Today we're talking about how to get motivated even when you don't feel like it with the world's number one expert on dopamine. Dr. Anna Lumpky is a professor

今天我們要聊：就算不想動時怎麼有動力——和世界頂尖多巴胺專家。Dr. Anna Lembke 是史丹佛大學醫學院教授

and the medical director of addiction medicine at Stanford University School of Medicine. What is dopamine and why is it important?

兼成癮醫學主任。什麼是多巴胺？為什麼重要？

>> Dopamine is a chemical that we make in our brain. Dopamine has many different functions, but one of its most important functions is in pleasure, reward, and

多巴胺是大腦製造的一種化學物質，功能很多，但最重要的功能之一與快樂、獎賞和

motivation. It makes us the ultimate seekers. Never satisfied with what we have, always wanting more.

動機有關。它讓我們成為終極追求者：永不滿足於已有，總想要更多。

>> You're saying that in modern life, especially with a phone, especially with so many things that give you quick little novel hit, boom, boom, boom,

你是說在現代生活裡，尤其有手機、有這麼多東西給你快速小刺激，砰、砰、砰、

boom. We are so out of whack. Whether it's substances or behaviors or work or relationships, we've made it more accessible, more potent, more novel, such that now we're vulnerable to get

砰，我們完全失衡。不管是物質、行為、工作還是關係，我們讓它更容易取得、更強、更新奇，以至於我們現在容易對

addicted to just about anything. Drugs and alcohol, all kinds of behaviors, gambling, social media, video games, online shopping. People can get addicted to other people. Really? Yes.

幾乎任何東西上癮。毒品酒精、各種行為、賭博、社群媒體、電玩、網購，人也可以對另一個人上癮。真的？對。

To be happier, to experience more joy, we need to do the counterintuitive thing of moderating and greatly reducing our use of instantaneous easy pleasures. By the end of the

要更快樂、體驗更多喜悅，我們得做反直覺的事：節制、大幅減少即時易得的快樂。對談結束時

conversation, you can get out of the vortex of compulsive overconumption and get to a place where you're not constantly seeking these rewards, but instead really showing up for your life.

你可以脫離強迫過度消費的漩渦，到達一個不再不斷追求這些獎賞、而是真正為人生在場的狀態。

Okay, before we jump in with the number one dopamine expert in the world and talk all things motivation, my team was showing me something. 57% of you who

好，在我們和世界頂尖多巴胺專家聊動機之前，我團隊給我看了一個數字：在 YouTube 看 Mel Robbins 播客的人有 57%

watch the Mel Robbins podcast here on YouTube are not subscribers. So, it's my goal that we get that number to 50%. And I know you're the kind of person that

沒訂閱。所以我的目標是把這數字降到 50%。我知道你是那種喜歡支持那些支持你的人。

loves supporting people who support you.

所以如果訂閱鈕亮著，就表示你沒訂閱。幫個忙按訂閱，這樣你就讓 Mel Robbins 和

So, if that subscribe button is lit up, it means you're not a subscriber. Do me a favor, just hit subscribe. That's how you can show your friend Mel Robbins and

我們團隊知道你在支持我們、你喜歡我們支持你。順便說按訂閱免費，這樣你不會漏掉任何一集，也讓

my team here that you are supporting us and you love that we support you. By the way, it's free to hit subscribe and that way you don't miss a thing. And it tells

我和團隊知道：天啊我愛這些專家，Mel 再多講多巴胺和動機，我們會持續請來給你。謝謝

me and the team, oh my gosh, I love these experts. Mel, tell me more about dopamine and motivation. and we will keep bringing them to you here. Thank

大家。好。

you. Thank you. Thank you. All righty.

準備好了嗎？我們來找動力、開始吧。歡迎 Dr. Anna Lembke 來到 Mel Robbins 播客。

You ready? Let's get motivated and jump in. Please help me welcome Dr. Anna Lumpkkey to the Mel Robbins podcast.

謝謝邀請，很開心能來。

>> Thank you for inviting me. I'm absolutely delighted to be here.

