Trauma is a 'stupid friend' that our minds & bodies don't forget: Dr. Gabor Maté

Why do we suffer? How can we heal?

These questions have been a driving force in the research and career of Hungarian-Canadian author and retired physician Dr. Gabor Maté for decades.

Maté, who recently co-authored a book with his son called The Myth of Normal, joined the Sickboy podcast for a wide-ranging conversation about the ubiquitous yet misunderstood role of trauma in our society. Below is part of that conversation between Maté and Sickboy's three co-hosts — Jeremie Saunders, Taylor MacGillivary and Brian Stever.

Sickboy57:47Trauma - Our Stupid Friend w/ Gabor Mate

Brian Stever: Gabor, is trauma normal?

Gabor Maté: Well, not in the sense that it's natural or healthy. It is very much the norm, in the sense that it happens all the time so that people get used to it. We get so used to it we don't even recognize it.

So there's the American author, David Foster Wallace — a wonderful writer — who wrote this amazing book called Infinite Jest. He gave a commencement speech at a college once. He tells the story of two young fish swimming along. Along comes an older fish and says, 'Good morning boys, how's the water?' And the two young fish swim along for a while and one turns to the other one and says, 'What the hell is the water?'

When something is so close to us and so big, we don't even recognize it anymore. We just assume that's just the world. And so trauma, to answer your question, is so ubiquitous in our culture that we just assume it's normal. 

Stever: I went into [therapy] thinking I didn't have any specific traumas that I wanted to talk about... And then in the first session that I had with my therapist, I started talking about my past and she was like, 'Wait a minute, your parents were divorced? You struggled in school?' And she started to classify these things that I had experienced as past traumas. And it was so overwhelming for me… There's all these past experiences that I have and these negative characteristics that I sort of embody, that I can now start to see how they are manifesting from these past experiences.

Maté: When you call them negative qualities, you're not being kind to yourself. Like, name one, for example. If you want to, let's talk about it. Give me negative thing. 

Stever: A fear of commitment. Specifically from my parents' divorce. 

Maté: Okay. Fear of commitment. With a child, where there's tension and rancour in the house and then the parents split, fear of commitment is actually a normal response. It's actually — there's something healthy about it. There's something adaptive about it. Because when you were committed — as you were as a kid, to the relationship — you were deeply disappointed. Hurt, actually. And so that the fear of commitment is an adaptive response.

Now, I understand what you're saying. That fear of commitment might make it difficult for you to form healthy relationships as an adult. But it came along as a protective thing. So rather than seeing it as negative, I encourage you to look at these characteristics as what we call stupid friends. They're friends because they came along to protect you. And the fear of commitment came along to protect you. The stupidity is that it doesn't learn that it's no longer needed. It can give you the same message, even though we are no longer this small child. And even though you have more capabilities. But they're friends. They don't come along to hurt you. They come along to help you.

The baby's reaction is defensive. In the adult, it's dysfunctional. And that's what I mean by the stupid friend.

Stever: I can't remember what I did last week, let alone what happened to me 20 or 30 years ago. I'm curious how that works in the brain and how a traumatic experience like that can imprint on you to the point where you're still remembering it on some subconscious level in the future.

Maté: Yeah. So Brian, what we have to do here is to make a distinction between memory and recall. Recall is only one aspect of memory. So you may not recall what happened, but you remember it. By memory, I mean the emotional imprint is stamped in your nervous system and in your brain. 

Explicit memory is when you can recall, you can call back what you had for breakfast. You can recall a conversation you had with somebody last night. Implicit memory is when there's no conscious recall, but the memory is in the body and in the nervous system. So what I'm saying to you is there's a lot that you remember that you don't recall.

For example, pretty much every time you're really upset with somebody, it's not about the present, it's about the past. You're remembering something, but you're not recalling it. And so in that sense, trauma has been called the tyranny of the past; when the past is showing up and it's governing your presence. The emotional upset, the pain and the hurt and the anger have little to do with the present moment. It has to do with the memory of something happening to you a long time before.

That's what makes relationships so difficult. Because we always think that the other person is doing something to us. No, they're not. They're just triggering some old memory.

Taylor MacGillivary: How does one seek to uncover the roots that underlie the traumas that end up causing dysfunction in our lives?

Maté: Well with a bit of help, it's not that difficult because the present reactions parallel or remember the original injuries. It shows up in our relationships, you know, like in the case of Brian and the difficulty of trusting relationships, which I'm sure you've experienced in multiple relationships as an adult... That difficulty to trust is the memory of trauma. You know why? Because otherwise you trust yourself. You would say: 'I've got my gut feelings. I'll know when the relationship is right and when it isn't. I don't have to be mistrustful of the other person because I can trust myself.' But when trauma happens in childhood, we don't get to trust ourselves anymore. Therefore we don't trust others... These patterns that we enact are telling us what the memory was.

Jeremie Saunders: To your earlier point, Brian, about saying that you went to therapy and you didn't realize that you had trauma until you started unearthing this stuff. And then all of a sudden you're like, 'Oh, I have trauma in my past.'

If there's anyone out there in the world who has not experienced trauma, there's probably a very slim few. And for the folks who feel like they definitely haven't experienced any trauma before, it's because they don't recognize what that trauma is.

