The Melanie Avalon Biohacking Podcast
The Melanie Avalon Biohacking Podcast

Episode 1 · 5 months ago

#140 - Dr. Anna Lembke: Understanding Addictions, Dopamine & Motivation, The Path To Recovery, Pain & Pleasure Balance, Socially Acceptable Addictions, Radical Honesty, Opioids, CBD & THC, And More!

ABOUT THIS EPISODE

GET TRANSCRIPT AND FULL SHOWNOTES: melanieavalon.com/dopamine

2:10 - IF Biohackers: Intermittent Fasting + Real Foods + Life: Join Melanie's Facebook Group For A Weekly Episode GIVEAWAY, And To Discuss And Learn About All Things Biohacking! All Conversations Welcome!

2:25 - Follow Melanie On Instagram To See The Latest Moments, Products, And #AllTheThings! @MelanieAvalon

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6:10 - FOOD SENSE GUIDE: Get Melanie's App At Melanieavalon.com/foodsenseguide To Tackle Your Food Sensitivities! Food Sense Includes A Searchable Catalogue Of 300+ Foods, Revealing Their Gluten, FODMAP, Lectin, Histamine, Amine, Glutamate, Oxalate, Salicylate, Sulfite, And Thiol Status. Food Sense Also Includes Compound Overviews, Reactions To Look For, Lists Of Foods High And Low In Them, The Ability To Create Your Own Personal Lists, And More!

6:55 - BEAUTYCOUNTER: Non-Toxic Beauty Products Tested For Heavy Metals, Which Support Skin Health And Look Amazing! Shop At beautycounter.com/melanieavalon For Something Magical! For Exclusive Offers And Discounts, And More On The Science Of Skincare, Get On Melanie's Private Beautycounter Email List At melanieavalon.com/cleanbeauty! Find Your Perfect Beautycounter Products With Melanie's Quiz: melanieavalon.com/beautycounterquiz

10:35 - Dr. Anna's Credentials

11:35 - Dr. Anna's Beginning

14:40 - What Is Addiction?

16:10 - The 4 Cs

17:20 - Withdrawal

17:50 - The Difference Between Enjoyment And Addiction

19:35 - Workaholism

​20:30 - SUNLIGHTEN: Get Up To $200 Off AND $99 Shipping (Regularly $598) With The Code MelanieAvalon At MelanieAvalon.Com/Sunlighten. Forward Your Proof Of Purchase To Podcast@MelanieAvalon.com, To Receive A Signed Copy Of What When Wine!

22:20 - Does The Feeling Of Fulfillment Matter?

24:45 - Dopamine And Motivation

25:50 - Pain And Pleasure Balance

31:10 - Dopamine And Hunger

32:30 - Addiction Ritual

36:00 - When Did Addiction Start?

37:10 - Modern Addiction

38:10 - Orgasm

39:50 - Who Is More Likely To Become Addicted?

41:50 - What Role Does Repetitive Exposure Play?

43:20 - LMNT: For Fasting Or Low-Carb Diets Electrolytes Are Key For Relieving Hunger, Cramps, Headaches, Tiredness, And Dizziness. With No Sugar, Artificial Ingredients, Coloring, And Only 2 Grams Of Carbs Per Packet Try LMNT For Complete And Total Hydration. For A Limited Time Go To drinklmnt.com/melanieavalon To Get A Sample Pack For Only The Price Of Shipping!

46:00 - Could We Evolve To No Longer Be Addicted?

49:00 - Can Everyone Recover From Addiction?

51:50 - CBD And Cannabis

52:50 - Can Anything Become Addictive?

55:10 - Finding A Solution

58:20 - Self Binding

1:01:10 - Shame And Guilt In Recovery

1:03:20 - Radical Honesty, And Our Addiction To Lying

The compulsive overconsumption, mild addiction to very severe, life threatening addiction. We're all somewhere on that spectrum and increasingly more and more of US are struggling. Struggling with these kinds of minor addictions, where now we need to use our drug of choice not to feel good but just to restore a level balance when we're not using the experiencing universal sympings of withdrawal, which is anxiety, or to build insomnia, dysphorian craving, and I think really all of us today can to some extent relate to this, even were just with our smartphones. Welcome to the Melanie Avalon biohacking podcasts, where we meet the world's top experts to explore the secrets of health, mindset on deevity and so much more. Are you ready to take charge of your existence and biohack your life? This show is for you. Please keep in mind we're not dispensing medical advice and are not responsible for any outcomes, and we experience from implementing the tactics mind hearing. Are you ready? Let's do this. Welcome back to the Melanie Avalon biohacking podcast. Oh my goodness, I am so honored about today's episode. From these. Second I heard Dr Lem key on Joe Rogan and then again on rich roll, I knew I had had had to book her if it all possible. I've been really wanting to do an episode on addiction and Dr Lem key is honestly one of the go to figures when it comes to understanding the science of what all is happening with that. Her Book Dopamine nation was so fascinating and it was a really fun read. She made it very personable. It wasn't dry at all. It really gave you a scientific look at the brain and really good examples of how that manifest in real life. In particular, I was really excited to talk to her about what I perceive as my own addiction, which is work addiction. So it's really nice to analyze that and learn about what actually is an addiction. It can't wait to hear what you guys think of today's episode. The show notes for today's episode will be at Melanie avaloncom dopamine. Though show notes will have a full transcript, so definitely check that out. There will be two episode giveaways for this episode. One will be in my facebook group. I have biohackers, intrimented fasting, plus real foods, plus life. Comment something you learned or something that resonated with you on the pinned post to enter to win something that I love, and then check out my instagram, Melanie Avalon. Also find the announcement post there and again enter to win something that I love. And you be really surprised. A lot of people don't really enter on that instagram and I am usually giving away full size beauty counter products. So if you want one of those, go into now. It is so, so easy. Okay, very exciting announcement, friends. We should be currently right now, when this air's running the largest discount yet on my Sara peptaise supplement. We are launching Sarah Peptai's subscriptions. These are amazing for so many reasons. Basically, it makes it super easy for you to always have your Sara peptase supplement or whatever supplement I make in the future. You don't have to worry about ordering and you get it at a major discount and it's more sustainable for the planet. For this Sarapeptase subscription, you get three bottles every four months and if you sign up now during the special launch period, which is probably going to end April nineteen, you will get twenty five percent off. Yes, twenty five percent off. That is huge. After this launch period you'll still be able to order subscriptions. There will still be a discount, but it won't be twenty five percent. So if you've been loving my Sarapeptase and want to keep it in your life at a discount while being more sustainable for the planet, sign up for that subscription now. To get that, go to avalon x dot US subscription. I have been loving hearing the feedback from you guys. You guys are loving my Sarapeptase just like I am. I've actually had requests for subscriptions, so this is really exciting. What is Sarah Peptase? It is a proteolytic enzyme created by the Japanese Silkworm. When you take it in the fastest state, it actually goes into your blood stream and can break down problematic proteins in your body. So it can help so many things by doing that. It can eradicate allergies. That's why I started taking it. We're talking clear sinuses like none other. It also can clear brain vog think razor sharp brain studies have shown it may enhance wound healing, reduce pain, get rid of fibroids, reduce cholesterol and fatty deposits and even breakdown amloi plaque. This is the coolest supplement ever. I love it and my Sarapeptase is the best on the market. It is free of toxic fillers, high potency, tested to be free of toxins like mold and heavy metals, which is who so important to me. It's Vegan and free of common allergens like gluten, wheat, nuts, soy, eggs, shellfish, dairy, even rice, which is very, very common, and a lot of supplements. Definitely get it now to get all of the announcements about this so that you don't miss anything in the future. Get on my email list. That's at Melanie avaloncom, avalon X, and to shop all of my supplements. That is at avalon x dot us. Of course, there's just this Arapep tase...

