Speaking of Psychology - The Molecule of More: Dopamine (SoP76)

Episode Date: March 13, 2019

Dopamine is known as the chemical of love, creativity and addiction. It pushes us to achieve greatness, but it can also lead to our downfall. To help us understand this tricky molecule, the guests for this episode are Dr. Daniel Lieberman, professor and vice chair for clinical affairs in the Department of Psychiatry and Behavioral Sciences at George Washington University, and Michael Long, a speechwriter, screenwriter and playwright who teaches writing at Georgetown University. They co-wrote a book called The Molecule of More: How a Single Chemical in Your Brain Drives Love, Sex, Creativity – and Will Determine the Fate of the Human Race. APA is currently seeking proposals for APA 2020 sessions, learn more at http://convention.apa.org/proposals Learn more about your ad choices. Visit megaphone.fm/adchoices

Welcome to Speaking of Psychology, a biweekly podcast from the American Psychological Association. I'm your host, Caitlin Luna. The topic for this episode is dopamine. It's known as the chemical of love, sex, creativity, and addiction. Dopamine always wants more. It pushes us to achieve greatness, but can also lead to our downfall. Our guests for this episode are Dr. Dan Lieberman, Professor and Vice Chair for Clinical Affairs and Department of Psychiatry and Behavioral Sciences at the George Washington University,

and Mike Long, a speechwriter, screenwriter and playwright who teaches writing at Georgetown University. They co-wrote a book called The Molecule of Moore, How a Single Chemical in Your Brain Drives Love, Sex, Creativity, and will determine the fate of the human race. Welcome, Dr. Lieberman and Mr. Long. Thank you. Happy to have you on the show. Yeah. So I'm sure many of our listeners have heard of dopamine, but may not know exactly what it is and exactly what it does.

So Dr. Lieberman, can you start off with a very basic question? What exactly is dopamine? Dopamine's a chemical in the brain. I like to think of it like the conductor of an orchestra. It turns on, turns off, turns up the volume, turns down the volume on a lot of different areas in the brain. And as a result, it has an outside, an outsized influence on our behavior. Everything in our body serves a purpose. So from evolutionary perspective, why does dopamine exist in our brains and are we the only animals who have dopamine. When people think about dopamine, they often think about reward. And that is an important aspect of it. We get feelings of pleasure, reinforcement, even euphoria, when we do things that promote our survival and our reproduction, eating food, drinking water, winning competitions,

and having sex. So from an evolutionary point of view, it's incredibly important. And that's why it's so powerful because it directs our behavior from the bottom up. It's designed to keep us alive and make us evolutionarily successful. So it's really been integral in what has helped us evolve from early humans to where we are today. It's true. And most animals do have it. It's a very ancient chemical, but humans seem to have more of it than any other organism. And we are much more sophisticated than other organisms. And so in human beings, it does a lot more than just reward us when we engage in pro-survival activities. It's responsible for a whole host of activities that people would never guess, such as love, creativity, even political affiliation. So, before you're

talking about animals. So would something like a distant relative of ours like a primate have dopamine? And would something simple like an earthworm have dopamine? You know, I don't know about earthworms. It's your next book. Yeah, that's right. Primates definitely have them. You may be surprised to learn the animal that has the most of it. And that is ravens, crows, blackbirds.

Yeah. They're actually incredibly good at solving problems, better even than chimpanzees. They've done experiments in which they've put together a problem for a raven to solve. It involves getting a piece of food. And it involves multi-steps. they've got to build a tool and then use the tool to get the food and they're able to do it. And we think it's because they've got so much dopamine. That's fascinating.

I think this begins to open the door on what we think is so interesting about the book. Dopamine obviously has this evolutionary role and it has fulfilled it well. And to this point, it's great. But here we are in a modern age where a lot of the things that it was required for in a raw, empty place, we don't have that problem anymore. We don't have to worry about where the next meal is coming from in most of the world. We don't have to worry about where we're going to sleep tonight and who we're going to sleep with, frankly. There are mechanisms in civilization to find that person. And yet dopamine remains, and correct me if I'm wrong, Dan, at the same

levels it's always been, more or less. Here we go. And dopamine has to have something to do. And that leads to these cultural effects, these cultural conflicts, these personal experiences that are sometimes frustrating, sometimes curious and strange. And that's where we went with the book, is understanding how dopamine got us to this point, how it explains so much trouble we find ourselves in today and so many curious experiences we have. I think perhaps the broadest way to describe dopamine is that it's designed to maximize future resources. And, and, and, and, And we can see that working in ourselves when we are constantly focused on the future. I need more.

I'm not satisfied. I'm not a good enough person. Rather than just kind of taking a deep breath and saying, wow, look at all the wonderful things I have, the good things I've done. I'm grateful for them. Dopamine doesn't want us to do that. It wants to keep us constantly on the run. Dopamine sets us up to appreciate the world, to experience the world in two ways. And for me, this was a revelatory.

