It really drives me crazy when people, even actual neuroscientists go around saying that dopamine is pleasure
because it clearly isn't.
And we've known this for like 15 years and they're still going on about like,
"Oh, dopamine, it's so fun."
And like dopamine kids and all this.
And it's like, "No, like that is not how it works at all."
But what dopamine does seem to be involved with is making you want more.
And sometimes that is pleasant and sometimes that isn't.
Welcome to the Re-Patterning Podcast where we believe your mind body system is your domain
and that choosing the beliefs, habits and patterns that best support you is your birthright.
I'm your host, Arden Leigh, creator of the Repatterning Project,
an eight week course in learning to free yourself from the patterns of your past
and program your mind for your dreams of the future.
Join me for these extraordinary conversations as we unpack the keys to creating our reality.
Hello, everyone and welcome back to the Re-Patterning Podcast.
Thank you so much for being with us today.
And if you're enjoying these conversations, I do want to remind you before we get started
with today's episode that you can support us on Patreon for as little as $5 a month
and that does give you access to our private Discord channel.
So come find us at patreon.com/therepatterningpodcast
and with that out of the way, I am so excited you guys about today's guest,
Maia Szalavitz. Maia, I have been fangirling over you ever since I'm probably dating myself with this,
but ever since I read your article in Elle magazine about Kent Barrage's research on dopamine.
And I'm so excited to ask you, like there's been so many things that I've like ever since then
I wanted to ask you and talk about. And so let me introduce for any of you who are listening
or unfamiliar. Maia Szalavitz is an acclaimed author and journalist in the fields of neuroscience,
addiction, drug policy, and recovery. She is the author of several books, including her most recent
book, Undoing Drugs. And my favorite book, Unbroken Brain, which I have my copy of here. And as you'll
see, it's like got all these underlinings and stars. It's all, I must have read it like at least
three times already. It is Unbroken Brain, a revolutionary new way of understanding addiction.
And she's also the author of Help at Any Cost, which is a book that takes a look at the troubled
team industry. So I'm excited to talk about that a little bit today too. She is a contributing
opinion writer at the New York Times and her work has also been featured in Time Magazine,
Scientific American and the Guardian. Maia, thank you so much for being here with me today.
I am so excited to talk with you about these subjects. Thanks so much for having me. By sheer
coincidence, I was speaking with Kent Barrage yesterday for something that I'm working on.
No kidding. Oh my god. Well, now I'm curious. Can we start there? What are you working on with
Kent Barrage? I am just, I'm working on a piece for the Times about AI and addiction. And it has
to do with wanting and liking. And it was so funny when I interviewed him for that L piece who
is so excited because I think he had a teenage daughter at the time and she was just like,
that was more impressive than a lot of his scientific publications. But he's lovely and I'm always
interested in the work that he's doing so it was good to catch up with him. I'm so curious about,
so I guess the first thing to do is probably unpack a little bit about that research that he did
on dopamine. And I know from me when I read that article, what struck me was basically the understanding
that liking and wanting are driven by two, there's two separate drives in the brain. They're not the same
thing. So you relate this to drug addiction in particular. But when I read that, I remember relating to
it with my relationship with my then partner because I was like, I have to be around you. I'm so
anxiously attached. I didn't know what anxious attachment was back then, but it was like, but now looking
back at it, I was so anxiously attached. I was like, oh my god, I can't stand to not be with you,
but I can't stand to be with you either. It's this idea that as our cravings increase, our actual
enjoyment of the thing that we're craving can decrease. And this blew my mind at the time. I was like,
how do we, how do I even like be in relationship if that's, if that's how this works? So yeah, unpack
a little bit about that. And I'd love to know how that intersects with AI. Sure. So basically in the brain
and Kent Barrage was one of the people who sort of elucidated the way this worked. But in the brain,
there's sort of two kinds of pleasure you might call them. And sometimes they're not actually
pleasurable, but we'll get into that in a minute. So there is wanting, which another person that I cite
in the book called the sort of the pleasures of the hunt, right? And so that's about like, oh yeah,
I'm going to get this. I'm psyched like I am, you know, on top of the world and I can do anything and
I'm, you know, I'm the cat who's definitely getting the mouse, right? So that is wanting. And wanting can
be pleasurable because like, you know, watch the cat enjoy the chase, right? But infinite wanting is
bad because if it's not satisfied in sex or anything else, it is no fun, right? And liking is the other
piece. And so you can compare that to what poetically is called the pleasures of the feast where you are,
you've caught your whatever and you are sitting down to eat and it is all good. You can also think
about this in sort of more crude terms as like desire versus orgasm and after, right? And it's
important because what can happen and some of Barrage's more recent work is actually looked at this
is you can want something that you really don't like anymore. And he has actually trained rats to sort
of want pain. And so that's kind of relate to those rats actually.
