Dr. Anna Lembke is a Professor of Psychiatry at Stanford University and author of the New York Times bestseller "Dopamine Nation: Finding Balance in the Age of Indulgence".
549: Dopamine Nation: Finding Balance
Dr. Anna Lembke
In this conversation, Dr. Anna Lemke discusses the dual nature of dopamine as both a pleasure molecule and a regulator of pain. Find out how modern life, with its abundance of pleasurable stimuli, has led to a '"drugification" of everyday experiences, making individuals more vulnerable to addiction and chronic dopamine deficit states. Learn about fostering resilience in children, and how to follow a mindful approach to pleasure and pain in our lives.
Ep 549- Lembke
Read the Transcript 🡮
*This is an auto-generated transcript*
Dr. Anna Lembke (00:00)
The problem is that we have applied science and technology to make very potent forms of these natural rewards to the point where it's way more than our brains can handle, where we get like this fire hose of dopamine.
Hunter (00:18)
You are listening to the Mindful Mama podcast episode #549. Today we're talking about dopamine nation and finding balance with Dr. Anna Lembke.
Welcome to the Mindful Mama Podcast. Here it's about becoming a less irritable, more joyful parent. At Mindful Mama, we know that you cannot give what you do not have. And when you have calm and peace within, then you can give it to your children. I'm your host, Hunter Clarke-Fields. I help smart, thoughtful parents stay calm so they can have strong, connected relationships with their children. I've been practicing mindfulness for over 25 years. I'm the creator of the Mindful Parenting Course and Teacher Training and the author of the international bestseller, “Raising Good Humans”, “Raising Good Humans Every Day” and the “Raising Good Humans Guided Journal”.
Hello and welcome back to the Mindful Mama Podcast. Welcome Mindful Mama community and a special welcome to you. This was awesome episode. I was such a huge fan girl of Dr. Anna Lembke. I read her work and I read “Dopamine Nation”. I devoured it. It's such a good book.
So I am talking to Dr. Anna Lembke, Professor of Psychiatry at Stanford University School of Medicine and author of “Dopamine Nation”. She's been featured in the New York Times and many other publications. “Dopamine Nation” is a New York Times bestseller and we are going to be talking about the dual nature of dopamine as both a pleasure molecule and regular pain and how our modern lives of pleasurable stimuli has led to like of everyday experiences and we're going to talk about how to foster resilience in our children and more. This is such a powerful episode. I know you're gonna get so much out of it. So join me at the table as I talk to Dr. Anna Lembke.
It's Hunter Clark author of “Raising Good Humans”. If you've ever thought I wish I could help other parents the way I've been helped, this is for you. The Mindful Parenting Teacher Certification Program is now open for enrollment! Keep in your mindfulness, learn to lead powerful parenting groups, and join a supportive heart-centered community. And right now you can save 500 bucks with a discount through July 15th. Ready to make a difference? Visit MindfulParentingCourse.com/teach. That's MindfulParentingCourse.com/teach.
Thank you so much for coming on the Mindful Mama podcast.
Dr. Anna Lembke:
I'm delighted to be here. Thank you for inviting me.
Hunter:
I'm kind of fangirling here because I really love your work so much. And I really, as I told you, I love “Dopamine Nation”. think it's so, so well done. And I follow your interviews and New York Times and I'm like, “Anna Lembke, she knows her stuff!”. So let's dive into it. You describe dopamine as a pleasure molecule, but also as something that also governs pain. So, can you pass through how the same chemical is responsible for both joy and suffering.
Dr. Anna Lembke:
Well, I think to sort of widen the lens a little bit on that, away from one specific brain chemical or neurotransmitter, it's more that the same parts of the brain that process pleasure also process pain, and they work like opposite sides of a balance, or if you imagine like a teeter totter in a kid's playground, when we experience pleasure, it tips one way, pain, tips the other. And when we experience pleasure, one of the molecules in the brain that gets released in the dedicated neural circuit of the brain called the reward pathway is dopamine. And the more dopamine that's released and the faster that it's released in the reward pathway in response to any stimulus, internal, external, a substance or behavior, the more likely that substance or behavior is to be positive, reinforcing, or just something that our brains recognize as necessary for survival that we need to approach, explore, and possibly do again. So, dopamine has become a kind of common currency for measuring the addictive potential of different substances and behaviors. And also we know that what happens in the brain as people get addicted is that this dopamine release mechanism goes awry in a very kind of predictable way.
