There is a delicate balance between pleasure and pain. Finding that balance is esssential for our leading our best quality of life.
This week we’re continuing our Productive Reading recurring series. In the past, we’ve talked about the lessons and key takeaways I found in books about productivity-related topics that I’ve found helpful and thought-provoking, including books by authors like Gary Keller, Charles Duhigg Brené Brown, Courtney Carver, Jeff Sanders, James Clear, Michael Hyatt, Maura Nevel Thomas, Joshua Becker, Greg McKeown, Cal Newport, Dominique Sachse, Laura Vanderkam, and most recently talking about Nir Eyal’s interesting book Indistractablle (episode 454). We’ll include links to past episodes of the Productive Reading series below. This time I’m sharing some of my most important takeaways from an intriguing book by Dr. Anna Lembke, called Dopamine Nation.
Who is Anna Lembke?
Book cover flap copy:
“Anna Lembke is the medical director of Stanford Addiction Medicine, program director for the Stanford Addiction Medicine Fellowship, and chief of the Stanford Addiction Medicine Dual Diagnosis Clinic. She is the recipient of numerous awards for outstanding research in mental illness, for excellence in teaching, and for clinical innovation in treatment. A clinician scholar, she has published more than a hundred peer-reviewed papers, book chapters, and commentaries in prestigious outlets such as The New England Journal of Medicine and JAMA. She sits on the board of several state and national addiction-focused organizations, has testified before various committees in the United States House of Representatives and Senate, keeps an active speaking calendar, and maintains a thriving clinical practice.”
Why did I read this book?
I don’t recall where I first heard of the book, but the title and description intrigued me, as one of my ongoing interests is puzzling out the reasons we so often struggle to do the things we need and want to do, including achieving goals we so meticulously and hopefully set for ourselves.
On our last installment of the Productive Reading series we looked at Nir Eyal’s intriguing book, Indistractable, subtitled How to Control Your Attention and Choose Your Life. As we discussed in that episode, the book asks us: “What could you accomplish if you could stay focused?” and then goes on to discuss the psychology of distraction and offer solutions to help us manage and maintain the focus needed to achieve our goals.
This episode’s book digs even deeper into similar issues, looking at both the psychology and the physiology of addictive behavior that can interfere with our ability to accomplish the things that are important to us.
The book is subtitled: Finding Balance in the Age of Indulgence. This was intriguing to me, as I seek a better sense of balance in my own life.
The book is divided into several parts
The introduction introduces the problem the book is intended to address:
“This book is about pleasure. It’s also about pain. Most important, it’s about the relationship between pleasure and pain, and how understanding that relationship has become essential for a life well lived.”
The reason for this necessity? “Because we’ve transformed the world from a place of scarcity to a place of overwhelming abundance: Drugs, food, news, gambling, shopping, gaming, texting, sexting, Facebooking, Instagramming, YouTubing, tweeting . . . the increased numbers, variety, and potency of highly rewarding stimuli today is staggering. The smartphone is the modern-day hypodermic needle, delivering digital dopamine 24/7 for a wired generation. If you haven’t met your drug of choice yet, it’s coming soon to a website near you.”
“This book offers practical solutions for how to manage compulsive overconsumption in a world where consumption has become the all-encompassing motive of our lives.”
This made me pause to think about how much our lives are centered around consumption and how little time most of us spend creating. Consider whether you create anything — past generations of women did needlework (sewing, embroidery, quilting, etc.) both for practical purposes and for creative expression; cooking/baking; gardening; and more. In a world where money and pre-made goods were scarce, our creative ingenuity was necessary for survival and could create a sense of satisfaction. Life is different now.
Part I – The Pursuit of Happiness
In this part she discusses, among other things, the science behind addiction and the risk factors.
“One of the biggest risk factors for getting addicted to any drug is easy access to that drug. When it’s easier to get a drug, we’re more likely to try it. In trying it, we’re more likely to get addicted to it.”
