Last Day

Trauma (with Dr. Gabor Maté)

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Dr. Gabor Maté is a world-renowned trauma expert who can (and will) deconstruct your happy childhood in a matter of minutes. At least, that’s what he did to our host, Stephanie. We start this episode with the question, “Why?” Why would someone get addicted to opioids? In this riveting interview, Dr. Maté expands our definition of trauma, breaks down how childhood trauma leaves wounds and how addictions of every kind are an attempt to soothe those wounds, and explains that healing is possible.


[00:42] Stephanie Wittels Wachs: If I were going to boil this entire season down to a single word, it would be “why,” with “fuck” being a close second. Why is my brother dead? Why is Stefano dead? Why are so many of your people dead? Why do people use drugs at all? Why is treatment so elusive? Why can’t we figure any of this stuff out? And the general consensus is, well, it’s complicated, and layered, and it’s not just one thing, it’s lots of things. But what if it isn’t? 


[01:21] Dr. Gabor Maté: In my work, whether it’s addictions or chronic illness or mental illness, trauma is just always there in the background. And it has many, many physical and psychological consequences. And unfortunately, it’s completely ignored in medical education. It’s completely ignored in most addiction treatment programs. It’s so ubiquitous, we don’t even see it. It’s so around us, it’s so everywhere that we actually think it’s part of normal life.


[01:53] Stephanie Wittels Wachs: Today, we are talking to a legitimate expert with a vastly different point of view on the root cause of addiction. World-renowned trauma expert and bestselling author Dr. Gabor Maté. 


[02:06] Dr. Gabor Maté: So can I just quote you on the pronunciation of my name? 


[02:10] Stephanie Wittels Wachs: Please do.

[02:11] Dr. Gabor Maté: So the first name’s Gah-bor, 


[02:12] Stephanie Wittels Wachs: Gah-bor. 


[02:14] Dr. Gabor Maté: And the surname is Maht-ay. 


[02:15] Stephanie Wittels Wachs: Maht-ay. Gabor Maté. Did I do it right?


[02:19] Dr. Gabor Maté: That is correct.


[02:22] Stephanie Wittels Wachs: OK! Well, let’s get all the names out of the way. I’m Stephanie Wittels Wachs and this is Last Day.


[02:43] Stephanie Wittels Wachs: Since the start of this season, I have been itching to get Dr. Maté on the show. And if I’m being honest, much of that was fueled by selfish reasons. One of the reasons I was so intrigued about having you on is because of all of this work that you’ve done with childhood trauma and addiction and the link between that. And I think something that has been so sort of confounding for my family has been talking about and thinking about why did Harris become addicted? You know, we had a beautiful upbringing, great parents still together. You know, we got to go to summer camp. We got to chase our dreams. Like, there was no observable trauma. And so we constantly are going, why, why, why, why, why? And I found your work. And it’s so compelling to me. So I want to talk about that and I want to talk about your work. 


[03:42] Dr. Gabor Maté: Let me just ask you something first. So are you still in the dark or confused about what might have happened to your brother? Or do you have any clues at all? 


[03:51] Stephanie Wittels Wachs: I know that he has, as a human, a very sort of extreme personality, right? He wants to go — he loved the band Phish, he wanted to go to 150 concerts. He ordered at a restaurant like he was running a marathon. 


[04:07] Dr. Gabor Maté: OK, so he was very intense.


[04:09] Stephanie Wittels Wachs: Very intense, very sensitive. 


[04:12] Dr. Gabor Maté: I was just going to say he’s one of these highly sensitive people. 


[04:16] Stephanie Wittels Wachs: Very sensitive, very creative. 


[04:17] Dr. Gabor Maté: Now, the first thing is that the more sensitive you are, the more you feel. And the more you feel, the less it takes to hurt you. So that events or circumstances that to somebody who’s less sensitive, more stolid, will not touch them that deeply at all. But the very sensitive person experiences them very deeply. And it can make a lot of pain. That’s the first point. So these are the people who are at highest risk. Secondly, I have talked to — well, hyperbolically — I have spoke to a million people. Of course I haven’t, but many, many hundreds at least. And this happy childhood takes me usually about two or three minutes to deconstruct it. And it’s not because the memories of happiness are not valid. It’s because they cover sometimes some very deep pain. And so you may not be in a position to answer these questions on behalf of your brother because you didn’t have his experience. No two children of the same parents or two children grew up in the same family. 


