Summary: The Myth of Normal: Trauma, Illness & Healing in a Toxic Culture by Gabor Maté

• The book is a revolutionary and urgent exploration of the causes and consequences of illness in our society, and how we can heal ourselves and our world by reconnecting with our true selves.
• The book challenges the conventional understanding of “normal” as a false and harmful concept that neglects the roles of trauma, stress, and the pressures of modern-day living on our bodies and minds.
• The book is written in a clear and compelling style, with many stories and examples from the author’s own life and practice. The book is also well-researched and evidence-based, drawing on the latest findings from neuroscience, psychology, medicine, spirituality, and social justice.

The Myth of Normal (2022) unpacks why chronic disease and mental illness are on the rise. Western medicine focuses on individual pathologies, but what if the key actually lies in our culture? Things we consider normal – like stress, adversity, and trauma – are often toxic and breed disease. The pathway back to health rests in identifying and addressing these underlying conditions.

Introduction: Discover how society’s idea of “normal” is making us sick.

In the 1990s, the Cleveland Clinic was witness to a strange phenomenon. Despite having fairly brief contact with patients, the nursing staff could often predict who would develop ALS, a degenerative autoimmune disease that attacks nerve cells in the brain and spine.

They would write comments in each patient’s chart like, “Probably has ALS, she is too nice,” or “No way, he is NOT nice enough.” To the astonishment of the neurologists, these predictions were almost always correct.

In the decades since, research has supported the nurses’ observations. The title of one published article is, Patients with ALS Are Usually Nice Persons. And it’s true for other diseases, too. In 2000, Cancer Nursing looked at the relationship between anger repression and cancer. But how could a personality trait like niceness possibly predict disease?

For world-renowned physician Dr. Gabor Maté, the answer lies in trauma and chronic stress. In fact, these factors often underlie much of what we call disease.

Drawing on his decades of experience as a physician, Dr. Maté has set out to debunk common myths about what makes us sick. In this summary, we’ll explore his powerful critique of how our society fosters illness – and one possible path to healing based on compassion.

In particular, Dr. Maté calls on us to stop seeing disease as an expression of individual pathology. Instead, people with illness are a “living alarm,” calling attention to the fact that what passes as normal in this culture is neither healthy nor natural. And things that are abnormal – addiction, mental health, and illness – are actually a reasonable response to the conditions of trauma and stress that many of us live in.

The clash between attachment and authenticity leads to a fractured self.

At 27, Mee Ok Icaro developed a rare and painful autoimmune disorder called scleroderma, where the connective tissue throughout the body hardens. It left Mee Ok bedridden and unable to move. She felt so much pain and despair that she wanted to end her life.

Mee Ok’s condition vexed doctors, so she began looking to her childhood for answers.

Born in Korea to a single mother, she was given up for adoption at six months. She was then taken in by an evangelical couple in the US, who raised her in a strict environment. For years, she suffered sexual abuse by her adoptive father – memories of which she’d repressed.

As Mee Ok began to confront her past, she realized how much emotional pain she had been stuffing down. To cope, she had learned to channel her energy into being hyperfunctional and indispensable at work, often carrying the pressures of everyone around her.

While Mee Ok’s disease is rare, her story is sadly not. Like the ALS patients at the Cleveland Clinic, these traits of self-sacrifice, suppressing negative emotions (especially anger), and high concern for social acceptance are common in patients with autoimmune diseases.

So what’s going on here? For Dr. Maté, it exemplifies what happens when two fundamental human needs – attachment and authenticity – are put in conflict. Attachment is your core need for emotional proximity and love. But you also need to be the author of your life, guided by a deep knowledge of your authentic self.

In Mee Ok’s case, the trauma of separation and sexual abuse was so painful and alarming that she had to disconnect entirely from her memories and her emotional self. At some point, she learned that working hard and being useful was a safe way to gain acceptance.

