Brain Development & Addiction with Gabor Mate

– gobbler Matt hey I work in the downtown east side of Vancouver as a doctor I've been in family practice before then for 20 years of knocked around the medical world doing various duties and engagements as I as my interest takes me and for the last 10 years I've worked at a place called the Portland hotel which is a domicile it's a place where a lot of people live who otherwise would be living in the street for the last several months I've worked at on-site which is the detox facility associated with insite the supervised the injection site so thank you all for honoring me by coming out to hear me and I just offer up the prayer or that the speaking that we do with one another this afternoon may benefit all of humanity and help ease the pain and suffering in this world of which there is a lot and it and a disproportionate largely large share of that pain and suffering falls upon Aboriginal peoples around the world whether in Latin America whether in Australia whether in the Middle East Africa or whether in North America much of that surfing is rooted in addiction which is my subject this afternoon now there's nothing about Aboriginal peoples that make them makes them more prone to addiction there's nothing intrinsic there's nothing innate there's nothing in their nature or their character that drives them to addiction so it's got nothing to do with any weakness or flaw or predisposition from the inside it really has to do with what are the conditions in the world that feed and drive and promote addiction and these patients of mine die young they get diseases from the HIV they get infections of their their heart valves of their spines they get crippled they commit suicide they're killed by violently they overdose to get cancer they die of liver disease and few of them live into their 50s and the question is why why do keep why do people keep doing these terribly damaging things to themselves which has such negative consequences in our lives where they lose their health they lose their lives their families their children their dignity their bodies their teeth their their their their earthly possessions and still they persist and it's not possible to answer that question it's not possible to answer that question if we see it as weakness of will if you see it as moral failure if we see that some kind of a bad decision that people make it's much deeper than that in fact the question really have to ask is if people are using drugs despite the negative consequences what does the drug do for them what makes the drug so important in their lives it must do something it must do something very essential otherwise they wouldn't do it so if we're going to understand addiction we first have to understand what is it that the person gets out of it it's clear for all of us to see what the damage is but what is the good what is the short term benefit that the addict is looking for well to answer that question just look at the drugs okay so there's one major class of drugs that you all know it's called they're called the opiates the opiates are drugs like heroin and morphine or which comes from a poppy plant and Asian poppy or they're man-made analogues like percocet and oxycontin and so on these are all opiates or whatever piates why do we use them in medicine what are they okay painkillers is the main thing maybe some is pink but the donors in the sense that they also they not only kill physical pain they also kill emotional pain they also kill emotional pain it turns out that if you look at the brain scan of human beings when they're feeling emotional pain the same part of the brain lights up as when they're feeling physical pain so whether I call you a terrible name that really hurts you and insult you or whether I cut you with a knife the same part of the brain registers it on the emotional level so the emotional suffering associated with physical pain is the same as the emotional suffering associated with psychological pain and it's felt in the same part of the brain and that's where the opiates work so it's about the relief of pain so the first question and dealing with addiction is always not why the addiction but why the pain but why the pain I don't have a single female patient in a Downtown Eastside who was not sexually abused as a child not one not even by accident I've talked to hundreds many the men were abused many sexually if not sexually then physically in other ways or emotionally abandoned and neglected and hurt one guy told me that native guy as well actually or matey is a meaty man his mother had a unique way of babysitting him she was a single mom and had her own addiction and drinking problems so she went out to the bars to meet guys she was in her early 20s and the babysitter was the dryer when this kid was three years old the mom would stick him in the dryer put a heavy object on the top so he couldn't climb out and that was her way of keeping him safe while she was out and that's not untypical so this is what people go out with so that's why that's oh why the pain then the reason drugs work in the human brain is because we have receptors for them not pirate receptors are here's a cell here's a brain cell okay this is my primitive drawing of a brain cell with the nucleus here now here's the drug okay it looks like this the molecule of the drug coming in to the cell it works only if the cell has a receptor that can receive it but another question is why do we have receptors for molecules or drugs that come from poppies we're not poppies after all well mummies and poppies are going well we don't have receptors for them what we have receptors for are our own substances that look just like it okay I mean there's in our brains we have opiates we have our own natural opiates and those are called endorphins and or fen endorphins are a body's endogenous or inner or naturally-occurring morphine like substances so the reason the opiates work because we have endorphins which look just like the opiates and so that's why we have these receptors but why do we have opiates in our bodies well yes pain relief we have to have something otherwise they would hurt too much I mean if I went like this if I had no endorphins I'd have way too much pain every time I touched anything so there has to be something to kill the pain to some degree so up opiates are painkillers they're also necessary for feelings of joy and an elation and and reward so when you do something thrilling and you'll and you're just overjoyed what's happening is you're having a lot of endorphins flooding your brain so people have Monday go bungee jumping and you measure their endorphin levels the higher the endorphin level the more elated they are after they go bungee jumping which by the way should tell you something about the nature of addiction because addiction is not just about drugs is it you can addicted to all kinds of things a lot of people get addicted to dangerous why that's what they get their endorphins so we have endorphins as painkillers we have endorphins as to give us joy and elation they also work on our immune system they do a lot of things but the most important thing I do and here's the key to all addiction this is the least known function of the endorphins our own natural opiates is they connect infant to parent they're the love chemicals when infant when that little baby is looking into your eyes is it he or she he he's got endorphins going in his brains so to you which is why you enjoyed so much if it in have endorphins it wouldn't enjoy a baby's very much let's face it parents have to put it with a lot of crap don't they you know literally and one of the things that