[05:23] Dr. Gabor Maté: But I’d ask questions like is there trauma in the family over the generations? What kind of childhood did your parents have? Was there any stress between them at all? How was the pregnancy? Was Harris ever — did he ever feel alone or unhappy as a child? If he did, who did you speak to about it? Did he perhaps have a tendency to have ADD-type problems which again, come out of a high degree of sensitivity? So I could ask you those questions about your family, but I don’t know that you’d be accurate in your responses, in a sense that you’d be giving your experience, but you wouldn’t be giving your brother’s. And none of that has anything to do with blaming parents. Because, yes, your parents were loving. Yes, they loved each other. They loved you guys. They would have done anything for you. But I’d want to know what stresses they had that a sensitive kid may have picked up on.


[06:18] Stephanie Wittels Wachs: You mean that, like, two kids can come from the same parents, live in the same house, and have two completely different experiences of that. 

[06:24] Dr. Gabor Maté: They don’t have the same parents, they don’t live in the same house. Externally, of course they do. And biologically, they do. But the parents they experience are not the same. The parents, they come along at a different stage in their parents’ lives. There’s a birth order difference. Who’s the older between the two of you? 


[06:41] Stephanie Wittels Wachs: I am 


[06:42] Dr. Gabor Maté: OK. Well, you had something that Harris never did, which is the parents’ undivided attention. On the other hand, Harris never had the insult of a new person intruding into the house all of a sudden, you know? So that’s already a difference, you see.


[06:57] Stephanie Wittels Wachs: As you say that I’m literally in my brain — I thought I had curfews. My brother never did. Like he was the second child, he had so much more freedom as a kid. And he was a boy. So my parents, my dad thought like, oh, he can do what he wants. You know, he’s a boy. You need to be more protected. You’re a girl. 


[07:15] Dr. Gabor Maté: Well, OK, that’s a huge difference already. So what to you seemed naturally enough as an unfair treatment, Harris might have experienced it as not much caring as you received. I mean, I don’t know. But I’m just saying that you didn’t have the same childhood. 


[07:32] Stephanie Wittels Wachs: Oh, my gosh. You’re blowing my mind right now. 


[07:35] Dr. Gabor Maté: So then you had different temperaments. So that the same events, even if they were the same, would strike you differently. Then you had the fact that each child evokes a different part of the parent. I have three kids, they all bring up different parts of me. I don’t relate to them all the same way. It’s not a question of do I love one of them more than the other. That’s not an issue. But am I the same parent? No, I’m not. So for that and many other reasons, no two children grew up in the same home.


[08:01] Stephanie Wittels Wachs: As he’s dismantling my entire childhood, all I can think about are my kids. My daughter was one month old when Harris went to rehab for the first time. And in the first year of her life, he was in and out of several programs. So I was a mess. It was a roller coaster. I was filled with this relentless sense of anxiety and just fear. And when she was 13 months old, the phone rang, mid-diaper change, and I learned that my brother was gone. And that catapulted me into a brutal motherfucker of a depression. And not to get to woo-woo, but if my baby was literally feeding from my body during such a horrific time, was she taking all of that in? I mean, as far as six-year-olds go, she is intense and sensitive. Her soul is wide and deep. And then I look at my son, who was born a year and a half ago, and essentially, if I were to describe him in one word, it would be “weeeee!” Is it because that’s just how he is wired? Or is it because he was born to a completely different mother?


[09:22] Stephanie Wittels Wachs: The idea of trauma, the idea of childhood trauma, it seems like such an extreme word or condition. What do you mean when you talk about trauma?

[09:37] Dr. Gabor Maté: Sure. So let’s just look at the word origin. It’s a Greek word. It means wound. So trauma is a wound, is what it is. And you can experience that wound because of egregiously horrific incidents like sexual abuse and beatings and emotional assaults. That’s the usual way that people think of trauma. But that’s not how I think of it. Trauma, again, going back to the word origin means a wound. And so people could be wounded in all kinds of ways, and especially a sensitive child can be wounded just because his feelings are not understood. Or his needs aren’t exactly met, or because the parent is too busy, or because the parents are stressed, and the child takes on the role of protecting the parent from the stresses by suppressing their own feelings. So there’s all kinds of ways in which people can be wounded. So trauma is not just a wound, but it’s a wound that’s not healed. So it causes a defensiveness. It causes more pain. Also, what happens to wounds is that they scar over. And if you look at a flesh wound that’s scarred by the scar tissue, it’s less flexible. It has less feeling in it. It doesn’t grow. It doesn’t develop. It’s a protective covering, but it doesn’t have the flexibility and the vitality of real flesh. And so people who are wounded are limited and constricted in their capacity to respond to the world. They become separated from their own feelings, sometimes from their own gut feelings, in fact, often from their own gut feelings. They develop a view of the world that’s tinted by pain or distrust. Or they lose their sense of security. They don’t know who to trust. Sometimes they trust the wrong people or they don’t trust the right people. So trauma has many implications and many consequences. And it doesn’t take horrific events to traumatize people. That’s what the big misunderstanding is.


