The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture

by Gabor Maté

but I am using “toxic culture” to characterize something even broader and more deeply rooted: the entire context of social structures, belief systems, assumptions, and values that surround us and necessarily pervade every aspect of our lives.

It is my contention that by its very nature our social and economic culture generates chronic stressors that undermine well-being in the most serious of ways, as they have done with increasing force over the past several decades.

in 2019 more than fifty million Americans, over 20 percent of U.S. adults, suffered an episode of mental illness.[9]

mental disorders have become “the largest health challenge of the 21st century.”[10]

“Distress about climate change is associated with young people perceiving that they have no future, that humanity is doomed,” found the authors of a 2021 survey of the attitudes of over ten thousand individuals in forty-two countries. Along with a sense of betrayal and abandonment by governments and adults, such despondence and hopelessness “are chronic stressors which will have significant, long-lasting and incremental negative implications on the mental health of children and young people.”[14]

On a societal level, then, “normal” often means “nothing to see here”: all systems are functioning as they should, no further inquiry needed. The truth as I see it is quite different.

“in the day-to-day trenches of adult existence, banal platitudes can have a life-or-death importance.”

to meet modern society’s criteria for normality is, in many ways, to conform to requirements that are profoundly abnormal in regard to our Nature-given needs—which is to say, unhealthy and harmful on the physiological, mental, and even spiritual levels.

If we could begin to see much illness itself not as a cruel twist of fate or some nefarious mystery but rather as an expected and therefore normal consequence of abnormal, unnatural circumstances, it would have revolutionary implications for how we approach everything health related. The ailing bodies and minds among us would no longer be regarded as expressions of individual pathology but as living alarms directing our attention toward where our society has gone askew, and where our prevailing certainties and assumptions around health are, in fact, fictions.

The current medical paradigm, owing to an ostensibly scientific bent that in some ways bears more resemblance to an ideology than to empirical knowledge, commits a double fault. It reduces complex events to their biology, and it separates mind from body, concerning itself almost exclusively with one or the other without appreciating their essential unity.

health and illness are not random states in a particular body or body part. They are, in fact, an expression of an entire life lived, one that cannot, in turn, be understood in isolation: it is influenced by—or better yet, it arises from—a web of circumstances, relationships, events, and experiences.

The meaning of the word “trauma,” in its Greek origin, is “wound.” Whether we realize it or not, it is our woundedness, or how we cope with it, that dictates much of our behavior, shapes our social habits, and informs our ways of thinking about the world.

offline. “All trauma is preverbal,” the psychiatrist Bessel van der Kolk has written.[4]

“Trauma is not what happens to you but what happens inside you” is how I formulate it.

What the two types share is succinctly summarized by Bessel van der Kolk: “Trauma is when we are not seen and known.”

They both represent a fracturing of the self and of one’s relationship to the world. That fracturing is the essence of trauma.

As the lost connection gets internalized, it forges our view of reality: we come to believe in the world we see through its cracked lens. It is sobering to realize that who we take ourselves to be and the ways we habitually act, including many of our seeming “strengths”—the least and the most functional aspects of our “normal” selves—are often, in part, the wages of traumatic loss.

there is no comparing suffering. Nor is it appropriate to use our own trauma as a way of placing ourselves above others—“You haven’t suffered like I have”—or as a cudgel to beat back others’ legitimate grievances when we behave destructively. We each carry our wounds in our own way; there is neither sense nor value in gauging them against those of others.

An event is traumatizing, or retraumatizing, only if it renders one diminished, which is to say psychically (or physically) more limited than before in a way that persists.

Alternatively, some people’s disconnection from their bodies manifests as not knowing when to stop eating or drinking—the “enough” signal doesn’t get through.

Emotions, he stressed, emerge not from the thinking brain but from ancient brain structures associated with survival. They are drivers and guarantors of life and development. Intense rage activates the fight response; intense fear mobilizes flight. Therefore, if the circumstances dictate that these natural, healthy impulses (to defend or run away) must be quelled, their gut-level cues—the feelings themselves—will have to be suppressed as well. No alarm, no mobilization.

I choose vulnerability over victimhood.

“Human freedom involves our capacity to pause between stimulus and response and, in that pause, to choose the one response toward which we wish to throw our weight,” wrote the psychologist Rollo May.[12] Trauma robs us of that freedom.

