Feel Better, Live More with Dr Rangan Chatterjee - #169 Dr Gabor Maté on Why We Are All Addicts

Episode Date: March 30, 2021

CAUTION ADVISED: This podcast contains themes of an adult nature. This week, I’ve decided to re-release a conversation that I had over 2 years ago, yet one that still remains one of the most important conversations that I’ve had to date on this podcast. Since I first released this conversation back on episode 37 of the podcast, the number of listeners has grown exponentially and I’m really keen that all of my new listeners hear this conversation. For those of you who have already heard the conversation, I think you will still get a huge amount of value from re-listening. Dr Gabor Maté is one of the world’s most revered thinkers on the psychology of addiction, his radical findings based on decades of work with patients, challenged by catastrophic drug addiction and mental illness are reframing how we view all human development. Dr Maté firmly believes that addiction is not a choice, neither is it all about drugs and illicit substances. Instead, he believes that addiction affects most of us – whether it be to alcohol, nicotine, sugar, work, or exercise…the list is endless. According to Dr. Maté, the source of addiction is not to be found in our genes but in our early childhood. He calls for a compassionate approach toward addiction, whether in ourselves or others. As he puts it, the question we need to ask is not why the addiction, but why the pain. We also talk about how we now live in a culture that doesn’t meet our human needs. Indeed, the conditions necessary for healthy child development are increasingly under threat in today’s society. We delve into how our emotional stress can translate into physical chronic illnesses. Loneliness and a lack of meaningful connection are on the rise, as are the rates of autoimmune disease and addiction. It was a real honour to sit down and talk eye-to-eye with Gabor about his truly revolutionary work. This was a deep and powerful conversation and I hope it helps you in your life. Show notes available at https://drchatterjee.com/169 Follow me on instagram.com/drchatterjee/ Follow me on facebook.com/DrChatterjee/ Follow me on twitter.com/drchatterjeeuk DISCLAIMER: The content in the podcast and on this webpage is not intended to constitute or be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or other qualified health care provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website.

You might liken modern society to a zoo, where you take an animal from a natural habitat and you put them in a completely artificial, restricted situation and you expect him to stay as normal as he was out there in the wild. So we live in a society that actually generates addiction in many of its members. When I speak to a room of people and I ask them how many are addicted, some people put their hand up. Then I give them my broader definition of addiction and everybody puts their hand up. Hi, my name is Rangan Chatterjee.

Welcome to Feel Better Live More. Hello, how are you doing? I hope life is good wherever you are in the world right now. This week on the show, I'm doing something a little bit different. I've decided to re-release a conversation that I first had about two and a half years ago. And I think it is still one of the most important conversations that I've had to date on my show. I first released it back on episode 37 in November 2018, and the podcast is now on episode 169. You see, since I first released this conversation, the amount of people listening to the show has grown exponentially. And I'm really keen that

all of my new listeners over the past two years have the opportunity to listen to this conversation. Of course, if you did hear it first time round, I still think you will get a huge amount of value from re-listening. My guest is the one and only Dr. Gabor Mate. Now, Dr. Mate is one of the world's most revered thinkers on the psychology of addiction, and his radical findings are based on decades of work with patients who've been challenged by catastrophic drug addiction and mental illness. Now, Dr. Mate firmly believes that addiction is not a choice. Neither is it all about drugs and illicit substances. Instead, he believes that addiction affects most of us, whether it be to alcohol, nicotine, sugar, work, exercise, gambling,

pornography. The list is endless. And according to Dr. Maté, the source of addiction is not to be found in our genes, but in our early childhood. Dr. Mate calls for a compassionate approach towards addiction, whether in ourselves or others. And as he puts it, the question that we need to ask is not why the addiction, but why the pain? We cover so many different themes in this conversation, including how modern society and culture is not at all set up to meet our basic human needs, and how the conditions necessary for healthy child development are increasingly under threat. We also talk about the strong link between emotional stress and physical chronic illness. It really was an honour to sit down and talk face-to-face

with this wonderful human being. This was a powerful conversation and I truly hope it helps you in your life. And now my conversation with the wonderful Dr Gabor Mate. The whole legal system is based on the assumption that people are making the choice to indulge in addictions and therefore the decisions they make that flow from that are conscious and deliberate.

And therefore, of course, what they need to do is to be punished for making such a choice. It's basically the same attitude that a lot of people take towards child-rearing. When a child does something we don't like, we punish them. This is our idea of child-rearing. Well, with adults, the punishment is called jail or legal sanctions. The assumption is totally false. There's no scientific basis to it. And having worked with addicts really seriously caught people who've been entrapped in the cycle and and and shoals of addiction

with all the consequences like HIV homelessness loss of health wealth teeth beauty personal relationships and never saw any instance of anybody having chosen to become that way. And having had my own addictive behaviors, I can also tell you, I never woke up one morning and said, my ambition is to become an addict. So it's an entirely shallow behaviorist view of human beings. And what we need to do is to look at the deeper reasons if what something appears to be a choice it's an unconscious one and we still have to look at

what is it that would drive a person in that direction conscious choice has nothing to do with it which means to say that the legal system has no logical basis to stand on. Yeah. Yeah, it's amazing how we have decided as a society that some addictions are criminal, but some are okay. And I've heard you talk about that many times in the past. I think that makes me think of a line in your book, In the Realm of Hungry Ghosts. And in the introduction, you say all drugs and all behaviors of addiction substance dependent or not whether gambling sex the internet or cocaine all of them either soothe pain directly or distracts from it hence your mantra the first question is not why the addiction but why the pain? And I think that beautifully sums it up. In that, you're likening addiction to drugs,

potentially to sex, gambling, alcohol, maybe shopping. So I've had my own shopping addiction, and I can tell you that what happens in my brain when I'm indulged in my shopping addiction is exactly the same that happens in the brain of the cocaine addict. In other words, there's an excitation of the reward, incentive, and motivation circuitry. And what the addict is after is that temporary change in brain status. Really what it is, all addictions are an attempt to regulate an unbearable emotional state internally. But you're trying to regulate your internal state through external means.

And that's what an addiction is. So temporarily, you get a change in the state of your brain, in the change of your physiology. You can do that through drugs. You can also do it through gambling or internet or sex or shopping. But essentially after that same revitalization of your incentive and motivation circuitry of your brain. So from my perspective, there's only one universal addiction process that dominates all addicted people. The targets of addiction may be different. The internal effects are much the same. Yeah.

And I'm sorry, I should add, when you look at the sources of it, the states that people are trying to escape are states of emotional distress, states of emotional pain, and hence, why the addiction? Not why the addiction, but why the pain? So some people who are listening to this or watching this right now might be thinking,

yeah, I get that that that all sounds fine for those people who are addicted but I of course I'm not addicted to anything so you've got a rather beautiful definition I think of addiction which I think will be really helpful to sort of go through at the start here so that people listening can actually figure out if it does relate to them or not? Well, when I speak to a room of people and I ask them how many are addicted, most people will only think of drugs, so some people put their hand up. Then I give them my broader definition of addiction, and not everybody puts their hand up. And that definition is that an addiction is manifested in any behavior

that a person finds temporary pleasure or relief in and therefore craves but suffers negative consequences in the long term and is going to be able to give it up. So any behavior, not just drugs. The key hallmarks are craving, pleasure, relief in the short term, negative outcomes in the long term, in the short term, negative outcomes in the long term, inability to give it up. That's what an addiction is. And that could be to drugs, nicotine, caffeine, alcohol, the lethal and legal substances.

