the myth of normal

by dr gabor mate

Last updated 10 February 2023

Here are some interesting quotes and themes from this book that I will surely be thinking about in the coming days.

What is normal, anyway?

Strange as it may sound, our miraculous talent for adaptation could also be a liability. Because our nature is so influenceable, different conditions evoke different versions of us, from benign to disastrous.

While it is in our nature to adjust to and survive in an almost infinite array of environments -- certainly more than oak trees can -- we are not necessarily at our best or our healthiest in all of them. Some of these, whether physical, emotional, or social, will make wellness an uphill battle.

If that's normal is assumed to be natural, the norm will endure. [...] Thus do materialistic cultures generate notions -- myths, in effect -- of selfish, aggressive striving and dominance as being behavioral baselines, encouraging characteristics that place a lesser value on connectedness to others and to Nature itself.

If we didn't mistake ourselves or one another for whatever personality features and behavioral traits appear on the surface, "good" or "bad", if in each person we could sense the potential for wholeness that can never be lost, that would be, for us all, a victory worth savoring.

Childhood and parenthood

The book starts with childhood and how the Traumas and traumas of one's early life will impact their health outcomes throughout their entire lives. There's reference to attachment theory although this is not developed to the point of identifying different types of secure or insecure attachments -- to some extent that level of specificity doesn't really matter since one of the core themes of the book is that due to traumas imposed by our culture, we are all insecurely attached, to some degree.

[C]hildren's sense of security, trust in the world, inter-relationships with others, and above all, connection to their authentic emotions hinge on the consistent availability of attuned, non-stressed, and emotionally reliable caregivers. The most stressed or distracted the latter, the shakier the emotional architecture of the child's mind will be.

"Doctors," Dr Buckley said, "are the agents of our society's expectations that we imprint on mothers, when they are very open and vulnerable, that technology is superior to the body and that women's bodies are intrinsically bound to fail. It really is obvious that the culture wants to impress upon women this view of their bodies as inherently defective."

[Emily] Oster writes that "motherhood can be lonely and isolating". Too true -- but those attributes pertain not to motherhood itself, but to motherhood in an alienating culture. Horticulture on the moon would doubtless be a maddening endeavor, but that tells us nothing about gardening.

In the absence of secure parental attachment, the child will seek out love and approval wherever they can find it, which is all too often with peers. However, the book casts this as a dangerous gamble: Left to its own callow devices, the peer group can offer only acceptance that is highly conditional and thus insecure, often demanding self-suppression and conformity in place of true individuality.-chapter 13

Addiction

I first encountered Dr Mate's work on addiction through his book In the Realm of Hungry Ghosts. Here, he builds off the previous work to broaden the definition of addiction to include really any experience that we seek out compulsively in order to separate ourselves from or numb ourselves to our current painful reality:

When it comes down to it, all addiction's incentives can be summed up as an escape from the confines of the self, by which I mean the mundane, lived-in experience of being uncomfortable and isolated in one's own skin. Underneath however many surface layers of "normal" functioning, that alienated discomfort can be disturbing to the point of torment: a persistent sense of being abnormal, unworthy, and deficient.

Why would the self need to be escaped? We long for escape when we are imprisoned, when we are suffering. Addiction calls to us when waking life amounts to being trapped in inner turmoil, doubt, loss of meaning, isolation, unworthiness [...] Pain, then, is the central theme. No wonder people so often speak about the benign numbing effect of their addictions: only a person in pain craves anaesthesia.

What is the value of a diagnosis?

[D]iagnoses reveal nothing about the underlying events and dynamics that animate the perceptions and experiences in question. They keep our gaze trained on effects and not their myriad causes.

[D]epression 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. Brain disturbances manifest the stresses of existence during formative periods and, once established, become a source of further stress.

It has been transformative for me to realize that my own mental health issues carry genuine meanings that arose from my life within my family of origin in a particular historical context.

A suffering child [...] has two possible options when it comes to processing her expeirnece. 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 better than the other one, which [...] is not an option at all. Better to believe "It's my fault; I'm bad", which lets you believe there's the chance that "if I work hard and be good, I will be lovable."

Self-pity takes a kind of solace in seeing oneself as an unfortunate character, beleaguered by fate. It undermines healing by reinforcing the stories that keep us ensconced in a world of hurt, and by discouraging responsibility of our own point of view. Self-compassion, by contrast, doesn't resist how things are, nor swaddle the pain in layers of narrative gauze; it just says, "I am hurting."

Healing, in a sense, is about unlearning the notion that we need to protect ourselves from our own pain.

Culture is sick

Self-abandonment programmed into the social character makes us passive even in the face of threats to our existence as a species. Healthy people connected to their real emotions and authentic requirements would not be susceptible to blandishments inciting artificial needs and the products to satisfy them, no matter how cleverly packaged. Nor would they accept the unacceptable.

