Dopamine Nation: Finding Balance - Dr. Anna Lembke

22:54Dr. Anna Lembke:And it's because the digital media are highly reinforcing and potentially addictive.

23:03Hunter Clarke-Fields:Yeah, I'm seeing that behavior, obviously, in my own family and myself. My dad, who's almost 80, is like, we were all sitting around watching TV, and he was on Facebook, and he's recently gotten into it, and he's really gotten into it. He's talking out loud about it and swiping and telling us things, and we're like, can you go do that somewhere else? But he's, you know and and actually recently i i've been my we've been talking with my 18 year old my husband and i about we were like oh this is it recently i've been feeling it i think i've been feeling the effects of like the creep of the phone just like the checking and checking and my husband daughter and i had considered we were talking about getting like dumber phones yeah some kind of flip phone or something like that.

23:55But then Maggie, my daughter, I guess like a week

23:59Hunter Clarke-Fields:and a half ago now, she said, Mom, give me your phone. And she got, took my phone. And she got rid of Facebook. She got rid of Instagram. She got rid of the New York Times. She went through every single app and was like, what is this? I'm getting rid of it. No more, no more digital thrifting for me on thredUP she got rid of all the things and it's yeah okay that's right good for her actually the thing we did is um we we live in Delaware we were just in the suburb of Philadelphia so I actually subscribed to the Philadelphia paper to actually be physically delivered to our house?

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25:57Hunter Clarke-Fields:And it really gets all those little nipples and straws and things. so you don't have to worry about it. If you're in the infant stage or know someone who is, you need these Mom Cozy products in your life. Right now, you can get 10 % off the Night Pro Bottle Warmer and 10 % when you pre-order the Deep Clean Bottle Washer 8 at momcozy.com with the code MINDFULMAMA. So head to momcozy.com and use code MINDFULMAMA for 10 % off my favorite Mom Cozy product. So it's been this like week, actually leading up to this conversation with you, of like a week and a half of like some changes and some shifts and I've been feeling some clarity, some more clarity.

26:43Hunter Clarke-Fields:It feels like it was cluttering up my brain. And I wonder with this idea of the smartphone as the modern hypodermic needle delivering the digital dopamine, I mean, it's affecting people in a way that really is negative, right? Like one thing I'm noticing, and I don't know, maybe you can confirm this or not, is that people seem sort of antisocial. Like it is hard to get people out of their houses. And I'm wondering if it's like, this is part of the problem about the way this reward pathway is stimulated. Can you tell me about that?

27:26Dr. Anna Lembke:Yeah, I mean, this is the great irony of this technology that, you know, the technology allows us to connect with each other without leaving our homes or even our couches for that matter. And yet, at the same time, the technology is driving us further apart. More people than ever before live alone. Young people now endorse preferring online communication to actually having face-to-face communication. The majority or at least half of young people endorse preferring online communication. More and more people are not leaving their homes. They're recreating in their homes. I mean, you know, it's like the trajectory.

28:10Dr. Anna Lembke:You want to frog and turn into like human versions of moles, right, who just sort of live indoors and never go out anymore. The Wally pod people. Right. Yeah, exactly. And it's funny because when you first said antisocial, I was thinking about the psychiatric notion of antisocial, which is not social, although that's happening too, and I think that's what you were alluding to. But the antisocial personality disorder where people are like sociopathic and are no longer in their lacking in integrity and morals. And that also happens, right? Because all of this information, more information than our brains were processing, And all the normalization out of this kind of deviant speech and deviant behaviors online, I think has contributed to a decay of morality more broadly, where just people kind of feel like, you know, anything goes and I can sort of say whatever I want.

29:09Dr. Anna Lembke:and the sort of civil discourse that we took for granted is now actively threatened. So, you know, both in terms of it limiting our socialization, but also contributing to a kind of a sociopathy, you know, I think that element is there. Again, you know, there are great things about the technology, right? You and I are having this conversation. We couldn't have it otherwise. otherwise there's all kinds of opportunities to connect and learn and you know appreciate things that we otherwise couldn't appreciate marginalized people you know have the ability so there are many good things but there are clearly also many bad things and i think it's good that we're having the conversation about the bad things um so that we can individually and collectively think about how you know how do i want to be in relationship with the technology i love what your daughter did Love it.

