anything goes with emma chamberlain - the age of indulgence, a talk with dr. lembke (revisit) [video]

Episode Date: December 17, 2023

[video available on Spotify] today i'm doing my very first interview. we're getting into serious podcast territory. i'm bringing dr. lembke on the show today because i've been obsessed with the sneaky addictions of our modern day. you know, the addictions that our grandparents and parents are warning us about: social media, food delivery, porn, gaming… all of the addictions that we're sort of in denial of. she describes the time that we're living in now as the age of indulgence, and i've never heard this time be characterized better. it really is this age of indulgence where everything is at our fingertips, and at face value it seems incredible. but there are a lot of scary downsides. i'm going to be discussing all of this and more with dr. lembke. link to dr. lembke’s book, dopamine nation: https://www.penguinrandomhouse.com/books/624957/dopamine-nation-by-anna-lembke-md/ Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hello, it's me, Emma. And right now, I'm on a holiday break. I'm taking a few weeks off to spend time with family, rest my brain, and sleep as much as possible. But in the meantime, I'm rerunning some of my favorite episodes from this year, just in case you haven't heard them yet, or just in case you want to hear them again. So I hope you enjoy this episode rerun, and I'll be back with new episodes on January 11th, 2024.

Happy holidays. I love you. I appreciate you. And I'll talk to you soon. OK, enjoy the episode. Today, I'm doing my very first interview. I am. I am feeling really nervous, to be honest.

I've interviewed people before. I interview people every day. You know, I interview my family, I interview my friends, but this feels different. This is like, we're getting into serious podcast territory. And I mean, yeah, I'm feeling a little intimidated, but we are interviewing an incredible person today. We're interviewing Dr. Anna Lemke. She is, you know what, I'm pulling out my paper, to read all of the smart things that she's done

in her career. She is the author of Dopamine Nation, finding balance in the age of indulgence, and drug dealer MD. She's a professor and medical director of addiction medicine at Stanford University School of Medicine. She's the program director of the Stanford Addiction Medicine Fellowship and is also chief of the Stanford Addiction Medicine dual diagnosis clinic. See, I can't even read these words because she's so smart. She was featured in the Netflix documentary, The Social Dilemma, incredible documentary. Please go watch that. So, I'm bringing Dr. Lemke on the show today because I've sort of been obsessed with

the sneaky addictions of our modern day. You know, the addictions that our grandparents and parents are warning us about. Social media, food delivery, porn, gaming, all of the addictions that we're sort of in denial of. She describes the time that we're living in now as the age of indulgence, and I've never heard this time be characterized better. It really is this age of indulgence where everything is kind of at our fingertips in a way. In that face value, it seems like an incredible, amazing thing. But there are

a lot of scary downsides. I'm going to be discussing all of this more with Dr. Lemke. Let's bring her in. This episode is brought to you by Bumble. You know what's really hot, kindness. And I'm not talking about the big stuff, like buying a super expensive gift. I'm talking about the little moments, like when they buy you flowers, just because, or check to make sure that you got home okay,

or when they treat you to your favorite drink, because make sure that you got home okay, or when they treat you to your favorite drink because they saw that you were having a rough day, and you don't even have to say anything, they just do it. That kind of thoughtfulness immediately makes them more attractive. Kindness is sexy. Find it on Bumble. This episode is brought to you by Hei Ye You, the streaming home of reality TV. Hey You gives you access to every episode of all your favourite reality TV franchises,

the same day as the US, the real housewives, van der Punt rules, below deck, southern charm, summer house and so many more. Get your daily dose of drama, try it for free today at hei.com. Teas and sees apply. This episode is brought to you by Airbnb. Let me tell you my favorite Airbnb story. It's a few years ago and a big group of friends and I decide we want to go to Joshua tree. Out in the desert of California, we just want to have a vibey weekend, okay? So we go on Airbnb and we find a beautiful home

in the middle of Joshua Tree and we book it. What I loved so much about this trip was kind of being roommates with my friends for the weekend. And we all just got to play house. We cooked for ourselves, we cleaned up after ourselves, and we just had a really good time. This house was phenomenal too. I mean, everybody got their own bedroom, everybody had their own private space. We had a private pool, a private hot tub. This house was so aesthetically beautiful that we were all just happy to be sitting in there and looking at it because it was just gorgeous. It was super private

so we could all just be ourselves and hang out in the backyard and have fun and truly be by ourselves in the desert. I have a lot of great Airbnb memories, more to come. To just jump right into it. I have a really sort of Google definition of dopamine and I think a lot of people my age do. Yeah. It's sort of this general understanding of like, it plays a role in what you're motivated to do, it plays a role in what choices you make,

it plays a role here or there, whatever. But I think everyone my age would benefit from a definition for dummies in a way. Right. You have to call us all dummies, okay? Like, sort of easy to digest definition. So first of all, dopamine is a neurotransmitter. And just to briefly define neurotransmitter, our brain

is made up of a lot of different cells. And one of the main cells is the neurons, and these are these long spindly cells that conduct electrical circuits, so essentially our brain is sort of made up like a bundle of wires. But those wires do not connect end to end there's a tiny little gap between them and that gap is called the synapse. So neurotransmitters are chemicals that go back and forth in that gap that help to modulate these electrical circuits.

