Quiet or Scattered

Traveling with Carly Elizabeth, 22 months today, has been a rich adventure for her and for me. Neither she nor I speak the language. People all around are talking about all sorts of things but what she and I mostly get is energy, hints of emotional context, but very little content. This creates a very unusual vantage point, at least for me. I get to experience, more or less, what Carly is experiencing, and the best word I can think of is energy. Suddenly all the people and things we encounter are big or little, intense or calm, loud or soft tornados of swirling energy, bumping into the other and changing as they react to these collisions.

Themes: 
attention
ADHD
storytelling
media

Attachment and Authenticity 08

The stress dis-ease connection
Gabor Maté

There was a study in Toronto where they looked at the women who had survived breast cancer and they asked them, what is it that they think had caused the cancer and what helped them survive it and more women put down stress than any other factor. Now the researchers, being medical doctors, said this just shows you how out of touch everybody is. People blame stress for everything. In fact, there’s no evidence that stress has anything to do with breast cancer. We know that there’s a lot of evidence linking hormones and breast cancer, maybe some evidence linking into certain genetics and maybe some evidence linking diet to breast cancer, but not stress. Well guess who was right? The medical doctors were dead wrong. The women were totally right.

If you look at the hormone related cancers, which by the way many of them are, like testicular cancer or prostate cancer in men or breast cancer in women, a number of things emerge. One is of course that the medical profession treats them totally as biological events, narrowly biological events. There was a study in Toronto where they looked at the women who had survived breast cancer and they asked them, what is it that they think had caused the cancer and what helped them survive it and more women put down stress than any other factor. Now the researchers, being medical doctors, said this just shows you how out of touch everybody is. People blame stress for everything. In fact, there’s no evidence that stress has anything to do with breast cancer. We know that there’s a lot of evidence linking hormones and breast cancer, maybe some evidence linking into certain genetics and maybe some evidence linking diet to breast cancer, but not stress. Well guess who was right? The medical doctors were dead wrong. The women were totally right.

First of all genetics, out of 100 women with breast cancer 7 will have the breast cancer gene, 93 do not. Out of 100 women with the breast cancer gene not all of them will get cancer. Their risk certainly goes up but there’s no one-to-one relationship between having the gene and having the cancer. And most women with breast cancer have no identified gene, number one. When it comes to diet there’s a very weak relationship. I won’t deny it but it’s statistically not all that significant. Hormonally, yes, some breast cancers are obviously driven by estrogen for example, so we give them medication to suppress or to block their estrogen receptors so that the estrogen no longer drives the cancer. But, where the argument breaks down is when you look at the relationship between stress and hormones, hormones have everything to do with stress. Whether in men or women, you can predictably interfere with their healthy hormonal balance by imposing emotional stresses on them. The loss of a football game will reduce the testosterone levels of the fans or the loss of a soccer game. Nobody ever touched them physically. If you measure their testosterone levels before and after the game, the losing team’s fans will have diminished testosterone levels. Now, in female monkeys in captivity, if you look at female hormone levels like estrogen, progesterone, folic or stimulating hormones and so on, and if you look at the cortisol levels, the monkeys who are subordinate therefore are bullied will have high cortisol levels, abnormal female hormone levels and ovulatory abnormal menstruation patterns compared to the dominant monkeys who are not stressed. But if you switch the groups around so that the dominant monkeys now become bullied and previously subordinate ones now become the at the top of the totem pole, their hormonal levels change within a month. Cortisol levels in the newly dominant monkeys go down and their menstruations become normal and vice versa. So for the researchers to say that hormones have a lot to do with it but stress is nothing, they don’t understand the simple relationship between hormones and stress and cortisol is a stress hormone.  How can you say that it has nothing to do with stress? It’s absurd.