We have things that we appreciate, the color of your top right now, the color of the walls of the room, the feel of this table, the taste of the cup of water here I have, things that we experience in the moment. We appreciate what they're like. That's one way we spend our time. The other way we spend our time is anticipating, planning, looking forward to, thinking about things that have yet to occur. And that's a different kind of pleasure. And dopamine is the conductor of that pleasure. And once you begin to divide the world, divide your experience, divide your personal experiences into those two categories, dopamine's role rises to the fore. It becomes obvious that there are different ways we move through the day and different reasons we are motivated. Some are more motivated by things in the future, things we're working toward. Some are motivated by how beautiful this is or what the experience is like and they're very different things. Yeah, I found that very fascinating in the book. You were talking about how dopamine is that initial chemical that floods your brain when you spot something novel or new, but that it does fade.

And in the context of love, which is an integral part of your book, dopamine is that chemical that when you fall in love, you feel euphoric and you just want to walk down the street singing and dancing. Because that's what dopamine does. It says, here's something new. There might be something useful in this that'll help me in the future, help me reproduce or keep me safe or whatever it is. In the case of loves, my goodness, look at this possibility. It's right in front of me, and you get this euphoria. And the more you learn about the thing, the less there is to explore, the dopamine begins to fade. It makes a promise that other senses would have or other chemicals would have to keep.

Yeah, that's also what I want to touch on too. You said, so, you know, the initial fall in love feeling, however long that might last for a specific person, it's probably up to the individual. But, you know, if that might taper off six to eight months a year. And then you need those other chemicals in your brain, neurotransmars, I believe, to basically take you to that next phase of making love last. And those you coined here and now molecules. So can you talk a little bit about that

and how those are important for keeping relationships alive? Sure. So dopamine is all about the future, making the future better, maximizing resources. It gives us desire and anticipation. But as Mike pointed out, it makes promises it can't keep. So, for example, you may be wanting a brand new TV and going on the internet, getting all

excited about that TV. But as soon as you get it, things change because it's gone from the future to the present. And dopamine can only process the future. So what happens is dopamine shuts down. And that's one of the causes of buyer's remorse, which everybody has heard of. Yeah. An experience probably too. Yeah.

And the same thing happens with love, unfortunately. we see someone from across the room and all of a sudden we start developing fantasies about how perfect they are. This person is my dream person. They're going to change my life. It has absolutely nothing to do with reality. And, you know, every therapist deals with patients who have this problem. They meet somebody new. They get all excited.

They say, this is the one. And then as soon as they get to know that person, as soon as the person changes from an object of desire in their imagination, to a real human being, they completely lose interest. And they go to their therapist and they say, how come I can't have long-term relationships? The answer is dopamine. They're not able to transfer from that dopaminergic hope and anticipation into the here and now.

So what are these chemicals? For love, probably the most important chemical is oxytocin. That's a chemical many people have heard of. It's sometimes called the cuddle chemical. basically what it does is it orientes us towards relationships. It's been administered intranasally in experiments, and it makes people have warm feelings, close feelings, to people that they count as part of their group.

That's something that can last. Dopaminergic love has been called passionate love, and that's the feeling of being in love, that almost insane feeling of passion for the other person, unbounded optimism, anything is positive. possible. That lasts about nine to 12 months. Okay. And then you got to transfer over. Convenient, nine months. Many babies are born. During the time. Yeah. Then you transfer over to what's called companion at love. That's the kind of love that can last a lifetime. And that's more driven by chemicals

like oxytocin and serotonin. It's so important. And I say that I'm projecting it on to other people. I know, but as I learned this material, it was, again, just such a revelation for me to see that when you talk about love, you're talking about two very different things. You're talking about the romantic phase or the passionate phase, and then you're talking about the companionate phase. And there are those of us who never escape the romantic phase, which sounds kind of exciting until you think about what that really means. The example we use in the book, we use two examples.

One is Mick Jagger and one is George Costanza, who, it turns out from this person. perspective are exactly the same person. Which sounds just kind of shocking when we hear that in comparison. George Costanza is sort of a balding McJagger is what we get there. Jagger told his biographer that he had been with 4,000 women over the course of his career. So it gives a new meaning to you. I can't get no satisfaction, by the way. And it's pretty safe to say that an individual who is going through 4,000 people over the

course of a few decades, I think we came up with one every two weeks, was what that, that one encounter every two weeks. Anybody who's living like that is dopaminergic completely and utterly in the realm of love. As soon as they meet somebody, it's a mystery, it's a wonder, and then as soon as the least bit of that mystery is solved, they're not interested anymore. And Costanza is the same way. He just doesn't have the swagger of Mick Jagger. You remember, that whenever he met a woman, he thought this was the one. He was in love with that woman. He was crazy for that word love. He said, in love with that was crazy for that woman. This was the one right up until he went out with her a few times. And then he had to extricate himself.

He was so awful in this way that when he, when he found the woman who finally agreed to marry him, he was disgusted with himself for having done it. And when she died from licking the poison envelopes in that famous episode. He was not crushed or sad. He was relieved. He was relieved. Now, it's, you know, it's easy to say that's a little hyperbolic, and I suppose it is from a dramatic perspective, but we know those people. They're desperate to get in a relationship, and as soon as they're in it, they're desperate to get out, because there are two kinds of love, the romance and the companionship. And not everybody makes that transition because it's a choice you make. am I going to say, look, I understand I can't find satisfaction and romance.