makes it enjoyable is that it we have these endorphins floating in our brains and so endorphins are necessary for that loving connection they've been called love chemicals they've been called love molecules of love is what they've been called you can have mice in a laboratory infant mice and you can knock out their and orphan receptors you can actually breed them genetically so that they don't have these things so now the not the end of the opiates have nowhere to act when these animals in the laboratory are born with the endorphins receptors knocked out they will not be upset when it's separated from the mother now what would that mean for them in the wild their death their death because the mother's loving nurturing presence is required to protect the child to to feed the child and also to bring up the child with that if the child is not looking to the mom because they're known their friends there's no love for them up from the child to the mother therefore no connection therefore no life so what I'm saying is that the opiates and the opiate addiction arises in the most essential brain circuit that we human beings have which is pain relief reward and love and connection which is the essential Dyna human life now when you ask why is it so powerful well because that's where it arises in that most essential brain circuit and I'll talk in a little while but why it arises there but the point is that's why it's so powerful now another chemical that's involved in addiction it's called dopamine and I just gave you enough science here to understand the basics dopamine is another brain chemical it's necessary for human life also why is it necessary to make us feel curious about something to give us a sense of vitality and excitement to make us explore something when you're exploring a novel environment like when you're checking something out for the first time and you're curious when you're checking out sorts of food when you're seeking a sexual partner you've got dopamine flowing in your brain without dopamine we're like zombies we're not interested in anything we're not curious about anything we won't explore anything in other words we're not human beings I'm mentioning dopamine because all the drugs of abuse including the opiates release dopamine in the brain as well but the stimulants particularly cocaine and nicotine and caffeine and crystal meth release dopamine in a major way now if you're seeking food or the expectation of being rewarded by food that'll get your dopamine circuits it'll give you a 50% increase in your dopamine levels so that's pretty good that's why you look for food you know you're hungry but also excited right when you're seeking a sexual partner or about to receive a sexual reward your dopamine level goes up 100% so doubles now a shot of cocaine will increase your dopamine levels by 300% I shot a crystal meth will increase your dopamine level by 1,200 percent so you see how powerful a drug crystal meth is by the way I will tell you that the crystal even though crystal meth is a very powerful drug these are all power drugs they don't cause the addiction the drugs are not addictive in themselves I mean just like a pack of cards you can look at a pack of cards and not become a gambler right you need food and not become a food addict you can somebody can open up a store but you don't necessarily to become shopping at it you can try crystal meth and most people who try it don't become addicted to it I'm not saying it's a good thing to try what I am saying is that the drug itself doesn't cause the addiction something else has to be there as well and that's something else is what I'll be telling you now in response to your question sorry when you're getting shots of dopamine from the outside from the cocaine then your brain says there's too much here and it reduces the number of dopamine receptors so these dopamine receptors on which the cocaine acts the dopamine acts if you have too much dopamine here the brain says oh is too much for me and it will kill off some of its own receptors now when you stop the cocaine you're not getting it from the outside and your body stop making it from the inside it takes a while for the brain to regenerate itself sometimes it takes a long time and while you why that's going on while it's regenerating you're irritable and you're tired and you're depressed and you're going through withdrawal and nobody likes being around you very much because you're pretty miserable person because you don't even have dopamine and you're unable to vend orphans so that's the second circuit involved in addiction now you have the law of reward pain relief chemical now you have the incentive motivation curiosity exploration chemical vitality chemical where addiction arises and then very quickly I'll tell you about two more brain circuits that don't work in addiction and actually how do we know these things because you could do a brain scan of people you do a scan a special kind of imaging with x-ray technology of somebody's brain these parts don't work and you can see that they don't work now two more circuits don't work in addiction one of them somebody mentioned has to do with stress the adrenaline circuitry now adrenal n is a stress hormone and we need that if I was to attack you know you'd have to be able to fight back and for that your body would create a lot of adrenaline that would help you escape or to fight back the flight-or-fight hormones adrenaline being one of them when you talk to addicts and ask them why you do drugs what is it that does for you one of the things it'll say is it helps me not be so stressed now in other words the addict doesn't know how to be not to be stressed I get stressed or easily the person who's addicted gets stressed for easily or the person who gets stressed easily is the more likely to be an addict because they're more likely to use the drugs to soothe their stress because drugs are stress relievers in a short term I mean as you say if you're upset right now if I gave you a shot of morphine you'd be pretty happy pretty quickly they relieve the stress the stress relievers but for the addict they don't have enough capacity to regulate their stress so they have to go to these external chemicals so that's the third circuit that doesn't work in addiction and the fourth one is what's called impulse control now impulses are urges and motivations to behave or to do something I might have the urge to in a store I might have the urge to grab an object that stick it into my pocket that's an impulse I might have the urge to go up to somebody attractive of the opposite sex and say something totally inappropriate or maybe all of these impulses but there's something in the brain that says ah ah you shouldn't do this not a good idea you might have the urge to do a injection of heroin something up here is supposed to say uh-uh not a good idea the part the part of my brain that that is supposed to control our impulses is called the gray matter or the cortex of the brain and it's supposed to say no it's okay for me to have all kinds of desires it's okay for me to want to kill all of you that's perfectly okay I might be hungry or cheesed off about something whose traffic was really bad and if you like killing everybody nothing wrong with that as long as there's something up here that says not a good idea these are human beings they don't deserve to be killed just because you having a bad day maybe they have their own problems you know in other words I'm exaggerating but impulse control is what stops us from doing what we ought not to do the addict doesn't have impulse control when he or she sees the drug sees the needle when the gambling addict is in