"I wrote "In The Realm of Hungry Ghosts" because I see addiction as one of the most misunderstood phenomena in our society. People -- including many people who should know better, such as doctors and policy makers -- believe it to be a matter of individual choice or, at best, a medical disease.Question: The title of your book has its origins in the Buddhist Wheel of Life. In the Hungry Ghost Realm, people feel empty and seek solace from the outside, from sources that can never nourish. In what ways is our culture trapped in this realm? What can society learn from drug addicts who take the feelings of lack that everyone has, to the extreme?
Addiction, or the capacity to become addicted, is very close to the core of the human experience. That is why almost anything can become addictive, from seemingly healthy activities such as eating or exercising to abusing drugs intended for healing. The issue is not the external target but our internal relationship to it.
Addictions, for the most part, develop in a compulsive attempt to ease one's pain or distress in the world. Given the amount of pain and dissatisfaction that human life engenders, many of us are driven to find solace in external things. The more we suffer, and the earlier in life we suffer, the more we are prone to become addicted. I believe there is one addiction process, whether it manifests in the lethal substance dependencies of my Downtown Eastside patients, the frantic self-soothing of overeaters or shopaholics, the obsessions of gamblers, sexaholics and compulsive internet users, or in the socially acceptable and even admired behaviors of the workaholic.
Drug addicts are often dismissed and discounted as unworthy of empathy and respect. In telling their stories my intent is to help their voices to be heard and to shed light on the origins and nature of their ill-fated struggle to overcome suffering through substance use. Both in their flaws and their virtues they share much in common with the society that ostracizes them. If they have chosen a path to nowhere, they still have much to teach the rest of us. In the dark mirror of their lives we can trace outlines of our own."
Gabor Maté: "Much of our culture and our economy are based on exploiting people's sense of emptiness and inadequacy, of not being enough as we are. We have the belief that if we do this or acquire that, if we achieve this or attain that, we'll be satisfied. This sense of lack and this belief feed many addictive behaviors, from shopping to eating to workaholism. In many respects we behave in a driven fashion that differs only in degree from the desperation of the drug addict."
Very interesting insights, I thought, but hey -- I'm not an addict -- ok, maybe a caffeine addict. Several days past and I knew deep within myself there was personal denial, maybe even self-deception. Then a paper by Irving Biederman came to my attention, and it all clicked -- yes, I am a knowledge addict.
So what's up with that? Let's break it down a bit:
"The pleasure of grasping a new concept triggers a biochemical cascade that rewards the brain with a shot of natural opium-like substances. The brain's craving for a fix motivates humans to maximize the rate at which they absorb knowledge. Biederman hypothesizes that knowledge addiction has strong evolutionary value because mate selection correlates closely with perceived intelligence. Only more pressing material needs, such as hunger, can suspend the quest for knowledge. The same mechanism is involved in the aesthetic experience providing a neurological explanation for the pleasure we derive from art. Biederman's theory holds that the greater the neural activity in the areas rich in opioid receptors, the greater the pleasure; however, repeated viewing of an attractive image lessened both the rating of pleasure and the activity in the opioid-rich areas. The quest for knowledge can never be sated -- as long as mu-opioid receptors remain unbound in the human brain."So there are biochemical incentives to seek out novel experiences -- until we get "satisfaction," but what does that mean? Some believe it's the interaction of dopamine, the hormone secreted in the brain in anticipation of pleasure, and cortisol, the chemical released when we are under stress [e.g. Gregory Berns]. Biederman briefly mentions the role of neurotransmitter GABA, gamma-aminobutyric acid (which one can buy at a health food store).
Clarity for the moment thus boils down to: opiates, aesthetic pleasures, and neuroscience. [The link herein goes to a PDF of: Irving Biederman & E.A. Vessel, Perceptual Pleasure and the Brain, American Scientist (2006), 94:249-255]
