Name: Joe Rogan Experience #1708 - Anne Lembke
Uploaded: 2021-09-16T00:00:00.000Z
Description: Watch the stand-up comedy video 'Joe Rogan Experience #1708 - Anne Lembke' from PowerfulJRE on Comedy Buff. Published 2021-09-16. Transcript available.

Watch the stand-up comedy video 'Joe Rogan Experience #1708 - Anne Lembke' from PowerfulJRE on Comedy Buff. Published 2021-09-16. Transcript available.

Joe Rogan Experience #1708 - Anne Lembke

Joe Rogan podcast, check it out.
The Joe Rogan experience.
Train by day, Joe Rogan podcast by night, all day.
Hello.
Hi.
Thanks for doing this, appreciate it.
I'm happy to be here.
I'm very excited to talk to you about this.
This is a very interesting subject.
I have had problems with addiction my whole life.
Okay.
Particularly, like I had a really bad video game addiction at one point in time.
And I had a quick cold turkey.
It was like an eight-hour-a-day addiction.
And when was that?
20 years ago, somewhere around then.
Okay.
Yeah, a little more than 20 years ago.
Okay, so you were in your 30s?
Yeah.
And how did you realize that you were addicted?
Oh, I knew.
Okay.
You knew from the very beginning?
Well, it was very fun.
I was playing this online video game called Quake.
And what it is is you play online and, you know, you are in this 3D environment.
Yes.
And you hear, like, sounds in 3D.
And the graphics are amazing.
And you're running around shooting at people and they're shooting at you.
And it's really exciting.
It's very thrilling.
But it's not real life.
And it'll eat your whole life away.
Yeah.
So, I'm curious.
How did you, I mean, did you know from the very beginning that you were
addicted?
No.
So, at what point, like, how long into it did you say, gee, this is a problem.
I should change this behavior?
Well, when I would go to bed in the morning.
Because I would come home from, like, a comedy show and I would literally play
all night long.
Okay.
And then I would realize it was, like, 8 o'clock in the morning and the sun was
up and I was just going to bed.
I was like, this is terrible for you.
Like, what am I doing?
I'm, like, basically working a night shift.
And I was also realizing that I was tired a lot because I was just, like,
really wrecking my system by doing that, by staying up.
And also, the game is so exciting.
You're like, you know, you're redlining.
Yeah.
And then you get out of there and you're, like, you feel cracked out.
Yeah.
So, usually, you know, as we become addicted to something, we don't see it
until there's some sort of threshold where maybe we have a bad consequence or
someone else makes a comment or just something happens so that we start to look
at our behavior in a different way.
So, I guess I'm wondering with your video game addiction, what was it for you?
Like, sort of, do you remember what the tipping point was where you said, I
have to stop doing this?
Well, I do a lot of self-auditing.
I don't think I was pretty aware that I was screwing up.
Okay.
I wasn't focusing enough on my career, like, my stand-up.
I wasn't focusing enough on other aspects of my life.
I was just way too into it.
And I was realizing also there's the reward.
It's, I have a problem.
I'm an obsessive person.
Like, I get into things.
The things that I like, I just think about them all the time.
It's not balanced.
Because I have this obsession with getting really good.
Right.
Like, whatever I get into, it becomes, like, too much of my life.
I was watching this documentary recently about my late friend, Anthony Bourdain.
And in the documentary, they were talking about how he used to be addicted to
heroin.
And then later on, it actually became a healthy thing.
It became jujitsu.
But it was like this addiction where he talked about it constantly.
And all the people that were working with him were laughing about how, like, he
never stopped talking about it.
He was just addicted to it.
And so, he was getting good at it.
It was healthy.
His body was getting very healthy.
But it was the same sort of function in the mind.
Right.
That's what I want to talk to you about.
What is that?
Yeah, yeah, yeah.
So, I mean, it's a great question.
It's something that people used to call the addictive personality.
We don't really call it that anymore.
We just use the idea of the disease model.
So, we say that somebody has the disease of addiction.
It's a chronic relapsing and remitting problem.
People come to it with different degrees of vulnerability.
And the risk for it can essentially be summarized as nature, nurture, and
neighborhood.
And just to briefly describe that, if you have a biological parent or grandparent
with addiction, you are at increased risk compared to the general population of
getting addicted yourself.
If you have a co-occurring mental illness, you are at increased risk of getting
addicted.
If you have certain character traits, like you're more impulsive, you have a
hard time putting a break between the idea to do something and actually doing
it, you're at increased risk for addiction.
So, that's kind of all in the sort of nature risk category.
There's also the nurture piece of it.
So, if you grow up in an environment where you experience a whole lot of trauma,
you are at increased risk for becoming addicted.
If you grew up in an environment where your caretakers model using drugs and
alcohol or other addictive substances or behaviors as a coping strategy, you
are at increased risk of becoming addicted.
Or even if they just implicitly condone it.
And then that brings us to the whole neighborhood idea.
And this, I think, is a really under-recognized aspect of our risk for
addiction, which is just simple access.
So, if you live in an environment where you have more access to highly
reinforcing drugs and behaviors, you're more likely to try them.
And just simply in being exposed, especially with the increasing potency,
variety, and novelty of drugs today, you're at increased risk of becoming
addicted.
So, if you go see a doctor who's more free with their prescription pad, you're
exposed to opioids or benzos, you're more likely to get addicted.
If you grow up in a culture where people are playing a lot of video games, you're
more likely to try them, more likely to get addicted.
