If You Feel Numb, Tired or Angry... DON’T Ignore It! — It’s Trauma Running Your Life | Gabor Maté

1. 0:00 – 1:42

   How modern society disrupts healthy development from pregnancy onward

   1. RCDr. Rangan Chatterjee0:00

      What exactly is going on in society that is so stigmatizing, that is so toxic for our physical, mental, and emotional wellbeing?

   2. GMDr. Gabor Maté0:12

      Yes. Well, for that we have to l- go back and ask the question, what are the needs of human beings for healthy development, and to what degree does our society or any society meet those needs? And this begins already in uterus, because we already know that stresses on pregnant women during the gestational period affect the brain development of infants in utero already. So the more stress there is on a woman when they're pregnant, the greater the risk that child is for mental health problems later on. It starts that early. And then we have to look at childbirth practices themselves, because the way nature set up childbirth, it wasn't just a matter of pushing a baby out of a womb, it was also a bonding experience chemically. A whole cocktail of hormones is released in the woman and the baby, oxytocin, endorphins, vasopressin, that help the bonding between mother and infant. Now, with the rising rates of intervention, unnecessary intervention, sometimes as you and I know as physicians, obstetrical intervention is lifesaving for mother and infant, and it's to be celebrated. But when we have situations where here in my province of British Columbia there's a 40% cesarean section rate, and this is generalizing across the c- the industrialized world. Sometimes it's even higher. We're having a massive interference with the natural process. And

2. 1:42 – 3:32

   Attachment and emotional permission: the foundations of a resilient brain

   1. GMDr. Gabor Maté1:42

      then we have to ask, what are the essential needs of human children for healthy development? And they include a safe, secure attachment relationship with parents who are emotionally attuned and present for them, which is increasingly difficult for parents to provide in today's stressed society. It includes the child not having to work to make the relationship work, so the child can be at rest in a relationship. It includes the freedom of the child to ex- to experience a- and express all their emotions. Now, the human brain is wired, like all mammals are wired, for certain emotions, including joy, playfulness, curiosity, grief, fear, anger. When ch- parenting practices inhibit a child from experiencing all their emotions, that interferes with the child's brain development. And so take something like depression, just a simple example. What does it mean to depress something? It means to push it down. What gets pushed down in depression? Well, I've had depression, um, and what gets pushed down is your emotions. But why would somebody push down their emotions? Because they weren't allowed to express them, because the expression of emotion threatened their relationship with their parents. And a lot of parenting practices today encourage parents to force kids to suppress their emotions.

   2. RCDr. Rangan Chatterjee3:11

      Yeah.

   3. GMDr. Gabor Maté3:12

      And so there's so much where our needs are not met. A- and, and the biggest factor, I would say, Rangan, is the stress on parents.

   4. RCDr. Rangan Chatterjee3:22

      Yeah.

   5. GMDr. Gabor Maté3:23

      The, the economic, social stress on parents, and the increasing social isolation. All of these bear upon the developing child.

3. 3:32 – 5:59

   A clinician’s lens on depression: healing through being heard

   1. RCDr. Rangan Chatterjee3:32

      So much there to pick up on, Gabor. I think in one of our previous conversations, I mentioned to you a case of a young lady who I saw in my first week in general practice who had symptoms consistent with depression, and it would've been very easy to diagnose her with depression, label her, and then put her on an antidepressant. But I won't retell that entire story, but over the course of four to six weeks, by seeing her every week, by listening to her compassionately, non-judgmentally, in a way that she didn't have outside the consultation room, her symptoms just started to resolve. And that really speaks to what you said about depression. We're depressing our feelings down, and I'm looking at that case now through that lens. I simply provided a safe space where she could start to un-depress those feelings, elevate those feelings, get them out, and as if by magic, her symptoms [laughs] started to get better. So yeah, I think that's a really nice way of thinking about depression. I just wanted to talk to you, though, about brain development. You mentioned there, you know, w- you know, the, your central thesis behind your book, to me at least, is that the culture around us is making us sick. Right? This is not really an individual issue. This is a societal and environmental issue. And then so if we then look at various aspects of modern society, at least modern Western society, when mothers and parents are having children these days, it's often, it's later than it used to be. It's often mid, late 20s, maybe into 30s, maybe sometimes into early 40s. This often coincides with them trying to make their way in their careers. Two parents working. They've moved away from home. They don't have support around them. So they're actually trying to incubate a baby inside the womb at a very stressful time. Often they're pushing themselves to try and buy a house where they can have a little garden and have s- have room for the little one. Society doesn't make it easy for us to have that calm, relaxed, attentive environment for the woman when she's pregnant or for the children when they're born, does it?

4. 5:59 – 9:26

   Brain architecture is built in relationships: what Harvard’s research says

   1. GMDr. Gabor Maté5:59

      No, and I wonder, Rangan, when you were in medical school, when you were taught prenatal care-Did anybody ever suggest to you that you pay attention to the emotional needs of the pregnant mother? I wasn't taught that either. And, uh, yet as I've already mentioned, that's a huge, uh, influence. Now, let me quote to you an article from Harvard University, from the Harvard Center on the Developing Child, which is the world's most prestigious child developmental study organization. The article appeared in a major medical journal, Pediatrics, in February 2012, and it talked about brain development, and I'm gonna quote it as best I can. It said that the archit- the architecture of the brain is constructed through an ongoing process that begins before birth, continues into adulthood, and establishes either a fragile or sturdy foundation for all the health and learning and behavior, and behavior that follow. So the architecture of the brain is constructed through an ongoing process beginning before birth, continuing into adulthood, which means that in any process of development, you have to have the right conditions from before birth to adulthood. That's the first point. The second point is, the second sentence in that same article says that the most important influence on the development of the brain is the emotional mutuality in the relationship between parents and children, especially in the early childhood years. Now, lots of studies have shown that when parents are busy, they're stressed, they're anxious, they're economically pressured, that interferes with their capacity to emotionally connect with their children. We're not blaming parents here. They're doing their best, but they're doing their best in an abnormal environment, abnormal from the point of view of human development because human creatures, we evolved in a communal context where parents had lots of support, lots of companionship, and kids were always surrounded by other kids and by adults, uh, who cared for them. That's how we evolved. That's our need. Now, if you get a society that increasingly isolates and stress parents, um, that's gonna impact the very circuitry of the child's brain, and that's gonna affect the child's psychological functioning.

   2. RCDr. Rangan Chatterjee8:25

      Yeah.

   3. GMDr. Gabor Maté8:26

      So that we know from British studies, for that matter, that mothers who are depressed, their kids are more likely to have ADHD later on. Why? Because the parents' emotional states affect the brain development of the child, and therefore the psychological development of the child as well. So what we cannot do is to separate the environment from the physiology of the brain. So in modern psychiatry, which really looks at mental health conditions as biological problems, the point they don't get and they ignore is that the brain's biology itself is, uh, affected by and shaped by the emotional and social context. And so when you have increasing isolation, parents who are stressed, struggling, as you say, without the community to support them anymore, uh, with, with the loss of connection, of course you're gonna get a lot of kids who are gonna be mentally challenged and emotionally, uh, in trouble. Of course you are.

5. 9:26 – 13:07

   Parent leave, ‘ex utero gestation,’ and the cost of early separation

   1. RCDr. Rangan Chatterjee9:26

      Given how important those formative years are, it would seem relatively urgent that we try and restructure elements of society to really prioritize those early years. So I know in America, I read a recent statistic that, is it 25% of women within two weeks of giving birth are back at work? I mean-

   2. GMDr. Gabor Maté9:51

      Yes

   3. RCDr. Rangan Chatterjee9:51

      ... if that is true, that's an absolutely incredible and, and actually very worrying statistic, and really shows us what that society is valuing and putting first. I'm interested, though, if we compare that to, let's say, Scandinavian countries where there's less financial inequality as there may be, let's say, in America. There's, I think, nine months in some of these Scandinavian countries, nine months of paternal leave, uh, same amount if not longer maternal leave. You know, clearly as a society we're saying, or they're saying, "Oh, the, the first nine months are very, very important." So I'm interested, number one, do we see less rates of mental health problems in cultures like that? Uh, perhaps we could, we could address that first, and then I'll go onto the next point.

   4. GMDr. Gabor Maté10:44

      Well, I wish I could, I wish I knew about Scandinavian statistics. There are, there are significant mental health problems in the Scandinavian-

   5. RCDr. Rangan Chatterjee10:50

      Yeah

   6. GMDr. Gabor Maté10:50

      ... countries as well. Um, but Finland, for example, is considered to be the happiest country in the world, according to a recent study, and, um, they have very different approaches to child-rearing and schooling and so on. In the Scandinavian countries, there is trauma and, and, you know, the, it's not that they're without their problems.

   7. RCDr. Rangan Chatterjee11:10

      Yeah.

