Book · 2008
In the Realm of Hungry Ghosts: Close Encounters with Addiction
by Gabor Maté
A Vancouver physician treats addicts in the Downtown Eastside and builds a case that addiction is trauma's echo, not a moral failure.
What does Reddit think of In the Realm of Hungry Ghosts: Close Encounters with Addiction?
Forty mentions across seven years, split almost evenly between r/therapists (20) and r/CPTSD (19), with one citation in r/InternalFamilySystems. Both communities treat the book as reference material rather than something to debate. r/therapists quotes it alongside the DSM-V's late-onset specifier, recommends it to colleagues working with substance use, and flags explicitly that it is not a treatment manual. That caveat travels. Maté's argument for decriminalization and his indictment of the War on Drugs get cited at ↑19, but practitioners separate the policy case from the clinical utility. r/CPTSD reads it as a trauma book that happens to be about addiction, pulling a quote about how culture itself wounds people to ↑269. The When the Body Says No comparison surfaces organically (↑34), positioning Hungry Ghosts as the addiction-specific companion in a larger body of work. Thirty-eight unique commenters, one clear verdict.
Community feedback & reader fit
Themes
- · Addiction as trauma response rather than moral failure
- · The role of early childhood adversity in substance dependence
- · Harm reduction and the case against drug criminalization
- · Physician proximity to suffering as a mode of inquiry
- · Cultural complicity in creating and sustaining addiction
Common praise
- + The decriminalization argument is grounded in clinical observation, which makes it land differently than a policy paper alone.
- + Therapists on r/therapists cite it as the book that explains addiction to clients who carry shame about their diagnosis.
- + The connection between CPTSD and substance use gets drawn more clearly here than in most dedicated trauma texts.
- + r/CPTSD readers pull direct quotes about cultural wounding to describe collective trauma, which tells you the prose holds up outside its stated subject.
- + Maté's position inside the Downtown Eastside — treating patients rather than studying them — gives the case studies a specificity most addiction books lack.
Common criticism
- − Its model that childhood trauma drives essentially all addiction is contested — many clinicians don't accept adverse experience as the main cause.
- − Practitioners on r/therapists consistently note it is not a treatment manual, meaning clinicians looking for protocol guidance will finish it empty-handed.
- − The policy sections on decriminalization read as advocacy, and readers who want the clinical argument without the political one have to do their own editing.
- − No mention of updated research post-publication; readers working with newer DSM criteria have to reconcile the book's framework themselves.
Who it's for
If you work with clients carrying both trauma histories and substance use disorders and want a single text that explains the overlap without separating the two into different diagnostic silos, this is the one r/therapists keeps returning to. Trauma survivors in r/CPTSD read it to understand their own histories, not just to support others. Know going in that Maté is building an argument, not handing you a protocol. Readers who want Maté but have already read When the Body Says No will find this covers different ground rather than repeating it.
Mentions over time
Top subreddits
Which Reddit comments matter for In the Realm of Hungry Ghosts: Close Encounters with Addiction?
The most relevant excerpts across the subreddits where this book is mentioned — opinionated, argued takes first, then top-upvoted mentions. Click through to read the full thread.
