NPR Fresh Air: Dr. Anna Lembke on pleasure, pain, and addiction

  • In 'Dopamine Nation,' Overabundance Keeps Us Craving More
    Psychiatrist Anna Lembke's new book explores the brain's connection between pleasure and pain. It also helps explain addictions — not just to drugs and…
    www.npr.org


    An intriguing episode of NPR's Fresh Air with Dr. Anna Lembke.


    I was initially pulled in by the pleasure and pain in the title and found some very interesting points for discussion here on the forum.


    Dr. Lembke clearly states evolution has given us pleasure and pain to guide us in what to pursue and what to avoid. I found her choice of words interesting.


    Is homeostasis similar to Epicurus's concepts of ataraxia and aponia? Did Dr. Lisa Feldman Barrett also talk about homeostasis?


    I had never heard the term anhedonia "absence of joy."


    Lembke's "Radical honesty" sounds a lot like Epicurean frank speech.


    Side note: One aspect of Epicureanism I find intriguing is that it deals with a real, physiological phenomenon - pleasure and pain - that can be researched. Stoics don't have that. Platonists don't have that. I don't know if that's a strength or not (I'm inclined to think it is), but the fact that I can find science videos and podcasts relevant to the philosophy is interesting.


    Thoughts?

  • https://www.psychologytoday.com/us/blog/the-athletes-way/202001/the-neuroscience-seeking-pleasure-and-avoiding-pain


    Here's another article from the popular magazine Psychology Today. I found the last section intriguing in light of the Stoic tendency/practice of enduring pain to "overcome" it.


    I'm also wondering if the usual translations of choice and avoidance is more due to modern nomenclature than Epicurus's original wording which was more choose and flee from.

  • I find it intriguing that homeostasis and katastematic have the same roots in light of my question above:


    Is homeostasis similar to Epicurus's concepts of ataraxia and aponia?

  • I'm going to say "No" because I don't even think Epicurus talked or was concerned about katastematic pleasure much at all, as per the Nikolsky article. On the other hand absence of pain and absence of disturbance do seem to have figured into the discussion mix from Epicurus himself.


    What is the definition you're working with for 'homeostasis"

  • What is the definition you're working with for 'homeostasis"

    Basically, the body's systems in equilibrium.

    If I remember correctly, a common Epicurean theme is sailing calm waters and safe harbors. Ataraxia itself has an "untroubled waters" connotation.

  • In looking (briefly) at some of the translations of katastematic, it seems to me that balanced or steady would be a better definition than "static." It comes from καθιστημι according to LSJ with connotations like restore, return, set in order, etc. So it's not a static state, it's a return to order (ataraxia and aponia) after the "excitement" of euphrosyne and khara.

  • This is a great find, Don, because – as I recall from the Epicurean Philosophy Facebook group – we've had numerous Stoic opponents rail against Epicureanism like it's a Gateway Drug to Hard Pleasures. This reinforces the centrality of stability in Epicurean philosophy and provides an obvious reason why not all pleasures are to be chosen.

  • This reinforces the centrality of stability in Epicurean philosophy and provides an obvious reason why not all pleasures are to be chosen.

    As a small adjustment if this were being stated formally, I would probably say "importance" rather than centrality lest someone take that as an indication that stability is the very center. Not to be picking nits but I think everytime someone uses a modifier or word other than pleasure they are opening themselves up to logical inconsistencies.


    Also, I don't think we have a good handle on the modifiers even when used clearly. Stable

    and "without pain" and "without disturbance" I think are adverbs, as are descriptions of intensity and duration. All apply to pleasure and don't stand alone. Plus I don't think we have a handle on how to rank even those, and it may well be that the reason we don't is that such a ranking is purely subjective.

  • Stable

    and "without pain" and "without disturbance" I think are adverbs

    ataraxia and aponia are nouns not adverbs. They are states, best translated into English by words ending in -ness, e.g., painlessness or calmness.

