The Mel Robbins Podcast - Dr. Gabor Maté: The Shocking Link Between ADHD, Addiction, Autoimmune Diseases, & Trauma
Episode Date: November 21, 2024Today, Mel’s dream guest joins her in the Boston studios: Dr. Gabor Maté, MD.Dr. Maté is a world-renowned trauma expert, and shares things today unlike he has ever shared before.This wide-ranging ...conversation covers ADHD, autoimmune diseases, anxiety, addiction, people pleasing, and trauma. Dr. Maté will take you on a deep dive into how your early life experiences can shape the way you feel and function today, both mentally and physically. This episode is about unlocking real healing and finding hope. Dr. Maté’s compassionate insights will show you how understanding your past can free you to make healthier choices right now.You’re about to discover powerful, science-backed ways to understand and care for yourself in ways you never have before. So, whether you’re on this journey for yourself or to help someone you love, this episode is for you.For more resources, including links to the studies mentioned in the episode, click here for the podcast episode page.If you liked this episode and want to reprogram your brain for more happiness and fulfillment, listen to this episode next: #1 Neurosurgeon: How to Manifest Anything You Want & Unlock the Unlimited Power of Your MindConnect with Mel: Watch the episodes on YouTubeGet Mel’s new book, The Let Them TheoryFollow Mel on Instagram The Mel Robbins Podcast InstagramMel's TikTok Sign up for Mel’s personal letter DisclaimerSubscribe to SiriusXM Podcasts+ on Apple Podcasts to listen to ad-free new episodes.
Transcript
Discussion (0)
Hey, it's your friend Mel and welcome to the Mel Robbins podcast.
You know, when I started this podcast, I sat down and I made a list of dream guests.
And I am so excited that you chose to listen to this episode because today one of those
dream guests is sitting here in our Boston studios.
His name is Dr. Gabor Mate.
Now, Dr. Mate is a five-time New York Times bestselling
author. He is one of the world's most respected and prolific experts on childhood development,
trauma, and the impact that it has on who you become as an adult. And his work has profoundly
changed my life. Around the world, he is considered the people whisperer
because when he talks about the connection
between your childhood and the things you struggle with
right now as an adult, you're gonna feel so seen
and so understood.
And today, he's here to share a very provocative opinion.
Dr. Mate believes that you are not born with conditions
like ADHD or addiction or an autoimmune disorder
or the inability to say no or being a people pleaser.
Dr. Mate says these are conditions that are created
by your childhood experience.
Now, one of the things that I love about his work
is that not only does he bring the science,
he also removes the shame.
None of what you experienced
and how it impacted you is your fault.
And when you understand the factors in your childhood
that create people-pleasing ADHD, addiction,
and health issues, and all the research and science
that supports it,
you are going to have a completely different roadmap to your own healing.
In fact, you're going to leave this conversation with five questions that Dr. Mate will tell
you you need to ask yourself that are going to help you take the very first step.
Hey, it's your friend Mel.
I am so excited that you're here with me today.
It is always an honor to be able to spend some time with you, to be together, to learn
together.
If you're brand new, I want to take a moment and welcome you to the Mel Robbins podcast
family.
Super excited that you're here.
And because you chose to listen to this episode, I know something about you.
You're the type of person who values your time.
And you're also in learning about simple ways
that you can improve your own life.
And I absolutely love that.
And you know what I also love?
I love that you and I are gonna get to spend time today
learning from the extraordinary Dr. Gabor Mate.
He's a world renowned physician
and New York Times bestselling author and a renowned addiction
expert who dives deep into childhood development and the impact of physiological and psychological
trauma and how it shapes our mental and physical health over your lifetime.
And today specifically, you and I are going to dive deep with Dr. Mate into how ADHD, people
pleasing, addiction, your inability to say no, and autoimmune disorders are not things
that you're born with.
They were created by your childhood.
So please help me welcome Dr. Gabor Mate to the Val Robbins podcast.
Thank you.
It's so nice to be here.
It is such an honor to sit down with you and spend some time together today. Thank you. It's so nice to be here. It is such an honor to sit down with you and spend some time together today.
Thank you.
I'm really excited about the topic today and your work around how childhood conditions and experiences in your childhood are connected to ADHD addiction and autoimmune diseases and disorders. And I have so many questions I want to ask you.
Why don't we start with just your definition
of what you're talking about
when you mean childhood conditions
so that as the person is listening to us today
and spending time with us together,
we're all using the same words and concepts
and we kind of start on the same page.
So child conditions include the physical conditions,
nutrition, housing, comfort, protection.
But they also include the emotional conditions,
which it has to do with a child's sense of being accepted
or being loved, not just as love,
but actually being seen, understood.
And also in the parents' emotional states, are the parents stressed? Are the parents
struggling with economic difficulties? Are the parents carrying traumas that they hadn't
worked through yet, like I had when I was a young parent?
Are the parents in a marriage that's relatively peaceful?
Is there a lot of conflict? Is there a lot of instability?
Is there unpredictability? What kind of community support there is?
Is there an extended family that can spell off the parents
and give them some kind of emotional support? Are they rather isolated?
Are you a single parent struggling to make a living and raise a child?
So all these conditions affect the personality and the brain development of the child.
I know you wrote the original book on childhood development in ADHD, Scattered Minds, 25 years
ago.
It is still on the bestseller list when it comes to ADHD topics.
Yeah.
I don't know if I'm going to say this correctly, but is it fair to say that your opinion is
that your childhood and the conditions and the experiences that you have directly create
or cause ADHD addiction and autoimmune issues?
Yes, along with certain genetic predispositions.
Okay.
But I can talk about genetics later, but what I want to say about them now is a predisposition
is not as a predetermination.
Okay.
So you can have predispositions, but then depending on the environmental conditions,
those predispositions can be then depending on the environmental conditions, those predispositions
can be expressed one way or another way.
So you can have animals with the same genes or humans with the same genes that have very
different outcomes depending on the kind of conditions under which the early years were
spent under.
So that's what I'm saying yes.
And the first recognition of that in my life came when I was diagnosed with ADHD at age 53 or 52
or something.
So I was diagnosed with ADHD at the age of 46
when our son, Oakley, was going through the process
of going through neuropsych evaluations for schools
and IEPs.
And as they were doing his evaluations,
I started going, oh, wait a minute, that's a lot like me.
