Dopamine Nation: Finding Balance in the Age of Indulgence

Lembke begins this chapter by mentioning Jacob once again. He reached out to her because he once again resorted to his compulsive behavior. He describes a near-constant bombardment of temptation. She implored him to dismantle and throw away his machine as soon as possible. Lembke uses this anecdote to introduce the concept of self-binding, a process whereby a person with an addiction or other compulsive behavior intentionally creates a barrier between themself and the drug or behavior. As an example, Lembke alludes to the example of Odysseus, who had his men literally bind him so that he wouldn’t be tempted by the Sirens. She then discusses a patient named Oscar, a patient with alcoholism whose wife had locked away all alcohol in his house. However, one day he noticed a liquor cabinet partially open, and proceeded to drink a bottle of wine through a straw. The simple sight of the wine created an irresistible temptation that caused Oscar to find a way around the obstacle of the locked alcohol. She discusses a pharmacological intervention, a drug called naltrexone, which imposes a similar kind of binding effect on a person at the cellular level, and is used to treat opioid and alcohol addiction.