Dr. Anna Lembke: Understanding & Treating Addiction

Anna Lembke 博士：理解和治疗成瘾

2021-08-16 | 官方页面 YouTube 官方音频

Andrew Huberman:

安德鲁·休伯曼：

Welcome to the Huberman Lab podcast, where we discuss science and science-based tools for everyday life.

欢迎来到休伯曼实验室播客，我们在这里讨论科学和基于科学的日常生活工具。

Andrew Huberman:

安德鲁·休伯曼：

I'm Andrew Huberman and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine.

我是安德鲁·胡伯曼，斯坦福大学医学院神经生物学和眼科教授。

Today I have the pleasure of introducing Dr. Anna Lembke.

今天我很高兴向大家介绍安娜·莱姆克博士。

Dr. Lembke is a psychiatrist and the Chief of the Addiction Medicine Dual Diagnosis Clinic at Stanford University School of Medicine.

Lembke 博士是一位精神病学家，也是斯坦福大学医学院成瘾医学双重诊断诊所的主任。

She's a psychiatrist who treats patients struggling with addiction.

她是一名精神科医生，专门治疗与毒瘾作斗争的患者。

She has successfully treated patients dealing with drug addiction, alcohol addiction and behavioral addictions, such as gambling and sex addiction, as well as other types of addiction.

她成功治疗了吸毒成瘾、酒精成瘾和赌博成瘾、性成瘾等行为成瘾以及其他类型成瘾的患者。

In fact, during our discussion, I learned that there are a huge range of behaviors and substances to which people can become addicted to, and that there is a common biological underpinning of all those addictions.

事实上，在我们的讨论中，我了解到人们可能对多种行为和物质上瘾，并且所有这些成瘾都有一个共同的生物学基础。

I also learned that there is a common path to the treatment and recovery from essentially all addictions.

我还了解到，基本上所有的成瘾都有一个共同的治疗和康复途径。

Dr. Lembke explained that to me and explained how to think about and conceptualize our own addictions, as well as the addictions of other people who are struggling to get treatment, move through treatment and stay sober from their addictions.

Lembke 博士向我解释了这一点，并解释了如何思考和概念化我们自己的成瘾，以及其他正在努力接受治疗、完成治疗并保持清醒的成瘾者的成瘾。

Andrew Huberman:

安德鲁·休伯曼：

In addition to treating patients, Dr. Lembke is an author and was featured in the 2020 Netflix documentary "The Social Dilemma." I'm excited to tell you that she has a new book coming out called "Dopamine Nation: Finding Balance in the Age of Indulgence." The book comes out August 24th and is an absolutely fascinating read into addiction and ways to treat various types of addiction.

除了治疗患者之外，Lembke 医生还是一名作家，并出现在 2020 年 Netflix 纪录片《社会困境》中。我很高兴地告诉你，她出版了一本新书，名为《多巴胺国家：在放纵时代寻找平衡》。这本书于 8 月 24 日出版，是一本关于成瘾和治疗各种类型成瘾的方法的绝对引人入胜的读物。

I've read the book cover to cover, and all I'll tell you is that at the very first chapter and throughout you are going to be absolutely blown away.

我从头到尾读完了这本书，我要告诉你的是，在第一章和整本书中，你会绝对被震撼。

The stories about her patients are extremely engaging.

关于她的病人的故事非常引人入胜。

It brings forward the real struggle of addiction and the incredible, I think it's fair to say heroic, battles that people fight in order to get through addictions of various kinds.

它提出了与毒瘾的真正斗争，以及人们为了摆脱各种毒瘾而进行的令人难以置信的战斗，我认为可以公平地说，这是英雄般的战斗。

And all of that is woven through with story, with science and ways that make it very accessible to anyone, whether or not you have a science background or not.

所有这些都与故事、科学以及任何人都可以轻松理解的方式交织在一起，无论您是否有科学背景。

Andrew Huberman:

安德鲁·休伯曼：

I can't recommend it highly enough.

我极力推荐它。

So again, the book is "Dopamine Nation: Finding Balance in the Age of Indulgence." It comes out August 24th of this year, 2021, and you can preorder that book by going to Amazon.

再说一次，这本书是《多巴胺国家：在放纵时代寻找平衡》。该书将于 2021 年 8 月 24 日出版，您可以通过亚马逊预订该书。

We will provide a link to that in the show caption.

我们将在节目标题中提供指向该链接的链接。

Before we begin, I just want to mention that this podcast is separate from my teaching and research roles at Stanford.

在我们开始之前，我只想提一下，这个播客与我在斯坦福大学的教学和研究角色是分开的。

It is, however, part of my desire and effort to bring zero-cost-to-consumer information about science and science-related tools to the general public.

然而，我的愿望和努力的一部分是将有关科学和科学相关工具的零成本消费者信息带给公众。

In keeping with that theme, I'd like to thank the sponsors of today's podcast.

为了与这个主题保持一致，我要感谢今天播客的赞助商。

And now for my discussion with Dr. Anna Lembke.

现在我与 Anna Lembke 博士进行了讨论。

All right, great to have you here.

好的，很高兴你能来到这里。

Anna Lembke:

安娜·伦布克：

Thank you for having me.

谢谢你有我。

I'm excited to be here.

我很高兴来到这里。

Andrew Huberman:

安德鲁·休伯曼：

Yeah, I have a lot of questions for you.

是的，我有很多问题要问你。

I and many listeners of this podcast are obsessed with dopamine, and what is dopamine?

我和这个播客的许多听众都沉迷于多巴胺，什么是多巴胺？

How does it work?

它是如何运作的？

We all hear that dopamine is this molecule associated with pleasure.

我们都听说多巴胺是一种与快乐相关的分子。

I think the term "dopamine hits," like I'm getting a dopamine hit from this, from Instagram or from likes or from praise, or from whatever, is now commonly heard.

我认为“多巴胺刺激”这个词现在已经很常见了，就像我从Instagram、点赞、赞美或其他什么方式中获得了多巴胺刺激一样。

What is dopamine and what are maybe some things about dopamine that most people don't know, and probably that I don't know either?

什么是多巴胺？关于多巴胺的一些事情可能是大多数人不知道的，也许我也不知道？

Anna Lembke:

安娜·伦布克：

So dopamine is a neurotransmitter, and neurotransmitters are those molecules that bridge the gap between two neurons.

因此，多巴胺是一种神经递质，而神经递质是那些在两个神经元之间架起桥梁的分子。

So they essentially allow one neuron, the presynaptic neuron, to communicate with the postsynaptic neuron.

因此，它们本质上允许一个神经元（突触前神经元）与突触后神经元进行通信。

Dopamine is intimately associated with the experience of reward, but also with movement, which I think is really interesting because movement and reward are linked, right?

多巴胺与奖励体验密切相关，但也与运动密切相关，我认为这非常有趣，因为运动和奖励是相关的，对吧？

If you think about early humans, you had to move in order to go seek out the water or the meat, or whatever it was.

如果你想想早期人类，你必须移动才能寻找水或肉，或任何东西。

And even in the most primitive organisms, dopamine is released when food is sensed in the environment — for example, C.

即使在最原始的生物体中，当在环境中感知到食物时，例如梭菌，也会释放多巴胺。

elegans, a very primitive worm.

线虫，一种非常原始的蠕虫。

So dopamine is this really powerful, important molecule in the brain that helps us experience pleasure.

因此，多巴胺是大脑中真正强大、重要的分子，可以帮助我们体验快乐。

It's not the only neurotransmitter involved in pleasure, but it's a really, really important one.

它不是唯一与快乐相关的神经递质，但它是一种非常非常重要的神经递质。

And if you want to think about something that most people don't know about dopamine, which I think is really interesting, is that we are always releasing dopamine at a kind of tonic baseline rate, and it's really the deviation from that baseline rather than hits of dopamine in a vacuum that make a difference.

如果你想思考一下大多数人不知道的关于多巴胺的事情，我认为这非常有趣，那就是我们总是以某种强直基线速率释放多巴胺，而真正产生影响的是与该基线的偏差，而不是真空中多巴胺的点击量。

So when we experience pleasure, our dopamine release goes above baseline, and, likewise, dopamine can go below that tonic baseline, and then we experience a kind of pain.

因此，当我们体验快乐时，我们的多巴胺释放量会高于基线，同样，多巴胺会低于强直基线，然后我们就会经历一种疼痛。

Andrew Huberman:

安德鲁·休伯曼：

Interesting.

有趣。

So is it fair to say that one's baseline levels of dopamine, how frequently we are releasing dopamine in the absence of some drug or food or experience, just sitting, being, is that associated with how happy somebody is?

那么，公平地说，一个人的多巴胺基线水平，即我们在没有某种药物、食物或经验的情况下释放多巴胺的频率，只是坐着、存在，与一个人的幸福程度有关吗？

Their kind of baseline of happiness or level of depression?

他们的幸福基线或抑郁程度是什么？

Anna Lembke:

安娜·伦布克：

There is evidence that shows that people who are depressed may indeed have lower tonic levels of dopamine.

有证据表明，抑郁症患者的多巴胺水平可能确实较低。

So that's a really reasonable thought, and there is some evidence to suggest that that may be true.

所以这是一个非常合理的想法，并且有一些证据表明这可能是真的。

The other thing that we know, and this is really kind of what the book is about, is that if we expose ourselves chronically to substances or behaviors that repeatedly release large amounts of dopamine in our brain's reward pathway, that we can change our tonic baseline and actually lower it over time as our brain tries to compensate for all of that dopamine, which is more really than we were designed to experience.

我们知道的另一件事，这确实是这本书的内容，那就是，如果我们长期暴露在大脑奖励通路中反复释放大量多巴胺的物质或行为中，我们就可以改变我们的强直基线，并随着时间的推移，随着我们的大脑试图补偿所有多巴胺而实际上降低它，这比我们设计时要经历的更真实。

Andrew Huberman:

安德鲁·休伯曼：

Interesting.

有趣。

And is it the case that our baseline levels of dopamine are set by our genetics, by our heredity?

我们的多巴胺基线水平是由我们的基因、遗传决定的吗？

Anna Lembke:

安娜·伦布克：

Well, I think if you think about the early stages of development and infancy, certainly that is true.

嗯，我认为如果你考虑一下发展的早期阶段和婴儿期，这当然是正确的。

You're kind of born with probably whatever is your baseline level, but obviously your experiences can have a huge impact on where your dopamine level ultimately settles out.

你可能生来就有你的基线水平，但显然你的经历会对你的多巴胺水平最终稳定产生巨大影响。

Andrew Huberman:

安德鲁·休伯曼：

So if somebody's disposition is one of constant excitement and anticipation, or easily excited, these are ...

因此，如果某人的性格是一种持续的兴奋和期待，或者很容易兴奋，那么这些都是......

I think about the kind of people where you say, "Hey, do you want to check out this new place for tacos?" They're like, "Yeah, that'd be great." And other people are a little more cynical, harder to budge, like my bulldog Costello, very, very stable, low levels of dopamine with big inflections, in his case.

我想到了这样的人，你会说：“嘿，你想看看这个新的炸玉米饼店吗？”他们会说：“是的，那就太好了。”而其他人则更加愤世嫉俗，难以让步，就像我的斗牛犬科斯特洛一样，他的多巴胺水平非常非常稳定，多巴胺水平低，变化很大。

Do you think that's set, in terms of our parents, and obviously nature and nurture interact, but is dopamine at the core of our temperament?

你认为就我们的父母而言，这是固定的吗？显然，先天和后天是相互作用的，但多巴胺是我们气质的核心吗？

Anna Lembke:

安娜·伦布克：

I don't really think we know the answer to that, but I will say that people are definitely born with different temperaments, and those temperaments do affect their ability to experience joy.

我真的不认为我们知道这个问题的答案，但我会说，人们肯定生来就具有不同的气质，而这些气质确实会影响他们体验快乐的能力。

And we've known that for a long time, and we describe that in many different ways.

我们很早就知道这一点，并且我们以多种不同的方式描述这一点。

One of the ways that we describe that in the modern era is to use psychiatric nomenclature like this person has a dysthymic temperament, or this person has chronic major depressive disorder.

我们在现代描述这一点的方法之一是使用精神病学术语，比如这个人有心境恶劣的气质，或者这个人患有慢性重度抑郁症。

In terms of looking specifically at who's vulnerable to addiction, that's an interesting sort of mixed bag because when you look at the research on risk factors for addiction — so what kind of temperament of a person makes them more vulnerable to addiction?

就专门研究谁容易上瘾而言，这是一种有趣的混合体，因为当你查看有关成瘾风险因素的研究时，那么什么样的性格使他们更容易上瘾呢？

You see some interesting findings.

您会看到一些有趣的发现。

First, you see that people who are more impulsive are more vulnerable to addiction.

首先，你会发现越冲动的人越容易上瘾。

So what is impulsivity?

那么什么是冲动呢？

That means having difficulty putting space between the thought or desire to do something and actually doing it.

这意味着很难在想做某事的想法或愿望与实际去做之间留出空间。

And people who have difficulty putting a space there, who have a thought to do something and just do it impulsively, are people who are more vulnerable to addiction.

那些很难在其中留出空间的人，那些想要做某事但只是冲动地去做的人，是更容易上瘾的人。

Andrew Huberman:

安德鲁·休伯曼：

Interesting.

有趣。

In terms of impulsivity, is this something that relates literally to the startle reflex?

就冲动而言，这真的与惊吓反射有关吗？

For instance, as a lab director, I'm familiar with walking around my lab, and deciding I'm going to talk to my people.

例如，作为一名实验室主任，我熟悉在实验室里走动，并决定与我的人员交谈。

Of course, when they knock on my door, it's always like, "Wait, why am I being bothered right now?" Even though I love to talk to them, but I walk around my lab from time to time, and some people, I notice I'll say, "Do you have a moment?" And they'll slowly turn around and say, "Yeah," or "No" in some cases, and other people will jump the moment I say their name; they actually have a kind of heightened startle reflex.

当然，当他们敲我的门时，我总是会说，“等等，为什么我现在被打扰了？”尽管我喜欢和他们交谈，但我时不时地在我的实验室里走动，我注意到有些人我会说，“你有空吗？”在某些情况下，他们会慢慢转过身来说“是”或“不”，当我说出他们的名字时，其他人会跳起来；他们实际上有一种增强的惊吓反射。

Is that related to impulsivity, or is what you're referring to an attempt to withhold behavior that's very deliberate under very deliberate conditions.

这是否与冲动有关，或者你指的是在非常刻意的条件下试图抑制非常刻意的行为。

Anna Lembke:

安娜·伦布克：

Yeah, so I don't think that that startle reflex is necessarily related to impulsivity, that can be related to anxiety.

是的，所以我认为惊吓反射不一定与冲动有关，而冲动可能与焦虑有关。

So people who are high anxiety people will tend to have more of a startle reflex.

因此，高度焦虑的人往往会出现更多的惊吓反射。

Impulsivity is a little bit different.

冲动有点不同。

And by the way, impulsivity is not always bad.

顺便说一句，冲动并不总是坏事。

Impulsivity is that thing where there's not a lot of self-editing or worrying about future consequences.

You have the idea to do something and you do it.

你有做某事的想法并且你就去做了。

And of course, we can imagine many scenarios where that's absolutely wonderful.

There can be sort of a, let's say, intimate interactions between people where you wouldn't really want to be super inhibited about it.

比如说，人与人之间可能存在某种亲密的互动，而你真的不想对此过度克制。

You would want to be disinhibited and impulsive.

你会想要不受约束和冲动。

I can also imagine sort of fight-or-flight scenarios, like battle scenarios where it would really be good to be impulsive and just go Andrew Huberman:

我还可以想象某种战斗或逃跑的场景，比如战斗场景，冲动地走安德鲁·胡伯曼真的很好：

Where hesitation can cost you your life.

犹豫可能会让你付出生命的代价。

Anna Lembke:

安娜·伦布克：

Right.

对。

Yes, that's right, that's right.

是的，没错，没错。

And I think this brings up a really ...

我认为这确实带来了......

Something that I've come to believe after 25 years of practicing psychiatry is that what we now conceptualize in our current ecosystem as mental illness are actually traits that in another ecosystem might be very advantageous.

经过 25 年的精神病学实践，我开始相信，我们现在在当前生态系统中所概念的精神疾病实际上是在另一个生态系统中可能非常有利的特征。

They're just not advantageous right now because of the world that we live in.

由于我们生活的世界，他们现在并不具有优势。

And I think impulsivity is potentially one of those, right?

我认为冲动可能是其中之一，对吧？

Because we live in this world that's sort of like you have to constantly be thinking rationally about the consequences of X, Y or Z.

因为我们生活在这个世界上，这有点像你必须不断理性地思考 X、Y 或 Z 的后果。

And it's such a sensory-rich environment, that we are being bombarded with all of these opportunities, these sensory opportunities, and we have to constantly check ourselves.

这是一个感官丰富的环境，我们受到所有这些机会、这些感官机会的轰炸，我们必须不断地检查自己。

And so impulsivity is something that right now can be a difficult trait but isn't in and of itself a bad thing.

因此，冲动现在可能是一种困难的特质，但其本身并不是一件坏事。

Andrew Huberman:

安德鲁·休伯曼：

I see.

我明白了。

Yeah.

是的。

And I'm beginning to realize it's a fine line between spontaneity and impulsivity.

我开始意识到自发性和冲动之间只有一线之隔。

Anna Lembke:

安娜·伦布克：

Yeah.

是的。

Andrew Huberman:

安德鲁·休伯曼：

What is pleasure and how does it work at the biological level?

And if it feels right at the psychological level?

在心理层面上感觉是否正确？

And if you don't mind painting a picture of the range of things that you have observed in your clinic or in life that people can become addicted to.

如果您不介意画出您在诊所或生活中观察到的一系列人们可能上瘾的事物的话。

But just to start off really simply, what is this thing that we call pleasure?

但首先简单来说，我们称之为快乐的东西是什么？

Anna Lembke:

安娜·伦布克：

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.

嗯，我认为实际上很难以任何一种简洁的方式来定义快乐，因为肯定存在着对快感或欣快感的追求，或者我认为大多数人都会将这种体验与快乐这个词联系起来，但对这些相同的物质和行为的追求通常是逃避痛苦的一种方式。

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.

例如，当我与成瘾者交谈时，有时他们最初尝试使用毒品是为了获得快乐，但很多时候这是逃避痛苦的一种方式，无论他们的痛苦是什么。

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.

当然，当人们上瘾时，即使是那些最初寻求快乐的人，最终也只是想避免戒断的痛苦或吸毒后果的痛苦。

So I think it's very hard to actually define it as this unitary thing.

And it's certainly not just getting a high.

这当然不仅仅是获得高潮。

There are so many ways in which people sort of want to escape, which is not the same thing as this hedonic wanting to feel pleasure.

人们想要逃避的方式有很多种，这与想要享受快乐的享乐不是一回事。

Andrew Huberman:

安德鲁·休伯曼：

So someone could decide that they want to go out and dance, or get up and dance, because of the pleasure of dancing.

I can imagine that, and maybe it's very difficult for them to stay seated when a particular song comes on, for instance.

我可以想象这一点，例如，当播放一首特定的歌曲时，他们可能很难坐下来。

But seeking what we would call pleasure in order to eliminate pain, that evokes a different picture in my mind; that evokes a picture of somebody that feels lost or depressed or underwhelmed.

但是为了消除痛苦而寻求我们所谓的快乐，这在我脑海中唤起了不同的画面；这让人想起一个人感到失落、沮丧或不知所措的画面。

I definitely want to get into the precise and general description of addiction and what that is, but in a previous conversation we had, you said something that really rung in my mind, which is that many people who become addicted to things, let's call them addicts, have this feeling that normal life isn't interesting enough, that they are seeking a super normal experience.

我确实想对成瘾及其含义进行准确和一般的描述，但在我们之前的一次谈话中，你说了一些真正在我脑海中响起的话，那就是许多对事物上瘾的人，让我们称他们为瘾君子，有一种感觉，正常的生活不够有趣，他们正在寻求一种超正常的体验。

And that the day-to-day routine balance, which is actually in the title of your book "Dopamine Nation: Finding Balance in the Age of Indulgence," that the word balance itself can sometimes be a bit of an aversive term for people.

日常的平衡，实际上是你的书《多巴胺国家：在放纵时代寻找平衡》的标题，平衡这个词本身有时对人们来说是一个令人厌恶的术语。

Andrew Huberman:

安德鲁·休伯曼：

And I'm struck by this idea, and the reason I want to explore it is because so much of what I see online is about generating a lack of balance, about being tilted forward at all times, really leaning into life hard, experiencing life, living a full life.

我对这个想法感到震惊，我想探索它的原因是因为我在网上看到的很多内容都是关于产生平衡的缺乏，关于始终向前倾斜，真正努力生活，体验生活，过充实的生活。

Even the commencement speech given by Steve Jobs on this campus was really about finding passion, digging.

甚至史蒂夫·乔布斯在这个校园里发表的毕业典礼演讲也确实是在寻找激情、挖掘。

That's so much in the narrative now.

现在的叙述就这么多了。

So maybe you could just tell us a little bit about your experience with this association, if it really exists, between people's sense of the normalcy, or maybe even how boring life can be, and their tendency to become addicts of some sort.

所以也许你可以告诉我们一些你对这种联系的经历，如果它真的存在，人们对常态的感觉，甚至可能是生活有多无聊，与他们成为某种成瘾者的倾向之间的联系。

Anna Lembke:

安娜·伦布克：

Yeah.

是的。

Well, I think that life for humans has always been hard, but I think that now it's harder in unprecedented ways.

And I think that the way that life is really hard now is that it actually is really boring.

And the reason that it's boring is because all of our survival needs are met.

We don't even have to leave our homes to meet every single physical need, as long as you're of a certain level of financial wellbeing, which frankly, we talk so much about the income gap.

我们甚至不必离开家来满足每一个物质需求，只要你有一定的财务状况，坦率地说，我们谈论了很多关于收入差距的问题。

And certainly there is this enormous gap between rich and poor, but that gap is smaller than it's ever been in the history of humans.

当然，贫富之间确实存在着巨大的差距，但这种差距比人类历史上的任何时候都要小。

Even the poorest of the poor have more excess income to spend on leisure goods than they ever have before in human history.

Anna Lembke:

安娜·伦布克：

If you look at leisure time, for example.

例如，如果你看看休闲时间。

So people without a high school education have 42% more leisure time than people with a college degree.

So my point here is that life is hard now in this really weird way, in that we don't really have anything that we have to do.

So we're all forced to make stuff up, whether it's being a scientist or being a doctor or being an Olympic athlete or climbing Mount Everest.

