Dopamine Nation Quotes

The paradox is that hedonism, the pursuit of pleasure for it's own sake, leads to anhedonia. Which is the inability to enjoy pleasure of any kind.

The reason we’re all so miserable may be because we’re working so hard to avoid being miserable.

Because we’ve transformed the world from a place of scarcity to a place of overwhelming abundance: Drugs, food, news, gambling, shopping, gaming, texting, sexting, Facebooking, Instagramming, YouTubing, tweeting . . . the increased numbers, variety, and potency of highly rewarding stimuli today is staggering. The smartphone is the modern-day hypodermic needle, delivering digital dopamine 24/7 for a wired generation.

[E]mpathy without accountability is a shortsighted attempt to relieve suffering.

Beyond extreme examples of running from pain, we’ve lost the ability to tolerate even minor forms of discomfort. We’re constantly seeking to distract ourselves from the present moment, to be entertained.

But, there is a cost to medicating away every type of human suffering, and as we shall see, there is an alternative path that might work better: embracing pain.

We’re all running from pain. Some of us take pills. Some of us couch surf while binge-watching Netflix. Some of us read romance novels. We’ll do almost anything to distract ourselves from ourselves. Yet all this trying to insulate ourselves from pain seems only to have made our pain worse.

Lessons of the balance. 1. The relentless pursuit of pleasure and avoidance of pain, leads to pain. 2. Recovery begins with abstinence 3. Abstinence rests the brains reward pathway and with it our capacity to take joy and simpler pleasures. 4. Self-binding creates literal and metacognitive space between desire and consumption, a modern necessity in our dopamine overloaded world. 5. Medications can restore homeostasis, but consider what we lose by medicating away our pain. 6. Pressing on the pain side, resets our balance to the side of pleasure. 7. Beware of getting addicted to pain. 8. Radical honesty promotes awareness, enhances intimacy and fosters a plenty mindset. 9. Prosocial shame affirms that we belong to the human tribe. 10. Instead of running away from the world, we can find escape by immersing ourselves in it.

I urge you to find a way to immerse yourself fully in the life that you’ve been given. To stop running from whatever you’re trying to escape, and instead to stop, and turn, and face whatever it is. Then I dare you to walk toward it. In this way, the world may reveal itself to you as something magical and awe-inspiring that does not require escape. Instead, the world may become something worth paying attention to.

The smartphone is the modern-day hypodermic needle, delivering digital dopamine 24/7 for a wired generation

As the neuroscientist, Daniel Freedman, who studies the foraging practices of Red Harvester ants, once remarked to me: "The world is sensory rich and causal poor". That is to say, we know the donut tastes good in the moment, but we are less aware that eating a donut every day for a month, adds 5 pounds to our waistline.

The reason we’re all so miserable may be because we’re working so hard to avoid being miserable.

With prolonged and repeated exposure to pleasurable stimuli, our capacity to tolerate pain decreases, and our threshold for experiencing pleasure increases.

I urge you to find a way to immerse yourself fully in the life that you’ve been given. To stop running from whatever you’re trying to escape, and instead to stop, and turn, and face whatever it is. Then I dare you to walk toward it. In this way, the world may reveal itself to you as something magical and awe-inspiring that does not require escape. Instead, the world may become something worth paying attention to. The rewards of finding and maintaining balance are neither immediate nor permanent. They require patience and maintenance. We must be willing to move forward despite being uncertain of what lies ahead. We must have faith that actions today that seem to have no impact in the present moment are in fact accumulating in a positive direction, which will be revealed to us only at some unknown time in the future. Healthy practices happen day by day. My patient Maria said to me, “Recovery is like that scene in Harry Potter when Dumbledore walks down a darkened alley lighting lampposts along the way. Only when he gets to the end of the alley and stops to look back does he see the whole alley illuminated, the light of his progress.

By protecting our children from adversity, have we made them deathly afraid of it? By bolstering their self-esteem with false praise and a lack of real-world consequences, have we made them less tolerant, more entitled, and ignorant of their own character defects? By giving in to their every desire, have we encouraged a new age of hedonism?