This is the split self: there are the parts of you that you believe are acceptable, and there are others you reject. When Mee Ok learned to reconnect with those once rejected parts, she began to heal. Today, she is off all medications and can walk, travel, and even hike again.

Next, we’ll explore how this split self sets the conditions for disease.

Stress wreaks havoc on the body, setting the stage for disease.

So, we’ve seen how the conflict between attachment – our need for connection with others – and authenticity – our need to be true to ourselves – can lead to a fractured self. We suppress certain parts, like our emotions, in order to win approval or affection.

The toll this takes on our health is significant. And the key here is stress. Constantly suppressing our emotions and needs activates the stress response. To better understand this, let’s look at what happens to a body under stress.

An emotional stressor first activates a complex network of connections – think of a major highway system with many interchanges – between the hypothalamus, which is the brain center responsible for keeping your biological systems in equilibrium, and the pituitary and adrenal glands, which release stress hormones like adrenaline and cortisol.

Prolonged or chronic stress leads to an excessive release of these hormones, exhausting the entire system over time. It also wreaks havoc on your nervous system, which you know if you’ve experienced those tense jitters before a big presentation or an exam.

What’s worse, this stress inhibits your body’s natural defense against sickness. When functioning properly, the immune system floods in to attack a foreign substance and then dissipates. But stress suppresses the signals that turn it off, leading to chronic inflammation. When the immune system attacks healthy cells, it’s an autoimmune response – like in ALS or Mee Ok’s scleroderma.

Stress can even affect our DNA. Telomeres are tiny structures that protect chromosomes from fraying – kind of like the little plastic aglets at the end of your shoestrings. These telomeres shorten as we age, but if they become too short, the host cell can become impaired. Scientists have found that stress and adversity significantly shorten telomeres, prematurely aging our cells and making us more prone to illness.

It’s evident that emotional stress is inseparable from the physical state of our bodies. Dr. Maté calls this mind-body unity. But while the stress response evolved to help us survive, modern social conditions are keeping it constantly activated – which is what we’ll explore next.

Our culture generates chronic stress and the conditions for illness.

Think back, for a moment, to high school biology. Remember the petri dish? That shallow, transparent container used for growing bacteria or fungi cultures? A petri dish can create the right environment for organisms to thrive: the perfect balance of light, temperature, and nutrients, along with an absence of toxins. If the environment is off, whatever is being cultured may not survive.

After decades of treating patients, Dr. Maté has come to see that the petri dish we live in – in other words, our culture – isn’t ideal for human flourishing. In fact, it’s toxic. It breeds the chronic stress that forms the basis of our many ailments.

Consider economic insecurity. Most people have had to work harder and more hours than previous generations to keep up financially. This leaves less time for family. For many, their job – a major source of self-esteem and purpose – feels precarious, like they could lose it at any moment.

People living in poverty often have to choose between putting food on the table or paying rent. But even the global middle class hasn’t fared well. According to the Organization for Economic Cooperation and Development, they’ve been under increased pressure since the 1980s.

Groups facing discrimination have far worse health outcomes. A 2020 study by Dr. Brad Greenwood and colleagues found that a Black baby’s risk of death at birth increases twofold if their doctor is not Black. And a Canadian study showed that women have worse outcomes than men after heart surgery because they have to resume their caregiving duties earlier. They simply don’t get the same time to rest and heal as men.

For Dr. Maté, all the stress and disconnection we feel is further exploited by our consumerist culture. Think about all the advertising campaigns that set out to make us feel insecure and insufficient in order to sell us products that promise to fulfill our needs.

What’s worse, the average person has far less influence over our collective destiny than those with financial power. A recent study found that when a large majority are in favor of a particular public policy, it’s rarely implemented if the economic elite are against it.

When we take a step back, it’s no wonder that people are experiencing more stress than ever.

Trauma often begins in childhood because society undermines our developmental needs.

Here’s the thing about a society that causes so much stress: children feel it most. That’s because parental stress easily transfers to the child. Consider a study by Sonia Lupien and colleagues, which found that a child’s stress-hormone levels rise if their mother is under economic stress.

