Dr. Gabor Mate speaking at the Neuroplasticity and Education conference - October 25, 2013

so this quickly introduce myself my name is Simon Hayes and I'm the principal of Eton aerosmith school in Vancouver at the University of British Columbia it's with great pleasure that I introduce our next guest speaker dr. Gabor Ma Tei for 12 years dr. Mattei has worked in the Vancouver's Downtown East Side with patients challenged by hardcore drug addiction mental illness and HIV including working at Vancouver's safe injection site with over 20 years of family practice and palliative care experience and extensive knowledge in the latest findings and cutting-edge research dr. Mattei has written multiple books and published in 20 languages around the world dr. Mehta is well sought-after expert in mind-body parenting and childhood development as well as illness and treatment of addictions a renowned thinker and speaker he regularly addresses health professionals educators and the lay out Ian Stroud North America at the core of his work is an understanding of the broader context in which human disease and disorder arise and with an intricate mind and body unity and the root of illness and health if you would like to look at his work further I'd suggest going to his website dr. bubay Gabor maté a calm so thank you doctor thank you thank you very much can you hear me at the back can you hear me at the back now yes okay I'll assume that you can what the introductions don't usually mention it I actually used to be a high school teacher I taught high school for three years in North Vancouver and decided that was way too stressful so I went to medical school instead and went to work in a Downtown East Side with Vancouver I thought that'd be a relief so I know about many of you up against it was in 1994 well then let me backtrack a bit today you're getting many speakers maybe more speakers that then I would think is helpful that's up to you that's up to you to decide it's just that I think it takes the brain a while to acquire a new information and to incorporate it and to tell you the truth with all respect to the wonderful organizers of this event I'd much rather be talking for an hour and a half than for 45 minutes not other the pleasure of hearing myself speak although that is considerable but but but because I just want the space to communicate and one of the things that is less than us available in our society is space to communicate and that's also happening to us as a culture it's just impossible for a culture to adjust to the rapidity of change that's going on technologically so that were not been with time to absorb integrate and process what's going on and that's part of the problem that we're facing as healthcare givers as educators as health workers as parents and certainly as children going up in in society well my subject is the emotional basis of cognition it was in 1994 that Antonio Antonio Damasio a neuroscientist published his book de cartes error and here's what he says and he's talking about learning and he's saying that he used to assume that learning cognition intellectualization was a separate and in a separate process from emotionality and you know in Latin Homo sapiens are the name of our species the man who knows so we're kind of assuming an intellectual definition of humaneness let me see human Homo sapiens but but what the Damacio said in his seminal work is in twenty years of owner almost is that cognition is actually something that rests on an edifice of emotion so that the basis of learning and cognition is actually or emotional being and that emotional being is very much connected to our visceral states in the states in our liver of our stomach over a heart of our lungs over internal organs and that the mind itself and the brain the brain itself is an organizational entity that brings together information that's coming at it from the outside and from the inside at the same time and in fact the brain receives many more messages from the inside of the body than sometimes it does from the outside and the messages that it receives from the inside has a lot to do with how well we can engage the external world so that means our capacity to pay attention and to learn have a lot to do with what's happening internally on the visceral and emotional level and what our gut feelings are telling us and so in a society where people are less and less connected to their gut feelings there's a less and less engagement with the realities of the external world even though we're externally focused we are externally focused in a less efficient manner because of that disconnect and let me ask you this question and ask for show of hands how many has had the experience of having a strong gut feeling about something ignoring it and being sorry afterwards put your hand up expand okay no you see that just about everyone raised their hands no how many of you had the experience the obverse experience of having a powerful gut feeling ignoring it and being glad afterwards now we have one or two hands in an audience of many hundreds in other words there's something about gut level cognition that is absolutely valid and we ignore it at our peril but that's a function of living in a society that's that actually cuts us off from our gut feelings so that there's something internal that knows that is much stronger than when intellect is telling us in any contest between the internal knowledge and the intellectual knowledge 99% of the time that internal knowing will be accurate and the intellectual rationalization will be inaccurate so the Maceo says the lower levels