As an example she talks about alcohol addiction and its effects declining during Prohibition and increasing after Prohibition was lifted. Some use (and overuse) will exist no matter what, but the harder something is to get, the less often it will be used and the fewer people will use it. Another example she mentions is pornography proliferation; it’s always been around, but the internet has made it easy to get. There is also the opioid crisis.
BUT when she refers to drugs, and the “drug of choice,” throughout the book, she’s not using it to mean just the things we typically think of as drugs, but as anything that can produce that hit of dopamine that our brains will then drive us to seek again–substances, yes, but also activities and experiences
Addiction is the compulsive pursuit of a particular reward-producing behavior or substance despite the resulting harm to self or others.
- A narrowed focus on getting/experiencing that drug of choice. It is, she says, bondage.
- “Compulsive overconsumption” of anything – drugs, alcohol, video games, social media, sex, . . .
We are, she says in one of her YouTube interviews (and in the book), “titillating ourselves to death”–pursuing pleasure to the point of damaging our health, our minds, and our relationships. The top 3 causes of death worldwide are diseases caused by modifiable risk factors, and those top 3 risk factors are overweight, smoking, and being sedentary–all of these fed by abundance and easy access to pleasure-producing substances and activities, from food to cigarettes to video games and beyond
Part II – Self-Binding
Here she talks about mechanisms and approaches for breaking the cycle and breaking free from addiction–whether to substances or behaviors.
Part III – The Pursuit of Pain
In this last part of the book she makes the case for more judicious use of medication for emotional and psychological struggles and more intentional acceptance of discomfort that can lead to a better balance in the areas of our brain that process pleasure and pain.
She is a medical doctor–a psychiatrist–so there’s lots of science (neuroscience) but it’s explained in a very accessible way and illustrated with stories of her own and her patients’ experiences with addictive behaviors.
Key takeaways and quotes
A couple of important scientific discoveries:
First, dopamine — a neurotransmitter (that carries messages across the synapses [gaps] between neurons in the brain) – was identified in the human brain 1950s.
Brief summary – “The main functional cells of the brain are called neurons. They communicate with each other at synapses via electrical signals and neurotransmitters.”
“Dopamine may play a bigger role in the motivation to get a reward than the pleasure of the reward itself. Wanting more than liking.”
“Dopamine is used to measure the addictive potential of any behavior or drug. The more dopamine a drug releases in the brain’s reward pathway . . . , and the faster it releases dopamine, the more addictive the drug. This is not to say that high-dopamine substances literally contain dopamine. Rather, they trigger the release of dopamine in our brain’s reward pathway.”
Second, that pleasure and pain are processed in the same area (or overlapping areas) of the brain. The brain prefers equilibrium–a balance between the two–also known as homeostasis.
So if we engage in a behavior or ingest a substance that evokes pleasure (i.e., rewards us with a hit of dopamine) the brain goes to work to reestablish homeostasis–to raise the pain side of the balance, by, among other things, regulating dopamine production — so it takes more of the activity or behavior just to feel the same level of pleasure (the 5th or 10th piece of chocolate doesn’t taste as good as the first one did); that drives us to overconsumption in an unconscious effort to recreate that first euphoric response, but it has the opposite result:
The greater the frequency and amount of the reward-producing activity or substance, the more the brain regulates and decreases the dopamine receptors and production.
She thinks this all explains the fact that in a time of unprecedented abundance, we as a species are measurably less happy than ever, experiencing unprecedented levels of depression, anxiety disorder, chronic pain, and suicide. Studies disclose the steepest declines in happiness in the wealthiest nations.
“Having too much material wealth can be as bad as having too little. Dopamine overload impairs our ability to delay gratification. Social media exaggeration and ‘post-truth’ politics (let’s call it what it is, lying) amplify our sense of scarcity. The result is that even amidst plenty, we feel impoverished.”
Reading that, I saw a possible explanation for the mystery of the number of wealthy famous people who either commit suicide or engage in self-destructive excess.
