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Thursday, March 26, 2015

Addiction Epidemic: Dr. Gabor Maté and "Hungry Ghosts"

Epidemic -- the word is frightening and entails such massive connotations of destruction that most people feel powerless to find any way to help stop the effects of its horrible impact. The United States of America is in the throes of a heroin epidemic. Denial of this fact is simply adding to the death toll that now has reached unbelievable proportions.

Perhaps it is time we rethink the source of addiction. Current prevention and recovery methods help so many, but the problem remains: we are failing our youth in the way we treat physical and emotional pain. Statistics will bear out these sad revelations. Today I hope we might find some new directions by reading about the work of a very special man.

Dr. Gabor Maté is a recovery expert and groundbreaking addiction specialist who works with addicts in Vancouver’s infamous Downtown Eastside, which is the area with the most concentrated levels of drug use in North America.

To fully understand Dr. Maté, it is imperative to read about his past. He shares this ...

"I am both a survivor and a child of the Nazi genocide, having lived most of my first year in Budapest under Nazi occupation. My maternal grandparents were killed in Auschwitz when I was five months old; my aunt had also been deported and was unheard-from; and my father was in a forced labour battalion in the service of the German and Hungarian armies.

"My mother and I barely survived our months in the Budapest ghetto. For a few weeks she had to part from me as the only way of saving me from sure death by starvation or disease. No great powers of imagination are required to understand that in her state of mind, and under the inhuman stresses she was facing daily, my mother was rarely up to the tender smiles and undivided attention a developing infant requires to imprint a sense of security and unconditional love in his mind.

"My mother, in fact, told me that on many days her despair was such that only the need to care for me motivated her to get up from bed. I learned early that I had to work for attention, to burden my mother as little as possible and that my anxiety and pain were best suppressed."

(Margaret Gunning. "Gabor Maté Interview." January Magazine. April, 2003) 

Dr. Maté believes the heroin epidemic among young people in North America stems from the fact that heroin is, above all, a pain-killer. He states ...

"The real question is not why is there a heroin epidemic, but why is there so much pain amongst young people today? And that has to do with two factors: one is that a lot of young people are traumatized and abused in childhood, and another is that lot of other people that are indirectly abused are still not getting their emotional needs met.

"Their parents are too busy, too stressed, too distracted, too depressed, too overwhelmed themselves to give them what they need. So children grow up with a sense of emotional lack and emptiness, fear, and distress. Heroin partially soothes that pain and that distress."

(Alexis Neiers. "How Do We Solve North America’s Heroin Epidemic?"
VICE Media LLC. July 28, 2013 )      

Even though genetics plays a role in addiction, the presence of "addictive genes" does not mean that someone is going to have a certain behavior. It does mean that behavior is more likely, given certain circumstances. Maté says it is these circumstances that either "turn off the gene or activate them -- we know this from both animal studies and human studies."

So, we currently understand the importance of education in fighting addiction, and we educate people to deal rationally with the unpleasant circumstances they face. For example, we warn youth of the dangers of heroin and the necessity of making good choices when faced with drug use. Yet, millions of these same children ignore the warnings and develop substance dependencies.

The natural remedy to help those who are dependent is treatment. No doubt, we lack adequate facilities to treat all of those who need affordable care. And, unfortunately, we understand treatment often doesn't work. It seems as if we need to do much more than treat people to help them gain power over their substance abuse. Again, Maté explains ...

"It's (treatment) ineffective, because it sees the addiction as the problem. The problem is everything else I've been talking about. Addiction is not the problem. Addiction is the addict's attempt to solve a problem. What did your addictive behavior do for you? I don't mean what was negative about it -- that’s obvious to everybody --but what did you get from it? It gave you something. What did it give you?

"... In other words, the addiction wasn't the problem.  Your addiction was your attempt to solve a problem. If you don't understand that, you can't talk to anybody."

The relationship between emotional stress and disease, and mental and physical health is often considered controversial within medical circles. Still, Dr. Maté argues too many doctors now seem to have forgotten what was once a commonplace assumption, that emotions are deeply implicated in both the development of illness, addictions and disorders, and in their healing.

Maté claims there is a "brain biology of addiction."

In other words, the addiction is related both psychologically,
in terms of emotional pain relief, and neurobiologically,
in relation to development and early adversity.