   8. GMDr. Gabor Maté11:11

      Um, but the, they don't, they don't nearly have the rate of children being medicated, adults being medicated that North America does. The, um, as, as best I know. The, uh, 25% figure, um, is accurate. Um, actually it was ... I saw it in The Guardian, um, based on an American report. The British, uh, anthropologist, the British-American anthropologist Ashley Montagu, um, talked about ex utero gestation. So there's ante utero gestation, which is the child in the womb, but then ex utero gestation is the continuing of the gestational process outside the womb. Because the human child is the least mature, the least developed, the most dependent of any cr- any mammal and, and our brains are far less developed than, say, that of other mammals. A horse can run on the first day of life. We can't do that for a year and a half, which means that the brain circuits that are in a horse are already present at birth-In a human being don't come online for another year and a half. And so that the gestational process needs to continue for a longer period of time in human beings. Now, when mothers are forced to return to work at such a high rate for economic reasons, what that amounts to is a massive abandonment of children. Ashley Montagu talked about the... He wrote a book called Skin: The Human Significance of Touch. The importance for the biological, physiological, and mental development of the child to have skin-to-skin contact with the mother. Now, in our society, increasingly that's less and less available.

   9. RCDr. Rangan Chatterjee12:57

      Yeah.

   10. GMDr. Gabor Maté12:58

       That actually has an impact on the child's sense of security and, and safety in the world. No wonder we have rising rates of anxiety.

6. 13:07 – 17:03

   Independence myths: why dependence is the pathway to autonomy

   1. RCDr. Rangan Chatterjee13:07

      Yeah. Another element of culture I've really been reflecting on recently, Gabor, is about this idea of kids living with their parents. Now, it's really interesting. I'm from an Indian background, so I remember in the summers when I'd go to India and spend six weeks with my family, you'd have joint families, extended families, three, four generations living in the same house. Now, I'm not saying everything was fantastic about that. There's pros and cons with everything in life. But I was chatting to my wife a few weeks ago saying, "Where did this idea come from that if you're still living with your parents at age 20 or 21, you're somehow a failure in life?" It seems to be a very Western, um, idea that I absorbed as a child that I think is there. You'll see social media posts, you'll see things online where if someone at 26 is still living at home, they're almost frowned upon in this society. And again, I've just been reflecting as to where did that come from? I'm not saying necessarily we shouldn't be promoting independence, we shouldn't be encouraging people to, you know, once they've had their child-rearing, to move on with their adult lives with that strong degree of independence. But have you reflected on this? You know, where did this idea come from? And what do we see in, in tribes and more native cultures?

   2. GMDr. Gabor Maté14:34

      Well, in our society, there's a real push on parents to drive their kids towards independence so that, um, e- even at an early age, um, we try and push them towards independence.

   3. RCDr. Rangan Chatterjee14:50

      Mm.

   4. GMDr. Gabor Maté14:50

      We think that we have to foster independence in the child by kind of pushing them away. And this enters into a lot of parenting practices. Now, actually, um, we forget something, which is that independence is nature's natural agenda. So if you look at bears, nature's agenda is that at some point the baby bear, the cub, grows up independent and goes off on their own and no longer dependent on the mother. The mother doesn't have to push them towards independence. Nature does that. It's in the agenda of nature that we develop into independent creatures because at some point our parents will die, you know? And so each generation needs to find its own independence. Um, but it does so in a, at a natural pace consistent with its own nature. The way you actually foster independence in human children is by inviting dependence. Is by meeting... 'Cause the human child is very dependent. If you meet the child's needs, we don't trust nature in this society is what it is. If, if you meet, if you meet the child's needs for dependence and belonging and connection and attachment, that child will automatically develop a sense of independence 'cause it's in the child's nature to do so.

   5. RCDr. Rangan Chatterjee16:08

      Yeah.

   6. GMDr. Gabor Maté16:08

      So we don't, we don't have to push it. On the contrary. It's not that we should coddle kids and, and so kind of hobble them and, and, and, and, um, you know, infantilize them. You just have to meet their genuine attachment needs, give them a sense of security. They will naturally move towards independence, exploration, finding their own way in the world. So this is another thing that, um, in our society we totally miss, and then we push our kids out. We expect them to find their way. Uh, older societies used to have rituals for inviting children into adulthood. These rituals would exist in virtually all traditional cultures. We have lost those rituals. So we've lost a lot of the map that would guide people to be genuine human beings in our culture.

7. 17:03 – 27:43

   Prince Harry as a case study in trauma, stigma, and public hostility

   1. RCDr. Rangan Chatterjee17:03

      Yeah. We're talking today about mental health, and I think that public figures can play a very important role, both from a point of view of raising awareness, but also from a point of view of highlighting that we all share a common humanity, and no matter who we are, what family we were born into, we're all susceptible to the same pressures with the same consequences on our physical and our mental health. Now, Prince Harry is, I think, one of the most prominent figures [laughs] certainly in the UK, talking about mental health, arguably globally. Until recently, I would say he was a very much a well-loved figure by all. But by talking about mental health, um, that seems to have changed, and you had the opportunity to talk to Harry that was publicized to a lot of people around the world. I'm first of all interested, from talking to someone so prominent about their mental health, about their trauma, what did you learn?

   2. GMDr. Gabor Maté18:20

      Having read, uh, Harry's book Spare, which really is a depiction of a child deeply traumatized, uh, suffering adult mental health problems as a result of that, in fact, in childhood as well from that trauma, um, and being made so wrong for it all in the, in the media. The first thing I learned is just how... [laughs] Well, there's a lot of things I learned by reading Harry's book and talking with the man, and by the way, I have to tell you, I really liked him.

   3. RCDr. Rangan Chatterjee18:56

      Yeah.

   4. GMDr. Gabor Maté18:56

      Down-to-earth, sensitive, insightful, intelligent, well-meaning human being who really wants to make a difference in the world. So I learned about him personally. Um, I also learned what he's up against because in the aftermath of our conversation, I was just caught up in this gale of venom in a lot of the British press, and, um, I was just astonished by the degree of, um, poisonous commentary, of poisonous attitudes. I just received a small portion of what he's been living with for so long now. Now, I was aware of Prince Harry's and his brother's interest in mental health issues. Back in 2017 already, they had already started a foundation to talk about mental health issues because they were traumatized kids. Their mother died, and they grew up in a family that was very dysfunctional, um, a loveless marriage. I mean, I could go on. Every... This is, this is public knowledge. And so these two young men started talking about mental health issues, and their grandmother, the Queen, at some point said, "Enough of this. Go back and talk about... Do your royal duties and forget these personal interests in mental health." That... This was publicly reported in The Sunday Times back in 2017. So he's had a commitment to talk about mental health and, and, um, I saw how that's much... that's resented in, in, in, in modern society because he's like the whistleblower. He's somebody who talked about his own pain, his own trauma, and, and the impact of that, and he also talks about healing. And so what I saw was a human being who's suffered, who recognizes that he grew up in incredible privilege, but inside that royal gilded cage, he was never allowed to be himself, and his... and he had this lifelong struggle to liberate himself from the expectations and programming that came with being a royal child, where literally was not... The message he got was, "Don't be yourself." He said this in so many words. So here's a man who's struggling to become himself and how much opprobrium that attracts from a lot of people in the media and in society. So the conversation was eye-opening for me in that here's this prince, grew up one of the most wealthiest families in Britain, uh, never mind wealthy, also revered and historically elevated to this high status, and he suffers like the rest of us.

   5. RCDr. Rangan Chatterjee21:42

      Yeah.

   6. GMDr. Gabor Maté21:43

      And he needs to s- and he needs to, and he needs to, and he needs to, um, struggle with that suffering. He needs to make sense of it. He needs to try to find himself. He needs to liberate himself. So that's what the conversation's about, and it was... to me, it was a very refreshing, um, very interesting, uh, conversation.

   7. RCDr. Rangan Chatterjee22:04

      Yeah, I mean, thank you for sharing that. It's interesting, and maybe we'll get to this later on in this conversation, how polarizing any conversation around Prince Harry is. And it's really interesting because I don't know Prince Harry. Um, I've seen him talk. I've seen a lot of that interview you had with him. I've seen some of his other talks. So when I say I've seen his talks, I've seen the actual conversations, not what the media are reporting about the conversation or the commentary from a prominent media expert about it. I've seen it with my own eyes. I've heard it with my own ears. And as someone who's spent over two decades interacting with patients, reading them, trying to pick up the messages behind their words, trying to read their body language to really get an impression of, who is this person? What is really going on here? I gotta say, the only thing I get from Prince Harry is somebody who is trying his best to come to terms with his past and then move on. I get the impression this is somebody who is incredibly emotionally grounded, and I totally get the impression that this is someone who does not see himself as a victim, someone who's trying to empower himself. I mean, what's your perspective on what I've just said?

   8. GMDr. Gabor Maté23:29

      Well, that's how I perceive it as well. Now, he, he's a young man. He's 38 years old, 39, is he? Um, he makes mistakes, but I'm 79, and I make mistakes, you know? And b- but, but the overall arc of his life is precisely as you've, uh, as, as you've described it, and I do get the sense of a person who's very much committed to making a difference in the world, uh, to... by... and, and in terms of victimhood, like, I got all these... I, I got a lot of followers on Instagram, you know? And all these venomous notes about, "I'm, I'm following you because you talked to this ginger whiner," you know? "And, and, and you got sucked in," you know, um, i- i- into... He's not a whiner. Uh, the British word is spelled W-H-I-N-G-E-R. How do you, how do you pronounce that? Winger or whiner or what do you, what do you say?

   9. RCDr. Rangan Chatterjee24:25

      Yeah, whiner, whinger.

   10. GMDr. Gabor Maté24:27

       Yeah, ginger whinger they call them. Yeah, okay.Uh, well, first of all, let me tell you something. Red-headed people are more sensitive than others. That- that's a physiological fact. They often need more anesthesia when they g- when they have surgery, for example. This is a well-known fact.

