Illness and the Impact of Our Psychological and Social Environment

Over the past couple of blog posts, I have focused on the manifestation of trauma and adverse childhood experiences in our negative self-thoughts and addictive behaviours.  Drawing on the work of Dr. Gabor Maté in the area of compassionate inquiry, I have also discussed how the compassionate approach to addiction is to look beneath the self-destructive behaviour to the person and pain that lies beneath.   In this post, I want to explore more of Gabor’s ideas about the negative impact of adverse psychological and social environments and how they lead to chronic disease.

Gabor suggests that a fundamental flaw of the traditional medical model is the separation of mind and body and viewing a person in isolation from their psychological and social environment.  This leads to a symptomatic perspective on illness and the use of medications to redress the symptoms.  He suggests that these deficiencies in the approach of traditional medical practice are no more highlighted than in the pursuit of the search for a cure for cancer.  He draws on the work of a holistic wellness expert who illustrates this flawed thinking by arguing that the research of individual cells for the source of cancer is like exploring the combustion engine as the cause of traffic jams.  

Gabor strongly maintains that his years of family medical practice and his role as Coordinator of palliative services (end-of-life care) for a hospital have convinced him that underlying all chronic disease, without exception, is a deficient psychological and social environment of the individual involved.  His assertion is based, in part, on the assumption that a defective social and psychological environment negatively impacts the immune system as well as other bodily systems (such as the respiratory and cardiovascular systems) that are inextricably interconnected.  He asserts in live with Buddhist philosophy that everything is connected to everything else and that “nothing exists on its own”.  He cites the Buddhist concept of life as the “interconnection of co-arising phenomena”.

He argues that in line with this perspective which reflects the reality of human existence, that a leaf and raindrop should be viewed not as isolated occurrences but as resulting from the interplay of soil, compost, sky, sun, rain and atmospheric conditions.  Louie Schwartzberg would add the role too of mycelium (mushrooms and their internet-like connected tentacles beneath the earth).  Gabor maintains that we have to take a “biocycle, social approach” to really address the causes of chronic illness.

The impacts of injurious psychological and social environments

Gabor in his YouTube© talk on “When the Body Says No”, draws on scientific studies to demonstrate the connection between stress and disease.  He maintains that an injurious psychological and social environment has major implications for the development of illness.  He illustrates this interconnection, for example, by discussing the impact of stressed parents on the physical welfare of a child.  Parents themselves can be stressed by their environments (economic and social systems, the presence or threat of war, racism) and/or their own lived experience of trauma or adverse childhood experiences.  The child, in consequence of this psychological/social environment, is stressed and scan suffer from asthma (which itself is treated with stress hormones to open the airways and reduce inflammation, resulting in the adrenal system becoming overcharged).

The parents’ stress is contagious – the child is aware of their own body and the impacts of parental stress on their bodily sensations.  The pain of the parent, mother and/or father, is experienced by the child but the real problem is that this pain “never gets discharged”.  Gabor cites Australian research that demonstrates that our bodies adapt to our psychological and social environment (as well as our physical environment).  He maintains that some of this adaption is helpful in the short term but in the longer term results in adverse bodily manifestations such as elevated blood pressure, heightened stroke risk, unhealthy sugar levels, arteriosclerosis and defective immune system.

Gabor also refers to research that shows that if a woman is both stressed (psychological environment) and isolated (social environment) her chances of a lump in her breast being diagnosed as malignant are increased immensely.  This research reinforces the interplay of illness and the psychological/social environment of an individual.  Other research shows that if one partner of an elderly couple dies, and the other partner is left bereaved and isolated, there are deleterious changes in the surviving partner’s immune, nervous, hormonal and cardiovascular systems, resulting in a “significant risk of dying”.

The development of illness through the suppression of challenging emotions and our own needs

Gabor demonstrates that suppression of challenging emotions such as anger negatively impacts the immune system and other connected bodily systems.  A person may suppress expressions of anger to gain and/or maintain parental affection and affiliation (because their absence is too painful).  The result of suppression of challenging emotions is “suppression of the immune system”. 

