Dopamine Nation: Finding Balance in the Age of Indulgence by Dr. Anna Lembke.
Publisher: Dutton, an imprint of Penguin Random House.
Pages: 304 Year of Publication” September 2021.

“I turned to Jacob and began. “What can I help you with?”
Other beginnings I’ve evolved over time include: “Tell me why you’re here,” “What brings you in today?” and even “Start at the beginning, wherever that is for you.”
Jacob looked me over. “I am hoping,” he said in a thick Eastern European accent, “you would be a man.”
I knew then we would be talking about sex.
“Why?” I asked, feigning ignorance.
“Because it might be hard for you, a woman, to hear about my problems.”
“I can assure you I’ve heard almost everything there is to hear.”
“You see,” he stumbled, looking shyly at me, “I have the sex addiction.”
I nodded and settled into my chair. “Go on . . .”

Every patient is an unopened package, an unread novel, an unexplored land. A patient once described to me how rock climbing feels: When he’s on the wall, nothing exists but infinite rock face juxtaposed against the finite decision of where next to put each finger and toe. Practicing psychotherapy is not unlike rock climbing. I immerse myself in story, the telling and retelling, and the rest falls away.”

That is how one of the paragraphs reads in Chapter 1 of the book, titled Our Masturbation Machines.

Jacob, a compulsive masturbator even thought of committing suicide by jumping from a four storey building because of his addiction but was assisted by Dr. Anna. Self stimulation can be a type of self-care and has been shown to lower tension and anxiety. Additionally, it can aid in enhancing one's physical image and self-esteem, she counseled.

Addiction, whether to sex or another substance, is risky. Unfortunately, because of our irrational desire for enjoyment, we are all prone to compulsive overconsumption.

Dr. Anna, in her book, explores the impact of modern technology and the easy availability of instant gratification on our brain chemistry, specifically on the neurotransmitter dopamine. Dr. Anna argues that we have become a dopamine nation, addicted to the pursuit of pleasure and gratification at all costs, often at the expense of our physical and mental health.

The emphasis of this book is on pleasure and the eventual pain. Understanding the connection between pleasure and suffering is essential to living a good existence. The world is immersed in abundance of drugs, food, news, gambling, buying, gaming, messaging, sexting, Facebooking, Instagramming, YouTubing, Tweeting—and there are no shortages of any of these gears. The quantity, variety, and strength of extremely rewarding stimulation available today is astounding, says the author. Smartphones are the modern-day hypodermic syringe, giving a connected population constant access to digital dopamine. The moment you decide to try out, your preferred dope is accessible just at the click of the button. Therefore, Dr. Anna argues that understanding the connection between pleasure and suffering is essential to living a good existence.

Whenever scientists measure the addictive potential of a new experience, they use dopamine as a measure. There is a direct correlation between a brain's reward pathway producing more dopamine and the experience being more addictive, as Dr. Anna explains. The brain processes pleasure and pain in the same place, a remarkable neuroscientific discovery in the past century, along with the discovery of dopamine. Furthermore, pleasure and pain are like opposing sides of the same coin.

Dr. Anna further gives an example about craving for such things such as wanting a couple more pieces of chocolate or to want to keep reading, watching, or playing something for as long as we can. Wanting is the result of the brain's pleasure balance tipping to the side of pain at that moment. As a result of exploring the neuroscience of reward, our understanding of how pleasure and pain are intertwined will be improved. However, neuroscience alone isn't enough. The lived experience of humans is also important. Compulsive overconsumption is best taught by those most susceptible to it: addicts.

Drawing on her experience as a psychiatrist and addiction specialist, Dr. Anna provides a compelling analysis of the underlying causes of addiction and the psychological and societal factors that contribute to it. She explains how our brains are wired to seek out pleasure and how the modern world, with its endless distractions and temptations, has made it easier than ever to indulge in addictive behaviors.

Delilah, another patient, regularly smoked marijuana to treat her nervousness. She originally hesitated when Dr. Anna asked her to stop for a month, but she ultimately consented. The dopamine structure was created to aid in lowering obsessive drug use. The framework entails compiling data on the drug being used, including its nature, dosage, and frequency of use. It urges the user to refrain from using drugs for at least a month in order to clear their mind and reboot their brain's incentive system.

Dopamine-rich drugs and habits can impair our perception and lead to issues. These drugs may be used by people for a variety of purposes, but they always have unintended effects. The negative effects of substance use may not be as severe for young people, but as one grows older, these effects only get worse. Mindfulness training can assist in regaining equilibrium and harmony in the pleasure-pain system. People can now grasp the underlying reasons for their substance use and how to rebalance their system's pleasure-pain response by using the dopamine framework.

The book is divided into three parts, the first being The Pursuit of Pleasure, the second, Self-Binding and the third being The Pursuit of Pain. She has an acronym for dopamine. D=Data, O=Objectives, P=Problems, A=Abstinence, M=Mindfulness, I=Insight, N=Next Steps, and E=Experiments. This is the framework within which, but not exclusively Dr. Anna works.

The most beautiful part of the book is the author's frankness. She is candid enough to admit her addiction to graphic and erotic novels and stories. While reading novels of the ilk of Twilight and 50 Shades of Grey and such she is fully conscious of her family commitments but she is so much engrossed in the plot that she rummages through the pages even between the interval of counseling her patients. She, of course, overcomes this addiction. Her own addiction has come to help her diagnose her patients in much better way because she knows what addiction is, firsthand. The book is so engaging that it isn’t just a case study of patients but it has a flavor of a thriller, a category of unputdownable.

Another strength of the book is the detailing of scientific research, and practical recommendations. A thorough overview of the latest scientific research on addiction and the brain, makes complex concepts accessible to the general reader. Her experiences working with patients to provide real-world examples of the challenges and rewards of breaking free from addictive behaviors is commendable.

"Dopamine Nation" is a thought-provoking book that raises important questions about the impact of modern society on our mental and physical health. Dr. Anna's insights and recommendations are well-researched and practical, making this book a valuable resource for anyone struggling with addiction or seeking a more balanced and fulfilling life.

However, "Dopamine Nation" is not just a doom-and-gloom analysis of the addiction epidemic. Dr. Anna also offers practical advice on how to break free from the cycle of instant gratification and find more balance and fulfillment in life. She emphasizes the importance of mindfulness, self-awareness, and community support in overcoming addiction and finding purpose and meaning in life.

This book should be on the shelf of every de-addiction and AA centers across the world and should be a part of the medical syllabi.