Gabor Maté: The Roots of Healing

Tami Simon: You’re listening to Insights at the Edge. Today my guest is Gabor Maté. Dr. Gabor Maté is a renowned speaker and bestselling author, and is highly sought after for his expertise on a range of topics including addiction, stress, and childhood development. Gabor Maté has written several best-selling books including the award winning In the Realm of Hungry Ghosts: Close Encounters with Addiction and When the Body Says No: Exploring the Stress-Disease Connection. He’s also the cofounder of Compassion for Addiction, a new nonprofit that focuses on addiction.

In this episode of Insights at the Edge, Gabor and I spoke about the immune system and how it is connected to healthy, emotional expression, and why it matters so much that we own our healthy anger and express it. We also talked about how our body can function as a teacher, and how he views such diagnoses as ADHD and depression, and how his views differ from the way the medical community views those conditions. We also talked about understanding healing through a bio-psycho-social lens and how a great number of mental health issues can actually be traced to childhood compensation. Finally, we talked about what Gabor is currently focusing on as he enters his 73rd year of life. Here’s my conversation with the very direct and brilliant Dr. Gabor Maté:

Gabor, I want to just begin by thanking you for making the time for this conversation. I know how busy you are and I feel appreciative. Thank you so much.

Gabor Maté: Well, I look forward to our talk.

TS: Okay, let’s jump right in. I wanted to begin by talking about you, and particularly your early years in Budapest. You were born in 1944, a Jewish infant under German occupation at the time [in] Budapest. And what I’m really curious to know is a little bit about your early life experiences and how you feel they’ve informed your work?

GM: Yes. So, I was born in January ’44, and when I was two months old the Wehrmacht, the German army, occupied Hungary, including Budapest, the capitol city. The extermination of the Jewish populations that had been nearly complete across eastern Europe had not yet touched Hungary, but now with the German occupation, it was our turn. So within five months, Nazis exterminated half a million Hungarian Jews, mostly in Auschwitz, but elsewhere as well. Amongst them my maternal grandparents.

Adolf Eichmann, the SS organizer of the deportations, said that the operation “went like a dream.” He killed more people in a shorter period of time than he had been able to anywhere else.

In Budapest, which is in the center of the country, the Jews were not deported because the Germans exterminated, deported the Jewish population of Hungary in a concentric fashion, starting from the outside of the country and moving in towards the center. And just before they got to the center, which is where my mother and I lived, international outcry has been so vociferous, including messages from the Pope and Franklin Delano Roosevelt, that the Hungarian government actually put a stop to the deportations. But we lived under Nazi occupation for the remainder of that year and into the beginning of the following year.

The salient story that I tell for most times because it did inform so much of my work, is that the day after the German army occupies Budapest, my mother calls the pediatrician to say that, “All my Jewish babies are crying.” No, I’m sorry—I’m running ahead of myself. She calls the pediatrician to say that, “Would you please come see my son? Because he’s crying all the time.”

And the pediatrician says, “Of course I will come, but I should tell you all my Jewish babies are crying.”

And so that anecdote told by my mother speaks to the very essence of childhood experience, which is to say that what happens to the parents happens to the child. And A. H. Almaas, who—and to you, with you, I greatly appreciate it [audio cuts out] says in one of his books—and I’m quoting here now, and I quote this very often; in fact, he may be the person I quote most often. He says, “The child is very open and can feel the pain and suffering going on in its immediate environment. The child is aware of its own body and can also feel the tension, rigidity, and pain in the body of the mother or of anyone else he’s with. If the mother is suffering, the baby suffers too. The pain never gets discharged.”

So that insight and coupled with that anecdote has informed a lot of my work, whether it comes to physical illness or addictions, or any other affliction that human beings might face.

My father came back from forced labor and my mother hadn’t known whether he was dead or alive for almost a year and a half. The Germans were finally expelled from Budapest by the Russian army in January of 1945. But not before—a month before the liberation of Budapest, my mother had handed me to a complete stranger in the streets of Budapest because she could no longer guarantee my survival. Jews were again, being deported and killed by Hungarian Nazis. She didn’t know when it would be her turn and so she gave me to a strange woman in the street, and I didn’t see her for a month.

Which then ingrained in me a life-long sense of abandonment and loss, which at age 73 still shows up sometimes in my relation with my wife. You want me to go on with my childhood?

TS:Well, I’m curious just to understand something a little more clearly. When you read that quote by A. H. Almaas and the idea that the parents’ pain, particularly in this case the mother’s pain, is felt and passed down almost like the child is transparent to it and takes it in, and you said this has informed so much of you work, tell me how? How has that idea influenced how you work with patients, how you work with addiction?

GM: Sure. So, a number of things happen. First of all, the child—the Buddha said at some point—in fact the very first quote in the Dhammapada, the collection of his sayings, is something like, “With our thoughts, we create the world.” I’m paraphrasing, but that’s what he says, basically that our thoughts create the world that we live in. But what it didn’t say, which is really the insight of modern psychology, is that before with our thoughts and our minds we create the world, the world creates our minds.

So then the question is—there’s a man right now, for example, who says that “The world is a horrible place,” I’m quoting directly. Well if we live in a world which is a horrible place, you’re going to have a certain attitude towards the world and a sort of way of conducting yourself. This man has just been elected president of the United States, and he lives in a world that’s horrible.

