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Dopamine Nation: The Neuroscience Of Our Everyday Addictions With Dr. Anna Lembke
Episode 2 • 10th January 2022 • Wise Effort • Dr. Diana Hill
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Our world is increasingly designed to addict us. What is happening in our brains when we are hooked and what can we do about it? In this episode, Dr. Anna Lembke and Dr. Diana Hill explore the neuroscience of addiction, and how we’ve become addicted to everything from sex, to food, to our smartphones. Anna and Diana also share their personal experiences with addiction and effective strategies to help you get your life and your brain back into balance. 

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Transcripts

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How can we navigate a world that is increasingly designed to addict us?

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What is happening in our brains?

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When we are caught in the relentless pursuit of pleasure and what

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This is what I'm going to explore today with Dr.

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Anna Lembke on Your Life in Process

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This is Dr.

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Diana Hill and as a clinical psychologist, I've really seen the

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And what we're beginning to understand is that we can

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And the core processes that underlie addiction are really the same,

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Underneath it is a pattern of emotional avoidance and dopamine

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This conversation with Dr.

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Anna Lembke is really one of my favorites because she has this beautiful

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that she's gained from her clients, as well as some of the neuroscience

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You may recognize Anna Lembke as a contributor to the Netflix

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And she's a professor of psychiatry at Stanford University School of Medicine

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She's published more than a hundred peer reviewed papers, book,

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Dr.

Lembke's newest book is Dopamine Nation:

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Finding Balance In the Age of Indulgence.

Lembke's newest book is Dopamine Nation:

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And it explores how to moderate our compulsive overconsumption

Lembke's newest book is Dopamine Nation:

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In this episode, we share about our addictions, how

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We even explore how to raise kids in this world of dopamine overstimulation.

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Should you really wait until high school to let your kids have phones?

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I hope this conversation helps you stop and think about your patterns of

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for those that are struggling with addictions in its many forms and the

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There is a degree of humility and common humanity that Dr.

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Lembke brings to the table.

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She really teaches us that our brains are prime for this.

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And our world is a mismatch for a modern day environment.

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As she describes, we are cactuses in a rainforest of dopamine.

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And the processes that underlie our sex addictions are the same as those that

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So how can we navigate this world in a way that has a little bit more contentment

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Let's listen to Dr.

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Anna Lembke and I'll meet you on the other side with some strategies

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I think probably a good place for us to start is just laying

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But even before we do that, I have to tell you that when I listened

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And I was like, oh, I'm going to listen to this great book.

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I want you to listen to it with me.

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And you open with your masturbation machines opening chapter.

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It started some conversations between us and by the end, we were in a

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us to talk about our own struggles, but also really relating to the

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So I appreciate all of them for sharing their stories.

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Uh, well thank you.

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Yes, so much gratitude to my patients and their willingness to share their

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And there's no doubt that it was a huge risk starting with Jacob's story.

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Um, in fact, I had been advised not to do that, but his story had so

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And I just, it seemed dishonest not to open with that.

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But I've definitely gotten pushback.

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There's even a review on Amazon.

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One of the very early reviews that gave me one star out of five, that just said,

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Um, And, you know, that made me sad, but, um, but I also understand it.

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I mean, that's fair,

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And if you stick with it, you start to see that the thread of Jacob's story.

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So he's a, it's a story about somebody that has a sexual addiction and, uh.

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But you start to see that the thread of what he's experiencing

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And you even mentioned your own addiction, which you bring up in the book as well.

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Yeah.

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And the, you know, the sort of aha moment for me to know that Jacob's story

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talking to me and I thought to myself, and by then I had gotten, let's say

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And the Twilight saga was my gateway drug.

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And, uh, it really did progress, you know, to a point where it

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Not anywhere on the order of the kind of life-threatening

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But nonetheless, there were so many parallels.

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And I remember as he was telling me his story, I thought to myself, you know what.

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That could have been me.

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I could have been Jacob.

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It did not have this kind of otherness to it, even though there are aspects of

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I, I, more than anything, I just identified with his

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And I just thought, you know, there before the grace of God go I.

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So that, that's why I wanted to open with it and draw that

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So I'd love to talk about what is that underlying process.

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know, like, like in a neuroscience way, what's happening in our brain.

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And then also just the process of what it looks like in life

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Yes.

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So let's start with the neuroscience, you know, to me, one of the fascinating

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So that means the same part of the brain that processes pleasure,

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And there are three rules governing this balance.

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The first is that the balance wants to stay level and our brains will work

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So let's say in my case, I read, uh, you know, some form of escapist

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releases dopamine, which is our reward or pleasure neurotransmitter

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We're always firing dopamine at baseline tonic levels.

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Sometimes those levels go up.

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That's when we feel pleasure or euphoria.

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Those levels go down, we feel it's opposite.

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But basically when I do something or we do something pleasurable, we

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But no sooner has that happened then our brains will adapt.

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To that deviation from neutrality or that increased dopamine in the

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And I like to imagine that as these little neuro adaptation gremlins

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But the thing about those gremlins is they really like it on the balance.

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So they don't get off when it's level.

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They stay on until it's tipped in equal and opposite amount to the side of pain.

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And that's that come down that after effect that moment for me when the book

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book, just like it, or very similar so that I can maintain that, that

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Um, now, you know, if we wait long enough those gremlins hop

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But it's important to fundamentally understand that the way that our

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any deviation from neutrality is to tip an equal and opposite amount to

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So if the initial stimulus was pleasurable, there's

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And it's, it's in pain.

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And sometimes it's very subtle and just outside our conscious

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The second rule governing this balance is that with repeated exposures to the same

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stimulus that initial response to pleasure gets shorter and weaker, but that after

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So one way to imagine that is that now that tiny little cute gremlin that

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Boom.

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Or maybe that little gremlin is accompanied by four other gremlins because

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They're sort of hiding in the wings and they love to be on the balance.

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So they're waiting for that opportunity.

