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A wide-ranging interview with Jamie Kilstein and Allison Kilkenny; Citizen Radio (Breakthru Radio Network, U.S.A.):

  • Part One: “the War on Drugs” and politics; drugs of abuse as painkillers; society, disconnection, and addiction; harm reduction and the Supervised Injection Site; stress and disease; environmental roots of ADD and other childhood issues.
  • Part Two: America’s overmedication; sympathy for Rush Limbaugh; Stephen Harper’s dead eyes; healthy anger and immunity; advice for addicts; what attracted Dr. Maté to addiction work?



In The Realm of Hungry Ghosts: Close Encounters With Addiction, explores addiction as a symptom of distress, from the pain of individual trauma and family history to the spiritual emptiness pervading our entire society. Dr. Maté weaves brain science, case studies, personal testimony, and social critique into a powerful and kaleidoscopic look at one of our culture’s most perplexing epidemics. In the Realm of Hungry Ghosts won the 2010 Hubert Evans Award for Best BC Non-Fiction Book.


Q. Are you saying that everyone who ends up addicted was traumatized or abused in childhood?
A. No, I’m not;  I am saying that all addictions come from emotional loss, and exist to soothe the pain resulting from that loss.  Trauma and abuse, as we define them, are certainly surefire sources of loss but they’re far from the only ones.  The human infant and toddler is a highly vulnerable creature, and emotional stresses of all kinds in the rearing environment can create long-lasting wounds in the psyche that a person will later try to soothe or numb with addictive behaviour.  In addition to things that do happen that shouldn’t happen, like abuse, there are things that (developmentally speaking) ought to happen that don’t.  For instance, any sustained sense of emotional disconnection with the parenting figure – which can often happen when the parent is excessively stressed or preoccupied over a period of time – has the capacity to have this sort of impact, especially if the child is constitutionally very sensitive.  In a stressed society like ours, with fewer and fewer supportive resources for parents, this is more and more common.

So many of us, whether or not we were acutely traumatized or faced extreme adversity as kids, have these sorts of lingering challenges to contend with.  We can and should be grateful things weren’t worse, but we shouldn’t discount or minimize the pain we carry from childhood even if it didn’t result from severe neglect or abuse.

Q. Are you saying that your own addiction to shopping for classical music is as bad as someone else’s heroin or cocaine addiction?
A. First of all, I wouldn’t put it in terms of “good” and “bad”, which can have the sort of moral connotations I consider unhelpful in talking about addiction.  I do write in the book that my addiction “wears dainty white gloves” compared with the problems my patients are living with.  That is, clearly a habit like mine is likely to have far milder consequences for my physical health, relationships, and social status than someone else’s dependence on crack, for instance.  I wouldn’t want to trade places with any of the people I’ve treated in the Downtown Eastside – the lives they’ve led have been far harsher and more unkind than mine, and they’ve had far fewer options available to them, by and large.

I do, however, place my addiction on the same continuum as theirs, and that’s important because I firmly believe – and the scientific research supports this – that there’s really only one addiction process.  Addictions are separated from each other only by degrees of severity, which are obviously tied to socioeconomic factors and personal history.  And any addiction has the capacity to fester and grow into a dynamic that can wreak havoc in someone’s life, to their self-esteem, their relationships, and so on.  The fact that some addictions are frowned upon and criminalized in our society (e.g. hard drugs), while others are more or less tolerated (e.g. alcoholism, tobacco smoking), and still others are encouraged or rewarded (e.g. workaholism, the quest for power or wealth) – that’s a rather arbitrary set of standards that has more to do with our culture’s self-delusions than with the truth of addiction per se.

So while the differences between me and my patients are obvious, I’ve chosen to focus on the similarities – the obsessive preoccupation, the negative impacts, the relapses, the rationalizing, the feeling of nagging emptiness at the core of the addict’s experience of life – in order to make this point about the addiction process, to which none of us can claim to be immune.

Q. Are there any “good” addictions?
A. Again, I’d rather not speak in terms of “good” or “bad”, but if by “good” you mean positive, healthy, nourishing, then I’d say that if it’s good, it’s probably a passion and not an addiction.  Passions can be very consuming of time and energy, but they also feed your soul, your sense of being alive, your feeling of wholeness as a person.  Addictions provide fleeting pleasure or gratification, but never leave you satisfied.  And the same activity could be a passion for one person and an addiction for another.  One might be a wine enthusiast, enjoying the refined pleasures the drink has to offer, while another person’s “love” for wine masks a fear of his own mind in its sober state.

To take a non-substance example, someone who’s passionate about social activism might work tirelessly for a cause, while her colleague may have a workaholic relationship with the same activity.  It all depends on the energy with which one pursues the activity, and what happens when the activity comes to an end.  There may be a letdown after a big event, but does the person feel a sense of basic worth in the absence of the adrenaline and the long hours?  Does she find comfort in the other parts of her life?  Or is she left irritable, restless, and less at ease with the people in her life?

The activity or feeling to which one is addicted may be in itself considered postive or laudable, but the energy of addiction always turns a “good” thing into a harmful one.  In the end it’s not about the object of addiction, but about the relationship one has to it.

Q. What about spirituality and addictions?  Do I need to believe in a “higher power” to get better?
A. When I speak about spirituality, I don’t mean any particular belief system so much as an awareness that one’s mind and personality, through which one has come to view and process the world, are conditioned and constrained by experience – and that there’s more to who you are than that.  Connecting with a “higher power” may just mean connecting with your own sense of being, that awareness that’s more expansive and universal than your habitual stream of thoughts, feelings, memories, and associations that have so far “defined” you as this or that.  You don’t have to “believe” anything to make that connection – you may only need to give up the belief that you’re all alone, you know yourself already, there’s no hope, etc.

If spiritual belief discomfits you, then don’t believe; instead, open yourself to the possibility that you could experience yourself and your life in a different, healthier way – that however difficult it’s been so far, “it ain’t necessarily so,” as the song goes.  But it’s also very helpful and healing if you can come to understand that you are not alone, that there is something greater within and without to connect with than your usual everyday mind, whether you see that as nature, or compassionate humanity, or a “higher power”.

It’s also worth remembering that even spiritual work can become addictive, particularly if one becomes attached to the religious practices or institutions it’s housed in, or the belief systems associated with them.  Anything that the ego can latch onto and say “Aha, now I’ve found the answer!” is likely to feed addictive tendencies, even if the expressed purpose is to move away from those tendencies.  Remember the ancient spiritual wisdom that “a finger pointing at the moon is not the moon itself” – focus on your own journey, your own experience, and not on the particular method or system you’ve chosen to help you on your way.

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