Nice fact, we all can. And yes, these are sort of the techniques of the bad boy friend. And you sort of,
you really, and so in relation to AI, I was looking at it sort of, so if you think about it for
was Barrage drugs first. So wanting is kind of like the stimulant experience like cocaine or
methamphetamine where again, you just feel like very powerful and you want something and you're
going to be able to get it and it feels great. And so that's the sort of early stage wanting where
it's pleasure. And drugs like opioids and alcohol are sort of, they simulate more the liking and the
satiation of desire. And so again, if you want to look at it sexually, the desire part is one thing,
the climax in after that is a different thing. And if you have the first without a second,
it's often not very fun. And so you can and I did end up really, really wanting something that I
didn't like anymore. And this becomes really acute with cocaine. And this seems to be driven by
the way dopamine works in the brain. And so it really drives me crazy when people even actual
neuroscientists go around saying that dopamine is pleasure because it clearly isn't. And we've
known this for like 15 years and they're still going on about like, oh, dopamine, it's so fun and like
dopamine kids and all this. And it's like, no, like that is not how it works at all. But what dopamine
does seem to be involved with is making you want more. And sometimes that is pleasant and sometimes
that isn't. And as you get addicted to something, a person, an activity, an AI, whatever,
what happens in the brain is that the region where dopamine is activated shifts over time. And it
goes from an area where you are sort of consciously wanting something and you like wanting it. And
it's all right to an area where it's kind of automated and the desire is just kind of built in. And
your actions become sort of less voluntary around that wanting. And for me, this really happened
very clearly with cocaine. And so I would be just crazily wanting it because I wanted to achieve
that sense of, you know, things are all right. I could do it and I'm going to get what I want, but
what I would get towards the end when I was like shooting up dozens of times a day, what I would end
up with is anxiety and paranoia and fear and shaking. And like, I knew before I injected the coke
that this is what was going to happen. And yet I could not stop myself from doing that. And it was
just a maddening horrifying experience. And this was, you know, eventually licked and turned
over to the recovery basically because when you desperately want something that you don't like,
it's awful. And, you know, so many people think that, oh, you know, people's addiction are just
having so much fun and you need to kick them in the butt to make them get better because like,
they're having so much fun, they would never stop. And it's like, no, not fun at all. This is really
not fun. You try having infinitely escalating desire and it not being satiated. Would you really
think that was fun? Seriously. So, you know, but anyway, the dissociation between these two experiences
is really important. And this is again, which drives me crazy about the oversimplification of dopamine
because dopamine really does seem to be involved in the pleasure of wanting, but not so much in
the pleasure of liking. And the pleasure of liking seems to be more opioid mediated. And so,
if you think about the way stimulants versus depressants act, like stimulants are, you know,
exciting and up and getting you doing stuff and depressants are calming and mellow. And that's what
the opioids in your brain are sort of, therefore, they are there to calm the stress system and to allow
you to chill and to feel safe, warm, loved and comfortable. And when people don't get that in their
lives or are missing the sensation of that, opioid drugs become obviously especially attractive.
And so, this is why when, like, Yohan Hari puts it like, you know, the opposite of addiction isn't
recovery. It's connection. And I think this is true. It is also more complicated, but it is very
true that a lot of the times what people with addiction are looking for from their substances is
a feeling of being wanted and loved and okay and, you know, not hated. And when you are actively addicted,
you do not feel these things very often. And you, you know, at first the drugs give them to you.
And I mean, one of the real differences between opioids and say a drug like cocaine is that even
when you are very deeply addicted to opioids, they still work. It's not like you take the opioid and
you get the opposite effect that like happens with stimulants. What happens instead is you take it and
you feel okay, but you're not really getting to that kind of amazing euphoria of okayness that
you used to get to, but it's not like you active. And this is actually what's speaking with Ken
Barraj about this because one of the challenges to his theories around addiction and
their wanting and liking is that like opioids don't produce that kind of very sensitized wanting in
as explicit away as the stimulants do. So one of the challenges to his idea about the way addiction
works is that opioids don't produce as pronounced a dissociation between wanting and liking as
stimulants do in later stage addiction. And so you could make the argument that like, oh,
this means that this does not apply to opioid addiction, but it does. It's just not the dissociation
is just not as extreme at least in my view and at least in in his view of the way the literature looks.
And from my understanding too, and in my experience, we can build a tolerance to nearly anything.
Like for me, it's actually it's kind of funny that I'm such a fan girl of your work and I've never
experienced what anyone on the outside would look at as addiction. I've never had a problem with
substances. I didn't start using substances until I was really like kind of in my late 20s and by then,
you know, I was I was able to kind of find, you know, the sweet spot in I mean, yeah, I might have had
a night or two that was, you know, but but for the most part, it would it never became a habit. And
I actually I picked up your book in early 2017 because I was in love with someone who was struggling
with addiction and I was also I didn't know it at the time, but I was definitely codependent and was
one of those, you know, like, let me figure out what your problems are. And I started reading it.
And all of a sudden I was like, wait a minute. This also describes me because what you talk about
when you talk about addiction as a learning disorder is and this is become, you know, I've sort of
paraphrased your concept of addiction to come up with my own my own definition of it is I've started
to call it that addiction is a pattern we have over learned beyond its usefulness because when we
start out like it's if it didn't work the first time, we wouldn't do it again, but then we do it
again and again and we build up that tolerance, you know, like we were saying. And so for me, as
someone who has never been addicted to a substance, at least in any overt kind of a way, I still very
much recognize myself in the pages of these books because there are certain things in my life that
again, I would crave, you need more and more and more of the thing to be satisfied.
Yeah. And I mean, this is fundamental to how you learn anything because what we do is like if
everything remained new, we couldn't learn it because it would be new all the time. So we wouldn't
recognize that it's familiar. And so making something from new and scary into safe and familiar
is basically going to talk. It's going from, you know, sort of being sensitized like, oh, this is new
I'm a little scared to, oh, yeah, I know this, it's fine. And so, but in order to learn anything, you kind
of have to be in that sweet spot where you're not overwhelmed by the newness, but you are a little bit
out of your comfort zone so that you can notice the novelty, incorporate the novelty and then you
have learned, okay, understand how to deal with whatever this thing may be. So we couldn't learn
without tolerance. And it is sad that like with drugs, for example, you get tolerant to the liking and
the good feeling and not to the wanting and the sort of desperation of craving like that escalates
because I mean, you could imagine a situation where the drug would, if liking, if you didn't get
tolerant to liking, the drug would just get better and better in smaller and smaller doses.
