Dr. Sanjay Gupta
00:00:00
Trauma. It's a word that gets tossed around a lot these days, a buzzword of sorts. But have you ever thought, what does it actually mean to have trauma? Gabor Mate unfortunately knows the answer to this all too well.
At 11 months of age, I was abandoned. My mother handed me to the total stranger in the street in Budapest, and I didn't see her for 5 or 6 weeks. And when I saw her again, I didn't look at her for several days, which is what infants do when they're abandoned, when they don't see their mothers.
Dr. Sanjay Gupta
00:00:36
Now, the first thing you may be wondering:What type of mother gives her baby to a total stranger? But as is so often the case, there is more to the story. You see, Mate mother was trying to save his life. Mate had been born into a Hungarian Jewish family during the Holocaust. The stranger that Mate's mother trusted was able to keep Mate safe and then deliver him to relatives living in hiding. Obviously he survived. And today, at 80 years old, he is a renowned author and physician. Some would say that he has literally written the book on trauma and healing. Several of them actually. And yet, as you're about to hear, Mate says, his past still catches up with him sometimes in the smallest and most unexpected moments. There was this one time he was at the airport on his way home from a speaking engagement.
On the way home, the airline bumps me up to first class. I arrive home feeling really good about myself. What a great guy. How successful and how wonderful life is. And when I arrive at the airport, there's a text from my wife saying. "I haven't that told me. Do you still want me to come?" She was supposed to pick me up. And I texted back in a dither saying never mind. And I take a taxi home. And I walk into the house 15 minutes later and I'm barely even looking at her.
Dr. Sanjay Gupta
00:02:10
Now, maybe that would have just been annoying to some people, but it struck a nerve deep within Mate.
And for 24 hours, I'm barely looking at her. I'm just grunting in sort of suppressed rage until she finally says, knock it off already. So I knocked it off after 24 hours. But then I thought about it. What was this all about? It's about abandonment. But of course, she wasn't abandoning me. It was a memory. And it's what we call an implicit memory. An emotional memory, which is one of the impacts of trauma. Now, that's circuitry of abandonment. And my reaction to it is a wired into my nervous system. And that's one of the impacts of trauma is that the past dominates the present.
Dr. Sanjay Gupta
00:02:55
It's part of the reason, Martel says understanding trauma is crucial. In fact, he says that it's something we could all benefit from. He has this book called Myth of Normal, where he makes the case that our understanding of trauma is all wrong and that many more of us than you might think are living with trauma. He goes so far as to say that he believes trauma is the root cause of many diseases, including things like addiction in our society. It is a bold claim, and for that reason I was incredibly curious and even excited to sit down with him. Now, I'll be honest with you, today's conversation gets pretty intimate, and there's a lot of things that I'm still processing and grappling with. I often come back to this notion that life is finite, but if life was infinite, maybe I'd make different decisions. Maybe I'd think about things differently. But it's finite. Still, I think there are lessons that we can all use for healing and ultimately help us find happiness, or at least get closer to it.
And you say, why am I feeling this way? You know, why do I keep making the same mistakes? Why are my children unhappy? Perhaps not in the sense of self accusation. Like why am I this way, but genuinely hmhm what happened here and get some help. I think if I could learn, I think everybody else can as well.
Dr. Sanjay Gupta
00:04:19
I'm Doctor Sanjay Gupta and this is Chasing Life. All right. I know what you might be thinking. Gabor Mate's story is incredibly moving, but maybe it's an extreme example. But here's the thing. You don't have to go through what Mate endured in order to have trauma. In fact, he says there are two types of trauma. There is big T trauma, and there is little T trauma. Surviving the Holocaust. A natural disaster. Violence. Abuse. All those things come under the big T trauma. But the little T traumas are significant. That's what you have to remember. And they also impact many more of us.
Little T traumas are more like parents who are stressed or themselves traumatized, or they have marriage difficulties, like my wife and I did when my kids were small. That our kids needs are not met. Our kids needs for acceptance, for being seen, for who they are, for being celebrated, for. Permission to experience all their emotions as their rules. Kids need that for healthy development. Those are the big trees where the needs are being made, and a lot of us grow up that way.
Dr. Sanjay Gupta
00:05:33
Regardless of what type of trauma you may have. Mate says it's important to start by showing yourself compassion. But he's also quick to point out that trauma is no excuse. It's no get out of jail free card.