Or it could be to heroin, cocaine, crystal meth, fentanyl, cannabis, any number of other substances. But it could also be to sex, to gambling, to shopping, to eating, to work, to exercise, to the internet, to gaming, to pornography, to political power, to the acquisition of wealth, to the hoarding of objects, anything. And when you give that definition and you ask people how many here would acknowledge some addiction in their lives, sometimes the vast majority of people would put their hands up, which means to say

that addictions are on a continuum, it's on a spectrum, and they're distributed, dispersed throughout all of our society, and so that the identified drug addicts make up only a small narrow segment of our addicted population. So really the whole way we think about addiction, the way we criminalize various forms of addiction really needs to change to a much more compassionate way of dealing with it, but also really trying to understand what's the root cause. Because I totally subscribe to your theories. And I think that ultimately, theories. And I think that ultimately, if the root cause of all addiction or all addictive behavior is the same, how do we tackle that? And where does that come from? What is that root cause?

So once you're asking not why the addiction, but why the pain, now you have to forget that it's a choice because nobody chooses to be in pain. And you also have to forget the medical idea that it's an inherited brain disease. You actually have to look at people's lives. Now, in Vancouver's downtown east side in Canada, where I worked for 12 years, with a highly addicted population, these people had multiple addictions, cocaine, alcohol, cannabis, opiates of all kinds, cigarettes in every case. They suffered with HIV, with hepatitis C. They would die of overdoses, suicide, infections of all kinds.

And these people, every single one of them had been heavily traumatized in childhood. All the women I worked with over 12 years had been sexually abused. All the men had been neglected or beaten or emotionally abused. I'm talking about not a severely addicted population, which is also what the large-scale study shows, that the greater the childhood adversity, the greater the risk for addiction in adulthood. Now, the more severe the childhood adversity, the greater the risk of substance addiction and injection use. However, if you look at my own case,

I wasn't beaten, I wasn't abused in my family of origin, wasn't neglected, but I was a Jewish infant born during the war in Hungary, and spent my first year under the Nazi regime, you can imagine under what circumstances. So I had a very unhappy, stressed, terrorized mother. And children can be hurt in two ways. Children can be hurt when bad things happen to them that shouldn't happen.

That's the abuse, that's the violence in the family, that's the parental addiction. But children can also be hurt when their needs are not met. Now, I had this need for an attuned, empathetic, emotionally responsive mother. She couldn't be that. Not because she didn't love me, not because she didn't do her best, but simply she was too terrorized, she was too depressed. but simply she was too terrorized, she was too depressed. The lack of that joyful, attuned, loving mother who, I shouldn't say loving because she loved me tremendously, but her love couldn't be translated into responsive behavior.

That alone was enough to hurt me. So in other words, the source of addiction is always some kind of a childhood hurt, either because bad things happen that shouldn't have, or because the good things that should have happened couldn't happen because of the parent's emotional states. Both of these are enough to hurt the child in a way to driving them to self-soothe through addictions. So do you think your own experience of trauma, really, as a young baby, not even a child, as a young baby, has impacted your own health, your own behaviors, and therefore ultimately where you are today, which is one of the world's leading voices on trauma and addiction. Do you think that has been instrumental in you getting to where you are today?

Having to deal with the impacts of that has been instrumental. I mean, I really, as an adult, I was a successful physician. You know, I was much in demand, a family practitioner. I was head of a palliative care department at a major hospital. I was a national medical columnist for a Canadian newspaper in my 50s. And internally, I was driven, workaholic, depressed, affected by ADHD, anxious and unfulfilled and unsatisfied. And it's when looking at those dynamics and wondering,

well, what the heck has happened to me here? And what is the gap between my external persona and my internal experience of myself? That's when I began to deal with trauma. Not to mention, as a family physician, and you and I were talking about this before, we get to see patients before they get sick. The specialists only see them after the illness has been diagnosed. I get to see people before they get ill. I get to see people in their context of their multi-generational family background. So we have a much broader view of who gets sick and why.

And so both through my medical work and having to deal with my own stuff, I began to realize the central role of trauma in shaping people's health or illness. Since I've been studying trauma myself, both with the work that you do, but just other things that I'm reading around it, it really helps me understand my patients. And their behavior is much better. You can start to tap in now

as to what they're coming in with more. You think, oh, that's what's going on behind that. Not the symptom they're describing, but why are they making those choices? And a few years ago, I did a series of documentaries on BBC One called Doctor in the House. And what I would do on that is I went to live alongside families who had health problems. They were already under GPs, they were already under specialists, they were all taking medication pretty much already, and they still weren't getting better and they were all taking medication pretty much already and they still weren't getting better

and they were still struggling so i went in to sometimes i'd stay the night in their houses i'd live alongside them really get to understand you know what choices they were making with their lifestyle sure but also i'd get to see you know various dynamics in the family the sort of thing that would never come up in the consultation room. Even if you ask that question, they would never even think to bring those things up. You would just start to spot things and little dynamics. I found that with every single family pretty much now, if I reflect back on all those families I stayed alongside, I was very fortunate to get really good health outcomes with them all after about six weeks. But there was a huge emotional component behind a lot of the illness. Now, just to be clear,

I'm not saying that it was in their head at all. They had proper physical symptoms that they were struggling with. And obviously that in some ways can make people feel down a little bit about themselves because they're not feeling so good. But I really got the strong sense that when you start to look at their lives and their upbringing and how they saw themselves, it was just it was uncanny how many times their emotional health was absolutely tied into their physical health. Well, so one of the books I've written, which will be published and written in a few months, is entitled When the Body Says No, The Cost of Hidden Stress. And I'm making the case, precisely as I heard you articulate just now, is that when it comes to chronic illness, and whether it's colitis or Crohn's disease, multiple sclerosis, ALS, or motor neuron disease in England, malignancy, chronic psoriasis, eczema, chronic fatigue syndrome, the physiological symptoms, which are not in people's heads in the sense that

they're imagining them, but it very much originates in people's heads in that it has a lot to do with certain relational and emotional patterns that they adopted in childhood. In other words, what I'm saying is that because of childhood programming, people impose certain unconscious stresses on themselves, and those stresses, because of the unity of mind and body, which unfortunately is not taught or recognized in the medical schools, but which scientifically is not even vaguely controversial, because the immune system and the emotional apparatus and the hormonal apparatus and the nervous system are part and parcel of the same system. So when something occurs emotionally, which it does on a chronic basis, that has an impact of undermining people's physiology, turning their immune system against

themselves or suppressing the immune system. So I absolutely agree that people's emotional patterns, which reflect not individual choices or mistakes, but multi-generational patterns in the family those emotional patterns translate into physical illness and and and and if we can address those emotional dynamics we can actually have an impact on the physiological course of their illness which is again not something that anybody in medical school will ever tell you because there's this unfortunate separation of mind and body that you and i are trained in yeah absolutely and i think the key one of the key things there for me was that you're not putting blame on people there's no blame yeah and i think that's really really a key point to maybe we can discuss now

because a lot of people may be hearing that feeling, you know, maybe I've done this to myself or my mother did this to me, for example. And that's not what you're saying at all, is it? Well, this is an interesting conversation. I make the distinction between blame and responsibility. Blame says that you did something that you could have done otherwise and so therefore you're at fault. That's what blame says. Responsibility says, yes, you did this to yourself, but not consciously or deliberately.

