CONTENTS

COPYRIGHT

DISCLAIMER

DEDICATION

PREFACE

THE PLAN

PART ONE: FOUNDATION

PART TWO: WHAT ARE SUDUALITY AND SUDISM?

PART THREE: WHY BELIEVE

PART FOUR: THE WORLD THROUGH SUDIST EYES

PART FIVE: RETHINKING PLEASURE AND PAIN

PART SIX: GREAT INDULGENCE, GREAT SUFFERING

PART SEVEN: SOLVING THE PROBLEM WITH SUDISM

ACKNOWLEDGEMENTS

APPENDIX: THE MANY KINDS OF PLEASURE AND PAIN

NOTES

GLOSSARY

SHARE THIS BOOK AND HELP INSPIRE OTHERS

COPYRIGHT

Sudist Books

Canada

Copyright © 2020 by Pierre Dalcourt.

First Edition, June 2020

Copying and distribution of this book, without modification, are permitted in any medium without royalty, provided that no money is charged beyond reasonable and customary charges for reproduction and distribution, and that the book is provided in its entirety including the copyright notice and disclaimer.

For the latest version of the book, please visit https://sudism.org/the-book-of-sudism/

ISBN: 978-1-7772404-0-0

Illustrations and diagrams by Pierre Dalcourt.

The cover photograph of the sandy path is courtesy of Alice Donovan Rouse (aliceprintco.com, Instagram: @alicekatart) via Unsplash.

DISCLAIMER

This book is for informational purposes only and does not constitute medical advice. As such, please consult a qualified physician in matters relating to your health and particularly with respect to any symptoms that may require diagnosis or medical attention. Please also consult a qualified physician prior to altering or terminating the dosage of any medications or other prescribed treatments.

The publisher and the author are providing this book and its contents on an “as is” basis and make no representations or warranties of any kind with respect to this book or its contents. The publisher and the author disclaim all such representations and warranties, including but not limited to warranties of healthcare for a particular purpose.

Although the author has made every effort to ensure that the information in this book was correct at the time of publication, he does not assume and hereby disclaims any liability to any party for any loss, damage, or disruption caused by errors or omissions, whether such errors or omissions result from negligence, accident, or any other cause. Any such errors or omissions, as well as comments or suggestions for improvements, can be reported to the author at the address below.

https://sudism.org/contact-us/

While the author has made every effort to provide accurate Internet addresses at the time of publication, the author does not assume any responsibility for errors or for changes that occur after publication. Further, the author does not have any control over and does not assume any responsibility for third-party websites or their content.

DEDICATION

This book is dedicated to all of us who have suffered unnecessarily, who suffer like this today, and who will continue to suffer this way tomorrow. May each of us come to accept our meaningful suffering, learn how to end our meaningless suffering, and gain the wisdom to tell them apart.

PREFACE

In an alternative timeline, I’ve been dead for over twenty years. In that version of my life, I lost my decade-long battle against severe depression and chronic anxiety, took my own life, and this book does not exist. In the midst of my afflictions, medical doctors diagnosed me and my psychiatrist tried her best to tweak my brain chemistry with one medication after another, but neither ultimately saved me. What did? Of all things, it was philosophy that cured me.

You see, I am not a medical doctor, nor am I a psychologist. But I am a philosopher, a thinker. There is nothing I love more than to ponder, analyze, and solve complex mysteries—from the big old-fashioned jigsaw puzzles of my childhood, to finding the broken piece in malfunctioning software during my former career. This profound curiosity is what drove me to try to figure out why I was suffering so much for so little reason. What could I do but gather as many pieces of the puzzle as I could and try my best to put them all together? What I ended up with I chose to call sudism, a view of life that enabled me to cure myself of nearly all of my own meaningless aches and pains, and which I believe can do the same for you and your loved ones.

This is not a “feel-good” book, yet it will show you how to improve the way you feel. Some of its ideas may seem scary, but have the potential to alleviate chronic fear and anxiety. And, though parts of it may seem utterly depressing, those very parts may hold the key to overcoming severe depression. This book is a paradox.

Though this book is not a medical or psychological guide to chronic pain, I hope you will see that it can be used alongside conventional medical and psychological advice. These disciplines are not mutually exclusive. If you’ve spent a lot of effort obtaining help from conventional sources but have failed to solve your health and wellness issues, this book offers a different perspective and alternative solutions that you can try, starting today.

I hope you find this book transformative, bringing you new ideas and perspectives that might at first seem strange but may eventually change the way you see the world. And so, before opening this book, I would encourage you to open your very own mind.

phi·LOS·o·phy

From the Greek philo (love) and sophos (wisdom).

Simply put, philosophy is the love of wisdom.

THE PLAN

Before we jump in, here is a bird’s-eye view of what we’ll cover:

Part One lays down a foundation of basic but crucial concepts.

Part Two describes sudism and suduality.

Part Three demonstrates suduality in action and why it makes sense to believe in it.

Part Four shows how to leverage suduality to gain a better perspective on happiness, suffering, and help us make better life decisions.

Part Five looks at pleasure and pain from a new perspective, one that many of us may have never considered before.

Part Six looks at the increasing indulgence and suffering of our modern era.

Part Seven shows how to use sudism to reduce or even eliminate anxiety, depression or other chronic pains—even if this pain has resisted all other forms of treatment.

Depending on how much time you have, you can read this book at three different speeds:

1. Slow: For those who have time, energy and want to learn the most, simply read the whole book from top to bottom.

2. Medium: For those with less time or energy but who still desire a thorough understanding, read everything except for the IN-DEPTH sections.

3. Fast: Finally, for those with little time or energy who just want the gist of any given part of the book, skip everything except for the Summary at the end of that part.

The details of all referenced studies, expert opinions, and anecdotal evidence are listed in the Notes.

There is also a Glossary that defines all of the main terminology used throughout the book.

Okay, let’s get started!

PART ONE: FOUNDATION

Introduction—The problem

What about the neuroscientific approach?

What is pleasure?

What is pain?

What is neutrality?

What is affect?

The Pan-Affect Chart—A chart of pleasures and pains

The source of all motivation

Pleasure and pain are all in our heads

What is anhedonia?

What is depression?

We don’t always react the same way to the same thing

What happens when we blend pleasure and pain?

What are negative and positive effects?

Can we measure pleasure and pain?

Conclusion of Part One—Something is missing!

Summary of Part One

Introduction—The problem

Why have I written this book? In my brief time on this Earth, I’ve seen too many people suffering unnecessarily. Some of them are among my friends and family members, while many are strangers both near and far. For a long time I was one of them. By many accounts, people all over the world are suffering more than ever. Danny Penman, an award-winning journalist and mindfulness teacher from the United Kingdom, keenly summarized the problem:

We live in a world filled with material wealth. We have never had so much political and economic freedom. We live longer and healthier lives. And yet, anxiety, stress, unhappiness, and depression have never been more common.

It wouldn’t be terribly inaccurate to call this modern epidemic the Great Suffering of humankind, a phenomenon we’ll examine more closely later on. Why all this suffering? What is going on?

I have a theory. A theory I have been thinking about for over twenty-five years, and have witnessed affecting countless people in countless places. A theory that may seem obvious to some, yet strange or irrational to others—at least at first. But hidden within it lies a powerful tool to reduce or eliminate much of the unnecessary chronic pain and suffering that is plaguing our world today. I call this theory suduality—which rhymes with reality and is pronounced soo-doo-AH-luh-tee.

In this part, we’ll lay down the groundwork for the rest of the book by covering a few basic but highly important concepts.

What about the neuroscientific approach?

Aren’t pain and pleasure controlled by neurons and neurotransmitters? Shouldn’t we be looking there for solutions to chronic pain and suffering?

Well, those little cells and chemicals certainly seem to be involved, but we’re not going to rely on neuroscientific evidence. Why not? Well, up until the 1980s, virtually all neuroscientists believed that dopamine was a “pleasure molecule.” But pioneering work by Kent Berridge, a professor of psychology and neuroscience at the University of Michigan, revealed that dopamine was not linked to pleasure at all, but to desire—which is something quite different. In fact, the idea that a single “pleasure molecule” exists has been thoroughly debunked because researchers have found not one, but at least ten brain regions as well as dozens of neurotransmitters that are linked to painful or pleasant sensations. Furthermore, pain specialists admit that though the very best tools can take accurate pictures of the body and brain, they simply can’t take pictures of pleasure or pain.

For many years, it was believed that “brain chemical imbalances” were the cause of many mental illnesses. But according to several experts in the field, such as psychiatric medication expert Dr. Joseph Glenmullen, author of The Antidepressant Solution, every such theory has eventually been proven false. Our understanding of the brain has changed dramatically over the past few decades and will likely continue to evolve. It could be argued that different nerves and neurotransmitters are not pain or pleasure in themselves, that they are simply messengers that either influence how we feel or are influenced by how we feel. In the end, trying to explain how we feel in terms of brain activity is a lot like trying to explain the phenomenon of consciousness by looking at neurons—at best, it’s incredibly hard, and at worst, virtually impossible.

In simpler terms: there is a soupy mix of squiggly bits floating around in our big mushy brains and we’re still not quite sure what’s going on in there.

Although neuroscience is fascinating, it has no impact on the principles we’ll cover in this book. If we start studying nerves and neurotransmitters, we’ll get lost in endless details and miss the forest for the trees, so to speak. While others may focus on the trees, you and I are about to go thousands of feet up in the air so we can get a good look at the forest.

KEY POINT #3: The precise relationship between brain activity and feelings is still poorly understood, which is why we won’t rely on neurological evidence in this book.

What is pleasure?

When you say “pleasure,” do you just mean simple physical pleasures like eating and lovemaking?

Those definitely count, but limiting ourselves to simple carnal pleasures will overlook many of the rich and subtle varieties of joy that life has to offer. Instead, we’re going to use the broadest possible definition: pleasure is any pleasant, desirable feeling we experience, whether physical, emotional, or otherwise. These positive feelings go by many names, such as joy, elation, rapture, or bliss, and vary in intensity from mild pleasantness to absolute ecstasy.

There are many kinds of pleasure in life. First, there are physical ones, which are closely tied to our bodies. For example:

Feeling toasty and warm

Eating tasty foods

Scratching a maddening itch

Making love

We can also experience emotional pleasures, such as when we:

Are amused by a good joke

Feel proud after completing a challenging task

Listen to music or play games we enjoy

Receive a heartfelt compliment

We can even feel good by:

Recalling pleasant memories

Anticipating good things in our future

These are just a sampling of life’s pleasures. We’ll show a comprehensive list in the upcoming Pan-Affect Chart.

Some of us might feel that pride, eating delicious foods, and enjoying good music can’t all be called “pleasure” because they feel quite different from each other. But they feel different in the same way that red, green, and blue look strikingly different yet are all distinct wavelengths of light. If all pleasant sensations felt the same, well, we wouldn’t be able to tell them apart, would we?

KEY POINT #4: Pleasure is any pleasant, desirable feeling that we can experience. It includes physical sensations—such as warmth and good food—as well as emotional ones—such as feeling successful or enjoying a good laugh.

What is pain?

When you say “pain,” do you just mean physical pain like cuts and bruises?

In the medical field, pain is sometimes defined in a strictly physical sense. But in the context of suduality, pain is any sensation that feels hurtful, bad, wrong, miserable, distressing, or unpleasant. This broader definition includes both physical aches and emotional suffering, and can range from mild discomfort to excruciating anguish.

There are many kinds of unpleasant feelings in life. First, we have physical ones that are closely linked to our bodies, such as:

Hunger or thirst

Strenuous physical effort

Extreme heat or cold

Physical injury or illness

Then we have emotional suffering, such as when we feel:

Angry or irritable

Embarrassed or ashamed

Lonely or rejected

Sad or depressed

We can even feel pain through our imagination, by:

Recalling painful memories of being humiliated or embarrassed

Feeling afraid of bad things that may happen in the future

We’ll see a comprehensive list of pains in the upcoming Pan-Affect Chart.

As with the different kinds of pleasure, some of us naturally feel that loneliness, hunger, itching, and humiliation can’t all be called “pain,” because each of them feels very unique. But sudism sees all unpleasant feelings as part of a single spectrum, like different colours in the same rainbow.

KEY POINT #5: Pain is any unpleasant, hurtful feeling, including physical aches—such as feeling hungry or sick—as well as emotional suffering—such as loneliness or shame. Pain and pleasure are opposites.

What is neutrality?

Now that we’ve defined what we mean by “pleasure” and “pain,” how do we describe those moments when we aren’t feeling anything? Those times when we feel neither good nor bad? Let’s call it neutrality, or feeling neutral. Some may describe it as feeling okay. It is emotional stillness, like a pond with no ripples.

What is affect?

At some point, saying “pleasure and pain” over and over may get a bit tiring. Enter the word affect. In this book, affect is simply a short way of saying “some degree of pleasant or painful sensations.” So, positive affect means pleasure, negative affect means pain, and neutral affect means neutrality.

The Pan-Affect Chart—A chart of pleasures and pains

Note: This section is reproduced from the Appendix at the end of the book.

Pleasure and pain play such a central role in our daily lives. That is why it seemed quite odd that, despite extensive research, I could not find any modern, comprehensive list of all human affects including those that are physical, emotional and intellectual. The closest compilation that I found was over two-hundred years old, for Pete’s sake! So, here is my attempt at compiling such a list. It is essentially a high-level map of all of the fundamental drives that motivate us each day. Green items (in the left half of each column) are pleasures, red items (in the right half of each column) are pains, and opposites are paired up side-by-side.

PHYSICAL ACTIVITY DRIVERS

MENTAL ACTIVITY DRIVERS

Pleasant physical activity

Physical restlessness,
Physical effort

Pleasant mental stimulation

Mirth

Boredom, Curiosity, Mental effort

Physical rest

Physical fatigue

Mental rest

Mental fatigue

THERMAL DRIVERS

SOCIAL DRIVERS

Pleasant core warming

Low core temperature

Pleasant touch

Longing for touch

Pleasant core cooling

High core temperature

Caring for others

Compassion

Pleasant surface warming

Low surface temperature

Feeling cared for

Feeling uncared for

Pleasant surface cooling

High surface temperature

Retribution

Anger

NUTRITIONAL DRIVERS

SEXUAL DRIVERS

Pleasant scents and flavours

Unpleasant scents and flavours

Sexual attraction

Sexual curiosity

Satisfying hunger

Hunger pains,
Stomach overfullness

Sexual activity

Sexual desire,
Sexual overactivity

Quenching thirst

Thirst,
Stomach overfullness

Being in love

Lovesickness

Breathing

Shortness of breath

EXPECTATION DRIVERS

Urinating or defecating

Urge to urinate or defecate

Satisfaction with self

Disappointment in self

Relief from expelling irritants

Nausea and indigestion,
Urge to cough,
Urge to sneeze,

Urge to gag

Satisfaction with others

Disappointment in others

NON-SPECIFIC DRIVERS

OTHER PHYSICAL SAFETY DRIVERS

Joy

Dysphoria

(no opposites)

Headaches
Musculoskeletal pains,
Unpleasant sounds,
Unpleasant brightness,
Other surface pains,
Other physical pains

IMAGINATION DRIVERS (past, present, future)

Remembering pleasure

Remembering pain

Imagining pleasure

Imagining pain

Scratching an itch

Itching

Anticipating pleasure

Anticipating pain

Pan-Affect Chart (version 1.2)

The source of all motivation

Let me ask you this: Why do you do anything you do? Why do you even get out of bed each morning? Think about it for a moment. If you wake up every day in a warm, safe, and comfortable bed, why on Earth would you want to leave it? To start, you might feel an urgent need to use the bathroom! But after a trip to the washroom you could simply lie back down. Later, you might get hungry or thirsty and visit the kitchen, but again you could simply return to your cozy bed. If you have a job or young children, you might start to feel guilty about neglecting your work or your family’s needs. Your significant other might make an appearance at some point to nag you—that is to say, gently remind you, for the third time—about other things you should be doing. Finally, even if all those needs are met, you’ll find that lying around all day eventually becomes intolerable as you become either restless, bored, or lonely. What do all of these motivators have in common—the urge to pee, eat, or drink, and the guilt, loneliness, restlessness and boredom? They’re all different kinds of pain.

On the other hand, you may find yourself leaping out of bed in joyful anticipation of a hearty breakfast, of spending quality time with loved ones, or of the many activities you have planned—in other words, a variety of pleasures you may be looking forward to.

What about these other scenarios: Would you have drunk and eaten as a baby if not for hunger pains and the pleasure of feeding? Would you have searched for a mate if not for the sometimes painful loneliness of being single and the joys of being intimate with one another? Would you and I even exist if it weren’t for our own parents feeling these very same feelings that brought them together?

Some of us may think we simply choose to eat, drink, work, and play. The deeper truth is that our daily choices are heavily influenced by pleasure and pain. Don’t just take it from little old me; big thinkers from Plato to Jeremy Bentham, and from Blaise Pascal to Sigmund Freud have all essentially said the same thing.

Pleasure and pain are all in our heads

Have you ever stubbed your toe or banged your knee against something hard? When your body takes a hit, it seems like the throbbing pain is coming from the part you’ve injured. If you move that aching part, it’ll even feel as if the pain itself is moving around. However, feeling that the pain is outside your mind is, quite simply, an illusion. Certainly, the injured part of you is sending signals to your brain that something is wrong, but it is your mind that chooses whether to translate those signals into a feeling of pain. This becomes obvious when we look at those who’ve lost limbs due to illness or injury. Many amputees still feel phantom sensations in their missing limbs, such as itching—which is maddening because they’re impossible to scratch.