If you look at the histories of men with testicular cancer you find childhood trauma as in Lance Armstrong. That guy is a traumatized person, hence his drive to succeed, his need to validate himself, his need to be at the top because he was an abused child who’s mother was a 17 or 18 year old when she had him, his father abandoned him. She marries an abusive guy called Armstrong who beats the hell out of the kid and Lance Armstrong has been compensating for that all his life, including with hormones. And if you talk to women with breast cancer, in their lives there’s always childhood emotional loss, significant emotional loss for which they compensate by suppressing themselves, by not saying no until their body says no for them and I’ve had hundreds of women tell me that. Once they read that chapter in my book they just recognized themselves and they’re grateful to do so. Some say you blame me for my disease. Again I say I’m not because you’re not doing this deliberately. These are your adaptive patterns that you applied without any conscious choice in the matter at all as a matter of survival. How can you be blamed for that? On the other hand, if you stop doing it now, that can enhance your health, if you recognize it and are able to break out of it. So again, the relationship between childhood experience, hormones, stress, and adult illness is very straightforward.

Attachment and Authenticity 07

The unscientific invalidity of blaming parents
Gabor Maté

What was true for you was also true for your parents. So we’re talking about multi-generational, transpersonal, and culturally imposed stress and trauma and there’s no individual to blame.

I get a lot of emails and a lot of people, parents who are just so thankful for even giving that perspective. But if they work on their attachment relationship with their child, if they’re attuned to their children, if they pay attention to their children, aware of the child’s needs, the child’s symptoms can abate and their children can undergo tremendous growth. So people are actually open to it.  Some people are not.  Some people are just not ready to look at themselves so they just want the child medicated.  As a parent how would most people rather see their kids, as being genetically flawed and doomed to this condition all their lives or would they rather understand that the child’s brain condition is a response to early stress that the parents unwittingly passed on to their children?  But which can be mitigated and new development can still overcome it or in many ways alleviate it if we provide the right conditions as a parent.  Which message would you rather hear? That there’s something you can do or your kid is genetically doomed, here’s a pill? Which would you rather hear? And actually many people would rather hear the message that yeah, our stress is contributed to this.  We couldn’t help it. We did our best. But now that we understand it we can actually do something differently.  And I find that both teachers of parents are very open to the message when they hear it.  It’s only that they don’t hear it from too many people.  In the ADD world, of all the books out there, mine is the only one that ever goes to the model of brain development and stress.

any parent who has a child with any problems already feels a tremendous responsibility and self-blame. So for some people then to hear that actually you know what, yes, it was your stresses that did play a huge role on the development of your child’s problems is devastating. So they’d rather hear that it’s genetic. So the genetic theory is very comforting for a lot of people because they don’t understand, they don’t hear the part that it wasn’t their fault because they actually did their best. And what they were acting out themselves as parents is the stuff that happened to them as kids. Nor was blaming their parents because what was true for them is also true for their parents. So we’re talking about multi-generational, transpersonal, and culturally imposed stress and trauma and there’s no individual to blame. So, there’s those studies where you can look at the child’s strain situation where at one year of age you submit a child to the presence of a stranger in the absence of the parent and the parent comes back in and whether the child can be sued by the parent or whether the child remains the actual suer, disconnected from the parent, and how the child responds tells us everything about the ability of that parent to have connected with the child emotionally, attuned to the child in the child’s first year of life. And that strange situation, how the child responds at one year to the same situation will predict very often how well they do in school or in life a decade later or decades later. And then, you can do the adult attachment into you that tells us about a parents or adults relationship to the attachment figures in their lives when they were children and you have this amazing correlation where you can do an adult attachment into you and somebody who is not even a parent yet and how they respond on the adult attachment into you will predict how they’re un-conceived child will years later respond in the strange situation at one year of age. Then we can see how in-personal these factors are, non-personal they are. They affect persons but they’re not personal, they’re trans-generational, transpersonal, transmitted patterns. And when you understand that, there’s nobody left to blame.

