Dr Gabor Maté on Childhood Trauma, The Real Cause of Anxiety and Our ‘Insane’ Culture

Martin Caparrotta
By Martin Caparrotta
Updated on 24 September 2020

Dr Gabor Maté is a renowned expert in addiction, childhood trauma and mind-body health.

In this interview, we spoke about a wide variety of topics, ranging from how he believes that most mental health conditions originate from unresolved childhood trauma, to why he describes current Western culture as ‘insane’ because of its failure to meet basic human needs.

He went into detail about what he sees as the root causes of conditions such as anxiety, panic attacks and fibromyalgia. We also spoke about the process of reconnecting with your authentic self.

Amongst other things, we also discussed his experience of working with plant medicines such as Ayahuasca.

Dr Gabor Maté has written four bestselling books. In The Realm of Hungry Ghosts: Close Encounters With Addiction, Hold On To Your Kids: Why Parents Need to Matter More Than Peers, When the Body Says No: The Cost of Hidden Stress and Scattered Minds: A New Look at the Origins and Healing of Attention Disorder. Click here to buy on Amazon.

It was a real privilege to spend some time speaking to Gabor in London to gain some valuable insights into such an important range of topics.

Editor's note: The content on this website is meant to be informative in nature, but it should not be taken as medical advice. Our articles and the products featured in them are not intended for use as diagnosis, prevention, and/or treatment of health problems. Always speak with a certified medical professional before making any changes to your lifestyle, diet, exercise routine, and/or taking any supplements.

Gabor, thanks very much for taking the time to speak to HumanWindow. You’re known as an expert in addiction, childhood trauma and mind-body health amongst other things. They sound like different topics but I guess your work ties them all together in some ways. Could you give us a bit of a background on your journey and explain how you first became interested in the field?

Sure, but in a certain sense I’m an absolute imposter, because I write all these different books and I speak in many different countries and talk about addiction, child development, stress, health and parenting… and I’m only saying one thing. When you treat children well, they’re going to be OK and if you don’t treat them well, they’re not going to be OK. It’s a very simple message that anybody’s great grandmother could have told them. The fact that this message is even necessary is a sign of the times.

As a family physician, you get to know people in their lives. You get to know families and different generations of families. You get to see who gets sick, who dies and who stays healthy. You get to see inter-generational dynamics. That led me to notice that who got sick and who didn’t, who got addicted and who didn’t, who had mental illness and didn’t – these were not accidental occurrences. There were causes in peoples’ lives. At the same time, during my mid-30s when I began my medical career, by the time I was in my mid-40s, I was very aware that I was not a very happy camper. I had depression myself. For all the success that I had, I wasn’t any happier than I had been.

I had problems with my own family – my children and my marriage, and so on. I had to look at the sources of that.

Whether I was looking at my clients, whether I was looking at my own history and trying to understand myself, I got to understand that so much of what people suffer from, whether it’s a physical illness, mental illness or an addiction, relates to childhood experience.

You couldn’t help but notice it. Then I discovered that there was a vast literature on the subject as well. People had studied trauma and child development, and the relationship with stress and health. And I began to look at the literature and develop my own ideas and understanding. It began with my own personal experience and my professional observations.

A lot of what you talk about is childhood trauma. What’s your definition of trauma?

It’s important to define it actually, because people use the word like ‘god’ and who knows what somebody means when they say ‘god’. It could be a punitive, dictatorial father figure with a white beard and somebody else might mean the essence of pure love in the world.

The origin of the word ‘trauma’ is the Greek for ‘wound’. Trauma is a wound. How I think about it is that if I wounded you, if I cut your flesh, the healing would involve scar tissue forming. If the wound was great enough, you’d get a big scar, and it would be without nerve endings so you wouldn’t feel, and it would be much less flexible than your normal tissue. Trauma is when there is a loss of feeling and there is a reduced flexibility in responding to the world. This is a response to a wound.

Trauma is a psychic wound that hardens you psychologically that then interferes with your ability to grow and develop. It pains you and now you’re acting out of pain.

It induces fear and now you’re acting out of fear. So without knowing it, your whole life is regulated by fear and pain that you’re trying to escape from in various ways.

Trauma is not what happens to you, it’s what happens inside you as a result of what happened to you.

Trauma is that scarring that makes you less flexible, more rigid, less feeling and more defended.

