Joe Rogan Experience #1708 — Anna Lembke Transcript

Transcript

0:00 The Joe Rogan Experience. I have had problems with addiction my whole life. Yeah, a little more than 20 years ago. No. Like, what am I doing? makes a comment or just something happens so that we start to look at our behavior in a different i'm an obsessive person like i get into things the things that i like all that i just think about and so he was getting good at it it was healthy his body was getting very healthy but it was

4:46 grandparent with addiction, you are at increased risk compared to the general population of getting caretakers model using drugs and alcohol or other addictive substances or behaviors as a coping culture where people are playing a lot of video games, you're more likely to try them, more likely if we continue to consume that substance or engage in that behavior,

7:51 the dragon, like the initial, like that's what they talk about it with heroin addiction, right? got a couple of different meanings. But yes, I mean, what you're saying is exactly right. And work very hard to restore a level balance, or what's called homeostasis. And it does that by repeated use, we get enough gremlins on the pain side of the balance to fill this whole room. And

10:54 anxiety, irritability, insomnia, dysphoria, and intrusive thoughts of wanting to use their drug again. We had a relapse of our video game addiction. Yes. I thought it would be fun to have. Is that your thought process? Don't call them gremlins. They will put us into a dopamine deficit state. again and again, the initial response to the stimulus gets weaker and shorter. And the

15:00 And you know, and this- But a lot of people do, right? Wow. you know, ever vigilant, ever seeking new and greater rewards, which is exactly what we need The idea of figuring out how to survive and feed the family. That's right. It absolutely is. And one of the things that I think about people with addiction in our modern times modern world, it can really be a curse to have that kind of temperament and that kind of physiology

19:44 And I think the answer is going to be different for Well, it might be that their spouse says, gee whiz, why are you playing golf all the time? you know, that is a great question and not one that I can answer for you, but maybe together we can find the answer. Because the truth is sometimes it is a question of needing to change like the Michael Jordans of the world, the people that are just absolutely,

22:13 behavior mediated by dopamine that is at play when we become addicted to something can be at play It's the same mental machinery that's being applied. talk about and think about. reward dries up and what those people's lives are like after that. we feel in the moment, rather than tolerating the feelings or the uncertainty of what's next I'm struggling, right? But I feel like, oh, I can get through this because when this is over,

27:15 reward myself today. I'm just going to get through the day. It totally changes the arc of our experience in the moment. And it's good to do the hard thing before you do the easy thing. You know, I know. we develop tolerance to, So difficult things, obsessive things, then the reward for that obsessive thing. What's the benefit of being in the moment? Uh-huh. What's the benefit of being in the moment?

31:40 They're unpredictable. Okay. This is my position though. My happiness has often come from very hard work. Those kind, that kind of happy. Not really. Like if you can do that on a daily basis, I believe it alleviates a considerable amount seeking out these challenges and trying to do my best to solve them. that you talk about, effortful engagement in daily practices that are not easy. So you've

36:19 But I guess, you know, where my mind goes, you know, thinking about you and your experience is whether Okay, so this is still working for you. Right. feel good. Then I feel like wrecked and I feel like I'm wasting my life. And it doesn't feel And everybody walks out of there and they feel good. And I think, do you remember when going postal was a thing where post office workers, for some reason, were just shooting a

40:05 is that because that's not challenging? at work and they have a coffee break and they have a great time and they feel completely biopsychosocial disease. And it's a really great construct because it speaks to the fact that I mean, it might be very interesting. It might be very boring. I do think that there are ways you So, you know, again, speaking to kind of the difficulty of modern life for many people, I mean, you have what appears to be a really interesting job. And you've made, I mean, I gather you're a self-made person, right? So you've made these opportunities for yourself, you know, which is a testament to your own discipline, but also there's an element

43:26 process or re-regulating mechanism to create dopamine in response to that, which is potentially But you're absolutely right. that the reason for that was number one, they realized they were still alive and happy to be so. boot. And it turns out the nail had gone right between his toes. So he, in fact, had no tissue injury, but his mind saw the boot,

46:35 Or is it, well, I guess it is, right? Where their mom has to take care of them or their wife has to take care of them and they act like a big baby. Well, okay. So anxiety exacerbates pain. So for example, people with chronic pain, and like towards your upper shoulder it's uh i guess your chest and your rib cage supposed to to just deal with stuff that that's right that's that's the innate But is that or is that a way of interfacing with reality?