But again, in a society that always looks to blame people, that when there’s something wrong we’re always looking for somebody to blame, rather than looking at causes we’re looking at who’s the enemy, who’s at fault, which is our approach to foreign policy and everything in this life. Then when you point out the early environment of people, people right away perceive that the parents are being blamed. So I’ve literally had reviewers who supposedly have read my book, where I talk about very deliberately and as articulately as I can generate, about the inappropriateness of blaming parents, about the unscientific invalidity of blaming parents and they will flat out say, he’s blaming parents. That’s all they can perceive because they haven’t dealt with their own shame and responsibilities. They think that I’m pointing a finger at them. They’re just pointing a finger at themselves. And they don’t realize that their attachment to genetic theory is just their way of fending off their self-blame. On the contrary I’m saying to them look, you’re not at fault. You did you best. It’s not your fault. It’s not personal to you. Now that takes a bit of sophistication, In that sense the genetic theories are very simple and therefore they are a relief to a lot of people. They’re a relief and they also leave us at a dead end.

Attachment and Authenticity 06

ADD is another coping mechanism
Gabor Maté

Because the initial environment was so stressed, not because the parent didn’t love them, it’s not because you’re blaming anybody, not because the parents didn’t do their best, but it was them themselves that was so stressed that the child dealt with the stress in the environment by tuning out when their brain was developing. And furthermore, when the Dopamine circuits, Dopamine they mean incentive motivation attention chemical, which we supplement with Ritalin or Dexedrine later on if we diagnose these people, those Dopamine circuits don’t develop well when the environment is totally stressed. So it’s a perfect storm that we’re creating in our society by stressing parents, by cutting asunder the tides of culture, tribe, clan, village, extended family, so neither children or parents have that supportive context. No wonder you’re going to have more children with troubled brains.

I had this naïve idea after my book on ADD came out, scattered in the states, people would say, wow! We finally get it! But in the ADD world, they don’t want to touch it. The book is a best seller in Canada and it’s doing well in the states but no thanks to the official organizations. They don’t even want to hear it because they think I’m blaming the parent. They want to believe that it’s a genetic disease. If it was a genetic disease then we don’t have to look at anything. We can just medicate. ADD is another coping mechanism. To go back to that Harvard study I mentioned earlier in there reported in Pediatrics, children’s response to their stress, adaptive responses that help them survive the stress, later become sources of pathology. Now, when I was diagnosed with ADD myself at age 54, it was really helpful to me because I understood a lot of things about myself, at least I thought I understood, at least I saw described about myself in a pattern that I hadn’t ever considered in any way represented some kind of a dynamic in me. So it was very helpful for me to be diagnosed and to be self-diagnosed primarily and then have that confirmed. But from the beginning I didn’t buy into the idea that it was a genetic disease. Not for a second because tuning out which is a hallmark of ADD, the absentmindedness is not a disease. It’s actually a coping mechanism. It’s one of the brain’s coping mechanisms. When the stress is too much and we can’t fight back, escape, or ask for help, then one of the ways the brain deals with it is to tune it out.

