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In the Realm of Hungry Ghosts: Close Encounters with Addiction

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In all innocence I picked up Gabor Mate's book and in no time I was stunned to find that I was reading about myself. No, I am neither a drug addict nor alcoholic, but I have several other addictions I have been ashamed of my whole life. By the time I finished reading this insightful, compassionate, detailed book, I knew finally who I was, how I got that way and what I could do about it.

I honestly have no idea how anyone could read this book and give less than 5 stars. First of all, the 3-star reviewer totally missed several important points concerning Mate's actions at home and on the job. Money was given to his staff, not as a bribe, but as an incentive for him to stop being late and to give himself a little spiritual humbling. As for Mate's own addictions, I feel so much safer to be in the hands of a man who is frank and transparent with me and says, "Let's try this," rather than one who is distantly perfect and ultimately unknowable, who is given to uttering commands and pronouncements. I know who I would trust more.

Mate may suffer from ADD (which I also do) but let me assure you that his prose is every bit as fluid, clear and inspired as the prose you are presently reading. More, his writing is a joy to read. The book itself is very well presented, almost like a mystery story with as happy an ending as one can expect after several murders have been committed in the beginning! The book starts with the stories, the life histories and personality details of his patients. It goes on to then give the medical and psychological and political facts about addictive behavior, and the last chapters are devoted to help, healing and hope. It could not be more beautifully structured!

Although the structure is sectioned like three strong men stacked upon each other's shoulders, each of these men are holding to their side many beautiful women, arms gracefully out and offering wisdom.
Such as Mate's definition of the difference between passion and addiction: "The difference between passion and addiction is that between a divine spark and a flame that incinerates." He elaborates more in that chapter.

Another: "When we flee our vulnerability, we lose our full capacity for feeling emotion." Think of any tyrant who stoically watches as his people suffer, or a terrorist who kills innocents without a blink of remorse. These people are in deep denial and HAVE to believe they are invulnerable in order to do such things. They believe vulnerability equals "weak," rather than "open." So they protect themselves by killing others.

Mate' offers many more sideways and heads-on truths. I believe he gets his insights from not blaming. Not blaming opens him up to seeing things others, in their defensive and prejudiced postures, fail to see. He recognizes that, "at the core of all addictions there lies a spiritual void."

But you want facts, don't you? Okay. He says, "all addictions have a biological dimension." Proof? He offers a wealth of recent studies that are not one bit boring, but are so amazing they can take your breath away. These studies involve people, mice and monkeys. When 6,000 people who where taking prescribed narcotics for pain were studied there was found to be "no significant risk of addiction." Gee, you mean it's NOT the drugs that addict you? No, it's not! Among rat babies who were given appropriate mother-nurturing, none of them showed the slightest interest in a narcotic drip even after they'd been injected! Those who did self-medicate, were beseiged when they were babies with "emotional isolation, powerlessness, and stress." This will also "promote the neurobiology of addiction in human beings."

Mate' includes ALL addictions in his studies, such as smoking, alcoholism, shopaholic, sugar addict, workaholic, gambling, and more, ending with "there has never before been a generation so stressed and so starved of nurturing adult relationships." He takes it from the street and shows us addiction throughout the world. In short, we are ALL addicted to something -- and you know he is right. He refuses to point a finger "out there," but puts it where it belongs, aiming it at our own inner self. This confirms my own observations that we're destroying our outer world (Earth) because our inner world has, in a crucial way, been destroyed.

The hope Mate' offers is important. He knows that every one of us craves "love, creativity, spiritual quest, the drive for mastery and autonomy, the impulse to make a contribution." That describes me and I know it describes you. These are the best and most profound attributes of what being human means. But many of us were foiled at the very beginning, some even in the womb. The brain, however, can lay down new tracks which allow us to proceed in a different, healthier, happier direction.

I will go out on a strong limb of a mighty oak and say that this book is one of the first "most important" books of the 21st century. Every college kid, every politician, every medical person, every media person and every parent should read it. This book could save the world. Or, at the very least, your world. And that's world enough.

Those who are looking for a brief look at addiction ought to look elsewhere; whatever else can be said about Gabor Mate's In the Realm of Hungry Ghosts, it represents a lengthy, multi-faceted look at the reality of addiction.

Mate is a Canadian physician who practices medicine in one of Canada's poorest and most socially challenged neighbourhoods: Vancouver's Downtown Eastside. Drawing upon his years of experience working with addicts, as well as his expertise in the fields of stress management and attention deficit disorder, Mate has produced a book that capably examines addiction from a wide variety of vantage points.