Hunter:
So I've been thinking about this over the last couple of days, especially because I just came from a dance weekend and I do Scottish country dancing. I love it, but I get so much dopamine from this behavior. I get such a rush and such a high and I'm having so much joy that sometimes I'm experiencing the other side of the teeter-totter and that's pretty natural I guess then on the Monday and the Tuesday after something like that.
Dr. Anna Lembke:
Yeah, that's a nice example because we don't usually think of there being a hangover or a come down from like being in a show or performing. But in fact, very often people will describe that. I remember I was doing a podcast with Russell Brand, you know, who's performed in front of very large live audiences and he talked about how he would get a total rush from that and then a really hard come down and then actually would use drugs like cocaine to sort of bring himself back up again, and that's quite common. And getting back to that teeter totter, to understand what's happening there, there are certain rules governing this teeter totter balance, and the first and most important rule is that the balance wants to remain level with the ground, or what neuroscientists call homeostasis, such that with any deviation from neutrality, whether to the side of pleasure or pain, our brains are going to work very hard to restore a level balance.
The way our brains do that is first by tilting an equal and opposite amount to whatever the initial stimulus is. So if we do something that's pleasurable reinforcing that releases dopamine in reward pathway, the balance tilts to the side of pleasure, but then our brain adapts by down regulating dopamine transmission. I like to imagine that as these little neuro adaptation gremlins hopping on the pain side of the balance to bring it level again, but they like it on the balance. So they don't get off on its level. They stay on until we're tilted equal and opposite amount to the side of pain. And that is the hangover, the come down, the blue Monday, or when you get back from a weekend of Scottish dancing, you're like, what is the meaning of my life? Why do I do what I do? Or whatever, know, kind of like the negative ruminations. Now, if we wait long enough without re-exposing ourselves to whatever our pleasurable reward is, then those gremlins get the message that their job is done, they hop off and homeostasis is restored.
But if we continue to expose our brains over years, over days to weeks to months to years, that initial deflection to the pleasure side gets weaker and shorter in duration, that's called tolerance. But that after response to pain gets stronger and longer. And you can imagine that as these gremlins multiplying and eventually they're kind of camped out there, tents and barbecues in tow. And now we've entered addicted brain where we've changed our hedonic or joy set point so that we're chronically in a dopamine deficit state, a tilt to the side of pain, such that we need more of our drug and more potent forms, not to get high, but just to level the balance and feel normal. And when we're not using, we're walking around with a balanced tilt to the side of pain, experiencing the universal symptoms of withdrawal from any addictive substance, which are anxiety, irritability, insomnia, depression, and craving.
Hunter:
My gosh. when you're talking about these addictive substances and dopamination, you're talking about a lot of different things that are kind of tilting us in the side. mean, I can imagine as you're describing the addictive piece when we have to sort of get our fix just to feel normal, like I can picture that in the instance of, you’re addicted to drugs. But then in “Dopamine Nation”, you describe this in a lot of different activities and substances, including like video games and smartphones and romance novels and all kinds of things. So tell me just a little bit more about that.
Dr. Anna Lembke:
Well, I mean, anything that is pleasurable or rewarding will release dopamine in the brain's reward pathway. And that doesn't make it bad, right? If it didn't release dopamine, we wouldn't want to do it again. And there are things that we need and want to do again that are necessary for survival, right? The basic natural rewards are food, clothing, shelter, finding a mate. If we weren't programmed, yeah, if we weren't programmed to want those things, we would have died out, you know, many, many hundreds of thousands of years ago. So it's not that dopamine is evil or we want less dopamine. The problem is that we have applied science and technology to make very potent forms of these natural rewards to the point where it's way more than our brains can handle, where we get like this fire hose of dopamine. We get it chronically in a way that our brain was not evolved for and also in a way that humans haven't had to deal with, except for like the last 200 years. I mean, just like take opioids, for example, you know, for most of human existence, for more than 2000 years, people have used opium from the poppy plant, right? But they had to have a bit of soil to cultivate poppies and then they had to grow them and wait till they were blooming and then they had to harvest them and then there was only so much and when it ran out, you had to start over again. Now, we have taken our technology to the point where we can make opioids in a laboratory without any plant precursors and we can make an incredibly potent form, 100 to 1,000 times more potent than opium, and we have needles that we can inject into our bodies that didn't exist before.