30:04Dr. Anna Lembke:I love that you're getting, you know, a regular paper. First of all, you're supporting a dying industry, which is the newspaper industry. But also that kind of slowed down, slowed form, you know, intentionally, slightly inconvenient way of consuming media is, I think, important to think about, right? I'm like, how do I want to get my information and what is a way that is, you know, kind of enriches my life to have this information versus detracting from my life? And everybody's going to maybe come down in a slightly different place. But I think most of us would agree we're sort of dealing with like not just information overload, but like sensationalized information overload.

30:51Dr. Anna Lembke:And especially kids. You know, kids, we have to connect. kids and kids' brains. Kids' brains are vulnerable. The frontal lobe isn't fully wired up to the limbic system. The kids are much more vulnerable to social judgment. They're much more social sensation-seeking. They're much more likely to take risks, or at least they used to be. Now the risks are online, which are riskier in some ways. So yeah, we have to think about you know, how we're rewiring kids' brains with the technology.

31:25Hunter Clarke-Fields:Yeah, you said in the New York Times interview, we're spending more and more of our energy and creativity investing in the online world, which means that we are actually leeching a real-life existence of our energy and creativity so that when we try to re-enter the real world, it actually is more boring because there's less going on because there's nobody there. I was thinking about that, like where people are on their phones and they're getting these hits all the time, all the time. And so then it's kind of filling this need in a superficial way. So then they're not getting the, yeah, they're not the real life.

32:06Hunter Clarke-Fields:It gets even less and less and less engaging, which is, I mean, that's horrifies me.

32:13Dr. Anna Lembke:Yeah, I mean, it means now when your spouse comes home and tells you about their day at work, like, you don't really want to listen because you'd rather go listen to your, you know, celebrity update or something. Right? So that's a problem. That's a genuine problem.

32:27Hunter Clarke-Fields:Yeah, yeah. Or you're not getting out of the house to do things with friends and then you're losing those social connections because you feel you're getting a semblance of it. You feel like you kind of got it, but you didn't really. It's not a real connection.

32:43Dr. Anna Lembke:Right. I mean, it's just so soothing. You know, it's this machine that we can use to soothe ourselves. We have a little bit of a buzz. We're entranced. And then when we try to stop, you know, we experience the come down that happens when you have to stop using any drug. And then there's this huge activation energy required to get ourselves to do anything else because it's so much harder relative to just like scrolling and consuming media online. So, and you know, this is gets right back to the pleasure pain balance being pleasure and pain relate to each other and they're relative, right? So if you're constantly consuming these soothing, pleasurable substances and behaviors, you're going to reset your hedonic threshold for what's pleasurable and what's painful.

33:33I know.

33:34Hunter Clarke-Fields:It makes me think of, you know, mindfulness, and I've studied mindfulness in the tradition of Thich Nhat Hanh and gone to the monasteries in the Plum Village tradition, Blue Cliff Monastery. And I think about that and how kind of what we do when we go on a retreat there is that we are retraining ourselves to, you know, and they are actively helping to train everybody who comes to find pleasure in things like the sound of the rain. or to find pleasure in the feeling of breathing or remembering that you are alive or the feeling of your footsteps walking or walking together through the woods, you know, collectively, the feeling of eating and the satisfaction of that.

34:25Hunter Clarke-Fields:And it's interesting and it's like really distilling down. It's almost like, you know, you talk about abstinence, right? in your sort of dopamine way of combating that. And it is kind of like taking abstinence was also actively encouraging and reminding people that you can find pleasure in very, very simple, essential things.

34:52Dr. Anna Lembke:Yeah, and you know, I think we often think of abstinence as sort of denying ourselves rewards, but really what it means is that we'll reset our reward threshold such that simple pleasures become rewarding again, which is exactly what you're talking about. And I think that's what, you know, it's not about denying ourselves pleasure or, you know, always living in pain. It's about how this constant comfort-seeking and pleasure-seeking is actually creating the pain that many of us experience living in the modern world and then to recapture some of that. The joy of life means to, you know, eschew these quick pleasures, intentionally pursue things that are challenging and difficult, and thereby get back the simple joys.

