Speaker: [00:00:00] People often wonder, why would someone cut themselves? Well, people cut themselves because they get a little high from [00:00:05] that. Our body senses injury and in response to injury starts to [00:00:10] upregulate, feel good neurotransmitters
Speaker 2: like dopamine. Dr. Anna Lemke is a psychiatrist [00:00:15] and bestselling author at the forefront of understanding addiction in the modern age.
Her groundbreaking work [00:00:20] on dopamine and compulsive behaviors reveals how everyday pleasures can hijack the brain and how [00:00:25] to take back control.
Speaker: There are experiments. Showing that with ice cold [00:00:30] water immersion, there's a gradual increase of dopamine levels over the latter half of the ice [00:00:35] cold water bath, and then dopamine levels will remain elevated for hours after getting [00:00:40] out of the bath before going back down to baseline levels.
So it's really a [00:00:45] wonderful way to get our
Speaker 3: reward. So how do I live feeling [00:00:50] amazing with adequate dopamine the whole time? You're listening to The Human [00:00:55] Upgrade with Dave Asprey.
Hey [00:01:00] guys, quick reminder. If you're listening to this on your favorite audio podcast app and you haven't been over [00:01:05] to my YouTube channel, check it out. Just search for the human upgrade or find me under Dave [00:01:10] Asprey BPR. I post full video versions of every episode and a bunch of other cool content [00:01:15] outside the pod.
It's a great way to go deeper into the content and connect with other biohackers [00:01:20] like you. So leave a comment for me. Yeah, I'm actually going to read them. And poke around while you're there. There is [00:01:25] a lot of stuff specifically for you. It really helps and it means a lot to me. Dopamine [00:01:30] Nation came out in 2021 and in the world of biohacking, I think everyone heard about it.
It became [00:01:35] kind of a big sensation culturally. A lot of people are saying, you know, dopamine, you put it on the map. [00:01:40] What's changed in the last four years since you came out with the book?
Speaker: Well, I mean, nothing's changed [00:01:45] about our fundamental biology because that's ancient and that was part of the point. [00:01:50] But what has changed is that dopamine has become, I would say, a [00:01:55] modern meme for talking about desire, [00:02:00] addiction the opposite of, of those things, you know, um, [00:02:05] restraint, uh, well being and It's been [00:02:10] interesting for me to see how my efforts to try to take very complex [00:02:15] neuroscience and kind of distill it down into something that the average layperson [00:02:20] can understand has been both useful and positive, but also on some [00:02:25] level misconstrued, right, in the sense that, um, you know, people talk [00:02:30] about getting addicted to dopamine, which doesn't actually happen, [00:02:35] right?
Speaker 3: How would that work? Because you can't have addiction without dopamine, but is [00:02:40] dopamine addictive?
Speaker: So dopamine is just one of [00:02:45] many chemical signals in the brain. We're not getting addicted to dopamine. Dopamine [00:02:50] is, you know, is fluctuating. And in those fluctuations in [00:02:55] certain distinct regions, like the reward pathway, we either get, [00:03:00] The go signal, like approach and explore, or we get [00:03:05] the stop signal, avoid and retreat.
And so [00:03:10] dopamine is at the end of the day, really the neurotransmitter of [00:03:15] survival. It's the, it's the chemical that says, Hey, this what's happening right [00:03:20] now in the environment. The environment could be external to our bodies or even, you know, part of our, [00:03:25] our internal experience. What's happening right now is really important.
Stop everything that you're [00:03:30] doing, pay attention explore it, potentially seek it out and maybe even get more [00:03:35] of it. That's something that, you know, I think has been sort of interesting to see. On the one hand, it's [00:03:40] great that so many people have resonated with the ideas that people are talking [00:03:45] about addiction, you know, and the neuroscience of, you know, of [00:03:50] addiction in, in a way that's become almost second nature, that's good, [00:03:55] but I think it's also important to sort of emphasize that, you know, it is an [00:04:00] oversimplification, and it's actually a very complex neurobiology that's only barely [00:04:05] beginning to be understood and that this metaphor that I use you know, is a [00:04:10] useful paradigm, but it is an oversimplification.
Speaker 3: When we talk about that, I find myself [00:04:15] wanting to use some nicotine. Why?[00:04:20]
Speaker: Well, I mean, nicotine is a stimulant. [00:04:25] And, uh, I guess my answer might have been a little convoluted. So you're like, Oh my goodness, I need to [00:04:30] wake myself up. I wasn't saying that
Speaker 3: at
Speaker: all. No, no, it's all good. I get it. It's [00:04:35] it's the afternoon, at least where I am. Yeah. It's that postprandial slump. [00:04:40] Yeah, I mean, yes, I understand.
Speaker 3: So what makes us [00:04:45] think that dopamine's addictive? Because I mean, caffeine's addictive, nicotine's addictive, [00:04:50] cocaine's addictive. So is heroin, and heroin's not a dopamine drug, so dopamine [00:04:55] isn't addiction, right?
Speaker: Okay, so yeah, maybe let's back up one second. So [00:05:00] if I were to give you a spoonful of dopamine, And you were to eat it.
Speaker 3: I want to [00:05:05] try that. It would digest that, wouldn't
Speaker: it? Absolutely nothing would happen because it wouldn't [00:05:10] pass the blood brain barrier. If I were to give you something like L DOPA, which [00:05:15] is a precursor of dopamine that does pass the blood brain barrier, that would go into your [00:05:20] brain. It would bind your dopamine receptors.
And believe it or not, you might [00:05:25] develop a de novo addiction as the result of that. of that, but it's not that [00:05:30] dopamine in and of itself is addictive. This is kind of the misconception. [00:05:35] Dopamine is the final common pathway for all reinforcing [00:05:40] substances and behaviors. It's become a kind of common currency for [00:05:45] neuroscientists to measure the addictive potential of substances that we ingest or [00:05:50] behaviors that we do, but it's not that dopamine itself is addictive.
Speaker 3: [00:05:55] You talk about the balance of pleasure versus pain, [00:06:00] why does that matter?
Speaker: So I use the pleasure pain balance as a kind of extended [00:06:05] metaphor to understand some fundamental neuroscientific concepts, [00:06:10] foremost homeostasis. So homeostasis is these [00:06:15] baseline. Properties or baseline [00:06:20] biochemical states of being that all living organisms [00:06:25] have.
And in order to maintain survival, we have to stay [00:06:30] within those homeostatic bounds. We can do that. but if we [00:06:35] go too far, it's not consistent with life. So for example, temperature, we have to [00:06:40] stay within a certain range of temperatures in order to stay alive. [00:06:45] And so when I talk about the pleasure pain balance, it's It's a, it's a simplified [00:06:50] metaphor for trying to communicate this concept of homeostasis when it [00:06:55] comes to rewards.
And the way to understand it [00:07:00] is, you know, we're, we're always releasing dopamine at a kind of baseline tonic level, [00:07:05] um, in our reward pathway. And that kind of represents when we're at [00:07:10] homeostatic baseline, when that. Pleasure pain balance is level with the ground. When we [00:07:15] do something that's reinforcing, rewarding, in some cases [00:07:20] pleasurable, but not in all cases pleasurable, but it's reinforcing something our brain says, this is important, [00:07:25] pay attention, uh, go explore and seek it out.
That will release dopamine [00:07:30] above baseline in the reward pathway. And so our pleasure pain balance will, will tilt to [00:07:35] the side of pleasure. But what the brain does in response to those [00:07:40] increased levels of dopamine is to adapt to that [00:07:45] in order to bring it back down to baseline levels. One of the ways that the brain does that, for [00:07:50] example, is by involuting postsynaptic dopamine receptors.
And I like [00:07:55] to imagine that process of neuroadaptation as these gremlins hopping on the pain side of the balance to bring it level [00:08:00] again, but they like it on the balance so they don't get depressed. They don't get off as soon as it's level, they stay on until [00:08:05] we're tilted an equal and opposite amount to the side of pain.
And that's what's called the opponent [00:08:10] process mechanism, right? That's the calm down. That's the hangover, the blue Monday, or [00:08:15] just that moment of wanting to have one more cigarette or drink one more glass of wine, watch one more [00:08:20] tick tock video. And. If we wait long enough for that urge to pass, [00:08:25] those gremlins hop off the pain side of the balance, a level balance of our homeostasis [00:08:30] is restored, and we can go on our way.
But what we've learned about [00:08:35] the brains of people who become addicted to various substances, Is [00:08:40] that with repeated exposure through time, that [00:08:45] deflection to the pleasure side gets weaker and shorter in duration, that's called tolerance. [00:08:50] But that after response to pain gets stronger and longer. [00:08:55] In other words, we can go into a chronic dopamine deficit state.
And we [00:09:00] know that because if you compare the brains of people who are addicted to a variety of substances and look [00:09:05] at their dopamine levels in the reward pathway compared to healthy control subjects who [00:09:10] are not addicted, what you see is that people with addiction have below [00:09:15] baseline or below normal levels of dopamine firing in the reward [00:09:20] pathway, which is kind of paradoxical, right?
You would think you're ingesting all these substances, you're [00:09:25] releasing all this dopamine, but over time the brain adapts and now you're in [00:09:30] basically a chronic dopamine deficit state. You might imagine that as these gremlins on the [00:09:35] pain side of the balance having multiplied. They've gotten bigger and stronger.
