Garland Jeffreys: New York's 'King Of In Between'

*** TRANSCRIPTION COMPANY BOUNDARY ***
..DATE:
20110623
..PGRM:
Fresh Air
..TIME:
12:00-13:00 PM
..NIEL:
N/A
..NTWK:
NPR
..SGMT:
'The Compass of Pleasure': Why Some Things Feel So Good

TERRY GROSS, host:

This is FRESH AIR. I'm Terry Gross.

When you're eating great food or making love, you're probably not
thinking about what's happening in your brain, but neuroscientists are
investigating that and are discovering the pleasure circuitry of the
brain. That's the subject of the new book "The Compass of Pleasure: How
Our Brains Make Fatty Foods, Orgasm, Exercise, Marijuana, Generosity,
Vodka, Learning and Gambling Feel So Good."

My guest is the author, David Linden. He's a professor of neuroscience
at the Johns Hopkins University School of Medicine. He's also the
editor-in-chief of the Journal of Neurophysiology. We're going to talk
about what happens anatomically and biochemically in the brain when we
experience pleasure and why some pleasures can cross the line into
addiction.

David Linden, welcome to FRESH AIR. So there's a region of the brain
that registers pleasure. Why is it a big deal to know that?

Professor DAVID LINDEN (Author, "The Compass of Pleasure: How Our Brains
Make Fatty Foods, Orgasm, Exercise, Marijuana, Generosity, Vodka,
Learning and Gambling Feel So Good"): Well, it's a big deal to know that
because this is the center of so much of what makes us human. It turns
out that this very anatomically and biochemically defined section of the
brain, which we call the medial forebrain pleasure circuit, and not to
get too technical here, medial just means it's in the middle of the
brain, and forebrain means it's in the front of the brain.

And this region of the brain, which is crucially dependent upon the
neurotransmitter dopamine, is absolutely essential to our evolutionary
survival. Not surprisingly, it's an evolutionarily ancient region, and
it exists originally because we want eating food and drinking water and
having sex to be pleasurable in order to have children and propagate our
genes in the next generation.

GROSS: Now, you say that there's all kinds of pleasure that registers in
that part of the brain, ranging from orgasm to eating, shopping, even
prayer, meditation, giving to charity.

Prof. LINDEN: Yes, this is entirely true. And so obviously some of these
things that we can do in humans - and with humans we do these
experiments with people in brain scanners.

So, for example, if we were doing an experiment and we had you in a
brain scanner, and you were really hungry, and then we gave you a bite
of a food that you found absolutely delicious, we would see these
regions in the medial forebrain pleasure circuit light up, meaning that
there was neural activity there, as you took that first bite of food.

And just as your subjective experience of pleasure is that the first
bite is great and the second bite is a little less, and then as you eat
and you become sated, the last bite is okay but not nearly as the first
bite, that would be reflected in the pattern of brain activation. We
would see strong activation in the first bite and subsequently weaker
activation as time went on.

What is surprising and what has emerged more recently in a lot of
research is that behaviors that societally we consider virtuous also
cause activation of the pleasure circuit, and I'm talking about things
like exercise and charitable donation and learning.

So a fascinating experiment was done at the University of Oregon, where
they gave subjects real money, and they said: Okay, here's your money.
You have the choice of giving donations to a food bank, or you can keep
the money for yourself, and we've set this up so that no one will ever
know what you did. It's all controlled by computers. None of the
experimenters will know at all.

And this was the truth. And what they found was that in the majority of
the subjects, not all of them, but in the majority of them, even
anonymous charitable donation was associated with activation of the
pleasure circuit.

And I think it's crucial that this is anonymous because we're deeply
social beings, and so one motivation to give to charity is to have
others think well of us - and having others think well of us does
activate the pleasure circuit - but in this case that was taken out of
the equation.

GROSS: Now as you point out, the dark side of pleasure is addiction.
Does something different happen in the pleasure circuits of the brain
when you're addicted to heroin than when you're, say, giving to charity
and getting pleasure out of that or, you know, eating good food and
getting pleasure out of that?

Prof. LINDEN: Well, I don't know anyone who has become addicted to
giving to charity, although I suppose it's theoretically possible.
Almost all things that activate the pleasure circuit, not all, but
almost all, are potential substrates for addiction. But some things have
a much greater potential for addiction than others.

