Books

Gabor Maté on Addiction and Love

'Why the pain?' the author asked a packed church. The question is for all of us.

By Shannon Melnyk, 19 Mar 2008, TheTyee.ca

Gabor Mate

Dr. Gabor Maté: No one's immune.

  • In the Realm of Hungry Ghosts
  • Gabor Maté
  • Random House (2008)

A man who has seen many demons found himself, last week, at the podium of a packed church musing on our notion of God. But Dr. Gabor Maté, Vancouver Downtown Eastside physician, author and social activist was more interested in finding a higher power not through blame, but possibility.

His topic was "The Globalization of Addiction." Maté dedicated the evening to the memory of a woman he called Serena in his new book, In the Realm of Hungry Ghosts. Buried on the same day of this community forum, Serena was a patient at the non-profit Portland Hotel on East Hastings. One of the many faces of addiction on the Downtown Eastside, she was a young woman ravaged by severe sexual abuse, neglect and dysfunction, and her death, in Maté's words, is indicative of a massive failure of society, science and compassion.

"The war on drugs. . . the war on drugs," Maté mused solemnly. "This is not a war on drugs. This is a war on drug addicts. We ask ourselves why people give up their lives, their relationships, their connections in this world, for the pursuit of a drug. Addiction can never be understood if looked at through the lens of moralism and judgement. It's time as a society we ask not: 'Why the addiction?' But: 'Why the pain?'"

He further claimed this war has not been a mistake but rather a political, emotional and spiritual corruption we all share. "At the political level, it controls the population of our most downtrodden. Emotionally, we are all addicted to negative behaviour for our short term gain, and spiritually, we marginalize the addict because we do not want to look at the mirror they are holding up to us. We fear the parts in ourselves we don't want to see."

Uncomfortable message

Maté is a man of science who has in the past made the scientific community uncomfortable. His insistence on combining research on brain biochemistry with matters of spirit, emotional pain and environmental nurturing has received criticism despite the mind, body and spirit health movement that has infiltrated mainstream sensibilities. Following the release of When the Body Says No, an exploration of the link between repressed emotion and disease, critics accused him of suggesting the ill blame themselves for their health woes. Maté implies through his work, however, that blame is not his aim, and that we are simply afraid of examining the root of what ails us.

And one of those demons that ails us is addiction. While In the Realm of Hungry Ghosts is a natural evolution of Maté's previous works and a stunning portrayal of the lives of addicts, more importantly he makes it clear that addiction touches every sector in society, be self-destructive indulgence in drugs, alcohol, sex, eating, shopping or work. In the hallowed grandness of the West End's St. Andrew's Wesley Church, he mentioned another institution, prison, the current home of Lord Conrad Black, whose drug of choice appears to be power. "That is a man with low self-esteem," Maté said. "No one with high self-esteem seeks to be called a lord of anything. Addiction to status led to contempt for the law."

So if no one is immune to addiction, who is then most susceptible? Maté marries his clinical experiences with new research to claim the root of addiction is in formative brain chemicals. He says the first five years of life and even the environment in the womb can dictate a predisposition to addiction, and uses recent studies to connect stress, abuse and lack of love and attachment to deficiencies in our ability to create endorphins and dopamine -- necessary chemicals in our bodies that give us both pleasure and pain relief.

Maté claims it is no coincidence that emotional and physical pain is interpreted in the same place in the brain and leads us to self-medicate when we are lacking these receptors. He suggests addicts are not addicted to the substance at all, but rather to their own brain chemicals.

An audience member aptly quoted Allen Ginsberg in saying perhaps we've literally been "frightened out of our natural ecstasy."

