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《多巴胺國度：在縱慾年代找到身心平衡》（DOPAMINE NATION: Finding Balance in the Age of Indulgence）
安娜．蘭布克醫師(Dr. Anna Lembke) 著
鄭煥昇 譯
美國暢銷20萬本
成功戒癮的經典之作
揭露人們在慾望國度中的瘋狂歷險、
所付出的代價，以及，如何平安歸來。
滑手機、瘋購物、狂自慰，
我們身處誘惑太多的時代，早已成癮卻無法自拔。
這本書要談成癮的爽、戒癮的痛，
以及爽痛之間如何取得平衡。
滑手機、熬夜追劇、大吃大喝、瘋狂消費，成為辛苦一天之後必備的自我慰勞；然而，我們已經網路成癮、購物成癮，或是酒癮、性成癮上身，卻不自知。
這不是我們的錯，而是多巴胺（dopamine）的問題。
多巴胺是一種神經傳導物質，又稱為「腦內啡」，要讓大腦釋放多巴胺很簡單，只要你做一件事情能讓自己開心就行了，像是上網、吃喝玩樂、盡情購物。不過，多巴胺會逐漸減少，需要更多的慾望、更強的刺激才行，也因此讓人愈來愈痛苦。
如果我們發現自己上網時間愈來愈長、暴飲暴食的次數愈來愈多、喝下肚的酒愈來愈烈、購物次數愈來愈頻繁，很有可能已經成癮。
安娜‧蘭布克醫師（Dr. Anna Lembke）是史丹佛大學醫學院精神科暨成癮醫學教授，也是史丹佛戒癮診所的主任，她以協助成癮者戒癮的多年經驗，在徵得病患同意之下，將她協助酒癮者、毒癮者、性成癮者如何戒癮的案例納入本書，詮釋慾望的來源、成癮的問題和戒癮的過程。
蘭布克醫師指出，在我們的腦中，爽快和痛苦如同翹翹板的兩端，當一端受到過度刺激，另一端就會翹起，多巴胺分泌的多寡影響爽與痛的平衡，一旦打亂，就會導致爽痛失衡。
她坦言，自己曾經有一段時間沉迷於閱讀網路言情小說，這個經驗讓她更了解，多巴胺導致我們在成癮的爽快與戒癮的痛苦之間擺盪。她發現，如果「痛」是為了「爽」而必須付出的代價，「爽」就是「痛」過之後兌換到的獎勵。
蘭布克醫師在書中整理出一套方法協助成癮者有效戒癮，這八個步驟的英文首字剛好對應多巴胺 DOPAMINE，包括：資料（Data）、目的（Objectives）、問題（Problems）、禁慾（Abstinence）、正念（Mindfulness）、洞見（Insight）、下一步（Next steps）和實驗（Experiment）。
身處充滿各種刺激的環境之中，究竟我們要如何不受到多巴胺過度控制，在成癮的爽快和戒癮的痛苦之間取得平衡？答案就在這本書。
｜各界好評｜
►《多巴胺國度》從成癮科學的角度，告訴讀者如何逃離那樣的無間地獄，回歸生活中的單純快樂，並承受適度的痛苦，以找回身心的平衡狀態。
——沈政男｜精神科醫師、專欄作家
►成癮就像是一個光譜，在重度成癮和絕對無癮的兩端之間，每個人都可以找到自己的位置。這本書讓我們知道，只要依循著適當的步驟、付出足夠的努力，就有可能調整自己在成癮光譜上的位置，而不是永遠被多巴胺牽著鼻子走。
——蔡振家｜臺灣大學音樂學研究所專任教師、神經生物與認知學研究中心成員
►我很喜歡《多巴胺國度》作者安娜‧蘭布克提到：正念（mindfulness）為什麼是需要的？因為正念把我們拉回基準點。換句話說，如果你處在負向的痛苦狀態，不要急著讓自己立刻變回正向的開心狀態，而是要先回到零點（基準點）的平靜狀態。
在平靜狀態之下，才有機會細細感受與覺察，自己想要什麼、什麼才是好的、有意義的。看見自己真實的內在，才能走向真實的快樂。
——蔡宇哲｜「哇賽！心理學」創辦人兼總編輯
►安娜‧蘭布克深刻地理解一種我常在診療室裡聽到，存在於現代人癮頭與我們原始大腦交會處的經驗。她在書中講的是她如何導引人在快感與痛覺中找到平衡與健康的故事，而那些故事都有著能改變你生命的力量。
——洛瑞‧戈特利布（Lori Gottlieb）｜《大西洋雜誌》「親愛的心理師」專欄作家、《紐約時報》暢銷書《也許你該找人聊聊》作者
►就在你以為自己對成癮危機已經瞭若指掌的一瞬間，安娜‧蘭布克醫師橫空出世，帶來了她第一本的成癮主題傑作，但這一次她書中的主角不是毒品，而是大腦中的化學物質之王：在人腦中統治痛覺與爽感中心的多巴胺。
在一個消費過度與慾望必須即刻獲得滿足的時代裡，《多巴胺國度》說明了一旦人一次次控制不住自己的癮頭，個人與社會要分別付出什麼樣的代價——而我們又要如何去讓這狀況得到控管。不論你發現自己身陷其中而無法自拔的東西是什麼——從網路成癮、爆食、工作狂到性成癮。
這本書都會讓你覺得欲罷不能、恐怖絕倫、一針見血、入木三分。蘭布克不疾不徐地在故事裡穿插著研究中的學理，銳利的眼光中聽得出她口氣中的同理。
