Canadian physician Gabor Maté is a specialist in terminal illnesses, chemical dependents, and HIV positive patients.

Dr. Maté is a renowned author of books and columnist known for his knowledge about attention deficit disorder, stress, chronic illness and parental relations. His theme at TEDxRio+20 was addiction — from drugs to power. From the lack of love to the desire to escape oneself, from susceptibility of the being to interior power — nothing escapes. And he risks a generic and generous prescription: “Find your nature and be nice to yourself.”

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The Power of Addiction and The Addiction of Power: Gabor Maté at TED - Transcript

0:09I’ve come to talk to you about addiction, the power of addiction,
0:13but also addiction to power.
0:16As a medical doctor, I work in Vancouver, Canada,
0:19and I have worked with some very, very addicted people.
0:22People who use heroin, they inject cocaine,
0:26they drink alcohol, crystal meth and every drug known to man.
0:31And these people suffer.
0:33If the success of a doctor is to be measured by how long his patients live,
0:38then I am a failure
0:39because my patients die very young, relatively speaking.
0:43They die of HIV, they die of hepatitis C,
0:47they die of infections of their heart valves,
0:50they die of infections of their brains, of their spines,
0:53of their hearts, of their bloodstream.
0:56They die of suicide, of overdose, of violence, of accidental deaths.
1:02And if you look at them, you call to mind
1:06the words of the great Egyptian novelist, Naguib Mahvouz, who wrote:
1:10″Nothing records the effects of a sad life as graphically as the human body.”
1:15Because these people lose everything.
1:17They lose their health, they lose their beauty,
1:20they lose their teeth, they lose their wealth,
1:23they lose human relationships
1:25and, in the end, they often lose their lives.
1:28And yet, nothing shakes them from their addiction.
1:31Nothing can force them to give up their addiction.
1:34The addictions are powerful and the question is: why?
1:38And as one of my patients said to me:
1:40″I’m not afraid of dying,” he said, “I’m more afraid of living.”
1:45And the question we have to ask is: Why are people afraid of life?
1:50And, if you want to understand addiction,
1:53you can’t look at what’s wrong with the addiction;
1:56you have to look at what’s right about it.
1:57In other words, what’s the person getting from the addiction?
2:00What are they getting that otherwise they don’t have?
2:03What addicts get is relief from pain,
2:07what they get is a sense of peace, a sense of control,
2:12a sense of calmness, very, very temporarily.
2:16And the question is why are these qualities missing from their lives,
2:19what happened to them?
2:22If you look at drugs like heroin, like morphine, like codeine,
2:27if you look at cocaine, if you look at alcohol,
2:31these are all painkillers.
2:33In one way or another, they all soothe pain.
2:36And that’s why the real question in addiction
2:38is not, “Why the addiction?,” but, “Why the pain?”
2:42Now, I just finished reading the biography of Keith Richards,
2:46the guitarist for the Rolling Stones
2:48and, as you probably know, everybody is still surprised
2:51that Richards is still alive today,
2:53because he was a heavy-duty heroine addict for a long time.
2:57And in his biography, he writes that the addiction
3:00was all about looking for oblivion, looking for forgetting.
3:05He said, “The contortions that we go through
3:08just not to be ourselves for a few hours.”
3:11And I understand that very well myself,
3:14because I know that discomfort with myself,
3:16I know that discomfort being in my own skin,
3:20I know that desire to escape from my own mind.
3:24The great British psychiatrist R.D. Laing said
3:29that there are three things that people are afraid of.
3:32They are afraid of death, of other people and of their own minds.
3:37For a long time in my life, I wanted to distract myself from my own mind,
3:42because I was afraid to be alone with it.
3:44And how would I distract myself?
3:46Well, I’ve never used drugs, but I’ve distracted myself through work,
3:50and throwing myself into activities.
3:53And I’ve distracted myself through shopping;
3:57in my case, for classical compact music, classical compact discs.
4:01But I’ve been a real addict that way.
4:03One week, I spent 8,000 dollars on classical compact discs,
4:06not because I wanted to,
4:08but because I couldn’t help going back to the store.
4:11And as a medical doctor, I used to deliver a lot of babies.
4:14And once I left a woman in labor in hospital
4:16to get a classical piece of music.
4:22I still could have made it back to the hospital on time,
4:25but once in the store you can’t leave,
4:28because there are these evil classical music dealers in the aisles:
4:32″Hey buddy, have you listened to the latest Mozart symphony cycle?”
4:36″You haven’t? Well…”
4:38So I missed the delivery of that baby,
4:40and I came home and I lied to my wife about it.
4:42Like any addict, I would lie about it and I would ignore my own children
4:46because of my obsession with work and with music.
4:49So I know what that escape from the self is like.
