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“A therapist once said to me, “If you face the choice between feeling guilt and resentment, choose the guilt every time.”   It is wisdom I have passed on to many others since.  If a refusal saddles you with guilt, while consent leaves resentment in its wake, opt for the guilt.

Resentment is soul suicide.


-Gabor Maté.  When the Body Says “No”. p.257



Reading Mate’s book called In the Realm of Hungry Ghosts.  I’ve been unable to put this book down as his research and insight into addictions and associated behaviours dovetails snugly with the clientele I work with most days.   Here is a brief excerpt from the chapter titled Trauma, Stress and the Biology of Addiction.

    “Hardcore drug addicts, whose lives invariably began under conditions of severe stress, are all too readily triggered into a stress reaction.  Not only does the stress response easily overwhelm the addict’s already challenged capacity for rational thought when emotionally aroused, but also the hormones of stress “cross-sensitize” with addictive substances.  The more one is present, the more the other is craved.  Addiction is a deeply ingrained response to stress, an attempt to cope with it through self-soothing.  Maladaptive in the long term, it is highly effective in the short term.

    Predictably, stress is a major cause of continued drug dependence.  It increases opiate craving and use, enhances the reward efficacy of drugs and provokes relapse to drug-seeking and drug-taking.  “Exposure to stress is the most powerful and reliable experimental manipulation used to induce reinstatement of alcohol or drug use,” one team of researchers reports.  “Stressful experiences,” another research group points out, “increase the vulnerability of the individual to either develop drug self-administration or relapse”. 

    Stress also diminishes the activity of the dopamine receptors in the emotional circuits of the forebrain, particularly in the nucleus accumbens, where the cravings for drugs increases as the dopamine receptors function decreases.  The research literature has identified three factors that universally lead to stress for human beings: uncertainty, lack of information and lose of control.  To these we may add conflict that the organism is unable to handle and isolation from emotionally supportive relationships.  Animal studies have demonstrated that isolation leads to changes in brain receptors and increased propensity for drug use in infant animals, and in adults reduces the activity of dopamine-dependent nerve cells.  Unlike rats reared together in isolation, rats housed together in stable social groupings resisted cocaine self-administration – in the same way that Bruce Alexander’s tenants in Rat Park were impervious to the charms of heroin.” 

– Dr. Gabor Mate.  In The Realm of Hungry Ghosts p.198


I’m not finished reading the book yet, so I expect to have a few more quotes to share.  What initially drew me in was the stories of how Dr.Maté interacts with his clientele in Vancouver’s Lower East Side and how he can see his own addictions mirrored in the people he helps everyday.


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