さんだーさんだ！（ブログ版）

2015年度より中高英語教員になりました。2020年度開校の幼小中混在校で働いています。

The Path to Enough

英語 英語学習 podcast 文字起こし

hiddenbrain.org
↑こちらのポッドキャストを、先日書いた↓こちらの文字起こしアプリで起こしてみた。
thunder0512.hatenablog.com

昨日の記事の後編です。
thunder0512.hatenablog.com


長いので、主な注意点を最初に🙏

  • [mm:ss]というタイムスタンプは、入っているところと入っていないところがあります。ChatGPT3.5の限界です。
  • 「-Japan（日本）」「-Barak Obama（バラク・オバマ）」というのも、単語帳作成のためのプロンプト中に例として挙げたものです。これまたChatGPT3.5の限界です。
  • その他にも日本語訳が抜けているなど不完全な部分は多々あるかと思いますが、基本的にはChatGPT3.5の限界だと思ってご了承ください。。
  • また、誤訳や不完全な文字起こしがあったとしても、なんの責任も負えませんので、ご自身で確かめながらご利用ください。

This is Hidden Brain, I'm Shankar Vedantam.

It seems like the simplest choice in the world.
Given the option between pain and pleasure,
we ought to choose pleasure.

Is it better to be hungry or full?
Better to be tired or alert?
Better to watch another episode of our favorite TV show
or do the dishes?

It isn't just our own minds
that tell us to choose the path of enjoyment and indulgence.
Our friends remind us that life is short,
say no to dessert or another round of drinks,
and someone might call you a spoiled sport.

At Stanford University,
psychiatrist Anna Lemke has heard the same messages.
But, as a scientist,
she's also studied the way our brains balance
pain and pleasure.

The two sit on opposite ends of a neural seesaw,
and the brain constantly attempts
to bring them into equilibrium,
or what is known as homeostasis.

[1:03]
When we pressed down hard and often
on the pleasure side of the seesaw,
triggering bursts of the neurotransmitter dopamine,
Anna says the brain automatically compensates
by pressing down on the other side,
producing a dopamine deficit.
Over time, as people press down too much
or too often on the pleasure side of the equation,
the brain compensates so forcefully
that we start to walk around
with a chronic dopamine deficit.
This can manifest as anxiety, irritability, and depression.
There is complex neurochemistry
behind the process of homeostasis,
but Anna has come up with a simple way to visualize this.
When you press down on one side of the seesaw,
imagine a bunch of gremlins inside your head
jumping on the other side of the seesaw.
We explored how this mechanism works and why it exists in our previous episode.

[2:03]
If you missed it, I strongly suggest you listen to it first.
Today we continue with the second part of our story about the paradoxical effects of pleasure.
And we ask what it means to live a life of balance and harmony,
to work with the brain rather than against it,
this week on Hidden Brain.

Ana Lemke is a psychiatrist at Stanford University.
She has worked with many patients who have addictions – not just to drugs like cocaine and heroin – but to everyday activities taken to excess.
She has treated patients with a range of out-of-control indulgences, from eating and drinking, to online shopping and sports betting.
From the time she turned 40, Ana found herself in the grip of an addiction.

[3:03]
She was consumed with romance novels and erotica.
At one point, she found herself swept up in the novel Fifty Shades of Gray.
The story, later made into a movie, revolves around a sadomasochistic relationship between a college student and a business tycoon.

"There are some people who say that I don't have a heart at all."

"Why would they say that?"

"Because they know me well."

"Um, do you have any interests outside of work?"

"I enjoy various physical pursuits."

I asked Anna what drew her to the book.

"I'm honestly not even sure I know, because it didn't really matter when I was reading it."

"is to say like the plot and the characters mattered not at all, I was reading it for the sex scenes."

"You know, embarrassing to admit that, but it's true."

"But I remember rationalizing it to myself as a modern day pride and prejudice."

"But you know, not really."

"Yeah, you don't think Jane Austen would have written Fifty Shades of Grey?"

"Don't think so."

"No, don't think so."

"So at a certain point Anna, you started to see that your enjoyment of romance novels and fantasy had tipped over from entertainment to something more potent."

"When did you have this realization, as you were reading Fifty Shades of Gray?"

"I remember it vividly."

"It was about three in the morning on a weeknight, well past the hour I should have been sleeping so that I could be prepared for the next day to come."

"And I got to a scene where, you know, the characters were using sadomasochistic sex toys."

"And I just thought to myself, how did I get here?"

"What am I doing?"

"That's not anything that I'm into or even interested in."

"It's sort of like, where am I and how did this happen."

"And I decided that's it."

"This is…something's gone seriously awry here."

"I need to look at this problem."

[5:09]
"When she would become so engrossed that it felt like she was in a trance."

"You can see this among people who have addictions to sports betting or pornography."

"You can see it among heavy users of YouTube or social media platforms like TikTok."

"And of course, you can see it in the way people disappear into their phones."

"Anna said she would lose track of time."

"Lose track of herself."

"And you know, we want to be in a trance."

"And I think that's something we have to admit to ourselves."

"We want to escape ourselves."

"And I think part of that is a function of this incredibly narcissistic society we live in."

"I mean, where we're so preoccupied with ourselves and our problems and our achievements."

[6:10]
"Like we're desperate to get away from ourselves."

"Plus, you know, you have all these amazing drugs that make that possible."

"So a turning point in your life came in 2011 during an encounter you had with a young resident who was training to be a psychiatrist."

"Tell me what happened and how it came about."

"Yeah, so this was a lovely young student of mine, a doctor in his residency for psychiatry and I was teaching a small group of residents how to do something called motivational interviewing which is a way of harnessing the patient's own motivation to change their behavior. So we got into these pairs so that one could role-play the psychiatrist and the other could role-play the patient and the patient could talk about a behavior that they wanna change, and the psychiatrists could do this motivational interviewing to try to explore how to help them do that."

"And, you know, we had an odd number, so that means that I had to pair with the student in order to do the role-play, so he said, I'll be the psychiatrist. I said, okay, I'll be the patient."

"And he said, you know, is there a behavior you'd like to change?"

"And I just sort of said without even thinking about it, yeah, you know, I do some late-night reading that I'd like to change."

"And an unusual motivational interview style I said well why is it that you want to change that behavior right you're trying to explore with the patient what their reasons are and I said well you know, I just think it's gotten into a bad habit it's interfering with my sleep, it's interfering with my ability to be present you know just sort of vague generalities I did not tell him what specific genre of book I was struggling with um so then he asked me what would you be giving up if you stop that behavior."

"And I said, I would be giving up the intense pleasure and feeling of escape that I get from reading."

"But then, when I said that I realized, yeah, but those things are not as important to me as being present for my husband and for my children, for being invested in, and good at the work that I do."

"So, I find it so striking and also so revealing Anna, that it took an actual conversation someone asked you a simple question and you had to answer aloud for you to see something about yourself? I mean, you're the trained psychiatrist. You're supposed to have insight and I think it just shows how difficult it is for all of us to see ourselves clearly."

"Yeah, isn't that amazing? And it is striking and a bit of a mystery, frankly, as to why putting into words what we're doing, especially telling another live human, has this remarkable ability to penetrate our lack of awareness and make us aware in a way that also then greatly enables our ability to change that behavior."

"So did the conversation end there or did the two of you come up with a plan for what you could do to change your behavior?"

"The conversation, as I'm recalling it, went on a little bit longer but not much longer frankly."

"So then he asked a very simple question."

"And he said, well, what's one thing you could do to take a step toward changing that behavior?"

