Review: The Myth of Normal (DNF)

Title: The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture

Author: Gabor Maté with Daniel Maté

Genre: Psychology/Health

Trigger Warnings: Chronic illness, terminal illness, pedophilia/childhood sexual abuse, rape, incest, domestic partner abuse, abandonment, war (mentions), cancer

Note: Trigger warnings in DNF books only cover the part I read. There may be triggers further in the book that I did not encounter.

Read To: 25%

Back Cover:

In this revolutionary book, renowned physician Gabor Maté eloquently dissects how in Western countries that pride themselves on their healthcare systems, chronic illness and general ill health are on the rise. Nearly 70 percent of Americans are on at least one prescription drug; more than half take two. In Canada, every fifth person has high blood pressure. In Europe, hypertension is diagnosed in more than 30 percent of the population. And everywhere, adolescent mental illness is on the rise. So what is really “normal” when it comes to health?

Over four decades of clinical experience, 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. For all our expertise and technological sophistication, 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. Now Maté brings his perspective to the great untangling of common myths about what makes us sick, connects the dots between the maladies of individuals and the declining soundness of society—and offers a compassionate guide for health and healing. Cowritten with his son Daniel, The Myth Of Normal is Maté’s most ambitious and urgent book yet.

Review:

I have read a LOT about trauma and its effects over the past few years (e.g. here, here, here, and here). This is a topic of personal interest for me, as well as one where, at this point, I feel fairly well-versed. From the emphasis on the back cover, I thought this was going to be about the many small and not-so-small traumas we face every day because of how society is set up (the “toxic society” promised in the subtitle) and how those affect our health. I expected something more along the lines of Sedated than anything.

I’m going to refer to author in the singular here because even though the book tries to emphasize that Daniel also had a large hand in the writing of the book, the concepts and ideas are obviously all Gabor’s.

The main premise of The Myth of Normal is that modern medicine’s fundamental assumptions about human health are wrong – that the mind and body are not and can never be truly separated, and that trying to treat illness as separate from the person’s life circumstances is short-sighted and misses essential underlying factors that affect a disease’s onset, progression, and treatment. All of which I do agree with. However, for all its emphasis on challenging fundamental assumptions, the book itself refuses to challenge or even acknowledge the fundamental assumptions that drive it:

1. There exists a state of perfect health which is possible for humans to achieve;
2. Achieving this state is both possible and essential for every human being;
3. Therefore, the ultimate goal (or one of the ultimate goals) of every human being should be to work to achieve this state.

To be fair, Gabor is a doctor and he likely doesn’t realize he is making those three assumptions in this book. These are underlying assumptions of our society as well – just look at any health, diet, or weight loss claim. Once you know to look for them, you’ll see these assumptions everywhere. So I don’t really blame Gabor for writing from that perspective. It’s great that he’s on board with the growing body of evidence about trauma’s effects on physical health. I think he just didn’t go far enough in the “challenging society’s assumptions about health” aspect.

There is a lot of research presented here, so I do give him credit for that. It’s not really anything I didn’t get from The Body Keeps the Score (Gabor even quotes Bessel van der Kolk several times), but if you’re not familiar with the concepts and the research, I think it would be a good introduction. Where I had issues was all the parts that weren’t research. The anecdotes and stories were incredibly sensationalized. It was always someone with a horrible and fatal disease going from being bed-bound to living a pretty much normal life due to healing from horrific childhood sexual abuse. Nobody was healing from schoolyard bullying or their parents’ divorce and as a result seeing improvement in their back pain or having fewer headaches. It was always people with something dramatic and incurable who healed their trauma and therefore fixed their disease.

As someone who is disabled/chronically ill, I’ve heard all of the “one weird trick to heal your incurable disease! Doctors are amazed!” stuff. And if you strip away the scientific trappings, what Gabor is presenting sounds exactly like the “natural cure without drugs!” bullshit you find in weird alternative health circles. Take out the fact that Gabor is a doctor and cut the parts where he cites research and you could replace “trauma healing” with “kale,” “yoga,” “unpronounceable exotic herb,” or whatever else in every single anecdote and it would sound exactly as outlandish. Gabor is pretty much promising that healing your trauma will fix anything and everything wrong with you, up to and including incurable and fatal conditions.

