Gabor Maté: The Hidden Wound Behind ADHD, People-Pleasing + Relationship Patterns

Summary

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Healing + Human Potential with Alyssa Nobriga

Episode: Gabor Maté: The Hidden Wound Behind ADHD, People-Pleasing + Relationship Patterns
Release Date: April 21, 2026
Guest: Dr. Gabor Maté

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Episode Overview

In this profoundly insightful conversation, Alyssa Nobriga sits down with world-renowned physician and trauma expert Dr. Gabor Maté to unpack the hidden roots behind ADHD, people-pleasing tendencies, chronic illness, and challenging relationship patterns. Maté challenges widely held misconceptions about genetics and mental health, explores the deep interplay between childhood experiences and adult life, and offers practical wisdom for healing. The episode is rich with science, compassion, and relatable stories—making complex topics accessible and human.

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Key Themes and Discussion Points

1. ADHD: Misunderstandings and the Role of Environment

• Genetic Myths Debunked:

  • Dr. Maté powerfully challenges the idea that ADHD is strictly genetic. He stresses no specific gene determines ADHD. Rather, environmental factors, especially early relationships, are the key.
  • Quote:

    "The whole idea that this is a genetic disease is absolute scientific nonsense. Nobody's ever found a gene that if you have it, you'll have ADD, and if you don't, you won't."
    — Dr. Gabor Maté [00:03]

• What ADHD Really Indicates:

  • ADHD describes certain traits—impulsivity, distractibility, hyperactivity—but the label is not an explanation, only a description.
  • The roots lie in a sensitive child's adaptation to a stressed early environment.
  • Quote:

    "The diagnosis is not an explanation, it's a description of certain traits."
    — Dr. Gabor Maté [02:07]

• Early Emotional Environment:

  • The quality of early emotional relationships shapes brain development much more than genetics.
  • Quote:

    "The most important influence on brain development actually is the quality of emotional relationships between the child and the parent."
    — Dr. Gabor Maté [00:13 & 07:36]

• Scientific Support:

  • Cites Harvard research:

    "The circuitry of the brain [is] critically influenced by the mutual responsiveness of adult-child relationships, particularly in the early childhood years."
    [05:25–06:12]

• Sensitivity as "Genetic" Predisposition:

  • What’s inherited is sensitivity; how this plays out depends on whether the environment stresses or nurtures the child.
  • Quote:

    "Sensitivity—the more sensitive you are genetically, the more you feel... That tuning out is an adaptation."
    — Dr. Gabor Maté [08:04]

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2. People-Pleasing and Sickness: The Hidden Costs

• Adaptation, Not Inheritance:

  • People-pleasing and the inability to say no are not genetic, but childhood adaptations to environments where self-expression is not accepted.
  • Quote:

    "There's no genes for people pleasing. It's an adaptation in early childhood when you get the message you're not acceptable the way you are... that means usually the repression of healthy anger."
    — Dr. Gabor Maté [21:44]

• Physical Consequences:

  • Chronic self-suppression and people-pleasing heighten stress, leading to immune dysfunction, autoimmune disorders, and even malignancy.
  • Healthy anger serves the same purpose for emotional boundaries as the immune system does for physical ones.
  • Quote:

    "Healthy anger is a boundary defense... the emotional system and immune system have the same role—boundaries."
    — Dr. Gabor Maté [23:16]

• Gender Dynamics:

  • Culture programs women especially to absorb stress, repress anger, and take on caretaking roles; this partly explains why 80% of autoimmune disease patients are women.
  • Quote:

    "Women get more autoimmune disease because of how we acculturate women in this patriarchal culture from early childhood on."
    — Dr. Gabor Maté [35:33]

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3. Trauma, Attachment, and Adult Relationships

• How Wounds Repeat:

  • We unconsciously seek partners with similar levels of emotional wounding. Healing in oneself shifts who and how we attract.
  • Quote:

    "You always marry somebody or partner with somebody who's at the same level of emotional wounding that you are."
    — Dr. Gabor Maté [42:14]

• Triggers and Attachment Styles:

  • Early traumas create attachment styles (e.g., avoidant, anxious) that continue to show up and challenge us in adult relationships.

  • Healing is possible through mutual commitment, awareness, and compassionate self-work.

  • Quotes:

    "That's ingrained in the nervous system. Anything that happens 60 years later that reminds you of that, triggers that."
    — Dr. Gabor Maté [45:15]

    "Awareness is the key but for traumatized people, triggers can override that prefrontal awareness."
    — Dr. Gabor Maté [45:54]

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4. The Biology of Stress, Illness, and the Mind-Body Connection

• Chronic Stress Harms Health:

  • Long-term stress can cause a cascade of illnesses, including osteoporosis, diabetes, heart disease, cancer, and autoimmune disease.
  • Quote:

    "In the long term, those same stress hormones thin the bones, cause osteoporosis, put fat on your belly, elevate blood sugar, turn on genes for cancer, turn off genes that protect you from cancer, makes you depressed..."
    — Dr. Gabor Maté [15:59]

• Separation of Mind and Body is Outdated:

  • Maté and Alyssa criticize the artificial divide between psychology and physiology in mainstream medicine.
  • Quote:

    "We are biopsychosocial creatures... our biology is affected by our emotions, which reflect our social relationships."
    — Dr. Gabor Maté [17:08]

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5. Healing Childhood Wounds and the Role of Therapy

• Emotional Validation:

  • Children require validation and acceptance of their full emotional range from caregivers for healthy development.
  • Emotional suppression as a child leads to adult disconnection, disease, and relationship struggles.
  • Quote:

    "If the child gets the message that certain emotions are not acceptable, they can't very well walk out of the parental relationship. The only choice is to give up authenticity for the attachment."
    — Dr. Gabor Maté [31:17]

• Therapy as Safe Space:

  • The therapeutic alliance provides a template to practice safe, authentic connection—first with the therapist, then extending to other relationships.

  • Quotes:

    "The essence of therapy... is relationship. The person learns it's safe to express whatever is happening."
    — Dr. Gabor Maté [51:59]

    "The therapeutic relationship can become a template for other relationships."
    — Dr. Gabor Maté [52:46]

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6. Parenting and Early Development

• The Critical Window (Womb to 3 Years):

  • The early years lay the emotional and physiological foundation for life.
  • The absence of adequate, emotionally attuned caretaking creates deep, lifelong wounds.
  • Quote:

    "You can't overemphasize the importance of the first three years."
    — Dr. Gabor Maté [56:41]

• Modern Culture and Disconnection:

  • Today’s society has forgotten ancestral community-based parenting, leading to widespread disconnection and stress for mothers and children.
  • Quote:

    "We're not just learning these things... what we've done is we've forgotten. As a species we used to know."
    — Dr. Gabor Maté [61:36]

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7. Siblings & Birth Order: Unique Experiences

• No Two Kids Grow Up in the Same Home:
  • Each child experiences parents differently due to birth order, parental states, temperament, and gender dynamics.
  • Quote:

    "No two kids have the same parents... each child evokes a different response from the parent."
    — Dr. Gabor Maté [63:25]

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8. The Inner Critic: Source and Healing

• Roots in Childhood:

  • The "critic" is an adaptive internal strategy to maintain attachment—but no longer needed in adulthood.

  • Self-compassion and acceptance help soften its grip rather than intensifying self-judgment.

  • Quotes:

    "The critic comes along as a reminder: you better not do that, think that, or feel that. It's an adaptation... But that critic kept you in line."
    — Dr. Gabor Maté [68:13]

    "Let's not be harsh on the critic, but let's also not listen to it."
    — Dr. Gabor Maté [70:59]

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9. Psychedelics in Healing Trauma

• Potential and Pitfalls:

  • Psychedelics can open "the royal road to the unconscious," surfacing deep trauma and offering a chance at healing when used with proper support.

  • Successful work requires the right set, setting, and integration; unchecked, it can be exploitative or even traumatic.

  • Quotes:

    "Psychedelics can show you what you've been dealing with, where adaptations came from, and also show you the real self that doesn't need these adaptations anymore."
    — Dr. Gabor Maté [75:21]

    "I'm not an evangelist... there'll never be enough psychedelic practitioners to deal with even a small percentage of the people that need it."
    — Dr. Gabor Maté [78:14]

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Notable Quotes & Memorable Moments

• “You always marry somebody who’s at the same level of emotional wounding that you are.” — Dr. Gabor Maté [42:14]
• "People pleasing, not saying no, and being very nice—these are not genetics, these are adaptations." — Dr. Gabor Maté [22:06]
• "The emotional system, the immune system, the hormonal apparatus and the nervous system are not even connected—they're one." — Dr. Gabor Maté [24:47]
• “You can't understand disease simply as a physiological event.” — Dr. Gabor Maté [17:08]
• “If you change the child's conditions, that kid could bloom and blossom.” — Dr. Gabor Maté [27:56]
• "Space is already held... It's attunement to the safety of the space that invites another nervous system to feel that." — Alyssa Nobriga [53:41]

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Key Timestamps

• [00:03] — Genetic misconceptions of ADHD
• [07:36] — Early relationships shape the brain
• [15:59] — Stress impacts on long-term health
• [23:16] — Emotional boundaries and the immune system
• [31:17] — How early emotional suppression shapes adult life
• [42:14] — How childhood wounds shape adult relationships
• [51:59] — Therapy as relational healing
• [56:41] — The first three years of life
• [63:25] — Sibling experience & uniqueness
• [68:13] — The origins of the inner critic
• [75:21] — Psychedelics and trauma healing

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Practical Wisdom from the Episode

• Healing is Possible: By understanding and validating our emotional experiences, and working through childhood conditioning, we can change lifelong patterns.
• Self-Compassion Matters: Embracing our inner critic with kindness allows us to outgrow it.
• Support is Essential: Therapy, deep friendships, and community connections all buffer stress and support healing.
• Parenting Beyond Blame: The goal isn’t parental perfection but compassionate awareness and doing our best in challenging circumstances.
• Environment over Genetics: Environmental stress and attunement shape brain development and health far more than biology alone.

