From teaching to medicine,
Dr. Gabor Maté's almost
40-year career as a physician
includes running a
family practice clinic
as well as treating the
terminally ill and drug addicts.
Dr. Maté specializes
in the connection
between society and
addiction and mental illness.
He's the author of
several books, including
"In the Realm of Hungry Ghosts:
Close Encounters with Addiction,"
and "Hold on to Your Kids:
Why Parents Need to
Matter More than Peers."
Today we hear excerpts
from a speech by Dr. Maté
which he gave in November 2011
in Berkeley, California.
It's very interesting to look at the
United States from the outside, of course,
because your politicians
are always saying,
"What a great
country we are.
They all want to be
like us, you know."
And I ask you this
psychological question:
If you met some guy
who kept telling you
how great he was
and how everybody
wants to be like him,
how would you
diagnose him?
Like I did, you'd say he's got a
grandiose personality disorder.
In other words, what
he is actually doing
is compensating for
his deep insecurities.
So this is a country that
in it's very rhetoric
betrays extraordinary insecurity.
I grew up in
communist Hungary
where the joke,
of course, was:
What is capitalism?
Capitalism is the exploitation
of man by man.
And what
is communism?
It's the opposite.
I grew up in a system that spoke
the language of socialism,
that spoke the
language of struggle,
of anti-imperialism,
of equality and justice,
but its actual functioning
was just the very opposite.
Then I came to North America
after the Hungarian Revolution,
which was really an uprising
against a very brutal dictatorship.
I came to North America and
I bought into the American ideal,
and that lasted
for exactly four years,
between 1957
and the early 60s
when the Vietnam War started.
What became
very clear to me
is that everything
that the Soviets
had said about the
Americans was true,
and everything they said
about themselves was also lies.
So the powers that be
are oppressive and unjust.
That's just how it is,
and it doesn't matter
in what guise.
This is not, by the way,
an anti-communist rant.
I may be one of the
only two Marxists I know
who came out of 
Eastern Europe.
And the reason 
I say that is
when they beat
you over the head
in the name of
a certain system,
you're not going to be going
for that system very much.
What I've gradually come 
to understand is
that it's really
important for people
to search for the
truth themselves,
and not to automatically identify
with any particular system
because as soon as
you start to identify,
as soon as you try to find
the answer outside yourself,
you may surrender
your critical faculties.
So if we hold on to our critical
faculties and look at the truth,
what do we see?
In this society,
what we see is a society that
literally makes people sick
because 50% of
North American adults
have a chronic illness,
either diabetes or
high blood pressure,
or heart disease or cancer,
or any number of 
auto-immune illnesses.
Now, according to the
strict medical model,
that's too bad.
These people are
just unfortunate
because what the 
medical model does,
whether with mental 
illness or physical illness,
is it makes
two separations.
It separates the
mind from the body
so that what happens 
to us emotionally
is not seen to have an impact
on our physical health.
That's number one,
and number two is
it separates individuals
from their environment
so that we try to understand individuals
in separation from their actual lives.
If somebody
has cancer,
well that's just
bad luck,
or maybe it is because they
smoke too many cigarettes
which leaves us completely
bereft of understanding
what causes
most disease.
What they're
betraying there
is the complete poverty
of understanding
of what makes the human brain tick,
what creates a human being,
and what causes people to
behave and to function
and to feel the
way they actually do.
Now those separations
are socially imposed.
They're culturally defined,
and scientifically they're
completely invalid
because the truth of it is
that the traditional teachings
of shamanic medicine,
or of cultures
around the world,
and of traditional Chinese medicine,
or Ayurvedic Indian medicine,
that mind and
body are inseparable,
have now been validated
by modern science.
So my profession,
although it claims
to ground itself in science
and what they call
evidence-based practice...
I only wish they looked
at the actual evidence.
I only wish they
would ask themselves
why it is that in
the United States
an Afro-American male
has six times the risk
of dying of prostate
cancer than a Caucasian.
It's got to be genetic.
No, it isn't because their
genetic relatives in Africa
don't suffer the 
same risk at all.
So what is it in this society?
Why are black women,
even middle class black women,
more likely to suffer
miscarriages in this country?
That's not a
genetic question.
It's a social question.
