In the Realm of Hungry Ghosts: Close Encounters with Addiction

by Gabor Maté MD, Peter A. Levine Ph.D. (Foreword by)

Overview

A groundbreaking look at addiction and recovery from the bestselling author of The Myth of Normal—the modern self-help classic that reframes everything you were taught about trauma and substance abuse

Addictions always originate in pain, whether felt openly or hidden in the unconscious.

In In the Realm of Hungry Ghosts, world-renowned physician and trauma expert Dr. Gabor Maté offers a frame-changing approach to understanding substance abuse and recovery—and challenges us to rethink everything we thought we knew about how addiction happens, who’s labeled an “addict,” and why our social systems and government structures fail to support real healing and wholeness.

This #1 international bestseller advocates for humane approaches to treatment and recovery and explores substance use disorder as an outcome of unhealed developmental trauma. Through case studies, cutting-edge neuropsychiatric research, and clear-eyed analysis, Maté reveals the root causes of addiction:

• Personal history
• Emotional development
• Brain chemistry
• Social conditions
• Structural factors
• The unhealed traumas we may not even realize we carry

He convincingly makes the case for solutions grounded in real, whole-person, whole-culture healing—not the punishment, stigma, isolation, and criminalization that actually lead to worse outcomes.

Since its original publication in 2010, this book has been essential reading for anyone seeking to understand addiction. It reframes substance use disorder as a response to suffering—not a “choice” or a moral failure. For readers struggling with substance abuse, for those looking to better understand their loved ones, and for anyone who wants to make sense of the twin epidemics of trauma and addiction, In the Realm of Hungry Ghosts offers a radical, authoritative path toward understanding, hope, and societal repair—and lights the way for true recovery.

Product Details

ISBN-13:	9781583944202
Publisher:	North Atlantic Books
Publication date:	06/28/2011
Sold by:	Penguin Random House Publisher Services
Format:	eBook
Pages:	520
File size:	13 MB
Note:	This product may take a few minutes to download.

About the Author

Gabor Maté, MD, is a physician, author, seminar leader, and acclaimed public speaker. His bestselling books include Scattered, When the Body Says No, and Hold onto Your Kids. In 2022, he also co-authored The Myth of Normal, the instant New York Times bestseller, with his son, Daniel Maté. A former medical columnist for The Vancouver Sun and The Globe and Mail, Dr. Gabor Maté lives in Vancouver, BC.
 
Peter A. Levine, PhD, holds doctorates in both medical biophysics and psychology. He developed Somatic Experiencing, a body-awareness approach to trauma treatment, and his bestselling book Waking the Tiger has been translated into 22 languages. His other works include In an Unspoken Voice, Healing Trauma, Trauma and Memory, and Trauma Through a Child’s Eyes. He lives in Encinitas, CA.

Read an Excerpt

No society can understand itself without looking at its shadow side. I believe there is one addiction process, whether it is manifested in the lethal substance dependencies of my Downtown Eastside patients; the frantic self_soothing of overeaters or shopaholics; the obsessions of gamblers, sexaholics and compulsive internet users; or the socially acceptable and even admired behaviours of the workaholic. Drug addicts are often dismissed and discounted as unworthy of empathy and respect. In telling their stories my intent is twofold: to help their voices to be heard and to shed light on the origins and nature of their ill_fated struggle to overcome suffering through substance abuse. They have much in common with the society that ostracizes them. If they seem to have chosen a path to nowhere, they still have much to teach the rest of us. In the dark mirror of their lives, we can trace outlines of our own.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 physiologically in the brains of addicted people?• How much choice does the addict really have?• Why is the "War on Drugs" 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 not dependent on powerful substances—that is, how do we approach the healing of the many behaviour addictions fostered by our culture?

