In the Realm of Hungry Ghosts: Close Encounters with Addiction

by Gabor Maté

When a person is encouraged to get in touch with and express his deepest feelings in the secure knowledge that he will not be rejected, criticized, nor expected to be different, some kind of rearrangement or sorting-out process often occurs within the mind which brings with it a sense of peace; a sense that the depths of the well of truth have really been reached.

“I fully acknowledge that my cravings and behaviours have been out of control and that my inability to regulate them has led to dysfunction and chaos in important areas of my life. I no longer deny their impact on myself or my coworkers or my loved ones, and I admit my failure to confront them honestly and consistently.”

since I pride myself on a strong intellect, I’ve resisted accepting that I’m powerless over any mental process. On the contrary, it is in the nature of the ego to turn anything to its advantage. Even the public disclosure of my addictive patterns has served to reassure me of my sincerity and honesty and “courage.”

real courage does not lie in speaking about addiction; it resides in actively doing something about it

In the absence of compassionate curiosity, any such admission brings up too much shame.

God does not change people’s lot until they first change what’s in their own hearts. The Qur’an (13:11)

“What we are looking for is what we are looking with.”

So there are two ways of promoting healthy brain development, and both are essential to the healing of addiction: by changing the external environment and by modifying the internal one.

Most encouraging were Dr. Diamond’s findings that even the brains of animals deprived before birth or damaged in infancy were able to compensate through structural changes in response to enriched living conditions.

Mindful awareness involves directing our attention not only to the mental content of our thoughts, but also to the emotions and mind-states that inform those thoughts. It is being aware of the processes of our mind even as we work through its materials. Mindful awareness is the key to unlocking the automatic patterns that fetter the addicted brain and mind.

As long as the effects of the addictive substance or behaviour last, resentment and fear are temporarily suppressed, but afterwards the emotions always rebound with greater force than before. It’s an endless cycle because the addicted life will unfailingly generate new sources to feed the energy of anxiety and resentment. In such a state, the philosopher and writer Friedrich Nietzsche remarked, “One cannot get rid of anything, one cannot get over anything, one cannot repel anything—everything hurts. Men and things obtrude too closely; experiences strike one too deeply; memory becomes a festering wound.”

“Everything has mind in the lead, has mind in the forefront, is made by the mind,” the Buddha said.

Traditional Buddhist psychology did not have our scientific knowledge about the development of the brain, whose activity generates most of what we understand as mind. It did recognize, however, that once mind structures are in place they determine our perceptions, behaviours and experiences. By consciously observing the workings of our mind, we are able gradually to let go of its habitual, programmed interpretations and automatic reactions.

“The unreflecting mind is a poor roof,” Buddha taught. “Passion, like the rain, floods the house. But if the roof is strong, there is shelter.”

“Although the content of consciousness depends in large measure on neuronal activity, awareness itself does not,” Penfield wrote. “To me it seems more and more reasonable to suggest that the mind may be a distinct and different essence from the brain.”

The automatic mind, the reactive product of brain circuits, constantly interprets the present in the light of past conditioning. In its psychological responses it has great difficulty telling past from present, especially whenever it is emotionally aroused. A trigger in the present will set off emotions that were programmed perhaps decades ago at a much more vulnerable time in the person’s life. What seems like a reaction to some present circumstance is, in fact, a reliving of past emotional experience. This subtle but pervasive process in the body, brain and nervous system has been called implicit memory, as compared to the explicit memory apparatus that recalls events, facts and circumstances.

implicit memory is active “when people are influenced by past experience without any awareness that they are remembering … If we are unaware that something is influencing our behavior, th...

Whenever a person “overreacts”—that is, reacts in a way that seems inappropriately exaggerated to the situation at hand, we can be sure that implicit memory is at work. The reaction is not to the irritant in the present but to some buried hurt in the past. Many of us look back puzzled on some emotional explosion and ask ourselves, “What the heck was that about?” It was about implicit memory; we just didn’t realize it at the time.

