DEPARTMENTS

Book Review: The Pleasure Principle

New and Notable

May 2022

Reading time min

Dopamine Nation book cover

Photo: Tuomas A. Lehtinen/Getty Images

We live in a world of abundance. But we’re operating with brains built to survive scarcity. That’s the baseline from which compulsive overconsumption, addiction, and even some depression and anxiety run rampant today, according to Anna Lembke, a professor of psychiatry and behavioral sciences and the medical director of Stanford Addiction Medicine, in Dopamine Nation: Finding Balance in the Age of Indulgence (Dutton).

Using sometimes shocking stories from patients she has treated over the years, as well as her own tumble down the rabbit hole of addiction in the form of romance novels, Lembke, MD ’95, blasts apart any argument that certain people—educated, healthy, successful, you name it—are immune to addiction, or at least the chronic problems that can develop from the constant pursuit of happiness. 

Our compulsive overconsumption risks not just our demise but also that of our planet. . . . We are devouring ourselves.

Pleasure, as Lembke describes it, is the result of any stimulus or behavior that gives your brain a hit of dopamine. And we live in a time of unprecedented, immediate access to high-dopamine stimuli, be it food, sex, social media, illicit drugs, one-day shipping, or anything that makes you feel good but that you kind of wish you had better control over. The problem with constant access to our drugs of choice is that our brains are forever trying to self-regulate or “correct” for the highs of reward by injecting us with a dose of the opposite feeling: pain. Which leads us to seek out even more pleasure, and before you know it, you’ve set down your work to check Instagram again for no reason, at which point you think, “Ohhh, I see it now.”

Dopamine Nation is not quite a how-to guide, though Lembke uses her work with patients to illustrate therapeutic approaches to eliminate or reduce unwanted consumption and explains the underpinnings that make programs like Alcoholics Anonymous successful. Lembke also delves into the issue of moderation, when that is possible. Indeed, many of our modern addictions (bet your smartphone is within reach right now) aren’t things we can reasonably expel from our lives. Mostly, the author offers a clearer understanding of why we do the things we do, a path toward recognizing and dealing with the stimuli that trouble us, and the space to be patient with and accepting of ourselves as we work toward better mental health. Pain, readers learn, is not the enemy. In fact, pain is necessary if our brains are to retain the ability to take pleasure in the small things. By learning to keep our dopamine in check and embracing pain—at least some of the time—we’ll end up living happier lives.


Summer Moore Batte, ’99, is the editor of Stanfordmag.org and author of Name and Tame Your Anxiety: A Kid’s Guide. You can reach her at summerm@stanford.edu.

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