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Addiction Treatment Philosophy / In the Realm of Hungry Ghosts
« on: July 11, 2011, 03:28:12 PM »
Gabor Maté In the Realm of Hungry Ghosts: Close Encounters with Addiction
Video Interview: http://www.democracynow.org/2010/2/3/addiction
I was surprised to find by search that this book appears to have only been mentioned on here once (in an AARC discussion). I’m sure many have read it. I’m glad to have and so I pass along a recommendation.
My thoughts were taken on small journeys through that which I hadn’t considered and development of that which I had considered with respect to Harm Reduction. Later in the tome, the proposals he outlines took me further still and I took great interest in the places that sections of the book took me to -where I was hesitant to follow.
In the preface to the U.S. edition he had me engaged with his response to remarks about praise for his book which called it “Humanizing”. His comment that he found this to be “an overstatement” was qualified with the thought provoking question “How can human beings be humanized, and who says addicts aren’t human to begin with?” This was a discrete presage to content which challenges the reader to acknowledge the biases regarding the tendency for our culture to regard some as the worthy poor and others the undeserving indigent. As well as challenge the war on drugs as a failure which claims as collateral damage those its purported purpose is to protect.
The breadth of this book is difficult to do justice to in a summary. The portrayals of the severely addicted individuals with whom he’s worked with are as compassionate as the depictions of these circumstances in which they are subsisting and dying amidst the addictions that brought them there are unblinkingly honest. Poignant are their experiences of brutality and privations which engendered the cycle of self inflicted pain and self neglect in which they seem trapped.
Page one he briefly elucidates three realms of the wheel of life based on Buddhist cosmology-- including the insatiable inhabitants of that which he selected the title of his book for. On that page also was a line which held a simple statement that was for me one of those stunning moments of seeing some quietly held personal belief that had seemed exclusive to me spelled out so matter of factly that the reflection caused me a stirring sense of awe.
Shortly thereafter he states that no society can understand itself without first understanding its shadow side. With this he writes:
There is a host of questions to be considered, among them:
• What are the causes of addictions?
• What is the nature of the addiction prone personality?
• What happens in physiologically in the brains of addicted people?
• How much choice does the addict really have?
• Why is the war on drugs such a failure and what might be a humane evidence based approach to the treatment of severe drug addiction?
• What are some of the paths for redeeming addicted minds [who are]not dependant on powerful substances—that is how do we approach the behavior addictions fostered by our culture?
He also states “The possibility of renewal in life exists so long as life exists. How to support that possibility of renewal in others and our selves is the question”
He introduces us to the Portland Hotel-- a place which many readers may regard as an extreme Harm Reduction model. To still others (attached to convictions that would resolve them to wage war on addiction and in so doing on the addict) this place (which Maté frequently refers to as a ghetto) would seem an almost enabling and contradictory contraindication. Some passages certainly challenged me; and at the time of reading this, I had already familiarized myself with the concepts and common practices of Harm Reduction.
Maté writes, “What makes the Portland Model unique and controversial among addiction services is the core intention to accept people as they are—no matter how dysfunctional, troubled and troubling they may be. At the Portland Hotel there is no […] expectation of socially acceptable outcomes, only an unsentimental recognition of the real needs of real human beings in the dingy present. We may (and do) hope that people can be liberated from the demons that haunt them, but we don’t fantasize that such a psychological exorcism can be forced on anyone.”
When examining the causes of addiction, he emphasizes that three environmental factors are essential to optimal human brain development. These are nutrition, physical security and consistent emotional nurturing. He outlines how disruption or deprivation of any of these prime necessities can have a deleterious influence on the developing brain. This he says is the brain biology of addiction “People are susceptible to the addiction process if they have a constant need to fill their minds or bodies with external sources of comfort, whether physical or emotional.” That need expresses a failure of self-regulation.
He gets a little tangential when discussing the topic of Behavioral Addictions which seems also muddled in the way that he chooses to interject it within the larger format of the text. I can understand what he was trying to underscore in those sections… the similitudes and differences and further, the hypocrisies with which our acquisitive and often dismissive culture regards its own nature versus that of the addict (seen as the other). I followed his reasoning, but it felt like a section of a separate book at times there, and perhaps his points would’ve been bettered by presenting examples of behavioral addiction other than just his own. Still, it is that very section which felt like a separate book that I am going to be recommending to a very informed friend who has OCD & ADD.
In later portions of the book (such as Toward an Enlightened Social Policy on Drugs) he expands upon his idea that society needs to reexamine the biases that influence our often misguided intentions toward treating addicts, that the intentions are ultimately undone when tainted with (largely unexamined) punitive tendencies. His own words in the interview linked above do justice to this discussion far better than my synopsis could of the costs to society of focusing on criminalizing rather than treating and preventing this result of abuse and neglect.
In the Realm of Hungry Ghosts: Close Encounters with Addiction is nearly 500 pages long, my review shall not be. If you’ve an interest in reading up on compassion based Addiction Treatment Philosophies or having your interpretation of Harm Reduction challenged or expanded—Go read it.