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That means, you know, for the second novel or the 20th or the

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But that urge to continue the feeling is even greater because that after response

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And if I continue that behavior over days to weeks to months to years, I end up with

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And now I'm in a dopamine deficit state, and this is essentially

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This is what happens in our brains as we become addicted that our brain in

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highly reinforcing and repetitive behaviors or substances essentially

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So we're basically walking around with a balance tilted to the side of pain.

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Those gremlins now have brought their tents and their barbecues, and they're

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It's not a permanent kind of thing, but it's very, very long

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It can take a long time to get back to a level balance.

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And the way we do that is to abstain.

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But even when we're abstaining, it can take, if we've been using for weeks

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And when you're talking about using, that can be using sort of what we think about

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romance novels or to our smartphones, or even to, other types of behaviors to

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That our definition of addiction has really expanded since when I learned about

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I remember having a conversation, I studied eating disorders, and I

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And at that time there was a very hard line that said we do not

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And then meanwhile, I had my own history of an eating disorder and I had,

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It wasn't the whole recovery process, but it was an important part of my recovery.

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In the back of my head I was like, I don't know.

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I think this is an addiction.

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I love it.

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So there is now a huge movement in the world of eating disorders or that the

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Bulimia follows that exact same cycle.

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Also the purging releases endorphins as our body tries to compensate

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Um, and then you get this flooding of, you know, uh, endogenous opioids, you

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Although body image can be a part of it.

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And the classical definition of eating disorders was always like, well,

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It's like, no, it's really about this compulsive behavior that we use to

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So you're absolutely right.

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That's being reclassified.

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And in general, you know, what I argue in the book is that really everything in

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If you think about what makes something reinforcing, really

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But generally it's, it's not, you know, in like the natural world.

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First of all, in the natural world or the, you know, let's say even hundreds

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Like it wasn't ready at hand the way it is now.

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But it also wasn't as potent.

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It was just like, you had to walk tens of kilometers to find water

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And you were really hungry after that.

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So you were in this dopamine deficit state because you were hungry and it

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Now what we have in food is a great example is food

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It's added sugar, added fat added salt, added chemical flavors made

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like French toast ice cream, because of course, French toast alone and

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So we had to combine them and make French toast ice cream.

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So food really like so many things has become a drug.

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And now it's releasing a huge amount of dopamine in that reward pathway, which

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whether it's, you know, um, sex or, uh, food or drugs or behaviors like shopping

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I even had recently, I was teaching some Stanford undergraduates in Psychology

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And one of them said to me, you know, can you get addicted to a person?

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And I was like, absolutely.

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That is easily falls into the category of sex and love addiction.

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And you can even add sex, love, and attachment addiction, you know,

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You know, that's my bucket.

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Which brings up the important point of drug of choice.

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So we're, we're all.

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Our pleasure pain balance is going to be tipped different

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Right?

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What really tips my pleasure pain balance side of pleasure

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At the same time, one of the things that I hear a lot in my practice

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And I've wondered about that because I actually do think that

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I'm married to my partner.

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Like he, he could drink coffee for two weeks and then just not drink coffee.

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He just doesn't get addicted to things.

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And I I've known this about myself from, for a long time and I wonder

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And you talk about some of them in the book to, uh, being prone to addiction.

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And then even, you know, sort of what would be the

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Like why, why would some people be more prone to this tendency of

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Yeah, well, great question.

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Let me first validate that we do come to the problem of addiction with

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And some of us are clearly much more vulnerable to this process of compulsive

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If you think about the risk factors of addiction, you can broadly categorize

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Nature has to do with our genetic load.

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And it's very clear that a significant portion of the risk

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It's not clear what, you know, what it is.

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It's complex, it's poly genic.

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It probably has to do with, you know, impulsivity, emotion dysregulation,

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So it might have something to do with, you know, co-occurring

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So, so that's very clear that there's this heritable heritable component.

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And it's based partially on family studies and twin studies showing that if you have

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of that substance using home, you have an increased risk of becoming addicted

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But then there's also nurture and nurture has to do with

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Right?

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So we all know trauma can have epigenetic influences, can, it can

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But also it goes the opposite way.

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If you're, if you're raised in a home where, you know, you have a strong

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and what you're doing and who you're hanging out with, those kids and those

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Those, those kids are less likely to become addicted.

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So, you know, that makes sense too.

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There are some resiliency factors.

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And then there's neighborhood and neighborhood is

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When we think about neighborhood, we really think about the social

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And if you were living in a neighborhood where drugs are sold on the street corner,

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So access itself is a really important risk factor, especially in the modern

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Now, let me just qualify all of that by saying that I used to think that

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Alcohol, it just gives me a headache and makes me sleepy.

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Caffeine doesn't wake me up.

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Food.

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I like food, but you know, food has never been a big draw for

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My escapist thing has always as, even as a young child been reading,

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But it wasn't until midlife when I got a Kindle and also, sort of you know,

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combined with this access to, you know, a genre of novel, which really has

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It's very formulaic.

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And all of a sudden I found myself caught up in that behavior in a way

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are not by virtue of nature or nurture vulnerable to the problem of addiction,

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And some of that neighborhood is in our pocket.

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Yes.

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A lot of

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It's not just neighbors.

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our, in our pocket and what I, what I've seen in my practice.

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Uh, as sort of a newer form of addiction, that definitely feels like it's on the

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I'm sure is influencing it, but it's also just access to being able to be productive

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And for the folks that maybe had a high-achieving habit and it

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And I will say what I struggle with now is that tendency to lean

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And I've had to use some of the same things that I, that I

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And it's, it's kind of, I that's the thing.

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I also appreciated with you when you talk about your book of how.

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In a lot of ways, the, the way that we approach addiction can

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So I'd love to talk a little bit about that.

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Like the newer types of addiction we're seeing show up and then

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Like what are effective ways to address it.

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Yeah, no, I think that's so important.

