Dr. Gabor Maté: The Shocking Link Between ADHD, Addiction, Autoimmune Diseases, & Trauma

Hey, it's your friend Mel, and welcome to the Mel Robbins Podcast. You know, when I started this podcast, I sat down and I made a list of dream guests, and I am so excited that you chose to listen to this episode because today, one of those dream guests is sitting here in our Boston studios.
His name is Dr. Gabor Mate.
Now, Dr. Mate is a five-time New York Times bestselling author.
He is one of the world's most respected and prolific experts on childhood development, trauma, and the impact that it has on who you become as an adult. And his work has profoundly changed my life.
Around the world, he is considered the people whisperer because when he talks about

the connection between your childhood and the things you struggle with right now as an adult, you're going to feel so seen and so understood. And today, he's here to share a very provocative opinion.
Dr. Mate believes that you are not born with conditions like ADHD or addiction or an autoimmune disorder or the inability to say no or being a people pleaser.
Dr. Mate says these are conditions that are created by your childhood experience.
Now, one of the things that I love about his work

is that not only does he bring the science, he also removes the shame. None of what you experienced

and how it impacted you is your fault. And when you understand the factors in your childhood that

create people-pleasing, ADHD, addiction, and health issues, and all the research and science

that supports it, you are going to have a completely different roadmap to your own healing. In fact, you're going to leave this conversation with five questions that Dr.
Mate will tell you you need to ask yourself that are going to help you take the very first step. Does it ever feel like you're a marketing professional just speaking into the void? Well, with LinkedIn ads, you can know you're reaching the right decision makers.
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Hey, it's your friend Mel. I'm so excited that you're here with me today it is always an honor to be able to spend some time with you to be together to learn together if you're brand new i want to take a moment and welcome you to the mel robbins podcast family super excited that you're here and because you chose to listen to this episode i know something you.
You're the type of person who values your time. And you're also in learning about simple ways that you can improve your own life.
And I absolutely love that. And you know what I also love? I love that you and I are going to get to spend time today learning from the extraordinary Dr.
Gabor Mate. He's a world-renowned physician and New York Times bestselling author and a renowned addiction expert who dives deep into childhood development and the impact of physiological and psychological trauma and how it shapes our mental and physical health over your lifetime.
And today specifically, you and I are going to dive deep with Dr. Mate into how ADHD, people-pleasing, addiction, your inability to say no, and autoimmune disorders are not things that you're born with.
They were created by your childhood. So please help me welcome Dr.
Gabor Mate to the Mel Robbins podcast. Thank you.
It's so nice to be here. It is such an honor to sit down with you and spend some time together today.
Thank you. I'm really excited about the topic today and your work around how childhood conditions and experiences in your childhood are connected to ADHD, addiction, and autoimmune diseases and disorders.
And I have so many questions I want to ask you. Why don't we start with just your definition of what you're talking about when you mean childhood conditions so that as the person is listening to us today and spending time with us together, we're all using the same words and concepts and we kind of start on the same page.
So child conditions include the physical conditions, nutrition, housing, comfort, protection, but they also include the emotional conditions, which it has to do with a child's sense of being accepted or being loved, not just his love, but actually being seen, understood. And also on the parents' emotional states.
Are the parents stressed? Are the parents struggling with economic difficulties? Are the parents carrying traumas that they hadn't worked through yet, like I had when I was a young parent. Are the parents in a marriage that's relatively peaceful? Is there a lot of conflict? Is there a lot of instability? Is there unpredictability? What kind of community support there is? Is there an extended family that can spell off the parents and give them some kind of emotional support? Are they rather isolated? Are you a single parent struggling to make a living and raise a child? So all these conditions affect the personality and the brain development of the child.
I know you wrote the original book on childhood development and ADHD, Scattered Minds, 25 years ago. It is still on the bestseller list when it comes to ADHD topics.
I don't know if I'm going to say this correctly, but is it fair to say that your opinion is that your childhood and the conditions and the experiences that you have directly create or cause ADHD addiction and autoimmune issues? Yes, along with certain genetic predispositions. Okay.
But I can talk about genetics later, but what I want to say about them now is a predisposition is not as a predetermination. Okay.
So you can have predispositions, but then depending on the environmental conditions, those predispositions can be expressed one way or another way. So you can have animals with the same genes or humans with the same genes that have very different outcomes depending on the kind of conditions under which the early years were spent under.
So that's what I'm saying, yes. And the first recognition of that in my life came when I was diagnosed with ADHD at age 53 or 52 or something.
So I was diagnosed with ADHD at the age of 46. Okay.
When our son, Oakley, was going through the process of going through neuropsych evaluations for schools and IEPs. And as they were doing his evaluations, I started going, oh, wait a minute.
That's a lot like me. And then I went through the formal process of being evaluated and diagnosed, dyslexia, ADHD.
And I had never, ever, ever heard anyone connect your childhood and adverse conditions or conditions where you didn't get your needs met being a contributing factor or a cause of ADHD? How is that even possible? Well, it's possible because Western medicine separates the mind from the body. So they tend to look at things purely from a biological point of view.
So ADHD is considered to be a genetic disease that you inherited. Here's the problem with that.

Number one, if that's the case, why are the numbers going up?

Genes don't change in a population over 10, 20, or 30 years.

So something's going on in the environment that's affecting the child development.

Number one, number two, even if you look at the physiology of the child's brain,

what's not understood by most physicians, because it's not taught in the medical schools,

but it's firmly and completely, unequivococally and uncontroversially established in brain science, is that the brain is a social product. That the brain development of the child depends on the emotional conditions under which the child lives from in utero onwards.
And so that the very circuitry of the child's brain is programmed by the action of the environment on the genes so different environments were like differently on the same genes no if you look at adhd yes what's the medication that we give i took it for a while stimulants yeah what do stimulants do they elevate the level of a chemical called dopamine in the And dopamine is essential for motivation and therefore for focus.

