In the Realm of Hungry Ghosts :Cloase Encounters with Addiction

The definitive book for understanding addiction In this timely and profoundly original book, writer and physician Gabor Maté looks at the epidemic of various addictions in our society, tells us why we are so prone to them and outlines what is needed to liberate ourselves from their hold. Starting with a dramatically close view of Maté''s drug addicted patients, In this timely and profoundly original book, writer and physician Gabor Maté looks at the epidemic of various addictions in our society, tells us why we are so prone to them and outlines what is needed to liberate ourselves from their hold. Starting with a dramatically close view of Maté's drug addicted patients, In the Realm of Hungry Ghosts weaves in stories of real people while providing a bold synthesis of clinical experience, insight and cutting-edge scientific findings. A haunting, compassionate and deeply personal examination of the nature of addiction.

Résumé

The definitive book for understanding addiction

In this timely and profoundly original book, writer and physician Gabor Maté looks at the epidemic of various addictions in our society, tells us why we are so prone to them and outlines what is needed to liberate ourselves from their hold. Starting with a dramatically close view of Maté's drug addicted patients, In the Realm of Hungry Ghosts weaves in stories of real people while providing a bold synthesis of clinical experience, insight and cutting-edge scientific findings. A haunting, compassionate and deeply personal examination of the nature of addiction.

Échantillon de lecture
The mandala, the Buddhist Wheel of Life, revolves through six realms. Each realm is populated by characters representing aspects of human ­existence–­our various ways of being. In the Beast Realm we are driven by basic survival instincts and appetites such as physical hunger and sexuality, what Freud called the id. The denizens of the Hell Realm are trapped in states of unbearable rage and anxiety. In the God Realm we transcend our troubles and our egos through sensual, aesthetic or religious experience, but only temporarily and in ignorance of spiritual truth. Even this enviable state is tinged with loss and ­suffering.

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.

Some people dwell much of their lives in one realm or another. Many of us move back and forth between them, perhaps through all of them in the course of a single ­day.

My medical work with drug addicts in Vancouver’s Downtown Eastside has given me a unique opportunity to know human beings who spend almost all their time as hungry ghosts. It’s their attempt, I believe, to escape the Hell Realm of overwhelming fear, rage and despair. The painful longing in their hearts reflects something of the emptiness that may also be experienced by people with apparently happier lives. Those whom we dismiss as “junkies” are not creatures from a different world, only men and women mired at the extreme end of a continuum on which, here or there, all of us might well locate ourselves. I can personally attest to that. “You slink around your life with a hungry look,” someone close once said to me. Facing the harmful compulsions of my patients, I have had to encounter my ­own.

No society can understand itself without looking at its shadow side. I believe there is one addiction process, whether it is manifested in the lethal substance dependencies of my Downtown Eastside patients; the frantic ­self-­soothing of overeaters or shopaholics; the obsessions of gamblers, sexaholics and compulsive Internet users; or the socially acceptable and even admired behaviours of the workaholic. Drug addicts are often dismissed and discounted as unworthy of empathy and respect. In telling their stories my intent is twofold: to help their voices to be heard and to shed light on the origins and nature of their ­ill-­fated struggle to overcome suffering through substance abuse. They have much in common with the society that ostracizes them. If they seem to have chosen a path to nowhere, they still have much to teach the rest of us. In the dark mirror of their lives, we can trace outlines of our ­own.

There is a host of questions to be considered. Among ­them:

• 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 the addict really ­have?
• Why is the “War on Drugs” a failure and what might be a humane, ­evidence-­based approach to the treatment of severe drug ­addiction?
• What are some of the paths for redeeming addicted minds not dependent on powerful ­substances–­that is, how do we approach the healing of the many behaviour addictions fostered by our ­culture?

The narrative passages in this book are based on my experience as a medical doctor in Vancouver’s drug ghetto and on extensive interviews with my ­patients–­more than I could cite. Many of them volunteered in the generous hope that their life histories might be of assistance to others who struggle with addiction problems or that they could help enlighten society regarding the experience of addiction. I also present information, reflections and insights distilled from many other sources, including my own addictive patterns. And finally, I provide a synthesis of what we can learn from the research literature on addiction and the development of the human brain and ­personality.

Although the closing chapters offer thoughts and suggestions concerning the healing of the addicted mind, this book is not a prescription. I can say only what I have learned as a person and describe what I have seen and understood as a physician. Not every story has a happy ending, as the reader will find out, but the discoveries of science, the teachings of the heart and the revelations of the soul all assure us that no human being is ever beyond redemption. The possibility of renewal exists so long as life exists. How to support that possibility in others and in ourselves is the ultimate ­question.

I dedicate this work to all my fellow hungry ghosts, be they ­inner-­city street dwellers with HIV, inmates of prisons or their more fortunate counterparts with homes, families, jobs and successful careers. May we all find ­peace.

As I pass through the grated metal door into the sunshine, a setting from a Fellini film reveals itself. It is a scene both familiar and outlandish, dreamlike and ­authentic.

On the Hastings Street sidewalk Eva, in her thirties but still ­waif-­like, with dark hair and olive complexion, taps out a bizarre cocaine flamenco. Jutting her hips, torso and pelvis this way and that, bending now at the waist and thrusting one or both arms in the air, she shifts her feet about in a clumsy but concerted pirouette. All the while she tracks me with her large, black ­eyes.

In the Downtown Eastside this piece of ­crack-­driven improvisational ballet is known as “the Hastings shuffle,” and it’s a familiar sight. During my medical rounds in the nei…