ERP 305: The Surprising & Powerful Benefits Of Learning To Tolerate Discomfort — An Interview With Dr. Anna Lembke

By Posted in - Podcast February 1st, 2022 0 Comments

Our brains are hardwired to seek pleasure and avoid pain and that’s what’s been keeping us alive. However, that’s a problem in this day and age where we have an overabundance of highly potent and reinforcing drugs at the tip of a finger. As a result, there’s been a significant increase in the percentage of anxiety, depression, and other psychiatric problems as we are constantly seeking pleasure.

In this episode, we’ll learn what’s happening in our neurobiology as we seek comfort in a dopamine-rewarding behavior as well as what happens when we learn to tolerate some discomfort. Understanding how our brains work will be extremely beneficial as we consider our personal development and relationships.

Anna Lembke, MD, is a 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 and she sits on the board of several state and national addiction-focused organizations. Her new book, Dopamine Nation: Finding Balance in the Age of Indulgence explores how to moderate compulsive overconsumption in a dopamine overloaded world.

In this Episode 

5:04 Understanding how we develop tendencies for seeking pleasure and overconsumption.

16:06 How social media, other technology, and even food contribute to these tendencies.

18:48 Our propensity to notice the behavior.

24:34 How to start a healthy balance between pain and pleasure.

30:15 Some real-life examples of tolerating the discomfort and its benefits.

Your Check List of Actions to Take

  • Start and maintain a healthy exercise regimen that suits your body type and needs.
  • Try to do an ice-cold bath a few times a week.
  • Consult with your nutritionist if you could start a fasting-type diet. 
  • Start practicning self-awareness.
  • Do things that are cognitively challenging, engaging, creative, and frustrating tasks that require sustained attention.
  • Sit with your discomfort instead of trying to distract yourself from it with ready-at-hand intoxicants.
  • Tell the truth even when it hurts.
  • Build deep and intimate connections with people.

Mentioned

Dopamine Nation: Finding Balance in the Age of Indulgence (book) (*Amazon affiliate link)

Stanford Marshmallow Experiment

Connect with Dr. Anna Lembke

Website annalembke.com

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Email: [email protected]

About Today’s Show

Dr. Anna Lembke, thank you for joining today. 

Well, I’m very happy to be here. Thank you for inviting me. 

Yes. And I was struck by your book, Dopamine Nation, and just your message and your support on helping people look at this tendency towards overconsumption, seeking pleasure, and also what we can do about it. 

So just as an overview of the bigger arc of the message, can you talk about this tendency for seeking pleasure and overconsumption and what you’re wanting people to understand around this? 

Sure. I mean, our brains are hardwired over millions of years of evolution to approach pleasure and avoid pain. It’s what’s kept us alive in a world of scarcity and ever-present danger. This hardwiring is conserved across species. It’s reflexive. It’s got powerful physiology behind it. But the problem is that this kind of ancient wiring is mismatched for the modern ecosystem, where we’ve got this incredible overabundance of highly potent, highly reinforcing drugs and behaviors at the touch of a finger. 

And the result is, in essence, that our sort of relentless pursuit of pleasure for its own sake is causing us all to be more miserable, not just on the individual level but also as nations. If you look at rates of depression worldwide, they’ve gone up 50% in the last 30 years. Rich nations are leading the charge. That’s consistent with other psychiatric problems as well (anxiety, suicide). All have increased worldwide, and all are at the highest rates in the most wealthy countries in the world, which really begs the question, what’s going on here? 

I mean, all of our basic survival needs are met, we’ve eliminated or eradicated many diseases, we’re living longer than ever. And yet, it really does appear that we’re more unhappy than ever. I contend, and this is basically the hypothesis of Dopamine Nation, that it’s the ways in which the constant bombardment of our brain’s reward pathway with highly reinforcing drugs and behaviors, in essence, putting us in a dopamine deficit state as a way to compensate. That is primarily what is leading us to be more anxious, more depressed, and less happy. 

Side view unhappy sorrowful African American couple sitting on bed back to back after having argument

“The ways in which the constant bombardment of our brain’s reward pathway with highly reinforcing drugs and behaviors are putting us in a dopamine deficit state as a way to compensate. That is primarily what is leading us to be more anxious, more depressed, and less happy.”