Gabor Mate on The Tim Ferriss Show (Photo: The Tim Ferriss Show / YouTube)

Gabor Mate on The Tim Ferriss Show (Photo: The Tim Ferriss Show / YouTube)

I’ve heard you mention in the past that we live in a highly-traumatised society. How widespread is trauma in society these days?

Well, if you look at the rates of overt trauma such as childhood sexual abuse, emotional neglect, stress in families that traumatises children… it’s widespread. Very few people really grow up full untraumatised in this culture.

Especially with the increasing stresses on people and the burgeoning of loneliness, so when they do suffer, they are alone with their suffering.

This is a highly stressed and traumatising society. And you can’t separate that from social-economic factors.

With neoliberalism and loss of peoples’ meaningful and secure employment, austerity, loss of communities – not only are more people stressed and traumatised, they’re also less resilient because resilience requires connection and communal support.

Since having explored my own issues, it’s become clear that we all have been traumatised to some extent. How do you think the majority of people understand trauma and how would you like that to change?

Well, first of all they don’t [understand trauma]. They think of it as maybe a tsunami or a bombing. Those are certainly traumatic events, but that’s how most people think of trauma, as something horrendous happening. They don’t think of it as an internal psychic wound that then limits their capacity to live as fully as they might, which is what trauma actually is. Worse than that, the average medical student doesn’t even hear the word ‘trauma’ in their education. They don’t hear the word! It’s not that they don’t get a lecture on it, they don’t hear the word, not in the sense that I’m talking about it.

They might hear about physical trauma but they will not hear of psychic trauma, except in the narrow field of post traumatic stress disorder, which some psychiatrists do learn about. Trauma which affects the average person, that’s not even thought about in the medical lexicon.

The legal system knows nothing about trauma.

So when all these traumatised people come in front of judges and lawyers, who are there because they were traumatised, who are now doing drugs or being violent and acting out their trauma, they are simply punished, rather than the system getting that these are really hurt people.

They could be rehabilitated if given the right support. The legal system doesn’t get it, the medical system doesn’t get it, the education system doesn’t get it, the politicians don’t get it. It’s a huge problem.

You spoke at your talk last night about how losing the connection to ourselves in childhood is responsible for many of our problems as adults. Could you give us a bit of an idea of how that happens?

When I talk about connection to oneself, I’m talking about something very simple. It’s an organism’s capacity to know what it feels and to be able to respond with emotions that are appropriate to the present moment.

Without that capacity, you can’t survive. If an animal does not have have a connection to itself and doesn’t know what it feels, it can’t respond to threats – it’s going to be dead.

The same with human beings in evolution. When I talk about being connected to ourselves, I’m talking about actually knowing what we feel and experience in a given moment, and being able to interpret that appropriately. Without that capacity, we’re lost. We were born with that capacity – you’ve never met an infant who’s not connected with its gut feelings.

By the time you talk to adults, you find many people who even if they have their gut feelings, they ignore them. Something happens between infancy and adulthood that disconnects us. What that is, is our need for acceptance by our environment.

Dr Gabor Maté and Martin Caparrotta

Dr Gabor Maté and Martin Caparrotta (Photo: Kieran Beckles)

If our environment cannot support our gut feelings and our emotions, then the child, in order to ‘belong’ and ‘fit in’ will automatically, unwittingly and unconsciously, suppress their emotions and their connections to themselves, for the sake of staying connected to the nurturing environment, without which the child cannot survive. A lot of children are in this dilemma – ‘can I feel and express what I feel or do I have to suppress that in order to be acceptable, to be a good kid, to be a nice kid?’

Furthermore, if the parents themselves are not in touch with their feelings, they can’t tolerate the child’s feelings because they threaten them. The parent reacts against the child for having anger – and the child learns, I mustn’t express what I feel, because I have to belong to my parents. If I don’t who will protect me and nurture me? Automatically we disconnect from ourselves, in order to continue to be looked after. It’s a tragic choice. It’s not even a choice – the child’s not aware of making a choice. It’s an automatic process.

Then we get into adulthood, and all of a sudden we say ‘I don’t know who I am’. Especially people in mid-life – they realise that they’ve been living lives that were not their own lives at all. They did it all because they got disconnected.

Eighty per cent of males in Canada said they were stressed by their jobs. The economy needs people that are going to do meaningless jobs with circumstances that are intolerable but they’ll put up with it. There’s a confluence between the needs of the economy and the way we parent kids.