That having been said, it is only fair to acknowledge that I, for one, was not equally enamoured of the book's every section. Mate is at his strongest as a narrator; I was truly gripped by the lengthy sections of the book in which Mate is content simply to share the experiences--the oftentimes harrowing experiences--of the clients with whom he works. I was equally impressed with his refreshingly accessible account of the implications of new discoveries in the field of brain science, as scientists try to explain the processes that create and perpetuate addiction.. In addition, the book's final section--on "the ecology of healing"-- contained some genuinely fresh insights and some genuinely practical suggestions. These sections most certainly justify the book's purchase.

I found other sections of the book less satisfactory. Although I share Mate's antipathy toward the "war on drugs", I found his own policy prescriptions less than fully convincing. (Then again, I'm glad to have had an opportunity to grapple with his recommendations). Although his willingness to speak frankly of his own addictive tendencies (he's a classical music junkie) are a sign of Mate's humility, by book's end that aspect of Hungry Ghosts had begun to wear a little thin; try as I might, I struggled to place Mate's addiction to classical CDs in the same category as his accounts of the life-threatening substance addictions with which his patients struggle. Finally, while eager to affirm Mate's recognition that there is a spiritual dimension both to addiction and to the process of healing from addiction, I found Mate's discussions of spirituality a wee bit thin, and the affirmation of hope with which the book concluded somewhat less than convincing.

Those criticisms notwithstanding, In the Realm of Hungry Ghosts, is a valuable book: one that will repay the time and energy of anyone looking for a deeper insight into the haunted world of addiction.

Dr. Mate's book is interesting and complete as he discusses the horrible problem of drug addiction. The book has sections about the life stories of addicts, the brain chemistry of addiction, the addictive process, the war on drugs, and the possibilities for overcoming addiction. Despite the very grim nature of the subject matter, the book is both hopeful and helpful.

There is a wide continuum of addiction from consumerism, to sugar, to tobacco, to alcohol, to narcotics. As I read the book, it become clear that many of us have at least some degree of unwanted behavior in response to the chemical promptings of our brains. Hardcore drug addicts are not so very different from the rest of us. Given this context, Dr. Mate's critique of the war on drugs is very compelling. I found his arguments for decriminalizing (but not legalizing) drugs to be very persuasive.

Near the end of the book he offers a four (or five) part approach to treating addiction that seems very helpful in part because it promises no magical overnight results, but instead calls for lots of mindful work repeated many times. "Hungry ghosts" is a metaphorical image from Buddhism for those with appetites that can't be met; the idea that mindfulness, often cultivated by meditation, is the best way to treat these appetites helps bring the book full circle.

It is hard for me to review this book. Dr. Mate says he has ADD, and it shows. Where was the editor for this book? It is all over the map; overlong, with chapters that proceed each other without any continuity, some more than excellent and others downright unreadable.

Yet, in parts it excels greatly, and for this I recommend it. I wish Dr. Mate would have dispensed with his discussion of his classical music CD buying "addiction", his forays into the 12-step rooms, and a chapter on one addicted woman's pregnancy "journal."

Otherwise, this is an excellent in-depth look at addiction and the our absurd "war on drugs." When Mate writes about true drug addiction (and not about himself), with clarity and compassion, he is at his best. As one who has struggled with addiction, I know from my gut-level reaction to (parts of) this book that it speaks the truth. Read it, skip the chapters an editor should have cut, or enjoy them as some people have. Regardless of its large flaws, this is an important book.

Gabor Maté works in a clinic for drug addicts and homeless people in Vancouver. We've heard a lot about the War on Drugs the last twenty or thirty years, but unlike the narcotics squad, Maté is on the real front lines: where people turn from life and turn to drugs. And as he shares his stories - his patients' stories - it looks like the real problem isn't heroine or cocaine, so much as the things that drive people to use them. As you hear about some of Maté's patients, it becomes pretty clear they never had much of a chance to begin with. Their environments left them with limited options and the kind of stress levels that foreclose clear thinking about what few options there are. The addiction cycle makes it worse, providing for a sort of automatic thinking. According to the research Maté runs through, a person with a long term addiction literally winds up with altered brain physiology, with decision-making and creative centers shrinking so that following the line of thought set up by the addiction may be about all that's left for those who are furthest gone.