Now, how does a child get a sense of what the world is like? We get it from our earliest experiences. So, what kind of a world did I get? I got a world in which, first of all, there is unexplainable suffering for which I have to compensate somehow, and one way of compensating for suffering, or enduring it or dealing with it, is to dissociate, to tune out. If you look at the burgeoning diagnosis of Attention Deficit Disorder in our society and the number of kids being diagnosed, what’s really happening is that parenting circumstances have become so stressful, and because the parents are stressed, the children are stressed; these children are tuning out to protect themselves at a time when their brain is developing. And now they’re being diagnosed left, right, and center with a so-called medical disease, an inheritable medical disease, which is neither a disease nor is it inheritable. It’s actually a normal response to an abnormal circumstance of parental stress. So what I’m saying is that a lot of the adult dysfunction mental illness and physical illness that I see is actually the outcome of childhood coping mechanisms.

Now, the other thing that happens is that children are narcissistic. And I don’t mean that in any negative sense, I mean in a purely clinical sense, that they think it’s all about them. So when bad things are happening, the child will believe that it’s about him, or her. And then we have to compensate for that. Furthermore, when my mother—and how do you compensate for it? Well, you compensate by developing all kinds of coping mechanisms. Almaas talks about the “Theory of Holes” in where our essence isn’t developed or recognized, we develop a hole which then we try to fill in with the false personality. So really, what we call our personalities and patterns are really finding their origin in coping patterns, to cope with the early pain and stress.

And, for example, one way to cope, if your parents are not able to appreciate and accept you the way you need to be—I’m not talking about whether they’re doing their best or they love you or not, but one way to compensate for that loss is to be extra nice to everybody and to look after everybody else emotionally. These are the people that develop autoimmune disease, for reasons that we can discuss. But in everybody with those kinds of diseases, I find the same kind of childhood patterns and the same kind of childhood experience.

Can I just say one more thing? Because Tami, when you start talking me on this subject, I can keep going for two days, but I’ll mention one more thing.

My mother then gives me to a stranger at one year of age. Now, how do I interpret that? I cannot know that she’s doing this to save my life, all I’m experiencing is the abandonment. Which means, a) I’m being abandoned, b), I’m not wanted. Now, that sense of abandonment then will show up in my marriage relationship decades later at the slightest instance, number one. Number two, if I’m not wanted and need to compensate for it, one way to compensate is to become a really successful medical doctor where people are going to want me all the time. Now that being wanted, in the deepest sense, is never satisfied by anything externally. Which is why it’s addictive—you just keep going for it and going for it. So therefore, now I’m a workaholic doctor and when the beeper goes, when the cellphone goes, and people want me to look after their illness or deliver their child, or take care of the dying person in the family, every time I want it. Therefore, I become a workaholic.

What then, is the impact on my family of a father who is away a lot because he’s needing to have his existence validated because his sense of worth was undermined when he was a year old? Nobody’s fault in the family—it’s just the way it went. So, what I’m saying is that addictions, physical illnesses, mental illnesses, all originate—well all, I say, most of them originate—in coping patterns that people adapt early in life but which then become sources of dysfunction later on.

TS: Now, one more clarifying question that I want to ask. You mentioned about your abandonment and sense of being left, and how that still comes up in your marriage, even now when you’re in your 70s, and here you know so much about transformation and healing. You’ve been exposed to so many techniques and teachers. What does that tell us about the process of growth and transformation? It still comes up? I think sometimes people have unrealistic ideas about what the human journey is going to be like and the level of healing that they’re going to have in their life.

GM: Well I think it’s Eckhart Tolle, who you also know very well, who said that—I’m paraphrasing here, but that, “Transformation, or enlightenment, for some people is an event, but for most people it’s a process.” So for him it was an event; he was in the depth of despair and then he woke up a different man the next morning. That’s not the say that his work ended there, but he did have a transformation that was almost instantaneous.

Now for me, and for most people I know, it’s not an event, it’s a process that happens over time. It’s [a process] of clarifying and going deeper and deeper and closer and closer to your essence. And that takes time. In fact, I have my epitaph already composed.

TS: Oh, please tell.

GM: Yeah, it’s gonna say, “It was a lot more work than I had anticipated.” [Tami laughs.] Because you know that process of transformation, for most of us, is work, and it also tells us that it is not an intellectual process. So it doesn’t matter how many times I read Adyashanti or read Eckhart or read Almaas or listen to Reginald Ray or any number of great teachers—or the Buddha himself, or Jesus. And it doesn’t matter how well I understand intellectually; it has to happen on a deeper level. So, insight and knowledge is helpful and—but as I said in one of my talks, if intellectual knowledge could lead to enlightenment, I would have been enlightened a long time before.

TS: Now, you also mentioned that through your work with clients and your research that you’ve seen some corollary between certain autoimmune diseases and early coping strategies that people develop. And you mentioned that we could talk more about that, and I think it’s important to clarify exactly what you mean. And really, I’d love to understand more how you see the immune system, and what supports a healthy immune system and what coping strategies do just the opposite and make us vulnerable at the level of our immune system?

GM: Well, the first thing you have to understand is that the immune system is not a separate system. So that’s modern science—quite apart from the insights of traditional medicinal practices around the world: Chinese Qi medicine and Indian Ayurvedic medicine and shamanic practices internationally, have always taken it for granted that mind and body can’t be separated. Now, Western medical practice separates mind from the body. George Engel, who’s a Harvard psychiatrist, back in 1970s wrote [that] there’s a kind of mind-body dualism that pervades medical practice. He called for a new model that was more of a unitary model, and that was 40 years ago. Well, his words have not been heeded yet. So we still practice this separation model.