You did it because you're programmed to do it by your own childhood experience, which in turn was programmed by your parents' childhood experience. So there's nobody at fault. Everybody does their best. What we do pass these unconscious patterns on. And you don't blame people for having unconscious patterns.

You try to make them conscious of it so they can take responsibility for it. So there's no responsibility without consciousness. And there's no blame. So I don't blame anybody for their illness. I don't blame their parents either. But I do say these unconscious patterns have been passed on and these unconscious emotional dynamics have an impact on your physiology.

That's all. And if you want to have an impact on your physiology, you've got to get conscious. You have to realize what have you been doing unconsciously so you can stop doing it or do it differently. So it's a matter of liberating people from these ingrained patterns for which they're not to be blamed. So in my world, there's no room for blame whatsoever, but there's room for helping people become responsible, for helping people being response-able, being able to respond to their circumstances. And without awareness, none of us are response-able.

Yeah, I think, if I think to my own life and my own health journey over the last few years and i guess what's really changed for me over the last few years you know i've done a lot with my lifestyle i've done a lot with my nutrition my sleep and those things have been great and they've really helped me but over the last years i've really been focused on my emotional health. I see a therapist pretty regularly and I can always feel when I've got something new, some deeper layer that's starting to come out. I have a session or I go through some sort of therapy and I feel good. I feel, oh yeah, I've got it now. I get it.

I get it why I do this. And it changes your behaviour certainly, but it's almost as if as you do that, there's multiple layers. It's like peeling back a layer of the, you know, it's peeling back layers of the onion and newer things keep coming out, which has been really rewarding for me because, you know, you talk about addiction and I think back to my own life and various things that I've done at certain points, you know, I don't think anyone who knows me well, maybe my close friends, but most people probably wouldn't think that I've done at certain points, I don't think anyone who knows me well, maybe my close friends, but most people probably wouldn't think

that I've ever had an addiction because we have all these connotations about addiction. It's like being on a street corner or being a drug addict or something. But everyone around me would know that I've got an addicted personality. And I used to think that that was my personality. That's the way I was born.

What's weird, that as I start to process my own emotional baggage and I start to clear it, I'm no longer as an addictive person as I used to be. And that's why I really, I kind of feel, I feel so strongly about the work that you're doing because I kind of feel that that wasn't my personality. That was the behavior I had chosen to soothe something that I was missing. So how would I would put it? I mean, I agree with your concept. I would use a different language around it. That was your personality, but it wasn't your person. It wasn't who you were.

That was your personality, but it wasn't your person. It wasn't who you were. The personality itself is a defensive structure that we develop as a way of dealing with our pain. So much of what we consider to be our personality is actually an overlay upon our two selves. choices in childhood, for example, with my ADD, the tuning out. I never chose to tune out, but when I was an infant under the conditions that I've described of being a Jewish infant under the Nazis, I had plenty of stress on me. And how does an infant deal with stress that they can't change? They tune out. And then the tuning out becomes programmed into my brain. And then so many years later, I'm diagnosed with ADD. It wasn't a choice that I made, it was an adaptation. So what I would say about the personality, including what you described as your addictive personality, it wasn't you, it was an adaptation that you took on as a way of surviving your

childhood, as a way of soothing your pain. It's when we get older that we realize that there's something more to us than a personality, that the personality is actually a defensive cover for who we truly are. And as we start, like as you describe your own process, you go through therapy and you go through layers, and then you realize, oh, that's not actually me. And I'm freer without it.

Then you realize that what we thought was the personality was actually just a defensive cover. And once we strip that defense off and we find it no longer necessary, we become much more true to ourselves so we become much more balanced and happier in our lives. So, yes, it was the personality personality but you are not your personality that's that's how i would formulate it yeah no i love the way you put that actually it really really helps me think about it in a slightly

different way um i think something came into my mind there which is you know and we were chatting a little bit about this before we got on air, um, about medicine and how, how reductionist it has become the practice of medicine. And I think like something like high blood pressure, for example, I think of as an appropriate response from the body to the signals that it's been given. Absolutely. And I think there's an analogy there with what you're saying, which is, if you're surrounded by stress as a young baby, whatever that stress is, your brain is going to adapt to that. It's an appropriate response to the signals that your brain is getting. Is that fair to say?

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That's drinkag1.com forward slash live more. That's right. So my next book is going to be entitled The Myth of Normal, Illness and Health in an Insane Culture. And when I say in culture, insane culture, I mean a culture that doesn't meet human needs so if you take a condition like high blood pressure for which what's the

medical term for high blood pressure hypertension hypertension all right and and doctors of course say our colleagues say well there's a few types of hypertension for which there's a cause like kidney disease or some kind of hormonal disorder but for most part we don't know what causes high blood pressure essential hypertension essential because essential which basically we don't know what the heck we're talking about that's what that means just take the word hypertension and slow down a bit hyper tension hyper tension hyper tension maybe there's too much tension in people's lives. And if you actually look at the rising rates of hypertension, it's got to do with social pressure and social stresses.

And I know that usually when I take care of myself, I have the blood pressure of a young person. But there's been times in my life when I've been driven by stress and I've had the blood pressure ranges in the in the risky end of the scale so so for me when my blood pressure goes up it's a real warning buddy you've got too much tension in your lives you better do something about it all we do in medicine is we hand out pills or we tell people to lose weight but we never address the sources of real tension in their lives and I'd say that most hypertension and so for, for example, if you look at black American males, they have a much higher risk of hypertension than, say, white American males. What we say is genetic. No, it isn't.

Their biological relatives in Africa do not have high blood pressure. So it's an artifact of being a black male in essentially a racist society and uh james baldwin the american writer once said that being a black american male is to live in a condition of suppressed rage all the time yeah well that suppressed rage will drive your blood pressure so hypertension drive other ill health yeah yeah so so high blood pressure is a great example of a socially induced physiological condition which is mediated through our emotions and the impact of our emotions on our autonomic nervous system and our hormones. like that before, you know, hypertension and it makes such sense when we think about it like that. You mentioned this new book you're writing, talking about how we've got, I think, is it an insane society around us? And I think of stress, you know, as I mentioned to you,

I've just spent a few months locked away writing a new book on stress called The Stress Solution. And I feel strongly that when we talk about making changes, so a lot of people, when they try and improve their health, they try and improve their lifestyle, which is a pretty reasonable start. But many people, I find, can't do that or they do it temporarily for a few weeks, a few days, a few months maybe, but then they revert back. days, a few months maybe, but then they revert back. And as a doctor, I've always been intrigued as to why do some patients keep coming back? And why do some patients with the same so-called problem get better with the same course of treatment? And I always think, well, if they keep coming back, I'm clearly not getting to the root cause of the problem. into the root cause of the problem. The more I think about your work, although people talk about you in the realm of addiction and trauma, I think your work doesn't only explain addiction and trauma, it explains all human behaviour. It has profound implications, not only for trauma, not only for pain, not only for for addiction but actually the whole of the health landscape well thank you and again in my various books

i've written about that um it just so happens that it's my addiction book that's being published right now first in england um when you get down to it it's very simple either you raise human beings whose needs are met or you raise human beings whose needs are met, or you raise human beings in a way that they don't meet their needs. When you don't meet people's needs, they have to adapt in artificial ways. Those adaptations become the sources of illness later on. There was a very interesting article in the Journal journal Pediatrics, which is the official journal of the American Academy of Pediatrics, published in January 2012. There was an article on childhood development generated by the Harvard Center on the Developing Child. So as prestigious as you get.