While Maté's stories are touching, it's his explanations of the research into addiction that made this most interesting to me. Some of the anecdotes have the feel of coming from overwrought novels. But when you see monkeys and rats using the same addiction mechanisms to deal with high stress and low status, you get a clearer sense of just what we're up against. To put it pithily, it's not just the demon weed that drives addiction; it's also the need to escape one's demons. If we truly want to help those with addictions, be it drugs, or gambling, or shopping or whatever, we need to get beyond moral judgments, and figure out just why some people wind up going down this path. Maté's book is a good start in that direction.

When I first picked up "In the Realm of Hungry Ghosts - Close Encounters with Addiction" I felt a little intimidated by the book's size and heavy topic.

MD, Gabor Mate's newest book published by North Atlantic Books was so highly recommended that I knew the content in its 450 plus pages provided new insights into addiction beyond what I could possibly imagine.

I first opened to the book's forward written by Peter Levine, author of Waking the Tiger and Healing Trauma.
Costs Associated with Addiction

Just reading Levine's recount of the costs of addiction to our society on so many levels offered stunning facts.

Levine went on to share that federal laws are changing to require insurers to cover both the mental and physical ailments associated with addiction equally.

This is a vast shift of the collective awareness from the "War on Drugs" mentality seeing addicts as deviant citizens who should be locked neatly away.
Questions About Addiction

In the book's Preface Mate states of his hopefulness as the cracks are opening to let in more light and openness by the public, which he feels will gradually translate into more effective help for those who are plighted with addiction.

This raised the important question: "What is effective treatment and how can it best be administered?" This seems like a million dollar question.

On page two Mate brings to the forefront additional questions that the book supplies many answers to:

* What are the causes of addictions?
* What is the nature of the addiction-prone personality?
* What happens physiologically in the brains of addicted people?
* How much choice does an addict really have?
* Why is the "War on Drugs" a failure and what might be a humane evidence-based approach to the treatment of server drug addictions?
* What are some of the paths for redeeming addicted minds not dependent on powerful substances--that is, how do we approach the hailing of the many behavior addictions fostered by our culture?

I soon realized the personal stories, cause of addiction facts, and insights of addiction physiology covered In the Realm of Hungry Ghosts would engage any reader in a helpful and hopeful personal, healing journey.

I knew reader's would not be disappointed and would finish the book more informed, enlightened, and with a fuller heart. They would also have a powerful resource on hand to share with others. We all know people who have or are suffering for one reason or another: friends, family, or acquaintances dealing with compulsive behaviors, self-sabotaging actions, or the inability to practice self-love.
Old Concepts About Addiction

The book quickly points out how ill equipped our society has been at understanding and truly helping those who are dealing with their ghosts.

The old concepts and approaches are not getting to the core issues affecting so many people suffering from some type of compulsive behavior.

The book offers an experience that everyone should have. The wisdom, compassion, and knowledge are quite profound. This isn't a book just for therapists, counselors, or mental health workers, but a book for everyone who knows someone.
More About Gabor Mate, MD

Gabor Mate, MD, a staff physician at the Portland hotel, a residence and harm reduction facility in Vancouver, Canada, has over twenty years of first-hand knowledge on addiction behaviors, which highly qualifies him to compile such a powerful and comprehensive study of addiction.

His previous books have all been best sellers in Canada and range in topics from ADD, stress illnesses, and mind/body unity. In the Realm of Hungry Ghosts has been nominated for the Hubert Evans Nonfiction Prize.

You will soon realize the book's impressive content offers grand insight for those haunted by the more hidden types of addiction including compulsive behaviors. For example those centered on:

* Food
* Tobacco
* Work
* Excessive Spending
* Prescription Drugs
* Internet Addiction
* TV Addiction
* Money and Wealth
* Power
* Sex

Dr. Gabor Mate examines the roots of addictive behavior and why people begin habits that are so very self-destructive. The causes and insights into our human cravings are well explored.

In the Realm of Hungry Ghosts is presented in three parts. Each section is synergistic to our understanding.
Part One - Touching Human Stories

I found myself page-turning, eager to sense how each individual's life events lead them down the path of addiction. I appreciated the dignity in the story telling as I felt like a fly on the wall observing their interactions.

Each story brought me closer to the human side of Dr. Mate while learning more about our culture's views of addiction. I couldn't help but feel a great deal of compassion for both the author and the patients with so much force seemingly against them.

The stories can't help but drive a person to want to break any stereotypical views that hold addicts as bad people who should be locked up, or broken people that can't get help because they don't know how to help themselves.
Part Two - Causes of Addiction

This section is a huge eye opener.

The clinical experiences combined with scientific understanding of brain development, neurophysiology, and psychology provide evidence that addiction is not about the availability of addictive things or substances, or the genetic theory.

