Gabor Maté (on trauma & addiction)

Welcome, welcome, welcome to Armchair Expert, Experts. on Expert. I'm Dan Shepard. I'm joined by the Minister of Duluth. That's not your name, but it is today.

It is today.

Yeah, what are you the minister of?

Do you think I'm a minister in a religious way? Of course. Oh, wow. Of my cult?

Yeah. Which we'll all be members of soon. Beautiful guest today. Holy smokes. I'm like embarrassed.

Yeah, he was incredible. And the way he moves around the world, seeing us all as equals, was very admirable.

Oh, he had a beautiful moment with you. I'll never forget it.

Yeah, it was really special.

For as long as I live, yeah. He has a new book out now called The Myth of Normal, Trauma, Illness, and Healing in a Toxic Culture. It's a beautiful book. I encourage everyone to read it. And I'm gonna say you're welcome because here's Gabor Maté, and he is special.

He's an armchair experimenter.

He's an armchair experimenter.

I'm good. I got my cup of tea here. Oh, you're sure you don't want a cold beer?

I don't actually.

I'm off coffee. How long? Late May, I participated in an ayahuasca ceremony.

Uh-huh.

There was a healer there who did this kind of scan and said, get off coffee for six weeks. So I did, but I haven't wanted to go back to it. Wow.

I've quit it a couple times. Well, you know, I'm a caffeine addict. I'm a hardcore.

Well, I mean, you're an addict. if it does, you harm. If you just enjoy it, there's no harm in it.

Right, don't you think that's sort of the definition?

Yeah.

There's a bunch we could throw in there. Secrecy. I'm not very secretive about my caffeine use. I'm pretty out loud about it.

As far as I know, you've been pretty open about your other stuff as well.

Yes, yes, yes. There's nowhere to hide, really.

Addict across the board, really.

Sure, full blown. Dr. Gabor, nice to meet you.

First of all, I'm gonna give you a pronunciation. Gabor.

Gabor.

Yeah, you know who screwed it up. for me is the Gabor sisters, Zsa, Zsa and Eva. Same name. Anyway, Hungarian, it's Gabor. And please drop the doctor bit, okay?

Okay, wonderful, wonderful, wonderful. I have opinions about that. I'm glad to hear you say that. Why would you prefer to not go by doctor?

It's a question of what kind of interaction do we want? I could call you, Mr. Shepard.

No, thank you.

Or you could call me Dr. Mate. Or we could both call each other by our first names. But if we don't do that equally, then there's a lack of balance, which makes me uncomfortable.

I like that. And let me just say, I am eternally grateful that we have doctors. So it's from no lack of not appreciating them. But I am suspicious of any title that immediately implies status. Just as a baseline, it seems a little bizarre to me that we have titles that imply status and that someone of lower status has to acknowledge the higher status when communicating.

I've been on panels with maybe three or four other people. Here's Joe, and here's Monica, or here's Josephine, and here's Dr. Mate. And I'm thinking, what the hell?

Right. You don't want to assume, then, that maybe they were your patients. No, no. If you introduce this joke.

It also adds a pressure. You have to be the doctor at all times.

Doctorial, yeah, it's a role, yeah. But you know what? A lot of my patients called me by my first name when I was in practice. Okay.

So, yes, just to do a really brief, I think you say it most efficiently in the book, which is you've delivered babies and you've run a palliative care clinic.

So I was in family practice for 22 years. And for seven of those years, I was also the coordinator of Canada's largest in-hospital palliative care unit, looking after terminally ill people. When I left that, then, I went to work in the downtown east side of Vancouver, which is North America's most concentrated and dire area of drug use, and more than anywhere else. So I had worked at a clinic there with people addicted to heroin, cocaine, caffeine, crystal meth, amphetamines of all kinds. So it was an area of deep trauma and deep addiction.

Yes, and you've written a ton about addiction and you're someone I heard about often. And it's funny, I've had some overlapping stuff, but yet we haven't had you yet. So I'm very excited to have you here. Obviously, addiction interests me greatly. Your last book, In the Realm of Hungry Ghosts, that's very addiction heavy in that book, yeah?

Well, In the Realm of Hungry Ghosts is all about addictions. It begins with the downtown east side, where people are suffering from homelessness, mental illness, HIV, hepatitis C, and all the complications of injection drug use, not to mention the addiction itself. The point I'm really making in addiction is that you can't just confine addiction to that particular drug ghetto, that addictions are revived through our society. And really, I had my own stuff, own addictive behaviors, and not to drugs, but other stuff. And sometimes people say, how can you compare it?

Well, we serve a helpful service, which is our addiction, by comparison, seems so terrible that your addiction, you can easily blow off. By comparison, relative to us, it could comfort you to know it could be worse.

That's right. The ostracization that those people experience is really our way of distancing ourselves.

At least that's not me.

That's right.

Well, you won't like this compliment, but I'm gonna applaud you because I've been around addicts for 20 years in recovery. We're not fucking easy. We are the biggest liars. We're the most manipulative. We're the most cunning.