And there’s a good reason for this. A child’s development makes them extremely sensitive to their environment. What happens in these formative years sets the foundations for everything to come – their health, brain development, and future relationships.

The child’s primary developmental need is having secure and reliable attachment to caregivers, coupled with warm, attuned, and consistent interactions. Poor attachment, or stressed and distracted interactions, can lead to shaky emotional and mental development.

Considering this, you might imagine that society would do everything in its power to provide a low-stress environment for childbirth and child-rearing. Yet that couldn’t be further from reality.

First of all, there is the stress of feeling alone and unsupported in raising children – and the economic pressure parents often face today. But alongside this, parents also take cues from a culture that centers child development around the needs of society rather than the needs of the child.

It begins with overly medicalized birthing practices, which often deny women’s agency and lead many to experience obstetric trauma. Then, the integral contact that a child needs with caregivers in the first months of life is undermined by parental leave policies. One quarter of American women, for example, return to work after just two weeks.

There are also parenting guides that subvert parental instincts by encouraging disconnection and punishment. Dr. Benjamin Spock’s influential guide, for example, encourages parents to sleep-train infants by leaving them to “cry it out.” The requirement here is for children to adjust to the demands of society’s work schedules.

A culture that undermines childrens’ need for secure attachment creates the conditions for the sort of embedded, chronic stress that comes with self-fracturing. This is the basis for trauma, an emotional and psychological woundedness that we can carry throughout life.

Your health is an expression of the life you’ve lived and the context surrounding it.

The template for Dr. Maté’s lifelong depression was set in his childhood. He was born into the trauma of Nazi-occupied Hungary, and his Jewish grandparents were killed in Auschwitz. His young mother, fearing for her baby’s health, sent him to live with relatives who found safer hiding conditions. But when the two were reunited later, he would not so much as look at his mother.

Today, Dr. Maté understands that his response to the trauma of separation was reasonable and adaptive. His detachment and emotional repression helped protect him against feeling such unbearable pain again, much like Mee Ok’s repressed memories of abuse.

He can also now see the ways in which he absorbed his own mother’s trauma from living through those harrowing events. But still, like with all children who experience trauma, it embedded itself in his nervous system and his mind, influencing his behavior well into adulthood.

When we treat mental illness, like depression, as merely a disease, we miss the opportunity to understand the purpose it once served. Many of the addiction patients Dr. Maté has treated first turned to drugs or alcohol as a way to escape their emotional pain and early trauma.

Understanding the source of suffering – trauma, adversity, and stress – as the social conditions of living in a toxic culture helps put sickness and disease in a different light. Within this new framework, sick bodies and minds are more like a siren: we might look at what disease and mental illness are expressing about the life and social context they emerged from.

We have a tendency to think of illness as something that springs up one day, completely out of the blue. What if, instead, we saw an illness as a process – a journey that may connect back to the earliest days of one’s life, and extend all the way to the present?

What if someone who is sick is in the midst of a transformation, and is being called to look honestly and with an open heart at the wounds they carry?

Healing is about finding a pathway to wholeness.

While detoxifying our culture is beyond the scope of this summary, there is still a lot of cause for hope. That’s because healing is possible.

For Dr. Maté, healing is the natural movement toward wholeness. If the conditions for disease begin with a separation from the self, emotions, and others, then it makes sense that one solution is to reintegrate our fractured parts. This process involves acknowledging our suffering, and the suffering of the world, and learning to confront the wounds that have caused disconnection.

A powerful strategy that you can begin to use in your own life is an exercise called Compassionate Inquiry. Compassion is an attitude that accepts what is, and the person you are. In other words, there is no should. It allows for genuine and open inquiry, where you don’t presume to have all the answers.

This is a practice to try daily, or weekly at first. It involves answering some introspective questions, and it’s best to write your answers out by hand.