It’s a form of disassociation, or what has been called divided attention. So that’s a coping mechanism and that was clear to me. So when you look at a condition like ADD, the diagnosis of which is just going up leaps and bounds every few years with the number of prescriptions going up, in the states there are three million kids on stimulant medications, half a million on anti-psychotic medications, many of them for ADHD, not because they’re psychotic but because the impulse control is so poor and we’re so bereft of understanding child development that we have to sedate them instead of helping them. When you get these numbers going up all the time it can’t be genetic because genes don’t change in a population over a few years, nor is it just that we’re recognizing it more. Really it’s that we have more and more kids who are just lacking impulse control and lacking the capacity to pay attention. Well why? Well, if we understand that tuning out, divided attention, disassociation, is a coping mechanism, then the question you have to ask is what’s stressing these kids so much that they have to respond that way? And if we ask that question we can no longer look at DNA. Now we have to look at what’s happening in those kid’s lives. Well their parents are more stressed. The village, the clan, the neighborhood, the tribe, that safe holy environment where children had many nurturing adults to relate to, uncles and aunts, is gone. The parents themselves have less support and both parents are having to work. So parents don’t even see their kids the whole day. So kids are very stressed. And of course kids, especially if they’re very sensitive, they absorb their parent’s stresses like I did as a Jewish infant in the ghetto of Budapest under Nazi occupation in Hungary in 1944. How does an infant deal with that stress? You can’t fight back. You can’t ask for help. You can’t run away. You tune it out. But when are you tuning it out? You’re tuning out when the brain is developing so there’s an astonishing brain developmental data that’s not even vaguely controversial, that is being fully established now in the last few decades, that the brain develops under the impact of the environment. And if my mind is stressed, then the tuning out which is a coping mechanism, goes from a temporary state because wiring the brain is a long term trait so we go from state to trait.  Now all we have eight years later or 54 years later is a person who is diagnosed with ADD. Why? Because the initial environment was so stressed, not because the parent didn’t love them, it’s not because you’re blaming anybody, not because the parents didn’t do their best, but it was them themselves that was so stressed that the child dealt with the stress in the environment by tuning out when their brain was developing. And furthermore, when the Dopamine circuits, Dopamine they mean incentive motivation attention chemical, which we supplement with Ritalin or Dexedrine later on if we diagnose these people, those Dopamine circuits don’t develop well when the environment is totally stressed. So it’s a perfect storm that we’re creating in our society by stressing parents, by cutting asunder the tides of culture, tribe, clan, village, extended family, so neither children or parents have that supportive context. No wonder you’re going to have more children with troubled brains.  It’s very simple, both psycho dynamically in terms of the need to tune out and then in terms of the brain development. And then along comes the pharmaceutical industry and says here’s what we can do, we can suppress the symptoms by increasing Dopamine levels by giving these kids these medications which may or may not be okay in individual cases but it does nothing for brain development. It does nothing for the child’s psychological growth, nothing. It simply is a suppressing of the symptom. Conceptually it’s obvious. Scientifically it’s the only reasonable case to be made and yet people are invested in not seeing it.

Attachment and Authenticity 05

We don’t have a medical system
Gabor Maté

We don’t have a medical system. We have a non-system, a patchwork of competing interests in hospitals and institutions and pharmaceuticals and schools of thought and invested interests and genuinely committed people working very narrow ways, but there’s no system. The system is a non-system.

It takes me a minute to prescribe a cortisol cream, the stress hormone cream, which is suppressed inflammation, but for them to be talked about their lives, now that would take some time. When an HMO tells me I’ve got six minutes with a patient and if I’m a Psychiatrist I get a whole ten minutes, what can I do besides prescribe a medication? So there’s that, but the basic limitation is not a financial one. It’s also an ideological one and it has to do with those blinders we talked about earlier, the fact that physicians are not trained that way. They’ve got their own unresolved stuff. They don’t know how to relate to this information. Yes, the whole system is devastatingly stupid and blind. Now there are pockets of light. In Massachusetts also. For example, that Jon Kabat-Zinn’s work is done, the mindfulness based stress reduction. They’ve applied this to medical conditions, always with benefit, never with harm. The model, I don’t think it goes deep enough. They don’t deal with all this emotional stuff that is important to pay attention to. But just mindfulness based stress reduction itself is a great step forward and the more credit to them. But yeah, to apply those models universally would take a complete overhaul of…you say the medical system. We don’t have a medical system. We have a non-system. We have a patchwork of competing interests in hospitals and institutions and pharmaceuticals and schools of thought and invested interests and genuinely committed people working very narrow ways, but there’s no system. The system is a non-system.