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Further Resources

• Books by Dr. Gabor Maté:

  • When the Body Says No
  • The Myth of Normal: Trauma, Illness & Healing in a Toxic Culture
  • Hello Again: A Fresh Start for Parents and Adult Children (forthcoming)

• Therapeutic Training:

  • "Compassionate Inquiry" online program for therapists [79:46]

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A must-listen for anyone interested in truly understanding themselves, deepening connections, and moving from adaptation to authenticity and healing. Dr. Maté and Alyssa Nobriga deliver timeless, science-based and deeply human insight with warmth and clarity.

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Transcript

[Alyson Briga]

What do you find? Most people misunderstand about adhd.

[Dr. Gabor Maté]

The whole idea that this is a genetic disease is absolute scientific nonsense. Nobody's ever found a gene that if you have it, you'll have add, and if you don't, you won't. The most important influence on brain development actually is the quality of emotional relationships between the child and the parent. In a society where parents are so stressed, why are we surprised that more and more kids are being diagnosed?

[Alyson Briga]

Talk about people pleasing and getting sick,

[Dr. Gabor Maté]

you get the message that you're not acceptable the way you are. One of the adaptations is to be very nice so people accept you. Here's the big secret that we've known for multiple decades and nobody teaches.

[Alyson Briga]

People are asking, how do I know I'm with the right one?

[Dr. Gabor Maté]

There's bad news and there's good news. The bad news is that you always marry somebody or partner with somebody who's at the same level of emotional wounding that you are.

[Alyson Briga]

The good news is this conversation might explain something about yourself that no one's ever been able to put into words before. I sit down with Dr. Gabor Mate, one of the most respected voices in the world of trauma, addiction and childhood development. And honestly, this is one of the most important conversations I've had all year. We talk about why people pleasing might literally be making you sick, why ADHD is so widely misunderstood even by the people who have it, why nearly half of adults are quietly living with loneliness, and how trauma doesn't just shape your emotional life, it silently ruins your relationships, your health, and the choices you think you're freely making. If you've ever felt like something's off but you couldn't quite name it, this one's for you. What do you find? Most people misunderstand about what causes adhd.

[Dr. Gabor Maté]

They think it's genetic and which is scientific nonsense and it's based on certain false assumptions which I could talk about if you like.

[Alyson Briga]

I would love that.

[Dr. Gabor Maté]

So the condition is characterized by poor impulse regulation, absent mindedness, tuning out, disorganization, and sometimes hyperactivity. And it doesn't explain anything. So first of all, notice how it doesn't account for anything. So I've been diagnosed with it.

[Alyson Briga]

Me too.

[Dr. Gabor Maté]

It was my first book that I wrote and so Gabor has ADHD or Elisa has adhd. Well, how do we know? Because they tend to tune out. They tend to be absent minded, they have poor impulse control. Why do they tune out? Why are they absent minded? Why do they have poor impulse control? Because they have adhd. How do we know they have adhd? Well, they tune out, they're absent minded. So the, the diagnosis is not an explanation, it's a description of certain traits. Nobody's ever found a gene that if you have it, you'll have add, and if you don't, you won't. Nobody's ever found a group of genes that if you have them you'll definitely have add, and if you don't have them, you won't. What there is is a bunch of genes that the more of them you have, the more likely you'll have to adhd, but it's not determined. So there's certain genetic predispositions, but that's not the same as a predetermination. That's the first point.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

The second point, the twin studies on which they base their genetic hypothesis on are completely nonsensical because the assumption is, say for example, if you take identical twins and you separate them at birth, then you can tell what's the difference between environmental or genetic input because since they're brought up in different environments, whatever they share has to be genetic. But the assumption is false because the brain starts to develop in uterus. And already all kinds of studies have shown that when mothers are stressed, that affects the brain development of the infant in the womb. Not only does it affect the brain development of the infant, even affects the chromosomal functioning of the infant that you can trace 40 years later. You can look at pregnant women who have a lot of stress. Forty years later, their kids will have more advanced biological aging of their chromosomes, so the intrauterine effects are powerful. Now any woman that's going to give a baby for adoption is by definition a stressed woman. She's a single mom, she's a addicted mom, an abused mom, a poor teenage mom, whatever. So for nine months the hormones of stress are going through to both of those twins affecting their brain development. Yeah, this is not even vaguely controversial, number one. Number two, at birth they both undergo the trauma of separation from the biological mother, which people say nobody remembers, but it's not true. Nobody recalls, but everybody remembers in the point of, from the point of view of implicit emotional memory. So therefore, to say that those twins separated at birth, brought up in different environments, is just wrong. And even then they show what call, what's called a concordance, which means if one has it, the other will have it. It's about 70%. This is identical twin separated at birth. If it's genetic, why isn't it 100% they have the same genes. So the Point is, that's the second point. The next point is that no infant has impulse regulation and no infant has attention, and there are no genes for attention as such or impulse regulation as such. They have to develop. Now, if we're talking about. And they say that ADHD is a neurodevelopmental condition, okay, folks, if it's a neurodevelopmental condition, let's look at how the nervous system actually develops. And what we know about the nervous system and the brain is it develops under the impact of the environment. So I'm going to quote you two sentences from a major paper from Harvard University. The Harvard center on the Developing Child appeared in the Journal of Pediatrics in February 2012. And it says, the architecture of the brain is constructed through an ongoing process that begins before birth and continues into adulthood and establishes either a sturdy or a fragile foundation for all the health, learning, and behavior that follow. That's the first sentence, the second sentence. And I know this by heart because I quote it every time I speak. The second thing is the circuit of the brain under the impact of the interaction of genes and experiences, not the genes, but the experiences, turning the genes on and off or potentiating the genes under the genes and experiences. And it's critically influenced by the mutual responsiveness of adult child relationships, particularly in the early childhood years. So what they're saying, and this was published in 2012, and by this time, this was old news, by the way, your friend Dan Siegel could tell you about this, because he was talking about this in the 1990s, that it's not the genes, but the environment acting on the genes. And the most important influence on brain development actually is the quality of emotional relationships between the child and the parent. So that's just pure brain science.

[Alyson Briga]

Can you say that again? I think that is so important, the

[Dr. Gabor Maté]

most important developmental influence on the construction of the brain, which means the circuitry, the dopamine levels, the endorphin levels, the oxytocin levels, the connections, the systems in the brain is the emotional relationship between the child and the nurturing parents. Now, in a society where parents are so stressed, why are we surprised that more and more kids are being diagnosed? Yeah, because when the parents are stressed, the kids are stressed. Now, let me tell you what is genetic. There is something genetic here in most cases, and that's sensitivity. And sensitivity from the Latin word sincere, to feel. The more sensitive you are genetically or temperamentally, the more you feel. And then stress comes along. And how does a small child deal with stress? When the parents Are stressed, The child is stressed. As a matter of fact, if you want to know how troubled a marriage is, you can do two things. You can ask the parents, or you can measure the stress hormone levels of the child. And how do we know these kids are hypersensitive? They have much more asthma, they have many more allergies. What are those? We call them hypersensitivities. So the tuning out then is the. An adaptation of the sensitive child to stress. And basically you tune out because you can't change the situation and you can't leave it. So the tuning out is like an adaptation. But as this Harvard article points out, those early adaptations help the child in the short term, but they become the sources of pathology or dysfunction or learning problems later on. And that's true about so many conditions. So as a genetic predisposition in the form of heightened sensitivity, you'll hardly meet an ADHD person who isn't very sensitive. That they feel more.

[Alyson Briga]

Well, that's a. What a gift.

[Dr. Gabor Maté]

It can be a gift, but it depends very much in the environment. So you can take animals who are more sensitive because of certain serotonin alleles or certain serotonin variations, and you put them in good environments, they become super leaders. But if you put the same animals into difficult situations, they become more troubled. So it's like a geneticist, by the way, he said that genetic senses set the sensitivity and the rest is up to the environment. So the whole idea that this is a genetic disease, first that it's a disease and secondly that it's genetic, is absolute scientific nonsense. And the people that cytogenetics don't understand the flaws of those twin studies. But the point is, what we have here is a condition that reflects environmental stress on highly sensitive brains.