Right. And we couldn't learn anything because we would just be in this little bliss, right? So
there is a price to pay and I guess it kind of goes back to like the tree of knowledge or something,
but anyway. Yeah, it's funny you mentioned the tree of knowledge too because I was thinking about your
research and specifically about building tolerance and I was thinking about applying that understanding
to my magic practice recently because magic is it's that same kind of dance of wanting and liking
because when you cast for it, you know, in intention, whatever you're doing, you put that intention
out there, you cast that spell, you do that ritual, whatever it is and you're in that like, oh, I want
this thing. And then you get it, right? And you get it, you know, hopefully if your magic works,
right? But then it's like you have to really watch and make sure that you're not overlearning that
pattern to where nothing is satisfying you. And I'm noticing like because, you know, and I'm autistic,
you know, as you are as well. So you know, as you talk about in the book and also also by the way,
your book also helped me to learn that I was autistic too. So thank you also for that. But yeah,
noticing that pattern and thinking like, oh, this could get dangerous for me. I could get to a place
where I have the entire world at my feet and yet nothing is satisfying to me. So I guess I'm curious
how do you or how do we make sure to, I mean, partly, I suppose it's like it's moderation,
but how do we also make sure that we just in living our lives or in going about the things that we
want to achieve that we're not desensitizing ourselves to the very things that we set out on that path for.
I mean, I think like the real, the only way to manage that is to just keep learning and to keep
challenging yourself and to, you know, there are sort of pleasures that are kind of easy like
drugs if you're not addiction, that, you know, you just take this, it works and it doesn't require
effort or learning, right? But if you try to learn a complex system, music, like, which is I am struggling
with and trying at the moment, um, and, you know, whatever it may be, like, a sport, uh, dance, um,
art, writing, you know, whatever it is like or loving people, you know, connecting with people,
all of those things, you have to get into that same kind of sweet spot where you're a bit challenged,
but you're not like overwhelmed. And I think people on the spectrum, we sensitize really easily,
which is why we tend to want like repetition and seameness and avoiding novelty sometimes.
So, you know, there, there is a balance to be had there because if you get overwhelmed, especially
if you have, you know, anything that gives you difficulty regulating yourself, that can be problematic.
So you need to sort of stay far enough out of your comfort zone to be challenged, but not so far
as to be like overwhelmed. And I think I've been thinking lately like so much of life is just about
like trying to stay in that spot where you are still learning and there's good novelty and who are
engaged, but you are not overwhelmed. And I think like one of the goals that I had with that book is to
have people understand that addiction is not this crazy, alien thing that like people who don't
have it can't understand. It is basically what it is like to be in love with something or someone.
And when that happens, you get, you know, your motivations change and you get craving and you get
attached to that person or a thing. And if it's a helpful, productive thing, that's great. You know,
now you get married and have kids or whatever the version of that is for you. But if it's if you are,
you know, addicted to an AI or a person who's bad for you or a drug that's bad for you, then,
you know, you end up in that compulsive behavior despite negative consequences state. And
the coping that you got from it doesn't really work that well over time anymore.
Yeah, I actually speaking of that, I would love to read my favorite quote from your book,
which is the same thing that distinguishes addiction from passionate interest also divides unhealthy
love from that, which is the highest experience of humanity. That is love is real when it expands and
enhances your life and troubling and problematic when it contracts or impairs it. Whether you love a
person, a drug or an intellectual interest, if it is spurring creativity, connection and kindness,
it's not an addiction, but if it's making you isolated and dull and mean, it is.
Thanks. Yeah. That's my favorite paragraph. Yeah, sometimes you hear your old stuff and you
cringe, but I was very pleased with that one. So the that is like, I wanted on my tombstone.
But yeah, no, I mean, I think I really think that that is the core of it. And I think a lot of times
people mistake addiction independence. And they think that like if you need something or someone
to function, there's something wrong with you. And we're all interdependent. People on the spectrum
need people just like anybody else does. It may be in a different way and in a different amount,
but it still is the case that like our stress system, the reason we have those opioids in our stress
systems is so that a mom can comfort a baby or a lover can comfort the partner or we can comfort our
friends like our stress systems are designed to be millowed out by kind social contact. And you know,
you can see this physiologically. It doesn't matter if a mom is like holding a three-year-old or
if she's like 90 and her daughter 70, the blood pressure of both of them is going to go down when
they are, if they are in supportive relationship, because we can also mess with each other. But if they are,
then we are soothing each other's stress system. And you know, we often think of yoga or running
or whatever for soothing your stress system, but we're designed for it to be through relationships.
And that means we are interdependent. And it doesn't mean that like yoga or running or whatever
works for you physical wise is bad. It just means that without, you know, loving social support,
we can't be healthy. And again, different doses for different people, different ways of achieving
that for different people, but it is still fundamental. And so if we think that like, oh, being dependent
is codependent, or if we think that if you need something too much, there's something wrong with you,
no, if you need something that's hurting you or somebody else, that's a problem. But if you just need,
you know, someone in order to be healthy, that's being part of human race. Again, that doesn't have
to be your romantic partner. It can take many different forms, but you know, being a hermit is just not
healthy. Yeah. And what I love especially about what you unpack in that quote too is that, I think for me,
for a very long time, my own weakness was like a neuro linguistic programming that have that concept
of like chunking down or chunking up, like, you know, where chunking down is like to focus on the details.
And I would do that. I would get so narrowly focused on, you know, every, every last little, it's like,
it's like the same thing that I do when like, you know, if you have like, like a zit or something,
and you're like, oh, god, I got to get this zit. And then you like, you back up and you're like, oh,
now, now, what was a tiny speck on my face is now like a giant crater when I back up and look in the mirror.
So like the chunking up, being like the backing up and looking in the mirror. And for a long time,
I was very incapable of doing that in my own life, that sort of zooming out and seeing the full picture of it.
And so that ability to really take a greater perspective and say, is this actually working for me?
Is the thing that I'm doing working? And that really like, you know, much, you know, thanks to your work,
thanks to like the body keeps the score and attachment theory and things like that. That really is
what I created the Re-Patterning Project out of was realizing that I have these underlying needs.
