The Jordan Harbinger Show - 951: Anna Lembke | Finding Dopamine Balance in the Age of Indulgence

Episode Date: February 13, 2024

Dopamine Nation author Anna Lembke helps us understand why it's difficult to resist the temptations of a world designed to exploit our pursuit of pleasure. What We Discuss with Anna Lembke: The neuroscience of addiction and the role dopamine plays in keeping us hooked. How modern society's unrestricted indulgence in pleasurable substances and behaviors can lead to addictive tendencies and the gratification of constant dopamine release. The pros and cons of using psychedelics. The impact of resource scarcity on instant gratification. The need to address underlying conditions for effective addiction treatment. And much more... Full show notes and resources can be found here: jordanharbinger.com/951 This Episode Is Brought To You By Our Fine Sponsors: jordanharbinger.com/deals Sign up for Six-Minute Networking — our free networking and relationship development mini course — at jordanharbinger.com/course! Like this show? Please leave us a review here — even one sentence helps! Consider including your Twitter handle so we can thank you personally!See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Coming up next on the Jordan Harbinger Show. We are so insulated from pain in our everyday lives. Most of us don't even really move our bodies very much at all. So we have more leisure time, more disposable income, more access to luxury goods. And now with the internet, instant access to digital drugs. I believe that that is a major contributor to the growing rates of unhappiness. It's because there's too much pleasure and too little of the right kinds of pain for our brains to be able to stay in a healthy balance.

Welcome to the show. I'm Jordan Harbinger. On the Jordan Harbinger show, we decode the stories, secrets, and skills are the world's most fascinating people and turn their wisdom into practical advice that you can use to impact your own life and those around you. Our mission is to help you become a better informed, more critical thinker through long-form conversations with a variety of amazing folks from spies to CEOs, athletes, authors, thinkers, performers, even the occasional economic hitman, gold smuggler, astronaut, legendary Hollywood filmmaker, or actor. If you're new to the show or you want to tell your friends about the show, I suggest our

episode starter packs, these are collections of our favorite episodes on persuasion and negotiation, psychology, geopolitics, disinformation, cyber warfare, crime, and cults, and more. That'll help new listeners get a taste of everything we do here on the show. Just visit jordanharbinger.com slash start, or you can search for us in your Spotify app to get started. Today on the show, Dr. Anna Lemke, psychiatrist at the Stanford School of Medicine, we're talking about dopamine and addiction, and dopamine addiction. Not only are we going to hit upon addiction to drugs and substances, but how about gambling, video games, even erotic novels?

This isn't a Nancy Reagan just say no episode, but a dive into how addiction and dopamine function in the brain, how our minds and bodies respond to the pull of substances and activities, even if we're not addicted, antidepressants, tolerance, something called the hedonic set point, and our innate ability to experience pleasure in the first place, cross-addiction, dopamine overload, and a whole lot more, a fascinating look into addiction and into the brain. Here today with Anna Lemke. So softcore vampire porn novels, eh?

Yeah, yeah, that's right. That's how it all began for me. Tell me about that, because that's not your usual foray into most brain science. I mean, at least as far as this podcast is concerned, most people don't dive into it, because they got addicted to Twilight or whatever. Right. So way to embarrass me up front.

Yeah, that's how we roll. Okay, here we go. So, you know, somewhere in my early 40s, which was some years hence now, I did get addicted to romance novels. And it started with the Twilight saga, which for those not in the know, is a vampire romance series written for teenagers. And I certainly wasn't a teenager. But for whatever reason, that was the thing that all the mom,

at the local elementary school were reading, and I thought, what the heck, because I've always been a reader. I've always enjoyed fiction and nonfiction throughout my life. But there was something about that book that was just incredibly reinforcing. It was sort of transportative for me, this kind of incredible escape. Not that I had a whole lot to escape from, which I really think it's important to emphasize. I have a wonderful husband, great kids, meaningful work, I'm privileged in many ways. So there wasn't like, you know, my life was not in any way particularly hard. But for whatever reason, that novel was just a wonderful experience. So I read the whole series, and I read it again, and I read it again. And I went from there to other vampire romance novels, which turns out there are a lot. And then I read Werewolf Romance

novels and Witch's Romance Novels and, you know, you name it. There's a whole universe out there. But all of it was still like reasonably manageable until I got a Kindle. And then I became a real chain reader. Like as soon as I finished one, I was reading another. I was staying up later and later at night. I developed what we call in the addiction business tolerance, which means that I needed more potent forms and more of my drug over time to get the same effect. So I progressed from relatively tame romance novels to kind of socially sanctioned pornography for women, very graphic. kinds of novels I got to a point where I would just like rush through the first two-thirds

because it turns out if you open any romance novel to about two-thirds of the way through, you will get right to the point. That's very familiar for most men, I think. We're like, oh, I can relate to that. Right, exactly. And then eventually I was like downloading really terrible romance novels from Amazon because they were free. I would like rush to the climax and then I wouldn't even finish the books.

I would be already on to the next one. The long and the short of it is, as much as it is possible to get addicted to romance novels, I really did develop a kind of a minor addiction, despite the fact that I am an addiction expert. I didn't really see it as it was happening. It took a specific event for me to go, oh, wow, I think I might have a problem here. If you're addicted to heroin and you get kicked out of your home and your friends leave you, and you wake up in a park one day and you're like, I've been here for two weeks. There's something wrong.

What is that rock bottom event when you're like, my Kindle is run out of memory. I mean, like, what is, what's that event for romance novels? Right. So for me, it was a couple of things. First of all, it was finding myself up at three in the morning on a weeknight, reading 50 Shades of Gray, which is like satamasochistic porn, basically. And being like, what am I doing? It was a particular scene with butt plugs.

And I read the word butt plugs. And I thought, how did I get here? I'm not interested in butt plugs. Like, what happened? So that was sort of a low for me. But then it was also, you know, just some of the behaviors where we went on a family vacation where we rented a beach place with some friends of ours. And I spent most of that weekend hiding in my room reading romance novels.

I just, it became the most salient thing for me, the most interesting. compelling, pleasurable thing. Other things became less pleasurable. And then one day I even brought a romance novel to work and was like reading it in the 10 minutes between patients. And some of that, all of that sort of swirling around together at one point, even that, frankly, well, like I didn't realize. But the tipping point for me was I actually was in a role play with a student where I had to be a patient and the psychiatrist who's a student was supposed to get me to think about behavior change. So he said, what is this? there a behavior in your life that you'd like to change? And I said, well, I hadn't pre-planned it. But in that moment, I was like, oh, yeah, I think I'd like to change my late-night reading

habit. I did not share with this young person what I was reading. I just said my late-night reading habit. And he said, oh, well, how is that interfering with your goals and your values? So, you know, very vaguely described that. But the point is that it wasn't until I said it out loud to him that I realized, oh, wow, this really is a problem. And the next day, I couldn't unsee it. So to get back to your question, though, addiction is a special. spectrum disorder, people who are way on one end of that spectrum, I think we could all agree there's a serious problem here. People who are on the other end of that spectrum, there could be an enormous amount of debate. Like, is spending all weekend long watching sports on television

