Why Our Toxic Culture Is Making Us Sick

Over four decades of clinical experience, Gabor Maté has come to recognize the prevailing understanding of “normal” as false, neglecting the roles that trauma and stress, and the pressures of modern-day living, exert on our bodies and our minds at the expense of good health. Western medicine often fails to treat the whole person, ignoring how today’s culture stresses the body, burdens the immune system, and undermines emotional balance.

Co-written with his son Daniel, The Myth of Normal is Maté’s most ambitious and urgent book yet. It connects the dots between the maladies of individuals and the declining soundness of society, offering a compassionate guide for health and healing.

The Two-Fold Problem: Split Medicine and Toxic Society

There is a two-fold problem leading to epidemics of chronic mental and physical health problems such as depression, burnout, autoimmune diseases, and heart disease. The first problem is that our whole conception of medicine and healthcare is too split into a biological view and a psychological view. While we know that many health problems are psychosomatic in nature, we do not treat them that way.

The second problem is that our society exacerbates these health problems and more often than not profits from them. The entire social construct of the world we’re living in is deeply flawed, with toxicities on every level. Capitalist society is making us physically and mentally unwell on a vast scale.

We Live in a Toxic Culture

What we have come to accept as “normal” is actually abnormal and fails to meet natural, inborn needs. In terms of physical health alone, statistics from the US tell a disturbing story: 60% of American adults have a chronic disorder, such as diabetes or hypertension; over 40% have two or more such conditions; and nearly 70% are on at least one prescription medication.

Diagnoses of mental illness, especially anxiety and depression, are also skyrocketing in the Western world. Amid spectacular economic, technological, and medical resources, our society induces countless humans to suffer illness born of stress, ignorance, inequality, environmental degradation, climate change, poverty, and social isolation.

For better or worse, we humans have a genius for getting used to things, especially when the changes are incremental. The newfangled verb “to normalize” refers to the mechanism by which something previously aberrant becomes normal enough that it passes beneath our radar. On a societal level, “normal” often means “nothing to see here”: all systems are functioning as they should, no further inquiry needed.

The truth as Maté sees it is quite different.

Expanding the Concept of Trauma: Small-t Versus Big-T

Maté expands the concept of trauma beyond its typical usage. The word is generally used to characterize profound distress related to the experience of war, natural disasters, or extreme abuse. He believes there’s another dimension: what he calls “small-t” trauma, the painful daily events that adversely affect individuals and predispose them to both physical and mental illness.

Small-t traumas are events that exceed our capacity to cope and cause a disruption in emotional functioning. They refer to distressing experiences that may not seem overwhelmingly dangerous or threatening at the time, but still deeply affect a person’s sense of safety, worth, or belonging. These can include constant criticism from caregivers or teachers, chronic feelings of neglect or being overlooked, relationship conflicts, prolonged stress, emotional abuse, loss of a job, or other everyday challenges.

Evidence now concludes that repeated exposure to little-t traumas can cause more emotional harm than exposure to a single big-T traumatic event. Failing to recognize or minimizing the impact of little-t trauma can create adverse coping behaviors such as bottling up emotions or attempting to manage symptoms without support.

The Gap Between How We Live and How Our Biology Wants Us to Live

Once, mental strains were addressed by communal activities and personal connections, but those remedies are vanishing in the digital age. The second level is the economic organization of techno-capitalism, which creates conditions of inequality, reclusiveness, and manipulation. Taken together, these issues create a yawning gap between how people live and how their biology wants them to live.

The constant pressure to perform in capitalist environments leads to chronic stress. This relentless pace can result in burnout, a state of physical and emotional exhaustion. Capitalism thrives on competition, and this competitive atmosphere fuels anxiety. The fear of job loss, financial instability, and the perpetual race to outdo others trigger significant mental health issues.

Attachment Versus Authenticity: The Childhood Trade-Off

A caregiver’s failure to respond to children’s distress induces panic. The preverbal child gets the message that the world is unsafe, that no one will help when they’re scared. Anxiety and other psychological problems begin to take root.

Two human needs compete during childhood: attachment and authenticity. Attachment will always win out over authenticity. The child learns early that nothing must threaten the bond with their parent; survival depends on it.

