(relaxing piano playing)
- Hi, my name is Ashley Mason
and I'm an assistant professor of psychiatry at UCSF
and I'm here with Rob Lustig
who is a neuro-endocrinologist here at UCSF as well.
And today we're talking about his new book,
called The Hacking of the American Mind.
So, Rob, why don't you start by telling us
what the book is about in a way
that folks without a medical degree would understand.
- Ashley, I wrote this book because we've suffered
a crisis in our culture, and I believe it comes down
to a mistake that we've made between
the interpretation of two of our most important
and positive emotions, pleasure and happiness.
Lot of people equate the two.
But I'm here to tell you that they are completely different.
Lot of people they're exactly the same.
In fact, on the internet, you can find definitions
that actually conflate and confuse the two.
So what are the differences between pleasure and happiness?
And I believe there are seven.
Pleasure is short-lived, happiness is long-lived.
Pleasure is visceral, happiness is ethereal.
Pleasure is taking, happiness is giving.
Pleasure can be achieved with substances,
happiness cannot be achieved with substances.
Pleasure is experienced alone,
happiness is experienced in social groups.
The extremes of pleasure all lead to addiction,
whether they be substances or behaviors.
Yet there's no such thing as being addicted
to too much happiness.
And finally, number seven, most important,
pleasure is dopamine and happiness is serotonin.
Now these are two biochemicals.
These are two neurotransmitters.
These are two chemicals that the brain makes
and uses to communicate between
one neuron brain cell and another.
Now, why do we care?
So what?
Well, turns out dopamine excites the next neuron
and neurons when they're excited
too much, too frequently, tend to die.
So the neuron has a defense mechanism against that.
What it does is it reduces the number of receptors
that are available to be stimulated
in an attempt to try to mitigate the damage.
- When you say to be stimulated,
you mean to be excited?
- To be excited, that's right.
And so we have a name for that process,
it's called down regulation.
And a lot of different chemicals in the body do that.
Now, you get a hit, you get a rush,
the receptors go down.
Next time, you need a bigger hit
to get the same rush,
'cause there are fewer receptors to occupy.
And you need a bigger hit, and a bigger hit,
and a bigger hit until finally,
taking a huge hit to get nothing.
That's called tolerance and then
when the neurons start to die, that's called addiction.
Serotonin however is inhibitory.
It's not excitatory.
It inhibits its receptor to provide contentment,
to zen out if you will.
So you can't overdose the serotonin neuron.
- And what does it mean to inhibit a receptor?
- What it means is it binds, but it doesn't activate
the process beyond the receptor.
So, what it does, is it basically slows down those neurons,
instead of causing them to fire up.
And in doing so, you end up with the process of contentment,
that feeling of one with the world, if you will.
That thing we call happiness.
Now, there's one thing that
down regulates serotonin, dopamine.
So the more pleasure you seek, the more unhappy you get.
And, Las Vegas, Madison Avenue, Wall Street,
Silicon Valley, and Washington DC,
have very specifically and in a coordinated fashion,
confused and conflated the term happiness
with the term pleasure.
So that you can buy happiness.
So that they can sell you their junk.
It's called the American economy.
And it's based on hedonic substances,
substances that drive pleasure, rather than happiness.
And in the process, we have become most decidedly unhappy.
And the problem is you can't fix a problem
unless you identify what the problem is.
That's the reason for this book.
- In the title of the book you use the word hacking.
This sounds pretty dark and conspiratorial.
Do you really think that there's been a plot
to control our minds?
- So let's first of all, I define the word hack.
So hack has a relatively short history.
The very first time the word hack was used,
other than in a butchery, was in 1955,
when it was used at MIT, the Model Railroad Club,
to talk about a unusual solution to a complex problem,
and that's what it meant for quite a while.
An example, stealing a car is a felony offense.
Stealing a Boston police car, dissembling it,
carrying each piece up five floors
to the great dome of MIT, reassembling it,
and putting a mannequin of a Boston police officer,
with a box of donuts in the front seat, that's a hack.