And like you talk about in the book, you talk about that addiction is not so much the problem in itself.
It is a bad solution to an underlying problem. And so whatever that underlying need is is legitimate.
It's the fact that I'm doing something that I think somehow in my head is going to work because maybe it
worked once, you know, or maybe it worked inconsistently. We can talk about like, Skinner and the,
you know, the pigeons and the intermittent reinforcement that like, if something works inconsistently,
there's no better way to get a human being or a pigeon or whoever, you know, to repeat that behavior,
you know, which, which feels so illogical when you zoom out and think of it that way.
It also makes sense in the, in sort of light of the fact that like, no human being is going to be
perfect at providing the reinforcements that you want, you know what I mean? And like, that's a good point.
This is really adapted for like love and parenting and friendship, like any kind of social thing,
because like nobody can meet anybody's needs perfectly. And if we only learn from
100% consistency, we wouldn't learn anything. So in order to, you know, there's a reason we get
trapped by intermittent reinforcement. We have to be careful not to let commercial interests use that
against us, but in terms of, and also like bad boyfriends or girlfriends, you know, but there is a reason
that that sort of hard to get or inconsistency like is attractive. And it is not necessarily bad
in and of itself. It is only bad in a context. Yeah. I'm wondering also, I wonder if there's a way
for two people to have a secure relationship and sort of like microdose that inconsistency in a
way that's actually healthy and consensual to keep things, you know, because there is that classic
sort of thing about, oh, the person who's always there, I'm not interested in, but the person who's,
you know, messing with me or whatever is, is very interesting to me. And I think about this a lot,
like, are there ways for two people to basically understand like, okay, if this is kind of how our
brains work, can we infuse this relationship with, you know, something that's going to keep it a little
more exciting? Esther Carell speaks of this a lot, you know, where like the book "Mating in
Captivity" where I love her work too. And so I do think that we have a love for novelty and a
love for seameness. And they've was obviously in conflict with each other. So it is never going to
be perfectly encapsulated, but yes, like I think keeping some sense of mystery and doing new things
with your partner, like, you know, one of the things like my husband's really into like, we do dance
lessons and it's like scary, but like, you know, it's a fun eventually, you know, eventually I get
slightly better. But the, you know, it's like, it's again, it's like like that bit of challenge and,
you know, also like something that is just inherently enjoyable, like moving to music, you know,
yeah, like keeping, like having some kind of adventure within your relationship, like that,
you know, I think is is good. And he's also really into kayaking, which I like to do the boring kind
of kayaking and he likes to do the challenging kind and that's fine. But it's just like, yeah, you have
to like work within each other's risk tolerance is basically. I'm curious also, you mentioned earlier
about learning music. Are you open to sharing about what you're, what you're doing with that?
I'm sure. So I'm like attempting to learn to sing and learn music theory. And so, you know, I have
a pretty okay voice. It is really interesting to like kind of try to learn how to actually use it and
to learn or part words and harmonies and like, scales and all these kinds of prieds, whatever. So it's,
I'm really enjoying it, you know, I was just in between this was just like trying to play these
chords terribly. But like I'm really learning like how it works. And I love music so much that it is
I just can like sit there for hours listening to things and I can hear things that I couldn't hear
before. And it's just really amazing. And so, you know, it's just something that like I always loved and,
you know, in high school, I had a friend that we just sing together and she is back in my life,
which is moved back to our area. And so we are going to do some more music, which is great. But it's,
yeah, so it's, it's just like, you know, one of those things that like I always like wanted to
be able to do more and know more about, but that I really, you know, didn't have the time or
energy to pursue when I was kind of trying to get my career to work. So it is, it's been super fun. And I,
I mean, one of the things like that music, I think is really interesting is that like it really works
on like your brain sort of trying to predict the next thing. And so you're like, you have the form
of Western music in your head because you've just listened to it all your life. And so you're
expecting certain things, which music theory can tell you what they are. But there's also more creative
ways of doing those things that if you predict it, but it's actually better than predicted. So that
like makes you happy. It's like what they call a positive prediction error. And this is dopamine
seems to be involved in like prediction error to some degree, a negative prediction error. This is
why disappointment sucks because you not only did you not get the reward that you predicted,
now you're punishing yourself for like having made a wrong prediction, positive prediction error
on the other hand is great. And so you're listening. And it's like, oh, I think next
gonna be this and oh, it's that, but is that's even better? And so it's like, I don't know, I'm just
really enjoying it. And it's really, yeah, I mean, I think everybody has like some kind of art or
physical activity music. There's just something that you love in the world that can be a crafter
practice. And it's infinite. What you can learn about music. I mean, it just you can't even possibly
listen to all the good music in the world. So it's great. And this does give you the, you know, you
always have something to like look forward to. And yes, like you're going to suck for a while, but,
you know, oh well. That's so cool. Yeah, I'm also I'm also a singer. And I write music too. So
so I'll just put it out there officially whenever you're ready, you know, for Arden and the Wolves
featuring my as all of its fly out to LA will write a song will we'll figure out. But yeah, I love for
that reason. I'm a big fan of switching up my lyrics on the second chorus because you've heard
the first chorus the first time and you think you know what's happening. And then like you get maybe
like three like that that third line that A B A B, right? And that that third line you switch up
the lyrics a little bit and you kind of throw something in there and it's like it's so satisfying to my
brain. But then of course, I can't do that in every song because then it becomes too bad. Right. And
then then you've got to deal as a bridge at some point. So, uh, bridges are like my favorite part
of a song because I feel like the I feel like the bridge is like when you drop in and you really
get real with what you're saying because that's it's like the point in the song where like you're
it's again, it's exactly what you're speaking of that pattern changes, you know, it's verse,
verse, verse, verse, and then all of a sudden it's the bridge and it's this opportunity I feel like
in a lot of songwriting, I feel like the thing that is really being said in the song kind of happens
in the bridge. Yeah. Yeah. That's the part you're getting on. Modulate correctly to whatever key is
going to actually work, which I don't know very much about yet. But and I think like, right,
the hardest parts and the best parts are the transition. Yeah. Also, I know that music, you know,
music and dopamine interact quite a bit. And I remember when I realized it was like I guess about
five years ago, I realized that I had ADHD because I have I didn't have the typical signs of aid. I was
I was a dissociative daydreamer. I was not like the restless hyperactive kid when I was growing up.