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I talked briefly in my book about workaholism in the modern

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I think, um, there are so many ways in which not only has work been made

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Um, you know, the ways that there are now built in bonuses and

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We have this incredibly narcissistic culture, which reinforces,

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So you're, you're absolutely right.

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This is, uh, this is something that we have to be thoughtful about.

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So how do we approach whatever the addiction they have.

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And, and how does it relate to that pleasure plate pain

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Yeah.

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Yeah.

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So, you know, what I've discovered is that the same approach that I take to

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any addiction, whether it's food or your smartphone or something that you

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And, and basically it starts with number one honestly,

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And writing down or telling another person in specific terms, what

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So this kind of radical honesty around what we're actually doing with our

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Because until we either tell another human being or put it on paper, it can

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But honestly, we can be living this double life even to ourselves, but once we either

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whether it's a friend or family member or a professional.

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So, yeah.

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You know, I, I do this behavior.

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I don't like that I do it because, you know, typically that we have

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I do it this many hours a day, or I use this much, this many days a week.

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I do it in these situations.

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And then also being honest about how we're lying to others about, about that

Lembke's newest book is Dopamine Nation:

:

In fact, one great definition of addiction I once heard was addiction

Lembke's newest book is Dopamine Nation:

:

The next step is to then, you know, have some self-compassion

Lembke's newest book is Dopamine Nation:

:

So I'm going through a dopamine acronym that I have in the book.

Lembke's newest book is Dopamine Nation:

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D stands for data.

Lembke's newest book is Dopamine Nation:

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That's where you kind of are honest about what you're doing

Lembke's newest book is Dopamine Nation:

:

O stands for objectives.

Lembke's newest book is Dopamine Nation:

:

Why do I do this thing?

Lembke's newest book is Dopamine Nation:

:

Right?

Lembke's newest book is Dopamine Nation:

:

Why do I read romance novels.

Lembke's newest book is Dopamine Nation:

:

An incredible escape for me, just lets me forget myself.

Lembke's newest book is Dopamine Nation:

:

Forget, work, forget everything for awhile, but people have different reasons.

Lembke's newest book is Dopamine Nation:

:

So what is, what is your reason.

Lembke's newest book is Dopamine Nation:

:

The P of dopamine stands for problems?

Lembke's newest book is Dopamine Nation:

:

What are the problems associate with the use.

Lembke's newest book is Dopamine Nation:

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And, um, sometimes it's hard to see those problems in all honesty, but it can be

Lembke's newest book is Dopamine Nation:

:

phone or it's affecting my health or it's affecting my ability to, you know, be

Lembke's newest book is Dopamine Nation:

:

And then A of dopmine stands for abstinence.

Lembke's newest book is Dopamine Nation:

:

And this is really, uh, the behavioral intervention.

Lembke's newest book is Dopamine Nation:

:

And this is a little bit unusual in the world of mental health today because.

Lembke's newest book is Dopamine Nation:

:

A lot of times, um, in mental health treatment we are told that

Lembke's newest book is Dopamine Nation:

:

If we could just, you know, understand the underlying trauma,

Lembke's newest book is Dopamine Nation:

:

And this kind of flips it on its head and says, you know what?

Lembke's newest book is Dopamine Nation:

:

Sometimes understanding is the booby prize and you just need to change the behavior.

Lembke's newest book is Dopamine Nation:

:

And the abstinence trial is asking folks to take 30 days out of

Lembke's newest book is Dopamine Nation:

:

And the reason for that is because abstaining from our drug of choice

Lembke's newest book is Dopamine Nation:

:

balance and for homeostasis or a level balance to be restored, which is

Lembke's newest book is Dopamine Nation:

:

Number one, to be able to actually widen our lens and pay attention to,

Lembke's newest book is Dopamine Nation:

:

And number two, to be able to look back and see true cause and effect

Lembke's newest book is Dopamine Nation:

:

Because the truth is there's an amazing disconnect that happens with addiction.

Lembke's newest book is Dopamine Nation:

:

And when we're chasing dopamine, we cannot see true cause and effect.

Lembke's newest book is Dopamine Nation:

:

It's very, very fascinating.

Lembke's newest book is Dopamine Nation:

:

It's a little bit like being in a manic episode, how people who are manic,

Lembke's newest book is Dopamine Nation:

:

The same thing happens with addiction.

Lembke's newest book is Dopamine Nation:

:

There's this incredible disconnect between the prefrontal cortex, which

Lembke's newest book is Dopamine Nation:

:

our lives and those lower brain brain structures, including the pleasure

Lembke's newest book is Dopamine Nation:

:

prefrontal cortex in essence, and start driving things when really, you know, it

Lembke's newest book is Dopamine Nation:

:

So that's the essential intervention.

Lembke's newest book is Dopamine Nation:

:

And that 30 days seems pretty important.

Lembke's newest book is Dopamine Nation:

:

And I, I love it when different schools of thought kind of come together.

Lembke's newest book is Dopamine Nation:

:

So if you are in a 12 step program, one of the things that you try and

Lembke's newest book is Dopamine Nation:

:

So you get radically honest, but then you work through 30 days is your first goal.

Lembke's newest book is Dopamine Nation:

:

And it seems like there's a, there's a reason why you've chosen that 30 days.

Lembke's newest book is Dopamine Nation:

:

It's not just sort of a random number, but actually it maps onto

Lembke's newest book is Dopamine Nation:

:

Yes.

Lembke's newest book is Dopamine Nation:

:

So number one, there's a very important experiment by Nora Volkow, the head

Lembke's newest book is Dopamine Nation:

:

scans, looking at levels of dopamine transmission in people who had used drugs

Lembke's newest book is Dopamine Nation:

:

Two weeks after they stopped using.

Lembke's newest book is Dopamine Nation:

:

And what she found was in that reward pathway area of their brain, their

Lembke's newest book is Dopamine Nation:

:

So they were still in a dopamine deficit state.

Lembke's newest book is Dopamine Nation:

:

Their gremlins were still on the pain side of the balance.