in the neural edifice of reason are the same ones that regulate the processing of emotion and feelings along with the body functions necessary for the organism survival so this is calling us to have a view of knowledge and learning and cognition that takes into account emotionality and our internal body fades in turn these lower levels maintain direct and mutual relationships with virtually every bodily organ thus placing the body directly within a chain of operations that generate the highest reaches of reasoning decision-making and by extension social behavior and creativity now what is the situation in North America the situation is that we have millions of children being diagnosed with this died on the other and my profession is really good at creating new diagnosis so every time in the dsm comes out there's a whole bunch of new diagnosis in it with which you can label people now so I'll give you one example a common one is ADHD these days attention deficit hyperactivity disorder the United States according to latest figures at least 3 million kids were receiving our stimulant medications for ADHD in Canada the number of prescriptions for stimulant medications has gone up 43 percent in the last 5 years let alone the hundreds of thousands of kids who are receiving antipsychotic medications not to control psychosis which they don't have put the control what to control their behaviors and we don't even know what the long-term effects are of antipsychotics on any developing human brain the early indications are nothing positive so what we've got here is a massive social experiment in a chemical control of children's brains because we don't know what else to do and so when children don't learn the way they do or sorry the way we expect them to and they don't behave the way we expect them to we have two dominant responses the one response is to medicalize it let's call it a medical name and it's medicated and by the way as a physician I'm not against medications I've taken them I've prescribed them this is not a rant against medications but I'm talking about the limitations of the medical approach and I'm talking about the overwhelming domination of pharmacological approaches to childhood issues so there's that response the medical approach and then there is the behavioral approach and the behavioral approach says what's wrong with here is what's wrong here is the behavior itself so let's fix and control the behavior and that's dominate psychology these days behavioral approaches so the problem is the behavior so when a child is acting out let's control the behavior and parenting books will call you when the kid isn't doing this the parent should do that the child acts out and the parents they should have some way of managing that acting out but here's the thing about acting out look at the phrase itself it's a good English phrase it is a very specific we act out and it doesn't mean that were behaving badly we act out when we don't have the language to say something in words that's what acting out actually means so in the game of charades where you're not allowed to speak you have to act out to deliver your message if you landed in the country where nobody spoke your language and you had to portray hunger you have to act out kids are acting out all the time and our response is to control the behavior we respond to the form of the message rather than to the content of it and then we wonder why it doesn't work now in a Toronto school three years ago I think it was two years ago there was an eight nine year old boy who ended up in handcuffs because the cops were called and what happened was that this kid had I think Asperger's one of these diagnoses which is involves poor social processing and poor impulse control amongst other features and this kid had been bullied and he was very upset he was screaming I don't know what he was doing the teachers in their wisdom decided that what he needed was to be isolated and how often we do that the kids we isolate them well he was put in a room by himself at which point he really freaked out and know physiologically he needed something very very different and I'll come to that later but what they did is isolating him at which point he started throwing things and I think destroying the furniture and that's why they called the police and the police handcuffed his nine-year-old and a debate afterwards was or was the police right to drank off the kid but that wasn't the right question when you call the police they're gonna do what the police do which is to restrain that's what they're trained to do the real question was how come that well-meaning and I assume all educated teachers in a major school system had no understanding that what that child needed at that moment was the emotional closeness with a nurturing adult to regulate his newer physiology that's what needed at that moment and these incidents are not totally isolated I mean handcuffing is isolated but you know it was in British Columbia here eight or nine years ago there was a case of a hyperactive kid and at the in in elementary school at the teacher dealt with it by taping his his head to the bench to the desk this is how she learned to control his hyperactivity now there's another way to understand all this which is that these behaviors rest on an emotional metaphase and when the behaviors are not such as meet our standards or expectations and don't serve the child we actually have to ask ourselves what is happening for that child emotionally at that moment now and some and and let's face it there's many many more kids who having behavior problems