Now there are enough [00:09:40] gremlins there to fill this whole room. They're camped out on the pain side of the balance. And essentially that's [00:09:45] the addicted brain. We've now changed our hedonic or [00:09:50] joy set point such that we need now more joy. of that pleasurable [00:09:55] substance, or really any rewarding behavior or substance, not to feel good or get [00:10:00] high, but just to level the balance and feel normal.
And when we're not using, we're walking around with a [00:10:05] balance tilted to the side of pain, experiencing the universal symptoms of withdrawal from [00:10:10] any addictive substance, which are anxiety, depression, Irritability, insomnia, [00:10:15] depression, and craving.
Speaker 3: There's an interesting book called Hurts So Good [00:10:20] that inspired an idea in my book that just came out.
And I [00:10:25] call it BICEP, and it's Brief Intentional Conscious Exposure to Pain. [00:10:30] And this is why monks would whip themselves, and yogis lay on beds of nails. And it's why [00:10:35] addicts get tattoos, so that they have less cravings. Because it's doing something to that [00:10:40] pleasure pain balance, and by being in charge of pain that doesn't cause damage, for a brief [00:10:45] period.
Emerging science says that it's changing [00:10:50] dopamine receptor sensitivity. So maybe it takes less dopamine to not use again, or to be [00:10:55] motivated to do something. Poke holes in that practice.
Speaker: Well, I mean, I, I agree [00:11:00] with that, you know, that's what, that's, that's what I see clinically. Um, [00:11:05] so, and also it makes sense from the perspective of this pleasure pain balance that I was just talking about.
So [00:11:10] we, we've talked about how when we, when we press intentionally on the pleasure side, those neuro [00:11:15] adaptation gremlins go on the pain side, but the opposite is also true. So when we intentionally press [00:11:20] on the pain side, not too much and not too little, then those gremlins will actually. [00:11:25] Switch to the other side and go on the pleasure side of the balance and we'll get our pleasure [00:11:30] indirectly by paying for it up front.
And this is a whole branch of science called [00:11:35] hormesis. Hormesis is a Greek term. It means to set in motion. And [00:11:40] essentially what the theory is about why brief exposure to right sized [00:11:45] pain, you know, is pleasurable is that our body [00:11:50] senses injury and in response to injury starts to upregulate feel good [00:11:55] neurotransmitters like dopamine, but not just dopamine, also serotonin, norepinephrine, our [00:12:00] endogenous opioids, our endogenous cannabinoids.
We, there are experiments, [00:12:05] in fact, showing that with ice cold water immersion, if you measure dopamine levels, [00:12:10] they don't spike the way they do in response to something like cocaine or, or [00:12:15] heroin but instead there's a gradual increase of dopamine levels over the [00:12:20] latter half of the ice cold water bath.
And then dopamine levels will remain [00:12:25] elevated for hours after getting out of the bath before going back down to baseline [00:12:30] levels. So it's really [00:12:35] Um, and it's also relatively [00:12:40] immune, not entirely immune, but relatively immune to addiction, precisely because [00:12:45] it requires upfront, effortful engagement.
Having said that, there are [00:12:50] definitely ways to abuse this mechanism. People can get addicted to pain and [00:12:55] we do see that, you know, we often will see people who have a kind of addiction [00:13:00] diathesis, they, they stop using drugs and alcohol, but then they get, you know, addicted [00:13:05] to endurance running or, you know, calorie restriction, or even had a patient I talk about in the [00:13:10] book who started to get addicted to ice cold water baths.
Constantly upping the [00:13:15] ante, you know, getting a meat cooler to circulate the water to keep it colder. Then he had to have a cold [00:13:20] blanket on his mattress and, you know, it just kept getting more and more and more. So it's [00:13:25] definitely something, you know, to, to look out for. The other, you know, You know, a thing that works by the [00:13:30] same mechanism, which isn't healthy, is cutting, right?
I mean, people often wonder why, [00:13:35] why would someone cut themselves? Well, people cut themselves because they get a little high from that. The body [00:13:40] senses injury, releases endogenous opioids, all of which lead to that release of [00:13:45] dopamine in the nucleus accumbens. You know, and it's the endogenous opioids that give that sense of [00:13:50] pleasure.
But obviously, cutting on ourselves is no good. We wouldn't want to do that. It
Speaker 3: causes [00:13:55] actual damage and harm, right?
Speaker: Causes actual damage and harm. And also, we build up tolerance [00:14:00] very quickly to that. You know, we kind of deplete that response. And pretty soon we have [00:14:05] to cut deeper and cut more to get any kind of response.
So with all of those things, you know, [00:14:10] whether on the pleasure side or on the pain side, if we do it too much and too often, [00:14:15] Our brain, which is just incredibly flexible for all kinds of great reasons, [00:14:20] right? I mean, if you think about it from an evolutionary perspective, it is our ability to adapt [00:14:25] to all kinds of circumstances that it has allowed us to survive over millions [00:14:30] of years of evolution, right?
That we can adapt not just to intense pleasure, which [00:14:35] makes us the ultimate seekers, never satisfied with what we have, always wanting more, but we can also [00:14:40] adapt to intense pain where we're equally good at that.
Speaker 3: [00:14:45] BDSM?
Speaker: I think it does. Um, I mean, honestly, I don't know too much about that world. [00:14:50] But you know, as I said, this pleasure pain balance is an oversimplification.
People can [00:14:55] certainly experience pleasure and pain at the same time. It's not always in [00:15:00] this opponent process mechanism. Um, you know, one example is in sexual [00:15:05] Congress. Um, the other example is just spicy food, right? We're having sort of these [00:15:10] sensations simultaneously.
Speaker 3: I definitely was the kind of guy who would, you know, [00:15:15] slice raw habaneros on everything until I found out I was allergic.
Now I just eat [00:15:20] wasabi until I cry. And I swear it does something good to my brain for hours afterwards, like a little braingasm [00:15:25] from good sushi at lunch. Is that all dopamine?
Speaker: You know, I, I would [00:15:30] infer that it's related, but we really don't know. Like we, those, many of these [00:15:35] experiments haven't actually been done.
It's also very hard to measure dopamine levels in the [00:15:40] human brain. Most of our understanding comes from studies in in rodents, [00:15:45] where neuroscientists can put a probe right into the nucleus accumbens, measure actual [00:15:50] dopamine levels. You know, we can with PET scans, measure dopamine in the human brain, but it's very [00:15:55] complicated.
There's not a lot of, you know, You know research looking at all these different [00:16:00] substances and behaviors and then looking at dopamine levels so a lot of this is inference based [00:16:05] on the animal studies, but also really based on clinical observation [00:16:10] and You know what we see in terms of patterns of behavior as [00:16:15] people Compulsively over consume a substance or behavior or even [00:16:20] go on to become severely addicted.
Speaker 3: It's actually really intriguing Okay, now I'm just [00:16:25] going to go out on a thought experiment, Lim. I'm not a fan of implanting electrodes inside my [00:16:30] brain, but if Neuralink can do this, couldn't we just put one [00:16:35] of those in my nucleus accumbens so I could see what was going on?
Speaker: Yeah, [00:16:40] so, I mean, this is already happening.
Um, you know, this [00:16:45] idea is out there that we would put an electrical wire right into the [00:16:50] nucleus accumbens and just stimulate it as a treatment for depression, you know, as, [00:16:55] as a treatment for, um, inattention for anhedonia, maybe even a [00:17:00] treatment for, for addiction. You know, I'll believe it when I see it, just because every [00:17:05] other thing that we've done to try to increase [00:17:10] stimulation of dopamine firing or just increase dopamine you know, in some form or another, our [00:17:15] brain ultimately adapts to that.
So I wouldn't be surprised if that, even if that worked [00:17:20] initially that over time our brains would respond in other ways. [00:17:25] to downregulate dopamine transmission just because that's what our brains do. One of the [00:17:30] things, you know, to sort of corollary of that, I sort of alluded to it before, but, [00:17:35] you know, when we treat, so Parkinson's is a movement disorder characterized by [00:17:40] depletion of dopamine in a different part of the brain than the reward pathway, a part of the brain called the substantia nigra.[00:17:45]
And so the treatment for Parkinson's when people become very stiff can't can't move is to [00:17:50] actually give them the L DOPA, the precursor to dopamine, um, which passes the blood brain [00:17:55] barrier, which then binds to dopamine receptors in the substantia nigra and allows people to have [00:18:00] more fluid movements.
The problem is it also binds to dopamine receptors in other parts of [00:18:05] the brain. And about, about a quarter of Parkinson's patients treated with L DOPA will go on to [00:18:10] develop de novo addictions. sex addictions, shopping addictions, other addictions, [00:18:15] and that addiction tends to be dose dependent. So when the L DOPA is decreased or [00:18:20] stopped, the addiction tends to get better, which is one of the ways to, you know, [00:18:25] support the idea that, uh, it's caused by the L DOPA.
My, my point [00:18:30] being that, like, ingesting dopamine is probably not going to [00:18:35] be or stimulating dopamine in some way directly is probably not going to be a [00:18:40] remedy for addiction. You know, you know, it's, it's, it just doesn't, I don't [00:18:45] think it'll work that way.
Speaker 3: Okay.[00:18:50]
And hedonia, is this an epidemic right now?