When I was in my addictive behaviors and it wasn't the drugs, I was just as manipulative. I lied to my wife. I ignored my kids. I even ignored my work. sometimes.

Yeah, but we would agree. as a caregiver, when you have a patient who's got appendicitis, let's say, and you go, what's happening? Where's the pain? You're getting some real details. You can start building upon the information that you're receiving.

First of all, if people lie, it's only because they're scared of being judged and punished.

Or ostracized, excommunicated.

That's exactly it. And I also know one thing that, unfortunately, most of my profession doesn't seem to accept, which is that addiction is always rooted in pain and trauma. If you see that about people, in the Realm of Hunger Ghosts, I discussed how, one time, one of my patients, who really liked me and respected me, stole my cell phone. I turned my back for a minute, and the cell phone was gone. I shut the office for half an hour, and I marched right to the hotel a few blocks away where he lived, and I knocked on his door, and I said, I want my cell phone back.

This is the first time. Oh my God. He had no idea.

I had no idea.

Like a lot of people are unloading their cell phones.

But then I asked the guy. I said, listen, I know you like me. I know you feel that I helped you. I know that you respect me. Why did you steal my cell phone?

It makes me think of the saying we have in AA a lot, which is I'm the type of person that will steal your wallet and then help you look for it.

We put these people in a situation where they're desperate to get the next hit. In Vancouver, we used to have a mayor who was quadriplegic in a skiing accident. And he said, if wheelchairs were illegal, I'd be a criminal. And to the addict, that substance of that behavior is their support. It's the way they get along.

Well, that's lovely. So your book that we are here to talk about is The Myth of Normal, Trauma, Illness, and Healing in a Toxic Culture. You start off immediately with pointing out we are at the pinnacle of our obsession with wellness and health. It's reflected in our spending. We're spending more than we ever have.

Because maybe we're running in the wrong direction. So we're working very hard and expending a lot of sweat and energy and muscle power, but we're heading in the wrong direction. We don't see the way to actual health. On the one hand, we have these miraculous achievements of modern medicine, which are truly stupendous and mind boggling. On the other hand, when it comes to chronic conditions of mind and body, the medical profession in which I'm trained has a very narrow perspective.

Yeah. And in fact, it would be later, but in, I want to say that second section of the book, we talk about this fundamental issue, which is science only studies things that are measurable. Implicit in that is, how are we measuring happiness, health, mental wellbeing?

Yeah. Although I have to say my knock on my own profession is not that we're too scientific, it's that we're not scientific enough. First of all, Western medicine separates the mind from the body. So if you come in with a physical problem, rheumatoid arthritis, multiple sclerosis, or even with depression or an addiction, most of you are going to focus on the biological aspects of your problem and on the behaviors, but we're not going to look at sources, because we separate the mind from the body and we separate the individual from the environment. This is just endemic in Western medicine and has been almost forever.

25,000?.

Yeah. But it took me a long time.

You and your son, let's give your son a shout out. Daniel?

Yeah, my brilliant son, Daniel, without whom I could not have written this book.

And when it's time to read from the book, Daniel steps up and does a wonderful job.

Yeah, Daniel did the audio, which is a good thing,

because I couldn't have.

But I think- Oh, sorry.

No, I just want to know what prompted you doing it with your son.

Well, look, this is a huge project and he's brilliant with words. I'm a good writer. But for this one, I needed somebody to rein me in, to make sure that I was reader-friendly, to make sure that I wasn't getting too much on my high horse as an expert.

It's beautifully written, highly readable, and the language is really beautiful and it's very efficient.

He's an award-winning lyricist. He has a way with words. So between him and I, we would bat it back and forth until we were both satisfied. So this is not a project I could have done without him.

This would be a dream of mine. That's so fun. To work with either of my daughters on something professionally.

They're a bit too young.

We'll see.

They're pretty sophisticated. Just going back to being affected by everything around us, you do a really clean and nice analogy, which is the lab culture. Will you talk about what a lab culture, how it functions?

In a laboratory, when we're growing organisms, we call that culturing. A laboratory culture is in a Petri dish or container, is a broth in which we are growing a certain organism, say a bacterium. And if those organisms are thriving and reproducing, well, we call that a healthy culture. But if all of a sudden large numbers started dying off or showing sign of pathology, we'd call that a toxic culture.

You would intuitively know it's the broth they're in.

We know that it's the broth. And I'm saying it's the same thing with human beings. When you look at the rise of autoimmune disease, the rise in overdoses, deaths, the rise in childhood suicide, the number of kids being diagnosed with ADHD, and so on, the number of people being medicated, something like 70% of the adult American population is at least on one medication and 40% is on two. Well, we're talking about a toxic culture.

Yes, so let's talk about toxic, because you do a great job at always delineating the words you're using, because so many of these are really zeitgeisty. They're pop culture-y. And I think it's really important that we differentiate, maybe the way you're using it. Even trauma, which we'll get into, the different types of trauma, but there's a lot of catchphrases. But your definition of toxic culture, what would you include in that?

