Anna Lembke, MD

American psychiatrist who is Chief of the Stanford Addiction Medicine Dual Diagnosis Clinic at Stanford University

Anna Lembke is professor of psychiatry at Stanford University School of Medicine and chief of the Stanford Addiction Medicine Dual Diagnosis Clinic. A clinician scholar, she has published more than a hundred peer-reviewed papers, book chapters, and commentaries. She sits on the board of several state and national addiction-focused organizations, has testified before various committees in the United States House of Representatives and Senate, keeps an active speaking calendar, and maintains a thriving clinical practice. In 2016, she published Drug Dealer, MD – How Doctors Were Duped, Patients Got Hooked, and Why It’s So Hard to Stop (Johns Hopkins University Press, 2016), which was highlighted in the New York Times as one of the top five books to read to understand the opioid epidemic (Zuger, 2018). Dr. Lembke recently appeared on the Netflix documentary The Social Dilemma, an unvarnished look at the impact of social media on our lives.

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Philosopher's Notes on Anna Lembke, MD's Books

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Philosopher's Notes

Dopamine Nation

by Anna Lembke, MD

I got this book years ago when it first came out, and I went hunting for it again after Jonathan Haidt quoted its unforgettable line in The Anxious Generation: “The smartphone is the modern-day hypodermic needle, delivering digital dopamine 24/7 for a wired generation.” Anna Lembke, the medical director of Stanford Addiction Medicine, delivers a clear, compassionate, deeply practical look at how pleasure and pain work in the brain, why abundance is frying our reward systems, and what we can do about it. Her core message is simple and sobering: every pleasure has a cost, repeated indulgence raises our dopamine set point, and we become “cacti in the rain forest,” drowning in stimulation while becoming more sensitive to pain and less capable of real joy. The antidote is not vague willpower, it’s wise constraints, strategic “self-binding,” dopamine fasting to restore balance, and the courage to tell the truth about what we’re doing and why. Big Ideas we explore include The Pleasure-Pain Balance, Dopamine Fasting (D-O-P-A-M-I-N-E), Self-Binding (space, time, meaning), Radical Honesty, and Prosocial Shame.

Quotes by Anna Lembke, MD

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The smartphone is the modern-day hypodermic needle, delivering digital dopamine 24/7 for a wired generation.

Anna Lembke, MD

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Please don’t misunderstand me. These medications can be lifesaving tools and I’m grateful I have them in clinical practice. But there is a cost to medicating away every type of human suffering, and as we shall see, there is an alternative path that might work better: embracing pain.

Anna Lembke, MD

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The reason we’re all so miserable is because we’re all working so hard to avoid being miserable.

Anna Lembke, MD

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The trick is to stop running away from painful emotions, and instead allow ourselves to tolerate them. When we’re able to do this, our experience takes on a new and unexpected rich texture. The pain is still there, but somehow transformed, seeming to encompass a vast landscape of communal suffering, rather than being wholly our own.

Anna Lembke, MD

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With intermittent exposure to pain, our natural hedonic set point gets weighted to the side of pleasure, such that we become less vulnerable to pain and more able to feel pleasure over time.

Anna Lembke, MD

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Today, more than one in four American adults—and more than one in twenty American children—takes a psychiatric drug on a daily basis.

Anna Lembke, MD

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I’ve seen a similar paradox in many of my patients over the years: They use drugs, prescribed or otherwise, to compensate for a basic lack of self-care, then attribute the costs to a mental illness, thus necessitating the need for more drugs. Hence poisons become vitamins.

Anna Lembke, MD

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As I tell my patients, just walking in your neighborhood for thirty minutes a day can make a difference. That’s because the evidence is indisputable: Exercise has a more profound and sustained positive effect on mood, anxiety, cognition, energy, and sleep than any pill I can prescribe.

Anna Lembke, MD

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Mutual honesty precludes shame and presages an intimacy explosion, a rush of emotional warmth that comes from feeling deeply connected to others when we’re accepted despite our flaws. It is not our perfection but our willingness to work together to remedy our mistakes that creates the intimacy we crave.

Anna Lembke, MD

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Although difficult in practice, this handy little tool—telling the truth—is amazingly within our reach. Anyone can wake up on any given day and decide, ‘Today I won’t lie about anything.’ And in doing so, not just change their individual lives for the better, but maybe even change the world.

Anna Lembke, MD