I watched a YouTube video a friend/coworker passed along to me on Trauma, Healing and the Brain by Dr. Gabor Maté. The premise behind his work is that people with childhood trauma become addicted to soothe themselves as a coping mechanism to avoid emotional pain. This intrigued me as I have had addictions to smoking in the past, coffee, shopping, and food, to name a few and wondered if his theory applied to more than drug and alcohol addiction. I have done a lot of quoting of others in this article, more so than I normally do, but I wanted to ensure I am capturing this right as it can be a very sensitive topic for some and I didn’t want to misguide anyone if I didn’t correctly capture the science and theory he supports.
Dr. Gabor Maté is a medical doctor recently retired from active practice. He was a family physician for two decades and for seven years he served as Medical Coordinator of the Palliative Care Unit in a Vancouver, British Columbia Hospital. For twelve years he worked in Vancouver’s Downtown Eastside with patients challenged by hard core addiction, mental illness, HIV and related conditions. For two years he was the onsite physician at Vancouver’s unique supervised injection site, one of the first in North America. He has written many books on the topic of trauma and addiction. I tried to borrow his book Hungry Ghosts: Close Encounter with Addictions and there were 53 people ahead of me to borrow one of the 5 copies they had at the library, 22 weeks approx. wait time for me to read it. I had not encountered this before when trying to borrow an online book and this intrigued me ever more. I found another route to get my hands on this book right away (Amazon Kindle) and in doing so, I wondered if my inability to wait 22 weeks to read his book was FOMO or not being able to delay gratification and is this also a form of addiction due to childhood trauma? I was curious if addictions really do come in all forms or are some just more of a habit and is there a similarity in the two. I also wondered if there was a correlation of all of this on family dynamics and how relationships might play out. As I delved into the book, I discovered I had more and more questions…
What is Addiction?
Addiction is any repeated behaviour, substance-related or not, in which a person feels compelled to persist, regardless of its negative impact on the individual’s life and the lives of others. An addict has impaired control because they don’t stop the behaviour in spite of its ill effects. They make promises to themselves or others to quit but despite pain, peril and promises, they keep relapsing. If there is some behaviour in your life that you know isn’t good, and you yoyo with it, it’s probably an addiction according to Dr. Maté. For me it’s eating foods like salty chips, and take out that I know aren’t healthy but I continue to put crap into my body and binge watch TV instead of doing productive activities that will move my life forward in a positive direction oh and I also struggle with impulse buying things I probably won’t use! All drug and non-drug related behaviours share the same brain circuits and brain chemicals and therefore they are categorized as being one in the same – addictions. This was an interesting find for me and I think too often, I look at things as habits and shrug them off easily but maybe by labeling them as what they really are, as addictions, I would want to do something about it…?
Drug Related Addictions
According to CTV News, in Canada in 2020, there were 3770 deaths related to overdoses compared to 3240 in 2019 with Ontario and Alberta being the hardest hit regions. The Government of Canada website states that there have been 21,174 apparent opioid toxicity deaths between January 2016 and December 2020. Of this horrific number, 96% are slotted as accidental. Also, interestingly 77% of total deaths were males aged 20-49 years old. These tragedies overwhelmed me, so many young people who had their life cut short due to their addiction. Mine seem very pale in comparison with food and TV versus what it must be like for the drug-related addictions. I know some people that have family members with more severe addictions and the heartbreak and hardship put on them is tragic. This brought up the question of how many of those people in these stats had childhood trauma in their life as Dr. Gabor Maté believes is a direct correlation. I also thought that if there is a lack of support for those addicted, how well do safe injection sites really help. I have a friend who lives across the street from the Sheldon Chumir Health Centre’s safe injection (consumption) site here in downtown Calgary. There’s been a lot of news lately about the Province closing it as they feel it’s too disruptive for the “neighborhood” and they don’t want to fund it anymore. My friend who lives in the “neighborhood” believes that even though it’s a place that may not look safe to the outside onlooker with all the gathering of addicts in one spot, she believes that the site does keep the needles contained compared to having them disposed all over the city. This summer, she ventured to another neighborhood to meet up with friends and sit in the park by the river. She laid a blanket down and soon found she was poked in her foot with a used needle left unsuspected, nestled in the grass. She spent the day back at Sheldon Chumir Urgent Care to be treated and found out it can take years to know if she is safe from contracting HIV from the needle. If there were more sites around the city, she feels this wouldn’t have happened. I hadn’t paid much attention to the news on the issue of cancelling the site until she shared her story with me and I do now look at it differently. The government wants to move the site to two other undisclosed locations in the city but didn’t want to wait until those were opened before shutting this one down. Apparently, the current site has more visits than any other in Alberta. People in the medical community believe many clients won’t transition to services elsewhere because the connections and trust they formed at this site will be lost and closing this site will results in deaths.