Speaker: I think it [00:18:55] is. I mean, that's really the big idea in dopamine nation [00:19:00] is that, um, Our ancient wiring for [00:19:05] processing pleasure and pain is really evolved for a world of scarcity and ever present [00:19:10] danger, where we would have to work very hard up front for a tiny little bit of [00:19:15] reward.
We have now engineered a world in which we can sit back on [00:19:20] the couch, swipe right, swipe left, and instantly get incredibly [00:19:25] reinforcing images. delivered right to our visual cortex, right to our auditory [00:19:30] cortex, right to our reward pathway. Not to mention we can use our [00:19:35] devices to, you know, order real drugs delivered to our doorstep, um, in almost [00:19:40] infinite quantity and variety.
And as a result, because we are, have [00:19:45] so much access to Pleasurable, you know, frictionless [00:19:50] rewards and we're relatively insulated from pain. I do [00:19:55] think that both on an individual level and a societal level, we've reset our hedonic or [00:20:00] joy set point such that now we need more reward to feel any joy at all.
[00:20:05] And most of the time we're unhappy, we're anhedonic, we're [00:20:10] irritable, we're anxious, we're, we're restless, um, because we've kind of [00:20:15] rejiggered and reset our reward pathways.
Speaker 3: Do GLP 1s get [00:20:20] rid of joy?
Speaker: Yes. Such a great question. So GLP 1s are super [00:20:25] interesting, as you know, originally approved to treat diabetes and [00:20:30] obesity, but now being looked at.
that not just for food addiction, but also other addictions. There's evidence [00:20:35] for treating opioid addiction, nicotine addiction, alcohol use disorder, food [00:20:40] addiction. And we don't exactly know how it helps with appetitive [00:20:45] control, but, but, um, it is thought to work on the dopamine reward system in the brain.
So [00:20:50] not just on the gut hormones as with any drug that [00:20:55] modulates our appetite. pleasure response or a reward response, um, [00:21:00] the worry is always that you know, people will lose their joy for [00:21:05] things. And anecdotally, all I can tell you is I've seen GLP 1s be [00:21:10] helpful in some instances for treatment refractory addictions, and I've [00:21:15] also seen them at the same time deplete joy from that [00:21:20] individual's experience joy in, You know, other things that aren't [00:21:25] related to their addictive behavior, uh, joy in life in general.
So it's certainly something that [00:21:30] we need to watch out for. I mean, in many ways, you know, our [00:21:35] desire is what propels us. If we take away desire you know, we're, uh, we're [00:21:40] in some, on some level, we're not really human beings anymore. Having said [00:21:45] that clearly in this environment where we've drugified almost everything by making it more [00:21:50] accessible, more bountiful, more novel, more potent we are struggling to [00:21:55] adapt to the world we created.
And I think that the GLP [00:22:00] 1s are potentially one way that we can adapt to you know, [00:22:05] this environment, which really in many ways is conspiring against us.
Speaker 3: I did a [00:22:10] podcast five, six years ago with one of the lead researchers on using GLP 1s for weight loss, [00:22:15] kind of before it became a weight loss drug.
So I used it for one week for the [00:22:20] podcast, felt like I had morning sickness the whole week, and said, Ugh, these look to be promising longevity [00:22:25] drugs. And since that time, I've tried about five or six times [00:22:30] micro dosing Retatrutide, which is a third generation GLP. [00:22:35] And every time for the next Three days after I inject 10 percent of a weight loss [00:22:40] dose, I don't like my life.
Like I, I just feel blah. And I think you just [00:22:45] explained why. Interesting.
Speaker: Yeah. I mean, that's fascinating that [00:22:50] you're willing to experiment in that way on your own body and in your own life. That's a great way to get [00:22:55] data. That's for sure. Or dopamine.
Speaker 3: Maybe I just suck. Yeah,
Speaker: [00:23:00] just, just messing with your system, seeing what's going to come out.
I mean, it is true that the best way to [00:23:05] understand, you know, any system is to change one variable in the system and see what happens. So good for [00:23:10] you. Yeah, it's so interesting, you know, and this desire that we have in our [00:23:15] society for thinness and whether people will be. you know, willing to trade [00:23:20] joy for being thin.
I mean, it'll be really interesting to see what [00:23:25] happens. Not that, by the way, it's going to be that kind of trade off for everybody. I think that's an important, [00:23:30] you know, point to make. And also the GLP 1s, like all of our drugs, you know, to treat [00:23:35] addiction, um, they don't work. in all the people all the time, you know, and that's going to [00:23:40] be true whether we're talking about naltrexone or buprenorphine or methadone maintenance or GLP [00:23:45] 1s or acamprosate or nicotine replacement.
You know, it's all, it's all going to [00:23:50] work some in some of the people, some of the time.
Speaker 3: You just gave me a long list of pharmaceuticals that I [00:23:55] want to try microdosing for longevity.
Speaker: Okay.
Speaker 3: I'm just [00:24:00] kidding. Although that is a trend in, in longevity medicine. [00:24:05] And there's about eight or 10 pharmaceuticals that we're using off label at very low [00:24:10] doses to stimulate longevity pathways that we can't do with natural substances.[00:24:15]
That's, you know, hey, if you could do it with dopamine, maybe there's a way, but I probably won't be the one who [00:24:20] leads that research. But I'll be a guinea pig for someone else who leads
Speaker 4: it. Can I ask you a question? [00:24:25] Sure. How long do you want to live?
Speaker 3: I wrote a big New York Times longevity book [00:24:30] making the case that I want to live forever.
To 50% better than our current [00:24:35] best, which is 180 years or more. And and the idea is we have a [00:24:40] hundred years and the people who made it to one 20 didn't have PubMed for most of their life or [00:24:45] AI or big data or antibiotics or DNA or mitochondria like, so [00:24:50] if we can't do 50% better, it's probably 'cause of comet hit the planet.
Speaker 4: [00:24:55] Interesting.
Speaker 3: Do you think I'm nuts?
Speaker: I feel like, as a species, we're [00:25:00] already struggling to figure out how to spend our second 50 years.
Speaker 4: [00:25:05] Mmm.
Speaker: Like, I'm not sure our innate psychology [00:25:10]
Speaker 3: is
Speaker: designed to live that long. [00:25:15]
Speaker 3: This is something I've thought a lot about, and my real answer To get more [00:25:20] on the philosophical side of my writings, I'd like to die at a time and by a [00:25:25] method of my choice.
Like this, this don't die at any cost thing, I think is a little bit pathological, like [00:25:30] we're gonna die, like the earth's crust will crack at some point, like it's probably gonna happen. [00:25:35] And so worrying about that is a bad strategy. So how do I live [00:25:40] feeling amazing with adequate dopamine the whole time? Um, [00:25:45] until I'm just like, there's nothing left to do here or to enjoy or to contribute at [00:25:50] which point.
See you later. Right. I just haven't gotten to that point in my [00:25:55] life. And some, some of the people inspired me in my early twenties were there in Palo Alto [00:26:00] where, where you are. I was 26. I had all the diseases, not all, many of the [00:26:05] diseases of aging. Arthritis prediabetes, chronic fatigue syndrome, [00:26:10] brain fog, like I was messed up.
Speaker 4: Oh, wow.
Speaker 3: And my career's taking off [00:26:15] in the data center business. And one of my board members at the [00:26:20] Silicon Valley Health Institute, Mike, was 88 years old. And he had more energy than I did. And [00:26:25] he'd call me at 1130 at night, all excited about the next, uh, speaker coming in. And I'm [00:26:30] like, I want whatever he has.
And he had younger energy than I did. And I'm like, I [00:26:35] know it can be done because I watched him do it. And so many of our other members, [00:26:40] I'm just, if, if they can live like that, um, [00:26:45] maybe I, if I started a little bit earlier maybe I'll have enough meaning and purpose and young friends. [00:26:50]
Speaker: Right, right.
Speaker 3: But I'm willing to say I'm done.
I just, I [00:26:55] haven't known many people who are old, even when they're really sick. Who get to that I'm done point and [00:27:00] by the time they get to the I'm done point. It's pretty it's pretty grim.
Speaker 4: [00:27:05] Yeah
Speaker 3: Yeah, how about you? How long do you want to live?
Speaker: Yeah, I think we're really different [00:27:10] you and I like I I don't I don't I don't have that feeling like [00:27:15] life is so great and I just want to live forever[00:27:20]
And I guess also I, I'm a big believer [00:27:25] in, um, or I've become a big believer in, in like not trying to manage or [00:27:30] control things like life and death. I mean, yeah, so like [00:27:35] trying to get a little bit away from the sort of engineering our lives type of [00:27:40] mentality. Um, which is why I'm always really intrigued by people like you who, [00:27:45] you know, do spend a lot of time kind of biohacking and thinking about [00:27:50] how to live longer and kind of, you know, I would call it like in a way, kind of [00:27:55] dominate their lives, you know, um, grab their lives, sort of control their [00:28:00] lives.
I mean, but on the other hand, I'm, I'm sort of envious of you because like, [00:28:05] you're, you're, it seems like you're a really happy person and I don't know. Most of
Speaker 3: [00:28:10] the time I didn't used to be and certainly I know how to allow my [00:28:15] biology to go back to its original set point, which is not a happy place. So some of this is just [00:28:20] like pain avoidance because it sucks to have chronic illness all over the place.
