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Copyright © 2017 by Robert Lustig, MD, MSL
Illustrations copyright © 2017 by Glenn Randle and Jeannie Choi, Randle Design
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Library of Congress Cataloging-in-Publication Data
Names: Lustig, Robert H., author.
Title: The hacking of the American mind : the science behind the corporate takeover of our bodies and brains / Robert H. Lustig, M.D., M.S.L.
Description: New York : Avery, 2017. | Includes bibliographical references and index.
Identifiers: LCCN 2017031139| ISBN 9781101982587 (hardcover) | ISBN 9781101982594 (epub)
Subjects: LCSH: Happiness. | Pleasure. | Contentment. | Satisfaction.
Classification: LCC BF575.H27 L83 2017 | DDC 152.4/2—dc23
LC record available at https://lccn.loc.gov/2017031139
While the author has made every effort to provide accurate Internet addresses and other contact information at the time of publication, neither the publisher nor the author assumes any responsibility for errors, or for changes that occur after publication. Further, the publisher does not have any control over and does not assume any responsibility for author or third-party websites or their content.
Version_1
Dedicated to my late mother, Judith Lustig Jenner (1934–2016), the inspiration for this book. My mother wasn’t a particularly happy person. A Depression baby, she had to grow up quickly, and was an adult by the age of four. She missed out on a real childhood, and spent the rest of her life trying to make up for it. To her, money was the route to happiness, and she didn’t want for it, but it never really made her happy. She certainly knew pleasures—in food and drink, in jewelry, in casinos, in exotic spots around the world. But few of her exploits or possessions brought her contentment. The only true happiness she knew were her children and grandchildren, and her eight-year relationship with her second husband, Myron Jenner, who was taken all too soon. Along the way and at the end, she also knew a large dose of pain and suffering as her body broke down from a debilitating neurological illness while her mind stayed as sharp as a tack. Rest in peace, Mom. I have no doubt that the happiness that eluded you in this world will be yours in the next.
CONTENTS
Title Page
Copyright
Dedication
Introduction
PART I
A Few Fries Short of a Happy Meal
1. The Garden of Earthly Delights
2. Looking for Love in All the Wrong Places
PART II
Reward—The Agony of Ecstasy
3. Desire and Dopamine, Pleasure and Opioids
4. Killing Jiminy: Stress, Fear, and Cortisol
5. The Descent into Hades
6. The Purification of Addiction
PART III
Contentment—The Bluebird of Happiness
7. Contentment and Serotonin
8. Picking the Lock to Nirvana
9. What You Eat in Private You Wear in Public
10. Self-Inflicted Misery: The Dopamine-Cortisol-Serotonin Connection
PART IV
Slaves to the Machine: How Did We Get Hacked?
11. Life, Liberty, and the Pursuit of Happiness?
12. Gross National Unhappiness
13. Extreme Makeover—Washington Edition
14. Are You “Lovin’ It”? Or “Liking It”?
15. The Death Spiral
PART V
Out of Our Minds—In Search of the Four Cs
16. Connect (Religion, Social Support, Conversation)
17. Contribute (Self-Worth, Altruism, Volunteerism, Philanthropy)
18. Cope (Sleep, Mindfulness, Exercise)
19. Cook (for Yourself, Your Friends, Your Family)
Epilogue
Acknowledgments
Glossary
Notes
Index
About the Author
INTRODUCTION
Happiness is neither virtue nor pleasure nor this thing nor that, but simply growth. We are happy when we are growing.
—JOHN BUTLER YEATS TO HIS SON WILLIAM BUTLER YEATS, 1909
We were all children once. Like you, more chance than not, my greatest moments of happiness during childhood have stuck with me, and to this day continue to bring a smile, and sometimes even a tear. Childhood is a time of mind expansion—not just in knowledge but in experimentation, in inquisitiveness, in trying out new concepts and strategies. Childhood is supposed to be a time when the balloon of happiness soars high above the mundane. The tools of the trade for most kids were a peanut butter sandwich, a bicycle, and a bedtime story. I became a pediatrician, in part, to relive and help channel the wonder and delight involved in growth.