Lembke 醫生，如果我今天把你教的全當真、真的把多巴胺與動機、快樂與痛苦中樞的研究

>> Dr. Dr. Lumpky, could you tell me if I take everything to heart that you're about to teach me today and I truly apply all this research about dopamine

都應用到生活裡？我的人生會怎麼變？

and motivation and happiness and pain and pleasure centers and I apply it to my life? How could my life change?

如果你像我、像很多病人，你可能在無意識地把整個人生圍繞獎賞和小多巴胺刺激來組織。從早上醒來

If you're like me and you're like many of my patients, you are probably unconsciously organizing your entire life around reward and little dopamine hits. From the moment we wake up in the

那一刻起我們就伸手拿手機、滑、喝咖啡因、上車聽音樂、覺得無聊就換臺。然後到公司突然得放下那些即時快樂，我們就

morning, we reach for our phones. We scroll. We go get our coffee with our caffeine. We get in the car. We're listening to our music. It's not

無聊、焦躁、坐立不安、焦慮、無法專注。於是我們不斷打斷自己：該看一下手機、該看那個影片。

interesting. We're flipping the stations. Then we get to work and all of a sudden we have to let go of those instantaneous pleasures. Now we're like

一整天都這樣，直到下班回家，等不及

bored, we're frustrated, we're restless, we're anxious, we can't concentrate. So then we're interrupting ourselves and saying, "Oh, I better check my phone or maybe I should look at that video." And

到家喝杯酒、看劇、吃塊蛋糕，然後晚上難入睡，因為我們太緊繃、太躁。所以

we're doing that through the entirety of the day until we get to the end of the day where we go home. We can't wait till

我想說的是：希望對談結束時你能脫離強迫過度消費的漩渦，到達一個

we get there to have a glass of wine, watch our shows, eat a cupcake, and then have difficulty falling asleep at night cuz we're so wound up and restless. So,

不再不斷追求這些獎賞、而是真正為人生在場的狀態。天啊。

what I'm saying to you is that I hope by the end of the conversation, you can get out of the vortex of compulsive overconumption and get to a place where

Lembke 醫生，所以我一直很想跟你聊，因為你剛說的就是我們每一個人，我們身在其中所以看不到

you're not constantly seeking these rewards, but instead really showing up for your life. Oh my god.

持續分心、伸手拿這些東西、你剛描述的一切。

Dr. Olymp, this is why I've been so excited to talk to you because you just explained every single one of us and we're in it and so we don't see how the

我目前的理解是：你的工作很大一部分圍繞一個事實——作為人我們體內有這種

constant distraction and reaching for all these things and everything you just described.

自然系統，我們會像貨運列車一樣朝感覺很好的東西衝過去，但會反射性地遠離任何

So what I got already so far is that a lot of your work centers around the fact that as a human being we have this kind

可能感覺很難的事。你說的是不是就是這個？

of natural system inside us that we will move right like a freight train towards what feels really good but we reflexively move away from anything that

對，總結得很好。

might feel hard. Is that kind of what you're talking about?

好。你的研究特別聚焦多巴胺。我們從基礎開始：多巴胺到底是什麼？為什麼重要？

>> Yes. Very nicely summarized.

多巴胺是大腦製造的一種化學物質，叫神經傳導物質。

>> Okay. and your research in particular focuses on dopamine. So let's just start at the basics. What exactly is dopamine and why is it important?

神經傳導物質是連接神經元之間空隙的分子。神經元是傳導電路的細長細胞，大腦本質上是一堆線。

Okay, so dopamine is a chemical that we make in our brain. It's what's called a neurotransmitter.

好，多巴胺是大腦製造的一種化學物質，叫做神經傳導物質。

Neurotransmitters are the molecules that bridge the gap between neurons. Neurons are these long spindly cells that conduct electrical circuits. Our brains are fundamentally a bunch of wires.

