The Hungarian-born Canadian physician Gabor Maté (born 1944) holds that addiction is not a choice or a disease of the brain alone, but an attempt to soothe pain, and that the pain usually goes back to trauma, often in childhood. His best-known question is not “Why the addiction?” but “Why the pain?”, and in The Myth of Normal (2022) he says that much of what modern society treats as normal is itself a source of trauma and illness. Therapeutic Shamanism reaches a similar place by its own route, since addiction always involves soul-lossSoul-loss. The sending-away of parts of the self in order to survive: through shock or trauma, or (the chief modern cause) exiling our own parts to fit in. With Power-loss, one of the two root causes of shamanic illness. Read the full answer and Power-lossPower-loss. Disconnection from nature, the web of life and our place in it: like being unplugged from the national grid. One of the two root causes of shamanic illness, healed by reconnection (not by soul retrieval), beginning with the Power Animal bond. Read the full answer, and the epidemic of addiction is a product of Taker cultureTaker culture. Daniel Quinn’s term for the totalitarian agricultural, owning, surplus-driven way of life that takes everything and leaves nothing, and calls itself ‘civilisation’. Cultural, not innate, which is why it can be changed. Used interchangeably with ‘Fallen culture’. Read the full answer.
Who is Gabor Maté? #
A physician and writer, born in January 1944 into a Jewish family in Budapest during the Nazi occupation of Hungary, a beginning he has written about as shaping his life and work. His family moved to Canada in 1956. He qualified in medicine at the University of British Columbia in 1977, ran a family practice in East Vancouver for over twenty years, coordinated the palliative care unit of a Vancouver hospital, and for twelve years was staff physician to the Portland Hotel Society, working with people in Vancouver’s Downtown Eastside living with addiction, mental illness and long-term conditions such as HIV. There he supported harm reduction, such as needle exchange and supervised injection.1
His books include Scattered Minds (1999), on attention deficit disorder; When the Body Says No (2003), on hidden stress and illness; Hold On to Your Kids (2004, with the psychologist Gordon Neufeld); In the Realm of Hungry Ghosts (2008), on addiction; and The Myth of Normal (2022, with his son Daniel Maté).
What does Maté say addiction is? #
Any behaviour, with a substance or without one, that a person craves and turns to for short-term relief, that brings long-term harm, and that they cannot give up. On that definition, drugs and alcohol are only part of the picture; gambling, food, sex, work, shopping and social media can all become addictions. What they share, he says, is that they are “attempts to regulate our internal emotional states”, ways of managing feelings that would otherwise be unbearable.2 So the useful question is not “Why this addiction?” but “Why this pain?”3
From his years in Vancouver he draws a strong conclusion, that “every addicted person was traumatized”. Early stress, he says, shapes the developing brain circuits that govern impulse, stress and emotional regulation, which is why people hurt early in life are more vulnerable later.2 He is critical of the ‘war on drugs’, which in his view punishes people for their pain and makes their addiction worse.
What does he mean by trauma? #
Not the event itself, but what it leaves inside us. In his foreword to a book by the trauma therapist Peter Levine, he writes that trauma is not what happens to us but “what we hold inside in the absence of an empathetic witness”, hurt that had no one to see it, share it and help it move through.4 On that view, what turns a hurt into trauma is not only how bad the event was, but whether anyone was there to see it and help hold it.
In The Myth of Normal, written with his son Daniel, he widens the lens from the individual to the culture. Much of what Western societies accept as normal, he says, is itself a source of the stress, trauma and illness so many people live with. See What is trauma, and how does Therapeutic Shamanism understand it?
How does Maté’s view relate to Therapeutic Shamanism? #
They meet on the root of addiction. In Therapeutic Shamanism, addictions and obsessions are possessions, and there are usually several different issues at play. An addiction will always involve some soul-loss and Power-loss, may involve wounded parts of the selfParts of the self. There are four parts of the self, the realm-corresponding members of the Inner Tribe: the Body and the middle-world self (both of the middle-world), the Soul (of the Lower-World) and the Spirit (of the Upper-World). The Aware Self, also called the Witness, is not a fifth part but a capacity: the awareness that can watch all four, with compassion and equanimity. Read the full answer, such as parts medicating in order to cope with anxiety or depression and the unresolved issues behind them, and may include inherited, ancestral issues.5 That is close to Maté’s pain beneath the habit, and to his wide definition, since smartphones, television, video games, gambling and much else can come to possess us too. See Is addiction a kind of possession?