If certain of the child’s tendencies, the expression of anger, for example, are considered unacceptable or unlikeable by the parent, the child will suppress or repress them so as not to compromise the relationship. When those needs conflict, kids will always choose attachment over authenticity because survival depends on connection. The cost? They decide a part of them is “bad,” repress it, and abandon pieces of themselves to stay loved.

It is this stifling of aspects of one’s essential nature that leads to problems, including physical illness, down the road. Our job as parents is to notice that trade and to do our best to make sure love never hinges on performance. Kids don’t need perfect parents; they need present ones. Presence, love, humility, and consistent repair grow the kind of attachment where authenticity can come home.

The Shocking Prenatal Effects of Maternal Stress

The prenatal effects of stress in the mother on the brain of the developing baby is shocking, especially how stress in the mother can lead to emotional and behavioral problems in the child years later. Equally shocking is how our culture has so little eye for stress-free pregnancy.

How many women are asked during prenatal checkups about their mental and emotional states, what stresses at home or on the job they may be experiencing? How many future physicians are even taught to pose such questions?

Dismissing Genetics: Trauma as Adaptation

Maté dismisses genetics and contends that many mental afflictions are understandable adaptations to needs that went unmet early in life. He laments that so few clinicians ask patients, even those who present with autoimmune disorders, what they’ve gone through in the time leading up to symptom presentation.

Research shows childhood trauma is significantly connected to elevated incidence of disease, chronic pain, and premature death. The more childhood traumatic events participants reported, the more chronic conditions they had. Mental health and socioeconomic status partially explain this association, but mental health contributed more to the analysis than socioeconomic status did.

Trauma exposure can result in shortened telomere length in chromosomes and advanced biological aging. Epigenetics and the modification of gene expression through methylation of DNA can be directly affected by trauma.

Mind-Body Split: A Recent and Flawed Invention

The distinction between the “mind” and the “body” is a relatively recent invention of Western Medicine, and one that even by its own standards of evidence doesn’t hold up to scrutiny. Our “mental” illnesses can be felt in the body, and our “physical” problems are often connected to our mental states, traumas, and outlooks.

Psychological trauma and early life adversity have been significantly connected to elevated incidence of disease and chronic pain. Shared characteristics among trauma, chronic pain, and disease include anxiety, depression, hyperarousal, behavioral avoidance, emotional lability, and difficulties with emotion regulation.

The Dangerous Link Between Niceness and Chronic Illness

Maté’s observation about the link between “niceness” and chronic illness has been the subject of research. A 1965 survey showed that people with rheumatoid arthritis, another chronic disease, displayed “an array of self-abnegating traits: a compulsive and self-sacrificing doing for others, suppression of anger, and excessive concern about social acceptability.”

Personality traits can confer risk for disease, in part, through health-risk behaviors. The impulsiveness facet of neuroticism was the strongest predictor of developing disease: For every standard deviation increase in impulsiveness, there was a 26% increased risk of developing disease and a 36% increased risk of getting more ill.

Research on chronic diseases shows suffering from physical illnesses increases irritability and interpersonal conflicts, perhaps because of a lowered level of patience or concern for other people’s troubles. As participants developed chronic illnesses, personality traits changed only modestly, with people becoming more conservative and closed off.

The Gender Gap: Why Women Bear the Burden

Given these personality traits, it shouldn’t be a surprise that women are at higher risk for chronic illness. Stress plays an “incendiary role” in whether or not a genetic predisposition will result in illness. And the gender gap has been borne out in the research. Women take twice as many antidepressants, get 80 percent of autoimmune disease, they get more chronic illness, more chronic pain than men do.

Yet women’s stress is often overlooked, Maté argues. Women are society’s “shock absorbers.” During Covid, on top of their own duties, women took on alleviating the stress of their husbands and their children. And they felt guilty when they couldn’t successfully do so. Women have always played that role in this patriarchal culture. It’s a society that imposes a certain expectation on one gender.

Acute Stress Versus Chronic Stress: Two Forms, Different Impacts

Stress can show up in two forms: as an immediate reaction to a threat or as a prolonged state. While acute stress is a necessary reaction that helps maintain our physical and mental integrity, chronic stress, ongoing and unrelieved, undermines both.