[11:38] Stephanie Wittels Wachs: I was just about to ask you how — I mean, the way that you’re defining it, it doesn’t seem possible that anyone would not be able to get through life without trauma. That seems like that would be the outlier. That trauma is is the norm.


[11:54] Dr. Gabor Maté: It is. It doesn’t have to be, but it is. Now, again, you have to understand, trauma is not that bad things happen to people. Because like the Buddha said 20,000 years ago, life brings suffering. So that’s just the norm. You know, people die, your pet dies. People might reject you. Somebody you love may not respond positively. You might suffer illness. This is painful. So life brings pain, but pain is not the same as trauma. Pain becomes traumatic when that pain isn’t resolved, when it doesn’t get the support it needs, when it isn’t metabolized, when we don’t learn and grow from it. Trauma is not what happens to us. Trauma is what happens inside us.


[12:37] Trauma isn’t what happens to us. It’s what happens inside us. I mean, whoa. So simple and so profound at the same time. I mean, why don’t you just go ahead and write that down? You can pause me, come right back. It is just so good. I mean, my first question for Gabor was,  “We’re stumped! We had such a happy childhood. What on earth could have possibly traumatized Harris?” But according to him, trauma can be lots of things. And the thing in and of itself isn’t guaranteed to traumatize a child. In the same way that an idyllic childhood isn’t guaranteed to ward off trauma. It’s what happens in response to the things that makes the difference.

[13:25] Dr. Gabor Maté: Two children could have the same experience of something really bad happening to them, but if one of them is held properly emotionally, and is allowed to express their emotions, and they can go through the process of releasing the emotions and the physical responses that are triggered by what happened, then they’re not going to be traumatized. If the same event happens to a different child who is emotionally alone and there’s nobody there to understand and to help them go through it, they’re going to be traumatized. 


[13:59] Stephanie Wittels Wachs: After the break, we link trauma to addiction. Stick with us. 


[15:22] Stephanie Wittels Wachs: We’re back. When we left off, Dr. Maté was dismantling my childhood and redefining my understanding of trauma. So what does any of this have to do with the opioid crisis? 


[15:36] Dr. Gabor Maté: So people say, well, what is the power of the opiates? Well, the first question we have to ask is not what’s wrong with the addiction, but what’s right about it. We know what’s wrong with it. But why don’t you ask somebody, what does it do for you? What is the appeal of it? Now, when you talk to people with opiate addiction, as I have, because I’ve worked with many of them, they tell you, well, the opiates, they soothe with my pain, my emotional pain. The opiates make me feel closer to other people. They make me feel better about life. Well, soothing emotional pain, feeling close to other people and feeling better about life are all desirable qualities that we all want. Now, not just opiates, but if you look at addictions in general, not just to opiates, but sex, gambling, shopping, cocaine, nicotine, whatever it is, they all do something physiologically in the human brain. And fundamentally, whether it’s overeating or whether it’s work addiction, whether it’s Internet addiction, whether it’s gaming addiction, pornography or drugs or alcohol, these are all attempts to escape pain. The first question is not why the addiction, but why the pain. And if you understand why the pain, you have to look at people’s lives. So the whole idea that addictions are a genetic disease is just scientific nonsense. Or that it’s a choice is even more scientific nonsense. Nobody chooses to be an addict and nobody’s born addicted. People are born with different sensitivities and predispositions, but addiction is not an inherited phenomena. It’s a response to life’s pain is what it is. 


[17:22] Stephanie Wittels Wachs: Well, this is different than what 99 percent of the people on this show have said. I mean, just two weeks ago, Lori’s son Ian stressed that he was born this way. Where did he get that concept? From the world, from doctors, from books, from shows like ours. Dr. Maté’s research suggests otherwise.


[17:46] Dr. Gabor Maté: So the first thing to realize is that the human brain is not a genetically determined organ. So which circuits develop in the brain, and to what degree and how functionally, depends very much on the environment. So take something which is really missing in addiction — impulse regulation. So addicts are forever acting impulsively. They know something is bad for them, but they’re going to do it anyway because the impulse regulation is not online. 