No, although if you look at the literature, there's a lot of toxins in the environment and a lot of junk in the food that a lot of people eat. So we could talk about toxins on that level. But here's what I mean. Going back to that laboratory broth analogy, if the nutrients that were necessary for the health of those organisms were provided to them, that'd be healthy. But if their needs were not met, they would be ill or life would be unsustainable.

Out of 250,000 years as a species.

And millions of years as a genus.

Yes, yes.

And so that means that until the blink of an eye ago, we lived under circumstances that are no longer available to us. Trying to understand human beings in this society and thinking that we're looking at normality is like looking at a zebra in a zoo. And how a zebra behaves in a zoo has nothing to do with their true nature.

Hence, the myth of normal, right? To us, and I think I've heard you compare it, which we talk about all the time, is the fish in the water. So everyone that listens is pretty familiar with that. That comes up quite a bit. But it appears normal.

You know, the confusion is perhaps understandable, but it's got some very significant consequences. So as a physician, I'm trained to understand that there's a normal range within which human life is possible. If your body temperature falls within that normal range, you're gonna be healthy. But if it's too low or too high, your life is at risk. Same with blood acidity.

We assume we're within the range.

Because that's all we see. And yet, it's neither healthy or natural.

And, as we were saying, you might look at the junkie and think, oh, my thing's not that bad. We also live in a geopolitical world where I can look at other places. And I can actually think that, well, in fact, on the spectrum, we're doing pretty well, because I can see over there that looks worse. And there's very few places we can point to that look better. I guess Scandinavia always comes up.

We tend to idealize Scandinavia. If you look at it closely, it's not as bright as all that. I mean, there's certain features of their societies that are worth emulating and considering. But there was an article just the other day that there's a huge rise in violence amongst youth in Sweden. Really?

I wanna get into trauma, but I just really appreciated this anecdote you gave about flying home from a conference. The conference had gone well. You were feeling very good. You even used the term good boy. Flying home, I got upgraded to business.

This is when I was at the younger, tender age of 72..

72,. right, right, right, right.

So, when I was young and stupid. She texts me saying, I have an atomia. Do you still want me to come? And I fly into a rage. My mood immediately turns sour.

No time. There's no time either.

You know, that flow state.

She's in the opposite state you are, which is she is entirely present.

Exactly.

And you are now, as you say.

In the past. What gets triggered in me is an old pain of abandonment, which goes back to being 11 months old and being given by my mother to a stranger in the street to save my life in wartime Budapest.

She's being ushered into a fenced-in ghetto.

Under the circumstances that we're living under, I would not have survived more than a couple of days. Yeah. And I was ill. So she gives me to a total stranger in the street, ask her to convey me to some relatives. And I don't see her for five or six weeks.

I don't want to experience this again. No. I have to protect myself.

So, on the one hand, I'm enraged. On the other hand, I'm withdrawing. Rather than saying, this really hurts me or disappoints me, I was listening.

And you're pre-verbal, as you say.

It's pre-verbal. I have no recollection for this, but I have an emotional memory of it. And so when my wife doesn't show up, guess what gets triggered?

I did it again. I let you in. I trusted you. I leaned on you. I was vulnerable for you.

Yeah, exactly. And I react not like a 72-year-old physician and best-selling author. I react like an 11-month-old.

It makes me really emotional to hear that that's your experience, because I have that quite frequently. And it's so outsized. It's so irrational. I intellectually know it doesn't matter. Most recently, we talked about it.

No, you have to really heal that trauma first. And you have to work at it. And when you're going through that experience with TSA, it's not just that you're having certain thoughts. Your whole body's in a totally different state. Yes.

Cortisol dump, adrenal dump.

Exactly, yeah.

How do we overcome those things that are traumas we can hardly even understand, if they're pre-verbal, or when we're babies and stuff, like we don't necessarily know. And then other people can't be around it. I have things like that. They just happen, as much as I can try to talk myself out of it. It takes over, but it gets in the way of relationships.

Yeah. Given that we're creatures of a relationship, by definition, it's human beings. And given that our early relationships really are the template for then how we approach later relationships, like with my wife, they're the most likely to trigger us. This word being triggered, by the way, it's an interesting word, because we always get trigger warning and don't trigger me.

Yeah, it sounds weak.

Yeah, but actually, if you look at a trigger, it's the smallest part of the weapon. There's ammunition, there, there's an explosive charge. So when you get triggered, or I get triggered, the really interesting thing is not what's the external thing that triggered me, but what's the explosive charge inside me and the ammunition that I haven't looked at yet. So those triggers can actually guide us to ourselves and to healing by understanding them. Number one.

Yeah.

Yeah, the thing that's been most helpful for me is when I can accurately predict it'll happen. Right. So it's like, I'm always pretty bad at the airport. If I don't take the time before we leave, it goes, you're gonna go there, they're gonna tell you to do this thing. that makes no sense to you, this is gonna happen, a lot of people are gonna ask for your picture, you're with your kids, you're not gonna like that.