My point being that shift with a drug as old as opium, we now have with almost everything that we do, we've drugified our food supply. We've drugified human connection with social media, right? Where now we have likes and comments and shares at scale, quantified to sometimes millions of people. And if we don't like what we see, we can swipe right and swipe left and go find something else. So the point being that by making many different natural awards, more accessible, more potent, more novel and more bountiful, we've essentially drugified the modern world, making all of us more vulnerable to addiction, but also more vulnerable to these chronic dopamine deficit states that mimic clinical depression, anxiety, irritability, attention deficit disorder. And that's kind of really the point of dopamine nation that modern life is difficult in holy unprecedented ways because of this mismatch between our ancient wiring that has us reflexively approaching pleasure and avoiding pain and the world that we find ourselves in where we can just sit on the couch and with the press of the button have access to all these drugified goods.
Hunter (12:34.286)
Stay tuned for more Mindful Mama podcasts right after this break.
Hunter (14:44.906)
It’s also so strange that this world of abundance, right? Where we have free time, where we have fruit all year round, where we have so much entertainment, all this stuff. A lot of people listening to this podcast anyway, know, look at all of this stuff is happening.
And yeah, and then we're seeing that, know, kids are more anxious, adults are more anxious than ever. People in societies like the United States are more anxious than in places that don't have all that stuff. And so it's so paradoxical because I wouldn't want to go back in any way she turned. maybe, actually I was thinking that maybe, you know how like, the Amish and the Mennonite, we have them around here in Pennsylvania. They've stopped technology. Maybe we could just, if I could, could just get a society that stops technology around 2000, like pre-smartphone. Like we've got the internet, we can have information, but we can stop it pre-smartphone. But like, it's, it's that we wouldn't want to change it anyway, right? But it was hard to go back against those comforts. But it's so frustrating that these comforts are, what you're pointing to is the fact that it's like more uncomfortable. They are actually making us sort of comfortable and more anxious.
Dr. Anna Lembke:
The Amish are a great example because the Amish community illustrates how the adoption of any technology that is beyond what you need for subsistence living is going to entail pros and cons. The Amish is a community that got to a point of productive farming beyond which they said, we don't want to adopt technology beyond this because what we will lose is our club goods. Now club goods is a behavioral economics term for the intangible benefits that people get from living in communities that are really core also to our basic needs and our survival, right, our attachment to each other. And so I mean, the Amish, you know, through their spirituality basically had this aha moment, really a revelation that more technology in our lives is going to take away from our spiritual community. And I feel like the rest of us living in the modern world are thirsting on a deep spiritual and communal level in large part because we have adopted, continued to adopt, you know, the technology that makes our lives so convenient and so comfortable and so interesting in so many ways, but also has these enormous detriments to it in the spheres of social and emotional well-being, in the sphere of human attachment versus alienation and loneliness, in the sphere of purpose and meaning versus nihilism and alienation. So it's, you know, it's a double-edged sword. It's kind of, you the golden handcuffs. Whatever you want to call, whatever metaphor or idiom you want to use, there's a price to pay for this comfort.
Hunter:
Yeah, I'm saying a lot, my strong Scottish dancing, but it's physical, social attachment to my-
Dr. Anna Lembke (18:39)
Yeah, that's nice, right? That's physical. It's social. Yeah, so when you leave that you probably feel lonely when you get away from that wonderful shared communal activity.
Hunter:
Sometimes, yeah, I just go to dance class two days later, but that's- I just don't know. It's okay. Well, there you go. So let's look at the smartphone, right? Because it's really, I feel like it's really accelerated and it's really something that really concerns me a lot. But anyway, it's been called the modern day hypodermic needle, dopamine 24/7 for the wired, delivering digital dope.