And then I went through the formal process
of being evaluated and diagnosed dyslexia, ADHD.
And I had never, ever, ever heard anyone connect
your childhood and adverse conditions
or conditions where you didn't get your
needs met being a contributing factor or a cause of ADHD. How is that even possible?
Well, it's possible because Western medicine separates the mind from the body.
So they tend to look at things purely from a biological point of view. So ADHD
is considered to be a genetic disease that you inherited.
Here's the problem with that.
Number one, if that's the case,
why are the numbers going up?
Genes don't change in a population
over 10, 20, or 30 years.
So something's going on in the environment
that's affecting the child development.
Number one, number two,
even if you look at the physiology of the child's brain,
what's not understood by most physicians,
because it's not taught in the medical schools, but it's firmly and completely, unequivocally and uncontroversially established in brain
science is that the brain is a social product, that the brain development of the child depends
on the emotional conditions under which the child lives from in utero onwards.
And so that the very circuitry of the child's brain is programmed by the action of the environment
on the genes.
So different environments will act differently on the same genes.
Now, if you look at ADHD, what's the medication that we give?
I took it for a while.
Stimulants.
What do stimulants do?
They elevate the level of a chemical called dopamine in the brain.
And dopamine is essential for motivation and therefore for focus.
And that's what Ritalin and Dexedrine and Natarol and all these medications elevate.
Now the dopamine circuitry of the child's brain develops in interaction with the environment.
And this is what most people who deal with ADHD just don't look at, even
though it's just a pure scientific fact. You know, and a summary from Harvard University
pointed out that the child's brain develops in interaction with the environment, especially
the emotional relationship with the nurturing adults. Now, dopamine is a brain chemical.
We have receptors forming in our brain. Receptors are molecules where the dopamine can land and do its job.
The number of dopamine receptors in a child is affected by stress on the mother already
in pregnancy, let alone afterwards.
If you take mice and you isolate them, the number of dopamine receptors will go down.
If you bring back into companionship, the number of dopamine receptors will go down. If you bring back into companionship,
the number of dopamine receptors will elevate.
In other words, the brain is a social organ.
It's interacted with the environment all our lives,
and therefore environmental conditions affect the brain,
especially during its phase of early development.
It's just pure science. It's not even controversial.
So the problem here is the tendency of the medical profession
in which I was trained is to separate the mind from the body
and to look at brain biology in isolation from the life circumstances
that shape that brain biology. So that's the one problem here.
So I'm going to try to distill what you just said,
because I've never heard it explained quite like that.
And I believe you.
What you're saying is that your brain is a social organ that
is developed in partnership with your relationship
to the adults around you.
Exactly.
When you're literally inside your mother's womb.
Yeah.
All the way until you are developing as a little kid.
Yeah.
And if you are in a condition,
whether it is the condition of being
inside your mother's womb and your mother is depressed
or experiencing racism or abuse or poverty or any of these things that create chronic stress on a human being,
it impacts the development of your brain. And what you're also saying is that
ADHD and the way that it is treated is
typically through
prescription drugs that flood the brain with dopamine.
And that is what helps your underdeveloped brain or whatever we want to call it, or the
brain that's been impacted by stressful conditions during your childhood or your development
in womb. and that the stressful conditions are what has interfered with the brain development.
And continues to. Now, can I ask you a quick question?
Yeah. So, I understand that when, as a human being, you're experiencing stress,
or you are experiencing a threat, or you're feeling isolated and lonely
and like you're invisible or nobody cares about you, that your body naturally switches
from being present and in the prefrontal cortex to the amygdala taking over and you're now
in like fight or flight.
When you're in fight or flight and you're kind of in that stress response state, does
it interfere with dopamine?
It interferes with dopamine, interferes with cortisol. It has an effect on the memory centers
in the brain like the hippocampus. It affects the amygdala, all those things. And if you look at
children in poverty or who experience racialized circumstances, they're
more likely to be diagnosed with ADHD.
The children of women with postpartum depression are more likely to be diagnosed with ADHD.
The children of women who are stressed during pregnancy are more likely to be diagnosed
with ADHD.
And there's this myth about it being genetic because it tends to run in families.
Like you were diagnosed, your kids were diagnosed, I was diagnosed, a couple of my kids were
diagnosed.
But it's not because of the so-called disease, personal is not even a disease, but it's not
because the so-called disease was passed on, but because the conditions that created the
brain.
That created your brain were also then repeated in your children's childhood as in mine.
So something running in a family says nothing about genetic causation.
And going back to the fight or fight thing, if a child is feeling stressed, and by the
way, I think there's something genetic here, and what is genetic here is sensitivity.
And the more sensitive kids are, the more they feel what's going on around them.
So if the parents are stressed, the child feels the stress.
Can the child escape or fight back?
No.
What do they do?
They tune out.
But when did they tune out?
They tune out when their brain is developing.
So that gets wired into the brain.
And now they're told you got this genetic disease.
No, you don't. It's an adaptation.
That began as an adaptation.
And as with many of these sheltered adaptations,
later on they create problems.
So they serve their purpose.
But now they are wired in and, you know, not to mention,
if you look at the traits of ADHD,
which is the absent-mindedness, the tuning out,
and then the other traits of ADHD
are poor impulse regulation,
which means that when you want to do something,
like I might have an impulse to do something,
there's nothing wrong with the impulse,
but there's something wrong with me acting out the impulse.
But impulse regulation depends
on certain circuitry in the brain.
No baby has any impulse regulation.
It has to develop.
For anything that's developmental, the conditions have to be right.
If a plant in your backyard wasn't growing the way you expected it,
you'd look at what's missing here.
Nutrition, sunlight, irrigation.
It's the same with kids.
When they've got these challenges,
let's look at the conditions that shape their development.
So, embolus regulation is another brain circuitry
that doesn't develop well in people with ADHD,
and incidentally, in people who are addicted,
which is why there's such a great link
between addictions and ADHD.
And then the third one is, which is sometimes they're not always hyperactivity.
Yeah.
More tends to be there more in boys.
Boys, not girls, yep.
And regulation of the body is a function of the midfrontal cortex.
That has to develop.
So under conditions of stress, given that the brain is a social organ and it's also
a historical organ, do you know that, does the name Bruce Perry mean anything to you?
Is he in Wisconsin?
I don't know where he is, but he's a well-known child trauma psychiatrist.
Yes, I believe he's in Milwaukee, Wisconsin, I think, but don't quote me on that.
