession and limits our capacity to deliver good care, and nothing in our training, uh, prepares us for it.

Dr. Rangan Chatterjee 53:18 A couple times in this conversation, you've mentioned stress.

Dr. Gabor Maté 53:22 Yeah.

Dr. Rangan Chatterjee 53:23 And I, I'd like to talk a little bit about stress, because I think it's a term that is thrown around a lot these days.

Dr. Gabor Maté 53:32 Yeah.

Dr. Rangan Chatterjee 53:33 And often when doctors talk about stress and put patient symptoms down to stress-

Dr. Gabor Maté 53:42 Yeah

Dr. Rangan Chatterjee 53:42 ... patients can often feel unheard and say, you know, that they feel... And I think often that comes to the way we communicate these things, and if we become skilled communicators, I think we can very clearly explain what we mean by that. But I think stress often gets misinterpreted. You mentioned when you were writing your latest book-

Dr. Gabor Maté 54:00 Yeah

Dr. Rangan Chatterjee 54:00 ... that the emotional stress that you created in your mind would-

Dr. Gabor Maté 54:04 Yeah

Dr. Rangan Chatterjee 54:04 ... raise your blood pressure.

Dr. Gabor Maté 54:06 Yeah.

Dr. Rangan Chatterjee 54:06 Right? So you were making yourself, you know, sick. [laughs]

Dr. Gabor Maté 54:11 Absolutely I was.

Dr. Rangan Chatterjee 54:13 Through no physical threat-

Dr. Gabor Maté 54:14 Yeah

Dr. Rangan Chatterjee 54:15 ... through just your relationship with this book and what you thought [laughs] it should be or could be.

Dr. Gabor Maté 54:19 Yeah.

Dr. Rangan Chatterjee 54:20 So stress is endemic these days. The World Health Organization still calls stress the health epidemic-

Dr. Gabor Maté 54:28 Yeah

Dr. Rangan Chatterjee 54:28 ... of the 21st century, right? So how do you see stress, and how do you see its relationship to disease?

Dr. Gabor Maté 54:36 Well, it's one of those, as you, uh, imply, it's one of those words with a double meaning, and it's all depends how we use it. A, a related word is psychosomatic. Like, you and I both know, in the best possible sense of the word, that a lot of illnesses are genuinely psychosomatic, because psyche means their emotional apparatus and soul, if you will, and soma is the body. And because of the mind-body unity and the unshakable unity of our emotional system and the brain's emotional circuits with the nervous system, the immune system, and the hormonal apparatus, it's a unit. It's a psychosomatic unit. That's a really great word. But when most people hear psychosomatic, they think we're just telling them they're imagining their diseases, which is very often how doctors have used it.

Dr. Rangan Chatterjee 55:27 Yeah.

Dr. Gabor Maté 55:28 And it's the same with stress. Now, stress is a genuine psychophysiological event. Stress isn't some fancied, imagined, uh, fantasy on the part of the patient. Stress is actually what happens when the organism faces pressures that are beyond its capacity to deal with chronically, and that results in the release of stress hormones, uh, adrenaline and cortisol, uh, amongst other things. Stress also affects the immune system. Stress affects the gut. Stress affects the brain. Uh, it affects the heart. You mentioned high blood pressure. What's the medical term for hypertens- for high blood pressure? Hypertension. I mean, as, as physicians we're trained that, well, there's 5% of hypertension is explainable due to kidney disease or some hormonal abnormality, but 95% is what we call essential hy-

Dr. Rangan Chatterjee 56:21 Essential

Dr. Gabor Maté 56:22 ... essential hypertension, which means we haven't got a clue what's causing it. Come on, people. Read the word. Hypertension. Hypertension. Too much tension. That's what causes hypertension, and we know this from all kinds of studies. In other words, it's the impact of stress and high levels of adrenaline on the cardiovascular system. Now, when your doctor use the word stress and the patient is- thinks that they, "I'm being dismissed," they often are being dismissed because the physician himself or herself or themselves don't recognize the unity of mind and body.

Dr. Rangan Chatterjee 57:02 Yeah.

Dr. Gabor Maté 57:02 So when they're, when that word leaves their lips, they do mean a kind of dismissive, "I can't find anything physically wrong with you, therefore it's just stress." Well, that's not how it works. In the genuine sense of the word, as we know from millions of studies, stress has huge impacts, and they have impacts even sometimes when we can't measure them, when, when we don't have the clinical tools to measure something. You mentioned fibromyalgia earlier. Well, there's no clinical test that'll diagnose or rule out fibromyalgia, but it's clearly a stress-related condition. And when you study people's lives with fibromyalgia, salient amongst the findings is significant degrees of childhood trauma and, and, and childhood adversity and their impacts on the body.

Dr. Rangan Chatterjee 57:52 Yeah.

Dr. Rangan Chatterjee 57:53 Can, can we at that point, Gabor, just explain what exactly do you mean when you say childhood trauma?

Dr. Gabor Maté 57:58 Well, geez, I'm so glad to, to be able to talk about that because that's another word that's, on the one hand, not appreciated, understood, even recognized by much of medical practice, on the one hand. The other hand, it's used too loosely sometimes. So people say, "I went to a movie last night and it was, I was really, uh, traumatized." No you weren't. You just were upset. You were sad. You were, you know, angry, but that doesn't mean you were traumatized. So what does it mean to... What does trauma mean? Well, again, if you look at word origins, the wo- the or- the origin of the word trauma is a Greek phrase for wounding or, um, a, a, a wound. So trauma is a wound that you sustained. Now, when people think of the word trauma, they often believe it has to do with what we call the big T events, the big trauma events such as sexual abuse, emotional abuse, neglect, a parent dying, violence in the family, parental addiction, um, maybe a, a rancorous divorce. These are traumatic, but trauma is not what happened to you. Trauma is what happened inside you as a result of what happened to you. So trauma is the psychic wound that you sustained. S- that's the first point. The second point is if we understand the nature of a wound, really there's two ways to look at a wound. If it stays open, it's very sore. You touch it. If I pat myself on the shoulder right now, I feel no pain. But if there was a wound there, and my shoulder was bare, and my nerve endings were close to the surface-

Dr. Rangan Chatterjee 59:37 Mm

Dr. Gabor Maté 59:37 ... in other words, if I was thin-skinned-

Dr. Rangan Chatterjee 59:39 Yeah

Dr. Gabor Maté 59:39 ... and if I tap myself with the same force, there'd be severe pain. So one aspect of trauma is like an open sore that if you touch it, you just react like you were just wounded all over again. That's one aspect of a wound. The other way to look at a wound is, is, is that it forms a scar. Now, scar tissue protects the wound, but at the same time it's thick, it's inflexible, it's hard, it's not capable of growth, and it lacks nerve endings, so you don't feel. So trauma both sensitizes us to certain stimuli and on the other hand numbs us to our own feelings and, and, and, and, and separates us from our bodies 'cause it's too painful to be in our bodies. Now, to traumatize people, you can do bad things to them, as I mentioned earlier. But you can also wound people, particularly sensitive kids, but all kids, but especially highly sensitive children, not just by doing bad things to them, but by not giving them the good things that they need. So it's not just what shouldn't have happened but did, but what should have happened but didn't. So for this, we have to understand children's basic needs. Children have certain developmental needs for healthy emotional and brain development.

Dr. Rangan Chatterjee 1:00:56 Yeah.

Dr. Gabor Maté 1:00:56 One of them is to be seen and heard and to be accepted for exactly who they are without any condition.

Dr. Rangan Chatterjee 1:01:02 Yeah.

Dr. Gabor Maté 1:01:03 Now, lots of people tell me they had happy childhoods, nothing traumatic, but when I delve into them, there is, there's even a little bit, that lack of un- unconditional un- uh, acceptance and understanding and being seen, um, is salient. You can hurt people that way. That can wound people. And so these traumas then show up in all kinds of coping mechanisms and adaptations. Many of them, we call them mental illnesses. Like take something like depression. Uh, again, look at a word origin. What does it mean to depress something? You push something down. Now, what gets pushed down in depression, and I've been diagnosed with that, um, what gets pushed down in depression is your emotions. But why would you push down your emotions? You push down your emotions when to feel them puts you at odds with your environment, so that if, if your parents can't handle your verve and your enthusiasm-

Dr. Rangan Chatterjee 1:02:01 Yeah

Dr. Gabor Maté 1:02:02 ... or your sadness or your grief or your anger, then in order to fit in with the family environment, you will push down those feelings, not consciously, but simply as a matter of automatic adaptation. 30 years later, you're diagnosed with this disease called depression, but it was a response to a childhood wounding, the wounding of not being seen and accepted with all your emotions, which is another essential need of the child. The child should be able to experience all their emotions no matter what they are. So that's a very simple example of childhood wounding trauma, which then shows up in the form of adult distress, and I can show the similar patterns for all manner of chronic illness, that there was childhood wounding either because of things happening that shouldn't have, or what I call the small T trauma of things not happening that should have, that then leads to adaptations, which adaptations in the long term promote illness.

Dr. Rangan Chatterjee 1:03:05 Yeah. There's a couple of things there, right? So childhood trauma then shows up later in a whole variety of different behaviors, a whole variety of different diseases.

Dr. Gabor Maté 1:03:19 Yeah.

Dr. Rangan Chatterjee 1:03:20 Right. So there's-- the question there is then, as an adult, how can we start addressing this? But there's also another piece, which is many people listening or watching are parents themselves.

