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In the Realm of Hungry Ghosts: Close Encounters with Addiction Paperback – Illustrated, January 5, 2010

4.7 4.7 out of 5 stars 5,641 ratings

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A “thought-provoking and powerful” study that reframes everything you’ve been taught about addiction and recovery—from the New York Times–bestselling author of The Myth of Normal (Bruce Perry, author of The Boy Who Was Raised as a Dog).

A world-renowned trauma expert combines real-life stories with cutting-edge research to offer a holistic approach to understanding addiction—its origins, its place in society, and the importance of self-compassion in recovery.


Based on Gabor Maté’s two decades of experience as a medical doctor and his groundbreaking work with people with addiction on Vancouver’s skid row, this #1 international bestseller radically re-envisions a much misunderstood condition by taking a compassionate approach to substance abuse and addiction recovery.
 
In the same vein as Bessel van der Kolk’s
The Body Keeps the Score, In the Realm of Hungry Ghosts traces the root causes of addiction to childhood trauma and examines the pervasiveness of addiction in society. Dr. Maté presents addiction not as a discrete phenomenon confined to an unfortunate or weak-willed few, but as a continuum that runs throughout—and perhaps underpins—our society. It is not a medical “condition” distinct from the lives it affects but rather the result of a complex interplay among personal history, emotional and neurological development, brain chemistry, and the drugs and behaviors of addiction.

Simplifying a wide array of brain and addiction research findings from around the globe, the book avoids glib self-help remedies, instead promoting a thorough and compassionate self-understanding as the first key to healing and wellness.

Dr. Maté argues persuasively against contemporary health, social, and criminal justice policies toward addiction and how they perpetuate the War on Drugs. The mix of personal stories—including the author’s candid discussion of his own “high-status” addictive tendencies—and science with positive solutions makes the book equally useful for lay readers and professionals.
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Editorial Reviews

Amazon.com Review

Amazon.com Exclusive: A Letter from Gabor Maté

Dear Amazon.com readers,

I've written 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. It is both simpler and more complex than that.

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.

The inner city drug addicts I work with are amongst the most abused and rejected people amongst us, but instead of compassion our society treats them with contempt. Instead of understanding and acceptance, we give them punishment and moral disapproval. In doing so, we fail to recognize our own deeply rooted problems and thereby forego an opportunity for healing not only for them, the extreme addicts, but also for ourselves as individuals and as a culture.

My book, in short, is an attempt to bring light to core issues shrouded in darkness. The many positive responses I’ve received encourage me to believe that I’ve succeeded in making a contribution toward that goal.

Best wishes,
Gabor Maté

A Q&A with the Author

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?

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.

Question: What makes your book so beautiful is its multi-layered, personal approach. You don’t rely solely on your patients’ stories, but also dig into your personal experience with addiction and the relevance of Buddha’s teachings. What were some challenges you faced when writing so frankly about your own addiction and your family?

Gabor Maté: In a sense my personal issues are not personal at all--just human. Once I understand something, I want to share it. There is no shame in having flaws--just challenges to keep learning. Many people have told me how much they have appreciated my being open like that--it helps them be open with themselves.

Question: Your book ends on a positive note, with the idea that brains do have the ability to change and grow in adult life and even to heal themselves. Does this undermine your previous assertion that you don’t expect most of your severely addicted patients to get clean?

Gabor Maté: No, there is no contradiction here. The human brain is exquisitely capable of development, a capacity known as neuroplasticity. But, as with all development, the conditions have to be right. My pessimism about my clients’ future is based not on any limitation of their innate potential, but on their dire social, economic and legal situation and on the essential indifference of policy makers--and of society--to their plight. In short, the resources that could go into rehabilitating people are now sunk, instead, into persecuting them and keeping them marginalized. It’s a failure of insight and of compassion. We are simply not living up to our possibilities as a society.

Read an Excerpt from In The Realm of Hungry Ghosts

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.