the casino or even thinks about the casino when a shopping addict thinks about the store there's nothing there to stop it people always talking about free will human beings don't have nearly as much free will as we think they do because for the most part were controlled by mechanisms deep in our brains that were no different conscious that we think we have free will the real problem addiction is not the free will as somebody said it's the free won't the addict is not able to say no the part of the brain that is supposed to say no doesn't function the brain of the addict how do we know that again you look at brain scans there's no free want up there we should be saying no but that part of brain doesn't function so I'll just quickly summarize four essential brain circuits the opiates which is a love connection reward pain relief dopamine which is incentive motivation vitality curiosity a sense of being alive impulse control and stress control these are the circuits that don't work in the addict and the people in whom these circuits don't work they're the ones to become addicts but why don't they work why don't they work in some people when the American army was cemented we went to Vietnam 20% of them came back as heroin addicts 20% of the GIS came back from Vietnam were heroin addicts a few years later only 1% was so 95 percent of them got over their addiction which is unbelievable I mean if if 5% of my patients in a Downtown Eastside overcame their addiction if we think I was a genius of some kind and here 95 percent overcame their addiction in other words the drugs by themselves can't cause the addiction because if they did they all would have stayed addicts because there were addicts there's something else must be going on so why are some people more prone what's wrong with these circuits in their brains and here's whether to look at life experience now most doctors and most experts were right about addiction they say it's a genetic disorder you inherit it well that's a nice explanation first of all it's simple secondly it makes sense because in a lot of families if one parent is an alcoholic chances are the kids will be too so it's runs in family so it looks like it's genetic looks like we inherited genetically thirdly the biggest advantage of that explanation though even though it has no scientific basis is that it explains everything without having to look at people's actual lives see if first nations people were addicted to alcohol and these other drugs because of something genetic now we don't have to get history now what happened in this country and what continues to happen in this country is irrelevant it's just all in the genes too bad it's nature's fault but we can't help it but what if it's not like that what if it's actually what happens in people's lives that make them addicted now that's a different story then you have to look at the whole society how are we treating each other what kind of system do we live in how do we look after our children and these are questions of course are much more painful than simply saying it's the matter of genetics well I'm here to tell you it's got Vale elude genetics at all why because these all have to do with the brain and how does the brain develop how does it even been actually developed where it turns out and this is not I'm telling you anything you I mean it's you may have heard us may have not I've heard it but I don't make it up this is just brain science the way we know it to be an absolute fact it's not even controversial anymore that the way that the human brain develops is an interaction with the environment it's shaped by the iron that baby hold is that baby there how many seven months see in the first year of life there are times in that kid's life when every second million connections are being made I mean maybe every second a million connections are being made at times in in in a kid's life the human brain is the only one that continues to grow in the same rate outside the uterus as it did inside the womb and we're born human beings are born in very premature brains we're premature we're born were all premature when were born doesn't matter when were born at nine months we'll still premature compared to a horse a horse can run on the first day of life right a human being can't manage that neurological control the balance the visual acuity the muscle strength the coordination for two years so the horse is two years ahead of us in terms of benevelon so the horse developed in the mother's womb in advance two years in advance of the human being and why is that it's because as human beings evolved began to have larger and larger heads and we began to have larger and larger heads so that we can use the hands so that they could tell the hand what to do because the hand is afraid I mean compare the hand to the hoof of a horse this is far more sophisticated this is far more complex the brain has to have a lot of circuits and and connections and systems to make this work I mean if you try to build a computer to make the pot the hoof work and if you try to make a computer to make this thing work imagine the circuitry has to be much more complex much larger and that's why you have these large brains so large brains and at the same time we began to walk on two legs so we can use the hands as hands so walk on two legs now the pelvis has to narrow so now we have a narrower pelvis large head narrow pelvis large head large head narrow pelvis you can't wait any longer inside otherwise you never get born if that kid wait another couple of months he'd be inside forever you know unless there was a cesarean section or something because the head is already lodged for the body so we had to be born prematurely to allows our brains to develop outside theaters and that means that most of our brain development occurs following birth and not before and most of that in the first three years of life by the end of first three years of life the human brain is 80 percent adult size and the human body is only 19 percent adult size it's totally disproportionate and that means most of our brain development occurs in the first three years under the impact of the environment and the circuits in the brain that get the appropriate input they get the right stimulation they develop and the ones that don't they even die and they suddenly won't develop very well and that's not so difficult to understand if you took a plant a seed and you stuck it in the floor here would you expect it to grow of course you wouldn't why because the conditions aren't here there's no irrigation there's no sunlight there's no nutrition here why would it go it's the same with the human brain it needs the right conditions now what are the right conditions well depends on which circuit we're talking about the visual circuits that allow us to see there's about 30 different circuits making up the visual system that needs light if this child wasn't dark for the first year five years of his life he'd be blind thereafter for the rest of his life because there's no light the brain says I don't need visual circuitry there's no light here I might as well put that energy into hearing or something else so for the development of seeing you need light waves now the circuits of the opiate love chemistry the dopamine incentive motivation system the impulse regulation and the stress control system also needs the right environment just like the visual circuitry needs light and what is the right condition for these important brain circuits and this is where we're letting our kids down I'm talking about as a whole society the necessary condition for the development of these circuits is the presence of an on stressed