Lumumba Shakur's Reviews > In the Realm of Hungry Ghosts: Close Encounters with Addiction

In the Realm of Hungry Ghosts by Gabor Maté
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May 29, 2011

it was amazing
bookshelves: child-development, current-events
Read from December 01, 2011 to February 02, 2012

This is a fascinating look at the chemistry of addiction and a call to a more progressive public policy. Dr. Gabor Mate's style of writing is captivating and he is masterful at explaining specialized knowledge in laymen's language. My own mother, a recent graduate of medical school, when I summarized some of his arguments, commented on how Dr. Mate made connections for her that she could not quite make herself during her medical training (due to the emphasis on "treatment" over cause with respect to mental disorders) and she agreed with his criticisms of the way in which doctors are educated in the West. She also was amazed at how I was able to explain things to her that she herself had spent the past 8 years of her life learning based on Dr. Gabe's explanations.

Stylistically, Dr. Mate draws you in by giving you the biographies of several of his patients at the harm-mitigation facility that he currently works for. Most, if not all, of the stories are of people who were severely abused as children and as a result of the pain, turned to substance abuse as a form of self-medication (and perhaps more importantly for his purposes: why this self-medication is actually an effective short-term solution) - stories of which I am all to familiar with in my own professional life as a youth counselor. Just as you feel you've been beat over the head one-too-many times with such heart wrenching stories, Dr. Mate switches themes and slowly takes you through the process of addiction and eventual self-recovery. As this is not a propaganda piece - very few of those initial stories have entirely happy endings. People are people and the story which stuck with me the most is of a man who called his sister in Ireland to tell her that he would not be flying home and that he instead would make arrangements for his body to be sent to the family plot. Other stories are perhaps more profound, but this particular one that he more-or-less ends with highlights the unfortunate reality that the lives of most hardcore addicts end in early death - something my family knows all too well.

Far from being a simple tract on addiction, Dr. Mate demonstrates how drug addicts are just an extreme end of a continuum of behavior that applies to large segments of society. By weaving together the connections between early childhood development (in ureto and post-natal) and the effects of trauma on the human psyche, Dr. Mate makes the case not only for a more comprehensive and compassionate health care system, but establishes the fact that the rising levels of addiction among modern (and I would say modernizing nations) is little more than a symptom of a larger social ill that is increasingly becoming more and more malignant: the breakdown of the traditional family and community social structure. That being so, no amount of "tough love" or criminal justice involvement is going to cure the problem. Instead, our approach (the American approach that we have unfortunately successfully forced down the throats of most other nations) only further punishes and ostracizes the same victims of abuse that we all felt compassion for at an earlier point in these same peoples' lives.

In keeping with the themes of his previous works (which I have not had the good fortune to read yet, but have heard numerous interviews Dr. Mate has given in American media), this is a book that should be essential reading for anyone involved in the health care industry - especially mental health and youth behavioral management - as the rate of substance abuse in those communities is incredibly high. I would also recommend this to anyone with young children, victims of abuse and young couples seeking to have little ones. Even more so, this is also a must read for anyone who suffers from any type of addiction. One particular chapter is of vital importance: "A Word to Families, Friends and Caregivers" in which he offers very realistic and practical advice to the families and loved ones' of addicts. The phrase, "Choose guilt over resentment" was profound and likewise was the self-critical analysis Dr. Mate prescribes for this group of people - most notably that we (as family, loved ones or caregivers) often make the process of recovery that much more difficult. The fact that in addition to being a youth counselor who worked with the very same sorts of people that eventually found their way into the Portland "Hotel", that I am also the son of a recovered drug addict and alcoholic made the book that much more meaningful to me.

After Dr. Mate establishes the causes and the physiological factors that lead to addiction - he gives advice on how to achieve sobriety. In terms of my own religious persuasion, I could see clear parallels between Dr. Mate's recommendations and my own religious spiritual tradition. His methods of self-help reflect the techniques recommended by a savant I am affiliated to as the most tried-and-true techniques for the breaking bad habits and removing sin from one's life. This is particularly true is his "Four Steps: Plus One", his adaptation of a self-help program designed by UCLA, which is in lock-step with the tarbiyah of the Darqawi-Shadhili Order and the famed "Muraqaba Durus" one of its contemporary Hashimi branches (which was adopted and expanded as a part of the practical spirituality contained in Agenda to Change Our Condition).

