October 20, 2025 • 37 mins
How does living in a drugified world affect our brains, and what can we about it? Renowned psychiatrist Anna Lembke vulnerably shares her own story of addiction to romance novels and erotica, how digital media hijacks our brains, and what freedom practically looks like. Along the way, you'll learn the meaning of dopamine fasting, self-binding strategies, and prosocial shame. Take notes!
Dr. Anna Lembke is professor of psychiatry at Stanford University School of Medicine and chief of the Stanford Addiction Medicine Dual Diagnosis Clinic. A clinician scholar, she has published more than a hundred peer-reviewed papers, book chapters, and commentaries. She sits on the board of several state and national addiction-focused organizations, has testified before various committees in the United States House of Representatives and Senate, keeps an active speaking calendar, and maintains a thriving clinical practice.
Buy Anna's books:
- Dopamine Nation: Finding Balance in the Age of Indulgence
- The Official Dopamine Nation Workbook: A Practical Guide to Finding Balance in the Age of Indulgence
- Drug Dealer, MD: How Doctors Were Duped, Patients Got Hooked, and Why It’s So Hard to Stop
Learn more about Anna at annalembke.com
Take the Husband Material Journey...
- Step 1: Listen to this podcast or watch on YouTube
- Step 2: Join the private Husband Material Community
- Step 3: Take the free mini-course: How To Outgrow Porn
- Step 4: Try the all-in-one program: Husband Material Academy
Thanks for listening!
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_00 (00:00):
Welcome to the Husband Material podcast, where
we help Christian men outgrowporn.
Why?
So you can change your brain,heal your heart, and save your
relationship.
My name is Drew Boa, and I'mhere to show you how.
Let's go.
Thank you for listening to myinterview with Anna Lemke.
(00:23):
Wow.
She gives us so much wisdomabout how addiction works and
what it looks like to break freethrough resetting your brain's
dopamine levels.
She makes neuroscience andresearch really easy to
understand.
Her book, Dopamine Nation, isfantastic.
(00:43):
It also has a companion, theDopamine Nation workbook.
And I would highly recommendboth.
I think Anna's voice isprophetic, frankly, for our
culture, for our time, where wehave 24-7 access to drugified
digital devices that she callsmasturbation machines.
(01:05):
And she's also incrediblyvulnerable in sharing her own
personal story of becomingaddicted to erotic novels.
I think you guys are going toresonate with her and learn a
lot.
Enjoy the episode.
Welcome to Hudson Material.
I have been looking forward tothis conversation literally for
years, hoping that I would getthe chance to interview Anna
Lemke.
She is the author of DopamineNation and the Dopamine Nation
(01:28):
workbook.
And it's all about findingbalance in an age of indulgence,
which is so important for us,for everyone, but especially for
anyone who wants freedom fromporn.
So welcome to the show.
SPEAKER_01 (01:42):
Thank you for having me.
I love the title of yourpodcast, by the way.
I think it's great.
SPEAKER_00 (01:46):
When I read your book, I was really moved that
you decided to be vulnerable andshare some of your personal
story as it relates toaddiction.
What did that look like for you?
SPEAKER_01 (01:57):
Well, thank you for saying that.
It was hard to share, but acouple things tipped me over.
First of all, I felt like Icouldn't reasonably ask my par
my patients to share theirstories, you know, to let me
share their stories in the bookand not also be willing to share
mine.
And also I have learned over theyears, again, mostly from my
(02:18):
patients, that when we share apart of ourselves and make
ourselves vulnerable, like wethink that people are going to
be grossed out, but you know, infact, the opposite happens and
it really draws people in.
We see our own humanity, our ownbrokenness.
So I know, I know how healingthat can be, having been on the
(02:39):
receiving end of other peoplesharing with me in a
professional context, but alsooutside of that context.
So yeah, that that's why Idecided to do it.
SPEAKER_00 (02:48):
For anyone who hasn't read your book, what is
your personal story?
SPEAKER_01 (02:53):
Okay.
So let's go back about 15 yearsnow.
I had just weaned my fourthchild, and I wasn't going to
have any more children.
Uh, that was something that myuh husband made clear.
And I kind of experienced a sortof a grief reaction, you know,
to sort of that being the end ofmy fertility, so to speak.
(03:16):
And in that context, I think Iwas trying to fill a sort of an
emptiness.
I've always been a reader.
That's always been, you know, myrefuge.
And someone recommended that Iread uh the Twilight saga or
series.
And so I was like, okay, youknow, sure, I'll give that a
(03:36):
try.
And I read it and it justtransported me in a way that I
it's hard for me to describe,but it just it just scratched an
itch that was just superpowerful.
So I read the whole four-bookseries and I read it again and
read again.
And then I kind of thought, huh,I wonder if there are any more
vampire romance novels outthere.
Turns out there's a whole lot.
(03:57):
So I started reading them moreand more.
I got a Kindle.
That basically turned me into achain reader.
I started staying up later andlater reading.
I started lying about what I wasreading, you know, which the
Kindle made possible because ofthe anonymity there.
And then I started, you know,reading in kind of really,
frankly, inappropriate placesand times.
(04:20):
Like we went on a familyvacation and instead of going to
the beach, I just stayed backand read.
We went to a neighborhoodpaella, like an outdoor cookout.
And I I literally brought a bookand found a room in their house.
And instead of attending theparty, I read romance novels.
And then sort of the, you know,the kind of clincher was I got
(04:41):
to a point where that's all Iwanted to do.
I didn't really want to be inthe real world.
I just wanted to be in myromance novels.
I started taking romance novelsto work and reading in the 10
minutes between patients, andyou know, instead of charting or
thinking, you know, reflectingon the patient and how I might
better help them.
I also started reading, youknow, more and more sort of
(05:03):
frank erotica, like the sort ofvanilla toast stuff that had
worked for me before wasn'tworking.
I, you know, I ended up in awhole genre of like
satomasochistic stuff that I hadnever been interested in, but
now somehow I needed that levelof stimulation.
And I got more and more kind ofanxious and depressed without
really linking the two things.
(05:24):
So that's kind of what happenedto me.
I I wouldn't want to trivializelike a severe life-threatening
addiction by comparing it to mylittle journey, but I share it
because I just want to highlightthat even things that we
typically think of as healthy,like reading, have essentially
become drugified.
And also, I just think it'simportant, you know, that I, as
(05:44):
like a physician and ahealthcare provider and a
psychiatrist who treatsaddiction, that even with all
that knowledge about addiction,that I could still develop this,
you know, mild addiction, Ithink is noteworthy.
SPEAKER_00 (05:57):
So many of our listeners can relate to what you
shared with porn.
And porn has become that thingfor them where consumption and
overconsumption leads tounhappiness and anhedonia.
I had never heard the wordanhedonia.
What does that mean?
SPEAKER_01 (06:17):
Yeah, so anhedonia is the essentially the inability
to take pleasure in anything atall.
It's akin to depression, butit's it's a kind of a more
extreme version of depression,where instead of there just
being sort of low interest orlow mood, there's absolute
absence of pleasure, includingin things that have historically
(06:38):
made us feel a spark of joy.
So things like, you know, let'ssay a mother no longer being
able to take joy in herchildren, whereas, you know, her
children were previously herpride and joy, or or anything
kind of along those lines.
SPEAKER_00 (06:52):
I can really resonate with that, especially
with all of the digital drugsthat we are immersed in every
day.
Why do you think that thedigital drugs and our
masturbation machines, as youcall them, are so powerful for
us?
SPEAKER_01 (07:11):
They offer the illusion of human connection
when the opposite is happening,when we are in fact becoming
more and more isolated.
You know, our brains inventeddigital media and social media.
So they're an incrediblycognitively adherent, potent
reinforcer.
It's like our brains turnedinside out on the world.
(07:32):
You know, something like alcoholor cannabis is something that
occurs in nature and mimicssomething that our brain makes.
But digital media, you know,especially videos, you know,
moving, moving images, is reallylike our brain turned inside
out.
There's no startup period forthat to be reinforcing, that's
instantly reinforcing, becauseof course we evolved to, you
(07:55):
know, observe the world, to tryto make sense of it through our
sensory experience, and thenhave that inform actions that
are important for our survival.
So digital media and socialmedia essentially hijacks that
evolutionary machinery formotivation and reward and
confuses our brains intothinking that we're engaging in
(08:16):
something that's important forsurvival, you know, meaningful
to our lives, when in fact it'sactually the opposite.
