Articles by Dr. Maté

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The Globe and Mail, January 2007

Addictions always originate in unhappiness, even if hidden.

They are emotional anesthetics; they numb pain.  The first question — always — is not “Why the addiction?” but “Why the pain?” The answer, ever the same, is scrawled with crude eloquence on the wall of my patient Anna’s room at the Portland Hotel in the heart of Vancouver’s Downtown Eastside: “Any place I went to, I wasn’t wanted. And that bites large.”
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The Globe and Mail, January 18, 2007

The U.S.-style law-and-order drug policies that the Conservative cabinet appears poised to embrace are doomed to fail in this country, as they have everywhere. What’s worse, they make impossible the rational and humane treatment of hard-core drug addiction.

It is not feasible to rehabilitate large numbers of substance-dependent people in the context of the so-called war on drugs. “The federal government continues to invest heavily in policies and practices that have been repeatedly shown in the scientific literature to be ineffective or harmful,” says a new study by physicians and researchers at the B.C. Centre for Excellence in HIV/AIDS. more »

The Globe and Mail, February 5, 2008

Marlene, a 46-year old native woman, sat in my office last week, slumped on her chair, blinking away her tears. I’d just shared the news that her most recent blood test confirmed she had “seroconverted” to HIV, become infected with the AIDS virus. Although an injection drug user, Marlene had always been careful to use clean needles. Her route of infection was sexual contact — with the resigned naiveté characteristic of so many aboriginal women in Vancouver’s Downtown Eastside, she had trusted a man, himself a drug addict, who assured her that he was a safe partner.
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The Globe and Mail, June 2004

Until his death this week, former U.S. president Ronald Reagan was the world’s most famous Alzheimer’s sufferer. “I now begin the journey that will lead me into the sunset of my life,” he wrote in his poignant farewell message to Americans when he was first diagnosed at 83.

The acknowledgment marked the formal onset of his long, sad decline, but it may be that Mr. Reagan’s entire life history and long-established emotional patterns had prepared the ground for the illness that eventually robbed him of thought, speech and movement.
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The Globe and Mail, February 1, 2003

Many CBC listeners were chagrined to learn last week that radio personality Shelagh Rogers is taking a break from her national morning program, Sounds Like Canada. Although Ms. Rogers is rumoured to be exhausted from hassles with CBC management, the ebullient radio host insisted, “It is not a stress leave. It is because I have high blood pressure.”

Ms. Rogers may be excused for making that false distinction. In keeping with the mind/body split endemic in Western culture, the medical profession itself fails to recognize — despite ample research evidence — the connection between the stresses of modern life and elevated blood pressure. Insufficient attention is paid to stress reduction as a way of treating high blood pressure.
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The Globe and Mail, May 28, 2005

Now that the winds of acrimony blowing from Ottawa have abated, we can reflect upon the differing emotional displays of our political leaders. They have much to teach us about how dysfunctional anger may afflict our personal lives.

We saw, on the one hand, the quietly poisonous anger of Stephen Harper. Even before Belinda Stronach’s defection, the Conservative leader was described as “simmering” these past few weeks. The day Ms. Stronach abandoned his party, Mr. Harper denounced her with soft sarcasm. His eyes glowering, his mouth pulled into the hint of a smile, he slipped in the dagger. “I never noticed complexity to be Belinda’s strong point,” he said, exhibiting passive-aggressive resentment.
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The Globe and Mail, November 28, 2008

Among the major challenges we face, as a society, is the widespread lack of resilience of many young people. Resilience is the capacity to overcome adversity, to let go of what doesn’t work, to adapt and to mature. Growing evidence of its absence among the young is as ominous for our future as the threat of climate change or financial crisis.

A disturbing measure is the increasing number of children diagnosed with mental-health conditions characterized by rigid and self-harming attitudes and behaviours, such as bipolar disorder, attention deficit hyperactivity disorder, eating disorders and “conduct” disorders. Hundreds of thousands of American children under 12 are being prescribed heavy-duty antipsychotic medications to control behaviours deemed unacceptable and unmanageable.
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The Globe and Mail, January 14, 2006

Many parents would be horrified at the sadism their children favour as entertainment. Ought they to be worried?