[Alyson Briga]

And if you know how to use your sensitivity, it can be used as a superpower. I had never made that correlation.

[Dr. Gabor Maté]

That's the whole point.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

Sometimes people ask, you know, why are people they ADHD so creative? Because they're so sensitive. It's not that the ADHD gives them the creativity, it's the sensitivity that creates both ADHD and the sensitivity.

[Alyson Briga]

Yeah. So then just using knowing how to work with that sensitivity so you're not taken over by it, but you can take care of yourself.

[Dr. Gabor Maté]

Well, let's start in childhood. Like if, if you're a parent and if you come to me with a ADHD child at age 6, what would you do other here, ma', am, you've got this, your kid's got this genetic condition determined by heredity and all we can do is change his behaviors and maybe medicate him. Or ma'. Am. Or sir. Or ma' am. And sir. You've got this highly sensitive child who's very responsive to the environment. And if you change the environment in positive ways, his brain will develop in very positive ways. For example, the parents, if they work on the parent. These kids are very sensitive. And if they grew up in a home where the parents are stressed in a relationship, the kids pick it up.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

So if the parents work on the relationship and there's more calm in the home, that kid automatically blooms. And not to mention, if you understand the internal emotional dynamics of the child, so you're not reacting to the behaviors, but you understand what emotional dynamics and needs the child's behavior reflects. Now you can go to work on meeting the child's emotional needs. Those behaviors automatically change.

[Alyson Briga]

Yeah. Those are just the result of a deeper wound.

[Dr. Gabor Maté]

Exactly. The behaviors are symptoms.

[Alyson Briga]

Yeah. And you know, as fellow therapists, like if somebody brings their child to a therapist, oftentimes the therapist will work with the adults.

[Dr. Gabor Maté]

Yeah.

[Alyson Briga]

You know, so it's like, okay, how do we change? And the best thing we can do as parents is really do our own work and to model that to create an environment that' support some in thriving. But I love this emotional attunement. That makes a lot of sense.

[Dr. Gabor Maté]

Yeah.

[Alyson Briga]

And I'm thinking about parents or just adults who are living in a high stress reality. They're feeling pressured to achieve and then they're abandoning their own needs. And that stress builds up on the body. What happens over time when somebody is in that high state of stress?

[Dr. Gabor Maté]

Let me say one more thing and then I'll come to your question.

[Alyson Briga]

Okay.

[Dr. Gabor Maté]

Which is we're not meant to parent the way we're parenting today. If you look at human evolution and the human homonym, creatures, human like creatures have been on the earth for millions of years. Evolution has been going on for a long time. Our own species, Homo sapiens, we've been here 150, 200,000 years. Even if you just take our own species, which is just a small slice of evolution, and if you put on the face of a clock that 150, 200,000 years until five minutes ago, we lived out in nature in small band hunter gatherer groups where kids were on the parents the whole day and where the whole group was responsible for parenting the child. Not a nuclear family stuck in an isolated home or a single parent. Parenting was a group effort. And there's this concept called allo mothering which means that the pregnant woman, or I should say the Parturian woman who just given birth, has lots of support from other women who come and hold the baby and feed the baby and so on. Yeah, this is the way it's been almost forever. What we have today, isolated women, the husband's often at work and she's stuck with the baby in the house, stressed. Now, if the child is high sensitive, on top of that there's economic stress or, you know, marial discord and so on, that baby is going to be affected by that. And this is not in any way to put blame on parents. We're talking about conditions in what I call a toxic culture. The work on stress was done originally in Canada by a fellow Hungarian. His name was Selye S E L Y E I and he worked at the University of Montreal. And he's the one that showed in the laboratory that if you stress animals, rodents, usually their immune organs shrink, their guts get ulcerated and their adrenal glands go bigger. And so he was sort of the pioneer of stress research. That was a hundred years ago and he's the one that coined the word stress in the way that we use it today, actually. And now we know what the long term effects are like. Stress is meant to be an essential part of life. I mean, if you're threatened, you need to mount a stress response which elevates your muscle strength and diverts blood supply from your intestines to your muscles. It makes you faster, more alert, more effective, gives you blood sugar so that you have more energy. That's what adrenaline and cortisol, the stress hormone do, that are released from the adrenal gland in response to a threat. In the short term, they're lifesavers.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

In the long term, those same stress hormones with people who have elevated stress over time, whether because of emotional reasons or physical reasons or whatever, those same stress hormones thin the bones, causing osteoporosis, put fat on your belly, increasing the risk of heart disease, elevate blood sugar levels, giving you diabetes, turn on genes that cause cancer, turn off genes that protect you from cancer, makes you depressed, can also eat the intestines, interfere with cognitive functioning and cause all kinds of havoc. So all kinds of illnesses that medical science throws up its hands and say we don't know what causes it, are actually owing to stress. Which is not my personal opinion. There's just a lot of science behind it.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

So that the whole point about human beings is, you know what Socrates said 3, 500 years ago, 2500 years ago. Sorry. He said the problem with the doctors of today is that separate the mind from the body.

[Alyson Briga]

Yes.

[Dr. Gabor Maté]

No, doctors still do. And there's an American physician called George Engel in 1977, by the way. He wasn't the first one either, but he actually said that he was a psychiatrist and an internist. And he said that the fatal flaw of modern medicine is that it separates the physiology from the psychology and the psychology from the social environment, where, in fact, we're biopsychosocial creatures, which means that our biology is affected by our emotions, which of course reflect our social relationships, so that you can't understand disease simply as a physiological event. So when there's a lot of emotional stress in people's lives, as there is in this world, you expect to see all kinds of illnesses, which is what we're getting. So there's a rise in autoimmune disease amongst young people, a rise in colon cancer amongst young people. Women have 80% of autoimmune disease. And we could talk about why that is, but these are all stress effects.

[Alyson Briga]

I know, I've heard you talk about how much is genetic versus not in terms of disease. Can you share a bit about that?

[Dr. Gabor Maté]

Well, there's some diseases that are purely genetic and when I say purely genetic, if you have the gene, you'll have the disease. No mental illnesses in that category. But muscular dystrophy, which runs in my family, anybody in my family in any generation who inherits the gene will have muscular dystrophy. Huntington's Korea is another one, a neurological degenerative disorder. If you got the gene, you'll have the disease. Some form of Alzheimer's genes can really increase the risk. But only a small percentage of Alzheimer patients actually have those genes. If you take. There are breast cancer genes which elevate the risk of breast cancer. But out of 100 women with the gene, out of 100 women with breast cancer, only 7% have the gene.

[Alyson Briga]

7%.

[Dr. Gabor Maté]

And out of 100 women with the gene, about 30 or 40% will have the disease. In other words, even in those case, even in that case, the genes are not by themselves determinant. They are a major risk factor, for sure, but those situations are rare. Those diseases where the genes are determinant are like 1 in 10,000, with the exception of breast cancer. So there's some cancers, rare ones that are genetically determined, but most people with cancer genes have nothing to do with it. Most people with autoimmune disease genes have nothing to do with it. So the genetic hypothesis Just doesn't apply to the preponderance of illnesses that beset this society.

[Alyson Briga]

Yeah. And I want to talk more about that. And I loved your book. I mean all of them. But when the body says no.

[Dr. Gabor Maté]

Yeah.

[Alyson Briga]

And you were talking about how being really nice can correlate to getting sick.

[Dr. Gabor Maté]

Yeah.

[Alyson Briga]

Can you talk about people pleasing and how that correlation. Sure.

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[Dr. Gabor Maté]

So first of all, there's no genes for people pleasing. It's an adaptation in early childhood when you get the message that you're not acceptable the way you are. One of the adaptations is to be very nice so people will accept you now. And that means usually the repression of healthy anger.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

Furthermore, it means trying to please people all the time, which means that you don't learn how to say no. No. Anybody who's a parent, they know that kids know how to say no. In fact, a two day old infant knows how to say no. Try feeding it something it doesn't want to eat. But specifically at age one and a half, what's the words they start using is no. So it's not in anybody's inheritance not to say no or to be nice. It's an adaptation to an environment that rejects you if you say no. So then you have to be very nice. Now if you're very nice and you don't say no, guess what? You're taking on a lot of stress. You'll always be trying to please people, bending yourself into a pretzel, suppressing your emotions, your authentic self expression. There was a study in Massachusetts. They looked at 2,000 women over a 10 year period. And those women that were unhappily married but didn't express their emotions were four times as likely to die as those women who were unhappily married and did express their emotions.

[Alyson Briga]

Wow.

