This Is Making Us SICK! - The Connection Between STRESS, TRAUMA & DISEASE | Dr. Gabor Maté

It's inevitable that whatever happens emotionally is going to show up physiologically. Furthermore, we know that childhood trauma elevates the circulation of inflammatory particles in the blood, cytokines.

How come we're seeing despite, you know, the best healthcare system in the world in North America, despite advances in medical science, despite innovations in medication, why are we seeing more and more illness, more mental illness, more addiction, more obesity, more chronic disease, more autoimmune disease, Seems like we're bailing a ship that's sinking with a teaspoon.

Yeah. Well, by the myth of normal, I mean that conditions that in our society we assume to be abnormal, that we believe are normal, from the point of view of human evolution and human needs are totally abnormal. So that we're living in a world that doesn't meet our needs. Yet we think this is the normal world. and it may be the norm statistically, but it's not normal in terms of, it's not natural, healthy in terms of what human beings actually need. Number one, number two, in this society, physical illness and mental illness are actually normal responses to abnormal circumstances.

Yeah.

So it's not in the disease, the so-called disease that we have to find the abnormality, but in the conditions that cause the disease.

Yeah.

And, you know, this is where medicine completely fails.

Yeah.

Because when we can identify the cause of an illness, it's some external agent like the novel coronavirus. Or we can point to the preponderance of lung cancer among smokers appropriately. Then we think we found the cause for something. But for chronic illnesses that don't have such an obvious external agent as the triggering or causative factor. We just call them idiopathic, which really means we haven't got a clue what causes them. And yet, if you look at the actual lives of anybody with autoimmune disease, or anybody with malignancy, or anybody with depression or anxiety or ADHD or bipolar illness, you'll find that these illnesses manifest people's life experiences. They don't come out of nowhere. Nowhere, right. And furthermore, we make this elementary mistake of thinking that by diagnosing something, we've explained something. But let me show you how circular and actually nonsensical it is.

Yeah, yeah.

So I've been treated for depression. Yeah. You know, and there was a time when I gladly took antidepressant medication. and it helped me. So I'm not here to militate against medical practice. I'm a practitioner of it. But say Gabor is sad and he's isolating and he's morose. Why? Because he's got depression. How do we know that he's got depression? Because he's sad and he's isolating and he's morose. Why is he sad, isolating and morose? Because he's got depression. How do we know that? these diagnoses don't explain anything. They describe things. Same with ADHD, same with bipolarness. For that matter, the same with a lot of physical analysis. The diagnoses describe something, but they say nothing about the origins. Yeah, I mean, you just described functional.

Medicine in a nutshell, which is, I always say, because you know the name of the disease doesn't mean you know what's wrong with you. It's just the name we give to people who share a collection of symptoms. That's right. and depression isn't the cause of you being sad, hopeless and helpless and have no interest in sex or can't sleep and all these different symptoms. And yet the doctors always fall into this trap of thinking that the name of the disease explains the cause. The cause of the symptoms is rheumatoid arthritis. That's why your joints are swollen. No, it's not because of that. It's because of childhood trauma, because of gluten, it could be because of mercury or a million other things. And so just because you know the name of the disease, it doesn't mean you know what's wrong with you. And I think this is never more rampant in any other field of medicine than psychiatry and then mental health issues because we just sort of label people and put them in groups and then we treat the label instead of the cause. And then your work is really been about treating the causes that are mostly invisible and that are not really even talked about. And we've really kind of pushed mental illness off in this sort of dark category. In some ways, it's very stigmatized and we blame the victim and we don't really understand the context in which it arises. And I really not thought of myself as someone who's actually experienced trauma. And I didn't really connect to it. It didn't really make sense to me. And as a doctor, obviously I encountered many people who experienced horrible traumas. But for myself, I was like, ah, my child, well, my parents were divorced and yeah, I had issues with my family and my parents and there was conflict. My parents hated each other. But yeah, it happens to a lot of people. What's the big deal? And then I began to look at some of my own dysfunctional patterns of workaholism, of people pleasing, of overdoing, of over caring, which got me to be very successful in my career, but had really negative consequences for me as a human being and led to many failed relationships, led to many illnesses on myself. And I think your work has really helped me to understand that having a deeper conversation about these traumas really matter. And I'll just share a little bit about my own story and then we'll get into the bigger context of everything. And I think, you know, my mother grew up in a deaf family in New York City in the 1930s. Her parents were deaf. So if anybody has seen the movie CODA, which won the best picture this year, it's about a young girl who grew up in a deaf family and There was a line in that movie where the mother is lamenting her daughter is going off to college and saying, She can't go. She's our baby. Meaning we need her. But the father said, She was never a baby. And my mother had a word for her childhood, which was a parentified child. In other words, she was her parents' parent. She took care of them. She had to be their voice and their ears. And they were very loving and beautiful people, but it robbed her of her own childhood and her own innocence. she thought then that loving was caring for somebody who was broken. Then she picked my father who was broken, and that didn't work out. And then she picked my stepfather who was broken, and that didn't really work out. And that was the environment in which I grew up. And my mother became very depressed, and she used me as her emotional crutch, as her therapist, if you will. And that led me to have the behavior that love was also about fixing broken people. And my first wife was an alcoholic and had bipolar disease and had experienced horrible sexual trauma as a child, which she didn't even remember her childhood before she was 16. And we kind of later uncovered this. And I began to think about how these patterns were really originated in my childhood of my behaviors that were really not creating a life for me that actually made me fulfilled and happy and good. And I sort of, by doing the work, by actually excavating, I call it soul archeology, I was able to really understand how my brain was working, how my love software was corrupted, and it allowed me to really be very different and rewire everything about myself in such a beautiful way. But it was not an easy process. And I used a lot of different approaches, including different kinds of therapy, psychedelic work, which now is sort of emerging. And I know you work with a lot in terms of your, your work on trauma and patients, and that really helped me to kind of move through a lot of this. And I know I probably still have a lot of work to do, but it really taught me that each of us, even if we don't conceptualize what happened to us as trauma, as a child, that it really does inform who we are and how we are. So I, that's where I sort of want to take off with your work because, you know, what you say in your work is that Trauma isn't what happens to us, it is about the meaning we make about what happens to us or something like that. So, where can you talk about how you first came to understand this concept? Because you yourself were traumatized. You were born in Hungary in World War II and it was a time of the Nazi regime and you were Jewish and that itself was a trauma. Can you talk about how you first came to understand that this pattern of your own trauma was linked to the greater cultural pattern of trauma and mental illness and struggle and how you came to understand your work.

Well, first, thank you for having me. Just reflecting on your story and the parentified child, the child who has to become a parent to the parent, essentially loses the parent. So, whether you know it or not, you were a motherless child.

Yeah.

That's maybe why I like that song so much.

Yeah.

And John Bowlby, who's the great British psychiatrist, pioneer of developmental research, attachment research, and I quote him in the book, he says that reversal of roles between parent and child is always a sign of pathology in the parent and invariably a source of pathology in the child.

Yeah.

So that we pay a lot, but of course you as a child, had nothing to compare it to. That was the childhood that you knew.

That's right.

And most people, when they think of trauma, they think of big disasters like a tsunami or a parent dying or severe abuse, sexual, emotional or physical and so on. But really, the word trauma itself simply means a wound.

Yeah.

And people can be wounded in all kinds of ways. And so it doesn't take the big ticket, big T events to wound a child. You can wound a child, especially if they're very sensitive, just by not meeting their needs.

Yeah.

Their essential needs for being understood and respected for who they are, being seen, being heard, being unconditionally welcomed into the world. A lot of kids are wounded without the terrible things happening to them that people think of as trauma. And as you said, Trauma is what happens inside us, not what happens to us. So trauma is the wound that we sustain, not the event that caused the wound, which is a good thing. Because if trauma was the thing that happened to me as an infant, a Jewish infant under the Nazis, that'll never not have happened. But if trauma is the meaning that I made out of that, that I wasn't lovable, that it wasn't worthwhile, well, that wound can be healed. How I came, to this work was both through my work as a family physician and also a palliative care doctor. So I looked after people from birth to death, and I began to see that people who got chronically ill, not just with mental illness, but also physical illnesses like malignancy and autoimmune disease and so on, invariably there was a backstory of trauma in childhood and a lifelong pattern of what you describe yourself as manifesting of of people pleasing, of trying to be nice, of trying to do everything for everybody, of being a compulsive helper, which of course I did as well as a workaholic doctor.

