The Myth of Normal – Trauma, Disease, and Healing in a Toxic Culture

Last year, I wrote an article titled “The Body Keeps Score, But We Can Change It!”  and summarized my views based on a global bestseller (
Now, the book Dr. Gabor MATÉ, who is the first person that springs to mind in modern psychotherapy, wrote with his son, Daniel, The Myth of Normal has been a bestseller for a while. If you are interested in a certain topic, you need to follow the new ideas about it. Mate’s book talks about why things aren’t working out and how everyone’s health is deteriorating in the most health-obsessed society of all time from a bio-psycho-social perspective. If you don’t agree, then don’t mind, let it go. Is the answer to the question “Why is my cholesterol level, which used to be 250 in my youth, now 150?” that insurance companies are willing to pay for treatments at this level, or what is the truth? Perhaps it is the decision of our insurers, who cover all our treatment expenses.

The book, The Myth of the Normal (*), opens with the quote below:

For if medicine is really to accomplish its great task, it must intervene in political and social life.  It must point out the hindrances that impede the normal social functioning of vital processes, and effect their removal.” Rudolf Virchow (19th century physician)

Authors claim that many things that are usually considered normal are neither healthy nor natural, and that meeting modern society’s criteria for normalcy is physiologically, mentally, and psychologically unhealthy, and even harmful. Health and disease do not emerge by chance, rather they are the result of the conditions, relationships, events, and experiences of a person. All diseases are the result of our physical and psychological interactions with our environment and the physiology that carries the burden of pains that have lasted for centuries, our social conditions, cultural conditioning, childhood trauma, stress, and emotional past,  argue the authors. Million-dollar industries rest on people’s physical and emotional investment in never-ending quests for a younger look, a longer life, and a more vibrant feeling. Even so, we see a rise in mental illnesses and addictions in addition to more chronic physical diseases. Based on his experience of over thirty years, Dr Maté claims that mental or physical chronic diseases occur as a result of the way we live.  

He refers to the entirety of the social constructs, belief systems, assumptions, and the context of values surrounding us and inevitably permeating all aspects of our lives with the term “toxic culture” in the book’s subtitle. He argues that it is critical to realize that the effects of social life, particularly of stress, inequality, and climate crisis, have moved our concept of well-being away from individuality onto a global level. In short, our social and economic culture, by nature, generates causes of chronic stress that undermine the concept of well-being most severely.

Our current culture subjects us to numerous diseases resulting from stress, ignorance, inequality, environmental degradation, climate change, poverty, and social isolation amidst superb economic, technological, and medical resources. 60 percent of adults in the USA suffer from a chronic disease, such as hypertension or diabetes while over 40 percent suffer from two or more such diseases. 70 percent of Americans use at least one prescription drug, with more than half of them taking two. In Mexico, 38 people are diagnosed with diabetes every hour. Today, people living in Asia are in a similar situation. China is entering the age of obesity. Studies reveal that more than 50 million Americans, that is over 20 percent of all adults, had a mental disease attack in 2019. Mental disorders are becoming the biggest healthcare problem of the 21st century in Europe. In the US, children’s suicide attempts are rising while in universities in the UK students similarly have higher levels of anxiety, mental breakdown, and depression. Attention deficit and hyperactivity disorder among children has become a healthcare problem in China. Likewise, autoimmune diseases are on the rise. In the UK, the diagnosis of Crohn’s disease (microbic ulcer in the digestive system) increased more than threefold between 1994 and 2014. In Canada, the rate of IBS and spastic colon disease diagnosis in children increased by over 7 percent between 1999 and 2010.

The causes of adverse effects on the mental health of children and young people seem closely associated with chronic stress factors resulting from the future anxiety caused by climate change and the perception that the world is falling apart. Based on the fact that he had to deal with the effects of the trauma caused by having to be away from his family for a while and the challenging conditions he had to endure in his first years in Budapest as a Hungarian Jew during and after the Second World War, the author has concluded that unresolved trauma limits the self both physically and psychologically.

There are two kinds of trauma. The first is the traumas experienced by vulnerable people, such as the abuse of the environment, domestic violence, a contested divorce, or similar events. The other is, what the author terms the global kind, the less remembered but hurtful and widespread misfortunes, such as peer victimization and parental rigidness. If an event lessens a person, that is, makes them more psychologically or physically limited than they used to be, and this shows persistence, then we can talk about the presence of trauma. On the contrary, if a certain event does not diminish your capacity to feel gratitude for the beauty of life, does not limit or restrict you, does not shrink your capacity to think, diminish your self-confidence, or compel you to soothe yourself, then it is not trauma. Trauma separates us from our instinctive emotions. The result is the suppression of the person’s emotional world and the hardening of the case of their soul for extra self-protection.

