The Tim Ferriss Show Transcripts: Dr. Gabor Maté (#298)

Please enjoy this transcript of my interview with Dr. Gabor Maté, a physician who specializes in neurology, psychiatry, and psychology. Transcripts may contain a few typos—with some episodes lasting 2+ hours, it’s difficult to catch some minor errors. Enjoy!

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Tim Ferriss: Hello, boys and girls. This is Tim Ferriss, and welcome to another episode of the Tim Ferriss Show where it is my job, each and every episode, to interview world class performers, world class experts from any range of disciplines to tease out the habits, routines, lessons, approaches, etc., that you can use. This episode features Dr. Gabor Maté. You can find him at drgabormate.com, also on Facebook /drgabormate. Gabor is a physician who specializes in neurology, psychiatry, and psychology. He is well known for his study and treatment of addiction. Dr. Maté has written several bestselling books, including the award winning In the Realm of Hungry Ghosts: Close Encounters with Addiction.

His works have been published internationally in 20 languages. Dr. Maté has received the Hubert Evans Nonfiction Prize, an honorary degree from the University of Northern British Columbia, and the 2012 Martin Luther King Humanitarian Award from Mothers Against Teen Violence. He is an adjunct professor in the faculty of Criminology at Simon Fraser University. And I’ve wanted to have him on the podcast for some time now because he is not only an expert in the so-called pathologies of addiction but looks at it very, very differently and also has experimented and used successfully tools that are perhaps outside the realm of traditional psychiatry, including, for instance, the psychedelic brew known as ayahuasca.

He is also a co-founder, along with Vicky Dulai of Compassion for Addiction, which is an organization that advocates for a new way to understand and treat addiction.

Their mission is to raise awareness and become a resource for organizations, people, and treatment modalities that are working to increase compassion and reduce the stigma around addiction. We get into that in our conversation. We also talk about how, even though you might not consider yourself an addict, if we look at compulsive behaviors, thought patterns, and so on, there are, of course, many shared similarities and shared treatments. Compassion for Addiction, and you can learn more about that at compassion4addiction.org will provide education and training to those working on the front lines of treating people suffering with addictions.

This population includes counselors, social workers, nurses, psychologists, and doctors. Check that out, compassion4addiction.org. I really enjoyed this conversation. It took place in Austin, Texas at the LZR facility, which was and is perhaps also known as the La Zona Rosa.

And it was courtesy of the help of John Price. So, John, thank you very much for letting us use your beautiful facility. And you guys can learn more about that facility. Check it out at lzratx.com. That’s lzratx.com. They have an incredible space for venues related to music, for events. They have any number of different rooms and locations where you can shoot film and perform music, interviews, etc. So, take a look. Check them out. And I hope that helps you out, John. Lzratx.com. Without further ado, let us get to Dr. Gabor Maté. Gabor, welcome to the show.

Dr. Gabor Maté: Tim, it’s a great pleasure to be here. Thank you.

Tim Ferriss: I have been looking forward to this conversation for a really long time. And I wanted to make an attempt, at least, to do it right. So, I wanted to have the video and the audio and everything else because I think the work you’re doing is very important. And we’re going to cover a lot of ground, which I’m very excited to cover because I think it’s a real contribution.

And you have tools and frameworks that can really help people. I thought we might start with books. And the reason I thought that could be a fun place to start, my audience loves books, No. 1. But No. 2, in Tribe of Mentors, the last book that I wrote, or that my guests wrote, you were featured. And I thought that many of the books you mentioned paint a picture of your life experience and also your life’s work, in many ways. And we can go in any particular order. But I thought maybe it would make sense to start with the Scourge of the Swastika.

And that was one that you mentioned had an impact on you or that perhaps you recommended on occasion. Why is that?

Dr. Gabor Maté: Well, so, this has to do with my family’s history. I grew up – I was born in Budapest, Hungary in 1944 in January two months before the Germans occupied the country.

And Hungary, at that time, was the only country in Eastern Europe where the Jewish population had not been annihilated. And now, it was our turn. And I was 2 months of age. The day after the German army marched into Budapest, my mother phoned the pediatrician to say would you please come and see Gabor. Of course, he’s crying all of the time. And the pediatrician said, “Of course, I will come. But I should tell you, all of my Jewish babies are crying.” And, of course, that’s the infants picking up on their mother’s terror and stress.

And that’s how I spent the first year of my life, which has a huge impact on my development and my lifelong struggles with depression, ADHD, self-shame, and other issues. Jumping ahead now, I knew very little about that history. And my parents didn’t say much about it, as I was growing up. I knew my grandparents had been killed in Auschwitz. I knew my father had been in forced labor.

And I never saw him for a year and a half. But, beyond that, I knew not much about the details, until I was about 9 or 10, maybe 11 years old, and there was a book on my parents’ shelf in Budapest with the title The Scourge of the Swastika, which was written by a British civil servant and member of the House of Lords. This man had served with the British army, and it was the first book published in the ‘50s that detailed the Nazi crimes. And I climbed up on a chair, took down the book, when I was I think 10 or 11. I began to read it, saw photographs of the horrors of the concentration camps and the extermination details in Eastern Europe.

And, all of a sudden, I [inaudible], because I got what happened to my family. And that question of how can people do such things to other human beings would strike me every day. And almost every day, this thought occurred to me for years and years and years.

And almost every day, I almost got dizzy with the question. So, why people suffer and why people make other people suffer, and what is the origin of that has been a motivating question in my life. So, that is why that book was so important to me.

Tim Ferriss: Thank you.

Dr. Gabor Maté: And I have to say my life’s work has been motivated by that question as a medical doctor. I’m always looking at what is it that makes people be the way they are. Why do we become cruel? Why do we become victims? Why do we become perpetrators? What drives us? What kind of insanity covers our basic human nature, which I believe to be good and positive? And what happens to us?

Tim Ferriss: We’re going to spend a lot of time, in that territory, for sure. So, you mentioned sanity or insanity. I’m not sure if that’s a good segue to Don Quixote. But I’ll let you choose the next one.

So, there are few that came up, and you described them briefly in the pages of the book. For instance, the background that you just gave me was much more in depth. So, we have a few. And these are going to strike folks as eclectic. Winnie the Pooh, The Dhammapada, The Drama of the Gifted Child, and Don Quixote. Which one of those would you like to explain next?

Dr. Gabor Maté: Let’s go with Winnie the Pooh.

Tim Ferriss: Let’s go with Winnie the Pooh.

Dr. Gabor Maté: Yeah. So, that was one of the seminal books of my childhood. And my parents would have read it to me long before I even knew how to read. The Hungarian title is [Hungarian]. Mitsy the Bear. And the translator is a great Hungarian humorist. So, if anything, the Hungarian book is even funnier than the original English, which is not something one usually says about translations. But what struck me about Pooh, of course, was 1) that there was this bear of little brains who was so much wiser than everybody else.

So, fundamentally, he found the peace inside, despite the fact that his intellect is just under functioning. 2) There was this relationship with the little boy, Christopher Robin. And there’s a passage towards the end of the book where Christopher Robin – I don’t know if you know the real story. In fact, there’s a movie about it right now. But Christopher Robin’s father, AA Milne, was a writer. And he bought these toys for his son to make stories about them. And Christopher Robin actually suffered because he was secondary to his father’s career. They did not have a good relationship.

So, these characters that the father made up kind of dominated and squeezed out Christopher Robin’s own life. And he himself became a book seller later on in his life. And he wrote about it in his autobiography. So, there’s something about the dysfunctionality and father/son relationship.

But, in the book, Christopher is playing with his toys. And then, he starts to grow up. And he has to go to school. And he won’t be able to play with his toys anymore. And, at the very end of the book, there’s a passage where the book ends with, “But wherever they go in the enchanted forest, a little boy and his bear will always be playing together.” And that would just bring tears to my eyes for decades upon decades upon decades. Until recently, I had an experience, actually, a psychedelic experience, when I realized that there’s nothing to mourn because I’m both the bear and the little boy.

And I always will be playing. Nothing is lost. But when I read that book, there was a sense of loss. When I read that passage, there was something being lost. Childhood innocence is being lost. Playfulness is being lost, which resonated with my own childhood because I did lose innocence and playfulness very early in life.

So, both for the fun and the humor. And then, of course, there’s Eeyore for whom everything always goes badly. And there’s a part of me that’s totally Eeyore, always expecting the worst, and nothing will ever work out in the end, never mind, leave me alone, I’m okay with my own suffering, all of that sort of determined victim attitude. That was also very much germane to my inner experience. So, that book just spoke to me and made me laugh, and it still does. It’s one of the funniest books ever written and one of the wisest as well.

Tim Ferriss: I’ve only – I’m ashamed to say this, but I’ve only seen the cartoon. I know, I know.

Dr. Gabor Maté: Listen, listen. One of the sins that Walt Disney is going to be burning in hell for the rest of existence is what he did with those stories because he Disney-fied them. You got to read the original. And you would laugh your head off.

Tim Ferriss: All right. I’m in. I’m in. I wish I spoke Hungarian, so I could read the translation.

Which of these would you like to, and we can certainly touch on other books, but so, we have three remaining on my list. The Dhammapada, The Drama of the Gifted Child, and Don Quixote.

Dr. Gabor Maté: Well, let’s go to The Drama of the Gifted Child. The Drama of the Gifted Child is by a Swiss German Jewish psychotherapist named Alice Miller who was, for three decades, a psychoanalyst. But she realized that the Freudian psychoanalytic method wasn’t helping anybody get better because it ignored trauma. So, The Drama of the Gifted Child, the German title of which was Prisoners of Childhood, was really all about the fact that stuff happens to us as children, negative things happen. Then, we adapt to those things by taking on certain defensive ways of being. And then, we live the rest of our lives from those defensive modes.

So, we’re not actually experiencing the present but constantly reliving the past from a perspective that we acquired when we were helpless and vulnerable children.

And when she says the gifted child, she means the sensitive child. So, the more sensitive the child is, the more he or she feels the pain and stress of the environment. And the more affected they are. And the more that shapes their lives. And that book came along for me when I was in my 40s, and I was a successful doctor, and I was a father. But I was depressed. I was anxious. I was a driven workaholic. You wouldn’t have known that when you saw me on the job. But inside me, I was discouraged. I had difficulties in my marriage. With my children, I felt they were afraid of me, and they were because of my rages.

And that book helped me understand. It was the first book to help me understand where all of that came from. So, that was, for me, as for many other people, a seminal read. And really, my whole work, since then, has been to help liberate people from that prison that childhood often imposes on so many of us.

Tim Ferriss: This book has come up repeatedly in my life as a recommendation, as a recommended book from friends who benefited from it, who are, certainly, from any outward perspective, highly functioning. In some cases, world class performers in their fields. And, in retrospect, I’m sad that I ignored those recommendations. But it was in part because I didn’t like the pairing of gifted child. I didn’t want to label myself gifted child. We could certainly psychoanalyze that.

But I was like, if this is a book written for people who are in say gifted and talented programs or have some God given talent, for whatever reason, I had a resistance to that, so I didn’t read it. But the Prisoners of Childhood makes a lot more sense to me anyway.

Dr. Gabor Maté: Well, I think it’s a more accurate title. But there are two things I would say in response.

First of all, why do you resist your own giftedness? You’re clearly gifted. So, why would you not want to find out about that?

Tim Ferriss: I don’t know.

Dr. Gabor Maté: Yeah. So, that’s something you might want to consider.

Tim Ferriss: Sure.

Dr. Gabor Maté: No. 2, really what she means is the sensitive child.

Tim Ferriss: Yeah. So, sensitive that would draw me in because I’ve had – we don’t have to necessarily go down this rabbit hole right now, but I’ve had a number of my friends recently ask me when did you know you were so sensitive. And not sensitive in a hyperreactive way, not in a negative way. Just in a perceptive way. And I’d never thought of myself – it would never have occurred to me to label myself sensitive. Just in the last year, I’ve been thinking about that. So, the sensitive child would make more sense or would be more appealing to me.

Dr. Gabor Maté: Well, you have to think of sensitive in terms of its word origin. Now, the word sensitive comes from the Latin word sense or to feel. So, the sensitive person feels more.

Tim Ferriss: Yeah.

Dr. Gabor Maté: So, the example I often give is – and that can lead to both very positive and very difficult consequences.

For example, if I tapped you on the shoulder right now, you wouldn’t feel any pain at all. But if you were not wearing a shirt, and your skin was exposed, furthermore, if you had a burn on your shoulder, so your nerve endings were close to the surface, if I tapped you with the same force, you’d feel extreme, excruciating pain, even though the external event was no different.

Tim Ferriss: Right.

Dr. Gabor Maté: So, sensitivity magnifies the pain that we have. Sensitivity also leads to more creativity. So, very often, the most creative people also have the most pain, which is why so many creative people escape from their pain through all kinds of dysfunctions like addictions and so on. So, there’s a really link between creativity and sensitivity, and creativity and sensitivity and suffering, at the same time. That’s the first point I would make. Now, the other thing goes back to what you said about these people that you know who are high performers. Look at that word performers. What does it mean to perform? One meaning of it is to put on a show.

Tim Ferriss: Sure. That’s one meaning.

Dr. Gabor Maté: And I would have been one of these people who is a high performer. In other words, look at us from the outside, successful, doctor, director of a palliative care unit at a major hospital, national columnist for a Canadian newspaper writing medical columns, performing at a high level. And inside, again, anxious, frustrated, depressed, discouraged, and, in my personal life, a lot of suffering. So, a lot of people who perform well are actually deeply troubled inside. And, of course, there are many famous examples of that.

Some of the greatest performers like Presley or Marilyn Monroe and any number of people I can name, that’s what they were. They were performers. And even from themselves, they hid their own suffering.

Tim Ferriss: Well, we are sitting in a venue right now recording this that is now known as LZR. And there is a mural of Prince outside because he performed one of his, as I understand it, last performances in this venue.

Dr. Gabor Maté: Really?

Tim Ferriss: Before he passed away.

Dr. Gabor Maté: And before he overdosed.

