Why Some People Get Addicted While Others Have It Easy - Anna Lembke

1. 0:00 – 0:40

   Intro

   1. ALAnna Lembke0:00

      We bombard our brains with so much dopamine that our brains have to compensate by way downregulating our own dopamine production and transmission, and we end up in this chronic dopamine deficit state where nothing else is enjoyable. We're only focused on our drug of choice. We need to keep using, not to feel good, but just to restore a level balance and feel normal. And when we're not using our drug, we're experiencing the universal symptoms of withdrawal from any addictive substance, which are anxiety, irritability, insomnia, depression, and craving. (air whooshing)

   2. CWChris Williamson0:34

      I- it's like one of those buzzwords at the moment. I've seen dopamine fasting and dopamine detoxes thrown around YouTube a lot,

2. 0:40 – 10:27

   How Does Dopamine Work?

   1. CWChris Williamson0:40

      and we're talking about imbalances in the brain, is it chemical, is it environmental? What's your favorite framework for explaining what dopamine is and how it affects us?

   2. ALAnna Lembke0:52

      Well, my framework for communicating the role that dopamine has in our brain, um, it really has to do with the fact that pleasure and pain are processed in the same part of the brain. Um, it's a part of the brain called the reward pathway. And pleasure and pain effectively work like opposite sides of a balance. So when we do something pleasurable, that balance tips to the side of pleasure, and we get a little release of dopamine in our brain's reward pathway, which is reinforcing and, and feels good. But one of the overarching rules governing this balance is that it wants to remain level. It doesn't wanna be tipped for very long to the side of pleasure or pain, and the brain will work very hard to restore a level balance, or what's called homeostasis. But importantly, the way that the brain brings that balance back to a level resting state is first by tipping it an equal and opposite amount to the side of pain, and that's wha- when our brain downregulates our own dopamine production and our own dopamine transmission, not just back to baseline levels, but actually below baseline levels to this dopamine deficit state. Now if we wait long enough, you know, that's that feeling of wanting another piece of chocolate, just one more video game, another drink. If we wait, that passes, and our balance is restored. But if we continue to, um, repeatedly expose ourselves to highly reinforcing drugs and behaviors, then over time, that initial stimulus gets shorter and weaker, but that after-response gets stronger and longer, which is why typically, we need more of a drug or more potent forms over time to get the same effect. And furthermore, what can end up happening is our, our balances can kind of get stuck on the pain side, where we end up. I like to think of it as these neuroadaptation gremlins hopping on the pain side of our balance, kind of camping out there. If we bombard our brains with so much dopamine that our brains have to compensate by way downregulating our own dopamine production and transmission, then we end up in this chronic dopamine deficit state where nothing else is enjoyable. We're only focused on our drug of choice. We need to keep using, not to feel good, but just to restore a level balance and feel normal. And when we're not using our drug, we're experiencing the universal symptoms of withdrawal from any addictive substance, which are anxiety, irritability, insomnia, depression, and craving.

   3. CWChris Williamson3:24

      What is the sensation of dopamine? How would you describe what it feels like for someone to have it and not have it?

   4. ALAnna Lembke3:32

      Well, dopamine fluctuates around this tonic baseline. So we're always, um, releasing dopamine at sort of a constant, steady rate, and it's really the way it fluctuates up and down below this baseline level that affects the way we feel. Typically, when it rises above baseline levels and we have more dopamine in our reward pathway, we feel good. We can feel really, really good. We can feel even euphoric. Or sometimes it's just a sense of calm well-being or a sense of not being anxious. Um, so it's all of those things wrapped into one. Whereas when dopamine goes below baseline, again, we feel restless. We feel anxious. We feel like something's missing in our life, um, and we have a lot of incentive and motivation to use that drug again in order to not just recreate that good feeling, but also just bring us back to a normal homeostasis.

   5. CWChris Williamson4:24

      Why do we have a dopamine balance? Is it adaptive?

   6. ALAnna Lembke4:28

      Well, it has been adaptive for most of human existence. If you think about it, our, our brains were evolved to approach pleasure and avoid pain, and that's been conserved over millions of years of evolution, as we've lived in a world of scarcity and ever-present danger. But the problem is that now, we no longer live in that world. We live in this world of overwhelming abundance, and we're very insulated from all kinds of painful experiences, such that what was once adaptive is no longer so. So I think that we really need to rethink the way that we live in this highly dopamine overloaded world.

   7. CWChris Williamson5:02

      (laughs) Why is it... So if that's the case, if, if it's the case that we feel calm sometimes at a moderate increase of dopamine and we feel comfortable, does that not mean that trying to feel calm and comfortable all of the time is inherently a wasted effort because you're going to go back to baseline eventually? I- is that something that we can't chase? We can't be in that sort of calm, comfortable situation all the time?

   8. ALAnna Lembke5:26

      Yeah, I mean, you've really intuited wh- what is essentially the bottom line of, uh, the way that pleasure and pain are processed in our brain, that really any kind of, for any kind of reward-seeking, there is a cost, and that cost is the comedown and the pain, and that the harder we try to, uh, be in that place of comfort and reward, the larger the price that we'll pay, the greater the dopamine deficit state, such that ultimately, there is futility, um, in seeking out reward for its own sake.

   9. CWChris Williamson5:59

      Is there a different dopamine set point for each person? Is that, uh, or tolerance or degrees in dopamine releases?

   10. ALAnna Lembke6:08

       Yeah, it's a great question, and there, there are, there is some science a- around this. Um, so for example, this pleasure-pain balance metaphor sort of assumes that we all start off with the same level balance, but it's probably not true. Um, there are probably people who, uh, you know, metaphorically start off with a balance that's tilted slightly to the side of pain. That could be because of people who live with chronic pain, that could be people with depression. Uh, there are studies showing that people with depression probably have lower baseline dopamine levels, or might be less sensitive to, um, typical rewards and might need more of certain types of rewards in order to get their dopamine to rise up above baseline levels. All of which potentially makes those people more vulnerable to the problem of addiction as they seek out rewards to just feel normal, not necessarily, you know, feel good.

   11. CWChris Williamson7:05

       Why is it that people that are in chronic pain don't find pleasure superbly easily then? If you're saying that it's one side of the same seesaw, the people that are in chronic pain should be able to feel amazing off just a tiny little glimpse of something that's nice. Is that not the way it works?