With regards to addiction, Dr. Maté puts it plainly, “Our society, with people increasingly desperate to escape the isolation and dismay of their daily lives, is rife with every manner of addiction, with more arising all the time”. What struck me about this sentence was how do we help ourselves or people that are desperate to escape their lives? I’m wondering if that’s where we start. A lot of my articles do focus on how to support depression and mental health through personal growth and hope as I have suffered from this myself. Not having been addicted to drugs though, I don’t know if something as simple as that would help in this scenario? The other piece that struck me out of this statement is “every manner of addiction”, and what does this include? Maté mentions the rising disorder of the internet addiction. How many teenagers are dealing with heightened anxiety due to trying to keep up with the next big thing on TickTok or other social media platforms. Internet gaming disorder and smart phones are another major addictive focus. Have you looked at the device on your phone lately to see how many minutes or hours you have spent on it? In all of this, Maté says, “we should not confuse the trees for the forest – the manifestation for the underlying process, the symptom for the cause. There are no new disorders here, only new targets for the universal and age-old addiction process, new forms of escape. The mind and brain processes are the same in all addictions, no matter what form, as is the psycho-spiritual emptiness that resided at the core.”
What constitutes as trauma?
So, what is this, the core? How do we uncover and look at the manifestations of despair without understanding the despair itself? What are the circumstances that promote despair and potentially the addiction? We are a very disconnected society as the magazine Adbusters noted, “You have 2672 friends and an average of thirty likes per post and no one to have dinner with on a Saturday”. I have definitely had these periods in my life and for a lot of people, the pandemic really highlighted this as some people, myself included in the past, if I was feeling lonely and had no-one to eat out with, I would still go to a restaurant, pub or theatre by myself and have some connections with the staff or a laugh with a crowd and go home feeling a bit more fulfilled but when we were locked down for so long, this was not possible. I had my kids move back home temporarily and was fortunate for the timing of that as it helped me enormously, but not everyone was so lucky. I think about the approx. 700 seniors who died in British Columbia in a week this past July from the extreme heat wave they had there as they were living alone and had no-one to check on them. If that could happen, then they were probably alone and detached from society during the pandemic as well. Maybe there’s something to what other cultures do when they live with multiple generations and not just to help out the older generation, but it ensures the other singles in the household are also connected. I was out with three of my girlfriends the other night and we were joking about moving in together down the road and being like the “Golden Girls” as there’s something to be said about having prolonged life if you are socially connected. Dr. Maté discusses the tragedies that isolation can have on the emotional well-being in his books as well.
So what drives people to take drugs and engage in addicted behaviours? According to trauma researcher Dr. Bessel van der Kolk, “People who feel good about themselves don’t do things that endanger their bodies…Traumatized people feel agitated, restless, tight in the chest. You hate the way you feel. You take drugs in order to stabilize your body.” So essentially, it’s the boredom and restlessness that creates this need to regulate the body and mind and to escape that. I wanted to go further into this. Why the boredom and restlessness in the first place? Maté’s patients often referred to this as escaping the emotional pain, deal with stress, gave me piece of mind, a sense of connection with others, a sense of control. He believes these responses show that addiction is neither a choice nor primarily a disease. It originates in a human being’s desperate attempt to solve a problem: the problem of emotional pain, of overwhelming stress, of lost connection, of loss of control, of a deep discomfort with the self. All drugs – and all behaviours of addiction, substance-dependent or not, whether to gambling, sex, the internet or cocaine – either soothe pain directly or distract from it. The first question is not “Why the addiction, but Why the pain?” Dr. Bruce Alexander in his work The Globalization of Addiction: A Study in the Poverty of the Spirit, “only chronically and severely dislocated people are vulnerable to addiction.” To him, dislocation means “an enduring lack of psychosocial integration.” So, what is psychosocial integration? It’s an essential part of human well-being, it reconciles people’s vital needs for social belonging with their equally vital needs for individual autonomy and achievement. This brings up a good point, you can live with someone and still feel lonely and sometimes it’s because you are not where you thought you would be in life with your achievements or purpose. I remember years ago, there was a lot of thought with regards to divorces happening due to the midlife crisis? Yup, that’s where you wake up one day, you are 40 or over and realize you’ve done nothing substantially or contributed to anything thus far in your life and you feel you’ve pissed away your best years! It could also be that you are in your twenties and the future looks very bleak and the hopelessness is overwhelming. Examples of Psychosocial factors are depression, social skills, anxiety, post-traumatic stress disorder, suicidal ideation, grief, fear, pain self-esteem and isolation. While Dr. Alexander calls it social disconnect dislocation, Dr. Maté calls it trauma.