神經傳導物質是連接神經元之間空隙的分子。神經元是細長的細胞，傳導電路，大腦本質上就是一綑線。

Okay? But those wires, the neurons, don't actually touch end to end. There's a little space between them. That space is called the syninnapse. Okay? And

但這些線、神經元，頭尾其實不接觸，中間有小空隙，叫突觸。而

neurotransmitters bridge that gap between neurons to allow for fine-tuned control of those electrical circuits.

神經傳導物質就是搭起那座橋，讓這些電路可以微調控制。

Dopamine has many different functions, but one of its most important functions is in pleasure, reward, and motivation.

多巴胺有很多功能，其中很重要的一項與快樂、獎賞和動機有關。

Okay? Now, it's not the only neurotransmitter involved in that process, but it has become a kind of common currency for neuroscientists to measure the reinforcing potential of

它不是參與這過程的唯一神經傳導物質，但已成為神經科學家衡量

different substances and behaviors.

不同物質和行為「強化潛力」的通用指標。

Fundamentally, the more dopamine that is released in the brain's reward pathway and the faster that it's released, the more likely is that substance to be

基本上，大腦獎賞路徑釋放的多巴胺越多、釋放得越快，該物質就越可能被

reinforcing or something that our brain recognizes as important for survival, something to approach, explore, and potentially exploit by doing it again and again. So, let me just give this

強化，或大腦會認為它對生存重要、要去接近、探索、一再重複以利用。所以讓我

back to you to see if I'm understanding this. So your brain releases these chemicals. Dopamine is one of them. And dopamine is related to motivation and

跟你確認一下我理解得對不對。所以大腦會釋放這些化學物質，多巴胺是其中之一，多巴胺跟動機、

>> Yes. A more fundamental way to talk about it is it's related to reinforcement. Okay. So something that I do y >> that's often associated with pleasure

對。更根本的說法是：它跟「強化」有關。所以某件事我做了，常常伴隨快樂

but not exclusively associated with pleasure which then I want to do again and again.

但不只限於快樂，然後我就會想一再做。

>> Okay. because my brain recognizes it as potentially important for survival. How important is dopamine in terms of the role that it plays when you are trying to either

好，因為大腦認為它可能對生存重要。多巴胺在你想戒掉壞習慣、建立新好習慣時有多重要？你懂我意思嗎？我馬上想到的是，每次聽人講海洛因、奧施康定之類，第一次用時有個「砰」

break and replace bad habits or create new positive habits. You see what I mean? I can understand what you're talking about because the thing the

戒掉壞習慣、建立新的好習慣時，多巴胺扮演的角色有多重要？你懂我意思嗎？

thing I immediately thought of is whenever I've heard anybody talk about something like heroin or oxycottton or something like that that first time that somebody sadly uses it there's this boom

我馬上想到的是，每次聽人講海洛因、奧施康定之類，第一次用時有個「砰」

huge reward >> right >> and then experts are very clear >> that the reward or the spike that you're getting declines with every use but the

超大獎賞，對吧？專家說得很清楚：獎賞或那個尖峰會隨著每次使用下降，但

poor person who is addicted is chasing that initial first spike and that feeling even though it's not coming exactly and that's often what we call

成癮的人還在追那個最初的尖峰和感覺，即使已經回不去了。我們常稱之為

euphoric recall. We tend to have this very vivid memory of initial exposure to highly emotionally potent stimuli whether pleasure or pain. our brain really remembers that and if it's

欣快回憶。我們對初次接觸高強度情緒刺激——無論快樂或痛苦——會有很鮮明的記憶，大腦會牢牢記住；若是

pleasurable uh we marshall all of our available resources to try to get it again.

快樂的，我們會動員所有資源再去得到它。

>> Oh, okay. Wait a minute. So, I think that that leads us to something I saw that you covered very early in your book, which is there is this pleasure

喔，等等。這讓我想起你書裡很早就提到的一點：人天生有一套快樂—

pain system that you were born with. It is in your body and there's something that you write about called the pleasure pain balance. Can you explain that a

痛苦系統，在身體裡，你還寫到「快樂痛苦平衡」。能解釋一下嗎？

>> Yes. So, this is an extended metaphor that I use to try to explain at a very fundamental level how we process pleasure and pain. And to me, one of the

好。我用一個比喻來解釋我們如何處理快樂與痛苦。神經科學裡有個發現很值得注意：

really interesting findings in neuroscience is that pain and pleasure are actually colllocated in the brain.

