Passion Struck with John R. Miles - Anna Lembke on How to Be Human in a Dopamine-Driven World | EP 625
Episode Date: June 17, 2025In this compelling episode of Passion Struck, John R. Miles sits down with Dr. Anna Lembke—renowned psychiatrist, Stanford professor, and bestselling author of Dopamine Nation—to unpack t...he invisible crisis of our times: how a world saturated with instant gratification is quietly numbing us, hijacking our attention, and severing our sense of connection.They explore the neuroscience behind addiction, why pleasure and pain share the same neural real estate, and how seemingly harmless behaviors—like binge-watching, social media scrolling, or even overworking—can rewire our brains in harmful ways. Dr. Lembke explains how real connection, meaning, and purpose are often sacrificed in our pursuit of dopamine—and how the antidote lies in facing discomfort, building community, and rediscovering what makes us human.John also shares his own journey through emotional numbness and addiction, making this conversation both intellectually rich and deeply personal.Click HERE for the full show notesExplore More: The Ignited Life SubstackIf today’s episode sparked something in you, you’ll love The Ignited Life— created to fuel your growth between episodes.👉 Subscribe now at TheIgnitedLife.net.Catch more of Dr. Anna Lembke: https://www.annalembke.com/If you liked the show, please leave us a review—it only takes a moment and helps us reach more people! Don’t forget to include your Twitter or Instagram handle so we can thank you personally.How to Connect with John:Connect with John on Twitter at @John_RMilesFollow him on Instagram at @John_R_MilesSubscribe to our main YouTube Channel and to our YouTube Clips ChannelFor more insights and resources, visit www.passionstruck.com.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
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Coming up next on passion struck.
When people with addiction get into recovery,
they get so good, like their lives are so much better.
And I don't know that we see the same kinds
of incredible improvements as when we're just like treating
run of the mill depression or bipolar disorder.
But with addiction, people with severe addiction, when they stop using and they get into recovery,
wow, they're often really remarkable people and there's such a ripple effect because of course
addiction negatively impacts not just their lives but the lives of people who love them
and the people around them.
So welcome to Passion Struck.
Hi, I'm your host, John R. Miles.
And on the show, we decipher the secrets, tips,
and guidance of the world's most inspiring people
and turn their wisdom into practical advice
for you and those around you.
Our mission is to help you unlock the power
of intentionality so that you can become
the best version of yourself.
If you're new to the show, I offer advice and answer listener questions on Fridays.
We have long form interviews the rest of the week with guests ranging from astronauts to
authors, CEOs, creators, innovators, scientists, military leaders, visionaries, and athletes.
Now let's go out there and become passion-struck.
Welcome to episode 625 of Passion Struck,
where intention meets impact
and the journey to a connected life begins.
If you're new here, welcome.
This show is for anyone bold enough
to ask life's deeper questions
and brave enough to live the answers.
If you've been with us for a while, thank you. Your presence is what powers this movement. Today we're
continuing our series on the connected life, an exploration of what it truly
means to live with depth, alignment, and purpose in a world that often keeps us
distracted and disconnected. Last week I welcomed two incredible guests. First,
Suzanne Geisman, one of the world's most respected
spiritual teachers, joined me to help us explore soul-led purpose
and what it means to matter to the universe itself.
Then on Thursday, I was joined by Dr.
David Hamilton, who unpacked the science of kindness, revealing
how compassion isn't just a virtue but a biological
necessity for mental health, connection, and well-being. And if you missed it, I also dropped a solo
episode on Friday on Taylor Swift and the art of valuing others, where we explored how one of the
most influential artists of our time uses empathy, intention, and presence to build genuine connection in a performative world.
Now let me ask you this, what happens when pleasure becomes pain?
When the things you crave, your phone, social media, alcohol, food, even validation, start consuming you?
My guest today is Dr. Anna Lemke, the best-selling author of Dopamine Nation
and one of the world's foremost
voices on addiction, compulsive behavior, and the neuroscience of Craven.
As a psychiatrist and professor at Stanford University School of Medicine, Dr. Lemke has
helped thousands of patients break free from the grip of modern-day addiction.
Her work challenges us to rethink how we relate to pleasure and how too much of anything can leave
us feeling empty, anxious, and disconnected. In this episode we explore why dopamine overload
is at the root of so many of today's struggles. How the pleasure pain balance governs our mental
health and relationships. We go into the paradox of abundance and why more access often leads to less satisfaction and how embracing intentional
discomfort can lead to deeper fulfillment, focus and freedom. Whether you're seeking to reset your
habits, reclaim your attention or simply live with more balance and intentionality, this conversation
will give you a scientific and deeply human blueprint for navigating the addictive nature
of modern life. And one last reminder our our Ignited Life substack is growing fast.
