Dopamine Nation: Finding Balance in the Age of Indulgence

Jacob, a middle-aged man, visited Anna Lembke, the book's author, and a therapist, to talk about his sex addiction. He remembered masturbating as a child and how he was taught to feel ashamed of it. He also even visited a Catholic priest once before to confess about it, thinking that masturbating was a sin.

Anna understood the struggle and helped Jacob to see that masturbation, when done responsibly, can be a healthy part of life. It has been proven to reduce stress and anxiety and can be a form of self-care. It can also help to improve one's self-esteem and body image.

Sex addiction, or any other form of addiction, on the other hand, is dangerous. Unfortunately, our insatiable desire for pleasure has rendered us all susceptible to compulsive overconsumption.

What's more, access to addictive substances or drugs, such as seen in the current US opioid epidemic, can increase the risk of addiction. History has proven this to be true, with the Prohibition in the 1920s reducing alcohol addiction by limiting access to it. The availability of addictive substances creates demand, and many individuals can become trapped in a cycle of compulsive use.

Relying solely on medication to treat conditions like anxiety and attention deficit disorder (ADD) is not always the best solution. This is because using medications alone can sometimes be used to mask the underlying issues and can lead to further problems. And because we commonly use these medications to run away from the pain and discomfort that we feel, we lose our ability to tolerate even minor forms of them.

To heal from mental illnesses such as anxiety and depression, we need to stop relying solely on medications. We also need to stop running away from pain by distracting ourselves, such as through binge-watching movies or reading romance novels. Instead, we need to train ourselves to be present in the moment and let ourselves experience pain as it is. This will not only increase our pain tolerance but also help us get more connected with ourselves, others, and the world as a whole.

Dopamine is a crucial neurotransmitter involved in the reward processing of the brain. It is released when an individual experiences pleasure, and the more dopamine a substance releases and the quicker it does so, the more addictive it becomes. This is why it's important to strike a balance between pleasure and pain in our lives.

We may not realize it, but addiction to something can actually lead to a dopamine deficit state. This is because the brain adjusts to the constant release of dopamine and develops a tolerance, which is a process known as neuroadaptation.

The opponent-process theory states that prolonged exposure to pleasurable stimuli can lead to an increase in pain over time, as the initial response to pleasure decreases while the after-response to pain increases. Studies conducted by neuroscientists have confirmed that heavy drug use can result in decreased dopamine transmission in the brain.

Delilah was a patient of Dr. Anna Lembke who used cannabis daily to manage her anxiety. Dr. Lembke asked her to quit for a month, and though Delilah was initially hesitant, she eventually agreed. To help reduce compulsive drug use, the DOPAMINE framework was developed. This is based on the understanding that high-dopamine substances and behaviors, such as cannabis use in Delilah's case, can lead to problems and negative consequences.

The framework involves gathering information about the substance being used, including what it is, how much is being used, and how often. It encourages the person to abstain from drug use for at least a month in order to reset the brain's reward pathway and gain clarity on their behaviors.

High-dopamine substances and behaviors can cloud our judgment and cause problems. People may use these substances for various reasons, but they always lead to unintended consequences. Young people may be less affected by the negative consequences of drug use, but as one gets older, the consequences of chronic drug use only multiply. To help restore homeostasis and balance in the pleasure-pain system, mindfulness can be practiced.

By utilizing the DOPAMINE framework, individuals can now better understand the root cause of their drug use and the ways to restore the pleasure-pain balance in their system.

Self-binding is a way to mitigate compulsive overconsumption. Take Jacob, for example, who was 65 years old and had overcome his compulsive sexual behaviors for a year. However, during a trip to Eastern Europe to visit his family, he relapsed. On the brink of another relapse, he reached out to his coach for help.

To address his problem, Jacob resorted to self-binding. This involves deliberately creating obstacles between oneself and the object of compulsive behavior to prevent excessive consumption.