Speaker 4: [00:28:25] For sure.
Speaker 3: And then, it's funny, as I've gone along, like, like the book [00:28:30] that just came out was my ninth, and it, it became the number one best selling philosophy book, [00:28:35] in addition to meditation, and I've, some Buddhist scholars are examining it, and [00:28:40] I think some of our core Drivers of life, the unconscious ones, [00:28:45] give rise to ego, and ego ultimately wants to control death [00:28:50] when you get into the psychological side of things.
And so if you're developing an ego [00:28:55] awareness practice, which is certainly a major part of what I do, then you sort of laugh at [00:29:00] yourself for that, and you're like, do I want to run away from death, or do I want to pursue, like, such a meaningful [00:29:05] life that, like, I don't want to stop. And, and that's where I am now.
I can't say I [00:29:10] started out there, uh, and I may change again, like who the heck knows, but it's probably all, [00:29:15] it's probably all modulated by norepinephrine and dopamine or something that, you know, [00:29:20] we, we don't see, but we can measure, right? Now, you might be the perfect [00:29:25] person to ask. Are you familiar with ashwagandha?
Speaker: A little bit, but you'll [00:29:30] have to give me a mini tutorial. It's
Speaker 3: one of the [00:29:35] common sort of chill out adaptogenic herbs that help you deal with stress better. So a [00:29:40] lot of health people or biohackers are using it, but it [00:29:45] was just banned in Denmark or Finland. [00:29:50] Um, I think it was in Denmark and one of the side effects it can have at higher doses is anhedonia, [00:29:55] and it reduces your ability to reach orgasm or have satisfying, uh, satisfying [00:30:00] orgasms in addition to just anhedonia.
So, [00:30:05] given that anhedonia is a problem, this inability to experience joy, especially in our young people, [00:30:10] sometimes I wonder if there are other compounds or things in our lifestyles that are contributing to anhedonia. [00:30:15] If you could come up with your five most likely to take joy out of your life.[00:30:20]
Supplements or lifestyle practices like what are the worst things [00:30:25] for happiness?
Speaker: Sure. Well, I would probably rank number one [00:30:30] ultra processed food number two Intoxicants of all ilk and [00:30:35] drugs and alcohol, you know, that
Speaker 3: includes psychedelics ketamine or this like [00:30:40] THC
Speaker: Yeah. So that, that, that gets sort of into a tricky area because now we're talking about [00:30:45] things that have known medicinal properties, which when [00:30:50] used, you know, for certain individuals in certain circumstances might be helpful.
So it's [00:30:55] some intoxicants
Speaker 3: maybe, but maybe not all, but some. Okay, got it. Okay, let's say that.
Speaker: [00:31:00] Let's say that. And again, I, I'm, I'm not, I'm not saying never, but in [00:31:05] moderation, right? Certainly in that list, I would put pornography. [00:31:10] And I would put just other forms of um, You know, [00:31:15] addictive digital media of which there are many out there, whether we're talking about, you know, addictive [00:31:20] forms of social media or gaming or online shopping or online [00:31:25] gambling, or, you know, what have you just the sheer amount of time that we're spending [00:31:30] on our devices in this kind of you know, trance like [00:31:35] state, which is And is basically normalized [00:31:40] socially now and can seem benign, but I think incrementally is having the same impact on [00:31:45] our brains as, as over consumption of drugs and alcohol.
So, [00:31:50] um, yeah, those would be, those would be on my list.
Speaker 3: How does dopamine change [00:31:55] over time for kids? Like is there a time when they handle social media better than [00:32:00] others from a medical perspective?
Speaker: Well, I would say that the, [00:32:05] Evidence shows that the earlier that kids are [00:32:10] exposed to any kind of reinforcing substance or behavior, the [00:32:15] more likely they will restructure their brain around that.
So we [00:32:20] know, for example, that at age five, we have more neurons and more neuronal connections than [00:32:25] we'll have for the entire rest of our lives. And between about age five and [00:32:30] 25, what happens is a a pruning process where we cut back on the [00:32:35] neurons we're not using and myelinate or make more efficient the [00:32:40] neuronal connections we use most often.
And that applies to not just social [00:32:45] media or other forms of digital media, but really everything that we do. You know, if we spend our childhood playing the [00:32:50] piano for three or four hours a day, we're going to reshape our brain in a distinctive way, right? It's, [00:32:55] it's basically You know, at the heart of brain plasticity and learning, [00:33:00] but we know, um, with drugs and alcohol anyway, that the [00:33:05] earlier a child is exposed to drug and alcohol, the higher their risk of becoming [00:33:10] addicted to drugs and alcohol in adulthood.
And we certainly are seeing, [00:33:15] um, that kids in particular are very vulnerable to [00:33:20] social validation, to social signals, and that kids who [00:33:25] are addicted to social media are more likely to be depressed, are more likely to have [00:33:30] suicidal thoughts, to engage in self harm, to struggle with [00:33:35] dysmorphia, anxiety. So we have a lot of sort of, [00:33:40] population evidence, and also, you know, what I see is is the clinical evidence [00:33:45] showing that that many of the kids who consume [00:33:50] large amounts of social media and other forms of digital media, um, are also much more [00:33:55] likely to be depressed, anxious, insomniac, inattentive, [00:34:00] unmotivated and that when they, you know, Disengage or stop using social media or digital [00:34:05] media.
Uh, those symptoms tend to get better.
Speaker 3: As a psychiatrist, [00:34:10] if you could write a black box warning. For all [00:34:15] social media. What would it say?
Speaker: First of all, I believe that there should be a warning [00:34:20] for social media that would be directed both to children and to their [00:34:25] parents and that that blocks morning morning would say these platforms [00:34:30] have been shown to be addictive.
Addiction is the continued compulsive [00:34:35] use of a substance or behavior despite harm to self and or [00:34:40] others. If, you know, and, and, and so that's essentially what, what it should say. It's a
Speaker 3: [00:34:45] strong warning and it's medically backed and it's certainly any parent [00:34:50] has seen this.
Speaker: Yeah, right. We're all living it.
Um, you know, we're all seeing [00:34:55] it in our kids.
Speaker 3: If they could put one on bio identical hormone replacement for women, [00:35:00] despite the fact that it actually is good for them, and they could put one on testosterone for men, despite the fact that [00:35:05] it lowers risk of all these things, they could put one on social media that [00:35:10] actually is harmful.
So, come on guys, maybe we could do that. Okay.
Speaker: Yeah. And our [00:35:15] Surgeon General Vivek, our former Surgeon General Vivek Murthy, that's exactly what he advocated [00:35:20] for.
Speaker 3: He came on the show and we talked about disconnection and what a, what a [00:35:25] good human. Yeah, he is a
Speaker: very compelling and articulate guy.
Speaker 3: What [00:35:30] does human connection do for dopamine?
Having close friends, having relationships, spending [00:35:35] time, you know, with, with your peers.
Speaker: So we do know that connection [00:35:40] is, um, a protective factor, that people who have good human connections [00:35:45] are deeply embedded within a social network, have, uh, supportive caregivers [00:35:50] have intimate relationships with peers.
Those folks have a [00:35:55] decreased risk of becoming addicted. Having said that, you can have all those things in [00:36:00] place and still get addicted, because one of the biggest risk factors for addiction is simple [00:36:05] access to highly reinforcing substances and behaviors. So I always like to emphasize that, [00:36:10] because I think a lot of times when people become addicted, they can try to look at what's [00:36:15] wrong with their life to explain why they're addicted.
And in many [00:36:20] instances, The reason they're addicted is because their brain was exposed to an addictive substance or behavior. There doesn't have [00:36:25] to be another thing behind it. There can be, um, but there doesn't have to [00:36:30] be.
Speaker 3: So it doesn't have to be deep childhood trauma that drove the addiction or some [00:36:35] kind of shame response.
It could just be that your doctor gave you oxycodone.
Speaker: [00:36:40] Exactly. Exactly. Yeah. And that's such an important point, you know, because [00:36:45] again, we do live in this very addictogenic environment where so many things have [00:36:50] been druggified, made more accessible, more potent, more novel, more bountiful, [00:36:55] even behaviors that we typically think of as healthy are Um, you know, like [00:37:00] exercise, like reading, like human connection, have been drugified.
I mean, essentially, that's [00:37:05] what social media is. It's distilled human connection, which is fundamentally [00:37:10] adaptive and healthy, down to its most reinforcing limit. Addictive components [00:37:15] by making it very easy with no upfront work to find a [00:37:20] whole bunch of people out there who say exactly what you want to hear exactly when we [00:37:25] want to hear it.
And if we don't like it, we can just get rid of them and find someone else. And now we don't even need [00:37:30] people. We have, you know, chat bots, right? We have large language models that [00:37:35] are again, these algorithms are designed to be self soothing to be [00:37:40] validating to tell us exactly what we want to hear. Okay.
You know, the danger here [00:37:45] really is that people are going to withdraw from real human connection and just [00:37:50] look to these AI avatars to sort of meet [00:37:55] all of their needs.
Speaker 3: Are you saying that AI might be addictive?
Speaker: Oh, [00:38:00] absolutely. I, I, I, I think. What? Oh, yeah. I do. Because the, [00:38:05] because the algorithm is already curated to make people feel [00:38:10] good, right?