Well, I mean, what you're describing is also what I'm sure that's familiar to you from the addiction world, to stay away from the places that trigger you, stay away from the friends that are drinking.

Don't spend the night at crack houses.

Exactly. What is it about airports, by the way, for you?

I would say there's three things. There's a timetable, and I always travel with my mother and it was always for work when we were younger.

So you're under somebody else's agenda.

You know, there's some anxiety that I'm gonna miss that flight, some irrational fear of missing the flight, which I don't ever miss. flights. Really, it's the authority from somebody who's telling me to do things that I am determined in my arrogance, are very arbitrary. And that is just very triggering. from a new stepdad would arrive in the house.

I remember reading once that, didn't you suggest some kind of legislation about no paparazzi for kids or something?

You know, there was legislation which we thought would never hold up in the courts because of First Amendment. So we actually built a coalition and went to all of the photo houses and got them to agree to stop printing that.

Because you said that we may be public, but our children are not.

There's three guys in army fatigues in the front yard that jump out when we leave the driveway, like my eight-month-old. They talk about trauma. Yeah, and I'm like, no, no, this is not acceptable. You can't do this to my child. It's not their fault.

Yeah.

Regardless, what I loved about what you point out in your own experience with your wife is it takes you out of the present.

Yeah, so one of the impacts of trauma is that you're actually living in the past, not in the present moment. It's so difficult to be present.

To be robbed of. that is a real tragedy.

Yeah, well, because, as any spiritual teacher will tell you, all there is is the present moment.

Yeah.

So when we're not in it, where are we? Whose life? are we living?

I learned the best distinction from your book, which is, as you say, trauma is not what happens to you, but what happens inside of you. Right. And your analogy is a concussion from a car accident. is the trauma. The accident is what happened.

That's right.

I feel like that's incredibly powerful to think about, because one thing is unalterable history, right? We're not gonna go back in time, erase my stepdads, but the trauma's in me currently. Yeah. That feels powerful.

If the trauma was that my grandparents died in Auschwitz, or that my mother gave me to a stranger when I was 11 months of age, it'll never not have happened.

Right. Right, right. There's something you can do about that.

But if the trauma is what happened inside of me, as a result of all that, I came to believe that I have to justify my existence, that I wasn't worthwhile as a human being. Perhaps I wasn't lovable. If that's the wound, that's what trauma means, by the way. It means a wound. So if the wound is in my own self relationship, if the wound is in essentially my rejection of myself, or my need to prove myself to others all the time, because I don't accept myself, that I can heal like that.

Until we have a time machine.

Until we have a time machine. Yeah, yeah, yeah. We do have a time machine. We do. Yeah, it's our minds.

That's true. We can float off into the future or the past.

As somebody once said, it's never too late to have a happy childhood. Oh, I like that.

That feels empowering too.

Which simply means that whatever happened then doesn't have to define how you feel about yourself now. It often does, but it doesn't have to.

It's all very tricky, because it also creates some incredible attributes that you don't want to say goodbye to.

Like?

I would say for me, I see other people with trauma. I am of great comfort to other people with trauma. I can smell it the second I meet them.

So do you mean that gives you empathy and compassion?

Yes, and an ability to connect. And I think I have, at least on the spectrum, a very low level of judgment of other people.

Well, it's certainly true that working your way through trauma can open up those qualities in yourself. And I've learned a lot through my own trauma work on myself and with multiple others.

You even said the fact that you could relate to the addicts about your own compulsions is so helpful.

Yeah, at the same time, it's not that we need trauma to give us compassion. Compassion and empathy are actually natural human qualities. That may seem like a strange thing to assert in a society that's based on greed and individualistic competition and acquisition, and being bigger and better and more beautiful than everybody else. But actually, empathy and compassion are intrinsic to human beings and to other animals. That natural empathy and compassion gets trampled on and they get crushed and they get kind of submerged because of the trauma that happens to people.

It's interesting, though, because if I'm just being dead honest with you, that all sounds wonderful. But yeah, another attribute would be like, sure, I'm not enough. I'm not worthy of love or being picked. So I become hysterical so that I can entertain you and you'll love me. And that'll be my value proposition to you.

I understand.

But maybe you would suggest, and maybe it is true, that I would have been able to make people laugh anyways.

I've studied comedians a bit. In this book, I talk about Robin Williams. Very tragic life.

I worked with him right before all that. Beautiful, beautiful guy.

Yeah, sensitive, incredibly talented, but also suffered a lot. In a previous book, I wrote about Gilda Radner. And both Robin and Gilda, they used their humor as children to get closer to their mothers. By making their mothers laugh, they could feel closer to them. But why should a child have to work to be close to their mothers?

Okay, well, that's the flip. Yeah, I'd have to embrace that.

Comedians tend to be very sensitive. Oh, the worst. When I say sensitive, I mean the word sincere, to feel, a Latin word. You just feel more. And some people are just genetically more sensitive.

