Lee Camp
[00:00:00] Hey, everybody. Lee here. As a part of our 'Best Of' episodes series, I wanted to rebroadcast our radio special in podcast form with Anna Lembke and John Mark Comer, and for all sorts of reasons.
One, because we just got such overwhelmingly positive feedback about those two interviews. Folks, including myself, found them so practical, providing real insight to the ways we're wired and real solutions and daily practices for living better.
Second, we continue to see research published, such as in the new book called 'Generations', which paints a distressingly bleak picture of the effects of social media, especially on younger folks, with extreme dangers like low self-esteem, depression, and even suicide correlated with high social media use. Of course, we may know this experientially, and the data continues to [00:01:00] overwhelmingly confirm it.
So what then? What do you do? What do we do? How do we overcome such addictions to begin to let go of their power? Anna Lembke and John Mark Comer have some rather practical advice in this regard, teaching us ways to live in a slower pace than the one our digital world seems to demand. I hope you'll find this immensely helpful. Here we go.
I'm Lee C. Camp. This is No Small Endeavor - exploring what it means to live a good life.
Today, the price of the pursuit of pleasure.
Anna Lembke
Every pleasure has a cost, and that cost is pain.
Lee Camp
That's Dr. Anna Lembke, Psychiatrist and Chief of the Stanford Addiction Medical Dual Diagnosis Clinic at Stanford University, and she's also the author of the New York Times bestselling book, 'Dopamine Nation'.
[00:02:00] Today, some practical wisdom about the distressing and endemic problem of our relentless pursuit of pleasure, and some helpful strategies to recover.
Also, John Mark Comer, bestselling author of 'The Ruthless Elimination of Hurry'.
John Mark Comer
Most people are too busy to do the things they need to do to become healthy and whole people.
Lee Camp
All coming right up.
I'm Lee C. Camp. This is No Small Endeavor - exploring what it means to live a good life.
In what seems to be an obvious upside of wealth and upward social mobility, many of us have instant and easy access to much that promises us pleasure. In the language of brain chemistry, massive hits of dopamine are available to us as we pursue [00:03:00] that pleasure - most any place, most anytime, day or night, dusk and dawn.
But today, we explore this question: what are some of the costs of that relentless pursuit?
Anna Lembke
Every pleasure has a cost, and that cost is pain.
Lee Camp
That's Dr. Anna Lembke, Professor and Psychiatrist, Chief of the Stanford Addiction Medical Dual Diagnosis Clinic at Stanford University. She's also the author of the New York Times bestselling book, 'Dopamine Nation: Finding Balance in the Age of Indulgence'.
Dr. Lembke points out that we are now bombarded with readily available dopamine hits at every turn. The opportunity for a craving is seemingly available everywhere. The potato chip bag, the prescription drugs, or the infinite feed in your pocket. But with a plethora of promises of feel-good options, [00:04:00] why then are rates of depression, anxiety, and suicide rising in the wealthiest nations?
Why is the life expectancy for some in America actually decreasing for the first time in a century? Turns out that the relentless pursuit of pleasure demands a steep price.
Anna Lembke
And we can either pay that upfront or we can pay it afterwards. And with things that are immediately reinforcing, like drugs and alcohol, or digital drugs like social media, video games, pornography, we will pay a price and that price will be the comedown.
Lee Camp
So perhaps you, my friend, might know such addictive effects, might know that compulsivity and craving from your smartphone, or food, or drink, or sex, or drugs. Well, what then?
Dr. Lembke has some practical and tested advice, often deriving from her many years [00:05:00] of clinical practice. But before we get to her suggested solutions, it might be helpful to first hear her describe the problem at greater length.
So let's start at maybe, but probably not, a surprising place - our addictions to our smartphones.
Yeah. You, you say-- you've already begun to comment on the smartphone, but you say, quote, "The smartphone is the modern day hypodermic needle, delivering dopamine 24/7 for a wired generation".
Talk to us a little bit more about how you see the smartphone and technology as central to the, the rise of such a problem.
Anna Lembke
To understand that metaphor, let me tell a little bit about the history of opioids, because it's, it's parallel and it's, it's relevant. So opioids are really any chemical that bind to our opioid receptors in our body.
Almost everything that's addictive is something that occurs in in nature [00:06:00] or external to us that mimics a chemical our body already makes. So we make our own opioids. And for millions and millions of years, people have used opioids, and some small percentage of them have gotten addicted to opioids, through their cultivation of the poppy plant, which is the source of opium.
Lee Camp
But in the early 1800s, humanity's access to opioids dramatically changed. Scientists derived in the laboratory a much more potent form of opium...