The screening for breast cancer, the screening for prostate cancer, now the studies are becoming increasingly clear about everything we’ve been telling people is useless. Breast self-examinations, guess what, they don’t save lives. Mammograms, guess what, they don’t save lives. Now, this has been clear to some of us for years because we looked at the research but now it’s being publically admitted, is that making a bit of a difference? No, because number one, people have to believe that what they’ve been doing all these years is useful. Number two, if your living then depends on screening mammograms or on prostate cancer tests and treatments, you’re going to have a hard time accepting the evidence. So, there’s kind of a vested interest that way but for the most part the denial and the disorganization in the system is not I don’t think cupid. It’s not based on cupidity.  It’s not based on economic self-interest. I think it’s based more on these broader emotional and ideological factors.

MM: The blinders.

The blinders, yes.  I don’t think a doctor says this will cost me money therefore I won’t look at it. There may be doctors like that but I don’t think that’s what drives it.  I think what drives it is more the blinders which fit hand in glove of course with the economic self-interest as well.

Attachment and Authenticity 03

Survival requires attachment and authenticity
Gabor Maté

Without attachment there’s no human life. It’s just impossible. Without mating, without communities you would not have survived as a species. The whole idea of human beings is competitive and aggressive is total nonsense. The other need that we have is for authenticity to be ourselves. That also has to do with survival. If you’re not in touch with yourself in the wild you don’t survive. Authenticity is being in touch with yourself and being able to act on your awareness of self in relationship to the environment. That‘s just authenticity.

The child basically has two needs; we have the need for attachment which is the seeking of closeness and proximity with another human being and fundamentally the attachment dynamic is the most powerful dynamic in human life. And its basic purpose is the protection and nurturing of the young so that infants attach to their parents and parents attach to their infants so     the person is on one hand being taken care of and the other of taking care of.  So that’s attachment and we’re wired for attachment, all our lives.  It’s the most important dynamic we have and as (G. Petreis??) could tell you, we’re wired for attachment and sometimes when our attachment needs get sent in certain directions it will trump everything else.

One needed everyone has for attachment.  Without attachment there’s no human life.  It’s just impossible.  And without mating, without communities, you would not have survived as a species either.  As rugged individuals we would not have got off the first evolutionary base, let alone come to where we are right now.  So it’s, the whole idea of human beings is competitive and aggressive is total nonsense.  But the other need that we have is for authenticity to be ourselves.  That again has to do with survival.  If you’re not in touch with yourself out in the wild you don’t survive.  So authenticity is being in touch with yourself and being able to act on your awareness of self in relationship to the environment.  That‘s just authenticity.  So if I feel something I pay attention to that.  If I don’t, I’m in danger.  So we have this need for authenticity.  But if a child is confronted with a dilemma, that if I’m authentic, express my feelings, then my attachments are threatened because my parents can’t handle it because they’re too stressed, depressed or traumatized themselves, then perforce the child will not automatically, I should say will automatically but not consciously suppress their authenticity.  So the suppression of gut feelings and authenticity is a coping mechanism.  That means I’m no longer in touch with my needs.  I no longer pay attention to my feelings and my emotions.  I will no longer be aware of them.  I won’t express them.  I won’t know what I need, which has all kinds of implications but one of them is that I’ll be compulsively then, I may then compulsively serve the needs of others ignoring my own, hence disease.  Or, I may then develop all kinds of false needs which then are really what the addictions are all about.  Now, so that it’s that irresolvable tension between authenticity and attachment that many children in our society are faced with that results in their self-suppression.  And that’s one of the outcomes, not the only possible outcome but one possible outcome is then that niceness as a coping mechanism.

Attachment and Authenticity 02

The need more research is a denial of people’s own emotional pain
Gabor Maté

If you deny pain due to early loss and early trauma, then the world becomes very complicated. If we see that the child has certain needs and if you meet those needs that child will be just fine and if you don’t he’ll have to adapt somehow and those adaptations are the basis of dysfunction later on. That’s really simple.

