When the Body Says No -- Caring for ourselves while caring for others. Dr. Gabor Maté

the book the book and this talk is based on my work as a family physician which i did for 20 years and seven of those years i was also medical coordinator of the palliative care unit at vancouver hospital looking after terminally ill people people dying of cancer neurological diseases and so on and what i found in all those years learned all those years what i had not been taught in medical school is that who gets sick and who doesn't is not accidental that although we tend to think on cancer and and multiple sclerosis which i mentioned last night or rheumatoid arthritis or chronic asthma psoriasis eczema colitis crohn's disease any number of chronic illnesses or some are random events that unfortunately and mysteriously strike a person and occasionally we think that we can explain the cause by uh the life style of the individual like smoking of course and its connection to lung cancer but other than that other than that we think that these diseases are either mysterious and unexplainable misfortunes or they are caused by people's genes and what i found that quite on the contrary that who got sick and who didn't wasn't random and that there were certain identifiable patterns certain personality traits and behavior ways of behaving that people unwittingly without knowing it unintentionally but they brought the disease on themselves and that wasn't their fault they didn't know what they were doing as you will see but since we're talking about caregivers and let me tell you one little fact that and since the book was published which was about 10 years ago now i think or nine years ago there's been so much more evidence pending in the same direction one bit of evidence about caregivers is that there's a structure at the end of our dna our chromosomes chromosomes is the strands where our dna is located in our in this in our cells in the nucleus of our cells and these strands of chromosomes have at the end a structure called a telomere a telomere is like the glue at the end of my shoelace to keep the strands from fraying to keep it together when we're born our telomeres are a certain length and as we get older gradually gradually they shorten as we age and until the at the end of the uh our life they become unraveled at which point so do we now they looked at the but it's a mark of aging in other words now they looked at the telomeres of the of mothers looking after chronically ill children and they found that these women in their 30s and their 40s their telomeres were 10 years shorter than their chronological chronological age would have predicted in other words the chronic stress of caregiving aged them by 10 years now that doesn't mean of course that we shouldn't care for children or for other people that require our support but it does mean that how we give care and what kind of support we get makes a huge difference to our health and that's what my topic is about this morning so i said that there were certain patterns of of being and behavior and psychological relating that are associated with chronic illness and again when i say chronic illness i mean everything virtually everything what these patterns were that i saw i'll identify or at least i'll illustrate for you by means of newspaper clippings that i'll read for you as i give this talk by the way uh my advice is that you relate it to yourself don't you see it as an academic exercise or as a storytelling but you see to what extent you recognize these patterns in yourself so the first clipping here is by a woman who's who writes the article herself these are often a global male and she's diagnosed with breast cancer his name is donna so she's diagnosed with breast cancer and her doctor's name is harold his her husband's name is hai and donna is the second wife the first wife died of breast cancer now donna the second wife is diagnosed with and so donna writes harold tells me that the lump is small and most assuredly not in my lymph nodes unlike that of his first first wife whose cancers had spread everywhere by the time they found it you're not going to die he reassures me but i'm worried about high i say i wanted the strength to support him what do you notice her first an automatic thought is how can i support my husband emotionally as i'm dealing with a potentially fatal illness so this compulsive and automatic concern for the needs of others while ignoring your own is a major risk factor for chronic illness the other clippings i will read you are obituaries all from the global male obituaries are fascinating because they tell us not only about the person who died but also about what we as a society value in other people and often what we value in other people is exactly what kills them in the first place you heard the expression the good day young they do and there's reasons for it a lot of you are healing a sigh of relief okay i don't worry about myself then you're saying but listen to these obituaries this one is a doctor who died age 55 and i'm talking here about people who died before their time this guy dies at age 55 in toronto of cancer the obituary says and this is written as if it was a good thing never for a day did he contemplate giving up the work he so loved at toronto sick children's hospital he carried on with his duties toward his year-long battle with cancer stopping only a few days before he died now think about that one if you're diagnosed with cancer or if your friend of yours was diagnosed with cancer would you say to him and her hey buddy here's what you do go back to work tomorrow and all the time that you're getting chemotherapy and radiation and whatever else you're going through just work every day until you die so this compulsive and rigid identification with duty role and responsibility rather than the needs of the self is a major risk factor for illness the next obituary is um by uh written by husband about his wife naomi who died at age 55 also of cancer and he writes in her entire life she never got into a fight with anyone the worst she could say was foue or something also else along those lines she had no ego she just blended in with the environment in an unassuming manner now the suppression of in other words never got angry with anybody the suppression the repression of healthy anger is a major risk factor for illness it actually suppresses the immune system for reasons that i will tell you later so there's basically um three ways of dealing with anger one is to repress it like this woman did so these are the people that are always nice you know they're always nice i worry about really nice people the other way is to give into it and to act it out to go into rages that's also unhealthy the first the repression of anger leads to autoimmune disease and cancer the when you're raging all the time that increases your risk of heart disease and strokes so in the aftermath the studies have shown that in the aftermath of a rage episode your risk of a heart attack doubles for the next two hours then there's the healthy of expression of anger or the healthy processing of anger which most of us don't know how to do we either do the one or we do the other i'll talk to you about healthy anger later but how do we deal with anger is has a crucial effect on our health and this guy writes you know she had no ego she just blended in with the environment in an unassuming manner and this is supposed to be a good thing now my wife's name is ray and she's an artist and it's one of her paintings that provided the detail here on on the cover and the color scheme for the cover for this book and sometimes i say