Dr. Gabor Maté 1:03:35 Yeah.

Dr. Rangan Chatterjee 1:03:36 And they may recognize certain things and certain behaviors they've had in their own life, uh, as I, as I certainly have done. But there's also, well, how do we not traumatize or, or shall I say, minimize [chuckles] the trauma that we put onto our kids? You know, what are those... If we, if we maybe start there-

Dr. Gabor Maté 1:03:56 Yeah

Dr. Rangan Chatterjee 1:03:56 ... because we, we're living in a society where it's very hard to be parents. It's very hard to be a mother.

Dr. Gabor Maté 1:04:02 It's very hard.

Dr. Rangan Chatterjee 1:04:03 You know, really hard. And actually, through no faults of parents-

Dr. Gabor Maté 1:04:09 Yeah

Dr. Rangan Chatterjee 1:04:09 ... they're struggling to be present and have time and, and patience-

Dr. Gabor Maté 1:04:14 Yeah

Dr. Rangan Chatterjee 1:04:14 ... with their children. I know in, in the book, you, you write that being understood as a child is as much of a need as food and shelter-

Dr. Gabor Maté 1:04:24 Yeah

Dr. Rangan Chatterjee 1:04:24 ... which I found really profound.

Dr. Gabor Maté 1:04:25 Yeah.

Dr. Rangan Chatterjee 1:04:26 Being understood, being seen, being heard.

Dr. Gabor Maté 1:04:28 Yeah.

Dr. Rangan Chatterjee 1:04:29 Right? So what can parents think about when trying to bring up their kids?

Dr. Gabor Maté 1:04:33 So first of all, it's very important to avoid any hint of parent blaming-

Dr. Rangan Chatterjee 1:04:36 Yeah

Dr. Gabor Maté 1:04:37 ... uh, a- as you say. And so it's not matter of individual failure, it's really the question of a society that doesn't put children's needs in the forefront at all. And so let's take a really simple example. Now, in, in the book, I talk about my own personal history, which is, you know, a Jewish infant under Nazi occupation in Hungary. Very dramatic, um, v- very terrible, uh, time in history for be a, to be a, an infant.

Dr. Rangan Chatterjee 1:05:05 Yeah.

Dr. Gabor Maté 1:05:06 And then, then my mother and I live under really deplorable conditions under threat of death, and at one point, she gives me up to a total stranger in the street. By the way, I was just in Budapest, uh, my, my home city, uh, two weeks ago, and I swam every morning at a sports club. It was right across the house where mother gave me to a stranger-

Dr. Rangan Chatterjee 1:05:27 Oh, wow

Dr. Gabor Maté 1:05:28 ... 76 years ago, 77 years ago, to save my life. So that's very dramatic. But forget the Nazis, forget genocide, forget the war. When my mother and I are still in the hospital, maternity hospital, and I'm two weeks old, she writes in her diary, "My poor little Gabor, my heart is breaking for you because you've been crying for the last one hour and a half, wanting to be fed. But I promised the doctor I'd only feed you every four hours. So it's not time yet. You're gonna have to learn that nighttime is for sleeping, not for eating." Her heart was breaking. She's completely suppressing her parental instinct to please the doctor. So forget the war, forget the genocide, forget all the drama. Just a mom, a 24-year-old mom, following doctor's orders. Now, in this society, parents are often advised to ignore their kids' needs, just like that. For example, you have this thing called sleep training, where parents are told, "Don't pick up the crying child." Now, you tell a mother orangutan not to pick up their crying child. You tell a mother cat to ignore the cries and distress of their infant. But we tell human beings this every day, and we call this sleep training, you know? And what we're doing is giving the child the mes- Now, you know it works. You ignore a child's cries for four nights, they're gonna sleep through the night. You know why? 'Cause they give up, and they, they can't stand it. They put themselves to sleep just to get away from the distress of it, and their brain is, brain is flooded with cortisol, which interferes with healthy brain development, and the message they get is that their feelings don't matter, that they're on their own, they're all alone. Now, this is done by loving parents under the advice of well-meaning professionals, and we call this parenting advice, or another simple little device that parents are often told to do, time out. Now, there's a very famous Canadian psychologist who I don't need to name, but in his mega-selling book, he advises parents that an angry little child should be made to sit by themselves until they come back to normal. It's not normal for a two-year-old to be angry, and that child should be excluded. The message the child should get is, "You're not acceptable to us when you have that emotion." A lot of parents, there's best-selling books on this technique of time out-

Dr. Rangan Chatterjee 1:07:48 Yeah

Dr. Gabor Maté 1:07:48 ... which basically means separating the child from yourself until they start behaving in ways that you can approve of. In other words, the message to the child is, "Your acceptance is purely conditional on your pleasing me." Now, we're not talking about parents that are beating their kids. We're not talking about parents who don't love their kids. We're not talking a- a- about parents who are trying to hurt their kids. We're just talking about parents who are, are, are complying with social norms and social values. Then there's the factor of stress that you mentioned, how stressful it is to be parenting. Again, we're not meant to parent in isolated homes, in one-person or two-person, uh, two-parent families. We're meant to parent in groups, in community. This is how we evolved as a species. We know already, and I spend chapters on this, the, a chapter on prenatal life-

Dr. Rangan Chatterjee 1:08:39 Yeah

Dr. Gabor Maté 1:08:39 ... that, that, that stress on the pregnant woman. You know, I mentioned telomeres earlier?

Dr. Rangan Chatterjee 1:08:44 Yeah.

Dr. Gabor Maté 1:08:47 The telomeres of infants born to highly stressed mothers are shorter already at birth. Uh, this is a new study that just came out since I wrote the book. So stress on pregnant women. Now, how are... Just exactly how are we taking care of pregnant women in our society? Are we honoring their needs? Are we making provisions for them on the job, or even to give them prenatal leave to take care of themselves? Or tell we... Are we telling husbands to really look after their wives' emotional needs? I mean, I talk about in the book about just what a unsupportive husband I was when I was, you know, when we were expecting our children. That has an impact on the developing child already in the womb. Not because the mother doesn't love the child, but because when she's stressed, that stress translates into physiological impacts on the child. Now, there are times in the first year of life when every second, millions of circuits, millions of connections are being made in the brain. The mother's emotional states directly affect the br- the brain development of the child. We know this from scientific studies.

Dr. Rangan Chatterjee 1:10:00 Yeah.

Dr. Gabor Maté 1:10:00 How are we taking care of new mothers in this society? What support are we giving them? How do we ensure that they have the best possible environment to raise that child? And so, um, what I'm saying is that this society is so stressful, and look, in Britain, I'm in Britain right now. I read the, the newspaper. 10% inflation rate while the economy is shrinking. How is that affecting... You know, one of the triggers for stress is uncertainty.

Dr. Rangan Chatterjee 1:10:27 Yeah.

Dr. Gabor Maté 1:10:28 So this is a soci- society, this rich society, that massively stresses its population, and those stressed parents then are supposed to raise healthy children?

Dr. Rangan Chatterjee 1:10:40 Yeah.

Dr. Gabor Maté 1:10:41 You know, so that, uh, uh, with lousy advice from experts to ignore the child's needs. I'm not even talking about trauma in a big sense.

Dr. Rangan Chatterjee 1:10:49 Yeah. You, you've been very open in the book about things that maybe you could have done better, whether it's-

Dr. Gabor Maté 1:11:00 To say the least. [laughs]

Dr. Rangan Chatterjee 1:11:01 Yeah. And it's, um, you know, it's, it's interesting, it's very insightful to read that from, from you. And I guess as you talk about your children there and how you maybe didn't give your wife as much support as you, as you could have done-

Dr. Gabor Maté 1:11:19 It was worse than that. I stressed her.

Dr. Rangan Chatterjee 1:11:22 Yeah.

Dr. Gabor Maté 1:11:23 I added to her stress.

Dr. Rangan Chatterjee 1:11:25 So you added to her stress. It had an impact on your children.

Dr. Gabor Maté 1:11:28 Yeah.

Dr. Rangan Chatterjee 1:11:29 You're writing about more and more of the research on the long-term implications of that.

Dr. Gabor Maté 1:11:33 Yeah.

Dr. Rangan Chatterjee 1:11:35 How do you feel about that now? Have you, have you made peace with it? Or do you beat yourself up?

Dr. Gabor Maté 1:11:41 Well, y- so this book that we're discussing was written with the help, with the brilliant help of my eldest son, who's a lyricist and a musi- uh, you know, a musical theater writer, but he's just a wonderful writer, and, uh, I couldn't have done it without him. And, uh, he's now, as the book comes out, he'll be 47 years old. This is the kid that, that when, when he was three years old, I slapped across the face 'cause he wouldn't sing Happy Birthday to me. Now, the story's worth telling. Um, it was my birthday party, and we had gathered at my parents' place. My mother gave me a, uh, made me a traditional Hungarian meal, you know, for my birthday, and my brothers were there with their wives, their families, my parents, my wife and I, and our eldest son, three years old. And Daniel, my co-writer on this book to be, announces, "I'm not singing Happy Birthday." And I said, "If you're not singing, you're not getting cake." "Well, I'm not singing anyway." I get more and more angry. Everybody's begging me to desist. Everybody's begging me to lay off. The more they asked me to do that, the more angrier I get. I ended up hitting him. Now, what was that all about? He was just being a three-year-old. He says, "I'm gonna exert my own personality. I'm not gonna go along with the crowd," you know? I might have said, "Hey, Daniel, sweetheart, don't sing. Just have the cake and enjoy it." What was being triggered in me is the sense I developed as a young child that I wasn't loved and lovable. So I needed this three-year-old to prove to me that I was lovable. When he didn't, I got enraged. I'm not either criticizing myself or defending myself. I'm just saying this is what happened. This is how we passed on our trauma unwittingly. So one of the pieces of advice I give to parents is deal with your trauma as much as you can. As you have children and before you have children and as you're raising them. Now, in terms of my own, um, trajectory with my kids, we've done a lot of repair, a lot of healing, and even this, writing this book together has been a tremendously healing process.

