Ghost-busting addictions

• Published in: CMAJ: Canadian Medical Association Journal 2008, Vol.178 (10), p.1325-1326
• Main Author: Skinner, W.J. Wayne
• Format: Review
• Language: English
• Subjects: Addictions; Behavior; Mate, Gabor; Medical treatment; Nonfiction; The Left Atrium
• ISSN: 0820-3946; 1488-2329
• DOI: 10.1503/cmaj.080408

Maté sees addiction as existing along a continuum, and we are all on it. It's not just about "them" - the marginalized, desperate aliens who represent our stereotype of addiction - it's about all of us, Maté included. He offers himself as an index case, revealing his attention-deficit hyperactivity disorder (the subject of an earlier book), his workaholism, and his compulsive CD buying. "At heart, I am no different than my patients - and I sometimes cannot stand seeing how little heaven-granted grace separates me from them." His view of addiction is a big one: "any repeated behaviour, substancerelated or not, in which a person feels compelled to persist, regardless of its negative consequences on his life and the lives of others." While he admits that addiction has profound biological and psychological aspects, it is a trap to reduce this complex problem to any 1 or 2 dimensions. "Addictions have biological, neurological, psychological, medical, emotional, social, political, economic and spiritual underpinnings - and perhaps others I haven't thought about." While the addiction process has features of illness and disease, it needs to be seen as more than that. Reductive thinking needs to be replaced by "an appreciation of complexity." The last section of the book ("The Ecology of Healing") starts with a caution: what Maté is about to state is not meant as a replacement for treatment or mutual aid. You should not be expected to do recover if your mind is on drugs: "Under the influence of brainaltering chemicals it's not possible for users to sustain the self-compassionate stance and conscious mental effort required to heal their addicted minds." What he, unfortunately leaves unanswered is how you get there from here. And is there - doing spiritual healing - where people need to be? To call for a change within that privileges the spiritual path over the others is to miss the opportunity to pull his "bio-psychosocial- plus" model together.