the emotion available constantly available parenting caregiver without the presence of an on stressed emotionally present constantly available parenting caregiver these circuits don't develop if you take a small truck if you take monkeys and you separate them from their mothers and you measure the dopamine levels they've got that down within a couple of days the endorphin and the dopamine level in the child's brain depend on the presence of a nurturing parent of an on stressed nurturing parent why do I say non stressed explain that in a moment I could give you all the science behind that that there's a let me just give you one example at the University of McGill in Montreal they experiment with rats and rats are easy to work with because they they were short gestation time so they're not pregnant that long and they grow up very quickly so you can study them between birth and death very quickly so rat mothers when the baby is born when the rat pup is expelled from the mother's womb the mother immediately starts licking that the rats licking that means on the perineum like on the bum just starts licking them and that's how they groom and that's how they connect with them that's their version of bringing a baby to the breast first they lick them now some rats do better than other rats some other rats lick their babies with more care and nurturing than other mother rats if you look at the babies that are well nurtured by their mothers in the first few hours of life and if you look at these babies as adults they're less anxious they're smarter and if you look at their brains they have more natural tranquilizing chemicals in their brains there's a class of drugs called benzodiazepines benzos or drugs like valium and Librium and ativan and so on we have our own natural benzos and our brains these rats that are well licked by the mothers they have more of the natural stuff in their brains then a rats that were not well licked but it's not genetic because if you take the rats whose mothers don't like them very well and you put them those baby rats with mothers who do they grow up to be just fine so the presence the proper brain chemistry of the infant depends on the presence of the mother and the capacity of the mother to nurture the baby and a group of monkeys they divide into three groups and they made it they created different conditions for food finding for these mothers these mothers had small babies that they look after and they find food for them the one group that made it difficult it was always difficult for them to find food predictably difficult the mothers knew that is always going to be hard to find food they had to work very hard for it another group they made it easy for them the food was just right there the middle group they made it sometimes difficult to find the food and sometimes easy to find the food so it was uncertain now guess which group of mothers was it that their infants when they grew up were more insecure they do do cocaine and alcohol the uncertain group yeah the mothers who always find difficult they adjusted to it the mothers always find easy no problem the ones who are stressed because they never knew and an uncertainty is a big cause of stress they're the ones as infants to grow up to be adults who did cocaine and alcohol and there's so many experiments like that now the same thing is true in human beings because when mother and infant when I say mother it could be the father could be a grandfather doesn't matter that when a nurturing parent is looking into the child's eyes and the child look into the mother's eyes the parents eyes that's when they both have endorphins happening in their brain and that promotes the development of the child's circuitry but what happens to people like Serena whose story I read to you and like all my other patients in a Downtown Eastside who never had that those circus don't develop so when they do heroin guess what it's like for the first time they feel loved in connection if it's for the first time they feel human or the first time they do cocaine they feel alive and vibrant and excited that's pretty powerful and it's the only way they got it so you try and take that away from them it's damn difficult to give it up addiction is pretty simple it's what happens to people when they don't get what they need and at the end of soothing themselves now this is not about blaming parents by the way you have to understand that when parents are stressed they can't help passing that stress on to their children they just can't help it there's no way to avoid it I was born to Jewish mother in 1944 in Budapest Hungary and you all heard about what happened to the Jews in Eastern Europe so I was born in January 44 and in March the Nazis marched into Budapest my hometown the day after the the Germans occupied Budapest my mother called the pediatrician and she said to her would you please come and see Gabby because he's crying all the time and the pediatrician said of course I come but I should tell you all my Jewish babies are crying now why would the Jews babies crying I didn't know anything about Nazis I didn't know anything with concentration camps or war or genocide why was that crying do you think because my mother was stressed infants pick it up infants pick it up and my mother was depressed because her parents three months later her parents were killed and so on that one when parents are in that state so and then trauma is passed on from one generation to the next at the University of Washington in Seattle they did a EGS electroencephalograms these are electrical readout of the brains of infants at six months of age whose mothers were depressed and the compared and you know so you get this – you get this wave like an electrical readout looks like this no they compared the EGS or the electrical activity of the infant's brain whose mother's was depressed with infants whose mothers was not depressed they could tell from the EEG of the child whose mother was depressed and which wasn't in other words the mother state of mind programs the electrical activity of the infant's brain and this these effects last a long time incised last a long time the mothers obviously don't become depressed on purpose nobody wakes up one morning says hey I think I become depressed maybe I shouldn't okay I will know these things happen to people nor we get stretched on purpose my mother did not create the Second World War just so that I would have a difficult first year of life the trauma has passed on multi-generationally from one generation to the next and that's how its inherited it's not inherited because of genes it's inherited because we keep creating the same conditions but that's why the drug addiction it's because of the early suffering and the early deprivation these circuits are crying out for those substances and when they get them they're happy and it's very difficult to tell a person if something makes them feel good for the first time in their lives that they should stop using that substance when they have no other way of making themselves feel good and they've never had any other way now that doesn't mean it's hopeless it just means that it's difficult and we can't do it by judging people by telling that they're bad that they're stupid and so on or even by telling them how bad it is for them they already know that they already know that we have to try something totally different there's many many different way to look at addictions No well no I looked at it from one angle there's another angle which is that drugs are a way of self-medicating some people have certain conditions medically that they stop medicate now what do people self-medicate they