...right now, but what is coming soon? Oh, my goodest friends, it's magnesium. My magnesium eight is going to be the best magnesium on the market, and I can really, really say this because it is. There's so much sketchiness in the supplement industry and I just want to make the best supplements that I want to put into my own personal body. I really want to make magnesium because it is involved in over three hundred insomatic processes in the body. So it can help everything from sleep to stress to muscle recovery to blood sugar control. It can really help with bowel movements if you want help in the Gi Department, and my magnesium has multiple forms on like most magnesiums on the market. That are just a few. It does not have toxic fillers. Check your magnesium supplement. It probably has fillers in there. If it has a name of something and you're not quite sure what that filler is, you might want to look it up to see what's in that. Basically, my magnesium is the one that you want and it's going to be in a glass bottle. I'm so, so excited about this magnesium and can't wait for you guys to try it. To make sure you don't miss our launch, because we might sell out again. Get on my email list. Melanie avaloncom avalon X, a Va Lon x another resource for you guys. Do you struggle with food sensitivities like I do? If so you've got to get my APP food since guide. It's a comprehensive catalog of over three hundred foods for eleven potentially problematic compounds. These are things you may be reacting to like gluten, Lectins, solicillates, soul fights, thiles, oxalates, Histamine, whether or not something as a night shade and so much more. It is a top itunes APP. I just checked and right now it is number ten in the itunes food and drinks chart. You can learn about the compounds, create your own list to share in print and, finally, take charge. If your foods in citivities, you can get it at Melanie avaloncom. Food since guide. And one more thing before we jump in. Have you cleaned up your food and your environment? Have you cleaned up your skin care and make up? Did you know that Europe has banned over a thousand compounds due to their toxicity? That are very, very common and conventional skin care and make up in the US? Guess how many of the US has banned? Eleven. When we put on conventional skin care and makeup, we are giving toxic compounds direct access to our blood stream. This is such a problem. Conventional Lipstick, for example, is often high and lead. And did you know that the half life of lead is up to thirty years? That means when you put on some conventional lipstick, thirty years later, half of that lead might have left your bones. It is so shocking. And when we're using these products they actually builds up in our bodies. And ladies, when you have a baby, a large portion of those toxins go through the placenta into the newborn. It is so sad. Thankfully, there's an easy, easy solution. There's a company called beauty counter and they were founded on a mission to change this. Every single ingredient is extensively tested to be safe for your skin. You can truly feel good about what you put on and their products really work. They have counter time for anti aging, counterstart for sensitive skin, counter control for oily skin and countermatch for normal skin. I love their overnight resurfacing peel and vitamin C serum. It keeps my skin looking young and glowing. I love it. You can shop with me at beauty countercom Melanie Avalon, and if you use that link, something really special and magical might happen after you place your first order. Also definitely get on my clean beauty email list. That's at Melanie avaloncom clean beauty. I give away a lot of free things on that list, so definitely check it out, and you can join me in my facebook group clean beauty and safe skin care with Melanie avalon. People share product reviews and give their experiences and I do a giveaway every single week in that group as well. And lastly, if you're thinking of making clean beauty and safe skin care a part of your future, like I have, I definitely recommend becoming a band of beauty member. It's sort of like the Amazon prime for clean beauty. You get ten percent back and product credit, free shipping on qualifying orders and I welcome give. This worth way more than the price at the yearlong membership. It's totally completely worth it and I'll put all this information in the show notes. All right, without further ado, please enjoy this wonderful conversation with Dr a at Limkey. Hi, friends, welcome back to the show. I am so, so excited about the conversation that I'm about to have a little backstory about today's show. So I heard Dr Anna Limp Key. I mean she's made all the podcast around. She's been on all the shows and I was listening to her interviews for her new book, Dopamine Nation, and I knew that I had to read the book asap and, if possible, had to get her on this show because I am very much fascinated by the brain and by addiction and in particular the concept of dopamine. Like I've I've always said that I'm and this is a very casual understanding of it, but I've always thought that I have an addictive personality and I've always said that dopamine is is my thing and that I could never really touch drugs or anything like that because that would just not go well. So I always had just an awareness of how I think my brain works with dopamine. But then reading dopamination was just so eye opening,...