We are engaging in an activitythat pulls us further and
further from other people, fromthe things that we need to be
doing, from our values, and soon.
SPEAKER_00 (08:31):
What do you notice about porn specifically serving
that purpose?
SPEAKER_01 (08:36):
Well, what's so interesting to me about working
with um sex and pornographyaddicted people over many years
now is like how it's not evenreally about sex.
It's just so much more aboutself-soothing, numbing,
uncomfortable feelings, avoidantcoping.
And it turns out to be anincredibly powerful vehicle for
(09:02):
doing that because we're doingit with our own bodies, right?
Like as one of my patients said,you know, the his bar is in the
brain, right?
The combination ofself-stimulation, you know,
auto-stimulation of our bodiesand fantasy augmented by these
potent visual images, it's justvery powerful, very convenient,
(09:25):
you know, leading to that floodof neurotransmitters, which is
sort of this wonderful soup ofnot, you know, not just like
like a stimulant or an opioid,but all of it, like, you know,
the sort of this symphony ofneuromodulators and hormones and
neurotransmitters that just issuper reinforcing, especially
for certain individuals.
(09:46):
And, you know, remember, we'resocial creatures.
Like we are wired to connect.
It's deeply embedded within ourDNA.
It's what keeps us alive,allowing us to protect ourselves
from enemies, steward scarceresources, find mates.
And, you know, pornography andsex addiction more broadly is
really uh hijacking thatspecific pursuit and turning it
(10:09):
into something that that harmsus rather than helps us.
SPEAKER_00 (10:12):
And as you talked about meeting survival needs,
I'm thinking about sex as a as asurvival of the species.
SPEAKER_01 (10:20):
Absolutely.
Our libido is key for you knowkeeping us alive.
And yet, you know, the theparadox again is that the more
we spend auto-stimulating withpornography, and I consider you
know romance novels, erotica tobe a socially sanctioned form of
uh pornography for women,primarily for women, but not
exclusively.
(10:41):
You know, the more that we usethat vehicle or that medium to
meet our sexual, emotional,psychological needs, the less we
turn to the people in our livesto meet that, those needs, and
the more we erode thoserelationships, including our
sexual relationships.
So typically people like myself,you know, who who engage in
(11:05):
autoerotic stimulation andpornography, they don't want sex
with their partners, right?
Because the kind of controlledmicrotitration of their own
bodies that they can get withpornography is just seems
better, right?
When we're in our addiction.
It isn't obviously better in thelong run, but it's because we
(11:25):
can control it and auto-titrateit that that it's so appealing.
SPEAKER_00 (11:30):
Yeah.
Especially in a season of griefor emptiness, you know, or or
where needs that used to be metare all of a sudden really
overwhelming, or we're justalone.
SPEAKER_01 (11:46):
Yeah, yeah, so true.
And thanks for kind of bringingit back to where I started.
Because I I actually didn't makethat connection between kind of
the grief of a no morechildbearing for me until a much
later when I was sort ofthought, like, why then?
Because I'd always, you know,there the the novels had always
existed out there, but I didn'treally discover them until,
(12:07):
yeah, a time of grief andlonging and some stress between
me and my husband, you know,around my like kind of wanting
more children and him saying,no, really, four is enough,
which is perfectly reasonable.
You know, four really is good.
Four is fine.
Yeah, right.
And he's a great husband and agreat father, and he's really my
better half.
I've learned to listen to him.
But still, there was sort ofthis absence and a longing, and
(12:31):
you know, whether it's thatcomes at at a time of a breakup
from a relationship or actualmourning the death or loss of a
loved one.
It's the self-soothing piece,you know, that draws us in, but
it's so isolating, you know, ifwe overdo it.
SPEAKER_00 (12:47):
Yeah.
You've also mentioned how we canbecome addicted to pain.
And I wonder if that might bepart of it for some porn users.
SPEAKER_01 (12:59):
Interesting.
So typically with intoxicantslike pornography, you know, the
reason that they're reinforcingis because they release a lot of
dopamine all at once in thereward pathway.
You get a spike of dopamine,which, you know, combined with
other chemicals, you know, leadsto pleasure, euphoria, or at
least a release of depression,anxiety, andhedonia, what have
(13:21):
you.
But what's key to note is thatover time the brain adapts to
that increased dopamine releaseand actually downregulates
dopamine transmission so thatwe're getting less and less
dopamine with ongoing exposure.
And eventually we can end up inthis chronic dopamine deficit
state where we don't get anypleasure at all from our drug of
(13:42):
choice, but we still feelcompelled to repeat the behavior
just to feel normal and bringour mood back to baseline.
And it's that's sometimesreferred to as dysphoria-driven
relapse.
But I think that's reallyimportant to understand that
what initially actually iseffective, you know, in
(14:03):
relieving psychological and orphysical pain ultimately isn't
effective, stops working, andthen can turn on us and do the
opposite and and make that painworse.
And that that's then like agrief reaction around that,
right?
Like, hey, my drug's not evenworking anymore, right?
But now I can't even stop it.
SPEAKER_00 (14:25):
It's so heartbreaking.
SPEAKER_01 (14:26):
Yeah.
SPEAKER_00 (14:27):
You have not only described these problems, but
also charted a path out.
And I think it's probably thelongest acronym I've ever seen.
Not very useful at the end ofthe day.
Dopamine.
D-O-P-A-M-I-N-E.
SPEAKER_01 (14:46):
That's it.
SPEAKER_00 (14:47):
I don't know if we can go through all of those, but
one that stood out to me wasabstinence.
SPEAKER_01 (14:52):
Yeah.
SPEAKER_00 (14:53):
And when I was growing up, abstinence education
was all about cutting off anykind of sexual activity to avoid
either like the wrath of God ora sexually transmitted disease
or something.
So I think that word abstinencekind of has a negative
connotation for some of us,maybe who grew up in purity
(15:13):
culture, but the way you frameit is a dopamine fast of like
counterintuitively removingthings that are pleasurable,
things that are stimulating,things that we've depended on
and taking the leap of faith tojump off of this thing I've been
(15:36):
I've been using to regulatemyself and and to go without it
for like a month or a couplemonths.
Am I getting that right?
SPEAKER_01 (15:44):
Yeah, absolutely.
So I think I'm reading betweenthe lines, I'm getting what
piece about this was helpful toyou.
Typically, when we think aboutdenying ourselves something that
we think of as pleasurable, oryou know, abstaining from
something that we think ashelpful or pleasurable, it feels
like we're removing somethingpositive and kind of punishing
(16:05):
ourselves.
But what I try to communicate isthe reframe that we're actually
doing something really positivefor ourselves.
Because when we get in theaddiction vortex, those
addictive behaviors and thechanges that they manifest, you
know, in our brains actually iswhat is making us anhedonic, you
(16:26):
know, unable to experiencepleasure, not only in the
addictive behavior, but inanything at all.
Whereas if we can abstain forlong enough for our brains to
get the message that we're nolonger getting this fire hose of
dopamine from this exogenoussubstance or behavior, our
brains will go, oh, okay, I needto start and make more dopamine.
I need to upregulate mypostsynaptic dopamine receptors.
(16:47):
I need to get things going againin my brain's dopamine factory
so that, you know, we can getback to baseline because we
always have kind of a baselinelevel of dopamine firing.
And so I think that reframe iscritical because our whole
culture is infused with thisnotion that if I'm not
comfortable 24-7 and not like ifI'm not euphoric, basically
(17:09):
something's wrong with my lifeor my job or my spouse or my
brain, I'm ill.
But in fact, we were wired forsuffering.
We are wired for friction.
And, you know, a certain degreeof friction is good for us.
And if we overdo the pleasurestuff, which is really easy to
do now in our drug-ified world,our brains actually are don't
(17:31):
know what to do with all of thatand end up in this dopamine
deficit state, which is reallyakin to a clinical depression.
So by abstaining for four weeks,which is the average amount of
time it takes for people tostart to feel better, what we're
doing is something reallypositive for ourselves, because
you know, it'll improve ourmood, our anxiety, our sleep.
We'll get outs outside of thatvortex of craving, we'll be able
(17:54):
to get our frontal lobes onlineand see true cause and effect
and all those good things.