Binding ourselves is a way to be free.

Shame makes us feel bad about ourselves as people, whereas guilt makes us feel bad about our actions while preserving a positive sense of self.

With intermittent exposure to pain, our natural hedonic set point gets weighted to the side of pleasure, such that we become less vulnerable to pain and more able to feel pleasure over time.

70% of the world global deaths are attributable to modifial behavioural risk factors like smoking, physical inactivity and diet. The leading global risks for mortality are high blood pressure 13%, tobacco use 9%, high blood sugar 6%, physical inactivity 6% and obesity 5%. In 2013, an estimated 2.1 billion adults were overweight, compared with 857 million in 1980. There are now more people world-wide, except in sub-Saharan parts of Africa and Asia who are obese, than who are underweight.

I urge you to find a way to immerse yourself fully in the life that you’ve been given. To stop running from whatever you’re trying to escape, and instead to stop, and turn, and face whatever it is.

Our brains are not evolved for this world of plenty. As Dr. Tom Finucane, who studies diabetes in the setting of chronic sedentary feeding, said, “We are cacti in the rain forest.” And like cacti adapted to an arid climate, we are drowning in dopamine.

The victim narrative reflects a wider societal trend in which we’re all prone to seeing ourselves as the victims of circumstance and deserving of compensation or reward for our suffering. Even when people have been victimized, if the narrative never moves beyond victimhood, it’s difficult for healing to occur.

Exercise increases many of the neurotransmitters involved in positive mood regulation: dopamine, serotonin, norepinephrine, epinephrine, endocannabinoids, and endogenous opioid peptides (endorphins). Exercise contributes to the birth of new neurons and supporting glial cells. Exercise even reduces the likelihood of using and getting addicted to drugs.

The implication here is that we are all now vulnerable to prefrontal cortical atrophy as our reward pathway has become the dominant driver of our lives.

The paradox is that hedonism, the pursuit of pleasure for its own sake, leads to anhedonia, which is the inability to enjoy pleasure of any kind.

It is not our perfection but our willingness to work together to remedy our mistakes that creates the intimacy we crave.

We’ve all experienced the letdown of unmet expectations. An expected reward that fails to materialize is worse than a reward that was never anticipated in the first place.

That’s because the evidence is indisputable: Exercise has a more profound and sustained positive effect on mood, anxiety, cognition, energy, and sleep than any pill I can prescribe.

Practicing mindfulness is something like observing the Milky Way. It demands that we see our thoughts and emotions as separate from us, and yet, simultaneously apart of us. Also the brain can do some pretty weird things, some of which are embarrassing, thus the importance of being without judgement. Reserving judgement is important to the practice of mindfulness because as soon as we start condemning what our brain is doing, eww, why would I be thinking about that, I'm a loser, I'm a freak - We stop being able to observe. Staying in the observer position is essential to getting to know our brains and ourselves in a new way.

But I worry that we have both oversanitized and overpathologized childhood, raising our children in the equivalent of a padded cell, with no way to injure themselves but also no means to ready themselves for the world.

Human beings, the ultimate seekers, have responded too well to the challenge of pursuing pleasure and avoiding pain. As a result, we’ve transformed the world from a place of scarcity to a place of overwhelming abundance.

Experiments show that a free rat will instinctively work to free another rat trapped inside a plastic bottle. But once that free rat has been allowed to self-administer heroin, it is no longer interested in helping out the caged rat, presumably too caught up in an opioid haze to care about a fellow member of its species.

Pleasure and pain are co-located. In addition to the discovery of dopamine, neuro-scientists have determined that pleasure and pain are processed in overlapping brain regions, and work via an opponent processing mechanism. Another way to say this is pleasure and pain work like a balance. Imagine our brains contains a balance, a scale with a fulcrum in the centre. When nothing is on the balance it's level with the ground. When we experience pleasure, dopamine is released in our reward pathway and the balance tips to the side of pleasure. The more our balance tips and the faster it tips, the more pleasure we feel. But here's the important thing about the balance. It wants to remain level! that is, in equilibrium. It does not want to be tipped for very long, to one side or another. Hence, everytime the balance tips towards pleasure, powerful self-regulating mechanisms kick into action to bring it level again. These self-regulating mechanisms do not require conscious thought or an act of will, they just happen like a reflex.

