Gabor Maté (physician)

Gabor Maté (born January 6, 1944) is a Hungarian-born Canadian physician who specializes in neurology, psychiatry, and psychology, as well as the study and treatment of addiction. In Dr. Maté's approach to addiction focuses on the trauma his patients have suffered and looks to address this in their recovery, with special regards to indigenous populations around the world. His book In The Realm of Hungry Ghosts, close encounters with addiction, Dr. Maté discusses the types of trauma suffered by addicts and how this affects their decision making in later life. He is also widely recognized for his perspective on attention deficit disorder and his firmly held belief in the connection between mind and body health. He has authored four books exploring topics including attention deficit disorder, stress, developmental psychology and addiction. He is a regular columnist for the Vancouver Sun and the Globe and Mail.

Born in Budapest, Hungary in 1944, he is a Jewish survivor of the Holocaust. His maternal grandparents were killed in Auschwitz when he was five months old, his aunt disappeared during the war, and his father endured forced labour at the hands of the Nazis. He emigrated to Canada with his family in 1956. He was a student radical during the Vietnam War era in the late 1960s and graduated with a B.A. from the University of British Columbia in Vancouver. He worked for a few years as a high school English and literature teacher, and later returned to school to pursue his childhood dream of being a physician.

Maté ran a private family practice in East Vancouver for over twenty years. He was also the medical coordinator of the Palliative Care Unit at Vancouver Hospital for seven years. Currently he is the staff physician at the Portland Hotel, a residence and resource centre for the people of Vancouver's Downtown. Many of his patients suffer from mental illness, drug addiction and HIV, or all three. He works in harm reduction clinics in Vancouver's Downtown Eastside. Most recently, he has written about his experiences working with addicts in In the Realm of Hungry Ghosts.

He made national headlines in defense of the physicians working at Insite (a legal supervised safe injection site) after the federal Minister of Health, Tony Clement, attacked them as unethical.

In 2010, Maté became interested in the traditional Amazonian plant medicine ayahuasca and its potential for treating addictions. He partnered with a Peruvian Shipibo ayahuasquero (traditional shamanic healer) and began leading multi-day retreats for addiction treatment, including ones in a Coast Salish First Nations community that were the subject of an observational study by health researchers from the University of Victoria and the University of British Columbia. Although preliminary and limited by the observational study design, the research results showed that Maté's claims of therapeutic efficacy were well-founded and that participants had significant improvements in some psychological measures and reductions in problematic substance use. However, when the conservative Canadian federal government learned about Maté's work with ayahuasca in 2011, Health Canada threatened him with arrest if he did not immediately stop his activities with what they claimed was a harmful illegal drug. Yet, Health Canada's own research on ayahuasca in 2008 showed that they knew the risks associated with the ceremonial use of the brew were very low, and that it had considerable potential value for spiritual and self-actualizing purposes.

A recurring theme in Maté's books is the impact of a person's childhood on their mental and physical health through neurological and psychological mechanisms, which he connects with the need for social change. In the book In the Realm of the Hungry Ghosts, he proposes new approaches to treating addiction (e.g. safe injection sites) based on an understanding of the biological and socio-economic roots of addiction. He describes the significant role of "early adversity" i.e. stress, mistreatment and particularly childhood abuse, in increasing susceptibility to addiction. This happens through the impairment of neurobiological development, impairing the brain circuitry involved in addiction, motivation and incentive. Dr Maté defines addiction as any behaviour or substance that a person uses or takes part in that has negative consequences. The person tries to stop but will crave the substance or behaviour and will ultimately relapse. By this definition there are many things in modern culture that have the potential to become addictive such as gambling, sex, work and of course drugs. He argues the "war on drugs" actually punishes people for having been abused and entrenches addiction more deeply as studies show that stress is the biggest driver of addictive relapse and behavior. He says a system that marginalizes, ostracizes and institutionalizes people in facilities with no care and easy access to drugs, only worsens the problem. He also argues the environmental causes of addiction point to the need to improve child welfare policies (e.g. U.S. welfare laws that force many single women to find low-paying jobs far away from home and their children) and the need for better support for families overall, as most children in North America are now away from their parents from an early age due to economic conditions. He feels that society needs to change policies that disadvantage certain minority groups, causing them more stress and therefore increased risks for addictions.

The impact of childhood adversity is also noted in When the Body Says No: Understanding the Stress-Disease Connection. He notes that early experiences have a key role in shaping a person's perceptions of the world and others, and in stress physiology, factors that affect the person's health later on. He says that emotional patterns ingrained in childhood live in the memory of cells and the brain and appear in interpersonal interactions. He describes the impact of 'adverse childhood experiences' or ACEs (e.g. a child being abused, violence in the family, a jailed parent, extreme stress of poverty, a rancorous divorce, an addict parent, etc.) on how people live their lives and their risk of addiction and mental and physical illnesses, as seen in a number of U.S.-based Adverse Childhood Experiences (ACE) studies. Having a number of ACEs exponentially increases a person's chances of becoming an addict later on e.g. a male child with six ACEs has a 4,600% or 46-fold increase in risk. ACEs also exponentially increase the risk of diseases e.g. cancer, high blood pressure, heart disease, etc. and also suicide and early death.

He argues that patients should therefore be encouraged to explore their childhoods and the impact on their adult behaviors. Overall, he argues people benefit by taking a holistic approach to their own health. For instance, he has seen people survive supposedly terminal diagnoses by seriously considering their "mind-body unity" and "spiritual unity"; going beyond "the medical model of treatment."

He has also spoken about how the rise in bullying, ADHD and other mental disorders in American children are the result of current societal conditions e.g. a disconnected society and "the loss of nurturing, non-stressed parenting." That is, we live in a society where for the first time in history, children are spending most of their time away from nurturing adults. He asserts that nurturing adults are necessary for healthy brain development.

• Scattered Minds: A New Look at the Origins and Healing of Attention Deficit Disorder, Toronto, Canada, A.A. Knopf Canada, 1999 (published in the United States as Scattered: How Attention Deficit Disorder Originates and What You Can Do About It).
• When the Body Says No: The Cost of Hidden Stress, Toronto, Canada, A.A. Knopf Canada, 2003 (published in the United States as When the Body Says No: Exploring the Stress-Disease Connection).
• Hold On to Your Kids: Why Parents Need to Matter More Than Peers, co-authored with developmental psychologist Gordon Neufeld, Toronto, Canada, A.A. Knopf Canada, 2004.
• In the Realm of Hungry Ghosts: Close Encounters with Addiction, Toronto, Canada, A.A. Knopf Canada, 2008.