...so enlightening. I really really learned about the science of what all was going on. And then, on top of that, Dr Lem key is an amazing writer and she shares a lot of personal stories as well from her work, so it's a really, really engaging read. I just have so many questions. So, Dr Lem key, thank you so much for being here. Oh my goodness, my pleasure and thank you for that lovely introduction. So listeners might be familiar with you from your books or from podcast interviews and things like that, but for those who are not familiar, I will just let them know that you received your Undergrad and humanities from Yale and your medical degree from Stanford and you are professor and Medical Director of addiction medicine at Stanford. You're also the program director of the Stanford Addiction Medicine Fellowship, Chief of the Stanford addiction medicine dual diagnosis clinic and a diplomat of both the American board of Psychiatry and neurology and the American Board of Addiction Medicine, and I'm sure a lot more other things, but those are quite the credentials. But to start things off, so, like I said, your book is just so engaging. The first note I had, because I have like thirty pages of notes, but the first note I have is she is a really good writer. You're really good, so engaging telling the stories of your patients and what you've learned from them and you know the epiphanies that you've had. So I was wondering if, to start things off, you could tell listeners a little bit about your personal story and what made you so interested in your work on medications and addiction and things like that, and your work with your patients, and just why are you doing what you're doing today? Maybe the best place for me to start is just to take a moment for me to express gratitude to my patients, many of whom I interviewed for this book and who were willing to share their stories with a pseudonym in the book. It was their courageous honesty that really made the book possible and I'm very grateful to them and really hopeful that the stories really bring to life the concepts for readers. I guess you know, thinking about why I wrote the book or how I got to this place that I wanted to write the book, is that a number of different things. When I've been practicing psychiatry for more than two decades and I've learned so much from my patients, who I hold up as modern day profits for the rest of us and how to live in this reward saturated world, and I also believe that narrative and story is fundamental to organizing our lives and shaping our experience and also teaching us. So I wanted to communicate the neuroscience, plus these true individual stories of my patients, to express certain ideas that I've evolved over two decades of practicing psychiatry about how to achieve the good life in a world that's, you know, constantly tempting us to engage in titillating ourselves or the pursuit of pleasure for its own sake. I should say too, that I open the book with the story of a patient of mine with a sex addiction, and I did that because I thought his story exemplified very specifically the ways in which technology and the Communications Revolution wrought by the Internet has made it so much hard order to manage consumption and essentially turned us all into some form of addict, but also because I wanted to draw parallels between his story and my own addiction to romance novels, which I do talk about in the book, you know, which was a much more minor kind of addiction compared to his addiction or that of many of my patients, but I think still illustrates again the ways in which so much in our world is now drugified and are increased access has made us all more vulnerable to this problem of addiction. Yeah, I really, really appreciate it that approach that you took. So, for listeners, the patient that Dr Limb key talks about with the sex addiction, it's to the level of he concocted an entire masturbation machine, which I think you know, people looking at that from the outside would clearly probably say, oh, yes, he's addicted to sex or masturbation. But then you tell your story about being addicted to Romance novels and you talk about twilight and I think it's really easy for people to look at that situation, I think, and say, oh well, that's not addiction, you just like Romance Novels. So a question from that how similar are those two situations? Like what is addiction and what determines when something becomes addiction versus just being something that you really, really like that is socially acceptable? Right? So you know, broadly speaking, addiction is defined as the continued compulsive...

...use of a substance or behavior despite harm to self and or others. Addiction occurs on a continuum, so everything from sort of compulsive overconsumption mild addiction to very severe, life threatening addiction. We're all somewhere on that spectrum and increasingly more and more of us are struggling, struggling with these kinds of minor, minor addictions, again, as so many things have become drugified and our access has become, you know, almost infinite, especially with the advent of the smartphone. When I use the word addiction, I'm talking about a maladaptive form of coping. I'm not talking about something that's like a passion or, you know, something that people are just spending a lot of time doing trying to achieve one thing or another. Now almost anything can sort of crossover into addiction and and the way that it's broadly defined is again harm to self and or others. The way that it's specifically divant defined in the diagnostic and statistical manual of mental disorders is captured by the forceas control, compulsion, craving and consequences, along with the physiologic signs of tolerance and dependence. So, just to briefly summarize, control refers to out of control use. Compulsion refers to a level of automaticity outside of conscious awareness. Craving refers to both the mental and physiologic on set of an intense urge to use despite the plan not to use, and then consequence has to do with all of the various consequences from, you know, subtle consequences of just not being fully present to you know, significant life threatening consequences, including, you know, jail, loss of serious relationships, loss of jobs, health consequences. Then they're the physiologic signals of adaptation, tolerance, needing more and more over time to get the same effect, and then dependence and withdrawal manifestations, physiologic manifestations of the absence of the drug. A lot of times people are familiar with like the very significant physical symptoms of withdrawal that you might get from stopping smoking or stopping opioids or stopping alcohol, but every drug and behavior that's addictive has universal psychological symptoms of withdrawal that people really undressed me, and those include anxiety, irritability, insomnia, dysphoria and intrusive thoughts of wanting to use. Okay, so I'm just I'm looking at those different criteria and I'm just wondering, like for me, for example, I think if I had an addiction, it would be probably workaholism. So just thinking about that, for example, is the difference really be the consequences, because I feel like like the way I engage with work, for example, could be seen as addictive. I do have conpulsion, I do have craving. If I didn't do it, the consequences might be that I have, you know, anxiety or like a feel the need to do it, but because it's so accepted in society and because it seems to benefit my life, I keep doing it. So it like like does that qualify as and a diction or not, because it doesn't have consequences? Right? So, so very important point for so ill. Let me just say those four seas, plus challenge dependence, that that's not a checklist. It's not like you have to meet all of those to criteria for addiction. It's basically a kind of a mix and match and the more criteria you meet, the more addicted you are, through mild modern severe, and maybe just one or two of those criteria would, might, might put you in the the mild range. So that's that's important. First thing that I that I want to say. But you're making a very good point, which I think can be captured by this concept of addiction and really all mental health disorders being biopsychosocial diseases. There's a biological component, a psychological component, component, and there's a social slash environmental component and on that social environmental piece of it, and that really speaks to the way in which addiction is in many ways defined not just by its biological factors, but by the way that it inner acts with whatever the culture is at that time. And there's no doubt that in our current, you know, culture, modern Western capitalist culture, there are certain types of behaviors that really meet almost all of the other criteria for addiction but which we don't call addiction because they're so socially validated and reinforced. And that certainly would include kind of a workoholism and the ways in which, you know, the sort of obsessive, compulsive, twenty four seven preoccupation with work and achievement...