   12. ALAnna Lembke7:21

       No. Remember, one of the overarching rules governing this balance is that it wants to preserve homeostasis, so it wants to go back to whatever that baseline is, and it will work very hard to do that. I mean, there are, you know, evolutionary just-so stories for, for why that is, but essentially a person with chronic pain who starts out in pain, their physiologic system will want to return to that baseline. So for example, if they take an opioid to try to get out of pain, that will initially work, but over time, they'll need more and more of that opioid to get the same effect, and ultimately the initial response to the opioid will get weaker and shorter in duration, and the aftereffect, and this is really probably the most fascinating aspect of this pleasure-pain balance, is that aftereffect gets stronger and longer. So with repeated exposure to the same or similar pleasure stimulus, we end up in a deeper def- dopamine deficit state. It, it lasts longer, it goes further down. So a person with chronic pain has to experience that pain below, even beyond their baseline pain before returning to their baseline pain. So in other words, there's no free lunch. What goes up must come down, and if you start out in chronic pain, you're also subject to the same problems of tolerance, needing more and more to get the same effect, and the dependence and withdrawal, which are essentially this dopamine deficit state.

   13. CWChris Williamson8:48

       It's a vicious asymmetry, the fact that you need-

   14. ALAnna Lembke8:51

       That's right.

   15. CWChris Williamson8:51

       ... more and more to gain less and less pleasure, but the more and more will incur an even larger power low return of depression and feeling bad on the other side.

   16. ALAnna Lembke9:02

       That's exactly right. I love that, uh, I love your terminology of a vicious asymmetry. And, you know, when we think about why on earth would mother nature do that to us? It seems so cruel. But if you think about it from the perspective of millions of years of evolution, and that for most of humanity we've lived in this very dangerous world, um, with very limited resources, and we've had to work very hard to get those resources in order to survive, it makes perfect sense, right? If you have a pleasure-pain balance, which with a single exposure will give you just a little bit of pleasure, but then afterwards will give you pain, then you're gonna be very motivated to keep going and find that next oasis or find that next berry bush. We, you know, it's what has turned us into these constant seekers, never happy with what we have, always wanting more, except that our ability to be constant seekers and always improve on our lives and on our circumstance has essentially allowed us to transform the world. This is really, you know, we're living in the Anthropocene in the sense that this is the first time in human history that we have used our brains and our technology to create more abundance than we could ever need or ever want. And not just abundance, these highly addictive, highly reinforcing feel-good drugs and behaviors, essentially making us all vulnerable to addiction because our primitive wiring wasn't adapted for the modern ecosystem.

3. 10:27 – 20:20

   Why Men Feel Sad After Sex

   1. ALAnna Lembke10:27

   2. CWChris Williamson10:27

      Have you heard the quote, "After copulation, the devil's laughter can be heard"?

   3. ALAnna Lembke10:32

      (laughs) I haven't, but that's good. (laughs)

   4. CWChris Williamson10:35

      Because a lot of men report, uh, how would you say, acute post-coital depression-

   5. ALAnna Lembke10:42

      Yeah. Mm-hmm.

   6. CWChris Williamson10:42

      ... um, is something that after guys have sex, sometimes you feel a bit existentially-

   7. ALAnna Lembke10:47

      Yeah.

   8. CWChris Williamson10:47

      ... once you've finished up. I can't remember, it was someone, like far too important and impressive, like Jung-

   9. ALAnna Lembke10:53

      (laughs)

   10. CWChris Williamson10:53

       ... Jung said, "After, after copulation, the devil's laughter can be heard." It sounds so apocalyptic, but y- that was something that I thought that was interesting. Why after something that's so enjoyable does something occur afterward that is a bit unenjoyable? And it's because if you only ever had sex once, then you probably wouldn't have very many grandkids, and we are grandchildren optimizing machines. So the sex just being a little bit more uncomfortable or dissatisfying than you thought, that meal just being a little bit more unfulfilling than you'd anticipated, those things, they make you wanna go again.

   11. ALAnna Lembke11:27

       Yes. Although let's tease this apart a little bit, 'cause I think there might be... I would wonder when that quote, when that quote was said, because it does get to the issue of sex addiction and pornography in kind of a nice segue, which I think is important to talk about, 'cause it, I think it's a huge and growing problem, and we don't talk about it enough. So as long as you're comfortable going there, um-

   12. CWChris Williamson11:48

       Take me there, Anna. Take me.

   13. ALAnna Lembke11:49

       Okay. All right. So I mean, you know, when we have an orgasm, it releases a huge amount of neurotransmitters in our brain, in- including dopamine. It is, in and of itself-... a, a chemical reinforcement. Um, you know, whether we're having sex with another person or sex with ourselves, the orgasm is reinforcing, and we do develop tolerance to that reinforcing effect. So if we repeatedly have orgasms over a short am- period of time, they will be less reinforcing w- with each subsequent orgasm. And there's, of course, this natural refractory period too, where it becomes even impossible to have an orgasm, um, if, if we are condensing so many orgasms in a short amount of time. So orgasms can very much work like a drug. And I think, um, you know, in the modern world where sex is almost the last bastion of physical things that we still do, where we are in our bodies and connecting with our bodies, it has becount- become a really vulnerable place for sex addiction. Um, so when I think about, you know, the devil's laughter after, after orgasm or intercourse, um, especially m- and y- you say for men, but I guess this could include women, um, I think where that's probably amplified is when sex is just an end in itself and it's not, um, you know, an expression of intimacy and love between loving partners, but it's really, um, a way to get an orgasm. And, and I think, you know, w- when sex becomes that, and, and only purely that, especially in large quantities, then it really becomes, um, all about the dopamine, and it b- it becomes about that release, um, divorced from other meaning. And then of course, we're gonna go into that dopamine deficit state and it's gonna be even more so, um, than if we were, let's say, having sex, um, less frequently and only i- in a way that's kind of sa- sacred or sanctified. So maybe that's a little bit too holier than thou, but those are sort of my thoughts on it. I'd be curious to hear your thoughts.

   14. CWChris Williamson13:56

       What I think is interesting is when... W- we've got two elements going on here. You have the experience and the subsequent physiological impact a- and the experience, the phenomenological experience of, of that impact. But after that event, you have the retrospective psychological way that you label the experience overall. That's the thing that I think is really, really interesting.

   15. ALAnna Lembke14:19

       Yeah.

   16. CWChris Williamson14:19

       What does it mean to think back on a situation that you had and to frame that in a different way, to feel shame or guilt or-

   17. ALAnna Lembke14:30

       Right. Mm-hmm.

   18. CWChris Williamson14:30

       ... envy or dissatisfaction-

   19. ALAnna Lembke14:32

       Right.

   20. CWChris Williamson14:34

       ... and this interpretation, h- how does this, how does that slot in?