Something's going on here.
If you look at something like
the rate of autism in this country
or in industrial societies,
but particularly
in North America,
it has gone up 40
fold in the last 50 years,
or it is 30 fold
in the last 30 years.
You can't be dealing
with a genetic effect
because genes 
don't change in a
population over 30
years, or even 500 years.
There's got to be
something going on in society
that's driving the
emotional ill health of children,
and furthermore,
if you look at addiction,
there are a couple of
myths associated with it.
One of them is that it's a
choice that people make,
and the
"criminal justice system,"
which I think is a very 
apt way of putting it--
it's a criminal system,
the justice system is criminal--
is based on
the very idea
that people are making choices
when they become addicts.
If they're not making choices,
why punish them for it?
The other idea is
that it's genetic.
The third idea, of course,
is that drugs are addictive,
which is inherently nonsense
because if it were true
then anybody who tried the 
drugs should become addicted,
but most people who try most
drugs don't become addicted.
Most who try cigarettes
don't become nicotine addicts.
Most people who have a drink
don't become alcoholics.
Most people who try heroin,
crystal meth, or cocaine
don't become addicts.
The real question is why the drugs
are addictive to certain people.
What creates
the susceptibility?
What makes
them vulnerable?
When the American army
came back from Vietnam,
fully 20 percent of the GIs
were addicted to heroin.
A few years later, only 1%.
There was a 95
percent cure rate,
if you wish,
but if in my work
with drug addicted clients
in the downtown
east side of Vancouver
I had a 16 percent
cure rate,
I'd be recognized as
an international genius
because the cure
rates are really, really low.
How come 95 percent of GIs,
if the drugs are
addictive in themselves,
managed to overcome
their addiction?
Well, maybe we have
to look at their lives,
and maybe we have to
look at the circumstances
under which they 
became addicted.
Furthermore, if you look at the
aboriginal populations of North America,
these people actually had potentially
addictive substances available to them.
Not only were they available;
they used them.
There was peyote.
There were alcoholic
spirits in New Mexico.
There was,
of course, tobacco,
but there was no addiction.
If the substances in themselves
had been addictive,
and if these people are
genetically predisposed,
they should
have been addicted,
but there was no
history of addiction
prior to the coming 
of the Caucasians.
As a matter of fact,
the natives used these plants,
but what did they
use them for?
They used them in spiritual ways.
In other words, they used them
to elevate their level of consciousness;
whereas the very
essence of addiction
is to lower your
level of consciousness
because you don't
want to be aware.
So addiction is an
escape from awareness;
whereas the spiritual
use of these substances
is the enhancement
of awareness.
Now, if choice and
genetics don't explain it,
we would have
to look at history.
We'd have to actually ask
what happened to
the native people
in this part of the world
that drove them into addiction.
Alcohol has been known
in the Western world
for thousands of years
and there was plenty of drunkenness,
even in ancient times,
but there was no alcoholism
for the most part.
Alcoholism came around
in the 18th century
with the rise of capitalism.
You can make
a very good case
that one of the
medical outcomes,
or one of the health outcomes
of capitalism, is addiction.
In other words,
can you understand people
in isolation from the
system in which they live?
The answer is
that you can't,
first of all because the
biology of human beings
is shaped by the psychological
and social environment in which they live.
I can give you one example:
asthma. It's well known
now (it's not controversial),
that children whose
parents are stressed
are more likely 
to have asthma.
If you ask the average physician
what the connection is,
they have no idea,
and yet if you 
ask the physician
how you treat the asthma,
she'll say you treat the asthma
with stress hormones,
with adrenaline and cortisol,
or copies of them.
This is how you
treat asthma.
I'm not going to go
into the reasons why,
but shouldn't the very fact
that we're treating this
condition with stress hormones
cause us to ask, maybe,
if stress has something
to do with it?
So in a polluted area
where children are more
likely to have asthma,
it is the children of
stressed parents
who are much more
likely to have asthma
simply because the
emotional stresses of the parents
disorganize the stress response
mechanisms of the child.
When women are
stressed during pregnancy,
their children have abnormal
stress hormone levels,
and are more likely to use addictive
substances to soothe their stresses.
That's because the
emotional states of the parents
have something to do
with the physiology of the child.
