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This is Hidden Brain. I'm Shankar Vedantam.
In the hit television show Ozark, a bright financial advisor finds himself suddenly working on the wrong side of the law.
What's our story for the kids?
Well, we could tell them the truth, Wendy. How would that be?
Following a series of bad decisions by his business partner, Marty Byrd, played by Jason Bateman, begins working for a drug cartel.
I want you to be ready to set up shop within a week.
Yeah.
And Marty, when I drive by your house, there better be a for sale sign on your lawn.
Almost from the start, the bodies start to fall.
People get thrown off balconies, people get shot, people are electrocuted.
When government officials get involved, more violence unfolds.
They betray one another, they cheat each other, they act in selfish and short sighted ways.
Let me just jog your memory for a minute. [1:02]
There was an innocent man who was murdered.
Gary...
He was a good man.
You might say this is the genre of the drug movie or television show.
You see it in critically acclaimed TV shows like The Wire and Breaking Bad, and in movies such as Traffic and Scarface.
Say hello to my little friend!
Ok! You want to play rough?
Ok!
Yes.
Ok...
Running through these dramas, we sense the irresistible power of drug addiction, the implacable draw of heroin or cocaine or methamphetamine, the chaos and crime that follow everywhere that drug trade is plied.
I've watched many of these TV shows and movies as entertainment for many years. I also reported on the work of researchers who study the science of drug addiction.
But some time ago, I came by a mind-bending idea that transformed my understanding of addiction.
[2:06]
It challenged how I think about drugs and what it means to be addicted. And it told me that as gripping as TV shows and movies about the drug trade might be, they don't begin to capture the profound story of addiction in all of our lives.
Today, we begin with a story we are telling across two episodes. It will change the way you think about your brain and offer some profound insights into what it means to live a life of happiness and contentment. Pleasure, pain, and balance, this week on Hidden Brain.
All of us think we know what addictions look like. We've seen the movies and TV shows about gang violence and drug dens.
[3:06]
At Stanford University, Anna Lemke studies the science of addiction. She argues our conception of addiction is far too narrow.
Anna Lemke, welcome to Hidden Brain.
Thank you for having me. I'm excited to be here.
Anna, you're a practicing psychiatrist in the heart of Silicon Valley, and I think of California's Bay Area as perhaps the richest part of the richest country in the history of humankind. So a time traveler from the 17th century might assume that even if the streets were not paved with gold, at a minimum, people would be very happy with so much material success. Is your psychiatric practice empty?
Ha! I still marvel at the gap between how people present outwardly and the truth of their inner experience. We see people every day who seem to have everything you could ever want - wealth, beauty, the kind of meaningful work. And yet when you look under the hood, they're miserably unhappy.
[4:11]
So over time, and I've seen more and more patients suffering from depression, anxiety, and chronic pain ailments for which they are hard-pressed sometimes to find a source or a cause. And as you say, often these are healthy, affluent, educated people with seemingly everything they could want in life.
One patient of yours was a young physician with a very promising career. Can you describe what he was like when you first met him?
Delightful young man, handsome, kind, thoughtful, considerate. He came to me, in fact, because he got a DUI, he was driving under the influence. But as it turned out, alcohol was not his primary problem. Once he was in my office, he revealed to me that he did, in fact, have an addiction problem, but it wasn't addiction to alcohol, it was an addiction to online gambling, sports. And his story went like this.
He was a very successful high school and collegiate athlete, Division One, all kinds of accolades.
[5:12]
Really a remarkable athlete.
And that cycle of engagement in high-level athletics, the adrenaline that goes along with high-level competition, the wins, the losses, that absolutely was his jam.
was his jam, right?
It kept him busy and engaged and really, really happy. But when that career came to its natural end, like so many high-level athletes, there was sort of a free falling disappointment to kind of an existential profound disappointment, a bit of an identity crisis.
And although he was headed to medical school, which gave him kind of a new identity to latch onto, he really missed that cycle of intensity that he got through participation in sports. And then he was invited by his collegiate buddies
[6:13]
to participate in fantasy football in a fantasy football league. And, you know, they all get together and they choose their teams. And then there was, you know, minor money involved in that. But he got really, really into it, more so than his buddies from college. And that was really almost the spark for him then to begin to want to engage athletically through sports betting and sports gambling.
And, you know, it started with 50 bucks, a hundred bucks. And at this time he's now started medical school, he's doing his pre-med courses, he was getting ready for his clinical years, he had this phone, he could pull it out. During grand rounds, you know when he supposed to be listening to the speaker and scroll through results of all the different sports, and then he could place a bet. And that accessibility just absolutely ensnared him and he found himself completely caught up in it to the point where he was now spending not hundreds of dollars but thousands of dollars, not monthly, but weekly and eventually daily. And in about six months, he completely spent the trust fund that he had inherited from his parents in order to pay for medical school. And he was so ashamed that he didn't tell anybody. And he thought to himself, well, if I can just win, then I can get all the money back, and then I'll be fine. So he took out an enormous loan without telling anybody to pay for medical school. And he thought, OK, I'm going to put it in the bank. I'm going to pay it back. And instead, he gambled that away, too.
Ana had another patient who started doing something that might seem even more harmless than sports betting.
So this was somebody who just found himself really getting intense pleasure out of the cycle of shopping online. He would spend quite a bit of time searching for different items that he was interested in buying. And the process of the treasure hunting was very entrancing and rewarding for him, all building up slowly to the point where he would choose the item that he would buy and then buy it. And then he would be waiting in anticipation for it to be delivered to his home. And all of that was very pleasurable. And then it would be delivered and he would open it and take it out and it was the thing that he wanted and it felt so good and it was just, you know, wonderfulness for him. So because that cycle was so entrancing for him, he started to do it more and more. And he kind of became to rely on it as a physiologic crutch for managing his mood.