Dr. Rangan Chatterjee 1:14:06 Yeah.

Dr. Gabor Maté 1:14:06 I mean, we've had our moments, believe me. Remember each other's throats. In fact, we have a another book contract. The next book we're writing together is gonna be called Hello Again: A Fresh Start for Adult Children and Their Parents.

Dr. Rangan Chatterjee 1:14:19 Oh, love it.

Dr. Gabor Maté 1:14:20 Yeah. So that, as soon as the hoopla on this book settles down, which I hope won't for a long time, but as soon as it does, we're gonna start writing that book together. So yeah, we've made the repair, and that repair is possible. But to young parents, I would say, "Don't make the repair necessary."

Dr. Rangan Chatterjee 1:14:39 Yeah.

Dr. Gabor Maté 1:14:39 You know, work on your own stuff. You learned something very important about yourself as your six-month-old got ill, and, um, I've heard you say that, uh, the greatest value to you is not your success as a physician or anything else, but, but the healthy raising of your children.

Dr. Rangan Chatterjee 1:15:00 Yeah.

Dr. Gabor Maté 1:15:00 Now, if, if you'd asked me that when my kids were small, I would've said, "Yeah, my highest value is the, the happiness of my own children," if you'd asked me that. But if you looked at my life-

Dr. Rangan Chatterjee 1:15:13 Yeah

Dr. Gabor Maté 1:15:13 ... that's not what you would've seen. You would've seen somebody consumed with success, consumed with professional security, consumed with his own egoic concerns. So what I would say to parents is really do evaluation of what's important to you, and to use your phrase, look at how your value, your life is aligned with what your best intentions are when it comes to parenting. It's not a question of not making mistakes. Of course you will. But if you actually live a life that even in this stressful society with all the pressures on you has its core value the genuine needs and wellbeing of your children, you're gonna do okay.

Dr. Rangan Chatterjee 1:15:55 Yeah. Some parents are likely to have heard what you said about sleep training.

Dr. Gabor Maté 1:16:03 Yeah.

Dr. Rangan Chatterjee 1:16:04 And I imagine they will have gone through their head and go, "Oh no, I, I, I did that with my baby. I did that with my child."

Dr. Gabor Maté 1:16:10 Yeah.

Dr. Rangan Chatterjee 1:16:10 "I didn't know any better."

Dr. Gabor Maté 1:16:11 Yeah.

Dr. Rangan Chatterjee 1:16:11 "I was reading the latest parenting book-

Dr. Gabor Maté 1:16:13 Yeah

Dr. Rangan Chatterjee 1:16:13 ... and I, I thought I was doing the right thing, but now I hear you, Gabor, explain it. It totally makes sense why that possibly wasn't the most helpful thing to do." A lot of people then take that next step and go into guilt and shame.

Dr. Gabor Maté 1:16:26 Yeah.

Dr. Rangan Chatterjee 1:16:26 They feel bad about themselves.

Dr. Gabor Maté 1:16:27 Yeah.

Dr. Rangan Chatterjee 1:16:27 They start to berate themselves. It, it, it feeds an existing pattern of negative self-talk within them.

Dr. Gabor Maté 1:16:32 Yeah.

Dr. Rangan Chatterjee 1:16:33 For someone who's doing that right now as they're listening, what would you say to them?

Dr. Gabor Maté 1:16:39 Well, first of all, I would just say I totally understand why you wanted to sleep train your child, 'cause you might have to go to work in the morning.

Dr. Rangan Chatterjee 1:16:46 Yeah.

Dr. Gabor Maté 1:16:46 It's not like we're hunter gatherers carrying our babies everywhere we go, you know?

Dr. Rangan Chatterjee 1:16:52 Yeah.

Dr. Gabor Maté 1:16:52 Um, we live in this harried, uh, world where there are demands on us, and a child who doesn't sleep at night really makes this difficult for us to live our lives. So I totally get it. So you should not blame yourself for that. Secondly, you should not blame yourself for accepting advice that, from people that you thought were experts. And, uh, but thirdly, I would ask you, what did it feel like to you? And if you ask most people, most parents would say, "It broke my heart."

Dr. Rangan Chatterjee 1:17:21 Yeah.

Dr. Gabor Maté 1:17:21 You know? And, and so I would say to them, "Henceforth, listen to yourself."

Dr. Rangan Chatterjee 1:17:26 Yeah.

Dr. Gabor Maté 1:17:26 Because we all have these parenting instincts, but, but, but the instincts have to be evoked by the environment, and we live in an artificial environment that not only does not evoke, but in fact suppresses our, our innate instincts. And so as much as possible, don't listen to the experts. Listen to your heart, and deal with your stuff. And as far as guilt, look, I'm telling you, I'm 78. I just told you the story of hitting my three-year-old, who's now 47 and helped me write the book of my life, you know? Um, doesn't matter what else I may write from now on. This is gonna be the book that expresses the essence of what I've learned, uh, at least so far. It's all repairable, but just wake up.

Dr. Rangan Chatterjee 1:18:16 Yeah.

Dr. Gabor Maté 1:18:16 As soon as possible, wake up. Forget the guilt. You did your best. I'm not defending myself. My reaction to my child that night, that was my best at the time. Not proud of it, but neither am I... Now, did I feel guilt, shame? Oh, yeah. I've had a lot that to deal with, but I've learned better.

Dr. Rangan Chatterjee 1:18:40 Yeah.

Dr. Gabor Maté 1:18:41 Uh, so that just accept yourself, that you're a human being who had certain traumas, certain stresses, certain wrong information. You know, there was a famous, uh, uh, pediatrician, Benjamin Spock. I don't know if his name was well-known in Britain, but for decades he was like the arbiter of how to raise children in North America. Millions of books sold. In many ways a good man, but he talked about the tyranny of the infant who wanted to be picked up at night. Can you imagine? The tyranny of the infant-

Dr. Rangan Chatterjee 1:19:16 Yeah

Dr. Gabor Maté 1:19:16 ... who just wants to be held by his parents, her parents, which is the natural desire of any mammalian infant.

Dr. Rangan Chatterjee 1:19:25 Yeah.

Dr. Gabor Maté 1:19:26 So don't blame yourself.

Dr. Rangan Chatterjee 1:19:28 Yeah. Blame, blame, guilt doesn't help anything, does it?

Dr. Gabor Maté 1:19:33 No.

Dr. Rangan Chatterjee 1:19:33 It keeps you locked, um-

Dr. Gabor Maté 1:19:34 Absolutely

Dr. Rangan Chatterjee 1:19:35 ... you know? And I remember, you may not remember this, or in fact you won't remember this because it's before I knew you. I was in LA at a conference, and I went to see you speak.

Dr. Gabor Maté 1:19:45 Oh.

Dr. Rangan Chatterjee 1:19:45 And I was... When you took Q&A at the end, I actually asked you a question.

Dr. Gabor Maté 1:19:49 Really?

Dr. Rangan Chatterjee 1:19:50 Yeah. Sorry to interrupt. If you are enjoying this content, there's loads more just like it on my channel, so please do take a moment to press subscribe, hit the notification bell, and now back to the conversation. Yeah, this is You know, years before I actually spoke to you on the podcast, before I even had a podcast or-

Dr. Gabor Maté 1:20:07 Okay

Dr. Rangan Chatterjee 1:20:07 ... I was just drawn to your work. And, um, you know, I was probably, I'm gonna guess it was two or three years after, you know, my, my son was sick.

Dr. Gabor Maté 1:20:18 Hm.

Dr. Rangan Chatterjee 1:20:19 And I, I can't remember now exactly what I asked you, um, but you gave a pretty, um, hard-hitting, uncompromising, I guess an uncomfortable truth-

Dr. Gabor Maté 1:20:32 Hm

Dr. Rangan Chatterjee 1:20:33 ... which I, I, I really value. You know-

Dr. Gabor Maté 1:20:36 Hm

Dr. Rangan Chatterjee 1:20:36 ... you weren't shying away from it. You were just kinda saying, "Get over yourself"-

Dr. Gabor Maté 1:20:40 Yeah

Dr. Rangan Chatterjee 1:20:40 ... i- in as compassionate a way as you could, but a very direct way, which I really needed because, you know, when, when, when my son was six months, he had a hypocalcemic convulsion, uh, secondary... So very low levels of calcium in his blood, secondary to nonexistent levels of vitamin D in his body.

Dr. Gabor Maté 1:21:01 Hm.