Each week I share exclusive tools, behind-the-scenes insights,
and curated playlists like this one. You can subscribe at the ignitedlife.net
or go to passionstruck.com. And don't forget to check out
our growing YouTube channels where we post extended interviews on John R. Miles
and Clip's videos on PassionStruck clips. Now let's dive into this transformative conversation
with the brilliant Dr. Anna Lemke. I am absolutely honored and thrilled today
to have Dr. Anna Lemke join us on Passion Struck. Welcome Ana.
Thank you for inviting me. So it's a few years now since the release of your groundbreaking book,
Dopamine Nation, Finding Balance in the Age of Indulgence. But I wanted to start out with
your own journey from writing about opioids to exploring digital addiction.
Was there a specific moment when you realized we're no longer dealing with
just some people struggling but that it's
almost like everyone is becoming vulnerable to addiction?
I have to say if there was one moment,
it was the moment I met my patient Jacob,
a Stanford professor himself who gave me permission ultimately
to share his story anonymously with readers.
A very bright, very successful, very kind man, a good person who had developed this
very severe sex addiction, which really took off with the advent of the smartphone, the
internet, and then the smartphone,
culminating ultimately in, as I write about him, him building his own
masturbation machine, and then getting so despair, despairing around his inability
to stop this behavior that was ruining his life that he seriously contemplated
ending his life going so far as to hang a noose.
And that was really the moment for me,
for a lot of different reasons.
It was a window into how the technology
has changed our relationship with these behaviors
that we are wired over many millions of years of evolution
to seek out in order to optimize for survival.
So it was like that the interface between his addiction and the technology. That was a sort of oh wow moment. But then also a big piece of it was recognizing myself
in him and realizing that my own addiction to romance novels that was really exacerbated by the advent of Kindle, my e-reader,
and my ability to essentially chain read without interruption and have access to a universe of
romance novels. This is like a very universal problem, especially since I had always thought
that I was somehow immune to addiction because although addiction runs in my family
in terms of quite a few alcoholics
going back the generations,
alcohol never did anything for me.
I was never vulnerable to alcohol addiction.
So it was a realization,
oh, it's not that I'm not vulnerable to addiction.
It's that just alcohol isn't my drug of choice.
But when I finally encountered my drug of choice,
I was off and running.
Well, I'm glad you brought up that form of addiction because typically when we think of addiction,
we think of drug or alcohol use, but you can be addicted to work, you could be addicted to
gaming, you could be addicted to many things in life. And on that same sort of topic line,
On that same topic line, we tend to live in a dopamine-rich world that,
as your research points out,
is designed to hijack our pleasure centers.
If you had to describe the modern environment that we're
living in one word from an addiction medicine lens,
what would it be and why?
I would probably use the word drugified.
I think we've drugified almost all substances and behaviors,
which is to say we've made them more potent, more accessible,
more bountiful, and more novel.
And all of those things increase the addictive potential
of anything, including even traditional drugs.
So access is a huge risk factor.
If you live in a neighborhood where drugs are available
in the street corner, you're more likely to try them
and more likely to get addicted to them.
And we live in now a world of really universal access.
There's really almost nothing that we can't get.
And we have drugs that didn't exist before,
including digital media.
In terms of potency, the classic trajectory of any drug
is that with chemical alterations,
we can make it more potent.
If you look at the history of opioids, for example,
morphine derived from opium is 10 times more potent
than opium, and then you ultimately add two acetyl groups
to morphine and you get heroin, that's more potent.
And then eventually you end up with fentanyl,
which is a hundred times more potent.
So that's a history of substances.
And we see that too, that kind of telescoping of potency
with digital media too, or just screen time in general.
Access potency, novelty is a way to overcome tolerance.
So all of these things, I think we've now infused our entire ecosystem with this
kind of drugification of everyday life.
Yeah, not too long ago, I read the Revenge of the Tipping Point, Malcolm
Gladwell's latest iteration of that famous book, and I'm not sure if you've read it or not, but he really starts out.
I was aware he came out with it.
Right.
Yeah.
He starts out the first section of the book talking about Purdue
Pharma and the opioid epidemic.
And he really brings about two, two key insights.
One, you just described in that they needed their drug to be even more
addictive.
And so they changed the formula to do.
And then he brought up about how McKenzie came in and they understood that the blanket
way that they were trying to attract all the doctors wasn't working.
Attract the doctors who are most addictive to making money
off of their product and super focus on their vulnerabilities because they're the super
prescribers. And so I'd never thought of prescribing out of financial desire to be an addiction,
but in the way he was describing it, it was almost like these
doctors were so addicted to making more money that they were willing to freely write more
prescriptions.
