Gabor Maté Quotes

Time after time it was the “nice” people, the ones who compulsively put other’s expectations and needs ahead of their own and who repressed their so-called negative emotions, who showed up with chronic illness in my family practice, or who came under my care at the hospital palliative ward I directed.

Nature’s ultimate goal is to foster the growth of the individual from absolute dependence to independence — or, more exactly, to the interdependence of mature adults living in community. Development is a process of moving from complete external regulation to self-regulation, as far as our genetic programming allows. Well-self-regulated people are the most capable of interacting fruitfully with others in a community and of nurturing children who will also grow into self-regulated adults. Anything that interferes with that natural agenda threatens the organism’s chances for long-term survival.

Almost from the beginning of life we see a tension between the complementary needs for security and for autonomy. Development requires a gradual and ageappropriate shift from security needs toward the drive for autonomy, from attachment to individuation. Neither is ever completely lost, and neither is meant to predominate at the expense of the other. With an increased capacity for self-regulation in adulthood comes also a heightened need for autonomy — for the freedom to make genuine choices. Whatever undermines autonomy will be experienced as a source of stress. Stress is magnified whenever the power to respond effectively to the social or physical environment is lacking or when the tested animal or human being feels helpless, without meaningful choices — in other words, when autonomy is undermined.

Autonomy, however, needs to be exercised in a way that does not disrupt the social relationships on which survival also depends, whether with emotional intimates or with important others — employers, fellow workers, social authority figures. The less the emotional capacity for self-regulation develops during infancy and childhood, the more the adult depends on relationships to maintain homeostasis. The greater the dependence, the greater the threat when those relationships are lost or become insecure. Thus, the vulnerability to subjective and physiological stress will be proportio

Trauma and stress are so normal in society that we take them to be almost natural occurrences... We think this is normal. But actually, from the point of view of human needs and human evolution, the current way of living that we pursue is actually abnormal and is the cause of a lot of ailments of body and mind... a lot can be done as long as we recognize the problem. The issue is that my own profession, the medical profession, despite all the science that links the mind and body, emotions and physiology, doesn’t link them... physicians are not trained in understanding the whole human being and the unshakeable oneness of our existence.

Many of us live, if not alone, then in emotionally inadequate relationships that do not recognize or honour our deepest needs. Isolation and stress affect many who may believe their lives are quite satisfactory.

The acronym COAL has been proposed for this attitude of compassionate curiosity: curiosity, openness, acceptance, and love:

The separation of mind and body is an erroneous view, incompatible with science. Personality traits—that is, psychological patterns—conduce to disease because the brain circuits and systems that process emotions not only exert a profound influence on our autonomic nerves, as well as our cardiovascular, hormonal, and immune systems: In reality, they are all conjoined... Most medical students never hear the word ‘trauma’ in all their years of training, except in the the sense of physical injury. ‘The medical profession is traumaphobic,’ a well-known colleague in San Francisco once told me. The results for patient care are devastating, whether in the treatment of physical or psychiatric conditions—a distinction that, given the mind/body unity, is in itself misleading.”

"A society that fails to value communality — our need to belong, to care for one another, and to feel caring energy flowing toward us — is a society facing away from the essence of what it means to be human. Pathology cannot but ensue. To say so is not a moral assertion but an objective assessment.

"When people start to lose a sense of meaning and get disconnected, that's where disease comes from, that's where breakdown in our health — mental, physical, social health — occurs," the psychiatrist and neuroscientist Bruce Perry told me. If a gene or virus were found that caused the same impacts on the population's well-being as disconnection does, news of it would bellow from front-page headlines. Because it transpires on so many levels and so pervasively, we almost take it for granted; it is the water we swim in.