35:47Hunter Clarke-Fields:So do you think that we as parents should try to prevent our children from experiencing dopamine spikes? What would you say to that? Yeah.

36:00Dr. Anna Lembke:I mean, I think in general, you know, it makes sense to me to not expose our children to like constant comfort and pleasure and soothing, easy things.

36:20Hunter Clarke-Fields:A.K.A. the iPad. Yeah.

36:23Dr. Anna Lembke:I think to raise healthy kids, you know, they need challenge. I mean, we're really wired to strive. That's, you know, how we evolved and kids feel good and get a sense of competence when they overcome obstacles and difficulties. And that's what gives them, you know, confidence to make it in the world. So I, yeah, I do think that I would recommend that.

36:47Hunter Clarke-Fields:Yeah, we, in our family, we had for most of, until about a year ago, we had a screen-free Sunday policy. And that was when, you know, and they had limited screen time and other times. And actually, the listener knows this because this podcast has already come out. I recently recorded an episode with my 18-year-old daughter where she actually thanked me for limiting her screen time when she was little. Yeah. But anyway, they would that was that is when the pleasure of the projects would come out, you know, where the you know, the box would become the ship and all the different things. And that that's when that would come out.

37:31Hunter Clarke-Fields:And it was just wonderful to see this kind of deep play. where, you know, it goes on for multiple hours sometimes, and they're just absorbed in it. And you describe that in Dopamine Nation as like a kind of like the dopamine release of a project and the satisfaction and the sort of slow, steady thing. And that might be something that we're sort of aiming for, I suppose, with our kids. By maybe denying them what everyone else in the neighborhood might be giving them, we might actually be giving them more.

38:13Dr. Anna Lembke:Exactly. Yeah. And going back to that metaphor of the teeter-totter, those gremlins are actually agnostic to the initial stimulus. So if we intentionally press on the pain side, they will actually go over on the pleasure side and we will get our dopamine indirectly by paying for it up front. There's a whole branch of science called hormesis, and hormesis is a Greek term. It means to set in motion. And what we're setting in motion is the body's own healing, re-regulating mechanisms. There are more and more studies showing that when you expose all different kinds of animals to mild to moderate doses of painful or toxic stimuli, you actually make the organism healthier.

38:55Dr. Anna Lembke:They live longer, they're more agile, what have you. So things like extreme cold, things like spinning in a centrifuge, just various kinds of physiologic stressors. And the same is true for humans. I mean, this is what we call the runner's high, right? Oh, I got that once. I got that once. Yeah, exactly. So we know that when we begin a strenuous exercise, or exercise even as tolerated, It doesn't even have to be that strenuous. Dopamine levels rise gradually over the latter half of the exercise, and then they remain elevated for hours afterwards before going back down to baseline levels of dopamine firing.

39:35Dr. Anna Lembke:And you never go into that dopamine deficit state that is characteristic of intoxicants where we have that upward spike and then that downward deflection before going back to baseline or in addiction getting stuck in that downward deflection. so this is a better way to get our dopamine because by getting it indirectly we are protecting ourselves to some degree from the addiction cycle now can people get addicted to pain absolutely it's rare but we do see things like people addicted to exercise often combined with calorie restriction and the intervention there is similar what we would do for any kind of addiction, we'd have them abstain from exercise and calorie restriction, you know, for a period of time to be able to reset reward pathways.

40:26Dr. Anna Lembke:We see people who cut, and the reason that they cut is because it releases endorphins, our endogenous opioids, which then releases dopamine, which feels good. People actually get high on that. And the intervention there, you know, is that we would have people abstain from cutting for a period of four weeks. Again, that kind of dopamine fast early intervention until they get out of the state of craving, cutting, and find better, healthier, adaptive coping strategies. So the addiction lens can be useful for many different types of compulsive behaviors and substance use. But in general, we encourage people to do hard things as a way to accelerate resetting their reward pathways to a healthier level.