[T]he more insecure people feel, the more they focus on material things. As materialism promises satisfaction but, instead, yields hollow dissatisfaction, it creates more craving.

What do we consume, exactly? Art, sometimes; harmless fun, often enough. But we also ingest the pain of wounded people, packaged as entertainment, to dull or perhaps validate our own distress.

A distinction must be made between accepting and tolerating. [...] Acceptance is vitalizing because it makes room for the other three As -- it grants admission to anger if such is present, increases our sense of free agency, and makes room for whatever our authentic experience might be. Tolerating the intolerable, on the other hand, is deadening.

To deal with racism, poverty, or any other societal ill, we must first recognize that they are realities of life in this culture. They exist, and we must acknowledge our pain and grief that they do. Now we can ask ourselves how we might effectively work to eliminate not only their expressions but their root causes.

Self-knowledge

In the final chapters of the book, we return to the idea that The personality is an adaptation, using this knowledge to give ourselves agency to change patterns of thinking we might have felt powerless over before. Specifically, we are invited to consider the difference between feelings and attitudes: Unlike feelings, which come and go of their own accord, attitudes can be invited, generated, and nurtured in the face of any emotional state.

We are given an exercise to practice identifying situations where we're not honoring our true selves:

1. In my life's important areas, what am I not saying no to? [...] With whom and in what situations do I find it most difficult to say no? Even if I say it, do I do so reluctantly, apologetically, or with guilt? Do I beat myself up about it afterward?
2. How does my inability to say no impact my life? You will find this impact lands in three main spheres: the physical, the emotional, and the interpersonal. [...] Resentment drives you further away because it will contaminate your love for that person. They too, will sense the emotional withdrawal. [...] Resentment can be seen as the residue of things unsaid, feelings not honored. [...] The question here would be "What do I miss out on in life as a result of my inability to assert myself?"
3. What bodily signals have I been overlooking? What symptoms have I been ignoring that could be warning signs, were I to pay conscious attention?
4. What is the hidden story behind my ability to say no? What feeds our habitual pattern of denying our "no" is what I call the story. By this I mean the narrative, the explanation, the justification, the rationalization that makes these habits seem normal and even necessary. In truth they sprout from limiting core beliefs about ourselves. [...] try asking, "What must I believe about myself to deny my own needs this way?"
5. Where did I learn these stories? [...] The intention in looking at the past is not to dwell on it but to let go of it.
6. Where have I ignored or denied the "yes" that wanted to be said? [...] What have you wanted to do, manifest, create, or say that you have forsaken in the name of perceived duty or out of fear? What desire to play or explore have you ignored? What joys have you denied yourself out of a belief that you don't deserve them, or out of a conditioned fear that they'll be snatched away?

The prospect of others' disapproval or disappointment triggers the intolerable conviction that we are bad, wrong, inexcusable. [...] Recognizing guilt for the well-meaning friend it is -- doggedly faithful to a fault -- we can make room for it. Engaging it in cordial conversation without believing its self-devaluing message, we realize we are talking to a very young and innocent creature. Understanding this opens space for compassion.

Anyone whose conscious recall is of a happy childhood -- a category that may range from innocuous to idyllic -- and yet is confronting chronic illness, emotional distress, addiction, or struggles to be authentic, is particularly invited to engage with it: When I felt sad, unhappy, angry, confused, bewildered, lonely, bullied, who did I speak to? Who did I tell? Who could I confide in?

Stop that thought

The final exercise given is a thought-stopping technique with 5 steps:

1. Relabel.The first step is to call the self-limiting thought what it is: a thought, a belief, not the truth.
2. Reattribute. In this step you learn to assign the relabeled belief to its proper source: "This is my brain sending me an old, familiar message."
3. Refocus. [...] If you manage to catch a negative self-belief struggling to seize control, find something else to do.
4. Revalue. [...] You can think of this step, then, as kind of an audit, an investigation into the objective costs of the beliefs your mind has invested so much time and energy in. What has this belief actually done for me?
5. Recreate. [...] In place of a life blighted by your compulsive obsession with acquisition, self-soothing, self-justification, admiration, oblivion, and meaningless activity, what is the life you really want? What do you choose to create? Write down your values and intentions and, once again, do so with conscious awareness. Envision yourself living with integrity, being able to look pople in the eye with compassion for them -- and yourself.

Conclusion

I don't know why I wrote this header. I don't have a conclusion. I need more time to think about whether I agree with the key premise of the book that physical health is determined in large part by our level of self-knowledge. This only works if we assume that

• health outcomes are worse now, with modern medicine, than they would have been in the past when medicine was less effective
• we as a culture are experiencing more trauma than people in the past did, or are somehow less self-actualized and less able to deal with the trauma we do experience