Published in September 2022, Canadian physician and author Gabor Maté’s new book, The Myth of Normal, is a rich examination of the conditions that lead not only to individual illness, but to the cultural normalization of stress, emotional repression, alienation, and disenfranchisement. Through his therapeutic practice of ‘compassionate inquiry,’ Maté shows how psychological trauma is exacerbated by cultural norms and capitalism, and emphasizes a curiosity toward individual circumstance as a way of understanding and healing core psychic wounds.

Accessibly written in collaboration with his son Daniel Maté, The Myth of Normal questions and dismantles notions of ‘normalcy,’ interrogating the factors behind the apparent rise of trauma-related illnesses and the oft overlooked social and economic circumstances that can make us sick.

The theme of disillusionment anchors The Myth of Normal, and the book signals in many ways an evolution from Maté’s earlier works including In the Realm of Hungry Ghosts (2008), a study of the addiction and opioid crisis in Canada. In that acclaimed earlier work, Maté makes a clear link between economic precarity, social disenfranchisement, and the stigmatization of difference with an individual’s predisposition to opiate addiction. As he wrote: “The question is never ‘Why the addiction?’ but ‘Why the pain?’”

Where Maté’s extensive study of the social roots of the opioid crisis ended, however, his new book picks up, tying in common threads with his 2003 work When the Body Says No. The Myth of Normal broadly explores the consequences of the “mind-body bifurcation,” or the dissonance between the mind’s narrative and the body’s sensed reality. This division is encouraged by social conditioning that traps people in traumatized patterns and maladaptive coping mechanisms based on emotional repression and denial.

Reiterating his past insights, Maté shows how chronic illness and immune disorders from cancer, multiple sclerosis, and ALS are often symptomatic of emotional repression and accumulated stress. The urgency of Maté’s arguments is clear as Canada’s health care system sees intensifying privatization, while social support systems become increasingly difficult to access.

As Maté writes, it is the “willingness to be disillusioned” that serves as a point of departure for bringing trauma awareness into medicine, legal systems, and educational environments in an intentional and systematic way.

“The personality is an adaptation”

While Maté emphasizes compassionate inquiry as a core element of his therapeutic practice, The Myth of Normal proposes curiosity as the foundation of a caring society. Curiosity, by nature, embraces the unknown. Its absence shapes a society where individuals are not in dynamic conversation with their environments and with unknown ‘others,’ and relate to one another through an ‘identity-by-template’ formula.

Without curiosity, we may become emotionally repressed, resentful, and disempowered. This is exacerbated when selected fragments of our lives are uploaded to social media platforms that are optimized based on unattainable ideals, and which are designed to capitalize on our most vulnerable insecurities.

Maté explores how dependence on external self‐presentation is an extension of neuromarketing, the normalized corporate strategy of targeting the pleasure response, which is often foundational to the algorithms that shape the content and behaviours of internet communities.

Indeed, social media is the ultimate marketplace for the self as product. It is geared towards optimizing the performance of self, of one’s visible social networks, and of a person’s aesthetic, gestures, expressions, and tonality. The result is a closed system where the self that best matches an algorithm displaces multiplicity and authentic diversity, convincing people into desiring to be anything but themselves. This creates a tension between the perception of self and an uncanny absence of self. As Maté writes, citing Trappist monk and poet Thomas Merton, this results in “living always in somebody else’s imagination” within a society “whose whole policy is to excite every nerve in the human body and keep it at the highest pitch of artificial tension.”

Contrary to notions of a fixed self, The Myth of Normal emphasizes permeability and changeability. “It is closer to the truth to think of the personality as a recurring phenomenon than a fixed or permanent one,” he writes, “much like the way individual movie frames projected at rapid speed create the optical illusion of a single, continuous narrative.”

This principle, however, doesn’t fit capitalist incentives for profit that trap us within states of insecurity and precarity, and which engender a perception of inner lack. Feelings of self-completeness, the absence of desperate co-dependence, and the fluidity of self-expression are much harder to influence and control—and are not profitable for industries that depend on keeping people stuck in their traumas, scrutinizing and fixating on their shortcomings.

But it also poses a challenge when a person’s sense of self is shaped by the narrative and scars of trauma, and disruptive traumatic response is internalized as an immutable part of one’s identity. Maté has addressed this in his previous writings, showing how addiction (a form of traumatic response and coping) can become an anchor for identity, with the addict seeing no other possibility for existence: “No matter how much he may acknowledge the costs of his addiction, he fears a loss of self if it were absent from his life. In his own mind, he would cease to exist as he knows himself.”

In an honest reflection on his own evolution in therapeutic practice in a chapter entitled “An Inaccurate Map of Our Pain,” Maté acknowledges the potential benefits of pharmacological approaches to treating symptoms of trauma, but bases the heart of his new book on healing the root of suffering rather than medicating. “In my medical practice I became something of a Prozac booster, succumbing to the error of looking for pathology where there was only everyday unhappiness,” he writes. “I am primarily interested in what will promote the healing of the psychic wounds the ongoing traumatic patterns represent.”

As in Maté’s previous books, The Myth of Normal includes many examples and stories of patients and individuals Maté has encountered to support his emphasis on psychic wounds within therapeutic practice in order to treat the root causes of suffering. Recounting the story of a young doctor in the section “A Physician Heals Herself,” Maté draws a portrait of a woman who systematically repressed her emotions and tolerated harassment at work. It took being admitted to a hospital for coronary distress and pre-cancerous cervical abnormality, and later becoming suicidal, to confront the abuse the interpersonal stress was inflicting on her emotional self.