痛苦和快樂其實在大腦裡是同一個區塊。

So the same parts of the brain that process pleasure also process pain and they work through what's called an opponent process mechanism.

處理快樂的腦區也處理痛苦，而且透過一種叫「對抗過程」的機制運作。

>> Okay. So imagine that deep in your reward pathway there is a scale or a balance something like a a teeter totter and a seesaw.

好。想像在你獎賞路徑深處有一座天平或蹺蹺板。

>> Like a seesaw. Yes.

像蹺蹺板。對。

>> Um and and when it's at rest it that balance or that that beam on the central fulcrum is level with the ground.

靜止時，那根橫桿在支點上是水平的。

>> Okay. When we experience pleasure, it tips one way and pain, it tips the other. Now again, this is a vast oversimplification because of course we

好。我們體驗快樂時，它往一邊傾；痛苦時，往另一邊傾。當然這是大幅簡化，因為我們

can experience pleasure and pain simultaneously. For example, when we eat spicy food and this the brain is just much much more complex than this pleasure pain balance. Okay,

可以同時體驗快樂和痛苦，例如吃辣。大腦比這套快樂痛苦平衡複雜得多。好，

>> but it's a useful framework for conceptualizing some fundamental concepts in neuroscience like the concept of homeostasis and the concept of neuro adaptation which I'm going to

但它是個有用的框架，用來理解神經科學裡的一些基本概念，像恆定和神經適應，我現在

explain now. Okay. Okay. So, let's say um you know I do something pleasurable.

就來解釋。好。假設我做了某件快樂的事。

We talked about potato chips. I also really like potato chips. Um you know I eat a potato chip that gives me pleasure. My pleasure pain balance tilts

我們聊過洋芋片，我也很愛。我吃一片洋芋片，得到快樂，我的快樂痛苦天平就往

to the side of pleasure. But there are certain rules governing this balance.

快樂那邊傾。但這座天平有規則。

And the first and most important rule is that the balance wants to remain level with the ground. This is what neuroscientists call homeostasis.

第一條、也是最重要的規則是：天平想保持水平。這就是神經科學家說的恆定。

Right? It's a range of baseline conditions that the organism must maintain in order to survive.

對吧？生物為求生存必須維持的一組基準條件。

>> So as soon as I've eaten that potato chip and my pleasure pain balance has tilted to the side of pleasure. I like how you tilt your head when I when I say

所以我一吃那片洋芋片、快樂痛苦天平往快樂那邊傾，你就歪頭——像狗在問：

>> Like a dog.

像狗。

>> Is she going to give me a treat?

她要給我零食嗎？

>> Right. Right. My brain is going to react by working very hard to bring that balance level again. And that process is called neuroaptation.

對。大腦會拚命工作，把天平拉回水平。這個過程叫神經適應。

And I like to imagine that as these little neuroaptation gremlins hopping on the pain side of balance because that's the level at which I understand it. But

我喜歡想像成一群神經適應小精靈跳到痛苦那一邊，因為這樣我比較好懂。但

the thing about those gremlins is that they don't get off as soon as I'm level.

這些小精靈不會在我一恢復水平就下來。

I wish they did, but they stay on until the balance is tilted an equal and opposite amount to the side of pain.

真希望會，但它們會一直待到天平往痛苦那邊傾到同等幅度才下來。

That's the come down, the craving, the hangover, or just that moment of wanting to have one more potato chip, drink one more glass of wine, you know, wa watch

那就是回落、渴求、宿醉，或只是「再一片洋芋片、再一杯酒、再一支

one more Tik Tok video. Oh, wait, hold on a second. Okay, I think I might have gotten this, but let me see.