[18:15] Stephanie Wittels Wachs: As we’ve heard before, impulse control lives in the prefrontal cortex. And evidence suggests that prolonged drug use can actually change the way the prefrontal cortex operates. It’s one of the reasons why people who use drugs are known for risky, impulsive behavior. It’s sort of like when your kid draws all over the wall with a permanent marker or decides to swan dive off the counter onto the tile floor below. Also, risky, impulsive behavior. Only for kids, it’s because their prefrontal cortex is still developing. And if that kid is living in a stressful environment, it can significantly impact brain development. 


[18:56] Dr. Gabor Maté: So when the parents are stressed, the child is not attuned with, or if specifically hurtful incidents happen early in life, those circuits just don’t develop properly. And I’m talking about their architecture and their connections and their chemicals. So the physiology of the brain develops through an ongoing process that begins in utero — before birth — and continues into adulthood, and is significantly shaped by the environment, particularly the child’s emotional relationships with the adults around them. So when adults are stressed, and they’re multitasking and whatever, even if they don’t hurt the child, that can affect a child’s brain development. 


[19:39] Stephanie Wittels Wachs: So the obscene amount of multitasking that I engage in every second of every day can actually be a source of trauma that can literally impact my kid’s brain development? OK. Well, buckle up, parents and caregivers, because Maté is about to delve into the long-term health implications of trauma. And quick disclaimer for those of you who are wired like me and are now breathing into a paper bag: I promise it’s going to be OK. There is a light at the end of this traumatic tunnel. Just got to hang in there a little bit longer. OK, back to Maté. 


[20:19] Dr. Gabor Maté: The more trauma there is, the more inflammation there is in the body. So children who were abused as kids, you can measure the level of certain chemicals, proteins in their blood as adults that speak of inflammation. And they’ll have elevated inflammatory proteins in their blood, which makes them at higher risk for depression, and for heart disease, and for autoimmune disease and all kinds of other problems.


[20:44] Stephanie Wittels Wachs: But that’s not all, according to Maté, trauma can take actual years off your life. And while addiction may not be genetic, the impact of trauma can affect us on a genetic level. Fair warning we are about to get science-y.


[20:59] Dr. Gabor Maté: See, there’s something called telomeres. Telomeres are strands of DNA at the end of our chromosomes that keep our chromosomes together. And as we age, they get shorter and shorter. Well, the more trauma there is, the shorter telomeres gets. So the more stress there is, the shorter our telomeres get. So that two people could be at the same biological age, but one could have much shorter telomeres because of a lot of stress, they are more likely to have disease and to die younger than somebody with longer telomeres. And that has a lot to do with many factors, including childhood trauma. So there’s so many ways in which trauma and — again, I’m talking about trauma not just in the specific sense of terrible things happening, but trauma in the sense of a child being wounded — can affect that child’s biology for the long term. 

[21:50] Stephanie Wittels Wachs: If you’re sitting there wondering where you or your children rank on the trauma scale, allow me to introduce you to the Adverse Childhood Experiences Study.


[22:00] Dr. Gabor Maté: The ACE Studies. A child experiences emotional or sexual or physical abuse — the three of them — a parent dying, a parent being jailed, a divorce, violence in the family and neglect — these are all adverse childhood experiences. And the more — a parent being addicted — and the more of these cases of adverse childhood experiences a child endures exponentially, the greater the risk of addiction


[22:30] Stephanie Wittels Wachs: And other stuff. Depression, obesity, heart disease, cancer, suicide. The ACES are making their way into the mainstream. As of this very month, children throughout California may be screened for childhood trauma during routine checkups at the pediatrician. But since I’ve aged out of pediatrician checkups, I took the ACES test online and my score is zero. Zero. And I’m still fucked up! So what happens when someone has a 5, 6, an 8, a 9, a 10? 


[23:07] Dr. Gabor Maté: So what’s it like to grow up in a home where the father is an alcoholic? And you never know who’s going to show up? The friendly, jolly father or the angry, sullen or withdrawn father? So the child is growing up under very uncertain, very unstable and emotionally taxing circumstances. That’s going to affect them. That’s going to give them emotional pain. Then they become addicts, or alcoholics, and you say, well, it’s genetic — not you say, but people say — it’s a genetic disease because, look, the father had it, now the daughter or the son had it. No, it’s not genetic. It’s passed on, multigenerationally, not through genes, but how the genes affected by the environment. Now, there may be a predisposition in the form of a heightened sensitivity in temperament. I think people are born with that. But a predisposition is not the same as a predetermination. And we know from animal and human studies that people or creatures, monkeys, for example, can be born with a predisposition, that is to say, a higher sensitivity. But if they’re brought up in nurturing circumstances, their risk of addiction is no greater than that of somebody who doesn’t have that genetic predisposition. So to call addiction a genetic disease,  like most physicians or the most treatment programs do, is just utter nonsense. And unfortunately, it takes the focus away from the trauma aspect. And even if addiction was 99 percent genetic and one percent environmental, which condition could we do something about? The genes or the environment?


