Gabor Maté teaches: “Ask not ‘Why the addiction?’ but ‘Why the pain?’” Alcohol was my solution until it was my problem. That’s the most honest accounting I have of it. I wasn’t broken in the way the world told me I was — some morally deficient person who couldn’t make better choices. I was in enough pain that a substance offering temporary relief made complete rational sense to use. And then use more of. And then organize my life around.
Maté worked twelve years in Vancouver’s Downtown Eastside with people at the severe end of addiction. What he found consistently: nobody was addicted to a substance. They were addicted to relief from something. “All addictions originate in trauma and emotional loss.” The question isn’t “what’s wrong with you?” It’s “what happened to you, and what were you trying to survive?”
Johann Hari, in Lost Connections, extends this into what heals it: “The opposite of addiction is not sobriety. The opposite of addiction is connection.” The pain underneath most addiction is fundamentally relational — isolation, disconnection, the experience of being alone with something unbearable. Which is why clinical approaches that address only the substance without addressing the isolation so often fail to hold.
Bessel van der Kolk adds the body dimension: trauma “compromises capacities for pleasure, engagement, self-control, and trust.” Those are exactly what addiction temporarily restores. You feel alive instead of numb, engaged instead of dissociated, briefly able to tolerate yourself. The reach for the substance is logical given the underlying deficit.
What changes the question from “why can’t you just stop?” to “what pain is this soothing?” is everything. It shifts the frame from moral failure to unmet need — and unmet needs can be addressed. They require real connection, real safety, real community. Not more willpower.
Ram Dass wrote: “We’re all just walking each other home.” The accountability relationship asks not what’s wrong with you, but what are you carrying, and how can I sit with you while you carry it. That’s the beginning of an answer to why the pain.
