Dopamine Nation: Finding Balance in the Age of Indulgence Audible Audiobook – Unabridged
Instant New York Times and Los Angeles Times Best Seller
“Brilliant…riveting, scary, cogent, and cleverly argued.” (Beth Macy, author of Dopesick
As heard on Fresh Air)
This book is about pleasure. It’s also about pain. Most important, it’s about how to find the delicate balance between the two, and why now more than ever finding balance is essential. We’re living in a time of unprecedented access to high-reward, high-dopamine stimuli: drugs, food, news, gambling, shopping, gaming, texting, sexting, Facebooking, Instagramming, YouTubing, tweeting....
The increased numbers, variety, and potency is staggering. The smartphone is the modern-day hypodermic needle, delivering digital dopamine 24/7 for a wired generation. As such we’ve all become vulnerable to compulsive overconsumption.
In Dopamine Nation, Dr. Anna Lembke, psychiatrist and author, explores the exciting new scientific discoveries that explain why the relentless pursuit of pleasure leads to pain…and what to do about it. Condensing complex neuroscience into easy-to-understand metaphors, Lembke illustrates how finding contentment and connectedness means keeping dopamine in check. The lived experiences of her patients are the gripping fabric of her narrative. Their riveting stories of suffering and redemption give us all hope for managing our consumption and transforming our lives. In essence, Dopamine Nation shows that the secret to finding balance is combining the science of desire with the wisdom of recovery.
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|Listening Length||6 hours and 11 minutes|
|Author||Dr. Anna Lembke|
|Narrator||Dr. Anna Lembke|
|Whispersync for Voice||Ready|
|Audible.com Release Date||August 24, 2021|
|Best Sellers Rank|| #386 in Audible Books & Originals (See Top 100 in Audible Books & Originals) |
#2 in Sociological Study of Medicine
#3 in Medical Clinical Psychology
#5 in Biology (Books)
Top reviews from the United States
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Knowing that dopamine spikes result in flatlining and other forms of mental disintegration, I immediately bought Dopamine Nation to glean insights into the numbness that seemed to be affecting me and others and perhaps give me an exit sign from this life of addiction and numbness.
Lembke does an excellent job of defining in layman's terms our addiction to dopamine, the brain’s reward pathway and addiction: “continued and compulsive consumption of a substance or behavior despite its harm to self and/or others.”
Lembke introduces us to some of her patients, all of whom suffer some addiction or other. They are debilitated, full of self-loathing, shame, and suicidal thoughts. They are addicted to online porn, antidepressants, and cannabis; one young man is an indulged snowflake whose parents give him no boundaries or responsibilities. Not surprisingly, he has no self-worth, is “psychologically fragile,” and takes drugs. All of these patients live in fear and despair. As one patient said, “I don’t want to die an addict.” Whatever differences they have in addiction, they have one thing in common: Their life of addiction has stripped them of meaning and a life of integrity. Their souls are in decay. They are consumers without a sense of the sacred. To underscore this point, Lembke quotes Philip Rieff from Triumph of the Therapeutic: “Religious man was born to be saved; psychological man was born to be pleased.”
As Lembke persuasively argues, we are pleasuring ourselves to death, and she makes references to Alduous Huxley’s Brave New World and Neil Postman’s Amusing Ourselves to Death to support her thesis. She observes that in spite of our abundant sources of pleasure, we are becoming more and more miserable. In fact, she cites the World Happiness Report that shows we were happier in 2008 than we were in 2018.
With an expertise in neuroscience, she shows the futility of seeking pleasure. Repeated exposure to our desired stimulus results in weaker and weaker pleasure until we feel nothing and enter a state of anhedonia.
The second half of the book focuses on the principles of recovery. Most crucial is dopamine fasting. She writes it takes a month of such fasting to reset the brain’s reward pathway, reduce our anxieties, and achieve homeostasis or psychological equilibrium.
Another important technique to recovery is self-binding, creating barriers between us and our addictive substance. Some of us have to avoid triggers. For me, for example, I have to avoid timepiece YouTube channels because I suffer from a watch addiction.
Another form of self binding is eating only whole foods or going vegan or going paleo because these boundaries limit our calorie intake.
Another tool for recovery is honesty. If we lead a double life and keep our addiction a secret, we will be trapped in a shame-addiction cycle in which we seek pleasure to medicate ourselves from the very shame and isolation caused by our addiction.
The author argues that we should replace meaningless dopamine with intimacy dopamine, the kind that results from meaningful connections with others.
Reading Lembke’s helpful book, I thought of Viktor Frankl’s masterpiece Man’s Search for Meaning. If we ditch our addictive substance, we’re going to have a gaping hole in our soul to fill or what Frankl calls the “existential vacuum.” I would therefore recommend Frankl’s book as a way of living after recovering from addiction.
In the short Introduction, Dr. Lembke explains that this book uses the stories from some of her patients as examples of unhealthy addition; and to help illustrate a growing problem in our society with compulsive over-consumption. She reveals that “the secret to finding balance is combining the science of desire with the wisdom of recovery.”
Part One – The Pursuit of Pleasure, has three chapters that deal with addictive behaviors in Dr. Lembke's patients. Dr. Lembke alternates between recalling the sometimes disturbing details of her patients' addictive behaviors, and describing general trends relating to addiction in modern society. She also includes some of her own personal experiences, as evidence that even trained psychologists are susceptible to the lures of over-consumption. The structure here is a little chaotic, with Dr. Lembke jumping around quite a bit in each chapter; from one patient to a personal experience, back to the patient and then to statistics on addiction and so on. At first this was a bit distracting, but it does allow her to approach her subject from different angles and give supporting evidence for her conclusions.
Chapter three gets more into the science of brain chemistry, discussing two key features of the effects of dopamine: the brain's tendency to seek homeostasis, and the development of tolerance or neuroadaptation.
In Part Two – Self Binding, Dr Lembke describes a few more encounters with patients, and how to keep addictive behaviors under control. She introduces the acronym DOPAMINE as a framework for discussing addiction: D for data, O for objectives, P for problems, A for abstinence, M for mindfulness, I for insight, N for next steps, and E for experiment. Dr. Lembke discusses self-binding, or creating barriers to prevent yourself from indulging in your addictive behaviors, and how this can make abstaining easier. She also discusses dependence on medications, and even her own struggles with whether to stay on Prozac permanently or not.
In Part Three – The Pursuit of Pain, Dr. Lembke explores the opposite side of the equation: seeking out things that are painful, in order for the brain to tend to increase feelings of pleasure immediately afterward in an attempt to regain homeostasis. She points out that seeking pain can also become addictive, and balance is key. Dr. Lembke also discusses “radical honesty”, and explains why being honest can increase self awareness, promote connections with others, and even help prevent addiction. She describes the difference between destructive shame and “prosocial shame”, and how prosocial shame can result in less self-destructive choices. In the Conclusion, Dr. Lembke summarizes her points, and advises seeking balance and confronting our fears or problems.
Overall, I enjoyed reading this book. At times I found the frequent jumping from story to story to be distracting, but I appreciated all of the insightful conclusions that Dr. Lembke offered. I think she makes a compelling case for the adoption of “radical honesty”, and I am grateful for her sharing her own personal struggles in an attempt to demonstrate her own familiarity with these issues.
Top reviews from other countries
It was a page turner for me, and I felt the "pain" associated with our dopamine system when I finished it.
To anyone who wants to learn about the mechanism I’d suggest the Huberman Lab podcast or the book: “The molecule of more”