And that's what Ritalin and Dexadrine and Adderall and all these medications elevate. Now, the dopamine circuitry of the child's brain develops in interaction with the environment.
And this is what most people who deal with ADHD just don't look at, even though it's just a pure scientific fact. You know, and a summary from Harvard University pointed out that the child's brain develops in interaction with the environment, especially the emotional relationship with the nurturing adults.
Now, dopamine is a brain chemical. We have receptors for when in our brain receptors are molecules where the dopamine can land and do its job.
The number of dopamine receptors in a child is affected by stress on the mother already in pregnancy, let alone afterwards. If you take mice and you isolate them, the number of dopamine receptors will go down.
If you bring them back into companionship, the number of dopamine receptors will elevate. In other words, the brain is a social organ.
It's interactive with the environment. All our lives, and therefore environmental conditions, affect the brain, especially during its phase of early development.
It's just pure science. It's not even controversial.
So the problem here is the tendency of the medical profession in which I was trained is to separate the mind from the body and to look at brain biology in isolation from the life circumstances that shape that brain biology. So that's one problem here.
So I'm going to try to distill what you just said. Because I've never it explained quite like that and i believe you what you're saying is that your brain is a social organ that is developed in partnership with your relationship to the adults around you exactly when you are when And you're literally inside your mother's womb all the way until you are developing as a little kid.
And if you are in a condition, whether it is the condition of being inside your mother's womb and your mother is depressed or experiencing racism or abuse or poverty or any of these things that

create chronic stress on a human being, it impacts the development of your brain. And what you're also saying is that ADHD and the way that it is treated is typically through prescription drugs that flood the brain with dopamine.

And that is what helps your underdeveloped brain or whatever we want to call it, or the brain that's been impacted by stressful conditions during your childhood or your development in womb. And that the stressful conditions are what has interfered with the brain development.
And continues to. Now...
Can I ask you a quick question? Yeah. So, I understand that when, as a human being, you're experiencing stress, or you are experiencing a threat, or you're feeling isolated and lonely

and like you're invisible or nobody cares about you, that your body naturally switches from being

present and in the prefrontal cortex to the amygdala taking over, and you're now in like

fight or flight. When you're in fight or flight and you're kind of in that stress response state,

does it interfere with dopamine? It interferes with dopamine. It interferes with cortisol.
It has an effect on the memory centers in the brain like the hippocampus. It affects the amygdala, all those things.
And if you look at children in poverty or who experience racialized circumstances, they're more likely to be diagnosed with ADHD. The children of women with postpartum depression are more likely to be diagnosed with ADHD.
The children of women who are stressed during pregnancy are more likely to be diagnosed with ADHD. And there's this myth about it being genetic because it tends to run in families.
Like you were diagnosed, your kids were diagnosed. I was diagnosed, a couple of my kids were diagnosed.
but it's not because it tends to run in families like you were diagnosed your kids were diagnosed i was diagnosed a couple of my kids were diagnosed but it's not because the so-called disease it's not even a disease but it's not because the so-called disease was passed on but because the conditions that created the brain they created your brain were also then repeated in your children's childhood as in mine.

So something running in a family says nothing about genetic causation.

And going back to the flight or fight thing, if a child is feeling stressed, and by the

way, I think there's something genetic here, and what is genetic here is sensitivity.

And the more sensitive kids are, the more they feel what's going on around them.

So if the family, if the parents are stressed, the child feels the stress.

Thank you. Genetic year is sensitivity.
And the more sensitive kids are, the more they feel what's going on around them. So if the parents are stressed, the child feels the stress.
Can the child escape or fight back? No. What do they do? They tune out.
But when did they tune out? They tune out when their brain is developing. So that gets wired into the brain.
And now they're told you got this genetic disease. No, you don't.
It's an adaptation that began as an adaptation. And as with many of these sheltered adaptations, later on they create problems.
So they serve their purpose. But now they are wired in.
And not to mention, if you look at the traits of ADHD, which is the absent-mindedness, the tuning out, and then the other traits of ADHD are poor impulse regulation, which means that when you want to do something, like I might have an impulse to do something, there's nothing wrong with the impulse. But there's something wrong with me acting out the impulse.
But impulse regulation depends on certain circuitry in the brain. No baby has any impulse regulation.
It has to develop. For anything that's developmental, the conditions have to be right.
If a plant in your backyard wasn't growing the way you expected it, you'd look at what's missing here. Nutrition, sunlight, irrigation.
It's the same with kids. When they've got these challenges, let's look at the conditions that shape their development.
So impulse regulation is another brain circuitry that doesn't develop well in people with ADHD. And incidentally, in people who are addicted, which is why there's such a great link between addictions and ADHD.
And then the third one is, which is sometimes they're not always hyperactivity. More tends to be there more in boys.
Boys, not girls. And the regulation of the body is a function of the midfrontal cortex.
That has to develop. So under conditions of stress, given that the brain is a social organ, and it's also a historical organ.
Do you know, does the name Bruce Perry mean anything to you? Is he in Wisconsin? I don't know where he is, but he's a well-known child trauma psychiatrist. Yes, I believe he's in Milwaukee, Wisconsin, I think.
But don't quote me on that. Did he write the book with Oprah Winfrey? Yeah, he wrote the book, What Happened to You? And he says the brain is a historical organ.
So it stores the impacts of life experiences. So when we look look at brain biology let's not think that the biology is somehow distinct and separated from life experience so there's no fault laying here and sometimes i do get accused of blaming parents it's the last thing i want to do i don't hear you blaming parents i hear you talking very factually no but but but there's a very well-known adhd psychologist who goes on youtube and says i blame parents and i don't actually i think parents do their best they love their kids but their best is limited by their own particular challenges and limitations you know there's no parent blaming here but we have to recognize the importance and impact of early experiences so what i'm saying saying is that ADHD is a result of all that stress and its impact on the brains of especially genetically sensitive kids.
That's what's inherited is the sensitivity. But if there was only the sensitivity and optimal conditions, they'd never have ADHD.
So it's not the ADHD that's inherited. It's the sensitivity.
That's the good news. If you were a parent with a kid with ADHD, and if I was a doctor, and I said to you, madam, your kid's got this genetic condition, brain biology, nothing we can do about it, but here's some medication.
Or if I said to you, Mel, your child's got this condition, your child's very sensitive, very responsive to the environment, and even now at age 8 or age 16 or whenever, if we create different conditions, the brain can still develop in different ways. Which message would you rather go with? The second.
Yeah, of course. This is a much more optimistic and much more science-based attitude.
But unfortunately, again, given the dominance of pharmaceutical companies and the biological mindedness, or what they call biological psychiatry, which is just fixating on the biology and fixing it rather than looking at the conditions that shape the biology, we're very much stuck in a state where hundreds of thousands and millions of kids are being medicated. And I'm not against medications.
I prescribe them. I've taken them.
But they're not the answer. What's fascinating is that when you really wrap your brain around it, it makes a lot of sense.
I'm sure you're familiar with that metaphor. It's not the most elegant metaphor that the genetics loads the gun.
Yeah. But the environment that pulls the trigger, which means you come into this world predisposed to certain things, but it's the environment that either deactivates or activates what you're predisposed to.
So that makes perfect sense. And the other thing that makes perfect sense in terms of my lived experience is being diagnosed with ADHD late in life and also having a son and two daughters that have ADHD.

