If there’s one constant among addicts of all types, it’s shame. It’s what makes us lie and hide. It’s what keeps us from asking for help – though we don’t think we need it because we’re also good at lying to ourselves.
About why we eat. Or shop. Or gamble. Or drink.
Dr. Gabor Maté knows the feeling well. Maté, a renowned doctor, speaker, and author, has seen it in the heroin-addicted men and women he treats in Vancouver’s Downtown Eastside. He sees it in the behavior of well-respected workaholics. The cosmetic surgery junkies. The power seekers. The ‘I Brake for Garage Sales’ shoppers.
He’s seen it in the mirror.
Maté, author of the groundbreaking book In the Realm of the Hungry Ghosts: Close Encounters with Addiction, believes shame is behind our unwindable ‘war on drugs.’ Our ‘tough on crime’ policies. Our judgment of addicts. Our marginalization of street junkies.
Maté knows, as so many of our spiritual teachers have tried to teach us, that our judgments of others are really all about us.
Maté, who serves as resident doctor at The Portland Hotel, a Vancouver housing project for adults coping with mental illness, addiction, and other challenges, saw himself in the stories of the women and men who, day after day, came to see him for treatment and who slowly, over years, revealed to him their pain.
Those of us still hiding and denying? Gabor Maté sees us too.
Gabor Maté was born into the Jewish ghetto of Budapest in 1944, just weeks before the Nazis seized Hungary, to a loving but overwhelmed mother and an absent father, who had been sent to a forced-labor camp. Just months later, his grandparents were killed at Auschwitz. At a year old, he was handed by his mother to a gentile stranger who was assigned his safety.
Maté understands now that those early experiences – or, more accurately, his mother’s frantic state of mind – guided the neural circuitry in his still-developing brain. Impaired circuitry that virtually prescribed a future of addiction and its close cousin, attention-deficit disorder (ADD).
Over years of hearing the stories of street drug users, examining his own past, and putting it together with his medical training, Maté became convinced that – as he says in a recent interview:
both addiction and ADD are rooted in childhood loss and trauma.
It’s a novel – and surprisingly controversial – approach, examining not the addiction but the pain behind it. Fighting not the substance but the circumstances that lead someone to seek out that self-soothing.
Circumstance Over Substance
Addiction, says Maté, is nothing more than an attempt to self-medicate emotional pain.
Absolutely anything can become an addiction… It’s not the external behaviors, it’s our relationship to it.
Maté calls addicts ‘hungry ghosts,’ a reference to one of the six realms of the Buddhist Circle of Life. These hungry ghosts are depicted with large empty bellies, small mouths, thin necks — starving for external satisfaction, seeking to fill but never being full, desperate to be soothed.
We all know that realm, he says, at least some of the time. The only difference between the identified addict and the rest of us is a matter of degrees.
It’s a view that has earned him some critics, not least of which is the Canadian Conservative government, which has sought to shut down the safe-injection site he helps oversee. The conventional medical community certainly hasn’t embraced his ideas. Addiction is typically viewed through one of two lenses: as a genetic component or as a moral failure.
Both, says Maté, are wrong.
And he says he’s got the brain science to prove it.
“A Warm, Soft Hug”
Maté points to a host of studies that clearly show how neural circuitry is developed in early childhood. Human babies, more than any other mammals, do most of their maturing outside the womb, which means that their environment plays a larger role in brain development than in any other species.
Factor in an abusive, or at least stressful, childhood environment and you’ve produced impaired brain circuitry – a brain that seeks the feel-good endorphins and stimulating dopamine that it is unable, or poorly able, to produce on its own. A brain that experiences the first rush of heroin as a “warm, soft hug,” as a 27-year-old sex trade worker described it to Maté.
It’s the adversity that creates this impaired development, says Maté, not the genetics emphasized by the medical community.
And our response to addicts – criminalization, marginalization, ostracism – piles on that adversity, fueling the addictive behavior.
The good news is that addiction can be prevented, but only if you start early. Maté writes in Hungry Ghosts:
[Prevention] needs to begin in the crib, and even before then… in the social recognition that nothing is more important for the future of our culture than the way children develop.
What about those children who are now addicted adults? Unprecedented brain research has revealed that brains can, essentially, be rewired. He continues:
Our brains are resilient organs… Some important circuits continue to develop throughout our entire lives, and they may do so even in the case of a hard-core drug addict whose brain ‘never had a chance’ in childhood.
What’s more, Maté, unlike many of his medical counterparts, factors in our potential for recovery, even transformation:
something else in us and about us: it is called by many names, ‘spirit’ being the most democratic and least denominational.
The Illusion of Choice
We’d like to think that addicts have a choice, that they can just choose to stop — even if it’s hard.
But Maté insists that the ability to choose is limited by the addict’s physiology and personal history. He states:
The more you’re driven by unconscious mechanisms, because of earlier defensive reaction to trauma, the less choice you actually have… Most people have much less choice in things than we actually recognize.