The more disconnected kids are, the more they can fit into the economy that doesn’t care about human feelings, but only cares about profitability and production. It’s just a cycle that keeps going.

Your new book is going to be called ‘The Myth of Normal: Illness and Health in an Insane Culture’. Just how insane is our culture?

Well, it depends on how you want to define ‘sanity’. If you look at sanity as something that’s congruent with human nature and human needs… Human needs for meaning, connection, validation, belonging and transcendence. These are human needs.

This society is insane because it utterly tramples on those human needs.

That’s what makes it insane. When somebody’s normal in this society, they are conforming to an insane standard, hence the title of the book.

I’m writing another book with my son, and it will be entitled ‘Hello Again: A fresh start for adult children and their parents’. Very often adult parent-child relationships are so fractured that by the time they become adults, we don’t even know how to relate to our parents and visa versa. That book is about bridging that inter-generational gap and helping each generation to take 100 per cent responsibility for their role in the dynamics.

Some of my close friends have struggled with anxiety and panic attacks. These are guys in their late 20s and early 30s. Do you think this is always rooted in childhood and is there any practical advice you’d give to someone who is trying to get to the root of it?

Sure. So in general I believe that most, almost all, mental health disorders originates in childhood experience – and it originates as a coping mechanism. If you look at anxiety, if I were to pull a gun on you, you would not be anxious, you’d be afraid, as you should be. When are we afraid? When we’re threatened with something.

Either something bad happened to us or something that we need is threatened to be taken away from us.

In the young child’s early life, anxiety is an attachment alarm. What is the child’s biggest need? Attachment with the parent, and connection with the parent. When the parent’s not around the child should feel some fear. That serves a positive purpose. When the child feels fear, he cries. And that brings the parent. Look at the mother cat responding to the kittens’ cries – it’s immediate.

It’s the same with human beings who are still connected to the parenting instinct – they will respond to the child’s cry for help. That fear is adaptive. It’s a coping mechanism.

But what happens to a person whose parents are taught by medical experts not to pick up their kids when they’re crying? Now that natural fear which causes the crying, which brings the parent and ends the anxiety is embedded in the child. So what begins as a coping mechanism, now becomes generalised.

Under certain circumstances, there should be fear and anxiety. But when I have this anxiety when there is no immediate threat – what is that about? It’s not a response to anything external, it’s the embedded anxiety that I developed as a child.

In a society that makes people more isolated all the time, where human social contact is replaced by the rather cold and impersonal world of the internet. And where young people have less opportunity for meaningful employment and belonging than their parents used to – there is a more general threat.

When that general threat hits people who are in childhood over-immersed in anxiety that’s not relieved by the parent coming to help them, now you’ve got an anxiety situation.

When it comes to your friends with anxiety, I would get them to really look at their childhoods and to recognise that the anxiety is really the desperate cry for help of some childhood part of themselves – and to learn to get help for that part, not just to drink booze or take tranquillisers not to feel the anxiety.

To actually see that the anxiety is a normal response on their part to what actually happened to them. And that it can be relieved and recovered from if you look at its sources.

Dr Gabor Maté interview

Dr Gabor Maté speaks to Martin Caparrotta (Photo: Kieran Beckles)

What advice would you give to someone who is just ‘waking up’ to some of the things your talking about, their own issues, and beginning to explore the root of them?

Continue. It’s an ongoing journey, as I’m sure you know yourself. But I’ve written my epitaph – carved on my gravestone, it’s going to say ‘it was a lot more work than I had anticipated’. It’s a lot of work, but it’s necessary work and it’s beautiful work because it really puts you into your life in a real way. It enriches your relationships. The more you get to know yourself, the freer you are. That’s why Jesus said, ‘you will know the truth, and the truth will free you’.

Jesus was a great psychologist, as are all the spiritual masters. He also said in the Gospel of Thomas that whatever you bring out of yourself will free you and whatever you don’t bring out of yourself will kill you.

All these stuff that we’re carrying can be unpleasant, scary… as much as we judge ourselves for having these issues, if we approach ourselves with some genuine curiosity about what it’s all about and with some compassion, it can be tremendously liberating.

So if you’ve begun that, continue it. And there are many paths. Also, honour your body. Make sure you eat well and get out into nature and exercise. Do body work like Yoga, martial arts or something else. Align your psyche with your body and get to know them both.

You’ve worked with Ayahuasca in recent years. Could you give us a bit of a background about your work with plant medicine and the role you think it can play?