...and money is something that we actually use to define our heroes and not people who are ill. And yet, I think through another Lens, you know, it's it's very credible and even useful to say, wait a minute, you know, are we individually and collectively addicted to the behavior surrounding work, and is it ultimately actually contributing to to our unhappiness? High Friends, one of the most valuable things that I do every single night of my life is my infrared sauna session. The brand that I use is Sun Laighton. I did a lot of research on infrared San as before deciding on them. Their SAUNAS are so high quality, their low EMF and what I really love is they have a solo unit. That's what I have and it's really great. If you live in a small apartment, might be moving. It's just really an amazing investment and they have incredible deals and offers on it. Right now you can actually get up to two hundred dollars off with the Code Melanie Avalon. Or if you're talking to a rap just tell them that I sent you and, like I said, that will be up to two hundred off and that will also get you ninety nine dollar shipping. Normally the shipping is like six hundred dollars. So that's a really, really big deal. And if you do purchase a sauna, forward your proof of purchase to podcast at Melanie avaloncom and I will also send you a sign copy of my book what when wine? If you'd like to learn more about these science of Sauna to resources. I interviewed the founder of Sun Lighten, Connie Zach. I'll put a link to that in the show notes, and then I also recently did an epic blog post all about the science of Sauna. Will also put that in the show notes. All right, now back to the show. I'm glad you said that about the unhappiness, because my extension question of that was, does it matter, like the awareness or the perception that you have when you quote achieve whatever you're achieving? And I don't necessarily mean just achievements like I mean as well, being addicted to a drug, for example, and to clarify further, so you talk about in the book of how a dopamine is. You know, the difference between wanting versus actually getting the thing, and so does it matter how fulfilled you feel when you get the thing that you're going for, even if you turn around and go for it again? So like a drug addict having a drug and wanting it, you know that wanting. Then they get the drug and then presumably they they just, you know, do it again. Compared to me, with the workaholism, I strive for these things that I want to do with my work and then I get them. That feels really good and I don't feel unhappy from that and then I just go for something else. Does your perception of getting what you wanted matter? Uh Huh, right, so so good question. Interesting question. Perception is a tricky thing, but I would say in general the phenomenon of being addicted to something is characterized by the law of diminishing returns, which is to say that that thing that we seek out and get is extremely pleasurable or rewarding or motivating to us the first time, and then we want and then we naturally work, work very hard, to try to recreate that experience, because that's how we've been wired over millions of years of evolution, which is to approach pleasure and avoid pain. It's what's kept us alive and and procreating. But what happens with addiction generally is that with repeated exposure to the same or similar reward, it becomes less rewarding over time. A couple hypotheses in your case. It could be that that you are just in this lucky category of your drug, your rewards not yet reaching that post point of diminishing returns, which is to say that eventually you will get there. or it could just be that somehow you've unlocked the secret to a type of reward that is rewarding and meaningful to you in a way that doesn't trigger this vicious cycle of compulsive overconsumption. Also, just going back to what you said originally about this wanting versus liking, we know that dopamine is released when we do something that's pleasurable. It is also fundamental to this process of motivation, which is slightly different from pleasure motivation, is the amount of effort we're willing to extend to get that reward. And what we've learned through neuroscience and also our own natural experiments in our lives is that dopamine is is integral not just to the experience of pleasure but to the motivation to seek it out. One of the ways that scientists have shown this as they engineered a rodent to have no dopamine in essentially no no dopamine transmission, and what they learned was that if they put...

...food in that animal's mouth, it would choose the food and seem to get pleasure from the foods while the food, but if they put the food and mirror body length away, the animal would die of starvation, not having enough motivation to get up and move that small distance to get the food. So this idea that that dopamine is important not just to the experience of pleasure and reward, but also to to the motivation to get the reward, and the way that that plays out is very interesting, because it's essentially the dopamine deficit state that follows on the heels of reward that drives, you know, the incentive to seek it out again. That is so fascinating. I remember you talking about that experiment with the rats and that just blew my mind. So what is the baseline state of human being like? We keep talking about pain and pleasure and wanting and liking and getting things. What is baseline? Is it no pain or no pleasure, or is it like fifty pain, you know, fifty pain, fifty pleasure, like when a organism is born. What makes them even want something if they haven't had anything to know that they want it? To understand this, I think it's important to understand that we have learned in the past seventy five years that pleasure and pain are co located in the brain, which means that the same parts of the brain that process pleasure also process pain. And in my book I describe the way that pleasure and pain Inter relate with each other by using the extended metaphor of a balance, which I think just makes it more understandable. So imagine that in that part of your brain called the reward pathway, which is a very old and conserved part of the brain, similar across species and through millions of years of evolution, there is a balance like a teeter totter and a kids playground, or a board carefully balanced on a full croome. And at our resting state that that board on the Fulcrum is level with the ground, it's not tipped to one side or the other, and that balance represents how we process pleasure and pain, because they work like opposite sides of the balance of a balance. When we when we experience something pleasurable, the balance tips one way and when we experience something painful, the balance tips in the opposite direction. Now there are three rules governing this balance. The first is that the balance wants to remain level and that our brains will work very hard to restore a level balance with any deviation from neutrality. And the way that the brain restores a level balance is by tipping the balance and equal and opposite amount to whatever the initial stimulus was. So if I do something that's pleasurable, then I get a little release of dope. Mean my balance tips to the side of pleasure, but in response my brain adapts to that pleasure by tipping my balance and equal and opposite amount to the side of pain before going level again. So that means that every pleasure has a cost. The second important rule governing that balance is that with repeated exposure to the same or similar stimulus, that initial response to get to pleasure gets weaker and shorter, but that after effect to the side of pain gets stronger and longer. And one of the ways that I imagine this is that there are these neuro I don't take adaptation gremlins that hop on the pain side of the balance in response to any pleasureable stimulus, but they like it on the bounce, so they stay on till it's tipped an equal and opposite amount to the side of pain. That's the come down, the hangover, the after effect before are hopping off and restoring a level balance. But if we continue to bombard our pleasure side with highly reinforcing drugs and behaviors, then we end up with more and more gremlins on the pain side of balance until they're we've got like a whole village and they're camped out with their tents and barbecues and toe. That is addiction right. That that that is when we've entered that vortex of compulsive overconsumption where now we need to use our drug of choice, not to feel good but just to restore a level balance. And when we're not using we're experiencing the universal symptoms of withdrawal from any addictive substance, which is anxiety or ability, insomnia, dysphorian craving, and I think really all of us today can to some extent relate to this. Even with just with our smartphones. This is when we get a text, it's reinforcing and makes us feel good, little bit of Dope, blip of Dope, mean that we put it away and say to ourselves now I'm going to focus on this other task. And yet there remains in our minds this burning compulsion to want to check it again and again and again, and that really suggests that now we've got gremlins popping up and down on the pain side of balance that are compelling us to do the work. To you know, restore, essentially restore homeostasis, because, remember, the driving biological principle is that the balance wants to be level. The final rule governing this balance is at the balance remembers. It has a very keen memory for those initial stimuli that either produced pleasure or produce pain, but we are almost amnestic for the Gremlins, that is, we don't remember the come down. Likewise,...