Even if you’ve never lost a limb, researchers can trick you into feeling pain inflicted on a prosthetic arm. How? By placing the realistic-looking arm where your real arm would normally be, then conditioning you to “adopt” the arm as your own, and finally whacking it with a hammer. How can you feel pleasant or unpleasant sensations from a body part that is gone, or a rubber arm that isn’t even yours? Simple: because it is your mind, or your central nervous system if you prefer, that ultimately generates each affective sensation you experience, not your body. “Pain is a construct of the brain,” explains internationally renowned Australian pain researcher (and occasional rubber-arm whacker) Dr. Lorimer Moseley. “Pain is an illusion 100 percent of the time.” Unfortunately, that doesn’t mean we can just wish our pain away. All pain feels very real, but it’s not necessarily coming from where we think it is—that’s the illusion.

It’s tempting to blame things outside our minds for causing any pain we experience, or for not getting as much enjoyment out of life as we’d like. However, this is ultimately incorrect. If anyone ever tells us that our pain is “all in our head,” we should heartily agree. Then, whack their rubber arm for being so insensitive!

KEY POINT #9: Pleasure and pain exist only in the mind, not the body, as illustrated by our ability to feel pain from missing limbs and rubber arms.

What is anhedonia?

John sits at the breakfast table and stares blankly at the pancakes set in front of him, one of his favourite meals since his childhood. Although they’re drizzled with the usual syrup and berries, they taste like cardboard. Later on, one of his favourite songs plays on the radio but he feels nothing. His wife tries to cheer him up with a hug but all he can manage is a hollow smile.

What is wrong with John? John is suffering from anhedonia. Anhedonia is a condition where we feel noticeably less pleasure than a healthy person would usually feel during pleasant activities. When we suffer from this condition, things like eating, socializing, or partaking in favourite hobbies may feel barely enjoyable, or even neutral. Jokes may no longer make them laugh. Anhedonia often goes undetected because it’s not about something that is obviously there. It is about something that is missing. Like many illnesses, it isn’t a black-and-white, “either we have it or we don’t” condition. Rather, it can happen in many shades of grey. If someone has suffered from anhedonia for most of their life, they may have gotten so used to it that they don’t even realize that the pleasure is missing. Can you and I truly be sure that we aren’t suffering from anhedonia to some degree?

What is depression?

Each day, Linda struggles to get out of bed. She is sad and tired most of the time and can’t motivate herself to do much because even simple tasks like showering or getting dressed feel painful and exhausting. She secretly believes that her close friends don’t care about her, so she has been avoiding them and ignores her phone when it rings. Increasingly, she feels she is a burden to her family and is beginning to think that everyone would be better off without her.

What’s going on with Linda? Linda is suffering from depression. It’s tempting to think of depression—sometimes called melancholy—as a single unpleasant feeling. However, depression isn’t one single emotion. Rather, it’s a combination of mood-lowering symptoms that can vary from one person to the next, including the following:

Feeling low, sad, or anxious

Feeling guilty, worthless, or hopeless

Feeling increased irritability

Experiencing increased fatigue or changes in sleep patterns

Having difficulty concentrating, remembering things, or making decisions

Feeling bodily aches and pains, such as headaches or cramps

Experiencing anhedonia

Thinking of committing suicide

So, while an average person might react like this to different life events . . .

. . . someone who’s depressed might experience the exact same events this way:

As you can see, depression brings us down—every point on the affect curve is lower than it should be. We feel less (or no) pleasure from positive events, we feel terrible when there is little reason to, and we feel even worse when bad things do eventually happen.

We don’t always react the same way to the same thing

Ever notice how sometimes you find something—or someone—fantastic, but your friend or lover absolutely despises it? As we’ve probably all experienced, different people can have very different affective reactions to the same thing. For example:

I love mushrooms, but if my daughter has to eat even the tiniest one, she will cry as if it were pure torture.

A few of us love being in front of an audience, while many find it terrifying.

Physical pain “differs enormously among individual patients, even those who appear to have identical injuries or illnesses,” according to the United States (US) National Institute of Health. Douglas Nelson, who spent decades treating musculoskeletal pain and authored The Mystery of Pain, observes that pain tolerance varies wildly and that an “athlete’s pain tolerance [is] off the charts.” There are even a small handful of individuals that can’t feel any physical pain, as we’ll see later on.

Even the same person experiencing the exact same thing at different times might lead to different reactions. How so?

If you’re starving, you’ll probably enjoy an old, dried out stick of celery a lot more than when you’re full. But if you’re depressed, that stick might taste downright awful instead.

If you’re out of shape, you’ll probably find jogging five kilometres a lot more painful than if you’ve been running all of your life.

Finally, on some days you might look in the mirror and think, “Hey, I look pretty good!” But on other days, though not much has changed, you might feel quite ugly.

Ultimately, it is our minds that choose the degree of pleasure or pain we end up feeling. Certainly, our tongue, skin, or eyes may send positive or negative signals to our brains, but our brains in turn can either “dampen the strength” of these signals or “ramp them up,” according to psychologist Beverly Thorn, author of Cognitive Therapy for Chronic Pain. Many factors, including our own thoughts and feelings, influence the level to which those signals are increased or decreased.

What happens when we blend pleasure and pain?

When our daughter turned five, she really wanted to get her ears pierced. So we took her to a tattoo parlour where a very kind, heavily-tattooed man named Tim Bob brought us into a room and laid out his tools. Despite the skill and care he took in performing the procedure, she yelped in pain when her first ear was pierced, then cried inconsolably as he did the other one. Tim Bob then calmly put his tools away and handed her a lollipop. Why? Simple—to help neutralize her pain! Even though the tongue and ears are separate body parts, the pleasant sweetness in her mouth helped to offset the pain in her ears. After that, our little trooper was okay.

Have you ever noticed that, at any given moment, we tend to either feel some amount of pain, some amount of pleasure, or neither—what we call neutrality? In other words, that we rarely feel both pleasure and pain at the same time? This notion didn’t escape the great, ancient Greek philosopher Socrates: “How singular is the thing called pleasure,” he said, “and how curiously related to pain, which might be thought to be the opposite of it; for they never come to a man together.” Even modern researchers concede that pain and pleasure generally offset each other.

Why don’t pleasure and pain typically come to us at the same time? The most reasonable explanation I can come up with is that what we feel at any moment is not simply “pleasure” nor “pain.” Rather, we feel the sum of all pleasure signals we experience at a given moment, minus all pain signals occurring that same moment. Our minds essentially assign negative values to each pain and positive ones to each pleasure, then sums them all up. And since a sum is a single amount, we end up feeling either pain (a negative sum), pleasure (a positive sum), or neutrality (a zero sum).

Although this phenomenon happens often, many of us haven’t quite put our finger on it. Here are a few more examples to illustrate what I call blending, the phenomenon that occurs when pleasurable sensations diminish painful ones and vice versa:

Someone who is hospitalized due to injury may receive morphine to reduce their pain. The patient does not feel both a pleasant morphine high and the injury pain independently—instead, the pleasurable morphine diminishes the pain.

Adding sugar to plain coffee or chocolate reduces or completely masks their bitter taste. Those who dislike bitter foods don’t experience both an unpleasant sensation of bitterness and a pleasant sweetness in parallel.

Laughing has been shown to reduce physical pain, anxiety, and even depression. This is why some say laughter is the best medicine.

Some of us eat when we’re upset, bored, or anxious, which we call comfort eating or emotional eating. Eating our favorite foods can take the sting out of our negative feelings.

IN-DEPTH: Here are more everyday examples of blending:

Depression, anxiety, and fear are all known to intensify physical pain.

Many of us listen to music while exercising or doing housework to take our minds off the physical strain, or to make a boring task tolerable. In other words, we use the enjoyment of music to offset our discomfort.

Playing sports or physical games with friends combines the fun of play and the discomfort of physical exertion, with the former offsetting the latter to some extent.

Kids having way too much fun often forget the rules. In other words, the joy of play overrides the unpleasant fear of the consequences of breaking these rules. They sometimes even forget their painful urge to pee!

If we’re uncomfortably hot under our blankets, sticking one arm or leg out—where the air is pleasantly cool—can immediately neutralize the unpleasant heat within the blankets. In other words, instead of us feeling both unpleasantly hot under the blankets and pleasantly cool outside the blanket, one negates the other.

Feeling depressed can cause normally enjoyable foods to taste bland or downright awful. On the other hand, being in a good mood can cancel out minor irritations such that they no longer bother us.

The more we think of the concept of blending, the more we might start noticing it around us. We can blend things ourselves (like exercising while listening to music) or others can blend them for us (like the way candy manufacturers combine sugar and bitter chocolate).

Just to be clear, this is not to say that we can’t feel many conflicting thoughts and emotions at once. We certainly can, such as feeling glad that a close friend found love while also being sad to see them move to another city to be with their loved one. However, our overall point-in-time sensation of pleasure or pain still seems to generally be one or the other, regardless of which mix of thoughts and feelings we are experiencing.

Finally, we should be aware of unblended pleasures and pains. These are positive or negative sensations in their purest form, not combined with any other sensation. For instance, doing strenuous physical exercise without being distracted by music, television, or other enjoyable things would be an unblended pain. It should feel painful every time (to some degree) since there is nothing to offset it. On the other hand, an example of a pure unblended pleasure would be the taste of refined sugar without any other ingredients, emotions, thoughts, or activities mixed in.

KEY POINT #13: Pleasures and pains that occur together usually blend together. If pleasure and pain occur at the same time, the more intense feeling generally diminishes the weaker one.

What are negative and positive effects?

Have you ever experienced morphine or any other opioid? If you’re feeling neutral, a strong shot of morphine can lift you into a euphoric high. On the other hand, if you’ve survived a car crash and lie injured in a hospital bed, the same dose of morphine may simply diminish the pain of your injury without any trace of euphoria. In both cases the morphine had a positive effect on you: it improved the way you felt by making you go from feeling neutral to feeling good, or from horrible to bearable.

Sugar works the same way. We can add it to bland foods to make them taste delectably sweet. But we can also add just enough to bitter foods like cranberries or coffee to neutralize their bitterness without making them taste sweet. In both cases, the sugar had a positive effect on the food’s flavour.

Here’s what these two examples of positive effects look like when plotted on a graph. The dotted line shows how we’d feel without the positive effects while the solid line shows how we’d feel with the positive effects: 

What about the inverse effect? In the same manner as above, adding a bitter ingredient to a sweet food can diminish its sweetness, while adding the same bitter ingredient to neutral-tasting food can make it taste unpleasantly bitter. In both cases, the bitter ingredient had a negative effect on the flavour. On a graph, these negative effects could be visualized like this:

Don’t be misled by the wording: a positive effect does not necessarily mean “good or healthy for you,” nor is a negative effect necessarily bad or unhealthy. These terms strictly refer to changes in affect (that is, pleasure and pain), not changes in health. Affect and health are two different beasts, though they have a very important relationship. We’ll have a closer look at this later on.

KEY POINT #14: A positive effect occurs when we experience an increase in pleasure or a decrease in pain over a period of time. A negative effect occurs when we experience a decrease in pleasure or an increase in pain over a period of time.

Can we measure pleasure and pain?

Over time, scientists have developed many precise instruments to measure various things. We have scales to measure weight, clocks to measure time, and rulers to measure distance. But when it comes to cognitive sciences, how can a scientist objectively measure how someone feels? These days, researchers wanting to measure pleasure, pain, or happiness typically rely on their subjects rating themselves by using a scale from 1 to 10 or by looking at a chart of smiley and frowny faces and picking the one that most closely matches how they feel.

Ideally, someone would invent a portable device that precisely measures the fluctuating pleasures and pains felt by the individual carrying it—a hypothetical gadget I call a sudumeter (pronounced soo-DOO-meh-ter). Unfortunately, no such device currently exists. The closest that scientists have gotten is through functional MRIs (fMRIs), where the patient’s head is inserted in a machine the size of a small garden shed. The fMRI captures images that can be used to roughly predict how much pain the patient felt. However, we have no way of knowing whether the machine is measuring pain itself or merely our brain’s reaction to pain. It turns out that even these large, sophisticated machines are not terribly good at detecting our affect—that is, our feelings of pleasure or pain. In this spirit, the American Academy of Pain Medicine admits that there are no tests or devices that can accurately measure pain, noting that “pain is what the patient says it is.”

Conclusion of Part One—Something is missing!

So far we’ve defined pleasure, pain, anhedonia, and depression, and we’ve touched on a few other concepts. What now? We already understand that pleasure is good, to be sought after, and that pain is bad, to be avoided. Millions of us on this beautiful green planet, maybe even billions, believe the goal of life is to get as much pleasure and happiness as possible while trying our best to eliminate pain and suffering. This belief comes in different flavours, such as hedonism (the selfish pursuit of pleasure) and utilitarianism (maximizing the pleasure and minimizing the pain of a group), which countless philosophers, psychologists, and laypersons of all walks of life fundamentally believe. And I used to be one of them.

But if our minds ultimately choose how much pleasure or pain we feel at any given moment, and the goal of life is to maximize the former and minimize the latter, then why don’t our minds simply give us a constant buzz of pleasure and turn off all our pain? If the mind holds the keys to the vault of infinite happiness, why doesn’t it rush in to grab as much as it can? There is absolutely nothing stopping the mind from flooding us with endless joy—or is there? Why does the mind often make us work so hard just to receive a little serving of pleasure? Why do we spend so much of our lives feeling neutral—that is, neither good nor bad? And why do we feel pain that can be just as intense—if not more so!—than any of our joys? Why do so many people suffer from chronic back pain, depression, or anxiety, for which the very best doctors can’t find a root cause? What on Earth is preventing our minds—the dispensers of pleasure and pain—from reaching the excruciatingly simple goal of infinite pleasure and happiness? Something is clearly missing in this picture. In the following parts, we’ll propose what precisely is that critical missing piece.

Summary of Part One

Here is a summary of all key points from Part One. It can be used as an optional refresher or an executive summary.

#1: By many accounts, people across the world are suffering more than ever from chronic emotional and physical pain. The main goal of this book is to provide both a plausible explanation and a practical solution to this problem.

#2: Sudism is not a medical or psychological approach to understanding and treating chronic pain and suffering—it is a philosophical approach.

#3: The precise relationship between brain activity and feelings is still poorly understood, which is why we won’t rely on neurological evidence in this book.

#4: Pleasure is any pleasant, desirable feeling that we can experience. It includes physical sensations—such as warmth and good food—as well as emotional ones—such as feeling successful or enjoying a good laugh.

#5: Pain is any unpleasant, hurtful feeling, including physical aches—such as feeling hungry or sick—as well as emotional suffering—such as loneliness or shame. Pain and pleasure are opposites.

#6: Neutrality is the state of not feeling any pleasure or pain.

#7: Affect simply means some degree of pleasure, pain, or neutrality. So, positive affect means pleasure, negative affect means pain, and neutral affect means neutrality.

#8: Pleasure and pain are the underlying forces that motivate most, if not all, of our actions.

#9: Pleasure and pain exist only in the mind, not the body, as illustrated by our ability to feel pain from missing limbs and rubber arms.

#10: Anhedonia is a difficulty feeling pleasure in situations that would normally be enjoyable. If we’ve experienced anhedonia for a long time, we may have gotten so used to it that we don’t even realize that we’re suffering from it.

#11: Depression is a condition that causes a combination of increased pains and reduced pleasures (anhedonia) for a period of time. In other words, depression makes pleasant things feel less enjoyable, makes neutral things feel bad, and makes unpleasant things feel even worse.

#12: The experience of pleasure or pain varies widely from one person to the next for the exact same situation, and even for the same person experiencing the same situation at different times. This makes it hard to predict how much pleasure or pain any person in any situation will actually feel.

#13: Pleasures and pains that occur together usually blend together. If pleasure and pain occur at the same time, the more intense feeling generally diminishes the weaker one.

#14: A positive effect occurs when we experience an increase in pleasure or a decrease in pain over a period of time. A negative effect occurs when we experience a decrease in pleasure or an increase in pain over a period of time.

#15: There is currently no such thing as a sudumeter—a scientific device that accurately measures pleasure or pain. When it comes to how we feel, scientists must instead rely on our subjective self-assessments.

#16: If the mind creates all pleasure and pain, and the goal of the mind is to feel happiness, why doesn’t the mind simply give us constant happiness? Why does it choose to make us suffer at all? Something doesn’t add up! As we’ll see shortly, suduality will help explain this peculiar mystery.

PART TWO: WHAT ARE SUDUALITY AND SUDISM?

Introduction—Life is a series of ups and downs

The theory of suduality

A paradigm shift

IN-DEPTH: Why call it suduality?

What is sudism and what are sudists?

IN-DEPTH: Is sudism a philosophy, a science, or a religion?

Conclusion of Part Two

Summary of Part Two

Introduction—Life is a series of ups and downs

Life is a series of ups and downs. I see this in my own day-to-day life. In fact, I’ve yet to meet someone who hasn’t. Here are a few others observing this phenomenon:

“Life is not linear; you have ups and downs. It’s how you deal with the troughs that defines you.”
Michael Lee-Chin, billionaire chairman of National Commercial Bank of Jamaica.