And people really vary in their need for friction, and some people need a lot more than others, and if they don't have it, they're really, really unhappy.

人们对摩擦的需求确实有所不同，有些人比其他人需要更多，如果他们没有摩擦，他们真的非常不快乐。

And I do think that a lot of the people that I see with addiction and other forms of mental illness are people who need more friction.

我确实认为，我看到的许多患有成瘾和其他形式精神疾病的人都是需要更多摩擦的人。

They're unhappy, not necessarily because there's something wrong with their brain, but because their brain is not suited to this world.

他们不快乐，不一定是因为他们的大脑出了问题，而是因为他们的大脑不适合这个世界。

Andrew Huberman:

安德鲁·休伯曼：

And do you think they have that sense, My brain isn't suited to this world, or they simply feel a restlessness and they're constantly seeking stimulation?

你认为他们有这样的感觉，我的大脑不适合这个世界，或者他们只是感到不安，他们不断地寻求刺激？

Anna Lembke:

安娜·伦布克：

I think that's right.

我认为这是对的。

Yeah.

是的。

I think it's not really knowing what's wrong with me.

Why am I unhappy?

我为什么不快乐？

How can I be happier?

我怎样才能更快乐？

And of course, as you talk about what's so pervasive in our narrative now is find your passion, find whatever it is to save the world.

And in a way that's good because it has people out in the world and seeking.

从某种意义上说，这是件好事，因为它让人们在世界各地寻求。

But in a way, it can also be misleading in the sense that I think people aren't entirely aware that the world is a hard place, and that life is hard, and that we're all kind of making it up.

但在某种程度上，它也可能具有误导性，因为我认为人们并没有完全意识到世界是一个艰难的地方，生活是艰难的，而我们都是在弥补。

Do you know what I mean?

你知道我的意思吗？

Andrew Huberman:

安德鲁·休伯曼：

Yeah.

是的。

Well, there's a book by Cal Newport; I don't know if you know Cal Newport's work, but you guys are very symbiotic in your messages.

嗯，有一本书是卡尔·纽波特写的；我不知道你是否了解卡尔·纽波特的工作，但你们的信息非常共生。

But he's a professor of computer science at Georgetown.

Yes, at Georgetown.

是的，在乔治城。

And wrote a book some years ago, really ahead of its time, called "So Good They Can't Ignore You," which is about not meditating or doing much work to try and figure out what one's passion is by thinking, but rather go out and acquire skills, and develop a sense of passion for something by your experience of hard work and getting better and feedback, a little bit of the growth mindset thing of our colleague Carol Dweck.

几年前，我写了一本书，非常超前，书名叫《如此优秀，他们不能忽视你》，书里讲的是，不要沉思或做太多工作来尝试通过思考找出自己的热情所在，而是走出去，获取技能，通过努力工作、变得更好和反馈的经验来培养对某件事的热情，这有点像我们同事卡罗尔·德韦克的成长心态。

But he's gone on to write books, "Deep Work," which is all about removing yourself from technology and doing deep work.

但他继续写了《深度工作》一书，这本书的主题是让自己远离技术并进行深度工作。

And he's been a big proponent of the evils of context switching too often throughout the day, for sake of productivity mostly.

Andrew Huberman:

安德鲁·休伯曼：

His new book is called "A World Without Email." I'm beginning to realize as I cite off these books and your book "Dopamine Nation: Finding Balance in the Age of Indulgence," that maybe the reason why you two don't know about one another is because neither of you are on social media.

他的新书名为《没有电子邮件的世界》。当我引用这些书和你的书《多巴胺国家：在放纵时代寻找平衡》时，我开始意识到，也许你们两个互相不了解的原因是因为你们都不在社交媒体上。

Anna Lembke:

安娜·伦布克：

That's it.

就是这样。

That's it.

就是这样。

Andrew Huberman:

安德鲁·休伯曼：

And yet, you're two of the most productive people that I know, including productive authors.

然而，你们是我认识的两位生产力最高的人，包括生产力最高的作家。

So that's a discussion unto itself, but I find this fascinating.

So let's talk about the pleasure-pain balance and addiction.

那么让我们来谈谈快乐与痛苦的平衡和成瘾。

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.

我听说你以前用过这种跷跷板或平衡秤的类比，我认为这是一个很棒的类比，对我来说，它确实澄清了成瘾是什么，至少在机械层面上。

Anna Lembke:

安娜·伦布克：

So to me, one of the most significant findings in neuroscience in the last 75 years is that pleasure and pain are colocated, which means the same parts of the brain that process pleasure also process pain, and they work like a balance.

所以对我来说，过去 75 年神经科学中最重要的发现之一是快乐和痛苦是共存的，这意味着大脑中处理快乐的部分也处理疼痛，而且它们就像平衡一样发挥作用。

So when we feel pleasure, our balance tips one way; when we feel pain, it tips in the opposite direction.

So when we feel pleasure, our balance tips one way;当我们感到疼痛时，它会向相反的方向倾斜。

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.

所以它不想长期处于快乐或痛苦的状态。

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, an equal and opposite amount to the other side.

大脑这样做的方式是，一侧受到任何刺激，另一侧都会有一个相等且相反的量的提示。

Andrew Huberman:

安德鲁·休伯曼：

It's like the principle laws of physics.

这就像物理原理一样。

Anna Lembke:

安娜·伦布克：

Right.

对。

So I like to watch YouTube videos.

所以我喜欢看 YouTube 视频。

When I watch YouTube videos of American Idol, it tips to the side of pleasure, and then when I stop watching it, I have a comedown, which is a tip to the equal and opposite amount on the other side.

当我观看《美国偶像》的 YouTube 视频时，它会向快乐的一侧倾斜，然后当我停止观看时，我会感到沮丧，这是向另一侧的同等和相反的量倾斜。

And that's that moment of wanting to watch one more YouTube video.

Right.

正确的。

Andrew Huberman:

安德鲁·休伯曼：

Well, and I just want to interject there.

好吧，我只想插话一下。

So this moment of wanting to watch another that is associated with pain, I think — are we always aware of that happening?

Because you just described in a very conscious way, but when I indulge in something I enjoy, I'm usually thinking about just wanting more of that thing.

因为你刚才以非常有意识的方式描述了，但是当我沉迷于我喜欢的东西时，我通常会想到只是想要更多那件事。

Anna Lembke:

安娜·伦布克：

Yes, yes.

是的，是的。

Andrew Huberman:

安德鲁·休伯曼：

I don't think about the pain.

我不考虑疼痛。

I just think about more.

我只是想多了。

Anna Lembke:

安娜·伦布克：

Yes, right.

是的，没错。

So really excellent point because we're mostly not aware of it, and it's also reflexive.

So it's not something that consciously happens, or that we're aware of, unless we really begin to pay attention.

所以这不是有意识地发生的事情，或者我们意识到的事情，除非我们真正开始注意。

And when we begin to pay attention, we really can become very aware of it in the moment.

当我们开始注意时，我们真的可以在那一刻变得非常清楚。

Again, it's like a falling away.

再次，这就像坠落。

You're on social media and 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 pain of falling away, a missing that feeling, a wanting more of it.

因为有这样的意识，一种潜在的意识，一旦我脱离这种行为，我就会体验到一种脱离的痛苦，一种想念那种感觉，一种想要更多的感觉。

And of course, one way to combat that is to do it more and more and more and more.

当然，解决这个问题的一种方法就是越来越多地这样做。

So I think that is really what I want people to tune into and get an awareness around.

Anna Lembke:

安娜·伦布克：

Because once you tune into it, you can see it a lot.

因为一旦你调准它，你就能看到很多。

And then when you begin to see it, you have ...

然后当你开始看到它时，你就......

And if you 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.

如果你牢记平衡模型，我认为它为人们提供了一种方式来想象他们在神经生物学层面上经历的事情并理解它。

And in that understanding, get some mastery over it, which is really what this is all about.

在这种理解中，掌握它，这才是真正的意义所在。

Because ultimately we do need to disengage.

因为最终我们确实需要脱离。

We can't live in that space all the time.

我们不能一直生活在那个空间里。

We have other things we need to do.

我们还有其他事情需要做。

And there are also serious consequences that come with trying to repeat and continue that experience or that feeling.

试图重复和继续这种经历或感觉也会带来严重的后果。

Andrew Huberman:

安德鲁·休伯曼：

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 it happens to be — and we will explore the full range of these.

因此，如果我理解正确的话，当我们发现某些东西，或者当某些东西找到我们时，我们会享受、感觉愉快：社交媒体、食物、性、赌博，无论它是什么——我们将探索这些的全部范围。

There's some dopamine release when we engage in that behavior.

当我们从事这种行为时，会释放一些多巴胺。

And then what you're telling me is that very quickly, and beneath my conscious awareness, there's a tilting back of this scale where pleasure is reduced by way of increasing pain.

然后你告诉我的是，很快，在我的意识之下，这种规模出现了向后倾斜，快乐随着痛苦的增加而减少。

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.

我以前听你说过，痛苦机制比快乐机制具有一些竞争优势，因此它不仅仅使规模恢复到水平。

It actually brings pain higher than pleasure.

它实际上带来的痛苦高于快乐。

Could you tell us a little bit more about that?

您能告诉我们更多相关信息吗？

Anna Lembke:

安娜·伦布克：

Yeah, yeah.

是啊，是啊。

So what happens ...

那么会发生什么...

again, so the hallmark of any addictive substance or behavior is that it releases a lot of dopamine in our brain's reward pathway.

再次强调，任何成瘾物质或行为的标志都是它在我们大脑的奖励通路中释放大量多巴胺。

Broccoli just doesn't release a lot of dopamine.

西兰花只是不会释放大量多巴胺。

Just doesn't, right?

只是没有，对吧？

Andrew Huberman:

安德鲁·休伯曼：

I'm trying to imagine.

我试着想象一下。

I was about to say maybe, and I stopped myself because no, broccoli's good.

我正想说也许，但我阻止了自己，因为不，西兰花很好吃。

It can be really good, but broccoli is never amazing.

它确实很美味，但西兰花从来都不是令人惊奇的。

Anna Lembke:

安娜·伦布克：

Broccoli's never amazing.

西兰花从来都不是令人惊叹的。

Andrew Huberman:

安德鲁·休伯曼：

Never like, this is the most amazing ...

从来不喜欢，这是最神奇的...

Anna Lembke:

安娜·伦布克：

Honestly, we can probably find somebody on the planet for whom broccoli is amazing.

老实说，我们可能会在这个星球上找到一个对西兰花来说很神奇的人。

And of course, if I'm starving, broccoli is amazing.

当然，如果我饿了，西兰花真是太棒了。

Andrew Huberman:

安德鲁·休伯曼：

Rich Roll-

丰富的卷-

Anna Lembke:

安娜·伦布克：

。

Andrew Huberman:

安德鲁·休伯曼：

Rich Roll is big on plants and he has a good relationship to plants.

里奇·罗尔（Rich Roll）对植物很感兴趣，并且与植物有着良好的关系。

Rich, tell us how to make broccoli amazing.

里奇，告诉我们如何让西兰花变得美味。

If anyone could do it'd be Rich.

如果有人能做到的话那就是里奇了。

Anna Lembke:

安娜·伦布克：

Yeah.

是的。

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 downregulating my own dopamine receptors, my own dopamine transmission, to compensate for that.

但是，在我做了一些真正令人愉悦的事情并释放大量多巴胺之后，我的大脑将立即通过下调我自己的多巴胺受体、我自己的多巴胺传输来进行补偿，以补偿这一点。

And that's that comedown, or the hangover or that aftereffect, that moment of wanting to do it more.

这就是那种情绪低落、宿醉或后遗症、想要做得更多的时刻。

Now, if I just wait for that feeling to pass, then my dopamine will reregulate itself, and I'll go back to whatever my chronic baseline is.

现在，如果我只是等待这种感觉过去，那么我的多巴胺就会重新调节自己，我就会回到我的长期基线。

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 that I've essentially reset my brain to what we call anhedonic or lacking-in-joy type of state, which is a dopamine deficit state.

但如果我不等待，这真的是关键：如果我一次又一次地沉迷，最终我会感到非常痛苦，以至于我基本上将我的大脑重置为我们所说的快感缺乏或缺乏快乐的状态，这是一种多巴胺缺乏状态。

Anna Lembke:

安娜·伦布克：

So that's really ...

所以这真的是...

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 downregulating 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.

疼痛之所以成为主要驱动力，是因为我沉迷于这些高回报的行为或物质，以至于我的大脑不得不通过下调自己的多巴胺来补偿，这样即使我不服用这种药物，我也处于多巴胺缺乏状态，这类似于临床抑郁症。

I have anxiety, irritability, insomnia, dysphoria and a lot of mental preoccupation with using again or getting the drug.

我有焦虑、烦躁、失眠、烦躁不安，并且在精神上全神贯注于再次使用或服用药物。

And so that's the piece there.

这就是那部分。

There's the single use which easily passes, but it's the chronic use that can then reset our dopamine thresholds.

单次使用很容易通过，但长期使用可以重置我们的多巴胺阈值。

And then nothing is enjoyable, that then everything sort of pales in comparison to this one drug that I want to keep doing.

然后没有什么是令人愉快的，与我想继续做的这种药物相比，一切都显得苍白无力。

Andrew Huberman:

安德鲁·休伯曼：

And that one drug could be a person.

那一种药物可能是一个人。

Anna Lembke:

安娜·伦布克：

Yes.

是的。

Andrew Huberman:

安德鲁·休伯曼：

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.

我知道我生活中的人们仍在谈论这段关系，这个人是如此伟大，尽管那件事充满了挑战，以至于他们几乎沉迷于这种叙述。

Maybe they still are addicted to the person.

也许他们仍然对这个人上瘾。

So it could be to any number of things: video games, sex, gambling, a person, a narrative.

所以它可以适用于任何事物：电子游戏、性、赌博、一个人、一个叙述。

To me, and because of the way you described this mechanism, this pleasure-pain balance, that all speaks to the kind of generalizability of our brain circuitry.

对我来说，由于你描述这种机制、这种快乐与痛苦的平衡的方式，所有这些都说明了我们大脑回路的普遍性。

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.

这是让我着迷的事情，我知道它也让你着迷，那就是大自然并没有针对 20 种不同类型的成瘾进化出 20 种不同的机制。

Just like anxiety is a couple of core sets of hormones and neurotransmitters and pathways.

就像焦虑一样，有几组核心的激素、神经递质和通路。

And one person is triggered by social interactions.

而一个人是由社交互动触发的。

Another person is triggered by spiders, but the underlying response is identical.

另一个人被蜘蛛触发，但潜在的反应是相同的。

It sounds like with addiction as well, there may be some nuance, but that there's sort of a core set of processes.

听起来就像成瘾一样，可能存在一些细微差别，但有一套核心流程。

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.

因此，无论是赌博、电子游戏、性还是关于前任情人或伴侣的叙述，都并不重要。

It's the same addictive process underneath that.

这背后是同样的上瘾过程。

Is that correct?

这是正确的吗？

Anna Lembke:

安娜·伦布克：

Yes, exactly.

是的，完全正确。

And that's where this whole idea of cross addiction comes in.

这就是交叉成瘾的整个想法的由来。

So once you've been addicted to a substance, severely addicted, that makes you more vulnerable to addiction to any substance.

因此，一旦你对某种物质上瘾，严重上瘾，你就会更容易对任何物质上瘾。

Andrew Huberman:

安德鲁·休伯曼：

And when you say substance, is what you just said also true for behaviors?

当你说实质时，你刚才所说的也适用于行为吗？

Anna Lembke:

安娜·伦布克：

Yes.

是的。

So when I use the word drug, I'm talking about substances and behaviors, really, and I'm talking about behaviors like gambling, sex-

所以当我使用毒品这个词时，我实际上是在谈论物质和行为，而且我在谈论赌博、性行为等行为——

Andrew Huberman:

安德鲁·休伯曼：

Porn.

色情。

Anna Lembke:

安娜·伦布克：

Gaming, porn.

游戏、色情。

Absolutely.

绝对地。

Shopping.

购物。

Andrew Huberman:

安德鲁·休伯曼：

Work.

工作。

Anna Lembke:

安娜·伦布克：

Work.

工作。

Andrew Huberman:

安德鲁·休伯曼：

You've accused me.

你已经指责我了。

Just for the record, Anna, Dr. Lembke, has accused me, not accused me, has diagnosed me outside the clinic in a playful way of being work addicted.

郑重声明一下，安娜，伦布克医生，是在指责我，而不是指责我，而是在诊所外以一种有趣的方式诊断出我工作成瘾。

You're probably right.

你可能是对的。

The first thoughts I have when I wake up are typically about work, certainly within 50 milliseconds or so of waking.

当我醒来时，我的第一个想法通常是关于工作，当然是在醒来后 50 毫秒左右的时间内。

And probably the last thoughts I have, I would hope are not about work.

我希望我最后的想法可能不是关于工作。

But yeah, I work constantly.

但是，是的，我一直在工作。

I do other things, but I have to actively turn that off.

我做其他事情，但我必须主动关闭它。

Anna Lembke:

安娜·伦布克：

Yes, that's exactly right.

是的，完全正确。

And you're certainly not alone in that.

当然，你并不孤单。

And of course-

当然还有——

Andrew Huberman:

安德鲁·休伯曼：

At Stanford, no, no, no.

在斯坦福大学，不，不，不。

Anna Lembke:

安娜·伦布克：

I mean here in Silicon Valley, right, It's highly rewarded.

我的意思是在硅谷，对吧，它的回报很高。

So that kind of Andrew Huberman:

安德鲁·胡伯曼（Andrew Huberman）就是这样：

It's embedded in the culture.

它已融入文化中。

Anna Lembke:

安娜·伦布克：

Absolutely.

绝对的。

Yeah.

是的。

Andrew Huberman:

安德鲁·休伯曼：

Absolutely.

绝对的。

And there's this other city, I think it's called New York, where they also work a lot, I hear, and it's heavily rewarded.

还有另一个城市，我想它叫纽约，我听说他们在那里工作很多，而且回报丰厚。

I once said, and I'm sure that I'm not the first person to say it, but I was thinking about addiction, and I was thinking about the underlying circuits, and I posted something to social media.

我曾经说过，我确信我不是第一个这么说的人，但我在思考成瘾，我在思考潜在的电路，我在社交媒体上发布了一些东西。

It said that addiction is a progressive narrowing of the things that bring you pleasure.

它说成瘾是一种逐渐缩小给你带来快乐的事物。

That was the way that I kind of crystallized the literature in my mind.

这就是我在脑海中将文学具体化的方式。

And then we met, and you of course came and gave these amazing lectures in the neuroanatomy course for the medical students, and the rest is history.

然后我们见面了，你当然也来了，为医学生在神经解剖学课程中做了这些精彩的讲座，剩下的就是历史了。

But I tossed out a kind of mirroring statement for that as well, which was a bit overstepping, I admit, which I said, "Addiction is a progressive narrowing of the things that bring you pleasure." And I said, dare I say, "Enlightenment is a progressive expansion of the things that bring you pleasure." Not that anybody...

但我也对此提出了一种类似的说法，我承认这有点过分，我说，“成瘾是一种逐渐缩小给你带来快乐的事物的范围。”我说，我敢说，“启蒙是对给你带来快乐的事物的逐步扩展。”不是说任何人...

Andrew Huberman:

安德鲁·休伯曼：

...

is a progressive expansion of the things that bring you pleasure.

是逐渐扩展给你带来快乐的事物。

Not that anybody knows what enlightenment is, but it was my attempt to take a little bit of a jab at the fact that nobody knows.

并不是说任何人都知道启蒙是什么，但我试图对没有人知道的事实进行一点攻击。

And so, why wouldn't I throw in a neurobiological explanation?

那么，我为什么不加入神经生物学的解释呢？

Just to sample the waters.

只是为了取样。

Andrew Huberman:

安德鲁·休伯曼：

And people had varying levels of response.

人们有不同程度的反应。

But the reason I bring that up is that I would imagine that being able to derive pleasure from many things would be a wonderful attribute.

但我提出这个问题的原因是，我认为能够从许多事情中获得快乐将是一个很棒的属性。

We know people like this, that can experience pleasure in little things, and in big events.

我们认识这样的人，他们可以在小事和大事中体验到快乐。

Not just the big milestones of life, but also the subtle, as the yogis would say, the subtle ripples of life.

不仅是生命中的重大里程碑，而且还有微妙的，正如瑜伽行者所说的，生命中微妙的涟漪。

If such an ability exists, do you think that that reflects a healthily tuned dopamine system?

如果存在这种能力，您认为这是否反映了健康调节的多巴胺系统？

One that can engage and enjoy, but then disengage?

一个可以参与并享受但随后又脱离的人？

Is that what we should be seeking?

这是我们应该寻求的吗？

And to underscore, I know nothing about enlightenment, meditation or any of it, I use these as opportunities to explore.

强调一下，我对启蒙、冥想或任何其他一无所知，我利用这些作为探索的机会。

Anna Lembke:

安娜·伦布克：

Yeah, it's a great question.

是的，这是一个很好的问题。

And I understand the question as what should we be striving for, right?

我把这个问题理解为我们应该争取什么，对吧？

Where should we settle out?

我们应该去哪里定居？

And in my book, I really hold out people in recovery from severe addiction as modern day prophets for the rest of us.

在我的书中，我确实将那些从严重成瘾中恢复过来的人视为我们其他人的现代先知。

Because I do think that people who have been addicted and then get into recovery do have a hard-won wisdom that we can all benefit from.

因为我确实认为那些上瘾然后康复的人确实拥有来之不易的智慧，我们都可以从中受益。

And the wisdom, to distill it down — it's many things, but in terms of dopamine, the wisdom is there are adaptive ways to get your dopamine, and there are less than adaptive ways.

总结起来，智慧有很多，但就多巴胺而言，智慧是有适应性的方法来获取多巴胺，但也有不那么适应性的方法。

And in general, you could describe the adaptive ways as not too potent, so not tipping that balance too hard or too fast to the side of pleasure-

一般来说，你可以将适应性方式描述为不太有效，所以不要太猛烈或太快地将平衡倾斜到快乐的一边——

Andrew Huberman:

安德鲁·休伯曼：

Does that mean never allowing myself to be absolutely in complete bliss?

这是否意味着永远不允许自己处于绝对的幸福之中？

Or does it mean not allowing myself to stay in that state too long?

还是说不让自己在那种状态下停留太久？

Anna Lembke:

安娜·伦布克：

I think the latter.

我认为是后者。

And then, that gets to temperament, so I'm going to get that to a second.

然后，就涉及到气质了，所以我要再谈一谈。

In general, what we want is some kind of flexibility in that balance, and the ability to easily reassert homeostasis.