to the exclusion of spending time with your family? Is that an addiction? Is that a passion, a hobby? People would probably maybe land differently talking about those types of like less obvious addictions, especially when it's kind of a socially sanctioned behavior. Sure. Like work? Zero inbox. Yeah. I'd love to see my dopamine levels when I finally close out that last starred email. I know that it spikes because I tell my wife about it. Oh, yeah. I'm done. There's no starred left. She's like, cool. There's cold chicken on the table, you weirdo. Yeah. I know that it happens. Yeah. But this is interesting. And what it says about dopamine and addiction is kind of terrifying. Look, the romance novel thing is kind of a funny

admission. It's good for you that you had that random exercise where you were forced to think through this example and it turned out to be something that you really wanted to get through. I think we need to define addiction then because I think most people will say things like, well, you're not really addicted to work because you don't get sick when you stop doing it or you know, romance novels say, okay, fine, it's hard for you to stop. But you're not, you don't chain yourself to a stump in the middle of the woods to come down from romance novels, right? Like a heroin addict or something like that might do. So can we define addiction more clearly? Okay. So addiction is defined as the continued compulsive use of a substance or behavior despite

harm to self and or others. In the diagnostic and statistical manual, there are 11 criteria that we use. The more criteria that you meet, the further you are on this mild, moderate to severe spectrum of addictive disorders. The criteria are somewhat physiologic, you know, in terms of like, do you have tolerance? Do you need more of your drug over time to get the same effect? Do you have withdrawal? You know, do you have psychological and physical manifestations when you stop? But most of the criteria have to do with what we call the three Cs, control, compulsion, and consequences. Is your use out of control in the sense that you plan to use a certain amount and then you're repeatedly using more? Or you keep planning to cut back and the cut back just

never happens or not consistently. Do you have compulsive use, which is to say, is there like a level of automaticity in your use where your mind is really preoccupied with using you're focused on it all day? You can't wait until you get it. You arrange your whole life around it. And then continued use to spite consequences. So whether you see the consequences or only other people see the consequences, when they're pointed out to you, do you take that in and kind of process it and say, gee whiz, maybe I should change this behavior, or do you find that you continue to use your drug of choice, whether a substance or behavior despite those consequences? Importantly, there is no brain scan or blood test to diagnose addiction. This is based on

phenomenology, that is patterns of behavior that we see repeatedly across cultures, across decades, across continents. That's interesting that there's no blood, I mean, of course, there's no blood test for it, but it seems like the definition is not super malleable, but it certainly seems like there's a little bit of flexibility, which is I think why people use that to rationalize that they're not addicted to something, even if they know all about addiction like yourself. You weren't immediately like, wow.

I mean, if you were doing cocaine between patients, you'd be like, I have an addiction, and I need to go get help for this right now. But you're like, I'm just reading. I'm just reading a book, whatever. Interestingly, I wasn't even having that conversation with myself, right? And that's the extent that denial can take. I wasn't even saying, oh, gee, I'm in the 10 minutes

I have instead of contemplating the case or writing it up or reading about it or preparing for my next patient, I'm just compulsively wanting to escape myself and where I am. There's not even the conversation happening. Here's the thing, even though there's no blood test or brain scan, it doesn't mean that addiction is not biological. It's actually highly biological. And the more we expose ourselves to addictive substances and behaviors, the more we change our brain. And there's an explosion in neuroscience that tells us exactly, you know, what is going on. They're not exactly. but, you know, there's a lot of information about what's happening in the brain has become addicted, but it's not the kind of information that you can sort of use diagnostically.

We hear a lot about opiates, and now the conversation, at least online, maybe only on Reddit, I don't know, is there's a lot of conversation about men and using online porn because I think a lot of guys have finally come to the conclusion that after our brains, guys my age, especially, I'm 43, we've had really good internet for, I don't know, what, 25 years now. Right. So a lot of guys my age are like, uh-oh, that wasn't good for me going to college and having super fast bandwidth. And now I think a lot of younger guys are starting to get the message too where they're like,

wait a minute. I wasn't really good with the opposite sex in high school and I didn't have to worry about it. And now I'm a grown-ass man working at General Motors. And I'm still just like I'm not doing anything about that because I can just, go home and use my phone or whatever, we're starting to see this as a real risk factor, not as severe as dying from an opiate addiction, but it's definitely something where people are expanding there, the idea of what they might label an addiction. Yeah, thanks for highlighting

that. Any and every addiction is a source of suffering in our lives, but I do think that the shame associated with sex and pornography addiction is almost more than with other addictions because of the the social and cultural climate right now, especially for men. The smartphone essentially came out in 2001, and it was almost exactly at that time that we started seeing more and more men coming into the clinic with sex, pornography, and compulsive masturbation addictions. And when I talk about addictions, I'm talking about massively out-of-control use with incredibly severe consequences and harm to these individuals, destructions of their marriage, loss of job, depression, anxiety, suicidal thinking, attempted suicide, completely consequential and directly relatable

to their compulsive use of pornography masturbation or whatever their particular sex-related addiction is. And without fail, what the men described was that they used pornography recreationally in the 80s and 90s, and it was manageable. But once the internet was invented, and especially then up this portable digital devices known as a smartphones, it became unmanageable, which really speaks to one of the big risk factors for addiction that we often don't talk about, which is simple access to our drug of choice. If you have more access, you're going to use more and you're going to change your brain more and you're more likely to get addicted. So super important that people recognize that these moving images are drugs. They light up the same part of the reward pathway as

drugs and alcohol. The phenomenology of addiction is identical to addiction to drugs and alcohol. People start out using for one or two reasons to have fun or to solve a problem if it works. They return to it with repeated use. They develop tolerance, eating more potent forms and more of the drug over time to get the same effect. With sex addiction, the way that manifests is. They start out with vanilla toast pornography, then it's more deviant pornography, that it's actually chat rooms and movie cams, and then it's actually meeting up and hookups and more. more and more risky behavior because the vanilla toast pornography they started out using doesn't work anymore because now their brains are changed. And this is what happens with addiction.

Incredible shame and guilt. And then when people stop a physiologic withdrawal, I've seen with sex addiction when people, what we ask for is that for them to abstain from orgasms with themselves and others for four weeks is sort of the initial intervention. And people will have nausea, vomiting, headaches, not to mention the kind of universal symptoms. of withdrawal from any addictive substance, which are anxiety, irritability, depression, anxiety, you know, those types of things. Wow. And you're right.

Drugs are digital now, right? Porn, gambling. I think just for some people, video games probably. Oh, for sure. We see a lot of that. Among gamers, there's kind of this, I'm not super familiar, but there's this kind of uproar because a lot of the companies have figured out how to, it's called loot. Have you heard of loot in games?

I don't even know exactly how it works, but it'll be like, you can. can get a different kind of character skin or uniform or gun or whatever for your, and people get super addicted to this stuff. And they made it randomized and they do all the things to get your brain kind of excited about the uncertainty. And there'll be people who make like $37,000 a year spending eight or 10 or more $1,000 on Fortnite skins and character stuff. Oh, yeah. Yeah. I mean, this is well known. It's sometimes referred to as the gamblification of gaming. You know, it's the treasure chest. It's all the things that you can win if you either put up money or spend more time on the site.