self-medicate depression with the drugs or antidepressants they self-medicate anxiety they self-medicate PTSD or post-traumatic stress disorder they make people less stressed they also self-medicate what you've got which is ADHD attention deficit hyperactivity disorder okay the stimulant drugs like cocaine and crystal meth which most people when they take them to get more hyper actually make you calmer why is that imagine that explain to imagine imagine that your brain was like a imagine a a busy street corner with traffic going in for directions you know save a bridge the street corner and here's a you got three lanes of traffic going in every direction right three lanes this way you know so but there's no stop sign and there's no traffic light what there is is an island here in the center and as the cops there's a cop standing on the island and the job of the cop is to stop traffic in this direction so can go in this direction right his job is to stop things okay imagine that your brain is like this business traffic corner with three lanes of traffic going in four directions the drivers don't know how to stop they don't want to regulate themselves there's no stop sign there's no traffic light there's a cop no imagine furthermore that the cop went to a party the night before so it's sitting there on a traffic island you know going like this and also and ghostly okay what's going to happen on this street corner total chaos right honking and people getting angry and upset but nobody getting anywhere just like you and your room what would you have to do to create order on the street corner yeah sorry no we can't do that he's good you got the one you got what are you gonna do with him what are you gonna do them I gave it totally right given a stimulant caffeine is a stimulant cocaine is different crystal meth is tonight nicotine is different eighty days another condition is just a condition that predisposes to addiction and people self medicate by this stimulant drugs a lot of the people that are taking crystal meth actually have a DD they may not know it but that's what they have almost any almost anywhere within fiction will have a dual diagnosis by definition they're going to be anxious they're gonna be depressed taking of a DD they're going to bipolar disorder they're going to post message so their personality sort of Sun is going to go on otherwise it won't be addicted the good news is that the human brain can develop new circuits even later on so even though the conditions is not like vision visions no vision is over at age five if a kid doesn't see light for five years he's blind forever but these circuits you can get new development even later on in life if the conditions are right even later in life it takes a long time it takes a lot of support but it can happen so the point is just because people were hurt early it doesn't mean that they were you know is it Larry see your name I'm sorry Eddie Eddie was in it in his prayer was talking about he said something what the the wisdom of healing that's inside of ourselves well that's it there's a wisdom in the body which allows healing and even your development it takes place even later on in life the longer we've done drugs the longer it takes and the more support you need but there's no way beyond redemption there's nobody beyond redemption now how long will take you see you're not just talking about the effects of the drugs you also talking about a lifelong Toronto so when you talk about healing addiction is not just getting somebody to stop using the drugs it's also developing new ways of coping and new ways of thinking about themselves and new ways of seeing the world that they never had from from the early life because the conditions weren't appropriate so let me say something here about the past and the generations the things I said about what's necessary for the healthy development of the person and the brain the kind of parenting that's exactly the way as far as we understand it from historians and anthropologists and from stories of the elders that's exactly the way First Nations people used to parent their kids kids were not parented in isolated families they're part of a village in the village it wasn't just a question of mummy and daddy it's a question of the whole community was responsible of the child the child had many many adults around to protect them and to nurture them and to teach them kids were never separated from the adults they they were carried everywhere the parents went the kids went with them just the kind of things that were science is now discovering we need to do to nurture kids people were doing it automatically without science without brain scans without all the stuff they were just doing it and that's why I originally by the way parent everywhere in the world under natural conditions and then you look at what happens and and there was actually substances in North America that could have been addictive those tobacco here there was alcohol in southern United States there was peyote but there was no addiction there was no problem with drug use even though it's drugs were here and it's the same with coca in Latin America there was no severe addiction problem so addiction problem comes along when you destroy people's ways of life that's when it comes along it's that simple you can you can predict it in the Western world those alcohol for thousands of years there was drunkenness people get drunk on holidays and festivities and but there's no alcoholism until the Industrial Revolution when people were chased away from their villages in their communities and there you had to go in the cities and now they're isolated away from their families and controlled and beaten and so on so no longer living under the natural conditions that's when the addiction comes on I don't to say that you can't do anything about it because you can't you did individually and people do on a community level but it's very difficult because there's a whole history that weighs down on you and it's not just the history it's still going on I mean if you actually look at what's going on it's not like all the landings have been settled it's like like it's not like there's no more discrimination it's not like governments are now being fair about it no a lot of the exploitation and so I'm still going on and there's a lot of infighting and I don't want to say about that because I'm not part of it but corruption and so on that happens in some of the First Nations organizations and so on it's a very very difficult situation I have no idea how to resolve the problem all I can say is on a social level Canadian society needs to do a lot more needs to do a lot more apologies are just are not enough I mean you do a lot more but just me saying it's going to make it happen and and and Stephen Harper is never for me to ask me what he should do I don't get it personally but he hasn't but communities are gonna have to find some creative response that that this trauma has been going on you know maybe there may be my where words can help is only with this maybe can help with the shame part because there's tremendous shame associated with abuse maybe if people get it that it's not their fault but it just happened they didn't create it they didn't call for it didn't ask for it it might be their responsibility now I mean whatever addiction issues exist in this community here you can wait for Stephen Harper to come and do something about it but I wouldn't hold your breath too much so it's your responsibility and you have to spawned but maybe forget that it's not your fault maybe you get that the shame that's associated with addiction maybe you can drop the shame maybe if