to ray you know we were married 42 years why can't you blend in with the environment you know in an unassuming man in an unassuming manner but rey has done her psychological work and she's read my book and she's also seen the studies you know there was a study just four or five years ago presented at a major medical conference they looked at 1700 women over a 10-year period and over a 10-year period out of these women those who who were unhappily married and suppressed their feelings were four times as likely to die as those who were also unhappily married but expressed their feelings so the issue wasn't happy marriage or unhappy marriage the issue was did the woman express herself or did she not so when i come to this point at my talk this permits me to reassure the man in the audience that the next time you think your wife is a [ __ ] you should be glad about it now um i'll read you one more of these i'll give you a couple more of these obituaries this is a mother in calgary who died in the early 50s again cancer just look at this a master at multitasking she juggled several hockey practices school board orchestra and other extracurricular activities june 2005 brought terrible news to this mother of three by now president of the parents council at western canada college emergency surgery revealed metastatic cancer she refused the cloak of illness she did not give up on any of her roles you know she had all these roles and they were more important than who she was she even continued her 5 a.m bicycle trips around the nearby reservoir and i imagine that when you're getting chemotherapy she enrolled in a life coaching course and upon graduation from the adler school she initiated living out loud a group for women with cancer that's very typical of people who get chronic disease and finally um an another physician who dies of cancer and again how the obituary writes something that's clearly when we look at it is self-destructive but the person didn't realize it and neither does the individual who writes the obituary sydney and his mother had an incredibly special relationship a bond that was apparent in all aspects of their lives until her death as a married man with young children sydney made a point to have dinner with his parents every day as his wife roslyn and their four kids waited for him at home sydney would walk in greeted by yet another dinner to eat and to enjoy never wanting to disappoint either woman in his life sydney kept eating two dinners a day for years until gradual weight gain began to raise suspicions so that this poor man suffered under the belief that number one um he was responsible for everybody else felt and number two he must never disappoint anybody so he actually couldn't say to his mother you know mom i got amazing news i got four kids and some and and i'm gonna have dinner with them most of the time nor could you say to his wife you know roslyn i i'm very close with my mom she needs my support so once or twice a week i'll have dinner with her he just tried to please everybody all the time and this need to please everybody all the time it'll kill you and as i'll for reasons i will tell you and these reasons are not psychological they're physiological they have to do with the body the immune system and everything else you can't separate the mind from the body and the problem with my profession the medical profession is that we make two separations that are actually in life impossible to make one is that we separate the mind from the body we think that people's emotional lives are somehow separate from their physiology completely false assumption unscientific refuted by all the research and yet if you go to a doctor i mean i know some of you here have had autoimmune illnesses for example so ask yourself when you've been to the physician with your rheumatoid arthritis your joint being inflamed or some other rheumatic condition did anybody ever ask you about your childhood anybody ever ask you about your stresses in your life anybody ever ask you about your marriage about how you how you relate to your work about how you look after yourself or how you don't likely not likely what they did is they said you got this illness we don't know why you got it and here are the so they'll give you a medication to suppress the inflammation or they'll give you a medication because autoimmune disease the immune system attacks the body itself so we give you a medication to suppress the immune system itself or will give you a cortisol or or some kind of other steroid well that's all we do we don't talk about the life factors that may have contributed to the onset of the illness and i can guarantee you i can guarantee you that any of you here who've had chronic illness of any kind you're going to recognize yourself in this talk completely in 100 and you're going to wonder why didn't anybody say this to me before because in the west when i say the west i mean the dominant western culture unlike aboriginal cultures unlike the traditional medicines of china or india or native traditions around the world we separate the mind from the body so we treat only in the body unless you have mental illness in which case we still separate the mind from the body we say and and the other thing we separate is the individual from the environment as i said to you last night those were they were there you can't separate people from their environment people are shaped by the environment and in lifelong in interaction with the environment they saw human beings live now let me give you three examples of that why you can't separate people from the environment it's been shown now for example that children whose parents are stressed are much more likely to have asthma now not controversial several studies have shown that so in polluted areas where there is more asthma it's the kids of parents who are stressed who are most likely to have the asthma now most doctors have never heard about that and if they did they can't explain it and yet it's so obvious you see those of you that have asthma anybody had asthma here before in your life okay you were given two kinds of inhalers if you had asthma one inhaler is probably called ventilan and its job is to open up the airways because what happens in asthma is you get a spasm of the muscles that surround the airway so you get this narrowing of the tube through which air has to pass into the lungs so you're wheezing and whistling and laboring your breathing and the other inhaler you got would have been a steroid to suppress the inflammation the swelling and the inflammatory debris that clutters up the airway so you get two inhalers one is called the bronchodilator to dilate open up the airway the other is to suppress the inflammation now what are these inhalers based on the the inhaler that opens up the airway is a copy of adrenaline and the um inhaler that opens up that suppress the inflammation is a copy of cortisol a service what are development and cortisol there are stress hormones exactly in other words we're giving asthmatics stress hormones the same stress hormones that are made by their own adrenal glands when they're stressed all that's happened is is that their own stress response mechanisms have been exhausted and now we have to give them stress hormones from the outside now guess what if you're rumored to arthritis or lupus what will they give you cortisol the stress hormone shouldn't we be asking ourselves that if we're treating people with stress hormones whether or not there might be connection between stress in their disease now of course why the children of parents who are stressed because the parent stresses actually