In fact, science has shown—I’m talking about hard science now—has shown that the immune system and the emotional apparatus called the psyche, the hormonal apparatus, and the nervous system are not separable; they’re actually one system. They’re different manifestations, different variegations of the same system. And that’s because as a complex being, we have to have complex, specialized activities to keep us in balance internally and to protect us externally. But they’re still the same system; therefore the immune system is not separable from our emotional apparatus. So when things happen emotionally, they inevitably have an impact on the immune system as well. That’s just how it works. And that’s not a miracle, it just couldn’t be any other way.

And I’ve written about, in one of my books, about the actual science that shows that these so-called separate systems—nervous system, hormonal, immune, and emotional systems, and I should also throw in at least the gut and also the cardiovascular system—they’re not separable at all. They’re just different manifestations of the same process whose function it is to keep our internal homeostasis, our physiological, psychological, and biochemical balance, and also to modulate our relationships with the external world.

And so when people suppress themselves emotionally, and they do that as a coping mechanism—let’s say that you’re two years old and you have a tantrum. Well, there’s nothing wrong with being two years old and throwing a tantrum because as a two year old, you can’t help it. You don’t get the cookie before dinner, you might throw a tantrum. But you shouldn’t have the cookie—if your parents are doing their job, they’re not gonna give you a cookie before dinner. So you’re gonna have a tantrum. But what if your parents grew up in a home where there was a lot of rage? Your parents are terrified of rage? So they give you the message that good little girls don’t get angry. The message that you get is angry little girls don’t get loved. So to maintain your relationship with your parents, then, you—or your brain actually, automatically, not you consciously but your brain—automatically now will repress anger in order to maintain a relationship with parents who can’t handle your anger. Because the maintaining of that relationship is the only way to ensure your survival.

So you repress that anger. It’s been shown in study after study that repression of anger also represses the immune system. For the very simple reason that a) the two systems are part and parcel of the same super system, number one. And number two, healthy anger and the immune system both have the same function, which is to protect you. When you’re suppressing your self-protection in one way, you’re suppressing it in another way as well and that same system will then turn against you. Now you got an autoimmune disease. And when I interviewed people with scleroderma, or colitis, or Crohn’s, or multiple sclerosis, or rheumatoid arthritis, or any number of autoimmune conditions, it’s all the same pattern. In childhood, they learned not consciously, but automatically to repress themselves, and that the emotional repression then disorganizes the immune system.

TS: Can you help me understand that very last thing you said, how the emotional repression disorganizes the immune system?

GM: Well, it’s been shown, for example, that women who repress their anger, they have less activity of a group of immune cells called natural killer cells. And these natural killer cells have the job of fighting foreign invaders like bacteria and viruses, but also malignancy, which is a foreign body in the body. So people who repress healthy anger also are suppressing the activity of their natural killer cells, which means they’re more prone to illness, including cancer. That’s just one of other examples.

TS: Sure. I’m feeling so good about being angry, there’s no end to this, Gabor. I’m gettin’ very happy over here. I like, you know, being in touch with healthy anger.

GM: Yes. There’s unhealthy anger which can also kill you. So in the aftermath of a rage episode, your risks of heart attack or stroke double for the next two hours because now you have too much adrenaline, your blood vessels are narrowed, there’s more clotting factors, your blood pressure goes up. So unhealthy anger also raises your risk of illness.

TS: So distinguish for our listeners between healthy and unhealthy anger and how I know the difference.

GM: Well, I think in one of his books Eckhart gives a beautiful example of what if human beings were like ducks? I don’t know if you remember that passage where he talks about, on the pond two ducks—one swims across, the other one swims too close to the other one. So the first duck will then quack and rustle his feathers and ruffle his feathers and chase the other duck off. But when he does that, it’s over, it’s finished. That’s healthy anger—it’s a boundary defense. But then Eckhart says, “What if the duck was like a human being? Then when the incident was over, the anger would continue, and he would say to himself, ‘Boy, that guy, he’s always coming near me. He did it last week, what’s wrong with him anyway? I bet next week he’ll do it again. I hate that guy.'” That’s the unhealthy anger.

Healthy anger is in the present and it has the job of boundary defense, which you need. We have a system in our brain that’s specifically for rage, and healthy rage is simply a boundary defense. All animals have it. But unhealthy rage has not to do with the present or self-protection; it has to do with recruiting negative memories from the past and projecting them into the present and the future. So there’s no end to it. So there’s no resolution of it, there’s no regulation of it.

So there’s healthy and unhealthy anger. The first is present-based, it’s a boundary defense. The second is past-based and it’s self-magnifying.

TS: In your book When the Body Says No, where you go into quite some detail about this mind-body functioning in the immune system, you say that one of the things we need to stay healthy is something you call “emotional competence.” And I think as you’re talking here about healthy anger, you’re pointing to an aspect of emotional competence, but I’m curious to know what emotional competence looks like to you in someone? When you say, “Oh, that person, they’re emotionally competent. Here’s what the competency looks like.”

GM: Well. It means that we’re in the present. And that we don’t take things personally. And it means that our response to the situation corresponds to the needs of the present moment and is not governed by past impressions and past hurts and past experiences.

So if you say to me “Gabor, I’m bored with this conversation,” I would take that as a statement about you. I would not let it undermine my sense of value of myself. I would not get angry with you. I would just say, “Huh. Well I’m curious why you say that? What’s happening for you?” But if I’m not emotionally competent, then your statement that you’re bored talking with me will simply reinforce my deficient sense of self, my hurts, my abandonment circuits might get triggered again, and I may even go into a rage as a way of protecting myself from that sadness and the disappointment. Which is not emotionally competent at all. So it really has to do with being in the present.

