In the Realm of Hungry Ghosts: Close Encounters with Addiction

by Gabor Maté

We have seen that addicts lack differentiation—the capacity to maintain emotional separateness from others. They absorb and take personally the emotional states of other people. Their diminished capacity for self-regulation leaves them easily overwhelmed by their automatic emotional mechanisms. They are prone to experience themselves as demeaned and abandoned by authority figures and caregivers, for reasons we have explored. When a busy physician or overworked nurse is short tempered and impatient with them, they interpret it as personal rejection. They react instinctively to the least tension or condescension on the part of caregivers. At the same time, it’s only natural that health care workers are especially prone to be stressed and impatient in the harried environments of overfull emergency departments and understaffed hospital wards. Irritability begets defensive hostility, and hostility sets off more reactive anxiety and rage. Two human beings—one who is seeking help and another who is committed to helping—are soon at loggerheads, quite contrary to their own intentions. There would be much less confrontation and more effective care, I am convinced, if medical and allied staff all took some mindfulness training and if we practiced observing, with awareness and curiosity, our mind-states and our reactions to these unconventional people. We would spare ourselves a lot of tension and stress, and protect our patients from further psychological trauma, if we learned to tak...