We... Being diagnosed with ADHD late in life and also having a son and two daughters that have ADHD.
We were in Boston in a very competitive public school system in the go, go, go, both spouses working, running to the club sports, doing this, doing that, busy, busy, busy, busy, busy. Yeah.
When we moved to Southern Vermont, open space. Amazing.
Things change. You change because the environment changes.
And if you just think about being on vacation, you leave the go, go, go, go, go, go, of your day to day and your work and your social and all that stuff. And you step away to a space that typically has a little bit more open space and a different pace to your life, you change.
That's right. And so I feel, because I was about to ask you, well, why does this matter to know this? But I feel that it matters deeply because if environmental conditions can shape your brain as a child, and we know that the brain develops and grows and changes through neuroplasticity through your entire life, then environmental changes, I suppose, also help you change and address these conditions.
Absolutely. And so when a family with ADHD child would come to me, once I had this recognition, I would say, well, we can consider medication in the short term if we need to, but it's not the first step.

It never should be the only step.

Can we look at the family atmosphere?

Can we look at the relationship between the parents?

Can we look at the stresses in the family?

Can you understand the child's behavior in a way that doesn't blame the child?

Because these kids tend to be blamed a lot for how they behave. Now, we talk about this phrase acting out.
Kids are acting out, which usually means they're being obstreperous, oppositional, defiant, or non-cooperative or rude or something. It means they're not doing what the parent wants them to do.
Yeah, but let's look at the phrase acting out is English meaning. We have something out when we don't have the language to say it in words.
So in a game of charades, we're not allowed to speak. What do you have to do? Act it out.
You have to act it out. These kids' behaviors are simply acting out their emotional needs and dynamics.
It's up to the parents to understand that rather than just to respond or react to the behavior in a controlling or punitive way, let's understand what is being acted out, which is one of the reasons I wrote that book, is I want parents to understand what is being acted out in this child's behavior. And if you change the relationship to the child, the child's behavior will change.
So it's not behavior control, it's actually promoting different conditions that'll support the child's healthy development you know this reminds me of something that's always really just made me feel very heartbroken about the state of society in the world particularly in the united states and that is when i was going through this experience where my husband and I were having our son go through the process of all the evaluations, the school kept saying, this is behavioral behavior. And we were like, I don't think so.
I don't think so. And so we were in a position to be able to have him tested here in Boston at Mass General outside the school.
And just three years prior, we would not have been able to afford to do that. And that diagnosis and understanding that his brain and the way that he learned and the development of his brain was just different and changed the trajectory of his life and my life.
And before I did what I do now, earlier in my career, I was a public defender in Manhattan. Yeah, I read that.
Doing criminal defense work. Yeah.
The statistics of people who are incarcerated. Yeah.
With ADHD. Yes, with ADHD, with learning differences who were never diagnosed.
That's right. When you trace it back to what you're saying, childhood conditions, a parent who is absent, chronic racism, which is a form of trauma.
Yeah. It makes very depressing and sad and unfair sense.
And I think a lot about the fact that it's simply because we were able to at that moment in our lives to be able to afford a test that sent him in one direction when kids who don't have that are sent in a different one. Yeah, we're actually hurting people for having been hurt.
Yes. And then they act out that hurt, and then we blame them for it, rather than understand what that's all about.
Let me say something else. The diagnosis doesn't explain anything.
What do you mean the diagnosis doesn't mean anything? So, Mel or Gabor have ADHD. How do we know? Well, they're absent-minded, they have poor impulse regulation, and they're hyperactive.
Why are they absent-minded and have poor impulse regulation? And why do they have activity? Because they have ADHD. How do we know they have ADHD? Because they're hyperactive, they tune out, and they have poor impulse control.
Why do they? It's circular. It's not an explanation.
It's a description. I mean, mistake.
Medical practice tends to mistake descriptions for explanations. They're not.
If you want to know why they're hyperactive or lacking post-regulation or tend to tune out, you got to look at their lives as those lives acted on their genes. That's the explanation.
The diagnosis describes something, but it doesn't explain anything. But understanding this helps you also understand the role that environment and how this happened.
I think descriptions are helpful. We just mustn't mistake them for explanations.
That's all. That makes a lot of sense.
Dr. Mate, let's take a quick pause.