impulse regulation problems body regulation problems emotional outbursts difficulties learning this is burgeoning in our society but the question is why is it because some genetic disease is someone mysteriously spreading in the population or something is happening in children's lives that is undermining their capacity to socially interact well to pay heed to pay attention to be emotionally regulated to have impulse regulation to be able to regulate their stresses now the prefrontal cortex you've been hearing what the brain today I'm sure and the prefrontal cortex has nine very important functions it regulates the body itself the people and cortex being the mammalian cortex the one that's latest to develop evolutionary speaking and it really is what distinguish ourselves from other animals it regulates the body it regulates attuned communication with others it is responsible for emotional balance it all allows us response flexibility so responsible accessibility means that if you say something to me that might upset me then instead of reacting by screaming back at you I can actually say oh okay what's happening for you that you said that to me and do I really have to take it personally and then I can respond rather than react providing insight providing empathy the modulation of fear so that when something happens then the fear circuits and the brain start taking over something in the prefrontal cortex will override that fear circuit saying okay calm down you can actually handle this intuition and morality now dr. Rick Hansen will follow my talk which i think is perfect and he'll be able to tell you that all nine of these modalities these nine functions of the Beefalo cortex are actually supported by mindful awareness practice and seven them at least and here's the key are supported and developed by nurturing parenting and I think all nine of them are because what we actually coming down to in our society and the reason that so many children are having so many problems is for no other cause but that the parenting environment has become so stressed so that parents are no longer able to provide their children with the environment that means functions and the prefrontal circuits that serve these functions can develop properly that's why the epidemic it's not bad parenting it's not the drinking water it's not some genetic disease that's spreading what's going on is that the conditions for healthy brain development of the prefrontal cortex unlesss less and less available for children let me turn now to an article that appeared in the journal Pediatrics which is the Official Journal of the American pediatric Association and this other quill appeared in February 2012 and it summed up very nicely the accumulated knowledge of the past several decades and the article is from the Harvard Center in a developing child and they say growing scientific evidence demonstrates that social and physical environments that threaten human development because of scarcity stress and I stressed the word stress here our instability can lead to short and physiologic and psychological adjustments that are necessary for immediate survival mentality ssin but which may come at a significant cost to long-term outcomes in learning behavior health and longevity in other words the things that young human beings have to develop as adaptive mechanisms to survive early stress will help them enjoy that early stress but in the long term will interfere with health and learning adaptation social relationships and even longevity now I was very glad to see that article appear because when I was diagnosed myself with ADHD back in my you know in in my mid 1950s sorry not in mid nineteen fifties in my mid 50s not that old I never bought into the idea that we're dealing with a genetic disease here that made no sense to me and here's why it made no sense to me first of all if anything is spreading in a population that quickly it can't be genetic because the genes don't change in a population over 10 years over 20 years not even 100 years so whatever it is is not genetic secondly I knew something by then and what I knew that tuning out which is the hallmark remember the prefrontal cortex function one of them is regulation of the body well I didn't know that but here's what I did know I knew that tuning out is not a disease on a contrary what actually is tuning out why the nature give us the capacity to to not to dissociate why do you think that is it's a survival mechanism it's a survival mechanism if I were to stress you right now by threatening you or just insulting you insulting your dignity as a human being you'd have three healthy options one would be to walk out escape flight the other would be to fight to challenge me stand up for yourself and if for whatever reason you're unable to engage in either of those modalities you have a third one the hundreds of people here in the room with you you could seek help because they please to help me this guy isn't bugging me but if none of those were available to you and the stress was immense and intense what your mind would do what your brain would do was escape from that I'm always escaping would be to just dissociate to tune out so tuning out is not a disease it's a nature given capacity that we have to escape or running stress that's what I knew what I didn't know and found out really almost by accident was that the human brain itself the very circuits in the prefrontal cortex that I mentioned those are those functions that develops under the impact of the environment so that which circuits develop which pre-fund circuits develop and how the