We learn how the stage is set at a very early age for the predisposition of addictive behaviors. Infants who lack emotional nurturing can find their endorphin receptors compromised. The altering effects of the infant's brain development can trigger the attraction to various addictive substances.

This is why "just saying no" to addictive actions and substances becomes practically impossible without the help of those trained to understand how to work with the deep rooted effects of brain physiology.

About now most people will get how important this book is for every person, therapist, and healer. The information provides empowerment to the so-called "enabler" and also enlightenment for those experiencing any type of self-sabotaging addictive behavior.

Just imagine a path of understanding to assist in filling the void within ourselves that invokes emotional imbalance while also understanding how our brain physiology can lead us astray.

Part Three: The Dark Side of Drug Reform

Here the reader is guided to really stop and take a look at how society as a whole handles addiction in all the wrong ways.

Lack of compassion and understanding have set up how addicts have been and still are being treated. Judgment, disassociation, and locking them away have been seen as the answer to addressing their diseased state.

Would we lock up a person who has heart disease or cancer just because they are susceptible and have a weakened system?

It really hits home how important it is to view each soul as a teacher and why compassion is so very important. The act of judging another is exposed for what it is, the lack of our capacity to love, love unconditionally.
In the Realm of Hungry Ghosts Book cover Hope, Wisdom, and Courage

Each story in this book can offer compassionate self-reflection that can be life changing for the reader. Hope is gained that the minds of society are opening to transform the whole way our culture "handles" addiction.

It may take just a little courage to set ego fears aside before opening the book. But with that said, I highly recommend "In the Realm of Hungry Ghosts" to anyone interested in deepening his or her understanding of all types of addictive behavior.

With Dr. Gabor Mate's help the foundation is being made to reexamine how to treat addiction from a new premise that engages and honors the heart and soul of humanity. The book ends with a new take on the 12-step program that can heal dysfunctional religious maps that translates to any belief system.

Gabor Maté's latest book effectively demolishes the belief that addictions arise from chemical imbalances, genetics, or bad choices.

As in his two previous books, Scattered Minds: A New Look at the Origins and Healing of Attention Deficit Disorder (1999) and When the Body Says No: The Cost of Hidden Stress (2003), Maté situates human suffering in a social context, inviting a political discussion of how social relations affect human health.

Scattered Minds locates symptoms of ADD in the social neglect of children's needs and concludes,

"What begins as a problem of society and human development has become almost exclusively defined as a medical ailment."

When the Body Says No indicts "industrialized society along the capitalist model" as a source of toxic stress that "escalates as the sense of control diminishes" and causes physical and mental breakdown.

In the Realm of Hungry Ghosts condemns society for depriving human beings of what they need to thrive and then persecuting and punishing them for using drugs to relieve their pain.

All three books are well-written, engaging and brilliantly expose the fake science that pushes a pill for every ill.

While Maté situates human distress in the social realm, he seeks solutions in the personal realm.

In When the Body Says No the author concludes,

"In numerous studies of cancer, the most consistent identified risk factor is the inability to express emotion, particularly the feelings associated with anger." (p.99)

Maté ignores industrial pollution as a cause of cancer and promotes the myth of "the cancer personality" - people who are more likely to get cancer because they repress their emotions, ignore their needs and put others first.

Even if there was evidence to back this myth, which there is not ([...]), these characteristics are not individual failings, but behaviors that society demands of all women and that employers demand of all workers.

In Hungry Ghosts, Maté questions why the war on drugs and drug addicts continues despite its total ineffectiveness and considerable harm. He avoids the logical conclusion that this war is not about drugs; it is the means by which the ruling class very effectively justifies its repressive military-prison system.

In all of his books, Maté questions why policy makers consistently ignore the research linking child deprivation and social stress with medical and social problems. He can't answer this question until he acknowledges the impact of class conflict; the ruling class can accumulate capital only by sacrificing the needs of the working class.

Maté's books are commercially successful because they tap into popular awareness of social problems while avoiding the uncomfortable conclusion that social revolution is required to solve them.

The result is a liberal version of blaming the victim - society cannot be changed, so the individual must change. This regressive message is more insidious because it is hidden behind a progressive cover.

I recommend these books for the wealth of facts within them. But draw your own conclusions about the solutions we need.

Dr. Gabor Mate has written an eloquent, insightful, brutally honest work, which explores the psychological causes creating the "lethal hold" of drugs on legions of men and women. The author's years of experience with his patients at his Skid Row clinic, those who are tragically drug addicted and emotionally dispirited, has prepared him to write this book.

