Gabor Mate, In the Realm of Hungry Ghosts

[EDIT: Hi. Welcome to my blog -- but why this post? Why is this the one that generates more traffic than any other post around here? Leave a comment, as I'd love to make sure the traffic isn't mostly automated! And frankly, some of my own favourites would be this one, or maybe this one.]


My name is Richard, and I'm an -- no, wait, that's not how to start this. First impressions and all that. Besides, I'm no alcoholic, since I sometimes go for weeks between drinks, rarely get more than a little tipsy, and only read it for the articles.

I spent more than 250 pages being increasingly and searingly annoyed with Gabor Mate, author of this month's book club selection, In the Realm of Hungry Ghosts: Close Encounters with Addiction. There are at least three books smooshed together in the one volume, and while two of them are fascinating and well done, the third one -- at least through the first 250 or so pages -- drove me beyond batty with its pretentiousness, egotism, and arrogance. I want to hear about how addiction works, emotionally as well as neurologically, both in its development and in its persistence. I need to hear about the lives of addicts in the Downtown Eastside of Vancouver, which is Canada's most drug-centred neighborhood, poorest neighborhood, most policed neighborhood, and so on; the lives of these people need to be honoured and recognized, rather than rejected. I do NOT want to hear a fairly well-off doctor equate his drive to purchase CD's of classical music with heroin, and his life with the life of a heroin addict suffering from spinal abscesses, multiple infections and HIV, whose children have died of overdoses and whose partner beats her.

If I hadn't finished the book, and I wasn't going to, that's roughly where this review was going to end up. I was appalled, utterly appalled, by Mate's including himself in this book as an addict. Even after finishing the book, I'm left wondering how he'd distinguish between addiction, obsessive-compulsive disorder, obsessions, habits, and passions, so part of his message didn't get through to this fairly careful reader. There's some incredible material here, and two of the threads are well worth your time, but the other one.... Shameful, is how it seemed to me. Flat out shameful.

And yet. And yet.

There came a point where I started seeing myself in this book, in these behaviours he's describing, even in Gabor Mate himself. I mean, I know that some of my habits aren't the healthiest, and even though I'd like to stop them, sometimes I can't, but addicted? Come on. Save the word for those who need it; let it keep its power. But people who know me well have a sense for how wildly I throw myself into activities. If you read this blog, you may have noticed that the great majority of posts go up when a sensible person has gone to bed. The recent conference, well, let's just say I should have empowered my colleagues to act cooperatively in the planning and execution, but that's not something I'm equipped to do. More personally, well, there've been some habits, some mostly harmless and others much less so.

By the end of the book, I could see why Mate was including himself in this book. His addiction process is the same as that of his patients, and we all need to achieve greater humility in how we face the world, and the people we'd like to think of as lesser individuals. There's room for him in In the Realm of Hungry Ghosts, and I wouldn't have seen myself there if he hadn't managed to find room. I still think it comes across somewhat amateurishly in the first two-thirds of the book, and I wouldn't blame a single person for quitting the book in protest at his including himself this way, but I'm glad to have finished the book. It's an open question, though, if I'd recommend it to other readers.

My name is Richard, and I'm....

Comments

Anonymous said…
Obviously you have never suffered from an addiction that has seriously affected your life, and you have never worked with addicts. Mate's book is an honest, compassionate work that shows this man's serious dedication to a cause that few people are brave enough to be involved in. This man is perceptive, kind and, in my opinion, a brilliant physician.

In order to step into the shoes of an addict, one must recognize your own problematic behaviour or patterns. This is not a pretty process, and one that few people can complete. Go to a meeting sometime to observe the heartbreak addiction can cause.

And Mate? Arrogant? Look no further than your own self righteous and judgemental post.
richard said…
I don't think you finished the post. I said that through the first 250 pages, I felt that Mate was arrogant in including his own experiences as an addict himself (NOT as someone working with individuals with addiction). I felt that Mate, as a BMW-driving CD-buying physician, came across as categorically different from a homeless, heroin-using, chronically abscessed person on the verge of death.

And I stand by that comment about the first half of the book, maybe the first two-thirds.