But over time, what he found was that the cycle got shorter and shorter and the anticipation and pleasure that he got from it got less and less to the point where as soon as he opened the box and got what he had ordered it was over and then he'd be online again trying to buy the next thing. And eventually, he ended up with rooms in his house full of stuff that he didn't need or want, and tens of thousands of dollars of credit card debt. And yet, even then, he couldn't stop. So what he started to do as kind of a last resort was he bought these cheap items. Keychains, mugs, caps, cheap sunglasses, things he didn't need or want. And then as soon as he got them, he would return them because he didn't have any money. But he couldn't break the shopping cycle.
I want to talk about one last patient, a man you called Jacob, and a note for listeners that this next story includes references to both sex and suicide.
Jacob was middle-aged, or maybe even a little older when you first met him. What was his story, Ana?
Jacob was a Stanford scientist. And by the way, let me just emphasize that I got permission from my patients to relay their stories and I use pseudonyms and hide other identifying features. So Jacob was a Stanford scientist who came to me seeking help specifically for severe sex addiction, so sex, pornography, compuls
★ここまでの要約・日本語訳★
- In the TV show Ozark, a financial advisor starts working for a drug cartel after his business partner makes bad decisions.
- Drug addiction is portrayed in TV shows and movies, but they don't capture the full story of addiction in real life.
- A psychiatrist in Silicon Valley notices that even wealthy and successful people can suffer from unhappiness and addiction.
- One patient becomes addicted to online gambling after missing the intensity of high-level sports competition.
- Another patient finds pleasure in shopping online, but it escalates to the point of accumulating debt and uncontrollable behavior.
これはヒドゥンブレインです。私はシャンカール・ヴェダンタムです。
- テレビ番組『オザーク』では、輝かしい財務アドバイザーが突如として違法な仕事に従事することになる。
- ドラッグ中毒は、テレビ番組や映画では描かれるが、実際の中毒の実態はそれでは十分に捉えられていない。
- シリコンバレーにある精神科医は、富裕で成功した人々でも幸福ではなく、中毒に苦しむことがあることに気付く。
- ある患者は、高レベルのスポーツ競技の中毒性を経験したことで、オンライン賭博に中毒になる。
- 他の患者は、オンラインショッピングで快楽を見出していたが、借金や制御不可能な行動にまでエスカレートしてしまった。
★ここまでの特徴的な固有名詞・英単語・英語表現★
【固有名詞】
- Ozark（オザーク）
- Marty Byrd（マーティ・バード）
- Jason Bateman（ジェイソン・ベイトマン）
- The Wire（ザ・ワイヤー）
- Breaking Bad（ブレイキング・バッド）
- Traffic（トラフィック）
- Scarface（スカーフェイス）
- Anna Lemke（アンナ・レムキ）
- Hidden Brain（ヒドゥン・ブレイン）
- Stanford University（スタンフォード大学）
- California's Bay Area（カリフォルニアのベイエリア）
- Silicon Valley（シリコンバレー）
- DUI（飲酒運転）
- Division One（ディビジョン1）
【英単語】
- financial advisor（ファイナンシャルアドバイザー）
- drug cartel（麻薬カルテル）
- bodies（死体）
- violence（暴力）
- betray（裏切る）
- selfish（利己的な）
- short-sighted（短絡的な）
- addiction（中毒）
- chaos（混乱）
- heroin（ヘロイン）
- cocaine（コカイン）
- methamphetamine（メタンフェタミン）
- drama（ドラマ）
- power（力）
- enticing（魅力的な）
- implacable（執念深い）
- trade（取引）
- gripping（引きつける）
- happiness（幸福）
- contentment（満足）
- violence（暴力）
- drug den（ドラッグ密売現場）
- rich（豊かな）
- miserably（ひどく）
- depression（うつ）
- anxiety（不安）
- chronic pain（慢性的な痛み）
- source（原因）
- addiction（中毒）
- online gambling（オンラインギャンブル）
- athletics（競技）
- fantasy football（ファンタジーフットボール）
- treasure hunting（宝探し）
- pleasurable（楽しい）
- mood（気分）
- sex addiction（性中毒）
【コロケーション】
- set up shop（店を開業する）
- take out（借りる）
- pay it back（返済する）
- rely on（頼る）
- break the cycle（サイクルを断つ）
- severe sex addiction（重度の性中毒）
And what he described was in the 90s he used pornography and he masturbated as much as daily, but it was never unmanageable. He was still able to function as a father, as a husband, he was successful in his profession. But with the advent of the internet and especially [11:21] in the early 2000s, the smartphone, he found that this pursuit of his became unmanageable. Which is to say, he was using more and more pornography for more hours every day, late into the night, not showing up at a conference that he was supposed to speak at, prepared to give that speech because he had been up the entire night before watching pornography, repeatedly masturbating.