Over the course of the next several decades,
the word hack became synonymous with clever approaches
to complex computer problems,
which we now call white hat hacking,
which is very prevalent and common here in Silicon Valley.
But in the process, we also now have black hat hacking,
as we learned during the 2016 presidential election
when the Russians hacked Hilary Clinton's emails.
- So then, black hat hacking is, can you define that?
- So it's a malevolence, in an attempt to
basically blackmail or to cause the crashing of a computer.
To wipe out a hard drive, so clearly not something good.
And the question is, how can your brain be hacked?
And the answer is, well it doesn't get hacked
with computer code but it gets hacked
with false information.
And in fact, we've had false information
since the time of the Romans, it's called propaganda.
So what's the difference between marketing,
which is what companies say they do, and propaganda?
And the answer is the truth, that's the difference.
When companies express a point of view
that furthers their goals, then that point of view
references true facts, that's called marketing.
When a company expresses a point of view
and tries to advance its goals based on
misinformation, that's called propaganda.
So the difference between marketing
and propaganda is the truth.
The corporations of America today have engaged
in a very specific attempt to market their propaganda
in order to get us to do different things
than we might otherwise have done.
Examples, the easiest one of course is food
and the one that I've written about previously.
The idea that foods can be healthy,
goes back a long way, in fact not eating food,
is not healthy, it's called starvation.
The question is which foods are the ones
that ultimately lead to health?
And the answer is not the ones
that the food industry has touted.
In fact, we have the data that demonstrates
that they knew what they were doing.
When we went low-fat in the 1970s,
The Sugar Association knew what it was doing.
In fact, there is a now paper trail of the communications
between The Sugar Association
and two Harvard school public health scientists,
to specifically exonerate sugar and finger saturated fat
as the culprit for our cardiovascular disease debacle.
Turns out, we now have the data to show that
that was completely untrue,
that we have actually experienced an increase
in obesity, cardiovascular disease,
type 2 diabetes, hypertension, lipid problems,
cancer and dementia because of our processed food diet,
which we were told was healthy.
And they knew, back in the 1970s that that was not the case.
That's black hat hacking.
Our minds have been hacked to believe certain things
that are not true.
And it's been a very specific corporate plot.
Now I won't go so far as to say it was a conspiracy,
because we do not have data that says,
that different corporations colluded with each other
to specifically defraud the American public,
and to inflict malice upon the american public.
But we do have the data to show,
that individual companies engaged
in their own plots to do so.
Another example of course was tobacco.
Tobacco made it very clear for many years
that there was no relation between nicotine and addiction,
except that they had the data that said otherwise
and they lied to congress, very specifically.
So, tobacco, alcohol, food, guns, energy,
these are all hedonic substances and or behaviors.
And they have costs and we're paying those costs now.
We're paying it in terms of our addiction crisis,
we're paying it in terms of our opiod,
our depression crisis, we're paying it in terms of
lives lost and we're paying it in terms
of our healthcare debacle.
And you can't reverse it, till you understand it.
You can't pull yourself out of the ditch
until you figure out how you drove into it.
- So Rob in your book, you talk a lot about the difference
between pleasure and happiness.
In just a few sentences, can you tell us
what is the major distinction between the two?
- So from a social standpoint,
pleasure is the feeling that this feels good.
I want more.
Happiness or contentment, is the feeling of
this feels good, I don't want or need anymore.
They're not the same.
In fact, pleasure begets more pleasure.
This is what the casinos are counting on.
On the other hand, I don't want or need anymore,
says, if there was something to purchase,
I don't need to purchase it.
In fact, all of the things that say,
this feels good I don't want or need any more,
are things that you can't buy.
They're not for sale.
They are however,
accessible to every single human being on the planet.
They're all the things your mother told you,
but you forgot.
I call them the four Cs.
First one, connect.
So, interpersonal connection turns out
to be extraordinarily important for happiness
and the reason is because face-to-face, eye-to-eye
connection, generates something called empathy.
Empathy activates a specific set of neurons
in your brain, which have been termed mirror neurons.
So that the feelings of the person you're talking to
ultimately become adopted by you as well.
And in that process, you generate contentment.