Yes, I am so grateful for what you’re pointing out here. And that you talked about in the book that the pleasure receptors and the pain receptors in the brain are located in the same area and that there’s a real relationship between the pleasure and the pain. And you’re speaking to this now, and it’s human, for us to seek pleasure and to avoid pain, and if the balance gets so overly skewed or so weighted in seeking pleasure, that it’s having a real impact that we’re actually experiencing more pain, is that right? 

Yeah, and the way to understand that physiology and sort of the neurobiology behind that is imagine that in your brain, there’s a balance, like a teeter-totter in a kid’s playground, except when nothing is on the balance, it’s level with the ground and that’s called homeostasis. That’s essentially an organism at rest. 

One of the major universal physiologic imperatives is that systems will want to preserve and return to homeostasis or a level balance. If that balance represents pleasure and pain, when we experience pleasure it tips to one side, and when we experience pain it tips to the opposite side. But remember, with any deviation from neutrality, the brain will work hard to restore level balance. So when we do something pleasurable, in my case, I eat a piece of chocolate, like I just did, that will release a little bit of dopamine, our brain’s reward neurotransmitter, in a very specific circuit of the brain called the reward pathway. You can imagine that as my balance tipping to the site of pleasure. But no sooner has that happened than the brain adapts to the increased dopamine by downregulating our own dopamine transmission and production not just to baseline levels but below baseline levels. 

Offended multiethnic women in room

“For every pleasure, there’s a price. That price is pain. It’s the comedown. It’s the after-effect.”

I’d like to imagine that as these little neuro adaptation Gremlins hopping on the pain side of the balance to bring it level again. But the Gremlins like it on the balance. They don’t hop off. When it’s level, they stay on until it’s tipped an equal and opposite amount to the side of pain. This is exactly what happens in the brain. That means for every pleasure, there’s a price. That price is pain. It’s the comedown. It’s the after-effect. For subtle pleasures, the comedown might also be very subtle, just outside of our awareness—for example, that moment of wanting a second piece of chocolate. Now, if I wait long enough, that moment passes, and I can kind of move on with my day. But if I continue to consume my drug of choice every day for weeks, to months, to years, what eventually happens is that I end up with so many Gremlins on the pain side of the balance that I’m in a semi-permanent dopamine deficit state or I’m walking around with a balance tilted chronically to the side of pain. That is essentially the addicted brain. 

Once that happens, then our focus narrows. We’re only interested in pursuing our drug. It feels volitional. But in fact, it’s being driven by the desire of the brain to restore homeostasis or a level balance. When I’m not using my drug, my balance is tilted to the side of pain. I’m experiencing the universal symptoms of withdrawal from any addictive substance, which are anxiety, irritability, insomnia, depression, and intrusive thoughts of wanting to use. And I need more and more of my drug overtime to get the same effect because the Gremlins are more efficient than I am. And now, when I use it, I don’t actually get pleasure from it. I just get relief from pain. I just restore level balance and feel normal. 

And so, those are really some of the key features of addiction and tolerance, needing more and more of the drug or more potent forms overtime to get the same effect. When I’m not using, I’m depressed, anxious, irritable. I can’t sleep. I’m craving. Other things lose their salience or their rewarding potential because now my brain is focused too narrowly on this one drug. And then ultimately, I spend all my time and energy and creativity, just trying to get the drug and use the drug and combat those neuro adaptation gremlins. We don’t even really see when we get caught in that loop. 

It’s this vicious cycle. I’m curious. I mean, this was an aha for me, and I know that it shouldn’t be in some respect because we all have some familiarity with what you’re describing from just an experience standpoint. But the real consciousness that, oh, if I’m going to engage in this dopamine reward activity or behavior, that this is going to have a pain consequence or a result, that there’s a real link there. How aware do you think people are of this? 

Not aware at all, which is one of the main reasons that I wanted to write the book. Because when we become aware and are mindful or tap into the experience, we can begin to observe it. We can observe that as we start to watch the YouTube video, it’s very pleasurable. Half an hour later, on YouTube video number five, now we’re just sort of searching for something similar, trying to recapture that original feeling. That’s those Gremlins hopping on the pain side of the balance in response to this surge of dopamine. 