Dr. Sanjay Gupta
00:05:46
It's nobody's fault that someone got in the car. And maybe it's someone's fault, but my point is that you wouldn't look at that and say, I behave this way and I'm a bad person because this. Like, if I have a limp after I've been in an accident, no one says, oh my gosh, why are you still limping? Right. I'm not. I'm not asking this very eloquently, but.
I understand. Yeah, I get it. I think I would answer you on two levels. Does the shame or remorse come up in me? Yes, but I have to deal with that because, you know, I need to take responsibility. I can't use that as an excuse to keep acting out like that. But do I judge myself for it? Or when somebody comes to me for therapy or healing of their trauma? Do I judge them? No I don't. What you just said. It's nobody's fault that they're traumatized. It's nobody's fault that those traumatic reactions are ingrained in their nervous system. It's their responsibility to deal with it, to learn from it, to grow from it, to heal those traumatic wounds. Yes, that's their responsibility, but it's not their fault. So I'm not into judging people.
Dr. Sanjay Gupta
00:06:53
'You know, I've struggled with this, sir. I feel like the idea of dealing with it, quote unquote, to some extent to me, means revisiting it. And I think humans want to find the lesson in things. You know, we want to find the meaning in misery. And I think now that I'm in my mid-fifties, I think sometimes pain is just pain, that maybe there is not always a lesson in it. Right? Am I wrong?
Well, maybe there is, maybe there isn't, but it's always worth asking. It's very interesting. You know, I was rereading the Ancient Greek plays a little while ago, and in The Agamemnon by Aeschylus, the chorus says that Zeus, the chief god, laid it down as a law that we have to suffer in to truth. So it's always worth asking, you know? And there's a modern teacher who says that all the difficult things that happen to you. Part of you was creating that so that you can learn a lesson. And all I can say is. Of course, lightning could strike me. What's the lesson? There's no lesson. Just bad luck. You know, so I'm not saying this is universal or always, but in my own life, whenever I've looked at the sources of the pain that I was experiencing, difficulties that I was facing, setbacks in my life. There was always a lesson in it, and in learning the lesson, I could move forward more powerfully in my life and feel lighter for it. Now, you may not always have an answer that this pain can teach me something, but often it can. That's my experience.
Dr. Sanjay Gupta
00:08:41
That's beautiful. It raises several questions. Going back to this beginning, though, the abandonment, which was sort of the the root issue that you identified with regard to how you may have reacted to your wife at that that moment, going back to when you're 11 months old, not even a year old.
Dr. Sanjay Gupta
00:08:59
To address that is forgiveness in some way part of the therapy? Is forgiveness a requisite part of the therapy in order to address the issues that may have caused the trauma in the first place?
'I don't prescribe forgiveness. Forgiveness is something that happens as you heal. Trauma is not what happens to us. Trauma is what happens inside of us and our reaction to what happens to us. So my trauma wasn't that my mother gave me to a stranger. My trauma was that I came to believe that I was abandoned and therefore I wasn't lovable. That's the trauma. That's the wound. And so when my wife doesn't pick me up, that wound gets exacerbated. That bone gets poked, you know. So now people who are hurt, let's say they're abused. A child who is being abused has got two, three healthy responses. The first one is to ask for help. But usually in situations of abuse, there is no help so that's not available to them. Or to run away. But a four year old can't run away and a 4 or 5 year old also can't fight back. So what do they do with the anger, the rage that they're feeling? They had to suppress it in order to survive. That's suppression of anger, which is a survival mechanism of the organism in childhood. That repression of anger messes with the immune system because anger is a boundary defense. Anger is meant to say, "This is my space, get out." We're wired for anger, you know. We have this anger circuit in our brain, as are other mammals, for the purpose of self-protection. Now, if you look at the science of psychoimmunology, you find that the immune system and the emotional apparatus and the hormones and the nervous system are not separate systems. It's all one unit. When you suppress one aspect of that dynamic unity, you're suppressing the other. And so if you look at people who develop autoimmune disease and malignancy very often, and according to all kinds of studies, and certainly in my experience, the repression of anger is a salient feature of their personality. They weren't born like that. It's a trauma response. So when you ask about forgiveness. No. First they have to go in touch with their anger that they suppressed all those years ago. Let them experience the anger. Let them get in touch with their defenses. Let them get in touch with their true selves. Forgiveness will come automatically, because at some point you realize your parents did their best. That was their best. That's multigenerational. It didn't begin with anybody. I passed on my trauma to my kids I'm talking about as a parent. Not because I meant to, I loved them, but I did. I couldn't help it. I didn't even know that I was traumatized. So forgiveness ultimately comes from dealing with your own trauma and then the understanding that it it didn't begin with any one particular person. It's multigenerational. There's nobody to blame. Who are we going to blame? Adam and Eve?