Dr. Anna Lembke:
I called it that. That's from “Dopamine Nation”.
Hunter:
You did it. You did it. Okay, great. like, I thought that might have been it. was like, I can't find it once. Anyway, I'm just going say it's been solved. All right. Well, can you tell us, Anna, how do smartphones affect the neurochemical balance for both thinking from the lens also both children?
Dr. Anna Lembke (19:40)
Well, let's look at the origins of the metaphor. Like I said, opium from the poppy plant has been around for millennia. In the early 1800s, morphine was isolated from opium, and they could do that in a laboratory. And it's approximately 10 times more potent than opium. And then when you add two acetyl groups to morphine, you get heroin, which was discovered in the late 1800s. But between the discovery of morphine and heroin, there was the invention of the hypodermic syringe in the 1850s. And the original idea behind the hypodermic syringe was that it would be a way to administer morphine such that people would not get addicted to morphine because they were already problems with serious addiction.
And of course that completely backfired, right? Because intravenous anything really, because of the rapid uptake in the brain is going to be even more addictive than if you eat it or drink it or smoke it. And so when I talk about the smartphone being the hypodermic syringe, a delivering digital dopamine, what I'm saying is that I'm not sure that the smartphone itself is the drug. But it's the delivery mechanism that allows for 24 access to the digital drugs that are now available on the internet. For example, addictive forms of social media. Not all social media is designed to be addictive, but most of the most popular types of social media are engineered to be addictive. What do I mean by that? I mean that they rely on our need for social validation, reciprocity, and group belonging, and the likes, the shares, the comments, the posts, the enumeration at scale, meaning that we're now quantifying how many people have liked it and shared our comments, the rapid turnaround. Because kinetics matter when it comes to addiction. If we had to wait a really long time to get a respond to our post, trust me, nobody would be posting. It's the fact that the response is almost immediate. That turnaround time is very reinforcing for our brains over that rapid time scale and all of that together means that social media, certain types of social media have essentially drugified human connection. We know human connection releases dopamine in the reward pathway, that's why falling in love feels good. But what's happened with social media is with almost no upfront effort, we've distilled social connection down to its most reinforcing elements and people are now on social media nominally to connect with other people, but really what they're doing is just delivering dopamine to their reward pathway. It's the medium itself that is the drug and the smartphone is the way that we get it 24-7 wherever we are in the bathroom, in the bedroom, at the dining table.
And you know that people who develop digital media addiction, whether it's social media or pornography or online games or online shopping or whatever it is, the pattern that they have is just like people have with cigarettes, the first thing in morning, you know, they light up, they reach for their phones, and then they reach for the phone multiple times all through the day. And then they get to the night time and the willpower is down and they're more tired. Then they go on, you know, the sort of endless scroll or the binge watching or, you know, and we're all vulnerable to it, right? And we can all relate to this phenomenon. Oh, I was just going to go and watch one YouTube video and two hours later I'm watching these completely ridiculous YouTube videos. So things like that, I think, is something that so many people are experiencing now. And it's because the digital media are highly reinforcing and potentially addictive.
Huter:
Yeah, I'm seeing that behavior obviously in my own family and myself. My dad’s recently gotten into it and then he's really gotten into it. He's talking out loud about it and swiping and telling us things and we're like, can you go do that somewhere else? We've been talking with my 18 year old- my husband and I- about, we were like, “I think I'd been feeling the effects of like the creep of the phone”. Just like the checking and my husband, daughter, and I had considered- we were talking about getting like dumber phones, some kind of flip phone or something like that. But then my daughter, I guess like a week and a half ago now she, said, “Mom, give me your phone. She took my phone and she got rid of Facebook. She got rid of the New York Times. She went through every single app and was like, what is this? I'm getting rid of it. No more, no more digital thrifting for me on thread. I rid of all the things and it's- got rid of Instagram. Actually, the thing we did is- we live in Delaware. We're just south of Philadelphia. So I actually subscribed to the Philadelphia paper to actually be physically delivered to our house.
Hunter (25:21)
Stay tuned for more Mindful Mama podcasts right after this break.