People who carry the traces of trauma develop a negative sense of self. In some cases, these negative views may be masked as high self-esteem. For example, individuals who border on narcissism instead of feeling shame may achieve higher social, economic, and political status.  Trauma imposes a worldview that is shaped by pain, fear, and doubt, or the person denies the fears they do not dare to accept and create an all-pink perspective for themselves.

Suppose trauma leads to disengagement from the self. In that case, we get stuck in a mentality that neglects today without making life any richer with social media, news updates, or sources of amusement. In contrast, we deprive ourselves of life itself by distracting ourselves. The authors advocate the view that trauma extends to multiple generations in most cases. He argues that trauma is multigenerational and passed by parents onto their children through behavioural, as well as prenatal, and epigenetic mechanisms. In contrast with the popular idiom “Time heals all wounds,” trauma tends to hang above us like an insoluble shadow if not directly confronted through therapy or some other method of healing.

Rather than noticing emotions, we lock them up in underground vaults. But we cannot escape their torment,” writes Maté.

When the individual comprehends that pain has a history of many generations within a family system or even a community, the tendency to blame their parents and the possibility of healing appears. According to the book, trauma can also be seen in the collective realm and affect all nations and people in different moments of history, such as the traumatic heritage of slavery and racism in the USA or of Anti-Semitism in Continental Europe.  

In a book she wrote in 1997, Molecules of Emotion, Candace Pert, a leading neuroscientist in the field, says that almost all diseases most certainly have at least a psychosomatic component at the core, that is, if they are not altogether psychosomatic. Pert coined the term “mind-body” to describe this unity. There are many studies associating the suppression of anger and other difficult emotions with cancer. A study published in Lancet Oncology reports that skin or lung cancer development increased among parents who lost an adult son in an accident in a military conflict. Despite all this evidence, the authors believe that how we deal with losses, our emotional reactions, and how we process them affects our physiology rather than the loss of a loved one. An important point: In 2005, Finnish researchers determined that “daily incidents,” that is, ordinary stress, as well as relationship and work problems, lead to symptoms similar to those of people traumatized by wars or disasters.

Psychoneuroimmunology, a new science, studies how our body-mind unity, emotions, the connections among our neural and immune systems, and stress can trigger diseases. The brain, neural, immune, and hormonal systems all work together and are influenced by each other.

Stress is actually a compulsory survival function and may emerge in two ways: either as an instant reaction to a threat or a long-term situation triggered by internal emotional factors.  Acute stress helps maintain our physical and mental integrity while chronic stress weakens both. For example, chronic anger can make us anxious or depressed, suppressing immunity.

The system our body uses to address stress smoothly is called the “HPA axis.” This acronym includes the hypothalamus (the small area in the center of the brain that is responsible for keeping our body healthy and balanced), the pathways connecting the pituitary gland on the brain stem and the suprarenal gland, and the feedback cycles. We now know that the HPA axis infrastructure is regulated at an early age, starting from the womb and lasting through childhood. The stress one is exposed to in this sensitive period may ruin the hormonal mechanism for life. Today, as a result of the weakened family bonds in societies, children lacking secure attachment figures turn to their peers, which, in turn, may expose them to the threat of rejection, exclusion, and bullying. Again, a study conducted in the UK reports higher inflammation in the bodies of unemployed people. Australian researchers found that a bad job is worse for the mind than unemployment. Dr. Elizabeth Blackburn (she received the Nobel Prize in 2009 for her work on telomeres, the small DNA structures at the end of chromosomes) discovered that telomeres carry the real traces of the conditions under which we lead our lives. Surprisingly, factors such as poverty, racism, or the chaos of a city can directly impact our genetic and molecular functions.

Genes respond to their environment and depend on environmental signals. Even in identical twins, one can be biologically older than the other depending on how much stress and trauma they have been exposed to. Because stress shortens telomeres. A study conducted with 25-year-old adults whose mothers had high stress levels during pregnancy found that they have shorter telomeres, that is, they grew old sooner.

A study recently published in the Journal of the American Medical Association reveals that the risk of autoimmune disease is noticeably higher in people with stress-related disorders and lower in patients treated with SSRI-type (Prozac) medications. The most widespread personality traits of people with chronic diseases (cancer, autoimmune diseases, addiction, migraine, fibromyalgia, and chronic fatigue syndrome, etc.) are:

– Ignoring their own needs,

– Automatic and compulsive worrying about others’ emotional needs,

– Firm self-identification with social roles, tasks, and responsibilities,

– Suppressing their anger,

– Believing they are responsible for how other people feel,

– Prioritizing never disappointing anyone.