49:33 up to nine and they won't budge. Okay. So I agree with you. There's no But let's acknowledge that people are different in all kinds of parameters. Yeah. just handle it. Like, but clearly this is, there's a psychological element that you highlighted Like that is absolutely true. But I also think that that's innately, And a lot of them are based on life experience, though.

53:06 you ever done one of those? Yes. Did you enjoy it? No, not at all. What did you do? Explain. And particularly if you learn some breathing exercises. How many times did you try it? like that builds resilience in other aspects of your life. Like, I wonder if you can, like, regularly expose thing. And that is so key in life, like knowing I endured that thing. And it's like you get to

56:03 I mean, this is hearsay. The way he described it very specifically is like, it's home. yeah like my friend kelly sends me There's something about it's not just the fact this guy wants to ride a dirt bike around the rim of a cliff. He loves just the, and I wonder what's going on with him. Feel my hands. I really freak out. career found climbing incredibly reinforcing, you know, got a huge dopamine hit in his reward

59:16 He says he knows a lot of people who have died because of that escalating process. Right. I know a lot of folks who had addiction issues with substances who got into endurance sports. A lot of them, like they got into triathlons or Ironman or, you know, marathon Interesting animal studies showing rats, for example, we used to think that. would drink the water that had heroin and cocaine in it and avoid the regular water

1:02:37 And that the environment itself of these cages with the bright fluorescent lights, of our modern world cubicle of addiction. However, I think that a central problem today, which is not appreciated, is that we have turned rat park into rat amusement park. in a warehouse, fill the trees and natural sunlight and all the things that a rat would But even when everything isn't ideal, even when you and I live in the best rat park in the world,

1:06:55 What is the running wheel to a rat? Uh-huh. There's something- Oh, they love it. Right. Do you think that all of those things, I mean, like there's a, for sure, there's people that Too many. Is it mostly men? They were all going to be that guy. because the things that I'm talking about, the things that I've been successful about, for some of your viewers.

1:11:05 get out of it they get stimulated yeah and they get stimulated while they're doing other things an addiction. Yes. And I'm not saying it is an addiction. Not everything is an addiction. Again, In fact, an interesting experiment trying to distinguish between motivation and pleasure. Right? spike in dopamine above baseline, that kind of euphoric recall, just

1:14:04 And then we're driven to go get it. So when patients come in to see me, and often their chief complaint is depression and anxiety. to make their own dopamine again. And then they restore homeostasis. And they're able to take Please do. setting. And you isolate them in a building and force them to read actual books made out of paper The O of dopamine stands for objectives.

1:17:15 Just writing that down or expressing those to another human being really makes it alive for Why do you do it? taper. And obviously, if they're physically dependent on something like alcohol or Klonopin reward, will tip to the side of pain. And in those first two weeks, they're going to experience for mindfulness. This is what I was talking about before. Instead of trying to do something to escape feeling bad, just tolerating it for a period of time. The N, wait, dopamine,

1:20:24 but using in more moderate amounts, which is what most people want to do. Then we it seems like there's something about endurance sports in particular that is very attractive because you're exhausted. There's been quite a few addicts that fight in MMA as well Yes, I agree with you. say painful, and I know you don't love that word, but I think of it as painful, you know, physical activities or endurance sports.

1:24:09 And it also becomes a way to achieve a new set point, a new hedonic set point or a new It seems to me like to be an extreme winner, though, and I keep coming back to Michael Jordan, to be a person like that, you almost have to be an addict. focused endeavor. The problem is that a person who is in their addiction may not be able to We don't think of the consequences and what the rubble of his life that's laid out other than the financial success.

1:27:04 much less with a Yeah. Well, I would imagine. Unless you crash on a bike. is a very steep mountain. it depends on the person, right? If like sports or exercise is not really their thing, I still I do believe that we have a part of our brain that's, you know, evolutionarily designed for spiritual practice, I ask them, you know, what kind of spiritual practices are you familiar with? Have you tried? And I recommend that they do that too.