And just like very broadly speaking, the more dopamine that is released in response to a ingesting something or doing something, the more dopamine that is released in response to a ingesting something or doing something the more reinforcing or Pleasurable that substance or behavior is So hence dopamine is this chemical that we make in our brains in response to things we ingest and things that we do that make that

substance or behavior reinforcing for us so that our brain wants to invest work into doing it again and again and again. Yes. So that's sort of, does that, is that that was an amazing, amazing, just definition. Okay. I would have been better. Okay. So I'm assuming that many years of go before there was technology like there was today, this was a survival mechanism. This is what inspired us to do anything that led humans to not only a fulfilling life,

but a life that can continue. Would you say this is accurate? So dopamine is fundamental to survival. Over millions of years of evolution, it is exactly the brain chemical that has motivated us to do the work, to go out and refine food, clothing, shelter, mates, which are essential for survival. So you're exactly right. Okay.

So you have described today's age as the age of indulgence. Right. And hearing those words, reading those words for me, just it was like the final piece in the puzzle, sort of describing this unusual time that I used to say like, oh, this is just the way that it is when I was a kid. I was like, this is just the way technology works. It just more keeps coming in whatever. But, you know, and then my grandparents or my parents would be like, this is actually quite unusual and actually kind of frightening. And there's a whole new set of concerns that we've never been faced with before. And this is not something that's just, you know, to be underestimated, I guess. Right.

But growing up with it, I was like, no, this is no big deal. Now that I'm an adult, I'm sort of realizing how troubling a lot of this really is. You know, I'm starting to look at what my grandparents said. And my parents said, and I'm like, whoa, this is really real. This is really, really, real. And through that journey of sort of discovering the troubling nature of today, the age of indulgence

just clicked for me. From a scientific perspective, what makes today so indulgent? Well, I mean, if we go back to this ancient wiring where we release dopamine after we've done a whole heck of a lot of work to get things that are essential for our survival.

And by the way, this ancient wiring has remained unchanged over millions of years of evolution and is essentially preserved across species, which is kind of amazing, right? Because we have all these layers of gray matter and cortex that have been added onto this ancient reward circuitry, but the reward circuitry itself is pretty much unchanged. And has also remained preserved across many different species. And that kind of persistence of a certain type of wearing tells you that that's really, really important for survival, right? It's been such a good, you know, set of neurons in there that we wouldn't possibly want to change it. Right. set of neurons in there that we wouldn't possibly want to change it. Now all of a sudden, fast forward to the last just about 200 years. What you have is now a situation in which human ingenuity and scientific discovery and

the internet essentially has absolutely transformed our world in unprecedented ways. Such that this ancient wiring is now highly mismatched for our modern ecosystem. And this is the source of a tremendous amount of our struggling and our suffering today. And to be very specific, what I mean is that no longer are we living in a world of scarcity and ever-present danger where we have to put an enormous effort to get the things that we need to survive. We're now living in a world where basically our survival needs are instantaneously met. I'm talking about not just people living in rich nations, which that's obviously true for that, but really

almost all over the world with exceptions, of course, people more than ever before are living longer, right? Living physically healthier, relatively insulated from pain, have more leisure time, and then on top of that, you know, our scientific insulated from pain, have more leisure time. And then on top of that, our scientific ingenuity innovation, all of that, has figured out ways to drugify almost every human behavior. And when I say drugify, what I mean is that,

we've been able to sort of hack these motivational reward systems to make everything more reinforcing, which means it's releasing way more dopamine than other natural rewards. It's more accessible. And access, simple access to drugs are one of the biggest risk factors for getting addicted, but we often underestimate it. It's more potent. So, as I said before, releasing dopamine, but we often underestimate it. It's more potent. So, you know, as I said before, releasing dopamine, but releasing really a lot of dopamine way more than our brains have evolved to accommodate. It's more novel and it's more abundant. So you've got more reinforcing, more

accessible, more of it, and more novel. Those things really have made what even used to be considered or could be considered healthy things potentially addictive from the food we eat to the exercise that we do to the way that we connect with other humans to to, you know, game playing, to sex, to shopping, you know, you name it, everything has now really been turned into a drug. And the result of that is that our major struggle now is essentially how can we not get addicted? Right. One of the major challenges of modern life, and it's a huge source of our suffering and one that we, I don don't think have really fully acknowledged

is just simply trying to live our lives without getting addicted to something. Right. Right. But many of us are addicted. Maybe not necessarily immediately aware. I think becoming more aware. And then we have all of this sequelae of addiction, which is a lot of pain and suffering. Yeah. It feels like, you know, we're at a point now where everybody is sort of an addict in some way. But yet, we do have a lot of people of all ages really kind of indenisble of this truth, me included. You know, I remember when my dad started telling me that I was addicted to my phone. I was like, no, I'm not. I could let it go at any given moment,

and I'd be totally fine. But even recently, when I feel like I've been working on my sort of addiction, especially to the internet, more recently, I sort of tried a light level of a dopamine detox, right? I know the term dopamine detox is questionable because you can't detox yourself from something that you're creating,

but no social media, no listening to music, no listening to podcasts, no watching YouTube, no food delivery, no sex, no house was there. It was like no exercise even. Oh, okay. So you really want to lie. I don't like love it. I couldn't do it.

I could not do it. We're so used to being so stimulated. It's happening and we don't realize it. That's right. That's right. Dopamine is something that we need to survive. We need it to survive. Right. But is it something that's sort of going to become like wisdom teeth where it's like, okay, we just have to get it removed or take medications to turn it off. Or like, you know, where, what's the solution? Because this is, this is making everyone feel sick without even realizing. Yeah.

