In the Realm of Hungry Ghosts: Close Encounters with Addiction

by Gabor Maté

The small child’s natural response to overwhelming emotional loss is a defensive shutdown. I’ve had a lifelong resistance to receiving love—not to being loved or even to knowing intellectually that I am loved, but to accepting love vulnerably and openly on a visceral, emotional level.

As for forays to Sikora’s, music-seeking offers excitement and tension that I can immediately resolve and a reward I can immediately attain—unlike other tensions in my life and other desired rewards. Music is a source of beauty and meaning outside myself that I can claim as my own without exploring how, in my life, I keep from directly experiencing those qualities. Addiction, in this sense, is the lazy pilgrim’s path to transcendence.

a child with a depressed mother feels constant deprivation and deep distress.

These sorts of experiences can also leave a deep impression in the psyche and create alterations in brain physiology that may—but do not necessarily, as we shall see—last a lifetime.

My sense of worth, unavailable to me for who I am, has come from work.

needed the flame of constant preoccupation to ward off the anxiety or depression or ennui that always lurked at the edges of my psyche.

The same dynamics come into play with eating disorders.

In human development the ingestion of food has significance far beyond its obvious dietary role.

When infants are anxious or upset, they are offered a human or a plastic nipple—in other words, a relationship with either a natural nurturing object or something that closely resembles it. That’s how emotional nourishment and oral feeding or soothing become closely associated in the mind. On the other hand, emotional deprivation will trigger a desire for oral stimulation or eating just as surely as hunger will. Children who continue to suck their thumbs past infancy are attempting to soothe themselves; it’s always a sign of emotional distress. Except in rare cases of physical disease, the more obese a person is, the more emotionally starved they have been at some crucial period in their life.

Invariably, people who eat too much have not only suffered emotional loss in the past but are also psychically deprived or highly stressed in the present.

Emotional energy expended without perceived reward is compensated for by calories ingested.

Similarly, many people who quit smoking begin to overeat because their craving for oral soothing is no longer eased by their cigarette and the loss of their stress reliever, nicotine, leaves them dopamine-deprived.

The obesity epidemic demonstrates a psychological and spiritual emptiness at the core of consumer society. We feel powerless and isolated, so we become passive.

our culture it’s just the opposite. Food is the universal soother, and many are driven to eat themselves into psychological oblivion.

The roots of sex addiction also reach back to childhood experience. Sex addiction authority Dr. Aviel Goodman points out that the vast majority of female sex addicts were sexually abused as children, as were up to 40 percent of the men.1

Sex addicts who were not abused as children may have had more subtle forms of sexualization projected on them by a parent, or they may have felt so unloved or undesirable that they now look to sexual contact as a quick source of comfort.

The so-called nymphomaniac, the female sex addict, is not addicted to sex at all, but to the dopamine and endorphin rewards that flow from the feeling of being desired and desirable.

As with all addictions, sex addiction is a stand-in for nurturing the person was deprived of. The dopamine and endorphin rewards that love is meant to provide are obtained by having sex—but, as with all addictions, only temporarily. The craving for contact is, perversely, accompanied by a terror of real intimacy because of the painful instability of early relationships.

“It’s very scary and potentially very painful to face one’s deepest fears.” By moving from one partner to another, a sex addict avoids the risk of intimacy, and just as with my constant quest for compact discs, the addict is always seeking the dopamine hit of the novel and the new.

Compulsive sexual roving, like all addictions, serves to help the addict avoid experiencing unpleasant emotions. “It takes a lot of discipline and courage to work through a negative thought and negative emotion,” Ms. Giard points out. “Replacing a negative emotion with a positive one is the core of addictive behavior.”2

In a person with addictive behaviors, the orbitofrontal cortex and its associated neurological systems have been tricked from childhood onward into valuing false wants above real needs (this is the process we have identified as salience attribution)—hence the desperation of the behavioral addict, the urgency to have that want answered immediately, as if it really were an essential requirement.

had a similar, if much milder, epiphany when in my midforties I was prescribed a serotonin-enhancing antidepressant. I was suffused by a sense of well-being I’d never imagined was possible. It was as if my brain cells were bathed in a normal chemical milieu for the first time. “So this is how human beings are meant to feel,” I remarked to my sister-in-law. You don’t know how depressed you’ve been until you know what it feels like not to be depressed.

Yet the point is rarely that parents don’t do their best no matter whom we consider:

The point is that, as in the parenting my children received, our best is circumscribed by our own issues and limitations.

other words, the parenting an infant receives can “program” her own brain circuitry in ways that will influence and may even determine how she will parent.

Stressed parents have difficulty offering their children a specific quality required for the development of the brain’s self-regulation circuits: the quality of attunement. Attunement is, literally, being “in tune” with someone else’s emotional states. It’s not a question of parental love but of the parent’s ability to be present emotionally in such a way that the infant or child feels understood, accepted, and mirrored.

For example, the infants of depressed parents experience physiological stress not because they are not loved, but because their parents are not attuned with them—and attunement is especially likely to be lacking if parents missed out on it in their own childhoods.

person with good self-regulation will not experience rapidly shifting extremes of emotional highs and lows in the face of life’s challenges, difficulties, disappointments, and satisfactions. She does not depend on other people’s responses or external activities or substances in order to feel okay. The person with poor self-regulation is more likely to look outside herself for emotional soothing, which is why the lack of attunement in infancy increases addiction risk.

Their infants, unlike the ones in the other two groups, grew up to be anxious, less social, and highly reactive as adults—traits known to increase addiction risk.

The void is not in the parent’s love or commitment, but in the child’s perception of being seen, understood, empathized with, and “gotten” on the emotional level. In our extraordinarily fragmented and stressed society, where parents often face the child-rearing task without the support that the tribe, clan, village, extended family, and community used to provide, misattuned parent–child interactions are increasingly the norm.

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.

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. As a therapist said to me, “Children swim in their parents’ unconscious like fish swim in the sea.”

For example, there is a strong association between parental neglect and the later development of obesity.8 Once more, neglect does not need to be intentional or overt: parental stress and depression during the child’s early years will have the same effect, owing to the lack of attunement that follows.

Addicts respond with rage toward anyone who tries to deprive them of their drug, and that rage is fueled by intense frustration.

our sneers always tell us who we feel we are. A powerful person’s self-esteem may appear to be high, but it’s a hollow shell if it’s based on externals, on the ability to impress or intimidate others.

By contrast, genuine self-esteem needs nothing from the outside. It doesn’t say, “I’m worthwhile because I’ve done this, that, or the other.” It says, “I’m worthwhile whether or not I’ve done this, that, or the other. I don’t need to be right or to wield power, to amass wealth or achievements.”

Self-esteem is not what the individual consciously thinks about himself; it’s the quality of self-respect manifested in his emotional life and behaviors.

People with a grandiose and inflated view of themselves are missing true self-esteem at the core. To compensate for a deep sense of worthlessness, they develop a craving for power and an exaggerated self-evaluation that may itself become a focus of addiction, as it appears to have done for the person who needed to become “Lord” Black.

Addiction is always a poor substitute for love.

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 (Preface, 2000)

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.

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.

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.

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.

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.

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:

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.

“What characterizes an addiction?” asks the spiritual teacher Eckhart Tolle. “Quite simply this: you no longer feel that you have the power to stop. It seems stronger than you. It also gives you a false sense of pleasure, pleasure that invariably turns into pain.”1