The more severe and the earlier the trauma, the less opportunity response flexibility has to become encoded in the appropriate brain circuits, and the faster it becomes disabled.

“Contained in the experience of shame,” writes the psychologist Gershen Kaufman, “is a piercing awareness of ourselves as fundamentally deficient in some vital way as a human being.”[13]

The most common form shame assumes in this culture is the belief that “I am not enough.”

“Everything has mind in the lead, has mind in the forefront, is made by the mind.” Thus opens the Dhammapada, the Buddha’s timeless collection of sayings.[15]

If trauma entails a disconnection from the self, then it makes sense to say that we are being collectively flooded with influences that both exploit and reinforce trauma.

Late-stage capitalism is expert in catering to this sense of present-moment dread—in fact, much of its success depends on the chasm between us and the present, our greatest gift, getting ever wider, the false products and artificial distractions of consumer culture designed to fill in the gap.

Trauma is in most cases multigenerational.

Blame becomes a meaningless concept the moment one understands how suffering in a family system or even in a community extends back through the generations.

If we treat trauma as an external event, something that happens to or around us, then it becomes a piece of history we can never dislodge. If, on the other hand, trauma is what took place inside us as a result of what happened, in the sense of wounding or disconnection, then healing and reconnection become tangible possibilities. Trying to keep awareness of trauma at bay hobbles our capacity to know ourselves. Conversely, fashioning from it a rock-hard identity—whether the attitude is defiance, cynicism, or self-pity—is to miss both the point and the opportunity of healing, since by definition trauma represents a distortion and limitation of who we were born to be.

Unless we can measure something, science won’t concede it exists, which is why science refuses to deal with such “nonthings” as the emotions, the mind, the soul, or the spirit. —Candace Pert, Ph.D., Molecules of Emotion

Our temperature, blood acidity or pressure, and heart rate, along with many other bodily metrics, are all obliged by Nature, on pain of death, to stay within definite and nonnegotiable limits.

Medical professionals often do little to encourage—and may even resist—people trusting their own hunches, which tend to synthesize signals from both mind and body.

there is “strong evidence that childhood traumatic events significantly impact the inflammatory immune system . . . offering a potential molecular pathway by which early trauma confers vulnerability to developing psychiatric and physical disorders later in life.”[18]

For every atom belonging to me as good belongs to you. —Walt Whitman, “Song of Myself,” in Leaves of Grass

refers to the individual’s multidimensional bond with the entire world, including people—from close relatives to strangers, from the living to ancestors who lived long before—and also the rocks, the plants, the earth, the sky, and all creatures. Ancient cultures have long understood that we exist in relationship to all, are affected by all, and affect all.

Krishna declares, “They live in wisdom who see themselves in all and all in them.”

the Buddha said. “When you look at a leaf or a raindrop, meditate on the conditions, near and distant, that contributed to the presence of that leaf or raindrop. Know that the world is woven of interconnected threads. This is because that is. This is not because that is not. This is born because that is born. This dies because that dies.”

Friedrich Nietzsche once called the Buddha “that profoundest physiologist.”

George Engel argued nearly half a century ago that the “crippling flaw” of modern medicine “is that it does not include the patient and

his attributes as a person. Yet in the everyday work of the physician the prime obje...

biopsychosocial approach: one that recognizes the unity of emotions and physiology, knowing both to be dynamic processes unfolding in a context of relationships, from the personal to the cultural.[2]

Dr. Bessel van der Kolk has noted that “our culture teaches us to focus on our personal uniqueness, but at a deeper level we barely exist as individual organisms.”[3]

“Trees of the same species are communal, and will often form alliances with trees of other species.”

“There are no separate entities,” he wrote, “only manifestations that rely on each other to be possible.”[17]

genes help make up the language of existence,

Many years later, a 1965 survey reported the prevalence in rheumatoid arthritis–prone individuals of an array of self-abnegating traits: a “compulsive and self-sacrificing doing for others, suppression of anger, and excessive concern about social acceptability.”[16]

No person is their disease, and no one did it to themselves—not in any conscious, deliberate, or culpable sense. Disease is an outcome of generations of suffering, of social conditions, of cultural conditioning, of childhood trauma, of physiology bearing the brunt of people’s stresses and emotional histories, all interacting with the physical and psychological environment.