Did he write the book with Oprah Winfrey?
Yeah, he wrote the book.
Yes, okay.
What happened to you?
And he says the brain is a historical organ.
So it stores the impacts of life experiences. So when we look at brain biology,
let's not think that the biology is somehow distinct and separated from life experience.
So there's no fault laying here. And sometimes I do get accused of blaming parents. It's the last
thing I want to do. I don't hear you blaming parents. I hear you talking very factually. No, but there's a very well-known ADHD psychologist who goes on YouTube and says, I blame parents.
And I don't.
Actually, I think parents do their best.
They love their kids.
But their best is limited by their own particular challenges and limitations.
You know, there's no parent blaming here.
But we have to recognize the importance and the impact of early experiences.
So what I'm saying is that ADHD is the result of all that stress and its impact on the brains
of especially genetically sensitive kids.
That's what's inherited is the sensitivity.
But if there was only the sensitivity and optimal conditions, they'd never have ADHD.
So it's not the ADHD that's inherited, it's the
sensitivity. Now that's the good news. If you have a parent with a kid with ADHD, and if I was a
doctor, and I said to you, madam, your kid's got this genetic condition, brain biology, nothing
we can do about it, but here's some medication. Or if I said to you, Mel, you know, your child's
got this condition, your child's very sensitive, very responsive
to the environment.
And even now at age eight or age 16 or whenever, if we can go in different conditions, the
brain can still develop in different ways.
Which message would you rather go with?
The second?
Yeah, of course.
This is a much more optimistic and much more science-based attitude.
But unfortunately, again, given the dominance
of pharmaceutical companies and the biological mindedness,
or what they call biological psychiatry,
which is just fixating on the biology and fixing it,
rather than looking at the conditions that shape the biology,
we're very much stuck in a state where hundreds of thousands
and millions of kids are being medicated.
And I'm not against medications.
I prescribe them, I've taken them,
but they're not the answer.
What's fascinating is that when you really wrap
your brain around it, it makes a lot of sense.
I'm sure you're familiar with that metaphor.
It's not the most elegant metaphor
that the genetics loads the gun,
but the environment that pulls the trigger, which means you come
into this world predisposed to certain things, but it's the environment that either deactivates
or activates what you're predisposed to.
So that makes perfect sense.
And the other thing that makes perfect sense in terms of my lived experience is being diagnosed
with ADHD late in life and also having a son and two daughters that have ADHD.
We were in Boston
in a very competitive public school system,
in the go, go, go, both spouses working,
running to the club sports, doing this, doing that,
busy, busy, busy, busy, busy.
When we moved to Southern Vermont, open space.
Amazing.
Things change.
You change because the environment changes.
And if you just think about being on vacation,
you leave the go, go, go, go, go, go, go,
of your day to day and your work and your social and all
that stuff, and you step away to a space that typically
has a little bit more open space and a different pace to your life, you change.
And so I feel, because I was about to ask you, well, why does this matter to know this?
But I feel that it matters deeply because if environmental conditions can shape your
brain as a child and we know that the brain develops and grows
and changes through neuroplasticity
through your entire life.
Then environmental changes, I suppose,
also help you change and address these conditions.
Absolutely.
And so when a family with ADHD child would come to me,
once I had this recognition. I would say,
well, we can consider medication in the short term if we need to, but it's not the
first step. It's never should be the only step. Can we look at the family
atmosphere? Can we look at the relationship between the parents? Can we
look at the stresses in the family? Can you understand the child's behavior in a
way that doesn't blame the child? Because these kids tend to be blamed a lot for how they behave.
Now we talk about this phase acting out.
Kids are acting out, which usually means they're being obstreperous, oppositional, defiant,
or non-corporative, or rude, or something.
It means they're not doing what the parent wants them to do.
Yeah, yeah.
But let's look at the phase acting out.
It's English meaning.
We have something out when we don't have the language
to say it in words.
So in a game of charades, we're not allowed to speak.
What do you have to do?
Act it out.
These kids' behaviors are simply acting out
their emotional needs and dynamics.
It's up to the parents to understand that,
rather than just to respond or react to the behavior
in a controlling or punitive way, let's understand what is being acted out, which is one of the reasons
I wrote that book, is I want parents to understand what is being acted out in this child's behavior.
And if you change the relationship to the child, the child's behavior will change.
So it's not behavior control, it's actually promoting different conditions that will support the
child's healthy development.
You know, this reminds me of something that's always really just made me feel very heartbroken
about the state of society in the world, particularly in the United States.
And that is when I was going through this experience where my husband and I
were having our son go through the process
of all the evaluations, the school kept saying
this is behavioral behavior, and we were like,
I don't think so, I don't think so.
And so we were in a position to be able to have him tested
here in Boston at Mass General outside the school.
And just three years prior, we would not have been able to afford to do that.
I understand.
And that diagnosis and understanding that his brain and the way that he learned and
the development of his brain was just different.
That's right.
And changed the trajectory of his life and my life.
And before I did what I do now,
earlier in my career, I was a public defender in Manhattan.
Yeah, I read that.
Doing criminal defense work.
Yeah.
The statistics of people who are incarcerated.
Yeah, with ADHD. Yes, with ADHD, with learning
differences who were never diagnosed. That's right. Who, when you trace it back to what you're saying,
childhood conditions, a parent who is absent, chronic racism, which is a form of trauma. Yeah.
It makes very depressing and sad and unfair sense.
Absolutely.
And I think a lot about the fact that it's simply
because we were able to at that moment in our lives
to be able to afford a test that sent him in one direction
when kids who don't have that are sent in a different one.
Yeah, we actually hurting people for having been hurt.
Yes. And then they act out that hurt and then we blame them for it rather than understand
what that's all about. Let me say something else. The diagnosis doesn't explain anything.
What do you mean the diagnosis doesn't mean anything? So, male or gabor have ADHD. How do we
know? Well, they're absent-minded, they have poor impulse regulation, and they're hyperactive.
Why are they absent-minded and have poor impulse regulation?
And why do they have activity?
Because they have ADHD.
How do we know they have ADHD?
Because they're hyperactive, they tune out, and they have poor impulse control.
Why do they?
It's circular.
Yes.
It's not an explanation.
It's a description.
I mean, mistake.
Medical practice tends to mistake descriptions for explanations.
They're not.