Gabor argues that a  key contributor to disease is a personal stance that is forever worrying about other people’s psychological needs while “ignoring your own needs”.  This can manifest as feeling responsible for the feelings of others and avoiding any words or actions that might disappoint them.  Gabor argues then that there are four significant risk factors that contribute to chronic illness and are life-threatening (18 minute mark of his talk):

  1. Ignoring your own emotional needs to cater for the perceived needs of others
  2. Identifying yourself with duty and responsibility in a way that is rigid (at the cost of your own authenticity, thus creating an external locus of control)
  3. Repressing challenging emotions such as anger or resentment
  4. Believing that you are responsible for how other people feel and, in consequence, trying assiduously not to disappoint them (and, as a result, never saying “no” when you should do so for your own health and welfare).

Gabor contends that “attachment” is the “most important dynamic in human life”.  Without it, we cannot survive as infants or adults.  We seek “closeness and proximity” with another so that we “are taken care of”.   He maintains that pathologies arise when our attachment needs are not met. This, in turn, leads to frustration of our other basic need, the need for “authenticity” – which he expresses in terms of our ability to be in touch with, and listen to, our “gut feelings”.  Gabor instances the  “please love me syndrome” of Robin Williams as an underlying cause of his depression and chronic illness,  leading to his death by suicide.

Reflection

We cannot ignore the impact of our psychological and social environment on our physical health.  At the same time, we have to recognise that we are contributing to the creation of a psychological and social environment that could be healing or harmful for others, especially if we are in a caring or managerial role.  Gabor explains his ideas about stress and illness in his book, When The Body Says No: The Cost Of Hidden Stress.  He also provides training and further resources on his website, The Wisdom of Trauma.

As we grow in mindfulness, we can become increasingly self-aware and aware of our impacts on the physical health and psychological welfare of others.  We can be more determined to take compassionate action, to look beneath self-destructive behaviours to find the person desirous of wellness and associated ease.

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Image by Pete Linforth from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group, and the resources to support the blog.

Understanding the Pain Beneath Trauma and Addiction

Dr. Gabor Maté encourages us to look beyond trauma and addiction to the unfulfilled needs and pain that lie beneath.   He maintains that the traumatic events and adverse childhood experiences are not the trauma but the catalyst for the trauma that is created within an individual.  This traumatised inner landscape reflects the pain of unfulfilled needs experienced by the individual and manifested in addictive behaviours, that are often self-destructive.  The internal trauma involves disassociation from one’s true self and distortion of internal and external perception.

Gabor offers compassionate inquiry as a way to help a client access their inner pain and distorted self-beliefs.  His approach is confronting but compassionate, penetrating but respectful, persistent but with a healing intent.  He is intent on helping an individual come to his own truth and to understand the connection between their trauma experiences and their addictive behaviour.   He makes the point that addiction is not just about drugs but people can be addicted to anything – to work, sex, “the need to please”, money, food, shopping, or anything else that holds them captive in compulsive behaviour that is injurious to the individual physically, mentally or intellectually.

One way we can understand the pain that lies beneath other people’s addiction and our own is to hear Gabor talk about examples and/or see him work with someone in his compassionate way.  By observing him unravel the threads that link a traumatic event or developmental experience to the self-talk that underlies addictive behaviour is enlightening and a motivation for compassion for others and self-compassion.

The negative self-stories that lie beneath addictive behaviour

We are very impressionable in early childhood and are forever trying to make meaning out of events in our life and experiences that flow from these.  Gabor states that children are basically “narcissists in the developmental sense” – everything is personal to them.   When parents, for example, are unhappy, fearful or sad because bad things are happening, then the child thinks “it must be about me” and develops low self-belief and negative self-talk accordingly.

Gabor talks about his own addiction to his work as a family medical practitioner as a way of fulfilling an unmet need.  His adverse childhood experiences during the Holocaust led him to believe that he “was not wanted in the world”.  His workaholic behaviour, negatively impacting his family and his clients, was designed to enable him to feel as though he was wanted and needed.  However, the continuous positive reinforcement of his role led to entrenchment of his addiction to work.  Beneath the workaholic behavior was an attempt to address the self-talk that reflected the pain of an unfulfilled need – the need to be wanted and protected (a basic attachment need).

In his interview podcast with Joe Polish, Gabor explored what Joe described as his sex addiction earlier on his life.  He had been molested in childhood over two years and his parents, who themselves were traumatised at the time, did not protect him.  His negative self-talk then was  around “I am only valued for my body” – thus leading to addiction to sex to fulfill his unmet need to be wanted and needed.  Gabor stated that acknowledging and confronting this unmet need is painful but essential for healing.  Addiction is often an escape to avoid facing up to a deep pain that seems bottomless.

