Chapter One
WHERE HAS ALL OUR
PLEASURE GONE?I can think of nothing less pleasurable
than a life devoted to pleasure.
-John D. Rockefeller
From the information I gleaned in my first interview with him,
Brian seemed like someone to be envied. He had it all! He grew up
in the best of neighborhoods with caring parents who provided him with
the best education. Then followed a great marriage and two adorable
children. To be honest, I was tempted to envy Brian that Thursday morning
during our first session. It was hard to believe that he needed help.
He certainly didn't show any outward signs of distress.
But as the session proceeded and we pulled back the veil of privacy,
it all came flooding out. For many of the reasons that I will be describing
in this book, Brian was extremely unhappy. He had what most of us
would consider a very successful life. At age thirty-four he had been
promoted to division sales manager, complete with a company car and
sizeable benefits package. He was active in his church and community,
and his family was looking forward to their annual vacation in a few
weeks. "So why do I feel so empty?"
he asked me. "I have everything I could
have ever hoped for, but I just can't
seem to enjoy any of it. No matter
what I achieve or acquire, it's like
I'm totally numb inside. What's wrong
with me?"
A certain numbness had become his regular feeling. He had been a
vibrant, outgoing, and energetic person, but now all he felt was persistent
apathy. It was now hard for him to be enthusiastic about anything. He had
lost interest in activities that used to excite him, and now only wow experiences
grabbed him. And on top of all of this, he had lost his ability to
extract even the slightest pleasure out of the ordinary things of life.
It's called anhedonia-a feeling of joylessness and cheerlessness.
Everyone feels it to some extent these days, and it's not going to go away.
In our fast-paced, pleasure-seeking society, we are obsessed with increasing
our level of excitement to feel a sense of pleasure. When we go to the
movies, we expect the action sequences to be more thrilling and spectacular
than before. Our music must be louder and edgier than the last
album. Even in our churches, preachers must out-wow their last sermon
or we might not go back again. We have become addictively dependent
on persistent thrills and kicks.
What's bad about this? The problem is that we are being thrilled to
death! Our continuous pursuit of high stimulation is snuffing out our
ability to experience genuine pleasure in simple things.
Scientists who are exploring anhedonia believe not only that we are
slowly losing our capacity for pleasure, but that this condition might be a
major factor in many emotional problems, such as depression and anxiety,
as well as contributing to addictions to sex, work, drugs, and other addicting
behaviors. More alarming to me is that anhedonia is impacting our
children and teenagers to a greater extent than parents, and if we don't take
action to correct it, I pity where the next generation is headed. Deriving
pleasure from the ordinary and healthy experiences of life will be a thing
of the past. We will come to rely entirely on psychotropic medications for
our happiness-and this happiness will only be artificial at best.
WHAT IS ANHEDONIA?
Anhedonia refers to the reduced ability to experience pleasure. And it is
a phenomenon that is growing in leaps and bounds. Scientists are
adamant that as we push the stress level and exciting stimulation higher
and higher, we are literally overloading the
pathways to the pleasure center of the brain.
This overload causes our brain's pleasure
center to demand a further increase in the
level of stimulation before delivering more
feelings of pleasure. This results in a decline
in our pleasure system's ability to deliver enjoyment out of ordinary,
simple things. I see this process at work in my patients, friends and
family, and even in myself.
I must confess that I know about a diminished pleasure response all
too well. Of course, I had seen patients who were anhedonic, but mostly
we believed that only people with severe depression or a mental disorder
could be so profoundly lacking in pleasure. But my experience of
anhedonia felt different.
My life had always been full of pleasurable experiences. I have never
lacked any ability to turn on my pleasure circuits. My hobbies, for
instance, are a great source of enjoyment-even today. I can't begin to
describe the hours of delight I have enjoyed in, for instance, crafting
gold rings for my wife and my daughters. I make a habit of collectingold gold when I travel back to my country of birth, South Africa, one
of the world's great gold producers. In fact, I grew up in a gold mining
town so cannot but be obsessed with its beauty.
I can also derive immense satisfaction from completing a computer
program I need for my research, or building a physiological instrument I
need for my laboratory, or reroofing a part of my house, or repairing my
car. I can plot and scheme and create so
much pleasurable experiences that I sometimes
worry about not living long enough to
accomplish all the things I want to accomplish.
And I am talking about things I want
to do, not work I have to do There's a big difference.
But every now and again without expecting it, I feel that I
couldn't be bothered. Pleasure is gone. Nothing can make me feel pleasure.
