The Dopamine Expert: Doing This Once A Day Fixes Your Dopamine! What Alcohol Is Really Doing To Your Brain! Your Childhood Shapes Future Addictions!

27:12So I think that's a really good way to develop a addiction probably because they're reaching for that substance to self medicate their psychiatric problem the issue with that is that it's not medicinal right it's not healing although in the short term substances can help with those kinds of feelings of psychological and physical pain over time because of the way the brain adapts as we've discussed. Substances and other addictive behaviors just make psychiatric problems worse right as we drive ourselves further into the kind of you know the pain side of the balance so is this why trauma often needs to addictive behaviors because the trauma has caused a pain of stress and we're searching for ways to to medicate that pain or stress.

28:03Yeah to numb ourselves to not be present in our reality and have to deal with what's going on there. It's dopamine what roles dopamine playing it's all the same dopamine originally was to help us find those things that we need to survive food clothing shelter a mate we call those natural rewards but today that same reward pathway that relies on dopamine has been hijacked by all of these artificial rewards that our brain confuses as necessary for survival which is why people with severe addiction will be willing to lose you know not consciously but unconsciously their loved ones their homes their jobs everything they have in pursuit of their drug of choice it's because their brain has been hijacked and they now confuse the drug as necessary for survival the other thing about drugs is that they're incredibly potent they release a lot of dopamine all at once which again is confusing for our brain natural rewards require upfront effort where we do a lot of work and then we get a little bit of dopamine and that's what our brains evolved for.

29:16I mean I can that makes sense in my own life when I'm most stressed or most challenged by something professionally is when I immediately notice that my diet goes out the window I start eating things that about I actually stop going to the gym as much. And it's it can form a bit of a downward spiral kind of I guess we've kind of seen from the dopamine scale. Can I can I get back to that your question about trauma stress so there's a very serious there's a very interesting series of experiments in rodents mice and rats where they first of all rodents very easily get addicted to cocaine they will press a lever for cocaine until exhaustion or death.

30:02But if that cocaine is then taken away that behavior will extinguish which means that the mice will eventually just stop pressing the lever right because they're not getting any cocaine totally makes sense and then they'll go off and do something else in the cage. But if they're then exposed to a very painful foot shock right so a very extreme physical pain which you could equate to a serious life stressor. The first thing the rat will do is run over to the lever and start pressing for cocaine which tells us that once our brain has discovered a drug that releases a lot of dopamine in our reward pathway even after we stop using that drug if we are exposed to an extreme stressor.

30:53Our brain will tell us immediately go and do that thing that gives us a lot of dopamine because you are under stress and I need to be relieved of stress does that make sense makes perfect sense yeah so if you especially if you discover your drug of choice when you're younger and it's food or it's pornography or fits I don't know anything that really made you feel good for a moment moment of pleasure that will always become in the case of these rodents experiments. The thing you run back to when life gets hard right and we see that again and again in people in sustained recovery from addiction that when they are under stress that is a trigger potentially for them to relapse so they have to be really thoughtful in their lives for number one trying to avoid stressful situations and by the way stress can come in many different forms there's a great acronym in alcoholics anonymous called HALT.

31:51Hungry angry lonely tired those kinds of stressors every day stressors which we all experience hungry angry lonely tired can trigger us to want to use so people in recovery have to be really thoughtful about not getting too hungry not getting too angry not getting too lonely and not getting too tired at the end of this conversation I want to go through all of the sort of practical solutions that someone struggling with an addiction to social media pornography food whatever it might be. Can implement to try and shift that cycle that they might be going through especially when they're holding hungry angry lonely or tired how often have you worked with addicts have you spent much time working with addicts directly oh my gosh yeah so that's the bulk of my career is working with people with all different kinds of addictions in example of the most obscure the most I had a patient who was addicted to water.

32:46I know hard to imagine you have to though understand her narrative so she had a very severe alcohol addiction she got into recovery from that addiction and gave up alcohol but she discovered that by drinking copious amounts of water she could become hyponatremic meaning that she could lower the sodium levels in her bloodstream which would then lead her to become delirious and so in her desire to just be checked out she would do that she would she would drink large amounts of water she's doing okay no sadly she's not she she ended up taking her own life so that was very sad gosh in that situation was there was there a root cause of that behavior pattern further upstream some kind of trauma or experience that had set this sort of cascade cascading set of issues off yeah you know I'm just speaking broadly for for some patients with severe addiction trauma is a huge factor especially severe early childhood trauma but there are also many folks we see who have kind of great parents and have had happy childhoods and have great social networks and and work that they enjoy and yet they still become addicted and that's because we again we are wired to consume as much as possible of whatever releases dopamine in our brains to have survived evolution to this state and yet we're living in this world where we have access to so many drugified substances and behaviors that we've all become vulnerable to this problem and the reason I highlight this is because one of the things that I think has happened in the field of addiction medicine that maybe isn't the best is that oftentimes patients themselves as well as their providers are digging really deep to find the trauma or the reason that someone has become addicted and I think that that's important to do in some cases but in other cases it can lead to kind of manufacturing trauma where there really isn't any furthermore I would say that when a person is in the throes of their addiction they're not going to be able to really do the complex emotional processing of their trauma while they're still using their drug of choice that they really need to get out of that vortex of addiction and get into some degree of recovery before you would even want to go tackle some of those early traumatic experiences.

35:30How many people do you think are struggling with some form of addiction? Well if you think of addiction as a spectrum disorder right there's mild moderate and severe and there's I would even say a kind of a pre addiction state where we're all sort of dabbling in compulsive over consumption. I would say the vast majority of us like 90 probably 95 % have some degree of compulsive over consumption and you know if and when it tips over into what we would call addiction there's not a brain scan or a blood test to assess that it's not like you know switching a light a light switch and it's like oh yeah now you have addiction.

36:07It's not like that it's you know it's a gradual often a gradual and insidious thing and we don't in fact have a biological measurement of addiction we base it on what we call phenomenology which is patterns of behavior that repeat themselves across time and broadly speaking the definition of addiction is the continued compulsive use of a substance or a behavior despite harm to self and our others. And so you know that harm can be very subtle or not right and it can be a judgment call. Interesting because we do throw the word addiction around a lot in society but but really the most important part of that is to understand if it's harming yourself or someone else the behavior pattern.

36:52Yes that's right and to also recognize that we're not very good judges of that when we're chasing dopamine. Okay so we sometimes justify behaviors we have as being not harmful and it's fine and it's not impacting me at all and what you mean. Exactly and we don't we're not very good at seeing true cause and effect honestly when it comes to these behaviors which is why oftentimes people won't really see the harm until they've stopped using for a period of time. In your book dopamine nation you talk about an addiction that you had. Yes. And it was really surprising to me because I would never have thought that being obsessed with erotic novels could be classified as an addiction.

37:32What happened what was the behavior take me into that that phase of your life. So I was in my early 40s my kids were no longer little I got a lot of my self worth and identity from being a mom and my kids were sort of entering adolescents they were doing fine but they didn't want to be. They didn't need me as much so I had kind of a grief reaction you know in response to that was trying to figure out you know how to navigate this next phase of my life. I'd always been a reader and in particular reader of novels in my own way that was how as a child I self sued was to escape into the fantasy life of novels.

38:12But I never had what I would call a problem with it. And then one day I heard another mother at school said that she was reading this great book it was called Twilight it was about these vampires and she was going on and on about it. And I read it and I can't tell you what it was but it was just like the key in my particular lock it was completely transporting. It just released a lot of dope mean is all I can imagine in my brains reward pathway and so I read the whole series and then I read the series again and I read it again. And of course by the third or fourth time it wasn't as you know reinforcing and I thought to myself I wonder if there are any more vampire romance novels.

38:51And then for me the real tipping point was I got an e -reader I got a Kindle because what happened was I even before I got the Kindle I started reading you know novels that I would say would be slightly embarrassed to admit that I was reading like kind of bodice ripper novels. As time went on I needed more and more like graphic kinds of descriptions in order to find it pleasurable. And by the way that's classic for the addiction narrative right where you start out with a little bit and it goes a long way and then over time you build up tolerance that's neuro adaptation the grandma's pressing down on the pain side of balance now I need more of my drug and more potent forms to get the same effect gradually over time I started reading you know more and more sort of graphic erotic sexualized versions of this novel.

39:45And I would I was embarrassed so I would hide that I was reading and that gets into the whole double life of addiction where now we're lying about our use where we're using our drug over here but pretending like we're not. So my kids are my husband would walk in the room and I would be you know hiding behind another book one book behind another book so it looked like I was reading something you know I don't know more sophisticated. And then the tipping point for me came really when I got a Kindle or an e -reader and then my reading was totally anonymous I could read these books anywhere anytime no one knew what I was reading and as soon as I finished one I could read another one.

40:24And I almost overnight became a chain reader like literally when I wasn't doing something else that I had to do I was reading romance novels one after another after another which meant I was you know less present for my kids less present for my husband I would often stay up till two three four in the morning on a weeknight reading romance novels have to get up two hours later go to work is a hostage not able to be present for my patients not enjoying my work. Gradually getting more depressed more irritable more anxious more insomnia we went on a family vacation with a family friends of ours everybody together at this beach house all the kids playing I was like hiding in a room reading romance novels so it and this is exactly what happens with addiction is that our focus narrows and the things that we used to enjoy are no longer pleasurable only this one thing has salience for us we plan our whole day around getting it using it hiding our use and that's what happened to me.