In Hostel, the gore flick young audiences have made into North America’s top-grossing theatre attraction, human beings perpetrate on one another whatever can be accomplished with knives, hooks, scalpels, tongs, drills, pincers and electrical saws.
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The Globe and Mail, June 4, 2008

Canada’s Health Minister urgently needs an education in harm reduction. Announcing his intention to shut down Insite, the supervised injection facility serving drug addicts in Vancouver’s Downtown Eastside, Tony Clement told the House of Commons health committee that “supervised injection is not medicine; it does not heal the person addicted to drugs.”

Mr. Clement got one thing right: Supervised injection does not heal addiction. It is, however, completely in line with accepted medical practice.
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The Globe and Mail, June 9, 2007

Researchers have deciphered the full DNA makeup of a single human being, a remarkable achievement which has, unfortunately, driven the crescendo of misplaced genomic enthusiasm to new heights. “This human’s life, decoded” was the front page headline in the Globe two days ago. Predictions of individualized gene-based therapies for a host of diseases are again being voiced, an expectation sure to be frustrated by scientific reality.

It’s not that genes do not matter–- they certainly do; it’s only that they do not and cannot determine even simple behaviours, let alone the infinitely complex and sacred process that is a human life. Nor can genes explain most illnesses or address possible cures for them.
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The Globe and Mail, February 25, 2006

During my years in family practice, I often noticed that the death or illness of a person, especially among the elderly, was rapidly followed by the illness or even death of the spouse. Such “coincidences,” noted by many physicians, have now been documented by a large-scale medical study.

The report, published in the New England Journal of Medicine, found that elderly people whose spouses are admitted to hospital are themselves at increased risk of death in the near future. “People are interconnected, and so their health is interconnected,” said Nicholas Christakis, the lead author and a professor at Harvard Medical School. His article acknowledged the existence of, so-named, “interpersonal health effects.” more »

The Globe and Mail, February 4, 2006

‘Some of our friends see us as weak parents because we haven’t Ferberized our children,” says my niece Rachel Maté, a 33-year-old Vancouver lawyer and mother of two. ” ‘You’re letting your baby control your lives,’ they argue. But it would break my heart to let my baby cry without comforting her.”

Named after Dr. Richard Ferber, the pediatric sleep expert quoted in Jan Wong’s article (in this section last week) on parents who share their beds with their children, Ferberization is the process of “training” an infant to sleep by ignoring her crying. As a family physician, I used to advocate the Ferber technique and, as a parent, practised it myself. Since then, I have come to believe that the method is harmful to infant development and to a child’s long-term emotional health.
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The Globe and Mail, February 9, 2005

The official U.S. response to the free heroin trial about to begin in Vancouver is predictably negative. A spokesman for John Walters, director of the White House Office of National Drug Control Policy, calls it “an inhumane medical experiment.”

“I would bet any amount of money the U.S. has exerted extreme pressure on Canada to abort this trial,” Alex Wodak, a prominent Australian addictions researcher, has said. He should know: U.S. opposition helped to abort a heroin trial in his country. It is to Ottawa’s credit that Canada has resisted similar pressure from the Bush administration, whose addictions policies owe more to narrow moralism than to science, compassion or insight.
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The Globe and Mail, February 5, 2005

When our two grown-up sons were in elementary school, my wife and I despaired of their ever getting along. Bickering, insults, mutual recrimination and, at times, physical altercations were the order of the day. The seemingly incessant squabbling went on for years. Our older son in particular appeared determined to make his brother’s life utterly miserable.

We made the same two mistakes many other parents fall into when they see their kids at odds with one another. First, we projected our children’s behaviour into the future, believing that these patterns would inevitably persist unless we nipped the fraternal hostility in the bud. Second, we focused on the behaviours, attempting to root them out by means of cajoling, lecturing, threats and, finally, punishments. We were triggered into acting in ways we later regretted. It’s in the nature of sibling conflict to bring out the deepest anxieties and least adaptive responses in the parent.
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The Globe and Mail, August 21, 2004

Nine-year-old Naomi stood in front of the mirror, an expression of rage on her face, her left hand pulling at her hair while with her right she wielded the scissors. Shiny black locks fell to the floor. When her mother, shocked at this act of self-mutilation, tried to intervene, the child pointed the scissors at her and screamed.