Now, not everybody feels betterafter a month of abstinence, but
I am amazed by how manypatients, no matter the
chronicity, severity, or type ofdrug that they're using, with a
month of abstinence from theiraddictive behaviors, really do
(18:16):
note marked improvement insocial, emotional, and
psychological well-being.
You know, that's what compelledme to write the book because
it's it's just remarkable.
I do not get that kind of signalwith any antidepressant or mood
stabilizer or anxiolytic that Iprescribe.
Even psychotherapy doesn't workthat well that quickly, but a
(18:38):
month of abstinence, it's it'sreally impressive how people
kind of come out of you knowserious doldrums and feel
better.
SPEAKER_00 (18:46):
This is about getting my life back.
Not about giving up what I love.
SPEAKER_01 (18:53):
Exactly.
SPEAKER_00 (18:54):
Yeah.
SPEAKER_01 (18:54):
Exactly.
Now, a a huge warning that youknow has to come with an
experiment of fasting orabstinence is that we will feel
worse before we feel better.
And if people don't know thatgoing into it, they're not gonna
make it because they're gonnathink, well, I can't live like
this.
This is worse than I feltbefore.
But the reason is because we'rein that dopamine deficit state.
(19:16):
We take away our drug of choice.
It takes a while for our brainto realize that it needs to
start upregulating dopaminetransmission.
Um, it doesn't happen rightaway.
And in the meantime, our brainis like gonna make us feel
miserable to get us to reach formore of our drug.
But if we can make it to about14 days, really, people
definitely, the majority ofpeople note, okay, I'm actually,
(19:38):
I feel like I'm feeling a littlebit better.
I'm not constantly craving.
The craving actually getsbetter, you know, stuff like
that.
And when I gave up romancenovels, I was just amazed at the
extent of the withdrawal that Iexperienced.
Because I I didn't really think,I thought, well, I'll give it
up, but I really didn't think Iwas addicted or, you know, had
any kind of physiologicdependency.
(19:58):
I was at the time at exactlybecause our brains are kind of
like little alarm clocks when itcomes to our drug of choice.
We're fine until we get to thatmoment when we would normally
use.
And then it's like ding dingding ding, you need to use right
now.
And when I got to the evening,you know, kind of going to bed,
sleep time, and like I didn'tread a remote cell.
I mean, my brain was just goingnuts.
And I was up, you know, in thefirst two weeks, I was up really
(20:20):
late, terrible restlessness,insomnia.
I was, I was impressed at howhard it was.
SPEAKER_00 (20:26):
I can relate to that.
This is an intense experience,and our brain is trying to reset
that balance.
SPEAKER_01 (20:35):
Exactly.
SPEAKER_00 (20:36):
I'm imagining that some listeners might be
thinking, well, I've been tryingto give up porn for that long.
It's just not working.
And I would be really curious tohear your thoughts on the
strategy of getting a specialdevice like a dumb phone instead
of a smartphone, in order to tryto create that space between
(20:59):
porn and normal everyday life.
SPEAKER_01 (21:02):
Yeah.
So that's what I call aself-binding strategy.
And self-binding is superimportant.
Way too many people try to,number one, go it alone.
And number two, rely onwillpower alone.
And the truth of the matter isthat willpower is not an
infinite resource.
We wake up in the morning withmore willpower than we'll have
in the rest of the day.
But by the end of the day, ifwe're tired and stressed and
(21:24):
having to like constantly resistour cravings, that willpower
runs out.
And as soon as it does, we'reusing again.
So what we need to do is createboth literal and metacognitive
barriers between ourselves andour drug of choice so that we
can press the pause buttonbetween desire and consumption.
Self-binding strategies come inmany different forms.
(21:45):
There's physical self-bindingwhere we actually create a
physical space between ourselvesand our drug, like deleting the
apps, right?
Or getting a dumb phone where wecan't have 24-7 mobile access to
the internet, or getting rid of,you know, the phone entirely and
relying more on, you know, Idon't know, our our laptops and,
(22:06):
you know, all kinds of ways wecan do that.
I even had a patient whoactually locked up all his
devices in a in like a bankvault, so he couldn't access
them for a month.
That that's what he had to do.
Now, for most folks, it's notthat extreme.
And we can combine it with otherself-binding strategies.
You know, another reallyimportant self-binding
strategies is what I callmeaning, which is basically
(22:28):
thinking about our values andgoals and trying to live in
accordance with those.
And so every time we think aboutour behaviors, is this in
accordance with my values andgoals?
Not in a punitive, shaming,self-judging way, but in a
compassionate, self-forgiving,forward-looking way.
You know, how do I want to livemy life?
Other people are a huge sourceof self-binding.
(22:48):
We we massively co-regulate withother people.
We can, you know, use thoserelationships in a positive way
to help us not use our drug ofchoice.
So I've seen a lot of folks withpornography actually give a
loved one an ability to monitor,you know, what they're doing.
I forget the name of the variousapps, but you know, in the right
kind of relationship where bothvoluntarily and willingly engage
(23:12):
in that kind of monitoring, thatcan be super helpful.
Or really 12-step groups andother mutual help groups like
sex and pornography addictsanonymous, sex a holics
anonymous, sex addictsanonymous.
There are a lot of differentflavors, but those can be
transformational, those groups,because then we're not doing it
alone.
We're, you know, we'reco-regulating with other people.
And then finally, we do havemedications.
(23:34):
Now, there is no FDA-approvedmedication specifically for sex
and pornography addiction, butsometimes we use the SSRIs,
which are antidepressants thathave as a side effect, they
decrease libido.
That can be very helpful forfolks with sex and pornography
addiction.
Sometimes we use naltrexone,which is an opioid receptor
blocker, FDA approved foralcohol addiction and opioid
(23:56):
addiction, but I've seen it bevery helpful in some individuals
with sex and pornographyaddiction.
There are even studies lookingat the GLP1s like Ozempic to
help people with sex andpornography addiction.
Ozempic works, most likely worksby decreasing the amount of
dopamine that's released in thenucleus accumbens, the reward
pathway in response toappetitive foods.
(24:18):
So, you know, who knows?
It may do something similar inin other contexts, and it's
being actively studied in thosecontexts.
You know, lots of differentideas.
But the main thing is to not tryto just go it alone, but to
reach out, get help, gettogether with other people
struggling with the same thing.
Your podcast is, you know, agreat, a great example of sort
of people helping other peoplewith the same problem.
SPEAKER_00 (24:39):
Yeah.
And in our community, I see menconnecting with each other
almost every day through whatyou call pro-social shame.
SPEAKER_01 (24:50):
Yeah.
SPEAKER_00 (24:51):
What is pro-social shame?
SPEAKER_01 (24:53):
Okay, so shame is, you know, a gut punch of an
emotion where we realize that wehave transgressed social norms,
often accompanied by the fear ofabandonment, which is
terrifying.
The idea that we would beshunned, kicked out of the
tribe, you know, left alone todie, whether metaphorically or
or literally.
So shame is probably one of theoldest emotions.
(25:15):
And it's fundamentally apro-social emotion, meaning that
we need to feel shame in orderto be able to live together in
communities and to make acivilization.
If we didn't feel shame fortransgressing, you know, group
norms, it would never work,right?
And though those norms, youknow, will change to some extent
(25:38):
across cultures and timeperiods.
But, you know, really, inessence, they're sort of like
the same big picture groupnorms, like let's be kind, let's
not cheat, lie, steal, you know,let's not kill each other.
So shame's important.
It has to be there.
But what can happen in addictionis that we're so overwhelmed by
our shame, and it becomes such atolerable emotion in and of
(26:01):
itself that it actuallyperpetuates and drives the
addiction.
And then we're dealing withdestructive shame, toxic shame,
malignant shame, where it'sactually perpetuating the
problem.
And that's not good.
So we've got to get out of thatloop of toxic shame and into the
loop of prosocial shame.
And one of the main ways to dothat is actually to open up to
(26:26):
another human being and tell thetruth.
But it's got to be somebody whowe trust and who we know
understands and who gives uslike a to-do list for how to not
do that behavior anymore.
So it can't just be like, I'mgonna tell you about this and
then I move on and keep doingit.
It's really connected to thisidea that I'm gonna tell you
(26:46):
this.
That's gonna welcome me intothis group, which is defined by
forgiving this behavior andproviding a pathway for
recovery.
And that's essentially what youknow, mutual recovery, mutual
help is the 12 steps ofsexualics anonymous is it's a
roadmap for post-shame recovery.
