Daniel Lieberman and Michael Long are the co-authors of a new book called The Molecule of More, How a Single Chemical in Your Brain Drives Love, Sex, and Creativity and Will Determine the Fate of the Human Race.
00:44:57.860Drugs go right to the center that produces dopamine, and it hits it and releases more dopamine than natural behaviors are able to.
00:45:06.680And so really what we're doing is we are handicapping the brain.
00:45:12.220We're bypassing all kinds of sophisticated, wonderful circuits we've developed through evolution, and we're kind of turning ourselves into much more primitive organisms with this direct chemical dopamine blast.
00:45:25.480And I imagine, too, you talk about this, too, that dopamine blast causes a desensitization of dopamine receptors.
00:45:32.340So it means that you require more dopamine or stronger hits of dopamine to actually get that feeling of desire that you were seeking in the first place.
00:45:42.400As good as it feels, brain cells don't like being overstimulated in that way.
00:45:47.500So what they do is they desensitize the receptors, and it becomes harder and harder to stimulate it.
00:45:53.100And then normal pleasures that we all get, talking with a friend, going out and having a nice dinner, they don't do anything because we've desensitized our dopamine system.
00:46:01.940And eventually, you give up all ordinary pleasures, and all you want to do is stay at home and do drugs.
00:46:42.100You know, it's interesting, just this week, the World Health Organization officially designated sexual addiction as a medical illness.
00:46:50.440And I think it was just a month ago or so that they designated video game addiction as a medical illness.
00:46:57.280It's been controversial whether behavioral addictions are the same as chemical addictions.
00:47:02.440But I think the World Health Organization's decisions is a sign that we're very much moving in the direction of treating them as being similar things.
00:47:14.940This is the thing that we've talked about.
00:47:17.900The role of dopamine is a great way to approach this idea of addiction as a broader kind of thing, as opposed to what my reaction often is.
00:47:28.040It's, oh, now another problem that people have has been carted off and set aside as a disease that's beyond their control.
00:47:35.420If we think about addiction not as, oh, and now we're looking for a list to fill in and another reason to excuse people's behavior, we can say the brain latches on to things that provide pleasure and encourages us to want them with less and less return about the experience.
00:47:52.880And if we say it doesn't really matter what it is, you can become addicted within certain boundaries to virtually anything.
00:47:59.820So it's not about pathologizing kids who play video games too much.
00:48:04.580It's about the brain can latch on to almost anything and make it a problem by abuse of this dopamine system.
00:48:12.220And that gets us away from the, oh, well, you're just excusing bad behavior.
00:48:16.560It's an abuse of the system itself inside our head.
00:48:20.180Well, so understanding how dopamine works, like what can people do to, you know, quash those addictions?
00:48:28.060You know, we've got a saying in the addiction field.
00:48:34.580Because the dopamine hits, I'm sorry, because the drugs hit the dopamine center stronger than anything else, it's going to be pretty tough to go against it with willpower.
00:48:44.640You know, the old saying, just say no, that really doesn't work.
00:48:48.780The addiction is primarily your desired dopamine, and so what you want to do is counteract it with your controlled dopamine.
00:48:54.260So, for example, you're struggling to stay sober because you are an alcoholic, but you've got to go to a work party in which alcohol is going to be served.
00:49:03.720To say to yourself, well, I'll just go, and I'll be strong.
00:49:07.980It's probably unrealistic because seeing that alcohol is going to unleash the dopamine.
00:49:13.700You're going to have overwhelming craving.
00:49:16.040And this experience of craving reduces voluntariness.
00:49:19.360What you're better off doing is getting a buddy to go with you to this party who can stand by your side and make sure that you don't drink.
00:49:28.720You've really got to strategize things rather than try to exert willpower in the moment.
00:49:34.060This brings us back to the earlier idea of the power of understanding.
00:49:37.600If you understand, then you're in a position to actually avoid the situation or to accommodate the temptation when it occurs.
00:49:46.440But it does begin with understanding, and I believe, again, I'm going to say this over and over, and maybe it's just the nature of my training as a physics person, is that if you understand the system beneath it, it feels a lot more reasonable to make a choice this way rather than saying, you know what?