What I recommend is finding balance. I think to be human is to desire. And if we didn't have desire, we wouldn't be human. So it's not a matter of getting rid of desire or getting rid of dopamine. And we wouldn't be able to do that anyway. It's so incredibly hardwired in our brain. And of course, balance is something that has been preached across the centuries, right? I mean, that was sort of Buddha's great discovery, right, that for a long time, a Buddha indulged in pleasures and then really

realized that did not make him happy. And then Buddha pursued a very ascetic life where he didn't eat and he didn't do things that were fun and he walked really far and stuff like that. And actually discovered that didn't make him happy either. So Buddha ultimately, I'm not a Buddhist, so I really kind of don't even know what I'm talking about, but but basically there's so much to be learned from that story. Yeah, right exactly. And then, you know, basically found found this kind of middle path. But what I am suggesting is that we need a slight update of that wisdom because we are living in this dopamine saturated world that is constantly

titillating us even when we're trying to avoid it, right? You can't even like go to the dentist or the doctor's office without hearing music piped into the elevator without being offered a movie, you know, while you're in the waiting room or actually while you're getting your teeth, I mean, whatever, it's it's everywhere. So what we need to do is number one, acknowledge that we're living in this completely drugified dopamine rich experience, such that we are experiencing incredible overload

and it's not good for us and we're getting out of balance, our physiology is out of balance because of this ecosystem. And then we need to find ways to recapture physiologic balance even in the world that we live in essentially by creating a world within a world and modifying our immediate environment and putting barriers between ourselves and these drugs of choice, recognizing that things like our screens and our devices and the internet are actually drugs because they can release a lot of dopamine in our reward pathway, which doesn't

mean that we're all going to get addicted to social media or whatever, but it does mean that we're all going to be vulnerable for this problem of compulsive over consumption where we get sucked in on their opportunity costs. We have difficulty cutting back. We have health and relationship consequences. You name it. This middle way has become adulterated essentially by our culture of convenience and drugification so that we have to ve of veer slightly toward pain,

and actually intentionally pursue things that are inconvenient, that are hard, intentionally issue or avoid over stimulating ourselves, avoid ingesting intoxicants too much and too often. It doesn't mean never, but we really have to recognize the ways in which these kinds of pursuits either to the side of pleasure or pain Are ultimately not good for us in a world that you know is constantly inviting us to Overindelge

This episode is brought to you by hey you the streaming home of reality TV Hey, he gives you access to every episode of all your favorite reality TV franchises, the same day as the US, the real housewives, van der Pum rules, below deck, southern charm, summer house, and so many more. Get your daily dose of drama. Try it for free today at heyu.com. Teas and sees apply.

This episode is brought to you by Airbnb. Let me tell you my favorite Airbnb story, okay? It's a few years ago and a big group of friends, and I decide we wanna go to Joshua Tree. Out in the desert of California, we just want to have a vibey weekend, okay? So we go on Airbnb and we find a beautiful home in the middle of Joshua Tree and we book it.

What I loved so much about this trip was kind of being roommates with my friends for the weekend. And we all just got to play house. We cooked for ourselves, we cleaned up after ourselves, and we just had a really good time. This house was phenomenal too. I mean, everybody got their own bedroom. Everybody had their own private space.

We had a private pool, a private hot tub. This house was so aesthetically beautiful that we were all just happy to be sitting in there and looking at it, because it was just gorgeous. It was super private, so we could all just happy to be sitting in there and looking at it because it was just gorgeous. It was super private so we could all just be ourselves and hang out in the backyard and have fun and truly be by ourselves in the desert. I have a lot of great Airbnb memories. More to come. Do you think that there's any way to find that balance without sort of going cold turkey on some things? Because I don't know if there's a way to be on social media without getting addicted.

I'm starting to question whether or not there is a healthy way to find balance with social media apps. Right. Because I personally have been working on it for over a year, and I cannot figure it out. Do you think there is a healthy way to do it? I think it depends on the person. And whether or not social media is your particular drug of choice. So what do we mean by drug of choice? That means that's the key that turns your lock,

that just is so reinforcing for your particular brain. And by the way, everybody's a little bit different that once you engage with that drug, and I use the term drug broadly to encompass behaviors and digital drugs as well, that it is very, it's so reinforcing that you get lost at it and it's difficult to stop. And figuring out what each of our particular drug of choice is and then making decisions

based on that awareness, I think is the key here. So if you on social media have repeatedly tried to cut back, to manage your use, to moderate. And I always do recommend a period of abstinence of about four weeks from whatever our drug of choice is before trying to go back to moderation so that we can reset reward pathways and enter into moderation from a place of strength and health. But if you find you've done that,

and every time you go back, you get into what we call the abstinence violation syndrome where you're like, now you're using more than ever or binging worse than ever. Right. Then it might get to a point where you have to say to yourself, this is a drug that I actually cannot moderate. Yep.

And that I'm going to have to abstain from maybe for a much longer period of time, or maybe potentially forever. And one of the things that I always like to say is that if we look at two people with like severe classical drug addictions like to alcohol or cocaine or meth or opioids who have gotten into recovery from those very serious life-threatening drugs, those individuals really are like modern-day profits for the rest of us because they have acquired a kind of lived wisdom that we can all benefit from. What that lived wisdom says is that lifetime abstinence from a drug of choice may be the only path for some people, but we're recently, we're also seeing that other individuals after

a sustained period of abstinence, maybe months, maybe years, can go back to using with an enormous amount of preparation and discipline and the creation of a lot of alternative sources of healthier dopamine that allows them to be able to manage consumption of their drug of choice. For example, we used to think people with alcohol use disorder, once in alcoholic, always in alcoholic, they could never go back to drinking. But in fact, we're seeing some individuals with a minority who have met criteria for alcohol use disorder can after a long period of abstinence go back to using immotoration. So my point is it is a journey of self-discovery,

it's being aware in a very truthful way of whether or not we can handle moderation. And then ultimately, if we can, kind of just owning it, and embracing that, as much as I would like to be able to manage this, comfortably, I'm not able to. So just to give, like, you know, to sort of relate on a more personal level, I'm not on social media. Yeah. And I don't even have a phone, except one that I turn on only for emergencies. And that is because I know myself.