...on the pain side, you know, I know that when I exercise, those Gremlins will help on the pleasure side and give me dope, Meine through this process called Hornisas, or upregulation of my own dope. mean. And yet I'm cold. Incredibly, I'm nestic about about that. Twenty four hours later, when I get up and I think I don't want to exercise, even though I should remember how good I felt afterwards, all I remember is the pain. Likewise, all we remember about the good stuff is the you fork reef recall of how we felt, but we don't remember all the bad stuff that came afterwards. It's so fascinating and I've been really realizing it and myself this past week because I told you just before recording I got covid last week. So I lost my sense of taste a few days ago. So I follow intermitten fasting protocol and I eat pretty much a very similar meal every single night, and so it's been fascinating to watch myself eat because I can't taste the food at all, like at all, but I still want to eat like the same amount that I always do. I'm still enjoying the process. So I've been watching myself engage with that. I'm not getting any pleasure from the food, like zero pleasure, and yet I still watch myself wanting to keep eating, and that has really made me realize wow, like if I mean if I'm having this response to this, I can't even imagine getting off of, you know, heart drugs. We are still getting the pleasure from it. We all have a sort of a baseline tonic level of Dope Meine firing, and that's a signal to us that allows us to know, you know, what to approach and what to avoid. And again, if it's something reinforcing, then that we get more dope me and it goes above that baseline level, we tip our bounce aside of pleasure. So when you are eating without being able to taste, what's absent for you is the dopamine release that comes from eating that food. But what is still present for you is the response to your hunger. Right so, Han hunger is one of the ways that we are balanced tips to the side of pain spontaneously as part of our survival mechanism. Right, I'm hungry. My hunger is now motivating me to do the work to get some food, both because it's pleasurable but also because it allows me to restore homeostasis. So so just we're wanted to put that out there in terms of kind of the parallel things that might have been going on. I'm really glad you said that and I was actually thinking about that. I have been thinking about it while eating at night. I've been thinking, you know, is this getting rid of my hunger and so that's why I'm doing it, or is it like I'm I just addicted to this ritual of eating? Right? So that's a very good point too, that we do develop all these rituals around, you know, these reinforcing substances and behaviors, and they become part and parcel of the experience as well. You know, where I remember I had this fascinating case of a young man in China who was addicted to Harrow in and his parents paid for him to have the addiction surgery. No, he had no idea what the addiction surgery was, but essentially they put in a Noltrek zone implant Al Trection as an opioid receptor blocker, which meant that for the next six months he would not be able to feel anything from injecting heroine. But he just continued to inject on a daily basis, partially because he didn't even he thought that somehow magically, you know, it would take away, I don't know, the whole ritual around it, as well as the craving, and it didn't actually do that, even though it was effectively giving him no reinforcing effects to take the heroine, but it was just part of his sort of ritualistic routine, which just speaks to the level at which, you know, addiction is this sort of innate reflexive response to wanting to restore homeostasis once we're in withdrawal, but it is also all of these other sort of Meta narratives and behaviors that that surround you know, that deeply ingreen behavior that goes along with the reinforcing effects, like when I've been eating. I was literally thinking about now trek zone and I was thinking, if I had an addiction that could be treated by that, would I have the same response that I'm having with a food where it doesn't even matter that it takes away that the reward, because I'm just so ingrained in that the ritual of all of it? Yeah, I mean the other thing too, is that hypothetically, if you permanently lost, you know, your ability to taste from covid theoretically that would eventually extinguish your craving for foods that taste good and you would get to a point where you would just basically eat for the sake of fuel. That would, of course, be horrible, but you know, with that's what we see in animal studies. So, for example, if you train a rat to press a lever to get cocaine immediately delivered to its blood stream, you know the rat will essentially press that lever until it exhausts itself and can't move or until it dies. But if you then stop delivering cocaine through, or whatever the drug...

...is, through that mechanism of the lever press, eventually that behavior will extinguish and the animal will no longer work to press the lever because the drugs no more no longer forthcoming. Although, interestingly, if you then explose that, expose that animal to a significant stress or like a very painful foot shock, it will then reflexively run to the lever and start pressing it again as a way to kind of, you know, create access to that reinforcing drug, which does speak to one of the many risk factors for drug relapse, which is an acute stressor is addiction only really possible in a society or situation and or an environment where you do have access to these either hyper palatable or, you know, these rewards that we wouldn't be able to get in nature? Like when did addictions start? Ha Ha, yeah, great question. So I think since it's the beginning of, you know, recorded time, there have been accounts of individuals who could not use various intoxicants in moderation, and you can go very, very far back thousands of years to find these accounts. So as long as there has been the discovery of intoxicants in nature, whether you know from grain alcohol or from, you know, opium from the poppy plant or coke leaves, there have been individuals vulnerable to the problem of addiction, and yet the majority of individuals have been able to use these substances in moderation, and that's still true today. So about ten. There's about a ten to fifteen percent lifetime prevalence for alcohol and drug addiction. In terms of behavioral addictions like pornography, gambling, you know, video games, we don't have as good numbers, but it would probably be something you know in that range. What's different today is that we have so much more access to a much broader variety of even more potent drugs that we've all become more vulnerable to the problem of addiction, which means that addiction rates are going up, including in demographic groups that were previously a less vulnerable to the problem, like older people and women, and likewise we have many, many more people struggling with minor, compulsive overconsumption and mild forms of addiction. I'm like the one that I describe. Happened to me with Romance Novels. Now, other people might not have conceptualized that my experience through the Lens of addiction, and and it's partially the work that I do that led me to look at it through that Lens. But I think it's a really useful Lens for conceptualizing addiction really as very much a spectrum disorder and and this idea that we're all potentially vulnerable given enough access to a potent and reinforcing drugs. Yeah, for listeners, you've got to get dopamine nation and read all of Dr Linkey story about the Romance novels and all of that. I just thought it was really, really eye opening. I have a super random question. You talked about in the book the level of dopamine. That is. Well, I guess it's not released, it's encouraged to be released or released. You talked about the dopamine levels of different substances. So morphine or fed, your inner meth. But you also mentioned Orgasms, for example. Is the orgasm feeling? Is that literally dopamine or some other nerd transmitter? Yeah, it's not. Just openmine. And let me just say that dopemine is not the only neural transmitter involved in pleasure, reward motivation, but it is the final common pathway for all addictive substances and behaviors. So an orgasm is characterized by a flooding of our brains in that moment by dopamine, Sarah tone and or upper and apron, all kinds of of, you know, endogenous feel good hormones, which makes, you know, sex addiction and pornography addiction really difficult, frankly, to overcome, because you don't have to go out to the store and get it. All you need is you know, your own body and your imagination and and sex addiction, you know, is a real, true and real thing and potentially life threatening and certainly devastating for people with the more severe forms, and on the rise, you know, with our twenty four seven access to these digital images, increasingly graphic digital images, as well as people themselves on the other end. You know, it's IT'S A it's an addiction that's really taken hold and I'm seeing more and more patients coming in with devastating consequences of sex addiction. Do we know why certain people get addicted to certain things and not others? Like why can one person experience an orgasm and not get addicted to sex, but another person does? Yeah, so interesting, like this...

