Photo: Getty Images: Drug users at Canada's Insite injection room in Vancouver's Downtown Eastside.Using punishment to try to rehabilitate people who have already suffered years of punishment doesn't work
By Maia Szalavitz
Dr. Gabor Mate is renowned in Canada for his work in treating people with the worst addictions, most notably at Vancouver's controversial Insite facility, which provides users with clean needles, medical support and a safe space to inject drugs.
Canada's Conservative government has tried to shut Insite down, but the country's Supreme Court ruled late last year that doing so would contravene human rights laws because the program has been shown to save lives.
In Mate's book In the Realm of Hungry Ghosts: Close Encounters with Addiction, which was a No. 1 bestseller in Canada, he advocates for the compassionate treatment of addiction, a position that is increasingly receiving international attention. Healthland recently spoke with Mate about the causes and consequences of addiction and what to do about the problem.
How do you define addiction?
Any behavior that is associated with craving and temporary relief, and with long-term negative consequences, that a person is not able to give up. Note that I said nothing about substances -- it's any behavior that has temporary relief and negative consequences and loss of control.
When you look at process or behavior -- sex, gambling, shopping or work or substances -- they engage the same brain circuitry, the same reward system, the same psychological dynamic and the same spiritual emptiness. People go from one to the other. The issue for me is not whether you're using something or not; it's, Are you craving, are you needing it for relief and does it have negative consequences?
Do you believe all addiction results from trauma?
I think childhood trauma or emotional loss is the universal template for addiction. It also depends on how you want to define trauma: if you want to define it as something bad happening, then it's true that not every addict [has experienced trauma], in the sense of a death of a parent or violence in the family or child abuse, or any of the usual markers of trauma.
But there's another [way to define it]. D.W. Winnicott [the late British child psychiatrist] said that there are two things that can go wrong in childhood: things that happen that shouldn't happen -- that's trauma -- and things that should happen that don't happen. Children are equally hurt by things that should happen and don't as they are by things that shouldn't happen but do. If the parents aren't emotionally available, [for example], no one will define that as trauma, but it will be for the child. If a mother has postpartum depression, that's not defined as trauma but it can lead to emotional neglect and that interferes with child brain development.
Continue Reading: time.com
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