In other words, you are exactly. Yeah. I was socialized female, you know, and autistic at the same time.
But I remember when I realized that like my my addiction to crushes was basically serving my dopamine
deficiency because I realized around this, I was like, Oh, this is why like when I have a crush on
someone, I feel like I'm going to do all these things and I'm going to, you know, when I feel so alive.
And then like when I'm I don't even have to be with a partner, I just have to have an interest in
someone like I've had like a plan, you know, and when I don't have that, it'd be like, you know,
I'd be like home from college break or whatever, like walking through the mall with my mom and I'd
be like the difference between like, I'm going to wear this to that party and, you know, versus like
this is just all a bunch of capitalist junk and everything is pointless.
But yeah, I mean like that kind of anodonic state is really really difficult to manage. And I mean,
you know, for me sometimes that actually I have a baseline of medication that I need to like
not go there, but it is like sort of I find like the link between like music and motivation and dopamine
because dopamine like is not just about prediction or wanting. It's also movement. And so like
motivation and movement are like inherently linked not just linguistically. And right, it's like
when you have that like sort of food aspect of dopamine, the sort of wanting, the confident wanting,
then right, you're just in it. But when you don't and when you have no sort of special interest or
special person that is like driving that, then you know, it can be very hard for people like us.
Yeah, yeah. So there I was, you know, it's like 2021 and I was I was in the stretch of time because it
was also the pandemic was happening. And I was in like my longest stretch of like going without a
crush like just without any romantic interest whatsoever. And I was so like, you know, and I remember
like when it finally clicked for me, what this was. And it was it was because I actually I remember
I had done magic about it. Like there was a person who I just like couldn't get out of my head and
you know, like the last person that I had caught a crush on. And it was like I really need to like
go that whole situation. They moved across the country and everything. And so I cast a spell to like
rid my mind of them. And it was like less than 24 hours later. I remember seeing some posts on
like Facebook or something like that. And it was stuff about dopamine. It was stuff about like,
you know, and for whatever reason, whatever it was, it clicked for me. I was like, oh, this is the
thing. I have a dopamine deficiency. This is what is serving this. And so of course I started
looking up like, all right, well, what are some natural sources of dopamine or whatever. And here I am.
And you know, I'm in the middle of making this like this album at the time, et cetera. And one of
the things was like, oh, well, listen to music. And I was like, but I'm cute. But I think I think
actually in some ways writing music, it's that same process of like you start writing a song. And
you know, it feels so amorphous. And every time I'm writing, I'm like every other success I've had
was a fluke. I'm not going to be able to do it. You know, I'm like, everything's coming out of my brain
is just mush, like forget it. And then you know, you get a foothold and you finish it and then it comes
out and it's, you know, it's this process. And I think for me, like, finding that has also been that
that source of dopamine that I'm doing something. I'm completing it. And then it's out there and it's
done. But I'd be curious, like, what else you think is the relationship between music and dope? But
like for those of us who are dopamine deficient, like how do you think that music serves that?
Well, I mean, I do think that because it is like a pattern of repetition that your brain is just happy
to predict it. And like that, like sort of motivates you. And it, you know, you might want to dance, you might,
you know, you just feel the emotion of the music, like moving you. And that I think it's lately different,
like playing or like beating music, but even just listening, if you're really into it, you will be
like engaged in that. And like we love to have patterns that are just predictable enough. Like,
and you know, again, it's that finding that sweet spot there. But that's what good music does for you.
And I mean, I don't know about you, but like, I will listen to something a zillion times. Like if I just,
I follow was songs all the time and like, I will just listen to this thing to death. And I will still
really like it later, but it's just like, I feel like I'm learning something from it somehow. And then
once I've learned that I've kind of incorporated it and I still like it, but it's not like that, like,
I must cure this again. I'm kind of saying that happens when I'm just like really sort of engaged in
trying to understand something music. So I think it's all of those things. And I think, you know, we do
get a fundamental pleasure from curiosity and learning. And I think especially like people who might
have some dopamine deficiency or whatever you want to call it, you would be especially drawn to that
because that combination of novelty and predictability is giving you a sense of confidence.
Yeah, I love that. Switching topics, but I wanted to make sure that we covered this also as part
of this episode. I'm really also curious about your work looking into the troubled teen industry. And
and I'll be transparent. I have not yet read help at any cost, although now that it's on my radar,
I really want to. But some of some of what my work has dealt with is, you know, I never intended to
create the Re-Patterning project. I was a theater major at NYU, you know, I intended to be a performer. And
yet having to sort of solve these problems that came up for me and that have, you know,
that have come up for others has has given me, you know, a sort of dual sense of purpose now in my life.
And so so much of what I deal with is the shortcomings of the mental health industry and
look on your fate for anyone who's not watching the video or anyone who's listening to just the audio
of the podcast. My face was priceless when I just when I just said that. And, you know, and ending up
working with people, especially who have been failed by other sectors of the mental health industry.
