How SOCIETY & CULTURE Leads Us Down A Path Of TRAUMA & ADDICTION | Dr. Gabor Maté

addiction is the most human thing there is all addictions to attempt to gain pain relief emotional pain relief for something or another then this whole society is so expert at selling us stuff to fill those holes temporarily this is the whole ethic of this culture would you go as far as to say that pretty much all of us in western society are addicted to something well your words about what it means to be a human being really speak to me because addiction is the most human thing there is and when you understand it when you don't understand it it looks like an aberration an abnormality and some kind of a moral deviation but when you understand it it's a very human thing so let's just define addiction as manifested in any behavior that a person finds temporary pleasure or relief in and therefore craves and continues with it despite negative consequences so the definition that involves pleasure relief craving in the short term harm in the long term inability to give it up despite the harm now by that definition of course we're not just talking about drugs we're talking about all manner of behaviors from uh sex to pornography to gambling to eating to shopping to the internet to to gaming um to self-cutting to work as probably as a physician you know and and to any number of other activities and my contention is that all addictions they're not primary problems they're not inherited diseases they're not aberrations they're not more failures their attempts to gain pain relief emotional pain relief for something or another and so the first question in addiction for me is not why the addiction but why the pain and so if you have to look at why the pain we have to look at people's lives their life experience their traumas their um their adversity their their suffering and so that's why i say that now when you talk to other people what did you get from your addiction they'll say peace of mind they'll say connection with other people they see sense of control they say stress relief they say a sense of purpose those are all supremely human qualities in fact they're qualities that we all want in fact have every right to expect so that's why i said there's nothing more human than addiction now problem of course is it creates more pain but the the but the impulse is simply the addict just wants to feel like a normal human being that's all yeah it's such a profoundly different way of looking at addiction compared to i think the norm in society certainly the way many people view you know addicts yeah there's a there's a certain view isn't there the the addict is on the street corners homeless as destitutes yet we often don't want to put that mirror up and look at our own lies and go oh wow you know by your definition by that definition there's probably very few of us who can honestly hold our hands up and say at some point in our life we weren't addicted to something i think in this society hardly anybody hence in part hence the title of my book the myth of normal like we think that so many things are normal then there's the abnormal people yeah who are different from us i'm saying that that's a myth that that from the from the most abject and most dependent and most ill drug addicted people that i worked with in vancouver canada to the most elevated segments of society addictions are just rife yeah and and we're completely are blind when we choose one segment of the population to ostracize and to punish and to feel superior to and what we're really doing is denying our own humanity when we do that there's all manner of different things that people can be addicted to yeah i want to talk about one which i don't think is spoken about enough and that's online pornography yeah it is something that i think is it's just seeping there underneath people aren't talking about it i remember one of my patients uh not that long ago this young man he couldn't look at me gabor he couldn't look him in the eye so ashamed so ashamed and he was just sharing with me how he was addicted to online pornography and um when i asked him has he opened up with anyone is he shared with anyone no hasn't told a single person i was the first person he told and what was really interesting as i got to know him and i built up trust with him and rapport when he knew that he could open up with me and i wasn't going to judge him or invalidate him or look down on him actually for this particular chap in his life he was very isolated he didn't have a tribe he didn't have a community there was no part of his life where he felt like he belonged and for him the ultimate solution was actually joining a boxing club it wasn't just the physical activity it was the tribe he got i remember he said to me gabo he said yeah you know before i joined the boxing club if someone said to me do 10 press ups i wouldn't do a single one but in a boxing gym 10 means 10. and my conclusion with him was simply that he was missing a tribe he was missing community so in the the hole that left inside him he decided to fill that hole with online pornography yeah it was a symptom absolutely off the problem which really speaks to what you just said well a number of things come up as i listen to this anecdote one is um the compassion that's required for people to open up and to actually heal and so one of my teachers says only when compassion is present will people allow themselves to see the truth and so i know that one of your three core values that you often talk about is compassion and that's what this man needed to be able to open up and share and to look at himself honestly that's the first thing the second thing is when you study people addicted to pornography they're not actually after the pornography it's not about sex it's about um it's about a temporary spike of dopamine in their brain and dopamine being the brain chemical that makes us feel alive and vital and present and excited and curious now so there was something happened to this man to shut down that mechanism so he needed the extreme stimulation and titillation of pornography to get that dopamine spike so he can feel really alive he just wanted to feel alive that's all he wanted then he connects with the boxing community and he gets himself going physically and he gets his engagement with the group all of a sudden he gets his needs met in a much healthier way so again to to to criticize him and ostracize him and to shame him as he shamed himself he just wanted to feel like a normal human being that's all he wanted and that's the thing with addictions there's uh a certain hierarchical kind of preference we give to them you know certain things are acceptable addictions certain things are not you know pornography is not an acceptable addiction heroin is not an acceptable addiction but it's okay to be addicted to instagram it's okay to be addicted to consumption shopping or power or power yeah one of the big messages i feel the new book really makes a strong case for is that we're living in a society that has its core some values that are not conducive to good physical mental and emotional health and it takes a lot of pressure off the individual it doesn't mean that the individual can do nothing about it but i think it helps people realize why they're struggling so much well i know that a real core value for you is authenticity you know and then being oneself being truly once and i know that you've been some struggle in your own life to become yourself or to realize who you were and to let go what wasn't certainly that's been my pattern and struggle and and commitment as well this is a society that fundamentally demands of people that they be other than who they are because the demand the expectations that we fit in into structures and workplaces and educational institutions and families and social settings where if we ourselves we risk being rejected so that there's almost a universal demand for self-suppression which is we both you and i know uh creates both mental and physical health problems so that the core values of the society which are fundamentally materialistic individualistic aggressive and competitive they go against what it really means to be a human being and when you look at how he evolved as human beings like if you want to study a zebra where would you study him if you understand his true nature you start him in the london zoo would you study him out in the savannah or wherever he you know he or she lives well you'd have to study them in the natural environment in our natural environment i'm talking about eons and millions and hundreds of thousands of years of evolution and even about 90 percent of our own existence as a species we lived out in nature in small band hunter-gatherer groups yeah connected engaged belonging connected to nature connected to our gut feelings we had to be otherwise we wouldn't survive that's what it means to be human being now we can adapt to other other environments but that doesn't mean that we can thrive in them as well and so that in a sense what i'm saying about our species really we're like zoo creatures right now yeah we're living in an unnatural environment i'm not suggesting we go back to being hunter-gatherers but i am suggesting we realize what we've lost and how the particular social system in which we live right now demands that we stay lost yeah that's my whole point once our eyes get open to this yeah because as you mentioned for much of my life i've been blind to this you know i i felt that success was important being competitive was important being a winner was important and as i've shared a lot of these behavioral adaptations to my own childhoods i find an inner sense of peace and contentment and calm that i never had before yeah and actually what's really interesting is as you do that a lot of the addictive tendencies i had they fall away not because you're trying to that's right you're not trying to stop the addiction this is kind of what i feel a lot of the time with let's say something like alcohol and there's medical doctors we say you know this is the limits you know you should drink under 14 units of alcohol a week or whatever it is which frankly i find a lot of public health guidance quite unhelpful i understand the need for it but a it's dry b there's no understanding within that of what role does the alcohol play in that person's life and yeah i feel the classic case of something like alcohol is new year you know people decide on january the first that this year's gonna be different i'm right i'm not gonna fall into the trap i fell in before i'm going to cut down my intake and you know they do for the first week and the second week and they they're not drinking at all but by the third week you know when the stress of work is still there when the toxic relationship that they're in is still there when the boss that doesn't value them is still there it starts to creep in because the alcohol is playing a role right serving in needs and coming back to this cultural point you mentioned where would you study a zebra yeah right i think there's a key point here you know who are we as humans many of us feel that we are competitive right conversation is something i think a lot about right as someone who used to be competitive who is no longer competitive really i can put my hand in my heart and say yeah i'm not competitive anymore that was a that was a trait i developed but some people say competition is natural and i i guess my view is that it comes down to the relationship you have with that composition so can you speak a little bit to competition well yeah well first of all i know something about your personal history which is that you know being um immigrants from the subcontinent here to to the uk and your parents with all their good will they put this pressure on you to excel that that if you were i think i heard you say once that if you only got 99 percent of the test your mother would say what's wrong about the how come you can get 100 you have to be the best that's to be the best yeah now they did that out of their anxiety that you succeed in this world in which you came with some disadvantage being immigrants and maybe people of color as well you know but as a result you become competitive that's not your nature that's just your second nature but even in the phrase second nature there's an implication that there's a first nature and and and the first nature is you just are human being you want to belong now competition it depends what the intention is if it's a competition in the sense that you want to manifest your best and in a sense you're competing with yourself yeah not to be better than anybody else not to beat or to dominate or to subjugate or exclude somebody else but just because you just want to be your best well that's that's great the idea that we're individually competitive creatures really comes along with the rise of capitalism which is a system based on competition where it is dog-eat-dog and where the bigger fish do follow the smaller ones and as we can see this happening right now with the tremendous rise of inequality in the last decades you know