And then when we manage it with difficulty to pull ourselves away from watching YouTube videos, we essentially crash, and our balance tips hard to the side of pain, and we’re in a dopamine deficit state because, remember, the way that the brain restores homeostasis after any increase in dopamine is to bring dopamine levels not just to baseline but below the baseline. And that dopamine deficit state is what creates the anxiety, restlessness, and discomfort that we experience after our drug wears off. 

I mean, if you drink a whole lot of alcohol, and you have a hangover the next day, then it’s quite obvious, and you are aware, but there are many subtle psychological symptoms that persist beyond the physiologic hangover that people aren’t aware of and they don’t fully appreciate is related to the use of their intoxicant. 

And the other thing that people really don’t get, because it’s hard to see, and even I have fallen into this trap and not realized it, is again that the cumulative effect of these intoxicants over many days to weeks, to months, puts us in this, basically, the equivalent of clinical depression, and now we’re walking around, and we feel like our drug is the only thing that’s helping us, but really all we’re doing is treating withdrawal from the last dose and trying to restore a level balance. And in fact, the intoxicant itself is what has created the dopamine deficit state, which is exactly those feelings of depression and anxiety that we’re trying to combat. 

And even in your languaging, it sounds like you’re giving space for a spectrum of overconsumption. It could be real addiction, and it can even be subtle ways that we’re habitually engaging and having consequences around but maybe aren’t fully to the state of the more advanced stages. Is that right?

Yes, addiction is absolutely a spectrum disorder. The DSM-5 codes it as mild, moderate, and severe, but even before people become truly addicted, there is this kind of gradual progression of compulsive overconsumption. 

Now, the vast majority of people will be able to auto-correct once they become aware of the behavior, which is half the battle. They will be able to say, “Oh, wait a minute. I need to do something about this.” And they’ll be able, without any kind of professional intervention, to be able to intervene. Whereas, when you get on the spectrum of addiction, especially severe addiction, even when people recognize it and they want to stop, some people are not able to without the help of professional treatment or engage others to help that person actually stop using their drug. People can progress to really devastating consequences if they have a very severe addiction. 

Your point is a good one. It’s a spectrum. I think the sort of central message is that we’re all somewhere on that spectrum because we all have reward pathways. And dopamine is, in essence, a very useful signal. It tells us when to approach and when to avoid. It alerts us to important changes and stimuli, not just in the environment but in our own physiology. And so, we’re all vulnerable to this problem of compulsive overconsumption. 

Two Men Looking Out a Window

“Dopamine is a very useful signal. It tells us when to approach and when to avoid. It alerts us to important changes and stimuli, not just in the environment but in our own physiology.”

And yes, and I’m also thinking about, I know, there are documentaries on this, but the way that social media is designed or even the way sometimes certain foods are crafted, it is intended. There’s some real brilliance around how these things are being designed to kind of access these human tendencies. And that if we’re not aware, we’re really susceptible to the slippery slope of overconsumption. 

Absolutely. Almost everything in our world today has become drugified with intention. How do you drugify something? You increase access. The smartphone is the equivalent of the hypodermic syringe delivering digital dopamine 24/7 to a wire generation. You increase the quantity. TikTok never runs out. You increase potency. How do you increase potency? You engineer it. Technology has allowed us to increase the potency of so many different drugs and behaviors. You combine drugs together. That’s another way to increase potency. You enumerate things that increase potency. 

And then, finally, there’s a novelty. So, just a minor tweak of a new molecular moiety on an old drug will make that a new drug—the same thing with online or digital products. You have a game, and then you add gambling and shopping inside the game where you have music, and you add gaming and gambling inside the American Idol or whatever it is. The point is that access quantity, potency, and novelty. I have created a world in which, really, everything has the potential now to be an addictive drug or behavior. And the result is indeed that we are all vulnerable in ways that we really were not in prior generations. I mean, there have always been people who could not use drugs in moderation. That’s been true since the beginning of humanity. But what we’re seeing now is not just growing rates of severe addiction and death due to addiction. In fact, 50% of global deaths due to addiction are occurring in people under the age of 50. And rates are going up in many different demographics that were previously thought to be immune. 