So, this nature, nurture, and neighborhood are the risk factors.
But, again, people bring different degrees of vulnerability to this problem of
addiction.
And some people are more vulnerable than others.
And you may, indeed, be in that category where you're just somebody who, you
know, once you find something that's reinforcing for you, you just go, vroom,
and you just want to do it again and again and again.
When you say reinforcing, what do you mean by that?
I mean that it's rewarding in some way.
Rewarding.
Rewarding, right.
So, it's pleasurable at first.
Now, the thing about addiction and the way that it changes our brains is that
that thing that initially is pleasurable and has us engaging in approach
behaviors, if we continue to consume that substance or engage in that behavior,
it ultimately actually puts us in a dopamine deficit state such that we want to
continue to do that behavior, not to feel good, but just to stop feeling bad.
And that's kind of one of the fundamental things about the disease of addiction.
It's innate vulnerability to start added to the changes that occur in the brain
as a result of ongoing consumption of our drug.
And those brain changes are what drive continued compulsive use.
So, that's the difference between being enthusiastic about something that you
enjoy versus something that consumes your life.
So, you're kind of chasing the dragon, like the initial, like that's what they
talk about it with heroin addiction, right?
Right.
Don't they say chasing the dragon?
Yeah.
The initial rush that you get from the first uses of it, you're always chasing
that, but really what you're doing later on in life is just trying to not be
sick.
Yes.
Because not having it in your body makes you feel terrible.
Right.
So, interesting, that term chasing the dragon, it comes in part from, as you
describe, like the elusiveness of trying to recreate that initial high, which
with continued use becomes harder and harder.
But it also literally comes from when heroin is inhaled.
So, if you put it on a piece of tinfoil and you light it underneath, you get
this kind of smoke.
Then that plume looks like a dragon's tail.
So, it's got a couple of different meanings.
But, yes, I mean, what you're saying is exactly right.
And the way that I describe this to patients and describe it to medical
students is imagine that in your brain there's a balance, kind of like a teeter-totter
in a kid's playground.
And one of the most interesting findings in neuroscience in the past 75 years
is that pleasure and pain are co-located, which means the same parts of our
brain that process pleasure also process pain.
And they work like opposite sides of a balance.
So, when we do something that's rewarding or reinforcing or pleasurable, our
balance tips slightly to the side of pleasure.
We get a little release of dopamine, the pleasure neurotransmitter in that part
of our brain, our reward pathway, and we feel good.
But the thing about that balance is that it wants to remain level.
And the brain will work very hard to restore a level balance or what's called
homeostasis.
And it does that by tipping the brain an equal and opposite amount to the side
of pain.
So, again, the way the balance restores homeostasis is to tip to the opposite
side.
That's the come down after using that moment of wanting to do it again, the
hangover.
If we wait long enough, that feeling passes and balance is restored.
But if we don't wait and we continue to use our drug again and again, we end up
with a balance that's essentially weighted to the side of pain.
And I imagine that like these little neuroadaptation gremlins hopping on the
pain side of the balance.
Not very scientific, I know.
But the point is that with repeated use, we get enough gremlins on the pain
side of the balance to fill this whole room.
And then we're essentially working from a dopamine deficit state.
We've downregulated our own dopamine.
We've downregulated our own dopamine transmission.
And those gremlins like it on the balance.
So, they don't get off after the hangover is over or the acute withdrawal.
They can persist there for weeks to months to years, which is why people with
addiction, even when their lives have become so much better, will relapse.
Because they're not walking around with a level pleasure-pain balance.
They're walking around with a balance tipped to the side of pain.
They're experiencing the universal symptoms of withdrawal from any addictive
substance or behavior, anxiety, irritability, insomnia, dysphoria, and intrusive
thoughts of wanting to use their drug again.
Now, with enough time elapsed, and again, in people with severe addiction, it
can take months to years, those neuroadaptation gremlins will hop off.
We will regenerate our own dopamine and our own dopamine receptors.
And our level balance or homeostasis will be restored.
Is it scientific to call them gremlins?
Super scientific.
I'm hearing it's like, well, that's a great way to put it.
Because like people that are, like Jamie can attest to this, we had a relapse
of our video game addiction.
We, at the old studio, had a bunch of computers set up and we started playing
again.
And then we wind up playing like hours and hours every day.
And I had to stop again.
I go, oh, I see what's happening here.
Right.
I'm right back into this.
But this was like decades later.
Yes.
Well, I mean, and there are a couple interesting points about that.
So one is that in creating easy access at your other studio, the temptation was,
you're not able to withstand it.
And that's how-
Well, no, no, there was no, it wasn't temptation, it was a plan.
Like we planned to set this up.
I thought it would be fun to have.
But then once I knew there was no temptation.
Like we never went, maybe one time again, one time we did it, we went back and
played again after like a year of not playing.
We played a couple times when the Doom guys came, but never went back to it
again.
I was like, oh, I know what that is.
And so the room just sat there with these computers and we never used it.
But the way of looking at it like gremlins is a very interesting, is that your
thought process?
Yes.
You look at it like gremlins.
Yes.
That's how