The motivation to gamble is based largely on the inability to predict the reward occurrence, rather than on financial gain.

One of the jobs of good psychotherapy is to help people tell healing stories. If autobiographical narrative is a river, psychotherapy is the means by which that river is mapped and in some cases rerouted.

Abstinence is necessary to restore homeostasis, and with it our ability to get pleasure from less potent rewards, as well as see, the true cause and effect between our substance use and the way we’re feeling.

Once we get the anticipated reward, brain dopamine firing increases well above tonic baseline, but if the reward we anticipated doesn't materialise, dopamine levels fall well below baseline. Which is to say, if we get the expected reward, we get an even bigger spike, if we don't get the expected reward, we experience an even bigger plunge. We've all experienced the letdown of unmet expectations. An expected reward that failed to materialise is worse than a reward that was never anticipated in the first place. How does cue-induced craving translate to our pleasure-pain balance? The balance tips to the side of pleasure, a dopamine mini spike, in anticipation of future reward. Immediately followed by a tip to the side of pain, a dopamine mini defecit, in the aftermath of the cue. The dopamine defecit is craving and drives drug seeking behaviour.

All that distracting yourself with devices may be contributing to your depression and anxiety. It’s pretty exhausting avoiding yourself all the time. I wonder if experiencing yourself in a different way might give you access to new thoughts and feelings, and help you feel more connected to yourself, to others, and to the world.

When the people around us lie and don’t keep their promises, we feel less confident about the future. The world becomes a dangerous place that can’t be relied upon to be orderly, predictable, or safe. We go into competitive survival mode and favor short-term gains over long-term ones, independent of actual material wealth. This is a scarcity mindset.

I suggested she try walking to class without listening to anything and just letting her own thoughts bubble to the surface. She looked at me both incredulous and afraid. “Why would I do that?” she asked, openmouthed. “Well,” I ventured, “it’s a way of becoming familiar with yourself. Of letting your experience unfold without trying to control it or run away from it. All that distracting yourself with devices may be contributing to your depression and anxiety. It’s pretty exhausting avoiding yourself all the time. I wonder if experiencing yourself in a different way might give you access to new thoughts and feelings, and help you feel more connected to yourself, to others, and to the world.” She thought about that for a moment. “But it’s so boring,” she said. “Yes, that’s true,” I said. “Boredom is not just boring. It can also be terrifying. It forces us to come face-to-face with bigger questions of meaning and purpose. But boredom is also an opportunity for discovery and invention. It creates the space necessary for a new thought to form, without which we’re endlessly reacting to stimuli around us, rather than allowing ourselves to be within our lived experience.

I tend to imagine the self-regulating system like little gremlins hoping on the pain side of the balance to counteract the weight on the pleasure side. The gremlins represent the work of homeostasis, the tendency of any living system to maintain physiologic equilibrium. Once the balance is level, it keeps going, tipping an equal and opposite amount to the side of pain. In the 1970s social scientists Richard Solomon and John Corbett called this reciprocal relationship between pleasure and pain "The Opponent Process Theory". Any prolonged or repeated departure from hedonic or adaptive neutrality has a cost. That cost is an after-reaction, that is opposite in value to the stimulus, or as the old saying goes: "What goes up, must come down".

When the people around us are reliable and tell us the truth, including keeping promises they’ve made to us, we feel more confident about the world and our own future in it. We feel we can rely not just on them but also on the world to be an orderly, predictable, safe kind of a place. Even in the midst of scarcity, we feel confident that things will turn out okay. This is a plenty mindset.