Lembke's newest book is Dopamine Nation:

:

That's really, really important because what it tells us is

Lembke's newest book is Dopamine Nation:

:

To restore homeostasis.

Lembke's newest book is Dopamine Nation:

:

I'll have a lot of folks who say, well, can I just stop for a week

Lembke's newest book is Dopamine Nation:

:

And I'll say, well, you could, but you really won't get to that place

Lembke's newest book is Dopamine Nation:

:

And in fact, all you may get is the painful parts and that will

Lembke's newest book is Dopamine Nation:

:

I always warn patients.

Lembke's newest book is Dopamine Nation:

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You're going to feel worse before you feel better, but if you can just get through

Lembke's newest book is Dopamine Nation:

:

week three or week four, in my clinical experience, you start to come out of that

Lembke's newest book is Dopamine Nation:

:

There's also a very, wonderful experiment by Brown and Schuchat showing that

Lembke's newest book is Dopamine Nation:

:

who are using alcohol in an addictive way, and also meet criteria for major

Lembke's newest book is Dopamine Nation:

:

You put them in the hospital, you give them no treatment, but the

Lembke's newest book is Dopamine Nation:

:

At the end of one month, 80% of those individuals no longer meet

Lembke's newest book is Dopamine Nation:

:

That is to say, just stopping drinking led to complete resolution

Lembke's newest book is Dopamine Nation:

:

So that's really, really important because I have so many patients who will

Lembke's newest book is Dopamine Nation:

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And if you can just help me be not depressed and anxious, I would stop.

Lembke's newest book is Dopamine Nation:

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And I said, well, I know that feels true, but it actually might be the opposite.

Lembke's newest book is Dopamine Nation:

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It might in fact be that your use of this substance or behavior is what is

Lembke's newest book is Dopamine Nation:

:

So what feels in the moment like it's a relief is actually just

Lembke's newest book is Dopamine Nation:

:

And if you could abstain for a month, you would discover that that is

Lembke's newest book is Dopamine Nation:

:

And so the important part there, as well as how you navigate those

Lembke's newest book is Dopamine Nation:

:

And there's actually, there's some tools that you talk about in the book, but I

Lembke's newest book is Dopamine Nation:

:

more acceptance based approaches, which is knowing your why, your values like where,

Lembke's newest book is Dopamine Nation:

:

Great.

Lembke's newest book is Dopamine Nation:

:

And then also the practice of being in the present moment with discomfort.

Lembke's newest book is Dopamine Nation:

:

And if there's one thing that this overstimulation of dopamine is actually

Lembke's newest book is Dopamine Nation:

:

Because we can escape it much more quickly than we've ever

Lembke's newest book is Dopamine Nation:

:

And one of my real concerns as a parent is that my children, they're 8 and

Lembke's newest book is Dopamine Nation:

:

phone, but they're right on that point where the, the access to to escape,

Lembke's newest book is Dopamine Nation:

:

And I would love to talk with you about maybe even your own decision-making

Lembke's newest book is Dopamine Nation:

:

Around kids and this, and how we help our kids basically not

Lembke's newest book is Dopamine Nation:

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That's right, right.

Lembke's newest book is Dopamine Nation:

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Or at least to know difference at least to know

Lembke's newest book is Dopamine Nation:

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or know to the

Lembke's newest book is Dopamine Nation:

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the difference.

Lembke's newest book is Dopamine Nation:

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Yeah.

Lembke's newest book is Dopamine Nation:

:

So I feel that the, the, those early years, that first decade, decade and

Lembke's newest book is Dopamine Nation:

:

creating a healthy platform for kids to know the difference and to develop

Lembke's newest book is Dopamine Nation:

:

And those are physical coping skills.

Lembke's newest book is Dopamine Nation:

:

They know how to be in their body.

Lembke's newest book is Dopamine Nation:

:

They know the importance of exercise and movement and connecting with

Lembke's newest book is Dopamine Nation:

:

They know how to interact socially with people in real time, in real life.

Lembke's newest book is Dopamine Nation:

:

How to greet people, how to be socially appropriate, how to

Lembke's newest book is Dopamine Nation:

:

How to deal with frustration tolerance.

Lembke's newest book is Dopamine Nation:

:

You know, if you don't know the answer to something, how to sit with it for

Lembke's newest book is Dopamine Nation:

:

All of these things are so important and we have a really small window

Lembke's newest book is Dopamine Nation:

:

The importance of going outside, being in nature, connecting with the environment,

Lembke's newest book is Dopamine Nation:

:

It's a window, it's such a window.

Lembke's newest book is Dopamine Nation:

:

And if we give our kids devices and that window, they are not going to

Lembke's newest book is Dopamine Nation:

:

So what we decided to do in our family was that we, our kids did

Lembke's newest book is Dopamine Nation:

:

Um, and we, in fact didn't even have wifi to the house.

Lembke's newest book is Dopamine Nation:

:

So that was kind of a radical decision that we made, but we just

Lembke's newest book is Dopamine Nation:

:

My husband and I had our computers at work and we came home,

Lembke's newest book is Dopamine Nation:

:

It worked for us and it was almost easier than what we have

Lembke's newest book is Dopamine Nation:

:

When our eldest started high school, she, we essentially had

Lembke's newest book is Dopamine Nation:

:

Now, this was all pre COVID.

Lembke's newest book is Dopamine Nation:

:

It's even harder now with COVID.

Lembke's newest book is Dopamine Nation:

:

And she then went out and bought her own phone and paid for her own phone plan.

Lembke's newest book is Dopamine Nation:

:

By the way, we have never bought any of our kids' phone or phones

Lembke's newest book is Dopamine Nation:

:

So that's the other thing.

