“This epidemic shows the limits of the system that our generation has created—a system that has thought only of economics and the race for quick profit, at the expense of the social and concern for others—a system that has completely lost sight of certain values such as solidarity, has disdained social investment and constantly “thought globally” to seek the cheapest possible labor at the ends of the world—a system where the public hospital was considered the fifth wheel of the cart when it should have been considered the bulwark of society. Who could have imagined that patients from a rich society could die in front of doctors who were helpless and forced to make horrible choices? Who would have thought that in the 21st century, people would be left to fend for themselves in institutions for the elderly, without even being given a burial? All this was unthinkable just three weeks ago. So I hope we learn from this pandemic that the world after the coronavirus will not be the same, that humanity will be able to return to being human beings, that the concepts of equality, dignity and empathy will be rehabilitated.”
– Dr. Denis Mukwege, 2018 Nobel Peace Prize Laureate. Source: Le Nobel Denis Mukwege : en Afrique, « il faut agir au plus vite si nous voulons éviter l’hécatombe » Le Monde, 2020/03/28 (Nobel Laureate Denis Mukwege: In Africa, “We must act as fast as possible if we wish to avoid catastrophe.”)
Russell Brand interviews Gabor Maté, March 21, 2020
Russell Brand (RB): Most of us know you for your work on addiction and on mental health. With a global pandemic, and the anxiety, fear and dread that it engenders, what have you observed so far, and what applicable therapeutic information do you have for us?
Gabor Maté (GM): You’re asking bigger questions than my brain is maybe ready to provide answers to, but just today I was online with a group of therapists that I’m training in my particular way of working, and two of them—one from New York City, and one from a First Nations community here in British Columbia—were saying that they’re working with a highly traumatized population. And amongst them the panic is just immense about this virus, and they’re asking how they can work with this. The first thing to recognize is when you’re traumatized, your brain is affected by that. Particularly if you were traumatized early in childhood, the fear center in the brain—the amygdala—is much more easily triggered. So that means that people experience things in different ways depending on how they were programmed in childhood. The response isn’t only to the actual facts and the actual realities of the spreading pandemic, but it’s a response of people’s own subjectivity, to the degree that they were living with fear all their lives. And the more fear-oriented they were in the first place, the more likely they are to panic right now. You really have to address that, and recognize that partly what we’re seeing here is a trauma response, but as well we’re seeing a genuine response to a real problem. We’re also seeing a trauma response.
RB: What kind of data is available on the impact of trauma in people’s early lives? Is it a binary response? Is it that people that have experienced trauma in early life are generally more fearful, or is the opposite response possible—a kind of numbness and dislocation?
GM: Both can happen. There are both. Either you get a heightened fear response, or you can get a dissociative response in which you are not even in touch with your feelings—on a neuro-biological level, where the trauma really changes the brain, or at least it alters the normal trajectory of brain development in such ways that, for example, as I said, the fear center—the amygdala—is larger and it’s more easily activated. Also when triggering events happen, when fear happens, the prefrontal cortex—which is the part of the brain that considers and makes decisions and makes choices and responds flexibly to situations—it kind of goes offline so that they’re actually functioning from emotions rather than from the thinking parts of the brain. But we see this in society all the time in all realms. I imagine these days it’s being very generalized as a result of not just the virus, but also… how can I put this? The virus has gone viral on social media. Not only is it a virus, it has also gone viral. The Lancet, which is a British medical journal, as you know, had an article about how to fight an infodemic. So we don’t just have an epidemic. We have an infodemic, and I quote the director-general of the of the World Health Organization who actually said, “We’re not just fighting an epidemic. We’re fighting an infodemic.” He said this in the middle of February at a conference in Germany.
RB: There’s nothing in living memory of a global event of this nature, is there, like 9/11? It’s difficult to quantify because, as you’ve said, I’ve never known anything so personal and so global, something that affects me on a personal level of “How is this going to affect me financially? How is this going to affect my ability to travel?” And then what’s going to happen to all of society, and the world? Everywhere you go, and everyone you talk to, if you’re not moving around, they’re all being impacted and affected. It seems like a unique event, and as you say, my personal fears are not “Oh no, I might get this virus.” They’re much more. The infrastructure that supports our society—which I’ve spent a long time saying is a construct and is conceptual and is based on systems, beliefs and hierarchies that are sustained through subjugation—they are now being shaken. And it’s an interesting and, I would say, pretty frightening thing.
GM: Well, yes, it’s all that, but let me put it in some broader context here. First of all, the kind of fears around disease that we’re having now: all over the world a lot of people have lived with them chronically. We just don’t think of them because we’re not threatened the same way as they are. Diarrhea kills tens and hundreds thousands of kids every year, but not in the Western countries. So, partly it’s out of sight; out of mind. That’s one thing. We have to put it into context. When you said 9/11, for example, that was a big shock to the United States because all of a sudden 3,000 people died in one shocking, terrible event, but it’s not such an unusual event in the lives of many people in the world when they are bombed by the United States or Britain, or whoever’s bombing them. A lot more people have died, but it’s 9/11 that we remember because it happened in the Western world, in North America. So partly it’s again because when it happens to us, that’s when we become aware of it. So that’s one thing I want to point out. The other I want to point out is: what if I said to you that there was a preventable condition that kills 800,000 people in Europe every year, 15,000 in Canada, and about 8 million in the world every year? What if I said to you there was such a condition? It’s air pollution. I’ve just given you the actual statistics. I’m not saying we shouldn’t be concerned about the virus, but one of the lessons for me in this virus is how naturally easy it is to recognize a threat when it’s all of a sudden, and it’s strange, but in the meantime we’re ignoring chronic health issues that are killing millions of people in our societies every year. What does that say about our culture?