   21. ALAnna Lembke14:38

       Yeah, I mean, I think that that's, that's exactly right. That that's, that's what I'm trying to get at, but you said it even better. Um, I mean, th- the meaning that we give to that sexual act has a huge impact on how we feel about it, how we feel about ourselves. Um, you know, sex itself, I mean, as you go through life, the, the more orgasms you have, it really is like a drug. You just, we inevitably build up tolerance. We need more and more potent forms to get the same effect. You know, the, the classic trajectory of my sex-addicted patients is that m- they might start out masturbating to sort of, you know, vanilla college girl pornography, and then 10 years later, you know, it's, it's something much more deviant than that, some sadomasochistic thing. And it's not really because they're, they're violent people or they have a preference for that anale, it's that they need some- something more to, you know, jazz it up because they've become tolerant. And, you know, th- and that's... And we're living longer now, you know, than we ever did before. Like, when we died at 30 it was like, "Well, you only had a limited amount of time to get enough sex in there." And now, gee, we're living longer.

   22. CWChris Williamson15:45

       Why, why is it that everyone isn't addicted to sex then? If that's the case-

   23. ALAnna Lembke15:48

       Yeah.

   24. CWChris Williamson15:48

       ... if over time the more orgasms that you have, the more that you need to be able to get the same level of pleasure from them, surely that just puts everybody on a path to sex addiction, but not everyone has that.

   25. ALAnna Lembke16:00

       No, not everyone has that because part of what makes somebody addicted is how hard they're willing to work for their drug. So my neuroscience colleague Rob Malenka, he once summarized that beautifully. He does b- a lo- bunch of animal studies and he said, "Yeah, you know, basically I can measure how addicted a rat is by how, how hard it's willing to work to get cocaine, how many times it's willing to press that lever, you know, to get a little squoosh of, of cocaine." And that's really what separates people who become addicted to a given drug from those who don't. At some point, most of us kind of tire out. They say, "You know what? It's not worth it, like, chasing that all around. I'm done. It's not worth it."

   26. CWChris Williamson16:37

       Oh, so there's a, there's a cost-benefit analysis that's going on-

   27. ALAnna Lembke16:41

       Yeah.

   28. CWChris Williamson16:41

       ... along with the pleasure-pain dynamic.

   29. ALAnna Lembke16:43

       Yes. Yes. Yes. Yes. And, and those people who are, like, relentlessly trying to oppose those neuroadaptation gremlins and bring that balance, not just level but tweak it down to the side of pleasure, and they'll just keep at it until they can do that. Those are the people who become addicted. Plus, don't forget, there's inter-individual variability in drug of choice. So what works for one person is not gonna work for another person. I mean, as I talk about in the book, I got addicted to romance novels. I started with the Twilight saga, and I eventually, you know, over time graduated to socially sanctioned pornography for women, which is these erotica novels. Not consistent with my values, really embarrassing to talk about, but, you know, I didn't really see it as it was happening. I sort of... Only once I sort of got to, you know, Fifty Shades of Grey at 2:00 in the morning, I was like, "Why am I reading this," you know? And then I stopped and I went through withdrawal, and it was really hard for me to stop, but I could really see that I had become addicted. But interestingly, I've never been tempted by alcohol. It makes me tired and gives me a headache. Caffeine, I would love if caffeine woke me up. It doesn't do a thing for me. So you've got to take into account that we've got these different types of drugs that work sli- and, and on a population level totally makes sense, right? You would want on a, like a, your tribe, you would want one guy to be out there, you know, chasing raspberries, and you would want someone else looking for meat, and somebody else rounding up, you know-

   30. CWChris Williamson18:09

       Oh.
4. 20:20 – 24:48

   Dopamine Detox Truths

   1. ALAnna Lembke20:20

   2. CWChris Williamson20:20

      Is dopamine detoxing legit then?

   3. ALAnna Lembke20:24

      You know, I think so. I, I was doing it in my practice long before it became popular in social media. I've been practicing psychiatry for 25 years, and, um, it was something that I just sort of happened along early on. I would have patients come in primarily seeking help for depression and anxiety, and early on I would prescribe them antidepressant or do psychotherapy. M- Many of them who were also actively using drugs and alcohol didn't really get much better. And then what I discovered, and this is also informed by the neuroscience, um, 'cause the, some studies show this too, that if instead of trying to initially target their depression, anxie- and anxiety, I got them to stop their drug of choice, what happened was... And I asked them to do that for 30 days, so a 30-day abstinence trial. Um, in the first 14 days, they felt much worse because they were experiencing the universal symptoms of withdrawal, but by 30 days, they really almost universally endorsed, endorsed feeling better than they had in a really long time. Less anxious, less depressed, better able to sleep. And when you look at that from the perspective of the neuroscience of addiction, it really makes sense 'cause essentially what's happening is that the substance itself is driving the depression and anxiety. That huge release of dopamine, the rewa- reward pathway, is invariably followed by a decrease in dopamine transmission below baseline, that dopamine deficit state, which is experienced as anxiety and depression. Then we reach for our drug again because we're feeling bad, and temporarily it feels like it alleviates that. So it's like, "Oh, this is making me feel better. I should keep doing this." But in fact, the drug itself is what is driving that dopamine deficit state that makes us anxious and depressed in the first place. So the intervention is to stop using the drug, allow your own dopamine transmission and other feel-good hormones to upregulate, and then if you go back to using your drug of choice, make sure that you use it in moderation and that you don't press too hard on that pleasure side of the balance so that you don't end up in that dopamine deficit state.

   4. CWChris Williamson22:35

      What else should people do? Let's say that someone wants to do a good dopamine detox. Other than abstaining from whatever the behavior or the drug is that they're currently addicted to, what else do you advise them to do during that period?

   5. ALAnna Lembke22:48

      Well, you have to also beware of triggers, um, and also eliminate those triggers. So if you're somebody who's addicted to video games, like a patient of mine, and you find that once you go on YouTube and you start watching other people play video games, you're more likely to play a video game yourself, then you should probably eliminate YouTube for that month. If you're somebody who's trying to quit smoking cigarettes and you find if you have a casual drink with friends you really wanna smoke a cigarette, you should probably eliminate alcohol for that month as well. And from the perspective of neuroscience, it makes a lot of sense because we don't just get a release of dopamine with our drug of choice. We also get a release of dopamine with any reminder of our drug of choice. So for example, my patient addicted to video games, when he watches other people play video games, that actually releases a little bit of dopamine in his reward pathway and he feels, he feels a dopamine surge. But right after that, it goes into a dopamine deficit state. He feels craving, and that craving is the physiologic drive that sends him to wanna go and play the video game, which is why, you know, Alcoholics Anonymous often talks about avoiding people, places, and things in that time when you're trying to avoid the drug as well.

   6. CWChris Williamson23:55

      What's happening in the brain when we get a cue and a craving? What's going on?

   7. ALAnna Lembke24:00

      So when we get a cue, uh, for our drug of choice, that is a remi- any, any kind of reminder of the drug, like an alert on our phone that someone texted us, we get dopamine released in our reward pathway. So that in itself is rewarding, but that reward is followed by a dopamine deficit state. And that dopamine deficit state, remember, that is craving. That is what makes us then wanna go out and get the drug. It's the deficit that drives the motivation, which is why people often talk about dopamine as not really being just about pleasure. It's also about motivation, because it's that dopamine deficit state and that balance to the pain side that is an incredibly powerful physiologic drive that gets us to do the work to get our drug.