Lembke's newest book is Dopamine Nation:

:

I think it teaches them responsibility and also, you know, how to, how much

Lembke's newest book is Dopamine Nation:

:

And we did that for all of our kids, and I'm so glad that we did because,

Lembke's newest book is Dopamine Nation:

:

active discussions about the complexity of our relationship to these digital

Lembke's newest book is Dopamine Nation:

:

I mean, and not, and I'm transparent with my kids about, you know, how it's hard

Lembke's newest book is Dopamine Nation:

:

One thing that's very fascinating to me is even though we kind of had the

Lembke's newest book is Dopamine Nation:

:

up, you know, once they became older teenagers and got their devices, my

Lembke's newest book is Dopamine Nation:

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All the time.

Lembke's newest book is Dopamine Nation:

:

So.

Lembke's newest book is Dopamine Nation:

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There, that's where I have to practice letting go as a parent.

Lembke's newest book is Dopamine Nation:

:

Right.

Lembke's newest book is Dopamine Nation:

:

Um, I have to, I mean, I can, I've given them the tools, they

Lembke's newest book is Dopamine Nation:

:

And you know, we still talk about it.

Lembke's newest book is Dopamine Nation:

:

We're going on vacation in next week for a week and nobody is bringing their devices.

Lembke's newest book is Dopamine Nation:

:

Of course, I have to bring mine to even get us on the plane and, you

Lembke's newest book is Dopamine Nation:

:

But the bottom line is they're willing to give them up, you

Lembke's newest book is Dopamine Nation:

:

And I'll be really curious to see how it goes.

Lembke's newest book is Dopamine Nation:

:

Cause it's been awhile since we've taken a tech free

Lembke's newest book is Dopamine Nation:

:

you know, as a parent, you can only do so much.

Lembke's newest book is Dopamine Nation:

:

And then at some point they are going to have to figure it out for themselves.

Lembke's newest book is Dopamine Nation:

:

Absolutely.

Lembke's newest book is Dopamine Nation:

:

You know, I think in some ways though, sort of like, I guess some of your eating

Lembke's newest book is Dopamine Nation:

:

feed you, you know, a certain way over your early childhood, and then you go

Lembke's newest book is Dopamine Nation:

:

Right,

Lembke's newest book is Dopamine Nation:

:

let's explore everything.

Lembke's newest book is Dopamine Nation:

:

And then, you know, you kind of come back to some of the principles that

Lembke's newest book is Dopamine Nation:

:

There's a little bit of exploratory phase with kids, but the attunement to

Lembke's newest book is Dopamine Nation:

:

your kids along the way, and even some of the commentary of like, wow, it

Lembke's newest book is Dopamine Nation:

:

And, you know, I don't have a phone in my hand so I can climb this tree, you all

Lembke's newest book is Dopamine Nation:

:

right?

Lembke's newest book is Dopamine Nation:

:

things.

Lembke's newest book is Dopamine Nation:

:

But I've noticed that we have we actually have conversations about

Lembke's newest book is Dopamine Nation:

:

They don't have phones, but they play Minecraft craft and they have a little bit

Lembke's newest book is Dopamine Nation:

:

It feels to not have that dominating our day.

Lembke's newest book is Dopamine Nation:

:

And the dopamine detox, I think, is actually something that people

Lembke's newest book is Dopamine Nation:

:

Folks that are in recovery and do a lot of spiritual retreats in

Lembke's newest book is Dopamine Nation:

:

I really make a commitment to at least doing two spiritual retreats a year.

Lembke's newest book is Dopamine Nation:

:

Actually when this is launched, I'm going to be on one in Costa Rica.

Lembke's newest book is Dopamine Nation:

:

And during that time, everything just settles down, back to basics

Lembke's newest book is Dopamine Nation:

:

What am I, you know, just eating

Lembke's newest book is Dopamine Nation:

:

right,

Lembke's newest book is Dopamine Nation:

:

the food, moving through the day and that that's enough.

Lembke's newest book is Dopamine Nation:

:

And in a lot of ways, I think that we've lost contact with our natural

Lembke's newest book is Dopamine Nation:

:

Oh, yeah.

Lembke's newest book is Dopamine Nation:

:

I really agree with you.

Lembke's newest book is Dopamine Nation:

:

And I love sort of your image of that thing.

Lembke's newest book is Dopamine Nation:

:

Things kind of settled down and go to their natural resting point

Lembke's newest book is Dopamine Nation:

:

That's really where we want to be.

Lembke's newest book is Dopamine Nation:

:

We want to be at that angle of repose, that natural resting point.

Lembke's newest book is Dopamine Nation:

:

So the secret, I think is how can we, how can we integrate

Lembke's newest book is Dopamine Nation:

:

So I, I, you know, take vacations or spiritual retreats.

Lembke's newest book is Dopamine Nation:

:

I think that's really great and important, but in a way, you know,

Lembke's newest book is Dopamine Nation:

:

If we could figure out a way to do that.

Lembke's newest book is Dopamine Nation:

:

Rather than having to like, take a break from life and then go back.

Lembke's newest book is Dopamine Nation:

:

And, and I, I think, I think that, I mean, that's what I'm trying to work toward.

Lembke's newest book is Dopamine Nation:

:

Um, it is really hard.

Lembke's newest book is Dopamine Nation:

:

It takes an intentional slowing down.

Lembke's newest book is Dopamine Nation:

:

I mean, a literal slowing down.

Lembke's newest book is Dopamine Nation:

:

Trying to have, I try to have a couple of days a week.

Lembke's newest book is Dopamine Nation:

:

I haven't achieved it very often where I have nothing at all on my

Lembke's newest book is Dopamine Nation:

:

I try not to rush places.

Lembke's newest book is Dopamine Nation:

:

I try to leave enough time for me to get there.

Lembke's newest book is Dopamine Nation:

:

And to get there in a calm and centered way.

Lembke's newest book is Dopamine Nation:

:

There they're just little things, but I think we, we, we, as, uh,

Lembke's newest book is Dopamine Nation:

:

And we need to work towards it because everything is so automatic.

