On the final lap of his book tour last March, Prince Harry sat in a comfy armchair on a living room set with a fire crackling in the background. Opposite him sat best-selling trauma expert, Dr. Gabor Maté.
Maté, 79, a Hungarian Canadian primary care doctor whose maternal grandparents were murdered in Auschwitz, argues that psychological problems and even psychotic illness often stem from childhood trauma. His 2010 book, In the Realm of Hungry Ghosts: Close Encounters with Addiction, turned him into a “late-in-life literary juggernaut.” He is now so in demand, his website states “he has to be booked years in advance.”
But, at this moment, Maté was training his gaze on the prince for an impromptu diagnostic session. Viewers paid $33 a ticket, which included a copy of Harry’s new memoir, Spare, to watch the live-streamed “intimate conversation.”
Maté used Spare as a means of analyzing the 38-year-old prince—by no means an accepted diagnostic method.
“Reading the book, I diagnose you with ADD,” said Maté. Attention deficit disorder, he went on to say, is “a normal response to normal stress, not a disease.” The dominant stress, Maté said, was the sudden death of Harry’s mother Princess Diana, who was 36 when in 1997 the driver of her car, who was drunk, lost control and crashed inside a Paris tunnel. The prince was just 12 years old when the tragedy struck.
“OK—should I accept that or should I look into it?” Harry asked gamely.
“You can do what you want with it,” Maté replied.
(Note: ADD and ADHD are understood by pediatricians and child psychiatrists to be neurodevelopmental disorders, not the result of devastating experiences.)
Of Harry’s youth, Maté concluded: “I know there were great moments but there was also a lot of trauma and suffering.”
Harry agreed with that. His book recounts how his father, King Charles III, didn’t hug him as a child, and he now feels, understandably, compelled to “smother” his own son and daughter with love. “I feel a huge responsibility that I don’t pass on any traumas. . . or negative experiences that I had as a kid or as a man growing up,” he told Maté.
There will unlikely be many hugs at his father’s coronation on Saturday, May 6. Harry will be seated 10 rows behind his brother and, tabloids report, may have no contact with his father. Nor will he have his own family there. Earlier this month it was reported that his wife, Meghan, declined an invitation to attend because she wants to stay in California for their son’s fourth birthday.
Meanwhile, ever since Harry’s session with the doctor, I’ve been thinking about its message. Over my decades of work as a psychiatrist, I have seen many patients continuing to nurse the wounds of childhood. Still, many others with unremarkable childhoods develop problems for reasons that have little to do with a troubled upbringing, such as feelings of failure, the inability to find love, or strong genetic predispositions that lead to mental illness later in life.
But Maté believes that trauma is anything that “wounds” a person and “leaves an imprint that shows up in multiple ways later on.” This, he claims, can manifest as a severe mental illness such as psychosis or medical conditions including “rheumatoid arthritis, multiple sclerosis, autoimmune diseases in general, many malignancies”—including lung, breast, prostate, and skin cancer. He has also blamed trauma for multiple sclerosis, rheumatoid arthritis, irritable bowel syndrome, asthma, Alzheimer’s disease, and amyotrophic lateral sclerosis (also known as Lou Gehrig’s disease).
This theory is further described in his 2022 bestseller, The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture, which was displayed on the fireplace mantel next to Spare during his interview with Harry. (Random House, which published both men, brought them together.)
Sharing the popular psychology firmament with Maté is the Dutch-born psychiatrist Bessel van der Kolk, 80. He shot to fame in 2014 with The Body Keeps the Score, which spent over 235 weeks on The New York Times Best Seller list and is now, nearly a decade later, #7 on the Amazon Charts. Van der Kolk is a professor of psychiatry at Boston University, and his research on veterans and treatment for post-traumatic stress disorder, among other subjects, is well-regarded. However, his theory that traumatic memories are routinely banished from consciousness and are instead manifest solely in the body, the core claim of his blockbuster book, has been seriously challenged.
His definition of trauma, like Maté’s, is broad—summed up, in his words, as “something that happens to you that makes you so upset that it overwhelms you.”
In short, it’s not the event per se that constitutes the trauma, it’s the person’s response to it. By that logic, a complete breakdown in the face of a microaggression could be no different from the onset of post-traumatic disorder caused by a physical assault, or watching fellow soldiers die on a battlefield.
