“No society can understand itself without looking at its shadow side.” 

Maté believes that all addictive urges come from the same source: The shadow side of a person. Because people make up society, the society must also have its shadow side. True understanding of a society cannot come from only looking at its achievements. There is much to learn from a society’s failures as well. 

“People jeopardize their lives for the sake of making the moment livable. Nothing sways them from the habit—not illness, not the sacrifice of love and relationship, not the loss of all earthly goods, not the crushing of their dignity, not the fear of dying. The drive is that relentless.” 

Maté’s thought after talking with Ralph. Ralph tells him a story about a Nazi work camp where Jewish prisoners refused to give up their cigarettes, even though if a soldier caught a man smoking the whole barracks would die. Even if the story is apocryphal, Maté sees echoes of its truth in his own compulsive behaviors. He never feels free of it, and is therefore constantly at risk from its consequences. 

“It is impossible to understand addiction without asking what relief the addict finds, or hopes to find, in the drug or the addictive behavior.” 

Much of the book discusses the various voids addicts tend to have. The patients at PHS use drugs as a substitute for the comforts and developmental milestones that denied to them in childhood. In Maté’s opinion, treating addiction as bad behavior and poor choices does not contribute to a real understanding of addiction. Addiction is a process that begun before the user indulged for the first time.