  • You're right I should probably say "accompaniments' rather than adverbs, but I would still maintain that they are manners of experiencing pleasure, (without pain and without disturbance) and don't really convey anything in themselves. Anytime we're talking "without" something I presume the main topic to be what's there in the first place, regardless of what might not be there at the same time.


    And I do see this as part of the huge problem of people thinking that "painlessness" and "calmness" are worth pursuing in themselves. I see that as variations on the "virtue" problem, since as you know I think (and I think we both agree Epicurus thinks) pleasure alone can be considered worth pursuing in and of itself.

  • Since this thread began with a modern science topic, it might be pertinent to mention Lisa Feldman Barrett. As I understand it she seems to consider "affect" to be a type of guiding faculty. She pictures affect as a combination of pleasant/unpleasant along, say, an x axis, and calmness/agitation along, say, a y axis. One's affect at a given moment would be described by a point somewhere in the two dimensional space defined by these two axes.


    I find this conception useful because it illustrates 1) that "pleasure" isn't the endpoint of an arrow or the center of a target but a combination of factors including pleasantness and arousal. And 2) calmness combined with unpleasantness would be considered lethargy (or something similar). When people speak of "without pain" or "without disturbance" and interpret those as pleasure, I think it helps to look at this 2D model to understand more of the nuance involved.


    So LFB, as I recall, refers to positive or negative affect as a neurological guide which we might be able to equate to pleasure or pain. Although hers isn't the language of Epicurus, I find it a helpful way to understand pleasure as the guide/goal.

  • Like different flavors of ice cream?

    I don't would say the better analogy would be like eating ice cream in an ice cream parlor vs in a jail cell vs in a war zone vs in a hospital etc.


    To me the important thing is first that you are in fact experiencing pleasure from eating ice cream, but we're also taking into account that the pleasure of eating it may be interrupted or disturbed (in a war zone or jail cell) or whether at the same time you are experiencing other pain (in a hospital with appendicitis).


    This is something that I think we debated at times over the last several years under the "doing more than one thing at once" category. My view is that you can experience pleasure from eating ice cream but at the same time be worried or afraid about getting shot (war zone) and having the pleasure interrupted, or even while you experience physical pain in another part of your body (hospital).


    With the point being that the best way to experience pleasure is without interruption or disturbance and without any accompanying pain of any kind.


    The issue I see is that to isolate the absence of disturbance or interruption or pain in itself, without first focusing on the primary point that you are experiencing pleasure from some positive activity of body or mind is to imply that there is some substance to the "absence of" something, which I think is not true.


    With an analogy being that matter has positive attributes (weight, shape, size, etc) while void has no attributes other than absence of matter, which gives matter space to be and move in. Matter is equivalent to void in one way only - quantity of space - and I would say pain is equivalent to pleasure in one way only - quantity of experience - as indicated by the quantity reference in PD3.

  • Like different flavors of ice cream?

    Don also I think we have to take into account here also the "purity" or "pure pleasure" or "unalloyed" issue that is addressed in PD12 and PD14 and I think other places as well.


    And this in turn probably stems from the purity argument by Plato in Philebus.


    The issue in contention seems to derive from some logical argument that having something without any mixture of something else is superior or better than having it mixed with something that is less desirable. Probably this is related to the contention that in order to be a highest good, it indeed has to be highest and not capable of improvement. Thus in order to discuss the highest state of pleasure possible, logically the pleasure experience which is best must be unalloyed and not combined with anything else (actual or fear of interruption or pain).


    I know it is tedious to constantly refer back to Platonic logical arguments, but I think that is exactly what Epicurus would have had to face in ancient Athens. Due to that he needed to either innoculate his students against the argument or deprogram them if they had already fallen for it. And the evidence for that is right there in Philebus which appears to be Plato's number one work denouncing pleasure as the goal of life. I would estimate the challenge would be similar to what we face today in many places in dealing with presumptions created by the Bible.


