Ten Percent Happier with Dan Harris - Modern Life Is Making You Sick, but It Doesn’t Have To | Dr. Gabor Maté

Episode Date: April 19, 2023

There’s so much to be grateful for in modern medicine. We can all agree that we would not do as well in a world with no Advil or dentistry. And yet, our guest today, who is a renowned doctor, says modern medicine is overlooking something crucial: the pernicious impact that modern living has on our minds and bodies. In other words, we are surrounded by these hidden societal and structural sources of stress and we aren’t thinking about how to treat and prevent these factors that are degrading our happiness and our immune systems. Dr. Gabor Maté is a bestselling author with an expertise on everything from stress to addiction to ADHD. His latest book is called, The Myth of Normal: Trauma, Illness, and Healing in a Toxic CultureContent Warning: This episode has mentions of child abuse, sexual trauma, suicide and addictionIn this episode we talk about:What he means by “the myth of normal”How diseases, such as autoimmune conditions, are an “artifact of civilization"How to begin to tackle what Dr. Maté calls, “the social sources of illness” His definition of trauma and the difference between “big T traumatic events” and the trauma of “wounding”How trauma in society is so normalized that we don’t even recognize itWhether the term trauma is overusedWhy comparing suffering is a fruitless endeavor What he means by “the necessity to be disillusioned” The power and possibility of psychedelics Why he thinks we should incorporate shamanic medicine into our western medical frameworkAnd what he means by “undoing self-limiting beliefs” and how these beliefs show up in our everyday livesFull Shownotes: https://www.tenpercent.com/podcast-episode/gabor-mate-586To join a live coaching session, sign up at tenpercent.com/coaching.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

This is the 10% Happier Podcast. I'm Dan Harris. Hey, everybody. How we doing? I am extremely grateful for modern medicine. As a frail man, I would definitely not have done well in a world with no Advil or dentistry. And yet, my guest today, who is a renowned doctor, says modern medicine is overlooking something crucial. The pernicious impact that modern living is having on our minds and bodies.

In other words, he says we're surrounded by these hidden societal and structural sources of stress, and most of us, as well as most of our doctors, aren't thinking about how to treat and prevent these factors that are degrading our happiness and our immune system. My guest today is Dr. Gabor Mate. He's a bestselling author with expertise in everything from stress to addiction to ADHD. His latest book is called The Myth of Normal, Trauma, Illness, and Healing in a Toxic Culture. In this conversation, we talked about what he means by the myth of normal, how diseases such as autoimmune conditions are, in his words, an artifact of civilization, how to

begin to tackle what Dr. Mate calls the social sources of illness, his definition of trauma and the difference between Big T traumatic events and the trauma of wounding, how trauma in society is so normalized that we often don't even recognize it. I also probe him a bit on whether the term trauma is overused. We talk about the power and possibility of psychedelics and why he thinks we should incorporate shamanic medicine into our Western medical framework and what he means by undoing self-limiting beliefs. Just to say a few things before we dive in here.

First, this is a rerun. We posted this episode several months ago and it did extremely well, so we're bringing it back. Also, there are some mentions here of child abuse, sexual trauma, suicide and addiction, so heads up on that. Dr. Gabor Mate coming right up. First though, time for a little BSP, Blatant Self-Promotion. I am doing two informal weekend retreats with my friends, Sabine Selassie and Jeff Warren.

We call them meditation parties. They're going down at the Omega Institute in Rhinebeck, New York. One is coming up in May and another in October. They're open for in-person and also virtual registration. You can find the links at danharris.com over on the events page. And by the way, if you are tired of listening to ads on this show, go over to the 10% Happier app. If you're a subscriber, to ads on this show, go over to the 10% Happier app.

If you're a subscriber, you can get these shows, all of them, all the way back to episode one, without ads and you get them a week before everybody else. Download the 10% Happier app wherever you get your apps and get started for free. Hello, I'm Emily, one of the hosts of Terribly Famous, the show that takes you inside the lives of our biggest celebrities. Some of them hit the big time overnight, some had to plug away for years, but in our latest series we're talking about a man who was world famous before he was even born. A life of extreme privilege that was mapped out from the start, but left him struggling

to find his true purpose. A man who, compared to his big brother, felt a bit, you know, spare. Yes, it's Prince Harry. You might think you know everything about him, but trust me, there's even more. We follow Harry and the obsessive, all-consuming relationship of his life, not with Meghan, but the British tabloid press. Hounded and harassed, Harry is taking on an institution almost every bit as powerful as his own royal family. Follow Terribly Famous wherever you listen to podcasts

or listen early and ad-free on Wandery Plus on Apple Podcasts or the Wandery app. I'm Afua Hirsch. I'm Peter Frankopan. And in our podcast, Legacy, we explore the lives of some of the biggest characters in history. This season, we delve into the life of Alan Turing. Why are we talking about Alan Turing, Peter?

Alan Turing is the father of computer science. And some of those questions we're thinking about today around artificial intelligence. Turing was so involved in setting and framing what some of those questions were, but he's also interesting for lots of other reasons, Afro. He had such a fascinating life. He was unapologetically gay at a time when that was completely criminalised and stigmatised. And from his imagination, he created ideas that have formed the very physical, practical foundation of all of the technology on which our lives depend. And on top of that, he's responsible for being part of a team that saved millions,

maybe even tens of millions of lives because of his work during the Second World War using maths and computer science to code break. So join us on Legacy wherever you get your podcasts. to Code Break. So join us on Legacy, wherever you get your podcasts. Dr. Gabor Mate, welcome to the show. Nice to be with you. Thank you, Dan. What do you mean by the myth of normal?

So as a physician, when I look at people's health, life is possible and health is thriving within a range of normal parameters like a normal body temperature or normal blood acidity or normal blood pressure range so in that sense what is Normal is also what healthy and natural But in society what was considered normal the things that we used to the things that we think have to be the way they are the things that we're used to, the things that we think have to be the way they are, I'm arguing is neither healthy or natural. So I'm saying that the norm in this society is actually making us sick in many ways. That's the myth of normal.