41:30It's so interesting because I was as you're talking about that was thinking about all the behaviors that I have that are maybe isolating me or you know I just even things like spending a lot of time on the internet just watching video after video after video on YouTube or those kinds of things or just like spending tons of time in my WhatsApp group chat talking like roasting my friends about nothing. How do you know if like this is because on one end of the spectrum I could say okay well that's harming my relationship with people in the real world but it's helping making me feel good and it's you know maybe helping me in another department because I'm learning more about vampires.

42:16You know because there's there might be net harm somewhere else but then an upside over here which and then I start rationalizing this behavior like how do you just distinguish between these behaviors and know what's bad and what's good. You know what it's really hard. These digital devices are powerful tools but also very potent drugs there's no doubt that digital media lights up the same reward pathway as drugs and alcohol. These devices and platforms were designed to be addictive that is to keep us scrolling and tapping long beyond what we plan for or what we want or even what's pleasurable.

43:00I think we can all relate to using this medium to a point where we don't even like it anymore and yet have difficulty getting ourselves off of it. That really speaks to the inherently reinforcing and cognitively adherent nature of this medium it is a drug and so you know if and when and how we're crossing into addictive use. I think we need to be very vigilant about whether that's happened in our lives and one of the ways to do that is actually to try cutting out that particular digital medium that website or that behavior for a period of time long enough to experience with draw potentially reset reward pathways and then reevaluate because when we're in the behavior as you yourself noted.

43:54It's very easy to rationalize oh I need to do this for work. Oh I need to do this to stay in touch with my friends. Oh I'm learning so much from this right and all that may have been true initially but may not be that true anymore. And what I often point to is the subtler signs of addiction which are things like depression anxiety in attention insomnia restlessness these can be early signals for our consumption entering into that addiction range but us not realizing it because again we don't see cause an effect which is why doing an experiment like I did with my romance novels you know from the beginning of the day.

44:40Following in the footsteps of my patients and taking the advice I give them and I gave my romance novels up for 30 days right just to see like okay I think this is a problematic behavior can I give it up how will I feel and the very first day that I the very first 24 hours that I did not read any romance novel any novel at all. I was astounded at my level of anxiety restlessness and utter insomnia I had completely unlearned the art of putting myself to sleep without this digital narrative. And that lasted a good 10 to 14 days completely mapping on with the amount of time it takes typically to get out of acute withdrawal that is to say for those neuro adaptation grandma's to hop off the pain side of the balance and for homeostasis to begin to be restored but by the time I got to weeks three and four I felt not just better than I had in the first two weeks but actually better than I had felt in a really long time I enjoyed my kids more.

45:48I was more present for them I enjoyed my husband more my work seemed salient again I started think maybe I should do something else you know maybe maybe I you know this work I'm doing a long time I don't it's not that interesting anymore all of a sudden it was interesting again right so you see the relativity of that had done a pathway and how when we're doing that behavior substance that so reinforcing that everything else loses its salience we can really miss identify. And it's causing our irritability anxiety insomnia until we stop that substance for long enough to see its impact on our lives how is it making you feel because I think a lot of people can't understand how you could get addicted to a book I'm sure some people understand that but for me it's not something I've ever become addicted to so how how did it feel was it like exciting is it a rousing is it somewhere in between.

46:47I mean I think that romance novels are essentially socially sanctioned pornography for women okay and the medium is narrative and if you're a person for whom narrative is a powerful drug as it is for me a story and narrative a fiction very potent since I was a child then you know it was a natural that that that would be the thing that I would get addicted to and basically just like we've hacked and bio engineered everything to make it a good thing. It's a bit more potent I mean people there's a formula for writing romance novels like if you take a physical copy if you go to a store and you pick up a romance novel and you literally physically open it to two thirds of the way through you will get to the climactic scene pun intended right it's it's like it's engineered.

47:34I mean I got to a point where I wouldn't even read it read it I wouldn't finish the book I would go on to the next book just to get to the climax pun and you'd be like yeah and I wouldn't even read the day new mom or like what happens to the characters I didn't care you didn't care about no and also I didn't I got to point where I didn't care about the quality of the writing or the depth of the care it didn't matter it was it was the drug it was that moment I was looking for and you know there are a lot of free books on Amazon some some of which are high quality and some which are not but like you know any good drug dealer knows free samples that's way you hook people I would search for these free samples and that's part of it to like the searching for the drug so the working the work upfront work you do for the job.

48:15The drug is part of the drug right it's all that you know the machinations and hiding in this and that that gets to be part of like all the rituals surrounding it as you're talking as well I thought about work and work addiction yes because you earlier use the term excessive consumption and when I think about work even my work I think Jesus I excessively consume work I start so many bloody businesses and invest in so many things and if you look to that behavior objectively if you're like an alien looking down at me you go this guy's got a fucking problem you know what I mean you think that's funny yeah I you know I feel for you you know and it's funny because in society we then those people are reinforced we clap that's right we clap we got this guy's not sleeping he's working 18 hours a day clap clap clap give him a trophy and award name a thing after him or her or you know and it's just really interesting that that that addiction of work and you tell me if it is it can be an addiction and certainly in the scale of one and being sort of consumption excessive consumption the other hand being addiction is on there somewhere people can get addicted to work and part of the reason is that we've drugified work right when I say drugified what I mean it we've made it more potent and this is true for all all these drugs we've made them more potent more novel more bountiful meaning there's more of it and more accessible so if we break that down with work how is work more potent well certain types of work are more reinforcing not all types of work so for example works work white collar work is often now associated with stock options and bonuses right there's often like a social media aspect to it or maybe even a fame aspect or as you point out those are our cultural heroes right so you get all this you know adulation for being a workaholic and that also because we're such social creatures right and human connection stimulates don't mean that that also makes work more of a potent drug personal brand right right you're linked in oh my god this person got a promotion right right right the likes the comments your imagination or I just had the awards the trophies and then you've got the fact the fact of novelty so once we've exposed our brains enough times to a certain drug as I said we develop tolerance right and then we need more potent forms or novel forms one of the ways we overcome tolerance is by taking our drug and then changing it slightly like adding a little new molecule on this chemical right or on the internet you know when we're searching videos we want something similar to what we like before but just a little bit different and that's what the algorithm does automatically right it offered oh you should check this out oh how about this oh check that out right and that engages our treasure seeking function we're looking for that that novel thing but that's not too novel right it has to be in our category of things we like and I think for work we have that to like there're so many ways now that people can engage in their work and it's not all bad that's not going to happen and that's not a big that it's novel, but you know, certain types of work, it makes it very enticing.

51:27Then you have quantity, right? I mean, work never ends. There's like no natural stopping point for work. You know, you do a line of cocaine, you run out of money, you run out of cocaine, you're done. Right? But that's not true for work. Everywhere, anytime, and then that gets to accessibility. One of the biggest risk factors for addiction to any drug or behavior is simple access. We know that if you grow up in a neighborhood where drugs are sold on a street corner, you're more likely to try them, more likely to get addicted. If you live in a world where you have access to work 24 -7, you're more likely to expose your brain to more work and more likely to get addicted to work.

52:07Again, especially if it's got all those other reinforcing qualities. This is probably in part why people quit their jobs. You mean if they just get overwhelmed, or it's partially why people can never quit? But I think it's important to make a distinction between work that's reinforcing in those ways, and then work that's completely not reinforcing. Yeah. Alienating, mind numbing, work in which the actual task is separated from the meaning of a task. I mean, they quit their jobs either in search of more dopamine. So if I'm working in a job where, I don't know, maybe it once gave me dopamine, and now it's become monotonous and the same.

52:46Right. I need to quit to go find this. There's novelty for you. That's right. Yeah. And that's true. Many people change jobs every two to three years. I recently read that the average life of a business now is like 15 years. Whereas 50 years ago, it was 50 years. And there's all this turnover, all this churn, chasing novelty. Also, I do want to emphasize that people who are in work that's not intrinsically rewarding, but is the opposite, kind of soul sucking. That's also a risk factor for addiction, because people just wait till the end of the day till they can go home and then use a drug to numb themselves from the stress of work.

53:26So it's plausible that people who are in lower pleasure jobs are more likely to be overweight or addicted or dependent on alcohol. Yeah. Or simply opt out of the workforce as many young men are doing now in the United States. And what we know from data that's been collected as many of them are playing video games, right? They've just completely opted out of the workforce. I guess this in part explains why there's a drinking culture that's associated with people who are potentially lower class, because they're doing potentially less pleasurable work. And therefore, if we think about the scale, that they would then end up in the pub after work.

54:09You know, maybe that's partially true, but even people doing like doctors and lawyers, there are equal rates of alcoholism among those groups. I think what's happening there, though, is that the nature of the work is just so stressful, whether it's white collar or blue collar, that there's this kind of work hard play hard, right? Where I'm going to work all day, at the end of the day, I'm going to reward myself. So now you've got a pleasure pain balance that's going, pleasure pain, pleasure pain, and remember, the biological definition of stress is any deviation from neutrality, so that every time our brain has to work to restore level balance, we're actually triggering our stress response, triggering our own adrenaline.

54:51It's stressful to have to restore the balance from those extremes of pleasure and pain. I read in your book, you were talking about how different behaviors and sort of chemicals and substances have different impacts, and it was on page 50 of dopamine nation. In a study of mice, sex increases, the release of dopamine by 100%, and amphetamines, which is drugs, hardcore drugs, increases it by 1 ,000%, by this accounting, one hit of a meth pipe is equal to 10 orgasms. Yes. It's interesting to think about the different behaviors we have and how they'll have a bigger impact on our dopamine. Is there like any, in a typical order of things that are like extremely dopamine -inducing and things that aren't?