Like calling a niceaholic.

Yeah, yeah, a nice, yeah. I wasn't always that nice, but I was certainly a workaholic and a helpaholic, you know, and as a way of justifying your existence. And so I began to notice these patterns in my medical work that behind chronic illness of all kinds, there was trauma and ongoing stress. And furthermore, in my 40s, I was a successful doctor, maybe like yourself, but with all kinds of personal challenges. I was depressed and anxious, and I was in a conflictual marriage, and my kids were actually sometimes scared of me. So I had to actually start asking myself, what's going on here? And so I began to go for my own therapy, and reading the literature and the combination of my observations as a physician, my personal experience and personal self-exploration. And then I just mentioned finally the vast body of scientific literature linking trauma and stress to physical illness, to mental illness. And here's where our profession, Marc, is just so behind the times.

Yeah.

You know, physicians the medical profession claims to be a scientific discipline, but they ignore all kinds of science to my own reality, to the reality of my patients, and also the reality of what science and research is actually telling us about human beings. Yeah, that's true.

I mean, there's just an enormous literature about this, and it's always surprising to me, and I see this with functional medicine, there's so much evidence and so much science, but if it doesn't fit the model, it's sort of ignored. Whether it's on the microbiome or toxins or stress or trauma, it's like there's plenty of data out there, and you talk a lot about it in your book. for example, about women who have breast cancer and how you could predict who was going to have breast cancer based on their personality type and how they repressed anger and were too nice. And, you know, the same with autoimmune disease.

Women have such a higher rate of autoimmune disease, which, yeah, women have 80% of autoimmune disease. And, and this is a big mystery. And, or if you take something like multiple sclerosis, which in the 1930s, the gender ratio, but was are equal. And now it's about three women to every man, which right away tells us it can't be genetic because genes don't change in a few decades. Can't be the weather or the food per se because that hasn't changed more for one gender than the other. What has changed is that women are facing more stresses than they used to by dint of having to still carry the brunt of the emotional work of their families and carry the emotional stresses of their spouses very often and having to work at the same time.

Yeah.

So when you got more stress and also people are more isolated now than they used to be. So what I'm really saying is that illness in a particular person is not a manifestation of individual biology, but as a consequence of multiple factors which include the social and cultural environment, the economy, the politics, one's personal relationships and one's personal multigenerational history.

That is true.

And just to separate the mind from the body as Western medicine does, and to separate the individual from the environment, is completely unscientific and not very helpful.

No, it is true. And I think medicine is starting to kind of tiptoe around this with the conversation about the social determinants of health.

What are the- yeah, they are beginning to talk about, yeah, there is a Canadian public health expert who said, if you want to stay healthy, be able to afford vacations in the sunshine and eat organic food and don't live in a poor neighborhood. Yeah, right. So doctors shouldn't be prescribing pills, they should be prescribing sun-filled vacations. Exactly. So there is some conversation now about the social determinants of health. And in Chicago, in some areas of Chicago, the life expectancy is 30 years less than in the wealthier parts. And these are the social determinants. But even the social determinants of health, is a narrow view.

Yeah.

Because it looks at only the most obvious. What's so beautiful about your book is.

That you talk not only about the, you know, it happens in the personal microcosm of a person's family and the developmental phases that they go through and the, yeah, the traumas that happen within the family, either the little t traumas, which are more of the invisible traumas, or the big T traumas like incest and abuse and so forth.

Yeah.

But you also talk about the, the social traumas and the societal traumas and the expectations and the toxic culture we live in. You know, Paul Farmer talks about structural violence, you know, the social, political, economic.

Conditions that drive disease.

We tend to ignore those.

The late and the lamented, who died before his time. Maybe because he took on too much, I don't know.

Maybe, I don't know what happened. I mean, I need to find out because I knew him and he's exactly my age.

But yeah, he did talk about these things and of course he put himself on the line. He worked a lot in Haiti with a very oppressed and impoverished population and he was very clear about the how power creates pathology. In this society, when I talk about a toxic culture, just, you know, like in scientific terms, in a laboratory, if we're culturing organisms, in a particular brew broth, we call that a laboratory culture. And if a lot of the organisms, the microorganisms we were growing, happen to die or get sick in large numbers, we would call that a toxic culture. Right. And that's what the assertion I'm making about our culture. And it's not just the social determinants are one important aspect of it. Like racism, for example, is a risk factor for aging and for inflammation and for malignancy and for asthma and for premature death. So that's a definite social determinant.

Independent of poverty?

Yeah, independent of poverty, raised quite apart from economic considerations. So that the, if you measure the biological aging of black American women of a better, of a higher social class, it'll be more advanced than white women of a lower social class. Now, if you combine race and poverty, Now you've got a double whammy. Double whammy, yeah. In fact, there's a triple whammy, because being a woman also puts you at higher risk for chronic illness. But even for those that are privileged, relatively speaking, a society that thinks that people have to be competitive and aggressive and selfish and individualistic actually denies the very nature of human evolution and human needs. So it'll create pathology even without the social determinants.

Yeah, it's so true. You talk about in your book this sort of crisis of separation that both on an individual level and a social level we're disconnected and how that gives rise to disease.

And.

The beautiful frame that Paul Farmer talked about when he talked about healing was accompaniment, which is the opposite of separation, how we have to accompany each other to health.

I tell the story of that was told to me by Louis Melmedrona. Louis is a Lakota, part Lakota. I know him.

Yeah.

Do you know him? I met him many years ago. Yeah.

A long time ago.

Yes. He's a physician, psychiatrist. Yeah. Trained in the Western model.

Yeah.

Like you and I both are. But he says in the Lakota tradition, when somebody gets ill, the community says, thank you. You are manifesting the dysfunction of the whole community. So your healing is our healing. It's all about connection. Scientifically, that's absolutely correct. Western medicine doesn't get it.

No.

I mean, we're social beings. And I think one of the interesting things to me when I look at the literature around disease, you think, oh, it's smoking, it's diet, it's obesity, and yes, it's all that. But more predictive than that was a sense of a loss of disconnection and a loss of control and a sense of isolation and loneliness.

Which is a more powerful predictor. Loneliness is an independent risk factor for getting ill faster and for dying of illness faster. And it's probably as significant as smoking 15 cigarettes a day, according to some of the research.

I mean, do you think this is like a modern phenomena, this crisis of separation, or has this been there throughout human history. And what is the cause of this, the root cause of the separation that we're seeing?

Well, if you look at the literature on loneliness, the number of people in the US who say that they're lonely went from 20% to 40% in a couple of decades. Not that long.

COVID, it's a lot worse.

It's a product of this particular system, for example. Walmart. Okay, so Walmart opens a store in a community and the local developers are happy. The local politicians are delighted to have this facility. People might even be pleased to have this big convenience department store available to them at lower prices. But what's the price that we pay? Local businesses have to shut down. They can't compete.

Yeah.

The local baker, the local butcher and candlestick maker, they all have to close down. People no longer walk to where they shop in the neighborhoods, seeing each other, meeting their friends and neighbors in the store, dealing with the merchants they personally have known all their lives. The Mr. Hooper of Sesame Street, they drive, each of them gets into a car all by themselves. and drive to this windowless, soulless facility where they're looked after by total strangers.

Yeah.

So, yes, you've gained a few pennies here and there.

Yeah.

And developers are happy because they sold the land. What happens to the community? And this is an inevitable product of globalized capitalism. It's happening all over the world. Hence the crisis of loneliness is, is burgeoning all over the world.

Yeah. So it's a sort product of sort of the globalization and of the way in which our profit motive has sort of driven systems in society that disconnect us from each other.

Yeah. Once profit becomes the prime motive and is even justified as the highest possible endeavor, which it is in a society, then what are you gonna get? They need companies that this is your field. I mean, sometimes you must be so frustrated because you're so adapted and understanding the essentials of human nutrition.

Yeah.

But there's companies that profit of delivering poisonous and developing and planning and concocting poisonous products.

Yeah.