Is it possible to have that form of addiction?
Oh, absolutely.
I think we see addiction to financial gain in many different forms. And we've drugified work by adding all kinds of bonuses
and stock options.
And even in the medical field,
I now get a monthly report telling me whether or not
I've met my relative value unit requirements,
which is shortened for RVU,
which is how much the insurance companies will reimburse per patient seen.
And if I go below my graph, I will not get a bonus. And if I go above my graph, I will get a bonus.
There are all kinds of visible and invisible incentives inside of medicine that encourage seeing more patients, billing more.
And it's not that doctors are necessarily bad people
or that doctors are worse than other people.
But when you have a system that incentivizes
and rewards certain types of behavior,
human beings are very sensitive to rewards
and we will work to press a lever to get rewards.
That's true, whatever the reward is.
Well, I think a lot of people assume
that addiction doesn't apply to them.
I have met a lot of friends who I think
have various forms of addiction, but none of them see it.
What's the biggest myth that you wish
more people understood about it?
There are lots of myths about addiction. One of the myths is that
people never get better. So we do have this vision of severely
addicted individual sleeping under a bench,
holding a round paper bag.
individual, sleeping under a bench, holding a round paper bag. And that's not to say that those people like that who fit that image don't deserve our empathy. Of course they do.
But the point I'm trying to make is that addiction is a spectrum disorder and there are a lot of
people walking around who have a pretty significant addiction, and you would never necessarily know
because they can manage it well,
just well enough to hide it
and to seem to continue to function.
But their loved ones know, right?
The people close to them,
and then there's this sort of throwing up of hands,
well, there's nothing I can do.
And I think that's the myth
that I most actively want to fight against
because we know that
treatment for addiction works.
And it works just about as well as treatment for other chronic relapsing and remitting
disorders with a behavioral component like type 2 diabetes, like obesity, like certain
forms of cardiac disease, certain forms of asthma, like depression, right?
So we know when we build a treatment infrastructure and people actively engage in treatment, they
have response rates that are on par with the response rates from those other chronic disorders.
So that's an important, important thing for people to realize.
Thank you so much for sharing that.
And on a theme that I explore often on this podcast is how so many people today
feel invisible and sick and, or insignificant.
And I remembered when I first started thinking about this, I kept hearing.
We have a hopelessness epidemic.
We have a loneliness epidemic.
There are so many people who feel burned out, invisible in their own lives, that they just
don't matter.
And the more I started to look at all these common symptoms, it made me think that they're
all just things that we're categorizing of something that's larger.
And do you think our turn towards addictive behaviors is in part a coping mechanism for that
deeper loss of meaning or connection? Yeah, it's a great question. And I guess I would answer it by
saying, I think it's a feedforward cycle. And by that, I mean that there that the lack of meaning and purpose in our lives, and frankly just
sheer boredom, can contribute to addiction.
But I think it's really important to recognize that being exposed to a lot of addictive substances
and behaviors can also create the absence of meaning and purpose and loneliness.
So the point being that while these kinds
of unmet existential needs certainly increase
the risk of addiction, the reverse is also true
and that when we get addicted to something
that's just really inherently addicting,
we can go from a life of connection and meaning
to a life without connection and without meaning.
So it's really a feed-forward,
bi-directional kind of a phenomenon.
In your book, you write that,
in addition to the discovery of dopamine,
one of the most remarkable neuroscientific findings
in the past century,
is that the brain processes pleasure and pain
in the same place.
Further, pleasure and pain work like opposite sides
of a balance or opposite sides of a balancing mechanism.
When you think of that topic of mattering
and our lack of connection that many people are facing,
how do those two different sides of the coin affect someone?
Because it seems like it's almost an inner battle between the two.
Gosh, I'm not really sure how to answer that,
how to make a direct link between that pleasure-pain balance,
which is just a metaphor to represent the drive
toward homeostasis, and how we achieve homeostasis
with any deviation from neutrality,
whether to pleasure or to pain.
I think a somewhat maybe counter-cultural view
that I have on this is that that our suffering really if we
can find the meaning in our suffering then we can find the meaning in our
lives. If we feel like our suffering is just gratuitous and pointless then that
really does breed a kind of nihilism. And I say that's counter-cultural
because it implies that suffering is maybe a good thing,
which is not that I would wish suffering on anybody.
And I certainly don't like suffering in my own life,
but I do know that the most important lessons in my life
and the experiences that have informed
my own sense of purpose and
direction have come from the hard things in my life.
I said, I'm not sure if that's what you're asking, but
I think that's part of it.
I recently had a guest on the show.
You may or may not be familiar with them, but he's one of the foremost.