Maté shows how these superficial symptoms can be addressed through a change of environment, with what appears to be a facet of personality or an unsolvable crisis transforming in conditions that are conducive to temperament and thriving.

Similarly, in the popular book Attached, authors Amir Levine and Rachel Heller write how elements of seeming pathology, which they reframe as chronic activation of attachment systems, can be understood and transformed by changing one’s environment. Through numerous examples of relationships with conflicting needs, the authors demonstrate how the absence of what Maté might call ‘compassionate inquiry’ within a relationship creates a defensive environment that shows fundamental lack of care for wellbeing.

Levine and Heller describe a relational framework that, rather logically, sees behaviours as interdependent and the conditions for wellbeing as being a product of reciprocation in their environments. While seemingly obvious, such thinking is not as normalized as punitive judgements of individuals. Crucially, the authors of Attached don’t assign moral judgement or prescribe doom to any attachment pattern or combination thereof. Rather, they emphasize the plasticity of behaviour through awareness, allowing people to retain dignity within confusion, and illustrating how different approaches can either contribute to perpetuating or resolving traumatic patterns.

An inherited legacy

The Myth of Normal offers many segues into domestic and global political issues, and many of them relate to repression and punishment of difference, and the internalization of shame as a mode of social control. In particular, Maté explores the profound consequences of emotional repression in intimate and social relationships due to a fear of risking non-compliance, and of disappointing or being cut off from a caregiver or authority. But as trauma theory and its vocabulary gain mainstream acceptance, the knowledge of traumatic response and its manifestations can also be used to discredit and exert coercive control over individuals, and to invalidate their criticisms—be it in the bedroom, the workplace, or in the geopolitical theatre.

In his chapter “A Template for Distress,” Maté describes the phenomenon of self-abandonment in the face of threats as ‘hypnotic passivity,’ which is programmed through punitive measures for non-conformity, protest, and spontaneity in ways of being. “As citizens in ostensibly democratic countries, we have free will, up to a point—but in practice that freedom rarely strays beyond the frontier of what is socially acceptable,” he writes. “Not daring to rock the boat, we risk sinking with it.”

In Sara Ahmed’s acclaimed book Complaint! (2021), the feminist theorist’s analysis of how institutional power in academia protects itself by discouraging, suppressing, disappearing, or even co-opting complaint shows the extent of normalization around guilt and shame for being a “trouble-maker” or “feminist killjoy.” Illustrating this phenomenon in an interview with The Paris Review, Ahmed described how institutional power pathologizes complaint and capitalizes on the internalization of shame to target individuals rather than confronting embedded, systemic problems: “A lot of people talked to me about how when they tried to make complaints, it was often the diversity agenda that would be used against them—as if they weren’t doing this the right way, as if they weren’t being appealing enough, as if by even using certain words they were trying to make life difficult for other people, including other minoritized staff.”

The relational nature of trauma explored in The Myth of Normal also recalls the cautionary angles on trauma’s place in social institutions raised in the book The Empire of Trauma (2009) by Didier Fassin and Richard Rechtman. Using France’s immigration system as an example, Fassin and Rechtman offer a nuanced critique of treating trauma as an unassailable moral category within systems that are already antagonistic toward vulnerable and marginalized people like refugees, veterans, and survivors of abuse and torture.

Reflecting on how the category of trauma has moved from clinical psychiatry into “everyday parlance,” the authors are wary of how, outside of a clinical context, the category of trauma gives a sense of social validation and status which are not otherwise afforded by society. “[T]he truth of trauma lies not in the psyche, the mind, or the brain,” they write, “but in the moral economy of contemporary societies.”

Fassin and Rechtman criticize the ideological underpinnings of social infrastructures based on a lack of compassion, and the trap of a cynical era that demands performance of victimhood in order for suffering to be heard and validated, and thus as “an important indication of the way in which the tragic is understood in contemporary societies.”

Speaking with Canadian Dimension, co-writer Daniel Maté explained that The Myth of Normal makes a point of trying to reach those “who might not already be convinced” by trauma theory. His response echoes the challenge of creating a ‘new normal’ and unmaking myths presented in the book’s last chapter.

“There are medical practitioners who haven’t fully ‘lost their religion’ or become disillusioned entirely with Western medicine, yet there is a sliver of openness there,” he described in an email. “And then there are the real tough nuts: people deeply ensconced in academia or scientific institutions who might have a knee-jerk distaste for this project.

“Often there are culture-war aspects to this: some people distrust the ‘woke’ use of victimized identity as a cudgel to force compliance in others, particularly on the level of oppressed groups, and see coddling as a danger.”

The Myth of Normal is a comprehensive volume that ties in common threads from across Gabor Maté’s previous works, and connects a progressive therapeutic approach toward trauma with the social crises borne under capitalism. The humanitarian tone of the book and the inherent liberatory potential of trauma-informed social praxis are at the heart of building a world whose visible and invisible structures can be guided by compassion instead of fear.

At its heart, the arguments presented in the book encourage the possibility that each of us can play a redemptive role in one another’s life; nudging off the well-trod pathways of self-sabotage, transforming one another’s betrayed sense of safety and vulnerability, and allowing the possibility for just one thing, this time, to be different on the way to an authentic life. As Maté invokes by quoting Victor Hugo: “At intervals can be seen a glimpse of truth, the daylight of the human soul.”

Lital Khaikin is an author and journalist based in Tiohtiá:ke (Montréal). She has published articles in Toward Freedom, Warscapes, Briarpatch, and the Media Co-op, and has appeared in literary publications like 3:AM Magazine, Berfrois, Tripwire, and Black Sun Lit’s “Vestiges” journal.