Fast-forward four decades. Children still grow, but sadly in my pediatric clinic I now watch many of them grow horizontally rather than vertically. Some take medicines previously reserved for adults, like metformin for type 2 diabetes or benazepril for hypertension. And that balloon of happiness, that sheer wonder of it all, is now so deflated, there isn’t enough buoyancy for it to soar. Rather, in its place has been dropped some weighty pleasures of the mundane, in this thing or that. Standard issue now are Capri Sun, Netflix, and Snapchat.
You might argue, well, that’s progress, that’s convenience, that’s technology, that’s our new instant gratification culture—buy a pleasure to increase happiness. But what if those pleasures, ostensibly developed and marketed in the name of increasing your happiness, actually did the opposite? What if they actually made you unhappy? What if they changed your brain so that happiness was sapped from you? What if today’s kids are actually canaries in the coal mine? What if these same brain changes extended to your coworkers, to your friends, to your family members, and to you? For better or worse? And better for whom?
Pleasure and happiness are similar, as they both feel good. But Yeats knew they weren’t the same. Since the recording of time, philosophers have tried to wrestle these two positive emotions to ground. These two uniquely human phenomena have together and separately occupied outsized parcels of our consciousness, our literature, and our national and international discourse. While our philosophers and social commentators have spent the last three thousand years defining and redefining these two terms for us, something quite unusual and likely even sinister has befallen these related yet decidedly different positive emotions.
These past forty years have witnessed the twin epidemics of the negative extremes of both of these emotions: addiction (from too much pleasure) and depression (from not enough happiness). Yet in these same forty years our knowledge of brain science has advanced to the point where these two emotions can now be dissected and parsed at a biochemical level. Did the uptick in prevalence of addiction and depression occur naturally? Separately? In a vacuum? Or under some form of outside pressure? What, or who, has ushered modern society into this new normal? What if all of Western society has been hacked, to profit a few at the expense of the many? And what if you didn’t even know you’d been hacked?
“Hack” is
a word with a relatively short history in our modern lexicon, with a fluid meaning. The first reference to a “hack” was at a meeting of the MIT (my alma mater) Model Railroad Club in 1955. At that time “hack” meant a “prank” whose perpetrators demonstrated style, resourcefulness, and whimsy in its performance. Stealing a car is a felony offense. Stealing a Boston Police Department vehicle, disassembling it, carrying each piece up five floors, and then reassembling it at the top of the Great Dome at MIT, complete with a life-size policeman mannequin and a box of doughnuts in the front seat—now that is a hack. More recently Silicon Valley types stole the word to denote clever solutions to difficult problems, known as “white hat” hacking. Yet “black hat” hacking dates back to 1963, when an unauthorized hacker remotely commandeered the MIT mainframe computer. As computers became more interconnected and more technologically advanced, less whimsical people started to create viruses to infect other computers, and hacking took on a much more ominous and sinister tone. As we all learned from the 2016 election debacle, today’s computer hacking encompasses three steps. Step one is pfishing, where a seemingly benign yet imperative e-mail message with a disguised zipfile or URL is sent to an unsuspecting victim; if the message is clicked, that computer is rendered vulnerable and the hacker can gain entry. Step two is the insertion of some form of malicious code into the victim’s computer. Depending on the goals of the hacker, step three is the hijacking of something—for instance, the material stored in a computer’s memory (like Democratic National Committee e-mails), which is transferred to the hacker, who can use it to humiliate or blackmail; or the computer’s executable files, in order to hold the computer for ransom; or even the victim’s hard drive, which can be crashed and erased, the ultimate in malevolence.