55:35What's at the top and bottom of the list? In your view. You know, I really think that it depends on the person, and we've got to look at drug of choice, right? I mean, potent drugs like methamphetamine, like opioids, like alcohol, like nicotine, like cannabis, are going to be very reinforcing for many people, but not for all people. And most people do have their one drug that they sort of prefer above all others. So, although generally speaking, intoxicants release a lot of dopamine in the reward pathway, I think every person is going to be different. And also, we don't really have good ways of measuring absolute values of dopamine in human beings.

56:20Right? We can do that in rats, but we can't really do that in humans. It's relative values. I've got this on picture here, which shows what looks like brain scans in normal person, but then in someone who's addicted to different substances. I'll put this on the screen, and I'll link it below in the description for anyone that needs it. I want to see it, but it effectively shows the impact that like cocaine has on the brain, meth, alcohol, and heroin. What is going on here? So, the red in this image represents dopamine transmission. So, how much dopamine is being released from the presynaptic neuron, crossing that synapse, binding to receptors on the post -ynaptic neuron, how much dopamine is kind of swirling around in the reward pathway part of the brain.

57:05And what this image shows is that on the left hand side, in healthy control subjects who do not have addiction, there's plenty of red. So, there's plenty of dopamine transmission in the reward pathway, specifically here, in the nucleus accumbens. But if you look at the right -hand column, you'll see that in these individuals who have been using cocaine, methamphetamine, alcohol, and heroin in addictive ways, there's almost no red, which means there's decreased or below normal levels of dopamine transmission. They are in a chronic dopamine deficit state. This is evidence of the brain trying to compensate for too much dopamine being triggered by down -regulating its own dopamine production and transmission, not just to baseline, but below baseline.

58:04And importantly, these individuals who are addicted to these substances, these brain scans were done two weeks after they stopped using. Oh, wow. Yeah, which tells us that this dopamine deficit state persists for some period of time. How long? Well, it depends on the person, but we know at least from this experiment that the first two weeks are this persistent dopamine deficit state, which is consistent with acute withdrawal. People feel, when they first stop their drug of choice, they feel terrible. They experience all of the symptoms of physical withdrawal that correspond with that particular drug they were using, usually the opposite of what the drug did, plus the universal symptoms of withdrawal from any addictive substance or behavior, anxiety, irritability, insomnia, depression, and craving.

58:57If they can get through the first 10 to 14 days, what we see clinically is those acute withdrawal symptoms slowly start to get better. And we think that that is mapping on to regenerating dopamine transmission in the reward pathway. And if they can make it to a month, that's usually the point for on average, based on clinical experience. When people really can start to get out of that constant state of craving for their drug of choice and begin to see some light at the end of the tunnel for what their lives might look like if they can maintain absence from their drug. And we can't just inject or drink dopamine.

59:40I mean, the guess that would be like drinking alcohol. We can't just artificially mess with the balances to try and restore the dopamine levels in an addict. Can we? Can't just add a little bit of dopamine? Yeah, it's a great question because we have some natural experiments that suggest what might happen if we do that. So as I mentioned before, people with Parkinson's have depletion of dopamine in the substantioneigra. That's what causes that motor disease. The treatment for it is to give L -dopa, which is a dopamine precursor. If I were to give you a spoonful of dopamine, it would do absolutely nothing because it doesn't cross into the brain.

1:00:15It doesn't cross the blood brain barrier. But I could give you L -dopa, which is a precursor chemical that would cross your blood brain barrier and get turned into dopamine and then diffusely bind dopamine receptors in your brain in the reward pathway, but also in the movement pathways. When we give patients with Parkinson's dopamine in this form, that can temporarily improve their movements. But in about one in four Parkinson's patients, they will develop a denovo addictive disorder, shopping addiction, sex addiction, other types of addiction. Because we have the same problem, we are stimulating the reward pathway with dopamine that is ingested exogenously from the outside.

1:01:05And our brain reads that as, oh boy, got a compensate by down regulating dopamine transmission to below baseline, which then puts us in that addiction vortex. Does that make sense? It does. So we have to... I mean, it tells me that we have to live lives in a certain sense of... We have to live our lives in a certain sort of homeostasis. And it's so easy not to, in the world we live in. It's like impossible to live in a perfect, homeostasis balance in the world we live in. Right. Even more than having to try to live within this sort of narrow range of homeostasis. In the world we live in today, we probably have to intentionally do things that are painful.

1:01:50Do things that are hard. Pleasure pain balance. Yeah. Like we learned that when we press on the pleasure side of the balance, like with alcohol or pornography or romance novels or cannabis or whatever it is, right? No sooner does that happen than our brain adapts by those neuro -adaptation groundlands hopping on the pain side of the balance to bring it level again, but they like it on the balance so they don't get off right when it's level. They stay on until we're tilted. An equal and opposite amount to the side of pain. That's the come down the hangover, etc. But it turns out the opposite is also true.

1:02:23If we intentionally press on the pain side of the balance, for example, with exercise or an ice cold water bath or intermittent fasting, those groundlands will hop on the pleasure side of the balance and we will get our dopamine indirectly by paying for it upfront. And there are studies in humans showing that when humans expose themselves to exercise, for example, dopamine levels gradually rise over the latter half of the exercise. And then when the exercise stops, dopamine levels will remain elevated for hours afterwards before going back down to the baseline level position without ever going into that dopamine deficit state.

1:03:06So it's a great way to get our dopamine indirectly because it's much less vulnerable to that compulsive craving phenomenon of overuse. So you're not going to get an exercise come down? You can, and people can get addicted to exercise, right? But typically it's very unusual because the upfront cost to do the work and endure the pain of exercise in the first place, mitigates our vulnerability to an exercise addiction. And in general, okay, it's so hard to do that it's going to be hard. It's not like pulling a lever on a slot machine or clicking on a porn website. It's difficult. Okay. So fighting for the dopamine is insulates us against the chance of an addiction having to really fight hard for it.

1:03:55Okay. And this kind of explains, I guess, in part why I pulled out some stats ahead of our conversation today that from 1996 to 2008, participation in ultra -marathons has increased by 1 ,676 percent. The ice bath market is expected to rise from 350 million in 2024 to nearly half a billion by 2030. The number of people taking part in obstacle course races like Tough Mudder or Hyrox, et cetera, et cetera has increased by almost 7x from 2010 to 2017. It seems like in society there's this counter movement towards people seeking out hard dopamine, chasing pain. Yeah, those are amazing. I didn't know that.

1:04:40Those are amazing numbers. In general, there's a part of me that wants to say, well, that's a good thing. But there's another part of me that's wary also because we're so good at drugifying everything that we do that there's a way in which these types of behaviors can also be drugified, right? Made more potent with all of the technology, the way that we count ourselves, the leaderboards, the social comparisons, all of that takes this thing, which is really in its natural state, kind of impervious to addiction. Like you just typically wouldn't get addicted to these types of painful physical activities.

1:05:18You would do what you needed to do for survival. But we've managed to make them addictive in all these different ways. I still think it's a better way to get your dopamine. Like I really encourage exercise. We always talk about movement as medicine. And in general, our life is so convenient, so easy, so passive, so sedentary, that I'm telling patients all the time, you know, get up off the couch, move your body, walk around the block. I think that's the bigger obstacle right now is just getting people to move. But I do think we need to be wary of not going too far in the direction of like the ultra, ultra, ultra, whatever it is.

1:05:55So what is a better way to live if we're trying to optimize for happiness and to keep our dopamine and balance and not have the crashes, etc. and come down and hang over? What is a optimal way to live our lives? Do we have to look back at our caveman ancestors and live like them? I think that part of the problem is that we've organized our lives now around rewards. Almost everything that we do is predicated on the feel good moment we'll have at the end of it. And because of that, we are missing out on the process. We're projecting our psyche forward into the future toward the reward and not able to really be here in the moment.

1:06:41Okay, this is going to be sound weird. I'm going to give you a weird example. So I'm driving over here today. I found I was nervous for this interview. And in a way looking forward to it, but in a way wanting it to be over, right. And seeing that in myself, I thought that's so sad. Like that's so sad that we live our lives that way. Myself included always this weird blend of wanting whatever we're doing to be over. So then in a way, we can just go hide and do whatever that self -stim thing is that we do where we're safe and we're like, you know, stimulating ourselves in some way. And then I thought, well, what if I knew that I was going to die right after, this is making me, I've been awfully weird now.

1:07:23But what if I knew that I was actually going to die right after our conversation today? That totally changes my perspective, doesn't it? Because this time you and I have, that's all I got. It's over for me when this, so this conversation is it. I really better be right here right now and really taking joy in whatever you and I can find together. And I think the more we can do that, the better. What's happening now? You're removing the thought of the outcome, the rewards, the potential, you know, failure or whatever, and you're focusing on just being present. And in doing so, what is happening?

1:08:00It's a great question and I've actually given this quite a lot of thought because I remember when I was in college and I, you know, met some like Zen people and they were like, be here now, be here now. And I thought, well, whenever I'm here now, I'm miserable. Like I don't like me and I don't like being in the world. I don't want to be here now. I want to be somewhere else. So I didn't really understand what they were getting at. It really took me, you know, till I had lived quite a lot of life and had some, you know, some significant experiences and given it some thought that I realized, oh, be here now means be here now and be uncomfortable and be okay with being uncomfortable and being okay with not being able to control my pleasure or my pain or my comfort level, but just being open to whatever comes.