[Dr. Gabor Maté]

Now why? Well, what's healthy? Anger. If you were to invade my space now in some intrusive, unwelcome way, I might say please stop. But if you didn't, I better get angry. No, stay out. So healthy anger is a boundary defense. Now if you look at emotional life in general, its overall purpose is to allow in and invite in what is nurturing and friendly and loving, but to keep out what isn't. So it's a yes or a no. And what's the role of the immune system? Same thing is to let in what is nurturing and, you know, nutritious and healthy. Make accommodations with healthy bacteria, but fight unhealthy bacteria, let in vitamins and food and so on, but to keep out toxins, keep out viruses and so on. So the emotional system, the immune system have the same role. It's a boundary that lets in some things, keeps us something else. Now, not only do they have the same role, but here's the big secret that we've only known for multiple decades and nobody teaches them to medical students, that the emotional system and the immune system and the hormonal apparatus and the nervous system are not even connected. They're one.

[Alyson Briga]

Oh, wow.

[Dr. Gabor Maté]

So even to say that they're connected is to indicate that they're different systems connected to each other. But they're not. It's all one system. And they're joined together through messenger substances in the blood to the autonomic nervous system through a million myriads of ways. So when something happens emotionally, guess what? It affects the immune system. And people that repress healthy anger have been shown in a laboratory to have diminished activity of some very important immune cells. So what happens to anger that you suppress? What happens to it? Does it evaporate? Where does it go?

[Alyson Briga]

It prolongs it, it stays in the body.

[Dr. Gabor Maté]

How does it affect a person?

[Alyson Briga]

I think they get resentful.

[Dr. Gabor Maté]

Yeah. It ends up turning against them.

[Alyson Briga]

Yeah, anger goes out or in.

[Dr. Gabor Maté]

Well, look, we talk about depression. Look at this. I mean, I love the English language. It's very expressive. What does it mean to depress something, Push down what gets pushed on in depression?

[Alyson Briga]

The sadness, the anger, the threat.

[Dr. Gabor Maté]

So, you know, so you push to any anger, it turns against you in a form of depression, self loathing and so on, which is why the immune system turns against you. And now you've got autoimmune disease because of the unity of the emotional system and the immune system. When a dynamic affects one, it affects the other. So there's diminished activity of important immune cells called natural killer cells whose job it is to fight malignancy and to a, you know, so either the immune system turns against you, now you have autoimmune disease, or it fails you and now you have malignancy. So that's what happens as a result of chronic stress and unnice people. And this has been described, this is not just my own observation.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

This is described in the literature, which is not taught. And here's the issue, this is not a theoretical consideration because when you have somebody with an autoimmune disease, and I've seen it over and over again, who recognizes that owing to childhood adversity, they've been suppressing themselves all their lives, they haven't learned how to say no, they haven't learned how to express healthy anger. But once they deal with that, their autoimmune disease diminishes or even goes away. And I've seen this with rheumatoid arthritis, I've seen this with systemic lupus, I've seen it in multiple sclerosis. Not only have I seen it, other people have seen it. As a matter of fact, I'll tell you an anecdote. We're here in near Los Angeles at one of the major local universities is a rheumatologist who works with autoimmune diseases. Rheumatoid arthritis, lupus, scleroderma, chronic fatigue, long Covid this kind of stuff. She met me at a conference a number of years ago and she'd read when the body says no and she says it made sense to me, I Saw it on my clients. All this self suppression, all this niceness. And I started to talk to them about it. And now I'm getting people off medication.

[Alyson Briga]

Wow.

[Dr. Gabor Maté]

And. Or using much less medication. But she said I can't tell my colleagues about it because she. They laughed me out of the profession. Such a shame. Because it's like with adhd. If we only understood that if you change the child's conditions that kid could bloom and blossom. And with autoimmune disease, if people learned to deal with their traumas and overcame their self suppression and had the appropriate therapy and therefore could fully express themselves and assert themselves, the disease would be significantly mitigated if not altogether gone. Look at all the good we could do.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

But all we do, these people come to us and we medicate them.

[Alyson Briga]

Yeah. And I think anger is probably the emotion that people have a least healthy relationship with. I think sometimes they think anger and violence the same. A feeling versus an action. So helpful to see that. But especially as for women.

[Dr. Gabor Maté]

Yeah.

[Alyson Briga]

They don't necessarily have a lot of examples of. Of healthy relationship with anger. And anger has a place. There's wisdom in all of it.

[Dr. Gabor Maté]

No, they don't.

[Alyson Briga]

And to be able to have that healthy anger and to feel their power and their. No. And speak their truth. And I understand what you're shar is like to connect and to create attachment. Pleasing might have happened so that we felt like we belong for survival reasons.

[Dr. Gabor Maté]

Well. And one of the needs of children, one of the evolution nature established needs of children, young children is to be able to feel all the emotions and to be able to express them and to have those emotions validated by the adults. So we're wired for anger. There's a wonderful neuroscientist no longer alive. Dan Siegel actually wrote the forward to one of his books. Yak Panksep his name was. And Bankstep showed that we share with other mammals brain circuitry for emotions such as for lust, such as for seeking playfulness, fear. All these are essential for survival. Anger, panic and grief, which happened because of separation of the infant from the adult. So we're wired for these emotions. And it's not that parents have to go out of the way to make the child feel all these emotions. The child will feel them. The child will feel angry because a three year old wants a cookie and you don't give it to him. A child will feel fear. A child will fear grief sometimes because his friend won't play with them or his dog dies or whatever. And so the. The job of the Adult is to validate, accept, hear the child's emotions. And again, as Dan points out, in the developing mind, it's the parental mature brain circuits that helps to regulate the child's emotions. Assuming the parent has well developed mature brain circuits, and I think the best

[Alyson Briga]

thing the parent can do is to get comfortable with the range of their human experience and emotions so that they can hold for the child's anger or pushing back to say that there's healthy ways to express and there's unhealthy, but to give space. And that will only be authentic to the degree that they've done the work themselves.

[Dr. Gabor Maté]

But if the child gets the message that certain emotions are not acceptable, they don't have much of a choice in the matter. They can't very well walk out of the parental relationship and okay, sorry, I'm two years old, but I'm not being accepted for who I am. So goodbye. The only choice is to give up the authenticity for the sake of the attachment, for the relationship, and then all their lives. And since authenticity, then that is to say feeling your emotions, being connected to yourself and expressing it threatens your earliest relationship. The message you download is I better not be myself with anybody. So on the job site or in relationships, people don't manifest. They are even afraid to feel what they feel, let alone to express it.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

And so that so many people then suffer the mental or physical consequences.

[Alyson Briga]

I just love that it's rooting back to having a healthy relationship with our emotions because as we do that, we have space for our child's emotion and then we do that as a culture. It's not just one on one. I'm still with this 80% of autoimmune diseases with women. And I hear that the connection around anger. And I'm curious, are there common characteristics of somebody that is more prone to autoimmune disease?

[Dr. Gabor Maté]

Yeah, they are. And they're very clear, actually. And again, this business that it's hormonal because it's the female hormones. Nonsense. Let me tell you a simple little fact. In the 1930s, the gender ratio of multiple sclerosis and autoimmune disease was one to one. Now it's three and a half women to every man. The hormones haven't changed.

[Alyson Briga]

Right.

[Dr. Gabor Maté]

The genes haven't changed. Something else is going on. In Denmark, the ratio of men, women getting multiple sclerosis doubled in 20 years. Not for men. It's not the hormones. There's something. So what is that something?

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

So the four characteristics of people that develop chronic illness, including malignancy but saliently. Autoimmune disease is an automatic and compulsive concern for the emotional needs of others who are while ignoring their own number one. Number two, a rigid identification with duty, role and responsibility rather than the needs of the self. Three, we already talked about being very nice. The repression of healthy anger, people pleasing. And then the fourth one is harboring two fatal beliefs. One is that you're responsible for other people feel and that you must never disappoint anybody. Now, nobody's responsible for the people feel. Unless you're the parent of a small child. Indeed. Then you're responsible, or at least you're responsible for dealing with the child's emotions. But if I come to Pasadena and I phone you up and say, can you have coffee? And. And you've been up all night with, you know, a sick friend or a child or whatever, and. Or just generally you're just too bummed out, you don't feel like having coffee and you say no, Gabo, sorry. How I feel about it is not your responsibility. How we show up is our responsibility, but how somebody else feels about it.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

And what happens, by the way, if I do blow into town and I call you have coffee and you don't feel like even up all night. What happens to you if you. If you don't say no?

[Alyson Briga]

Then I overextend.

[Dr. Gabor Maté]

You overextend. And that is a consequence on your physiology. And you also might be resentful. You know, in no way does it help anything. So. So those four, those four are the traits. And when we look at why in this culture, women get more autoimmune disease, which gender is acculturated in this patriarchal culture to take on those characteristics from early childhood on. I heard it is women.

[Alyson Briga]

Yeah. And it's very codependent, especially the fourth one.

[Dr. Gabor Maté]

Yeah.

[Alyson Briga]

Let me take care of you so you take care of me rather than taking care of self and being considerate and in relationship.

[Dr. Gabor Maté]

Well, it's not even let me take care of you so you can take care of me. Just let me take care of you.

[Podcast Host/Announcer]

Yeah.

[Dr. Gabor Maté]

Yeah. So that I can extreme. So that I can feel okay about myself.

[Alyson Briga]

But that's what I mean, like, let me take care of you so I'm okay.

