Dopamine Nation – About A Book – Or More?


Unlike some of the recent blog entries here, including the previous, this is about the world within. Or is it?

OMG, he is getting philosophical again.” I will do my best to limit it. But I need a conduit into why I want to write about a book which I read recently: Dopamine Nation (Dopamine nation: finding balance in the age of indulgence / Anna Lembke, M.D., 2021, ISBN 9781524746728 (hardcover) | ISBN 9781524746735 (ebook)).

Neurophysiology is part of science. Neuroscience is scientific research aiming to understand the inner workings of the brain. That includes the human brain, the most complex entity that we know about in the Universe. No superstition here: There may be, and I believe there are, more complex entities in the Universe, whatever the Universe is. But our knowledge about the Universe is extremely local, and extremely limited along the temporal dimension as well. In this corner of this Universe, and now, our own brain is the most complex composite physical entity that we know about. Its complexity pales everything else. I highly recommend, as I have done before, David Eagleman’s popular science book “The Brain“. I love it, my children loved it, and the TV series “The Brain” (PBS Documentary, 2015, available on Apple TV) with which David Eagleman stunningly transformed his book into a highly enjoyable visual companion to the book is still relevant, and thoroughly enlightening.

The brain is made from neurons and from other matter. The uniqueness of the human brain sits with that a stunning number of, give or take, 100 billion neurons are forming a highly complex neuronal network. Connected with sophisticated sensory input devices, having a plethora of means to communicate, and being able to steer the body and to contribute to regulate the inner functions of this larger entity we call “our body”, the combined result is much more than a walking and talking biological robot: Self-awareness and the emergence of a persona, in my case “Stefan Feller”, are amongst the results of these inner workings.

Describing it this way allows me to stay away from the philosophical, or spiritual, part. Whilst this part is extremely important to me personally, I can draw a line excluding the question whether this emerging persona is all there is. I will leave it with one thought by pointing to what some refer to as a “soul”, others may name it a “consciousness”, and as to which extent this is only specific for humans, or also true for other living beings, or even beyond, for everything there is. That’s where belief plays a role, inner perception and introspection kicks in, and a whole bunch of belief systems and dogmatic approaches may include deterministic, agnostic, spiritual, or religious explanations for “what there is”. I’m sorry to say, but fanatism starts in this realm, too. That’s part of my other blog entries.

Notwithstanding whether this “walking and talking biological robot” has only a persona, or is also a temporary seat for a soul, one fact is part of neuroscience: That physical processes govern this brain, and that chemical substances are key in not only how the brain works on a biological level, but also how this “resulting persona” is composed, how this persona is able to contribute to the complex equilibrium making this a healthy body, hosting a healthy mind, being part of a healthy “super structure”, meaning a community, a society, a culture, a nation (as the title of the book suggests).

What I want to say: The brain plays an important role by, so to speak, being the “home base” for my identity. Therefore,“Stefan Feller” and how this construct perceives, interprets, acts, reacts, thinks, or not, feels, and how, all that is highly dependent on chemistry. Dopamine is a chemical substance.

Neuroscience increasingly contributes to understanding how human beings perceive, regulate, act, react, are motivated, are functional, less functional, dysfunctional, are mentally sane, sometimes not, or less, and so much more. Neuroscience is able to contribute to important questions such as how to achieve happiness. On an individual level, and on a societal level.

And that is where I wanted to arrive, after so many times re-phrasing my writing, at the end of this introduction: The way how chemical substances produced by, and used by, the body and the brain, and how they are part of complex inner regulative systems ensuring stability, sanity, healthiness, and happiness, of body and mind, by extension they have a profound impact on the health and sanity of a society at large. Dopamine, and how we regulate the inner systems in our brain which are using Dopamine, affects not only the condition in which an individual, but also societies find themselves in.

That’s what Anna Lembke’s book is about. That’s why it has the title “Dopamine Nation”.