...interindividual variability, this concept of drug of choice, that what tilts your balance the side of pleasure may not tell mine, and vice versa. And you know, what we don't have very much information I want. One of the things I did in writing this book was kind of went looking for that and couldn't find very much. Talk to the leading neuroscientists and interestingly, there there isn't a lot of knowledge on this. I speculate that from an evolutionary perspective, there's a good argument for making sure that within the tribe, people like different things. Like a Priori, are just attracted to different things, which is to say if everybody you know we're looking for like the Red Berry, then we would have too many red berries and not enough you know, let's say, grain or water or, you know, other people to potentially increase our mating potential. So I think that Mother Nature has sort of covered this by making sure that, you know, people are different in this regard and attracted to different things, working for different kinds of rewards, so that at the end of the day, the tribe as a whole has what it needs. I was thinking that maybe it was something societal, where what you just said that people needed to to do different things in order to keep this society going, kind of like how people, people are different sleep coronotypes, because to function as a society. We need to to have people alert at different times of the day. That's interesting. Had not heard that before, but that that makes sense. Yeah, I think about it with like songs, for example, like why do certain people become so obsessed with certain songs and other people don't? So sometimes, like you can first hear a song and you could care less about it, but then you keep hearing it and then it grows on you, but then you get tired of it, like as the same arc. So what role does repetitive exposure play and addiction, even if you don't initially like it? Well, if that thing is inherently addictive, then you know you're your brain will cycle through the very same phenomenon as if you know you had originally like that thing, which is to say, with repeated exposure, that initial pleasurable response, or just that initial response, even if not all that pleasurable, gets weaker and shorter, but the after response that come down stronger and longer and now you really want that thing, not really to experience pleasure but just sort of to restore on me a stays. So obviously I'm making a big inference and that's hypothetical, but I think another analogy as if you think about the use of opioids in the treatment of pain. So people who can get addicted to opioids prescribed by their doctor for pain, and what they will tell you, which I'm sure is true, is that when they first took the opioid it did not give them any kind of sense of euphoria. It just relieved them from from pain temporarily. But it doesn't really matter that euphoria was an APP wasn't present. You can still get addicted just because it real leads some kind of pain. So it doesn't that that balance. It doesn't really if it, even if it starts out tip to the side of pain. That process of neuro adaptation and Gremlin's compensating, you know on the after effect and changing the set point, that that still occurs. So I mean I could speculate that that's what's going on there with the song. That is high. Friends, I'm about to tell you how you can get free electrolite supplements, some of which are clean, fast approved, all developed by none other than Rob Wolf. Have you been struggling to feel good with low car paleo, Keto or fasting? Have you heard of something called the Keto flu. Here's the thing. The keto flu is not actually a condition. Nope, Keto flu just refers to a bundle of symptoms, headaches, fatigue, muscle cramps and insomnia the people experience in the early stages of Keto dieting. Here's what's going on. When you eat a low carb diet, your insulin levels drop. Low Insulin in turn lowers the production of the hormone aldosterone. Now, aldosterone is made in the kidneys and it helps you retain sodium. So low aldosterone on a Keto Diet makes you lose sodium at a rapid rate and even if you are consciously consuming electrolytes, you might not be getting enough. In particular, you need electrolytes, especially sodium and potassium, in order for nerve impulses to properly fire. Rob Wolf, who, as you guys know, is my hero in the holistic health world, worked with the guys at Keto gains to get the exact formulation for electrolytes supplements to formulate element recharge so you can maintain ketosis and feel your best. Element recharge has no sugar, no coloring, no artificial ingredients, no junk. They're used by three navy seals teams. They are the official hydration partner to team USA weightlifting, they're used by multiple NFL teams and so much more. And Element has an amazing offer for my audience. It's you can...