1:08:55And I think that's a really a key shift that I'm not trying to control my experience in the moment and that it's okay to be unhappy or restless or uncomfortable and not trying to run away from that, but just really turn and face it and embrace the discomfort, which I also think is quite universal. I don't think I'm alone in that. And then the key piece about not not anticipating the reward is helps me be in the moment, right, because I'm not just waiting for the good thing to come after. I'm saying to myself, imagine there's nothing good coming after, nothing at all, right? There's just there aren't rewards.

1:09:36This is it. And then also being able to say, and it's okay if in the moment, like it's not great, like I can embrace that, you know, I can be unhappy or restless or anxious or whatever it is. And then when I do that, you know, I feel like there's a funny, funny thing that happens and all of a sudden, I'm not as anxious, right? And I am present and there is some joy there. Interesting. So when you allow yourself to deal with being uncomfortable in the moment, it turns out, it removes the thing that was making you uncomfortable in the moment, which is like the avoidance or the worry or overthinking, whatever else.

1:10:19Yeah, I think we have this, and it's fed by modern culture, this kind of expectancy that really we should be happy all the time. And then if, you know, if we have arranged things appropriately for our lives and we've done our work and, you know, aimed true, then we should just be like, life is great. And I don't believe that anymore. I think that, you know, I mean, like Buddha said, life is suffering, but I really think that fundamentally, like it's uncomfortable to be alive. And that it's a kind of a constant state of restlessness and discomfort. If we're being really honest and tuning in, when I really let myself see that and feel that, all of a sudden, I'm freed from some of that.

1:11:11What has caused your anxiety throughout your life in the moment? You referenced earlier that some things have happened that have led you to understand this better and understand yourself better. What are you missing from this jigsaw puzzle? Yeah, you're good. You could have been a psychiatrist. No, I'm really here. It's always time. It's not too late. You get an impression. Yeah, I think, you know, for me, the big turning point was that we lost our, we lost a child. And in the immediate aftermath of our child's death, I was just determined to like sort of undo the experience and, you know, get enough psychotherapy and enough, whatever it took to sort of not feel that pain.

1:12:03And it wasn't until I really just said, oh, I'm going to feel this pain for the rest of my life. It's never going away. But suddenly, I felt some relief from that pain. And that was a real window for me. So interesting that it's acceptance. Yeah. And, you know, and I think, you know, one of the reasons I love treating patients with addiction is because I really relate to that hitting bottom moment. You know, that moment when it's like, you just have a feeling that like everything I try to do to manage this behavior or to make my life better only makes it worse. I felt like I had a very similar experience.

1:12:48And that it was only one I kind of realized, oh, I, yeah, I, I can't run from that. I cannot run this pain that I began to have some, the beginnings of relief from that experience. I can't outrun this pain. So natural sort of disposition to try and outrun pain, isn't it? That's the irony, right? We're really wired to run the pain. We are, like we reflexively seek out pleasure and avoid pain. And yet that's the very thing thing that doesn't get us to where we want to go. But we do now live in a world where it's very easy to outrun the pain. Yes. This is not a line that's chasing me. This could be a bad email.

1:13:30And then I open up a tab and start doom scrolling or open up a tab and start watching video playing video games or pornography or whatever. Yeah, that's exactly right. There are so many ways that we can now distract ourselves from, you know, our own suffering or our own awareness. And what do you find yourself now with dealing with that grief and the pain? As we sit here? Yeah. I mean, I feel like in many ways it's been a real gift in my life. You know, it's really informed my life in ways that, I mean, I've learned things from that experience that I think it would have been almost impossible for me to learn otherwise.

1:14:10You deal with a lot of people that are in a state of suffering.

1:14:17I imagine that's a weight because I even hearing the story of the lady that passed away after that water addiction, it was like a weight on my shoulders just to hear it. So if your profession puts you right at the heart of this type of suffering, how do you manage that to hold that weight? A couple things. First of all, a lot of people get better. And when people with addiction get better, it's so much better that it's incredibly rewarding to see. And they're amazing people, absolutely, like some of the most tenacious, talented people you'll ever meet. And when they get better, it impacts so many other people, right?

1:15:02They're friends, they're family, the people they work with. So it's very rewarding work and not at all burdensome. Of course, for patients who don't get better or patients who die, it's a terrible feeling. And there is a sense of responsibility and guilt. Even when I feel like there was nothing that I could have done otherwise, I carry those losses with me, so it's hard. Is there any particular cases that have stayed with you the most? I mean, every patient I've had who's died while under my care, those are incredibly painful. And I will never, you know, those are sort of it. Those people will be with me as a part of me for all of my life.

1:15:49Young and old? Yeah, young and old. Yeah, it's especially tragic to lose young people. And it always feels like they're second -guessing. Like, oh, if only I had done that, or if only we had intervened here. But I just think that's the nature of death. We can't get away from the feelings of guilt around it, no matter who we are and no matter the circumstances. How young can addiction and the consequences of addiction ruin someone's life? Like, how young can someone be when their life is ruined? From the work you've done and the patients you've worked with, and what are those addictions typically that seem to be most susceptible to those that are young?

1:16:29Well, I mean, you know, some kids start with drugs and alcohol, you know, 5, 6, 7, 8, I mean, 5, 6, 7, 8. Yeah, I mean, it's, you know, some kids use with their parents or their caregivers, they're exposed very early. If we seriously conceptualize digital media as a drug, I mean, then we've got, you know, even younger cohorts starting with that. And we do know that kids can get addicted to digital media. And as a result, die from that. I mean, there was just this tragic case of a young man who essentially got addicted to a chat box. I think he was 14, not my patient. It was written up in the New York Times and the Wall Street Journal.

1:17:13And he fell in love with this chat box, started to isolate, wasn't spending time with his family or friends, and then eventually took his own life purportedly so he could join this imaginary person.

1:17:28What's the youngest patient you've ever seen? The youngest I've seen is probably around 15, 14, 15. And they had an addiction. Yeah, usually cannabis, alcohol, nicotine. Can you get addicted to cannabis? Oh, yeah. Oh my gosh. Cannabis is very addictive. Really? Oh, yeah. Yeah. Harmful? Very harmful. The target organ that it damages the most is the brain. It's harmful in many ways. I mean, number one, it demotivates people often. And so they can have the feeling that they're getting a stuff done or that they're creative when in fact they're not doing anything. Most people smoke it. And so it can be damaging to the lungs and other other organs.

1:18:18A lot of people say that, well, cannabis isn't addictive because I don't have this standard withdrawal phenomenon when I stop. Like, I don't have the shakes or anything like that. But keep in mind, the universal symptoms of addiction are psychological symptoms, anxiety, irritability, depression, insomnia, craving. And people have that in spades when they try to stop using cannabis. Plus, we often see something called the hyper -emesis syndrome. So cannabis can help with nausea and vomiting. It can help decrease the feeling of wanting to vomit. But again, as the brain continues to be exposed to it, there's this process of neuroadaptation.

1:18:56It stops working and it can even turn on them and do the opposite. So eventually people can actually have a cyclical vomiting syndrome as a result of cannabis. So they'll show up in the emergency room and say, I can't stop vomiting. And the reason is because of the cannabis that they may be initially started to stop feelings of nausea. On page 40 of dopamine nation, you say, we've lost the ability to tolerate even minor forms of discomfort. And as I was reading through this section of your book, I was thinking, it sounds like we've gone a little bit soft. We've reset our pleasure pain thresholds to the side of pain that even the slightest thing feels like trauma to us.

1:19:39Even things that objectively speaking, a generational two -ego would not have been considered traumatic are now trauma. We live in a bit of a trauma society. One that doesn't appear to be very resilient. And the only measure of that that I have is, if I think about the work that my grandfather had to do versus the work that people, maybe in my generation, do and complain about and seem to be objectively suffering over and stressed about, it seems like there's been a shift in our threshold at our tolerance levels. Can this be explained through dopamine? What's going on here? And do you believe that's true?

1:20:09Have we gone a bit soft? I would say succinctly, yes, I do believe we have gone a bit soft, but I don't think it's a moral problem or a character problem. I actually think it's a physiological problem based on the fact that we're insulated from pain and we're exposed to all kinds of pleasures. So I really think that we have individually and collectively reset our reward pathways to the side of pain, meaning that the Gremlins have now accumulated on the pain side. We've had so much pleasure. Because we've had so much pleasure. Yes, thanks for having me clarify. So that now we need more and more pleasure to feel any pleasure at all.

1:20:47And the slightest little pain and we're experiencing excruciating pain, you add to that the fact that we have a culture that tells us we should never be in pain and that if we are something's wrong with our life or something's wrong with our wife or something's wrong with our job. And so now you've got a whole generation of folks who feels like they're experiencing more pain because they're literally do not have the mental calluses to tolerate pain. And now they're being told, and if you have any pain at all, you must have something wrong with your brain. Go see a doctor, go take a pill. And I think this is really, this is not a direction we want to keep going in.

1:21:28We have a mental health culture where we assume most things are mental health illness. In page 186 of your book, you say, I've become convinced that the way we tell our personal stories is a market and predictor of mental health. Now if you live in a society where everything has a label and it's a it's a disease or an illness or you know, I don't feel good today. So I've got this disorder and therefore I need this medication. I guess there's two questions. Is my assessment of this situation correct? And B, is this a bad place to be in a society where we think everything, every feeling we have every, you know, we think everything that makes us different is a deficiency?