Buddhist teachers.
His name is Yonge Mingor Rinpoche.
And we were talking and Rinpoche was talking about how
for him panic attacks were something that plagued him and were causing him to really
disengage from a lot of things in life.
And then he learned to lean into it, to overcome it.
And through that learning, it's what led him down the path
of now using it as an example of by overcoming it
and getting used to the idea that he was having them,
it now opened him up in other ways of his life
that he never would have been able to feel or observe
had it not been for the panic attacks.
So very similar kind of theme.
I think we live in a culture
and we certainly have a medical model
that we should do all that we can
to escape painful feelings and experiences,
whether physically painful or emotionally painful.
And I also think that's very reflexive and instinctive.
Like I think we evolve to reflexively approach pleasure
and avoid pain.
And it's how we've survived in a world of scarcity
and danger.
But it is also very true that like ultimately pain
in various forms is really unavoidable.
And the more that we try to escape it,
the worse it actually gets.
And what really needs to happen is we need to turn and face it and even enter into it
in a kind of a metaphysical sense.
And I think in doing that, we paradoxically get a respite from it.
So I want to look at the other side of this.
How does the superabundance of pleasure tie into a deeper spiritual or psychological poverty
that people are experiencing?
Well, if you look at the neuroscience,
what we know is that no matter how much pleasure we get,
ultimately our brains will adapt to that experience
and need more and more over time to get the same effect.
Or that even that pleasurable experience because of neuroadaptation will turn on us and we'll
get the opposite of what we used to get from it.
Just to take a very common example, people often use cannabis to feel good, get high,
or to stop feeling anxious or depressed or to help themselves go to sleep. But with heavy daily use, very often and quite quickly experience that
it stops working, they need more and more to get the same effect or that it
actually starts to make them anxious or makes them paranoid or suspicious or
wakes them up instead of puts them to sleep. These sort of age old adages from all the major religions
and philosophies that say the pursuit of pleasure
and of material gain is not ultimately a rewarding life.
We now actually have pretty good neuroscience showing
how and why that happens.
Speaking of neuroscience, in your view,
what happens to the brain when someone internalizes
the belief that they don't matter?
Well, I don't think we really know.
The belief that you don't matter
is probably a very complicated neurological phenomenon.
It's probably different in different people. But phenomenologically, it's probably pretty
similar to what happens when people get depressed. And what we know from studies of depression
is that there's a dampening of neurological firing in different parts of the brain, especially the frontal lobes, but probably also in the motivational reward systems.
So people I think kind of de-cathect or withdraw from life, and they stop engaging, they stop paying attention, they stop connecting or seeking out. Yeah, so I just wanted to bring in my own personal story
because I think it typically will help a listener.
So I was a high functioning senior executive
in the Fortune 500 world.
I was a senior executive at Lowe's
and during my time there, I noticed,
and it happened really gradually,
but it was just like, I
couldn't put my finger on it, but the world just didn't feel as bright as it once did.
Like the connections weren't as strong.
My sense of having a desire to go out and have fun just wasn't there as much.
My desire to go above and beyond at work
seemed to take a step back.
And at first I dismissed it.
And over time, it just seemed to get
a little bit darker gradually.
And it's so gradual that you almost
don't even know what's happening.
And I remember as I was going down this path and things in my life seemed to start unraveling,
I ended up going to see a psychotherapist who told me that what I was experiencing was dysthymia.
And is what I'm describing a similar case of what that feels like if
someone's experiencing it? Dysthymia, the difference between dysthymia and
depression generally is the chronicity as well as the severity. So, dysthymia is
like a long-lasting low-grade depression, whereas major depressive
disorder is usually more
episodic, deeper depressions. But these characterizations are limited. They'll
never fully capture human experience, but certainly what you're describing
sounds pretty classic for some form of depression. I was just really, if someone's
never been through it, I used to think at this point,
having not experienced depression, that when people say someone's has a chronic or severe
depression and it's keeping them out of work or something else, I never understood what
that meant until I went from this gradual to I say, a medium grade, then eventually to a severe grade.
And when it hit me severely, it just
felt like I was completely emotionally dead inside,
something I wouldn't wish on anyone.
And it was almost like I would wake up and not
want to do anything.
So powerful.
And unless you've experienced it yourself or seen it in a
loved one, it's really hard to understand or imagine. But yeah, that kind of, first
of all, I think you highlight something really important. Not all depressions are
characterized by sadness, right? Some people just feel the absence of feeling
or kind of numbness, which it sounds like you were describing. Other people get
very irritable and cranky and angry when they're depressed can manifest differently but certainly
it's almost like life has been leached of its color or you have the dark shade over your eyes
or it's a very strange feeling. That is and during this time I had moved on from Lowe's to Dell
and I'm now operating directly with Michael
Dell and that level.