"And I thought, well, I could get rid of my Kindle, because my Kindle gives me such incredible easy access to these downloadable reads, including free reads from Amazon, that if I got rid of it, it would create a barrier between me and the romance novel so that I'd have to do more work to get it."

"So that's what I decided to do."

★ここまでの要約・日本語訳★

  • Psychiatrist Anna Lemke studies the balance between pain and pleasure in the brain.
  • When we focus too much on pleasure, it can lead to a chronic dopamine deficit and manifest as anxiety, irritability, and depression.
  • Anna herself experienced addiction to romance novels and erotica.
  • She realized she needed to change when she found herself engrossed in a scene that she didn't actually enjoy.
  • A conversation with a young resident helped her realize the importance of being present and led her to take steps to change her behavior.

★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】

  • mind（心）
  • choose（選ぶ）
  • pleasure（快楽）
  • hungry（空腹）
  • full（満腹）
  • tired（疲れた）
  • alert（警戒した）
  • episode（エピソード）
  • favorite（お気に入り）
  • dishes（皿洗い）
  • scientist（科学者）
  • brain（脳）
  • pain（痛み）
  • balance（バランス）
  • equilibrium（平衡）
  • homeostasis（恒常性）
  • press（押す）
  • dopamine（ドーパミン）
  • compensate（補償する）
  • deficit（不足）
  • manifest（現れる）
  • anxiety（不安）
  • irritability（イライラ）
  • depression（うつ病）
  • neurochemistry（神経化学）
  • visualize（視覚化する）
  • gremlin（グレムリン）
  • neural（神経の）
  • seesaw（シーソー）
  • mechanism（メカニズム）
  • paradoxical（逆説的）
  • effects（効果）
  • indulgence（快楽）
  • balance（バランス）
  • harmony（調和）
  • addiction（中毒）
  • romance（ロマンス）
  • erotica（エロティカ）
  • novel（小説）
  • plot（筋立て）
  • characters（登場人物）
  • embarrassing（恥ずかしい）
  • rationalizing（正当化）
  • awry（誤った）
  • problem（問題）
  • engrossed（没頭して）
  • trance（トランス）
  • addiction（中毒）
  • sports betting（スポーツベッティング）
  • pornography（ポルノグラフィ）
  • Youtube（ユーチューブ）
  • social media（ソーシャルメディア）
  • narcissistic（ナルシスト）
  • escape（逃避）
  • turning point（転機）
  • resident（研修医）
  • psychiatry（精神医学）
  • residency（研修）
  • motivational interviewing（モチベーショナル・インタビュー）
  • behavior（行動）
  • realization（認識）
  • genre（ジャンル）
  • specific（具体的な）
  • vague（曖昧な）
  • potent（強力な）
  • awareness（意識）
  • penetrate（浸透する）
  • enable（可能にする）
  • plan（計画）
  • Kindle（キンドル）
  • barrier（障壁）
  • downloadable（ダウンロード可能な）

【コロケーション】

  • choose pleasure（快楽を選ぶ）
  • have an addiction（中毒になる）
  • be in the grip of an addiction（中毒に苦しむ）
  • be consumed with（~に夢中になる）
  • take to excess（過度に行う）
  • sweep up in（~に夢中になる）
  • be in a trance（トランス状態になる）
  • disappear into（~に没頭する）
  • be engrossed in（~に夢中になる）
  • lose track of time（時間の感覚を失う）
  • escape ourselves（自分自身から逃れる）

So how did that go?
Did you just quit Cold Turkey?

Once I had had that conversation with him
and I thought about it the next day,
I had a moment where I realized, oh, wow,
I think I've developed a minor addiction
to romance novels and erotica.
And so then I, as I simply made a decision
to do what I recommend my patients do,
which is abstain for four weeks,
got rid of the Kindle,
and just, you know, made a strong commitment
to not reading romance novels and erotica.

[10:16]
But what shocked me was that very night,
which was the first 24-hour period
of my not engaging in romance novel reading
as a way to put myself to sleep.
I was gripped by anxiety and restlessness and agitation.
And I was surprised, right?
Because I, first of all,
didn't think there would be a huge physiological
or even psychological response.
But I experienced withdrawal,
the same kind of withdrawal that my patients described.
I had a very difficult time putting myself to sleep.
And so, it was extremely difficult.
I lay awake for several hours
and finally was able to put myself to sleep.
And that went on for about 10 to 14 days.
So in fact, it was the process of trying to give it up
that really brought home to me how addicted I had become.

What happened at the end of the month, Anna?
I felt much better.
And I thought to myself, I'm good.

[11:17]
Now I'm going to go back to reading romance novels,
now and then, in a very rational and tempered way,
and we're all gonna be fine here.
And so I went and I got some book,
and I completely binged.
I spent the whole weekend reading, all day, every day,
and late into the night on Sunday,
went to work blurry-eyed on Monday,
and I realized, wow, that was a complete mess.
And it's clear that whatever those circuits are
that have been kindled in my brain, they're still kindled.
And that a month is not sufficient,
and I need to recommit to a longer period of abstinence,
and that's what I did.
I recommitted to a year of abstinence
from romance novels, erotica of any sort.
One of the things that's hardest
about problems involving the mind
is that we need our minds
to battle the problems we have with our minds.
Imagine trying to fix a broken toaster,
and the only tool you have is the very same broken toaster.

[12:20]
When we come back, how to reset our relationship
to pain and pleasure in a way
that produces enduring satisfaction.
You're listening to Hidden Brain, I'm Shankar Vedantam.

Let's test it out.
In our previous episode, which I highly recommend you listen to if you haven't heard it yet,
Stanford University psychiatrist Anna Lemke explained how our minds come with an internal
imbalance to achieve what is called homeostasis.
When you bite into a delicious dessert or bet on a sports game and wait excitedly for
the result, you're pressing on the pleasure side of the seesaw.
You trigger a burst of dopamine.
To return to balance, the brain compensates by pressing down on the other side of the
seesaw.
Over time, if we press too hard or too often on the pleasure side, the brain starts to compensate
more and more forcefully, leaving us with a dopamine deficit.
This can leave us feeling down and miserable and prompt us to go find our next jolt
of pleasure.
You can see how this quickly can become a vicious cycle.
Anna, it's clear that simply seeking out more pleasure and more intense pleasure
or more constant pleasure is not the answer, and you often recommend something
that you call a dopamine fast to your patients.
How does it work? Well, the dopamine fast is a
little bit of a misnomer in the sense that we're not actually ingesting dopamine.
In fact, what we're doing is using substances and behaviors that trigger the release or increase in firing
in dopamine that we make in our brain.
What the dopamine fast refers to is to abstain from the
substance or behavior for long enough
for our brain to get the memo,
oh, wait a minute,

[14:21]
I'm not getting this external source anymore.
It's time for me to start to make more
of my own endogenous or innate dopamine
to upregulate our own dopamine receptors
and increase dopamine transmission.
Because in response to substances and behaviors
that release a lot of dopamine in our brain,
this fire hose of dopamine,
what our brains essentially do is downregulate
dopamine transmission, not just to baseline,
but below baseline, which is this state
that's really akin to a clinical depression.
There is an important caveat to this recommendation.
The more severe the addiction,
the more a dopamine fast will produce painful symptoms
known as withdrawal.
In some cases, withdrawal can be so severe
that it can pose medical risks of its own.
Anybody with a severe addiction
is going to need medical supervision and support.
And especially if they're physiologically dependent
to a chemical like alcohol or benzodiazepines,

[15:22]
or opioids, such that they would be at risk
for life-threatening withdrawal.
Because essentially what happens in withdrawal
is that we experience the opposite
of whatever that drug does for us,
and with sedatives like alcohol, opioids, and benzos,
we can experience a physiological storm
including life-threatening seizures.
So, individuals who are struggling
with that kind of severe chemical dependency
should not just quit cold turkey.
They need medically-monitored detoxification or tapering
in order to get off of their drug of choice.
But the principle is still the same,
that they need to get off of that chemical
in order to allow their brain to heal.
So you once treated a patient whom you called Delilah,
a young woman who was a heavy user of cannabis.
So you broached the idea of a Dopamine Fast to her
and what was her reaction?
Well, first of all, she came to me seeking help
for anxiety and depression, not seeking help for cannabis.