One very interesting patient that I had told me that he had gambled recreationally for years and actually never had a problem with it was always able to manage his gambling with money. But what really led to severe addiction was a game online that didn't involve real money. It was fake money. So it wasn't even real money that he was winning or losing, but he got in the cycle of it and just got so addicted to the betting around the fake money that what was happening was that all his time and attention was being usurped by the game. So it doesn't even have to be real money for people to get addicted to it.

I mean, the Kindle book thing is also wild, which is a good reminder for our show fans to use our links in the show notes to buy your softcore vampire porn and support the show and purchasing things from Amazon. But I remember my language arts teacher in middle school saying, be careful of marijuana, not because marijuana is bad for you. I smoked marijuana when I was young. She was kind of like this, you know, hippie woman who was probably in her 50s, 60s back then. And she said, but now it's so much more potent. Before it was just crap that grew in a field and people would plant the seeds that fell out of the bag they bought.

And that was their marijuana plant. And now it's all like genetically engineered and crossbred. and it's 43% THC instead of one or whatever they had back in the 60s. And she's like, and processed food is going to be the same thing. We didn't have Cheetos back then. We ate cheese. And that was it. You stopped when you were full.

Now it's tricking your brain. And I feel like she was right now that I read things like dopamine nation. Yeah. They are trying to figure this out so that it's more potent and more accessible. Yeah, your teacher was prescient. There's no doubt about it. What we've seen now is that almost every aspect of human experience has become drugified in some way. By that, I mean, it's been made more potent.

And when things are more potent, they release more dopamine, our reward neurotransmitter, more quickly in the reward pathways in the brain. Drugs are more accessible. We can get them 24-7 delivered to our doorstep. They're more bountiful so they don't run out. There's no natural stopping point. If cocaine were as abundant as TikTok, we would have. have many, many more cocaine-addicted individuals. And then there's also novelty. One of the ways to

overcome tolerance with drugs is to make them more potent by combining two drugs together. So, for example, combining an opioid with a benzodiazepine increases the potency of the high of the opioid. The same thing happens with digital drugs, right? You've got a game and now you gamblify it, right? Or you've got, you know, a YouTube video or a YouTube show with singing, which is, of course, you know, reinforcing for people who like music. And now you gamify it. You make it a competition. I mean, that's happening all the time. You make it more potent by making it shorter duration. So the TikTok videos, the reason that they're so difficult to stop watching once you start is because they're so short and so potent that they cause a really huge surge, most likely of dopamine

unfollowed by dopamine free fall right afterwards. And it's that plunge in dopamine below baseline firing levels that then creates the craving to want to do it again and again and again. So, you know, you've got potency, access, quantity, and novelty. And you can apply that to almost everything that humans in wealthy nations do, whether it's the food we eat or, you know, the games we play or the books we read or the exercise that we do or what have you. It's scary for somebody who creates long form content, right? Because everyone's like, you need to be creating short form stuff. But then you find yourself creating for this weird algorithm and it's all kind of meaningless. How much am I really going to fit into, is it 90 seconds?

I don't have the app because I don't want to be spied on by China, although I'd rather be spied on by Mark Zuckerberg, which is, or whoever. But I don't have it because I don't like that kind of content, but it's really hard as a creator to get around it because people will say YouTube shorts, TikTok shorts, Instagram reels, and it is incredibly popular, but it's a little scary because I've tested it. It doesn't lead to people coming to the long form content

because they don't want that anymore. Yeah, it's interesting. I mean, I think you're getting a very different experience with short form versus long form content. I think with short form content, you're getting the dopamine hit, and that's what people are looking for. But with long form content, I mean, I think people will stick around for that because that's where you kind of settle into a softer brain rhythm that is like more receptive, potentially, you know, to learning and having kind of a shared slower experience. I'm optimistic about long form. I think people will realize that in the long run, it's probably better. So far, so good, right?

I mean, this show is growing and podcasting is growing. And I think part of the reason is because people go, oh, I'm not sure what I'm getting from watching 500 TikTok videos per day. Right. Maybe I want a deeper dive into something that's interesting. And then they stick around for years at a time. Oh, that's great. With one yutz like me talking to a bunch of brilliant people like you.

And that seems to work, which is kind of a miracle, given what you've just told me about dopamine. It is. And, you know, getting back to your comment about pornography and a whole generation of men kind of maturing through pornography and then kind of looking back and going, like, what was that? And changing course. That's very encouraging. There's like you may be or may or may not be aware, but there's a no-fap movement. Yes, sir. That's so funny to hear somebody else say that out loud. Yeah, that's really no-fap. But that's real. And believe it or not, it's international. So I've, and for those. those of your listeners, that means people who are committing to not masturbating, mostly men, committing to not masturbating, not watching pornography. And it's international. So my book is available in Korea, so I've had lots of nice contact with readers in Korea. And this is a big deal in South Korea, too, like a whole generation of men kind of going, you know what, I'm not going

to auto-stimulate anymore. And I'm going to, and I feel better for it. So it's kind of exciting, you know, people are starting to talk about this and make some efforts. to kind of correct. You're listening to the Jordan Harbinger Show with our guest, Anna Limke. We'll be right back. If you're wondering how I managed to book all these great authors, thinkers, scientists, creators every single week, it is because of my network, the circle of people I know like and trust.

And now I'm teaching you how to build the same thing for yourself for free over at six-minute networking.com. This course is all about improving your relationship building skills. It's not cringy. It's very easy. It's only going to take a few minutes a day. It'll make you a better colleague, a better friend, a better peer. By the way, many of the guests on the show already subscribe and contribute to the course.

So come join us. You'll be in smart company where you belong. All for free at six-minute networking.com. Now, back to Anna Lemke. You mentioned in the book, humanity, or at least the United States maybe, is on this quest to live in a pain-free world. What have you noticed about that? Because it seems to be the reason for us diving into a lot of these issues, headfirst, antidepressants, the massive.

I guess over-prescription of those? I'm not even sure if, are they over-prescribed? It sure sounds like they are, given the numbers that you mentioned in the book. And if you have those numbers handy, that would be interesting. Do you buy any chance? I don't have them handy.

I'd have to go get a copy of the book and crack them open. Okay, I wrote down one, but it sounds like fully one in five people, including maybe children, were taking stimulants and or antidepressants, which is honestly freaking unbelievable.

And I think it's something we're going to look back on in a few decades, with utter shock and total shame because the amount of people on pills to modify their brains today, it'll be like, well, think of that like we think of the lobotomy now. People just won't believe that we did this to ourselves. So I think that statistic is one in five adults, take some type of psychotropic and one in ten children, which I find especially scary, takes some kind of psychotropic or intentionally, you know, mind or mood-altering substance either an antidepressant or an

anxialytic or a stimulant or something like that. So that's really, it's scary. I mean, look, I was educated in the 90s. That's the decade of the brain. That was the decade where psychopharmacology was going to come to the rescue of mental health and there was going to be a pill for everything that ailed us. And there was so much excitement and so much promise. And, you know, here we are 25 years later. And there's this realization that, gee whiz, the drugs aren't working as well as we'd hoped. In fact, rates of depression, anxiety are going up despite destigmatizing mental illness and creating more access to these psychotropic drugs. So that's one big clue that we're getting something fundamentally wrong. And then I think the other conversation that we're having that we

needed to have is that there's probably no free lunch and that these drugs have potential marked downsides that we've been ignoring, some of them life-threatening and some of them. more subtle, but important, like, you know, gee, if I'm on an antidepressant, yeah, it's true, I'm not as depressed, but I also don't feel very much. You know, my mom just died and I couldn't even cried her funeral. For example, you know, patients will say to me things like that. Wow. So it's like, well, what are we really, you know, what's going on there? Plus, you've got the sociodemographic data that suggests that we prescribe a lot more psychotropics to poor people and minorities and people who are disenfranchised, the unemployed,

which really does, you know, suggest some kind of Orwellian phenomenon where we're actually using the medications to sort of pacify large segments of society who have really good reason to be unhappy with their circumstances. I do want to caveat that there's, it's not that there's no place for these medications. I want to be clear about that. I don't want to, I don't want people to be like Jordan and Anna Lemke are shaming me because I'm on SSRIs or whatever. But It seems clear that they're over-prescribed in some way. So, yeah, thank you for that. I mean, I'm a psychiatrist.