Ayahuasca specifically is a plant that grows in the Amazon basin in Peru, Colombia, Brazil and Ecuador.

The shamans there, of different ethnic backgrounds by the way, have been using the plants for at least hundreds, possible a thousand years or more in ceremonial context as a healing agent. Ayahuasca is really the combination of two plants which are boiled and mixed together by the shamans.

It has the capacity, and this has been shown on brain scans, to open up areas of the brain that carry childhood emotional memories and also adult insight. To put it in a very simplistic nutshell, under the proper circumstances, when you do the Ayahuasca, you can relive your childhood experience with the insight of an adult.

You may experience visions along the way. I don’t much. I wish I did, I wish some jaguars would come and talk to me, but so far they haven’t! A lot of people do and those always have a meaning. That meaning is not magical, that meaning has to do with some dynamic within yourself. The anaconda or the jaguar becomes a symbol for something inside of yourself and how that connects to nature as well.

We come from nature, we’re part of nature, and certainly in the Amazon, people are very related to nature. Through these visions, the childhood emotional states, the joy and the bliss, or the fear and the terror and the pain, you get to know your true nature. And you get to make friends with it, accompanying it with the insight of the adult.

That’s a somewhat romanticised version of what happens. Sometimes all you get is a stomach ache and you throw up. It can be very difficult indeed for some people with the fears and terrors arising within them.

But in the right context, with the right support and guidance, they can be deeply meaningful experiences. It’s not unusual to hear people say that those ceremonies gave me more than 10 years of psychotherapy ever had. I get that all the time.

They are not for everybody. You are either called by it or you’re not called by it. Nobody should force themselves and certain people should not do them.

Certain medications are not compatible with it. But for certain people, they can be profound journeys into the soul.

Gabor Mate

(Photo: Gabor Mate / Handout)

I know a few women who have recently been diagnosed with things such as endometriosis and fibromyalgia. Again, would you say conditions like this are always rooted in childhood development?

Only 100 per cent of the time. If you actually speak to these women with endometriosis or fibromyalgia, these are physiological processes, but we know from science and intuition, that the mind and body cannot be separated. These people invariably suffer from severe stress.

Those stresses have to do with suppressing the self that actually began in childhood as a coping mechanism. I’ve known people who have healed themselves from endometriosis or fibromyalgia and even more threatening conditions through the process of deep self work with the appropriate support.

For those people suffering from endometriosis and fibromyalgia, I really urge them to read my book ‘When the Body Says No’ because my contention is that their so-called disease is actually the body saying ‘no’ to stresses in their lives that they have not said ‘no’ to.

I would invite them to look at their relationships, especially with their partners. How much of their partner’s stress do they take on? How much of a people pleaser are you? How nice are you to people no matter how you feel? How much do you take on the problems of other people and ignore your own? How well do you know yourself?

Where are you not saying no when you want to say ‘no’ but you’re afraid to? If they engage with those questions, their bodies will respond very positively.

What advice would you go back and give your 18-year-old self?

Put the focus internally. As an 18-year-old, I was very focused on fixing the world. There’s nothing wrong with that, but it was also an escape from the immense distress I was carrying inside without looking at it. Socrates said that the unexamined life is not worth living, which is true.

I would say, get to know yourself. Get curious – curiosity means that you really don’t know and that you’re open to finding out and any kind of outcome. That takes a lot, because people are afraid of what they will find. Donald Trump and Hilary Clinton both said that they don’t want psychotherapy because they don’t want to find out stuff about themselves that they’re afraid of.

I’d say to my 18-year-old self relax, the world is benign, it will support you, you just need to support yourself and get to know yourself. Put as much attention internally, not on your selfish needs, but on your real needs, as you do on the outside. Don’t neglect the one for the other.

Where’s the best place for someone to find out more about your work and buy your books?

The books are available in book stores. They are published in Britain now and apparently they are selling quite well. They are also available on Amazon.

In terms of my own work, I have a website, drgabormate.com. Dozens of my lectures have been filmed by people and put on YouTube on topics such as the ones you and I have discussed.

I give an online course now called Compassionate Enquiry, which is a deep dive into the self. It’s mostly for people who work as therapists and so on. But there will be a laypersons version available in a few months.

It’s easy to find me and my work. I really am fortunate to say that even if I should find myself disabled from working or suffer my demise, there’s enough of my work out there that people will be able to find it for a long time.

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