Dr. Gabor Maté on How Culture and Early Life Shape Health

The book I'm working on now is titled Toxic Culture. The argument behind it is straightforward: the way our society is organized produces lives that wear people down physically. That burden isn't shared evenly. Some postal codes carry more of it than others, and so do certain income brackets, genders, and racial groups, because the social pressure bearing down on those populations is heavier, and for reasons that aren't hard to see. But the point where these pressures first reach into a person's biology is much earlier than most people assume. It happens in the womb and again in the first years of life. All of that unfolds inside a particular culture and a particular society. So social conditions, physical surroundings, and the emotional climate we grow up in go on to shape the brain, the nervous system, how the body handles stress, the immune response, and even the beliefs we hold about ourselves and our place in the world. Those are the things that sort out who stays well and who doesn't.

Erik: That's helpful, thank you. I think the listeners will want to hear more about your idea that many of the traumas steering us toward either health or illness take hold before we're even born. Maybe you could begin with what reaches us at that earliest stage and move forward from there.

Dr. Maté: Start with a premise that older healing traditions never doubted, that the mind and the body are one thing and that a person can't be pulled apart from their surroundings. Conception takes place inside a woman, and that woman is either held up by her environment or she isn't. She's either settled, fed, and at ease, or she's somewhere short of that, by degrees. Wherever her needs go unmet, she carries stress. It might come from having no emotional support around her, from loneliness, from trauma lodged in her own mind, from strain in her relationship with her partner, from money problems, from racial oppression, or from the opposite of all that, a sense of comfort and belonging.

Whatever the source, it registers physically in her body: in the immune system, the nervous system, the hormonal machinery. Those hormones cross the placenta and reach the developing child. When a woman is under heavy stress, so is the fetus. The stress hormones, cortisol and adrenaline among them, circulate in greater or smaller amounts, and those amounts help determine how the infant's physiology takes shape. So a pregnant woman's stress is already leaving its mark before birth.

Look at where this leaves us as a society. We're seeing an explosion of diagnoses, from ADHD to autism and a long list of other childhood conditions. Children get labeled, they get put on medication, and the number of these diagnoses keeps climbing at a rate that doesn't level off.