Where justice and treatment meet:

Trauma is at the nature of addiction, according to Dr. Gabor Mate.

“Addiction is only a symptom, it’s not the fundamental problem. The fundamental problem is trauma,” said Mate.

He believes that anything we’ve ever craved helped us escape emotional pain. It gave us peace of mind, a sense of control and a feeling of happiness.

And all of that, explains Dr. Maté, reveals a great deal about addiction, which he defines as any behaviour that gives a person temporary relief and pleasure, but also has negative consequences, and to which the individual will return time and again.

At the heart of Dr. Maté’s philosophy is the belief that there’s no such thing as an “addictive personality”. And nor is addiction a “disease”. Instead, it originates in a person’s need to solve a problem: a deep-seated problem, often from our earliest years that was to do with trauma or loss.

Dr. Maté, a wiry, energetic man in his mid-70s, has his own experience of both childhood trauma and addiction, more of which later.

Well-known in Canada, where he lives, he gives some interesting reasons why Britain is “just waking up to me” and his bestselling book In the Realm of Hungry Ghosts.

There’s a generational conflict here, he says, around being open about past trauma: he cites Princes William and Harry opening up about their mother’s death, and says it’s something the Queen’s generation would never have done.

He applauds the new approach: “I think they [the princes] are right to be leading and validating that sense of enquiry, without which life is not worth living.”

William and Harry opening up about their mother’s death is something the Queen’s generation would never have done
The infamous British stiff upper lip is something Dr. Maté has watched with fascination over the years.

Born of our imperial past, he says, it was maintained for as long as there was something to show for it. Boarding school culture and traumatic childhoods played out into dominance of other countries and cultures, giving the “buttoned-up” approach inherent value. But once the empire crumbled, lips quavered.

“With rising inequality and all the other problems there are right now,” he says, “people are having to question how they live their lives. People in Britain are beginning to realise they paid a huge price internally for all those suppressed emotions.”

Part of that price was addiction – whether to alcohol or drugs, gambling or sex, overwork or porn, extreme sports or gaming – but essential to understanding it, says Dr. Maté, is to realise that addiction is not in itself the problem but rather an attempt to solve a problem. “Our birthright as human beings is to be happy, and the addict just wants to be a human being.”

And addictive behaviour, though damaging in the medium or long term, can save you in the short term. “The primary drive is to regulate your situation to something more bearable.”

So rather than some people having brains that are wired for addiction, Dr. Maté argues, we all have brains that are wired for happiness. And if our happiness is threatened at a deep level, by traumas in our past that we’ve not resolved, we resort to addictions to restore the happiness we truly crave.

Life is certainly a lot more work than I anticipated
He speaks from experience: Dr. Maté is a physician who specialised in family practice, palliative care and, finally, addiction medicine. He became a workaholic and lived with ADHD and depression until, in his 40s and 50s, he began to unravel the root cause – and that took him all the way back to Budapest, where he was born in January 1944.

Two months later, the Nazis occupied Hungary: his mother took him to the doctor because he wouldn’t stop crying. “Right now,” the doctor replied, “all the Jewish babies are crying.” This is because, explains Maté, what happens to the parent happens to the child: the mothers were terrified, the babies were suffering, but unlike their mothers they couldn’t understand what the suffering was about.

Later, Dr. Maté’s mother, fearing for his survival, left him for a month in the care of a stranger. All this, he explains, gave him a lifelong sense of abandonment and loss which had an impact on his psychological health. It affected his marriage and his own parenting experience. To compensate for his buried trauma, he had buried himself in work and neglected his family.

Opening up to the trauma, exploring it and investigating it, was incredibly difficult. “The problems for me showed up in the dichotomy between my success as a physician and my miseries as a husband and a father,” he recalls.

“There was a big gap between them, and it’s taken me a long time to work through what I needed to work through.” As Oscar Wilde believed, pain is the path to perfection; and nearly five decades on from the day of their wedding, Maté says his marriage is better than ever.