She sees the correlation between access to an overabundance of goods and experiences and a decline in happiness–those depressive emotions are the result of repeated exposure to highly pleasurable/rewarding behaviors and substances, which pushes the brain to decrease dopamine and move us to the pain side of the scale. (When dopamine production decreases beyond a certain point, our compulsive seeking of it creates an obsessive focus on that one substance or experience, and we are unable to find pleasure in other areas of life–careers, relationships, etc.).
The more we expose our brains to highly rewarding activities and substances, the more likely it is our brains will tip us toward the side of pain, trying to restore homeostasis. The result: “chronic dopamine deficits” leading to the emotional/mental health effects already mentioned. Thus, she says, we can “conceptualize modern despair as a result of overabundance.”
Why is all this happening?
We have “brains that evolved in a world of scarcity and ever-present danger.” This led to us reflexively approach pleasure and avoid pain; a useful survival mechanism in times of scarcity, but counterproductive in an age of abundance, because the overabundance of and our repeated exposure to the reward-producing substances and activities triggers that balancing mechanism that we experience as developing a tolerance for it:
“Needing more of a substance to feel pleasure, or experiencing less pleasure at a given dose, is called tolerance. Tolerance is an important factor in the development of addiction.”
It’s so important to recognize that this isn’t just about inherently harmful substances like cocaine or alcohol. This concept applies across the board–including to things that aren’t inherently dangerous or “bad,” like shopping, coffee, social media, sex, food, video games, work, physical activities like bodybuilding or sky diving. It’s easy to identify compulsive overconsumption in others, but not so easy in ourselves
“The risk of addiction to any substance or behavior increases with increasing potency, quantity, and duration.”
My thought in reading and listening to her talk about this: the more we pursue “happiness,” the more we experience the chronic dopamine deficit that leaves us less happy than ever.
“The paradox is that hedonism, the pursuit of pleasure for its own sake, leads to anhedonia, which is the inability to enjoy pleasure of any kind.”
“Science teaches us that every pleasure exacts a price, and the pain that follows is longer lasting and more intense than the pleasure that gave rise to it. With prolonged and repeated exposure to pleasurable stimuli, our capacity to tolerate pain decreases, and our threshold for experiencing pleasure increases.”
“The net effect is that we now need more reward to feel pleasure, and less injury to feel pain. This recalibration is occurring not just at the level of the individual but also at the level of nations.”
We really are more easily wounded (emotionally, psychologically); to some extent, we are all “snowflakes”–or more so as a society than 10, 20, or 30 years ago. This helps to explain the rampant inability to tolerate disagreement or those who think differently than we do
She says:
“We’re all running from pain. Some of us take pills. Some of us couch surf while binge-watching Netflix. Some of us read romance novels. We’ll do almost anything to distract ourselves from ourselves. Yet all this trying to insulate ourselves from pain seems only to have made our pain worse.”
This is so consistent with the message from Nir Eyal’s book, where he noted that “the drive to relieve discomfort is the root cause of all our behavior, while everything else is a proximate cause. . . . Unless we deal with the root causes of our distraction, we’ll continue to find ways to distract ourselves. Distraction, it turns out, isn’t about the distraction itself; rather, it’s about how we respond to it. . . . Only by understanding our pain can we begin to control it and find better ways to deal with negative urges.”
Both messages are similar to what Brooke Castillo talks about with respect to learning to feel emotions instead of buffering (which is her word for the things we do to distract ourselves from uncomfortable emotions).
Nir Eyal says in his book: “We can cope with uncomfortable internal triggers by reflecting on, rather than reacting to, our discomfort.”
Seeking pleasure and avoiding pain evolved as a survival mechanism and is subconscious and reflexive. To counter it, we have to be intentional about seeking out certain types of pain, such as exercise in moderation and “radical truth-telling” because these kinds of pain are interpreted by the brain as injury, and the brain responds by tipping us to the pleasure side (increasing dopamine production and activating dopamine receptors) as a means of restoring homeostasis!