So it's been this like week, actually leading up to this conversation with you of like a week and a half of like some changes and some shifts and I've been feeling some clarity. It feels like it was cluttering up my brain and I wonder with this idea of the smartphone as the modern hypodermic needle delivering the digital dopamine, some more clarity. It’s affecting people in a way that really is negative, right? Like one thing I'm noticing, and I don't know, maybe you can confirm this or not, is that people seem sort of anti-social. Like it is hard to get people out of. I'm wondering if it's like, this is part of the way this reward pathway is stimulated. Can you tell me about that?
Dr. Anna Lembke:
Yeah, I mean, this is the great irony of this technology that, you know, the technology allows us to connect with each other without leaving our homes or even our couches for that matter. And yet at the same time, the technology is driving us further apart. More people than ever before live alone. Young people now endorse preferring online communication to actually having face-to-face communication. The majority, or at least half of young people, endorse preferring online communication. More and more people are not leaving their homes. They're recreating in their homes. I mean, it's like the trajectory, you wonder if Rogan turns to human versions of moles, right, who just sort of live indoors and never go out anymore. Yeah. Right. Yeah, exactly.
So, yeah, and it's funny because when you first said antisocial, I was thinking about the psychiatric notion of antisocial, which is not, you know, not social, although that's happening too, and I think that's what you were alluding to. But the antisocial personality disorder where people are like sociopathic and are no longer in their lacking in integrity and morals. And that also happens, right? Because all of this information, more information than our brains were processing all the normalization out of this kind of deviant speech and deviant behaviors online, I think has contributed to a decay of morality more broadly where just people kind of feel like, you know, anything goes and I can sort of say whatever I want. And the sort of civil discourse that we took for granted is now actively threatened. So, you know, both in terms of it limiting our socialization, but also contributing to a kind of a sociopathy. You know, think that element is there. Again, you know, there are great things about the technology. You and I are having this conversation, we couldn't have it otherwise. There's all kinds of opportunities to connect and learn and appreciate things that we otherwise couldn't appreciate, marginalized people have the ability to So there are many good things, but there are clearly also many bad things.
And I think it's good that we're having the conversation about the bad things so that we can individually and collectively think about how do I want to be in relationship with the technology. I love what your daughter did. Love it. I love that you're getting a regular paper. First of all, you're supporting a dying industry, which is the newspaper industry. But also that kind of slowed down, slowed form, intentionally slightly inconvenient way of consuming media, it is, I think, important to think about, right? Like, how do I want to get my information and what is a way that is, you know, kind of enriches my life to have this information versus detracting from my life? And everybody's going to maybe come down in a slightly different place. But I think most of us would agree we're sort of dealing with like, not just information overload, but like sensationalized information overload. And especially kids, know, kids, have to connect, we have to protect kids and kids' brains. Kids' brains are vulnerable. You know, the frontal lobe isn't fully wired up to the limbic system. The kids are much more vulnerable to social judgment. They're much more social sensation seeking. They're much more likely to take risks, or at least they used to be, now the risks are online, which are riskier in some ways. So yeah, we have to think about, you know, how we're rewiring kids' brains with the technology.
Hunter:
Yeah, you said in the New York Times interview, we're spending more and more of our energy in creativity in the online world, which means that we are in online world, really in creativity so that when we try to the real world, it actually is more boring because there's less going on because there's nobody there. I was thinking about that, like where people are on their phones and investing in actually leeching a real real life existence of our energy to read their phones, they're getting these hits all the time. And so then it's kind of filling this need in a superficial way. then they're not getting the real life that gets even less interesting, which is, I mean, that's horrifies me.
Dr. Anna Lembke:
Yeah, I mean it means now when your spouse comes home and tells you about their day at work, like you don't really want to listen because you'd rather go listen to your, you know, celebrity update or something, right? So that's a problem. That's a genuine problem.
Hunter:
Yeah, yeah, or you're not getting out of the house to do things with friends and then you're losing those social connections because you feel you're getting a semblance of it. You feel like you kind of got it, but you didn't really. It's not a real connection.