These unconscious impulses are why we find ourselves with our hands in a bag of chocolate after an argument with our spouse. It’s why we’re on Craigslist arranging a sexual encounter while our wife sleeps beside us. It’s why a respected medical doctor finds himself lying to his wife. Again.
“‘Have you been obsessing and buying?’ she’s asked me a number of times in the past few weeks,” Maté writes in Hungry Ghosts. “I look directly at my life partner of thirty-nine years and I lie. I tell myself I don’t want to hurt her. Nonsense. I fear losing her affection. I don’t want to look bad in her eyes. I’m afraid of her anger. That’s what I don’t want.”
For years, Maté struggled with a shopping addiction, spending thousands of dollars on classical music CDs in a single spree, then unable to resist the impulse to do it again weeks later after promising his wife he’d stop. It’s an addiction he refers to as wearing ‘dainty white gloves’ compared to the grinding drug abuse of his Downtown Eastside patients.
But, he writes, “I’ve come to see addiction not as a discrete, solid entity – a case of either you’ve got it or you don’t got it – but as a subtle and extensive continuum.”
Unless we become fully aware of the drivers of our addiction, he says, we’ll continue to live a life in which ‘choice’ is an illusion.
“Passion Creates, Addiction Consumes”
Is there a difference between a drug addiction and being hooked on a behavior — like sex? The medical community continues to debate the question, but Maté is adamant.
All addictions, whether to drugs or to behaviors such as compulsive sexual acting out, involve the same brain circuits, the same brain chemicals and evoke the same emotional dynamics… Behavior addictions trigger substances internally. So (behavior addicts) are substance addicts.
Where do we draw the line between addiction and, well, passion? What about the Steve Jobs of the world, who drive themselves — and others — to push harder, work longer, produce more and do everything better?
Daniel Maté, Gabor’s son and an editor of his books, says:
A lot of people make wonderful contributions to the world at their own cost… We often lionize unhealthy things.
To determine whether we’re serving a passion or feeding an addiction, Daniel Maté suggests that it comes down to a simple question, answered honestly: Are you free or are you not free?
His father takes it further.
What function is the addiction performing in your life? What questions is it answering . . . and how do we restore that?
Or, as he writes in Hungry Ghosts, “Passion creates, addiction consumes.”
Compassion for the Addict — and Ourselves
Responding to addiction requires us not only to care for the body and mind but also the soul, Maté says. The spiritual element of his practice is critical, he says, not only to understand the hard-core street addict but also our own struggle.
We lack compassion for the addict precisely because we are addicted ourselves in ways we don’t want to accept and because we lack self-compassion. – Gabor Maté
And so we treat the addict as an ‘other’ – this criminal, this person making poor choices – to whom we can feel superior.
Compassion is understanding, and to understand is to forgive.
We need, he says, to turn compassion into policy.
Maté summed it up nicely in a 2010 talk at Reed College:
To . . . point the finger at that street-corner drug addict who’s in that position because of that early trauma is blind to say the very least… I think that if we developed a more compassionate view of addiction and a more deep understanding of the addict and if we recognized the similarities between the ostracized addict at the social periphery and the rest of society, and if we did so with compassion both for them and for the rest of us, we would not only have more efficient, more successful drug treatment programs, we would also have a better society.
Good read, although I extend the dynamics within the context of culture used in that article, beyond the atypical family environment to the ‘by-product’ which our society is responsible for. More over how our society regiments humans in general as more the primary issue with respect to abuse point blank. How do we accept this culture and learn to live with it? How do we endure it?
Hi I am a recovering alcoholic with a good number of years of sobriety. I have read all comments with interest – it is good to hear those voices of support – and rather scarey to read the opinions of some who condemn and judge (as if they really know).
I totally agree that all children- developing adults- need acceptance, love and support – and when this is lacking all kinds of addictive behaviours can develop. Yes, they may vary in type and/or intensity – but yes, I believe, are caused by early trauma, neglect, unloving carers, various forms of rejection, abuse, shameing, bullying, violence etc.
A child doesn’t know why bad things are happening- just that they are happening and are bad- and their reactions (their coping strategies) will vary in type and intensity and mostly will not be conscious to the child/developing adult. Whatever gives a deprived or damaged soul some comfort has the potential to become addictive to her/him.
The biggest hindrance I think, to preventing it developing is that the person is not conscious, when beginning to become addicted to either a substance or a behavioural pattern, that it IS a developing addiction. The psychological need for love, comfort,security etc insidiously overwhelms any conscious attempt to stop. It’s like quicksand- they don’t see it until it is too late to break free – and then they may try but find themselves in the grip of forces too great to resist. The worse it gets the worse they feel and the harder it becomes to break free.
BUT – given some support – whether re-hab, a group meeting or other informed method of help- and they have something to take hold of in order to pull away from the life-sucking danger they are in.
The help given IS the real need being met. The addiction can then be discarded, often almost miraculously, instantly. Sometimes more slowly.