Naomi’s behaviour turned out to be the effect of a sudden stoppage of the antidepressant paroxetine, better known under its trade name of Paxil. Paroxetine belongs to a class of drugs called selective serotonin re-uptake inhibitors, or SSRIs, widely used in the past two decades in the treatment of depression, anxiety and other disorders.
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The Globe and Mail, January 17, 2004

Should cancer of the lung be added to the list of health risks women face just because they are women?

A study presented recently at the annual meeting of the Radiological Society of North America in Chicago showed that women who smoke are twice as likely to develop lung cancer as their male counterparts. As a risk factor for smokers, female gender appears to outweigh age and amount smoked. Some researchers point fingers at the female hormone estrogen, but there is strong evidence implicating a more likely culprit: the bottling up of emotions, particularly anger.
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The Globe and Mail, October 17, 2003

Autism is increasing at an alarming rate, according to Autism Society Canada, and may have doubled in the past decade. About 105,000 Canadians have an autistic or other developmental disorder, and 3,000 new cases were diagnosed in Canada in 2002. Statistics from school boards in Saskatchewan, British Columbia and Quebec show an average increase in autism cases of 63 per cent over the last two years. Experts see no clear reason for the increase. The answer appears invisible only because it’s too close for us to recognize it.
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The Globe and Mail, December 18, 2004

Recent news should alarm all but the most complacent observers of today’s youth scene. In Toronto, two teenagers have been stabbed to death by their peers in the past few weeks, one just outside his own home as he tried to prevent some party-crashers from entering. Also in Toronto, three adolescents are on trial for the killing of a 12-year-old boy, the younger brother of one of the accused. The police officer who arrested two of them testified that, on being apprehended, they “seemed unconcerned . . . they seemed, uh, cold.”

Such events, still shocking if no longer unusual, bespeak a deep current of aggression in present-day youth culture and also an emotional detachment that has drained many young people of healthy human reactions.
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The Vancouver Sun, April 8, 2003

“I never get angry,” says a Woody Allen character in one of the director’s movies, “I grow a tumour instead.” Much more scientific truth is encapsulated in that droll remark than many doctors would recognize.

For all its triumphs and technical progress, mainstream Western medical practice militantly dismisses the role of emotions in the physiological functioning of the human organism. Its rejection of the mind/body unity is a classic case of denial.
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The Globe and Mail, September 17, 2003

A Statistics Canada study on job stress, reported last week in the journal Canadian Social Trends, ought to rivet the attention of Canadian economic and political leaders.Work-related stress takes a high toll on the emotional well-being of millions of employees, undermines the health of many and incurs a forbidding financial penalty. Stress-induced absences have been calculated to cost employers about $3.5-billion annually, and that figure that does not include the medical expenses of treating stress-induced illness. Much job strain could be prevented if those who have the power to make decisions understood some basic principles.

Much more than emotional upset, stress is a wide-ranging sequence of physiological events involving virtually every organ in the body. The emotional centres in the brain that process stressful stimuli are directly linked with the nervous system, the hormonal apparatus and the immune system. Chronic stress, therefore, has profoundly negative effects on health. It weakens immunity, exhausts the nervous system and upsets the body’s hormonal balance.
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The Globe and Mail, July 2003

The observer may be excused who, looking at the ecstatic faces pictured on the front pages of Canada’s national daily and of its local Vancouver competitors, were to believe that some event of great and joyous moment to humankind was being reported on the morning of July 3.  But no, we are celebrating the 2010 Winter Games.  We greet with unbridled happiness nothing more than a decision that, seven years hence, a series of competitions to be pursued on flat icy surfaces or on frozen or powdered slopes will take place in southern British Columbia.