SPEAKER_00 (27:07):
Yeah.
I find that if I'm feeling shameabout something, big or small,
if I share it with a friend or asafe group and I'm radically
honest, it creates deeperconnection.
SPEAKER_01 (27:22):
Totally.
SPEAKER_00 (27:23):
Those are the closest friendships I have.
SPEAKER_01 (27:25):
Absolutely.
Those are our real safe spaces,right?
Where we know we're loved, youknow, warts and all, warts and
all so important.
And the other really interestingthing that I learned from my own
many patients, my ownexperience, that we really hide
hide from our shame.
We're ashamed of our shame.
So we it doesn't always manifestas shame.
(27:46):
And what I learned from onepatient uh in particular was
that shame can often masqueradeas resentment, which I think is
so interesting.
You know, that we can end uplike being angry and resentful
at people who we associate withour shame instead of just really
tapping into our shame.
SPEAKER_00 (28:05):
I can see that happening in a couple
relationship quite easily.
SPEAKER_01 (28:11):
Yeah, for sure.
SPEAKER_00 (28:12):
So I hear you saying that shame is not necessarily
bad.
What matters is what we do withit, and hopefully we use it to
be radically honest and connect.
SPEAKER_01 (28:23):
Yeah, I mean, shame feels bad, like it feels
horrible, but it's importantinformation.
We can't ignore our shame.
When we when we feel shame, weneed to say, oh, okay, what you
know, what's happening, what'sgoing on there?
And instead of you know engagingin avoidant coping by doing our
behaviors and running away fromit, we have to really enter into
(28:44):
it.
SPEAKER_00 (28:45):
So if I avoid shame, it's probably gonna drive me
back to addiction somehow.
SPEAKER_01 (28:48):
Yeah, exactly.
SPEAKER_00 (28:50):
You've worked with so many patients and helped so
many people.
What's one of your favoritestories that reminds you why you
do this work?
SPEAKER_01 (28:59):
Gosh, there are so many.
I guess one that comes to mindright now is a Stanford student
who uh was struggling with analcohol use disorder, who got
into recovery from her alcoholuse disorder and engaged in, you
know, the recovery community atStanford and just really
embraced recovery and herselfended, ended up helping so many
(29:23):
people.
And it was just a joy to seethat.
And she just like lived in thisstate of gratitude, which I had
really admired.
She was just so grateful for herown recovery, so so humbled by
it, such as such a good person.
But what was the one of the mostmemorable and interesting things
was that when it came time forher to you know leave Stanford
and move on, she and I had ourlast appointment together.
(29:45):
And as usual, she expressed aton of gratitude.
And I was like, I'm just witnessto your journey, you know.
But she was so sweet.
She said, You know, you helpedme so much.
And then she said to me, and onething I never told you, but
which I you know learned.
About from your book or realizedfrom your book was that I
actually had a pornography, havehad a pornography addiction that
(30:06):
started when she was very young,like five or six years old.
She was living in a house with abunch of older siblings.
So there was early exposure.
And it was just a moment for mebecause I thought, wow, I've
been treating this person forfour years, and we've talked
about a lot of things.
And yet it wasn't until you knowher the term termination visit
(30:30):
that she finally was able totalk about her pornography
addiction, which just speaks tohow shameful it can be for
people, even people dealing withother types of addictions.
Somehow bringing up thatpornography addiction just like
is just so hard.
And I I get it.
unknown (30:50):
Yeah.
SPEAKER_00 (30:51):
For me, one of the most powerful concepts you
teach, and one of the hardestones for me to communicate is
the idea of the pleasure-painbalance, like a seesaw.
SPEAKER_01 (31:06):
Can you explain how that works?
Sure.
So this is a metaphor for kindof how we process pleasure and
fit and pain.
It's informed by theneuroscience, but also by the
clinical science and clinicalobservation.
And basically, it comes fromscience showing that pain and
pleasure are co-located in thebrain, right?
So imagine that in your rewardpathway, there's something like
(31:27):
a teeter-totter in a kid'splayground.
When we experience pleasure, ittips to one side, pain, it tips
to the other.
And that's obviously anoversimplification because we
can experience pleasure and painat the same time, like when
we're eating spicy food.
But in general, pleasure andpain do work through this what's
called an opponent processmechanism.
(31:48):
And to understand what happensin addiction, you have to
understand that there arecertain rules governing this
pleasure and pain balance.
And the first and most importantone is that the balance wants to
remain level, or what scientistscall homeostasis.
So what is homeostasis?
Homeostasis is a discrete numberof states that an organism must
(32:12):
remain within in order tomaintain survival.
Temperature is a great example.
Like we can get hotter and wecan get colder, but if we get
too cold for too long or too hotfor too long, we're gonna die.
And the same thing is true withour pleasure-pain processing,
right?
So we can experience pleasure,but too much pleasure stretches
(32:34):
our brains too far, too muchpain stretches our brains too
far.
So one of the rules, again, themain rule governing this balance
is that we, with any deviationfrom neutrality, our brains are
going to work very hard toreturn back to a level balance,
back to homeostasis.
And the way that our brains dothat is by tilting an equal and
opposite amount to whatever theinitial stimulus is.
(32:57):
So when we do somethingpleasurable, that releases
dopamine in the reward pathway,tilts our brain to the side of
pleasure, but then the brainadapts by downregulating
dopamine transmission.
I imagine that as these gremlinshopping on the pain side of the
balance to bring them levelagain.
But the gremlins don't get offas soon as the balance is level.
They stay on until we're tiltedand equal and opposite amount to
(33:18):
the side of pain.
That is the hangover, the calmdown, or just that moment of
craving, you know, wanting to doit one more time, even though we
told ourselves this would be theend.
Now, if we wait long enoughwithout repeating that behavior,
those gremlins hop off andhomeostasis is restored and the
craving goes away.
(33:39):
But with repeated exposure toour drug of choice over days to
weeks to months to years, whathappens is that dopamine spike
gets less and less.
That deflection to the pleasureside gets weaker and shorter in
duration, but the gremlinsmultiply until we have so many
gremlins on the pain side of thebalance that they fill this
(33:59):
whole room.
Now we've entered into addictedbrain.
We've changed our joy set point,right?
And now we need to do ourbehavior not to like get relief
from anxiety or to feelpleasure, but just to level the
balance and feel normal.
And that is the state that we'rein, you know, when we're in an
(34:20):
addiction.
SPEAKER_00 (34:21):
That was mind-blowing for me.
That it's not primarily abouttrying to be happy, but trying
to get back to homeostasis.
SPEAKER_01 (34:28):
Right, exactly.
SPEAKER_00 (34:30):
I wonder if that's one of the reasons why having a
great day can be such a trigger.
SPEAKER_01 (34:35):
Ah, love it.
We typically think of peoplerelapsing when they're under a
lot of stress, but that's nottrue for everybody.
For some people, stress isactually a way to keep them on
the straight and narrow.
It's like, okay, you know, I'min survival mode.
I can't use it, I gotta be onit.
You know, they're likeadrenalized, and the adrenaline
actually helps them engage inhealthier behaviors.
(34:58):
And that's really interestingbecause those are the very same
people that when things aregoing well in their life, that's
when they're vulnerable torelapse.
Because it's like, oh,everything is going well, you
know, I can relax, I can let myguard down, you know, let's
let's lower the bridge over themoat, it's all good.
And that's when they're, youknow, they're vulnerable to
(35:19):
relapse.
So we really have to figure outlike which of those categories
we're in.
And I know for me, I'm a like,okay, when there's stress, I am
less likely to engage in myaddictive behaviors.
But when things are going welland I kind of relax, that's when
I'm really vulnerable.
SPEAKER_00 (35:37):
Yeah, I resonate with that too, and so many
others do.
In order to really understandour own addiction system and to
make progress toward freedom, Iwould highly recommend not just
the book Dopamine Nation, butalso the workbook.
It's really well done.
SPEAKER_01 (35:55):
Thank you.
SPEAKER_00 (35:56):
If you all would like to get a copy of the book
andor the workbook, go down tothe links in the show notes.
You can also find Dr.
Lumke's website to connect withher.
Anna, what is your favoritething about freedom?
SPEAKER_01 (36:10):
I think freedom gives us the ability to choose
well.
It's not just that we have thefreedom to choose, it's that we
have the freedom to choose well.
SPEAKER_00 (36:21):
In other words, it's not just freedom from something,
it's freedom for something.