1:31:06 That's interesting. I'll have to come back another time when I've learned more and tell you about that. a loaded term um but i think you know some kind of practice that that sort of you know relates where I went up to the Keck Observatory. is gonna suck and then you drive through the clouds and then all of a sudden you're at the top And then you're faced with this impossible vision of size and of scope

1:34:57 You know, I mean, there was gods in nature, there was gods in the water and all sorts of gods, To me, that's awe and that's that kind of feeling it all kind of went away. And for some of my patients, it was like, oh my gosh, this is what, Yeah, right. And it's, you know, I lived in Massachusetts and it gets it's just part of life. make it all about you the goal is to get a show or a movie where it's all about you. That's weird. And so this sort of lack of dealing with the

1:39:24 in me anyway, kind of quiet with a good thunderstorm. Right. Being attacked by bears? No, I think so too. But I think that the way our bodies are designed is not much different than the way the bodies of people that were And now we're talking shit on Twitter. Like that it was, this was a hijacking of whatever systems that I had that were in place that craved excitement and stimulation.

1:43:51 showing real brain changes that occur as people become addicted, and the physiologic, you know, And again, you know, you and I have used the term loosely to define a broad spectrum of behaviors and a broad spectrum of severity. sort out what type of personality they are, like where they fall into and maybe what is this get here? What are some of the early antecedents, including like childhood antecedents or trauma?

1:47:39 get better in a jiffy. And no matter what I did, I couldn't help them. So I don't predict anymore. They're clear-minded. better and more likely to think that they're going to get better and more Yeah, it's a great question. person is... They're fucked. That's the case with everything. Let me just say it's a slow road. Alcoholics Anonymous is always referred to as Friends of Bill, right?

1:50:44 And Jamie, see if you can pull up the history of Alcoholics Anonymous and LSD. This was all in – when was this? 43. including a friend of mine, my friend Ed, who started up a clinic in Mexico. He got addicted to pills. research it. In general, I always have concerns about using, you know, a potentially addictive mind-altering substance. I don't think Ibogaine's addictive. I think it's so brutal that nobody

1:54:04 Have you ever experienced it? No. No, Like what method does – in which method does Ibogaine help addicts with addiction? know too much about this. So yes, and I will be the first to Again, I don't know too much about this. how does Ibogaine work, control release of the feel-good and reward chemicals in the brain. because it can inhibit the access to some of these dopamine receptors.

1:57:44 Yeah. Appreciate you. Yeah. But we also need to think about the set and setting, as they talk about, of how it was done. And we need to It was lacking in their lives. is you're dealing with people that would include, in a way, the category of medications administered by modern day shamans, and it was part of a sacred ritual. So it wasn't like a binge drinking pattern of addiction.

2:02:13 So I'm going to do it with my friend, you know, at the top of Kite Hill. Probably not a good idea. perceptions and allows you to think of things in a different way that might not really be possible Well, thank you to MAPS and Rick Doblin and all the great people that have done some have experienced trauma. I'm open to the idea. Yeah. Yeah. I'm open to the idea. I'm not convinced.

2:05:15 So like there's almost maybe a benefit in recovering from addiction? And there's, boy, nothing that will humble you more than, you know, getting seriously addicted and having to crawl your way out of that. Like, what is it about you that wants to proclaim yourself that you're so great? What is healthy narcissism? concept of healthy narcissism. It's when narcissism, you know, goes to like anything to a pathological

2:08:46 highly seductive thing because it's sort of the trope of our modern culture. Yeah, I shouldn't say worse, but I would want to say harder to recover from. And that sometimes comes up in clinical care. I never thought of it that way, but that makes sense. fault and how much of it is the way they interface with people around them and how much of it is

2:11:57 And again, their project is then, you know, engaging in difficult things in small incremental And if you do it through your own hard incremental work over a long period of time, Yes. no structure that for a lot of people, it feels very lonely and confusing. Like recognizing that there are these chemical pathways, were to use a religious framework or a moral framework people are not gonna

2:16:21 paints on my house. And he said, it's really silly, but it's really helpful for me, you know, because I know if I just wait long enough, they'll hop off and homeostasis will be restored and I'll be able to move on. I used to get that from passing by pool halls. You've got to figure out how much of it is just fun and how much of it is you are avoiding real things in your life.

2:17:35 And just that awareness, I think, can help people. It's available everywhere. I hate when some actor person reads anyone's book. That is a brain. Well, thank you very much. That's a good place to be. But hopefully my publisher is working on it, and I know they're working on it.