I don’t want to deny the fact that there is research. Unlike most “cures” in this non-medical modes of healing space, the trauma-health connection actually has a lot of promising research around it. Which I think is why I take such issue with the way it’s presented here. Could healing your trauma help your physical health? Absolutely, and there’s research to back that up. Will healing your trauma cure your cancer? I can’t bring myself to believe that, no matter how fancy the credentials of the doctor telling me the story.

This book may have fallen prey to the whims of marketing, ignoring scientific nuance in favor of something that will sell – and sensationalism sells. Or maybe Gabor completely believes in trauma healing as a miracle cure. I don’t know. But regardless, I don’t recommend this one. The concepts and research are good, but you can get the same information in other books (I recommend The Body Keeps the Score and It Didn’t Start With You) with many fewer issues. The effects of trauma on physical health are worth learning about. But not from this book.

Review: It Didn’t Start With You

Title: It Didn’t Start with You: How Inherited Family Trauma Shapes Who We Are and How to End the Cycle

Author: Mark Wolynn

Genre: Health/Psychology

Trigger Warnings: Genocide, child abuse (mentions), addiction, chronic illness, death, death of children, death of parent, suicidal thoughts

Back Cover:

Depression. Anxiety. Chronic Pain. Phobias. Obsessive thoughts. The evidence is compelling: the roots of these difficulties may not reside in our immediate life experience or in chemical imbalances in our brains–but in the lives of our parents, grandparents, and even great-grandparents. The latest scientific research, now making headlines, supports what many have long intuited–that traumatic experience can be passed down through generations. It Didn’t Start with You builds on the work of leading experts in post-traumatic stress, including Mount Sinai School of Medicine neuroscientist Rachel Yehuda and psychiatrist Bessel van der Kolk, author of The Body Keeps the Score. Even if the person who suffered the original trauma has died, or the story has been forgotten or silenced, memory and feelings can live on. These emotional legacies are often hidden, encoded in everything from gene expression to everyday language, and they play a far greater role in our emotional and physical health than has ever before been understood.

As a pioneer in the field of inherited family trauma, Mark Wolynn has worked with individuals and groups on a therapeutic level for over twenty years. It Didn’t Start with You offers a pragmatic and prescriptive guide to his method, the Core Language Approach. Diagnostic self-inventories provide a way to uncover the fears and anxieties conveyed through everyday words, behaviors, and physical symptoms. Techniques for developing a genogram or extended family tree create a map of experiences going back through the generations. And visualization, active imagination, and direct dialogue create pathways to reconnection, integration, and reclaiming life and health. It Didn’t Start With You is a transformative approach to resolving longstanding difficulties that in many cases, traditional therapy, drugs, or other interventions have not had the capacity to touch.

Review:

In my online research about trauma, I came across the idea of intergenerational trauma – that you can inherit the trauma of your ancestors. However, the sites that talked about healing your intergenerational trauma also tended to be the type that advised rose quartz would heal your mother wound and other such less-than-scientific “treatments.” So I was excited for this book, hoping to get a more trustworthy look at intergenerational trauma and see if the idea has any scientific merit.

I was surprised to find that it actually does. The book starts with a solid scientific foundation, discussing the basics of epigenetics and how trauma not only changes our own genes, but the genes that go into our egg and sperm cells that later become our children. It traces why trauma can be shared back three generations but often isn’t passed down longer than that, and it discusses how outside of genetics, family dynamics can encourage people to take on traumas from relatives they’re not directly descended from (e.g. aunts and uncles). I was fascinated to find such a strong scientific basis for inheriting trauma.