Anna Lembke
...called morphine, which then very rapidly led to an increase in people getting addicted to opioids, because it was more available and because it was more potent.
Lee Camp
These two properties, access and potency, are two of the four key factors contributing to addiction, which Dr. Lembke talks about throughout her book, 'Dopamine Nation'.
Anna Lembke
Access, quantity, potency, and novelty are four of the characteristics in modernity that contribute to the problem of [00:07:00] addiction of many different types of drugs.
Lee Camp
Say those four one more time.
Anna Lembke
Sure. So access - our access to a drug is, is in fact one of the biggest risk factors for getting addicted to any drug. If, if you live in a neighborhood where that drug is re-- readily available, you're more likely to try it, more likely to get addicted.
Quantity is the second one. So if, if the drug is more bountiful, in fact if it's infinite, you might think here of TikTok, uh, you're more likely to get addicted to the drug, because it doesn't run out. And it turns out that quantity and frequency of consumption are major contributors to addiction. The more often we use and the more we use, the more likely we are to get addicted.
Number three is potency. That has to do with, you know, how much bang for our buck we get. The more potent a drug is, the more dopamine it releases in the reward pathway. And technology has created incredibly potent drugs, including drugs that are potent that didn't [00:08:00] even exist before.
And then finally you have novelty. So dopamine, which is our reward neurotransmitters, is extremely sensitive to newness. Anything that's new in the environment will trigger dopamine, which is why we can even get addicted to things like bad news through doom scrolling.
Lee Camp
Anna Lembke
That's because dopamine is released in response to newness, new being the fundamental word in news.
But getting back to opioids, so in the early 1800s we saw the creation of, of morphine or the, the discovery of this alkaline derived from opium, which was morphine, which was more potent. And people, more people got addicted 'cause they had, you know, more [00:09:00] access to this higher potency drug.
And then came along, uh, the invention of the hypodermic syringe in the 1850s. And this was heralded to be an amazing invention because it would allow people to inject drugs directly into the bloodstream, and it was hypothesized that people were less likely to get addicted to drugs like opioids if they were directly injected into the bloodstream.
Lee Camp
Anna Lembke
Now anybody who's listening out there knows that that turned out to be very, very wrong because, in fact, the opposite was true.
What, what that allowed was that instead of having to smoke the drug or eat the drug, you could now deliver the drug directly to the brain, which made it much, much more potent, because one of the ways to increase potency is to change the delivery mechanism.
Lee Camp
This led to the narcomania of the late 1800s, which exploded during the American Civil War and led to the discovery of a new form of medicine that would come to replace morphine. [00:10:00] One that was said to have all the pain relieving properties of morphine, but none of the addictive potential, or so it was thought.
Anna Lembke
And that was discovered by Bayer Pharmaceuticals in Germany, and they were so excited about this new discovery that they called it 'heroisch', which is German for 'heroic', and that, of course, was heroin.
Lee Camp
Then, in the late 1900s, another new discovery.
Anna Lembke
Fentanyl, which is fifty to a hundred times more potent than morphine, can be made in the laboratory cheaply without even using a plant precursor. So you don't need any more poppy plants, you can make it just from chemicals. And that trajectory can be traced with every drug that you can name - an increase in access, potency, novelty, and quantity.
That makes us all more vulnerable to the problem of addiction.
Lee Camp
And now, [00:11:00] the newest drug is not even a chemical in its own right. Instead, it's something that's been engineered by tech companies with trillion dollar market caps to hack the biochemistry of our brain. And hacking that brain biochemistry often leads to addiction.
Anna Lembke
So what the smartphone allowed was for 24/7 access to digital drugs. And that means there's no stopping point. At any moment, whatever we're doing, we can reach for that phone and access a digital drug that we can get lost in. And that means that we were, or we are now, all of us, with rare exception, very, very vulnerable to getting addicted to digital content in all its, you know, manifold forms.
Lee Camp
This new level of availability, quantity, potency, and novelty has given rise to addiction, not just in adults, but in children as well. And all this [00:12:00] correlates, says Lembke, with the luxuries afforded us by a consumerist society. We have increased access to all kinds of products, engineered to get us to consume more. To that fact, add that we also have more leisure time than ever before, further increasing odds of getting hooked. But all this pleasure, she says, it is contributing to a rise in a new phenomenon: deaths of despair.
Anna Lembke
So the deaths of despair is a phrase that was coined by Anne Case and Angus Deaton, two Princeton economist, to describe the decrease in lifespan seen in middle-aged white Americans for the first time in generations, due to the top three causes of death in that demographic, which have been documented to be cirrhosis, primarily due to alcoholic liver cirrhosis, drug overdoses, and suicide.
