The Biases of Western Medicine | Gabor Maté, MD


From Sustainable Human: “In the realm of child development, I just wish we’d actually look at the evidence. But we don’t.

I worked in family practice for 32 years — 12 of them with hardcore drug addicts, the other 20 in a straightforward family practice. And in those years, I found that the people who got sick and didn’t get sick had certain patterns.

There’s one major source of illness, and I’m talking about any kind of illness, whether that’s so-called mental illness or physical illness. And that’s childhood trauma.

Trauma is what happens inside you as a result of what happens to you. And things can happen inside you for which you don’t need very dramatic events.

Growing scientific evidence demonstrates that social and physical environments that threaten human development, because of scarcity, stress, or instability, can lead to short-term physiologic and psychological adjustments that are necessary for immediate survival and adaptation, but which may come at a significant cost to long-term outcomes in learning, behavior, health and longevity.

Because those early coping patterns, here’s the problem with them: They’re meant to be temporary states. If you’re familiar with my idea about ADHD, which I’ve been diagnosed with, it’s a coping mechanism. Young infants, when there is stress around them, and they can’t escape, fight back, or change the situation, they tune out as a way of coping. But then it gets wired into their brain, and now it goes from a temporary state, which it is meant to be, to a long-term trait.

There’s nothing wrong with her coping that way if she could drop it once she no longer needed to be that way. But of course, that’s not how it works. These coping mechanisms are unconscious, therefore they’re not chosen deliberately. Therefore they cannot be released deliberately either. We’re not even aware of them.

The reason these patterns make you ill is because it turns out that, as traditional medicinal practices have always known, you can’t actually separate the mind from the body — except in medical school. But not in real life.

Now Western medicine looks at disease from a particular perspective. And you have to understand something about medicine: It’s science, all right. But it’s also ideology. And there’s a difference between science and ideology. An ideology is a worldview that you’re not conscious of, that you have hidden beliefs that you don’t question. And that exists in all realms, whether it is science or politics or history or economics or any field of human thought or investigation. So there’s always ideological biases hidden in any system.

Now, what are the biases of Western medicine? The hidden biases are, number one, that diseases have either physical causes, in the sense of genes or external forces like bacteria or viruses or toxins, or that diseases are what we call ‘idiopathic,’ [meaning] we don’t know what the source of it is. So that’s one bias, is that causes are purely physical.

The second bias is that diseases happen to organs. So you have heart disease, and you have lung disease, and you have diseases of the connective tissue or the liver or whatever, and then there’s specialties designated to study in depth the diseases of these organs. So we separate the organ from the whole person.

We might acknowledge the role of the physical environment, but we certainly are not acknowledging the role of the social environment. So I could clearly and trivially change your physiology in a split second. I simply would have to utter a piercing, blood-curdling scream and brandish a weapon at you. And your physiology would change like that. Your hormonal glands would start behaving differently. Your intestines would stop digesting. More blood would flow to your muscles and you’d be ready for fight or flight. Now that’s an obvious example, where the emotion changes the physiology in a split second. Well guess what, that goes on 24/7. So that interaction between the physiology and the emotions is constant. It’s just that for the most part we’re not aware of it, unless it’s dramatic.

In general, the role of the emotions is to invite in what is nurturing and welcome and healthy and to keep out that which is unwelcome, dangerous, and toxic. So with some people, sometimes we’ll invite even greater proximity, and others we never want to be anywhere close to them. That’s the job of our emotions, to maintain those boundaries.

Your conflicts, all the difficult things, the problematic situations in your life are not chance or haphazard. They’re specifically yours, designed specifically for you, by a part of you that loves you more than anything else. The part of you that loves you more than anything else has created roadblocks to lead you to yourself.

We can look at psychological problems, relationship conflicts, and illness as just problems to get rid of, or we could look upon them as opportunities for learning and development and growth. You don’t say to somebody just diagnosed with cancer, ‘hey, great, this is a great teaching moment.’ But if somebody wants to learn, if they start asking why, it’s a powerful teacher.

And contrary to what my profession believes — that these diseases have a life of their own, separate from the individual — they don’t. They are processes inside people, and people have the response-ability to affect those processes, once they get it, and they drop the automatic patterns that have been driving them.”


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