1:22:07Let me let me start. Let me let me answer this by talking a little bit about the role of language and narrative because I think this is very fascinating. And you know, as a psychiatrist and a therapist, that is my bread and butter, right? Is narrative, how people tell their stories. By giving language to our experience, we gain awareness of our conceptual models of the world. And what I have learned over time is that the way people tell their stories is a window into their model of the world and that there are healthy narratives and not so healthy narratives. And in general, in my clinical experience, when people come into the room and they tell their life story in such a way that they're always the victim of other people and circumstance in the world, those are people who are number one, not doing well.

1:23:08And number two, not going to do well, going forward unless they change that narrative to acknowledge what they've contributed to the and the reason for that is because the way that we narrate our lives is not just a way to understand our past, it actually is our roadmap for the future. So if I see myself as a victim and that's my narrative, I will literally create victimhood for myself going forward. I will literally change my sensed experience so that whatever happens, I'll make sure I end up as a victim. When people with severe addiction get into recovery, one of the most palpable changes that I see is the way that they narrate their lives.

1:23:56They go from in addiction talking about their lives as if it's always everybody else's fault to in recovery talking about their lives in a way that says, oh, you know what? I could have done better here. Or you know what? That's something that I keep doing that really messes with my life that I want to change and I'm going to figure out how to change that. Why is it so hard to take responsibility in such a way? Great question. We just hate to do it. Because when we do it, we feel shame and shame is an incredibly painful emotion. It's like a gut punch of an emotion that is associated with fear of abandonment, fear of being shunned by our tribe.

1:24:36We'd much rather paper that shame over with anger and resentment toward others. It's interesting because there'll be a different groups of people listening to this now. There'll be the high responsibility group that just love and revel in taking responsibility because they think taking responsibility means that they are strong. It means that I'm so strong I can take the blame and withstand it. And it's funny because the more I've learned to take responsibility for things in certain areas of my life, the more I've become proud of myself and the more I think I'm strong and I'm like, oh, look at me, I can take responsibility for anything.

1:25:09And then if you go down this spectrum, you'll eventually get the end of the spectrum where you've got people who even as they heard you say that will feel cognitive dissonant. They'll feel a sense, like a little irritate them. It'll piss them off and they will be the what about Trigank. They'll be saying, yes, but what about Dave? He did this to me and they'll meet like that immediate reaction would be they're pissed off. They've probably gone now. They've gone. So we're not even talking to them anymore. But if you say, that's fine, we can talk about them. They're no longer here. But that group of people, my question really is, how do you speak to that group of people and convince them that actually taking personal responsibility is a good thing for them.

1:25:47And if they're focused on what their core values are, their North Star is in their life, and personal responsibility is the path there, not blame, not victimhood. How do you turn those people around? Great question. And I have to say, what I know about this, I learned from alcoholics anonymous and what they do, because they do something that's really incredible. First of all, it's necessary to validate somebody's victimhood. So this is to say, you have been wrong. If they really have been wronged to validate that, or you experienced this trauma, or you were born into this crappy situation and you were just a kid and you had no choice about that and to really acknowledge that.

1:26:30But then the fourth step of the 12 steps of alcoholics anonymous talks about looking at each of those situations and after writing down like this person wronged me, and exactly what they did. So taking time to focus on the resentment, right? Then only after that to say, okay, but is there anything that I did that contributed to that problem? Is there anything at all that I could have done differently? And for a little kid born into a horrific situation, there's not much, right? That a kid could have, we don't expect a child to take responsibility, but the adult who was that child who continues to perpetuate some of the harms they experienced on other people, now we're talking.

1:27:25Now you can begin to take responsibility for your actions in the world. So I think starting with validating the trauma or the victimhood or the way in which we were wronged, processing it, so giving it airtime, right? But not stopping there, which is by the way often in therapy, certain types of therapy, that's often where we stop. We don't then take it that in very important next step and say, but let's go and look at that again. Is there anything at all that you're contributing to this problem? Maybe it's just that you continue to ruminate about it, right? That you're ruminating on your resentments in a way, you're happy place.

1:28:14And maybe that's what you need to stop doing. So that form of psychotherapy that stops there can help keep us sick and make us sick. It's interesting because someone that's in that therapy room who has ruminated themselves all the way down to having a low self -esteem, being depressed or whatever, it appears to me that people who are at that sort of ground floor state find it hard as to take responsibility for some reason. That's an observation in my life that the people that I have met that are the worst or that struggle the most with taking responsibility of those that have a very low self -esteem.

1:28:49So it's almost a double -edged catch -22. And then I've also pondered whether someone that never takes responsibility is more likely to have bad things happen to them, make mistakes, which are then going to further hurt their self -esteem, which are going to make it even harder to take responsibility. So I guess the question is, is there a relationship between my current self -esteem and my ability or inability to take responsibility for a situation? Yeah, great question. I bring us to mind a patient of mine who said to me that and he had very, very low self -esteem. And he said, essentially, Dr.

1:29:27Lamke, I'm the piece of crap around which the universe revolves. Meaning that he had his own brand of narcissism in which he wasn't the most successful person. He was the most successful at being the least successful person. And that became his identity, right? That was sort of how he saw himself and also how he saw the world. And it became very entrenched. And it was a kind of a narcissism because he created then situations in order to perpetuate like, I'm the worst of the worst. So I think the ways in which we get these sort of entrenched ideas about ourselves and the world can really hold us back from seeing clearly who we are, who other people are, and what the possibilities are.

1:30:22There's our personal narrative need to be positive. I mean, what do you mean, my positive? Like, bra, I'm great. Almost like have a positive ending because I'm thinking about the personal narrative I've created in my life. And my personal narrative is like, kid born in Africa, came to the UK, a little bit of racial abuse here and there, felt different shame. In security, parents weren't around. This made me independent. The shame made me motivated. And then I did this, this, this, and well, that's like my personal narrative. But if my personal narrative was moved to Plymouth from Botswana and Africa, a little bit of shame, a little bit of pain, parents weren't around.

1:30:56My parents didn't love me. People don't love me. Right. Right. If my personal narrative ended there, would it be, you know, would it be detrimental to me ever becoming successful, happy, healthy? I'm just wondering if, because we all have a personal narrative, we have like a story. If we're up on stage and someone passes a mic to us and says, tell us your story, we'll narrate this version of events, skewed towards victimhood, to heroism, yeah. I mean, as I said before, how we narrate our lives is important, right? It's, it's not trivial. And there are healthier narratives and there are not healthy narratives.

1:31:33And I would argue that the, you know, the victim narrative where, you know, perpetuates victimhood, you could make the same argument that the, the hero's journey narrative perpetuates herohood. Having said that, if we get too stuck in any fixed identity or any narrative, I think that can become its own trap, right? And then we wall ourselves off feeling like we have to show up in a certain way or be a certain person. And I wonder if you have that experience, I know you have this, hero's journey and now you've got to be this hero. And I mean, I can imagine that that would be burdensome at times.

1:32:08Yeah, I think it causes a lot of like dissonance internally. What I mean, like just so when I say dissonance, I mean discomfort internally because people meet a version of you that doesn't reflect the version of you that you know. So like the experience you have when you go, like I go to the gym or something. Yes. And I say this to my team all the time. Anyone that knows me personally, you know, his head me say this 50 times. I will say the phrase, I just don't understand what these people are talking about. Like I just don't get it. And I said to my team the other day in the office, I went, it's almost like I think they're lying to me.

1:32:37And I said, I was in this meeting. When you say you don't understand even when they when they praise you or, okay, yeah, yeah, yeah, it's so yeah, unbelievable. Yeah, what they're saying to me. Yeah, that it, that it feels like you're, I've never been watched a Truman judge know what it means, but it feels like this is just these people are just all lying to you. Yeah. And I said, I was said, I think we're talking to Jack and the team the other day about going to Thailand and being so far away from home and people coming up to you like thousands of people were doing this meeting great thing and saying these things to you.

1:33:08And I said to the team, I was like, I think it's like it's part of my brain that's like these people are lying to me. And also, yeah, you can see how it can be a slippery slope to slide in to their narrative of you. Right. And you've got to do quite a lot to just like stay at home. What do I mean by stay at home? I don't mean like physical location. I mean like staying grounded in like who you actually are. Right. And this goes for people that obviously have a public platform or don't. It's very easy for one person on the internet to say something to you and then to start to accept that as your narrative.

1:33:41It's easy for your parents to tell you that you should be a doctor and then you go to university and you study to be a doctor and you become a doctor and then you start thinking you're a doctor and how that can sway you away from the full array of things that make you who you are. The music, you know, the whatever hobbies you had. Narratives are comfortable sometimes. They make us feel heard and understood. They make us fit. Yeah. But they also are a double -edged sword because they can take us away from like who we actually are. Yes. Yes. So when I think about, you know, your experience of feeling like people must be lying to you.

1:34:17I mean sometimes we call this something like the imposter syndrome where you feel like that. Interesting. I never thought of it like that. You know, a projected, yeah, projected personal persona that is, you know, true in a way but also doesn't capture the fullness of who you are or maybe is so extreme in terms of looking good that it's inevitable that you'll feel some dissonance with that kind of heroic figure. And I think the way to think about that and also, you know, not become like cynically suspicious of people who who who who praise you when they meet you is just to recognize that you have become a kind of cipher or a vehicle for their projections.

1:35:03So they've listened to you. They've had a very positive experience or maybe they learned something and it meant a lot in their lives and you were the vehicle for that. And so you're a symbol for them and they're projecting positive feelings onto you and because you're now integrated in their mental tapestry as kind of a, you know, a totemic figure or a token, something important and symbolic. Interesting. Because what are you just as you're talking? I was thinking, you know what's interesting? I don't even, I'm not even the smart one in this. I'm interviewing these smart people. No, no, the smart people are changing their lives and that's what comes up to me in Thailand and so you're wrong about that.

