Maté's Trauma Cause Causes Trauma

By Kevin Gallagher 10/09/14

Gabor Maté's Trauma Theory feels good, but how "good" is it?

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Cum hoc ergo propter hoc. In Latin it means, "with this, therefore because of this" and it is the logic problem of many reductive theories, especially in regards to addiction. Basically, it is the problem of finding a correlation, say between owning a red car and getting speeding tickets, and then inferring a causal relationship, saying that owning a red car causes increased speeding violations. Of course, there are going to be many other factors that should be taken into account. For example, red is the color of aggression and aggressive drivers could be drawn to that color. Without the correlation, we could not have come to a better explanation, but the correlation is not causation. I believe Gabor Maté has made this logic mistake.

Dr. Maté is a fantastic physician and a fine human being. His work is beyond commendable. There are times where I wonder how Dr. Maté has the strength to attend to these extreme levels of suffering. However, this suffering may have tinted his philosophical lens. I too work with those they label "chronically homeless." With chronic homelessness comes addiction and mental health issues. Sometimes, many times even, these issues include trauma. But I am not ready to accept a universally causal relationship betwixt the two.

There are a few people, Stanton Peele being the most vocal, who see similarities between Dr. Maté's Trauma Theory and the old Disease Theory. Maté's theory is that behind every addiction lies something traumatic. (e.g. neglect, abuse, Ferberizing). Something, in the past of the person who is suffering, created the groundwork for the oxytocin/cortisol attachment system to get thrown off track. This "something" has led to traumatic stress which inevitably leads to a neurological malformation that is later embodied in addictive behavior. Drugs, alcohol, sex and other addictive experiences will become self-medications for this prior trauma.

The first problem with this theory is that, no matter who you are, existence on this earth as a conscious human being will bring trauma. It may not be the "Law and Order SVU" kind, but it will be there. So, if trauma does inevitable damage to this biological system, how can we account for resiliency? Not everyone who experiences trauma at a very young age becomes addicted. And, not everyone who becomes addicted experiences early age trauma.

Another problem is how Dr. Maté argues against genetic reductionism, without understanding the similarities his theory and reductive genetics have. Twin adoption studies also showed a correlation between genetics and alcoholism. Some researchers, and way too many members of the media, ran with this idea right into the cum hoc ergo propter hoc problem. There was no examination of psychosocial problems, cultural differences or economics. Genetics could not account for all factors that affect the creation of addictive behaviors, and neither can trauma.

If Dr. Maté's theory was true, addiction would be more equally distributed along the lines of race, gender and class. However, just as I and Dr. Maté have seen, addiction issues disproportionately affect poor and minority communities even though more affluent communities use the majority of drugs. Even in these impoverished environments, Dr. Carl Hart has shown how people make cognitive choices in regards to their addictions. I'll bet a good percentage of the research participants in Dr. Hart's research had trauma in their past. Yet, they were able to act through this predisposition and make rational choices.

Dr. Maté is a humanist. His caring for those suffering and his ability to see incongruencies in national policy shows this. It is why he was brought on as the keynote speaker at a conference on addiction and social justice. But the theory he puts forward is not as humanistic as it first sounds. In many ways, it is based on the reductionist scientism that humanistic psychology is trying to move away from.

In my last post here on The Fix, I was arguing that addiction needs to be theorized from an existential and phenomenological model; one that takes into account subjective experiences. A horizontalized and inclusive approach would eliminate the need for direct causality, in favor of allowing for variance and subjectivity. By doing this, we can escape the cum hoc ergo propter hoc problems that have arisen from trying to theorize universally. We would better understand the ways that multiple factors influence and create addiction. Trauma Theory is not this way.

Instead, it insists that all "addicts" must have trauma in their past, creating the neurological cause of their addiction. Disease theory insisted that all "addicts" must have a genetic predisposition or a chemical imbalance that led to a loss of control. Both eliminate efficacy by forcing people to accept a reality that may not fit their experience.

In other words, Maté's trauma cause causes trauma...then again, that may be a little cum hoc ergo propter hoc as well...

Kevin Gallagher lives in Pittsburgh. He works as a homeless case manager and is a graduate student focusing on addiction, recovery and harm reduction at Point Park University.

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Kevin Gallagher lives in Pittsburgh. He works as a homeless case manager and is a graduate student focusing on addiction, recovery and harm reduction at Point Park University. You can find him on Linkedin.