"We may not be responsible for the world that created our minds, but we can take responsibility for the mind with which we create our world".–Gabor Maté
Video Interview: http://www.democracynow.org/2010/2/3/addiction
I was surprised to find by search that this book appears to have only been mentioned on here once (in an AARC discussion). I’m sure many have read it. I’m glad to have and so I pass along a recommendation.
My thoughts were taken on small journeys through that which I hadn’t considered and development of that which I had considered with respect to Harm Reduction. Later in the tome, the proposals he outlines took me further still and I took great interest in the places that sections of the book took me to -where I was hesitant to follow.
In the preface to the U.S. edition he had me engaged with his response to remarks about praise for his book which called it “Humanizing”. His comment that he found this to be “an overstatement” was qualified with the thought provoking question “How can human beings be humanized, and who says addicts aren’t human to begin with?” This was a discrete presage to content which challenges the reader to acknowledge the biases regarding the tendency for our culture to regard some as the worthy poor and others the undeserving indigent. As well as challenge the war on drugs as a failure which claims as collateral damage those its purported purpose is to protect.
The breadth of this book is difficult to do justice to in a summary. The portrayals of the severely addicted individuals with whom he’s worked with are as compassionate as the depictions of these circumstances in which they are subsisting and dying amidst the addictions that brought them there are unblinkingly honest. Poignant are their experiences of brutality and privations which engendered the cycle of self inflicted pain and self neglect in which they seem trapped.
Page one he briefly elucidates three realms of the wheel of life based on Buddhist cosmology-- including the insatiable inhabitants of that which he selected the title of his book for. On that page also was a line which held a simple statement that was for me one of those stunning moments of seeing some quietly held personal belief that had seemed exclusive to me spelled out so matter of factly that the reflection caused me a stirring sense of awe.
Shortly thereafter he states that no society can understand itself without first understanding its shadow side. With this he writes:
There is a host of questions to be considered, among them:
• What are the causes of addictions?
• What is the nature of the addiction prone personality?
• What happens in physiologically in the brains of addicted people?
• How much choice does the addict really have?
• Why is the war on drugs such a failure and what might be a humane evidence based approach to the treatment of severe drug addiction?
• What are some of the paths for redeeming addicted minds [who are]not dependant on powerful substances—that is how do we approach the behavior addictions fostered by our culture?
He also states “The possibility of renewal in life exists so long as life exists. How to support that possibility of renewal in others and our selves is the question”
He introduces us to the Portland Hotel-- a place which many readers may regard as an extreme Harm Reduction model. To still others (attached to convictions that would resolve them to wage war on addiction and in so doing on the addict) this place (which Maté frequently refers to as a ghetto) would seem an almost enabling and contradictory contraindication. Some passages certainly challenged me; and at the time of reading this, I had already familiarized myself with the concepts and common practices of Harm Reduction.
Maté writes, “What makes the Portland Model unique and controversial among addiction services is the core intention to accept people as they are—no matter how dysfunctional, troubled and troubling they may be. At the Portland Hotel there is no […] expectation of socially acceptable outcomes, only an unsentimental recognition of the real needs of real human beings in the dingy present. We may (and do) hope that people can be liberated from the demons that haunt them, but we don’t fantasize that such a psychological exorcism can be forced on anyone.”
When examining the causes of addiction, he emphasizes that three environmental factors are essential to optimal human brain development. These are nutrition, physical security and consistent emotional nurturing. He outlines how disruption or deprivation of any of these prime necessities can have a deleterious influence on the developing brain. This he says is the brain biology of addiction “People are susceptible to the addiction process if they have a constant need to fill their minds or bodies with external sources of comfort, whether physical or emotional.” That need expresses a failure of self-regulation.
He gets a little tangential when discussing the topic of Behavioral Addictions which seems also muddled in the way that he chooses to interject it within the larger format of the text. I can understand what he was trying to underscore in those sections… the similitudes and differences and further, the hypocrisies with which our acquisitive and often dismissive culture regards its own nature versus that of the addict (seen as the other). I followed his reasoning, but it felt like a section of a separate book at times there, and perhaps his points would’ve been bettered by presenting examples of behavioral addiction other than just his own. Still, it is that very section which felt like a separate book that I am going to be recommending to a very informed friend who has OCD & ADD.
In later portions of the book (such as Toward an Enlightened Social Policy on Drugs) he expands upon his idea that society needs to reexamine the biases that influence our often misguided intentions toward treating addicts, that the intentions are ultimately undone when tainted with (largely unexamined) punitive tendencies. His own words in the interview linked above do justice to this discussion far better than my synopsis could of the costs to society of focusing on criminalizing rather than treating and preventing this result of abuse and neglect.
In the Realm of Hungry Ghosts: Close Encounters with Addiction is nearly 500 pages long, my review shall not be. If you’ve an interest in reading up on compassion based Addiction Treatment Philosophies or having your interpretation of Harm Reduction challenged or expanded—Go read it.
"We may not be responsible for the world that created our minds, but we can take responsibility for the mind with which we create our world".–Gabor Maté