SPEAKER_01 (36:27):
Yeah.
And it's freedom for the kindsof values that we know, you
know, at the bottom of ourhearts are consistent with a
flourishing life and with the,you know, the improvement, not
just of ourselves, but of oflike humankind more broadly.
Awesome.
SPEAKER_00 (36:47):
Well, thank you so much for being with us and for
being part of making our worldmore like that.
SPEAKER_01 (36:54):
Thank you.
SPEAKER_00 (36:56):
So, for anyone who's listening, thank you so much,
even just for taking the risk toengage with this.
And I hope you have people whocan witness you on your journey.
That's a big part of why HusbandMaterial exists.
And always remember you areGod's beloved son, and you, he
is well pleased.
Welcome to the Husband Material podcast, where
we help Christian men outgrowporn.
Why?
So you can change your brain,heal your heart, and save your
relationship.
My name is Drew Boa, and I'mhere to show you how.
Let's go.
Thank you for listening to myinterview with Anna Lemke.
(00:23):
Wow.
She gives us so much wisdomabout how addiction works and
what it looks like to break freethrough resetting your brain's
dopamine levels.
She makes neuroscience andresearch really easy to
understand.
Her book, Dopamine Nation, isfantastic.
(00:43):
It also has a companion, theDopamine Nation workbook.
And I would highly recommendboth.
I think Anna's voice isprophetic, frankly, for our
culture, for our time, where wehave 24-7 access to drugified
digital devices that she callsmasturbation machines.
(01:05):
And she's also incrediblyvulnerable in sharing her own
personal story of becomingaddicted to erotic novels.
I think you guys are going toresonate with her and learn a
lot.
Enjoy the episode.
Welcome to Hudson Material.
I have been looking forward tothis conversation literally for
years, hoping that I would getthe chance to interview Anna
Lemke.
She is the author of DopamineNation and the Dopamine Nation
(01:28):
workbook.
And it's all about findingbalance in an age of indulgence,
which is so important for us,for everyone, but especially for
anyone who wants freedom fromporn.
So welcome to the show.
SPEAKER_01 (01:42):
Thank you for having me.
I love the title of yourpodcast, by the way.
I think it's great.
SPEAKER_00 (01:46):
When I read your book, I was really moved that
you decided to be vulnerable andshare some of your personal
story as it relates toaddiction.
What did that look like for you?
SPEAKER_01 (01:57):
Well, thank you for saying that.
It was hard to share, but acouple things tipped me over.
First of all, I felt like Icouldn't reasonably ask my par
my patients to share theirstories, you know, to let me
share their stories in the bookand not also be willing to share
mine.
And also I have learned over theyears, again, mostly from my
(02:18):
patients, that when we share apart of ourselves and make
ourselves vulnerable, like wethink that people are going to
be grossed out, but you know, infact, the opposite happens and
it really draws people in.
We see our own humanity, our ownbrokenness.
So I know, I know how healingthat can be, having been on the
(02:39):
receiving end of other peoplesharing with me in a
professional context, but alsooutside of that context.
So yeah, that that's why Idecided to do it.
SPEAKER_00 (02:48):
For anyone who hasn't read your book, what is
your personal story?
SPEAKER_01 (02:53):
Okay.
So let's go back about 15 yearsnow.
I had just weaned my fourthchild, and I wasn't going to
have any more children.
Uh, that was something that myuh husband made clear.
And I kind of experienced a sortof a grief reaction, you know,
to sort of that being the end ofmy fertility, so to speak.
(03:16):
And in that context, I think Iwas trying to fill a sort of an
emptiness.
I've always been a reader.
That's always been, you know, myrefuge.
And someone recommended that Iread uh the Twilight saga or
series.
And so I was like, okay, youknow, sure, I'll give that a
(03:36):
try.
And I read it and it justtransported me in a way that I
it's hard for me to describe,but it just it just scratched an
itch that was just superpowerful.
So I read the whole four-bookseries and I read it again and
read again.
And then I kind of thought, huh,I wonder if there are any more
vampire romance novels outthere.
Turns out there's a whole lot.
(03:57):
So I started reading them moreand more.
I got a Kindle.
That basically turned me into achain reader.
I started staying up later andlater reading.
I started lying about what I wasreading, you know, which the
Kindle made possible because ofthe anonymity there.
And then I started, you know,reading in kind of really,
frankly, inappropriate placesand times.
(04:20):
Like we went on a familyvacation and instead of going to
the beach, I just stayed backand read.
We went to a neighborhoodpaella, like an outdoor cookout.
And I I literally brought a bookand found a room in their house.
And instead of attending theparty, I read romance novels.
And then sort of the, you know,the kind of clincher was I got
(04:41):
to a point where that's all Iwanted to do.
I didn't really want to be inthe real world.
I just wanted to be in myromance novels.
I started taking romance novelsto work and reading in the 10
minutes between patients, andyou know, instead of charting or
thinking, you know, reflectingon the patient and how I might
better help them.
I also started reading, youknow, more and more sort of
(05:03):
frank erotica, like the sort ofvanilla toast stuff that had
worked for me before wasn'tworking.
I, you know, I ended up in awhole genre of like
satomasochistic stuff that I hadnever been interested in, but
now somehow I needed that levelof stimulation.
And I got more and more kind ofanxious and depressed without
really linking the two things.
(05:24):
So that's kind of what happenedto me.
I I wouldn't want to trivializelike a severe life-threatening
addiction by comparing it to mylittle journey, but I share it
because I just want to highlightthat even things that we
typically think of as healthy,like reading, have essentially
become drugified.
And also, I just think it'simportant, you know, that I, as
(05:44):
like a physician and ahealthcare provider and a
psychiatrist who treatsaddiction, that even with all
that knowledge about addiction,that I could still develop this,
you know, mild addiction, Ithink is noteworthy.
SPEAKER_00 (05:57):
So many of our listeners can relate to what you
shared with porn.
And porn has become that thingfor them where consumption and
overconsumption leads tounhappiness and anhedonia.
I had never heard the wordanhedonia.
What does that mean?
SPEAKER_01 (06:17):
Yeah, so anhedonia is the essentially the inability
to take pleasure in anything atall.
It's akin to depression, butit's it's a kind of a more
extreme version of depression,where instead of there just
being sort of low interest orlow mood, there's absolute
absence of pleasure, includingin things that have historically
(06:38):
made us feel a spark of joy.
So things like, you know, let'ssay a mother no longer being
able to take joy in herchildren, whereas, you know, her
children were previously herpride and joy, or or anything
kind of along those lines.
SPEAKER_00 (06:52):
I can really resonate with that, especially
with all of the digital drugsthat we are immersed in every
day.
Why do you think that thedigital drugs and our
masturbation machines, as youcall them, are so powerful for
us?
SPEAKER_01 (07:11):
They offer the illusion of human connection
when the opposite is happening,when we are in fact becoming
more and more isolated.
You know, our brains inventeddigital media and social media.
So they're an incrediblycognitively adherent, potent
reinforcer.
It's like our brains turnedinside out on the world.
(07:32):
You know, something like alcoholor cannabis is something that
occurs in nature and mimicssomething that our brain makes.
But digital media, you know,especially videos, you know,
moving, moving images, is reallylike our brain turned inside
out.
There's no startup period forthat to be reinforcing, that's
instantly reinforcing, becauseof course we evolved to, you
(07:55):
know, observe the world, to tryto make sense of it through our
sensory experience, and thenhave that inform actions that
are important for our survival.
So digital media and socialmedia essentially hijacks that
evolutionary machinery formotivation and reward and
confuses our brains intothinking that we're engaging in
(08:16):
something that's important forsurvival, you know, meaningful
to our lives, when in fact it'sactually the opposite.
We are engaging in an activitythat pulls us further and
further from other people, fromthe things that we need to be
doing, from our values, and soon.
SPEAKER_00 (08:31):
What do you notice about porn specifically serving
that purpose?
SPEAKER_01 (08:36):
Well, what's so interesting to me about working
with um sex and pornographyaddicted people over many years
now is like how it's not evenreally about sex.
It's just so much more aboutself-soothing, numbing,
uncomfortable feelings, avoidantcoping.
And it turns out to be anincredibly powerful vehicle for
(09:02):
doing that because we're doingit with our own bodies, right?
Like as one of my patients said,you know, the his bar is in the
brain, right?