you drop the shame that'll help lift the weight off your shoulders a bit so you can get on with it maybe it's the shame that keeps people stuck the attunement piece is big one attunement means when two people when one person gets the emotional space of another person and is able to communicate that I get it now with babies we do this all the time when the baby starts crying we are tuned right away what do we do what do you do when you see a baby crying what happens to your face you all know so yeah you're committing you're communicating that okay baby I get it you're feeling sad I get that you think that I feel sad too when you feel sad that's a tournament now we all need that the children need it for their development where the parent is not attune to the child then a kid doesn't get the feeling of being received and understood so they get the sense that is something wrong with them even if the parents never beat them or hurt them just because if they were stressed and they were and my parents are stressed they can't be attuned because they're too stressed and that's why that that eg whether depressed mother or the infants where the mothers are depressed you could tell from the child's brain whose mother was depression wasn't because the mothers weren't attune to the child nurse was dealing with addiction then given that the the first condition that was lacking was this attuned presence of caregivers what do you think the first condition is if we're going to heal people the same thing it's not enough to tell people that you guys stopped doing this is bad for you people need first of all some loving acceptance in their lives they need to be given the message that their addiction may not be okay but they're okay but it's not their fault but they're not stupid that they're not deficient that there's nothing to be ashamed of nobody woke up at 3 years of age and said I'm going to become a drug addict nobody woke up at 15 years of age and said I'm going to become a drug addict people drifted into it they drifted into it because of all the stuff that I talked about so the we have to lift the shame and the only way lift a shame so drug addicts are very ashamed of themselves anybody here who's ever had an addiction problem you know how shame you were and how poisonous that shame is and how healing it is if somebody can talk to you was not judging you who's not rejecting you who's not punishing you for just as hey you got a problem so that's the actual first step then in that context we need to help people understand themselves and understand their behaviors let me tell you a story about myself too I've been married to my wife Reina for 39 years next month so let's say one night ten years ago I stayed away oh you know I I indicate that I'd like to have intimate physical contact sex and she says no and I know that's hard to believe that she would say that to me but it's happened how do I react well so I'm say ten years ago in 54 years old ten years old and I'm a natural medical writer for the goal male I'm busy felony doctor and I'm a speaker and all kind of stuff and director of palliative care at Vancouver I call these titles and achievements so how does describe respond when his wife says no well in my case I either go into a rage or I curl into a fetal ball like this and they wished that I was dead and next morning I can't even look her in the eye no what sense does that make what sense does it make when there's nothing to worry about and that's when you worry well I'll tell you what sense it makes it has to do with memory it has to do with a kind of memory called implicit memory implicit memory okay I'll tell you what that is there's two kinds of memories in the brain in the body one kind of memory is what we call recall you can call back recall what you had for breakfast yesterday what you did two weeks ago what a teacher said to you when you're in grade five that's recall that's called explicit memory explicit memory or recall but the part of the brain that remembers that way that encodes or photographs explicit memory isn't even developed to the second or third year of life so nobody recalls anything if I ask you what did the nurse where when you might have delivered you you wouldn't be able to tell me there's no recall for that your brain wasn't even ready to recall that two to two you know but there's another kind of memory called the implicit memory that's there right from birth and that's the emotional memory of what happened without the recall so the emotional experiences are imprinted in your brain but you don't recall what caused the emotion okay now you told us that you abuse traumatized when you were two years old or one year old right you have no recall for that but you have memory the emotional memory the implicit memory is here in your brain now what do you think emotionally you were experiencing when nothing was going on when you were one a half years old but you already been traumatized anxiety that something would happen at any time and you have to pay attention if you're not seeing something maybe that's the most dangerous time at all of all there's a kind of thing that happens where mothers are men children are separated from the mothers the children for the first few days are anxious they look everywhere for the mom then they give up they get depressed they won't look anymore they won't eat they won't play they won't do anything and then after a few days of that they come out of it you can feed them again the plague and they'll interact with caregivers but what happens when the mother comes back when the mother comes back they get stressed physically their heart rate goes up they get very tense and they won't even look at the mother they won't look at the mother and what do you think that's about but they don't attach in case she leaves again it's called defensive detachment and that the brain that the kid is not doing it deliberately the kid's brain is doing it the kid's brain is saying when you abandon me I felt so hurt that I'll never want to be that hurt again so I'm never going to connect with you again now when I was 11 month old my mother gave me to a total stranger in the street and said to her take this baby away that's what she did and she did have to save my life because she could barely stay alive herself and I might have I was very sick and I might have died so she smuggled me out from the ghetto and I lived some relatives for a few weeks until the Germans were defeated and they left Budapest by the Russian army and then I I was reunited when I read that story about what happens to kids I asked my mother how did I respond to you when our real reunited she said like an utter stranger you wouldn't even look at me for several days now my wife says no to me okay if I was purely an adult I would say okay that's disappointing but I can handle it because life is disappointment right I mean life is joy and life is pain and life is beauty in life is ugliness and life is everything including disappointment so what that's just life but when she says no to me that memory of being abandoned by my mother gets triggered because here's this woman on whom I'm relying in my life and who I depend and I need her to love me and to hold me and she's saying no to me that implicit memory gets triggered and now I'm responding like I'm a one-year-old child and by the way most of the time there's a problem in your relationship with your spouse but with your friends and you got all upset it's good not good with the present you know that because you go back afterwards and you say what the heck was that about and what it was about was the implicit memory that tells you about your childhood