There's something very reassuring about Dr Gabor Maté’s voice. As the doctor and author talks to Ray D'Arcy, it’s easy to dive into that calm, soothing, intelligent sound and be carried along by it, until you realise almost 40 minutes have passed and you now have a much better understanding of trauma and its effects.

Dr Maté has a new book out called The Myth of Normal: Trauma, Illness, & Healing in a Toxic Culture and it ties together the emotional and psychological pain people often suffer in childhood and early life and the physical and mental illnesses they can be afflicted with in adulthood:

"As a physician, if your eyes are open, you can’t help notice that physical illness and psychological stress and trauma are simply inseparable. In fact, one is an essential – not the only – but an essential contributing factor to the other."

The importance of the family doctor is often underestimated, Dr Maté believes, and the way the system works means people’s symptoms get treated, but the causes of their illnesses are rarely discovered:

"As a family physician, I had an advantage over my specialist colleagues in that I knew people before they got sick. They only see a specialist, they only go see a neurologist or a gastroenterologist, a rheumatologist when something’s already wrong and has been identified. Or at least the area of the organ or the body has been identified. But that specialist never knows the person prior to that. They don’t know their family history, they don’t know their family background, they don’t know their larger family. They don’t know them in the context of their lives. And I did."

In his book, Dr Maté states his belief that, "You can’t cleave biology from biography," and he expands on that belief while talking to Ray:

"You can’t cleave a physiology from a psychology. The one affects the other, both ways. And so that when things happen emotionally, they’re going to have a physiological impact. And so this is why trauma and stress play such a huge role in the onset of so many illnesses of both mind and body. Both autoimmune disease or malignancy, or what we call mental illnesses significantly have trauma and stress as the significant contributing factor."

Medical science has long been puzzled by the causes of autoimmune disease, which is what happens when the body’s natural defence system mistakenly attacks normal cells instead of invading organisms. Dr Maté tells Ray that he believes that trauma is a likely cause of autoimmune disease:

"If you’re a person with an autoimmune disease like rheumatoid arthritis or scleroderma or lupus or colitis, what would you rather hear – you've got this mysterious biological condition for which we have no explanation whatsoever and all we can do is mitigate the symptoms by heavy duty medications, some of which will have side effects, but they may control – or may not control – your condition; or would you rather hear that there are factors in your life that you’re not aware of, that you’re unconscious of, that you took on for no fault of your own during your childhood, but which have affected your physiology, and if you become familiar with and learn how to regain some agency over, you might actually make a huge difference in your condition. Which of these is actually more positive?"

The process of dealing with childhood trauma is not easy, Dr Maté says, but it is necessary and the end result is a much better outcome for people suffering from conditions like autoimmune disease:

"It’s challenging because people have to confront the emotional pain that they haven’t perhaps looked at, they have to confront the stresses, the traits of their personality that don’t serve them very well. But the cost of not doing so is ongoing helplessness in the face of illness."

Ray wonders about how the word trauma is bandied about so casually these days, something that Dr Maté agrees with. He cites people going to see a film and saying afterwards that it was traumatic – no, it wasn’t, it may have been an emotionally affecting experience, but it was not traumatic. On the other hand, Dr Maté says, we may not be using the word trauma enough:

"Where it really matters – understanding people’s emotional states, their relationship problems, their embittered political views or their illnesses of mind and body – we don’t use them nearly enough. So the average medical student... never hears a single lecture on the connection between trauma and physical illness. And yet there’s a vast body of literature, scientific literature, pointing out both the correlation and the pathway, physiologically, by which trauma inflicts its damaging impacts on the body."

In The Myth of Normal, Dr Maté talks about Big T trauma and Small T trauma. While discussing it with Ray, he clarifies what he means by these terms and what he means when he says trauma:

"Some events are clearly traumatic, such as death of a parent or family member, such as violence in a family, such as physical, sexual or emotional abuse, a war, you know, these are traumatic events, but they’re not the trauma. The trauma is not the events, the trauma is the wound that you sustain as a result. From which it follows that, although people are often wounded by these "Big T" events – and don’t we just know how often that has happened in Irish history for one thing – but also the "Small T" ones, which is not about the terrible things that happened, but about the good things that didn’t happen."

The good things that didn’t happen, Dr Maté says, are all the ways in which children are raised by parents who, mostly not at all deliberately, don’t do the right things for their children:

"Children are born with certain emotional needs. In this modern world, what I call this toxic culture, children’s emotional needs are often not met, not even understood and that’s wounding to the child’s soul."

Ray reads out a text from a listener who says that in their family, four out of six people are alcoholics and wonders what role genetics plays in alcoholism. But Dr Maté doesn’t have much time for the notion that alcoholism may be have a genetic cause:

"Well, if my three children became medical doctors, would that mean that practising medicine is a genetic disease? I mean, things can run in families for all kinds of different reasons. First of all, from the scientific point of view, I just assure you or the listener, nobody’s ever found a gene for alcoholism. When they thought they’d found it, they had to retract it. Nobody’s ever found a group of genes, that if you have it, you’ll be an alcoholic. Nobody’s ever found any group of genes that if you don’t have it, you can’t be an alcoholic. No such thing exists. That’s a scientific fact... What’s being passed on is not the alcoholism, but the trauma."

The voice remains soothing and calm, but Dr Gabor Maté is decidedly firm in his belief that trauma lies at the heart of so many of modern life’s illnesses. If only we paid it more attention. You can hear Ray’s full conversation with Dr Maté - it’s long, but very well worth your while – by going here.

The Myth of Normal: Trauma, Illness, & Healing in a Toxic Culture by Dr Gabor Maté with Daniel Maté is published by Vermilion.