Dr. Sanjay Gupta
00:12:04
I just want to tell you everything you're saying is resonating very deeply with me. Going back to even how we evolved, I, you know, humans as as someone told me recently, it was an adaptive trait to evolve, to be happy. That wasn't going to help your survival from a tiger that might be chasing you down. Happiness was a luxury. Anger may have been more sort of ingrained as you, as you said, because that could actually help you live. Being suspicious was actually more ingrained because you needed to be suspicious of people.
I'm going to push back if I can. Happiness is not a trait. Happiness is, is a state of mind that comes out of certain experiences. Now, if you don't know what we are wired for. If you look at there's a great late neuroscientist called Jaak Panksepp, and he studied what he called affective neuroscience, the neuroscience of emotions. And Panksepp pointed out that there's certain emotional circuits that we share with other mammals. They include anger. Grief. Fear. Panic. Last. Seeking. Curiosity. And playfulness. And we have circuits in our brains, as do other mammals. And if you look at all mammals, they all play. And play Panksepp and many other researchers have pointed out. Is essential for healthy brain development, and play is the state of joyful happiness. So it's not that we're wired for happiness. It's that we're wired for play. And if you want to know what play looks like, imagine just think back to yourself and one of your three children. I understand you have three teenage kids. Think back to when they were born and you or your spouse held them in your arm as babies, and you looked at each other and you played peekaboo. Wasn't that the greatest joy you've ever experienced? I mean, you're wired for it. It's not true that we're wired for only for danger and so on. That joyful state of play is essential for healthy brain development. In fact, it's much more essential than formal learning and an education and an instruction. So we are wired for it. If we don't experience it, what we really have to ask is what is blocking it? You know. And so it's not a question of that. It's not there. It's I mean, you deal with the question of happiness. Let's use another word for it: joy. We're wired for joy. And the question we have to ask is what happens in life to block our joy? One of the things that happens is when we can't be ourselves, because otherwise we are not accepted by our environment. We have to suppress who we are when we have to repress our healthy emotions. There's many factors in modern society that cause us to develop that way. And from my perspective, these are sources of pathology, both mental and physical, later on. In 1939, at Harvard Medical School, there was a very famous teacher who to this day is honored by a day in his honor. Every year there's a Soma Weiss Day research day at Harvard. To this day. And Weiss was a Hungarian Jew like myself. He came from Transylvania and he was revered. And he gave a in 1939, he gave a lecture to the medical school class. And he said that emotional factors are at least as important in causation, causation of illnesses, physiological ones, and they have to be at least as important in treatment. Now, this lecture of his was reprinted in the Journal of the American Medical Association in 1940. Do you think anybody remembers it? Does anybody ever talk about it? Despite the fact that since then we've had 85 years of science proving the accuracy of what he said. So if you're hearing a certain degree of frustration, it's because. You know, we we physicians think that we're being scientific. And of course, in many ways we are. And you're a neurosurgeon. I mean, the miracles that you can achieve are stupendous. But at the same time as our modern scientific achievements, we've excluded so much science that would give us a broader view of things. And that's that's what I'm always railing about.