We are steeped in the normalized myth that we are, each of us, mere individuals striving to attain private goals. The more we define ourselves that way, the more estranged we become from vital aspects of who we are and what we need to be healthy. Among psychologists there is a wide-ranging consensus about what our core needs consist of. These have been variously listed as:

- belonging, relatedness, or connectedness;
- autonomy: a sense of control in one's life;
- mastery or competence;
- genuine self-esteem, not dependent on achievement, attainment, acquisition, or valuation by others;
- trust: a sense of having the personal and social resources needed to sustain one through life;
- purpose, meaning, transcendence: knowing oneself as part of something larger than isolated, self-centered concerns, whether that something is overtly spiritual or simply universal/humanistic, or, given our evolutionary origins, Nature. "The statement that the physical and mental life of man, and nature, are interdependent means simply that nature is interdependent with itself, for man is a part of nature." So wrote a twent

As Selye pointed out, the salient stressors in the lives of most human beings today — at least in the industrialized world — are emotional. Just like laboratory animals unable to escape, people find themselves trapped in lifestyles and emotional patterns inimical to their health. The higher the level of economic development, it seems, the more anaesthetized we have become to our emotional realities. We no longer sense what is happening in our bodies and cannot therefore act in self-preserving ways. The physiology of stress eats away at our bodies not because it has outlived its usefulness but because we may no longer have the competence to recognize its signals. (p36)

"Throughout the human life span there remains a constant two-way interaction between psychological states and the neurochemistry of the frontal lobes, a fact that many doctors do not pay enough attention to. One result is the overreliance on medications in the treatment of mental disorders. Modern psychiatry is doing too much listening to Prozac and not enough listening to human beings; people’s life histories should be given at least as much importance as the chemistry of their brains. The dominant tendency is to explain mental conditions by deficiencies of the brain’s chemical messengers, the neurotransmitters.

As Daniel J. Siegel has sharply remarked, “We hear it said everywhere these days that the experience of human beings comes from their chemicals.” Depression, according to the simple biochemical model, is due to a lack of serotonin — and, it is said, so is excessive aggression. The answer is Prozac, which increases serotonin levels in the brain. Attention deficit is thought to be due in part to an undersupply of dopamine, one of the brain’s most important neurotransmitters, crucial to attention and to experiencing reward states. The answer is Ritalin. Just as Prozac elevates serotonin levels, Ritalin or other psychostimulants are thought to increase the availability of dopamine in the brain’s
prefrontal areas.

This is believed to increase motivation and attention by improving the functioning of areas in the prefrontal cortex. Although they carry some truth, such biochemical explanations of complex mental states are dangerous oversimplifications — as the neurologist Antonio Damasio cautions: "When it comes to explaining behavior and mind, it is not enough to mention neurochemistry... The problem is that it is not the absence or low amount of serotonin per se that “causes” certain manifestations.

Serotonin is part of an exceedingly complicated mechanism which operates at the level of molecules, synapses, local circuits, and systems, and in which sociocultur

So self-acceptance does not mean self-admiration or even self-liking at every moment of our lives, but tolerance for all our emotions, including those that make us feel uncomfortable.

Not why the addiction but why the pain.

Whereas individual people can become dislocated by misfortunes in any society, only a free-market society produces mass dislocation as part of its normal functioning, even during periods of prosperity. (p288)

People far-flung have told me that it saved their lives, it changed their view of addiction or it made a big difference to their families... the book addresses — the origins of addiction and a sane and humane way of treating addiction of all kinds — has not become mainstream practice or awareness yet... When the book came out, we still had a federal government that was completely against supervised injection sites, for example, or the provision under observed circumstances of prescribed heroin to dependence users who needed it. We had a completely retrograde federal policy which has opened up quite a bit under the current administration.

Do I live my life according to my own deepest truths, or in order to fulfill someone else’s expectations? How much of what I have believed and done is actually my own and how much has been in service to a self-image I originally created in the belief it was necessary to please my parents?

The wondrous power of a drug is to offer the addict protection from pain while at the same time enabling her to engage the world with excitement and meaning. “It’s not that my senses are dulled — no, they open, expanded,” explained a young woman whose substances of choice are cocaine and marijuana. “But the anxiety is removed, and the nagging guilt and — yeah!” The drug restores to the addict the childhood vivacity she suppressed long ago.