Maté: Trauma isn't necessarily terrible things happening to you. Trauma is a wound that you sustain. And you can wound kids two ways: you can wound them by doing bad things to them, which happens to a lot of kids. They get hit — spanking is very traumatic for kids. I've been through all the studies. But a lot of parents think it's okay to spank their kids. And the parents say, 'Well, this is normal.' It's not. There's nothing healthy or natural about it. Kids should not be hit by adults. But it doesn't have to be even that. Trauma is not what happens to us. Trauma is the wound that we sustain. And you can wound kids not just by doing bad things to them, but by not meeting their needs. 

All I'm saying is it's so easy to wound kids without even realizing it.

There's such a lack of trauma awareness in the law, in medicine, in education, and in parenting that no wonder we don't see it.- Dr. Gabor Maté

Saunders: So we understand that trauma is pain that has been placed upon us. We understand that trauma seemingly is so widespread that there's probably not a single person out there who hasn't experienced it in some form. So with something that's so widespread, why on earth is it still so misunderstood?  

Maté: Well, because, first of all, it's painful to look at this stuff. People don't like pain. And that's natural. It's painful to consider that the people who actually loved you also really badly hurt you. That's painful. People don't want to be blaming their parents, and nor should they, because the parents did their best given what happened to them. But we're afraid of that pain — number one.

And number two: people have a hard time taking responsibility for themselves.

The third reason is the biggest one. In this culture, as widespread and as ubiquitous as trauma is, we don't really understand it. The average physician never gets a single lecture on trauma. In this book, I point out so many physical illnesses, most chronic illnesses of mind and body, that there's a significant traumatic component in their genesis.

The average teacher has no understanding that the kid with ADD is a very sensitive child who stresses so much that they're tuning out as the defence against the stress. So instead, they're punished and ridiculed. Or maybe it's considered a disease and given a stigma. So there's a profound lack of trauma awareness in this culture. 

I mentioned in other contexts that if you look at who's in the jails of this country, 30% of the people in jail in Canada are Indigenous people. They make up 5% of the population. [Roughly] 50% of the women in jail in this country are Indigenous. They're 5% of the population. Is it a coincidence that they're also the most traumatized segment of the population? Is it a coincidence that the rate of rheumatoid arthritis among Indigenous women is six times the rate of anybody else? It's a strict trauma response. The inflammation in the body is a response to trauma. But there's such a lack of trauma awareness in the law, in medicine, in education, and in parenting that no wonder we don't see it.

Saunders: What are your thoughts on how we can create more of a trauma-informed society as a whole? 

Maté: We need to use the word in its proper sense. People tend to misuse the word. They'll say, 'I went to a movie last night and I was traumatized.' No, you weren't. You just felt sad. 'I had a fight with my partner and it was so traumatic.' No, it wasn't. It was just painful. 'I went to this meeting and it was so traumatic.' No, it wasn't. It was just stressful. So not every pain and not every stress is trauma.

Trauma is when we are wounded and that wound persists and affects our lives in significant ways. It's really important to make that distinction. That's why the first chapter of our book is about what trauma is and what it isn't... Which means the wound that I've sustained that is constricting my life, is affecting who I am with my child, with my partner, how I relate to myself, what kind of work I choose and so on. So that's the first aspect, to use the word in its proper sense.

There's a study in Canada that showed that men who were sexually abused in childhood had triple the rate of heart attacks as adults. And not because they smoked or drank to soothe their pain. No — regardless of that. So what if doctors were trained to understand trauma? Which they're not. The average medical student does not get a single lecture, not one lecture, on how trauma underlies so much physical illness and mental illness as well. So, first of all, let's train the healthcare givers.

This is what's so frustrating for me sometimes. Nobody taught me this stuff in medical school. I had to learn it by myself. Then I looked at this vast body of literature, scientific literature, that shows the background of what I'm talking to you about. Any average doctor never gets that information during their education. There's a huge gap between the science and the medical practice. 

So when you go to a doctor with heart disease or rheumatoid arthritis, yes, they should give you the physical medical treatment that you need for sure, which is often lifesaving and miraculous and very beneficial. But what about also engaging you, when that's done, in a conversation about looking at your life and in what ways might trauma be affecting your present life that are not healthy for you? That if you dealt with it, you could look forward to better health. Now that'd be an important conversation. 

As I said earlier, like if in school the kid is not paying attention or has poor impulse control, or they tend to talk out of turn, or they tend to bully other kids, or they tend to be bullied chronically. What if we just didn't see these as behaviour or learning problems or diseases? What if we saw that kid — whether the bully or the victim — they're both traumatized. And the kid who's not paying attention; that was their way of surviving the stress in their environment. So what can we do to de-stress the environment? How can we support that child in a way that'll help them develop a healthier brain? In other words, what if we introduce trauma education and trauma information into education?

I already mentioned the law. It's a scandal that 50% of the women in jail in this country are Indigenous. They're the most traumatized segment of the population, A) because they're women and B) because they're Indigenous. Now we punish them for their trauma and stick them into prisons? What if we actually had a correctional system that corrected something instead of just punished it? Let alone what if politicians understood it. So this trauma awareness, which is so easy to obtain, the information is out there. It's been published and published and published. What if we just learn from what's already been studied and proven? This could be a very different society.

This Q&A was edited for length & clarity. Produced by Émilie Quesnel.