Yeah. Right. And I mean, even the little bit of flashes that I go on to watch YouTube or even my email, you know, I'm compulsive about it. So I am personally much happier when I'm just, I just don't do that, right? And then what I, I get a lot of good energy because I'm not using my energy to manage not that.

That's right. Addiction. Right. Because it's exhausting. It's exhausting. And what's interesting is, you know, obviously now we're getting to a point where a lot of people are becoming aware of how mentally damaging these sort of modern indulgences are and these modern addictions are I think at first It was like no, this is awesome. We can order food whenever we want. We can go on our phone whenever we want

We can google anything we want. This is awesome and then very quickly. We all figured out something's kind of off about this Why why is mental health declining across the board? Why are we unhealthy in a way that we weren't before or in different ways, shall I say? What's going on? Why do you think we continue to participate in these behaviors and sort of write them off as not real addictions. When deep down we all know that this is a problem. So for many, many decades in the field of addiction medicine treating people with drug and alcohol addictions, there's been a very well-known concept that's more broadly applicable to different situations, but is very specifically applicable

to addiction, which is the concept of denial. And denial is a really kind of odd split brain process, where on the one hand, I know what I'm doing, but on the other hand, I actually don't. Right? So there are ways in which when we're chasing dopamine, we can really minimize to ourselves as well as to others, the amount of time, the amount of energy, the amount of money, the amount of creativity that we're investing in getting our drug, consuming our drug, potentially hiding our drug use.

So that's part of an answer to your question. The other part, though, which I think is really important for people to understand is the following. By exposing our brains to these highly reinforcing drugs and behaviors, which is essentially like the equivalent of a fire hose of dopamine in our reward pathways, our brains are reeling to try to compensate, and the way that we're compensating ultimately is by down regulating our own dopamine production and transmission, not just to tonic baseline levels of dopamine firing, which we all were always releasing dopamine at a tonic baseline level, like a heartbeat in the brain. We're actually to compensate bringing those endogenous or innate dopamine levels below baseline, which is really the equivalent of a clinical depression,

or a clinical anxiety, or a clinical insomnia. So that we're literally making ourselves psychiatrically ill as a way to compensate for too much stimulation, too much reinforcement, too much dopamine. Right. And that is, I think, in part why we're seeing rising rates of anxiety, depression, and suicide all over the world, but especially in rich nations. It's really a kind of plenty paradox. Like, if you look at happiness surveys, for example, prior to, like the advent of the smartphone in 2001,

what you'll see is that as wealth increased across nations, happiness increased. Yeah. Starting in about 2001, as wealth has increased, happiness has gone down. And I just really think we've reached a kind of a tipping point where abundance itself has become a physiologic stressor. So it's not that we're like morally weak or lazy or even indulgent, you know, I use that word. It's that the world has become a place that is mismatched for our basic neurology and physiology. Right. And we are trying to figure it out, but it's super, super hard.

And we're getting sick in the process. And this is, I think, a truism, I think, based not just on what we know about the neuroscience of pleasure and pain, and what happens in the brain is we become addicted, but also what I've seen clinically in my practice, which is more and more young people like yourself, coming in with terrible anxiety, terrible depression, a kind of annihilism, unable to get out of bed in the morning,

unable to take joy in anything, really. And yet, when you explore their lives, they have great friends, they have amazing jobs that other people might envy, right? They have, you know, no one has the perfect childhood, but they have the good enough childhood, right? Totally. And so when we think about like what causes mental illness,

we often think, oh, multi-generational trauma, well, you can go looking for trauma, but you're not necessarily gonna find it, right? And we think about, oh, they don't have enough support, enough, you know, enough friends, enough stuff. No, they've got great friends, right? They've got great relations. Oh, okay, they need meaningful work.

Nope. They've got really meaningful work. Oh, I know it's a chemical imbalance caused by a depression that they inherited. And so we got to give them like SSRIs, like Rose, I bet. Well, a lot of these people are not getting better with SSRIs, right? Or maybe they're getting worse. So I think we have to reorient on this problem and consider the possibility that what is causing the despair is actually too much of the wrong kinds of pleasures. Yes. I mean, I've personally experienced that, you know, like I, I've struggled with both anxiety and depression. Yeah. While, while having a great life, yeah, you know, outside of it.

Right. And I've found myself in sort of an existential crisis. Right. Feeling like Feeling like things are great. What is wrong? And the lack of daily challenge in struggle and discomfort. It almost lowers your self-esteem. Is the lack of challenge also making people feel anxious and depressed? Oh, for sure. I mean, one of the, you know, the other great challenges of modern life is that it's pretty boring. Yeah.