Situational anger, for example, is an instance of acute stress being marshaled for a positive purpose. Chronic rage, by contrast, floods the system with stress hormones long past the allotted time. The constant pressure to perform can lead to chronic stress, which manifests as physical symptoms like headaches, muscle tension, and fatigue. Over time, chronic stress can weaken the immune system and increase the risk of serious health problems such as heart disease and hypertension.

American Corporate Capitalism and Its Four Toxic Principles

Research shows that the more people value materialistic aspirations as goals, the lower their happiness and life satisfaction. Depression, anxiety, and substance abuse also tend to be higher among people who value the aims encouraged by consumer society.

This stems from four central principles of American corporate capitalism: it fosters and encourages a set of values based on self-interest, a strong desire for financial success, high levels of consumption, and interpersonal styles based on competition. Capitalism thrives on competition, and it isn’t profitable for anyone to be satisfied. No one makes a profit if you are content.

Loneliness as a Health Hazard

The rise of loneliness as a health hazard tracks with the entrenchment of values and practices that supersede any notion of “individual choices.” The dynamics include reduced social programs, less available “common” spaces such as public libraries, cuts in services for the vulnerable and the elderly, stress, poverty, and the inexorable monopolization of economic life that shreds local communities.

One of the facets of the toxicity of our culture is the way generations are split and alienated from one another. No healthy culture would have such generation gaps, where one generation can’t speak the language of the next one, and where we’re presumed to have nothing to learn from one another in either direction.

Racism: The Epigenetic Health Effect

Racism is another factor. A study observed higher rates of inflammation in African Americans than in Caucasians, an epigenetic effect that remained even when comparing those of the same socioeconomic level. Experiences with racism and discrimination accounted for more than 50% of the black-white difference in the activity of genes that increase inflammation.

This research demonstrates how social oppression literally gets under the skin, altering gene expression and creating health disparities that persist across generations. The biological impact of racism isn’t metaphorical; it’s measurable and profound.

Medical Profession: The Wall Between Science and Practice

Maté is frustrated with the medical profession. While there have been many scientific studies highlighting the link between trauma and illness, doctors still focus on “biological psychiatry.” There’s almost like a wall between science and practice. We keep talking about evidence-based practice, but there’s vast evidence that’s totally ignored. He calls resistance to these ideas “institutional inertia.”

The healthcare system profits from treating symptoms rather than addressing root causes. Pharmaceutical companies benefit from lifelong medication regimens. Insurance models reward quick fixes over comprehensive healing. This creates perverse incentives where keeping people partially sick but functional is more profitable than helping them truly heal.

From Victims to Active Participants

When we cease to view illness as a concrete, autonomous thing with a predetermined trajectory, we can start to exercise agency in the matter. After all, if disease is a manifestation of something in our lives rather than merely their cruel disruptor, we have options: we can pursue new understandings, ask new questions, perhaps make new choices. We can be active participants in the process, rather than remain its victims, helpless but for our reliance on medical miracle workers.

This shift from passive patient to active participant represents a fundamental change in how we relate to our health. It doesn’t mean blaming ourselves for illness or rejecting medical intervention. It means recognizing that healing involves more than symptom suppression.

The Path Forward: Individual and Societal Healing

Individuals must accept their traumas in order to move past them and toward true healing. Stress, alienation, and isolation should be denormalized. At the sociopolitical level, making the medical, legal, and teaching professions more humanistic would be a good start.

Maté’s vision for healing operates on multiple levels. At the individual level, it requires acknowledging trauma, processing emotions, and reconnecting with authentic needs. At the interpersonal level, it means building genuine connections and supportive communities. At the societal level, it demands challenging the toxic values and structures that make us sick in the first place.

The book is filled with stories of people in the grip of illness or in the triumphant wake of recovery. These narratives demonstrate that true health is possible, if we’re willing to question what we’ve accepted as normal and build something better.

Questioning Normal: The First Step

The first step toward healing, both individually and collectively, is questioning the myth of normal. What we’ve been taught to accept as inevitable, biological, or just “the way things are” often reflects social choices that can be challenged and changed.

Why do we accept that 60% of adults have chronic disease? Why do we normalize burnout as the cost of success? Why do we treat anxiety and depression as individual brain chemistry problems rather than understandable responses to living in a toxic culture?

These questions don’t have simple answers, but asking them opens possibilities. It shifts us from passive acceptance to active engagement with our health, our communities, and our society.