No, absolutely not.

Why not?

Well, A, I have an opinion of them. that's much higher than me. So I believe they will be wonderful without that.

Okay, but would you want to impose suffering on them in order to give them these qualities that you value in yourself?

No, I wouldn't. What's weird is, I don't have necessarily faith that I could have achieved this or come to this place without that. But I do have the faith that they can.

I don't mean to be intrusive here.

Please be intrusive. I'm certainly intrusive.

But then I would say that you still have a trauma-tinged view of yourself. You don't fully see yourself yet.

I couldn't agree more.

Because if you did, you'd see the same possibility and you celebrate the same capacities in yourself that you do in your daughters.

I've tried to articulate this a couple times on here and not done great at it. But yes, in fact, they are my gateway to that healing. I'm trying to reverse project. If I think that way about them and they're half me and I see little me in them, it's helping me find my way to that.

I can totally relate. One of the impacts of trauma is, first of all, hard to be in the present moment. The second is we develop a negative view of ourselves. When, for example, the parents hurt you, it's not them you start hating, but yourself. There's a wonderful American black psychologist called Kenneth Hardy, who I quote in the book.

Your caregivers are the ones that seem to know how this place works.

Exactly.

So if they've labeled you as defunct, somehow, you're inclined to believe it, because they know how everything else works.

Or if they just don't meet your needs, then you realize that your needs don't matter. I got a lot of admiration and remuneration for being a physician. I was always there for my patients, day or night. I would take on all kinds of work just because people wanted me. But why?

Yeah, it's the fuel. Let's talk about capital T and little t trauma. Many people will think, I didn't have an incarcerated parent. I didn't have food scarcity. I didn't have sexual abuse.

So you can hurt people in two ways. One is by doing bad things to them. that should never happen to them. And you've mentioned some of them, a parent dying or being abused or racialized.

Given to a stranger for seven weeks at 11 months old.

About six weeks, actually. So those are the things that shouldn't happen to children, not ideally. But then there's another way. you can hurt people, not by doing bad things to them that you shouldn't have, but by the things that should have happened, not happening. So children are born with certain needs.

Right, and you say these are non-cultural.

They're dictated by evolution. Right. A baby rat, a baby monkey, is an expectation for being nurtured and held and licked by the mother. A human infant is an expectation for unconditional loving attachment. They're an expectation that they don't have to work to make the relationship with the parents work.

But just being themselves.

Just being themselves. That's an expectation.

But then chronic anger.

Well, that's something else. Yeah. Healthy anger, we can talk about what that is later, but we have a need for that. Grief. Life is full of losses.

Well, you say someone without trauma is an outlier.

Yeah, in this society, not because parents don't love their kids, not because they don't do their best, and not because they're not dedicated. Even difficult parents are doing their best. That just happens to be their best because of their own traumas, but because of the stresses on the parenting environment have become so intolerable, and they're becoming increasingly so, that parents are just not able to provide those needs of their children. And it's not a question of love, because the child doesn't experience what the parent feels. The child experiences how the parent is.

Yeah, there's a hard example we could give now. It's much later in the book, but I found it really fascinating. And that is this chapter about Trump and Hillary Clinton.

Yeah, and you've had Hillary on your program.

I have, yes, I adored her. I had so much fun interacting with her. We got kind of a playful side of her.

It was Zoom, which is such a bummer. I wish we could have had her in person, but she was great.

You point out that for the supporters, those two seem diametrically opposed, but in fact, they have some similarities. One of them is they both track in the upper quintile of cold-heartedness.

Which is not my assertion, it was based on a study.

What were the metrics?

Well, there's some clues, right? And this is his point about the myth of normal, which is on the night of her nomination, they play a video and it's well-produced.

It's actually narrated by the voice of God, Morgan Freeman. Morgan Freeman.

And the things that she's proud to share are that her father said, don't whine, don't complain. Do what you're supposed to do. Do it to the best of your ability. Spanked the kids excessively. Mom said there's no rooms for cowards in this house when she was being bullied.

So here's what happened. There's a conservative columnist for the New York Times, David Brooks, whose political views I totally disagree with, but who I find very insightful and rather a deep thinker.

There's insightful thinkers on both sides.

Oh, yeah, sure, there are. Brooks pointed out that what Trump and Hillary Clinton shared was a denial of vulnerability. At this Democratic convention, right after her nomination, they played a video about her life, narrated by Morgan Freeman, in which Hillary talks about how her mother taught her resilience and she gives the following example. And as I'm telling you this, Dax, Monica, do you have kids?

I don't.

Okay, well, Dax, as I'm telling you this anecdote, think about your own children in that situation, okay? So she's four years old. Neighborhood kids are bullying her. And she runs into the mother's home for protection. And the mom says, there's no room for cowards in this house.