That's just how it works
because you can't separate
the mind from the body,
and you can't separate the
individual from the environment.
If you look at the
parameters of stress,
what is it that stresses people?
The research shows
that what is the most stressful
for people is uncertainty,
lack of information,
loss of control,
and lack of opportunity
to express yourself.
When Karl Marx
talked about freedom,
he talked about freedom
in three senses of the word.
Freedom for him
was, number one,
freedom from
economic necessity,
freedom from
the threat to life,
freedom from interference
by other people,
and the freedom to express
yourself, to be yourself.
That's freedom.
What freedom is
there in this "free society,"
the "free world," the 
"freest society in history"?
What freedom is there when
people are not free of economic worry,
where there's tremendous
uncertainty and fear,
lack of control?
When people lack
control over their lives,
they have no freedom,
and they're
physiologically stressed.
When they're
physiologically stressed,
that's going to manifest
in the form of illness.
If you look at the
California-based studies
called the Adverse Childhood
Experiences Studies,
they looked at 18,000 people--
80 percent Caucasians,
10 percent Hispanics,
10 percent Afro-Americans.
They looked at what happened
to them in childhood
and what the adult
outcomes were.
An adverse childhood experience
was something like physical,
sexual or emotional abuse,
the loss of a parent due
to a death or being jailed,
or a rancorous divorce,
violence in the family,
addiction in the family.
For each of these
adverse childhood experiences,
the risk of addiction went up
by two to four fold,
so by the time a male child had
had six of these experiences,
his risk of becoming an
injection-using substance addict was
460 percent greater than that
of a male child that had
no such experiences.
So the risk of mental
illness goes up exponentially.
The risk of physical illness,
like autoimmune disease,
goes up exponentially,
and in Canadian studies
it has been shown
when children are
abused in childhood,
their cancer risk goes
up by nearly 50%.
Why?
Because you can't separate
the mind from the body,
and you can't
separate individuals
from the psychosocial environment.
But if you understand human
beings in their psycho-social context,
what do we see?
We see that stress is not just
an abstract psychological event.
It has physiological correlates.
So when you're stressed,
your whole body homeostasis,
or the internal balance, is perturbed,
and fundamentally you have
disturbances of the nervous system,
increases in the heart 
rate, blood pressure
and in the stress hormones
cortisol and adrenaline
which do their job
in helping you escape
or to fight back in the
face of an acute threat.
But if you're
chronically stressed,
they actually create disease.
Thin your bones, suppress
your immune system,
give you heart disease,
high blood pressure,
diabetes, and a whole
range of health conditions.
You're listening to
Dr. Gabor Maté
speaking in November
2011 in Berkeley, California
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We now return to hear
more of Dr. Gabor Maté
speaking about the connection
between society, addiction and illness.
Now, when it comes
to addiction,
and specifically in the
downtown east side of Vancouver,
I never had a
single female patient
who had not been
sexually abused as a child,
as were many
of the men,
and so what's always
at the heart of addiction
is emotional loss,
and the obvious ones
are those losses incurred
by those adverse
childhood experiences
identified in this
California study.
But there's another
side to it as well
because if you look
at what's happening
with this burgeoning
number of children
being diagnosed
with this or that disorder,
not all of them
are abused.
Many of them
were not,
but what's going on?
As D.W. Winnicott,
the great British child
psychiatrist pointed out,
there are two things that
can go wrong in childhood.
First of all, when things happen 
that shouldn't happen,
and that's the abuse
and the trauma,
and secondly, when things don't
happen that should happen,
and that's the presence
of non-stressed,
non-depressed, emotionally-
attuned available caregivers.
That's not available
in a country
where the average
maternity leave
is six and a
half weeks.
That's not available where kids
spend most of their time
away from the nurturing
adults in their lives,
in the company
of other kids
so that they're forced
to look to each other
as their
attachment figures.
The desperation of
kids to always connect,
the sense of
disorientation they feel
when they can't connect
with their friends
by some electronic means
is not a technological problem.
It's an attachment problem.
Those kids have been disconnected
from the adults in their lives
because the adults
are not there for them.
They can't be.
They're too stressed.