I had been a smoker in my early years of life. I started out at the age of 9 as I had older siblings that were smoking at 14 and the rule in our house was you were allowed to smoke in front of parents at 13 so obviously they didn’t know I was smoking at this age. If I wanted to hang around with my siblings, it was the thing to do. When I reached my 20’s and was having children, that all stopped. I quit smoking for 15 years and then found myself divorced and having to make new friends on this next chapter of my life. That first year I was going out more to the pubs and bars to socialize, I was actively meeting new friends and creating my new social circle when the bylaw around smoking indoors in public places changed at midnight on New Year’s Eve 2006. After that, I found myself sitting alone at the table inside the bar while my friends were having fun socializing outside smoking. A few weeks of this, I too found myself going outside to smoke so I could connect and be around people. My 13-year hiatus from smoking was over. It took me another 9 years to quit. Reflecting now on this, I think I use a lot of “addictions” to connect with others possibly from not feeling connected in my childhood…
In Canada, we have decriminalized small quantities of marijuana and the government is looking at turning their sites on doing that for small amounts of harder drugs like cocaine and heroin. As Maté puts it, “the decriminalization of people who use drugs, not the decriminalization of the drugs”. There was a time not so long ago, that people with drug addictions were ostracized instead of offered help. And instead of jails, people are encouraged to enter rehabilitations programs. I’m not sure yet how I feel about decriminalizing harder drugs and will need to research this further in the future. To get back to main issue in this article, is there a correlation with trauma and addictions, the evidence supports a simple yes on that. Addictions are more prevalent and most deadly among populations who, historically have suffered the most enduring trauma and dislocation. In recent months there has been a spotlight on the suffering and trauma left behind for the Indigenous Peoples and in Canada having a very high rate of addiction, it is seen extensively in these communities. In all countries with a colonial legacy, the questions we must ask are straight forward. How do societies move to heal the multigenerational trauma that drives the misery of many Indigenous communities? Other communities where there has been ethnic cleansing and refugees have taken up status in North America also have trauma issues to overcome and substance abuse addictions seem to be a way that some deal with it as well. Preventing and healing trauma is a universal issue, not restricted to any one class or any particular ethnic or racial grouping. Maté says we will not be able to stop the tide of addiction, “so long as our system fails to recognize the source of the problem in trauma and social dislocation, and so long as treatment facilities focus mostly on trying to change the behaviours of addicted human beings instead of healing the pain that drives those behaviours.” In the medical field even today when there is ample evidence of trauma linked to mental and physical illness and addiction, there is no training for these professionals. I think this is crazy since we look to them for answers. I feel there is so much push and money to be made by pharmaceuticals that they are driving some of this. It’s easier to prescribe pills then look into what is causing the issue. It may seem odd to lump the pandemic of the drug addictions facing countries today with mild addictions like shopping or internet surfing, but they are real and could also be a stepping stone to more serious problems for the individual as any addiction is a threat to their well-being!
The Link between Childhood Trauma and Addictions
There are many definitions of what childhood trauma is on the internet and many websites are similar and since the content in the article revolves around Canada, I wanted to use that government’s website information for consistency. The government site depicts childhood traumas as physical abuse, sexual abuse, neglect, emotional harm and exposure to family violence. I can relate to a few of these growing up in a household with an alcoholic. I am sure there were many instances that happened when I was a baby and toddler that I don’t remember, but some experiences come to mind when I was school aged that did determine much of my life for a time. When I was too young to stay home alone, my younger brother and I spent a few summers while mom was at work, in the back seat of dad’s car for 6+ hours in front of the bar while he was in there drinking with his buddies. Our lunch usually consisted of whatever the small-town bar carried for hand held snacks like pickled eggs and chips that he would bring out when he checked on us and reaffirm we were not to leave the car. Many loud arguments and sometimes physical fights happened at our house and as my siblings and I hid under the covers, in closets or cupboards to avoid getting in the line of fire or worse taken away by one parent who would threaten to leave and take us with them. Don’t get me wrong, it wasn’t always like this, but it happened on more occasions than I would have liked to remember. I do have to say also, that by the time I was 18, my dad had more or less quit drinking and for the remaining 30 years before he passed, it was rare to see him drunk and if he was, his disposition was not mean and angry but full of laughter and singing songs to entertain. This was always amazing to me how he went from drinking everyday quite heavily for years to basically not at all. I am grateful that’s how those latter 30 years went, but by this time 6 children had been impacted at varying degrees.