[16:26]
In fact, she identified cannabis as the only thing
that helped with her anxiety.
And she wanted me to prescribe a pill
or offer some kind of psychotherapy
that would help with her anxiety and depression.
But what I said to her, which is what I say to many people
who now come to me wanting help with anxiety
and depression and other psychiatric symptoms
whom I discover are using
high dopamine rewards excessively,
is that instead of prescribing them a pill
or recommending any kind of psychotherapy,
what I invite them to do is to engage in an experiment,
which is the dopamine fast for four weeks
in order to reset reward pathways.
Because there's a possibility, I tell them,
that just by doing that alone,
their anxiety and depression may get substantially better
without our having to do any other intervention.
So that's what I suggested to Delilah.
So you say that four weeks of abstention

[17:28]
are also necessary to begin to see one's life more clearly,
to accurately perceive cause and effect
when it comes to our moods
and the things that are bringing us up and down.
What do you mean by that
and how did that work out with Delilah?
When we're chasing dopamine,
it's very difficult to see the true impact
of our drug of choice,
whether a substance or behavior, on our lives.
All we see is the immediate relief that we get from it.
We're not able to see that over time what's happening
is that we're changing our brains
in a way that's probably exacerbating
the problem we're trying to solve.
So I suggested to Delilah
that she try giving up cannabis
for a month in order to reset her reward pathways.
And what she said to me is,
you know, why would I do that?
Cannabis is the only thing
that helps with my anxiety.
And I said to her,
I hear you that in the moment
you get relief from the cannabis,
but what I suggest to you

[18:29]
is that what you're really doing
is medicating withdrawal from the last dose
rather than treating your underlying anxiety disorder.
And that in fact, what the cannabis is doing over time
is changing your hedonic or joy set point
such that now you need more and more cannabis
to feel any pleasure at all.
And in fact, what I see is that people who use cannabis,
the pot can actually start to do the opposite
and make them more anxious and even paranoid over time.
And still, she was not interested in stopping.
She said, you know, maybe someday, but not now.
And then I do something that I often do with patients
and I try to get them to look at the larger timeline
of their lives, so I said

★ここまでの要約・日本語訳★
1. The speaker realized they had developed an addiction to romance novels and erotica and decided to abstain from reading them for four weeks. They experienced withdrawal symptoms during this period.
その話者は、恋愛小説やエロティカに対して軽度の中毒を持っていることに気付き、4週間の読書禁止を決意した。その期間中、禁止することによる離脱症状を経験した。

2. After a month of abstinence, the speaker felt better but quickly relapsed and realized they needed a longer period of abstinence. They committed to abstaining from romance novels and erotica for a year.
1ヶ月の禁止期間後、話者は気分が良くなったが、すぐに再発し、より長い禁止期間が必要だと気付いた。彼らは1年間の恋愛小説とエロティカの禁止を決意した。

3. Seeking constant pleasure can lead to a dopamine deficit, leaving individuals feeling down and prompting them to seek more pleasure. A dopamine fast, abstaining from triggering substances or behaviors, can help reset reward pathways.
常に快楽を求めることはドーパミンの不足を引き起こし、個人は落ち込んで次の快楽を求めるようになることがある。ドーパミンファストは、刺激性物質や行動を禁止することで報酬経路をリセットするのに役立つ。

4. A dopamine fast should be approached with caution, as severe addictions may result in withdrawal symptoms that require medical supervision and support.
ドーパミンファストは注意して取り組む必要があります。重度の中毒では禁断症状が起こり、医療的な監視と支援が必要になる場合があります。

5. Encouraging patients to abstain from high dopamine rewards for four weeks can help improve symptoms of anxiety and depression by resetting reward pathways.
患者に高いドーパミンの報酬を4週間禁止するよう勧めることで、報酬経路をリセットし、不安やうつ症状を改善することができる。

(Note: The bullet points have been summarized based on the English text provided. If there are any specific terms or details that need to be accurately translated, please let me know.)

★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）
  • Shankar Vedantam（シャンカール・ベダンタム）
  • Stanford University（スタンフォード大学）
  • Anna Lemke（アンナ・レムキア）
  • Delilah（デリラ）

【英単語】

  • withdrawal（離脱）
  • addiction（中毒）
  • anxiety（不安）
  • depression（うつ）
  • intervention（介入）
  • medication（薬物治療）
  • abstention（控えめな行動）
  • cannabis（大麻）
  • dopamine（ドパミン）
  • ingestion（摂取）
  • deficit（不足）
  • depression（うつ状態）
  • prescription（処方箋）

【コロケーション】

  • put oneself to sleep（眠りにつく）
  • make a strong commitment（強い決意をする）
  • give up（やめる）
  • recommit to（再び〜に取り組む）
  • battle the problems（問題に立ち向かう）
  • reset our relationship（関係をリセットする）
  • produce enduring satisfaction（持続的な満足を生み出す）
  • seek out（求める）
  • intense pleasure（強烈な快楽）
  • physiological response（生理的な反応）
  • dopamine fast（ドーパミンファースト）
  • ingesting dopamine（ドーパミンを摂取する）
  • abstain from（控える）
  • increase dopamine transmission（ドーパミンの伝達を増やす）
  • medical supervision（医師の指導）
  • severe addiction（重度の依存症）
  • withdrawal symptoms（離脱症状）
  • medical risks（医学的なリスク）
  • physiologically dependent（生理的に依存している）
  • tapering（減量）
  • clinical depression（うつ病）
  • psychiatric symptoms（精神症状）
  • hedonic set point（快楽の設定点）
  • look at the larger timeline（大枠を見る）

So I said to her, okay, well, you don't want to be smoking this way in 10 years. How about five years? She says, nah, I don't want to be smoking this way in five years. And I said, okay, how about in a year? And then she stopped and kind of thought about it. And she said, okay, I get where you're going with this doc. You're basically telling me, if I don't want to be doing it in 10 years or five years or a year from now, why not try stopping now? And I said, exactly. And then she agreed to do it. And how did it turn out? Really interesting. She came back four weeks later, and she said Dr. Lemke, you wouldn't believe it. And this is what's so funny, the patients will always say, you wouldn't believe it. As if I'm gonna be shocked. I said, tell me. She goes well, first of all, stopping pot made me realize that I had been addicted to pot. It's something I really didn't realize before. And I said, well, how did you realize that? And she said, well, first of all, the first week I was vomiting violently.

[20:32]
So remember that withdrawal is the opposite both psychologically and physiologically from whatever the drug was doing for us. And we know that cannabis can be an anti-hematec or an anti-nausea kind of effect. So when she stopped using it, she started vomiting. And that was the signal to her that her body had been changed by her chronic heavy use. A more even in her case, than temporarily increased anxiety and insomnia, which I had warned her about. And then she said, and you wouldn't believe it but I feel so much better now after four weeks of stopping than I have in a really long time. I feel less anxious, I feel less depressed, I'm more able to enjoy things, I can breathe better. I feel physically better, I'm sleeping better. And this happens again, and again, and again. We see this so often in clinical care. And people are so surprised. Because when we're in it, we don't see the harm. All we know is that, oh, this joint makes me feel better after a long, hard day.

