An Audience with Gabor Maté

By Linda Stansberry 09/22/14

According to the rock star of addiction theory, every addict had a traumatic childhood whether they realize it or not.

Gabor Maté

It's intermission on the second day of a seminar on addiction, trauma, and social change. I have three cups of weak coffee inside me and I'm trying to make it to the women's bathroom before the line stretches down the hallway. My friend, the atheist, spots me, mistakes my expression for empathetic indignation and pulls me into his arms. 

“All he's saying is 'find another church,'” he hisses, shaking his head.

We go out for burritos after the day's lectures are finished and I find out why he's annoyed. The morning's keynote speaker spoke extensively on indigenous belief systems and suggested that separation from spirituality and the natural world was a root cause of addiction.

Maté calls for holistic change, for us not to simply medicate or legislate our issues away.

“If he were a Catholic priest talking about church he would be booed off the stage,” says my friend.

I pick at my mole burrito and nod dutifully. Political correctness is about as automatic to me as breathing, and the whole conversation makes me uncomfortable, but I appreciate the value of an equal-opportunity atheist. Anyway, tomorrow will be dedicated to the man we all came to see: Dr. Gabor Maté.

Insofar as it's possible to be a rock star in the field of addiction theory, Maté is that rock star. When I began my certification process as a drug and alcohol counselor, his bestseller In the Realm of the Hungry Ghosts was breathlessly pushed into my hands by a colleague. All the answers, I was told, were in there. The War on Drugs has failed. Addicts need to be “met where they're at,” to be supported rather than stigmatized. The biomedical model of addiction, which hinges on a genetic propensity for addiction, is extremely limited. A child's early brain development and exposure to trauma is one of the most important factors in their potential for addiction. Unconditional positive regard and humanism need to be applied on a system-wide level. 

And how could anyone who has worked with addicts say anything but yes? Maté's theories on infant brain development and the effects of trauma have been documented by numerous studies. Anecdotal evidence, obtained by talking with addicts, only serves to bolster the idea that, while genetics play a part, a traumatic childhood will create the biochemical irregularities that a person might then later treat with drugs and alcohol. Statistically, oppressed and marginalized communities with legacies of trauma have higher rates of addiction. Even without the studies and brain scans, conversation after conversation with my clients supported Maté's work. 

So when I heard the man himself was coming to town, I did a little dance of joy. I wasn't the only one. The recovery community was abuzz with his arrival. I exchanged excited smiles and high-fives with social workers and therapists, fellow Maté groupies. On the day of his presentation, the lecture hall was filled to capacity.

Maté is an engaging speaker, with wild hair, a soft voice and self-effacing manner. He often makes jokes and plays music to underscore his points. (“Mother,” by John Lennon, for example, created a wave of sniffles in the audience.) He paused often to take questions and interact with audience members, engaging in a back-and-forth line of therapeutic questioning, assertively separating “feelings” from “perceptions,” and regularly drawing the audience member's current dilemma back to childhood experiences. The audience was enamored. And that's what bothered me.

Maté is much more tactful about bringing atheists into the fold of his humanistic approach to recovery, but when he opened his address by suggesting the bio-medical model be revised as a bio-medical-social-spiritual model I saw the back of my friend's neck stiffen.

And when Dr. Maté suggested that Robin Williams' diagnosis of Parkinson’s disease and subsequent suicide could be traced back to a traumatic childhood and the inability of Williams to “say no,” my own neck stiffened. Most of us have an intuitive grasp of the role stress plays in illness. Dr. Maté's book, When the Body Says No: Exploring the Stress-Disease Connection, offers some compelling research into the importance of the mind-body connection. Maté did not say that Williams' Parkinson’s was caused by trauma, but rather induced. I'm not sure the audience heard him. Actually, I know they didn't.

“Did he just say that Robin Williams' Parkinson’s was caused by stress?” whispered the man next to me.

I shrugged. I was waiting for someone to cough or raise their hand and challenge this assertion. Nobody did. And, to be fair, I didn't either.

