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Life Arts    H4'ed 11/24/15

Gabor Mate: How to Build a Culture of Good Health

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Interactions between the brain and body also determine that adverse early childhood circumstances--even in utero experiences--leave us in the long term with more than psychological and emotional effects. The physical impact of early childhood experiences can also directly promote disease. Studies from the United States and New Zealand have shown, for example, that healthy adults who suffered childhood mistreatment were more likely to have elevated inflammatory products in their circulation in response to stressful experiences. Such overactive stress reactions are, in turn, a risk factor for conditions such as heart disease, diabetes, and a host of other illnesses.

It is impossible to overstate the impact of childhood trauma on adult mental and physical health. Myriad studies have demonstrated that early-life suffering potentiates many illnesses, from mental diseases such as depression, psychosis, or addiction to autoimmune conditions to cancer. One Canadian study demonstrated that childhood abuse raised the risk of cancer nearly 50 percent, even when controlled for lifestyle habits such as smoking and drinking.

The first question is never why the addiction, but why the pain?

Addictions in particular are responses to early trauma. Whether to drugs, food, gambling, or whatever other form they take, all are attempts to soothe stress and emotional pain. The first question is never why the addiction, but why the pain? We cannot understand the addictions that beset our society without recognizing the suffering and stress they are intended to alleviate, or the childhood trauma at their source. In this light, the obesity epidemic now facing us reflects primarily an epidemic of pain and stress.

Astonishing to say, most medical students never hear the word "trauma" in all their years of training, except in the the sense of physical injury. "The medical profession is traumaphobic," a well-known colleague in San Francisco once told me. The results for patient care are devastating, whether in the treatment of physical or psychiatric conditions--a distinction that, given the mind/body unity, is in itself misleading.

Individual family dynamics unfold in the context of culture and society. Just as families have their histories in which they transmit trauma across the generations, so do societies. We can see, then, why the poor and the racially oppressed and the historically traumatized are more prone to disease. Need we mention the high rates of alcoholism, violence, obesity, diabetes, and overdose deaths amongst aboriginal populations in North America and, say, Australia, or the relatively unfavorable health outlook and life expectancy of black Americans?

The effects of trauma become multigenerational through repeated psychological dysfunctions. The new science of epigenetics is identifying the mechanisms that even affect gene functioning. The children of Holocaust survivors, for example, have altered genetic mechanisms leading to abnormal stress hormone levels. Animal studies are showing that the physiological effects of trauma can be passed on even to the third generation.

Finally, family stresses, trauma, and social and economic deprivation can also affect human brain development in ways that lead to behavioral problems, learning disabilities, and mental illness. CT scan studies at the University of Wisconsin showed that brain centers responsible for academic performance were up to 10 percent smaller in children who grew up in the poorest homes. Why? Because the human brain itself is a social organ, shaped in its neurophysiological and neurochemical development by the child's relationships. In the words of the above-cited Pediatrics article:

"The interaction of genes and experiences literally shapes the circuitry of the developing brain, and is critically influenced by the mutual responsiveness of adult-child relationships, particularly in the early childhood years."

Parents stressed by multigenerational trauma, relationship issues, economic insecurity, maternal depression, or social disconnection are simply unable to give their children the "mutually responsive" attuned interactions that optimal childhood development requires. The result is the epidemic of developmental disorders among our children that we are now witnessing. In line with the prevailing ideology, the medical response is mostly pharmaceutical. Rather than considering the environment that, throughout childhood, shapes the brain, we seek to manipulate the child's brain chemistry instead.

To be whole is much more than to experience the absence of disease.

What then are people to do when doctors, the gatekeepers to health care and its primary providers, are blind to the basic realities of what generates health and what undermines it? When their training denies them knowledge of the unshakeable unity of mind and body, of emotions and physiology? When they do not recognize that social factors are far more powerful determinants of health than genetic predispositions? When they are unaware of the powerful role of psychological trauma in human life?

On the societal level, we must understand that health is not an individual outcome, but arises from social cohesion, community ties, and mutual support. In this alienated culture, where "friends" may be virtual electronic entities rather than human beings, too many suffer from what University of Chicago psychologist John Cacioppo calls "the lethality of loneliness." We need a broad attitudinal and practical shift, consciously willed and created, toward a culture based on the fundamental sociality of human beings. We know all too well, from data too persuasive and too somber to be disputed, that emotional isolation kills.

Policymakers and community leaders need to be taught that economic and social disparities, insecurities, and stresses, as well as racial or ethnic inequalities, inevitably result in health problems and vastly increased health costs. In truth, almost all diseases are social diseases.

Health promotion must begin at conception. In the womb the growing human is already affected by maternal stress. Pregnant women need much more than blood tests, physical exams, and ultrasounds. They require emotional support so the hormones of stress do not chronically flow into the fetus via the umbilical cord. Current birthing practices, egregiously over-medicalized, interfere with natural physiologic processes and maternal-infant bonding.

With the role of parental presence and attunement being recognized in brain and personality development, young mothers and fathers must be helped to spend much more time with their children. In advanced European countries even fathers are accorded parental leave.

Adults need to know, even if their physicians often do not, that their health issues are rarely isolated manifestations. Any symptom, any illness is also an opportunity to consider where our lives may be out of balance, where our childhood coping patterns have become maladaptive, exacting costs on our physical well-being.

When we take on too much stress, whether at work or in our personal lives, when we are not able to say no, inevitably our bodies will say it for us. We need to be very honest with ourselves, very compassionate, but very thorough in considering how our childhood programming still runs our lives, to our detriment.

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Gabor Maté, M.D., frequently addresses lay and professional audiences across North America and internationally. His books include When the Body Says No: Exploring the Stress-Disease Connection, and In the (more...)
 
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Gabor Mate: How to Build a Culture of Good Health

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