Dr Rangan Chatterjee chats with Dr Gabor Maté about his radical findings based on decades of work with patients. We’re currently living in a culture that doesn’t meet our human needs. Maté and Chatterjee delve into how our emotional stress can translate into physical chronic illnesses, and how loneliness and a lack of meaningful connection are on the rise, as are the rates of autoimmune disease and addiction.
Related Post
Quality Social Connections (Relationships)Quality Social Connections (Relationships)
Did you know that through a series of controversial (and incredibly sad) experiments, psychologist Harry Harlow, was able to demonstrate the importance of early attachments, affection, and emotional bonds on the course of healthy development. Harlow discovered that love and affections may be primary needs that are just as strong as or even stronger than those of hunger or thirst.
1 Think positive
This sounds easier said than done. I challenge you to intentionally consider alternatives to your habitual, default thinking pattern. We all want to be liked by others – because we want to belong to a group and to feel valued, needed and wanted. Worrying about social situations is very natural because we want to be perceived by others in a certain way. Other people’s perceptions are out of our control. So, we worry about it. We worry about things that are out of our control. We also know that we control our own behaviour, therefore, we feel responsible for behaving in ways that will mesh with others. We believe the likelihood of being liked will increase if we behave in certain ways.
Worrying can become problematic if we overthink past and future interactions, and perhaps we choose to avoid some or all interactions to protect ourselves. But then we don’t get the social connection we need.
I challenge you to think positive. Choose that instead. It will take energy because it might not be your default thinking pattern. Set your positive intention. Use mental energy. Trust that the opposite of your thinking can be true as well.
2 Forget comparison – unless you are a clone of someone else, you don’t have their genes, their life experience, their upbringing, their family history etc. It’s kind of illogical to compare yourself to someone else if you think about it, hey.
Don’t be concerned if others appear to have more or better friends than you. Quality and enjoyment matter more than quantity. Savour the moments of connection, wherever you can find them.
3 Anticipate change
Our life circumstances can leave us vulnerable to a sense of isolation. Relationships shift over time, and we may lose touch with friends who were once important. People form new relationships, move away, start families, become busier at work or start studying etc. Accepting change as normal can help you adjust to a change in your relationships. Just as we grow, evolve, and change, so will our relationships. Couples who were once in love will fall out of love. And friendships that were once enjoyed may become less enjoyable overtime.
4 Tolerate discomfort
Anxiety may cause you to avoid socialising. Understand that feeling awkward or embarrassed in social situations does not mean you are doing anything “wrong”. I remember a period I went through growing up. I noticed people around me starting to use for sophisticated language. I thought I had nothing of value to say, or nothing of interest. I would struggle to form sentences in my head. I was becoming so anxious that my social cognition was compromised. Learning to be comfortable with myself, relaxing into conversations, and listening more deeply to the other person helped me. I remember going on dates thinking I have absolutely nothing to say to this person. That cognition, that thought, wasn’t true. It was part of a larger story that I was creating in my mind.
Reach out to others and your skills will improve with time.
5 Listen well
Practice listening. Ask questions and really listen to the answers, rather than just waiting for your turn to talk, or worrying about how you will respond. If you’re curious about what someone is saying, your mind will naturally form a question or recall a similar experience that you can share.
Respond warmly to people’s experiences through your posture, facial expressions and words. Put the mobile phone away and be present.
6 Rehearse
Out of practice with small talk? Spend some time thinking about questions you can use when conversation stalls. You might ask if the other person has been overseas or travelled, what music do they like, or what movies they like to see at the cinema. A natural question to ask is what did you get up to today? What do you have planned for the weekend?
I once attended a training for work. The facilitator shared her experience of often finding herself in similar situations, and she decided to formulate a “go-to” script for when she became tense, and a conversation stalled. Rather than panic, she had a mental go-to script to bridge the gap until the conversation returned to a natural flow. Sometimes it’s nice to allow for a silence, scan your environment and discuss something happening around you.
7 Go offline
Social media helps many people, but it can also increase disconnection, depression, loneliness, anxiety, and headaches. Ensure you have a healthy offline life. Perhaps invite trusted online friends to an offline meeting to build your relationship.
8 Help and service
Helping someone gives a feel-good rush. Oxytocin and dopamine neurotransmitters have been shown to be involved in human bonding. These chemicals can make us feel pleasure. Create a bond with someone by offering help or asking for it. If we’re not someone who asks for help often, the people who know us well will likely feel closer to you because you need them for something, nourishing the bond you have. Have you noticed that strangers in the street are often very willing to help someone with directions? It makes people feel good to help others and be helped in return. Something as little as assistance with a bag or holding a lift can help people feel seen and cared for.
9 Get involved
I know this one may make some people go “Eeeeek” and cringe. However, evolutionary and developmental psychology … and all psychology, has suggested time and time again, that feeling part of a larger community and getting involved makes us feel alive and part-of. Joining in connects you to other people, unites you in a shared activity, and provides an easy way to get to know people better.