So, rates of alcohol use disorder have gone up 50% in the elderly, 80% in women in recent generations, 70% of the global deaths are due to modifiable risk factors like diet, inactivity, and smoking. So we’ve really reached a tipping point where we are harming ourselves and, frankly, our planet due to our compulsive overconsumption. 

One of the things that you speak to in the book that I’m feeling as you’re talking is just how we have the propensity to even internalize and judgment around the behavior or the use and thinking that something’s problematic with us or ourselves and isolation that comes with that. Do you want to speak to that at all? That if we’re battling this overconsumption or noticing this or we’re feeling anxious, depressed, in this pain of the Gremlins that we might not even be able to tie it back to the overconsumption. But what we’re experiencing, we will internalize it as we’re the problem or something’s wrong, or we’re flawed. 

Yeah. So, lots of themes there. I mean, I see a lot of patients who come in wanting help for anxiety and depression, and they anticipate that the first thing that I will do is prescribe them a pill and an antidepressant, for example, or recommend some type of psychotherapy to explore early childhood trauma. But in fact, most often, the first thing I do is have them eliminate their drug of choice if I discover that they’re propulsively overusing some kind of potent dopamine-releasing substance or behavior, whether it’s cannabis or alcohol, or pornography, or shopping, or Netflix. 

And in about 80% of patients, if they are able to eliminate their drug for 30 days, they will come back feeling much improvement in terms of anxiety, depression, insomnia, and many of the symptoms that they originally came in seeking help for, which is really powerful because it tells us that what feels subjectively like what we call form first mental illness or mental illness that originates in the brain due to what’s commonly described as a chemical imbalance, you know, too little serotonin, or maybe the result of trauma or epigenetics, that in fact, what feels like is a sort of independently co-occurring psychiatric disorder may, in fact, be the downstream effect of too much dopamine release in the reward pathway. And just by eliminating that dopamine-releasing drug for long enough to allow the Gremlins to hop off the balance for that balance to re-equilibrate. And for dopamine firing to return to healthy normal baseline levels. 

Many people have almost total resolution of those symptoms. So, that’s why that’s always my first pass. And there are data to support this too. There’s a famous study by Brown and Chuckit, showing that adult males who are drinking alcohol in an addictive way and also meet criteria for clinical depression, and you put them in a psychiatric hospital, where they don’t have access to alcohol for a month, but also don’t get any specific treatment at all for depression, 80% of those individuals will no longer meet criteria for depression at the end of the month. In other words, just quitting drinking resolved their symptoms of clinical depression. 

So, that’s a powerful statement. It means that it’s the intoxicant itself that is creating the psychiatric disorder. And not the other way around. Although subjectively, people will feel like their drug relieves their psychiatric symptoms. But it also means that 20% of folks will be left with continuing psychiatric symptoms. And that’s also useful information, right? That means that it’s not primarily or even related to the substance, although it’s almost always related in some way to the substance, but that the individual has a co-occurring psychiatric disorder that also needs attention. 

Absolutely. And when we’re looking at this larger scale, as you’re talking about the nation or even globally, that 80% of people can have such alleviation and have some return to homeostasis, that that’s so encouraging and hopeful when we’re looking at the magnitude of this. 

Yeah, it really is. And yet, it’s shockingly hard to give up our drug of choice. I mean, I know that from my own experiences I talked about in the book. I got addicted to romance novels over the course of about two years. It took me a while to see what I considered to be just a benign recreational activity had actually progressed to something maladaptive and on the addiction spectrum. And when I decided to give it up for a month, I mean, I was shocked at how difficult it was for me. I had really lost the art of going to sleep without my drug. I was restless. I was anxious. It changed the whole shape of my day.

Bored mature female supporting head and thinking while sitting on seat inside modern train in subway

“Many of my patients will talk about how much more time they have when they’re not using their drug and how that in and of itself is scary. They’re faced with boredom and inactivity and wondering what to do with themselves.”

So yes, on the face of it, it sounds simple but enacted, it’s actually really, really hard. So, I have enormous compassion for the Mount Everest that it really represents to give up our drug. And that circles back to something else that you had mentioned earlier that I didn’t respond to, but I want to respond to, which is just the shame that goes along with our unchecked desire. It’s really a powerful, powerful thing how much shame we have in the face of what I’ll call incontinence or our inability to control our consumption of certain things. And that shame can in and of itself drive continued consumption as we lie, and we isolate, and we live that double life, which then just perpetuates the problem. 