If you want to know why they're active, have you active, or lacking post-regulation, or
tend to do not, you got to look at their lives.
As those lives acted on their genes.
That's the explanation.
The diagnosis describes something,
but it doesn't explain anything.
But understanding this helps you also
understand the role that environment.
Oh, yeah.
And how this happened.
I think descriptions are helpful.
We just mustn't mistake them for explanations. That's all.
That makes a lot of sense.
Dr. Mate, let's take a quick pause. I would love our sponsors
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Welcome back, it's your friend Mel Robbins.
And today you and I are spending time
with the extraordinary Gabor Mate.
And we're learning all about how your childhood impacted
who you became as an adult.
So I have another question for you.
You know, you mentioned addiction childhood impacted who you became as an adult. So I have another question for you.
You mentioned addiction, and there is a lot of research
that shows a direct link between ADHD and addiction.
Yeah.
And what does your research and experience show
about your childhood experience and conditions
and the connection to addiction.
So for 12 years I worked in Vancouver, British Columbia's downtown east side, which is North
America's most concentrated area of drug use.
We have more drug users there in a few squabble of radius than anywhere in the States or anywhere
else in Canada, in fact anywhere in Europe.
Wow.
So I was there for 12 years.
And a significant percentage of my patients clearly had ADHD that had not been diagnosed.
Now let's look at the commonalities.
First of all, both addicts and people with ADHD lack impulse control.
Like somebody said about addiction is that the problem in addiction is not lack of free
will, but lack of a free won't.
Lack of a free?
Won't.
Won't, oh.
They have nothing to say no with because that circuitry didn't develop.
Okay, number one.
Number two, addictions all work on the dopamine system,
which is what is affected in ADHD as well.
So stimulant addicts like crystal meth addicts, cocaine addicts, nicotine addicts, caffeine
addicts, they're literally boosting their dopamine levels, which is precisely what's
the issue in ADHD is as well.
So if you look at the studies, something like a good 30% or more of stimulant addicts actually
are diagnosable with ADHD. But again, this is a study then reported,
but not much is done with it in medical practice.
Furthermore, all addictions, no matter what they are,
they work on the dopamine circuitry.
I will define addiction for you as manifested in any behavior
in which a person finds temporary relief or pleasure and therefore
craves but then suffers negative consequences as a result of and doesn't give up despite
the harm. So, craving pleasure, relief in the short term, harm, inability to give it
up. That's what an addiction is. Now, let me just go sideways a little bit.
Okay.
Let me ask you a question.
Yeah.
And you already answered it, but according to that, notice I didn't say anything about
drugs.
I said any behavior.
Yeah.
Now, if I speak to a room of a thousand people and I give that definition and I say, according
to that definition, which is not controversial, if you ever had an addictive pattern in your
life, just raise your hand.
Another 1,999.
Yes.
Well, raise the hands of this one liar who won't, you know, but basically it's almost
everybody.
Now, here's the second question.
And I don't care what your addictive patterns were, whether they were to alcohol, which
you mentioned, or to whatever else.
No, what was wrong with it?
What was right about it?
What did it give you in the short term that you wanted?
So what did it give you in the short term that you wanted? So what did it give you?
Oh, well, with alcohol, it was like a sense of belonging and relief.
And it was a way to turn my brain off.
Okay.
And to escape.
Okay. When do people need to escape?
When they're stressed.
When they're suffering?
Yeah.
Okay. So the addiction wasn't the disease that you had. It wasn't your primary problem.
It was an attempt to solve the problem
of emotional pain and isolation.
So my mantra on addiction is,
don't ask why the addiction, ask why the pain.
And if you want to understand the pain,
look at the person's life, rather than just their genes.
Okay, so both people are addicted addicted and people who did HD often share these genes
for sensitivity, which means they suffer more when circumstances aren't right. And so they're
most obviously the conditions will go together. And furthermore, to go back to dopamine, the
shopping addict, the gambling addict, the pornography addict. The social media addict.
And I've had my behavior addictions.
The gaming addiction addict.
The busyness.
You know what they're after?
They're after a hit of dopamine in the brain, which they get through seeking that behavior.
And then you feel bad though that you did it.
Well, yeah.
And I had my behavior addictions.
But what I'm saying is, it's all based partly on the dopamine circuitry.
Which didn't develop. Which didn't develop the way it should have.
Because of your childhood.
Exactly. So now you have to get your dopamine hit through pornography.
And if you do brain scans on pornography addicts, they get multiple spikes of dopamine hits
in their brain when they're...
Just like a drug addict.
Yeah. Yeah.
It makes absolutely perfect sense. What do you do if you're listening to this and you either, you yourself are recognizing
this is you or you're like, you are describing my spouse or my adult child or my parent or
whomever in my life.
Like what do you do with this particular information of the connection between childhood conditions
and development and ADHD
and addiction.
May I just say one more thing about the brain?
Please.
Yeah, opiates.
Okay.
So, people get addicted to heroin or Oxycontin or diluted hydromorphone or codeine or whatever,
you know, fentanyl, unfortunately, which is a very dangerous one.
These are opiates. They come from the opium plant in Afghanistan,
or they're human-manufactured copies of the same molecule.
No.
Why do opiates, why does a plant from Afghanistan
work in the human brain here in the States?
I don't know.
Well, because the opiate molecule, we have receptors for it in our brains,
which means we have our internal opiate system. This is just pure brain science. And the opiate
system is called endorphins. Endorphin means endogenous internal morphine-like substance.
So we have an opiate system in our bodies bodies which affects many functions in our body from the gut to the immune
system, but
what do they do in the brain? If we understand opiate addiction, we have to understand what do endorphins do in the human
trajectory. First of all, they provide pain relief,
both physical and emotional pain relief.
Internal endorphins do that. We have to have pain in life because without pain,
we don't survive because we can hurt ourselves,
but we also have pain relief.
So endorphins relieve pain,
but not just physical pain, also emotional pain.
Because the part of the brain
where people experience physical pain,
the suffering of physical pain,
it's also where they experience
the suffering of emotional pain.
So the endorphins,
the opiates work there. That's their first role. The second role, along with dopamine,
is to give you a sense of pleasure, elation, and joy. But that's rather important in human
life, because human life is difficult. So we have to have some expectation of pleasure,
joy, relief. That's what the opiates do. That's the second thing they do.
But the third thing they do,
they facilitate a little thing called love.
