ON TRAUMA AND
(THE LIMITS OF) COMPASSION
March 17, 2022
Gabor Maté is a retired physician who, after twenty years of family practice and palliative care experience, worked for over a decade in Vancouver’s Downtown Eastside with patients challenged by drug addiction and mental illness. The best-selling author of five books published in forty languages, Gabor is an internationally renowned speaker highly sought after for his expertise on addiction, trauma, childhood development, and the relationship between stress and illness. His book on addiction received the Hubert Evans Prize for literary nonfiction. For his groundbreaking medical work and writing, he has been awarded the Order of Canada, his country’s highest civilian distinction, and the Civic Merit Award from his hometown, Vancouver. His books include: In the Realm of Hungry Ghosts: Close Encounters with Addiction (2018); When the Body Says No: The Cost of Hidden Stress (2019); Scattered Minds: The Origins and Healing of Attention Deficit Disorder (2019); and Hold on to Your Kids: Why Parents Need to Matter More than Peers (2019, with Gordon Neufeld). Gabor’s most recent book, The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture, was published in 2022.
ILAN PAPPÉ: When we start such a conversation in this particular moment, we cannot avoid mentioning Ukraine, even if our series focuses on decolonization in Palestine. We feel compassion toward the victims of the brutal war waged on that country, and anger at those who have the ability to stop the war and do not. And yet, Western media and political coverage of the war has exposed high levels of hypocrisy—particularly if you are aware of the human-made and nature-made catastrophes in the Arab world, the African continent, the inner cities of North America, the pueblos of South America, and in Palestine.
I would like to speak with you about this by attempting to associate your world of treating, healing, and caring for the individual’s mental and medical health with my world of recording the chronicles of groups of people, nations, and minorities, who are individually and collectively under daily oppression and whose only crime is their perceived identity and location. I will preface our conversation with the following question: How far can we go in projecting or applying your insights on trauma, fear, depression, and addiction, which are interconnected in the treatment of the individual, to an analysis of collectives—be they nations, movements, minorities, or groups bound by a shared identity?
Can we talk about a collective trauma? Can we talk about addictions to ideologies, to fanaticism, to warmongering, to self-victimization, or to the victimization of others by using the same methodology, in order to learn why traumas are invisible? How can we make them visible, and what impact do they have on our lives when they are denied?
Let’s unpack one example: ideology. Can ideology be defined as an addiction? Can a harmful ideology be sustained either because of denial of its harm, or because it seems to be pursued as a passion but, in fact, it is both self-harmful and harmful to others? Intuitively, as a historian I feel that this could be an extremely helpful dimension, which I haven’t explored, or a new entry point to chronicling inhumanity as a major topic—especially in Palestine, but not only there. And being moved to tears when discovering the rays of humanity there.
As a personal inclination, I am not sure whether this has become an addiction in a way. Preparing for this talk, I remember that Edward Said once called me a “Nakba junkie.” Fondly, I should say! I still believe it is a passion to know, or to want to know, what happened in 1948 during the Nakba—as a pursuit of justice and not addiction to inhumanities or massacres. But I feel this is much more ambiguous after reading your work.
Racism, fanaticism, and the harmful dehumanization of others are at the heart of the chronicles of inhumanity that I narrate. Can we relate them to the realm of your compassionate approach to people who are addicted, in the broadest possible meaning of the term?
GABOR MATÉ: You are asking me a multilayered question, and I’m not sure that I am adequate to respond to it. But let me begin. First, you touched upon Ukraine. It is both quite astonishing and dismaying to see what’s happening right now. We agree on the unjustifiability of the war, the cruelty of it.
But it is the hypocrisy that strikes me the most. Three weeks ago, a New York Times columnist published an article with the headline “‘This Is True Barbarity’: Life and Death under Russian Occupation.” We’ve just woken up again, as if we thought barbarism is over. I wanted to respond, “Have you heard about Iraq? Have you heard about Yemen? Have you heard about Guatemala? Have you heard about Gaza? Have you heard about the Occupied Territories? You are just waking up to the reality that there’s barbarism in the world? What kind of selective mindset would ignore all that?”
