Dr. Gabor Mate: Addiction

and joining us now dr. Gabor maté a he is the author of most recently in the realm of hungry ghosts close encounters with addiction it's nice to have you back at Evo pleasure but on this channel a lot I guess people are very interested in both you and this topic not surprising you're a physician who treats patients who have serious addictions to some of the most illicit drugs going so you're a good person to ask this first question of what's the cause of addiction you know in medicine it's a mistake to try and ascribe the things just to one cause but if there's one single major cause dominant cause then the major cause of severe substance addiction is always childhood trauma childhood trauma yeah not just according to my experience and my experience is that I don't have anybody in a downtown east side of Vancouver where work who wasn't abused as a child not even by accident and all the women were sexually abused specifically but also going to all the research that the more adverse childhood experience as a person has the exponentially greater the likelihood of substance abuse later on so those who say it's all hereditary you say what that's nonsense nonsense yeah yeah genes may have some predisposing role but predispositions are not the same as P determinations I mean know know that genes are actually turned on and off by the environment there was a study a couple of weeks ago that came out that showed that even people who have a predisposition to addiction genetically that gene is turned off if they received good nurturing parenting but we hear all the time if your dad was an alcoholic chances are you will be too sure under what conditions do you go up if your parents if your father was an alcoholic in other words how is that trait passed on is it passed on genetically was it passed on through the fact that you had stressful early experiences and even if you were adopted you still had stressful experiences because your mother was stressed for nine months and we already know that stress on the on the partying woman on the pregnant woman has an impact on the child development and on the chart stress levels and then of course there's a separation from the birth mother so whether you look at the doctor studies or straight family linear histories just because of parent is addicted and the child becomes an addict as well shed says nothing about genetic causation okay but it must go beyond childhood trauma as well if even if you a blessed childhood but you've had some extraordinary thing happen to you as an adult you can get addicted as well can you not highly unlikely what we know about the human brain now is that it's actually shaped by the early environment that the physiology and the chemistry of the brain is in fact physiologically under the influence of the early environment so that those circuits are either set up or not set up fairly early in life nobody with a blessed childhood becomes an addict some people think that have less a childhood but that's only because they haven't looked at what that she didn't work in their childhood some people have terrible life experiences and they do not become addicted to drugs other people do overcome their addictions despite the fact they have terrible childhoods so where does willpower factor into all of this willpower is a difficult question to discern because if you actually look at the circuits on the brain that make conscious decisions they're very weak and they're much dominated by our impulses which come from deeper brain centers and the gap between an impulse and a decision is only a split second so when you actually look at people who had a lot of negative experiences but they didn't have become addicts first of all addiction is not the only outcome a lot of people compensate for terrible experiences by becoming code really good people and they end up making themselves ill because they repress so much and I read in the book about that as well other people may have had terrible experiences but they may have had an opportunity to process it maybe there was a sympathetic witness in their lives with whom they could share and at least emotionally resolve the trauma then they don't need to become addicts but the people overwhelming will become severe substance users or people that were traumatized early and had nobody there to help them process the experience what percentage of your patients would you guess overcome their addictions or my patients in a downtown incident in Vancouver yes yeah if I if I could say 5% I D hailed as an international genius it'd be less than that less than 5% oh yeah and that's just not that's not only my statistics that's Jenny - across the board however the question is why not what keeps them and that's we had to come into our society how it twists the addict hard to use the addict punishes the addict in the context of we have right now social exclusion authorization and this war on drugs all we're doing is entrenching tens of thousands of people and heavy addictive behaviors in other words we don't have the context to heal or to redeem people we just don't have it they say in baseball if you're a hitter and you fail seven times out of ten you're a star because you're still getting three hits out of ten mm so are you saying that you're not having success with more than 95% of your patients but you're still doing really well by the yardstick of your profession is that right I'm not saying I'm doing really well I'm saying I'm doing what I'm doing under the