I make my living essentially prescribing medications. They're absolutely life-saving in some instances. So it's not an overall to say that we want to throw the baby out with the bathwater. These are useful tools. I'm very grateful for them. But it's just that we probably prescribe them too often at two high doses for too long. And polypharmacy is a known serious problem in the field where you've got somebody who's not really doing well, not responding. Instead of taking the medicine away, we just pile on more and more and

then you don't know what's working. So again, it's not to condemn the whole field that I'm an active part of. It's just to sort of get people thinking about some of these other aspects. I've never heard of that polypharmacy. Is that just when you're on multiple medications? Yeah. So we see, you know, many people who are on 10, 15, 20 different psychotropic medications. What? That's ridiculous. Oh, it's very common. These are often severely mentally ill people. The intention is to try to help them, but obviously when you're on that many different meds,

you just don't know what it's doing anymore. Yeah. How do they even know that that's not interacting? I mean, it just seems so complicated. I wouldn't even take 20 vitamins, right? It just seems dangerous to me. I just saw a patient yesterday who was on like 10 different psychotropics and 10 different vitamins that a vitamin doctor had recommended.

So, you know, I always say, like, I don't know much about vitamins. vitamins. Vitamins are, they're all in like one thing. I guess I'm sort of exaggerating here, but a drug that says, this one makes you feel better, but it's, you know, this one helps with the side effects of the other one, and you hear about that, but I thought, okay, three or four, gosh, that's a lot. But 15 to 20, it just seems impossible to manage that.

You'd need a computer algorithm, make sure you weren't creating another substance just in your stomach that's causing your liver to die or something like that. It's partially a function of our dysfunctional health care system. you know, they got somebody who's really suffering. The doctor doesn't know what to do. The medicines they're on may be helping, but it's not clear, but they're not doing well. So then you add another one thinking that that may help. And then their insurance changes and they go see another doctor. And it's just really, there's so much churn in the system and there's so little psychosocial support that medicines are sort of like the default or the go-to in our health care system. But we know that this kind of polypharmacy is not

optimal. So sometimes what we'll do is we'll admit patients who are very mentally ill to the hospital solely for the purpose of getting them off of pretty much everything and starting over again and seeing what's underneath there. Oh, man, hitting the reset button. So then they're just miserable during the withdrawal period and then you slowly add things back in. These poor people. Yeah. I know in the book you said Americans report being unhappier in 2018 than in 2008. and here we are halfway to from there to 2028, I guess. Americans frequently report being in pain, physical or otherwise. And you said in the book that you think this is in part due to our obsession with avoiding

feeling uncomfortable or feeling pain. What do you mean by that? Are we talking about physical pain or we're just talking about everything in general? Talking about both physical and mental suffering. I talk a lot in the book about sort of the basic neuroscience of how we process pleasure and pain. and it turns out that pleasure and pain are co-located in the brain to the same parts of the brain that process pleasure also process pain they work like opposite sides of a balance i mean that's an oversimplification

but it really gets at the heart of how we manage those fundamental reflexive systems and what happens when we do something that's really pleasurable it releases dopamine our reward neurotransmitter in that reward circuit and that balance tilts to the side of pleasure but there are certain rules governing that balance, the first and most important is the balance wants to remain level, which is what neuroscientists call homeostasis. And in order to level the balance, what it does is first tilt an equal and opposite amount to the side of pain. So that's the opponent process mechanism, the come down, craving, the after effect, the hangover. I like to imagine that as these neuroadaptation gremlins hopping on the pain side of the balance to bring it level again, but they like it there. So they

don't get off when it's level, they stay on until it's tilted to the side of pain. Now, if we wait long enough and we don't repeat that behavior or ingest the substance again, those gremlins hop off and homeostasis is restored. But if we continue to expose our brain repeatedly to highly reinforcing substances and behaviors, those gremlins essentially multiply until there's enough to fill this whole room. And now we're entering into addicted brain or a kind of chronic dopamine deficit state. where in order to compensate for all the reinforcing substances and behaviors that our brains were not evolved for, because our brains were evolved for a world of scarcity and ever-present danger, what we've done is we've sort of changed our hedonic or joy set point by down-regulating dopamine

transmission into this below normal threshold. And I think that's what we are doing, both individually and as nations. We're exposing our brains to so many pleasures and we're so insulated from pain that our brains are essentially reeling in an effort to compensate, and they're doing that by downregulating all those feel-good neurotransmitters. And that's important if it's true, because it means that the intervention is going to be very different, right? Our main mental health intervention now is like, you're uncomfortable, make yourself more comfortable, right? You're experiencing pain. Oh, you can't be experiencing that pain. We need to give you a pill or do something else to take that pain away. But, you know, because of the way that,

that pain and pleasure work like these opposite sides of a balance, the truth is that will never work. And the more we try to make ourselves comfortable, the more we're going to end up unhappy. And instead, what we need to do is intentionally seek out challenging and even painful experiences to a degree and avoid intoxicants as a way to reset healthy dopamine levels. Is this what Alex talk about when they say there's, all right, I need X amount of heroin just to feel normal. It's not about getting high anymore. It's about just being able to function and they have to shoot up to just like do anything. Right, exactly. So once you accumulate all those gremlins on the pain side of the balance and you're in that chronic dopamine deficit

state, you've changed your hedonic set point. Remember, we're always releasing dopamine at a baseline tonic level, kind of like the heartbeat of the brain. But if we overexpose our brains to highly reinforcing substances and behaviors, our brains compensate by decreasing baseline dopamine release to this dopamine deficit state, visualized as the gremlins really camped out on the pain side of the balance. Now I need more of my drug in more potent forms, not to get high, but just to level the balance and feel normal. And when I'm not using, I'm walking around with a balance, tilted to the side of pain, experiencing the universal symptoms of withdrawal, which are anxiety, irritability, insomnia, depression, craving. And really, all of my energy is taking out with just

thinking about getting my drug so I can restore homeostasis. Because the drive to restore homeostasis, because the drive to restore homeostasis is one of the most powerful physiologic rules governing all living organisms. What is the absence of pleasure is what, Anhedonia, something like that? It just sounds absolutely miserable where it's not just chasing the dragon, right, where your tolerance is built up and you're like, I want that really high, high. That's long gone. Now it's just you want to wake up without a slamming headache and feeling sick and unable to focus.

that sounds like one of the worst ways to exist. You have to put this poison, illegal poison into your body to just do anything without feeling awful. Right. And it's important to understand how intense and overwhelming those feelings are in order to understand why people with addiction

will relapse, even after they can see objectively that their lives would be better off if they didn't use. It's because their brains are screaming out for them to go get the drug and use the drug in order to, to restore homeostasis. So it's not about seeking a pleasure.