Table of Contents

Author’s Note
Hungry Ghosts: The Realm of Addiction

PART I: HELLBOUND TRAIN
1.The Only Home He’s Ever Had
2.The Lethal Hold of Drugs
3.The Keys of Paradise
4.You Wouldn’t Believe My Life Story
5.Angela’s Grandfather
6.Pregnancy Journal
7.Beethoven’s Birth Room
8.There’s Got to Be Some Light

PART II: PHYSICIAN, HEAL THYSELF
9.Takes One to Know One
10.Twelve-Step Journal

PART III: A DIFFERENT STATE: THE ADDICTED BRAIN
11.What Is Addiction?
12.From Vietnam to “Rat Park”
13.A Different State of the Brain
14.Through a Needle, a Warm Soft Hug
15.Cocaine, Dopamine and Candy Bars
16.Like a Child Not Released

PART IV: HOW THE ADDICTED BRAIN DEVELOPS
17.Their Brains Never Had a Chance
18.Trauma, Stress and the Biology of Addiction
19.It’s Not in the Genes

PART V: THE ADDICTION PROCESS AND THE ADDICTIVE PERSONALITY
20.“A Void I’ll Do Anything to Avoid”
21.Too Much Time on External Things
22.Poor Substitutes For Love

PART VI: IMAGINING A HUMANE REALITY: BEYOND THE WAR ON DRUGS
23.Dislocation and the Social Roots of Addiction
24.Know Thine Enemy
25.A Failed War
26.Freedom of Choice and the Choice of Freedom
27.Imagining an Enlightened Social Policy on Drugs
28.A Necessary Small Step: Harm Reduction

PART VII: THE ECOLOGY OF HEALING
29.The Power of Compassionate Curiosity
30.The Internal Climate
31.The Four Steps, Plus One
32.Sobriety and the External Milieu
33.A Word to Families, Friends and Caregivers
34.There Is Nothing Lost

Memories and Miracles: An Epilogue
Postscript

Appendices

i:Adoption and Twin Study Fallacies ii:A Close Link: Attention Deficit Disorder and Addictions iii:The Prevention of Addiction iv:The Twelve Steps

Endnotes
Acknowledgments
Permissions
Index

What People are Saying About This

From the Publisher

"A harrowingly honest, compassionate, sometimes angry look at addiction and the people whose lives have been disordered by it."
—Ottawa Citizen

"Maté does a great service by forcing us to confront the us-and-them mentality that drives the get-tough responses to addiction.... I highly recommend Hungry Ghosts to everyone seeking insight into addiction."
—The Vancouver Sun

"Excellent.... One of the book's strengths is Maté's detailed and compassionate characterization of the afflicted addicts he treats, but this is not just a memoir. Rather, using his own experience as well as the most advanced recent research, he attempts to delineate the closely interrelated psychological, social, and neurological dimensions of addiction.... A calm, unjudging, compassionate attentiveness to what is happening within."
—The Walrus

Editorial Reviews

I recommend this wonderful book for anyone struggling with the heartache of addiction personally or professionally. Dr. Maté makes the thought-provoking and powerful arguments that human connections heal; and that the poverty of relationships in the modern world contribute to our vulnerability to unhealthy addictions of all manner. His uniquely humane perspective—all too absent from much of the ‘modern’ approach to addictions—should be a part of the training of all therapists, social workers, and physicians.”
—Bruce Perry, MD, PhD, co-author of The Boy Who Was Raised as a Dog

“A riveting account of human cravings, this book needs to get into as many hands as possible. Maté’s resonant, unflinching analysis of addiction today shatters the assumptions underlying our War on Drugs.”
—Norm Stamper, former Seattle Chief of Police and author of Breaking Rank

“In this brilliant and well-documented book, Gabor Maté locates the source of addictions in the trauma of an emotionally empty childhood, making it a relational rather than a medical problem. Such a radical thesis of cause leads to human connection rather than traditional treatment as the cure. This passionate and compassionate book, filled with scientific evidence and personal narratives, should be on the shelf of every person interested in the pervasive challenge of addiction.”
—Harville Hendrix, PhD, author of Getting the Love You Want and cofounder of Imago Relationship Therapy

“Dr. Maté’s latest book is a moving, debate-provoking, and multi-layered look at how addiction arises, the people afflicted with it and why he supports decriminalization of all drugs, including crystal meth.… [In the Realm of Hungry Ghosts] reads not only as a lively textbook analysis of the physiological and psychological causes of drug addiction, but also as an investigation into his heart and mind.”
—The Globe and Mail