一般来说，我们想要的是这种平衡的某种灵活性，以及轻松恢复体内平衡的能力。

We don't want to break our balance, which is possible if we overindulge for enough period of time and end up with a balance tipped to the side of pain, this dopamine deficit state we've been talking about.

我们不想打破我们的平衡，如果我们过度放纵足够长的时间，最终平衡会向疼痛一侧倾斜，这是我们一直在谈论的多巴胺缺乏状态，这是可能的。

We want a flexible, resilient balance, which can be sensitive to things going on in the environment, which can experience pleasure and approach, which can experience pain and recoil.

我们想要一种灵活的、有弹性的平衡，它可以对环境中发生的事情敏感，它可以体验快乐和接近，它可以体验痛苦和反冲。

This is all adaptive and healthy and necessary and good.

这都是适应性的、健康的、必要的和好的。

Anna Lembke:

安娜·伦布克：

We would never want a balance that doesn't tilt, that would be a disaster, we wouldn't be human.

我们永远不会想要一个不倾斜的平衡，那将是一场灾难，我们就不是人类了。

And we wouldn't want that, it would be really, really boring.

我们不希望这样，那真的非常非常无聊。

On the other hand, what people in recovery from addiction talk about is, to some extent, having to learn to live with things being a little boring a lot of the time.

另一方面，从某种程度上来说，从成瘾中恢复的人们谈论的是必须学会忍受很多时候有点无聊的事情。

So, trying to avoid some of this intensity and thrill seeking and escapism that really is at the core of addictive tendencies.

因此，要尽量避免这种强度、寻求刺激和逃避现实的行为，而这确实是成瘾倾向的核心。

Andrew Huberman:

安德鲁·休伯曼：

Sorry to interrupt, but when you say boring, can we add stressful and boring?

抱歉打扰，但是当你说无聊时，我们可以加上压力和无聊吗？

Anna Lembke:

安娜·伦布克：

Yes.

是的。

Andrew Huberman:

安德鲁·休伯曼：

Because there are days where, I'm one of these people that have to remind myself to have fun because I forgot what the term means.

因为有时候，我是那些必须提醒自己要玩得开心的人之一，因为我忘记了这个词的含义。

Because I like to think that I experience a lot of pleasure in little things, but I'm a pretty hard-driving guy.

因为我喜欢认为我可以在小事中体验到很多乐趣，但我是一个非常努力的人。

I like goals and big milestones, and all that stuff.

我喜欢目标和重大里程碑，以及所有这些东西。

Anyway, the point being that many days I'm not bored, thinking, "Oh, there's nothing to do," but I am overwhelmed by the number of things that are really not pleasurable that I have to do.

不管怎样，重点是很多天我并不感到无聊，想着“哦，没什么可做的”，但我却被我不得不做的许多确实不愉快的事情压垮了。

I won't mention what they are, because I don't want my colleagues to be like, "So, that's why you don't respond to emails." No, just your emails.

我不会提及它们是什么，因为我不希望我的同事说，“所以，这就是你不回复电子邮件的原因。”不，只是您的电子邮件。

Not yours, Anna.

不是你的，安娜。

In any event, anxiety and boredom can hang out together, am I correct in-

无论如何，焦虑和无聊都会同时出现，我的说法正确吗——

Anna Lembke:

安娜·伦布克：

Oh, for sure.

哦，当然。

Actually, boredom is highly anxiety-provoking.

事实上，无聊很容易引发焦虑。

Because when-

因为当——

Andrew Huberman:

安德鲁·休伯曼：

Okay, that's good to know, because I think people hear "boredom," and they think, "Oh, there's nothing to do here." I feel like we have a ton to do, we just don't really want to do it, as opposed to something that we're excited to do.

好吧，知道这一点很好，因为我认为人们听到“无聊”，他们会想，“哦，这里没什么可做的。”我觉得我们有很多事情要做，我们只是不想做，而不是我们很高兴做的事情。

Anna Lembke:

安娜·伦布克：

Right, okay, so that this gets to some of the core things also we were talking about earlier about finding your passion.

好的，好的，这涉及到我们之前讨论过的一些核心问题，即找到你的激情。

So I'm going to try to link it all together.

所以我将尝试将它们联系在一起。

But first of all, boredom is a rare experience for modern humans, because we're constantly distracting ourselves from the present moment.

但首先，无聊对于现代人来说是一种罕见的经历，因为我们不断地分散自己对当下时刻的注意力。

And we have an infinite number of ways to do that.

我们有无数种方法可以做到这一点。

But boredom is really, I think, an important and necessary experience.

但我认为，无聊确实是一种重要且必要的经历。

But it is scary, because when you allow yourself to be bored, let's say you had that list of all the things you hate to do but you actually got them all done.

但这很可怕，因为当你让自己感到无聊时，假设你列出了所有你讨厌做的事情的清单，但你实际上把它们都完成了。

Imagine that, and you got your forthcoming book done, and you did all your interviews-

想象一下，你完成了即将出版的书，并且完成了所有采访 -

Andrew Huberman:

安德鲁·休伯曼：

It could happen, lightning could strike.

这可能会发生，闪电可能会袭击。

Anna Lembke:

安娜·伦布克：

Right.

对。

And you walked your dog, and you cleaned your house, and you went shopping.

你遛狗、打扫房子、去购物。

Imagine that for a moment.

想象一下。

You would be sitting in your house, and my guess is you would be terrified.

你会坐在你的房子里，我猜你会感到害怕。

Because, wow, what am I supposed to do now?

因为，哇，我现在应该做什么？

There's nothing I really have to do.

我真的没有什么必须做的。

And that is really, really scary.

这真的非常非常可怕。

That can feel like freefall.

这感觉就像自由落体一样。

And yet, that's really an important and good experience to have.

然而，这确实是一次重要而美好的经历。

And I think that is an experience out of which we can have a lot of creative initiative, but also really consider our priorities and values.

我认为这是一种经验，我们可以从中产生很多创造性的主动性，但也可以真正考虑我们的优先事项和价值观。

Okay, here I am on Planet Earth, what the hee-haw am I going to do with my life?

好吧，我在地球上，我的人生到底要做什么？

What do I really care about?

我真正关心的是什么？

How do I really want to spend my time when I'm not distracting myself in order to spend it?

当我不分散自己的注意力时，我真正想如何度过时间？

Anna Lembke:

安娜·伦布克：

And then, this gets back to our conversation a little bit earlier about finding your passion.

然后，这又回到了我们之前关于找到你的激情的谈话。

So, I think that one of the big problems now, that's very misguided, about this idea of finding your passion: it's almost as if people are looking to fit the key into the lock of the thing that was meant for them to do.

所以，我认为现在的一个大问题是，关于寻找你的激情的想法是非常误导的：这几乎就像人们正在寻找将钥匙插入他们本来要做的事情的锁中一样。

Andrew Huberman:

安德鲁·休伯曼：

Right, and then everything will feel like a natural progression.

是的，然后一切都会变得自然而然。

Anna Lembke:

安娜·伦布克：

Right, and then everything will be wonderful, and I'll-

好吧，然后一切都会变得美好，我会-

Andrew Huberman:

安德鲁·休伯曼：

Yeah, I can attest to the fact that is not how it works in any endeavor.

是的，我可以证明，在任何努力中都不是这样的。

Anna Lembke:

安娜·伦布克：

Right, and that you'll have all this great success.

是的，您将获得所有这些巨大的成功。

And here's where I really think the answer lies.

我认为这就是答案所在。

And I really, really believe this.

我真的真的相信这一点。

Stop looking for your passion, and instead look around right where you are.

停止寻找你的激情，而是看看你所在的地方。

Stop distracting yourself, look around right where you are, and see what needs to be done.

不要让自己分心，环顾四周，看看需要做什么。

So, not what do I want to do, but what is the work that needs to be done?

所以，不是我想做什么，而是需要做什么工作？

And more importantly, it doesn't have to be some grandiose work.

更重要的是，它不一定是一些宏伟的工作。

Does the garbage need to be taken out?

垃圾需要倒掉吗？

Is there some garbage on your neighbor's lawn that someone threw there that you could actually bend over and pick up and put into the garbage can?

你邻居的草坪上是否有一些垃圾是有人扔在那里的，你实际上可以弯腰捡起来并扔进垃圾桶？

Look around you.

看看你的周围。

There is so much work that needs to be done that nobody wants to do that is really, really important.

有如此多的工作需要完成，但没有人愿意做，而这确实非常重要。

And if we all did that, I really think the world would be a much better place.

如果我们都这样做，我真的认为世界会变得更加美好。

Anna Lembke:

安娜·伦布克：

And this is what people who have severe addiction who get into recovery realize.

这就是重度成瘾者在康复过程中所意识到的。

They're like, "It's not about me and my will, and what I'm going to will in my life or in the world.

他们会说，“这与我和我的意愿无关，也与我在生活或世界上的意愿无关。

It's about looking around, what needs to be done, what is the work that I am called to do in this moment?" Which also is incredibly freeing, because I don't have to search for the perfect thing.

这是环顾四周，需要做什么，此刻我被召唤去做的工作是什么？”这也是令人难以置信的自由，因为我不必寻找完美的东西。

There's a lot of burden now on young people that they have to find that perfect thing, and until they've found that perfect thing, they're going to be miserable.

现在年轻人背负着很大的负担，他们必须找到完美的东西，而在他们找到完美的东西之前，他们会很痛苦。

You don't have to do that.

你不必这样做。

Look at the life you are given, look at the people around you, look at the jobs that present themselves to you, and do that job simply and honorably one day at a time with a kind of humility.

看看你被赋予的生活，看看你周围的人，看看摆在你面前的工作，并以一种谦逊的态度，一天一天地简单而光荣地完成这项工作。

Anna Lembke:

安娜·伦布克：

I think this is really what's so striking to me about the wisdom of people in recovery, there's this incredible humility that comes out of that experience.

我认为这确实是人们在康复过程中所表现出的智慧让我印象深刻的地方，这种经历带来了令人难以置信的谦逊。

You feel so broken, so ashamed, but you pick yourself up one day at a time, and you build a life that's around, what can I do right in this moment that might benefit another person, and thereby benefit me?

你感到如此破碎，如此羞愧，但你一天天地振作起来，你建立了一种周围的生活，此时此刻我能做些什么，可能使他人受益，从而使我受益？

Andrew Huberman:

安德鲁·休伯曼：

Yeah, it's a really important point.

是的，这是非常重要的一点。

And if you're willing, I'd like to actually stay on this issue of passion.

如果你愿意的话，我想继续讨论这个激情问题。

Because I think, if I understand them correctly, the dopamine systems merge with this work that you're referring to, this immediacy of things calling to us, like taking out the trash.

因为我认为，如果我理解正确的话，多巴胺系统会与你所指的这项工作融合在一起，这种召唤我们的事情的即时性，比如倒垃圾。

Which sounds, frankly, really boring, to be honest.

老实说，这听起来真的很无聊。

I hate taking out the trash, but I do it because I like a clean home, and I like the home that smells good, or at least doesn't smell bad.

我讨厌倒垃圾，但我这样做是因为我喜欢干净的家，而且我喜欢闻起来很香的家，或者至少闻起来不难闻。

So, we do these things, and not that we want to offer some larger carrot as a consequence of doing those things, but if I understand correctly, what you're saying is in the act of looking at one's immediate environment, acting on that immediate environment, we cultivate a relationship to these circuits in our brain about action and reward that, at least in my mind, span the range of small things being rewarding, and then lead us to the bigger things being rewarding.

所以，我们做这些事情，并不是说我们想因为做这些事情而提供一些更大的胡萝卜，但如果我理解正确的话，你所说的是在观察一个人的直接环境的行为中，在该直接环境中采取行动，我们与大脑中关于行动和奖励的回路建立了一种关系，至少在我看来，这种关系跨越了有奖励的小事情的范围，然后引导我们去做有奖励的更大的事情。

Andrew Huberman:

安德鲁·休伯曼：

It's not like all we're going to do is take out trash and tend to house, we eventually will venture out, and we eventually will find careers and work on those.

这并不是说我们要做的就是倒垃圾和收拾房子，我们最终会冒险出去，我们最终会找到职业并从事这些工作。

But if I understand correctly, you're talking about getting into a functional, or adaptive, action step, and it's the action step that, these days, we tend to overlook, because most of our mindset is in things that are truly outside of our immediate reality.

但如果我理解正确的话，你所说的是进入功能性或适应性行动步骤，而这是如今我们往往忽视的行动步骤，因为我们的大多数心态都在真正超出我们眼前现实的事情上。

Do I have that correct?

我说的对吗？

Anna Lembke:

安娜·伦布克：

Yeah, that was beautifully said.

是的，这话说得很漂亮。

And I would just add to that, I see a lot of young people who, for example, spend most of their waking hours playing video games.

我想补充一点，例如，我看到很多年轻人将大部分醒着的时间都花在玩电子游戏上。

And they come to me and they say, "I'm anxious and depressed.

他们来找我说：“我很焦虑，也很沮丧。

I'm majoring in computer science, I hate it.

我学的是计算机科学，我讨厌它。

I thought I would like it.

我以为我会喜欢它。

If I could only find that thing that I was really meant to do, my life would be better." And my first intervention for the many, many people like that that I see in clinical care is, "You have it backwards." I don't say it quite like that.

如果我能找到我真正想做的事情，我的生活就会更好。”对于我在临床护理中看到的很多很多这样的人，我的第一个干预措施是，“你把事情搞反了。”我不这么说。

"You are waiting for that thing to pull you out of the video game world, and you're never going to find it as long as you're playing video games."

“你正在等待那个东西把你从电子游戏世界中拉出来，但只要你还在玩电子游戏，你就永远找不到它。”

Anna Lembke:

安娜·伦布克：

Because the video games are so powerfully dopaminergic that you have this distorted sense of, really, pleasure and pain.

因为电子游戏具有如此强大的多巴胺能，以至于你会对快乐和痛苦产生扭曲的感觉。

And you will not be able to find that thing that you enjoy.

而且你将无法找到你喜欢的东西。

And so, of course, the intervention is abstain from video games, reset your reward pathways, start with a level balance.

因此，当然，干预措施是戒掉电子游戏，重置你的奖励途径，从水平平衡开始。

And what invariably happens, and I've just seen it, over 20 years, so many times, I've become really a believer in this.

总是会发生的事情，我刚刚亲眼目睹，20多年来，很多次，我已经真正相信了这一点。

All of a sudden it's like, "Oh, wow, my computer science class is interesting this quarter." You have a receptivity then to experiencing pleasure and reward in a way you just don't have when you're bombarding your reward pathways with these high-dopamine drugs.

突然之间，“哦，哇，这个季度我的计算机科学课很有趣。”当你用这些高多巴胺药物轰炸你的奖励途径时，你就会以一种你所没有的方式接受体验快乐和奖励。

Andrew Huberman:

安德鲁·休伯曼：

Very interesting.

非常有趣。

And just to underscore this notion that tending to the immediate things can lead to super performance, I may have mentioned it earlier this episode, but if I didn't, I'll mention it now, which is I have the great privilege of having some close friends that were in the SEAL teams and doing some work with those communities.

为了强调这种观念，即关注眼前的事情可以带来超级表现，我可能在本集早些时候提到过这一点，但如果我没有，我现在会提到这一点，这就是我很荣幸能在海豹突击队中拥有一些亲密的朋友，并与这些社区一起工作。

And it's a remarkable community for reasons that I think most people don't understand.

这是一个非凡的社区，其原因我认为大多数人都不理解。

They see the images carrying logs down the beach, and all the blowing stuff up, all the stuff that's fun for guys like that.

他们看到了沿着海滩搬运原木的图像，以及所有炸毁的东西，所有对这样的人来说很有趣的东西。

But all of the guys I know who are in the SEAL teams have this sense of duty about immediate things.

但我认识的所有海豹突击队队员都对眼前的事情有这种责任感。

And not just holding the door and helping with the dishes and moving things around, they are constantly scanning their environment for what can be done.

他们不只是守门、帮忙洗碗、搬东西，他们还不断地审视周围的环境，寻找可以做的事情。

They essentially conquer every environment they're in.

他们基本上征服了他们所处的每一个环境。

Andrew Huberman:

安德鲁·休伯曼：

They are also some of the most competitive human beings in the world.

他们也是世界上最具竞争力的人之一。

And unless they're in the act of war-fighting, which is their real job, they do it in every environment in a very benevolent way.

除非他们正在参与战斗（这是他们真正的工作），否则他们在任何环境下都会以非常仁慈的方式做到这一点。

And it's a remarkable thing, because I think it's part of what they're selected for.

这是一件了不起的事情，因为我认为这是他们被选中的一部分。

And there's a range there, but I think when we hear about tending to the immediate things, or this phrase, "How you do one thing is how you do anything"; that's a tricky one for me because there's certain things I just don't do well.

那里有一个范围，但我认为当我们听到关注眼前的事情或这句话时，“你如何做一件事就是如何做任何事情”；这对我来说是一件棘手的事情，因为有些事情我做得不好。

But should we always be trying?

但我们应该一直努力吗？

I think that setting the horizon in closely and tending to things in one's immediate environment, I think it is very powerful and translates.

我认为，密切关注自己的视野并关注眼前环境中的事物，我认为这是非常强大的并且可以转化。

Because again, I think the nervous system, it performs algorithms, it has action steps.

因为我再次认为神经系统，它执行算法，它有行动步骤。

The brain doesn't evolve to do one thing, it evolves to be able to use the same approach to doing lots of different things.

大脑的进化并不是为了做一件事，而是为了能够使用相同的方法做许多不同的事情。

Anna Lembke:

安娜·伦布克：

Yes.

是的。

I just want to add, even beyond that, because that totally resonates for me, and is very consistent with people in recovery from addiction who learn to take it one day at a time, which is one of the ...

我只是想补充一点，甚至除此之外，因为这完全引起了我的共鸣，并且与那些正在从成瘾中恢复的人们学习一天一次地服用它非常一致，这是......

standard lingo from Alcoholics Anonymous and other 12-step groups.

来自戒酒互诫协会和其他 12 步团体的标准行话。

But I think also, as you say, our brain is really wired for the 24-hour period.

但我也认为，正如您所说，我们的大脑实际上是 24 小时的。

We're not very good at the 10-year, 20.

我们对10年、20年的情况不太擅长。

We have these huge frontal lobes, and yes, we're great planners.

我们有巨大的额叶，是的，我们是伟大的规划者。

But if we live too much in that space, we can really get very anxious and depressed and lost, and either catastrophize or get grandiose.

但如果我们在这个空间里生活得太多，我们真的会变得非常焦虑、沮丧和迷失，要么陷入灾难，要么变得自大。

But if you can chunk it down to a day, what people in recovery talk about is how if I can just do today right, then I will get a chain of days that seem insignificant in their individual units, but after six months, or a year, or two years of those good days, I've got two very good years.

但如果你能把它分解为一天，康复中的人们谈论的是，如果我今天能做对，那么我将得到一连串的日子，这些日子在他们的个人单位中似乎微不足道，但在六个月、一年或两年的美好时光之后，我将度过两年非常美好的时光。

And I look back, and it's like, "Oh, wow.

我回头看，感觉就像是，“哦，哇。

I guess I did all that."

我想这一切都是我做的。”

Anna Lembke:

安娜·伦布克：

But I think that's really one of the keys, is really taking it one day at a time.

但我认为这确实是关键之一，就是一天一天地坚持下去。

And also, this connecting with the environment.

而且，这与环境有关。

Being awake and alert to your environment, and connecting with your environment, not trying to escape it.

对你的环境保持清醒和警惕，并与你的环境联系起来，而不是试图逃避它。

And of course, escapism is what we all want and desire, that experience of nonbeing, and we get it from the Internet, or from drugs or whatever it is.

当然，逃避现实是我们所有人想要和渴望的，那种不存在的体验，我们从互联网、毒品或其他任何东西中获得它。

But it's the booby prize, because ultimately, it takes you further and further away from your immediate environment, which is where we really have to connect to get that sense of groundedness and authenticity, and of being in our own lives.

但这是一个诱杀奖，因为最终，它会让你离你周围的环境越来越远，而这是我们真正必须联系起来才能获得扎根和真实感以及融入我们自己的生活的感觉的地方。

Andrew Huberman:

安德鲁·休伯曼：

Well, I think the unit of the day is something that comes up again and again in my discussions with colleagues who are extremely successful and who also have balanced lives.

嗯，我认为今天的单元是我与非常成功且生活平衡的同事讨论时一次又一次出现的内容。

This actually came up in the discussion with Karl Deisseroth, who is also a successful scientist and clinician and manages a family, et cetera.

这实际上是在与 Karl Deisseroth 的讨论中提出的，Karl Deisseroth 也是一位成功的科学家和临床医生，并管理着一个家庭等等。

So, the unit of the day, I think, is fundamental, and those stack up, as you mentioned.

所以，我认为，当天的单位是基本的，正如你提到的，这些是叠加的。

Along those lines, I've heard you say that in order to reset the dopamine system, essentially in order to break an addictive pattern, to become unaddicted, 30 days of zero interaction with that substance, that person, et cetera.

沿着这些思路，我听你说过，为了重置多巴胺系统，本质上是为了打破成瘾模式，变得不上瘾，30天与那种物质、那个人等等零互动。

Is that correct?

这是正确的吗？

Anna Lembke:

安娜·伦布克：

Yeah.

是的。

And 30 days is, in my clinical experience, the average amount of time it takes for the brain to reset reward pathways, for dopamine transmission to regenerate itself.

根据我的临床经验，30 天是大脑重置奖励路径、多巴胺传输自我再生所需的平均时间。

There's also a little bit of science that suggests that that's true.

还有一点科学表明这是真的。

Some imaging studies showing that our brains are still in a dopamine deficit state two weeks after we've been using our drug, and then a study by Schuckit and Brown, which took a group of depressed men who also were addicted to alcohol, put them in a hospital.

一些影像学研究表明，在我们使用药物两周后，我们的大脑仍然处于多巴胺缺乏状态，然后舒基特和布朗的一项研究将一群同样酗酒的抑郁男性送进了医院。

They had received no treatment for depression, but they had no access to alcohol in that time.

他们没有接受抑郁症治疗，但当时也无法饮酒。

And after four weeks, 80% of them no longer met criteria for major depression.

四个星期后，80% 的人不再符合重度抑郁症的标准。

So again, this idea that by depriving ourselves of this high dopamine, high reward substance or behavior, we allow our brains to regenerate its own dopamine for the balance to really equilibrate.

再说一遍，通过剥夺自己这种高多巴胺、高奖励物质或行为，我们可以让我们的大脑再生自己的多巴胺，以达到真正平衡的平衡。

And then, we're in a place where we can enjoy other things.