“Don’t struggle about the struggle. In other words, life’s full of ups and downs. So if you’re struggling, don’t worry, everyone else has or will at some point.”
Sean Covey, best-selling author of The Seven Habits of Highly Effective Teenagers.

“I’ve had my ups and downs in my private life.”
Novak Djokovic, the #1 rated tennis player in the world in 2015.

“I’m just like anybody. I have my ups and downs.”
Björk, quirky Icelandic singer/songwriter.

“I’ve had ups and downs, super highs and some really low lows. I’ve been so blessed that I could never say, ‘I wish this didn’t happen.’ It’s part of who I am.”
Jennifer Lopez, Latin American singer and choreographer.

Life is a series of ups and downs.

What is up? Happiness, joy, satisfaction, being in a good mood, having fun with friends, a delicious meal, and so on. In other words, ups are forms of pleasure.

What is down? Suffering, irritability, sadness, depression, frustration, illness, and the like. These downs are various pains.

Do you ever wonder why the best-tasting foods are precisely the ones that are the worst for our health?

Do you ever wonder why most (if not all) medications that help us also come with a long list of unpleasant potential side effects?

Do you ever wonder why we have to struggle through unpleasant physical exercise in order to obtain its many health and mood benefits?

In short, do you ever wonder why “positive” (pleasurable) things often have “negative” (painful) side effects, and “negative” (painful) things often have “positive” (pleasurable) side effects? I see this everywhere I look, over and over.

Life is a series of ups and downs. Why can’t life just be up, up, up all the time? What if there is a good reason for all of this?

What if we couldn’t have more positives (pleasures) without also having more negatives (pains)? What if pleasure and pain were joined together somehow—in other words, united?

Now let’s look at what exactly is this thing called suduality.

The theory of suduality

The theory of suduality is deceptively simple. It can be stated in one sentence:

The amount of pleasure and pain we experience in life are equal to each other.

It is the centrepiece of this book. Virtually everything else in here either leads to it or derives from it.

It could be illustrated with the following simple equation, which we will expand later on:

The theory of suduality says that this equality is true no matter what we do or don’t do, no matter what others do or don’t do, no matter what is our past or our future. It says that in the long run we are locked into a balance of pleasure and pain that we can’t overcome, no matter how hard we try.

The theory of suduality describes pleasure and pain as two sides of the same coin, two edges of the same blade, two equal and opposing forces. It tells us that life is a zero-sum game where we can’t take more of one without also receiving more of the other.

A paradigm shift

Those from Eastern and Native American cultures seem to be more familiar with the idea of pleasure and pain being strongly interconnected since it corresponds with some of their cultural beliefs. Meanwhile, those from Western cultures often find it strange, confusing, and perhaps even absurd. But didn’t Albert Einstein himself once say, “If at first the idea is not absurd, then there is no hope for it?”

Most of us prefer to think we can continually seek and accumulate pleasure or happiness, while doing our best to minimize our pain and suffering. As we’ve seen, this approach comes in different flavours such as self-centered hedonism, or socially-oriented utilitarianism. Indeed, it is appealing to believe that positive and negative feelings are disconnected from each other—that if we simply try hard enough and make the right decisions, we can ultimately get rid of our suffering while gathering as much joy as we can. Part of me would love to believe that too, but there is one little problem: the evidence doesn’t support that idea, as we’ll see in Part Three.

If your initial reaction to the idea of suduality is one of skepticism or incredulity, you aren’t alone. Even I struggled with this idea at first. That being said, I invite you to keep an open mind. As seekers of truth, we must try to be both skeptical and open-minded. When we encounter a strange new idea, we should neither automatically accept it as true nor automatically reject it without giving it a chance. To some, suduality may not seem to make much sense on the surface. But as we dig deeper, we’ll start to see how it helps to explain many seemingly unrelated phenomena. Believing that pleasure and pain are fundamentally interconnected can be challenging. It is a true paradigm shift, not unlike going from believing the Earth is flat to realizing it is round. As the old saying goes, which some credit to nineteenth-century German philosopher Arthur Schopenhauer: “All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.”

KEY POINT #19: Many of us are skeptical of suduality, but a healthy dose of skepticism is a normal reaction to new ideas. For many of us, suduality is a challenging paradigm shift.

In the seventeenth century, legendary philosopher and scientist Sir Isaac Newton developed the theory of gravity, which most of us now accept as self-evident. However, what may surprise some of us is that he was quite reluctant to publish it! Why? Because it relied on the strange idea that—holy cannoli!—a tiny particle could have an effect on another one thousands of miles away, an effect then called “action at a distance.” This concept was so foreign at the time that even Newton described it as “absurd” and was sure that anyone with any intellectual competence would feel the same. On the other hand, the theory at the heart of this book says that if you create a positive effect at a given point in time, it will also create an equivalent negative effect at a different time in your life—again action at a distance, except in this case the distance is across time instead of space. Newton also formulated the third law of motion, commonly paraphrased as “For every action there is an equal and opposite reaction.” In suduality, the parallel is that “for every positive effect there must be an equal and opposite negative effect” in order to keep the two balanced.

In the early eighteenth century, scientists thought electricity consisted of two different fluids—vitreous (positively charged) fluid and resinous (negatively charged) fluid—and believed each could be created independently. However, Benjamin Franklin, one of the founding fathers of America and no slouch of a scientist, carried out a series of experiments on electricity and discovered something interesting: try as he might, he simply couldn’t create a positive electrical charge without creating an equivalent negative charge somewhere else. He called this the law of conservation of charge, a principle that holds true to this day. As a parallel to this conservation law, many people believe pleasure (positive sensations) and pain (negative sensations) can be created and manipulated independently. But suduality tells us that we can’t create a positive effect (i.e. increasing pleasure or decreasing pain) without creating an equivalent negative effect (i.e. decreasing pleasure or increasing pain) somewhere else in our lives. As we’ll soon see, Franklin also believed in the equilibrium of pleasure and pain—what we call suduality.

KEY POINT #20: Suduality proposes that pleasure and pain have the same conservation property as electrical charges.

IN-DEPTH: Why call it suduality?

As we’ll see shortly, the central theory of this book has been around since time immemorial. Curiously, no one seems to have bothered to give this powerful force a name. So I chose to call it suduality. Why? Ancient Buddhist and Hindu thinkers, who originated many theories on pleasure and pain, used the ancient Pali word “sukha” to roughly mean “pleasure,” as well as “dukkha” to roughly mean “pain or suffering.” After some consideration, I chose to combine three words—the “su” from sukha, the “du” from “dukkha” as well as part of “equality”—to make a new word: “suduality.” This also contains the word duality, which implies the state of two opposites. So, suduality represents the opposites of “pleasure” and “pain” united together. Suduality rhymes with reality and is pronounced soo-doo-AH-leh-tee. Suduality simply means “the theory that pleasure and pain always balance each other out over time.”

What is sudism and what are sudists?

It is also useful to have a word to represent the belief in suduality and another to represent those who believe in it. In this spirit, we’ll use the term sudism to mean “the belief in suduality” and sudist to mean “someone who believes in suduality.” Any uncanny resemblance to the terms Buddhism and Buddhist is purely intentional.

IN-DEPTH: Is sudism a philosophy, a science, or a religion?

Good question! Well, let’s see now. . . Philosophy is based on logic and reasoning but doesn’t require the ability to precisely measure things, while science requires the ability to measure or observe things in a repeatable fashion—what we call the scientific method. Religion, meanwhile, could be described as a set of beliefs regarding the big questions of life, such as the origin of the universe, the difference between right and wrong, and what happens after we die.

Having a scientific background, I would prefer that sudism be approached as a science, except that there is one little problem: we have no device to reliably measure pleasure and pain; those sudumeters we talked about simply don’t exist. We can certainly take rough measurements using surveys, fMRIs, and so on, but their lack of precision makes it impossible to fully confirm that, over time, pleasure and pain occur in equal amounts in any given individual. Despite this minor setback, we can still observe many effects when investigating or applying suduality. That’s why I would say that sudism is more than a pure philosophy but not quite a science. As a compromise, let’s call it a practical philosophy.

Finally, sudism is not a religion. Yet it does require a leap of faith in something we can’t easily see or measure. This theory is not about a superhuman controlling power, but is about believing in a controlling force—much like believing in the invisible forces of gravity or electromagnetism. Indeed, there are fascinating parallels between philosophy and religion. As we’ll see later, several religions and religious figures do incorporate or express sudist-like beliefs, but sudism is nondenominational and ultimately stands on its own. You can probably be a sudist Christian or Muslim just as much as you could be an agnostic sudist. And though “sudism” may sound a bit mystical, perhaps like the Islamic mysticism known as “sufism,” it isn’t. There’s no magic to it, no rituals, no spirituality, and no promised enlightenment. In the end, it all revolves around two things: pleasure and pain.

KEY POINT #22: Sudism is neither a science nor a religion. It is a practical philosophy that each of us can use every day.

Conclusion of Part Two

Suduality is a simple concept that can significantly challenge our current beliefs. Does sudism really make sense, we might wonder? Why should we believe in suduality at all? We’ll tackle those important questions in the next part.

Summary of Part Two

Here is a summary of all key points from Part Two. It can be used as an optional refresher or an executive summary.

#17: Many of us notice that life is a series of ups and downs, of good days and bad days.

#18: Suduality is the theory that pleasure and pain always balance each other out in the long run. In other words, that we can’t have more (or less) pleasure than pain overall.

#19: Many of us are skeptical of suduality, but a healthy dose of skepticism is a normal reaction to new ideas. For many of us, suduality is a challenging paradigm shift.

#20: Suduality proposes that pleasure and pain have the same conservation property as electrical charges.

#21: Sudism is the belief in suduality, and sudists are those that believe in suduality.

#22: Sudism is neither a science nor a religion. It is a practical philosophy that each of us can use every day.

PART THREE: WHY BELIEVE

Introduction—The bridge between theory and evidence

Others should have observed suduality before

We should each witness suduality happening within ourselves

What are negative and positive tension?

It should be impossible to feel endless pleasure

It should be impossible to feel endless pain

Changing the frequency of pleasure should usually affect its intensity

Changing the frequency of pain should usually affect its intensity

Inducing positive effects should lead to negative effects

IN-DEPTH: Do normal, healthy pleasures have side effects?

Inducing negative effects should lead to positive effects

What are happiness and unhappiness?

Fairy-tale happiness should be impossible

Sustained misery should be impossible

We should adapt to all “positive” or “negative” life changes

Hacking the brain

Conclusion of Part Three

Summary of Part Three

Introduction—The bridge between theory and evidence

Those who believe that pleasure and pain balance each other out rarely seem to provide much evidence. Meanwhile, those who understand the supporting evidence rarely link it all back to the idea of suduality. In this part of the book, we’ll try our best to bridge that gap between the theory and the underlying evidence.

Having a scientific background, I would love to provide a simple, rock-solid proof to suduality. But without a functioning sudumeter that can accurately measure pleasure and pain, this task is impossible. For the same reason, suduality also can’t be disproven. However, I also have an artistic side. From that perspective, I feel like I am standing in front of our universe attempting to paint for you what I see, with these words as my brushstrokes and this book as my canvas. Unfortunately, the picture I am painting is not completely accurate. Why? Because words are often ambiguous. Because we cannot precisely measure our joys and aches. Because the data we have are often lacking, and many scientific studies merely show correlation (that two things are somehow related) and not causation (that one thing definitely causes the other). And because sometimes the only data available on a specific topic is anecdotal. In the end, this book perhaps resembles an impressionist painting such as those of Claude Monet. If we look closely at the details we may notice inaccuracies, but when we stand back and look at the big picture, I hope it still captures and conveys the truth.

Instead of a formal proof, my goal in Part Three: Why believe is to examine the body of evidence supporting this theory. Suduality is based on an ancient concept, but only recently has substantial amounts of supporting information become easily available, from scientific studies and expert opinions to anecdotal evidence. So I’ve tried to assemble a compelling, evidence-based argument in favour of suduality. Metaphorically speaking, I’ll be doing cartwheels across the shoulders of many giants. Despite my best efforts to convince you otherwise, I freely admit that the theory could be entirely wrong. Or perhaps just a little bit wrong, like Newton’s theory of gravity. You get to judge for yourself.

The principle known as Ockham’s razor essentially says that, all other things being equal, simpler theories that explain or predict larger quantities of phenomena are more likely to be true than more complex theories. This theory is about as simple as it gets, while the phenomena it helps explain and predict are numerous, as we will see shortly.

So let’s have a look at how suduality happens around us every single day. Those of us who are more skeptical may wish to pore over all of the evidence, while others who need less convincing may skim this part as they wish. I’m not here to bludgeon you to death with data! Our goal is simply to look at real-life people and situations from a new perspective, and show how they behave in a way that is consistent with suduality.

Others should have observed suduality before

Over twenty-five years ago, I had an apple-falling-on-my-head “ouch! I mean, a-ha!” moment in which the notion of suduality first occurred to me. And for a long time, I did not encounter anyone else who saw things this way, leading me to believe I was alone in my peculiar worldview. As I got a little older and wiser, it dawned on me that if suduality exists, others should have noticed it as well. After all, whenever I had an interesting idea, some dastardly person had usually beaten me to it! It turns out that the basic idea that pleasure and pain are equal—or at least, heavily interconnected—has turned up in many places and eras, all the way back to ancient times:

There is an ancient Buddhist saying (date and authorship disputed) that “life is made up of 10,000 joys and 10,000 sorrows”—in other words, an equal helping of both.

The ancient Greek Democritus (circa 460–370 BCE), who helped formulate an atom-based theory of the universe and became known as the father of modern science, is attributed as saying, “Throw moderation to the winds, and the greatest pleasures bring the greatest pains.”

The Mishna (compiled circa 189) was the first written compilation of the Jewish Oral Torah. In section Pirkei Avos 5:26 it is written, “According to the pain is the reward.” Some rabbis interpret this passage as saying pain is the price you pay for pleasure.

Saint Maximus the Confessor (circa 580–662) was a Christian monk, theologian, and scholar who wrote in the compilation Philokalia, “[man] finds by experience that every pleasure is inevitably succeeded by pain, and so directs his whole effort towards pleasure and does all he can to avoid pain. He struggles with all his might to attain pleasure and he fights against pain with immense zeal. By doing this he hopes to keep the two apart from each other—which is impossible—and to indulge his self-love in ways which bring only pleasure and are entirely free from pain. Dominated by the passion of self-love he is, it appears, ignorant that pleasure can never exist without pain. For pain is intertwined with pleasure, even though this seems to escape the notice of those who suffer it.”

Leonardo da Vinci (1452–1519), the famed Italian renaissance polymath, once sketched a drawing entitled Allegory of Pleasure and Pain depicting two men joined at the trunk: “Pleasure and Pain are represented as twins,” da Vinci wrote, “as though they were joined together, for there is never the one without the other. . . They are made with their backs turned to each other because they are contrary the one to the other. They are made growing out of the same trunk because they have one and the same foundation, for the foundation of pleasure is labour with pain, and the foundations of pain are vain and lascivious pleasures.”

Benjamin Franklin (1706–1790) was an inventor, philosopher, as well as governor of Pennsylvania, and is considered one of the founding fathers of the United States of America. In 1725, Franklin published a dissertation with his view that “every creature hath as much pleasure as pain” and that “no State of Life can be happier than the present, because Pleasure and Pain are inseparable.” Growing concerned about the effect this controversial paper would have on his reputation, he burned all remaining undistributed copies.

Friedrich Nietzsche (1844–1900) was an influential German philosopher who in his work The Gay Science wrote that pleasure and pain were “twins” that either increased together or decreased together, and that they were “so knotted together that whoever wants as much as possible of the one, must also have as much as possible of the other . . . The stoics believed that this was so and were consistent in desiring as little as possible [of both].”

Dr. Bhagavan Das (1869–1958) was a religious philosopher who worked for the Central Legislative Assembly of British India. He also received the Bharat Ratna, the highest civilian award bestowed by the Indian government. In his 1930 book, Eugenics, Ethics and Metaphysics, he wrote, “After pleasure, pain; after pain, pleasure. They are always balancing up, in the long run or the short run, on all possible scales. . . . both have to be equal and opposite, lest the Repose of the Supreme be disturbed.”

Carl Jung (1875–1961), the pioneering Swiss psychologist and psychiatrist, wrote, “The principal aim of psychotherapy is not to transport the patient to an impossible state of happiness, but to help him acquire steadfastness and philosophic patience in face of suffering. Life demands for its completion and fulfillment a balance between joy and sorrow.”

Alan Watts (1915–1973), who studied both as a Christian priest as well as a Zen Buddhist, popularized many Eastern philosophies for Western audiences. In The Wisdom of Insecurity (1951), he wrote: “we can’t be more sensitive to pleasure without being more sensitive to pain.” Trying to have pleasure without pain, he said, was “as contradictory as trying to have up without down.”

IN-DEPTH: Here are some other great thinkers who have expressed sudist-like beliefs:

Many ancient Chinese Philosophers (circa 1000 BCE or earlier) noted that many observable phenomena in life are composed of “yin” and “yang,” two equal opposites that form a whole. These opposites are so interdependent that one can’t exist without the other—that light can’t exist with darkness, hot without cold, or pleasure without pain.