And looking also at especially at mental institutions and places that are supposed to care for people
and they're actually doing more harm, you know, in the last season, we have our, yeah, our,
first of all, like for kids, we have zero good mental health care. I mean, almost zero. Even the richest
people in the country can't like find decent care. This is how you have like Paris Hilton ending up
being a spokesperson for the harms done in the trouble teen industry because she was getting sent to
basically the same place that the Medicaid kids were getting sent to. And it is astonishing how
bad it is. Like I have a friend right now who's dedicated, who's dealing with some of this stuff. And
it's just like we just do the stupidest things. And even the like most professional people in the
area sometimes do incredibly stupid things around pharmacology. And, you know, it's just, it's crazy.
So the help at any cost was basically the first investigation into what I label and the survivors
labels the trouble teen industry. And what that is is a group of residential facilities or wilderness
programs, emotional growth, boarding schools, Christian programs, there's all kinds of different ones.
But fundamentally, the thing that marks the trouble teen industry is that the abuse is the treatment.
The idea is we will break you to fix you. And this comes out of a lot of really literal cults
that also came to dominate the adult addiction treatment system in America. So I want to talk about
like rehabs as well because I know you've had also experienced, yeah. All of that. Famously, there was
a cult called synonym, which was founded by a guy in AA who thought that AA wasn't tough enough. And so
they ended up having these very confrontational and humiliating encounter group kind of things,
where, you know, they thought they were getting bail and honest by being really mean to each other. And
the thing about it is that when somebody treats you cruelly, we have a sort of natural instinct to think
that wasn't meaningless, I deserved it. Or that wasn't meaningless, that helped me. And so people
started engaging in this. And because at the time research on heroin addiction was in its infancy,
people just thought there's no cure for this. And this guy's developed a cure. And literally states from
all over like, you know, New York scent people like this to this guy founds a facility where basically
the treatment is screaming at you. And, you know, so New York state sends people like California sends
like all over the country. They're like, look, this guy cured heroin addiction. Let's like learn from
him. All anecdotes, no data. In fact, the only, this is where I have to give props to New Jersey.
The only state that did any data gathering on this was New Jersey. And New Jersey was like, okay,
let's look at the data. And they're like, Oh, gee, what happens is basically 80% of the people who go
to this place drop out in the first few weeks. And of the 20% that stay 85% of those do okay. And so
basically what you're doing is you're selecting for the people who are most motivated to quit.
Like, because if you really want to quit, you'll do whatever they tell you.
And so, but you probably would have done fine anyway. Yeah. And so, but by selecting for the natural
recovery rate and not counting dropouts as part of your measurements of treatment success,
like this, they still do this. Like rehabs all over the country will still say, we've got an 80% success
rate with graduates. And it's like, okay, but 80% dropped out in the first few weeks and you have to
count them. And if you don't count them, that is not a good study. There's known technically as
intention to treat analysis. And if you are going to look at any outcome study of anything
psychological, you need to look at that. And my silly example of this would be like, if you had
an antitabressant that caused itching in 99% of people that was unbearable, and you only counted
the one person for whom that was not an issue, we would not call this a viable drug.
We the FDA would not allow that, right? But in behavioral and mental health care, we allow
anecdote to be data all the time. And we end up with this horrific system. So these trouble team places
were sort of modeled on this cult. And until at least the 80s, about 50% of publicly funded
addiction treatment that wasn't method on basically was these places where people scream at you for 18
months. And synodon wasn't just like a fake cult. They were a full-fledged cult so much so that basically
they started requiring people to swap partners. They required men to get bisectamies. They had
women get abortions. They started stockpiling weapons. And when a lawyer started suing them, they
took the rattle off a rattle snake and put it in his mailbox to try to kill him.
And so fortunately, the guy, he did get bit, but his dogs were there and his neighbor was there,
and he got saved. So the police went to arrest the founder of synodon, who was obviously this great
example of sobriety and recovery for conspiracy to commit murder by rattle snake. When they showed up
to get him, he was drunk. So anyway, but like that did not shut synodon and that did not end the
prevalence of this model called the therapeutic community in the field. Like we still hear like,
yeah, I want to be fair, there is a therapeutic community model that is based in Europe that is
different than the American model. But any American program that calls itself a therapeutic community
and is for addiction, at least originated in the synodon cult. And like either it originated by like
somebody from synodon came and founded it or somebody who founded the thing went and studied synodon
or went and studied someone who had studied it synodon. This was like enormously prevalent.
Any 18 month addiction rehab in the United States from like the 60s through the mid 2000s at
least was basically based on this. And so, you know, the 28 day rehabs like the hazeldoons and stuff
like that, they also took up some of this for a while. But by the mid 80s, they started realizing that,
you know, this may not be such a great idea that like, you know, oh, wow, like we got a lot of
traumatized people here and retraumatizing them might not really be the best way to get them into
recovery. But there's still a lot of that kind of crap and there's still an enormous amount of
this ridiculous behavior stuff that that lives in treatments for addiction or depression or any of
these residential things for kids, they often have this idea that what you need to do is like, you know,
okay, you have to earn X number of points for good behavior or we'll take away your right to talk
to your parents or will, you know, and you can't graduate until you earn X number of points. And
oh, gee, this happens to coincide with our financial interests because of stay the more we get paid.
Of course.
You know, and it's just like nobody learns that way. Like, you don't like learn from like if you try
to teach me singing by slapping me when I got a no wrong note, I'm not really going to
grow as a singer very much and I'm also probably going to start to hate singing.
Yeah. And also this does not give me any technique.
You know, like we don't expect people to learn math by, you know, okay, we're going to punish you
if you don't know addition by the end of the day. Like, we recognize that there are skills needed.
And similarly with mental health care, there are skills that people who have,
you know, most mental illnesses and being on the spectrum involve some kind of emotional dysregulation.
And you tend to try to self-medicate that with like, you know, steaming or with drugs or with whatever
worse for you. And oftentimes what worse for you is not the greatest idea. And so you end up in trouble
or hurting worse than you were before. So people need skills to be able to develop new ways of coping.