[24:44] Stephanie Wittels Wachs: If it is environmental, then that means that it’s something we can exercise will over, correct? And we can do something about it.


[24:51] Dr. Gabor Maté: Yes. And if trauma is a wound that has not healed, we can heal the trauma. We can heal the wound. So this perspective that I’m putting forward — and I’m not the only one — maybe far more challenging for people emotionally, and daunting for families, because then they have to look at really what happened here over the generations. But at the same time, it offers the possibility of redemption and healing. Whereas the genetic perspective is just deterministic and fatalistic and the best you can do is manage it, but we can’t heal it. 

[25:24] Stephanie Wittels Wachs: What a freeing notion. On the one hand, the genetic perspective is alluring, right? Because it’s like, hey, it’s nobody’s fault. What are you going to do? But on the other hand, it sucks because it means you have no agency whatsoever over your life. In Gabor’s version of humanity, there is a cause for the way that we are. But there’s also a solution. 


[25:51] Stephanie Wittels Wachs: So how do you get out of the woods on that? I mean, if you have a trauma and you — like you say, we need to address it, what does addressing it look like?


[26:04] Dr. Gabor Maté: You mean you when you’re an adult? 


[26:08] Stephanie Wittels Wachs: Yeah. 


[26:10] Dr. Gabor Maté: Well, I begin in the case of addicted people, I begin by just asking what I asked you. Not what’s wrong with the addiction, but what’s right about it? What does it do for you? You know. So they’ll say, well, it soothes my pain, or it makes me feel closer to the people, or it gives me a sense of control, or gives me peace of mind, or helps me escape stress. And I say, OK, well, those are all valid intentions. And so it begins with just looking at it. And looking at it compassionately. So all of a sudden, you’re not looking at yourself like a big screw-up who’s just messed up every opportunity in life and become disordered addict. But you’re looking at yourself as, look, I’m a human being who suffered, and this addiction was my response to the suffering. So then you can disconnect it from parts of yourself. The healing of trauma is all about reconnection. 


[27:02] Stephanie Wittels Wachs: Trauma treatment, like addiction treatment, must be tailored to the individual. 


[27:08] Dr. Gabor Maté: Well, you know, there’s no one-size-fits-all. And we really have to find the right approach to each person. What makes the biggest difference is not actually the technique, but the quality of relationship between the therapist and the client. So there has to be safety and trust and vulnerability there. Unfortunately, again, since physicians are not trained in trauma at all — I mean, the average physician does not get a single lecture on trauma in all their years of medical school. I mean, that’s hard to believe, but it’s the case. Empathy is very often lacking in medical treatments. No wonder people don’t do so well. 


[27:46] Stephanie Wittels Wachs: So, like Dr. Maté said, trauma treatment isn’t one-size-fits-all. There’s as many trauma therapies as there are people listening to this podcast. There are experiential therapies like EMDR and sensory motor work. There are new psychedelic therapies like ketamine. And some providers are even using MDMA to treat PTSD, which sounds kind of out-there for an opioids podcast, but early studies on its effectiveness are so promising that the FDA has labeled MDMA as breakthrough therapy and prioritized its review for approval. 


[28:20] Dr. Gabor Maté: So there’s multiple ways of working. It’s a question of recognizing that’s what the issue is. And then that’s what the roadblock is, that’s what the bottleneck is, that people just don’t get the trauma connection, therefore they don’t introduce it into the treatment. And most people go through — your brother, you mentioned, went through various treatment programs. I doubt very much that trauma was ever approached in his treatment programs. I doubt it. I mean, it might have been. 


[28:45] Stephanie Wittels Wachs: I don’t believe so. No, I don’t believe so. 


[28:47] Dr. Gabor Maté: And of course, if it wasn’t, they weren’t dealing with what matters most. That’s just how it is. 


[28:53] Stephanie Wittels Wachs: This season, we’ve heard from numerous addiction specialists about why people get hooked on opioids, all the biological factors that tell your brain, “this is amazing! Keep doing this forever!” It’s the soothing effect that Maté mentioned earlier. But he takes it a step further. For some, the drugs make them feel something that they’ve never felt before.