Human environments that, because of scarcity or stress, trouble young children, cause these children to make adaptations, which are psychological and physiological adjustments that are necessary for immediate survival and adaptation, but which may come at a long-term cost to health, behavior, and longevity. In other words, the way that young children adapt to stress early on helps them survive that early stress, but in the long term, those same adaptations become sources of pathology. So if you look at my own tuning out, so the tuning out that I did as an infant under conditions of severe psychological strain is an adaptation. It helped me as an infant survive a year where the situation was utterly impossible. But that same tuning out gets programmed into my brain, and now I'm diagnosed with a medical condition, ADHD, decades later. So what was adaptive in one circumstance becomes maladaptive later on. I'm suggesting that much of illness begins with that, that these are necessary personally adaptations, however, which then stress us later on. And so that is a real, so what's common to my work is that I look at the sources of adult

function or dysfunction in our formative experiences. And, you know, that's not controversial if you look at a gardener. I mean, if a gardener looks at their plants, they know that how they treat that young plant will have a huge impact on the adult plant. that how they treat that young plant will have a huge impact on the adult plant. Anybody who is in animal husbandry will realize that how you treat the young, whether it's a dog or a horse, will have a huge impact on the personality and behavior of that animal later on. Why don't we get the same thing in human beings?

It's the same principle. So it's essentially very simple. Yeah, it really is, isn't it? When you break it down like that, it's essentially very simple yeah it really is isn't it when you when you break it down to the yeah like that it's super simple we need to we need a society that really supports children and babies and mothers and parents at a young age absolutely and then i guess what comes to my mind is and you may know the stats on this i don't but we here in the UK, we always are talking about Scandinavia and we talk about how they are really prioritizing those early years. They give a lot of maternity leave, a lot of paternity leave. Yes, they may have high taxes, but it seems to me that the society there

has prioritized family and bringing up children. Whereas I don't think we're quite as good here, but I don't think we're as bad as the US. A really good friend of mine, he married an American girl and she, I can't remember, but maybe after she gave birth to her first child, she might have been back at work. It might have been something like four weeks

or something obscene to me, or it sounds obscene to me. Absolutely. and the child's in daycare yeah and i wonder i wonder if you could talk about that a little bit how society is set up now and then what that is doing because you mentioned your mum's clearly that's a huge trauma i mean that's hopefully the sort of trauma that most of us aren't experiencing but are there similarities in terms of what that's doing to the child? Oh, absolutely. So the United States, which to hear their politicians, is the best and most glorious country in the world.

Which itself, by the way, is interesting. Like if you met a person person if your neighbor was always telling you how great he was and how he's the best and everybody wants to be like him what would you think of him yeah you think he's got a grandiose personality disorder and he's compensating for his real sense of deficiency well that's the united states and they have a lot to compensate for and what you say about child care is absolutely true, is that they have a barbaric child care system, a barbaric maternity leave system,

where women, and often poor women on welfare, have to go back to work after a few weeks of giving birth. Now, if you look at human evolution, or look at an ape culture, the ape mothers hold their babies for months. There's no separation. The child actually develops through being held by the mother. And human societies, until very recently,

were organized around children being around the parents really all their lives, certainly through childhood and adolescence. There was just no separation. What we do in our culture, more in the States than elsewhere, really all their lives, certainly through a childhood and adolescence. There was just no separation. What we do in our culture, more in the States than elsewhere, but increasingly elsewhere as well, we separate children from their parents. In other words, we're depriving them from the natural conditions for healthy development. There was a study last year or two years ago comparing the crying of British, German,

Canadian and Danish children. Lo and behold Danish kids cried much less than these others. What was the difference? The parents were around much more and the parents were much more likely to pick up the kids whenever crying. That's what made the difference. Now that crying child is an anxious child. When the child is crying, it's not just a benign thing. The child is crying because they're stressed. When they're stressed, their brains are suffused by stress hormones, adrenaline and cortisol.

Adrenaline and cortisol interfere with your physiology, interfere with healthy brain development. So just the fact of holding a child, which was historically and prehistorically the standard, is an essential aspect of child rearing, which modern societies have denied. And as a matter of fact, I don't know what it's like in England, but in North America, we actually advise parents not to pick up their kids. When they're crying at night, we tell them not to pick them up. We sleep train the kid by not picking them up. In other words, we're denying the child's needs for connection. And what's that doing to the child, do you think?

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

um number one so it gives that would be me going into the doctor okay or in in just various assets of my life and you, the people pleaser. Always doing, you know, always, yeah, yeah, no problem. You know, the amount of times I think just on a social thing, you'd be like, oh, where do you want to go, guys? Yeah, yeah, no worries, wherever, wherever. You end up somewhere you just don't want to be in. You're in a restaurant you hate the food in.

But, hey, yeah, it's cool, guys, no problem. And it's, sorry, I don't mean to trivialize what you're saying. You're not trivializing it. What you're actually illustrating, you're telling me exactly what kind of infancy you had. Yeah. And physiologically, what does it do? The baby's crying.

And again, these stress hormones. Now, one of the things that Aboriginal peoples don't do is let their babies cry. When I say it's not that they forbid them to cry, they pick them up. They don't even put them down babies cry. When I say it's not that they forbid them to cry, they pick them up. They don't even put them down, to tell you the truth. But should they cry, they pick them up immediately. We, in our society, we actually advise people to let their babies cry. When the baby's crying, it's because they're stressed. When they're stressed, again, their brains are suffused by

stress hormones. That interferes with healthy brain development. I mean, what about this whole idea that, you know, we're quite isolated now. You know, many of us have moved away from where we grew up. We don't have friends. We don't have a family network around us. So, and often two parents are working. Yeah. So you've got this really stressful situation

where everyone's trying to do the best that they can. They're trying to, you know, make enough money to feed themselves, to house themselves. They're also trying to do the best that they can. They're trying to make enough money to feed themselves, to house themselves. They're also trying to spend enough time with their children, yet they have no support. So there's a huge amount of pressure then that goes on to the kids, but also on the parents. And I think I saw you talk last night at the Tabernacle in London. It was an amazing talk. You mentioned a little bit about hunter-gatherer societies and how for the bulk of human evolution, we have lived and raised our children a certain way. I wonder if you could expand on that. Some versions of human beings have been on

the earth for millions of years. They've been hominids for millions of years. There have been human species for hundreds of thousands of years, and our own particular species probably for about 100,000 years, Homo sapiens, which is the latest and the only current human species that's extant. For all of that prehistory, until about 9,000 years ago, virtually all human beings lived in small hunter-gatherer bands. This is a revolution. This is how we became human beings. So to think that, now, you might liken modern society to a zoo, where you take an animal from a natural habitat, and you

put them in a completely artificial, restricted restricted situation and you expect him to stay as normal as he was out there in the wild essentially that's what's happened to human beings in that in a very short space of time in a blink of an eye from the perspective of evolution we've been we've gone from the hunter-gatherer small band communal attachment-based group to a society which is alienated, disconnected, and that disconnection is accelerating at a tremendous rate throughout the world. Urbanization, it's taking people out of their villages and into the big cities where they're alone. Here in Britain, there was quite a deliberate assault on community

under the Thatcher regime with the destruction of neighborhoods and communities and so on. And that trend has continued. So what we're having is societies that are less and less natural to the actual makeup of human beings from the evolutionary perspective, which means that children are being brought up under increasingly artificial and disconnected circumstances and uh you know johan harry who's written a book recently on the on depression called lost connections is pointing exactly that's what happened in modern society so that these lost connections characterize the modern world.