Here in Vancouver, a young Russian pianist was invited to play at a musical concert organization—he is now being banned. And the tennis association is talking about banning the Russian players, like Medvedev and Rublev, from tournaments. I think that’s great— let’s sanction the Russians. But let’s also exclude any Canadian athletes because Canada sells weapons to the Saudis, which they use to murder Yemenis. Let’s also sanction the Americans for any number of internationally known killings, massacres, and invasions, which are much larger when compared with Ukraine. Let’s also sanction the UK. The UK has no right to be in any sports tournaments given its history and its current engagements.
The hypocrisy comes out of ideology. By its very nature, an ideology includes and it excludes. And it has hidden blind spots, which preclude it from allowing any material that would challenge it to penetrate.
I have my own particular history—let me talk about my serial disillusionment. I grew up in communist Hungary, a Jewish infant survivor of the genocide. The Soviet army were my heroes, they saved my life. I also believed in the system. And then there was the ’56 revolution against this brutal Stalinist oppression that I wasn’t aware of as a child because my parents weren’t telling me about it. So I got disillusioned. Then we came to the West and that was America, the shining city on the hill. Four years later, they’re massacring millions of Vietnamese on television, supported by the press. So I got disillusioned there. And then I was a Zionist and I got disillusioned with that. I’m talking about the value of disillusion, by the way. It’s good to be disillusioned. I would always ask people, “Would you rather be illusioned or disillusioned? Would you rather know the truth, or would you rather hold on to fancy ideas?”
As a young Zionist leader, I was given the task of giving a talk on how to counter Arab propaganda on university campuses. I thought, “Well, if I’m going to counter Arab propaganda on campuses, maybe I should find out what Arab propaganda actually says.” That’s when I started looking into the other side. When I say the other side, I didn’t read Arab propaganda—I read Jewish sources about Zionism, long before Ilan and his fellow new historians came on the scene. But there was already enough evidence in ’67 to lead me to conclude that what happened was the exclusion of one people to establish a land for another. That what happened in ’67 was a very deliberately concocted war, which Ilan has eloquently documented. So I then present my point of view, not yet believing in it, and my fellow Zionists were angry with me. “How can you be saying these things?” And I said, “I’m just pretending to be an Arab speaking my side.” I fulfilled the assignment, but they were upset with me for doing too good a job of it. So, one more disillusionment.
An ideology is addictive, in a certain sense. Let me define addiction for you. An addiction is manifested in any behavior that a person finds relief or pleasure in and therefore craves and holds on to despite negative consequences—they do not give it up despite those negative consequences. I don’t want to call ideology exactly an addiction, but it has features in common.
It does provide psychological comfort to people. When you’re a Zionist, you have a reason to live, you have meaning, you have a collective, you have a history that makes sense to you. You get to be both a victim but also a victor, which is deeply satisfying. In other words, you don’t need to deal with your vulnerability. All addiction is about not dealing with vulnerability. Addiction is about being so hurt and vulnerability threatens you so much, you try to numb yourself to your vulnerability.
As an ideology, Zionism is an antidote to vulnerability. Because now we have an answer to everything and we can justify whatever we do. We don’t need to be vulnerable. We don’t need to look at the truth. Ideologies are very seductive and they work. Like the addict is in denial of the problem that he is creating for himself, let alone for other people, a person who is attracted or addicted to an ideology will be in denial of the harm being done to themselves and particularly to others.
So, yes, I think it’s useful to talk about ideology as addictive. Just as addiction, in my view, is people’s attempt not to feel their pain. It’s understandable. In the same way, when I think of my grandparents who were killed in Auschwitz, that’s very painful. If I can believe that there’s redemption, response, and revenge through a particular state and its activities, then I can then deal with or not feel as much the pain of what happened.
