On Addiction and Capitalism

Extracts of Dr. Gabor Maté’s radio interview on “Making Contact”, about the origins of addiction:

“What we see is a society that literally makes people sick. 50% of North American adults have a chronic illness: diabetes, high blood pressure, heart disease, cancer or any number of auto-immune illnesses. According to the strict medical model, that is too bad, these people are just unfortunate, because what the medical model does, whether with mental illness or physical illness, it makes two separations:

1) It separates the mind from the body, so that what happens emotionally is not seen to have an impact on our physical health;

2) It separates individuals from their environment, so that we try to understand individuals in separation from their actual lives.

Those separations are socially imposed, they’re culturally defined and scientifically they are completely invalid. (…)

The justice system is criminal. It’s based on the very idea that people are making choices when they become addicts. If they are not making choices, why punish them for it? Another idea is that it is genetics. And a third idea, of course, is that drugs are addictive, which is inherently nonsense. If it was true then anybody who tried a drug should become addicted. But most people who try most drugs don’t become addicted. Most people who try cigarettes don’t become nicotine addicts. Most people who have a drink don’t become alcoholics.

Ex:

If you look at the aboriginal population of North America, these people actually had potentially addictive substances available to them. Not only were they available, they used them. If the substances in themselves had been addictive, and if these people are genetically predisposed, they should have been addicted. But there was no history of addiction prior to the coming of the caucasians. As a matter of fact, the natives used these plants, but what did they use them for? They used them in spiritual ways. They used them to elevate their level of consciousness, whereas the very essence of addiction is to obstruct your level of consciousness, because you don’t want to be aware. So, addiction is an escape from awareness whereas the spiritual use of these substances is the enhancement of awareness.

Now if choice and genetics don’t explain it, all we have to do is look at history. We’d have to actually ask what happened to the native people in this part of the world that drove them into addiction. Now alcohol has been known in the Western world for thousands of years, and there was plenty of drunkenness, even in ancient times, but there is no alcoholism for the most part. Alcoholism came around in the 18th century with the rise of capitalism. You can make a very good case that one of the medical outcomes or one of the health outcomes of capitalism is addiction. In other words, you can’t understand people in isolation from the system in which they live.

First of all, because the biology of human beings is shaped by the psychological and social environment in which they live. I can give you one example. Asthma. It’s well known now, not controversial, that children whose parents are stressed, are more likely to have asthma. Now, ask the average physician what’s the connection and they’d have no idea. And yet, if you ask the physician “how do you treat the asthma?”: with stress hormones — with adrenaline and cortisol, or copies of it. I’m not going to go into the reasons why, but shouldn’t the very fact that we are treating this condition with stress hormones cause us to ask if stress has something to do with it? The emotional levels of stress in the parents disorganize the stress response mechanisms of the child. And when women are stressed during pregnancy, their children have abnormal stress hormone levels and are more likely to use addictive substances to soothe their stresses.

Now, if you look at the parameters of stress, what it is that stresses people? The research shows that what is the most stressful in people is

1) uncertainty, lack of information, loss of control, and

2) lack of opportunity to express yourself.

When Karl Marx talked about freedom, he talked about freedom in 4 senses of the word. Freedom, for him, was:

1) freedom from economic necessities,

2) freedom from the threat to life,

3) freedom from interference of other people, and

4) freedom to express yourself — to be yourself.

That’s freedom. Now what freedom is there in this “free society”, you know, in the free world, the freest society in history? What freedom is there when people are not free of economic worry, where there is tremendous uncertainty and fear lack of control? When people lack control over their lives, they have no freedom. And they’re physiologically stressed. And when they’re physiologically stressed, that’s going to manifest in the form of illness.

Ex:

The California-based “Adverse Childhood Experience Studies” looked at 18,000 people: 80% Caucasian, 10 Hispanic, 10 Afro-American. They looked at what happened to them in childhood and what the adult outcomes were. An adverse childhood experience could be something like physical, sexual, or emotional abuse, the loss of a parent due to a death, being jailed, or rancorous divorce, violence in the family, addiction in the family; for each of these adverse childhood experiences the risk of addiction went up by 2 to 4 fold. So, by the time a male child had had 6 of these experiences, his risk of becoming an injection using substance addict was 4600 greater than that of a male child that had had no such experiences. (…)

Stress is not just an abstract psycho social event. When you’re stressed, your whole body - homeostasis or the internal balanc - is perturbed and fundamentally you have: disturbances in the nervous system; increase in heart-rate, blood pressure, and in the stress hormones cortisol and adrenaline - which play their job in helping you escape, or to fight back in the face of an acute threat. But if you’re chronically stressed they actually create stress, thin your bones, suppress your immune system, give you heart disease, high blood pressure, diabetes– a whole range of heart conditions.

When it comes to addiction, I never had a single female patient who had not been sexually abused as a child. As were many of the men. The heart of addiction is always emotional loss. And the obvious ones were those losses incurred by those adverse childhood experiences identified in this California study. But there is another side to it as well, because if you look at what is happening with this burgeoning number of children being diagnosed with this or that disorder — not all of them were abused, many of them were not, but what is going on?

As D.W. Winnicott, the great British child psychiatrist pointed out, there are two things that can go wrong in childhood:

1) When things happen that shouldn’t happen: that’s the abuse and the trauma, and

2) When things don’t happen that should happen: that’s the presence of non-stressed, non depressed, emotionally attuned available caregivers.

That’s not available in a country with average maternity leave with 6 and a half weeks. That’s not available where kids spend most of the time away from the nurturing adults in their lives and in company of other kids. So that they are forced to look to each other as their attachment figures - the desperation of the kids to always connect. (…)

A study out of Notre Dame University showed that the healthiest environment for child rearing is the hunter gatherer society, hunter gatherer village. Why? Because in the HG village, 3 things happen to the kids that does not happen in our culture anymore for many kids:

1) The kids are always with their parents.

2) When the kids cry, they get picked up. Imagine picking up a kid when he is crying! We tell people when the kid is five or six months old, “don’t pick up, you want them to become independent”. We are missing a point. The way to promote independence is to invite dependence, because people go independent when they feel secure in the world. So you promote independence by inviting dependence.

3) Children are brought up in the context of nurturing adults but not just parents - not just the father, not just the mother, but a clan, a tribe, a community.”

On the indigenous family

Extract from “An intimate history of humanity”, by Theodore Zeldin.