In the Realm of Hungry Ghosts: Close Encounters with Addiction

A long but interesting important read for all who work with people with substance use disorders or process addictions.

A book that humanizes addicts. Dr Gabor Mate is a great writer, doctor, and most importantly, human.

As a fellow social services type, working with "those less fortunate", I appreciated Dr. Mate's unflinching unromantic, and realistic approach. That dark sense of humor, which seems to creep into all of us working in the trenches. The media, and the non profits, love to fill the airwaves with hopeful images of recovery, but realisitcally, that just brings in dollars, to keep the same old, same old afloat. How to change those who don't even see that they have a problem? Or those so neurologically impaired, damage control is really the best we can do? Not what the public (or the funding agencies) want to hear, but maybe they need to start listening.

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

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.

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

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, c