[00:13:00] So for many generations now, people have been living longer than their parents and grandparents. But now, for the first time in maybe a hundred or more years, we have a, a demographic - white America, white middle-aged America - who are dying younger than their parents and grandparents.
So this is very powerful, uh, because, again, what it says is that we've reached some kind of tipping point where our technology and our innovation and our science has allowed us to live longer, through antibiotics and cancer treatment, and all the things that normally would kill us are no longer killing us, but now we're killing ourselves with, with over consumption.
Lee Camp
The other sobering [00:14:00] indicators, which Dr. Lembke highlights alongside deaths of despair, is the rising rate of depression and anxiety.
Anna Lembke
Look at those rates in the last 30 years. There's been an increase in almost every country in the world, with the steepest rises in the wealthiest nations, which is a paradox because it suggests that the richer we get, the more unhappy we get.
And this is documented in a lot of different ways, and even confounds, like access to mental health treatment, don't explain this phenomenon. In fact, the highest rates of anxiety, depression, and suicide occur in the countries with the most access to mental health treatment. Which strongly suggests that we're not understanding some fundamental causative piece here about why we're so unhappy and why we're suicidal.
Lee Camp
So why is it in our pursuit of pleasure, our search for happiness, that we are instead anxious, [00:15:00] depressed, and, well, unhappy? Dr. Lembke argues that at least a significant part of the answer may be found in the relevant brain chemistry.
Anna Lembke
Neuroscience has shown in the last 50 to 75 years that the same parts of the brain that process pleasure, also process pain.
That is to say they're co-located and that they work like opposite sides of a balance. So in the book, I use this extended metaphor of like a teeter-totter in a kid's playground.
Lee Camp
So picture a teeter-totter. Since pain and pleasure are both processed in the same part of the brain, you tip it to one side, well, that's us experiencing pleasure. You tip it to the other side, there's the pain.
Anna Lembke
But there's a very important rule covering this balance, and it is that the balance wants to remain level. It doesn't wanna be deviated for very long to the side of pleasure or pain. And [00:16:00] with any deviation from neutrality, our brains will work very hard to restore a level balance.
And here's the key piece. The way our brain restores a level balance is first by tilting an equal and opposite amount to whatever the initial stimulus was. So if we do something pleasurable, which releases dopamine in our brain's reward pathway, a very specific identified circuit in the brain, our brain responds immediately by tipping our balance an equal and opposite amount to the side of pain.
That's the comedown, the after-effect, the hangover. And it does that before going back to the level position. So that's really, really important information because it tells us that in the neurobiological economy, uh, every pleasure has a cost, and that cost is pain. And we can either pay that [00:17:00] upfront or we can pay it afterwards.
And with things that are immediately reinforcing, like drugs and alcohol or digital drugs, like social media, video games, pornography, we will pay a price, and that price will be the comedown. And this is essential for understanding what happens in our brains as we become addicted. Because the second rule of the balance is that with repeated exposure to the same or similar reinforcing stimulus, that initial response to pleasure gets weaker and shorter, but that after response to pain gets stronger and longer. In other words, our brains remember, they learn, what we've done before, and they accommodate, or what neuroscientists call 'neuro-adapt' to that stimulus, such that we don't get as much dopamine the second or third or twenty-fifth or hundredth time around. And eventually what happens is that we get no [00:18:00] release at all potentially, but we get a huge comedown, and eventually we end up in this kind of chronic state where our balance is tilted chronically to the side of pain.
Lee Camp
Dr. Lembke suggests that we imagine little, little pain gremlins piling onto the pain side of the teeter-totter.
They just start living there, setting up camp, having a barbecue on the pain side of your brain's pleasure-pain teeter-totter, hanging out for the long haul.
Anna Lembke
From a neurobiological standpoint, what happens is we get into a dopamine deficit state, which is to say, to accommodate the fire hose of dopamine that we're exposing our brain to by repeated exposure to these highly reinforcing drugs and behaviors, our brains have to down-regulate dopamine transmission by involuting dopamine receptors, decreasing dopamine production, and we eventually end up in this chronic dopamine deficit state, and that is the addicted brain. Because once that has happened, now we need to use our drug, not to get [00:19:00] high, but just to re-equilibrate the balance, just to restore a level balance, or what neuroscientists call homeostasis.
And when we're not using, we are experiencing the universal symptoms of withdrawal from any addictive substance, which are anxiety, insomnia, irritability, depression, and craving. Furthermore, and this is very, very important, when we engage in other consumption of other more modest rewards that used to give us pleasure, those things no longer give us pleasure, right?
