Key Points from Dr. Gabor Mate' Seminar

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Gabor Mate’ Key Points - Trauma and the Bio Psycho Social Model of SUD

Training - January 27, 2017


Trauma defined: Limitation of one’s capacity to respond 


When people feel safe:

  • Ventral Vagal
  • Parasympathetic activation
  • Social/engagement mode

When people feel danger:

  • Sympathetic activation
  • Rage, panic, increased heart rate
  • fight/flight

When people feel their life is threatened:

  • Dorsal Vagal and elevated endorphins
  • Freeze state, checked out/disassociation
  • Opposing systems or neurology running at same time – hyper arousal and intense numbing

Goal of treatment: Help person to connect (re-connect) with the self.

  • Help them identify what they know and solidify that
  • They need to start with noticing their internal state – NOT with relating to other people (makes group work difficult)
  • Ask the client - What happened to you? Why the pain?
  • Therapists need to work out their own stuff so they can show up with confidence and hope to the therapeutic relationship
  • The most important thing we can offer our clients is “who we are in relationship”
  • Client must sense safety before they can enter into social/engagement mode (eye contact can trigger anxiety – do not push this)
  • People in long-term freeze state (unable to connect with emotion: psychopathology) showed transformation after meditation training

Misc. information:

  • Hippocampus not developed until age 4 or 5, so early trauma is stored in sensory centers
  • 5-7% is genetics not 50-70% as NIDA states
  • Trauma/stress source of most SUD, medical issues, MH issues
  • All substance use is self-medicating
  • 4 systems involved in addiction – endorphins (love, bonding, pain mgmt.), stimulants (elevated dopamine, reward, elation, desire, learning, survival), stress (cortisol, adrenaline, glucose), self-regulation or impulse control (generated from source of appetite, mirrors ADHD, inability to say no)
  • Endorphins – molecules of emotion, pleasure, pain relief, love, drive to attach
  • Oxytocin – chemical apparatus for love – protecting and nurturing life
  • ACC – active with both physical and emotional pain – lots of opioid receptors
  • VTA – Center for elation/desire - VTA releases dopamine into NA. Connect to forebrain where memory gets reinforced. (Dopamine tags)
  • OFC – Decision making and cravings. Abnormal in drug users.

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