   11. RCDr. Rangan Chatterjee24:43

       Wow.

   12. GMDr. Gabor Maté24:43

       So they ... The more sensitive you are, the more you experience, the more deeply you experience, the more things hurt. That's his nature. He's very ... And, and he told me that all his life he felt different from others. He's just more sensitive, but he's not a victim. He doesn't perceive himself as a victim, not in the least. That's the first question I asked him.

   13. RCDr. Rangan Chatterjee25:03

       Yeah.

   14. GMDr. Gabor Maté25:03

       And, and in fact, when we talk about trauma, which he experienced, certainly I have, and it's, it's my work in the world, I, I don't talk about trauma as a way of victimizing people, but as a way of empowering them. A- and in Harry's own case, as in my own case, and, uh, a lot of other people, when you understand how you've been traumatized, then you have the, then you have the responsibility and the freedom to do something about it.

   15. RCDr. Rangan Chatterjee25:34

       Yeah.

   16. GMDr. Gabor Maté25:35

       So to recognize trauma ... Now, you can wrap yourself in this cloak of victim, where, "I was traumatized, I can't help it. This is the way I am." Most people I know are not like that. Most people want to understand what happened to them as a way of empowering themselves to heal, and that's his particular trajectory as well. So he's not a victim. He doesn't see himself that way. I don't see him that way, and, uh, he is increasingly grounded. He's far happier now than he ever used to be, as he should be. And as, as far as his children, he's determined not to, um, inflict on his children the kind of pain and emotional deprivation that he experienced in his childhood. And isn't that just what all parents want, is, is not to make our kids hurt the way we were hurt? I mean, again, it's the universality, the, the, the ubiquitous humanity that shows up in his life experience, despite his incredibly special circumstances.

   17. RCDr. Rangan Chatterjee26:37

       Yeah.

   18. GMDr. Gabor Maté26:37

       That's what's so interesting.

   19. RCDr. Rangan Chatterjee26:41

       If you look at that story, Harry's story, from the outside, and you remove the royal family component, which of course, for many people it's very hard to do. But of course, as clinicians, uh, as physicians, Gabor, we always have to treat the people who come in front of us with compassion. It doesn't matter if they're a CEO or they're addicted to drugs or they're poor or they're rich. Makes no difference to a, to a healthcare professional. We treat them all the same. So if you look at this as a human story, and you remove the royal family element, we would be celebrating this, saying, "Wow, what strength to confront your past, to speak up about it, to try and move on, to try and not pass on your own trauma to your children." And so why, why do you think that is? Why, when you put the royal family envelope around this story, why does the narrative start to change?

8. 27:43 – 37:50

   Emotional deprivation inside privilege: attachment injuries across generations

   1. GMDr. Gabor Maté27:43

      You know, I think it's ... First of all, people want to idealize. They want to have these fantasy bonds with figures that, whose lives they find glamorous and more meaningful than their own, and they don't want that illusion shattered. I think that's a part of it. But I think there's a more general cause, which is doesn't have to do with royalty. So if you look at, um, if you look at, uh, Harry's life, he's born to a young, emotionally fairly, hmm, troubled woman, who is in a loveless marriage, whose husband basically, wh- himself was, uh, Charles himself was a bullied, sensitive child, emotionally deprived. There was a story about Prince Charles, current king, um, five years old. His mother, Queen Elizabeth, goes on a royal tour for several months. When she comes back, she greets him by shaking his hand. When ... Now, that's a deprivation. Ashley Montagu talked about the need to be held. When Harry's mother dies, Diana, his father comes into his room early in the morning to tell him, doesn't hug the child. Imagine telling a child that your mother just died, and you don't hug the child. He spends a few minutes, touches the kid on the knee, and says, "It'll be okay," and leaves, and Harry's left on his own. Now, take that out of the royal context. Would you not see that as a example of tragic deprivation, emotional deprivation?

   2. RCDr. Rangan Chatterjee29:26

      Yeah.

   3. GMDr. Gabor Maté29:26

      And so ... And here's one of the funny things in the, about the British press. I quoted Ashley Montagu, and I said that Montagu talks about the importance of cuddling and holding kids and skin-to-skin contact. And I said even animals cuddle their kids. I mean, you tell a mother orangutan to ignore her child's emotional distress, you know, or a mother monkey or a mother cat, for that matter. I said even animals hold their kids. The Sunday Times wrote that I said-

   4. RCDr. Rangan Chatterjee30:00

      I'm delighted to announce that AG1, the daily health drink that has been in my own life for over six years now, have updated and improved their formulation based upon the latest science, and to celebrate by giving my audience a very special summer offer. Some of the upgrades include more magnesium, which supports muscle function and improves the ability of your nervous system to relax, and also five strains of bacteria instead of just two to reflect the latest advances in microbiome scienceIt also contains key nutrients like vitamin C, biotin, niacin, vitamin B6, riboflavin, thiamine, zinc, and folate in bioavailable forms the body can easily and readily utilize, maximizing their potential benefits. Nutrition can often seem really complicated. What diet should we be following? What supplements should we be taking? And I think that's one of the main reasons I really like AG1. They make it really simple for you to be the best version of you. Over 17 ingredients, one scoop once a day for less than a cup of coffee. So if you wanna support your health seven mornings a week, get started with AG1, and right now we have a very special limited time summer offer worth 58 pounds, which is around 80 US dollars. To get 10 free travel packs instead of the usual five and an awesome welcome kit containing your shaker, scoop, and canister with your first subscription, go to drinkag1.com/livemore.

   5. GMDr. Gabor Maté31:39

      That the royal family treated their kids like animals. I said the opposite. I said they only wish they had treated them like animals, cuddled them when they needed to be held. So that's an example of, of, of severe deprivation. Not anybody's fault. It's multigenerational in that family. So when I asked Harry, "Well, where does that leave you?" He says, "It leaves me wanting to cuddle my kids and hold them all the time."

   6. RCDr. Rangan Chatterjee32:05

      Yeah.

   7. GMDr. Gabor Maté32:06

      You know? 'Cause he doesn't wanna pass that pain on. What is so difficult for people to understand about that, you know? It's because people are themselves hurt, and they have trouble looking at the sources of their pain. So when Harry talks about the source of his pain in his family of origin, and again, this is not a blaming conversation. We pass on our stuff, I did to my kids without meaning to, so he was in the same position, and now he wants to liberate his own children-

   8. RCDr. Rangan Chatterjee32:40

      Yeah

   9. GMDr. Gabor Maté32:40

      ... from that multigenerational transmission of essential emotional deprivation and trauma. He's vilified for it because he is speaking about what you're not supposed to talk about in this society, which is the emotional pain that suffuses so many families.

   10. RCDr. Rangan Chatterjee32:57

       Yeah. If we take the macro and bring it right back to the micro, any individual who has become aware of some slightly toxic family dynamics, again, no blame there. You know, I will admit there's been some toxic dynamics in my own family that since I became aware and started to address them and change them, initially there was a bit of friction, but on the other side of that is a real beautiful, authentic connection and interaction that comes from a place of want, not a place of obligation, and I think there's a real opportunity there for all of us-

   11. GMDr. Gabor Maté33:40

       Can I interrupt you for a minute? 'Cause you just gave me a thought. Can you imagine what an incredible gift to the world it would be, it's not gonna happen, but what a gift to the world it would be if the royal family all said, "Yes, for all our privilege, we carry trauma. The trauma that was inflicted on a generation of men in our family in those public schools with their bullying and their whippings and their, and their, uh, cruel treatment of children. The suppression of women. If you look, we as a royal family are now willing to look at our traumas," and anybody who knows the history of that family knows that in every generation there's been one difficult relationship after another, one divorce after another, one dysfunction after another. "But we recognize the multigenerational trauma, and we as a family want to heal it, and we're gonna take that on as our task, and we encourage all of you in society do the same thing." Can you imagine what a gift that would be to the world? It's not gonna happen.

   12. RCDr. Rangan Chatterjee34:50

       Why, Dr. Maté, so pessimistic? Why is it not gonna happen?

   13. GMDr. Gabor Maté34:57

       Because, um, we're all of us too attached to social role and social expectation, and we allow that to trump our inner need for authenticity. So when somebody like Harry struggles all his life to be authentically himself, and that's really what his book is all about, o- of, of, of a human being wanting to be themselves at all costs. Most people are... A lot of people are not willing to take that on, and, a- and why not? 'Cause people are afraid to look at their own pain. It's painful to look at our pain. It's easier to lose ourselves in our roles and in, and in our image, self-images, and in our, um, worldly activities. So there's a powerful weight of historical burden that's keeping that family, um, pretty close-

   14. RCDr. Rangan Chatterjee35:50

       Yeah

   15. GMDr. Gabor Maté35:50

       ... and not very open about their struggles. But, you know, at least Harry and his brother, uh, did at some point initiate some conversation around this, and that, that, that was a step forward.