Dr. Sanjay Gupta
00:16:27
'You've probably heard by now that the mind and body are linked. That isn't new, but Mate takes that a step further in a way that's really fascinating to me. He basically says that the body and the mind are one. You cannot separate them, you cannot disentangle them, and that when trauma takes a toll on your mental or emotional health, that can lead to physical consequences in the long term, because in a way you become disconnected from your body. How do you know if you're disconnected from your body? Well, Mate says a good clue can be that you have trouble identifying how you truly feel. If answering the question a simple question like this how are you? If answering that honestly is hard for you because you aren't sure, well, that might be a sign. The truth is, if you've experienced trauma at a young age, you may have learned to ignore your, quote, gut feelings. And that's a coping mechanism, a survival skill, he says. Something we needed to get through the danger at that moment. The problem is when this disconnection from how you're actually feeling continues in the long term, that can literally alter something that we in neuroscience call your response flexibility. That your ability to evaluate and choose how to address life's inevitable challenges. This function of our brain happens in the cerebral cortex, and it's something our brain learns as we grow. Unless, of course, trauma stunts our development. Those who have experienced trauma may have trouble handling stressful situations, even if they are small, like what Matt described earlier as having happened to him at the airport. That's because our brain is sort of stuck in defense mode with an inadequate toolbox to handle life's stressors. The brain circuits to make different choices just haven't been fully laid down. As Mate writes in The Myth of Normal, quote, the past hijacks and co-opts the present again and again. And as Mate wants us to understand, this disconnection between our mind and our body that can lead to physical consequences. He basically is saying that trauma is literally making us sick.
'So there's a lot of research that childhood trauma has a lot to do with chronic pain later on, and that emotional self suppression has a lot to do with chronic pain. So there was a American physiatrist, rehabilitation specialist, a medical doctor called John Sarno. Who dealt a lot with chronic back pain. And he found, guess what? That people with chronic back pain and they'd have their X-rays done and they show bulging disk or this and that, but a lot of people with the same X-ray findings don't have pain. So the X-ray findings don't necessarily explain the pain. By the way, I'm talking as a person who's had back surgery from a neurosurgeon, and I was so bloody grateful for it. So I'm not here to talk against surgery. I'm just saying that people with chronic pain hold a lot of tension in their body, based on childhood trauma. It's that tension that creates the pain, and then the brain creates a pain memory that it doesn't let go on. And when people deal with the emotional stuff, I can tell you examples of people who were told you're going to have to have surgery medications for the rest of your life. They dealt with the emotional stuff; the pain went away. And Sarno became very famous for his approach to back pain. And he was trained like you and I, you know. So chronic pain, there's a message in it, and the message is: there's something emotional in that you're not dealing with. And if you deal with the if you in other words, if you look at it, resolve it, the pain might very well resolve. I'm far from the only person to say so. There's lots of scientific papers again showing the connection between childhood trauma and chronic pain. Trauma's the big unseen. It's the big word that we don't ... like the average medical student doesn't get a single lecture on emotional trauma, which is astonishing given the preponderance of evidence linking it to conditions like depression and anxiety and chronic illness, autoimmune disease, and so on. The gap between science and medical practices is astonishing to me. Except I understand it in the context of a society that manufacturers stress almost like a byproduct.
Dr. Sanjay Gupta
00:21:03
To that point. When you look at trauma with a little T, how we're dealing with it, how it's affecting our bodies. How common is this, do you think, in a society?
See, if you look at how human beings evolved, we actually evolved in small band hunter gatherer groups until like a few thousand years ago. We lived in small groups where parents were with the kids the whole day, where people were in a community that supported each other, where communality was the ethic rather than rugged individualism. But we've gone so far away from our roots. People are so isolated. They don't trust each other. Families are under tremendous economic and political stress. If they even stay together. Extended families, the community has been largely eroded. 47% of Americans say that they experience loneliness. There's an epidemic of loneliness. Your Surgeon General, Vivek Murthy, just published a paper on loneliness just a couple of months ago. And loneliness is as big a risk factor for illness and death as smoking 15 cigarets a day. And if you look at the the triggers for physiological stress. And by stress, I mean over activation of the pituitary hypothalamic adrenal axis, the HPA axis, you know, the release of stress hormones. If you look at the triggers for what are the loss of control, uncertainty, lack of information and conflict.In other words, this society might as well be designed to stress people. And then the isolation that I mentioned. No wonder 70% of American adults are at least on one medication. And this is in the most scientifically advanced richest country in the history of the world. It's a stressful culture. It's in the it's in the nature of this culture that creates all this. And our profession could do so much to alleviate it if we only looked at the science combined with the ancient wisdom.