[Dr. Gabor Maté]

Yeah.

[Alyson Briga]

To try to manage.

[Dr. Gabor Maté]

Yeah. It's codependent that way.

[Podcast Host/Announcer]

Yeah.

[Dr. Gabor Maté]

Now, during the COVID epidemic, there was an article in the New York Times, the title of which I adapted as one of the chapters in my book the Myth of Normal. And the article was entitled Society's shock absorbers. And it's about women. How a lot of women took on the job of mitigating the stress because of COVID on their children and on their husbands, and they felt guilty if the husband or the children experience stress. Now how is that for the woman taking on that stress?

[Alyson Briga]

Yeah, it's too much.

[Dr. Gabor Maté]

So that's one dimension. The other dimension is socioeconomic status and race. In Canada, an indigenous woman has six times the risk of rheumatoid arthritis than a Caucasian male. This is in a population that never used to have rheumatoid arthritis.

[Alyson Briga]

Wow.

[Dr. Gabor Maté]

Same thing in the United States. People of color are more likely to have autoimmune disease than Caucasians. So anything that magnifies the stress and causes suppression will increase the risk. Now, let me go back to this question of what happened with multiple sclerosis. But here's what happened. So women always had this shock absorber role, this caretaking role. And by the way, I can tell you, my own marriage is an example. I'm fortunate that I'm married to somebody who. They took on that role, but they always resisted it. And finally they said no. But in a lot of marriages, there's a kind of dynamic where men have their unmet mothering needs in this culture because stress is on women, and they project that onto their wives. So a lot of women will have three children. One two years old, the other five years old, and the third one 38 years old.

[Alyson Briga]

And culturally, it changes too. There are more of that that plays out in certain cultures.

[Dr. Gabor Maté]

Yeah. And that's. That's hard on women. So they've always had that role. They also had the primary role for raising the children. So they had the role of taking care, you know, and. But now what's happened since the 30s is that a lot of women are in the workforce, but that hasn't until recently, diminished their other role of being the stress absorbers. And there's a third factor. Isolation. People used to have much more social connection, extended family, communal networks. So more stress, more isolation. Of course, you have an increase in this condition, and it's got nothing to do with genetics and nothing to do with strict biological hormones.

[Alyson Briga]

Yeah. One in four American adults are estranged from a close family member.

[Dr. Gabor Maté]

Yeah.

[Alyson Briga]

And I'm just curious why you think that is. And how do you know if the relationship can be repaired?

[Dr. Gabor Maté]

I'm laughing because I'm just, as we speak, two weeks away from completing my next book that I'm writing with my son. It's called hello again, A Fresh Start for parents and adult children. And it's all about this dynamic. There's a whole lot of reasons. One of them is positive in that there's more freedom now, in a certain sense, you know, the old adages about, you know, blood is thicker than water and. Well, no, it isn't. You know, if people are in difficult relationships that are beyond repair or are just too stressful, the adult child is not obligated. Stick around the parent. And honoring your parent is a nice injunction, but it's got to work both ways. Your children also have to be honored. So in that sense, there's a bit more freedom. But there's other reasons as well. First of all, there are the fraying of social networks that could support family members in some sort of conundrum. The meeting in the effective community of people who love and care for both of you and could talk to you and say, you know, well, maybe this could be worked out. You know, this is very little of that left. There is economic independence, used to work in farms and communal villages and so on. Well, kids now go off and live in a totally different town, far away from the parents, which doesn't necessarily make for alienation, but it makes contact less necessary. And then there's. I think there's an unfortunate immaturity in our emotional reactions. Like, we tend not to tolerate discomfort. So, like, in a marriage, if you don't want to tolerate discomfort, don't be married. You know, so there's. But there's a certain negotiation that takes place where we respect the differences, where we work out our difficulties. People are less and less willing to do that. And, you know, people are a bit more easily drawn into diagnosing the other person as a narcissist or this or that. And, you know, I'm gonna be a narcissist. I got nothing to do with you. Well, I think that's a bit.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

More than a bit flawed.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

And also, people just don't have the emotional wherewithal to work on difficulties, and it makes it easier just to withdraw.

[Alyson Briga]

Yeah. Think that you're the problem. I'm gonna cut you out. And so then. And yet the pattern is in you. So if it's not healed, you're gonna replace that and see that in someone else.

[Dr. Gabor Maté]

Oh, yeah.

[Alyson Briga]

And I do think that this resiliency, this ability to be with discomfort is one of the biggest things why we do this podcast, is to teach people.

[Dr. Gabor Maté]

Yeah.

[Alyson Briga]

And I want it. Which brings me to this other question. A lot of the times people are asking, how do I know I'm with the right one, and I'd love for you to share the connection between unmet childhood wounds and our adult relationships.

[Dr. Gabor Maté]

This is hardly original to me, but there's good news, there's bad news and there's good news. The bad news is that you always marry somebody or partner with somebody who's at the same level of emotional wounding that you are.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

No. The wound may not have been occurred the same way. I was born into wartime Hungary, a Jewish infant under the Nazis. My wife was born in peaceful Canada. So our traumas don't look the same, but they're the same intensity. So we always find somebody at the same level of emotional woundedness that we're at. Which also means that I may have had a certain degree of childhood trauma, but if I've healed to some degree, I will not hook up with somebody who hasn't healed as much as I have. And so that's the first dynamic. That's the bad news. The good news is that if there's mutual commitment and love, then this is also an opportunity to grow up together and to heal together. Yeah, but that has to be taken on consciously.

[Alyson Briga]

Yes.

[Dr. Gabor Maté]

And certain dynamics that are, you know, we talk about attachment styles and so on. So there's the avoidant attachment style, which is me. When something happens, I tend to withdraw to create safety. Withdraw, you know, which is what I did after I saw my mother, after I was separated from her for six weeks as a 11 month old because I had to be to save my life. And when I saw her again, I wouldn't even look at her, which is what young kids do on separation. So that's imprinted in my nervous system. So that's my default setting, is that after 56 years of marriage, now we have a disagreement. Am I in the right relationship? That's the default setting.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

It doesn't need to predominate or to control your behavior. But it's still. I noticed. It still comes up in me. I notice it.

[Alyson Briga]

Yeah. It's a safety strategy.

[Dr. Gabor Maté]

Yeah. Yeah.

[Alyson Briga]

And I love that you, you're. What I keep hearing in this conversation is like, that was the. That was an adaptation. That was the way you created safety because you needed to at the time.

[Dr. Gabor Maté]

That's right.

[Alyson Briga]

And now that we have awareness, if it comes up again, we have compassion. We can see it without getting caught up in believing that it's true.

[Dr. Gabor Maté]

If we can recognize it when it arises. Yeah. That withdrawal. And John Bowlby, the attachment pioneer, studied. This is defensive. It says when I was Separate? When you left me, when I was separated from you. And the young child can only interpret separation from the parent as a rejection, as an abandonment. When you abandon me, I was so hurt that I'll not open myself up again to that kind of vulnerability.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

So then that's ingrained in the nervous system. Anything that happens 60 years later that reminds you of that, triggers that. That's what triggers are all about, by the way. And so now if there's the awareness, as you say, the problem, the difficulty for a lot of people is that the response flexibility and the awareness are functions of the prefrontal cortex. But for traumatized people, when the trigger is strong enough, the orbital frontal cortex goes offline and the more primitive, emotional, old brain circuits take over. So just when you need the awareness is when it's most likely to evaporate.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

But again, that's the stuff of therapy and that's the stuff of spiritual work and that's the stuff of meditation and

[Alyson Briga]

all that stretching the window to be able to notice and not just react. I know that with couples getting in arguments, one of the big things is somebody wanting to be right.

[Dr. Gabor Maté]

Yeah.

[Alyson Briga]

And I'm curious where you feel like the motive is behind this wanting to be right. Wanting to be right.

[Dr. Gabor Maté]

The world. It's interesting. I'm just reading the Bhagavad Gita.

[Alyson Briga]

Huh.

[Dr. Gabor Maté]

And they talk about the mind, the conditioned mind, and it's got a number of different features. And one of them is Bodhi, which is discernment, and the other is Manas, which is like memory and will and so on. And then there's what they call ahmakara. Ahamkara. And aham means I, and kara means maker. So ahamkara is the eye maker. It's what we identify with is deeply unconscious. If my sense of ego is fragile and identify with having to be right in order to be a valid human being, then you can talk to me very reasonably about some issue on which I don't agree with you. But not only will I disagree with you, I'll feel very offended and perceive myself as being attacked and by your very disagreement with me. Because I've identified so much with this need to be right. So it has to do with identification. And identification is very unconscious. And you see it played out in politics.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

Where there's a lot of political issues I could talk about where the facts are very easy to ascertain and to muster, but there's no agreement because one side or the other identifies so much with one position. You also identify because you want to belong. So that in a cult it's very clear, but it diffuses throughout society. So in a cult there's certain rigid beliefs, and if you want to identify with the group, you have to hold on to those beliefs. And any other beliefs are threatening and pernicious. Most of us don't belong to cults, but we do belong to social groups with certain points of view more subtle, and we don't want to give that up. So we identify so much with belonging that it's hard for us to come to our own independent position. So it's really about identification on a deep level.

