Tuesday, January 1, 2013


Dr. Gabor Maté wrote the bestsellers Scattered: HowAttention Deficit Disorder Originates In the Realm of Hungry Ghosts: CloseEncounters with Addiction. The following article was adapted from an interview by Amy Goodman. Our society is suffering in a variety of ways - from widespread drug abuse to mass killings. Dr. Mate looks deeply to uncover the root of many of society's problems.

'Post-industrial' capitalism has destroyed the conditions for healthy childhood development. The hardcore drug addicts that I treat, are, without exception, people who have had extraordinarily difficult lives. The commonality is childhood abuse. These people all enter life under extremely adverse circumstances. Not only did they not get what they need for healthy development, they actually got negative circumstances of neglect. I don’t have a single female patient in the Downtown Eastside of Vancouver who wasn’t sexually abused, for example, as were many of the men--or abused, neglected and abandoned serially, over and over again. That’s what sets up the brain biology of addiction. In other words, the addiction is related both psychologically, in terms of emotional pain relief, and neurobiological development to early adversity.

AG: What does the title of your book mean, In the Realm of Hungry Ghosts?

GM: In the Buddhists’ psychology, there are a number of realms that human beings cycle through, all of us. One is the human realm, which is our ordinary selves. The hell realm is that of unbearable rage, fear, you know, these emotions that are difficult to handle. The animal realm is our instincts and our id and our passions.

Now, the hungry ghost realm, the creatures in it are depicted as people with large empty bellies, small mouths and scrawny thin necks. They can never get enough satisfaction. They can never fill their bellies. They’re always hungry, always empty, always seeking it from the outside. That speaks to a part of us that I have and everybody in our society has, where we want satisfaction from the outside, where we’re empty, where we want to be soothed by something in the short term, but we can never feel that or fulfill that insatiety from the outside. Addicts are in that realm all the time. Most of us are in that realm some of the time. My point really is, is that there’s no clear distinction between the identified addict and the rest of us. There’s a continuum in which we all may be found. They’re on it, because they’ve suffered a lot more than most of us.

AG: Can you talk about the biology of addiction?

GM: If you look at the brain circuits involved in addiction—and that’s true whether it’s a shopping addiction like mine or an addiction to opiates like the heroin addict—we’re looking for endorphins in our brains. Endorphins are the brain’s feel good, reward, pleasure and pain relief chemicals. They also happen to be the love chemicals that connect us to the universe and to one another.
Now, that circuitry in addicts doesn’t function very well, as the circuitry of incentive and motivation, which involves the chemical dopamine, also doesn’t function very well. Stimulant drugs like cocaine, crystal meth, nicotine and caffeine, all elevate dopamine levels in the brain, as do sexual acting out, extreme sports, workaholism and so on. The issue is, why do these circuits not work so well in some people, because the drugs in themselves are not surprisingly addictive. What I mean by that is that most people who try most drugs never become addicted to them. So, there has to be susceptibility there. The susceptible people are the ones with these impaired brain circuits, an impairment caused by early adversity, rather than by genetics.

AG: What do you mean, “early adversity”?

GM: Well, the human brain, unlike any other mammal, for the most part develops under the influence of the environment. And that’s because, from the evolutionary point of view, we developed these large heads, large fore-brains, and to walk on two legs we have a narrow pelvis. That means—large head, narrow pelvis—we have to be born prematurely. Otherwise, we would never get born. The head already is the biggest part of the body. Now, the horse can run on the first day of life. Human beings aren’t that developed for two years. That means much of our brain development, that in other animals occurs safely in the uterus, for us has to occur out there in the environment. And which circuits develop and which don’t depend very much on environmental input. When people are mistreated, stressed or abused, their brains don’t develop the way they ought to. It’s that simple. And unfortunately, my profession, the medical profession, puts all the emphasis on genetics rather than on the environment, which, of course, is a simple explanation. It also takes everybody off the hook.

AG: What do you mean, it takes people off the hook?