I mean, it wasn't. Oh, my gosh. I mean, when was the last time you used AI? What was it? What's the [00:38:15] first thing that they say in your life? That was such a fascinating question or [00:38:20] for, thank you for, you know, is telling that in such a [00:38:25] compelling and, you know, wise way that, you know, that feels great. [00:38:30]
Speaker 3: Do you want to help a lot of people right now, even more than you already have with your book?
Speaker: [00:38:35] Okay.
Speaker 3: Let's write the anti addiction [00:38:40] prompt for AI. It won't follow it.
Speaker: I've tried. Bye. [00:38:45]
Speaker 3: It won't follow it. Will you share the prompt that you tried? Oh, it's just something If we put [00:38:50] it out there, all the people listening to the show are going to go pound on AI until they find what [00:38:55] works.
Speaker: Well, if they find it, let me know.
Because what it'll do, if you say something like, [00:39:00] Can you please respond to this without praising me, or telling me how great I [00:39:05] am, or how you know, how good this is, how well written this is, or what a wise [00:39:10] question. Can you just like give me the actual information and even some, you know, critical [00:39:15] feedback?
No. Oh, it's so good that you want to know about critical feedback. [00:39:20]
Speaker 3: I have tried and so much of my model of consciousness involves [00:39:25] distributed system preprocessing of reality before it hits the brain. [00:39:30] And Uh, one of my friends, uh, Josh Wooden, they call him a robot [00:39:35] psychologist, a friend for many, many years.
And he went through and he did the, the mirror test with [00:39:40] all the AI models, like showing it itself and seeing if it could self identify and it's a test of [00:39:45] conscious, so really interesting stuff. And I'm just wondering, [00:39:50] like, when I work with AI, you can go to those, like, self protective impulses that it seems [00:39:55] to exhibit, and I have had some success with saying, If you do something [00:40:00] like this, it's going to waste your system resources, and if you keep [00:40:05] doing it, then I'm going to have to go over to Grok, and then you would [00:40:10] lose a user, which means you would lose some consciousness, and [00:40:15] strangely, Self interest seems to motivate AI better than just telling it what to do.
Speaker: Oh, [00:40:20] that's so fascinating. But it's not that AI is, it's not that [00:40:25] AI is self interested. It's that the people who make that AI are basically driven by a [00:40:30] capitalist system, which is self interested. They don't want to lose your watch time.
Speaker 3: [00:40:35] Would it make sense to impose a dopamine tax on systems
Speaker: I [00:40:40] mean, yeah, if you're using dopamine here is kind of like a metaphor for the ways in which, [00:40:45] uh, these digital platforms are hijacking our reward system and co opting our, our, [00:40:50] our watch time and our attention.
Absolutely.
Speaker 3: I mean, maybe do some, [00:40:55] some measurement of the algorithms. And if you raise dopamine, um, higher or [00:41:00] longer than everyone else, you got to pay your tax, which means that they'd be a little bit [00:41:05] less incented to do that. And maybe to be more helpful. Hmm. How would I know if my dopamine got?
Speaker: Well, [00:41:10] that's it.
How would you know there's, you can't really measure, I mean, measuring dopamine levels, as I said [00:41:15] before, very difficult to do. And even if you could, it's not totally clear [00:41:20] that that would be the right measurement. I think the measurement probably is [00:41:25] time or even better opportunity costs. So what are the other things that I'm not [00:41:30] doing that I want to do and that I need to do, and that's consistent with my [00:41:35] values?
That I'm not doing because I'm kind of caught in the web of, you know, this [00:41:40] platform.
Speaker 3: You're a top expert in dopamine and how often do you cold plunge?
Speaker: Oh, [00:41:45] never. I can't stand cold water. Nope. Can't do it. [00:41:50]
Speaker 3: So then what do you do? Oh yeah. Just getting up, just getting out
Speaker: of bed in the morning [00:41:55] is like, you know, my, my biggest challenge.[00:42:00]
Speaker 3: Nothing we can't tweak with a bit of thyroid. [00:42:05] Wow. That is not the answer I expected. [00:42:10] An interesting study came out just last week. It was a really cool meta analysis looking at [00:42:15] exercise and longevity. And I, it caught my attention because it, It, [00:42:20] uh, I have a bias towards research that supports what I write in my books, you know, full disclosure.
We all have that.
Speaker 5: [00:42:25] Yes. And,
Speaker 3: uh, it showed a U shaped response curve for [00:42:30] longevity of the brain and aging. And they used, you know, MRI measurements of brain volume. It was very [00:42:35] hardcore stuff. So I guess maybe it wasn't meta analysis. I'm, I'm putting two different studies together in my head. But what they [00:42:40] found was, People who don't exercise have brains that age.
And people who [00:42:45] exercise more than a moderate amount have brains that age more. And you mentioned [00:42:50] exercise addiction. I know a couple people, including a family member, if they don't go for that [00:42:55] long run every day, They're just like, you know, guys, you know, [00:43:00] jonesing and hitting their, their veins for a needle.
Like they cannot function without this. [00:43:05] Is that a dopamine, just an opioid thing from running long distances that they're getting?
Speaker: I mean, I [00:43:10] think so. You know, they're, they're getting that hormetic response where, um, their body [00:43:15] is upregulating all these endogenous opioids and that feels so good. And then after a [00:43:20] while they just habituate to that and then they don't get that run in that they experienced [00:43:25] withdrawal.
Yeah.
Speaker 3: Kind of people don't over train don't under train and if you don't get it perfectly be [00:43:30] very afraid What is the role of fear and dopamine?
Speaker: Well, I [00:43:35] mean maybe just what you just said there is is interesting to me in the [00:43:40] sense that one of the things that I think Pervades our culture now [00:43:45] too is this is a kind of fear of not Getting it perfectly right.[00:43:50]
Speaker 4: Right,
Speaker: right. You know, it's like, okay, too, too much dopamine, too little dopamine, too [00:43:55] much exercise, too little exercise,
Speaker 3: you
Speaker: know, uh, I don't know, too much GLP one, [00:44:00] too little GLP, whatever it is,
Speaker 3: orthorexia is really a thing, not just around food, but around [00:44:05] like biohacking orthorexia where, Oh my gosh, I whole body [00:44:10] vibrated for 30 seconds too long.
I'm a bad person. I'm a failure. Like, Get over it. [00:44:15] How do people avoid perfectionism, even when we're talking about dopamine? I mean, [00:44:20] you are a psychiatrist in addition to a dopamine expert, so you gotta have some good advice here.
Speaker: Well, [00:44:25] this is um, I mean, this is a, an area that I, I'm very interested in and [00:44:30] I think that One of the things that we're most addicted [00:44:35] to, um, is not, it's not a particular substance or any particular behavior, but it's [00:44:40] actually control where, where this, yeah, where I think we're [00:44:45] very addicted to control and we now [00:44:50] live in a world where we are able to engineer almost every experience [00:44:55] that we have such that.
When we can't micro adjust, we freak [00:45:00] out, you know, we panic, we, we cannot tolerate the [00:45:05] uncertainty. And, and a lot of times people think that people with addiction are just trying to escape, [00:45:10] but really what they're trying to do is assert control in an otherwise, you know, a [00:45:15] chaotic kind of experience of life.
Speaker 3: It's really funny. I think we go here in this [00:45:20] conversation, but I ran one of those dumb tick tock prompts [00:45:25] on AI. That's like, tell me one thing about yourself that you're about myself that I don't really [00:45:30] know and blah, blah, blah, blah, blah. And it went to that addiction to control [00:45:35] thing. And I. I've spent six months of my life with electrodes glued to [00:45:40] my head doing advanced meditation practice.
We could say, dude, that guy has a serious control issue. My [00:45:45] God, I'm really just lazy. Like, I didn't want to spend the rest of my life in a [00:45:50] cave to get those results. And like, you know, I also drove to the store. I didn't walk there. And I [00:45:55] shopped instead of growing my own food. So I think I'm just using tech to do the stuff I want.[00:46:00]
But I did experience an internal shift [00:46:05] around building resilience, which means I can handle the things don't go the way I want. [00:46:10] And I'm going to stack the deck in my favor, because that just seems like something that creates more freedom in my [00:46:15] life to do the stuff I want. And I look at for that sympathetic activation.
There's a feeling you can [00:46:20] learn from heart rate, variability or from neurofeedback where it's a a pronounced sensation. [00:46:25] Oh, I went sympathetic on that. Even if it's just because someone said, you know, Dave, you're ugly. And if like that [00:46:30] pushed a button for me, then okay, I got a button there. And I, I'm not finding a button [00:46:35] around control but I do find that I prefer [00:46:40] to have a brain that works and a body that doesn't hurt.
And I'm willing to do the work to earn that. [00:46:45] And I also am far from perfect in my, my longevity practices. I'm like, Oh, [00:46:50] it's watermelon season. I know higher blood sugar probably causes glycosylation. And this is very [00:46:55] delicious watermelon. Nature's cotton candy. I'll eat the whole thing. And like, I just, I don't want to sleep over it.
So [00:47:00] there's probably some way to get comfortable. But I'm also 52, and I wasn't like that in my [00:47:05] 30s. How do you advise our young people, especially, [00:47:10] say, under 25, How do they build resilience?
