In his introduction, Maté asks why it is that, despite the vast resources invested in health care on an individual and societal level in the 21st century, “our collective health is deteriorating” (1). Maté cites the fact that in the United States in 2017, 60% of adults suffered from a chronic condition like high blood pressure or diabetes. Meanwhile, in 2019, nearly 20% of Americans suffered from a mental-health-related episode. Maté explains this contradiction between the resources spent on health care in the West and increasing incidences of illness by arguing that we live in a “toxic culture” (3). Maté means by this term that we live in a cultural context that is inimical to human wellbeing and flourishing. The reason for this, according to Maté, is that our culture contains many stress-inducing factors for individuals, including environmental degradation, poverty, and social isolation. Maté sees it as his role to expose these deleterious social influences, whose impact on health has typically been downplayed and normalized.

In Chapter 1, Maté discusses the nature and effects of trauma. He begins doing so by describing an anecdote from his own life when, on returning from a flight from a speaking tour, his wife was unable to pick him up from the airport.