Tim Ferriss: Before he overdosed, exactly. And we can certainly come back to this. But part of the reason I wanted to – a big piece of the reason I wanted to have you on this show was that I spent – I’m in a much better place now for many reasons that may be outside of this interview but feeling the exact same way you just described.

Dr. Gabor Maté: Yeah.

Tim Ferriss: Outwardly successful, inwardly tortured. How do you answer the question, if someone meets you, and you just have a short interaction, what do you do?

Dr. Gabor Maté: What do I do?

Tim Ferriss: Yeah, what do you do?

Dr. Gabor Maté: It may be self-serving, but somebody once called me a people whisperer.

Tim Ferriss: A people whisperer.

Dr. Gabor Maté: I do have a gift for seeing inside because I’ve studied – I’m also sensitive, in some ways, and I’ve also studied my self very deeply.

I’ve had to because my life just wasn’t working. And as a medical doctor, I worked with all manner of conditions, terminal diseases, newborns, families, physical illnesses, mental dysfunctions. I’ve spent 12 years working with addictions. I spent time exploring my own and other people’s ADHD. And so, I work with people to bring out the truth of their experience, so that they’re no longer prisoners of their childhood but that they can make a conscious choice about how to live in the present moment, not based on how they were programmed in childhood. And but for that, you have to do it in a way that the dog whisperers do, in a very compassionate way.

Otherwise, people just shut down, and they shrivel up, and they protect themselves. So, that’s what I do. And I know, I also write, and I speak publicly and so on. But the intent is always to bring insight and liberation to people.

Tim Ferriss: So, I’m going to come back to the medicine because I’d love to know when your journey into medicine began. But first, since I know my listeners will say but you forgot the other two books, what about the other two books, The Dhammapada, Don Quixote in any order you like.

Dr. Gabor Maté: Well, let’s go in the order that I discovered them, which is Don Quixote, which, again, I read that as a child and then, reread many times as an adult. And he’s my favorite character. So, Quixote is this deluded, Spanish, small, nobleman who want to revive the age of chivalry and knighthood. So, he gets this broken down horse called Rocinante and his lance and his sword, and he gets this squire called Sancho Panza on his donkey and off they go for these adventures. And he does not see reality. He thinks windmills are giants, and he attacks them. And, of course, he gets hurt.

And he keeps getting hurt because he doesn’t see reality. But his heart is purely committed to liberating people, to truth, to justice, to fighting oppressors, to liberating the oppressed. So, here’s this guy who really wants to do good in the world, and he’s just deluded in his vision. But he’s far truer and deeper and more human than all of the people that scoff at him and laugh at him. So, what a great character. And the book is both poignant and very funny. And he’s one of the great creations of world literature. And, of course, again, that yearning for justice has always burned in my heart with what happened to me and what I witnessed.

Tim Ferriss: And The Dhammapada?

Dr. Gabor Maté: The Dhammapada is the Buddhist collection of sayings. And it begins with, basically, the idea that we create the world with our minds.

He says everything is thought in the lead. So, how we see the world determines the world that we live in. So, if I see the world as a horrible place, according to current president of the United States, then, I will be defensive and aggrandizing and selfish because I want to take before they take from me. I want to attack before I get attacked. I’ll always be looking out for myself because the world is not to be trusted. So, if that’s the world you live in, that’s the world you’re going to create. And the Buddha was a great psychologist in that he recognized that our perceptions shaped the world that we live in.

Now, what he didn’t say, and that’s where modern psychology comes in, is that before, with our mind, we create our world, the world creates our minds. So, the kind of world that we live in is very much shaped by early experiences. Buddha didn’t say that. But, interestingly enough, when you think about his search for truth, what happened to him, if you read his biography, his mother died before he was a week old.

So, he’s lost his most important relationship. So, his life began with suffering. And then, he spent all of his life trying to find the nature of suffering and how to transcend suffering and how to get beyond it. And this is how he ended up with this particular method of meditation and contemplation and truth seeking. So, that book was written 2,500 years ago. And psychologically, we’re still trying to catch up to the wisdom in it.

Tim Ferriss: So, let’s talk about wisdom or perhaps science first.

Dr. Gabor Maté: Yeah.

Tim Ferriss: And maybe they’re related in some fashion, although I know we’ll dig into certainly some things that might be missing. When did medicine enter your life or an interest in medicine, interest in being a doctor, either of those things?

Dr. Gabor Maté: Well, I’ve speculated on that. And there are a number of sources. Strangely enough, or not so strangely enough, my grandfather who was killed in Auschwitz in his 50s happened to be a writer and a doctor.

Grandson ends up as a writer and a doctor. So, I think part of it was me trying to fill a hole in my mother’s life. That was a devastating blow to her. This is not conscious, but I’m speculating, looking back. It’s not that she ever said you have to become a doctor. It’s not that she ever said you have to follow in your grandfather’s footsteps. But I think, unconsciously, I stepped into that role, No. 1. No. 2, another reason is that, as a Jew in Eastern Europe, you had every reason to feel insecure. And my mother never failed to tell me that, as a doctor, you carry your profession in your hands.

So, you don’t have to have a business. You don’t have to have riches. You just have to have the knowledge. And then, you can go anywhere in the world, and you’ll be okay. Beyond that, healing and making this world a better place and help people lead healthy lives was just an ideal of mine.

Then, there were egotistical reasons. Let’s face it, doctors get respect. They have a role. They have a good income. People look up to them. And they have a sense of authority that I think I lacked, in my own life. So, it was a combination of unconscious reasons and idealistic reasons and egotistical reasons. But all I know is that, all of my life, I had wanted to be nothing else but a doctor. I grew up knowing I would be a physician.

Tim Ferriss: And when you were studying medicine, what did you think your specialty or specialties might be?

Dr. Gabor Maté: Well, first of all, I should say I didn’t end up following the dream because, in my late teens, I just couldn’t concentrate and study hard enough to get through the sciences. I could get through them, but I couldn’t get the high marks needed to get to medical school. So, I actually taught high school for three years. I taught English and history for three years. And then, I would wake up, and there was this voice in my, you’ve got to be a doctor.

You’ve got to be a doctor. And so, then, I went back to medical school and a lot of hard work. Having been an older student in medical school and being interested in history and literature and the larger picture, I always wanted to put medicine in the context of history and the context of society and the context of human experience, not just as an isolated science but as part of the broader human experience. And I was interested right away in the beginning between – in the connections between the emotions and illness, between social factors and health and so on.

So, I was always a larger picture person. And so, that was with me already in medical school.

Tim Ferriss: So, the integration of mind and body, as opposed to the sort of Cartesian duality and separation of mind and body.

Dr. Gabor Maté: Exactly. Not that anything in medical school prepared me for that. In medical school, you just don’t get that information at all.

But that was always my interest. And then, I started practicing. If your eyes are at all open, you just can’t help but to see it that who gets sick and who doesn’t isn’t accidental. And who gets cancer and who doesn’t isn’t accidental. And who gets addicted and who doesn’t isn’t accidental. In other words, there’s reasons. And those reasons go beyond the individual. And it has to do with their emotional lives and their relationships and society and the culture that they live in. So, more and more, over the decades, my own personal struggles and my medical experience showed me that these connections are important.

Tim Ferriss: How did you end up in palliative care? I suppose, for those people listening who don’t know what palliative care is, perhaps you could give just a brief explanation of what that is. Some people might think of it as hospice care, which I don’t think are necessarily identical. But how did you end up – what was the road to palliative care, and what is palliative care?

Dr. Gabor Maté: So, I was a family physician and a very driven one. And also, I have ADD, which means that you want to move around and have distant experiences because you get tired of the same thing. And really, in retrospect, I might say that there is some guidance in all of this. But how it occurred was a series of accidents. So, I happened to be walking down the hall of Vancouver’s major hospital when the current director of palliative care said, “I’m quitting. How would you like to come and work in palliative care?” And I said, “Sure.” I didn’t take – it took me not a moment to think about it.

Tim Ferriss: He was just looking for someone to grab.

Dr. Gabor Maté: Palliative care? Sure, thank you. What is that? And deeply meaningful work because, when people are facing death, they also come up against the truth of their lives. And, if you can face death, you can face life.

Tim Ferriss: And palliative care meaning you’re helping people with the transition with terminal illness from life to death.

Dr. Gabor Maté: These are people terminally ill for whom nothing curative or healing is going to happen, in the sense of physical healing. So, they need to be helped with their symptoms, with their pain, or debility or weakness or nausea. But also, you have to help them go through the psychological process of adjusting to a very short future. And the people that go into palliative care work, the nurses, and the doctors, tend to be a special breed because many doctors are not comfortable with death. They’re not comfortable with not being able to do something to save somebody. So, you have to develop a lot of patience and a lot of acceptance.

You have to let go of your power to change things. So, it’s deeply meaningful and deeply transformative work. And you also have to work with a lot of people with multiple different attitudes towards life and death, religious, nonreligious, spiritual, nonspiritual, in denial, in acceptance, and all of those stages in between.

So, it was beautiful, beautiful work and one of the highlights of my medical career. Although, at the same time, I was still doing my family practice.

Tim Ferriss: And when did a focus on addiction or an acute interest in addiction start to steer your medical practice?

Dr. Gabor Maté: So, as a family physician, I’ve always had substantive addicts in my practice. Just a few. And, again, it was an accident. I got fired from that palliative care job. And my argument is that I was filed for gross competence. I was just too damn good at it but also for gross arrogance. In other words, with my spontaneous and insightful and rather radical, nontraditional style, I could have great results, and often did, in palliative care.

Tim Ferriss: If I might interrupt for one second, what would be, or might be, an example of your approach that others thought was radical, or something you would say, or something you would do with a patient that got great results but that would see very radical to others?

Dr. Gabor Maté: Well, I would engage them in deep conversations. Stuff would come up that would be painful but would be transformative. Physically, I would just use methods that had not been proven but occurred right to me. And they seemed to be helpful in helping people out of pain or deal with issues and so on. I was very open in multiple approaches. I wasn’t just following things by the book. So, that was my competence. The arrogance was that I had a very busy life. I was still delivering babies, running my family practice. So, I would get into palliative care.

And the nurses said working with me was like working in the eye of a tornado. And other physicians who didn’t have my attitude or my particular mindset would legitimately question what I was doing.

But I would regard all such questioning as an attack rather than as an inquiry. And I would react like a bull dog who is being threatened. And that’s the arrogance. And that’s what ended up leading me to be fired. And it was a great firing because, as always, I learned a lot about myself. It took me a while. And then, three weeks after I was fired, I got this phone call from a clinic in Vancouver’s downtown eastside. Now, the downtown eastside of Vancouver is North America’s most concentrated area of drug use. We have more injection users in a few square block radius than anywhere in North America.

So, I get this call saying how would you like to come and work down here. And this is three weeks after I’m fired from palliative care. Had I not been fired, I couldn’t have taken that other job, which then led me to the high point for my career, which is working 12 years with addicted population and, eventually, leaving family practice and doing that full time. So, who orchestrated all of this? I have no idea. But it was a beautiful progression.

Tim Ferriss: Something that’s come up quite a bit in interviews on this podcast is some variation of sometimes, you need life to save you from what you want to give you what you need.

Dr. Gabor Maté: Exactly.

Tim Ferriss: And I think about that a lot. At the very least, it’s a pain relieving lens through which to view events that unfold. How do you define addiction? Or maybe a better question is what is addiction? And along with that, if you want to tackle it, what are poor definitions of addiction or misconceptions?

Dr. Gabor Maté: Fair enough. So, an addiction is a complex psychological, physiological process but which manifests in any behavior that a person enjoys, finds relief in, and therefore, craves in the short term but suffers negative consequences in the long term, and doesn’t give up despite the negative consequences. So, craving pleasure relief in the short term, negative consequences in the long term, inability to give it up.

Now, notice I said nothing about substances. I said any behavior. So, it could be related to cocaine, crystal meth, heroin, Fentanyl, marijuana, nicotine, alcohol, whatever. It could also be sex, gambling, internet, relationships, shopping, eating, work, extreme sports, working out, pornography, any number of human activities. So, I said any behavior. Now, the official definition of addiction, according to the American Society for Addiction Medicine, is a primary brain disorder. It arises in the brain largely due to genetic reasons. This is how they see it. And I say that’s just not true.

The other popular idea about addiction is that it’s a choice that somebody makes. That people choose to be addicted, which is what the legal system is based on because, if people aren’t choosing, what are we punishing them for?

Although, I think the medical definition is closer to the truth, I don’t see it as just genetic disorder. And I don’t see it as a primary brain disorder. So, let me perhaps show you why, if that’s okay. So, I gave you this definition of addiction. Again, craving relief, pleasure, short term, negative consequence, long term, inability to give it up. Would you be willing to tell me if you’ve ever had an addiction in your life? I don’t care to what. I’m not asking what.

Tim Ferriss: Oh, yeah. I can say yes. And I can tell you exactly what it was. So, in high school, I suffered from what I suppose most people would consider depressive periods beginning, at latest, age 10. And I never found relief from that, until I was competing in wrestling very seriously in high school, all throughout high school. And an older teammate introduced me to ephedrine.

Dr. Gabor Maté: That’s a stimulant.

Tim Ferriss: Ephedrine hydrochloride, which, for those people who are curious, is, at least at one point, ephedrine was found – well, at the very least pseudoephedrine in something called Primatene Mist used for asthma. And I think they also mixed it with guaifenesin. Nonetheless, the reason you cannot buy, in many places, large amounts of Primatene Mist is because people freebased it into methamphetamine.

Dr. Gabor Maté: That’s right.

Tim Ferriss: So, you have Ephedrine, which is a very strong stimulant, combined with caffeine and aspirin. And when you combine those three, it’s not an incremental increase in effect. It’s probably logarithmic. It’s a very synergistic affect.

Dr. Gabor Maté: Exponentially.

Tim Ferriss: Exactly. And he was recommending it for increased endurance. And there is some affect, although it is also very highly thermogenic, which wasn’t good for me. So, it made me really hot, which was already a weakness of mine. But it ended up providing me with relief.

It was a very strong stimulant, and I began to not only use it for sports but to self-medicate using it.