You say, well, that’s computers . . . What does this have to do with the human body or brain? How about everything? While human hacking does not occur via computer code, there are many ways to tinker with the human brain. Certainly drugs can do the tampering. How about cleverly disguised messages, disinformation, propaganda, and the newest method of tampering, fake news? Can these messages act like phishing? And what if one of these messages gains hold? Can these alter your brain? Or how about something as innocuous as food? All of the above.
In this book I am going to develop separate and parallel scientific, cultural, historical, economic, and social arguments that our minds have been hacked. I will also demonstrate that this hack—the systematic confusion and conflation of the concepts and definitions of pleasure and happiness—has been inserted into the limbic system (the emotional part) of our brains, thereby precipitating a slow-motion crash of a substantial percentage (somewhere between 25 and 50 percent) of individuals and exacting a severe detrimental impact on our whole society. I will also demonstrate that this hack wasn’t accidental but in fact has been a plot—that is, the hack was not to just create mischief; rather, it was specifically designed and engineered with a profit motive. And, similar to the Russian hack of the 2016 presidential election, this plot has been and continues to be executed by private interests with governmental support.
In order to convince the reader of each of these arguments, I will first lay out (in simple terms) the neuroscience of each of these two otherwise positive emotions, how they can sometimes appear similar, but more importantly how they differ, what underlies our experience of each one, and how they influence each other. I will then explain how the business community and government have taken advantage of this neuroscience to hack our decision-making capacity and alter our level of individual and collective well-being. But fear not: even though this plot is pervasive in all walks of life, there are ways to insulate yourself and fend off this hack. Because when we understand the neuroscience of pleasure and happiness, each one’s relationship to the other, and how they are manipulated by our current food, technology, and media environments, we can more accurately denote the causes—and in turn the treatments—for our own personal well-being, and for our twin societal scourges.
I am not a psychiatrist or an addiction specialist. I am not a motivational speaker or a pop culture icon. I am not a Buddhist or a self-help guru. I am definitely not Dr. Oz or Dr. Phil, nor do I want to be: those guys have got their own problems. I am not a purveyor or user of psychoactive substances (although I’ve consulted with some experts for this book). I am not even a strict practitioner of all the precepts elaborated in this volume. And I certainly don’t have a corner on either the pleasure or happiness markets. Hell, I’ve got my own issues and baggage.
I am a practicing pediatric endocrinologist (hormone problems in children) and obesity research scientist at UCSF, an academic medical center. Endocrinology is a profession that has morphed over the past three decades from one that previously generated great joy and satisfaction into one of the unhappiest occupations around. Burnout rates are at 54 percent of all doctors but 75 percent of endocrinologists. Our subspecialty takes care of patients with obesity who never get thinner and patients with diabetes who never get better, most of whom eschew the advice that we recommend and destroy their bodies and their minds in the process. The practice of endocrinology is particularly prone to mythology and quackery, because hormones are chemicals you can’t see. People can see the damage that smoking does to their lungs on X-rays, or to their hearts on catheterization. But you can’t see the hormones at work in obesity and diabetes. And so people don’t believe. For many people, not seeing is believing. And charlatans can make people not see anything they want.
I’m not a conspiracy theorist by nature. A conspiracy would suggest corporate malevolence with collusion between industry actors, with intended malice and with government approval. Woodward and Bernstein had to connect many dots before the pernicious nature and the smoking gun of Watergate was revealed. It took whistleblower Jeffrey Wigand and the publication of the “tobacco documents” before officials could demonstrate that tobacco industry executives were engaged in a conspiracy to defraud the public. In The Hacking of the American Mind, I have a lot of dots that I must connect for you in successive chapters (biochemistry, neuroscience, genetics, physiology, medicine, nutrition, psychology/psychiatry, public health, economics, philosophy, theology, history, law). Although there are indications that some of the perpetrators (like tobacco) have colluded, or at least shared data and practices, I’m going to declare right now there is no smoking gun (other than smoking), and so I’m not going to stick my neck so far out as to say that there has been a conspiracy between different industries and the government to purposefully inflict malice on the public. Nonetheless, I will argue that there has been a plot by some industries to obfuscate the link between their products and disease, and to willfully confuse the concepts of pleasure and happiness with the sole motive being profit. I will then tie these seemingly separate strands together to convince the reader of the new alt-reality that has been manufactured by these industries. The science, the history, and the politics are strong enough to provide circumstantial and empirical evidence. In successive parts of this book, I will elaborate on each of these.