I'm going to work on this as a companionate relationship. So that's a conscious choice. Absolutely. Okay. So it's not something it just kind of turns over? I'm not exactly. Yeah. Don't let me get out in front of my skis here.

Yeah, go ahead. I don't think it is a conscious choice. I think it's something that is a sign of maturity and that one has to work on. The ability to step away from the thrill, the excitement, and say, I want something more enduring, longer lasting. I had a patient who was very similar to George Costanza slash Mick Jagger, an image, which I will not be able to get out of my mind. A mashup.

And he had had hundreds of girlfriends. She's cold, Jerry. She's gold. She's not, I guess. Go ahead. He had hundreds of girlfriends. And like the cocaine addict, who no longer gets pleasure from the drug, but has to keep doing it,

he was no longer getting pleasure from these. counters, but he couldn't make that transition for one reason or another to the companion phase. So one day, he met a girl, dated her for a couple weeks, and then persuaded her to come to Las Vegas with him and get married. Because he thought that he could take control of this situation. He'd get married to her and live happily ever after, and it did not work out. Yes, that's not totally surprising. But I guess one question that this leads me to is, do different people have different amounts of dopamine in their brains that could influence this type of behavior? They do. They do. A large part of it is genetic. Oh, interesting. Yeah. There are

there are proteins on the cell called dopamine receptors that react to the chemical dopamine and change the functioning of the cell as a result. Some of these are more sensitive than others. And there's other structures in their brain as well that are genetically determined to have a stronger or weaker effect to dopamine. And these are associated with particular kinds of personalities. Okay. There's different example. Yeah, sure. There's different dopamine tracks in the brain.

And depending on which one is particularly active, we can see different manifestations of this obsession with the future. So, for example, there is a track called the mesolimbic track, which we in the book called the desire pathway. And if you've got a very strong desire pathway, you're going to be at risk of becoming addicted to drugs. You're going to be constantly pursuing pleasure. that's where you're going to get your more, more, more.

There's another pathway, though, that goes up to the frontal lobes. We call that the control pathway. As opposed to the desire pathway, which is more immediate gratification, this plans for longer-term gain. And so people with very strong control systems are going to be more the type A workaholics. They can't relax. They work incredibly hard. They're the kind of people who can afford beach houses but can't enjoy.

them because the last thing they're going to be able to do is sit on the beach soaking up the sun. Very, very highly dopamine urge people can have mental illnesses such as bipolar disorder and schizophrenia. And then very closely related to that, surprisingly, are very creative people. People who are musicians, actors, writers, they can also have very high levels of dopamine. and that's why we see in this population a somewhat higher vulnerability to mental illness. I want to roll back just to a phrase you use that's so key to understanding this, if you can hold on to the phrase, and that is dopamine driving the pursuit of pleasure.

The takeaway is pursuit, not pleasure. It promises that if you do these things, if you do all this heavy mental lifting, you will have pleasure at the end. Dopamine is literally unequipped to give you that pleasure in any way. That has to be provided by the here and now neurotransmitters. So it promises all day long. You're ambitious to say, why do you work? I'll work so I can be successful, so I can have great pleasure and great things.

Find the person who says that who's actually enjoying those things. Like you said about the beach house, the one who can afford it is not the one who will enjoy it. That's what dopamine does. It sends you on the trip promising that there. There are great rewards at the end, but it can't do anything about that. And if you're not equipped to engage in that experience, in that appreciation, you're not going to be happy. There's an old saying to travel hopefully is better than to arrive.

That's the same. Have you heard that? No, I haven't. I like that, though. It's a same thing of dopamine. And it's very much a double-edged sword. If traveling hopefully is enjoyable, it's going to give you the motivation and the incentive to get things done.

But then when you arrive, it's all over. And so you can work hard, but you can never enjoy what you've worked for. I'm going to say this. And I think the difference between us is one of degrees. Writing this book was a lot of fun. We enjoyed it. We had fun disagreements. We had silly arguments.

We had serious discussions. And I'm going to say, for my part, writing the book was a lot more fun than having it in your hand. I mean, I'm proud of it and I learned a lot. But that two-year course we went through, I wouldn't trade that for anything. And it was simply the experience of going through that. Yeah. It was good. And I wanted to touch on what you mentioned about addiction.

So addictions, we're hearing about this all the time now, especially with hard drugs like opioids. It's part of our national conversation. Many people, obviously, today are addicted to drugs. And what role does dopamine play in addiction? and has there, what has been the research in this area about dopamine? Really, dopamine is the essence of addiction. Any drug that's potentially addictive is going to cause the release of dopamine, the activity of dopamine in that desire circuit.

And conversely, any substance which causes this dopamine activity is going to be addictive. There was a lot of debate some time ago about whether or not marijuana could be addictive. It can. Yeah. And now that we're seeing these very high potent strains available, we have a lot of, we have a lot of we are finding people who are losing control of their marijuana use, but opioids, cocaine, this causes a lot more dopamine release, and so these are extremely addictive. There are certain behaviors that cause dopamine release that also can get out of control.