When you break it down, this is one household out of hundreds of thousands in this country where some sort of emotional trauma has taken place. During Covid, it has become even more evident with families struggling in close quarters, financial problems with the economic effects of the pandemic and so on. It really is something we should be talking more about and bringing awareness to. Many people I know have expressed to me over the years that they don’t get along well with their family and based on what I’ve just shared about mine, I fit into this category as well. With the many trials and tribulations, I have had with my parents and siblings, mostly out of the inability to communicate, be assertive, set boundaries and express how I’m feeling, each of us deals with our own inner battle of that upbringing differently. Whether it was through bullying, or controlling or avoiding situations, it left us very disconnected and spread out all over the country. It is usually only at weddings and funerals that we manage to get some of us together and these are rare occasions. My family dynamic is not unusual and seems to be more of the normal for my generation and the one before us in this country. Leaving many people with some sort of trauma as insignificant as it may be for some to perceive it that way, it is there lingering in the background possibly running the program of whatever their addiction might be.
Dr. Maté also associates childhood trauma as something simple as being left alone by parents who worked all the time. Canadian studies have been done that determine, traumatized children grow up to be adults and the likely-hood of developing cancer increases by 50%. He links ADHD, MS, crohns, colitis and all other autoimmune diseases with childhood trauma. Why? Because the abuse and trauma created, makes the child feel they aren’t worthy enough and they compensate by trying to show everyone they are, and they can’t say no to others and take on too much and they stress themselves out. It has an impact on their immune system and the cardiovascular system. These diseases are a result of life long stresses and the childs attempt to compensate. This either shows up in addiction or disease and in some cases both. You cannot separate the mind from the body. The link of this trauma and addiction is based off extensive research and studies and some were done by Dr. Vincent Felitti, chief investigator in a one of over seventeen thousand middle class Americans for Kaiser Permanente and Centres for Disease Control. He says, “The basic cause of addiction is predominantly experience-dependent during childhood, and not substance-dependent.” Maté says, “This doesn’t mean that genes don’t play a role in brain development, as they do dictate the basic organization, developmental schedule and anatomical structure of the human central nervous system, but it’s left to the environment to sculpt and fine-tune the chemistry, connections, circuits, networks and systems that determine how well we function.” Dopamine circuits of incentive-motivation and the opioid circuitry of attachment reward, as well as for the regulatory centres in the prefrontal cortex, such as the orbitofrontal cortex, – in other words, for all the major brain systems implicated in addiction. These circuits which process emotions and govern behaviour, it is the emotional environment that is decisive. The dominant aspect of this environment is the role of the nurturing adults in the child’s life, especially in the early years. Infants read, react to and are developmentally influenced by the psychological states of the parents. Maté writes a whole chapter on how the moods of the parents if stressed or depressed likely encode negative emotional patterns in the infant’s brain. Studies show that there is higher levels of the stress hormone cortisol in children of clinically depressed mothers, making this theory that the brain is experience-dependent. Studies have shown that the majority of hard-core substance-dependent adults lived, as infants and children, under conditions of severe adversity that left a stamp on their development. Their predisposition to addiction was programmed in their early years. Their brains never had a chance according to Dr. Maté.
What I like about Dr. Male’s teachings is that he has an understanding and compassion for parenting and the difficult task it can be. It’s not about blaming the parents all the time. Sometimes there are economic reasons that the parents behave the way they do and they are in survival mode themselves. He recognizes that no-one becomes depressed on purpose and if a mother is depressed, it’s an obvious reflection of a lack of sufficient support in her environment. I do have so much compassion and empathy towards my parents as I know they too had childhood trauma and this was some of the reasons that contributed to the environment I was raised in and I also see the gifts in my life now from going through the childhood I had. I have touched on many different aspects of childhood trauma and addiction here as this is such a broad topic that leads to so many rabbit holes. I hope this has brought up questions for you as well and if so, that you go searching for some answers as I believe through more stories, education and awareness, there will be a chance for healing and for someone with a serious addiction to be helped. Trauma and family disconnection can be healed given the right conditions, we now know the brain can heal itself. I was moved by this next statement from Dr. Maté, “Truth as we know it brings freedom even as it may evoke pain. Opening our hearts is the path to healing addiction – opening our compassion for the pain within ourselves, and the pain all around us.”