Nicotine, for example, is extraordinarily addictive. So 80 percent of
all people who ever try cigarettes will become nicotine addicts, whereas
about 30 percent of all people who inject heroin in their arms will
become heroin addicts.

You can become addicted to all kinds of behavioral things. You can
become an exercise addict or a gambling addict or a sex addict, as well.

GROSS: So let's look at drugs for a second. Take nicotine. You say it's
very addictive. Eighty percent of the people who start smoking become
nicotine addicts. Is that what you said?

Prof. LINDEN: That's right. And in a way, this is deeply
counterintuitive, right? Because the psychoactive pleasure effect, the
pleasure buzz that you get from the puff of a cigarette is very subtle,
whereas the pleasure buzz that you get from a shot of heroin is quite
profound. So I think it's worthwhile to back up and talk about the
pharmacology of the pleasure circuit just a little bit.

GROSS: Yeah, go ahead.

Prof. LINDEN: So not every psychoactive drug activates the pleasure
circuit. So alcohol and nicotine and heroin, cocaine and amphetamines
and cannabis all do, but the hallucinogens, LSD and mescaline do not,
and certain tranquilizers do not. And there is a perfect correlation
between those drugs that activate the pleasure circuit and those drugs
where there is some risk for addiction.

So LSD and mescaline and certain tranquilizers are not ever addicting,
whereas these other drugs have various rates: heroin, 30 percent;
nicotine, 80 percent. Why is that?

GROSS: Let me offer you my guess first.

Prof. LINDEN: Yes, please.

GROSS: That people know heroin is really dangerous and it could ruin
your life, whereas nicotine, it's dangerous, but you're not going to be
a junkie in the streets looking like a toothpick and having sores all
over and having to go to horrible neighborhoods to see a drug dealer,
spending all your money on heroin. Do you know what I'm saying? It's
like there are behavioral reasons. There are social reasons. There are
prison reasons why it's easier to smoke than do heroin.

Prof. LINDEN: Well, that's absolutely true. And if heroin is illegal and
harder to come by, you're less likely to do it than something that you
can just buy at the filling station.

GROSS: But there's more, right?

Prof. LINDEN: But there's more. So there's a neuropharmacological
reason. So, addiction is a form of learning. When we, for example, puff
on a cigarette or inject heroin in our arm, we are developing
associations between the act of puffing or the act of injecting and all
the other sensory information that's around, the sights and the smells,
the people we're with, the music we're hearing, the room we're in, the
situation that surrounds us and the pleasure that is produced as a
result of puffing that cigarette or injecting that heroin.

Now, imagine by analogy that we have a dog and we want to train our dog
to come when called. And we have a 10-ounce steak that we're holding
behind our back and we call: Come, Rover. Come, Rover. And after a
little while the dog comes and we give the dog the 10-ounce steak, and
the dog eats the steak, and then that steak is gone for the next 12
hours. We don't have another steak to give.

And that's more or less the situation with heroin. It's a very large
reward, but even a stoned junkie is unlikely to shoot up more than three
times a day. So it's very intermittent.

Now, imagine by contrast a pack-a-day cigarette smoker; 20 cigarettes in
a pack, about 10 puffs per cigarette. So imagine by analogy you've got
your steak and you've cut it into 200 tiny little pieces and you have
them in a sack behind your back. Come, Rover. Rover comes, there's a
tiny morsel of steak and you repeat that 200 times. Well, by the end of
the day, that dog will have learned to come when called.

And consequently, when we smoke cigarettes, and we have extremely
reliable small rewards over and over and over again that are associated
with the act of puffing the cigarette, we are extraordinarily good
trainers of our inner dog, and that is one primary reason why cigarette
smoking is so addictive.

GROSS: So could you describe in simple words that we could understand
what nicotine is doing to your brain when you smoke?

Prof. LINDEN: Right. Well, so I think there's two parts to the question:
What is it doing on the short term, and what is it doing on the long
term? So on the short term, nicotine, when you take it into your lungs,
it passes into your bloodstream, and it passes from your bloodstream
into your brain, and then within the brain, it binds specialized
receptor molecules on the surface of neurons within your pleasure
circuit.

And through an indirect set of biochemical steps that I'll skip over, it
causes dopamine-containing neurons within that circuit, within a brain
region called the ventral tegmental area, to fire more strongly and
release dopamine, and it is that dopamine release that gives us the
pleasure buzz from nicotine.