然后，我们就可以享受其他事情了。

Andrew Huberman:

安德鲁·休伯曼：

So, that progressive narrowing of what brings one pleasure eventually expands.

因此，带来快乐的东西的逐渐缩小最终会扩大。

I'd like to dissect out that 30 days a little more finely.

我想更仔细地剖析一下这 30 天。

And I also want to address, how does one stop doing something for 30 days if the thing is a thought?

我还想解决一个问题，如果某件事只是一个想法，那么一个人如何在 30 天内停止做某件事？

So, I'll put that on the shelf for a moment.

所以，我会把它暂时搁置起来。

Andrew Huberman:

安德鲁·休伯曼：

So, days one through 10, I would imagine, will be very uncomfortable.

所以，我想，第一天到第十天会非常不舒服。

They're going to suck, basically, to be quite honest.

老实说，他们基本上会很糟糕。

Because the way you described this pleasure-pain balance, to my mind, says that if you remove what little pleasure one is getting, or a lot of pleasure from engaging in some behavior, that's gone.

因为在我看来，你描述这种快乐与痛苦平衡的方式是说，如果你消除了一个人从从事某种行为中获得的一点点快乐，或者大量的快乐，那么这些快乐就消失了。

The pain system is really ramped up, and nothing is making me feel good.

疼痛系统确实增强了，没有什么能让我感觉良好。

I'll just use myself as an example, I'm not in recovery.

我只是以我自己为例，我还没有康复。

But that 10 days is going to be miserable.

但这10天将会是痛苦的。

Anxiety, trouble sleeping, physical agitation, and to the point where maybe impulsive, angry.

焦虑、睡眠困难、身体烦躁，甚至可能冲动、愤怒。

Should one expect all of that?

人们应该期待这一切吗？

Should the family members of people expect all of that?

人们的家人应该期待这一切吗？

Anna Lembke:

安娜·伦布克：

Yeah.

是的。

What I say to patients, and it's a really important piece of this intervention, is that you will feel worse before you feel better.

我对患者说的是，在感觉好转之前，您会感觉更糟，这是这种干预的一个非常重要的部分。

Andrew Huberman:

安德鲁·休伯曼：

For how long?

持续多久？

This is probably the first question they ask, right?

这可能是他们问的第一个问题，对吧？

Anna Lembke:

安娜·伦布克：

Yes.

是的。

And I say, "Usually, in my clinical experience, you'll feel worse for two weeks.

我说：“根据我的临床经验，通常情况下，你会感觉更糟两周。

But if you can make it through those first two weeks, the sun will start to come out in week three.

但如果你能熬过前两周，第三周太阳就会开始出现。

And by week four, most people are feeling a whole lot better than they were before they stopped using their substance." It's a hard thing, you have to sign up for it.

到第四周，大多数人感觉比停止使用药物之前好多了。”这是一件很难的事，你必须注册。

And I will say, obviously there are people with addictions that are so severe that, as long as they have access to their drug or behavior, they're not able to stop themselves.

我要说的是，显然有些人的毒瘾非常严重，只要他们能够接触到药物或行为，他们就无法阻止自己。

And that's why we have higher levels of care, or residential treatment.

这就是为什么我们有更高水平的护理或住院治疗。

This is not going to be for everybody, this intervention, but it's amazing how many people with really severe addictions to things like heroin, cocaine, very severe pornography addictions, I posit this, and I do it as an experiment.

这种干预并不适合所有人，但令人惊讶的是，有多少人对海洛因、可卡因、非常严重的色情成瘾等东西有严重的成瘾，我假设这一点，并且我将其作为一个实验。

I said, "You know what?

我说：“你知道吗？

let's try this experiment."

让我们尝试一下这个实验。”

Anna Lembke:

安娜·伦布克：

I'm always amazed, number one, how many of them are willing, and number two, how many of them are actually able to do it.

我总是感到惊讶，第一，他们中有多少人愿意，第二，他们中有多少人真正能够做到。

They are able to do it.

他们有能力做到。

And so, that little nudge is just what they need, and the carrot is there's a better life out there for you.

所以，这个小小的推动正是他们所需要的，而胡萝卜就是你可以过上更好的生活。

And you'll be able to taste it in a month.

一个月后你就可以品尝到它了。

You really will be able to begin to see that you can feel better and that there's another way.

你真的会开始发现你可以感觉更好，而且还有另一种方法。

Andrew Huberman:

安德鲁·休伯曼：

The way you describe it, it seems like it's hard, but it's doable for most people, not everybody.

从你的描述来看，这似乎很难，但对大多数人来说都是可行的，而不是每个人。

And we'll return to that category of people who can't do that on their own.

我们将回到那些无法靠自己做到这一点的人类别。

Well, then days 21 through 30, people are feeling better.

那么，从第 21 天到第 30 天，人们感觉好多了。

The sun is starting to come out, as you mentioned, which translates in the narrative we've created here, and is supported by biology, that dopamine is starting to be released in response to the taste of a really good cup of coffee, for instance.

正如你提到的，太阳开始出来了，这翻译成我们在这里创造的叙述，并得到生物学的支持，例如，多巴胺开始释放，以响应一杯真正好的咖啡的味道。

Anna Lembke:

安娜·伦布克：

Yes, exactly.

是的，完全正确。

Andrew Huberman:

安德鲁·休伯曼：

Whereas before, it was only to insert addictive behavior, whichever it happens to-

而以前，它只是插入成瘾行为，无论发生什么情况——

Anna Lembke:

安娜·伦布克：

Of course, coffee can be addictive too, but we'll leave that aside.

当然，咖啡也会让人上瘾，但我们先把它放在一边。

Andrew Huberman:

安德鲁·休伯曼：

Sure.

当然。

I feel like coffee has a consumption-limiting mechanism built in, where at some point you just can't ingest anymore.

我觉得咖啡有一种内置的消费限制机制，在某些时候你就无法再摄入了。

But maybe that's wrong.

但也许这是错误的。

Sorry to give lift to the caffeine addicts out there, as I clutch my mug.

当我抓着我的杯子时，很抱歉给那些咖啡因成瘾者带来了帮助。

So, days 21 through 30, I've seen a lot of people go through addiction and addiction treatment.

所以，从第 21 天到第 30 天，我看到很多人经历了毒瘾和毒瘾治疗。

I've spent a lot of time in those places, actually looking at it, researching, I've got friends in that community, I'm close with that community.

我在那些地方花了很多时间，实际观察、研究，我在那个社区有朋友，我与那个社区关系密切。

One thing I've seen over and over again, sadly often in the same individuals, is they get sober from whatever, they're doing great.

我一遍又一遍地看到一件事，可悲的是，经常在同一个人身上看到，他们从任何事情中都清醒了，他们做得很好。

These are people with families, these are people that you discard your normal image of an addict, and insert the most normal, typical healthy person you can imagine.

这些人都是有家庭的人，这些人是你抛弃你正常的瘾君子形象，插入你能想象到的最正常、典型的健康人的人。

Because a lot of these people, you wouldn't know were addicts.

因为你不知道其中很多人都是瘾君子。

Andrew Huberman:

安德鲁·休伯曼：

And then all of a sudden, you get this call, "So-and-so is back in jail.

然后突然，你接到这样的电话：“某某人又回到监狱了。

So-and-so's wife is going to leave him because he drank two bottles of wine and took a Xanax at 7:00 a.m., crashed his truck into a pole.

某某的妻子即将离开他，因为他在早上 7:00 喝了两瓶酒并服用了 Xanax，他的卡车撞上了一根柱子。

He's got two beautiful kids, how did this happen again?" To the point where, by the fourth and fifth time, people are just done.

他有两个漂亮的孩子，怎么又发生这种事了？”到了第四次、第五次的时候，人们就已经完成了。

You might be able to detect the frustration of my voice.

你也许能听出我声音中的沮丧。

I'm dealing with this with somebody, I don't even know that I want to help this time.

我正在和某人处理这件事，我什至不知道这次我想帮忙。

It's been so many times, to the point where I'm starting to wonder, "Is this person just an addict?

已经有很多次了，以至于我开始怀疑，“这个人只是一个瘾君子吗？

This is just what they do and who they are." And you never want to give up on people, and I'm hanging in there for them.

这就是他们所做的事情和他们是谁。”你永远不想放弃别人，而我会为他们坚持下去。

But I will say that many people have given up on them.

但我要说的是，很多人已经放弃了它们。

Andrew Huberman:

安德鲁·休伯曼：

And so, what I'd like to talk about in this context is what sorts of things help other people that we know that are addicted?

因此，在这种情况下，我想谈谈什么样的事情可以帮助我们认识的其他上瘾的人？

What really helps?

什么真正有帮助？

Not what could help, but what really helps?

不是什么可以帮助，而是什么真正有帮助？

And are there certain people for whom it's hopeless?

对某些人来说这是没有希望的吗？

I don't like to hold the conversation that way, but I wouldn't be close to the real-life data if I didn't ask, is it hopeless?

我不喜欢这样说话，但如果我不问，我就不会接近现实生活中的数据，是不是没有希望了？

Are there people who just will not be able to quit their substance use or their addictive behavior, despite, I have to assume, really wanting to?

是否有些人就是无法戒掉药物滥用或成瘾行为，尽管我不得不假设他们真的很想戒掉？

Anna Lembke:

安娜·伦布克：

Yeah, there are people who will die of their disease of addiction.

是的，有些人会死于毒瘾。

And I think conceptualizing it as a disease is a helpful frame.

我认为将其概念化为一种疾病是一个有用的框架。

There are other frames that we could use, but I do think, given the brain physiologic changes that occur with sustained heavy drug use and what we know happens to the brain, it is really reasonable to think of it as a brain disease.

我们还可以使用其他框架，但我确实认为，考虑到持续大量使用药物所发生的大脑生理变化以及我们所知道的大脑发生的情况，将其视为一种大脑疾病确实是合理的。

And for me, the real window of, let's say, being able to access my compassion around people who are repeat relapsers even when their life is so much better when they're in recovery — it's like a no-brainer, is to conceptualize this balance and the dopamine deficit state, and a balance tilted to the side of pain.

对我来说，真正的窗口，比方说，能够对那些复发的人表达我的同情心，即使他们在康复期间生活好多了——这就像一个简单的道理，就是概念化这种平衡和多巴胺缺乏状态，以及倾斜到疼痛一侧的平衡。

And to imagine that, for some people, after a month, or six months, or maybe even six years, their balance is still tipped to the side of pain.

想象一下，对于某些人来说，一个月、六个月、甚至六年后，他们的天平仍然偏向痛苦的一边。

That on some level, that balance has lost its resilience and its ability to restore homeostasis.

在某种程度上，这种平衡已经失去了弹性和恢复体内平衡的能力。

Andrew Huberman:

安德鲁·休伯曼：

It's almost like the hinge on that balance is messed up.

就好像平衡的铰链被搞乱了。

Anna Lembke:

安娜·伦布克：

Yes, exactly.

是的，完全正确。

And so, for someone who's never experienced addiction, like yourself, maybe one way to conceptualize it is-

因此，对于像你这样从未经历过成瘾的人来说，也许一种概念化的方法是——

Andrew Huberman:

安德鲁·休伯曼：

Well, I didn't say that.

嗯，我没那么说。

Anna Lembke:

安娜·伦布克：

Oh, okay.

哦，好吧。

。

Andrew Huberman:

安德鲁·休伯曼：

To be clear, I was not referring to myself.

需要澄清的是，我并不是指我自己。

But in this example I was give; if I were, I would come clean, I would reveal that.

但在这个例子中，我得到了；如果我是，我会坦白，我会透露这一点。

But I think that, especially after hearing some of your lectures and descriptions of the range of things that are addictive, I've been fortunate that I don't have a propensity for drugs or alcohol.

但我认为，特别是在听了您的一些讲座和对一系列令人上瘾的事物的描述之后，我很幸运，我没有吸毒或酗酒的倾向。

I'm lucky in that way.

我在这方面很幸运。

Now, frankly, if they remove all the alcohol from the planet, I'll just be relieved because no one will offer it to me anymore.

现在，坦率地说，如果他们从地球上清除所有酒精，我就会松一口气，因为没有人会再向我提供酒精了。

So, don't send me any alcohol, it won't go to me.

所以，别给我送酒，它不会送给我。

I like to think I have the compassion, but I don't have that empathy for taking a really good situation, and what from the outside, looks to be throwing it in the trash.

我喜欢认为我有同情心，但我没有那种同情心去接受一个真正好的情况，从外面看，它看起来像是把它扔进垃圾桶。

Anna Lembke:

安娜·伦布克：

Yeah.

是的。

Okay, and this is really, I think, important, because I also had to come to an understanding of this, and I feel that I have in my 20 years of seeing these patients.

好吧，我认为这确实很重要，因为我也必须了解这一点，而且我觉得在我看诊这些患者的 20 年里，我已经了解了这一点。

And of course, addiction is a spectrum disease, and so you've got the severe end of things.

当然，成瘾是一种谱系疾病，因此后果很严重。

Imagine that you had an itch somewhere on your body, we've all had that, whatever the source, and it was super, super itchy.

想象一下，你身体的某个地方很痒，我们都有过这种感觉，无论是什么原因，而且非常非常痒。

If you really focus, you could go for a pretty good amount of time not scratching it.

如果你真正集中注意力，你可以花很长一段时间不抓挠它。

But the moment you stopped focusing on not scratching it, you would scratch it.

但一旦你不再专注于不去抓它，你就会抓它。

And maybe you would do it while you were asleep.

也许你会在睡觉时这样做。

And that is what happens to people with severe addiction.

这就是重度成瘾者的情况。

That balance is essentially broken, homeostasis does not get restored despite sustained abstinence.

这种平衡基本上被打破了，尽管持续禁欲，体内平衡也没有恢复。

They're living with that constant specter of that pull.

他们生活在这种拉力的持续幽灵之中。

It never goes away.

它永远不会消失。

Anna Lembke:

安娜·伦布克：

Let me say, there are lots of people with addiction for whom that does go away.

让我说，有很多上瘾的人确实会消失。

And it goes away at four weeks for many of them.

对于他们中的许多人来说，这种情况会在四个星期后消失。

But in severe cases, that's always there, and it's lingering.

但在严重的情况下，这种情况始终存在，而且挥之不去。

And it's the moment when they're not focusing on not using, it's like a reflex, they fall back into it.

当他们不专注于不使用的那一刻，就像一种条件反射，他们又陷入了其中。

It's not purposeful, it's not because they want to get high, it's not because they value using drugs more than they do their family, none of that.

这不是有目的的，不是因为他们想吸毒，也不是因为他们比家人更看重吸毒，这些都不是。

It's that really, they cannot not do it when given the opportunity and that moment when they're not thinking about it.

确实，当有机会并且没有想到的那一刻，他们不能不这样做。

Does that make sense?

这有道理吗？

Andrew Huberman:

安德鲁·休伯曼：

That's a great description.

这是一个很棒的描述。

And actually, in that description, I can feel a bit of empathy.

事实上，在这个描述中，我能感受到一点同理心。

Because the way you describe scratching an itch in your sleep, I've done that with mosquito bites, and scratching, and you wake up scratching that mosquito bite.

因为你描述的在睡梦中抓痒的方式，我曾经用蚊子叮咬做过，然后抓挠，然后你醒来就抓着蚊子叮咬的地方。

And I also have to admit that I've experienced not feeling like I want to pick up my phone because it's so rewarding, but just finding myself doing it.

我还必须承认，我经历过不想拿起手机的感觉，因为它是如此有益，但只是发现自己在这样做。

Anna Lembke:

安娜·伦布克：

Yes, of course.#

是的，当然。#

Andrew Huberman:

安德鲁·休伯曼：

Like, "I'm not going to use this thing, I'm not going to use this thing," and then just finding myself doing it.

就像，“我不会使用这个东西，我不会使用这个东西”，然后发现自己在这样做。

Like, "What am I doing here?

就像，“我在这里做什么？

How did I get back here again?" And I know enough about brain function to understand that we have circuits that generate deliberate behavior, and we have circuits that generate reflexive behavior.

我怎么又回到这里了？”我对大脑功能有足够的了解，知道我们有产生故意行为的回路，也有产生反射性行为的回路。

And one of the goals of the nervous system is to make the deliberate stuff reflexive so you don't have to make the decision, because decision-making is a very costly thing to do.

神经系统的目标之一是使深思熟虑的事情成为反射性的，这样你就不必做出决定，因为决策是一件成本非常高的事情。

Decision making of any kind.

任何类型的决策。

Andrew Huberman:

安德鲁·休伯曼：

So, that does really help.

所以，这确实有帮助。

I want to just try and weave together this dopamine puzzle, however, because first phase of this 30 or 40 day detox, it's like a dopamine fast, right?

我想尝试将这个多巴胺拼图编织在一起，但是，因为 30 或 40 天排毒的第一阶段，它就像多巴胺禁食，对吗？

Anna Lembke:

安娜·伦布克：

Right.

对。

Andrew Huberman:

安德鲁·休伯曼：

Okay, first 10 days are miserable, middle 10 days, the clouds are out, there may be some shards of sunlight coming through.

好吧，前10天很痛苦，中间10天，乌云散去，可能会有一些阳光透过来。

And then all of a sudden, sun starts to come out, it gets brighter and brighter.

然后突然间，太阳开始出来，它变得越来越亮。

Why is it, then, that people will relapse, not just after getting fired from a job, or their spouse leaving them, but when things are going really well?

那么，为什么人们会旧病复发，不仅仅是在被解雇或配偶离开之后，而是在事情进展顺利的时候呢？

Is it this unconscious mechanism?

是这种无意识的机制吗？

Because I've seen this before, they have a great win.

因为我以前见过这样的情况，所以他们取得了一场伟大的胜利。

I have a friend who's a really impressive creative, I don't want to reveal any more than that, and relapsed upon getting another really terrific opportunity to create for the entire world.

我有一个朋友，他的创意非常令人印象深刻，我不想透露更多，但在获得另一个为整个世界创造的绝佳机会后，他又旧病复发了。

And I was like, "How can that happen?" But now I'm beginning to wonder, was it the dopamine associated with that win that opened the spigot on this dopamine system?

我当时想，“怎么会发生这种事？”但现在我开始怀疑，是不是与那场胜利相关的多巴胺打开了这个多巴胺系统的水龙头？

Because it happened in a phase of a really great stretch of life.

因为它发生在人生的一个非常伟大的阶段。

Anna Lembke:

安娜·伦布克：

Right.

对。

Yeah, so you raised that great point about triggers.

是的，所以你提出了关于触发器的重要观点。

And triggers are things that make us want to go back to using our drug.

触发因素是让我们想要重新使用药物的因素。

And the key thing about triggers, whatever they are, is they also release a little bit of dopamine.

触发器的关键在于，无论它们是什么，它们也会释放一点多巴胺。

So, just thinking about whatever the trigger is that we associate with drug use, or just thinking about drug use, can already release this anticipatory dopamine, this little mini spike.

因此，只要想到与吸毒相关的触发因素，或者只是想到吸毒，就已经可以释放出这种预期的多巴胺，即这种小小的尖峰。

But here's the part that I think is really fascinating.

但这是我认为真正令人着迷的部分。

That mini spike is followed by a mini deficit state, so it goes up, and then it doesn't go back down to baseline, it goes below baseline tonic levels.

这个小高峰之后是一个小赤字状态，所以它上升，然后它不会回到基线，它低于基线的紧张水平。

And that's craving.

这就是渴望。

So, that anticipation is immediately followed by wanting the drug.

因此，这种期待之后立即就会想要这种药物。

And it's that dopamine deficit state that drives the motivation to go and get the drug.

正是这种多巴胺缺乏状态驱动了去服用药物的动力。

Many people talk about dopamine, it's not really about-

很多人谈论多巴胺，其实并不是——

Anna Lembke:

安娜·伦布克：

..to go and get the drugs.

..去拿药。

So many people talk about dopamine is not really about pleasure, but about wanting and about motivation.

很多人谈论多巴胺实际上并不是关于快乐，而是关于想要和动力。

And so it is that deficit state that then drives the locomotion to get it.

因此，正是这种赤字状态驱动了获得它的动力。

Andrew Huberman:

安德鲁·休伯曼：

And earlier your description of dopamine being involved in the desire for more giving the sense of reward, but also movement-

早些时候你对多巴胺的描述涉及更多给予奖励感和运动感的欲望——

Anna Lembke:

安娜·伦布克：

Right?

对吗？

Andrew Huberman:

安德鲁·休伯曼：

I have to assume that those things are braided together in our nervous system for the specific intention of when you feel something good, then you feel the pain or maybe you don't notice it and then the next thing you know you're pursuing more of the-

我必须假设这些东西在我们的神经系统中编织在一起，以实现特定的意图：当你感觉良好时，然后你会感到痛苦，或者也许你没有注意到它，然后你知道你正在追求的下一件事是 -

Anna Lembke:

安娜·伦布克：

Yes.

是的。

And I love the way you use the word braided together, that's beautiful.

我喜欢你使用“编织”这个词的方式，这很漂亮。

And let me also just say something that I find also fascinating in my work with patients, and I see this all the time.

我还要说一些我在与患者的工作中发现的也很有趣的事情，而且我一直看到这一点。

There are people for whom bad life experiences; loss in any form, stress in many different forms, that's a trigger.

有些人的生活经历很糟糕；任何形式的损失、多种不同形式的压力，都是触发因素。

But there are absolutely people for whom the trigger is things going well, and the things going well can be like the reward of the thing is going well but very often what it is the removal of the hypervigilant state that's required to keep their use in check.

但绝对有一些人的触发因素是事情进展顺利，而事情进展顺利可能就像事情进展顺利的奖励，但通常是消除高度警惕的状态，以控制他们的使用。

So it's this sense of, "I want to celebrate or this reward happened, I want to put more reward on there." And it's really fascinating because when people come to that realization about themselves, that they're most vulnerable when things are going well, that's really a valuable insight because then they can put some things in place or barriers in place, or go to more meetings or whatever it is that they do to protect themselves.

所以就是这样的感觉，“我想庆祝或者这个奖励发生了，我想在那里放更多的奖励。”这真的很有趣，因为当人们意识到自己在事情进展顺利时最容易受到伤害，这确实是一个有价值的见解，因为这样他们就可以采取一些措施或设置障碍，或者参加更多的会议或采取任何措施来保护自己。

Andrew Huberman:

安德鲁·休伯曼：

Along those lines, I have a friend, 40 years sober, who was a severe drug and alcohol addict from a very young age.

沿着这个思路，我有一个朋友，40 年来一直保持清醒，他从小就严重吸毒和酗酒。

Really impressive person, does a lot of important work in the at-risk youth community out in Hawaii.