No kidding. And I appreciate your compassion. I felt that throughout the book. I know in Dopamine Nation, you give real protocol of how to work some of this healthy balance between pain and pleasure and a lot through this abstinence and really good people support. What I really found fascinating, Anna, is that being able to start to tolerate some of the pain or to be able to have this abstinence as you’re speaking to. It starts to change our brain and starts to change things neurologically. Is that right? 

Absolutely. And it changes it in a really healthy direction, but it’s a really hard thing to do. Basically, what it demands of people is to invite a painful project into their lives to know that they’re signing up for something that’s really hard and really uncomfortable but that the payoff down the road will be worth it. 

And that’s key because when you were speaking to pressing on pain, meaning engaging in something that might be uncomfortable or even scary or unpleasant, that that’s pressing on pain, and that it feels like it relates to, which I think is what you were just saying, this immediate gratification versus more a delay, where there is a positive, but it perhaps is coming down the road a little bit. And it might mean tolerating some of that pain or discomfort in the interest of that growth or that reward. Is that right? 

Yes. And the neurobiology of this is really compelling. So, if you think back to the pleasure-pain balance, that analogy for how we process pleasure and pain in the reward pathway, and you’ll remember that when we have an initial stimulus that’s pleasurable, those neuro adaptation Gremlins will hop on the pain side and tippet in that direction, but if the initial stimulus is painful, then those neural adaptation Gremlins hop on the pleasure side and tip our balance to the side of pleasure. 

This is essentially the science of hormesis. The idea is that by exposing ourselves to mild to moderate noxious or painful stimuli, what we do is we signal to the body that the body needs to start to upregulate feel-good hormones in order to combat these toxic, painful, or noxious stimuli. So, in essence, what’s happening is that by exposing ourselves to, again, painful stimuli, and I use that term pain very broadly to include physical and psychological challenging things. What happens is our body starts to upregulate dopamine production, upregulate endocannabinoids, and endo opioid serotonin-norepinephrine. 

Not only does our body do this in a kind of slow, continuous way throughout the period of feeling the pain, but it keeps those feel-good hormones elevated for hours afterward. And then, eventually, they will drop back down to baseline levels. But you’ll note there’s no dopamine deficit state, right. So for example, an experiment in which the subjects were immersed in an ice-cold water bath and dopamine levels checked, what they found is dopamine levels increased at a steady rate while they were in the bath and then remained elevated for two to three hours after the ice-cold bath before returning to baseline levels. 

Now, contrast that to what happens when we use a feel-good drug or behavior. That works instantly. i.e., when we press on the pleasure side. What we see there is a sudden rise in dopamine levels in the reward pathway followed by a sudden decrease not just to baseline but again below baseline, the Gremlins hopping on the pain side before eventually, we go back to baseline. So, we pay a huge price for that kind of dopamine. Whereas if we get our dopamine indirectly through effortful engagement in painful and challenging activities, we get a longer and more sustained amount of dopamine, and we don’t have to endure that dopamine deficit state. 

And to clarify, some of these other activities might be, as you mentioned in the book, exercise or delaying eating for a certain amount of time. Is this also what you’re referring to as far as pressing on pain or some of these difficult, challenging activities or behaviors? 

Yes, exercise is the one for which there’s probably the most human evidence, but there’s also ice-cold water baths, there is fasting, there’s decreased stimulation. So, just decreasing the amount of stimulation. In this day and age, even just going for several hours without listening to anything or watching anything. Sitting in a quiet room can be really challenging for many of us because our day-to-day lives are sort of characterized by this constant influx of music and images. Those are small hits of dopamine throughout our day. Also, psychological challenges, for example, doing things that make us anxious, doing things that are cognitively challenging, engaging in frustrating creative tasks that require sustained attention. These are all things that constitute pressing on the pain side, with the result being that we get dopamine down the road. 