If you’re denying climate change, the more educated you are, the more entrenched you are and you’re in denial. So it’s not that education leads to more openness, education leads to less openness. Because what it does is that the intellectual weapons that you gain and sharpen in the course of your post graduate education actually allows you to use your weapon and to marshal them in the service of your denial. But the denial comes first. So what I am saying is that there’s an emotional block. It’s not an existential block, we don’t need a stitch more research on what causes addiction. We don’t need one more bit of research on what causes violence, rape, psychopathic behavior, mental illness. We don’t need a stitch more research. I now that sounds like a radical statement in a society which is so research oriented and we’re whole intellectual industries, knowledge factories are based on having to gather more money for research to justify more jobs, to justify more papers, but I’m telling you, if we simply applied what we already know, if we simply do the lessons of what’s already been clearly shown, we would have a totally different world. So, even that need for more research is a factor of denial.

Whether from in the states or England I forget, they showed that childhood trauma maybe be a predisposing factor in addictions. More study is required. And I’m thinking what planet are these people living on? Are they not familiar with the hundreds of studies that are showing the relationship between trauma and addiction? Do they not know Adler Childhood Experience studies? Are they not aware of the data on brain development and trauma? What intellectual labyrinth have they been lost in for the last 50 years for them to come up with a study that says childhood trauma may be related to addictions, maybe, and that more study is required? So what I am saying is that the very need for research and intellectualization is actually a factor of denial. It represents denial and that denial is really people’s own emotional pain. So the block is that this stuff is painful and therefore we dare not look at it in ourselves and therefore we don’t open to its existence in others and then we have to look for all kinds of other reasons. If you deny pain owing into early experience and early loss and early trauma, then the world becomes very complicated and justify all kinds of complicated explanations. Yet, if we see that the child has certain needs and if you meet those needs that child will be just fine and if you don’t he’ll have to adapt somehow and those adaptations are the basis of dysfunction later on. That’s really simple. They call it simplistic. It’s not simplistic. It’s simple. The world is really very simple. We make it complicated because of our denial.

Attachment and Authenticity 01

At greater risk at every level
Gabor Maté

The more losses that accrue in early childhood the greater risk of addiction, the greater risk for cancer, greater risk of auto immune disease, mental illness, dysfunction, criminality, relationship problems, personality disorders, etc., etc.

Well it’s interesting to look at what happens when, I for example, speak to professional audiences and I speak to thousands of people every month and the most difficult audiences are the medical ones who deal with the manifestations of early childhood loss but they don’t know that that’s what they’re dealing with. They think they’re looking at diseases, symptoms, mental illness, dysfunctions, psychosis, behaviors that are categorized under one diagnosis or another. They don’t realize that the commonality is the early childhood loss in trauma. Present them with that information and you present it to them in detail with all the research perimeters being covered so that it’s not just impressionistic or antidotal but actually research based and they sit there stunned. They don’t know what to do with it. If that was only my own failure to communicate I could say okay well if somebody else presented it then maybe they would listen. But no.

Dr. Bruce Perry who’s the head of the Houston Child Trauma Academy, leading research on childhood trauma and brain development, he tells me the same thing. And Dr. Vincent Falliti who’s the lead investigator of the Adler’s Childhood Experience Studies in California has shown again the exponential impact of childhood loss. The more losses that accrue the greater risk of addiction, the greater risk for cancer, greater risk of auto immune disease, mental illness, dysfunction, criminality, relationship problems, personality disorders, etc., etc. He tells me the same thing. So when you’re dealing with a professional audience particularly who are intellectually trained, they sit there wrapped in their intellectual armor and they literally are petrified by this material.

Lifelong Implications of Attachment

Author: 
Gabor Maté

Gabor Maté M.D. is a physician and bestselling author on a range of topics, from addiction and attention deficit disorder (ADD) to mind-body wellness, adolescent mental health, and parenting. He focuses on understanding the broader context in which human disease and disorders arise. Gabor’s approach is holistic and kaleidoscopic – linking everything from neurophysiology, immunology, and developmental psychology to economic and social policy – and even touches on the spiritual dimensions of disease and healing.