[Alyson Briga]

And I think the weaker the egoic structure, the stronger the need to be right.

[Dr. Gabor Maté]

Oh, yeah. And I see this in politics all the time. The weaker the intellectual position, the more powerful the drive to be the one who knows.

[Alyson Briga]

We're also in a loneliness epidemic and one in two US adults feel lonely or isolated. And that's comparable in terms of the health impacts to 15 cigarettes a day. And I'm curious what you think for people that are in relationship but they're feeling lonely. What's the missing equation there?

[Dr. Gabor Maté]

If you're in a relationship with somebody but you don't see how it is for you, you don't own how you feel, you don't express yourself, you're going to feel totally lonely. You can be. You can have a thousand friends and be totally lonely because you're not expressing yourself. And we see this in the tragic cases of suicides where all these people that he was so nice and we loved them so much, but they never knew him and. And he kept it all to himself. So you can be lonely in the middle of a crowd. Isolation is significant. An American study showed that women with breast cancer who've got good friends, their chance of surviving is four times greater.

[Alyson Briga]

Wow.

[Dr. Gabor Maté]

In multiple sclerosis, the more social support you have, the less risk of a relapse you have.

[Alyson Briga]

Yeah. Community and mental health is so important.

[Dr. Gabor Maté]

Yeah. Connections, emotional connections and community and mental health and physical health. I mean, this is physical health we're talking about. There was an Australian study, really interesting. It showed that they looked at women with breast biopsies suspicious for malignancy. And before the results came back, the women underwent a psychological profile. After the results were collated, it was found that if a woman was emotionally isolated, that by itself didn't increase the risk of that lump in cancers. If a woman experienced stressful events prior to the onset of that lump, that also did not increase the. The chance of the lumping cancers, zero effect, zero and zero. You know, but if a woman was emotionally isolated and stressed, the risk of that lumping cancers was nine times as great as the average.

[Alyson Briga]

Wow.

[Dr. Gabor Maté]

And the. And the researchers had difficulty, you know, being left brained scientists. How does 0 and 0 add up to 9? But it's obvious. If you're stressed and the stress hormones are playing havoc with your physiology and you're alone with it, then the stress just accumulates and you keep perseverating in it. But if you're not socially isolated and you talk about it, what happens to your stress levels? It's immediately diminished. So obviously. But that's how important social relationships are.

[Alyson Briga]

Yeah. And what do you think would be a healthy step for somebody that's listening and feeling isolation and maybe scared to bring their vulnerable truth, their authentic feelings into connection?

[Dr. Gabor Maté]

Well, that's the stuff of therapy.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

That's the stuff of talking to somebody. And the essence of therapy is, I'm sure you will both agree is not a particular method. I mean you might use a Komi or neuro linguistic programming or my method of compassion inquiry or whatever method. But it's. The relationship is the substance or not the substance, but the essence of therapy. And the essence of the relationship is that that person learns to be safe, to express whatever is happening for them.

[Alyson Briga]

Yeah. That they could start there and then also to move that into another relationship in their life where they feel.

[Dr. Gabor Maté]

Well, that's the whole point.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

So that the therapeutic relationship can become a template for the relationship. And a lot of clients are surprised to find out that it's okay for them to hate somebody. At least it's okay for them to have that feeling. It's okay for them to be afraid. It's okay, you know, and it's safe because the therapist will not. Not reject them or criticize them.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

If the therapist is dealt with their own stuff.

[Alyson Briga]

That's right.

[Dr. Gabor Maté]

And if they haven't.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

Not so well.

[Alyson Briga]

Yeah. Anyone holding space? I think that's our professional responsibility is to continue doing our work so that saving compassion.

[Dr. Gabor Maté]

By the way, it's an interesting phrase. Have you thought about holding space?

[Alyson Briga]

I have.

[Dr. Gabor Maté]

Is there one thing you can't do?

[Alyson Briga]

Yeah, the space is held.

[Dr. Gabor Maté]

Yeah. No, we can't. You can't hold.

[Alyson Briga]

Oh, you mean practically.

[Dr. Gabor Maté]

Yeah. But you can't hold space.

[Alyson Briga]

You can't.

[Dr. Gabor Maté]

It's the one thing in the world you can't. Space. Oh. So what does it actually mean? But it.

[Alyson Briga]

I've. This is a great inquiry because for me I thought about it. And it's not that I am holding space, but the space is already held. And it's an attunement to the safety of the space that invites another nervous system to feel that.

[Dr. Gabor Maté]

That's exactly it. You don't intrude on the space.

[Alyson Briga]

Yeah, yeah.

[Dr. Gabor Maté]

So that the client can be just free to experience and express whatever needs to come up for them.

[Alyson Briga]

Yeah. And to meet all of it with. With acceptance.

[Dr. Gabor Maté]

Yeah.

[Alyson Briga]

To invite them to learn how to do that within themselves. It's like the anger is welcome. The grief, the no is welcome.

[Dr. Gabor Maté]

Well, you know what? So I've just been reading a book about Auto Rank, who's one of Freud's acolytes, and then became dissident because as opposed to this cold stone wall expert psychoanalytic method that Freud developed, Auto Rank said, you have. You have to bring mother love into the relationship. These days, nobody in their right mind questions relationality and when it comes to therapy. But that was new 100 years ago. And even now there's a lot of therapies that functions way too much on methods and. And skills and cognitive changes, and they don't allow for the emotional unfolding of the client.

[Alyson Briga]

Yeah, yeah. And I do think us doing our own work is the best thing, just like parenting. Also facilitating. I'll train and certified coaches to do their own work so that they can hold a compassionate, safe space. This trauma informed.

[Dr. Gabor Maté]

Absolutely. And not just doing our own work in the sense of having done it, but continuing to do.

[Alyson Briga]

That's right. That's right.

[Dr. Gabor Maté]

Yeah.

[Alyson Briga]

Yeah. That's one of the things I love about the therapeutic model is continuing to do that so that we can. Because we're going to have blind spots. And, you know, that's. To me, it's the best work we can do in the world is doing our own because our life expands. We have more resilience. We have more freedom and peace.

[Dr. Gabor Maté]

Absolutely. And when you think about it metaphorically, what do you want ultimately to do? What do you want the patient ultimately to be capable of doing? Is to see themselves clearly.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

But if you are the mirror, you better be a very clear mirror. And you have to keep working on the smudges.

[Alyson Briga]

That's right.

[Dr. Gabor Maté]

Otherwise they won't see themselves clearly.

[Alyson Briga]

That's right. Yeah. And we see our own wholeness. We can't help but to see, even if they're saying a story of that they're broken, to really deeply see them. One of the things I really love about your work is the somatic and the psychosomatic connection. I mean you are uniquely qualified to speak to that. I just want to give you the space to share any. Because this is not in the field. There's doctors and there's therapists. You're both. Even earlier you were talking about, I think I've heard in your work from womb up to three years how important that time is. I just want to open this space for you to share any insights about that that you feel like would be valuable for people people to hear.

[Dr. Gabor Maté]

I did see a study once which I wish I remembered and I've asked a bunch of colleagues and they also vaguely knew about it, but nobody knows the exact source. But anyway, what it says is that if you get the first three years right and then problems happen, those people do much better than if you get the first three years wrong and then everything is okay afterwards. Because as Alan Shore, who's of seminal psychologist and researcher has done tremendous work on brain development and his recent books have to do with the development of the right brain, which is the emotional brain, which develops before the cognitive, intellectual left brain, both from the point of evolution and also in the life of the individual. So much of what happens, the emotional patterns and dynamics are laid down long pre verbally in the right brain in the first couple of years, including in uterus. So that's just essential. And that's the template then for pretty much so much of what happens later on. So you can't overemphasize the importance of the first three years. And look at America. 25% of women in this country have to go back to work within two weeks of giving birth, which is a scandal. And then we wonder why so many kids in trouble. Those kids need not just the mother, but the mother supported by a whole community for months and years actually. And if women are to go back to work, which is their right. And first of all, there's a difference. These 25% don't go back to work because they want to. They go back to work because economically they cannot afford not to. Which means a massive abandonment of infants. If women are to go back to work whenever it's appropriate for them to do so. Well, sometimes the father can still stay home. And when we talk about mothering, we're not talking about women necessarily.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

We're talking about whoever fulfills the mothering function, the nurturing function. By the way, do you know what? When fathers begin to mother, their hormones change.

[Alyson Briga]

Oh really?

[Dr. Gabor Maté]

Yeah. And they develop different brain circuits.

[Alyson Briga]

Oh wow.

[Dr. Gabor Maté]

This is shown recently. So that mothering is not and as Jag Panksep points out, the neuroscientist, that parenting and nurturing is not necessarily a gender determined or gender delineated female attribute. It's a question of who's doing the mothering. And men who do the mothering develop mother circuits in their brains. So what I'm saying is somebody's got a mother that baby, you know. But in our society, we're not aware of the importance of that attachment for healthy psychological and for physiological brain development. So a lot of kids don't get the parenting that they need.