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Terms and conditions apply. Welcome back.
It's your friend Mel Robbins. And and today you and i are spending time with the

extraordinary gabor mate and we're learning all about how your childhood impacted who you became

as an adult so i have another question for you you know you mentioned addiction yeah and there

is a lot of research that shows a direct link between ADHD and addiction. Yeah.
And what does your research and experience show about your childhood experience and conditions? Yeah. And the connection to addiction? So for 12 years, I worked in Vancouver, British Columbia's downtown Eastside, which is North America's most concentrated area of drug use.

We have more drug users there in a few square buck radius than anywhere in the States or anywhere else in Canada.

In fact, anywhere in Europe.

Wow.

So I was there for 12 years.

And a significant percentage of my patients clearly had ADHD that had not been diagnosed.

Now, let's look at the commonalities.

First of all, both addicts and people with ADHD lack impulse control.

Thank you. clearly at ADHD that had not been diagnosed.
Now, let's look at the commonalities. First of all, both addicts and people with ADHD lack impulse control.
Like somebody said about addiction, is that the problem in addiction is not lack of free will, but lack of a free won't. Lack of a free? Won't.
Won't. Oh.
They have nothing to say no with, because that circuitry didn't develop. Okay, number one.
Number two, addictions all work on the dopamine system, which is what is affected in ADHD as well. So stimulant addicts like crystal meth addicts, cocaine addicts, nicotine addicts, caffeine addicts, they're literally boosting their dopamine levels, which is precisely what's the issue in ADHD is as well.
So if you look at the studies, something like about 30% or more of stimulant addicts actually are diagnosable with ADHD. But again, this is studied and reported, but not much is done with it in medical practice.
Furthermore, all addictions, no matter what they are, they work on the dopamine circuitry. I will define addiction for you as manifested in any behavior in which a person finds temporary relief or pleasure and therefore craves, but then suffers negative consequences as a result of and doesn't give up despite the harm.
So craving pleasure relief in the short term, harm, inability to give it up. That's what an addiction is.
Now, let me just go sideways a little bit. Okay.
Let me ask you a question. Yeah.
And you've already answered it, but according to that, notice I didn't say anything about drugs. I said any behavior.
Yeah. Now, if I speak to a room of a thousand people and I give that definition and I say, I'll go into that definition, which is not controversial.
If you ever had an addictive pattern in your life, just raise your hand. An out of a thousand, 999.
Yes. We'll raise their hands and there's one liar who won't, you know, but basically it's almost everybody.
Now, here's the second question. And I don't care what your addictive patterns were, whether they were to alcohol, which you mentioned, or to whatever else.
Know what was wrong with it, but what was right about it? What did it give you in the short term that you wanted? So what did it give you? Oh, well, with alcohol, it was like a sense of belonging and relief, and it was a way to turn my brain off. Okay.
And to escape. Okay.
When do people need to escape? When they're stressed. When they're suffering.
Yeah. Okay.
So the addiction wasn't the disease that you had. It wasn't your primary problem.
It was an attempt to solve the problem of emotional pain and isolation. So my mentor on the addiction is, don't ask why the addiction, ask why the pain.
And if you understand the pain, look at the person's life rather than just their genes. Okay? So both people who are addicted and people who do ADHD often share these genes for sensitivity, which means they suffer more when circumstances aren't right.
And so they're both, obviously those conditions will go together. And furthermore, to go back to dopamine, the shopping addict, the gambling addict, the pornography addict.
The social media addict. The social media.
And I've had my behavior addiction. The gaming addiction addict.
The busyness. You know what they're after? They're after a hit of dopamine in the brain, which they get through seeking that behavior.
And then you feel bad, though, that you did it. Well, yeah.
And I had my behavior addictions. But what I'm saying is, it's all based partly on the dopamine circuitry.
Which didn't develop. Which didn't develop the way it should have.
Because of your childhood. Exactly.
So now you have to get your dopamine hit through pornography. And if you do brain scans on pornography addicts, they get multiple spikes of dopamine hits in their brain when they're...
Just like a drug addict. Yeah.
Yeah. It makes absolutely perfect sense.
How do you... What do you do if you're listening to this and you either...
You yourself are recognizing this is you. or you're like, you are describing my spouse or my adult child or my parent or whomever in my life like what do you do with this particular information of the connection between childhood conditions and development and adhd and addiction may i just say one more thing about the brain please yeah opi Okay.
So people get addicted to heroin or Oxycontin or Dilaudid, hydromorphone or codeine or whatever, you know, fentanyl, unfortunately, which is a very dangerous one. These are opiates.
They come from the opium plant in Afghanistan or they're human manufactured copies of the same molecule. Now, Why do opiates, why does a plant from Afghanistan work in the human brain here in the States? I don't know.
Well, because the opiate molecule, we have receptors for it in our brains, which means we have our internal opiate system. This is just pure brain science.
And the opiate system is called endorphins. Endorphin means endogenous internal morphine-like substance.
So we have an opiate system in our bodies, which affects many functions in our body from the gut to the immune system. But what do they do in the brain? If we understand opiate addiction, we have to understand what do endorphins do in the human trajectory.
First of all, they provide pain relief, both physical and emotional pain relief. Internal endorphins do that.
We have to have pain in life because without pain, we don't survive because we can hurt ourselves. But we also have pain relief.
So endorphins relieve pain, but not just physical pain, also emotional pain. Because the part of the brain where people experience physical pain, the suffering of physical pain, it's also where they experience the suffering of emotional pain.
So the endorphins, the opiates work there. That's their first role.
The second role, along with dopamine, is to give you a sense of pleasure, elation, and joy. But that's rather important in human life because human life is difficult.
So we have to have some expectation of pleasure, joy, relief. That's what the opiates do.
That's the second thing they do. But the third thing they do, they facilitate a little thing called love.
Endorphins help to feel connected to other people. And particularly they help feel parents connected to their kids without which the child doesn't survive.
And if you take little animals and you knock out their opiate receptors, they will not call for their mothers on separation. What would that do to them? It would kill them in the wild.
So that's how important the opiates are. Now, who are these people that develop opiate addictions? People whose lives have undermined their opiate circuitry.
And I had a sex trade worker in the downtown East of Vancouver. I asked her, what did the heroin do for you? She said, time i did heroin it felt like a warm soft hug so just like the alcohol which gave you a more sense of belonging it gave her a sense of being loved a sense of warmth that's why people get addicted is because they suffered that early pain and that trying to escape from and because their brain circuitry was affected by adverse conditions so that these circuits didn't develop optimally and now they have to substitute you know so that's that's that's a shinny on addiction it's not an inherited disease it's a response to the environment and it's not genetic contrary to what 99 of physicians believe The reason why this is so important is because there is so much shame and self-blame when you have an addiction or you have something that you're struggling with like ADHD.
And when you understand the brain circuitry and the connection to brain development and human development and childhood conditions and experiences and how that has a direct impact on the working and wiring of the functioning of your brain, you can separate yourself as a human being from the thing that caused this. That's the whole point.
And then that allows you from that moment of separation and detachment and objectivity to go, wait a minute. I'm not to blame for this.
That's right. This is a circuitry and a conditioning problem.
It's my responsibility. And now it's my responsibility.
Exactly, yeah. To do what I need to do with this.
Yeah. To heal it and make it better.
Exactly right. And to go back to your question about now, what do we do with this information? If you are parents of a child who's been diagnosed with, say, ADHD, then make a considered decision about whether you want the kid medicated or not.
Medications can sometimes help. Sometimes they cause side effects.
No child should be forced to be on medication because no child at any age