Also to say that then when people have mental or physical health conditions, we call them abnormal. I'm saying those are normal responses to an abnormal situation. I mean, I know something of your personal history, and I don't know what you suffered from when you had your anxiety attack, but as a journalist covering the wars that you've covered, a certain degree of PTSD would be actually a normal response to abnormal circumstances. So where's the abnormality in the individual or in the culture? I'm saying it's in the culture. What are the aspects of our culture that you consider

from the historical perspective, the wide perspective of our species, which runs back many millennia, what are you considering abnormal and unhealthy? Well, if you want to know what an elephant is like, if you looked at an elephant in one context, you would say the elephant is a big animal that spends most of the time sleeping, gets up every once in a while to eat, walks around a little bit and lies down again.

That's if we studied an elephant in a zoo. But if we studied the elephant in its natural habitat, we get a very different sense of what an elephant is all about and what their true nature is. Now human beings have evolved for hundreds of thousands of years. We lived in small band, hunter-gatherer groups as communal creatures, where the children were with the parents the whole day, where the whole community acted as parents to the kids,

where the interests were not individualistic and competitive, but collaborative, communal and connected. That's the only way we survived. And we lived like that until about 15,000 years ago. So our own species, which has been on the earth for say 200,000 years, if that could be expressed in one hour until five minutes ago, that's how we lived.

And then the conditions that civilization has created with increasing inequality, increasing gender disparity, increasing isolation, particularly in modern society, loneliness, the belief that human nature is competitive, aggressive, greedy, selfish. These have created conditions which for human beings, it's like studying animals in a zoo under completely artificial conditions that don't meet our essential needs. And in the book, The Myth of Normal, I began with prenatal life through birth, through childhood,

through all of our cultural manifestations. I'm saying we live in a culture that makes us sick because it sets us against our very needs as human beings. Just a couple of questions. Is it possible that we can idealize our history in what is often referred to as deep time, the hunter-gatherer societies, were they not problematic and patriarchal and violent and they didn't have good dentistry, etc., etc.?

Well, actually, if you look at the people who have researched indigenous peoples in pre-colonial times or non-colonized areas. They tend to live much healthier lives than we do. It's not a question of idealizing. You know, like indigenous people here in British Columbia, they had slaves. Now those were past hunter-gatherer days, but it's not a question of idealizing the past, but it is recognizing that they did live much closer to human needs and nature than we did. And as a result, we've lost a lot. It's not a matter of giving up on the achievements of civilization, science, technology. Those are astonishing accomplishments.

But we also have to recognize what we've lost in being disconnected from our own true nature. So we can't idealize the past, nor can we aspire to go back to it, no sure we want to. But let's get conscious about what we're missing in the way that we're living our lives. And in terms of human relationships and interactions and family life and community, they're much more adept than we are. And the way they parented their kids,

they were much healthier than the way we parent our kids. For what it's worth, and I'm not sure it's worth much, I very much agree with you on, you call it our true nature, but you could just also call it the way we were designed by nature to live in community, to have these social connections. And it seems quite obvious that much about the structure of modern society is making us sick because it's denying us

these sources of happiness and flourishing and wellbeing that we really need. And yet, as you indicated, there are so many good things about modern society from semi-jokingly referred to dentistry, but obviously modern medicine, many of the technologies that have improved people's lives and brought people out of poverty, et cetera, et cetera. No, it's not a question of arguing with modern achievements, but given the science, given the awareness, given what we know and what we're capable of, why are some people living in poverty?

Why are so many people going to food banks in North America in the richest area of the world in the history? Why is there such a documentable illness due to inequality? Why is being of color or indigenous in Canada a major health risk, not just for COVID, but also for malignancy and autoimmune disease and mental health conditions and so on. Why is the rate of suicide amongst young people rising in North America? Why did the United States last year suffer over 100,000 overdose deaths from drugs? Almost twice as many Americans died in one year last year from overdoses as died in the Vietnam,

Afghanistan, and Iraq wars altogether. And the real question is, given all the technology information and capabilities that we've garnered, why are we doing so badly? Why are more kids being medicated and diagnosed with all kinds of mental health conditions? You have answered this a little bit, but you just asked a bunch of questions starting with the word why. Can you say a little bit more about why you think we're seeing more addiction, more suicide, more illness? What is going on? Well, when you look at illness, you can look upon it as an individual, maybe genetically

determined misfortune. That's one way to look at it. But that doesn't explain anything. And why is this misfortune increasing in the modern world, despite the advances of modern medicine? Why is there more autoimmune disease now? Why in the 1930s, there was a gender ratio of multiple sclerosis that was one to one,

and now it's three and a half women for every man. It's clearly not genetic because genes don't change in a population. Why are more kids being diagnosed with ADHD? My fellow physicians basically think that it's a genetic mental health condition. I say it's not genetic at all. It has to do with social conditions.

So the question is, do we look at pathology as a misfortune in a particular organ in an isolated individual, or do we recognize that it's a response to the environment. Now if we recognize that, we have the answer. Because emotional stress is a significant physical factor. It's not just an emotional event, it's a physiological event. So that modern science has shown that mind and body cannot be separated. It's one unit. When things happen emotionally, they happen

physiologically. The emotional factors affect our immune system, our hormonal apparatus, our nervous system, our guts, our heart, and so on. So, a study out of Harvard three years ago showed that the higher the symptoms of PTSD in a woman, double the risk of ovarian cancer. In other words, emotions can't be separated. An American study showed that the more depression in a woman double the risk of ovarian cancer. In other words, emotions can't be separated. An American study showed that the more depression in a woman, the poorer her prognosis with breast cancer is. So the mind and body can't be separated. And as an American physician, George Engel, pointed out in 1977, we are biopsychosocial creatures, which means our biology is inseparable from our social relationships, our psychological

dynamics. Now we can look at the source of problems in how we live our lives in a social psychological context. And the more stressed we are, the more illness of mind and body we're going to have. You want to know why more kids are killing themselves? Why more kids have ADHD? Because conditions of parenting have become so stressed that kids are being left bereft of the emotional needs being met. And that's why they're in despair. And that's why they're tuning out. And that's why they're hyperactive.

And that's why they're oppositional. And that's why they have anxiety. So these are normal responses to abnormal circumstances. Or in my own country, Canada, if you're an indigenous woman, your risk of rheumatoid arthritis is six times greater than the average. And women in general have 80% of autoimmune disease. Why? Because they're the most stressed segments of society for all kinds of reasons.