Dr. Anna Lembke (32:12.814)
Right, I mean it's just so soothing. You know, it's this machine that we can use to soothe ourselves. We have a little bit of a buzz, we're entranced. And then when we try to stop, you we experience the come down that happens when you have to stop using any drug. And then there's this huge activation energy required to get ourselves to do anything else because it's so much harder relative to just like scrolling and consuming media online. And you know, this gets right back to the pleasure pain balance. I pleasure and pain relate to each other and they're relative, right? So if you're constantly consuming these soothing pleasurable substances and behaviors, you know, you're gonna reset your hedonic threshold for what's pleasurable and what's painful.
Hunter:
It makes me think of mindfulness and I've studied mindfulness in the tradition of Thich Nhat Hanh and gone to the monasteries in the Plum Village tradition, Blue Cliff Monastery. And I think about that and what we do when we go on a retreat there is that we are retraining ourselves to, and they are actively helping train everybody to find honest pleasure in things like the sound of the rain or to find pleasure in the feeling of breathing or remembering that are alive or the feeling of your footsteps walking or walking together through the woods, you know, collectively, the feeling of eating and the satisfaction of that. And it's interesting and it's like really distilling down. It's almost like you talk about abstinence in your sort of dopamine way of combating that is kind of like taking abstinence was also actively encouraging and reminding people that you can find pleasure in very simple, essential things- dinner. Very simple.
Dr. Anna Lembke:
Yeah, and you know, I think we often think of abstinence as sort of denying ourselves rewards, but really what it means is that we'll reset our reward threshold such that simple pleasures become rewarding again, which is exactly what you're talking about. And I think that's what, you know, it's not about denying ourselves pleasure or, you know, always living in pain. It's about how this constant comfort seeking and pleasure seeking is actually creating the pain that many of us experience living in the modern world and then to recapture some of that. The joy of life means to, you know, eschew these quick pleasures, intentionally pursue things that are challenging and difficult and thereby get back the simple joys.
Hunter:
So do you think that we as parents should try to prevent our children from experiencing dopamine spikes? What would you say?
Dr. Anna Lembke:
Yeah, I mean, I think in general, you know, it makes sense to me to not expose our children to like constant comfort and pleasure and soothing easy things aka the iPad. I think to raise healthy kids, they need challenge. We're really wired to strive. That's how we evolved and kids feel good and get a sense of competence when they overcome obstacles and difficulties. And that's what gives them confidence to make it in the world. So yeah, I do think that I would recommend that.
Hunter:
Yeah, in our family- had from most of until about a year ago, and that was when they had screen time and other times. And actually-the listener knows this, because this podcast has already come out- Maggie recently recorded an episode with where she actually thanked me for limiting her screen time when she was little. But anyway, that is when the pleasure of the projects would come out, where the box would become the ship and all the different things. And that's when that would come out. And it was just wonderful to see this kind of deep play where it goes on for multiple hours sometimes. it's just, they're just absorbed in it and you describe that in dopamine nation as like a kind of like the dopamine release of a project and the satisfaction and the sort of slow thing and that might be something that we're sort of aiming at. By maybe denying them what everyone else in the might be giving them, we might actually be giving them more.
Dr. Anna Lembke (37:43)
Exactly, yeah. And going back to that metaphor of the teeter totter, those gremlins are actually agnostic to the initial stimulus. So if we intentionally press on the pain side, they will actually go over on the pleasure side and we will get our dopamine indirectly by paying for it upfront. There's a whole branch of science called hormesis, and hormesis is a Greek term. means to set in motion. And what we're setting in motion is the body's own healing, re-regulating mechanisms. There are more and more studies showing that when you expose all different kinds of animals to mild to moderate doses of painful or toxic stimuli, you actually make the organism healthier. They live longer, they're more agile, what have you. Things like extreme cold, things like spinning in a centrifuge, just various kinds of physiologic stressors. And the same is true for humans. I mean, this is what we call the runner's high, right?
Hunter:
I got that once.
Dr. Anna Lembke:
Yeah, exactly. So we know that when we begin a strenuous exercise or exercise even as tolerated, doesn't even have to be that strenuous, dopamine levels rise gradually over the latter half of the exercise and then they remain elevated for hours afterwards before going back down to baseline levels of dopamine firing. And you never go into that dopamine deficit state that is characteristic of intoxicants where we have that upward spike and then that downward deflection before going back to baseline or in addiction getting stuck in that downward deflection. So this is a better way to get our dopamine because by getting it indirectly, we are protecting ourselves to some degree from the addiction cycle. Now, can people get addicted to pain? Absolutely. It's rare, but we do see things like people addicted to exercise often combined with calorie restriction.
