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The Power of Addiction and The Addiction to Power: Gabor Maté Transcript

Gabor Maté at TEDxRio 20

Dr. Gabor Maté – Renowned Speaker and Author

I’ve come to talk to you about addiction, the power of addiction, but also addiction to power.

As a medical doctor, I work in Vancouver, Canada and I have worked with some very, very addicted people. People who use heroin, they inject cocaine; they drink alcohol, crystal meth and every drug known to man. And these people suffer.

If the success of a doctor is to be measured by how long his patients live, then I am a failure because my patients die very young, relatively speaking. They die of HIV, they die of hepatitis C, they die of infections of their heart valves, they die of infections of their brains, of their spines, of their hearts, of their bloodstream. They die of suicide, of overdose, of violence, of accidental deaths.

And if you look at them, you call to mind, the words of the great Egyptian novelist, Naguib Mahvouz, who wrote, “nothing records the effects of a sad life as graphically as the human body.” Because these people lose everything. They lose their health, they lose their beauty, they lose their teeth, they lose their wealth, they lose human relationships and in the end, they often lose their lives. And yet, nothing shakes them from their addiction, nothing can force them to give up their addiction.

The addictions are powerful and the question is: why? And as one of my patients said to me, “I’m not afraid of dying,” he said, “I’m more afraid of living.” A question we have to ask is: why are people afraid of life? And, if you want to understand addiction, you can’t look at what’s wrong with the addiction, you have to look at what’s right about it.

In other words, what is the person getting from the addiction? What are they getting that otherwise they don’t have? What addicts get is release from pain, what they get is a sense of peace, a sense of control, a sense of calmness, very, very temporarily.

And the question is: why are these qualities missing from their lives, what happened to them?

Now if you look at the drugs like heroin, like morphine, like codeine, if you look at cocaine, if you look at alcohol, these are all pain killers. In one way or another, they all soothe pain. And thus the real question in addiction is not why the addiction, but why the pain?

Now, I just finished reading the biography of Keith Richards, the lead guitarist of the Rolling Stones and as you probably know, everybody is still surprised that Richards is still alive today because he was a heavy-duty heroine addict for a long time. And in his biography, he writes that the addiction was all about looking for oblivion, looking for forgetting. He says “the contortions that we go through just not to be ourselves for a few hours.”

And I understand that very well myself because I know that discomfort with myself, I know that discomfort being in my own skin, I know that desire to escape from my own mind. The great British psychiatrist…R.D. Laing said that the three things that people are afraid of are: death, of other people, and of their own minds.

For a long time in my life I wanted to distract myself from my own mind, I was afraid to be alone with it. And how would I distract myself? Well, I’ve never used drugs but I’ve distracted myself through work, and throwing myself into activities. And I’ve distracted myself through shopping, in my case, for classical compact music, classical compact discs. But I’ve been a real addict that way, one week I spent $8,000 on classical compact discs, not because I wanted to, but because I couldn’t help going back to the store. And as a medical doctor, I used to deliver a lot of babies and once I left a woman in labor in the hospital to get a classical piece of music. I still could have made it back…to the hospital on time, but once in the store you can’t leave because there are these evil classical music dealers in the aisles, you know, who “hey buddy, have you listened to the latest Mozart symphony cycle?” “You haven’t?”

So I missed the delivery of that baby, and I come home and I lied to my wife about it like any addict, I would lie about it. And I would ignore my own children because of my obsession with work and with music. So I know what that escape from the self is like.

My definition of addiction is: any behavior that gives you temporary relief, temporary pleasure, but in the long term, causes harm, has some negative consequences and you can’t give it up despite those negative consequences.

And from that perspective, you can understand that there are many, many addictions. Yes, there is the addiction to drugs, but there is also the addiction to consumerism, there is the addiction to sex, to the internet, to shopping, to food.

The Buddhists have this idea of the hungry ghosts — the hungry ghosts are these creatures with large empty bellies and small, scrawny necks and tiny little mouths, so they can never get enough, they can never fill this emptiness on the inside. And we are all hungry ghosts in this society, we all have this emptiness and so many of us are trying to fill that emptiness from the outside and the addiction is all about trying to fill that emptiness from the outside.

Now, if you want to ask the question of why people are in pain, you can’t look at their genetics, you have to look at their lives. And in the case of my patients, my highly addicted patients, it’s very clear why they are in pain. Because they have been abused all of their lives, they began life as abused children. All of the women I have worked with over a twelve year period, hundreds of them, they had all been sexually abused as children. And the men had been traumatized as well; the men had been sexually abused, neglected, physically abused, abandoned and emotionally over and over again. And that’s why the pain.

And there is something else here too: the human brain. The human brain itself develops an interaction with the environment; it’s not just genetically programmed. The kind of environment that a child has will actually shape the development of the brain.

Now, I can tell you about two experiments with mice. You take a little mouse and you put food in its mouth and he’ll eat it and enjoy it and swallow it, but if you put the food down a few inches away from his nose, he will not move to eat it, he will actually starve to death rather than eat. Why? Because, genetically, they knocked out the receptors for a chemical in the brain called dopamine. Dopamine is the incentive and motivation chemical.

Dopamine flows whenever we are motivated, excited, vital, vibrant, curious about something, whether seeking food or a sexual partner. Without the dopamine, we have no motivation.

Now what do you think the addict gets? When the addict shoots cocaine, when the addict shoots crystal meth or almost any drug, they get a hit of dopamine in their brain and the question is: what happened to their brains in the first place? Because it’s a myth that drugs are addictive. Drugs are not by themselves addictive, because most people who try most drugs never become addicted.

So the question is: why are some people vulnerable to getting addicted? Just like food is not addictive but to some people it is, shopping is not addictive but to some people it is, television is not addictive but to some people it is. So the question is: why the susceptibility?

There’s another little experiment with mice where infant mice, if they are separated from their mothers will not cry for their mothers. Now what would that mean in the wild? It means that they would die. Because only the mother protects the child’s life and nurtures the child and why? Because genetically they knocked out the receptors, the chemical binding sites in the brain, for endorphins and endorphins are indigenous, morphine-like substances; endorphins are our own natural pain killers.

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