“A lot of people dislike some of the ones I like, but that said, I will tell you some of the ones that supported my growth. That doesn’t mean I loved the book 100%, but was able to take what served me and use it. Brene Brown- all of them, I think she makes her work accessible and is easy to underst…
“In the Realm of Hungry Ghosts by Gabor Maté
“With the DSM-V there's actually a qualifier for late onset. I really love this new specifier, because it does add legitimacy for clients to resonate with. I really recommend reading Gabor Maté, In The Realm of Hungry Ghosts. Even though it pertains to addiction, I believe it explains in a beautiful,…
“Gabor Maté’s book “In The Realm of Hungry Ghosts” does an extremely thorough treatment of this issue, and comes up with the verdict that decriminalizing drugs is necessary to reduce the soaring rates of addiction and overdose. He cites the dismal outcomes of The War On Drugs for both addicts and for…
“In The Realm of Hungry Ghosts by Gabor Mate
“I’ve loved Gabor’s work since I first read In The Realm of Hungry Ghosts years ago as a Master’s student. Now I work primarily with teens who have experienced developmental trauma and his work has been so important to me in helping my clients understand and process their experiences. His concept of …
“Check out Dr. Gabor Maté's In the Realm of Hungry Ghosts. He's worked with hundreds of severely addicted people, and he mentions that they all had traumatic childhood, and all of the women were sexually abused as children. He also says if you want to understand the addict, look at what the drugs act…
“"In the Realm of Hungry Ghosts" and "The Myth of Normal" by Gabor Mate. Hungry Ghosts if I had to choose one though!
“Gabor Maté has an excellent book on this called "In the Realm of Hungry Ghosts: Close Encounters with Addiction." One line that stands out is: "*Don't ask why the addiction, ask why the pain*"
“In the Realm of Hungry Ghosts or really anything by Dr. Mate'
“This is my favorite thing to quote when I have a client who is afraid to change their life because of guilt (leaving a job, ending a relationship, etc.): “When it comes to a choice between feeling guilt or resentment, choose the guilt every time.”- Gabor Mate from In The Realm of Hungry Ghosts
“In the Realm of Hungry Ghosts - Dr. Gabor Maté
“Gabor Maté also wrote an absolutely brilliant book called *In the Realm of Hungry Ghosts* about childhood trauma and addiction — 10/10 recommend.
“Thank you so much for the resources and advice! Just another note to say I love Gabor Mate and his work. I'm currently reading In the Realm of Hungry Ghosts (I was an opiate addict for 10 years) and it is so validating and eye opening. I was so excited to hear he was releasing a new book and it soun…
“Totally. You should check out In The Realm of Hungry Ghosts by Gabor Mate! It is about addiction, but specifically its mental health and trauma underpinnings. Early in the book (and woven throughout) Mate himself reveals his own struggles with cPTSD and addictive behavior in connection to his trauma…
Convinced? Pick up In the Realm of Hungry Ghosts: Close Encounters with Addiction
Readers also mention
Books that share discussion threads with In the Realm of Hungry Ghosts: Close Encounters with Addiction — counted from the comments, not curated.
In the Realm of Hungry Ghosts: Close Encounters with Addiction — frequently asked
What does Reddit think of In the Realm of Hungry Ghosts?+
r/therapists cites it as essential reading on substance use and trauma; r/CPTSD uses it as a framework for understanding their own histories. Neither community debates its value much — it functions more as a shared reference point than a contested text. Thirty-eight unique commenters, zero pushback.
Is In the Realm of Hungry Ghosts a clinical manual or a narrative book?+
Narrative, not manual. r/therapists is explicit: the book explains addiction through Maté's direct clinical experience and makes a case for decriminalization, but it does not provide treatment protocols. Practitioners recommend it for conceptual grounding, then look elsewhere for session-level technique. Multiple commenters flag this before recommending it anyway.
How does In the Realm of Hungry Ghosts compare to Gabor Maté's other books?+
r/CPTSD positions it as the addiction-specific entry in Maté's work, with When the Body Says No covering somatic illness and trauma more broadly. One commenter (↑34) recommends both as companion reads. Hungry Ghosts goes deeper on substance dependence and drug policy; When the Body Says No covers a wider diagnostic range.
Should I read In the Realm of Hungry Ghosts if I don't work with addiction directly?+
Depends on your interest in trauma. r/CPTSD, which accounts for 19 of the book's 40 mentions, reads it as a trauma book that uses addiction as its primary lens — the argument that culture creates conditions for suffering applies beyond substance use. If you want addiction-specific clinical content, the absence of treatment protocols will frustrate you.