Lembke's newest book is Dopamine Nation:

:

I mean, everything from, it used to be if, when, if I had clients coming always

Lembke's newest book is Dopamine Nation:

:

of just settling in the chair and kind of getting here and being just sort

Lembke's newest book is Dopamine Nation:

:

And we're in this world where you're on a screen and boom, you're right there.

Lembke's newest book is Dopamine Nation:

:

Boom let's go.

Lembke's newest book is Dopamine Nation:

:

So the the purposeful insertion of slowing down, I think, is it also

Lembke's newest book is Dopamine Nation:

:

If we can be , in the slowness a bit more.

Lembke's newest book is Dopamine Nation:

:

Yeah, I love that.

Lembke's newest book is Dopamine Nation:

:

I love the way you describe things.

Lembke's newest book is Dopamine Nation:

:

It's really nice.

Lembke's newest book is Dopamine Nation:

:

And I think that what we're talking about right here too, is also

Lembke's newest book is Dopamine Nation:

:

Because I will have parents, you know, so desperate that their kids are spending all

Lembke's newest book is Dopamine Nation:

:

And yet those parents will be doing the exact same thing, even

Lembke's newest book is Dopamine Nation:

:

If you know, they'll get, you know, I don't know how many

Lembke's newest book is Dopamine Nation:

:

So we, we really need to model, you know, what we want our kids, the

Lembke's newest book is Dopamine Nation:

:

And I do think this kind of centeredness and slowing down and the ability to

Lembke's newest book is Dopamine Nation:

:

is really important for parenting, especially uh, small children, because

Lembke's newest book is Dopamine Nation:

:

restless, um, you know, feeling that we can generate, um, when we're not,

Lembke's newest book is Dopamine Nation:

:

there are some key processes to healing our addictions, including

Lembke's newest book is Dopamine Nation:

:

And if you want to explore some of these with me, then go download the Act Daily

Lembke's newest book is Dopamine Nation:

:

The practices that you teach is the detox, the dopamine detox.

Lembke's newest book is Dopamine Nation:

:

And then the other one you teach is around self-binding.

Lembke's newest book is Dopamine Nation:

:

Which in, in the way that I would describe it as sort of environmental

Lembke's newest book is Dopamine Nation:

:

Like, what's that, how was your neighborhood supporting you in of

Lembke's newest book is Dopamine Nation:

:

Can you talk a little bit about that in terms of the self binding?

Lembke's newest book is Dopamine Nation:

:

Yeah.

Lembke's newest book is Dopamine Nation:

:

So I think it's really important to acknowledge that if we just rely on our

Lembke's newest book is Dopamine Nation:

:

this, you know, what presented with our the object of our desire, we are going

Lembke's newest book is Dopamine Nation:

:

What we need to recognize is that we need to change the immediate environment in

Lembke's newest book is Dopamine Nation:

:

So, you know, I've learned from my patients, many different types of

Lembke's newest book is Dopamine Nation:

:

from literally getting, you know, potato chips out of the house

Lembke's newest book is Dopamine Nation:

:

Not having it there.

Lembke's newest book is Dopamine Nation:

:

People with pornography addiction or alcohol addiction, when they travel,

Lembke's newest book is Dopamine Nation:

:

Just really recognizing that I will do better if I'm not

Lembke's newest book is Dopamine Nation:

:

Um, and interestingly, even on a neurochemical level, we can do this now.

Lembke's newest book is Dopamine Nation:

:

So there are new medicines that you can take that, for example,

Lembke's newest book is Dopamine Nation:

:

Opioids mediate a lot of the reinforcing substances and behaviors that we use

Lembke's newest book is Dopamine Nation:

:

receptor, that can be a way to, to kind of create an environment where we're

Lembke's newest book is Dopamine Nation:

:

I had a patient who said that he didn't even realize he was an alcoholic until

Lembke's newest book is Dopamine Nation:

:

Which I thought was really fascinating because that would

Lembke's newest book is Dopamine Nation:

:

Or patients I've had patients who walk into like a break room and

Lembke's newest book is Dopamine Nation:

:

I mean, people really don't appreciate that, that that's the intense kind

Lembke's newest book is Dopamine Nation:

:

So ways to kind of, you know, put these barriers between

Lembke's newest book is Dopamine Nation:

:

It can also be time can be a barrier if our goal is moderation

Lembke's newest book is Dopamine Nation:

:

So after the 30 days, some people want to continue abstinence.

Lembke's newest book is Dopamine Nation:

:

Some people say, no, I want to go back to using, but I want to use in moderation.

Lembke's newest book is Dopamine Nation:

:

Then you can use things like time constraints.

Lembke's newest book is Dopamine Nation:

:

I'm only going to use two days a week.

Lembke's newest book is Dopamine Nation:

:

I'm only going to use two hours a day, for example, with video games or um,

Lembke's newest book is Dopamine Nation:

:

Um, we're saying I'm only going to use, you know, with friends in celebratory

Lembke's newest book is Dopamine Nation:

:

that you don't have a celebratory occasion every single day, which happens by the

Lembke's newest book is Dopamine Nation:

:

So these are the types of kind of self binding strategies.

Lembke's newest book is Dopamine Nation:

:

This idea, again, of anticipating that we will be tempted and then

Lembke's newest book is Dopamine Nation:

:

limits the kind of willpower work that we have to do because willpower

Lembke's newest book is Dopamine Nation:

:

We wake up with more willpower in the morning than we

Lembke's newest book is Dopamine Nation:

:

And we can only exercise that willpower so long and then we

Lembke's newest book is Dopamine Nation:

:

Okay.

Lembke's newest book is Dopamine Nation:

:

So I have a question around this, and this is, um, I think coming from very much

Lembke's newest book is Dopamine Nation:

:

to create sort of some of the self binding or environments that prevent you from

Lembke's newest book is Dopamine Nation:

:

Right?

Lembke's newest book is Dopamine Nation:

:

For example, I work with clients.

Lembke's newest book is Dopamine Nation:

:

Let's get rid of the scale, like first day, you know,

Lembke's newest book is Dopamine Nation:

:

There's nothing helpful that you're going to see on there.