eight people in the world now control as much wealth as the bottom 50 percent of humanity now the interesting thing about human nature is that when people do something selfish or aggressive or competitive what do we say well that's just human nature but when people do something selfless and generous and kind nobody says oh that's just human nature so there's an assumption in this culture and what we do is we take the core values of a particular materialistic culture and we project them onto human beings as if that was our true nature it isn't and to the extent that we try to conform to it we create suffering for ourselves and for others you know now competition as between liverpool and manchester city in this capitalist world even like it's pretty vicious not in the sense of the players being vicious but in a sense of how can we get the best players in the world and who can pay the most money for the best striker and where will hogland go will go to manchester city or arsenal even on that level what is meant to be play we talk about playing football but it's no longer a play becomes a business of dominating others so whereas it could be just play which is and then play there's no consequences to humans and who doesn't yeah it's just for the process it's just for the enjoyment it's just with the sheer pleasure of the activity the human beings are meant to play there's a circuit in our brain that's designated to play play is essential for human development for human child development for the brain development but even the play we've been into a competitive cutthroat endeavor yeah that's how far d nature be become i think if you are familiar with johnny wilkinson probably one of the world certainly one of england's most famous rugby players ever when johnny was a little boy yeah he wrote down his dreams on a piece of paper he said i want to play for england i want to win the world cup now the problem for johnny is that by the age of 24 he'd achieved his dreams right so yes he plays for england and then he helps england win the world cup in the most fairy tale situation he kicks the winning goal in the final minute of the world cup final the sort of thing that kids all over the world now would dream about doing he did it at age 24 the problem is is that he said as the ball left his boots even before it had gone through the goals he's starting to go down i get it in his mind the following morning this is after they won the world cup first time in years national hero he can't get out of bed hmm lonely depressed i find his story incredibly fascinating because he ticked the boxes of what society says you need to do to be happy and successful yet it left him with this inner turmoil and he said something to speak about he said many things but one thing in particular remember is he said i used to play rugby for the joy of the game it's a play at some point it changed from being joyful and playful to being something that said something about who i was yeah and he thought winning would say something about him and his relationship to rugby changed yeah it's a incredibly powerful story and it illustrates the point that i've often made is that this two common ways to wake up one of them is to fail but and even more dramatic ways to succeed because then you realize that you've got what you wanted and it's empty yeah because it's all been external and so in a certain sense people who are succeeding they're they're fortunate because they have because as long as you're failing you might keep thinking if only i succeeded i'd be happy you know but the people who succeed and then they realized that they have a much more rapid opportunity to wake up because knife got what i wanted and i and it's nothing that's still the whole yeah i mean you and i both know this i mean we both have been successful physicians and as a child whereas if your parent could have pictured your future you're my future you know famous and physician and successful and all this kind of stuff but we both know how empty it is in itself no it doesn't need to be if it's fulfilling if it expresses who we are if it's aligned as you say if we're in alignment then it's great but it's precisely when we succeed that we find out was this an alignment or was it not and often it isn't i guess there's that wider point there which is success yes what what is that definition of success yeah because if we talk about the toxic culture in which we live many of us around the world live yeah actually you know by its metrics of success society is successful you know making a load of money people consuming lots of different things you know new fashion every three months people buying clothes they don't need endlessly consuming things that they don't want even you know i was thinking the other day about sustainability and the environment and even the word sustainable and then sustainable products i was looking yeah the elephant in the room here is that we sure there's there's a value to sustainable products but if we're still over consuming sustainable products it's not that sustainable and what it ignores is that like if everybody in what we call the third world order will be eu famously called the developing world consumed at the same level as we do in this world it would take several earths to support the population so even the so-called sustainability is only sustainability so far as it's restricted to a fairly small proportion of the earth's population and so that in a global sense there's nothing sustainable about it whatsoever people often hear this get what they hear you speaking or me speaking or whoever is saying you know these things don't make us happy yeah jim carrey i think was once quoted as saying i wish everyone would become rich and famous so they could realize it doesn't make you happy but the common view from people is yes it's okay for you jim to say that you've had all that success gabor it's okay for you you've got all these successful books millions of people around the world watch your thoughts it's okay for you or or the same thing to me right so i guess the question is how do we help people see this without having to go to that extreme first is it possible well you know and those people who point that out to us they're making a valid yeah statement you know i agree yeah it is easy for you and i do this at this point all i can say to people is you have to find out for yourself you know when do you feel good about yourself when you're straining for something external or when you're aligned with yourself when you've have got other people's approval even on a limited basis i mean not everybody's going to be famous neither is going to be you know in the public eye but everybody has a certain circle of belonging a certain circle of engagement when in that world you get a probation from others but you're denying yourself how do you feel when you are being yourself even if others don't approve how do you feel when i say how do you feel what's happening in your body and most people most of the time if they've paid close attention they'd realize that when they're being authentic is when they feel really good about themselves even if it means and let's face it i mean but to be but to be fair to you and i we didn't exactly make it because we tried to fit in we made it because we at some point decided that we're just going to speak our truth yeah and especially as physicians you don't immediately get a lot of brownie points for pointing out the shallowness and just limited world view and and actually harmful binary division of mind and body you don't get a lot of accolades within the profession for pointing these things out so it's not like i didn't set out for success honest to god i didn't i wanted it i'm not denying it you know and i had a lot of ego investment and whatever i did i did but fundamentally that wasn't what was driving me or calling what was calling me is i just once that you start seeing certain things yeah you just want to speak them and it was that desire to speak my truth that led to whatever success i've had yeah and i would guess that something similar is true for you as well yeah 100 and i think what's so powerful about that is that these things can co-exist right you can be speaking your truth you can feel compelled to write a book that the world needs but you need to write that's right and also like the success that comes with it right it's not either or it's not either it's completely selfless you know maybe there is a selfish component to these things as well at least at the start at the start yes at least so that's certainly been my experience you know i felt compelled to speak the truth as i saw it the frustrations i had within medicine that for so many patients i think we're underserving them with our reductionist simplistic biomedical model without taking into consideration all the other aspects that drive health yeah but yes it was you know my son nearly dying when he was six months old that oh gosh um where he drove me it completely changed my world view on what is important you know i i had to speak up i had i thought i had no choice but to speak up that's right and yes over the last years i've had a high degree of success whether it's with this podcast or my books for sure but over the last two or three years i've really i've already gone deep capital your work's helped me hugely with that for sure but also the work of you know dick schwartz and ifs yeah you know internal family systems has been transformative for me in terms of making peace with various parts of myself and yes now honestly i sit here before you like a different person to when i first met you three or four years ago like i i feel when i when i met you last time face to face i feel i had multiple holes in my soul and you know we had a great conversation that people enjoyed for sure but i feel i sit alongside you today complete and whole and i've never felt this deep sense of contentment and happiness hmm well i'm so happy for you um when you talk about holes there's a teacher of mine that i quote often age almost and he says that we're born with these innate essential qualities as the world doesn't recognize them or discourages them we shut them off and we develop holes instead then we spend all our lives trying to fill these holes until we realize that just as soon as you know like self-love or you know self-acceptance or clarity or courage or love for others or a sense of belonging or a sense of unity these get shut down develop these holes instead then this whole society is so expert at selling us stuff to fill those holes temporarily but only temporarily so you have to get getting more and more and more and the whole society lives on trying to fill people's holes that can never be filled from the outside this is the whole ethic of this culture in terms of the writing the book i was sharing with you before and then writing this one um it it it really wasn't okay i'm gonna write this book and become even more famous uh honest to god because uh i suffered writing this book i mean i i'm not saying this self-pitying the i'm just telling you what happened 10 years i collected 25 000 articles uh of newspaper reports scientific papers medical journals and so on a couple hundred books uh 300 interviews and then three years of writing like every day and at times i sat there had nothing to say i didn't know there's nothing was coming out of flowing from the tips of my fingers and i thought i can't do this i talked to russell brand once and russell said remember something you're not doing this for yourself you're doing this for the world and that really helped get over your own ego just do what you need to do and at some point they actually weekly talked to a therapist for a couple of months i was so despondent about this feeling that i had um there's so much i want to say and what i want to say is at least i think is so important and i'm not finding the way to to get it out of me so that wasn't done for my pleasure believe me that that was really done because there's something in me that i just wanted to be said you know that's so powerful gabor because i think for people to hear that yeah that you this esteemed globally respected physician when writing this latest book and you've written many fantastic books already right that you are getting consumed with self-doubt and insecurity about you know have i got anything my my blood pressure which is usually that of a baby's was going up yeah i was getting concerned i would have to go on blood pressure no of course i didn't have to go on medication but it was just the finding somebody you know somebody said to me a very wise therapist she said your problem is not the book your problem is your relationship to the book and just that the rugby player that you mentioned i'd allow myself to be totally identified with the book yeah so my success or my validation as a human being depended on how well this book was doing well actually what's the reality let's see if i'd written a lousy book and nobody wanted it and it's not the end of the world it doesn't change who i am it just means that for once i didn't succeed you know