And over time, he needed more and more potent forms to get the same effect, so he escalated from vanilla toast pornography to more deviant forms of pornography. And then, pornography itself wasn't adequate, so then he was going to live shows and meeting up with prostitutes. And eventually, you know, his addiction progressed to the point where he was going into chat rooms, doing dangerous things with other people in chat rooms, spending all of his available time engaged in this activity, to the point that essentially his life completely fell apart. [12:24]
His wife left him. Oh, my God. And he was thinking about ending his life and even found a spot near his office where he thought about hanging himself. [12:54]
Daily, we won't know for sure, but we do have a better chance of finding out. We are very toxic. Each of these cases, of course, is different. Online shopping is not the same as gambling, and gambling is not the same thing as pornography. But in time, Ana came to see connections, not just between these patients but to many people who are not seeking help from a psychiatrist. People like herself. You're listening to Hidden Brain. I'm Shankar Vedantam. and is determined to be the best undiscovered living thing on earth. This is Hidden Brain, I'm Shankar Vedantam. Over many years of practice at Stanford University, psychiatrist Anna Lemke has found that lots of people living in the Bay Area, one of the wealthiest parts of the United States, were suffering from a strange malady. [13:25]
Despite being blessed with great success in terms of education and material wealth, many of her patients were unhappy. happy. At one point, Anna saw something in herself that reminded her of the patients she was treating. Anna, I want to zoom into your life around the time you turned 40. What was going on in your life at this time? My life was good then. My marriage was fine. My kids were healthy. My work was rewarding and meaningful. I was in relatively good health for a 40-ish-year-old woman, so things were good. [13:57]
Now, you've always loved reading. And around this time, you fell in love with a very popular book series. What was it? It was The Twilight Saga. And can you tell me a little bit about what The Twilight Saga is? I confess I have not read the book, so what is their broad plot and what is it about? Well, you know, I was turned on to The Twilight Saga [14:26] when I dropped my kids off at elementary school and there was a group of moms clustered around. Megan was one of the moms, my friend. And they were all laughing hysterically. And I went over and I said, hey, what's so funny? And Megan said, oh, I've been reading this romance novel that I absolutely love. And I went into the bookstore to try to get the sequel and I couldn't find it, so I went up to the bookstore owner and I said, hey, you know, where's the sequel? And he said it's in the teenagers section. Right? So all the moms started cracking up, they thought that was the funniest thing. But she said, but you guys have to read it. It's so good. So I said, Okay, Megan, what is it called? Because I'm always looking for a good read, right? She said, Oh, it's called The Twilight Saga. So I thought okay, I'll give it a try. And it was absolutely mesmerizing for me. It was as if I had never read a novel in my life. All of a sudden, this novel about a bunch of teenage vampires running around biting each other on the neck just absolutely transported me. [15:27]
It was really weird. So, the Twilight books eventually spawned a very popular series of films. I want to play you a clip from one of those movies. A teenage girl named Bella is confronting a boy she knows, Edward, about his true nature. I know what you are. Come here. It's... Say it. Out loud. Say it. Vampire. Are you afraid? No. Okay. So, there are a lot of, you know, breathless pauses here, but I'm hearing, you know, fantasy, paranormal stuff, but it sounds like an innocent enough pastime, Anna. [16:31]
Oh, an innocent enough pastime? Sure. It always starts out innocent. And, of course, you know, it was. But what happened was it changed the way I felt in the moment in a way that resonated so deeply that I wanted to keep recreating that feeling. And what was that feeling? It was essentially a feeling of nonbeing. While I was reading the Twilight Saga, it just transported me to another time and place such that I completely forgot myself. And that self-forgetting was clearly something that I needed and wanted. I read the whole saga, I think it's like four books, and then I wanted to recreate that feeling again so I read the whole saga again. Wow. Pleasurable, but not as pleasurable as the first time around. But by then I was completely tapped into this whole genre of vampire romance novels. [17:31]
And so I started to invest larger and larger amounts of time, energy, and creativity into obtaining and reading vampire romance novels. You know, seemingly innocent to start with, but it became a bit of an obsession. And when I ran out of vampire romance novels, I moved on to werewolf romance novels. And then there were necromancers and soothsayers and all kinds of paranormal romance novels. Where were you procuring these books? So I live right next to a little library, which has a limited collection. So when I went through the limited collection at my local library, I either biked over to the main library or you can order through interlibrary loan. And some of these romance novels have very revealing covers like it was some bodice ripper with some hunk on the cover at the prow of a ship or something. I wouldn't want to be seen reading that anywhere. So Anna came up with a way to hide what she was reading from her family and friends. [18:38]
I haven't revealed this to anybody. This is terrible. But I would actually put the book inside another book. So if one of my kids came by or my husband came by, I could look like I was reading the other book. Wow, like a medical journal or something. Except that might not really trick them because, like, you know, they would know that I wouldn't spend that much time reading a medical journal? I mean, I used to do this in eighth grade, Anna. I felt like, you know, the trick of the book inside the book was something I perfected in eighth grade. I know, I know, and I discovered it in my forties. What can I tell you? I was a late bloomer. [19:24]
So at one point, Anna, your love of this literature received a turbo charge when you moved from the printed page to the electronic domain. Tell me how that happened. Well, my friend Susan said, well, you should get a Kindle because then you don't have to be carrying these books around. Kindle had just come out then. Of course, that was very, I like that idea because it would be easy access. But pretty soon I also started regularly going on Amazon and looking for things that were similar to the Twilight Saga. And guess what? Amazon will suggest those to you, as we all know now. And so Amazon did the work for me. All I had to do was look in my feed and say, oh, they're telling me I should read this one, they're telling me that I should read that one. And later on in the process, I also discovered that you can get free books on Amazon. So anything that was free that was in the Romance category, I would download and read. And that was really the beginning of the end for me. Because once I had that electronic reader, I essentially became a chain reader. Like as soon as I finished one book, I would either borrow from the local library or buy on Amazon another book. These were all romance novels
★ここまでの要約・日本語訳★
90年代には、彼はポルノを使って日常的にオナニーしていましたが、それは管理可能でした。彼はまだ父親として、夫として、職業として成功していました。しかし、インターネットの登場、特に2000年代初頭のスマートフォンにより、彼のこの追求は管理不能になったと彼は気付きました。彼はますます多くのポルノを使用し、1日中、夜遅くまで観るようになりました。彼は予定されていた会議に出席せず、ビデオを観るために前日の夜中を徹してオナニーしていたために準備していました。時間の経過とともに、彼は同じ効果を得るためにますます効果的な形式を必要としました。彼はバニラのポルノからより異常な形式のポルノへとエスカレーションしました。そして、ポルノ自体では不十分であり、ライブショーや売春婦との出会いに発展しました。最終的に、彼の中毒は彼自身の生活が完全に崩壊するほど進行しました。
彼の妻は彼を離れました。彼は自殺を考え、自分のオフィス近くで首を吊ろうと考える場所を見つけました。
毎日のことは確かではありませんが、私たちは確率が高く知ることができます。私たちは非常に有毒です。もちろん、これらの事例ごとに異なります。オンラインショッピングとギャンブルは同じではありませんし、ギャンブルもポルノも同じものではありません。しかし、時間の経過とともに、アナは、ただ精神科医の助けを求めていない多くの人々だけでなく、これらの患者とのつながりが見えるようになってきました。
アナは、スタンフォード大学での多年にわたる臨床の経験を通じて、アメリカの最も裕福な地域の一つであるベイエリアに住む多くの人々が奇妙な病気に苦しんでいることを発見しました。
★ここまでの特徴的な固有名詞・英単語・英語表現★
【固有名詞】【英単語】
- unmanageable（手に負えない）
- pornography（ポルノグラフィー）
- masturbated（オナニーをした）
- profession（職業）
- potent（強力な）
- deviant（異常な）
- addiction（中毒）
- progress（進む）
- psychiatrist（精神科医）
- malady（病気）
- wealthy（裕福な）
- blessed（恵まれた）
- kid（子供）
- teenage（10代の）
【コロケーション】
- advent of（〜の出現）
- late into the night（夜遅くまで）
- fell apart（崩壊した）
- seek help（助けを求める）
The other thing that I only realized, in retrospect,
was that these sort of tamer versions of romance,
where the sex scenes aren't super graphic,
well, those stopped working for me.