And I heard you talk yesterday, sugar. Sugar has been called the most addictive substance in the world.

Yeah.

And in that sense, America is the center of the world's drug trade when.

It comes to sugar. Yeah, absolutely.

You know, as somebody once pointed out, and they push these sugary products into the developing world where more and more people are dying as a result. And so, let alone the pharmaceutical companies that is publicly known now, created opiates that they told physicians were not addictive or less addictive, knowing full well that that wasn't the case. And look at the tens and hundreds of thousands of opiate deaths now. Not that they're making them fully responsible, but they sure profited off it and they drove the dynamic as well. So once profit becomes the ultimate motive, then human health becomes a byproduct and.

A.

Sunk cost, as it were. it's not a concern anymore.

Yeah, it's so true. And I think, you know, we have such a negative view of addiction and in some ways we blame the victim. Yeah. Just like we blame the victim for being obese, we blame the victim for addiction and say, well, you know, you need to deal with your problem. You need to admit you have a problem. I mean, in fact, that's the, you know, that's the first step of a 12-step program, which is, you know, I realize I'm powerless over alcohol. Like, there's some higher power I have to give up to. Well, you know, that may be a little perverted in a sense because it doesn't take into account the truth of why addiction happens, which is out of some injury to our soul, injury to our mind, injury to our bodies. It happens when we're young that is a source of discomfort and pain that we're trying to deal with and medicate.

Well.

The very famous ACE Adverse Childhood Experiences Studies that looked at the correlation between childhood trauma and adversity and the later onset of addiction actually began when a physician acquaintance, maybe both of us, Dr. Vince Felitti, was working at an obesity clinic. And they found they could help people lose weight but couldn't help them keep it off. And then they started actually, they did something that amazing for medical doctors. They started listening to the stories of these patients. Yes. And the stories that they all had been traumatized, abused in childhood, suffered significant loss, the eating was their way of soothing themselves, which is any addiction is a way of soothing yourself. And that then gave rise to the ACE studies, which showed indisputably the connection between childhood trauma and loss and the adult onset of addictions, but also of mental health conditions. also of autoimmune conditions, also of cancer, relational issues and so on. Heart disease, all of it. There's so much research now that, and when I worked in the downtown east side of Vancouver, which is east side of Vancouver, which is North America's most concentrated area of drug use, and I don't know if you've ever had a chance to visit Vancouver, but if you walk through the downtown east side, there's this open air drug market, people are shooting up in the back alleys. It's quite the scene, and I worked there for 12 years. In those 12 years, I did not have a single female patient who had not been sexually abused as a child.

Not a single female patient had not been abused.

Not one out of hundreds. And that's also what the literature shows. So it's not just my anecdotal observation, it's also what the studies over and over again show. And yet despite that, society still insists on looking at addictions as a choice that some people make for which they are to be blamed. And as you pointed out, stigmatized or ostracized. Or in the medical profession, we have a more humane and somewhat more forward-looking, but still completely in norious perspective that we're dealing with brain diseases with a large genetic component. No, we're not. We're dealing with people's response to human suffering.

Yeah. And there's a whole field of medicine now emerging called narrative medicine, which is listening to people's story. What a novel concept, right? We should actually elicit a person's story. And it's one of the most important things I do as a functional medicine doctor, and I think that you do, is we we actually excavate and we start to dig, you know, what was your childhood like? Where were you born? What was it like? And what were your early life experiences? And you start to unpack things. And I have like trick questions in my questionnaire about, you know, trauma or abuse or little things that poke around. And it's amazing what you find when you start digging and you see the correlation between that and the breakdown in the body. And I always say that disease is the body's best attempt to deal with a bad set of circumstances. Exactly.

And that's exactly what you're saying. I'm saying that very much. And I'm also saying that therefore the disease, and I have a chapter on this, the disease can actually act as a teacher. Now, as a teacher who guides you back to your reality. Now, I'm not recommending it. I don't recommend anybody get rheumatoid arthritis or multiple sclerosis or for that matter depression or anything. It's a way of learning anything. All I'm saying is I've talked to so many people who once they developed these conditions, they used it to learn about what dynamics in their lives triggered it. And when they changed those dynamics, those illnesses have a very different course than the usual ones if they just treated biologically. And so the disease can act as a big wake-up call for a lot of people. Again, I don't recommend it. One of my intentions, and I'm sure one of yours as well, is to wake people up before disease comes knocking at their door. But once it does, it's astonishing what people are able to learn about themselves. And this has been documented as well.

Well, you know, this is the thing that I think was shocking to me personally as I began to work with my patterns of emotional relating and beliefs and what I call my sort of corrupted love software. I, I, I didn't think I could change the inner dialogue, the inner narrative. I call it the inner, you know, and, and as I kind of went through this process of healing in my mind, I actually started to change that. And, and it was shocking to me because I remember hearing Ram Dass speak years ago, and, and he said, you know, you never really get rid of your neuroses. You just become friends with them and you, you tell them, like, you know, annoying cousins or uncles. to go away and leave you alone, but they're always there. And I thought I had that belief, but I think in your work, you talk about the beauty of the fact that because these incels happen to you and you made meaning of it, that you can kind of rewire your neural circuits and rewire your brain and your emotional framework in a way that actually gets you free. And this is really, you talk about one of your favorite books being the Dhammapada, and I studied Buddhism in college, and it's through the Buddhist aphorisms and sayings. And I think the Buddhist framework is really about the liberation of the mind. And it's really what your work is about. And so how do people, how can people come to understand this work from a perspective of rewiring and the healing? Because we can all identify things that happen to us and we can all sort of relate to that. and yet it's very difficult to kind of reset. And I found myself for years just trying to reset and until I really kind of had this sort of almost somatic experience of resetting through a bunch of different things I did and through a lot of emotional breakthroughs and a lot of crying. It's like, yeah, able to kind of get, and in particular it was really around this movie was such a catalyst for me. I don't know if you saw the movie, but it was such a catalyst because it was my mother's story and it was my story embedded in her story and I began to sort of understand it all and it was just like, like a, what they call a Shakti experience. It sort of went through my nervous system and I came out of it feeling very different. How do people get there? Well, there's a big clue in what.

You just said, because you said there was a lot of crying. There's a psychologist, a psychologist friend of mine with whom I wrote a book together, Hold On to youo Kids, and his name was Gordon Neufeld. And he's really the world's leading developmental psychologist, not as nearly as well known as he might be. because he is more interested in working with people than in publishing in academia. But he said once to me that you should be saved in an ocean of tears. And what that means is that you have to grieve what you've lost. Rather than just defend it against it, pretend it didn't happen, you have to grieve it. So some of the process of healing is actually a process of healthy grieving.

Grieving, yeah, that's what it felt like.

You mentioned the Dhamma part of the Buddha's collection of sayings, it begins with that everything is mind in the lead. So basically, with our minds, we whatever we believe, whatever we think, we create the world that we live in. So that if you believe, for example, that the world is a horrible place, that is dog eat dog, that it's every person for themselves against everybody else, that your neighbors, even your friends want your wife and they want your house and they want your dog, then you know who you're gonna be. you can be president of the United States. Because a recent president of the United States wrote that in his autobiography. That's his worldview. Now, how did he arrive at that worldview? So the Buddha says that with our minds we create the world. But he didn't say, which is what modern psychology says, that before with our mind, with our thoughts or beliefs, we create the world that we live in. The world creates our minds. through our childhood experience.

And so that- We might create the world, but our world creates our minds.

Before we create the world with our minds, the mind creates our world.

Yeah.