RB: I think what it says is, as you’ve already explained, that it is outside, out of mind. If something doesn’t penetrate our awareness, or if we can operate without being impeded by it, we will happily do so. But I also think that the socio-economic impact of the coronavirus has meant that whether or not you are affected medically or biologically by the condition, you are affected psychologically. Also, I think it’s tapped into a deep and archetypal fear that we have that we are not in control of reality because we are not in control of reality. I’m reminded of the Osho quote, of all things: “What is society? Society is just a clearing in the forest.” And I feel like we can suddenly feel, “Oh no, not only in this biological, botanical world could the vines and plants reclaim us, but also in the microbiological world there are invisible forces that can be unloaded and weaponized at any moment.” And that for me, personally—even as a man dedicated to recovery and dedicated to personal awakening and participating in awakening however I can—I recognize that the personal experience of going to a super market and seeing empty shelves had a visceral sense of foreboding that I didn’t anticipate. I’m out here in a relatively remote part of Australia, and I’m fortunate enough to be with my family, but to have the uncertainty…. We consistently live with uncertainty, as you have explained. We consistently live with disease—but the idea that our structures and systems are impermanent, that they are faith-based systems, economics. And air travel—they’re even asking for bailouts for the airline companies in the UK! All of these things are held together by faith and belief, and when that is shaken, our reality is shaken. Now, when I look at this optimistically, I see it’s a great opportunity for reordering. The level of uncertainty about how long this may endure means we’re not talking three to six months, or nine months. Who knows when people will freely travel, freely move, if ever again? The silver lining is that, potentially, people will start to consider different ways of living that are more harmonious and connected to nature, but it’s very interesting, I suppose, because I’m affected egoistically as an individual. When can I go back to England? How do I go back to England? How will this personally impact me? And what does this mean for the reordering of civilization?
GM: One thing that arose for me as you were speaking was something that a Buddhist teacher said once. What happened was that I was supposed to go and give a talk on addiction at a particular town here in British Columbia, but my airplane didn’t make it. They had to turn around because of some mechanical issue, so there were 300 people waiting at this church hall for me to give this talk on addiction, but I didn’t show up. In the audience waiting for me to come was a Buddhist monk, so they recruited him to give a talk on a Buddhist view of addiction. I got a recording of the talk, and it was really great. What he said was that in the West we’re always saying, “Panic, panic! Everything is out of control!” In the Buddhist world they say, “Relax. Everything is out of control.” So one of the teachings that maybe we could learn is precisely that. Whether you’re Buddhist or not, just the idea of impermanence and everything changes, and we’re not in control, and how to be with whatever happens, how to be with the present moment, regardless of what happens. I mean that would make a huge difference in every crisis like this. The Chinese see a crisis as a combination of danger and opportunity. In the crisis is always danger, but there is always an opportunity. So, like you, I’m actually wondering if this will perhaps function as a teaching moment for a lot of humanity. I’m not that optimistic that it will, but it’s certainly a possibility. It’s certainly a potential, isn’t it? And, of course, the other thing is, doesn’t it just clarify your values? Don’t we all at this point realize what’s really important in life? Hasn’t that been shocked into us by this pandemic. How suddenly things that we thought were so important [are not]. What is really important? It is a possible learning moment. The question is: will we take that opportunity or not? And I think the system militates against us doing so. They all want us to go back to our ordinary, narrow, individualistic, disassociated, isolated mode of thinking. That’s how the system survives. So whether or not we can transcend that, we’ll see.
RB: In my optimism I imagine that if you could see this through some kind of thermal lens, you would see across the world a kind of stirring, a global recognition of the principles you’ve described, of “what is important to me is the people I love, community, having access to amenities and resources. And I live in a system that doesn’t allow that or permit that, and thinking about it, I don’t want to do my job and travel through all these places, and do these things. The only reasons I’m doing these jobs is to participate in an economic system that will dispatch me very, very quickly while propping up banks and airlines.” There’s no doubt that, as you know, using the Chinese definition, that opportunity is part of this. Gabor, I wondered often when speaking with you and listening to you—and because of the brilliant essay you wrote that Martin Freeman read for the event I did at the Old Vic, on the nature of mental health, suicide, and addiction—what you can extrapolate from your work with individuals that could be mapped onto sociological models in terms of disconnection, isolation, the impacts of trauma, and also the possibility of recovery. I know that’s a big question, but we’ve got time.
GM: I would love to answer that question, but there is just a point that I really would like to make, totally unrelated to what you just asked.