——貝絲‧梅西（Beth Macy）｜《華盛頓郵報》年度好書、《紐約時報》二○一八年矚目好書暨暢銷書《毒役：經銷商、醫生和讓美國人上癮的毒品公司》（Dopesick: Dealers, Doctors, and the Drug Company That Addicted America）作者
►我們都渴望掙脫日常中的一成不變，都想不再為某部分的生活所苦。但如果，我們面對這些不變與痛苦不用再逃避呢？要是我們可以學著去面對它們，可以跟我們自己，也跟我們的生活伴侶達到一種和諧的狀態呢？蘭布克用這本書，從根本上改變了我們看待心理疾病、快感、痛覺、獎賞、壓力的方式。轉身面向這一切，你將會有慶幸的感覺。
——丹尼爾‧列維廷（Daniel Levitin）｜《紐約時報》暢銷書《大腦超載時代的思考學》（The Organized Mind）與《成功地老去》（Successful Aging）
►本書探索了一組楚河漢界，一邊是一針多巴胺打進身體的感覺，那針頭可能是手機、是賭博、或是一大袋樂事玉米片，另一邊是在健康、正向、穩定的生活中持續往前。
——《紐約時報》「暢銷書清單的內幕」（Inside the Bestseller List）專欄
►令人耳目一新地調查調查了快感的尋求與成癮現象……但凡想找到平衡點的讀者，都終究會發現蘭布克的導引令人恍然大悟，讀來直叫人欲罷不能。
——《出版人週刊》（Publishers Weekly）星級書評
►個案故事精采淋漓，因應之道精闢成理。
——《科克斯書評》（Kirkus Reviews）
｜目次｜
【推薦序】
超脫上癮與戒斷的輪迴，找回身心的平衡狀態 文／沈政男
疼痛的快感，何其痛快！ 文／蔡振家
看見真實的內在，走向真實的快樂 文／蔡宇哲
【前言】真正的問題
第一部：追求快感
第一章：我們的自慰機器
第二章：逃離痛苦
第三章：爽與痛的平衡
第二部：自縛
第四章：多巴胺的齋戒
第五章：空間、時間與意義
第六章：壞掉的天秤？
第三部：自討苦吃
第七章：朝痛端往下壓
第八章：徹底的誠實
第九章：利社會的羞恥
結論：爽痛平衡教會我們的事
作者的話
致謝
作者簡介
圖表索引
｜引言｜真正的問題
爽一下，爽一下，全世界的錢都花在爽一下。
—美國音樂人兼演員李翁．赫姆（Levon Helm）
這本書要談的是爽。這本書要談的是痛。最重要的是，這本書要談爽跟痛之間的關係，也要談對這層關係的了解何以已經是我們要把日子過好的必備條件。
為什麼是必備條件？
因為這個原本匱乏的世界已經在我們的改造下，變成一個東西充足得不像話的地方：藥物、食物、新聞報導、博弈、血拚、電玩、訊息、性愛訊息、刷臉書、曬IG（Instagram）、當油土伯（YouTuber）、發推特（Twitter）……今日各種高回報刺激的數目之多、種類之繁、效果之強，在在都令人嘖舌。智慧手機是現代版的皮下注射針頭，一天二十四小時且全年無休地輸送數位多巴胺給這個連網的世代。別擔心你還沒找到合胃口的毒品，新產品很快就可以供你在附近的官網上下訂。
多巴胺是科學家所倚賴的一種「泛用貨幣」，有了它科學家便能測量出人類任何一種經驗的成癮潛力。大腦的獎勵路徑中測得愈多多巴胺，該項經驗的成癮性就益發可觀。
除了多巴胺以外，近一世紀神經科學上的另一項重大發現是大腦處理爽跟痛是在同一個地方。再者，爽跟痛的運作就像是翹翹板的兩端。
我們都知道那種馬上想再來一片巧克力蛋糕，或是巴不得一本好書、一部電影、一款電玩能延續到天荒地老，永遠不要完結的感覺。「想要」的那個瞬間，就是腦內的翹翹板從爽倒向痛的同一個瞬間。
這本書想做的，是為大家開箱「獎勵」當中的神經科學，並在這麼做的過程中讓我們找到痛與爽之間一個更理想、更健康的平衡。光談神經科學是不夠的。我們還需要血肉之軀的實際生活經驗。試問想找人來教導我們克服有如強迫症的過度消費，還有誰能贏過對其最沒有抵抗力的那群人呢？沒錯，我說的就是成癮者。
這本書根據的是我病人的真人真事，是他們從不敵癮頭到尋得出路的實際過程。他們慨允我訴說他們的故事，才讓各位跟我一樣，都能從他們的智慧中獲益良多。有些故事可能會讓你大驚失色，但對我而言這些故事完全可能發生在我們身上，頂多是極端一點而已。一如集哲學家與神學家於一身的肯特．鄧寧頓（Kent Dunnington）寫道，「重度成癮的人是當代的預言家，不把他們當回事，沒有好下場的是我們，因為他們反映的正是我們真實的面貌」。
不論是糖分還是購物、偷窺還是電子菸，社群媒體貼文或是《華盛頓郵報》（Washington Post），我們沒有人不做著自己引以為恥或覺得後悔的行為。這本書想教大家用務實的方式去管理過度消費的衝動，畢竟我們已經處在一個不論生活中的哪一方面，無一不由消費在推動的世界。
歸根結柢，找到平衡點的祕訣就在於：結合成癮的科學和戒癮的智慧。
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