Because we're walking around with our gremlins camped out on the pain side of the balance. We're in this dopamine deficit state now. We need enormous quantities of pleasure to feel any pleasure at all, and equally important, we're very vulnerable to the meerest kind of pain stimulus. Even the meerest pain is very painful to us.
And I believe that, both on an individual and a global scale, [00:20:00] we are all in this dopamine deficit state, right? Because our lives are so comfortable and because we have this infinite access to these highly reinforcing drugs and behaviors, and the cumulative effect of that in an iterative fashion through time, means that we're resetting our joy pathways to the side of pain.
Lee Camp
You're listening to No Small Endeavor and our episode, 'The Price of the Pursuit of Pleasure'.
I love hearing from you. Tell us what you're reading, who you're paying attention to, or send us feedback about today's episode. You can reach me at lee@nosmallendeavor.com.
You can get show notes for this episode in your podcast app or wherever you listen. These notes also include a link to [00:21:00] a full transcript.
Coming up, we hear from John Mark Comer about what he calls our societal addiction to hurry, and what we might do to break it.
Welcome back. Just a reminder that Dr. Lembke earlier said that there are four main factors that lead toward addiction:
Anna Lembke
Access, quantity, potency, and novelty.
Lee Camp
But in a society where millions and millions of dollars are spent to engineer new ways to keep us coming back for more, there's a strange accommodation that we have to make, namely the hurry with which we live our lives. But what are the constant hits of dopamine and the increase in speed doing to us?
John Mark Comer
The question is not 'are you becoming someone?', but 'who are, or what, are you becoming?' So that's premise one - that you are already being formed. [00:22:00]
Lee Camp
John Mark Comer is the founding pastor of Bridgetown Church in Portland, Oregon. Author of the book, 'The Ruthless Elimination of Hurry', Comer contends that the hurry with which we live our lives means that we're missing out on what it means to be truly human.
John Mark Comer
Most people are too busy to do the things they need to do to become healthy and whole people.
Lee Camp
Comer had read that the author John Ortberg had approached his mentor, the philosopher Dallas Willard. Ortberg was tired, stressed, and asked Willard for advice. He told him, simply, "you must ruthlessly eliminate hurry from your life".
Thus began John Mark Comer's own quest to live more slowly.
John Mark Comer
When I was first exposed to that line, which was Willard's line to Ortberg, and actually there's two sentences there. The second one was, "you must ruthlessly eliminate hurry from your life". The first one [00:23:00] was, "hurry is the great enemy of spiritual life in our day".
Lee Camp
John Mark Comer
Which is similar to the Carl Jung, you know, "hurry isn't of the devil, it is the devil". Or I quote Corrie ten Boom in the book, "if the devil can't make you sin, he'll make you busy".
Lee Camp
John Mark Comer
And when I first heard that, it was like a head scratcher for me. You know, on one hand it was like, part of my like, rational brain said, what are you talking about? Hurry?
Like, I mean, I live in Portland, Oregon. We were recently named the least religious, not just least Christian, least religious city in all of the United States of America. And, uh, if you were to ask me prior to hearing that, like, what's the greatest challenge you face in pastoring people in a city like Portland? I don't know what I would've said, but hurry would not have even entered my mind or imagination. It would not have even made the list.
But on the other hand, it's like resonating with me deeply, you know?
Lee Camp
John Mark Comer
And the longer I've sat with that thesis, the more I've come to agree with it. I do think that hurry is kind of the issue underneath so many of the other issues, whether that be political polarization…
[00:24:00] I'm just shocked at the complexity of the world and the oversimplification of partisan politics. Do you understand how complex an issue like immigration is, or systemic racism is, or, fill in the blank. These are, like, extraordinarily complex issues that don't often have clear solutions to the problems, but yet people talk about 'em as it's just this right-left binary, us versus them, simple, good versus evil kind of thing.
But in order to understand that complexity, it would take a lot of time, it would take humility, it would take compassion to hear another person's perspective. When you're in a hurry, you simply don't have the time, you know? So that's one of a thousand issues right now that plague our society and our soul, of which I think hurry is an underlying cause.[00:25:00]
Lee Camp
And it seems that, increasingly for me, if I really have any interest in making a contribution to my own transformation, and the good of my community, I increasingly think of attention...
John Mark Comer
Lee Camp
...along with intention...
John Mark Comer
Lee Camp
John Mark Comer
Lee Camp
Which we simply can't do when we're in a hurry.
Recently, Comer's church, Bridgetown Church in Portland, Oregon, made an effort to be intentional about their attention.