The myth of normal is that what we’re experiencing is natural, inevitable, and largely beyond our control. The truth, as Maté shows through decades of clinical experience and extensive research, is quite different. We’re living in abnormal conditions that predictably produce suffering. Recognizing this isn’t pessimistic; it’s empowering.

If our environment makes us sick, changing that environment can help us heal. If trauma shapes our health trajectories, processing that trauma can redirect those paths. If disconnection drives disease, reconnection can foster wellness.

The book challenges us to expand our minds and question deeply held assumptions about health, disease, trauma, and what it means to live well. It asserts that the problems plaguing us are not only related to the traumas we’ve suffered but are also symptoms of the toxic nature of our materialistic, isolating culture.

This is a brave and life-shaking work of examining the truth of your life and the culture that we are literally in the death grips of. If you’re ready for that examination, this book offers both diagnosis and hope.

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Frequently Asked Questions

1. What does Gabor Maté mean by “the myth of normal”?

Maté argues that what we’ve come to accept as “normal” is actually abnormal and fails to meet natural, inborn needs. The prevailing understanding of normal neglects the roles that trauma, stress, and the pressures of modern living exert on our bodies and minds. Statistics reveal this clearly: 60% of American adults have a chronic disorder, over 40% have two or more such conditions, and nearly 70% are on at least one prescription medication. We’ve normalized a toxic culture that creates conditions of inequality, isolation, and chronic stress that our biology was never designed to handle.

2. What is small-t trauma and how does it differ from big-T trauma?

While big-T trauma typically involves single, life-altering events such as war, natural disasters, or severe abuse, small-t trauma refers to painful daily events that adversely affect individuals and predispose them to both physical and mental illness. These include constant criticism, chronic neglect, relationship conflicts, prolonged stress, and emotional abuse. Evidence shows that repeated exposure to little-t traumas can cause more emotional harm than exposure to a single big-T traumatic event. Small-t traumas exceed our capacity to cope and cause disruption in emotional functioning, deeply affecting a person’s sense of safety, worth, or belonging.

3. How does the attachment versus authenticity conflict in childhood affect adult health?

Two human needs compete during childhood: attachment and authenticity. Attachment will always win out because survival depends on connection. When certain tendencies like expressing anger are unacceptable to parents, children suppress or repress them to preserve the relationship. The cost is that children decide parts of themselves are “bad” and abandon pieces of themselves to stay loved. This stifling of one’s essential nature leads to problems, including physical illness, later in life. Research shows this self-abnegation, particularly suppression of anger and excessive concern about social acceptability, links directly to chronic diseases like autoimmune disorders.

4. Why are women disproportionately affected by chronic illness according to Maté?

Women are at higher risk for chronic illness because stress plays an “incendiary role” in whether genetic predispositions result in illness, and women experience disproportionate stress. Women take twice as many antidepressants, get 80 percent of autoimmune disease, and experience more chronic illness and chronic pain than men. Maté argues women are society’s “shock absorbers,” taking on alleviating the stress of husbands and children while feeling guilty when they can’t succeed. Women are socialized toward self-abnegating traits like compulsive doing for others, suppression of anger, and excessive concern about social acceptability, all of which correlate with chronic disease.

5. What is the connection between capitalism and declining health according to the book?

American corporate capitalism fosters four toxic principles: values based on self-interest, strong desire for financial success, high levels of consumption, and interpersonal styles based on competition. Research shows the more people value materialistic aspirations as goals, the lower their happiness and life satisfaction, with higher rates of depression, anxiety, and substance abuse. The constant pressure to perform leads to chronic stress and burnout. Capitalism creates conditions where loneliness becomes a health hazard through reduced social programs, less communal spaces, cuts in services for vulnerable populations, and monopolization that shreds local communities. The system profits from treating symptoms rather than addressing root causes.

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Who wrote this book summary?

This book summary was written by me, Binod Shankar. I’m an executive coach and leadership development expert based in Dubai. With decades of experience at KPMG and EY, plus successful entrepreneurship ventures, I help professionals move from being stuck to unstoppable. My approach challenges conventional business wisdom and focuses on practical, actionable strategies that drive real transformation. If you’re looking to question assumptions and build more sustainable leadership practices, let’s talk!