真是令人印象深刻的人，在夏威夷的高危青年社区做了很多重要的工作。

And he said something to me, he said, as former addicts often do, they got these great sayings, but I think it fits very well with what you're describing.

他对我说了一些话，他说，就像以前的瘾君子经常做的那样，他们有这些伟大的格言，但我认为这与你所描述的非常吻合。

He said, "No matter how far you drive, you're always the same distance from the ditch." And I said, "Well, that's kind of depressing." And he said, "No, that's actually what gives me peace."

他说：“无论你开多远，你离沟渠的距离总是一样的。”我说：“嗯，这有点令人沮丧。”他说：“不，这实际上给了我平安。”

Anna Lembke:

安娜·伦布克：

Yeah.

是的。

Andrew Huberman:

安德鲁·休伯曼：

Because what would happen is for so many years of relapsing and relapsing, recovering and relapsing, he felt like it was hopeless.

因为这么多年的复发又复发，痊愈又复发，他感觉已经没有希望了。

And then somehow conceptualizing that the vigilance can never go away.

然后以某种方式概念化，警惕性永远不会消失。

Instead of making him feel burdened, it made him feel relieved.

不但没有让他感到负担，反而让他感到轻松。

So I often think about that statement, no matter how far you drive, you're always the same distance from the ditch.

所以我经常想起这句话，无论你开多远，你离沟渠的距离总是一样的。

Because in my mind I conceptualize that as, "Gosh, that's a tough way to drive down the road." But actually, on a road where you know where the ditch is and where the lane lines are, it's actually a pretty nice drive.

因为在我的脑海里，我将其概念化为：“天哪，这真是一条艰难的道路。”但实际上，在一条你知道沟渠在哪里、车道线在哪里的道路上，这实际上是一次相当不错的驾驶。

It's when you don't know where the shoulder is that you constantly have to be looking around.

当你不知道肩膀在哪里时，你就必须不断地环顾四周。

So there's this, we're speaking now in analogies and imagery, and science, but one of the things I find so incredible about this community of 12-step, and there a variety of them, or the communities that they create for themselves, and some of these sayings, which I do believe link back to really core biological mechanisms.

所以，我们现在用类比、想象和科学来谈论这一点，但我发现这个 12 步社区非常令人难以置信的一件事是，有各种各样的社区，或者他们为自己创建的社区，以及其中一些谚语，我确实相信它们与真正的核心生物机制有关。

Anna Lembke:

安娜·伦布克：

Yes.

是的。

Andrew Huberman:

安德鲁·休伯曼：

I do want to ask about those communities.

我确实想询问这些社区的情况。

I have a question, which might be a little bit controversial.

我有一个问题，可能有点争议。

Anna Lembke:

安娜·伦布克：

Great.

太棒了。

Andrew Huberman:

安德鲁·休伯曼：

Which is, is it possible that people who were addicted to drugs or alcohol or some gambling or some other behavior get addicted to the addiction community?

也就是说，沉迷于毒品、酒精、赌博或其他行为的人是否有可能沉迷于成瘾社区？

Because one thing that I think I observe over and over is that there's some circuit in the brain of human beings that has to tell you about the dream they had the night before, for whatever reason.

因为我想我一遍又一遍地观察到的一件事是，人类大脑中有一些回路必须告诉你他们前一天晚上所做的梦，无论出于何种原因。

There's another circuit that leads people to wake you up if they themselves can't sleep, I don't know what circuit it is.

还有一个电路会导致人们自己睡不着的时候叫醒你，我不知道是什么电路。

I'm being facetious here.

我在这里开玩笑。

But there does seem to also be a circuit in the brain of addicts to discuss and want to talk about their recovery a lot.

但成瘾者的大脑中似乎确实存在一个回路，可以经常讨论并想要谈论他们的康复。

And I mentioned this, not to poke at them, but rather the opposite.

我提到这一点，不是为了讽刺他们，而是相反。

Because I think that one thing that is challenging, at least for me, and having friends that have a propensity for drug or alcohol addiction, not all of them, but certainly some of them, is when they're talking about their recovery, I feel like it's all they talk about; this meeting, that meeting, that way.

因为我认为，至少对我来说，一件具有挑战性的事情是，我的朋友有吸毒或酗酒的倾向，不是全部，但肯定是其中一些人，当他们谈论康复时，我觉得这就是他们谈论的全部；这次会议，那次会议，那样。

Andrew Huberman:

安德鲁·休伯曼：

So what I'm really asking here is can we become addicted to sobriety?

所以我真正想问的是我们会对清醒上瘾吗？

Anna Lembke:

安娜·伦布克：

So this is a great question, and it links into some of the other things we've been talking about having to do with where do we settle out, what is the way to live between pleasure and pain.

所以这是一个很好的问题，它与我们一直在谈论的其他一些问题有关，这些问题涉及我们在哪里定居，如何在快乐和痛苦之间生活。

And I implied earlier that ultimately we want to resilient balance that's sensitive to pleasure and pain but that can easily restore homeostasis after we indulge, even when we indulge greatly.

我之前暗示，最终我们想要一种弹性平衡，这种平衡对快乐和痛苦敏感，但在我们沉迷之后，即使我们非常沉迷，也可以很容易地恢复体内平衡。

But the truth of the matter is that people with severe addiction, I believe, temperamentally, want those extremes, and they're wired for that intensity that is more than just the slight adjustments around the fulcrum, right?

但事实是，我相信，严重成瘾的人在性情上想要这些极端，而且他们天生就追求这种强度，而不仅仅是围绕支点进行细微的调整，对吗？

It's like they want the big highs and the big lows.

就好像他们想要大的高点和大的低点。

Andrew Huberman:

安德鲁·休伯曼：

They'll say, "Great meeting."

他们会说：“很棒的会议。”

Anna Lembke:

安娜·伦布克：

Yeah.

是的。

Andrew Huberman:

安德鲁·休伯曼：

They're like, "That was such an amazing meeting." Or they find a group in a location.

他们说，“那真是一次令人惊奇的会议。”或者他们在某个地方找到了一群人。

This is almost an inside joke in those communities.

这在那些社区里几乎是一个内部笑话。

Again, I'm not reporting, I'm not talking about a friend in quotes.

再说一次，我不是在报道，我不是在用引号谈论朋友。

This isn't me reporting.

这不是我报道的。

They'll talk about how attractive people are at a given meeting or how bonded they feel to people at a given meeting, that the meetings themselves become their own form of dopamine hit.

他们会谈论人们在一次特定会议上的吸引力有多大，或者他们在一次特定会议上与人们的联系有多紧密，会议本身就成为他们自己的多巴胺刺激形式。

Anna Lembke:

安娜·伦布克：

Yes.

是的。

Andrew Huberman:

安德鲁·休伯曼：

And again, I'm not being disparaging, I want to understand this.

再说一次，我不是在贬低，我想理解这一点。

Anna Lembke:

安娜·伦布克：

Right.

对。

So yes, a lot of times patients will say to me, "Oh, I don't want to go to AA.

所以，是的，很多时候病人会对我说，“哦，我不想去 AA。

It's a cult." And my response to that is, because it's a cult is exactly why it works.

这是一种邪教。”我对此的回应是，因为它是一种邪教，这正是它起作用的原因。

Okay.

好的。

Because yes, it is much better for you to be addicted to AA and to recovery than almost any other addiction I could think of.

因为是的，对你来说，对 AA 上瘾并康复比我能想到的几乎任何其他上瘾要好得多。

And we know from Rob Malenka's work, who's here at Stanford, that oxytocin is the hormone that's involved in human pair bonding and relationships and love.

我们从斯坦福大学的罗布·马伦卡 (Rob Malenka) 的研究中得知，催产素是一种与人类夫妻关系、人际关系和爱情有关的激素。

And it directly links to dopamine neurons and causes the release of dopamine.

它直接与多巴胺神经元相连并导致多巴胺的释放。

So yes, when we connect with other humans, especially in a transcendent spiritual way, that's a huge dopamine hit.

所以，是的，当我们与其他人联系时，尤其是以超然的精神方式联系时，多巴胺会受到巨大的冲击。

And it does replace the dopamine that people get from drugs.

它确实取代了人们从毒品中获得的多巴胺。

And for people who have this addiction temperament, they need it on a more intense level.

对于有这种成瘾气质的人来说，他们需要更强烈的程度。

Anna Lembke:

安娜·伦布克：

They're not going to be generally satisfied with a sort of acquaintanceship, right?

他们通常不会满足于某种熟人关系，对吗？

They want that intensity of the intimacy that you get with people when you're cathartically exposing, warts and all.

他们想要那种当你宣泄地暴露自己的缺点时与人之间的那种强烈的亲密感。

So yes, people can get addicted to recovery and good for them, go for it!

所以，是的，人们可能会对康复上瘾，这对他们有好处，加油吧！

And of course, this can be disruptive for friendships and relationships where the one person is not in recovery, and "You're going to so many meetings, you're always talking about recovery" but you know what?

当然，如果一个人没有康复，这可能会破坏友谊和人际关系，并且“你要去参加很多会议，你总是在谈论康复”，但你知道吗？

Much better than them being intoxicated, right?

比他们喝醉要好得多吧？

So although you may tire of your friends talking about their meeting all the time, I'm sure you would rather have them do that than be in their addiction.

因此，尽管您可能厌倦了您的朋友一直谈论他们的会议，但我相信您宁愿让他们这样做，也不愿沉迷其中。

Andrew Huberman:

安德鲁·休伯曼：

Yeah, absolutely.

是的，绝对是。

And this is now the second time you've done this during this discussion, but now I have empathy because the way you describe their enthusiasm about meetings is probably the way that people feel about me and your work and in neuroscience.

这是你在这次讨论中第二次这样做，但现在我有同理心，因为你描述他们对会议的热情的方式可能就是人们对我、你的工作以及神经科学的感受。

I mean, I've been getting up in front of the class since I was eight years old and talking about things I read over the weekend.

我的意思是，从八岁起我就开始在全班同学面前谈论我周末读到的东西。

Now I just happen to have this thing called a podcast.

现在我碰巧有一个叫做播客的东西。

I've been doing it since I was little, about yet another amazing meeting or for ...

我从很小的时候就开始这样做了，为了另一场精彩的会议或者为了......

There's a different form of this, but there's some people for which they just love intense experiences.

这有一种不同的形式，但有些人就是喜欢激烈的体验。

Anna Lembke:

安娜·伦布克：

Yes.

是的。

Andrew Huberman:

安德鲁·休伯曼：

There're always trying to pull me off to Bali because they're talking about how sensual it is all the time.

总是有人想带我去巴厘岛，因为他们一直在谈论巴厘岛是多么性感。

I'm sure Bali's wonderful.

我确信巴厘岛很棒。

But there's this ratcheting up, it's like seeking Burning Man all year long.

但这种情况越来越严重，就像全年都在寻找火人节一样。

I've never been to Burning Man, no desire to go to Burning Man.

我从来没有去过火人节，也不想去火人节。

But inside of academia, I mean if I were to just turn the mirror at myself, inside of academia or here in Silicon Valley, work and the pursuit of more success, even if money is divorced from that, sometimes it is, sometimes it isn't.

但在学术界内部，我的意思是，如果我把镜子转向自己，在学术界内部或在硅谷，工作和追求更大的成功，即使金钱与此分离，有时是，有时不是。

Academic work is for sake of pursuit of knowledge.

学术工作是为了追求知识。

It sounds to me like the same mechanism.

在我看来，这听起来像是相同的机制。

In fact, it feels to me very much like the same mechanism.

事实上，我觉得这非常像相同的机制。

Anna Lembke:

安娜·伦布克：

So Andrew, here's what I love about you.

安德鲁，这就是我爱你的地方。

First of all, you're willing to bring your own flaws and foibles to this conversation.

首先，你愿意在这次谈话中提出自己的缺点和缺点。

Andrew Huberman:

安德鲁·休伯曼：

Well, they're everywhere.

嗯，它们无处不在。

Anna Lembke:

安娜·伦布克：

Well, you know what?

嗯，你知道吗？

It's wonderful.

太棒了。

And then you are really open and curious and wanting to understand, because I can't tell you how many people I have met who really see addiction as some kind of otherness.

然后你就会变得非常开放、好奇并想要了解，因为我无法告诉你我见过多少人真正将成瘾视为某种异类。

But the truth is, we're all wired for addiction.

但事实是，我们都容易上瘾。

And if you're not addicted yet, it's right around the corner, do you know what I mean?

如果你还没有上瘾，它就在眼前，你明白我的意思吗？

Especially with the incredible panoply of new drugs and behaviors that are out there.

尤其是面对令人难以置信的新药物和新行为。

So I love that you're willing to take a moment and really try to understand this, because it is — we can all relate and you're relating it to your, essentially, your work addiction, is right and apt. You just happen to be addicted to something that is really socially rewarded.

所以我喜欢你愿意花点时间真正尝试理解这一点，因为它是——我们都可以联系起来，你将它与你的本质上的工作成瘾联系起来，是正确且恰当的。你只是碰巧沉迷于真正能带来社会回报的东西。

You know, you figured that out at an early age, "Oh, when I do X, Y and Z, all these people go look at that smart kid" or whatever it is-

你知道，你在很小的时候就发现了这一点，“哦，当我做 X、Y 和 Z 时，所有这些人都会去看那个聪明的孩子”或者不管它是什么 -

Andrew Huberman:

安德鲁·休伯曼：

For me, it made me feel safe.

对我来说，这让我感到安全。

Anna Lembke:

安娜·伦布克：

Okay.

好的。

Andrew Huberman:

安德鲁·休伯曼：

I felt like, yeah, I just felt like this ...

我感觉，是的，我就是这样的感觉......

and I pause there because it's like peace.

我停在那里，因为这就像和平。

I'm like, "Ah, I can relax for a moment."

我想，“啊，我可以放松一会儿。”

Anna Lembke:

安娜·伦布克：

When you're talking about neuroscience?

当你谈论神经科学时？

Andrew Huberman:

安德鲁·休伯曼：

No. Or just when I feel like I'm on the right path and I'm onto something, or if I see something that I'm excited about, I'm like, I feel filled with, it must be dopamine.

不。或者当我感觉自己走在正确的道路上并且正在做某件事时，或者如果我看到一些令我兴奋的事情，我会觉得，我感觉充满了，那一定是多巴胺。

Anna Lembke:

安娜·伦布克：

Yes.

是的。

Andrew Huberman:

安德鲁·休伯曼：

I feel flooded with pleasure, literally from head to toe.

我感到从头到脚都充满了快乐。

And then my next thought is more.

然后我的下一个想法是更多。

Anna Lembke:

安娜·伦布克：

So true, you're really, you're a true addict.

真的，你真的是一个真正的瘾君子。

Andrew Huberman:

安德鲁·休伯曼：

Okay.

好的。

Anna Lembke:

安娜·伦布克：

You are.

你是。

Andrew Huberman:

安德鲁·休伯曼：

Thank you.

谢谢你。

Anna Lembke:

安娜·伦布克：

You are.

你是。

But you just got really-

但你真的——

Andrew Huberman:

安德鲁·休伯曼：

I think, thank you.

我想，谢谢。

Anna Lembke:

安娜·伦布克：

You really got lucky with the fact that what you're drawn to is adaptive, essentially.

你真的很幸运，因为你所吸引的东西本质上是适应性的。

And then your challenge is going to be that your life doesn't get too out of balance in the sense that your 24/7 work, and you don't stop and do some other things or think about-

然后你的挑战将是你的生活不会变得太不平衡，因为你的 24/7 工作，并且你不会停下来做一些其他事情或思考 -

Andrew Huberman:

安德鲁·休伯曼：

And my life, admittedly, is somewhat asymmetric.

诚然，我的生活有些不对称。

I mean it has other components of physical health, et cetera, but it is somewhat asymmetric, which is why I got a dog.

我的意思是它还有身体健康的其他组成部分等等，但它有点不对称，这就是我养狗的原因。

Although I talk about him an awful lot.

虽然我经常谈论他。

Anna Lembke:

安娜·伦布克：

But the dog is good, because that draws you out of yourself and a little bit away from the work.

但狗很好，因为它能让你脱离自我，远离工作。

But again, I think the key here is for people who feel like they've never experienced addiction or they don't know anybody with addiction, or if they do, they don't get it.

但同样，我认为这里的关键是对于那些感觉自己从未经历过成瘾的人，或者他们不认识任何成瘾的人，或者即使他们经历过，他们也不明白。

Just think of that one thing that is the most important thing in your life that you do that gives you pleasure and meaning and purpose.

想想你一生中所做的最重要的一件事，它给你带来快乐、意义和目的。

And then imagine if you couldn't do it.

然后想象一下如果你做不到的话。

Andrew Huberman:

安德鲁·休伯曼：

Oh yeah, let's not talk about that.

哦，是的，我们不谈这个了。

Well, I appreciate the feedback, and you can send me a bill at the end.

嗯，我很感激您的反馈，您可以在最后给我发送一份账单。

What is the most ridiculous-sounding addiction that you've ever witnessed that was actually a real addiction, along these lines?

你所见过的、听起来最可笑但实际上却是真正的瘾是什么？

Because I think we all know the standard heroin pill.

因为我想我们都知道标准的海洛因药丸。

I should mention because it's important, your previous book, and we will try to link to that as well, focused on the opioid crisis and what we thought was medication turned out to be just as bad, if not worse, than a lot of so-called street drugs.

我应该提到，因为这很重要，你的上一本书，我们也会尝试链接到这本书，重点关注阿片类药物危机，我们认为的药物结果证明与许多所谓的街头毒品一样糟糕，甚至更糟。

So we understand those: gambling, sex addiction, porn addiction, now video games.

所以我们理解这些：赌博、性成瘾、色情成瘾，现在是视频游戏。

We'll talk about social media a little bit more in-depth, but what's the most like, "Wow, I didn't realize people could get addicted to that."

我们将更深入地讨论社交媒体，但最常见的是，“哇，我没有意识到人们会对此上瘾。”

Anna Lembke:

安娜·伦布克：

Water.

水。

Andrew Huberman:

安德鲁·休伯曼：

Really?

真的吗？

Anna Lembke:

安娜·伦布克：

Really.

真的。

So I had a very lovely patient who had a severe alcohol addiction, and she got into recovery from her alcohol addiction for many years, but she had a sort of a polydipsia or an urge to be drinking something a lot.

我有一个非常可爱的病人，她有严重的酒瘾，她从酒瘾中恢复了很多年，但她有一种烦渴或想喝很多东西的冲动。

And so she drank a lot of water, and slowly over time she realized that if she drank enough water, she could become hyponatremic and delirious and be out of herself-

于是她喝了很多水，随着时间的推移，她慢慢意识到，如果她喝了足够多的水，她可能会出现低钠血症、神志不清，甚至失去自我——

Andrew Huberman:

安德鲁·休伯曼：

Can die from it, right?

会因此而死吧？

Anna Lembke:

安娜·伦布克：

Right.

对。

She just wanted to be out of her own head.

她只是想摆脱自己的头脑。

And so she would periodically, intentionally, overdose on water in order to ...

因此，她会定期、故意过量饮水，以便……

I know, it was so sad.

我知道，那真是太悲伤了。

Andrew Huberman:

安德鲁·休伯曼：

What happened to her?

她怎么了？

Anna Lembke:

安娜·伦布克：

She eventually took her own life.

她最终结束了自己的生命。

Andrew Huberman:

安德鲁·休伯曼：

Wow.

哇。

Anna Lembke:

安娜·伦布克：

Yeah.

是的。

It was really-

真的是——

Andrew Huberman:

安德鲁·休伯曼：

That's rough.

这很粗糙。

Anna Lembke:

安娜·伦布克：

She was a lovely woman.

她是一个可爱的女人。

She was so bright.

她是如此明亮。

She had so many interests and passions.

她有很多兴趣和热情。

And of course it was very sad when she died, but that was a wow to me, it was like, "Wow, if you have this disease of addiction, you can even get addicted to water."

当然，当她去世时，我感到非常悲伤，但这对我来说是一个哇，就像，“哇，如果你患有这种成瘾症，你甚至会对水上瘾。”

Andrew Huberman:

安德鲁·休伯曼：

Wow.

哇。

And I think it just underscores the generalized ability of these circuits.

我认为它只是强调了这些电路的通用能力。

There isn't a brain circuit for addiction to water that she happened to have.

她碰巧有一个对水成瘾的大脑回路。

There's a brain circuit for pleasure and pain and addiction, and water plugged into that circuit.

大脑中有一个负责快乐、痛苦和成瘾的回路，并且水插入该回路。

Anna Lembke:

安娜·伦布克：

Right.

对。

Andrew Huberman:

安德鲁·休伯曼：

Wow, that's intense.

哇，太激烈了。

In your book "Dopamine Nation," you also describe some amazing paths to recovery.

在您的《多巴胺国家》一书中，您还描述了一些令人惊奇的康复之路。

People that from reading it, I won't say which ones and who, because there's some great surprises in the book too.

人们读完这本书后，我不会说是哪些人和谁，因为书中也有一些很大的惊喜。

Both tragic and triumphant, as they say.

正如他们所说，既悲惨又胜利。

You've often described your patients as your heroes.

您经常将您的患者描述为您的英雄。

Anna Lembke:

安娜·伦布克：

Yeah.

是的。

Andrew Huberman:

安德鲁·休伯曼：

Tell us a little bit more about that.

请告诉我们更多相关信息。

Anna Lembke:

安娜·伦布克：

When you think about how hard it is to give up a drug or a behavior that you're addicted to, how much courage that takes and fortitude and discipline and stick-to-itiveness, these people are really amazing people.

当你想到放弃毒品或你上瘾的行为是多么困难，需要多大的勇气、毅力、纪律和坚持时，这些人真是了不起的人。

I don't know that I could do it, what they do.

我不知道我能做到，也不知道他们能做什么。

And we talked a little bit about just the constant ever-present urge to use, even after sustained periods of abstinence for some people — that's really hard.

我们讨论了一些持续存在的使用冲动，即使对某些人来说持续禁欲一段时间之后也是如此——这真的很难。

And of course, then you double down on the shame that they feel because of that urge, even when their lives are so much better.

当然，即使他们的生活好多了，你也会因为这种冲动而感到羞耻。

I mean, these people are really remarkable, and you take their remarkable accomplishment, and then you imagine the world that we live in now, where we are constantly invited and tempted and really bombarded with opportunities to become addicted at every turn.

我的意思是，这些人真的很了不起，你看到他们非凡的成就，然后你想象一下我们现在生活的世界，在那里我们不断地受到邀请和诱惑，并且在每一个转折点上都受到上瘾的机会的轰炸。

Andrew Huberman:

安德鲁·休伯曼：

It's like feeling an inch everywhere.