Have you ever watched a group of people in the street having a laugh, or watched people playing a sports game, or doing an activity together – while you’re sitting alone on the outside. You might mock them to yourself to make yourself feel superior or protected. We’d rather be part of. It’s just the truth.
10 Manage stress
Everybody has some social situations they dread. Practice simple stress management techniques, such as breathing deeply and slowly, to help keep your stress in check through awkward moments.
We need stress to perform optimally. Befriend your stress. When it becomes overwhelming, recognise that it’s happening, allow it to be there, investigate where it’s living in your body, and nurture that part of yourself. Talk to a trusted friend in times of excessive or toxic stress. Do whatever you need to come back home to yourself. Rest. Drink water. Eat nutritious food. Shower or bathe. Spend time outdoors in nature. Watch something on tv. Listen to music. Come home to your true self, recharge the batteries, and then jump back in. You’re allowed to switch off for a while.
11. Practice, practice, practice
Relationship skills can be learnt. Don’t be discouraged. Remember that social connections are good for you. If you feel like you need support to build better connections skills, a counsellor or therapist can help.
We learn from new experiences. They create, wire, and strengthen, neural pathways in the brain. You can be silent and listen during social interactions. Get curious about the other person. Ask questions. Share some of your story and ideas. And breath. Practice makes progress – not perfection.
Predicting behaviour: Social Psychological Models of BehaviourPredicting behaviour: Social Psychological Models of Behaviour
Social psychological models of behaviour attempt to explain why individuals act the way they do in various social contexts. These models integrate individual, interpersonal, and societal factors to provide insights into behaviour. Here’s an overview of some key models:
1. Theory of Planned Behaviour (TPB) proposes that behaviour is influenced by:
– Attitudes toward the behaviour
– Subjective norms (perceptions of others’ approval)
– Perceived behavioural control (i.e., confidence in one’s ability to perform the behaviour [self-efficacy])
2. Social Cognitive Theory (SCT) suggests that behaviour is the result of:
– Reciprocal interaction between personal factors (beliefs, attitudes), environmental factors (social norms), and behaviour itself
– Concepts like self-efficacy (belief in one’s ability) play a major role.
3. Health Belief Model (HBM), designed to predict health-related behaviours. Behaviour is driven by factors such as perceived:
– Susceptibility (risk of harm)
– Severity (consequences of harm)
– Benefits (advantages of action)
– Barriers (obstacles to action)
4. Cognitive Dissonance Theory explains how people strive for consistency between their beliefs, attitudes, and behaviours. When inconsistency arises, they feel dissonance (mental discomfort) and are motivated to reduce it by changing their attitudes or actions.
5. Social Identity Theory examines how individuals define themselves within social groups. Behaviour is influenced by group membership, including in-group favouritism and out-group bias.
6. Attribution Theory focuses on how people explain their own and others’ behaviours. Explains behaviour as being attributed either to internal (dispositional) or external (situational) factors. For example, it is common for people to attribute negative outcomes in their life to external factors rather than internal factors.
7. Elaboration Likelihood Model (ELM) explains how people process persuasive messages and what determines whether those messages will change attitudes or behaviour. It’s often applied in areas like marketing, communication, and public health campaigns. The ELM identifies two primary routes through which persuasion can occur:
– Central Route; this route involves deep, thoughtful consideration of the content and logic of a message. People are more likely to take the central route when they are motivated to process the message (e.g., the topic is personally relevant or important to them) and they can understand and evaluate the arguments (e.g., they aren’t distracted, and they have enough knowledge about the subject). Persuasion through the central route tends to result in long-lasting attitude change that is resistant to counterarguments. Example: A person researching the pros and cons of electric cars before deciding to buy one.
– Peripheral Route, which relies on superficial cues or heuristics (mental shortcuts) rather than the message’s content. People are more likely to take the peripheral route when they are not highly motivated or lack the ability to process the message deeply, and when they focus on external factors like the attractiveness or credibility of the speaker, emotional appeals, or catchy slogans. Persuasion through this route tends to result in temporary attitude change that is less resistant to counterarguments. Example: A person choosing a product because their favourite celebrity endorsed it.
8. Self-Determination Theory (SDT) emphasizes intrinsic and extrinsic motivation. It emphasizes the role of intrinsic motivation—doing something for its inherent satisfaction—over extrinsic motivation, which is driven by external rewards or pressures. It suggests that behaviour is influenced by the need for:
– Autonomy (control over one’s actions); When people perceive they have a choice and are acting in alignment with their values, their motivation and satisfaction increase.
– Competence; Refers to the need to feel effective, capable, and successful in achieving desired outcomes. People are motivated when tasks challenge them at an appropriate level and provide opportunities for growth and mastery. Example: A gamer progressing through increasingly difficult levels, gaining skills and confidence along the way.