Brain biology? It is human nature to look constantly for things that release endorphins -- the brain’s feel good, reward, pleasure and pain relief chemicals. Stimulant drugs like heroin, cocaine, crystal meth, nicotine, and caffeine all elevate dopamine levels in the brain. We understand that most people who try drugs do not become addicted.

Yet, Maté believes the most susceptible people are the ones with impaired brain circuits, and the impairment is caused by early adversity, rather than by genetics. He claims the medical profession should consider environment more than genetics when evaluating reasons for addiction. He thinks the profession puts overemphasis on genetics because it "gets them off the hook." According to Maté ...

"If people’s behaviors and dysfunctions are regulated, controlled and determined by genes, we don’t have to look at child welfare policies, we don’t have to look at the kind of support that we give to pregnant women, we don’t have to look at the kind of non-support that we give to families, so that, you know, most children in North America now have to be away from their parents from an early age on because of economic considerations.

"And especially in the States, because of the welfare laws, women are forced to go find low-paying jobs far away from home, often single women, and not see their kids for most of the day. Under those conditions, kids’ brains don’t develop the way they need to.

"And so, if it’s all caused by genetics, we don’t have to look at those social policies; we don’t have to look at our politics that disadvantage certain minority groups, so cause them more stress, cause them more pain, in other words, more predisposition for addictions; we don’t have to look at economic inequalities. If it’s all genes, it’s all -- we’re all innocent, and society doesn’t have to take a hard look at its own attitudes and policies."

(Amy Goodman. "Dr. Gabor Maté on the Stress-Disease Connection, Addiction, Attention Deficit Disorder and the Destruction of American Childhood." Democracy Now! May 30, 2011)

In his book, In the Realm of Hungry Ghosts, Maté describes its title as a Buddhist phrase. He explains how this relates to addiction ...

"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. The addicts are in that realm all the time. Most of us are in that realm some of the time. And my point really is, is that there’s no clear distinction between the identified addict and the rest of us. There’s just a continuum in which we all may be found. They’re on it, because they’ve suffered a lot more than most of us."

(Amy Goodman. "Dr. Gabor Maté on the Stress-Disease Connection, Addiction, Attention Deficit Disorder and the Destruction of American Childhood." Democracy Now! May 30, 2011)

Implications For Solving an Epidemic

Dr. Gabor Maté and his studies tell us that a baby faces the war on drugs as soon as he or she is born. He emphasizes that this war is being fought in a manner that entrenches addiction deeply. Here are some key points ...

* Severe addicts are, for most part, abused children. Maté says they are trapped "in a system that ostracizes, marginalizes, impoverishes and ensures their disease."

* Children are experiencing not "bad parenting" but rather "extremely stressed parenting. They pick up on the stresses of their parents, and without proper development of their brain circuits, the children deal with that much stress by tuning it out. To prove his point, Maté invites us to look at the preponderance of ADD and the three million kids in the States that are on stimulant medication plus the half-a-million who are on anti-psychotics.

* We punish people for having been abused by institutionalizing them in punitive "correctional" facilities with no care. There, people suffer more, and then they come out, they’re more entrenched in their addiction than they were when they went in.

* The sense "of never being soothed, of never having enough" is rampant. So instead of a punitive approach, we need to have a much more compassionate, caring approach that would allow these people to develop, because the development is stuck at a very early age.

* For the first time in history, children are not spending most of their time around the nurturing adults in their lives. They’re spending their lives away from the nurturing adults, which is what they need for healthy brain development. Read this and consider whether Maté's image of development is true ...

"The normal basis for child development has always been the clan, the tribe, the community, the neighborhood, the extended family. Essentially, post-industrial capitalism has completely destroyed those conditions. People no longer live in communities which are still connected to one another. People don’t work where they live. They don’t shop where they live. The kids don’t go to school, necessarily, where they live. The parents are away most of the day." 

* Kids are still learning from the people they’re attached to, but now it’s other kids. So we have whole generations of kids that are looking to other kids now to be their main cue-givers.

* Research clearly shows that the biggest driver of addictive relapse and addictive behavior is actually stress. Stress drives addiction.

“Nothing records the effects of a sad life so graphically
as the human body.”

--Naguib Mahfouz, Egyptian writer   

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