Lembke's newest book is Dopamine Nation:

:

If it's up, it's bad.

Lembke's newest book is Dopamine Nation:

:

If it's down, it's bad.

Lembke's newest book is Dopamine Nation:

:

If it stays the same, it's It's going to drive, it's going to

Lembke's newest book is Dopamine Nation:

:

Right.

Lembke's newest book is Dopamine Nation:

:

It's a cue.

Lembke's newest book is Dopamine Nation:

:

So we need to look at what's cuing our behavior.

Lembke's newest book is Dopamine Nation:

:

On the other hand, there's very much a philosophy that I really believe

Lembke's newest book is Dopamine Nation:

:

things that cue us and how can, because we can't go around the world, you

Lembke's newest book is Dopamine Nation:

:

Oh my gosh, there's a scale.

Lembke's newest book is Dopamine Nation:

:

And they'll come back and they're like, I stepped on the scale and I'm

Lembke's newest book is Dopamine Nation:

:

And we work with the, the thoughts that show up for you and how

Lembke's newest book is Dopamine Nation:

:

We work with the urges.

Lembke's newest book is Dopamine Nation:

:

We work with the story.

Lembke's newest book is Dopamine Nation:

:

We work with all the stuff that shows up in the presence of your cues.

Lembke's newest book is Dopamine Nation:

:

And I, and it's a real kind of, choice point, like some of this decision point as

Lembke's newest book is Dopamine Nation:

:

And then also when is the time to say, you know what, this just doesn't safe for me.

Lembke's newest book is Dopamine Nation:

:

So I think a couple things here.

Lembke's newest book is Dopamine Nation:

:

One it has to do with timing where we are in our recovery.

Lembke's newest book is Dopamine Nation:

:

And if we're in the very beginning, just that very first 30 day dopamine

Lembke's newest book is Dopamine Nation:

:

That's a time to really avoid triggers so that you can make

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If after that, when, when you know, we've restored homeostasis and we've got, you

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we're enjoying other things and we've developed some other coping strategies and

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If at that point know.

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We want to try some exposure therapy, just so we can make it in the world.

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Because as you say, you know, you, can't sort of, you don't want to be, you

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Um, you know, then I think, you know, graded exposure is I'm a huge proponent.

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And, you know, I write about it in the book with a patient of mine

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And then he goes through this graded exposure, and really gets

Lembke's newest book is Dopamine Nation:

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Of course, I had a terrible flying phobia.

Lembke's newest book is Dopamine Nation:

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My, my treatment for myself was just to fly a lot.

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I still don't love flying, but it's much better than it was before, but

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I think there has to be a place where we can go where things

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And it's not like we're not always like the challenge, you know?

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Um, so I guess that that's, I would think about in terms of the timing

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the world, but really wanting to preserve at least one place where,

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So I've been thinking about that for you shared about your, your own

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a kid who read and, uh, it would be sad if you couldn't, you know, read or maybe have

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How have you navigated that for yourself?

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Very interesting.

Lembke's newest book is Dopamine Nation:

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So I did a 30 day dopamine fast.

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I, I, uh, experienced quite intense withdrawal.

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I was not able to sleep initially, but got through the first two weeks, got 30 days.

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Um, felt really good about that, felt better.

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Decided I was going to go back to reading romance novels.

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Binged.

Lembke's newest book is Dopamine Nation:

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Had a terrible binge weekend.

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That's called

Lembke's newest book is Dopamine Nation:

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and that

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abstinence violation

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abstinence violation effect.

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I said, oh dear, this is a bigger problem than I thought.

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So I gave it up for a whole year.

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And when I say I gave up romance novels, I also gave up a certain behavior that

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I did that for a whole year.

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Um,

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And something very interesting happened, which I hear also from

Lembke's newest book is Dopamine Nation:

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They are zero appealing to me and it's not because I still have the

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They don't do it anymore.

Lembke's newest book is Dopamine Nation:

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Like the drug doesn't work.

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I have like burned out those, those neurons or those,

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And I will hear that all the time from patients of mine that their

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If they can't get to where they want to go.

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They still crave it.

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And I still crave romance novels.

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But when I actually pick one up and start to read it, I'm like, oh my

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So what I have done, because I do love to read is I've changed what I read and

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in the book, which is if you can't get your dopamine by pressing on the pleasure

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Because what happens when we press on the pain side is that those neuro adaptation

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So now I read a lot of nonfiction, which is something I never read before

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So, I read, I read more memoirs.

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So I'm reading like in a whole different area.

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It's not the kind of escapist numbing thing that I used to love.

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Every once in a while, I'll find a mystery that does that for me

Lembke's newest book is Dopamine Nation:

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It's a weird icky, hungover feeling because almost inevitably

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I can't stop.

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So I'll go the whole day.

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Then I'll go into the night until I finish it.

Lembke's newest book is Dopamine Nation:

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The next day I'll be tired.

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So it's a, it's a very strange loop.

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Yeah, it's a sort of cotton candy

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That's right.

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like, ooh, but I can't quite bite into it.

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I, I want, I want that feeling of a bite and satisfaction uh, and certainly

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with my own clients of the anticipation, it tells you it's going to be so much

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And also when you have awareness, when you start to have greater awareness of

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I wonder about that component of pain and stepping on the pain side and

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He's a experimental psychologist at Yale.

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I don't know if you've read his book, but his book is called The Sweet Spot.

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So it's very much about this, uh, the sweet spot between pleasure and

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You would love his book.

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I'll

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Yeah, put it on your nonfiction list.

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Yeah.

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To binge on.

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Uh, and, and I think it also maps onto a lot of ancient traditions and ancient

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sort of the Four Noble Truths of our attachment in our craving is what causes

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And the, the pain side can be everything from being willing to

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Yeah.

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hot yoga.