Yeah, it's pretty boring. And the reason it's boring is because there's nothing that we actually have to be doing in order to survive. So we kind of have to make it up, you know, and find a sense of meaning and purpose, which we can do. I'm not saying, you know, I'm not a nihilist by any stretch of the imagination, we can find meaning and purpose through meaningful work, through human connection, through our spiritual pathways. But it's a lot harder, because it's really non-obvious, and meanwhile, we're just sort of figuring out,

like, should I be doing this, or should I be doing that, or what is that person doing? And it can create a really untethered disconnected feeling, which is really, really profoundly scary. The other thing, and we feel free to cut this next part out if it's too personal. No, we can. But go off. Yeah, okay. But I mean, I have a lot of sort of empathy for someone in your position who is very public facing and who has a lot of personal fame. Like I can only imagine the pain and suffering

that you experience from the disconnect between the public persona and then your interior existence, which of course is filled with the same longing and suffering and despair as like everybody else, the gap just is always a lot bigger between your internal experience and your external life. I also think fame, which is its own source of dopamine, can obviously become this terrible, vicious cycle and being incredibly burdensome. This episode is brought to you by Sunwing Vacations.

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You don't have any excuse right you better be happy because you have you have everything that I'm dreaming of, that all my friends are dreaming of. Right. But what's so fascinating about it is it's such an incredible example of yin and yang, right? Right. Because it's like you get this abundant life. But fame is just by nature.

One of the most toxic things I've ever experienced in my life. And we see a lot of public figures have a really hard time. I think a lot of people are perplexed by that because from the outside looking in, it's like, you have a big house. But it's like, they can't go to the store. Like certain celebrities can't go to the store.

They can't, you know, in order for them to feel satisfied, it's almost like their whole life has to be fake. You know, it's like, if they want to go run an errand, they have to go shut down the grocery store or something to go in there. You know what I mean? It takes away humanity. I'm lucky that I'm at a place where I still have absolutely some humanity, but even I struggle with it. I mean, I'm curious about this sort of addiction to fame and with social media, what that kind of looks like, and how extreme it really is, I've experienced it to an extent,

but to be honest, I don't even know what's going on. I don't know why it's so hard, or why it's so painful, or why it's made me so depressed and anxious over the years when I started all of this to help me get away from my depression and anxiety to have something To do that wouldn't make give me meaning, but yet it's been One of the largest psychological challenges of my life just being in this public space But yet I feel addicted to it

So what do you make of all of that? Yeah. Well, I think it is our natural state to be part of a tribe and to be deeply connected and in a group and to actually not be singled out and separated. And yet we have this incredibly narcissistic culture that encourages all of us to separate ourselves and distinguish ourselves in some way. So it's in the culture, right, from the way that we are schooled to the way that we as parents raise our children, I try to consciously avoid doing it with my own kids and yet they'll come home from a track meet or a swim meet or school, I'll be like, oh, how'd you do?

And of course, there's a secret part of me that wants them to have won. Yes, of course. Like, and it's very gratifying for me to hear when they win trophies or when they get compliments. I mean, it's really, really, of course. I'm very, like, I tried to avoid being a narcissistically invested parent, but I totally really, of course. You know, I'm very like, I tried to avoid being a narcissistically invested parent, but I totally am.

Of course. I'm awarely narcissistic, is that a word? But anyway. For sure. Yeah. But my point is that this kind of drive that we all are encouraged into embrace because it's part and parcel of our culture today,

that separates us out is a huge source of our suffering, because the natural antidote to this kind of separating ourselves from the tribe is to feel shame. Yeah. Because shame is probably the most ancient human emotion, the function of which is to bring us back into the tribe, because we are stronger together. We are absolutely stronger together.

So I think conserved over again, millions of years of our shaping through time is forces that will bring us back together and shame is a powerful source of that. The problem is that so we will reflexively experience that shame. So you as a famous person, you want these things, right, that single you out, you know, as do I, as all of us do. And yet it's a twinning. I mean, you said you had an egg, but it's a twinning. As soon as we have that, we feel a reflexive shame.

but it's a twinning. As soon as we have that, we feel a reflexive shame. It's wired in. And that is why, as a psychiatrist, I see so much self-loathing. It's sort of endemic in the environment. We just hate ourselves. And I think that's the twinning that comes with narcissism. And a lot of the sort of interventions with that self-loathing,

I'm not sure they're quite in the right direction. So a lot of what we encourage is while we'll love yourself, find your authentic self or figure out the source of why you don't love yourself, maybe it's early childhood trauma or some relation. I mean, some of that can help. But I think what we're not recognizing is the extent to which the culture is shaming. Yeah, because shame is the natural cousin or comes on the heels of narcissism, which is just sort of how we live now. That puts it into words perfectly because it is interesting how I never feel a sense of

excitement or accomplishment or fulfillment from anything that happens on an accolade level. It's so weird. I've never, I've always expected to feel fulfilled or something from a larger than life sort of achievement. But what's interesting is, I feel nothing. And the guilt and shame that comes with that alone is painful. But then on top of that, you know,

there's a sense of imposter syndrome feeling like I don't deserve this. I didn't earn this. Even if I maybe did, I will never feel like I did. And then expressing that can feel shameful as well because then it's like, well, why aren't you grateful? It's like, I don't know, you know. I think it's so great that you're sharing that though. I mean, it's so great that people can hear that. And because of course, we're all having those types of experiences in our lives. On every level.