So, interpersonal connection is extraordinarily important.
This is one of the reasons why we have religion,
is for that interpersonal connection.
Turns out the faith is not important,
the interpersonal connection is.
But then you have to ask the question,
well, what about non-interpersonal connection?
Like for instance, Facebook.
Turns out Facebook actually sows unhappiness,
in part because there is no interpersonal connection,
there's no serotonin rise.
There's a dopamine rise every time a message
flashes across your screen, it's called variable reward.
And actually causes you to increase your actions
to access more Facebook and that actually drives
further depression and the data now,
show that this is a vicious cycle.
Second one, contribute.
And contribute means not to your bankbook,
it means to outside of yourself.
So you can do it within your work,
by making the work a better place for your colleagues,
or you can do it outside of your work,
by volunteerism, or philanthropy.
So there are a lot of different ways
to accomplish, contribute.
But ultimately it has to be outside yourself.
Third one, cope.
So in order to reduce stress,
thereby improving your serotonin receptors
to allow for better feelings of happiness.
There are three things.
One, sleep, something we're getting much less of,
in part because of our screens.
In fact, my colleague Kristine Madsen
at UC Berkeley showed that 8th graders
who slept with their cellphone in their room,
got 28 minutes less sleep each night,
then those who charged their cellphones outside the room.
A recent study showed that if the cellphone
is sitting on the desk, even if it's off,
it takes three times as long to accomplish the task,
as if the cellphone is not there.
By being a distraction and from the blue light
emanating from the screen and actually activating
that part of your brain that keeps you awake.
Cellphones and other screens,
which now have dominated our lives,
have actually promoted unhappiness.
Second thing within cope, mindfulness.
We know a lot about mindfulness, we study it,
along with other people at the Osher Center here at UCSF.
In fact, multitasking is probably the single biggest
destroyer of happiness that we have.
People pride themselves on their being able to multitask,
companies look for the people who can multitask the best,
turns out, only about 2.5% of the population
can actually do two things at once.
Everybody else, it's smoke and mirrors,
and the most things you take on,
the quicker you get unhappy
and the lower your serotonin goes.
And finally, within cope, the last one is exercise.
It turns out exercise will tamp down dopamine
and increase serotonin on its own.
And when you use exercise as a mitigator of stress,
you can clearly advance your serotonin
in a very positive way.
And then lastly, the fourth C, cook for yourself.
When you go out to a fast food restaurant,
you don't know what you're eating.
It turns there are three items in your diet
that matter in terms of the serotonin, dopamine connection.
First one, tryptophan.
Tryptophan is the amino acid that is the building block
to make serotonin.
Happens to be the rarest amino acid in our diet.
It's mostly found in fish and flax.
We don't eat a lot of fish, in general.
It's probably low on our list.
In part because of shipping processes,
farmed fish versus wild fish, et cetera.
But the bottom line is,
fish have a very high level of tryptophan.
Omega-3 fatty acids.
Those are found also in fish
and they are found in certain food stuffs
that are grown, mostly algae, things that eat algae
ultimately increase your omega-3s.
So fish eat algae, we eat the fish.
Why are omega-3s important?
Because they provide stability to neuronal membranes.
So it's less likely that neurons will die.
And they can be compressed easier,
they allow for neurons to come back to shape,
so that you don't kill off the neurons
that ultimately drive happiness.
And then lastly, the negative one, fructose, sugar,
the one that actually drives dopamine up,
also drives serotonin down.
So high tryptophan, high omega-3 fatty acids,
low fructose, that's called real food.
When you cook for yourself, that's what your making,
that's what you're eating.
And, you're cooking for yourself and your family,
you get the interpersonal connection,
you get the contribution to something outside yourself.
It's basically a win-win-win.
On the other hand, in fast food, you're eating alone.
You're eating things, you don't know what's in it.
And you're eating a hell of a lot of sugar,
because every item at the fast food restaurant
has been spiked with added sugar,
specifically for their purposes, not for yours.
So we have moved on to a fast food consumption society,
and in the process,
we have actually impeded our ability to get happy.