After a lifetime of contemplation, on the day of his execution by poison, influential ancient Greek philosopher Socrates (circa 470–399 BCE) remarked, “How singular is the thing called pleasure, and how curiously related to pain, which might be thought to be the opposite of it; for they never come to a man together, and yet he who pursues either of them is generally compelled to take the other.”

Irishman Jonathan Swift (1667–1745), author of Gulliver’s Travels, wrote, “All fits of pleasure are balanced by an equal degree of pain or languor.”

Francisque Bouillier (1813–1899) was a French philosopher, professor, and later dean of the University of Lyons. In his 1865 book Du plaisir et de la douleur, he wrote, “As much as it is impossible to separate pain from pleasure, it is also impossible that they not be in proportion one with the other. Great joys are conditional upon great pains.”

Ralph Waldo Emerson (1803–1882), an influential American writer and philosopher, wrote in his essay Compensation that, “The same dualism underlies the nature and condition of man. Every excess causes a defect; every defect an excess. Every sweet hath its sour; every evil its good. Every faculty which is a receiver of pleasure has an equal penalty put on its abuse . . . Punishment is a fruit that unsuspected ripens within the flower of the pleasure which concealed it.”

“The deeper that sorrow carves into your being, the more joy you can contain,” wrote Lebanese philosopher Kahlil Gibran (1883–1931) in his best-known work The Prophet. “Some of you say, ‘Joy is greater than sorrow’, and others say, ‘Nay, sorrow is the greater’. But I say unto you, they are inseparable. Together they come, and when one sits alone with you at your board, remember that the other is asleep upon your bed.”

Swami Sivananda Saraswati (1887–1963) was a Hindu spiritual teacher, author, and founder of the Divine Life Society. In his book The Bliss Divine, he wrote, “You cannot have pleasure without pain. Wherever there is pleasure, there is pain. You vainly seek pleasure in gold, in women, in this mundane existence. You cannot have absolute happiness in a relative physical plane of pairs of opposites. The pairs of opposites rotate in their turn. Death follows life. Night follows day. Light follows darkness. Pain follows pleasure. . . . Pleasure and Pain are two names for one thing. They are two aspects of one thing. For a worldly man without philosophical knowledge, they appear as two different entities.”

Sri Nisargadatta Maharaj (1897–1981) was an Indian Guru of Shiva Advaita (nondualism). In 1973 he published I Am That, considered his masterpiece, in which he states, “Pain and pleasure go always together. Freedom from one means freedom from the both. If you do not care for pleasure, you will not be afraid of pain.”

After decades of living and working in poor and rich countries alike, pioneering physician Dr. Paul W Brand, CBE (1914–2003) reflected, “Increasingly I have become aware of the curious intertwining of pain and pleasure,” he said, “I now agree more closely with Da Vinci’s depiction of pleasure and pain as Siamese twins.”

“Another shift that most people in our culture are required to make . . . is overcoming the artificial separation of pleasure and pain,” wrote pain specialist Dr. Erv Hinds (1941) in his book A Life Larger than Pain. “We blithely assume that pleasure is good and pain is bad, so we pursue one and flee from the other. But pain is not punishment, and pleasure is not reward, despite our persistent attempts to treat them as such. Where in Western society did we ever get the idea that we can have pleasure without pain? . . . Pleasure and pain are inextricably linked.”

Glennon Doyle (1976), a present-day author and speaker who’s chronicled her life and personal struggles in two bestselling memoirs, came to this conclusion: “The more I opened my heart to the folks in my circles, the more convinced I became that life is equal parts brutal and beautiful. Life is brutiful.” She notes, “Life’s brutal and beautiful are woven together so tightly that they can’t be separated.”

KEY POINT #24: Many thinkers from ancient to modern times have observed that pleasure and pain are tightly interconnected, including Chinese, Greek, French, American, and German philosophers; Buddhists, Christians, Hindus, and Jews; and even the father of modern science and one of the founding fathers of the United States.

This raises an interesting question: why do so many of us easily believe that life is a series of ups and downs, of good days and bad days, but very few of us seem to consider the slightly more precise possibility that life provides equal amounts of positive and negative feelings? Why do few of us seem to make that small conceptual leap from quasi-suduality to full-blown suduality? Once the notion of suduality finally clicked in my own mind, it profoundly transformed the way I saw and interacted with the world.

We should each witness suduality happening within ourselves

I don’t suggest blindly accepting suduality, just as I wouldn’t blindly accept any dogma that others may want me to believe. There are many ways to put the theory of suduality to the test, and one of them is simply by looking within. Focus your awareness on every flicker of pleasure or jolt of pain you experience. In the same way that you can feel the pulsing rhythm of your heart by pushing your finger on your wrist, you can feel your affective pulse by keeping your attention pressed firmly on how you feel from moment to moment. Perhaps you already practise this kind of self-awareness or mindfulness. If you do, you may over time witness your own joys and sufferings, your ups and downs, balancing each other evenly as time goes on, regardless of the particular circumstances of your life.

What patterns or trends do you notice in your life? Do you ever have a day entirely without pain, or without pleasure? Set aside what you think everyone else feels and what they say you should feel. Focus on what you actually feel. In my own experience, pleasure and pain don’t always balance out within a minute, hour, or day. Sometimes it takes a few days, weeks, or even months. To notice this requires prolonged self-observation, but it is the key to directly witnessing the pleasures and pains of life equalizing each other over time.

Being mindful

What does it really mean to be mindful? What common mistakes do we make while examining ourselves this way?

Mindfulness is usually defined as being focused on the present moment—on our senses, thoughts, and feelings. This excludes thinking about the past, the future, or anything other than what’s happening right now. It means clearing our minds of unnecessary thoughts or fantasies. I like to think of mindfulness as meditation on the go, since meditation is usually done in a stationary position while mindfulness can be done as we go about our day.

In the context of this book, mindfulness is especially useful for becoming more aware of every pleasant and unpleasant feeling we experience each day. Turning our gaze inwards to focus on our feelings for long periods of time can take practice but provide many benefits. We may increasingly notice how pleasure and pain form part of our daily landscape, and that they heavily influence many of our decisions. Pain and pleasure are part of the foundation of our lives.

To gain greater insight into yourself, try to be mindful as you live, work, and play. Notice the ebbs and flows of pleasant and unpleasant feelings, and how there are long stretches where you simply feel neutral—in other words, neither good nor bad. You may even notice subtle feelings that you had never noticed before, buried underneath the hustle and bustle of daily thoughts and activities.

What is going on in your mind? Do you fantasize about upcoming events, or about living an alternate life? Perhaps you often hear music in your mind, like I do? Do you spend time worrying about which decision to make or what other people may think? What about anxiety or anger, joy, or self-confidence? According to psychologist Paul Bloom, some studies suggest that we spend about half of our waking time doing some sort of daydreaming, whether it’s thinking about the past, the future, or outright fantasies. We may discover amazing things about ourselves if we simply take the time to look inward. Becoming more self-aware can be a major step towards making positive changes in our lives.

Furthermore, knowing in detail how you feel today can provide a baseline, a reference point to compare yourself to in the future. This can help you discover whether, over time, certain pains or pleasures in your life have shrunk or grown in intensity, duration, or frequency. If you suffer from any pain of unknown cause—perhaps back aches, migraines, anxiety, or depression—keep a close eye on these, especially if you choose to make lifestyle changes based on the ideas in this book. After all, I hope to show you how you can reduce or eliminate these kinds of unnecessary suffering in your own life.

KEY POINT #26: Being mindful can increase our awareness of the many varieties and intensities of pain and pleasure we feel every day, which can yield many insights into ourselves.

How to assess our own affect

Without a device to accurately measure our aches and joys, mindfulness is likely the best tool we have to assess our own affect—that is, our various pleasant and unpleasant feelings. However, while mindfully tallying up the various pleasures and pains of our lives, we sometimes make these common mistakes:

We tend to overlook parts of our lives that don’t need to be “fixed,” and focus instead on our problems. It’s easy to overlook all the little joys in our daily lives—such as warm showers, tasty foods, good times with friends and family, or simply watching a favourite television show. These reliable pleasures are always there, so it’s natural to take them for granted. But they count and they can really add up.

We tend to overlook the suffering we intentionally cause ourselves, such as physical exercise or other hard work, because we have chosen that pain rather than having it inflicted on us. It’s tempting to think, “I chose to do that, so it doesn’t count.” But self-inflicted pain counts as much as any other kind of suffering.

We suffer from the peak-end bias effect: psychologists have shown that, for any given “episode” in our lives, such as a vacation or a workweek, we tend to remember the peaks (the most pleasurable and painful moments) and how we felt at the end, while generally forgetting the rest. Unfortunately, this can skew our perception. And the longer it’s been since the event, the more blurry or distorted our memory of it becomes. Studies show that our memory is far from 100 percent accurate, being malleable and subject to change over time.

We find it hard to quantify our feelings, in other words, to assign them a score and communicate them accurately. If we were to map all our feelings on a numeric scale from -10 (utter agony) to 10 (absolute ecstasy), what would a 3 feel like? Could we easily tell the difference between a 3 and a 4? And how would we know if your 5 was the same as my 5?

Here are a few more things to consider while mindfully assessing our feelings.

My coworker irritates me to no end but I plan to switch jobs, so I won’t factor that in.

Yes, temporary irritants and problems caused by others still count as suffering.

I’ve suffered from headaches/back pain/cramps for as long as I can remember. It’s just the way I am.

Even if you’ve had those aches as far back as you can remember, they’re part of your suffering too.

I’m depressed and anxious but my doctor said it’s because of a chemical imbalance in my brain.

I feel your pain, but regardless of the cause or explanation, those also count.

I accidentally tripped and fell down a cliff, broke my arm, leg, and three ribs.

Ouch! Do you need a ride to the hospital?

But what about. . .

Yes, that counts too! Every little ounce of pleasure and pain matters, even if we think it’s temporary, or within our control, or someone else’s fault, or an accident, or a chronic condition, or genetic, or even “part of our personality.” Even the things we don’t think count, well, they count! Also, if we focus solely on our problems while taking all our positive experiences for granted—the glass half-empty, so to speak—we’d inevitably conclude that life is pure misery. But how true would it be?

KEY POINT #27: When we take score of our own pleasant and unpleasant feelings, it is easy to overlook the ones we caused, the ones we blame on other people, and the ones that we are used to, but all of them count.

What are negative and positive tension?

According to sudism, our pleasant and unpleasant feelings balance each other out over the course of our entire lifetime. In practice, however, the balancing out of these opposing sensations often occurs over shorter time frames like hours, days, or weeks. There is a 1996 study by Eunkook Suh and Ed Diener that showed that only events in the past three or so months impacted subjective well-being. And in my own experience, things generally balance out within that time frame. This is why I draw a line at three months for the longest time we typically remain out of balance.

For suduality to work, there must be a kind of invisible “tension” that pulls us towards a state of balance when we’ve experienced more pleasure than pain, or vice versa. This tension eventually restores the balance between the two opposites. It is like being tied to a post by a stretchy bungee cord. The post is firmly anchored in the spot representing perfect balance. The further we walk away from that post, the harder the bungee cord pulls us back towards the post.

As we experience more pleasure than pain, we walk away from that post in one direction and we increasingly experience negative tension. This tension represents the likelihood we’ll experience more pain than pleasure in the short-term future. In other words, we’ve been over-pleasured, had too much of a good thing and will soon have to pay up. Our pleasure tolerance will increase, meaning that it is harder to experience pleasure from any given activity. When this becomes noticeable, we call it anhedonia. The more heavily our past is weighted toward pleasure, the more strongly negative the tension will be.

Positive tension happens when we walk away from that post in the direction of pain. When the sum of our past experiences leans more towards pain, we will seem to find pleasure more easily and pain will have a harder time finding us. That is, our pain tolerance will increase. In other words, we’ve been over-pained and much-needed relief is coming. The more our past is weighted towards pain, the more strongly positive our tension will be. Sometimes it’s as if we can sense this tension—do you ever feel that good times are just around the corner?

Finally, neutral tension occurs when we’ve experienced as much pain as pleasure in our past. In this case, there is no tension in either direction.

At any given point in time, we either experience positive tension, negative tension, or neutral tension. These ultimately represent how likely we are to feel pleasure versus pain in our short-term future.

It should be impossible to feel endless pleasure

We all know what triggers an orgasm, but have you ever wondered why an orgasm has to end? The question may seem silly at first, but upon further inspection it is quite thought-provoking. Why can’t it last just a little longer, or be a little more intense? Why does there seem to be a limit to the intensity and duration of that feeling, or for that matter, any other pleasant feeling in life?

If we believed that pain and pleasure were truly independent of each other, then it should be possible for us to obtain endless pleasure without any painful consequences. On the other hand, if suduality is true, then all episodes of pleasure should be limited in intensity and duration. Why? Suduality, by definition, says that pleasure and pain balance each other out over time. As described in the previous section, if we try to procure pleasure in a continuous fashion, the negative tension should continually increase, meaning it will become harder to obtain more pleasure without somehow first experiencing more pain. Eventually, we should reach a point where it is no longer possible to experience more pleasant sensations, no matter how hard we try—thus making it impossible to feel endless pleasure. In the words of the nineteenth-century German philosopher Arthur Schopenhauer, “No attained object of willing can give a satisfaction that lasts and no longer declines.”

As an amusing exercise, try to give yourself endless pleasure without experiencing any pain or neutrality. Maybe you’ve already tried! Pick your pleasure (the list below provides some ideas) and see if you can prolong it beyond one week, or even beyond a single day. Even if you are very lenient and allow breaks to sleep, eat, and use the washroom, sudism predicts the end result will be the same. No matter how hard you try, you will eventually reach a point where you just can’t eke out any more pleasure from whatever activity you’ve chosen.

In short, if suduality exists, we shouldn’t be able to obtain endless pleasure. Here are a few simple ways you can test this limitation for yourself:

What is your favourite song? If you listen to it over and over, you’ve probably noticed that you eventually can’t get any more enjoyment out of it. Continue listening and it will eventually start getting on your nerves. Have you ever had a song stuck in your head for a day or two? Even if it’s a song you truly love, there’s a good chance that hearing it loop endlessly in your mind will drive you a little crazy.

Warm showers usually feel quite nice—at least at first. Even with an endless supply of hot water, it doesn’t take long before your body adapts to the heat and no longer sends any pleasure signals to the brain. Oh, you might increase the temperature to make it feel nice again for a little while, but the body can only tolerate so many heat increases until it becomes unbearable.

People quickly get used to the same pleasant scent, after which they can barely perceive it, as researcher Pamela Dalton of the Monell Chemical Senses Center has shown. This phenomenon is called olfactory adaptation. Some companies have tried to combat this with room-scenting devices that periodically alternate which scent they emit throughout the day. But can they really provide you with endless scented pleasure?

Whether flying solo or with someone else, see if you can provide yourself endless sexual pleasure, whichever way you like. Some might call this tantric sex. I’ve honestly never tried going for hours on end but I have experienced that “petering out” of pleasure—eventually, it simply doesn’t feel good anymore. Our bodies become numb, as if our minds stubbornly say, “That’s enough, thanks!” Similarly, one 1998 study published in medical journal European Urology showed that watching the same adult movie over and over—perhaps not surprisingly—resulted in progressively less sexual excitement during each subsequent viewing.

A single joke might make you laugh, but if you listen to the same joke over and over it stops being funny pretty quickly. Even if you only listen to a hilarious joke once, why do you eventually stop laughing? It’s tempting to say that it’s because the novelty of that particular joke has worn off. If that was the only reason, then listening to a never-ending variety of jokes should be perpetually amusing, shouldn't it? But in my own experience, this is not what happens. Even the funniest stand-up comedians can only make me laugh for about an hour before I become “laughed out” and struggle to enjoy the remaining jokes. While I regrettably couldn’t find any studies examining the longest amount of time people laugh, many have anecdotally recalled their longest laughter sessions as lasting around one hour as well. Even the alleged world record holder of forced laughter, Belachew Girma of Ethiopia, lasted just 3 hours and 6 minutes. Either way, this is easy for you to test—set yourself up with several hours of funny videos and see how long you can joyfully laugh!

I’ve only covered a few pleasant activities that don’t seem to lead to endless enjoyment. Even indulging in what may be the most potent and direct source of pleasure—hard drugs like heroin—users seem unable to stay euphoric for more than a few hours or days. With prolonged use, they eventually can no longer get high and must continue taking the drug to merely feel normal. I also haven’t even touched the possibility of combining these activities (sex at a comedy club, anyone?). But I can virtually guarantee you that no matter what you try, you will come to the same conclusion: we can only continually squeeze so much pleasure out of life until the well of pleasure simply dries out. This is what some call the Paradox of Hedonism. “Continued pleasures wear off,” observed Dutch psychologist and emotion researcher Nico Frijda. “Pleasure is always contingent upon change and disappears with continuous satisfaction.” “The pleasures we experience are like railway stations along a long journey,” said clinical psychologist Archibald Hart, author of Thrilled to Death: How the Endless Pursuit of Pleasure is Leaving Us Numb. “They are short stops that infuse our life with fulfilling enjoyment, but then the train has to move on to the next part of the journey.” Or finally, as actor and comedian Denis Leary puts it, “Happiness comes in small doses folks. It’s a cigarette butt, or a chocolate chip cookie or a five-second orgasm. You come, you smoke the butt, you eat the cookie, you go to sleep, wake up, and go back to [expletive] work the next morning, that’s it!”