Review

“I recommend this wonderful book for anyone struggling with the heartache of addiction personally or professionally. Dr. Maté makes the thought-provoking and powerful arguments that human connections heal; and that the poverty of relationships in the modern world contribute to our vulnerability to unhealthy addictions of all manner. His uniquely humane perspective—all too absent from much of the ‘modern’ approach to addictions—should be a part of the training of all therapists, social workers, and physicians.”
—Bruce Perry, MD, PhD, co-author of The Boy Who Was Raised as a Dog

“A riveting account of human cravings, this book needs to get into as many hands as possible. Maté’s resonant, unflinching analysis of addiction today shatters the assumptions underlying our War on Drugs.”
—Norm Stamper, former Seattle Chief of Police and author of Breaking Rank

“In this brilliant and well-documented book, Gabor Maté locates the source of addictions in the trauma of an emotionally empty childhood, making it a relational rather than a medical problem. Such a radical thesis of cause leads to human connection rather than traditional treatment as the cure. This passionate and compassionate book, filled with scientific evidence and personal narratives, should be on the shelf of every person interested in the pervasive challenge of addiction.”
—Harville Hendrix, PhD, author of Getting the Love You Want and cofounder of Imago Relationship Therapy

“Dr. Maté’s latest book is a moving, debate-provoking, and multi-layered look at how addiction arises, the people afflicted with it and why he supports decriminalization of all drugs, including crystal meth.… [
In the Realm of Hungry Ghosts] reads not only as a lively textbook analysis of the physiological and psychological causes of drug addiction, but also as an investigation into his heart and mind.”
The Globe and Mail

“In this comprehensive and courageous book … Maté relates, with compassion and honesty, the poignant stories of severe substance addicts – the hungry ghosts, in Buddhist-realm terminology – whom he treats. And it is the addicts’ stories and the clear logic of the latest science and statistics that Maté shares which convince the reader that society’s attitudes toward, and treatment of, addiction must change. …. This 480-page tome, exhausting in delineating and substantiating its causes, remains a remarkably lyrical, engaging read.”
—In Recovery Magazine

“It’s time to give Maté … the Order of Canada for this erudite and sensitive book about the lives of Downtown Eastside intravenous-drug users, the neurobiology of addiction, and the folly of the war on drugs. It’s compulsively readable and packed with new scientific discoveries about addiction. If you know the parent or sibling of an addict—or the prime minister, for that matter—please give him this book.”
The Georgia Straight

“Gabor Maté’s connections—between the intensely personal and the global, the spiritual and the medical, the psychological and the political—are bold, wise and deeply moral. He is a healer to be cherished and this exciting book arrives at just the right time.”
—Naomi Klein, author of No Logo and The Shock Doctrine

“With unparalleled sympathy for the human condition, Gabor Maté depicts the suffocation of the spirit by addictive urges, and holds up a dark mirror to our society. This is a powerful narrative of the realm of human nature where confused and conflicted emotions underlie our pretensions to rational thought.”
—Dr. Jaak Panksepp, Distinguished Research Professor of Psychobiology, Bowling Green University, Adjunct Professor of Psychiatry, Medical College of Ohio, and author of Affective Neuroscience

“With superb descriptive talents, Gabor Maté takes us into the lives of the emotionally destitute and addicted human beings who are his patients. In this highly readable and penetrating book, he gives us the disturbing truths about the nature of addiction and its roots in people’s early years–truths that are usually concealed by time and protected by shame, secrecy, and social taboo.”
—Vincent Felitti, MD, Clinical Professor of Medicine, University of California, and Co-Principal Investigator, Adverse Childhood Experiences Study

“Dr. Gabor Maté distills the suffering of injection-drug users into moving case histories and reveals how clearly he himself, as a music collector and workaholic physician, fits his own definition of addiction. Informed by the new research on brain chemistry, he proposes sensible drug laws to replace the War on Drugs. Inspired by the evolving spirituality that underlies his life and work, he outlines practical ways of overcoming addiction. This is not a fix-it book to hurry through, but a deep analysis to reflect upon.”
—Dr. Bruce Alexander, Professor Emeritus (Psychology), Simon Fraser University, and author of The Globalization of Addiction

“Maté’s subjects are the living, breathing embodiment of Canada’s grimmest statistics for HIV/AIDS, hepatitis, homelessness, crime, abuse, neglect, overdose, and death. More than merely poor and disenfranchised, they are truly the lowest of the low, reviled by society and demonized by law enforcement. [
In the Realm of Hungry Ghosts] is enormously compelling and Maté is admirably, sometimes inexplicably, empathetic to all who cross his path.”
Toronto Star

“[
In the Realm of Hungry Ghosts] shows an unflinching look at addiction… Dr. Maté makes observations that cut through all the myths and misinterpretations about addicts and how they live… There are many nuggets of wisdom and insight throughout the book. Readers can literally pick up the book and leaf to any chapter and begin reading—and learn something valuable. It’s never boring, never condescending, never too much to read.”
Addiction Treatment Magazine