Developmental trauma and worldview

In the interview with Joe Polish, Gabor maintained that there is another form of trauma that is not derived from a specific traumatic event.  He described developmental trauma as a disconnection from self that arises through a defective developmental childhood, resulting in a distorted worldview.  He instanced the different developmental traumas that can arise with parents who fail (for whatever reason) to provide a balanced environment for a developing child.  If, for example, the father was highly competitive, aggressive, domineering and “raging” at times, the child learned that the world “is a horrible place” and the way to survive is to be aggressive, grandiose and defensive. 

If, on the other hand, a child experienced an early childhood environment where she was bullied by her peers and informed by her mother that she should get out there and face them for “there is no room for cowardice”.  In Gabor’s interpretation, the message would be “to suck it up” – put up with whatever is happening, even if it is abusive and bullying.  Gabor commented that this worldview would lead to passive behaviour, even where someone is abusive and aggressively invading your personal space.

So our early developmental experiences can lead to aggressivity or passivity, depending on the nature of these experiences.  In both the early childhood experiences described above, there was an unmet need for protection and warmth.  The pain of this deficit was hidden beneath the individual’s distorted worldviews and consequent “habituated behavioural patterns”.

Reflection

Gabor maintains that “recovery” from trauma and addiction involves “reconnection with yourself” – being in touch with your feelings, intuition and insight.  It also involves replacing distorted perceptions of the world and self with compassionate understanding of the fragility and complexity of the human condition.

When I think of my early childhood, I recall the 18 months I spent in an orphanage separated from my younger sister and parents when I was four years old, as well as the 12 months boarding 100 kilometres from home when I was seven years old.  My negative self-talk, in line with Gabor’s experience, would have been “I am not wanted by my mother” (even though she was suffering serious illness at the time and could not take care of me while my father was on army duty overseas).  These early adverse childhood experiences may have translated, after completing secondary school, to my pursuit of study for the priesthood  – a very strong desire of my mother.  Thus I could have been trying to fulfill that unmet need to be valued by my mother – and during the five years of my religious life I certainly gained reinforcement of how much my mother valued me in that role.  I left the religious life more than 50 years ago because I decided “it was not for me”.

On reflection, I can see that my distorted perspective of what I perceived as a lack of care and concern for me by my mother was derived from my narcissistic orientation as a child (in reality, my mother was incredibly thoughtful, kind, generous and courageous – at the time of my separation she was not only very seriously ill, but grieving for the death of my four month old brother that occurred just before I was sent to the orphanage).

As we grow in mindfulness through reflection and meditation, we can gain insight into the antecedents for our behaviours and come to understand the source of our negative self-talk.  We can also renew our sense of wonder and awe, not only about nature but human life as well.

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Image by Carina Chen from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group, and the resources to support the blog.

Compassionate Inquiry as a Healing Mode for Trauma and Addiction

Compassionate Inquiry is a psychotherapy method developed by Dr. Gabor Maté to help people suffering from the effects of trauma and addiction to experience “deep healing and transformation”.   Gabor is a world authority on trauma and addiction and has developed his method after many years in family medical practice, covering the whole range of human experience from obstetrics to palliative care.  He found through his counselling sessions conducted each day after his clinic hours that trauma underlay many of the numerous physical and mental illnesses he encountered in his medical consultations.  Gabor intensified his research in related fields and explored his own addictive behaviour and its trauma-induced origins.

Gabor acknowledges that his early efforts at therapy were inadequate because he had not been trained in the area.  However, he persisted because there were very few people offering a psychotherapy approach to addiction and trauma – even psychologists, in the main, trained in the medical model, adopted a symptomatic approach and related medication treatment.  They did not explore the root cause of the addictive behaviour or the distorting impacts of various traumas experienced by people, especially in early childhood.

Compassionate inquiry to heal addiction and trauma

Gabor learned through his early experience that healing lay in enabling the client “to experience the truth of themselves within themselves”.   So what he attempts to achieve is not just an intellectual exercise – it involves engaging the whole person, their distorted perceptions, thoughts, and feelings.  He maintains that his approach is compassionate even though he interrupts people, challenges assumptions, and explores aspects that are painful for the client.  He believes that it is not his role to make the person feel good but to help them to genuinely face their pain and the truth about themselves. 

Gabor stated that often therapists are dealing with their own trauma and addiction issues (as he was in his early stages) and are not able to be totally present to the client nor able to control their responses to what the person is saying or doing – their help is not offered unconditionally.  He suggests that therapists need to work on themselves to ensure that they do not contaminate their interaction with their client/patient because of their own unresolved issues.  He stated that therapists who display anger or other challenging emotions undermine the healing process for the other person.

