Gabor Maté

The distressing internal state is not examined: thefocus is entirely on the outside: What can Ireceive from the world thatwill make me feel okay, if only for a moment? Bare attention can showher that these moods and feelings have only the meaning and powerthat she gives them. Eventually she will realize that there is nothing torun away from. Situations might need to be changed, but there is nointernal hell that one must escape by dulling or stimulating the mind.

The hardcore drug addicts that I treat, are, without exception, people who have had extraordinarily difficult lives. The commonality is childhood abuse. These people all enter life under extremely adverse circumstances. Not only did they not get what they need for healthy development; they actually got negative circumstances of neglect. I don__ have a single female patient in the Downtown Eastside of Vancouver who wasn__ sexually abused, for example, as were many of the men, or abused, neglected and abandoned serially, over and over again. That__ what sets up the brain biology of addiction. In other words, the addiction is related both psychologically, in terms of emotional pain relief, and neurobiological development to early adversity.

Narrow behaviourist thinkingpermeates political and social policy and medical practice, thechildrearing advice dispensed by __arenting experts_ and academicdiscourse. We keep trying to change people__ behaviours without a fullunderstanding of how and why those behaviours arise. __nner causesare not the proper domain of psychology,_ writes Roy Wise, an experton the psychology of addiction, and a prominent investigator in theNational Institute on Drug Abuse in the U.S.A.3 This statement seemsastonishing, coming from a psychologist. In reality, there can be nounderstanding of human beings, let alone of addicted human beings,without looking at __nner causes,_ tricky as those causes can be to pindown at times. Behaviours, especially compulsive behaviours, areoften the active representations of emotional states and of specialkinds of brain functioning.As we have seen, the dominant emotional states and the brainpatterns of human beings are shaped by their early environment.Throughout their lifetimes, they are in dynamic interaction with varioussocial and emotional milieus. If we are to help addicts, we must striveto change not them but their environments. These are the only thingswe can change. Transformation of the addict must come from withinand the best we can do is to encourage it. Fortunately, there is muchthat we can do.

Not all addictions are rooted in abuse or trauma, but I do believe they can all be traced to painful experience. A hurt is at the centre of all addictive behaviours. It is present in the gambler, the Internet addict, the compulsive shopper and the workaholic. The wound may not be as deep and the ache not as excruciating, and it may even be entirely hidden__ut it__ there. As we__l see, the effects of early stress or adverse experiences directly shape both the psychology and the neurobiology of addiction in the brain.

Adults envy the open-hearted and open-minded explorations of children; seeing their joy and curiosity, we pine for our own capacity for wide-eyed wonder.

The attempt to escape from pain, is what creates more pain.

It is impossible to understand addiction without asking what relief the addict finds, or hopes to find, in the drug or the addictive behaviour.

Passion creates, addiction consumes.

The War on Drugs, from the Hastings-facing window of the PortlandHotel, is manifested in the pregnant Celia kneeling on the sidewalk,handcuffed wrists behind her back, eyes cast on the ground. Therewas no Detective-Sergeant Gillespie to protect her when, as a littlegirl, she was raped by her stepfather and subjected to the nocturnalspitting ritual, so in the War on Drugs she has become one of theenemy.

Addiction is pretty simple. It's what happens when peolme don't get what they need, and end up soothing themselves.

What we call the personality is often a jumble of genuine traits and adopted coping styles that do not reflect our true self at all but the loss of it.

As children become increasingly less connected to adults, they rely more and more on each other; the whole natural order of things change. In the natural order of all mammalian cultures, animals or humans, the young stay under the wings of adults until they themselves reach adulthood. Immature creatures were never meant to bring one another to maturity. They were never meant to look to one another for primary nurturing, modelling, cue giving or mentoring. They are not equipped to give one another a sense of direction or values. As a result of today`s shift to this peer orientation, we are seeing the increasing immaturity, alienation, violence and precocious sexualization of North American Youth. The disruption of family life, rapid economic and social changes to human culture and relationships, and the erosion of stable communities are at the core of this shift.