To start with, a confession: I make no claim to neutrality since this is a book I have been waiting for. For quite a few years I have asked myself the questions: How can an individual be healthy in an unhealthy society? How can a person retain sanity in an “insane” culture? This ambitious book, co-written by bestselling author Dr. Gabor Maté and his son Daniel Maté, sets out to answer these very questions, which are becoming particularly urgent in the 2020s.
Dr. Maté’s earlier books looked at addiction, stress and child development. For example, in In the Realm of Hungry Ghosts (2008), Maté used case studies, pioneering research and lessons learnt from his work as a doctor, as well as his observations about his own addictive behaviour, to write a penetrating work on addiction, whether it be to “drugs, sex, money or anything self-destructive.” (In Buddhism, “hungry ghosts” refers to beings who are driven by desire and never satisfied.)
In The Myth of Normal, the authors widen the frame from individual and family pathology to pathology as it manifests in society and culture, even bringing in the role played by our economic system. This is particularly courageous and necessary in the North American context, which is still largely dominated by a focus on individuals rather than an analysis of the systems that work collectively to create a sick society.
The book is divided into five sections: Our Interconnected Nature, The Distortion of Human Development, Rethinking Abnormal: Afflictions as Adaptations, The Toxicities of Our Culture and Pathways to Wholeness.
The authors starts with a critique of modern, Western medicine, which lacks a holistic way of dealing with disease. The field of interpersonal neurobiology, they say, has proved through research studies (so dear to Western Science) that “nothing about us, mental or physical, can be comprehended apart from the many-faceted milieu in which we exist.” They also mention “all my relations,” a concept originating in Indigenous communities in Canada, which “refers to the individual’s multidimensional bond with the entire world.” Indeed, this concept has been widely accepted and embraced in myth and religion since ancient times and can also be found in the multi- and cross-disciplinary approaches of certain academics and practitioners in various fields.
Throughout the book the authors cite many studies that affirm this holistic worldview. Everything is connected and a sick society will create sick individuals. Here is just one remarkable example from the book: Nobel Prize-winner Dr. Elizabeth Blackburn discovered that even our chromosomal composition bears the marks of external factors – poverty, racism and urban blight. Dr. Elissa Epel’s work, in confirming the above findings, also found that interventions to relieve the effect of environmental stressors repaired ailing chromosomes.
Dr. Maté has shown these complex connections in his earlier books like When the Body Says No: the Cost of Hidden Stress, and the authors revisit these notions again in this book. For example, killer diseases like Multiple Sclerosis (MS) can have their origin and continuation in life stressors of different kinds. And MS is not the only disease triggered and fostered by stress. They also discusses personality traits that can cause chronic disease: compulsive concern for other people’s emotional needs while ignoring one’s own; rigid identification with social roles; overdriven, externally focussed behaviour; repression of “healthy” anger and an “I must never disappoint anyone” attitude.
While dissecting individual pathology, throughout the book, the authors also lay bare social pathology – the debilitating external pressures individuals are subjected to whether as children, workers, parents, citizens or simply human beings. In the ultimate analysis, we do not have the freedom to shape our own selves or lives, so hemmed in are we by external expectations, standards and demands. According to the authors, there is a profound disconnect between people, people and society, people and values, and people and meaning, as in the meaning of life.
They pay special attention to race and gender: again, studies have shown the particularly detrimental health effects from just being born black and female, for example. Later pages also deal with the role capitalism has played in creating a sick society, from breaking unions and putting profits before people to ruthlessly pushing addictive consumerism, as well as the creation of real addiction – from sugar (labelled as one of the most dangerous drugs of all time) to deadly mass-marketed opioids sold as “medicines.”
Throughout the book, Dr. Maté weaves in other people’s stories as well as his own. Born into a Jewish family in Budapest, young Gabor’s close family members either died or suffered because of Nazi fascism. He was handed over to a Christian woman, a stranger, for safekeeping when he was one year old, and was therefore separated from his mother for five weeks. The trauma induced by this necessary abandonment has had a deep, negative impact on his life.
Finally – on page 361– begins a chapter called Pathways to Wholeness. I had been waiting for this part, wondering what possible panacea could the good doctor and his son offer in the face of so much that has gone incredibly wrong!
They start by defining healing as “a natural movement towards wholeness.” Healing is not a matter of being cured, but rather an ever-evolving process with great challenges and wonderful rewards. I won’t summarize this chapter as it is not fair to give everything away in a review. Suffice to say that here, as well, the authors deliver. They offer analytical frameworks to unpack and understand individual malaise and explores ways of dealing with it.
Dr. Maté’s own life changed decisively after an experience with mind-altering drugs in a ritualistic setting with shamans in South America, which took him beyond the thinking mind and brought him into the realm of the spirit. However, he is no “psychedelic evangelist,” as he puts it. Psychedelics helped him break through layers of defensiveness and neurosis, as they have done for many. Yet everyone, he says, has a different path to wholeness.
At a societal level the authors advocate what they call a “trauma-conscious society.” In previous books, as in this one, Dr. Maté discusses childhood trauma (whether severe or less severe) as the basis of individual “dis-ease.” Not dealing effectively with this trauma can lead to devastating consequences, hence the need for a trauma-aware system of medicine, law and education. Encouragingly, there is already some movement in this direction in some places. The authors also mention how getting involved in a cause – something bigger than the self – can contribute to healing.
In this complex and timely book, the authors help readers connect the dots and see the big picture. I emerged not only much better informed, but also more empowered and hopeful. The book is also practical. I plan to use the last chapter – Pathways to Wholeness – to reflect on some personal issues and work on myself.