Is love enough? The link between addiction and parent-infant interaction.

When I started reading In the Realm of Hungry Ghosts, by Canadian physician, Dr. Gabor Maté, I was not expecting to learn an incredibly important lesson in parenting. Instead, I thought I was going to learn about the trials and tribulations of addiction. Yet, in this captivating read, Dr. Maté elucidates a powerful connection between our early infant-parent / caregiver interactions and the propensity to turn to substances later in life.

It’s important, before getting too far into the meat, to touch on the important subject of blame. The research Dr. Maté shares and thus, the research I will write about in this post, showcase the paramount importance of early interactions between parent and child as the foundation for long-term emotional health and addiction-free functioning. This is, without question, an incredibly sensitive subject. Firstly, it challenges our heavy reliance on genes as an explanation for “bad” behaviour. Secondly, it challenges the assumption that only situations of abuse, neglect or trauma can trigger addictive behaviour. But most importantly, it places an incredible onus on the caregiver to ensure they aren’t wiring their child’s brain for addiction. This is where the blame game can come into play; however, that’s not Maté’s intention, nor is it mine. It’s simply to help us better understand this incredibly powerful process and how we influence it.

While genes play a role in the development of our stress apparatus and response, research demonstrates exposure to cortisol in utero can increase the release of cortisol in infants one year postpartum. Pregnant women who witnessed 9/11 were more likely to have infants with higher than normal levels of cortisol. Cortisol levels varied depending on the stage of pregnancy the woman was at; babies exposed in the third trimester had higher cortisol secretion than babies exposed in the first or second trimester. This highlights the role and power of the environment as opposed to a genetic transmission from mom to baby. Right from the get go, new parents need to be aware of how powerful their stress levels can impact their growing little one.

Yet, Dr. Mate spends most of his time discussing the importance of the caregiver- infant interaction and its association with addictive behaviour later in life.

“Infants have no ability to manage their own stress apparatus…they are completely dependent on the relationship with his or her parent,” writes Maté. Regular, predictable and stable contact is essential for the development of important brain circuitry, specifically our dopamine (reward) receptors and the growth of nerve endings that release dopamine. And it’s not simply physical contact and presence, it’s emotional presence as well. Specifically, whether or not we are attuned to our children.

What is attunement? As Dr. Mate describes it, “…it is literally being “in tune” with someone else’s emotional states.” To be clear, it is not about parental love. You can love your child deeply, but still not be attuned to them. It is about the “parents ability to be present emotionally in such a way that the infant or child feels understood, accepted and mirrored.” Sounds incredibly easy, yes? Me thinks not.

“Poorly attuned relationships provide an inadequate template for the development of a child’s neurological and psychological self-regulation systems,” writes Maté.  When we do not feel as though we are understood and accepted as infants, the circuitry needed for stress management and self-regulation does not adequately develop. We become less able to handle what life has to throw at us – we don’t do well with change, rejection, loss, disappointment. We may turn to external events, people, and in some cases, substances to help us regulate the turmoil we feel inside. More specifically, when we lack dopamine receptors and nerve endings that secrete dopamine, we need to find a way to increase the release of this potent neurotransmitter. And there’s no more effective way than drugs, alcohol or a highly rewarding experience such as sex, eating, or being wanted. 

Maté highlights the importance of consistency and connectedness via a study that investigated the parent-infant interaction among primates using three different foraging conditions. The first group had easy access to food; the second group had to work hard to find their food; and the third group sometimes found food easily, sometimes with more difficulty. The infants in the always easy or always hard group were well-adjusted; the parent-infant interactions were consistent, just as the foraging conditions had been. It was the infants in the third group, where foraging conditions were inconsistent, who did not become well-adjusted adults. The stress of not knowing, was enough to put these mothers on edge, to be more erratic and sometimes dismissive. These infants grew into “anxious adults, less social and highly reactive – traits known to increase addiction risk.” Our environments shape our interactions; our interactions shape our brain.

As a new parent, this sounds incredibly daunting. How can I always be attuned to my daughter? The intensity of my love, as Maté writes, does not necessarily ensure successful brain circuity development, nor protect her from addiction later in life. It is more than my love I must give to her; I must strive to mirror and connect with her emotional states in a way that she feels understood and genuinely cared for. And that, well, that’s big. It means I cannot explain away her bad behaviour based on her genetic code (which would also be partly my fault, and my parents and their parents fault too, right?). It means I must take responsibility now for her future actions and emotional well-being and strive to provide as stable, consistent and predictable an environment as I am able to. No small feat.

So what’s the overarching lesson (for me, at least)? Love isn’t always enough. 


P.S. Go and read the book.



Maté, Gabor. In the Realm of Hungry Ghosts. 2008.







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