However, instead of such troubled obsessions, the person should be able to be honest with themselves and shape their lives through deliberate and conscious choices. But unfortunately, we generally opt for “hiding our emotions even from ourselves.” By thus renouncing our real selves, who we are, and how we feel, we suppose we secure our position in our physical and emotional lives. In many cultures, this struggle is usually admired. In my opinion, the most unique aspect of Mate’s approach lies in his explanations about those aspects of culture that impact human health: Our culture creates a consumption hunger, the social character mistakes desire for need and reaches a point where their nervous system feels anger when denied the objects they desire. Neil Postman’s cultural critique, ‘Amusing Ourselves to Death: Public Discourse in the Age of Show Business’, emphasizes that TV ads that are full of happy people do not tell anything about the marketed products but tell everything about the fears, fantasies, and dreams of the people who may purchase them. This observation points to the fact that the culturally worked-up feeling of inadequacy causes us to become addicted to consumption and that driven by this belief, we abandon ourselves to the culture of consumption. Another character trait imposed by culture is hypnotic passivity. Social institutions diminish people’s efforts to control their destinies.  The inevitable uncertainty, strife, lack of control, and knowledge in capitalist societies come knocking on our door as strong stress sources that challenge our health. In this context, personal health and happiness are associated with the general economic and political conditions. Culture threatens our well-being through all sorts of biopsychosocial ways, including stress-related inflammation, telomere degradation, early ageing, how and what we eat, the toxins we breathe, and even epigenetic causes, like the impending food supply loss being a significant stress factor for any living being. On the other hand, the mass uncertainty created by the lifesaving economic-political principles dictated by global finance institutions, such as the IMF and World Bank, works up stress. Even if they can vote, people’s views do not make any difference in public policy. In the consumption market, companies aware of people’s desire to be a part of something bigger than themselves, such as Nike, Lululemon, and Body Shop, sell meaning, identity, and a sense of belonging through their brands. As a matter of fact, neuromarketing rises as a strategic invasion aiming for the hyperactivation and constant agitation of the brain’s dopamine/endorphin functions.

On top of all this, social isolation and chronic loneliness, which became more widespread in Western society with the COVID-19 pandemic, led to a public health crisis. Disconnection, alienation, loneliness, loss of meaning, and dislocation become the most abundant products of our culture. Under the concept of cultural stress, racial and class alienation propagandas penetrate us at a young age and shape our biology and development. In racism, the self is defined by the other. Intersecting with poverty and inequality, racism invites diseases. Now watched in childhood, porn leads to a wrong conceptualization of the sexual roles of men and women. Socially, women generally assume the role of emotional adhesive that keeps the nuclear families, extended families, and communities together. The best example of how looking after the ill weakens the immune system is the high rates of depression and respiratory tract diseases in the nurses of Alzheimer’s patients, most of whom are women. It is claimed that the disproportionately high anxiety and depression rates in women result, to a great extent, from the fact that men do not internalize their worries and culturally assume the responsibility of soothing their partners. Finally, the authors conclude that in the field of politics, the outmost layer of the biopsychosocial perspective, diplomacy and the surrounding media culture are more toxic than ever today. When the shaping of the political agenda is examined, it is seen that the wounded choose the wounded, the traumatized lead the traumatized, and the policies reinforcing traumatizing social conditions are ruthlessly implemented.

Michael Millburn from Massachusetts University highlights that the harsher their parents were when growing up, the more prone leaders are to supporting authoritarian and aggressive policies, such as foreign wars, punitive laws, and death. Policy and trauma being intertwined is not a recent phenomenon. Alice Miller has drawn attention to how the unpermissive childbearing practices that were the order of the day for a long time in Germany helped devise templates for Nazi authoritarianism. When we realize how millions of people unconsciously seek to have their unmet childhood needs met by their leaders now, politics assumes a deeper meaning. Is it possible to evolve into a state where we leave the feeling of guilt behind, give reactions, and enjoy self-compassion for social healing? To this end, Maté devotes the last quarter of his book to exploring the “ways to wholeness,” or how to liberate ourselves from this unhealthy and unhappy state we have created for ourselves. He argues we can start getting free from the effects of modern culture by cultivating the four qualities of authenticity, agency, healthy anger, and self-acceptance. The possibility of change rests on the principles of individual and social self-questioning and compassion. But who will change and build a new, healthy culture?

Those governing countries, the public, or the people?

I am a little confused about this…


(*) Mate, G. (2023). Normal Efsanesi: Toksik Bir Kültürde, Travma, Hastalık, İyileşme; Hep Kitap, pp.552.

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