Dr. Gabor Maté: Great. So, let me quickly ask you what did it do for you? Relief from what?

Tim Ferriss: It made me, or at least contributed to, euphoria, optimism, energy. So, I didn’t feel the symptoms of what I, in retrospect, I would call depression. The lethargy, the pessimistic lens through which I viewed things. It seemed to magically just erase all of that in about 30 minutes.

Dr. Gabor Maté: So, euphoria literally means good feeling.

Tim Ferriss: Right.

Dr. Gabor Maté: It gave you energy. It made you feel good. It made you optimistic.

Tim Ferriss: Also, improved sports performance, right.

Dr. Gabor Maté: I’m sure it did.

Tim Ferriss: Yeah.

Dr. Gabor Maté: Are those good things or bad things? To feel optimistic –

Tim Ferriss: Those are all good things.

Dr. Gabor Maté: Okay. In other words, the addiction wasn’t your primary problem. Your primary problem was that you were depressed, that you lacked a sense of wellbeing, that you lacked energy.

Tim Ferriss: Right.

Dr. Gabor Maté: So, in other words, the addiction is not the primary problem. It’s an attempt to solve a problem. And then, the real question is how did the problem arise.

Tim Ferriss: Right.

Dr. Gabor Maté: In other words, this is where my theory is that it’s always rooted in childhood trauma and that the addiction is an attempt to deal with the affects of childhood trauma, which it does temporarily while it creates even more problems in the long term. I would have one more side question for you, given that a stimulant was your drug of choice. This may not be true for you, but do you think or suspect you might have had ADHD as a kid?

Tim Ferriss: Quite possibly.

Dr. Gabor Maté: Because, typically, people with ADHD self-medicate with stimulants because how we treat ADHD now, we give people stimulants.

Tim Ferriss: Yeah. Ritalin, methylphenidate.

Dr. Gabor Maté: Ritalin. So, a lot of the people that choose stimulants as self medication like nicotine and caffeine and crystal meth and ephedrine are actually self medicating ADHD.

Tim Ferriss: It’s very likely. And I was punished by teachers for I wouldn’t say not paying attention but being interested in other things in class. So, I remember very distinctly, my kindergarten teacher, I’ll name her by name because it’s shameful, Ms. Bevin, or Mrs. Bevin, I refused to learn the alphabet because she wouldn’t give me a good reason why I needed to learn the alphabet. It was just you need to learn the alphabet. So, she made me eat soap in front of the class and put me at the bad table. She got [inaudible]. But I was always interested in doing many, many, many things. In fact, one of the reasons that I started wrestling was because I was very hyperactive.

And, as I believe the story goes, other mothers recommended to my mom that she put me into something called Kiddie Wrestling to drain my batteries before I got home. So, that makes perfect sense. I’ve never been drawn to depressants. Never been drawn to opiates. In fact, after surgeries, I get very sick, if I’m given Vicodin or anything like that. So, I’ve opted out.

I have never, personally, had any issues with alcohol, though a lot of people do. It’s always been a draw to stimulants. And once the – we don’t have to go down this path because I want you to be able to focus on these definitions, but where I got myself into trouble was having never been physically addicted to any substance before, I started using the [inaudible] once a day. My friend was using it twice a day. I started using it twice a day. And then, I started using it three times a day. And you develop a tolerance very quickly.

Dr. Gabor Maté: Right. You need more and more.

Tim Ferriss: And if you stop, the withdrawal symptoms are awful. I had never experienced that. So, I continued, after sports, to use this. And, certainly, in the long term there are some very nasty side effects. But that didn’t stop me for many, many years.

Dr. Gabor Maté: Well, so, there’s a great link between ADD and addictions and not just because they both begin with the same three letters.

And I can tell you about my own ADHD. And this is where we go back to childhood again. So, that tuning out, that absent mindedness, that desire to scatter your attention all over the place, that’s not a disease. They say it’s an inherited disease. The hell it is. That tuning out, that divided attention is, actually – well, let me give you a personal question again. If I were to become abusive towards you right now, verbally or otherwise, what would be your options right now?

Tim Ferriss: I could ignore.

Dr. Gabor Maté: But that’s not what you would do first, is it?

Tim Ferriss: Not likely. I would probably just listen and pause. I shut down, often, if I get attacked verbally because I don’t want to respond with rage, which has historically been my response.

Dr. Gabor Maté: I hear you. But let’s get a big more basic about it. The rational response, if I were to become abusive, would be for you to just assert yourself saying don’t talk to me that way.

Tim Ferriss: Right.

Dr. Gabor Maté: Or it would be to leave saying this interview is over. And if, for some reason, you had not the strength to do either of those, there are other people in the room here with us, you could ask for help.

Tim Ferriss: Right.

Dr. Gabor Maté: But what if you couldn’t escape, fight back, or seek help? Then, you would shut down or tune out.

Tim Ferriss: Right.

Dr. Gabor Maté: Now, there is the tuning out is simply a defensive response in the part of the brain. Now, put me back into my infancy where my mother is so grief stricken that I’m crying because she’s in pain. And I’ll read you a quote here, if I may.

Tim Ferriss: Yes, please.

Dr. Gabor Maté: And this has to do with the sensitive child. “The child is very open and can feel the pain and suffering going on in its immediate environment. The child is aware of his own body and can also feel the tension, rigidity, and pain in the body of the mother of anyone else he’s with. If the mother is suffering, the baby suffers, too. The pain never gets discharged. The organism does not develop the confidence that it can regulate itself, that things will happen the way they should, hence lack of optimism.”

Now, my mother didn’t abuse me. She did her best to look after me, but she was stressed, depressed, terrorized, grief stricken. I’m picking that up as a sensitive infant. Can I fight back, change the situation, or escape?

Tim Ferriss: No.

Dr. Gabor Maté: None of those. What can I do? Nothing I can do. My brain will tune out as a way of dealing with the stress. So, I’m not talking about abuse here. I’m just talking about stress mothering or parenting. The child’s brain them will tune out. When is the child’s brain tuning out? When the brain is developing. So, the tuning out then becomes programmed then, as the default setting. And that’s why ADD. So, it’s not an inherited disease. It’s not a disease at all. It begins as a coping mechanism, which then gets programmed into the brain. And as a lot of these early coping mechanisms function, they help you, in the short term, create problems in the long term.

And ADD is one of these examples. And, of course, it also makes it more fun to be addicted because, now, when you tune out, life becomes less interesting. You shut down emotionally to protect yourself. Now, you feel depressed. What does depression actually mean? You said you were depressed. What does depression mean? To depress something is to push it down. What do people push down in depression? They push down their emotions. Why would they? Because the emotions are too painful. So, even depression begins as a coping mechanism. You push it down, so you don’t feel the pain.

But then, later on, that interferes with your life functioning. So, it all begins as a coping mechanism and later on becomes a source of dysfunction. And all of this is happening when the brain is actually developing, which we can talk about later. So, these are the links I began to make, including after I was diagnosed with it. So, and then, despite the fact that a couple of my kids were diagnosed, I knew that this wasn’t a genetic disease.

What it is is a coping mechanism, which got programmed to the brain. And then, when I read the literature on brain development, wow. It turns out that the human brain is shaped by the environment and, particularly, by the adult/child relationships. And so, it all began to make perfect sense to me.

Tim Ferriss: There are a few things I’d love to underscore or reiterate because I think they’re very astute and very helpful. And, certainly, if I had had some of these reframes, I think that I would have been able to be proactive with working on a lot of my own issues much, much earlier.

Dr. Gabor Maté: Me, too, by the way.

Tim Ferriss: Yeah. For instance, and we can come back to this. I’m actually just going to mention two things, and then, we can go where that takes us. But the first is rather than asking why the addiction, asking why the pain.

Dr. Gabor Maté: Exactly.

Tim Ferriss: So, instead of looking at the consequences, looking at the causes and not confusing the symptoms with the causes. So, instead of asking why the addiction, why the pain. And the other, this might take a moment for me to read, but I think it’s worth reading. And I should say that Compassion for Addiction, this is an organization co-founded by yourself and Vicky, I’m going to make a guess, I’ve never actually said her last name, but Dulai. Vicky, just for context for folks who are wondering, was actually the very first person, about five years ago, to recommend that we meet. And I took a note of it in a notebook I still have.

And that’s part of the reason that I reached out for the book. And just because we may revisit this, I met Vicky at a gathering at the home of someone named George Sarlow who shares a lot of common background with you and, certainly, common interests.

But we’ll come back to that. The part that I wanted to read is the following. And I’m going to make an attempt here. “So, the mainstream view of addiction,” you mentioned this, “compared to the clinical perspective is that addiction is a matter of individual choice, moral failure, or weakness, which is why so many approaches are based on deterrents and punishment,” which includes self-help approaches, for that matter, that I’ve attempted myself. “The clinical view is that addiction is a disease of the brain, with disordered brain circuits and behaviors and accurate yet narrow perspective.”

So, I think that’s a really important line, an accurate yet narrow perspective. So, perhaps accurate but incomplete. “It is accurate that, in the addicted brain, that the addicted brain is demonstrably physiologically dysfunctional brain but narrow because it seeks to explain the dysfunction in strictly physiological and biochemical terms, without recognizing the emotional and social component of how the brain works.”

And this was really driven home for me recently. In the last several years, I’ve gotten to know Tony Robbins. And I attended an event not too long ago with several of my very close friends called Date with Destiny. And at this event, he asked the audience of about 5,000 people how many people here know someone who takes antidepressants? Pretty much every hand goes up. How many people here knows someone who takes antidepressants yet is still depressed. And it was probably 80 percent of the people who raised their hands the first time.

And I personally know quite a few people who take antidepressants, which seem to help, on some level, although the tolerance for some of these pharmaceuticals can also be developed very quickly. And yet, if my experience is anything like the experience of – or I should say, if the experiences of other people is anything like my personal experience with friends, let’s say, who have depression, you witness these thought patterns and verbal patterns that can take them from the highest high or just a baseline of optimism and drive them back into depression.

And so, it seems to be, just from an empirical or observational standpoint, more to the story. So, I really appreciate you putting into words what I’ve grasped to try to understand and also convey. So, with this definition of addiction, how do you work with patients?

Dr. Gabor Maté: Well, let’s go back to what I said, what you quoted me saying, not why the addiction but why the pain. So, if we understand that addiction, in every case, is rooted in some painful, internal experience, when you ask people what does the addiction do for you, they’ll say it numbs me. It soothes the pain. It makes me feel connected with other people.

It gives me a sense of control. It gives me inner peace. Well, the lack of inner peace, the lack of control, the lack of connection, they all are forms of emotional pain. If I ask the question now why the addiction but why the pain, then, that leads to an examination of that person’s life rather than looking just at their brain chemistry. So, I’m quoted from an article that appeared in the Journal of Pediatrics, which is the official journal of the American Academy of Pediatrics.

It’s about as prestigious as you can get. In 2012, the article comes from the Harvard Center on the Developing Child, again, a prestigious child development research institution at Harvard University. This article did to present new information so much as it elegantly summarized decades of research. And notice what they say.

They say growing scientific evidence 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, or which may come at a significant cost to long term outcomes in learning, behavior, health, and longevity. That’s what I was saying before. That those early adaptations, like pushing down your feelings when the feelings are too painful, will help you as an infant or young child. But then, they cause problems later on.

The tuning out that you do to protect you from the stress in your environment, if you’re very sensitive, it doesn’t take a lot of stress, helps you endure but, in the long term, it becomes a problem. That’s exactly what they’re saying. Now, I’ll jump a few pages ahead to what they say about brain development. And this is so crucial, and it’s so crucial because they still don’t teach this at medical schools. Even though, scientifically, it’s not even vaguely controversial.

The human brain develops in interaction with the environment. It’s not genetically programmed purely. Here’s what they say. The architecture of the brain is constructed through an ongoing process that begins before birth, continues into adulthood, and establishes either a sturdy or a fragile foundation for all the health learning and behavior that follow. Not some of the health learning, all of the health learning. Now, notice what they say. First of all, the architecture of the brain is constructed through ongoing process that begins before birth, which already means what happens in the womb already has an impact on you.

So, if your mother is stressed, and she’s got high levels of stress hormone, that’s already affecting your brain development. Think of all of the stress on pregnant women out there. No wonder we see so many kids in trouble. And we know from American studies, international studies that when mothers are stressed, their placenta will naturally have more cortisol and adrenaline, the stress hormone. Those kids will be more likely to have stress issues later on, abnormal stress hormone levels, even at 1-year of age, behavioral problems, learning problems, and so on, which tells us a lot as to why adopted kids have so many more problems.

That’s another issue. But the next paragraph is key. “The interactions of genes and experiences literally shapes the circuitry of the developing brain and is critically influenced by,” in other words, the circuitry, the chemistry of the brain and which centers and which circuits and which systems develop, and which neuro chemicals will be presented, and what quantities depends on the early environment and is critically influenced by the mutual responsiveness of adult/child relationships, particularly in the early childhood years.

In other words, the most important influence shaping the physiological development of the brain is the quality of parent/child relationships. Now, when parents are stressed or distracted or workaholics like I was a young parent, if there is instability, economic troubles, relationship troubles, unresolved trauma on the part of the parent, loving parents who are just stressed that will interfere with the child’s brain development.

That’s why we’re seeing so much more ADHD now, so much more autism, and so much more other problems because of stress in society that affects the parenting environment. In other words, yes, there’s physiological problems with the brain. But it’s not a genetic issue. It’s related to early experience. So, when you look at brain scans of adults that are troubled brain scans, as you do in addicts, you’re not just looking at the impact of addiction, you’re also looking at the impact of childhood trauma and childhood stress. And this has been shown over and over and over and over again.

So, there’s no separation between the physiology and the psychology. So, if you come to me, as an addict, and you say I’ve got such and such, and I ask you what does it do for you, you say it numbs the pain, then, my question is where did you develop the pain? What happened? And then, we have an inquiry. And now, it no longer becomes a shameful thing that you chose this. Nor does it mean that you’re stuck with it because you’ve got this genetic problem.

