Im certainly not qualified enough to answer that. Gabor mate is all about how our psyche affects our health, and so going down that route of thinking and giving a very armchair physician approach to it, it could be that very early on people who later develop ALS could have formed a maladaptive defense mechanism to social interactions by taking the “be as nice as possible no matter what so that other people will like me, cooperate with me, etc…” This could lead to repressed emotions not properly expressing themselves, such as anger, disappointment, boundary setting, etc… which could eventually lead to disease after enough years.

Or could it be that the disease itself causes people to be extra nice? Chicken or the egg? Idk. All I know is that it’s clinically observed that people with ALS are incredibly nice, and in some physicians opinion, almost pathologically so.