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And can you tell us a little bit about that and some of, cause you talk, you

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So I'm going to talk about you this whole science of hormesis, this idea

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to that injury by upregulating our feel good hormones and neurotransmitters like

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And there's lots of interesting science to show that that's true,

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And the quintessential example is always exercise.

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Exercise, I think in particular.

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Is relevant for dopamine because of course, dopamine is essential to movement.

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Um, even in primitive nematodes, dopamine is released to allow that worm to move

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Parkinson's disease, is a disease caused by lack of dopamine or too

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So movement and dopamine and reward and pleasure are all mixed together.

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And what happens when we exercise is we're essentially, you know,

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But again, what that does is that triggers our own homeostatic reregulating

Lembke's newest book is Dopamine Nation:

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And studies show that when people exercise, dopamine slowly increases

Lembke's newest book is Dopamine Nation:

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really, really fascinating in stark contrast to when we like eat a cookie

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a really a sudden release of dopamine in the reward pathway followed very

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That's the dopamine deficit state, until we eventually return to baseline.

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So there's a really high costs that we pay.

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Whereas when we intentionally do things that are painful, whether

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It's money in the bank, right, that we can then draw off of for hours afterwards.

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Moving our bodies, whether or adults is in some ways a panacea for so

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I mean, meant, to move and if you can move in nature.

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And if you can move with other people, and if you can move in a way that it's

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And even if you can move while doing something meaningful to you.

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So I love the work of Katie Bowman who's a biomechanist.

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And she, she really changed my life about 10 years ago to start

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Everything from, are you whipping your cream with by hand and like passing

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And I see it, you know, the, the fascination with fidget spinners

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they move up and down and then now it's these little poppers that kids

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All right.

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I know, I

Lembke's newest book is Dopamine Nation:

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You don't need a fidget spinner.

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So it movement is important.

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And I will also say, and you do mention this in the book that

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I mean, it's just, it's kind of

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I know, I know, but, but, you know, but, but we we get addicted to moving because

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So, so like these machines that allow us to track, you know, our heart rate and

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And that that's the addictive, you know, like, like Strava or,

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Yeah.

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The Apple Watch

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of

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how many times I'm asking people to take 30 day detox from that.

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Hey, this is Diana.

Lembke's newest book is Dopamine Nation:

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So there's this awkward ending when my internet dropped and Dr.

Lembke's newest book is Dopamine Nation:

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Lembke was able to hop on and just do a quick goodbye.

Lembke's newest book is Dopamine Nation:

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But we didn't really get a chance to close.

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And I guess I just wanted to say to her, if I had a chance to say

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I would say thank you for modeling radical honesty in your work.

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Thank you for standing behind your values.

Lembke's newest book is Dopamine Nation:

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As a parent, even as the world around you is doing something different and thank

Lembke's newest book is Dopamine Nation:

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Thank you, Dr.

Lembke's newest book is Dopamine Nation:

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Lembke for being on the show.

Lembke's newest book is Dopamine Nation:

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Diana, it has been such a pleasure to talk to you.

Lembke's newest book is Dopamine Nation:

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I feel like I, I learned a lot and, um, I really appreciate

Lembke's newest book is Dopamine Nation:

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I can see how you would be a really excellent therapist.

Lembke's newest book is Dopamine Nation:

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Maybe I'll come see you someday.

Lembke's newest book is Dopamine Nation:

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Okay, let's take some of these teachings from Dr.

Lembke's newest book is Dopamine Nation:

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Anna Lembke and apply them to your life.

Lembke's newest book is Dopamine Nation:

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Here're some tangible takeaways that I would encourage you to consider,

Lembke's newest book is Dopamine Nation:

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Number one, get honest.

Lembke's newest book is Dopamine Nation:

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What are you addicted to?

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It might be email or weighing yourself or social media.

Lembke's newest book is Dopamine Nation:

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Maybe it's a substance.

Lembke's newest book is Dopamine Nation:

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Get honest and tell someone about it.

Lembke's newest book is Dopamine Nation:

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It takes some psychological flexibility processes like being present and

Lembke's newest book is Dopamine Nation:

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about our addictions, but it's really difficult to work with something or change

Lembke's newest book is Dopamine Nation:

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And then the second part that I encourage all of us to try is to

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Pick something small that you're willing to detoxify for the next 30

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What are you willing to commit to?

Lembke's newest book is Dopamine Nation:

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You can support yourself by setting up your environment to support your detox.

Lembke's newest book is Dopamine Nation:

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Create some self binding, maybe change the cues that trigger your

Lembke's newest book is Dopamine Nation:

:

And then number 3.

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Identify the values behind the change that you want to make.

Lembke's newest book is Dopamine Nation:

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Values, again, are another core process in psychological flexibility, and

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Your values are what I want you to draw upon and remember, and bring up close

Lembke's newest book is Dopamine Nation:

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and allow for the discomfort, because it's in the service of your values,

Lembke's newest book is Dopamine Nation:

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Root yourself in your values.

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Let them be your ground and your direction.

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Okay.

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So here's the things to focus on.

Lembke's newest book is Dopamine Nation:

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Get honest.

Lembke's newest book is Dopamine Nation:

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Make a 30 day commitment.

Lembke's newest book is Dopamine Nation:

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Set up an environment and self binding that supports you.

Lembke's newest book is Dopamine Nation:

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And root yourself in your values.

Lembke's newest book is Dopamine Nation:

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Let me know how it goes for you.

Lembke's newest book is Dopamine Nation:

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I want to know.

Lembke's newest book is Dopamine Nation:

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Thank you so much for listening to this episode of Your Life in Process.

Lembke's newest book is Dopamine Nation:

:

When you enter your life in process, when you become psychologically

Lembke's newest book is Dopamine Nation:

:

If you like this episode or think it would be helpful to somebody, please

Lembke's newest book is Dopamine Nation:

:

If you have any questions, you can leave them for me by phone at (805) 457-2776 or

Lembke's newest book is Dopamine Nation:

:

And it's not meant to be a substitute for mental health treatment.

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