And so then the question arises, is it a case of individual pathology or does it represent the social malaise? And I'm saying that the two cannot be separated. I know objectively privileged people who've gotten very, very sick at a young age. So it can be just a genetic thing or bad luck or whatever, but it also can be a societal thing. No, I would push back against what you just said, if I may.

I didn't say that only poor or people of color get sick. I said the risks are higher proportionately. I mentioned earlier, indigenous women in Canada had six times the rate of autoimmune disease of rheumatoid arthritis than that of anybody else. This in a population that before colonization had no rheumatoid arthritis whatsoever. But that doesn't mean that in this society,

stress doesn't spare any sector, any segment, any stratum. But I would say that those people that were privileged economically or socially speaking who got sick, they had a lot of stress in their lives, including probably childhood trauma. And stress and trauma, scientifically speaking, are documentably significant sources of physical illness because of the mind-body unity. And so you don't have to be poor or of color or oppressed to develop illness. It's just that the more you are oppressed

and the more you're stressed, the greater the risk goes up. In this society, if you look at the sources of stress, the scientific studies on stress, what drives physiological stress are loss of control, uncertainty, lack of information and conflict. And those kinds of stresses permeate all strata of this society. So everybody's at risk.

This is what I'm trying to get clear at on though, because even in the hunter gatherer societies, people got sick. And this isn't me pushing back on you, this is me just trying to understand. The illness does happen. You're just saying the odds go up if you are stressed and the odds of stress go up if you are in a marginalized community is that close to accurate there's a lot of truth to that but again if you look at

indigenous societies they didn't use to have autoimmune disease at all autoimmune disease is an artifact of civilization. I'll give you an example from South Africa during apartheid days. When black people moved into the cities from their tribal villages, they began to develop rheumatoid arthritis at much higher rates. So the more alienation, the more disconnection, and the more stress you get, certain kinds of stress, the more illness you're going to have. And now you're having autoimmune diseases in cultures that never used to have them at

all due to globalization. In China now, under the impact of industrialization, increased social isolation, the destruction of community, all in the name of economic progress, which has been pretty remarkable in China in the last 40 years or so, they've also developed mental health conditions, ADHD, addictions, and so on. So the real question for all of us is how can we maintain economic progress, which of course is very unequally distributed as we both know, and the inequalities rising over the last several decades.

But nevertheless, how can we maintain our modern achievements and at the same time also maintain our health? And that's the challenge. You articulate that well, and I want to make a hard run at that question because I know you have a lot to say about it. But before we get there, let me see if you're open to hitting another issue which you spent

a lot of time on in your new book, which is, given that so many aspects of modern life appear to be making us sick, what can we do as individuals, not on a structural level, but as individuals to reclaim, and this is the word you often use, our wholeness? Yes. So the essence of trauma is actually a disconnection from the self. Now, how to say this clearly, that's not in itself a bad thing. Take an extreme example. If I'm being abused as a child,

it's unbearable for me to be with the emotional pain and fear and terror of what's happening to me. So to disconnect from myself is a survival mechanism. But it also means that now I am separated from my emotions and from my gut feelings, which put me at risk for stress later on. So those early adaptations that are necessary, like in my case, I talk about my infancy as a Jewish infant under the Nazis, tuning out from the terrible things that were going around

me was my way of surviving. Later on, I'm diagnosed with ADHD because I have a hard time staying present because staying present was so painful for me as an infant. And that's happening when my brain is developing. So that absent-mindedness, that tuning out gets programmed into my brain because that's another piece of news that unfortunately science has established. What medical practice doesn't appreciate is that the human brain is shaped by your emotional interactions with the environment. And so the essence of trauma is that the human being is shaped by your emotional interactions with the environment. And so the essence of trauma is that disconnection from the self, which at the time served the

survival function, but later on it becomes a problem. And so you live in New York, I live in Canada, it is pretty cold in the wintertime. We adapt to that by putting on warm clothing. But what would happen to us if in the heat of the summer we're still wearing that warm clothing that we donned in the winter time? It would make us sick. So the same adaptations that in the one context helped us now will undermine our health. That's the nature of traumatic adaptations in childhood is that they're necessary for immediate survival, but then they create pathology later on. And so the individual task is to reconnect with the self that trauma disconnected from

us. That's a shorthand way of saying something that I spent many chapters on the book on, outlining the pathways to wholeness. In fact, if you look at the word health itself, the source of the word health is an Anglo-Saxon word for wholeness. And in Hungarian, which is my mother tongue, literally to say health is to say wholeness. And so, yes, health does mean coming back to ourselves. I think it's worth getting specific about definitions. When you say trauma, what do you mean?

And how universal is it? Because I've had plenty of illness in my life, not catastrophic, but I don't think by my layman understanding of trauma that I've ever experienced it. And I think there are probably a lot of people listening to this who have experienced trauma for sure and others who don't see themselves in that word. How open are you to an inquiry about your own experience right now? Always. So let me first of all talk to you about trauma and then let me ask you a few questions if

that's okay with you. Of course. Okay. So trauma, again, it has a word origin. It's the Greek word for wound or wounding. So trauma is a wound. Trauma is a psychological wound that then is stamped in the body and the nervous system in the brain and in the physiology or organs.

Now, trauma is not the bad thing that happened to you. Trauma is what happened inside you as a result of what happened to you. So I gave my own example. I was given to a total stranger at age 11 months by my mother. I didn't see my mother for five or six weeks. That saved my life. As a Jewish infant under the Nazis, I would not have survived in a place where my mother for five or six weeks. That saved my life. As a Jewish infant under the Nazis, I would not have survived in a place where my mother had to live. However, that wasn't a trauma. The trauma wasn't that she gave me to a stranger.

The trauma was the wound that I suffered in my relationship to myself. Now, what does an 11-month-old believe implicitly when they're given away to a stranger by their mother? That they're not loved, that they're not lovable. That's the trauma. So the trauma is not what happened to me, which is I was given to a stranger.

The trauma is what happened inside me, which is I developed a sense of not being worthy. Now I spent much of my life trying to prove my worthiness by becoming a workaholic doctor, for example. Now, there are two kinds of traumatic events, what I call Big T traumas, which is the documented and much studied adverse childhood experiences such as physical, sexual or emotional abuse,

parent dying, addiction in a family, violence in a family, neglect of parent being jailed. These are all imposed traumas in the child. And you can study them proportionately. The more the child experiences, the greater the risk for addiction, for mental health problems, for autoimmune disease, for malignancy, and all kinds of other issues. That's the big T traumatic events. But there's another kind of trauma, of wounding. Keep in mind that trauma means wounding.

