Dr. Gabor Maté on Addiction, Trauma, and the Mind the World Builds in Us

You could argue this alienation isn't new at all. The traces of it go back thousands of years. When the Buddha was teaching, he was already speaking to the very same condition, and you can find it running through the whole of Indian civilization. What's different today is the degree. It has grown sharper, more poisonous. And partly because of that intensity, more people than before are casting around for another way to live.

When Erik asked which psychedelic therapies had proven most useful, Maté first circled back to the work he'd done on addiction. His book In the Realm of Hungry Ghosts makes a simple argument: addiction is not a disease of the brain, it's a reaction to trauma. Everyone he treated in Vancouver's Downtown Eastside had been a wounded child. The women, without exception, had been sexually abused. The men had been beaten, neglected, abandoned. Those are the people who end up as the hardest drug users. That kind of early injury leaves behind a reservoir of emotional pain, and the drugs become a way out of it.

So the question he starts with is never why the addiction. It's why the pain. To answer that, you don't examine someone's genes. You look at the life they've actually lived.

There's a second layer to it, having to do with how the brain itself forms. Neuroscience now accepts that the brain grows through its exchange with the surrounding world. A child raised under trauma simply doesn't receive the inputs that healthy development requires. The circuitry tied to reward, to pleasure, to relief from pain, to connection and to love fails to come online properly. And those are exactly the circuits that drugs and compulsive behaviors manage to quiet for a little while. That's the source of their grip. On the emotional side and on the developmental side both, trauma primes a person for addiction.

Then there's the matter of worldview. The Buddha taught that with our minds we make the world, that the way we perceive things determines the kind of world we end up inhabiting. If I'm convinced everyone is out to get me, I'll carry a gun and reach for it the instant I feel cornered, and it's my own mind manufacturing that reality. But modern psychology adds something the Buddha's formula leaves out. Before the mind makes the world, the world makes the mind.

So ask what sort of mind the world hands to a child who has been hurt. The world that child's mind will take as given is one full of threat, a place where he or she stands alone, where love is absent, where trust has no footing, and where no meaningful God can be found.