There was a study
out a few weeks ago
that showed that
stressed parents,
not unloving parents,
but stressed parents,
simply are
not as attuned
to the emotional cues of
their kids as they'd like to be,
and that's what the
psychologist formerly at UCLA,
Eleanor Shore, calls
proximal separation.
Proximal separation is parents
being physically there
but emotionally unavailable
because they're too stressed
and too distracted,
and that's what my
children experienced
when they were small
because I was a
workaholic physician.
This society rewards workaholism.
They tell you what
a great guy you are.
They reward you
for the very things
that undermine the
health of your family,
and for a lot of people
it's not even a
question of a choice.
When under the sainted
and behaloed Bill Clinton
the welfare laws
were changed
so that mothers could have only
a certain number of years on welfare,
then had to go to work,
where exactly does a single
welfare mother go to work?
Usually at a low paying job
far away from home
where she has to commute
for an hour or two.
All that time she's working,
and all that time
that she's commuting,
her child is in
some daycare,
inadequately staffed with
under-trained personnel.
Who has that kid got
to connect to?
The other kids.
Then children become
each other's connection.
That means that for
the first time in history
you have large
numbers of kids,
immature creatures, getting 
their modeling and their cue-giving,
and their sense of direction,
and sense of values,
how to walk
and how to talk,
from other immature creatures.
What do you expect in
that culture
but all kinds
of dysfunction?
And again, that's not an individual
choice that parents have made.
That's just another
way in which this system
has undermined the necessary
conditions for child development.
A study out of Notre
Dame University last year
showed that the healthiest environment,
actually, for child rearing
is the hunter-gatherer society,
the hunter-gatherer village.
Why?
Because in the
hunter-gatherer village
three things
happen to kids
that don't happen in our culture
anymore for many, many kids.
Number one, the kids
are always with the parent.
That's not possible
in this country.
Civilized countries actually
have paternity leave.
Never mind a six-week
maternity leave.
When the Puritans
arrived in North America,
they were appalled at the
parenting practices of the natives.
Do you know why?
Because the natives
didn't beat their kids,
and to the Christians this meant 
sparing the rod, spoiling the child.
So that's the first thing.
The second thing is
when kids cried
they were picked up.
Imagine that--
picking up a kid
when he's crying.
We're telling people,
when their kids are five 
months, six months old,
don't pick them up.
You want them to
become independent.
We're missing the point that the
way to promote independence
is to invite
dependence
because people
become independent
when they feel
secure in the world.
You promote independence
by inviting dependence.
In these aboriginal cultures,
they picked up kids
when they were crying,
which meant that
the kids' brains
didn't become overwhelmed
by the stress hormones.
When the child's brain becomes 
overwhelmed by stress hormones
because he was 
not picked up,
that has all kinds of impacts
on the child's brain development
because the brain develops
in interaction with the environment.
Even if you don't abuse
kids in this country
and you just follow
the parenting practices
recommended by
the so-called experts,
you're going to screw up
your kids tremendously.
Then the third quality
of the hunter-gatherer society
is that children
are brought up
in the context
of nurturing adults,
not just the parents,
not just the father,
not just the mother,
but that clan, community, 
neighborhood
that I was talking about before.
Any system that destroys
those conditions,
that stresses the parents, [hurts children].
If we think it's genetic, 
we don't have to ask
what happened to Black
people in this country,
and what the stresses
are on black males
that trigger their
prostate cancers.
We don't have to look 
at what happened
to the native people in this country, 
at what triggers their addictions,
or to many other
people, native or black,
or Caucasian, or whoever.
"It's all in the genes"
is an explanation
for the way things are
that does not threaten
the way things are.
Why should someone
feel unhappy
or engage in
antisocial behavior
when that
person is living
in the freest and most
prosperous nation on earth?
It can't be
the system.
There must be a flaw
in their wiring somewhere.
And finally, let me just
read you a quote
from another chapter
of my book on addiction.
Detective Sergeant Paul Gillespie,
head of Toronto Sex Crimes Unit,
rescued children from the
purveyors of internet pornography
as the Globe and Mail reported.
"On his retirement
from police work,
six years at that job
had not inured him to the
horrors that he witnessed."
This guy made it his job
to find out where in
the world it was happening,
where this child was
being abused on the net.