but it's the identification that had me so anxious as we have this conversation you are maybe two months out from publication three it's okay three months okay but this is going to come out yeah when the book sounds yeah a lot of us we know the right things to say you know you know we we've studied this we know what we should value yet we still can't help falling into traps these these traps i think society lays out for us at this stage in your life you've heard me say that i think your new book is a masterpiece yeah um and i genuinely mean it from the bottom of my heart let's say the book comes out and it's not as successful as i think it's going to be as maybe you think it's going to be or maybe your publishers think it's going to be as i think it should be well yeah right what is as honestly as you can what would you say is your relationship with that now if this book tanks when it comes out yeah what does that say about you know something that's something i've engaged with over time now whether i'm fooling myself or whether i'm being authentic here what comes out of me is you know what this is the book i wanted to write yeah after all that struggle and all that this book it's a long book but it was double as long when i first finished writing it my son and i who helped me write it and we had to cut it and trim it and rewrite it and rewrite rewrite it but now you know what this is the book i had envisioned 10 years ago when it first occurred to me so you know what no it's out in the world not up to me anymore but i'm but i'm satisfied that i said what i needed to say now talk to me four months from now if the book tanks how will i be feeling probably feeling lousy in some ways but it's not going to fundamentally affect who i am and it's not going to really affect my core happiness uh my core sense of what my life is about uh my sense of myself it is not going to affect that yeah it's going to be okay regardless i believe you i i honestly believe you um i happen to think it will be a big international bestseller as they say i i think it's a must read book for everyone but if i may i'm going to share my own experience with that which again you know the wrong enough even five years ago would have felt too shy and um insecure about sharing right um you've touched on some of my childhood story i know you've read my latest book you've heard a lot about how i saw myself when i grew up which was very much i felt loved and validated when i had high levels of success it's nobody's fault my parents did the best that they could they wanted the best for me yeah but little rongan took on this very very toxic idea that has led to a very lonely place inside me for much of my life yeah now like you i'm i'm someone who has taken all of these societal blocks of success yeah you know this is a you know millions listen to this podcast each week a lot of people buy my books they've all been sunday times bestsellers right yeah now what was interesting is my latest book happy mind happy life came out i don't know two months ago two and a half months ago in the uk yeah and you can't write a book like this without doing a lot of self-reflection on yourself and i remember the week or two before it came out i was just chatting with people close to me i was thinking about it and i genuinely thought like you've said gabor this book is the best that i can do at this moment in time it's exactly what i want it to be i've i've really tried to distill a lot of complex ideas down make it really simple very readable very practical which is my goal when writing it how this book does in the world yeah it's no reflection of who i am as a human being if nobody buys this book it is still a great book i'm still incredibly proud of it and it says nothing about who i am now i was pretty convinced that i honestly believed that but as you've hinted to we're pretty good as humans are kidding ourselves as well yeah yeah now here's the reality the book comes out this is a success it's the most successful of any book i've ever published and about a week after it came out like i got a text from my senior editor saying hey wrong can you give me a call please i thought this is this is weird i never kept text like this so i said sure so that's why i called her she said wrong and we just found out this sunday you're going to be the number one sunday times paperback bestseller in the country congratulations yeah now the point of me sharing this and this is where my insecurities come for sharing something like this you know will people think i'm being arrogant what they think i'm boasting i i promise from all my heart and soul this is not the purpose of sharing this the purpose of sharing this is in that moment gabble i didn't feel this artificial ego elevation yeah i really didn't yeah i i was just quietly content i could hear her excitement and the team's excitement in the background i didn't feel i know for a fact that five years ago i would have been jumping through the ceiling yeah i would have phoned all my friends but honestly i thought okay this is awesome this my message is going to get out there to more people fantastic but my wife's out i still need to wash my daughter's uh sports clothing before school tomorrow still needs to cook the kids dinner yeah and for me it was a real life test where i thought you're saying the right things you think this is happening now in the actual reality now look what would have happened had the book tanked i i don't know yeah because that didn't happen but i for me that was a really powerful real-life scenario where i thought hey hey buddy maybe you have actually healed these these holes inside yourself because actually you didn't feel it you didn't feel it like you used to well it's wonderful i you mentioned your wife when you were talking it made me think of my wife because she has never wanted my success she wanted me the real person and so she as much as she appreciates the success and celebrates it if i get too caught up in it if i start identifying myself with it i have somebody to come home to who'll knock me off my pedestal pretty quickly you know which is great you know you know and uh you know her my relationship with with rey is woven throughout the book because it shows up in so many areas of parenting and male female relationships and why women get chronic illnesses more than men do and so that we've sort of lived the whole thing and uh i have to say left on my own uh my head will be a whole lot bigger than it is but but but thanks to no of course i give myself credit i chose that relationship yeah and i chose to stay in it i i'd rather have the truth than whatever similar outcome of truth i could sort of project and blow a balloon like out there in the world but i it it it's it's essential because you know i'm and and i came to success rather late in life i mean you're a young whippersnapper compared to me you know um but here i'm 78 and it i can handle it now yeah i i honestly got 10 years ago it would have blown me away yeah it's interesting because i think all these things are relative right because you're saying 10 years ago you would have struggled yeah but 10 years ago you were still you know pretty experienced in life right yes you know and and i say because where i think these things all become relative is my first appearance on the public stage was in i don't know 2015 where i got my own prime time bbc one series called doctrine the house where i go and live alongside families who are struggling with their health for four to six weeks they've all been under gps and specialists before they're all struggling and without fail every single family after six weeks either their conditions were fully reversed or they were significantly better whether it's you know type 2 diabetes has been put into remission fibromyalgia pains gone in six weeks uh panic attacks down by eastman all through helping them understand the various drivers in their life that were influenced in their health what does that say about the actual practice of medicine because you take something like fibromyalgia which most physicians if they know anything about it all they just throw up their hands in frustration yeah uh whereas what imagine what happened was that the presence of a compassionate um witness and physician and guide changed those people's relationship to themselves yeah and it's that whatever lifestyle choices they may have made that would be more healthier fundamentally what happened is the transformation of the relationship themselves and and that's the key to healing um not just in pharmacy but in a whole lot of other conditions as well that's something i explore quite a bit but it's that that's the part that western medicine doesn't get and and so these so-called miracles turn out not to be miracles at all they're only what you'd expect if you understand the mind-body unity in its scientifically demonstrated physiological psychophysiological unity you'd expect somebody to get better once they get into a healthier relationship with themselves for which they need somebody with compassion and some insight to to guide them and to reflect their process you must be frustrated as i am sometimes and i know some colleagues of our ours are as well it's just how much more we could achieve as physicians if we just understood these basic principles yeah i am i've gone through various emotions over my career you know i'm pretty much 21 years then yeah in my practice as we speak um i used to get frustrated and i guess i went through a phase of anger yeah um but i'm a lot more at peace with things now i i it doesn't really rile me up in the way that it used to i feel a lot calmer about it um i i want to talk about some of the problems with western medicine so i think you know we're both physicians we both practiced for many years within that system yeah so i think we we have a perspective that's useful for people i'm sure i think there's a whole multitude of problems i'd love your view on that one of the things i've been thinking a lot about recently is in fact i was on the tube last night i normally only record podcasts now in my studio but i knew you were in london i i had to speak as i came down to london i got the tube to my hotel and a chap stopped me and on the tube to talk to me which is very rare in london he'd heard me on a podcast he he's a psychologist he he loved the sort of content he was hearing and he said something to me which is it's interesting that you guys as doctors you seem to know a lot about psychology and yourself but actually most doctors he meets and works with he says he doesn't have that perception of them and he said to be a clinical psychologist you have to demonstrate that you have done a lot of self-reflection that's right i found this fascinating i thought wow and i said what's the average age when someone becomes a clinical psychologist and i think what he said to me was around 27 and i thought was really interesting in the uk you can go to medical school when you're 17 straight out of high school yeah you can depending on where your birthday is in the year 17 or you've just i mean i i had literally just turned 18 when i went to medical school so i was actually so you didn't have to do a four years of pre-med you go straight to medical school which means you could potentially be a practicing doctor at 22 or 23. frightening it is frightening because what you know of course everyone's different but what life experience yeah do you have but i find that really interesting how many doctors have never been through a period of self-reflection and therefore potentially can't help their patients with that it's even worse than that uh i don't know what the quality of medical the experience of medical school here is in britain but when you talk to fellow physicians when i talk to fellow physicians in writing this book and reflecting on my own experience there's a lot of pressure stress and even trauma in medical training and there's one particular study that's rather alarming you know what telomeres are telomeres being the these chromosomal structures or dna structures end of our chromosomes that are meant to keep our chromosomes healthy let me just put it in shorthand like that the length of our telomeres are some markers of biological aging and stress so that the more stress the more aged we get the shorter our telomeres get the telomeres of medical residents medical students fray more rapidly than those of other people their age in other words the the stress of trainers is so not only are we callow and unexperienced and without a broader vision when we enter medical school the pressure that we're under further traumatizes us and makes us even more tight and less open so that when they've done studies on compassion um in medical students some of the studies show that the highest level of compassion is as they begin their studies and after that it diminishes and not because they mean ill or anything like that but because of the stress and pressure of the training itself and because of the narrowness of the education yeah so that then then we get out there and we deal with people with complex life