While they are caught in the addiction trap they often cannot see a way out. They cannot do it alone because it is precisely BECAUSE they feel alone, rejected, abandoned, outcast even, that they felt the need to self-medicate in the first place. So to say ‘pull yourself together’ is never going to work. Alone, unwanted as they often feel, there is nothing TO pull together. Addicts often feel as if they are ‘nothing’- not worth anything (often because they have not been shown that they are valued – by anybody!) Tribes used to punish offenders by banishment – and most often the one so punished would die. A developing child absolutely NEEDS acceptance and support. Or he feels he may as well just give up and die – or he tries to find whatever makes him feel some comfort – even if it kills him. For what has he to lose? He never HAD anything worth having – like self respect. How would you have self respect or ‘love yourself’ if no one respected or loved you in the first place?
So thank you for bringing this to people’s attention. Those who haven’t experienced the pain of feeling rejected, abandoned and/or uncared for – even abused- probably won’t be able to see it – but many people have experienced these things to some degree so may have an inkling. Addicts are, in my view, and in my personal experience, those who have experienced these things to the extreme.
Unfortunately, the effects on a person of drugs, alcohol or addictive behaviours do not make a person endearing to others – so sympathy from those not addicted – or not so extremely – is often not forthcoming.
They – we – don’t need your sympathy – but we do need society as a whole to offer help. And it would be far better if that help was given really early – to children and young people in need. Children ALL need societies’ interest, care and attention. We are all responsible for that. We can do whatever it takes to raise our children into adults who feel part of society- valued, appreciated – Yes, loved! We can start with our own families and then extend to those around us who may not be getting the care they need. It’s not so hard really – if we just see that all that’s needed is a little care/interest/encouragement/support in place of their opposites. Who will do it if WE don’t? Who if not I? We can all save ourselves while saving each other.
No disrespect is intended toward any individual commenter. There is such a lack of information out there to help ordinary folk understand – it’s not surprising that people don’t understand. Thank you to any who read this. I hope it helps some to see how much our children need us. In the words I heard in a film about a young boy – ‘You don’t need to abuse a child to harm them – you just have to not love them’.
I don’t completely agree here! A spanking is traumatizing to one child but is not traumatizing to another! One child is terrified by a movie, the other is not! One man walks from a relationship while the other won’t let go! I just think that deciding on any one root cause of addiction is folly and a person is liable to see trauma in all of them! Or all people using medications for physical “trauma” have an addiction to them! Their are as many reasons an addict does what they do as their are addicts! If emotional trauma was the reason an addicted behavior started, then reversely, the pain from the addicted behavior will be the trauma that helps them end the addictive behavior! Trauma in, trauma out! Until then, maybe the trauma, real or perceived, is the excuse they use not the reason! Why is it so difficult for people to see that for some peoples lifetime and for others on a temporary basis, they don’t give a damn! Why is that so hard to accept? Oh it’s trauma that has them acting this way! Some maybe, but for so many, they could give a crap. I’m trying to understand how this like so many topics, has that ring of this is correct or that is correct. Does it say in the DSM5 what a healthy person cares about and what they don’t? If I don’t care, I must be deficient, I must be traumatized, I must be a bad person! It’s OK not to feel like you care. I would bet most of the time the trauma is from the people around them judging them because they don’t care about what others around them do even before any addictive actions start! Thus starts the so called trauma! But I doubt it is the key! It’s the excuse!
Interesting yet he doesn’t offer what to do, what can I do to deal with my addiction. I’ll keep looking on this site, but so far nothing concrete as to how and what to do.
Dr. Gabor Mate is probably the most Enlightened thinker on the subject of Addiction and how love and compassion can assist in healing the early childhood wounding we have all suffered more or less.
I totally agree. I myself am an alcoholic in recovery. My childhood was dysfunctional (I hate that word but it’s the best I can do). Alcoholic father and dominating mother, I was stuck in the middle, along with 2 siblings. I never felt love by nor from my mother, who was the “nurturer” because my father was drunk most of the time. All my life and even now, although it’s not quite as lonely inside. My faith in a God who will never abandon me, as my parents did and as every man I loved did – sustains me. Abandonment is my biggest fear and always was.
And re-wiring of the brain, I also believe. AA and my faith have helped me to think differently, although I can go back at any time….but I now recognize that I don’t have to feel that way. Thank you, thank you
In order to overcome early childhood programming that leads to self-medicating (soothing), there needs to be a person outside of the family who steps in and shows kindness to a suffering child, Some children with stronger hearts and minds than their family of origin or their society will disrupt the family programming with recalcitrant behavior. Their undaunted neural circuitry will object to and fight that programming every step of the way. These children will be then outcasted by their families. The strong ones are so strong that they never give up, they can make it on their own, and turn out to the staunchest helper and protector of the down-trodden. All it takes is one person outside the family to show a struggling child that there is kindness in the world, and that they are seen and loved. A show of altruism and kindness repairs broken hearts and minds. (dedicated to Helen Moore, who helped me).