1:35:41So you're obviously really smart and you also have, you know, a really high emotion quotient, right, which is its own kind of underappreciated smarts where you read people really well and you have intuitive reasoning. And I mean, I don't know you, but you also seem very humble and real and so all of these things that people have a craving for, you know, authenticity, someone they can relate to, someone familiar. I mean, keep in mind too that more and more people live alone and have maybe fewer close contacts. So a person like you with a regular show that they tune into regularly, you become, you're in their living room.

1:36:25Yeah, you're not just some distance, so I were like, you are your voices there, your faces there, they feel they know you because they've seen you in all these different situations. And I think that's really natural and normal and not a bad thing. So you just have to realize when you go out into the world, you know, you become a symbol for people. They're projecting onto you. You don't have to necessarily identify with that, but it's okay to let them have, you know, their experience through you. If that makes any sense. It makes a lot of sense. Okay. Yeah, no, it makes a lot of sense. I felt the same in Poster syndrome, as you said, everything now.

1:37:03It's like that's some very kind of you to say, but it's just for, I think part of the dissonance comes from the fact that I sit here in a room with you. And there's only the person in this whole room where in this big studio here in Los Angeles is Jack. Yeah. And so there's part of your brain, the like prehistoric brain that thinks the three people that are aware of what happened in this room are me, you and Jack, that's it. And then you go to top, you go to quit. Right. It's amazing. And the key to touching the gym and goes, that conversation that you had about addiction. Right. And that's the dissonance like you and that.

1:37:35But it's, I don't know, the prehistoric brain might not be able to fully comprehend the ideas of cameras and numbers. Right. People are listening in the middle. Right. Oh, no, they feel that they're there. And they, and again, you know, the guests are totally secondary because they're watching because they're identifying with you. And the questions that you ask, as you yourself said, are questions that you anticipate they would want to ask, right. You said that. So you are also channeling them. When it comes to food, I trust my gut and I trust Zoe, a business I'm an investor in and today's sponsor of this podcast, all the nutritionists I've spoken to have highlighted just how misleading information is out there when it comes to food.

1:38:13Take healthy halos, the claims you see on packaging, that say things like low sugar and nothing artificial or often a sign of foods to avoid. Have you ever noticed a health claim on fresh fruit? You probably get my point. Understandably, there's loads of distrust out there. Who should you turn to for accurate information? I, you Zoe, which is backed by one of the world's largest microbiome databases and most scientifically advanced at home gut health tests. Zoe gives you proven science whenever you need it. As a Zoe member, you'll get an at -home test kit and personalized nutrition program to help you make smarter food choices that support your gut.

1:38:49To sign up, visit Zoe .com and use my code Bartlett 10 for 10 % of your membership. That's Zoe .com. Code Bartlett 10. Trust your gut. Trust Zoe. Q1 is often when businesses start implementing new systems and processes in hopes of creating efficiencies for the year ahead. And over the course of my career, I've learnt just how crucial having the right systems in places, one which has helped me across many of my investments is NetSuite. They're also a sponsor of this podcast. NetSuite is the number one cloud financial system through their streamlined platform. You'll find all of your accounting financial management inventory and HR in one place.

1:39:27Their technology has been a real game changer, especially for my team at Flight Studio. As over the last year, we've moved out of startup mode and into scale at mode. We no longer have to juggle multiple systems and having everything together has reduced the number of manual tasks and errors. Over 41 ,000 businesses have chosen to future -proof their business with NetSuite. So if you'd like to learn how it can help your business, head to netsuite .com slash Bartlett and free download the CFO's guide to AI and machine learning. That's netsuite .com slash Bartlett. On this point of how we help someone in our lives who's suffering with some of the things we've talked about today, what is a bad way to try and help someone?

1:40:07Because we're in our love for them sometimes we do things, which even in my own experience of people that are struggling in my life, I think actually I think in my pursuit of helping that I've actually hurt them in some way. Yes. Well, you know, there's this whole sort of area of the addiction field called codependency. And codependency refers to the ways in which a loved one of the addicted person can actually enable or make their addiction worse without realizing it and without intending to. And the way that essentially happens is that we can, well, number one, addiction is very often a family systems problem.

1:40:47So the person who gets addicted, their addiction affects everybody in the family. And in order to cope and compensate, the families can end up in these very strange, maladaptive places. But they often have difficulties seeing how to get out of those situations or how their behavior is harming their addicted loved one. Because in a sense, they themselves get addicted to the addicted person and then use that addicted person to regulate the way that they feel. So for example, I treat a lot of families where like the adult child is deep in their addiction. The parents know that the money they're giving the child is mostly going to drugs and yet cannot bring themselves to stop giving the money.

1:41:32And often they're manipulated by the child, the child saying, well, the adult child saying something like, well, if you don't give me money for drugs, I'm going to go get it off the streets and it's going to be lace with fentanyl and then I'm going to die and it's going to be on your hands. So this kind of like emotional hostage taking. But even when it's not that blatant, what can happen is just this very fascinating, very twisted and meshed relationship between the addicted person and the codependent person, where again, having the person engage in their addiction in a way is a predictable scenario for the codependent person.

1:42:09So even though they may say on the face of it, they want this person to stop their addiction on another level. They really don't. They get to be the martyr. They get to be the savior or they even just get to predict what that person is doing based on their use. I've had experiences in my life and this is why I really want to start this question where I thought I was helping someone. And then the minute I withdrew the help and basically completely gave up the person got better. But for six, seven, eight years, this person struggled. And the minute I stopped helping, they got better. So I said to my partner before when I was talking about this, I was like, it's possible to prop someone up in their like compulsive behavior and not realize you're doing it.

1:42:54In fact, there's three examples, which mean my friends are aware of. And one of my friends talks openly about this where I was propping him up. I was letting him stay at my house, providing for him while he was in his struggles. The minute I had a difficult conversation with him when he was, I think I was 25 years old and he was 30. And I said, you got to go. You got to go. You got to get out my house. He went back, moved in with his parents in his childhood room. He built up his whole life again. He's out of the compulsive behaviors. He's very successful, very rich, living abroad now. And I was like, God, if I hadn't have pushed him out my like basement, he probably would still be there.

1:43:28I thought I was doing in the favor. And there's another one who I've known for many, many, many years. The minute I said to them, listen, I mean, this sounds really harsh, right? Because I tried paying for their therapy, tried paying for everything for this person. And eventually I got to the point where I said, honestly, I tried, don't talk to me about this anymore. Yeah. I'm done. I'm done. Just don't message me about it. Don't talk to me about anyone. They got better. Yep. Yeah. It's really that. So there's Kai Erickson wrote this book on deviance where he studied Puritan societies and found that no matter what group of humans you looked at, there was always, there were always going to be people who were on the margins of the society.

1:44:09He used the word deviance. His point being that groups of humans, we just have these roles and we have these hierarchies. And there's always somebody on top and always somebody below. And when, when we're occupying a certain niche or when we stop occupying it, we make room for somebody else. So when you stop being the hero and the savior, that person had room to stop being the sick victim. Interesting. Yeah. And my last question on this then is how do you approach that conversation with that person? Because so often it's approached through frustration or shame or blame. What's the best way to approach someone who's struggling with the behavior?

1:44:50To express that you're concerned. And to, I don't know, offer your help if that's a good thing. I think we can always try to find our empathy for them without necessarily doing things that would perpetuate or enable that behavior. And we need to recognize that for many people with severe addiction, the only thing that will get them into recovery is real life consequences, real life negative consequences. And that are trying to protect them from that is not protecting them at all. We've got to let them hit the rock bottom. I mean, this is a hard one because you have a lot of families now dealing with children who are severely addicted to opioids for whom, you know, being out on the streets might really result in their death.

1:45:39So this is not for every situation, but I can tell you in my clinical experience after 25 plus years, the majority of people with severe addiction who get into recovery get into recovery as the result of a real life negative consequences. Lost their job, lost their partner, ended up in jail, whatever it was. Until there are those significant consequences, for some people they just won't be able to have the motivation to go back to a court. I heard a long time ago, some 10 years ago, that said change happens when the pain of staying the same becomes greater than the pain of making a change. There you go.

1:46:18That's a good one. I want to talk about digital drugs. One of the subjects that's been recurring theme on this podcast. Inspired initially, I think it was mentioned in an episode we had, but then it was such a huge amount of the feedback we got in the comments section that I thought we need to talk about this more because clearly there's a lot of people suffering. We also then used a tool which looks at what people are googling in searching a lot. One of the most popular searches around the subject matter of addiction is pornography addiction. It's actually it was number one and four in the search tool that we used.

1:46:51The phrases people are using are how to stop pornography addiction, how to help someone with pornography addiction, how to rewire my brain, which is all correlated themes. So pornography addiction, something you see a lot. I have to create a little bit of a space before I ask this question because I did a porn debate on the show and I got a very long voice note from a good friend of mine who said, just watch the porn debate. There was two of them in there and a guy and me, Steven, but I just wish someone had mentioned that women get addicted to porn too. And then on the episode, one of the top three comments on the episode is, I'm a woman, it wasn't mentioned, but I also have a pornography addiction.