I don't think if there's a consensus yet about whether we're going to call it addiction, but things like video games, consuming pornography, these are things that look very much like addiction. Yeah, it just sort of seems like there's all these temptations. out there in the world. Maybe there always has been, but in our modern age, there seems to be so many. And that's really what dopamine wants to promise that you'll enjoy these things. And when you find yourself trapped in the cycle of being addicted to a drug or whether it's, like you said, some of these things, they're still figuring out today whether it's an actual addiction. But video games, pornography, that kind of thing. Just this is of something that really can take hold. Yes, that's right.

You know, in the old days, we used to think about addiction as physical dependence. That is that somebody would get tolerance. They'd need more and more to get the same effect. Or they'd have withdrawal if they stop using it. And so we used to treat addiction through detoxification. We thought if we can get all the drug out of the body, send them out clean and sober, they'd have a fresh start, and it did not work. Yeah, because that's not what dopamine does.

Dopamine not only gives you pleasure when you use the drug, but more important, it gives you craving. And it's craving that's the essence of addiction. And we all know what that feels like. You know, you say, I'm going to start a new exercise routine. I'm going to set my alarm clock for 30 minutes early. The alarm goes off and you crave sleep. Yes, no one to get off.

And the experience is that it actually diminishes free will. It does not take it away completely. People still have a choice, but it makes making the right choice so much more difficult. because we respond to the biological activity of our brain, and dopamine is very, very powerful in that respect. Dan, would you talk about, I remember when this first came up when we were working, and you talked about it in terms of logic, which was another, I'm wearing this word out, but it was another revelation for me, the thing that I learned from you about this, was that it ceases to be about craving so much as, well, this is the right thing to do. This is a smart thing to do. It's logical that I would sacrifice these things to get the hit of this drug. How could you think otherwise?

Can you expand on that idea a little bit? Yeah, that's a great point. You know, when we see the addict, let's say that we see an alcoholic who's homeless, he's down on the street, he's got a bottle in a brown paper bag. He's given up his family, his job, his home, his health. He's given up everything in order to consume this drug. We look at from the outside, it seems utterly. irrational. Why would somebody destroy their life just so that they can drink? From the inside,

though, it's actually very rational because you have to remember that these circuits were designed by evolution to keep us alive and make us successful. The problem with drugs is they give this chemical blast to the dopamine system, almost like a guided missile that causes more dopamine stimulation than natural behaviors. The brain rates behaviors based on how much dopamine they produce. So earning a million dollars produces more dopamine than earning $10. So you're going to go after that big payoff. Using drugs produces more dopamine than providing for your children. And so we can still use different parts of our brains to say, hey, that's wrong. But our motivation system is telling us logically it makes more sense to use the drug. Yeah, we obviously, a lot of people often look

at addiction as due to moral failings, lack of willpower, personality flaws, you name it. But you wrote that dopamine is a major factor why people get addicted to things. And as you're saying it, it's not just about detoxing, it's about the cravings. And it's about your brain constantly wanting you to go back to what you were using. And in your book, you wrote how overcoming addiction takes enormous strength determination and support. So can you explain again? Why does dopamine, make it so hard to kick an addiction. You know, why does it bring people back? And that's the interesting behavior from the inside versus the outside.

From the outside, it does look like a moral failing. It looks like people are just using very bad judgment or they're indulging themselves, their desire for pleasure. From the inside, though, it's very, very different. They've got these feelings of overwhelming cravings. If we look at it from that point of view, from brain behavior, we can look at it as a medical illness and we can use medical treatments to address it. And the simple fact is that medical treatments are extremely successful. Psychotherapy is the most important one. We also have medications that can

increase the likelihood of success of psychotherapy. If you just look at it as a moral failing, you're just not going to have a lot of success. And I think that's why it's so important to become a little bit more sophisticated. Go beyond just making interpretations of the behavior to ask yourself, what's going on in the brain and how can we overcome this pathological brain behavior? Do you think that's where the conversations are going in this country about how to treat addictions that we're seeing? I think so. I think there's still an enormous amount of stigma. In general, brain illnesses are more stigmatized compared to other illnesses. But we're making progress. You're probably too young to remember, but there was a time when having cancer was stigmatized.

Wow. Yeah. Yeah, I don't know that. Yeah. If someone in your family, cancer, you hushed it up. It was an enormously shameful thing. Today, that seems utterly absurd. Right. Absolutely. There's all these awareness programs, walks, fundraisers. There's a scene in a motion picture. It's a Woody Allen picture, actually. And the parents are talking there in the 1940s, and the mother goes, she has cancer and just whispers it and they make a big thing about how you never set it out loud. Yeah, that's right. So, I'm optimistic that we're going to get there with brain diseases and even addictions. It's going to take a little while, but I think that more and more people are realizing what's going on. And I tell you what, there's nothing that helps people

overcome stigma better than experiencing it themselves or having a loved one. Absolutely. That's what it seems like it does push the tide more. And I mean, something like opioids is affecting so many people and friends, family, that sort of thing. That's right. People say, look, I know my son is a good person. And yet some somehow he got trapped in this web. Therefore, maybe I was wrong. Maybe this really is something besides a moral failing. And moving on to creativity, which is always a fun topic to talk about.