As she notes in the book, just as repeated exposure to pleasure-inducing stimuli can build tolerance (reducing our experience of pleasure), we can, through careful repeated exposure to discomfort, build tolerance to that as well. The first step to overcoming this is a dopamine fast–abstaining from the “drug of choice” for a period long enough for our brains to reset the neurological pleasure pathways so the person can find pleasure again in other ways. She finds it takes about 4 weeks.
The process, then, is this:
- Identify what your drug of choice is.
- Engage in a dopamine fast–at least 4 weeks
- Mindfulness practices are extremely important during this time:
“Many of us use high-dopamine substances and behaviors to distract ourselves from our own thoughts. When we first stop using dopamine to escape, those painful thoughts, emotions, and sensations come crashing down on us. The trick is to stop running away from painful emotions and instead allow ourselves to tolerate them. When we’re able to do this, our experience takes on a new and unexpectedly rich texture. The pain is still there, but somehow transformed, seeming to encompass a vast landscape of communal suffering, rather than being wholly our own.”
During that time, though, prepare a detailed plan for after the fast is over (how you will proceed in such a way as to avoid succumbing again).
(a) Self-binding mechanisms–finding ways to make access less easy, for example, using space and time.
“Just tracking how much time we spend consuming, for example, by clocking our smartphone use, is one way to become aware of and thereby mitigate consumption. When we make conscious use of objective fact like how much time we’re using, we are less able to deny them, and therefore in a better position to take action.”
(b) Finding other, healthier ways to trigger healthy amounts of dopamine production
I was interested in her discussion of the fact that “Learning also increases dopamine firing in the brain. . . . The brain changes that occur in response to a stimulating and novel environment are similar to those seen with high-dopamine (addictive) drugs.”
She’s an advocate of physical movement as a means to boosting our mental health:
“A key to well-being is for us to get off the couch and move our real bodies, not our virtual ones. As I tell my patients, just walking in your neighborhood for thirty minutes a day can make a difference. That’s because the evidence is indisputable: Exercise has a more profound and sustained positive effect on mood, anxiety, cognition, energy, and sleep than any pill I can prescribe.”
(c) The role of radical honesty
Compulsive overconsumption, leading to or as a part of addiction, is fed by lies (to ourselves and to others).
“Humans are not the only animals with the capacity for deception. . . . But no other animal rivals the human capacity for lying.”
“Radical honesty–telling the truth about things large and small, especially when doing so exposes our foibles and entails consequences–is essential not just to recovery from addiction but for all of us trying to live a more balanced life in our reward-saturated ecosystem. It works on many levels. First, radical honesty promotes awareness of our actions. Second, it fosters intimate human connections. Third, it leads to a truthful autobiography, which holds us accountable not just to our present but also to our future selves. Further, telling the truth is contagious, and might even prevent the development of future addiction.”
“Truth-telling may change our brain, allowing us to be more aware of our pleasure-pain balance and the mental processes driving compulsive consumption, and thereby change our behavior.”
To her point about honesty fostering intimate connections, she says, “Telling the truth draws people in, especially when we’re willing to expose our own vulnerabilities. This is counterintuitive because we assume that unmasking the less desirable aspects of ourselves will drive people away. It logically makes sense that people would distance themselves when they learn about our character flaws and transgressions. In fact, the opposite happens. People come closer. They see in our brokenness their own vulnerability and humanity. They are reassured that they are not alone in their doubts, fears, and weaknesses.”
I thought of the connection here to Brené Brown’s writings on shame and vulnerability and how the first isolates us while the second brings us closer together. “Intimacy is its own source of dopamine.” (And Dr. Lembke talks about the science behind human connection.)
“Mutual honesty precludes shame and presages an intimacy explosion, a rush of emotional warmth that comes from feeling deeply connected to others when we’re accepted despite our flaws. It is not our perfection but our willingness to work together to remedy our mistakes that creates the intimacy we crave. This kind of intimacy explosion is almost certainly accompanied by the release of our brain’s own endogenous dopamine. But unlike the rush of dopamine we get from cheap pleasures, the rush we get from true intimacy is adaptive, rejuvenating, and health-promoting.”