you're back in a state of implicit memory now the addicts are always full of implicit memory so what was the addicts memory the addicts memory was that he or she was abused by authority figures so you're an authority figure and you speak to them in a harsh way guess what that makes you they respond to you like you're the guy abusing them in the first place and now you can't get the first base and that means that people working with addicts have to really take care of themselves they have to be very aware of what's happening internally because I tell what happens to me when I'm not taking care of myself let's face it in a relationship between myself and my clients who's got the part I do I mean I got the status if they can play if they complain about me they don't get anywhere I mean let a druggie from the Downtown Eastside go to the College of Physicians and make a complaint about a doctor how far will they get I'm just saying I'm not saying how it should be I'm saying how it is and all their lives they have never experienced any power at all so they won't even you know they've threatened and all that I don't give the prescription okay I'm going to the college okay go ahead I have to be very careful now when I'm not looking after myself when I'm very stressed then that means I go to work and I'm irritable and so I'm irritable what do I trigger I triggered an implicit memory of another authority figure we just doesn't give a damn about them and when do I do that most especially especially when I myself am NOT living with integrity so let me read your paragraph here so I told you I I heard this propensity to binge on shopping and and obsess about it and spend a lot of money and so when I'm like that of course I'm very judgmental of my patience I'm looking at them saying how can be so weak willed and why can just give it up you know exactly what I'm doing myself right we always judge other people for exactly we don't deal within ourselves in January 2006 when I'm in the midst of an extended seedy obsession and of course when I'm buying crap like this of course I become a complete addict I lie I bring them home and my wife says every shopping again how can even think such a thing and I stash it on the porch and when she goes to sleep I smuggled her into the house in January 2006 when I'm in the midst of an extended seedy obsession Shawn comes the morning into my office I'm messing up he says I'm puking and shitting I've been doing heroin oh man Shawn has been in the recovery room for months so I haven't seen him for a long time but he did call regularly proudly reporting on his progress and his determination to stay clean once he left the voicemail I'm calling to say that I appreciate all your help I just want to say thanks man now he's back in the Downtown Eastside pale bedraggled emaciated unwashed he's been living in the streets for weeks but plans to admit himself to a Christian rehabilitation camp don't you think she'll be back on a methadone I suggest Shawn eagerly downs his first dose before recounting the details of his most recent relapse I don't know why doc I thought I just used one time just the one time and that was it so I going through with that question rehab thing my family is pushing me but I'm not up to it have you told them that no what stops you from being straight with them hurting them they helped me so much and I turned around and failed so miserably I'm instantly filled with judgment annoyed by his neediness and weakness the will that is by my own I want to teach him a lesson I don't believe you I Connor not that you don't mean it but you're not being honest with yourself you're not worried about hurting them you already are hurting them yes I am but I want to go to that Christian place I know what it's all about it's really tough they're a complete schedule it's harsh and rigid that's not the point I'm talking about telling your family the truth about how you feeling what you're up to you just want to be fuel to have you just want to face the hassle of being clear with them your fate of their judgment or of your own you're too chicken to be honest Sean throws me a direct glance and the bad smile on his face that's how it is dog well then get off it be open about what you want and what you don't want that much you do or your family and dog having pushed his addicted patient to tell the truth will now go home and lie to his wife his beef gets stuffed with the latest haul of classical music and that's how it is for all of us when we're not in integrity that's when we're most judgmental of other people because we can't stand seeing others what we don't like about ourselves which is I think why people have such a hard time with drug addicts because who in this society is not addicted this whole society is all about getting soothing from the outside you have to look that way you have to be that way you have to buy that get that do that it's all getting something from the outside to make yourself feel okay which is what addiction is all about getting something from the outside to make you feel okay temporarily that's what addiction is this whole society's addicted the whole economy and look at the consequence the consequences that we're destroying the earth we actually destroy the earth and then we say to the drug addict how can you shoot yourself low cocaine man it's so damaging to you well how can we do what we're doing to the earth when saw damage to all of us but we can't stand seeing that part of ourselves so we push it all to the Attic to see what's wrong with you so the biggest thing that stands in the way of society helping the addict and of people individually up in the Attic is their judgments if the judgments so I ask a question I ask you to look at not by the way there's nothing wrong with having judgments it's very human you can't help it in fact you're not even doing it when you have a judgment you're not doing it it's not that you deliberately say to yourself hmm what judgment can I come up with now your brain does it right you're not even there your brain is doing it without you even deliberately me so when I say there's nothing wrong with it it's perfectly human there's nothing wrong with the judgment being that the problem is when you believe that judgment so the thing is to notice it because if you don't notice that it's going to get in the way son ask your question up so I'm just going to look at yourself now and tell me if you're willing to and we invite you to Tony to share with me some judgment that you've had about an addict in your life it could be somebody else it could be yourself so what I'm trying to say is that the most important thing we can look at people when working with addicts is ourselves is ourselves and how we respond and because Hobbie respond has to do with us and if we're going to work with people or with ourselves we have to be really compassionate with ourselves and with the other person too yeah yeah and you know what there's nothing to do about that except that if you're gonna be with an alcoholic be with him if you can't stand being with him then don't be with him but don't be with him and wanting him to be any different than the way is like to be with him and resent him at the same time what's the point you don't have to be with him it's a total pain in the ass to be with an alcoholic I mean whom who you know nobody's expected to put up with that but if you choose to be with him choose to be with him exactly the way he is without any move to try and make any different because there's a spiritual teacher that I I read a lot and she said that only in the presence of compassion well people allow themselves to see the truth you you