Mindfulness practices are especially important in the early days of abstinence. Many of us use high-dopamine substances and behaviors to distract ourselves from our own thoughts. When we first stop using dopamine to escape, those painful thoughts, emotions, and sensations come crashing down on us.

A truthful self-inventory leads not only to a better understanding of our own shortcomings. It also allows us to more objectively appraise and respond to the shortcomings of others. When we're accountable to ourselves, we're able to hold others accountable. We can leverage shame without shaming. The key here is accountability with compassion. These lessons apply to all of us, addicted or not, and translate to every type of relationship in our everyday lives.

For a rat in a box, chocolate increases the basal output of dopamine in the brain by 55 percent, sex by 100 percent, nicotine by 150 percent, and cocaine by 225 percent. Amphetamine, the active ingredient in the street drugs “speed,” “ice,” and “shabu” as well as in medications like Adderall that are used to treat attention deficit disorder, increases the release of dopamine by 1,000 percent. By this accounting, one hit off a meth pipe is equal to ten orgasms.

Nora Volkow, showing that dopamine transmission is still below normal two weeks after quitting drugs. Her study is consistent with my clinical experience that two weeks of abstinence is not enough. At two weeks, patients are usually still experiencing withdrawal. They are still in a dopamine deficit state. On the other hand, four weeks is often sufficient.

But if we consume just the right amount, “inhibiting great pain with little pain,” we discover the path to hormetic healing, and maybe even the occasional “fit of joy.

Not to mention that the entire cycle of anticipation and craving can occur outside the threshold of conscious awareness.

But by creating tangible barriers between ourselves and our drug of choice, we press the pause button between desire and action.

This means that although the brain changes are permanent, we can find new synaptic pathways to create healthy behaviors.

Mindfulness is simply the ability to observe what our brain is doing while it’s doing it, without judgment.

One in four gastric bypass surgery recipients develops a new problem with alcohol addiction.

Skydiving can be addictive and can lead to persistent dysphoria if engaged in repeatedly.

Just as it is possible to have a scarcity mindset amidst plenty, it is also possible to have a plenty mindset amidst scarcity.

What’s pleasurable for one person may not be for another. Each person has their “drug of choice.

Without pleasure we wouldn’t eat, drink, or reproduce. Without pain we wouldn’t protect ourselves from injury and death.

The paradox is that hedonism, the pursuit of pleasure for its own sake, leads to anhedonia, which is the inability to enjoy pleasure of any kind.

Needing more of a substance to feel pleasure, or experiencing less pleasure at a given dose, is called tolerance. Tolerance is an important factor in the development of addiction.

This is not to say that high-dopamine substances literally contain dopamine. Rather, they trigger the release of dopamine in our brain’s reward pathway.

But boredom is also an opportunity for discovery and invention. It creates the space necessary for a new thought to form, without which we’re endlessly reacting to stimuli around

With a wry smile, he went on to hypothesize more generally—and, I suspect, only half-jokingly—that addicts are bored or frustrated problem-solvers who instinctively contrive Houdini-like situations from which to disentangle themselves when no other challenge happens to present itself. The drug becomes the reward when they succeed and the consolation prize when they fail.

We must have faith that actions that seem to have no impact in the present moment are in fact accumulating in a positive direction, which will be revealed to us only at some unknown time in the future.

In humans, high levels of physical activity in junior high, high school, and early adulthood predict lower levels of drug use. Exercise has also been shown to help those already addicted to stop or cut back.

The more dopamine a drug releases in the brain’s reward pathway (a brain circuit that links the ventral tegmental area, the nucleus accumbens, and the prefrontal cortex), and the faster it releases dopamine, the more addictive the drug.

With repeated exposure to the same or similar pleasure stimulus, the initial deviation to the side of pleasure gets weaker and shorter and the after- response to the side of pain gets stronger and longer, a process scientists call neuroadaptation.

While truth-telling promotes human attachment, compulsive overconsumption of high-dopamine goods is the antithesis of human attachment. Consuming leads to isolation and indifference, as the drug comes to replace the reward obtained from being in relationship with others.