[21:32]
We can't see the ways in which the cumulative effects actually are making us feel worse. So, this is not the only client who discovered that the symptoms that she thought she was treating with the drug might actually have been caused by the drug. I understand that there has been research on this front not just looking at individual patients, but a classic study conducted with a group of alcoholic men who also had clinical depression. Tell me about that study and what it found, Anna. Yeah, so this is a famous study by Brown and Schucket where they took a group of adult men who met clinical criteria for alcoholism and also met clinical criteria for major depressive episodes. They put them in the hospital for four weeks, during which time they had no access to alcohol. You know, they made sure they didn't have life-threatening withdrawal, but also during which time they gave them no specific or general treatment for major depression.

[22:33]
And what they found is that at the end of those four weeks, 80% of those individuals no longer met criteria for major depressive episode. In other words, just stopping drinking resolved their depression. And that is very consistent with what we see clinically. People who have anxiety, depression, insomnia, inattention just by stopping their substance or behavior of choice for four weeks largely resolves many of those symptoms in about 80% of patients who come in. I mean, this is consistent with your larger hypothesis that this is the Plan-T paradox at work. that the overabundance of things that trigger dopamine in our heads is causing those gremlins in our brain to sort of lean so hard on the other side of the teeter-totter, that now, we are walking around feeling depressed and anxious, and if we try and just get back to equilibrium, we're gonna feel much better when we're not chasing sort of those highs anymore to get rid of our feelings of depression.

[23:35]
Yeah, exactly. I mean, we're clearly in the midst of a severe mental health crisis, especially affecting our youth. and there's lots of speculation for why that is. And a hypothesis that I've put forward is this idea that the source of our unhappiness is in fact our relentless pursuit of pleasure, the many drugified things in our world today that make that possible, and the ways that our brains are trying to compensate for that by actually going into this dopamine deficit state, is very similar to clinical depression, or anxiety, insomnia, et cetera. So one of the most important claims that you're making here is that the sea of plenty in which many of us find ourselves in nowadays is causally responsible for the fact that many of us actually might be more unhappy than we were 30 years ago, 50 years ago, 100 years ago.

[24:38]
Are we sure that there is a causal connection between those two things? And if so, how are we sure of that, Anna? It's a hypothesis based on inference, but let me tell you what the data points are. First of all, when you look at happiness surveys, about 50 years ago, you could track that people who were living in wealthier nations were more happy than people living in poor nations and that they were getting happier over time. Starting about 20 years ago, people in the richest countries in the world started to be less and less happy. Now, what the cause of that is, we don't know for sure, but you could make the inference, and as I have done, that we reached some kind of tipping point in terms of abundance, where what started out as a good thing became an overabundance and is actually contributing now to our suffering.

[25:42]
And by the way that holds true also for increasing rates of depression, anxiety and suicide all over the world, which are going up all over the world but which are rising fastest in the wealthiest nations. So again there's kind of plenty paradox. You have even here in the United States, rising rates of anxiety, depression and suicidal thinking among teenagers corresponding specifically with the past 20 years and the increasing amounts of time that people are spending on the internet and consuming digital media. And then you have a much smaller data point, which is what we see clinically when we intervene and ask people to stop ingesting these high reward substances and behaviors, people who come in seeking help for anxiety, depression, suicidal thinking. And what we find is that their anxiety depression, suicidal thoughts in the vast majority get better without having to do anything else other than cut out for a period of time their high dopamine substances and behaviors.

[26:46]
we come back, techniques to get addictive behaviors under control, and the crucial role that relationships and community can play in helping us to reset our brains. You're listening to Hidden Brain. I'm Shankar Vedantam. I'm Shankar Vedantam. Psychiatrist Ana Lembke is the author of Dopamine Nation, Finding Balance in the Age of Indulgence. She argues that when we seek out pleasures on a non-stop basis, whether those pleasures are legal indulgences or illegal substances, we mess with the neurochemistry of the brain. Paradoxically, the more we chase pleasure,

[27:49]
the more the brain tries to compensate, leaving us in a dopamine depleted state. Ana recommends multiple techniques to help get indulgences under control. She calls these self-binding techniques. Self-binding techniques create both literal and metacognitive barriers between ourselves and our substance or behavior of choice so that we can press the pause button between desire and consumption. And there are many different ways to do that. I sort of organize it into time, space, and meaning to give us a fighting chance to be able to abstain. So what would what would some of these look like, you know, for example, the physical or spatial self-binding that you talk about? What does that look like? That looks like for example, not having the substance in the house If it's alcohol or potato chips or cookies or whatever, it is not having it in the house. It's a really simple one My patients talk about when they travel calling the hotel in advance and having the hotel remove the mini bar from the room in some

[28:56]
cases remove the mini-bar and the television set so there's not access to the kind of cable channels that make people vulnerable. I've had patients use things like the kitchen safe, you know, so that they lock their device in there, they can't get it out for a certain period of time. It could also sometimes help to decide when you are going to engage in an activity. So, this is the way to use time as a self-binding construct. What I think is really interesting is the way that we essentially organize our time around rewards in the modern world in a way that I think is unprecedented.

★ここまでの要約・日本語訳★

  • A doctor convinces a patient to quit smoking by showing her the long-term consequences
  • The patient experiences withdrawal symptoms after stopping marijuana use
  • Stopping substance use can improve overall well-being and resolve symptoms such as anxiety and insomnia
  • A study shows that quitting alcohol can also alleviate depression
  • The pursuit of pleasure and abundance may be causing mental health issues

したがって、医師が患者に長期的な副作用を示して喫煙をやめさせる

  • 患者はマリファナの使用をやめると離脱症状が現れます
  • 物質使用をやめることで、全体的な幸福感が向上し、不安や不眠症などの症状が改善されることがあります
  • 研究によるとアルコールをやめることでうつ病も緩和される
  • 快楽と過剰な豊かさが精神的な問題を引き起こす可能性がある

★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】

  • addiction（中毒）
  • vomiting（嘔吐）
  • withdrawal（断薬）
  • depression（うつ）
  • anxiety（不安）
  • insomnia（不眠）
  • happiness（幸福）
  • abundance（豊富）
  • suffering（苦しみ）
  • internet（インターネット）
  • media（メディア）
  • relationships（人間関係）
  • community（共同体）
  • balance（バランス）
  • indulgence（快楽）
  • neurochemistry（神経化学）
  • self-binding（自己制約）
  • substance（物質）
  • desire（欲望）
  • consumption（消費）
  • access（アクセス）
  • device（装置）
  • activity（活動）
  • rewards（報酬）

【コロケーション】

  • chronic heavy use（慢性的な重度の使用）
  • drugified things（薬になった物事）
  • dopamine deficit（ドーパミンの欠乏）
  • mental health crisis（精神保健危機）
  • happiness surveys（幸福調査）
  • major depressive episode（重度のうつ病のエピソード）
  • tipping point（転換点）
  • anxiety, depression, and suicidal thinking（不安、うつ、自殺思考）
  • high reward substances and behaviors（高報酬の物質と行動）
  • hidden brain（隠れた脳）
  • neurochemistry of the brain（脳の神経化学）
  • dopamine depleted state（ドーパミンが枯渇した状態）
  • metacognitive barriers（メタ認知の障壁）
  • press the pause button（一時停止ボタンを押す）
  • physical or spatial self-binding（物理的または空間的な自己制約）
  • mini bar（ミニバー）
  • cable channels（ケーブルチャンネル）
  • kitchen safe（キッチンセーフ）

