| GLOBE
& MAIL
Saturday,
March 15, 2003
Page: D7
Section: Health
Diagnosis:
a bad case of strained theory
Review by Robin Roger
In a note to the reader at the beginning of When The Body
Says No: The Cost of Hidden Stress, Vancouver physician
and author Gabor Maté states: "It is a pleasure
and a privilege . . . to bring in front of the reader
the findings of modern science that reaffirm the intuitions
of age-old wisdom." This seemingly simple statement
is confusing. Does Maté mean that he is bringing
only those findings that reaffirm wisdom? If so, what
about the "findings" which contradict this wisdom?
And if modern science reaffirms wisdom, is he equating
the two? This is but one example of the way in which Maté
implies a lot but clarifies little.
Maté's thesis, in a nutshell, is that the autoimmune
system fails when we are subjected to too much stress
and the chief cause of too much stress is repressed anger.
To prove this, he examines a host of fate-worse-than-death-diseases,
including ALS, multiple sclerosis, Alzheimer's and rheumatoid
arthritis, as well as a medley of other grim reapers such
as breast, prostate and skin cancer that appear to have
an autoimmune deficiency component. The "No"
in the title refers to the inability of many of the victims
of these diseases to say no to people (chiefly parents
and spouses) who exploited, abused, humiliated or neglected
them.
"When we have been prevented from learning how to
say no, our bodies may end up saying it for us,"
Maté concludes. Note the vague "may end up"
formulation. If our bodies may end up saying no, they
also may not.
To understand autoimmune disease, according to Maté,
is to understand the interplay of mind and body. The inability
to say no stems from a mind that represses, the stress
is felt in the body via autoimmune failure. The invisible
mental process of repression yields visible physical symptoms.
Thus, physical health is dependent on mental health. Although
Maté denies that he is blaming those who succumb
to illness for bringing it on themselves through their
psychological state, his own logic leads to this conclusion.
If physical health requires mental health, then mental
illness contributes to physical illness.
Maté presents the "findings of modern science"
that support his thesis, bombarding the reader with citations
from well over 100 scientific journals, textbooks, symposia
and other sources, as if sheer accumulation of data will
prove his point. But the reader is not in a position to
know how scientifically valid this data is. Many respected
publications are cited, but so are several experts and
organizations that could justifiably be described as New
Age, and are selling their stress-fighting products on
the Web. Furthermore, although Maté does not include
any studies that refute his point, they do exist. As an
example, Maté argues that stress is often the cause
of the progression of cancer in patients who lack support
or suffer from social disconnectedness. Yet the research
on the effect of support groups on survival has been "split
down the middle," according to the Harvard Health
Letter. Maté only provides half of the split, and
we are entitled to wonder why.
Maté profiles people with autoimmune and stress-related
diseases. Here the reader need not wonder about bias;
Maté openly leads his subjects to the conclusion
he wants. When a woman with irritable bowel syndrome states
that she has some marital problems he comments:
"These are problems you are aware of. Is it possible
that the pains you get reflect something else you haven't
been paying attention to? . . . perhaps [the pains] really
are gut feelings that are telling you something . . .
If you don't pay attention to them either, you really
are in deep trouble."
It seems almost comical that Maté would go about
proving the existence of repression in his subjects by
telling them they are repressed. By definition, repression
is not consciously accessible. A symptom may be a derivative
of repressed anger, but urging a patient to acknowledge
this will not result in awareness. What is bewildering
is that Maté knows this, as he explicates the insidious
and subtle ways that mental pathologies develop outside
of conscious awareness at other points in the book. It
seems as if he cannot restrain himself from forcing his
subjects to acquiesce with his theory. This is one of
the most disturbing aspects of the book. While claiming
to be the compassionate seeker of insight into agonizing
illness, Maté frequently appears to browbeat his
subjects, or worse, to reduce their complexities into
simple formulae.
Even so, this book has many strengths. Maté is
particularly good at explaining complex physiological
processes, such as the critical nexus of the hypothalamus,
pituitary and adrenal glands known as the HPA axis, and
how it functions as the "hub of the stress mechanism."
And we can all agree that trauma, suffering and deprivation
have terrible cascading consequences. When Maté
witnesses and testifies to human suffering, including
his own, he is compassionate and compelling. But when
he tries to prove his theory absolutely, my mind says
no.
Robin Roger is a writer and psychotherapist living
in Toronto.
BACK |
Now comes Gabor Maté , an
insightful, no-nonsense, and thoroughly compassionate
physician who provides an overview of all these perspectives
and comes to the marvelously humane conclusion that ADD/ADHD
is neither nature (genetics) nor nurture (parenting/environment)
but, rather, the result of the collision of a predisposing
nature with an ADD-hostile life situation, family, school,
or job. How refreshing!
-Thom
Hartman, author of ADD: A Different Perception and many
other books about ADD |
