49 pages • 1 hour read
Gabor MatéIn the Realm of Hungry Ghosts
Nonfiction | Book | Adult | Published in 2008A modern alternative to SparkNotes and CliffsNotes, SuperSummary offers high-quality Study Guides with detailed chapter summaries and analysis of major themes, characters, and more.
Part 5 Chapter Summaries & Analyses
Part 5: “The Addiction Process and the Addictive Personality”
Part 5, Chapter 20 Summary: “A Void I’ll Do Anything to Avoid”
In the Brahmajala Sutta, the spiritual master Gautama—known to us as the Buddha—says that many pleasures are addictive. Any repeated behavior has the characteristic of addiction, if the addicted person cannot resist. Dr. Aviel Goodman considers all addictive disorders as sharing the same characteristics of what he calls “the addictive process” (224). Craving and shame are common factors in all forms of addiction. They commonly lead to deception, which can lead to guilt and self-loathing on the part of the addict who lies.
Maté examines pathological gambling as an example of this concept of pleasure as addiction. Studies suggest that chronic gamblers have low serotonin and high dopamine levels. The feeling of pleasure—largely due to the anticipation of winning—prior to gambling, activates the reward circuits of the brain, which are the same circuits playing a pivotal role in drug addiction.
Compulsive overeaters and shoppers experience the same fluctuations. Their dopamine levels rise and they find themselves propelled into the addictive behavior as the thinking parts of the brain go away.
While working on In the Realm of Hungry Ghosts, Maté asked his son Daniel for edits. After helping him, Daniel wrote him a letter. In the letter, he describes Maté’s CD addiction as confusing and pathetic, and states that that he did not understand it as a child. He thought his father was acting out of selfishness. However, Daniel later developed his own obsessions: blogging and self-improvement workshops. When he is addicted, he feels a pleasing level of drama, like the high of a honeymoon. He recognizes that his own obsessions are as bad for him as Maté’s have been for him. With a new, empathetic perspective on his father and his own compulsions, Daniel vows to be “vigilant, patient, and good-humored with it” (231).
Part 5, Chapter 21 Summary: “Too Much Time on External Things—The Addiction-Prone Personality”
Maté visits the William Head Institution to talk with bank robber, addict, and author Stephen Reid. In 1999, Reid committed the robbery that sent him to prison for 18 years. They discuss the concept of bottoming out: The relief of hitting rock bottom and knowing one cannot go any lower.
Maté is skeptical about the concept of the bottom, because everyone has a different low. He contrasts his addictive behaviors with those of his patients: theirs are destructive; his have rewarded him with a nice home and an impressive music collection. He, like them, has also abandoned his family and withheld his time.
Addiction can lead to self-hatred and is a form of self-betrayal. Stephen says that he focuses only on outside things, and never turns inward. He feels safer when he focuses on the external things he can control, not the inner emotions that threaten to overwhelm him.
Maté is unsure of whether there is such a thing as an addiction-prone personality. Self-regulation is a key to avoiding addiction, and it is an ability acquired in childhood. If circumstances deprive a child of the ability to self-regulate emotions, that child will be more prone to addiction, and will have increased chances of poor impulse control.
Maté sees one of the basic questions of addiction as how to grow more mature when one’s early environment disrupted or destroyed the chance for normal development.
Part 5, Chapter 22 Summary: “Poor Substitutes for Love—Behavioral Addictions and Their Origins”
There are more possibilities for behavioral addictions than for drugs. Maté wonders why compulsive CD shopping drives him in the same way that blogging drove his son, and wonders if there may be genetic sensitivities to music.
For the first 15 months of Maté’s life, his father was in a Nazi labor camp. German soldiers killed his grandparents at Auschwitz when he was five months old. His mother left him alone in his crib often during the war. A doctor told her, when Maté would not stop crying: “All my Jewish babies are crying” (241).
Music always makes Maté feel as if he is self-sufficient: He does not need anything, or anyone. His trips to Sikora’s provide instant stress relief that he believes may be a result of the uncontrollable, war-related stress he lived through as a child.