So what is the role of dopamine in creative behavior? And I went just before I mentioned that too. You talked about how creativity and madness are more related than each is to a ordinary brain. Can you talk a little more about that? Sure. So let me just go back to the mantra. The role of dopamine is to maximize future resources. So dopamine is not interested in things that already exist or simply things that you already have.

It always wants something new, something more. And that's its link to creativity. It's, you know, creativity is making connections between things that did not previously seem connected. So dopamine is scanning the environment, looking for opportunities to get new resources. Sometimes that means going after resources that are already there. but in a much more exciting fashion, sometimes it means creating resources that never existed before.

Highly dopaminergic people are easily distracted in many cases. They see something, they want to know what it is. And so there are a lot more random things, and I'm speaking in broad terms here, but there are a lot more random things, concepts, images, what have you, floating around in their brains

than non-dopaminergic people or people with lower levels of dopamine. dopamine. And just by dint of having more things, is more likely to associate things that haven't been associated before. And when you said that a moment ago, Dan, I think that's, if you're listening to this, you're wondering, well, what do you mean by creativity? This is one good way to begin to understand it. Creativity is associating things that have not been commonly associated before. When I talk about this in a seminar, I talk about Brian Wilson as an example. And you listen to a song, his magnum opus, good vibrations. And it's so familiar to us now, we don't think much

about it. But when you listen to it, you'll hear, for instance, a theremin in the background. That sound like that you're hearing it. Up until that point, that had only been used as a sound effect in horror movies, but Brian Wilson brought it in. You'll notice that in this little three-minute pop song, it actually has three movements like a lot of classical pieces do. There was so much floating around in this man's brain, and he brought it all together for the first time. It's especially striking if you listen to that song and then actually do it in this order. You listen to the song that was number one before Good Vibrations and then listen to Good Vibrations. The one before was a song called Winchester Cathedral, which was the epitome of grocery store music.

Yeah, I've never heard of it. The thing that knocked it out was this wonderful melange of sound. that Brian Wilson created, and he's clearly a highly dopaminergic person who walked that line and fell between creativity and madness. I believe he's been diagnosed with schizophrenia or schizoaffective disorder. Schizophrenia. So, yeah, if I can try to make that connection, let's say you're walking down the street and you see a pebble lying in a puddle. You're probably not going to think anything of it. But if a highly dopaminergic poet is walking down the street and sees that same pebble,

He may feel that that pebble is speaking to him in a very deep way, that that pebble is revealing something about humanity and the world. He may even feel like that that pebble somehow reveals the hidden divinity of the world, and he may go and write a very beautiful poem about that that inspires dozens of people. Yeah, it's more about inspiration. Yeah, you're talking about, like, you know, these dope me can help with inspiration. He said, making connections. Well, what kind of art is a metaphor?

Yeah. Now, I just want to take this poet and I want to turn up his dopamine a little bit more. Now he sees the pebble and instead of metaphorically speaking to him, it's really speaking to him. Instead of revealing divinity of the world, it reveals the fact that he himself is God. Now we've tipped over into mental illness. So having a lot of dopamine can be a very good thing, can be a very exciting thing. But if you have too much, you get a break with reality. There's a splendid demonstration of this, and it involves, again, a famous artist.

Bob Dylan's subterranean homesick blues. And whether you're familiar with the words or not, I can share very quickly just a few of them. Johnny's in the basement mixing up the medicine. I'm on the pavement thinking about the government. It goes on and on like this. That is one step removed from word salad, which I think is the term you use for when schizophrenics are sort of speaking out of control. Is that, that's right speaking in completely unorganized ways.

And so that's one step away from ink pen, walk it to mommy. Whoa, that's a dog. And I bought sound. Yes. So it's not like the non sequiturs. It's just someone completely not making sense. It's that fine line between, oh, here are these things and I can put them together into something useful.

And here are these things and they're just going to spill out. That's right. There's a fine line between art and insanity. Sometimes we don't know. Right. Sometimes initially we say, hey, this is crazy. This is not art. And then maybe a few decades later, we take a second look and we say, wait a minute, that is art.

Yeah, so for people with serious mental illness, I mean, what is dopamine due to someone's brain? And how is that treated? So I think that schizophrenia is the classic illness of too much dopamine. When we scan our environment for things that are important, what we're most interested in is how is it important for me? Let's say that you're sitting at a butt stop killing time and you're reading the newspaper and you're reading about some Canadian trade agreement. Your dopamine is pretty much going to be shut down. Probably.

Unless you're really in a trade. Yeah, that's right. Canadian trade agreement. Unless you work for a company that trades with Canada. Exactly. Then maybe you are interested. But let's say you read it and all of a sudden you run across the name of somebody you went to school with who's involved in the negotiations.

You're going to get some dopamine. Yeah. Oh, I know that person. Yes. Okay. Yeah. All right. You're connected to the story. There you go.