And not because terrible things happen to children, but the good things that should have happened that didn't happen. Human children are born with certain needs. and in the book I outline what their essential needs are. I can hurt you by doing bad things to you, but I can also hurt you by denying your needs. So that's trauma. In this society, hardly anybody escapes that because of the way we view children. It's so estranged from what the human child actually needs.

With that little introduction, if I can ask you a few questions, okay? Of course, I appreciate the introduction, just to say. Okay, anybody ever hit you as a kid? I was spanked occasionally, yes. I remember once in a great while, my one parent or the other would, you know, fold me or my brother over their knee and spank us on the tush.

And our nanny would occasionally smack us on the tush with a spatula. Okay. Do you have kids? Yes. One boy, Alexander, who's eight. Okay. How old were you when you were, as you say, hit on the tush? And you say that rather dismissively, but how old were you then? I'll cop to that, by the way. I don't recall my age.

Well, give me the earliest rough estimate that you can muster. Maybe five or six. Would you hate your child when they were five? No, and I wouldn't hit them now and I can't foresee ever hitting them. Why would you not hit them? I don't think teaching kids that violence

is the right answer. No, no, but wait a minute, that's a pedagogical answer. Why would you not hate your kid? Yeah, that's true. I love him so much. And if I, when I see him in pain and give me pain, so why would I cause him pain or me pain? You perceive that it would cause your child pain if you hit him.

Yes. What does it feel like for a child to be hit by the person on whom they rely for protection and support and love? What would you say an experience if you hit him at age five? Perhaps small T trauma. No, but nevermind smaller big T. What would your son experience if you hit him at age five? Perhaps small T trauma. No, but never mind small or big T. What would they experience emotionally? Fear.

Okay. Betrayal, physical pain. Okay, so when you experience fear, betrayal and physical pain, who would you speak to about it? He would talk to your parents ideally. No, I'm asking who did you speak to about it? Oh, me? My parents. You talked to them about it?

Yes. You said I'm afraid right now. You said I'm in pain right now. Oh, while they were hitting me? Yeah. No, I can't remember that. I don't have very clear memories of being hit honestly, but I highly doubt that I would have said something to that effect to them in that moment. Had you said it, you would remember it. True.

Okay. Now, if your son, if Alexander felt pain and fear and didn't speak to you said it, you would remember it. True. Okay, now, if your son, if Alexander felt pain and fear and didn't speak to you about it, how would you explain that? That he must not trust me enough to tell me. What's it like for a five-year-old not to trust their parents? Confusing. Confusing, that's an intellectual answer.

What's it like emotionally? Confusing, scary. Okay, now, good. Thank you, Dan. Tell me again that you weren't traumatized, okay? Well, fair enough, scary. Okay, now good. Thank you, Dan. Tell me again that you weren't traumatized, okay? Well, fair enough, yeah. I think I walk around telling myself a story that is not entirely untrue.

I'm sure your parents loved you and they did their best. I'm not accusing them of anything, you know? All I'm saying is, children are wounded in ways we don't even recognize because we think they're normal. And when you look at the studies on spanking, by the way, they show that kids are just as traumatized in many ways as kids who are hit more severely.

That's what the science shows. And what I'm saying about trauma in this society, it's so normalized, we don't even recognize it. And just that question, who did you speak to? Whether you're hit or not, who did you speak to? We ever bullied as a kid, by the way or not? Who did you speak to? We have a bully does a kid by the way Yes, how did that feel like by the way? I was bullied and I bullied I got it that already tells me you were traumatized Why would you need to bully somebody because you need to feel bigger and better? Yes

Why did you feel that because you didn't feel good, right? It didn't feel strong. These are all signs of trauma I'm telling you so trauma is very common in this culture. And by the way, who did you speak to when you were bullied? Sometimes nobody, sometimes I did tell my parents. If your son was bullied and they didn't talk to you about it, how would you explain that one? Shame, fear. Right.

And the first day you were born, if you were unhappy, did you express it? Yes. So somewhere you learned that your parents weren't available for you. And that's a disconnect. Okay? And that's very painful. Look, in the book, I give a very well-known example that nobody recognizes traumatic. If I told you about a four-year-old girl who's bullied by neighborhood kids, and she was into her home to her mother for protection, and the mother says,

there's no room for cards in this house, now you get out there and deal with those bullies, how would you see that as parenting? How would you see it? Matthew F. Larson Malpractice. Dario Larrondo And what's the impact on the child? Matthew F. Larson I would imagine the child would not feel that they could trust their parent anymore as a source of comfort and adversity. And they mustn't be vulnerable, they have to suck it up. This story was told on public television in front of millions of people the night that

Hillary Clinton was nominated for the Democratic candidacy for the presidency. The story was told as a wonderful example of resilience building parenting and nobody commented that what was really being celebrated here publicly was the traumatization of a four-year-old. And the message she got was not that there's no room for cards in this house because a four-year-old kid looking for help from the mother is not a coward. You tell a mother orangutan not to come to the defense over a child or a mother elephant or a mother bear. What was being celebrated here was the traumatization of a four-year-old. The message is there's no room for you to be vulnerable. You better suck it up. And 60 years

later, when she develops pneumonia during the election campaign, remember what she did with it? She hit it. She hit it. She collapsed with dehydration and fever in the street and nobody in the United States commented. This is how normal trauma is in this culture. I'm not talking about politics here. I'm talking about our normalization of trauma. Although that has an impact on politics and not to be partisan about it, her opponent

is an even more traumatized individual when you look at his childhood. So, yeah, the American public had the choice between the two traumatized individuals to run their country. I really appreciate this discussion about trauma because the word gets used a lot in, I think, not very helpful, nonspecific ways. And the way you're clarifying it is helpful because, as I started to say earlier, I have this story, which is not entirely untrue, that I've just been extraordinarily lucky.

My parents were, I have no defense for the spanking other than that it was the culturally done thing at the time, but they were incredibly loving and supportive, and I did feel really comfortable with them. I grew up in a leafy suburb of Boston, etc. Here I am talking to you who survived the Holocaust. By contrast, my story to myself is, you have no business associating yourself with trauma.

