Dr. Gabor Maté on the Truth About ADHD and Anxiety

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From The Joe Rogan Experience: “The medical profession and a lot of the so-called experts think about [ADHD] as a disease, another one of these ‘inherited diseases’ — in fact, they say it’s the most heritable ‘mental illness’ there is. And I say, it’s neither an illness, nor is it heritable . . . As soon as I learned about the diagnosis, I knew something: this is not a disease, and it’s not heritable — despite the fact that some of my kids were ‘diagnosed’ with it. So tuning out is not a disease. Let me ask you a question. If I were to stress you right now, create stress, emotional difficulty or tension for you right now, what would be your options of dealing with that, of dealing with me? . . . You could fight back, flight or fight. But what if you didn’t have those options? Then you’re stuck. And now, what does the brain do when you’re stuck like that? It tunes out . . . In other words, it’s a coping mechanism.

. . . If you look at my infancy — and, it sounds like, yours — we spent our first year or two under very difficult circumstances, a lot of stress. Infants can’t help but absorb the stress of their parents, they can’t help it. What does an infant do? Could I have escaped or fought back? Could you have? All we could do is tune out. But when is this tuning out happening? When our brain is being developed. And our brain — this is the part that nobody taught me in medical school . . . the human brain develops under the impact of the environment.

So, the most salient feature of the environment that shapes the circuits of the human brain is actually the relationship with the parents. And if the parents are present and emotionally attuned and available, child brains develop properly. But if the parents are stressed, the child absorbs the stress, what can they do with it? They tune out. And that tuning out then gets programmed into the brain, and then 10 years later or 50 years later we say, ‘You got this disease.’ No, you don’t. You’ve got a coping mechanism — that’s no longer working for you, but it had a function when it first came along.

If a family comes to me with an ADHD child, I’ll say to them, what you’ve got here is a very sensitive child. That sensitive child is picking up on all the vibes, energies, and stresses in your family. Want to help this child? Deal with the whole family. Look at the parental relationship. Look at what stress is there in your life. Look at how you react to the child. Look at, do you understand the child’s behavior or the emotions that the child is having, or are you just trying to control the child’s behaviors? Look at all that. And very often, parents will tell me after they’ve read my book on ADHD, is they’ve totally changed their relationship to their child, [and then] the child changes — what a surprise. But you go to most doctors: ‘You got this disease, here’s a pill.’

. . . The brain can change if you treat it right. So this reliance on medications that we have is a real poverty of the spirit, a real poverty of imagination, a poverty of medical education. The average doctor never learns this stuff. The average physician never gets a single lecture on brain development, how the brain develops in interaction with the environment. Let alone do they hear about trauma — they don’t, hardly, at all. So when they see an adult with ADHD, or depression, or addiction, or bipolar conditions, or for that matter autoimmune illness, or anything else — they don’t think of trauma, they just think of this ‘disease.’ And they think that the diagnosis explains everything, but the diagnoses don’t explain anything. Because, think about it. Let’s say Gabor or Joe goes to a doctor and they’re diagnosed with ADHD. Well, what are the hallmarks of ADHD? Tuning out, poor impulse regulation, maybe hyperactivity. Why does Gabor have poor impulse control, hyperactivity and tuning out? Because he’s got ADHD. How do we know he’s got ADHD? Because he’s got poor impulse control, tunes out, and he’s hyperactive. Why is he hyperactive, tunes out and has poor impulse control? He’s got ADHD. How do we know he’s got ADHD? Because — you know, it’s circular, it doesn’t explain it, it doesn’t explain anything. Diagnoses describe things, and they can be helpful that way. But they don’t explain.

. . . One of the brain circuits that we have, as described by a very prominent late neuroscientist, Jaak Panksepp, is for panic and grief. Panic and grief are the normal responses of the young human being or the young animal when care isn’t available. So when the parents are stressed, distracted — economically or politically, or because of their own unresolved trauma — or whatever is going on in their lives, and they don’t respond to the child’s distress, they don’t pick up the child when they’re crying, they make the child be alone when the child is upset, the child’s panic circuits get activated — as they should be, because when the child’s panic circuits get activated, they cry for help. So it’s necessary for survival. A young animal should feel panic when the adult is unavailable. In a rational world, in a sane world, that child would be responded to. But when children, as in our society, are not responded to in their distress, the panic becomes built into their nervous system, and now you have a lot of anxious people. And that’s why more and more kids are being diagnosed. You’re right, it’s not a disease, it’s a response to the environment.

. . . The thought process is that the child’s behavior is the problem and so we have to fix the behavior by controlling it. Now actually, the opposite is true. Because if you pick up the child when a child has distress, physical or emotional distress, you’re teaching the child that the world is safe, and they don’t have to be anxious about it, and they can just ask for help. And it doesn’t entrench kind of crying, manipulative behavior. How it works — Dr. Daniel Siegel, who’s a psychiatrist at UCLA and a very prolific author and mind researcher, says in his book The Developing Mind that the child uses the mature circuits of the adult brain to regulate its own immature, unregulated circuits. So when the adults show up in a calm, loving way, the child downloads that into his own nervous system. And then he grows — he’s not going to be an infant forever; at some point he’s going to be a mature adult who knows how to take care of themselves. That’s a natural process. We don’t have to teach kids to be independent; independence is nature’s agenda, because the parents are going to die. At some point, the mother bear is going to disappear; that bear cub has to be able to look after themselves in a mature, confident way. That’s nature’s natural agenda. What the mother bear needs to do is to meet the needs of that infant bear, so the infant bear can mature. So if we meet the child’s needs, they’re going to mature out of that helpless state with a sense of self-regulation and calm confidence in their own capacity. But when you don’t pick kids up, what you teach them is that the world is not available, that they’re alone, and that they’re helpless. Talk about a formula for anxiety.”

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