TikTok」的那一瞬間。喔，等等。好，我好像懂了，讓我確認一下。

So takeaway number one as I was listening is that you are designed with this pleasure pain balance and we're imagining a seessaw in life between the

我聽下來的第一個重點是：你天生有這套快樂痛苦平衡，我們想像成人生裡的蹺蹺板，一邊是

things that are easy that you love pleasurable the things that are very hard that you need to do that you avoid pain right but your brain is not only

輕鬆、你愛、快樂的事，另一邊是很難、你該做卻逃避的事——痛苦。但大腦不只能往快樂或痛苦傾、讓你體驗，還會一直想把蹺蹺板拉回水平。但

able to tilt toward pleasure or tilt toward pain so you can experience it but it's always going to want to get itself back to that seessaw being level. But

大腦不只能往快樂或痛苦傾，還會一直想把蹺蹺板拉回水平。但

you also said another word, craving.

你還提到另一個詞：渴求。

Is craving part of this pain thing which then tries to get you to get more pleasure? Is that like what where does craving come into this?

渴求是「痛苦」這一邊的一部分嗎？它是不是在推你去追求更多快樂？渴求在這套裡扮演什麼角色？

>> Yeah. Yeah. You're you're definitely on the right track in the general area absorbing this.

對，你方向對了，大方向也抓到了。

>> You are you are you are definitely absorbing this. So the first rule is any deviation from homeostasis is essentially a biological stressor and our brain will want to do the work to

你確實有聽進去。第一條規則是：偏離恆定本身就是一種生物壓力，大腦會努力把我們

get us back to homeostasis. Okay. Yep.

拉回恆定。好。對。

Um and and there are a couple ways we can get back there. We can just wait till the gremlins hop off and homeostasis is restored. That is not

有幾種方式可以回去：可以等小精靈自己下來、恆定恢復——那就不

have more potato chips. Or we can have more potato chips because that will get us back there faster. And of course, you know, potato chips are yummy. So that

再吃洋芋片。或者再吃洋芋片，因為那樣更快回到水平，而且洋芋片好吃，所以

that's what I want to do. But this this brings us to the second rule of the balance. And the second rule of the balance is with repeated exposure to the

我想那樣做。但這就帶出天平的第二條規則。第二條規則是：反覆接觸

same or similar reinforcing stimulus, that initial deflection to the side of pleasure gets weaker and shorter in duration, but that after response to pain gets stronger and longer. In other

相同或類似的強化刺激時，往快樂那邊的初次偏斜會變弱、變短，但往痛苦那邊的反應會變強、變長。換句話說，

words, those gremlins start to multiply.

那些小精靈會開始變多。

They're now lifting weights. We've got Arnold Schwarzenegger gremlins, right?

它們開始練舉重了，變成阿諾級小精靈，對吧？

So, this sense of like I'm doing something pleasurable for me right now.

所以「我現在在做一件讓自己快樂的事」這種感覺，

Yes, that's true cuz it brings us back to level position. But in the long run, what it does is it drives us down to the

對，沒錯，因為它讓我們回到水平。但長期來看，它做的是把我們推向

side of pain. And this is really key for understanding what happens in the brain as we become addicted. Because if we continue to consume our drug of choice

痛苦那一邊。這對理解成癮時大腦發生什麼非常關鍵。因為如果我們持續使用自己選擇的「毒品」

over days to weeks to months to years, we then have enough gremlins on the pain side of the balance to fill this whole room and eventually they are camped out

從幾天、幾週、幾個月到幾年，痛苦那邊就會有足夠多的小精靈塞滿整個房間，最後它們在那裡紮營、烤肉。於是我們改變了「快樂設定點」，

there tensen barbecues and tow. And then we've changed our hydonic or joy set point. Right now, we need more of our drug in more potent forms, more potato

快樂設定點改變了。現在我們需要更多、更強的「毒品」——更多洋芋片——不是為了感覺好，

chips, not to feel good, but just to level the balance and feel normal. And when we're not using, we're walking around with a pleasure pain balance,

只是為了把天平拉平、感覺正常。不用的時候，我們帶著一座往痛苦那邊傾的快樂痛苦天平生活，

tilted to the side of pain, experiencing the universal symptoms of withdrawal from any addictive substance or behavior, which are anxiety, irritability, insomnia, depression, and craving. And this is why it is so

經歷戒斷任何成癮物質或行為的共通症狀：焦慮、易怒、失眠、憂鬱和渴求。所以一旦我們改變了大腦、長期反覆接觸自己選擇的「毒品」或

difficult to stop eating potato chips or whatever it is once we've changed our brain and gotten into a habitual pattern of exposure to our drug of choice or our

要戒掉洋芋片或任何東西都非常困難。

reinforcing behavior over a long period of time.

