A typical American life in 2022 might include spending 50 hours a week mostly alone in a cubicle, riddled with chronic stress but on track for a promotion. Evenings pass isolated in a tower, where a doorman ensures strangers and even neighbors are kept at bay. You swipe down into the bowels of Instagram until you fall asleep. Something on Netflix plays in the background, but only so you don’t have to listen to your own thoughts.

Typical, perhaps. But none of that should be accepted as natural, argues Dr. Gabor Maté in his new book, The Myth of Normal: Trauma, Illness and Healing in a Toxic Culture. Our cardiovascular systems were not built for the stress of a Wall Street job and single decisions that move billions. Humans evolved as collective hunter-gatherers who cohabitate, not hyper–individualized competitors locked away in steel skyscrapers. And the psyche was not designed to handle a single entire life and all its inevitable blemishes compared with billions of people’s photoshopped images cherry-picked to share only their happiest milliseconds.

Moreover, all of that roughly describes what many consider “success” and says nothing about poverty, racism, or sexism—three cancers of the modern Western world with serious health impacts that are thoroughly documented but seldom discussed. For example, the average life span of people living in areas of Chicago that are just a few miles apart can differ by close to 30 years.

The Myth of Normal—written with the help of Maté’s son, Daniel—prescribes a more authentic self that breaks free of the world’s expectations of us, offers a path to happiness, and also promises to alleviate physical ailments, because, as Maté reminds us, the mind and body are not separate.

The former physician, now approaching 80, has spent decades exploring these connections, first in his 1999 book Scattered Minds: The Origins and Healing of Attention Deficit Disorder; next in 2003’s When the Body Says No: The Cost of Hidden Stress; and then in 2008’s seminal work on addiction, In the Realm of Hungry Ghosts: Close Encounters with Addiction. This most recent book, The Myth of Normal, is the culmination of a life’s work. It is also presented at a time when our culture has never needed it more.

“Acquired personality traits such as excessive identification with socially imposed duty, role and responsibility at the expense of one’s own needs can jeopardize health,” Maté writes in the book. “This and other conditioned characteristics are the result of a child’s developmental needs being denied, of Nature being thwarted. Culture cements them through reinforcement and reward, encouraging people to perform tasks even if chronically stressful, under circumstances they might naturally want to avoid.

“My own workaholism as a physician earned me much respect, gratitude, remuneration, and status in the world, even as it undermined my mental health and my family’s emotional balance,” he continues. “And why was I a workaholic? Because, stemming from my early experiences, I needed to be needed, wanted, and admired as a substitute for love. I never consciously decided to be driven that way, and yet it ‘worked’ all too well for me in the social and professional realms.”

Dr. Gabor Maté recently spoke with me about his new book, how forgotten traumas and misfired defense mechanisms shape us as adults, and the health implications of unrestrained capitalism.

TRAVIS LUPICK: The title of the book is The Myth of Normal. What are some things that we accept as “normal” that we should not?

GABOR MATÉ: There are many conditions in a society that are completely unnatural and unhealthy. But we mistake normal for healthy and natural. The way we live, the way we raise kids, the way we deliver babies, the way we go to work—we all assume them to be normal, and therefore natural and healthy. But it’s a bit like studying zebras in a zoo. You can study zebras in a zoo and learn things about them. But you’re not learning about them the way they naturally are in a context that is naturally healthy for them. It is the same with human beings. To assume that this society, because it’s the norm, is therefore natural and healthy, is a really false and dangerous assumption. That’s the one sense in which I am talking about the myth of normal.

The other is that we have this idea that those who are sick are abnormal, and the rest of us are normal. Whereas I think there’s a real spectrum of well-being and ill-being that runs through society. There are no clear lines between normal and abnormal.

And then the third sense in which I mean it is that the people who are ill—mentally ill or physically ill—they’re not abnormal. These are normal responses to abnormal circumstances.

What are the abnormal circumstances that we accept as normal?

We know, for example, that stress in pregnant women has a huge impact on the biological and emotional development of the child. Yet a lot of women, when they’re pregnant, are under terrible stress, in terms of work and their personal lives, and physicians are not even asking them questions about what it is that is stressing them in their life. Then there is child-rearing. Parents get all kinds of advice on child-rearing, like sleep training babies, learning not to pick them up at night, or making them sit by themselves if they are angry, putting them in timeout. These are considered normal practices, and yet they completely undermine healthy human development. And then schooling. I could talk about every aspect and developmental experience, and point out that, from the point of view of human needs, it’s not normal. Yet they are considered norms, in this culture.

The book serves as an urgent criticism of modern life. What are we doing wrong?

The biggest thing that we do wrong is that we are meant to be connected to our gut feelings and are meant to be true to ourselves. But just like in Brave New World, people are designed to want what society wants from them; not what is good for them. In this society, we create expectations for people that they should not be authentic to themselves, but rather, that they should fit into society. To be suppressing their own needs for the sake of being accepted. To be attractive rather than valuing themselves for who they really are. To conform rather than to really know what their own minds are. And for women, particularly, to suppress their emotions for the sake of meeting the emotional needs of their environment. That people should take on jobs that have no meaning or purpose for them. Their only recourse to make a living, though, is to accept employment that is soul-destroying for them, in many ways. To accept cultural icons that are completely manufactured personalities—that are manufactured in terms of their looks and in terms of their personas—and yet are our heroes. Totally inauthentic ways of being are modeled for us. I’m supposed to care about which Hollywood celebrity sleeps with who, as if this really mattered. And the papers are full of this kind of information. But the things that really matter, we don’t talk about.

It’s evident that this book is the culmination of ideas you explore in your previous books and have been wrestling with for a very long time. Talk about your central thesis and the journey that brought you here.