TS: But you said a qualifier about being in the present and having the experience and it being impersonal and I was kind of with you, and then you said, “And not being governed by”—I don’t think you exactly used the words “past conditioning,” but by past experiences we could say traumas that the person has experiences in the past or previous disappointments, something like that—anything from the past. And I thought, “Wow. That’s competence? That sounds like being an emotional genius to me. I mean, that’s a lot.” How many people don’t have their emotional experiences colored by something that happened in the past? That’s a pretty high bar.

GM: Fair enough. Thank you for calling me on that. Well, I can climb down from that high perch for a moment and add another layer, then. It simply means that when things do get riled in you, you are aware of them. So, let’s give you an abandonment example that I gleefully cite these days. I’m 73 now but let’s make it when I was young and stupid, two years ago when I was 71. And I arrive home from Philadelphia from a speaking trip, back to Vancouver, BC where I live. My wife, Rae, is going to pick me up at the airport but—and I’m feeling really good about myself ’cause I gave a good talk, good response, the airline bumped me up to first class on the way home, I couldn’t be feeling better. And I think, “Boy, I finally got it, you know? I’m just in a good space.” It’s always a setup for a problem.

I land, the airplane lands, and I get a text from my wife that says, “I’m still at home, do you still want me to come?” She’s a painter, and so painters get caught up in their art and time disappears for them, that’s all that happened. My response is a terse, “Nevermind.” And I call—I have the deeply traumatic experience of calling a cab to take me home. 20 minute ride from the airport. And when I get home, I barely even want to talk to her, or look at her. Well, emotional competence—and what’s happening is my abandonment circuits had been triggered. My emotional competence is not necessarily that those circuits will not have been triggered; emotional competence would have been I would have noticed that, “Oh, it’s these old feelings that are present right now.” And I just have to be with them, but not project them onto my wife. So competence in that sense doesn’t mean no reactivity and being trivial, but it does mean the capacity to take responsibility when emotions get triggered.

TS: And then, I’d love for you to make the link, when we’re living in an emotionally competent way, how that affects our health and what the kind of mechanism is inside the body that it responds positively to this type of emotional competence.

GM: Oh. Again, to go back to my earlier example, you said something about being bored with my conversation and [if] I’m not emotionally competent, then that statement of yours will trigger every anxiety that I have. And then I may work very, very hard to please you, to excite you, to engage you. In other words, I will suppress, only at that moment, my connection to myself, in order to become the person that you will accept.

Well, that effort over a lifetime is very, very stressful. It’s physiologically stressful, because it means you’re always taking on more than you can handle. You’re always putting yourself into situations where demands will be made on you that are hard on your system. That chronic stress of trying to please people and trying to be like the one that they will accept will have an impact on your physiology. And there’s a wonderful book, you’re maybe familiar with it, that Anita Moorjani [wrote]. The book is called Dying to be Me. Are you aware of that book at all?

TS: I’m not.

GM: OK, all right. So this woman is in [a] hospital bed in Singapore, I think—this [was] published three years ago, she’s never heard of me or read my book When the Body Says No, but it is exactly the same story. So she’s in hospital with terminally ill with lymphoma, she’s got maybe three weeks to live. Literally three, so even the medical doctors can do nothing for her. And then she has an out-of-body experience in which she gets that all her life she’s tried to please others, she’s never been for herself. And that this is actually killing her. And when she comes back into her body she’s different person, she’s transformed—she’s had one of these experiences that you can’t account for, you can’t prescribe, and you can’t strive for. But it happened to her.

And so that’s the type—and she walks out of hospital totally free of cancer. And has been free of cancer ever since. And such stories are, I wouldn’t say common, but they’re certainly more than rare. The book is called Dying to be Me. Literally, she had to be nearly on the verge of death to become herself. Not being herself is what then caused the immune system disturbance that lead to her lymphoma. And I’ve seen that over and over and over and over again.

TS:You offer this interesting list in the book When the Body Says No of different coping styles, or you call them “unconscious beliefs,” that magnify people’s risk for illness. This idea of pleasing other people, you’ve already talked about; the idea of not expressing anger as something that magnifies our risk. But I wanted to highlight a couple of the things that you put in this list of beliefs that magnify our risk for illness, and here’s one, “I’m responsible for the whole world.” I thought that was interesting, the sense of, “I feel responsible for everything that’s happening,” especially, in light of our current political situation. And I know I’ve talked to some people who have said things like, “I can’t believe the world is in such terrible condition during my lifetime. I feel responsible.”

GM: Well, it depends on how you want to use the word “responsible.” If you want to use the word responsible in the sense that, “I’m guilty, I’m to be blamed,” that’s a heavy burden to lay on one’s self. But if you want to use the word in a sense that’s more hopeful and profound, I think, then responsible simply means response-able. It’s the capacity to respond. Now, we’re 100 percent responsible in that sense.

So we can respond to this world—you know, somebody who, like myself—and without overdramatizing it, just stating the bald fact—who is nearly thrown into an oven at age 6 months, you can’t tell me that the world is getting worse. So the sense that the world is getting worse, there’s a lot of truth behind that observation but really what it is, is history cycling itself. There have always been horrible things in the world. The latest manifestation is—apart of course from the overarching threat of global climate change which can put an end to us all, but in general sense the world has always been a difficult place where there’s been terrible things happening and beautiful things happening at the same time.