program the physiology of the child because you can't separate the individual from the environment and this is true all our lives a study of women in australia 500 women 550 women who had lumps in their breasts that were of sufficient concern is to require a biopsy now they had these biopsies but before the results came back they also had a psychological interview or questionnaire it turns out after the results came back that if a woman had had a significant stressful incident in her life just prior to the onset of that lump that by itself had zero effect on whether or not that lumpus cancers similarly if a woman was emotionally isolated that also had zero effect but if a woman was emotionally isolated and headed a major stressor the risk of that lump being cancerous was nine times as great as the average now the medical doctors running the study couldn't understand this one either because they said how does zero and zero add up to nine you see because we don't understand the connection between individuals and the environment now here's the deal if i were to act inappropriately towards you right now if i were to stress you right now physically or or emotionally you'd have three healthy options but well never let's say i won't go into that right now uh if i were to stress you right now what would happen is that that stress wouldn't just be in your head you'd be in your whole body you know your heart rate would go up your nervous system would be firing off all kinds of impulses your adrenal glands would be pouring adrenaline and cortisol so that you could escape or fight back these are the flight or fight hormones and so your body would be in a different state physiologically in a split second in order to help you fight to escape that's good so in the short term the stress hormones help you fight or to escape but what do they do in the long term in the long term the stress hormones deplete your body suppress your immune system give you heart disease high blood pressure give you ulcers thin your bones okay now what would happen if if you were stressed something happened that was stressful to you and you're sitting there all upset about it and your body is in a state of uh imbalance and and upset but somebody that you trust came along and said hey friend i see that you're not feeling well i see that you're upset puts a hand on your shoulder and says hey do you want to talk about it now what would happen to your body right away yes it would relax you take a deep breath your brain would get oxygen you start thinking more clearly your heart rate would slow down your blood pressure diminish the stress hormones abate in your system and you go back into a healthy balance all because somebody said hey buddy do you want to talk about it those women that had been stressed but were emotionally alone the stress hormone acted on their system for months that's why they were more likely to get cancer it's really straightforward in other words again the physiology of one individual can't be separated from the psychological and social environment and finally at the end of life a study in a major medical journal a few years ago showed that amongst elderly couples when one of them is hospitalized what do you suppose happens to the other one they get sick in other words the risk of illness goes up and the other one when the one is hospitalized why because their immune systems are not isolated from our psychological emotional social relationships you can't separate the mind from the body and you can't separate the individual from the environment so how this works i'll tell you in a few minutes but i'll just illustrate it with a disease that i'm quite interested in because again medical science says we don't know the cause of it and i think that it's only because we're not looking and i'm talking about a rare condition called als amyotrophic lateral sclerosis which is a degenerative condition of the nervous system that leaves you very rapidly completely paralyzed your mind is intact but your body is paralyzed and in the end you can't breathe and you die of respiratory failure and right now there's a court case with somebody with als who wants the right to medical suicide and remembers rodriguez in victoria who went through the same thing and her case was rejected in the supreme court so it's a very dire disease and it carries a terrible prognosis and most people who get it are dead within a few years and it strikes otherwise healthy people so a woman came to me for a second opinion about 12 years ago now actually referred to me by my friend gordon neufeld psychologist and her story was that she'd been diagnosed with als by one of the leading experts in the condition in british columbia or in the world actually and but she didn't want to accept the diagnosis she wanted me to tell her that it was only stress well it was als but it was also stress her story was that she was a teacher and a vice principal at an elementary school in lower mainland of bc in richmond and she found at a certain point that she could no longer hold the pen in her hands because her fingers just wouldn't obey her brain's commands she also began to experience difficulty walking now you think if that occurred to you you would very urgently seek a medical opinion not her what she did is she'd get up for months she would get up at 5 30 every morning slowly get herself dressed of course because her fingers would have trouble buttoning or pulling zippers she'd drive herself to school walking to school at 7 30 with her troubled gait she would clutch the chalk in her clenched fist and painstakingly scrawl the day's lesson on the board for the students teach the whole day go home stayed up late at night to prepare the next day's lesson everything was slow for her you see and next morning get up at 5 30 and she did that until she could no longer walk now or barely now is she alone in this not at all everybody i've ever looked at with als has got exactly the same personality and the same behavior pattern without exception without any exception doesn't matter who i interviewed or read about in writing this book i also looked at the medical literature and in 1970 there was a study at yale university medical school about als patients by two psychiatrists who wrote the following these patients they invariably evoked admiration and respect from all staff who came into contact with them characteristic was their attempt to avoid asking for help hard study work without recourse to help from others was pervasive there seemed to have been habitual denial suppression or isolation of fear anxiety and sadness so no expression of negative emotion so-called some spoke gradually of their deterioration or sorry casually like it didn't matter or did so with engaging smiles now then i looked up the biography of lou gehrig after whom the disease is named in north america now those of you who are old enough might know that lou gehrig was a great baseball player played for the new york yankees and in the 1930s and he set a record for a number of hits per new york yankee that was only broken two years ago by derek jeter so that record stood for 80 years now gary said another record that was stood for nearly 60 years and that was consecutive games played so he never missed the game now that he never missed a game and he was called the iron horse i didn't know about this before i read his biography i just knew he died of his als let's look at what happened to him well same thing he was known as the iron horse because he never missed the game and he didn't never miss a game because he was never sick he was a human being he had flues and colds like