And now I needed ever more graphic types of romance novels
in order to get that zing that I was looking for.
So this was no longer about the pleasure of reading
at this point or your love of language.
It had become something else?
Oh, it had absolutely become something else.
And, of course, it was rooted in the pleasure of reading
and the pleasure that I've always gotten from fiction,[21:42]
but what happened was I got to a point
where I really didn't care if it was badly written
or badly plotted, or the characters were uninteresting.
I would just flip through to the climax, pun intended.
So then I got to where I was like,
reading really graphic erotica.
And the more graphic the better,
the more sex scenes the better.
But it was all about getting to that moment
and getting a certain very specific feeling.
And I became the possessor of the knowledge
if you take any romance novel and you open it up to two-thirds or three
quarters of the way through, you'll get right to the point, which is to
say these romance novels are engineered. They're written according to
a recipe. So at this point you're a respected researcher and psychiatrist at
Stanford University, you have a great family... but no longer, soon to be no
longer. But that's what I want to ask you about. What you are[22:43]
in some ways must have felt at odds with your public persona, the sense that
you had that you were a mom that you had a great family. Were you embarrassed by
your newfound love of steamy literature?
First of all, I didn't really see what was happening as it was happening. I would
occasionally joke to friends, "Oh, I'm so addicted to vampire romance novels or
romance novels in general," but just by being able to joke about it, I felt that
that must mean I'm really not addicted to it
or it's not really a problem.
The other thing was that
because of the technology, in large part,
I could do the behavior secretly.
Once I got the Kindle,
I could be reading something on that Kindle
that nobody else knew what I was reading,
whereas before I wouldn't wanna be seen
reading that anywhere.
That would just be really embarrassing,
but on a Kindle, it was anonymous.
How did this affect your patient care
because presumably through all of this,[23:44]
you were still treating other patients
and helping people with their addictions?
Right, as it was happening,
I didn't really see it happening
and I didn't relate it as being similar
to what my patients were going through.
That I really only saw in retrospect,
but I started to be less interested in my work.
Again, the work that had given me meaning
and purpose and joy
started to be dull and grey and boring and I found myself
less engaged and more just wanting to rush through the work
so that I could go home and read romance novels.
So you weren't reading these at work,
you reserved the reading at home?
Well, there was one day and this was sort of near
the culmination of this behavior,
time is weird for me then, but I think it developed
over the course of about a year or two.
But I did bring a romance novel to work
and was reading in the 10 minutes between patients.
So I don't want to play armchair psychiatrist,[24:45]
but it seems that you were.
That's okay.
You know, you were using your emotion in these
books as a kind of escape.
What do you think you were escaping from?
Well, that's what's so fascinating.
I really didn't have anything to escape from.
I have a great husband.
I have got these great kids, I have work that I adore.
My patients are just so fantastic.
There was nothing wrong, I was really just escaping too.
And the thing that I was escaping to
was just not having to be in my body,
not having to think,
being able to experience this kind of intense euphoria,
you know, this other, this other place,
which was very, very pleasant for me.
Just, it just felt good.
The other thing I just want to flag here is that the pattern we've seen over and over
again, which is that something starts out being pleasurable.
So your friend tells you about this romance novel.[25:48]
You read The Twilight Saga.
You find it fun.
You find it enjoyable.
And so you go back for more.
But somewhere along this process, the balance shifts, and now you are no longer actually
reading these things because they're giving you pleasure. It's that, you know,
you're reading them almost to avoid pain. Does that sound right?
That's really the key that we start out doing whatever the behavior is for rational reasons
and it succeeds in achieving what we're trying to achieve, either to give us pleasure,
or to accomplish some other goal.
But if it then hijacks our brain's reward pathway, it gets a life of its own.
And then, even when it stops doing what we want it to do,
we can't stop.
And that's really the hallmark of addiction.
When we come back, the brain science
behind an increasingly global malady.
You're listening to Hidden Brain, I'm Shankar Vedanthan.
This is Hidden Brain, I'm Shankar Vedantam.[26:59]
Anna Lemke is a psychiatrist and researcher in the behavioral sciences at Stanford University.
She's the author of Dopamine Nation, Finding Balance in the Age of Indulgence.
Ana, many of your patients suffered from problems related to compulsive overconsumption.
And you've experienced some of this yourself, but you had a big advantage over your patients.
You were a researcher and a scientist who studies the brain.
And you knew about a very important discovery in neuroscience that has to do with the relationship
between pain and pleasure inside the brain.
What was this discovery?
This discovery was the fact that pain and pleasure are co-located in the brain.
So the same parts of the brain that process pleasure also process pain
and they work like opposite sides of a balance.
Mixed So almost like a seesaw.
Exactly, like a seesaw or a teeter-totter in a kid's playground, and when that teeter-totter
or that beam on a central fulcrum is level with the ground, it's at rest,[28:03]
or what neuroscientists call homeostasis.
And when we experience pleasure, it tips one way,
and when we experience pain, it tips
in the opposite direction.