Knowing oneself comes from attending with compassionate curiosity to what is happening within. Methods for gaining self-knowledge and self-mastery through conscious awareness strengthen the mind’s capacity to act as its own impartial observer. Among the simplest and most skilful of the meditative techniques taught in many spiritual traditions is the disciplined practice of what Buddhists call “bare attention.” Nietzsche called Buddha “that profound physiologist” and his teachings less a religion than a “kind of hygiene.” When the Buddha seeks to liberate the soul from resentment, Nietzsche wrote, “It is not morality that speaks thus; thus speaks physiology.” Many of our automatic brain processes have to do with either wanting something or not wanting something else—very much the way a small child’s mental life functions. We are forever desiring and longing, or judging and rejecting. Mental hygiene consists of noticing the ebb and flow of all those automatic grasping or rejecting impulses without being hooked by them. Bare attention is directed not only toward what’s happening on the outside, but also to what’s taking place on the inside.

“Be at least as interested in your reactions as in the person or situation that triggers them,” Eckhart Tolle advises.

The addict seldom questions the reality of the unpleasant mood or feeling she wants to escape. She rarely examines the perspective from which her mind experiences and understands the world around her and from which she hears and sees the people in her life. She is in a constant state of reactivity—not to the world so much as to her own interpretations of it. The distressing internal state is not examined: the focus is entirely on the outside:

Bare attention can show her that these moods and feelings have only the meaning and power that she gives them.

Addicted people often say, “I don’t know who I really am.” If the addict has more than the usual difficulty in holding on to a healthy sense of self, it’s because in the addicted brain the reaction patterns, emotions and thoughts that create a sense of self fluctuate so widely. Due to impaired regulation over easily triggered feelings of craving and distress, the addicted mind lacks consistency.

Many addicts define themselves through their addictions and feel quite unmoored and lost without them. Substance-dependent people do this, but so do workaholics and other behaviour addicts. They fear giving up their addiction not only because of the temporary relief it offers, but also because they just cannot conceive who they might be without

Bare attention allows us to take an objective stand outside the ever-moving ebb and flow of thought, reaction and emotion and to reinforce the part of us that can observe, know and decide consciously. It allows us to observe the many individual “frames,” as it were, that make up the self-created movies in our minds.

The greatest damage done by neglect, trauma or emotional loss is not the immediate pain they inflict but the long-term distortions they induce in the way a developing child will continue to interpret the world and her situation in it. All too often these ill-conditioned implicit beliefs become self-fulfilling prophecies in our lives. We create meanings from our unconscious interpretation of early events, and then we forge our present experiences from the meanings we’ve created. Unwittingly, we write the story of our future from narratives based on the past.

Although my mother likely saved my life by sending me away from the dangers of the Budapest ghetto before my first birthday, I experienced the event the only way an infant could: as abandonment. It left me with a permanent core sense that I must never be emotionally open and vulnerable. When Rae, my wife, says no to me or behaves in a way that upsets me, my automatic belief is that I’m being rejected or abandoned by the woman whose love I need, and my mechanical reaction is to detach emotionally, to withdraw. This is a common response of young children who experience emotional or physical separation from their parents.

Addiction confers invulnerability because it allows us to soothe vulnerable emotions like pain or fear or the aching for love with behaviours, objects or substances whenever we choose. It’s a way to avoid intimacy. Mindful awareness can bring into consciousness those hid...

“Your worst enemy cannot hurt you as much as your own thoughts, when you haven’t mastered them,” said the Buddha. “But once mastered, no one can help you as much—not even your father and your mother.”

And what is commitment? Commitment is sticking with something not because “it works” or because I enjoy it, but because I have an intention that overrides momentary feelings or opinions.

You don’t have to feel or believe that it’s working for you: you just have to do it and to understand that if you have lapsed, it doesn’t mean that you have failed. It’s an opportunity to begin anew.