everybody else furthermore being an athlete he was injured at one point his hands were x-rayed and it turned out that his fingers had been fractured 17 separate times and each time he would play through the injury and his teammates would describe him as grimacing like a maddened monkey in agony as he fielded the ball but he never missed the game and yet when a teammate of his a young rookie gets sick with the flu illness and he can't play and the manager is really upset with the guy gary says what on earth are you talking about he's sick he can't play takes the rookie poem to his own house where he lived with his mother his mother puts this rookie into garry's own bed lou sleeps in the living room couch as his mother nurses his kid back to health and he himself never missed the game until he could no longer walk now this is typical with everybody with als now are we blaming patients for causing their own illness well no we're not because it's not deliberate it's not deliberate these are unconscious patterns let me give you uh an example for my personal life so um when i was 54 and my mother 78 she was in a nursing home because she had a genetic illness called muscular dystrophy and she could no longer walk move her arms much mentally of course she was completely with it she died at age 82. and by this time she was a widow and she had to be in a nursing home now one afternoon i'm visiting her in a nursing home and as i'm walking down the hall of the nursing home i have a bit of a lamp just a slight lamp the reason i had a limp is because i had arthroscopic surgery that morning on one of my knees surgery which is minimally invasive and i just cut out a piece of a torn cartilage which i incurred because i used to jog on cement and i didn't pay attention to the fact that it hurt jogging on cement i missed the lecture in medical school about the relationship between pain and tissue damage so that i didn't know this is bad things i continued to jog on cement torque cartilage surgery that morning that afternoon bit of a limp when i get to my mother's room i open the door and my limp disappears and i walk into her room with a perfectly normal gate greet her revisit i walk out again in a balanced way and then i close the door behind me and i start limping again know what he supposed i was doing anyone taking care of her not not wanting her to worry yeah but here's the thing about my mother she was 78 she had survived the second world war she had survived the nazi genocide the death of her parents in auschwitz she's she's she survived communist dictatorship the hungarian revolution in 1956 immigration to canada with two adolescent boys and and my father uh the birth of a child in canada when she was 39 in a new country uh the whole immigration experience do you think she could have handled the and she was a mentally and emotionally very strong person do you think she could handle the fact that her middle-aged son had a bit of a limp the afternoon of arthroscopic surgery had i thought about it i would not have suppressed my lamp but the point is i didn't think about it it went back to my very first year of life when i was two months old when the german army marched into budapest and my mother phones the pediatrician to say would you please come and see gabor of course he's crying all the time the day after the invasion and the pediatrician says of course i will come but i should tell you all my jewish babies are crying now what do you think that was about what did i as a two-year as a two-month-old know about nazis or hitler or genocide what was i reacting to the stress of my mother infants pick up on the stress of their mothers and the infant learns very quickly that if the mother is so stressed already that if i add more stress to it that might threaten my relationship with her because she'll be even more unhappy then the infant will learn to suppress their own pain simply to maintain a relationship now that's not another desire ever to give that message to an infant but we do automatically and unconsciously that's just how it works and that becomes the memory and i'll talk to you more about those memories later but it becomes a memory without recall i don't recall that time in my life but the memories in my body and my friend servas who works with bodies a lot he sees the body memories in the way people stand or they hold themselves or the way they walk and we hold these memories in our bodies and we're not even aware of them up here because there's no conscious recollection so that suppression of my limb was a body memory of what i had to do to maintain my relationship with my mother now the woman with als the teacher she was an adopted child and shortly after the adoption guess what her mother gets pregnant and the biological child was the mother's center of attention and the adopted child from an early age unlearned or at least perceived that she wasn't loved and accepted and celebrated like the biological child was and hence she worked to make herself lovable and how do you work might make to make yourself lovable by suppressing your own feelings by always being nice by always taking care and always ignoring your own needs and it was purely unconscious this is her this is her coping patterns since she was a small child she did not do it deliberately and lou gehrig's father was an alcoholic and if any of you grew up in homes where there's alcoholism you know how it works is that the children or one of the children becomes the caregiver to the parents emotionally or even physically sometimes and that then becomes your personality that then becomes how you live your life because you think that's who you are because how we are as kids we think that's who we are that's not who we are but that's what we come to believe and that's who we that's how we behave then and that's what creates these patterns so there's nobody here to be blamed here nobody here to be blamed it's just hard works now why does these why do these patterns translate into illness that's because as traditional medicine is always understood and as western science has now confirmed mind and body are inseparable so if you look at the important systems in the body and the brain they're completely connected so that the emotional centers in the brain are connected to the immune system and the hormonal apparatus and the nervous system now the emotional centers in your brain have one major role to play to keep you alive now what is the biggest need of the newborn emotionally speaking and even physically speaking is attachment to the adults without that attachment we don't survive you can see that this is true of course of baby birds and and baby mammals but especially of human beings because we're the most um underdeveloped and the least mature and the most helpless for the longest period of time of any creature on earth and i'll say much more about that in my talk on adhd now that means that our brains are wired for attachment we're wired to attach big centers in our brains are dedicated to maintaining our attachment relationships that's our biggest need those emotional centers in the brain are connected with the nervous system because the nervous system warns us when our attachment needs are not being met and then we cry and then we get stressed that's the immune that's the hormonal apparatus and all that has an impact on our immunity because it turns out that all these systems the hormonal apparatus the immune system nervous system and emotional centers in the brain are connected by the nervous system into one giant electrical grade fibers of the nervous system connect them all together so that anything that