Rock stars or messiahs can't be faulted for the failings of their followers. Even if your overall message is positive and powerful, it's inevitable that some of it might be corrupted or taken to logical extremes by a deluded enthusiast. The charm of the bio-medical model of addiction and disease is that it removed the element of morality from how we treat addicts. Understanding that addiction is a brain disease, a chemical imbalance, is eminently more reassuring and useful than being told that it is a weakness of character. Maté alleges that this model is limited—it “lets society off the hook.” What causes a person to seek alcohol or drugs as a solution in the first place? Early childhood trauma and neglect, which result in insufficient neural development. Our current culture, where people are increasingly isolated, spiritually estranged and emotionally stunted, can only create a society of addicts. 

Yes, but... sometimes people who do everything right, good people, get sick and die. The bio-medical model points studiously away from the issue of morality, but the bio-medical-social-spiritual model risks being perverted into pointing right back to it. From juice cleanses to trans fats to gluten allergies, good health has become the moral indicator de rigueur.  Robin Williams' depression, Parkinson’s and suicide were the result of a crippling chemical disorder and unlucky roll of the genetic dice, which was probably exacerbated by a lack of resiliency factors and stressful lifestyle. It's insulting that some people might come away from Maté's lecture with the simplistic idea that if he had just “learned to say no”—if he had meditated, prayed, done Tai Chi or gone to a mountain top retreat—he wouldn't have died. 

Maté often draws on examples from his own life to underscore his points about trauma, as well as engaging his audience members. At one point he asked if anyone in the crowd had had a perfectly happy and loving childhood yet still turned out to be an addict. One brave soul raised his hand.

“Now, I'm going to show you that you are wrong,” Maté said in his soft Hungarian accent. The audience tittered. The man blushed.

“So you are definitely an addict, you were a real addict or alcoholic, really bad?” The doctor continued, and the audience member confirmed that, yes, he was, that he had drank and used for about 12 years.

“And what about your childhood? You say it was a happy one?”

“Well, yes, I had a really good childhood. I had a sister that died when I was about eight, and I was sad about that,” said the man.

Maté brushed over this.

“Tell me about your early childhood, before you were three or four.”

“Well, I don't really remember a lot...”

“Ah ha,” said the doctor, and the audience tittered again. Earlier he had said that “if a person can't remember their childhood, that tells me all I need to know.”

I found myself feeling extremely uncomfortable for the man having his life dissected in front of 200 giggling people.

“Did you get spanked as a child?” 

“No...well, my mother used to hit us sometimes with a flyswatter.”

“Uh huh....” The doctor's tone was droll. A couple of audience members laughed openly. My discomfort grew.

Gabor Maté proceeded to explain that whether he was aware of it or not, the way his mother disciplined him in early childhood had an impact on his brain chemistry which led inevitably to his addictive behavior in later life. The audience nodded assiduously.

The next day, I overheard the man doing a post-mortem with another audience member over breakfast. He didn't seem too fazed by the experience, nor did he think that Gabor Maté had uncovered anything earth-shattering about the origins of his addiction. 

“The flyswatter wasn't a big deal, really,” he said, “I never even think about it.”

This encounter encapsulated my misgivings about the whole experience. Getting to know Maté better didn't shake my faith in his work. In fact, my respect for him grew after I sent him an email full of cynical questions for this article and he replied to it on the same day.

What it did do is shake my faith in the ability of people, even smart people, to interpret his work in a smart way. Maté calls for holistic change, for us not to simply medicate or legislate our issues away. But holistic change requires the intervention of a cynic or two, because even the most open-hearted people can occasionally fall into binary thinking. The man who was hit with a flyswatter as a child might have drunk to alleviate the sadness of his sister's death, might have transitioned from habituation and into abuse and become chemically dependent on a substance due to repeated use. Studies of rats and many case studies support the theory that repeated exposure to an addictive substance is a key pathway to addiction. Many, many diseases require medical intervention and medication, and thank God that medication is available. A healthy community requires all institutions working in concert: the home, the hospital, the court, and the church. I just worry that all some people will hear is “find another church.”

Linda Stansberry is a regular contributor to The Fix. She has recently written about the ayahuasca trail and the glut of misery memoirs.

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