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

by Gabor Maté

What is trauma? As I use the word, “trauma” is an inner injury, a lasting rupture or split within the self due to difficult or hurtful events. By this definition, trauma is primarily what happens within someone as a result of the difficult or hurtful events that befall them; it is not the events themselves. “Trauma is not what happens to you but what happens inside you” is how I formulate it.

We might well admire someone who puts another’s needs before their own in a crisis, or the leader of a struggle for the rights of many, but such sacrifices are undertaken in a conscious and time-bound manner, appropriate to the situation at hand and with full awareness of the risks.

Yes, parents are responsible for their children; no, they did not create the world in which they must parent them.

the second cornerstone query regarding addiction, one that has become something of a mantra with me: Ask not why the addiction, but why the pain.

trauma/injury is about what happens inside us, and how those effects persist, not what happens to us.

Addiction begins as an attempt to induce feelings that we were biologically programmed to generate innately, and would have—if unhealthy development hadn’t got in the way.

As Bruce Perry explains, adverse childhood experiences—of the big-ticket kind that merit the official ACE designation—are of consequence, but “not as determinative as your history in relationships . . . The most powerful predictor of your functioning in the present is your current relational connectedness and then the second most powerful component that we see is your history of connectedness.”

If we are not to see mental distress solely as illness, then what is it? The view I have come to favor is of a piece with how I approach many other conditions under the “illness” umbrella: rather than seeing it as an intruder from the outside, consider what it might be expressing about the life in which it arises.

If we label this depression of feeling a disease, we risk not recognizing its original adaptive function: to distance oneself from emotions that are unbearable at a time in life when to experience them is to court greater calamity. Recall what I called the tragic tension between authenticity and attachment. When experiencing and expressing what we feel threatens our closest relationships, we suppress. More accurately, we don’t: our mind does that automatically and unconsciously on our behalf.

He, too, saw depression as an adaptation of the brain to the loss of connection, as a physiological “shutdown mechanism” to terminate distress, “which, if sustained, would be dangerous for infant mammals.”[2] In other words, far from expressing inherited pathology, depression appears as a coping mechanism to alleviate grief and rage and to inhibit behaviors that would invite danger. It is not that neurotransmitters are not involved in depression—only that their abnormalities reflect experiences, rather than being the primary cause of them.

many actions and beliefs that look like pure insanity from one perspective make sense from another—and always made sense at the start. It is our task, if healing is the goal, to make sense of them newly, now, with the benefit of adult discernment and compassion.

these deeply wounded individuals, like the bearers of every mental-emotional burden we have touched on, are all too rarely asked the key questions: Where did this come from? and What valid problem is it trying to fix?

Pleasure, Rob Lustig pointed out, is “This feels good. I want more.” Happiness, on the other hand, is “This feels good. I am contented. I am complete.”

And what is healing, anyway? When I speak of healing, I am referring to nothing more or less than a natural movement toward wholeness. Notice that I do not define it as the end state of being completely whole, or “enlightened,” or any similar psychospiritual ideal. It is a direction, not a destination; a line on a map, not a dot. Nor is healing synonymous with self-improvement. Closer to the mark would be to say it is self-retrieval.

Healing is also distinct from being cured: the latter means the absence of disease; the former implies coming to wholeness. “It’s possible to be healed but not cured, and it’s possible to be cured but not healed,” my colleague Dr. Lissa Rankin[*] points out. “Ideally, healing and curing happen together, but this isn’t always the case.”

Any movement toward wholeness begins with the acknowledgment of our own suffering, and of the suffering in the world.

True healing simply means opening ourselves to the truth of our lives, past and present, as plainly and objectively as we can. We acknowledge where we were wounded and, as we are able, perform an honest audit of the impacts of those injuries as they have touched both our own lives and those of others around us.

None of us need be perfect, nor exercise saintly compassion, nor reach any emotional or spiritual benchmark before we can say we’re on the healing path. All we need is readiness to participate in whatever process wants to unfold within us so that healing can happen naturally.

Agency is the capacity to freely take responsibility for our existence, exercising “response ability” in all essential decisions that affect our lives, to every extent possible.

Anger in its natural, healthy form is a boundary defense, a dynamic activated when we perceive a threat to our lives or our physical or emotional integrity.

Anger’s core message is a concise and potent no, said as forcefully as the moment demands. Wherever we find ourselves tolerating or explaining away situations that persistently stress us, insisting that “it’s not so bad” or “I can handle it” or “I don’t want to make a fuss about it,” there is likely an opportunity to practice giving anger some space to emerge. Even the plainspoken admission that “I don’t like this” or “I don’t want this” can be a step forward.

acceptance is the recognition, ever accurate, that in this moment things cannot be other than how they are. We abstain from rejecting or condoning. Instead of resisting the truth or denying or fantasizing our way out of it, we endeavor to just be with it.

The compassion of truth recognizes that pain is not the enemy. In fact, pain is inherently compassionate, as it tries to alert us to what is amiss.

There is nothing touchy-feely here. Compassion is distinct from conjuring up warm feelings toward anyone, including the self. It is an attitude, not a feeling. Unlike feelings, which come and go of their own accord, attitudes can be invited, generated, and nurtured in the face of any emotional state. The attitude here is one of inexhaustible non-judgment toward whatever one notices. When self-judgments arise—as they inevitably do—we can stay curious about their origin without believing their content.

There is a world of difference between a considered, conscious “yes” and a compulsive suppression of a “no.”

just getting clear that we are consciously and purposefully accepting a situation that incurs chronic stress is already a step up from doing so automatically.

the Chinese phrase for “crisis” is a compound of symbols for “danger” and “opportunity.”