happens in one aspect of that system happens in the other aspects so they're connected so that electrical fibers or nervous fibers from the brain go to the spleen where the red cells are stored or to the bone marrow where they're manufactured or to the thymus gland in the neck where immune cells mature and back up to the brain so there's a constant neurological communication that's going on in our systems 24 7 every second every millisecond that's one form of connection the other connection is by means of chemical messengers that each of these systems secrete into the circulation which then travel to the other organs so that the brain reads what's happening in the body and the body reads what's happening in the brain so it turns out that the immune cells in our circulation can manufacture every hormone at the brain can manufacture so the immune cells in your circulation are talking to the brain and listening to the brain that's the second connection the third connection is the brain gut connection so let me ask you this question and i'll ask for a show of hands if you've had the following experience please just put your hand up that is that you had a powerful gut feeling about something and you ignored it and you were sorry afterwards okay if you've had that experience put your hand up okay just about everybody here now why is it that the gut is so much strong so much brighter than the brain is that not the brain but the mind than the intellect i should say it's very simple because the god is connected to the brain in fact the god sends many more connections to the brain than vice versa when the god receives messages from the brain it reads them and it magnifies them and sends them back out to the brain so the gut feelings tell you the whole picture your thoughts only tell you a small part of the picture so people who had a stroke in the part of the brain where language is processed these are called aphasiacs they're much better able to tell when somebody's lying than the average person who can understand speech why do you suppose since they don't understand the words what are they paying attention to they got feelings which read the body language of the person the facial expression the congruity of the mouth and the eyes is it really when the person is smiling is it just a mouth house smiling you've seen that have you seen that the parliamentary debate on you know on and the politicians stand up and they smile they're grinning here there's nothing up here it makes you uncomfortable to look at it anybody with gut feelings would turn the tv off now there's another large group of people and not your large group of human beings who read gut feelings accurately and respond to them and what do we call those people children small children young babies don't listen to words they don't even understand them but they react unerringly and intuitively to gut feelings now guess what when you put your hand up and told me that you've had stronger things that you've ignored in your story afterwards because you believed your intellect rather than your gods you told me the story of your childhood because and the story of your childhood is that you were born with the gut feelings intact and connected completely but at some point something happened to you at some point you got the message that in order to survive and to be acceptable you have to suppress your gut feelings because here's how it works children have two needs infants anybody any human being we have two basic needs and the more immature we are the more important the first need becomes and that's for attachment an attachment means that connection with another human being for the purpose of being taken care of that's an absolute need of the small child can't live without it impossible so that's one large need another need however we have to function as full human beings is to be authentic authentic means that we know who we are what we feel are able to express it and able to honor it in our behavior so we have the need for attachment and we have the need for authenticity so far so good but what happens if in order to attach we have to suppress our authenticity because our parents can't handle who we are because they can't handle our anger as two-year-olds because they can't handle our our expression of our needs because they're too stressed they're too needy like my mother was in that terrible situation then we suppress who we are we suppress our authenticity and we suppress our awareness of our gut feelings because the expression of them would bring us into conflict with our caregivers and threaten our attachments and so our problem as adults is that a lot of our behaviors are still coming out of our need to attach so we're still behaving like little kids who need to attach and need to be liked they need to be accepted and approved of at the expense of our authenticity and that people is what makes us sick now a fourth connection i didn't even know about but has been described since i wrote my book is the heart brain connection in terms of that the heart itself has a nervous system in the pericardium which is the fibrous membrane that surrounds the heart there's a network of nerves which have predictive capacities so when people say especially for negative things so when you say oh i knew it in my heart you did and that brain in the heart is connected to the brain up here so that's yet another kind of connection so then naturally whatever happens emotionally uh and how we live our lives has a huge impact on our physiology because these systems are not separate they're just one system so let's look at the question of how the repression of anger then might suppress our immune system okay so um i'll ask for a volunteer here and whoever volunteers uh i i can promise you two things one is that you might feel uncomfortable for a minute in other words that you learn something about yourself okay so any volunteers you know thanks right there just stay where you are here's what's your name lorraine well thanks for volunteering here are the rules okay this is a metaphor or a representation of your life you sitting in that chair therefore you can't leave the chair okay so whatever happens you're going to stay exactly where you are other than that you can do whatever you need to you got it okay so lorraine we're going to ask you is if you're okay with me standing right here as i give the lecture this is comfortable for you okay so i'm going to come closer now and ask you if it's still okay if i give the lecture here that's still okay with you it's fine what about if i stood right here and gave the rest of the lecture right here how would that be for you it would be a little uncomfortable it's uncomfortable so what would you like to do about it for you to step back you'd like me to step back and okay how are you going to get that ask me you can ask me okay you can ask and i'm gonna say heck with you and come a bit closer okay no wait no no okay okay now you push me away now you push me away right you push me away okay very good as you were pushing what emotion do you think you'd be generating my guts were just going like this and i was feeling really smothered that's that's why you pushed me away but as you were pushing what do you think you'd be feeling not what you felt but what you would feel if you were actually pushing me what's the emotion do you think that'd be there for you i don't know a little bit of anger exactly anger and that's a healthy anger now healthy anger is nothing but a defense of your boundaries and basically lorraine what you'd be pushing what you'd be saying to me is you're in my space get out you're in my