We get it as an adaptive response to something that happened. And we can heal that. The reason why addiction treatment is failing is because physicians don’t understand it. They keep dealing with the effects, which is the addiction, and the behaviors, which are the effects of the addiction, but not the cause, which is the childhood distress. And the impact of the childhood distress that carry into adulthood, in other words, hugs stay prisoners of childhood. And so, present methods of treatment in psychiatry and addiction medicine and childhood psychiatry deal with effects rather than causes. And this is where we’re so ineffective at it.

Tim Ferriss: I have many questions. So, the first is just to underscore something, which is our software, the genetics play a role, but it’s not a comprehensive explanation for what we’re discussing.

Dr. Gabor Maté: Genes can predispose, but they don’t predetermine.

Tim Ferriss: Right, exactly.

Dr. Gabor Maté: Now, there are very few genetic diseases. There’s one that runs in my family, muscular dystrophy. If you’ve got the gene, you’ll have the disease. My mother had it. My aunt had it.

Tim Ferriss: Right. So, that would be predetermined.

Dr. Gabor Maté: That’s just predetermined. Very rare, those diseases. Let me tell you an interesting study from either Australia or New Zealand. They looked at a group of people for aggression. They found that the most aggressive people had a certain gene variant. Do you think they found the gene for aggression? No, they didn’t because the least aggressive people in the group had the same gene. So, the most aggressive and the least aggressive shared the same gene as compared to the average. The gene could not have been for aggression.

Now, if you actually looked at the life histories of those people, the most aggressive people had been brought up in troubled, sometimes abusive, but always very stressed homes. The least aggressive were brought up in very nurturing homes.

What was the gene for? Sensitivity. The more sensitive you are, the more you’re going to be affected. When you’re brought up in a peaceful home, you’re going to be that much more peaceful. When you’re brought up in a stormy home, you’re going to be that much more aggressive. So, there are these predispositions, but they’re not for specific illnesses. They are for temperament, which means that you’re going to be more or less affected by the environment. And so, yeah, there are some predisposing genes.

But we know both from animal studies and monkey studies and human studies that even if you find a gene that, for similar reasons, predisposes somebody to addiction, if that animal or if that human being is brought up in good, nurturing circumstances, their risk of addiction is no greater than creatures without that gene. So, it’s just not a genetic disease. And the fact that it runs in families doesn’t prove anything because, as I always point out, I’m a medical doctor. And if two of my kids become medical doctors, which is no danger whatsoever, but if they did, that wouldn’t prove that the practice of medicine is a genetic disease.

Tim Ferriss: Right, right. It’s not a catch all explanation. Also, because of a few of the books I’ve written, I hear a lot of stories both successful and unsuccessful about people attempting to lose weight. And they’ll often say it runs in my family. My parents are fat, my grandparents are fat. And I’ll say do you have pets? And they’ll say yes. I’ll say are your pets over weight? And they’re like yeah, my pets are fat. I’m like, okay, it’s clearly not just a genetic issue.

Dr. Gabor Maté: Well, let me say something on that. Have you heard about the adverse childhood experience studies, the ACE studies?

Tim Ferriss: The average child –

Dr. Gabor Maté: Adverse childhood experience studies.

Tim Ferriss: You know, I haven’t. But I feel like there’s a questionnaire or a test that you can take.

Dr. Gabor Maté: There is. So, the adverse childhood experience studies were done in California with I think 14,000 or 17,000 adults, mostly Caucasians, half of them university educated.

And they looked at the relationship between childhood adversity and adult outcomes. And an adverse childhood experience was defined as physical or sexual or emotional abuse, a divorce, a parent being jailed, violence in the family, a parent being evicted, a parent being mentally ill, a parent dying. These are the main ones. And for each of these adverse childhood experiences, the risk of addiction goes up exponentially. The risk of autoimmune disease goes up. The risk of depression goes up. The risk of ADHD goes up. The risk of relationship problems, STDs, everything goes up.

Now, do you know how these studies started? These studies started in an obesity clinic. Dr. Vincent Feliti who is a San Diego internist, wonderful guy, deep thinker and researcher. They noticed that, at this clinic, with rigorous dietary control and exercise, they could help people lose weight. But what do you think they couldn’t do?

Tim Ferriss: They couldn’t ensure they continue those behaviors when they leave.

Dr. Gabor Maté: Exactly. They couldn’t help them keep it off. And then, Feliti did something that, I have to say, is unusual for a medical doctor. He listened to his patients. And they said don’t you get it? We’re stuffing down our pain. This is all based on childhood trauma.

And so, obesity itself is a response to childhood trauma. It’s just another addiction. I could talk about it in many ways. And the adverse childhood experiences studies have been repeated numerous times, nine other countries, always with the same results. And so, the obesity epidemic right now is not just an epidemic of junk foods and sedentary lifestyles. That is true.

Tim Ferriss: Yeah. Those are contributing factors, but –

Dr. Gabor Maté: But the underlying basis is people self soothing their stresses in their lives. And so, it’s really an epidemic of stress.

Tim Ferriss: So, let me return to another point or one thing you said in passing, which I’d love to dig into a little bit, and that was how, at the time, say the example I think we were discussing – actually, before that, let me mention one thing. So, I’ve had my full genome sequence. A predisposition to alcoholism is very prevalent, in my family, from a genetic standpoint, just from a software based. However, I mentioned earlier, I never had issues with alcohol. It was with stimulants. So, just as a footnote, but what I’d love to ask you, and then, I’d really love to hear what you do with patients, once you start looking at their pain and the tools you use or the approaches you use.

But one of the epiphanies for me in the last very recent year or two has been looking at my coping mechanism very differently. And what I mean by that is, for a very long time, I had certain behaviors, certain defaults that I hated, which, of course, I’m hating a part of myself.

Dr. Gabor Maté: That’s right.

Tim Ferriss: And that included anger, rage responses, use of stimulants, you name it. A close friend of mine who is a therapist, but I’ve never engaged him as a therapist, and there are certainly bad therapists out there, which I think is a separate topic, nonetheless, he was helping, and I’m sure we’ll get back to this, but in preparation for a very controlled, supervised psychedelic experience. He was helping another friend of ours prepare.

Dr. Gabor Maté: Is this with MDMA?

Tim Ferriss: This is with ayahuasca.

Dr. Gabor Maté: Okay.

Tim Ferriss: And this person had a number of addictions. And she hated these addictions. And she said, “I hate these. I realize they’re terrible. They’ve ruined my life. They’re ruining my life.” And it was all a negative relationship to these behaviors. And he said, “Did these ever serve you? Did these ever help? What did these do for you?” And she described how they helped her cope with very difficult circumstances early on. And he said, “Perhaps what you should do, as an exercise, and what we can do, is for you to, effectively, thank those behaviors for the role they played and for the necessity they filled, and to then, recognize – thank they for their duty, effectively, but to let them go because they’re no longer needed.” And that was a huge eye opener for me. And I began to – this is coinciding with a number of things.

And I don’t want to take us off the rails. But I began to use something called loving kindness meditation, or metta, M-E-T-T-A, meditation, which I was introduced to by a gentleman from Google, actually, or formerly Google, Chade Mang Teng, and then, also Jack Cornfield who really reiterated it for me.

Dr. Gabor Maté: Of course.

Tim Ferriss: But I never applied it to myself. I always applied this loving kindness meditation to other people. And what was recommended is that I apply that loving kindness to the younger Tim, to the other versions of Tim who had these behaviors that I had grown to hate and resent, and to actually thank them for the role that they played. For instance, that rage, that anger was the fuel that got me out of Long Island. And where I grew up, there are a lot of serious drug issues, particularly with opiates. And my best friend died of Fentanyl. Many of my friends are addicted to opiates that I grew up with. Many of died.

And I got out because I was angry. In part, I think that was the fuel. But that fuel ended up, over the long term, being very corrosive. But, in a way, to reconcile myself with that, I had to stop resenting it.

And I suppose that’s I suppose that’s maybe more of a confession than a question. But your comment brought it to mind. And maybe, as a segue, I’d just love to hear, and we can take it anywhere we want, of course, but once you have shifted the focus from why the addiction to why the pain, and you start to work with someone, what approaches have you found to help? What tools?

Dr. Gabor Maté: So, I very much solute your friend’s approach. It’s exactly the approach I would take myself. And I call it compassionate inquiry. So, inquiring in a compassionate way, not why did I do this. But why did I do this? The first one is not a question, it’s a statement. It’s a self-condemnation. The second one is a question. I wonder why I did this. Oh, it soothed my pain. And so, what your friend said that it served you, so thank it, love it, but let go of it is absolutely right.

I call it the stupid friend. The stupid friend is the one who helped you in a particular way at a certain time. But it can’t learn that that way doesn’t function anymore. Instead of helping, now, it’s hurting. So, it’s a friend because it’s really trying to help, but it’s stupid because it’s not learning that you’re no longer that 3-year-old or that 5-year-old or that 15-year-old. So, now, this leads to the other question of trauma because it’s one thing to recognize that all of this originates in childhood pain. It’s quite another to transform that pain. And for that, we have to understand what trauma is. So, people often think that trauma is what happens to you.

So, trauma is a divorce when you were small, and your parents fighting. Trauma is your mother’s depression. Trauma is your father’s alcoholism. Trauma is your parents’ argumentation. Trauma is physical or sexual abuse or something else. Those aren’t the traumas. Those are traumatic.

But the trauma is not what happens to you. The trauma is what happens inside of you. And, as a result of these traumatic events, what happens inside you is you get disconnected from your emotions, and you get disconnected from your body, and you have difficulty being in the present moment. And you develop a negative view of your world and a negative view of yourself and a defensive view of other people. And these perspectives keep showing up in your life in the present because they’re the stupid friends.

And so, the issue is not just to recognize what happened 10, 15, 30, however many years ago, but to actually recognize their manifestations in the present moment, and to transcend them. And how do you do that? By reconnecting with yourself, by restoring the connection with your body, primarily, and with your emotions that you lost. And once you do, when you’ve found these things again, then, you have what we call recovery.

Because what does it mean to recover something? It means to find it again. So, what is it that people find when they recover? They find themselves. And the loss of self is the essence of trauma. So, the real purpose of addiction treatment, mental health treatment, any kind of healing is reconnection.

Tim Ferriss: For people who are listening and want to reconnect with themselves, with their bodies, for instance, what recommendations might you have, whether that’s things they can do or resources they can look to, or both, or something else? What recommendations?

Because I’m sure – actually, I’m 100 percent sure because I’ve had people come on and, for the very first time on this podcast, talk about sexual abuse that they endured as children and what they did to help recover from that. Many people listening, I am sure, have addictions, both traumatic past experiences and trauma. What recommendations could you make for them?

Dr. Gabor Maté: Sure. I want to say, first of all, that, for trauma, you don’t need terribly traumatic events. So, there’s two ways to look at trauma. One is that bad things happen that shouldn’t have. We’ve talked about those. But the other way to get traumatized is when good things happen that should have happened – good things didn’t happen that should have happened, sorry. So, when you look at –

Tim Ferriss: The trauma of omission.

Dr. Gabor Maté: The trauma of omission where the parents, not that they didn’t love you, not that they didn’t do their best, but they were too stressed, traumatized, distracted themselves. Then, you didn’t get the kind of attention, and the kind of acceptance, and the kind of attuned being with that you needed. That itself can make you disconnect from yourself. A child needs that acceptance, that connection, that attunement. Our brain development requires it. Our emotional development demands it. And when we don’t get it, not because the parents don’t love us, but simply because of their own issues, we can also suffer that disconnection.

So, that’s what I call developmental trauma. And how do we connect? Well, there are many, many forms of therapy. It’s very difficult for anybody to do this on their own. Some people do it. I certainly couldn’t do it on my own. I’ve needed a lot of help, in terms of therapy, that helps me understand what happened to me. And so, there’s a reason for it. So, that not if there’s a reason for it, then, it’s no longer me. I’m not somebody to be ashamed of. I’m just somebody who developed along certain lines for some very good reasons. But it’s not in my deepest character, and it’s not who I am, and I don’t have to be that way.

That’s a relief to know. It’s also not that I’m genetically programmed, so I’m doomed to stay that way. No. 2, you have to reconnect with the body. There are various body therapies. My friend, Peter Levine, and his traumatic experiencing –

Tim Ferriss: Is that walking the tiger –

Dr. Gabor Maté: Waking the Tiger.

Tim Ferriss: Waking the Tiger.

Dr. Gabor Maté: Waking the Tiger was his first book. And he’s written many wonderful books since then.

Tim Ferriss: It’s the somatic experience.

Dr. Gabor Maté: Somatic experience, and his method is called, which he developed. It’s brilliant. There is EMDR, eye movement, desensitization, reprogramming, which is a way of bypassing the conscious mind and getting to the emotional brain quicker than talk therapy by itself can do. So, it’s combined with talk therapy, but it takes you past just the conscious, defensive, egoic mind. There is emotional freedom tapping that people do. There are variations on that. There are motor sensory integration techniques. Then, there is the traditional therapies like yoga.

Now, yoga was not simply a physical modality, when it first developed. Yoga, actually, means unity. So, the very essence of yoga is to regain that unity. Not just with ourselves but also with the larger creation. And so, yoga, when it’s practiced in its intended way, not just the hot yoga where you get a good work out, that’s great, I’m not against it, but I’m talking about intentional yoga with a meditative aspect to it, which is taught by a number of disciplines. Body work of all kinds.

Tim Ferriss: I’m just going to hit pause for one second. Do you practice yoga, and if so, what type do you practice?

Dr. Gabor Maté: So, I’ve always said that, with my ADHD, I’m not a yoga person. I can’t do it. Until a year and a half ago, I met actually a yogi. His name is Sadhguru. And he’s an Indian yogi with a big following. I was very skeptical, but I met the guy. I now have a 50 minute daily yoga practice, which I did this morning before coming to the interview. And it’s made an enormous difference in my life. With my ADHD mind, I really have trouble just sitting there. When I sit there on the meditation cushion, my mind is all over the place.

But with the yoga, which is more body based, I can stay much more present. There is a meditational component to it. And so, the answer is yes. If you had asked me 18 months ago, I would have said no. I support it, but I don’t do it. But now, I’m actually a very committed practitioner, and it really has made a difference.