Okay, look, Dan, if you were five years old and if you came to me, I got hit and I got bullied by neighborhood kids. And I'm really afraid and in pain. And I can't talk to my parents about it. Because you say you're comfortable. No, you weren't. If you were comfortable, you had talked with them about it. So there was some gaps in that

comfort. Now, by the way, not criticizing your parents, I passed on my trauma to my kids. I'm not here to castigate anybody. I'm just talking about how it works. But let's say you come to me at age five or let's say your son comes to me at age five. Put Alexander in that situation. He's being bullied and he's not talking to you about it, but he's talking to me. If I said to him, look, Alexander, okay, you're being bullied and you're afraid and you don't trust your father to tell him about it, but hey, you're not starving and you're not going through a Holocaust, no big deal. Would that be fair to your son if I said that to him?

No. But you're not being fair to yourself either. Do you notice that? I do and I appreciate you pointing it out. Yeah. So that lack of self-compassion, which is one of the big themes in my book, is a typical marker of trauma, okay? Where you would say to yourself, I was lucky compared to you. You don't know the rest of my childhood.

Maybe I was luckier than you in some ways. It doesn't do to compare suffering. We all have our individual versions of it. Coming up, Dr. Gabor Mate talks about his list of the four A's and the five compassions, what he would add to his list as a fifth A, and what he means by the necessity to be disillusioned. Okay, so I'm thinking Danny and Kylie. No, no, no, I'm thinking Anne Boleyn and the other Boleyn. No, no Barry and Paul Chuckle No, it's Noel and Liam Gallagher. Now these two couldn't be more different, but they're tied to each other in musical dependency Despite their music catching the attention of people around the world, Liam's behavior could destroy their chances

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over on our companion meditation app, which is also called 10% Happier. You can listen to all the episodes, no ads, and you get to listen a week before everybody else does. Download the 10% Happier app today wherever you get your apps. You have done a lot of great foundational work in this conversation up until this point. If you're cool with it, I'd like to go back to, you know, if the world is making us sick, how do we thrive? And you dedicate a lot of time to this in your book.

If it's okay with you, I'd like to start with one of the areas where you start, which is the four A's and the five compassions. Can you unpack the four A's and five compassions for us? Sure. So, and my work as a physician, both in family practice and in palliative care work and also in addiction medicine. I came to understand that people's emotional patterns are inseparable from their physiology.

Nobody taught me this in medical school, but then there's all this incredible scientific research showing exactly the same thing, which also means that if we gain some emotional intelligence and balance, that can positively affect our physiology as well. So some of the principles of emotional healing are what I call the four ways. And by the way, if I were to write a book over again, I would put in the fifth one. The four ways are agency. In other words, we take charge of ourselves. We no longer are just subject to the experts or to our own unconscious emotional dynamics.

We take charge. So when people get sick, don't just assume that you've had this misfortune and this genetic bad luck, but that, yeah, there were things about your life that you can change, that you can gain agency over, that's gonna promote your health. So that's agency. Then there is acceptance,

which is simply recognizing how things are, not tolerating how things are, but accepting that this is how it is now. There was a study out of Massachusetts that looked at 2,000 women over a 10-year period. Those women that were unhappy married and didn't talk about their feelings were four times as likely to die as those women who unhappy married who did express their emotions. So those women who talked about their feelings, they accepted reality. They didn't necessarily like it, but they accepted that this is how it is and they're willing

to talk about it. So that's acceptance. Now, authenticity is an essential theme in my book because as I pointed out earlier in our conversation that disconnecting from ourselves, our authentic selves is the essence of trauma. So reconnecting. How many times are people afraid to say no to other people because they're afraid of offending somebody? They wanna say no to some task or some expectation, some demand of the world, but they're too concerned with fitting in.

So they don't say no, they're not being authentic. That's gonna cost you. When you don't say no, that's not being authentic, that's going to cost you. When you don't say no, that's going to cost your body and your mind. You're going to have to pay a heavy price for that little note that you didn't say. When people don't know how to say no, the bodies will do it for them in the form of illness. So, authenticity, connection with ourselves, and then healthy anger. If I were to get rude with you right now or if I turn the conversation into kind

of an aggressive assault on your psyche, one of your healthy responses would be anger. No, you don't do that. Healthy anger is a boundary defense. We have a circuit in our brain for anger. Nature gave that to us for a good reason. It's to maintain our boundaries. But in some families, my parents listen to the advice of certain stupid psychologists who tell parents that angry kids should be punished and should be given a timeout. The child gets the message that if I'm angry, I'm not acceptable to my parents. But if I'm not acceptable to my parents, I can't live. So in order to be acceptable, I have to suppress my anger.

Now given the scientifically proven and documented and over-documented unity of emotions and the immune system, when you suppress your anger, you're also suppressing your immune system. And that makes you more prone for autoimmune disease where the immune system turns against you. By the way, that's why women get 80% of autoimmune disease, because who in this society taught more than other people to suppress the healthy anger and to fit in and to be nice and to be accommodating and to be peacemakers and to absorb the stresses of other people?

So healthy anger is the fourth A. I'm not criticizing women, by the way. I'm saying that's a cultural artifact. And the great American black writer James Baldwin said that to be black in the States is to live in a place of suppressed anger. Why do you think black men have a much higher rate of high blood pressure? It's got nothing to do with genetics. Their African relatives don't have high blood pressure. It's because of the suppressed anger very often, the suppressed tension, hyper tension.

So anger has a huge role in health. I'm talking about healthy anger. I'm not talking about rage. I'm not talking about losing it. That's also unhealthy. I'm talking about healthy boundary setting anger because anger is a boundary defense. What's the immune system?

It's a boundary defense and the two are one system. Now the fifth day that I would put in there is probably something that you'd be comfortable with given your own writings and your own experience is awareness, which is necessary for all the other four ways. So it was a lack of awareness on my part that left out awareness from this book,

but I'd put it in. But by the way, let me just, something that, I have this ADD brain that jumps all over the place, so there's an association that came up for me. I saw that one of the people that endorsed your book online is Mark Epstein. And Mark Epstein is a Buddhist teacher whose work I've followed for decades.