space get out now if you said that in the first place you would need to be pushing me right but the pushing itself it's good it's a good response it's a healthy response so in other words healthy anger is an expression of a boundary defense so the job of our emotions now by the way if i was somebody else in your life i mean somebody that you know had a different relationship with you might welcome them coming close to you right no no no i don't mean me i mean your child or your partner or whoever or you know somebody you might actually embrace them right in a different situation so the so the role of emotions basically is to respond to approach and welcome the healthy and positive approach and to keep out the unhealthy and aggressive one so it's either i want more of this or i want less of this so that's the job of healthy anger that's the job of the emotions in other words it's to let in what's healthy and nourishing and to keep out what's dangerous and unwelcome that's the job of emotions basically now what is the job of the immune system yeah so basically the job of the immune system is to keep out what's unhealthy like bacteria or to kill cancer cells that's what it does or to let in what's healthy like vitamins and nourishments and so on if your immune system attacked the particles of food and destroyed them before the chance to absorb them you wouldn't live so that the job immune system immune system is like that it's been called the floating brain because it has recognition capacity reactive capacity and learning capacity that's the same as the emotions the immune immune system does the same thing as the emotions protect us and let in what we need given the unity of all these systems it's obvious that when you suppress the one you're suppressing the other and that's why people that suppress anger they have diminished activity of their immune system as has been shown in studies or what happens is that the immune system gets so confused because their emotions are confused that it turns against ourselves and that's when you get autoimmune disease when the immune system actually attacks the body itself fundamentally what happens is one way or the other if you don't know how to say no when you need to your body will say it for you in the form of illness so chronic illness represents the budding saying no when you didn't do it not your fault this is how you were programmed before you had any choice in the matter so again it's not a question of blame or self-blame but it does mean that to prevent illness or if you have an illness to deal with it more effectively you need to learn to assert who you are and to say no now that might be difficult sometimes because the people in your life have got used to you as a yes they've always heard you say yes some of them might not like you very much if you start saying no all of a sudden and what you're gonna do when you start saying no is you're gonna find out who your friends are because they're real ones they're gonna say to you hey oh so i'm so glad you're finally saying no and the ones that were simply there because you're constantly available for them are gonna oh what happened to her or him you know that's it but so it it'll create some conflict which which will trigger all your fears about attachment so you're gonna have to learn that you're that you are more important than your attachments that wasn't true when you were a kid but it's true as an adult i'm going to finish with one story and then we'll take questions and do a couple of little exercises for you gilda radner you might remember her as a comedienne on saturday night live and she died of ovarian cancer and i didn't know anything about her life but i read her biography because i knew she died of cancer and guess what it's the same story over again so gilda radner was a very unhappy child and she was overweight as a child and she was thin as an adult because she was she was bulimic so all the time that she was a star she was actually a bulimic typically she didn't tell her mother her mother didn't know that she was bulimic out until after she had died why because she was still protecting her mother just like i was with suppressing my limp her father died when she was 12. a loss she never overcame and so what she did she always got into relationships with men where she would suppress herself to fit the image that the man had of that that he wanted of her and the only way she could feel close to her mother was to make her laugh so guess what she becomes a comedian so many comedians by the way are very troubled people and guess what i have a son who wants to be a comedian for good reason and then she develops ovarian cancer even after her symptoms of ovarian cancer began to cause physical distress including bowel blockage radner was more concerned with satisfying others than with her own needs she thought and received advice from sun resources her dilemma she writes in her autobiography suddenly i began to wonder how to please so many people do i take magnesium citrate what about the coffee enema do i do both do i do the abdominal massage or the colonic do i tell the doctors about each other eats meets west in gilda's body western medicine down my throat eastern medicine up my butt when it seems she had been successfully treated gilda became a poster girl for ovarian cancer featured on the cover of life magazine she was an inspiration to many but the recovery was short-lived still attached to roles she had developed as a child she berated herself for having cold let down others by developing terminal illness i had become a spokes woman for the wellness community and a symbol of getting well i had been a model cancer patient completely active in my own therapy now i felt like a living example that didn't work i'm just a fraud i thought only close to her death did gilda finally learn that she could not be mother to the world i couldn't do everything i wanted to do i couldn't keep calling all the cancer patients i knew and i couldn't try to help all the women with ovarian cancer and i couldn't read every letter i received because it was ripping me apart i couldn't cry all those tears for everybody else i had to take care of myself it was important to realize that you have to take care of yourself because you can't take care of anybody else until you do well trouble as you can but if you don't take care of yourself in the process you're going to make yourself ill so the issue of course is not that we shouldn't provide care to other people i mean caring for others and being kind that's wired into us as human beings that's a true expression of who we are but going along with that has to be self-care that means that you must demand support if you're caring for others you must demand support and when you need it you must be able to have a break you must be able to ask for help when you need it uh you must be able to express how you feel you must take time for yourself there must be times in your life which is just for you so that we have to find ways amidst the role of caregivers to actually care for the person here because if we don't the result is burnout and illness so again it's not a question of being selfish and unconcerned that's not so good either for your health but it's a question of being as kind to yourself as uh you are wanting to be to others uh it's kind of the golden rule turned around you know do unto you not just do unto others what you would have them do to you but also do unto yourself what you wish to do to others any questions on what i've said yes please well um addictions is something a bit different addiction happens when we're stressed and we