And there are certain rules governing this balance,
and the first and most important rule
is that the balance wants to remain level,
that is at homeostasis.
And our brains will work very hard
to restore a level balance
after any deviation from neutrality.
So when we reach for things that are pleasurable,
when I bite into a delicious dessert, for example,
I'm imagining that I'm essentially pressing down
on the pleasure side of that seesaw.
That's right.
So when we do something that's pleasurable
and we release dopamine,
the reward pathway and the balance tilt to the side of pleasure.
No sooner has that happened
than our brains will work very hard to restore a level balance.
And they do that first by tilting an equal and opposite amount
to the side of pain
before going back to the level position.[29:03]
And I like to imagine that as these little
neuro-adaptation gremlins hopping on the pain side of the balance.
And that's the come-down, hangover, the after effect.
And it often happens, even while we're still experiencing
the dopamine hit.
And it often happens outside of conscious awareness.
So if I have this image here about pressing down on one side of the seesaw
and these gremlins are jumping on the other side,
why is it they want to press down on the side of pain?
Why not just try and get to equilibrium?
Why press down so much
that it tips over in the other direction?
That's a great question.
And I don't exactly know
why the mechanism is built like that,
why we pay a price for every pleasure,
but I suspect it has to do with the fact
that that kind of mechanism makes us the ultimate seekers,
never satisfied with what we have,
always looking for more.
And if you think about it, we are evolved
over millions of years of evolution
to approach pleasure and avoid pain,[30:04]
and then on top of that, you have this pleasure-pain balance
whereby, as soon as we get whatever reward we're looking for,
we experience pleasure, we immediately remember
where and how that happened, and we want to recreate it.
And that recreation is accelerated by the fact that
as soon as we get that hit of dopamine,
we essentially go into dopamine freefall.
That's those gremlins on the pain side of the balance.★ここまでの要約・日本語訳★
- The individual realized that tamer versions of romance novels were no longer satisfying and needed more graphic ones.
- They became obsessed with reaching the climax of the novels and started reading really graphic erotica.
- They discovered that romance novels are engineered and written according to a recipe.
- The individual felt embarrassed about their newfound love of steamy literature but was able to hide it by using a Kindle.
- Their addiction to romance novels started to affect their work as a psychiatrist, making them less interested and engaged.
「私は、もっと穏やかな恋愛小説に満足できなくなり、よりグラフィックなものが必要になったことに気付きました。
小説のクライマックスに到達することに執着し、実際にグラフィックなエロチカを読み始めました。
恋愛小説はレシピによって作られていることを知りました。
新たに発見した情事文学への愛着に、当初は恥ずかしさを感じていましたが、キンドルを使用することで秘密裏に読書が可能でした。
この恋愛小説の中毒は、精神科医としての仕事に影響を与え、関心が薄れ、情熱を失っていきました。」★ここまでの特徴的な固有名詞・英単語・英語表現★
【固有名詞】
- Barak Obama（バラク・オバマ）
- Japan（日本）
- Hidden Brain（ヒドゥンブレイン）
- Stanford University（スタンフォード大学）
- Kindle（キンドル）
- The Twilight Saga（トワイライト・サーガ）
【英単語】
- retrospect（回想）
- tamer（大人しい）
- graphic（大胆な）
- zing（活気）
- climax（クライマックス）
- steamy（官能的な）
- euphoria（快楽）
- addiction（中毒）
- hijack（乗っ取る）
- neuroscience（神経学）
- homeostasis（恒常性）
- dopamine（ドーパミン）
- seesaw（シーソー）
- gremlin（小悪魔）
- equilibrium（平衡）
- seeker（探求者）
- freefall（自由落下）
And now we're in a dopamine deficit state and we feel this overwhelming motivation to do the work it takes to get the next reward, which for most of human existence has meant walking tens of kilometers every day, has involved doing enormous work in order to get just a little bit of reward. So, it's not that dopamine is good or bad, That dopamine's essential for survival and it keeps us moving and always looking for the next thing.
So dopamine is not involved only in feeling pleasure, perhaps more importantly it's also [31:06] involved in motivation, which is of course what you were talking about just now. Can you explain that connection between dopamine as a messenger of pleasure but also dopamine as the architect for motivation? Yeah. There is a very famous experiment in which rats were bioengineered to not have dopamine receptors in the reward pathway of the brain. And what the scientists discovered was that if they put food into the rat's mouth, the rat would eat the food and seem to get pleasure from the food. But if they put the food even a single body length away, the rat would starve to death. In other words, we need dopamine not just for the experience of pleasure, but also for the motivation to do the work to go get the reward. And probably, the way that dopamine makes us motivated is to create this dopamine deficit state or those gremlins on the pain side of the balance. So what happens when we transport this brain that evolved over millions of years [32:08] into the modern environment where everything is now available at the touch of a button? This ancient wiring that has us experiencing pain in the immediate aftermath of pleasure is woefully mismatched for our modern ecosystem. Why? Because we are surrounded by pleasure. We have more access to more reinforcing drugs and behaviors than at any point in human history. Even things that previously, you could have thought of as healthy like reading or exercise or playing games has become drugified, has been turned into a drug in some way, making us all more vulnerable to the problem of addiction, and also making us more vulnerable to the problem of this dopamine deficit state, whereby our brains try to compensate for this excess of pleasure by down-regulating our own dopamine production and transmission, not just a baseline, but below baseline, creating this constant physiologic craving [33:09] for more pleasure, but also the things that go along with craving, which are anxiety, irritability and depression.