The first things to ask yourself are: When do I struggle to say no in the areas of my life that matter, and how does that impact me? When have I denied following my urge to say yes? These questions are about identifying the ways in which you deny your emotions and needs, and prioritize others.

Then you can ask, What bodily signals have I been ignoring? What symptoms could be trying to give me warning? In these questions, you’re focusing on the mind-body connection, identifying where emotional stress is held in your body.

Next, try to identify the hidden story behind your inability to say no. Where did you learn these stories? This is about untangling the narrative, so that you can see how your responses and behaviors once served you.

And that’s it. The goal of this healing work is to learn to hear your authentic, essential self. Once you’ve achieved that, you can free yourself from the automatic responses and adaptations to stress, adversity, and trauma that keep you disconnected.

Summary

Born into an environment that centers around the needs of society rather than parents and children, many of us experience small and large traumas of all kinds. To cope, we split from those painful emotions – rejecting parts of ourselves and turning away from loving connection. The source of mental illness, addiction, and disease often traces back to these inner wounds and the stress they lock into our body.

Despite many societal advances, disease and mental illness are on the rise. But the medical system rarely considers the whole life of a patient or their inner emotional world. Instead, it isolates the biology of disease from its social context, trying to cure illness so we can get back to normal. But what is normal? It may just be the very thing that is making us sick in the first place.

About the author

A renowned speaker and bestselling author, Dr. Gabor Maté is highly sought after for his expertise on a range of topics including addiction, stress, and childhood development. Dr. Maté has written several bestselling books, including the award-winning In the Realm of Hungry Ghosts: Close Encounters with Addiction, When the Body Says No: Exploring the Stress-Disease Connection, and Scattered: How Attention Deficit Disorder Originates and What You Can Do About It, and has coauthored Hold On to Your Kids: Why Parents Need to Matter More Than Peers. His works have been published internationally in nearly thirty languages.

Daniel Maté is a Brooklyn-based composer-lyricist who has received the Kleban Prize, Cole Porter Award, and Jonathan Larson Grant. His musicals include The Trouble With Doug and The Longing and the Short of It. Other shows in development include Hansel & Gretl & Heidi & Günter, Middle School Mysteries, and an adaptation of the Russell Banks novel The Sweet Hereafter. He is the host of the YouTube program Lyrics To Go and runs a "mental chiropractic" service called Walk With Daniel.

Table of Contents

Introduction Why Normal Is a Myth (And Why That Matters) 1
Part I Our Interconnected Nature
Chapter 1 The Last Place You Want to Be: Facets of Trauma 15
Chapter 2 Living in an Immaterial World: Emotions, Health, and the Body-Mind Unity 37
Chapter 3 You Rattle My Brain: Our Highly Interpersonal Biology 52
Chapter 4 Everything I'm Surrounded By: Dispatches from the New Science 59
Chapter 5 Mutiny on the Body: The Mystery of the Rebellious Immune System 68
Chapter 6 It Ain't a Thing: Disease as Process 85
Chapter 7 A Traumatic Tension: Attachment vs. Authenticity 96
Part II The Distortion of Human Development
Chapter 8 Who Are We Really? Human Nature, Human Needs 115
Chapter 9 A Sturdy or Fragile Foundation: Children's Irreducible Needs 123
Chapter 10 Trouble at the Threshold: Before We Come into the World 136
Chapter 11 What Choice Do I Have? Childbirth in a Medicalized Culture 146
Chapter 12 Horticulture on the Moon: Parenting, Undermined 160
Chapter 13 Forcing the Brain in the Wrong Direction: The Sabotage of Childhood 179
Chapter 14 A Template for Distress: How Culture Builds Our Character 197
Part III Rethinking Abnormal: Afflictions as Adaptations
Chapter 15 Just Not to Be You: Debunking the Myths About Addiction 211
Chapter 16 Show of Hands: A New View of Addiction 224
Chapter 17 An Inaccurate Map of Our Pain: What We Get Wrong About Mental Illness 235
Chapter 18 The Mind Can Do Some Amazing Things: From Madness to Meaning 253
Part IV The Toxicities of Our Culture
Chapter 19 From Society to Cell: Uncertainty, Conflict, and Loss of Control 275
Chapter 20 Robbing the Human Spirit: Disconnection and Its Discontents 286
Chapter 21 They Just Don't Care If It Kills You: Sociopathy as Strategy 297
Chapter 22 The Assaulted Sense of Self: How Race and Class Get Under the Skin 311
Chapter 23 Society's Shock Absorbers: Why Women Have It Worse 329
Chapter 24 We Feel Their Pain: Our Trauma-Infused Politics 343
Part V Pathways to Wholeness
Chapter 25 Mind in the Lead: The Possibility of Healing 361
Chapter 26 Four A's and Five Compassions: Some Healing Principles 374
Chapter 27 A Dreadful Gift: Disease as Teacher 390
Chapter 28 Before the Body Says No: First Steps on the Return to Self 408
Chapter 29 Seeing Is Disbelieving: Undoing Self-Limiting Beliefs 422
Chapter 30 Foes to Friends: Working with the Obstacles to Healing 430
Chapter 31 Jesus in the Tipi: Psychedelics and Healing 447
Chapter 32 My Life as a Genuine Thing: Touching Spirit 463
Chapter 33 Unmaking a Mytb: Visioning a Saner Society 481
Acknowledgments 499
Notes 503
Index 546

