Author challenges conventions of addiction treatments

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Author challenges conventions of addiction treatments

Dr. Gabor Maté urges health sciences students to take a broader perspective on patient's histories and trauma
Bobbi Nodell

Dr. Gabor Maté, the renowned author on addictions, last week told more than 100 UW health-sciences students that the educational framework they are being taught is woefully inadequate because it separates the mind from the body.

“For all the medical students, how many are taking courses on brain development?”

Only a handful of  med students were in the room. None had an answer.

For Maté, author of “In the Realm of Hungry Ghosts, Close Encounters with Addiction,” how our brains are affected by relationships, stress and trauma – from the earliest of ages -- has everything to do with the development of a host of addictions. Health, he said, is a psychological issue as much as physical issue.

“The medical profession is trauma-phobic,” he told the emerging healthcare professionals, urging them to get a broader perspective on their patients' histories.

He cited study after study showing what happens to babies when their mothers are depressed, what happens when mice are denied endorphins or dopamine, and when people are both depressed and lack emotional support. In short, he said, people with psychological pain are going to get sicker. Some will develop addictions depending on their environment.

Linking addictions to genetics, he said, is a “cop out.”

His best-selling book on addictions was chosen as the common book for all health sciences students in the current year. Maté spent more than 20 years in family practice, including as a palliative care physician and working in Vancouver with patients challenged by hardcore drug addictions, mental illness and HIV. Working with addicts for 12 years made him passionate about developing compassion for people suffering from a range of addictions.

“How many of you have struggled with addictions?” he asked the students.

More than half of the room raised a hand. He asked what the addiction did for them.

“It made me feel in control,” one student said. “It soothed my anxiety,” said another. “It distracted me from my life,” said another.

Who wouldn’t want to feel in control, less anxious and happier? Maté said. “Addiction is an adaptation.”

He talked freely of his own addiction with workaholism and buying classical music, including missing a patient's delivery because he was in a music store.

He said addicts are often using an addiction to get more endorphins or dopamine -- neurochemicals linked to happiness. Some addicts are driven to greatness and find validation from achievements, he said, citing President  Bill Clinton.

Maté talked for an hour with students, then spoke on a panel at the Washington Club, and that evening gave a 90-minute lecture at a packed Kane Hall.

When a mother of a heroin addict challenged Maté that her son had a charmed life and no reason to be hooked on heroin, Maté told her, “Let me have three minutes with him. …You don’t know his inner life.”

Maté’s visit was sponsored by UW Health Sciences Schools and the Health Equity Circle, an interdisciplinary organization of UW  students and community members who believe that health comprises complete physical, mental and social well-being, not merely the absence of disease or infirmity.

Kristen Hansen Day, a second-year medical student and a leader with the Health Equity Circle, said Maté’s perspective pushed students to think beyond genetic determinism as the reason for disease and addiction.

"As he said, you can't separate the mind from the body and you can't separate the person from the environment. His perspective promotes health equity because it compels healthcare providers to look around at the society they live in and advocate for changes that will prevent oppression, incarceration, violence, trauma, neglect -- all the things that affect people's brain development and lead to addiction and disease," she said.

Visit Maté's website for details about his books, TEDx talk and blog. Watch Seattle documentarian Phil Borges' four-minute interview with Maté.