“All the substances of abuse, whether they’re opiates or cocaine or anything else, they’re actually pain killers. Some of them specifically are painkillers. But physical pain and emotional pain, the suffering is experienced in the same part of the brain. So when people suffer emotional rejection, the same part of the brain will light up as if you stuck them with a knife. Eckhart Tolle says very nicely that addictions begin with pain and end with pain. So that all the addictions are attempts to soothe the pain. When I work with addictions, the first question is always, not why the addiction but why the pain. And what you find is emotional loss or a trauma.
In the case of the severe addicts as in the downtown Eastside here, there were every single one of them traumatized. There’s no women walking the streets here who have not been sexually abused, not even by accident. But you know, whether it’s a sex addiction, or internet, or a relationship, or shopping, or work addiction, these are all attempts to get away from distress.
Keith Richards, the Rolling Stones guitarist, who used to have a severe heroin addiction, as you know, said, “All the contortions we go through are just not to be ourselves for a few hours.” Why would somebody not want to be themselves? Because they’re in too much distress, in too much pain. So I don’t care what they tell you, about genetics or choices or any of that nonsense, it’s always about pain.
The Tibetan Book of Living and Dying, it’s got a wonderful line in it,
Whatever you do, don’t try and escape from your pain, but be with it.
西藏生死書裡有句精彩的文字：
無論你/妳怎麼做，不要試圖逃避你/妳的痛苦，而是面對它。
Because the attempt to escape from pain is what creates more pain, and that’s the reality of addiction. But the question is how can people be with their pain? Only if they sense some compassion from somebody. As another teacher says, only when compassion is present will people allow themselves to see the truth.
So addicted people need a compassionate present which will permit them to experience their pain without having to run away from it. And all the attempt to run away, it’s like another teacher says, the surest way to go to hell is to try to run away from hell. So you gotta be with that pain, you just have to be with it, but you have to have some support.
And we live in a society that, one way or the other is always about instant relief, quick satisfaction, distraction. In other words, we live in a culture that is based on, both economically and psychologically, on not supporting people to be with themselves. So its always the quick getaway. So its very difficult to deal with addictions in this society.
It is a matter of, at some point finding a way of being with your pain, so that you can actually get to know what it’s really all about.”
在某種程度上而言，你/妳必須找到方法面對自己痛苦的方法，你/妳才能真正理解它真正的內涵。
“Not all addictions are rooted in abuse or trauma, but I do believe they can all be traced to painful experience. A hurt is at the centre of all addictive behaviours. It is present in the gambler, the Internet addict, the compulsive shopper and the workaholic. The wound may not be as deep and the ache not as excruciating, and it may even be entirely hidden—but it’s there. As we’ll see, the effects of early stress or adverse experiences directly shape both the psychology and the neurobiology of addiction in the brain.” ― Gabor Maté, In the Realm of Hungry Ghosts: Close Encounters with Addiction
“The hardcore drug addicts that I treat, are, without exception, people who have had extraordinarily difficult lives. The commonality is childhood abuse. These people all enter life under extremely adverse circumstances. Not only did they not get what they need for healthy development; they actually got negative circumstances of neglect. I don’t have a single female patient in the Downtown Eastside of Vancouver who wasn’t sexually abused, for example, as were many of the men, or abused, neglected and abandoned serially, over and over again. That’s what sets up the brain biology of addiction. In other words, the addiction is related both psychologically, in terms of emotional pain relief, and neurobiological development to early adversity.” ― Gabor Maté
“The greatest damage done by neglect, trauma or emotional loss is not the immediate pain they inflict but the long-term distortions they induce in the way a developing child will continue to interpret the world and her situation in it. All too often these ill-conditioned implicit beliefs become self-fulfilling prophecies in our lives. We create meanings from our unconscious interpretation of early events, and then we forge our present experiences from the meaning we’ve created. Unwittingly, we write the story of our future from narratives based on the past...Mindful awareness can bring into consciousness those hidden, past-based perspectives so that they no longer frame our worldview.’Choice begins the moment you disidentify from the mind and its conditioned patterns, the moment you become present…Until you reach that point, you are unconscious.’ …In present awareness we are liberated from the past.” ― Gabor Maté, In the Realm of Hungry Ghosts: Close Encounters with Addiction
“Being cut off from our own natural self-compassion is one of the greatest impairments we can suffer. Along with our ability to feel our own pain go our best hopes for healing, dignity and love. What seems nonadapative and self-harming in the present was, at some point in our lives, an adaptation to help us endure what we then had to go through. If people are addicted to self-soothing behaviours, it's only because in their formative years they did not receive the soothing they needed. Such understanding helps delete toxic self-judgment on the past and supports responsibility for the now. Hence the need for compassionate self-inquiry.” ― Gabor Maté, In the Realm of Hungry Ghosts: Close Encounters with Addiction
“It’s a subtle thing, freedom. It takes effort; it takes attention and focus to not act something like an automaton. Although we do have freedom, we exercise it only when we strive for awareness, when we are conscious not just of the content of the mind but also of the mind itself as a process.’ We may say, then, that in the world of the psyche, freedom is a relative concept: the power to choose exists only when our automatic mechanisms are subject to those brain systems that are able to maintain conscious awareness. A person experiences greater or less freedom from one situation to the next, from one interaction to the next, from one moment to the next. Anyone whose automatic brain mechanisms habitually run in overdrive has diminished capacity for free decision making, especially if the parts of the brain that facilitate conscious choice are impaired or underdeveloped.” ― Gabor Maté, In the Realm of Hungry Ghosts: Close Encounters with Addiction