【日本語訳】
【固有名詞】

【英単語】

  • 中毒
  • 嘔吐
  • 断薬
  • うつ
  • 不安
  • 不眠
  • 幸福
  • 豊富
  • 苦しみ
  • インターネット
  • メディア
  • 人間関係
  • 共同体
  • バランス
  • 快楽
  • 神経化学
  • 自己制約
  • 物質
  • 欲望
  • 消費
  • アクセス
  • 装置
  • 活動
  • 報酬

【コロケーション】

  • 慢性的な重度の使用
  • 薬になった物事
  • ドーパミンの欠乏
  • 精神保健危機
  • 幸福調査
  • 重度のうつ病のエピソード
  • 転換点
  • 不安、うつ、自殺思考
  • 高報酬の物質と行動
  • 隠れた脳
  • 脳の神経化学
  • ドーパミンが枯渇した状態
  • メタ認知の障壁
  • 一時停止ボタンを押す
  • 物理的または空間的な自己制約
  • ミニバー
  • ケーブルチャンネル
  • キッチンセーフ

You know, we sort of look forward to our coffee in the morning and then we can't wait to get home at night and watch our shows. And so, what I ask patients to do is to be aware of that and then use time to their advantage. For example, if they've done the dopamine fast and now they want to go back to using their substance or behavior, but they want to use in moderation, they could commit to, for example,

[29:57]
only playing video games two days a week, two hours a day and specify when that is or if they want to have some mindless scrolling on social media, they can say, okay, I'm gonna dedicate half an hour a day and this is when it's gonna be and then I know I'm gonna do mindless scrolling or YouTube watching, but outside of that I'm not gonna do that. I'm gonna wait till I finish this exam or turn in my paper or get this job promotion and then use that as a way to bind themselves. I understand you had a patient, Mitch, who was addicted to sports gambling and he had to take some pretty extreme measures to bind himself to keep himself from using his drug of choice. Yeah, so he had to do something called self-banning, where he basically went to the casinos and put himself on a band list, which is very common among pathological gamblers, pathological sports betters. It's really hard with the new online apps, but you can also ban yourself on an online app. The other thing that he did was he avoided

[31:00]
what I call the stepping stone effect where certain behaviors are not necessarily our substance or behavior of choice, but they're a stepping stone to it. So he realized that he couldn't really watch sports in any capacity. He couldn't read about sports in the paper, he couldn't listen to sports radio, he couldn't watch sports on television or on the computer, because as soon as he did that, the cravings to bet were just overwhelming. I mean, this is like people who have, let's say, an alcohol dependence problem, and you know, you're taught don't walk by the bar on your way home from work, take a different route. So in other words, the things that you put in your environment end up shaping the choices that you make. Oh, absolutely, such a key point. You know, to expect ourselves to be able to change without changing our environment in a dopamine overloaded world is just expecting us to not be human.

[32:01]
I deal with a lot of families where the kids are addicted to video games or social media and the parents are like, I don't know why he just won't stop or she just won't stop. Meanwhile, their house is like fiber optic high-speed internet. They've got a screen in every room, in every bedroom. Everybody's got 12 devices. No. And also at school, it's a huge problem. The kids are allowed to have their phones during class. How can a teacher possibly compete with YouTube? There's no way. So one of the most radical suggestions that you have, and radical in the sense that I think would appear to many people to be very counterintuitive and hard to digest, is that one way to deal with compulsive over-consumption is to actively seek out its opposite. You say that we should deliberately seek out experiences of pain and hardship. Now, most of us try our best to avoid pain. Why would we choose to deliberately invite pain into our lives? Yeah, I know this sounds really wackadoodle,

[33:02]
but there's actually science behind it. It's the science of hormesis, and hormesis is Greek for to set in motion. And what we're talking about is very mild to moderate doses of adaptive or healthy pain as tolerated. And if you don't like the word pain, maybe you use the word discomfort or challenge or something along those lines, although often, it does involve some physical duress, at the right doses to upregulate our own healing mechanisms, but not so much that it causes irreversible harm. And what the science of hormesis shows in humans and in animals is that if you expose an organism to mild to moderate doses of painful, toxic, or noxious stimuli, you will actually make that organism healthier, more resilient, more robust. And we have evidence for that, overwhelming evidence for that through exercise,

[34:04]
but also, some emerging evidence for ice cold water plunges. There's also some evidence showing that prayer and meditation, which, you know, are not necessarily painful, but do require effortful engagement and a certain kind of concentration, which is not immediately necessarily pleasurable, that those behaviors also release dopamine, things like exposure therapy for forcing ourselves to do things that make us psychologically uncomfortable. These are all things that are hard in the initial experience, but essentially trigger our body to sense injury, and in sensing injury, our bodies start to upregulate our protective hormones, like again, our endogenous opioids, all ultimately leading to the release of dopamine. And so it's a really great way to overall reset our hedonic or joy threshold to the side of pleasure, which means that we're more resilient in the face of pain and we're generally happier. Let me summarize what you're saying and make sure I'm understanding this correctly. Your essential argument here is that there is a system in the brain that tries to maintain homeostasis. When we press down on the pleasure side of the balance, the brain gremlins get on the pain side of the balance to try and compensate it and recover equilibrium. But if we were to press down on the pain side of the balance, now homeostasis starts to work in some ways in our favor because the gremlins hop onto the pleasure side of the balance, and they basically get us to a state where we're feeling better on average than we were doing before? That's exactly right. And there is overwhelming evidence to support this. So, for example, we know that if you track dopamine levels as well as other feel-good neurotransmitters like endogenous serotonin, neuropinephrine, endogenous opioids, endogenous cannabinoids, what you find is that initially when people engage in exercise those neurotransmitters are low, but over the latter half of exercise, they slowly start to rise. And then when the exercise is stopped, those neurotransmitter levels remain elevated for hours afterward. And of course, this is our runner's high. And then eventually, those elevated levels of dopamine will go back down to baseline levels homeostasis, but without ever going into that dopamine deficit state. In other words, by paying for our dopamine upfront, we get those feel-good experiences, which we need, right. We're humans. We can't just hang out in homeostasis, but we can get those good feelings without ever having to go into our cash dopamine reserves. You want to speak? You made an interesting analogy a second ago, and I want to just draw attention to it, which is that there is an analogy here between the way we engage with our brains and the way we engage with money. You can buy things on credit, and that is sometimes valuable and smart to do, but it does mean that you're getting the good stuff first and then paying for it later. So that's what we do when we intentionally trigger dopamine in our heads, we're getting the good feelings now but have to deal with it later. You're arguing that focusing on the pain side of the equation in some ways is, as you say, paying for the dopamine upfront, you're doing the difficult thing now in exchange for the reward down the road. Exactly. And you can see the ways in which actually the way we pay for things makes us all more vulnerable to addiction because now they have these credit cards where you don't even have to pay for them in real-time. You can pay for them later, which is just terrible. I'm wondering if it will sound to many people that you're almost recommending a life of asceticism here. Are you recommending that people become ascetics, Anna? I'm recommending a new form of asceticism for the modern age, and what I mean by that is we are living in an unprecedented time of overwhelming access to highly reinforcing drugs and behavior, such that I think that our existence is going to be reliant upon figuring out how to navigate this world of overabundance. And so in fact, in order to be healthy, we actually have to intentionally veer slightly to the side of pain and insulate ourselves from pleasure in order to preserve balance. Have you done this yourself? Oh yeah, I do this on a regular basis.