And in his book, The Trauma of Everyday Life, he says that the traumas of everyday life can leave all of us feeling that motherless children. And he was actually basically talking about the ubiquity of trauma in this culture, just as I talk about it. But he's certainly somebody that advocates awareness and mindfulness, you know, as one of the healing modalities. Massive figure in my own life, Mark Epstein and a great friend. So you've got four A's, now five A's, and also five Compassions. What are the five Compassions? So a great spiritual teacher of mine, A.H. Almous,

said once that only in the presence of Compassion will people allow themselves to see the truth. And Chekhov, Anton Chekhov, the great writer and playwright, he also trained as a medical doctor. And he also said that Compassion is the healing agent. Now, why is that the case? What I'm talking about is painful stuff. Trauma is painful stuff. I mean, I've said some stuff to you that if you really think about it, might bring up some pain in you.

Indeed. Now, only in the presence of compassion will people allow themselves to see the truth. Now, what is compassion? So, I've distinguished five levels of compassion in my own therapeutic work with myself and others. First of all, what I call ordinary human compassion, which by ordinary I don't mean mundane or useless. I just mean our capacity to recognize the suffering of other people and to feel bad when other people suffer. You know, if I see a homeless person, I should feel bad, and most people do. So that's the level of ordinary human compassion. Compassion means

suffering, calm means with. So compassion means being able to be with the suffering of other people in an empathic way. That's the first level of compassion. I worked in Vancouver's downtown Eastside with North America's most concentrated area of drug use. The people in Vancouver, if you've been to the downtown Eastside, you don't see anything like that anywhere in North America in terms of the outdoor drug market, the people using the desperation, the poverty, the illness and so on. And it's not enough to feel bad for them. The second level of compassion is what I call the compassion of understanding.

You also have to understand why they're that way. Now, if you look at addiction in general and specifically of the people in downtown Eastside, they all suffered significant trauma. Over a 12-year period when I worked there with hundreds of female patients, not one had not been sexually abused as a child. So it's not enough for me to feel bad that they're suffering. I should ask why they're suffering or they were traumatized. Their drug use is just a desperate attempt to soothe the pain. That's what it is. And so that's the compassion of understanding.

The third level of compassion is what I call the compassion of recognition because I also live in a leafy, lovely area of Vancouver in a beautiful house and I've been privileged a middle-class physician with remuneration and rewards and social respect. But you know what? The hunger to kill the emotional pain inside myself, the need to fill myself from the outside with activities and shopping and so on, the dishonesty and the shame that I experienced, I was the same as my patients. And when I told them about my addictive patterns, which were not to do with drugs, but it had to do with behaviors, you know what they said? They shook their head and I laughed, Doc, you just like to do with drugs, but it had to do with behaviors.

You know what they said? They shook their head and I laughed, Doc, you just like the rest of us, aren't you? And that's what I call the compassion of recognition. When I've seen myself that I'm not different as a human being, I might be more privileged in significant ways and I'm not comparing myself to the suffering of those people. But in many ways, I wasn't different from them. I was just as capable of manipulation and dishonesty, ignoring my family, to pursue my addictive drives, which were rooted in my own trauma. That's what I call the compassion of recognition.

The fourth level is compassion of truth, which means that, see, if I didn't want to cause you discomfort, if my interest was purely to save your discomfort, I would never have asked you about your childhood. But I'm more interested in the truth. And I'm more interested if I can help you to recognize the truth in your own life. I'm more interested in that than whether or not I caused you pain. It wasn't my intention to cause you pain. My intention was that you should recognize some truth about your life.

You got to be committed to the truth to help people. But you have to do so compassionately, because without compassion, people are not willing to face the truth. The fifth level of compassion in this little journey through the compassion spectrum is what I call the compassion of possibility. I recognize in you, I recognize in me,

I recognize in my downtown Eastside patients, their essential humanity, their goodness, and their capacity to heal. And I recognize that even when they don't. And so that I mirror that back to them. That's what I call the compassion of possibility or the compassion of transformation. When you don't look at people through the prism of their behavior or how they look to you, whether they're scruffy, whether they look hostile, whether they look troubled,

confused, ugly or beautiful, whatever those terms mean. You look at them through their essential humanity, you see the possibility of goodness and transformation. And that's what I call the compassion of possibility. There are so many big and compelling ideas contained within the four slash five A's and the five flavors of compassion. It's the question that comes up in my mind after having you walk us through these ideas

is how do we operationalize them in our lives? Well, it begins with a self-inquiry. It begins with self-compassion and recognizing when we're not being compassionate to ourselves. It begins by learning the truth about ourselves. It also begins on a social level by, in the last chapter of what I call the necessity to be disillusioned. And people often say, you know, I got disillusioned. And I say to them, would you rather be illusioned or disillusioned?

You know, would you rather believe the false view of reality and write a book called Enlightenment Now, or do you want to actually look at how things really are? So I think the necessity to be disillusioned about our own lives and about society in general is the first necessary step. You have to look truth in the face and say, this is how it is, and accept that this is how it is. Now what am I going to do about it? What am I going to do about it in my own personal life?

As long as my trauma is running my life, I'm like a puppet on a string. I'm like Pinocchio. And you know what Pinocchio says at the end when he becomes a real boy? He says, how foolish I was when I was a puppet. Well, this liberating myself from the strings of my traumatic imprints has been and continues

to be a lifelong journeylong journey for me. But it's essential. And on a social level, it's the same thing. Do we not tell ourselves that we're living in the best possible society in the history of the world? Or do we look at all the things that are not working and why they're not working? And what can we do as a community, as a communality, as a species, as a society, to liberate ourselves from these traumas that are so omnipresent, that are so everyday, as Mark Epstein points out, so

ubiquitous and so unrecognized. What are we going to do? That's the question I'm going to leave the reader with. But if the reader engages with that question, with the sense of possibility, then I'll have done my job. You say you've been wrestling with becoming a real boy for many, many years for your life. What are the modalities that you've employed to do that?

Therapy, I know you've worked with psychedelics. What are the hows of this work? Yeah, well, so if I may say, I do outline a lot of that in the book itself, but to give you a quick answer, and by the way, it is a lifelong process. Sometimes I share with people my epitaph. You know what it's gonna say in my gravestone?

It's gonna be in carved. It was a lot more work than I had anticipated. So this task of becoming a real boy is really a lifelong one, if my experience is any measure of that, and I'm far from finished with it. But I would say the how-to involves emotional work, so that may mean therapy or rigorous self-examination.