And psychologically and relationally, I’m often encouraging people to turn towards some of their emotional discomfort in the interest of learning and perhaps understanding and self-awareness. I’m also hearing that that actually gives this neurological or neurobiology result of pressing on pain. Is that true? I’ll use myself in this example. If I’m upset and I don’t know why, and I turn towards my journal and/or I talk to my husband, and I give myself space to go there and feel it and understand it, that that’s not pleasurable. It’s not something I want to do. Is that an example of pressing on the pain? 

Yeah, that’s a beautiful example. Right. I’m inviting a period of time where we just sit with our discomfort instead of trying to distract ourselves from it with any number of ready-at-hand intoxicants. And when I think relationally about it, I’m always struck by how hard it is to talk with the person that we are in conflict with, right, but our tendency is to want to go and talk to a hundred other people about that person rather than going and talking to that person, how scary that is. 

That’s a great example of the kind of pressing the pain sites or the mounting anxiety and tension we feel as we anticipate it, and then actually sitting down and saying to our partner, our loved one, you know, “This is what I’m feeling. This is why I’m angry. This is why I’m sad.” Not knowing what their reaction will be or where it will lead, but those are the types of things that are so worth it because most of the time, when we do take that brave step to engage with people and tell them honestly kind of where we are, it’s very well received. And it’s often a relief for that person too. “Thank God I’m not the only one who’s feeling that things are amiss.” or “I’m not the only one who’s upset about this.” 

Or maybe their reaction is to get more upset. But then again, it’s an opportunity to allow them to express that, to tolerate it, to take it in, to think about it. These are all so important. I would say for the vast majority of us, including myself, I don’t want to do it. There are so many things I’d rather do than sit down and tell that person what I’m feeling, what I’m thinking, and why I’m hurt. So, that’s another example. 

I imagine as we’re talking that as one starts to engage, feels the reward. And again, maybe not even consciously understanding all the neural biology but that they actually feel the reward inside themselves in their own integrity, perhaps they feel better. And that might be some of the neural biologies and also relationally, there’s good that comes from that. I just want to underscore that for myself when I’m up against these moments. I think it’s Gay and Katie Hendricks. They termed this like a sweaty 10-minute conversation, right? Like, these conversations that we tremble and, like you said, don’t want to do, but yet, there’s so much value that will come in that. That’s one thought of just this actually has so many benefits. You have a section in your book about radical honesty and the actual brain science there. I was very intrigued by the result of this neurobiology or neurologically. 

Right. What I advocate in the book is that we tell the truth about things in large and small, especially when telling the truth exposes our own mistakes and foibles and regrets and shameful behavior. And there’s a science to back that up. 

So, first of all, we always talk about how relationships and intimacy is the antidote to addiction, but we don’t often talk about how to get there. First of all, I’ve seen it consistently in my patients in recovery. They say to me, “Oh, I can’t lie about anything. If I lie about anything, I’m going to relapse.” So it’s a tried and true technique that people in recovery have road-tested and know works. I think the reason that it works is we think when we tell these shameful things to other people that they’re going to run away from us, but in fact, the opposite happens. 

It really promotes intimacy because people like to be told the truth, and they also then feel that they can share their hidden secrets, and we’re united in our humanity and our brokenness. It’s also true that oxytocin, which is the love hormone, that we know is released during sex and during pair bonding, and Mother-Child nursing actually binds to dopamine-releasing hormones in the reward pathway and releases dopamine. So, when we have these kinds of deep, intimate connections with other people, it’s very reinforcing and very pleasurable. And that too is mediated by dopamine. And for the most part, that’s a healthy and adaptive source of dopamine. 

The other thing that that’s interesting in science is that when we intentionally set out to tell the truth on any given day and not lie about anything, which by the way, is really hard because the average person tells about one to two little white lies a day. But when we do that, we’re probably stimulating our prefrontal cortex. And the prefrontal cortex is a big grey matter part of the brain right behind our foreheads that’s really important for helping us manage our pleasure-pain balance. 

My colleague did a study where he showed that if you use transcranial magnetic stimulation to create an electrical current to stimulate the prefrontal cortex externally, what you can do is get people to lie less when they’re engaged in a die-rolling test. That’s really fascinating, right? So, you have a sham group, and then you have the real group. And what you find is that it really does make a difference. People will lie less in this die-rolling task if you use a magnet to stimulate their prefrontal cortex. 