The Internet promotes compulsive overconsumption not merely by providing increased access to drugs old and new, but also by suggesting behaviors that otherwise may never have occurred to us. Videos don’t just “go viral.” They’re literally contagious, hence the advent of the meme.

The pursuit of personal happiness has become a modern maxim, crowding out other definitions of the “good life.” Even acts of kindness toward others are framed as a strategy for personal happiness. Altruism, no longer merely a good in itself, has become a vehicle for our own “well-being".

dopamine is used to measure the addictive potential of any behavior or drug. The more dopamine a drug releases in the brain’s reward pathway (a brain circuit that links the ventral tegmental area, the nucleus accumbens, and the prefrontal cortex), and the faster it releases dopamine, the more addictive the drug.

Social media propels our tendency toward self-shame by inviting so much invidious distinction. We’re now comparing ourselves not just to our classmates, neighbors, and coworkers, but to the whole world, making it all too easy to convince ourselves that we should have done more, or gotten more, or just lived differently.

final day of the original experiment. When the scientists examined the rats’ brains, they saw cocaine-induced changes in the rats’ reward pathways consistent with persistent cocaine sensitization. These findings show that a drug like cocaine can alter the brain forever. Similar findings have been shown with other addictive substances, from alcohol to opioids to cannabis. In my clinical work I see people who struggle with severe addiction slipping right back into compulsive use with a single exposure, even after years of abstinence. This may occur because of persistent sensitization to the drug of choice, the distant echoes of earlier drug use.

…we use the dopaminergic power of the happiness of pursuit to motivate us to work for rewards that come -after we are dead- depending on your culture, this can be knowing that your nation is closer to winning a war because you’ve sacrificed yourself in battle, that your kids will inherit money because of your financial sacrifices, or that you will spend eternity in paradise. It is extraordinary neural circuitry that bucks temporal discounting enough to allow (some of) us to care about the temperature of the planet that our great-grandchildren will inherit. Basically, it’s unknown how we humans do this. We may merely be a type of animal, mammal, primate, and ape, but we’re a profoundly unique one.

Boredom is not just boring. It can also be terrifying. It forces us to come face-to-face with bigger questions of meaning and purpose. But boredom is also an opportunity for discovery and invention. It creates the space necessary for a new thought to form, without which we’re endlessly reacting to stimuli around us, rather than allowing ourselves to be within our lived experience.

Recounting our experiences gives us mastery over them. Whether in the context of psychotherapy, talking to an AA sponsor, confessing to a priest, confiding in a friend, or writing in a journal, our honest disclosure brings our behavior into relief, allowing us in some cases to see it for the first time. This is especially true for behaviors that involve a level of automaticity outside of conscious awareness.

Learning also increases dopamine firing in the brain. Female rats housed for three months in a diverse, novel, and stimulating environment show a proliferation of dopamine-rich synapses in the brain’s reward pathway compared to rats housed in standard laboratory cages. The brain changes that occur in response to a stimulating and novel environment are similar to those seen with high-dopamine (addictive) drugs.

Not very well.” For a single instant he looked ashamed. Over the past three decades, I have seen growing numbers of patients like David and Kevin who appear to have every advantage in life—supportive families, quality education, financial stability, good health—yet develop debilitating anxiety, depression, and physical pain. Not only are they not functioning to their potential; they’re barely able to get out of bed in the morning.

After he was discharged, he began weekly exposure therapy with a talented young therapist on our team. The basic principle of exposure therapy is to expose people in escalating increments to the very thing—being in crowds, driving across bridges, flying in airplanes—that causes the uncomfortable emotion they’re trying to flee, and in doing so, augment their ability to tolerate that activity. In time they may even come to enjoy it.

The phylogenetically uber-ancient neurological machinery for processing pleasure and pain has remained largely intact throughout evolution and across species. It is perfectly adapted for a world of scarcity. Without pleasure we wouldn’t eat, drink, or reproduce. Without pain we wouldn’t protect ourselves from injury and death. By raising our neural set point with repeated pleasures, we become endless strivers, never satisfied with what we have, always looking for more.