And as they do, you're getting the spread of autoimmune disease into countries that never used to have it before. So we think autoimmune disease is one of these, or addictions for that matter. So if you look at the rate of addiction now in countries like China and India, it's going up exponentially precisely because of the... And it's not a question of idealizing

the old way of life. No. We can't go back. And of course, there's all kinds of benefits to progress and industrialization. Trouble is that as we progress, we forget the benefits of...

We forget what we've lost. So instead of combining progress, we're trying to hold on to what was best about some of the old ways we just throw everything out and and we think we can reinvent ourselves and as we do we're making ourselves sick yeah you're right and i think it's a really great point to bring up we're not saying we need to go back to hunter-gatherer tribes we can't yeah not only should we not we can't. There are so many great benefits of the modern world and as you say industrialization. I guess it's how do we learn from the past? How do we learn from our evolutionary heritage and what can we implement from that within

the constraints of the modern world? Certainly that's how I see it. You mentioned Johan Hari's new book and I write a huge quarter of my book on stress is about relationships and our lack of connection these days. One on one level, we're being told anyway that we're more connected than we've ever been before. And certainly in a digital sense, that may be the case. But when we talk about real human meaningful connection, what I see around me with the public, but what I also see in my practice as a doctor, is I don't think we've ever been this disconnected and lonely. We're more wired, but we're less connected, is how I would put it. Because genuine connection happens between people, not between pieces of technology. So as you and I are talking to each other, there's a

real interaction. Yeah, when you speak, I'm looking at you, I'm listening to the modulation of your voice, I may not in agreement or shake my head and disagreement, vice versa. But the communication is taking place on many different holes. That's a connection. If you're never having the same conversation online, it would be a whole different ballgame, and I'd have no idea actually who I'm talking to.

They'd just be exchanging words. So we're wired together, but we're not actually connected. We're actually disconnected in this world because people are isolated modules sending out messages via the Ethernet or the Internet. When it comes to addictions, it's the disconnection again that leaves us so alone. So we're traumatized in the first place. We then develop behaviors that soothe our pain, but which actually keeps us more isolated from other people because we're ashamed of ourselves and we hide it and we furtively seek out our addictive

pleasures. And that disconnection then furthers our sense of isolation. That isolation further our pain and that pain further drives our addiction. So we live in a society that actually generates addiction in many of its members. Yeah. It really does, doesn't it? I did a post on my social media channels, I think just yesterday, actually, about friendship. And I was saying that, look, seeing your friends in real life, so not over the internet, in real life is a necessity for human health, not a luxury. And I know myself,

I've neglected some of the friendships closest to me over the last few years because I've been busy with my career and my family. And so, you know, and you sort of see on social media what your friends are doing. So you feel less of a need to actually see them in real life. And I was really surprised with how much that post on social media resonated with people. So many people started interacting and saying, yeah, you know what, I've not seen my friends in months. Yes, I've maybe had a bit of a text conversation with them, but I'm not seeing them in real life. And this is me trying to sort of challenge everyone to say, hey, look, get a date in the diary now. Even if it's in two months time with one of your friends, email them, call them, text them, whatever.

But put a date in the diary where you're going to see your friends in real life. And it's crazy, isn't it, that we need to say these things. I mean, these things have always been there in human culture, yet we're now having to talk about them and remind us what has just been our norm for so many thousands, millions of years. And what's interesting, of course, is that on Facebook, we use the same language as we would in real life. So on Facebook, people have friends.

But these friends that we have, these are people we don't know. We have nothing necessarily in common with except maybe certain cultural ideas or interests. And so these friendships aren't genuinely

supportive relationships. They're pseudo friendships. And we actually substitute the one for the other. And then on Facebook, people like each other, which again is a substitute for genuine contact. But it's not that they like each other. They don't even know each other but but but but which are again is a substitute for genuine contact but it's not that they like each other they don't know each other you don't know somebody until you

hung out with them and and so we substitute the language of friendship and we substitute the language of connection for genuine friendship and genuine connection and then we wonder why we feel so lonely and why we feel so dissatisfied. And why we are seeking pleasure or seeking to numb that discomfort with the choices we're making, whether it is heroin, cocaine, or shopping and sugar. Yeah. Because I guess a lot of people listening to my podcast are trying to make lifestyle change. And a lot of them feel inspired to do so by what they hear. But some of them, I know, are struggling. Well, you know, I'm very interested in language. And even the phrase lifestyle change.

It's not lifestyle changes people need to make. It's life changes people need to make. You can change the style. But style is a rather superficial thing. You know, the style of clothing, you know, it's the life changes that people need. And we need to help people see the life changes that are required, not the lifestyle changes

they need to require. It's the fundamental life that's being lived that needs to change, not the external behaviors. And lifestyle largely refers to behaviors, but not necessarily a transformation within. And really to deal with addiction, it's not a question of dealing with the lifestyle, it's a question of dealing with the life. And it's a question of really owning the life, that this is my life, and I'm the one who needs to be the agent of my own life. And here are the reasons why the wound, or trauma is another word for wound, actually.

So the wounding that I received as a child has had me behave in certain ways. It's not those behaviors I need to change. I need to heal that wound. I need to change my life. And then the life behavior changes will automatically follow. You've really got me thinking about language, actually, because two terms that I use very commonly in my work, whether it's hypertension or lifestyle, you've just, you know, in seconds, reframed what those words actually mean. And I wonder where that comes from. You know, you're an immigrant to North America.

Where has this fascination with language come from? Well, I think as an immigrant, you get to see the language a bit more clearly than the people who are actually in it. And you get to see the construction of language. And by the way, in my secret life, I used to be an English teacher. So I did that before I went to medical school.

So I've always paid a lot of attention to language. And language very often unconsciously expresses realities and truths that when you pay attention to it are revealing. And so words should never, even the word addict, the word addiction actually comes from a Latin phrase for slavery. In the Roman world, when you couldn't pay a debt,

you would be assigned as a slave to somebody until you worked off the debt. So you'd be an addictus. Somebody was assigned to somebody. So that's the origin of the word. So it implies slavery. So we actually understand that addict refers or originates in the word for slavery we realize that it's not a choice because who would who would ever choose to be a slave you know so i think language is absolutely revelatory if you understand the sources and meanings of words yeah yeah very

much so okay well i want to go to um to something you did last night in your talk, which, you know, I went out for dinner with my friends afterwards. We all attended it and we were all talking about it, which was you peppered throughout the evening. feels they have some form of addiction without childhood trauma and you're happy to talk about it, please raise your hand. And, you know, at the end you actually found someone who, you know, quite confidently put their hand up and was, you know, pretty nonchalant that they had a happy childhood. And so you started inquiring into her childhood. And I remember the tone of her voice initially was very much, you said, you know, you have a happy childhood. And I remember the tone of her voice initially was very much, you said, you know, you have a happy childhood. Yes, happy childhood. Parents said, yeah, parents absolutely love me. You know, really sort of very vocal about how great her childhood was. And then it wasn't long before it became clear that actually she felt that her parents really

loved each other. And sometimes she was intruding on them. That's right. And I think it was really powerful for the whole audience of 300 to see how we all potentially tell ourselves a certain narrative, stories that we continue telling ourselves. And, you know, she obviously maybe is a fan of your work. She's come here. She's come to watch you speak, but hadn't reflected on her own experience. And I wonder, you know, what's going on there? So what's happened here is that this woman said she had this happy childhood, but within a couple of minutes. And, you know, my mantra is not by the addiction, but by the pain. And so I always say that there's pain underneath it.