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...would say that, you know, we're all in recovery from life. And when I think about this pleasure pain balance, I really think about it as as not on a triangular fulcrum, but really on a ball, like a beam, on a ball like you might imagine in a circus, where, in order to stay balanced on that beam, on that ball, were constantly having to maneuver and and and, you know, shift our footwork and and make adjustments in order to stay in balance. And and people with addiction in recovery have to do that and the rest of us have to do that too, right every day. You know, it's kind of okay, I have to adjust here after they have to adjust there, and that's because the world is a constantly, you know, changing to continue to try to draw us in. The example that I use in the book is the idea of a gluten free diet. So you know, people with CELIAC disease can't have gluten, which means that they can have things with flower in them, which means that in general, historically they have able to have a lot of the kinds of cakes and sweets and snack foods that other people can have. So in recent decades a lot of people adopted the gluten diet, not because they have CELIAC disease, but because it became a good way to restrict certain categories of foods. Well, what did the gluten industry do? It immediately started to make all kinds of gluten free cakes and cookies. So you know that all of a sudden being gluten free didn't confer that kind of advantage as a restrictive category. The same thing happens with drugs all the time. Like you know, nicotine and cannabis are now available in so called medicinal forms. So you know, just as soon as you figure out how to stop using a certain drug, it sort of represents itself in a new packaging that says hey, I'm good for you now. I didn't want to ask you about that because people will often say, like CBD for cannabis, for example, is quote, not addictive. Why do they say that? And is that true? Huh? So, so there are more than four hundred active ingredients in cannabis. The ones that were most familiar, familiar with our THHC and CBD. THHC BINDS CB one receptors and is addictive. CBD BINDS CBTWO receptors and is not addictive. So it's really true that CBD is not addictive. The problem is that it's actually very hard to get pure CBD. So a lot of these socalled pure CBD products, which are not well regulated, act really have thhc in them and or people are intentionally using a tincture that combines both of those things and thhc it is highly addictive. So that's the complexity there. It's it is true that CBD is is not addictive. It's really hard to know if you're just getting a CBD even if it's not addictive as a literal compound. In your brain. Can anything and theory, become addictive if we perceive it as something addictive, like a habit? So yeah, so habit versus addictions. So habit, you know, describes a behavior that we do that is outside of conscious awareness, right that we can start doing that thing without even really realizing that we're doing it, whether it's biting your nails, picking your nose, I can, or a thumb, whatever it is. And in many ways habits are really useful because it's a very and energy efficient way of engaging in motor activities without the content of load, of having to think about doing it. Like, you know, tying my shoes is a habit. I don't I no longer have to think about, you know, making the bunny ears and having the bunny go up and up until down the hole or whatever. But so habit and of itself, you know, is not a bad thing, although we can have bad habits. Addiction sort of encompasses habit and yet is more than that. So there's certainly a level of automaticity in in most of us our addictions where we start doing the thing before we even realize that we're doing it. But addiction, it is beyond habit and it's negative, almost always negative. I think of addiction, you know, as conceptually as a again a maladaptive form of coping that encompasses habit. So I think there's CBDs kind of a tough example because you know, the science to date suggest that it actually doesn't have much impact on the brain, even though you know it is ft approved for this rare form of epilepsy and even though a lot of people swear by it, the controlled studies suggest it's really no different from place boat or a sugar pill. On the other hand, place bows are powerful even when people know they're taking a place boat. If they were told that it helped other people, they will have benefit from it, even when they know it's a placey boat. So I guess what you're what you're asking in a way, is something like if you believe that what you're doing releases dope, Meine. You know, is that the same...

...thing is releasing? Don't mean I don't. I don't know the answer to that question. That was what I was wondering. Going back to the solution here, I feel like there's two big camps that are here, and one of them you talk about at length in the book. So something like complete abstinence, so like Aa for alcohols, anonymous for example, compared to a camp of more, you know, moderation. How do you feel about those two different approaches? And is it that some people just really do require complete abstinence forever? Can some people moderate like. What is the recovery pathway look like, especially in regards to abstinence? Whether your goal is abstinence or your goal is a moderation, the place to start is a period of abstinence long enough to allow those neuroadaptation gramlins to hop off the pain side of the balance so that baseline home, a stasis, can be restored. So when patients come into me and they say, you know, ultimately I'd like to use this substance or behavior like quote unquote normal people, I say, okay, I can help you with that. I can try to help you with that, but but first you have to abstain for thirty days, because otherwise you're not going to reset reward pathways. It is a much harder to going to go from using a lot to using a moderation than it is to go from using a lot to using none to going into moderation. So it always begins with this period of abstince and again I argue that the neuroscience supports that path. Then you know in terms of you know, after that month of abstinence and resetting reward pathways, you know who should continue to abstain and who can use in moderation. I don't even have the ability to predict that right. You might think, based on past experience you know that I could predict that, but but I've really given up trying to make those types of predictions and I just really try to help patients do the experiments to figure out for themselves what I what I can tell you is that if if you're going to try moderation, then it's very important to be very specific about what the goal of moderation is. We have data for alcohol, but we don't really have data for anything else. So it just comes down to, well, what what sounds like moderation to you? Moderation usually means not daily used. It usually means not binge used, and people are pretty good. It's sort of like thinking about, okay, well, I think I want to, you know, smoke this many days, you know, in a week or a month, under these conditions with this type of substance, or play this many video games under these conditions with this type of video game, or whatever it is. And I talk a lot in the book about various self binding strategies because I think it's an important point when we're talking about absence versus moderation. That there are, frankly, certain drugs that it's impossible to abstain from. If you're addicted to food, you can't just stop eating. If you're addicted to digital devices, for most people, their work requires them to be on devices to be able to do their jobs. So then the discussion of moderation becomes a universal one, where we then all need to think about, okay, how how can I, you know, manage my consumption of this thing that I essentially must consume in the modern world or for my survival? I love the section on categorical selfbinding. I've thought about this a lot, especially being the host of the intermitten fasting podcast. I really think the reason that intermitted fasting works so well for people, especially if you're reading your book, is because it's categorical selfbinding. You have your eating window and so you really can only eat during your eating window, and so it solves or addresses all the issues of overconsuming all day. Right, and I think you mean chronological selfbinding. Those category because I was a yeah, categorical was like going gluten free. Yes, that's right, that's right, like Paleo or something. Right. So, yeah, so what were the different ones? Yeah, so so it's sort of physical selfbinding, or Geogo, what I called geographical, which are literal barriers in space. There are chronological selfbinding, which is using time as a construct, and then there are these categorical ones where you say, well, I'm going to do this type of food but not that type of food. But I absolutely agree with you. The intermittent fasting is a really great example of chronological selfbinding and how by just I'm putting up these guard rails of saying I am going to eat during these times and not during these other times, it's just sort of releases you. You know you don't, you don't then perseverate in those times of nightting. He's like, Nope, this is my not eating time, and then the eating time you're like yeah, you know, I can pretty much eat whatever I want because this is my eating time, and I think for some people that works just really, really well and works much better than saying well, I'm going to have I'm not going to have cakes and cookies, you know, but I can eat at any time. I think the other reason that it works really nicely is because as we approach the end of our day, we also tend to exhaust...

