Anna Lembke

And from a survival point of view or an evolutionary point of view, our brains want us to make connections to other people because we're more likely to find mates, more likely to be able to protect ourselves from predators, more likely to be able to steward scarce resources.

So our brains get us to make those connections by releasing dopamine and making sure that it feels good.

The problem with addiction is that essentially our substance or behavior of choice comes to replace those human connections.

And so we move further and further into isolation and we meet those basic needs through our drug rather than through making deep human connections.

And so part of getting into recovery from addiction means moving out of isolation and trying to make deep and rewarding intimate connections with other people, because essentially that's what we're really looking for.

But we get fooled by these kinds of false stand-ins for human connections.

So AA, Alcoholics Anonymous and Narcotics Anonymous, in my opinion, are among the most remarkable social movements of the last 100 years.

These are amazing grassroots organizations composed of people with addiction trying to help other people with addiction.

And it's remarkably successful for those who actively participate.

So you'll read a lot in the media now about

how AA and other 12-step organizations don't work, but that's not really a faithful representation of the evidence.

There are many people who will not participate or get anything out of it, but for those who actively participate, engagement in AA and other 12-step groups is as effective and possibly even more effective than professional treatment.

So what is the secret of these 12-step groups?

Well, first of all, they provide a sober social network.

They provide a specific path for recovery.

But importantly, they're also really de-shaming because you realize, oh, wow, I'm not the only one.

And like I have this thing that happened to my brain because I'm human and I have this particular vulnerability and other people have experienced and done similar things that I have done in pursuit of their drug.

And that is an incredible burst of intimacy and yes, dopamine, right?

That we get then from being taken into the fold of like-minded individuals who understand us and accept us in all our brokenness.

Yeah, so this was really something that I learned from my patients.