What has interested me, as a physician, is what promotes human health and what undermines it. And what I find is that the more people are divorced from their true selves—whether it be for personal, traumatic, or cultural reasons—the more illness they’re going to have. For me, it’s a journey of health. There is, for example, the way we live in isolated apartments. In the last several decades, there’s been, throughout the Western world, a documented and highly pernicious rise in loneliness. Loneliness is as bad for health as smoking, according to many studies. And in the United States, twice as many people say they’re lonely as did 20 years ago. So as a physician, I’m concerned with, what are the factors in society that promote behaviors or situations that undermine health? Loneliness is one of them. 

The trajectory of my work has been to look at mental health conditions like ADHD—such as I’m diagnosed with [and wrote about in Scattered Minds]—the connection between physical stress, emotional stress, and illness—as I did in When the Body Says No—and the traumatic basis of addiction [covered in In the Realm of Hungry Ghosts]. In this book, I just broadened the lens to look at the whole culture, and say, what are the social, economic, and political factors that are driving all this? And what are their impacts on human health? How can we live a healthy life, even in the face of all this stress that this society puts us under?

How is the body connected to the mind? How is what we put our minds through and how we treat ourselves affecting the health of our physical bodies?

Even the word “connection” is inaccurate, because it implies that two separate things are connected. The mind and body are not the same, but they are one unit. You can’t have one without the other. There are studies that show, for example, the more episodes of racism Black American women experience, the greater their risk for asthma. The stress of racism actually inflames the lungs and makes the airways narrow. Children with parents who are stressed are much more likely to have asthma. The emotional states of the parents are affecting the physiology of the child. Why? Because both racism and stress in parents are highly stressful to the individual organism emotionally, and those emotions translate into physiology, as they can’t help but do, because the mind and body are inseparable. 

What’s frustrating here is that this science has been documented voluminously, over decades now. It’s not controversial, scientifically, but it’s not even talked about in medical schools. For example, a study three years ago in the Journal of Cancer showed that the greater the symptoms of PTSD in a woman, the higher her risk for ovarian cancer. Women with severe PTSD symptoms have double the risk of ovarian cancer. Why? Because emotions are not separable from physiology. Those stressed emotions undermine the immune system, they cause inflammation, they trigger cancerous change, and they depress the body’s defenses. Because the emotional apparatus of the human organism is one part and parcel of the hormone apparatus, of the nervous system, and of the immunological system, the immune system. When something happens in any one of those areas, it affects all the others. There’s no separation of mind and body in real life. And yet it’s a separation that is entrenched in Western medical thinking, contrary to all the evidence.

Lacking healthy coping mechanisms and holistic ways to heal and grow, what are the ways you see people responding to these pressures and so much trauma?

The problem is, when people are hurt in childhood, they have to find ways of coping. Those coping mechanisms are helpful in the short term, but they can create problems in the long term. One coping mechanism for too much stress is for the child to tune out, because the child can’t escape or change the situation. If my mother is stressed, as a 1-year-old, I am stressed. What do I do with it? I scatter my attention. I tune out. Later on, that gets diagnosed as ADHD, as if I had this genetic disease. I don’t have a disease. It’s not genetic. I have a coping mechanism that was helpful at some point, but that is no longer helpful. If your parents can’t handle your emotions—because they’re too stressed, depressed, or too behavior-oriented—and so discourage your expression of strong emotion, then you push down your emotions in order to maintain a relationship with your parents. What’s another word for pushing things down? Depression. We depress our emotions to survive in our environments. Later on, we are diagnosed with the so-called disease called depression. Yet it started off as a coping mechanism. 

Addictions are all started off as a coping mechanism. They are attempts to soothe pain. The issue, for me, with addiction, is not, why the addiction? But rather, why the pain? If you look at why there is pain in addicted people—whether they’re addicted to drugs, sex, pornography, or gambling—that pain always originates in childhood. And then the addiction is an attempt to cope with the pain of it, to escape from it, temporarily. 

In families where the parents are very needy, where the parents are alcoholics, or where they are emotionally troubled, the child will very often cope by pushing down and repressing their own emotions, in order not to bother the parents. That repression of emotion shows up in the form of autoimmune disease or malignancy later on. This is not idle speculation. It’s pure science. It’s been shown many times. It’s also why women have 80% of autoimmune disease. Because they’re the ones in this society who are most trained to repress their own needs and serve the needs of others. Not surprisingly, in Canada, an Indigenous woman has six times the rate of rheumatoid arthritis than that of anybody else. Why? Because they’re the most traumatized and most oppressed segment of the population.

Moving from the individual to the collective, you present capitalism as the backdrop for many of our myths of normal. What needs to change?

Capitalism is the system that we live under, so that’s the system I’m looking at. And for all its economic achievements and scientific breakthroughs—which are very unevenly distributed, with a lot of inequality, which itself is a source of illness—it’s a system that’s based on fundamental assumptions. One is that the profit of the few is for the benefit of the many. That’s not how it is showing up. Also, that people are individualistic and competitive. That’s not our nature as human beings. In fact, from an evolutionary point of view, had we been individualistic and competitive, we never would have evolved. We evolved as communal creatures in close contact with each other, with a lot of mutual support. Now, if you develop a system that’s based on the opposite perspective—because that’s the nature of this system—then you’re running roughshod over human needs. And so to understand what’s happening on an individual level, you really have to look at what’s happening on a macro level. And this trauma shows up, not only in the personalized, but of course in politics and other areas of our culture. So we really have to look at the larger picture, and not just think that illness is somehow an individual aberration. It’s really a manifestation of a system that is a toxic culture