52 pages • 1 hour read
Gabor Maté, Daniel MatéThe Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture
Nonfiction | Book | Adult | Published in 2022A modern alternative to SparkNotes and CliffsNotes, SuperSummary offers high-quality Study Guides with detailed chapter summaries and analysis of major themes, characters, and more.
Summary
Background
Chapter Summaries & Analyses
Key Figures
Themes
Index of Terms
Important Quotes
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BetaIntroduction and Part 1, Chapters 1-3Chapter Summaries & Analyses
Introduction Summary: “Why Normal Is a Myth”
In his introduction, Maté asks why it is that, despite the vast resources invested in health care on an individual and societal level in the 21st century, “our collective health is deteriorating” (1). Maté cites the fact that in the United States in 2017, 60% of adults suffered from a chronic condition like high blood pressure or diabetes. Meanwhile, in 2019, nearly 20% of Americans suffered from a mental-health-related episode. Maté explains this contradiction between the resources spent on health care in the West and increasing incidences of illness by arguing that we live in a “toxic culture” (3). Maté means by this term that we live in a cultural context that is inimical to human wellbeing and flourishing. The reason for this, according to Maté, is that our culture contains many stress-inducing factors for individuals, including environmental degradation, poverty, and social isolation. Maté sees it as his role to expose these deleterious social influences, whose impact on health has typically been downplayed and normalized.
Chapter 1 Summary: “The Last Place You Want to Be”
In Chapter 1, Maté discusses the nature and effects of trauma. He begins doing so by describing an anecdote from his own life when, on returning from a flight from a speaking tour, his wife was unable to pick him up from the airport. This incident led to a defensive and hostile reaction from Maté. Maté argues that this reaction stemmed from being abandoned by his mother as a child. The response is illustrative of trauma’s effects in two ways. First, trauma represents an injury that has long-standing and damaging effects on our behavior and worldview well beyond the initial painful event. Second, it leads to reactions that cut us off from others and limit our ability to respond in rational or healthy ways.
Maté distinguishes trauma from mere stress: While “all traumatic events are stressful” (24), the effects of non-traumatic stress are limited in time and severity, and do not continue to impact upon us for large swathes of our lives. Trauma separates us from awareness of our body and of our emotions, leading to an impoverished life. It traps us in the past, making it difficult for us to enjoy or respond to new situations or develop new relationships and experiences.
Chapter 2 Summary: “Living in an Immaterial World”
One of the problems of modern medicine is that it treats the body and mind as separable even though, on an intuitive level, we sense that the body and mind are deeply interconnected. It is common to connect the occurrence of stress in our lives to bodily symptoms like ulcers and headaches, and these intuitions are backed up by empirical studies. A 2000 study in Cancer Nursing confirmed a relationship between anger repression and cancer. Likewise, as Maté highlights, “in a study of men with prostate cancer, anger suppression was associated with a diminished effectiveness of natural killer (NK) cells” (41). The latter are cells that help to fight against malign cells and invaders in the body. Studies have also shown a connection between grief and a variety of cancers. For this reason, we need a new kind of holistic medicine that looks more closely at the links between illness and the human organism overall, including the emotions, mind, and their connections to the body.
Chapter 3 Summary: “You Rattle My Brain”
While it is important to look at the connections between the mind and body, “our brains and minds are not independent operators, functioning in isolation from other brains and minds” (55). Rather, our health is constituted by the social context in which we exist and our relations with others. This is evidenced in the connection between the quality of our immediate social relations and our health. For example, as Maté emphasizes, married people have, on average, higher life expectancies than those who are single. However, it is not just our immediate social ties that affect our health. Our place in a broad matrix of social relations and contexts also affects our health and biology. Factors like unemployment, work satisfaction, and our place within social hierarchies all affect our chances of developing chronic illnesses. As such, both our interpersonal relations and the social and political contexts in which we live must be considered when thinking about illness and health.
Introduction-Chapter 3 Analysis
Maté believes “we have cause to celebrate the past two centuries astonishing medical advances” (9). From the eradication of smallpox and the invention of antibiotics to treatments for HIV and a COVID-19 vaccine, modern medicine’s success is undeniable. Countless lives have been saved and profoundly improved due to its understanding and treatment of the human body. Yet, for all its achievements, modern medicine in its current form is ill equipped to deal with the health crises of the new century. Whether in terms of growing cases of autoimmune disease, cancer, or mental health problems, modern medicine is found wanting. A key part of the reason for this failing lies in the very factors that underpinned its initial success.
Principal amongst these is the medical and scientific paradigm of atomization. Following the empirical science of the 17th century, modern medicine made advances by isolating parts of the human body and understanding them through experimentation. This treated “human biology as strictly self-contained in an artificial setting like a medical laboratory or pathology theatre” (55). Such a paradigm, looking at the body as a type of isolatable chemical-material object, allowed for a clearer understanding of things like blood and the heart. It also allowed for the isolation of pathogens and the development of drugs and vaccines to combat them. Unfortunately, this paradigm had two problematic consequences. First, it meant that modern medicine “separates mind from body” (8). Rather than seeing illness and health in terms of a complex whole, bound up with our psychology and world, it is inclined to view them as “random states in a particular body or body part” (9). Second, it tends to treat illness in an isolated, atomized way. Since illness is seen as an aberration in an isolated part of the body or brain, it follows that drugs or surgeries that target those specific parts hold the key to recovery.
Why these corollaries to the modern medical paradigm are problematic is clear when looking at the effects of trauma. As Maté notes, quoting recent research, there is “strong evidence that childhood traumatic events significantly impact the inflammatory immune system” (50). The stress placed on the body by the traumatic event itself, then years of repression, can have devastating physical consequences. Put in a permanent state of defensive tension and cut off from emotional release, the body of the traumatized person may never get the proper chance to relax or recover. Over the long run, this strain can lead to the deterioration and malfunction of key body systems, as seen with Crohn’s disease or fibromyalgia.
Modern medicine is inclined to overlook these connections. Seeing the mind and body as separate, the atomized paradigm is more likely to look for local causes of such diseases and ignore the broader life context in which they occur. Meanwhile, in so far as modern medicine acknowledges the effects of trauma at all, it is likely to focus on what Maté calls “capital-T- trauma” (22). This is trauma related to some exceptionally bad event, such as physical or sexual abuse or the early death of parents, because it fits with the idea that illness must be the result of something abnormal or aberrant. Conversely, it is far less likely to examine the effects of “small-t-trauma” (22) on health. The latter is small scale “everyday” trauma that happens to most of us in various forms and can include a chronic lack of recognition or emotional support.
Such traumas are connected to our interpersonal relations and broader socio-political contexts and problems. This is why modern medicine, with its atomized and aberrant model of illness, is resistant to seeing these “normal” stresses as a cause of disease. To develop a more productive model of medicine, Maté challenge both the atomistic assumptions of modern medicine and the normalization of modern life’s stress factors, in which the former is complicit. Further, his use of his own Personal Narrative and New Ways of Healing and the stories of other individuals to point the way to one method he pursues to accomplish this: Namely, to re-orientate medicine, and individuals themselves, to explore the personal contexts in which disease arises. Thus, they can make the connections between body and mind and between themselves and society, which modern medicine has too often overlooked.
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