   8. CWChris Williamson24:47

      Mm.

5. 24:48 – 31:40

   How Social Media Impacts Dopamine Levels

   1. CWChris Williamson24:48

      What does social media and technology do to our dopamine levels? Have you looked at this?

   2. ALAnna Lembke24:53

      Yeah. So social media has essentially has drugified human connection. We are evolved over millions of years to want to connect with other people, we are tribal creatures, we're social animals. Um, my colleague, Rob Malenka, recently showed that oxytocin, the love hormone, when it's released, binds to dopamine, uh, neurons in the reward pathway and causes a release of dopamine. It's not really a surprise to most of us. We are motivated to connect and our d- our brain gets us to do that by releasing dopamine so it feels good to connect. That means that all of those meta experiences that tell us we're making a connection also release dopamine. So, we, we have a dopamine release when people like us, we have a dopamine release when people agree with us, we have a pa- a dopamine release when people, um, you know, um, enhance our reputation. We have a dopamine release when we're experiencing the same emotion at the same time as other people. So, that's very powerful, which is why social media can really be like this frenzy because when we are getting outraged at the same time as somebody else, that releases dopamine. When we're laughing at the same time as somebody else, that releases dopamine. When we watch somebody watching a video and we have the same reaction as they have to that video, that releases dopamine, which explains the mystery of why we would ever wanna watch people watching other people. But it makes perfect intuitive sense from the perspective-

   3. CWChris Williamson26:20

      Reaction videos explained. Yeah, exactly.

   4. ALAnna Lembke26:22

      Yeah. Right. But what social media has unfortunately the potential to do is actually drugify human connection by contributing to all of the features that make something addictive, and that is access, quantity, potency, and novelty. So, if we have easy access to our drug of choice, which we do with social media, um, then we're more likely to get addicted, especially when you compare that to prior to social media, what you had to do to go out and meet people, right? First of all, you had to get off the couch, you had to go out and find the people, most of them are gonna be average looking and average interesting, right? It's not like that now. You know, you can just stay on your couch and swipe right or swipe left, swipe left. Quantity, right? So, if you think about almost all traditional drugs and alcohol, I mean, typically eventually you run out and you gotta go out and get more. TikTok never runs out. If you look at potency, how do we make things more potency? We combine... With potent? We combine two drugs together, and that's exactly what social media has done. It's combined beautiful images with sex, with gaming, uh, with gambling, um, with music, with flashing lights to make it all the more potent. And then finally, novelty. Dopamine is very sensitive to anything that's new, especially if it's something that we liked before, but it's a slight variation on that. And these AI algorithms are basically learning us, figuring out what we liked before, and then suggesting something that's similar but slightly different, which automatically triggers dopamine, automatically triggers our search and explore function, our treasure hunting function. You know, when we're off and running, looking for that next slightly better thing. And then finally, s- uh, social media has enumerated things. It's given it numbers. And for reasons we don't fully understand, when we numerate things or when we have rankings or number of likes, that's really reinforcing. We tend to like that.

   5. CWChris Williamson28:16

      Why is it that some people find certain things rewarding, uh, in terms of how we interpret them? So for instance, one person might really get geed up by gaining followers on Instagram, but another one might be really interested in shooting people in a video game, and another one might w- be funny cat videos. Is this more of that genetic spread from the group, do you think, or is there something else going on?

   6. ALAnna Lembke28:39

      I think it's mostly, um, just natural drug of choice, you know, that some people are just going to enjoy certain drugs and not others, and that there's variation in the human population. But some of it too, um, has to do with our social networks. So, addiction really does spread like a virus, and we're more likely to try and use drugs that people in our social network are trying and using. So, if you hang up, hang, hang out with a bunch of video gamers, you're more likely to get online, partially because it's, you know, socially enhancing and bo- binds you to them, which is, you know, also important for people.

   7. CWChris Williamson29:15

      Are behavioral interventions the only solution then at dopamine detox, and you spend time away from your drug or your activity of choice? Is it just down to behavioral interventions or is there pharmacological solution for this? Can we, can we pray the addiction away? What's going on?

   8. ALAnna Lembke29:32

      Yeah. So, addiction really is the quintessential biopsychosocial disease, which means that we need biological interventions, psychological interventions, and social interventions. Behavioral interventions kind... You know, the... Like, like a dopamine fast sort of cross all of those because biologically what we're doing is allowing reward pathways to reset themselves, allowing ourselves to s- look back and see tru- true cause and effect. But also in order to accomplish that, um, we often have to change our environment or change the people that we hang out with. So, it's also psychological and social. But the... That's not the only intervention. We can also use, um, chemicals to help people stop using. So for example, naltrexone is an opioid receptor blocker which can be used to treat people not just with opioid addiction but also with alcohol addiction. Alcohol is mediated in part through our endogenous opioid system, so by blocking our opioid receptors we make the alcohol less reinforcing, which means people can use it not just to help them stop drinking all- altogether but actually to reduce the amount that they're drinking. And that's a really nifty tool because a lot of people don't want to stop altogether, they want to use in moderation, and when they use naltrexone what they say is that, "I, I'm just better able to stop at two or three drinks rather than progressing to six or seven drinks." I also just want to jump in and emphasize that addiction really is a spectrum disorder, mild, moderate, and severe. And this dopamine fast intervention is only really gonna work for folks who are sort of on the borderline between being addicted and being a little addicted or maybe a mild to moderate addiction in terms of-... just asking people to do it on their own. For people who are more severely addicted, the dopamine fast is equally important, but they probably won't be able to do it entirely on their own. They may have to go into a rehab, a residential treatment center, or they may have to be given, you know, um, medications like an opioid receptor blocker in order to even make it possible for them to abstain. So I, I, I just really wanna emphasize that. We're talking about a spectrum disorder, and my book is mainly targeting people who are a little bit addicted, um, although the, the ideas in there apply really to addiction

6. 31:40 – 37:45

   Which People are More Likely to Become Addicted?

   1. ALAnna Lembke31:40

      more broadly as well.

   2. CWChris Williamson31:41

      Is there a certain type of person who's more likely to become addicted or m- more likely to have multiple addictions across multiple domains?

   3. ALAnna Lembke31:50

      Yeah. So our innate vulnerability to addiction varies, and some people are definitely more vulnerable than others. Um, about 50% of the risk of getting addicted is biological or inherited. So there are studies showing that if you have a biological parent or grandparent with addiction, you are at increased risk compared to the general population of becoming addicted yourself, even if raised outside of that substance-using home. So there are really interesting adoption studies showing that when people with a biological parent with addiction are raised in a non-substance using home, they are at increased risk of developing an addiction themselves. Um-

   4. CWChris Williamson32:24

      Do you know if that crosses domains? Do you know if someone who has an alcoholic father is more likely to be a gaming-addicted son?

