In the Realm of Hungry Ghosts is a personal and compassionate look at addiction from a doctor who treats some of the hardest cases. In this book, what Dr. Gabor Maté faces is not just addiction in its most obvious forms but addiction as it prevails in our society at large, at every level of functioning and socioeconomic success. In a chapter titled, “The Social Roots of Addiction,” Maté writes, “We despise, ostracize, and punish the addict because we don’t wish to see how much we resemble him. In his dark mirror our own features are unmistakable…Like the hard-core addict’s pursuit of drugs, much of our economic and cultural life caters to people’s craving to escape mental and emotional distress.”
Maté suggests that addiction is a contiuum which most of us, if not all of us, experience to some degree or another. As he readily admits, Maté’s own addictions are to overworking and to compulsive buying of classical music CDs: though he acknowledges that these addictions are considerably less destructive than the heroin and cocaine addictions of his patients, he nonetheless notes a similar subjective experience surrounding his drugs of choice. “My sense of self worth…has come from work. For a long time it was impossible for me to turn down work–the drug of being wanted was far too powerful to refuse, and in any case I needed the flame of constant preoccupation to ward off the anxiety or depression or ennui that always lurked at the edges of my psyche. Like any addict, I used my addictions to help regulate my moods, my internal experience. On weekends when the beeper fell silent I felt empty and irritable–the addict in withdrawal.”
Maté is brave in his willingness to see addiction as a problem that plagues all of us, regardless of how successful we look from the outside. While our culture celebrates the “work-ethic” of those who neglect their families and their own mental and physical health for the sake of economic success, Maté is not fooled. He is not afraid to take himself to task for his failures in this department, and to point the finger at our culture at large for its heavy demands on individuals, families, and whole communities.
While Maté recognizes the adverse effects of early childhood abuse, trauma and neglect on children’s outcomes concerning addiction, these circumstances are only a part of the picture. None of us are immune to the negative consequences levied by what Lewis Lapham described as ‘consumer markets selling promises of instant relief from the pain of thought, loneliness, doubt, experience, envy, and old age.” Even good parents in secure circumstances have their own emotional battles to fight, leaving them with not enough attention and attunement to satisfy their children’s needs for early connection. All of us are victims of a culture that deems us as not enough and distracts us from simply being who we are with false images of what we “should” be.
The worst elements of our economy, including our insatiable quest for oil (see Maté’s thoughts on George W. Bush’s 2006 State of the Union address) are predicated on addiction, along with such destructive impulses as hedonism, celebrity-worshipping envy, and heedless convenience materialism that privileges short-term gratification over the long-term health of communities and ecosystems.
For managing addiction, Maté proposes a four-step process that involves paying attention to and delaying addictive urges by recognizing the ways that you have allowed “ingrained mechanisms wired into your brain” to control your behavior. He asks, “In place of a life blighted by your addictive need for acquisition, self-soothing, admiration, oblivion, and meaningless activity, what is the life you really want? What do you choose to create?”
This approach, while promising, still puts the onus on the individual to become aware of and resist everything that the cultural environment tries to program into him, her, or them. This is nothing if not an uphill battle, and there is still more pressing work to be done, at the level of the culture at large, to make the world into a humane, livable place.