In the preface (p.xv) Mate notes that the book opens in Canada, in the drug ghettos of Vancouver's Downtown Eastside, which is north of Seattle, just a three hour drive. He states that the research he presents is largely United States-based, and therein lies a paradox. The United States leads the world in scientific knowledge in many areas, but trails in applying that knowledge to social and human realities.

One fact demonstrates the imbalance:

Americans make up five percent of the world's population, yet have twenty-five percent of the world's prison population. He asserts the main cause of this shocking discrepancy is "the antiquated social and legal approach to addiction."

A former Seattle police chief, Norm Stamper, believes "We pay dearly for a vindictive system that often serves to make matters worse, much worse."

In the Foreword (p. xvii) by Peter Levine, the Swiss psychologist Alice Miller asks "What is addiction, really?" She answers, "It is a sign, a signal, a symptom of distress. It is a language that tells us about a plight that must be understood."

Mate observes (p. 201) that early childhood trauma has consequences for how human beings respond to stress all their lives, and stress has everything to do with addiction.
Canadian stress researcher and physician Hans Selye wrote "It may be said that for man the most important stressors are emotional."

This book contains fascinating examples of the most recent brain research. It's been found (p. 202) that early stress establishes a lower "set point" for a child's internal stress system; such a person becomes stressed more easily than normal throughout her life.

Also, the hormone pathways of sexually abused children are chronically altered. Even a relatively mild stressor such as maternal depression-let alone neglect, abandonment or abuse- can disturb an infant's stress mechanisms (p.203).

This is just a sampling of the scientific research that helps us gain a deeper understanding of addiction, its causes and effects. Dr. Mate is very forthright in exposing his own addictive behaviors, making the point that we live in times where we are programmed (by corporations, media, commercials, etc.) to constantly want more and more. More possessions, more wealth, more recognition, more power, the list goes on and on.

This is a book that should be required reading for policy makers, those in the medical field, law enforcement, teachers, students, and all who long to have a better understanding of addiction, and its devastating consequences on individuals, family members, and society in general.

Dr. Mate explains why our drug policies are misdirected and failing. He proposes sensible options. This is a phenomenal book which can change the way we perceive addiction in its many forms, and move us forward as a society, in understanding and empathy.

Thanks to Dr. Mate, and to all the other researchers, for giving us new ways of looking at addiction. Highly, heartily, recommended!!

This is an exhaustive look at addiction: what it is, what causes it, recovery from it. There is also a section devoted to the "War on Drugs." It's a pretty intensive read, as Maté inspects addiction from the biological, psychological, and sociological levels. The book is a balance of hard science and statistics as well as anecdotal evidence culled from his years as a doctor who treats primarily drug addicts. While it's acknowledged that every person is, ultimately, responsible for the choices they make and the actions they take, the book is compassionate towards the victims of addiction -- including, often, the addicts themselves.

Some sections of the book drag more than others, but they're mostly the sections that are heavy on scientific facts and figures. While interesting, those sections read like a text book -- and, while informative as well as necessary to the book, they're not exactly page turners.

Where the book falls short is in the personal narrative of Maté, especially with regards to his own life. His insights into his patient's lives are touching, but his own story of "addiction" (purchasing CDs) wears thin after the first mention. His repeated mentions of his compulsive shopping seem like an attempt to identify with addicts and make the story more personal and thus more moving. However, I feel that the book would be better without regular intervals regarding his shopping habits.

A few dry sections and Maté's personal life aside, In The Realm of Hungry Ghosts is an amazing look at addiction and definitely worth reading.

A Poignant and Informative Piece on Addiction

I left a 12-step group about 8 months ago and stumbled upon this book while looking for a Peter Levine Book. The title sounded right up my alley so I ordered. Did not disappoint and gave me an alternate view of addiction and all its manifestations. I cried many times as a sense of recognition hit. I read my self in this book over and over. I owe Dr. Mate' a great sense of gratitude for making the right, conscious decision for ME on leaving 12-step groups and the "disease" model. He validated a lot of my feelings in this book on where exactly my addictions came from and what pieces of me had yet to be seen where 12-steps overlooked those parts. As I am still reading this great book, and uncover more hidden gems within myself which is what I needed all along. I continue to stay sober/clean and work on my internal mess and come to the solutions that are best for me. Thank You Dr. Mate' if you changed 1 person, it's me and I owe you a huge hug and a resounding "YES!" from the bottom of my heart. Thank you for this wonderful manual of healing and hope!