Based on our childhood experience. And so that we really have to look at the forces that shaped us and gave us the particular view, like that I have to be a compulsive helper or that you had to become a compulsive helper and people pleaser. Nobody's born like that. Those are childhood patterns, their adaptations to fit into our environment when that environment demands it. Then with that mindset, we create the world. Not everybody's so clear on that. What's striking for me is often I run across somebody who says, But, you know, Doc, I was addicted, but I really happy childhood. And then that's when I issue what I call the Happy Childhood Challenge. It takes about three minutes of conversation. Just asking a few basic questions. And like you said, you have these trick questions that you ask people. I have my own bag of tricks as well. And that happy childhood story never stands up to any kind of scrutiny. And it's really important that it doesn't, because otherwise people blame themselves. I had this, you know, one of the saddest letters I received, I mentioned this in the MythoNormal. There was a guy in Seattle who read my book on addiction, in which I point out and argue that addiction is a response to trauma, and particularly trauma incurred in childhood. And he writes back, he wrote me a letter saying, I found your book very interesting, but I can't blame my mother. I'm a because of myself. I just felt so bad for the guy. Because he didn't get it. First of all, I didn't blame his mother. I don't blame parents at all. Parents do their best. It's just that his mother, like maybe I as a parent and perhaps you as a parent, our best wasn't good enough. Because at that time we still haven't worked our stuff. But there's no blame in recognizing that. But more than that, in that statement that I'm a s*** because of me, he was expressing self-loathing and self-rejection. which are the hallmarks of trauma. But with that mind, that's the world he lives in, image he is worthless. And that mind was created by his childhood, but he can't see it.

Yeah, it's so true. I recently had this incident about myself as well, because I had a father and a stepfather who were very disapproving, very judgmental. I was never good enough. I mean, my stepfather would say when I said, Dad, I got 98 on my test, he's like, what happened? The other two points, and he wasn't kidding. you know, and, and, and I think that left me with a sense of, of lack and void that I always trying to fill and always trying to be seen and known and acknowledged. And it sort of, I've actually built a career on that, and it worked, but now I'm sort of reorganizing all that in my mind and what matters and how I want to live and how I relate to my work and other people and the need for validation. And I never, if you would have said, Mark, you know, do you love yourself? I was, of course I do. do you have high self-esteem?

Yes, I do.

Do you have a lot of self-worth? Of course I do.

But the truth was, I don't think I really did.

Well, you did based on external conditions.

Yeah, I was like, I really didn't.

And I've really been cultivating. Yeah, I'm the same way. That level of self-worth and self-love. And I actually went to a retreat for myself. I wanted to sort of lock myself away for a month. And I went to Vermont and I just stayed in a cabin. I pulled out all the distractions, phone, computer, books, TV, nothing. And I just sat with myself. myself. And I walked and I, you know, ate and I, I was in nature and I wrote. And that was one thing I did do. And I was just sort of amazed to sort of begin to realize that I was enough, you know, like, that was. And, and, and I had this feeling. It was after this work around my mother and this trauma that I began to kind of have this Insight about what was driving me and trying my behavior that, you know, had a lot of good results, but that actually left me not feeling that great and also sacrificing my health and doing all kinds of things that weren't in service of, you know, my soul and what really mattered.

Yeah.

And, and I was like, I was such a shock and a friend of myself, you don't love yourself. You don't have self-worth. I'm like, what do you mean? Like, of course I do. But actually, I realized I didn't. And the cultivation of that has really changed my whole internal architecture.

Yeah. Yeah.

It was for me. And then, of course, the way the society works is, is you pointed out a couple of times in this conversation, It rewards us for our self betrayal.

Yeah.

You know, and so that I was this respected doctor always available and he's so kind and all this and my wife was going to a supermarket and they see the credit card and are you the wife of the great so and so on? And she would grit her teeth.

Yeah, because the great at home.

Because the great so and so wasn't available at home. Yeah, it was too busy working all the time. wasn't available for his own kids, for his own self-care, for the relationship, you know. But the world externally rewards us for that. So as much as it grinds some people down, it elevates some people.

For.

The wrong reasons and for reasons that they, which then reinforces, and it's very addictive because if my value depends on how much I'm helping others, it becomes addictive. And the reason it becomes addictive is because there's always a niggling doubt inside, which is maybe unconscious, but says, okay, they want me, but do they want me or do they want what I'm giving them?

Yeah.

So that that satisfaction of getting that praise and valuation from the outside is a temporary hit. like somebody's temporary hit from heroin.

Yeah.

And then you have to have it again and again and again.

And our culture rewards that.

I mean, it doesn't reward. So our culture rewards that kind of addiction big time, values it and, and, and, and, and estems it. Meanwhile, the soul is being ground to dust inside.

Yeah.

And, and that's one of the, that's another example of the myth of normal.

Yeah, it's so true. I, I think And it's, you know, the stories we tell ourselves are often so distorted. And, yeah, you know, one of my closest friends, I thought for 20 years he'd had a happy childhood, because he always said he had a happy childhood. And it wasn't until I went away on a, did a workshop with his sister. We were at the same place. And I started sharing about this, and she's like, what are you talking about? My mother was crazy, and she did this, and she did that, and it was awful. And I'm like, what? It was a shock. And it explained so much about his behavior and his patterns. and I think a lot of us do that. We kind of prematurely transcend, in a way, our trauma. And instead of actually going through it, we try to go past it and end up having all these maladaptive patterns of living and being and not functioning in a way that brings us joy and happiness and peace, which is what we're all after anyway.

And as you mentioned earlier, then you go to a physician. And I've often done this in talks that I give. I ask people, well, if you've been to a cardiologist or a respirologist or an oncologist or a dermatologist, any kind of an ologist in the last five years, just raise your hands. So, you know, out of a 500 people in a room, half of them at least will put their hands up, maybe more. And then I'll say, Now, keep your hands up if they ask you about any childhood trauma.

Yeah.

Your current relationship. any stresses at work, how do you feel about yourself as a human being? The hands mostly go down. And yet, yet I say to people, and I say this with full scientific backing, that those questions that are not being asked are what drove you to that doctor in the first place. Whether that trauma manifested in chronic physical illness or mental health conditions, or addictions, that's the source. And unless you deal with that source, you're only dealing with symptomatology and not actual cause.

So for people listening, they're probably wondering, wow, maybe I haven't identified this or that as trauma, or maybe actually I did survive a really traumatic child that I'm aware of. But I'm stuck in these dysfunctional patterns. I don't know how to break through. I don't know how to rewire. And, and, you know, how do we kind of re reconstitute ourselves in this modern world? It's a toxic culture because it's. So if we all got to go off and live in a monastery somewhere, it might be okay. But, yeah, how do we do that? How do, how do you provide a path for people to think about their own healing?

Well, it's very difficult because partly it's a matter of resources, like those that are. fortunate enough economically to be able to afford a good therapist. And I have to emphasize good because there's a lot of really useless therapies out there. I could talk at great length about that. That don't go to the heart of the things, but you only deal with the surface.

Yeah.

So if you can afford to do that, by all means, you know, just as you take your car in for a tune-up, take yourself in for a tune-up and finds out, find out what is grinding and what is not working and where it's not lubricated and, you know, what actually happened. There's lots of therapeutic modalities. I know I've developed one, you mentioned that in your introduction, Compassion Inquiry, but I don't claim it's a panacea.

What is that?

Well, at this point, I'm only mentioning it as one possible amongst many, many others.

There are.

So many forms of therapy out there and people can find whatever works for them. So there's MICE Compassion Inquiry. There's My good friend Dick Schwartz's Internal Family Systems, which is getting increasing traction and attention for good reason. There is Peter Levine's Somatic Experiencing.

Body-based therapies.

Body-based therapies, that's right. The cranial sacral work, body work such as massages and so on. And very interesting how many times people will get a massage and a therapist will touch therapists will touch a certain part of their body and all of a sudden the tears come, you know, because like Bessel van der Kolk says in his bestselling book, the body does keep the score. The body keeps the score. So the sensory motor therapies, Pat Ogden, I could name many, many therapies. But if you're going to find a therapy, find one that's trauma informed. Most therapies are not trauma-informed, something like cognitive behavioral therapy mostly deal with, I'm not saying it's categorically, but mostly deals with the surface of things. It doesn't deal with the underlying traumatic template for why you think the way you do. Also, but for people who can't afford a private therapist, well, or the community programs, Online there's all kinds of information about trauma. Many of my talks have been uploaded to YouTube, not by me, but just by others on trauma. You can get lots of information, not just from me, but from others as well. Then there are modalities that anybody can do, such as meditation and mindfulness. Like you spent a month on your own and basically I've done similar things. where you're just alone with your mind.

Yeah. And that's a scary thing.

It can be a very scary thing for sure. But that means taking a break from the digital world.

Yeah.