And from the outside, you would have thought everything in my world was completely fine,
but inside, it just felt like everything was falling apart.
And so as this was going on, I tried to fill the void because I really felt an absence
of mattering at that point and I started
to try to fill the void with alcohol. And what I wanted to ask, and I know I used my
story, I probably went longer into it than I should have, but-
No, no, thanks for sharing. It totally enriches everything because it's, yeah, a lot of people
out there struggling with these problems.
Well I so at this point I was completely burned out, I was emotionally numb, I'm drinking more,
and I guess my question to you for someone who might be in a similar situation is how whether
it's alcohol, drugs, another addiction, how do those addictions make that void deeper
and does it make it deeper?
There are a lot of doorways into addiction
and certainly trying to quote unquote self-medicate
a depressive state is a common pathway.
And the reason that it's so common
is because in the short term,
alcohol makes a depressed person
feel a little less depressed.
The problem is that it's very short-lived
and that ultimately, you know,
what daily heavy alcohol use does
is essentially cause the brain to say,
oh, wait a minute,
we're getting all this exogenous dopamine, so to speak,
or these exogenous source
of these sort of feel-good chemicals that we can, we don't need to make our own anymore. We can now
down-regulate production of our own endogenous opioids, our own endogenous dopamine, and ultimately
you get to a point where you're in this chronic dopamine deficit state where now you need to use
alcohol, not to get out of your depression,
but just to bring yourself from a state lower than your depressed state back up to your
original depressed state.
So it gets to be this very insidious kind of chasing your tail phenomenon.
But the problem is that in the immediate moment of using again, there's at least very briefly
some relief from those
symptoms and so you get in this kind of vicious cycle. Which is why I say to
patients you need to abstain from your drug of choice long enough in order for
your brain to reset those reward pathways and even if your baseline was
depressed, it was probably less depressed than you are now since you've been
drinking.
And if you look at sort of large scale epidemiologic data,
what is that addiction is rates of addiction are higher
in people with co-occurring mental illnesses,
but that when people with mental illnesses of all sorts
are engaging in their addiction,
they have worse outcomes than people
with the same mental illness who are not addicted to substances. So for example, whether it's
schizophrenia or major depression or bipolar disorder, somebody who is using a
substance to cope with that mental illness is very likely to have more
prolonged episodes, to need more medication, to have more hospitalizations, to have more complications,
and ultimately to die of their disease.
I know, and I don't talk about it a lot on the show,
but I've been sober for a while now,
and life is just completely different.
It takes a little bit to get there,
but it's just, you sleep so much better,
your cognitive functioning is so much higher.
You, it's just like the world for me is brighter without it.
And I'm not advocating for people on the show to drink or not drink.
I just know for me, it's been a godsend that I was able to move away from it
because it was no longer serving a point in my life that was helping me in any way.
And I found it was the common link between all the moments
that seemed to go wrong in my life.
So for me, it was just a need to break from it.
And I actually just did it to cold Turkey.
I just told myself starting August 1st, I'm going to just stop.
And I initially thought I'd stop for a couple of weeks.
And then it just felt so good that I just permanently stopped.
Oh, that's great.
Was that this past August?
Two August ago.
Two August ago.
Oh, that's great.
Yeah, that's why I love this work.
Because when people with addiction get into recovery,
they get so good. Their lives are so much better.
And I don't know that we see the same kinds of incredible improvements as when we're just like treating run-of-the-mill depression or
bipolar disorder. But with addiction, people with severe addiction, when they stop using and they get into recovery, wow,
they're often really remarkable people and
there's such a ripple effect because of course
addiction negatively impacts not just their lives but the lives of people who love them and the people around them.
So it's great to hear that you're feeling kind of this new lease on life.
I'm curious though looking back you described it as first there was this sort of
kind of low-grade depression,
diagnosis, dysthymia, and then a more severe depression, and then the drinking.
But looking back, I'm curious, were you already drinking heavily
before you got, when your mood went down?
I would not say heavily, no.
Okay.
No.
And I was never one of those people who drank like a bottle of liquor a week. For me, it was typically wine. And it was generally after I came
home from work, I wasn't a day drinker. It was typically, I used to do something
to relax or I'm a severe introvert. So I just found oftentimes in that world that
I existed in where you had to act like an extrovert all the time. I was so exhausted by the time I got home that it was a way for me to just
lessen the emotional drain that I'd been feeling. And I think that's why I started doing it.
But I noticed that the more I felt this sense of invisibility or weight take over me, it
led to an increase in drinking.