Ideologies and addictions have a lot in common—mostly the rigid incapacity and unwillingness to look at the truth of it.
ILAN PAPPÉ: Let’s talk a bit more about disillusionment, denial, and how we confront them in the situations we face in Canada and Israel, looking toward past evils and in current evils. We both come from a European Jewish background, with different trajectories and different fields of professional interest. And yet, in many ways, our concern about Palestine and the Palestinians is our first meeting point. But I noticed in an interview you gave to Haaretz, at the end of the interview (which is typical to Israeli journalists) they asked you about your take on Israel and Palestine—as if this were a passing issue and not entirely related to the conversation on crime, addiction, and trauma. I would like to take a different approach. I would rather have a general discussion about these issues as related to Palestine and other concerns including decolonization, racism, and social justice.
To fuse what you did in Canada and what is unfolding in Palestine, which we are both watching with horror, let us talk about our two settler-colonial societies. Two political projects established in the past with the help of what the late Patrick Wolfe called “the logic of the elimination of the native.” These settler-colonial societies, Canada and Israel, still by and large deny their past—and this denial enables them to continue the elimination in the present.
But we both approach it with some caution, I think. You express your sense of gratitude for a Canada that received you and your family, which is probably akin to what I should have felt toward Zionism in Palestine, which gave refuge to my parents escaping from Nazi Germany in the 1930s. We both were unaware of the settler-colonial setting, genocide, and ethnic cleansing that accompanied these two safe havens for our families, and probably our lives changed when we learned of these atrocities.
You dealt with it in a very positive way when you told the Toronto Star, “For Canadians to be truly strong and free, we must come to terms with our grim past”—a quote which leads me to assert that these are not just personal journeys we have taken. We were and are guided by the Indigenous victims of these colonization projects who helped us to decolonize our knowledge. Without this struggle for liberation, we have no way of changing the ideological systems that have power to continue narrating their version of history, as well as continuing the colonization that this narrative is meant to justify.
We can treat Canadian and Israeli denial as a political situation. But from what you are saying, it seems that this is also a mental situation. Can we also treat that denial in the way you would treat denial when you meet patients or clients who deny their trauma, depression, and addiction? I have some frustration when applying this process to Israel. As an activist I do believe that some measure of acknowledgment and even co-resistance must come from the settler or colonialist community for the healing process, namely decolonization, to succeed. But to begin this, you need to be able to elicit some compassion from the Israeli Jews for the Palestinian plight, and this hardly exists.
Do you feel that a similar problem prevents such a process in Canada? As you are leading the way in showing compassion to addicts in a society that tends to view them as criminals rather than victims, perhaps your interaction with the state antidrug policy and the overall culture of social denial and criminalization can help us. Not least to deal with the lack of compassion in our societies, which I feel is the main hurdle to starting a conversation about denial. Because as long as Israel would be in a state of denial, in the double meaning of “a state of denial,” I can see no way of ending the violence that Israel imposes on the Palestinians, wherever they are.
GABOR MATÉ: Canada did receive our family with open arms, and we appreciated it. I didn’t know what was happening here. The same year that we arrived in British Columbia as Hungarian refugees, in 1957, there was a native woman who was then four years old. I’ve met her since and her name is Carlene. She was taken to a residential school, which were places run by the churches where the government mandated that native children be abducted from their families. They were not permitted to see their parents, who were threatened with jail if they tried to see their kids. In these residential schools, children were abused emotionally, sexually, physically, culturally, spiritually, and starved as well. Thousands died. This last summer, June of 2021, they discovered a group of bodies of young children. This wasn’t news to the Indigenous population—they had been talking about these missing children for decades. But here was proof. Thousands of bodies were discovered. Two weeks before these bodies were discovered, a public opinion poll found that 70 percent of Canadians said they knew nothing or little about the residential schools. In a certain sense, this is astonishing. In another sense, it’s an artifact of colonialism and denialism.