   16. RCDr. Rangan Chatterjee36:02

       It's so fascinating, this, this, th- this entire story and the way it blows up. It's interesting, have... 'Cause I'm not really, in general, I'm not that interested in popular media. I'm not interested in celebrity gossip. I'm not... You know, the stories that the media publish, I don't really read that stuff. I'm, I'm just not interested, but the, the Harry story has fascinated me incredibly. Observing it from the outside-It, it strikes me as though a lot of people who have been through this process themselves, they've had to self-examine, maybe they've had therapy, whatever it might be, and they've recognized, you know, that very important first step. They've recognized, "Oh, there's an issue here. I'm being ... I'm living in the present based upon my past," i.e., I'm not really living in the present, I'm still living in the past, and they go through the process of changing things or trying to change things. As hard as it might be, I sort of feel that people who know what that feels like can see very clearly the Harry story with what is going on. And I feel that people who either have not been traumatized, I'm not sure how many people [laughs] have not been traumatized in, um, the, the, you know, the modern world in which we live, but for people who maybe have been, yet, as of yet at least, haven't acknowledged that or been aware of that, I think it's very easy to go, "What are you talking about? This is, this is victimhood. You know, you should be keeping your dirty laundry to yourself." That's one of the things they'll say, Gabor, won't they? They will say, "Okay, fine, but why do this in public?" I wonder what your perspective is, having spoken to him.

9. 37:50 – 41:14

   Destigmatizing mental illness: ‘more conversation’ and ‘what happened to you?’

   1. GMDr. Gabor Maté37:50

      Well, um, I think people that were not traumatized at all, and I don't meet too many of those, but they would just have natural empathy. It's the people that were traumatized but are afraid to look at it, they're the ones who react so, um, violently, I believe, which I think is a lot of people in this society. Uh, now, he, he talks about it publicly. There, there is a point in our conversation where people sent in questions, and the very first question that came in, and I believe you have the clip of it, is, is, uh, how do we remove the stigma of mental illness?

   2. RCDr. Rangan Chatterjee38:33

      Well, let's just play that clip 'cause, Gabor, we do have that. Let's just play that now so people can see it.

   3. GMDr. Gabor Maté38:39

      Okay. [beep] This is from, um, Janet Joy from Brooklyn. From your experience, what do you think it will take to eliminate the stigma of mental illness? What will it take?

   4. SPSpeaker38:52

      More conversation.

   5. GMDr. Gabor Maté38:54

      Yeah.

   6. SPSpeaker38:54

      Uh, more and more conversation. Uh, less, uh, less of us and them.

   7. GMDr. Gabor Maté39:01

      Mm-hmm.

   8. SPSpeaker39:02

      I think we're all, I think we're all on the spectrum.

   9. GMDr. Gabor Maté39:05

      Yes.

   10. SPSpeaker39:05

       And I think, I think we slide-

   11. GMDr. Gabor Maté39:07

       Yeah

   12. SPSpeaker39:07

       ... up and down depending on what is happening in our life.

   13. GMDr. Gabor Maté39:10

       Yeah.

   14. SPSpeaker39:10

       But I think the sooner we all accept that we're all on the spectrum and that we all have our own stuff to deal with-

   15. GMDr. Gabor Maté39:15

       Yeah

   16. SPSpeaker39:15

       ... it, the labeling is not helpful.

   17. GMDr. Gabor Maté39:18

       Yeah.

   18. SPSpeaker39:18

       It may be helpful for some people where it's like, "Ah."

   19. GMDr. Gabor Maté39:20

       Yeah.

   20. SPSpeaker39:21

       "I've been diagnosed."

   21. GMDr. Gabor Maté39:22

       Yeah.

   22. SPSpeaker39:22

       "Now I know that ... Now I know what it is."

   23. GMDr. Gabor Maté39:25

       Yeah.

   24. SPSpeaker39:25

       But again, it goes back to this whole thing of what has happened to you rather than what is wrong with you.

   25. GMDr. Gabor Maté39:29

       Exactly. So, yeah.

   26. SPSpeaker39:29

       And therefore, the more we talk about it, the more people share-

   27. GMDr. Gabor Maté39:32

       Yeah

   28. SPSpeaker39:33

       ... in your own environment, but also the more, you know, leaders, public figures, I think the more that we can all just acknowledge this and have conversations about it-

   29. GMDr. Gabor Maté39:43

       Yeah

   30. SPSpeaker39:43

       ... um, and know that the people who push back or fight against it, that is probably based in their own fear.
10. 41:14 – 1:00:06

    When criticism hits old wounds: Maté on triggers, ‘not being seen,’ and asking for help

    1. GMDr. Gabor Maté41:14

       And by the way, sorry, can I just make another comment here? [laughs]

    2. RCDr. Rangan Chatterjee41:17

       Please. [laughs]

    3. GMDr. Gabor Maté41:21

       [laughs] You know, I've, I have to tell you, I've, I've, I've been sort of silent for weeks now after this interview and watch all this nonsense. So there was a British psychiatrist, very respectable tie and respectable collar and very respectable demeanor, who did this online critique of my interview with Harry. I'm not gonna go into the whole thing. I only watched a few minutes of it. One of the things he criticized me for was looking at my watch. You're not supposed to look at your watch during a therapy session. Dear sir, I want to say to him, this wasn't a therapy session. It was a conversation. The reason I looked at my watch was because people were gonna ... sending in questions, and I had to make sure there was enough time in our discussion [laughs] to answer the questions. So this question about how do we destigmatize, sir psychiatrist, I was looking at my watch 'cause I wanted to make sure that we had time to answer people's questions.

    4. RCDr. Rangan Chatterjee42:19

       Yeah.

    5. GMDr. Gabor Maté42:19

       Okay? So I'm talking about the, um ... I'm venting a little bit. I, I, you know, I, I, I admit it. Um, but, but y- you know, uh, this is the level of commentary that, that followed.

    6. RCDr. Rangan Chatterjee42:32

       Gabor, you're only human, right? I cannot imagine what it-... must have been like to get caught up in that whirlwind. In fact, I'll be honest with you, when I spoke to you on the phone, well, over Zoom a couple of weeks ago, and we were talking about this, I was quite saddened afterwards. You looked worn out. You looked exhausted, physically and emotionally worn out. And I remember I said to my wife afterwards, "This man, you know, Gabor is someone who's had such a huge impact on my life, my professional career, how I view the world. And to see him in his late 70s looking like that when I know how vibrant and how energetic he is," it really did sadden me. Perhaps you could, um, explain. You are someone who's done the work on yourself, right? So it will take a lot, I suspect, these days to trigger you. So what was it about the press, in your view, misrepresenting what had actually happened? What was it exactly that bothered you so much?

    7. GMDr. Gabor Maté43:44

       Well, you're touching on a key question, and first of all, thanks for your empathy and for noticing. I was in a troubled state afterwards. I thought I was past it. No, this really was more than I had expected. And it was also an opportunity for growth and insight and learning.

    8. RCDr. Rangan Chatterjee44:02

       Yeah.

    9. GMDr. Gabor Maté44:03

       Everything that comes along in life that may be troubling or shows up as disturbing, there's a potential teaching in it. So I was in the aftermath of that interview and, and, and, and the feedback, you know, the, the, this tsunami of venom that came my way, um, I was troubled. And I did something. You know, do you know the book The, The Boy, The Mole, The Fox and The Horse?

    10. RCDr. Rangan Chatterjee44:26

        Yeah. Yeah.

    11. GMDr. Gabor Maté44:28

        Yeah. By Charlie Mackesy. A lot of beautiful wisdom in that book, and the horse is the most grounded of those four friends. And the horse is asked, "What's the most courageous thing you've ever said?" Remember what the horse says?

    12. RCDr. Rangan Chatterjee44:42

        No.

    13. GMDr. Gabor Maté44:43

        He says, "Help." It's so hard for us to ask for help. So in the midst of that hurricane, you might say, that I was caught up in, in that whirlwind afterwards, and I was exactly the way you described me. I thought, "Well, what's going on here? I know better than this." But somehow I can't get ahold of it. So I called for help. I phoned up a, a friend of mine, um, psychiatrist Dan Siegel, who's very well known-

    14. RCDr. Rangan Chatterjee45:16

        Yeah

    15. GMDr. Gabor Maté45:16

        ... and has done beautiful work. And I said, "Dan, this is bigger than me. Can you help me?" And he says, "What is it about this whole thing that is so upsetting for you?" And I thought about it for a moment. I said, "It's not being seen. I don't mind being criticized. If people disagree with me, critique me, that's just fine. But let them critique who I am and let them critique what I actually said, not their own distortions of it." And Dan said, "Given your early childhood, your infancy, where you were not seen as a human being, as a Jewish infant in Hungary, not being seen was life-threatening to you." And I said [sighs] "Yeah."

    16. RCDr. Rangan Chatterjee45:59

        Yeah.

    17. GMDr. Gabor Maté46:00

        That not being seen on such a massive scale, being misrepresented, triggered some very deep anxieties. As soon as he said it, I said, "Yeah, this makes sense now."

    18. RCDr. Rangan Chatterjee46:12

        Yeah.

    19. GMDr. Gabor Maté46:13

        You know? And so understanding the source of our dysfunction, um, and our, our, our, our suffering is a big step towards... The Buddha said once that once you know the source of your, know the source of your suffering, you're on the way towards healing it.

    20. RCDr. Rangan Chatterjee46:29

        Yeah.

    21. GMDr. Gabor Maté46:30

        And so that's what happened for me. In retrospect, you know, I can be grateful for this whole experience 'cause I learned something, and you come- and I came out of it, I believe stronger and more accepting of myself. And you know what? Even with more compassion for all those critics because I'm seeing where does it come from.

    22. RCDr. Rangan Chatterjee46:48

        Yeah.