Dr. Rangan Chatterjee 1:21:01 And as somebody who used to be, I shall say now, as someone who used to be a perfectionist-

Dr. Gabor Maté 1:21:08 Mm

Dr. Rangan Chatterjee 1:21:09 ... I felt I'd let my son down. I, I felt that I had been a substandard parent. And, you know, modern medicine saved his life, but it did nothing to help me understand what might are the consequences of being low in vitamin D for six months-

Dr. Gabor Maté 1:21:24 Mm

Dr. Rangan Chatterjee 1:21:24 ... for the development of his immune system-

Dr. Gabor Maté 1:21:26 Mm

Dr. Rangan Chatterjee 1:21:26 ... and all the other functions that this-

Dr. Gabor Maté 1:21:27 Mm

Dr. Rangan Chatterjee 1:21:27 ... vitamin, or I should say hormone, does in the body. You know, this is where when we make things too binary, it gets really confusing, and it, and it, and it keeps us locked. So we left the hospital after five days with, you know, them saying, "Yeah, you know, he's fine now. You can go." And I was thinking-

Dr. Gabor Maté 1:21:42 Yeah

Dr. Rangan Chatterjee 1:21:42 ... "Well, what about everything else?" [laughs] You know, is this it? I made myself a vow. As we were walking out of the hospital, I made myself a vow. I'm gonna get my son back to full health-

Dr. Gabor Maté 1:21:52 Mm

Dr. Rangan Chatterjee 1:21:52 ... as if this had never happened.

Dr. Gabor Maté 1:21:54 Mm.

Dr. Rangan Chatterjee 1:21:54 And I became obsessed. I would read. I would study nutrition, the gut microbiome, the immune system, four or five hours a day, obsessed with one goal, to get him back to full health. And you know, he, he is... You know, as of last week, he's 12. He's a thriving, happy, healthy 12-year-old boy.

Dr. Gabor Maté 1:22:13 Mm.

Dr. Rangan Chatterjee 1:22:13 But I realized for the first, I don't know, five, six years of, of, of me being a father, I was consumed by guilt. I thought I'd let him down, and that would drive everything I, I really would encourage him to do. And I realized after a while, "He doesn't need your guilt."

Dr. Gabor Maté 1:22:28 Exactly.

Dr. Rangan Chatterjee 1:22:29 He doesn't need your guilt. He, he just wants a present dad. He doesn't... Nobody else, my wife didn't think I was to blame. The medical profession didn't think I was to blame.

Dr. Gabor Maté 1:22:36 [laughs]

Dr. Rangan Chatterjee 1:22:36 It's a self-created story in my heads. But-

Dr. Gabor Maté 1:22:38 Oh, yeah. Well, so I so resonate with that. But first of all, let me just say something. You say you felt you let him down. You felt you didn't help him. You f- those aren't feelings. Those are beliefs.

Dr. Rangan Chatterjee 1:22:51 Yeah.

Dr. Gabor Maté 1:22:52 You believe them. Now, if you like the feeling, it's probably shame-

Dr. Rangan Chatterjee 1:22:57 Oh, yeah

Dr. Gabor Maté 1:22:58 ... and guilt. And then if I asked you, shame and guilt, is that the first time when you felt them? You would say no. They probably go back a long, long way. In other words, your son had nothing to do with it.

Dr. Rangan Chatterjee 1:23:09 Yeah.

Dr. Gabor Maté 1:23:10 You know? Um, and, a- a- and my kids have given me that message so m- l- leave off with your guilt already.

Dr. Rangan Chatterjee 1:23:16 Yeah.

Dr. Gabor Maté 1:23:16 L- leave off with your mea culpas already. They say, "We don't wanna be seen as your mistakes."

Dr. Rangan Chatterjee 1:23:21 Yeah.

Dr. Gabor Maté 1:23:21 "We don't wanna be seen as your failure. We're people."

Dr. Rangan Chatterjee 1:23:23 That's a great point.

Dr. Gabor Maté 1:23:24 You know? And so that you're doing nobody any favors when you look at your children through the eyes of your own guilt, which has nothing to do with them anyway.

Dr. Rangan Chatterjee 1:23:32 Yeah. Completely. And, and, and, and I've noticed how as I've done the work through IFS, through-

Dr. Gabor Maté 1:23:37 Yeah, yeah

Dr. Rangan Chatterjee 1:23:37 ... all kinds of different modalities, as I've let go of that, and I, I think I mostly have. I'm sure it comes up now and again-

Dr. Gabor Maté 1:23:44 Yeah, yeah

Dr. Rangan Chatterjee 1:23:44 ... at certain times, and then it's another, it's another self-awareness piece of, "Oh, God, I thought I was over that. That's, [laughs] that's coming up again." What, what is that part trying to say?

Dr. Gabor Maté 1:23:52 Well, well, it's interesting because I know that, uh, amongst your core values, I think it's you, you talk about integrity, compassion, and, uh-

Dr. Rangan Chatterjee 1:24:00 Curiosity

Dr. Gabor Maté 1:24:01 ... is it curiosity? So I teach a course called Compassionate Inquiry-

Dr. Rangan Chatterjee 1:24:04 Yeah

Dr. Gabor Maté 1:24:04 ... but where they... In fact, Dick Schwartz and I did a program together recently where we talked about the differences and similarities between his approach and mine, and there's a lot of overlap.

Dr. Rangan Chatterjee 1:24:12 Yeah, for sure.

Dr. Gabor Maté 1:24:13 And, and so if you took the same dynamic of you and your son, and, and, and, and, and, and your guilt, if you applied some compassionate inquiry to it, what would you find out? You would find out that you did nothing wrong. You'd find out that the guilt and the shame that you're experiencing had nothing to do with your son. They predated his, they predated his birth by a couple of decades at least.

Dr. Rangan Chatterjee 1:24:36 Yeah.

Dr. Gabor Maté 1:24:36 You know? And that you do yourself and him no favor by projecting it onto him.

Dr. Rangan Chatterjee 1:24:42 Yeah.

Dr. Gabor Maté 1:24:43 So again, when it comes back to, to parents, it's so important that you be compassionate to yourselves.

Dr. Rangan Chatterjee 1:24:50 Yeah.

Dr. Gabor Maté 1:24:51 And if you make mistakes, rather than making yourself wrong for it, inquire. Well, why did I do that? If you wanna use IFS model, what part of me did that? What part of me hit my kid, you know, uh, was so angry? Uh, or if you wanna use compassionate inquiry, you know, what need of mine was not being met there-

Dr. Rangan Chatterjee 1:25:12 Yeah

Dr. Gabor Maté 1:25:12 ... that, that led to that outrage on my part? You know, again, this is not to take anybody off the hook or to excuse any kind of behavior. But if we want to grow, we have to understand, and if we don't take a stance of compassionate curio- curiosity towards ourselves, if you... Like, if I say the... Like, if you said to yourself, "Why did I do this?" That's not a question. That's a statement full of judgment. But if you said to yourself, "Hmm, I wonder why I did that"-

Dr. Rangan Chatterjee 1:25:48 Yeah

Dr. Gabor Maté 1:25:48 ... then that's a question.

Dr. Rangan Chatterjee 1:25:48 Boom. Yeah. Having let go of that guilt-

Dr. Gabor Maté 1:25:56 Yeah

Dr. Rangan Chatterjee 1:25:56 ... or, or much of it, or certainly I hope most of it-

Dr. Gabor Maté 1:26:00 Yeah

Dr. Rangan Chatterjee 1:26:00 ... there's a more authentic interaction-

Dr. Gabor Maté 1:26:04 Yeah

Dr. Rangan Chatterjee 1:26:04 ... between us now.

Dr. Gabor Maté 1:26:05 Yeah.

Dr. Rangan Chatterjee 1:26:06 Um-

Dr. Gabor Maté 1:26:06 You and your son, you mean?

Dr. Rangan Chatterjee 1:26:07 Yeah. M- m- my son and I.

Dr. Gabor Maté 1:26:08 Of course, yeah.

Dr. Rangan Chatterjee 1:26:11 It, it's really beautiful and, and I think for me this speaks to the incredible power in your work. Through all your work, but speaking about this latest book, I think one of the most powerful things it gives people is awareness.

Dr. Gabor Maté 1:26:31 Mm.

Dr. Rangan Chatterjee 1:26:32 Because everyone wants to jump from awareness to what do I do now? And, and-

Dr. Gabor Maté 1:26:35 That's right

Dr. Rangan Chatterjee 1:26:35 ... and I think we underestimate just how powerful that first step is.

Dr. Gabor Maté 1:26:40 Yeah.

Dr. Rangan Chatterjee 1:26:41 Just to be, "Oh, oh, that's why I behave like that. [laughs] Oh, I had no idea." You know? W- w- I guess we're blind until we're not.

Dr. Gabor Maté 1:26:49 That's right.

Dr. Rangan Chatterjee 1:26:49 We're unaware until we're not, and then we can't un-see what we see.

Dr. Gabor Maté 1:26:54 Exactly.

Dr. Rangan Chatterjee 1:26:54 And I, and I, I really feel your work beautifully helps people see patterns in their life that they weren't previously aware of, and there are multiple ways that they can then go and move forward through that. But I, I think that's very, very powerful.

Dr. Rangan Chatterjee 1:27:08 In terms of patterns, you write i- in this book about personality.

Dr. Gabor Maté 1:27:16 Yeah.

Dr. Rangan Chatterjee 1:27:18 And there's a very powerful section where you talk about the association between certain personality types-

Dr. Gabor Maté 1:27:25 Yeah

Dr. Rangan Chatterjee 1:27:25 ... and disease. And-

Dr. Gabor Maté 1:27:26 Yeah

Dr. Rangan Chatterjee 1:27:26 ... in particular, I like that section where you mention William Osler, and he was talking about the type of people who he observed getting angina.

