I've finally finished reading this amazing book and knew that this blog would be a perfect place to talk about it. Lengthy? Yes. An "easy read"? No. Worth every moment spent reading it? Absolutely. One thing that I want to note right away is that although this book may appear to be about addictions and dealing with people who are addicted to substances it is so much more than that and should be read by anyone who works in the social work field, with young children and families (especially Head Start), and anyone who has had to overcome personal challenges in their childhood or adulthood due to their own undesired behaviors. Addictions can be much more than just drug related: overeating, gambling, shopping, etc., and those addictions that aren't drug related tend to be brushed under the carpet much more and overlooked as being a concern. If you have ever heard of Vincent Felitti, MD, and the ACE scale, then this book is right up your alley.
In this book Mate shares his experiences working in the ghetto with patients who are to the extreme on the addiction scale (if one existed, that is) and shares insights into what he believes causes such addictions and why people remain in such states. He also sheds light onto the larger picture- the so called "war on drugs"- and how society views those with addictions (especially drugs) and how these approaches are far from what is most beneficial in helping addicts to overcome their struggles and become productive citizens in our society. Mate is able to step back and view these people for who they are- not as addicts or criminals or a waste of space. He not only sees these people, but he also sees that they have become who they are due to circumstances beyond their control in life beginning as early as in the womb. Many people he helps have suffered greatly: carried by a crack addicted mother, physically abused by a parent, molested by a relative, left to fend for themselves or take care of their siblings at a young age, the list goes on and on and can make a person cry thinking of all these things happening right here in the very world that we live in (the ACE scale clearly outlines such negative circumstances that have the greatest impact on development).
Mate understands that to help such people we need to see the larger picture and see that these people need help in many ways, such as counseling and social supports to help teach them how to live productively. By criminalizing people who are already struggling and see no positives in this world we are not helping them one bit, and are not helping the generations that will follow after them. Locking them up and refusing them proper care and the supports they need to overcome their challenges will not only hurt the hundreds of thousands of 'criminals', but it actually isn't beneficial to the government either, both financially and from a social reform point of view.
Below I will share some of my favorite quotes from the book to give you some insight into what Mate is trying to relay. I hope that you will take the time to read the book on your own and then make your own opinions about addiction. Everyone has their own story...
"It has been estimated that state and federal governments in the United States spend more than $15 billion per year, and insurers at least another $5 billion per year, on substance-abuse treatment services for some four million people... Today many clinics across the country have lengthy waiting lists, and researchers estimate that some twenty million American who could benefit from treatment are not getting it. The costs in human suffering, family disintegration, and lost productivity are staggering. The lingering questions remain, What is effective treatment? and How can it best be administered?" p.xvii
Speaking about the Mandala, the Buddhist wheel of life: "The inhabitants of the hungry ghost realm are depicted as creatures with scrawny necks, small mouths, emaciated limbs, and large, bloated, empty bellies. This is the domain of addiction, where we constantly seek something outside ourselves to curb an insatiable yearning for relief or fulfillment. The aching emptiness is perpetual because the substances, objects, or pursuits we hope will soothe it are not what we really need. We don't know what we need, and so long as we stay in the hungry ghost mode, we'll never know. We haunt our lives without being fully present." p. 1
"The fundamental addiction is to the fleeting experience of not being addicted. The addict craves the absence of the craving state. For a brief moment he's liberated from emptiness, from boredom, from lack of meaning, from yearning, from being driven or from pain. He is free. His enslavement to the external- the substance, the object, or the activity- consists of the impossibility, in his mind, of finding within himself the freedom from longing or irritability. 'I want nothing and fear nothing,' said Zorba the Greek. 'I'm free.' There are not many Zorbas among us." p. 114
"A child's capacity to handle psychological and physiological stress is completely dependent on the relationship with his parent or parents. Infants have no ability to regulate their own stress apparatus, and that's why they will stress themselves to death if they are never picked up. We acquire that capacity gradually as we mature- or we don't, depending on our childhood relationships with our caregivers. A responsive, predictable nurturing adult plays a key role in the development of our healthy stress-response neurobiology...