    23. GMDr. Gabor Maté46:48

        You know? It comes from their own pain, I believe.

    24. RCDr. Rangan Chatterjee46:52

        Yeah. Well, thank you for sharing that, first of all, and I think there's such a key lesson for all of us there, which really speaks to victimhood versus empowerment. You could have, and maybe you did for a short while, wallow in, you know, I've worked so hard. I've written an amazing book. It's now getting misrepresented. People are writing lies about me, or whatever story may have gone on in your head. And look, we're all human, so sometimes we fall into these kind of traps, and they are traps. Um, but because of the work you've done and because you had the strength to call someone and say, "Hey, you know what? I'm struggling, man. Can you help me?" You know? You showed your strength through your vulnerability. Someone else was able to mirror for you and, and once you realize that, it's like, ah, I get it. I've had another opportunity to learn. I thought that was healed. Oh wow, there's [chuckles] there's still somewhere to go. That's very empowering. And then that second point about looking at your critics with compassion, I love that. It's something I try very much to do in my own life. It's a very beautiful place to get to because it's a less judgmental place. It's a, it's a place of if I was that person with their childhood, with their life experiences, I'd be acting in exactly the same way as them. And I think, Gabor, that really speaks to the whole Harry conversation. A lot of people will think, what's he moaning about? He's got as much money as he wants, or he certainly did. I don't know his current financial situation. He's, you know, he's got cars to take him places. He can get tickets to everything. You know, he doesn't have the stresses that we do. If I were him, I wouldn't be acting like that, which is a very judgmental place to be because when you really understand, if you were that person, you would actually be doing exactly the same thing because you would be them. You would have their experiences. You would have their trauma. But that brings up another part of that conversation, Gabor. I didn't see it all, but I've seen, uh, quite a lot of it, and there was a really profound part in it where you said to Prince Harry-That your impression of his childhood was one of deprivation, but you weren't talking about physical deprivation. You were talking about emotional deprivation.

    25. GMDr. Gabor Maté49:19

        Yeah. And so, [clears throat] by the way, just not to paint too romantic a picture of myself, it's not that I walk around with a lot of compassion for my critics all the time. It's just [laughs] sometimes I'm just enraged, you know? But, but, but at the same time, I can see the, the tightness and narrowness of their position does come out of a, uh, does come out of trauma. I mean, that's, that's my impression, you know? Um, I wish I could feel compassionate towards such people all the time. Fact is, I'm a human being. I oscillate between, you know, compassion sometimes and, and hostility at other times. That's just me, you know? The diff- the difference is that I recognize those oscillations inside myself, you know? And I see them as my own dynamic, not caused by somebody else. They don't cause me to be that way. It's, it's, it's, it's my own responsibility how I am. Now, in terms of the, um, suffering inside of privilege, well, you know, again, what would anybody say about a... Anybody who's ever had a dog or a cat, these are attachment-based creatures. They want you. Your dog wants to love you. Your dog wants to be loved by you. They, when you treat them with a lack of it, they suffer. Well, how is that not the same, too, of human beings? And it's not just a question of love that the parent feels, 'cause, you know, I loved my kids, but that doesn't mean I treated them lovingly a lot of the time. In significant ways, I didn't because of my own stuff. So in, in the case of Harry, it's not that his parents didn't love him. I'm sure they did. But if you look at the adverse childhood experiences studies, the childhood adversities that are, mm, associated with adult mental health challenges, they include the death of a parent, they include a, a, a, a rancorous divorce, and preceding that divorce, a marriage in which there's all kinds of stress.

    26. RCDr. Rangan Chatterjee51:44

        [gentle music] Now, I'm a huge fan of Vivobarefoot shoes. I've been wearing them for about 12 years now. And one of the main reasons I love them is because when I'm wearing Vivos, I feel fully connected to the ground beneath my feet. What do we want? We want feet that move naturally. And because Vivos are wide, thin, and flexible, your foot can move in the way that it's meant to. A lot of modern shoes are stiff, they're narrow. They start to manipulate the way your foot functions. Whereas in Vivos, your feet can do what they're meant to do, and that means they help your feet become stronger. There was this trial that showed within four months of wearing Vivos, your feet are around 60% stronger. Your feet are your foundation, and when you've got problems in your feet, it goes all the way up the chain. It can go to your ankle, to your knee, to your hip, to your back, and even to your shoulder and neck. And as a doctor, I have seen back pain, hip pain, and knee pain actually start to get better when people start to wear barefoot shoes. To get 20% off your first order, go to vivobarefoot.com/livemore.

    27. GMDr. Gabor Maté52:59

        When the mother's often absent, when the father's emotionally distant, this is depri- again, this is deprivation. These are guaranteed. So when Harry, in his book, describes his various diagnoses, um, of, of, of agoraphobia, severe panic attacks, of, uh, post-traumatic stress, uh, of episodes, not chronic, but some episodes of depression, um, um, th- these... a- and, and his occasional resort to substances to ease his mental suffering, such as, you know, a- a- alcohol or marijuana, these are normal responses to the kind of adversities that he experienced.

    28. RCDr. Rangan Chatterjee53:50

        Mm.

    29. GMDr. Gabor Maté53:50

        So again, that all these various diagnoses to which, as you know, I added one, but, but, but all these diagnoses, these are not m- abnormalities.

    30. RCDr. Rangan Chatterjee54:00

        Yeah.
11. 1:00:06 – 1:07:37

    ADD/ADHD and the limits of diagnosis: description vs explanation

    1. RCDr. Rangan Chatterjee1:00:06

       Yeah. I wanna talk about the second part of that clip from the conversation you had with Harry, and that's to do with labeling. As we've said before in previous discussions that we've had together, you know, certainly one of my big frustrations with the way we practice medicine is that the end point is often the diagnosis. You know, what can we do? How, how... Oh, we got the diagnosis. Okay, we can relax now. We got the diagnosis, here's the treatment. And really medicine, the way, certainly for chronic illness, the way we're taught to practice, the way you were taught to practice, the way I was taught to practice, and I think very much is still happening in medical schools, it's the medicine of what, not the medicine of why. It's the medicine of symptomatology, not the medicine of etiology. And I think Harry very astutely mentions in that conversation that labeling is not helpful. He said, "Labeling really is simply saying what is wrong with you rather than what has happened to you." And-One of the other really controversial areas from... I say cont- controversial, I don't think it was controversial if you see how you said it in the conversation. The way it's been reported has generated a lot of controversy in the public and the media, and from some of your colleagues, was to do with the labeling of ADD. So Gabor, I wonder if you could first speak to labeling, why it's not always as helpful as it might seem, and then perhaps you could clarify for all of us what you were trying to get at when you brought up ADD.

    2. GMDr. Gabor Maté1:01:53

       Um, I'm, I'm, I'm breathing a sigh of relief here at hearing your question, 'cause [laughs] I have an o- opportunity now to actually, um, clarify what I meant and, and how I see it. Well, first of all, diagnoses don't explain anything. This is true for ADD, for any mental health diagnosis. They describe something, but they don't explain it. There's a descr- there's a difference between description and explanation. So let's take me. I was diagnosed with ADD in my mid-50s. Attention deficit hyperactivity disorder, ADD or ADHD. And it became my first book, Scattered Minds. And I thought, "Okay, this explains something." But actually, it doesn't explain anything, 'cause let's look at it. It's kind of a tautology. It's a circle. Gabor is ADD. How do we know? 'Cause he has trouble paying attention, he's easily distractible, he has poor impulse control, and has difficulty being still. Why does Gabor have difficulty being still, is distractible, tunes out a lot? 'Cause he's got ADD. How do we know he's got ADD? 'Cause he's distractible, you know. I haven't explained anything. I've just described it. Now, that... It may be helpful, and I found it helpful. "Oh, yeah, okay, here. Here's there's something I can relate to." But it doesn't explain anything. Now, the explanation is, what happened to you? So when I was an infant, and anybody who's heard me speak or read my books, a Jewish infant, Nazi occupation, mother under the threat of death for a whole year, grandparents being killed in Auschwitz. I lived under highly stressed circumstances as an infant. Now, what does an infant do with that? I can't change the situation. I can't escape it. I tune out. Tune out, tuning out is a protection. It's a nature-given adaptation, is what it is. But this is happening when my brain is developing, so my brain develops along those lines. And then 55 years later, I'm diagnosed with this so-called disease. It's not a disease. It's a normal response to abnormal circumstances. It's a coping mechanism. Just like pushing down, depressing your feelings when you're not allowed to have them is a coping mechanism that helps you survive in your family of origin, tuning out is another coping mechanism. Now, when I read Harry's book, he talks about his d- distractibility, his poor impulse control. He talks about the fact he could never listen to a lecture, keep his mind on it, never read a book, f- find it difficult. And he was called stupid, and he was called naughty. He says, "I didn't want to be naughty. I wanted to be noble." But he was stigmatized as thicko, they called him. I imagine it's a British expression for stupid, thick-headed. So I was saying to him, "Harry, there's nothing wrong with you. Your distractibility and your poor impulse regulation, um, your difficulty listening to a lecture, these are normal responses." You don't... So I diagnosed him with a non-disease. And a lot of people got their knickers in a knot about that, you know? While I'd read the book very carefully, I'd also talked with the man for an hour before the diag- before we had the formal interview. So in saying to him, "It takes one to know one," 'cause believe me, I know the ADD mind from the inside out, literally, personally. And reading his history, I was just saying to him, "All that stigma you received as a child, you didn't deserve it. You were not naughty and you were not stupid. You just had a mind that was reacting in a certain way to s- the stresses, especially given your very sensitive nature." So that's what I was saying.