Endorphins help to feel as connected to other people.
And particularly, they help feel parents connected
to their kids without which the child doesn't survive.
And if you take little animals and you knock out their opiate receptors, connected to their kids, without which the child doesn't survive.
And if you take little animals and you knock out their opiate receptors, they will not
call for their mothers on separation.
What would that do to them?
It would kill them in the wild.
So that's how important the opiates are.
Now who are these people that develop opiate addictions?
People whose lives have undermined their open circuitry.
And I had a sex trade worker in the downtown east of Vancouver.
I asked her, what did the heroin do for you?
She said, the first time I did heroin, it felt like a warm, soft hug.
So just like the alcohol, which gave you more sense of belonging,
it gave you a sense of being loved, a sense of warmth.
That's why people get addicted is because
they suffer that early pain and that trying to escape from and because the brain circuitry
was affected by adverse conditions so that these circuits didn't develop optimally. Now
they have to substitute, you know, so that's, that's, that's a shinnian addiction. It's
not an inherited disease. It's a response to the addiction. It's not an inherited disease.
It's a response to the environment.
And it's not genetic contrary
to what 99% of physicians believe.
The reason why this is so important
is because there is so much shame and self-blame
when you have an addiction
or you have something that you're struggling with like ADHD.
And when you understand the brain circuitry and the connection to brain
development and human development and childhood conditions and experiences and
how that has a direct impact on the working and wiring of the functioning of
your brain, you can separate yourself as a human being
from the thing that caused this.
That's the whole point.
And then that allows you from that moment of separation
and detachment and objectivity to go,
oh, wait a minute, I'm not to blame for this.
That's right.
This is a circuitry and a conditioning problem.
It's my responsibility.
And now it's my responsibility.
Exactly, yeah. To do what I need to do with this. Yeah. To heal it and make it better. Exactly right. And
to go back to your question about now what do we do with this information?
If you are parents of a child who's been diagnosed with say ADHD, then make a considered decision
about whether you want the kid medicated or not.
Medications can sometimes help, sometimes they cause side effects.
No child should be forced to be on medication because no child at any age should get the
message that they're only acceptable to the adults when their brain is sedated.
You don't want to give that message to any child.
But they can help sometimes to mitigate symptoms.
They do nothing for brain development in the long term.
So then the question is, can we create in this family better conditions for the child's
brain to develop in more optimal ways?
And yes, we can.
And that has a lot to do with the emotional atmosphere in the family and the degree of
understanding and connection, not love, because that's already there,
but actually understanding and connection
between the parents and the child.
And, I mean, that book's been out 25 years,
and I've been told by so often
that it totally changed the family just to read that book.
You know, and it totally changed their children.
Well, it's very empowering because I think
if you're the person struggling with the addiction or ADHD
or a condition like that, you feel deficient.
You feel that you've done something wrong,
and you can never heal while you're punishing yourself at the same time.
And the world is punishing you.
Yes.
Teachers are punishing you.
That's true.
Your parents are exasperated with you.
Yes.
When it comes to treating addiction,
then it's very complex,
but the person again needs to understand
there's nothing wrong with them.
They weren't born with any kind of disease.
That addiction is a perfectly normal response
to abnormal circumstances.
I mean, look at all the veterans who are traumatized
and they become alcoholics or opiate addicts.
And then there's the opposite study
about the veterans from Vietnam
who were using opioids in Vietnam,
but then came home to a supportive environment
and were not addicted.
Exactly. I quote that study in my book on addiction
because it's such a silly fact.
In fact, it's been done with laboratory rats,
you know, where done with laboratory rats,
where they took laboratory rats
and exposed them to different,
their mal-mental conditions.
And they tried to get them addicted to opioids.
Now, those rats that were stressed and isolated
and under adverse conditions,
they very easily became addicted to opioids.
The rats who had good conditions,
you couldn't even make them addicted to opioids.
Doesn't matter how much you gave them.
The main thing is that if the environment
is actually creating the conditions in your brain
and body for addiction and ADHD,
then the environment is a huge piece of you healing this
and growing in new ways and figuring out new adaptations for how to heal.
Well, and I think it's not an individual process. It should be for the most part.
Yes.
You need the social help. That's what the 12-step groups are.
I have my critiques of them, but the 12 steps themselves, I think, are wonderful.
And the group process is wonderful, where people can share themselves and be heard
compassionately and not be shamed.
They can declare their so-called dysfunctions
and be accepted.
So I think it's not just an individual process,
but I think what's missing from the 12-second rules,
unfortunately, is awareness of trauma,
which is interesting, because Bill W.,
the original funder, was an abandoned child,
highly traumatized.
And for some reason, trauma hasn't
entered the conversation of the positive movement
as much as I'd like to see it done.
But again, healing should not be just
seen as an individual process.
It should be seen as a social process.
And people that deal with addictions,
they need to understand trauma.
Kabor, I've never heard it explained like that.
That makes so much sense.
And this feels like a good time to take a quick pause
so we can hear a word from our amazing sponsors.
And while you're listening to our sponsors,
take a moment and share this with somebody
that you care about, because there's no doubt in my mind
that this can help change somebody else's life. And don't go anywhere because we have so much more to dig into with you.
And we're going to be waiting for you after a short break. So stay with us.
Welcome back. It's your friend Mel Robbins. And today you and I are with the extraordinary
Dr. Gabor Makhtey. So Dr. Makhtey, I have another question. What do you think is missing from
the conversation that women need to know when it comes to diagnosing and supporting women
who are largely getting late in life diagnoses of ADHD?
Yeah, I have to think here. I think what happens is when we get older,
they tend to get a bit less repressed.
And the tendencies that are in them
that they've tried to kind of control
in order to be acceptable and to fit in,
it becomes intolerable for them,
particularly perimenopausal.
It becomes a real chore for women
to continue to fit the stereotype
in which they were molded.
So I think whatever's in them is more likely to show up.
And I would say to them,
and what I say to anybody,
get curious about what is being manifested in this condition.
You know, in your book, Hungry Ghosts,
you mention your own struggles
with addictions to praise, even to classical music.
To the music, sorry.
To shopping for classical music.
Oh.
There's a distinction.
Yes.
I love the music, but that doesn't make me an addict.
That just makes me a music lover.
It's the shopping.