The combination ofself-stimulation, you know,
auto-stimulation of our bodiesand fantasy augmented by these
potent visual images, it's justvery powerful, very convenient,
(09:25):
you know, leading to that floodof neurotransmitters, which is
sort of this wonderful soup ofnot, you know, not just like
like a stimulant or an opioid,but all of it, like, you know,
the sort of this symphony ofneuromodulators and hormones and
neurotransmitters that just issuper reinforcing, especially
for certain individuals.
(09:46):
And, you know, remember, we'resocial creatures.
Like we are wired to connect.
It's deeply embedded within ourDNA.
It's what keeps us alive,allowing us to protect ourselves
from enemies, steward scarceresources, find mates.
And, you know, pornography andsex addiction more broadly is
really uh hijacking thatspecific pursuit and turning it
(10:09):
into something that that harmsus rather than helps us.
SPEAKER_00 (10:12):
And as you talked about meeting survival needs,
I'm thinking about sex as a as asurvival of the species.
SPEAKER_01 (10:20):
Absolutely.
Our libido is key for you knowkeeping us alive.
And yet, you know, the theparadox again is that the more
we spend auto-stimulating withpornography, and I consider you
know romance novels, erotica tobe a socially sanctioned form of
uh pornography for women,primarily for women, but not
exclusively.
(10:41):
You know, the more that we usethat vehicle or that medium to
meet our sexual, emotional,psychological needs, the less we
turn to the people in our livesto meet that, those needs, and
the more we erode thoserelationships, including our
sexual relationships.
So typically people like myself,you know, who who engage in
(11:05):
autoerotic stimulation andpornography, they don't want sex
with their partners, right?
Because the kind of controlledmicrotitration of their own
bodies that they can get withpornography is just seems
better, right?
When we're in our addiction.
It isn't obviously better in thelong run, but it's because we
(11:25):
can control it and auto-titrateit that that it's so appealing.
SPEAKER_00 (11:30):
Yeah.
Especially in a season of griefor emptiness, you know, or or
where needs that used to be metare all of a sudden really
overwhelming, or we're justalone.
SPEAKER_01 (11:46):
Yeah, yeah, so true.
And thanks for kind of bringingit back to where I started.
Because I I actually didn't makethat connection between kind of
the grief of a no morechildbearing for me until a much
later when I was sort ofthought, like, why then?
Because I'd always, you know,there the the novels had always
existed out there, but I didn'treally discover them until,
(12:07):
yeah, a time of grief andlonging and some stress between
me and my husband, you know,around my like kind of wanting
more children and him saying,no, really, four is enough,
which is perfectly reasonable.
You know, four really is good.
Four is fine.
Yeah, right.
And he's a great husband and agreat father, and he's really my
better half.
I've learned to listen to him.
But still, there was sort ofthis absence and a longing, and
(12:31):
you know, whether it's thatcomes at at a time of a breakup
from a relationship or actualmourning the death or loss of a
loved one.
It's the self-soothing piece,you know, that draws us in, but
it's so isolating, you know, ifwe overdo it.
SPEAKER_00 (12:47):
Yeah.
You've also mentioned how we canbecome addicted to pain.
And I wonder if that might bepart of it for some porn users.
SPEAKER_01 (12:59):
Interesting.
So typically with intoxicantslike pornography, you know, the
reason that they're reinforcingis because they release a lot of
dopamine all at once in thereward pathway.
You get a spike of dopamine,which, you know, combined with
other chemicals, you know, leadsto pleasure, euphoria, or at
least a release of depression,anxiety, andhedonia, what have
(13:21):
you.
But what's key to note is thatover time the brain adapts to
that increased dopamine releaseand actually downregulates
dopamine transmission so thatwe're getting less and less
dopamine with ongoing exposure.
And eventually we can end up inthis chronic dopamine deficit
state where we don't get anypleasure at all from our drug of
(13:42):
choice, but we still feelcompelled to repeat the behavior
just to feel normal and bringour mood back to baseline.
And it's that's sometimesreferred to as dysphoria-driven
relapse.
But I think that's reallyimportant to understand that
what initially actually iseffective, you know, in
(14:03):
relieving psychological and orphysical pain ultimately isn't
effective, stops working, andthen can turn on us and do the
opposite and and make that painworse.
And that that's then like agrief reaction around that,
right?
Like, hey, my drug's not evenworking anymore, right?
But now I can't even stop it.
SPEAKER_00 (14:25):
It's so heartbreaking.
SPEAKER_01 (14:26):
Yeah.
SPEAKER_00 (14:27):
You have not only described these problems, but
also charted a path out.
And I think it's probably thelongest acronym I've ever seen.
Not very useful at the end ofthe day.
Dopamine.
D-O-P-A-M-I-N-E.
SPEAKER_01 (14:46):
That's it.
SPEAKER_00 (14:47):
I don't know if we can go through all of those, but
one that stood out to me wasabstinence.
SPEAKER_01 (14:52):
Yeah.
SPEAKER_00 (14:53):
And when I was growing up, abstinence education
was all about cutting off anykind of sexual activity to avoid
either like the wrath of God ora sexually transmitted disease
or something.
So I think that word abstinencekind of has a negative
connotation for some of us,maybe who grew up in purity
(15:13):
culture, but the way you frameit is a dopamine fast of like
counterintuitively removingthings that are pleasurable,
things that are stimulating,things that we've depended on
and taking the leap of faith tojump off of this thing I've been
(15:36):
I've been using to regulatemyself and and to go without it
for like a month or a couplemonths.
Am I getting that right?
SPEAKER_01 (15:44):
Yeah, absolutely.
So I think I'm reading betweenthe lines, I'm getting what
piece about this was helpful toyou.
Typically, when we think aboutdenying ourselves something that
we think of as pleasurable, oryou know, abstaining from
something that we think ashelpful or pleasurable, it feels
like we're removing somethingpositive and kind of punishing
(16:05):
ourselves.
But what I try to communicate isthe reframe that we're actually
doing something really positivefor ourselves.
Because when we get in theaddiction vortex, those
addictive behaviors and thechanges that they manifest, you
know, in our brains actually iswhat is making us anhedonic, you
(16:26):
know, unable to experiencepleasure, not only in the
addictive behavior, but inanything at all.
Whereas if we can abstain forlong enough for our brains to
get the message that we're nolonger getting this fire hose of
dopamine from this exogenoussubstance or behavior, our
brains will go, oh, okay, I needto start and make more dopamine.
I need to upregulate mypostsynaptic dopamine receptors.
(16:47):
I need to get things going againin my brain's dopamine factory
so that, you know, we can getback to baseline because we
always have kind of a baselinelevel of dopamine firing.
And so I think that reframe iscritical because our whole
culture is infused with thisnotion that if I'm not
comfortable 24-7 and not like ifI'm not euphoric, basically
(17:09):
something's wrong with my lifeor my job or my spouse or my
brain, I'm ill.
But in fact, we were wired forsuffering.
We are wired for friction.
And, you know, a certain degreeof friction is good for us.
And if we overdo the pleasurestuff, which is really easy to
do now in our drug-ified world,our brains actually are don't
(17:31):
know what to do with all of thatand end up in this dopamine
deficit state, which is reallyakin to a clinical depression.
So by abstaining for four weeks,which is the average amount of
time it takes for people tostart to feel better, what we're
doing is something reallypositive for ourselves, because
you know, it'll improve ourmood, our anxiety, our sleep.
We'll get outs outside of thatvortex of craving, we'll be able
(17:54):
to get our frontal lobes onlineand see true cause and effect
and all those good things.
Now, not everybody feels betterafter a month of abstinence, but
I am amazed by how manypatients, no matter the
chronicity, severity, or type ofdrug that they're using, with a
month of abstinence from theiraddictive behaviors, really do
(18:16):
note marked improvement insocial, emotional, and
psychological well-being.
You know, that's what compelledme to write the book because
it's it's just remarkable.
I do not get that kind of signalwith any antidepressant or mood
stabilizer or anxiolytic that Iprescribe.
Even psychotherapy doesn't workthat well that quickly, but a
(18:38):
month of abstinence, it's it'sreally impressive how people
kind of come out of you knowserious doldrums and feel
better.
SPEAKER_00 (18:46):
This is about getting my life back.
Not about giving up what I love.
SPEAKER_01 (18:53):
Exactly.
SPEAKER_00 (18:54):
Yeah.