Call me judgemental if you want to, but the distinctions between Mate's life and the lives of his patients are vast, vast, vast. The equation he draws is a false one, except in the mechanism at work. I'm not going to accept each complaint against oppression as equivalent just because there's actual oppression at work: someone whose life is threatened because of ethnic identity is categorically different from someone whose life is made a little less comfortable.

But I did say that by book's end, I understood why Mate was including himself. I didn't specifically use the word "humility" in reference to him, but you know, I can't see how one wouldn't see it as a reference to him and with his valuable work. He's a heck of a guy, and I'm delighted that he's been so committed for so long to the extremely important issue of addiction, especially in the DTES. This, however, doesn't mean I have to like how he structures this book.

As for the appeal for me to keep my trap shut until my life's been affected by addiction -- I don't expose all my scabs publicly. Addiction has been part of my life, though I don't want to talk about it. But until late in the book, I still didn't appreciate how Mate included himself as a representative addict.
Daniel Maté said…
Hi -

I'm Gabor's son Daniel. Just stumbled across your review. I appreciate your candor in describing your initial frustration with the book, and how that point of view shifted (at least somewhat.)

Two observations:

1) He doesn't "equate" his addiction process with his patients' -- he does juxtapose them. I can't remember the exact wording, but he says something like "The differences between me and my patients are glaring and obvious; but that doesn't stop me from seeing the (disturbing) similarities." He's had a much more fortunate life than the people he works with, and so his self-destructive patterns "wear dainty white gloves" compared with theirs. Still, there may be something to be learned from looking at the commonalities -- especially since we tend to turn addicts into "Others" in our society. That, I take it, is his point.

2) He doesn't drive a BMW; he drives a rather compact Honda Civic. :)

best,
Daniel
richard said…
Hi Daniel,

Thanks for stopping by, and for showing restraint in your reply to what seems to me now a more ranting review than I thought it was at the time.

And I didn't say it in the review, but I was fascinated by your place in the book. I can't go check it, as I borrowed it from a friend, but I do remember being really interested in your dual role as character/person. (If that makes sense, which it may not.)

By book's end, I think in my mind your father did get to the point he was making about seeing ourselves in the addicted, about finding a way to avoid the destructive othering we inflict on people we don't want to identify with. That's why the book worked for me, in the end. But for me, it was such a tough go to get there. The juxtaposition, as you called it, was too jarring for me: it wasn't othering, and that's a good thing, but I read it too like identification, and I got cranky.

As for the car -- I stand corrected :-) Someone on Hornby must have told me he drove a Beemer!
Anonymous said…
I am a Seattle physician, the mother of Robin who died of an overdose (oxycontin and cocaine) 3 years ago. I am deeply disturbed by this doctor's philosophy that all addiction and mental illness are due to childhood abuse or trauma, disrupted relationships. Neither would I equate opiate addiction with an eating disorder although the two might initially feel "healing" to the individual.
Rosemary Orr
richard said…
Well, this is interesting for me: a six-month-old review that prompts both a comment and correction from the author's son, and that the same week prompts a blunt challenge from someone else TO the author!

Thanks for your thoughts, Rosemary, and I am sorry for your loss. I'm not knowledgeable enough to disagree all that effectively with Gabor Mate, so I will say only that at times I felt the accuracy with which he was occasionally linking disparate phenomena, and at other times I was very upset by them. As I think you were -- did you read the book, then, or are you just responding to this review?
Anonymous said…
I work for a battered woman's shelter and many of the women we see have serious substance abuse issues. I happened to hear Dr. Mate interviewed by Bob Edwards this morning and I was fascinated by his perspective as well as his ability to connect non-substance behaviors to what an addict experiences. I was not offended by the revelation of his own compulsive behavior but was in fact able to find a common place that bound me to the addict.

I extend my heartfelt condolence to Robin's mother but would suggest that there is always an exception, or even multiple exceptions that defy the 'rule' but it, they do not negate the validity of that rule. Further, why is an opiate addiction different from an eating disorder? One has been criminalized while the other has not.