   5. ALAnna Lembke32:32

      That's very interesting. I don't think we have data on that. These data are mainly looking at alcohol use disorder in, um, fathers and sons. Um, but th- that would be great to look into. What we speculate though is that this is a general vulnerability to addiction, uh, rather than a specific, um, you know, vulnerability to only one substance. And we know that because many times when people will get in recovery from one addiction, one of the dangers is cross-addiction, that they'll go on to become addicted to something else.

   6. CWChris Williamson33:02

      Mm. What about psychological life events? So we've got 50% of this is heritable because behavioral genetics is just this emerging immutable bastard of a field that keeps on telling everyone that perhaps the freedoms you used to think that you have, they're not quite as-

   7. ALAnna Lembke33:17

      (laughs)

   8. CWChris Williamson33:18

      ... they're not quite as free as they were. Uh-

   9. ALAnna Lembke33:20

      Yeah.

   10. CWChris Williamson33:20

       ... what about psychological life events, stuff that happens in early childhood? Are the things that predispose us to addictions?

   11. ALAnna Lembke33:27

       Yeah. So there are certain types of mental illnesses that make people more vulnerable to addiction separate from the i- illness of addiction itself. Um, you know, people with, um, bipolar disorder are more likely to get addicted or any kind of intense emotion dysregulation, certain types of anxiety disorders, um, attention deficit disorders is, uh, correlated, uh, with increased risk of addiction. But not just innate mental illnesses, also, um, you know, life, early life experiences like early life trauma, um, and epigenetics can contribute to addiction risk. We know that people who experience significant trauma in early life are at increased risk to go o- to go on and develop addiction. But also other environmental factors like living in poverty increases the risk of becoming addicted. Unemployment increases the risk of becoming addicted. And then very importantly, um, access is really important. So if, if you live in a neighborhood or a region of the country or a society where addictive substances and behaviors are more readily available, you are more likely to get addicted. And I think that's one of the most important risk factors today, but it's not, it's seldom appreciated.

   12. CWChris Williamson34:36

       Well, it's that Robert Plomin argument where he talks about you can have all of the genes for alcoholism but if you're raised on a desert island that doesn't have any alcohol, it doesn't come to fruition. You can have 100% likelihood of being an alcoholic, but if you're not raised around any alcohol, it's not happening. So yeah-

   13. ALAnna Lembke34:51

       Exactly. Yeah. And the converse is true too. You can have very little risk for, uh, becoming addicted to alcohol, and yet if you're constantly surrounded by it 24/7 and tempted and encouraged to use it, and you use enough of it, it can change your brain and you can become, become addicted to alcohol. So, so I think that, that's right. Um, it, it's this interesting stress vulnerability diathesis, which is true for most mental illnesses. Uh, whether it's, you know, anorexia nervosa or psychosis or addiction, it's this interplay between our innate God-given vulnerability, uh, and the environment that we live in.

   14. CWChris Williamson35:28

       What, what are some of the other risk factors then? The, uh, loneliness, uh, you mentioned poverty is one of them. Do, does having a family or having a dog, does that make you less likely to be addicted? Have you looked at these?

   15. ALAnna Lembke35:41

       Yeah. Yeah. So, um, i- in general people who have, um, intimate supportive human connections in their lives, um, are at decreased risk for becoming addicted. People who have, um, meaningful work and are gainfully employed are at decreased risk of becoming addicted. People who actively participate in religious organizations are at decreased risk of becoming addicted. But again, remember these are l- large epidemiologic studies, so these are from a population level. On an individual level nobody is immune. You can have the best family and the best job and be t- the most spiritual person on, on the planet and you can still get addicted.

   16. CWChris Williamson36:25

       What's happening with the dopamine levels to do with religion and family and connection and jobs and stuff, what's happening with the dopamine that's permitting those people to be less susceptible?

   17. ALAnna Lembke36:38

       Well, probably what's happening is that they're, they're getting their dopamine in more adaptive ways, right? I mean, um, one of the things I talk about in the book is what are some healthy and adaptive sources of dopamine. And certainly intimate supportive human connections is a really essential and important and healthy source of dopamine.But also, um, meaning and purpose in life. You know, having work that you believe in and that keeps you busy and that you, you feel like is, um, valuable, um, for the world. Th- that's very important to giving people, um, you know, making them l- less likely for them to get addicted. General psychological resilience really helps, and that's typically fostered by other wellness practices, like for example, exercising, um, and making sure that you're physically healthy, getting enough sleep. Um, there's a great acronym in Alcoholics Anonymous called HALT. It stands for hungry, angry, lonely, and tired, and it's just a nice way to warn people that when you're hungry, angry, lonely, and tired, you're at risk of using your drug, so try to beware and take care of, uh, those things, uh, before you get to that point.

   18. CWChris Williamson37:44

       That's amazing.

7. 37:45 – 43:55

   Preventing Addiction Through Purpose

   1. CWChris Williamson37:46

      I'm trying to work out... You mentioned about meaning and purpose there, and some of the more ephemeral, difficult-to-define longer-term life goals, some of these are quite conservative views, things to do with family connections and so on and so forth. A lot of the time what people are trying to chase, whether it be through internet use or drug use or finding a new game or getting themselves into a community of some kind or whatever it is, uh, they're, they're trying to chase some sense of pleasure. And if dopamine-

   2. ALAnna Lembke38:17

      Yeah.

   3. CWChris Williamson38:18

      ... is the primary key pleasure-giving hormone that we have in our brain. Hormone? Chemical?

   4. ALAnna Lembke38:25

      Yeah, chemical neurotransmitter.

   5. CWChris Williamson38:26

      Neurotransmitter, yep. Ah, I knew that.

   6. ALAnna Lembke38:29

      (laughs)

   7. CWChris Williamson38:29

      If that's the c- if that's the case, starting afresh, trying to really step back from the urgent day-to-day things that you're doing with your life and actually trying to connect to a deeper sense of purpose, that must be one of the most robust ways that you can actually ensure that you have a scalable, continuous s- sense of pleasure throughout the remainder of your life, to try and find and really, really genuinely deeply connect with the things that you are doing. And it seems like what we have in a hyper-convenient world is a very shiny object that sits over the top like a shiny glaze that people continue going back to that doesn't allow us to get to the much more replicable, uh, and consistent deeper meaning that you get underneath. Is that right?