    3. RCDr. Rangan Chatterjee1:06:06

       Yeah. Thank you so much for clarifying and elaborating on that, because unfortunately, that interview isn't publicly available online for people to watch. I, I really wish it was, because I feel that it would do a great service to mental health awareness, and it would help people understand themselves, and I think understand Prince Harry a lot better through that conversation. Um, but nonetheless, it's not. Um, your book, Scattered Minds, i- is, is a, is a fabulous read, and actually, a very close friend of mine read that book about three years ago and realized through reading it that they had ADD, and you know, have, has taken steps in their own life to, to try and address it. But you know, this is where labels, again, not to be too black or white, this is where labels can be helpful, at least initially, to know, "Oh, I'm not crazy. I'm not mad. There's nothing wrong with me. This is what I've got because of what happened when my brain was developing. Now that I know that, I'm empowered to do something about it, rather than be a victim to this thing that just happened and there's nothing I can do." So I think-I think that's really important. Um, but I wonder if you could just clarify, Gabor, ADD, ADHD, these are terms that I think people have heard of. So could you just clarify what those

12. 1:07:37 – 1:13:06

    Genetics, sensitivity, and environment: how critics misunderstand ‘biology’

    1. RCDr. Rangan Chatterjee1:07:37

       two abbreviations are, and then what would critics of your work say about the way you view ADD? What would they say and how would you counteract that?

    2. GMDr. Gabor Maté1:07:48

       So, so the diagnosis simply means, um, that you have these traits of, um, distractibility, tuning out, poor attention skills. So your mind tends to be elsewhere a lot of the time, an unwilled kind of tuning out. Most people tune out sometimes, you know. Um, but people with ADD, they tend to do it much more than the average person does, and it does interfere with the capacity to learn or to complete tasks and so on at sometimes. Um, so that's the attention part. The H part, which is sometimes present, sometimes isn't, it, it also means poor impulse regulation. So when something occurs, it- people tend to blurt things out and say things, and their mind tend to wander a lot. And sometimes when you talk to a person with ADD, like they'll start talking about one thing, and that one thing leads to something else. And if you don't stop them, an hour later they're still talking far away, tangentially far away from the original point of the conversation. Um, so that's the distractibility, attention part, poor impulse regulation, uh, I've certainly had that in my life. Um, uh, and then the H part, if it's present, is the hyperactivity, difficulty sitting still, being uncomfortable, becoming bored easily, wanting to move and get away from things. Um, generally when I go to public meetings, unless I'm the speaker, uh, [laughs] I tend to sit at the back so I can make a quick getaway in case I get bored, you know. Um, in a classroom, the very hyper kids, you can easily recognize them 'cause they have trouble sitting still, you know. So they're the ones that are easily diagnosed. Now, I'm saying that all these are normal responses to stresses in, uh, on highly sensitive kids in early life. What the critics would say is that, uh, number one, this is a genetic disorder. It's, it runs in families, therefore it's not a question of the environment. Uh, secondly, it's biological. It has to do with lack of dopamine in the brain, and therefore when we give somebody medication that elevates dopamine levels, which is the incentive motivation chemical, they cannot pay attention. Now, I've taken medication. It's true. It helped me. When I wrote Scattered Minds, I was taking a stimulant. That helped me, you know. What I say in response to the critics though is, number one, just 'cause something runs in families, it doesn't make it genetic. I mean, you're a medical doctor. I'm a medical doctor. If our kids became medical doctors, which there's no risk in my case of that happening, would that mean that the practice of medicine is a genetic disorder? You know, in other words, could be, or maybe it isn't. In other words, there's a way in which we pass on stuff that's environmental rather than genetic. And my kids didn't experience stress the way I did. There was no war. But they grew up in a family of origin where there was a lot of conflict between the parents.

    3. RCDr. Rangan Chatterjee1:10:56

       Yeah.

    4. GMDr. Gabor Maté1:10:57

       You know, and that had an impact on them. So we can pass on stuff, not genetically, but through these circumstances. As far as the biology is concerned, this is what the average psychiatrist doesn't understand, because they're not taught it-

    5. RCDr. Rangan Chatterjee1:11:10

       Yeah

    6. GMDr. Gabor Maté1:11:11

       ... that the b- biology of the brain is shaped by the emotional environment. So yes, there's biology involved, but that biology is not determined by genetics. What is genetic here is what I've said about Harry and a lot of other people. There are genes for sensitivity. So here's the, here's the shinny on, on genetics and mental health. For all the talk about depression and bipolar illness and schizophrenia and ADHD and, uh, being genetic, there's no gene or group of genes that if you have them you'll have a certain disease. There's no goo- gene or group of genes that if you don't have them you will not have that mental health condition. What there is, and every time they think they've discovered some gene for an illness, two years later they have to retract it. What there is, it seems to be, this is as, as best I can understand the latest research, there's a large group of genes that the more of them you have the more likely to have any number of mental health conditions, but no specific one. What is being actually transmitted genetically is sensitivity.

    7. RCDr. Rangan Chatterjee1:12:19

       Mm-hmm.

    8. GMDr. Gabor Maté1:12:20

       The more sensitivity genes you have, the more likely you'll be affected by the environment.

    9. RCDr. Rangan Chatterjee1:12:26

       Yeah.

    10. GMDr. Gabor Maté1:12:26

        So when there's dysfunction, trauma, stress in environment, you'll be more affected by somebody who's not as sensitive as you are genetically. That's what's genetic here. But the, but the so-called diseases are not. The diseases themselves, as I keep pointing out, or what we call diseases, are so-called, are so-called diseases are adaptations.

    11. RCDr. Rangan Chatterjee1:12:47

        Yeah.

    12. GMDr. Gabor Maté1:12:48

        The depression is an adaptation. The, um, so-called personality disorder, not trusting people, it's an adaptation. The tuning out of ADHD, it's an adaptation on the part of sensitive children to stresses in their environment.

13. 1:13:06 – 1:18:36

    Gendered pressures and trauma expression: women absorb, men act out

    1. RCDr. Rangan Chatterjee1:13:06

       Gabor, last time we spoke we mentioned the unique pressures on women in society today. You've written a whole chapter on this in The Myth of Normal, how women are society's, I think, shock absorbers, I think is how you referred to them, and you drew the strong connection between women's rolesAnd the fact that 70 to 80% of autoimmune diseases are afflicted to women, right? So we've covered that, and I think it's really, really interesting. This is not really in relation to Harry. I wanna broaden it out beyond Harry because I think Harry had some quite unique pressures [laughs] that most of us, 99.9% of the world's population, will never know what sort of expectation there is to behave a certain way, to be a certain way, to perform a certain way when you're a prince, right? So I don't think that's maybe that relatable. But the point I'm trying to get to is there's unique pressures on women in society, but there's also unique toxic pressures on men. What do you see as the key difference between what we're being asked to do, and is it biological or is it cultural?

    2. GMDr. Gabor Maté1:14:26

       Well, deep question. Um, statistically, women are much more likely to be diagnosed with PTSD, double with anxiety and depression. They tend to take... They're, they're the ones who tend to take psych- psychiatric medications much more often than men do statistically. And, uh, I don't think that has to do with any biological, um, determinant. This has to do with what you just summarized, which is that women tend to act as the emotional shock absorbers. So very often... There's a fascinating study out of Sweden. They looked at, um, prematurity, premature birth. If a woman had depression during pregnancy, I think in the first trimester or the second, that increased their chance of premature birth, late premature birth, so 32 weeks or afterwards. But if the father had depression, that increased the chance of even earlier premature birth.

    3. RCDr. Rangan Chatterjee1:15:33

       Wow.

    4. GMDr. Gabor Maté1:15:34

       Now, how do we explain that? Because the woman absorbs the stresses of the husband, so... And that affects her physiology. So the w- the reason women are more likely to be diagnosed, quite apart from the fact that being a woman in society, being a female child really exposes you to trauma. Not that being a male protects you from it, but sexual abuse, which happens to men as well, young boys as well, as we know-

    5. RCDr. Rangan Chatterjee1:16:03

       Yeah

    6. GMDr. Gabor Maté1:16:03

       ... is more likely to happen to a young girl. And, uh, so that, um... So trauma, that particular form of trauma, which is a significant risk factor for mental health conditions, depression, substance abuse, anxiety and so on, um, happens to young girls more. So, and then there's the general role of women as shock absorbers. Now, men also suffer, just as you say, but the way that, um, men are acculturated is to act out their stresses whereas women act them in, so that in the women it has to be more internal. The man will act out his suffering through substance use or through violence, um, through dominating a woman, um, through finding a woman to absorb his stresses. You know? Um, um, there's this toxic masculinity. When you, when you talk to men with PTSD, soldiers who've been in battle and come back with severe symptoms, one of the things that inhibit their healing is the expectation that they should be tough and suck it up and not talk about their vulnerability. So that the expectation on men not to be vulnerable is a huge source of, uh, pressure and dysfunction for men. And when they heal, these tough veterans who've had their friends killed, who they themselves may have been injured, who've killed others, they soften up. They start having, finding their tears. They start finding their vulnerability that they've had to suppress all their lives. So that's how it works with, with men.