The book’s key message
She ends with the ten Lessons of the Balance, beginning with 1) The relentless pursuit of pleasure (and avoidance of pain) leads to pain and ending with 10) Instead of running away from the world, we can find escape by immersing ourselves in it
“The rewards of finding and maintaining balance are neither immediate nor permanent. They require patience and maintenance. We must be willing to move forward despite being uncertain of what lies ahead. We must have faith that actions today that seem to have no impact in the present moment are in fact accumulating in a positive direction, which we be revealed to us only at some unknown time in the future. Healthy practices happen day by day.”
Some final thoughts
There is more to this book than what I’ve mentioned here. What I like about it best is that it is so honest and thoughtful and backed by science. It was incredibly thought-provoking. Especially in the last half of the book she offers some very practical and inspiring suggestions on steps we can take to break the bondage of compulsive consumption and engage fully in making our own lives that matter.
“I urge you to find a way to immerse yourself fully in the life that you’ve been given. To stop running from whatever you’re trying to escape, and instead to stop, and turn, and face whatever it is. Then I dare you to walk toward it. In this way, the world may reveal itself to you as something magical and inspiring that does not require escape. Instead, the world may become something worth paying attention to.”
What is this book’s relevance to a podcast about productivity? Understanding how our minds work is important. If it helps us identify something that might be interfering with our ability to accomplish the things we care about, then it’s worth considering.
What do you think?
Have you read Dopamine Nation? If so, what did you think? Share your takeaway with us. If you haven’t yet read it, what’s a productivity-related book you’ve read recently that you’d recommend? Please share your thoughts in the comments section below or in The Productive Woman Community Facebook group, or send me an email
Resources and Links
Dr. Anna Lembke’s books:
- Dopamine Nation: Finding Balance in the Age of Indulgence
- Workbook for Dopamine Nation
- Drug Dealer, MD
- YouTube video: Dopamine: The Hidden Driver of Mental Health (and others — search for her name in YouTube
Other episodes in the Productive Reading Series:
- Gary Keller’s The ONE Thing (episode 133)
- The Power of Habit, by Charles Duhigg (episode 147)
- 3 books written by Brené Brown (episode 166)
- Soulful Simplicity, by Courtney Carver (episode 182)
- The Free-Time Formula by Jeff Sanders (episode 211)
- James Clear’s wonderful Atomic Habits (episode 230)
- Free to Focus, by Michael Hyatt (episode 250)
- Attention Management, by Maura Nevel Thomas (episode 271)
- The Minimalist Home, by Joshua Becker (episode 324)
- Effortless, by Greg McKeown (episode 349)
- Cal Newport’s Digital Minimalism (episode 366)
- Life Makeover, by Dominique Sachse (episode 403)
- Laura Vanderkam’s Tranquility by Tuesday (episode 420)
- Nir Eyal’s Indistractable (episode 454)
Feedback Options:
Please share your questions or thoughts in the comments section below this post or on The Productive Woman’s Facebook page, or send me an email. Also, don’t forget to tell a friend about this episode, share it using the social sharing buttons at the top of this post, or leave a review in Apple Podcasts.
Help Spread the Word!
Tell a friend about The Productive Woman podcast. Share an episode using the social sharing buttons at the top of this post, and consider leaving a review on Apple Podcast.
Thank you to our sponsor, Calm
If you’d like help in practicing mindfulness, remember that Calm is offering a special limited-time promotion of 40% off a Calm Premium subscription at CALM.COM/TPW. That’s 40% off unlimited access to Calm’s entire library of guided meditations, sleep stories, and more, and new content is added every week.
Click here to discover my favorite apps!
I Was Just Thinking . . .I would love to have your help!
Royse City, Texas
Legal Blog: Real Estate Law Blog
Follow @LauraMcMom
Contact me
Leave a Reply