Children who suffer disruptions in their attachment relationships will not have the same biochemical milieu in their brains as will their well-attached and well-nurtured peers. As a result their experiences and interpretations of their environment, and their responses to it, will be less flexible, less adaptive, and less conducive to health and maturity. Their vulnerability both to the mood-enhancing effects of drugs and to drug dependency will increase." p. 201
"Poor attunement is also not something parents easily recall as they strive to understand the addictive behaviors of their adult children. As parents we make the natural mistake of believing that the intense love we feel for our kids necessarily means that they actually receive that love in a pure form. Further, parents who did not have attuned caring as small children may not notice their difficulty attuning to their own infants, just as people stressed from an early age may not realize just how stressed they often are... As a rule, whatever we don't deal with in our lives, we pass on to our children. Our unfinished emotional business becomes theirs." p.253
In the chapter "Ignorant Fanaticism": The Failed War on Drugs, Mate makes a valid argument: "Drugs do not make the addict into a criminal; the law does. When alcohol was prohibited, drinkers were breaking the law. If cigarettes were illegal, there would be a huge underground market for tobacco products. Gangs would form, criminal business empires would flourish, and smokers would be spending a large proportion of their income on nicotine-containing substances. Add the health ravages and medical and economic costs of nicotine addiction, the hundreds of thousands of deaths it causes, and the many family tragedies it already creates- and then factor in the enormous expenses of waging the War on Drugs on yet another front... Most of the social harm related to drugs does not come from the effects of the substances themselves but from legal prohibitions against their use." p.294
"The scarcity of scientific thought informing public debates on addiction is mirrored in the academic and medical arenas. In this era of sub-subspecialization, each discipline appears to work in isolation from knowledge gathered by other researchers in closely related fields. We need far more integration of knowledge both in the professional realm and among laypeople... 'As such, medicine has been the most resistant professional group to absorb and integrate the emerging findings about brain development and the importance of early childhood'". p. 314
"We need to take stock of ourselves and give up and hint of moral superiority and judgment toward the addict... We cannot help people when we put ourselves in a position of judgment. Addicts... are deeply self-critical and harsh with themselves. They are keenly sensitive to judgmental tones in others and respond with withdrawal or defensive denial. Worse, morally judging others clouds our eyes not only to their needs, but to our own true needs as well." p. 316
"'The War on Drugs in a cultural schizophrenia,' says Dr. Panskepp. I agree. The War on Drugs expresses a split mind-set in two ways: we want to eradicate or limit addictions, yet our social policies are best suited to promote it, and we condemn the addict for qualities we dare not acknowledge in ourselves. Rather than exhort the addict to be other than the way she is, we need to find the strength to admit that we have greatly exacerbated her distress and perhaps our own. If we want to help people seek the possibility of transformation within themselves, we first have to transform our own view of our relationship to them." p. 319
"Healing, then, must take into account the internal psychological climate- the beliefs, memories, mind-states, and emotions that feed addictive impulses and behaviors- as well as the external milieu. In an ecological framework recovery from addiction does not mean a 'cure' for a disease but the creation of new resources, internal and external, that can support different, healthy ways of satisfying one's genuine needs. It also involves developing new brain circuits that can facilitate more adaptive responses and behaviors." p. 360
"Painful early experiences program both the neurophysiology of addiction and the distressing psychological states that addiction promises to relieve. Yet human beings who are able to direct conscious attention toward their mental processes discover something surprising: it's not what happened in the past that creates our present misery but the way we have allowed past events to define how we see and experience ourselves in the present. A person can survive being beaten but cannot remain psychologically intact if he convinces himself that he was beaten because he is by nature blameworthy or because the world by its very nature is cruel. A child can overcome sexual violation, but she will be debilitated if she thinks that she somehow either deserved the abuse or brought it upon herself. She also cannot function as a self-respecting adult if she comes to believe that she is lovable or acceptable only for her sexuality. A neglected child may be helpless, but the damage comes if he acquires the defining belief that helplessness is his real and permanent star in the world. The greatest damage done by neglect, trauma, or emotional loss is not the immediate pain they inflict but the long-term distortions they induce in the way a developing child will continue to interpret the world and her situation in it. All too often these ill-conditioned implicit beliefs become self-fulfilling prophecies in our lives. We create meanings from our unconscious interpretation of early events, and then we forge our present experiences from the meanings we've created. Unwittingly, we write the story of our future from narratives based on the past." p.370
"The ego's tragic flaw is to mistake form for substance, surface illusion for reality. As long as the ego rules, we are all like the Hebrews who wandered to desert on their way to the Promised Land, 'a stiff-necked people.' We keep rejecting truth, bow to the Golden Calf, and scorn what would save us. As the present state of the planet indicates, we're not fast learners, we human beings. Each generation must absorb the same lessons over and over again, groping its blind way through the realm of the hungry ghosts. The truth is within, which is why outward-directed attempts to fill in the void created when we lose touch with it cannot bring us closer to the serenity we long for." p. 420
All references in this blog post come directly from the work cited below:
Maté, G. (2010). In the realm of hungry ghosts: close encounters with addiction. Berkeley, Calif.: North Atlantic Books.