So there are some drugs, like cocaine and amphetamines, that directly
affect the dopamine levels, and there are others, like cannabis and
nicotine and alcohol and heroin, that affect it indirectly. But the
final common denominator of pleasure on a biochemical level on the brain
is dopamine release within this particular pleasure circuit.

GROSS: If you're just joining us, my guest is David Linden, and he's a
neuroscientist who teaches at the Johns Hopkins University Medical
School. And he's also the author of the new book, "The Compass of
Pleasure: How Our Brains Make Fatty Foods, Orgasm, Exercise, Marijuana,
Generosity, Vodka, Learning and Gambling Feel So Good."

Let's take a short break here, and then we'll talk more about the
pleasure circuits of the brain, addiction and other related things. This
is FRESH AIR.

(Soundbite of music)

GROSS: If you're just joining us, my guest is David Linden, author of
the new book, "The Compass of Pleasure: How Our Brains Make Fatty Foods,
Orgasm, Exercise, Marijuana, Generosity, Vodka, Learning and Gambling
Feel So Good." He's a professor of neuroscience at Johns Hopkins
University School of Medicine.

Now, you write that people assume that drug addicts become addicts
because they derive greater reward from getting high than other people
do. But you say the biology says no, drug addicts actually seem to want
it more, but like it less. Would you explain that?

Prof. LINDEN: Yeah, I mean, I think it's very compelling notion not just
for drug addicts, but also for any kind of addict - a gambling addict or
a sex addict. Well, why are you an addict? Well, that person must really
love getting high. That person must really love gambling and get so much
pleasure out of it. That person must really love sex, more than the rest
of us do, and so that's why they're motivated to do it more and more.

And the converging evidence from many different studies, both in humans
and in animal model systems, is that it is precisely 180 degrees the
opposite. That is to say, there are variants in genes that turn down the
function of dopamine signaling within the pleasure circuit. That blunts
the pleasures that are felt.

And when you carry these gene variants, and you have a blunted dopamine
system, a blunted pleasure circuit, the result of that is that in order
to seek the same set point of pleasure that so-called normals would be
able to achieve with moderate indulgence, you have to, on the other
hand, overdo it.

In order to get to that same set point of pleasure that others would get
to easily, maybe with two drinks at the bar and a laugh with friends,
you need six drinks at the bar to get the same thing.

GROSS: Is that why a lot of people describe drinking, smoking, taking
drugs as self-medicating?

Prof. LINDEN: I don't know if that is entirely the reason, but it would
be a reasonable explanation. In this case - I think when people use the
term self-medicating, usually they are referring to something like
dealing with stress in their lives.

GROSS: Depression.

Prof. LINDEN: Or dealing with depression. And this isn't precisely that.
This is something that - this is mostly something that you're born with.
That said, a big determinant of the development of addiction is stress.
So we know that predisposition for addiction, whether it to be drugs or
these behavioral addictions we've mentioned, is roughly speaking, about
40 percent genetic.

And the remainder is a number of life experience factors, but the most
important of those life experience factors is stress. And when we talk
about stress, you might imagine that we have moved into an airy-fairy
realm of psychology that this biology professor has now taken off his
white coat and put on a paisley jacket. But that's not the case at all.
Stress is a distinct biological phenomenon.

When you are stressed from having an argument with your sweetheart or
with your boss, or you're fighting off an infection, stress hormones are
secreted by your adrenal glands that sit on top of your kidneys, and
they pass into your brain, and they bind stress hormone receptors on
neurons in your pleasure circuit, and they set in motion a series of
biochemical steps that end with...

GROSS: Ice cream. I'm sorry, go ahead.

(Soundbite of laughter)

Prof. LINDEN: Cravings for ice cream or gambling or cocaine or whatever
your particular pleasure might be.

GROSS: So you're saying that stress does something biochemically that
makes us crave pleasure more?

Prof. LINDEN: It does. And this is important not only in determining the
onset of pleasure-seeking behavior, but in addicts who are trying to
stay clean. Anyone who is an addict, who is trying to stay clean or who
works with addicts or has one in their family knows that relapse doesn't
tend to happen when everything's going great, right? Relapse happens
when there's a stressful situation. And we now understand the biology of
this.