The Chemistry – And Neuroscience for Dummies

Dopamine is a chemical substance. In human beings, Dopamine is produced by the body itself, in the brain, and in the kidneys. The use of Dopamine for functions in living organisms is pretty widespread, it appears to be synthesized in plants and most animals.

Dopamine is also a member of a family of chemical substances which we call “hormones”. Which are, according to, for example, “MedLine Plus”, “your body’s chemical messengers“. As far as I want to take this explanation here, Dopamine appears to serve several of such uses in the body, but for the context of this book review only one is relevant: Dopamine is part of a family of substances called “neurotransmitters“. Dopamine is released by neurons in order to send signals to other neurons. From a chemical perspective, it is enough to appreciate that Dopamine is produced in specific areas of the brain, whilst the use of Dopamine by neurons in the brain is affecting many regions.

There are more than 100 substances which are currently identified as being neurotransmitters, the list appears to be open-ended. Neurotransmitters serve a vast array of functions which we increasingly understand, and as far as I would know, the ability of neurons to establish regulative systems in the brain without neurotransmitters is non-existent. Think about the brain without neurotransmitters: If I understand it correctly, you’re annihilated. Take away neurotransmitters, and not only a few functions break down. Simply put, the processes which also lead to the establishment of your persona, they are gone.

Including that which we describe as a free will, or as an illusion of free will. Whether we have one, or not, the jury is out and in this discussion philosophers, neurophysicists, even quantum-physicists, other scientists engage with people of faith, and even with people who have no idea what they are talking about. So, this is not more than a side-remark to make you smile, but also to think deeply about whether you have a “free will”, and what it means.

However, at minimum the workings of regulative systems in the brain which require neurotransmitters have a heavy impact on the ability of you to “freely” decide. If these regulative systems run off kilter, life as you know it changes. If the systems using Dopamine run haywire, your life becomes unmanageable.

Anna Lembke‘s book “Dopamine Nation” is dealing with regulative systems in the brain, or more specifically, with a subset of them. Broadly speaking, Lembke talks about the reward pathways in the brain. The brain, including these so-called reward pathways, is a product of millions of years of evolution, adding new layers, new parts, new features, to systems which we share with many other beings. All these, including what we sometimes call the “lizard brain”, contribute to the complex entity that we call “our brain”. More recently, in evolutionary terms, brain parts such as the frontal temporal lobe have been added. Added, not replaced something evolutionary older. Everything, including the “lizard parts” of the brain, contributes to what makes “us” the entities we are, how we perceive ourselves, how we are driven, consciously, or mostly without even knowing it. Ask specialists in the advertising industry about the latter. I should perhaps ask ChatGPT. But that’s for another blog entry.

But Anna Lembke’s book is not an academic piece relevant for students of neuroscience. She is covering vast territory of consequences that happen when the regulative balance within the reward pathways of the brain is triggered. There are parts of the book where she explains in layman’s language what happens when this system in the brain is allowed to work as it is supposed to work since millions of years.

Her focus, however, sits with what happens when it is put out of homoestasis for longer periods of time.

The Relevance

I am not lazy by saying that I won’t attempt to summarize the workings of this regulative process in the brain, and what happens when the delicate balance is lost.

On one hand, I want to encourage you to read the book, and/or other literature on these findings. On another note, though I feel very qualified in personally appreciating the consequences of the reward pathways entering a runaway process, I don’t feel qualified to summarize what already has been simplifed and summarized by Anna Lembke. But I will say that Annal Lembke and I share a deep-seated personal understanding, from different perspectives of professional qualification, about the consequences of the reward pathways not working any longer in a healthy way. In additon, we also share a personal experience about what happens then. So, I am not superstitious by elevating my own experience to the one of a distinguished scientific expert. Rather, as Anna Lembke describes her own experiences with addiction, I feel that I can safely say that I have my own experiences as well.