emotional circuits developed depends very much on the early environment and the example is that of vision if you don't see light for five years after birth it doesn't matter how good your eyes are how good your genes are you'll be blind for their still life because it takes light waves to promote the development of the visual circuits it's that simple with the emotional self-regulation circuits that are not functioning very well on our kids these days with the attentional circuits that are not functioning very well with the impulse regulation circuits with the stress regulation circuits it's the same thing just like light is needed for vision the right environment is needed for those circuits to develop I'm talking about the physiological development I'm talking about the neuro chemistry of the brain I'm talking about oxytocin serotonin dopamine endorphins gabapentin not gabapentin but yeah all the important neuro chemicals that that modulate our behaviors the quantities of them their interaction the surface that modulate them they depend on the environment for their development an alien brain is particularly vulnerable because unlike other animals most of our brain development occurs after birth not before but also before so we also know we also know that already what happens in pregnancy has significant impact on the developing brain of the child so the more stressed women are the more likely the kids are going to be affected so if you're looking at the preponderance of autism and all kinds of other childhood conditions what are we looking at we're looking at the impact of stress on the parenting environment including a pregnant women a study after 9/11 looked at the stress hormone levels or one year with infants whose parent whose mothers had suffered post-traumatic stress disorder as a result of 9/11 during pregnancy and these children at 1 year of age had abnormal stress hormone levels which means that their stress regulation circuitry had been negatively affected by the mother stress during pregnancy which means they're more prone for addictions and behavior problems by the way and learning difficulties because too much cortisol the stress hormone interferes with learning and actually shrinks the hippocampus which is the part of the brain responsible for retaining memory and one could speak to you for at least an hour and really a day just on the effects of prenatal stress then there was a study out of UBC here either last year or the year before I think it's last year 2012 they looked at the genetic functioning we have this whole idea that genes regulate things and that genetics control things they do not genes are turned on and off by the environment that study is called epigenetics epigenetics is how genes are regulated by the environment so that in both in human studies in animal studies we know that even if people have certain genes that might predispose them to addictions if they're brought up in nurturing environments those genes are turned off so this UBC study looked at 150 genes in teenagers the expression which is the activity of the genes 120 of them had been affected by stress on the mother in the first few years of life 30 had been affected by stress on the father in the preschool years so that the stresses on the parents translate into the genetic expression of the teenagers a decade later so that the environment actually modulates the activity of genes and to return into this Harvard article then I can't give you all the information on brain development and the environment but they summarized it very nicely in this article and they write the architecture of the brain is constructed through an ongoing process that begins before birth continues into adulthood and establishes either a sturdy or fragile foundation for all the health all the health learning and behavior that follow and then they say the interaction of genes and experiences literally shapes the circuitry of the developing brain and is critically influenced by the mutual responsiveness of adult-child relationships particularly early childhood years so the key issue is the mutual responsiveness of adult-child relationships so that is a spectrum on the one hand you can have the calm non-depressed emotionally present attuned parent and on the other you can have the parent who abuses the child traumatizing the child now in the downtown east side of Vancouver over 12-year period I did not have a single female patient who would not be sexually abused as a child so the people that our government is jailing in large numbers or people that have been traumatized as children that's just the society that we live in in between that calm attune non-stressed grinding environment which incidentally is what people offer themselves when they practice mindful awareness the modalities as dr. Hanson will tell you yeah they're giving them stuff that attuned quite attention that's why it works in between that and the extreme of parents who actually act there won't from out on their children by traumatizing them there's a whole range and in our society that range is increasingly moving towards stress because parents no longer have the support they used to have they no longer have the extended family and tribe village there was an article out of Notre Dame University a couple of years ago they looked at the optimal parenting environment and it was the hunter-gatherer tribe because in hunter-gatherer tribe parents were present physically multiple adults of multiple generations will connect the emotion with kids the parents were always with the kids and so on and so forth the more spent