And we have to understand these problems,
in order to unravel them.
- A lot of the substances that you're talking about
are everywhere, they're ubiquitous.
- [Robert] Indeed.
- How do we become aware of our addictions to them?
- Well, it can be hard.
I can tell you, I know what I'm addicted to, caffeine.
My wife and I, two codependents with a crux.
The fact is, that a lot of people
don't necessarily understand that they are addicted.
They know they need something,
when want becomes need, that's usually a sign of addiction.
And I will tell you, I need my two cups of coffee
in the morning just to function
and I'm not proud of it.
On the other hand, if you take my Starbucks away from me,
I will kill you.
A lot of people say they have a sweet tooth,
that's usually a sign of sugar addiction, if they say that.
If they find themselves, not being able to concentrate
on their job, or on their family,
because this craving is calling to them
and it's interfering with their daily life in some fashion,
or in their work, that's usually a sign of addiction.
And that can happen from shopping, from porn,
from video games and cellphones,
that of course has been the most recent addition to this.
If you find yourself checking your cellphone
every two minutes waiting for a new email,
that's usually a sign of cellphone addiction.
And it works in the same way in terms of the dopamine.
There's a paradigm that companies use to get us addicted.
It was outlined in a book by Nir Eyal called Hooked.
It starts with a trigger, an itch if you will,
and then that itch has to be scratched
and presumably the scratch is something
that's socially acceptable,
like for instance, checking your cellphone.
And then, variable reward.
Now if the rewards the same every time,
it won't become a habit,
it won't become an addiction.
But, if it's different each time,
then there is an impetuous and a pressure
to keep doing it and keep checking it.
And ultimately it becomes part of your daily life.
That is what cellphones have done
over the last 10 years.
They've basically occupied this primary position
within our culture, to the point where,
we almost now can't even concentrate on our jobs.
And the last part of the cycle is investment.
That is, you have to be willing to be plunk down
another $299 for the next iPhone
in order to keep the addiction going.
And indeed, virtually everyone in America
has opted for that addiction,
virtually over everything else.
So this has been a slow but nonetheless,
steady drumbeat that has preoccupied America
and not just America but the entire world
and it's one of the reasons why
Apple and Samsung duke it out for market share,
because basically, it's about who's going to supply
the rest of the world with their addiction.
- So then, craving is big component of it,
being willing to forgo these components of happiness
is another component and then,
being willing to invest.
- Well, not necessarily forgo feelings of happiness.
The problem is, that you have to know what happiness is
in order to be able to--
- Forgo in the connection and the contribution,
and all of these things.
- Right.
So the question is, why is it that
pleasure and happiness have become confused.
Did industry start that?
It actually started early than that.
It started with the declaration of independence.
Remember life, liberty and the pursuit of happiness?
Well, turns out life is going in the wrong direction.
We now know that lifespan, average lifespan
in the United States is going down for the first time.
Liberty, turns out depending on where you were born
that determines your final salary.
If you were born in Palm Springs or in Los Angeles,
you make more money than if you
were born in Baltimore or Detroit, for the exact same job.
We've constructed ghettos of our own volition,
whether they be inner-city ghettos,
or walled ghettos in fancy parts of town.
They're still prisons, gilded ones sometimes,
but prisons nonetheless.
And finally, happiness.
Remember that clause the pursuit of happiness?
It was said twice.
Once in The Virginia Declaration of Rights in 1776
and then re-appropriated by Thomas Jefferson
for The Declaration of Independence.
- One of the substances that you've written and talked about
the most, has been food, processed food.
And of course, how this contributes to metabolic disease.
It seems like our healthcare system
is setup, albeit not the best, to treat metabolic problems,
more than to prevent them.
Is it hopeless?
Where do you see this going?
- Right now, we have more money going out
for chronic metabolic disease, then for everything else.
In fact, 75% of our healthcare expenditures
are for the diseases that constitute metabolic syndrome,
that is type 2 diabetes, hypertension,
lipid problems, cardiovascular disease, cancer and dementia.
You add that up, that's 75% of expenditures.
Here's the math.