And then I had an incident about eight or nine years ago where I walked in on an armed
robber in my house who pointed a gun on me and I had to evade him.
And that kind of brought up all the PTSD from my past and combat and other things.
And then I went into another bat at that point
of learning to drink heavily again,
probably to cope from that incident.
All right, wow.
So I wanted to move now to technology.
You've compared in other interviews
that I've listened to social media companies
to almost drug dealers.
Do you think these platforms in any way hijack our need
to matter and commodify it through things like likes,
follows and metrics?
Well, let me just say, I'm still optimistic
that we can make less addictive forms of social media.
And I think that the fact that so much of us
spend so much time online is in some ways positive
in that it speaks to our desire for connection
with each other, which is a good thing.
But there's no doubt in my mind that there are certain forms
of social media that are highly addictive
and have been engineered to be addictive through
the algorithm that learns what we've liked before and then pushes that content to us in ever shorter
now primarily video format which is very reinforcing for our brains and that it actually now takes work to stop viewing these videos rather than to view the videos.
Plus, the ability to control the experience I think is hugely contributory to its addictive nature.
Because a big piece of addiction is actually the control that we can reach for a substance or a behavior
and in a second change the way
we feel. And the fact that the digital medium can be is and can be specifically
tailored to our wants needs and likes and if we get bored or frustrated we can
just get rid of it and get something else is really a key piece of its
addictive potential and why it's a departure, very
much departure in my mind from like TV. TV had its own addictive potential, but I think
we've now gone from the equivalent of heroin to the equivalent of fentanyl with these new
digital mediums. Yeah, they're highly reinforcing, again, the control piece, the interactive piece,
all of these design elements, the shares, the likes, the comments, the posts, the quantification, the endless scroll, the notifications, all of it is really engineered to hijack our branch
reward pathway and it does so very effectively. And you can see that in many different ways.
And you can see that in many different ways. Here clinically, we see people coming in with very severe addictions to social media and
other forms of online communication and entertainment.
But you can just like walk around in an airport or in a museum or in a theater or at a musical performance or whatever it is in a
classroom, right, where people are supposed to be engaged and learning and the extent to which
people are not engaged in the thing that they're supposed to be engaged in but distracted by
these devices I think kind of speaks for itself. So it's almost like you're saying we're not just addicted
to dopamine, but to digital proxies of mattering.
Well, dopamine is a metaphor.
Like we're not actually addicted to dopamine.
Dopamine is a brain signal.
The changes in dopamine from baseline
tell us to approach or avoid.
We know that screens and digital media, social media, pornography, video games, they light
up the same reward pathway as drugs and alcohol.
So they clearly release dopamine in this ventral tegmental area.
And anything that releases a lot of dopamine at once has the potential to be addictive. But I think getting
back to your kind of question or comment, it's anything that gets us addictive will pull us away
from meaning and mattering because it's a false worship, right? We're now in this very narrow loop of auto titillation
and we're disengaged from the people around us
and from the world around us.
And to find meaning and to feel we matter,
we need to be engaged with other people in the world.
And we can't do that if we're self stimulating.
Yeah, it was really interesting.
A friend of mine sent me this article about
Satya Nadella, CEO of Microsoft, the other day. And he was saying that today he's an avid listener
podcast, but he's making the decision that going forward, he's going to stop listening to podcasts
and instead upload the transcripts from the podcasts.
And I'm not sure if you saw this article, but he was going to upload
the art, the transcripts into AI and then have conversations with AI.
Um, and it just really, to me, alarm bells were going off because.
Well, I remember when Steve jobs used to talk about the reason he created the iPhone, it
was to help people connect more.
And it sounds like what Satya is describing here is that he's going to take the human
form of listening to a podcast and that interaction and switch it to an artificial form.
And I just worry the long-term implications
of if we start having more and more interactions
and conversations with artificial intelligence
instead of people, where does that lead?
And I think that's a very legitimate concern.
We already anthropomorphize our AI interactions, right?
People will commonly say, thank you to ChatGTP
for helping them and the experience
that large language models are so advanced
that the experience feels very much like
talking to another human being.
I think there really is a very real danger
of de-cuffecting or withdrawing from real people
because we can get all of our needs met
from this technology which seems more and more human,
even though it's not.
In my book, when I talk about my patient, Jacob,
who ultimately as an engineer built this
masturbation machine that got more and more advanced
and complex over time, and like my initial reaction to hearing about that
was one of horror, that someone would actually build
a machine to engage his genitals in that way.
But in a flash, in that moment, I realized,
oh, these smartphones, they're a masturbation machine.
That's essentially what we're all doing.