I am intrigued by Dr. Mate's work and how it might alter the attitudes we too often adopt when working with the women who live in our shelters as well as how we can be more supportive of the children who accompany them.
Alex said…
Richard,

I have just seen Dr Mate interviewed on Democracy Now TV. There is a lot of substance to his theory of diet relating to disease and the imprint of parents on children. For example he addressed a similarity to the effect of overly neat mothers who may imprint male children with the propensity for rheumatoid arthritis.
I look forward to more of your reviews. Having survived several addictions, I am afraid that I have imprinted my sons. But I never congealed my paradigms like they have. They are 30 years younger than me. I am also glad that your "commenters" criticized your review and not you.
richard said…
Thanks, Alex. Commenters here generally tend to be a polite bunch; the first one on this review took my comments pretty hard, but these things happen.

Maté's ideas about rheumatoid arthritis are from his previous book, I think, When the Body Says No (a book I read not long after my own body said "no" pretty emphatically). His point there is that stress causes all kinds of odd effects on human health -- animal health, too, but that's not his main point. I remember getting antsy about the particular connections, and while I don't recall the "neat mother" --> "rheumatoid arthritis" link, that's the kind of thing that would have me raising my eyebrows. I'd need to know quite a bit more about the research before I'd walk very far with that particular theory.

And I'm just a book guy who read Maté for a book club, so I'm unlikely to spend much time digging up the research!
Gabe said…
I am a physician. I just saw Mate speak at a conference in Toronto, and what he said about the link between cancer and alcoholic parents and stress and rheumatoid arthritis had me raising my eyebrows on numerous occasions. What really got me was how he insulted Western Medicine, accusing most if not all traditional physicians of twisting data to support their incorrect beliefs and calling it "science". Sure, some do, it's human nature. But he did not give us any data to support his claims, only said "research supports this" over and over again, telling us to look it up in his book if we were curious. His work is intriguing, and he is a captivating speaker, but he IS antagonistic, he IS arrogant, and he is a know-it-all. I'd warn anyone to be weary of someone who does not acknowledge the controversial nature of subjects and who does not acknowledge their own lack of knowledge on a subject. Unfortunately, fire and brimstone sell more books and captivate more followers than objectivity and humility.

I cannot speak to his works on addiction, which is ultimately what your post is about, only to my opinion of his speech at our convention. Maybe he's more reasonable in "In the Realm of Hungry Ghosts". I should really read his stuff and look up his data, but then I fear he'd call me a western doctor who is closed-minded and "clinging to my old beliefs".
richard said…
It's so fascinating to me that there's been such heat generated by Maté and his book. There was an immediate reply from someone who felt I'd done a character assassination, and subsequently a milder corrective from his son, and since then there've been a few comments which felt I was far too easy on him.

I'd like to think, Gabe, that Maté is objecting to the practices of certain doctors and programs, rather than to all of Western medicine, but I wasn't there. Certainly there's room to read his book as if it was asserting either position.

Were there particular comments that had your head a-shaking?
Backward Child (Teragram) said…
It's been a while since I've read the book, and I too had a mixed reaction. Hey, if he were stealing the CDs and hawking them for illicit drugs, maybe. . .

Gabor Mate has gone on the record to say that people should "do as I say, not as I do". This takes something away from the intensity of the message. He seems to have a compulsive need to externalize his considerable load of "stuff" from past and present, through writing, speaking, teaching, etc. I don't think he can stand to just be himself: he has to be "up there", and while his ideas definitely have merit, once you look beyond the beautiful, skillful and somewhat seductive writing, you see problems.