It involves relational work. The biggest lesson and school for me has been my marriage relationship. I've been married 53 years now. And at some point I had a decision to make, do I wanna be right or do I wanna be married? Do I want to be a victim or do I wanna be a partner? When I say victim, a perceived victim, where I see my problems and my triggers

as being the other person's fault, or do I wanna grow up and take responsibility? And fortunately, I'm in a marriage where that's seeking for truth in ourselves and in the other person's fault, or do I want to grow up and take responsibility? And fortunately, I'm in a marriage where that seeking for truth in ourselves and in the other has been an ethic that we've shared, not consistently and not always successfully, but it's been a significant theme in our lives and continues to be. So individually, internally, emotional work, relational work, spiritual work. In one of my books, I said that I have a profound relation with meditation.

I think about it every day. Which is, I'm more, you know, I think about it more than I do it. And you know, with my 80-D brain, I can literally sit there and chant a mantra in my head for 20 minutes and be thinking about everything else for that whole 20 minutes. But you know what?

Spiritual work ethic is really important and as much as I laugh at my own lack of discipline, it's been an important theme in my life as well. A colleague and a mentor and friend of mine, Dan Siegel, a psychiatrist, just wrote a book called Intra Connected. Not even interconnected, intra connected. And our inner selves are themselves connected with everything in the world. And Dan talks about this concept of me and we put together in one world so that a part of healing really has to be our recognition of our sociality that we are biopsychosocial creatures. And I've

been fortunate enough to have some input from Indigenous healers, both in South America but also here in Canada, and the big theme is interconnection. And in the Indigenous sense, health rests on the four quadrants, the mental, which means the intellectual and emotional, the social, the physical, and the spiritual. And we have to find health and connect all those four quadrants. So that's in a small nutshell, my idea of health is both individual, interpersonal, intrapersonal, and social and spiritual.

Coming up, Dr. Mate talks about the power and potential of psychedelics, the importance of incorporating shamanic medicine into our Western medical framework, what he means by undoing self-limiting beliefs, and how to begin to tackle what he calls the social sources of illness. Behind every successful business is a story, and some of them may very well surprise you. Like how Chobani's first yogurt factory was discovered on a piece of junk mail, or how the founder of the multi-million dollar cosmetics brand Drunk Elephant was told by everybody,

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You can listen to the best one yet ad free right now on Wondery means business. I believe you've said, and please correct me if I'm wrong, that your work with psychedelics has helped make you kind of lighter over time. Yeah. If that's true, what's the mechanism? The mechanism is that you're not just a person who's been in a relationship with a person for a long time, but you're also a person who's been in a relationship

with a person for a long time. And that's what I'm wrong, that your work with psychedelics has helped make you kind of lighter over time. Yeah. If that's true, what's the mechanism? So Sigmund Freud once said that dreams are the royal road to the unconscious, because during the dream state, your conscious mind goes to sleep,

and the childhood emotional circuits wake up, and they tell you what you're carrying in your unconscious. Now I would say that psychedelics are the royal rule to the unconscious because, again, we have to parenthesize this. This has to be in the right setting with the right guidance, the right leadership. This is not you take some stuff and so on if you go. I don't recommend it. As a physician and healer, I've worked with psychedelics for about over a dozen years

now and I've seen what they can do for physical illness, for addictions, for mental health conditions. Very powerful healing possibilities. Why? Because the psychedelics in the right context, with the right guidance, they remove the membrane between the conscious and the unconscious. So you get to see all the stuff that you're carrying unconsciously that without your awareness run your life.

The fear, the hatred, the panic, the anger that you've suppressed or separated from. Psychologists also make it possible for you to see your true essential connected loving nature, which subverts your sense of an individual, aggressive, competitive individualist. So they can show you the difficult stuff that you're carrying. They can also show you the beauty that we all share, the oneness.

Now, shamanic medicine, the shamans are trained in ways that Western physicians can't even dream about. This is not to say that they're better. If I broke my leg or if I needed a valve replacement in my heart, I wouldn't go to a shaman. I don't want to go to a Western medical doctor, you know? But there are huge areas of health that Western medicine doesn't know what to do with,

which comes to chronic mental health and chronic physical health issues. The best we can do is to mitigate the symptoms. Traditional medicine, shamanic medicines, have a lot to offer. They're not the panacea, and it's not one or the other. It's a question of recognizing value where we see it. So when shamans in the jungle work with me, they saw things about me in one night of chanting without asking me a single question. And they saw

right into my soul and what I needed in ways that 10 million Western trained physicians couldn't have done over 10 million years. So I don't want to idealize psychedelics and I'm not an evangelist for them, but I've seen their possibilities and they're immense. So I'm with those many others who are advocating for their rational use, their research, and as we come to understand them, their incorporation into our healing armamentarium. When it comes to healing, there's another process that you recommend in the book and it has to do with, I believe your term is undoing self-limiting beliefs.

What's that about? Well, so my mother gives me to a stranger in the street of Budapest. I conclude from that that I'm not lovable and I'm not wanted. What else could I conclude? So then, 35 years later, I'm a workaholic medical doctor. Why am I a workaholic? Because if I believe I'm not important

and I'm not lovable, one way to make yourself lovable and important is to go to medical school. Now they're going to want you all the time. When they're sick, when they're being born, when they're dying, they're going to want you all the time. So you get to prove to yourself how lovable you are, how important you are.

But the very fact that I'm not lovable just because I'm a human being and that I'm not important just because I exist, that's a limiting belief because the fact is we're all lovable because we're human beings. We're all just, you know, we're born that way. I shouldn't have to prove to anybody that I'm important. If I should have a stroke tonight and I couldn't work anymore, I couldn't speak anymore, does my importance of a human being diminish by one iota? No, it doesn't. And so that fact that I'm not important, that's a limiting belief imposed by trauma. And healing implies undoing those limiting beliefs that I have to justify my existence. That I have to be pretty.

That I have to be attractive. That I have to be acceptable to others. These are all limiting beliefs. And they limit our capacity to be truly ourselves and to really be fully alive in this world. So that's what I mean by undoing limiting beliefs. Is there a first step by which we can find out what our limiting beliefs are and work on them?