If there were a way to obtain endless pleasure without painful consequences—a specific activity that would always guarantee immediate and unflagging pleasure--wouldn’t people be doing it all day long? Wouldn’t we have discovered this “pleasure loophole” long ago and be exploiting it constantly? From an evolutionary perspective, this wouldn’t make much sense because we’d probably stop doing all the other activities necessary to sustain life. Champion table tennis player and journalist Michael Syed put this spin on it in his 2010 book Bounce: “If goal fulfillment induced indefinite periods of contentment, we would be robbed of all future motivation.” I don’t know of anyone who has truly achieved a blissful state of endless pleasure—do you?

KEY POINT #29: Evidence suggests it’s impossible to obtain continuous pleasure from enjoyable activities such as eating, having sex, listening to music, and consuming recreational drugs.

It should be impossible to feel endless pain

In the previous section, we asked ourselves: why do virtually all pleasures seem limited in intensity and duration? Now we ask the opposite: is suffering always limited in intensity and duration? Is it possible to suffer indefinitely?

If we believed that pain and pleasure were truly independent of each other, then it should be possible to suffer endlessly without any relief. But if suduality is true, then all episodes of pain should be limited in intensity and duration. Why? If we somehow end up in a situation where someone or something is continuously inflicting us pain—and it could be our very own minds or bodies that are tormenting us—our positive tension should continually rise. In other words, it should become harder and harder for us to feel more pain. Eventually, we should reach a point where it is no longer possible to suffer, no matter how hard our tormentor tries—thus making it impossible to feel endless pain.

Is it difficult to believe that it’s impossible to suffer endlessly? Here are some scenarios that illustrate this limitation of human suffering:

One time when I was about twelve years old, I was shovelling mountains of dense snow off of a neighbour’s driveway. The strenuous physical effort left me utterly exhausted and my muscles deeply aching. Normally I would have taken a break, but because my father was nearby and I didn’t want him to think I was a wimp, I kept on shovelling through the pain. And after suffering a while, something surprising happened: I suddenly felt a rush of energy and all of the pain went away. This enabled me to shovel twice as hard and quickly finish the job. What happened? It turns out this is a well-documented phenomenon: continuous physical exertion eventually leads to what is called second wind or the runner’s high, a sudden pleasant rush of additional energy to go on. Beyond this effect, the body has its own limitations and we eventually run out of physical energy (or mental willpower), forcing us to rest and end the pain of exertion. So the pain of physical exertion always comes to an end one way or another.

If you have just gone through a terrible loss, such as being laid off from a job, breaking up with your romantic partner, or experiencing the death of a loved one, you may feel like the grief will never end. However, extensive research from Dr. George Bonanno, a leading expert in the field of grief, shows that this is not generally what happens. Though some adults do go through a longer grieving process than others, most of us are much more resilient than we think and we generally rebound within weeks of traumatic events. As in Psalm 30:5, “Weeping may endure for a night but joy cometh in the morning”—that is, our grief does not last forever.

If we believe that pain and pleasure are truly disconnected, then starving for prolonged periods without any food should lead to continuous painful hunger. In fact, we should reasonably expect that the hunger would become more urgent and intense as we progressively lost weight because, after all, we are inching closer to death. The mind should strongly motivate us with hunger pain to find food above all other priorities. Instead, science writer Sharman Apt Russell shows in her book Hunger: An Unnatural History that most people who undergo long-term fasting report that the hunger pains end and they eventually feel a heightened sense of well-being or even periods of euphoria during their fast. Is this phenomenon simply strange, or is it simply suduality?

If we are in an intensely cold environment without sufficient clothing, we normally feel unpleasantly cold. If pleasant and unpleasant sensations were independent from each other, then staying in such an environment for a long time should continue to make us feel cold. And as our body temperature continues to drop, the intensity and urgency of this feeling should increase since we’re heading into dangerous territory—possibly coma or death. However, according to the Canadian Centre for Occupational Health & Safety, instead we gradually go numb, we feel less and less cold. And at the point where the most physical damage can occur, we may not actually feel any pain.

Imagine being held prisoner, separated from your loved ones, regularly beaten, forced to work long hours in the freezing cold, all while being severely underfed. This abuse and torture is precisely what psychiatrist and holocaust survivor Dr. Viktor Frankl endured for three years while incarcerated in German concentration camps during the Second World War. In his landmark book Man’s Search for Meaning, he described in vivid detail how he and his comrades actually adapted to these horrifying conditions: “Apathy, the blunting of the emotions and the feeling that one could not care anymore, were the symptoms arising during the second stage of the prisoner’s psychological reactions, and which eventually made him insensitive to daily and hourly beatings. By means of this insensibility the prisoner soon surrounded himself with a very necessary protective shell.” In other words, being subjected to regular, frequent abuse caused the prisoners’ minds to become numb to it. Similarly, according to pain researcher David Wynick from the University of Bristol, “People who have been repeatedly tortured often say that when the pain became too intense they either lost consciousness or lost awareness of the passage of time.” In other words, they eventually disconnected from the agony.

When we suffer from overwhelming pain, stress, or fear, our reaction is often to faint, which of course ends our ability to sense these pains. In threatening situations where neither fight nor flight are options, some will instead freeze and go numb, which is also known as tonic immobility. Many victims of rape, for instance, have reported becoming paralyzed and no longer feeling any pain during the assault. This has even been reported by those who’ve survived major traumas such as falling from great heights or being mauled by animals. Such a response significantly reduces their physical pain and emotional distress, which may actually aid in their survival. This isn’t to say that these survivors don’t experience any pain or suffering later on, such as post-traumatic stress disorder, but it supports the idea that the mind imposes a limit on the duration and intensity of each episode of pain.

What about people who have chronic pain? Is their suffering not endless?

Yes, many of us do suffer from chronic, recurring pain. But we tend to misinterpret it as meaning “continuous” or “never ending” pain. According to behavioural geneticist Susan Smalley, founder of the Mindful Awareness Research Centre at the University of California, Los Angeles (UCLA), there is no pain, even chronic pain, that lasts forever. Instead, chronic pain waxes and wanes, it comes and goes.

We clearly haven’t covered everything that could possibly lead to endless pain. Regardless of the source of our agony, sudism says we will come to the same conclusion: we can only suffer so much until the pain runs out. Feel free to test this on yourself, if you are brave enough!

KEY POINT #30: Evidence suggests it is impossible to obtain continuous pain, as illustrated by prolonged physical exertion, starvation, and even torture.

Changing the frequency of pleasure should usually affect its intensity

If, according to the previous sections, doing a pleasant or unpleasant activity continuously causes their associated feelings to diminish, what happens when we vary the interval between each time we do these activities? If we believed that pain and pleasure were truly independent of each other, then changing the frequency of a pleasant activity should have no impact on the future pleasantness of that activity nor on how we feel when we aren’t partaking in that activity. But if suduality is true, then changing the frequency of a pleasant activity should indeed impact these things. Why?

If you choose to do something you enjoy more often—perhaps shopping or listening to your favourite song—without changing anything else, it would amount to adding a certain amount of joy to your life. For the sake of argument, we’ll assume that any activity being replaced was neutral as opposed to pleasant or painful. Therefore, to maintain the overall balance between your pleasant and unpleasant experiences, one or both of the following effects should eventually happen, according to sudism:

Effect 1: The amount of pleasure you feel each time you do that activity will decrease. For instance, doubling the frequency of the activity may halve its pleasantness, thus maintaining the same overall sum of pleasantness over time.

Effect 2: For all the times you aren’t doing that activity, the amount of pain you feel overall will increase, or the amount of pleasure you feel overall might decrease, in proportion to the extra pleasure you are getting from the increased pleasant activity.

On the other hand, if you do the opposite—that is, decrease the frequency of your enjoyable activity—you should then experience the opposite of the above effects.

For now, let’s look at examples of effect 1 in action. We’ll cover effect 2 in later sections:

Dr. Paul W. Brand, co-author of The Gift of Pain, was born to missionary parents in India and lived his childhood in poverty. His family couldn’t afford certain foods like strawberries so they tried to grow some, but bugs and animals would invariably eat most of their crop. At the end of the growing season, they may have cultivated a measly two or three fully-grown strawberries, which they had to divide amongst his family. Though as an adult he could now buy any quantity of fresh strawberries at any time, “the pleasure I get from eating those strawberries does not compare with my experience from childhood,” he noticed. In other words, having strawberries less frequently made them much more appetizing. Is this a typical reaction? According to psychologist Wendy Wood, an expert on human habits, while habits become stronger with repetition, “Feelings, however, become weaker with repetition.” For instance, “the more often you eat ice cream, the less pleasure you get from eating it.” The Chinese even have an old proverb: “The more you eat, the less flavor; the less you eat, the more flavour.”

Conversely, after fasting for a period of time, food will generally taste better than it did before the fast. Various anorexics, while regularly starve themselves, have said that smelling food or imagining eating it literally excites them. When breaking a fast, they find food more delicious than when they are not fasting, describing otherwise ordinary foods as “the greatest thing I’ve ever tasted”, or as intensely pleasurable as sex. Even for shorter periods without eating, research from psychologists Siri Leknes & Brock Bastian confirms: “Food and drink taste better when providing relief from hunger or thirst.” In other words, decreasing the frequency of eating (which increases hunger) increases its enjoyability.

A 2015 study by researchers at Carnegie Mellon University randomly assigned married couples to either double their frequency of intercourse or to keep it unchanged. Surveying these couples before, during, and at the end of the three-month experiment, they found that couples who doubled their sexual activity did not experience an increase in overall. Furthermore, these couples reported lower sexual desire and reduced sexual enjoyment. True, the reduced enjoyment might be due to feeling obliged to be intimate. But my own personal experience says otherwise. For the longest time, I was convinced that if only my wife and I could do it more often, I would be that much happier. When we started trying to conceive our first child, we agreed to dramatically increase the frequency to increase our chances of conceiving, and I was looking forward to it! The first time was gratifying, the next time less so, and after a few times I caught myself thinking something I never believed I’d think in a hundred years: “Oh no, not sex again!” High-frequency sex lost its charm rather quickly. On the other hand, the more time has passed since we’ve been intimate, the more satisfying it feels. Of course, different people have different sex drives, but the principle remains the same. Could this relationship between frequency and intensity also help explain why women—who tend to have fewer orgasms than men—experience them more intensely than their male counterparts? At the extreme, some experience hundreds of spontaneous orgasms per day due to persistent genital arousal disorder. Those with the disorder reveal that, rather than being enjoyable, it is quite painful and exhausting.

If someone tries powerful recreational drugs like heroin or cocaine for the first time, they usually experience euphoria. If that person chooses to regularly consume the drug, it is widely documented that they will develop a tolerance to it. In other words, the twentieth or hundredth dose produces less euphoria than the first one. At the extreme end of tolerance, the drug may no longer have any euphoric effect but will have to be taken just to feel normal. To reverse this effect, many users report taking “tolerance breaks”—abstaining from drugs for a while so that their potency is increased when they resume taking them. Tolerance doesn’t only occur with illegal substances—research shows that it also happens with legal drugs such as tobacco and alcohol.

According to a study of wealthy US residents by Boston College, there is significant evidence that the pleasure we get from what researchers call “excessive consumption”—such as going to a spa, eating at a five-star restaurant, or going on shopping sprees—decreases the more often we partake in these. Those who are less wealthy may only splurge on such luxuries occasionally but enjoy them more than those who can afford to experience them often.

The same thing happens when we spoil children. When we give a child a gift they desire, it might make them happy for a little while. Some of us then conclude that the more we give them what they want, the happier they will be. But psychologist Dan Kindlon, author of Too Much of a Good Thing: Raising Children of Character in an Indulgent Age, tells us otherwise: “If you give kids so much early on, they get to a point where they can’t be satisfied with anything.” In other words, increasing the frequency of gift-giving decreases the enjoyment of gift-receiving.

Think of it this way: if you celebrated your birthday every month, it wouldn’t feel quite as special, would it? And if you celebrated it every single day, it would completely cease to be a special day. As Harvard psychologist Dr. Daniel Gilbert wrote in his book Stumbling on Happiness, “Among life’s cruelest truths is this one: Wonderful things are especially wonderful the first time they happen, but their wonderfulness wanes with repetition. Just compare the first and last time your child said ‘Mama’ or your partner said ‘I love you’ and you’ll know exactly what I mean.” Increasing the amount of time between repetitions of the same experience increases their pleasantness, he adds.

KEY POINT #31: Evidence suggests that increasing the frequency of pleasurable experiences reduces their pleasurable intensity, while reducing their frequency increases their intensity, which is consistent with suduality.

Changing the frequency of pain should usually affect its intensity

If we believed that pain and pleasure were truly independent of each other, then changing the frequency of a painful activity (such as eating awful-tasting food or doing a hard workout) should have no impact on the future painfulness of that activity nor on how we feel when we aren’t partaking in that activity. But if suduality is true, then changing the frequency of a painful activity should impact these things. Why?

If you increase how often you do this activity, without changing anything else in your routine, it would amount to adding more pain to your life. For the sake of argument, we’ll assume that any activity being replaced was neutral (as opposed to pleasant or painful). According to sudism, one or both of the following should eventually happen for pleasure and pain to stay in balance:

Effect 1: The amount of pain you feel each time you do that activity should decrease. For example, doubling that activity might halve its intensity, thus maintaining the overall amount of pain.

Effect 2: The amount of pleasure (or pain relief) you feel while not doing that activity should increase, in proportion to the extra pain from the increased unpleasant activity.

Furthermore, if you do the opposite—decrease the frequency of that painful habit—then you should experience the opposite of the above effects. Let’s look at a few examples of effect 1 here, and we’ll look at effect 2 in later sections:

Research shows that regular physical exercise increases overall muscle mass, strengthens the heart, widens capillary blood vessels, and boosts the number of mitochondria—the little “power plants” in each cell that generate energy for our bodies. Mark Verstegen, whose company, Athlete’s Performance, directs training for the National Football League (NFL) Players Association and other professional athletes, notes in his Core Performance book series that these changes explain why, as we make fitness gains, we are likely to feel less pain with each workout. Athletes, who are among those who exercise the most, have a “pain tolerance [that is] off the charts,” according to Douglas Nelson, who spent decades treating musculoskeletal pain. In other words, those who frequently engage in strenuous exercise feel much less pain than those who don’t.

For those of us suffering from back pain, the old advice used to be to rest your back as much as possible. But recent studies show that the more we rest our backs to avoid these aches, the more intense the pain we’ll feel when we do get up and start using our backs again. Increasing the rate of activities that require our backs—to the degree we’re able to—paradoxically leads to a reduction in back pain.

When I used to eat sweetened chocolate bars, I found unsweetened baker’s chocolate disgustingly bitter and avoided it like the plague. But after quitting sugar and choosing to eat unsweetened chocolate every day, I grew to not only tolerate their dark flavour but to actually enjoy them. As award-winning chef and author Jennifer McLagan wrote in her book Bitter, eating unpleasantly bitter foods more often gradually causes us to get accustomed to their flavour and enjoying them more. The same phenomenon happens with spicy foods.

John Honerkamp, chief coach of the New York Road Runners organization, says runners may initially be put off by running in cold weather, but they get used to it after a few weeks of exposure. How about walking barefoot in winter, which may not sound so pleasant if your winters are cold and icy? Steve Bloor, podiatrist, advocates year-round barefoot walking. He confirms that, through various mechanisms of action, your bare feet gradually acclimatize to the cold—though you should avoid extreme cold, which could cause frostbite. In other words, the more we’re exposed to the cold, the less unpleasant it becomes.

New York State’s Department of Health, as well as various anecdotal reports, indicate that people who are exposed to awful smells—such as rotting compost or garbage—get used to these fairly quickly if they are around them regularly. What if your entire town smells bad? The town of Rotorua, New Zealand, is home to very pungent geothermal activity that has earned it the nickname Sulphur City. The town professes that, “The smell however grows on you, and not in an uncomfortable fungal way!” Adding, “Instead of the smell becoming unbearable the longer you stay, the aroma fades, and once a traveller has moved on from Rotorua, it may even be missed.” And finally, which self-respecting philosopher could overlook that the smell of our own farts (which we’re exposed to frequently) smell okay, but other peoples’ farts (which we only have to endure infrequently) usually stink? Studies indeed show that we consistently rank our own body odour as more pleasant than everyone else does.

Those of us who have crippling anxieties or phobias, such as a fear of needles, spiders, or social situations, naturally avoid these. However, a 2011 review published in Psychiatric Times concluded that of the different available treatments for anxiety—as well as a related condition, post-traumatic stress disorder—the most effective approach was exposure therapy. This consists of a therapist gradually increasing the individual’s exposure to the feared object, animal, or situation, in a controlled manner, which gradually reduces the patient’s fear response.

KEY POINT #32: In general, evidence suggests that increasing the frequency of painful experiences reduces their perceived intensity, and reducing their frequency increases their perceived intensity. In other words, the frequency and intensity of painful activities we partake in tend to inversely correlate. This is consistent with suduality.