Dr. Gabor Maté 1:27:34 Yeah.

Dr. Rangan Chatterjee 1:27:34 And you contrasted that with this kind of Type C personality which is-

Dr. Gabor Maté 1:27:39 Yeah

Dr. Rangan Chatterjee 1:27:39 ... associated with all kinds of other chronic conditions.

Dr. Gabor Maté 1:27:41 Yeah.

Dr. Rangan Chatterjee 1:27:41 I wonder if you could speak to those things a little bit.

Dr. Gabor Maté 1:27:44 Sure. So, um, again, um, these are the things that nobody teaches you in medical school. But I, as I advanced in my experience in family practice and also did seven years of palliative care work, I began to notice that who developed chronic illness and who didn't wasn't accidental, that the people that developed chronic illness, by that I mean autoimmune diseases like rheumatoid arthritis, uh, multiple sclerosis, scleroderma, lupus, um, chronic fatigue, fibromyalgia, um, uh, inflammatory bowel disease, chronic asthma, et cetera, et cetera, these people had certain personality patterns that I kept noticing over and over again. And especially in palliative care, when people were dying of chronic illness, often malignancy, I, I, I would see these patterns. And what were they? So there were, um, automatic concern for the emotional needs of others while suppressing your own, um, exemplified by a woman who... This is a true story. She's diagnosed with breast cancer. Her husband's first wife died of breast cancer, and now the doct- doctor tells her she's got it, and her first response is, "But I'm worried about my husband. How will I support him?" Now, she's the one that's gonna have to go through chemotherapy, radiation, and, and possibly surgery or whatever. "How will I support my husband?" So this automatic concern for the emotional needs of others while ignoring your own. That's a salient characteristic of people dealing with chronic illness. Secondly, uh, a rigid identification with duty, role, and responsibility. Is, is in the case of when I was writing the book, and I was rigidly identified with the book, and my blood pressure was going up.

Dr. Rangan Chatterjee 1:29:30 Yeah.

Dr. Gabor Maté 1:29:30 You know? 'Cause I wasn't thinking of myself. You know? Um, number three, repression of healthy anger. That's a major one. Healthy anger is one of my healing principles, and, and it's essential. Healthy anger is simply a boundary defense that says, "No, you're in my space. Get out." That's what healthy anger is. It does its job, it's gone. But without that boundary defense, you get trampled on all the time. And these really so-called really nice people who never get angry, they're the ones to develop malignancy and autoimmune disease. Uh, and the fourth characteristic is, um, two fatal beliefs. And I say fatal beliefs, potentially fatal. One is that you're responsible for what other people feel, and the other is that you must never disappoint anybody. Now, how these traits predispo- I don't say they cause the disease. I don't deal in causes. It's simplistic to talk about single causes. But they contribute to the onset significantly, and people with chronic illness invariably have them.

Dr. Rangan Chatterjee 1:30:35 Yeah.

Dr. Gabor Maté 1:30:36 I never find otherwise. These are not... Nobody's born with these traits. I mean, have you ever met a one-day-old baby that doesn't know how to say no?

Dr. Rangan Chatterjee 1:30:47 [laughs]

Dr. Gabor Maté 1:30:48 Try and feed them something they don't wanna eat, you know? Um, these are personality traits that we develop to fit in with our environment.

Dr. Rangan Chatterjee 1:30:57 Yeah.

Dr. Gabor Maté 1:30:58 And if their environment is if your parents are alcoholics, you're gonna end up a, as a caretaker. As a four or five-year-old, you're gonna be the emotional caretaker by suppressing your own needs. Now, that's gonna show up in illness of mind or body later on in life, and, uh, for all kinds of physiological reasons, mostly because it invites all kinds of stress. You're creating all kinds of stress for yourself, which then has all kinds of physiological impacts. So these character traits are in contrast with the... But they're not the pers- who the person really is.

Dr. Rangan Chatterjee 1:31:34 It's who they became.

Dr. Gabor Maté 1:31:36 It's who they became-

Dr. Rangan Chatterjee 1:31:37 Yeah

Dr. Gabor Maté 1:31:37 ... as an adaptation to their environment. Then the body says no. The body rebels and says, "No, this is not good for you." But the question is, are people gonna learn from their disease or not? And a lot of people, whether through help or whether through some intuition or some grace, if they learn to, to look at their diseases not just as something to get rid of, but also as a teacher of where in my life was I not being myself? Now, I don't recommend disease as a way of learning, and I'm not saying people shouldn't Do whatever they can to get treatment and to heal in other ways. But at the same time, if they open that inquiry-

Dr. Rangan Chatterjee 1:32:21 Yeah

Dr. Gabor Maté 1:32:22 ... of what is this disease here to teach me about me, they're gonna find that these patterns were present, and they don't need to be.

Dr. Rangan Chatterjee 1:32:28 Yeah.

Dr. Gabor Maté 1:32:28 Because they're no longer the children that are constrained to be that way.

Dr. Rangan Chatterjee 1:32:35 It's not either/or. It's not either it's emotional [laughs] or it's physical.

Dr. Gabor Maté 1:32:39 No, it's not.

Dr. Rangan Chatterjee 1:32:39 It's these, these things are complex and, you know, disease as a teacher-

Dr. Gabor Maté 1:32:45 Yeah

Dr. Rangan Chatterjee 1:32:45 ... wow. I mean, I completely agree with you. That is something that many people may find triggering.

Dr. Gabor Maté 1:32:53 Yeah.

Dr. Rangan Chatterjee 1:32:54 Uh, the medical profession, certainly in my experience of it, the Western medical profession-

Dr. Gabor Maté 1:33:00 Yeah

Dr. Rangan Chatterjee 1:33:00 ... doesn't really acknowledge that side of things. Disease is that discrete entity. Now you have it. We've got the proof.

Dr. Gabor Maté 1:33:05 Yeah.

Dr. Rangan Chatterjee 1:33:05 Now we need to treat it.

Dr. Gabor Maté 1:33:06 Yeah.

Dr. Rangan Chatterjee 1:33:06 Without an understanding. You know, it's, it's the biomedical model, not the biopsychosocial-

Dr. Gabor Maté 1:33:12 Social

Dr. Rangan Chatterjee 1:33:13 ... model, right?

Dr. Gabor Maté 1:33:14 Yeah. Spiritual. Yeah.

Dr. Rangan Chatterjee 1:33:14 Spiritual, yeah.

Dr. Gabor Maté 1:33:15 Yeah.

Dr. Rangan Chatterjee 1:33:15 I mean, what, what role does spirituality play in modern medicine at the moment?

Dr. Gabor Maté 1:33:19 Yeah.

Dr. Rangan Chatterjee 1:33:20 Very little for me, and it's... I think, I think it's very important. You know, you, you explained that there with compassion. Um, it, it is such a tricky area, I found, to communicate with people because-

Dr. Gabor Maté 1:33:38 Yeah

Dr. Rangan Chatterjee 1:33:38 ... a lot of people who are that way inclined feel this as, as blame. You know?

Dr. Gabor Maté 1:33:41 Yeah.

Dr. Rangan Chatterjee 1:33:41 I've, I've made myself get sick. Uh, what are you saying, Dr. Maté? Are you saying that my, my personality has caused my illness? And let's just sort of expand on that a little bit-

Dr. Gabor Maté 1:33:51 Yeah

Dr. Rangan Chatterjee 1:33:51 ... in case anyone is thinking like that.

Dr. Gabor Maté 1:33:53 Well, it's a really essential question. I would say yes, aspects of your personality contributed to the onset of your illness. Uh, again, I don't use cause, 'cause there's so many different aspects to causation. But yes, aspects of it. But the r- reason it's important to pay an- attention to that is 'cause if, if I could tell you that aspects of your personality, ways of being, contributed to illness, I'm also telling you that if you were to transform those, you could actually affect your illness in a very positive way. Now, on, on... That's the first thing. The second thing is, I would say, is it's not your fault. You didn't choose to suppress yourself. Those are adaptations to your environment. You didn't choose to put other people's needs ahead of your own, uh, chronically and pathologically. That was your response to the environment. Why would I blame you for an unconscious adaptation that you developed when you were two years old and could, and didn't know any better? So there's absolutely no blame in this perspective-

Dr. Rangan Chatterjee 1:34:49 Yeah

Dr. Gabor Maté 1:34:49 ... whatsoever. Absolutely none, and it's inappropriate to even think of blame. But, um, do people perceive it that way? Yeah, they can. But I would, I would say to them, "Look, what would you rather have? What would you rather be told? That you're simply a physical object in the hands of your physicians with no agency whatsoever?" I mean, you talk about, when you talk about your principles of healing in your book, y- you, control is one of them. And I, I hadn't read your book when I wrote mine, and you hadn't read mine when I-

Dr. Rangan Chatterjee 1:35:18 Yeah

Dr. Gabor Maté 1:35:18 ... you wrote yours. But I talk about the same dynamic.

Dr. Rangan Chatterjee 1:35:21 Yeah.

Dr. Gabor Maté 1:35:21 I, I call it agency. You call it control, but it's the same thing. Would you rather be a, an object in the hand of your physicians, or you have some agency? Would you rather be actually, actually involved and, and, and, and, and to, and to learn how aspects of your life that you developed as a helpless young child are no longer serving you?

Dr. Rangan Chatterjee 1:35:40 Yeah.