The key to making self-binding effective is to acknowledge the lack of control one experiences under the influence of a strong compulsion and to bind oneself while still retaining the ability to make conscious choices.

Self-binding can be organized into three broad categories:

• Physical strategies (space): involves creating a barrier between yourself and the object of your compulsive behavior. If you're addicted to alcohol, for example, you could throw it away or keep it locked up in a cabinet. This strategy is meant to limit physical access to the object of addiction.

• Chronological strategies (time): involves limiting a substance consumption to a limited time frame. Here, your aim should be to moderately use the substance to avoid spiraling into compulsive consumption. For example, limiting drug consumption to certain days of the week or specific hours of the day.

• Categorical strategies (meaning): involves sorting dopamine into different categories: those subtypes we allow ourselves to consume and those we do not. For example, if you're addicted to sports betting, you could identify all the other things you do that trigger you to do that addictive thing, such as watching sports news, reading a sports newspaper, and so on. By identifying these things, you'll be able to mitigate your tendency to engage in sports betting.

For centuries, cold water therapy has been utilized to alleviate both physical and psychological ailments. Studies have shown that it increases dopamine and norepinephrine levels in the blood, which are neurotransmitters that regulate pleasure, motivation, mood, appetite, sleep, and alertness.

Aside from cold water therapy, exposure to low-dose radiation can also be beneficial for our health. It can stimulate DNA damage repair and help eliminate cancer cells.

In fact, there have been studies on fruit flies that showed that when they were spun in a centrifuge for a few weeks, they lived longer and were more agile than the flies that weren't spun.

Similarly, Japanese citizens living outside the epicenter of the 1945 nuclear attack who were exposed to low-dose radiation were also shown to have longer lifespans and lower rates of cancer compared to unirradiated individuals.

Embracing radical honesty can lead you to a better life. This principle is rooted in major religions and ethical codes, and is crucial for sustained recovery and limiting compulsive overconsumption. It's also a way to get to the authentic self.

Take it from Maria, who was able to improve her strained relationship with her mother through radical honesty. During her recovery process, Maria shifted her focus from the perceived failures of her mother to her own role in their strained relationship. She realized that she had been fixated on her mother's refusal to visit her at home and form a relationship with her husband and children but had overlooked her own contribution to the issue. She also recognized that her resentment toward her mother was holding her back and causing her distress.

Through the process of writing down her character flaws and examining their impact on her relationship, Maria was able to see the truth more clearly and release her anger. Her newfound honesty and self-awareness improved her relationship with her mother and taught her to be more forgiving and less judgmental.

Like Maria, we can also improve our relationships with people and all the other aspects of our lives by showing radical honesty. This means letting go of our "false self" and instead embracing our authentic self.

Donald Winnicott was the first to introduce the concept of the "false self" in the 1960s. This self-constructed persona is a defense mechanism against external stress and demands but can lead to feelings of emptiness and disconnection. The rise of social media has only heightened the problem by making it easier to present a false image of one's life.

When our lived experience diverges from our projected image, we tend to feel detached and unreal, as fake as the false images we’ve created. Psychiatrists call this feeling "derealization" and "depersonalization."

Contrastingly, showing our authentic selves will free us from all these lies and false mental images of ourselves. And radical honesty is the way to achieve this. It's a tool that will help us reconnect with our true selves and the world. It also frees up mental energy and allows for greater openness and spontaneity.

Shame, in relation to compulsive overconsumption, has a complex nature as it can both fuel and combat the behavior.

In psychology, shame is seen as a different emotion from guilt. Shame is considered harmful while guilt is seen as positive.

If a person is met with rejection, condemnation, or isolation, they can fall into a cycle of harmful shame, which only intensifies their experience and drives them to repeat the behavior that caused the shame.

On the other hand, if the person is met with acceptance, support, and clear guidance, they can enter a cycle of prosocial shame, which reduces the impact of the shame and can lead to recovery. This type of shame has a positive impact, connecting the person to their social network and reducing their addictive tendencies.