is this not that this has nothing do with bad parenting it has huge stress granting the studies again are very clear when parents are stressed they're less able to attune to their kids the less able to attune to their kids the more likely their children's brain will not develop optimally and that's what educators you're up against these days now when we look at furthermore what the impact impact of early stress is on the child's brain and the capacity to learn what are we up against for we're up against those coping mechanisms that the child adapted so one coping mechanism was the dissociation the tuning out the problem is that when a child has to adapt these modalities chronically early in childhood that gets programmed into the brain and then 10 years later when Mikey's 55 years later that person is diagnosed with ADHD because there are times in the first year of life when every second so consider this space of time millions of circuits are being laid down millions of connections are being made it's that rapid it's that intense the brain growth so if stress happens in the parents life during that period if the mother is depressed for example or the father overworked or there's unresolved family issues that will have an impact on a child we're not talking about learned behaviors here we're talking about emotional based coping mechanisms no that's one way to the brain protects itself from stress another way that the brain protects is often stress is a calm emotional shock down of not being aware of feelings incidentally when you all put your hand up and said that you'd had the experience of having strong gut feelings and ignoring it you were telling the story of your childhood do you know that and your story of your childhood was is that your authentic emotions were not responded to by your parents not because they didn't love you but because they themselves were too stressed and that means you disconnected because it was too painful to feelings that were not validated by the world so they learned to dissociate you've got feelings from your aunt elect and then you became stupid in a sense of the inner knowing no longer being available to you now at the extreme case of that you have people who totally shut down emotionally the problem is shutting down emotionally means you stop learning emotional learning stops when you shut down so you shut down to protect yourself but for development you need the vulnerability vulnerability from the Latin bird Volman ari Willner ari to wound so vulnerabilities our capacity to be wounded and nothing grows when it's not vulnerable the tree doesn't go over it's hard and thick it goes where it's soft and green and vulnerable a crustacean animal like a crab cannot grow encased in a hard shell to grow it has to molt make itself soft and vulnerable same with children when children shut down emotionally they have difficulty learning especially from negative experience so they keep repeating the same stuff over and over again and despite the negative consequences they learn nothing from it and then the a dog gets exasperated I've told him a thousand times not to do it and he's still doing it well the proper response is if you've told him a thousand times and he's still doing it who's got the learning problem here clearly what clearly what we have to do clearly what we have to do is we have to find out what's going on for that child the third way of amor of emotional support action is detachment from relationship and particularly from relationships that threaten you so lot of kids detached from adult relationships and by default as we point out Gordon you for the nine-hour book hold on to your kids they connect to other kids and and when that happens learning also stops because for learning what you need you need curiosity but curiosity is vulnerable when you are curious you care about something when you emotionally shut down you don't care about anything it's boring it doesn't matter number one you also learn from trial and error but for tiny error you have to have the vulnerability to admit that something doesn't work and to be sad about it when you're defending against sadness when nothing matters you're not going to learn from negative experiences you're not gonna try something again instead you can say I don't care and you just give up but I don't care of the frustrated child people learn through attachment in other words when you are emotionally attached to somebody you want to emulate them you want to be like them you want to learn from them well that's fine in societies when children still attach to adults but what happens in a society when children emotionally are connected to each other so much that they can't bear to be without each other for one moment and every second that they're not in physically in each other's presence they have to be testing one another that's not a technological problem it's an attachment problem it also means that they're not learning from from the adults who can actually tell them what life is about they're learning from immature creatures so these are the consequences of those early adaptive mechanisms on learning so I need to be summing us up very very soon what is required then for the learning capacity of the young human being to really express itself well again a bit of neurophysiology if you will the human being has three fundamental ways to respond to the environment and and these follow an evolutionary ladder if you will our fundamental mode or at least I should say our most most primitive mode is the reptilian one and the reptilian brain is our brain stem low down in the