Inducing positive effects should lead to negative effects

If we believed that pain and pleasure were truly independent of each other, then we’d expect that intentionally boosting one would have no impact on the other. On the other hand, if the theory of suduality is true, then inducing a positive effect (a decrease in pain or an increase in pleasure, as defined earlier) should lead to future negative effects (reductions of pleasure or augmentations of pain later on). We’ll consider diseases to be “negative effects” since, as researchers indicate, the vast majority of diseases are accompanied by various aches and pains.

In the following sections, we’ll look at a few different substances and activities that humankind has discovered over the course of history that all have one thing in common: they usually make us feel better in the short-term. We’ll start with those that reliably boost pleasure, and end with a few that readily relieve pain. In virtually all cases, we believed—at least initially—that these things had the magical ability to improve how we felt with few or no ill side effects. As a result, they were greeted with widespread enthusiasm and their use eventually spread across the globe. However, we will also see that evidence of unintended side effects has steadily accumulated over the years. Since the following subsections go over quite a bit of data, you may wish to skip or skim them based on how much time and interest you have.

Food Additives

We all need food to survive. But have you ever noticed that the foods widely considered the healthiest (such as plain, unseasoned whole vegetables, fruits, nuts, lean meats and fish) generally taste much less appetizing than those considered the least healthy (such as typical pizzas, hot dogs, cookies, and other sweets)? To be sure, each of us has different culinary preferences, which have been shaped by where we live and what we ate growing up. However, most of us will agree that the foods we find most delicious are invariably either sweetened or salted. Late Kitchen Confidential author Anthony Bourdain described a world without salt as “a world without flavor.” Through my own kitchen experimentation, I’ve concluded that if you take any food and remove all of its savourizers (i.e. sodium and glutamates) and sweeteners (whether natural or artificial), it will virtually always end up tasting bland. It might still look good, smell good, and have an appealing texture, but any pleasurable taste will have mostly disappeared.

Now let’s go over both the positive (pleasurable) and negative (painful) effects of some of the most extensively studied food ingredients.

Natural sugars

Natural sugar comes in many forms. This includes those naturally found in food like carrots or apples, as well as refined “free sugars” which are added to foods, such as cane sugar, honey, corn syrup, and fruit juice. We all know that sugar makes food and beverages taste sweeter. But what is less well known is that sugar is also used to mask unpleasant flavours such as the acidity of tomatoes, improve the tenderness of baked goods, and make some foods crunchier while making others, like ice cream, silkier. Ultimately, sugar is one of our most consistent sources of daily pleasure. Can you imagine what chocolate, soda pop, and your favorite desserts would taste like without sugar or other sweeteners? You can find out by getting your hands on some Gymnema Sylvestre, an herb that “destroys” our ability to taste sweetness for up to an hour without affecting other flavours. The result? Granulated sugar ends up tasting like sand, honey tastes like wood, and chocolate tastes like lumpy wax.

On the other hand, studies increasingly link consuming too much sugar, mostly in the form of sugar that’s added to foods and beverages, to various negative physical effects. These include dental cavities, obesity, chronic diarrhea, irritable bowel syndrome, non-alcoholic fatty liver disease, cardiovascular disease, and diabetes. It is also linked to cognitive decline, pancreatic cancer, and kidney disease. Frank Gresham, founder of The Chronic Pain Center in the state of Virginia, US, says sugar is also a major culprit of various body aches and pains. Eliminating all added sugars in all forms is often the first strategy he recommends to reduce or eliminate his patients’ chronic pain. Many migraine sufferers, and some doctors, link sugar consumption to migraine headaches. Action on Sugar, an international group of specialists, state that: “Free sugars damage health. The leading public health bodies all agree the scientific evidence is solid”. Many consumers also link sugar to feeling worse emotionally. Indeed, research published in the British Journal of Psychiatry and elsewhere concludes that increased sugar consumption can worsen symptoms of schizophrenia and depression. Though the science is still sparse in this area, many individuals and registered dieticians have observed that foods high in sugar can worsen anxiety symptoms.

Alternative sweeteners

Ever wonder what the first ever alternative sweetener was? Some might say it was saccharin, which was discovered by accident in 1879 by an American researcher. But the story of alternative sweeteners actually goes back thousands of years to ancient Rome. The Romans used to store wine in leaden pots and discovered that, over time, their wine would mysteriously become sweeter. This was due to lead acetate, or sugar of lead, which naturally leached out of their leaden pots. Despite budding awareness in those times that lead might cause certain illnesses, this sweetener continued to be used for centuries. Its use only ended in modern times when a better understanding of lead’s toxicity, and accurate methods to detect it in food and beverages, became widespread.

We may no longer deliberately use lead to sweeten things, but food scientists have since discovered, again often by accident, quite an arsenal of alternative sweeteners, including aspartame, sucralose, and sugar alcohols such as sorbitol, maltitol, and xylitol. Their goal? Provide a pleasantly sweet flavour but with fewer calories than natural sugar. As such, they are used in a variety of foods in place of regular sugar with the assumption that they will be healthier and assist those trying to lose weight. However, their ability to make us lose weight has been called into doubt by scientists. According to obesity and weight-loss specialist Dr. David Ludwig, studies link frequent consumption of diet drinks (containing low-calorie sweeteners) with significantly increased risk of being overweight or obese, and developing metabolic syndrome or type 2 diabetes. They have also been linked to increased risk of stroke. Randomized and prospective studies show that these artificial sweeteners can also cause or aggravate a variety of other negative effects such as depression and migraines. Unfortunately, the alternative sweeteners that seemed to solve the problems associated with natural sugars turned out to create many problems of their own.

Sodium

Commonly consumed in the form of table salt, sodium is a mineral our bodies need to manage blood pressure and perform other basic functions. However, many of us don’t realize how little of it we actually need nor that we often consume five to ten times our daily requirement of sodium.

Sodium produces plenty of short-term positive effects—in other words, it can boost pleasure or relieve pain. Most people are aware that foods seasoned with sodium (or table salt) taste significantly better than those that aren’t. But it also improves the texture of foods like doughs, cheeses, and meats, as well as the colour of cured meats, breads, and other edibles. Salt, as per the principle of blending, can also mask bitterness and chemical or metallic “off” flavours. Finally, though it may seem counterintuitive, salt can actually make sweet things taste even sweeter. As such, sodium is a virtually guaranteed pleasure-booster, which many of us consume at every meal and snacking opportunity. Can you imagine the flavour of hot dogs, chips, soup, cheese, and even bread without any sodium? Pulitzer Prize-winning journalist Michael Moss didn’t have to use his imagination. Kellogg’s R&D department prepared special salt-free versions of some of their best-known products for him to taste. His reaction? “I have to tell you, it was a God-awful experience tasting those things,” he confessed.

Though widespread salting of food has been going on for centuries, the realization of sodium’s negative health effects has only recently gained momentum. Higher sodium intake is now correlated with a laundry list of long-term health and affect problems. The international group of health experts known as World Action on Salt and Health (WASH) warns that a high-salt diet can contribute to high blood pressure, stroke, heart disease, osteoporosis, stomach cancer, kidney disease, renal stones, and obesity. Finally, excess salt may also increase the risk of headaches and migraines, vascular dementia, increased cognitive decline in older sedentary adults, increased appetite and food intake, weight gain (independently of total food intake), diabetes, asthma, and other respiratory issues.

Monosodium glutamate (MSG)

Monosodium glutamate, commonly known as MSG, is a widely-used flavouring ingredient. Many people assume MSG is only found in a few types of foods, such as “Chinese food” and soy sauce. However, it is also often added to soups, bouillons, gravies, snacks, and other prepared foods. It can be notoriously difficult to identify in a product’s ingredient list because it masquerades under dozens of different names such as hydrolyzed protein, autolyzed yeast, yeast extract, and cultured celery extract.

MSG’s short-term positive effect is rather straightforward: it gives food a pleasant, sought-after umami flavour, which some describe as deliciously “meaty” or “savoury.” However, MSG as an additive has a long and controversial history of negative effects. Anecdotally, some individuals report that cutting out MSG has reduced or eliminated their headaches, body aches, fatigue, dizziness, depression, nausea, chest pains, and in some cases even their Parkinson’s disease or attention deficit disorder (ADD) symptoms. Many studies over the years have conflicted regarding whether MSG causes problems such as the so-called Chinese Restaurant Syndrome—a mix of headaches, chest pain, sweating, and other symptoms. Beyond this controversial syndrome, studies have gradually accumulated showing other problems associated with this additive.

Author and retired neurosurgeon Dr. Russell L. Blaylock was a pioneer in demonstrating that consuming MSG could overexcite neurons in the hypothalamus thereby causing them to self-destruct. He thus classified them as excitotoxins. Furthermore, his research and that of others found that this caused problems with appetite regulation, which increased the risk of obesity. Another study of MSG consumption in Chinese adults linked higher MSG intake with being overweight, independent of total calorie intake and total physical activity. “Consumers should know that the glutamate industry funded the majority of studies ‘proving’ the safety of MSG,” warns Dr. Kathleen Holton, nutritional neuroscientist and food additive researcher at American University. “Independent scientists have not always agreed with those findings.” In one of her studies, she showed that those suffering from fibromyalgia and irritable bowel syndrome (IBS) experienced worse headaches, diarrhea, gastrointestinal pain, fatigue, muscle pain, and cognitive dysfunction after consuming MSG compared to those on a low-MSG diet.

When considering all the food additives we’ve looked at, we can conclude:

KEY POINT #34: Though sweeteners and savourizers can boost the flavours and textures of everything we eat and drink, evidence increasingly shows that they also have many longer-term negative effects.

Commonplace drugs

Let’s turn our attention to another source of everyday pleasure: broadly legalized, commonplace drugs. Alcohol, caffeine and nicotine are widely consumed in nearly all countries. However, since they have milder effects than so-called hard drugs like heroin or cocaine, we tend not to think of them as psychoactive drugs and may therefore think they are relatively harmless. Let’s take a closer look.

Alcohol

Alcohol is one of the oldest drugs in the world, with evidence of it being produced by humans for over 10,000 years. As with virtually all other drugs, we tend to consume it for its short-term positive effects. As journalist and recovering alcoholic Caroline Knapp explained in her best-selling memoir Drinking: A Love Story, she drank to overcome her shyness, fear, depression, and anxiety. “The comfort was enormous,” she said, “I was an easier, stronger version of myself, as though I’d been coated from the inside out with a warm liquid armor.” Indeed, many of us consume alcohol to relieve stress, relax, and simply feel better. Alcohol is also shown to reduce depression and anxiety in the short-term, which can translate to a boost in confidence, earning it the nickname liquid courage. Last but not least, it also has analgesic properties, which reduce physical aches and pains. That is why many of us drink—to numb the pain in our bodies and in our hearts.

Alcohol’s soothing effects quickly made it a popular beverage around the world, but our awareness of its many harmful negative effects only slowly started gaining momentum in the 1800s. “Your life gets ugly and you drink more,” Knapp observed. “You drink more and your life gets uglier still.” In other words, her drinking caused her various problems, and the solution was to drink even more. According to a 2000 review of alcohol studies, the same alcohol that can temporarily reduce our anxiety may also paradoxically increase it later on, which may lead users to develop anxiety disorders they didn’t have before. Higher alcohol intake is also correlated with increased risk of headaches and migraines. Dreaded hangovers, consisting of headaches, body aches, fatigue, irritability, nausea, anxiety, and depression, often occur after a single period of heavy drinking. Alcohol can impair cognitive function and increase irritability as well—factors that cause alcohol to often be implicated in vehicle accidents, injuries, and violent confrontations.

The World Health Organization states that regular alcohol consumption (especially heavy consumption) increases the risk of over 200 illnesses and injury conditions, including cirrhosis of the liver, various cancers, heart disease, sexual dysfunction, and depression. Although heavy drinkers (defined as 10 drinks per week for a woman, 15 for a man) are most at risk of these diseases, recent studies show that even moderate drinkers are at risk. A less known fact is that even regular moderate drinkers can suffer from something called a permanent hangover—an ongoing feeling of sluggishness and difficulty concentrating that many don’t realize are caused by the alcohol. Even light drinking has recently been associated with increased risk of cancer by the American Society of Clinical Oncology.

Although the benefits of moderate drinking have long been promoted, a team of researchers in British Columbia led by Dr. Tim Stockwell, director of the University of Victoria’s Centre for Addictions Research, reviewed 87 long-term studies on alcohol and mortality rates encompassing nearly four million people. They discovered that many prior studies which touted the health benefits of moderate drinking made the same critical mistake: they combined life-long abstainers with long-time drinkers who stopped when their health took a nosedive into a single group of “non-drinkers.” After separating these into two groups and re-analyzing the studies, they concluded in 2016 that moderate drinking actually offered no health benefits compared to abstaining. Stockwell concluded that drinking may be pleasurable, “but if you think it’s for your health, you’re deluding yourself.”

Caffeine

For millions around the planet, drinking coffee, tea, energy drinks, or other caffeinated beverages is a daily ritual. The caffeine in these beverages gives us many short-term positive effects such as decreasing our fatigue, increasing our alertness and concentration, and boosting our energy levels. It can also lower our stress and boost our sense of well-being. According to research conducted by Dr. Gary Wenk, professor of psychology and neuroscience at Ohio State University and Medical Center, caffeine actually mimics the action of cocaine and marijuana in our brains. It’s so woven into our social lives, through “afternoon tea” or “going for a coffee” with friends, that it’s the single most widely used psychoactive stimulant in the world.

However, according to the 2018 medical review Neurologic Effects of Caffeine, consuming sufficient levels of caffeine can also lead to negative effects such as restlessness and insomnia. Paradoxically, the same caffeine that boosts our energy and lowers our stress may make us feel more tired and anxious later on when its effects fade, potentially inducing panic attacks. It may also impair learning and memory. And finally, when we haven’t consumed it for somewhere between three and twenty-four hours, we may begin to experience withdrawal symptoms, which can include headaches, irritability, depression, nausea, and tremors.

Nicotine

According to the Canadian Cancer Society, the nicotine in cigarettes gives rise to various positive effects. It boosts our mood, makes us feel calm, and helps relieve our stress, anxiety, or boredom. It also reduces our hunger and increases our alertness. However, these effects eventually wear off and the ensuing cravings are so strong that smoking is considered one of the hardest addictions to quit. Over time, the effect per dose of nicotine decreases; the user develops a tolerance to it, which means they need to consume even more to maintain the same effect.

People have been smoking and chewing tobacco products for hundreds of years, but widespread understanding of their negative consequences is relatively recent. How many people started smoking tobacco before it became widely known that it caused lung cancer and other diseases, which eventually kill up to half of all smokers? Depending on the extent of their addiction, smokers may experience nicotine withdrawal within a few hours after their last intake. Withdrawal can include dysphoria (which is a sense of unease or dissatisfaction), anhedonia, irritability, and headaches. Though many smoke to soothe their anxiety, they often don’t realize that nicotine also causes anxiety during withdrawal. Finally, according to the US Centers for Disease Control and Prevention, smoking also harms nearly every organ in the body, damages blood vessels, and increases the risk of many illnesses including stroke, heart disease, diabetes, erectile dysfunction, cataracts, and Alzheimer’s disease.

Some claim that nicotine vaping products, a recent innovation, are safer than smoking. However, long-term data is not yet available to confirm these claims. Vaping can also cause certain types of lung injury—such as EVALI (e-cigarette or vaping product use associated lung injury)—that aren’t associated with traditional cigarettes. It is worth noting that some vaping cartridges contain more nicotine than cigarettes, which may make them even more potent and addictive.

In summary:

KEY POINT #35: Commonplace drugs like alcohol, caffeine and nicotine temporarily relieve our stress and elevate our mood, but evidence is increasingly showing they have longer-term negative effects.

Prescription and non-prescription medications

Many of us rely on medications to ease our health problems, which can range from mild toothaches to severe depression. The average American filled around 12 prescriptions in 2013. There are thousands of different types of medications worldwide. Many of these can only be prescribed by doctors, while there are some that we can freely buy and use whenever we feel the need. Though the potent primary effects of these drugs are clearly positive, virtually all medications—prescription or otherwise—also come with a laundry list of potential negative side effects.

Let’s look at both the positive and negative effects of some of the most prescribed medications in the world:

Atorvastatin (brand name Lipitor), the best-selling drug of all-time, helps prevent heart attacks and strokes by controlling cholesterol levels. According to the U.S. National Library of Medicine, its side effects include heartburn, nausea, joint and muscle pain, chest pain, memory loss, confusion, fatigue, and flu-like symptoms.

Anti-anxiety drugs may relieve anxiety but also potentially cause side effects such as cognitive impairment, sleepwalking, amnesia, depression, and violent behaviour. Benzodiazepines, the most commonly-prescribed type of anti-anxiety medication, also commonly cause emotional anaesthesia—the inability to feel both painful and pleasant emotions.

Selective serotonin reuptake inhibitors (SSRIs), the most popular class of antidepressants, are scientifically linked with emotional blunting—a reduction of both painful and pleasant emotions.

Headache medications such as triptans and opioids have been found to potentially cause or worsen chronic headaches, called rebound headaches, according to the United Kingdom (UK) National Health Service.