I would drop $3,000 in a music store and go back two
hours later because I had to get the next one. Typical addictive behavior. So it's the
shopping that I was addicted to. It's not the having, but to the acquisition. And that's
... And you know what? When I was in the classical music store, I had no ADHD. I had high dopamine
levels. I was focused. I can almost remember
which record did I buy in which store, you know, which CD that is. So just to make the distinction,
it's not the music, it's the shopping I was addicted to. I love that distinction because I can relate to it.
I think in the biggest moments of crisis in my life, like facing bankruptcy,
literally about to lose it all, if I had a tiny bit of money,
I would go to the mall as an escape.
And I would say, given that daily addiction,
whether it's the mom pouring a couple glasses of wine
at night, or it is just scrolling for three hours,
or it is mindlessly shopping or whatever it may be.
Yeah.
What strategies have you found most effective in really
either controlling or managing through
these tendencies or patterns of behavior that that so many of us have?
Well, here's where we have to make a distinction between drug addictions
and behavior addictions, because drug addictions become a chemical problem and people go through withdrawal
and that has to be managed and all that. Now, the behavior addicts, by the way, also go through
withdrawal, but it's less noticeable. Like with my work addiction, my workaholism, when I was at home,
I'd go through I'd be irritable and depressed. That's withdrawal, because the dopamine wasn't flowing. You know?
So, but obviously it's more easily manageable.
So, I say two things.
One is, let's look at the need that is serving in your life.
What is the need it is serving in your life?
Yeah, so-
Well, doom scrolling for me, the need is to tune out?
No, that's not the need.
What is the need for tuning out serving your life?
Oh, boy. Um, scrolling out is the... Oh, I have no joy play or relaxation. Okay. So you don't know how to, you're not comfortable with yourself. You need to, you can't
just be, you have to be doing and your attention is to be external. Yeah. But that goes back to early childhood.
It means that you weren't comfortable and you developed a comfort with the self.
You develop that sense of your own goodness and validity.
And so that when you're alone and you're not doing something, there's distress and your
mind is going all over the place.
Yeah.
You know, so that's a need that it's serving.
So then you say, well, it's meeting this need to escape from myself.
How can I learn to be with myself?
So what techniques, what could I do?
And this way is to do that.
I mean, I have many suggestions in my books, but essentially it's recognizing the need
that's being met, not invalidating the need, validating the need, but essentially it's recognizing the need that's being met, not invalidating the need,
validating the need, but recognizing that the behavior itself only temporarily suits it,
but it doesn't meet the need. Well, I feel like I've been fixing the wrong problem
because I'm focused on don't drink the drink, don't pick up the phone. And what you're saying is,
no, no, no, you're like over here looking at this thing. There's a deeper issue about just learning to be with yourself, about learning to be
in the 5 to 7 p.m. time zone and be okay with all that comes up and know that you can move
through it without pouring a drink.
That's the whole point.
And there's nothing wrong with saying don't drink and all that.
It's only that it doesn't deal with the fundamental
Yes need
So let's recognize the need those needs are valid
You need for social contact or not being isolated
Social isolation which you interpreted as rejection and your husband points out you're not being rejected
They just you know something else, but your childhood programming tells you that it's rejected. It's true
So does everything come back to our childhood? Yes They're just, you know, something else. But your childhood programming tells you that it's rejected. It's true.
So does everything come back to our childhood?
Yes, pretty much.
That's why we're shaped.
Look, have you ever had a puppy dog?
Yes, too.
Look, we're telling you about them.
I mean, how you treat that puppy will not define to a significant degree what kind of
creature they're going to be.
It's true.
Yeah.
Well, this here means an infinite thing more complex than puppy dogs. And it's totally true. So what I'm saying is recognize the need, validate
the need, but then ask the question, okay, how can I meet that need in ways that are not harmful?
One of the things that you're talking a lot about is the connection between childhood conditions and experiences, how they shape you,
and the significant rise in autoimmune disorders and diseases in women.
Yes, you know, there are 80% of people, 80% of autoimmune disease, which are diseases where
the immune system attacks the body that is supposed to protect. What are a few examples
of an autoimmune disease? Multiple sclerosis, rheumatoid arthritis, systemic lupus, probably fibromyalgia, chronic
fatigue, ulcerative colitis, Crohn's disease, thrombocerosis, autoimmune eczema, scleroderma.
I could go on and on.
There's about 100 or so of these, and 80% of them happen to women.
Why?
So in my medical practice, I began to notice and here's my advantage over my specialist
colleagues is that they know a lot more about certain body parts and systems as they should,
but they don't know the patient.
I knew people before they got sick and I knew them in the context of their families of origin
and the extended family very often.
So I got to see who got sick and who didn't. And when I was in palliative care, again, I saw
who ended up in palliative care and who didn't. And these people had four significant characteristics.
One is they tended to put other people's emotional needs ahead of their own, and they tend to ignore their own.
Number one.
Number two, they tend to identify with duty,
role, and responsibility rather than the needs of the self.
Number three, they tend to be very nice,
which means they repressed healthy anger.
The healthy anger is a boundary defense,
and these people tend to be very nice.
And number four, these people tended to believe that they're responsible for what other people
feel, which is a point that you address in your book, Let Them.
And they just believed that there was never a disappointment in anybody.
Now those beliefs lead you into not saying no to the demands of the world, and you're
constantly taking on stuff and stress and other people's stress.
You get stressed.
That stress undermines the immune system, which then turns against you.
Now, and I could explain the physiology of it.
And by the way, people, because the immune system and the hormonal apparatus and the
nervous system and the emotional system
are one system.
They're not separate.
They're wired together in a whole lot of chemical and neurological ways.
I'm not making this up.
This is science.
Science is called psychoneuroimmunology.
It was psychology, neurology, immunology and endocrinology, the hormones, it's all one system.
People that repress healthy anger, they're suppressing their immune system, biologically.
No.
If you understand that it's all one system, and if you ask why, well, what is the role
of healthy anger?
It's a boundary defense.
What is the role of the immune system? It's a boundary defense. What is the role of the immune system?
It's a boundary defense. It's meant to let in what is good and nurturing, keep out what
is toxic and dangerous. When you're suppressing your emotions, you're also messing with your
immune system because it's all one system.
It's almost like you're training your immune system not to protect you from the outside? That's what happens.
And that ought to turn against you.
Like anger that you repress
turns against you in the form of depression or self-loathing.
The same way that your negative thoughts
where you think you're to blame for all of the stuff going on
when you're a child that are not your responsibility
turns into the negative self-talk that's aimed against you.