   8. ALAnna Lembke39:18

      Yeah, I mean, I w- I would agree with that. I, I, you know, I, h- the pursuit of pleasure for its own sake ultimately leads to anhedonia, or the absence of pleasure in anything that we do. And so on some level, pursuing pleasure is a mistake. I mean, we're constantly being told that we should pursue pleasure and that there's pleasure out there waiting for us, and that if we're not happy or, you know, ecstatic, then something's wrong with us, we need to get new friends or a new job or a new spouse, but the truth is that, that, again, just this relentless pursuit of pleasure actually makes us miserable, and what we need to do is stop looking for it, stop looking for that dopamine hit, and essentially try to find a way of being in the world that isn't primarily focused on rewards, but instead, um, you know, fosters a different meaning and purpose, um, h- for being. And you, you know, you hit on it exactly. I mean people g- can get this in different ways, but, you know, finding a sense of, of purpose in the world or, you know, a reason for living, typically this is, uh, living for others, um, that can really make us feel like it's all worth it without necessarily making us feel that we're experiencing pleasure. But, but really almost more that we can endure the pain of being alive, because being alive is actually pretty painful, and that it's worth it, it's worth sticking around for, um, because, you know, we wanna be here to accomplish some, some greater goal or we have, we believe that we have, uh, some meaning and purpose in life. So I do, I do really think that that's really important and that we need to shift our whole frame around, um, you know, this mirage really of the pursuit of pleasure. Unfortunately, it is the natural byproduct and the, and the dark side of capitalism. You know, a successfully capitalist society will ultimately tell us that the highest good is to consume, and, uh, that the more we consume and the better the stuff that we get, um, the happier we'll be. And of course, uh, that's, that's not true.

   9. CWChris Williamson41:30

      Is dopamine related to the hedonic treadmill then?

   10. ALAnna Lembke41:34

       Oh, absolutely. I mean, it's fundamentally related, right? Because if we just... This, this relentless pursuit of dopamine hits ultimately drives down our own endogenous production of dopamine and we end up, um, less happy than where we started. Whereas the pursuit of pain, and I use that, that term very broadly to mean not just physical pain, although I include that too, but also just doing things that are hard and inconvenient and require effortful engagement, those are the things that lightly press on our pain side and ultimately cause our own endogenous re-regulating mechanisms to up-regulate dopamine and norepinephrine and serotonin, all those feel-good ho- hormones, but not with the initial stimulus. They're the delayed reward as the compensatory or healing mechanism for the initially painful stimulus.

   11. CWChris Williamson42:23

       The brain's managed to turn everything into a drug, hasn't it? The, the end result, the net end result of everything is neurotransmitters in different levels. So whether that be buying the 200,000 pounds car and then thinking, "Oh, well, that one hasn't quite g-" but the 250,000 pounds car, that's a-

   12. ALAnna Lembke42:39

       Right.

   13. CWChris Williamson42:39

       And it'll be once I get the new lights in the driveway and then when I upgrade the house and when I do... And that is just the dopamine system playing out in real life. That when people talk about the fact that keeping up with the Joneses, what is that? It's the dopamine system existing in the real world, manifesting in people's purchasing behaviors.

   14. ALAnna Lembke42:58

       Yes, exactly. I mean, you're exactly right. We created this world and it's sort of the, the natural endpoint of our pleasure-pain balance, because we're constantly... We're wired to constantly seek out pleasure and, and avoid pain. But I'm, I'm hopeful that it's not the end of us, although the data would suggest it just might be. 70% of global deaths are attributable to modifiable risk factors, that is to say smoking, diet, and lack of exercise. Um, so if we don't rapidly turn around the way that we're constantly consuming, um, then, you know, we're probably gonna go extinct. We're gonna sort of titillate ourselves to death. But I, I, humans are kind of amazing in their adaptability, and I am optimistic that, you know, with these kinds of conversations, um, we're gonna say, "Okay, wait a minute, we need to change something here." Um, what, what's a new way to orient on this, as you say, hyperconvenient

8. 43:55 – 50:37

   Utilising Discomfort to Rebalance Dopamine

   1. ALAnna Lembke43:55

      world?

   2. CWChris Williamson43:56

      Let's talk about the other side of the seesaw then. How can people utilize pain effectively, or discomfort to make their lives better?

   3. ALAnna Lembke44:05

      There's a whole science of hormesis, and hormesis is Greek for, to set in motion. And the idea of hormesis is that by exposing ourselves to mild, toxic, or noxious stimuli, we can actually, um, become stronger and heal. And the way that works is that, um, when we expose ourselves to noxious stimuli, and examples would be extreme temperatures, um, starvation, um, exercise. Exercise is a noxious stimulus at the cellular level. What that does is that sets in motion our body's own healing mechanisms, and it tells our body, "Oh, boy, there's an injury here. You need to upregulate dopamine, serotonin, norepinephrine," all those feel-good hom- hormones. And so hormesis is actually a way to press on the pain side of the balance in order to get the gremlins to hop o- hop on the pleasure side to reset the, the hedonic set point to the side of pleasure, and it really does work, and I think it is the necessary modus operandum for this dopamine overloaded world. We have to intentionally and willfully invite pain into our lives. And, and that means we need to do things like exercise, take cold water baths, um, you know, do things that are effortful and hard, expose ourselves to things that makes us, make us anxious, and we have to do it on purpose, and we have to do it on a regular, daily basis in order to keep our hedonic set point to the side of joy.

   4. CWChris Williamson45:33

      What are some of the discomforts, uh, pathways that people might not realize are... So it's something like trying to learn a new language or trying to write an article or trying to learn something. Are th- are these the same? Are there any others?

   5. ALAnna Lembke45:49

      Yeah, anything that requires a kind of sustained concentration, and, and by the way, that, that's getting harder and harder 'cause we're constantly interrupting ourselves with intrusive thoughts of wanting to check our devices. So putting all the devices away, turning off all the l- alerts, and just allowing ourselves to try in the moment to focus, and to notice when we're interrupting ourselves but to not let ourselves be distracted with something else, and to try to stay in that moment, ride it out, and then continue to concentrate. Um, that's a simple example. You know, to do something creative or to read something that's kind of difficult, or learn something new, learn a language, those are all... Learning is a great, great example. Um, other things can be things that are just boring, right? I mean, we're so... We've sort of lost the ability to be bored, we're so constantly entertained, you know, whether it's music pumping in one direction or what have you. So just kind of letting ourselves, um, you know, in some, some ways, some people call it meditation or breathing, or just going for a walk without headphones in, allowing ourselves to be, uh, bored, anxious, paying attention to the constant ruminations of our own brain, which are mostly boring and annoying and negative. (laughs) Um, but, you know, instead of trying to just drown them out, just saying, "Oh, okay. I'll be, uh, let's be curious about that and try to learn something about ourselves and the world." Try to focus, um, on the world. So I think we do so much trying to escape into a fantasy world and pay less and less attention to our immediate environments, but just try to, like, pay attention to the environment and tolerate the distress of being in the moment. One of the things I, I think is important to emphasize is, you know, there's this, this kind of language like, "Be here now and be in the moment," and when I was in college, I kept trying to do that and thought I was doing it wrong, because every time I would do that, I was like, "Ugh, I, I hate this feeling." You know, being here in the moment's, it's miserable, it's boring, it's, it's awful. And I thought I was doing it wrong somehow compared to other people because I thought, "Well, if I could just get this right, I would feel good." But what I finally realized is, no, being in the moment is... It's hard. It is all those awful things, including being bored and being anxious, and that's kind of the point, that letting ourselves be here now and tolerate the distress of being alive is something that we need to do on purpose.

