Gabor Maté is the author of the bestselling books Scattered Minds and When the Body Says No. He is a former medical columnist with the Globe and Mail and has most recently worked as a physician with the Portland Hotel Society in Vancouver’s Downtown Eastside. He has recently released a new book, In the Realm of Hungry Ghosts: Close Encounters with Addiction. He spoke with Am Johal at Chambar in Vancouver.

Am Johal: Could you talk about how you came to write this book in particular with its specific themes around the psychology and sociology of addiction?

Gabor Maté: I had been doing my practice for twenty years, delivering babies to doing palliative care to looking after dying people. I was looking for a challenge. At that point the Portland Hotel Society showed up in my life. I wanted to work in the Downtown Eastside. I was drawn to the place. I had resonance to the people facing addictions. I didn’t see myself as very different, perhaps a bit more fortunate or luckier to be in my circumstances.

The Downtown Eastside is characterized by a high rate of HIV/AIDS, overdose deaths and dual diagnosis. It is a particularly traumatized environment, especially through the nineties with the drug trade and the cutbacks to social services in this decade. Itâe(TM)s an environment that calls for engaged medical work.

You use the Tibetan metaphor of the “hungry ghost” as the title for your book.

It refers to the aspect of human beings who are looking for some insatiable pain, to end the hunger. Really, fundamentally, the Buddhists believe people go through a phase where they look to the outside for fulfillment. We are still in the attachment mode, we are attached to something rather than our true selves. It is one of the six realms.

It’s not like the rest of us don’t go there at all. It’s only that my patients have more to escape from, more hunger to soothe, the more likely they are driven there through there own circumstances. It’s in me and in you and in everybody else.

One of the main themes in your book is that we are all capable of addictions, whether it’s power, money, fame or drugs âe” that we are suffering from a cultural malaise that is embedded in our current value system. What is it about this particular moment in time in civilization that we are all still capable of being such primitive and unaware beings?

There are three levels that are inter-related. We have lost any sense of community. Children are bereft of nurturing, healthy adult attachments. As a society, we do nothing to support positive and young parenting, and very little to prevent child abuse. Those who are most abused as children are the most addicted.

This misunderstanding of the first few years of life in child rearing is prevalent. Western ideas of not coddling your children are incorrect âe” children need love, attention and attachment. This inability to provide structures and atmosphere feeds emptiness, and therefore addiction. Physical, social dislocation and economic dislocation adds to that. Structures and connection are lost left and right. There is a loss of early attachments. There is a parallel stress and dislocation. The idea that you should let your child cry so they do not get too attached is totally incorrect.

There is the reality of the spiritual emptiness of our culture which values economic achievement above all else. We worship those who make money. There’s a tremendous discontentment âe” when you value economic achievements and not human values âe” and people need to soothe themselves.

The economic system is built on creating needs out of wants. People need affirmation from the outside world. There is the loss of spiritual connection. Values are not taught or nurtured, period. Any commonly held set of spiritual values are basically non-existent.

Many of your clients are aboriginal. Can you explain the complications of the urban inner-city environment in the context in which you see it as a doctor?

Thirty per cent of my clients are aboriginal Canadians. It’s because of this dislocation. Their family structures, self-esteem, the validity of their cultural life have all been eroded, brutally. It has happened to aboriginal cultures around the world. Same thing in Australia, Canada, Africa and other colonized places.

This would happen to anyone in the world if you took away these basic elements of culture and identity. We are still racist as a society.

You argue against the drug war in your book. Can you speak about harm reduction and other positions that you support?

The role of harm reduction is important and initiatives like Insite, the safe injection site, are important. It’s a popular project amongst the public. Poll after poll shows that the public supports it. Study after study shows that it works. Only as a society we don’t have the maturity level to deal with this at the public policy level.

We’ve never implemented the four pillar approach properly âe” we have one pillar of enforcement and three toothpicks for prevention, treatment and harm reduction.

The federal authorities have said we need more information about the supervised injections site, then they cut the research funding âe” they have not been very supportive despite the evidence.

The first thing you have to do is decriminalize drugs. There’s no possibility of changing things fundamentally until you do that. As long as you force people to hustle to get their drugs, you can’t do very much. That’s the first thing.

You can take all the money, put that towards rehabilitation with well-trained staff and you make it a long-term project. It’s not like you go to detox for a week and go away. That’s not even a Band-Aid. I’m less interested in the practicality of it. It would be complicated but not that difficult if it were done humanely.

How does your background, in terms of being Jewish in Hungary, inform your social activism?

Three factors. Being Jewish in World War II gave me a powerful sense of what injustices can occur in the world. My grandfather was gassed in Auschwitz. This idea that people create their own misfortune is bullshit. Innocent people are hurt all the time through no fault of their own.

Though the post-war communist system in Hungary was a travesty and a tyranny, the values they socially transmitted âe” not that they manifested within their system âe” were freedom, justice and social equality. That had an impact on shaping my world-view.

The crushing of the Hungarian revolution by the Russians made me appreciate the rights of the underdog. The tyrannies of the communist system in Hungary opened my eyes to oppression. The Western world is just as tyrannical but more subtly so, more cleverly so, whether in Vietnam or Iraq, Nicaragua or Palestine, or at home.

As a Jew and a former Zionist, it is galling to me what is going on in the Middle East. Supposedly, Jewish suffering is being redeemed while Palestinians are being oppressed. Oppression and hypocrisy are worth challenging âe” those are the values I grew up with due to my background and history.

Am Johal

Am Johal

Am Johal is an independent Vancouver writer whose work has appeared in Seven Oaks Magazine, ZNet, Georgia Straight, Electronic Intifada, Arena Magazine, Inter Press Service, Worldpress.org, rabble.ca...