Same way the immune system turns against you. Wow! That makes so much sense. Physiologicallytalk that's aimed against you. Same way they use it, sometimes against you.
Wow. That makes so much sense.
Well, physiologically, it's just a fact.
Now, why is it women?
Because who in this culture is programmed
to always look after everybody's emotional needs,
taking everybody's stresses,
identify with their duties and their role,
be nice all the time, not be angry in a healthy way,
and to take responsibility
for other people's feelings.
It's women.
It's not a gender issue.
It's a cultural issue.
And of course, the more stress that women experiences, the greater the risk of autoimmune
disease.
So if you look at minority women, they have a higher percentage because they're women
and they're minority.
I was just about to ask you whether or not there were studies for minority women and
people that are in first responder roles.
Many studies.
Yeah.
Many studies.
And in Canada...
It makes sense.
In Canada, an Indigenous woman has six times the rate of rheumatoid arthritis
than somebody else. And this is in a population that never used to have rheumatoid arthritis.
By the way, again, are we blaming people here?
No, we're not.
Because we have to look at what happened here.
What happened here is the child is born with all these emotions wired into their brains,
but the child has two big needs here.
The need for attachment, for belonging, for being held, for being accepted, supported
and so on.
That's a need that you have.
It's not negotiable.
Without it, there's an infant, there's a young child.
You die.
You die, yeah.
So, there's one need, but you have another need as well, which I call authenticity, which
means being connected to your emotions and your gut feelings.
Now, in any audience, when I ask people, have you had the experience of having a strong
gut feeling about something,
ignoring it and being sorry afterwards, most people put their hands up.
You probably would.
Now, gut feelings were programmed into us by evolution.
We evolved out in nature.
For millions of years, hundreds of thousands of years, we lived out in nature.
How long does any creature in nature survive if they don't pay attention to their gut feelings?
Not until the end of the day.
You're a goner.
At this point, so we have this two-need attachment and authenticity being connected to ourselves.
Now, if the child gets the message that they're being authentic with their emotions and so
on, they're not acceptable to the environment. Guess what's good?
In the contest between us and-
Oh, you're trained to not trust your instincts.
Yeah, and you're trained to disconnect
and you're trained to push down your feelings.
So we give up our authenticity
for the sake of attachment.
Now in your book,
there's an example of this guy who's about to get married.
Yes.
And it's got all these misgivings.
Yes.
And then he's afraid of what everybody else will think.
Yes.
And you tell him, and you're wishing
he would say no to the wedding.
Yes.
You know, what's going on?
He's stuck in this tension between attachment,
which is the need to be acceptable,
and authenticity, being himself.
Women are caught in that trap in this society.
So are many men, of course.
It's not just a gender issue,
but overwhelmingly, it's women who have to choose the attachment
to being acceptable over authenticity.
That's why they have much more on immune disease.
Wow, and often, I'd say for a lot of us,
we choose attachment rather than staying connected
to ourselves.
That's the whole point.
As a child, you have no choice.
The question is, as an adult, can we develop that choice?
Do I have to keep choosing the attachment
over the authenticity?
Well, you also hear doctors say that all
of these autoimmune disorders, diseases, whatever
you want to call them, flare up in moments of stress,
in moments of overwhelm.
And the main thing that they're treated with is steroids.
Yes, and take better care of yourself.
Oh, yeah, yeah.
Impress.
No, but here's what's interesting.
Typically for these conditions, we give cortisol.
A stress hormone?
Yeah.
Yeah, like if you go into the dermatologist and inflamed skin, they're going to give you
a steroid cream, cortisol.
If you go to a gastroenterologist with an inflamed intestine, they'll at some point
give you cortisol, stress hormone.
If you go with an inflamed nervous system, multiple sclerosis, they're going to give
you a stress hormone, cortisol.
I could go on, but we never ask ourselves, gosh, we're giving stress hormones to people.
Is it possible that stress may have something to do with their condition?
So doctors know that in cases of acute stress, that can flare up a disease.
That's clear.
Right.
What they don't recognize is those emotional patterns that I'm talking about, which stress
people chronically, but in less dramatic ways.
Because what's it like to always have to repress your anger to be pleasing other people?
It's exhausting.
That's the whole point.
And that's what the stress that I think often instigates.
You've abandoned yourself
and now your body function is abandoning you.
That's the whole point.
Is there good news here?
Yeah, the good news is if you change these patterns,
you can actually significantly affect
the course of your illness.
And I know lots of examples of that.
How can someone find the root cause of the emotional pain?
Or the, like how do you begin the process of healing?
Because you've now painted this landscape that helps us really understand the connection between childhood experiences and conditioning.
How that shapes your body, your brain function, your physiology, your immune system,
and how continued environmental stress
and continued abandonment of self
for the sake of being accepted by other people.
When you see all this, it's incredibly empowering.
What is one step that you would want someone to take if they're having an
awakening or they've been sent this episode by somebody who loves them and they're like,
this is me.
Okay.
So let's take one example.
Okay.
A very simple one.
Prior to your awakening and transformational journey that you undertook sometime in your
forties, how easy did you find it to say no to
other people's expectations?
Oh, I couldn't.
Okay.
So you couldn't say no?
No.
All right.
So I ask people this question.
Where in your life do you have difficulty saying no?
It shows up in two areas, work and in personal life.
Okay?
So you couldn't say no.
The second question I ask people then is, what's the
impact on you of your difficulty saying no?
It's exhausting. I don't like my own behavior.
Yeah. So it's this shame.
Lack of control.
Lack of control. Lack of control, by the way.
Anger. Blaming other people and making it their fault that I can't say no.
That's right. And loss of control is one of the most significant triggers for stress, by the way, according
to the stress literature.
Well, that makes sense because we have a biological hardwired need for safety.
Exactly.
Which we try to achieve by controlling everything and everyone around us.
Only because we learned in childhood that if we didn't, there'd be no safety.
If we learned that there was safety, we would trust the world a lot more,
and we wouldn't have the control.
So nobody's a control freak.
Nobody's born a control freak.
It's an adaptive trait is what that is.
But this is what I'm saying,
so that going through this exercise,
so what's the impact?
You identify some impacts.
Could also be frequent colds, illness, and so on.
The third question is, what's your belief that keeps you from saying no?
So when you had trouble saying no, what's the story?