Dr. Sanjay Gupta
00:23:05
I'll be honest. Like I said at the top of the podcast, the idea of confronting the negative thoughts or memories, the way Monty describes that can feel daunting, especially if you grew up learning not to complain or share emotions like so many of us did. That's why after the break, I'm going to ask him for his advice for healing and for living a happier life. We'll be right back. Where do you find the hope in all this, Gabor? I mean, are you optimistic? I mean, if stress and trauma are part of this toxic culture in which we live and it's making us sick, and you can draw the lines. You want the evidence, the evidence is there. And as you say, it's been there for a long time, but it's systemic. So what does that mean for individuals then? What can we do to to address this?
Well, you know, fundamentally I believe in human beings. I think not just humans, but all living creatures are endowed with significant capacities for healing, given the right conditions. I've seen a lot of people with severe addictions heal and become very productive and very not just productive in the economic sense, but contributing members of society. Once they deal with their own trauma, they're there for others to help heal them. We see this all the time. I've seen people with chronic illnesses do a whole lot better once they deal with, not just the physical which is necessary, but also the emotional psychic aspects of their experience. I see goodness everywhere. Even people with whom politically am I totally disagree. If I look at them on a human level very often, they're really open hearted, generous individuals who just happen to see the world differently. So I see what I see hope it's not so much hope. It's a possibility. I think the possibility for healing and wholeness and togetherness and people want nothing more, actually, then to connect and to be themselves and to be accepted for who they are and to accept others. In our heart of hearts, people want nothing more. That's covered up with all kinds of trauma and defensive mechanisms and aggressions. And but it's there. So that's why I see the possibility. And the older I get, the less cynical I got. Let me put it that way.
Dr. Sanjay Gupta
00:25:32
Somebody said something to me, which I thought was very true. And I'm curious what you think, that they basically said this, that it is hard to hate close up. And I think maybe that your point is, well, even with people that you disagree with.
'Even those malignant people, their behavior is malignant for sure. When you look at the histories this very often trauma underneath it. And what's showing up in that malignancy is actually their defensive aggression and and rage, which they then they act on the world, and not that they should be allowed to get away with it or that we should excuse it, but it does have a source. If you look at studies on mass killers, for example, invariably they were severely traumatized, which doesn't justify anything. I'm just saying, if you if you -- and there's an old expression that says that to understand is to forgive. Once you understand somebody, it's much easier to see where they come from. That doesn't mean you excuse or allow their behavior. So that I make that distinction just as you made it. But the room for it disappears. And Bruce Perry, who you might know is an American psychiatrist and trauma expert. And Bruce says that fundamentally, we're born for love and everything else is a distortion of that. And I see it the same way.
Dr. Sanjay Gupta
00:27:01
You are an incredibly well read learned, evolved individual.
Dr. Sanjay Gupta
00:27:08
Sometimes going back to the story with your wife. It took you some time to get there. I mean, should I feel hopeful that you got there? Or should I feel intimidated that it took you? You know, you're so well read and you evolve into these these learnings and teachings. Can I get there? I mean, can anybody.
Look. Here's what I can tell you. I just turned 80 years old in January, and I often tell myself, Thank God. I would not want to be as young and stupid as I was when I was 79. So you're in your 50s. Oh my God. You have so much potential. So does everybody. If you undertake that journey, if you start asking some of these questions, if you start looking at your life not self critically, but with a discerning and curious eye, and you say, why am I feeling this way? You know, why is this happening for me? Why do I keep making the same mistakes? Why are my children unhappy? Perhaps not in the sense of self accusation. Like why am I this way, but genuinely hmhm what happened here and get some help? Yeah, I think if I could learn, I think everybody else can as well. And it's an ongoing process. You know, it's never over, but that's okay.
Dr. Sanjay Gupta
00:28:24
I think finding this balance for me between call it happiness, the ability to feel joy. I think for me, for a period of my life, maybe you felt this way in med school or training or wherever, but I think there were times in my life where I felt I didn't have as high a capacity for joy. It wasn't that I didn't experience it. It's just that when I saw other people experiencing, they really seemed to experience these incredible peaks. I did not seem to have those incredible peaks, but I also did not have these incredible lows either. You know, my my cycle was flatter, I guess, in terms of things. And at times I thought that was a pathology. And maybe it is. I still don't know. But I think you've you've certainly give me a lot to think about.