Now, in that same year that I arrived in Canada, Carlene was taken to a residential school. She made the mistake of speaking her own language, her tribal language. The punishment was that she had a pin stuck in her tongue—and for a whole hour this little girl couldn’t put her tongue back in her mouth because she would cut her lips. That’s before the sexual abuse began. She was an alcoholic by the time she was nine years old. Can you imagine? And her grandchildren are now drug addicted. Two weeks after these bodies were discovered, a prominent Canadian pseudo-journalist named Conrad Black, who was knighted by the queen, wrote an article saying, “What’s the big deal about a few dead bodies?”
It’s illegal to deny the Holocaust in Canada, but it’s perfectly legal to deny the cultural and physical genocide of native people. That’s denial. And the denial has two bases. First, if you’re the perpetrator and you want to continue to perpetrate, then you just need to deny that you’re perpetrating. But that’s not where most people come from in their denial. For most people, the source of denial is a confluence of personal history and large-scale, societal history.
Denial happens when to admit the facts is just too painful. A lot of people are traumatized in this culture, more than we realize. For them to be aware of how they were hurt by people who love them or were meant to love them is too painful to admit, so they’re in denial. What I’m saying is that in this culture, regardless of the history or perpetration of genocide, people are individually, on a large scale, psychologically programmed to be in denial about the reality of the world.
When people are psychologically minded to deny, that will then support large-scale historical denial. Furthermore, there’s a kind of passivity that this society engenders in people. Who really wants the Earth to be destroyed? But what are most people doing about it? Nothing. The psychologist Erich Fromm talked about “social character.” The social character is inculcated to the family of origin, but it serves the social purpose of making people fit into the society as it is structured. So apart from the personal denial that feeds the social denial, there’s also this passivity. If you ask the average Israeli, Canadian, or British person, “Put together three intelligent sentences about the history of Palestine,” they couldn’t do it. You can ask the average British person, whose country participated in the invasion of Iraq with the death of over half a million people, “Put together three intelligent sentences on the history of Iraq or of Afghanistan.” Or right now, “Give me three intelligent sentences about the history of Ukraine in the last ten years.” They couldn’t do it. Because an ingrained passivity is built into the social character, and that serves the interest of the social-political structure that it is designed to perpetuate. Because people are in denial and people are passive. So here’s where the personal psychological feeds into the social and historical.
ILAN PAPPÉ: I recognize it so easily when thinking about Israel. Just recently, an Israeli filmmaker was able to expose the mass graves of a horrific massacre that happened in 1948, which was denied for many years.1 This documentary film provided the most important solid evidence for what we have been claiming happened. He told me that now the whole discussion about the atrocities committed in 1948 will change in Israel.
I said to him, “It won’t change. Because even the people you are interviewing, who admit perpetrating the massacre, say, ‘Hey, why do you want to talk about it? There’s no need.’ And secondly, they lived for many years denying that massacre, which reflects the society’s denial of that event.” So the connection between the individual denial of one’s own part and accountability and the overall orchestrated denial by the state go hand in hand.
But when you talk about the First Nations in Canada and the Indigenous community, I also notice that you not only tell us the horrific experiences that they had, but you also feel that we have a lot to learn from them, as I do when I talk to Palestinians. Both in your medical treatment and your overall comprehension of reality. In this respect, in Canada we can see how decolonization is connected with Indigenous rights but also, and because of that, with ecology.
You had a dialogue with a group called Indigenous Climate Action (ICA) that works on the assumption that ecological disasters and disruptions are an ongoing traumatic event, or even a structure, that spans generations. Eriel Tchekwie Deranger, the founder and director of ICA, said that the trauma of climate change in Canada— but not only in Canada—“is interwoven into colonization in the form of modern extraction practices.” So colonization is based on denying the intricate, maybe even organic, relations between identity and our natural surroundings. You told this group, “If we somehow learned how to drop our arrogance, and I mean the arrogance of Western/Northern culture, and opened ourselves to learning, what could we learn from you and bring us back to ourselves and stop this madness?”
