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

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 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.

3. RCDr. Rangan Chatterjee3:11

   Yeah.

4. 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.

5. RCDr. Rangan Chatterjee3:22

   Yeah.

6. GMDr. Gabor Maté3:23

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

7. 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?

8. 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.

9. RCDr. Rangan Chatterjee8:25

   Yeah.

10. 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.

11. 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-

12. GMDr. Gabor Maté9:51

    Yes

13. 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.

14. 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-

15. RCDr. Rangan Chatterjee10:50

    Yeah

16. 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.

17. RCDr. Rangan Chatterjee11:10

    Yeah.

18. 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.

19. RCDr. Rangan Chatterjee12:57

    Yeah.

20. 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.

21. 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?

22. 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.

23. RCDr. Rangan Chatterjee14:50

    Mm.

24. 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.

25. RCDr. Rangan Chatterjee16:08

    Yeah.

26. 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.

27. 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?

28. 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.

29. RCDr. Rangan Chatterjee18:56

    Yeah.

30. 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.

Episode duration: 1:40:36