In the Realm of Hungry Ghosts: Close Encounters with Addiction - by Gabor Maté

Two recent articles look at/excerpt the new book by Gabor Maté, In the Realm of Hungry Ghosts: Close Encounters with Addiction. This seems like a very useful book for any of us who seek to bridge the gap between Buddhism and Western psychology.

First, from Wisdom Quarterly, an interview:

What is the "Realm of Hungry Ghosts"?

Hungry Ghosts may be understood in terms of Buddhist cosmology or psychology: Whereas one makes them hard to believe in, the other is undeniable because it's us.

What does the book title In the Realm of Hungry Ghosts mean?

DR. GABOR MATE: It's a Buddhist phrase. In Buddhist Psychology, there are a number of realms that human beings cycle through. All of us. One is the Human Realm, which is our ordinary selves. The Hell Realm is that of unbearable rage, fear, terror, you know, these emotions that are difficult to handle. The Animal Realm is our instincts and our [hate] and our passions.

Now, the Hungry Ghost Realm, the creatures in it are depicted as people with large, empty bellies, small mouths, and scrawny, thin necks. They can never get enough satisfaction. They can never fill their bellies. They're always hungry, always empty, always seeking it from the outside. That speaks to a part of us that I have, and everybody in our society has, where we want satisfaction from the outside, where we're empty, where we want to be soothed by something in the short term. But we can never feel that, or fulfill that, insatiety from outside.

The addicts are in that realm all the time. Most of us are in that realm some of the time. And my point really is, is that there's no clear distinction between the identified addict and the rest of us. There's just a continuum on which we all may be found. They're on it because they suffered more than most of us.

Can you talk about the biology of addiction?

DR. MATE: Sure, you see, if you look at the brain circuits of addiction -- and that's true whether it's a shopping addiction, like mine, or an addiction to opiates like the heroin addict -- we're looking for endorphins in our brains. Endorphins are the brain's feelgood, reward, pleasure, and pain-relief chemicals. They also happen to be the love chemicals that connect us to the universe and to one another.

A visit to the Hungry Ghost Realm, circa 1969, with petas before they became horribly disfigured by their all-consuming addictions.

Now, that circuitry in addicts doesn't function very well. As the circuitry of incentive and motivation, which involves the chemical dopamine, also doesn't function very well. Stimulant drugs like cocaine and crystal meth, nicotine and caffeine -- all elevate dopamine levels in the brain -- as does sexual acting out, as does extreme sports, as does workaholism, and so on.

Now the issue is, Why do these circuits not work so well in some people? Because the drugs in themselves are not, surprisingly, addictive. And what I mean by that is, is that most people who try most drugs never become addicted to them. And so there has to be susceptibility there. And the susceptible people are the ones with these impaired brain circuits. And the impairment is caused by early adversity rather than by genetics...

What do you mean "early adversity"?

DR. MATE: Well, the human brain, unlike any other mammal, for the most part develops under the influence of the environment. And that's because, from the evolutionary point of view, we develop these large heads, large fore brains, and to walk on two legs... Listen to more (4:20)

REAL BUDDHIST GHOST STORIES
The Stories of Ghosts (Petavatthu) is a Theravada Buddhist scripture. It is included in the Khuddaka Nikaya of the Pali Canon's Sutta Pitaka. It is composed of 51 verse narratives describing how the effects of bad actions can lead to rebirth in the unhappy world of hungry ghosts (petas). Such rebirth takes place in accordance with the doctrine of karma. It also highlights the teaching that giving alms to very moral individuals in particular and monastics in general might benefit one's relatives who have passed away.

Next up is an excerpt from Reality Sandwich.

In the Realm of Hungry Ghosts

Gabor Maté

The following is excerpted from In the Realm of Hungry Ghosts: Close Encounters with Addiction (North Atlantic Books 2010)

"I believe that to pursue the American Dream is not only futile but self-destructive because ultimately it destroys everything and everyone involved with it. By definition it must, because it nurtures everything except those things that are important: integrity, ethics, truth, our very heart and soul. Why? The reason is simple: because Life/life is about giving, not getting." -- Hubert Selby, Jr.

Requiem for a Dream

Ralph, the God-starved, pseudo-Nazi poet, said something to me in the hospital that ought to make many of us upstanding, righteous citizens squirm. I was challenging his belief in emancipation through drugs. "You talk about freedom. But how much freedom can there be when you're chasing the drug the whole day for just a few minutes of satisfaction? Where's the freedom in that?"

Ralph shrugs his shoulders. "What else am I going to do? What do you do? You get up in the morning, and somebody cooks you bacon and eggs . . ."

"Yogurt and banana," I interject. "I prepare it myself."

Ralph shakes his head impatiently. "Okay. . . yogurt and banana. Then you go to the office and you see a couple of dozen patients . . . and all your money goes to the bank at the end of that, and then you count up your shekels or your doubloons. At the end of the day, what have you done? You've collected the summation of what you think freedom is. You're looking for security, and you think that will give you freedom. You collected a hundred shekels of gold, and to you this gold has the capacity of keeping you in a fancy house or maybe you can salt away another six weeks' worth up and above what you already have in the bank.

"But what are you looking for? What have you spent your whole day searching for? That same bit of freedom or satisfaction that I want; we just get it differently. What's everybody chasing all the money for if not to get them something that will make them feel good for a while or make them feel they're free? How are they freer than I am?