[29:17] Dr. Gabor Maté: A little thing called love. Without which there’s no human life. By love, I mean attachment, connection to another human being. I once asked a sex-trade worker in the Downtown east side of Vancouver, where I worked as a physician, hooked on opiates, and I said, what does that do for you? She said, “the first time I did heroin, it felt like a warm, soft hug.” And that’s what the opiate addicts are after. What they’re after is perfectly normal. The question is what happened to them that they don’t have those qualities in their lives? Well, what happened to them is that childhood trauma prevented the healthy development of their own opiate circuits, and that stress later on in life continued to keep the circuits unbalanced. So that’s what happened. 


[30:02] Stephanie Wittels Wachs: Oh, my gosh.


[30:03] Dr. Gabor Maté: Let me say one more thing, which is in my mind, which is not quite connected to what I’m saying now. Just an article I read recently, actually, in the Journal of the American Medical Association. And they showed that in areas where they shut down auto plants, there was an 85 percent rise in opioid deaths. So when we’re talking about trauma, we’re not just talking about childhood trauma. We’re also talking about the stresses that our failing economic system imposes on — the way it discards people and makes them useless. And what happens when we’re told that all of a sudden you’re redundant, you’re not needed anymore, you’re useless, you know? And then that can tap into all kinds of childhood pain. 


[30:45] Dr. Gabor Maté: What I’m saying is that the 400,000 deaths from overdoses aren’t just the result of childhood trauma. They’re also the result of stresses, insecurities that this system daily imposes on hundreds of thousands and millions of people. 


[31:03] Stephanie Wittels Wachs: So basically, we are all getting repeatedly traumatized by a variety of sources throughout our lives, beginning in infancy. Cool. I currently feel traumatized by all of this new information on trauma. And I need a break. When we come back, my conversation with Dr. Maté takes an unexpected turn and hits extremely close to home. Stay with us.

[32:43] Stephanie Wittels Wachs: We’re back with trauma expert Dr. Gabor Maté.


[32:50] Stephanie Wittels Wachs: You’ve said that, in an interview I heard, “nobody’s saying that every traumatized person becomes addicted. I’m saying that every addicted person was traumatized.” And with that, I guess my question is, have you seen any sort of pattern that hints to why some trauma leads to addiction and others do not? Like why — you know, you’ve kind of like cracked my brain open in terms of my own childhood, and thinking about my own personal traumas, and that they definitely were there even though we had a happy home, and why I didn’t become addicted and my brother did. And what determines that? 


[33:24] Dr. Gabor Maté: OK. How personal do you want to get here?


[33:26] Stephanie Wittels Wachs: I mean, listen, I’ll get very personal. I’m happy to get personal. 


[33:30] Dr. Gabor Maté: OK, terrific. So you say you didn’t get addicted? Well, maybe not. But let me give you a definition of addiction, and then you tell me whether it applies to you or not, OK? So addiction is manifested in any behavior that a person finds temporary pleasure or relief in and therefore craves, suffers negative consequences as a result of, but does not give up despite negative consequences. So craving pleasure relief in the short term, negative consequence in the long term, difficulty or inability to give it up? OK. That’s what addiction is. That can be, as I said before, substances of all kinds. Could be relationships. Could be sex. Could be gambling. Could be eating, could be bulimia. Could be work. Could be extreme sports. Shopping. In other words, it’s not the behavior per se that defines whether it’s addiction or not. It’s the internal relationship to it. Is there creating pleasure relief in the short term, negative consequence, inability to give it up? So let me ask you from that point of you, your answer might still be no, but I’m just curious, by that definition, have you ever had an addiction in your life? 


[34:41] Stephanie Wittels Wachs: Yes, 100 percent. 


[34:43] Dr. Gabor Maté: Well, there you go. You said you didn’t have an addiction.


[34:46] Stephanie Wittels Wachs: I guess I didn’t have an addiction to opioids, but yes.


[34:49] Dr. Gabor Maté: OK, terrific. But that’s the whole point. That’s just such a narrow view of addiction. Opioids are one particular form of addiction. But it’s the same process. In fact, the same brain circuits are involved in just about all addictions that I’ve listed here. Let me ask you this, now. I’m not going to ask you what you’re addicted to, but I want to ask you what did it do for you in the short term? 


[35:07] Stephanie Wittels Wachs: I’ll tell you, I’m very addicted to work. Extremely, extremely. 


[35:11] Dr. Gabor Maté: What does it do for you? 