And in my own case, I am successfully adressing those since now ten years, by arresting the runaway process, and experiencing a lifestyle which is beyond my wildest dreams. Insofar, that my life has not only become more manageable, but that it also makes sense beyond what was the situation before: I was extremely successful in my work life, but my private life accumulated more and more damage, to myself, and to people I held, and hold, closest to my heart.

Anna Lembke’s book, beyond the neuroscientific explanation of how the parts of the brain which regulate reward, and pain, includes an impressive compilation of personal stories from her work as a therapist. Some of these you will find shocking. You should read all of them.

This is because Anna Lembke’s book does not start with explaining neuroscience, and then entering into the field of treatment of compulsive self-rewarding behavior which turns, over time, slowly and surely, the life of a human being and the lifes of persons around that person into one or another of the many forms of nightmare. If you happen to think about compulsive and addictive forms of self-abuse in a limited way, associating mainly alcohol or substance abuse with it, if you think that the plethora of possible behavioral forms of self-abuse are for the morally weak, you are in for a ride.

I hope this book would open your eyes, in that case.

But even there, the book does not end. Anna Lembke makes it abundantly clear that the consequences of runaway processes in the reward pathways of the human brain are going far beyond what we would want to see, and what we don’t want to see. In my view, she makes a very convincing argument for the pervasiveness of an attitude within our societies which she labels “the age of indulgence”. She clearly demonstrates the myriad forms by which we have gotten used to, and are exposed to, instant gratification. From where I sit, with my own experience, and with the heuristic and vast knowledge stemming from my own work on myself within a network of uncounted individuals who have found one of probably several ways how to re-establish a healthy form of living, allowing self-moderation, wholeness, and happiness, I can only testify for that what Anna Lembke is describing in those parts of her book is very relevant.

Yet, I am not done with praising this book:

Anna Lembke does not only explain that the dysfunctional processes within the reward pathways of the brain affect those who then have to experience a rock-bottom before being ready to acknowledge defeat, and being open to real recovery, and then healing. She goes beyond, by saying that this dysfunctionality has increasingly become the new normal. Like, any parent talking about the effects of Tic Toc on their children will immediately agree. Just mentioning this as one example. I don’t want to become too narrow in my focus here, the opportunities for constant, easy and immediate gratification go so far beyond any limited or exemplary explanation that I don’t feel qualified to eleborate here on it. Because, I even don’t know whether you have made it until here, or if you have given up already, thinking “What the hell is he now talking about?

What the hell I am talking about? I am talking about something which experts in the advertisement industry have understood since long. Something which those who design social media applications have brought to the next level. And using Artificial Intelligence for those computer algorhythms has brought the incorporation of neuroscientific understanding of how one can become addicted into perfection. May be you want to watch “The Social Dilemma” on Netflix. There you will hear it from those who admit that they have designed their products exactly this way.

And that, using and re-phrasing a catchphrase of one of my favorite Youtube personae, Sabine Hossenfelder, “That’s what Anna Lembke is talking about”.

Perhaps my little own personal disclosure has made it interesting for you to get until here. My blog is addressing topics of trauma and reconciliation for a reason which includes my own experiences with that. But if you have never thought about this topic, you may have a long way to go, both in appreciating the sheer width and depth of this societal problem, and especially because, as long as you are suffering from the consequences of this dysfunction yourself, you are literally unable to see it, in your own case.

Lastly, I join Anna Lembke in her thoughts about how the collective wisdom of the recovery community, especialy those known as Twelve Step Groups, could be beneficial way beyond recovery, as it is commonly understood. Again, from my own and very specific experience, I can testify that the number of people who are increasingly asking this question, is growing. I am meeting a lot of them on an almost daily basis.

Zoom is a blessing. I am still working on less long-winded sentences. Apologies, I wanted to be precise.

And love from Tigger and me. His reward pathways are a little out of control as well, I have been too permissive in giving him treats. But we are working on that…

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