Dr. Gabor Maté 1:35:40 And if you alter them... Now, in that chapter called Disease as Teacher-

Dr. Rangan Chatterjee 1:35:44 Yeah

Dr. Gabor Maté 1:35:45 ... I quote two American researchers, um, absolutely credentialed. One of them is a physician at Harvard, uh, Dr. Jeff Rediger.

Dr. Rangan Chatterjee 1:35:54 Yeah.

Dr. Gabor Maté 1:35:54 Have you had-

Dr. Rangan Chatterjee 1:35:54 Great book

Dr. Gabor Maté 1:35:55 ... have you had re- Jeff on you?

Dr. Rangan Chatterjee 1:35:56 No, I want to. We, we went to schedule it, and then he couldn't travel, and I just-

Dr. Gabor Maté 1:35:59 Oh

Dr. Rangan Chatterjee 1:35:59 ... haven't got around to it, but I really want to. Maybe that, this will be a nice impetus for me to-

Dr. Gabor Maté 1:36:03 Yeah

Dr. Rangan Chatterjee 1:36:03 ... re-contact him.

Dr. Gabor Maté 1:36:04 So Jeff wrote a book called, uh, Cured.

Dr. Rangan Chatterjee 1:36:06 Cured, yeah.

Dr. Gabor Maté 1:36:06 About what, what they call spontaneous healing. These are people that are given terminal diagnosis.

Dr. Rangan Chatterjee 1:36:12 Yeah.

Dr. Gabor Maté 1:36:13 By the way, h- here in Britain, there's a wonderful example of it. Uh, Stephen Hawking, who was diagnosed with ALS at age 20, he was given two years to live, and he became one of the world's great physicians and writers and lived, lived to, well into his, deep into his 70s. Maybe we don't know everything as physicians. Is that possible that we don't? You know? Um, but in any case, Jeff Rediger is a director of a hospital unit at Harvard, at McLean's Hospital in, in, in Massachusetts. He's also a doctor of divinity and a psychiatrist and a physician. And in this book, he researched people with so-called spontaneous healing. These are people that have been written off by the medical profession as terminally ill, death sentences, either because medical treatment had failed or because they had refused them, and they got better anyway and lived decades longer. And so Jeff says, "Well, what happened here?" Another Cana- uh, American researcher, uh, oncological psychologist, Kelly Turner, wrote a book called Radical Recovery. Radical Remission, I'm sorry. Same thing. I've done the same kind of research myself. What all three of us have found is that whatever else people did, these, these, uh, healings were not spontaneous, didn't just happen.

Dr. Rangan Chatterjee 1:37:32 No.

Dr. Gabor Maté 1:37:32 These people have changed their lives. They took supplements. They, um, did yoga. They meditated. They went into nature. They got counseling, whatever they did, but the biggest change was in their relationship to themselves.

Dr. Rangan Chatterjee 1:37:48 Yeah.

Dr. Gabor Maté 1:37:49 You know? And, uh, now I'm not saying we have a cure-all for everybody, but I'm saying that if these dramatic examples exist, what if we applied that all across the whole range of medicine? What if everybody with chronic illness, this question was raised, "Well, what is your relationship to yourself, and what extent are you-

Dr. Rangan Chatterjee 1:38:08 Yeah

Dr. Gabor Maté 1:38:08 ... being authentic?" And y- you know what? Uh, this may sound surprising, and, and I don't recommend it But even when I was working in palliative care, I had the occasional patient say to me, "Doc, this cancer was the best thing that ever happened to me." This- They're saying this a week or two before they died. Why? "Because I learned so much about myself that otherwise I never would have found out. It's made my whole life worthwhile." Again, people, I'm not recommending cancer-

Dr. Rangan Chatterjee 1:38:39 Yeah

Dr. Gabor Maté 1:38:39 ... as a way of waking up. All I'm saying is even that experience, we can use it to learn something about ourselves.

Dr. Rangan Chatterjee 1:38:49 Yeah. I think that, that, that chapter is so powerful. I know a friend of a friend who, who's no longer with us.

Dr. Gabor Maté 1:38:56 Mm.

Dr. Rangan Chatterjee 1:38:57 He at a young age was diagnosed with multiple sclerosis, and before that he was super active, captain of a sports team, super active, was in a wheelchair for many years. And I got to know him only for about three years or so.

Dr. Gabor Maté 1:39:09 Mm.

Dr. Rangan Chatterjee 1:39:09 And I remember the last time I spoke to him... Well, I say I spoke to him, we'd communicate on WhatsApp.

Dr. Gabor Maté 1:39:16 Mm.

Dr. Rangan Chatterjee 1:39:17 Um, it was really funny 'cause he, he, he would really enjoy listening to the podcast, and he'd send me messages on what he'd learned or what he was think- And, and he said once, um, "I've never felt this happy and content."

Dr. Gabor Maté 1:39:30 Mm.

Dr. Rangan Chatterjee 1:39:31 And, you know, at that time he couldn't communicate with his voice. It could only be via words. He was... All his needs were taken care of by a, you know, by a carer. He was in a wheelchair to move around. Previously very sporty, very active. And I thought, "Wow, never felt this happy and content." And again, you speak to what, what Jeff was saying, what... You write about this in that chapter, you know. Yes, one of my core values is curiosity. I think every physician [laughs] should have that as one of their core values because what do we often do in medicine with these healings or these things we can't explain? We, we kind of pretend they're not happening. We can't explain them in our reductionist model, so they're not real, you know? I don't know, maybe the patient's lying-

Dr. Gabor Maté 1:40:15 Yeah

Dr. Rangan Chatterjee 1:40:15 ... is often what people think.

Dr. Gabor Maté 1:40:17 Yeah, yeah.

Dr. Rangan Chatterjee 1:40:17 You know? Which is ridiculous. It's like, well, isn't that interesting that we don't know? Like, I, I love learning things that I don't know and go, "Wow-

Dr. Gabor Maté 1:40:25 Yeah

Dr. Rangan Chatterjee 1:40:25 ... what, what is going on there?" And-

Dr. Gabor Maté 1:40:26 Yeah. Yeah, but to interrupt for a moment, for curiosity you have to let go of something.

Dr. Rangan Chatterjee 1:40:32 Ego.

Dr. Gabor Maté 1:40:33 You have to let go of the-

Dr. Rangan Chatterjee 1:40:33 Be open

Dr. Gabor Maté 1:40:34 ... that, that I know.

Dr. Rangan Chatterjee 1:40:35 Yeah.

Dr. Gabor Maté 1:40:36 You know? And, uh, unfortunately, uh, physicians, it's not that they think they know everything, but they think that what they don't know is not worth knowing.

Dr. Rangan Chatterjee 1:40:43 Exactly. Exactly.

Dr. Gabor Maté 1:40:45 Yeah.

Dr. Rangan Chatterjee 1:40:45 And also it goes into how we even... You talk about culture, right? Unfortunately, a lot of people who end up in medicine simply went into medicine because they were good at school at academic subjects.

Dr. Gabor Maté 1:40:57 Yeah.

Dr. Rangan Chatterjee 1:40:57 That is so, so common.

Dr. Gabor Maté 1:41:00 Yeah.

Dr. Rangan Chatterjee 1:41:00 They, they often weren't drawn to healing.

Dr. Gabor Maté 1:41:02 Mm-hmm.

Dr. Rangan Chatterjee 1:41:02 It was just like, "Oh, I'm good at school. I want to do a good job that pays decent money and gives me security."

Dr. Gabor Maté 1:41:08 Yeah.

Dr. Rangan Chatterjee 1:41:08 And I understand why people make those decisions, I, I really do.

Dr. Gabor Maté 1:41:11 Yeah.

Dr. Rangan Chatterjee 1:41:12 But the truth is, is that at some point [laughs] in your career if you didn't go in for the right reasons, you don't actually figure some of that stuff out, you're gonna be having quite an-

Dr. Gabor Maté 1:41:20 Yeah

Dr. Rangan Chatterjee 1:41:20 ... unhappy, discontented life which is gonna impact the way that you look after your patients.

Dr. Gabor Maté 1:41:25 Absolutely.

Dr. Rangan Chatterjee 1:41:25 But this kind of emotional stress within our minds, the way we view ourselves, it is always, in my experience, a missing piece that unless we look at, we have a limit on our recovery.

Dr. Gabor Maté 1:41:38 Mm-hmm.

Dr. Rangan Chatterjee 1:41:38 Um, there, there's a patient I wrote about in Happy Mind, Happy Life, who this 48-year-old lady who she had upper abdominal pain, she had bloating, she had bilateral upper arm pains, and she'd been to see a variety of physicians. Um, she wasn't getting much better. The medications weren't helping.

Dr. Gabor Maté 1:41:55 Mm.

Dr. Rangan Chatterjee 1:41:56 She then had... was reading things online. She was empowering herself. She made changes to her lifestyle. She changed her, her diets.

Dr. Gabor Maté 1:42:03 Yeah.

Dr. Rangan Chatterjee 1:42:03 She would move more regularly.

Dr. Gabor Maté 1:42:05 Yeah.

Dr. Rangan Chatterjee 1:42:05 She would prioritize her sleep and stress reduction, and there was some improvement, but there, there was still a ceiling. There was-

Dr. Gabor Maté 1:42:10 Yeah

Dr. Rangan Chatterjee 1:42:10 ... still these symptoms affecting her. Where... And when she came to me I remember thinking, "What are we missing here? What are we missing?" Her, her life, a lot of these choices now in her life look, look pretty great. Well, what's going on here? And as I inquired, as I compassionately inquired, right? It became very clear. She, she said something. She... Th- this is when I knew, "Oh, here we go." She said, "Doc, I always end up in relationships with older men. They're usually married."