Many people not caught up in the triumphalist frenzy regard this news as disconcerting, at the very least.  Only two weeks ago the B.C. government was prevented by public outrage, no more than temporarily perhaps, from shutting down facilities for learning-disabled children and emotionally traumatized youth in order to save a paltry 22 million dollars.  Now hundreds of millions are to be lavished on a highway so that athletes and rich spectators may have easier passage to the ski hills of Whistler. Future generations will consider with dismay what this scale of priorities denotes about the values we as a society cherish today.
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The Globe and Mail, October 12, 2002

The Bully, the Bullied, and the Bystander: From Pre-School to High-School — How Parents and Teachers Can Break the Cycle of Violence
By Barbara Coloroso
HarperCollins, 217 pages, $34.95

And Words Can Hurt Forever: How to Protect Adolescents from Bullying, Harassment, and Emotional Violence
By James Garbarino and Ellen de Lara
Free Press, 238 pages, $38

Bullying has a long and dishonourable tradition, as anyone will know who recalls the swaggering but cowardly ruffian Flashman from the Victorian boys’ classic, Tom Brown’s Schooldays. We may soothe ourselves with the notion that what we are witnessing today in our children’s lives is no fresh cause for alarm, but the facts are not reassuring.
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The Globe and Mail, March 1, 2003

This week, a seven-year-old boy in Timmins, Ont., became front-page news across the nation because his parents are suing the local board of education. They allege that he has been repeatedly locked in a closet at school to control his behaviour.

Such punishment may seem cruel, but it is not all that unusual. It’s an extreme example of the classic “time-out” — one of the more prevalent, and pernicious, notions advocated by parenting experts.
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The Globe and Mail, January 18, 2003

Gordon Campbell’s drunken driving arrest is more than a painful episode in the life of an individual and more than a “severe misjudgment,” as the B.C. premier’s said, in the career of a politician.  It highlights the dysfunction that characterizes the lives of many adults whose childhoods were blighted by the alcoholism of their parents.

Mr. Campbell was 13 when his father committed suicide in a state of alcohol-related depression.  A childhood spent under the shadow of alcoholism could explain much about the premier’s public stiffness and perceived aloofness from ordinary people.  It also helps to account for a political style that has him, without the least show of concern, institute policies which throw old people out of nursing homes or force pregnant women to travel long distances to give birth or impoverish the most helpless and vulnerable members of society.   On a personal level it is not a lack of humanity that underlies such manifestations but wounded humanity; not a lack of feeling but, on the contrary, too much emotional pain.
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The Globe and Mail, March 21, 2002

The trial of two British Columbia teenagers, awaiting judgment next week, has again highlighted the problem of school bullying.

The girls were charged with uttering threats in the wake of the suicide of 14-year-old Dawn-Marie Wesley. In November, 2000, Dawn-Marie killed herself shortly after she was accused of spreading false rumours. She was allegedly threatened with a beating, or even death.
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The Vancouver Sun, March 2000

The report of a Port Hardy teacher taping a seven-year-old hyperactive boy’s head to his desk ought to ring alarm bells about the ill-preparedness of our educational system to cope with the increasing number of children struggling with attention deficit/hyperactivity disorder and other neuropsychological problems.

This particular teacher’s response may not be typical either of her or of teachers in general. It does, however, exemplify the helpless frustration many educators feel when confronted with the disruptive and out of control behaviour of the troubled child who, single-handedly, appears to have the power to make shambles of an entire day’s lesson plan. If we are to avoid the shaming attitudes that so often make the classroom experience of the ADD child a humiliating misery, we need to conduct a compassionate inquiry into the emotional life of the child and appreciate the physiological and psychological impulses that drive his behaviours. Beyond that, school boards and governments must avoid making individual classroom teachers solely responsible for what is clearly a growing problem of societal dimensions.
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The Globe and Mail, July 2000

Expressions of near-religious awe and prophesies of dramatic medical advances greeted last week’s announcement that scientists are close to deciphering the human genome, the genetic blueprint for the human body.  “Today we are learning the language in which God created life,” President Bill Clinton said at the White House ceremony marking the truce between two groups of scientists racing to complete the genome.  “I truly feel this is going to revolutionize medicine because we are going to understand not only what causes disease but what prevents disease,” enthused Dr. Stephen Warren, a U.S. medical geneticist and editor of The American Journal of Human Genetics.

The actual results are bound to be disappointing, except perhaps to the profit margins of pharmaceutical companies and to the grant coffers of researchers. A sober assessment would show that very little can be expected from the genome program that will lead to any health benefits of broad significance in the near future, if ever.
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