“In this comprehensive and courageous book … Maté relates, with compassion and honesty, the poignant stories of severe substance addicts – the hungry ghosts, in Buddhist-realm terminology – whom he treats. And it is the addicts’ stories and the clear logic of the latest science and statistics that Maté shares which convince the reader that society’s attitudes toward, and treatment of, addiction must change. …. This 480-page tome, exhausting in delineating and substantiating its causes, remains a remarkably lyrical, engaging read.”
—In Recovery Magazine

“It’s time to give Maté … the Order of Canada for this erudite and sensitive book about the lives of Downtown Eastside intravenous-drug users, the neurobiology of addiction, and the folly of the war on drugs. It’s compulsively readable and packed with new scientific discoveries about addiction. If you know the parent or sibling of an addict—or the prime minister, for that matter—please give him this book.”
—The Georgia Straight

“Gabor Maté’s connections—between the intensely personal and the global, the spiritual and the medical, the psychological and the political—are bold, wise and deeply moral. He is a healer to be cherished and this exciting book arrives at just the right time.”
—Naomi Klein, author of No Logo and The Shock Doctrine

“With unparalleled sympathy for the human condition, Gabor Maté depicts the suffocation of the spirit by addictive urges, and holds up a dark mirror to our society. This is a powerful narrative of the realm of human nature where confused and conflicted emotions underlie our pretensions to rational thought.”
—Dr. Jaak Panksepp, Distinguished Research Professor of Psychobiology, Bowling Green University, Adjunct Professor of Psychiatry, Medical College of Ohio, and author of Affective Neuroscience

“With superb descriptive talents, Gabor Maté takes us into the lives of the emotionally destitute and addicted human beings who are his patients. In this highly readable and penetrating book, he gives us the disturbing truths about the nature of addiction and its roots in people’s early years–truths that are usually concealed by time and protected by shame, secrecy, and social taboo.”
—Vincent Felitti, MD, Clinical Professor of Medicine, University of California, and Co-Principal Investigator, Adverse Childhood Experiences Study

“Dr. Gabor Maté distills the suffering of injection-drug users into moving case histories and reveals how clearly he himself, as a music collector and workaholic physician, fits his own definition of addiction. Informed by the new research on brain chemistry, he proposes sensible drug laws to replace the War on Drugs. Inspired by the evolving spirituality that underlies his life and work, he outlines practical ways of overcoming addiction. This is not a fix-it book to hurry through, but a deep analysis to reflect upon.”
—Dr. Bruce Alexander, Professor Emeritus (Psychology), Simon Fraser University, and author of The Globalization of Addiction

“Maté’s subjects are the living, breathing embodiment of Canada’s grimmest statistics for HIV/AIDS, hepatitis, homelessness, crime, abuse, neglect, overdose, and death. More than merely poor and disenfranchised, they are truly the lowest of the low, reviled by society and demonized by law enforcement. [In the Realm of Hungry Ghosts] is enormously compelling and Maté is admirably, sometimes inexplicably, empathetic to all who cross his path.”
—Toronto Star

“[In the Realm of Hungry Ghosts] shows an unflinching look at addiction… Dr. Maté makes observations that cut through all the myths and misinterpretations about addicts and how they live… There are many nuggets of wisdom and insight throughout the book. Readers can literally pick up the book and leaf to any chapter and begin reading—and learn something valuable. It’s never boring, never condescending, never too much to read.”
—Addiction Treatment Magazine

“[Gabor Maté], a front-line professional combating addiction in Canada, questions the premise that addiction is a choice that people make. If people are diseased or predisposed or making a moral compromises through their own free will, then society is allowed to simplify a complicated issue and avoid any share of the responsibility. For instance, the thesis of this book criticizes the criminal justice’s unscientific assumption that drug addicts are culpable because they choose to do drugs. Does that make sense – people want to, choose to be addicted?”
—Addiction Magazine

From the Publisher