So I don’t perceive the world as any worse because a certain person got elected. Just the world declaring some of its nature. Or some of its being.

TS: OK, well that’s helpful, I think, and especially hearing it from you, I notice I find it perspective-creating for me. But I want to just understand this idea if somebody feels—and let’s not get too hung up on the word but “I feel a sense of the burden of the whole world” and now this might magnify someone’s risk for illness?

GM: Yes. So, in my talks on this subject I quote from obituaries, and obituaries are really interesting because you heard the expression of “the good die young”?

TS: Yes?

GM: Well they do. Because the people that are considered good, are the people that do way more than they need to for others all the time and without regard for themselves. So there’s actually an obituary that I quote—this is almost incredible, except it’s verbatim out of countless national newspaper [inaudible]. A 71-year-old physician who dies in Ottawa of cancer. And the obituary says—and notice that it says it in a laudatory way—it says, “Sidney and his mother had an incredibly special relationship, a bond that was apparent in all aspects of their lives. As a married man with young children, Sidney had dinner with his parents every day. Then he would arrive home where his wife, Roslyn, and their four young children waited for him, greeted by yet another dinner to eat and to enjoy.” It says, “Sid kept having two dinners a day for years until gradual weight gain began to raise suspicions.”

Now this man believes that he’s responsible for everybody else’s feels. So he could not say to his mother, “Mom, you know, I hate to disappoint you, but I’m gonna have dinner with my family most of the time.” And he couldn’t say to his wife, “Roslyn, I’m sorry to disappoint you but once or twice a week, my parents being old and being needy of me, I’m gonna have dinner with them.” He tried to please everybody. He was responsible for what everybody felt. And the second belief that he had, that he must never disappoint anybody. But those beliefs are very common to people who develop cancer. Again, for reasons that I’ve already alluded to.

By the way, let me tell you an interesting story if I may?

TS: Please.

GM: Remember Hillary Clinton’s pneumonia?

TS: Yes?

GM: Remember that she almost fell, she collapsed?

TS: Yep.

GM: Her Secret Service detail had to hold her up and put her into a van? So at the Democratic Convention, when she was nominated, they told—here was kind of a hero biographic, or a very laudatory video about her life, narrated by, in sonorous and laudatory terms by Morgan Freeman.

TS: I remember that.

GM: And they told a story about her childhood. And the story was that Hillary’s four years old, and she runs into her house, scared, because neighborhood kids were bullying and threatening her. And her mother says—and again this is presented as an example of great parenting and character-building—and her mother says to her, “There [is] no room for cowards in this house. Now you get out there and figure out what to do about those kids.”

And what’s the actual message to the child? There’s no room for vulnerability in this house? There’s no room for your emotions in this house? And you’re on your own, suck it up. 60-odd years later, that woman becomes an emotionally opaque person to the extent that people don’t experience her as quite human, as many people had that problem with her. And she has pneumonia and she won’t tell anybody about it. That poor woman—the way she coped with that particular kind of parenting made her, maybe successful in a certain sense, but also restricted her emotional competence in another sense. So these patterns go way, way back and they have health consequences. But it also meant that her body was saying “no” and she didn’t listen.

I want to address very specifically about the phrasing “burden of responsibility” or “burdened by responsibility.” We all want to be responsible; we all want to be able to respond to what’s going on in the world. It’s very positive to care about the state of the world, to have empathy for others, and to notice and wish to do something about the suffering, unfairness, and just general malaise that we see around us. It’s quite another thing to be burdened by it. And responsibility will not make us ill, but that burden will make us ill. When you’re carrying a heavy burden, that’ll tell on our physical or emotional mental health.

And to the people that experience that burden, I’m gonna say this: your sense of burden, in my own experience with myself and also working with hundreds of others—that burden does not have to do with the state of the world. That has to do with your psychological-emotional orientation and that was developed long before you knew anything about the world. That was developed early in your life, in relationship to your environment that nurtured you. And usually the people that feel burdened are people whose parents were troubled, distressed, dysfunctional, and the child felt a responsibility for making the parents happy. And so that, for a child, that kind of responsibility is a burden, it’s one that no child should have to take on. But many of us do, because children automatically and unconsciously make everything about themselves. So when they experience, witness our stress around them, they think it’s because of them and it’s their job to fix it.

And that’s the burden if you experience, you really need to drop, and when you drop it then you can be responsible in a genuine present-moment sense for how you deal with and try to address the problems you see out there in the world.

TS: In the book When the Body Says No you talk about how our body is a teacher, in a sense, when it’s giving us these messages of stopping and taking care of ourselves. I’m curious to know, in your own life and health process, have you dealt with an illness that became a teacher for you and in what way?

GM: Well, knock on wood, I’ve been physically healthy. Except for low back problems, which themselves are a sign of something, I know full well. But I’ve had more health issues in the emotional, psychological sense. I’ve been diagnosed with ADHD. My first book is about that condition. And I’ve been severely depressed. So, that’s how my system has said “no.”

TS: Just to ask about the diagnosis of ADHD—here you are, you’re so tremendously accomplished and have written gobs of articles and four-plus books, I don’t understand that diagnosis and how much you’ve accomplished as a professional.

GM: Well there are high-functioning people with ADHD. Mozart was probably one of them, if you look at his life. John Lennon was another, for sure, when I read his biography. There’s a range in every condition from milder to severe. I’m not the most severe case you ever met. And in ADHD, it’s not a complete deficit of attention, it’s a selective deficit of attention.