...our will power. And so if we haven't put a hard stop on the time that we are going to, you know, stop eating, it can be harder and harder to stop as we, you know, sort of want to reward ourselves at the end of the day. Words we say to ourselves, you know what, come whatever, five PM, seven PM, nine pm, I can eat past that. Then it's like look, there it is. It's like Cinderella and or Pumpkin. You know, note, no more carriage, it's a Pumpkin. I have found the inch chronological binding to be super helpful with food as well. Yeah, people will often say to me that they can never do and written fasting because it requires too much will power, and my response is it's the answer to not having will power, because you don't have to make all those decisions all day. You just have your system right. And the other thing I think with intermittent fasting is that we are actually wake up with more will power than then we're going to have for the rest of the day. So if you're going to exercise your will power, it is, I think, in the morning easier to do that. At the end of the day, you know, you can make sure that you have a time when you're eating then but that also has a cutoff point. And then one other last thing that you talked about, though, is so, so interesting to me, was the role of shame and guilt and recovery and this concept of prosocial shame. I was warning if you could talk just a little bit about that. What is the role of engaging with other people when we're trying to address these addictions? Yeah, so I think it's important to acknowledge that one of the things that actually can perpetuate addiction is shame, feeling shameful about that behavior and hiding it from others and then using more of our addictive substance in order to sort of just deal with the increase shame, than terrible vicious loop. But it's also very true that shame can be leveraged in a positive way to help launch us into better and more healthy behaviors, and alcoholics anonymous as a really good example of, you know, a mutual health group that is both dshaming in the sense that people realize they're not alone and they're accepted for who they are and their behavior is one that other people understand and share, but at the same time, Pro Social Shame is leveraged in the sense that you know, then you're engaging in this activity of changing your behavior and working the program with other people. And then there's this desire to not use because it would be, you know, shameful to have to go back and say, you know, I relapsed and so you're you know, you want to get your thirty day chip, your Sixty Day chip, your ninety day chip. You don't want to have to go and tell your sponsor, Oh, you know, I drank again. But importantly, if you do, you know, use again and and you are honest about it, you will be warmheartedly accepted into the fold. You won't be shunned for that behavior. So that's really important about pro social shaming and shame is one of our most social emotions right it's the fear of abandonment when we admit to the shameful behavior that both motivates us to keep the the behavior hidden, which perpetuates it, but also strongly motivates us not to repeat that behavior because we don't want to have the experience of shame that is so painful to endure. You also talk about the role of radical honesty and the narrative that we tell about our addictions and also a really cool section on on just lying with your patients. What role does honesty about their addictions play, and do you think most people are honest about their addictions, or is that possibly one of the biggest hurdling blocks to tackling one's addiction? Well, whether whether you have addiction or not, we're all natural liars. I think on average we tell one to two little white lies per day, unless we're really working hard not to do that. And one of the recurring themes that I've seen in my work with patients with severe addiction is that it is almost impossible to get into recovery without practicing radical honesty. Another way of saying that is that truth telling is fundamental to recovery. And I've heard that, whether people get into recovery through AA, which makes, you know, honesty one of their most important philosophical doctrines, or they get into recovery on their own or by other means, almost everybody in recovery discovers that they need to be radically honest, not just about their drug use and their addiction, but really about everything, and that that became sort of a source of fascination and to me in one that then I tried to incorporate into my own life. You know, can I go through a whole day and not lie about anything? And and the lies that we, we tell, all of us, tend to be those those lies that cover up, you know, things that small acts of selfishness or things were embarrassed about, you know, things that we think would make us look a little bit better in somebody else's eyes. They seem really inconsequential. But but I believe, I've come to believe through my patients, that they actually a are highly consequential and that fundamental to managing our own compulsive overconsumption...

...in this reward weary world that we live in is and begins with radical truth telling, to actually setting up a kind of a little watchdog organization in our own minds where we're monitoring whether or not we're telling the truth. And and I try to practice that, as do my patients, and I think it's it talked about all the myriad ways. Why? I think it's it's an ingredient for a life well lived. But even, you know, even I practicing at every once in a while now find myself kind of Jo that really, you know, that wasn't entirely true. Was it like a you know, it really was. It really was two hours, whatever the detail, but I said it was for you know, it's just so funny when you start observing yourself and going on GE that's so weird, like what did I like? Who Cares? Only I care about that. But anyway, it's another very fascinating exercise that I recommend, and I do prescribe it to my patient to is they're trying to quit their drug of choice. I say the other thing you have to do this month is to not tell a lie about anything, because it's fundamental to your ability to manage that reflexive pleasure pain balance. I love that so much. One of the things that I'm actually most grateful for from my upbringing is I should ask my mom about this. I don't know why, but her one thing for us that was like the worst was no lying, like it was just me so clear that, like, you do not lie. That's stuck with me. Yeah, that's great, we'll give your give your Mama, you know, a big pat on the back. I was actually raised in a family where there was a lot of lies, and so it took me well into midlife to eat frankly, to even realize on some level that I was lying as much as I was in small ways, and then, you know, quite a bit longer to try to get a hold on it. I'm very fortunate that I married a man who, you know, lies less than average, I would say, and he really also helped open my eyes to that. Well, thank you so much, Dr Lim key. This has been absolutely incredible. I really cannot recommend not only your book enough. I just want to thank you for everything that you're doing, because it's really truly life changing. So listeners will have to get your book, and I will say this as a complete tangent. Now, I feel like they need to reevaluate a lot of the studies they've done on rats on the running wheel, because you talked about how they're actually potentially addicted to running. Oh yeah, so that was fascinating that I learned that through the lsus are writting the book. That sign neuroside is used to believe that the running wheel was inert and just a way to measure, you know, physical activity of rodents in captivity, but then they discovered that running wheels are actually a drug and that some, some animals will run themselves to death they like it so much and even animals in the wild will engage, you know, running wheel in preference to their many natural wards, which I think just speaks volumes to all the way that all the ways in which we've now drug afied exercise. But that's that's for another day. Maybe it's so, so incredible. It just makes you wonder. I don't know when they figured that out, but it makes you wonder what other things might be going on as like just go to protocols and experiments that might actually have completely different implications. So it's fascinating. So thank you so so much. The last question I ask every single guest on this show and it's just because I realize more and more each day how important mindset is. So what is something that you're grateful for? Oh my gosh, I'm grateful for so much, but I probably at the top of the list is my family and my patients and my students. Awesome. Well, thank you, Dr Lim Kay. will put links to all of your websites in your books in the show notes and hopefully you can come back again in the future. That was absolutely amazing. Yeah, Nice Conversation for me to thank you so much for having me. Thank you, bye bye. Thank you so much for listening to the Melanie Avalon biohacking podcast. For more information, you can check out my book what when? Why? Lose? Wait and feel great with Paleo style meals, intermittent fasting and wine, as well as my blog, Melanie avaloncom. Feel free to contact me at podcast at Melanie Avaloncom and always remember you got this.

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