should get the message

that they're only acceptable to the adults

when their brain is sedated.

You don't want to give that message to any child.

But they can help sometimes to mitigate

symptoms.

They know nothing for brain development in the long term.

So then the question is

can we create in this family

better conditions for that child's brain to develop in more optimal ways? And yes, we can. And that has a lot to do with the emotional atmosphere in the family and the degree of understanding and connection.
Not love, because that's already there, but the actual understanding and connection between the parents and the child. And I mean, that book's been out 25 years and I've been told by so often that it totally changed the family just to read that book you know and it totally changed their children well it's very empowering because i think if you're the person struggling with the addiction or adhd or a condition like that you feel deficient you feel that you've done something wrong and you can never heal while you're punishing yourself at the same time.
And the world is punishing you. Yes.
Teachers are punishing you. That's true.
Your parents are exasperated with you. Yes.
When it comes to treating addiction, then it's very complex. But the person, again, needs to understand there's nothing wrong with them.
They weren't born with any kind of disease. That addiction is a perfectly normal response to abnormal circumstances.
I mean, look at all the veterans who are traumatized and they become alcoholics or opiate addicts. And then there's the opposite study about the veterans from Vietnam who were using opioids in Vietnam, but then came home to a supportive environment.
Exactly. And were not addicted.
Exactly. I quote that study in my book on addiction because it's such a salient fact.
In fact, it's been done with laboratory rats, where they took laboratory rats and exposed them to different environmental conditions. And they tried to get them addicted to opioids.
Now, those rats that were stressed and isolated and under adverse conditions, they easily became addicted to opioids. The rats were in good conditions.
You couldn't even make them addicted to opioids. It doesn't matter how much you gave them.
The main thing is that if the environment is actually creating the conditions in your brain and body for addiction and ADHD, then the environment is a huge piece of you healing this and growing in new ways and figuring out new adaptations for how to heal. Well, and I think it's not an individual process.
It should be for the most part. You need the social help.
That's what the 12-step groups are. I have my critiques of them, but the 12 steps themselves, I think, are wonderful.
And the group process is wonderful, where people can share themselves and be heard compassionately and not be shamed. They can declare their so-called dysfunctions and be accepted.
So I think it's not just an individual process. but I think what's missing from the 12-step groups, unfortunately, is awareness of trauma, which is interesting because Bill W., the original funder, was an abandoned child, highly traumatized.
And for some reason, trauma hasn't entered the conversation of the 12-step movement as much as I'd like to see it done. But again, healing should not be just seen as an individual process.
It should be seen as a social process. And people that deal with addictions, they need to understand trauma.
Kabor, I've never heard it explained like that. That makes so much sense.
And this feels like a good time to take a quick pause so we can hear a word from our amazing sponsors. And while you're listening to our sponsors, take a moment and share this with somebody that you care about, because there's no doubt in my mind that this can help change somebody else's life.
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Terms and conditions apply. Welcome back.
It's your friend Mel Robbins. And today you and I are with the extraordinary Dr.
Gabor Mate. So Dr.
Mate, I have another question. What do you think is missing from the conversation that women need to know when it comes to diagnosing and supporting women who are largely getting late in life diagnoses of ADHD? Yeah, I'd love to think here.
I think what happens is when we get older, they tend to get a bit less repressed. And the tendencies that are in them that they've tried to kind of control in order to be acceptable and to fit in, it becomes intolerable for them.
Particularly perimenopausally, it becomes a little chore for women to continue to fit the stereotype in which they were molded. So I think whatever's in them is more likely to show up.
And I would say to them, what I say to anybody, get curious about what is being manifested in this condition. You know, in your book, Hungry Ghosts, you mention your own struggles yeah with addictions to praise even to classical music not to the music sorry to shopping for classical music oh there's a distinction yes i love the music but that doesn't make me an addict that just means me a music lover it's the shopping i would drop three thousand dollars in a music store and go back two hours later because i had to get the next one typical addictive behavior so it's the it's the shopping that i was addicted to it's the not the having but to the acquisition and that's and you know what when i was in the classical music store i had no ADHD i had high dopamine levels i was.
I can almost remember which record did I buy in which store,

you know, which CD that is.