And you know, most people with addiction have either a predisposition to mental illness or severe
childhood trauma. More often, severe childhood trauma leads the predisposition to become a mental
illness and then the person self-medicate. So without understanding that when you're just trying
to humiliate people into stopping, which is most of what our treatment has done for a very long time
outside of the medication, which was used in the system, this very racist and humiliating in a
different way, the, you know, what people actually need. Addiction is defined as compulsive drug use
despite negative consequences. This means that it does not respond to punishment by definition.
So what people need in order to get better is to learn new skills. And that requires wanting to
learn new skills and understanding what those skills are and being taught them and making all the
mistakes you're going to make because nobody learns anything perfectly at first. Like anything you
are trying to learn, you are going to make mistakes and you're not going to be able to get any skills
without practicing. And you're going to practice and make mistakes and then you learn how not to
make the mistakes. Yeah, something I'm really curious about is I know there are a number of charities
and especially I mentioned, you know, that I also have my my music project and in the music industry
there are a number of charities that work to help musicians, you know, overcome things like addiction
and also, you know, get them access to healthcare and things like that. And I'm hoping that, you know,
in the not too distant future, I can be in a place where I can advocate, you know, for better mental health
treatment and I'd really love to know what would you advise me to say, like if I get to a place where I
have that that access and that platform, what would I say to a really well-meaning music industry
charity that is paying, that is giving their money that they've raised to these rehab centers,
like, oh, here's 10k to take care of this musician. Right. And then because I've had friends who have
gone, you know, and they weren't helped by the rehab, they were helped by what I
saw and noticed in them instead, you know, so how would one, yeah, how would one advocate to a charity
and say maybe your money is not going in the best place? I mean, I think, you know, so there,
there is an organization that is trying to create sort of national quality standards for addiction
treatment. I still think they aren't quite there yet, but I do think that understanding that
our treatment is not mostly based on evidence and that, you know, 12 step programs are absolutely
fabulous for some people, but you can get all the 12 step information and all the 12 step support
for free in virtually every church basement in this country. So we shouldn't be paying for 12 step
facilitation or for these groups in rehabs that cost $10,000 a day or some, you know, crazy amount of
money for what you can get for free. What you should be learning in rehab is you should be getting a
complete psychiatric evaluation, which you usually don't get. You should, because figuring out what's
underneath the addiction is fundamental. And yes, you're not going to address trauma while somebody's
detoxing, although people try, what you want to do is understand what this person's strengths are,
what this person's issues are, what's underneath why this person is using drugs compulsively,
and finding alternatives for, you know, and I mean with musicians, like people who are doing music
tend to have a meaning and purpose that they get for music, right? But that by itself is not enough.
And they will need the, maybe they have depression that needs medication. Maybe they have
tell-to-trauma and they need to, you know, sort of work through that in various ways.
There's a million different reasons that people self-medicate, but if you just take away the medication
and scream at them and tell them to go to meetings, for a lot of people that does not work.
And for the people who say that screaming at me worked, it worked, you know, well, you,
unless you have 10 identical twins who weren't screamed at, you don't know that that's what worked,
right? This is why we don't rely on anecdotes for the rest of medicine. We real,
the medicine started advancing when we actually did controlled clinical trials and started to try to
like see, you know, what works for different people. Like you can't just say like it worked for
me, so therefore it will work for you because that is just not the case. So that's a really difficult
question and I like struggle with people all the time who need help. Like where do I send them?
You know, and there are starting to be better options, but I think and the sort of whole world of
harm reduction is a good place to sort of start with that because like that whole idea that like we
have to meet people where they are and reduce harm first and foremost is especially fundamental when
you have a dangerous drug like fentanyl out there or a thing like HIV. What happened when people
started taking, you know, doing things like syringe exchange for HIV, they realized that, oh wow,
a lot of what people need is to be heard and be treated respectfully and kindly. And when you
start doing that, people are sort of like, oh, well, I really kind of might like to stop this. Like,
okay, this is good. I've now, you know, I'm musically needles now and so I've got rid of the HIV risk,
but you know, this is not really going so great for me, but you know, the last time I went to treatment,
I got screamed at. So, you know, this allows people to get into decent care and the people who work
at these places often know the ways to, you know, the good treatment places and sort of how to help
somebody who needs more that, you know, because I mean, what's also interesting with addiction is
a lot of people do stop on their own even from like very severe addiction. And what happens in
those circumstances? Well, often they fall in love with somebody, they get a new job. Some kind of
opportunity opens for them that gives them hope. And they are able to let go of that coping mechanism
in a way that they couldn't if they didn't have that help. Now, obviously, this doesn't happen for
everyone. And a lot of times people are going to need assistance, but the main thing that people need
is to get their chemistry sorted out in their heads, whatever, you know, maybe they need some kind
of medication, maybe they need some kind of talk therapy, whatever it is, like whatever that underlying
thing is. And then they need a sense of meaning and purpose and a decent life to live. Because if you
just like take the drugs away from somebody who, you know, has no education, no job, no house, no
relationships, like, why would you get so? Like, you know, like, you need people need to have an
opportunity to live a life that is good for them from their point of view. And if we don't have people
having access to opportunities for that, like, you're really going to expect me to give up the
only thing that gives me safety and comfort and meaning and purpose for nothing. Like, really?
