In the Realm of Hungry Ghosts

In the Realm of Hungry Ghosts: Close Encounters with Addiction by Gabor Maté, M.D.Full Title: In the Realm of Hungry Ghosts: Close Encounters with Addiction
Author: Gabor Maté, M.D.
Publisher: Knopf Canada (2008)
Number of Pages: 399 (plus an epilogue and four appendices, so total 423)
How long it took me to read: Almost three weeks
Where I bought this book: I took it out of the library; it was someone’s pick for the book club I belong to.
ISBN: 978-0-676-97740-0
Interview with Author: Maté discussing his work at the Portland Hotel Society on Democracy Now!

Like a Moth to a Flame

I’d heard interviews with the author, Gabor Maté, on the radio. He’s quite controversial because he advocates a harm-reduction model of substance abuse treatment (allowing people with addictions to use cleanly and safely with help from public health nurses and other professionals, as opposed to in back alleys and on the fringes of society the way they do now). His work with addicts in Vancouver’s Downtown Eastside gives him a unique perspective on a gritty issue.

Favorite Five

I propose that the top 5 quotes from this book are:

5. “The War on Drugs fails, and is doomed to perpetual failure, because it is directed not against the root cause of drug addiction and the international black market in drugs, but only against some drug producers, traffickers and users…The pertinent question is not why the War on Drugs is being lost, but why it continues to be waged in the face of all the evidence against it.” (p.283)

4. “Far more than a quest for pleasure, chronic substance use is the addict’s attempt to escape distress…Addictions always originate in pain, whether felt openly or hidden in the unconscious. They are emotional anesthetics.” (p.33)

3. “Brain development in the uterus and during childhood is the single most important biological fact in determining whether or not a person will be predisposed to substance dependence and to addictive behaviours of any sort, whether drug-related or not.” (p.180)

2. “The scientific literature is nearly unanimous in viewing drug addiction as a chronic brain condition, and this alone ought to discourage anyone from blaming or punishing the sufferer. No one, after all, blames a person suffering from rheumatoid arthritis for having a relapse, since relapse is one of the characteristics of chronic illness.” (p.147)

…and my pick for the No.1 quote is…

1. “Anything can serve as the object of the addiction process, including religions that promise salvation and freedom. The physical entity called Jerusalem has itself become a fetish for many people of several faiths, with bloodshed and hatred being the consequence. It is no accident that in all major religions the most rigidly fundamentalist elements take the harshest, most punitive line against addicted people. Could it be that they see their own weakness and fear—and false attachments—reflected in the dark mirror addiction holds up to them?” (p.390)

Conversation with the Reader

While I read, I write, and as I write, I read. Here’s some of what I wrote while I read this book:

“I’m a new mom—there’s a lot I could do wrong that would affect my daughter in the future. Her brain functions, receptors and systems have been forming since before she was born. Picking her up when she cries, making her feel safe and loved and fulfilled have always been important, but seeing just how much that early stuff can influence her actual brain structure for later in life has really hit home.

“Although I’ve never been a fan of the “cry it out” philosophy of parenting (letting a baby/kid cry for a while before going to soothe him/her), it’s definitely something I’m even less inclined to do after reading this book. The rational part of me knows that my daughter is growing up in a happy home with two healthy, emotionally intelligent adults and that is going to determine her success as a child and an adult. But another part of me, probably the guilty mother part, is even more in tune with going to her as soon as she cries (as opposed to letting her cry for a minute or two) after reading this book. Letting her look into my eyes, stopping what I’m doing and returning her smiles, etc., while something I always did, seem to have more importance now, backed up by the research Maté cites into parent-child attachments.

“Also, peer group affiliation—something my mom was always looking out for—is more important than I thought. My mom knew my friends when I was a kid and made sure my peers were on the right path in life. Mom didn’t tell me until much, much later which of my friends she thought may have been a bad influence, but made sure I was busy with other activities if a particular friend who she didn’t approve of wanted to play. When I was a teenager, my mom balked at letting me hang out downtown at night (‘nothing good happens downtown after dark,’ she always said). Smart lady—she had instincts, not the science that Maté cites, including research that shows peer-reared monkeys are more likely to turn to booze than adult-reared monkeys. Maté discusses the mammalian need to get instruction, education, love and attention from adults, not peers, and the detrimental effects on those animals and humans that don’t have that adult role model.”

“It makes me so angry that the War on Drugs continues despite the immense evidence that it’s not working; it’s failing the people who most need help. Politicians have to see the information presented here and in other publications, about harm reduction and decriminalization, and just willfully ignore it. The drug boogey-man is a lot easier to sell to the voting public than spending on prevention and treatment programs for those most at risk of becoming addicted to drugs or alcohol. Funny, it makes economic sense to help people with addictions instead of throwing them in jail, so the right-wing politicians so concerned with crime and punishment and wasteful spending should be the ones pushing for help rather than prison.”

“Some of the science stuff I glossed over, but it really was interesting to read the more social aspects of research into brain development and how it relates to addiction—the fact that rats who were licked (i.e., loved) less by their mothers had different brain structures and were more likely to get addicted to opiates and alcohol. Maté talks about our society feeling sorry for children who are abused, children who are rescued during child pornography busts, etc., and then when those children turn 17, 18, 19, and treat their earlier pain with drugs, we feel distaste, discomfort and even contempt for the dirty, scary addicts. It’s interesting that humans have such a difficult time connecting one to the other and changing our long-held views about addictions.”