So just to make the distinction,

it's not the music, it's the shopping I was addicted to.

I love that distinction because I can relate to it.

I think in the biggest moments of crisis in my life,

like facing bankruptcy, literally about to lose it all,

if I had a tiny bit of money, I would go to the mall as an escape. And I would say given that daily addiction, whether it's the mom pouring a couple glasses of wine at night, or it is just scrolling for three hours, or it is mindlessly shopping or whatever it may be.
What strategies have you found most effective in really either controlling or managing through these tendencies or patterns of behavior that so many of us have? Well, here's where we have to make a distinction between drug addictions and behavior addictions. Because drug addictions become a very significant chemical problem.
And people go through withdrawal and that has to be managed and all that. Now, the behavior addicts, by the way, also go through withdrawal, but it's less noticeable.
Like with my work addiction, my workaholism, when I was at home, I'd be irritable and depressed. That's withdrawal because the dopamine wasn't flowing.
But obviously, it's more easily manageable. So I say two things.
One is, let's look at the need that is serving in your life. What is the need it is serving in your life? Well, doom scrolling for me, the need is to tune out.
No, that's not the need. What is the need for tuning out, serving life oh boy um scrolling out oh i have no joy play or relaxation okay so you don't know how to you're not comfortable with yourself you need to you can't just be you have to be doing and your attention is to be external yeah that.
That goes back to your childhood. It means that you weren't comfortable and you develop that comfort with the self.
You develop that sense of your own goodness and validity. And so that when you're alone and you're not doing something, there's distress and your mind is going all over the place.
Yeah. So that's the need that it's serving.

So then you say, well, it's meeting this need to escape from myself.

How can I learn to be with myself?

So what techniques, what could I do?

And there's ways to do that.

I mean, I have many suggestions in my books,

but essentially it's recognizing the need

that's being met, not invalidating the need,

validating the need,

but recognizing that the behavior itself

Thank you. But essentially, it's recognizing the need that's being met, not invalidating the need, validating the need, but recognizing that the behavior itself only temporarily soothes it, but it doesn't meet the need.
Well, I feel like I've been fixing the wrong problem because I'm focused on don't drink the drink, don't pick up the phone. And what you're saying is, no, no, no, you're like over here looking at this thing.
There's a deeper issue about just learning to be with yourself,

about learning to be in the 5 to 7 p.m. time zone

and be okay with all that comes up

and know that you can move through it

without pouring a drink.

That's the whole point.

And there's nothing wrong with saying don't drink.

I mean, all that.

It's only that it doesn't deal with the fundamental need. So let's recognize the need.
Those needs are valid. Your need for social contact or not being isolated.
Social isolation, which you interpreted as rejection, and your husband points out you're not being rejected. It's just something else.
But your childhood programming tells you that it's rejected. It's true.
Does everything come back to our childhood? Yes. Pretty much.
That's when we're shaped. Look, have you ever had a puppy dog? Yes.
Two. Okay, well, tell me about them.
I mean, how you treat that puppy. Will that not define to a significant degree what kind of creature they're going to be? It's true.
Yeah, well, humans are infinitely more complex than puppy dogs. And it's totally true.
So what I'm saying is recognize the need, validate the need, but then ask the question, okay, how can I meet that need in ways that are not harmful? One of the things that you're talking a lot about is the connection between childhood conditions and experiences, how they shape you, and the significant rise in autoimmune disorders and diseases in women. You know, there are 80% of people, 80% of autoimmune disease, which are diseases where the immune system attacks the body that it's supposed to protect.
What are a few examples of an autoimmune disease? Multiple sclerosis, rheumatoid arthritis, systemic lupus, probably fibromyalgia, chronic fatigue, ulcerative colitis, Crohn's disease, pharons of psoriasis, autoimmune eczema, scleroderma.

I could go on and on.

There's about 100 or so of these, and 80% of them happen to women.

Why?

So in my medical practice, I began to notice. And here's my advantage over my specialist colleagues is that they know a lot more about certain body parts and systems as they should, but they don't know the patient.
I knew people before they got sick and I knew them in their context or their families of origin and the extended family very often. So I got to see who got sick and who didn't.
And when I was in palliative care, again, I saw who ended up in palliative care and who didn't. And these people had four significant characteristics.
One is they tended to put other people's emotional needs ahead of their own and they tend to ignore their own number one number two they tended to identify with rule duty role and responsibility rather than the needs of the self number three they tended to be very nice which means they repressed healthy anger the healthy anger is a boundary defense and these people tended very nice. And number four, these people tended to believe that they're responsible for what other people feel, which is a point that you address in your book, Let Them.
And they had this belief that there was never disappoint anybody. Now, those beliefs lead you into not saying no to the demands of the world.

And you're constantly taking on stuff and stress and other people stress.

You get stressed.

That stress undermines the immune system, which then turns against you.

Now, and I could explain the physiology of it.