4:53My definition of addiction
4:54is any behavior that gives you temporary relief, temporary pleasure,
5:01but in the long term causes harm, has some negative consequences
5:05and you can’t give it up, despite those negative consequences.
5:09And from that perspective, you can understand
5:12that there are many, many addictions.
5:16Yes, there is the addiction to drugs,
5:17but there is also the addiction to consumerism,
5:21there is the addiction to sex, to the internet,
5:25to shopping, to food.
5:29The Buddhists have this idea of the hungry ghosts.
5:33The hungry ghosts are creatures with large empty bellies
5:36and small, scrawny necks and tiny little mouths,
5:39so they can never get enough,
5:41they can never fill this emptiness on the inside.
5:43And we are all hungry ghosts in this society,
5:46we all have this emptiness,
5:48and so many of us are trying to fill that emptiness from the outside
5:52and the addiction is all about trying to fill that emptiness from the outside.
5:57Now, if you want to ask the question of why people are in pain,
6:03you can’t look at their genetics.
6:06You have to look at their lives.
6:08And in the case of my patients, my highly addicted patients,
6:11it’s very clear why they are in pain.
6:14Because they have been abused all of their lives,
6:16they began life as abused children.
6:18All of the women I have worked with over a 12-year period, hundreds of them,
6:22they had all been sexually abused as children.
6:24And the men had been traumatized as well.
6:26The men had been sexually abused, neglected,
6:30physically abused, abandoned
6:32and emotionally hurt over and over again.
6:36And that’s why the pain.
6:38And there is something else here too: the human brain.
6:42The human brains itself, as you’ve heard already,
6:45develops an interaction with the environment.
6:47It’s not just genetically programed.
6:49So the kind of environment that a child has
6:53will actually shape the development of the brain.
6:56Now, I can tell you about two experiments with mice.
7:00You take a little mouse and you put food in its mouth
7:03and he’ll eat it and enjoy it and swallow it,
7:07but if you put the food down a few inches away from his nose,
7:10he will not move to eat it;
7:12he will actually starve to death rather than eat.
7:16Why?
7:17Because, genetically, they knocked out the receptors for a chemical in the brain
7:21called dopamine.
7:23Dopamine is the incentive and motivation chemical.
7:26Dopamine flows whenever we are motivated,
7:29excited, vital, vibrant, curious about something,
7:33when we are seeking food or a sexual partner.
7:35Without the dopamine, we have no motivation.
7:37Now what do you think the addict gets?
7:39When the addict shoots cocaine,
7:41when the addict shoots crystal meth or almost any drug,
7:44they get a hit of dopamine in their brain.
7:47And the question is,
7:48what happened to their brains in the first place?
7:52Because it’s a myth that drugs are addictive.
7:55Drugs are not by themselves addictive,
7:57because most people who try most drugs never become addicted.
8:00So the question is,
8:02why are some people vulnerable to being addicted?
8:05Just like food is not addictive, but to some people it is;
8:08shopping is not addictive, but to some people it is;
8:11television is not addictive, but to some people it is.
8:13So the question is, why this susceptibility?
8:19There’s another little experiment with mice
8:21where infant mice,
8:23if they are separated from their mothers will not cry for their mothers.
8:27Now what would that mean in the wild?
8:29It means that they would die,
8:30because only the mother protects the child’s life and nurtures the child.
8:34And why?
8:35Because genetically they knocked out the receptors,
8:38the chemical binding sites in the brain, for endorphins
8:42and endorphins are indigenous morphine-like substances;
8:46endorphins are our own natural painkillers.
8:50What morphine or endorphins also do is they make possible the experience of love;
8:56they make possible the experience of attachment to the parent
8:59and the parents’ attachment to the child.
9:01So these little mice without endorphin receptors in their brains
9:05will naturally not call for their mothers.
9:07In other words,
9:08the addiction to these drugs and of course the heroine and the morphine,
9:14what they do is they act on the endorphin system;
9:17that’s why they work.
9:19And so, the question is,
9:23what happens to people that they need these chemicals from the outside?
9:27Well, what happens to them is, when they are abused as children,
9:30those circuits don’t develop.
9:33When you don’t have love and connection in your life,
9:36when you are very, very young,
9:37then those important brain circuits just don’t develop properly.
9:41And under conditions of abuse, things just don’t develop properly
9:46and their brains then are susceptible when they do the drugs.
9:51Now they feel normal, now they feel pain relief,
9:54now they feel love.
9:56And as one patient said to me: “When I first did heroine,” she said,
10:00″it felt like a warm soft hug, just like a mother hugging her baby.”
10:06Now, I’ve had that same emptiness, not to the same degree as my patients.
10:12What happened to me is that I was born in Budapest, Hungary,
10:16in 1944, to Jewish parents,
10:19just before the Germans occupied Hungary.