“Maté doesn’t mince words about the people he works with—he acknowledges that his clients/patients steal, manipulate and cheat even him, who is working to help them. I’m not sure if this book changed my view of people with addiction; I am more aware about the complicated and often tragic histories these people have. Maté didn’t really talk about the people with addictions who simply do drugs (say, in high school) and just ‘get hooked.’ In fact, he rejects that drugs themselves are addictive (and provides evidence of the brain chemistry necessary for a person to become addicted to a drug). I buy that, but part of me doesn’t—there must be some people who just simply get addicted, right? Not everyone with an addiction was abused as a kid. Pretty much everyone I know experimented with drugs in their youth, whether pot or alcohol or cocaine or LSD, and very few people I know are addicted—those who are, are addicted to alcohol, not the illegal drugs they tried on a lark. My own experience just reinforces the fact that as a society, we choose to condone (and legalize) some drugs and not others—alcohol over marijuana, for example. It’s completely arbitrary, and I hope to instill in my daughter a healthy dose of skepticism about what she learns in school about drugs. Drug education is similar to sex education—difficult for parents to discuss, and overhyped by the school system. Hopefully, my husband and I will have ongoing discussions with our daughter about both, so that neither is demonized.”

Kate Dubinski

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  1. Tootle Peep says:

    “Not everyone with an addiction was abused as a kid.”

    It depends what the person means by “abuse”. Everyone has their own definitions, but I think the best term would work in the context of adult-to-adult interactions. Do we spank other adults for disagreeing with us? Do we force them into timeouts? Do we threaten them with the withholding of food or love? Do we manipulate them emotionally and expect them to “win” our approval? Do we force them to finish their lunches and dinners, even after they explain how full they feel? Usually not, for if this happens in adult interactions, people would quickly point it out as physical and/or psychological abuse, and that the victim should end the relationship.

    What’s even more interesting is that adult-to-adult interactions and relationships are almost exclusively voluntary. They choose to interact and be a part of each other’s lives. This cannot be said in the case of a child. They did not choose their parents, their place of birth, their time of birth, or any other bit of environment. Therefore, anything that is wrong for an adult to do to another adult is infinitely more horrendous to do to a child. Period. If you are one of integrity and consistency, this shouldn’t be hard to accept.

    With all of that said, let’s go back to “Not everyone with an addiction was abused as a kid.” That’s really difficult to know, even if you use the term “abuse” to mean outright hitting, shouting, and/or sexual abuse. You may be surprised to find out what actually goes on in family homes if you had access to secret video footage. I know of a few families that appear happy and normal from the outside, but what the people around me seem ignorant of is the great dysfunction and abuse that takes place in the house. Boy! Were they sure surprised to find out a daughter got caught doing drugs! I mean, she’s part of such a loving, warm family after all, right?

  2. […] thoughts about comfort and love from a baby’s first day were confirmed when I read In the Realm of Hungry Ghosts (see previous review I did) which cited research about parental love and response to infants’ […]

  3. Isabelle Payette says:

    Most serious hardcore addicts, I think, do not have the ability to think rationally because most are stuck in their fear and hopelessness. They use in order to cope and minimize the harmful effects of their past trauma. Unfortunately, all the current medical system has to offer is a prescription for pills that will never do anything more then dull the mind, if that, and have very serious long term harmful side effects. We must insist on more professional counselling services and more on-going support for trauma victims. We can also start by teaching parenting in highschool… education is part of the solution.

  4. Teta Bombardieri says:

    I’m very sad for you Debbie, for having missed ‘the love of an emotionally present mother’….. Would you be wanting to try to give a baby what you were so desperatly needing for yourself ?

    • Debbie Farrell says:

      Very thankful to have had the work of Gabor and many other brilliant minds to help me meet the needs of my children :-).

  5. Direct link to FAQ by Dr Mate clears up much

  6. Charles McLean says:

    The obvious arguement that “not every addict was abused as a kid” I have used myself but perhaps it is too black and white an arguement in regards to the complexities of brain development and to the variations in early experiences that people have. For instance: perhaps an infant that is comforted each and every time he is distraught will later have less innate anxiety than a child who was comforted only half the time, and a person comforted only occasionally or further, a child who was ignored or even yelled at or spanked when crying will experience a greater intensity of anxiety and a greater drive to quell it with opiates etc. Ignoring a crying infant 50% of the time may not qualify as abuse in court but it may influence their degree of susceptability to seek some kind of relief later on.

    • Debbie Farrell says:

      My sentiments exactly Charles. First we need to define abuse.I am a recovering addict and when I started my journey i did not feel the I suffered abuse as a child. As I peeled the onion, i have found that my needs were not met as a child. The fact is that my mother was an alcohlic fighting her own demons and was not able to provide for me the emotional presence. I was fed, clothed, and had a roof over my head so at a glance one would have thought that all my needs were met, therefore was not abused. What was lacking in my life was the love of an emotionally present mother.

  7. david r evans says:

    Mate is a modern day hero, a true crusader, for the disenfranchised,addict. His voice though quiet resonates loudly.

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