41:14Dr. Anna Lembke:And again, this can be exercise, it can be ice-cold water plunges, it can even be things like meditation and prayer, which when done consistently do tend to be effortful and aren't like an immediate high for most people, but with sustained effort can lead to quieting the mind and release dopamine and improvements in that regard. mm-hmm that's nice to hear that and you you talk about exercise in dopamination um on page 151

41:49Hunter Clarke-Fields:you say high levels of physical activity in junior high high school and early adulthood predict lower levels of drug use um which is so cool it's interesting that you're describing it as this like pain thing which is not how i think of it because i'm exercises are you know it's a must in my life, right? And people can't understand, I guess, like, or my kids watch me. Sometimes I do this body pump class, and sometimes I do it at home. I've got all the weights, and I'm, like, lifting these heavy weights and doing, like, five, six minutes of squats in a row. But it's, yeah, it's painful at the time, I guess you would say.

42:30Hunter Clarke-Fields:I mean, that is. I don't really think of it that way. But afterwards, for hours after, I feel so good. And if I'm in a bad mood, that completely, completely turns me around.

42:43Dr. Anna Lembke:Yeah, that's right. That's exactly right.

42:46Hunter Clarke-Fields:So yeah, you talk about in dopamine nation, some of the antidotes to our addictive nature. You just described some of them, meditation, exercise. When going back to our conversation about the smartphone, what would you say to parents and how can parents model healthy phone behavior and not go down that slippery slope of leeching their real world of energy and creativity?

43:21Dr. Anna Lembke:Yeah, well, I mean, I would say to parents, whatever you're doing now, it's never too late to do it a little differently. It's true that once your kids become teenagers, it gets much harder to intervene with those behaviors, especially if you've established certain norms in your household. It can be difficult to change those norms. But it can be done with a lot of talking about it and consensus building and also parents changing their behaviors too, not just expecting kids to change without parents also changing. In general, I say to parents that if you have a child under the age of 13 or even a little older, a child under the age of let's say 15, best to not give them their own personal device connecting to the internet.

44:09Dr. Anna Lembke:Wait as long as you possibly can. And then when you give that device or you give approval for such a device, make sure that it comes with warnings and disclaimers. that is to say you can give the device to take it away if the child is showing that they're really not able to moderate their use or use in ways that are socially appropriate and safe and have you know etiquette you know established again norms digital etiquette around when it's appropriate to use the device and when it's not like not at the dinner table and not when we have friends visiting and not when someone is trying to talk with you and not when you're doing your homework, right?

44:50Hunter Clarke-Fields:Yeah, and I always encourage parents to get that alarm clock.

44:57Dr. Anna Lembke:Oh, yeah, really basic.

44:59Hunter Clarke-Fields:Get yourself an alarm clock and don't use your phone for an alarm clock. Get all the phones out of the bedrooms, get them into the living rooms, downstairs in the kitchen, whatever. You know, just that physical, it's, I guess, as I learned in Dopamine Nation, It's like a practice of binding. It's keeping some barrier between you and the, you know, the odd thing that is addictive.

45:23Dr. Anna Lembke:That's right.

45:24Hunter Clarke-Fields:So one more thing. In the end of Dopamine Nation, you talk about some antidotes to our addictive nature. Awareness, radical honesty, and pro-social shame. And for me, it was like, hmm, okay, because I'm used to thinking of shame as kind of a destructive feeling because shame is this thing that I am bad, whereas guilt is like I did something bad. What is pro-social shame, and how do you see it as helping people?

45:55Dr. Anna Lembke:Yeah, I mean, whether you call it shame or guilt, what we're basically talking about is related emotions where we feel badly about something that we've done or said or, you know, a regret. Yet, typically, we might be inclined to lie about it in order to cover it up because the fear of being rejected by our tribe is so overwhelming that we would rather hide it and be found out and risk the fear of shunning. And shame can absolutely be a very negative thing and can perpetuate the problem of addiction, especially when combined with habitual lying. so that we lie about it, then we feel more shame, then we use to cover up the shame, and then we lie some more.

46:48Dr. Anna Lembke:And you can get into this really vicious cycle, something's called malignant shame or toxic shame, that can drive addiction. On the other hand, if we didn't feel some degree of shame for these behaviors, we also wouldn't be motivated to change them. So in many ways, shame is possibly our most pro-social emotion, right? because it's what gets us to adhere to certain types of expected behaviors that we need to adhere to in order to live in larger communities. And so the key to turning malignant shame into pro-social shame, I think, begins with truth-telling. That's this idea of radical honesty, which we actually prescribe to patients.