Well, here's where I gotta add the very complicated analysis. in that situation. I do believe if you grew up like I did, what you may tell yourself is, if you don't learn to stand up now, you're actually gonna experience much more suffering for the rest of your minimally childhood. So the parent definitely believes, God, I gotta give them the skill, or they're gonna suffer endlessly at the hands of bullies, because bullies are ever present.

That may be true. And I'm not blaming the mother. She was doing her best. Right. My question is, what's the impact on a four year old?

Yeah, I would be so scared in that situation.

You validate their emotions and then they develop confidence in themselves and they'll naturally stand up to the bullies.

I hate that story because I'm sure that did happen, but even if it didn't happen, she felt she had to do that, because in this culture, we do elevate toughness, resilience, especially for women, in leadership roles.

I know.

And the highest leadership role of all. She had to prove. I'm like men.

And men have to prove they're tough. So Trump's proving the same thing to his tyrant father.

Well, that's exactly the point that David Brooks makes. Yeah. Is that the both of them deny vulnerability. You're right.

Women have an uphill battle in that, because we already believe that about men. They're already tough and he's already this, but if she doesn't show it, she's automatically weak.

We won't trust her to be the commander in chief in wartime.

Exactly, and I think what you're describing, Monica, is what we may call sort of a patriarchy. Yeah. A lot of people don't like to use that word. If you don't see it as a conspiracy of some kind, which it isn't, but as a mindset, then we're overemphasizing the so-called masculine qualities of toughness and individualism, and I'll make it. I'm not vulnerable.

I don't have emotions. I'm not a coward.

I'm not a coward. And when you look at veterans with PTSD, that's what they have to learn is that they're vulnerable, and to have emotions is not to be weak. It's actually to be strong. So what you're saying about women in this culture, and Hillary in particular, it's absolutely true. I totally understand why she would think of it that way, but I'm telling you that denial of our vulnerability is toxic, not just to women, but also to men.

Yeah, I want you to talk about breast cancer and the different correlations with breast cancer.

Yeah, so I talked earlier today about the need to experience your healthy anger, which is a boundary defense. You're in my space, get out. But let's say you grew up in a family where, as a two-year-old, you throw a tantrum. Now, by the way, if you're a parent, at some point or another, you're gonna frustrate your kids. If you're a good parent, you'll frustrate them because that two-year-old, they want a cookie before dinner.

At least two times a day, you're gonna tell them to brush their teeth. They're not gonna like that.

Exactly, yeah. What do you and I do? when we don't get what we think our needs are, we get frustrated. So a two-year-old gets frustrated. What does a two-year-old do?

Listen, this is where I want to get selfish with you and say, in addition to being an addict, I also have psoriatic arthritis, an autoimmune condition. All right. And I think you see some connection there.

In my view, and this is not theoretical, I've seen people heal significantly from autoimmune conditions. I describe in something in the book, whether it's multiple sclerosis, or rheumatoid arthritis, or scleroderma, or systemic lupus, people heal if they heal their emotions. I'm not promising, like a snake oil here. I'm not saying do this and you'll be okay. It's a long, difficult process.

Oh, I'd love to talk to you, but yeah, I'm trying to exploit your free services right now.

Okay. How easy have you found it in life to say no?

I can say no, pretty well.

All your life, you've been able to do that? To other people's demands, needs, and expectations?

Well, I was molested at a young age, and post that, I have had a modus operandi of, I will die before I do anything I don't want to do, to a full.

How old were you when you were molested?

I would guess eight.

Who did you talk to about it?

I didn't talk to anybody until I was 17.. A girl confided in me she had been raped, and I felt obliged to, yeah.

You got two adolescent girls? Eight and 10.. I thought they were a bit older, okay. Yeah.

Believe me, when I look at them, and I go, wow, okay, at this point, that already happened to you.

Okay, this happened to you when you were eight? One of your daughters is eight? If anybody even looked at it the wrong way, who would you want her to talk to?

Well, yeah, me, of course. Um, actually, maybe mom. It'd probably be safer to tell mom.

Okay, well, one of the parents, at least.

Yes, yes, yes.

If something like that happened to them, and they didn't talk to you or your wife, how would you understand that?

It would obviously break my heart.

No, but I understand how you'd feel about it, but how would you explain it?

I would have to assume they would have thought they were no longer worthy of our love if they had been tainted in this way.

In other words, they had no trust.

Oh, can I add, though? I wanna be thorough. Yeah. They could also just be driven by shame.

Yeah.

But trusting that you'll love them as far as that.

That it's a safe place to feel that in front of sure, but that is a powerful force, though, when you have the immediate shame.

But shame is interpersonal. What I'm saying, I can't dictate this to you, but I'm suggesting, by the age of eight, you learned how to suppress yourself.

To me, it's all very clear now, in retrospect. Yes, I developed OCD around this time. I started doing things compulsively.

You also suppressed who you really were, and I'm suggesting that that's self-suppression, which is not your fault. It was how you adapted to the circumstances. I'm not even saying it's your mother's fault, because she would have gone through a whole lot of stuff. Let me even ask you this. Let's say something like that happened to your daughter.