1:47:31And you've also kind of echoed that with the erotic novels that you mentioned, the romance novels. So pornography addiction. Do you see that often? And I guess critically, how does one go about overcoming that? And how do you know it's a pornography addiction? I guess it goes back to the point of harm, but yeah. Yes. Yes. So I do think that pornography addiction is one of the biggest addictions and the most silent and the most shameful addictions that we have now in the modern world. We will not infrequently have a patient come in to the clinic who claims to have other problems. And it's not until visit three or four that they finally fess up.

1:48:13I'm really here for a pornography addiction. There's so much shame around it. It's so incredibly shameful for people to admit that they are spending their time looking at these images often associated with compulsive masturbation. Some people, their addiction manifests by actually pursuing partners. So dating apps are highly addictive and in meetups. All of this is related to sex and orgasm, which releases dopamine and the reward pathway, but it's not just the moment of orgasm. It's all of the rituals and the build up and the searching that's related to it. Women can get addicted to pornography as well as men, although I would say that men outnumber women, probably in my clinical experience, I don't know, tend to one.

1:49:04Women, however, are much more vulnerable to love addiction, which is also real, right? The pathological, compulsive, falling in love with partners and then getting into these relationships that are really dramatic and not healthy and then falling out of love and then pursuing another love partner. So these addictions are real. They are very harmful for people who get addicted. Ultimately, they're not even about sex. They're about human attachment and the desire for human attachment and also just as a way to self -suse and escape our own everyday suffering. And I'm particularly concerned about girls and boys who now have access to all kinds of sexual images that would not have been possible for them to get access to a generation or two ago.

1:50:00And now, you know, a child of five with an iPad can accidentally end up on a site that has very graphic sexual images and videos. So - What's the harm of pornography? Watching pornography? Well, there's a lot of potential harms. One of the harms, especially if combined with, you know, compulsive masturbation, is that it's just simply addictive, which means that the more people do it, the more they want to do it, then they have the calm down where they don't feel good, and then pretty soon it becomes like an appulsive repetitive loop where they're spending large amounts of their day engaging in this activity.

1:50:39And that in itself is highly debilitating. But other harms, I think, that are significant, are it really does change a person's conceptualization of what sex is and what sex is for. And I don't want to get into the whole thing of like, you know, sex as exercise or sex as recreational fun compared with sex, you know, as something that's maybe more sacred, because I'm not here to judge any of that, except to say that if a main pathway for a young person to learn about sex is through watching pornography, that's going to give them a very distorted view of what, you know, real sex is like. Not to mention what relationships are like, right, and how sex becomes a part of an intimate relationship.

1:51:34I've heard a few people say that pornography lowers our motivation to go out there in the world and to pursue getting a job and getting a career and going to the gym, et cetera, et cetera. And through the lens of what we've talked about today, where dopamine was this motivating force for those rats to just reach out and eat the food. If you removed the dopamine from the rats brain, it wouldn't even eat food in front of it and it will starve to death. When we think about men, you said roughly, in your practice, about 90 % of the people that come in with a pornography addiction are men. This all kind of overlaps to create this picture that in the modern world, when we think about why more men are lonely, why they're more often in their basements playing video games now or watching pornography than ever before, why they're having less sex and having sex later, why they're struggling to form relationships, why less men are potentially in college at the moment.

1:52:28Maybe some of the answers are in the fact of just like how men are wired because if they're thinking this through, if men are more likely to have a disposition to these kinds of behaviors, then these kinds of behaviors are more likely to impact and demotivate and destabilize is that all like rough, broadly accurate? I absolutely agree, which is why I've talked about the smartphone as a masturbation machine. Essentially, these devices have become the way that we meet our physical, emotional, sexual, intellectual needs. And taken to the extreme, that would mean that we're no longer relying on other people to meet those needs.

1:53:11We're meeting the needs ourselves with this technology and with the devices. And I don't think that's a future that anybody wants taken to the extreme, because we are social creatures. We need to connect with each other. Human connection is vital to a thriving life and survival in general. So yes, I have a lot of concerns that that pornography is now replacing intimacy with people in real life or disrupting our expectations of intimacy with people in real life. When you say expectations, do you mean the hard work we have to do to create and find intimacy? That too, and also just expectations around sex.

1:53:53So a lot of folks that I work with with sex addiction as they try to give up pornography, compulsive masturbation, or whatever they define as their sexual, sexually addictive behaviors. What they find is that they almost go in the opposite direction and they kind of have zero interest in sex, or they just don't have interest in sex with their real life partner, or they can't enjoy sex with their real life partner, which all kind of makes sense. When you've hijacked the reward pathway with this incredibly potent version of sex, you come back down to earth with your actual partner who's got his or her own needs and aging bodies or whatever it is.

1:54:36It's hard to experience pleasure in that round. In an attempt to offer people out there now that are struggling with some kind of form of compulsive behavior addiction, a pathway to turn this around. What is step one? In your book, I read all these incredible ideas around the wisdom we can learn from addicts. I learned about dopamine fasting, and I also learned about radical honesty and the role that that plays. What is the process? So someone listening to this right now, they're struggling with one of these addictions. They've got a pornography addiction. They're addicted to gaming. Maybe it's food.

1:55:06Maybe it's erotic novels. Maybe they're on the twilight, the reading twilight at the moment. What do you say to that person at the step one is? Step one is really just acknowledging the behavior that it's problematic and that it might require some changing in our lives. The next step is being honest with ourselves and maybe another person about why we do the behavior, what we get out of it, what's positive. Step three would be honestly making a list of all the problems with the behavior. How is it interfering with my goals and as we talked about my values? What do other people say to me about how it's problematic?

1:55:44Is one of the problems potentially that it's just not working anymore the way that it used to, right? I'm developing tolerance. I need more to get the same effect. It's doing the opposite of what I want it to do. And after we've done all that, really done a really honest self -assessment about the behavior. I recommend a 30 -day dopamine fast. Now, we're not really fasting from dopamine, right? Because we're not really ingesting dopamine. What we're doing a fast from is whatever that substance or behavior is that is causing these kinds of problems potentially. Maybe we aren't even really sure, but we think it might be.

1:56:21Give it up for 30 days. Why 30 days? Well, we know that two weeks is not enough, right? We know that from this imaging study, right? That people are still in that dopamine deficit state two weeks after stopping. But 30 days based on clinical experience, not just mine, but that of many other people who do this work that know for most people, no matter the drug and no matter sort of the severity and the chronicity, once they get to about 30 days, they begin to feel better. They begin to come out of that tunnel of constant craving. They begin to be able to imagine a life in which they would, you know, not necessarily have to rely on this substance or on this behavior.

1:57:05What I always tell folks when they're preparing for the dopamine fast is just remember, you will feel worse before you feel better. But that is withdrawal mediated suffering. Once you get through those first 14 days, you'll begin to feel better. And potentially by 30 days, you'll feel much better than you have in a really long time. Now, this is not to say that 30 days of fasting is going to cure your addiction, not at all. But it's the beginning. It's the beginning of being able to see causality, getting some insight. It's an experiment, right? Our lives are one big experiment. What better way to understand the variables in our lives than to change one thing, one variable and see what happens?

1:57:46Do we then need to, you talk about this concept of self -binding? Yes. Self -binding. Right. What role does that plan? All of this. Self -binding is a way of acknowledging that if we rely on willpower alone, we will not be successful, especially living in this drugified world. And what we need to do is anticipate desire before we're in the throes of desire. By creating both literal and meta -cognitive or thought, you know, good -dunking experiment, like barriers between ourselves and our drug of choice. So these barriers can be actual physical barriers, like putting our device into a kitchen safe and locking it up over the night or leaving it outside of our bedroom or getting the potato chips, the alcohol, the cannabis out of the house, deleting our contact drug dealers information and telling our drug dealer, don't call me and I won't call you.

1:58:40Because these are all cues. These are all cues. That's right. And that cues can be physical things. So someone I see, can cues, cues can also be basically an emotion. You talked about halt, hungry, angry, lowly, tired. I eat well during the day. Like, now, as I leave here, there'll be a salad I reckon in the green room over there for me. And the only time where I'm susceptible to not eating well is if it's late. And so when you said the hungry, angry, lowly, tired thing, that is probably the state that I'm in sometimes when I get home. Certainly hungry, certainly tired, probably a little bit lonely as well.

1:59:18But certainly those two things, and that seems to be one of most susceptible to making a regrettable decision as it relates to my dopamine. I've also wondered if dopamine is responsible for what people almost call like the sugar cravings that we have. So what I've observed is in previous years of my life, when I was eating lots of sugar, I would then go into about like a two week cycle of like, bingeing the sugar. And right now, I'm in like a really great cycle with my food where I have no cravings for the sugar. I'm in a staying in a hotel here in LA. There's a mini bar in the room with Oreos and gummy, all these chocolates and all these things.

1:59:52And I haven't touched them because for some reason, in this like couple of weeks of my life or whatever, I just don't have the cravings anymore. But I kind of suspect that if I start eating them, then the next four weeks will be a car crash. Yes. What does this happen? Yeah, it's so fascinating. And I think this is sort of a universal experience. So first of all, sugar is addictive. It lights up the same reward pathway as drugs and alcohol. Clear dopamine release in the nucleus, acumbens part of the reward pathway in response to sugar. And when we quit sugar, we have a come down, right? We go into withdrawal and it's manifested in all the different ways that we've talked about.

2:00:34And it lasts for about two weeks. And one of the most salient symptoms is intense craving for sugar. And it's so amazing how intense it is. But if we can get through that period and get out of that vortex of addictive craving, the craving gradually gets better and then eventually goes away, which is by the way, very paradoxical because whatever our drug is when we first stop it, we have intense cravings and we have the feeling that the cravings will only get worse with time. Even though we logically may have experienced otherwise by giving it up before, we have the feeling this is going to last forever.