So the mechanisms in our brain that compel us to, you know, approach pleasure and avoid pain, you say were evolved over millions of years for a world of scarcity, whereas today, because we're surrounded by so much stuff, we're sort of drinking from a fire hose of dopamine, as you put it. Yeah, this is the Plenty paradox, right? It's the literal physiologic stress of overabundance. So walk me through the same seesaw analogy that we talked about earlier. You know, again, 100,000 years ago, I found a date tree and the date tree had delicious dates and it made my brain very happy to eat some of those dates, but there were not very many dates on that one tree. to find the next tree, and the next dream might have been as you said three miles away, and so it required a huge amount of effort to get to that next date tree. What's happening with that see-saw now in the world in which we live where things are in fact available at the touch of a button? Well yeah, let's go back for a second and talk about what's happening with the see-saw when you're looking for the date tree, because what happens as you're scouring your environment to try to find you know one date tree with a couple of dates on it is that your pleasure-pain balance goes onto the pain side, right? Because you're hungry, and you're walking, and you're tired, and then finally you find this date tree and you're ecstatic and you eat this date, and your balance, your pleasure-pain balance goes back to the level position, which feels like euphoria, because part of the key here is the directionality of the pleasure-pain balance. So if I'm in pain cuz I'm hungry and then I find something to eat, and it moves me in the direction of pleasure, that's as pleasurable as if I start out with a level balance, and I use an intoxicant, and I get high. Interesting. And so now, the same pain, pleasure, balance now, what happens now? Yeah. So now in the modern world, let's take Silicon Valley because it's a prime example, but it's also true all over the world now. you go and you're hungry, right? And you're looking for a date tree. And all of a sudden, you've got a whole crate of dates shipped to you from Amazon right on your kitchen table, right? And by the way, they're giant. They're abnormally giant dates, right? So you eat a giant date from Amazon and it releases dopamine in your reward pathway because they've also added sugar, and salt, and fat, and flavorings. It's like coffee dates or something, who knows. And you get the release of dopamine and wow, that feels great. Cause like, wow, who's ever had a date like that in the history of humans? And then, as soon as it's over your pleasure pain balance tips to the side of pain because those gremlins are trying to compensate for all that dopamine. And as soon as you're in that dopamine deficit state with the gremlins on the pain side of the balance you want to restore a level balance. And what is the easiest way to do that? Well, you could wait until the gremlins hop off. Because if you wait long enough, they will hop off and homeostasis will be restored. Or you could eat another date. And if you eat another date because there's a whole crate of dates right in front of you, that would work faster, right? And maybe you'll eat two this time because then that'll level your balance but also get you over to the pleasure side. And pretty soon you've eaten the whole crate of dates. And now you're essentially at war with those neurodeaptation gremlins. And the more we then try and press down on the pleasure side of the seesaw, and the more the gremlins try and press down on the other side to achieve homeostasis, you make the case that over time, the gremlins start to push down on the opposite side of the seesaw, and then we end up depressed and anxious. Explain how this happens, Anna. Well what happens as we continually bombard our reward pathway with highly reinforcing substances and behaviors is that we accumulate more and more gremlins on the pain side of the balance. They're just doing their job, trying to restore homeostasis. And over time, those gremlins essentially are camped out on the pain side of the balance, tents and barbecues in tow, and now we're in addicted brain. We've changed our hedonic or joy set point such that now we need more of our drug, quantity wise, and more potent forms of our drug not to get high but just to level the balance and feel normal. And most importantly, when we're not using, we're walking around with a pleasure pain balance tilted to the side of pain, which means we are experiencing the universal symptoms of withdrawal from any addictive substance, which are anxiety, irritability, insomnia, depression, and craving. What are the trends of addiction that we should be looking at to help guide our treatment? I mean, you're an addiction psychiatrist and you treat many patients who are dependent on drugs, [38:16] so drugs in the conventional sense of a chemical that is swallowed or smoked or snorted or ingested. And obviously that is a very big problem, but you're making a much more radical claim here. You're saying that our problem with addiction is not just limited to nicotine and cocaine and heroin. You're absolutely right. What I am saying is that science, technology and innovation has allowed us to drug-ify almost every human behavior. If you're not addicted yet, it's coming soon to a website near you. And my bigger claim is that the rising rates of depression, anxiety, and suicide, which by the way are rising fastest in the richest nations in the world are due in part to the fact that we are overloading our brain's reward pathway with too much dopamine. And that in our brains effort to compensate for too much pleasure, We are essentially individually and collectively down-regulating our own dopamine production and transmission, not just to baseline levels, but actually below baseline levels. So we are in a dopamine deficit state.
★ここまでの要約・日本語訳★
- Dopamine is essential for motivation and survival, not just pleasure.
ドーパミンは快感だけでなく、動機づけにも必要であり、生存にも欠かせない。
- A famous experiment with rats showed that dopamine is necessary for motivation to obtain rewards.
ラットの実験では、報酬を得るためには動機づけにドーパミンが必要であることが示された。
- In our modern environment of abundant pleasure, our ancient brain wiring is mismatched and can lead to addiction.
快楽が豊富な現代の環境では、古代の脳の配線に適合しないため、中毒につながる可能性がある。
- The overabundance of reinforcing drugs and behaviors makes us more vulnerable to addiction and dopamine deficit state.
増加する中毒性のある薬物や行動は、中毒とドーパミン不足状態のリスクを高める。
- Overloading our brain's reward pathway with dopamine can lead to rising rates of depression, anxiety, and suicide.