need to soothe ourselves so when we allow the stress to wash over us and we don't keep the stress away then we get overwhelmed then one way to deal with the stress is to become addicted so that it's very interesting when you look at families with addictions you also see a lot of illness in other members so they just represent different coping styles the addicts shoes themselves to the addictive behavior the person with who doesn't go to addiction they're good they're good they're good they're going to go suppress themselves and develop illness instead a question here yeah yeah uh that's what i was gonna ask you about the person that has an addiction problem like i've seen this in quite a bit of people they could they could let me give you the mic so that people can hear you it's a good question thank you uh people with addictions um like maybe alcohol they've been using alcohol to help themselves to self-medicate but yeah after that they stop using alcohol and and knowing that um their mentally and emotionally development isn't too power they they become chronically ill like i've seen that in in a lot of people that i've worked with yeah yes you would expect something like that because um if you look at chronic illness if you look at the childhood conditions that give rise to addiction they also give rise to chronic illness so these adverse childhood experiences that i mentioned last night any of you know not there last night okay so there's a group of studies called the adverse childhood expansive studies they look at children or they look at adults and if they had physical sexual emotional abuse or death of a parent or some other catastrophic event in their lives the more of these events there were the more likely they become to be addicted as adults and the more likely that they have autoimmune disease or cancer so when pers people stop soothing themselves with the alcohol but they're not dealing with the stresses then as you say they're not dealing with the emotional stuff then the illness will show up that would not be not to mention that alcohol itself promotes certain kind of cancer other questions on what i've said yes okay yeah so i'll just get you folks with questions to speak to the mic and that way everybody can hear you i was just curious when you had mentioned about uh not limping going into your mother's room when you had mentioned about not limping going into your mother's room you know there's other theories about birth order yeah and you're the oldest yeah in the family i mean can you isolate yeah i think first order you know i've seen this chronic caregiver pattern i've seen it at every birth order possible it's not automatically a first burn phenomena i mean sometimes it's the second child who uh who becomes the good kid because like like with our my two boys with the first time we had a lot of conflict because we didn't order weren't very adept parents so the second son pulls in and suppresses themselves more as a way of i don't want that hassle i don't want all that conflict so he becomes the peacemaker and so it can happen at any point so birth order does have an impact but uh so many other factors are play into it so that wouldn't isolate that one there's another question somewhere else yeah you are yeah i was just wondering you mentioned bulimia bulimia is a form of addiction and it arises for the same reasons that addiction arises what's that you know what it is it's it it it's um it's a buildup of tension and an urgent release so that it's a way of actually self-created it's a way of releasing tension and there's that relief so the addiction i define as any behavior that you crave that has um a sense of relief or associated with it and which has negative consequences and you don't give it up despite the negative consequences that's what addiction is bulimia is an addiction the best way to understand it is a form of addiction and the causes of it go back to exactly the same factors that would underlie addiction see there's only one story there's only one story you treat kids well they grow up to be healthy adults you don't treat them well they're going to act out their unwellness in a number of ways and all the illnesses that we have and all these diagnoses are just different forms of people manifesting early trauma in early early distress that's all it's very simple yes anorexia is or is related suppressant it's um well let me just formulate it for you anorexia is an attempt to be in control of something when you don't feel your life is in control that's one way to be in control because that's that's something nobody can control you with so you're going to be totally in charge it's it's an emotional um or it's an attempt to deal with severe emotional loss that helps leaves you completely helpless but but in this one area of your life you're totally in charge that's how i understand it and invariably it has to do with relationships with caregivers particularly mothers i don't blame others because the mother is just acting out what happened to them as kids but with the but the kids these kids with anorexia there's always issues and um you know um i know that like the singer aunt murray i think her daughter was an anorexic and what i read about them it is a self-suppression on the part of the daughter i think there's a lot of anger there that's being suppressed in anorexia and that anger is being taken out on the self that's how i understand it uh there was a hand somewhere else yes please what about what do you think about the idea of somebody getting cancer if they've experienced repeated physical traumas that have been accidental well first of all i would say that nobody has a series of accidents accidentally okay so that for example um if you have if you constantly get into accidents i mean statistically it might happen sometimes purely randomly that you know you're you always happen to be where the lightning strikes but you know overall people that are accident prone it doesn't come from the outside there's something about them where they ignore risk or they're unaware of their environment or something and that has to do with early defense mechanisms i'll say more about that my talk on adhd wishes to say that they're stressed so it would not be unusual then for them to get cancer but i don't think it's the physical injury directly that causes the cancer i think it's more the stress and even if i had a physical injury you see if you had a physical injury that's not the stress you know what the stress is let me ask you this question here i mean some of you may not you know some of you may wish to answer if you don't that's perfectly okay but is anybody here willing to acknowledge and you don't have to there's no pressure here that you were sexually abused as a child if that's true for you just put your hand up okay very good thank you at the very back how old were you when that happened for and for how long 30 years about a year and in that year who did you tell about it nobody thank you how old were you when it happened 11 11 or for how long did it go on a few weeks a few days okay in those few days what did you tell about it nobody okay that's what the stress is because stress is not just what happens to us it's how we process it what you should have had to been able to do was to scream and yell as soon as anybody touched you the wrong way that's what you should have been able to do too is just to scream and run and ask for help the fact that you didn't is not your fault by the time you were four and the time you were 11 you had already learned that you were alone in the world and there was nobody there to listen to you so it's not