Exactly. Let's say you keep reading and you run across your own name. You're going to get a big surge of dopamine. So dopamine responds to things in the environment that your brain thinks is important to you. Yeah. Now with schizophrenia, we flip the equation. You've got the dopamine circuit going off at inappropriate times. And so what that means is that you may see something that's completely neutral.

your dopamine circuit goes off and you develop the mistaken belief that it's about you. You're watching TV and some radio or TV announcer is talking about some CIA spying program. All of a sudden your dopamine circuit goes off for no reason and you developed the idea that the CIA is spying on you. I had a patient who was walking down the street and he saw a stop sign and he developed the belief that his mother had put that there to tell him to stop thinking about women. And we call that paranoia. That's when you interpret things personally that actually have nothing to do with you. Yeah. So the way we treat it is by giving medications that block dopamine.

Completely? No, not completely. Not completely. And that's part of the art of giving these medications. We want to give just the right dose that the paranoia, the delusions go away, but it doesn't take away all of the patient's enjoyment and motivation in life. It can be a tricky thing to do, but no matter what, a patient's life usually gets dramatically better when they start taking these medications.

And you were talking about achievement with dopamine, how it helps us push us to this next level. So what is the role of dopamine in making us successful? So I want to talk about how it makes it successful and also how can make us, you know, lie, cheat, steal and do all sorts of bad things, like, you know, commit an act of violence. So to get a sense of what it feels like to have dopamine pushing you along versus trying to go forward without dopamine, think about working on a project that you're incredibly excited about. Typically, it's going to be a project that involves some degree of creativity. I do a little bit of programming.

I also love to make PowerPoint presentations. I'm a total nerd. You can do elaborate things with PowerPoint. You can. You can. You see a nice presentation, though. It really captures your attention. It can be boring or could be interesting, right?

It is. And I can be working on that and completely lose track of time. I'm excited. I'm happy. I'm fulfilled. That's dopamine pushing me along and it feels fantastic. Alternatively, I may be filling out some paperwork for insurance reimbursement. Yeah.

You know, unless I'm going to be getting a whole lot of money, there's no dopamine there. And I've just got to push myself. And I'm looking for any excuse to get away from it. my email, my voicemail messages. So dopamine makes it feel really, really good to pursue things. And that's why sometimes people tell young people, the most important thing is to find your passion. That's another word for the activity that stimulates dopamine. Okay, so that can be something like a job or a hobby or to something immersion.

Yeah, something you're immersed in. Yeah, something that's personally meaningful. It doesn't matter what it is. And then also can, but then dopamine can also push us. to by the act of achieving, you might also be hurting other people, correct? Yeah, it can do that. It can make us obsessed with our work and take us away from a personal life. And of course, a work-life balance is very important.

And dopamine can ruin that balance. But it can also prevent us from getting satisfaction from what we're working for so hard. It's never enough. I saw a patient today who is an incredibly successful real estate developer. And he has more money than he will ever be able to spend. And through his life, he's achieved higher and higher and higher levels. But every time he takes a step, he starts comparing himself to the person at the higher level. And his self-esteem is terrible.

In spite of all of his achievements, in spite of having a wonderful family, he constantly sees himself as a failure because he's always looking for what he has not yet achieved. And that's a pathological behavior of dopamine. Understand, too, that dopamine doesn't say, what's the best way to achieve this goal in a moral way? Yeah. It says, what's the best way to get there? And it falls to us and our development and use of the other neurotransmitters to say, this isn't good. If you're obsessed with winning, anything goes.

Right. Unless, I mean, to dopamine, anything goes, unless there's some measure of activity on the other side. That's right. You know, there's two very different ways of looking at what's best. I'm putting the final touches on a paper that looks at the famous trolley problem from the point of view of dopamine. Are you familiar with the trolley? No, I'm not. Yeah.

Can you explain it? Yeah. So here's a situation. There's a runaway trolley barreling down the tracks out of control, five workers on the tracks. They can't escape for whatever reason and they're all going to be killed. However, there's a side track. and on that side track is one single worker. And next to you is a switch.

You can pull that switch, and what pulling the switch will do is divert the train under the sidetrack. So the question is, is it ethically permissible to pull the switch to save five lives at the expense of one? That's a tough question.

Wow, you don't want to be that conductor on that troll. We can make it easier or harder. Now, if you survey people about that, about 90% of people are going to say that it's ethically permissible to pull the switch. And we call that a utilitarian approach to ethics. Maximize future resources. It's very dopaminergic. It's better to save five lives at the expense of one.

So this is a situation in which dopamine determines our ethical approach. But let me change the situation slightly. And what my change is going to do is it's going to shift the neurotransmitters you're going to to think about this problem and it's going to change the way you view it. All right. So here's the other way. Trains going down the tracks, five people on the tracks. But now, instead of a side track, you're standing on a bridge next to another man.

And you know that if you push him onto the tracks, his weight will slow down the train enough to stop it and save the lives of five workers. The question is, is it ethically permissible to push that man? onto the tracks. You survey people about this, and 90% now say, no, it's not ethically permissible to do it. Interesting, but it's still five to one, one to five. Yes.