On every level. And so if like a very famous, successful person like you is also having those feelings, I think it's good because, I mean, it's not good that you're having it, but it's good for people to hear about it, to recognize, gosh, we're all suffering. And attaining this thing that Emma Chamberlain has, is not going to take away that kind of unique suffering,

which is just part of the modern human condition. Yeah, I mean, I really do think that, yeah, no one's safe. Right. The rich and famous are not safe. Oh gosh, no. I mean, even young kids at this point aren't safe. no one's safe. Right. The rich and famous are not safe. I mean, even young kids at this point aren't safe. But there's hope. There's hope. Okay. And the hope comes from doing this work in a way in which you remind yourself of its purposefulness and its meaning to you. Yeah. By going back to some of the, whatever the powerful emotional experiences

were in your life, that originally gave this work meaning. So we can lose touch with that. But if we go back to that emotional experience and remember, wait a minute, why did I ever think that this was important or meaningful? And that also helps with imposter syndrome, you know, because it's like, wait a minute, no, I'm not an imposter. These are these key junctures where I had a profound, usually emotional experience and reconnect with that, that's number two. And then I think another important thing is to really take ourselves out of it and really

see ourselves as vessels and another power working through us. However, you want to define that. And there are different tricks or hacks to help with that. I mean, obviously, spiritual practices, whatever they are can help. But one of the things that I do, you know, I'm not obviously anywhere on your level, but I do quite a bit of public speaking and, you know, things like that. I never watch myself. It's funny. You say that I had to stop. Yeah.

Kim completely stopped. Yeah. And it really, really helps. Yeah. Right. Because I do think there are a lot of people who are not narcissistic by nature. Right. Who are, you know, sort of being pushed to perform narcissistic behaviors

in a way that feels wrong, right? I mean, I think fame is a great example of that, but even just kids are people who feel pressure to participate online in some way, even if it's sort of against their nature to post photos of themselves or get attention in that way, it's sort of the norm now to be constantly putting out forms of narcissism in one way or another. And it's celebrated. Oh yeah. In every way shape before. Oh absolutely. You know, there's so much

emphasis on being present online, whether you're an entrepreneur or you're just a, you know, human being. Right. It's like if you don't exist on social media, do you exist at all? Right. But, you know, on top of that, there's never been more sort of obsession with fame. There's a major obsession with fame, especially with young people. Yeah. All of these things are pushing people to kind of become narcissists.

Yeah, absolutely. Or if they already maybe have narcissistic traits, become even more narcissistic. I'm curious. Like, I know that there's some people who, there are some people who are narcissistic, they have the disorder. But how does performing narcissistic behaviors as a non-narsacistic person? How does that happen? And is there any way to sort of turn that off

once you get to that point, right? So I would say it's a challenge to manage, but I believe it's doable. This is the nature of the beast for all people who are highly invested in and successful in any specific endeavor. So whether you're a highly achieving athlete or you're in a highly achieving celebrity or a business person, it takes enormous amount of investment in the self and exertion of our self will in the world to reach these kinds of achievements, unless you're just an accidental celebrity.

But most celebrities are not accidental, they're accidental narcissists or maybe they're real narcissists, right? But this kind of, like, let's say that the non-pathological narcissist, but someone who's just really trying to achieve excellence, it takes a lot of self-focus, right? So it becomes part and parcel of the achievement. And I do think it is why so many people who achieve at a very high level, and I'm going go on on a limb here and say, especially women.

But I do think that there is something there, it feels super empty when you actually get there and super painful. And then is accompanied by these feelings of shame and self-loathing, which are kind of inexplicable. So, you know, again, what I would say is managing it is hard, just like managing social media is hard. But it is possible through the intentional exertion, first of all, intentional awareness of the enormous preponderance of narcissism in our culture and in ourselves. So just trying to be aware and trying to stay humble

to acknowledge that we've probably hurt other people unintentionally, but we have, you know, trying to apologize when we can, trying to remind ourselves to not be narcissistic, and then also just really honestly embrace like all of the harms to ourselves and others that come with this and the kind of seeping out of the joy.

And then trying to figure out, but I care about this thing that I'm doing. So how can I do it in a non-narsistic way? And I think it's possible with effort, with, you know, continual reminders. I'm again, this idea that sort of it's not really us, we're just sort of a vessel through which maybe good things can happen. I do think this is where, you know, spirituality is super helpful I do think this is where, you know, spirituality is super helpful. And psychology is less, less helpful. I mean, I think now more than ever, we need mindfulness. And yet there's never been a less mindful time, right?

I mean, being mindful through, you know, just sitting there and thinking or meditating or journaling or whatever, it's never been harder to sit down and do that. Yeah. It's never been harder. And I'm curious if you have any advice on how to get to a place where you can practice that again when you maybe are moving way too fast because I mean, I find myself having no motivation and no ability to concentrate. Right. Do you have any advice? Yeah. So I always like to, when mindfulness comes up, I always like to define it because it's

one of those words that we use a lot and People are like, what is that? I mean, you know, we think we know what we're talking about. Yeah, so generally this is mindfulness is a spiritual practice that was adapted from Eastern traditions like Buddhism and Broadly speaking, it's the ability to observe our thoughts and feelings without judgment and without trying to run away from them. And so it's a skill that we can learn and that we can practice. And it's a very useful skill for augmenting awareness, for knowing what we're doing in

the moment, what we're feeling, that awareness, for example, the moment that we become anxious or angry or sad or whatever it is. If we practice mindfulness, we can become aware sooner of when that happens, which then we're a little bit better at managing it, but also potentially knowing what the trigger was, all of which is very good and helpful. However, I think we can take mindfulness too far. And this kind of focus on the self and self-rumination and trying to find my real self and authentic self. And that can become its own kind of problematic yeah, addiction or obsession, right?

And not the way through, in fact. And that sometimes the way through is to stop thinking about ourselves. I know. Just turn it off. I know. Don't go there. And just like look around you and focus on other people and think about your conscience.