The food industry grosses 1.46 trillion dollars a year,
of which 657 billion dollars is gross profit.
They're making a huge profit.
However, healthcare expenditures
are 3.2 trillion dollars, of which 75%
is chronic metabolic disease,
of which 75% of that could be prevented
if we could fix the food problem.
Bottom line.
You can't have healthcare reform,
unless you have health reform.
And you can't have health reform,
unless you have diet reform.
Now, Obamacare promised that we could put
32 million sick people onto the rolls.
And that we would pay for it,
with preventative services,
by being able to go to your doctor,
you wouldn't have to have the emergency room,
which costs 50 times as much.
And that's how we would be able to pay for all these people.
Turns out, that with Obamacare,
emergency room visits went up, not down
and costs went so high that
three of the major insurers opted out.
And that was one of the reasons
for the election of 2016 focusing on healthcare.
Here's the problem.
Obamacare did not address diet.
But neither does Trumpcare and neither does
the current senate and house bills
that are trying to repeal and replace.
The bottom line is, until we address the problem of diet,
which will also of course address the question
of pleasure and happiness at the same time.
We will not see an improvement
in our healthcare system anytime soon.
This has to be front and center.
In addition, food is 20% of investment,
but it is 40% of climate change.
Agriculture contributes 40% of climate change.
So if people are worried about this problem,
as they should be,
then fixing America's diet has to be front and center
for the two biggest problems that we have today,
climate change and healthcare.
This is at the center of both of these phenomena
and we will not be able to solve it,
until we start to address it.
- Can you tell us a little bit about what lead you
to write this book in the first place?
- I've known about the dopamine,
serotonin connection for 30 years.
I knew about this when
I was a post-doctoral fellow at Rockefeller University,
cutting up rat brains
and studying how hormones effected neurons.
But it wasn't until 2014,
when I was giving psychiatry grand rounds
at a major medical school here in the United States,
and I talked to the outpatient coordinator
of their recovery program,
who herself was a reformed heroin addict.
And, she told me something, that was so jarring.
What she said to me was, she said,
"When I was shooting up, I was happy.
"What my new life has brought me, is pleasure."
and I thought to myself, wait a second,
this is exactly opposite.
When she was shooting up,
that's what brought her pleasure,
because it was heroin.
And her new life has provided her with a more steady,
long-term feeling of contentment.
So I thought to myself, how often does this happen?
And is this potentially at the bottom
of why we have an opiod and an addiction crisis?
And I've talked with many psychiatrists
who have had the same experiences
told to them by their patients.
About a week and a half after I got
back from that trip, I was talking to my sister-in-law.
And she used to work the help desk at Pillsbury,
before they were taken over by General Mills.
People would call in,
why they have icicles in their Poppin' Fresh dough.
Why the carton would, the microwave carton would melt
in the microwave, things like that.
And she stayed friends with the people she worked with
and they had a gourmet club every year
and they would all bring things.
And one of the members of her gourmet club
said to my sister-in-law, "You always stay
"so nice and thin, how do you do it?"
And this woman had just
undergone bariatric surgery for obesity.
And my sister-in-law said, "Well, really,
"I just only eat when I'm hungry."
And the woman said to her,
"Eating for hunger?
"Eating is for happiness."
and I thought to myself, a-ha.
I take care of obese kids for a living
and I've heard that story,
but it was never so jarring
as when I heard this,
this discussion and I put the two together,
and I said, "We don't know the difference."
and indeed, there is an entire paper trail
of not knowing the difference.
And you can see it on television, on YouTube,
virtually every day.
Coca-Cola's Open Happiness campaign.
Happy hour.
Cialis, will you be ready?
Add a little stress thrown in.
Bottom line, we have mistaken
the experience of pleasure
for the experience of happiness.
And so we continue to drive our interest
in pleasure at the expense of our happiness.
And you can't undo the paradigm unless you understand it.
And the four Cs, are the way to fix the problem.
- Thank you for talking with us today about your new book.
You can buy Rob Lustig's new book,
The Hacking of the American Mind,
at amazon.com or a bookstore near you.
(upbeat piano music)