    7. RCDr. Rangan Chatterjee1:17:56

       Yeah.

    8. GMDr. Gabor Maté1:17:56

       And you know, Harry and I did talk about vulnerability. Vulnerability comes from the Latin word vulnerari, to wound. And, uh, human beings are profoundly vulnerable from conception until death. We're all vulnerable. We can all be wounded. But in our society, men are expected to stifle and hide and reject their vulnerability. "Don't be a sissy." We, we, we, we associate vulnerability with feminine qualities that we're supposed to disdain.

    9. RCDr. Rangan Chatterjee1:18:32

       Yeah.

    10. GMDr. Gabor Maté1:18:32

        And that's a big pressure on men.

14. 1:18:36 – 1:27:16

    No blame, no shame: remorse without guilt and the possibility of repair

    1. RCDr. Rangan Chatterjee1:18:36

       Thank you. Gabor, just to finish off this conversation, I think there's just two points to, to, to try and address. In relation to what you've just said about the importance of vulnerability for men and women, but let's say particularly men in the context of what you've just said, you are actually someone who I think is a pretty phenomenal example of that. You share your vulnerability in every single one of your books. And actually in our last conversation, the third conversation we had together on this podcast, you shared a story that when Daniel, one of your children, was young, you mentioned and you shared openly how you slapped him across the face for something that you can now reflect on and see as being very trivial. Now, what's really interesting is that-When we put that out, it's amazing to see how triggering content like that can be for people. Now, some people are admiring you and going, "Wow, this is why I love Dr. Maté. He's sharing. He's not trying to present himself as being perfect." But other people are being very judgemental and saying, "I can't believe he just admitted child abuse in public. You know, this is not something to be celebrated. This is something he should be ashamed about." Right? So again, we have a very polarized debate around you sharing something that you're not looking for sympathy for. You're just trying to say this is a matter of fact, this is what happened. This is what I did. This has been the consequence. So I think there's a, there's a wider point here, which is about blame, okay? It relates to the Prince Harry conversation. It relates to even how we talk about the royal family. Um, your conversation with Prince Harry, what I've heard of it from what you've explained, was not about blaming his brother or his father or his uncle or his grandma, right? It was simply about saying what is. It was understanding that we're all playing out our trauma. We're all doing the best we can based upon what we've experienced. You mentioned Prince Charles, now King Charles, how he was brought up and how he was taught to show affection, so of course he's gonna replay that. So I wanna really just make sure we get across that we're trying to be compassionate. We're not blaming anyone. But also for people, Gabor, who hear what you're saying about, oh, if the mother's stressed during pregnancy, the child's more likely to be stressed, a lot of people go immediately to guilt, and they go, "Oh man, I was so stressed during my pregnancy. Oh, I did this to my child." So I wonder if you could wrap up those themes together and leave people on an inspiring note, if that's possible.

    2. GMDr. Gabor Maté1:21:34

       Sure. Well, when we talk about the importance of pregnancy and early childhood, almost inevitably it brings up a lot of remorse in a lot of parents. And there's no question about it. But it's not about blaming anybody, 'cause they all did their best.

    3. RCDr. Rangan Chatterjee1:21:50

       Yeah.

    4. GMDr. Gabor Maté1:21:50

       When Prince Charles came into Harry's room and told him, "Your mother has died," touches him on the knee and says, "It's gonna be okay," and leaves, he was doing his best. That was his best based on what happened to him as a child. There's nobody to be blamed here. Um, when I hit my son when he was three years old, I'm not proud of it. I have remorse about it, but it happened, and I have to understand what happened and why I did it, and I didn't do it deliberately. It just came upon me, you know? Um, and it had consequences. And my son Dan and I just wrote this book together, The Myth of Normal, that you've mentioned, and we're writing another book together called Hello Again: A Fresh Start for Adult Children and Their Parents.

    5. RCDr. Rangan Chatterjee1:22:44

       Oh.

    6. GMDr. Gabor Maté1:22:44

       Just yesterday I arrived home from a hiking trip that I did with my two so- my two adult sons. So when I talk about this stuff, it's to say, first of all, don't blame yourself. You're not different from me. I'm not different from anybody else. We do our best, but our best sometimes can be very hurtful to the next generation because of our own unresolved stuff. And secondly, we can look this in the eye. We can actually deal with it and, without shame, understand what happened. You can have remorse, but shame, beating yourself wrong and, and, and thinking you're a terrible person, that's not helpful to anybody. And to all the parents who say, "I pas- passed on my stresses to your kids," you know, sometimes when I give talks somebody will say, "I'm afraid I sc- screwed up my kids." And, and I say to all those people who think you screwed up my kids, I said, "Don't worry about it. Of course you did, you know? We all do. That's what happened." But if each, if at each generation we can just heal a little bit or a lot, we'll pass on a lot less. And what I say to all parents is, "What morn..." Who feel guilty, I say to them, "What morning did you wake up and decide to screw up your kids? Was it a Saturday afternoon that you made the decision to screw up your kids? Was it Monday morning? Were you 19 or 25 or 35 when you made that decision?" People laugh. Nobody makes that decision to trouble or to hurt their kids.

    7. RCDr. Rangan Chatterjee1:24:18

       Yeah.

    8. GMDr. Gabor Maté1:24:18

       We just do, but it's not a guilt. It's not a fault. It's not a deliberate act. It's just the unresolved impacts of our own trauma, and that can be healed, and the more as parents we heal, the more we heal our kids.

    9. RCDr. Rangan Chatterjee1:24:33

       Yeah.

    10. GMDr. Gabor Maté1:24:33

        And that healing is a lifelong process. And so that the fact that my sons and I just came back from this beautiful hiking trip in Utah and that my son and I are, Dan and I are writing two books together, that's an example of the healing that can happen, both each in ourselves and also in our relationships. So to go back to why talk about all this stuff, precisely the point is if you recognize that there's nothing intrinsically wrong with us, but that many of our dysfunctions, mental health conditions, challenges are the outcomes of traumas, that's not victimization or passing of responsibility. That is the seizing of responsibility. 'Cause when I understand what happened, now it's my responsibility and my liberty to find the healing. So to me, it's an entirely positive message.

    11. RCDr. Rangan Chatterjee1:25:30

        Yeah.

    12. GMDr. Gabor Maté1:25:30

        And, you know, across all mental health conditions, if we understand the wounding that's at the heart of them, we can heal that wou-Sometimes we will require medications to get us through a difficult time. That's all right, but the medications don't heal anything.

    13. RCDr. Rangan Chatterjee1:25:49

        Yeah.

    14. GMDr. Gabor Maté1:25:49

        The healing has to en- involve getting help, looking at yourself, and understanding the wounding, and to realize that you're not that wound-

    15. RCDr. Rangan Chatterjee1:26:01

        Yeah

    16. GMDr. Gabor Maté1:26:02

        ... and that wound can be healed at any time. That's my message.

    17. RCDr. Rangan Chatterjee1:26:06

        Thank you, Gabor. I think it's so powerful when someone as respected as yourself in this field shares things like that. I think it's great when people like Prince Harry share that you can get traumatized anywhere, and this, it really speaks to honesty, helping people understand because without the honesty and the self-awareness, you're never going to change. We're unconscious until we're not. Says, Maya Angelou says, "Once you know better, you do better."

    18. GMDr. Gabor Maté1:26:35

        In response to what you just said about, uh, we're, until we're not conscious, remember Pinocchio? Pinocchio is this puppet who wants to become a real boy, and as long as trauma- traumatic dynamics run our lives, we really are like puppets on a string. We're being pulled by unconscious forces, and to recognize the trauma and to heal it is to liberate ourselves from those strings. You know what Pinocchio says at the, uh, at the end of the book when he becomes a real boy? He says, "I was so foolish when I was a puppet."

    19. RCDr. Rangan Chatterjee1:27:09

        [laughs]

    20. GMDr. Gabor Maté1:27:10

        Well, we're all so foolish when we're puppets, and none of us have to be.

15. 1:27:16 – 1:40:35

    Practical paths to healing: therapy, nature, mindfulness, service, spirituality, and psychedelics

    1. RCDr. Rangan Chatterjee1:27:16

       Gabor, it's great that we can raise awareness of these issues, but what can people actually do to start healing themselves?