Dr. Gabor Maté 1:42:39 Yeah.

Dr. Rangan Chatterjee 1:42:40 Um, "And they always treat me really badly."

Dr. Gabor Maté 1:42:42 That's right.

Dr. Rangan Chatterjee 1:42:43 And as you... As I... As, as we sort of together inquired-

Dr. Gabor Maté 1:42:48 Mm-hmm

Dr. Rangan Chatterjee 1:42:48 ... we obviously all routes went back to her childhood.

Dr. Gabor Maté 1:42:51 Yeah.

Dr. Rangan Chatterjee 1:42:51 And she perceived as a child that her older sister got more attention than her from her parents. And it was incredible because even as she was saying it-

Dr. Gabor Maté 1:43:04 Mm

Dr. Rangan Chatterjee 1:43:04 ... you could see the, the light bulb moment-

Dr. Gabor Maté 1:43:06 Yeah

Dr. Rangan Chatterjee 1:43:06 ... in her own heads.

Dr. Gabor Maté 1:43:07 Yeah.

Dr. Rangan Chatterjee 1:43:07 This wasn't physician-

Dr. Gabor Maté 1:43:08 Yeah

Dr. Rangan Chatterjee 1:43:08 ... healing the patient.

Dr. Gabor Maté 1:43:09 No.

Dr. Rangan Chatterjee 1:43:09 This was, you know, me just simply being a guide to help her find her own truth. And as she came to terms with that, as she did a variety of things to help process that-

Dr. Gabor Maté 1:43:18 Yeah

Dr. Rangan Chatterjee 1:43:18 ... honestly, right, six months later she ends up in a relationship with a man her own age who treated her really well. Three months later all the symptoms had gone, and they haven't come back since.

Dr. Gabor Maté 1:43:29 Wow.

Dr. Rangan Chatterjee 1:43:29 Right? This is real. Like, emotional stress is real.

Dr. Gabor Maté 1:43:32 Which is what you would expect if you understood the science.

Dr. Rangan Chatterjee 1:43:35 Yeah, exactly, but it's not something we're taught.

Dr. Gabor Maté 1:43:37 Yeah.

Dr. Rangan Chatterjee 1:43:37 And, and also something you said, Gabor, I think is, is really powerful, this idea of agency.

Dr. Gabor Maté 1:43:42 Yeah.

Dr. Rangan Chatterjee 1:43:43 You know, you say, "What would you prefer? Me not to share with you what the science is?"

Dr. Gabor Maté 1:43:46 Yeah.

Dr. Rangan Chatterjee 1:43:46 "You just keep going in this disempowering model?" No.

Dr. Gabor Maté 1:43:49 Yeah, yeah, yeah.

Dr. Rangan Chatterjee 1:43:49 Or, or explain and-

Dr. Gabor Maté 1:43:50 Yeah

Dr. Rangan Chatterjee 1:43:50 ... that's something... You know, I mentioned competitiveness before.

Dr. Gabor Maté 1:43:54 Yeah.

Dr. Rangan Chatterjee 1:43:55 Competitiveness is if you'd ask any of my friends they'd say, "Rangan's really competitive. He's super... He won't lose." They're right, I wouldn't lose.

Dr. Gabor Maté 1:44:03 Mm-hmm. Mm-hmm.

Dr. Rangan Chatterjee 1:44:03 I would not. I would do anything I needed to do-

Dr. Gabor Maté 1:44:05 Yeah

Dr. Rangan Chatterjee 1:44:06 ... to not lose, but it wasn't because-

Dr. Gabor Maté 1:44:08 Yeah

Dr. Rangan Chatterjee 1:44:08 ... I enjoyed winning.

Dr. Gabor Maté 1:44:09 Yeah.

Dr. Rangan Chatterjee 1:44:09 It's 'cause it, it was too painful.

Dr. Gabor Maté 1:44:11 Yeah.

Dr. Rangan Chatterjee 1:44:12 Loss was too painful for me.

Dr. Gabor Maté 1:44:13 Yeah, yeah.

Dr. Rangan Chatterjee 1:44:14 But now hand on heart I'm not competitive.

Dr. Gabor Maté 1:44:17 Yeah.

Dr. Rangan Chatterjee 1:44:17 So it wasn't my personality, it was a behavioral adaptation.

Dr. Gabor Maté 1:44:21 Yeah.

Dr. Rangan Chatterjee 1:44:22 And I no longer need that behavioral adaptation, and I think people don't get that. They think the personality, who they are now is who they have to remain-

Dr. Gabor Maté 1:44:29 Well, let me just-

Dr. Rangan Chatterjee 1:44:29 ... and it's not

Dr. Gabor Maté 1:44:30 ... you know, I, I, I phrase that a little bit differently. I mean, the concept we totally agree on. I would say it was your personality, but your personality wasn't who you were. In other words, the personality is, is an amalgam of genuine aspects of ourselves with these adaptations

Dr. Rangan Chatterjee 1:44:43 Yeah

Dr. Gabor Maté 1:44:43 And what we can actually do is to purify the personality so that, uh, there's no distinction between ourselves and our-- there's no contradiction between ourselves and our personality. So, uh, certain personality traits are not us at all. They're simply who we learn to be-

Dr. Rangan Chatterjee 1:45:00 Yeah

Dr. Gabor Maté 1:45:00 ... in order to get through.

Dr. Rangan Chatterjee 1:45:02 And we can unlearn them.

Dr. Gabor Maté 1:45:03 We can absolutely unlearn them. And, and, and sometimes, of course, illness comes along. Just again, if somebody got sick, I'd never go to them and say, "Listen, congratulations. This is a great wake-up call. Learn from it." I would never say that to anybody 'cause that's, you know, people have to come to that realization themselves. But I would ask them, "Have you considered the possibility that, you know, along with the physical treatments we're gonna give you, have you considered the possibility that there may be aspects of, of your life that have contributed to the onset of this condition that'd be worth investigating so that you can become empowered to do something about them?"

Dr. Gabor Maté 1:45:42 And I wanna go back to something you said earlier about the 10-minute visit. You know, that needn't be a barrier.

Dr. Rangan Chatterjee 1:45:49 Yeah. I-

Dr. Gabor Maté 1:45:50 You know, because the barrier is not the 10 minutes. The barrier is the lack of awareness of the physician. Because even in 10 minutes, you can say to a person, "You know, there's some considerable evidence that your rheumatoid arthritis, that your lupus, that your multiple sclerosis, that your inflamed bowel is related to emotional factors. Is that something you'd be willing to explore in addition to whatever treatment I'm gonna give you? Are you willing to talk to somebody? I'm not expert to talk about that. I wasn't trained to do that, but I'm aware of those-

Dr. Rangan Chatterjee 1:46:23 Yeah

Dr. Gabor Maté 1:46:23 ... relationships. Are you willing to talk to somebody?" So the physician doesn't have to do it all.

Dr. Rangan Chatterjee 1:46:28 Yeah.

Dr. Gabor Maté 1:46:28 The physician just has to be aware of it. That's all. And let me just say one thing that-- something else that occurs to me that's really important to say here. It's not exactly apropos, but it does come up for me. Um, this is not just individual, it is also social. If you look at where-- If you look at here, here in Britain, who was more, um, prone to develop COVID, it wasn't just-- They say that we're all on the same boat, we're all in this together. No, we weren't. People that were, uh, Black or immigrants of color, they were at much higher risk.

Dr. Rangan Chatterjee 1:47:00 Yeah.

Dr. Gabor Maté 1:47:01 In the United States, people of color were at much higher risk of COVID. People of color in, in, in my country, Canada, an indigenous woman has six times the rate of rheumatoid arthritis than that of other people. This is amongst a population that never used to have autoimmune disease whatsoever. And so we're not just talking about individual choices or even individual personality traits. We're also talking about large social trends-

Dr. Rangan Chatterjee 1:47:28 Yeah

Dr. Gabor Maté 1:47:28 ... that, that exclude or, or, or, or, or, or oppress or, or, or, or, um, put extra burden on, you know, uh, on, on certain segments of the population. So we have to really-- I just wanna make sure that we exte-

Dr. Rangan Chatterjee 1:47:42 Yeah

Dr. Gabor Maté 1:47:42 ... we broaden the conversation beyond the individual to, uh, to the social level as well.

Dr. Rangan Chatterjee 1:47:46 And, and I think your book beautifully makes that case, doesn't it?

Dr. Gabor Maté 1:47:49 Yeah.

Dr. Rangan Chatterjee 1:47:49 That, that a lot of this is driven by the world around us and culture.

Dr. Gabor Maté 1:47:52 Yeah. Yeah.

Dr. Rangan Chatterjee 1:47:52 Uh, but of course, within that, there are things that if we empower ourselves, that we can do.

Dr. Gabor Maté 1:47:56 Yeah.

Dr. Rangan Chatterjee 1:47:57 I also wanna just say I totally agree on the 10 minutes. Um, it doesn't have to be a barrier. Sure, more time would probably be optimal.

Dr. Gabor Maté 1:48:03 Yeah.

Dr. Rangan Chatterjee 1:48:03 But even having a physician who's aware and then says-- and points towards one of your books, for example.

Dr. Gabor Maté 1:48:09 Yeah.