problems and all these chronic conditions that have huge emotional um scientifically demonstrated and demonstrable pathways where their emotions and their relationships and their social standing and [Music] their context has everything to do with their physical conditions we're in nowhere people no we're prepared to recognize that so we concentrate as you said earlier in this conversation on pretty um shallow symptom control at the very best yeah now you and i both know the miracles that western medicine has also achieved yeah you know so this is not in any way to dismiss the findings and brilliant achievements of our profession and the science that we follow it's only if we could apply that science in a much more broader and humanly framed perspective we could achieve so much more and the population could be so much more healthy yeah there's a couple of things there for me um i just want to echo what you said that modern medicine has you know had so many phenomenal achievements and so many life-saving treatments and and all kinds of things that it does but i do certainly feel for much of chronic disease exactly i would say much if monitor medicine is broken i think i really do well certainly parts of it if we take the i guess if we take dick's uh ifs model and different parts within ourselves i guess we could apply that same thing to what to modern medicine and chronic disease management that there are certain parts within it that have been exiled well let me exactly so let me give you a really salient example take something like multiple sclerosis yeah which is an autoimmune condition that affects the nervous system results in weakness paralysis sometimes blindness um you know balance issues um it can be very debilitating now the multiple sclerosis was first described by a french physician called jean-marie charcoal in the 1800s sometimes the mid-19th century i forget exactly when he said that this is caused by long-term vexation and grief now since then there's been dozens of studies showing a relationship between childhood trauma multiple sclerosis stress and multiple sclerosis overwhelming evidence and also that if we deal with these stresses or we have social support the disease abates or becomes you know so so what i'm saying is it's not this is not fanciful we also know the pathways you know because we know how stress can cause inflammation in the nervous system you know um and despite this scientifically demonstrated relationship between stress and multiple sclerosis the average neurologist will never ask their client about their childhood trauma or about what stresses are in their lives or but even helping them understand that the flare-up of the disease could be a teaching moment and where the patient could investigate well how did i stress myself or what stress i was under before this flare-up in other words the disease is assumed to have a life of its own yeah but but it doesn't the disease is a process that that reflects the life experience and if we can affect that life experience we can affect that process now i'm talking pure science here but it's science that completely eludes most people in our profession you've detailed yes in this book but also in your previous books as well the detailed science behind this and then when we talk about evidence-based medicine yeah you just think well you know really are we practicing evidence-based medicine or are we practicing selective evidence-based medicine well you know what my opinion evidence-based so if there's one phrase i could delete from the medical dictionary would be evidence-based yeah because i only wish you know it's not evidence-based practice it's practice placed evidence and like we we keep doing the same thing over and over again and then we gather the evidence from what we do yeah it's also you know this this whole thing you know what is that you know holistic definition of evidence-based medicine it's three things isn't it it's research evidence it's clinical experience and expertise and patient preference whereas yeah in this modern world now it's just become one of those things what's what does the research show yeah as if our clinical expertise as if seeing people reading them what a patient might want for their condition is like irrelevance and and so i i have a real problem with that term as well i do think all doctors at their core want to help of course uh i don't think the system is that helpful you know certainly 10-minute consultations 15-minute consultations really are completely inadequate now to actually look at the various things that are influencing disease and i guess one of the great things for doctor in the house for me was that i would see things coupled even if i had an hour with a patient in a consultation stream i would never they would never come up i would see relationship dynamics how would one party talk how would a husband talk to a wife that's right what was going on before bedtime yeah i was like oh this is interesting um i wonder if that's why she is sick at the moment you know all these things started to go in my mind i thought this is almost like um i feel so fortunate to have had that experience well you know and this is where i think that family physicians should they choose to use the opportunity or in an advantageous position because there's a family dog i knew a lot more than my specialist colleagues they understand not about their particular field which they knew infinitely more than i did but i knew the person before they got sick i knew the family background i knew the multi-generational family background and so that to me the person wasn't just a disease it was somebody manifesting a life not that i knew that right away it took me some time to realize what was i looking at but you knew intuitively but intuitively i knew and so uh there's another face that might drive you as badly as it drives me this evidence-based practice then there's anecdotal that's anecdotal like if you tell a story about a patient that's actually for god's sakes yes it's anecdotal and i pay attention to anecdotes people's life experience matters to me yeah and and how these how they view their life experience matters to me it's part of the evidence yeah one of the other things you mentioned before when talking about the medical school students fraying their telomeres and shortening them yeah it just made me think like an idea that i spend a lot of time sitting with these days is that our experience of the world is dependent on the state of our nervous system yes so if we have a nice calm relaxed nervous system yeah we can see things our vision is peripheral we're open it's outward we can hear whereas when we have this stress the tuning of your nervous system then is slightly higher maybe significantly higher and what happens when we're feeling stressed our vision becomes narrow and focused right so if we think about the profession as a whole if there's a chronic state of stress and you've only got 10 or 15 minute consultations and you have patients coming in with chronic complex issues your focus being narrow is a problem you know it's fundamentally built into the system and do you know what i mean it makes me think totally and and patients feel it patients feel because they come out of there thinking or i wasn't hurt i wasn't seen you know and um it's certainly true that the the state of our nervous system determines the state of the world as we perceive it and going back to a point you made earlier what if an essential aspect of medical training was actually self-awareness and not just only self-awareness of the broad sense of who we are and all that but just what am i experiencing at the moment because the energy that i'm experiencing at the moment is going to be felt by the patient now i'm in a position of authority as a physician [Music] if i'm tense there's no way that's not going to affect the the the emotional and physiological state of the of the patient now in certain in the more mechanical aspects of our profession like an orthopedic surgeon when the person when the patient is asleep on the table you know i i just want a guy to have good hands and with a woman to have good hands and and to be able to perform the technical aspect of the operation so in that acute sense it's not as important not that it isn't but it's not not nearly as important i'd rather have a technically skilled those big surgeon who is an emotional idiot then than somebody who's emotionally really sensitive and lousy hands you know if they're going to operate on my femur you know but that's a rare example when we talk about the chronic conditions of the mind as in psychiatry um or in chronic conditions of the body as in autoimmune disease and malignancy and and and uh you know chronic inflammations and and so on um this lack of awareness of self and of the client is a huge handicap that burdens our profession and limits our capacity to deliver good care and nothing in our training uh prepares us for it a couple of times in this conversation you mentioned stress yeah and i'd like to talk a little bit about stress because i think it's a term that is thrown around a lot these days and often when doctors talk about stress and put patient symptoms down to stress yeah patients can often feel unheard and say you know that they feel and i think often that comes to the way we communicate these things and if we become skilled communicators i think we can very clearly explain what we mean by that but i think stress hormone gets misinterpreted you mentioned when you were writing your latest book yeah that the emotional stress that you created in your mind would raise your blood pressure yeah right so you were making yourself you know sick absolutely i was through no physical threat yeah through just your relationship with this book and what you thought it should be or could be yeah so stress is endemic these days the world health organization still calls stress the health epidemic of the 21st century right so how do you see stress and how do you see its relationship to disease well it's one of those as you uh imply it's one of those words with a double meaning and it all depends how we use it a related word is psychosomatic like you and i both know in the best possible sense of the word that a lot of illnesses are genuinely psychosomatic because psyche means their emotional apparatus and soul if you will and soma is the body and because of the mind-body unity and the unshakable unity of our emotional system and the brains the emotional circuits with the nervous system the immune system and the hormonal apparatus it's a unit it's a psychosomatic unit that's a really great word but when most people hear psychosomatic they think we're just telling them they're imagining their diseases which is very often if doctors have used it yeah and the same with stress now stress is a genuine psychophysiological event stress isn't some fancied imagined fantasy on the part of the patient stress is actually what happens when the organism faces pressures that are beyond its capacity to deal with chronically and that results in the release of stress hormones adrenaline and cortisol amongst other things stress also affects the immune system stress affects the gut starts to affect the brain it affects the heart you mentioned high blood pressure what's the medical term for hypertension for high blood pressure hypertension i mean as physicians we're trained that well there's five percent of hypertension is explainable due to kidney disease or some hormonal abnormality but 95 is we call it essential essential hypertension which means we haven't got a clue what's causing it come on people read the word hyper tension hyper tension too much tension that's what causes hypertension i mean in those from all kinds of studies in other words it's the impact of stress and high levels of adrenaline on the cardiovascular system now when your doctor used the word stress and the patient who thinks that i'm being dismissed they often are being dismissed because the physician himself or herself or themselves don't recognize the unity of mind and body yeah so in their when the word leaves their lips they do mean a kind of dismissive i can't find anything physically wrong with you therefore it's just stress well that's not how it works in a genuine sense of the word as we know from millions of studies stress has huge impacts and they have impacts even sometimes when we can't measure them remember the clinical tools to measure something you mentioned fibromyalgia earlier well there's no clinical tests that'll diagnose or rule out fibromyalgia but it's clearly a stress-related condition and when you study people's lives with fibromyalgia salient amongst the findings is significant degrees of childhood trauma and and childhood adversity and their impacts on the body yeah can we at that point can we just explain what exactly do you mean when you say childhood trauma well jesus i'm so glad to to be able to talk about that because that's another word that's on the one hand not appreciated understood even recognized by much of medical practice on one another hand is used too loosely