Actually spending time alone with the mind and then writing about it, journaling about it, talking to people about it. There's lots of stuff that people can do and increasingly, There are more and more books that are really good guides to understanding and working with trauma. Peter Levine's work, Waking the Tiger, in an Unspoken Voice. That's another one of Peter's work. My various books that you were kind enough to mention, including the most recent one, Bessel's the Body Keeps the Score, Bruce Perry and Oprah's recent book called what Happened to youo? About Childhood Trauma.

Yeah.

Memoirs like Educated by Tara Westover, which is quite a wake-up call about trauma and its impacts. There's lots of stuff out there now. At least we're living in a world where this conversation, although it's not penetrating the medical profession very much, at least it's happening out there in the world.

Yeah, it's true. And I think, you know, historically, illness was seen as a spiritual problem. Yeah. In most cultures, you mentioned Lakota, you know, when they, someone's sick, they bring the community together.

Yeah.

And the shamans and medicine men were the healers. And there was no division between spirituality and disease and health. It was all one continuum. And I spent a lot of time in very interesting cultures when I was in medical school. It was a Hopi reservation, and another was in Nepal. And there was this embedded culture of shamanism and medicine men and healers. And I remember being up in mountains and way in the remote areas near Tibet, we were in Nepal, we were in a medical expedition, and the Damai Jonkris were the Nepalese healers.

And.

There was this incredible ceremony with the whole community around and the ill person. It wasn't like you went to the doctor and you went and sat in an office by yourself. The whole community was there. And the healer was there working on the person and they were doing whatever they were doing, but activating, you know, different healing mechanisms of the body that we actually can activate through these various different modalities. And, you know, many cultures historically have used medicines, plant medicines, to actually heal. And now, with the Advent of this field of psychedelic assisted therapy, this whole conversation is changing. In fact, the psychedelics, and we've had Michael Pollan in the podcast, Tony Bossis and others who are doing this work, and, and they, they really have, have sort sort of resurrected this, this body of research that started in the 50s around psychedelics and LSD to look at how we can use these to help heal the mind. And, and I know you sort of work with this.

Yeah.

Model as well as part of the modalities. And, and like you said, there are many, but for many people, this can be an Interruption in their normal view of themselves and their world and great safety, you know, and I, I members of my own family who've been able to take advantage of this and actually start to find peace and start to kind of unpack the sort of traumas. And I have many friends and many colleagues who've used this. And a lot of it's sort of underground now, but it's really emerging. And, you know, whether it's ketamine therapy, whether it's MDMA, psilocybin therapy, whether it's ayahuasca or ibogaine, which is incredibly interesting to me as an addiction treatment. We want to sort of talk about that a little bit. And even things like stellate ganglion blocks, which are a nerve block in the neck that interrupts the fight or flight response, these are all technologies, let's call them ancient technologies, some more modern technologies that actually seem to help people sort of take a quantum jump over and leapfrog over a lot of the sort of slogging through the the traumas through traditional therapy and traditional psychiatry and medication, which often doesn't really work that well.

Well, I wonder if you had, like myself, often wished or not often wished that if we could just combine the amazing achievements of modern medicine with some humility to look at the traditional wisdoms, teachings of indigenous peoples, because it's not a question of one over the other. But boy, if we had that kind of wisdom infused into our technological minds, we will be so much more powerful as healers. And, you know, as you suggested, illnesses not just as a biological event, but as a psychological, spiritual event. So the medicine wheel of North American indigenous people, which the four quadrants of mind and spirit and body and sociality, all have to be balanced. And as regards psychedelics, so my third to last chapter in this book is on psychedelics. And because I have worked with them quite a bit, and I spoke with Michael Pollan and I asked him if he was surprised by the success of his book, How to Change youe Mind. And he said, what he was most surprised was that he expected a lot more pushback within the medical profession, but he says, People are realizing how thin our toolkit actually is, and then we have to have to find some other solutions. And I myself have found both individually for me, but also as a healing modality for people I work with. Psychedelics to be a very powerful.

Potential.

A modern potential is a very powerful modality. And I'm not a psychedelic evangelist. I don't think psychedelics are going to save the world or save medicine. but boy, are we nuts not to explore them and to employ them? Because they have so much potentially to offer in so many conditions. In the book, I give examples of people healing, not just from mental health, but also from physical conditions, based on changing their mindset as it flows from psychedelic experience.

So Gabor, how do these medicines work? And I think they're all different, right? But how do they reset these neural networks and how do they help people metabolize their trauma and heal it?

Some traditions, like for example with ayahuasca, it wasn't necessarily the client who would take the plant, but the shaman would. And the shaman would then get a vision and deep insight. And I've worked with these indigenous shamans in the Peruvian rainforest. Let me tell you, they're penetrating.

The Shabobo healers.

Yeah, the sheep people are deep and they see things that Western medicine just hasn't got a clue about. I'm talking personally, I had that experience.

Yeah. Can you share that?

Yeah. And they just saw right into me. They had no idea who I was. They were not impressed.

And read all your books?

They didn't read my books. They were not impressed with my credentials. They just saw this human being carrying a lot of trauma. and they just saw it and they worked with it. And I didn't have to be on the platform for them to see that. I was, but it was their own vision that allowed them to see that. So that's the first point. Is that partly it has to do with who's administering it, in what context, and what training they've had.

Yeah, the set and setting they call it.

The set and setting. You just go to a party and tension and stuff. And then it works. Secondly, Sigmund Freud once said that dreams are the royal road to the unconscious, meaning that in dreams you manifest some of our most unconscious emotional dynamics, which is true, but the interpretation of dreams is notoriously difficult. And I think Freud certainly had his own, he had his own delusions when it came to interpreting other people's dreams. But I think psychedelics are, might be said to be a royal route to the unconscious because they remove the usual defenses of the egoic mind. So you get to see both the pain and the possibility that underlies the egoic mindset. So people get in touch with some deep agony sometimes. They also get in touch with some beauty that they had not been touched with, but they've been inside them all along. So you get to see both the, the traumatized, unprotected, uncovered, traumatized aspect of your personality that's been pulling the strings behind the curtains for a long time now. But you also get to see the possibilities of oneness and unity and love and beauty so that you don't have to keep running, you don't have to keep employing these defenses. That's it in a very small nutshell. the potential is tremendous and I've seen it happen. I've experienced some of it myself and I've certainly seen it happen a lot in my work with other people.

Yeah, I think it's very powerful and the sort of addiction space is sort of fascinating because not all psychedelics or plant medicine are the same and this particular compound, which I don't think we've talked about in the podcast Ibogaine derived from the iboga tree, Yeah, one of.

The things I wish I talked about in this chapter, but I didn't, and I'm not even sure why I omitted it. I was probably just want to get the book finished.

There's only 4000 pages already.

Was iboga, because iboga, which is a plant that goes in Gabon, by the Bwiti people. Yeah, and it's been used as a spiritual enzyme, you might say, by those people, they're tribally speaking. But it's got the amazing quality of not just of unearthing traumatic imprints like many of the other psychedelics do, but also in the case of opiates actually obviating opiate withdrawals. You could be on heroin for 20 years and after two nights of Iboga or Ibogaine, which is the extract, you are not going through withdrawal symptoms.

It's shocking from a medical perspective.

Right.

An alcoholic, you know, I worked in the emergency room and someone come in with alcohol withdrawal. It's a physiological phenomena. Yeah.

Heroin addiction is a, and withdrawal is a physiological phenomena. So how do you interrupt that? Well, opiate withdrawal is terrible. The dependence because of the, you know, the loss of opiate receptors and therefore all of a sudden you don't get the opiate from the outside, your system is in total shock. Ibogaine prevents that. Now, again, it's not for everybody. There's some medical contraindications and the context has to be really right and pristine, both psychologically and medically and physically. But in the proper hands, it's transformative. And there's studies being done now with American veterans with PTSD. showing amazing results with using iboga. Stanford is running such a study. But of course, in the wisdom of our current society, it's illegal and it's considered to be medically useless. And therefore, it's hard to even get permission to study it.