感觉到处都是寸土寸金。

Anna Lembke:

安娜·伦布克：

Oh yeah.

哦，是的。

I mean you can't escape it.

我的意思是你无法逃避它。

You know, you cannot escape it, that you'll get an email in your inbox inviting you to do X, Y or Z.

您知道，您无法逃避，您的收件箱中会收到一封电子邮件，邀请您执行 X、Y 或 Z。

And if you're addicted to that thing, and, you know, tried to delete all your apps and not go here, all of a sudden your work inbox, you're getting those images, let's say — really hard.

如果你沉迷于那个东西，并且，你知道，尝试删除所有应用程序而不去这里，突然你的工作收件箱，你会收到这些图像，可以说 - 真的很难。

And yet these people find a way to do it.

然而这些人找到了一种方法来做到这一点。

I think it's absolutely amazing.

我认为这绝对是惊人的。

And they're really wise people.

他们确实是聪明人。

They have so much wisdom to offer.

他们有很多智慧可以提供。

They've taught me a lot, as I talk about in my book, I have my own addictions, and I really just took a page right out of there.

他们教会了我很多东西，正如我在书中谈到的那样，我有自己的瘾，我真的只是从中吸取了教训。

But I was like, "Okay, what do I do now?

但我当时想，“好吧，我现在该怎么办？

All right, what did this patient do?

好吧，这个病人做了什么？

Okay, I'm going to try that."

好吧，我会尝试一下。”

Andrew Huberman:

安德鲁·休伯曼：

It is an amazing community of people that they are very sage.

这是一个令人惊叹的社区，他们都是非常圣人的人。

I wanted to just touch on something that you mentioned, which is the shame.

我想谈谈你提到的一些事情，这就是耻辱。

You know, you can't go to a meeting or talk to addicts without detecting or hearing about lies, shame, et cetera.

你知道，在参加会议或与成瘾者交谈时，你不可能不发现或听到谎言、羞耻等内容。

I heard you say in an interview with somebody else recently that truth-telling and secrets are sort of at the core of recovery.

我听到你最近在接受别人采访时说，说实话和秘密是康复的核心。

And tell us more about that.

请告诉我们更多相关信息。

Anna Lembke:

安娜·伦布克：

Yeah, so one of the things that I found really fascinating about working with people in recovery was how telling the truth even about the merest detail of their lives was central to their recovery.

是的，所以我发现与康复中的人们一起工作真正令人着迷的事情之一是，即使是他们生活中最微小的细节，说出真相对于他们的康复也至关重要。

And I became really curious about that.

我对此感到非常好奇。

Why would truth-telling be so important?

为什么说真话如此重要？

And of course, there is the obvious thing that when people are in their addiction, they're lying about using.

当然，有一个明显的事实是，当人们上瘾时，他们会在使用方面撒谎。

So part of getting into recovery is to stop lying to the people they care about about their use.

因此，恢复的一部分就是停止向他们关心的人撒谎。

But it's really more than that because what people in recovery have taught me is that it's not even just not lying about using drugs, I have to not lie about anything.

但事实远不止于此，因为康复中的人们告诉我，这不仅仅是在吸毒问题上不撒谎，我还必须在任何事情上都不能撒谎。

I can't lie about why I was late to work this morning, which we all do.

我不能对我今天早上上班迟到的原因撒谎，我们都会这样做。

"Oh, I hit traffic." No, I didn't hit traffic.

“哦，我撞车了。”不，我没有交通堵塞。

I wanted to spend two more minutes reading the paper and drinking my coffee, right?

我想再花两分钟读报纸、喝咖啡，对吗？

Or just lying about, I don't know, where I had dinner.

或者只是躺在那里，我不知道，我在哪里吃过晚饭。

Anna Lembke:

安娜·伦布克：

So people with addiction will get into the lying habit, where they're lying about random stuff because they're sort of in the habit of lying, and how recovery is really about telling the truth in all ways.

因此，上瘾的人会养成说谎的习惯，他们在随机的事情上撒谎，因为他们有点习惯说谎，而康复实际上就是以各种方式说实话。

And so one of the things that I had a lot of fun with in writing the book is exploring the neuroscience around why truth-telling is important to leading a balanced life.

因此，我在写这本书时感到非常有趣的事情之一就是探索神经科学，探讨为什么说真话对于过上平衡的生活很重要。

And we know every religion since the beginning of time is all about telling the truth.

我们知道，每一种宗教从一开始就都是关于讲真话的。

Well, why?

嗯，为什么？

And there's really interesting neuroscience behind it that suggests that when we tell the truth, we actually potentially strengthen our prefrontal cortical circuits and their connections to our limbic brain and our reward brain.

它背后有非常有趣的神经科学表明，当我们说实话时，我们实际上有可能加强我们的前额皮质回路及其与边缘脑和奖励脑的联系。

And of course, these are the circuits that get disconnected when we're in our addiction, our balance in our reward pathway, our limbic brain, our emotion brain is doing one thing.

当然，当我们陷入成瘾状态时，这些回路就会断开，我们的奖励途径、我们的边缘大脑、我们的情感大脑中的平衡正在做一件事。

Anna Lembke:

安娜·伦布克：

And our cortical circuits are completely disengaged from that, ignoring what's happening, which is easy to do because it's reflexive.

我们的皮质回路完全脱离了这一点，忽略了正在发生的事情，这很容易做到，因为它是反射性的。

We don't need to think about that balance for the balance to be happening.

我们不需要考虑这种平衡就能实现平衡。

But we have to reengage those circuits, anticipate future consequences, think through the drink, not just how am I going to feel now if I use, but how am I going to feel tomorrow or six months from now?

但我们必须重新启动这些回路，预测未来的后果，仔细思考饮料，不仅仅是如果我现在使用的话我会感觉如何，而是明天或六个月后我会感觉如何？

And that telling the truth is in fact a way to do that, to make these connections stronger.

事实上，说实话是实现这一目标的一种方式，可以使这些联系更加牢固。

And there I talk about some studies in my book that indirectly show that.

我在书中谈到了一些间接表明这一点的研究。

So I find that really fascinating.

所以我觉得这真的很有趣。

Plus being open and honest with people really does create very intimate connections, and those intimate connections create dopamine.

另外，对人开诚布公确实能创造出非常亲密的联系，而这些亲密的联系会产生多巴胺。

Anna Lembke:

安娜·伦布克：

So we were talking a little bit about how you, a bunch of people who need intensity in their lives.

所以我们谈论了一些关于你们这些生活中需要强度的人的事情。

For me, I need a lot of intensity in my human connections.

对我来说，我需要大量的人际关系。

I'm really not interested in, and bored by, and made anxious by casual interactions.

我真的对随意的互动不感兴趣、无聊、焦虑。

But having this discussion with you that's very intense and also intimate and self-disclosing is very rewarding for me.

但与你们进行这次非常激烈、亲密和自我揭露的讨论对我来说是非常有益的。

So that's an important source of dopamine.

所以这是多巴胺的重要来源。

Thank God I became a psychiatrist.

感谢上帝，我成为了一名精神科医生。

Andrew Huberman:

安德鲁·休伯曼：

Absolutely.

绝对的。

Anna Lembke:

安娜·伦布克：

I can't disclose all my stuff, but I am quite transparent with my patients, which is a slightly unorthodox.

我不能透露我所有的事情，但我对我的病人相当透明，这有点不正统。

But when I think it's right, I'm also transparent with them.

但当我认为正确的时候，我也会对他们开诚布公。

So that's a source of dopamine too, when we're honest and we disclose and that.

因此，当我们诚实并披露这一点时，这也是多巴胺的来源。

You think people are going to run away from you if you tell them about all your weird neuroses, but really they don't.

你认为如果你告诉他们你所有奇怪的神经症，人们就会逃离你，但实际上他们不会。

What they're like is, "Oh thank God I'm not the only one." Right?

他们的感觉是，“哦，感谢上帝，我不是唯一一个。”正确的？

Andrew Huberman:

安德鲁·休伯曼：

Well what I love about ...

嗯，我喜欢什么...

I love many things about your book.

我喜欢你的书的很多东西。

I read it in one sweep.

我一口气读完了。

Anna Lembke:

安娜·伦布克：

Oh thank you.

哦，谢谢。

Andrew Huberman:

安德鲁·休伯曼：

And I was like, "Wow." I was pleasantly surprised, but I was like, "Wow, she's really opening up in this book from the very beginning," and I don't want to give it away but, yeah, you're very open where it's appropriate.

我当时想，“哇。”我很惊喜，但我想，“哇，她从一开始就在这本书中真的很开放，”我不想放弃它，但是，是的，你在适当的地方非常开放。

And also I think that this question about truth-telling, I always think about like, "Tell the truth, a hundred percent about the truth." But there's also this element about do you report previous lies?

而且我认为这个关于说真话的问题，我总是在想，“说真话，百分百的真话。”但还有一个因素是关于你是否举报以前的谎言？

Right?

正确的？

What about prior behavior?

之前的行为又如何呢？

And I'm fascinated by this, because to me telling the truth has many facets.

我对此很着迷，因为对我来说，说实话有很多方面。

But the three sides of this thing in my mind are, one is reporting everything accurately.

但我认为这件事的三个方面是，一是准确地报告一切。

The other is what do you withhold, what do you not withhold, right?

另一个是你克制什么，你不克制什么，对吗？

Because some people say tell the truth or at least don't lie.

因为有人说要说实话，或者至少不要说谎。

That's sort of a-

这有点像——

Anna Lembke:

安娜·伦布克：

Lies of omission.

遗漏的谎言。

Andrew Huberman:

安德鲁·休伯曼：

That's lies of omission.

这就是遗漏的谎言。

And then there's, what I have to assume for most people, is a small-to-enormous batch of things that they lied about in the past that still thread into the future.

然后，对于大多数人来说，我必须假设，他们过去撒谎的一小部分到大量的事情仍然会影响到未来。

So how important is it for the addict, or every person really, to ...

那么，对于瘾君子或每个人来说，... 有多重要？

Because it sounds like cultivating the circuitry between prefrontal cortex and the dopamine system would be great for anybody, since we're all addicts.

因为听起来培养前额皮质和多巴胺系统之间的回路对任何人来说都是好事，因为我们都是瘾君子。

Everyone should do it, but in all seriousness, it sounds like a good thing for everybody to do.

每个人都应该这样做，但认真地说，这听起来对每个人来说都是一件好事。

How much work needs to be done on all the priors, all the stuff we've hidden.

对于我们隐藏的所有先验知识和所有内容，需要做多少工作。

I mean, not me, but all the stuff that everybody else has hidden.

我的意思是，不是我，而是其他人隐藏的所有东西。

Anna Lembke:

安娜·伦布克：

So the steps of the 12 steps of Alcoholics Anonymous, a good number of those steps are about that very thing: the past, the ways that we've harmed people in the past.

因此，戒酒互诫协会的 12 个步骤中的很多步骤都与这一点有关：过去，我们过去伤害他人的方式。

And the fourth step is about making amends by admitting the ways that we've contributed to harming others.

第四步是通过承认我们伤害他人的方式来进行弥补。

And it is a really big piece of recovery.

这是一个非常大的复苏。

So for people with addiction, it's really important to go back and make amends.

所以对于上瘾的人来说，回去弥补是非常重要的。

The key idea there is you just go back and you apologize, and you don't have to get any particular response, or you don't need to be forgiven.

关键的想法是你只要回去道歉，你不需要得到任何特定的回应，或者你不需要被原谅。

It's the act itself of apologizing about the ways in which we've harmed or lied to people in the past that is cathartic and renewing and allows us to shed this skin and be new in our lives and begin again, sort of absolved of past sins, so to speak.

就我们过去伤害或欺骗他人的方式道歉的行为本身就是一种宣泄和更新，让我们能够脱去这层皮，重新开始我们的生活，重新开始，可以这么说，某种程度上免除了过去的罪过。

Anna Lembke:

安娜·伦布克：

So it is really important.

所以这真的很重要。

Are there situations when it's maybe not a good idea because of that person or the nature?

是否存在因人或自然原因而可能不是一个好主意的情况？

Sure.

当然。

There are always going to be ...

总会有...

It doesn't have to be ...

它不一定是...

We're talking about, not like Kant's idea about "Never lie, even if you have robbers in your house, and you're a stowaway." You can't lie even about that?

我们谈论的是，而不是像康德所说的“永远不要说谎，即使你家里有强盗，而且你是一个偷渡者”。你连这个都不能撒谎吗？

It's like, "No, there are probably situations where-

就像是，“不，可能在某些情况下——

Andrew Huberman:

安德鲁·休伯曼：

Absolutely.

绝对的。

For sake of other people's safety, or children's safety, sure.

当然，为了其他人的安全，或者孩子的安全。

Anna Lembke:

安娜·伦布克：

Right.

对。

I mean, you can think of a million scenarios, but in general, when we're taking stock ...

我的意思是，你可以想到一百万个场景，但总的来说，当我们盘点时......

Because I don't know about you, but I have a lot of regrets and guilt about a lot of things in my life, and they haunt me, and sometimes I'll have nightmares, right?

因为我不了解你，但我对生活中的很多事情有很多遗憾和愧疚，它们困扰着我，有时我会做噩梦，对吧？

And I think that's true for most people.

我认为这对大多数人来说都是如此。

I mean, I occasionally will meet somebody who's like, "Oh, I don't have any regrets in my life." I'm like, "Wow," I cannot relate to that at all.

我的意思是，我偶尔会遇到一些人，他们会说：“哦，我的人生没有任何遗憾。”我想，“哇，”我根本无法理解这一点。

So this idea of catharsis and well, I mean in the 12 steps, it's telling God or your higher power, telling another human being, the ways in which you've wronged others, considering your own character defects and how those have contributed.

所以这个宣泄的想法，我的意思是在12个步骤中，它告诉上帝或你更高的力量，告诉另一个人，你冤枉他人的方式，考虑你自己的性格缺陷以及这些缺陷是如何造成的。

Anna Lembke:

安娜·伦布克：

To me, that's a really important piece and something that we don't do enough in our current culture, especially in psychiatry, frankly, where there's a lot of eternally empathizing with patients, but not a whole lot of like going, "Well actually you kind of messed that up," or like, "That was really bad on you." And in my work, I don't necessarily use that language, but patients may say, "I really feel badly about this thing." I'll be like, "Yeah, I get it.

对我来说，这是一个非常重要的部分，而且在我们当前的文化中我们做得还不够，坦率地说，尤其是在精神病学领域，那里有很多对病人的永恒的同情，但不是很多像“好吧，实际上你把事情搞砸了”，或者“这对你来说真的很糟糕”。在我的工作中，我不一定会使用这种语言，但患者可能会说，“我对这件事真的感觉很糟糕。”我会说：“是的，我明白了。

I understand that you feel ..."

我理解你的感受……”

Andrew Huberman:

安德鲁·休伯曼：

Well.

好吧。

Guilt is a ...

内疚是一种...

There's a circuit for that too.

也有一个电路。

Anna Lembke:

安娜·伦布克：

Right.

对。

And it's important, right?

这很重要，对吧？

And it's also important to recovery and to not becoming addicted — experiencing a certain amount of appropriate shame for things that we have done.

对于康复和不上瘾也很重要——为我们所做的事情经历一定程度的适当羞耻。

And feeling the pain that comes with shame, which is an incredibly painful emotion.

感受到羞耻带来的痛苦，这是一种令人难以置信的痛苦情绪。

And I think that may be the one that we all try to avoid more than any other, is that shame of not being liked or not being accepted or not being celebrated-

我认为这可能是我们所有人都比其他任何人都更想避免的一种耻辱，那就是不被喜欢、不被接受或不被庆祝的耻辱——

Andrew Huberman:

安德鲁·休伯曼：

Or that we did is really despicable.

或者说我们的做法实在是太卑鄙了。

Anna Lembke:

安娜·伦布克：

Right.

对。

It's really, yeah.

确实是这样啊

Like, "Oh, my God, I did that horrible thing." Right.

就像，“哦，天哪，我做了那件可怕的事。”对。

So I mean, I've done horrible things that I haven't gone back and said, "I did this horrible thing," but maybe I've tried to pay it forward.

所以我的意思是，我做了一些可怕的事情，但我没有回去说：“我做了这件可怕的事情”，但也许我已经试图将其偿还。

I've told my kids, "You know, when I was younger, I did this horrible thing and it still haunts me.

我告诉我的孩子们，“你知道，当我年轻的时候，我做了这件可怕的事情，它仍然困扰着我。

So if you're ever tempted to do something like what I did, you might think about my situation." So some kind of way.

所以，如果你曾经想做像我一样的事情，你可能会考虑一下我的处境。”所以某种方式。

But I think wrestling with that is important.

但我认为解决这个问题很重要。

Andrew Huberman:

安德鲁·休伯曼：

I think it's a really important element to all this.

我认为这对所有这一切来说都是一个非常重要的因素。

I love that there's neuroscience being done on truth-telling and the value of truth-telling.

我喜欢神经科学正在研究说真话和说真话的价值。

I think if I were to predict a new and truly exciting area that people are going to be really curious about in this huge sphere we call neuroscience, I hope they'll continue to do more work.

我想，如果我要预测一个新的、真正令人兴奋的领域，人们会对这个我们称之为神经科学的巨大领域感到非常好奇，我希望他们会继续做更多的工作。

I'm so glad to hear that's happening here at Stanford.

我很高兴听到斯坦福大学发生了这样的事情。

Anna Lembke:

安娜·伦布克：

No. The literature that I look at isn't Stanford work, but there's work; there might be people at Stanford.

不。我看的文献不是斯坦福大学的作品，但确实有作品；斯坦福大学可能有人。

Andrew Huberman:

安德鲁·休伯曼：

Regardless of where it's happening, more of that and all the rest, please.

不管它发生在哪里，请多说一些。

Want to ask you about using drugs to treat drug addiction.

想请教您有关使用药物治疗毒瘾的问题。

These days there's a growing interest, or at least discussion about, ibogaine.

如今，人们对伊博加因的兴趣越来越大，或者至少是讨论越来越多。

People going out of country because I think it's still illegal here, or is illegal here, going out of country to, I don't know, either inject it or smoke it or whatever it is.

人们出国，因为我认为这在这里仍然是非法的，或者在这里是非法的，出国去，我不知道，要么注射它，要么吸食它，或者无论它是什么。

Or people going and doing ayahuasca journeys, or MDMA, which is still an illegal drug in this country, but there are clinical trials.

或者人们去死藤水之旅，或者摇头丸，它在这个国家仍然是非法药物，但有临床试验。

There are people on this campus doing experimental studies, I don't know if clinical trials, but at Johns Hopkins there are clinical trials, et cetera.

这个校园里有人在做实验研究，我不知道是否有临床试验，但在约翰·霍普金斯大学有临床试验等等。

So this is a vast area, different chemistries for different drugs and different purposes.

所以这是一个广阔的领域，不同的化学物质用于不同的药物和不同的目的。

But the rationale, as I understand it, is take people who are in a pattern of addiction, launch them into an experience that's also chemical and extreme, often of the extreme serotonin and or extreme dopamine type.

但据我了解，其基本原理是让那些处于成瘾模式的人进入一种化学和极端的体验，通常是极端的血清素和/或极端的多巴胺类型。

Andrew Huberman:

安德鲁·休伯曼：

So MDMA, ecstasy, for instance, tons of serotonin dumped, tons of dopamine dumped — how neurotoxic, if neurotoxic, debatable, et cetera, not a topic for now, but a lot.

例如，摇头丸、摇头丸、大量的血清素、大量的多巴胺——有多神经毒性，如果有神经毒性，值得商榷等等，目前不是一个话题，但很多。

And then somehow that extreme experience wrapped inside of a supported network in there, whether or not there's just someone there or whether or not they're actively working through something with the patient, is supposed to eject the person into a life where drug use isn't as much of interest.

然后，不知何故，这种极端的体验被包裹在一个受支持的网络中，无论那里是否只有一个人，或者他们是否正在积极地与患者一起解决某些问题，都应该将患者带入一种对吸毒不那么感兴趣的生活中。

This violates at a purely rational level.

这违反了纯粹理性的水平。

This violates everything that we've talked about in terms of dopamine biology.

这违反了我们在多巴胺生物学方面所讨论的一切。

It would, if this arrangement is the way I described it, cause more addiction — is anything but a dopamine fast.

如果这种安排如我所描述的那样，它会导致更多的成瘾——绝不是多巴胺禁食。

It's a dopamine feast.

这是一场多巴胺盛宴。

So we hear about successful transitions through this, at least anecdotally and maybe some clinical study, What is going on?

因此，我们听说了通过此成功过渡的消息，至少是轶事，也许还有一些临床研究，到底发生了什么？

What is going on?

到底是怎么回事？

Doesn't make any sense to me.

对我来说没有任何意义。

Yeah.

是的。

Anna Lembke:

安娜·伦布克：

Yeah.

是的。

So I think it's good that you're skeptical.

所以我认为你持怀疑态度是件好事。

I think we all should be skeptical.

我想我们都应该持怀疑态度。

Having said that, there are clinical studies showing, and these are small studies, and they're short durations, small number of subjects, but taking people, for example, who are addicted to alcohol and then having them have this, let's say, psychedelic experience in a very controlled setting.

话虽如此，有临床研究表明，这些都是小型研究，持续时间短，受试者数量少，但以酗酒成瘾的人为例，然后让他们在一个非常受控的环境中获得迷幻体验。

Andrew Huberman:

安德鲁·休伯曼：

So either, typically it's a high-dose psilocybin or three dose, as I saw it for the MAP study of MDMA, of ecstasy.

因此，通常是高剂量裸盖菇素或三剂量，正如我在 MDMA 和摇头丸的 MAP 研究中看到的那样。

Seem to be the kind of-

好像是这样的——

Anna Lembke:

安娜·伦布克：

The typical.

典型的。

Andrew Huberman:

安德鲁·休伯曼：

The kind of bread-and-butter of this kind of work.

这种工作就是谋生之道。

Anna Lembke:

安娜·伦布克：

But the thing to really keep in mind is that this is completely interwoven with regular psychotherapy, and that these are highly selected individuals.

但真正要记住的是，这与常规心理治疗完全交织在一起，而且这些人都是经过精心挑选的个体。

Andrew Huberman:

安德鲁·休伯曼：

And clinical trials.

和临床试验。

Anna Lembke:

安娜·伦布克：

Right.

对。

Andrew Huberman:

安德鲁·休伯曼：

We're referring to legal clinical trials.

我们指的是合法的临床试验。

Anna Lembke:

安娜·伦布克：

Right.