10:22And you know what happened to the Jewish people in Eastern Europe.
10:25And I was 2 months old when the German army moved into Budapest.
10:29And the day after they did, my mother phoned the pediatrician
10:33and she said,
10:35″Would you please come and see Gabor because he is crying all the time.”
10:38And the pediatrician said, “Of course, I will come to see him,
10:41but I should tell you, all of my Jewish babies are crying.”
10:45Now why?
10:46What do babies know about Hitler or genocide or war?
10:51Nothing.
10:52What we were picking up on is the stresses and the terrors
10:55and the depression of our mothers
10:57and that actually shapes the child’s brain.
11:02And of course, what happens then
11:07is I get the message that the world doesn’t want me,
11:10because if my mother is not happy around me,
11:12she must not want me.
11:15Why do I become a workaholic later?
11:17Because if they don’t want me, at least they are going to need me.
11:21And I’ll be an important doctor and they are going to need me
11:24and that way I can make up
11:26for the feeling of not being wanted in the first place.
11:29And what does that mean?
11:31It means that I am working all the time,
11:33and when I am not working, I’m consumed by buying music.
11:38What message do my kids get?
11:40My kids get the same message that they are not wanted.
11:43And this is how we pass it on, we pass on the trauma,
11:46and we pass on the suffering, unconsciously,
11:49from one generation to the next.
11:52So obviously, there are many, many ways to fill this emptiness,
11:56and for each person, there is a different way of filling the emptiness,
11:59but the emptiness always goes back
12:01to what we didn’t get when we were very small.
12:07And then we look at the drug addict and we say to the drug addict,
12:11″How can you possibly do this to yourself?
12:13How can you possibly inject this terrible substance into your body
12:17that may kill you?”
12:18But look at what we are doing to the earth.
12:21We are injecting all kinds of things into the atmosphere
12:24and the oceans and the environment
12:28that is killing us, that’s killing the earth.
12:30Now which addiction is greater?
12:33The addiction to oil? Or to consumerism?
12:36Which causes the greater harm?
12:38And yet we judge the drug addict
12:40because we actually see that they are just like us
12:43and we don’t like that.
12:45So we say, “You are different from us, you are worse than we are.”
12:48(Applause)
12:55On the plane to São Paulo and Rio de Janeiro,
13:00I was reading the New York Times, on June 9th,
13:04and there was an article about Brazil
13:06and the article was about a man called Nísio Gomes,
13:10a leader of the Guarani people in the Amazon,
13:14who was killed last November and you probably heard about him.
13:18And he was killed because he was protecting his people
13:21from the big farmers and the companies
13:25that are taking over the rainforest and destroying the rainforest
13:28and that are destroying the habitat of the native Indian people here in Brazil.
13:32And I can tell you that coming from Canada the same thing has happened over there.
13:36And many of my patients are actually First Nation’s Indian people,
13:39native Indian people in Canada, and they are heavily addicted.
13:43They make up a small percentage of the population,
13:47but they make up a large percentage of the people in jail,
13:50the people who are addicted,
13:51the people who are mentally ill,
13:53the people who commit suicide. Why?
13:55Because their lands were taken away from them,
13:57and because they were killed and abused for generations and generations.
14:02But the question I ask is,
14:04if you can understand the suffering of these native people
14:07and how that suffering makes them seek relief from pain in their addictions,
14:11what about the people who are perpetrating it?
14:14What are they addicted to?
14:15Well, they are addicted to power,
14:17they are addicted to wealth,
14:19they are addicted to acquisition.
14:21They want to make themselves bigger.
14:23And when I was trying to understand the addiction to power,
14:26I looked at some of the most powerful people in history.
14:28I looked at Alexander the Great, I looked at Napoleon, I looked at Hitler,
14:33I looked at Genghis Kahn, I looked at Stalin.
14:35It’s very interesting when you look at these people.
14:38First of all, why did they need power so much?
14:41Interestingly enough,
14:43physically they were all very small people,
14:46my size or smaller; actually smaller.
14:52They came from outsiders,
14:56they were not part of the major population.
14:59Stalin was a Georgian, not a Russian; Napoleon was a Corsican, not a Frenchman;
15:06Alexander was a Macedonian, not a Greek; and Hitler was an Austrian, not a German.
15:13So a real sense of insecurity and inferiority.
15:16And they needed power to feel okay in themselves,
15:19to make themselves bigger,
15:21and in order to get that power, they were quite willing to fight wars
15:24and to kill a lot of people, just to maintain that power.
15:29I’m not saying that only small people can be power-hungry
15:32but it is interesting to look at these examples,
15:34because power, the addiction to power, is always about the emptiness
15:38that you try and fill from the outside.
15:40And Napoleon, even in exile on the island of St. Helena,
15:45after he lost his power, he said, “I love power, I love power.”