People oh, so want to follow someone - look at that idiot who killed those people in the sweat lodge. It's incredible how it works. Anyone who shows any self-confidence at all becomes a magnet. I always feel as if Mate looks strong, but is about to blow over like a blade of grass in a storm. Tough and fragile at the same time, and that means we MUST keep our critical minds open when we read or hear his ideas. Not that they're bad, wrong or ill-ressearched. But he is a classic example of "take my advice, I'm not using it." Caveat emptor.
Seems like the book did it's job, it got you to think outside of the addiction "box" and how the spectrum of process addictions leaves no victims. Good luck.
Phumbling said…
Better late than never...I disagree with well over 60% of your review of Gabor's, "In the Realm...". You seemed to focus on what did not work for you and, I believe, in that process explained a lot about yourself to your readers...you don't like to point the finger back at yourself. I don't believe Mate is 'arrogant' or 'self-righteous' or other slanderous things you may have said - I believe he finds a commonality with himself and his 'clients' so he can better understand and explain the 'problems' with addiction being a societal problem and not something an addict has to carry all alone. I believe we all fall in there somewhere...I don't know though. This is your forum and I'm guessing by using Gabor's name in your title has landed you a few more hits than you might have otherwise had :) Thanks for putting his name out there and generating conversation. I was just a little upset that you filled your blog with 90% criticism of (what you deem) only 33% of the book. That's what my issue is...you also made some wild assumptions...you know what they say about assumptions... :)
richard said…
It's always interesting to see how cranky people get about a review that they haven't read all that carefully.

You said I'd spent 90% of my words criticizing 33% of the book. Really, it's more like 75% criticizing 70% of the book: I said I was focusing on one of the three stories, but the one I focused on takes up most of the book.

And yeah, I do make assumptions. Those are the short-cuts we live by so we don't have to work things out anew every single time. Sure, sometimes it means that I'm wrong to assume people reading my blog will expect an individual response, and sometimes it means that a reader here will be wrong to assume I'm providing an objective review. But if we keep at it, we'll get over whatever conflict arises.

Here's what I said almost 18 months ago, in reply to someone else arguing much the same thing you did:

"He's a heck of a guy, and I'm delighted that he's been so committed for so long to the extremely important issue of addiction, especially in the DTES. This, however, doesn't mean I have to like how he structures this book."

Thanks for stopping by, though. You might like Brian Brett's Trauma Farm, too, as well as Janisse Ray's lovely Ecology of a Cracker Childhood - click the titles for links.
Anonymous said…
Thank you for the review and your approach to "in the realm of Hungry Ghosts." I am a criminal defense lawyer and a Social Services attorney in child abuse cases and atty for parents of abused children in another jurisdiction (all for 39 years now) Dr. Mates work opens many doors to understanding and opportunities for helping victims of abuse and the subsequent addictions and stress which affect so very many lives..I am happy to have read him and for having discovered his series of works ..He is a compassionate and devoted caregiver...and I think your review was fair and very perceptive..readers might finish it before being critical..your subtle self criticism gets lost sometimes..Thank you again.
richard said…
Thanks for your thoughts, Anon., and for noticing the self-criticism in my response. I'd thought Mate supporters might notice that as a sign that I'd taken on some of his writing stance, but apparently not.

I wish you well with your important work.
Anonymous said…
I just finished reading Mate's book called - "Scattered Minds, the origins and healing of Attention Deficit Disorder".

I completely get what you are saying about the addiction to CD's and such. I felt the same way as I read that part of the book - it almost seemed silly that he was calling it an addiction. But in the context of the book it really does help to bring the concept about addiction down to the basics.

Too many people have their own destructive behavior but don't notice it because it's not drugs or alcohol or the other "obvious" destruction.

After reading his book I discovered I am fully ADD and it explained so much and his story about his own addiction (as trivial as it may seem on the surface in comparison) really helps to relate to the non-abused, non-drug using "addictive" personality.

YOu should pick it up...
Anonymous said…
As an addict who has struggled to stay clean for 23 years with some success but little actual options...other than 12 steps, Gabor Mate is the only person whom has made any sense to me. I see myself completely in his book and it changed my life.
Even Einstein said that he disagreed with the notion of person freedom...which could actually be applied to the realm of addiction, in as much as, what compels people to do things? (in addiction, people's ability to direct the will is weak or nonexistent.) Einstein said that a person's action is determined either by external compulsions or internal need. I don't think it would be hard to make the leap(for a clever person like Richard) to the realm of addiction...whether the addiction is to a self-harming thing...or to things about that are somewhat harmless...or even things that are beneficial to the person.

The simple fact is the phenomenon of addiction, in the abstract, is that the addictive phychological process doesn't change in respect to the effects of the behavior(good or bad)

If you want to get philosophical, Buddhist treat an addiction as an attachment which binds the host to suffering. As the mind progresses along the path of deeper and deeper addiction, the behavior solidifies. The Sanskrit term is Sankhara...kind of like a self-amplifying feedback loop.