对。

And so I think the metaphor that helps me think about this is there are many ways to the top of the mountain, and these are taking the gondola instead of walking up, it's sort of instead of doing a year of psychoanalysis, where you're sitting on the couch every week reflecting on your life, it's a condensed version of psychoanalysis or psychotherapy, plus MDMA, which gets you there faster.

所以我认为帮助我思考这个问题的比喻是有很多方法可以到达山顶，这些是乘坐缆车而不是步行，这有点像而不是进行一年的精神分析，每周坐在沙发上反思你的生活，这是精神分析或心理治疗的浓缩版本，再加上摇头丸，它可以让你更快地到达山顶。

Andrew Huberman:

安德鲁·休伯曼：

Creates the intimacy, presumably, because of this-

创造亲密感，大概是因为这个——

Anna Lembke:

安娜·伦布克：

Well, I think the main thing that happens when it's beneficial...

嗯，我认为当它有益时发生的主要事情......

Anna Lembke:

安娜·伦布克：

...

thing that happens when it's beneficial is it just allows the person to get outside of their own head, and to consider themselves not mired in the quotidian sort of details of their life, but rather as a human on the large planet earth, in the vast universe.

当它有益时发生的事情是，它只是让人们摆脱自己的头脑，并认为自己没有陷入生活的日常细节中，而是作为地球这个大行星和浩瀚宇宙中的人类。

So I think it takes ...

所以我认为需要...

when it works, it's a transformational experience because it gives the person another lens through which to view their lives, their lives, which I think for some people is positive and powerful because they can come back from that and be like, "Oh my gosh, I care about my family, and I want X, Y or Z for them, and I realize that my continuing to drink is not going to achieve that." So it's almost like a spiritual or values-based.

当它起作用时，这是一种变革性的体验，因为它给了人们另一个视角来看待他们的生活，他们的生活，我认为这对某些人来说是积极和强大的，因为他们可以从中回来并说，“哦，天哪，我关心我的家人，我想要他们的X，Y或Z，我意识到我继续喝酒不会实现这一点。”所以它几乎就像是一种精神或价值观基础。

So I think it can be very powerful.

所以我认为它可能非常强大。

But having said that, I truly am quite skeptical because addiction is a chronic, relapsing and remitting problem.

但话虽如此，我确实很怀疑，因为成瘾是一个慢性、复发性和缓解性的问题。

It's hard for me to imagine that there's something that works very quickly, short term, that's going to work for a disease that's really long lasting.

我很难想象有一种药物可以在短期内快速发挥作用，对治疗真正持久的疾病有效。

Andrew Huberman:

安德鲁·休伯曼：

The two addicts I know that that did MDMA-assisted psychotherapy, as part of this thing, both got worse.

我认识的两个瘾君子在接受摇头丸辅助心理治疗后，情况都变得更糟。

But the people I know who had severe trauma who did this, took this approach, seemed to be doing better.

但我认识的那些遭受过严重创伤的人，采取了这种方法，似乎做得更好。

Anna Lembke:

安娜·伦布克：

Okay, interesting.

好吧，有趣。

Andrew Huberman:

安德鲁·休伯曼：

And so I think that the discussion, as we hear it now, is just sort of psychedelics, which is a huge category that includes many different drugs and compounds with different effects, and we hear about trauma and addiction lumped together.

因此，我认为我们现在听到的讨论只是迷幻药，这是一个巨大的类别，包括许多不同的药物和具有不同效果的化合物，我们听到创伤和成瘾混为一谈。

And I think that I'm a splitter, not a lumper, as we say in science.

我认为我是一个分裂者，而不是像我们在科学中所说的那样。

And I think it's going to be important for people to know that this is definitely not a one-size-fits-all kind of thing, but it sounds like it may have some utility under certain conditions.

我认为让人们知道这绝对不是一刀切的事情很重要，但听起来它在某些条件下可能会有一些用处。

Anna Lembke:

安娜·伦布克：

Yeah, I think so.

是的，我想是的。

I think I'm trying to be very open-minded about its potential utility for certain individuals.

我想我正在努力对其对某些人的潜在效用持非常开放的态度。

But I can tell you in my clinical work, what is a very concerning, unintended consequence of this narrative is I have a lot of people who are looking for some kind of spiritual awakening who, on their own, not in the context of any kind of therapeutic psychological work, microdose or want to try psilocybin or MDMA with a friend, or wherever, so they can have this spiritual experience, that they can figure out their lives.

但我可以在我的临床工作中告诉你，这种叙述的一个非常令人担忧的、意想不到的后果是，我有很多人正在寻找某种精神觉醒，他们自己，而不是在任何类型的治疗性心理工作、微剂量或想与朋友一起尝试裸盖菇素或摇头丸的背景下，或者在任何地方，这样他们就可以获得这种精神体验，他们可以弄清楚自己的生活。

That's a disaster and almost never works out well.

这是一场灾难，而且几乎永远不会有好的结果。

And I've then had people who literally — supposedly you can't get addicted to psychedelics because something with the biochemistry, which I don't fully understand because it doesn't make any sense to me.

然后我遇到过一些人，他们认为，你不会对迷幻药上瘾，因为它与生物化学有关，我并不完全理解，因为它对我来说没有任何意义。

But I have patients clinically who definitely are addicted to MDMA, to microdosing.

但临床上我有一些患者肯定对 MDMA 上瘾，对微剂量药物上瘾。

So that's very concerning to me because Pollan's "How to Change Your Mind" — I respect that work, but on the other hand, it's penetrated the culture.

所以这对我来说非常令人担忧，因为波伦的《如何改变你的想法》——我尊重那部作品，但另一方面，它已经渗透到了文化中。

Andrew Huberman:

安德鲁·休伯曼：

Michael Pollan's book.

迈克尔·波伦的书。

Anna Lembke:

安娜·伦布克：

Yeah.

是的。

Andrew Huberman:

安德鲁·休伯曼：

Well, and I don't know him, and so I don't have a problem taking a stance.

好吧，我不认识他，所以我不介意采取立场。

So I'll just say my stance on that is the narrative of popular authors can expand and wick out so fast that pretty soon people are essentially taking their mental health into their own hands.

因此，我只想说我的立场是，流行作家的叙述可以如此迅速地扩展和消失，以至于很快人们基本上就可以将自己的心理健康掌握在自己手中。

And I actually have great optimism for this business of clinical use of psychedelics, including MDMA.

事实上，我对迷幻药（包括 MDMA）的临床使用业务非常乐观。

Matthew Johnson, at Johns Hopkins is doing fabulous work on this.

约翰·霍普金斯大学的马修·约翰逊在这方面做了出色的工作。

And there are others too, of course.

当然还有其他的。

But those are controlled settings, and the pharmacology is being tuned up.

但这些都是受控设置，并且药理学正在调整。

And one thing that I think is coming — there are several papers published recently in great journals like Nature and Science, et cetera, where there are scientists who are removing the hallucinogenic components of these drugs and finding that they still have the antidepressant effects.

我认为即将发生的一件事是，最近在《自然》和《科学》等优秀期刊上发表了几篇论文，其中有科学家正在去除这些药物的致幻成分，发现它们仍然具有抗抑郁作用。

Anna Lembke:

安娜·伦布克：

Interesting.

有趣。

Andrew Huberman:

安德鲁·休伯曼：

And so the experience of a psychedelic and the long-term effects of the psychedelic might actually be dissociable.

因此，迷幻剂的体验和迷幻剂的长期影响实际上可能是分离的。

So again, and I'm always careful to say I'm neither for something or against it, I just think that treading carefully is what's important.

再说一次，我总是小心地说我既不支持也不反对某件事，我只是认为谨慎行事才是重要的。

Anna Lembke:

安娜·伦布克：

I agree with you, and I can just tell you that the downstream effect for the average person, for many of whom present in our clinic, is that they've misconstrued the data on the use of psychedelics for mental health conditions to this idea that they're safe, or that anybody can take them in any circumstance and have this kind of awakening.

我同意你的观点，我可以告诉你，对普通人（对我们诊所的许多人来说）的下游影响是，他们误解了使用致幻剂治疗心理健康状况的数据，认为它们是安全的，或者任何人都可以在任何情况下服用它们并获得这种觉醒。

And that's not what the data show.

数据显示的并非如此。

The data are these highly controlled settings, carefully selected patients.

数据是这些高度控制的环境、精心挑选的患者。

So that, that's my worry.

所以，这就是我的担心。

Andrew Huberman:

安德鲁·休伯曼：

And I'm going to be sitting down with Matthew Johnson at some point and we'll discuss this.

我将在某个时候与马修·约翰逊坐下来讨论这个问题。

And I think that that care, and that cocoon of real clinical care, does seem to be an important component.

我认为这种护理以及真正的临床护理的茧似乎确实是一个重要组成部分。

Well I'm glad we could touch on it, and I'm sure I'll get a bunch of comments telling me that.

嗯，我很高兴我们能讨论这个问题，我相信我会收到很多评论告诉我这一点。

Andrew Huberman:

安德鲁·休伯曼：

But I think it is important to explore things from all sides, and that's what we do as scientists.

但我认为从各个方面探索事物很重要，这就是我们作为科学家所做的事情。

And if Michael Pollan wants to chat, we can do that too.

如果迈克尔·波伦想聊天，我们也可以这么做。

That's fine.

没关系。

I very much enjoyed the book, actually.

事实上，我非常喜欢这本书。

But I think that people run with ideas.

但我认为人们是带着想法奔跑的。

Anna Lembke:

安娜·伦布克：

That's right.

没错。

Andrew Huberman:

安德鲁·休伯曼：

They don't walk with them.

他们不与他们同行。

They sprint.

他们冲刺。

There are a couple other things I just want to touch on, but they all relate to social media.

我只想谈谈其他一些事情，但它们都与社交媒体有关。

You were featured in "The Social Dilemma"; it's a powerful movie.

你曾出演过《社会困境》；这是一部强大的电影。

I think many people avoided seeing that movie because it reflects back on us just how addicted we all are and how manipulated we all are.

我想很多人都避免看那部电影，因为它反映了我们是多么上瘾以及我们是多么被操纵。

But it doesn't seem to have changed behavior much.

但它似乎并没有改变太多的行为。

I have to say that the movie changed my understanding and my perception, but not my behavior too much.

我不得不说，这部电影改变了我的理解和看法，但并没有改变我太多的行为。

If we look at addiction as a maladaptive thing, something that's making our lives worse or us less functional at work and in relationships, I could imagine a version of social media where it's making me more connected.

如果我们将成瘾视为一种适应不良的事物，一种使我们的生活变得更糟或使我们在工作和人际关系中功能下降的事物，我可以想象社交媒体的一个版本，它让我的联系更加紧密。

Andrew Huberman:

安德鲁·休伯曼：

I mean, this is a podcast after all.

我的意思是，这毕竟是一个播客。

I post videos.

我发布视频。

This will show up on YouTube and elements of it on Instagram as well.

这将显示在 YouTube 上以及 Instagram 上的部分内容。

So, much like sugar or other things, I have to imagine that we need to regulate, not necessarily eliminate, this behavior.

因此，就像糖或其他东西一样，我必须想象我们需要规范而不一定要消除这种行为。

So I want to talk about what that looks like, and I want to talk about what you've referred to as this narcissistic preoccupation that social media is creating.

所以我想谈谈这是什么样的，我想谈谈你所说的社交媒体正在创造的这种自恋的专注。

That we are all far more keenly aware of how we look and how we sound and how we are being perceived than we were 10 years ago.

与十年前相比，我们都更加敏锐地意识到自己的外表、声音以及他人对我们的看法。

So first of all, social media, how addicting is it really?

首先，社交媒体到底有多让人上瘾？

And what is healthy social media behavior?

什么是健康的社交媒体行为？

Anna Lembke:

安娜·伦布克：

So the first message I would want to get across about social media is that it really is a drug, and it's engineered to be a drug.

因此，关于社交媒体，我想传达的第一条信息是，它确实是一种药物，而且它是被设计成一种药物的。

And it's based on potency, quantity, variety, the bottomless polls, the likes, the way that it's enumerated, all of that.

它基于效力、数量、多样性、无底线的民意调查、点赞、枚举方式，所有这些。

Which doesn't mean that we can't use it, but we need to be very thoughtful about the way we use it.

这并不意味着我们不能使用它，但我们需要非常仔细地考虑我们使用它的方式。

Just like we need to be thoughtful about the way we use any drug.

就像我们需要考虑使用任何药物的方式一样。

Anna Lembke:

安娜·伦布克：

And so that means with intention and in advance, planning our use and trying to use it as a really awesome tool to potentially connect with other people and not to be used by it or get lost in it.

因此，这意味着有意识地提前计划我们的使用，并尝试将其用作一个真正很棒的工具，以潜在地与其他人联系，而不是被它使用或迷失其中。

And of course people are going to come with different propensities for addiction to any drug.

当然，人们对任何药物的成瘾倾向都会有所不同。

And that's true for social media too.

对于社交媒体来说也是如此。

Some people will have no problem using it in moderation or using it in a way that's adaptive, and other people will immediately get sucked in.

有些人适度使用它或以适应性的方式使用它不会有任何问题，而其他人会立即被吸引。

And the key thing about getting addicted is when it's happening, nobody who's getting addicted thinks they're getting addicted.

上瘾的关键在于，当它发生时，上瘾的人不会认为自己上瘾了。

Let's face it.

让我们面对现实吧。

It's only after the fact that we go, "Whoops.

只有在事后我们才会说：“哎呀。

What was that about?"

那是什么事？”

Andrew Huberman:

安德鲁·休伯曼：

Well, remember texting and driving.

好吧，记住发短信和开车。

There were all these books about texting and driving, how terrible it was.

到处都是关于发短信和开车的书，那是多么可怕啊。

Even the governments have largely given up.

就连政府也基本上放弃了。

You see these billboards like "Don't text and drive" or "Any text can wait" or "Not worth dying for." But everybody's texting and driving.

您会看到这些广告牌，例如“开车时不要发短信”或“任何短信都可以等待”或“不值得为之而死”。但每个人都一边开车一边发短信。

Anna Lembke:

安娜·伦布克：

And if you look at young people, they, teenagers I mean, they're basically cybernetically enhanced, that the phone is there; it's like they're talking to you and texting 12 friends at the same time, and there's no stopping it.

如果你看看年轻人，他们，我的意思是青少年，他们基本上在控制论上得到了增强，电话就在那里；就像他们在与您交谈的同时给 12 个朋友发短信，而且无法阻止。

I mean, the genie is out of the bottle, where, it's not going back.

我的意思是，精灵已经从瓶子里出来了，它不会再回去了。

So we do need to figure out how to make this tool something that's going to be good for us and not ultimately harmful.

因此，我们确实需要弄清楚如何使这个工具对我们有利，而不是最终有害。

And I don't have all the answers by any stretch of the imagination, but I do think some of the wisdom that we have learned from using other drugs also applies to social media, which is to say that we have to again put barriers in place that allow us to remain in control of our use, which means not too much, not too often, not too potent.

我无法想象出所有的答案，但我确实认为我们从使用其他药物中学到的一些智慧也适用于社交媒体，也就是说，我们必须再次设置障碍，使我们能够继续控制我们的使用，这意味着不要太多，不要太频繁，也不要太有效。

Andrew Huberman:

安德鲁·休伯曼：

Do you think, in going back to this idea of the unit of the day being a good tractable unit, a manageable unit of time for most people.

你认为，回到“一天的单位是一个易于处理的单位”这个想法，对于大多数人来说是一个易于管理的时间单位吗？

So you're saying in advance, so allocating two hours in which you're going to allow yourself to have free reign use of the phone and all its apps and all its things, or even more restricted than that, meaning I'm only going to allow myself 30 minutes a day to post and comment, and then that's a closeout completely.

所以你提前说，所以分配两个小时，让自己可以自由地使用手机及其所有应用程序和所有东西，甚至比这更受限制，这意味着我每天只允许自己 30 分钟发帖和评论，然后就完全结束了。

Anna Lembke:

安娜·伦布克：

So I think it depends on the person, and it's sort of a combination.

所以我认为这取决于人，而且是综合因素。

We talked earlier about having an itch and scratching yourself at night.

我们之前讨论过晚上发痒和抓挠自己。

We've gotten to a point with smartphones, people are pulling them out, and they're utterly unconscious of doing so, pulling them out, a couple texts, they don't know they're doing it.

我们已经发展到了智能手机的发展阶段，人们正在把它们拿出来，而他们完全没有意识到这样做，拿出它们，发几条短信，他们不知道自己在这样做。

Andrew Huberman:

安德鲁·休伯曼：

I have a friend who works in, delivers babies.

我有一个工作的朋友，负责接生。

And many pregnant mothers won't actually deliver without their phone in hand.

许多孕妇在没有手机的情况下实际上不会分娩。

And this used to be the hand that was connected to their spouse.

这曾经是与他们的配偶相连的手。

This may be a comment on spouses more than on phones, but it sounds like it's a kind of security blanket.

这可能更多是对配偶的评论，而不是对电话的评论，但这听起来像是一种安全毯。

Anna Lembke:

安娜·伦布克：

Like a transitional object.

就像一个过渡对象。

Yeah.

是的。

Andrew Huberman:

安德鲁·休伯曼：

Yeah.

是的。

Actually that reminds me, you've referred to the phone, I think it's the phone, but maybe it's our online persona or ourselves, as we've become sort of infantile in our need for, it's like a baby and a bottle.

实际上这让我想起，你提到了电话，我认为是电话，但也许是我们的在线角色或我们自己，因为我们对它的需求变得有点幼稚，它就像婴儿和瓶子一样。

And so I do wonder if we have regressed, and I do think we've regressed a bit in terms of our online behavior, our inability to act like ...

所以我确实想知道我们是否已经退步了，我确实认为我们在网上行为方面已经退步了一点，我们无法表现得像......

I always thought an adult was somebody that can control their behavior.

我一直认为成年人是可以控制自己行为的人。

That's the difference between a baby and an adult.

这就是婴儿和成人的区别。

You don't have to be a developmental neurobiologist for very long to understand that a young organism can't control its behavior, an older one can.

你不必成为一名发育神经生物学家很长时间就能明白，年轻的有机体无法控制其行为，而年长的有机体却可以。

Andrew Huberman:

安德鲁·休伯曼：

So to me, a mature organism, mature in years organism that can't control its behavior is a baby.

所以对我来说，一个成熟的有机体，成熟多年的有机体，无法控制自己的行为，就像一个婴儿。

It's an immature version of itself.

它本身就是一个不成熟的版本。

And there's neuro, there's neuroscience to support that statement.

有神经学、神经科学来支持这一说法。

I look at my own behavior with the phone sometimes, and I think I'm a grown man.

有时我会用手机审视自己的行为，我想我已经是一个成年人了。

What is the problem here?

这里有什么问题呢？

I don't eat baby food, but I'm acting like a baby with the phone, all right.

我不吃婴儿食品，但我拿着手机表现得像个婴儿，好吧。

In the sense that I'm reflexively picking it up.

从某种意义上说，我条件反射地捡起了它。

I'm not being intentioned and deliberate with it.

我不是故意的，也不是故意的。

Do I need a full 30 days, Anna?

我需要整整 30 天吗，安娜？

Anna Lembke:

安娜·伦布克：

So yeah.

所以是的。

Andrew Huberman:

安德鲁·休伯曼：

Thirty days away from my phone.

距离我的手机已经三十天了。

Anna Lembke:

安娜·伦布克：

As you know, that's my recommendation, full 30 days to reset.

如您所知，这是我的建议，整整 30 天来重置。

If you're severely addicted, that I recommend the 30 days.

如果你严重上瘾，我建议30天。

But if you're just a little bit addicted, like most of us, you probably don't need 30 days.

但如果您像我们大多数人一样有点上瘾，您可能不需要 30 天。

In fact, a single day not only would be challenging, but probably may be sufficient.

事实上，一天不仅具有挑战性，而且可能就足够了。

Andrew Huberman:

安德鲁·休伯曼：

My phone is off for substantial segments of the day.

我的手机一天中大部分时间都处于关机状态。

Anna Lembke:

安娜·伦布克：

Okay, that's great.

好的，太好了。

Andrew Huberman:

安德鲁·休伯曼：

And it drives other people crazy.

这会让其他人发疯。

People expect me to respond, but I don't care.

人们期望我做出回应，但我不在乎。

I really don't.

我真的不知道。

Anna Lembke:

安娜·伦布克：

Right.

对。

Andrew Huberman:

安德鲁·休伯曼：

And I actually take a little bit of pleasure in the fact that, well, because I think the point I'm trying to make is the right one, which is that it's not just right for me, but why ...

事实上，我感到有点高兴，因为我认为我想要表达的观点是正确的，这不仅适合我，而且为什么......

I don't see a clause on text messages or emails that says "must be responded to within X amount of time or else." Or else.

我没有看到关于短信或电子邮件的条款说“必须在 X 时间内回复，否则。”否则。

So I take the liberty of replying when I'm able to.

因此，当我可以的时候，我会冒昧地回复。

Anna Lembke:

安娜·伦布克：

Yeah, that's right.

是的，没错。

Andrew Huberman:

安德鲁·休伯曼：

Or want to.

或者想要。

Anna Lembke:

安娜·伦布克：

But which touches on one of the big challenges about social media is that as more and more of us are spending more and more time on social media, we're divesting our libidinous energies, et cetera, from real-life interactions.

但社交媒体面临的一大挑战是，随着越来越多的人在社交媒体上花费越来越多的时间，我们正在从现实生活的互动中剥离我们的性欲能量等。

So that means even when we want to choose to not be online connecting, we go outside and there's no there there, there's nobody else there.

所以这意味着即使我们想选择不在线连接，我们走到外面却发现那里没有，也没有其他人。

So I think our collective challenge, and it should be our mission, is to make sure that we are preserving and maintaining offline ways to connect with each other.

因此，我认为我们的集体挑战，并且应该是我们的使命，是确保我们保留和维护彼此之间的线下联系方式。

Because if we don't do that, then we'll be very lonely if we were not online.

因为如果我们不这样做，那么如果我们不上网，我们就会感到非常孤独。

Anna Lembke:

安娜·伦布克：

But if you have a tribe of folks that you can be with, none of whom are on their phones while you're together for that discrete amount of time, then it's wonderful and liberating, and nobody's distracted.

但如果你有一群人可以和你在一起，当你们在一起的那段时间里，没有人在玩手机，那么这是美妙的、自由的，没有人会分心。

And I think that's really the key.

我认为这确实是关键。

And I think young people are figuring that out.

