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

by Gabor Maté

For all our love and dedication as parents and educators, the world in which we must rear children these days undercuts our best efforts in a multitude of ways, all masquerading as “just the way it is.”

“How we function as individuals cannot be understood outside of our relationship to the larger group.” In other words, our character and personalities reflect the needs of the milieu in which we develop.

Thomas Merton,

“The logic of worldly success rests on a fallacy: the strange error that our perfection depends on the thoughts and opinions and applause of other men! A weird life it is, indeed, to be living always in somebody else’s imagination, as if that were the only place in which one could at last become real!”[3]

Somehow the system’s values and expectations get under the skin, to the point where we confuse them with ourselves.

Thus, what is considered normal and natural are established not by what is good for people, but by what is expected of them, which traits and attitudes serve the maintenance of the culture.

Mechanisms for estranging people from themselves abound. They begin acting on us from the earliest moments of our existence with stresses in the parenting environment and socially sanctioned child-rearing practices that negate the child’s needs.

We consume our needs, unaware that what we take to be a ‘need’ has been artificially produced.”[6]

As Thomas Merton noted dolefully in 1948, “We live in a society whose whole policy is to excite every nerve in the human body and keep it at the highest pitch of artificial tension, to strain every human desire to the limit and create as many new desires and synthetic passions as possible, in order to cater to them with the products of our factories and printing presses and movie studios and all the rest.”[7]

Glover said to me.

The structure of capitalism creates a situation where people’s value relies on their capacity to consume. I don’t care if it’s consuming from Walmart or from Saks Fifth Avenue. When we talk about addiction, whether it be to drugs or whether it be to other forms of behavior, they all symbolize the sense of being devalued as a human being within a system.

Not daring to rock the boat, we risk sinking with it.

These all contribute to the inner emptiness, the void that addictions and covetous compulsions will later attempt to fill, even as our independent spirit is subjugated to the demands of an imbalanced, materialist culture.

Recent] studies have shown that repeated drug use leads to long-lasting changes in the brain that undermine voluntary control.”[3]

It’s worth asking: Who has ever heard of a “disease” that makes you “feel normal”? Or, when’s the last time getting sick made you “function better than normally”?

only a person in pain craves anesthesia. As a quest for self-escape, the internal logic of addiction is inescapable. Where I am is intolerable. Get me out of here.

Here we arrive at 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.

Multiple large-scale studies attest to the dynamic of childhood trauma, including sexual abuse, potentiating later addiction.

Addiction is a complex psychological, emotional, physiological, neurobiological, social, and spiritual process. It manifests through any behavior in which a person finds temporary relief or pleasure and therefore craves, but that in the long term causes them or others negative consequences, and yet the person refuses or is unable to give it up. Accordingly, the three main hallmarks of addiction are short-term relief or pleasure and therefore craving; long-term suffering for oneself or others; and an inability to stop.

Whatever the degree of injury, all addiction is a kind of refugee story: from intolerable feelings incurred through adversity and never processed, and into a state of temporary freedom, even if illusory. Again, try saying no to that.

In other words, this is an understandable attempt at self-treatment with something that almost works, thus creating a drive for further doses.”[2]

What’s true of physical illness is just as true of addiction: genes are turned on and off by the environment, and we now know that early adversity affects genetic activity in ways that create a template for future dysfunction.

Human and animal studies have both confirmed that any genetic risks for substance abuse can be offset by being reared in a nurturing environment.[3]

Dopamine is the essential neurotransmitter in the motivation system,

We don’t understand any major mental disorder biologically. —Professor Anne Harrington[*]

Like all concepts, mental illness is a construct—a particular frame we have developed to understand a phenomenon and explain what we observe. It may be valid in some respects and erroneous in others; it most definitely isn’t objective.

Diagnoses are abstractions, or summaries: sometimes helpful, always incomplete.

How does this culture disrupt healthy adult-child relationships? Why are we diagnosing children with a disorder, instead of “diagnosing”—and treating—their families, communities, schools, and society?

I’m not so interested in the formal diagnosis as such. My “diagnostic” focus goes to the specific challenges the person is facing in their life and the traumas animating those challenges.

There are fifty or more neurotransmitters in the brain whose complex interactions we are only now beginning to explore, not to mention the almost infinite possibilities inherent in the lifelong intersection of experience with the biology of body and brain.

Richard Bentall, a clinical psychologist, academic, and Fellow of the British Academy, summed up the science a few years ago: “The evidence of a link between childhood misfortune and future psychiatric disorder is about as strong statistically as the link between smoking and lung cancer,” he wrote.

Despite the genetic hoopla in the popular media and all the lavishly funded DNA-hunting in the scientific world, no one has ever identified any gene that causes mental illness, nor any group of genes that code for specific mental health conditions or are required for the presence of mental disorder.

If genes truly rule our fate like capricious, microscopic gods, then we are off the hook.

if phenomena like addiction or mental distress are determined mostly by biological heredity, we are spared from having to look at how our social environment supports, or does not support, the parents of young children, and at how social attitudes, prejudices, and policies burden, stress, and exclude certain segments of the population, thereby increasing their propensity for suffering.

It’s all in the genes’: an explanation for the way things are that does not threaten the way things are. Why should someone feel unhappy or engage in antisocial behavior when that person is living in the freest and most prosperous nation on earth? It can’t be the system! There must be a flaw in the wiring somewhere.”[17]

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.

There is a catch, however: we cannot select which emotions to force below consciousness, nor willfully reverse the mechanism even after it has outlived its usefulness.

Thus the repression of emotion, while adaptive in one circumstance, can become a state of chronic disconnect, a withdrawal from life. It becomes programmed into the brain, embedded in the personality.

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.

The mind is a meaning-making machine. It will generate stories that “make sense” of the emotions that, at a vulnerable time, it could not contain and perhaps still cannot.

has two possible options when it comes to processing her experience. She can conclude either that the people she relies on for love are incompetent, malicious, or otherwise ill-suited to the task, and she is all alone in this scary world; or that she herself is to blame for, well, everything. As painful as the latter explanation is, it is far preferable to the other one, which paints a life-threatening picture for a young being with zero power or recourse.

It is adaptive for the brain of a child in her situation to be in a state of hyperalert fear, even when no immediate danger is present. These adaptations to adversity, once habitual, cannot discern between major and minor threats—or no threat at all.

That more and more people are resorting to self-harm is a marker of the growing prevalence of stress and trauma.

Again, what is being transmitted, if anything, is sensitivity and not disease.

Self-fragmentation is one of the defenses evoked when the experience of how things are cannot be endured.

In the face of trauma, splitting from the present is a form of instantaneous self-defense.[9] From that perspective, it is a miraculous dynamic allowing vulnerable creatures to survive the unendurable.

Today, voluminous research has linked the symptoms of ADHD to trauma or early stress, and has shown that both can impact the dopamine circuits of the brain and that adversity can interfere with a child’s subsequent capacity to focus and to organize tasks.[15]

If we saw the condition and its associated traits as manifestations of biopsychosocial underdevelopment rather than as symptoms of a disease, we would ask ourselves how to provide the right conditions for healthy brain plasticity and psychological growth.

I replied with a question of my own. “What if your delusions are perfectly accurate? Not accurate in a concrete sense, but accurate to your emotional reality?” I pointed out that both fantasies—“I had ruined my family” and “I could save the world”—have something in common. Caterina was quick to catch the similarity: “In both, I have a sense of control! I’m very powerful.”