If you want to get metaphysical...you could say the the soul attracts that which it secretly most loves...and FEARS...and HATES.

It shows a level of understanding by Gabor to freely associate his own behavior and the resulting addictive patterns within the scope of the abnormal pathologies of addiction.

...and it's nice to see Richard begin the process of self-awareness which leads to a better understanding of social behaviors...and a better understanding of life.


"Enough for me the mystery of the eternity of life, and the inkling of the marvellous structure of reality, together with the single-hearted endeavour to
comprehend a portion, be it never so tiny, of the reason that manifests itself in nature."
--Einstein
Even Einstein said that he disagreed with the notion of person freedom...which could actually be applied to the realm of addiction, in as much as, what compels people to do things? (in addiction, people's ability to direct the will is weak or nonexistent.) Einstein said that a person's action is determined either by external compulsions or internal need. I don't think it would be hard to make the leap(for a clever person like Richard) to the realm of addiction...whether the addiction is to a self-harming thing...or to things about that are somewhat harmless...or even things that are beneficial to the person.

The simple fact is the phenomenon of addiction, in the abstract, is that the addictive phychological process doesn't change in respect to the effects of the behavior(good or bad)

If you want to get philosophical, Buddhist treat an addiction as an attachment which binds the host to suffering. As the mind progresses along the path of deeper and deeper addiction, the behavior solidifies. The Sanskrit term is Sankhara...kind of like a self-amplifying feedback loop.

If you want to get metaphysical...you could say the the soul attracts that which it secretly most loves...and FEARS...and HATES.

It shows a level of understanding by Gabor to freely associate his own behavior and the resulting addictive patterns within the scope of the abnormal pathologies of addiction.

...and it's nice to see Richard begin the process of self-awareness which leads to a better understanding of social behaviors...and a better understanding of life.

"Enough for me
the mystery of the eternity of life, and the inkling of the marvellous
structure of reality, together with the single-hearted endeavour to
comprehend a portion, be it never so tiny, of the reason that manifests
itself in nature."--Einstein
Anonymous said…
I thought GM might be interested in knowing that at "59thrills" on You Tube there is a performance by Classical Revolution PDX String Quartet of a piece by Arkady Fillipenko- the only known recording of this once celebrated but now obscure Ukrainian composer. Sikora's eat your heart out!
Kristo said…
Richard, he didnt equate himself to the addicts of heroin etc. he just compared the two, as they are interpreted in the same parts of the brain, so the reader would get a better clue on what happens to us. you shouldn focus so much on that part, rather than the whole picture. and for you, who commented on western medicine part, gabe i think, its no surprise to me, your comment i mean, as you are one who practices western medicine. and to all the other readers, i would suggest the same thing. rather than focusing so much on one part, try to understand his views and the whole picture. i think it would be stupid even, to think, that his intention at any time was to compare himself to a heroin addict who has HIV and has lost everything in life. All the best to everyone ! I personally love his work. Thanks.
Anonymous said…
To Philosophy of Phat:

I find some of your statements to be rather misguiding, patronizing/condescending, or judgmental instead of “philosophical.”

The claim that “in addiction, people's ability to direct the will is weak or nonexistent,” is a matter of debate because addiction is not a one-size-fits-all behavior. The ability to direct the will (or whatever it means) exists; the problem is that it’s directed towards self-defeat.

As great a scientist as Einstein was, his specialty wasn’t on human behavior or brain processes, but in physics. As far as I know, compulsions come from within our brain, the same as “internal needs.”

It won’t be hard for Anyone—including you and me—“to make the leap to the realm of addiction.” As long as we have a limbic system and our amygdala keeps all its functions, the prospect of engaging in compulsive behaviors is alive and well. Isn’t it by repetition the way in which we learn habits? Toss in the pleasure factor and you’ll have a nice recipe for a persisting behavior that anyone would work around it in order to keep it going.