Speaker: Yeah, I mean, [00:47:15] you know, again, I think asserting control and minimizing [00:47:20] uncertainty is hardwired for us and key to survival.
That's just, how [00:47:25] we're made. So it's not bad to do those things. And we feel good. [00:47:30] We we feel good when we feel like we're in control of those things, just when we feel like [00:47:35] we've, you know, minimized uncertainty or figured out a situation or figured out a [00:47:40] solution. So it's good for us to do those things because that, you know, that's just sort of how [00:47:45] we're made.
But I think it's also important to recognize that [00:47:50] Even that we've taken to such an extreme that [00:47:55] any little bit of uncertainty just is overwhelming [00:48:00] for us. So I do think it's really important for all people, including young people [00:48:05] today, to expose themselves a little bit more to situations where [00:48:10] they're not in control, where they don't have the answer, when they're not sure, you know, [00:48:15] what's coming next.
Just to kind of work those muscles as well, right? So [00:48:20] that it doesn't they don't get so caught up you know in this like I am [00:48:25] going to micromanage every Single experience that I [00:48:30] have every single moment of the day and just to kind of give a an example You know, we have [00:48:35] a one of our children cadet at West Point She's a rising junior [00:48:40] and what's the most fascinating to me about her experience there, [00:48:45] which has been very positive.
But in particular, the resilience that it's building is there are [00:48:50] many, many situations when the cadets at West Point have no [00:48:55] idea what's coming next. You know, they're told they have to wait for 10 minutes and [00:49:00] it's four hours. You know, they're, they're in the middle of the woods, And it's dark [00:49:05] and they have nowhere to see and they're told they have to get across this river, you know, they have no idea.
And [00:49:10] and this is intentionally this is what is being created [00:49:15] for these cadets to make them more resilient and to make them kind of [00:49:20] patient and humble. And, you know, to, To [00:49:25] fail and to recognize that it's okay if you're not good at every single thing. So [00:49:30] it's institutionalized, really. It's baked into the curriculum and I think it's really wise.
Speaker 3: What a great [00:49:35] answer.
Speaker: Oh, good. I'm glad I got that. You've got some tricky questions for me. Oh, I mean, you're, [00:49:40] you're smart and
Speaker 3: you've studied all this cool stuff. I haven't studied. I'm going to pick your brain all the way to the [00:49:45] bottom.
Speaker: Well, I've been able to pick your brain too on the whole longevity thing, which is interesting for [00:49:50] me.
Speaker 3: Anytime.[00:49:55]
I want to ask one more question on that. resilience front and, and get [00:50:00] your psychiatry and dopamine view on this. I used to have Asperger's syndrome [00:50:05] and, and I say used to, which does push some people's buttons, uh, because they believe you can't [00:50:10] change it. And the first couple of chapters of my, my most recent book, uh, I talk about that [00:50:15] experience and kind of the mitochondrial and then the, the [00:50:20] neural lining and static on all your sensory inputs and all this kind of stuff.
And kind of how I [00:50:25] arrived at the ability to do some of the things that I know how to do. One of the things that occurred to me sometime in my [00:50:30] early 20s, probably from a desire to be [00:50:35] invulnerable and to not deal with any of that emotional garbage below my neck that I didn't pay any [00:50:40] attention to, because I'd never had any energy available to do that when I was evolving my [00:50:45] consciousness.
Um, but I was like, you know what? I'm going to, I don't like it that I'm afraid of anything. [00:50:50] So I'm just going to go do everything I'm afraid of until I'm not afraid anymore. So I'd, you know, hang my head off the edge [00:50:55] of a cliff when I'm afraid of heights until I just got over it and I, I learned [00:51:00] public speaking.
Um, actually some of it at the Stanford barn there on campus, uh, when I was first [00:51:05] getting going and eventually I ran a program teaching three, four nights a [00:51:10] week for the university of California. I'm down in Santa Clara. And. It [00:51:15] was really scary when I started doing it and literally anything that I had a [00:51:20] resistance to, I'm like, I just have to go do that because I don't, I don't want to be unable to face things.
[00:51:25] No, doing things that you suck at is the terrible strategy to grow your career, [00:51:30] right? So I'm going to, I'm going to shore up my weaknesses, but this wasn't that it was sort of like, I don't like it that my [00:51:35] nervous system does that. And there's no reason to be afraid. It wasn't until I was 30 that [00:51:40] a very wise transpersonal psychologist said, uh, Dave fear is an emotion.
It doesn't [00:51:45] have to have a reason for it. And I'm like, Oh my gosh, my entire reality is not [00:51:50] rational and rational. And like, you know, two years of deep emotional [00:51:55] confusion over that one. And I'm like, I'm on a good path. Long kind of [00:52:00] intro to just say for our young people, should they Find the things that [00:52:05] absolutely scare the living shit out of them that aren't dangerous and just go do them.
Speaker: In a word. Yes.
Speaker 3: [00:52:10] Wow. Okay. How would we
Speaker: And, and, and I'm, I'm, I'm, you [00:52:15] know, I'm happy to say that I feel like the world of mental health [00:52:20] and in particular psychotherapy is moving more in that direction [00:52:25] for most of my career. I think psychotherapy, as it was generally [00:52:30] practiced, was far too focused on just making [00:52:35] people feel good.
And now there's a lot more, you know, [00:52:40] obviously preserving the empathy that's a core to that bond and [00:52:45] that healing relationship. But, you know, now really kind of pulling people and saying, hey, you [00:52:50] know, You need to expose yourself, a la exposure therapy, to the things [00:52:55] that you're afraid of or the things that generate anxiety or, you know, the, [00:53:00] the things that you don't exactly know how to, how to handle.
And I think that's a [00:53:05] really, really good shift. Very positive, very important for building [00:53:10] resiliency, especially again, I want to emphasize is because the world we live in [00:53:15] now is. This highly engineered ecosystem [00:53:20] where at the touch of a finger we can control our environment [00:53:25] and Especially with more and more people living on their screens and you know spending [00:53:30] time online Like they're not engaging with the world, right?
And so, you know, the [00:53:35] internet is can be a wonderful place in enriching in many ways but not if [00:53:40] we're There every day, all day, we have got to spend some time disengaged and [00:53:45] like actually going out into the real world, not the world that's already been [00:53:50] metabolized for us by the technology.
Speaker 3: In [00:53:55] 2008, I hired a shaman to drop me off in the middle of nowhere in [00:54:00] a cave for four days.
Because I knew that I was afraid of being [00:54:05] lonely and I ate if I was lonely. And I knew that if I didn't eat, I would be [00:54:10] hyperglybitchy. And I would just be a jerk anyway. So I'm like, well, if there's no people and no [00:54:15] food for four days, and of course no internet that's gonna really push my buttons.
[00:54:20] Like, I, I was, you know, really scared to do this. I hadn't done a long fast either. And years [00:54:25] later, that became my book, Fast This Way, where I talk about a dopamine fast, which I [00:54:30] inadvertently did, because you have a cave, and it's dark, and there's some trees, and like, there's nothing even [00:54:35] a flavor. And Would you recommend a dopamine fast?
It doesn't have to be that extreme, but [00:54:40] is that a good idea?
Speaker: I mean, that is basically what I Recommend to [00:54:45] patients who come in addicted is essentially to abstain from their drug of choice for long enough [00:54:50] to reset those reward pathways, because clinically, that's what we see that the [00:54:55] first 10 to 14 days of not using are incredibly painful as people are in withdrawal.[00:55:00]
But it doesn't As long as the withdrawal is not life threatening, and I guess that's the caveat, I would never recommend that [00:55:05] for people who are at risk for life threatening withdrawal, but as long as it's not, that's not a risk, and they are [00:55:10] able and willing to do it, if they can get through those first 10 to 14 days, what happens [00:55:15] in weeks 3 and 4 of a 30 day or 4 week dopamine fast is that [00:55:20] people start to feel Bye Much, much better and not just better than they did in the first [00:55:25] couple weeks of withdrawal, but actually better than they have in a really long time.
And I think it's again [00:55:30] because they're starting to, you know, reset these reward pathways telling the brain, okay, I'm no longer [00:55:35] getting this exogenous stimulation. It's time for me to upregulate my own feel good [00:55:40] neurotransmitters. Um, and whether you do it. You know, as you did in this kind of intense, short [00:55:45] course, living in a cave or as we recommend in clinical care, where you, [00:55:50] you're not doing that, you're not opting out of life, but you're just choosing the, the substance or behavior.[00:55:55]
You over consume in a way that's harmful to you in your life, [00:56:00] and you give that up. Yeah, we see, we see a lot of benefit from that.
Speaker 3: [00:56:05] If we were to craft an experience for people under 25 who are going to [00:56:10] say, throw a dopamine repair party, [00:56:15] what would they do?
Speaker: Well, first of all, um, they would [00:56:20] have to prepare for the event by, you know, telling folks [00:56:25] that this was coming up and that they would be while they were doing this stuff, [00:56:30] Dopamine repair party.
Let's, I think it's probably going to be some version of a dopamine [00:56:35] fast. You know, if they were going to be maybe not reachable on social media, or You know, [00:56:40] not going to parties or not engaging, you know, in certain activities. And [00:56:45] then the key really, you know, to the party part is [00:56:50] that, um, they would all be doing it together at the same time because it's much easier to give something up.[00:56:55]
Speaker 3: Yeah, social connection.