Well, there are many first steps, but I can recommend a very easy one. This little word, no, that I talked about before. When in your life, do you have difficulty saying no? By no, I mean, what is a no that wants to be said, but you don't say it? And that shows up in two major areas, personal relationships or work. So let's say I come to New York, wherever you happen to live, and I phone you up and say,

Dan, do you wanna come for a cup of coffee? You don't feel like it, because you're tired and you have other things on your mind. But you have faith to disappoint me. So you don't say the no that wants to be said. So you come for coffee with me. Now what's gonna be the impact of that on you?

What do you think? Maybe add to my burnout, because I'm not taking care of myself. Exactly. Okay. So that's what I'm asking. Where in your life do you have difficulty saying no? Sit down for five minutes, take a piece of paper and write down. This exercise is in the book, but where in your life do you have difficulty saying no? It's either work or personal relationships.

The second question is, what's the impact? Well, burnout. In many cases illness or depression or anxiety or sleeplessness. That's the impact. The third question is, what is the belief behind your difficulty saying no? So if I come to your town or where you happen to live and we have a cup of coffee and you say yes when you feel like saying no, what's the belief that has you? Yes when you want to say no, what's the belief? What do you believe if I say no then? I'm gonna let them down. They're not gonna want to stay friends with me Exactly. So there's limiting beliefs are it's my responsibility not to disappoint somebody else

Yes, and how they feel is my responsibility Yes. And how they feel is my responsibility. Number one, I'm only acceptable as long as I'm compliant. I can't be myself in this relationship because if I'm myself, they won't like me. It's that simple, people. So start with that question. Now, there's other questions that follow, and there's a chapter in this in the book, but just that question of where do I have difficulty saying no?

What is the impact? What is the impact? What is the belief? I'm told that has changed the life of a lot of people. I believe that. I mean, even in just my cursory beginning investigation and the interstices of your sentences here that I can see that that's a rich field for exploration for myself, we're in the home stretch here. So I do want to make sure I get back to a question and you dedicate a lot of time to this in the book.

So this is a big question. But if you can give us a sense of what can we do structurally to keep the beautiful and mind-boggling conveniences and technologies of modern life while making sure we create a society where people aren't continuing to get sick psychologically, physiologically, and both? Yeah, well we have to tackle the social sources of illness, which documentably is inequality, is racism, is a belief in human nature as competitive, aggressive, selfish, greedy, and individualistic. None of that is true. We have to incorporate trauma education.

All the discussion that we had today on the mind-body unity and trauma and the impact of trauma on human health, the average medical student doesn't hear a single lecture about any of this in all their education. Incredible. This is in the face of all the science. We have to incorporate trauma education into education. All these kids who have troubled behaviors with ADHD and oppositionality and bullying and being bullied, learning problems, behavior problems,

they're all acting out markers of trauma. Babbage teacher sees them only as behavior problems to be corrected and controlled and suppressed. We have to introduce trauma education into the education of our pedagogues. In Canada, 50% of the women in jail are indigenous. Indigenous women make up 6% of our female population. 30% of the people in our jails are indigenous.

They make up 5% of our population. Why? Because they're the most traumatized segment of our population by colonialism, by ongoing racism, by the residential schools and all their horrors, by the abduction of the children from their homes, by the state and the church that went on for over 100 years in Canada. And there are similar dynamics in the states. Of course, in the states, you also have the history and the legacy of slavery and so on. And yet the average lawyer never hears a single lecture on trauma. Can you believe it? But they don't. And if you do the research on who's in jail, traumatized people, for the most part. We punish people for being traumatized. So let's get trauma conscious.

That's achievable, doable. All the science is there, all the evidence is there. We have to turn our attention to that. This has been a fascinating, fascinating discussion. I usually conclude with two questions. One is, is there something I should have asked but didn't? You know, the conversation has been so wide ranging and so deep, and thanks to your willingness and courage, so personal,

that really I can't think of a single thing that we haven't talked about at this point. I appreciate that. If you'll bear with me, because many of my guests don't like doing this, but I'm going to try to push you a little bit to plug your book, any previous books, anything else you're putting out into the universe. For listeners who want to learn more from you, how can they do so? Well, thank you. So the book is called The Myth of Normal, Trauma, Illness, and Healing in a Toxic Culture.

The book is being published in almost 30 languages internationally. It's been an eight-week New York Times bestseller. I have four other books. My first one was an ADHD. When I was diagnosed with it, it's called Scattered Minds. I look at the origins and healing of attention deficit disorder in which I argue that it's not this inherited disease, but a response to the environment, and it can be healed that way.

My book, When the Body Says No, the relationship between stress and illness, emotional stress and physical illness. My book on addiction is called The Inner Realm of Hungry Ghosts, Close Encounters of Addiction, in which I point out that addiction is not an inherited disease or a disease at all and certainly not a choice, but it's a response to trauma. And hold on to your kids why parents need to matter more than peers, which I really beg you to read, Dan, because it's a very important parenting book. And I say that without arrogance in this case, because I'm not the main writer of it.

The main writer is a friend and colleague and mentor called Gordon Newfeld in Gordon's work showing that kids get too connected to peers in this culture. As a result, parents lose their influence, and that is toxic for their healthy development. If you go on YouTube, it's impossible to avoid me, just put my name in there. Dozens of my lectures have been uploaded to YouTube. My website is Dr. Gabor Mate. My Instagram handle, whatever Instagram is,

I never go on Instagram. My daughter handles it for me, but it's Gabor Mate, MD. I have a Twitter handle apparently. Again, I don't deal in Twitter, but you can find me there as well. And there's a documentary about my work called The Wisdom of Trauma, which you can access online, thewisdomoftrauma.com.

I'm easy to find and I hope you look for me. Dr. Mate, I'm grateful to you for your time. Thank you. And for you, thank you very much. Thanks again to Dr. Gabor Mate. Really appreciate him coming on. Thank you to you for listening and thanks to everybody who worked so hard

to make this show a reality. Our producers are Lauren Smith and Tara Anderson, and we get additional production support from Colin Lester Fleming, Isabelle Hibbard, Carolyn Keenan, and Wanbo Wu. Marissa Schneiderman is our senior producer. Kevin O'Connell is our director of audio and post production. DJ Cashmere is our managing producer.

And Nick Thorburn of the band Islands wrote our theme. If you like 10% happier, and I hope you do, you can listen early and ad free right now by joining Wondery Plus in the Wondery app or on Apple podcasts. Prime members can listen ad free on Amazon Music. Before you go, tell us about yourself by filling out a short survey at Wondery.com slash survey.