In the Realm of Hungry Ghosts: Close Encounters with Addiction

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Knopf Canada, Apr 3, 2009 - Psychology - 480 pages
In this timely and profoundly original new book, bestselling writer and physician Gabor Maté looks at the epidemic of addictions in our society, tells us why we are so prone to them and what is needed to liberate ourselves from their hold on our emotions and behaviours.

For over seven years Gabor Maté has been the staff physician at the Portland Hotel, a residence and harm reduction facility in Vancouver’s Downtown Eastside. His patients are challenged by life-threatening drug addictions, mental illness, Hepatitis C or HIV and, in many cases, all four. But if Dr. Maté’s patients are at the far end of the spectrum, there are many others among us who are also struggling with addictions. Drugs, alcohol, tobacco, work, food, sex, gambling and excessive inappropriate spending: what is amiss with our lives that we seek such self-destructive ways to comfort ourselves? And why is it so difficult to stop these habits, even as they threaten our health, jeopardize our relationships and corrode our lives?

Beginning with a dramatically close view of his drug addicted patients, Dr. Maté looks at his own history of compulsive behaviour. He weaves the stories of real people who have struggled with addiction with the latest research on addiction and the brain. Providing a bold synthesis of clinical experience, insight and cutting edge scientific findings, Dr. Maté sheds light on this most puzzling of human frailties. He proposes a compassionate approach to helping drug addicts and, for the many behaviour addicts among us, to addressing the void addiction is meant to fill.

I believe there is one addiction process, whether it manifests 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 in 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 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 use. Both in their flaws and their virtues they share much in common with the society that ostracizes them. If they 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.
from In the Realm of Hungry Ghosts
 

Contents

Authors Note
1
The Only Home Hes Ever
7
The Lethal Hold of Drugs
25
The Keys of Paradise
33
You Wouldnt Believe My Life Story
47
Angelas Grandfather
56
Beethovens Birth Room
73
Theres Got to Be Some Light
85
Poor Substitutes for Love
229
IMAGINING A HUMANE REALITY
249
o Know Thine Enemy
267
A Failed War
273
Freedom of Choice and the Choice of Freedom
284
2 Imagining an Enlightened Social Policy on Drugs
295
Harm Reduction
312
The Power of Compassionate Curiosity
329

Takes One to Know One
101
io TwelveStep Journal il 6
116
What Is Addiction?
127
A Different State of the Brain
140
Through a Needle a Warm Soft Hug
148
Cocaine Dopamine and Candy Bars
158
Like a Child Not Released
165
HOW THE ADDICTED BRAIN DEVELOPS
177
Trauma Stress and the Biology of Addiction
188
Its Not in the Genes
201
THE ADDICTION PROCESS
211
Too Much Time on External Things
222
The Internal Climate
340
The Four Steps Plus One
353
Sobriety and the External Milieu
363
A Word to Families Friends and Caregivers
377
There Is Nothing Lost
387
An Epilogue
399
Postscript
407
Attention Deficit Disorder
415
The Twelve Steps
423
Endnotes
449
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About the author (2009)

Gabor Maté, M.D. is the author of the bestselling books Scattered Minds and When the Body Says No–published in ten languages on five continents–and co-author, with Gordon Neufeld, of Hold On To Your Kids. Former medical columnist for the Globe and Mail, where his byline continues to be seen on issues of health and parenting, Dr. Maté has had a family practice, worked as a palliative care physician and, most recently, with the addicted men and women in the Downtown Eastside of Vancouver.

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