Realm of dreams….(Part Two)

by katiclops

(Continued from Part One…)

What I wasn’t expecting about In the Realm of Hungry Ghosts was how effectively he breaks down the barriers that exist between the reader and the residents he is writing about. Dr. Maté is an accomplished physician, author and renown speaker. He has a family and lives in a comfortable home away from the DTES. I’m guessing it’s likely in the tree-lined streets of the west side of the city, quiet in the evenings, filled with affluent families, dogs on walks to the beach, and the odd baby stroller.

Dr. Maté’s book is well referenced, he provides over twenty pages of end-notes to supplement and bolster his arguments. The book is sprinkled with references to classical music and literature. But what is sneaky about the book, is that of course, the average reader, soldiering through 400 dense pages of largely scientific and academic writing will identify here and there with the people interviewed and contributing, but realistically, these same people are far more likely to identify with Dr. Maté himself. I was able to quickly locate the music he refers to, I’ve read many of the authors and thinkers he refers to—I was lulled into identifying with him. His relentless unabashed oversharing of his personal experiences and home life allow you to think of Dr. Maté as an actual person. This is helped along as many of the clients participating in the work also see him as such—they talk back to him, challenge him and manipulate him, in part (I’m guessing) because after a system has failed them so completely, what would the use be in continuing to participate in the staunch hierarchies that exist to protect it. The book’s greatest case study, is in fact, Dr. Maté himself.

Where this tactic become particularly effective is that as Dr. Maté switches to explaining the symptoms and causes of addiction, he uses himself as an example to illustrate the principles. At first, the links and parallels seem tenuous, but by the end of the work (it is impossible to feel as though this is a short book—it’s a veritable tome!), it works. That is why this book is so effective, and imperative to read for change makers, anyone really. It is why this book becomes accessible:

My addiction, though I call it that, wears dainty white gloves compared to theirs. I’ve also had far more opportunity to make free choices in my life, and I still do. But if the differences between my behaviours and the self-annihilating life patterns of my clients are obvious, the similarities are illuminating—and humbling. I have come to see addiction not as a discrete, solid entity—a case of “Either you got it or you don’t got it”–but as a subtle and extensive continuum. Its central, defining qualities are active in all addicts, from the honoured workaholic at the apex of society to the impoverished and criminalized crack fiend who haunts Skid Row. Somewhere along that continuum I locate myself.

Dr. Maté’s quirky illustration of himself as a learned, compassionate man that suffers from addictions, forces the readers to attempt to assess their own lives and social moralities. Ultimately, as illustrated in Chapter 33 “A Word to Friends, Families and Colleagues”–you can’t sort out other people’s shit unless you are able to objectively try to sort out your own, or at the very least, realize that you (and everyone else) has work to do. This is the deeply humbling and universal message of this book, that there is a need for compassion and a holistic approach to dealing with all social issues, not only is this the most effective way, but also the most efficient because the impacts are on so many levels: support systems in all aspects of life. Holistic approaches are more complicated than the current systems in place, but the problems arising out of the current “silver bullet” solutions are so much more costly and complicated.

Recently I was privileged enough to have the good fortune of reading a report on the experiences of transexuals in the medical community. Specifically looking at access to PAP smears for female-to-male transitioning persons. An incredible presentation of this report is available here (I will be adding a youtube link in the near future, pending permission of the presenter :). Before this report, I had never given this type of experience much thought, it’s a blind spot—a matter of privilege that I would have never pondered PAP access for non-female persons. I hesitate to extrapolate on the issues brought up in the piece for fear of diluting them too much, however it touches upon several key tenets that are equally applicable to the addiction community, and other groups facing prejudice. That was the second major impact I took away from this book: the double edged sword of the medical system. It is a gateway window, through which so many other services can be accessed, but also a window through which so many other services can be severed.

Those involved in the medical community are tirelessly working jobs in which they often see hundreds (if not thousands) of patients a year. However, for those being served by the medical community, it may be one of the only interactions they have with “the System,” or worse, it might contribute to conditioned responses to the System. For example, someone who is overweight and plagued by health concerns may be told every time they see care that they need to lose weight, leading them to neglect seeking care for unrelated or other preventable issues. In my own case, my high-stress levels led me to avoid seeking proper care until I developed a condition that will take several years of medication to cure. Integration of services and providing safe, sound access can promote harm reduction, as well as form relationships and in-roads into communities that will contribute to long-term healing and increased access for service delivery.

Finally, this book echoed my previous post about childhood and Lullabies for little Criminals, what we take for granted and what is out of our control—but by the same token how it takes a village to raise a child, and how we must continue to focus our efforts on not only the early years, but on supporting family units, young mothers and fathers, and the bonds and friendships that contribute to community. Dr. Maté paints the DTES not only as a place plagued with “third world levels of HIV, AIDS and life expectancies” but also a place that people can come to for an acceptance and community they would be unable to find by and large anywhere else in Canada, let alone the world.

I would highly recommend this book to anyone with the emotional capacity and time to process the complex issues it delves into. Although I don’t agree 100% with every argument Dr. Maté brings forward, ultimately I couldn’t agree more with his demands to demonstrate “curious compassion” and constant questioning: from the systems that suspend us to the actions that hold us in it’s grasp, inviting us to a lifelong work of constant redevelopment.

I would also love to recommend this post from Radical Public Health for anyone looking for another opinion on the book!