So conversely, it makes sense that if you’re telling the truth or lying less, you’re probably stimulating your prefrontal cortex and strengthening that area and strengthening the connections with the reward pathway, which is really fundamental. The other important thing about truth-telling is that it allows us to tell more authentic autobiographies. In other words, the stories that we tell about our lives are not just important to understanding our past, but they actually shape our future. And if we’re telling stories in which we’re always the victim, and it’s always everybody else’s fault, there’s a good chance we’re going to continue to go on and be the victim. But if we can tell stories that truly capture all sides of the situation, including the ways in which we have contributed to the problem, we’re much more likely to get true clarity on what’s going on and then much less likely to repeat those mistakes going forward. 

Family Walking on Path

“An important thing about truth-telling is that it allows us to tell more authentic autobiographies. In other words, the stories that we tell about our lives are not just important to understanding our past, but they actually shape our future.”

I think that’s a really powerful reason to tell the truth even when it hurts. I mean, the thing about truth-telling is that it speeds up consequences, right? Instead of getting the big bad consequence, ten years down the road for all the little lies, what you get is the experience of shame and potentially other consequences short term, but that is what helps change and shape behavior in a positive direction before it becomes a huge problem. 

I also talk about the ways in which when we tell the truth, it’s contagious and gets other people to tell the truth. Our community then creates what I call a plenty mindset where people feel like they can rely on other people and rely on the future. They don’t have to grab things and run because other people might take it. There’s this sense that, no, I can rely on people. I don’t have to put all this energy into lying and tracking my lies. I can tell the truth. I’ll be accepted for who I am. These are all really powerful mediators of group solidarity. 

One of my favorite experiments is the Stanford Marshmallow Experiment, where kids were put in a room and given a marshmallow on a plate and told by the researcher, “Now, I’m going to come back in 15 minutes. And if you can not eat that marshmallow for the whole 15 minutes while I’m gone, I’ll give you a second marshmallow.” They’re basically looking at their capacity for delayed gratification. And these were kids between the ages of about three and five. And what they found was that the older the child, the more likely the child could wait longer. And then there were other temperamental traits that predicted which kids could wait for a second marshmallow and which kids ate it right away. And that, in essence, was the very famous Stanford Marshmallow Experiment. 

But they did an interesting twist on the experiment where they took a group of kids, and they said to them, “I’m going to go away, and I’m going to come back in 15 minutes. And if you can wait 15 minutes, I’ll give you a second marshmallow. And by the way, if you need me at any point in those 15 minutes, and you ring this bell, I’ll come back.” And in half of the kids, when they rang the bell, they came back, and the other half of the kids, they didn’t come back. So, they essentially lied to the kids. 

In the group where they lied to the kids, those kids were much more likely to eat that first marshmallow and not be able to wait for that second marshmallow. And I think that’s just such a wonderful prism for the microcosms of families and other groups that we make in our lives. If we’re interacting with people who lie, and if we’re lying, there’s going to be a kind of survival mentality that surfaces where people just take what they can and consume. And you know, this sort of like, just very competitive consumptive reward survival-focused mentality rather than being able to delay gratification and trusting that things will still be available 15 minutes later. 

Disappointed Man Talking to his Partner

“If we’re interacting with people who lie, and if we’re lying, there’s going to be a kind of survival mentality that surfaces where people just take what they can and consume.”

Anna, you help people with the science and the research and really help spell this out. The way that it impacts, I can just feel there’s so much more here with the prefrontal cortex and activating and increasing that, what that actually means in our development personally, and then also collectively. And then when you’re speaking to how we can feel this sense of intimacy and also reliability in others and the attachment system that is within each one of us and how that’s being impacted. I mean, these are really important things that we’re discussing. 

Yeah, thank you. I mean, I agree. I think it is important. I think it’s sort of fundamental to thinking about how to live in the world now and how to kind of manage this really, in many ways, wonderful and exciting world that we’ve created. I believe it’s a very challenging time to live in ways that are sort of subtle and invisible and pertain to the things that we’ve been talking about. 

