Stanford Psychiatrist and Addiction Expert Anna Lembke - The New Neuroscience of Pleasure, Pain, and Balance
Jan 26, 2024
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Stanford Psychiatrist and Addiction Expert Anna Lembke discusses the new neuroscience of pleasure, pain, and balance. Topics explored include the increase in behavioral addictions and the devastating effects they have, the impact of digital media addiction on mental health, treatments for attention deficit disorder, seeking healthy dopamine through diet and exercise, and the regulation of online sex video games and exercise addiction.
The brain constantly strives for balance between pleasure and pain, adapting to increased dopamine release and leading to cravings and a tilt towards pain when deprived of addictive substances or behaviors.
The overabundance of cheap dopamine sources in our modern world has contributed to a mental health crisis, highlighting the need for top-down interventions, including regulation by companies and governments, as well as changes in school policies and integration of technology.
To regain control over addictive behaviors, implementing strategies like dopamine fasts, self-binding, and radical honesty can be effective, while also emphasizing the importance of finding meaning and purpose in combating addiction and fostering overall well-being.
Deep dives
The Neuroscience of Pleasure and Pain
The podcast explores the balance between pleasure and pain in the brain. Pleasure and pain coexist in the same parts of the brain, functioning like opposite sides of a balance. When we experience pleasure, the balance tilts in favor of pleasure, and when we experience pain, it tilts in favor of pain. The brain constantly strives to maintain a level balance, or homeostasis, often adapting to increased dopamine release by down-regulating dopamine transmission. This neuroadaptation leads to cravings and a tilt towards pain when deprived of the addictive substance or behavior.
The Mismatch in the Modern World
The podcast discusses the mismatch between our modern world of abundant rewards and our brain's ancient wiring for scarcity and danger. The pursuit of instant gratification and the overabundance of cheap dopamine sources, such as drugs, food, shopping, gambling, and social media, have contributed to a mental health crisis. Rates of depression and anxiety are rising, particularly in the wealthiest nations where there is easy access to addictive substances and behaviors. The podcast highlights the need for top-down interventions, including regulation by companies and governments, as well as changes in school policies and integration of technology.
Digital Addiction and Radical Honesty
The podcast addresses the issue of digital addiction, particularly among young people, and the impact of constant stimulation and dopamine release. It emphasizes the importance of moderation and implementing strategies like dopamine fasts and self-binding to regain control over addictive behaviors. Additionally, the podcast suggests the power of radical honesty as a tool for promoting intimacy, activating the prefrontal cortex, and reshaping narratives about oneself. The discussion also explores the need for a societal shift towards radical honesty and away from projecting a false self on social media. Finally, it highlights the role of meaning and purpose in combating addiction and fostering overall well-being.
Dopamine Acronym Approach to Address Addiction
The podcast discusses a clinical approach to treating addiction using a dopamine acronym. The approach involves gathering data about one's substance use, identifying the reasons for using, understanding the problems associated with it, and practicing abstinence for 30 days. The abstinence period allows individuals to gain clarity on the impact of their behavior and begin experiencing cognitive clarity. Mindfulness and insight are also recommended to observe thoughts and triggers. Self-binding is suggested as a way to create barriers between individuals and addictive substances or behaviors. The podcast emphasizes the importance of recognizing when behavior becomes maladaptive and addresses the link between childhood trauma and addiction.
Understanding Control Illusion in Addiction
The podcast explores the illusion of control inherent in addiction. It highlights how individuals may believe they are in control of their addictive behaviors, but in reality, their lives become unmanageable. Radical honesty and surrendering control are emphasized as important steps in recovery. The podcast suggests that individuals should seek healthy dopamine sources and engage in activities that provide deeper meaning and purpose. It also addresses the need for governments to regulate online sources of cheap dopamine, particularly for children, to protect them from addiction.
We're living in a time of unprecedented access to high-reward, high-dopamine stimuli: drugs, food, news, gambling, shopping, gaming, texting, sexting, Facebooking, Instagramming, YouTubing, tweeting... We've all become vulnerable to compulsive overconsumption.
Dr Anna Lembke is here to help. Professor of Psychiatry at Stanford University School of Medicine, chief of the Stanford Addiction Medicine Dual Diagnosis Clinic, and an internationally renowned expert in addiction medicine treatment and education, she joins MindHealth360 Founder and Editor Kirkland Newman to share the secret of finding balance in our age of indulgence.