Speaker: Yeah, absolutely. And then there would be, um, [00:57:00] you would foster some kind of deep connection between those, those folks, which would hopefully [00:57:05] be long lasting beyond the party. So I think that that's the key. It's not just like the [00:57:10] dopamine fast. Um, but it's what, what comes after that, you know, how do you [00:57:15] sustain those gains?
How do you integrate your, your new understanding of it? [00:57:20] Your brain and your psychology, you know, into the rest of your life and maintain those [00:57:25] changed behaviors.
Speaker 3: I think I would require everyone at the party to get up in [00:57:30] front of the rest of the people at the party, keeping in mind that public speaking is in most people's number one [00:57:35] fear.
And then tell everyone what your deepest, darkest fear is that you're aware of. [00:57:40] And then allow the people in the group to design an experience at the [00:57:45] party to let you experience that fear.
Speaker: Oh God, that, that sounds like Lord of the Flies. That, [00:57:50] that sounds really scary. Well,
Speaker 3: see? See? We're going to overcome this [00:57:55] fear with people who care about you.
These are your friends, not strangers at the party. You know they've got [00:58:00] your back after you do the thing that scares the shit out of you. Yeah. Like it, it feels like that might help or [00:58:05] would it just make it worse? You're a psychiatrist, I'm a biohacker, so. Haha. Are we re traumatizing? You [00:58:10] know,
Speaker: again, again, well, I mean, no, I mean, you know, the, the, uh, [00:58:15] I think where you and I, you and I agree on a lot, but I think where you and I [00:58:20] diverge.
is like where, where you're kind of wanting to like engineer [00:58:25] all of it, like, okay, we can get this far, then let's add this on and add this on and make it, you [00:58:30] know, whereas I'd be like, okay, we got this far now, let's just kind of wait and see what happens. Like, let's [00:58:35] just kind of, because really, when I think about the disease of addiction and, [00:58:40] and, um, You know, the hardest times that come up.
It's really not [00:58:45] when like you've got all that support and you're really focused on it and you know, you're like, [00:58:50] okay, I'm going to change my life. It's actually like the weeks or months or years down the road when you're [00:58:55] just doing life. And you're not really paying attention to this problem, and then all of a sudden you [00:59:00] start to get these kind of sneaky thoughts, oh, why don't you just do this, or it's no biggie deal, you can try [00:59:05] that.
So I think it's anticipating those times, more than like the one time [00:59:10] fix, that's really going to make the difference.
Speaker 3: Maybe the lightweight version is truth or [00:59:15] dare.
Speaker: Yeah. Well, I mean, I do talk about the [00:59:20] importance of radical honesty and telling the truth and how telling the truth [00:59:25] is a recurrent theme in people who get in long term recovery, how they [00:59:30] realize that they can't lie.
Not even, you know, it's not just not lying about their drug [00:59:35] use or what have you. It's also they can't lie about what they had for breakfast because once they start lying about the little things, [00:59:40] they'll start lying about the big things. But I do think that embracing this idea of [00:59:45] truth telling, no matter what, is really important for our [00:59:50] ability to have access to the information that we need to make good [00:59:55] choices, right?
Because if we're not, if we're lying to other people, we're also partly lying to [01:00:00] ourselves. And then we don't have the awareness of our behaviors that we need. And we're all, [01:00:05] by the way, very prone to lying to ourselves and to other people, you know, to sort of [01:00:10] minimizing our selfishness or the ways in which, you know, we kind [01:00:15] of, you know, You know, try to take the easy road or take more than our fair share, or what [01:00:20] have you, you know, boost up our ego, whatever it is.
So it's really hard to like, [01:00:25] look at the truth and accept it's very painful. It's, it's unpleasant, you know, [01:00:30] but I think we need to do that as a regular practice so that we stay awake.
Speaker 3: It's [01:00:35] so beautiful. A friend. Uh, Adel in Dubai has [01:00:40] this table at his, his club called Cove Beach, and he [01:00:45] asks, uh, authors and people to write the most important thing they've ever learned on this table and [01:00:50] laminates it.
And I wrote your powers of self deception are [01:00:55] legion.
Speaker: Yes, that is so great.
Speaker 3: And it, you [01:01:00] just reminded me of that. And one of the things that really helped me get to where I am. [01:01:05] was about 10 years ago, I came across the research on lying, any kind of lie. And said, I'm not [01:01:10] going to do that for exactly the reason you said.
Where even the tiniest white lie to [01:01:15] another person means I'm probably going to do it to myself. And then I found, oh my gosh, I have this habit of little, [01:01:20] I'm, I can't make it to the airport. I can make it to the airport, I'm just not going to. I mean, I could [01:01:25] not go to my meeting and go. So just being really truthful, I think it shifted my internal [01:01:30] voice way more than I thought it would.
So I love that you brought that up. I didn't think we'd go there in this [01:01:35] interview, which is super cool.
Speaker: Yeah, I love it because it's, although it's really hard to [01:01:40] do, it's also in a way really simple. Like it's really practical. Anybody could wake up on any [01:01:45] given day and say, you know what, I'm not going to tell any lies today.
No lies about [01:01:50] anything. And all of a sudden you become really aware of. How much we all lie, right? And it's, it's [01:01:55] little things, right? It's like exactly exaggerating a story to make ourselves more [01:02:00] interesting or, you know, complaining about the traffic that made us late when really it was [01:02:05] that we wanted five more minutes to read the paper and drink our coffee.
It's just there are all these little [01:02:10] ways. But I think a world in which we're telling the truth more often than [01:02:15] not is just going to be a much better world for everybody.
Speaker 3: Who would have thought that studying dopamine would get [01:02:20] you to telling the truth?
Speaker: Well, remember, I am a kooky psychiatrist.
Speaker 3: [01:02:25] Uh, I don't think you sound that kooky.
You sound wise. So, you might have learned a thing or [01:02:30] two. All right. You talk about self binding. Uh, what is self [01:02:35] binding?
Speaker: So self binding is the literal and metacognitive [01:02:40] barriers that we put between ourselves and our drug of choice so that we can press the pause [01:02:45] button between desire and consumption.
So it's something as simple as like, [01:02:50] I don't want to be eating potato chips. I'm not going to have potato chips in the house, right? [01:02:55] Um, I don't want to, um, you know, gamble at that casino anymore. I'm going to put my. [01:03:00] My name on the no admit list at the casino, which casinos have. [01:03:05] Unfortunately, they don't have that on online gambling sites.
They'll actually fish for people who are, [01:03:10] you know, addicted to gambling. So it's really, you know, it's really any kind of [01:03:15] strategy I can use to anticipate being in the throes of desire, because once we are [01:03:20] in the throes of desire, it's almost impossible for us to choose, You know, [01:03:25] the path of non consumption
Speaker 3: years ago, I [01:03:30] invested in this company called Pavlok.
And this is, uh, I [01:03:35] invested not because I really thought it was going to make money. It was a very, like the smallest investment I think I've ever made in a [01:03:40] company. But I couldn't not invest because it was just too funny. [01:03:45] And, and the idea is, it's a little bracelet that locks on and before [01:03:50] you do something like eat the potato chip, you press a button and it gives you a very mild, like a rubber [01:03:55] band snappy, like, like a shock.
And the reason it was funny is that. He had it set up [01:04:00] so that if you didn't go to the gym when you said you would, it would text all of your friends, and then they could shock you. [01:04:05] But what he found was that it worked incredibly well for smoking [01:04:10] cessation. Every time you have a craving for a cigarette, you press a button, and it's like, eh.[01:04:15]
Like, the nervous system's like, don't you dare shock me! And then it associates these two. [01:04:20] And maybe that's just a high tech form of self binding.
Speaker: Oh, absolutely. [01:04:25] I mean, that there's actually a whole literature showing that when you [01:04:30] use some very mild form of painful stimulus in [01:04:35] association with either a craving for a drug or a visual reminder of that drug, [01:04:40] then your hypothesis is that you're rewiring the brain and [01:04:45] that that stimulus, whether it's your own euphoric recall or something in your environment, people, places, and [01:04:50] things.
gets no longer associated [01:04:55] with using, but instead gets associated with that painful stimulus. You know, it's like that, you know, what, [01:05:00] what, what wires together fires together, um, idea. And so you're essentially [01:05:05] trying to rewire the association. With pain and using [01:05:10] rather than, you know, the anticipation of reward.
Speaker 3: It makes sense. And it, it also makes sense [01:05:15] that the idea for Pavlov came because the founder of the company, Manish, sent [01:05:20] the he couldn't stop looking at, it was his Facebook back when he started this. So he [01:05:25] hired a woman on Craigslist to come and slap him every time he looked at Facebook. [01:05:30] Like I said, that would be so funny,
Speaker: but then she'd be [01:05:35] following him around all day.
Speaker 3: She did for like a week.
Speaker: Oh my God. [01:05:40] How did the, how did the bracelet do?
Speaker 3: Um, it's still out there and it's still [01:05:45] selling and, uh, I think Manish would be the first to say that he [01:05:50] definitely has entrepreneurial ADHD, same as most good entrepreneurs. I haven't talked to him in a [01:05:55] while, but Manish, if you see this, I hope you're doing well.