present situation the way it's set up with this war on drugs and incidentally there is no war on drugs you can't war on inanimate objects but there is a war on drug addicts when there's a war on drug addicts it's very difficult to save anybody what I do is I treat people's illnesses I reduce the harm of their addictions and of the social attitude towards addiction if I wanted to redeem and cure a lot more people I'd need a lot more behind me I need to be a politician Holmes I need this insane and counterproductive board to come to an end I need resources now that are not put into into jail facilities and police work to go into treatment we need a lot more in other words we could do a lot more so in a present context our failure rate is high if by failure we define that people give up their addictions there must be a broad spectrum though of obsession or of compulsion however you want to describe this every time you buy one end I guess it's you pick up your blackberry too often at the other end your mainlining heroin you know five times a day or whatever all right given that broad spectrum are you an addict of something well that's the whole point in our society is based on addictive behaviors and I define as an addictive behavior as a compulsive repetition of behaviors that gives you temporary pleasure and relief in a long-term create problems and negative consequences you still persist in still relapse no by that definition yes I've had addictive behaviors to work with negative constant on my family on the on the bringing my children on there under emotional health I have a negative attachment to purchasing classic compact music I spend a lot of money ignore my family and and lie you went out one weekend in blue eight grand on CDs right the truth is out I did yeah and I wasn't a conscious choice in other words not that I woke up Monday morning and I said hey what should I spend this eight thousand dollars on it's more like I just had to keep going back and going back thirty percent of Canadians know they find themselves workaholics between ages of 19 and sixty-five according to STATS can and that means they're listless and irritable and and not at work their mind is on the work they're not with their families there are kinds of negative consequences but that's how they soothe their sense of emptiness and dissatisfaction some of the most creative wonderfulness though comes out of addictive behavior would you not agree with that no you don't agree I think there's a difference within passion and addiction you can be passionate about something devoted to it but be conscious and be aware and be mindful and be in charge of it any addiction is the addiction that's in charge you are driven you're not in charge you're not in the driver's seat that always has negative consequences now it may be that some good stuff comes out of that but the negative always always to that the good do you discuss your own compulsive behavior or addiction whatever you want to call it with your patients I do they know about it oh yeah sure they know about in fact they laugh and they shake their heads and they say oh yeah I get it you normally they totally get it it is you know it's qualitatively it's the same thing quantitatively it's not they're far worse but they've suffered a lot more than I ever have so they need for soothing is much greater and and I've also had few advantages in terms of education and stable upbringing than I've had but do you ever get them saying you know given your own troubles with addiction who are you to tell us or give us advice with I don't how to live our lives no on the contrary what they say is it's nice to talk to somebody about she gets it gone and doesn't see himself as someone superior okay you work as you've told us in Vancouver's Downtown Eastside which some people have described as kind of the poorest postal code in the whole country yeah and here's how you describe it in your book let's do an excerpt here not that we lack real infestation in the Downtown Eastside rodents thrive between hotel walls and in the garbage strewn back alleys vermin populate many of my patients beds clothes and bodies bedbugs lice scabies cockroaches occasionally drop out from shakin shirts and pant legs in my office and scurry for cover under my desk now this neighborhood can't always have been like that how did it turn into that well you know actually I find out today that the filmmaker Alan King did a film on the Skid Row area of and Hoover in 1957 so it's been like that for a long time what you have in Vancouver is proponents is relatively cheap housing and the unreasonable climate and so Vancouver has become the receptacle really of the dysfunction as generated across the country but because of climate and because of the the cheap housing available in that part of the world we have this heavy concentration of addicted people and of course then services come in to support these people because they have to be supported they have to be served you have to feed people look after them and then given a lack of services elsewhere in the country in fact the negative and and ostracizing attitudes that people experience elsewhere where also they congregate except with others of their own kind where they have a kind of community which falls disfunction at least gives them a sense of belonging and to some degree security you are trying to provide a service for some of the most unfortunate people in society but my hunch is the people in the rest of Vancouver are not that enamored