Yeah, so that's a hard reality to confront, yes, that I am very attuned to what's going on. I picked them up from someone's house. What's happening? Finally get out. Oh, they prayed at dinner.

So here's where it's multigenerational. Your mom didn't have that kind of sensitivity. Why not? Because in her childhood, she had to learn to suppress herself.

She was molested.

Exactly.

The whole family.

So it's multigenerational. It's nobody's fault. Right. Nobody's being blamed here. I'm just saying this is how it works.

Yeah. I think one of the stats in your book that is heartbreaking is that women with PTSD have double the risk of ovarian cancer.

Yeah, which is a study that came out of Harvard about five years ago. That study alone should send every doctor running to figure out the mind-body connection. Because in the same study also showed that the milder the symptoms of PTSD, the less the risk of ovarian cancer.

So they're proportionally related.

That doesn't mean that PTSD is the only cause, or even the cause. I'm saying that those painful emotions, unresolved, are a contributor. And they're one of the things that we can deal with, but as a medical system, we don't.

It's really heartbreaking that you experience those things and then the reward for it is a physical ailment down the road.

Yeah, there's so many studies on that. Canadian study, men who are sexually abused triple the rate of heart attacks, double the risk of cancer. This is regardless of whether they smoke or drink or not. Because trauma itself causes inflammation in the body. The science is so clear.

Yeah. How do we reframe our definition of abnormal?

I'd like to reframe it in terms of what are actually human needs and human qualities and those conditions that don't support them, they're abnormal. And those that do are normal. So normal is no longer what we're used to or we're not used to, but it's actually based on what is healthy and natural. In other words, I would put normal back into that triad of normal, therefore healthy and natural, or healthy and natural and therefore normal. That's how I would reframe it.

Yeah. Can you tell me how afflictions, say, like addiction, are adaptations?

Okay. You and I have. both are addictive behaviors. Monica, have you?

Yeah, again, not drugs.

Oh, so, let me give you a definition of addiction. Then you tell me. Okay. By the way, the word addiction comes from a Latin word for slavery. Oh.

Oh, yeah. Well, isn't that accurate? Yeah.

Addiction is manifested in any behavior in which a person finds temporary relief or pleasure and therefore craves, but then suffers negative consequences in the long-term and doesn't give up despite the negative consequences. So pleasure, craving, relief in the short-term, harm in the long-term, refusal or inability to give it up. That's what an addiction is. I didn't say anything about drugs. It could include drugs, obviously.

So, yes.

So the issue is not- I'll cut to the chase, absolutely. So here's what I'm gonna ask both of you guys now. Not what was wrong with the addiction, not even what the addiction was, but what did you get from it in the short-term that you craved? So, Monica, what did you get?

Validation.

Can you say more about that?

Feelings of being worthy.

Okay, thank you. Darius, what did your addictions give you?

Relief. From?

Pain. Yeah. Hence my mantra. Don't ask why the addiction, ask why the pain. In my case, it's also validation, for example, and also a real sense of being alive.

Yes.

Temporary.

I'm an arousal junkie, yeah, yeah.

Sense of being alive, sense of being worthy, pain relief, are they good things or bad things? In themselves. Great things.

Good things.

Essential. Yeah, yeah, yeah. The addiction wasn't your primary problem. Your addiction was an attempt to solve a problem. It's an adaptation.

And I'm not telling on Monica out of school, because we've talked about this a bunch on here. What is really salient is, yeah, so mine involves like criminal activity. Hers is not, but the result is just as strong. In fact, definitely as strong. Yeah, yeah.

And maybe even more strong. That's the whole point.

Yeah, being brown in the South and liking a boy and having the boy say, I can't like you back because you're brown, is like, well, that's a wrap on that.

And some passed down abandonment stuff. This is my issue. I know that about myself, but it's like what we said earlier. It happens in here all the time. And it continues to happen where I don't feel like I should be here and I don't know how to stop it.

The therapist on me wants to jump on this like a dog on a bone. I want you to.

Attack, attack, sicker.

Okay, but let's just conclude the point. Your addictions, my addictions, were adaptations. Adaptations to what? To emotional pain. Where is that pain sourced?

I meant the inciting trauma to me. You could try to evaluate as being more traumatic than that.

I don't compare traumas.

That was the point I was making is I would debunk that.

Yeah, even though yours is criminal, hers is just as devastating.

Yes, exactly. The result's the same.

So, Monica, can I ask you a couple of questions?

Yeah.

First of all, you said that you don't feel like you belong. Is that the phrase you used?

I think I did say that, yeah.

Freudian slip. So let me give you a bit of coaching, if I may.

Yeah, please.

I don't belong is not a feeling. Feelings, I'm tired, I'm hungry, I'm sad, I'm angry. Those are feelings or emotions. What is I don't belong?

Opinion, a fact?

Fear. It's an opinion. It's a point of view.

Yeah.

What do you feel when you believe that you don't belong?