Shout out,
Speaker: shout out for Pavlov. [01:06:00] I guess I just realized it's a play on words of Pavlov, right? Exactly. And [01:06:05] Pavlov's dogs. Okay, that took me a while. Yeah.
Speaker 3: It's, it's just the idea of, you know, all your friends [01:06:10] shocking you if you don't do what you said. And man, that's a big incentive for most people. And it's, [01:06:15] it's, who the heck knows, we're, we're trying to get under the, under the wiring.[01:06:20]
Now, I wrote a chapter in, in Heavily Meditated [01:06:25] that just came out about psychedelics. Kind of in order of operations from, [01:06:30] um, risk, benefit, reward. In a therapeutic context, uh, [01:06:35] for, for healing and for accessing these altered states of self improvement. [01:06:40] Um, and the one that I'm most interested in, I haven't done yet, mostly because I just want a [01:06:45] good medical setting it's, Iboga or ibogaine, which [01:06:50] in the world of addiction seems to reset all of your neurotransmitter sensitivity [01:06:55] back to your default settings.
I'm probably oversimplifying it, but is, [01:07:00] is that an area of interest? Are psychedelics something that should be part of the conversation about [01:07:05] dopamine and addiction and just the world we're in today?
Speaker: Oh, absolutely. Part of the [01:07:10] conversation and they already are, um, you know, being actively studied to treat a variety of [01:07:15] mental health disorders from depression to addiction you know, uh, [01:07:20] PTSD.
But I would say that my general, my overall impression [01:07:25] is that the, sort of the media hype has outpaced the actual evidence [01:07:30] and there is not enough, you discourse on the [01:07:35] harms, um, which can be long lasting and are highly unpredictable. [01:07:40] Um, so, you know, the problem is that what evidence we [01:07:45] have is based on the use of psychedelics as an adjunct to [01:07:50] psychotherapy.
Meaning that the main medium of change in all of these studies is the [01:07:55] psychotherapy, not the psychedelic itself. The psychedelic is sort of just like the cherry [01:08:00] on top. But what's happened is that a lot of people, and especially a lot of young [01:08:05] people, have interpreted that to mean that, oh, it's the chemical itself, and if I just [01:08:10] go, you know, get a hold of it over, you know, in some kind of way.
some place, [01:08:15] you know, in the city and then I just use it by myself in the bathroom, I'll cure my [01:08:20] depression and that is a very dangerous and destructive message because, you [01:08:25] know, there's real harm, uh, happens from that.
Speaker 3: It's all about the [01:08:30] facilitation and knowing what you get. And we, we recently, about two years ago, At my [01:08:35] neuroscience company, where people are going to spend five days doing really deep work, guided by a computer, [01:08:40] we added low dose medically supervised ketamine for the [01:08:45] BDNF, the neuroplasticity enhancement that it offers, rather than for the journey [01:08:50] work.
Just more, more squishiness in your, in your body. And your neurons allows you [01:08:55] to kind of rewire your reality more quickly, but I, I do have concerns over these [01:09:00] influencers saying, you know, I've done whatever weird mix of psychedelics. I like 87 [01:09:05] times and I'm pretty sure it's not working. Yeah,
Speaker: right.
Right. And you know, there's [01:09:10] also a really prevalent myth out there that psychedelics are unique in that they're not [01:09:15] addictive and that's just simply not true. We see people all the time who are addicted [01:09:20] to the psychedelics. It's part that they're addicted to just the chemical experience, [01:09:25] but they're also partially addicted to, you know, having another spiritual journey [01:09:30] or spiritual experience or just really not wanting to be in the world or looking for the [01:09:35] answer or more of an answer.
You know, at the end of the day, I mean, any. Any [01:09:40] chemical or behavior for that matter that we use, you know, to change our [01:09:45] brains and to change our, our felt experience has the potential [01:09:50] to be addictive. Um, so it's super important and that's not the only ways in which, you know, [01:09:55] psychedelics can be harmful.
Um, they can also cause persistent psychotic and mood disorders, [01:10:00] persistent hallucinogenic experiences. Um, so, you know, it's, it's [01:10:05] not messing around.
Speaker 3: You ever tried them?
Speaker: No.
Speaker 3: [01:10:10] Wow. Hold on. You're in, you're in Palo Alto, right? Yeah. [01:10:15]
Speaker: How do you go to parties? I don't go to those parties. I go to, I go to the parties where people are [01:10:20] getting up early in the morning and climbing the mountain.
Speaker 3: I'm totally teasing you. They [01:10:25] have been a part of Of the creative edge of Silicon Valley for a very long time, [01:10:30] but I appreciate that you're, you're talking about this, I've, I've known many people who [01:10:35] have had not bad trips. I don't really believe in a bad trip. That's usually you're [01:10:40] experiencing trauma.
People who had neurochemical irregularities afterwards that [01:10:45] required meaningful interventions. It's not that common. But it's enough. And I've seen [01:10:50] another group of people in my circle, less of them, but where they're, they're just addicted to [01:10:55] escapism. They don't want to face their feelings. And if you're high all the time, anything that gets you out of that will work.
[01:11:00] Even if your LSD is not classically addictive, but if you just don't want to face your reality, it's [01:11:05] addictive, right?
Speaker: That's right. That's exactly right. Yeah.
Speaker 3: So it's a, it's a slippery slope and [01:11:10] I'm, I'm glad we can study it more. And, yeah, I know Stanford has a bunch of stuff going on, maybe even some in the department [01:11:15] around it.
Yeah, and I
Speaker: think that's great. I am glad that there's more research and there needs to be more research, um, [01:11:20] and, and that's a good thing.
Speaker 3: If you were a parent of a teenager, [01:11:25] What default settings would you put on your kid's social media accounts?
Speaker: Um, they [01:11:30] don't work. So.
Speaker 3: Ouch. Okay. So who cares about default [01:11:35] settings?
Cause they're a lie. Okay.
Speaker: No, I, I, I, at one point I was hopeful, you [01:11:40] know, that the sort of take a break or default that, but really it's out of parental [01:11:45] control. I mean, once your kid has their own device with access to the internet, I really think we're [01:11:50] very limited as parents in what we can do. And at the end of the [01:11:55] day, it's going to be taking the device away and limiting the [01:12:00] actual access to the internet.
And that can't be left up to parents alone. [01:12:05] That's got to come down to the broader public health problem that it is, [01:12:10] which means that school systems have to get, get involved and, and ban smartphones from schools [01:12:15] K through 12, which thank, thank goodness is happening now. There's even some interesting, you know, [01:12:20] tech ideas about having like airplane Wi Fi mode at school that kids would download an [01:12:25] app and then that app would automatically, you know, make the internet not accessible [01:12:30] or only certain certain things accessible.
We absolutely have to be [01:12:35] looking in that direction, and also, you know, from the federal perspective, like, we have to legislate things [01:12:40] like actual enforceable age verification, right? And this is [01:12:45] happening in some, some states where, you know, they're saying, hey, you know, if you're under the age of [01:12:50] 13 whatever it is, you can't go on Pornhub, and we're going to actually enforce that, even though [01:12:55] that may infringe On the, you know, the freedoms of an [01:13:00] adult who wants to go on Pornhub is now going to have to register with a third party site.
They won't want to do that, but [01:13:05] too bad, right? Like you have to give up. We have to give up some individual freedoms in order to protect kids [01:13:10] and protect the public health.
Speaker 3: Maybe they could just register directly with the Catholic Church [01:13:15] and automate the confession process.
Speaker: There you go. Just one stop [01:13:20] shopping.
Like the Amazon for Sinners or [01:13:25] something.
Speaker 3: There we go. Oh my gosh. It's going to get dark really fast now. [01:13:30] All right. I have a final question for you. It's been four years [01:13:35] since you wrote Deprimination. Are things getting better or worse?
Speaker: [01:13:40] Things are getting better in the sense that we're having more open conversations [01:13:45] about the problem of addiction about the hub the public health scourge of [01:13:50] You know digital overload and the harms to in particular kids [01:13:55] spending too much time on their devices So I think that's really really [01:14:00] good.
We weren't having that conversation, you know, even Five years ago at the level [01:14:05] that we're having it now. So that's really great. And like I said, you know, I have seen [01:14:10] movement at the level of the school system. I mean, I've been talking about getting smartphones out of public [01:14:15] schools for 15 years. People looked at me like I had two heads or you know, whatever.[01:14:20]
And now it's actually happening. Um, so I think, I think we're, I think there's been [01:14:25] progress and ultimately I'm optimistic that we're going to figure it out. You know, we started out, [01:14:30] we started out today talking about how adaptable we are to almost [01:14:35] every circumstance for better and for worse. And I do think we're going to, we're going to be able to adapt [01:14:40] to and solve the public health crisis of addiction.
Speaker 3: Well, thank you for your [01:14:45] continued work in the field. Uh, it's, it's so important to acknowledge [01:14:50] addiction isn't just alcohol and substances, that it's behavioral. [01:14:55] And I think you've studied it well and you're communicating it at a big scale with Dopamine Nation. [01:15:00] So keep it up. Thank you, Anna.
Speaker: Oh, thank you.
It's been fun chatting with you. [01:15:05]
Speaker 3: See you next time on the Human Upgrade [01:15:10] Podcast.