“[Gabor Maté], a front-line professional combating addiction in Canada, questions the premise that addiction is a choice that people make. If people are diseased or predisposed or making a moral compromises through their own free will, then society is allowed to simplify a complicated issue and avoid any share of the responsibility. For instance, the thesis of this book criticizes the criminal justice’s unscientific assumption that drug addicts are culpable because they choose to do drugs. Does that make sense – people want to, choose to be addicted?”
Addiction Magazine

Product details

  • Publisher ‏ : ‎ North Atlantic Books; Illustrated edition (January 5, 2010)
  • Language ‏ : ‎ English
  • Paperback ‏ : ‎ 536 pages
  • ISBN-10 ‏ : ‎ 155643880X
  • ISBN-13 ‏ : ‎ 978-1556438806
  • Item Weight ‏ : ‎ 1.8 pounds
  • Dimensions ‏ : ‎ 6 x 1.09 x 8.93 inches
  • Customer Reviews:
    4.7 4.7 out of 5 stars 5,641 ratings

About the author

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Gabor Maté
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A celebrated speaker and bestselling author, DR. GABOR MATÉ is highly sought after for his expertise on a range of topics, such as addiction, stress, and childhood development. Dr. Maté has written several bestselling books, including the award-winning In the Realm of Hungry Ghosts: Close Encounters with Addiction; When the Body Says No: The Cost of Hidden Stress; and Scattered Minds: The Origins and Healing of Attention Deficit Disorder. He is also the co-author of Hold On to Your Kids: Why Parents Need to Matter More Than Peers. His works have been published internationally in more than thirty languages.

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4.7 out of 5 stars
5,641 global ratings

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Customers say

Customers find the book insightful and interesting. They describe it as a compelling read that makes sense. Readers praise the author's compassion and understanding of the topic. The writing style is easy to understand and engaging. Overall, customers find the book honest and realistic, providing an objective analysis of addiction.

AI-generated from the text of customer reviews

258 customers mention "Insight"247 positive11 negative

Customers find the book provides insightful information on addiction psychology. They appreciate the author's compassion and understanding of addiction in its various layers, from individual to society. The writing is clear and will not overwhelm readers with medical jargon.

"...stories of hardcore homeless addicted people penned by a man of incredible insight and empathy who worked on the front lines to help them...." Read more

"...It’s eye-opening and challenges common assumptions about addiction and trauma. A must-read for anyone interested in understanding human behavior!" Read more

"...He relates well to his audience and is an incredible influence on my own healing journey!..." Read more

"Eye-Opening and Compassionate Mate, a doctor who's battled his own behavioral addiction, dives deep into the world of addiction...." Read more

230 customers mention "Readability"225 positive5 negative

Customers find the book engaging and well-written. They describe it as a compelling read that is worth their time. Readers mention the case examples read like short stories, offering a powerful and insightful look at human behavior.

"...His work is amazing, his perceptions, experience and openness are inspiring and comforting. Real and raw in a factual way...." Read more

"...It's not a self-help book in the traditional sense, but it offers a powerful and insightful look at the human condition." Read more

"...Amazing book!..." Read more

"...The hallmark of a good book for me is one which I find enlightening and enjoyable AS I'm reading it, as well as how much I keep thinking about the..." Read more

184 customers mention "Enlightenedness"181 positive3 negative

Customers find the book insightful and well-researched. They say it provides a fascinating insight into the workings and reasons behind addiction. The book is thorough and organized, with an innate understanding of the human psyche.

"...Full of raw and powerful stories of hardcore homeless addicted people penned by a man of incredible insight and empathy who worked on the front..." Read more

"...Gabor Maté combines personal stories, scientific insight, and deep compassion to explain the roots of addiction...." Read more

"...His work is amazing, his perceptions, experience and openness are inspiring and comforting. Real and raw in a factual way...." Read more

"...Mate and Darcia Narvaez for bravely making this sound and objective analysis of the topic, as it would certainly be regarded as somewhat offensive..." Read more

110 customers mention "Writing quality"95 positive15 negative

Customers find the book well-written and easy to understand. They appreciate the engaging prose style and feel the author really relates to them. The narrative with characters keeps readers invested and emotionally engaged. Readers find the author's ability to lead them through the needed territory of understanding and clarity helpful.

"...Real and raw in a factual way. He relates well to his audience and is an incredible influence on my own healing journey!..." Read more

"Really interesting book on addiction. Some parts are really easy to read and others are a little tougher, especially when he gets into the..." Read more

"...This book is very well written and well researched...." Read more

"...psychological features of the addiction process, Dr. Mate's prose style is very engaging and quite readable...." Read more

77 customers mention "Compassion"77 positive0 negative

Customers find the book compassionate and heart-wrenching. They say it provides consistent emotional nurturing and is clearly grounded in psychological, medical, and historical fact. The author is described as a compassionate doctor who looks at the whole human being.

