What is Addiction? Dr. Gabor Maté All the substances of abuse, whether they're opiates or cocaine or anything else, they're actually pain killers. Some of them specifically are painkillers, but physical pain and emotional pain, the suffering is experienced in the same part of the brain. So when people suffer emotional rejection, the same part of the brain will light up as if you stuck them with a knife. Eckhart Tolle says very nicely that addictions begin with pain and end with pain. So that all the addiction are attempts are attempts to soothe the pain. When I work with addictions, the first question is always not why the addiction but why the pain. And what you find is emotional loss or a trauma. In the case of the severe addicts as in the downtown Eastside here, there were every single one of them traumatized. There's no woman walking the streets here who have not been sexually abused, not even by accident. But you know, whether it's a sex addiction or internet or a relationship or shopping or work addiction, these are all attempts to get away from distress. Keith Richards the Rolling Stones guitarist said that - who used to have a severe heroin habit as you know, he said that: "All the contortions we go through (are) just not to be ourselves for a few hours." Why would somebody not want to be themselves? Because they're in too much distress, in too much pain. So I don't care what they tell you about genetics or choices or any of that nonsense, it's always about pain. The Tibetan Book of Living and Dying, it's got a wonderful line in it. Whatever you do, don't try and escape from your pain, but be with it. Because the attempt to escape from pain is what creates more pain, and that's the reality of addiction. But the question is how can people be with their pain? Only if they sense of compassion from somebody. As another teacher says, only when compassion is present will people allow themselves to see the truth. So addicted people need a compassionate present which will permit them to experience their pain without having to run away from it. And all the attempts to run away, it's like another teacher says, the surest way to go to hell is to try to run away from hell. So you gotta be with that pain, you just have to be with it, but you have to have some support. And we live in a society that, one way or the other is always about instant relief, quick satisfaction, distraction. In other words, we live in a culture that is based on, both economically and psychologically, on not supporting people to be with themselves. So it's always the quick getaway. So it's very difficult to deal with addictions in this society. It is a matter of, at some point finding a way of being with your pain so that you can actually get to know what it's really all about.