And we don't need a biologist to tell us that stress is a trigger for
relapse, but when we understand the biology of it, this underscores some
strategies that we can do. And some of these strategies are simple
behavioral things.

So if you're an addict trying to stay clean, you are very well-served by
adopting behavioral strategies that reduce stress, whether that is
playing with your dog or prayer or meditation or exercise. And what it
means is that if you're a drug company trying to develop therapies to
help addicts stay clean and reduce their chance of relapse, then one
good way to do that is to try to biochemically interfere with the
binding of stress hormones to their receptors on the neurons in the
pleasure circuit in the brain.

GROSS: So knowing that addictive substances actually arouse the pleasure
circuitry of the brain, what implications are there for that, do you
think, in how we deal with addiction?

Prof. LINDEN: Well, I think the thing to realize is that there is a
common story for all kinds of addictions. So let's imagine a little
thought experiment. We have three autobiographies of addicts lying on
the table before us, and one is the autobiography of a heroin addict,
and one is a gambling addict, and one is a sex addict.

And then we hire research assistants to go through and, before we read
these autobiographies, remove all the specific references to the
particular addiction, to gambling or heroin or sex. And then we read all
these stories. And what we find is that actually there is the same story
arc in all of them, and it goes something like this.

Well, I did this particular thing, and it was pleasurable. So I did it
some more, and it was really good. And so I started doing it all the
time, and as I did it all the time, I found that I developed tolerance
so that I needed higher doses or more frequent behavior in order to feel
as good, as high, as much pleasure as I did before.

But then what happened, as I started to do it more and more, gradually
my liking got transformed into wanting, and in the end, I wasn't doing
this thing for pleasure at all. I was just doing it not to feel bad,
just to be able to get up in the morning, to fall asleep at night, to
have an appetite, to eat food, to face the day, to not have shakes and
chills and tremors and anxiety attacks.

And so this transformation of liking to wanting that occurs in all forms
of addiction has an underlying biology to it, and not surprisingly, that
biology occurs within the pleasure circuit.

GROSS: What's going on?

Prof. LINDEN: Well, so what's going on is that during this process,
there are physical changes of neurons within the pleasure circuit. We
know that neurons receive chemical signals from their neighboring
neurons at structures called synapses. And those synapses can either
work with low efficiency or high efficiency.

And we know that the synapses that use the neurotransmitter glutamate,
which is excitatory, start to work with much higher efficiency, and we
believe that these are some of the changes that underlie the conversion
from liking to wanting, that underlie the development of cravings and
that make it so that when you're an addict, and even you have stayed
clean for months and years, your brain is forever changed. You are never
going to be like someone who was never an addict.

And if you should fall off the wagon and take a drink, for example,
after three years of sobriety, that first drink is going to feel better
to you than it does to anyone else, and that's not just a psychological
phenomenon, that's because addiction has physically rewired your brain.

GROSS: My guest, David Linden, will be back in the second half of the
show. His new book is called "The Compass of Pleasure." He's a professor
of neuroscience at the Johns Hopkins University School of Medicine. I'm
Terry Gross, and this is FRESH AIR.

(Soundbite of music)

GROSS: This is FRESH AIR. I'm Terry Gross. We're talking about the
pleasure circuitry of the brain, what happens anatomically and
biochemically in the brain when we experience pleasure, and why some
pleasures can turn into addiction.

My guest, David Linden, is the author of the new book "The Compass of
Pleasure." He's a professor of neuroscience at the Johns Hopkins
University School of Medicine, and is the editor-in-chief of the Journal
of Neurophysiology.

Let's pick up where we left off. Linden was describing how addiction
actually rewires your brain.

Dr. LINDEN: It physically rewires our brain and I think this is crucial
in terms of the way we think about how our attitude towards addicts and
our laws and our policies – our public policies about addiction - should
be created.

When you understand the biology of the pleasure circuit and when you
understand how the contribution of genetics, and stress, and life
experience - actually even starting in the womb and going forward - all
come together. The end result is that you have to realize that any one
of us, any one of us, could be an addict at any time. Addiction is not
fundamentally a moral failing. It's not a disease of weak-willed losers.
When you look at the biology, the only model of addiction that makes
sense is a disease-based model and the only attitude towards addicts
that makes sense is one of compassion.