They meet on the culture as well. Addiction was not an issue in hunter-gatherer tribes, at least not until their way of life began to fall apart through contact with Taker culture. Today addiction is so pervasive that we hardly notice it, and it is intrinsic to Taker culture, the desire to take everything and leave nothing; the epidemic around us is the result of our domesticationDomestication. The process by which, in domesticating other species, we domesticated ourselves. When dated precisely, Domestication begins with the Neolithic era, before the Fall proper, which begins with the first city-state cultures around 4000 BCE. What rewilding works to undo. More about this and the FallThe Fall. The catastrophe at the root of the whole diagnosis: the shift from animist, egalitarian hunter-gatherer life to owning, agricultural Taker culture. In domesticating other species we domesticated ourselves, cutting ourselves off from Mother Earth (Power-loss) and from parts of our own nature (soul-loss). When dated precisely, the Fall begins with the first city-state cultures, around 4000 BCE (Domestication begins earlier, with the Neolithic). A sickness, not our true nature. ‘Fallen culture’ is used interchangeably with Taker culture; the Great Rupture is a looser alternate name. Read the full answer.5 In the same way, like the frog in the saucepan, we accept as normal things that are not normal at all, which is very much the argument of The Myth of Normal.6 See What are Taker and Leaver cultures? and What is collective trauma?
And they meet on trauma. We all have trauma; it is part and parcel of the middle-worldMiddle-world. Ordinary physical reality together with its energetic layers: the realm of individuality, separation and mixed intentions, and the only realm where harm is possible. “If there is a hell, then it is the middle-world.” Read the full answer, and what matters is what we do with it. From a shamanic point of view, much of what we call trauma is soul loss. When something is more than we can bear, a part of us leaves and often stays stuck in the time and place where it happened. See What is soul-loss?
Where does Therapeutic Shamanism see more than Maté does? #
In the other-than-human side of addiction. Maté’s account is medical, psychological and social. Therapeutic Shamanism adds that substances such as alcohol, tobacco and opium have strong spirits of their own, great teacher spirits that were used in their original cultures with respect, never recreationally. The problem comes when someone riddled with soul-loss and Power-loss, their energy body weakened and full of holes, meets such a spirit without understanding its power and is taken over by it.7 So the healing looks to the realms as well as to the person’s history, to soul retrieval, Power retrieval and, where needed, depossessionDe-possession. The healing for a full entity takeover: persuading or compelling the possessing entity out, then disposing of it, and always addressing the underlying soul-loss and Power-loss that let it in. More about this, done with respect for the spirit of the substance, alongside whatever medical and psychological help the person needs. See What is possession, and what is de-possession?
Is Maté’s view disputed? #
Yes. Several psychologists and a psychiatrist think he leans too heavily on trauma. The psychologist Stanton Peele disagrees with tracing every addiction back to childhood trauma and calls Maté’s view “a reductionist vision of addiction”. The psychologist Nick Haslam, of the University of Melbourne, finds his focus on trauma as the single main cause of ill health unbalanced, and the psychologist James Coyne, of the University of Pennsylvania, has said that Maté urges people to abandon evidence-based solutions to health and social problems, and the psychiatrist Vincenzo Di Nicola, of the University of Montreal, that many of his views are well-trodden ground and some of his work is not evidence-based.8
On the place of biology, Maté answers that he does not deny it but sets it in context. He holds that “There is no evidence” that genes can cause or maintain addictions, and that the environment, especially early relationships, regulates how genes are expressed, which is the study of epigenetics.9 He describes his approach as biopsychosocial, giving weight to stress, relationships and social conditions as well as to the brain. That reply speaks to the place of genes; it does not take up Peele’s charge of reductionism or Coyne’s about evidence-based treatment.
Can shamanic work help with addiction alongside treatment? #
Yes, and alongside, not instead of. Shamanic work for oneself can be of great help with depression, anxiety and addictions, as long as a person still has a reasonably good grip on ordinary reality, and shamanism can almost always safely be used alongside medical treatments, because shamans are generally pragmatists who understand the need for those too.10 Maté, for his part, worked for years inside the medical system, prescribing methadone and supporting harm reduction, whilst arguing that the deeper healing lies in attending to the pain beneath the addiction. See Is shamanic work safe if I have a mental health condition?
