Reward and contentment are both positive emotions, highly valued by humans, and both reasons for initiative and personal betterment. It’s hard to be happy if you derive no pleasure for your efforts—but this is exactly what is seen in the various forms of addiction. Conversely, if you are perennially discontent, as is so often seen in patients with clinical depression, you may lose the impetus to better your social position in life, and it’s virtually impossible to derive reward for your efforts. Reward and contentment rely on the presence of the other. Nonetheless, they are decidedly different phenomena. Yet both have been slowly and mysteriously vanishing from our global ethos as the prevalence of addiction and depression continues to climb.
Drumroll . . . without further ado, behold the seven differences between reward and contentment:
Reward is short-lived (about an hour, like a good meal). Get it, experience it, and get over it. Why do you think you can’t remember what you ate for dinner yesterday? Conversely, contentment lasts much longer (weeks to months to years). It’s what happens when you have a working marriage or watch your teenager graduate from high school. And if you experience contentment from a sense of achievement or purpose, the chances are that you will feel it for a long time to come, perhaps even the rest of your life.
Reward is visceral in terms of excitement (e.g., a casino, a football game, or a strip club). It activates the body’s fight-or-flight system, which causes blood pressure and heart rate to go up. Conversely, contentment is ethereal and calming (e.g., listening to soothing music or watching the waves of the ocean). It makes your heart rate slow and your blood pressure decline.
Reward can be achieved with different substances (e.g., heroin, nicotine, cocaine, caffeine, alcohol, and of course sugar). Each stimulates the reward center of the brain. Some are legal, some are not. Conversely, contentment is not achievable with substance use. Rather, contentment is usually achieved with deeds (like graduating from college or having a child who can navigate his or her own path in life).
Reward occurs with the process of taking (like from a casino). Gambling is definitely a high: when you win, it is fundamentally rewarding, both viscerally and economically. But go back to the same table the next day. Maybe you’ll feel a jolt of excitement to try again. But there’s no glow, no lasting feeling from the night before. Or go buy a nice dress at Macy’s. Then try it on again a month later. Does it generate the same enthusiasm? Conversely, contentment is often generated through giving (like giving money to a charity, or giving your time to your child, or devoting time and energy to a worthwhile project).
Reward is yours and yours alone. Your sense of reward does not immediately impact anyone else. Conversely, your contentment, or lack of it, often impacts other people directly and can impact society at large. Those who are extremely unhappy (the Columbine shooters) can take their unhappiness out on others. It should be said at this point that pleasure and happiness are by no means mutually exclusive. A dinner at the Bay Area Michelin three-star restaurant the French Laundry can likely generate simultaneous pleasure for you from the stellar food and wine but can also generate contentment from the shared experience with spouse, family, or friends, and then possibly a bit of unhappiness when the bill arrives.
Reward when unchecked can lead us into misery, like addiction. Too much substance use (food, drugs, nicotine, alcohol) or compulsive behaviors (gambling, shopping, surfing the internet, sex) will overload the reward pathway and lead not just to dejection, destitution, and disease but not uncommonly death as well. Conversely, walking in the woods or playing with your grandchildren or pets (as long as you don’t have to clean up after them) could bring contentment and keep you from being miserable in the first place.
Last and most important, reward is driven by dopamine, and contentment by serotonin. Each is a neurotransmitter—a biochemical manufactured in the brain that drives feelings and emotions—but the two couldn’t be more different. Although dopamine and serotonin drive separate brain processes, it is where they overlap and how they influence each other that generates the action in this story. Two separate chemicals, two separate brain pathways, two separate regulatory schemes, and two separate physiological and psychological outcomes. How and where these two chemicals work, and how they work either in concert or in opposition to each other, is the holy grail in the ultimate quest for both pleasure and happiness.
The Hacking of the American Mind will not just elaborate how reward and contentment work on a biochemical level, it will show what the differences between them mean for your personal and mental health and for the health of our society. However, right at the start, I must acknowledge three caveats.
First, the science of these two phenomena relies primarily on animal models. Who says depression in a rat is the same as depression in a human? Or even addiction, for that matter? Can rats become sex addicts?
Second, most human studies that are available are correlative, not causative. Correlation is a snapshot in time. You can only say that two things are related to each other. And even that can be a stretch. Might they have nothing to do with each other? For instance, ice cream consumption correlates with frequency of drownings. Does that mean eating ice cream causes you to drown? Or do survivors of the drowned victim bury their sorrows in a banana split? More likely, we eat ice cream when it’s hot, we swim when it’s hot, and some unfortunate people drown when they swim. Just because there is a correlation, does that really mean there is a cause-and-effect relationship?
There are other complications in interpreting human studies:
It’s very hard to do causative studies on emotions and psychiatric illness. Determining causation means assessing the disease process over time. Few people have had magnetic resonance imaging (MRI) or positron emission tomography (PET) scans of their brains performed before their mental illness occurred.