GROSS: So as a neuroscientist, should I presume that you're against
imprisonment for drug addiction, for carrying drugs, as opposed to
rehab?

Dr. LINDEN: Oh, absolutely. There should be - simple possession should
never be dealt with predominately in the penal system. It is a medical
phenomenon. Now I think some people might say oh, well, look, you know,
you're just a bleeding heart liberal. You are making excuses for
antisocial behavior of addicts. And that's not the case at all. I mean,
let's look at another disease that also has a heritable component. If
you have heart disease, you go into your doctor and you learn that you
have heart disease. We don't say well, you have heart disease. You suck.
You are morally unfit. You are weak. No. We say well, you have heart
disease. But now that you know you have heart disease you have certain
responsibilities. You should eat a healthy diet, and you should
exercise, and you should see your cardiologist and you should take your
meds. And if you don't do those things, it's not society's problem, it
is your own darn fault.

And that should be our same attitude towards addicts. We should say
okay, well, you're an addict. You have something wrong with your brain
the way this other guy had something wrong with his heart. But it's not
a free ride. Now that you know you're an addict you better get in
treatment. You should do stress reduction strategies. You should avoid
the triggers for your addiction. You should be in a group that can offer
you social support. And if you don't do those things it's your own darn
fault.

GROSS: So punish the addict when the addict commits a crime, but not for
using or holding.

Dr. LINDEN: That's certainly my view and I would say it is the dominant
view in the medical world.

GROSS: Mm-hmm. So, you know, we've talked about drugs. We've talked
about nicotine and how they arouse the pleasure circuitry in the brain
and what happens chemically when you're addicted to a substance. Let's
talk about food. Obesity is such a problem in the United States now, and
I think some people feel that they have become food addicts. Food is a
necessity. You have to eat to live. You don't need to take heroine or
nicotine to live, although some people might feel that they do. But I
mean you must eat to survive. So can you make a chemical argument for
food addiction or is it just like food cravings and, you know, that some
people maybe are more wired to enjoy food than others. Is it ever an
addiction, per se? What can you tell us about that?

Dr. LINDEN: Yeah. So basically speaking, most about 90 percent cases of
severe obesity are food addiction. Now you might imagine well, no,
actually it has a lot to do with metabolism. But it turns out that only
about 10 percent of the cases of severe obesity have to do with a
metabolic defect. And if you look carefully, most severe obesity comes
about as a result of overeating. Now you could say well, everybody's got
to eat. And so, you know, overeating is somehow fundamentally different
than gambling, which is not necessary, or taking cocaine or alcohol,
which are not necessary. But what we do know is this: First of all, body
weight is about 80 percent heritable. And actually I should say body
mass index - that is to say the amount of weight that you have for your
height – is about 80 percent heritable. It is one of the very most
heritable human traits that there is.

So what we now know is that the same genetic variants we spoke about
earlier in drug addict, that blunt the dopamine pleasure circuit, also
give rise to over eating. It is, at its root, the same neurobiological
problem.

GROSS: So you're saying overeating actually creates physiological
changes in the brain?

Dr. LINDEN: I'm saying two different things. One of them is that there
is generic variation in your reward circuit that will make it more
likely that you will overeat. The second thing we now know, is that if
you eat certain classes of food, like very sweet things and very fatty
things repeatedly, that this will rewire the pleasure circuit of your
brain that, in a way, that down-regulates your pleasure circuit and will
compel you to seek those things out more and more. So in that sense,
fats and sugars are faintly addictive substances.

GROSS: Faintly addictive.

Dr. LINDEN: Well, they're not addictive in the same way that heroin and
nicotine are. But in the sense that they do rewire your brain's pleasure
circuitry, at least temporarily, yes.

GROSS: So do you think food marketing people are aware of this
neuroscience about the pleasure of high-fat and very sweet and salty
foods and are using that?

Dr. LINDEN: Well, I think they are aware of it. But in truth, you don't
need to know the neuroscience in order to be an effective corporate food
marketer. If you look at the average weight of an American between 1960
and now, it's gone up by an astonishing 26 pounds. And that's not
because American's genomes have changed significantly in that time. It
is entirely a result of 32 ounce sodas and fast food, and food
corporations realizing that certain combinations of flavors and textures
produce craving.