Opioids, such as oxycodone (sold under trade names such as OxyContin and in combination drugs such as Percocet and Vicodin), are widely prescribed for their highly effective short-term painkilling properties. They also have the ability to generate feelings of well-being and even euphoria. Although opioids are widely prescribed in North America, Pulitzer Prize-winning New York Times reporter Barry Meier argues in his book Pain Killer: An Empire of Deceit and the Origin of America’s Opioid Epidemic that long-term use causes a variety of significant health problems. These include lethargy, addiction, and hyperalgesia, which is paradoxically an increased sensitivity to pain. Other recent research shows that opioids significantly increase the risk of major depressive disorder. Meier describes how opioids became the most popular pain treatment option because they provided the fastest short-term solution, but that doctors are increasingly realizing that “using them on a massive scale to treat chronic pain has had really disastrous consequences.”

KEY POINT #36: Don’t be fooled by their name: many painkillers don’t merely kill pain, but can also make us feel good and even euphoric, just like many recreational drugs.

If suduality wasn’t true and all pleasant and unpleasant feelings were independent from each other, taking pain medication should only reduce pain. However, French surgeon and pain specialist René Leriche observed that the use of pain medicines had the unintended consequence of making people more sensitive to pain than their ancestors. Furthermore, if painkillers worked as described, shouldn’t they consistently erase pain? However, up to 95 percent of patients receiving around-the-clock analgesics to control pain end up experiencing breakthrough pain—pain that unexpectedly “breaks through” the analgesic. “What everyone wants is a drug that is highly selective for the pain and leaves everything else untouched,” according to therapist Douglas Nelson, author of The Mystery of Pain. “This is the Holy Grail of pharmacology research and pain.” Unfortunately, this kind of wonder drug has yet to be found.

If you weren’t already aware of the many side effects of the above medications, the universality of these effects may come as a surprise. To make matters worse, we’ve merely scratched the surface of the published side effects. Many unintended effects are only discovered after the medicine is in common use, which the pharmaceutical industry calls postmarketing side effects.

Side effect exercise: If you take any medications regularly, I encourage you to get familiar with all of their potential side effects. Keep an eye out for any unusual symptoms that may arise while taking these or after you discontinue them, regardless of whether these symptoms are officially recognized. Talk to your doctor, but also go online and find others who may be going through the same experiences you are.

Recreational drugs

Philip K. Dick was a popular science-fiction writer whose stories were often about recreational drugs, or written while under their influence. His award-winning, semi-autobiographical novel A Scanner Darkly described a world dominated by a fictional drug called Substance D. The story chronicled the progressive brain damage experienced by the various characters hooked on this drug. In the book’s epilogue, Dick reflected about his own circle of friends and their real-life experience with illicit drugs: “We really all were very happy for a while . . . but it was for such a terribly brief time, and then the punishment was beyond belief: even when we could see it, we could not believe it.” He dedicated his book to 15 people he knew (including himself), half of whom developed permanent health problems from their substance use, including psychosis and brain damage. The other half died prematurely. Dick’s view was that “drug misuse is not a disease, it is a decision, like the decision to step out in front of a moving car . . . If there was any ‘sin,’ it was that these people wanted to keep on having a good time forever, and were punished for that.”

As Dick illustrated, many who begin consuming recreational drugs for their primary effects of euphoria or pain relief are, to some degree, unaware of how powerful the impending side effects will be. When each of these drugs was first discovered, knowledge of their particular mix of side effects was minimal. As a result, many consumed them exuberantly and repeatedly. Today, it is widely documented that virtually all recreational drugs that produce euphoric or pain-relieving effects have many negative side effects; that chronic use often leads to addiction; and that discontinuation can lead to difficult withdrawal symptoms. This isn’t to say that these substances do not have proper medicinal uses in certain controlled situations, but our focus will instead be on their recreational use.

Marijuana

Marijuana—also known as cannabis, pot, or weed—is the most consumed drug in the world that is, in most countries, still illegal. It gives us a variety of well-known pleasant effects, including a feeling of relaxation, mood elevation, and even euphoria. It heightens sensory awareness and increases appetite—what users call having the munchies. In a review commissioned in 1996 by the UK Department of Health, marijuana was shown to be effective at reducing nausea, relieving pain, reducing anxiety, and improving sleep. Some users describe it as the “ultimate boredom killer,” while many others say that marijuana makes sex, eating, and socializing more enjoyable. “Weed is not a drug; it’s a seasoning . . . like salt for your life,” explained one user to Canadian researchers.

However, marijuana, which many perceive as harmless, often causes negative side effects. Some of the milder side effects include dizziness, dry mouth, mood swings, decreased libido, and frequent colds or flus. Some studies have found that increased marijuana use is linked to increased anxiety and panic symptoms. According to the Centre for Addiction and Mental Health, cannabis is increasingly linked to hallucinations, paranoia, and potentially long-term psychosis such as schizophrenia, especially in adolescent users. Higher frequency of marijuana use in adolescence predicts higher rates of anxiety and depression later on. Some longitudinal studies have shown that those satisfying the diagnostic criteria for cannabis abuse are four times more likely than non-abusers to develop depressive symptoms including anhedonia and suicidal ideation. Very heavy use of marijuana (that is, over ten joints a day) is associated with reduced cognitive performance, such as memory loss and learning difficulties, even after abstaining for 28 days. “I was a smart guy before weed,” lamented one reddit.com user. It should then be no surprise that marijuana use also correlates to having more relationship problems, lower academic and career success, and increased likelihood of accidents. Contrary to popular belief, some users can and do become dependent on the drug. And long-term users who have quit have reported withdrawal symptoms such as irritability, anhedonia, nausea, chills, anxiety, and cravings for the drug.

Cocaine

Cocaine’s short-term positive effects include a brief but intensely pleasurable high. “It is the single greatest feeling I’ve ever felt in my life,” wrote Cracked.com columnist Adam Tod Brown about his first time trying crack cocaine—one of its most potent forms. In the short-term, cocaine has analgesic (pain-relieving) properties, and can also increase self-confidence, boost energy and alertness, and give the illusion of increased physical strength or mental capacity, which leads some users to temporarily feel invincible. It can also amplify the pleasure of everyday activities such as having a conversation or having sex.

In the nineteenth century, the early years of cocaine, this drug was widely promoted as a miracle cure for nearly every illness and included in many medicines and tonics. It even made its way into popular soft drinks such as Coca Cola. Some psychoanalysts of the time, including Sigmund Freud, proposed using cocaine as a treatment for addictions to other substances such as alcohol and morphine. However, over the years it eventually became clear that cocaine’s positive effects were generally followed by a variety of unpleasant effects, including intense depression and nervousness, which fuelled cravings for another dose. Some first-time users become addicted after a single dose. Cocaine also increases the risk of nausea, irritability, formication (the feeling of “bugs crawling under the skin”), anxiety, paranoia, seizures, hallucinations, and even respiratory failure. Long-term use can damage various organs, cause malnutrition due to loss of appetite, and lead to severe tooth decay, sexual dysfunction, and high blood pressure. The latter may in turn increase the risk of heart attacks and strokes. Addicts eventually lose interest in everyday activities such as socializing, spending time with family, eating, and even sex. According to the U.S. National Library of Medicine, withdrawal symptoms include agitation, depression, fatigue, and cravings for the drug.

Heroin

The short-term positive effects of heroin include feelings of euphoria and powerful pain suppression. If our pleasure scale goes from 1 to 100, then eating a delicious piece of chocolate might feel like a 5 or a 10 but heroin “shoots you right to 100,” according to Rick Diaz, clinical director of the Arizona Counseling and Treatment Services rehabilitation centre. Heroin users further report that it increases their self-esteem and relieves their anxiety, depression, dark thoughts, and feelings of hostility.

When doctors began treating patients with heroin, the initial clinical results were so positive that it was hailed as a wonder drug that could treat a wide variety of illnesses. When it was first sold to the public in the 1890s, companies like Bayer heavily promoted it as non-addictive, and even as a treatment for morphine addiction. It was available to the public without prescription, and even promoted for use by children. As with cocaine, it took a few years for the initial exuberance to gradually fade while its side effect profile progressively became better understood. Within a few decades, several bans and treaties, such as the American Anti-Heroin Act of 1924, had been put in place to stop the spread of heroin.

With a century of heroin experience under our collective belt, we now know that some of its short-term negative effects include intense itching, nausea, dry mouth, and drowsiness. Longer-term effects include depression, sexual dysfunction, as well as liver and kidney disease. Withdrawal has been anecdotally described as “the worst flu you’ve ever had, times ten” with symptoms that include insomnia, restlessness, nausea, feeling too hot or too cold, and physical pain to the degree that, according to Diaz, “every muscle and bone in your body [feels] like it’s dying.” Similarly to cocaine addicts, heroin addicts lose the motivation to pursue normal, healthy activities and instead spend virtually all of their time seeking and using the drug.

If heroin feels like the best chocolate times 10, followed by the worst flu times 10, then clearly heroin doesn’t simply make us high, it amplifies both pleasure and pain.

Based on all of the illicit drugs we’ve seen so far, we can conclude:

KEY POINT #38: Recreational drugs can give us tremendous euphoria and pain relief, but this comes at the cost of pronounced depression, anxiety, withdrawal symptoms, and other painful effects.

Entertainment

Pornography

Real-life relationships require the building of trust and closeness before any physical intimacy might occur. Pornography, on the other hand, bypasses all of this time and effort and gets straight to the sex—in the form of explicit images, stories, or videos. In the world of porn, we don’t have to consider the other person’s feelings and desires. We don’t need to fear being rejected, or worry about pregnancy and sexually transmitted diseases. Porn enables us to selfishly focus on our own sexual enjoyment. And those of us with high-speed internet can access a virtually endless variety of explicit content anytime, anywhere, to satisfy any sexual fetish, while skipping over anything we don’t find arousing. For these reasons, many of us nowadays habitually watch pornography.

For the longest time, I and many others considered pornography a harmless pastime. Yet research is increasingly linking porn to various negative psychological effects: “After adjusting for demographics,” found a 2011 study published in the Journal of Sexual Medicine, “[sexually explicit media] users, compared to nonusers, reported greater depressive symptoms, poorer quality of life, more mental- and physical-health diminished days, and lower health status.” A growing number of experts argue that porn can be addictive. Emerging scientific studies are finally making a connection between pornography consumption and sexual dysfunction. Psychologist Phillip Zimbardo, famed for his 1971 Stanford prison experiment, noted that “arousal addictions” (such as excessive use of pornography, the internet, and video games) are major contributing factors to social anxiety, and are causing boys and men to increasingly fail in their education and romantic relationships. One survey found that 60 percent of male users said watching porn led them to have a reduced interest in pursuing social or romantic relationships. Finally, one widely-cited 1988 study showed that exposure to non-violent pornography uniformly reduced satisfaction with their sexual partners, including their physical appearance, sexual curiosity, and sexual performance. This effect is similar to how regularly eating sweetened foods makes unsweetened foods taste less appealing.

Watching television (TV)

Whether we consume it online, through cable, or over the air, millions of us spend hours each day watching television. Ultimately, TV is a blank canvas: a medium that allows us to dream up any combination of images and sounds. On the one hand, TV programming can provide value and meaning by educating us, by keeping us informed of current events, by inspiring us, and by teaching us how different people feel, think, and behave. At the other extreme, it can serve up mindless entertainment with no purpose other than to numb or excite us with things like witty dialogue, jokes, beautiful people, sexuality, music, and unrealistic drama. Such television typically has most of the boring or difficult parts of life edited out. It is in this latter context that many of us watch television—to relax, enjoy ourselves, and forget all of our real-life worries.

Though TV-watching may seem like a rather innocent pastime, Public Health England reports that higher levels of TV viewing negatively impact children’s feelings of self-esteem and self-reported happiness. It can also lead to higher levels of emotional distress, anxiety, and depression. Several studies associate greater TV watching with greater attention deficit problems. One seven-year study published in 2009 in the Archives of General Psychiatry found a link between adolescents who watched more television and consumed more media and an increased risk of depression in young adulthood. Finally, a 2011 study published in Psychiatry Research found an association between increased TV watching and dysthymia (mild persistent depression), panic disorder and agoraphobia, independent of overall physical activity levels.

Playing video games

Much like the medium of television, video games provide a blank slate onto which we can project our collective imagination. Some games can be beneficial, teaching us valuable life skills such as how to do math, fly a plane, or even perform surgery. However, most games available today are not designed as educational tools but rather as escapist fantasies that develop few real-world skills. The top 10 best-selling retail games of 2019, for instance, consisted entirely of fantasy sports, shoot ‘em ups, action/adventure, fantasy warfare, fighting, and racing.

Research shows that video games can provide several benefits such as strengthening cognitive abilities, including hand-eye coordination and visual attention skills. However, based on my thousands of hours of gaming experience alone and with friends, the main reason we play these games is because they offer so many kinds of virtual satisfaction. They fulfill our desire to explore (by letting us roam large worlds), to achieve goals (by gathering items and completing levels), to unleash our aggression and our desire for superiority (by beating endless opponents), and to simply have fun.

The degree of rewarding stimulation from video games, however, can cause players to feel less satisfaction from real-world activities—“for a lot of guys, real life is just not as rewarding as video games,” observed psychologist Philip Zimbardo. This means that the more video games are played, the less desire there may be to accomplish real-life goals. Countless wives complain that their husbands spend hours playing while neglecting their spouse, children, and household chores. Studies led by Douglas Gentile, a leading expert on the effects of media on children and adults, show that students who play more video games tend to lose interest in school and drop in grades. Players may also lose interest in their romantic partners and their relationships may falter. Many could be classified as “addicted,” with some researchers comparing these games to heroin or cocaine. Increased video gaming is also causally linked to repetitive strain injuries, weight gain, attention deficit disorder (ADD), worsening depression, social phobias, and anxiety. “The destructive effects of video games are not on boys’ cognitive abilities or their reaction times,” wrote research psychologist Leonard Sax in his book Boys Adrift: The Five Factors Driving the Growing Epidemic of Unmotivated Boys and Underachieving Young Men. Sax notes that the real negative impacts are rather “on their motivation and their connectedness with the real world.”

Regarding the different kinds of entertainment we’ve looked at, we can conclude:

KEY POINT #40: Entertainment forms like video games, pornography, and television can be pleasant ways to pass the time and soothe ourselves, but evidence increasingly links them to depression, anxiety, and difficulty enjoying normal everyday activities.

Constant pleasure-seeking

Many of us living in Western societies base our lives on the pursuit of pleasure and the avoidance of suffering, believing that we can seek as much of the former as we like without needing any of the latter. According to clinical psychologist Archibald Hart, all of this pleasure-seeking has had surprising, unintended consequences. Anhedonia, he says, used to happen only to those with serious disorders such as schizophrenia and drug addiction. But now, even otherwise-healthy people are suffering from this inability to feel normal, everyday pleasures. “Anhedonia,” wrote Hart in his book Thrilled to Death, “is brought on, paradoxically, by the excessive pursuit of pleasure.” Modern pleasure-seekers require a higher level of stimulation to feel the same amount of pleasure as previous generations, he argues, adding that, “despite having more sources of pleasure than ever before in history, we are probably the unhappiest people who have ever lived.” As pain specialist Dr. Erv Hinds equally noted in his book A Life Larger than Pain, “Why the deep irony that affluence in our Western society seems to make pleasure more difficult to reach?”

KEY POINT #41: Our constant pleasure-seeking, whether through food, recreational drugs, or entertainment forms such as TV and pornography, progressively numbs us to the simple pleasures in life, such as watching a sunset, joking around with our friends, or holding hands with a loved one.

Avoiding traumatic pain

Positive effects aren’t just about adding pleasure to our lives. They also take the form of reducing our pain. These twin behaviours are essentially equivalent—they are two sides of the same coin. Let’s briefly look at a few examples of pain reduction.

In his extensive work with trauma patients, Dr. John Briere, former president of the International Society for Traumatic Stress Studies, uncovered a phenomenon he called the pain paradox. Here is how it works: those trauma patients who try to avoid and bury their pain—by medicating themselves with drugs or alcohol, suppressing painful thoughts through denial or dissociation, or indulging in shopping or other pleasant activities—tend to experience chronic post-traumatic issues. On the other hand, patients that directly engage with and experience their trauma—whether by facing difficult memories, or through exposure to the traumatic thing in a therapeutic context—tend to have better outcomes and suffer from fewer chronic trauma-related conditions. Psychologist Carl Jung similarly said, “Neurosis is always a substitute for legitimate suffering.” According to Jung, deliberately avoiding normal and healthy suffering leads to neuroses like anxiety, obsessions, and narcissism. And Patrick Wall, a twentieth-century neuroscientist and possibly the most highly-regarded pain researcher of all time, wondered before his own death whether physical pain that isn’t fully experienced always turns into chronic pain. In other words:

KEY POINT #42: Prematurely avoiding or eliminating pain (a positive effect) can cause that pain to resurface later on (a negative effect). Continual pain-avoidance (instead of pain-acceptance) tends to cause or worsen long-term chronic post-traumatic conditions.

The fewer responsibilities we have, the more we worry about little things

Suduality predicts that if we remove big problems, responsibilities, and workloads from our lives, it won’t automatically mean that we’ll suffer less. Instead, little things in the background of our lives that didn’t used to bother us may rise into the foreground and become “big deals” to us as our focus shifts from our larger problems to our smaller ones. For instance, my wife and I experienced this effect as our kids grew older and raising them became easier—we started worrying more about how our house and lawn looked than we had in years, things we had not cared about while we were busy changing diapers.