Tim Ferriss: Is there a particular – is it a particular type of yoga that people could Google or learn more about?

Dr. Gabor Maté: So, I’m not a yoga expert. And there are many forms of yoga that other people more knowledgeable than I am could recommend. But the one I learned is called inner engineering, and it’s taught by either Sadhguru or his followers. And you can look up inner engineering online. When I recommend it to friends and others, everybody has only been grateful, so I can highly recommend it.

Typically, there is to me what seems a cult around the guy, which I don’t take to particularly, but he’s the genuine article, in terms of having a deep experience and being able to transmit that experience to others and creating a practical system around it. So, it’s worked for me. I’m not here to recruit anybody else. But since you’re asking –

Tim Ferriss: No, no. My fans appreciate – well, I’m not going to blame it on my fans. I like specifics.

Dr. Gabor Maté: Yeah. So, inner engineering, you can look up online, and it’s taught here in the states and in Canada, internationally, actually.

Tim Ferriss: But I did interrupt you. You were about to mention, I think, another technique or modality that can help. You talked about, for instance, the somatic experience, the emotional freedom tapping, motor sensory integration techniques, yoga, and then, there was something coming up after that.

Dr. Gabor Maté: Well, about 10 years ago, I began to work with psychedelics. Now, if 15 years ago you would have asked me will I ever be working with psychedelics as a healing modality, I would have said you’re out of your mind. But then, through a series of events, I became aware of the potential role of psychedelics in healing.

And I’ve been doing work with them now for 10 years. And they’re another potent method. They’re not for everybody. And I have to emphasize that whatever modality you choose of a psychedelic nature; you have to do it with adept practitioners with deep integrity and deep knowledge and experience. But in such hands, and in such a context, it can be like a super highway to self-awareness. Not in isolation, but it opens doors that otherwise might take years. And so, it’s not unusual for me to conduct a psychedelic session with somebody or a series of sessions either in a group or individual setting and have them say that was like 10 years of psychotherapy in 1 day.

And I’ve had the same experience myself. So, again, it’s not to be isolated from other kinds of work. And it has to be integrated. But it’s another potent way of working.

And, of course, as I know you’re personally aware, there’s an increasing movement amongst psychologists, therapists, psychiatrists, medical doctors, other healers to find ways of incorporating psychedelic healing in the larger therapeutic scheme.

Tim Ferriss: So, Gabor, you mentioned a series of events leading you to psychedelics or to consider psychedelics, potentially, as a healing or medical modality. If you’re able to, could you describe any of those events?

Dr. Gabor Maté: Sure. So, in 2008, my book on addiction, In the Realm of Hungry Ghosts: Close Encounters with Addiction, was published in Canada and very quickly became a No. 1 national bestseller. It was subsequently published in the states as well. And I was on a book tour. And people kept asking me what do you know about addictions and ayahuasca as a treatment, ayahuasca being an Amazonian vine that’s made into a brew that has psychedelic properties.

I knew nothing. The next speech or the next event, somebody else would ask what do you know about ayahuasca and internalization. I finally started getting annoyed with it. Like leave me alone. I’ve just written a book. I’ve spent years researching it. My life experience and all kinds of scientific exploration went into it. Ask me about something I know about. And then, I realized that maybe the universe is knocking on my door. And somebody said did you know you can experience it here in Vancouver. There was a Peruvian shaman leading some ceremonies up in Vancouver.

So, who am I to say no? And I jumped right in. And I sat in this tent with 50 other people.

Tim Ferriss: Fifty?

Dr. Gabor Maté: Yeah. That’s how they set it up. It’s not what I recommend, but that’s how they set it up. They played beautiful music. And there was a little baby in the room. Mother and dad were there for the experience.

The baby was in the room, and the baby was cooing away. And tears started flowing down my face. And these were not tears of sorrow, they were tears of joy. And I got in touch with such profound love that I had never consciously experienced before. And they were tears of love. And it wasn’t love for anybody in particular. It was just love. And then, I saw in all of the ways that I had closed my heart against love in my life and how I had betrayed love in my personal relationship with my spouse and my children and in other ways.

So, I just got this experience of love as something profound and universal and life defining. But something from my life has just been cut off in so many ways. And I got it.

Because I closed my heart against love precisely because, when I was vulnerable and small, I’d be so hurt going through my mother’s states of mind. She couldn’t respond to me when I needed to be responded to. Not her fault, but she couldn’t. And then, when I was a year old, she gave me to a stranger to save my life. And I didn’t see her for a month, which is a huge –

Tim Ferriss: Explain that for a second.

Dr. Gabor Maté: So, again, it’s Budapest, Hungary, World War II, January. The Russians have circle Budapest and are fighting the Germans. The government in power is a right winged, fascist, anti-Semitic, military force. And even though the deportations of Jews have stopped, the Germans had annihilated half a million Hungarian Jews in three or four months. But now, the Hungarian fascists were killing Jews in Budapest, including in the house where my mother and I were living. So, my mother gave me to a stranger in the street, a Christian woman, because she didn’t know if she’d be dead or alive the next day or that I would be.

And I was quite sick, so I didn’t see her for a month, which I experienced as a deep abandonment. How else could I experience it. So, my heart closes against love. And I got all of this. And so, I got that if this plant, this plant that, as you say, manifests the mind, can show me both the ways in which I’ve closed off from myself and that I don’t need to because the love is still there, what healing potential it has. Now, I wish I could say that, after that experience, I became a loving husband and a loving human being. I didn’t. It’s not that simple, as my wife could tell you. Never the less, it opened a door for me.

And I got it right away. Now, however the thought that I had was that I had no induction, I had no introduction, I had no processing afterwards. Ayahuasca is a medicinal plant that has been used in the Amazon Basin for hundreds of years, maybe longer, in its cultural context.

In a tribe, in a village where people know each other, where they know the shaman, where they share the assumptions and the same history. That’s not the same as a bunch of westerners, strangers to each other, coming together for one night and drinking the stuff, and then, going their separate ways.

Tim Ferriss: Agreed.

Dr. Gabor Maté: So, immediately, a question that came up for me was how can we create a setting that at least resembles, as best we can, fashion the original setting? So, we came up with an idea of a retreat where a small number of people get together with properly trained shamans who have integrity and experience, deep experience, and with me facilitating people’s preparation and their post ceremony integration. And so, I’ve been doing that now for 10 years.

And a lot of learning involved. We’ve made mistakes, but it evolved. And the essence of it is that people don’t come to it cold. They come into it with preparation in a safe setting where, pretty soon, a group becomes a family to each other, which means that not only do they love each other and support each other, but they also trigger each other. And, basically, I tell people, guess what, you’re back in your family origin. And everything you’ve hated about your family origin is going to show up here, but in the context where it’s safe for that to happen. And so, I’ve seen a lot of great healing.

I’ve had people with multiple suicide attempts healed from depression. I’ve seen people get much better with their autoimmune diseases. I’ve seen people deal with all kinds of addictions and life issues, relationship problems, come out of it much more themselves, much more able to deal with these issues, so long as the proper integration is done afterwards. So, that was my personal experience. Now, that then, introduced me to the whole world of psychedelics.

And I realized there’s a lot of research being done these days. There’s this organization, MAPS, Multidisciplinary Association for Psychedelic Studies, which is a group of psychologists, psychiatrists, medical doctors, therapists, counselors, interested people just studying scientifically the role of psychedelics in healing and, as you’re probably aware, interesting studies have been done around [inaudible] and end of life anxiety. Studies have been done, which are revolutionary, in using MDMA assisted psychotherapy, MDMA being the technical name for ecstasy.

Again, in the right setting, with the right leadership, these have proven to be very powerful modalities of healing. And so, there’s a whole new resurgence of psychedelic research in a number of different areas, some of them manmade, some of them plant based. But there’s a whole world that I was introduced to.

And I learned a lot, in the last 10 years. And, again, I both practice it in my own healing work, and I’m interested in it also as a participant.

Tim Ferriss: I’d love to add a few things to your second comment and then, ask a bunch of questions about the first. So, for people who are, and I’ll maybe direct this to camera because I don’t usually have cameras, so I’ll just ask, for people who are – actually, no, that’s too weird. For people who are – I don’t know where to look. I should definitely keep that in. For people who are interested in learning more about the current scientific studies and mechanisms of action related to some of these compounds and what is being done, there are a number of very interesting and very competent organizations, as far as I can tell.

MAPS is one that you mentioned. And I’ll actually be seeing the founder, Rick Doblin, in just a few days’ time.

There is the Hefter Institute, which I’ve worked with primarily run by MDs and PhDs, or at least the board and so on is comprised of scientists and medical doctors. It was through the Hefter Foundation and also directly with Johns Hopkins. So, I’ve had some involvement with psilocybin studies. And, actually, thank you to many of you in my audience who helped through a crowd funding campaign to raise funds for a study at Johns Hopkins related to treatment resistant depression and psilocybin. So, Hefter Institute, excellent organization to look into.

And then, USONA also, which I believe is primarily focused on psilocybin. Whereas MAPS, at this point, has done great work on many levels, including helping to facilitate MDMA, being designated a breakthrough therapy and, effectively, getting fast tracked into Phase 3 trials.

Dr. Gabor Maté: But the FDA.

Tim Ferriss: That’s right. And these are all organizations that I would encourage people to look into. And it’s really an exciting time and also, a fragile time, as it relates to these compounds, which have, certainly, demonstrated, historically, excepting MDMA. Let’s just look at the studies many of which were done starting in say the ‘50s and ‘60s looking at the clinical efficacy of using these compounds for everything ranging from alcoholism to nicotine addiction to many of the things that you mentioned.

Dr. Gabor Maté: Well, what is little known but that Bill Wilson, Dr. Bill, one of the founders of AA, actually had some powerful LSD experiences, which helped him in his spiritual growth.

Tim Ferriss: Well, he wanted to make –

Dr. Gabor Maté: In AA, they don’t talk about that very much, but it’s a fact. If I may parenthetically say, as much as I support the 12 steps, what AA also doesn’t tend to talk about is the trauma that first causes the addiction.

And Bill Wilson himself was a traumatized child. He was abandoned by his parents, when he was very young. And so, it’s interesting that AA, for all the good work that it does do, which I support, I don’t support people being forced into any particular form of treatment. But as a self-chosen form of treatment, it can be very helpful to many people. But they don’t talk about two very interesting things, which one is the psychedelic part, and the other is the trauma part.

Tim Ferriss: Yeah. For me, just looking at my own childhood experiences and exploring recovery, defined as you defined it, in the last several years, especially in the last six months, it’s been fascinating and frustrating to discover and try to piece together these various elements. But the –

Dr. Gabor Maté: What is the frustrating part?

Tim Ferriss: That there is – well, it may exist, but I couldn’t find one stop shopping that checked all of the boxes.

Dr. Gabor Maté: There aren’t any.

Tim Ferriss: Right. So, it’s been an exercise in collecting various tools and piecing them together. Like you said, you have the – AA does incredible work. And what they’ve done, in terms of a distributed free service with social accountability and support, is incredible.

Dr. Gabor Maté: Absolutely.

Tim Ferriss: The psychedelic component, which Bill actually wanted to, as I understand it, make one of the steps in AA, needless to say, it was hard to get widespread leadership support for that, and then, you have the trauma piece. So, these are all tools in the toolkit that people can use for their own sort of bespoke approach, in some respects. Coming back to the ayahuasca, specifically, and I should, just as a caveat, point out because I do think that these tools – I know these tools are very powerful.

I have firsthand familiarity from past experiences. And I have been very engaged with this scientific community for some time now. They can be misused. There are many charlatan.

Dr. Gabor Maté: And, unfortunately, there’s more than that. There are some very powerful healers, shamans, who, unfortunately, exploit people sexually and financially.

Tim Ferriss: Very common, yeah.

Dr. Gabor Maté: And now, this is, of course, not just restricted to ayahuasca world. It also happens in the spiritual world. How many spiritual leaders with tremendous power, tremendous healing influence have, at the same time, exploited men and women and created all kinds of further trauma? So, unfortunately, when you have that much power, and you haven’t totally done your integration work, you can start misusing that power. And that happens in all of the healing modalities, as we know. But it certainly happens in the psychedelic world as well.

Tim Ferriss: Yeah. It’s very – I wish I could say it’s rare. It’s not. But it’s something to safeguard against, especially when you’re in that vulnerable state.

So, I would actually recommend that people see a documentary called Kumaré, which is very much worth watching. And the brief overview is it’s an Indian film maker who begins studying various gurus and healers in the US, in hopes of, I believe, the original impetus was to simply do a documentary on charlatans. And then, he went to India, and he said they’re just as bad here. And he said 99 percent are just as bad or worse. And he decides to make himself a guru as an experiment. And it’s a very thought provoking documentary that I think will –

Dr. Gabor Maté: So, he becomes a kind of fake guru, right?

Tim Ferriss: That’s right.

Dr. Gabor Maté: Yeah, I remember it.

Tim Ferriss: And then, he unveils it. I don’t want to give too much away, but it’s very well done, very worth watching because it helps to prepare you, I think, psychologically, to not lose yourself in a dangerous way.

Dr. Gabor Maté: And here’s the problem, you see, what I said about the essence of trauma is you lose connection to yourself. And that means you lose connection to your gut feelings.

Tim Ferriss: Right, yes.

Dr. Gabor Maté: Now, as long as your gut feelings are with you, and you honor them, they’ll protect you. But the very essence of trauma is the loss of that, which means that, when you lose connection to your gut feelings, then, you’re very vulnerable to being exploited. And when you talk to people who were exploited, in any context, psychedelic or not, if you ask them do you have any kind of vague sense that this is not quite right, they’ll say yeah, but I didn’t listen to it. And the fact that they didn’t listen to it is already a marker of trauma.

So, since it’s traumatized people, which is most of us, who seek healing, it’s also vulnerable people who seek healing. And this is what some of these people can exploit. So, the very portal into healing, which is opening up the vulnerability that we’ve shut down against, is also the portal for potential loss. So, people have to do their due diligence.