Be fully aware of the sense of urgency that attends the impulse and keep labelling it as a manifestation of addiction, rather than any reality that you must act upon.

the Impartial Spectator as the capacity to stand outside yourself and watch yourself in action, which is essentially the same mental action as the ancient Buddhist concept of mindful awareness.”

“Conscious attention must be paid,” Jeffrey Schwartz emphasizes. “Therein lies the key. Physical changes in the brain depend for their creation on a mental state in the mind—the state called attention. Paying attention matters.”

“In Re-attribute you learn to place the blame squarely on your brain. This is my brain sending me a false message.”

“Because they are deeply ingrained in my brain and because they are easily triggered whenever I’m stressed or fatigued or unhappy or bored.”

The addictive compulsion says nothing about you as a person. It is not a moral failure or a character weakness; it is just the effect of circumstances over which you had no control. What you do have some control over is how you respond to the compulsion in the present. You were not responsible for the stressful circumstances that shaped your brain and worldview, but you can take responsibility now.

Once more, don’t allow yourself to be frustrated when what you have let go returns. It will—probably soon. When it does, you will re-label it and re-attribute it: “Hello, old brain circuits,” you say. “I see you’re still active. Well, so am I.” If you change how you respond to those old circuits, you will eventually weaken them. They will persist for a long time—

“It’s not how you feel that counts; it’s what you do.” Rather than engage in 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.

The purpose of Re-focus is to teach your brain that it doesn’t have to obey the addictive call.

As you perform the alternative activity, stay aware of what you are doing. You are doing something difficult. No matter how simple it may seem to others who do not have to live with your particular brain, you know that holding out for even a short period

We know that the addicted brain assigns a falsely high value to the addictive object, substance or behaviour, the process called salience attribution.

Addiction has moved in and taken over your attachment-reward and incentive-motivation circuits. Where love and vitality should be, addiction roosts. The distorted brain circuits, including the orbitofrontal cortex, are making you believe that experiences that can come authentically only from genuine intimacy, creativity or honest endeavour will be yours for the taking through addiction.

What has this addictive urge done for me? you will ask. It has caused me to spend money heedlessly or to stuff myself when I wasn’t hungry or to be absent from the ones I love or to expend my energies on activities I later regretted. It has wasted my time. It has led me to lie and to cheat and to pretend—first to myself and then to everyone close to me. It has left me feeling ashamed and isolated. It promised joy and delivered bitterness. Such has been its real value to me; such has been the effect of my allowing some disordered brain circuits to run my life. The real “value” of my addictive compulsion has been that it has caused me to betray my true values and disregard my true goals.

Do all this without judging yourself. You are gathering information, not conducting a criminal trial against yourself.

the two A’s: Anticipate and Accept. To anticipate is to know that the compulsive drive to engage in addictive behaviour will return. There is no final victory—every moment the urge is turned away is a triumph. What is certain is that with time the addictive drive will be drained of energy if you continue to apply the four steps and also take care of the internal and external environments

accept that the addiction exists not because of yourself, but in spite of yourself.

You have values. You have passions. You have intention, talent, capability. In your heart there is love, and you want to connect that with the love in the world, in the universe. As you re-label, re-attribute, re-focus and re-value, you are releasing patterns that have held you and that you have held on to. In place of a life blighted by your addictive need for acquisition, self-soothing, admiration, oblivion, meaningless activity, what is the life you really want? What do you choose to create?

“What is in us must out,” wrote the great Canadian stress researcher, Dr. Hans Selye, “otherwise we may explode at the wrong places or become hopelessly hemmed in by frustrations. The great art is to express our vitality through the particular channels and at the particular speed Nature foresaw for us.”

What matters is not the features of our character or the drives and instincts per se, but rather the stand we take toward them. And the capacity to take such a stand is what makes us human beings. VICTOR FRANKL The Will to Meaning