Embrace of addiction

In sharing the tale of an addict who likened heroin to a mother's hug, Maté's message of compassion was clear. In his years of treating sex trade workers, he stressed that without exception, every single addict was a victim of neglect, abandonment or abuse. These are not facts Maté could ignore as he wrote In the Realm of Hungry Ghosts, and following the burial of yet another one of his patients, he stressed addiction was a lonely journey. He wanted to use a Beatles lyric in his book to approach ideas of "saving souls" with love, but in the interest of copyright complications, instead tossed about the Buddhist philosophy that purity belongs to oneself, as no one can purify another.

In a response to a man who queried the idea of "tough love" in the loss of his brother to the Downtown Eastside, Maté replied, "Forget tough love. Love is enough. Your biggest challenge is to fully accept him while protecting yourself and your boundaries."

Despite spirit and science being uneasy bedfellows, Maté remains unwavering in his frustration with the medical community, the government and the media. He says they are simply not reading the research. While the institutions scramble around for band-aids to soothe the ever increasing fallout of addiction, increasing numbers of people are willing to look at holistic common sense. "Only in the presence of compassion," Gabor Maté insisted, "will people see the truth."

 [Tyee]

10  Comments:

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  • deeby

    4 years ago

    Yet more reasons...

    ...why I'm sorry that Gabor left his family practice.

    However, our loss is the DES's gain. The man is a visionary.

  • snert

    4 years ago

    Very easy to say. Very hard to do.

    Quote:
    Your biggest challenge is to fully accept him while protecting yourself and your boundaries."

    I suspect most people are not that emotionally stable themselves to handle that challenge.

  • ME2

    4 years ago

    War Games

    The "War Against Drugs": the "War Against Alcohol"; the "War Against Tobacco"; the "War Against Sexual Deviancy"; the "War Against Pornography"; the "War against Prostitution"; etc etc, are all-of-a-kind.

    Demonise the producer, demonise the seller, and demonise the user. These are the primary weapons of choice in waging these Wars. This instilling of fear in the population thus justifies the most extreme penalties the public will tolerate.

    In times past, the Inquisition justified the burning of heretics at the Stake. In the early days of Tobacco, some European nations levied the death penalties on users, being so worried about the massive drains on their treasuries importation was causing. But people learned to grow their own.

    It doesn't matter that NONE of these "Wars" have ever been won, or that in the end they have ALWAYS caused far more harm than the ills they were theoretically meant to eliminate.

    Repressive legislation, especially in the morality sphere, is a favourite of authoritarian governments, since elitists of all stripes have held that the ordinary citizen must be forced into doing the "right thing". The problem is, that once given their head, they don't know when - or where - to stop.

    A contemporary example concerns Tobacco. Few people would hold that nicotine is not addictive (though it is otherwise harmless), or that the burning of tobacco produces known carcinogens. Thus the smoker agreed with the campaign to curtai smoking among the young. But now the drive toward prohibition is clearly underway.

    It doesn't matter that the second-hand smoke studies have been contrived to produce the desired results in precisely the same manner as have been the hoked-up studies re Marijuana.

    And so too the conditioning of the non-smokers who see smokers forced to stand in the rain in what is clearly another proof for the Milgram Experiments. And THAT, in my opinion, bodes ill for this society,

    The next one coming down the pike is the CO2 scare. The Oilco producers have already been demonised along with their partners in crime, the industrialists and auto manufacturers, and now the finger is being pointed at you and me, characterised in another TYEE story as being those primarily responsible for CO2 emissions and thus those who will bear the brunt of the costs required to "fix" the problem - which may or may not actually exist.

    The end result all of this is precisely the same as that described in the article offered above:

    Our authoritarian governments don't really give a tinker's damn about druggies, or the obvious fact that their laws can't reduce the use of - or harm from - illicit drugs.

    what is most important is that we recognise who is in charge and that their laws must be obeyed without question, period, full stop.

  • Booker

    4 years ago

    health

    It's remarkable that in this day and age our political leaders (especially the current batch of theocons in Ottawa) consider addiction to be mainly a moral issue rather than a health issue. Seeing it as a moral issue allows them to sit back and condemn the addicts rather than do anything about it.