It's really about trying to no longer be in pain. What scared me in the book is drugs like Adderall, which a ton of people take increased dopamine output by a thousand percent. And I took Adderall in law school because a lot of people were doing it and I took the ADD test and I was like, this is yeah, sure I have ADD,

and now I can function and study really hard. And I just, you know, I was 20 years ago, I was not thinking about this kind of stuff at all. And I felt, so good while I was on it, but I thought it was because, wow, this is how normal people feel every day. They're just so focused. My ADD really is a disability. This is crazy. And now I realize, no, it's just my brain just bathing in dopamine at the time. And that was not how normal people feel at all. That's how drugged up amphetamine addicts feel, because that's what I was taking.

Yeah. So this is an important point because it highlights a fallacy in the mental health field, which is that if you take a medicine and it does for you what it was intended to do, then you must have the disorder that the medication was meant to treat. So, for example, if you take attention to have a disorder, and it is true that people with that label probably do have a different processing brain, a different way of processing information than other people. Now, whether or not we should label that pathological, people can disagree. And I might even disagree with that.

I think it's a different way of processing, but not necessarily a pathological way of processing. But what we've done is we said, take this stimulant, oh, does that help your brain process in this more neurotypical way? If it does, then you must have ADHD. But the truth is, if you gave anybody a stimulant or most people a stimulant, they would be better at a certain kind of sustained attention and repetitive behavior that stimulants promote. You don't have to have ADHD to get that effect. So that kind of backward causal thinking, I think, you know, permeates a psychiatry and mental health and isn't really a good way to think about it. I do prescribe stimulants to a few rare patients who have shown that they really benefit from it. But I also do it in the context of opening the discussion

about, you know, with pros and cons. Because again, there's no free lunch with any of these medications and even people who can manage their stimulants and report benefit will admit that it makes them more anxious. It makes them, gives them more insomnia, that there's a come down in their mood. You know, and those are really important to acknowledge because, you know, there's a tipping point where you reach it where it's like, well, really, is it really worth it? Plus, of course, there's the risk for addiction. Again, addiction is a spectrum disorder. Not everybody who is exposed to a stimulant is going to get addicted to stimulants. Not everybody who drinks alcohol is going to get addicted to alcohol. But there will be a subset

of individuals who will go there and it will be large. outside of their volitional control. You mentioned before that drug and alcohol use change the brain forever. In the book, there's a rats and cocaine example, and this is really, well, a bummer is kind of an understatement. This is really scary, I think, because it seems like no matter how much time off you take from a substance, you're just as vulnerable to it if you take it again,

even years down the line. It's almost like the drug tattoos your brain in some way. Yeah, so there's quite a bit of evidence, both in the animal literature, but as well as in our clinical, you know, observation, that once an individual has become severely addicted to a substance or behavior, even after they've abstained and gone into remission or recovery for, in some cases, decades, if they're re-exposed to that substance or a similar related substance, that can reignite those addictive behaviors almost instantly. And yeah, that is kind of depressing, but I think it's important.

to just acknowledge that that's very often the case. Not in every case. I mean, humans are really complicated in our brains. We're only at the sort of brink of understanding what's happening. So again, none of these things are 100 percent. But in most people, that is the case. What we think happens with recovery is those damaged areas probably never repair themselves, but people are able to create new neural networks that route around those damaged areas. So I always like to emphasize that recovery is real. Recovery, you know, happens on a neurological level. Recovery is robust. People will get into recovery from even very severe addictions and remain in recovery for the rest of their lives. But they'll always probably remain vulnerable. And so it's good to keep that in mind.

Earlier you mentioned that we live in this world of abundance, but our brains are evolved for scarcity. In the book, you write that we're cacti in the rainforest and we're drowning in dopamine. I think that's a really interesting metaphor, because it really does seem like, There's so much food around. There's so many drugs around. There's so much whatever online. It sounds like from reading the book, though, it takes more pleasure now to produce dopamine and less injury or whatever to produce pain.

So are we more fragile now? Has our ability to bounce back from things? Has that been degraded by our environment? I think so. What we're dealing with now is a mismatch between our ancient wiring for processing pleasure and pain. and the world that we have created, which is, you know, in this era of the Anthropocene, where human activity for the first time in human history has actually changed the environment. We usually

use global warming as the example of that or whatever you want to call it the way that we've polluted our environment. But this phenomenon of the drugification of everyday life is also a real thing that is impacting our lived experience because we are so insulated from pain in our every day. Most of us don't even really move our bodies very much at all, or many of us. And we're also have more access than ever to reinforcing substances and behaviors, importantly, even among the poorest of the poor. So we have more leisure time, more disposable income, more access to luxury goods. And now with the internet, instant access to digital drugs, which can have the same effect. I believe that that is a major contributor to the growing rates of unhappiness, growing rates of anxiety,

depression, you know, the mental health crisis that we're seeing among our youth. It's because there's too much pleasure and too little of the right kinds of pain for our brains to be able to stay in healthy balance. This is the Jordan Harbinger Show with our guest, Anna Lemke. We'll be right back. If you like this episode of the show, I invite you to do what other smart and considerate listeners do, which is take a moment and support our sponsors. All the deals, discount codes, and ways to support the show are at Jordan Harbinger.com

slash deals. Hey, and if you can't remember the name of a sponsor, you can't find that code. Go ahead and email me Jordan at Jordan Harbinger.com. I am more than happy to surface that code for you. It's that important. Thank you for supporting those who support the show. Now for the rest of my conversation with Anna Limke. The gambling example you gave in the book was really interesting and counterintuitive. I think you'd said something along the lines of the dopamine reaction in gamblers was highest, not when they won, but when the probability of winning and losing was about 50-50. So this, I never saw coming. So it seems like it's actually the uncertainty that triggers the dopamine hit, not winning

money in the game. And gambling for me personally never really clicked. I felt kind of good when I won and I felt really dumb when I lost. And I only felt anxiety in between. Right. So it wasn't hard for me to decide that that was not something I wanted to keep doing. Right. You know, it was just like you go to a bachelor party, you make your,

piddly little $80 budget and you sit there with your friends, and you're like, all right, this is me sitting with my friends. But I had no desire to stay up until 3 a.m. with the other, like, the hardcore guys trading sleep for dopamine. Sports betting, same thing. I mean, it probably helps that I don't like sports. And as it turns out, being a giant dork has actually saved me quite a bit of money. But I wonder how social media compares to gambling with respect to the dopamine and the ups and the downs, but the uncertainty of what you're going to see on Instagram or TikTok or whether people are going to like your stuff. Is that uncertainty at play here as well? Oh, absolutely.