Review

The book is a revolutionary and urgent exploration of the causes and consequences of illness in our society, and how we can heal ourselves and our world. The book challenges the conventional understanding of “normal” as a false and harmful concept that neglects the roles of trauma, stress, and the pressures of modern-day living on our bodies and minds. The book argues that disease is not an aberration, but a natural reflection of a life spent growing further and further apart from our true selves. The book draws on the author’s four decades of clinical experience as a physician and addiction expert, as well as his personal journey of healing from childhood trauma and chronic illness. The book covers the following topics:

• The myth of normal: how our culture defines normality based on external standards and expectations, and how this creates a sense of inadequacy, alienation, and disconnection from ourselves and others.
• The sources of trauma: how trauma is not only caused by extreme events, but also by everyday experiences of neglect, abuse, oppression, and invalidation that shape our beliefs, emotions, and behaviors.
• The effects of trauma: how trauma impacts our physical, mental, emotional, and spiritual health, leading to chronic conditions such as autoimmune diseases, cancer, depression, anxiety, addiction, and more.
• The healing of trauma: how we can heal from trauma by reconnecting with our true selves, our emotions, our bodies, our relationships, and our purpose. The book offers practical tools and strategies for self-awareness, self-compassion, self-regulation, self-expression, and self-transformation.
• The transformation of society: how we can transform our society by creating a culture of compassion, empathy, authenticity, and cooperation that supports the health and well-being of all living beings.

The book is a powerful and inspiring work that offers a new vision of health and healing for ourselves and our world. The book is written in a clear and compelling style, with many stories and examples from the author’s own life and practice. The book is also well-researched and evidence-based, drawing on the latest findings from neuroscience, psychology, medicine, spirituality, and social justice.

The book is not meant to be a comprehensive or definitive guide on trauma or health, but rather an invitation for readers to question their assumptions, challenge their norms, and seek their own truth. The book is based on the author’s own perspective and experience, which may not always agree with other experts or sources. However, the book does not claim to be the final or ultimate word on trauma or health, but rather a catalyst for dialogue and action.

The book is a must-read for anyone who wants to understand the root causes of illness in our society, and how we can heal ourselves and our world. The book is also suitable for anyone who wants to learn more about themselves, their emotions, their bodies, their relationships, and their purpose. The book is highly recommended for anyone who wants to learn more about the myth of normal.

Summary: The Myth of Normal: Trauma, Illness & Healing in a Toxic Culture by Gabor Maté