Hungarian-Canadian physician (1944–)
Gabor Maté CM (born January 6, 1944) is a Hungarian-Canadian physician and author. He has a background in family practice and a special interest in childhood development, trauma and potential lifelong impacts on physical and mental health including autoimmune disease, cancer, attention deficit hyperactivity disorder (ADHD), addictions and a wide range of other conditions.
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Settling for the view that illnesses, mental or physical, are primarily genetic allows us to avoid disturbing questions about the nature of the society in which we live. If “science” enables us to ignore poverty or man-made toxins or a frenetic and stressful social culture as contributors to disease, we can look only to simple answers: pharmacological and biological.
Emotional competence requires • the capacity to feel our emotions, so that we are aware when we are experiencing stress; • the ability to express our emotions effectively and thereby to assert our needs and to maintain the integrity of our emotional boundaries; • the facility to distinguish between psychological reactions that are pertinent to the present situation and those that represent residue from the past. What we want and demand from the world needs to conform to our present needs, not to unconscious, unsatisfied needs from childhood. If distinctions between past and present blur, we will perceive loss or the threat of loss where none exists; and • the awareness of those genuine needs that do require satisfaction, rather than their repression for the sake of gaining the acceptance or approval of others. Stress occurs in the absence of these criteria, and it leads to the disruption of homeostasis. Chronic disruption results in ill health.
The hardcore drug addicts that I treat, are, without exception, people who have had extraordinarily difficult lives. The commonality is childhood abuse. These people all enter life under extremely adverse circumstances. Not only did they not get what they need for healthy development; they actually got negative circumstances of neglect. I don’t have a single female patient in the Downtown Eastside of Vancouver who wasn’t sexually abused, for example, as were many of the men, or abused, neglected and abandoned serially, over and over again. That’s what sets up the brain biology of addiction. In other words, the addiction is related both psychologically, in terms of emotional pain relief, and neurobiological development to early adversity.
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Work pressures, multitasking, social media, news updates, multiplicities of entertainment sources — these all induce us to become lost in thoughts, frantic activities, gadgets, meaningless conversations. We are caught up in pursuits of all kinds that draw us on not because they are necessary or inspiring or uplifting, or because they enrich or add meaning to our lives, but simply because they obliterate the present.
And here is where I’m humbled. I’m humbled by my feebleness in helping this person. Humbled that I had the arrogance to believe I’d seen and heard it all. You can never see and hear it all because, for all their sordid similarities, each story in the Downtown Eastside unfolded in the particular existence of a unique human being. Each one needs to be heard, witnessed, and acknowledged anew, every time it’s told. And I’m especially humbled because I dared to imagine that Serena was less than the complex and luminous person she is. Who am I to judge her for being driven to the belief that only through drugs will she find respite from her torments? Spiritual teachings of all traditions enjoin us to see the divine in each other. Namaste, the Sanskrit holy greeting, means, “The divine in me salutes the divine in you.” The divine? It’s so hard for us even to see the human. What have I to offer this young Native woman whose three decades of life bear the compressed torment of generations? An antidepressant capsule every morning, to be dispensed with her methadone, and half an hour of my time once or twice a month.
I do not believe ADD leads to creativity any more than creativity causes ADD. Rather, they both originate in the same inborn trait: sensitivity. For creativity, a temperamental sensitivity is indispensable. The sensitive individual, as we have seen, draws into herself the unseen emotional and psychic communications of her environment. On some levels of the unconscious, she will, therefore, have a deeper awareness of the world. She may also be more attuned to particular sensory input, such as sound, color or musical tone. Thus the sensitivity provides her with the raw materials her mind will rework and reshape. Thus sensitivity contributes to the emergence of attention deficit disorder, as well as to creativity.
In the absence of relief, a young person’s natural response — their only response, really — is to repress and disconnect from the feeling-states associated with suffering. One no longer knows one’s body. Oddly, this self-estrangement can show up later in life in the form of an apparent strength, such as my ability to perform at a high level when hungry or stressed or fatigued, pushing on without awareness of my need for pause, nutrition, or rest.
It’s a subtle thing, freedom. It takes effort; it takes attention and focus to not act something like an automaton. Although we do have freedom, we exercise it only when we strive for awareness, when we are conscious not just of the content of the mind but also of the mind itself as a process.’
We may say, then, that in the world of the psyche, freedom is a relative concept: the power to choose exists only when our automatic mechanisms are subject to those brain systems that are able to maintain conscious awareness. A person experiences greater or less freedom from one situation to the next, from one interaction to the next, from one moment to the next. Anyone whose automatic brain mechanisms habitually run in overdrive has diminished capacity for free decision making, especially if the parts of the brain that facilitate conscious choice are impaired or underdeveloped.
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Dr. Cai Song is an internationally known researcher at the University of British Columbia and co-author of a recent textbook, Fundamentals of Psychoneuroimmunology. “I am convinced that Alzheimer’s is an autoimmune disease,” says Dr. Song. “It is probably triggered by chronic stress acting on an aging immune system.