And I said to the audience, it never takes more than three minutes to drill down to where the pain is. You just have to ask the right questions. And I've got to say, about a minute in, I thought, maybe this is the first one who Gabriel won't get to. I actually thought because she was so confident in her answers. Anyway, please continue. Well, that confidence itself is a giveaway. Yeah. Because it's an assumed stance to protect herself from the pain that she doesn't want to feel or she's afraid to feel.

So she said, well, maybe I felt I was intruding on my parents. And in other words, really what she felt was that she wasn't accepted and loved for who she was. And when she felt unhappy, there was nobody for her to talk to. And all you have to do is ask that person, if your own child the same thing how would you understand it and they totally get it so what's going on there she's not lying but believing that she had a happy childhood was her way of dealing with her pain because if she dropped that idea she'd have to realize that she suffered and she actually as much as her parents did their best and loved her, we're not blaming the parents, but she herself got the impression that she was alone and unsupported and unloved for who she was. But that's very painful. Yeah.

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

and I felt myself as an intrusion on my parents yeah now she can understand what her pain was but but not feeling that pain was how she survived her childhood because as a child how would she survive if she believed that she was in love for who she was life would be intolerable for her so she has to deny and suppress that so she had an appropriate response to the signals that were given to her that's exactly what you said before and that's exactly what happened with her so that that suppression of her pain and denial of it is a completely appropriate defensive response these are not mistakes that we make these are these are essential survival adaptations the problem is then we spend a whole,

because we learned how to ignore our feelings as children, now we learn to ignore them for the rest of our lives. And that then creates problems for us. So again, it's that whole idea of an early adaptation, essential adaptation, brilliant adaptation, but because it's unconscious, it stays with us and now it limits our lives. So we become imprisoned with our own adaptations. Our childhood patterns become the prison through which we live our lives. So hopefully last night for her might have been a

key step potentially in her now being able to really go out and seek real healing transformative healing uh hopefully touch wood um touch wood but i would say that the very fact that she came to the talk and the very fact that she raised her hand she was already working at it yeah because she didn't have to raise her hand yeah so if she did it meant that she already had a curiosity about it yeah so she'd already taken the first step yeah absolutely okay well in your in your book uh in the realm of hungry ghosts i think is it the second chapter where you talk about um a funeral you go to of one of your uh someone you were looking after an addict a 35 year old or overd yeah. And I will let you tell the story, but one thing it really illustrates to me is how addiction is on a spectrum,

of course, but how powerful that addictive drive is for some people. And I just wonder if you could expand on that, because that was really, really interesting. I just wonder if you could expand on that because that was really, really interesting. Before we get back to this week's episode, I just wanted to let you know that I am doing my very first national UK theatre tour. I am planning a really special evening where I share how you can break free from the habits that are holding you back and make meaningful changes in your life that truly last. It is called the Thrive Tour. Be the architect of your health and happiness. So many people tell me that health feels really complicated, but it really doesn't

need to be. In my live event, I'm going to simplify health and together we're going to learn the skill of happiness, the secrets to optimal health, how to break free from the habits that are holding you back in your life. And I'm going to teach you how to make changes that actually last. Sound good? All you have to do is go to drchatterjee.com forward slash tour. I can't wait to see you there. This episode is also brought to you by the Three Question Journal, the journal that I designed and created in partnership with Intelligent Change. Now, journaling is something that I've been recommending to my patients for years. It can help improve sleep, lead to better decision-making,

and reduce symptoms of anxiety and depression. It's also been shown to decrease emotional stress, make it easier to turn new behaviours into long-term habits and improve our relationships. There are of course many different ways to journal and as with most things it's important that you find the method that works best for you. One method that you may want to consider is the one that I outline in the three question journal. In it, you will find a really simple and structured way of answering the three most impactful questions I believe that we can all ask ourselves every morning and every evening. Answering these questions will take you less than five minutes,

but the practice of answering them regularly will be transformative. Since the journal was published in January, I have received hundreds of messages from people telling me how much it has helped them and how much more in control of their lives they now feel. Now, if you already have a journal or you don't actually want to buy a journal, that is completely fine.

I go through in detail all of the questions within the three-question journal completely free on episode 413 of this podcast. But if you are keen to check it out, all you have to do is go to drchatterjee.com forward slash journal or click on the link in your podcast app. So this woman's real name was Shannon, which I can tell now. She was 35 and she was a beautiful woman as a young woman. When I met her, she was already fading. She was in her mid-30s or early 30s when I met her. She had severe opiate addiction. And because she injected, she had blood-borne infection in one of her knees. So she had osteomyelitis, a joint infection or a bone infection in her knee bones. She needed to be hospitalized for intravenous antibiotic care,

but she could never be hospitalized long enough. She had to leave and use, and every time she left and used, she was expelled from the hospital. So her osteomyelitis was never treated. Expelled from the hospital. Expelled from the hospital because she... She wasn't engaging in treatments? Well, shepelled from the hospital. Expelled from the hospital because she... She wasn't engaging in treatments? Well, she was leaving

the hospital to use. Right. So therefore, they wouldn't treat her. Yeah, so she wouldn't... They didn't want her using her IV lines for shooting.

Sure. No. Since then, we've developed a facility where people can have intravenous antibiotics and use if they need to. But this is before the days of that particular facility.

Yeah. So out of the regular hospitals, she'd be regularly kicked out before her six or eight weeks of antibiotics treatment was completed. So by the mid thirties, and they were actually talking about amputating the knee because there's nothing more they could do. And so by the mid thirts, she was in a wheelchair, and she would quickly wheel her wheelchair down the street looking for her next hit. She left the Downtown Eastside for six months,

and she actually got clean. And then she came back, and within three days was dead of an overdose. Because what happened, of course, is that she used the same amount she used before she left the Downtown Eastside, but now she was detoxed. So she lost her tolerance.

So you would understand what I mean by that. So the same dose that she could tolerate prior to leaving the Downtown Eastside, now that she was free of drugs, the same dose killed her. And so we wrote her a funeral and there's all these friends of hers, each of them with their HIV or their hepatitis C or their chronic infections. And they're mourning

their friend. And I'm thinking how powerful the drive of the addiction is that this young woman would shed her life for the sake of that next hit. And her friends who are watching her being buried and memorialized are going to continue using despite this dire example. Yeah, they're going to continue using despite seeing that. Just seeing that wasn't enough to go, right, we're going to change our behavior now. And which is why anybody who thinks this is a choice is out of their minds. why anybody who thinks this is a choice is out of their minds. Nobody would choose to blight and endanger their lives like that. And so this is what made me thinking, well,

what is this powerful drive? I mean, it must be really deeply built in to the human brain and the human soul for people to engage in this behavior despite all this deterrence that they witness around them. And so what made that event powerful for me was the starkness of the experience of these people and the social idea that somehow this is any kind of a choice. Wow. I mean, it's incredible to hear that actually. And certainly me and maybe all the listeners on some level in their lives may know, maybe

not to the same degree as that, but may know what that drive feels like when you know you shouldn't be doing something, but you choose to do it nonetheless. Well, I know that. I mean, I've had that in my own life. And there's something in you that knows you shouldn't be doing it. It's almost recently I became aware of a form of therapy called internal family systems. Oh my God, that's what I'm doing at the moment. IFS.

