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Kindle Notes & Highlights
by
Gabor Maté
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March 9 - September 14, 2025
Of any group in North America, whether in the U.S. or Canada, none can be said to be more psychologically and socially oppressed than Native women.
It is commonly thought that peer affiliation leads to drug use because kids set bad examples for each other. That’s part of the picture, but a deeper reason is that under ordinary circumstances, adolescents who rely on their peers for emotional acceptance are more prone to being hurt, to experiencing the sting of each other’s immature and therefore often insensitive ways of relating. They are far more stressed than children who are well connected to nurturing adults.
Cops are not necessarily predisposed to harshness, but a loss of humane interaction inevitably results whenever an entire group of people is de-legitimized while another group is granted virtually unrestrained physical authority over them.
people may poison themselves with alcohol or kill themselves with cigarette-derived toxins, but those whose drug of choice is a narcotic or a stimulant are to be considered criminals.
In speaking with him, one feels that every request is a manipulation, every word hides an agenda and every interaction serves some ulterior motive. I doubt he is aware of how he appears to others; to borrow from Nietzsche, he lies his way out of reality because he has been hurt by reality. The manipulation and dishonesty have been his automatic defences since childhood. He must be terrified that without them he will suffer deprivation.
Even in cases where abstinence is not achieved, redemption would mean the reintegration of the user into the larger community and the restoration of his value as a person in his own eyes.
It’s important to note that decriminalization does not mean legalization. Legalization would make manufacturing and selling drugs legal, acceptable commercial activities. Decriminalization refers only to removing from the penal code the possession of drugs for personal use. It would create the possibility of medically supervised dispensing when necessary.
The fear that easier access to drugs would fuel addiction is unfounded: drugs, we have seen, are not the cause of addiction. Despite the fact that cannabis is openly available in Holland, for instance, Dutch per-capita use of marijuana is half that in the United States.
The issue in medical practice is always how best to help a patient. If a cure is possible and probable without doing greater harm, then cure is the objective. When it isn’t—and in most chronic medical conditions cure is not the expected outcome—the physician’s role is to help the patient with the symptoms and to reduce the harm done by the disease process.
Instead of hurling an accusatory brick at your own head (e.g., “I’m so stupid; when will I ever learn,” etc.), the question “Why did I do this again, knowing full well the negative consequences?” can become the subject of a fruitful inquiry, a gentle investigation.
The acronym COAL has been proposed for this attitude of compassionate curiosity: curiosity, openness, acceptance and love: “Hmm. I wonder what drove me to do this again?”
The purpose is not to justify or rationalize but to understand. Justification is another form of judgment every bit as debilitating as condemnation. When we justify, we hope to win the judge’s favour or to hoodwink her. Justification connives to absolve the self of responsibility; understanding helps us assume responsibility.
What seems nonadaptive and self-harming in the present was, at some point in our lives, an adaptation to help us endure what we then had to go through. If people are addicted to self-soothing behaviours, it’s only because in their formative years they did not receive the soothing they needed.
“I admit I am powerless over my addiction process.” That is, “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.”
In an ecological framework recovery from addiction does not mean a “cure” for a disease but the creation of new resources, internal and external, that can support different, healthy ways of satisfying one’s genuine needs.
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.
“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.
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 of time is an achievement. You are teaching your old brain new tricks. Unlike the case with old dogs, no one can tell you it can’t be done.
A therapist once said to me, “When it comes to a choice between feeling guilt or resentment, choose the guilt every time.” It is wisdom I have passed on to many others since. If refusal to take on responsibility for another person’s behaviours burdens you with guilt, while consenting to it leaves you eaten by resentment, opt for the guilt. Resentment is soul suicide.
if such an intervention is to have any hope of success—indeed, any hope of not further poisoning the situation—it needs to be put into action with love, in a pure way that is not adulterated with judgement, vindictiveness or a tone of rejection. It requires clarity of purpose: Is my aim here to set my limits and to express my needs, or am I trying to change the other person? You may find it necessary, say, to tell your spouse or adult child about the negative way their actions affect you—not in order to control or blame them, only to communicate what you will accept and what you cannot and
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We may not be responsible for another’s addiction or the life history that preceded it, but many painful situations could be avoided if we recognized that we are responsible for the way we ourselves enter into the interaction.