SPEAKER_01 (18:54):
Exactly.
Now, a a huge warning that youknow has to come with an
experiment of fasting orabstinence is that we will feel
worse before we feel better.
And if people don't know thatgoing into it, they're not gonna
make it because they're gonnathink, well, I can't live like
this.
This is worse than I feltbefore.
But the reason is because we'rein that dopamine deficit state.
(19:16):
We take away our drug of choice.
It takes a while for our brainto realize that it needs to
start upregulating dopaminetransmission.
Um, it doesn't happen rightaway.
And in the meantime, our brainis like gonna make us feel
miserable to get us to reach formore of our drug.
But if we can make it to about14 days, really, people
definitely, the majority ofpeople note, okay, I'm actually,
(19:38):
I feel like I'm feeling a littlebit better.
I'm not constantly craving.
The craving actually getsbetter, you know, stuff like
that.
And when I gave up romancenovels, I was just amazed at the
extent of the withdrawal that Iexperienced.
Because I I didn't really think,I thought, well, I'll give it
up, but I really didn't think Iwas addicted or, you know, had
any kind of physiologicdependency.
(19:58):
I was at the time at exactlybecause our brains are kind of
like little alarm clocks when itcomes to our drug of choice.
We're fine until we get to thatmoment when we would normally
use.
And then it's like ding dingding ding, you need to use right
now.
And when I got to the evening,you know, kind of going to bed,
sleep time, and like I didn'tread a remote cell.
I mean, my brain was just goingnuts.
And I was up, you know, in thefirst two weeks, I was up really
(20:20):
late, terrible restlessness,insomnia.
I was, I was impressed at howhard it was.
SPEAKER_00 (20:26):
I can relate to that.
This is an intense experience,and our brain is trying to reset
that balance.
SPEAKER_01 (20:35):
Exactly.
SPEAKER_00 (20:36):
I'm imagining that some listeners might be
thinking, well, I've been tryingto give up porn for that long.
It's just not working.
And I would be really curious tohear your thoughts on the
strategy of getting a specialdevice like a dumb phone instead
of a smartphone, in order to tryto create that space between
(20:59):
porn and normal everyday life.
SPEAKER_01 (21:02):
Yeah.
So that's what I call aself-binding strategy.
And self-binding is superimportant.
Way too many people try to,number one, go it alone.
And number two, rely onwillpower alone.
And the truth of the matter isthat willpower is not an
infinite resource.
We wake up in the morning withmore willpower than we'll have
in the rest of the day.
But by the end of the day, ifwe're tired and stressed and
(21:24):
having to like constantly resistour cravings, that willpower
runs out.
And as soon as it does, we'reusing again.
So what we need to do is createboth literal and metacognitive
barriers between ourselves andour drug of choice so that we
can press the pause buttonbetween desire and consumption.
Self-binding strategies come inmany different forms.
(21:45):
There's physical self-bindingwhere we actually create a
physical space between ourselvesand our drug, like deleting the
apps, right?
Or getting a dumb phone where wecan't have 24-7 mobile access to
the internet, or getting rid of,you know, the phone entirely and
relying more on, you know, Idon't know, our our laptops and,
(22:06):
you know, all kinds of ways wecan do that.
I even had a patient whoactually locked up all his
devices in a in like a bankvault, so he couldn't access
them for a month.
That that's what he had to do.
Now, for most folks, it's notthat extreme.
And we can combine it with otherself-binding strategies.
You know, another reallyimportant self-binding
strategies is what I callmeaning, which is basically
(22:28):
thinking about our values andgoals and trying to live in
accordance with those.
And so every time we think aboutour behaviors, is this in
accordance with my values andgoals?
Not in a punitive, shaming,self-judging way, but in a
compassionate, self-forgiving,forward-looking way.
You know, how do I want to livemy life?
Other people are a huge sourceof self-binding.
(22:48):
We we massively co-regulate withother people.
We can, you know, use thoserelationships in a positive way
to help us not use our drug ofchoice.
So I've seen a lot of folks withpornography actually give a
loved one an ability to monitor,you know, what they're doing.
I forget the name of the variousapps, but you know, in the right
kind of relationship where bothvoluntarily and willingly engage
(23:12):
in that kind of monitoring, thatcan be super helpful.
Or really 12-step groups andother mutual help groups like
sex and pornography addictsanonymous, sex a holics
anonymous, sex addictsanonymous.
There are a lot of differentflavors, but those can be
transformational, those groups,because then we're not doing it
alone.
We're, you know, we'reco-regulating with other people.
And then finally, we do havemedications.
(23:34):
Now, there is no FDA-approvedmedication specifically for sex
and pornography addiction, butsometimes we use the SSRIs,
which are antidepressants thathave as a side effect, they
decrease libido.
That can be very helpful forfolks with sex and pornography
addiction.
Sometimes we use naltrexone,which is an opioid receptor
blocker, FDA approved foralcohol addiction and opioid
(23:56):
addiction, but I've seen it bevery helpful in some individuals
with sex and pornographyaddiction.
There are even studies lookingat the GLP1s like Ozempic to
help people with sex andpornography addiction.
Ozempic works, most likely worksby decreasing the amount of
dopamine that's released in thenucleus accumbens, the reward
pathway in response toappetitive foods.
(24:18):
So, you know, who knows?
It may do something similar inin other contexts, and it's
being actively studied in thosecontexts.
You know, lots of differentideas.
But the main thing is to not tryto just go it alone, but to
reach out, get help, gettogether with other people
struggling with the same thing.
Your podcast is, you know, agreat, a great example of sort
of people helping other peoplewith the same problem.
SPEAKER_00 (24:39):
Yeah.
And in our community, I see menconnecting with each other
almost every day through whatyou call pro-social shame.
SPEAKER_01 (24:50):
Yeah.
SPEAKER_00 (24:51):
What is pro-social shame?
SPEAKER_01 (24:53):
Okay, so shame is, you know, a gut punch of an
emotion where we realize that wehave transgressed social norms,
often accompanied by the fear ofabandonment, which is
terrifying.
The idea that we would beshunned, kicked out of the
tribe, you know, left alone todie, whether metaphorically or
or literally.
So shame is probably one of theoldest emotions.
(25:15):
And it's fundamentally apro-social emotion, meaning that
we need to feel shame in orderto be able to live together in
communities and to make acivilization.
If we didn't feel shame fortransgressing, you know, group
norms, it would never work,right?
And though those norms, youknow, will change to some extent
(25:38):
across cultures and timeperiods.
But, you know, really, inessence, they're sort of like
the same big picture groupnorms, like let's be kind, let's
not cheat, lie, steal, you know,let's not kill each other.
So shame's important.
It has to be there.
But what can happen in addictionis that we're so overwhelmed by
our shame, and it becomes such atolerable emotion in and of
(26:01):
itself that it actuallyperpetuates and drives the
addiction.
And then we're dealing withdestructive shame, toxic shame,
malignant shame, where it'sactually perpetuating the
problem.
And that's not good.
So we've got to get out of thatloop of toxic shame and into the
loop of prosocial shame.
And one of the main ways to dothat is actually to open up to
(26:26):
another human being and tell thetruth.
But it's got to be somebody whowe trust and who we know
understands and who gives uslike a to-do list for how to not
do that behavior anymore.
So it can't just be like, I'mgonna tell you about this and
then I move on and keep doingit.
It's really connected to thisidea that I'm gonna tell you
(26:46):
this.
That's gonna welcome me intothis group, which is defined by
forgiving this behavior andproviding a pathway for
recovery.
And that's essentially what youknow, mutual recovery, mutual
help is the 12 steps ofsexualics anonymous is it's a
roadmap for post-shame recovery.
SPEAKER_00 (27:07):
Yeah.
I find that if I'm feeling shameabout something, big or small,
if I share it with a friend or asafe group and I'm radically
honest, it creates deeperconnection.
SPEAKER_01 (27:22):
Totally.
SPEAKER_00 (27:23):
Those are the closest friendships I have.
SPEAKER_01 (27:25):
Absolutely.
Those are our real safe spaces,right?
Where we know we're loved, youknow, warts and all, warts and
all so important.
And the other really interestingthing that I learned from my own
many patients, my ownexperience, that we really hide
hide from our shame.
We're ashamed of our shame.
So we it doesn't always manifestas shame.
(27:46):
And what I learned from onepatient uh in particular was
that shame can often masqueradeas resentment, which I think is
so interesting.