"Everybody's searching for that feeling of well-being, that greater happiness. But I'd rather be a dog out in the street than do what many people go through to find their summation of freedom."

"There's a lot of truth there," I concede. "I can get caught up in all sorts of meaningless activities that leave me only temporarily satisfied, if that. Sometimes they leave me feeling worse. But I do believe there's a greater freedom than either your pursuit of the drug or my pursuit of security or success can provide."

Ralph looks at me as a benign but worldly-wise uncle would gaze upon a naive child. "And what would that freedom of pursuits be? What would be the ultimate freedom to be searching for?"

I hesitate. Can I authentically say this? "The freedom from pursuits," I say finally. "The freedom from being so needy that our whole life is spent trying to appease our desires or fill in the emptiness. I've never experienced total freedom, but I believe it's possible."

Ralph is adamant. "If it could be different, it would be. It is what it is. Let me put it to you this way: why is it that some people, through no merit whatsoever, get to have whatever they think will give them happiness? Others, through no fault of their own, are deprived."

I agree it's an unfair world in many ways.

"Then how can you or anyone else tell me that my way is wrong, theirs is right? It's just power, isn't it?"

I've often heard Ralph's worldview espoused by other drug addicts, if less eloquently. It's clear and obvious that his (and their) rationalization for addiction misses something essential. The defeatist belief that all pursuits arise from a selfish core in all humanity denies the deeper motives that also activate people: love, creativity, spiritual quest, the drive for mastery and autonomy, the impulse to make a contribution.

Although the cracks in his argument are easy to discern, perhaps it would be more worthwhile to consider what realities the drug-dependent Ralph might be articulating and what we might learn about ourselves in the dark mirror he holds up for us. Though we pretend otherwise, in our materialist culture many of us conduct ourselves as if Ralph's cynicism reflected the truth -- that it's each man for himself, that the world offers nothing other than brief, illusory satisfactions. But from his pinched and narrow perch at the edge of society, the drug addict sees who we are -- or more exactly, who we are choosing to be. He sees that we resemble him in our frantic material pursuits and our delusions and that we exceed him in our hypocrisies.

If Ralph's view is cynical, it's no more cynical than society's view of drug addicts as flawed and culpable, as people to be isolated and shunned. We flatter ourselves.

And if I'm being honest, I might ask myself to what extent my insistence on that greater freedom is really not just the sentimentality of the privileged, pseudoenlightened addict -- a way for me to rationalize my own addictions: I know I'm hooked, but I'm working on getting free, so I'm different from you. If I really knew that kind of freedom, would I need to argue for it? Would I not just manifest it in my life and way of being?

At heart, I am not that different from my patients -- and sometimes I cannot stand seeing how little psychological space, how little heavengranted grace separates me from them. There are moments when I'm revolted by my patients' disheveled appearances, their stained and decayed teeth, the look of insatiable hunger in their eyes, their demands, complaints, and neediness. Those are times when I would do well to examine myself for irresponsibility in my own life, for self-neglect -- in my case not so much physical as spiritual -- and for placing false needs above real ones.

When I am sharply judgmental of any other person, it's because I sense or see reflected in them some aspect of myself that I don't want to acknowledge. I'm speaking here not of my critique of another person's behavior in objective terms but of the self-righteous tone of personal judgment that colors my opinion. If, for example, I resent some person close to me as "controlling," it may be owing to my own inability to assert myself. Or I may react against another person because he or she has a trait that I myself have -- and dislike -- but don't wish to acknowledge: for example, a tendency to want to control others. Some mornings I vituperate about right-wing political columnists. My opinion remains more or less constant: their views are based on a highly selective reading of the facts and are rooted in a denial of reality. What does vary from day to day is the emotional charge that infuses my opinion. Some days I dismiss them with intense hostility; at other times I see their perspective as one possible way of looking at things, as an interpretation of their experience of life.

On the surface, the differences are obvious: they support wars I oppose and justify policies I dislike. I can tell myself that we're different. Moral judgments, however, are never about the obvious: they always speak to the underlying similarities between the judge and the condemned. My judgments of others are an accurate gauge of how, beneath the surface, I feel about myself. It's only the willful blindness in me that condemns others for deluding themselves; my own selfishness that excoriates others for being self-serving; my lack of authenticity that judges falsehood in others. It is the same, I believe, for all moral judgments people cast on each other and for all vehemently held communal judgments a society visits upon its members. So it is with the harsh social attitudes toward addicts, especially hard-core drug addicts.

© 2010 by Gabor Maté. Reprinted by permission of publisher.

Gabor Maté, MD, is the author of the bestselling books Scattered: How Attention Deficit Disorder Originates and What You Can Do about It and When the Body Says No: Understanding the Stress-Disease Connection -- published in ten languages on five continents -- and coauthor, with Gordon Neufeld, of Hold On to Your Kids: Why Parents Need to Matter More Than Peers. Former medical columnist for the Globe and Mail, where his byline continues to be seen on issues of health and parenting, Dr. Maté has had a family practice, worked as a palliative care physician, and, most recently, devoted his energies to the addicted men and women in the Downtown Eastside of Vancouver.

Tags: In the Realm of Hungry Ghosts, Close Encounters with Addiction, Gabor Maté, Wisdom Quarterly, Reality Sandwich, Buddhism, Psychology, addiction, Buddhist Psychology, Hungry Ghost Realm, craving, attachment, empty, brain, neuroscience, dopamine