15:49He couldn’t think of himself without power.
15:52He had no sense of himself without being powerful externally.
15:56And that’s very interesting when you compare it to people
16:01like the Buddha or Jesus,
16:03because if you look at the story about Jesus and Buddha,
16:05both of them were tempted by the devil
16:08and one of the things that the devil offers them is power, earthly power,
16:14and they both say no.
16:16Now why do they say no?
16:18They say no because they have the power inside of themselves,
16:23they don’t need it from the outside.
16:25And they both say no because they don’t want to control people,
16:28they want to teach people.
16:30They want to teach people by example and by soft words,
16:35and by wisdom, not through force; so they refuse power.
16:41And it’s very interesting what they say about that.
16:46Jesus says that the power and the reality is not outside of yourself but inside.
16:53He says the Kingdom of God is within.
16:57And the Buddha, before he dies and his monks are mourning and crying
17:01and they are all upset,
17:02he says, “Don’t mourn me,” he says, “And don’t worship me.
17:06Find a lamp inside yourself, be a lamp unto yourselves, find a light within.”
17:12And so as we look this difficult world with the loss of the environment
17:16and global warming and the depredations in the oceans,
17:21let’s not look to the people in power to change things,
17:25because the people in power, I’m afraid to say, are very often
17:28some of the emptiest people in the world
17:31and they are not going to change things for us.
17:33We have to find that light within ourselves,
17:35we have to find the light within communities
17:38and within our own wisdom and our own creativity.
17:41We can’t wait for the people in power to make things better for us,
17:45because they are never going to, not unless we make them.
17:53They say that human nature is competitive, that human nature is aggressive,
17:58that human nature is selfish.
18:00It’s just the opposite; human nature is actually cooperative,
18:03human nature is actually generous, human nature is actually community-minded.
18:09What we see here at this conference with people sharing information,
18:13people receiving information, people committed to the better world,
18:17that’s actually human nature.
18:19And what I am saying to you is,
18:20if you find that light within, if you find your own nature,
18:23then we will be kinder to ourselves
18:25and we will also be kinder to nature.
18:27Thank you.

What is Addiction?

What is Addiction - Transcript

0:04all the substances of abuse whether
0:07they’re opiates or cocaine or anything
0:09else they’re actually painkillers
0:10some of them specifically are
0:12painkillers but physical pain and
0:14emotional pain the suffering is
0:16experienced in the same part of the
0:17brain so when people suffer emotional
0:20rejection the same part of the brain
0:21will light up as if you stuck them with
0:23a knife the neck are told this is very
0:25nicely that addictions begin with pain
0:27and end with pain so that all the
0:30addictions are attempts to soothe the
0:31pain so when I work with addictions the
0:35first question is always not why the
0:37addiction will buy the pain and what you
0:40find is emotional loss or trauma in the
0:44case of the severe addicts as in the
0:45downtown insider they were every single
0:47one of them traumatized there’s no women
0:50walking the streets here we’re not being
0:51sexually abused not impacted but but you
0:55know whether it’s a sex addiction or
0:56internet or relationship or shopping or
1:01work addiction these are all attempts to
1:03get away from distress Keith Richards
1:06the rolling stone guitars said who the
1:09east have severe heroin habit as you
1:11know he said that all the contortions we
1:16go through just not to be ourselves for
1:18a few hours or why would somebody not
1:21want to be themselves because they’re in
1:23too much distress in too much pain so I
1:26don’t care what they tell you but
1:27genetics or any other choices and that
1:30nonsense it’s always about being well
1:33the Tibetan Book of living and dying
1:34it’s got a wonderful line in it whatever
1:37you do don’t try and escape from your
1:39pain
1:40but be with it because there is the
1:44attempt to escape from pain is what
1:46creates more pain that’s the reality
1:48with addiction but the question is how
1:51can people who with their pain well only
1:54if they send some compassion on somebody
1:59so as another teacher says only when
2:02compassion is present well people love
2:04themselves see the truth so I think that
2:08people need a compassionate present
2:10which will permit them to experience
2:12their pain without having to run away
2:13from and all the attempts to run away
2:16it’s like another teacher says the
2:18surest way to go to hell is to try to
2:20run away from hell so you’ve got to be
2:24with that pain you just have to be with
2:25it but you have to have some support and
2:28and we live in a society that one way or
2:33the other is always about instant relief
2:35quick satisfaction distraction in other
2:41words we live in a culture that is based
2:42on both economically and psychologically
2:45on not supporting people to be with
2:50themselves so it’s always the quick
2:53getaway so it’s very difficult to deal
2:56with the diction’s in a society but yeah
2:58it is a matter of at some point finding
3:01a way of being with your pain so that
3:03you can actually get to know what it’s
3:04vide all about
3:18you