★ここまでの要約・日本語訳★
朝のコーヒーや夜の自分の好きな番組を楽しみにしています。患者に求めるのは、そのことに気づき、時間を利用することです。例えば、ドーパミンファーストを終えてからも、適度に物質や行動を使いたい場合は、週に2日、1日2時間だけビデオゲームをすることを約束し、それがいつなのか指定することができます。また、ソーシャルメディアで無駄にスクロールしたい場合は、毎日30分だけ充てることができます。その他の時間はそれをしないようにします。例えば、試験終了後や論文提出後、昇進後にすると約束します。スポーツ賭博に熱中していた患者のMitchさんは、自身の選択の制限のためにかなりの手段を講じなければなりませんでした。彼は自己禁止措置というものを行いました。これは病的ギャンブラーやスポーツベッターの間で非常に一般的な手段です。新しいオンラインアプリでは難しいですが、オンラインアプリでも自己禁止をすることができます。彼がしたもう1つのことは、いわゆる「ステッピングストーン効果」を避けることです。ある行動が必ずしも選択した物質や行動ではなく、それに至る段階であることに気付いたのです。彼はスポーツをどんな形でも見ることができないことに気付きました。新聞でスポーツについて読んだり、スポーツのラジオを聞いたり、テレビやコンピュータでスポーツを見たりすると、賭ける衝動が圧倒的に高まってしまうのです。それは例えば、アルコール依存症の人が、帰り道にバーの前を通らないようにするように教えられるのと同じです。つまり、環境に置かれたものが私たちの選択を形作るということです。はい、非常に重要なポイントです。ドーパミンが過剰な世界で自分自身を変えることを期待するのは、人間でなくなることと同じです。私は、子供がビデオゲームやソーシャルメディアに依存している家族と取り組んでいますが、両親は何故彼らが止めないのかわかりません。しかし、家にはファイバーオプティックの高速インターネットがあります。部屋ごとに画面があり、寝室ごとにあります。誰もが12のデバイスを持っています。また、学校でも大きな問題です。子供たちは授業中に携帯電話を持っていることが許されています。教師がYouTubeに対抗することは不可能です。というわけで、強迫的な過消費に立ち向かう方法の一つは、その逆を意図的に探し出すことです。あなたは、我々が痛みや苦難の経験を積極的に求めるべきだと述べています。私たちは普段、痛みを避けるように最善を尽くしています。なぜ私たちはわざわざ痛みを自分の人生に取り入れるのでしょうか？うーん、これは本当に奇妙なことに聞こえるかもしれませんが、実際には科学的な根拠があります。それがホルメシスという科学で、ギリシャ語で「運動する」という意味です。私たちが言っているのは、適応的または健康的な痛みを、非常に軽度から中等度まで耐えることです。もし痛みという言葉が嫌いなら、不快さや挑戦などの言葉を使うかもしれませんが、しばしば身体的な苦境も伴う場合があります。これらの刺激を適切な量で与えると、私たち自身の癒しのメカニズムが高まりますが、それが逆に不可逆な害を引き起こすほどではありません。ホルメシスの科学は、人間や動物において、軽度から中等度の痛み、有毒性、有害な刺激に曝されると、その生物は実際に健康でより強靭で頑健になることを示しています。そして、それは運動を通じた証拠や、氷の冷たい水に浸かることに対するいくつかの新たな証拠もあります。また、祈りや瞑想もドーパミンを放出することがわかっており、それは即座に楽しいとは限らない一定の努力と集中力が必要です。心理的に快適ではないことを強制する暴露療法なども、心理的に不快なことをするよう自分自身を迫ることです。これらの経験は初めのうちは難しいですが、私たちの体は怪我を感じることで、自己保護のホルモンを増やし、最終的にはドーパミンを放出するようになるのです。そのため、これは私たちの快楽のしきい値を再設定する素晴らしい方法であり、痛みに対してより強く、一般的には幸せでいられるようになります。あなたの言っていることをまとめて、正しく理解しているか確認させてください。ここでのあなたの主張は、脳内のホメオスタシスを維持しようとするシステムがあるということです。快楽側のバランスが傾くと、脳の対抗策として痛み側に働きかけてバランスを取ろうとします。しかし、痛み側のバランスを傾けると、ホメオスタシスが私たちにとって有利に機能するようになります。なぜなら、脳は快楽側に反応し、以前よりも平均的に良い状態になるようにします。その通りです。これを支持する科学的な証拠は圧倒的です。例えば、運動を行うとドーパミンやエンドゲナスセロトニン、ノルエピネフリン、エンドゲナスオピオイド、エンドゲナスカンナビノイドなどの快感物質が最初は低下しますが、後半にはゆっくりと上昇し始めます。そして運動が停止すると、これらの神経伝達物質のレベルは数時間にわたって上昇したままとなります。もちろん、これがランナーズハイです。そして最終的には、ドーパミンのレベルは基準

★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】

  • dopamine（ドーパミン）
  • patients（患者）
  • substance（物質）
  • behavior（行動）
  • moderation（節度）
  • video games（ビデオゲーム）
  • mindless scrolling（無意識のスクロール）
  • YouTube watching（YouTube視聴）
  • exam（試験）
  • paper（論文）
  • job promotion（昇進）

【コロケーション】

  • take a look（見てみる）
  • in front of（〜の前に）
  • self-banning（自己禁止）
  • pathological gamblers（病的なギャンブラー）
  • stepping stone effect（関連する行動）
  • alcohol dependence（アルコール依存）
  • environment（環境）
  • compulsive over-consumption（強迫的な過消費）
  • hormesis（ホルメーシス）
  • adaptive pain（適応的な痛み）
  • physical duress（肉体的苦痛）
  • joy threshold（喜びのしきい値）
  • exposure therapy（暴露療法）
  • psychologically uncomfortable（心理的に不快な）
  • endogenous opioids（内因性オピオイド）
  • homeostasis（恒常性）
  • pleasure side（快楽側）
  • pain side（苦痛側）
  • hedonic or joy threshold（快楽または喜びのしきい値）
  • neurotransmitters（神経伝達物質）
  • endogenous serotonin（内因性セロトニン）
  • neuropinephrine（ノルエピネフリン）
  • endogenous cannabinoids（内因性カンナビノイド）
  • runner's high（ランナーズハイ）
  • homeostasis（恒常性）
  • cash dopamine reserves（ドーパミンの現金準備）
  • asceticism（禁欲主義）
  • overabundance（過剰）

【日本語訳】

  • Japan（日本）
  • Barak Obama（バラク・オバマ）
  • Mitch（ミッチ）
  • dopamine（ドーパミン）
  • patients（患者）
  • substance（物質）
  • behavior（行動）
  • moderation（節度）
  • video games（ビデオゲーム）
  • mindless scrolling（無意識のスクロール）
  • YouTube watching（YouTube視聴）
  • exam（試験）
  • paper（論文）
  • job promotion（昇進）
  • take a look（見てみる）
  • in front of（〜の前に）
  • self-banning（自己禁止）
  • pathological gamblers（病的なギャンブラー）
  • stepping stone effect（関連する行動）
  • alcohol dependence（アルコール依存）
  • environment（環境）
  • compulsive over-consumption（強迫的な過消費）
  • hormesis（ホルメーシス）
  • adaptive pain（適応的な痛み）
  • physical duress（肉体的苦痛）
  • joy threshold（喜びのしきい値）
  • exposure therapy（暴露療法）
  • psychologically uncomfortable（心理的に不快な）
  • endogenous opioids（内因性オピオイド）
  • homeostasis（恒常性）
  • pleasure side（快楽側）
  • pain side（苦痛側）
  • hedonic or joy threshold（快楽または喜びのしきい値）
  • neurotransmitters（神経伝達物質）
  • endogenous serotonin（内因性セロトニン）
  • neuropinephrine（ノルエピネフリン）
  • endogenous cannabinoids（内因性カンナビノイド）
  • runner's high（ランナーズハイ）
  • homeostasis（恒常性）
  • cash dopamine reserves（ドーパミンの現金準備）
  • asceticism（禁欲主義）
  • overabundance（過剰）

What do you do?