Yes. And I feel like these are keys that are helping people know how to work with their neurobiology in a way that’s supportive for health and well-being and healthy relationships. We probably don’t have as much time to go into it, but the empathy without accountability, right, if we’re always empathizing without a container for accountability and what that means, and maybe you could say a few things about that. It just feels like you’re offering really important keys for us to work with. You’re not telling people what to do. You’re giving them brain science and research. But it’s really laying it out on the table for us to be more aware and work with and experiment with. 

Yeah. So, this whole idea, whether it’s in the context of mental health care providers working with clients and patients or in the context of parents raising children, I do think that we have become over-reliant on this idea of empathy sort of being enough. Empathy, by the way, I think is very important. It’s certainly the starting place—empathy, compassion. But sometimes, if we just stop there, and we don’t hold people accountable, and validate the ways in which shame for some behaviors is actually appropriate, then we’re really not leveraging, frankly, our biology in order to make and motivate behavior change. And ultimately, that’s what we want. We want behavior change, right? We want to live differently. People want to know how to live. 

Women Leaning on Each Others Back

“Empathy, I think, is very important. It’s certainly the starting place. But sometimes, if we just stop there and we don’t hold people accountable and validate the ways in which shame for some behaviors is actually appropriate, then we’re really not leveraging our biology in order to make and motivate behavior change.”

You can think till the cows come home about it, but how do we actually implement behavior change in a positive direction. And so, I do think it’s very important, whether we’re talking to our kids or partners, or our patients, that we empathize and we validate the experience, and we show compassion, but then we also say, “Yeah, that was wrong. That was a wrong thing.” It’s appropriate that you feel some shame about that. How do you think you can change going forward? 

Or, for example, in raising our kids. I use quite a few examples of raising my own kids in the book. One of the mistakes that we’ve made, and I made this mistake too as parents, is thinking that if we just boost our kids’ self-esteem, then they’ll be protected from any kind of mental health problems. And in fact, the opposite happens because if we sort of over-validate, over-empathize, over-affirm, then we’re not really giving our kids a realistic assessment of who they are and their own talents and flaws, and character defects. 

Whereas how we can really help our kids is to give them realistic feedback like, “Oh, I think this is a character problem that you have. Let’s talk about it because it’s coming up in our family, and I bet it’s going to come up for you in other contexts. Maybe you can be aware of it.” I use the specific example of one of our children who clearly from very early on was oppositional defiant. If we said, go right, he would go left. Even if he really wanted to go right. And that was just his character, you know, sort of hardwired. And it makes sense from an evolutionary perspective that you would want people like that. When all the lemmings are jumping off the cliff, you want a few people who just say, “No, I’m not going to jump, and I’m not going to jump because everybody else is jumping.” And that’s good, right? That means there’ll be a few landings left that made it. But in general, that’s really difficult to treat because we are social creatures, and we need to get along. 

So again, just pointing that out to our son and saying, “You need to watch for this.” And then when it comes out, “This is coming up again. Do you really want to go left? What do you really want? Or are you just going left because we said go right?” Because, in a way, you’re then depriving yourself of the thing that you really want because of this character defect. So things like that. I think it’s that kind of realistic but compassionate feedback. So accountability without judgment. 

And it’s empathy with accountability, right? 

That’s a nice way to put it. Yeah. 

In some ways, too, another way that I’m hearing it right now is it’s supportive for, in this case, your child’s growth or children’s growth and helping them have a sense of self-efficacy and just helping them develop. It also possibly speaks to pressing on pain a little bit. Nobody really wants to be held accountable for stuff that’s hard, right? Because then there’s a lot more on the line. And at the same time, it could be pressing on this pain that allows us to grow in ways that are really important. 

Yes, absolutely. I agree. 

Okay, wonderful. Well, I know this is such a gift to those listening. And to me, just to everyone that is getting a chance to hear everything you’re having to offer around this. Dopamine Nation, I encourage people to check that out. Is there anything else you want to say before we sign off?

I’ve enjoyed the conversation. Thank you so much for inviting me. 

You’re welcome. And I’ll make sure to have the link to the book and anything else, Anna, that you want me to have. I’ll make sure to have that on the show notes. 

Great. Thank you so much.

Signing Off

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Shifting Criticism For Connected Communication

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Dr. Jessica Higgins ~ Relationship and Transformational Coaching