Pain, Pleasure, and Finding the Balance | Anna Lembke, MD

Our modern world grants us unprecedented access to high-reward, high-dopamine stimuli—not just drugs, but also food, news, shopping, sex, gaming, social media, gambling, and more. But psychiatrist Anna Lembke, MD argues that this society-wide overindulgence in pleasure threatens to lead us to deeper pain. Dr. Lembke is the director of the Addiction Medicine Service at Stanford Medicine and is the author of two bestselling books, Dopamine Nation and Drug Dealer, MD. As one of the first doctors to sound the alarm on the opioid epidemic in America, she's an expert on the issue and has advised policymakers at the highest levels of government. In this episode, Dr. Lembke describes her work treating all kinds of addiction, discusses her deep concern with the overconsumption of pleasure in our culture, and shares what we can all do to renew meaning and connectedness in our lives through balancing pain and pleasure.

In this episode, you will hear about:

• What first drew Dr. Lembke to a medical career and how she initially discovered psychiatry - 2:13
• Why Dr. Lembke dedicates herself to addiction medicine, and how her philosophy can help others find meaningful work - 9:16
• The historical shift, with the advent of the opioid epidemic, to understanding addiction as a medical condition instead of a moral or personal failing - 12:53
• Reframing addiction as a medical diagnosis and approaching patients facing addictive disorders with compassion - 17:58
• How flaws in contemporary medical practice and misaligned incentives for doctors contributed to the opioid crisis - 24:15
• A discussion of Dr. Lemke’s book Dopamine Nation, including how easy access to pleasure causes addictagenic responses in nearly every aspect of our lives - 29:32
• How humans can reconnect with meaning despite living in a culture that often substitutes meaning with cheap pleasure - 34:15
• Dr. Lembke’s advice to all clinicians for how to better connect with patients - 45:20

Tyler refers to the essay “I Used to be a Human Being” by Andrew Sullivan.

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