The bulk of this book, though, is a healing program to help the reader identify the trauma, figure out who in their family system it actually belongs to, and “give it back” so they don’t have to deal with a trauma that isn’t even theirs. There’s an assortment of writing and reflection exercises, interspersed with nearly-miraculous stories of healing from people Mark has taken through these steps. You’re supposed to do each of the exercises as you read, but I was listening to this at work and couldn’t really stop doing my job and pull out a notebook. I did do one of the exercises (number 12, I think) on a break, and it was intense and enlightening. This is one of those books that I want to read again in a different format so I can follow along better and actually do the exercises.

Though I think this book can and will be very helpful, I don’t think it’s perfect. The stories of recovery Mark shares seem almost impossible in their rapidity and completeness, which makes me skeptical, but I’m going to reserve judgement on that until I actually try all the steps. What bothered me the most was towards the end, the book harped really hard on forgiving your parents, reconciling with them, and putting effort into having a relationship with them. Putting aside the fact that I’m definitely not ready to forgive my mother, I kept thinking, What if your parents aren’t safe? I don’t think my parents would be physically violent or attempt to ruin my life or anything like that when I come out to them, but I highly doubt they’ll be willing to use my real name and pronouns. Should I just live with their clear and obvious disregard for who I am just to have a relationship with my parents? And what about queer people who are in legitimate physical danger of injury or even death from parents who won’t accept them? Should they put themselves in danger to attempt a relationship with parents who would rather have a dead child than a gay or trans one? It’s all well and good when your parents still love you and the only thing between you and them is trauma, separation, and/or differences in how you give and receive love, but I have to imagine there are ways to heal that don’t involve exposing yourself to people who are dangerous to you.

That said, I still consider this a valuable book. It has a solid basis in science, and it’s full of practical steps with plenty of examples to follow. As I mentioned, this is one I want to get in physical or ebook form to actually follow along with the steps. (The audiobook is supposed to have a PDF with the exercises and diagrams, but my library apparently doesn’t include accompanying PDFs with audiobooks.) Though I’m skeptical about advising “you need a relationship with your parents” to everyone, overall I think this is a very important book.

Review: The Body Keeps the Score

Title: The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma

Author: Bessel van der Kolk

Genre: Health/Psychology

Trigger Warnings: Pretty much every event or circumstance that can cause trauma responses is mentioned, including graphic descriptions of self-harm, suicide, suicide attempts, sexual assault, sexual violence, rape, child abuse, child death, child sexual abuse/molestation/pedophilia, incest, domestic abuse, 9/11, car crashes, and war atrocities

Back Cover:

Trauma is a fact of life. Veterans and their families deal with the painful aftermath of combat; one in five Americans has been molested; one in four grew up with alcoholics; one in three couples have engaged in physical violence. Such experiences inevitably leave traces on minds, emotions, and even on biology. Sadly, trauma sufferers frequently pass on their stress to their partners and children.

Renowned trauma expert Bessel van der Kolk has spent over three decades working with survivors. In The Body Keeps the Score, he transforms our understanding of traumatic stress, revealing how it literally rearranges the brain’s wiring–specifically areas dedicated to pleasure, engagement, control, and trust. He shows how these areas can be reactivated through innovative treatments including neurofeedback, mindfulness techniques, play, yoga, and other therapies. Based on Dr. van der Kolk’s own research and that of other leading specialists, The Body Keeps the Score offers proven alternatives to drugs and talk therapy–and a way to reclaim lives.

Review:

I think this book is supposed to just be a review of Dr. van der Kolk’s research on trauma, with an overview of the physiological effects of trauma and discussions of the various therapies he’s tried with traumatized patients and the biology and neuroscience of how they helped or didn’t. However, all of these points are made with stories of Bessel and his patients, and I found it to be a combination of the science of trauma, insights about my own trauma, and hope that there are effective therapies out there that might help me.

Like all good books that make me recontextualize my past, I could only read this book in small doses. But that may not be a bad way to read this book – it is absolutely packed with information and you’ll need time to absorb it. From the history of trauma being recognized as an actual problem to the biological and neurological underpinnings of the symptoms of being traumatized to the different therapies he has found to be effective and the neuroscience and psychology of why they work, it’s thirty years of trauma research condensed to less than 500 pages. One read doesn’t feel like it’s enough to grasp all the information and possibilities here.