強化行為，長期下來就會這樣。

>> And you use the word addiction, but you mean that in the broadest of all possible terms. So for my benefit and for the person who's listening benefit,

你用「成癮」這個詞，是指最廣義的那種。為了我和聽眾，

give me a range of things that people could become addicted to and not realize that it's because of this pleasure pain balance getting out of whack and then

舉一些人們可能成癮卻沒意識到、其實是快樂痛苦平衡失衡、然後

getting into a pain deficit.

陷入痛苦赤字的事。

>> Yes. where you're anxious and depressed and craving and like all of these things that you just described that a lot of people feel but may not realize. Great

對。就是你焦慮、憂鬱、渴求、你剛描述的那些——很多人有感覺但可能沒意識到。好

question. So, so first of all, let's define addiction. Okay. It it is a brain disease, but we don't have a brain scan or a blood test to diagnose it. We base

問題。首先我們來定義成癮。它是腦部疾病，但沒有腦掃描或血液檢查可以診斷，我們靠

it on patterns of behavior. It is the continued compulsive use of a substance or a behavior despite harm to self and or others. You could have a range of

行為模式判斷。它是指持續、強迫地使用某種物質或行為，儘管對自己或他人造成傷害。成癮有

addictions to mild, moderate, and severe. And you could have pre-addicted states, right? Where you haven't quite yet crossed over into addiction, but now you've got a compulsive habitual

輕、中、重度之分，也有成癮前狀態——還沒完全跨進成癮，但已有強迫、習慣性的

behavior where you've lost some agency, but not all agency, and you know it's not good for you. You have regret about doing it. You have some difficulty

行為，失去部分但不完全的自主，你也知道不好、會後悔、停下來有點難。

stopping. But if you really set your mind to it, you you can. Okay, so that let's just frame that as kind of what we're talking about. It's really a

但若真的下定決心，還是可以停。好，我們就把它當成我們在談的範圍。它其實是一個

spectrum or a continuum.

光譜、一個連續體。

>> What immediately came to mind for me >> is just constantly being on your phone.

我馬上想到的是：一直滑手機。

>> And this sense of I wish I weren't on my phone.

還有那種「真希望我沒在滑手機」的感覺。

>> Enough or as much and that feeling that every one of us has after you blow through 2 hours mindlessly scrolling.

滑夠了或滑太多，然後那種我們每個人無意識刷了兩小時之後都有的感覺。

>> And wishing that you hadn't. So is that an example of what you're talking about in this range?

然後希望自己沒那樣。所以這算你說的這個範圍裡的例子嗎？

>> That is a great example. and digital media, social media, short form videos activate the same reward pathway as drugs and alcohol. They're highly reinforcing. We do see in clinical care

那是很好的例子。數位媒體、社群、短影片會活化跟毒品酒精一樣的獎賞路徑，強化效果很強。臨床上我們確實看到

people who are getting addicted to many different forms of digital media. Um, and just looking around, you can see that people are overly engaged with

很多人對各種數位媒體成癮。放眼望去，大家過度黏著

their phones. Now, maybe they're not meeting threshold criteria for a clinical addiction, but it's getting in the way in many instances, um, you know, with their their goals and even their

手機。也許還不到臨床成癮的門檻，但在很多情況下已經妨礙他們的目標、甚至

values. So, that initial exposure to whatever our drug of choice is, and we're all wired a little differently.

價值觀。所以，無論我們選擇的「毒品」是什麼——我們每個人都有點不同——初次接觸都很重要。