Yeah, it's incredible. Dick Schwartz's stuff. Yeah, I've had two or three sessions and it's been brilliant for me so far. Amazing. Yeah, it's incredible. Dick Schwartz's stuff. Yeah, I've had two or three sessions. And it's been brilliant for me so far. Amazing. Yeah. So I met the founder of it recently, we've become good friends. And but I've learned the technique to some degree. I'm not an official practitioner of it, but I am quick to catch on. So in internal time systems, you realize there's these different parts of you. And these different parts form like a squabbling family. Some of them like each other, some of them don't like each other. So there's a part of me that can watch the other part doing its thing, knowing that he shouldn't be doing it, but feels quite helpless to intervene. So I watch myself, like for example, when I am supposed to be working, looking after clients, but instead I watch myself go to the store to engage in my shopping addiction. I'm not unaware of what's happening. There's a part of me that's watching

it, disapproving of it, wanting me not to do it. But that part is not strong enough to assert itself. The part that's driving the behavior is leading, is driving the boat. And so it's a question of becoming friendly with all these parts, finding out what is it they really want, what are they after, and the part that's driving me to do the shopping, when I should be looking after my patients, part that's driving me to do the shopping when I should be looking after my patients is a part that really is just spread from for me desperate for me to feel good for a moment

that's all I want it just wants to be happy it's not an evil part it just wants to be happy and and it's not a question of indulging it but it's a question of really getting to know it and understanding it understanding it and actually being compassionate with it and and then teaching it you know what it's okay but this guy can be happy without indulging in that behavior yeah he doesn't need to do that you may think he does but he doesn't i think compassion is um something that's coming up quite a lot isn't it as society, how do we deal with addiction no matter what it is? Instead of locking people up because we've deemed them to have an illegal addiction, we should be treating them with compassion, but we should also be treating

ourselves with compassion, I think, and not beating ourselves up over the choices we make because often, you know, they're just a protective mechanism. choices we make because often, you know, they're just a protective mechanism. Well, so you mentioned a number of times the question of the arbitrariness of which drugs we choose to illegalize. As physicians, tell me if you disagree with me but give me a thousand people who smoke heavily every day give me another thousand who drink heavily every day give me a thousand who smoke cannabis every day

and give me a thousand who shoot heroin four times a day in a dose that doesn't create an overdose at the end of 30 years in which groups are we going to see more disease and death? Amongst those four groups. Alcohol, probably.

Alcohol and the smoking, the cigarette smoking. By far, by far, these are far more lethal drugs than the heroin and the cannabis. But they're okay, aren't they? They're legal. Yeah, no, the heroin, it's true.

If you overdose, it'll kill you. But I'm talking about in doses. Yeah. Part of, many of the overdoses happen because people are having to shoot up in back alleys with who know what impurities.

What if we gave them their heroin and as they do in some clinics in the UK, at least they used to, and prescribe doses that keeps them from going into withdrawal. Yeah. But doesn't overdose them,

that group will be far healthier 30 years later. So by what arbitrary standard have we decided that it's okay for people to murder themselves with cigarettes and alcohol, but they can't use heroin legally? What logic is behind that? It has nothing to do with medicine, for sure. It has nothing to do with health. sure it has nothing to do with health

yeah and now i'm not saying we should sell heroin in the streets i'm talking about the legalization and the criminalization and the ostracization why is that drug addict more to be more reprehensible than the person who smokes cigarettes where do we get these ideas from it's the why not the the what. That's right. You know, it's, and really, I mean, we were talking about this before, before we started recording, but, you know, we're both, on one level, we are both just GPs. We're just family physicians. And it's something I talk about quite a lot is, I think we've certainly overvalued the specialist within medicine for far too long and really undervalued the role of the generalist.

And I am very proud to be an expert generalist. And one of the reasons I moved from specialism into general practice, which was a rather unusual decision for many, and certainly my father, who was an immigrant to the UK and was really shocked as to why his son would do that, qualify as a specialist and then move to generalism It was a demotion in his mind Yeah, I think he was just confused

and I understand that and I think the doctors of the future the healthcare practitioners of the future who are going to have the best outcome with their patients are the ones who are expert generalists and can see everything. I know we're running short on time, so we will hopefully continue this at another time because there's so much to talk about. But I do find it interesting that you're one of the world's leading voices on trauma and addiction, and you're a family practitioner. And a lot of what you do with your patients, you have intuitively picked up,

you do a lot of emotional work with your patients. And I'm finding the more I understand about the human body and the more I really understand what's driving my patient's behavior, I'm doing a lot of emotional work with them. And yes, yes of course referring them to an appropriate practitioner where it's needed where someone's got that expertise but that wasn't my job i didn't train to do that but i figured out as someone who's really inquisitive as to how can i get my patient better i find well i have to go there because it's really important well so I think you and I are both properly and dramatically impressed by the capacities and skills of our very specialist colleagues. Absolutely.

It's amazing what they can do. So this is without any sense of diminishing or devaluing their work. Of course. not without this is without any sense of diminishing or devaluing their work of course but they're trained in a certain ideology which is purely biologically based so they look upon the human body as a physiological entity divided into various organs and systems and that's what they deal with and what they're not taught is that human beings the mind and the body the emotions and the physiology are inseparable, scientifically inseparable, and we have the science to show the unity.

They're also not taught that human beings are social creatures, so that our very physiology is shaped by our social relationships. And our very brains develop in a social context, so that whether we talk about neurophysiology, psychology, or the physiology of the body, we're talking about influences that go well beyond our genetic and physiological endowment. They're not taught that. And therefore, when they see a person, what they see is a disease in a particular organ.

Whereas if you're a generalist, a properly trained or at least a generalist who's developed a broader view, you see that human being in context, you see it in relationship to their lives, in relationship to their environment. or for that matter rheumatoid arthritis or scleroderma or anything else is a manifestation not just of a system but of an entire life and that life is lived in a context and we have to address that if we're going to deal with the illness and unfortunately both you and I have had the experience of having to come to that conclusion through our own work and through our own internal experience of this satisfaction with how our lives are going, but nobody taught this to us. And yet this is the way that the... So the average medical student,

despite all the trauma that you and I have discussed today, particularly in relationship to addiction and all the research showing how the addicted brain develops in response to the environment and how the addiction itself is a response to the environment, the average medical student in North America, and I would argue probably in Britain, doesn't even hear the word trauma once in four years of medical school.

I mean, did you hear the word trauma when you went to school? I don't think I heard it until a few years ago, frankly. Let's learn at medical school. And it's not a word that they should hear. It's a course they should have. Every physician should be deeply trained in trauma because everything they see, virtually everything they see has got a traumatic connection to it, particularly in the mental health field. But I would say in the physical health field as well, they don't even hear the word. So essentially, when a person goes to a physician

they go to somebody with very deep but very limited knowledge who does not see the whole individual who's not trained to see the whole individual even even the fact that we say physical health and mental health as two separate things is almost a reflection of that in many ways that's right you know because they're not different are are they? And again, I heard world health is interesting because what's the origin of the world health? It's wholeness. Wholeness. So to talk about physical health is already a contradiction because you can't talk about physical wholeness.