And the intervention there is similar to what we would do for any kind of addiction. We'd have them abstain from exercise and calorie restriction, you know, for a period of time to be able to reset reward pathways. We see people who cut and the reason that they cut is because it releases endorphins, our endogenous opioids, which then releases dopamine, which feels good. People actually get high on that. And the intervention there, you know, is that we would have people abstain from cutting for a period of four weeks, again, that kind of dopamine fast early intervention, until they get out of the state of craving, cutting, and find better, healthier, adaptive coping strategies. So the addiction lens can be useful for many different types of compulsives, behaviors, and substance use. But in general, we encourage people to do hard things as a way to accelerate resetting their reward pathways to a healthier level. And again, this can be exercise, it can be ice cold water plunges, it can even be things like meditation and prayer, which when done consistently do tend to be effortful and aren't like an immediate high for most people, but with sustained effort can lead to, you know, quieting the mind and really, and release dopamine and improvements in that regard.
Hunter:
That’s nice to hear that. Anyway, you talk about exercise in “Dopamine Nation” p. 151, say, high levels of physical activity in junior high, high school, and early adulthood, predict lower levels of drug use. It's interesting that you're describing it as this like pain thing, which is not how I think of it. Cause I'm exercises are, you know, it's a must in my life. Right. And, people can't understand, I guess, like, or my kids watch me. Sometimes I do this body pump class and sometimes I do it at home. I've got all the lifting these heavy weights and doing like five, six minutes of school in a row. But it's painful at the time, guess it is. I don't really think of it that way, And if I'm in a bad mood, that completely- for hours after I feel good. Completely turns me around.
Dr. Anna Lembke:
Yeah, that's right. That's exactly right.
Hunter:
So yeah, you talk about in “Dopamine Nation”, some of the, the antidotes to our addictive nature. I just described some of them- meditation, exercise. When going back to our conversation about phones, how would yo- what would you say to people about healthy phone behavior?
Dr. Anna Lembke:
Yeah, well, I mean, I would say to parents whatever you're doing now, it's never too late to do it a little differently. It's true that once your kids become teenagers, it gets much harder to intervene with those behaviors, especially if you've established certain norms in your household. It can be difficult to change those norms. But it can be done, you know, with a lot of talking about it and consensus building and also parents changing their behaviors too, not just expecting kids to change without parents also changing. In general, I say to parents that if you have a child under the age of 13 or even, you know, even a little older, a child under the age of let's say 15, best to not give them their own personal device connecting to the internet. Wait as long as you possibly can.
And then when you give that device or you give approval for such a device, make sure that it comes with warnings and disclaimers. That is to say, you can give the device to take it away if the child is showing that they're really not able to moderate their use or use in ways that are socially appropriate and safe. And have, you know, etiquette, you know, established again norms, digital etiquette around when it's appropriate to use the device and when it's not, like, at the dinner table and not when we have friends visiting and not when someone is trying to talk with you and not when you're doing your homework, right?
Hunter (44:19)
Yeah, and I always encourage parents to get that alarm clock. Get yourself an alarm clock and don't use your phone for an alarm clock. Get all the phones out of into the living rooms, downstairs, in the kitchen, wherever. know, just that physical, it's, guess, as I learned in dopamine nation, it's like a practice of keeping your between you and the, you know, the odd thing that is addictive. That's right.
So one more thing: in the end of “Dopamine Nation”, you talk about some antidotes- awareness, radical honesty, social shame. for me, I was like, hmm, okay. Cause I'm used to thinking of shame as kind of a destructive feeling. Cause shame is this thing that I am, where guilt is like, did something bad. What is pro-social shame and how do you it as helping people?