with having this community in its midst how does that manifest itself in your life well people don't like it for to be honest some people just on a human level believe that we ought to do better than to ghettoize people like the way we have in my career Downtown Eastside some people don't like it cuz it looks bad for example the next two Olympic city takes the glow the glitter off our sense of Vancouver being is a great place to live and so they want to make changes for that reason although these mothers and fathers say they're they're planning to do something about this part of the city now because Olympics are coming yeah it's not nice is it well it's nice that they want to do something I don't care why people want to do it as long as they actually provide some decent services and housing on the other hand for decades now they've been starving the area of housing support so that you know are we doing it to look good are we doing it because what you mean and that's the question we have to ask yourself do you care what the what the reason is as long as it gets done I do care because the if you do it because we're committed to being humane that's gonna carry on if you're only doing to look good then once the camera is off us we're gonna stop it but do you believe the city mothers and fathers when they say it's now a priority of ours to help clean up this area I think there are many people in mancora politics were very sincere about that and I think that crosses the political spectrum blessedly so what's the Portland hotel the portal hotel is a domicile for the most unhealthy bola Vancouver's Downtown Eastside people are the average person staying at the place not a hotel actually it's just called that the average person there would have had five or six addresses in the previous 12 months prior to being admitted there so people have been given housing medical services my clinic has been in that facility for the last ten years their medications are given out to them in the morning and we're trying to mitigate the effect of the harshness of their lives and the harshness of social authorization have you yet figured out what it is about you you're a medical doctor right you can make a fortune doing anything else yeah not a fortune you can make a good living doing anything else what is it about these kinds of people and that location and this world that draws you there well you know that's always a complex question because there's always a combination of conscious and unconscious that motivates any of us but as far as I can tell with myself it's I do have a genuine commitment to working with people who suffer that's why I went to medicine in the first place and I have a very clear sense that some people suffer for no fault of their own for no nobody at age three has to be sexually abused then I resonate I mean I get that are very similar to that so something pulls me there and then it's a very authentic place to work I mean people may lie in a cheat but they don't pretend to be other than who they are our it's a rough crowd though I don't have to tell you now having read about it in your book you are dealing with some very tough people who've gone through awful things and you know they're very sweet people the very sweet warm yours people who have an immeasurable capacity for loving responses if they're giving the opening for that that's that's what's behind that veneer of toughness they can see a lot of vulnerability yeah that's so that's how it is but manipulative to low right but who isn't okay fair enough I mean I you know I can be manipulative sometime your friends or partners may tell you that you you can be that way these people are manipulate because they're weak they're in a weak position the weak has to manipulate that's taken for granted but that's not unique to them in any way at all just finally I presume you have two different kinds of days there are the days where you wake up and you say you know if not for me these people would fall off the edge of the world because nobody cares about them and then I guess there are days where you wake up and you think you know I could work 80 hours a day never mind 24 and would be not and it wouldn't be enough and I'm not making the kind of progress I wish I were what do you have more days of Oh many more of the first kind of days of not where I think that if but for me they would fall out but but certainly but for the kind of work that's being done on there including by myself these people would suffer a lot more and that makes it really worthwhile so you do feel you're having an impact yes you have an impact on people because you're giving them something that otherwise they'd never get which is again it's not personal to me I'm talking about the work itself not not me but acceptance non-judgement compassionate response to their suffering practical help but for the people that worked on there these people would not be getting that and all that would happen is that their early trauma would be view visited upon them daily till the end of their lives which is largely what happens anyway but at least be mitigated to some degree understood book is called in the realm of hungry ghosts close encounters with addiction good to have you here at tbo tonight my pleasure thank you

Channel: TVO Today

Views: 289,221

Keywords: TVO, TVOntario, Canada, Agenda, Steve, Paikin, Addiction, compulsive, society, Health, in, the, realm, of, hungry, ghost

Id: _-APGWvYupU

Length: 15min 33sec (933 seconds)

Published: Tue May 12 2009