Well, I like to start my day with pain, namely doing some kind of exercise, mainly walking or swimming because I'm in my 50s now, but I every morning, you know when I wake up, trust me, I do not want to get out of bed but I absolutely force myself to do it most of the time because I know I'll feel so much better afterwards and it's just a great anxiolytic and mood stabilizer for me.

And then we've raised our family with a lot of, [39:12] you know forced marches and outdoor wilderness experiences which were challenging and difficult. We've insulated ourselves from digital media in the sense that we didn't have any devices or Wi-Fi, even Wi-Fi to the home until our eldest went to high school and then she came back and said that she essentially couldn't function as a high school student without Wi-Fi in the home. They change the schedule every day, you have to log on every day just to know what class you're supposed to go to, It's crazy.

So I'm really sad because now we have you know, Wifi and fiber optic and it makes it a lot harder for me personally to manage my consumption cause like I'll get into these bad YouTube watching habits in the evenings, you know you can just imagine, but anyway that's something that we did. We bike a lot of places instead of driving. In fact we have one 25 year old mini van which has 75,000 miles on it. And when my husband tried to re-register for the insurance, didn't believe us that it only had 75,000 miles, that they made us like get an affidavit. [40:15]

Yeah, so what is the reward for living this way, Anna what do you see in your life do you think you're seeing effects in your mind, on your brain?

Oh yeah, you know, I used to think that my life was really hard, and that that was the source of my unhappiness. But now I actually think that all along my life was actually too easy. And that's why I was unhappy. One of the most striking things about stories of addiction is that they often involve increasing levels of social isolation. Think of the person who is up playing endless first-person shooter video games in an apartment by himself at four o'clock in the morning, or the furtive, heavy consumer of pornography, the young woman addicted to pot. And I feel like we may have painted an overly negative picture of dopamine in this conversation. Yes, you can have an unhealthy relationship with dopamine but the problem is not with dopamine per se but the ways we go about triggering it. You say that relationships are a [41:16] powerful way to trigger dopamine in a healthy fashion, can you talk about that idea?

Yes, so my colleague Rob Malenka, here at Stanford, is a neuroscientist. He and his colleagues have shown that oxytocin which is our love hormone binds to dopamine releasing neurons and the reward pathway, so that makes a lot of sense, because we know when we fall in love, we feel high, right, that's a great feeling and from a survival point of view or an evolutionary point of view, our brains want us to make connections to other people, because we're more likely to find mates, more likely to be able to protect ourselves from predators, more likely to be able to steward scarce resources, so our brains get us to make those connections by releasing dopamine and making sure that it feels good. The problem with addiction is that essentially our substance or behavior of choice comes to replace those human connections. [42:17]

And so we move further and further into isolation and we meet those basic needs through our drug rather than through making deep human connections. And so part of getting into recovery from addiction means moving out of isolation and trying to make deep and rewarding intimate connections with other people because essentially that's what we're really looking for, but we get fooled by these kinds of faux stand-ins for human connection. I'm wondering if you can tell me a little bit about the role of community here? There are many groups that have sprung up to try and fight addictions, you know, groups like AA or NA or Gamblers Anonymous, for example. Tell me about the role that they play, and in some ways is it part of the same equation that we are looking at here, the role of human relationships in battling addiction?

Yeah. So, you know, AA, Alcoholics Anonymous, and Narcotics Anonymous, in my opinion, are among the most remarkable social movements of the last 100 years. [43:20] P Fest. These are amazing grassroots organizations composed of people with addiction trying to help other people with addiction. And it's remarkably successful for those who actively participate. So you'll read a lot in the media now about how A.A. and other 12 step organizations don't work. But that's not really a faithful representation of the evidence. There are many people who will not participate or get anything out of it. But for those who actively participate engagement in AA and other 12-step groups, is as effective, and possibly even more effective, than professional treatment. We can't do this.

We're supposed to do this.

So what is the secret of these 12-step groups?

Well, first of all, they provide a sober social network, they provide a specific path for recovery, but importantly, they're also really de-shaming because you realize, oh wow, I'm not the only one. like I have this thing that happened in my brain [44:20] because I'm human. And I have this particular vulnerability and other people have experienced and done similar things that I have done in pursuit of their drug. And that is an incredible burst of intimacy and yes dopamine, right? That we get then from being taken into the fold of like-minded individuals who understand us and accept us in all our brokenness.

♪ One important idea that Anna has adopted in her own life powerfully resonates with the message of groups such as AA and NA. Change begins with telling the truth.

Yeah, so this was really something that I learned from my patients. Over many years of seeing patients get into recovery from severe addictions, what I noticed was that those who seemed to get into the best recovery and be able to maintain recovery the longest were those who were committed to telling the truth, and that was a central value [45:25] for them, which they saw as just pivotal for maintaining sobriety and recovery, and I thought that was really interesting like, what is it about truth-telling that enables recovery, and enables people to stay in recovery. Because it just was such a consistent theme, whether they got into recovery through 12 steps, like AAA or NA or just through their own journey, it was inevitable that they would be like, oh, yeah, no, I can't lie. And when they said that, they weren't just talking about, I can't lie about my addictive behaviors. They meant they couldn't lie about anything, that the lying itself was sort of the first breach the dam for them and that they had to be truthful in all things in order to maintain recovery. So that was really interesting to me and I began to explore that both, you know, from a scientific perspective as well as try to employ it in my own life.

One of the things I find so striking about this conversation, Ana, is that you're someone [46:28] who spends her day helping patients. But I'm not getting the sense that you see yourself as better or even different from the people you're trying to help. I understand that you're a fan of the philosopher Martin Buber, who has talked about what it's like to truly engage with another person. He talks about this I am thou moment, which he believed can occur between any two individuals who just make the effort to be fully present with each other, and it's a divine moment, right, where everything else falls away. It's not sexualized love, it's something akin to love, But what's so interesting about this I Am Thou concept is that it can be achieved in a nanosecond with anybody. You could achieve it with a stranger. This idea being that when we kind of come to the encounter fully open and vulnerable in our shared humanity and we see each other, that's a really special and remarkable experience. [47:30] and I try to create that in my work with patients because that alone is healing. I've probably learned more from my patients than I think I've given them in return. I really see people in recovery from severe addictions as modern day prophets because these are folks who have had to figure out pleasure and pain and consumption in a dopamine-overloaded world And they've had to do it as a matter of life and death. And they've been able to do it. And so, they really provided this roadmap of deep wisdom for the rest of us. Ana Lemke is a psychiatrist and a researcher in the behavioral sciences at Stanford University. She's the author of Dopamine Nation, Finding Balance in the Age of Indulgence.

★ここまでの要約・日本語訳★

  • The speaker starts their day with exercise to improve their mood and anxiety levels.
  • The speaker and their family lived without digital media until their eldest went to high school, but now find it harder to manage their media consumption.
  • The speaker prioritizes biking instead of driving and has a minimalistic lifestyle.
  • The speaker believes that addiction often leads to social isolation and replacing human connections with substances or behaviors.
  • The speaker praises the role of community, particularly organizations like AA and NA, in helping people recover from addiction through providing support and de-shaming.