GROSS: Yeah. Let's talk about a couple of those things. You say the
combination of something soft with something crunchy - like say
chocolate chip ice cream or cookie crunch ice cream is going to be more
appealing than just plain ice cream.

Dr. LINDEN: That's right. And we don't really understand the
neuroscience behind this, but one thing is definitely true, we like
certain types of contrasting flavors and textures. So ice cream with
bits of fruit or nut or candy in it, tends to sell much better and to be
much more craveable(ph) than an ice cream that just has a single flavor
distributed, uniformly, throughout it.

GROSS: Now another thing that you mention in your book regarding food,
you say people will eat more if they don't have to work too hard to chew
and swallow. So much of the meat in chain restaurants has been
mechanically tenderized and injected with marinade to dissolve in your
mouth and it's lubricated for swallowing by high water content. You say,
in essence, the factory has done half of your chewing and swallowing for
you, so that you can eat more.

(Soundbite of laughter)

Dr. LINDEN: Well, that's right. That's one of the things that the
restaurant chains have realized. The other thing they realized is that
we tend to finish what's on our plate. So if you put twice as much food
on the plate we're very likely to eat it all up.

GROSS: So what does this lead you to think about how to stop eating a
lot for a lot of fatty, sweet foods if you are overweight and if you
feel it's having a bad effect on your health?

Dr. LINDEN: Well, I think one of the things to do is to try to take your
pleasures broadly. Exercise. Meditate. Learn. Have moderate consumption
of alcohol, moderate consumption of your food. Spread your pleasures
around and that's the way to not become compulsive in any one realm.

GROSS: If you're just joining us, my guest is David Linden. We're
talking about his new book "The Compass of Pleasure: How Our Brains Make
Fatty Foods, Orgasm, Exercise, Marijuana, Generosity, Vodka, Learning,
and Gambling Feel So Good." He's a professor of neuroscience at the
Johns Hopkins University School of Medicine.

Let's take a short break here and then we'll talk some more.

This is FRESH AIR.

(Soundbite of music)

GROSS: If you're just joining us, my guest is David Linden, author of
the new book "The Compass of Pleasure: How Our Brains Make Fatty Foods,
Orgasm, Exercise, Marijuana, Generosity, Vodka, Learning, and Gambling
Feel So Good." He's a professor of neuroscience at Johns Hopkins
University School of Medicine.

What do you think of the new FDA strategy that's going to begin next
year – to have cigarette packs feature not only a written warning, but
images of the damages cigarettes can cause? For example, perhaps they'll
have to show one of nine different pictures. One of them is a picture of
a cancerous mouth with brown teeth and big sore on the lower lip, with
the caption: cigarette causes cancer.

Another is an image of a corpse with the caption: smoking can kill you.
There's one that says smoking during pregnancy can harm your baby. And
there's an image of a baby, of a newborn infant in the ICU.

I know you're dealing with the pleasure circuitry and the effects of
nicotine on the pleasure circuitry. What about those kind of really
negative reinforcement? Do you think that that's helpful?

Dr. LINDEN: It turns out that we already know, in large part, what's
going to happen because this experiment has already been done in Europe.
And in Europe what happens is that when these gory images were first
introduced on cigarette packs it spurred a lot of people to quit, and it
probably dissuaded a lot of people from starting smoking, and that's
great. But what happens over time is that we humans can get used to
anything. Our entire human cognition and sensory systems are not about
detecting what's always there, but about what changes. And so as a
consequence, even these gory horrific images we tend to acclimate to
them. And so their effectiveness, while not going to zero in Europe,
diminishes greatly over time. There's shock value at the beginning and
then we get used to them.

GROSS: Let's talk about sex. I think there's still a debate about
whether there is such a thing as sex addiction or not. So what's your
opinion? You're studying the neuroscience of addiction. Is there sex
addiction?

Dr. LINDEN: Well, sex addiction is real. But sex addiction is rare. I
think most people are understandably very suspicious of the whole notion
of sex addiction. This is, they think oh, well, this is something that
philandering celebrities and their publicists make up as some way of
excusing their antisocial behavior. And the truth is that, just liking
sex a lot, doesn't make you a sex addict. And just cheating or engaging
with prostitutes or other antisocial behavior, doesn't make you a sex
addict. If you are a sex addict, just like a heroin addict, you have
undergone that transformation, from liking to wanting. And so you are at
the point where you are having sex, not because you are deriving great
pleasure from it, but because you need to do that just to fall asleep at
night and wake up in the morning and face the day and not have
withdrawal symptoms. And so sex addiction is real, but it's rare. And if
you look at someone and they are still enjoying their sex, they're not a
sex addict.

