In the last few years I’ve read a fair number of books that deal with the effects of trauma and long-term stress on our psychological and physical health, and how these negative effects can possibly be dismantled. I find this to be the most important challenge of our time, because traumatized, stressed people are damaged people, and damaged people are potentially dangerous people. We humans are the most destructive creatures on our planet, a species whose only predator is itself. The greatest threat we face is to be found in the effects of our unhealed, unexamined darkness, which when not dealt with spiral downward through the generations and upward into the chambers of power.
So what is to be done? Quite a lot, as it turns out, because in the last couple of decades has come a revolution in our understanding of the brain, how it is shaped by experience to influence our inner life and behavior, and how it can be reshaped and reformed by wise, compassionate treatment. In many different fields people are working with these new insights, and though at present they are swimming against the stream of a culture which still prefers to see things in terms of rigid divisions and blindly wage war against a mythical “other”, I have hope that in time a new paradigm will emerge. This will mean seeing how we are all connected, how our social interactions form our individual selves, and how in turn the healing and support of the individual will make us better members of our communities. It will mean seeing that no war is winnable, that we have to stop fighting and start understanding one another, and that the first place to begin to understand the other is with an honest look at ourselves.
Gabor Maté’s book, In the Realm of Hungry Ghosts: Close Encounters with Addiction, looks through the lens of addiction to explore these questions and themes, taking his work with the hardcore drug addicts of Vancouver, Canada as his starting point. Rather than demonizing these people and excoriating them as a scourge to society, can we understand what would turn a person to so intractably persist in doing things that endanger his or her own life and health? And what could potentially transform this destructive pattern?
This question is illuminated by the new knowledge about how brain systems are formed, how they operate, and how they are damaged by trauma and adverse childhood experiences — which can be much more subtle than one might expect, as children and even unborn infants are highly sensitive to stress and trauma in their parents, and even loving parents can be lacking in the emotional attunement that developing humans crave. The result is an addictive drive for false “wants” that replaces the healthy fulfillment of real needs. And addiction doesn’t just mean heroin junkies on the street; it refers to a range of behaviors, some of which are quite socially acceptable and even applauded — like an addiction to work or sport — and some of which are accepted as normal but destructive on a global scale, like our rampant consumerism. What they all have in common is that the person feels compelled to persist in behaviors no matter how harmful to self and others they may be.
With unusual self-awareness and honesty, Dr. Maté uses himself as a case study, examining his own addiction to buying classical music CDs to demonstrate how the addictive process works, and how it really is the same process that underlies all kinds of manifestations. He persuasively points to early trauma and stress (in his case, as a member of a Hungarian Jewish family during the Holocaust) as sources of the addictive pattern, because defense mechanisms and adaptive patterns that the body and brain use to try to protect themselves and meet fundamental needs become maladaptive when they persist in the long run.
It’s not about blaming caregivers, but about becoming aware of how sensitive and needy we human beings really are, how dependent upon our emotional and social environment to grow up as strong individuals. Nor can we put the entire blame on genetic factors, absolving us of the responsibility to change ourselves and our society; Maté convincingly presents evidence that genes are strongly affected by environment and upbringing, so much so that genes alone cannot be held responsible for much of anything of importance. We have to put in place better supports for mothers and other caregivers, put a high priority on nurturance of all kinds, and be less punitive and judgmental of the inevitable products of an adverse upbringing. This is not easy to do, because nearly all of us have wounds of some kind, too; as one researcher quoted in the book puts it, “What we are looking for is what we are looking with.” Maté’s personal story is a moving demonstration of how one person has tried to live out this difficult but essential quest, with humility and integrity.
Dr. Maté makes a strong case that the “War on Drugs” is an expensive failure and a humanitarian tragedy. Shifting focus and resources to prevention and care rather than law enforcement and imprisonment, where they currently reside, would be far more effective and less costly. He explains the principle of “harm reduction,” which means giving addicts the substance they need under safe, medically controlled conditions, eliminating their need to resort to criminal activities to get it, deflating the robust black market that has only grown over the decades of this worldwide “war,” and reducing the burden on the medical system. It does not mean legalizing the substance on the free market or downplaying its harmfulness. But it acknowledges that moralizing and promoting forced abstinence as the only course for addicts are ineffective. There has to be a better way to promote the conditions that may in time lead to healing; ordering it by force simply does not work.
In fact, as Maté points out, legal addictive substances and behavioral addictions also do tremendous harm; the point is not to draw some arbitrary line which allows us to scapegoat some addicts as criminals while others run free, but to dig down to the source of addictive behavior of all kinds, and work in this realm to create the strength and resilience that can protect our vulnerable brains from its lure. We are a long way from this goal, but steps are being made.
This is a spiritual endeavor, through which we need to understand not only our brains, but the “something” that lives in and through the brain, yet is not bound by its laws. This “something” is hard to grasp, difficult to define, and yet without it, there is no way to explain how the turnaround can possibly happen, how a person can start to dig out of the hole of addictive programming and become free of compulsions — which means not eliminating or suppressing them, but becoming able to observe and to think about them. It is the “witness” in us, the part that extends by an infinitesimal amount the tiny fraction of a second that is all the time we have in which to allow or deny the impulses which constantly arise in our unconscious minds. This part can be strengthened by practice, by inner training, and Dr. Maté mentions some practices that have been helpful for him and for sufferers from OCD, a disorder which bears some relationship to addiction.
It’s a very promising line of inquiry, that I also have found to bear effects in my own struggles with adverse experiences and the resulting unwanted behavior (food issues in my case). Since the book is more than a decade old, I assume there has been more work done in the field, and I’d be interested to learn more about it.
Overall, I highly recommend In the Realm of Hungry Ghosts as a rich source of information, human stories, spiritual insight, compassion, and hope for the healing of this most painful, soul-destroying condition. May it be an aid to all who are seeking such healing, for ourselves and for our troubled world.
Gabor Maté, In the Realm of Hungry Ghosts: Close Encounters with Addiction (North Atlantic Books, 2010; originally published 2008)
8 thoughts on “Nonfiction November review: In the Realm of Hungry Ghosts”
A very interesting post on this book, I remember when it came out and garnered much attention and debate. The research done into how the brain works is so fascinating, and really we still know so little.
It’s just a beginning, as I think Dr. Maté makes clear. His own recovery is a work in progress.
What a fantastic review. I’d heard of this one but I don’t think I realized it encompassed as much as it does – that is, exploring how similar various addictions are and what brain wiring those are affected by and even techniques or ideas in how to begin changing ways of thinking. I think I understood as being more about his work with drug addicts instead of using that as a jumping-off point. I appreciate the stance it sounds like he takes on dealing with addiction too, in that it’s such a thorny issue but the war on drugs hasn’t been the right approach at all.
The way you write about the tiny fraction of a second that makes the difference in giving in to an impulse or retraining is really what makes me want to read this. That to me encompasses exactly why addictive behaviors are so difficult to treat.
This one is immediately going on my list. Thanks for such a thoughtful and insightful look at it!
Some of those ideas are just touched on, or have a lot more research to be done, but the basic point that we have to start changing our ideas about addiction is solidly made, I think. It really is not possible for many people to “just say no,” and I can now understand why.
This sounds fascinating. It’s new to me. Thank you for sharing it.
Thank you, I’m glad it was of interest.
A very thoughtful review, thanks for sharing.
Thank you for reading.
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