Paying attention to the cues

There is one very important aspect to paying attention to the cues provided by the client’s words, actions and non-verbals – and that is the issue of consent.  Gabor seeks consent to explore behaviour in-depth with the person he is working with but he also checks that he has consent to continue when the going becomes challenging.  He argues that the person will give some cues if they are too uncomfortable and these should be used to confirm ongoing consent.  In a podcast conversation for Banyen Books, Gabor said that he exceeded the consent boundaries in his earlier days as a therapist when he would drop into therapy mode with his family members – who outright rejected his approach given that they had not given consent. He soon realised that they wanted him as a spouse, parent, friend or supporter – not as their therapist.

The other key aspect of paying attention to cues is that they give the therapist insight into what is really going on for the client.  Gabor illustrates how “unconscious metaphors” (such as the sun revolving around the moon) can indicate that the balance of dependence and inter-dependence is distorted in a relationship between daughter and mother.  The daughter might be “carrying” the mother, thus creating a traumatic experience of missing out on maternal support in the early stages of development.   Gabor maintains that metaphors a person uses are instructive, even if employed unconsciously.  He uses this cue to explore the meaning of the metaphor for the client and the underlying thought processes and emotional component. 

His compassionate inquiry approach is designed to get at the “basic human need” that lies unfulfilled in the person he is working with.  He argues that no matter what the words or behaviour of the individual (e.g. aggressive or obnoxious) there is a ‘real human being underneath”.  He uses the words of Marshall Rosenberg when he describes addiction as “the tragic communication of a need”.   The challenge is to enable the client/patient to go inside themselves and confront the uncomfortable and painful truth that they are futilely pursuing an unmet, and unacknowledged, need deriving from adverse childhood experiences or adult traumatic events.   Gabor spontaneously illustrates his compassionate inquiry approach in a podcast interview with Tim Ferriss.

Gabor makes the point that his approach does not involve having people tell detailed stories about their traumatic events or adverse childhood experiences, he consciously chooses to focus instead on the impacts of these events/experiences in terms of the person’s distorted perceptions, false self-beliefs and/or addictive behaviour.  He sees his task as staying present to the person and their “here and now” experience so that he can “mirror back to them their true selves”.  Gabor’s compassionate inquiry approach is supported by Bessel van der Kolk, a global authority on trauma, who has used attachment research and neuroscience to develop innovative treatments for adults and children who have suffered from traumatic events.  Bessel contends that his research demonstrates that to change the way we feel we need “to become aware of our inner experience” and then learn to “befriend what is going on inside ourselves”.

Training in compassionate inquiry

Gabor maintains that compassionate inquiry requires an “unconditional determination to understand a person”.   He offers several training courses for people who want to develop the requisite skills and personal wholeness to be able to offer compassionate inquiry in their therapeutic/consulting practice.  He indicated that experience with these courses shows that participants gain insight into themselves as much as learning about the compassionate inquiry method.  Gabor often uses inquiry into the experiences of individual participants themselves to illustrate his perspective and process.  He offers a one year, online course in compassionate inquiry over 12 months, as well as an add-on certification process for those who want more advanced training.

An alternative to the online training is paid access over a 1-year period to Gabor’s recorded seminars based on a weekend workshop conducted in Vancouver in 2018.  The four videos involved cover more than 9 hours of training by Gabor.  Free access to Gabor’s perspective and methodology can also be gained by exploring his YouTube Channel, which includes his interviews and his TED Talk.  Gabor’s website also provides additional resources.

Reflection

With his compassionate inquiry approach, Gabor provides a methodology that a skilled facilitator with adequate training and immersion in his approach, could employ to help people who seek assistance with addiction and/or the effects of trauma.  Compassionate inquiry practitioners are available in multiple locations around the world.  Gabor also offers CI Circles facilitated by a certified CI practitioner for anyone who wants to learn more about CI concepts and practices and to engage in self-inquiry.  The Circles involve self-reflective journalling and a willingness to  share insights and disclose present moment experiences, somatic and otherwise.

As we grow in mindfulness and associated self-awareness through reflection, meditation and guided inquiry methods, we are better placed to help ourselves deal with the impact of traumatic events from our past life and to assist others with similar needs.

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Image by John Hain from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group, and the resources to support the blog.