GROSS: Why do you think sexually inappropriate behavior seems to be an
attribute of men with power – whether it's celebrity power, political
power? And I don't want to over generalize here, but there has been,
lately...

(Soundbite of laughter)

Dr. LINDEN: Mm-hmm.

GROSS: ...a kind of, you know, rash of these stories becoming public.

Dr. LINDEN: Right. I think the thing to keep in mind is that when you
have genetic variation that gives you a blunted pleasure circuit, and
this drives more pleasure seeking, novelty seeking and impulsive
behavior, these are traits that are, to a certain degree, particularly
in males, adaptive. These are some of the same traits that make people
be innovators and leaders. And they also give rise to impulse control
disorders, whether they are in the realm of drug addiction or sexual
behavior or gambling. And these things are all comorbid.

So what I would say is that it's not an accident. People tend to say,
well, if you're a man of power and you're in this situation and you're
surrounded by people paying attention to you, telling you how great you
are and eager to cover up for your mistakes, and that's all true. But I
think another contributor is that you are likely to have gone to your
position in part because of this novelty-seeking, compulsive personality
that also sows the seeds of these particular antisocial behaviors.

GROSS: Risk-taking is a part of that set of...

Dr. LINDEN: Risk-taking is a deep part of that. Risk-taking, novelty-
seeking and compulsion all come together in a package, and they all
correlate with low dopamine function within the pleasure circuit.

GROSS: Since you have studied pleasure and the pleasure circuitry of the
brain, has that affected your own relationship with pleasure and the
things that you seek or try not to get pleasure from?

Dr. LINDEN: Well, I try deeply to not let it do that. I certainly, when
I'm enjoying a glass of wine, I don't want to be thinking about dopamine
levels. And for the most part, fortunately, I've been able to avoid
doing that. I'm blessed with not having a particularly addictive
personality, although I'm a bit of a hedonist. So it hasn't actually
made too much of an impact on my own life.

GROSS: What do you mean when you say you're a bit of a hedonist?

Dr. LINDEN: Well, I enjoy my pleasures. But I am taking my own
prescription. I am seeking them widely. I am not compulsively indulging
in one to excess. I am spreading them among the vices and virtues.

GROSS: David Linden, thank you so much for talking with us. I wish you
pleasure in moderation.

Dr. LINDEN: Thank you. Thanks for having me on.

(Soundbite of laughter)

Dr. LINDEN: It was indeed a pleasure.

GROSS: David Linden is the author of the new book "The Compass of
Pleasure." You can read an excerpt on our website: freshair.npr.org.

Coming up, rock critic Ken Tucker reviews Garland Jeffreys' first album
of new music in over a decade.

This is FRESH AIR.
..COST:
$00.00
..INDX:
137348338
*** TRANSCRIPTION COMPANY BOUNDARY ***
..DATE:
20110623
..PGRM:
Fresh Air
..TIME:
12:00-13:00 PM
..NIEL:
N/A
..NTWK:
NPR
..SGMT:
Garland Jeffreys: New York's 'King Of In Between'

TERRY GROSS, host:

Garland Jeffreys has released his first album of new music in over a
decade. It's called "The King of In Between." In 1977, he was hailed as
Rolling Stones' best new artist. In recent decades, Jeffreys, a native
New Yorker, has had more success in Europe.

Rock critic Ken Tucker says his new album showcases a lively artist
whose talent is undimmed.

(Soundbite of song, "I'm Alive")

Mr. GARLAND JEFFREYS (Singer-songwriter): (Singing) I strolled on down
to the valley of death. I met the angel and the devil's breath. I can
tell you, I was not alone. It was me and myself and the bright lights
on. Yes. Yes. Yes. It ain't no jive. Grateful I'm here and still alive.
I stumbled all along my path, but I took down notes and I photographed.
I'm alive. I'm alive. Alive. I'm alive. I'm alive. I'm alive. I'm alive.
I'm alive. I'm alive. I'm alive. I'm not dead. I'm alive. I'm alive. I'm
alive.

I continue to tell you my story...