Dr. Rangan Chatterjee 1:48:10 That's useful. I know there are thousands of medical doctors now who, certainly in the UK, 'cause they talk to me and they contact me and they say, "Yeah, I've only got 10 minutes, but I, I just raised something," and then I point them to one of your podcasts or one of your books.

Dr. Gabor Maté 1:48:22 Yes. Yeah.

Dr. Rangan Chatterjee 1:48:23 And so it's a way that you can-

Dr. Gabor Maté 1:48:24 That's right

Dr. Rangan Chatterjee 1:48:25 ... because this information, this can help patients in their own time. When they're gardening at the weekend or going out for a walk-

Dr. Gabor Maté 1:48:30 That's right

Dr. Rangan Chatterjee 1:48:30 ... they can be learning, and that's-

Dr. Gabor Maté 1:48:32 Yeah.

Dr. Rangan Chatterjee 1:48:32 That's one of the things that gives me hope at the moment, is that-

Dr. Gabor Maté 1:48:35 Yeah

Dr. Rangan Chatterjee 1:48:35 ... this information is not behind locked doors in universities and research institutions, you know?

Dr. Gabor Maté 1:48:41 Yeah.

Dr. Rangan Chatterjee 1:48:42 People are consuming this content. People-

Dr. Gabor Maté 1:48:44 Yeah.

Dr. Rangan Chatterjee 1:48:44 If you look at your talks on YouTube, millions of people have watched them and are then-

Dr. Gabor Maté 1:48:48 Yeah

Dr. Rangan Chatterjee 1:48:48 ... empowering themselves.

Dr. Gabor Maté 1:48:50 Yeah. Yeah.

Dr. Rangan Chatterjee 1:48:50 So, um, Gabor, as we come towards the end of this conversation, just to close the loop on something you mentioned earlier, which is women and increased rates of chronic disease.

Dr. Gabor Maté 1:49:00 Mm.

Dr. Rangan Chatterjee 1:49:00 I don't wanna leave that open-ended.

Dr. Gabor Maté 1:49:02 Ah.

Dr. Rangan Chatterjee 1:49:02 Um, could you just explain maybe why you think there may be a relationship there?

Dr. Gabor Maté 1:49:08 Well, if you take something like multiple sclerosis, which I've mentioned a number of times, the gender ratio in the '30s was about one to one.

Dr. Rangan Chatterjee 1:49:17 Yeah.

Dr. Gabor Maté 1:49:17 So for each man diagnosed, there'd be a woman. The gender ratio now is three and a half women for every man. Now, that tells us a few things immediately. Can't be genetics, 'cause that doesn't change over a short period of time. Can't be the diet or the climate, 'cause that doesn't change more for one gender than the other. What is it? It's stress. Now, if you look at those four character traits that I said contributed to the onset of illness, the emotional concern for the needs of others, the, uh, suppression of healthy anger, the, uh, identification with duty, role, and responsibility, the belief that you're responsible for the people's emotions and you mustn't disappoint anybody. Which gender is acculturated in our society to take on those traits more than the other? Of course, it's women. So women have 80% of autoimmune disease.

Dr. Rangan Chatterjee 1:50:02 Yeah.

Dr. Gabor Maté 1:50:03 80% of autoimmune disease are women, and a b- big mystery. It's not a mystery. They're acculturated to play a certain role. Their role has always been to absorb the stresses of their families and also of their spouses, and certainly that's a role that my wife took on early in our relationship, and she had to rebel against it to stay healthy, you know? Um, there was a study in Sweden that showed that, this is remarkable, that if a woman was depressed prenatally, that increased the risk of a late premature birth, 32 weeks to 36 weeks If the man was depressed, the father was depressed prenatally, that increased the risk of an even earlier premature birth. Why? Because the woman was absorbing the stress of the man. And so women do that automatically, not biologically necessarily, but because that's the role they've been given in the society. Plus that they have to go out and work now as well to make a living and to make a, a, you know, m- m- money for the family to survive and, or to just to succeed out there in the workforce. And people are more isolated than they ever were. So in Britain, there's, they, they appointed the Minister of Loneliness. So greater stress, more isolation, that's why women are getting more autoimmune disease. And during COVID, there was an article in The New York Times about women who took on the emotional stress of their husbands and their children during COVID, and they felt guilty 'cause of the suffering of their men and their children, 'cause it was somehow their job to, to eliminate or alleviate it. Well, that socially appointed and then automatically assumed role that women have been thrust into has physical implications. That's why women get most autoimmune disease. What if we just recognize this?

Dr. Rangan Chatterjee 1:52:01 Yeah.

Dr. Gabor Maté 1:52:01 You know? And this, this big mystery. No mystery. This is a particular dramatic example of the biopsychosocial nature of human beings.

Dr. Rangan Chatterjee 1:52:13 Yeah.

Dr. Gabor Maté 1:52:14 Our biology is inseparable from our psychological functioning and our social relationships.

Dr. Rangan Chatterjee 1:52:20 Yeah.

Dr. Gabor Maté 1:52:21 And who has the brunt of all that? Women of color.

Dr. Rangan Chatterjee 1:52:25 Yeah.

Dr. Gabor Maté 1:52:25 They're much more likely to develop these diseases than Caucasian women. Why? Because of the added stress of social and, and, and racial-

Dr. Rangan Chatterjee 1:52:34 Yeah

Dr. Gabor Maté 1:52:34 ... uh, s- uh, oppression, you, or, or, or exclusion.

Dr. Rangan Chatterjee 1:52:39 I guess the culture, the society around us impacts so much of how we experience the world and, and what we chase and what we pursue and how we are. And of course, it can take a long time for culture to change.

Dr. Gabor Maté 1:52:52 Yeah, yeah. I'm not saying that people have to wait for the society to change. If they did wait, it'd be a long, long wait, I would think. There's a lot that we can do, even in the context of this culture. And of course, what we can do is not totally, mm, freely, uh, um, available equal to everybody. Let's face it.

Dr. Rangan Chatterjee 1:53:16 Yeah.

Dr. Gabor Maté 1:53:16 Certain classes of people have much less, fewer options than others. That's just the reality of this culture that we have to really look in the face.

Dr. Rangan Chatterjee 1:53:23 Yeah.

Dr. Gabor Maté 1:53:23 You know? But there's still a lot that people can do. And, but if I can go back to the confluence of your book and mine, you have these three concepts of, of the healing concepts, of alignment, which is, I call authenticity, being, being, becoming true to ourselves. That's available to all, all of us. You talk about contentment, which I talk about in terms of acceptance. Just actually-

Dr. Rangan Chatterjee 1:53:46 Yeah

Dr. Gabor Maté 1:53:46 ... recognizing how things are and being with them. Not necessarily that we don't want anything to be different, but that we don't stress ourselves a- about things. Thirdly, what you call control, which is, we've already talked about, what I call agency. Those are some core healing principles that interestingly enough, both you and I, without any, um, uh, discussion or awareness of what each of us is writing, why did we come up with that?

Dr. Rangan Chatterjee 1:54:12 Yeah.

Dr. Gabor Maté 1:54:12 Because they're real, and that's, and we've seen them both in, in, in, in medical practice and, and, and, and the function of them. Now, I add anger, another A, called anger, which is I think is very important for people to be able to say no and to... We have a system in our brain for healthy aggression.

Dr. Rangan Chatterjee 1:54:30 Yeah.

Dr. Gabor Maté 1:54:31 Just as we have one for play, for love, for lust, for fear, for grief. We have systems in our brain for anger. Why? 'Cause it has to protect us. I think people need to be angry. Not enraged, not chronically resentful, but they have to be able to say, "No, you will not do this to me. No, you will not enter my space. No, you will not manipulate me. No, you will not use me." So that's a small-

Dr. Rangan Chatterjee 1:55:00 Yeah

Dr. Gabor Maté 1:55:00 ... microcosmic statement of my healing principles, but I certainly think that healing is possible. And let's face it, if you didn't think healing was possible, would you write your books? You know what I mean? If, if all, if all you wanted to do is tell people how terrible things are, you wouldn't write a book.

Dr. Rangan Chatterjee 1:55:18 Yeah.

Dr. Gabor Maté 1:55:19 We both write books because we actually believe in human beings-

Dr. Rangan Chatterjee 1:55:21 Yeah

Dr. Gabor Maté 1:55:21 ... in the, in the capacity of human beings for transformation, and that there's some guidance that can be provided to promote that transformation. That's why we write.

Dr. Rangan Chatterjee 1:55:30 Yeah.

Dr. Gabor Maté 1:55:31 And that's why I wrote this book. And so yes, healing is possible, but we have to be aware, I think, as I think you said earlier, we have to wake up to what's going on.

Dr. Rangan Chatterjee 1:55:39 Yeah.

Dr. Gabor Maté 1:55:40 Until then, we're just working in the dark.

Dr. Rangan Chatterjee 1:55:44 Gabor, it's always a pleasure spending time with you. I feel very honored these days to call you a friend.

Dr. Gabor Maté 1:55:48 Well, the sense of being honored is mutual.

Dr. Rangan Chatterjee 1:55:51 For sure.

Dr. Gabor Maté 1:55:51 Yeah.

Dr. Rangan Chatterjee 1:55:52 Thank you.

Dr. Gabor Maté 1:55:53 Thank you.

Dr. Rangan Chatterjee 1:55:53 [upbeat music] 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.

Speaker 1:56:01 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, hmm, that you need to practice