  • mopled

    4 years ago

    Criminalizing the victim

    The OSS and the Flying Tigers moved heroin
    during and after WW2. The CIA picked up where they left off.

    Criminalizing the victim happens when the perpetrator is too powerful to be brought to justice.

    http://joeplummer.com/government_drug_running.html

    This is a 15 minute excerpt from the documentary "American Drug War." It includes an admission (by the former head of the DEA - Robert Bonner) that the CIA smuggled cocaine into the United States to help finance its operations.

  • ME2

    4 years ago

    More on "Wars"

    The other half of my posting above expands upon my assertion that:

    The Wars against ".....etc etc, are all-of-a-kind."

    That is, that ultimately they are waged primarily against the lowest echelons among the public, people who in various ways are far more victims in these "Wars" than perperators in it, a distinction which then hinges upon authoritarian vs libertarian interprtations of "morality",

    I wrote that fear was propagandised to the public in order validate the authoritarian means of waging these Wars and noted the efficacy of doing so re second-hand-smoke, and purposly hilited the results of doing so:

    "And so too the conditioning of the non-smokers who see smokers forced to stand in the rain in what is clearly another proof for the Milgram Experiments. And THAT, in my opinion, bodes ill for this society,"

    And that was my reason for writing that post, that the "wars" are primarily Red Herrings designed to keep you and me fighting among ourselves, seeing ourselves as "the enemy within".

    I realise that more than a few reading this believe these Wars are necessary - regardless of consequences - and think they are based upon sound moral principles.

    So I ask you all, if our elites, including the religious ones, are indeed concerned about maintaining, if not restoring, moral rectitude in our society, when will we see a "War Against Elitist Corruption"?

    Certainly CEOs who've looted corporate treasuries by creating illusory paper profits while taking real dollar bonuses and so on, are as criminal as any drug lord, and cetainly the derivatives meltdown will create at least as much societal havoc as has drugs - though the media will certainly not play up those effects.

    The list of such potential "Wars against" is long, and I'm sure TYEE readers could fill many columns with them.

    It is highly unlikely, however, that without the help of certain-to-be-reluctant elites, such a War would never get off the ground.

    So I ask you, dear fellow TYEE reader, the next time you feel compelled to chime in and support one of the various "Wars", ask yourself are you supporting it because you have critically examined the data, or is it because you have supported its moralistic underpinnings.

    And when you see a smoker standing out in the rain, remind yourself that: "But for the Grace of God, and pending a different War - there go I"

  • zalm

    4 years ago

    Am I missing something?

    For all the people who suffered abuse and never succumbed to addiction, what of their triumph? Are they failures for not having followed the career path of the abused?

    I'm not expert, and I'm certainly not a war-monger. But like Mate, I'm certainly very firm now around protecting my boundaries from my drug-addicted friend in the DTES, who grew up in in West Van with the best of everything ....and it wasn't enough. Whatever his emotional pain was, he allowed himself to wallow in it rather than heal it. Then when schizophrenia took him, the "war" was over. He's been in that POW camp for nigh on twenty years.

    I'm confused, and Mate hasn't helped much. Drug addicts will tell you any story they think will advance their interests or advantage from you. How is any meaningful research possible? After nigh on twenty years in the hospital system, I'm quite familiar with the social services system and can say without rancor that it's substantially non-judgemental with respect to personal addictions. That's not to say that judgements are absent - society wouldn't be as varied as it is if everyone thought the same. What's being asked of us? Are 100% of us supposed to be 100% non-judgemental before any progress is possible in treatment? That one idle comment will cause permanent relapse in thousands of addicts?

    Just as Vioxx without guided introspection is useless for treating depression, treatment, compassion and harm reduction are useless without a considerable measure of guided introspection. Everyone has to go back to "school" to understand themselves. Some go, some drop out, but many are never invited. That's the real tragedy.