What was the belief?
That I would get fired from my job and then we wouldn't be able to pay our bills and then
we would lose our house and then on and on and on and on and on.
Or they wouldn't like me or my mother would be mad at me or this would happen or that
would happen like the weight of the world on my shoulders.
Exactly.
So then the fourth question is,
how did you develop that story
that if I say no, I'll be rejected?
Where did you learn that?
I'm sure for me, even though I don't quite remember,
it was that I had, it was my job
to make sure everybody was okay in the house and that everybody was happy.
And that made me feel safe.
In other words, you learned it when you're two or three or four years old or five.
Yes.
And now you're adult, as you say in...
My book, that's why this has been such a game changer because when I say let them, I separate someone else's emotions and their expectations from what's my responsibility.
You're choosing authenticity over attachment is what you're doing.
Oh, I love that. You're right. I'm staying connected to myself.
That's the whole game. That's what I'm talking about here. So once you understand that you
learned the story when you were hypnotized into it as it's by the way, three or four year olds are in hypnotic states. That's why they believe that when they're playing
monsters, they're actually monsters, you know. So those hypnotic influences are really powerful.
They stay with us. So then the next question is, who would you be if you didn't believe that you
couldn't, that you mustn't say no. Would you be then? Free. Exactly.
Do that exercise once a week. Five questions to freedom.
It's in the myth of normal, there's a chapter on it.
This is the sixth question.
What is the sixth question?
Where you're not saying yes.
Oh my God, everywhere to free time, to play, to joy, to-
Creativity.
Creativity, to rest?
Well, that not saying yes is as harmful
as the not saying no.
So those two little words,
just that little exercise you do that once a week,
it changes people's lives.
You just, the sixth question.
What are you not saying yes to?
That one made my heart contract a little.
Okay.
Because that's where I really saw truly what I'm missing out on.
Yeah.
Where are you not saying yes?
To play and the rest.
I mean, I'm much better than I used to be.
As a matter of fact, I've told this story many times,
but five years ago I was in London giving a talk on my book,
When the Body Says No, and I was very articulate and adept on stage.
But personally, I was irritated.
I was working too hard.
I was driving myself too hard.
I was not kind to my wife.
And she said to me, her name is Ray.
And she said, buddy, you read the book called When the Body, buddy, you've written a book called When the Body Says No,
now you better write a one-call book when the wife says no.
And you know, so part of what has helped me
draw up these patterns, and I'm still working on it,
is because I love this relationship, I want to be in it.
And I don't want to be this person who's not saying yes.
I'm an 80, you know. Again, when you look at the top five reguettes of dying people, you know,
that book that I mentioned in another conversation, this was written by a palliative care nurse
who worked with dying people.
The top reguette was that I didn't have the courage to be myself.
And the third reguette was I didn't have the courage to express my emotions.
And the fifth reguette was, and I neglected my friends.
The fourth regret, and then the fifth one I think was I, I wish I hadn't worked so hard.
I wish I had played more.
I wish I had given more scope for the creativity and playfulness and childlike self that I
am, you know.
So I'm still looking for that one to develop it more.
I'm a whole lot better than I used to be.
Well, we're a whole lot better than we used to be
because of what we're learning from you.
Well, thank you.
Gabor Mate.
Wow. Any final things you want to say?
Everybody's got the capacity to heal.
As long as there's consciousness, there's the capacity to heal.
And for some people it's tougher, there's the capacity to heal.
And for some people it's tougher because they don't have the resources.
But you know, you can go on YouTube, lots of my talks on YouTube, people have told me
that's changed their lives for the better.
That didn't cost a penny.
And not just my talks, by the way, talks by other wonderful teachers, some of my colleagues,
some spiritual teachers.
That doesn't cost any money to watch that.
You can take books out of the library.
That doesn't cost a penny.
And that can be very helpful.
You can learn to meditate and be with yourself and observe your mind.
That can be very helpful. There's free meditation instruction on the line
or in the many books.
Those people that can afford therapy,
if it's the right kind of therapy,
they can address these issues.
They can connect with nature.
Nature's got a huge healing capacity.
As our indigenous people really know, we can learn a lot from them about connecting with nature. Nature's got a huge healing capacity. As are indigenous people, we really know.
We can learn a lot from them about connecting with nature. Those people that have the capacity
to get out of the city or even go to a park and connect with the plants and the trees
and the flowers. That sounds hokey, but it's hugely healing. Exercise, giving your body
what it needs, eating the proper food if you can afford it.
And most people, may not be able to afford the best foods, but they could probably afford
to eat better than they do if they paid attention to themselves.
So all those things are not inaccessible.
So in other words, healing is possible, it's available to all of us, and it just takes the decision to embark on that path.
Well, you've empowered us to make the decision today.
Yeah.
Thank you, thank you, thank you.
Well, thank you.
It's amazing to spend time with you.
Yeah, thanks.
There are so many people
that I want to share this episode with.
I feel empowered and excited for you.
And so I just want to thank you for listening all the way
to the end and sharing this with people that you love.
And I also wanted to be sure to tell you,
in case no one else tells you, that I love you
and I believe in you.
And I believe in your ability to create a better life.
And listening to this today is certainly going to help you take the steps to create a better life. And listening to this today is certainly going to help you
take the steps to create it.
And I will be waiting for you in the very next episode.
I'll see you there.
[♪ Music Fades Out.
So, Dr. Oh my God.
Okay.
And then I look at the bottom and it's like, wow, wow, wow.
Thank you.
Wow.
Fantastic.
I'm the one that says fantastic, right?
Okay.
Do you need me to do those?
Okay.
Great.
Great.
Okay.
Great.
Great.
Great.
Wait a minute.
Yeah.
Okay.
Hold on.
Oh, sorry.
There's a helicopter.
That's okay. We're in it. I'm like, wait, wow. Fantastic. We got it done. You like that? Okay, great. All right.
That's it.
We're wrapped. Well done.
Oh, and one more thing.
And no, this is not a blooper.
This is the legal language.
You know what the lawyers write
and what I need to read to you.
This podcast is presented solely for educational and entertainment purposes.
I'm just your friend. I am not a licensed therapist and this podcast is not intended
as a substitute for the advice of a physician, professional coach,
psychotherapist or other qualified professional. Got it? Good. I'll see you in the next episode.
qualified professional. Got it?
Good.
I'll see you in the next episode.
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