Tim Ferriss: Yeah.

Dr. Gabor Maté: And I’m not trying to create paranoia here, but people just should be careful.

Tim Ferriss: You just mentioned something that I would really love to just pause and emphasize. You mentioned a few things. So, No. 1 is that your gut feeling/physiological intuition can help you. And that’s something that, for many reasons, I completely muted or ignored for a very long time. So, it’s been a process of getting reacquainted with that. So, I would say two things that I found helpful. And if you have any comments on the second, in particular, I’d love to hear it. One was dramatically decreasing my caffeine intake, which I found was almost like turning up the volume on static.

It made it very difficult for me to read or feel other things. I was using it maybe for many reasons, but it had the side effect, at least, of muting, maybe that was why I did it subconsciously, many of these feelings. The second was, in fact, a video that was recommended to me, but it corresponds to a book called The Gift of Fear by Gavin de Becker who actually owns a company that does protective services and executive security. So, you have to keep in mind maybe you don’t always want to ask a barber if you need a haircut.

So, keeping that in mind, it also, in brief, points to the benefits of some of these reactions or emotional states that we are prone to labeling negative. And the – as you said, not to make anyone paranoid, but rather to inform them, these are currently existent risks.

And one of the hopes, certainly, with say, ultimately, better researching these compounds after they’ve been really unfairly but, of understandable reasons, politicized and put into the same schedule in the United States as heroin and cocaine, to have them rescheduled, so that they are prescribable. And if then, that happens, the ability to certify therapists to regulate and to maintain a broad type of quality control goes up. So, that’s also one of the hopes is that that will decrease the likelihood of bad actors and allow appropriate punishment for bad actors.

Dr. Gabor Maté: Mind you, as we know, even in legalized, legitimate professions –

Tim Ferriss: It still happens.

Dr. Gabor Maté: This still happens. So, ultimately, gut feelings are still the best response. And let me address first why we shut down our gut feelings, if I may.

Tim Ferriss: Please.

Dr. Gabor Maté: So, a human being has two fundamental needs, apart from the physical needs in infancy, in childhood. One is for attachment. Now, attachment is the closeness and proximity with another human being or the sake of being looked after or for the sake of looking after the other. Now, human beings, as mammals, and even birds, are creatures of attachment. We have to connect and attach because, otherwise, we don’t survive. If there’s nobody that’s motivated to take care of us, to attach to us that way, and if not motivated to attach to others, we just can’t survive.

One additional thing is that the endorphins, which are the body’s internal opiate, make chemicals, which heroin and all the other opiates resemble, they help facilitate attachment.

So, if you take infant mice, and you knock out their endorphin receptors, so they don’t have endorphin opiate activity in their brain, they won’t cry for help and separate from their mothers, which would mean that they would die in the wild, which goes back to what happens in early childhood. When there’s stress and trauma, these endorphin systems don’t develop. And then, when people do heroin, it feels like a warm, soft hug to them. They feel love and connection for the first time.

That’s why it’s so powerful. So, we have this need for attachment, which, obviously, the human infant who is the most helpless, the most dependent, the least mature of any creature in the universe at birth, cannot survive, without the attachment. And that attachment relationship, given that we have the longest period of development of any creature, well into adolescence and beyond, attachment is not a negotiable need.

But we have another need, which is authenticity. Now, authenticity, autho to self means being connected to ourselves. Just knowing what we feel and being able to act on it. So, that means our gut feelings. So, let’s look at how human beings evolved. For hundreds of thousands of years, and for 100,000 years or of this species existing on earth, how did we live? We didn’t live in cities and houses and so on. We lived out there in the wild, until very recently in human existence. Now, just how long do you survive in the wild, if you’re not connected to your gut feelings?

Tim Ferriss: Not very long.

Dr. Gabor Maté: Not very long. If you start using your intellect instead of your gut feelings, you just don’t survive. So, that’s a powerful survival need as well. So, attachment is a survival need. Authenticity is a survival need. But what happens if your authenticity threatens your attachment relationships? For example, as a 2-year-old, you get angry because you didn’t get that cookie before dinner.

But your parents can handle anger because they grew up in homes when there was rage-holism, and they’re terrified at the very expression of anger, so they give you the message that good, little kids don’t get angry. The message you receive is not that good, little kids don’t get angry, but that angry little kids don’t get loved because your parents are on their cell. They won’t look at you. They talk to you in a harsh way. You’re not getting loved, not experiencing love, at that moment. Now, but you’ve got to stay attached. Guess what you’re going to suppress? The authenticity every time.

And this is how we lose connection to ourselves and to our gut feeling. So that, strangely enough, that very dynamic, which is essential for human survival in a natural setting, now becomes a threat to our survival in this more modern setting where to stay authentic is to threaten attachment. And so, we give up our authenticity. And then, we wonder who the hell we are and whose life is this and who is experiencing all of this. And who am I really? And so, that’s where the reconnection has to happen.

That’s where the healing happens is with that reconnection. But it’s because of that conflict, that tragic conflict in childhood between authenticity and attachment that most of us face that we lose ourselves and lose connection to our gut feelings.

Tim Ferriss: There are so many directions we can go with this. And I’m really glad you shared that because that had an enormous – that observation has had an enormous impact on some of my close friends and something I was only exposed to really today because our mutual friend, Vicky, recommended that I ask you to expand on it. What I’d love to return to, if we can –

Dr. Gabor Maté: Can I say something?

Tim Ferriss: Of course.

Dr. Gabor Maté: Sorry. In this building, there’s a picture of Elvis Presley.

Tim Ferriss: Yes.

Dr. Gabor Maté: So, the song of his that I play at my retreats and my events all of the time, it’s called Any Way You Love Me. Do you remember how it goes?

Tim Ferriss: I don’t.

Dr. Gabor Maté: I could actually play it for you, but it goes any way you love me, that’s the way I’ll be. In your hands, my heart is clay. I’ll be strong as a mountain or weak as willow tree. I’ll be powerful. I’ll be like a little baby. Any way you want me, that’s how I will be.

Now, that’s considered a love song. It isn’t. It’s a lack of love song. It’s a song that says just attach to me. I’ll give up anything about myself. Just accept me the way you want me to be. It’s the saddest song. And when you hear him sing it, there’s deep sadness in it. And some of the power of Presley actually came from his own suffering. He wasn’t just singing a song. He was actually infusing it with all of the emotions of loss.

So, even though it’s presented like a love song, it’s actually a song about the loss of love. And that’s the situation of the infant who say just love me. I’ll be anything you want m to be. And that’s the tragic conflict between attachment and authenticity.

Tim Ferriss: So, this ties into exactly where I was going, which is related to your pre and post work with psychedelics. And for people who are watching this or listening to it, I’m returning to this not because I want to hammer home psychedelics. They’re not for everyone. And, in my experience, the vast majority – or I should say, in my observation, the vast majority of psychedelic use is very irresponsible. And I would not recommend because you – it can certainly cause a good amount of harm if not done in a supervised, safe fashion. But the pre and post work could apply to many modalities.

It does, in this case, this example we’re about to talk about, apply to psychedelics. But it could, and correct me if I’m wrong, but it seems like it could very easily apply to going into any intense or unusual modality –

Dr. Gabor Maté: Like Vipassana meditation.

Tim Ferriss: Like Vipassana, like this Date with Destiny Tony Robbins I mentioned, which is certainly intense and very, very different, very powerful. That’s why I’m coming back to this. But we can discuss it as it applies specifically to psychedelics and, even specifically to ayahuasca if that is the primary compound we’re talking about, which is really, just for people who are wondering, it’s – one of the reasons ayahuasca is really tricky is that it is unlike say, I’m going to get off topic for a second, but it’s still on topic, it’s not quite like mushrooms and what people consider the primary psychoactive of psilocybin.

It’s a bit different. It’s more of an old fashioned. If you go to a bar, and you order vodka and soda, pretty much everywhere you go, vodka and soda, very similar, assuming the pour is the same.

Ayahuasca is more like an old fashioned. There are few ingredients that are almost always there. So, if you go to let’s say I want to say [inaudible] or other parts of Peru, it’s going to be mostly the ayahuasca vine, plus a plant called chacruna or a [inaudible], which is a DMT. I suppose it must be NNDMT containing plant, which is made orally active through the MAO inhibitors, monoaminoxidase inhibitors in the vine. How they figured out is a whole separate story, which is kind of wild. The plants told them, is the short version.

Dr. Gabor Maté: I know. I have a scientific friend who gave me a startling simple explanation, which makes more sense to the western mind. When I was in Peru, they also told me the plants told us, which, on some level, I accept. But I just want to say something here because we’re talking in an extended way about the psychedelics. I don’t want to create the impression that this is most of my life work.

It isn’t. I do this stuff one or two or three weeks a year. So, it’s not like the major part of what I do. But it is a very interesting part because it illuminates everything else that I do, in the sense that it goes very deep. Now, this scientific friend of mind, this science friend of mine, says actually, let’s say using the ayahuasca and boiling it up because ayahuasca itself, the vine, has some psychedelic properties on its own without the chacruna.

Tim Ferriss: Yeah. Very strong auditory in particular.

Dr. Gabor Maté: Yeah. So, then, what happens is some leaves of chacruna fall into it. Inevitably, over hundreds of years, that’s going to happen. And they say this combination is even more powerful. So, it need not be as esoteric as – it could have been a rather simple discovery.

Tim Ferriss: For sure.

Dr. Gabor Maté: So, who knows what the real story is? But in any case, the preparation and the processing.

Tim Ferriss: And I was just going to add one thing to that, which is that is one combination. You then, also have, in certain regions, and it’s found in other places outside of Peru most certainly. And the largest ayahuasca sacrament based churches are actually out of Brazil, but it can also be ayahuasca vine plus [inaudible], which is a different plant, also DMT containing, but, for some people, substantially different experience. And then, the only reason I’m mentioning this is so that people are aware of why I am particularly concerned when people are cavalier about my friend is ordering some ayahuasca from Hawaii, and we’re going to put it in a slow cooker and have it at his house this weekend.

I’m like bad, bad idea. Many, many centers, even well intentioned centers, in Peru will also put other things in the brew because they think foreigners want more of X. So, they’ll put coca leaves, so think cocaine, coca leaves.

They’re put toy, which is even Datura, which is even scarier in some respects. Coca, not that scary. So, just be aware that, when you say ayahuasca – not you. But when people think ayahuasca, it is not a standardized dose that you are getting.

Dr. Gabor Maté: Right. And recently, I was at a retreat in Costa Rica where really, four different nights, they had ceremonies, and each time with a different concoction. So, one night was the Peruvian [inaudible] tradition preparation. One night was the [inaudible] from Columbia. And it’s who prepares it, how much they bowl it for, what combination, what intention and so on. So, that’s by and large true. And really, the people I’ve worked with, it’s always – not that it’s always the same drink every night, but it’s pretty much the same preparation.

Tim Ferriss: Same preparation, yeah. And so, I took us down a little rabbit hole.

But the question I have is with all of your clinical experience in recognizing that this is a therapy, but it’s an adjunct therapy, it’s not used in isolation, and you’ve, through trial and error and design, come to a place now where you have maybe certain best practices or approaches to the pre and post work. Could you tell us about either or both of those? And, ideally, maybe exercises or questions people could think about on their own?

And I know it’s hard to recommend that in isolation perhaps. But I’d love to hear any details that you’re willing to share about the pre and post because it’s so, so important. I just – it’s hard to, for me at least, in my limited experience even, to over emphasize.

Dr. Gabor Maté: But with ayahuasca specifically, which is not the only modality I work with, but that specifically, there’s a physician preparation.

For example, no caffeine for a period of time, no red meat, cutting down on salt, excluding dairy products. So, there’s a physical preparation just to cleanse the body and to make it more receptive to the ayahuasca. From the emotional and psychological point of view, you want somebody to really form an intention. What actually do I want out of this experience because intention is everything? So, it’s not like I’m going to take this stuff, and let’s see what happens. Why am I here for? Why am I coming? What is my intention in going there? What do I want to find out? What issues am I working with?

So, intention setting and really considering what is my purpose in undertaking this experience? When people arrive, we don’t just plunge into ceremony. In my ayahuasca retreats, we have a day and a half of group preparation. So, everybody articulates their intention, why they’re there. And we deeply explore how that intention arose and what in their lives brought them to this point.

And what issues do they need to deal with? And my way of working is to get people very deeply to their core issues, which they may not be even aware of, but, again, through this process I call compassionate inquiry, this is true whether I’m working with plants or not, they get to see what it is that they’re really seeking. And what are they seeking? They’re seeking themselves. They’re seeking reconnection, ultimately. But there are steps that you go through. And then, we help them set a specific intention for that first ceremony. And the specific intention is what do I want to learn tonight.

Not just want I want to learn in general, but what I want to learn tonight. Some people want to learn about – tell me about my fear. Teach me about my pain.

Show me what love is. Show me what courage is. Show me what my strength is. See, it’s not that the ayahuasca comes with an agenda. It works through you. And it manifests what’s in you, so that your intention, the more specific it is to you where you are in life, at that moment, the more effective it’s going to be. And then, the shamans work with you during the ceremony, and they chant to you based on what they’re picking up from you, at that moment. They work with you energetically. Sometimes, they work hands on, as well. And you both have your own experience, and you share the group energy.

And then, people go to sleep. And the next day, and then, the following day, we then process what happened to you. What visions came to you? Now, some people will have visions. Some people with more prosaic minds like me will hardly ever get visions.

I did, originally, get visions, but it’s been years, since I’ve seen anything. Some people will have bodily experiences. Some people will go through intense emotional states, which, in my view, are always memories of maybe forgotten memories but indwelling memories of regular experiences, intense. Some people will have beautiful entities coming and teaching them. Jaguars and anacondas or various angelic entities. I’ve never been blessed with that. I used to get frustrated. But, actually, whatever experience you have, that’s the experience you need to have. And for me, it’s not about the visions or anything; it’s about what is the teaching.

And the teaching is always there. And the purpose of the processing is to help you find the teaching that was imparted to you by whatever experience you had, not about comparing your experience to the night before or two nights before or to the experience of other people.