His sense of personal value has come from work. Medicine helps him feel that he is useful and indispensable. But work also gives him a sense of control that he lacked in childhood. When he works, he has tangible results proving that his efforts matter.
Eating disorders come from a similar place. Maté believes that the obesity epidemic is born from a passivity stemming from isolation and a feeling of powerlessness.
Reid is confused by Maté’s story of his childhood. Reid doesn’t understand how Maté is free, and why he is in jail, since Reid did not have such a traumatic childhood. But after his first 15 months, Maté grew up in a stable home. Reid, however, suffered from sexual abuse as a child and received drugs as a preadolescent.
Maté’s son, Daniel, admits that he never doubted his father’s love, but he wanted love in a more simple, straightforward way than he received it. Maté’s workaholism made him an inconsistent, if loving, parent. The child’s perception of being “gotten” (252) is critical, and was missing during early stages of Daniel’s development. He wonders if it might have led to his obsession with blogging and self-improvement, both things that were under his control.
Part 5 Analysis
Much of Part 5 focuses on the idea that addiction is a process, and it is possible to break processes down into observable, evaluated steps, and hopefully, changed in ways that strengthen the addict. Maté begins Chapter 20 by quoting the Buddha, because Buddhism is associated with a sophisticated process of engendering self-understanding.
If, as the Buddha suggests, everything pleasurable is potentially addictive, then how should one live? Avoiding pleasure at all costs to avoid its addictive properties is not the prescription. Maté believes that the key is to acknowledge and observe the states of mind that allow cravings to arise. A craving that comes to dominate a person’s thoughts ultimately results in action. He believes that “All addictions, substance related or not, share states of mind such as craving and shame and behaviors and such as deception, manipulation, and relapse” (224).
When Maté describes his CD buying addiction, his addictive process is always the same. He finds himself swept up by an urge that he is barely aware of until he is already in Sikora’s, buying music. This is “a fact that further buttresses the unitary theory that there’s a common addiction process” (227). Quitting one addictive behavior doesn’t guarantee that another doesn’t arise to take its place. An addict that ceases a behavior experiences withdrawals, but another addictive behavior can assuage the addictive pull, because any compulsive activity that produces a burst of dopamine will suffice. When Maté interviews the bank robber Stephen Reid, Reid says, “I’m working on sifting through the extremes in my life” (228). The forms the extremes take do not matter to the addict as much as the fact that they exist and that they can be satisfied.
Maté’s anecdote about his son Daniel echoes his earlier statements in Part 4 that addictions and compulsive tendencies are heritable. In his letter to Maté he calls his CD buying addiction—viewed as a 14 year old—as “a pet alibi for being so erratic and absentminded” (229). But then Daniel finds himself addicted to blogging and self-improvement workshops. Daniel’s addictions also began as something pleasurable that gave the form of control, before the urges dominated his life and his psyche. His addictions “became his life in a way that didn’t work” (230).
Daniel is only able to make progress on his addictions—and to see Maté’s addictions with empathy—once he acknowledges them as addictions. This follows the Buddha’s ideas about the relinquishment of cravings being the beginning of peace, and Maté’s coming ideas about self-awareness, self-scrutiny, and a commitment to truth speaking.
In Chapter 22, Maté attempts to link his addictions to his past. Even though he believes that stress is the common factor shared by all addicts, the forms the addictions take vary wildly. He quotes Dr. Aviel Goodman as saying that the specificity of an addiction “has a lot to do with which experience brings relief from whatever pains us” (240). Maté wonders if his parents left him alone in his crib alone for significant periods during the terror of World War II, and if the soothing nature of music is now a substitute for that possible lack of attachment. He writes that, “Music gives me a sense of self-sufficiency and nourishment. I don’t need anyone or anything. I bathe in it as an amniotic fluid; it surrounds and protects me” (242). The sentiment is eloquent, but not necessarily proof linking his need for music to the tumult of his infancy.
Maté‘s description of addiction as a process prepares the reader for the next step in his observations and arguments: how society and governmental policy help perpetuate the addiction process.
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