Then he retired and
the newspaper wrote:
"Paul Gillespie still can't get used
to the sounds of crying and pain
in the graphic videos
of children being
raped and molested
that he has seen all
too often on the web.
'It's beyond horrible
to listen to the soundtracks
of these movies,'
said Canada's best-known
child porn cop.
But it is the silent images of desolate 
children that tear most at his heart.
'They aren't screaming;
just accepting,' he said,
of the infant's captured
in these pictures.
'They have dead eyes.
You can tell that
their spirit is broken.
That's their life.'"
Why the dead eyes?
Because the child can't escape,
fight back, or seek help.
The only way that they can
possibly endure the trauma
is to shut down their
emotional awareness of the pain.
In this society, we have a massive
emotional shutdown,
and you can see it in the
increasing violence in the culture.
You can see it in the increasing
violence in the media culture.
Gory movies have to
be more and more gory.
Sports have to
be more violent.
People have to beat each
other to a pulp on television.
Because we're so
emotionally shut down,
it takes more and
more to titillate us,
and the sex has to be
more and more objectified,
more and more
salacious, really,
because what used to
excite people decades ago
is no longer sufficient.
Why?
Because we're shutting down.
And why are we shutting down?
Because we are hurt so much,
and the more we're shut down,
the more we need external
sources of stimulation
to make us feel anything at all.
In the case of the
abused child, of course,
the shutdown--it's obvious
as to why it's happening.
But the second point is
that if that same cop,
instead of quitting the force,
had transferred to the drug squad,
according to all the research,
who do you think he'd
be chasing in the streets?
Those same kids that
he didn't rescue
because according to all the research and the brain developmental data,
they are the ones who become
the street drug addicts,
because they're the ones
who are in so much pain
that they have to soothe themselves
with drugs.
Then what do we do?
We take people who
are abused to start with
and then we make
them a social enemy.
They are the ones who
make up our jail population.
So we try and rescue
them if we can,
and if we fail to rescue them,
then we persecute them
for the rest of their lives.
And that's what we're
doing with this war on drugs.
There's no war on drugs
because you can't wage
war on inanimate objects.
There's only a war
on drug addicts,
which means that
we're warring
on the most abused and
vulnerable segments of the population.
We could argue
left and right
about what a failure the
war on drugs has been
because you can
see that it's not working,
but you know what?
I have a different
point of view.
If decade after decade
after decade
the stated intentions of our
policies are not being realized,
in fact the very
opposite is happening,
then is it really a failure?
Or maybe is it serving
some purpose?
Maybe it's serving
the purpose
of maintaining
the rationale,
the raison d'etre
of law enforcement
and a repressive apparatus.
Then it can be used
against the people
when the need arises.
Maybe it has the
function of demonizing
a certain section
of the population,
and increasing the fear in
the rest of the population,
that justifies
more repression.
Maybe it has
the function
of keeping a whole
legal apparatus going.
Maybe it has
the function
of making a lot of money
for a lot of people.
Maybe it has
the function
of fueling the privatized
incarceration industry,
so maybe after all
it is not such
a failure at all.
And from
that perspective
was the Vietnam
War a failure?
No, it wasn't.
It was lost militarily,
but the end result was
that the US still gets to control
the economies of Southeast Asia.
Was the Iraq war a failure?
Well, it was for the
people who died there,
for the half a million Iraqis,
or a million,
whose lives are lost,
but it's not a failure
for the American oil companies.
So with every war
we have to be careful
before we call them failures.
Somebody wins,
but the somebodies who win
are the same people
who destroy neighborhoods
and communities.
It's the same system that
undermines human health,
that undermines
human dignity,
that undermines
human connection,
that really makes life
less tolerable on our planet.
We don't have to agree on
what the solutions might be,
and that's okay,
but what we do agree on
is the importance
of speaking the truth.
What we do agree on
is the importance of
people getting together
and struggling in a healthy way
for a different life
because if it's the
loss of control,
and the isolation,
and the suppression
of self-expression
that are the greatest
causes of stress,
then surely one answer
to the stress of this culture
is to get together and
to express ourselves
and not to be silent,
and to connect with
other human beings or,
as Joe Hill said, "Don't mourn.
Organize."
Thank you very much.