    2. GMDr. Gabor Maté1:27:27

       Yeah, so this question very much came up in my conversation with Prince Harry and, uh, reading his book but also, you know, doing my own work and, and, um, observing. Uh, there's certain principles or practices, and s- some of them show up in, in his book. So therapy. So in other words, just asking for help, talking to somebody when that's available to you, you know? Absolutely essential. Just when I needed help recently, I reached out for help. Asking for help, a peer counselor, a professional, but somebody. Don't be alone with it, in other words. Share it. Talk about it. That's the first principle. Harry, in his own book, writes very beautifully about his experience with nature. Nature was very healing for him. Being outdoors in the Arctic or, or, or actually the Antarctic or, or, or, or in Africa. My boys and I just came back from this week-long hiking trip in Utah. Incredible mountains and rocks and, oh, sunsets and sunrises. Nature is harmonizing. In our society, we're so alienated from nature. We have to get back into nature to heal. Um, Harry talked about meditation being very important for him. Now, that's not easy for an ADD brain to do, but or for any brain to do. But, you know, recently I've been rededicating myself to awareness, so when I eat now... I, I was just reading a book by the Buddhist teacher, Buddhist teacher Thich Nhat Hanh who died over a year ago now. Wonderful teacher of mindfulness. Eating mindfully, walking mindfully, being aware, really powerfully important for healing. Doesn't cost a penny. Um, relationships. In my own healing, my marriage relationship has been such a reality check. I know that's true for Harry as well. We talked about that a bit. He talks about it in his book. I know it's true for your marriage 'cause you've talked a bit about-

    3. RCDr. Rangan Chatterjee1:29:35

       Yeah

    4. GMDr. Gabor Maté1:29:35

       ... you know, your relationship with your wife, and she's the one that provides the reality principle, you know, brings you back to yourself and grounds you-

    5. RCDr. Rangan Chatterjee1:29:41

       Yeah

    6. GMDr. Gabor Maté1:29:41

       ... and calls you on your stuff. So I think relationship is really important for healing. Um, Harry mentioned service to other people. In other words, living a life that isn't just for you, isn't a life that isn't all about what can I acquire, attain, and achieve and possess, but how do I give to others? People find that incredibly healing as well. F- Spirituality, whatever that means for you, um, but the sense that we're part of something larger than just the individual isolated ego, that we are connected, that we belong, that we are part of a unity, that's incredibly healing, and I know Harry's had some of those experiences of recognition of unity and connection. Now, spirituality means different things to different people. We each have to, each have... Nobody can prescribe it to anybody else, but in the indigenous medicine wheel in North America, they talk about the four quadrants of health, health, which is, uh, mental, physical, social, and spiritual. So that's spirituality, and, and you come from a country where there's a lot of spiritual tradition and practice and, and, and wisdom. So that's an important part, whatever form that takes for you. And then Harry and I talked about psychedelics as well. Uh, we've both had experiences with it. Uh, he told me, uh, how did he put it? Um, he said that, um, I have this written down 'cause I wanna ex- remember his exact words, but he said that, um, "The psychedelics didn't simply allow me to escape reality for a while. They helped me redefine reality." And he got to see that there's m- more to him than just in the individual isolated self. So for him, as in my own life and my own clinical work as well, and again, there was a lot of negative commentary about this in the British press who didn't know what the heck they were talking about-Psychedelics are not a panacea. They're not for everybody. Um, they're not without their risks. But believe me, I've seen so many people undergo such profound healing with the help of psychedelic substances, whether it's natural plants like ayahuasca or mushrooms, or whether it's human-made substances like MDMA. I've seen incredible healing f- for mental health conditions because the psychedelics remove a kind of membrane between the conscious and the unconscious mind, and they help you see what's underneath it.

    7. RCDr. Rangan Chatterjee1:32:21

       Yeah.

    8. GMDr. Gabor Maté1:32:21

       So in the right context, they can be very helpful as well. So these are some of the modalities of healing. Now, in terms of therapy, there's all kinds. There's internal family systems, the Dick Schwartz that I think you know very well.

    9. RCDr. Rangan Chatterjee1:32:34

       Yeah.

    10. GMDr. Gabor Maté1:32:35

        There's compassionate inquiry, which is what I teach. There's, uh, sensory motor, uh, psychotherapy of Pat Ogden. Uh, there is Bessel van der Kolk's amazing work, Peter Levine's Somatic Experiencing. There's EMDR. There are many modalities, none of which are taught in the average medical school, and yet all of which go way beyond the narrow view of mental illness, and they all affect, or they all address the fundamental traumatic, uh, conditions that give rise to mental illness, so... or what we call mental illness. So lots of healing modalities out there. Some of them freely available to us, some of them we have to seek out, but nobody needs to be stuck. Nobody needs to be stuck.

    11. RCDr. Rangan Chatterjee1:33:22

        Yeah, Gabor, thank you for sharing that. Throughout this conversation, we've both been very mindful to talk about privilege and opportunity, and of course, someone like Prince Harry would no doubt have had the resources and access to some of the best therapists out there. Now, of course, you mentioned statistics from people, um, in more deprived communities than, let's say, Prince Harry, certainly from a physical and materialistic, uh, viewpoint. For someone, because these conversations go all over the world, right? So there'll be somebody listening or watching to this right now who has resonated with a lot of this content and who is thinking, "You know what? Yeah, that's me. I'm being driven by patterns from my past. Trauma is driving so much of what I'm doing. I've just had a realization, but I've got no money. I can't access a therapist," or whatever it might be. To that person, what would you say to them?

    12. GMDr. Gabor Maté1:34:29

        Well, first of all, yes, that's a real dilemma, and, uh, I wish I had an easy answer for it. I do wish that healthcare providers, systems like the National Health Service in, uh, in Britain or the Canadian system, understood the importance of psychological healing and did provide resources for it. Now, in fact, they're depriving resources rather than increasing them, but I do wish that systems understood that people need these kind of services, number one. But that's a hope. It's not a reality. Um, I would say, look, yeah, but it's true, but there's lots of content online that is free. This conversation-

    13. RCDr. Rangan Chatterjee1:35:18

        Yeah

    14. GMDr. Gabor Maté1:35:18

        ... is online. It's gonna be free. I'm sure, R- Rangan, that you've had people approach you or write to you saying that this podcast really tran- changed my life. I don't mean this podcast with me. I mean some of your other podcasts, including perhaps some of them with me. So you can gain a lot of insight and self-awareness by a lot of free content that's on the internet.

    15. RCDr. Rangan Chatterjee1:35:39

        Yeah.

    16. GMDr. Gabor Maté1:35:39

        There's the books that you've written, there are the books that I've written, that many other wonderful colleagues have written. They're available in libraries, published in many languages. People can read them. People can self-reflect. People can find peer counseling. People can fi- join groups online or in person to find support. People can walk out in nature. They can meditate. They can... Lots of free meditation instruction on the internet or available in, available in wonderful books, including by the aforementioned Thich Nhat Hanh. Um, there's journaling. There's expressing your emotions through art if you have the talent or the interest. So there's a lot of things that people can do. You don't need to be... And talk to your friends. If you have good friends that can listen to you, just ask them to listen.

    17. RCDr. Rangan Chatterjee1:36:33

        Yeah.

    18. GMDr. Gabor Maté1:36:33

        Not to give you advice, not to correct you or direct you, but, "Would you just listen to me and hear me?" Go back to the horse who said when he was asked, "What's the most courageous things you've ever said?" And he said, "Help."

    19. RCDr. Rangan Chatterjee1:36:49

        Yeah. And for all the, um, the toxicity in the modern world, the culture, society, many of the things that you've written about, we've spoken about, well, let's look at some of the benefits. As you say, information has never been more freely available. Yes, you're absolutely right. One of the drives for me to do this podcast is to help people. To- I understand that not everyone can get access to the best care. Even if you can get an appointment, maybe you don't have the funds to have enough. Even if you get to go see the doctor, maybe you only get 10 minutes with them, which is clearly inadequate [laughs] to get to the bottom of these. And so the reason I do long-form podcasting, not short 30, 40-minute conversations, is because it's through hearing these experiences in a, in a way that's not about us, but through hearing other people's stories, we connect. We connect in a way where the spotlight's not on us. If it's on us, sometimes it can be too intimidating. But in someone else-Oh, wow, I, I recognize that in myself. Even that awareness I think is healing. Many people say to me, Gabor, "Oh, I've got the awareness. Now what?" I'm like, "Hold on a minute. Don't underestimate the power of awareness. Before you were aware you weren't." That is more than 50% of the journey, simply knowing that there's work to do. So I just wanna echo what you said. Yes, it would be great if everyone had the resources to have access to therapy, a good therapist having said that. But at the same time, if you don't, please try and take on that empowering mindset that says, "I can do something about this. I can start somewhere."

    20. GMDr. Gabor Maté1:38:34

        Absolutely. And, um, I just finish with this anecdote from my own life. Uh, when I was working with this highly addicted population in Vancouver's Downtown Eastside, who were heavily dependent on drugs of all kinds, and they had very difficult lives, all had suffered severe trauma. Um, but I had my own addictive behaviors, not with drugs, but with shopping and work. And sometimes I would tell my clients, you know, I behave addictively and, and I lie, and I cheat, and I hide, and, and I'm ashamed of it. And now of course I wasn't comparing myself. Their lives were infinitely difficult. Mine was privileged, you know? But there were certain dynamics that I shared with them, and they said to me, "Hey, Doc, you're just like the rest of us, aren't you?" And here's the point. We are all just like the rest of us. Whether we wanna recognize it or not, we're all on the same boat. And if the question is, do we see that or do we not see it? But as human beings, people, we're all on the same boat.

    21. RCDr. Rangan Chatterjee1:39:48

        Gabor, I think your work's been incredible. The book, The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture, is just fantastic. And it's so good to see you looking refreshed and rejuvenated from your two or three days with your kids. I'm sure that was wonderful, and, uh, I look forward to the next conversation we have together, hopefully in person when you're in the UK later on in the year.

    22. GMDr. Gabor Maté1:40:13

        Thank you for speaking with me again. Such a pleasure. [upbeat music]

    23. RCDr. Rangan Chatterjee1:40:15

        If you enjoyed watching, check out this fantastic conversation on how you can find your purpose and live your best life.

    24. SPSpeaker1:40:22

        We have 60 to 80,000 thoughts per day. You can't control 60 to 80,000 thoughts per day, but you can control the first thought of the day and the last thought of the day

Episode duration: 1:40:36