I think that's part of what makes social media potentially so addictive for some individuals. It's that you can post and get a really positive response and get a nice burst of dopamine and feel really good. But then the next time around you post again, you don't get that response. And probably what's happening in the brain is not that then dopamine levels are new. neutral, they actually go below baseline because we know that when we anticipate or expect a certain reward and we don't get that reward, that dopamine firing goes below baseline. And so if we are predisposed to be addicted to that activity, because people differ as you yourself acknowledged in terms of what their drug of choice is, if we're predisposed not to be addicted to that activity,

we'll have that negative experience and we'll walk away, right? Well, so that wasn't any fun. But if we're predisposed to get addicted to that activity, we'll have that negative experience and that will then motivate us to want to do it even more to post even more or to in the case of gambling you know gamble even more spend more time there in order to bring dopamine levels back up and potentially above baseline again that stuff scares me because it's hard to get a kid for example away from social media because they look at it like I'm talking to my friends this is not my friends interact so you're essentially you're ripping them away from their social circle if you told your kid to stop vaping because it's bad for them they probably know that

But if you tell them, hey, stop liking your friend's outfits on Instagram, they're going to be like, what is wrong with you? Why is dad so triggered by this stupid thing? Who cares? Yeah. I'm literally just telling my friend, she looks good in a dress. And meanwhile, her brain is going crazy. Yeah, well, there's plenty of evidence now to show that the longer that people, including young people, spend on social media, the more likely they are to be depressed, anxious, unable to sleep, and generally on. happy. And I think that the field is coming to consensus that this is not just correlative,

but actually causative, and that it's the time on social media that's driving those feelings of unhappiness, anxiety, depression, insomnia. And I think that there's even a slight shift shift among young people themselves. For example, my kids are in their teenage years, and a lot of their friends will actually say, I actually hate social media. Like, I want to stop, but I don't feel that I can or I have difficulty stopping. Or I feel that my entire identity is there. Yeah. So young people are beginning, sort of like the way you reported young men who lived through

a certain period of time and looking back and going like, pornography may not be the thing. I think we're going to have a sort of reckoning with this generation of Gen Xters sort of realizing, wow, like all that time I've spent on social media made me feel bad. And I want to try to change it. But as you say, very difficult because when all your friends are hanging out there, if you try to change it alone, you're alone. For example, in California, there's a group of young people who call themselves the Luddites, and they've decided to not carry their phones around, and they're doing it together. You know, so I think that's great. That gives me a lot of hope that we're going to

collectively, you know, move toward a healthier relationship with the technology. Yeah, I suppose there will be and are ways to limit these things. I've been thinking about this a lot, because I have two young kids. One is four. One is not even two. And I'm like, we have. We have, have to be able to find them and get a hold of them, but I don't want them to be sitting on a web browsers or apps. And the sort of interim solution that I won't have to apply for another decade, but the interim solution now, I would imagine for people who are listening and they're freaking out about their own kids is get them an Apple Watch that has the cellular in it so they don't need their phone to use it because you can't browse on that thing. But you can get texts.

You can make a call. You can receive a call. But you can't like anything. I mean, maybe you can, but it's such a pain of the ass, right? You've got this little crown. It's like you're just not going to do it. Right. But you can have all the functions. And for parents, you can still track your kid and find out where they are and reach them at any time without them, I don't know, getting accosted by a predator generally on some online forum or through DMs. Yeah, right. Yeah. So I think that that's right. There's these interim solutions, right? You can get your kid a dumb phone, just a flip phone, right, that just does text and phone calls. There are even these things called light phones that, even have rideshare and some other features, but don't allow access to the internet for anything else.

They have maps, ride share, texting, phone. I also think that we have to, like, push back a little bit on this idea that, like, we as parents have to know exactly where our kids are all the time and the way that we kind of track them. Obviously, for a small child. Yeah, for small kids, definitely. But, yeah, you're right. For a teenager, maybe we don't need to be like, I know where you are. Right, right. Or even, you know, teenagers going off to college now and their parents still, I mean.

Yeah, that's weird. It's the culture in a way it's just normalized. You could say, well, it's a nice way to keep families close, and that's partially true. But I think there's a real danger there that your kid just doesn't, like, get the kind of autonomy that they need in order to be independent in the world. So, I don't these are all interesting. Now, you're right. I don't want to know if my daughter's at a frat party because I will not sleep until I see the dot float back to her dorm room or whatever. And this is a problem I'm going to have in, what, two decades?

I probably shouldn't even be thinking about this right now. Probably not. There'll be something all new by the time you get there. Yeah, exactly. Addiction distorting our time horizons, this was an interesting bit in the book. I had no idea that addiction could do this. Can you speak to this a little bit? It's not just instant gratification, but there was all kinds of distortion of how we perceive time that I just never thought of. Yeah. So we really lose track of time when we're chasing dopamine. And in fact, that's part of the appeal, right, that we get lost in the space time continuum. We're not thinking about scheduling. or what we have to do next or appointments, we're just sort of lost to time. But that's also really

problematic because we're on our phones and we think it's half an hour and it's really been two hours. That's part of what contributes to the harm that's caused by these highly reinforcing substances and behaviors. The other thing that can happen is that we can engage in what sometimes referred to as delayed discounting, where we overvalue short-term rewards and undervalue long-term rewards. You know, so for example, if I offered you $10 right now or $100 in a week, just to take an extreme example, you would probably choose $100 in a week. For sure. Right, as would most people.

But if you are severely addicted to heroin, what experiments show is that many more people with severely addicted to heroin would take $10 right now over $100 in a week. Not all of them, but many of them. At least the curve would be shifted. And what that says is that you're in a really different mental state when you are in an addiction. You're liable without even necessarily realizing it to really overvalue short-term rewards and not be able to, not only not be able to delay gratification, but not even to see the need for it. What I thought was very, very interesting was that growing up in resource poor environments,

as opposed to growing up in resource-rich environments, that also shifted the curve. So heroin aside, how we react to short-term needs, instant gratification is completely different. So people, I think you or the researcher had tested people who grew up in favelas, they tended to gravitate towards instant gratification. And I started to think about that and you think, okay, rap and a lot of hip-hop is like, go get the money right now, like cash only, get it right now. And I remember when I worked in Detroit, I worked with a lot of people who were sort of adjacent to that.

And they would get paid that night, and they would go spend the money right away. And I was like, what are you doing? We just had a conversation about how you're sick of living with your mom or your car's broken and you can't, and you're like, yeah, but I want to go get this chain. I'm like, it's 3 a.m. man, it's 3 o'clock. And the pawn shops open all day all night. I'm like, just put it under your mattress and go to bed for God's. And they like could not do that.

And athletes going broke, right? A lot of these guys grow up in that environment. And they can't. The money is burning a hole in their purpose. pocket. This was quite intuitive once you mentioned it in the book. I personally, I don't worry about resources. I know whatever it is I want is going to be there later. I didn't even want to pay the $10 to get my L-sat, which is the law school entrance. I didn't want to pay $10 to get my score a month earlier. And people around me were like, what are you doing? You don't know what your score is?

And I'm like, they have to mail it to me. I'm not giving them much for money. Right. And it is, it's just something I grew up being able to do because I grew up in a middle class environment. I wasn't like, where's my next meal coming from? I wasn't worried about any of that. Others that don't have that certainty, this pattern is set growing up. But one, that's terrifying. But two, can this be reprogrammed? Or do we just have to be careful forever if we grew up with less?