They began to build their church around a rule of life. A so-called 'rule of life' is modeled after ancient practices one might still find today in monasteries. Community life is centered around shared core practices. Everyone in the community makes the same commitments, commits to the same practices. The center of these traditional [00:26:00] commitments in the Christian tradition is usually expressed as 'ora et labora', translated 'pray and work', which provides a communal structure and framework.
The underlying idea is this. We are formed by what we do, so be intentional about what we do, so that we may be formed in a way we intend. This is part of what Comer cites as his working theory of change. It's his undergirding philosophy of how he believes people are transformed into more whole, complete, authentic human beings.
But this grand idea has one humongous problem.
John Mark Comer
I think I tell this story in the book, but five years ago, before we basically rearchitected and rebuilt our whole church around spiritual formation and practices and started to walk our church into a rule of life, I sat down with my therapist, who is also this like PhD, [00:27:00] seventy-something, like a bit of a legend where I'm from, just a literal brilliant guru kind of man, and I ran by him our whole working theory of change and our whole model of church we're about to embark on.
I said, I want you to shred this. I want you to like-- talk to me as a clinical psychologist, like poke holes, and all of this. We had this great conversation, and he mostly affirmed, like, our theory of change and our model of church. But then he just basically, he's very much a realist, he said, "the number one problem you will face is time". And he said, "most people in your church will never do this because it will take time".
And his experience as a therapist, after forty-something years or whatever, of giving therapy, was that most people are too busy to do the things they need to do to become healthy and whole people.
The major obstacle to spiritual formation, for most people, it's just this, whether you wanna call it hurry or busyness or digital distraction or a lack of capacity for attention, it is [00:28:00] this just life of speed that is literally incompatible, I think, with a life of prayer, you know?
C.S. Lewis, his spiritual director called hurry "the death of prayer".
Lee Camp
Now, you may or may not be the praying type, but regardless, there seems to be something worth long consideration here: that we are formed - our dispositions, loves, desires, all shaped by what we do. And that hurry may be forming us in destructive ways.
John Mark Comer
Spiritual formation is not a Christian thing or religious thing, it's a human thing.
Lee Camp
John Mark Comer
To be human is to be dynamic, not static. We're all being formed. We're all becoming a person. The question is not, 'are you becoming someone?', but 'who are, or what, are you becoming?' So that's premise one - that you are already being formed.
Lee Camp
Well, and it also goes back to what you said your psychologist friend said to you, in [00:29:00] that most people don't ever take any time to allow themselves to consider, how may I go about changing?
John Mark Comer
Lee Camp
Right. And this reminds me of, you know, one of the lines I love from Alasdair McIntyre, who, he says, "the-- the nature of a good life is a life spent seeking in the nature of a good life".
John Mark Comer
Lee Camp
And it's this sort of iterative process where we're taking seriously our lives, right? And we're taking seriously what sorts of practices, habits, disposition, skills, narratives, community...
John Mark Comer
Lee Camp
John Mark Comer
Lee Camp
...and lead us to who we are becoming, you know? And it holds before us-- you know, that's one of the big critiques McIntyre made, of the Enlightenment, was that we've taken away any sort of teleological picture of what it means to be human.
John Mark Comer
Lee Camp
We don't have that picture of the 'why' question that you raised a minute ago. For what, and for what purpose, and why, are we trying to do life, right?
John Mark Comer
So then the default purpose just becomes pleasure.
Lee Camp
Yes. Or whatever the marketers sell us, right?
John Mark Comer
Lee Camp
Yeah. And so we're always being captive [00:30:00] by something if we're not paying attention, right?
John Mark Comer
Yeah, that's, I think, the great myth of the Enlightenment is that we're these autonomous, rational selves.
Lee Camp
John Mark Comer
Rather than what any scientist or Christian theologian would tell you, which is that you are a easily emotionally manipulated...
Lee Camp
John Mark Comer
...completely social creature, like, follow the herd mentality, easily capable of self-delusional thinking... [laughs]
Lee Camp
John Mark Comer
...you know? Which is-- science and scripture both align on that point.
Lee Camp
John Mark Comer
But it's so against the Western narrative - I'm this rational, autonomous self, I'll just think for myself, you do, you the voter is always right, you know, people know best--
Lee Camp
John Mark Comer
Lee Camp
But like you say, most of us know better than that when you spend much time paying attention to it.
John Mark Comer
Yeah. If you're honest. Yeah.
Lee Camp
Give us a short list of some of your favorite [00:31:00] practices for eliminating hurry.