What would be the morally right next thing to do? And not what you feel like doing, right? So again, we've moved really toward a lot of emphasis on knowing our thoughts and our feelings and being authentic, but we can take that too far. Oh, I know. And I've done that. I like, it's so funny you say that because I've absolutely done that. Yeah, right. You know, especially during the pandemic when there was so much time to reflect. At first, it was like, I am expanding. Wow, I am expanding. I am discovering. I like, it was amazing. And then it went too far. Yeah. And it became obsessive. Right. And I became obsessed with myself. But in all the wrong ways, not in the positive in the positive ways and I you know I became a perfectionist in a way okay because I

Was like well now I just I was so hyper aware of myself for what felt like the first time in a weird way and then I Sort of became a perfectionist and I'm still sort of struggling with that now, but I'm curious. I want to dig into the kids of today. Uh-huh, yeah. Because I'm 21, you know, I'm not planning on having kids any time soon. Please, no kids for me. But I do want to have kids one day. And, you know, you want to do the right thing as a parent. I can imagine there are so many parents one day. And you know, you want to do the right thing as a parent. I can imagine there are so many parents out there. You included probably just trying to figure out how to navigate,

raising a child in this time. You know, you don't want to isolate your child. You don't want to just shove your kid in the backyard and say, you can't have any of the modern indulgences, right? Like you can't have any of the modern indulgences, right? Like you can't have any. What's your personal take on how to do it? Now it is. One of the main things I would say is again, getting back to this theme of acknowledging that we are in this world of overabundance that there are many reinforcers in particular digital media, but other drugs

too are incredibly accessible, abundance and potent. At the same time that we're largely insulated from painful experiences, both physical and emotional pain, so nowadays in elementary school, like every kid gets an award, which really diminishes in many ways the value of the reward. It's also true that it's really great the way that elementary schools, for example, teach kids, social awareness, and things like mindfulness, a kind of a secular spirituality, if you will. But I do think there is too much emphasis, again, on this kind of naval gazing and internal exploration, and not enough emphasis on sort of being of

service and common decency and picking up your garbage, and, you know, sort of like trying trying to leapfrog the day-to-day without focusing on what realistically a child can do now. I guess, you know, when I think about, you know, what message for parents out there. First of all, like, please protect your child from the internet for as long as you possibly can. And then when your child does get their own device, which hopefully isn't before about the age of 12 or 13,

please monitor what they do and have lots of active discussions about appropriate use and the importance of quantity and frequency because more we expose our brains to these devices, the more we change our brains, not necessarily in good ways. And then of course we all want our kids to like us, but good parenting does consist of not necessarily being your kids friend all the time. And maybe for a couple of years there in adolescence, maybe not at all, and being able to tolerate that.

So those are broadly speaking some of the things that I think about. It's interesting too, because I know a lot of people my age don't want kids, which I sort of understand to an extent, because it's like, what the hell? Right, right. But I don't know, it feels like things are going in a weird direction. Yeah. And I think that you can be nihilistic about it. Yeah. And I have moments where I am. I bet you probably do too here and there. Yeah, I mean, yeah, I wouldn't have written the book otherwise. You know, it was this worry for

for the generations to follow. Yeah, definitely. You know, part of my how I think about things. I mean, I think ultimately I am an optimist. And I do believe that we are incredibly adaptable and we will figure this out. It may take a couple hundred years, but we are going to figure it out. We'll be long on. But in the meantime, you know, really trying to mitigate the, not just the profound suffering, but actually loss of life. I mean, I'm so terrified to see these beautiful young people who are, you

know, ending their lives because some little thing, which doesn't seem little to them in the moment, but really is little, you know, didn't work out for them. And just, yeah, I mean, more broadly, this kind of nihilism that many people experience in life today, this feeling that like things aren't real. They're not real in the world. Nothing matters. We're a rock hurtling through space. Why do I do anything that I do?

It's kind of untethered feeling. And really wanting to help people as well as myself, because I struggle with these feelings too, kind of feeling connected to life, feeling a sense of flow and meaning and purpose. Yeah, I mean, these are the things that I think are really worth fighting for and figuring out. I mean, it really just comes down to figuring it out for yourself and just hoping that that inspires someone else to do the same.

Well, let me know what I mean. Yeah. So that's a very interesting, that is the sort of modern notion, right, that we can pull meaning from ourselves. But I would suggest to you that, and this is of course what Nietzsche thought, right, that we should pull meaning from ourselves, but Kierkegaard, who is the philosopher who talked about the leap of faith, his thought, which I ultimately agree with, whatever your spiritual orientation, is that the well eventually runs dry when we try to pull meaning from ourselves. Absolutely.

And that we really have to transcend the self and find some meaning outside of ourselves. However, we can do that. So I don't know if I believe really that we just need to figure it out for ourselves. I think we actually maybe need to turn out word. That's a great point. You know what? I think the way to put it would be, figure it out in your own life. That's a great point. You know what? I think the way to put it would be, you know, figure it out in your own life.

That's right. So it's like take control of your own life, but not necessarily find it all within yourself. Because you make an incredible point. A lot of times the fulfillment and the joy comes from the people in our lives. Because what would be the point of being on this planet if there's no one else here?