Many of the studies measure blood levels of these neurotransmitters. However, what is going on in the brain may be different than what is going on in the blood.
Brain neuroimaging studies require special equipment; some involve radioisotopes and are therefore terribly expensive to perform and often not immediately available.
It’s not just all dopamine and serotonin. Other neurochemicals do play major roles in how we think and feel, are part of these pleasure and happiness pathways as well, and thus complicate the picture.
All of these pathways and neurochemicals are influenced by genetic, epigenetic (changes to the expression of DNA, not changes to the sequence), and experiential forces. Thus, what might be true for one individual may not be true for another.
The science on serotonin was stymied for forty years by Congress and the FDA. I’ll expand on this later in the book. But it means we have way less information on the role of serotonin on behavior than we should.
Third and finally, the connecting of our moods and emotions to rational public policy is complex, nuanced, and indirect. People can’t be told what to do. As a New Yorker, I admit that if someone tells me to jump, my first response is not “How high?” But to have even a remote chance to unhack our brains, first we have to recognize what the hack is and how it works.
Part I will discuss the differences between reward and contentment, how their meanings have been confused and obscured, and how they indeed can be opposites. We will also start to explore what parts of the brain are involved in each experience. Part II will elaborate on the biology of reward and the science of dopamine. I will explain why the motivation for pleasurable experiences starts with dopamine but how too much of it can lead to aggression and irritability. There really can be too much of a good thing. It can even kill you. Throw on top of that some emotional stress, which aggravates the need for pleasure seeking, and you’ve got a great recipe for addiction. Part III will discuss the biology of contentment and the science of serotonin and how the reward and contentment systems overlap (or don’t). For instance, certain serotonin
agonists (like psychedelics) can improve mood, while other serotonin-boosting medications (known as selective serotonin reuptake inhibitors, or SSRIs) treat depression. In Part IV, I will show how the perpetration of this “plot” has brought us to this place, from a personal, historical, cultural, and economic standpoint. In the last half century, America and most of the Western world have become more and more unhappy, sicker, and broke as well. Marketing, media, and technology have capitalized on subverting our brain physiology to their advantage in order to veer us away from the pursuit of happiness to the pursuit of pleasure, which for them of course equals the pursuit of profit. Fueling our quest for reward has only contributed to the epidemics of non-communicable diseases such as diabetes, heart disease, cancer, and dementia, which are eating away at our health, our health care system, and the fabric of our society. Lastly in Part V, I will offer simple solutions that all of us can employ to defend against the pernicious peddling of pleasure, and ways to mitigate the stress that drives both addiction and depression, so that we may be able to pursue our individual happiness to the fullest. I will explore how and why different modalities for taming dopamine and increasing serotonin work and how we can rethink our lives and our goals so we can enjoy health (more than we have now) as well as pleasure (sometimes) and happiness (all the time). But you can’t solve the problem until you know what the problem is. That’s what this book is about.
Humans speak many languages, have varying standards of beauty, and worship at the altars of different deities, but their underlying biochemistry and what makes them tick is nonetheless the same. All our behaviors are manifestations of the biochemistry that drives them. To pull ourselves and our children back from the edge of this man-made abyss at which we now stand, we first have to understand the science.
PART I
A Few Fries Short of a Happy Meal
1.
The Garden of Earthly Delights
Once upon a time we were happy. Then the snake showed up. And we’ve been miserable ever since. Hieronymus Bosch’s painting Garden of Earthly Delights (circa 1500) is a triptych housed in the Prado in Madrid. It is an allegorical warning of what happens when we squander our birthright of happiness divined from God in one garden and move on to the pleasures of the flesh in the next garden, with the inevitable result of eternal damnation. Figures. Our most lauded goal in life—to be happy—is seemingly an illusion, out of reach for us common folk. Except the rich aren’t any happier. Happiness seems to be a mirage, something to chase after, to keep us turning over rocks, kissing frogs, and trying to fit keys into the magic lock.
But along the way, wandering through our own individual gardens of earthly delights in search of our seemingly unobtainable nirvanas, we’ve sure had a whole lot of fun. Or we’ve at least tried to. We buy shiny things, play Powerball, imbibe with friends or sometimes alone. So why are so many of us miserable? Are we destined just to sink further into the abyss of pleasure with no hope of extricating ourselves to find real happiness? Is it all futile? Lots of people have died trying to get to that magic place of contentment and inner peace, that thing called “happiness.” But if we can’t get there, what’s the point?
What if I told you that happiness is right there in front of you, just behind the curtain of your own brain?
To some, an argument over the difference between pleasure and happiness might seem like a straw man, a false argument not really worth having. Hey, they both feel good; why should you care? And pleasure is here, now. Happiness . . . maybe not so much, and not so soon.