I mean, there is a woman who's spoken to and I've heard her speak, Deborah Mash, who's a scientist, has worked with NIH-funded studies and has done a lot of the key work in this area of Iboga and it talks about the development of derivatives of Iboga like noribogaine and other derivatives that actually may not have some of the adverse effects but can kind of benefit people. We've actually had conversations about food addiction. You mentioned sugar being the most addictive compound in the world. I've talked about it with my books. Rats will work eight times harder to get sugar than to get cocaine. If they're already addicted to cocaine, they'll switch over to sugar. and I sort of had said, Hey, maybe, I don't know if this is anybody even looked at this, but wouldn't it be interesting if a lot of the sort of maladies we have now are related to food, which are driven by food addiction, could be treated with this plant medicine? It would be kind of a fascinating line of inquiry.

And what does that make Kellogg's with their sugar frosted flakes or Coca-Cola?

Drug pushers.

They make them the biggest drug pushers in the world. and yet, you know, they're respectable brand name companies and talk about the myth of normal. It's true.

I mean, the first podcast I ever did is Dr. Oz's Pharmacy with Michael Moss on Sugar, Salt and Fat. And, oh yeah, he documented the ways in which the food industry deliberately created addictive foods. They have taste institutes, they hire craving experts to create the bliss point of food.

I know, and if one of my patients in the downtown east side got caught with an ounce of cocaine, that he might have tried to be sell to feed his own illegal habit, and I could talk at length about why these habits are illegal and others are not, but if one of my clients got caught with an ounce of cocaine, he'd go to jail. And these corporations, they kill millions.

Oh, yeah.

And they're just respectable citizens. respective entities. I mean, the absurdity of it and injustice of it just cries to the heavens.

That's true. Addiction, we'll say 70,000 people lower dose in America, guns maybe 70,000, probably 700,000 die in America.

100,000 last year, more than 100,000 last year.

Yeah, but still, I mean, still like seven or maybe 10 times that are caused by... oh, yeah. And we don't really have a national conversation about that. Even with COVID no, where diet plays such a huge role in predisposing people to hospitalizations and death, it still isn't part of the national narrative. I mean, in other countries it is.

Now, but, and again, COVID, I mean, we used to say in the beginning, we're all in this together, no, we're not. People that are of color, people that are poor, people that are driven by stress into obesity, these people are significantly higher risk than people that were more privileged. So, no, we're not all in this together. In this society, we're all in this together is a real lie is what it is.

I mean, I find it really, you know, despite the depressing nature of this conversation, I actually find it very hopeful because, you know, when you kind of identify and name a problem, and you understand the root cause of it.

Yeah.

And you can map out a series of strategies to help.

Yeah.

Treat the problem is actually very reassuring.

Well, you know what? So in the last chapter, I talk about the values of disillusionment. And it's really good to be disillusioned. Like, I ask people, would you rather be illusioned or disillusioned? Would you rather, would you rather believe in a false universe that doesn't actually exist? Would you rather things the way, rather see things the way they are so you can do something about it? So I wouldn't have written this book if I saw no possibility, if I saw no redemption, if I didn't see the healing capacity within individuals or even within society. So in that sense, you might call me an optimist. Yeah, but I do think that in order to get there, we really have to look at how things are unflinchingly and not pretend to ourselves that what we think is normal is actually normal. It isn't.

It's not. No, that's the myth of normal. I mean, in a way, it's a book of redemption. It's like, how do we redeem ourselves from a toxic culture, from toxic families, from a toxic environment? And how do we heal that? And that's a conversation that's so invisible that hasn't been brought forth by many doctors. I think, you know, you're one of the few.

Well, as physicians, we're not trained to do that and trained actually to look away from it.

And.

You know, there was one study on physicians, actually on residents, medical residents, without going into the details, when they looked at markers of biological aging, they aged faster than other people their age, which has to do with the tremendous stress and trauma that physicians are grown through in order to make it. And so that they just, they have to ignore their own stuff, their own stress and their own trauma, you know, to be successful. Then when they get out there to practice, that's the last thing they think about. That's true.

I mean, I remember, I remember being told by residents who are older than me, basically, as we were on rotations, like, basically, lunch and sleep were weaknesses, you know?

Yeah.

I'm like, what?

I was 50 years old when I found out that you can actually sit down to have lunch. You don't have to do it running between offices. That's true.

This is such a good conversation. I have a few more things I want to sort of dive into. One is the biology of psychology. Carol Mose talks about how our biography becomes our biology. I mean, our biology also can become our biography, right? physical things can cause mental illness, but also psychological stresses can cause physical illness. And, Candace Pert, you talk about in your book, I had the chance to meet her who worked for the NIH and studied the mind-body effect. She called it body-mind and the molecules of emotion. And, can you explore a little bit about the science behind how these traumas and these psychological stresses manifest in the.

Body as physical illness? So here's the, let me begin with the frustrating thing.

So.

In 1860s, Jean-Martin Charcot, the father of modern neurology, who first described multiple sclerosis, said that it was caused by long-term vexation and grief.

Ah.

William Osler, a great physician at Johns Hopkins, one of the founding physicians at Johns Hopkins, He said rheumatoid arthritis was caused by long-term stress.

He also said that it's more important to know the person who has a disease than the disease itself.

That's right, yeah. An American surgeon called Padgett wrote about breast cancer that had a lot to do with depression and so on. So that in 1938, there was a Hungarian American physician at Harvard called Soma Weiss, who was so revered that there's still a research day in his honor at Harvard to this day. And he said in a lecture to a medical school class, another Hungarian Jew, another Hungarian Jew published in, published in the Journal of the American Medical Association. He said that mental and emotional factors are as important in the causation of illness as physiological ones and have to be at least as important in the treatment.

Yeah.

In 1977, the great American physician and psychiatrist George Engel called for a biopsychosocial approach, which recognizes that biology is inseparable from our psychological dynamics and social relationships.

So not new.

So this is nothing new. Now, What is new is that these great pioneers, what they recognized intuitively, now we have proven by means of heart science. So in terms of heart science, the body and the mind can't be separated. No. That the emotional centers in the brain are connected with the nervous system, with the hormonal apparatus, with the immune system, with the gut and with the heart. In other words, they're not even connected, because even to say connected, creates the impression that separate entities are somehow wired together. These are not separate. They're the one system.

Yeah, one system.

Just as Candace protocol, the body mind is one system. Therefore, it just stands to reason that whatever happens emotionally will have its manifestation physiologically. And sure enough, you know, when people get emotionally stressed, that's not just a psychological event. their hormonal apparatus goes into gear. They secrete stress hormones, cortisol and adrenaline. Now here's an interesting little fact. When you go to a dermatologist for inflammation of the skin or a rheumatologist for inflammation of the joints or a neurologist for inflammation of the intestines or a respirologist for inflammation of your lungs, and I could go on, what medicine are you gonna get? You're gonna get some analog of cortisol, which is the stress hormone. Now you think as physicians we might ask ourselves, gosh, we're treating everything with stress hormones. Could stress have something to do with the onset of these conditions? Maybe just perhaps. Yeah. And of course the research is indubitable that it, that's actually the case.

Yeah.

And the physiological pathways have to do with these connections. that what happens emotionally affects the immune system, that what happens or what happens in the immune system can actually affect the emotions. So if you get a viral infection that can release hormones from the white blood cells that will make you depressed.

Yeah, when I had COVID, I was so depressed and I'm never really depressed like that. I was like, I understand why people want to kill themselves.

Yeah, so I knew it was COVID.

But I was like, holy cow.

Yeah, so it goes both ways. So it's not just the, so the physiology, so because it's one unit and it's one system, it's inevitable that whatever happens emotionally is gonna show up physiologically. Furthermore, we know that childhood trauma elevates the circulation of inflammatory particles in the blood, cytokines so-called, which can turn on cancer genes, which can reduce the body's defenses, which can support the growth of blood vessels to support tumors, so on. We know that stress, even in utero, if your mother experiences stress, that will show up in your physiology at age 45. Yeah. By mechanisms I write about in the book, but I won't go into now. But in other words, it's just a, this constant dance between our psychological lives in our physiology and it's unscientific to ignore it. And I've only mentioned a few mechanisms. Then there's the impact of stress and emotions on the functioning of our genes, which is studied by epigenetics. Or one could go just on and on and on.

Yeah, the microbiome, your bacteria are listening to your thoughts. Your immune cells are listening to your thoughts. Telomeres, like you said, your genes.