47:32Dr. Anna Lembke:We say, in addition to not using your drug of choice this month, we want you to engage in radical honesty. That means you can't tell any lies about anything. And the little lies possibly matter more than the big lies. So you can't lie about why you were five minutes late for the meeting. You can't lie about what you had for breakfast. You can't lie about where you are, what you're doing, or any of it. And what we find is that people in robust recovery from addiction have already naturally discovered that the lying habit is a harbinger and a part of addiction, whereas the truth-telling habit or radical honesty, rigorous honesty in AA is really necessary to maintaining recovery.

48:14Dr. Anna Lembke:We're not exactly sure what the connection is. I mean, I speculate in the book that it's related to the prefrontal cortex and that engaging in active honesty, which takes effort because we're natural liars, might actually strengthen our prefrontal cortex. The prefrontal cortex kind of acts like the brakes on the car when it comes to appetitive control. It's also true that when we're telling the truth. We promote intimacy, you know, when we're making ourselves vulnerable to other people, being honest. We think that people are going to be repelled by the things we've done. But in fact, they see themselves in us, in a mutual flawed humanity, and it often fosters intimacy and brings people closer to us.

48:58Dr. Anna Lembke:And that's a great paradox because we have a lot of resistance to being truthful about our, you know, warts and all. But when we really do share, it is a way to bring people closer, and then that's a wonderful source of healthier, feel-good neurotransmitters like dopamine. So yeah, so that's kind of the difference. That's what I talk about when I talk about pro-social shame. It has value as a pro-social emotion. Well, Anna, there's so much

49:27Hunter Clarke-Fields:here, you know, dear listener, if you are interested in how the brain works, if you're interested in our addictive nature and just want to learn about it, I highly recommend Dopamine Nation. I was telling Anna before we started talking that I, I mean, I read a lot of books and get a lot of books that are a lot of, that a lot of different things. And I really, really appreciate about how, how engaging Dopamine Nation is as a read. And it includes so much incredible information as well. So go get it. Everywhere books are sold. It's been a while now, so you maybe already have it and you can just tell her how great it is.

50:10Hunter Clarke-Fields:But Anna, I really appreciate you coming and I appreciate the way you've distilled your learning down into this way and the way you share it with the world with such measured steadiness and honesty. I find it all like super refreshing and I'm a great fan. So anyway, thank you for coming on the podcast and everything you've done.

50:39Dr. Anna Lembke:Well, thank you. Thank you for those kind words and for having me on your podcast.

50:48Hunter Clarke-Fields:This is so fascinating, isn't it? I hope you will share this episode with one, if not one, many friends today because I think it's so, so important to understand. And I'd love to hear your feedback. I'm on socials at Mindful Mama Mentor. And yeah, let me know what you think about this. I think this is so, so important and interesting and important for us to understand. And actually, I have an update for you. So when I talked to Dr. Lemke, I was, I had recently, Maggie had recently taken the apps, New York Times and Instagram and Facebook off my phone. And I have been keeping to it successfully pretty much.

51:37Hunter Clarke-Fields:It's kind of changed my relationship with my phone over the last few months. And I am feeling a lot better, feeling a lot less distracted, feeling more regulated, feeling more at ease and just kind of in my life um anyway so I recommend it if you can do that to just take that stuff off um so yeah and then like maybe go on on your laptop or something and tell me what you think of the episode how it's going and I'll cheer you on I promise I will um yeah So that's the update. It's been good. I did actually subscribe to the Philadelphia Inquirer physical newspaper delivered to my house every day. So I'm kind of like reinvigorating my, you know, physical, real life and everything's a lot better now.

52:34I recommend.

52:35Hunter Clarke-Fields:Okay, that's my update. All right. I'm wishing you a beautiful week. Thank you so much for listening. Next week, We have an awesome episode with Michelle Grosser about co-regulation and the nervous system, managing overwhelm. So check back in and I will talk to you then. Take care, my friend. Namaste.

53:08Dr. Anna Lembke:This episode is brought to you by ChatGPT. Hey, it's Bill Simmons from the Bill Simmons Podcast. Have you guys heard about ChatGPT work?

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