"...homeless addicted people penned by a man of incredible insight and empathy who worked on the front lines to help them...." Read more

"...amazing, his perceptions, experience and openness are inspiring and comforting. Real and raw in a factual way...." Read more

"Eye-Opening and Compassionate Mate, a doctor who's battled his own behavioral addiction, dives deep into the world of addiction...." Read more

"...I love Mate’s compassion met with truth." Read more

19 customers mention "Authenticity"19 positive0 negative

Customers appreciate the book's authenticity. They find it honest and relatable, providing a realistic yet compassionate view of people affected by mental health issues. The author is described as humble and down-to-earth.

"...Real and raw in a factual way. He relates well to his audience and is an incredible influence on my own healing journey!..." Read more

"Dr. Gabor Mate wrote this amazing, eye opening, brutally honest, and heart rending book about his work, his findings, his concerns, and his personal..." Read more

"Great book written by a man of enormous humility and authenticity...." Read more

"...This one ranks as being one of the best. Dr. Mate has a realistic but compassionate view of people who are addicts...." Read more

19 customers mention "Brain physiology"19 positive0 negative

Customers find the book helpful for understanding the complex brain physiology and neurological dynamics of addiction. They appreciate the case studies, brain chemical responses, and latest science pertaining to brain and psychological development. The author does a good job explaining the neuro-mechanisms, but doesn't go into very much detail.

"...This book also offers a deep dive into the physiological and emotional causes and mechanisms of addiction." Read more

"...The author does a good job explaining the neuro-mechanisms, but does not go into very much detail, which is understandable since the book is..." Read more

"...deal of technical information, particularly in its excellent explanation of the brain chemistry and psychological features of the addiction process,..." Read more

"...me deep insight into the heart of homeless addicts and those with mental health issues...." Read more

22 customers mention "Emotional content"15 positive7 negative

Customers have different views on the emotional content of the book. Some find it moving and educational, while others find it heartbreaking and depressing. The real-life stories are tragic and wasteful of potential.

"...It delves into trauma and the phrase “hungry ghosts”...." Read more

"...Profoundly moving and helpful. I purchased two copies so I could mark up and tag one and keep the other clean." Read more

"...The stories are, well...cliche because like most cliche's so true...heartbreaking...." Read more

"...research and the social implications involved is enlightening and heartbreaking...." Read more

A very insightful book.
5 out of 5 stars
A very insightful book.
I ordered this book because I have several friends and family members whom I've watched battle addiction. It has impacted my life to see addiction take control of theses loved ones lives; in addition, some paying the ultimate cost, their life itself. Addiction not only impacts the addict themselves, but all who's lives touch theirs.This book brings to light a new way for me to view and think of addicts. It takes a new look at how we view addiction wrongly, as a medical problem and addresses some of the why's one may become an addict, ranging from early childhood emptiness, abuse, and so on. He backs up his claims with scientific evidence, research and the personal narratives of many addicts. I found the book to be a refreshing take on addiction and one that is quite insightful. It is well written, and was able to capture my full attention. I'd recommend it to all, but especially those who battle addiction, of any kind, whether it be drugs, alcohol, sex, work, wealth and so on; in addition, the many whom are casualties of loving and addict, be it spouse, child, family or friends.
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Top reviews from the United States

  • Reviewed in the United States on November 26, 2024
    This is a must read for anyone in addiction recovery. Full of raw and powerful stories of hardcore homeless addicted people penned by a man of incredible insight and empathy who worked on the front lines to help them.