And the difference is that when you're looking at things from a distance, you tend to use your dopamine circuits. When you look at things up close, you use your hearing now circuits. They follow a different ethical tradition, not utilitarianism, but harm aversion. And Harmor Vision says that it's wrong to hurt people, even if others will benefit from their suffering. Utilitarianism says we should act to save lives.

These are both very, very valid ways of approaching a problem. But what's interesting is that depending on the location in three-dimensional space, our brain uses different circuits to process the problem, and we come up with different solutions. Wow, this sounds very complex. It's hard to believe this is all happening in our... Well, it has profound implications for drone warfare. How do you program the machine? If you're going to be purely utilitarian, the answer's easy, but then you have to deal with the aftermath. There was even a film about, I'm sorry, I forget the name, we talk about it in the book.

This really is a problem today. And it has to be answered one way or the other. There's no middle ground here. I think what the film looked at was that they were going to kill some terrorists who were planning a plot that was going to blow up a stadium. But in order to do that, they were going to have to also kill an innocent child. Right. And the question was, should we save the hundreds of lives in the stadium at the expense of intentionally murdering this innocent child? And it's an updated version of the trolley problem. And I think it's interesting to note that if you hear about it or

if you see it on a screen or if you're touching, every level that increases that here and now participation makes the problem harder. So you think it'd be more difficult if you're sitting somewhere remotely conducting using a drone as opposed to being flying a plane or something? Easier. Easier. Easier. Easier. It would be easier to program the drone to say take out the terrorists and the children. Yeah. Then it would be if you were standing right there on location, let's say with a gun and you were told pull the trigger, but you've got to shoot through the child to get the terrorist. In fact, the easiest of all is to program the drone to do it because there's nobody involved at all. Everything is hypothetical.

It's a pattern that you're dealing with, not particulars. So the easiest of all is to program a drone to take the utilitarian answer because you don't have to feel anything when you write code. This may never be used first. Yeah, right. But you hope it never does. I mean, it's very complicated. It is. Yeah.

Our brains are complicated. In a way, it's complicated. In a way, it's gut-twistingly simple. Or here's another simple question. How should self-driving cars be programmed? Let's say that your self-driving car is going to get in an accident. Should it be programmed to minimize loss of life? Or should it be programmed to save the life of its owner?

Oh. It's a difficult question. Yeah, because right now a car is just, obviously, it's not programmed. Well, the driver decides. Yeah. And instinctually, what we do is we drive to protect ourselves. And that's something we have no control over. Yeah, just make a supposed to like a decision.

We will swerve into a crowd of people if we think it's going to save her own life. And it's not a decision we make. It's, but with self-driving cars, that becomes a decision we need to make as we program it. And it's very difficult decision and nobody's talking about it too much. There's a lot of interesting ethical, you know, as we get more removed by using technology, some interesting ethical issues that come into play. But yeah, you mentioned about winning. So I'm winning in morality.

I think that leads me to my next question about politics. So how is dopamine involved in politics? And does it affect whether we're liberal, conservative, or moderate? When I was researching the book, this was the thing that surprised me the most. It never occurred to me that political ideology could be so influenced by brain chemistry. We can figure out who's more dopaminergic and who's more. here and now simply by looking at the labels that are attached to the different parties. The left calls themselves progressives.

They're interested in progress. They want to make the world a better place. And that's maximizing future resources. And so they're interested in things like taking control, helping people to live healthier, longer lives by making it difficult for them to access unhealthy food or tobacco or alcohol or things like that. And so they're very much about taking control of things to maximize the goodness. The right on the other side, they call themselves conservatives. They're much less interested in change. They're much less interested in things that are new. They're more here and now.

They want to preserve the things they've valued that they've inherited from their forebears. And so they're much less likely to have active dopaminergic circuits. And we can look at genetics. And we can actually predict a person's political ideology by looking at their dopamine genes. Well, that's fascinating. Not only that, but we can actually shift people to the left or the right by surreptitiously influencing what parts of their brain are going to be more active. So, for example, if you are under threat, that's going to activate your here and now circuits because you need to protect what you already have.

So it's this fascinating experiment in which they surveyed people about their political ideology and they randomized them. In one, they put a hand sanitizer dispenser in the room as a very subtle reminder of the risk of infection. The simple presence of that hand sanitizer pushed people to be more conservative in their answers to the survey. That's interesting. Yeah, I mean, I guess what I'm just thinking about.

Can you, so as you're saying, it's like less about persuasion and like trying to bring someone to your side and more about some of the chemicals in our brains? Unfortunately, that seems to be the case. And politicians know this. We know that when there is a terrorist attack or any kind of threat to the country, it pushes people to the right. We also know that when there's the possibility of prosperity, it pushes people to the left. And so the saying is to provide or protect. Provide is more to the left. Let's make this country a better place. Let's progress more. Protect is more to the right.

Let's maintain the good things that we have. And that's more here and now neurotransmitters. And can you increase or decrease the amount of dopamine you have? I mean, you said a lot of it's determined by genetics. And, you know, thinking, not a person who's affected by a serious mental illness, but for a general person, can you increase that? Everybody wants to increase their dopamine. And that's dopamine at work.