[35:12] Stephanie Wittels Wachs: I mean, it cuts down on the noise, I think. It cuts down on like my internal noise. 


[35:18] Dr. Gabor Maté: OK, well, very good. OK. So one thing it does, it gives you some peace of mind. 


[35:24] Stephanie Wittels Wachs: Yes. 


[35:25] Dr. Gabor Maté: OK. Well, is that a good thing or a bad thing, to have peace of mind? 


[35:29] Stephanie Wittels Wachs: It’s great. 


[35:31] Dr. Gabor Maté: Terrific. Question is, why is there so much noise in your brain? In other words, the addiction is not your problem. The addiction is your attempt to solve a problem. And addictions are always an attempt to solve a problem. And if you understand the addiction, you have to understand the problem. So then I’d have to talk to you, and we could, but, you know, maybe it’s some deeper and longer conversation than we have time for, but I wouldn’t ask a person, “well, how did you get all this noise in your mind?” And that always goes back to childhood. 


[36:00] Stephanie Wittels Wachs:It just did. 


[36:03] Dr. Gabor Maté: And I know you told me in the beginning what a happy family you came from, but I’m telling you–  and I’m not saying that that memory is incorrect so far as it goes, but it’s incomplete. 


[36:14] Stephanie Wittels Wachs: Yeah.


[36:17] Stephanie Wittels Wachs: Just a warning to our listeners: um, if you ever find yourself on the phone with a world famous trauma expert and they ask if you want to get personal, just consider your answer very carefully before sounds start to come out of your mouth. I mean, this whole exchange caught me off-guard for a variety of reasons. One being that I intended to talk to him about other people’s trauma, and two, that he is absolutely fucking correct. My talking points on my happy childhood are incomplete. That constant noise in my head that work helps me silence, it traces back to a singular event.


[37:01] Stephanie Wittels Wachs: When I was 15, I had an abortion. While this isn’t the case for every woman, at that point in my life, it was a definitively traumatic experience for me. I felt more ashamed and alone than I could ever begin to articulate. My parents were dealing with their own shame and pain around it, and that manifested it in a real period of disconnection between us. And in the aftermath of that experience, I felt this compulsive need to prove to them that I was good and smart and worthy. All the things that I didn’t feel. And in an effort to do so, I channeled my sorrow into relentless productivity. Studying obsessively night and day. Becoming a straight-A student at the top of my class. Getting the lead in the school play. All of it. And as far as coping mechanisms go, it was pretty effective. Working hard made me feel less ashamed. Which made me feel less alone. And that was healing. Work was how I kept going. And I guess I just never stopped doing that. 


[38:21] Dr. Gabor Maté: Let me ask you a simple question. Well, a question I ask everybody is, “did you ever feel unhappy or sad as a kid?” 


[38:29] Stephanie Wittels Wachs: Oh, totally. Yeah. 


[38:31] Dr. Gabor Maté: Who did you speak to when that happened? 


[38:32] Stephanie Wittels Wachs: Well, I couldn’t really go to my parents. I had to go elsewhere. 


[38:36] Dr. Gabor Maté: OK. Now you’ve got kids, right? You’ve got two children? 


[38:39] Stephanie Wittels Wachs: Yeah. 


[38:40] Dr. Gabor Maté: If they’re sad or unhappy, who would you want them to talk to?


[38:43] Stephanie Wittels Wachs: Me. 


[38:45] Dr. Gabor Maté: OK. If you found out that your children were sad or unhappy and they didn’t talk to you, how would you understand that? How would you explain it? 


[38:55] Stephanie Wittels Wachs: I mean, it would be horrible. I don’t know. I mean, I would feel like a failure. I would feel like — 


[39:03] Dr. Gabor Maté: No, I’m not asking you to judge yourself. 


[39:05] Stephanie Wittels Wachs: Oh, I do that so well, though. 


[39:06] Dr. Gabor Maté: I’m not asking how you feel about it. I’m asking you, how would you just explain why my kids are not coming to me with their sorrow and their pain? How would you explain that?


[39:16] Stephanie Wittels Wachs: They don’t feel comfortable to? I don’t know. 


[39:19] Dr. Gabor Maté: They don’t feel comfortable, they don’t feel safe? 


[39:21] Stephanie Wittels Wachs: Yeah. 


