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?