[Alyson Briga]

Yeah. And I think it's important. I think we're just in the awareness stage of this as a society that the, the pregnancy itself and up to three years is such an important template. But I also just want to invite moms or parents to forgive any guilt as they hear this, because we, we. The goal is to continue evolving our lineage, to do our work, to make it lighter and we learn.

[Dr. Gabor Maté]

You know, I quoted that article from Harvard University on pain development. So I spoke to Dr. Jack Shonkov, who's a pediatrician and he's the head of the Harvard Child Development Institute, and I asked him, do you worry about guilting parents when you talk about early development? He says, yeah. He says, I think about it all the time.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

But he says we can't, on the one hand, scientifically talk about brain development and human development and the importance of the early environment without pointing out to parents the essentiality of their role and the things to do with compassion.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

The thing is to understand that parents do their best.

[Alyson Briga]

That's right.

[Dr. Gabor Maté]

And that best is determined by their own upbringing very often and by social, economic, political, communal circumstances and how much support they have and support they don't have. So we have to be able to deliver this information without any sense of blame.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

Unfortunately, here's what happens a lot is people have guilt already. And when you talk about that early years, they project a guilt onto that conversation, which is not intended.

[Alyson Briga]

Yeah. And it's hard to parent and to have your humanity reflected in that is so normal. And so learning to parent ourselves as we feel the guilt and to create safety in our own nervous system. Be like, parenting is hard and I'm learning and we're evolving. We're just learning these things now.

[Dr. Gabor Maté]

Yeah. Well, we're not just learning these things as a society.

[Alyson Briga]

Maybe on a bigger scale, what we've

[Dr. Gabor Maté]

done is we've forgotten.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

What is a species we used to know. If you look at indigenous cultures, tribal cultures, they know how to Parent.

[Alyson Briga]

I feel like we're going back to a lot of indigenous ways. We're hopefully.

[Dr. Gabor Maté]

Yeah. So it's not that what we're learning. Let's say we were relearning.

[Alyson Briga]

Relearning. Remembering.

[Dr. Gabor Maté]

Yeah, Relearning. There's a wonderful psychologist now retired, but she's still active. Darcy and Darcia Narvaez at Notre Dame University, who's written extensively about indigenous and primal parenting and how we used to be able to create these environments for kids and now we don't. You know, and he says we basically. We've lost the. What she calls the commons, the constituent setting for healthy parenting. And so parents are not only having to relearn all this stuff, but they're also doing it in the context of a society that's essentially hostile to what they're trying to do.

[Alyson Briga]

Yeah. The society is not set up for it.

[Dr. Gabor Maté]

No.

[Alyson Briga]

It's not set up to speak to. In the Myth of Normal. Yeah.

[Dr. Gabor Maté]

Which is why I call that book, that subtitle is Trauma in a Toxic Culture. This is an essentially toxic culture.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

That doesn't meet people's needs. In fact, it undermines people and subverts and diverts people's needs and then gives all kinds of wrong advice to parents as to how to handle their kids, which further undermines their parenting instinct. So it's almost like parents have to. The culture should support you, but here you have to go against the culture.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

To be a healthy. A really connected parent.

[Alyson Briga]

Yeah. Connected parent. I like that. And I know you said that siblings don't grow up in the same household.

[Dr. Gabor Maté]

No.

[Alyson Briga]

Can you unpack that for us?

[Dr. Gabor Maté]

Yeah, sure. So often I'm asked, you know, how come my kids all grew up in the same home, but they're so different? Well, first of all, no two kids grow up in the same home and no two kids have the same parents. And there's a number of reasons for that. Number one is birth order. The first child does not have the same experience as the second child. They just don't. The first child gets to be the only one.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

The second child never gets to be the only one on one hand. On the other hand, the second child doesn't suffer the insult of an intruder coming into the house where I used to be the only one. And, you know, it's a totally different experience. Number one, the parents relationship might be different. Their state of their relationship or their economic situation might be different.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

The marriage might be more or less strained when one child comes into the home than another. Number Three. Each child evokes a different response from the parent. The parents, the kids create the parents as much as the parents create the kids. That's interesting. But it's, it's like that. So the child's temperament will affect how the parent reacts to that child.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

And kids are born with different temperaments, so they'll evoke a different spot, different response from the parent. It's not that parents love one child more than the other, although that happens sometimes. It's sad when it does, but it's. The child evokes a different response from the parent. There's birth order. There's the emotional physical situation of the parents that could be different. There's the child's temperament that evokes a different response. There's gender differences. A girl child does not evoke the same response. I'll tell you an interesting fact. Boys are more sensitive than girls.

[Alyson Briga]

Tell me more.

[Dr. Gabor Maté]

Yeah, they're more affected, they're more fragile, less resilient, but they're treated more harshly.

[Alyson Briga]

Interesting. You know, and also the. I've noticed a correlation with same sex parents. So like boys with their dads. Yeah, there's some correlation. I don't have any research behind it, but I've just noticed also it's a. It's easier to project onto a same sex.

[Dr. Gabor Maté]

Yeah.

[Alyson Briga]

Child.

[Dr. Gabor Maté]

That's right. So there's all these reasons. And so I think it was D.W. winnicott, the great British child psychiatrist, who said that even if the mother could be the same mother that to all eight of her kids, where she couldn't be for the reasons I explained, they still have eight different mothers because they each, they experience each of them through their own particular sensitivity and temperament.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

And I've seen different parenting given to identical twins. When I was in family practice, I attended a lot of birth and a patient of mine gave birth to identical twins. But one of them was a pound lighter and came out five minutes later. And the mother always felt a bit guilty or somehow over concerned that he had been muscled aside in the womb by the more robust sibling. So when she talked to him or about him, there was always an edge of concern and softness about her voice that wasn't quite there when she talked to the older, more robust larger twin.

[Alyson Briga]

Interesting.

[Dr. Gabor Maté]

And not that she loved one of them more or favored one more than the other, but she wasn't the same mother. Those kids did not have the same mother.

[Alyson Briga]

Yeah. I was even just thinking when I was learning somatic psychotherapy. There's pre and perinatal and they would talk about the birth story was really set the pace or some of the psychology of the. The child.

[Dr. Gabor Maté]

Yeah.

[Alyson Briga]

So, yeah, I'm just aware of that. Of like, oh, it took a really long time for my brother to come out and he's really slow and his life. Whereas like I came out third child ready to go and that's how I do life. There's some correlation to that.

[Dr. Gabor Maté]

Yeah. Well, the birth experience we know is very impactful and that that could be different from one child to the other.

[Alyson Briga]

Yeah. I also know that the inner critic is so hard for a lot of people. And a lot of people deal with this. I, I did many years ago and I realized as I changed my relationship with the critic, the critic would change. As I got curious about it and brought compassion, it started to soften. And I used to try to drown it out for a while because I didn't have any other tools. But I know you have a compassionate perspective on the critic and I think the critic has a bad rap.

[Dr. Gabor Maté]

Yeah.

[Alyson Briga]

Will you share how, where you see the critic, what, where does it root back to?

[Dr. Gabor Maté]

Well, again, the child's essential and non negotiable need is for attachment, sense of belonging, being accepted by the parents. If the child receives what Carl Rogers called unconditional positive regard.

[Alyson Briga]

Love him.

[Dr. Gabor Maté]

Which is a regard that doesn't depend on the child being cute or cuddly or compliant or performing. Performing anything. Then the child learns, I'm just such a fine creature. I'm just okay in this world, you know. But if the parents can't offer that, and a lot of parents can't because of their own stuff and because of everything we've talked about, then the child has to learn to comply. And the critic comes along as a kind of reminder, you better not do that and you better not think that and you better not feel that. And if you do, there's something wrong with you. So it's an adaptation and it just, it keeps you on the critic, keeps you in line. That's its original role.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

Now if we could say to the critic, and you know, and guilt comes along to keep you in line. Now if you could say to the critic, and you know, they do this quite nicely in internal family systems, you know, it's not the only way to do it. But if you could say to the critic, thank you, I get it, you came along to protect me, to keep me aligned with the relationship without which I couldn't have survived. But I don't need you anymore. Thank you very much. But the Trouble is, it's so deeply ingrained, we tend to believe it now. Very interesting. Sheryl Crow, the singer songwriter, she had breast cancer. And after breast cancer, you know what she said? She said, I always used to try and please other people and no concern with my own needs. Since I had breast cancer, I learned to put myself first. And she said, there used to be a voice in my head telling me that whatever I did was wrong, and now I've learned to silence it. But it took the crisis of that illness to finally get her to divorce from that inner critic. But that critic in the first place came along for the same reason that she tried to please other people all the time, which was to keep her aligned with the original attachment relationship. So let's not be harsh on the critic, but let's also not listen to it.

[Alyson Briga]

Yeah, it's like we don't want to criticize the critic, which is another layer of criticism. Yeah. And I think it oftentimes it thinks if I tell myself all the things I'm doing wrong, then I'll do better so that I belong and that I. And so it's innocent. It's got a positive intention. It's just not very effective.