Nonetheless, ECT provides a hormetic shock to the brain, which in turn spurs a broad compensatory response to reassert homeostasis: “ECT brings about various neuro-physiological as well as neuro-chemical changes in the macro- and micro-environment of the brain. Diverse changes involving expression of genes, functional connectivity, neurochemicals, permeability of blood-brain-barrier, alteration in immune system has [sic] been suggested to be responsible for the therapeutic effects of ECT.

IN 2012, researchers at the University of Rochester, altered the 1968 Stanford Marshmallow experiment in one crucial way. One group of children experienced a broken promise before the marshmallow test was conducted. The researchers left the room and said they would return when the child rang the bell, but then didn't. The other group of children were told the same, but when they rang the bell, the researcher returned. The children in the latter group where the researcher came back, were willing to wait up to 4 times longer - 12 minutes - for a 2nd marshmallow, than the children in the broken promise group.

The evolution of the gluten-free diet illustrates how attempts to control consumption are swiftly countered by modern market forces, just one more example of the challenges inherent in our dopamine economy. There are many other modern examples of previously taboo drugs being transformed into socially acceptable commodities, often in the guise of medicines. Cigarettes became vape pens and ZYN pouches. Heroin became OxyContin. Cannabis became “medical marijuana.” No sooner have we committed to abstinence than our old drug reappears as a nicely packaged, affordable new product saying, Hey! This is okay. I’m good for you now.

Researchers interviewed nearly 150 thousand people in 26 countries to determine the prevalence of generalized anxiety disorder to find, had excessive and uncontrollable worry adversely affected their life. They found that richer countries had higher rates of anxiety than poor ones. The authors wrote, "The disorder is significantly more prevalent and impairing in high income countries than in low or middle income countries." The number of new cases of depression world-wide increased 50% between 1990 and 2017. The highest increases in new cases were seen in countries with the highest sociodemographic index income, especially North America. Physical pain too is increasing. Over the course of my career, I have seen more patients, including otherwise healthy young people presenting with full-bodied pain despite the absence of any identifiable disease or tissue injury. The numbers and types of unexplained physical pain syndromes have grown. Complex regional pain syndrome, fibromyalgia... [], and so on. When researchers ask the following question to people in 30 countries around the world. "During the past four weeks, how often have you had bodily aches or pains"...[]. They found that Americans reported more pain than any other country. 34% of Americans said they experienced pain often or very often, compared to 19% of people living in China, 18% of people living in Japan, 13% of people living in Switzerland, and 11% of people living in South Africa. The question is, "Why in an unprecedented time of wealth, freedom, technological progress, and medical advancement, do we appear to be unhappier and in more pain than ever?'. The reason we're all so miserable may be because we're working so hard to avoid being miserable.

If we consume too much pain, or in too potent a form, we run the risk of compulsive, destructive overconsumption. But if we consume just the right amount, inhibiting great pain with little pain, we discover the path to hormetic healing, and maybe even the occasional fit of joy.

What if, instead of seeking oblivion by escaping from the world, we turn toward it? What if instead of leaving the world behind, we immerse ourselves in it?

Seventy percent of world global deaths are attributable to modifiable behavioral risk factors

Trauma, social upheaval, and poverty contribute to addiction risk, as drugs become a means of coping and lead to epigenetic changes—heritable changes to the strands of DNA outside of inherited base pairs—affecting gene expression in both an individual and their offspring.

limbic capitalism,

It is not our perfection but our willingness to work together to remedy our mistakes that creates the intimacy that we crave.

Exercise has a more profound and sustained positive effect on mood, anxiety, cognition, energy, and sleep than any pill I can prescribe. But pursuing pain is harder than pursuing pleasure. It goes against our innate reflex to avoid pain and pursue pleasure. It adds to our cognitive load: We have to remember that we will feel pleasure after pain, and we’re remarkably amnestic about this sort of thing. I know I have to relearn the lessons of pain every morning as I force myself to get out of bed and go exercise.