You know, that we can end uplike being angry and resentful
at people who we associate withour shame instead of just really
tapping into our shame.
SPEAKER_00 (28:05):
I can see that happening in a couple
relationship quite easily.
SPEAKER_01 (28:11):
Yeah, for sure.
SPEAKER_00 (28:12):
So I hear you saying that shame is not necessarily
bad.
What matters is what we do withit, and hopefully we use it to
be radically honest and connect.
SPEAKER_01 (28:23):
Yeah, I mean, shame feels bad, like it feels
horrible, but it's importantinformation.
We can't ignore our shame.
When we when we feel shame, weneed to say, oh, okay, what you
know, what's happening, what'sgoing on there?
And instead of you know engagingin avoidant coping by doing our
behaviors and running away fromit, we have to really enter into
(28:44):
it.
SPEAKER_00 (28:45):
So if I avoid shame, it's probably gonna drive me
back to addiction somehow.
SPEAKER_01 (28:48):
Yeah, exactly.
SPEAKER_00 (28:50):
You've worked with so many patients and helped so
many people.
What's one of your favoritestories that reminds you why you
do this work?
SPEAKER_01 (28:59):
Gosh, there are so many.
I guess one that comes to mindright now is a Stanford student
who uh was struggling with analcohol use disorder, who got
into recovery from her alcoholuse disorder and engaged in, you
know, the recovery community atStanford and just really
embraced recovery and herselfended, ended up helping so many
(29:23):
people.
And it was just a joy to seethat.
And she just like lived in thisstate of gratitude, which I had
really admired.
She was just so grateful for herown recovery, so so humbled by
it, such as such a good person.
But what was the one of the mostmemorable and interesting things
was that when it came time forher to you know leave Stanford
and move on, she and I had ourlast appointment together.
(29:45):
And as usual, she expressed aton of gratitude.
And I was like, I'm just witnessto your journey, you know.
But she was so sweet.
She said, You know, you helpedme so much.
And then she said to me, and onething I never told you, but
which I you know learned.
About from your book or realizedfrom your book was that I
actually had a pornography, havehad a pornography addiction that
(30:06):
started when she was very young,like five or six years old.
She was living in a house with abunch of older siblings.
So there was early exposure.
And it was just a moment for mebecause I thought, wow, I've
been treating this person forfour years, and we've talked
about a lot of things.
And yet it wasn't until you knowher the term termination visit
(30:30):
that she finally was able totalk about her pornography
addiction, which just speaks tohow shameful it can be for
people, even people dealing withother types of addictions.
Somehow bringing up thatpornography addiction just like
is just so hard.
And I I get it.
unknown (30:50):
Yeah.
SPEAKER_00 (30:51):
For me, one of the most powerful concepts you
teach, and one of the hardestones for me to communicate is
the idea of the pleasure-painbalance, like a seesaw.
SPEAKER_01 (31:06):
Can you explain how that works?
Sure.
So this is a metaphor for kindof how we process pleasure and
fit and pain.
It's informed by theneuroscience, but also by the
clinical science and clinicalobservation.
And basically, it comes fromscience showing that pain and
pleasure are co-located in thebrain, right?
So imagine that in your rewardpathway, there's something like
(31:27):
a teeter-totter in a kid'splayground.
When we experience pleasure, ittips to one side, pain, it tips
to the other.
And that's obviously anoversimplification because we
can experience pleasure and painat the same time, like when
we're eating spicy food.
But in general, pleasure andpain do work through this what's
called an opponent processmechanism.
(31:48):
And to understand what happensin addiction, you have to
understand that there arecertain rules governing this
pleasure and pain balance.
And the first and most importantone is that the balance wants to
remain level, or what scientistscall homeostasis.
So what is homeostasis?
Homeostasis is a discrete numberof states that an organism must
(32:12):
remain within in order tomaintain survival.
Temperature is a great example.
Like we can get hotter and wecan get colder, but if we get
too cold for too long or too hotfor too long, we're gonna die.
And the same thing is true withour pleasure-pain processing,
right?
So we can experience pleasure,but too much pleasure stretches
(32:34):
our brains too far, too muchpain stretches our brains too
far.
So one of the rules, again, themain rule governing this balance
is that we, with any deviationfrom neutrality, our brains are
going to work very hard toreturn back to a level balance,
back to homeostasis.
And the way that our brains dothat is by tilting an equal and
opposite amount to whatever theinitial stimulus is.
(32:57):
So when we do somethingpleasurable, that releases
dopamine in the reward pathway,tilts our brain to the side of
pleasure, but then the brainadapts by downregulating
dopamine transmission.
I imagine that as these gremlinshopping on the pain side of the
balance to bring them levelagain.
But the gremlins don't get offas soon as the balance is level.
They stay on until we're tiltedand equal and opposite amount to
(33:18):
the side of pain.
That is the hangover, the calmdown, or just that moment of
craving, you know, wanting to doit one more time, even though we
told ourselves this would be theend.
Now, if we wait long enoughwithout repeating that behavior,
those gremlins hop off andhomeostasis is restored and the
craving goes away.
(33:39):
But with repeated exposure toour drug of choice over days to
weeks to months to years, whathappens is that dopamine spike
gets less and less.
That deflection to the pleasureside gets weaker and shorter in
duration, but the gremlinsmultiply until we have so many
gremlins on the pain side of thebalance that they fill this
(33:59):
whole room.
Now we've entered into addictedbrain.
We've changed our joy set point,right?
And now we need to do ourbehavior not to like get relief
from anxiety or to feelpleasure, but just to level the
balance and feel normal.
And that is the state that we'rein, you know, when we're in an
(34:20):
addiction.
SPEAKER_00 (34:21):
That was mind-blowing for me.
That it's not primarily abouttrying to be happy, but trying
to get back to homeostasis.
SPEAKER_01 (34:28):
Right, exactly.
SPEAKER_00 (34:30):
I wonder if that's one of the reasons why having a
great day can be such a trigger.
SPEAKER_01 (34:35):
Ah, love it.
We typically think of peoplerelapsing when they're under a
lot of stress, but that's nottrue for everybody.
For some people, stress isactually a way to keep them on
the straight and narrow.
It's like, okay, you know, I'min survival mode.
I can't use it, I gotta be onit.
You know, they're likeadrenalized, and the adrenaline
actually helps them engage inhealthier behaviors.
(34:58):
And that's really interestingbecause those are the very same
people that when things aregoing well in their life, that's
when they're vulnerable torelapse.
Because it's like, oh,everything is going well, you
know, I can relax, I can let myguard down, you know, let's
let's lower the bridge over themoat, it's all good.
And that's when they're, youknow, they're vulnerable to
(35:19):
relapse.
So we really have to figure outlike which of those categories
we're in.
And I know for me, I'm a like,okay, when there's stress, I am
less likely to engage in myaddictive behaviors.
But when things are going welland I kind of relax, that's when
I'm really vulnerable.
SPEAKER_00 (35:37):
Yeah, I resonate with that too, and so many
others do.
In order to really understandour own addiction system and to
make progress toward freedom, Iwould highly recommend not just
the book Dopamine Nation, butalso the workbook.
It's really well done.
SPEAKER_01 (35:55):
Thank you.
SPEAKER_00 (35:56):
If you all would like to get a copy of the book
andor the workbook, go down tothe links in the show notes.
You can also find Dr.
Lumke's website to connect withher.
Anna, what is your favoritething about freedom?
SPEAKER_01 (36:10):
I think freedom gives us the ability to choose
well.
It's not just that we have thefreedom to choose, it's that we
have the freedom to choose well.
SPEAKER_00 (36:21):
In other words, it's not just freedom from something,
it's freedom for something.
SPEAKER_01 (36:27):
Yeah.
And it's freedom for the kindsof values that we know, you
know, at the bottom of ourhearts are consistent with a
flourishing life and with the,you know, the improvement, not
just of ourselves, but of oflike humankind more broadly.
Awesome.
SPEAKER_00 (36:47):
Well, thank you so much for being with us and for
being part of making our worldmore like that.
SPEAKER_01 (36:54):
Thank you.
SPEAKER_00 (36:56):
So, for anyone who's listening, thank you so much,
even just for taking the risk toengage with this.
And I hope you have people whocan witness you on your journey.
That's a big part of why HusbandMaterial exists.
And always remember you areGod's beloved son, and you, he
is well pleased.
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