And one study I looked at was stress on the mother during pregnancy will interfere with the infant's microbiome.

Yeah.

You know, so it's just so that these dynamics are inseparable and inextricable. They're just a unit. This is a scientific fact. So when our profession talks about scientific medicine and evidence-based medicine, If there was one phrase that could delete from the medical lexicon, it would be evidence-based. Because I only wish that we were evidence-based. Yeah, I think I often say we're reimbursement-based, not evidence-based.

We do what we get paid to do, not what the right thing to do is. And I think that's one of the flaws. And a lot of the evidence is ignored because it's not large randomized clinical trials, which are only one form of evidence.

Which is one form of evidence and mostly to the benefit of the pharmaceutical companies.

Exactly. and then population studies are another form of evidence, but again, those don't necessarily prove cause and effect.

And you know what's another form of evidence? I know I'm heretical to say so, just listen to people's stories. Let them tell you about their lives. That's evidence. Exactly. It's only not evidence to the people who are terminally cut off from their heart, you know?

I think the advent of systems biology, quantum computing, artificial official intelligence, and quantified self metrics which are how we measure our own biology, are going to revolutionize the way we understand all of this because it's not too far in the future that we're gonna be able to plant a chip in our skin and come up with everything that's happening in our body and have it read by some supercomputer and make sense of all these connections and patterns and see how it works. But it's so true. And I think the thing that you mentioned that I want to dive a little bit deeper into is this concept of epigenetics. And for people listening, just a little background, your genes are fixed. you can edit them maybe with CRISPR and these new technologies, but basically you've got 20,000 genes, you've got a lot of variations in those genes, but those genes are regulated by something called the epigenome, which sits on top of your genes. And those epigenetic marks, let's call them, like bookmarks in your book of life, which is your genome, determine which pages get read, which genes get read. And that determines your health. or determines what diseases you're going to get. And what's really striking to me, and there's some interesting literature on the Holocaust, which you were in many ways sort of representative of the trauma from that generation, is that generational trauma is real. It's not just an abstract idea, but the biblical idea that the sins of the fathers are visited upon their sons. I mean, there's actually scientific evidence now that we know how our imprinting in our grandparents or their grandparents is transmitted generationally through these little tags or bookmarks on our genes that determine what happens to us. So can you talk about that and what we know about how that works and what we can do about it? Can it be, can you change those marks?

So it's a very interesting new field, a relatively new field, epigenetics, as you see on top of genes. I'm certainly no expert on it, but I did interview experts, people who are Moshé Safir in Montreal and Dr. Rachel Yehuda at Mount Sinai actually in New York. And these people have done elegant research that show exactly what you're talking about, that experiences in life can change how genes are turned on and off by the environment. And those effects can be transmitted into new generations without any change in genetic structure.

Yeah.

And there's this tremendous misbelief in the power of genes in the general public and certainly in the medical profession. There are very few genetic diseases. There's very few genetic diseases that if you have the gene, you're going to get a disease. One runs in my family, muscular dystrophy. If you got that gene, you're gonna have the disease. to the generations and I've shown up in every generation of my family. That's very rare.

It's like 1%.

1% maybe or less.

Less, right?

Huntingtons, Korea, things that already when it comes to breast cancer, for example, everybody talks about being genetic. No, it isn't. Out of 100 women with breast cancer, seven have the gene and over 100 women with the gene, not all of them will get the disease.

Exactly.

In other words, the genes themselves, even in the case of breast cancer, like Angelina Jolie very famously had mastectomies and oophorectomies, their ovaries were taken out. And she made a calculated decision because an aggressive form of that gene runs in her family. And so I understand that, but that's very rare competitively speaking. And so in most illnesses, the genetic effect, if any, is minimal and not at all decisive. And what is decisive is how the environment acts on the genes, which is the epigenetics. And we believe in genes because it's so convenient. First of all, it's simple. Secondly, it allows us not to deal with our stuff. So that is a society. We don't have to look at all the ways in which society stresses and oppresses or really pathologizes people or, and venoms makes them sick, toxifies them and so on. So if it's genetics, well, I don't have to worry about that. If addiction is genetic, we don't have to look at the trauma that so many people suffer, and the way in which the system itself traumatizes people. So genetics kind of takes us off the hook. But scientifically, it's absolute nonsense.

Yeah.

And I think the epigenetic conversation is to me really important because just in ways that our genes can be marked for disease, they can actually be unmarked.

That's right. And genetics, there are geneticists who say that. They say that, genetics may confer certain sensitivities on people. but after that, it's the environment. So you can have the same set of genes, different experiences, and have completely different outcomes. You can have identical twins who've got the same set of genes, but totally different outcomes. If you're subjected to different experiences.

That's true. I mean, when they looked at actually 88,000 twins, 44,000 twin pairs in cancer, they found there was only a 10% correlation. It means 90% of cancers in those twins were not genetically related, which is kind of a striking thing in twins.

And by the way, even that 10% is probably not as much as it looks. Do you know why?

Because they both had similar traumas, maybe.

They spent nine months in the same uterus. So, we already know lots of studies have shown that stress is on a woman during pregnancy has an impact on the fetus. So you can stress pregnant animals in the laboratory just by exposing, say, a mother rat to an hour of loud noise once a week in the second trimester. Their offspring would be more likely to drink alcohol and use cocaine as adults.

Yeah.

So that even those twin studies, they ignore the fact that those twins, there might be, even if they grew up in different environments, they still spent nine months in the same universe.

Yeah, that's so true. And I think, you know, we, we had the Human Genome Project, which in around 2000, yeah. Decoded the Human Genome. And it was this great event that.

Yeah.

Was an advance that was promising to end disease. As we know.

Bill Clinton said something like, we're finding out the language in which God wrote life, something like that, you know. Well, we found out nothing of the sort.

Well, right. And, and so it's been a massive failure in many ways, although it has led to many discoveries because it ignored the story that hasn't been really told, which is not the genome but the exposome, which is what our genes are exposed to, whether it's the toxic environment psychologically or whether it's a literal toxic environment, pesticides and chemicals or bad diet or stress. All these things are the real determinants of health. So, 90% of chronic disease is determined by the exposome, not the genome.

That's right. Well, only I would slightly demure from your assertion that the epigenome was a massive failure. It was a massive success for all the billions of dollars that it generated for all kinds of companies and researchers. Failure in terms of benefiting human health, yes. And some of his most fervent advocates have admitted as much. They said they're ashamed of themselves now.

It is not that it is bad to have done that and decoded it, but I think it is like what we now need to understand is how those genes are regulated.

Yeah, that's right.

How those genes are expressed. And, and that's what we have really a lot of control over.

Yeah.

And I, and I wonder even some of these psychedelic therapies, if they work on some of these pathways and if they work on some of these ways. Because I, I, I, I don't understand how, for example, the iboga works around addiction. It just, it's such a fast.

Yeah, I think that biological phenomenon. Not just a psychological. No, we don't know the physiology. No, it does something to There's a psychiatrist in New York called Ken Alpert that you might want to talk to about it. He's kind of a world expert on iboga and how it works, but I don't think anybody really knows fully how any of these things really work in the brain. People have theories and we can show on scans how they light up certain parts of the brain, but you know what? I don't care. The reason I don't care is it works. Because it works.

For people listening, and I sort of want to loop back this before we close, you know, I imagine people are paying attention to their own stories, their own narratives, their own Origins, their families, and sort of their own behaviors, addictions, mental health challenges, and, and trying to sort of figure out a map for how do we sort of go forward. And you mentioned a lot of the potential therapies, but, you know, I think I think the question for me that I want to keep coming back to with you is how do we really rewire these patterns and is it really possible? Because you kind of tell the story in your book of coming home from a trip, getting to the airport, expecting your wife's going to pick you up and for some reason she was busy and you went to this, you know, kind of tailspin about it.

Totally.

And we're kind of giving her the cold shoulder for a week.

Well, only, you know, she let me get away give it for a day.

Oh, a day, a day.

Then she said, knock it off already. But what happens is that, hey, I'm age, at that time, 72. I was just young and stupid, age 72.

You were young and stupid at 72?

Yeah.

