Views of Anna Lembke on Addiction (Anna Lembke is professor of psychiatry at Stanford University School of Medicine and chief of the Stanford Addiction Medicine Dual Diagnosis Clinic.)
The pain-pleasure balancing act
One of the most exciting findings in neuroscience in the past half century or so, is that pain and pleasure are co-located, which means the same parts of the brain that process pleasure also process pain, and they work like opposite sides of a balance. So if you were to imagine that in your brain, there’s a little teeter-totter like in a kid’s playground. And that when we experience something pleasurable that teeter-totter tips to the side of pleasure and something painful it tips to the side of pain.
Dopamine-deficit states
The central sort of takeaway from the way that our brains restore homeostasis, which is not just to bring dopamine back to level baseline – because we’re always secreting a tonic baseline level of dopamine – but actually to bring it below baseline. So, that’s really the key neurobiological concept that I want people to grasp. It’s not just like you use up the dopamine you have and then you’ve run out and you’re even again. The way that the brain restores homeostasis is to go below baseline and put us in this dopamine deficit state, which is essentially akin to depression.
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