that you made a mistake you just simply did what any child would which is to assess the situation unconsciously and you already knew that nobody there was there to support you and there when there's no support there then you can't express how you feel it's that suppression of feeling and the non-expression of the stress response that actually creates the long-term chronic stress so even in somebody with chronic accidents first of all there's reasons why they had them in the first place in the second place they may not have had the environment where they could actually talk about their feelings and be re-listened to and understood and that's what creates the long-term stress so it's the suppression that's the issue here this is how we respond without knowing anything about the particular case but this would be a general answer to your question yes okay now you have to really yell or come to the mic or they know what is wrong with them yeah so but they say why bother yeah you know what do you have suggestions on how we can work with them and yeah yeah well first of all let me ask you a question all of you how many of you did again i asked for a show of hands how many of you made new year's resolutions this year how many of you made new year's resolutions can you see the hands how many are still kept them okay how many of you know what it takes to live have a really good life i'm in terms of nutrition and exercise and emotional balance and all that how many of you know what it takes how many of you are living it okay so first of all thank you first of all the person you're talking about is not that unique are they they're just like the rest of us so what i would say to that person is you know what uh listen to them what are they saying to you they're saying that they're discouraged so just hear this instead of talking them out of it listen to them oh you sound really discouraged i wonder what that's about for you you must feel really hopeless sometimes you know what even me i know how to live a good life but i don't do it it's just very hard really listen to them make sure that they feel validated and understood by you then they can get past it if you try and talk them out of it you can't and again a bit louder please second point yeah right now i kind of think maybe it's time to change my field but i mean i used to be a yes person yeah i'm wondering you know when i had trauma about five years ago um is that and then this past year is when i started getting this depressive issue and um ulster's on my leg and is there a timeline when it's finally starts to really affect your body or you know like i always talk to my staff about self-care how important it is and i've been doing that myself learning to say you know no i have to create these boundaries because as i was wanting to help people make them not make me feel better but then i realized that i wasn't taking care of me right is there any suggestions on really how to take back some of that well let me tell you about a friend of mine who lives in calgary her name is shannon duke and shannon is 48 years old now and when she was 37 she was diagnosed with stage 4 breast cancer the stage 4 meant that the cancer was already in her bones by the time it was diagnosed at that time she had two young children age one and three and married to a well-to-do businessman she herself was a very high functioning executive for microsoft in calgary and then she's diagnosed she had the perfect life perfect marriage perfect home of course and then she's diagnosed and healthy physically you know fit always ate well and then she's diagnosed with stage four breast cancer and she has a transformation now she gets the best medical advice she can get anywhere in north america and she traveled to new york and elsewhere she got the best medical treatment and with that she was given one year to live because that's the prognosis stage four despite the medical treatment chances are you'll be dead in one year now a year ago in february just a year ago now shannon traveled to the napa valley of california with some of her friends and they celebrated her 10th year survival and her 47th birthday and the transformation that she experienced was that when she was diagnosed and started paying attention she realized that her life had not been her life because she was sexually abused as a child and her response to the abuse was of course as many children will experience it can't be about the adults it's about me so if i would if this terrible thing happened to me i must be a very bad person so i have to be very good to compensate so the good daughter who doesn't talk about it doesn't disturb the waters to go to employee the good student the good wife who doesn't talk about the husband's addiction issues because that would again disturb the waters and when she's diagnosed and she decides she wants to live she says the hell with all this perfection and goodness and she confronts her family a virgin about the abuse that she had endured and she confronts her husband and she starts leaving authentic and she leaves the job by the way which wasn't her wasn't really expressing who she was now 11 years later the cancer is still in her bones but it's completely inactive but she knows that if she wants to stay alive she needs to stay authentic so that i believe that many of these issues are reversible and i i'm not promising a cure here to anybody but shannon really underwent a major self-journey and she continues every day to work at it and she she practices her spiritual ways which she ignored all those years and she pays attention to herself and she keeps clearing the stuff out and she is the picture of health her and i give workshops together sometimes so that there's ways to get there but it's a commitment and of course it might threaten the attachment relationships so that's always your call i was um curious about um any correlation with the uh endocrine system with a person that is either living with alcohol-related birth defects and um and trauma so so when we look at what you're presenting here about um mind and body connection and the immune system so so you're speaking about a lot of the hormones so my questions about um if the endocrine system is not developed fully uh because of alcohol-related birth defects i i don't know the answer i don't i don't know the effect of i'm not expert enough to tell you if there is any correlation between alcohol effects and the hormonal apparatus the endocrine system i do know that there's a correlation between trauma and their consistent that's what i've been talking about but i don't know the specific answer about alcohol it's a good question i may need to look it up uh are you telling me it's finished or you have a question we've got five minutes okay well look uh rather than take another question at the moment let me just ask you to take a couple of minutes and answer the following question for yourself in what area of your life are you not saying no i'm talking about where there's a no that wants to be said but you're not saying it those areas are usually work or personal relationships okay and i suggest you just talk to each other just tell each other at your table or a partner if you don't want to talk write it but have a conversation with yourself or somebody else at the table about where you're not saying no in your life that would be a personal relationship or on your job okay just have that conversation

Channel: SCSASmithers

Views: 2,295,259

Keywords: Dr. Gabor Maté, stress, caregivers, chronic disease, When the body says no

Id: c6IL8WVyMMs

Length: 75min 48sec (4548 seconds)

Published: Wed Mar 06 2013