Yeah. Right? more more more yeah so the answer is yes you can increase your dopamine but it's a dangerous thing to do okay because i read an article that said you can eat more protein exercise and sleep more is like is that even true that's just good advice yeah i'm really containing a healthy lifestyle but i was like that seems a little simplistic you're saying it's it's not as easy as that no it's not you know that might influence your dopamine a tiny bit probably not enough to have an effect on you um drugs like pain amphetamine.

Okay. So not good things. Things we don't want to do. Things we don't want to do. Okay. And so, you know, people will take amphetamine and it will make them work harder. It will make them more excited. It will focus them in on being goal directed, but eventually will also ruin their life.

So artificially boosting dopamine is not the best strategy for a successful life. And just to be technical for a minute, it doesn't actually increase the volume of dopamine and increases the dopaminergic activity across the cells, right? Yes. Right, it increases the amount of dopamine that's active at any given point in time. But that's basically by farrying it from an inactive place to an active place. Right, right. It's not an increase in the volume of dopamine.

It's an increase in the activity associated with the dopamine you already have. That's right. In the same way an antidepressant can work. Now, there are some illnesses that are characterized by problematically low levels of dopamine. And for example, attention deficit disorder. And in that case, it is appropriate to prescribe something like amphetamine, which boosts the activity of dopamine. And that's a very safe. Like a riddlein? Riddle. Okay. Yeah. Or Adderall. Yeah. People abuse that as well to say,

goal-oriented focus. They do. They do. Parkinson's disease is also an illness of too little dopamine. And we prescribed dopaminergic drugs to treat that too. And in our book, we mentioned how that that can be very effective for Parkinson's symptoms, but it can also get people into trouble. Yeah, that was an interesting part of when you're talking about how it can lead people to have a much higher interest in sex and gambling. Gambling. Yeah, gambling. It's fascinating. There's been some case reports of people who have been completely abstinent from sex their entire life. They're treated with these drugs, and all of a sudden, they become compulsively sexual. There's also examples, though, of people developing artistic and poetic talent as a result of getting these dopamine boosting drugs.

This is probably something that's studied in psychiatry a lot or, you know, in the medical field. It's a fun area of study. Yeah, that sounds absolutely fascinating. So can we control dopamine to use to our advantage and not to our peril? The ultimate question. We can. You know, one of the oldest pieces of wisdom can be found at the Greek oracle of Delphi, and that is know thyself.

If you know what's going on in your brain, you don't have to be a slave to it. You can say, I'm experiencing cravings or I'm experiencing dissatisfaction. And maybe it's not because of the reality I'm living in. Maybe it's because of the way my brain is responding to reality. And that allows us to take a step back. We call it the observing ego to sort of step back and look at how we're responding and say, is this the best way to respond? Or do I want to maybe act contrary to my biology and make a different kind of decision?

So I think that knowing and being able to recognize when your dopamine circuit's active, when you're here and now circuits active, and is this really the way you want to behave, that's what's going to empower you. I'll add just this because that's right on the nose. If you're aware that there are two ways to anticipate or to experience the world, to anticipate it or to experience it and to learn which one is the trouble. point for you. For most people, probably most people listening to this podcast, it's going to be on the dopaminergic side. Anticipation. Yes, anticipation. To cultivate your ability to just experience where you are. To put the simple things like put the phone down during dinner, turn it off. When you're talking to somebody, look in their eyes and listen to what they say. Don't worry about what you're going to say next. Listen to it. Be here now, as the phrase goes.

the simple awareness that this exists at all is a profound gift that you can give yourself. And the irony is that when people do that, they talk about how much they enjoy it, and yet they do it so little because their dopamine circuits are saying, don't waste your time. Yeah. Think ahead. And the good news is this is a choice anyone can make. Yeah.

And this is what we're seeing with this emphasis on mindfulness and people wanting to be here and now. I think because we are living in a world that's very, dopamine-centric, you know, with constant, you know, instant gratification all the time. So that's where I imagine, this is me just editorializing, but where we're seeing this boom and mindfulness in that country, yeah. We really do have it off. We don't need a new cell phone. We don't need a bigger TV. We need to just experience what we have and enjoy it. So I do have one last question for you. Where can people find your book? You can go to moleculeofmore.com to read more about it. You can get it Amazon or anywhere such excellent books are sold.

Absolutely. And in 10 countries, I think, by the end of 2020. And translate into new languages? Nine languages. Wow, that's amazing. Thank you so much for joining us. This has been an absolutely fascinating conversation. Thank you, Caitlin.

It's been a pleasure. Thank you. If you've been a long-time listener or are new to our podcast, please consider giving us a rating in iTunes. And if you have time, write a review. We'd really appreciate it. Also, we'd like to hear from you directly. So if you have any questions, comments, or ideas to share,

please email me at K-Luna at APA.org. That's KLUNA at APA.org. Speaking of Psychology is part of the APA Podcast Network, which includes the podcast's APA Journal's dialogue about new psychological research and progress notes about the practice of psychology. You can find all our podcasts on iTunes, Stitcher, or wherever you get your podcasts.

You can also visit our website, Speaking of Psychology.org, to listen to more episodes and to see resources on the topics we discuss. I'm Caitlin Luna with the American Psychological Association.