KEN TUCKER: Garland Jeffreys is indeed alive. I took down notes and I
photographed, he says on that song "I'm Alive." It's Jeffreys' precisely
recalled details about a life begun in Brooklyn, studying art history in
college and the decades-long pursuit of rock and roll redemption – if
not stardom - that continues to give his music its fizz. Jeffreys is one
of the few performers who came of commercial age in the era of Bruce
Springsteen who can still make that guitar-based, myth-making impulse
work as intimate art.

(Soundbite of song, "Streetwise")

Mr. JEFFREYS: (Singing) All of my relatives have gone to their peaceful
resting place. (unintelligible) to carry on, to do what's right. Leave a
smile on your face.

And one thing my father said, I looked into his eyes. Then he turned his
head and he said, you've got to be streetwise.

TUCKER: Singing about his own upbringing in New York City and observing
his daughter's walks down what Jeffreys would never stoop to call those
mean streets, he's at once a wary realist and an appreciator of the
culture lurking amidst the potential dangers. The song is called
"Streetwise," a quality Jeffreys possesses in abundance without letting
the swagger overtake his reportorial skills. The music has a cinematic,
string-section swirl that's reminiscent of Curtis Mayfield's soundtracks
for films such as "Superfly" and "Claudine," but bent to his will by his
own guitar hooks.

Garland Jeffreys retains a pride in his roots that's both fierce and
sentimental. Perhaps that's why he had himself photographed on the cover
of "The King of In Between" standing at the intersection of Malcolm X
and Martin Luther King, Jr. Boulevards in Harlem. It's an image echoed
in the music: he's at a crossroads, trying once again to break through
the noise of the music industry while remaining true to his own eclectic
style.

(Soundbite of song, "Roller Coaster Town")

Mr. JEFFREYS: (Singing) New York's my home, and I'm 40,000 yards from
the cyclone. Every time I turn and look around, I realize how much I
love this roller coaster town.

New York's the place where everybody's here from the human race, where
they lift you up when you're feeling down. That's why I love this roller
coaster town.

Going back to Brooklyn...

TUCKER: Jeffreys' music has always been rich with his diverse interest
in all sorts of popular music and his heritage as a man born to a black
father and a Puerto Rican mother. He's written incisive songs about
mixed race and mixed feelings: Too black to be white, too white to be
black, he's said ruefully. And he's never forgotten where he was born:
22 stops on the subway from Manhattan, where he started playing
professionally with jazz and rock musicians. Except for the vehement use
of the phrase rock and roll itself, it's hard to believe this is the
music of a 67-year-old, isn't it?

(Soundbite of music)

Mr. JEFFREYS: (Singing) When the day comes that I'm 64, I won't be one
of those guys who falls on the floor. But if it so happens, I'll pick
myself up and dust myself off and listen some more to the rock and roll
music, rock and roll music. Rock and roll music. Rock, rock, rock, rock,
rock, rock, rock on.

When I'm feeling low...

TUCKER: Jeffreys counts Springsteen as his friend and Lou Reed as on
old-school chum. Reed sings back-up vocals on one cut here. If you
aren't familiar with his music, well, the best compliment I can pay
Garland Jeffreys is to say that his newest album is as good an
introduction to his excellence as the superb album that put him on the
map, "Ghost Writer" in 1977. There are quite a few mentions of mortality
scattered throughout his new collection. On one song, Jeffreys says he
doesn't want to die on stage with a microphone in my hand, but he makes
it sound as though it might be a beautiful way to go. In every respect,
he's not just artfully ambivalent. He's the king of in-between.

GROSS: Ken Tucker is editor-at-large at Entertainment Weekly. He
reviewed "The King of In Between" by Garland Jeffreys.

(Soundbite of song, "God's Waiting Room")

Mr. JEFFREYS: (Singing) Laughing at notion of death. Giddy at the notion
of my very last breath, while the world replicates the feelings of doom.
I'll be standing in line in God's waiting room.

The Staple Singers will be present in my very last dream. Fingers at my
funeral, on guitar is turned up to 16. Nothing really changed in the
colors I see, 'cause I'm laughing at death when God's finger points for
me, in God's waiting room.
..COST:
$00.00
..INDX:
137112172

Transcripts are created on a rush deadline, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of Fresh Air interviews and reviews are the audio recordings of each segment.