我认为年轻人正在弄清楚这一点。

They're trying to create these spaces or try to, let's say, instead of doing a dopamine fast by yourself, do it with your friends, then the FOMO is less if you're missing out because, oh, you're all doing the dopamine fast together.

他们试图创造这些空间，或者尝试，比方说，不是自己做多巴胺禁食，而是和你的朋友一起做，那么如果你错过了，那么 FOMO 就会减少，因为，哦，你们都在一起做多巴胺禁食。

So these are some of the tricks that we can come up with, but-

所以这些是我们可以想出的一些技巧，但是-

Andrew Huberman:

安德鲁·休伯曼：

I like that.

我喜欢这样。

Yeah.

是的。

Anna Lembke:

安娜·伦布克：

Okay, good.

好的，很好。

Andrew Huberman:

安德鲁·休伯曼：

I like that.

我喜欢这样。

I have a home gym and I love working out.

我有一个家庭健身房，我喜欢锻炼。

I just enjoy it and always have.

我只是享受它并且一直如此。

And I don't allow my phone in my gym anymore.

我不再允许我的手机进入健身房。

And I live in an area where I don't get any reception two meters outside my door.

我住的地方在门外两米处收不到任何信号。

So all my dog walks now are just with the dog.

所以我现在所有的遛狗都是和狗一起。

And they were boring as hell.

他们非常无聊。

Yes.

是的。

I also have a bulldog, he doesn't like to walk.

我也有一只斗牛犬，他不喜欢走路。

It's really slow.

真的很慢。

And it was so boring for a while.

而且有一段时间很无聊。

Because I was so used to taking calls when I walk and it's super efficient.

因为我已经习惯了走路时接听电话，而且效率非常高。

Why wouldn't I do that?

我为什么不这样做呢？

The walks now are part some of my favorite part of the day.

现在散步是我一天中最喜欢的部分之一。

And if the phone, if I were to get a call on one of those or they brought reception to the area, I would be very dismayed.

如果电话，如果我接到其中一个电话，或者他们给该地区带来了信号接收，我会非常沮丧。

So I can attest to this, and I don't think I'm a phone addict, but I do put work into regulating my Anna Lembke:

所以我可以证明这一点，我不认为我是一个电话成瘾者，但我确实花了很多功夫来规范我的安娜·伦布克：

Yeah.

是的。

So this is the key.

所以这是关键。

You have to, with intention, prior to being in that situation, think of literal, physical, and metacognitive barriers that you can put between yourself and your phone, or whatever your drug is, to create these intentional spaces where you're not constantly interrupting yourself essentially and distracting yourself.

在陷入这种情况之前，你必须有意识地考虑在自己和手机或任何药物之间可以设置的字面的、身体的和元认知的障碍，以创造这些有意的空间，让你不会不断地打扰自己并分散自己的注意力。

Because I really do think, I think we talked just before we started with the interview; we're losing the ability to have a sustained thought.

因为我确实认为，我想我们在采访开始之前就谈过了；我们正在失去持续思考的能力。

I mean, we get so far.

我的意思是，我们已经走到这一步了。

And then you get to that point in the thought where it's a little bit hard to know what's coming next.

然后你就会想到，很难知道接下来会发生什么。

And it's very easy to check your phone or check your email or look something up on the Internet.

检查手机、电子邮件或在互联网上查找信息都非常容易。

And then you never get that opportunity to finish that thought, which is really the source of creative energy and an original thought.

然后你就永远没有机会完成这个想法，而这确实是创造性能量和原创想法的源泉。

You're not just reacting to what's coming at you.

你不只是对即将发生的事情做出反应。

Andrew Huberman:

安德鲁·休伯曼：

And something that could contribute to the world.

以及可以为世界做出贡献的东西。

I'm a big believer that you're either consuming or you are creating.

我坚信你要么在消费，要么在创造。

And I should mention, it's important.

我应该提到，这很重要。

I do believe in neutral time.

我确实相信中立时间。

I think sleep is great.

我认为睡眠很棒。

I'm a big proponent of sleep and talked a lot about it on the podcast.

我是睡眠的大力支持者，并在播客上谈论了很多关于睡眠的话题。

I care a lot about sleep and not just for sake of performance, I actually just really like sleep.

我非常关心睡眠，不仅仅是为了表现，我实际上真的很喜欢睡眠。

I think that being a constant consumer of visual information and information of all kinds can be a problem.

我认为不断地消费视觉信息和各种信息可能是一个问题。

But there's some really great sources of information on the Internet, and I certainly benefit from the fact that those channels exist.

但互联网上有一些非常好的信息来源，我当然受益于这些渠道的存在。

Narcissistic preoccupation: am I a narcissist?

自恋的关注：我是一个自恋者吗？

Anna Lembke:

安娜·伦布克：

First of all there's healthy-

首先是健康——

Andrew Huberman:

安德鲁·休伯曼：

Or is the fact that I asked, does that take me out of ...

或者我问的事实是否会让我脱离......

would a narcissist never ask that question?

自恋者永远不会问这个问题吗？

Anna Lembke:

安娜·伦布克：

Oh yes.

哦，是的。

A highly sophisticated narcissist would know to do that.

一个高度成熟的自恋者会知道这样做。

Andrew Huberman:

安德鲁·休伯曼：

Well, I'm not very sophisticated.

嗯，我不是很老练。

Anna Lembke:

安娜·伦布克：

So there's healthy narcissism, which means that we all invest our personal energies into things that we care about.

因此，存在健康的自恋，这意味着我们都将个人精力投入到我们关心的事情上。

And if our competence in that arena is threatened, we would all experience a narcissistic injury.

如果我们在这个领域的能力受到威胁，我们都会受到自恋的伤害。

And that's normal and healthy.

这是正常且健康的。

But we are living in a narcissistic culture.

但我们生活在一种自恋的文化中。

I mean, that's not news.

我的意思是，这不是新闻。

This preoccupation with individual achievement and individual self-worth and individual self-confidence.

这种对个人成就、个人自我价值和个人自信的关注。

And I think all of that is just fueled by social media, where we're not just seeing ourselves, but we're seeing people's reactions to ourselves, and every single thing we say or do, we get likes and this and that.

我认为所有这一切都是由社交媒体推动的，我们不仅看到自己，还看到人们对自己的反应，我们所说或所做的每件事，我们都会得到喜欢等等。

Anna Lembke:

安娜·伦布克：

It's really insidious, and it contributes, I think, ultimately to a lot of personal shame because we're not really meant to be individuals bouncing around in the universe.

这确实是阴险的，我认为，它最终会带来很多个人耻辱，因为我们并不是真正注定要成为在宇宙中蹦蹦跳跳的个体。

We're social animals, and we're probably generally happiest, even for natural contrarians among us, when we're part of a tribe.

我们是群居动物，当我们成为一个部落的一部分时，我们通常可能是最快乐的，即使对于我们当中天生的逆向者也是如此。

And if we do too much to kind of separate ourselves from that tribe, I think that the brain's natural and instinctive corrective mechanism against that is self-loathing and shame.

如果我们做了太多的事情来将自己与那个部落分开，我认为大脑的自然和本能的纠正机制就是自我厌恶和羞耻。

So it's so ironic because the culture tells us if we just achieve more, we'll like ourselves more.

所以这很讽刺，因为文化告诉我们，如果我们取得更多成就，我们就会更喜欢自己。

But the truth is actually the opposite, that I think when people get these pinnacles of personal achievement, you have things like the imposter syndrome or whatever.

但事实恰恰相反，我认为当人们获得个人成就的顶峰时，就会出现冒名顶替综合症之类的情况。

Andrew Huberman:

安德鲁·休伯曼：

We're at Stanford, after all, with a lot of high achievers, some phenomenal, amazing people like yourself and other colleagues of mine that just, I'm always in awe.

毕竟，我们在斯坦福大学，有很多成就斐然的人，一些像你和我的其他同事这样非凡、令人惊叹的人，我总是感到敬畏。

It's just amazing.

这真是太棒了。

The mean is shifted so high.

平均值移动得如此之高。

And also people who have amazing paths to get here, coming from very little and accomplishing so much.

还有那些通过令人惊奇的道路到达这里的人，他们出身微薄，却取得了如此巨大的成就。

But it's also the pressure.

但这也是压力。

The way that this career was described to me, the day I got my job, was one colleague of mine, the late Ben Bar, said, "Welcome to schizophrenia, because you're never going to be able to complete anything without getting interrupted." That was partially true.

在我得到这份工作的那天，我的一位同事、已故的本·巴尔 (Ben Bar) 向我描述了这份职业，他说：“欢迎来到精神分裂症，因为你永远无法在不被打扰的情况下完成任何事情。”这部分是正确的。

Although I've created buffers.

虽然我已经创建了缓冲区。

Andrew Huberman:

安德鲁·休伯曼：

The other one, very successful scientist, a member of the National Academy, et cetera, said to me, "Just remember, it's pinball.

另一位非常成功的科学家、国家科学院院士等等对我说：“记住，这是弹球游戏。

You never win.

你永远不会赢。

The best you can do is just keep playing." And I thought, "Wow, okay." And then you just go.

你能做的最好的事情就是继续比赛。”我想，“哇，好吧。”然后你就走吧。

But I think that as we achieve more, not just academics of course, but as anyone achieves more, there's the relishing in the accomplishment.

但我认为，随着我们取得更多成就，当然不仅仅是学术上的成就，而是当任何人取得更多成就时，都会对成就感到满意。

There's often the desire for more, but there's also the pressure of, "Well now I have to do this for the next 30 years, even though I love it." It's the pressure of, "Well, if the mountain is this high, then how do I get here and here and here?" And then you start shoveling more dirt on so you can keep climbing.

人们常常渴望得到更多，但也有压力，“现在我必须在接下来的 30 年里继续这样做，尽管我很喜欢它。”这是一种压力，“好吧，如果山这么高，那么我如何到达这里、这里和这里？”然后你开始铲更多的泥土，这样你就可以继续攀爬。

And it's a lot of work.

而且工作量很大。

And I think that the perception of success is that there's a roar of the crowd and you cruise.

我认为成功的感觉就是人群的欢呼声和你的巡航。

You don't cruise, they just give you more to do, or you give yourself more to do.

你不需要巡航，他们只是给你更多的事情去做，或者你给自己更多的事情去做。

Anna Lembke:

安娜·伦布克：

Well, what I think is, at least in my life experience, and I've heard this from other people as well, it's that prize that we're going for, that if we get it is so unsatisfying, and it's the prize that we never imagined, that we kind of go, "Well how did that happen?

嗯，我的想法是，至少在我的生活经历中，我也从其他人那里听到过这样的说法，这就是我们想要的奖品，如果我们得到了它，那就太不令人满意了，这是我们从未想象过的奖品，我们会说，“那是怎么发生的？

But gee, that feels good." So I'm very, it's-

不过，哎呀，这感觉真好。”所以我非常，这是-

Andrew Huberman:

安德鲁·休伯曼：

That's like a mirage in the one case, and it's like, yeah, it's almost like dopamine can create these mirages.

在一种情况下，这就像海市蜃楼，是的，几乎就像多巴胺可以创造这些海市蜃楼。

That there's some place there.

那里有某个地方。

Anna Lembke:

安娜·伦布克：

That's right.

没错。

And if I just; it's that pot of gold if I-

如果我只是；这就是那一桶金如果我-

Andrew Huberman:

安德鲁·休伯曼：

Just constant dopamine.

只是持续不断的多巴胺。

Right?

正确的？

Anna Lembke:

安娜·伦布克：

That's right.

没错。

That's right.

这是正确的。

And I think this really, I think, is related to our discussion earlier about this, taking it one day at a time or paying attention to that 24-hour period in your environment.

我认为这确实与我们之前的讨论有关，一次一天服用一次，或者注意您环境中的 24 小时时间段。

I am absolutely fascinated by the ways in which we accumulate success when we do that, totally independent of the desire for success.

我对我们在这样做时积累成功的方式非常着迷，完全独立于对成功的渴望。

It's really process-oriented.

它确实是面向过程的。

It's like, "Where am I today?

就像，“今天我在哪里？

How can I make today a good and meaningful day a little bit better, or as good as some other days I've had?" Constantly tweaking and experimenting with this experiment that we call our human existence.

我怎样才能让今天美好而有意义的一天变得更好一点，或者像我其他日子一样好呢？”不断地调整和实验这个我们称之为人类存在的实验。

And when we do that in a way that's authentic and paying attention and value driven, whatever our values are informed by, it is very, very interesting how those days, again, accumulate and you find, "Well, I guess I contributed something of value there, but I wasn't trying to do that."

当我们以一种真实的、关注和价值驱动的方式做到这一点时，无论我们的价值观是如何传达的，那些日子再次积累起来，你会发现，“嗯，我想我在那里贡献了一些有价值的东西，但我并没有试图这样做，这是非常非常有趣的。”

Anna Lembke:

安娜·伦布克：

I think that's really ...

我认为这真的是...

what I'm so amazed by is 20 years ago when I went to Stanford Medical School, 25 years ago, I was happy to just be a good doctor.

令我如此惊讶的是，20年前，25年前，当我进入斯坦福医学院时，我很高兴能成为一名好医生。

I was like, "I guess I'm just going to try to figure out how to be a good doctor, and I'm here to learn that." And now I see these medical students, and they're wonderful, they're brilliant and well-intentioned, all that.

我当时想，“我想我只是想弄清楚如何成为一名好医生，我来这里就是为了学习这一点。”现在我看到这些医学生，他们很棒，他们才华横溢，善意，所有这些。

But they're like, "How can I write the great American novel, do my startup, go to Africa, apply for that grant?" Really?

但他们会说，“我怎样才能写出伟大的美国小说，创办我的公司，去非洲，申请这笔资助？”真的吗？

I was just trying to learn how to be a doctor.

我只是想学习如何成为一名医生。

And as you say, it's a lot of pressure on them.

正如你所说，这对他们来说压力很大。

And it's also kind of a weird leapfrogging of the real way to accomplish something right, which isn't about like, "Oh, how can I accomplish something?" It's like, "What can I do today that would be of service?" And then finding that of trying to be of service and not really going for recognition can sometimes lead to what people call success.

这也是一种奇怪的跳跃式的真正方法来完成正确的事情，而不是像“哦，我怎样才能完成某件事？”就像，“今天我能做什么有用的事情？”然后发现尝试提供服务而不是真正寻求认可有时会带来人们所谓的成功。

Although that wasn't what you were aiming for.

虽然那不是你的目的。

Andrew Huberman:

安德鲁·休伯曼：

And it's all the more beautiful when it's not what you're aiming for.

当它不是你的目标时，它会变得更加美丽。

Anna Lembke:

安娜·伦布克：

So much better.

好多了。

So much better.

好多了。

Andrew Huberman:

安德鲁·休伯曼：

Yeah.

是的。

I'm a big believer that when one can align their compulsion with some greater good, a service to humanity or the planet or animals, whatever it is, that that's where the really good stuff emerges.

我坚信，当一个人能够将自己的冲动与某种更大的利益结合起来时，为人类、地球或动物服务，无论是什么，那就是真正的好东西出现的地方。

Because there's a lot of reciprocity there.

因为那里有很多互惠。

The world starts to, you're supporting the world, and then it starts to support in a way that feels very fluid.

世界开始，你在支持世界，然后它开始以一种感觉非常流畅的方式提供支持。

Anna Lembke:

安娜·伦布克：

And that comes back.

那又回来了。

And I mean, that speaks to you.

我的意思是，这对你来说很重要。

Like your generosity to me, vis-à-vis my book.

就像你对我、对我的书的慷慨一样。

And I have to say-

我不得不说——

Andrew Huberman:

安德鲁·休伯曼：

Well, I love the book.

嗯，我喜欢这本书。

We're not in a business deal, folks.

伙计们，我们不是在做生意。

It's just purely that I heard Anna lecture in my course.

纯粹是我在课程中听到安娜讲课。

I wanted to learn more about dopamine.

我想更多地了解多巴胺。

She taught me, I asked her if she would come on the podcast.

她教我，我问她是否愿意参加播客。

Turned out she wrote this amazing book.

原来她写了这本很棒的书。

She sent me an advance copy of the book.

她寄给我这本书的预印本。

I read it in one sweep.

我一口气读完了。

It's incredible.

太不可思议了。

And I love it.

我喜欢它。

So just like the eight-year-old version of me, now, the 45 version of myself, I can't stop blabbing about the things I love.

就像 8 岁时的我一样，现在 45 岁的我，我无法停止谈论我喜欢的事情。

Anna Lembke:

安娜·伦布克：

Well, it's awesome.

嗯，太棒了。

But I have to say, I have been surprised by your generosity.

但我不得不说，你的慷慨让我感到惊讶。

It's not something I've encountered frequently at Stanford, which is a wonderful place.

这不是我在斯坦福大学经常遇到的事情，斯坦福大学是一个很棒的地方。

But there is a general sense that if I give away to somebody else, I've lost something.

但普遍的感觉是，如果我把东西送给别人，我就失去了一些东西。

Which is not the right way to think about it.

这不是正确的思考方式。

Not how you are, and also not how the world works.

不是你的本来面目，也不是世界的运作方式。

Because when we give away to other people, we get back so much more.

因为当我们给予他人时，我们会得到更多。

But it takes a long time, and it might not come through that path

但这需要很长时间，而且可能走不到那条路

Andrew Huberman:

安德鲁·休伯曼：

I never think about reciprocity.

我从来不考虑互惠。

But I was weaned by good advisors.

但优秀的顾问让我断奶了。

Anna Lembke:

安娜·伦布克：

That's very nice.

这非常好。

Andrew Huberman:

安德鲁·休伯曼：

I think it just sort of got drilled into me that the more you give, the better your immediate life is.

我认为这已经深深地印在了我的脑海里：你付出的越多，你眼前的生活就越好。

Anna Lembke:

安娜·伦布克：

Yes.

是的。

Andrew Huberman:

安德鲁·休伯曼：

But I also don't have a long-term vision.

但我也没有长远的眼光。

I'm excited about the book.

我对这本书很兴奋。

I'm excited that people are learning about the brain and dopamine.

我很高兴人们正在了解大脑和多巴胺。

I have to admit, having grown up in neuroscience, essentially, I did not understand that pleasure and pain were orchestrated the way that they are.

我必须承认，作为在神经科学领域长大的人，本质上我并不理解快乐和痛苦是如何精心策划的。

I'm very mindful of it now.

我现在非常注意这一点。

Anna Lembke:

安娜·伦布克：

Oh good.

哦，很好。

Andrew Huberman:

安德鲁·休伯曼：

And it's changed a number of my behaviors.

它改变了我的一些行为。

I know a number of people are going to have questions and want to get in contact with you.

我知道很多人都会有疑问并希望与您联系。

You are not on social media.

你不在社交媒体上。

Anna Lembke:

安娜·伦布克：

That's correct.

这是正确的。

Yes.

是的。

Andrew Huberman:

安德鲁·休伯曼：

You are true to your ideology.

你忠于你的意识形态。

That's great.

那太棒了。

Anna Lembke:

安娜·伦布克：

And the reason for that is just I wouldn't be able to control myself.

原因就是我无法控制自己。

I mean, that really would be my drug.

我的意思是，那确实是我的药物。

People are my drug, intimacy is my drug.

人是我的药物，亲密是我的药物。

And I wouldn't be able to manage it.

我将无法管理它。

And so it was just easier for me to not do it at all rather than try to moderate it.

所以对我来说，根本不做比尝试调节它更容易。

Andrew Huberman:

安德鲁·休伯曼：

Well the book, as you mentioned before, and as I can attest to, it has a certain intimacy.

嗯，这本书，正如你之前提到的，而且我可以证明，它有一定的亲密感。

People get to know you through the book.

人们通过这本书认识你。

So definitely check out the book.

所以一定要看看书。

If you have questions about the book, et cetera, you're welcome to send them my way.

如果您对本书等有疑问，欢迎您向我发送。

I will buffer you from all those questions.

我会缓冲你所有这些问题。

I'll filter them.

我会过滤它们。

Anna, Dr. Lembke; I should be formal.

安娜，伦布克博士；我应该是正式的。

Forgive me, I've been referring to you the whole way through.

请原谅我，我自始至终都在提到你。

Anna Lembke:

安娜·伦布克：

No, no. That's fine.

不，不。没关系。

Andrew Huberman:

安德鲁·休伯曼：

Because we're colleagues.

因为我们是同事。

But thank you so much for sharing this information, and I know I learned a ton, and I know everyone else is going to learn a lot more about addiction and the good side of dopamine.

但非常感谢您分享这些信息，我知道我学到了很多东西，我知道其他人也会更多地了解成瘾和多巴胺的好处。

Anna Lembke:

安娜·伦布克：

That's right.

没错。

Thank you for having me.

谢谢你有我。

It's been really, really great to talk with you.

与你交谈真的非常非常高兴。

Andrew Huberman:

安德鲁·休伯曼：

Great, thank you.

太好了，谢谢。

Thank you for joining me for my discussion with Dr. Anna Lembke.

感谢您参加我与 Anna Lembke 博士的讨论。

I hope you enjoyed it as much as I did.

我希望你和我一样喜欢它。

Please be sure to check out her new book, "Dopamine Nation, Finding Balance in the Age of Indulgence." You can preorder it on Amazon or any places where books are sold.

请务必阅读她的新书《多巴胺国家，在放纵时代寻找平衡》。您可以在亚马逊或任何出售书籍的地方预订。

It's an absolutely fascinating and engaging read all about addiction and dopamine.

这是一本关于成瘾和多巴胺的绝对引人入胜且引人入胜的读物。

Andrew Huberman:

安德鲁·休伯曼：

If you're learning from and/or enjoying this podcast, please follow us on YouTube by subscribing to the Huberman Lab Channel.

如果您正在学习和/或喜欢此播客，请通过订阅 Huberman 实验室频道在 YouTube 上关注我们。

In addition, you can subscribe to the podcast on Apple and Spotify.

此外，您还可以在 Apple 和 Spotify 上订阅播客。

And on Apple, you have the opportunity to leave us up to a five-star review.

在苹果上，您有机会给我们五星级的评价。

If you have comments or suggestions for topics for future podcasts, please put those in the comment section below this episode on YouTube.

如果您对未来播客的主题有意见或建议，请将其放入 YouTube 上本集下方的评论部分。

Please also check out our sponsors that we mentioned at the beginning of the episode.

另请查看我们在本集开头提到的赞助商。

That's a terrific way to support our podcast and our ability to continue to bring you zero-cost-to-consumer information about science and science-related tools.

这是支持我们播客的绝佳方式，也是我们继续为消费者提供有关科学和科学相关工具的零成本信息的能力。

And last but not least, thank you for your interest in science.

最后但并非最不重要的一点是，感谢您对科学的兴趣。