More on this book
Community
Kindle Notes & Highlights
by
Gabor Maté
Read between
May 12 - May 29, 2024
I rarely resort to such threats, as I find them ethically unjustifiable and, for the most part, valueless in practice.
“Don Giovanni,”
his poetic talent and his drive for mastery only serve his relentless need to possess.
Addictions, even as they resemble normal human yearnings, are more about desire than attainment.
The addict craves the absence of the craving state.
passion can become an addiction; but then how to distinguish between the two? The central question is: who’s in charge, the individual or their behavior?
Are you closer to the people you love after your passion has been fulfilled or more isolated? Have you come more truly into who you really are, or are you left feeling hollow?
difference between passion and addiction is that between a divine spark and a flame that incinerates.
Passion is divine fire: it enlivens and makes holy;
Passion is generous because it’s not ego-driven; addiction is self-centered. Passion gives and enriches; addiction is a thief. Passion is a source of truth and enlightenment; addictive behaviors lead you into darkness.
with freedom, joy, and a full assertion of your truest self and values.
My negativity stems from my internal dissatisfaction, my harsh self-critique.
Above all, I’m absent. It’s impossible to be fully present when you’re putting up walls to keep from being seen.
“We are here to surrender—to let go of the old ideas that keep us stuck.”
Two things alcoholics hate is work and time.
Addiction is impact and dependency.
addiction is a “chronic neurobiological disease … characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.”
The issue is not the quantity or even the frequency, but the impact.
compulsive engagement with the behavior, a preoccupation with it; impaired control over the behavior; persistence or relapse despite evidence of harm; and dissatisfaction, irritability, or intense craving
On the biochemical level the purpose of all addictions is to create an altered physiological state in the brain.
Addiction has biological, chemical, neurological, psychological, medical, emotional, social, political, economic, and spiritual underpinnings—and
“The heart of addiction is dependency, excessive dependency, unhealthy dependency—unhealthy in the sense of unwhole, dependency that disintegrates and destroys.”
CHAPTER 12
Stress and susceptibility lead to addiction
“Doubts or concerns about opioid efficacy, toxicity, tolerance, and abuse or addiction should no longer be used to justify withholding opioids,”
Overturned? Dangers of opiates seen now.
highest rate of dependence after any use is for tobacco: 32 percent of people who used nicotine even once went on to long-term habitual use.
alcohol, marijuana, and cocaine the rate is about 15 percent, and for heroin the rate is 23 percent.
three factors need to coincide for substance addiction to occur: a susceptible organism; a drug with addictive potential; and stress.
basic physiological level, addiction represents “a different state of the brain,” in the words of physician and researcher Charles O’Brien.
is the brain of the habitual user somehow susceptible before drug use begins?
In the part of the cerebral cortex responsible for regulating emotional impulses and for making rational decisions, addicted brains have reduced activity.
If it is flooded with artificially high dopamine levels, it seeks to restore the equilibrium by reducing the number of receptors where the dopamine can act. This mechanism helps to explain the phenomenon of tolerance,
Cocaine, one might say, is a dopamine reuptake inhibitor.
CHAPTER 16
Can’t control self once addiction rewrites brain and limits processes
addiction also disrupts the self-regulation circuits—which the addict needs in order to choose not to be an addict.
Any thoughts of negative consequences are thrust aside: the part of the OFC that might speak up to warn her of these consequences is “gagged and bound.” Thus Claire’s OFC, impaired by years of drug use and perhaps even before then, encourages the self-harming activity rather than inhibiting it. She injects.
CHAPTER 17
Nurturing required in childhood to build regulation.
Brain development in the uterus and during childhood is the single most important biological factor in determining whether or not a person will be predisposed to substance dependence
three environmental conditions absolutely essential to optimal human brain development are nutrition, physical security, and consistent emotional nurturing.
Stress,
stress-response mechanism.
stress reduces the numbers of both opiate and dopamine receptors.
Adverse Childhood Experiences (ACE) Study, looked at the incidence of ten separate categories of painful circumstances—including
mistreated children have been shown to be smaller than normal by 7 or 8 percent, with below-average volumes in multiple brain areas, including in the impulse-regulating prefrontal cortex; in the corpus callosum (CC),
The lack of integration between the two halves of the brain would mean that information from the two views, negative and positive, is not melded into one complete picture.
shrinking from normal experience is also an outcome of early trauma and stress,