00:50:08.000No, this is a matter of understanding how the system works and using it to your advantage.
00:50:12.900You wouldn't try to put gas in the window of the car.
00:50:15.400It goes where the gas hole is in the back, and this is something we need to know about our brain, understanding the underlying piece and anticipate and work to make use of it.
00:50:26.580So it sounds like you're using controlled dopamine to override that desired dopamine, right?
00:50:38.120It's even better because there are so many systems in the body, in the brain, for that matter, that act in opposition.
00:50:44.200And this is actually using the system the way it's intended to be used.
00:50:48.800So, yeah, I mean, so using controlled dopamine, you are setting up constraints, maybe making changes in your environment to accommodate for that.
00:50:55.520So if you have – if you're addicted to a drug, that might mean just like get rid of all of it, right?
00:51:01.120Get it out of your house so it's not there in that – I mean, it's so close to you, right?
00:51:07.340It could mean, like you said, having a buddy.
00:51:09.400I'm curious, are there other things we can do with the, say, here and now neurotransmitters to oppose desire dopamine in an addiction situation?
00:51:21.060Well, can we talk about triggers for a second besides just the avoiding the alcohol?
00:51:26.080If you know that – like one of the stories in the book is about a person who used drugs, and whenever they smelled bleach, they were instantly drawn back to it.
00:51:38.260And they had to avoid the smell of bleach because it reminded them of cleaning the needles, to be rather graphic here.
00:51:45.820I believe that's how we wrote this out.
00:51:48.420And just to make it clear, the stimulation of dopamine can bring about different kinds of experiences.
00:51:54.300It can bring about euphoria and excitement and motivation, which is all good, but it can also bring about craving, the desire for something you don't have that in many cases is going to harm you.
00:52:56.020They're there for you for emotional support when you're having trouble.
00:52:59.740Also, there is the here and now experience of guilt if you let them down and you have a slip.
00:53:05.560And as all mothers know, there are few things as powerful for motivating behavior as guilt.
00:53:13.300So the here and now circuits can be just as powerful as dopamine.
00:53:18.620And so it's a very good idea to bring them to bear when we're trying to overcome an addiction.
00:53:23.100So let's talk, we've been talking about some of the benefits of dopamine, the downsides of dopamine.
00:53:28.640This is something that we interact with on a day-to-day basis.
00:53:31.120I'm curious, based on your research and your experience, are there like just some best practices that people can use day in and day out to ensure they get the benefits of dopamine while mitigating its downsides?
00:53:42.660I think that in modern Western culture, we tend to be a little bit over-dopaminergic.
00:53:48.640We've got all of this information flowing in towards us.
00:53:52.140We've got all kinds of new products on the grocery store shelves.
00:53:56.920So the most important thing is to be in balance.
00:54:00.120And so I think that for most of us, in order to achieve that balance, we want to do a better job of boosting our here and now activity.
00:54:08.980One way we do that is by engaging in hobbies, doing things not for the purpose of making the future better, but doing things for the purpose of enjoying right here, right now.
00:54:22.600Woodworking, crocheting, just spending time with your family and your friends.
00:54:58.600When I drive into the city, I stop purposefully and I remind myself when I drive past the Washington Miami, I go, my goodness, some people see that once in their lives.
00:55:07.200I see it every time I drive into the city.
00:55:41.000And you have to remind yourself to do this because it certainly doesn't come naturally to me.
00:55:45.300But to actually taste the food and how it feels in your mouth, the way the place smells when you're there, to indulge yourself and experience itself is a way to remind you on a regular basis that the whole world is not before you.
00:56:19.880I think as a psychiatrist, I would say the first thing they need to do is make sure they're not suffering from an illness such as depression.
00:56:26.680Because if that's the case, that's very, very treatable.
00:56:29.700People who are low-dopaminergic, they're less likely to be low-energy, and they're more likely to just be simply very, very content.
00:56:39.380There are some people who just don't want to be in the rat race.
00:56:42.040They just want to sit around and smell the flowers all day long.
00:56:46.300And I think one might say, well, there's nothing wrong with it.
00:56:49.100They just want to be happy, and they just want to be a beautiful creature.