sometimes some people say i went to a movie last night and it was i was really traumatized no you weren't you just were upset you were sad you were you know angry but that doesn't mean you were traumatized so what does it mean to what does trauma mean well again if you look at word origins the the origin of the word trauma is a greek phrase for wounding or a wound so trauma is the wound that you sustained now when people think of the word trauma they often believe it has to do with what we call the big t events the big trauma events such as sexual abuse emotional abuse neglect apparent dying violence in the family parental addiction may be as rankers divorce these are traumatic but trauma is not what happened to you trauma is what happened inside you as a result of what happened to you so trauma is the psychic wound that you sustained that's the first point the second point is if we understand the nature of a wound really there's two ways to look at a wound if it stays open it's very sore you touch it if i pat myself on the shoulder right now i feel no pain but if there was a wound there and my shoulder was bare and my nerve endings were close to the surface in other words if i was thin-skinned yeah and if i tap myself with the same force there'd be severe pain so one aspect of trauma is like an open sword that if you touch it you just react like you just won't do it all over again that's one aspect of a wound the other way to look at a wound is is that it forms a scar a scar tissue protects the wound but at the same time it's thick it's inflexible it's hard it's not capable of growth and it lacks nerve endings so you don't feel so trauma both sensitizes us to certain stimuli and the other hand numbs us to our own feelings and and and and separates us from our bodies because it's too painful to be in our bodies now to traumatize people you can do bad things to them as i mentioned earlier but you can also wound people particularly sensitive kids but all kids but especially highly sensitive children not just by doing bad things to them but by not giving them the good things that they need so it's not just what shouldn't have happened but did but what should have happened what didn't so for this we have to understand children's basic needs children of certain developmental needs for healthy emotional and brain development one of them is to be seen and heard and to be accepted for exactly who they are without any condition yeah now lots of people tell me they had happy childhoods nothing traumatic but when i delve into them their history is even a little bit that lack of unconditional acceptance and understanding and being seen um is salient you can hurt people that way that can wound people and so these traumas then show up in all kinds of coping mechanisms and adaptations many of them we call them mental illnesses like take something like depression uh again look at the word origin what does it mean to depress something you push something down now what gets pushed on the depression and i've been diagnosed with that um what got pushed on depression is your emotions but why would you push down on your emotions you pushed on your emotions when to feel them put your eyes with your environment so that if if your parents can't handle your verve and your enthusiasm or your sadness or your grief or your anger then in order to fit in with the family environment you will push down those feelings not consciously but simply as a matter of automatic adaptation 30 years later you're diagnosed with this disease called depression but it was a response to a childhood wounding the wounding of not being seen and accepted with all your emotions which is another essential need of the child the child should be able to experience all their emotions no matter what they are so that's a very simple example of childhood wounding trauma which then shows up in a form of adult distress and i can show the similar patterns for all manner of chronic illness that there was childhood wounding either because of things happening that shouldn't have or what i call the small t trauma of things not happening that should have that then leads to adaptations which adaptations in the long term promote illness yeah but there's a couple of things there right so childhood trauma then shows up later in a whole variety of different behaviors a whole variety of different diseases yeah right so there's the question there is then as an adult how can we start addressing this but there's also another piece which is many people listening or watching our parents themselves yeah and they may recognize certain things and certain behaviors they've had in their own life as i certainly have done but there's also well how do we not traumatize or shall i say minimize the trauma that we put onto our kids you know what are those if we if we maybe start there yeah because we we're living in a society where it's very hard to be a parent it's very hard to be a mother it's very own you know really hard and actually through no fault of parents they're struggling to be present and have time and and patience yeah with their children i know in the book you write that being understood as a child is as much of a need as food and shelter which i found really profound yeah being understood being seen being heard right so what can parents think about when trying to bring up their kids so first of all it's very important to avoid any hint of parent blaming yeah as you say and so it's not made of individual failures really is the question of a society that doesn't put children's needs in the forefront at all and so let's take a really simple example now in in the book i talk about my personal history which is you know a jewish infant on the nazi occupation in hungary very dramatic um be a terrible uh time in history for beer to be a an infant yeah and and my mother and i live under really deplorable conditions under the threat of death and at one point she gives me up to a total stranger in the street by the way i was just in budapest my home city two weeks ago and i swam every morning at a sports club it was right across the house where mother gave me to a stranger oh wow 76 years ago 77 years ago to save my life so that's very dramatic but forget the nazis forget genocide forget the war when my mother and i are still in the hospital maternity hospital and i'm two weeks old she writes in her diary my poor little gabor my heart is breaking for you because you've been crying for the last one hour and a half wanted to be fed but i promised the doctor i'd only feed you every four hours so it's not time yet you're gonna have to learn that nighttime is for sleeping not for eating her heart was breaking she was completely suppressing her parental instinct to please the doctor so forget the war forget the genocide forget all the drama just a mom a 24 year old mom following doctor's orders now in this society parents are often advised to ignore their kids needs just like that for example you just think of sleep training where parents are told don't pick up the crying child now you tell a mother orangutan not to pick up their crying child you tell a mother cat to ignore the cries and the stress of their infant but we tell human beings this every day and we call this sleep training you know and what we're doing is giving the child the mess no you know it works you ignore child's christ for four nights they're going to sleep through the night you know why because they give up and they can't stand it they put themselves to sleep just to get away from the distress of it and their blindness brain is flooded with cortisol which interferes with healthy brain development and the message they get is that their feelings don't matter that they're on their own they're all alone now this is done by loving parents under the advice of well-meaning professionals and we call this parenting advice or another simple little device that parents are often told to do time out now there's a very famous canadian psychologist who i don't need to name but in his mega selling book he advises parents that an angry little child should be made to sit by themselves until they come back to normal it's not normal for a two-year-old to be angry and that child should be excluded the message the child should get is you're not acceptable to us when you have that emotion a lot of parents there's best-selling books on this technique of time out which basically means separating the child from yourself until they start behaving in ways that you can approve of in other words the message to the child is your acceptance is purely conditional when you're pleasing me now we're not talking about parents that are beating their kids we're not talking about parents who don't love their kids we're not parents who are trying to hurt their kids we just talk about parents who are are complying with social norms and social values then there's the factor of stress that you mentioned how stressful it is to be parenting again we're not meant to parent in isolated homes in one person or two-person two-parent families were meant to parent in groups in community this is how it evolved as a species we know already and i spend chapters on this the the chapter on prenatal life yeah that that stress on the pregnant woman you know i mentioned telemetry yeah the telomeres of infants born to highly stressed mothers are shorter already at birth this is a new study that just came out since i wrote the book so stress on pregnant women now how just exactly how are we taking care of pregnant women in our society are we honoring their needs are we making provisions for them on the job or even to give them prenatal leave to take care of themselves or tell are we telling husbands to really look after their wives emotional needs i mean i talk about in the book about just what an unsupportive husband i was when i was you know we were expecting our children that has an impact on the developing child already in the womb not because the mother doesn't love the child because when she's stressed that stress translates into physiological impacts on a child now there are times in the first year of life when every second millions of circus millions of connections are being made in the brain the mother's emotional states directly affect the brain development of the child we know this from scientific studies how are we taking care of new mothers in this society what support are we giving them how do we ensure that they have the best possible environment to raise that child and so what i'm saying is that this society is so stressful and look in britain i'm in britain right now i read the newspaper 10 inflation rate while the economy is shrinking how does that affecting you know one of the triggers for stress is uncertainty yeah so this is a society this rich society that massively stresses its population and those stressed parents then are supposed to raise healthy children yeah you know so that would love the advice from experts to ignore the child's needs i'm not even talking about trauma in a big sense yeah you've been very open in the book about things that maybe you could have done better whether it's to say the least yeah and it's um you know it's interesting it's very insightful to read that from from you and i guess as you talk about your children there and how you maybe didn't give your wife as much support as you as you could have done it was worse than that i stressed her yeah i added to her stress so you added to a stress i had an impact on your children yeah you're writing about more and more of the research on the long-term implications of that how do you feel about that now have you have you made peace with it or do you beat yourself up well so this book that we're discussing was written with the help with the brilliant help of my eldest son who's a lyricist and a music you know a musical theater writer but he's just a wonderful writer and uh i couldn't have done that without him and uh he's now as the book comes out he'll be 47 years old this is the kid that when he was three years old i slapped across the face because he wouldn't think happy birthday to me now the story's worth telling um it was my birthday party and we had gathered at my parents place my mother gave me a made me a traditional hungarian meal you know for my birthday and my brothers were there with their wives their families my parents my wife and i and our eldest son three years old and daniel my co-writer on this book to be announces i'm not singing happy birthday and i said if you're not singing you're not getting cake well i'm not singing anyway i get more and more angry everybody's begging me to resist everybody's begging me to lay off the more they asked me to do that the more angry i get they ended up hitting him no what was that all about he was just being a three-year-old he says i'm gonna exert my own personality i'm not gonna go along with the crowd you know i might have said hey daniel sweetheart don't sing just have the cake and enjoy it what was being triggered in me is the sense i developed as a young child that i wasn't loved and lovable so i needed this three-year-old to