The substance that got me started on thinking about nutrition, health, disease, and how our emotions are manipulated—the substance that revealed its hidden iniquities to me back in 2006—is sugar. Sugar is the other white powder. It was the science of sugar that showed me that the behaviors associated with obesity (gluttony and sloth) were in fact due to a change in biochemistry, and that the biochemistry was due to a change in the environment. You may have read my book Fat Chance, which asked two questions: Why are we all so fat and sick? And in just thirty years? Fat Chance is a treatise on the science of obesity and metabolic syndrome, and the implications that the science portends for people and policy. But it was understanding the brain science that allowed me to put the data together to form a unifying hypothesis, and that sparked the impetus for my efforts to educate the public—to debunk the myths surrounding the obesity epidemic, which had prevented policy makers from addressing t
he deficiencies of our toxic food environment, rather than ineffectively trying to modulate the behaviors that are the result of that biochemistry. This meant I needed to know the law surrounding public health in order to understand and impact policy. So in my sixth decade I went to law school.
In the process of putting together the scientific argument in Fat Chance for nutrition and physical health, it became apparent to me that there is a wealth of information on the role of nutrition on outcomes related to behavioral health. Yet this information remains virtually unknown to most doctors and patients. Worse still, entire industries and governments have pushed hedonic (reward-generating) substances and behaviors on their unsuspecting populations for their profit, which has only caused further unhappiness. I also came to realize that some of the basic tenets of modern medicine were simply rubbish. They may sound right, but they do not stand up to scientific scrutiny.
This book, The Hacking of the American Mind, is similar to Fat Chance in that it uses biochemistry to educate the reader about the toxic environment in which we currently find ourselves—and perhaps even more importantly, how we remain there. (As was true in Fat Chance, the punch line is that it’s not about personal responsibility, but only you can help yourself, because no one else will.) Because pleasure and happiness, for all their apparent similarity, are separate phenomena, and in their extreme function as opposites. In fact, pleasure is the slippery slope to tolerance and addiction, while happiness is the key to long life. But if we don’t understand what’s actually happening to our brains, we become prey to industries that capitalize on our addictions in the name of selling happiness.
At this point it’s essential to define and clarify what I mean by these two words—pleasure and happiness—which can mean different things to different people.
Merriam-Webster’s Dictionary defines “pleasure” as “enjoyment or satisfaction derived from what is to one’s liking”; or “gratification”; or “reward.” While “pleasure” has a multitude of synonyms, it is this phenomenon of reward that we will explore, as scientists have elaborated a specific “reward pathway” in the brain, and we now understand the neuroscience of its regulation. Conversely, “happiness” is defined as “the quality or state of being happy”; or “joy”; or “contentment.” While there are many synonyms for “happiness,” it is the phenomenon that Aristotle originally referred to as eudemonia, or the internal experience of contentment, that we will parse in this book. Contentment is the lowest baseline level of happiness, the state in which it’s not necessary to seek more. In the movie Lovers and Other Strangers (1970), middle-aged married couple Beatrice Arthur and Richard Castellano were asked the question “Are you happy?”—to which they responded, “Happy? Who’s happy? We’re content.” Scientists now understand that there is a specific “contentment pathway” that is completely separate from the pleasure or reward pathway in the brain and under completely different regulation. Pleasure (reward) is the emotional state where your brain says, This feels good—I want more, while happiness (contentment) is the emotional state where your brain says, This feels good—I don’t want or need any more.
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