That's right. There's no point. And I think we forget that sometimes. How truly important other people are. And trying to figure out ways to put ourselves in spaces where we're around good people. And we get to be in those communities again, because going back to the beginning with dopamine,

it's like we're getting all this dopamine from being on our phones, right? Feeling like we're being social, but we're really just isolated. We get all this dopamine from ordering food to our house. When we're missing out on cooking with family or friends and enjoying that experience, even like shopping, you know, ordering stuff to your house,

there's social interaction that you're missing out on that you could be having at the grocery store. Right. I think making those little shifts. That it down, making things in the slower, less convenient way, doing things in real life with real people, doing things that are hard, intentionally doing things that are hard so that we're paying for our dopamine up front and getting it into directly through the effort and the work that we do. And I think too, you said something earlier in our conversation, which I think is essential, which is kind of the spirit of trust that we will get

through it. So kind of a patience and a waiting and that also speaks to the problem of overindulgence, wanting things to be solved immediately. Yeah, and I'm going to figure it out. And realizing that, okay, I'm not probably going to figure it out today and maybe not even tomorrow or a month or now. I can wait, I have the patience and the trust that the answer will reveal itself. And I can do the next right thing. So kind of walking through that way one day at

a time, which is also how people in recovery, you know, from addiction walk through life, you know, one day at a time. Absolutely. We'll get through it. That's it. We will get through it. I did want to ask you about one thing. Yes. So because I thought it was really interesting. And I think it was your Jimmy Kimmel interview. Yes. And he asked you, well, what do you think about when you interview people? Yeah. And you said something that I thought was absolutely fascinating.

You said, do you remember this? I was like, nothing. Yes. I know 100% nothing. Yes. Although, that's, so here's what's interesting. So I've done like super short form interviews on Red Carpets, right?

It's like three minutes each person. It's so on the move. This is my first time doing an interview that is long form. Ever. You're my first one. It's you. Oh, how interesting.

First interview ever. Here's why I found it important and fascinating that your response to what do you think about when you're interviewing people is that why don't really think about anything. Because I think that may be part of your secret. We have our rational minds and then we have these more intuitive emotion parts of our minds. And this is this sort of more intuitive piece, I think, is underappreciated, under recognized. And we can bring it to an experience by essentially on some level, not thinking. Like shut it.

Yeah, you probably, this is probably not not anything new to you, but I thought it was really great that in that moment, you really kind of validated whether you knew it or not the sort of the presence that you bring on a purely emotional, intuitive, non-rational level. So I just think it's great that you said that and great that you do that and probably why people resonate because it's just your open. Thank you. Yeah.

That makes a lot of sense to me because I've actually struggled with that side of myself, the fact that I am not someone who heavily calculates heavily plans. You know, I came in today doing my first real sit down interview. And I, you know, I wanted to have notes because I had so many questions that I was like, oh, I don't want to forget something.

But I found that it actually just stressed me out. That's right. Yep. So moral history, it's this girl's darn thing out of here. Because that mess with my head. Yeah, right. And I mean, obviously first one ever, I wasn't sure, I guess more preparations

better than none. But I really do think that tapping into that just intuitive side, it relieves so much stress and anxiety. And also, I really do think that overthinking or overplanning is the thief of all spontaneity and joy. I do think that that's a skill that is underappreciated. Yeah, absolutely. It's not validated.

I will say that I'm glad that you prepared for our interview today. Yeah. And that's an act of generosity and consideration for me that, you know, that really matters to me and makes for a better interaction and all that. But I absolutely do agree with you that don't lose that thread of what makes you a uniquely good interviewer, right? Thank you. You don't need, you can prepare, but then there's that time where you let it go. Yeah.

And you just sort of see what unfolds, and you don't have to overthink it. Yes. I mean, in fact, it's like, you know, the just sort of trusting again that, that this meeting of the minds and hearts, right? Well, together unfold something that's, you know, good. This was not only my first real long interview, but it was also the first therapy session I've had in a while. I'll tell you, it's been a little bit for me.

And it was truly, I learned so much today that I feel like there's something about learning that does make you feel calmer. Yeah. Which I think is another thing that we're kind of lacking right now is excitement to learn in a lot of ways. Yeah. And it's interesting because I didn't finish high school. I left junior year.

But it's only made me want to learn more. Yeah. Because now I'm learning on my own terms. Yeah. And that's definitely a, like, you know, that's a special privilege because not everyone, there's certain careers and jobs where you go to college, you have to go to college.

And you have to learn certain things. I've been so fortunate that I just kind of went and did my own thing. Yeah. But I do think it's important to learn for you. Yeah. And that's a great source of entertainment nowadays. Mm-hmm. Nice.

That, you know what I'm saying? Yeah. That sort of, it entertains you, but it also fulfills you and calms you in a lot of ways. Right, right. Oh yeah, I mean, learning releases dopamine in the Brains Reward Path. See, that's some good dopamine, though.

That is good dopamine. This is good dopamine, yes. And it turns out that using drugs before trying to learn actually prevents our ability to get dopamine from learning. It sort of usurps that ability. So really important that, yeah, we're getting our dopamine from good sources. You know, I don't know why you left high school early, but I suspect it was because it

wasn't an environment that validated the way that you learned and the way that you are. And so it's great that you've been able to find a way of learning that, yeah, comes from sort of a deep sense of wanting to know this and feeling that by sitting with it, you can learn it, right? That is one of the beautiful things about now. Yeah, you can learn anything.

Yeah, it is good. At any given moment. Right. Although there's some false info out there. There's a lot of it. And so you might run into some of that. Yeah. But it is pretty magical that you can kind of,

you can teach yourself just about anything nowadays. Yeah, it is nice. It's true. So I guess we'll end this episode off with the one good thing about the internet. You can learn anything you want at any given moment. But you might find some false info. So maybe it's not a good thing. That's right. Thank you so much.

You're welcome. It was so nice to meet you. It's such a pleasure. I hope you'll be back one day. Of course. Happy to. Thank you so much. You're welcome. It was so nice to meet you. It's such a pleasure. I hope you'll be back one day.

Of course. Happy to. Amazing.