   6. CWChris Williamson48:14

      What's happening in the brain? We spoke about smartphone addiction. What happens when we have that desire to check our phone? Let's say that the notification hasn't gone off, but we have a compulsion. What is that? Is that myelination? Is that just that we have a bunch of very well, um, rehearsed, uh, pathways in our brain that wants us to do it, or is there something else? Is there an imbalance? What's going on?

   7. ALAnna Lembke48:38

      I, I think basically what's happened is, you know, we've gotten into the euphoric recall loop. So people with severe addiction will often talk about euphoric recall, how their own memory of using itself becomes a trigger that then triggers cravings and drives use, and that can happen with all of us, well, uh, for example, with the phone, where suddenly, you know, we have... And part of craving is, by the way, intrusive thoughts. So it's not like we intentionally have the thought. The thought just... barges in on our current thought process, and we can have that all the time with our phone, like, "Oh, uh, you know, I wonder..." Y- so this is my... We don't have alerts, so we're just, "Oh, I wonder, I wonder who emailed me? I wonder," you know, "I wonder who texted me?" And then that's essentially euphoric recall, and that drives dopamine up, followed by dopamine deficit, followed by craving. And then we're really in physiologic withdrawal, and we feel like this feeling can only be resolved by my checking my phone. And indeed, we check the phone, and it does temporarily resolve the feeling, because now we get a bigger hit of dopamine, and we've, you know, restored homeostasis. But right afterwards, it's gonna drive it down even further, which it sets up these loops.

   8. CWChris Williamson49:47

      So euphoric recall is like a self-perpetuated, self-created cue.

   9. ALAnna Lembke49:55

      Yes, exactly.

   10. CWChris Williamson49:56

       Fuck. The human brain-

   11. ALAnna Lembke49:58

       (laughs)

   12. CWChris Williamson49:58

       ... is so great, and then there's some things and you're like, "Why is that there? Who put that in there?"

   13. ALAnna Lembke50:02

       Yeah, I know. I know.

   14. CWChris Williamson50:02

       "That's such a stupid feature."

   15. ALAnna Lembke50:04

       (laughs) Yes, I know. That's, it's so true. But again, I just look at it from an evolutionary perspective. Like, if you, you know, were sitting around, you know, and you'd eaten all the berries, and, like, and you just could chill out there for, like, a week, that would not be good, right? You would, you would probably starve to death, 'cause by... You wouldn't have gotten up and, and put enough effort into finding the next berry bush, or whatever, running away from the lion. So I just think it's, you know, it's how we evolve for a world of scarcity. But as you say, it's really messed up for our current ecosystem.

9. 50:37 – 1:02:49

   Anna’s Tips to Control Dopamine

   1. CWChris Williamson50:37

      What would you give people as advice overall to keep dopamine under control? Let's say that someone doesn't have a outstanding use addiction. Maybe sometimes they spend too much time on their phone. Maybe sometimes when they're on a night out, they struggle to not go from five drinks to 10. But just a, a very sort of standard user of dopamine. What are some of the ways that people can... Or the habits that people can take away, that they can in- instantiate into their daily life?

   2. ALAnna Lembke51:06

      Yeah. Well, I do recommend starting out with a dopamine fast in order to restore, um, homeostati- static baselines. And if you can't do a month, can you do two weeks? You know, in my experience, to really reset reward pathways, it does take a month of not using our drug of choice. But if you can't spare that, do a couple weeks. If you can't even do that, just do a single day, and notice in that day how you will go through experiences of craving. Intrusive thoughts, euphoric recall, triggers. Um, how hard it is. How you'll be restless, anxious. I think just becoming mindfully aware of that process is, is a good and helpful first step. Then when we go back to using, keep in mind the balance and the gremlins, and try to use in moderation so that you don't get into this vicious cycle of too many gremlins hopping on the pain side of the balance, so that you're in this dopamine deficit state where you're basically net negative, and you have to keep using just to feel normal. And ways to do that are to engage in pleasurable activities that are not too potent, and to do it not too often so that you leave enough space in between for the gremlins to hop off and for homeostasis to be restored. Certainly, once we're into daily use, um, it's much harder to keep our balance in check. And I would also add that, um, a lot of times people will be like, "Well, I only use cannabis once a week, but I... And I only use alcohol once a week, and I only use poppers once a week." But at the end of the week, they've used something every day. So you also wanna be mindful of that. And, and what we're really talking about, uh, is that you wanna have two or three days ev- at least every week where you're not using any kind of potent, uh, rewarding behavior. And again, that's all to leave enough time for homeostasis to be restored. Um, and then you wanna put, you know, self-linding strategies in place. These can be physical or metacognitive. That's things like not keeping your drug, um, easily accessible in your home, or, um, you know, putting your phone on grayscale. These are all things people have talked about to make it less potent. Or deleting certain apps, um, or keeping a careful record. Anything that kind of keeps you accountable, but also puts a little bit of a pause between how-

   3. CWChris Williamson53:14

      A bit more friction.

   4. ALAnna Lembke53:15

      Yeah. A little bit more friction, exactly, between you and your drug of choice. And then a metacognitive strategy that I find is really useful is telling the truth. If we force ourselves to tell the truth about what we're doing, where we've been, what we've consumed, to other humans, we're much more likely to be truthful with ourselves. And also, there is evidence that telling the truth, which is an active and engaging and difficult thing to do, um, probably upregulates or potentially upregulates the prefrontal cortex, that big gray matter area behind, behind our foreheads. And the prefrontal cortex is really important for helping us regulate our pleasure-pain balance. So telling the truth about things large and small, what I call radical honesty, is really, really important for being able to delay gratification and also hold ourselves accountable, not just to our past selves but also our future selves.

   5. CWChris Williamson54:06

      Is that why vulnerability and opening up to people can sometimes inherently feel pleasurable?

   6. ALAnna Lembke54:12

      Yeah. So as I said before, deep human connections are a really healthy and adaptive source of dopamine, and one of the way to, one of the ways to create intimacy is to be honest with people, especially when it's hard to do, especially when we're telling them something about ourselves which casts ourselves in a somewhat negative light or makes us look, you know, not as awesome as maybe we would like to look in their eyes. And we always think that when we, when we're, when we do that, that will... Like, people will run away from us. But in fact, the opposite happens. People experience a shared, a sense of brokenness and a s- shared sense of vulnerability and actually feel closer to us.