    This book also offers a deep dive into the physiological and emotional causes and mechanisms of addiction.
    4 people found this helpful
    Report
  • Reviewed in the United States on December 27, 2024
    I bought this book for someone studying psychology, and it’s an excellent choice. Gabor Maté combines personal stories, scientific insight, and deep compassion to explain the roots of addiction. It’s eye-opening and challenges common assumptions about addiction and trauma. A must-read for anyone interested in understanding human behavior!
  • Reviewed in the United States on February 21, 2024
    I’ve read all Dr. Mate’s books, listened to hours of interviews/podcasts. His work is amazing, his perceptions, experience and openness are inspiring and comforting. Real and raw in a factual way. He relates well to his audience and is an incredible influence on my own healing journey! I have purchased this book for others-I even gave my first copy away halfway through reading it because I thought it would help that person who needed it more than me at that time!! Incredible man, incredible work, incredible writings! I’m planning to buy multiple copies of his books and donate them to libraries and schools, those little community library stands u see in some places because his books changed my life for the better just by opening my mind to things and confirming other things I had always intuitively known.
    26 people found this helpful
    Report
  • Reviewed in the United States on March 14, 2024
    Eye-Opening and Compassionate
    Mate, a doctor who's battled his own behavioral addiction, dives deep into the world of addiction. He gets it, man. He truly understands the addicts he treats, many of them from Vancouver's rough Eastside. Unlike some experts who toss around statistics, Mate tells their stories. Heartbreaking stories, of lives ravaged by addiction, often rooted in childhood trauma.
    Not a Blame Game
    This book isn't about pointing fingers. Mate argues that addiction is a sociological and psychological problem, not a moral failing. We, as a society, are quick to demonize addicts and throw them in prison, a system Mate sees as draconian and ineffective. He advocates for treatment and compassion, not punishment.
    Science and Authenticity
    Mate backs up his arguments with science, studies of the brain and how addiction hijacks it. But this book is more than just facts and figures. It's about the human experience. Mate talks about the authenticity he finds in the addict community, a stark contrast to the phoniness of media and some politicians.
    A Call to Action
    "In the Realm of Hungry Ghosts" isn't just about addicts, it's about all of us. It challenges us to be more genuine, to look at the root causes of problems, and to build a more compassionate society. It's a wake-up call, and frankly, we could all use a good jolt sometimes.

    The book isn't without flaws. Some parts are a bit repetitive, and the focus on the hardcore addicts can feel overwhelming at times. But those are minor quibbles.

    This book is a must-read for anyone who wants to understand addiction, including those struggling with it themselves. It's not a self-help book in the traditional sense, but it offers a powerful and insightful look at the human condition.
    18 people found this helpful
    Report
  • Reviewed in the United States on January 31, 2013
    Really interesting book on addiction. Some parts are really easy to read and others are a little tougher, especially when he gets into the neurotransmitters and circuits in the brain. I have only read half so far, as I needed some time to process. I liked that he was able to correlate his own "seemingly innocent addiction" to that of hard core addiction. I have worked with many therapists over the years and everything that Mate writes about has been discussed in various forms and I have been working with someone on the Dopamine, Seratonin thing for years and it helps keep me balanced. Although I am not a typical drug or alcohol addict I do love to gamble, but am able to stay away for long periods, but I would say he is right on and when I compared his opinions to people in my life that suffer hard core addiction.....it all makes more sense! Amazing book! I gave it four only because of the one section that has been difficult to follow and is a little more medical than I could stay engaged with!
    5 people found this helpful
    Report

Top reviews from other countries

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  • Jose Jimenez
    5.0 out of 5 stars Insightful
    Reviewed in Mexico on October 23, 2024
    Just an amazing book
  • Renate Horst
    5.0 out of 5 stars Bestes buch für diese problematik
    Reviewed in Germany on January 2, 2025
    Nicht leicht zu lesen aber sehr informativ
  • Andrea S.
    5.0 out of 5 stars Libro dai contenuti ottimi
    Reviewed in Italy on December 28, 2024
    Libro che consiglio di leggere a tutti, ti fa conoscere e capire le dipendenze
  • Cundrie
    5.0 out of 5 stars Comprehensive
    Reviewed in the United Kingdom on July 24, 2024
    Explaining the physical effects on the developing infant brain of good mothering, the author describes the damage caused by insufficient emotional closeness between infant and mother (or main caregiver). Although reactions to poor parenting vary, the baby’s experience of sensitive maternal attunement is shown to be an essential part of forming a mind. The absence or not-enoughness of this leaves a ‘black hole’. It is against this backdrop that the addictions are introduced. A substance or an addictive set of actions can be an unconsciously chosen means of stopping up the ‘hole’ in the archaic self. The author emphasises that there is a continuum of addictive behaviours, confessing to some of his own, and although the vignettes of his work with severely addicted patients may shock, the readers are encouraged to see that the tendency towards addiction is a tragic part of human nature. This book is a masterpiece of expertise and compassion.
  • Vetri
    5.0 out of 5 stars Drug addicts are human too
    Reviewed in India on July 6, 2023
    The psychology behind the process of why people fall prey to addiction and how to care for them without judging their drug habits is well portrayed by Dr Gabor ..great book