[39:23] Stephanie Wittels Wachs: Dr. Maté is asking me what possible reasons my kids might have for why they don’t feel comfortable bothering me with their feelings. And I’m misinterpreting his question in every way possible because it’s hard. It’s a hard thing to fucking look at. But I know the answer. It’s work. I mean, the other day my daughter burst into tears because I was answering emails, which turned into how sad she is that I never come to lunch with her anymore, like all the other mommies and daddies, because I’m always working and it destroyed me. Because intellectually, I know that I’m one of millions of working moms struggling every day to strike the balance that’s at the core of every HuffPost listicle with the top ten secrets of having it all. But after this interview, I’m also conscious of how much work is tied up into my own trauma. I don’t just do it because I have to. I do it because it feels good. And now my trauma response has the potential to traumatize my child. That is what we call a cycle.


[40:29] Dr. Gabor Maté: Maybe they’re trying to protect you from too much stress because they sense how stressed you are. Now, how happy is that for the child not to be able to go to the parents with their with their sorrow and their pain? 


[40:40] Stephanie Wittels Wachs: Yeah, it feels wrong. 


[40:41] Dr. Gabor Maté: Just imagine one of your children in that situation. How would they feel? 


[40:45] Stephanie Wittels Wachs: Makes my eyes well up with tears to think about. 


[40:50] Dr. Gabor Maté: Give it some words. 


[40:52] Stephanie Wittels Wachs: They would feel terrible. They would feel sad and alone. Very alone.


[40:56] Dr. Gabor Maté: But that’s your childhood you just told me about. I know. And you tell me how happy it was. And you don’t understand. And you don’t understand why your brother might have become an addict. Oh, man. If he’s more sensitive than — think of these dynamics magnified in his case, and that’s all it takes. So it’s not, you know — I told you that it takes me two or three minutes usually. That’s all there is to it.


[41:20] Stephanie Wittels Wachs: Well, I knew we were gonna have a good conversation. I had no idea it was gonna be this good. I am going to go home and play this whole tape for my husband because you have like blown over my mind about my own personal life and how I’m going to relate to my children. So thank you for this free therapy session. I appreciate it. 


[41:42] Stephanie Wittels Wachs: Gabor stressed dozens of times during our conversation that my parents loved me more than anything in the world, which they did, and that they did the best that they could. Even still, like most of us, I didn’t escape childhood without wounds. And I know my kids will wind up with wounds of their own. So how do I get ahead of it? How do I take the inevitability of pain and make sure it doesn’t turn into permanent trauma? Gabor has a simple and actionable answer: connection. 


[42:22] Dr. Gabor Maté: My deep depression over the loss of my brother is part of the story of my early days of motherhood. But the other part is that I held my baby for hours and hours and hours every day. I nursed her. I rocked her. I danced with her. I held her hand. And that continues to this day. Every night at 1 a.m., she scurries into our bed like a little mouse and jumps in and attaches to me like a leech. And perhaps I should walk her back to her room because I get way better sleep without the repeated kicks and punches. But I get the sense that that physical connection is something that she needs.


[43:07] Stephanie Wittels Wachs: I cannot shield her from pain. But I can hold her and hug her and love her and be physically and emotionally there for her. I can do that. And I will.


[43:32] Stephanie Wittels Wachs: If you want more from Dr. Maté, check out our show notes where we’ll provide information on different types of trauma therapy, along with links to all of his books. Next week, we talk to two women about their childhood trauma and find out where they are today. 


[43:50] Woman: It broke my heart because I was going to be the one that didn’t do to their children what my mother did to me, what my dad did to me. And the truth is, I did exactly. I abandoned my children. Emotionally, physically. And that was a tough, tough realization to come to. I mean, it made sobriety that much more difficult. 


[44:27] Stephanie Wittels Wachs: Last Day is a production of Lemonada Media. This episode was produced by Jackie Danziger. Our associate producer is Nicolle Galteland and our assistant producer is Claire Jones. Jessica Cordova Kramer is our executive producer. Kegan Zema is our technical director. Bryan Castillo is our editor. Our executive producer is Jessica Cordova Kramer and our music is by Hannis Brown. Special thanks to Westwood One, our ad sales and distribution partner. You can find us online @LemonadaMedia. And you can find me @wittelstephanie. If you liked what you heard today, tell your family and friends to listen and subscribe, rate and review us on Apple, Spotify, Stitcher or wherever you get your podcasts. I’m Stephanie Wittels Wachs. See you next week.


[45:25] Producer: OK, we’re clear. 


[45:27] Stephanie Wittels Wachs: Oh, my gosh. OK. Was that as intense to listen to as it was to have? I was like, what’s happening? This might be one of the most intense conversations I’ve ever had in my life, not just on the show. 

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