2:01:12It never does. Right? With time, the craving goes away. And once we are in that arena where we're not constantly craving, we might have something that triggers the craving, right? But like stress, but generally, we're not dealing with the craving. If we were then to re -expose our brains to a little bit of sugar, immediately back in the vortex of craving. And there's an experiment I love that illustrates this. It's an experiment in rats where rats were injected with cocaine, the same amount of cocaine every day for seven days. And over the course of those seven days, the rats went from kind of hiding in the shadows of the cage to progressively running a little bit more and a little bit more.

2:01:57In bite day seven, they were going to running frenzy, right? As measured by these beams of light that they were crossing, then there was no more cocaine injected after seven days. And no cocaine or any addictive substance administered to the rats for a year, which is a rat lifetime, a really long time that would make you think, oh, you know, that there's no more cocaine in the system. No, none of that. And then the rats were injected with a single dose of cocaine. And immediately they were plunged back into that running frenzy that you saw on day seven. Really important information because it tells us that there's some kind of permanent latent echo.

2:02:38In our brains, once we've been exposed to and especially if we become addicted to a particular substance, such that even with sustained absence on the order of years and decades, if we are re -exposed to that drug, we can immediately be plunged into the depths of our addiction. There's no ramp up period that happens. And of course, we see this all the time, you know, people with alcohol addiction who are then exposed to alcohol and right back to their max use or even exposed to something like opioids. And alcohol also works on our endogenous opioid system. So there's some homology or similarity between alcohol and opioids.

2:03:17And then immediately being plunged into opioid addiction, which then leads them back to their alcohol addiction. It made me think about children. It made me think about children because if I'm a five -year -old and I'm binging on sugar, this sets me up for a life where I'm going to be, I mean, based on the analogy I just had, the experiment, I just had, based on the experiment I just had there, it sets me up for a life where I'm going to so easily slip right back into that addiction for sugar. And also, I know that the brain isn't fully developed on my children. So maybe the effect is even more lasting and significant.

2:03:55Is any of that true? Yeah, it's all true, which is why a big focus of the addiction medicine field is prevention and trying to make sure that we protect kids' brains from the harms of these addictive substances and behaviors. Like what? From sugar to digital media, video games, pornography, social media, or any other drug, you know, nicotine. So many kids are vaping now, you know, taking 50 plus puffs a day on their nicotine -vate cannabis, alcohol. What's going on in the brain if we, if a kid is exposed to those things? So essentially at age five, we have more neurons and neuronal connections than we have in the rest of our adult lives, about 50 % more neuronal connections than we'll have it as adults, which is what makes us such good learners when we're kids.

2:04:44Kids can just absorb anything because they're sort of like these toady potent sponges with all these neurons and all these neuronal connections. But as we age through adolescence to about age 25, we cut back or what's called prune the neural circuits that we don't use and we mile and ate or make more efficient the neural circuits that we use most often such that by age 25, we are left with the neurological scaffolding that will serve us for the rest of our adult lives. That means that if we're engaging in addictive maladaptive coping at a young age, we're elaborating a neural circuitry based on that maladaptive coping, which is going to set us up for addiction and adulthood.

2:05:27I always like to emphasize though that because the child and adolescent brain is so plastic or toady potent or so changeable, that's also a very hopeful message. It means that even a young person exposed at a young age to an addictive substance, if we can get in there early enough while their brain is still plastic enough, we can rewire them. Whereas when I treat people in their 70s and 80s who have been smoking pot their whole lives or drinking alcohol, mainly it was manageable. Now all of a sudden they retire, they're in their 60s all this time, the pots a lot more potent. They can develop these full blown addictive disorders late in life and it's very hard to treat them because they've lost a lot of that plasticity that would allow them to regenerate new neural pathways once they abstain.

2:06:19What is the most important thing that we didn't talk about that we should have as it relates to dopamine? Oh my god, we talked about so much. I don't even know. I seem like it was a lot of stuff. I guess based on the questions you were exposed to from the general public, is there anything that we missed that someone at home right now is going to be screaming at the screen? Yeah, well, I mean, I guess I would emphasize that when I talk about the dopamine fasting, it's an early intervention. It's not an intervention that I would recommend for someone who had repeatedly tried to quit on their own and been unable to.

2:06:54Clearly that would be an exercise in futility that person should go and get professional help. Maybe they need to go to a residential treatment center. I also wouldn't recommend dopamine fasting or just quitting your drug of choice if you're at risk for a life threatening withdrawal. So we could have life threatening withdrawal from alcohol and benzodiazepines like clonipin zanaxe ademen. Again, in those cases, go see a professional get help with a medical detoxification before you try to sustain abstence for a period of time. So I would blanket the whole thing with the caveat. Go see the addiction medicine specialist, near you.

2:07:33Thank you so much. It's been so unbelievably thought provoking for me in so many ways. I thought I knew what dopamine was. I thought I had covered all the ground there was to cover on these subjects of sort of compulsive behaviors, but I was so unbelievably wrong. And it wasn't until I got into your book and started reading through your work that I was like, oh my god, most people don't have a clue about dopamine and the role it plays on us. And this scale analogy is particularly memorable because that helps me to think through many of the behaviors that I have in my life that I've either struggled with or become quite stubborn in various ways.

2:08:05But also it's turned a couple of lights on to some of the things I said about my sugar eating sugar and even like going to the gym and why my motivation can seem to fluctuate with the gym sometimes. It's so unbelievably important because this little neurotransmitter seems to control so much of our lives. And we never taught anything about it. So we become these kind of puppets. And the puppet master is this brain which is firing off all of these neurotransmitters that are determining who we are, who we become and also who we don't become. Thank you so so so much. I know you are nervous coming here today, but I have to tell you you are very brilliant.

2:08:42You're exceptionally brilliant. And so many ways, as I said, you should start a podcast because you're really built for this medium. You have a certain warmth and empathy to you while also being incredibly smart and accessible in the way that you communicate. So please carry on because I don't think although you overcame that the difficulty of those nerves, I think there's so many hundreds of thousands and millions of people listening now that are so thankful that you did. I can really thank for that you did. I mean, you've just nudged their life a little bit in a better direction. That's worth well.

2:09:12So thank you. We have a closing tradition on this podcast where the last guest leaves a question for the next guest without knowing who they're going to be leaving it for. What is the most recent piece of information that changed your life?

2:09:29I think the most recent piece of information that was very impactful for me was the realization that we are probably going to be cybernetically enhanced in the future and interfacing with technology in a way that's completely seamless and that this is inevitable. We're going to become cyborgs. Or at least we're going to be surrounded by the technology in a way that's invisible. And it's going to be just completely integrated into our lives whether it'll actually be under the skin. I think it will be. But I can see in that so much potential good and promise and so much that's really terrifying, especially when I think about the way it's going to change us as humans.

2:10:33And my big fear about it is that we will become more and more isolated and then we'll end up sort of in these little cubicles of our own making scattered alone all across planet Earth. I hope it doesn't lead to that, but that's my worry. It's interesting when we become connected to the internet. We truly interface with the internet. We really don't need to use our physical being anymore because we can experience all the joy and adventure and travel digitally. And that's, I mean, it just messes with the incentive structures like we've talked about with dopamine. Yeah. Changes our ability to get up and go and to do things.

2:11:15I mean, that's a lovely hopeful ending question. Thank you so much. Oh, you're welcome. Yeah, thanks for the opportunity to teach people about this information. I hope it's helpful for people. Super helpful. And I'm going to link both of these books below. I've got the dopamine nation book, which was the original, I believe. Yes. And then following that, you released dopamine nation workbook, which is a practical guide to find balance in an age of indulgence. I highly recommend everybody reads these. I'm going to go and reread them on my journey home back to London tonight. So I really, really appreciate you reading these books.

2:11:49Honestly, everyone needs to go read these books. I'm sure they will. So thank you so much. Thank you so much. Do you know that 80 % of New Year's resolutions fail by February? It's because we focus too much on the end goal. And we forget the small daily actions that actually move us forward. Those actions that are easy to do are also easy not to do in life. It's easy to save a dollar. So it's also easy not to making one small improvement each day. One tiny step in the right direction has a big difference over time. And that is the 1 % mindset, which is why we created the 1 % diary, a 90 day journal designed to help you stay consistent and focus on the small wins and make real progress over time.

2:12:26It also gives you access to the 1 % community, a space where you can stay accountable, motivated, inspired, along with many others on the same journey. We launched the 1 % diary in November and it sold out. So now we're doing a second drop. Join the wait list at the diary .com and you'll be the first to know as soon as it's back in stock. I'll put the link below.

2:13:00Q1 is often when businesses start implementing new systems and processes in hopes of creating efficiencies for the year ahead. And over the course of my career, I've learnt just how crucial having the right systems in places, one which has helped me across many of my investments is net suite. They're also a sponsor of this podcast. Net suite is the number one cloud financial system through their streamlined platform. You'll find all of your accounting financial management inventory and HR in one place. Their technology has been a real game changer, especially for my team at Flight Studio. As over the last year, we've moved out of startup mode and into scale at mode.

2:13:35We no longer have to juggle multiple systems and having everything together has reduced the number of manual tasks and errors. Over 41 ,000 businesses have chosen to future proof their business with net suite. So if you'd like to learn how it can help your business, head to netsweep .com slash Bartlett and free download the CFO's guide to AI and machine learning. That's netsweep .com slash