For instance, in regard to the first step, "Relabeling" Dr. Mate gives the following insight,
The point of relabeling is not to make the addictive urge disappear - it's not going to, at least not for a long time, since it was wired into the brain long ago. It is strengthening every time you give in to it and every time you try to suppress it forcibly. (p. 377-8)
Upon reading this, I was reminded simultaneously of the Sufic insights regarding khawatir (thoughts) and how they turn into obsessions (i.e. "behavioral addiction"), Mawlay al-Arabi's elucidations on hawa ("vain caprice" - which is precisely what Dr. Mate is talking about when he identifies addictive behaviors as things we all know are not good for us in the long run, even as they serve some short-term purpose) and of the advice that in respect to spiritual self-discipline intended to rid oneself of such problems, one should not go overboard, "lest the nafs kick-and-scream in revolt".

As another example, on "Refocusing":
Rather than engage the addictive activity, find something else to do. Your initial goal is modest: buy yourself just fifteen minutes. Choose something that you enjoy and that will keep you active: preferably something healthy and creative, but anything that will please you without causing greater harm. (p. 379-80)
I.e. "Ours is not a way of rigorous spiritual struggle. Rather, ours is a way of diplomacy. We give the nafs what it wants within the convinces of the Sacred Law on the condition that it is going to work for us when we need it to." And the entire chapter "Sobriety and the External Milieu" can be summed up with the words of Abu al-Hasan al-Shadhili, "Do not stir your feet except where you expect the reward of Allah; and do not sit except where you are likely to be safe from disobeying Allah." Or as Dr. Mate put it,
[C]reating an external environment that can support one's move towards conscious awareness is one essential feature of the recovery process. (p. 388)
I could go on and on as I found myself able to fill in the gaps explicitly for Dr. Mate in this part of the book, as he clearly has studied Buddhism and his spirituality is rooted entirely in that world-view. Also being a Jew, he is familiar enough with the Old and New Testament - but seems to have little to no familiarity with Islam and its spiritual teachings (though I do appreciate his referencing of the Qur'an). Due to this, perhaps the only chapter of the book that I was not incredibly fond of was his attempt to relate the religious message of AA's "12 Step Program" to a wider audience - which undoubtedly involved a certain world-view and theological relativism. This is perhaps the weakest chapter of the book, though I would imagine that those who share his philosophy may disagree with me. And as it is fairly short, you do not get the impression that you are being preached to. Rather, Dr. Mate is clearly trying his best to articulate his spirituality to a general audience that may not necessarily agree with his personal theological conclusions. And in that, he succeeded, as I found myself agreeing with the overall message of this particular chapter.

In sum, from cover to cover, this is a fascinating book that I highly recommend to everyone as there are few of us who to one degree or another is not addicted to something - whether it be methamphetamine, prestige, attention or power. Everyone who is honest with themselves will see something of themselves between the covers and will walk away a better person for it. And those who know, love or have loved someone addicted to life-debilitating and/or illegal substances will walk away with a more profound understanding of their struggles.

Wa-Llahu `alim wa musta`am
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Reading Progress

12/12/2011 page 210
44.0% "Dr. Mate provides a number of insights, too many to recount here, that have relevancy in understanding oneself and the neurological processes that contribute/cause addiction. Most pertinent is early childhood brain development and trauma and his dispelling the myth of genetics being the primary factor of the human personality."
03/20/2016 marked as: read

Comments (showing 1-2 of 2) (2 new)

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asmā khātun Would you recommend any books that are about recovering from addiction from the Islamic perspective?

Lumumba Shakur I am not aware of any that exists, but the advice he gives in the last part of this book, I couldn't find much to object to on religious grounds.

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