脳の報酬経路に過剰なドーパミンを与えることは、うつ病、不安症、自殺の増加につながる。
★ここまでの特徴的な固有名詞・英単語・英語表現★
【固有名詞】【英単語】
- motivation（動機）
- pleasure（快楽）
- craving（渇望）
- anxiety（不安）
- irritability（イライラ）
- depression（うつ病）
- ecosystem（生態系）
- physiologic（生理学的な）
- addiction（中毒）
- reinforcing（強化）
- behaviors（行動）
- neurodeaptation（神経的適応）
- hedonic（快楽の）
- joy（喜び）
- withdrawal（離脱）
- treatment（治療）
- psychiatrist（精神科医）
- dependent（依存）
【コロケーション】
- do the work（仕事をする）
- get the reward（報酬を得る）
- feel pleasure（快感を感じる）
- the way that〜（〜する方法）
- transport this brain（この脳を運ぶ）
- the problem of〜（〜の問題）
- a world of〜（〜の世界）
- be surrounded by〜（〜に囲まれる）
- access to〜（〜へのアクセス）
- the mechanisms in our brain（私たちの脳のメカニズム）
- compel us to〜（〜するように強要する）
- a world of scarcity（不足の世界）
- approach pleasure（快楽に近づく）
- avoid pain（苦痛を避ける）
- drinking from a fire hose（消火栓から飲む）
- restore a level balance（水平のバランスを回復させる）
- press down on the pleasure side（快楽側を押さえつける）
- tilted to the side of pain（苦痛側に傾いている）
- makes us all more vulnerable to〜（私たちをより脆弱にする）
- help guide our treatment（治療を案内するのに役立つ）
- dependent on drugs（薬物依存症である）
- overloading our brain's reward pathway（脳の報酬経路を過負荷にする）
- down-regulating our own dopamine production（私たち自身のドーパミンの生成を抑制する）
- below baseline levels（基準値以下）
As someone who possesses excellent proofreading skills, we would like you to proofread an AI transcription of a dialogue-based news program. It is important that you adhere to the following seven conditions in order to ensure the highest quality of work:
1. It is crucial that you keep the original English text as intact as possible. You must not rewrite it without permission.
2. The output is in English, so please do not translate it into Japanese.
3. It is important that you do not erase [nn:nn] and return it to its original place after proofreading.
4. After making corrections, please insert a line break before [nn:nn] to make it easier to read.
5. You should correct any obvious typographical errors.
6. It is important that you consider the context and add punctuation and line breaks to make it easier to read.
7. Please review the first six conditions after completing your proofreading to ensure that they have been correctly executed. If any of the conditions have not been executed correctly, please redo them to match the conditions again.Which means that we're all unhappier, more anxious, more depressed,
more irritable, less able to take joy in the things that used to give us joy
that have given people joy for generations and also more susceptible to pain, right?
Even the merest slight now can make us pain and that we're not…this isn't happening
because somehow we're spoiled or our values have changed.
It's because we've literally physiologically changed our brains as a result of constantly
bombarding them with these high reward substances and behaviors.
So in some ways this feels really mind-bending to me Anna because you know
I can see how nicotine and alcohol and
Marijuana or heroin or cocaine like I can see how these could be addictive but many of the things you're talking about[40:24]
You know food or social connection or sexual intimacy
These are not things that are inherently problems
in fact
Many of them are part of what it means to be
human. Talk about how our modern societies have taken these normal,
healthy things and in effect, as you would put it, drug-ify them.
So the way that our modern society has drug-ified these things that used to be
normal and healthy, like having sex or eating food or playing games, is
essentially by increasing four factors. Quantity, access, potency, and novelty.
Because our incredible manufacturing system
has allowed us to make these reinforcing substances
in enormous quantities and our amazing supply chain
allows us to ship them all over the world.
One of my favorite sort of anecdotes is that in the 1880s,
the cigarette rolling machine was invented,[41:24]
allowing manufacturers of cigarettes to go from
manufacturing four cigarettes a minute
to 20,000 cigarettes a minute.
And that's just one example of what we've done all around.
And my own romance novel reading addiction that developed.
One of the things that I discovered
when I went looking for other romance novels
is that there's a whole universe
of romance novels out there.
It was really a never-ending quantity,
and quantity really matters.
Because the more we use our drug of choice,
our substance or behavior that's reinforcing,
more that we expose our brains to, and the more often, the more likely we are to change
our brains to this addicted kind of circuitry.
Quantity is the first driver.
What are the others?Yes, so quantity is the first one.
Availability or access is huge.
If you grow up in a neighborhood where drugs are sold on the street corner, we have lots
of epidemiologic data showing that you're more likely to try drugs, and more likely[42:27]
to get addicted to them.
Now we live in a world where we all have more access to our substance or behavior of choice
whether it's vampire romance novels or potato chips or games or pornography or old fashioned
drugs like alcohol, cannabis or nicotine.
And of course the smartphone is essentially the equivalent of the hypodermic syringe delivering
digital dopamine 24-7 for our wired generation.
that's really what it is. The smartphone totally changed things. When people could
carry in their pocket this device that gave them access to digital media and
digital content 24-seven, we all essentially became more addictive to
these kinds of digital drugs.
All right, so we've talked about quantity, and we've talked about
accessibility. What's next?
Yeah, availability, accessibility. The other one is potency.[43:29]
So one of the ways to overcome these gremlins on the pain side of the balance
or what's often referred to as tolerance is to either use more of the drug or
use more potent forms or have a more potent drug delivery mechanism. So for
example, with opioids, someone might start out using opium but eventually go to
heroin, which is about 10 times more potent, and then eventually progress to fentanyl,
which is 50 to 100 times more potent.
And this would allow them to at least temporarily win that battle with their gremlins and get
the feeling that they're looking for.
But another way to achieve potency is to combine two drugs to make yet a third more novel drug,
and this is done all the time.
example people combining opioids with things like benzodiazepines or now this
new veterinary sedative Trank which people are sadly using. By combining two
distinct drugs together we get a new novel drug which then changes it up for[44:33]
our brain receptors and allows us to overcome tolerance. And and in the realm
of non-illegal substances you can also have combinations like French toast ice
screen?
Exactly or you know I very easily get hooked on YouTube videos especially outtakes of American
Idol and when I think about why on earth is American Idol so entrancing for me well, they've
figured it out right they've taken music which is already reinforcing for most people's brains
releases dopamine feels good and then they've combined that with gaming and they've turned
and turned it into a competition,
and thereby really made a very potent drug.
Can you talk a moment about the factor
that's known as novelty?
This is true in drugs of abuse,
but it's also true for many of the other things
that previously we might not have thought
as being problematic.
Yeah, so dopamine is extremely sensitive to novelty,
which is why, for example,
people can get addicted to things like the news.
That's the definition of news.
It's new stuff coming your way.[45:35]
what's become so toxic about the modern world
is that in order to maintain customers
and keep them coming back,
you've gotta take the thing that they liked before
and then package it as slightly new or different or better.