Listen, this is a line I use. I'm 78 now, and thank God for rewiring and neuroplasticity, because I would not wish to be as young and stupid as I was when I was 77. Never mind that the callow age is 72. But the point is, I had a meltdown. I became an abandoned infant. Because that's the trigger. That's the circuit in my brain stamped with the sense of abandonment that got triggered. Yes, we can rewire with practice and with attention. You can rewire the brain. And the last eight chapters of the book is really all about how do we rewire, how do we.

To go.

Back to what you said in the beginning, how do we make new meaning, and let go of the old meanings that trauma imposed on us. So it's entirely possible. I proposed some ways in various chapters in the last section of my book, and I said earlier there's other modalities as well. So yes, it can be done. And I think that healing capacity really is an inherent quality of human beings, which again, as physicians, we're not learning how to line up with and support and enliven if we did, we would be so much more powerful as healers, you know? So what we can do mechanically is brilliant, and it's miraculous. I never cease to Marvel at what can be done.

Sure.

You know, but at the same time, there's so much that we miss.

Yeah.

And so much more that we could do if we could align with people's natural human capacities. If we were a bit more humble. a bit more inclusive, open-minded. And if you just look at the science.

Yeah, yeah. And it's true. I mean, the body has its own innate healing system and capacity that we've really ignored in traditional medicine because we think we're the doctors and we're going to fix people.

Yeah.

But actually all we need to do.

Is get out of the way and let the body do the healing. Very often, that's what we have to do.

Yeah.

Now, you know, look, if I broke my fever, fever in three places, I wouldn't want some orthopedic just to get out of the way. I wanted to get in there and nail me together, you know?

Exactly.

But for most chronic conditions of body and the mind, what we're saying is absolutely true. Yeah.

So just to close, you know, we've been talking a lot about the personal story and the personal journey, but a lot of your book is about the toxic culture we live in and the ways in which our policies and our corporations and the structure and our education all perpetuate a world that keeps perpetuating the trauma.

The last chapter of the book, I began by asking, well, how do we change this culture that is so determined to even destroy the earth rather than to give up its prerogatives, you know, which is how it is.

Yeah.

You know, and. And we're quite willing to ignore causes of illness. that kill millions. We generated a very powerful and very urgent response to the COVID situation. Some people might not agree with some of how that went down, but there's no question that resources and ingenuity were mobilized to tackle this public health threat. But there's ongoing public health threats that kill many or more people annually. that have to do with the environment, that has to do with poor food, that has to do with poverty, that has to do with racism, has to do with inequality, has to do with just the stress on even successful people in this culture that we don't address.

So.

When I ask the question, how do we address all that? My honest answer is, I don't know. I mean, I do have my own political views. I do have a vision of a society that's very different than the ones we're living in.

But what does it look like?

It's certainly based on our evolutionary needs for communality and connection and cooperation rather than aggression and, and competition and rugged individualism and this belief that we're isolated cells. But right now, in an immediate sense, we could simply listen to the science and infuse some trauma awareness into the medical profession, including how doctors are trained, not just in what they're taught, but how they're treated.

Yeah.

So that they're not traumatized in doing their training. So infusing trauma awareness into the medical profession would go a long way. Inducing trauma awareness introducing trauma awareness into the legal profession. Most people in the jails of traumatized. Well, the United States is the most richest country in the world. It's also the one with the largest percentage of its population in jail, disproportionately colored people of color, which is just a. Or can I say it's a reprise of slavery?

It actually is.

Most people who are in jail are there because of trauma. You know, the predictions of people going to the foster care system ending up in jail are extraordinarily high. But what if even if you had to isolate people from society to protect society, even if you had to do that, what if you did so with compassion, with trauma awareness? We know the impact of trauma-informed programs in jails. They're miraculous.

Huge.

But they're so rare and so poorly funded and not at all part of the mandate of what we call the correction system. And, you know, I think for good reason, we call it a criminal justice system. It is a criminal system.

Right.

And, and it, because it hurts the innocent, it hurts people that don't deserve to be hurt. It hurts people that even if they did bad things, they still deserve to be treated by human beings.

Yeah.

And to be corrected. So we've had a real correctional system. That would have to be a trauma informed system. The average physician does not get a single lecture on trauma in all their years of training, which is incredible. But neither does the average lawyer or the average judge or correctional officer or policeman. They don't know anything about it, which is insane because that's all they do with. Deal with day in, day out. Exactly. The educational profession. needs to be trauma informed. Because all these kids with learning difficulties and behavior problems and so-called bogus diagnosis like oppositional defiant disorder, with diagnosis like ADHD, they need to be told, educators do, that we're looking at is kids who are stressed and troubled at home. And that's what needs to be dealt with. One of the points I make is that in our society we've become alienated from our own parenting instincts. So we parent our kids under stressful conditions, following the wrong advice. We could go so far, so far in the right direction if we just recognize what the irreducible needs of children are.

Yeah.

For unconditional loving acceptance, for fee playing nature, for not having to work like you did to make the relationship with your mother work. to have rest from that. For children to be allowed to feel all their emotions, not punishing a kid for being angry, but by helping them express the anger in an acceptable way, just meeting kids' basic needs. If parents were just informed, if parents were supported, in the United States, 20% or 25% of women had to go back to work within two weeks of giving birth. which amounts to an abandonment of the child.

So a quarter of kids are being.

Abandoned by their mothers, not because the mothers don't love them or are trying to do their best, but because economically they're forced to do so because of lack of child support. That's what happened to you in the Holocaust.

Your mother had to hide you.

My mother had to hide you in a Christian family because you were Jewish. But that was special circumstance. Here in North America, now it's normal. In America, that's a common circumstance. So there's so much child rearing, so much in our education, in our healthcare, in our legal system, we could do if we just embraced the evidence that we already have. So we're not talking about miracles here. We're talking about what's known, what's possible, what's available, and what would cost a lot less. You know, it's so simple. Then the economic costs of ignoring human.

Needs, And it's, you know, you mentioned the economics of it, but it's staggering the economic impact of this in terms of the cost of society. In fact, there was an economic analysis of the impact of chronic disease over the next 35 years and its economic impact. It was going to cost $95 trillion, which is, you know, considering our GDP is about, you know, 20 trillion, It's a lot of money and healthcare is a huge part of that. And the majority of that, believe it or not, was depression, was the, what they call the loss of quality of life years, the quality adjusted life years lost, right? Or the sort of lack of productivity or effectiveness as a citizen or as a member of society because you're depressed. I mean, that's just a staggering amount. And that, again, all that arises from exactly what we've been talking about on the podcast. And I think as you've been talking, it's really clear to me we need to reimagine society in a way that brings connection, not separation, in a way that creates safety around these conversations, in a way that reimagines education, reimagines social discourse, reimagines our policies to support these, reimagines our criminal justice system, our medical system. Really, every area has to actually be trauma-informed, trauma-conscious, as you talked about it. and your work is so important, Gabor. And I thank God, you know, your mom saved you. Maybe it's, you know, I don't know how many years later, 70-something years later.

Yeah.

But we, we, we're, I think, now ready as a society for this conversation.

If I just made a comment about the story of my mother, because it, it, it speaks to the theme of healing. So, yes, I arrived at the airport and my wife is not there to pick me up. and my abandonment trauma gets triggered. But, you know, as a one-year-old, I could not interpret my mother giving me to a stranger to save my life as anything other than abandonment. But you know what? Once I heal, I realize what? It was a great act of love. Can you imagine for a 24-year-old young mom whose parents had been killed in Auschwitz, whose husband was dead or alive, she didn't know, than to give their baby to a stranger. And what an act of love it was for that strange Christian woman to take this little Jewish baby and take him to safety, you know, so that what all my life I had emotionally interpreted as abandonment actually was a tremendous act of love. And I think this is where the healing and the wiring, the rewiring that we've been talking about can actually take place. It's not just the event, it's the meaning that we give them. When it comes to healing, we can create our own meanings going forward.

If you loved that last video, you're gonna love the next one. Check it out here. I don't want to be unhappy. I don't want to be angry. I don't want to talk trash about people. I don't want to complain. I want to blame. I don't want to make excuses. I don't want to feel lack. I don't want to have an attitude that's telling me I can't, it's too hard.