毎朝、運動をして気分と不安を改善する。
スピーカーと家族は高校生になるまでデジタルメディアを使わずに過ごし、現在はメディアの使用を管理するのが難しいと感じている。
車の代わりに自転車を利用するなど、シンプルな生活を送っている。
中毒は社会的な孤立を引き起こし、人間関係とのつながりが置き換えられると考えている。
AAやNAなどの団体の役割を高く評価し、サポートと非難の軽減を提供すると述べている。

★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】

  • exercise（運動）
  • walking（散歩）
  • swimming（泳ぐ）
  • trust（信じる）
  • force（強制する）
  • anxiolytic（抗不安薬）
  • mood stabilizer（気分 estabilizer）
  • family（家族）
  • forced marches（強制行軍）
  • outdoor（野外の）
  • wilderness（荒野）
  • experiences（経験）
  • challenging（困難な）
  • difficult（難しい）
  • insulate（遮断する）
  • digital media（デジタルメディア）
  • devices（デバイス）
  • Wi-Fi（Wi-Fi）
  • high school（高校）
  • schedule（スケジュール）
  • class（授業）
  • driving（運転）
  • mini van（ミニバン）
  • mile（マイル）
  • insurance（保険）
  • re-register（再登録）
  • affidavit（公認声明）
  • reward（報酬）
  • way（方法）
  • day（日）
  • effects（効果）
  • mind（心）
  • brain（脳）
  • life（生活）
  • sad（悲しい）
  • Wifi（Wi-Fi）
  • fiber optic（ファイバーオプティック）
  • management（管理）
  • consumption（消費）
  • habit（習慣）
  • Youtube（YouTube）
  • evening（夜）
  • bike（自転車）
  • 25 year old（25年間）
  • registration（登録）
  • insurance（保険）
  • believe（信じる）
  • miles（マイル）
  • replace（置き換える）
  • human（人間）
  • relationships（関係）
  • powerful（強力な）
  • love hormone（愛のホルモン）
  • neuroscientist（神経科学者）
  • reward pathway（報酬経路）
  • survival（生存）
  • evolutionary（進化）
  • steward（管理する）
  • scarce（不足している）
  • addiction（中毒）
  • substance（物質）
  • behavior（行動）
  • replacement（代用）
  • recovery（回復）
  • battle（戦う）
  • community（共同体）
  • social movements（社会運動）
  • AA（アルコホーリクス・アノニマス）
  • Gamblers Anonymous（ギャンブラーズ・アノニマス）
  • sobriety（禁酒）
  • intimacy（親密さ）
  • value（価値）
  • truth（真実）
  • journey（旅）
  • patients（患者）
  • severe（重度の）
  • scientific（科学的）
  • philosopher（哲学者）
  • attempt（試み）
  • truly（真に）
  • engage（関わる）
  • individual（個人）
  • present（存在）
  • divine（神聖な）
  • acquire（得る）
  • Japanese relationships（人間関係）
  • battling（闘う）
  • remarkable（注目すべき）
  • grassroots organizations（地域の組織）
  • composed（組成）
  • remarkably（驚くほど）
  • successful（成功した）
  • media（メディア）
  • faithful（忠実な）
  • evidence（証拠）
  • engage（関与する）
  • effective（効果的な）
  • professional treatment（専門治療）
  • sober（酒に酔っていない）
  • de-shaming（恥ずかしさをなくす）
  • brain（脳）
  • shared humanity（共有された人間性）
  • akin（似たような）
  • transformative（変革的な）
  • healing（癒し）
  • wisdom（知恵）
  • prophet（預言者）
  • severe addictions（深刻な中毒）
  • modern day（現代の）
  • paint（描く）
  • smile（笑顔）

Ana, thank you so much for joining me today on Hidden Brain. Oh, you're welcome. It was a real pleasure.

[48:31]

♪
If you have follow-up questions for Ana Lemke
about the science of addiction
and are willing to have those questions
shared with a larger Hidden Brain audience,
please record a voice memo on your phone
and email it to us at ideas at HiddenBrain.org.
60 seconds is plenty.
Please remember to include your name and a phone number
where we can reach you.
Again, email the question to us at ideasathiddenbrain.org
and use the subject line, addiction.

Hidden Brain is produced by Hidden Brain Media.
Our audio production team includes Bridget McCarthy,
Annie Murphy-Paul, Christian Wong, Laura Querel,
Ryan Katz, Autumn Barnes, and Andrew Chadwick.
Tara Boyle is our executive producer.
I'm HiddenBrain's executive editor.
Our unsung hero this week is Howard Wolfe.
Howard is president of the Stanford Alumni Association

[49:32]
and he invited me some time ago to attend a symposium
featuring interesting research at the university.
Anna Lembke was one of the speakers
and within minutes of listening to her,
I knew we needed to have her on HiddenBrain.
Howard is one of the most wise and generous people I know
and a gifted communicator in his own right.
Thanks for putting these great ideas on our radar, Howard.
If you would like to help us build more stories like this,
please act now.
Visit support.hiddenbrain.org
and join the hundreds of other Hidden Brain listeners
who have agreed to help.
Again, that's support.hiddenbrain.org.
I'm Shankar Vedantam.
See you soon.
You

★ここまでの要約・日本語訳★

  • Ana Lemke is invited to answer follow-up questions about the science of addiction
  • Hidden Brain is produced by Hidden Brain Media with a team of audio production members
  • Howard Wolfe, president of the Stanford Alumni Association, invited Shankar Vedantam to attend a symposium featuring interesting research at the university
  • Anna Lembke was one of the speakers at the symposium and impressed Vedantam
  • Vedantam thanks Howard for bringing these great ideas to his attention

Ana Lemkeには、アディクションの科学に関する質問が寄せられる予定である。
Hidden BrainはHidden Brain Mediaによって制作され、オーディオ制作チームによってサポートされている。
スタンフォード大学の校友会長であるHoward Wolfeは、興味深い研究を特集するシンポジウムにVedantamを招待しました。
Anna Lembkeはシンポジウムのスピーカーの一人であり、Vedantamに強い印象を与えました。
この素晴らしいアイデアをVedantamの注目にふる役割を果たしたHowardに感謝します。

★ここまでの特徴的な固有名詞・英単語・英語表現★
【固有名詞】

  • Japan（日本）
  • Barak Obama（バラク・オバマ）
  • Ana Lemke（アナ・レムカ）
  • Hidden Brain（ヒドゥン・ブレイン）
  • Bridget McCarthy（ブリジット・マッカーシー）
  • Annie Murphy-Paul（アニー・マーフィー・ポール）
  • Christian Wong（クリスチャン・ウォン）
  • Laura Querel（ローラ・クィレル）
  • Ryan Katz（ライアン・カッツ）
  • Autumn Barnes（オータム・バーンズ）
  • Andrew Chadwick（アンドリュー・チャドウィック）
  • Tara Boyle（タラ・ボイル）
  • Howard Wolfe（ハワード・ウルフ）
  • Stanford Alumni Association（スタンフォード卒業生協会）
  • Anna Lembke（アンナ・レンブカ）
  • Shankar Vedantam（シャンカール・ヴェダンタム）

【英単語】

  • pleasure（快適）
  • audience（聴衆）
  • questions（質問）
  • phone（電話）
  • voice（声）
  • idea（アイディア）
  • subject（題目）
  • line（行）
  • addiction（中毒）
  • hero（英雄）
  • wisdom（知恵）
  • communicator（コミュニケーター）
  • support（支援）
  • listeners（聴取者）
  • stories（物語）

【コロケーション】

  • follow-up questions（追加の質問）
  • voice memo（音声メモ）
  • email（メール）
  • phone number（電話番号）
  • subject line（件名）
  • audio production team（音響制作チーム）
  • executive producer（製作総指揮）
  • unsung hero（無名の英雄）
  • research（研究）
  • speakers（スピーカー）
  • listening to（聞く）
  • act now（今すぐ行動する）
  • build more stories（より多くの物語を作り上げる）