John Mark Comer
There's four in the book that I name, not because they're the best per se, they're just the ones that have been the most helpful to me, and they're also, all four are ones that I did not grow up in, and that's not a part of the church tradition I was in.
So they are Sabbath, silence and solitude, simplicity, and slowing.
Lee Camp
That's Sabbath, silence and solitude, simplicity, and slowing.
John Mark Comer
So Sabbath - an entire day set aside to stop and rest and delight and worship.
Silence and solitude - regular time built in, where you are just alone with yourself and with God and prayer, and kind of free of any external inputs other than from God Himself and maybe from scripture.
Three, simplicity, or, or you know, some people will call that simple living or minimalism or whatever, but simplifying not just your possessions and your wardrobe, but even your activities and your commitments down to really live in [00:32:00] alignment with your deepest desires.
And finally, slowing - that's language from Richard Foster and John Ortberg, who talk about slowing, actually as a spiritual discipline for the modern age.
They mean exactly what it sounds like. Actually just slowing down and doing things slower.
Lee Camp
As a Christian pastor, John Mark says that this discipline of slowing down comes directly out of the life of his faith central figure.
John Mark Comer
You know, if you pay attention to Jesus, he just was not hurried. Willard was once asked, "describe Jesus in one word', and thought about it for a minute, and he said, "relaxed".
If you think about, if you just read through the four gospels and take a short tally of how many of the stories in the gospels are unplanned, unscheduled interruptions. So almost all of them. There's very few, like, 4:00 PM on Thursday, September 28th, and you'll spit in a man's eyes and rub mud on him, [Lee laughs] and make for a great story a couple decades later in this biography.
No, it's just like, that was Jesus responding to an [00:33:00] interruption. C.S. Lewis had that great line, that how you respond to an interruption is who you really are, [laughs] which is like, dagger to the heart for me. If a hurried person like me--
Lee Camp
Say, say that way one more time.
John Mark Comer
How you respond to an interruption is who you really are.
Lee Camp
Yeah. Man, that's pretty...
John Mark Comer
You know, 'cause you're not performing at that point.
Lee Camp
That's great, and that's awful.
John Mark Comer
It's awful. I hate that saying. [Lee laughs] Darn you, C.S. Lewis!
Lee Camp
We're going to take a short break, but coming right up, more from Anna Lembke and John Mark Comer about what we can do in the face of our addiction to dopamine-fueled hurry.
Now we're gonna return to Dr. Anna Lembke, psychiatrist and [00:34:00] author of the New York Times bestselling book, 'Dopamine Nation'. At the top of the show, she outlined the problem of too much dopamine - that brain chemical, which is, in reality, a powerful drug, released when we pursue and experience pleasure, and released in our brains in great abundance, in our world of great abundance. Now easily accessible, abundant, highly potent, and ever novel experiences. It becomes a chemical facilitated by everything from chocolate to cocaine, shopping to internet searching, porn to prescription drugs. Many pathways to the high, to the really high, but eventually the teeter-totter of brain homeostasis insists on coming back down. So we need more and more in our attempt to get that high again.
Many of us know this problem well, whatever our so-called drug of [00:35:00] choice. So what about some solutions? Dr. Lembke has some practical suggestions, which arise out of her research, including her years of clinical work with clients. The first suggestion, quote, "build a world within a world where we intentionally limit our access to these drugs", endquote. She calls this practice self-binding.
Anna Lembke
And self-binding can take different forms. These can be literal barriers where we, for example, don't have potato chips in the house. When we travel, we ask the hotel to remove the mini bar before we get there. We have a system of making sure that we don't bring our smartphone or other digital devices into the bedroom.
So these are all kind of, legit, uh, literal, uh, geographical barriers.
Lee Camp
Another suggestion is what she calls metacognitive barriers. Like basing our engagement with our dopamine producing drug of [00:36:00] choice on a timer.
Anna Lembke
I'm not going to use on these days of the week, or when I do use, I'm only gonna use for a couple hours. Or I'm not gonna use until I cross this finish line, either the finish line being I'm gonna abstain for a certain amount of time so that I can reset my reward pathways and then I'll use, or I'm not gonna use until I take my qualifying exam or finish this big project or get to this holiday on the calendar.
Lee Camp
Another option, the use of categorical barriers.
Anna Lembke
And that's where we say, I'm not gonna use, except in this particular context, like I'm not gonna use alone. So these are all the kinds of ways in which we can create barriers between ourselves and our drug of choice. Acknowledging that we have to temper our use in a world of overwhelming overabundance.
Lee Camp
So self-binding requires intentionality, forethought, and planning.