RB: Oh great. What have you just started? Why don’t you just sing a song?
GM: [Laughter] I’ll come back to your question. I just want to note something. In January, the World Health Organization asked the donor countries for 675 million dollars so that the agency could respond to the virus. They asked for 675 million dollars in January. Do you know how much they received from all the wealthy countries? 54 million. So even in responding to this virus, what is our system doing? Even in the face of this, we’re still being… When I say “we” I mean the people that make the decisions with our money. They are being so short-sighted. So I know that’s not what you asked me, but I just had that fact in front of me and I wanted to throw it in.
RB: You do what you like, Gabor Maté. When I do an interview with you, I don’t imagine for a moment I will be in charge of how it goes. The rhetoric that’s emerging from political leaders often indicates that, as we have known, the priority of the system is self-preservation, and all else is subsequent to that. We naively assume, or at least hope, that these systems of governance exist in the most primitive form of social contract. We exchange taxes for protection given by the sovereign or the state, but we can see in the revelation of crisis that what is genuinely important is that the system is able to withstand the shock of this crisis. Even as recently as January when it was dislocated and in non-Western countries, we were willing to go for the gamble of not making substantial donations.
GM: Right. Now to come back to your brilliant question of before.
RB: If you can remember it.
GM: I remember it. You were asking about working with traumatized people. What can I extrapolate from that to social transformation, social dislocation, and so on?
RB: All right, you do remember it.
GM: Yeah, so the first thing is that the two are not separate. So the addiction… I have a very brilliant friend, Bruce Alexander, who has written the second-best book on addiction, which is called… What’s it called now?
RB: Good. I’m glad you’ve forgotten that. We’ll look it up—Bruce Alexander, book on addiction.
GM: It’s about dislocation, and he’s saying that addiction is a sign of social disruption, but not just a sign. It’s an outcome. It’s called The Globalization of Addiction . It’s a study on the poverty of the spirit. That’s what it’s called. As I said, it’s the second most important book ever written on addiction, and I say that with full modesty because I’m forgetting that you wrote one, too.
RB: Haha. You are very, very funny. Listen, I’ll do the jokes. You do the therapy. I don’t tell people how to run their lives. Oh no, I do tell people how to do that.
GM: I got my job description, thank you. So Bruce is saying that addiction is a marker of social dislocation to start with. He points out, for example, that the gin craze Britain, in England in the 17th century, happened as a direct… There’s always been drinking and drunkenness, but there wasn’t alcoholism on a social scale until—in order to shuttle people into these “satanic Mills,” as Blake put it, into the factories—they closed the Commons and people were dislocated. They had to leave their homeland. They had to leave their homes, their villages. They had to move into the cities. They dislocated them socially and economically, and that’s what gave rise to the to the gin craze. He makes the same argument globally, and we can see it in China where they pushed people off land into the cities in a couple of decades. Now they have a huge addiction problem. That individual dislocation is a marker of social dislocation, so the one is not to be separated from the other. In terms of what we can learn from it, though… What can we learn from it? What can I extrapolate from the personal to the social? It’s that individuals learn the sources of their problem, and, instead of being in denial about it, get over the shame of acknowledging their own behavior and their own dysfunctions, and they learn that they didn’t do this deliberately, but that this was defensive and protective. This was a pain-relieving mechanism on their part. If they open themselves humbly, as you talk about in the 12 steps, they can actually transform. That would also be true on a social level. What if as a society we actually admitted all our dysfunctions? What if we said this doesn’t work? What if we stop being in denial? Somebody’s written a book I call the fourth best book on addiction. It’s called When Society is an Addict [Ann Wilson Schaef, 2013]… What if we apply the same kind of thinking to the social level? OK, what’s really going on? Let’s not deny it anymore. Let’s acknowledge that there’s poverty. There’s inequality. There’s dislocation. There’s discrimination. There’s oppression. There’s prejudice against certain genders, certain colors of people, certain classes of people. What if we actually acknowledged all that as a society, and instead of shaming ourselves for it, we said, “OK, how do we wish to move forward?” Look at when revolutions happen. If you look at the French Revolution, or the Russian Revolution, or an individual addiction, they happened when things got intolerable. At a certain point things get intolerable. I know that revolutions have a bad name because they’ve had some pretty negative outcomes in places, but that’s just the nature of history. The point is they always happen when people finally get that something is intolerable and they can’t keep on going in the old way anymore. Now, nobody can make that happen, but I think from that point of view, what we’ve seen in Western society, certainly in the last four or five years, is people asking a lot more questions about the nature of this society, about the fundamental assumptions of the society. So this virus can also maybe contribute to that questioning. For example, when you look at the response to the virus, what was it? It was denial everywhere it was happening. In China there was denial. Had there not been the denial in China, there might not have been a huge epidemic. When the doctors first spoke the truth about it, they were shut down. They were silenced. And the same thing happened in Iran at first. The Koreans have done a lot better, but there was that initial response. What if we stop being a society in denial? Even this viral outbreak would have been different. I don’t know. Did I did I pontificate enough on that one?
RB: Haha. Could you end all of your announcements with that statement?