    With of course the ultimate reason for the argument always going back to the "what is the greatest good?" formulation. In order to have an answer to that question which meets the Platonic objections, we have to have a description of a way of experiencing pleasure that is both unalloyed (with no pain) and continuous (with no disturbance).


    If you're experiencing pleasure with any mixture of pain or interruption, then you're saying that this pleasure experience could be improved, and if it can be improved then it's not the best, and if it's not the best then it's not the "greatest good."


    All of that is largely a word game, but for someone devoted to logical analysis it's a game you find yourself playing as part of philosophy.


    Better just to point at puppies and kittens and babies and say "See, unperverted life pursues pleasure and avoids pain" but Torquatus says that some people (even some who call themselves Epicureans) say that that's not a good enough argument.

  • On Lisa Feldman Barrett's affect:

    Affect is a form of cognition: A neurobiological analysis
    In this paper, we suggest that affect meets the traditional definition of “cognition” such that the affect–cognition distinction is phenomenological, rather…
    www.ncbi.nlm.nih.gov

    This is an older paper (and WAY into the weeds!) but I thought this quote was helpful:

    Quote

    The term “core affect” has been recently introduced to refer to a basic, psychologically primitive state that can be described by two psychological properties: hedonic valence (pleasure/displeasure) and arousal (activation/sleepy).

    This is the idea of the "affective circumplex" (the name for the 2d grid).

    Google Image Result for https://www.researchgate.net/profile/Emilio-Vivancos/publication/331781233/figure/fig1/AS:764176179920896@1559205207611/The-circumplex-model-of-affect-Source-Russell-and-Barrett-1999_Q640.jpg

  • I don't would say the better analogy would be like eating ice cream in an ice cream parlor vs in a jail cell vs in a war zone vs in a hospital etc.

    I'm not sure I agree with your analogy. Pleasure and pain are the most basic categories of feelings. I think that's why Epicurus can say "the feelings are two." But within those two, if you drill down, you have joy, excitement, sorrow, calmness, boredom, anxiety, etc. All are words or divisions we give to degrees or types of pleasure and pain. Pleasure is "ice cream". Strawberry, Rocky Road, and vanilla are joy, excitement, and anticipation.


    I have more thoughts on your other points. I'll get that posted asap.

  • Don also I think we have to take into account here also the "purity" or "pure pleasure" or "unalloyed" issue that is addressed in PD12 and PD14 and I think other places as well.

    I don't think those PD's say what you're trying to make them say.


    To my interpretation, PD12 and its ἀκεραίους τὰς ἡδονὰς (akeraious tas hedonas) "pure pleasures" are simply pleasures experienced without the taint of fear. I think the Epicurus Wiki translation does a good of highlighting this: http://wiki.epicurism.info/Principal_Doctrine_12/

    Quote

    Thus, concludes Epicurus, the study of nature is necessary, for without an understanding of nature, it is quite impossible to enjoy one's pleasures unsullied by fear.

    It's not the pleasures themselves that are "pure" it is the experience of pleasure that is pure. Without understanding nature and eliminating the fear of the gods, you can't experience pleasure without that nagging in the back of your mind of fear of the supernatural gods raining down punishments on your heads or being scared of lightning, thunder, earthquakes, etc. as some form of divine retribution.


    And PD14 doesn't talk about "pure pleasures" but the "truest safety" from other people. So, there's no purity of pleasure problem there. The "surest safety" is simply that which is free from anxiety or fear of harm from other people.


    That's all I have time for now (sorry), but I have more thoughts on your other points. "Film at 11" ;)

  • Obviousky I didn't say it very well because I thought I was trying exactly what you said :)


    Absolutely pleasure is pleasure and pain is pain and the two are entirely separate - that is explicit in PD3.


    Why I think we are both talking about is walking and chewing gum at the same time -. We can experience more than one thing at once, with one hand feeling pleasure and the other feeling pain (though there are probably better examples).


    I think that Epicurus has explicitly ruled out a single sensation being both pleasure and pain at the same time, which is why the conclusion I think you and I both agree on focuses on the total experiences of the person, not a single sensation.