– Relatedness; Refers to the need to feel connected to others and experience a sense of belonging. Supportive relationships and positive social interactions enhance motivation and well-being. Example: Employees feeling a bond with their colleagues in a collaborative work environment.
9. Social Learning Theory proposes that behaviour is learned through observation and imitation. Role models and reinforcement play a key role in shaping actions.
10. Transtheoretical Model (Stages of Change) explains behaviour change as a process occurring in stages: precontemplation, contemplation (ambivalence), preparation, action, and maintenance
These models provide frameworks to understand behaviours in contexts like health, decision-making, group dynamics, and social influence.
The continued differential treatment of mental illness and addiction compared to physical illness by broader society is rooted in several factors:The continued differential treatment of mental illness and addiction compared to physical illness by broader society is rooted in several factors:
Historical Context
Historically, mental illness and addiction have been misunderstood and stigmatized. For much of history, these conditions were seen as moral failings or character flaws rather than medical issues. This has led to a persistent stigma that continues to influence societal attitudes.
Lack of Awareness and Education
There is still a significant lack of awareness and education about mental health and addiction. Many people do not understand that these conditions are medical issues that require treatment, just like physical illnesses. This lack of understanding contributes to negative attitudes and discrimination.
Media Representation
Media often portrays mental illness and addiction in a negative light, reinforcing stereotypes and misconceptions. These portrayals can shape public perception and contribute to the stigma surrounding these conditions.
Criminalization
Addiction, in particular, has been heavily criminalised. This has led to a perception of addiction as a criminal issue rather than a health issue, further entrenching stigma and discrimination.
Internalised Stigma
Individuals with mental illness or addiction often internalise the stigma they experience, leading to feelings of shame and low self-worth. This can prevent them from seeking help and support, perpetuating the cycle of stigma and discrimination.
Healthcare System
Even within the healthcare system, biases and stigma can affect the quality of care provided to individuals with mental illness or addiction. This can lead to inadequate treatment and support, further exacerbating the issue.
Social and Cultural Factors
Social and cultural factors also play a role in how mental illness and addiction are perceived. Different cultures have varying attitudes towards these conditions, which can influence how they are treated and supported.
The differential treatment of treatment-resistant substance use disorder (SUD) and treatment-resistant cancer by society can be attributed to several factors:
1. Perception of Control
Substance use disorders are often perceived as a result of personal choices or moral failings, whereas cancer is seen as an uncontrollable disease. This perception leads to stigma and blame towards individuals with SUD, while those with cancer are more likely to receive sympathy and support.
2. Historical Stigma
Historically, substance use has been stigmatised and criminalised, leading to a societal view that addiction is a choice rather than a medical condition. In contrast, cancer has been recognized as a medical condition requiring treatment and compassion.
3. Media Representation
Media often portrays substance use in a negative light, emphasising criminality and moral failure. Cancer, on the other hand, is often depicted with empathy and urgency, highlighting the need for medical intervention and support.
4. Healthcare System
The healthcare system has historically been more equipped to handle cancer treatment, with extensive research, funding, and specialized care. SUD treatment has lagged behind, with fewer resources and less comprehensive care options.
5. Complexity of Treatment
Treatment-resistant SUD involves complex psychological, social, and biological factors, making it challenging to treat effectively. Cancer treatment resistance, while also complex, has seen significant advancements in research and technology, leading to more effective treatments.
6. Social and Cultural Factors
Cultural attitudes towards substance use and addiction vary widely, with some societies viewing it as a personal failing. Cancer is generally viewed more universally as a disease that requires medical intervention.
REFERENCES
Substance Use Disorder and Stigma
Australian Government Department of Health and Aged Care. (2024). Initiatives and programs. Retrieved from https://www.health.gov.au/about-us/what-we-do/initiatives-and-programs
Morrison, A. P., Birchwood, M., Pyle, M., Flach, C., Stewart, S. L. K., Byrne, R., Patterson, P., Jones, P. B., Fowler, D., & Gumley, A. I. (2013). Impact of cognitive therapy on internalised stigma in people with at-risk mental states. The British Journal of Psychiatry, 203(2), 140-145. https://doi.org/10.1192/bjp.bp.112.112110
Wood, L., Byrne, R., Burke, E., Enache, G., & Morrison, A. P. (2017). The impact of stigma on emotional distress and recovery from psychosis: The mediatory role of internalised shame and self-esteem. Retrieved from https://repository.essex.ac.uk/21927/1/woodpr2017.pdf
Cancer Treatment and Stigma
American Cancer Society. (2023). Cancer treatment and survivorship. Retrieved from https://www.cancer.org/treatment/treatments-and-side-effects.html
National Cancer Institute. (2022). Cancer treatment (PDQ)–Patient version. Retrieved from https://www.cancer.gov/types/treatment-pdq/patient/cancer-treatment-pdq
World Health Organization. (2021). Cancer treatment and palliative care. Retrieved from https://www.who.int/cancer/prevention/diagnosis-screening/cancer-treatment-palliative-care/en/