It’s your specific experience, what does it mean in your life. And now, post retreat, then, again, whether you do a program like Vipassana, whether you do the [inaudible], or whether you do a Hoffman process, or whether you do any kind of transformational work or meditation retreat, if you don’t integrate what you’ve learned into your life, and you build up some practice around it, it’s going to become a memory, a nice memory.

Tim Ferriss: At best, right?

Dr. Gabor Maté: Yeah.

Tim Ferriss: If you go straight back into making hypercritical decisions impulsively 12 hours later also, it could be very destructive.

Dr. Gabor Maté: Absolutely. So, the more integration we can – and, generally, in psychedelic work, there’s a question of integration is becoming more and more recognized and more and more practiced. So, integration means keeping in touch with people that can help you stay on track, keeping in touch with the group that you shared the experience with, putting some practice into your life, such as journaling, meditation, yoga.

Perhaps, you’re going to return and do some more plant work, or perhaps you won’t. That’s entirely up to you. There’s no prescription to be made there. But the point is to go from experience that is discrete, and time limited to some kind of integration that happens over time.

Tim Ferriss: How do you format that integration? Are you interacting with the people on your retreat once a week for four weeks? Or you have two sessions in the following week? What does the actual format look like?

Dr. Gabor Maté: Well, that’s evolving. And that’s different for different people. But, in general, I would say that, if you can talk to somebody regularly over time, and if you can maintain your contact with the group sort of like a Facebook group where people share experiences, if you take on certain practices, and you do them together, or at least you do them simultaneously, and then, you share about the practices, these are all forms of integration.

Tim Ferriss: Which, and we’ve mentioned this a few times, applies to more than just the modality of using plant medicine.

Dr. Gabor Maté: Absolutely.

Tim Ferriss: So, after this – not to sound like a broken record, but this is very recent, after going to this Tony Robbins event with a number of people, including – we have a photo online, so I think he’s fine with me saying it, Joe Gebia, co-founder of Airbnb, Mark Benioff the CEO of Sales Force was sitting right behind me. He wasn’t part of the group, but he’s a friend, at least an acquaintance, getting to know each other. In any case, we kept a group text going afterwards to hold each other accountable and also to set follow up group calls and so on.

A number of things I’d really like to underscore because you mentioned them, and I’d like to reiterate their importance and also, how they transcend the plant medicine work, the psychedelics.

The first is how you mentioned intentions. And I’ll just share my experience and also a number of recommendations that helped me tremendously with plant medicine work but then life, in general, which is you set a clear intention, but the clear intention is not the same as an expectation.

Dr. Gabor Maté: That’s right.

Tim Ferriss: And, if you go in, and you have an expectation you can’t let go of, you end up – many people end up trying to white knuckle the experience.

Dr. Gabor Maté: And that’s true in general life, and it’s very true for plant experiences. So, if you get that this is going to happen, this should happen – and some people sit through the whole night resisting their experience because it doesn’t meet their expectations.

Tim Ferriss: Right. So, there’s a card that I was given as a gift, which I didn’t come to appreciate fully, until maybe a year or two ago. I’ve been carrying it a long time. And it was given to me by an ex-girlfriend.

And it says, “The task which hinders your task is your task.” And so, you mentioned a few things, and you said that is the work for that night. And I’ve come to know a few people I respect as I hesitate to use the word because there are really only two or three people I have personally met that I would feel comfortable calling a shaman, and they all have minimum of 10 or 15 years’ experience in a traditional apprenticeship setting.

Dr. Gabor Maté: And, by the way, that means deep personal work.

Tim Ferriss: Very deep.

Dr. Gabor Maté: That means sitting in the jungle by yourself being bitten by mosquitos. That means drinking various plants, tobacco and other plants, beyond ayahuasca and really preparing. I know somebody on that path right now, let me tell you. It’s deep, committed work. It’s not for the faint hearted. I would never do it.

Tim Ferriss: Yeah. It’s very intense. Very, very intense. And there are people who do 15 months of isolation, dieting, various plants, no sex, no salt, no pork, no red meat. And you know the drill. We won’t get into it right now.

And what – they’ve shared a few examples with me of say I’ve never – well, that’s not true. But I’ve always, in the past, shied away from large groups. That’s why I was taken aback with mentioning 50 people. It seems very common in any group, especially larger groups, and this is true in psychedelics or at Vipassana retreats.

The nickname for it that was given at the 10 day silent retreat I did at Spirit Rock was the Vipassana vendetta where you decide that someone who is sitting close to you is coughing too loudly or clears their throat too often or whatever, and it starts to – you start to perseverate and think about it incessantly and maybe get angry about it.

Dr. Gabor Maté: Instead of watching your own reactions.

Tim Ferriss: Instead of watching your own reaction. And the example that was given to me by this particular I’m just going to ayahuascaro to simplify things.

Ayahuascaro, someone who works with ayahuasca, he told me about this westerner who came down. I guess they’re kind of westerners, too. They’re just south of the border. So, Northern American who came down and was furious that someone in the group wouldn’t shut up with their screaming. He was just furious about this. And there are a number of ways an organizer can handle that. But he took the guy outside, and he said that person is your work tonight.

Dr. Gabor Maté: Absolutely.

Tim Ferriss: And if you think about that reframe and how to view something that perhaps, historically, you would respond to as a problem or an annoyance or offensive to view that – and there are certain times when you have to fight and stand up for yourself. I’m not saying you shouldn’t. But I think that, in my case, and in the cases of many folks, we fight too often. We wear ourselves out. We get upset too often.

How can you view that as a gift? How can you view that as your work?

Dr. Gabor Maté: Well, can I, again, give you a quote?

Tim Ferriss: Yes, please.

Dr. Gabor Maté: Which I love. It’s from one of my favorite teachers. And his name is AH Olness. And he says, “Your conflicts, all the difficult things, the problematic situations in your life are not chance or haphazard, they’re actually yours. They’re specifically yours designed specifically for you by a part of you that loves you more than anything else. That part of you that loves you more than anything else has created roadblocks to lead you to yourself. You’re not going to go in the right direction, unless there’s something pricking you in the side telling you look here, this way.

That part of you loves you so much that it doesn’t want you to lose the chance. It will go to extreme measures to wake you up. It will make you suffer greatly if you don’t listen. What else can it do? That’s its purpose.” And I found this to be true of physical illness and mental problems and everything. You’ve got to see what is the teaching here.

So, we can look at all of these things as problems to get rid of, which is what the personality wants to do, or we can look at them as learning opportunities, which is what your true self wants to do. Now, two things. One is you talked about intention in life. So, my wife and I had a holiday recently in Costa Rica. Partly, it was a working holiday, but partly it was just a holiday. Traditionally, we’ve had terrible times during holidays, partly because of my workaholism, and once I go to a holiday, I just collapse. And now, my wife is dragging a corpse around on a holiday because I’m a workaholic, and I hadn’t cleared space.

So, this time, we actually went into the holiday with intention. This has nothing to do with psychedelics. It’s just to do that we set an intention. What is an intention? And if we have an intention, I’ve learned from a couple of very wise teachers, what structures do we want to set up to support our intention? And how are we going to handle when there’s kind of disagreement or conflict? We had a beautiful holiday because it was the first intentional holiday that we’ve had.

So, that intention in life, in general, is absolutely essential. Like every morning, what is my actual intention? So, the problems, the upset – so, want a little bit of an exercise?

Tim Ferriss: Sure.

Dr. Gabor Maté: And if you don’t like it, just tell me. When was the last – this is something I do in my groups or when I speak or in the summer when I teach. So, I ask people to tell me some recent episode when they were upset with somebody with their life, and something that they’re open to sharing. So, it doesn’t have to be anything sorted, but just something whether it’s your spouse, partner, the bus driver, I don’t care who, a friend.

Tim Ferriss: Sure, okay.

Dr. Gabor Maté: So, are you willing to go there?

Tim Ferriss: Anything? I can share anything?

Dr. Gabor Maté: Just when you were upset with somebody.

Tim Ferriss: Okay, yes.

Dr. Gabor Maté: So, what happened?

Tim Ferriss: Describe it?

Dr. Gabor Maté: What happened, yeah?

Tim Ferriss: All right. There were a number of issues in my home, broken aspects of the home, things that were falling apart or needed to be fixed.

Dr. Gabor Maté: Physically?

Tim Ferriss: Physically, right. And I had hired someone to do these things while I was gone, and I came back, and none of them were fixed.

Dr. Gabor Maté: Okay. And your emotional reaction was?

Tim Ferriss: Anger.

Dr. Gabor Maté: Rage, anger, okay. Anything else besides anger?

Tim Ferriss: I think they’re close cousins, frustration.

Dr. Gabor Maté: Frustration is anger, yeah.

Tim Ferriss: I was disappointed.

Dr. Gabor Maté: Disappointment is sadness.

Tim Ferriss: Yeah. It’s a different feeling. So, I was disappointed in myself also because I started to look at how maybe –

Dr. Gabor Maté: Well, disappointed is not so much an emotion as a state of mind. I’m asking what emotions were – what’s inside of disappointment? Something didn’t happen that I wanted to happen. How do I feel? Isn’t there sadness there?

Tim Ferriss: Sure, there’s sadness.

Dr. Gabor Maté: I’m not talking you into it. I’m just asking.

Tim Ferriss: Well, I suppose I might be confusing states of mind and emotions, since I’m not sure how to delineate them.

Dr. Gabor Maté: Yes, I’m looking at the raw emotion.

Tim Ferriss: Yeah. Sadness.

Dr. Gabor Maté: So, there’s anger and sadness, those are the emotions?

Tim Ferriss: Let’s go with that, yeah.

Dr. Gabor Maté: Okay. So, I’m going to ask you a silly question. What were you sad and angry about?

Tim Ferriss: Well, I suppose the answer, which is not the right answering I’m expecting, was I was angry that someone had made commitments to me and not fulfilled those commitments.

Dr. Gabor Maté: Okay. That’s what happened. They had made the commitment. But that doesn’t tell me what you’re sad or angry about. What does that mean that they didn’t fulfill their commitments?

Tim Ferriss: It meant that they didn’t care about me. They didn’t respect me.

Dr. Gabor Maté: So, they didn’t care about you, and they didn’t respect you? What kind of person doesn’t get cared or respected?

Tim Ferriss: I might need a lifeline here. I don’t know. Someone who doesn’t deserve to be cared for or respected.

Dr. Gabor Maté: Exactly. Somebody unworthy, right?

Tim Ferriss: Sure.

Dr. Gabor Maté: Of respect and care.

Tim Ferriss: Mm-hmm.

Dr. Gabor Maté: Okay. Now, if there are other people here, which there usually are, when I do this exercise, I would ask them, okay, we just listened to Tim tell us about this experience. Are there other reasons why this other person might not have done the work that has nothing to do with him or her not caring about Tim or not respecting him? So, what other reasons might there be?

Tim Ferriss: A million and one.

Dr. Gabor Maté: A million and one?

Tim Ferriss: Yeah. He could be in the hospital. His [inaudible] could have been in a car accident.

Dr. Gabor Maté: Exactly.

Tim Ferriss: He had a flight delay and got caught in Puerto Rico during a hurricane.

Dr. Gabor Maté: Yeah. He’s got ADHD.

Tim Ferriss: Yeah.

Dr. Gabor Maté: And he can’t follow through. He’s under stress, and he couldn’t –

Tim Ferriss: Right. The email that I was supposed to send is sitting in drafts, and I thought I had sent it. But, in fact, he had never received it.

Dr. Gabor Maté: Okay. And any number of possibilities.

Tim Ferriss: Yeah.

Dr. Gabor Maté: Now, of all of the possibilities that you’ve just outlined, including they don’t care about you or respect you, which is the worst one?

Tim Ferriss: The one I immediately defaulted to.

Dr. Gabor Maté: Right.

Tim Ferriss: I mean, the worst – if the guy is dead, then, it’s bad.

Dr. Gabor Maté: No, no, but internally.

Tim Ferriss: Internally, the worst assumption is the one that I immediately made.

Dr. Gabor Maté: Exactly. So, let’s notice something. A) You, I should say we, because we’re all like this, we don’t respond to what happens. We respond to our perception of what happens.

Tim Ferriss: Right.

Dr. Gabor Maté: That’s what the Buddha said. It’s with our minds we create the world. So, that if you found out he had ADHD, or he was stressed, you might have been sad for him, but you would not have been angry, and you would not have been sad. Okay? You might have – so, first of all, we don’t respond to what happens.

We respond to our perception of what happens, to our interpretation of what happens, 1). 2) Of all of the possible interpretations, we choose the worst one. Thirdly, what I just said isn’t true. We didn’t choose it. It’s not like you went through all of these possibilities, and you said –

Tim Ferriss: Which multiple choice, I chose Option D.

Dr. Gabor Maté: Oh, no, he doesn’t care about me. He doesn’t respect me. You didn’t do that. Your brain jumped there automatically, right? The question is why.

Tim Ferriss: Yeah.

Dr. Gabor Maté: Now, here is the learning. The first time in your life that you felt hurt and angry, when you perceived somebody didn’t care about you or didn’t respect you, or has it happened before?

Tim Ferriss: This is where the exercise might go sideways. I’m going to hit pause on that. I think that’s probably for more of a conversation over wine.

Dr. Gabor Maté: But you probably agree it’s not the first time.

Tim Ferriss: It’s not the first time.

Dr. Gabor Maté: Very good. And most people I talk to, it goes way back.

Tim Ferriss: Yeah, this goes way back.

Dr. Gabor Maté: Into childhood.

Tim Ferriss: Mm-hmm.

Dr. Gabor Maté: And that’s what trauma is. We don’t respond to the present moment. We respond to the past. Now, but along the lines of our discussion, it’s a beautiful learning opportunity. Now, you get to know – now, what if you assumed, for a moment that you’re the most lovable, most worthy of care, most worthy of respect person in the history of the universe, and this guy doesn’t do your home, what’s your response?

Tim Ferriss: Any number of the other options, which does not trigger an intense, negative emotional state. And none of those other options would trigger that.