And by the way, people, because the immune system and the hormonal apparatus and the nervous system and the emotional system are one system. They're not separate.
They're wired together in a whole lot of chemical and neurological ways. I'm not making this up.
This is science. Science is called psychoneuroimmunology with psychology and neurology, immunology, and endocrinology, the hormones.
It's all one system. People that repress healthy anger, they're suppressing their immune system biologically.
Now, if you understand that it's all one system, and if you ask why, well, what is the role of healthy anger? It's a boundary defense. What is the role of the immune system? It's a boundary defense.
It's meant to let in what is good and nurture and keep up what is toxic and dangerous. When you're suppressing your emotions, you're also messing with the immune system because it's all one.
It's almost like you're training your immune system not to protect you from the outside. That's what happens.
And I ought to turn against you. Like anger that you repress turns against you in the form of depression or self-loathing.
The same way that your negative thoughts where you think you're to blame for all of the stuff going on when you're a child that are not your responsibility turns into the negative self-talk that's aimed against you. Same way the immune system turns against you.
Wow. That makes so much sense.
Well, physiologically, it's just a fact. Now, why is it women? Because who in this culture is programmed to always look after everybody's emotional needs, taking everybody's stresses, identify with their duties and their role, be nice all the time, not be angry in a healthy way, and to take responsibility for other people's feelings.
It's women. It's not a gender issue.
It's a cultural issue. And of course, the more stress the woman experiences, the greater the risk of autoimmune disease.
So if you look at minority women, they have a higher percentage because they're women and they're minority. I was just about to ask you whether or not there were studies for minority women and people that are in first responder roles.
Many studies. Many studies.
And in Canada. It makes sense.
In Canada, an indigenous woman has six times the rate of rheumatoid arthritis than somebody else. And this is in the population that never used to have rheumatoid arthritis.
And by the way, again, are we blaming people here? No, we're not. Because we have to look at what happened here.
What happened here is the child is born with all these emotions wired into their brains, but the child has two big needs here. The need for attachment, for belonging, for being held, for being accepted, supported, and so on.
That's a need that you have. It's not negotiable.
Without it, as an infant, as a young child, you die. So there's one need, but you have another need as well, which I call authenticity, which means being connected to your emotions and your gut feelings.
Now in any audience, when I ask people, have you had the experience of having a strong gut feeling about something ignoring it and being sorry afterwards most people put their hands up you probably would now gut feelings were programmed into us by evolution we evolved out in nature for millions of years hundreds of thousands of years we lived out in nature how long does any creature in nature survive if they don't pay attention to their gut feelings? Not until the end of the day. You're a goner.
That's the point. So we have this two need, attachment and authenticity, being connected to ourselves.
Now, if the child gets the message that they're being authentic with their emotions and so on, they're not acceptable to the environment, guess what's good in the contest between us? Oh, you get trained to not trust your instincts. Yeah, and you're trained to disconnect and you're trained to push down your feelings.
So we give up our authenticity for the sake of attachment. Now, in your book, there's an example of this guy who's about to get married.
Yes. And it's called his misgivings.
Yes. And then he's afraid of what everybody else will think.
Yes. And you're wishing

he would say no to the wedding.

Yes.

You know,

what's going on?

He's stuck in this tension

between attachment,

which is the need to be acceptable,

and authenticity,

being himself.

Women are caught

in that trap in this society.

So are many men, of course.

It's not just a gender issue,

but overwhelmingly,

it's women

who have to choose the attachment of being acceptable over authenticity. That's why they have much more autoimmune disease.
Wow. And often, I'd say for a lot of us, we choose attachment rather than staying connected to ourselves.
That's the whole point. As a child, you have no choice.
The question is, as an adult, can we develop that choice? Do I have to keep choosing the attachment over the authenticity? Well, you also hear doctors say that all of these autoimmune disorders, diseases, whatever you want to call them, flare up in moments of stress, in moments of overwhelm. And the main thing that they're treated with is...
Steroids. Yes, and take better care of yourself.
Oh, yeah. Stress.
No, but here's what's interesting. Typically for these conditions, we give cortisol.
A stress hormone? Yeah. If you go into the dermatologist with an inflamed skin, they're going to give you a steroid cream, cortisol.
If you go to a gastroenterologist with an inflamed intestine, they'll at some point give you cortisol, stress hormone. If you go with an inflamed nervous system, multiple sclerosis, they're going to give you a stress hormone, cortisol.
I could go on. But we never ask ourselves, gosh, we're giving stress hormones to people.
Is it possible that stress may have something to do with their condition? So doctors know that in cases of acute stress, that can flare up a disease. That's clear.
What they don't recognize is those emotional patterns that I'm talking about, which stress people chronically, but in less dramatic ways. Because what's it like to always have to repress your anger, to be pleasing other people? Exhausting.
That's the whole point. And that's what the stress that I think often instigates.

You've abandoned yourself and now your body function is abandoning you. That's the whole point.
Is there good news here? Yeah, the good news is if you change these patterns, you can actually significantly affect the course of your illness. And I know lots of examples of that.
How can someone find the root cause of the emotional pain?

Or how do you begin the process of healing? Because you've now painted this landscape that helps us really understand the connection between childhood experiences and conditioning. how that shapes your body, your brain function, your physiology, your immune system,

and how continued environmental stress and continued abandonment of self for the sake of being accepted by other people. Yeah.
When you see all this, it's incredibly empowering. What is one step that you would want someone to take if they're having an awakening, or they've been sent this episode by somebody who loves them, and they're like, this is me? Okay.
So let's take one example. Very simple one.
Prior to your awakening and transformational journey that you undertook sometime in your 40s, how easy did you find it to say no to other people's expectations? Oh, I couldn't. Okay, so you couldn't say no? No.
All right. So I ask people this question.
Where in your life do you have difficulty saying no? It shows up in two areas, work and in personal life. Okay, so you couldn't say no.
The second question I ask people then is, what's the impact on you of your difficulty saying no?

It's exhausting.

I don't like my own behavior.

Yeah.

So it's this shame.

Lack of control.

Lack of control.

Lack of control, by the way.

Anger.

Blaming other people and making it their fault that I can't say no.

That's right.

And loss of control is one of the most significant triggers for stress, by the way, according to the stress literature.

Well, that makes sense because we have a biological hardwired need for safety. Exactly.
Which we try to achieve by controlling everything and everyone around us. Only because we learned in childhood that if we didn't, there'd be no safety.
If we learned that there was safety, we would trust the world a lot more and we wouldn't have to control. So nobody's a control freak.
Nobody's born a control freak. It's an adaptive trait is what that is.
But here's what I'm saying. So that going through this exercise, so what's the impact? You identify some impacts.
Could also be frequent calls, illness, and so on. The third question is, what's your belief that keeps you from saying no? So when you had trouble saying no, what's the story? What was the belief? That I would get fired from my job, and then we wouldn't be able to pay our bills, and then we would lose our house, and then on and on and on and on, or they wouldn't like me, or my mother would be mad at me, or this would happen, or that would happen, like the weight of the world on my shoulders.
Exactly. So then the fourth question is, how did you develop that story that if I see no, I'll be rejected? Where did you learn that? I'm sure for me, even though I don't quite remember, it was that I had, it was my job to make sure everybody was okay in the house and that everybody was happy.

