Colman Noctor: The long reach of trauma in our lives
Dr Gabor Maté, world-renowned Trauma and Mental Health Expert and New York Times bestselling Author. Photograph: Sasko Lazarov / Photocall Ireland
I was one of the lucky people who attended Gabor Maté's workshop at the RDS last week. For anyone who doesn’t know, Maté is an internationally renowned physician who has spent years developing his expertise in trauma, addiction, stress, and the body-mind connection. While much of his work relates to adults, he has extensively explored the impact of childhood trauma on health and behaviour, which he believes can stay with us for a lifetime.
Maté was born to a Jewish family in Budapest, Hungary, in 1944. His maternal grandparents were killed in Auschwitz. When he was one year old, his mother put him in the care of a stranger for more than five weeks to save his life. He says the trauma of the abandonment continued into his adult life. Maté immigrated to Canada and gained an MD in general family practice in 1977. Over the subsequent years, he developed an interest in childhood trauma and the body-mind connection, linking trauma to the manifestation of adult physical illness
During the day-long workshop in Dublin, Maté explained how many people view trauma as an ‘event’ or series of events that occur. However, to truly understand trauma, he said we must look at the lasting impact of the emotional wound caused by the event and the effect it has on our subsequent experiences.
While listening to this description, I was reminded of a young person I worked with many years ago who had been a victim of sexual abuse. When describing the impact of the trauma, she said to me, “The Jenny (not her real name) who came out of that room was different to the Jenny that went in”. In one sentence, she eloquently explained how the abuse profoundly affected her and that she was never the same person again.
Maté believes medicine and pharmaceuticals play an essential role in the treatment of mental and physical illnesses, and he openly acknowledges taking anti-depressants at one point in his life, finding the medication effective in lifting his mood. However, he argued that the over-reliance on pharmacological treatment at the cost of environmental and psychological support is hugely problematic.
He highlighted how stress during childhood, particularly that which stems from neglect, abuse, or a lack of emotional support, can disrupt the development of the brain and body. He spoke about how this can lead to increased vulnerability to addiction, autoimmune diseases, and other health problems.
His views on addiction reminded me of a series of experiments conducted in the late 1970s by Canadian psychologist Bruce K Alexander and his colleagues. Their famous 'Rat Park Study’ aimed to investigate the nature of drug addiction, challenging the prevailing notion that drugs were inherently addictive. The study placed laboratory rats in cages and offered them the choice of plain water or water laced with the opioid morphine. The rats consumed significantly more of the morphine-laced water, confirming the addictive quality of the substances.
However, a follow-up study designed Rat Park, a larger environment enriched with amenities such as wheels, toys, food, and social interaction with other rats. The rats in this enriched experiment were given the same choice between water bottles: one containing only water and the other laced with a morphine solution. The rats in the diverse Rat Park environment were much less interested in the morphine-laced water and consumed significantly less of it than the isolated rats.
The study's findings implied that human addiction might also be influenced significantly by social and environmental factors, leading to discussions about the role of community, mental health, and social conditions in addiction.
People who have experienced trauma can have strong emotional reactions to seemingly innocuous situations known as ‘triggers’.
Maté likened the trigger to a small part of a gun that must be accompanied by ammunition and an explosive charge to have an impact. He used this metaphor to explain how our experiences of trauma act as the ammunition and explosive charge, which is far more critical in understanding emotional distress than focusing on the trigger alone.
He also discussed secure attachment between children and their caregivers.A lack of secure attachment could impair emotional regulation and lead to issues such as anxiety, depression, and behavioural problems later in life. His belief in the importance of the first 1,000 days of a child’s life is undoubtedly influenced by his early formative experiences.
According to Maté, mental illness symptoms should be understood as coping mechanisms for dealing with unresolved trauma and not only neurological or genetic manifestations. He believes that understanding and addressing the underlying trauma is crucial for effective treatment.
The shortcomings of the Irish mental health services were discussed during a panel discussion with mental health advocates Niall Breslin, Tammy Darcy, and Brent Pope. Maté contributed by explaining how societal norms and structures, such as economic inequality, lack of social support, and cultural attitudes towards parenting and mental health, contribute to stress and trauma.
Gabor Maté has been a significant part of my professional journey, especially his insights into interpreting problematic childhood behaviour as a coping strategy instead of a symptom. I was also influenced by the excellent book he co-authored with Gordon Neufeld, titled ‘ ’.
During the workshop, Maté referred to the core principles outlined in this book, a helpful guide to supporting children who have experienced trauma. He explained that children have four essential needs: attachment, rest, freedom and play. Secure attachment involves a relationship with adult caregivers. Rest means the child doesn't have to work to make the relationship work, nor meet their parent's emotional needs. Freedom involves the capacity to experience all one's emotions, whether it's rage, anger, or grief. And play means ‘creative, imaginative play where nothing is required. There is no winning, no losing and no purpose other than interaction’.
While not what you might describe as an animated speaker, Maté has an authenticity that holds your attention. It was refreshing to hear him honestly speak about his difficulties. As a psychotherapist, it is reassuring to know that despite being an expert in the theory of emotions, even the world’s leading experts can struggle. His droll humour was also evident when he said how some people come up to him and say, ‘Your book saved my life,’ to which he told the audience, ‘Perhaps I should read it myself’.
The aspect of the day that resonated with me most was when he stated that children have ‘two deep, biological needs, which he called ‘attachment (connection with another person) and authenticity (being connected with yourself and being able to act on it)’. He explained how no child can survive without attachment, but they also need authenticity so they can be themselves. Many people who fear being abandoned sacrifice their authenticity for fear of being rejected by others.
Maté's observation seems especially relevant in the contemporary world where so many young people are preoccupied with fitting in and being accepted but at the cost of being themselves.
- Dr Colman Noctor is a child psychotherapist
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