Well, I wouldn't want to pathologize it necessarily, but what you're describing for yourself, this is very true for me as well. Joy was almost foreign concept to me. Like I saw people overjoyed and I said, what's going on for them? Now, I'd want to know what happened. I'm not going to go into this now obviously. You wouldn't either. But if I was talking to you personally, I would want to talk to you about your mother and your father and their emotional states and what stresses they might have been going through when you were very small, and what you might have taken on and how much playfulness they could have given you when you were an infant to get those joy circuits flowing. You know what was going on in their lives. Not in the sense of blaming them, but just as an investigation. I'd also want to know, what pressures are you putting on yourself? What are you taking on? What burdens are you carrying that keep you more down than you need to be? And again, what the reasons for that might be? In other words, Jaak Panksepp the neuroscientist who wrote a book called The Archeology of the Mind. And it's like we have to become our own archeologists and kind of look at our minds and say, well, what happened here? You know, so I understand exactly the state that you're describing and even even talk about it in the myth of normal. So joy has been a state difficult for me to attain. I would not say that anymore, but it was certainly true for much of my life, and that's what I was given.
Dr. Sanjay Gupta
00:30:34
'I will say this, that I think that, I do feel like my experience was not that novel. Children of immigrants. You know, my my parents, both scientists and dad's a mathematician and their engineers. And I think, you know, I think for a lot of people, especially children of immigrants, their parents lives were stressful. I mean, there were times when they didn't know that they were going to be able to make it in the United States, and that there was always, when I was a kid, this possibility that we weren't going to make it and that, you know, my parents would have to move back to India and I would obviously go with them having been born here in the States. But I never blame them. There wasn't anything to forgive because like you, I didn't blame them. And so I think sometimes the self-exploration sort of stalled at that point. To what end? I would ask myself.
Well, some of the blame, I think is inappropriate, unscientific and cruel. Okay. Parent blaming and I talk about in all my books at the same time, the reality is that the early emotional environment shapes your brain, shapes your personality. You already told me a lot about your parents. They were scientists. You said mathematicians, engineers. Those people very often are very much up in their heads and not that connected to their emotions. They can do amazing things in this world. It's not a question of denigrating their capacities or their skills or their commitment. But they also live lives that are somewhat emotionally deprived very often. And I don't know your parents. I'm purely speculating, I'm talking in general terms from what I've seen, but it also means. If that's the case. And adding to that, the pressures of having to validate their existence in this new culture in the face of racism, actually, and in the face of all kinds of difficulties, you might have experienced more stresses in childhood and you might have taken on more of an emotional burden than you might have realized. And it's not a matter of blaming anybody. But the question we have to ask ourselves in the present. What are the imprints of those burdens, and how do we still carry them and how do we put them down?
Dr. Sanjay Gupta
00:32:47
This is profound. I am going to be thinking about this for a long time to come. Thank you sir, and please give my best to your wife as well. I'm glad you guys started that. All that.
We did. It's a pleasure to speak with you.
Dr. Sanjay Gupta
00:33:04
It is not possible to undo or erase trauma when it happens to us. That's a fact. But what gives me hope is knowing that healing is possible. Whether you've gone through little T or big T trauma. I hope this conversation at least helped you realize that you're not alone and that real change is possible. Sometimes it can be painful to confront the past. But as Mate believes, it can be therapeutic as well. If you do it the right way. I find a lot of comfort in reading Mate's work and in sitting down with him, and I really hope you did as well. Next week. Our season of exploring the science of happiness continues with the conversation about building confidence.
Confidence is a bridge over uncertainty. The future is always uncertain, but confidence allows you to price in uncertainty, to to be able to handle uncertainty and the possibility of failure.
Dr. Sanjay Gupta
00:34:14
Join us next Tuesday. Chasing life is a production of CNN audio. Our podcast is produced by Erin Mathewson, Jennifer Lai, Grace Walker, and Jesse Remedios. Our senior producer and showrunner is Felicia Patinkin. Andrea Kane is our medical writer. Dan De Zula is our technical director, and the executive producer of CNN Audio is Steve Lickteig, with support from Jamus Andrest, Jon DiaNora, and Haley Thomas, Alex Manasseri, Robert Mathers, Lainie Steinhardt, Nichole Pesaru, and Lisa Namerow. Special thanks to Ben Tinker, Amanda Sealy and Nadia Kunang of CNN Health and Katie Hinman.