It's as if something in my brain switches off, and life feels boring, blah,
blunted, and bland. (That little alliteration did give me a pleasure boost.)
And many of you reading this book feel the same. Up and down on
the pleasure scale-like a yo-yo. Many today are beginning to suffer
from an emotional disorder called hedonic dysregulation. In simple terms,
it means that your brain's pleasure center is not working properly.
When it should be giving you pleasure, it doesn't.
But if only our disregulated pleasure centers would confine themselves
to the realm of pleasure, I would not bother to write this book.
Anhedonia, in and of itself, is no big deal when you put it in life's larger
perspective. But other consequences of anhedonia are much more serious
and pervasive than this. The lack of ability to experience pleasure
affects every aspect of our lives, from sexuality to addictions, from relationships
to spirituality. Even our capacity to experience God to the fullest
is seriously compromised when we suffer from even the mildest form of
anhedonia.
Anhedonia is a disorder that is here to stay, and it already has its tentacles
in many of us.
ANHEDONIA'S INNER WORLD
The inner world of severely anhedonic people can be summed up by the
following comment of a high-achieving, success-driven patient: "My
food seems tasteless. A beautiful woman no longer attracts me. Music
no longer pleases me. I don't care if I never go to a movie again. My
friends seem dull. I look forward to nothing. I don't want to die, but I
don't care about living. I don't get a kick out of anything, except perhaps
making some big deal come to reality."
And these are not the sentiments of a severely depressed patient.
They are the experience of a lot of ordinary people. I know, because I
meet them every day, wherever I go. I've just returned from a three-country
speaking tour and found anhedonic people in South Africa,
Germany, and Switzerland, just as I have in the United States.
How does anhedonia show itself? Anhedonic people smile very
weakly, if at all. Someone cracks a joke, but they don't laugh when everyone
else is laughing. They express little or no feelings even when grief
or mourning is the appropriate emotion. The more severe the anhedonia,
the more completely it shuts down the pleasure system and experience
of any joyful feelings. Eventually it can cause a severe emotional
disorder such as major depression. For most of us who suffer from what
is called stress-induced anhedonia, however, the loss of pleasure sensitivity
is more insidious and less severe, though still problematic. There's no
fun to be had when you go through life always seeking that wow experience
to scrape together a little bit of pleasure.
If you are wondering just how lacking you are in your ability to extract
real pleasure from life, be patient. I will offer a test for anhedonia in the
next chapter. This test will help you get a clearer picture of just how far
down the road to annihilation you have taken your pleasure system.
I can best clarify what anhedonia feels like through two short stories.
Suzie has just given birth to her first child. It wasn't a very difficult
labor, and everything went like clockwork. She had looked forward
with great anticipation to having a baby, especially since she miscarried
her first baby-a devastating loss. This baby would make up for her pain
and fear that she would never be able to have a second chance at motherhood.
So you can imagine her dismay when in the moments after the
nurse placed her newborn baby in her arms, she felt no joy. It must be the
effect of the drugs, or maybe I am just exhausted, she thought. Tomorrow I
will feel more excited. But she didn't. Holding her baby, flesh of her flesh,
left her feeling numb. No joy or pleasure whatsoever as she coddled this
helpless, dependent gift of life. Welcome to anhedonia! In this case, it
is being caused by postpartum depression.
Mary is a teenager. She's been learning to drive and was planning on
getting a job soon so she could pay the matching half her father had
promised and buy her own car. Most of her friends already had wheels,
and this token of emerging adulthood meant a lot to her. She took her
driving test and aced it. Walking back to the car with her license in hand,
her father asked her how she felt. "Nothing," was her reply. He wasn't
very surprised, since this has been her tone for some time now. Despite
eagerly anticipating this significant milestone in her life, she was totally
unmoved. Teenage anhedonia.
EVERYONE NEEDS TO KNOW ABOUT ANHEDONIA
The term anhedonia is derived from the Greek a- (without), and hedone
(pleasure, delight). The word hedone is also the root of hedonism (a philosophy
that emphasizes pleasure as an aim of life, and often considered
to be sinful in Christian circles), hedonist (a pleasure seeker), and hedonophobia
(an excessive fear of feeling pleasure).
To use metaphoric language, anhedonia is not having anything in
your life that can move your heart. Your happiness is deadened because
your joy is missing.
