49 pages • 1 hour read
Gabor MatéIn the Realm of Hungry Ghosts
Nonfiction | Book | Adult | Published in 2008A modern alternative to SparkNotes and CliffsNotes, SuperSummary offers high-quality Study Guides with detailed chapter summaries and analysis of major themes, characters, and more.
Themes
The Addict as Outsider
The work of the PHS appears innovative to its supporters and naïve to its detractors. Part of Maté’s project is to encourage the view that addicts are often a product of childhood trauma. Next, their status of “addicts” becomes more pronounced as society views them with fear, contempt, or both, pushing them to the fringes in the process.
The circumstances that lead to a heightened susceptibility to addiction are already outliers, relative to the non-addicted populace. Addicts are already outsiders in the sense that their pasts do not typically mirror those of the non-addicted. The pain caused by societal ostracism is yet another source of misery to numb with substances.
Society pays lip service to the idea that addicts are people who have made bad choices, and who need help. However, society places addicts viewed as dangerous, subhuman criminals outside the margins of proper society despite claiming an interest in helping them. Even Maté admits that sometimes he feels contempt for his clients.
Self-Awareness
Maté uses his own compulsions and obsessive thought loops to examine parallels between him and the substance addicts he treats. His self-scrutiny teaches him the value of self-awareness for those who struggle with addiction. Drugs fill what the title of Chapter 20, “A Void I’ll Do Anything to Avoid,” speaks to. But the chapter title shows a level of self-awareness that Maté believes many addicts lack.
Throughout the book, Maté’s anecdotes about himself and his patients reinforce the idea that addicts tend to blame others for their problems. They are often unaware that the circumstances of their childhoods might have caused the pain that they are trying to avoid. Until the final third of the book, Maté is prone to hide his spending sprees from his wife. He has the awareness to feel shame over his deceptions, but does not connect his compulsive urges to his experiences in World War II until he is decades into his life.
The practice of compassion—both for the self and others—is a function of how well people understand themselves. Self-scrutiny, despite its discomforts, is a requisite for self-awareness. Those who suffer from addictions and obsessive behaviors must study them. These are the people who may be least inclined to study their own minds, however, given that they wish to avoid their thoughts by using substances.
Passion versus Addiction
Maté calls himself a workaholic, or someone who is literally addicted to the stimulus and distraction of working. This results in the authorship of his books, long hours at the office, a crowded public speaking itinerary, and substantial acclaim. But he is self-aware enough to learn that, even though he has a passion for the work, his need to work stems from a compulsion to fill the void caused by sitting with his own thoughts.
He writes that:
Addiction is centrifugal. It sucks energy from you, creating a vacuum of inertia. A passion energizes you and enriches your relationships. It empowers you and gives strength to others. Passion creates; addiction consumes—first the self and then the others within its orbit (117).
But rather than enriching his relationship, Maté’s addiction to work places distance between him, his wife, and his son. Instead of feeling empowered by what could be his admirable work ethic, he weakens himself (in his own estimation) each time he gives in to the urge to work because his compulsions have defeated him again.
Harm Reduction
Maté admits that rehabilitation can’t help every addict. For the most difficult cases of addiction, in which recovery is the least likely outcome, he believes that hard reduction should be the priority. This is part of the philosophy that underlies the work undertaken at PHS. PHA does not judge or coax addicts into treatment. Instead, physicians present options on a continuum ranging from rehab options to harm reduction.
Despite the benefits Maté sees in this approach, critics of harm reduction argue that it is a form of giving up on people, or enabling their continued addictions instead of pursuing more stringent measures of legal or medical treatment.
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