For example, I’ve always wanted to be a doctor. Growing up, I never wanted to be anything else, but my difficulty concentrating and therefore my propensity to have to study midnight to late in the morning before every exam, allowed me to do well in courses where my articulateness and self-expression, like in English and History, could cover up holes in my knowledge, but the science courses which I needed to get into medical school, I couldn’t have done.

So I drifted into high school teaching—really, I drifted into it. I got a BA mostly by not attending classes and staying up all night before every exam. Literally one night I studied for the wrong exam so I came into a European Literature exam having studied Shakespeare all night, just ’cause I didn’t pay attention to the exam schedule. And I could tell you a lot of hair-raising stories like that. It wasn’t until I was older, in my late 20s, that I developed the discipline enough to compensate for my inattention, and then I really had to work very hard to get into medical school and to get through it. Much harder than some of my classmates.

Not for lack of intelligence, just because lack of focus. And that lack of focus and the impulse regulation problems that go along with it showed up very heavily in my personal relationships, in my home life, and even in my work. So yes, I’m bright, and I’m talented, and I’m gifted in some ways for sure, but what would I have achieved if I didn’t have the attention deficit? Maybe a lot more? I don’t know, I’m not gonna question it, I’m not gonna cry about it, I’m just telling you that if you read that book, you’ll see in what significant ways that condition actually played havoc with my life.

And again, how did it begin? It begins as a coping mechanism with that early stress. Because when my mother’s stressed, I’m stressed. Now, the way you deal with stress is you fight back or you escape or you ask for help, but what do you do when you can’t do any of those? You don’t do anything. The mind will then kick in and one way it will kick in to protect you is by dissociating, by tuning out. But as an infant, a young child [who] is living in a very stressed environment and has to tune out a lot, that tuning out becomes programmed into the brain.

So, I don’t know about you, but I’ve never heard—as much as I love classical music for example, I’ve never heard a single movement of a single symphony from beginning to the end. Never. Because my mind will go elsewhere, automatically.

TS: So if I’m understanding you correctly, you’re saying that ADHD was a response to not feeling fully met, held, loved, and it was a kind of escape into disembodiment and a dream space of going other places, traveling, not being present, because being present was too painful as a young person, and that’s a core part of your understanding of ADHD?

GM: This is where my view on ADHD and mental [issues] in general deviate—not deviate, I should say, departs from the standard medical view. So again, I see most mental health issues as being rooted in childhood compensations.

There’s an article published in Journal of Pediatrics, which is the official journal of the American Academy of Pediatrics. You can’t get more prestigious than that. And the article’s from the Harvard Center on the Developing Child, published in 2012. And I’ll see if I can quote from it. They say that growing scientific evidence demonstrates that social and physical environments that threaten human development, because of scarcity, stress, or instability, lead to short-term physiological and psychological adjustments that are necessary for immediate survival and adaptation, but which may come at a significant cost for long term outcomes in learning, behavior, health, and longevity. In other words, the way young children cope with stress and instability help them endure through difficult times, but the same coping mechanisms become social pathology later on.

And that’s what I’ve seen all along. ADHD’s a typical example. And if you want to know why the diagnosis is burgeoning and why all these millions of kids are on medications, why more and more kids are being diagnosed? It’s precisely because it is not a genetic disease, it’s not an inherited disease—it’s not a disease at all, it’s a problem of development. And when kids are developing in circumstances that are stressful, then tuning out is one of their coping mechanisms. And that gets wired into the brain in the early years of brain development. It’s really that simple.

No other explanation can account for why all these kids all of a sudden? But if you see it as a social problem, because of increasing stress in society, then you can totally understand—as more parents are stressed the children feel the pain of the parents, they can’t escape from it, they can’t fight back, they can’t ask for help—one of the ways they cope with it, they tune out. Five years later, ten years later, thirty years later, they’ll be diagnosed with ADHD. And then we think, “Now we have a medical problem.” No, you don’t. You have a developmental problem which began as a coping mechanism.

TS: And what have you found is effective to help people—someone who has this ADHD diagnosis, you obviously had to help yourself as well—stay embodied and not make that dissociated move during times of stress. What helps?

GM: First of all, it depends at what age. Let’s say I’m the physician and you’re coming to me for help, it depends what age do I meet you? So if a child is brought to me with ADHD—and many children were after I became a bit of a specialist in it, not formally but practically—then I don’t try to fix the kid. I say to the parents, “This child is manifesting a multidimensional family dynamic. The more stress there is to more likely it is to tune out. The less secure he feels with you, the more likely he is to tune out and to act out. So let’s look at what stresses there are in the family environment. How are your relationships with one another? How stressed are you in your job? How do you understand your child’s acting out?”

Now, that phrase “acting out” is interesting, because we usually mean the kid is behaving badly. But when you look at the phrase “acting out” from an etymological point of view, it simply means you portray in behavior something you haven’t got the words to say in language. Like in a game of charades, you can’t speak; you have to act it out. So then let’s—so I teach two things to parents. One is that how they are and how they live their lives and what kind of environment is in the home has a lot to do with the child’s mental states, and so the more we can regularize and balance that, the less need the child will have to tune out, number one. And number two, the child’s already imprinted behaviors have to be understood not as behavioral problems, but as manifestations of emotional pain. Then how do we assuage that pain?

So that’s what I do with a child, I’ll talk with the parents about it. I’m not blaming the parents—they did their best. But their best was constrained by societal stress and their own traumatic history and whatever else is going on in their lives. So the question then is, how do we balance, how do we bring some peace into the home environment? That’s how you help the child.