We're getting all of our needs met through these machines,
our intellectual needs, our intellectual needs, our
emotional needs, our sexual needs. I mean pretty soon we won't need each other because we'll just
be relying on this technology. So I think we have to really seriously talk about how can we live
in balance with the technology because the technology is here to stay and there are a lot
of great things about it,
which nobody would want to get rid of. On the other hand, there is this really potential dark side and it's already here.
It's a reality, right? Like we see in clinic people who have no friends at all, almost no human interactions,
and spend all of their waking hours online interacting with AI avatars as their surrogate girlfriend or boyfriend or friend.
And I don't know, these are not well people.
Like this is not quality life.
So I was listening to what you were saying
because I know it's happening more
and I know there was a big warning
that just went out to parents to not let their kids
start getting the habit of doing this because it's like having an imaginary friend that talks back
at you.
But do you think that if you were thinking about how the brain is processing this, do
you think it treats this sense of communication and the meaning that you're getting from a digital device the same
way that it does with a human? Or do you think there's a difference?
No, I think there's a difference, but not in the sense that our brain is able to distinguish
it as non-human. I think we very much experience it as human. But you add on top of that the medium itself, which is so
reinforcing in the sense that like with the human there would be all the added complexity
and reciprocity that is required of real human relationships, right? Like I ask you a question
and you talk and then you ask me a question and I talk and we have to tolerate each other's
idiosyncrasies and we have to tolerate frustration
and boredom and all those things. But online if my AI avatar says something I don't like or
is boring, I can just tell it to recalibrate, right? I experience it as human but it's a human
interaction that I can control. And again, you know, a big part of addiction is control, right? So
it's not, it takes those aspects, the reinforcing aspects of human connection and then turns
the volume way up on those, which is precisely why it's so reinforcing and potentially addictive.
I do want to interject though that there is a way in which, for example, asking AI or asking chat GPT a question about
some kind of personal problem, could positive way access some kind of collective wisdom.
So this is working in a way where you could get good information and useful information,
but the whole idea is that it would be information that you would then take with you out into the real world as you're navigating your real
world encounters. What we don't want is that becomes the entire experience.
So Anna, I wanted to spend a couple of questions on what
do we do about these scenarios?
So how do we begin to heal in a culture where
people are treated as consumers more than they do as human
beings?
I think we have to consciously and with intention
detach from our consumerist tendencies and take a break for long enough to
reacquaint ourselves with the natural rhythms of our own brain processing and
see the ways in which this capitalist consumers culture can really hijack our
reward pathways. It's very hard when we're chasing dopamine so to speak to
really see true cause and effect and it's painful to disconnect from this kind of addictive hedonic
treadmill but when we do it can be incredibly liberating and just a real
aha moment. So that's why I recommend taking a break from our drug of choice
whatever it is typically for four weeks knowing that we'll feel worse before we feel better. That's a withdrawal. The first 10 to 14 days are
super hard. But by the time we get to week three or four, the craving to continue to
use goes away.
Well, from personal experience, I can tell you it absolutely does.
Tell me more.
At the first couple of days, it's like a novel thing and you don't really think
about it, the hardest thing for me wasn't necessarily not drinking.
It was just that.
Everyone around you is doing it.
I remember when I first stopped drinking for the first two, three,
four weeks, I would go out into restaurants and literally 99.9% of the people in a restaurant are
drinking alcohol. And it is just so widely accepted culturally that we almost don't realize how
that we almost don't realize how normalized it's been.
So when you stop and everyone else around you has that as part of their ritual,
it was harder for me because I didn't really want
to be around those things.
I didn't want to go to a bar.
I didn't want to hang out at a bar in a restaurant.
I still wanted to talk to people,
but what was strange is people were asking me, well,
why don't you drink?
Why are you stopping?
And it was just weird for me to even get the question of why do I want to make a personal
choice?
That's my personal choice, and why are you questioning of me?
But I have noticed that as a result of it, I've had friends drifted away.
But when I look back upon it, those friendships typically had alcohol as a form of medium that was holding the group apart to begin with.
So when I look at it, was it a true friendship or was it more like a drinking buddy?
Right. But it was the most interesting thing for me was just how much society
gravitates towards its use and how abnormal I felt at first.
And even because a lot of restaurants make it very difficult for you to find
other, I didn't want to drink soda.
I didn't want to drink iced tea because I didn't want to stay up all night.