“We’re happier, but it’s taken many years of work,” he says. In a few weeks it will be the couple’s 49th wedding anniversary. “We’ll go out for dinner and raise a glass to five happy years,” he quips. He’s already chosen his epitaph: “It’s going to say, this life is a lot more work than I anticipated. Because it takes a lot of work to wake up as a human being, and it’s a lot easier to stay asleep than to wake up.”

It takes a lot of work to wake up as a human being, and it’s a lot easier to stay asleep than to wake up
For Dr. Maté, self-awareness is the bottom line: when we wake up and become properly self-aware, we are able to address the traumatic childhood issues that leave us vulnerable to addiction.

But because the process inevitably involves pain, we don’t address the issues until we absolutely have to – until something happens that forces us to face up to the fact that our lives aren’t working as they should. And as with the individual, so too with society: although all around us in politics and the wider world is mayhem and chaos, Dr. Maté holds on to the fact that this discomfort – which we are communally aware of – will force us to examine what’s gone wrong in our collective psyche, and to seek to correct it.

Unsurprisingly, given his central message, Dr. Maté is in favour of drug decriminalisation. He points to Portugal, where it is no longer illegal to possess a small amount of heroin or cocaine, and says the country has seen a reduction of drug-taking, less criminality and more people in treatment. In his view, it’s not really the drugs that are being decriminalised, it’s the people who are taking them – and given that they are, in his view, always victims of trauma, and never merely “bad” or “dangerous”, that’s entirely logical. But decriminalisation is only the beginning: reform must cut much deeper.

“The whole legal system is based on the idea that people are making a choice,” he says. “This is false – because no one chooses to be an addict, or to be violent.”

And when readers tell him – sometimes accusingly, sometimes gratefully – that his work humanises addicts, he can only answer: addicts are human. The only question for him is, why has it taken us so long to realise that?

Dr. Maté was in Regina on Wednesday to speak at the sixth International Training Symposium on Innovative Approaches to Justice: Where Justice and Treatment Meet.

The conference started Tuesday and runs until Friday at the Hotel Saskatchewan. Judges, lawyers, counsellors and professionals who work in treatment courts from across the country are in attendance, along with a handful of people from the United States. The conference is held every two years, with the last one being held in Vancouver.

“A lot of issues that people have are related to a trauma in their life … so we’re bringing in professionals to talk about the nuts and bolts of how you deal with that population,” said Saskatchewan Provincial Court Judge Clifford Toth, one of the organizers of the conference.

Dr. Mate a doctor from Vancouver, is one of the keynote speakers. He worked for 12 years in Vancouver’s downtown east side, which is one of the most concentrated areas of drug use in Canada. He also wrote a book about addiction entitled In the Realm of Hungry Ghosts.

His talk at the conference, A Bio-physical Perspective on Addiction, focused on the nature of addiction, what causes it and the way to best approach people who are suffering from it.

“Before we ask how we handle something, we have to understand what are we handling,” Dr. Maté said.

Addiction connects back to trauma that people have experienced in their life. Once people understand this, then treatment can happen.

“Unfortunately most of the medical profession and the legal system does not understand addiction. Therefore our treatment and legal solutions tend not to be helpful, and in fact they often tend to be harmful,” he said.

Dr Maté sees drug treatment courts, like the one that is operated in Regina, as a step in the right direction. The courts are a step away from the traditional punishment approach. There is recognition in the courts that there is no justice without health, Mate said. These courts recognize that people are acting out because of their trauma.

Dr Maté: “When we understand that the people who are addicted are traumatized people, now we have to take an approach that will help them heal that trauma, rather than make it worse.”

Mate sees the conference as a way to open peoples’ minds to giving people that treatment.

“What I get about the conference is that it’s a real earnest and well- organized attempt to broaden the conversation and to bring together people from different disciplines,” Dr. Gabor Maté.