Episode Details

My guest today is Dr Anna Lembke who is a professor of psychiatry at Stanford – she’s also the author of a best selling book called Dopamine Nation.

In this episode:-

• Anna began by defining Dopamine for us: - it’s a neurotransmitter which is central to pleasure, reward, and motivation, and plays a crucial role in addiction.
• One of the most exciting findings in neuroscience is that the same parts of the brain that process pleasure also process pain, and they work like opposite sides of a seesaw or a balance.
• In Anna’s book Dopamine Nation you’ll find some great illustrations which demonstrate the pleasure-pain balance and which feature little pain gremlins hopping on and off the see saw!
• There are 3 rules governing this balance
• Rule no 1.  The brain will always seek homeostasis as the neutral position
• Rule no 2.  Repeated exposure to alcohol can result in a chronic dopamine deficit - which is in fact the definition of addiction 
• Rule no 3.  The brain remembers addictive behaviours which means that a single exposure can result in relapse –that’s why moderation never works once we’ve crossed the line into dependence
• To quit drinking Anna recommends beginning with a dopamine fast, a 30-day period of abstaining which will allow the brain to restore homeostasis.
• The first 10-14 days will be spent in withdrawal so will be difficult but that difficult stage is going to pass so
• The key is to keep going – rather than stopping and starting which just means doings that really difficult bit again and again!
• Genetic vulnerability plays a role in addiction, - An alcoholic parent means you’re 4 times as likely to develop a dependence 
• But remember that "genetics may be the gun but your lifestyle is the trigger" – you can break the generational pattern
• Our brains were wired for survival in a world of scarcity but they don’t fit quite so well in this modern world of abundance… and that’s why so many people become addicted
• Anna recommends engaging in what she calls hard things, like exercise or cold water immersion, which can indirectly increase dopamine levels and provide a sense of reward.
• For example regular gym sessions will trigger the feel-good neurotransmitters
•  I asked Anna why support groups work so well and she explained that the genuine connections in recovery communities release both dopamine and oxytocin so
• If you’re looking for a recovery community to keep your dopamine flowing as you tackle this journey then just go to ts.com and click on join our tribe
• We also discussed the early sobriety blues – that low mood that can strike a few months into sobriety
• I certainly went through a period of feeling very low and uninspired in early sobriety – plenty of time on my hands but no idea what to do with it - a period I referred to as the void
• Anna says that tolerating the void is an important part of the human experience which can lead to bursts of creativity – that certainly happened in my case but certainly it took a while
• We now advise Tribe Members to get a project if they get the early sobriety blues – something to keep the mind busy and engaged - rather than sitting around waiting for happiness to strike!
• In fact we discussed the unrealistic societal expections to be happy all the time – these expectations can lead to people to believe that they are sick if they’re not happy
• This reminded me of my conversation with neuroscientist Staci Danford who believes that unhappiness is our default and that happiness is a learned skill –  a link to that podcast is here
• As Anna said we have to recognise that life is full of pain and to be alive means sometimes we have to suffer 
• I explained that at Tribe Sober we try to focus on what we gain in recovery,