I see a contradiction in the statement, “The simple fact is the phenomenon of addiction, in the abstract, is that the addictive psychological process doesn't change in respect to the effects of the behavior (good or bad)” because we are talking about a symbiotic process; one lives off the other; one influences the other in a continual process that can be reversed by guess what, another habit of purposely changing the thinking patterns.

This takes me to that behavior which “solidifies.” The brain’s plasticity can prevent this from happening by our purposeful reversing of the thinking patterns and perhaps by making some modifications in our external environment (the things we can control) and how we go about our lives. Therefore regaining homeostasis in certain neurochemical processes in the CNS. Unfortunately, mythology all too often gets mixed with the social structures that are supposed to help people prevent deeper involvement, but these structures keep failing at this task.

Some time ago, I learned that hate comes from painful experiences that in turn come from fear. Fear is the primal emotion, not love. I suspect that love is a fairly recently learned emotion in human history, and that human empathy and cooperation as a matter of survival was there all along.

I find it quite annoying how you play the Judge in-chief role when you toss your condescending attitude on the author of the blog:

“...it's nice to see Richard begin the process of self-awareness which leads to a better understanding of social behaviors...and a better understanding of life.”

Somehow these statements make me reflect on how grandiosity can be a pervasive theme among us humans.
Anonymous said…
Yo, bud. The feeling I get from the review is "I am superior to this doctor from Canada who spent decades with addicted people, trying to help them. You can't judge me. And you are inferior to my intellect."

Also, you don't have to be so insecure. He's trying to figure out a solution. He's not judging you as an addict.
richard said…
Um - "bud"? Huh. That's ... quite the thumbnail review.

And I'm also from Canada, incidentally, so although you're right that I'm not crazy about his writing in this book, his nationality has nothing to do with my assessment of him.
Anonymous said…
Dear Richard,

I am a recovered addict from the downtown streets, actually right on the corner of PAIN & WASTINGS!! Now in the role of helping others, the only thing I have pivitol is that I LISTEN!!! Thats it. 80 thousand student loan and all I do is LISTEN!!!!

Just food for thought!!!
Anonymous said…
Hi Richard,

Just a few words of support. I read your entire review and I heard and understood its ambivalent but cautiously positive, if equivocal, tone (and yet, and yet...). Then I read the comments. My comment is this: It takes courage to put reviews on the internet, because ambivalence and complexity don't sit well with many people. We like things either all good or all bad. And if somebody is less than glowing about one of our personal idols, be it Lady Gaga or the good doctor Mate, watch out! It's fascinating how people get angry at you without actually finishing or absorbing your review. Ad hominem attacks are so much simpler.

Having a point of view ain't easy.

Best regards.

Roger
Anonymous said…
Dear Doctor , i was a addict but not any more . Your book was excellent , i thank God for your honesty . Only people who have been there understand and i'm one . Keep up the great work . I share your book alot and at present have it lent out I always here that guy knows what he is saying , i always agree , yes he does , your friend kim
richard said…
Thanks for stopping by, Kim. Dr. Maté isn't connected to this blog, or even this individual review, but I'm sure he'd appreciate your words. Maybe write to him directly?