  1. what an excellent speech This is why we as youth and adults need parenting courses as well as growth and development courses to ba able to parent well .

  2. I like the way that he explains complex things like behaviour and brain activity in a way you can understand.

  3. I think we should be treating drug addiction as a health issue vs. a criminal issue. The way we do it is costing us horribly both financially and in overall morale. We created a war on our own people in the 80's and 90's with the epidemic of crack cocaine on African Americans. At that time the name of the game was mass incarceration and harsher
    sentencing and we called it a war on drugs – a war on our own people. There have been many casualties in that war. We need to reevaluate many of those harsher sentences. Especially, as now it is scientifically proven that harsher drugs like crack cocaine high-jack the brain. Addiction is now considered a disease of the brain. Let me give you just one example – just one of literally thousands – of someone whose sentence should be reconsidered — Lenny Singleton (shown in the profile pic).

    Lenny committed 8 "grab & dash" robberies in a 7 day period while high on alcohol and crack cocaine to fund his crack addiction. He did not have a gun. He did not kill anyone. In fact, no one was physically injured and not one person filed against him as a "victim." He stole a total of less than $550 and these were his first felonies. He wasn't part of a gang or a habitual criminal. He earned a college degree and served in our Navy before he allowed his addiction to destroy his life. What he needed was some help with his addiction.

    What he got was 2 Life Sentences plus 100 years with no chance of parole. The judge, without any explanation to Lenny or the courtroom as documented by his court transcripts, sentenced Lenny to more time than repeat violent offenders, rapists, child molesters, and murderers. Lenny would be the first to tell you he needed to do some time, but he didn't need to have his life taken away from him. Murderers in the state that Lenny
    is incarcerated in have been given 17 years and will walk free while Lenny
    remains in prison.
    Lenny, while incarcerated these past 20+ years, works every business day in a position of authority, lives in the Honor's Dorm, takes every available class for self-improvement
    offered, and in his spare time, he has co-authored and published a book to help others headed down the same path called, "Love Conquers All," available now on Amazon. During
    the entire 20+ years he has been in prison, he has not received a single infraction for anything – very rare for lifers. He is deserving of a second chance.
    To keep Lenny behind bars for the rest of his life will cost taxpayers well over a million dollars – for stealing less than $550 in crimes where no one was physically injured. This makes absolutely no sense on any level. And smarter sentencing in Lenny's case would be a reduction of cost to the American taxpayer. His case should be reconsidered. That million plus dollars would be better spent on rehabilitation services or preventative education or rebuilding infrastructures – anything rather than keeping 1 man who stole less than $550 in crimes where no one was physically injured behind bars for the rest of his life. When you multiple this by the literally thousands of cases all across the country you begin to understand the magnitude of the problem. It is time for true criminal justice reform in this country.

    Please learn more about Lenny Singleton and sign his petition at
    Justice will not have been served if Lenny dies in prison.

  4. One off the most insightful explanations of addiction I have ever heard. If I was the Canadian Prime minister  I would ask Dr. Mate to craft a national drug treatment program, and then implement it.

  5. I went to my first AA meeting and I met the most inspirational people. Everybody contributed to the conversation by talking about what it means to be a part of the group. The first person filled me with inspiration and healing, the next talked about networking, another used a clever analogy to stay grounded, one person described themselves to be like a child. The whole meeting had a lot for me to appreciate and I hope to give back when I see these wonderful individuals in a few weeks. I could not get over the fact that every individual supplied you with knowledge and they all talked about the fact that they thank God that they came back to this particular family. Thank you to all those individuals for their courage and inspiration.

  6. don't ask why ime here.. actually.. naah, ANYWAY!! This Is The First Video jacksepiceye Ever Pressed The Like Button On 😝

  7. I luv this guy, he is the greatest mind, we are so fortunate that he is also Canadian, we should give him a reward in Canada for being a hero instead of some overpaid athlete or dumb ass actor. I vote for Gabor for president! Lol – he is truly my hero, voice of reason, sanity, and truth. Addicts like him, because addicts do not respond to anyone who does not tell the truth, they respond to truth – someone who knows them. And this Dr possesses a honest, kind, perspective.

  8. Dr Gabor is one of the greatest minds of today, he is a educator and can so easily make sense of science, reality our culture, and dysfunction. He speaks the truth – and is the only person who makes sense. The voice of reason & the TRUTH.

  9. ▶  Brain Development & Addiction with Gabor Mate:  ~Uploaded Feb 23, 2009
    ▶ Connect @Peta_de_Aztlan:

  10. Why is it important to have a reliable adult through infancy (a consistently available caretaker)?I know that having a consistent person is less stressful for the baby, but specifically hat does it provide for the development of the baby's brain? Does it help them to cultivate trust?

  11. I cut myself as a teenager.. I was told that it increased the endorphins that's why I continued it.. I have stopped cutting but traded it for chemicals..This man knows his stuff..

  12. Hmmm… I really wanted to watch this, but he starts of by saying something that has been scientifically disproven, that addiction does not come from the inside. In actuality some people would get nothing out of sniffing coke and some would get very high, that's genetics. While I do believe this presentation can be good it is not scientific… my search continues.

  13. Dr. Mate is no less than incredible. I even passed a few of his videos over to my own therapist to read up on and he was extremely impressed by his perspective. It is refreshing that someone can finally shed some light on such a dark topic.

  14. Thank you!!!! This put lots of things into perspective.  I can't thank you enough for shedding light on so many subjects, from Psychology, to socio dynamics between parent and child to addiction, pain and everything else in between.  This talk explained two of my ex-boyfriends' strange behaviours.  I thought they're weirdos and sociopaths, turns out they're just addicts.

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