Wholeness means everything. Yeah. Oh, I love it. I love it thinking about it like that. Look, Gabriel, for many people listening, we've gone through some quite dark stuff, hopefully illuminating for people, but potentially dark and quite demoralizing potentially for some people in terms of them thinking about their own ability as a father and what you could have potentially done better all the time, remembering that you've done the best that you can at that time. I wonder if we can finish off with a few notes of positivity for people that there is hope and there are things that we can do to help change this? Well, first of all, I don't see this as a gloomy discussion, because I think

for people to understand themselves, they need to look at all aspects of their existence. So to me, this is illuminating. And St. Paul says somewhere that once you shed light into darkness, the darkness itself becomes light. And so I just think we have to look at all these dark places, we have to shed light onto all of them so we can fully understand ourselves. To me, that's a positive. I'm always delighted to find out something about myself that maybe I haven't seen so clearly before.

I always find it liberating, and I believe people do as well. Number one. Number two, what we haven't said, though, and I think probably both you and I would agree, is that the human beings have a tremendous healing capacity. And one of the failures of modern medical training is that we put all the expertise and the hope for help into the hands of the physician. The physician is the one who's going to deliver the cure, but we don't teach people about the innate healing capacity of the human being. And we don't learn how do you promote that healing capacity.

We may have to administer whatever treatments are appropriate and whatever genius treatments we have developed. That's great. But nevertheless, that person still has an innate healing capacity. How do we engage in it? How do we evoke it? How do we encourage it? That's not a question that we ask ourselves. And yet there's many examples of people healing or doing much better with

illnesses than medical prognosis would have told them. Now look at the recent case of the recent death of Stephen Hawking, the physicist who I discussed in one of my books. Now he was given two years to live when he was 20 years old. He outlived his diagnosis by more than five decades. Something in him allowed him to do that. Something in him that the medical mind could not have fathomed at the time. So there's much more to people than we realize. And so we have a lot, we have to have a lot more faith and a lot more curiosity. What is, about what is it in people that allows them to overcome the challenge of addiction? What is it that helps them

live much longer than we had predicted? What is healing? What is it that helps them live much longer than we had predicted? What is healing? What is becoming whole really all about? These are the questions that medicine ought to engage with, but unfortunately does not. So I think your work and your podcast and your books, as I understand them, and the same thing with me are designed to help people find within themselves that which can uh empower them to support their own healing and we can't say that strongly enough yeah absolutely no thanks for that cable um for people who are listening who you know maybe maybe something you've said has really deeply struck a chord with them about their own life. And they want to go on that journey, but don't know how.

Have you got any words of advice as to how they can start, you know, even listening to this and start to be aware, of course, is a very critical first step. But, you know, where can they go next? Well, so you and I are both authors and i would highly recommend they check out their books first because i think and in my case i hope they check out my books because of course there's a lot of what i know and what i've learned that i've poured into my books and a lot of people find a lot of self-knowledge just by seeing the mirror that's held up in my writings or in my multiple YouTube talks, for example. Now, where do they go in their own lives?

I actually think that once people start asking these questions, they find the answers in their own lives. In other words, there's an old saying that when the student is ready, the teacher appears. And I think there's many modalities of healing that are practiced here in Britain or anywhere else in the world that once you start seeing the limitations without rejecting the value

but seeing at the same time the limitations of mainstream medicine start looking outside it a little bit or start finding practitioners within mainstream medicine that have a broader view in other words go where the help is and don't assume that because somebody's got a degree after their name that they know everything that needs to be known in other words become the become the agent in your own healing once people take that on generally they find help i find i can't give them a specific go to except that once you start asking the right questions the answers will start

coming yeah i love the way you put that and as i always say on this podcast i i want to empower and inspire people to become the architects of their own health exactly um and i think that's really really important particularly what you said about don't just assume because someone's got a qualification or a series of letters after their name that actually they're going to be the right ones to help you i've got to say gabriel i think your work is phenomenal i really genuinely do i think it's got huge potential to help uh i'm just gonna say thousands but really millions of people around the globe so i really would highly recommend that people buy the book and actually i think it's going to help your own life it might even help someone close to you

and gabriel where can people find you apart from your books? Is there somewhere they can follow you online? So I have a website, Dr. Gabor Mate, where all my public speaking engagements, many of my articles, YouTube lectures are available. Chapters of my books are downloadable. No cost to any of that. There's no cost to anything. Or they can just go on YouTube, put in my name, and I have many dozens of lectures that people have filmed and put on YouTube. Again, there's no cost to any of that. And I speak about addiction, child development, stress and health, the relationship between social factors and illness.

So I'm very easy to find on social media. I also have a Facebook wall, whatever that means that people, because I don't post anything, but somebody does on my behalf that people can follow. So I'm easily identifiable and discoverable online. And what I'll do is in the show notes page for this episode of the podcast, I will link to everything that Gabor and I have discussed today on the episode, and I'll link to your website and your various talks to make it really easy for people to find. So let me just say, Rangan,

that as you may have found yourself in the beginning when your mind starts opening to new possibilities, it's a bit of a lonely journey within the medical field because most of your colleagues just aren't aware they're not open to what you're talking about so it's always such a delight to run across a colleague who quite at all without knowing each other we just find ourselves still in the same soil and mining the same veins and trying to discover the same truths, which only speaks to the nature of truth and how it just asserts itself.

But it's always such a pleasure to meet somebody who's done some of the same work and is looking in the same directions because both you and I, as confident as I am in my ideas and you seem to be in yours, we still need validation. So it's really wonderful to meet somebody who really is asking the same questions. I can't say what that means to me, coming from someone like yourself. It's a huge honor for me to be here today and talk to you and I look forward to the next time. Thank you. Likewise. Thank you. Really hope you enjoyed that conversation. I think Gabor's philosophy and wisdom is so, so important for pretty much all of us. And I would dearly love to hear what you thought of

this conversation. Please do get in touch on social media and let me know. And of course, if you have a moment, please do share this episode with other people in your life who you feel would benefit. Gabor also came on my show back on episode 106. So if you enjoyed this conversation, I think you are going to love that one as well. And I've actually been in touch with him over the past few weeks. He's agreed to come back onto my show for the third time later on this year. So if you have any questions and topics that you would like me to put to him on our next conversation, please do let me know.

The best way is probably to sign up for my newsletter at drchatterjee.com forward slash subscribe. And you can reply to one of those emails with your requests. If you want to find out more about Gabor Mate, his work, and his books, just head over to the show notes page on my website. And please do remember that this conversation took place two and a half years ago. The book that I had just finished writing at that time, which came up in my conversation with Gabor, was my second book, The Stress Solution, Four Steps to a Calmer, Happier, Healthier You. So if you're interested in taking a look, you can pick it up in all the usual places all over the world, in paperback, ebook, and as an audio book, which I am narrating. And before we

finish, I just want to let you know about Friday Five. It's my brand new weekly newsletter that contains five short doses of positivity, a practical tip for your health, a book, article, or video that I found inspiring, a quote that's caused me to stop and reflect basically anything that I feel would be helpful and uplifting. I'm really glad I started the newsletter at the turn of the year because so many of you contact me every single week saying you're really enjoying it and that it's a wonderful way to finish off your week and get you ready for the weekend. So if that sounds like something that you would like to receive each Friday, you can sign up at drchatterjee.com forward slash Friday five. Thank you so much for listening to the show. Have a wonderful week and please do press

follow on whichever podcast platform you listen on. So you will get notified when my latest conversation comes out. Remember, you are the architects of your own health. Making lifestyle changes always worth it because when you feel better, you live more.