prove to me that i was lovable when he didn't i got enraged i'm not either criticizing myself or defending myself i'm just saying this is what happened this is how we passed on our trauma unwittingly so one of the pieces of advice to give to parents is deal with your trauma as much as you can as you have children and before you have children and as you're raising them now in terms of my own trajectory with my kids we've done a lot of repair a lot of healing and even this writing this book together has been a tremendously healing process i mean we've had our moments believe me remember each other's throats in fact we have another book contract the next book we're writing together is going to be called hello again a fresh start for other children and their parents yeah so that as soon as the hoopla on this book settles down which i hope won't for a long time but as soon as it does we're going to start writing that book together so yeah we've made the repair and that repair is possible but to young parents i would say don't make the repair necessary you know work on your own stuff you learned something very important about yourself as your six-month-old god ill and i've heard you say that the greatest value to you is not your success as a physician anything else but but the healthy raising of your children yeah now if if you'd asked me that when my kids were small i would have said yeah my highest value is the happiness of my own children if you'd asked me that but if you looked at my life that's not what you would have seen you would have seen somebody consume this success consume the professional security consumed with zoe igori concerns so what i would say to parents is really do evaluation of what's important to you and to use your phrase look at how your value your life is aligned with what your best intentions are when it comes to parenting it's not a question of not making mistakes of course you will but if you actually live a life that even in this stressful society with all the pressures on you has its core value the genuine needs and well-being of your children you're going to do okay yeah some parents are likely to have heard what you said about sleep training yeah and i imagine they would have gone through their head and go oh no i i did that with my baby i did that with my child i didn't know any better i was reading the latest parenting book and i thought i was doing the right thing but now i hear you gabbar explain it it totally makes sense why that possibly wasn't the most helpful thing to do a lot of people then take that next step and go into guilt and shame they feel bad about themselves they start to berate themselves it feeds an existing pattern of negative self-talk within them yeah for someone who's doing that right now as they're listening what would you say to them well first of all i would just say i totally understand why you wanted to sleep train your child because you might have to go to work in the morning yeah it's not like we were hunter-gatherers carrying our babies everywhere we go you know um we're live in this harried world where there's demands on us and a child who doesn't sleep at night really makes us difficult for us to live our lives so i totally get it so you should not blame yourself for that secondly you should not blame yourself for accepting advice that from people that you thought were experts and but thirdly i would ask you what did it feel like to you and if you ask most people most parents would say it broke my heart yeah you know and so i would say to them henceforth listen to yourself yeah because we all have these parenting instincts but but but the instincts have to be evoked by the environment and we live in an artificial environment that not only does not evoke but in fact suppresses our our innate instincts and so as much as possible don't listen to the experts listen to your heart and deal with your stuff and as far as guilt look i'm telling you i'm 78 i just told you the story of hitting my three-year-old who's now 47 and helped me write the book of my life you know um doesn't matter what else am i right from now on this is going to be the book that expresses the essence of what i've learned at least so far it's all repairable but just wake up yeah as soon as possible wake up forget the guilt you did your best i'm not defending myself my reaction to my child that night that was my best at the time not proud of it but neither am i no did i feel guilt shame oh yeah i've had a lot that to deal with but i've learned better yeah so that just accept yourself that you're a human being who had certain traumas certain stresses certain wrong information you know there's a famous uh pediatrician benjamin spock i don't know if his name was well known in britain but for decades he was like the arbiter of hard race children in north america millions of books sold in many ways a good man but he talked about the tyranny of the infant who wanted to be picked up at night can you imagine the tyranny of the infant who just wants to be held by his parents her parents which is the natural desire of any mammalian infant yeah so don't blame yourself yeah blame blame guilt doesn't help anything does it it keeps you locked um oh sorry you know and i remember you may not remember this so in fact you won't remember this because before i knew you i was in l.a at a conference and i went to see you speak and i was when you took q a at the end i actually asked you a question really yeah sorry interrupts if you are enjoying this content there's loads more just like it on my channel so please do take a moment to press subscribe hit the notification bell and now back to the conversation yeah this is you know years before i actually spoke to you on the podcast before i even had a podcast or i was just drawn to your work and um you know i was probably i'm gonna guess it was two or three years after you know my son was sick and i can't remember now exactly what i asked you um but you gave a pretty um [Music] hard-hitting uncompromising i guess an uncomfortable truth which i i really value you know you weren't shying away from it you were just kind of saying get over yourself in as compassionate a way as you could but a very direct way which i really needed because you know when when my son was six months he had a hypocalcemic convulsion uh secondary so very low levels of calcium in his blood secondary to non-existent levels of vitamin d in his body and as somebody who used to be i shall say now as someone who used to be a perfectionist i felt i'd let my son down i felt that i had been a substandard parent and you know modern medicine saved his side but it did nothing to help me understand what might are the consequences of being low in vitamin d for six months for the developments of his immune system and all the other functions that this vitamin or i should say hormone does in the body you know this is where when we make things too binary it gets really confusing and and it keeps us locked so we left the hospital after five days with you know them saying yeah you know he's fine now he can go and i was thinking well what about everything else you know is this it i made myself a vow as we are walking out the hospital i made myself a vow i'm gonna get my son back to full health as if this had never happened and i became obsessed i would read i would study nutrition the gut microbiome the immune system four or five hours a day obsessed with one goal to get him back to full health and you know he is you know as of last week he's 12. he's a thriving happy healthy 12 year old boy but i realized for the first i don't know five six years of of me being a father i was consumed my guilt i thought i'd let him down and that would drive everything i i really would encourage him to do and i realized after a while he doesn't need your guilt exactly he doesn't need your guilt he just wants a present dad he doesn't nobody else my wife didn't think i was to blame the medical profession didn't think i was to blame it's a self-created story in my head oh yeah well so i still resonate with that but first of all let me just say something you say you felt you let him down you felt you didn't help him those aren't feelings those are beliefs yeah you believe them now if you like the feeling it's probably shame oh yeah and guilt and then if i asked you shame and guilt is that the first time when you felt them you would say no they probably go back a long long way in other words your son had nothing to do with it yeah you know um and and my kids have given me that message to me leave up with your guilt already yeah leave up with you mia corporals already they said we don't want to be seen as your mistakes we don't be seen as your failure we're people that's a great point you know and so that you're doing nobody any favors when you look at your children through the as you own guilt which has nothing to do with them anyway yeah completely and and and i've noticed as i've done the work through ifs through all kinds of different modalities as i've let go of that and i i think i'd mostly have i'm sure it comes up now and again at certain times and then it's another it's another self-awareness piece of oh kind of i thought i was over that that's that's coming up again what is that part trying to say well it's interesting because i know that amongst your core values i think it's you you talk about integrity compassion and uh curiosity curiosity so i teach a course called compassionate inquiry yeah but where the in fact dick schwartz and i did a program together recently where we talked about the differences and similarities within his approach and mind and there's a lot of overlap yeah and and so if you took the same dynamic of you and your son and and and and your guild if you apply some compassion it inquired to it what would you find out you would find out that you did nothing wrong you'd find out that the guilt and the shame that you're experiencing had nothing to do with your son they predicted his they predated his birth by a couple of decades at least you know and that you do yourself and him no favor by projecting it onto him yeah so again when it comes back to the parents it's so important that you be compassionate to yourselves and if you make mistakes rather than making stuff wrong for it inquire well why do they do that if you want to use ifs model what part of me did that what part of me hit my kid you know was so angry or if you want to use compassion inquiry you know what need of mind was not being met there yeah that that led to that outrage on my part you know again this is not to take anybody off the hook or to excuse any kind of behavior but if we want to grow we have to understand and if we don't take a stance of compassionate curiosity towards ourselves if you like if i say like if you said to yourself why did i do this that's not a question that's a statement full of judgment but if you said to yourself hmm i wonder why i did that but that's the question yeah having let go of that guilt yeah or or much of it or certainly i hope most of it yeah there's a more authentic interaction between us now yeah um you and your son you yeah my son and i of course and it's it's really beautiful and i think for me this speaks to the incredible power in your work through all your work but speaking about this latest book i think one of the most powerful things that gives people is awareness because everyone wants to jump from awareness to what do i do now and and i think we underestimate just how powerful that first step is yeah just to be oh that's why i behave like that oh i had no idea you know i guess we're blind until we're not we're unaware until we're not and then we can't unsee what we see exactly and i i really feel your work beautifully helps people see patterns in their life that they weren't previously aware of and there are multiple ways that they can then go and move forward through that but i think that's very very powerful in terms of patterns you write in this book about personality yeah and there's very powerful section where you talk about the association between certain personality types and disease and yeah in particular i like that section where you mentioned william osler and he was talking about the type of people who he observed getting angina yeah and you contrasted that with this kind of type c personality which is associated with all kinds of other chronic conditions so what if you could speak to those things a little bit sure so um again um these are the things that nobody teaches you in medical school but i as i advanced in my experience in family practice and also did seven years of palliative care work i began to notice that who developed chronic illness and who didn't wasn't accidental that the people that developed chronic illness by that i mean autoimmune diseases like rheumatoid arthritis multiple sclerosis scleroderma lupus chronic fatigue fibromyalgia um inflammatory bowel disease chronic asthma et cetera et cetera these people have certain personality patterns that i kept noticing over and over again and especially in palliative care when people are dying of chronic