Oh, unnecessary, or that's an opinion.

Unnecessary is not a feeling.

You're right. Okay. Okay. I guess sad, but that seems basic.

What do you mean? that seems basic?

It seems so obvious, but it feels deeper than the word sad.

No, no, wait a minute now. If you're willing to work with this, just work with it. Stay with this belief that I don't belong here. Did you experience it here today? Yes.

Physically, I feel hot.

Okay. If this was on camera, when you said that, what would the audience have seen on your face?

Just now, when I said it?

Yeah, you probably don't know.

Did I smile or laugh?

You smiled.

What's funny about it? I wanna smile again.

What's funny about it?

Nothing.

Okay. So what you're already doing is you're distancing yourself from your feeling. That's not a criticism, just an observation. For a good reason, you learned that I better not be with my feelings. I better kind of minimize them.

I would say hopeless.

That's not a feeling.

Oh God.

Hopeless is a belief that there's no hope. What do you feel when you believe things are hopeless? Sad. Sadness. Yeah.

Everything feels retreated and deflated.

Kind of constriction? Yes. In your chest and your belly, and so on? Can you be with that emotion right now, just for a moment? Is it okay that things are constricted?

It's uncomfortable and painful. Like it hurts.

There's pain there. Can you be with that pain?

I don't want to.

Who the heck wants to? Yeah. Of course you don't want to. I know. But can you be?

Yeah.

Okay, that's the way through, is you actually have to allow yourself to have those emotions and to be with them, because it's got nothing to do with being worthy or not worthy. It's got to do with these emotions that we don't know how to be with, because as a child, you weren't given the support to experience all your emotions. So you can actually work your way through it, but your way through is through the body, not just by talking about it. You're gonna have to actually be with this stuff. I'm not a Buddhist teacher by any means, but I'm talking basic, you know, but the Buddha said, you just got to be with all this stuff and notice.

No.

Okay.

I love you, buddy.

And, by the way, Dax and I will both tell you that we've had the same stuff happening to us. That's why I was a workaholic doctor, to prove my worthiness.

While you're talking to her, I can feel my own anxiety. My brain going, hmm, I need the perfect answer, which is all a part of the same symptom. Yeah. What's the right, perfect answer? And then I got to be smarter than this, because that's another thing that people might like about me.

This drive that we have to be this or that, number one, that's how we adapt. And that's how we abandon ourselves. And that's the third big effect of trauma is that we get disconnected from ourselves. And again, the toxicity of the culture resides in the fact that the culture then rewards those defense mechanisms. Like when you're smiling all the time, you're likable and you're pleasant to be with.

Hey, what a tragedy.

That's the first thing people said. That's the biggest regret dying people had. They had other regrets.

They never gave it a shot.

Because they tried too hard to be accepted by everybody else.

Because it's life or death. We're a social primate. We know it's life or death.

Exactly. And that's what I'm saying about the toxicity of the culture. It's vying all the things that we develop to protect ourselves from our vulnerability.

I do wanna add, the last 150 pages of your book do provide a pathway to wholeness.

One pathway.

Okay, a pathway to wholeness. With many different things within that pathway. Would you mind telling me about the four A's and the five compassions?

If I can remember them.

Well, tell me about three of the A's and four of the compassions.

There's anger that we've talked about. So the necessity to set our boundaries. Not an automatic defensive way, by the way. And healthy anger is a boundary defense. So that if you invade my boundaries and I say, no, stay out, get out.

You already did pretty good.

I got two of the four.

We could call your son.

Rob's gonna look it up. He might remember.

Rob will look it up.

Acceptance, thank you. That's a kind of a Freudian thing, isn't it? God, I couldn't remember acceptance because in my life, I've always resisted.

You know from recovery, acceptance is the answer to all of our problems. That's one of our many sayings.

And acceptance doesn't mean intolerance. It doesn't mean that you put up with everything, but you do accept that. this is how it is now. No point resenting reality. You know, I flew here from Winnipeg last night through Vancouver to LA.

Life on life's terms, we also say, right?

That's a good way to put it. The fact of compassion, I do have a course called Compassionate Inquiry. We teach to therapists and counselors and doctors and so on. We've had over 3,000 students now in 80 countries. And the essence of the compassion?

Cars, I meant.

But there's nothing in you that isn't in me, vice versa. That's the compassion of recognition. Boy, if that one was prevalent in the society.

Yeah, that kind of gets rid of the us-them paradigm.

That's the whole point. It gets rid of the other. One of the worst myths that we have is that there's us and there's others. And the fourth compassion is what I call the compassion of truth, which is like, for example, Monica, in this exchange between you and I a few minutes ago, you experienced pain, but you experienced pain because that was the truth. My intention was not to protect you from pain.

I think we almost categorize people by their limitations.

That's the whole point.

Really, you're assessing the people in your life and going, oh, I gotta be aware of that limitation and that limitation. I gotta safeguard myself from that. This person's prone to backstab me.

Which, by the way, is because we look at ourselves that way.