Well, I think this really speaks to if you grow up in a world of extreme scarcity where people are in survival mode, and then to grab as much as you can, as fast as you can, of scarce resources is actually healthy and a chance. adaptive and increases your likelihood of survival in that environment. So it can be really difficult to make the shift to an environment of plenty where those resources are going to be there tomorrow. It's hard to believe it when you've grown up an environment where you were taught that that was not the case. But of course, people can shift. Of course, with repeated exposures of letting the resource be there and seeing that it's not going to go away, people can make changes.

but still those early experiences do have a powerful impact our whole lives. What can we do about some of this? It seems it's a little bit desperate, right? You mentioned earlier stopping the behavior for, was it four weeks? Right. And is that what dopamine fasting is? Is that essentially? Yes.

Tell me more about that because easier said than done. Oh, just stop your addictive behavior for a month. Like, okay, I hadn't thought about that before getting arrested twice or getting caught by my wife or whatever. Yes, I mean, much easier. said than done, but what I hope is that once people understand what's going on in our brains, they will be more motivated to give it a try, whether with a substance or behavior that they know they have a problem with or maybe a substance or behavior that they are not sure or they even don't think they have a problem with, but maybe other people have commented that it's a problem.

Giving it up for four weeks is about the average amount of time it takes to reset dopamine reward pathways. So to have those metaphorical gremlins hop off the pain. inside the balance and have homeostasis be restored. And the reason that it's important to do that is because, number one, when we reset reward pathways, we're able to take joy in other more modest rewards again. And number two, we're able to look back at the impact of our drug use on our lives with more objective clarity. Because when we're in it, because of things like delay discounting and, you know, losing a sense of space time, we really aren't very good judges of the true impact of our use on our lives. It's only when we get some distance. I've often had patients who will come back

after four weeks of abstaining and be shocked to look back at their former selves and how much energy and time and money they invested in chasing their drug. So it's really important to take a break, to give your brain a break. Even if after that break, you decide you want to go back to using, which many of our patients do, but they almost all universally want to use differently. They want to use less. They want to have a different kind of attachment to their drug of choice, a healthier attachment. So I think it's a really important and well-informed experiment that people can just do in their lives. Now, importantly, this is not something I would recommend for somebody who was so severely addicted that they could never stop on their own. They had repeatedly tried and just

couldn't do it. Or somebody who was at risk for life-threatening withdrawal from a substance like alcohol or a benzodiazepine like Xanax or an opioid. die if you stopped taking those? I didn't realize that you could die from that. Yes, specifically alcohol and benzodiazepines like Xanax, Valium, Clonopin in particular. If you become very physiologically dependent, so you really change your brain physiology with repeated use, if you stop suddenly, you can experience a profound physiologic storm that can lead to death in some instances. You can have seas and you can die. Wow. So for those kinds of drugs, people really need to see a medical professional and to be monitored and potentially get medicines to help them withdraw.

I think a lot of people, unfortunately, they just trade one addiction for another. I remember I went to a bunch of these meetings like N.A. and A.A. just to see what they were like because I was giving advice on my show and I was like, I should probably know what I'm recommending. I had friends that were in there like, yeah, come with me. So I noticed that, for example, with A.A., a ton of people were smoking and vaping outside of the meeting. And I did not trying to be judgey here, but it really seemed like a lot of the people had went from either smoking and drinking or just drinking, and now they're just smoking a lot or vaping a lot. And I wondered how many people just traded one addiction for another one. This concept of cross-addiction is really

important because people with addiction who give up one drug are very vulnerable to increase use of another drug or even take on a drug, a new drug, or switch to a behavior and engage in that behavior in an addictive way. So we always talk about the risk of cross-addiction. But I do want to emphasize that, you know, in our work with patients, when we talk about dopamine fasting, we're not asking patients to necessarily give up every single drug or vice, quote-unquote vice that they have. We're really asking them to identify that substance or that behavior that is causing problems in their lives and to really focus on that one. If their use of alcohol is, for example, linked to their use of cigarettes, like every time they smoke a cigarette, they want to drink,

but otherwise they don't want to drink, then we might say, well, geez, maybe you should give up the cigarettes and the alcohol at the same time. There are a few studies showing that when people give up cigarettes and alcohol at the same time, they actually have better outcomes for both than if they try to give up one, but not the other. And the hypothesis there is that as long as you're using anything that sort of pings your reward pathway, you're kind of, you know, setting yourself up for relapse because all rewarding substances and behaviors work on the same final common pathway. They all release dopamine in the reward circuitry. But now having said that, if somebody identifies in their life that alcohol is super destructive to themselves and others, et cetera, but that nicotine, although,

yes, obviously harmful for health, is something that they want to keep doing, we support patients in that. It's good that they're willing to give up the one substance, even if they're going to continue the other. We just really caution them against not increasing use of the other. And then over time, we will maybe re-enter the discussion. Like, well, you've been able to stop drinking. You're doing so much better. Do you want to take a look at quitting smoking or quitting cigarettes? What's very interesting is when people use cannabis and nicotine, they will almost always tell you that they want to quit smoking cigarettes, but they almost never want to quit cannabis because, you know, cannabis is their medicine. So you have these funny cultural overlays, too, sort of what's healthy, what's healthy, what

What's a medicine? You know, what's a drug? You know, what's addictive? What is it? I know we talked about things like weed and food becoming more and more potent. Right. I know there's, man, for the last 20, 30, whatever years, there's been a lot of manipulation of drug formulation. Even breaking bad, right? It was about the super methamphetamine. I don't know if you saw that series. No, but my sons absolutely love that series. Well, you might enjoy it. Yeah, I'm sure I would. I'm sure with all the free time you have.

Yeah. But I mean, I won't say it beats vampire porn, but it's pretty damn good. I bet it's way up there. Yeah. I know that law enforcement is also concerned about this. It's been a factor, a significant factor in the explosion of mental illness and homelessness in America, according to some of the sources that I saw, just drugs being crazy, crazy potent, methamphetamine and things like that.

Do you believe that there are some substances which are so disruptive to the brain that recovery is impossible or highly improbable? or is that too catastrophic for us? Yeah. I mean, I always believe that recovery is possible. I have seen people with very severe addictions after decades of use get into recovery. So there's always hope recovery is always possible.

We need to never give up on people. But it is true that the longer that people use their drug of choice and the more potent that drug, the more potential damage to the brain, which is the ultimate end organ that is being damaged by addictive drugs and behaviors. I mean, fentanyl is the perfect example. It's a highly potent opioid, 50 to 100 times more potent than heroin. It's available cheaply on the streets of every major city. It's also very lethal because it slows down heart rate, slows down breathing, people fall asleep

and don't wake up again. People aren't using it for that reason. You know, they're using it for its psychotropic effects or euphorogenic effects, but they accidentally overdose. So, you know, obviously these really potent drugs, which by the way, are a result of our scientific revolution, right? It's the dark side of technology and innovation that's allowed us to manufacture drugs that are this incredibly potent. This is totally off topic, but I worry about the brain machine interfaces that we're going to have in a few decades and you'll be able to get feelings from those things. That's just going to be a whole, you're going to have a whole subpractice if you're still practicing by then of people who can't stop, I don't know, shocking their dopamine

centers. I mean, that's just going to be crazy. I think we're already there. Our digital devices essentially are auto-stimulators, auto-erotic stimulators there. That's fair. They're the ways in which we meet all of these deep physical and psychological needs without another human being, right? We're just doing it with a device. I think it's a real danger, especially we have so many people who do live in isolation, who are experiencing loneliness. Now you've got a device that can sort of take care of your needs, which then contributes to more loneliness and isolation, people not really needing to go out to find other people to meet these basic human needs for connection. I mean, it's already upon us.