illness often malignancy i i would see these patterns and what were they so [Music] there were um automatic concern for the emotional needs of others while suppressing your own [Music] exemplified by a woman who it's a true story she's diagnosed with breast cancer her husband's first wife died of breast cancer another doctor tells her she's got it and her first response is but i'm worried about my husband how will i support him now she's the one that's gonna have to go through chemotherapy radiation and and possibly surgery or whatever how will i support my husband so this automatic concern for the emotional needs of others while ignoring your own that's the salient characteristic of people who have chronic illness secondly a rigid identification with duty role and responsibility is in the case of when i was writing the book and i was visually identified with the book and my blood pressure was going up yeah you know because i wasn't thinking of myself you know number three the oppression of healthy anger that's a major one healthy anger is one of my healing principles and and it's essential healthy anger is simply a boundary defend that says no you're in my space get out that's what healthy anger is it does its job it's gone but without that boundary defense you get trampled on all the time and these really so-called really nice people who never get angry they're the ones to develop malignancy and autoimmune disease and the fourth characteristic is two fatal beliefs and i say fatal beliefs potentially fatal one is that you're responsible for other people feel and the other is that you must never disappoint anybody now how these traits predispo i don't say that cause the disease i don't deal in causes it's simplistic to talk about single causes but they contribute to the onset significantly and people with chronic illness invariably have them yeah i never find otherwise these are not nobody's born with these traits i mean have you ever met a one day old baby that doesn't know how to say no try and feed them something they don't want to eat you know these are personally traits that we develop to fit in with our environment and if their environment is if your parents are alcoholics you're going to end up as a caretaker as a four or five year old you're going to be an emotional caretaker by suppressing your own needs now that's going to show up in illness of mind or body later on in life and uh for all kinds of physiological reasons mostly because it invites all kinds of stress you're creating all kinds of stress for yourself which then has all kinds of physiological impacts so these character traits are in contrast with the but they're not the pers who the person really is so they became is who they became as an adaptation to their environment then the body says no the body rebels and says no this is not good for you but the question is are people gonna learn from their disease or not and a lot of people whether through help or whether through some intuition or some grace if they learn to to look at their diseases not just to somebody get rid of but also as a teacher of why in my life was i not being myself now i don't recommend disease as a way of learning and i'm not saying people shouldn't do whatever they can to get treatment and to heal in other ways but at the same time if they open that inquiry or what is the disease here to teach them about me they're going to find that these patterns are present and they don't need to be because they're no longer the children that are constrained to be that way it's not either or it's not either it's emotional or it's physical it's these these things are complex and you know disease as a teacher yeah wow i mean i completely agree with you that is something that many people may find triggering yeah the medical profession certainly in my experience of it the western medical profession doesn't really acknowledge that side of things disease is that discreet entity now you have it we've got the proof now we need to treat it without an understanding you know it's it's the biomedical model not the bio psycho social model spiritual spiritual yeah i mean what role does spirituality play in modern medicine at the moment yeah very little for me and it's i think i think it's very important you know you explain that there with compassion um it is such a tricky area i found to communicate with people because a lot of people who are that way inclined feel this is as blame you know i've i've made myself get sick what are you saying dr mata you're saying that my my personality has caused my illness and let's just sort of expand on that a little bit in case anyone is thinking like that well it's a really essential question i would say yes aspects of your personality contributed to the onset of your illness again i don't use cause because there's so many different aspects to causation but yes aspects of it but the reason it's important to pay attention to that is because if i could tell you that aspects of your personality ways of being contributed to illness i'm also telling you that if you were to transform those you could actually affect your illness in a very positive way now that's the first thing the second thing is i would say is it's not your fault you didn't choose to suppress yourself those are adaptations to your environment you didn't choose to put other people's needs ahead of your own uh chronically and pathologically that was your response to the environment why would i blame you for an unconscious adaptation that you developed when you were two years old and could and didn't know any better so there's absolutely no blame in this perspective whatsoever absolutely none and it's inappropriate to even think of blame but um do people perceive it that way yeah they can but i would say to them look what would you rather have what would you rather be told that you're simply a physical object in the hands of your physicians with no agency whatsoever i mean you talk about when you talk about your principles of healing in your book you control it's one of them and i i hadn't read your book when i wrote mine and you hadn't had mine when i you're a royals but i talk about the same dynamic i call it agency you call the control but it's the same thing would you rather be a an object in the hands of physicians would you have some agency would you rather be actually actually involved and and and to and to learn how aspects of your life that you developed as a helpless young child are no longer serving you yeah and if you alter them now in that chapter called diseases teacher i quote two american researchers um absolutely credentialed one of them is a physician at harvard uh dr jeff rediger yeah have you heard no i won't say we we went to schedule it then he couldn't travel and i just haven't got around to it but i really want to maybe that this will be a nice impetus for me to really contact him so jeff wrote a book called uh cured about what what they call spontaneous healing these are people that are given terminal diagnosis yeah by the way here in britain there's a wonderful example of it stephen hawking who was diagnosed with als at age 20 he was given two years to live and he became one of the world's great physicians and writers and lived well into his deep into his 70s maybe we don't know everything as physicians is that possible that we don't you know um but in any case jeff rediger is a director of a hospital unit at harvard at mclean's hospital in in massachusetts he's also a doctor divinity and a psychiatrist and a physician and in this book he researched people with so-called spontaneous healing these are people that have been written off by the medical profession as terminally ill death sentences either because medical treatment had failed or because they had refused them and they got better anyway and lived decades longer and suggest as well what happened here another american researcher uh oncological psychologist kelly turner wrote a book called radical recovery radical remission i'm sorry same thing i've done the same kind of research myself what all three of us have found is that whatever else people did this these uh healings were not spontaneous didn't just happen these people are changed their lives they took supplements they um did yoga they meditated they went into nature they got counseling whatever they did but the biggest change was in their relationship to themselves you know and uh now i'm not saying we have a cure all for everybody but i'm saying that if these dramatic examples exist what if we apply that all across the whole range of medicine what if everybody with chronic illness this question was raised about what is your relationship to yourself and what extent are you being authentic and you know what this may sound surprising and i don't recommend it but even when i was working in palliative care i had the occasional patients say to me doc this cancer was the best thing that ever happened to me this they're saying this a week or two before they died why because i learned so much about myself that otherwise i never would have found out it's made my whole life worthwhile again people i'm not recommending cancer as a way of waking up all i'm saying is even that experience we can use it to learn something about ourselves i mean that that chapter is so powerful i know a friend of her friends who's no longer with us he at a young age was diagnosed with multiple sclerosis and before that he was super active captain of a sports team super active i was in a wheelchair for many years and i got to know him only for about three years or so and i remember the last time i spoke to him well i say i spoke to him we'd communicate on whatsapp um it was really funny because he he would really enjoy listening to the podcast and he'd send me messages on what he'd learned or what he was saying and he said once um i've never felt this happy and content and you know at that time he couldn't communicate with his voice it could only be by words he was all his needs were taken care of by you know by a carrier he was in a wheelchair to move around previously very sporty very active and i thought wow never felt this happy and content and again you speak to what jeff was saying what you write about this in that chapter you know yes one of my core values is curiosity i think every physician should have that's one of their core values because what do we often do in medicine with these healings all these things we can't explain we kind of pretend they're not happening we can't explain them in our reductionist model so they're not real you know i don't know maybe the patient's lying it's often what people think you know which is ridiculous it's like well isn't that interesting that we don't know like i i love learning things that i don't i go wow what is going on there yeah but do interrupt someone for curiosity you have to let go of something ego you have to be the one that i know yeah you know and uh unfortunately physicians it's not that they think they know everything but they think that what they don't know is not worth nothing exactly exactly and also it goes into how we even you talk about culture right unfortunately a lot of people who end up in medicine simply went into medicine because they were good at school academic subjects that is so so common yeah they they often weren't drawn to healing it was just like oh i'm good at school i want to do a good job that pays decent money and gives me security and i understand why people make those decisions i really do yeah but the truth is is that at some point in your career if you didn't go in for the right reasons you don't actually figure some of that stuff out you're going to be having quite an unhappy discontented life which is going to impact the way that you look after your patients absolutely but this kind of emotional stress within our minds the way we view ourselves it is always in my experience a missing piece that unless we look at we have a limit on our recovery um there's a patient i raised about and happy mind happy life through this 48 year old lady who she had upper abdominal pain she had bloating she had bilateral upper arm pains and she'd been to see a variety of physicians she wasn't getting much better medications weren't helping she then had was reading things online she was empowering herself she made changes to her lifestyle she changed her diets yeah she would move more regularly she would prioritize her sleep and stress reduction and there was some improvement but there was still a ceiling there was still these symptoms of flexing everywhere and when she came to me i remember thinking what are we missing here what are we missing her her life a lot of these choices now in her life look look pretty great what's going on here and as i inquired as i compassionately inquired right it became very clear she said something she this is what i knew oh here we go she said doc i always end up in relationships with older men they're usually married um and they always treat me really badly that's right and as you as i as as we sort of together inquired we obviously all roots went back to her childhood and she