So really it just left me with water or soda water to drink soda. I didn't want to drink iced tea because I didn't want to stay up all night. So really it just left me with water or soda water to drink. And that was the hardest thing for me to
get used to. Now 20 months in, it doesn't bother me at all. But that was probably one of the things
plus how friends and the groups I was in started to treat me differently. Yeah, yeah, that's it's the social networks. Interesting in the last, I feel like in the last,
I don't know, five to ten years, there has been this kind of like sober movement when it comes
to alcohol and more and more people are embracing not drinking alcohol. I've got the whole mocktail
movement. That's been really interesting to see
and to analogize that to social media and how difficult it is to get off social media because
not only are you the only one often not on, but all of our systems, the QR codes and the school
schedules and the homework, it's all on there. Which is why, again, this is not just like an individual solution where
I can say, well, I'm going to stop drinking or I'm going to not use social media. It really has to be
a top-down solution as well, where we, especially when I think about the digital media, create
boundaries around being online and create spaces where people know they can come together and not
be connected to their devices and know that other people won they can come together and not be connected
to their devices and know that other people won't be connected to their devices either,
which is why I'm a big proponent of getting smartphones out of schools, K through 12,
so that kids don't have as much FOMO and they know that they're not online, but the other
kids aren't either, and so they're more present for each other interacting during the school
day.
Well, I think that's an important change.
And I think another form of addiction, at least I saw it in my own kids was an
addiction to success, to feeling that their significance was driven by success.
And I think that starts early on with kids because everything is a reward
system based on grades and testing and things like that.
And I agree that there needs to be structural changes, but I also agree that it really begins
in the family unit and in individual persons changing their mindset about how they're viewing
what makes life fulfilling or not and what
we're teaching our kids about that and what they should value.
I really agree.
I think that's why the nuclear family is a really important foundational unit.
And what parents both model in their behavior as well as say about what
the family values are, I think that's so impactful for how that kid
then views themselves in relation to their family,
but also in relation to the world
and how you measure and define success.
Is it the grades you get
or is it how you treat other human beings?
And I have one last question for you
and it's a fun question.
Great.
There's a lot of talk now about going to Mars and if you
were selected as an astronaut on the first mission to Mars and you knew what had happened
to Earth, what would be one principle, guideline, governing law, something that you would put in
place for our new civilization? Oh my gosh.
Well, first of all,
honestly, if I were offered a mission to Mars,
I would refuse.
I am so terrified of even getting on an airplane.
I'm never getting in a rocket ship.
But yeah, I see your broader point.
Like what would be some foundational principle
for starting a new colony, a new human colony?
I really think that at the end of the day, the thing that matters most is really our relationships with other people.
So I would look toward any kind of foundational principles that would really enhance our relationships, building trust and intimacy and regard and care for each other.
building trust and intimacy and regard and care for each other.
And Ana, the last thing is I know you're not on social media. So where, if people want to learn about your research, your book, your workbook that accompanies your great book,
where's the best place for them to go?
I'm not on social media, so I guess the best place is just the books themselves, the speaker themselves,
and then podcasts like yours are a pretty good place too.
Well, thank you so much for joining us.
It was such an honor to have you.
Thank you for inviting me.
Thanks for sharing a bit of your life.
That's a wrap on this powerful episode with Dr. Anna Lemke.
What I appreciate most about Anna's work
is her unflinching honesty.
She doesn't just diagnose the problem, she gives us hope.
Hope that we can reclaim our brains, our lives, and our sense of meaning.
Not by avoiding discomfort, but by embracing it intentionally.
As you reflect on this conversation, I invite you to consider what's one habit in your
life that used to bring you joy, but now leaves you feeling drained?
Where can you create more balance between pleasure and purpose?
And how might you build micro-moments
of intentional discomfort
that actually restore your capacity for deeper joy?
If today's episode challenged or inspired you,
I'd love for you to leave a five-star review.
It helps others to discover this content
and helps us grow this mission.
For more information on Dr. Lemke's work,
check out the links in the show notes or visit passionstruck.com. And don't forget, if you'd like to take this message even further,
I'm now booking for speaking engagements in the fall and winter. You can learn more about
my public speaking engagements at johnrmiles.com slash speaking. Next up on Passion Struck,
I'm joined by Bill McGowan, Emmy-winning journalist and one of the world's top
executive communication coaches.
Will unpack the art of persuasive storytelling
and how to communicate with clarity, authenticity
and presence in every room you enter.
I think it's a fool's errand to try to replicate the style
and the content of an established speaker.
The minute you start playing somebody else's game,
you've lost.
And because there's no way you're ever able
to recreate that, it's not you.
I often tell people that the best way to create content
in a presentation or a speech
is not to sit down at a computer and write it.
And the reason why is because unless you've worked in TV or radio, your writing style, it that is easy to deliver and is also easy for the audience to absorb.
So what I often recommend to people is...
Until then, remember, if you got value from today's conversation, share it and more importantly, live it.
Because knowledge alone doesn't change lives, action does. Until next time, live life, passion struck.