Mind you, Google's algorithms have made this humble post one of the entire web's leading comments about Dr. Maté's work on addiction, so maybe he should give me a royalty or something....
jackie said…
You're right, Richard, you are helping spread the word about Gabor Mate and his work. I had heard about him never actually read his work. Last night I watched a commentary about him on "On the Nature of Things" and today wanted to learn more so googled and there was your blog. I enjoyed reading your review and the ensuing conversation. Thanks.
Rachel T. Scott said…
I just watched the documentary online from the CBC about Dr. Mate and the Jungle Prescription. As someone who has been chased all my life by something terrible and finally found out what it was... my Father tried several times to kill me. The memories were hidden. I suffered with depression, anxiety and made several suicide attempts. Only in writing to someone very loving did I finally uncover why I was such a mess. I am obese and defineatly am addicted to food. I was normal weight untill about four years ago when my father committed suicide and then the eating raged out of control. Mental illness and addiction go hand in hand. Dr. Mate is in my opinion RIGHT. I am fortuneate to have someone that I trust to write the whole truth to and to have found a somewhat lax but ever important spiritual connection. I have not even read his books. I suspect I have lived them and understand them in my own way. I am fortunate to have a very high IQ and can stand apart and look at my situation and analyze. For me the documentary encouraged that I can establish rituals of healing for myself. Having been through the painful process of revelation... I can now begin healing. I will certainly read his books soon. I am almost 50 years old and I have had doctors, therapists and on and on... not get to the core of what was going on with me. Luckily I avoided all drugs, except some anti-anxiety medication that I might need once or twice a year. So many doctors just do NOT get it and try to patch you up. Dr. Mate is not completely alone in his beliefs. He is a pioneer and it gives me great hope to see that someone relatively normal is onto the truth. I hope one day those addicts... those beautiful tortured souls... are not still forced to try and heal in the DTES but somwhere beautiful. I have had that blessing. A house in a forest by the sea... and privacy... As the french doctor said it is not so much the drug it is the ritual. Being freed from the tyranny of an extremely damaging and tormenting hidden memory is the beginning... and if a drug can help you do THAT I am all for it. Adding the ritual of healing and revelation... moving forward out of the hell.. so hopeful. I lived in Vancouver for 20 years. Seeing the addicts on the streets would just horrify and profoundly sadden me. I live on the other coast right now. I left to find healing and I am on my journey. I am glad Dr. Mate is making progress and opening care givers minds. The rest of my blog will be about my healing... rituals of healing.
Anonymous said…
I haven't read the book but am planning on doing so. I have, however, seen him on youtube discuss his addiction, so I know what you are referring to.

I was also sorta taken aback when he equated his CD addiction with substance abuse, but I then realized that I was making an unfair judgement. An addiction, after all, is an addiction. I think that the difference is in how easy it is to hide from a potential observer.

If a person is addicted to, let's say, purchasing CDs, this sort of addiction, while it may cause some financial problems (assuming it is a really out-of-control addiction), and possibly problems with space at home or wherever they're being stored, would be difficult for an onlooker to *see.* While that addiction might cause significant stress for the person experiencing it, they still look okay and act okay so to an onlooker, it doesn't seem like such a big deal. But maybe it is for that person.

On the other hand, addictions that involve intoxication are easilly seen by an observer no matter how hard the intoxicated individual (even in their intoxicated state) tries to hide it, or tries to 'act normal.'

People who have gambling addictions might have completely dismantled lives but a stranger probably couldn't see that just by looking at them. A hoarder might have to climb mountains of junk to get to a bathroom, but when they leave the house, no one would know that.

I think that his objective in relating his experience is to show that we are all subject to our chemistry. An addiction can be visible, invisible, accepted, tolerated and/or intolerable, but it's still an addiction. This attitude helps society come to common terms with addicts because the fact of the matter is that we all have the potential to experience that ourselves no matter how seemingly innocuous something might appear or not appear.
richard said…
"I haven't read the book, but": always an encouraging way to start a blog comment about a book review! But thanks for your thoughts.
Anonymous said…
Gabor Mate tells his truth. That's all I care about. He doesn't come across as having the need to impress in the manner of a head tripper meandering through abstractions while equating reading news reports and academic research papers about life in the lower east side with having actually been there for more than an hour or two and lived the experience in their gut as well as their egoistic fantasies.
Douglas E. said…
My reaction was that he spent a lot of time at the first part of the book with classic really down and out addicts. I was sort of put off that Mate might be saying that these people are representative of addiction. But like Richard said, the later parts of the book tie together the bigger issues of addiction and addictive society. I teach a class called Chemical Dependence and Oriental Medicine and have the book on the recommended list.
Anonymous said…
The reviewer's skepticism of the first part of the self-indulgent, intellectualised and weirdly self-centered bulk of the book is exactly correct. There is a reason the reviewer picked up on it. Because to any of us who have to do recovery to keep going, putting one's personality first - the way GM does in his book and in his careerism - rings false, stunted, showy... all the things we aim to grow out of and away from.

But GM is not in recovery. Because he doesn't have the addiction, which must be abstained from, and for which harm reduction is simply suicide (or murder) on installment plans.

Harm reduction doesn't work. Ask the addiction doctors who actually get people to LIVE instead of stay dead.

