Last night, I attended Gabor Maté’s talk on “Trauma, Illness & Healing in a Toxic Culture” and it was certainly a thought-provoking experience. Maté’s talk revolves around the profound impact of trauma on our physical and mental well-being, challenging conventional understandings of conditions like ADHD, autoimmune disease and mental illness. He argues that it’s not “what happened to us, but what happens inside of us” that shapes our lives, emphasising the need to “change our mind” and acknowledge the role of early experiences.
“It’s not what happened to us, but what happens inside of us”
Maté’s perspective on ADHD was particularly striking. He asserts that ADHD is not primarily genetic, but rather a diagnosis that doesn’t truly explain the underlying issues. He suggests that the impact of experiences, particularly trauma, plays a much more significant role. He has been diagnosed with ADHD himself and shared his own experience of “tuning out” as a manifestation of his personal trauma. He indicated that medication made him more of a workaholic.
While I appreciate Dr. Maté’s focus on trauma and early childhood experiences, his conclusions about ADHD’s origins is not something I agree with. He downplays the role of genetics, but many studies point to a strong genetic link. My own work as a psychologist and previously as a caseworker in child protection, brighter futures, and out-of-home care adoptions has given me firsthand experience with hundreds of traumatised children and families, including those dealing with trauma. This work has shown me just how complex ADHD and trauma is. Many children who experience trauma are diagnosed with ADHD, but many others aren’t.
Trauma comes in many forms – accidents, war, medical trauma, bullying, abuse, neglect – and it’s something almost everyone experiences at some point. Yet, according to a 2009 meta-analysis by Simon et al., only a small percentage of adults (around 2.5%) are diagnosed with ADHD. This discrepancy raises important questions that we need to explore further. Why do some children exposed to trauma develop ADHD while others don’t? What other factors are at play?
ADHD is a neurodevelopmental disorder that affects attention, hyperactivity, and impulsivity. It’s one of the most common childhood disorders, affecting about 5% of children, and it can continue into adulthood, causing problems with work, relationships, and self-esteem. We don’t fully understand what causes ADHD, but it’s believed to be a mix of genetic and environmental factors. Research indicates that ADHD is highly heritable, meaning it can be passed down through families. In fact research, such as Faraone and Larsson (2019) suggests that genetics account for about 74% of the risk of developing ADHD. Large studies, like the one by Demontis et al. (2019), have identified several genes that may be involved, affecting how the brain develops and works. While environmental factors certainly play a role, this several years of research (that is still ongoing) highlights the genetic basis of ADHD.
Maté also discussed the societal pressures to conform, and the “conditioning” from trauma that forces us to suppress our authentic selves. He stressed the importance of recognising and embracing our authentic selves and the felt sense of authenticity rather than an idea or a belief in our thinking mind.
One of the most powerful aspects of the evening was the Q&A session. A brave woman shared her experience with trauma and multiple diagnoses, including Borderline Personality Disorder and ADHD, expressing feelings of being “broken.” Maté responded with compassion, challenging the notion of being “unbroken” as a belief rooted in shame. He guided her to explore where she felt this “brokenness” in her body, highlighting the deeply personal nature of trauma.
Another woman recounted her experience with domestic violence and the estrangement from her adult children. Maté offered suggestions for acceptance and acknowledged the complex dynamics of family relationships, particularly the unique challenges faced by mothers. He mentioned something that resonated with some and perhaps not with others. He indicated that women often face unfair blame from their children, particularly in situations of conflict. This comment, while perhaps intended to offer solace, felt somewhat generalised and potentially problematic. I know many individuals who deeply love and appreciate their mothers, especially those who have escaped and are survivors of abusive relationships. The complexities of these situations are vast, and generalisations can be harmful.
Overall, Gabor Maté’s talk was a valuable contribution to the conversation surrounding trauma, mental health, and the search for our authentic selves. While I don’t agree with all of his conclusions, particularly regarding the dismissal of genetic factors in mental health conditions, his emphasis on the psychosocial model and the importance of considering trauma in diagnosis and treatment is crucial. His compassionate approach to addressing individual stories of pain and resilience was deeply moving, and the evening provided much food for thought. It’s clear that the interplay between trauma, genetics, and environment is complex, and further research is needed to fully understand these intricate connections. We need to acknowledge the complexity of mental health conditions like ADHD, listen to people’s lived experiences and move beyond simplistic explanations. For many, like those I worked with, both trauma and ADHD are realities that need to be addressed concurrently for healing to begin.
References
Demontis D, Walters RK, Martin J, et al.: Discovery of the first genome-wide significant risk loci for attention deficit/hyperactivity disorder. Nat Genet 51(1):63–75, 2019 30478444
Maté, G. (2025, February 16). Trauma, Illness & Healing in a Toxic Culture. [Conference presentation]. ICC Sydney Theatre, Sydney, Australia.
Faraone SV, Larsson H: Genetics of attention deficit hyperactivity disorder. Mol Psychiatry 24(4):562–575, 2019.