brain and we share that with reptiles the reptiles being creatures who are cold blooded who cannot expend a lot of energy who have to conserve energy their method of doing of animal challenge is to freeze sink under the water so they don't have to use up too much oxygen conserve energy and that's the function of certain brain circuits which when activated will put us into a freeze mode that's fine for the reptile it can be deadly for the human being and it's certainly interferes with learning the second mode is the mammalian flight-or-fight response which happens higher up in the brain and it at the key activates the sympathetic nervous system allowing the so-called flight of fight response which involves adrenaline and cortisol the stress hormones which give us more sugar it so we have more energy which increased our heart rate so we have more blood pumping to our brain and our muscles and so on that's all fine but the problem is that these are both defensive modes and the human organism can be in defensive mode or growth mode learning mode but not both at the same time so that the mode in which we're in a learning phase when I'm paying attention to another person where I'm listening to a message that they're delivering when my middle ear muscles are activated in such a way as to take in verbal information when my head turns towards you so I can observe your face and respond to your facial expressions when I'm taking in and responding to the prosody the modulation of your voice that's yet another brain circuit that's another brain circuit and it activates a totally different set of nerves in a different part of the nervous system and that's called the social engagement mode and that and the nerves that regulate our social engagement behavior are very much connected to the nerves that carry information from our viscera from our internal organs and the nerves that at the same time regulate our breathing or breath whether it's shallow or deep whether our Airways are narrow or broad and our heart rate so again to go back to what DiMaggio said about that unity between the internal environment and our capacity to learn modulated through the emotional apparatus and that's called the social engagement mode but to be in a social engagement mode we have to we have to feel safe we have to feel emotionally safe now let me tell you as a physician interested in ADHD and that was the subject of my first book how many adults in their 40s and 50s I saw in my office who spoke with choked tones and sometimes tears in their eyes about something that a teacher said to them decades ago that was humiliating and the teacher meant nothing harmful by it they might even be in trying to humorously support the kid but as recent research shows there seem to be receptors in our temporal lobe that gauge our degree of safety emotional safety and when we don't feel safe then either fees or the flight-or-fight mechanisms are engaged and when a child isn't at fight-or-flight mechanism they can't learn when we yell at a kid when we exclude a child when we isolate them when we look at them in a harsh way I'm use a tone of voice that expresses our ETH our irritation and in comprehension when we don't understand the child's emotional state so the child feels a lack of a tournament with us were actually triggering their defensive states now one of the things that mindfulness practice will do such as we teach kids is to actually help them regulate their internal states but surely as long as they're immature and given that they're so connected to adults and children are necessarily dependent on the environment because they're not they're not independent they're not mature as long as that's the case and incidentally this is the truth for a lifetime that their emotional states their visual states the the heart and lungs the receptivity of their nerves their sense of safety depends purely on the environment and largely on the environment so it's up to us then to provide that emotional safety for them and that's much more important than the academic learning we're trying to convey not that that isn't important but without that emotional basis to it it just will not penetrate so dr. Stephen Fergus who's done a lot of the work on the neurophysiology that I've conveyed to you some of he says in an end to you when fear is removed it's empowering if your nervous system is safe you can do lots of interesting things when your nervous system detects risk and fear you can even sit in your room without being hyper-vigilant and that depends very much on our internal perception of safety but the problem is and this is my final comment the problem is is that when children grew up in stressed environments is increasing they do they don't even perceive safety when it's there they mistake safety for lack of safety and unfortunately sometimes they mistake lack of safety first and these are the kids are get into trouble and so that our job as educators as health care givers as psychologists as parents as anybody that is anything to do whatsoever children is primarily and first of all to forget about the not to forget about them but but but to prioritize and the first priority has to be the absolute emotional security of our children thank you [Applause] [Music]

Channel: Eaton Arrowsmith

Views: 43,428

Keywords: Neuroplasticity, Conference, Eaton Arrowsmith School, Magnussen School, Eaton Cognitive Improvement Centre, Eaton Educational Group, Education, Neuroplasticity and Education, Westin Bayshore Hotel, Gabor Maté (Person)

Id: OgiqMQTfw1Y

Length: 40min 28sec (2428 seconds)

Published: Mon Nov 04 2013