A chance for you to observe yourself as separate from your thoughts, emotions, and sensations, including pain. This practice is sometimes called mindfulness.

The medication naltrexone is used to treat alcohol and opioid addiction, and is being used for a variety of other addictions as well, from gambling to overeating to shopping. Naltrexone blocks the opioid receptor, which in turn diminishes the reinforcing effects of different types of rewarding behavior. I’ve had patients report a near or complete cessation of alcohol craving with naltrexone. For patients who have struggled for decades with this problem, the ability to not drink at all, or to drink in moderation like “normal people,” comes as a revelation.

Using blood samples, the researchers showed that plasma (blood) dopamine concentrations increased 250 percent, and plasma norepinephrine concentrations increased 530 percent as a result of cold-water immersion. Dopamine rose gradually and steadily over the course of the cold bath and remained elevated for an hour afterward. Norepinephrine rose precipitously in the first thirty minutes, plateaued in the latter thirty minutes, and dropped by about a third in the hour afterward, but it remained elevated well above baseline even into the second hour after the bath.

Exercise even reduces the likelihood of using and getting addicted to drugs.

Honesty Promotes Intimate Human Connections Telling the truth draws people in, especially when we’re willing to expose our own vulnerabilities. This is counterintuitive because we assume that unmasking the less desirable aspects of ourselves will drive people away. It logically makes sense that people would distance themselves when they learn about our character flaws and transgressions. In fact, the opposite happens. People come closer. They see in our brokenness their own vulnerability and humanity. They are reassured that they are not alone in their doubts, fears, and weaknesses.

While truth-telling promotes human attachment, compulsive overconsumption of high-dopamine goods is the antithesis of human attachment. Consuming leads to isolation and indifference, as the drug comes to replace the reward obtained from being in relationship with others. Experiments

In more than twenty years as a psychiatrist listening to tens of thousands of patient stories, I have become convinced that the way we tell our personal stories is a marker and predictor of mental health. Patients who tell stories in which they are frequently the victim, seldom bearing responsibility for bad outcomes, are often unwell and remain unwell. They are too busy blaming others to get down to the business of their own recovery. By contrast, when my patients start telling stories that accurately portray their responsibility, I know they’re getting better. The victim narrative reflects a wider societal trend in which we’re all prone to seeing ourselves as the victims of circumstance and deserving of compensation or reward for our suffering. Even when people have been victimized, if the narrative never moves beyond victimhood, it’s difficult for healing to occur. One

A key to well-being is for us to get off the couch and move our real bodies, not our virtual ones. As I tell my patients, just walking in your neighborhood for thirty minutes a day can make a difference. That’s because the evidence is indisputable: Exercise has a more profound and sustained positive effect on mood, anxiety, cognition, energy, and sleep than any pill I can prescribe. —

What’s really cool,” he went on, “is that it’s become a family activity, and something we do with friends. Doing drugs was always social. In college a lot of people partied hard. It was always sitting around together drinking or doing lines of coke. “Now I don’t do that anymore. Instead, a couple of our friends come over. . . . They have kids too, and we have a cold-water party. I have a custom trough set in the mid-forties, and everybody takes turns getting in, alternating with the hot tub. We have a timer and we cheer each other on, including the kids. The trend has caught on among our friends too. This group of all women in our friend group goes to the Bay once a week and gets in. They immerse themselves to their necks. That water’s in the fifties.” “Then what?” “I don’t know,” he laughed. “They probably go out and party.” We both smiled.

Radical honesty—telling the truth about things large and small, especially when doing so exposes our foibles and entails consequences—is essential not just to recovery from addiction but for all of us trying to live a more balanced life in our reward-saturated ecosystem. It works on many levels. First, radical honesty promotes awareness of our actions. Second, it fosters intimate human connections. Third, it leads to a truthful autobiography, which holds us accountable not just to our present but also to our future selves. Further, telling

Could the much-celebrated Danish aesthetic influence the nation’s mood? I wondered. Or are they just high on dopamine from all those pastries?