And, now if you’re an adult, then I talk about self-parenting, because now you’re the one who has to parent yourself. So I’ll say, “Well, what are the stresses in your life? Because the more stressed you are the more tuned out you’ll be. So what is stressing you? Your relationships, your job, how you see yourself, the sense of shame that you’re carrying about your very existence? How well do you treat yourself? If you’re your own parent, what kind of food would you want to give yourself? How often would you take yourself out in nature so that you can commune with something greater than yourself? How much time do you spend just resting? Or paying attention to yourself in a sense of, say, mindfulness or meditation?” Which is difficult for people with ADD by the way—or yoga, which is easier since it involves some movement.

But just, “How well are you taking care of yourself?” So you may choose to take medications, if that helps you symptomatically, but don’t think for a moment that the medications solve the problem. They’re just dealing with the symptoms. Solving the problem means transforming your relationship to yourself. I’m talking to an adult now. And the problem with the child means transforming the child’s relationship to the parents.

TS: That’s very clear. Now I also wanted to pick up—you mentioned your own journey through depression as a person. And this is something that’s been an important topic for me to look into. At Sounds True, we published an anthology of about 20 different people, different writers, artists, as well as psychologists, called Darkness Before Dawn: Redefining the Journey Through Depression. I’m curious to know how you view it from your own experience—as a passage of some kind that taught you something?

Clearly, from listening to you and becoming somewhat familiar with some of your writing, you don’t create simple answers. You talk about things not just from a biological perspective, but from a social, spiritual, psychological—that’s one of the things I really like about you.

GM: Well thank you, and the reason for that is that you cannot separate the biological from the psychological. George Engel, that Harvard psychiatrist that I quoted, he called for a bio-psycho-social perspective. Which recognizes that human biology is actually shaped by our psychological and social relationships.

To give you two very obvious examples. It’s been known for a long time, many studies have shown that the more stressed that the parents are, the more likely the kid is to have asthma. Now I’m not going to go into the—there’s very simple physiological pathways by which that happens but, for lack of time I’m not gonna go into that, but I’ll tell you what, it’s almost predictable that the more stressed the parents are the more medication for asthma the child will need. And this has been shown in a whole number of studies. It’s also been shown that in Chicago, Puerto Rican kids are most likely to have asthma because they’re the ones that seem to be the most psycho-socially stressed, economically stressed population.

Another study this year—I’m sorry last year, 2016—showed that an American black woman, the more episodes of racism she experiences the greater risk of asthma. In other words, you can’t separate the mind from the body. And that’s because again, it’s all one system.

Having said which, I’ve forgotten—oh yeah, depression. OK. It’s the same with depression, OK? So the biological view of depression is that it’s a problem of lack of serotonin in your brain. Serotonin being a neurotransmitter, a chemical messenger implicated in mood regulation, amongst other functions. So the SSRIs, the selective serotonin uptake inhibitors like Prozac and Paxil and Zoloft and Celexa and the others, they all elevate by a certain mechanism the activity of serotonin in the brain. But serotonin levels are set very early in life based on our emotional relationships with our parents. And not only that but also what happens in utero. How much stress the pregnant woman has while she’s carrying you inside the womb. In other words, the biology is potentiated and conditioned by our psychological and social relationships.

And if you take the case of American women, black women and asthma, you can see that we’re not dealing with a medical problem here, we’re dealing with a social problem here that manifests as a medical issue.

Now depression—if you actually look at the word “depression,” what does it mean to depress something?

TS: Hold it down, yes? Hold it down.

GM: Pushing it down, right? Remember I said that it all begins as a coping mechanism? Let’s go back to the hypothetical example of the two-year-old who throws the tantrum whose parents can’t handle the anger. What will the child do to maintain a relation with the parents? Is to repress the anger, to push it down.

Depression is largely about the suppression of negative emotions or emotions we are afraid to feel because if we did, it would be in to conflict with our early environment. Not such a huge mystery as far as I’m concerned. Not to mention your brain’s physiology’s being affected by those dynamics.

TS: So in your own life then, this learning of emotional competence in the way that you described it, was that a working successful response, if you will, to depression for you?

GM: Well depression is not an emotion, it’s a state of mind in which emotions are actually repressed. But again, Almaas has a wonderful quote where he says that, “Your conflicts and all the difficult things, the problematic issues in your life are not chance or haphazard,” he says. “They’re actually yours.” And he says, “They’re actually brought to you by a part of you that loves you so much, that it wants you to learn about yourself and reality. And so it’ll make you suffer if you don’t listen. What else can it do?” He says, “That’s its job.” So we can look on depression as just a medical disease to get rid of. Or we can look at it as a teacher that guides us closer to ourselves.

In case of depression you might say, “Well what have I been pushing down? And what have I learned that I had to push certain things down? And how do I relate to that depression now? Do I relate to it as an enemy to be [gotten] rid of? Or as a condition to be medicated? Or as something that’ll instigate an inquiry into how I live my life and my relation to myself?”

Having said that, I really want to emphasize that I’m not against medications, I’ve taken them myself. Sometimes I think they’re essential for some people. As long as we recognize that they are not the answer to anything. They help, they can provide relief, they can provide—when you’re caught in a swamp and if you lift one leg, the other one sinks deeper into the muck, you want to be put on dry land. Medications, for some people, can put them on that dry land where they can start walking, but you still have to walk. So the medication will not get you where you want to go. But sometimes in some situations, they can put you on dry land.