Theories about trauma now penetrate deep into the field of psychiatry, even changing how we define post-traumatic stress disorder. Four decades ago, the American Psychiatric Association rightly defined PTSD as a disorder caused by exposure to terrifying, usually life-threatening, events outside the bounds of everyday experience that would “evoke significant symptoms of distress in almost everyone.” But, over the years, this definition has expanded, with marital discord, exposure to crude jokes, and even vicarious experiences now deemed capable of sparking PTSD. (Contrary to popular impression, lifetime prevalence of PTSD in the trauma-exposed is well under ten percent; immediately after exposure, rates in victims are closer to ten percent on average.)
It may be no coincidence that two of the most popular mental health figures in America today focus on trauma. (Maté, it should be noted, is not a psychologist or psychiatrist.) But why? What draws millions to their podcasts, workshops, and lectures?
First, they sound good. I am impressed by their sincerity and empathy; they express genuine optimism that their audiences can attain emotional growth. Surely, some people who reexamine their values and understanding of events can reconfigure their lives in rewarding ways. That is self-help at its best.
But I also worry about luring people down the psychological path of least resistance. After all, the trauma narrative provides several comforts: a tidy origin story; a self-justifying narrative for those ashamed of their behavior; and the balm of exoneration that comes with victimhood.
And then there are the logical flaws in the doctors’ arguments. The claims from both van der Kolk and Maté that ancient trauma can surface in the body years later cannot be disproved, which makes their claims unscientific.
Think about it: most of us have had at least one bad, even awful, early experience. And most of us also suffer with some kind of ongoing physical or mental ailment. Anyone who wants to connect the dots can easily do so and call it a causal chain of events. Like the palm reader who sees heartbreak in your past—my God, she’s right!—adverse events will always be there, ready to be mined for a future diagnosis of “trauma.”
But who can really know what from our past truly explains our current circumstances?
Maté’s trauma theory also contains some worrisome falsehoods.
“The idea that most of us are carrying past traumas, it’s not true,” clinical psychologist George Bonanno, director of the Loss, Trauma, and Emotion Lab at Teachers College at Columbia, told me.
In his 2021 book, The End of Trauma: How the New Science of Resilience Is Changing How We Think About PTSD, Bonanno summarizes years of epidemiological research showing that most people who’ve experienced potentially traumatic events are not crippled by the experience later in life.
Indeed, a large body of research confirms that resilience is the human default response to trauma. Bonanno says most patients have a “flexibility” mindset, giving them optimism and confidence in their ability to cope. According to his findings, patients usually take a “challenge orientation” in their approach to past trauma—believing they can overcome the challenge rather than be defeated by it.
And yet, the trauma therapists continue to see suffering everywhere. The very purpose of The Body Keeps the Score, van der Kolk writes, is “to help us to become a trauma-informed society that will confront and deal with our largest public health issue: psychological trauma.”
Maté, too, hopes to see “a trauma-informed society”—a realm in which “parents, teachers, physicians, policy-makers and legal personnel. . . [seek] to understand the sources from which troubling behaviors and diseases spring in the wounded human soul.”
The trauma-informed society primes us to see our early lives through the lens of misfortune, mistreatment, and deprivation, interpreting events in a purely negative way.
But this intense focus on trauma, according to Bonanno, can also lead to a dangerous search for trauma—a phenomenon that has already led to several modern-day scandals. In the mid-1980s to mid-1990s, for example, children “recovered” false memories of animal torture, Satanic cults, and being penetrated with objects after being questioned by authorities in a highly suggestible manner. In 1994, a father successfully sued two Orange County therapists for implanting memories of abuse in his child. And in 2011, a jury in Madison, Wisconsin, awarded a couple $1 million against therapists who falsely suggested to their daughter that the father had raped her, the mother had tried to drown her, and the family was part of a cult that engaged in infanticide.
Without a doubt, early events shape us. For some, the impact can be devastating. But experts who see the trauma response at the root of almost every problem risk deluding people looking for self-knowledge.
In the end, no one will know what Prince Harry derived from his encounter with Dr. Maté. But whatever his “diagnosis,” the prince unwittingly participated in a project that excavates early wounds and often precludes the search for other, more useful answers.
Sally Satel is a psychiatrist and a senior fellow at the American Enterprise Institute. Follow her on Twitter @slsatel.
For more groundbreaking reporting on medicine, read David Zweig’s piece, “Is Gain-of-Function Research ‘A Risk Worth Taking’? Or ‘Insanity’?”
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