To the mental health professionals reading this book, let me say that
I am not using the term anhedonia in the strict clinical sense. As every
psychologist and psychiatrist knows, severe anhedonia is the cardinal
symptom of such disorders as major depression and schizophrenia. No, I
am talking about a more subtle and insidious loss, a decline over time of
the ability to find joy in small events
and simple experiences while being
pushed into ever increasing levels of
stimulation. What used to make us feel
ecstatic now has no power to thrill us.
It is the decline of the pleasure we were born with and nature intended
us to enjoy before the modern, excessive pursuit of excitement took over
and hijacked the brain's pleasure system. In a real sense, we have lost our
pleasure by becoming addicted to pleasure that is outside the box of
normal existence.
Pastors also know very well what I mean here. I do a lot of seminars
for clergy. When they are young, just starting out on their calling and
fresh from seminary, they could take great joy in what they were able to
do for God. Every day was a thrilling adventure. But with time, subject
to many of the factors I will be sharing in this book, something changed.
Pleasure was lost. As one pastor said to me recently, "I no longer feel
any pleasure in my work as a pastor. I don't enjoy my wife and family.
And the other night, it dawned on me that I don't even find any pleasure
in God anymore." An honest comment-but indicative of how
widespread anhedonia has become.
But take heart, this is not a pessimistic book. You can repair the part
of your brain that delivers deep, satisfying pleasure and become a joyful,
happy person again. I know. I did it for myself. And I've helped
many others do it as well.
UNCOVERING THE BRAIN'S PLEASURE SYSTEM
Simply put, anhedonia, the reduced ability to experience pleasure, is
brought on, paradoxically, by the excessive pursuit of pleasure. Mainly
it develops out of the high amount of stress most of us experience
today. It is a by-product of the fantastic
technological improvements in our
world. We now have such a high level
of stimulation that we can escape boredom
in an instant.
Just think about it. Are you ever
lonely? Just log on to your favorite
Internet chat group and bye-bye loneliness. Bored? Turn on your
iPod or watch a movie on your portable DVD player. Fed up? Grab
your cell phone and text-message the person you are ticked off with
to get it off your chest. Of course, your stress level will go higher
when twenty seconds later you get a message back, venting on you.
Need to work on a project or homework? Put your iPod earpiece in
one ear, your cell phone earpiece in the other, turn on your laptop to
check your e-mail, and now you can concentrate on your project or
homework.
All of this stimulates your brain to the point of overload. Technology
is revolutionizing our lives but ravaging our brains. A reasonable use of
technology is good, but too much is bad as we will see.
THE BRAIN'S PLEASURE CENTER
This brings me to the central focus of this book. The problem of anhedonia
revolves around an important part of the brain that is increasingly
getting the attention of scientists. To really grasp the problem of anhedonia,
you have to understand a little about how the brain works to
deliver us pleasure. So bear with me.
Not too many years ago, scientists discovered that the brains of both
humans and animals had what they called a reward or pleasure center.
This hardwired system in the brain is responsible for creating the feeling
we call pleasure. There are several pathways to this center, depending
on what is creating the pleasure. This specific part of the brain has
one exclusive and exquisite purpose: to deliver pleasure to our consciousness.
This remarkable discovery happened quite by accident, and it's a
story worth telling here.
In 1954 two researchers, Olds and Milner, were experimenting with
implanted electrodes in a rat. They discovered that when they sent a
small electric signal in one particular location in the brain, the animal
would go into an unaccountable rage. They had discovered that the
brain had a rage center. Each time this center was electrically stimulated,
the animal would go into a rage and then stop as soon as the signal
stopped.
One day, quite by mistake, the researchers put the electrode into an
adjacent area. When they applied the signal, instead of creating a rage
response, the animal seemed to like it. Really like it! So they set up a
lever that the rat could press and deliver electrical signals to this newly
discovered part of the brain whenever it chose to. And it chose to, all
right. Again and again.
This area in the brain-which exists in all animals, including
humans-was named the locus accumbens, but it is more commonly called
the pleasure center. Very much later it was discovered that there are several
centers in the brain that work together to deliver pleasure, but for
the purpose in this book I will simply refer to the complex connections
that help us know when something is pleasurable as the pleasure system.
At the heart of this pleasure system is the pleasure center.
To show just how powerful this pleasure center is, controlled animal
experiments with rats that could self-administer shots of pleasure
as often as desired found that they would continue to do so as
often as possible. One rat achieved a rate of ten thousand presses on
the lever an hour. An animal could self-stimulate all day and night
without rest and would forgo food and sex and even cross a painful grid
that gave severe shocks to the feet to get to that pleasure-delivering
lever.
(Continues.)