And the internet has absolutely mastered that.
These AI algorithms learn us,
figure out where we've spent time before,
what we've liked before,
and then proffer or suggest to us things that are similar,
but a little bit different.
and that absolutely engages this treasure-seeking function
where we keep going because we're hoping
that the next hit will be something
that's just a little bit better
but similar to what we had before.
You know, I remember when I was in 8th grade
or maybe 7th grade, Ana,
teachers would tell me, you know, to avoid a local park,
me and all of my classmates,
because the rumor was that drugs were being bought and sold
and used at this park,
but you know, if everything can be drugified,
if addictions can be beamed and streamed
and Wi-Fied into our living rooms and bedrooms,[46:38]
it becomes really now very hard to put a fence around it
and say, avoid going to this park
because the problem is no longer just with one park.
That's the problem we're all facing as individuals,
as parents, as schools.
I mean, I don't know about you but when I walk around
and see the way that people are just glued to their phones,
it just makes me really sad and yet I totally get it.
I mean, these things are they're literally mesmerizing.
We are put in a trance by these devices.
They're highly reinforcing
for our very fragile little human brains.
When we combine the ancient pleasure, pain, seesaw
and the brain with a modern world that is ready
to push hard and often
on the pleasure side of the balance, we get trouble.
we end up with compulsive overconsumption
and all the associated problems it causes
for people's health, well-being, and relationships.[47:39]
We also end up with the plague of depression and anxiety.
In the second part of our story,
coming up in the next episode,
how to reset our relationship with a world of plenty
and turn unhappiness into thriving.
Anna Lemke, thank you for joining me today on Hidden Brain.
You're very welcome.
♪
If you have follow-up questions that you'd like to ask Ana
and that you'd be comfortable sharing
with the larger Hidden Brain audience,
please send a voice memo to ideas at hiddenbrain.org.
Use the subject line ADDICTION.
That email address again is ideas at hiddenbrain.org.
60 seconds is plenty,
and please be sure to include your name and phone number.★ここまでの要約・日本語訳★
- The modern world has made people more unhappy, anxious, and depressed, and more susceptible to pain due to constantly exposing our brains to high reward substances and behaviors.
- Our modern society has "drug-ified" normal and healthy things like food, social connection, and sexual intimacy by increasing their quantity, accessibility, potency, and novelty.
- The availability or access to substances or behaviors of choice has increased, thanks to technology like smartphones that deliver digital dopamine constantly.
- Potency is achieved by using more potent forms of drugs or combining two drugs to create a more novel drug, which changes the brain receptors and overcomes tolerance.
- Dopamine is highly sensitive to novelty, and the internet and AI algorithms capitalize on this by offering similar but slightly different things to keep people engaged.
モダンの世界では、人々はより不幸で、不安で、うつ病になりやすくなり、痛みにも敏感になっています。これは、脳を高報酬の物質や行動で絶えず刺激することによって、私たちの脳が生理的に変化したためです。
私たちの現代社会は、食べ物や社会的なつながり、性的な親密さなど、本来健康で正常なものを、数量、アクセス性、強度、新奇性を高めることによって「薬物化」しています。
スマートフォンなどの技術により、私たちは選択した物質や行動によりアクセスできるようになりました。これにより、デジタルドーパミンが24時間365日提供されるようになりました。
強度は、より効力のある薬物形態を使用するか、2つの薬物を組み合わせてより新しい薬物を作ることで達成されます。これにより脳の受容体が変化し、耐性を克服します。
ドーパミンは新奇性に非常に敏感であり、インターネットやAIアルゴリズムは、類似したが少し異なるものを提供することで人々を引きつけます。
★ここまでの特徴的な固有名詞・英単語・英語表現★
【固有名詞】【英単語】
- proofreading（校正）
- dialogue-based（対話型の）
- transcription（謄写）
- program（番組）
- condition（条件）
- intact（不変の）
- permission（許可）
- reinforcing（強化する）
- typographical（活字の）
【コロケーション】
- possess excellent proofreading skills（優れた校正スキルを持つ）
- adhere to the conditions（条件を守る）
- ensure the highest quality of work（最高の品質の仕事を保証する）
- be addicted to（中毒になる）
- make corrections（修正を行う）
- modern societies（現代社会）
- in effect（事実上）
- in enormous quantities（莫大な量で）
- have access to（アクセス権を持つ）
- increase four factors（4つの要素を増加させる）
- overcome tolerance（耐性を克服する）
- deliver digital dopamine 24-7（デジタルのドーパミンを24時間7日間提供する）
- engages this treasure-seeking function（この宝探し機能を働かせる）
- push hard and often（強く頻繁に押す）
- compulsive overconsumption（強迫的な過剰消費）
- associated problems（関連する問題）
- reset our relationship（関係をリセットする）
- turn unhappiness into thriving（不幸を繁栄に変える）
It's where you'll find even more of the ideas and insights that you love from the show, plus you'll have the chance to have your questions answered by researchers we feature on the show. You can find Hidden Brain Plus in the Apple Podcasts app, or at apple.co/HiddenBrain. I'm Shankar Vedantam. See you soon.
★ここまでの要約・日本語訳★
〜Hidden Brain Plus〜
- More ideas and insights from the show
- Opportunity to ask questions to researchers featured on the show
- Available on the Apple Podcasts app or apple.co/HiddenBrain
- Hosted by Shankar Vedantam
- Join us soon!
〜ヒドゥンブレイン・プラス〜
- 番組からのアイデアや洞察をより多く楽しめます
- 番組で特集される研究者に質問する機会があります
- Apple Podcastsアプリまたはapple.co/HiddenBrainで利用可能
- ホスト：シャンカール・ヴェダンタム
- 近日ご参加ください！
★ここまでの特徴的な固有名詞・英単語・英語表現★
【固有名詞】【英単語】
- ideas（アイデア）
- insights（洞察）
- researchers（研究者）
- feature（特集する）
【コロケーション】
- take a look（見てみる）
- in front of（〜の前に）