This unlearning and learning can help us to decolonize our ecological world. Where are we with this dialogue in Canada, in not only telling the chronicles of what has been done, but respecting Indigenous communities as a group that can teach us how to deal with ecology, nature, and reality?
GABOR MATÉ: There’s a lot to be learned. Let me tell you a story. In my field of medicine—there are terrific achievements in Western medicine, but it’s also hopelessly narrow in its perspective. It separates entities that in real life are inseparable. It separates the mind from the body.
When you go see the average physician with a chronic medical problem, they’re never going to ask you about your childhood, your traumas, your personal relationships, how you feel about yourself as a human being, your stresses on the job. And yet, these have everything to do with why most people get sick, chronically. They separate the mind from the body. They separate the individual from the environment, so that disease is seen as a biological event in an organ.
Now, that’s not how it works in reality. I’ll give you a couple of examples. The more racism a Black American woman experiences, the greater her risk for asthma. Indigenous women in Canada, who never used to have any rheumatoid arthritis or autoimmune disease prior to colonization, now have six times the rate of rheumatoid arthritis of any other person in Canada. I won’t go into the reasons, but it is related to suppression and self-repression, which is imposed by a colonialist, male-dominated society. The patriarchy.
But Western medicine doesn’t make those connections, despite all kinds of evidence. It’s not that we don’t have the science—we have the science! We just choose not to look at it. Talk about an ideological blinder. By contrast, I was talking to a colleague of mine, an American physician and psychiatrist who is part Lakota Sioux. He said that in the Lakota tradition, when someone gets sick, the whole community gathers and says, “Thank you. Your illness is manifesting the pathology of the whole community. And so your healing is our healing.”
From the perspective of hard science, that’s much more scientifically accurate than the split Western view. And that’s not the only area in which we could learn a lot. We could learn about resilience. Dire and horrific as the situation is in some of Canada’s First Nations communities with the impacts of multigenerational abuse, and dire and horrific as the situation often is in Palestine, I’m sure that you have been as impressed as I have with the sheer resilience of people. With their capacity to survive, endure, and continue to create and have positive responses, even in the face of unbearable oppression.
I know a woman in Jericho who does Sufi dancing in her work with Palestinian children who have spent months in jail without being allowed to see their parents. Her neck was broken by the Israeli army, and an Israeli surgeon saved her, but she dances with these children. How do you have that kind of positive energy after your neck has been broken and when you are so oppressed? We can learn a lot about resilience.
We can learn a lot about the unity of all beings. When an Indigenous person thinks of a river, the river is part of them and they are part of the river. That’s a totally different way of relating. You aren’t looking at an object “out there”—they are looking at an entity that is a part of them. It’s hard to put it into words, but this is a point of view that could save us and the planet, if we learned.
ILAN PAPPÉ: I want to take it a bit further in thinking about the way that we are dealing with the COVID-19 crisis, especially in Western societies. You’ve given us a warning about the risks of basing medicine on biology and chemistry alone, and cautioned against the conventional rejection of a more holistic approach to illness and treatment. As you put it, the norm is treating disease as an independent entity—an approach that decontextualizes illnesses from its social, cultural, and even political environments.
Was this approach also the basis of how Western societies, governments, and even the World Health Organization (WHO) dealt with COVID-19 and still are dealing with it? Can there be another approach to the pandemic?
GABOR MATÉ: I think it will take time for us to really absorb the lessons of the Covid experience, but some things are already apparent. Who is more prone to getting Covid? In Britain, it was Black people, Asian people—people of color. They were more likely to get Covid or to die from it. That’s not an isolated biological fact. That’s a social fact of who is oppressed, who has power, and who is stressed.
Boris Johnson, the former prime minister, was hospitalized. He spent time in an ICU, came out, and became a weight-loss evangelist. Because he says that obesity is a risk factor for Covid. But what causes obesity? The last few decades have seen an epidemic of obesity in the West, and throughout the world, with the spread of neoliberalism. The obesity epidemic is not separate from the oppression and stress that people experience when economic and social conditions become more challenging. But Johnson would never talk about that in his anti-obesity campaign.