Dr. Anna Lembke:
Yeah, I mean, whether you call it shame or guilt, what we're basically talking about is related emotions where we feel badly about something that we've done or said or, you know, a regret. Typically, we might be inclined to lie about it in order to cover it up because the fear of being rejected by our tribe is so overwhelming that we would rather hide it and be found out and risk the fear of shunning. shame can absolutely be a very negative thing and can perpetuate the problem of addiction, especially when combined with habitual lying, so that we lie about it, we feel more shame, then we use to cover up the shame, and then we lie some more. And you can get into this really vicious cycle, something that's called malignant shame or toxic shame. that can drive addiction. On the other hand, if we didn't feel some degree of shame for these behaviors, we also wouldn't be motivated to change them. So in many ways, shame is possibly our most pro-social emotion, Because it's what gets us to adhere to certain types of expected behaviors that we need to adhere to in order to live in larger communities.
And so the key to turning malignant shame into pro-social shame, I think, begins with truth-telling. And that's this idea of radical honesty, which we actually prescribe to patients. We say, in addition to not using your drug of choice this month, we want you to engage in radical honesty. That means you can't tell any lies about anything. And the little lies possibly matter more than the big lies. So you can't lie about why you were five minutes late for the meeting. You can't lie about what you had for breakfast. You can't lie about where you are, what you're doing any of it. And what we find is that people in robust recovery from addiction have already naturally discovered that the lying habit is a harbinger and a part of addiction, whereas the truth-telling habit or radical honesty, rigorous honesty in AA is really necessary to maintaining recovery. We're not exactly sure what the connection is. I I speculate in the book that it's related to the prefrontal cortex and that engaging in active honesty which takes effort because we're natural liars might actually strengthen our prefrontal cortex. The prefrontal cortex kind of acts like the brakes on the car when it comes to a repetitive control. It's also true that when we're telling the truth, we promote intimacy, you know, when we're making ourselves vulnerable to other people being honest. We think that people are going to be repelled by the things we've done.
But in fact, they see themselves in us in our flaw, in a mutual flawed humanity and it often fosters intimacy and brings people closer to us. And that's a great paradox because we have a lot of resistance to being truthful about our warts and all. But when we really do share, it is a way to bring people closer and then that's a wonderful source of healthier, feel-good neurotransmitters like dopamine. So yeah, so that's kind of the different, that's what I talk about when I talk about pro-social shame, it has value as a pro-social emotion.
Hunter:
Well, Anna, there's so much here, know, dear listener, if you are interested in how the brain works, if you interested in our addictive nature and just want to learn about it, I highly recommend “Dopamine Nation”. I was telling Anna before we started talking that I, I mean, I read a lot of books, then forget a lot of books, lot of, thought a lot of different things. And I really, really appreciate how about how engaging “Dopamine Nation” is as a read. So get it everywhere books are sold. So you maybe already have it and you could just tell it is. But Anna, I really appreciate you coming and I appreciate the way you've distilled your being down into the way and the way you share much incredible information. I find it all like super refreshing and I'm a great fan. anyway, for coming on the podcast and everything you've done. Thank you.
Dr. Anna Lembke:
Well, thank you. Thank you for those kind words and for having me on your podcast.
Hunter (50:18)
This is so fascinating, isn't it? I hope you will share this episode with your today because I think it's fascinating. I'm on socials @MindfulMamaMentor.
And yeah, let me know what you think about this. And actually I have an update for you: when I talked to Dr. Lemke, as I had recently, Maggie had recently taken the apps- New York Times, and Instagram, and Facebook- off my phone. And I have been keeping to it successfully pretty much. It’s changed my relationship with my phone over the last few months and I am feeling a lot better: feeling a lot less distracted, feeling more regulated. I'm really, it's kind of. feeling more at ease and just kind of in my life. Anyway, so I recommend it. It can do that if you can just take that stuff off.
And then like maybe go on your laptop or something and tell me what you think of the episode and how it's going and I'll cheer you on. I promise I will. I've been to the Philadelphia Inquirer- physical newspaper delivered to my house every day, some kind of like reinvigorating my physical real life and everything's a lot better now.
Okay. That's my update. Wishing you a beautiful week. Thank you so much. Next, we have an awesome episode with Michelle Grosser about co-regulation and the nervous system, managing overwhelms. So check back in. I will talk to you then. Take care, my friend. Namaste.
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