But it does matter. And not just to you but to all of society. Explaining the differences between these two otherwise positive emotions forms the narrative arc of this book.
Terms of Endearment
Pleasure takes many forms and has many synonyms: “gratification,” “amusement,” “indulgence,” “titillation,” “turn-on.” But the experience of pleasure is the visceral readout of activity of a specific brain area known as the “reward pathway.” In fact, pleasure is actually two phenomena in one. First, one experiences the motivation for a given reward. Second, one experiences the consummation of that reward as the visceral experience we call pleasure. For simplicity, I will call it reward so both the social science and the neuroscience can effectively be treated as one.
The old adage goes, “Beauty is in the eye of the beholder.” Same for happiness. Happiness is in the brain of the experiencer. And it too has its own brain area, known as the “contentment pathway.” But as a philosophical concept, happiness has a long history and has been tangled up with the history of society for as long as there’s been society. Happiness consists of a grab bag of definitions that have changed and morphed over time.1 The root of the word, “hap,” means luck. And we see this etymological root in other words relating to chance occurrence: for instance, happenstance or perhaps. Early societies weren’t very happy; after all, with famine, plague, and war, they had a lot to be unhappy about. Happiness was chance, fleeting, and seemed to alight on only a select few in any given society.
The God Factor
Religion has been the arbiter of both pleasure and happiness since there was religion. By no means is the brief history that follows meant to be exhaustive, but understanding where we came from can help us determine where we are going.
The Jewish tradition says that the study of the Torah is the path to happiness, because “all its paths are peace,” and by following the law one could not help but achieve happiness. The Greeks are on record for jump-starting both the pleasure and happiness industries. In the third century BCE they wrestled the concept of happiness away from the concept of hedonism, the philosophy that said that the goal of life was net pleasure (pleasure minus pain). Aristotle expanded on the Jewish concept and argued that happiness consisted of being a good ethical person, a manifestation of reason and virtue, and coined the term eudemonia, a synonym for “contentment” (the concept on which this book is based). Zeno, the father of Stoicism, took this up a notch to say that unhappiness resulted from errors of judgment and that the true sage was immune to unhappiness; the converse of this was, of course, that if you were unhappy, you were no sage. Epicurus weighed in to say that happiness was a state of peace, absence of fear, absence of pain, and a life surrounded by friends—threads of which remain with us today.
Then came Christianity, which said many things, one of which was that happiness will occur there and later as opposed to here and now. Life is unpleasant, but if you live it as an upstanding Christian, heaven awaits. Pleasure was the devil on earth, and pain in the form of humility and service was the path to a happy afterlife, a gift from God. Islam refined the concept to turning it into a struggle, the war between good and evil on earth, and one would be rewarded with happiness in the afterlife. And the Baha’i faith has its feet in both camps by stating that we humans are noble from the start and capable of continual spiritual growth both in this world and in the afterlife. So make the world a better place now and heaven a better place later.
The Eastern religions take a slightly different approach, by establishing the methods for achieving happiness now rather than later, because there is no later—at least, not the heaven of Western theology. Hinduism proffered the theory of reincarnation as a means of “getting it right”—that the goal of religion was to adhere to a way of stopping the process of death-rebirth (so you don’t come back as a frog). Buddhism added specific practices allowing us to break free of this cycle to achieve “nirvana,” or liberation. Thus, pleasure has historically been the cultural antagonist to achieving happiness. In terms of the science, nothing’s changed.
Indeed, there is not one definition of “happiness.” What it means to be happy is quite different, depending on the times in which you live, your religious and cultural affiliations, and likely the language you use. For instance, some languages define “happiness” as “good luck and favorable circumstances” (i.e., out of your control), while in others “ha
ppiness” refers to “favorable internal feeling states” (somewhat in your control).2 Obviously, this makes it very hard to write about, because the definitions and the criteria for inclusion have been a moving target.
Happy Endings?
Happiness is what most people say they really want: the spouse who can manage those things you can’t; the house with the porch and the white picket fence; the two matched children (one boy, one girl) who get all the awards in high school and go on to Ivy League colleges; seeing the world with your family; having a retirement nest egg (I always liked the Prudential commercial with psychologist Dan Gilbert that states, “Retirement is paying yourself for what you like to do”); and growing old with your spouse without infirmity. Then again, most parents today simply wish for minimal psychiatric bills, no trips to rehab and no police record, good colleges on their children’s résumés, and offspring who are neither bullies nor bullied. Yet virtually any hallmarks of happiness are noticeably absent from most of our written history,3 in part because who’d want to read it? That’s kind of the point. Happiness is what we say we want. But reading about someone else’s happiness can get kind of boring. Lack of conflict doesn’t make for a very good page-turner or miniseries.
The Hacking of the American Mind Page 2