The unfortunate problem is that most of psychiatry is based on this biological view of human beings that if you’re depressed, there’s not enough serotonin, let’s give you a drug to elevate serotonin levels—and that’s it. The average medical student, the average psychiatrist, their mind is not trained in trauma, they don’t even hear the word “trauma” in all their years of training. And they don’t learn about brain development, they don’t learn about childhood development, they just learn about physiology and anthropology. So they have no holistic understanding of human beings. Which is why people find it so difficult to get help.

TS: You know, I’m gonna share now a confession with you; at the beginning of this conversion I had a secret goal—just me and myself here had this goal—which was through the course of spending an hour with you and getting to know you a little bit, could I start to see through the lens, if you will, that you see illness and healing? How does Gabor see this complex question of illness and healing, when we put together the social components with the spiritual needs of the individual, the bio-psycho-social as you described here in this conversation. And I feel like I’m sort of getting in touch with some of the puzzle pieces, if you will, but I wonder, as we bring our conversation to a close, if you would be willing to just summarize for me in a sense if there is a kind of working—it might not be a map, but a working kind of framework that you view healing through?

GM: All right. So the word “healing” comes from an Anglo-Saxon word for “wholeness.” So when we ask, “How do we heal?” The question is, how do we become whole? And that raises the question, how is it that we’re not whole to start with? Again, it’s Almaas who says the fundamental problem—the latest catastrophe, he says, is not that there’s no love or support in our childhood. He says the greater calamity—in other words, the first calamity—is that you lost a connection to your essence. So he says that’s much more important than whether your mother and father love you or not.

The real source of disconnect, then, is as a result of the environmental problems you and I have touched upon, we lose connection with ourselves. And that loss of connection with ourselves can manifest in physical or any number of physical and mental health conditions. So healing, then, is reconnecting, becoming whole again. That’s the origin of the word “healing.” And that has to begin with recognizing how we’re not whole—has to be recognizing in all the ways, when it comes to physical illness, you have to start paying attention to your body. So, what is your body telling you?

The body says “no”—the body will say “no” in all kinds of ways if you don’t know how to say it. If you take on more than what’s good for you, your body’s gonna say “no.” It’s gonna say “no” in the form of a cough, a form of back pain, stomach aches, migraines, nervousness, dry mouth, poor sleep, muscle tension, rashes, frequent illnesses in call kinds of ways. So first of all, listen to our bodies. Because one of the alienations that beset us in modern societies is that we lose connection to our bodies. Secondly, because our emotions were not received and welcomed and processed when we were small, we even lose touch with our emotions. But then you have to do the work to reconnect.

So it’s all about reconnection. If I can put healing in a simple phrase, I’d say it’s reconnection. And that can happen through a whole number of modalities. It can happen through psychotherapy of course; through reading in the works of the great teachers, some of whom I’ve quoted today. Also, the venture to seek reading them. It can happen through meditation, it can happen through yoga, [through] other forms of spiritual work: somatic experiencing, EMDR, physical activity, paying attention to what we eat. All these things have to go into it, but it’s all about reconnecting.

TS: And just as a final question to end on. Here you are—you mentioned, 73 years old at this point? And I’m wondering, what is your current focus now? What really matters to you now at this point in your life?

GM: You had to leave the toughest for last didn’t you, Tami?

TS: It’s a lot of work, this whole thing, it’s a lot of work.

GM: Well, a lot more work than I anticipated. Well, you know, I’m still very committed to teaching people. I just think what I’m saying is so important, not because I’m saying it, but because it’s true. So I’m committed to teaching, speaking at seminars and [the] writing that I’m doing. I’m committed to transformation, so sometimes I work with psychedelics—that would be a whole other conversation about my work with psychedelic plants and helping promoting people’s transformation through that work.

On a personal level, I’m—as I said to you earlier, I discovered I was—I lucked into a yoga practice and so—and yoga’s all about unity of course, it’s all about becoming one with oneself and whatever’s out there or around us. But now I have the daily yoga practice I’m totally committed to, and with my ADD it’s been very difficult to do any kind of regular practice about anything. But I’m very pleased as punch to say that for nearly three months now, I’ve had at least a 45 minute a day yoga practice, which is all for me. It doesn’t matter where I am, where I’ve traveled, or what I’m doing, or what’s going on in my life—I’ll take that time just for me, to connect with my body and to connect with the spirit and just to promote my own healing and ongoing transformation.

And I’m also committed to a loving, beautiful relationship with my spouse of 50 years. The marriage is 47 years old, but that relationship has been the ground of so much learning and growth and suffering and mutual pain and mutual joy, but it’s also my greatest teacher. So these are all the things that I’m committed to.

TS: And in the future, I would love to have a separate conversation with you on psychedelic therapy. I think that’s an area that I have a lot of questions and, if I confess, also concerns, and I think we would have to devote a whole session to that. But I would love to talk with you about that.

And to take a moment now just to thank you for the conversation that we’ve had, and also for you joining our work here are Sounds True. In the near future you’ll be recording an audio learning series with us that will come out, that will delve deeper into your work on healing and wholeness and reconnection. And I just feel a very natural and warmth and resonance with you, Gabor, I feel grateful that you’re on the planet. Thank you. Thanks for all that work.

GM: Thank you Tami. I’m gonna listen to your words for “This is Sounds True presents,” and the voice is so unmistakable and the warmth behind the voice is also unmistakable. So it’s a great pleasure to speak with you.

TS: many voices, one journey. Thanks for listening.

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