And that made me feel safe.

In other words, you learned it when you're two or three or four years old

or five.

And now you're an adult.

That's why this has been such a game changer

because when I say let them

I separate

someone else's emotions and their

expectations from what's my responsibility. You're choosing authenticity over attachment is what you're doing oh i love that you're right i'm staying connected to myself that's the whole game that's what i'm talking about here so once you understand that you learned the story when you were hypnotized into it as it's by the way three or four year are in hypnotic states.
That's why they believe that when they're playing monsters, they're actually monsters. So those hypnotic influences are really powerful.
They stay with us. So then the next question is, who would you be if you didn't believe that you mustn't say no? Who would you be then? Free.
Exactly. Do that exercise once a week.
Five questions to freedom. It's in the method normal.
There's a chapter on it. There's a sixth question.
What is the sixth question? Where you're not saying yes. Oh my God, everywhere.
To free time, to play, to joy, to creativity, to rest.

Well, that not saying yes is as harmful as the not saying no.

So those two little words, just that little exercise,

you do that once a week, it changes people's lives.

The sixth question, what are you not saying yes to?

That one made my heart contract a little. Okay.
Because that's where I really saw truly what I'm missing out on. Yeah.
Where are you not saying yes? To play and rest. I mean, I'm much better than I used to be.
As a matter of fact, I've told this story many times, but five years ago, I was in London giving a talk on my book, When the Body Says No. And I was very articulate and adept on stage.
But personally, I was irritated. I was working too hard.
I was driving myself too hard. I was not kind to my wife.
And she said to me, her name is Ray. And she said, buddy, you've written a book called When the Body Says No.

No, you better write it on called When the Wife Says No. And, you know, so part of what's helped me draw up these patterns, and I'm still working on it, is because I love this relationship when I'm reading it.
And I don't want to be this person who's not saying yes. I'm an 80, you know when you look at the top five regrets of dying people, that book that I mentioned in another conversation, this was written by a palliative care nurse who worked with dying people.
The top regret was that I didn't have the courage to be myself. And the third regret was I didn't have the courage to express my emotions.
And the fifth was and I neglected my friends the fourth regret and then the fifth one I think was I I wish I hadn't worked so hard I wish I had played more I wish I'd given more scope for the creativity and playfulness and childlike self that I am you know so I'm still looking for that one uh to develop it more. I'm a whole lot better than I used to be.

Well, we're a whole lot better than we used to be because of what we're learning from you.

Well, thank you.

Gaber Mate.

Wow.

Any final things you want to say?

Everybody's got the capacity to heal.

As long as there's consciousness, there's the capacity to heal.

And for some people, it's tougher because they don't have the resources. But you know, you can go on YouTube.
Lots of my talks on YouTube, people have told me that it's changed their lives for the better. That doesn't cost a penny.
And not just my talks, by the way, talks by other wonderful teachers, some of my colleagues, some spiritual teachers. That doesn't cost any money to watch that.
You can take books out of the library. That doesn't cost a penny.
And they can be very helpful. You can learn to meditate and be with yourself and observe your mind.
That can be very helpful. There's free meditation instruction on the line or in many books.
Those people that can afford therapy, if it's the right kind of therapy, they can address these issues. They can connect with nature.
Nature has got a huge healing capacity, as our indigenous people really know. We can learn a lot from them about connecting with nature.
Those people that have the capacity to get out of the city and, or even to go to a park and connect with the plants and the trees and the flowers. That sounds folky, but it's hugely healing.
Exercise, giving your body what it needs, eating the proper food, if you can afford it. And most people may not be able to afford the best foods, but they could probably afford to eat better than they do if they paid attention to themselves.
So all those things are not inaccessible. So, in other words, healing is possible.
It's available to all of us. And it just takes the decision to embark on that path.
Well, you've empowered us to make the decision today. Yeah.
Thank you. Thank you.
Thank you. Oh, thank you.
It's amazing to spend time with you. Yeah, thanks.
There are so many people that I want to share this episode with. I feel empowered and excited for you.
And so I just want to thank you for listening all the way to the end and sharing this with people that you love. And I also wanted to be sure to tell you, in case no one else tells you, that I love you, and I believe in you.
And I believe in your ability to create a better life. And listening to this today is certainly going to help you take the steps to create it.
And I will be waiting for you in the very next episode. I'll see you there.
So doctor, oh my God. Okay.
And then I look at the bottom and it's like, wow, wow, wow. Thank you.
Wow. Fantastic.
I'm the one that says fantastic, right? Okay. Do you need me to do God.
Okay. And then I look at the bottom, and it's like, wow, wow, wow.

Thank you.

Wow.

I'm the one that says fantastic, right?

Okay, do you need me to do those?

Okay, great, great.

Okay, great, great, great.

Can I wait a minute?

Yeah.

Okay, hold on.

I'm sorry.

There's a helicopter there.

That's okay.

We're in it.

I was like, all of a sudden, I'm like, wait.

Wow.

You're fantastic.

We did it. We got it done.

You like that?

Okay, great.

All right.

That's it. We're wrapped.
Well done. Oh, and one more thing.
And no, this is not a blooper. This is the legal language.
You know what the lawyers write and what I need to read to you. This podcast is presented solely for educational

and entertainment purposes. I'm just your friend.
I am not a licensed therapist and this podcast is

not intended as a substitute for the advice of a physician, professional coach, psychotherapist,

or other qualified professional. Got it? Good.
I'll see you in the next episode.

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