The Realm of Hungry Ghosts

If we view addiction as compulsive behavior, then many people could be considered to be addicted to something. Dr. Gabor Maté gives an extraordinary overview of the origin, real causes, and persistence of addictions in his magnificent book In the Realm of Hungry Ghosts.
The Realm of Hungry Ghosts
Sergio De Dios González

Reviewed and approved by the psychologist Sergio De Dios González.

Written by Sonia Budner

Last update: 21 December, 2022

Dr. Gabor Maté is one of the most prestigious scholars in the field of addiction. He’s also the author of the book In the Realm of Hungry Ghosts. He’s a well-regarded figure for his work with people who suffer from addiction. In fact, he worked for 12 years with drug addicts in Vancouver’s Downtown Eastside in the United States.

Maté defines addiction as a continuum ranging from the drug addict we would avoid on a street corner to workaholics, compulsive shoppers, or food addicts. Gabor Maté argues that we all possess addictions to some extent and maintains that they arise from our own emotional core.

His theory, which he discusses in-depth in In the Realm of Hungry Ghosts, shows us addiction that we can trace to childhood abuse. According to Maté, the early years of life dictate the likelihood and type of addiction. From his clinical experiences, he concluded that the source of addiction is in the brain’s chemicals in a person’s formative years.

He also compared studies linking lack of love, abuse, and different types of attachment to a deficiency in the body’s capacity to process endorphins and dopamine. These substances are linked to feelings of pleasure and pain reduction. In this sense, addiction would be in charge of replacing this deficiency in neurostimulation.

A sad woman.

Are we all addicts?

In the book, Gabor Maté talks about the spectrum of compulsion that he understands as addiction. He also brilliantly reflects how everyone can be susceptible to being part of such a spectrum of compulsive behavior to a greater or lesser extent.

His examples range from watching TV, compulsive shopping, sex, food, and even an addiction to keeping oneself entertained. He explains that looking at it from this standpoint produces a mirror effect in which we can all see ourselves reflected, individually but also collectively.

Addictions stem from pain

In In the Realm of Hungry Ghosts, Gabor explains that the origin of all addictions is pain. This pain is due to traumas suffered in childhood to a greater or lesser degree. That would be the origin, but the real problem lies in the failed attempts to fill an internal void through external measures. None of these external measures treats the origin of the pain, only the symptoms.

Thus, Gabor Maté raises a key question in all attempts to cope with addiction, of whatever nature. The question isn’t “Why the addiction?” as we might think. The key question would be “Why the pain?

Patient stories

According to Maté’s vision, this chemical substitution that the addict needs and that his body can’t produce occurs both in individuals addicted to drugs and in those who seek to fill voids through different external stimulants.

In In the Realm of Hungry Ghosts, Maté goes over some stories of patients addicted to heroin, crystal meth, and cocaine. In all these cases, patterns of low self-esteem and lack of coping skills seem to repeat themselves. It’s often easy to find a history of abuse and neglect in their childhood, while they also seem to share low dopamine levels.

Taking responsibility for actions

The book starts from the premise that any addiction or compulsion could have its origin in a defense mechanism developed at a specific time and circumstance. In the past, this mechanism helped the individuals protect themselves. However, later on, it becomes an element that drives other aspects of their lives.

Therefore, according to Gabor, coping with addictions involves recognizing both the origin and the defense mechanism, as well as recognizing the lack of need for that mechanism today. The situation that provoked the pain and the need to defend oneself no longer exists. As a result of that, the defense mechanism has also lost its meaning.

A depressed woman.

The realm of hungry ghosts

The author of In the Realm of Hungry Ghosts has, therefore, advocated a state program in which psychoactive substances are freely administered to addicted people. The idea is to do so in a controlled, hygienic environment, where there’s no judgment of these people.

Dr. Gabor is a staunch advocate of this idea. Moreover, it seems to be proving effective in reducing the mortality rate of addicted people. This would be the direct consequence of these people no longer needing to steal or engage in prostitution to pay for their addiction. At the same time, the transmission of diseases is controlled.

Despite many voices calling for caution in this regard, the data is encouraging. It’s showing that the administration of these substances in environments other than those that created the addiction strengthens the willpower of those who want to quit.

Many people don’t feel able to overcome their addiction by undergoing any other form of treatment. Therefore, these centers at least give them the opportunity to lead more dignified, healthier, and less risky lives.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • Kelly L. (2008). In the realm of hungry ghosts. Close encounters with addiction. Canadian Family Physician, 54(6), 894.
  • Small D. (2008). Fighting addiction’s death row: British Columbia Supreme Court Justice Ian Pitfield shows a measure of legal courage. Harm reduction journal, 5, 31. doi:10.1186/1477-7517-5-31
  • Rodriguez, Alejandro (2015). En el reino de los fantasmas hambrientos, encuentros cercanos con la adicción. Signs of the Times. Recuperado de
  • Peele, Stanton (2011). The Seductive (But Dangerous) Allure of Gabor Maté Gabor Maté is admirable, but leads us down the wrong road

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.