Anna Lembke
If we wait [00:37:00] until we're in the throes of desire, we will essentially not be able to override the powerful physiology of neuroadaptation that drives us to want to consume our drug.
Lee Camp
So the notion, then, of limiting ourselves or placing some sort of fast or self-imposed limits then becomes a route to a new sort of freedom.
Is that one way to say what I hear you describing?
Anna Lembke
Yeah, I think that's a really nice way to put it, because we have to have a kind of awe for the power of our brain's physiology to drive compulsive over-consumption in the context of overwhelming abundance.
Lee Camp
Earlier we heard Dr. Lembke share that pain and pleasure are processed in the [00:38:00] same part of the brain and that the brain wants homeostasis, or balance. She described it like a teeter-totter.
If, she suggestively imagines, little pleasure gremlins hop on one side, then little pain gremlins are produced in the brain to hop on the other side to balance out the teeter-totter. Self-binding, or abstinence, is a conscious decision to move some of the pleasure gremlins off of the balance.
Anna Lembke
Then we really need to abstain for long enough for those neuroadaptation gremlins to hop off the pain side of the balance. So that homeostasis or a level balance can be restored.
And this is really important because restoring a level balance allows us, number one, to take joy again in more modest rewards, or in our drug of choice in more modest amounts, but also, really importantly, allows us to get our prefrontal cortex back online so that we can see true cause [00:39:00] and effect.
Because when we're chasing dopamine, we really are unable to see the true impact of our drug use or our over-consumption of whatever the drug or behavior is, on . Our lives. And I've seen that so many times with patients, where they kind of have this 'aha' moment. They're like, that's, I don't even recognize myself.
Lee Camp
Yeah. That, it's a fascinating scientific description of commentaries, whether from a recovery perspective or a philosophical, moral philosoph-- philosophical perspective, or even a theological perspective on issues like powerlessness and willpower. And so what I hear you saying is that the notion of powerlessness is very real. That there's a moment in our seeking which one simply cannot employ the prefrontal cortex to say, no, I'm not gonna do that. That we do what we don't wanna do. But one can still employ their willpower, but the willpower comes in at the level of, in this case, doing the act of self-binding, of giving some sort of distance between [00:40:00] the, uh, stimulus and our reaction to the stimulus, which is, it is just, it's just very, very fascinating.
Anna Lembke
Yeah. No, that I, I love that. That was beautifully said.
You know, one of the common themes in addiction medicine is that the relapse doesn't happen the moment that the person ingests their drug after a period of abstinence. The relapse happens in the days and weeks before, as the, the person begins to disregard, well, what, what I call self-binding, the, the important barriers and practices that they know they need to engage in on a regular basis in order to stay in recovery or in order to maintain their abstinence. And that's really, really true, because we-- essentially, you know, addiction is the loss of autonomy or agency.
The gremlins take over and we are their slaves.
Lee Camp
But, she says, even in the throes of craving, when we may find our [00:41:00] prefrontal cortex dangerously close or well beyond its capacity to control our choices, we do still have one relevant specific capacity within our willpower.
Anna Lembke
We still in that moment have a will to ask for help.
And that is very fascinating, and something that, you know, you probably can't create an animal model for, but which is distinctly human - that moment where we can give it over to someone else or a power greater than ourselves and ask for help. And that is a fascinating thing. The way in which acknowledging our own loss of, of, of will, and, you know, surrendering it or giving it over to a power greater than ourselves, allows us, you know, in this very fascinating and mysterious way, to actually, uh, regain some degree of agency.
Lee Camp
Another [00:42:00] sort of, perhaps counterintuitive practice you prescribe is the pursuit of pain.
Anna Lembke
Lee Camp
So talk to us about that.
Anna Lembke
Well, it really leads right from the neuroscience, which is to say, we know that when we press on the pleasure side of the balance, we get an equal and opposite effect on the side of pain. And eventually repeated pleasures lead to this chronic dopamine deficit state, or the gremlins camped out on the pain side of the balance.
But it turns out, if the initial stimulus is a moderate press on the pain side of the balance, then the gremlins will hop on the pleasure side in order to bring it level again.
And that has very interesting implications because it means that maybe with painful stimuli, whether psychological or cognitive or actual physical pain, we can actually get our dopamine indirectly by paying for it upfront. And there's a wealth of science in an area called the science of hormesis, which is [00:43:00] Greek for 'to set in motion', which shows that by exposing an organism to mild to moderate toxic or noxious stimuli, uh, you actually make the organism more resilient and healthier.