perceived as a child that her older sister got more attention than her from her parents and it was incredible because even as she was saying here you could see the the light bulb moment in her own heads this wasn't physician healing the patient this was you know me simply being a guy to help her find her own truth and as she came to terms with that as she did a variety of things to help process that honestly right six months later she ends up in a relationship with a man her own age who treated her really well three months later all the symptoms had gone and they haven't come back since wow right this is real like emotional stress is real which is what you'd expect if you understood the science yeah exactly but it's not something we're taught and also something you said gabriel i think is is really powerful this idea of agency yeah you know you say what would you prefer i mean not to share with you what the science is you just keep going in this disempowering model no or explain and that's something you know i mentioned competitiveness before yeah competitiveness is if you'd ask any of my friends they say wrong is really competitive he won't lose they're right i wouldn't lose i would not i would do anything i needed to do yeah to not lose but it wasn't because i enjoyed winning because it was too painful loss was too painful for me but now hand on her i'm not competitive yeah so it wasn't my personality it was a behavioral adaptation yeah and i no longer need that behavioral adaptation and i think people don't get that they think the personality who they are now is who they have to remain well let me just see i i face a little bit differently i mean the concept we totally agree on i would say it was your personality but your personality wasn't who you were yeah you know there's a personality is enamel game of genuine aspects of ourselves with these adaptations yeah and what we can actually do is to purify the personality so that there's no distinction between ourselves and our there's no contradiction between ourselves and our personality so uh certain personality traits are not us at all they're simply who we learn to be in order to get through and we can unlearn them we can absolutely learn them and and sometimes of course illness comes along just again if somebody got sick i never go to them and say listen congratulations this is a great wake-up call learned from i would never say that to anybody because that's you know people have to come to that realization themselves but i would ask them have you considered the possibility that you know along with the physical treatments we're going to give you have you considered the possibility that there may be aspects of of your life that have contributed to the onset of this condition that'd be worth investigating so that you can become empowered to do something about them and i want to go back to something you said earlier about the 10 minute visit you know that needn't be a barrier yeah i you know because the barrier is not the 10 minutes it bears the lack of awareness of the physician because even in 10 minutes you can say to a person you know there's some considerable evidence that your rheumatoid arthritis that you lupus that your multiple sclerosis like your inflamed bowel is related to emotional factors is that something you'd be willing to explore in addition to whatever treatment i'm going to give you are you willing to talk to somebody i'm not expected to talk about that i wasn't trained to do that but i'm aware of those relationships or you want to talk to somebody so the physician doesn't have to do it all yeah the physician just has to be aware of it that's all and let me just say one thing something else that occurs to me that's really important to say here it's not exactly apropos but it does come up for me um this is not just individual it's also social if you look at who if you look at him here in britain who was more prone to develop kovid it wasn't just they say that we're all on the same boat wellness together no we weren't people that were black or immigrants of color they were at much higher risk you know united states people of color were at much higher risk of covet people of color in in my country canada an indigenous woman has six times the rate of rheumatoid arthritis than that of other people this is amongst the population and never used to have autoimmune disease whatsoever and so we're not just talking about individual choices or even individual personality traits we're also talking about large social trends that that exclude or or or or oppress or or or or put extra burden on you know uh on on certain segments of the population so we have to really i just want to make sure that we extend yeah broaden the conversation beyond the individual to uh to the social level as well and i think your book beautifully makes that case doesn't it that a lot of this is driven by the world around us and culture yeah but of course within that there are things that if we empower ourselves that we can do yeah i also want to just say i totally agree on the 10 minutes um it doesn't have to be a barrier sure more time would probably be optimal yeah but even having a physician who's aware and then says and points into one of your books for example yeah that's useful i know there are thousands of medical doctors now who certainly in the uk because they talk to me they contact me and they say yeah i've already got 10 minutes but i i just raised something and then i point into one of your podcasts or one of your books yeah and so it's a way that you can that's right because this information this can help patients in their own time when they're gardening at the weekend or going out for a walk they can be learning and that's that's one of the things that gives me hope at the moment is that this information is not behind locked doors in universities and research institutions you know people are consuming this content people if you look at your talks on youtube millions of people have watched them and are then empowering themselves so um garrosh we come towards the end of this conversation just to close a loop on something you mentioned earlier which is women and increased rates of chronic disease i don't want to leave that open-ended um could you just explain maybe why you think there may be a relationship there well if you take something like multiple sclerosis which i've mentioned a number of times the gender ratio in the thirties was about one to one yeah so if each man diagnosed the bible and the gender ratio now is three and a half women for every man now that tells us a few things immediately can't be genetics because that doesn't change over a short period of time it can't be the diet or the climate because that doesn't change more for one gender than the other what is it it's stress now if you look at those four character traits that i said contributed to the onset of illness the emotional concern for the needs of others the uh suppression of healthy anger the identification with duty role and responsibility the belief that you're responsible for the people's emotions and you mustn't disappoint anybody which gender is accurate our society to take on those traits more than the other of course it's women so women have eighty percent of autoimmune disease yeah eighty percent of volunteers are women and a big mystery it's not a mystery they're acculturated to play a certain role their role has always been to absorb the stresses of their families and also of their spouses and certainly that's a role that my wife took on early in our relationship and she had to rebel against it to stay healthy you know there was a study in sweden that showed that this is remarkable that if a woman was depressed in italy that increased the risk of a late premature birth 32 weeks to 36 weeks if the man was depressed the father was depressed prenatally that increased the risk of an even earlier premature birth why because the woman was absorbing the stress of the man and so women do that automatically not biologically necessarily but because that's the role they've been given in the society plus that they have to go out and work now as well to make a living and make a you know money for the family to survive and or just to succeed out there in the workforce and people are more isolated than they ever were so in britain there's they appointed the minister of loneliness so greater stress more isolation that's why women are getting a more autoimmune disease and during kovid there was an article in the new york times about women who took on the emotional stress of their husbands and their children during kovid and they felt guilty because of the suffering of their men and their children because it was somehow their job to eliminate or alleviate it well that socially appointed and then automatically assumed role that women have been thrust into has physical implications that's why women get most autoimmune disease what if we just recognize this you know it's this big mystery no mystery this is a particular dramatic example of the biopsychosocial nature of human beings our biology is inseparable from our psychological functioning and our social relationships and who has the brunt of all that women of color they're much more likely to develop these diseases than caucasian women why because of the added stress of social and and racial uh oppression or exclusion i guess the culture the society around us impacts so much of how we experience the world and what we chase and what we pursue and how we are and of course it can take a long time for culture to change yeah yeah i'm not saying that people have to wait for the society to change if they did wait it'd be a long long wait i would think there's a lot that we can do even in the context of this culture now of course what we can do is not totally [Music] freely uh um available equally to everybody let's face it yes certain classes of people have much less fewer options than others that's just the reality of this culture that we have to really look in the face yeah you know but there's still a lot that people can do and but if i can go back to the confluence of your book and mine you have these three concepts of the healing concepts of alignment which is i call authenticity being becoming true to ourselves that's available to all all of us you talk about contentment which i talk about in terms of acceptance just actually recognizing how things are and being with them not necessarily that we don't want anything to be different but that we don't stress ourselves about things thirdly what you call control which is we've already talked about what i call agency those are some core young principles that interestingly enough both you and i without any um discussion or awareness of what each of us is writing why do we come up with that because they're real and that's and we've seen them both in in in medical practice and and and the function of them now i had anger another a called anger which i think is very important for people to be able to say no and to we have a system in our brain for healthy aggression yeah just as we have one for play for love for lust for fear for grief we have system in our brain for anger why because it has to protect us i think people need to be angry not enraged not chronically resentful but they have to be able to say no you will not do this to me no you will not enter my space no you will not manipulate me no you will not use me so that's a small microcosmic statement of my healing principles but i certainly think that healing is possible and let's face it if you didn't think healing was possible would you write your books you know i mean if if all you want to do is tell people how terrible things are you wouldn't write about we both write books because we actually believe in human beings yeah in the capacity of human beings for transformation and that there's some guidance that can be provided to promote that transformation that's why we write and that's why i wrote this book and so yes healing is possible but we have to be aware i think as i think you said earlier we have to wake up to what's going on until then we're just working in the dark kabul it's always a pleasure spending time with you i feel very honored these days call your friends well the sense of being honored is mutual for sure yeah thank you thank you if that conversation resonated with you here is another incredibly powerful one that i really think you're going to enjoy give it a click if you actually went to the happiness gym several times a week you'll actually have a happier life right and the happiness gym is very straightforward it's a set of skills that you need to practice

Channel: Dr Rangan Chatterjee

Views: 764,863

Keywords: the4pillarplan, thestresssolution, feelbetterin5, wellness, drchatterjee, feelbetterlivemore, ranganchatterjee, 4pillars, drchatterjee podcast, health tips, nutrition tips, health hacks, live longer, age in reverse, self help, self improvement, self development, personal development, motivation, inspiration, health interview

Id: kPfQCQX30vw

Length: 116min 13sec (6973 seconds)

Published: Wed Sep 14 2022