[Dr. Gabor Maté]

You know what an analogy that comes up is? Maybe you've heard of these Japanese soldiers in the Philippines, I think, who never knew that the war was over. And so Even in the 60s, they were hiding in the jungles and surviving. And then when they were found, Even in the 70s, perhaps, you know, like 30 years after the war, they were taken back to Japan and welcomed with open arms. And you can give it up now, the war's over, you don't need to keep fighting.

[Alyson Briga]

Yeah, yeah.

[Dr. Gabor Maté]

Well, that's. That inner critic. It comes along as a defense, but it. But those wars over, you're not that child anymore.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

Who needs that protection?

[Alyson Briga]

Yeah. But I love what you said. Accepting it, thanking it, it softens. It's almost like parts of us start. They defend until they feel accepted. And so when we really just see them, they soften. So just meeting all of it with love. Just in closing, I would love to hear if there's anything around using psychedelics for healing that you've heard about in terms of research or anything that's cutting edge around that that you think would be helpful to share.

[Dr. Gabor Maté]

Well, I mean, after my book on addiction came out in the realm of Hunger Goals, which he argued that addiction is another non genetic disease, but it's a response to trauma. When I was on book tour, people kept asking me, what do I know about ayahuasca and the healing of addiction. I said nothing and then somebody else would ask me the same question and I finally got annoyed. I just spent three years pouring my life and work into this and everything I've studied into this. But you're asking me what the one thing I don't know anything about. But then I had opportunity to experience it myself and I got it. And so that was 17 years ago now. And I began to work with psychedelics. So I see tremendous potential in them. Freud said once that dreams are the royal road to the unconscious. And it's true. Dreams express our unconscious. And what happens in a dream state, it seems that the blood supply to the conscious parts of the brain diminishes, but it increases in those parts of the brain, that whole childhood emotional memories. So dreams always represent in a significant degree some childhood experience with some present day resonance. Trouble is, Freud's interpretation of dreams was atrocious. Like they were just complete nonsense, arbitrary projections of his own neurosis. Which doesn't mean dreams can't be a gate to the unconscious. But I think you have to be very good and very talented to be able to discern somebody else's dreams. And some people do that. But psychedelics are certainly a royal road to the unconscious because no matter which one you're talking about, whether it's ayahuasca or MDMA or Wachuma, San Pedro, mescaline, peyote, ketamine, the man made ones like ketamine and mdma, lsd, they have tremendous power to unlock the unconscious and so that you experience dynamics in you that you weren't even aware of. Like, let me tell you about. I had an LSD experience, a therapeutic one. And the therapist said, I won't leave you, I won't desert you. And she went to the kitchen like for 30 seconds. And I went into a total panic

[Alyson Briga]

because that brought up some of the

[Dr. Gabor Maté]

abandonment stuff that was still deeply in. Yeah, you know, so they have a chance, you know, the difference is you get to do it in an environment where you're safe.

[Alyson Briga]

I mean, I'm so glad that it came up so that you could see it and then integrate it.

[Dr. Gabor Maté]

Exactly. So it can really bring up stuff.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

On a deeper level, I know that you do spiritual work. Some psychic experiences can be deeply spiritual experiences of oneness and unity and, you know, melding with nature or even the ego dissolving momentarily. And it's just all a big. I don't know what. Because I never had that mystery. I never had that big unitary experience. So it can show you what you've been dealing with and where all these adaptations that we've been talking about came along to adjust to. But it can also show you the real self that doesn't need these adaptations anymore.

[Alyson Briga]

That's right.

[Dr. Gabor Maté]

So psychedelics are potentially very good. They can also be potentially very bad. I've seen people have experiences that the providers had no way of understanding or holding, and they were deeply hurt by. It took them a long time.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

To work their way out of it. I've seen sexual exploitation in the psychedelic world. I've seen profiteering in the psychedelic world. So it's like with everything else.

[Alyson Briga]

That's right. That's right. Set and setting is important. The intention, where we're coming from, when we're doing it. You know, I hear a lot of people in my circles are like, this is medicine. But not always doing it ceremonially or therapeutically.

[Dr. Gabor Maté]

And the integration afterwards is important.

[Alyson Briga]

Even I think that's one of the most important things. I think having a ceremony done with the right set and setting and intention and space holding and integrity. And integrity 100%. But then having the integration afterwards.

[Dr. Gabor Maté]

Absolutely.

[Alyson Briga]

Really important.

[Dr. Gabor Maté]

So we know and, and. And some of them can be very dramatic. So you probably know about iboga or ibogaine. And there's a substance that, quite apart from its therapeutic potential, which is tremendous in terms of dealing with trauma and addiction. Yeah. But it also is. The quality is that you could be on heroin for 20 years, and after you do boogie and a couple of times, you have no withdrawal.

[Alyson Briga]

I mean, I think that's incredible.

[Dr. Gabor Maté]

So now does it work 100 of the time?

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

No, maybe only 50 of the time,

[Alyson Briga]

but that's still like 10 times better. Yeah.

[Dr. Gabor Maté]

Than anything. Modern psychiatry is what to offer. So it's a field that needs to be explored and judiciously used. But I'm not an evangelist that way. And the reason I'm not is because the social problems and the stresses that we've been talking about, that generates so much distress and so much dysfunction and so much suffering, the traumas that are almost every day in the society. There'll never be enough psychedelic practitioners to deal with even a small percentage of the people that need it. And furthermore, it's very expensive. And who can afford.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

A minimum $250 a night for a ceremony, you know, at very minimum. You know, and so that's why I'm not an evangelist.

[Alyson Briga]

Yeah. Yeah.

[Dr. Gabor Maté]

They have their place.

[Alyson Briga]

No, I appreciate the contexting of it because I think that's important. I don't think enough research has been done but I think more will be and you know, as we learn more about how to use it, I think it will be even more helpful to accelerate. But it's. You have to have a holistic way of doing this. And in your book the Myth of Normal, like it's not that we have to address it with so many different angles and societally as well. I just have so much respect for you and your work, all of your work and I'm such a fan of it and I want to support it getting out in the world. Tell us about what you're up to. We'll put the link here below about the Myth of Normal. Some of your other books too. But I know my audience is going to want to stay connected well.

[Dr. Gabor Maté]

So as I mentioned just this month we're going to complete work on the next book. Hello again. A fresh start for parents and adult children where the approach we take is not trying to coach people and tell them how to behave, but how to transform their relationship to the relationship relationship. So that'll be coming out next year. Other than that, you know, it's hard to avoid me. I mean I'm all over YouTube and Instagram, very loved. Apparently I'm tick tock but I never seen TikTok, so I don't know. That's great.

[Alyson Briga]

That's perfect.

[Dr. Gabor Maté]

Yeah, I've never seen it. Yeah, lots of my talks on YouTube so I don't, you know. And now one thing I, if any therapists are interested.

[Alyson Briga]

Yeah.

[Dr. Gabor Maté]

I do teach a program called Compassionate Inquiry which is based on work that I've developed and other people have systematized it more and it's a year long, emotionally challenging, time consuming online program.

[Alyson Briga]

It's for therapists.

[Dr. Gabor Maté]

It's for therapists. Yeah. We've had over 3, 000 therapists, 980 countries studying it.

[Alyson Briga]

Amazing.

[Dr. Gabor Maté]

We do it three times a year. You can look it up. Compassion Inquiry professional training. It's not for everybody. In fact, after four weeks. And the reason it's not for everybody is because people join it thinking they're going to learn this technique. And actually they learn precisely what you and I have been talking about. They got to work on themselves too.

[Alyson Briga]

That's right. I love that you do that same. The best practitioners do their own work, not just once but ongoing.

[Dr. Gabor Maté]

So for the first three months is all about that. That's called Compassion Inquiry. And again, and a lot of people have done it, have absolutely attested that it's changed not just their professional work, but their own lives. And some people don't take to it at all.

[Alyson Briga]

I've seen it. It's really beautiful. It's really gentle. And it invites people into themselves more fully.

[Dr. Gabor Maté]

Well, that's the whole point.

[Alyson Briga]

Yeah, I got it.

[Dr. Gabor Maté]

And the underlying assumption is that the truth is inside everybody.

[Alyson Briga]

That's right.

[Dr. Gabor Maté]

And as the right questions in the right way, that truth will emerge.

[Alyson Briga]

That's right.

[Dr. Gabor Maté]

Yeah.

[Alyson Briga]

I just. I'm so aligned with you and. And how you move through the world. It is such a pleasure and an honor to have you here in my home. And I just thank you for who you are and how you move through the world.

[Dr. Gabor Maté]

Well, thanks very much. I mean, I naturally didn't know that you existed, but. But I'm glad you do.

[Alyson Briga]

I'm so grateful.

[Dr. Gabor Maté]

And thanks for inviting me.

[Alyson Briga]

Yeah. What a gift.

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[Alyson Briga]

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[Alyson Briga]

Sa.