Lee Camp
Anna Lembke
And the way that happens is that the body senses injury, and in response, upregulates the body's own reregulating healing mechanisms. So, for example, when we exercise, we know that exercise is immediately toxic to cells. And when the body senses that, what it starts to do is increase our feel good hormones and neurotransmitters like dopamine, serotonin, norepinephrine, you know, you name it, endogenous opioids.
And that those elevated levels of dopamine, which begin in the latter half of the exercise, not right away, because they're a response to the injury, then remain-- those dopamine levels remain elevated for hours afterwards, before going back down to baseline levels.
So that has very compelling [00:44:00] implications for ways that we can get pleasure and get dopamine, which we want, because, you know, uh, we, we need that in our lives, but we can do it indirectly by inviting or exposing ourselves to painful stimuli.
It can't be too much pain and it can't be all at once, because then the organism dies, right? Which is why doing something like cutting on ourselves is not healthy, because that's too much pain. It's too potent to form. We get a huge release of endogenous opioids in response to self-cutting, and then we essentially deplete our opioid system, so that then we're anhedonic or unable to release opioids afterwards.
The same thing, interestingly, with jumping out of airplanes, which produces this profound high that can last for days, but then leads - and there's a small literature on this - often leads to a kind of anhedonia and a need to then repeatedly jump out of airplanes to experience any joy at all.
Lee Camp
So rather than jumping out of an airplane, she recommends [00:45:00] mild to moderate forms of pain, what she calls 'noxious stimuli'.
One of my favorites, which she discusses - the cold shower. Someday I'll have to do a whole episode on cold showers.
But, she goes on...
Anna Lembke
Prayer, meditation, exercise, martial arts, other kinds of mind-body work, sustained concentrations, sustained creative endeavors, these types of things that are effortful at a modest degree, iterative over many days, that up-regulate our own endogenous dopamine production.
Lee Camp
Dr. Lembke suggests some other practices helpful for overcoming addiction and living a more balanced life. One of them is quite forward, even if not easy - to tell the truth about oneself. You can hear more about that in our extended interview with Dr. Lembke on our podcast.
In the couple minutes we have left. I wanna turn to your very last chapter, where you speak of the importance of [00:46:00] turning toward our lived experience in the world.
And I, I wonder-- if I recollect correctly, your, um, perhaps undergraduate studies were in the humanities.
Anna Lembke
Lee Camp
I wonder if this is kind of where your humanities come back into your work - this sort of beautiful picture of engaging a full, abundant life, taking the beauty of the world and the beauty of life seriously.
But tell us a little bit more about that.
Anna Lembke
Yeah, I mean, I-- certainly, my, you know, humanities education, you know, philosophical traditions have influenced these ideas, theological traditions. But what, what I think, where I'm coming from most strongly is just my clinical experience over the last five years.
Observing how all of us increasingly are turning away from the lives that we've been given and seeking to distract ourselves with the ever-increasing types of distractions that are available to us. And I think it's [00:47:00] a natural, natural that we want to do that. We, we want to forget ourselves. We want to merge with something greater than ourselves.
And what we're turning toward now to do that is, you know, the many, ever-increasing numbers of escapist behaviors, especially online, that really can, in the short term, serve this purpose and function, but which don't get us to where we really want to go, because you know, at some point we have to come out of our intoxicated reverie, and then we're left with a much more impoverished life.
So instead, what we need to do is really avoid these intoxicants and this pleasure seeking for its own sake and turn toward, uh, the pain in our lives, turn toward the hard things. Find that angle of repose in the lives that we've been given, tolerate the boredom, tolerate the distress and dis-ease, and see how the shape of our lives changes when we do that and become something three-dimensional and [00:48:00] beautiful and really awe-inspiring, as well as, you know, terrific, with the entomology of 'terror' built into it, um, that we're not going to find in escapist fantasy distractions.
Lee Camp
You've been listening to No Small Endeavor and our episode with Anna Lembke, author of New York Times Bestseller 'Dopamine Nation'. And John Mark Comer, author of New York Times Bestseller, 'The Ruthless Elimination of Hurry'.
We gratefully acknowledge the support of Lilly Endowment Incorporated, a private philanthropic foundation supporting the causes of community development, education, and religion, and the support of the John Templeton Foundation, whose vision is to become a global [00:49:00] catalyst for discoveries that contribute to human flourishing.
Our thanks to all the stellar team that makes this show possible. Christie Bragg, Jakob Lewis, Sophie Byard, Tom Anderson, Kate Hays, Mary Eveleen Brown, Cariad Harmon, Ellis Osburn, and Tim Lauer.
Thanks for listening, and let's keep exploring what it means to live a good life, together.
No Small Endeavor is a production of Tokens Media, LLC, and Great Feeling Studios.