What is pleasure and how does it work at the biological level? And if it feels right at the psychological level, I think we, and if you don't mind painting a picture of sort of the range of things that you have observed in your clinic or in life that people can become addicted to, but just to start off really simply, what is this thing that we call pleasure?

Well, I think it's actually really hard to define pleasure in any kind of succinct way because certainly there is the seeking out of a high or a euphoria or I think the kind of experience that most anybody would associate with the word pleasure, but also the seeking out of those same substances and behaviors is often a way to escape pain.

So for example, when I talk to people with addiction sometimes their initial foray into using a drug is to get pleasure, but very often it's a way to escape their suffering, whatever their suffering may be. And certainly as people become addicted, even those who initially were seeking out pleasure are ultimately just trying to avoid the pain of withdrawal or the pain of the consequences of their drug use.

So I think it's very hard to actually define it as this unitary thing. And it's certainly not just getting a high. There are so many ways in which people sort of want to escape, which is not the same thing as sort of this hedonic, you know, wanting to feel pleasure.

That's fascinating. So let's talk about the pleasure pain balance and addiction. And I've heard you use this seesaw or balance scale analogy before. And I think it's a wonderful one that really, for me, clarified what addiction is, at least at the mechanistic level. Yeah, so to me, one of the most significant findings in neuroscience in the last 75 years is that pleasure and pain are co-located, which means the same parts of the brain that process pleasure also process pain.

And they work like a balance. So when we feel pleasure, our balance tips one way. When we feel pain, it tips in the opposite direction. And one of the overriding rules governing this balance is that it wants to stay level so it doesn't want to remain tipped very long to pleasure or to pain.

And with any deviation from neutrality, the brain will work very hard to restore a level balance or what scientists call homeostasis. And the way the brain does that is with any stimulus to one side, there will be a tip in equal and opposite amount to the other side. It's like you have principle laws of physics.

Yes, right. Right. So like, I like to watch YouTube videos when I watch YouTube videos of American Idol, you know, it tips to the side of pleasure. And then when I stop watching it, I have a come down, right, which is a tip to the equal and opposite amount on the other side.

And that's that moment of wanting to watch one more YouTube video, right? Yeah. And I just want to interject there. So this moment of wanting to watch another that is associated with pain, I think, is, are we always aware of that happening? Because you just described it in a very conscious way.

Right. But when I indulge in something I enjoy, I'm usually thinking about just wanting more of that thing. Yes, yes. I don't think about the pain, I just think about more. Yes. Right. Right. So really excellent point because we're mostly not aware of it. And it's also reflexive. So we, it's not something that consciously happens or that we're aware of unless we really begin to pay attention.

And when we begin to pay attention, we really can become very aware of it in the moment. Again, it's like a falling away, like that, you know, you're on social media and, you know, you get a good tweet of something and then you can't stop yourself because there's this awareness, a latent awareness that as soon as I disengage from this behavior, I'm going to experience a kind of a pain, right?

A falling away, a missing that feeling, a wanting more of it. And of course, one way to combat that is to do it more, right? And more and more and more. So I think, I think that is really what I want people to tune into and get an awareness around.

Because once you tune into it, you can see it a lot. And then when you begin to see it, you have, and if you, you know, keep the model of the balance in mind, I think it gives people kind of a way to imagine what they're experiencing on a neurobiological level and understand it.

And in that understanding, get some mastery over it, which is really what this is all about. Because ultimately, we do need to disengage, right? We can't live in that space all the time, right? We have other things we need to do. And there are also serious consequences that come with trying to repeat and continue that experience or that feeling.

Yeah. So if I understand this correctly, when we find something, or when something finds us, that we enjoy, that feels pleasureful, social media, food, sex, gambling, whatever happens to be, and we will explore the full range of these, there's some dopamine release when we engage in that behavior. And then what you're telling me is that very quickly.

And beneath my conscious awareness, there's a tilting back of the scale, where pleasure is reduced by way of increasing pain, and I've heard you say before that the pain mechanism has some competitive advantages over the pleasure mechanism, such that it doesn't just bring the scale back to level, it actually brings pain higher than pleasure.

Could you tell us a little bit more about that? Yeah, yeah. So what happens, again, so the hallmark of any addictive substance or behavior is that it releases a lot of dopamine in our brain's reward pathway, right? Like broccoli just doesn't release a lot of dopamine, just doesn't, right?

I'm trying to imagine, I was about to say, and I stopped myself because, no, broccoli's good, it can be really good, but broccoli is not. - Yeah, broccoli is never amazing. - Right. Broccoli's never amazing, I mean, honestly, we can probably find somebody on the planet for whom broccoli is amazing.

- Yeah. - And of course, if I'm starving, broccoli is amazing, right? - Yeah, Rich Roll, Rich Roll is big on plants, and he has a good relationship to plants. - Right. - Rich, tell us how to make broccoli amazing. If anyone could do it, he'd be rich. - Yeah, yeah.

But what happens right after I do something that is really pleasurable and releases a lot of dopamine is, again, my brain is going to immediately compensate by down-regulating my own dopamine receptors, my own dopamine transmission, to compensate for that, okay? And that's that come down, or the hangover, or that after effect, that moment of wanting to do it more.

Now, if I just wait for that feeling to pass, then my dopamine will re-regulate itself, and I'll go back to whatever my chronic baseline is. But if I don't wait, and here's really the key, if I keep indulging again and again and again, ultimately, I have so much on the pain side, right?

That I've essentially reset my brain to what we call like an anhedonic or lacking in joy type of state, which is a dopamine deficit state. So that's really the way in which pain can become the main driver is because I've indulged so much in these high reward behaviors or substances that my brain has had to compensate by way down-regulating my own dopamine such that even when I'm not doing that drug, I'm in a dopamine deficit state, which is akin to a clinical depression, I have anxiety, irritability, insomnia, dysphoria, and a lot of mental preoccupation with using again or getting the drug.

And so that's the piece there. There's the single use, which easily passes, but it's the chronic use that can then reset really our dopamine thresholds. And then nothing is enjoyable, right? Then everything sort of pales in comparison to this one drug that I want to keep doing. And that one drug could be a person, right?

Yes. I mean, I know people in my life that are still talking about this one relationship, this one person that was just so great, despite all the challenges of that thing, that it's almost like they're addicted to the narrative. They were, maybe you're still are addicted to the person.

So it could be to any number of things, video games, sex, gambling, a person, a narrative. To me, and because of the way you described this mechanism, this pleasure pain balance, that all speaks to the kind of generalize ability of our brain circuitry. And this is something that fascinates me and I know it fascinates you as well, which is that nature did not evolve 20 different mechanisms for 20 different types of addiction.

Just like anxiety is a couple of core sets of hormones and neurotransmitters and pathways. And one person is triggered by social interactions. Another person is triggered by spiders, but the underlying response is identical. It sounds like with addiction as well, there, there may be some nuance, but that they're sort of a core set of processes.

So it doesn't really matter if it's gambling or video games or sex or a narrative about a previous lover or partner or whatever. It's the same addictive process underneath that, is that correct? Yes, exactly. And that's where this whole idea of cross addiction comes in. So once you've been addicted to a substance, severely addicted, that makes you more vulnerable to addiction to any substance.

And when you say substance, does the same, is what you just said also true for behaviors? Yes. So when I use the word drug, I'm talking about substances and behaviors really. And I'm talking about behaviors like gambling, sex, you know, gaming, porn. Absolutely. And I'm talking about behaviors like gambling, sex, you know, and I'm talking about drugs.