Dr. Gabor Maté: So, something in you, I would argue, still believes that you’re not worthy of care and respect. And that’s what gets triggered. So, who is the one that doesn’t care about you, and who is the one that doesn’t think you’re worthy of respect?

Tim Ferriss: It would be me.

Dr. Gabor Maté: It would be you. That’s a learning.

Tim Ferriss: No, it is, yeah.

Dr. Gabor Maté: And this is exactly what you’re talking about. You’re saying how these difficult things, how these problems are always teaching opportunities.

And that’s the beauty of healing is that, when you reframe things, and you actually see the source within ourselves, all of a sudden, that’s liberating because, guess what, if you’re feeling that way because this guy did this or didn’t do that, that makes you a victim.

Tim Ferriss: Yeah.

Dr. Gabor Maté: But if you see that you’re the source, now, you’re powerful.

Tim Ferriss: Yeah, you’re empowered. This is something that a friend of mine here in Austin, Robert Rodriguez, recently said to me, in a very similar way. I mean, it was a completely different context. He was actually telling a story about someone else who was constantly blaming people for everything in the film world. And he said, “If you are the victim, and it’s everyone else’s fault, you’re powerless. But keep in mind, every time you’re pointing a finger at someone,” and I had never heard this, I know it now after the fact that there are other people who have said this.

But he said, “Every time you’re pointing a finger at someone, keep in mind that there are three fingers pointing back at you.” And I thought about that. And I was like wow, that’s just a good sentence to keep in mind.

Dr. Gabor Maté: Now, this is a recording studio sometimes?

Tim Ferriss: Yeah. They do recordings, they do –

Dr. Gabor Maté: Did they record in the past? Did Johnny Cash ever record here, by any chance?

Tim Ferriss: I don’t know if Johnny Cash was ever here. I would say it’s possible because it’s been around for a long time.

Dr. Gabor Maté: The reason I ask is because he’s got a song that I play at all of my events. In Your Mind, it’s called. This all goes down in your mind. It’s from the soundtrack of Deadman Walking. And I think he wrote it himself. It all goes down in your mind, and it goes one foot in the fire – one foot on Jacob’s ladder, another in the fire. It all goes down in your mind. So, whether you’re going to hell, or you’re on your way to Heaven, it all happens up here, which is such a powerful teaching because this is what we can work on. If we’re victims of the world – Ramana Maharshi who is a great Indian guru, he said something like if your foot hurts when you walk outside, you can do two things.

One is wrap the whole world in burlap, or you can get a pair of shoes. So, you can see yourself as a victim of the world and try and change the world, so they won’t hurt you anymore, or you can actually empower yourself. And that’s what the healing is all about.

Tim Ferriss: Well, I will say the reason I wanted to have you on now is because I’ve been so focused on trying to navigate these things myself over the last several years, but most intensely over the last several months. And I wanted to be ready to have this conversation with you.

Dr. Gabor Maté: And how are you doing so far?

Tim Ferriss: I’m great. I’m great. I’m great. I’m doing very well. I think I’m the sanest and, arguably, in the best place I’ve been maybe ever. So, I feel very good.

Dr. Gabor Maté: That’s fabulous. Which means that healing is just available. It’s just possible. I got an email a few months ago from a woman called [inaudible]. Now, [inaudible] was chief of the Luftwaffe and the –

Tim Ferriss: Oh, my God, that’s right. I was wondering where I knew that name.

Dr. Gabor Maté: Yeah. And he was head of the gestapo, just an opiate addict, by the way, and a very clever, very ruthless man. His great niece sent me an email a few months ago to thank me for my work. And she’s been through her own process. Imagine the karma she was carrying and all the healing she has had to do. So, there was her great uncle trying to kill me and my people. And there’s the great niece making contact with me.

And, to me, it just – and your example and my example and the examples of so many people I know. It’s not like I’m a big piece of cake. It’s going to continue as long as I live. But I’m experiencing, internally, the goodness and the healing that’s available to us. And I didn’t used to. And I used to think I could help heal everybody but that I was beyond healing myself. That was my core belief.

Tim Ferriss: Well, it’s been my core belief for the last 10 years.

Dr. Gabor Maté: Okay. It just ain’t true. And anybody listening, I just want you to know, it doesn’t matter what state of mind you’re in, it doesn’t matter what you’re experiencing. It’s human. It is transmutable. It is transformable because that true self that you got disconnected from is still available to you. So, it’s not a question of just talking about what happened in the past. It’s a question of how do we reconnect to ourselves. And what you’re describing about your own state, if I can put it in one sentence, you’d probably agree with me that you’re probably much more connected to yourself than you used to be.

Tim Ferriss: Oh, 100 percent.

Dr. Gabor Maté: Yeah. And that’s the –

Tim Ferriss: That’s the pre-requisite. That’s why I feel the way I described.

Dr. Gabor Maté: Exactly.

Tim Ferriss: Gabor, I really want to encourage people to learn more about you and your work. And there are certainly a number of places they could start. Where would you suggest people dig more deeply? Is there a particular book of your books you would suggest they start with? Is there a particular social media handle where they can pay attention and learn various announcements and see what you share of your work in others?

Dr. Gabor Maté: Well, thanks for asking. The simplest thing is my website, www.drgabormate.com, where are my speaking events and I travel. I’ll be in North America and five countries abroad this year. My speaking events are listed.

Chapters of my books are available. Writeups about my books, articles I’ve written. I have multiple talks on You Tube that people have filmed and posted seen by hundreds of thousands of people. I have a Facebook video that somebody did about my work that’s been seen 12 million times now. So, there are all kinds of ways to discover me on Facebook, on You Tube, at my website. And I would also really hope that people check out my books of which I’ve written four. The first one, the American title is Scattered. And it’s about ADHD. And I wrote it after my own diagnosis.

And pretty much, what I said earlier, that I don’t see it as an inherited disease. I do see it as a response to family, multigenerational, and social stress, in sensitive children. People say you’re blaming the parents. I’m not blaming the parents. I don’t blame myself, but I know how stressed my family was, when I was a workaholic doctor.

And so, that’s my first book. And when you say why are we looking at the percentage of kids with ADHD going up so fast, it’s not because of any genetic problem. Genes don’t change in a population over five or ten years. It’s a social problem. There’s much more stress in the culture now. There’s much less connection in the culture now. And the less connected people are, and the more stress there is, the more pressure there is on sensitive kids. So, that’s Scattered. Another parenting book of mine is the work of a brilliant psychologist friend of mine, Gordon Neufeld, Dr. Neufeld who is the world’s leading developmental psychologist, as far as I’m personally concerned.

And I say this advisedly. And the book is called Hold Onto Your Kids: Why Parents Need to Matter More Than Peers. That’s been published in over 20 languages now. And it’s about the fact that, since kids need attachment, the attachment need is the primary drive that we have. And we’ve talked about that. It’s like a duckling, when the duckling hatches from the egg.

The duckling would prefer to attach and imprint on the mother duck. But what will he do if the mother duck is not around? He’ll imprint on a toy or a dog or a horse or kids because the parents are too distracted and stressed in our society and are not around so much anymore physically as during human evolution, now find themselves in the company of other kids. Guess what they imprint on? Their peer groups. And now, you have immature creatures influencing each other immoderately. And this happens through the social media. It happens in personal contact. And, as that happens, the parents get pushed into the background.

They get more and more frustrated. Now, they get more authoritarian, or they just give up. And kids, therefore, don’t grow up. They don’t mature. And they develop all kinds of problems not because the parents don’t love them but simply because, in this culture, the connection with the kids and the parents have been really disturbed. And how to restore that connection is a subject of Hold Onto Your Kids. So, three of my books, I wrote on my own. This one, I wrote with Gordon.

My next book, which is on mind, body, unity, and health and illness, and that’s a conversation you and I could have another time, but, again, where I show that cancer, autoimmune disease, ALS, multiple sclerosis, Parkinson’s, colitis, Crohn’s disease, chronic fatigue, fibromyalgia are not accidental and separate physical events. They had to do with the scientifically proven fact that mind and body can’t be separated. And when things happen emotionally, they will also physiologically. In fact, it can’t be any other way.

And that the emotional system in our brains, in our bodies, and part and parcel of the same system that also governs immunity, neurological response, and hormonal response. And, therefore, when our life link patterns of emotional repression, when people have to suppress themselves in order to maintain their attachments, that will have a negative impact on their immune system and on their hormonal apparatus and the nervous systems as well.

And that book is called When the Body Says No: Understanding the Stress-Disease Connection. And that’s been published in over 20 countries internationally as well, including in the US. My final, and to my mind, my favorite book is the most recent, In the Realm of Hungry Ghosts: Close Encounters with Addiction, which explores addiction, not from the point of view of a disease model or a choice model, but how it is a response to a childhood loss, stress, and trauma, and how to address that. And also, how to deal with – like if you look at the United States, right now, do you know what the facts are?

The most common cause of death under the age of 50 is now overdose. And, in the US, every three weeks, you have the equivalent of a 9/11. Every three weeks, a 9/11, in terms of the number of people dying. Where is the public outcry? Where are the resources? Where is the political will? Where is the mobilization of the media and all of the public health energies compared to what happened after 9/11?

And we’re having this every three weeks. And why? Because the treatment profession, the medical profession, and politicians, and the legal profession does not understand trauma and its relationship to addiction. The average medical student doesn’t even hear the word trauma in four years of education. Doesn’t even hear the word, let alone get a lecture on it, let alone get a course about it. The stuff I told you about pain development is still not taught in most medical schools.

So, we have this response to addiction, which is just dealing with the effects, the behaviors, controlling the manifestations, and not dealing with the causative factors. That’s why people don’t get better. And, if you look at why, right now, it’s because social stresses increased, economic insecurity has increased. You’re going to look at where do the overdose happens more. It’s in areas where there’s despondency and despair.

Tim Ferriss: Totally.

Dr. Gabor Maté: And so, that’s the book In the Realm of Hungry Ghosts. But other than that, lots of my talks are on You Tube. But I think the best hub to check all of this stuff out is my website. And I hope to generate regular podcasts fairly soon, if the people around me can twist my arm strong enough and organize me well enough to do it.

There will be a podcast. And I hope that will be up soon. But knowing myself, I don’t want to make any promises. But that will, certainly, be listed at my website, if it happens.

Tim Ferriss: And could you give your website URL one more time?

Dr. Gabor Maté: Okay. Drgabormate.com

Tim Ferriss: And drgabormate.com, and to everybody listening and watching, I will also put that in the show notes. So, for everything we’ve discussed, the books, resources, organizations, everything, including your website, which will be at the very top, it will be listed in the show notes, which you can find at tim.blog/podcast. And it will be right at the top. So, all of that will be very easy to find. Just in closing, and we may very well end up doing a Round 2, at some point, it wouldn’t surprise me, even if it’s off camera, certainly, we’d love to spend more time together, do you have any final, closing words or a request or suggestion to the audience?

Anything for people listening that you would like them to consider after they finish this interview?

Dr. Gabor Maté: Yeah. Okay. I hope people will listen to this interview, in a very personal sense, not just as an interesting experience, but as possibly pertaining to themselves. And that discussion with you will help people look at themselves in maybe a new way with what I call compassionate inquiry. So, rather than self judgment about stuff that went wrong, or they did to themselves or others, they got curious. What made me do that? They get curious compassionately because we’re all born in a center, and we’re all born just wanting to be loving and loved.

And then, something happens. And then, it’s a hard road back. But I hope that this conversation helps people reconnect with that path or encourages them to continue on it. And then, secondly, not to see it as an individual issue. It’s a social issue. We live in a society that really does disconnect people. And so, it’s not just an individual problem or an individual family problem. It’s multigenerational. We never even talked about the multigenerational nature of trauma, what it is. We pass this on from one generation to the next, not because we intend to but because we can’t help it.

So, it needs to be looked at in deep over the generations and broadly as the function of a whole society. Now, let me give you one quick example, if I may.

Tim Ferriss: Sure.

Dr. Gabor Maté: A study last year showed that American black women, the more experience with racism they have, the greater the risk of asthma.

What does that tell us? What do we give people to control their asthma? We give them inhalers that contain a copy of adrenaline and a copy of cortisol. That’s stress hormones. In other words, asthma has everything to do with stress. I’ll not go into the scientific details now. I could, but I won’t. But it shows this question. Is the asthma of an American black woman an individual disease, or is it a dysfunction or our entire society? And, obviously, it’s the latter.

So, that the Buddha said that without the many, they cannot be the one. Without the one, they cannot be the many. And he talked about the interconnected core rising of phenomena. So, we are social creatures. Our brains are wired together. Dr. Dan Segal talks about interpersonal neurobiology. We’re not isolated creatures.

So, whatever you’re dealing with, you have to look at not just the individual internal environment, but also the broader social and cultural environment of which you’re one particular manifestation. And as our mutual friend, [inaudible] so fervently want, we need to change the conversation around these issues, particularly, for example, around addiction from a blaming and shaming and ostracizing and just medical model perspective to one that takes into account trauma and social issues and brings compassion into it.

And that must be the same for all mental health issues as well. And whatever we look at, we have to look at both the individual and the broader context.

Tim Ferriss: Thank you for that. And you mentioned how we all begin loving and wanting to be loved or needing love. And then, something happens, and it’s a hard road back. And what I’d like to add to that is it’s a hard road back, but it’s a worthwhile road back. And it is possible to find your way back. If you had told me that a year ago, I would have completely dismissed it. But I’m in a different place now. And I would just like to thank you for helping people to navigate that. And it’s very meaningful work that you do.

Dr. Gabor Maté: Thank you.

Tim Ferriss: And thank you for taking the time today as well.

Dr. Gabor Maté: It’s a great pleasure to speak with you. Thank you.

Tim Ferriss: And to everybody listening and watching, as I mentioned before, definitely, also visit the show notes. Revisit this. This is not a one and done, something you listen to, and then, you go on as if you never heard it. Please, look at the show notes. Look at Gabor’s work. And you can find all of that at tim.blog/podcast. And to everybody listening, I would just say, as always, thank you so much for joining in.

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