  • anarcho

    4 years ago

    Not all abused lives the same

    In my own case, why did I not turn to substance abuse? My upbringing, though one of abuse and bullying, was contradictory. I learned to love reading at an early age and thus as bad as things might get, there was always another positive world there.(Some might say reading is my dope.) It also helped to be highly intelligent. Living in the country, there was always nature as a solace. As lousy as most teachers were, there was always one that helped me. As much as I was bullied, I always had some friends. I could go on, but I think you will get my point...

    I suspect that addicts are not fortunate enough to have such situations in their life.

  • Shell

    4 years ago

    Response to Zalm's comment

    Zalm,
    Yes. As you say, you are confused. You speak of your friend who "wallowed in his pain, rather than heal it." You then go on to say that "when schizophrenia took him". What?! These 2 statements alone indicate your lack of knowledge and understanding of the issues of both addiction and mental illness.
    Schizophrenia did not "take him" after drug use! Schizophrenia most likely had him, unbeknownst to anyone, from birth - and was lurking & waiting to make it's ugly appearance during his teens. Your friend was almost certainly experiencing shizophrenic symptoms and episodes from his mid to late teens at the latest, and his use of drugs was his effort to self-medicate to try to manage the utterly confusing & terrifying experience of schizophrenia. I would bet that his "best of everything West Van" family had no clue that their son had schizophrenia, and thus were unable to access the kinds of treatment, care and support that he needed early on. This is a failure of our health care system, our society, our social supports and scarcity of available effective interventions.
    In point of fact, your friend's story is an absolutely perfect example of what Dr. Mate is explaining. "What is the pain?" In this case, the pain was mental illness. And, in case you didn't realize it, one cannot somehow work oneself out of schizophrenia with "guided introspection". The very statement is ludicrous, since schizophrenics not being treated have no control over their thought processes. And are in the grip of a very powerful disease. There by for the Grace of god go you or me or any of us.

  • zalm

    4 years ago

    Shell

    John appeared healthy and normal - and when you ask him in a serious moment, would say so himself - till he was about 25 when schizophrenia began to manifest itself. We didn't know what it was, and neither did he, but in the year it took us all to discover his illness, he then discovered he really DID have something to complain about.

    Before that, either his parents were too hard on him,or his teachers didn't like him, or the coach wouldn't let him play pitcher because he was only favouring his own kid to be the pitcher, or the cops had it in for him, that's why he had so many speeding tickets.... on and on it went, and often he REALLY believed what he was saying. He had little concept of self-control. He said he was diagnosed "hyperactive" at about age 10 but his parents refused to put him on medication. We were neighbours for fifteen years growing up, and his parents never expressed any concerns about his "hyperactivity" to us kids, or to our parents, nor was medication mentioned. They did, however, as parents do, try to rear him to control his impuslsive behaviour.

    John got to do pretty much whatever he wanted until it came to taking responsibility for his actions, whether he broke a neighbour's window with a softball, was caught bullying others, or when it came to getting or keeping a job when he was older.

    Bad parenting? Perhaps. Schizophrenia at an early age? I don't think so. Causes of mental illnesses are complex, and can rarely be reduced to single events. In retrospect, one might have been able to see a mood change in John a couple of years before 25, when he changed his taste in music, began living only in basement suites instead of apartments, and live his life at night, rather than in the daytime. Was he a lycanthrope? No. But when you ask him about those times, he still calls them 'the good old days'. He was obviously coping with something, even though he couldn't sense anything different about himself.

    I'm sure I wasn't very clear in my previous post, but you draw too many straight lines from cause to effect. John's schizophrenia has been medicated for many yearssince age 26, without any improvement. Guided introspection, whatever you want to call it, is the only thing that will complement the drug therapy that controls the worst of his symptoms.

    But John still refuses to look at his life. It's all still happening to him "out there". And nobody can help.

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