   7. CWChris Williamson54:52

      Let's say that someone's had a behavioral addiction. It could have involved a substance or it might not have done. It could have been phone use or smoking-

   8. ALAnna Lembke54:59

      Mm-hmm.

   9. CWChris Williamson54:59

      ... and they've engaged in this behavior consistently for a long period of time, and then they stop.Do those neural pathways ever disappear? Do they ever, uh, atrophy or are they always there? Are we always going to have an increased level of susceptibility? The reason I ask this is I once heard a story about a young girl who used to go horse riding and when she turned 14 or 15 she started smoking when she was horse riding because her parents weren't around and th- they could never smell it on her because she came back stinking of horses, not smoke.

   10. ALAnna Lembke55:30

       (laughs)

   11. CWChris Williamson55:30

       Uh, and then 10 or 15 years later, she had a daughter, and she wanted to take her daughter horse riding. She'd stopped smoking when she got pregnant. She'd stopped smoking when she'd had the daughter. Took the daughter horse riding again, got on a horse for the first time in 15 years, immediately wanted to have a cigarette.

   12. ALAnna Lembke55:44

       Yeah.

   13. CWChris Williamson55:44

       So, is it the case that we need to be incredibly... Th- the, um, pathways that we lay down early in our lives are with us for the rest of time, or can we actually get them to atrophy and go away?

   14. ALAnna Lembke55:57

       So, a little bit of both. There's, there is evidence that once we become addicted to a substance or behavior, there's a latent scar of that addiction that will always be there and will never go away. And the example that you gave is, is a, is a, is a really good one. And what, what often happens with people with severe addiction is when they're triggered, uh, or, or exposed to the drug itself or another drug, that can plummet them not just into moderate use, but right back to where they were in the deepest depths of their addiction. There's also, uh, interesting animal studies showing that if you take a rat and you inject it over, um, seven successive days with cocaine, what you will find is that the rat will go from hovering on the edges of the cage to running around in the middle of the cage. And by the seventh day, it's in a running frenzy. And that can be measured by how often it, it breaks beams of light that are across th- the cage. Now, if you take that cocaine away, uh, for a whole lifetime... for a whole year, which is essentially a rat lifetime, and then you expose that sa... and what'll happen is they'll stop running and they'll start going back to their normal behavior. Um, but then if a year later you expose that rat to a single injection of cocaine, they'll immediately be back into that running frenzy as if they were on day seven, very strongly suggesting that there's some fundamental brain change that occurs that never goes away. On the other hand, although the evidence supports the idea that there are damaged areas of the brain that never heal, there's also really interesting work being done by my colleagues here at Stanford showing that recovery is characterized by building new neural, neural pathways around these damaged areas. So, recovery can happen. It can be... it's robust. People can get into recovery and be in recovery their whole lives and never relapse again. And what's probably happening is, again, they're building new neural n- networks that reroute around those damaged areas.

   15. CWChris Williamson57:56

       What I'm thinking about is the common addiction that pretty much everybody has, which is overuse of phones.

   16. ALAnna Lembke58:02

       Yeah.

   17. CWChris Williamson58:03

       And, uh, you really do set the tone f- for your later life with the actions that you make in your earlier life.

   18. ALAnna Lembke58:14

       Yes.

   19. CWChris Williamson58:14

       And if it's the case that every time that you have, uh, something in your pocket that you automatically go to pick it up to take it out, you have your apps in the position you can almost navigate with your eyes closed-

   20. ALAnna Lembke58:25

       Yeah.

   21. CWChris Williamson58:25

       ...to go through these sorts of things, the implications are, like, really, really grave, and it sounds like they're quite... it's... we should pick up behaviors with real trepidation.

   22. ALAnna Lembke58:40

       Yes, I agree with you. It's why I strongly advocate that children not have their own devices until they're at least 12 or 13.

   23. CWChris Williamson58:49

       Why is that?

   24. ALAnna Lembke58:49

       And that... Well, just as, as you say, um, you know, those are formative years. The brain is developing rapidly. The coping strategies that kids learn early in life will last them a lifetime. And if we don't in that time teach them healthy coping strategies, if we don't foster social networks with people in real life, if we don't, um, teach them about, you know, how to be well with exercise and, and diet and, and, uh, spiritual practices and we just give them a phone, um, that's, that's gonna be very bad for their ability to reverse those behaviors later on. Um, so I think it's essential that, you know, kids be shielded from these devices for as long as possible. Now, once they become teenagers, they're just gonna go out and get their own devices if you don't get them one. Um, but even then, monitoring their use. Um, you know, data show that, that parents who are actually... um, know where their kids are and what their kids are doing and what, what kinds of things they're doing online, those kids are less likely to develop, um, serious addictions to, uh, social media and other things than, than parents who are super hands-off. So, it does require, um, you know, careful monitoring and discussion, um, early in life so that people can be mindful. But having said that, I will say that I have seen people with very severe addictions get into recovery in mid and late life. So, it's really remarkable what people can reverse in terms of these incredibly addictive and reinforcing behaviors when, you know, when they, when they decide and when they have access to the resources to help them get into and maintain recovery.

   25. CWChris Williamson1:00:26

       That's reassuring to hear. It's a-

   26. ALAnna Lembke1:00:28

       Yeah, it is.

   27. CWChris Williamson1:00:29

       ... a bunch of, a bunch of things floating around in my mind. James Clear saying, "First we make our habits and then our habits make us."

   28. ALAnna Lembke1:00:36

       Yes.

   29. CWChris Williamson1:00:36

       That every action that you take is a vote for the future sort of person that you're going to become.

   30. ALAnna Lembke1:00:40

       Mm-hmm.
10. 1:02:49 – 1:03:32

    Where to Find Anna

    1. CWChris Williamson1:02:49

       Nation: Finding Balance in the Age of Indulgence will be linked in the show notes below. Where should people go if they want to find out more of the stuff that you do?

    2. ALAnna Lembke1:02:58

       Well, let's see. I'm not on social media, but, um-

    3. CWChris Williamson1:03:01

       Smart.

    4. ALAnna Lembke1:03:03

       ... annalembke., annalembke.com has, is sort of a website that has other information. And of course, shows like yours are, you know, gr- great, great opportunity to have great conversations, so thank you.

    5. CWChris Williamson1:03:13

       Thank you. What's happening, people? Thank you very much for tuning in. If you enjoyed that episode, then press here for a selection of the best clips from the podcast over the last few weeks. And don't forget to subscribe. Peace.

Episode duration: 1:03:33