Yeah, seriously. Those are great. Thank you. And thank you. I'm going to revisit this episode
in the future when I hopefully one day, you know, have, have more access and have a voice to be able to
advocate and not feel I want to invite Tomi to come on and ask her question. And because we're
nearing the end of our episode. So Tomi, do you have a question for Maia today? Yeah, I was really glad
that you brought up Maia's work with the troubled teen industry because that was her work I was first
introduced to and kind of taking this from less of a place of concern and more a place of, like,
almost active hate. I'm having to deal with waves of, I'm frankly wanting to get your opinion on
what do we do about the resurgence of conversion therapy coming back in many states where, like,
I really thought this was going to be a thing of the past as I got older and now it's coming back
with a vengeance despite more evidence than ever that this doesn't work. So as someone who's worked
in a more generalized setting against these troubled team camps, what do you recommend people do to
push back against something that's so fueled by, frankly, bigotry? The conversion therapy stuff
grew out of the awful techniques used in the troubled team industry. A lot of it did. Now,
there's some different strands of it, but there was something one of the biggest
conversion therapy places was based on street incorporated, which was one of the most abusive
troubled team programs and it directly used the exact same techniques and same people. So we know
it was directly related. The best way to counter this and one of the things, there was a recent
Supreme Court decision that sort of seemed to say that the states can't ban conversion therapy,
but it's actually slightly more complicated than that, which is good because there still is
room to be able to ban them. And I think, you know, because the Supreme Court sent it down to a lower
court. And hopefully, you cannot have a standard of care for mental health care if you cannot ban
certain ideas because the standard of care is going to be something like trying to change
somebody's gender identity or sexual identity is not going to work. You know that this does not work
and it does harm and it has led people to die by suicide. If you're going to have a standard of
care, it has to ban things that are harmful. And what we need to be able to fight is this idea that
I should be able to say I'm a therapist and I am using medical care to convert somebody.
Like, A, that's not possible. And B, it's harmful. And C, that is not medicine. Like, if you're going to
sell something as therapeutic, as medical, as healthcare, as something insurance should cover,
you need to meet a standard of care. Otherwise, there is absolutely no point in regulating mental
healthcare in any way because I can just set up my stand on my head rehab and make a lot of money.
And I don't have to prove it works because I can just get the unmotivated people to not stand on
their head and off over whatever I'm doing. So I think this fight isn't lost yet and I think that even
in the courts, it's not lost yet. So I'm hoping to write about this more soon because I do think that
professional speech should be regulated. There is simply no way around that if it's going to be
professional speech. Like, this woman who wants to provide like, conversion therapy, fine, just don't
give her a license. You know, don't let insurance pay for it. Don't let it be covered, you know,
be part of the mental health, you know, get it from your church. If that's what you want, you know what I
mean? Like, you can't offer a therapy that isn't a therapy. Like, otherwise the word therapy isn't
meaningful. So I'm with you. Thank you all. Look forward to seeing some anti-conversion therapy,
writing, hopefully in the times. And yeah, I appreciate the encouragement or at least that glimmer of hope
that maybe things are not as black and white as they seem. Now, I mean, and it is like, I'm not saying
it's not bad. I'm just saying that like, there is some wiggle room in this, in this decision such that
it may not be as bad as we think. And I think also like, over time, people are going to realize that like,
if mental health care is to mean anything, any kind of talk therapies, to mean anything, you have to be
able to regulate it in some way. And if you think that demeaning people is helpful when all we know
shows that it's not, you shouldn't be able to sell that. You should be sued for malpractice if you
sell that. And that's, you know, what we kind of need to work on. Yeah, so much, so much treatment out
there that in my opinion, deserves to be sued for malpractice. I'll just say one more thing.
So go ahead. Yeah. We need more lawyers to be able to take these cases. Like one of the best ways to
regulate this stuff is to allow something called a private right of action, which basically six
and army of lawyers on these people. And that way, even if the government doesn't do its job,
the lawyers who want to make money, nice. That is good to know. Definitely that idea that,
you know, if we want to call something therapy, it needs to actually be proven to work. Yeah.
Which, you know, like as with as with any theory, perhaps, you know, is a bad solution
to the, to the underlying problem. We have an FDA for drugs. Who knows how long we will continue
to have it, but we do have it now. And the, you know, the whole point of it is that the thing has to be
safe and effective before you can sell it. And I think anything medical that should be true for.
And yes, that makes it difficult with measuring efficacy of talk therapy. But you know what?
Do the research. Amen to that. Thank you again so much, Maia. This has been such a pleasure. I've
so enjoyed talking with you. This is again, it's been like the past 10 years that your work has
informed my work. And to be able to talk with you here and have these conversations like, and there's
a million more things that I could go on about to barely got even to like half of the points that I
had written down. But this was such a wonderful talk. Thank you so much. I am such a fan of your work.
So thank you for being here today. Oh, thank you so much for having me. And thank you,
listeners for tuning in. And this has been the Re-Patterning Podcast. So stay tuned. And we'll see you next time.
Go forth and Re-Pattern. Thank you for listening to the Re-Patterning Podcast. If you're curious about
the Re-Patterning Project, the eight-week course in mental mastery and creative freedom that inspires
these conversations, you can check out more details at the repatterningproject.com. We run a cohort
twice a year, or you can download the self-study version of the course and get started today.
We also offer a four-week course on narrative magic and archetype titled "Mits and Magic,"
changing your life through story, also twice a year. If you'd like to join our community,
the Re-Patterning Parlor on Discord, you can sign up for five dollars a month at patreon.com/the
Re-Patterning Podcast. Thanks to everyone who makes the Re-Patterning Podcast possible.
Firstly, our award-winning producer, Tomi Trembath, of the Keymaster Collective Network of
Podcasts. She also produces transcending comics, vision in the void, and giant-sized violence.
Thanks also to Animation Studio Mortis and Madriacs, who created the video for our introduction,
as well as to Andrew Means, who composed and produced our theme music. And also thanks to Al Alvarez,
who took the photos of yours truly that you see on the cover of each episode if you're watching
the video version. And finally, thanks to you, our listeners, who give meaning to this work.
Our greatest wish is that whatever you've heard today inspires you to live freely and begin
creating your reality from the inside out. Thanks for tuning in and we'll see you again soon.
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