Anna Lembke
A book that made it into my recommendations list in 2022 was ‘The Molecule of More‘ by Daniel Z. Lieberman & Michael E. Long. That book, as I wrote in my review then, made a complex subject very accessible and even entertaining, with interesting experiments, real-life scenarios and very less jargon. And it got me interested in the subject. I discovered Dopamine Nation thanks to a podcast, where Dr. Anna Lembke gave a very lucid explanation of the relationship between pleasure and pain.
The book is divided into three sections – The Pursuit of Pleasure, Self-Binding, and The Pursuit of Pain. Each of these is further divided into three chapters giving the book a structure that is easy to follow. In her introduction, she writes about the overwhelming amount of stimuli around us and calls the smartphone ‘the modern-day hypodermic needle delivering digital dopamine for a wired generation.’ So how does one find balance in this age of indulgence? A big risk-factor in addiction is ease of access and across digital and reality, that has very less mediation. ” I was struck by how much hotel rooms are like latter-day Skinner boxes: a bed, a TV, and a minibar. Nothing to do but press the lever for a drug”. A dopamine economy or ‘limbic capitalism’ (David Courtwright).
Continuing this thought, she writes about how we run from pain. She throws light on how “the pursuit of personal happiness has become a modern maxim, crowding out other definitions of the “good life”. Even acts of kindness towards others are framed as a strategy for personal happiness. Altruism, no longer merely a good in itself, has become a vehicle for our own ‘well-being'”.
To illustrate the pleasure-pain balance, she imagines our brain having a balance – a scale with a fulcrum. When we experience pleasure, dopamine is released in our reward pathway and the balance tips to the side of pleasure. (the first in a packet of chips) But the problem is that the system wants homeostasis. The self-regulating system now starts functioning. Meanwhile, with repeated exposure to the pleasure, the initial deviation of the scale towards pleasure becomes weaker and shorter, and the response from the self regulation gets stronger and longer. This is neuroadaptation. Now you need the second chip from the packet, and the more you eat, the bigger the craving and more the irritation if you don’t get it. You consume the chips though it no longer gives you pleasure, just to avoid the pain. It doesn’t end there. The biggest paradox is that hedonism leads to anhedonia, the inability to enjoy pleasure of any kind. The good news is that abstinence can lead to a natural homeostasis.
In short, “science teaches us that every pleasure extracts a price, and the pain that follows is longer and lasting and more intense than the pleasure that gave rise to it. With prolonged and repeated exposure to pleasurable stimuli, our capacity to tolerate pain decreases, and our threshold for experiencing pleasure increases.”
In the Self-Binding section, she charts out the escape path with an acronym for dopamine – data, objectives, problems, abstinence, mindfulness, insight, next steps, experiment. Broadly, abstinence can be aided by space (physically creating barriers to access, or even reminders), time (restricting consumption to a certain time, or only as a reward) and by finding meaning in something, to replace the pull of the craving. In the last chapter of this section, she points out how anti-depressants can actually go beyond their call of duty and limit the ability to experience the full range of emotions. Making us a person different from our natural self. A difficult trade-off.
I found the third section very interesting on two counts. One, a new idea in the first chapter of this section. What if we reverse the pain-pleasure balance by pushing on the side of pain? “With intermittent exposure to pain, our natural (self regulating) hedonic set point gets weighted to the side of pleasure, such that we become less vulnerable to pain and more able to feel pleasure over time”. Cold water baths is an example used. So are extreme sports. Obviously too much of anything will result in addiction.
Two, some excellent connections in the second chapter of this section, titled Radical Honesty, which also touches upon the trend of ‘disclosure p0rn’. The connection is on a favourite topic of mine – scarcity and abundance mindsets. The author’s hypothesis is that truth-telling engenders an abundance mindset, and lies, a scarcity mindset. She explains this both in terms of us feeling more confident about the world when people around us tell the truth, as well as how when resources are (perceived to be) scarce, people are more invested in immediate gains. I connected this to something I read in The molecule of more – the two kinds of activities we do. Agentic, formed for the purpose of accomplishing a goal and orchestrated by dopamine, vs affiliative, formed for the pleasure of interaction, driven by oxytocin, vasopressin and others more interested in the here and now. The connection I made? Scarcity mindset – Lies – Agentic activities – Dopamine pathways for quick rewards. I am still thinking of direction and causality, but I intuitively sense a thread.
In essence, I found this a very interesting read. And if you’re intrigued by behaviour – yours or others’ – I think this will be an engaging read for you as well. Best paired with the book I mentioned in the beginning.