Furthermore, if we understood the world from a genuinely global sense and knowing that viruses know no geographical or political boundaries, we wouldn’t have given the vaccine to all the healthy people in the rich countries. We would have inoculated the vulnerable people all over the world. That would have been a far more effective public health measure.
But of course, it’s “we have the money, we have the power.” Not to mention that governments gave enormous sums of money to private companies to develop the vaccine, yet they share none of the profits. Some of these companies are making $1,000 per second from a product that was developed with government money. So not Covid, not anything, can be separated from the global colonial situation.
If we didn’t have a colonial mentality, if we saw someone in South Africa or India or Papua New Guinea or Latin America as important as we are and as valid members of the community that we’re a part of, then we would not make decisions based on privilege. We would make decisions based on inclusion. And that certainly hasn’t happened in this Covid crisis. Not to mention the outrageous amounts of money that the pharmaceutical companies want to charge poorer countries. Why don’t they just make the patent available to everyone? Are we humanitarians or are we profiteers? Well, we’re profiteers, which is the essence of colonialism. In Israel, they inoculated all the Israelis, but the Palestinians? “That’s not our responsibility. Let them do it themselves.”
ILAN PAPPÉ: I think one of the problems is that there is an intricate explanation here. Above every other problem we have in challenging the narrative given to justify these unjust policies, we don’t always have the time span or the ability to elicit the patience of people to hear and listen to a more intricate explanation. You cannot do these things by sound bites. You really need a space for it.
A final question for the activists among us. One of the really impressive things in your biography is your willingness to risk lawlessness, and maybe even prison, when you refuse to adhere to policies or instructions that prohibit the administration of drugs to addicts. You do this so that people will not resort to a lethal overdose in case of an abrupt withdrawal or detoxification process, and when using traditional or Indigenous medicine in your clinic.
Many of our students are also activists and they keep asking themselves how far they can take their action and activism vis-àvis the law of the land, the regulation. Do you have a sense of when it’s time to break the law in a seemingly democratic society? How far we can go with this? Because you must have consciously known that you were disobeying a policy, regulation, or even a law in some of your actions in Vancouver.
Is this part of social activism and our role in the struggle against denial and oppression? Is it part of learning from the resilience of those on the receiving end of these colonialist and racist practices?
GABOR MATÉ: It would be an over-valorization of my own history to say that I’ve ever really faced any serious threat to my liberty. I was never in that kind of situation. I don’t know what I would have done if I had been. I’d like to think I would have acted on principle, but who really knows? You don’t know until you’re up against it.
What I faced, personally, is when in 1967 I wrote an article that Israel started this war to take over the territories. I was kicked out of my father’s house. To give him credit, he came around later in life and started to see reality. So first you face a decision to make. Do you want to speak your truth, or do you want to maintain your emotional relationships if the truth threatens those relationships? I think that’s an important question for all of us. I can’t tell anyone else what to do, but I’ve never been able to stay silent about things that I felt were important to speak about, including Israel/Palestine. And that’s cost me some relationships, but that’s the price you pay.
I’m in no position to advise anyone about breaking the law or not. There are many inspiring examples here in Canada right now. Young people are protesting against the further takeover and destruction of native resources. They’re being treated brutally by the police, and the press doesn’t even report it. Police brutality is not news in this country. But I haven’t done that myself. A friend of mine—a seventy-six-year-old grandmother who stands up to my eyebrows—was arrested for threatening the peace because she stood on the bridge blocking traffic as a protest against the destruction of native lands.
I can’t advise anyone because I don’t know what I would do if I were confronted with that kind of a choice. I think the question we need to keep asking ourselves is: What is the truth worth to us and what are we willing to give up in order to serve the truth, as we understand it? That’s a highly individual question. Throughout history some people have given—and continue to give—brave answers to that question.