I read Michael Pollens how to change your mind a few years ago. He was on the show's episode 81, by the way, and I was left with the impression that psychedelics are largely the cure for a lot of this stuff or could be. What do you think of substances like LSD, ketamine, MDMA, being the future of psychiatry to treat things like hardcore trauma and, I don't know, neurosis, asking for a friend, of course. Right. Yeah. So, I mean, I think it's really unfortunate that the hype about these drugs have so outstripped the evidence. You know, the evidence is really preliminary. It's also in the context of an augmentation strategy for psychotherapy. So when people talk about, you know, the evidence that's out there, it's really stuff.

in which the medium for healing is psychotherapy, you know, talking to somebody and then using the psychedelics to strengthen that therapeutic alliance or augment that connection or the work that's done there, which, by the way, I fundamentally oppose because it seems to me that one of our major missions is to help people create alliances with other people without using drugs, right? We've got lots of patients who that's the only way they know how to connect with other people. it's really sad to me, you're saying, well, now you're going to use, you know, now you need a drug to have a connection with your therapist. Having said that, I can imagine scenarios in which there may be utility like at the very end of life where people don't have the time that you might need to make that kind of connection. But what's very sad is that, of course, this idea of using psychedelics in a therapeutic context has become individuals using it with their friends or by themselves at home, you know,

not in the context of medical treatment, to have some kind of spiritual awakening. And I think that's people should be very, very skeptical. These drugs are addictive. Anything that changes the way you feel has the potential to be addictive. We're seeing more and more people getting addicted to psychedelics, showing up in emergency rooms, dying from psychedelics. I mean, people really underestimate the harms and the potential harms and really overestimate the benefits and the utility. So I just proceed with caution. I would also say if you look at like sort of the spirituality measures, the questions that they ask people, you know, to sort of measure spiritual awakening,

look a whole heck of a lot like the questions you would get around what it feels like to be high. Did you feel a sense of expansiveness as if you were floating above at all, deep connection to other people? I mean, that's how people feel when they get high. So this idea that you take a shortcut to a spiritual awakening. You're skeptical. from the sound of it. This book really did help me understand how addiction works in a new way

and especially just the dopamine centers in the brain. It's kind of dopamine's almost buzzwordy these days because you hear about it with respect to everything from Instagram to opiates to Cheetos. And this really does provide a lot of foundation to, I think, the conversation that we're having now, which is interesting because this is not a brand new book.

You were just ahead of the curve, I think. So, one, thank you for that. but to leave us with something positive because, okay, psychedelics, oh, no, just kidding. And what about this? Well, also highly addictive. Oh, and your brain might never change, but, you know, bye. Yeah, right. Well, I mean, I'm very optimistic, actually. I think the one thing about humans is how adaptive we are. And I do think that addiction is the modern plague, but I also believe we'll figure it out. Part of that result will be a new modern form of asceticism, which is to say the intentional seeking out of difficult or painful circumstances and activities as a way to reset reward pathways.

And so inviting challenge into our life, encouraging our children to have challenging experiences, not immediately rushing to the rescue to make sure that people get out of pain, but instead acknowledging the utility of pain in our lives and, in fact, the ways in which we're wired for pain, we're meant to strive. If we don't have something to strive for, we're a lot less happy. Thank you very much. Really appreciate your time and expertise. This is fascinating, even if it is a little bit terrifying. And I appreciate it. Well, you're very welcome. Thanks for having me. Ever wonder why seemingly rational individuals can wholeheartedly embrace the most irrational beliefs? You're about to hear a preview of the Jordan Harbinger show where Dan Ariely uncovers the captivating psychology behind these puzzling convictions.

I'm a social scientist. The moment you adopt this misbelieving perspective where you distrust, everything and you just look for signals for bad things that are happening, you can find them. We can deteriorate quickly into a very undesirable state of beliefs. It affects people's well-being and optimism. It affects people's willingness to help, to donate money. We are very much attuned to bad things. So when bad things happen, we really want to understand the mechanism. And I think this is really the goal of social science, is to take those things we have no intuition, but help us understand them and give us some better rules for life. If we understand that misbeliefs are bad reactions to a real problem,

can we help our friends have better reactions to a bad problem? Where's reality? Where's the truth? We are becoming more politicized, more identity-driven, more separatist. It feels like the things that divide us are becoming larger than the things that you us. And the moment we have these feelings of intolerance, we are just chasing those people away from our lives. And one of the best antidotes is resilience. You know, at the end of the day, society's strength is in our unity, in our trust with each other. Trust is the unobserved lubricant of society. To hear more about Dan Ariely's own chilling encounters with conspiracy

theorists, check out episode 903 of the Jordan Harbinger Show. It never gets old. I could just listen. I should have been a brain scientist. If I were smarter, I would have done that. What I didn't know is that any substance or activity that pushes on the pleasure center has the capacity to become addictive. I mean, it makes sense now that I hear it, but it's sort of scary because I'm thinking of all the things that I kind of like doing and I'm like, oh man, can I get addicted to that? That's right, folks. Let your imagination run wild with that one. It's very important to treat the underlying condition. So gastric bypass surgery, right, where they sort of staple off part of your stomach, they probably don't do that anymore, but you know, same kind of idea. Maybe people lose weight, but they still have addictive behaviors. So they might start drinking, they might start popping pills. And of course, they're at higher risk because they absorb booze and other substances faster because they had gastric bypass. So it's really interesting what happens, interesting in a bad way, I suppose, what happens if you don't treat the underlying condition to this whole thing. So really sort of a lot to be said here for the way we treat addiction,

substance abuse, etc. All things, Anna Lemke will be in the show notes at Jordan Harbinger.com, transcripts in the show notes as well. Advertisers, deals, discount codes, ways to support the show. All at Jordan Harbinger.com slash deals. Please consider supporting those who support the show. We've also got our newsletter. Each week, the team and I dig into an older episode of the show

and dissect the lessons from it. So if you are a fan of the show, you want to recap of important highlights and takeaways or you just want to know what to listen to next. The newsletter is a great place to do that. Jordanharbinger.com slash news is where you can find it. Don't forget about six-minute networking as well over at six-minute networking.com. I'd love to hear from you anywhere on any platform. I'm at Jordan Harbinger on Twitter and Instagram.

You can even connect with me on LinkedIn. This show is created in association with Podcast 1. My team is Jen Harbinger, Jace Sanderson, Robert Fogarty, Millio Campo, Ian Baird, and Gabriel Mizrahi. Remember, we rise by lifting others. The fee for the show is you share it with friends and you find something useful or interesting, the greatest compliment you can give us

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so let me save you some time. If you like the Jordan Harbinger show, you'll probably like Something You Should Know with Mike Carruthers. It's one of those shows that makes you smarter in a practical, useful way. Same curiosity vibe we go for here, just in a fast-focused format. Mike brings on top experts and asks the exact questions

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