The story of the functioning opiate addict surgeon who practices til 120 years old on his daily regimen of dope is used as a rationalisation for keeping people on dope and methadone in this book. Think about how that relates to a hope to die junkie, not Mate's conscience or drive to power. The addict cannot stop and will not, until it is over. GM knows F all about that kind of powerlessness.

Has he ever been able to stop himself from injecting himself with opiates he's stealing from his workplace? Tried to kill himself with them? Not at all. Are there doctors out there who have? Yes. Do they buy into Mate's conflations, rationlisations and justifications? Not a bit.

Sometimes Gabor's flying on his amphetamines, sometimes he's not. Sometimes he's full of grandiosity and his ego's running, the show, sometimes it's not. Sometimes he's buying some extra CD's... and ALL the time he's not going down because of it. Seems like he's doing the best HE can with whatever motivations he has, to help the way he can, but not having a spiritual program that takes the ego out of the equation.

Seems like he's been to 2 meetings and bailed - because he doesn't have it bad.

His comparison of his little CD habit with the low bottom addict is all he can do.

He's all problem, and add to the problem. Very little solution from what I can see. Just keep sick people getting sicker, and give them a little dope along their way to the morgue, thank you very much... no hope for you!

He has no f'n clue how hard it is to get and stay clean. I don't trust this self appointed guru, neither do the better addictions MD's I know. If he was serene and grounded, maybe. But you never know when he's flying on speed. For fek's sake.
Anonymous said…
i am really late to the party, arent I? i am not even sure anyone will read hit, but either way, heres my two cents worth: i am a former drugaddicted, if i'd lived in canada, it would probably be in that same area as GM worked. that was until 7 years ago.

i read "in the realm of hungry ghosts" one year ago. and my reaction was quite similiar to the reviewers. the book is unorganized (well, GM does have ADD...), and some parts of it are not that easy to get throught. but ultimately totally worth it - esp if you have addiction issues.
richard said…
Welcome to the party, anonymous! Congrats on coming through your addiction to the other side: good on you.
Anonymous said…
Dear Richard,

I am an addictions counselor. Today a patient recommended the book and suggested I read it. I ame across this blog. The comments have given me some food for thought. I think I will take my patient's recommendation and read it. Thanks
richard said…
Thanks, my newest Anon: it's a really influential book, so yes, I'd also recommend that you read it.

But as the comments here indicate, there's a distinct mythology around the book and its author. (Not exactly a cult, as that's unfair to Maté, but it feels like that at times.) Anyone who doubts the book publicly is in for some critiques, and almost certainly some insults. I always read that phenomenon as a terrible sign for the book itself, entering the world of faith and enmity, rather than readership and response.
Anonymous said…
To all persons on this Blog.

We all have lop-sided perceptions on many areas in our lives. The main one here is that Dr Mate is somehow not qualified to address the subject matter. What a person has as material possesions does not make him/her larger than the person with less. But, he seems a humble man, with a real life childhood, that has created a "Valuë"in his life. That value is to help humanity in some manner.
And guess what - he gets paid.
And so do others that do work!!!
The universe gives more to those than can handle more. Let it be.
We are all addicts, some are high priority addictions and some are low priority addictions.
Throw the first stone!!!
With gratitude.
Ann Allen said…
Dr. Mate,
I work with many wonderful collegues in similar work, but few of them are medical porfessionals. I am a social worker serving people that are high utilizers of the emergency department in a close by city. I want to thank-you for re-invigorating our commitment to the work and the plea for compassion and harm reduction as being the most effective approach. I am looking forward to your visit to UW in the near future.
Sincerely,
Ann Allen
Ann Allen said…
Thank-you Dr. Mate,

I am a social worker in a nearby city and work with similar patients. My population are high utilizer of the emergency dpeartment, most are homeless and addicted, mentally ill and chronically ill. Your plea for compassion and harm reduction helps me to remain committed. I have always said, every person we serve has their own story. It is wonderful to see it put on paper. I wish I had your ability to relay stories. Thank-you for work and services to people in such great need.
I look forward to seeing at UW in the near future.
Ann Allen, LICW

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