To my non-medical-trained ears, some of the problems caused by trauma and some of the miraculous healing from trauma described in this book seemed nothing short of outlandish. However, Bessel van der Kolk is one of the world’s top researchers in trauma studies and is partially responsible for the National Child Traumatic Stress Network (a Congressionally mandated initiative for helping traumatized children) and for PTSD being considered an actual diagnosis in the first place. So he probably knows what he’s talking about.

The main drawback to this book is that the people who most need to read it – i.e. people who are dealing with the long-lasting effects of trauma – are the ones most likely to be triggered by the graphic descriptions of abuse and neglect. It does make for much less boring reading than facts and statistics and I recognize that knowing about the specific traumas is integral to most stories of how the patients recovered, but I found myself wondering if the graphic details couldn’t have been toned down just a bit for the sake of traumatized non-doctors reading about this research on their own behalf. Bessel does mention in one anecdote that an instructor in one of the therapies he was learning criticized him for “voyeuristic tendencies” and wanting to know everything about his patients’ traumas, and I wonder if the graphic descriptions in these anecdotes were an unintentional expression of his own interest in other people’s traumas.

This book is very thorough and very intense. If you’re in the medical field, it’s absolutely worth reading. If you’re traumatized yourself, it’s also worth reading, but take it slow and be aware that it’s full of descriptions of abuse that might be triggering. But it’s also full of hope that we don’t have to be defined by our trauma forever.

Review: Health at Every Size

Title: Health at Every Size: The Surprising Truth About Your Weight

Author: Lindo Bacon, PhD

Genre: Food and Health

Trigger Warnings: Eating disorders, dieting, fatphobia, moralizing about food, weight loss

If these trigger warnings concern you, please read the review before making a decision about reading this book.

Back Cover:

Fat isn’t the problem. Dieting is the problem. A society that rejects anyone whose body shape or size doesn’t match an impossible ideal is the problem. A medical establishment that equates “thin” with “healthy” is the problem. Health at Every Size: The Surprising Truth About Your Weight by Lindo Bacon, PhD, presents a well-researched, healthy-living manual that debunks the weight myths and translates the latest science into practical advice to help readers forever end their battle with weight.

Review:

This is a book about why the “obesity epidemic” is a problem – and the problem isn’t people being fat. Health At Every Size (HAES) is a movement to reduce the stigmatization of fat bodies and change the conversation around health away from weight as the only marker of health to an evidence-based paradigm focusing on health, not just BMI. Lindo Bacon didn’t start the movement, and they make very clear that this book isn’t the end-all be-all of HAES, but it does put the fundamental principles of the movement into a single accessible volume.

There is some content in this book that can be triggering to people with eating disorders. Though Lindo comes at all these issues with compassion and sensitivity, there is still extended discussions of diet behaviors, weight loss, fatphobia, moralizing about food, and similar topics. However, it’s also full of really important information that is helpful in recovering from an eating disorder. If a healthcare professional who’s working with you on your eating disorder recommends it, or if you are past the beginning of your recovery and feel you can handle diets being mentioned in the context of “diets are a really bad idea and here’s the science of why,” I think this book can be very helpful. (If you’re still early on in your recovery, though, please use caution.)

I had hoped to learn a lot from this book, but personally I didn’t learn much. That’s because I’ve been learning about HAES principles from various other places for years in the course of recovering from my own eating disorder. What this book did do for me, though, is provide citations. It’s one thing to see someone on Tumblr post that people in the “overweight” BMI category have a longer life expectancy than in the “normal” category, it’s another thing to have a researcher and professor with a PhD in physiology and a graduate degree in exercise metabolism discuss the peer-reviewed studies that demonstrated this fact.

This is an incredibly valuable book. If you’ve ever been on a diet or counted calories, been told to “lose weight for your health,” or felt bad about your weight, if you’re a medical professional who interacts with patients, or if you’re a mental health professional who treats people with eating disorders or people with body image issues, this book will be invaluable. The way modern society treats weight is not only cruel, it completely goes against what the science says about weight.