#5: Treating the Pain

When attempting to unpack this extremely dense and impossibly intricate topic it is very important to direct our attention to the first chapters of these stories. While browsing the internet for different and deeper perspectives on addiction I came across a doctor that shared not only my Hungarian heritage but also my open minded and wide approach to the subject. His unconventional idea of what addiction means was illustrated during an interview with the Huffington Post. “Dr. Gabor Maté believes — based on research and his own experience working at harm reduction clinics in Vancouver’s Downtown Eastside, a poor area that has one of the worst drug problems in North America — that the root of addictive behaviors can be traced all the way back to childhood”(Gregorie Huffington Post).  Maté argues that all addiction starts with pain, that there is a hurt driving every addict whether their outlet is substance abuse, work, shopping, a relationship, sex, food or anything else that can be used as a painkiller. Depending on the situation “the wound may not be as deep and the ache not as excruciating, and it may even be entirely hidden — but it’s there”(Maté).


Gabor Mate's Ted Talk on his Perspectives on addiction.

Gabor Mate’s Ted Talk on addiction.

Before really digging further into the topic we must first define the term. I myself have a fairly broad definition of addiction which isn’t dependent on the object of addiction, but rather the behaviors and mental state of the person.  Dr Maté defines the term as  “a complex process that involves brain, body, emotions, psychology and social relationships. The expression of addiction is any behavior where a person craves and finds temporary pleasure or relief in something, but suffers negative consequences as a result of and is unable to give up despite those negative consequences”(Maté)

Through the lens of Maté, the conflict in this story isn’t the substances themselves. He’s “saying that the substances are not in themselves addictive. It has to do with the availability of the target of the behavior and the susceptibility of the individual. So the real question is, what creates the susceptibility?” (Maté)

So in that case what does create susceptibility? He believes that”the single factor that’s at the core of all addictions is trauma. By trauma I mean emotional loss in childhood, and in the case of severe addicts, you can see — and large-scale population studies show — that there is significant childhood trauma such as family violence, addiction in the family, sexual and emotional abuse, physical abuse, a parent being mentally ill or in jail”(Maté).

Alright, so trauma being a main source of susceptibility to addictive behaviors makes sense, but surely it can’t be the only factor, especially when we are talking in terms not limited to the use of hard drugs. There is a variety of mundane, ordinary addictions that don’t seem remotely detrimental at first glance, is he suggesting that that the driver behind these situations must also be a case of trauma?

No, according to him, the factor of trauma is not completely alone in creating susceptibility.

There’s another set of difficult experiences that’s a bit harder to distinguish, and that’s not when bad things happen but when good things don’t happen. A child has certain fundamental needs for emotional development and also for brain development. If you look at the human brain, it develops under the impact of the environment…So for example, in the case of addiction, the brain’s reward circuitry is impaired… the person’s circuits, which have to do with the chemical dopamine and which give you a sense of reward incentive and motivation, are not well-developed. Those circuits need the support of the environment to help them in their development, and the essential quality of the environment is a mutually responsive relationship with the parent or caregiver.

Gabor Maté believes that even seemingly amiable activities such as working or loving classical music (two of his own previous addictions) can be developed into real, and harmful addictions. It all depends on the subconscious motivation for the activity. All objects of addiction are pain-causing painkillers in some way or another. His method for treating addicts is not to ask ‘why the addiction?’, but ‘why the pain?’


I highly recommend giving his Ted Talk a watch, it touches on many other aspects of addiction in the world that I do not discuss in this post.


Now that we’ve talked about the root causes of susceptibility to addiction, let’s talk about treatment.

The conflict in a New York Times article on recovery from addiction is the fact that we keep doing what hasn’t been working, even with the presence of newer, provenly more effective options. “Of the 23.5 million teenagers and adults addicted to alcohol or drugs, only about 1 in 10 gets treatment, which too often fails to keep them drug-free. Many of these programs fail to use proven methods to deal with the factors that underlie addiction and set off relapse”(Jane E. Brody). Now that we see that current methods for treatment don’t work shouldn’t we move on to something else? The truth is we should have moved on to something else a long time ago. “There are exceptions, but of the many thousands of treatment programs out there, most use exactly the same kind of treatment you would have received in 1950, not modern scientific approaches” (Thomas McLellan). This is yet another of many situations where Einstein’s definition of insanity can be applied. He said that the definition of insanity is doing something over and over again and expecting a different result.  As our various drug epidemics and abusive relationships with substance have gotten worse, we continue to use the same methods and (surprisingly) have received nothing but the same results.

Maybe the issue with treatment comes from the fact that it is an intimidating problem to confront. Each case is unique, many-layered and involves the messy process of resolving many internal and external conflicts triggering the addictive behaviors. We treat these situations as though the addiction itself is the main problem as opposed to just a symptom of something more profound. It’s much more difficult to target the problem at the source, so instead we spend even more energy running around, trying to find an easier way. “The short-term fix mentality partially explains why so many people go back to their old habits.” We need to abandon this mentality and focus on curing the lives, not curing the addictions.




Gregoire, Carolyn. “Why This Doctor Believes Addictions Start In Childhood.”Huffingtonpost.com/. N.p., n.d. Web. <http://www.huffingtonpost.com/entry/gabor-mate-addiction_us_569fd18ae4b0fca5ba76415c?s284obt9>

Brody, Jane E. “Effective Addiction Treatment.” Nytimes.com. The New York Times, n.d. Web. <http://well.blogs.nytimes.com/2013/02/04/effective-addiction-treatment/?_r=0>.

Kati Tolgyesi

2 Responses to “#5: Treating the Pain

  • Emily Rinkema
    7 years ago

    Hi Kati,

    Again, I am so impressed by the thoughtful and thorough nature of your posts. I watched the TED talk and was so interested in Mate’s approach to addiction. I was struck by his question (and yours) What’s the pain? His thesis that addiction is a pain-killer makes sense to me, though I do wonder about the role of genetics as well. So many people who experience great pain or loss do not become addicts, so why is it that some do?

    You write that we need to cure the life not the addiction. This matches your thinking from the last few posts–that our focus on society, on the external, may help address the internal. Unfortunately this is a huge topic! I get the sense you are getting closer to narrowing down your own focus, and I can’t wait to see where you end up. Are you still thinking about a focus on the children affected by addiction?

    Hope you’re enjoying the fall!

    • Thank you for another thoughtful response!

      I do realize that this is still very broad. I see myself either zooming in and focusing on the children’s experience with addiction, or zooming out and trying to look at addiction in a more abstract and holistic way. At this point in the game I remain flexible, the final angle will depend on what happens during the collaborative process.

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