While those who are poor may worry about where their next meal will come from, the wealthy may fuss about whether their meals are too cold, too bland, or too chewy. While the poor worry about having clothes on their backs, the rich worry that their clothing may no longer be in fashion. While the poor worry about just having a roof over their heads, the rich worry about how presentable their house looks. In other words, people in wealthy countries tend to worry endlessly about so-called first-world problems such as which colour to paint a wall, or when they should upgrade their gadgets. And the most pampered among us seem to fret about the smallest things, like celebrities throwing tantrums from not having the right kind of bottled water or the right colour of linens in their hotel rooms. Indeed, after reviewing a study of those worth over USD $25 million, Graeme Wood, award-winning journalist and National Correspondent for The Atlantic, concluded (with emphasis added) that, “Enormous wealth takes care of so many day-to-day concerns, that the remaining ones grow that much more frustrating.”

KEY POINT #43: Solving our larger problems (which is a positive effect) often causes smaller issues to rise to the foreground and become our main source of worry and frustration (which is the counterbalancing negative effect).

IN-DEPTH: Do normal, healthy pleasures have side effects?

Some of us may wonder: if all positive (pleasant) effects are counterbalanced by negative (unpleasant) effects, shouldn’t this also apply to hum-drum healthy activities like eating plain, wholesome foods and lovemaking? That is a great question and there are a few reasonable ways to answer it:

First, it’s important to understand that pleasant effects don’t always have to be followed by their counterbalancing negative effects. They may instead be preceded by them. In fact, these everyday pleasures are often “prepaid” by our painful desire for them. In other words, our unpleasant hunger to eat and our gnawing itch to be intimate help to counterbalance the satisfaction we eventually get from those activities.

Second, our minds presumably plan what you might call a “balanced affective budget” to account for the variety of pleasant and unpleasant activities it anticipates in the coming days. It may do so by preallocating fixed amounts of pleasure for certain events and fixed amounts of pain for others, such that they altogether balance out. If the budget is followed, the combination of painful events would then counterbalance the combination of joyful events, without requiring individualized unpleasant effects to be matched up one-to-one to each individual pleasant effect.

Finally, even if we break our “affective budget” and take in more pleasure than pain overall, the deficit we accumulate—and thus the resulting consequences—will likely be minor. This is because most everyday pleasures are mild in nature compared to those we saw earlier—compare for instance carrots to cake and cocaine. As such, our negative tension builds much more gradually and the resulting negative effects are milder and less frequent, therefore less noticeable. We might end up experiencing a day where we feel slightly down, but we are very unlikely to experience any severe effects such as full-blown depression or panic attacks.

Inducing negative effects should lead to positive effects

If suduality does not exist and pain and pleasure are truly independent of each other, then we’d expect that deliberately increasing one would have no effect on the other. However, if suduality does exist, then creating a negative effect in our lives—less pleasure or more pain—should later cause equivalent positive effects—more pain or less pleasure—in order to maintain the balance between the two sides. “[H]aving a negative experience leads to a more positive experience afterwards,” observed social psychologist Brock Bastian, “more so than what would have been there if you didn't have the negative experience in the first place.” The ensuing positive effects may happen to us within minutes, hours, days, or even weeks of the negative effect.

In the next few sections, we will see a variety of scenarios demonstrating this effect. First, we’ll cover a few examples of deliberately increasing various pains, then a few examples of deliberately decreasing various pleasures. Again, since we’re going to cover a fair amount of material, I encourage you to skip and skim the following evidence based on how much time and interest you have.

Physical exercise

The short-term painful effects of physical exercise are fairly obvious: exerting ourselves physically can feel quite demanding and unpleasant. The longer and harder we work our muscles and joints, the more painful it can become. That is why those who lift heavy weights or do many repetitions of an exercise say they eventually feel the burn in their muscles. This doesn’t only happen in a gym or on a runner’s track. We can also feel this burn while doing everyday vigorous activities such as raking leaves, shovelling snow, or scrubbing the burnt remains off of a kitchen pot.

Is exercise only good for losing weight and toning our muscles? Actually, exercise has been scientifically linked with a veritable smorgasbord of long-term positive effects. Did you know that it can effectively reduce anxiety, stress, and depression just as well as antidepressants or cognitive therapy? The more exercise we do, the larger the benefits we get. Even if we aren’t depressed or anxious, it makes us feel even better than we would have otherwise. In 2014, a study led by Dr. Einat Kodesh was among several to experimentally demonstrate that exercise causes hypoalgesia—a decreased sensitivity to pain. Other researchers have shown that it can significantly reduce various chronic pains—such as chronic back pain or shoulder pain—in a dose-dependent fashion. On the cognitive side, exercise boosts our memory, our focus, and our ability to process information, making it easier for us to handle mental tasks. It gives us more energy while also improving our sleep, so we feel less tired and sluggish. Finally, exercise reduces our risk for many diseases and health problems (and their corresponding unpleasant effects) such as stroke, diabetes, Alzheimer’s disease, and several types of cancer.

An exercise on exercise: Choose a physical activity that you enjoy, such as jogging, biking or swimming, and do it until you are physically aching and tired out. Afterwards, monitor how you feel over the next day or two, both physically and emotionally. Do you notice a lift in your mood or a reduction in your body aches?

Caution: Please consult with a doctor beforehand to ensure you are sufficiently healthy to carry out whichever exercise you have chosen. You may also choose to do this exercise using other varieties of pain, but please do so in a safe manner.

Hard work

Every day, most of us have no choice but to work hard to earn our living or to tend to our family and home. As much as we may wish that life were somehow easier, increasing evidence shows that there is a payoff to all of our daily struggles. Numerous studies now confirm that striving towards a goal increases self-reported happiness. For instance, after interviewing hundreds of people around the world, Swedish researchers from Gothenburg University found that working towards a goal, rather than actually attaining it, provided the most satisfaction of all. By comparison, achieving our goals—even something as extravagant as winning the lottery—provided only short-lived highs. For those of us with dependents, a 2013 study confirmed that the more parents sacrificed their time and effort towards their children, the more happiness they got out of parenting. Countless people have noticed that hard work is often rewarding. “The foundation of pleasure is labour with pain,” noted renaissance polymath Leonardo da Vinci. Nobel-winning playwright Eugene O’Neill offered this perspective: “Any fool knows that to work hard at something you want to accomplish is the only way to be happy.”

KEY POINT #46: As countless people have observed, hard work pays off—not just financially but also in increased satisfaction, love, joy, and other positive emotions. The harder the struggle, the sweeter the reward.

Meditation

Have you ever tried meditating? All you have to do is sit quietly and focus on the present moment. On the surface it seems quite easy, doesn’t it? But if you’re like most of us, your mind is to some degree like a raging bull that doesn’t like to be told to stay put. Holding your mind still for a period of time is the challenge of mindful meditation. Mindfulness usually means letting all your thoughts, emotions, and sensations come and go while focusing on the present moment. This means suffering through whatever unpleasant thoughts and feelings may come up without trying to suppress them with food, medication, or other distractions.

The challenges of meditation, however, lead to many positive effects. According to Emma Seppälä, science director at Stanford University’s Center for Compassion and Altruism Research and Education, there are hundreds of studies showing that meditation not only decreases our stress, anxiety, and depression, it also improves our memory and attention, and increases our empathy and social connection to others. Moreover, according to the American College of Physicians, some scientific studies have shown dramatic reductions in chronic pain among patients who meditate regularly.

Exposure to cold

Most of us go to great lengths to avoid feeling chilly when it’s cold outside, by wearing heavy clothing or by hibernating in our heated homes. However, Dutchman Wim Hof discovered for himself the profound value hidden within the cold. One day, tragedy struck unexpectedly when his wife committed suicide. Despondent, he searched far and wide for a way to silence his grief, trying one thing or another without success. He eventually found solace, of all places, in the cold. Exposing himself to extreme cold—whether swimming in frigid waters, taking ice baths, or hiking snowy mountains wearing only shorts—caused a powerful counter-reaction in his body that produced warm and pleasant feelings. “The cold is my warm friend,” he explained in a 2015 interview with Dr. Rhonda Patrick. “If you go into the cold, then this fire comes up, you feel good. That’s [what] the inner fire [is] all about.” Hof now spends his time teaching his techniques to others: “Why I teach this method? To show that with a simple method out of nature we are able to tackle the greatest problems, which is depression, fear, anxiety, and pain. People with chronic pain. That’s all unnecessary suffering going on, and all this industry’s keeping on and say ‘yeah that’s normal,’ and I think that’s sick.” Indeed, various studies have clearly shown that exposure to cold water measurably boosts our mood while relieving our pain.

Cold shower exercise: Try switching from warm to lukewarm showers. If you feel brave, you may even try one completely with cold water. See how you feel for the next 24 hours. Has your mood improved? Do you feel fewer physical aches? Try it out, you may be surprised at how it makes you feel.

Bullet ant stings

Getting stung by an ant may not seem like a big deal, but there is one particularly large variety of tropical ant that is armed with a surprisingly potent venom: the bullet ant. Most of us know bee stings really hurt, but a bullet ant sting is said to be an astounding thirty times more painful, thus being quite deserving of its name. Rather than quickly fading away, the sting inflicts wave upon wave of agony for up to twelve hours. This makes it a contender for one of the worst possible pains any man, woman, or child can experience.

You would think this would be enough to motivate everyone in the world to avoid these critters like the plague! Yet, somewhere deep in the Amazon forest, a tribe called the Sateré-Mawé does exactly the opposite. All boys who wish to become warriors must first prove their strength by facing off against bullet ants. This ritual consists of wearing a special pair of handmade gloves, into which dozens of live bullet ants have been woven. For ten excruciating minutes, they dance with their tribe in a circle while the ants sting their hands over and over. To see for himself what this felt like, English naturalist and award-winning television journalist Steven Backshall agreed to undergo this initiation for an episode of the Discovery Channel show Venom Hunters. After enduring the entire ten minutes, the gloves were removed and Backshall howled, hunched over, and collapsed in tears. As the pain intensified over the next few hours, the cameras showed him passing in and out of consciousness. What happened next? After the agony finally died down, Backshall did not merely feel back to normal. Rather, he said he felt “like a god.” He later confirmed that he continued to feel unusually great for several weeks. Is this strange, or is it suduality?

KEY POINT #49: Bullet ant stings are among the most excruciating pains a human can experience, yet they can lead to an intense and prolonged sense of well-being.

Giving up delicious foods

If I told you that you could enjoy eating pure baker’s chocolate—the bitter kind that contains no sugar or sweetener—would you believe me? Whenever I tell someone this, they usually think I’m crazy. However, there is a well-documented phenomenon called taste adaptation. For instance, giving up sweetened treats will cause your taste buds to gradually adapt and increasingly enjoy all kinds of foods that aren’t so sweet. In other words, giving up sweetened foods causes other foods to taste sweeter. In the summer of 2010, I took the plunge myself and cut out all desserts and sweets from my diet. Only a few weeks later, I noticed a significant flavour boost in everything that I still ate. For one, I could suddenly taste the lactose sugar in milk, a flavour I had never noticed in my life. Plain radishes, which I used to find repulsively pungent, also became sweeter. And tahini, which is a slightly bitter paste made of sesame seeds, sometimes tasted like caramel despite not containing any sugar whatsoever. Is this strange, or is it suduality?

Dr. Terry Wahls, a clinical professor of medicine at the University of Iowa and the author of The Wahls Protocol: How I Beat Progressive MS Using Paleo Principles and Functional Medicine, eliminated the pain and fatigue associated with her multiple sclerosis (MS) by drastically improving her diet. After much research, the author of more than sixty peer-reviewed academic papers realized that the “biggest factor contributing to chronic pain is poor diet quality. Most people with chronic pain are addicted to sugar, eating 150 pounds of sugar and 100 pounds of [white processed] flour or more each year . . . Replacing sugar and grain-based products with vegetables and berries and removing gluten from the diet have often resulted in our patients reporting a steady reduction in pain, which often fades away entirely.” In other words, by altering the diet—rather than relying on medication—she was able to cure many of her patients of their chronic pain conditions.

Giving up all food or air

If pain is simply our minds’ way of telling us there is something wrong, then anyone who stops eating for several days or weeks should logically feel hunger pains throughout their entire fast. We might even expect that these pains should intensify as they inch closer and closer to death. Yet this isn’t what happens. Most people who have undergone long-term fasting report that their hunger fades away and they eventually feel a heightened sense of well-being during their fast—even periods of outright euphoria.

If we can induce euphoria by depriving ourselves of food, might it also be possible to achieve a similar effect by depriving ourselves of air? Indeed, some children and adolescents in search of an easy high play something called the choking game. This dangerous game, as the US Centers for Disease Control and Prevention describes it, consists of “self-strangulation or strangulation by another person with the hands or a noose to achieve a brief euphoric state caused by cerebral hypoxia.” This practice isn’t limited to children. Some adults also use choking to enhance the thrill of sexual encounters.

Why would someone experience a sense of euphoria from prolonged air or food starvation, which is clearly terrible for us? This makes little sense according to conventional thinking, but makes perfect sense according to suduality: the pain of starvation provokes a strong counterbalancing effect, which we experience as a pleasant sense of well-being.

When we consider all of the different kinds of negative effects we’ve looked at, we can conclude the following:

KEY POINT #51: Generally speaking, exercise, hard work, meditation, and other short-term painful events have been shown to lead to longer-term pleasant effects. Likewise, giving up pleasure from various sources has also been shown to lead to positive effects.

What are happiness and unhappiness?

Many of us see happiness as the ultimate goal in life, but what is it exactly? Some of us believe that happiness has a single, universal definition. Yet when we compare different cultures across the world, we discover that there are actually several interpretations of “happiness.” To better understand suduality, we’ll need to clear up what this word actually means.

To begin, some people think happiness has little or nothing to do with pleasure and pain:

1. Americans, among other cultures, believe that happiness is something that can be actively sought. The pursuit of happiness is even enshrined in their country’s Declaration of Independence. However other places, including Germany, feel that happiness is not something they can seek but rather something that happens to them. Even the English word “happiness” is based on the Old Norse word “happ,” which means “good luck.” In short, some people view happiness as having good fortune or luck.

2. Happiness can mean that we have achieved our target lifestyle, regardless of how we feel. Our neighbor may tell us they are happy because they make a lot of money and have a nice car, despite feeling miserable inside. Another might say they’re unhappy because they’re poor or single, even though they actually feel pretty good. Case in point: researchers found those who are wealthier tend to report being happier overall than those with less money, but when asked how happy they were yesterday, they are essentially no happier than anyone else.

3. Happiness can mean that we feel our lives have meaning. We might feel we are contributing to a higher purpose, like building a community or giving to those less fortunate. So if our lives felt meaningless, we would describe ourselves as “unhappy.”

Next, there are definitions of “happiness” that depend on whether we feel pleasure in a given moment:

4. Some consider themselves happy when they feel mildly content. Others in countries like Portugal or Ecuador would only consider themselves happy if they experience a rare, extreme joy. In both cases, we’ll call these momentary happiness. Thus, the opposite—momentary unhappiness—happens when we feel any kind of pain in a given moment.

Happiness can also be defined by how much pleasure or pain we’ve felt in the short term:

5. We’ll say that short-term happiness occurs when we feel more pleasure than pain, regardless of which kind, in a short-term period, such as a few hours, days, or weeks. So the opposite, short-term unhappiness, would happen when we experience more pain than pleasure in the short term.

Finally, happiness can be defined as how much pleasure or pain we’ve felt in the long term:

6. We’ll say that long-term happiness occurs when we feel more pleasure than pain, regardless of the kind, in a long-term period, perhaps several months or years. So its opposite, long-term unhappiness, would mean feeling more pain than pleasure in a similar period of time.

7. What if we feel significant amounts of pleasure and only mild, useful pains (such as hunger and fatigue, but not chronic anxiety or migraines) over a period of months or years? Let’s call this one fairy-tale happiness, because it resembles the happily-ever-after endings of many fairy-tales. It’s actually a subset of long-term happiness. And we can call the opposite sustained misery: suffering significant pain with, at most, mild intermittent pleasure over the long term.

Leading psychologist Martin Seligman concludes that, “Many happiness researchers subscribe to the notion that happiness is necessarily subjective and is essentially whatever the individual defines it to be.” In short, happiness and unhappiness have many meanings depending on who you ask. I hope this makes us question what it truly means the next time someone tells us they’re happy or miserable!

KEY POINT #52: Words like happiness and unhappiness mean different things to different people, leading to misunderstandings. In this book, momentary happiness means feeling pleasure in a given moment, short-term happiness means feeling more pleasure than pain over a period of hours or days, while long-term happiness means feeling more pleasure than pain over a period of months or years.

KEY POINT #53: Fairy-tale happiness means experiencing much pleasure but only mild, useful pains (such as hunger and fatigue) over a period of months or years. Symmetrically, sustained misery means suffering significant pain with only mild intermittent pleasures over the long term.

Fairy-tale happiness should be impossible

In my younger years, I deeply believed in fairy-tale happiness—which we described as feeling lots of pleasant feelings but only the occasional mild, practical ache (like hunger or fatigue). I believed that if I made the right choices, said the right things, and had the right friends, that I would eventually feel this amazing kind of happiness that I heard others talk about but had never experienced myself. So I tried and tried but every time, something would go wrong. Long-term happiness would always slip out of my grasp, no matter how tightly I tried to cling to it. I tried playing endless video games and listening to lots of music thinking these would make me happy, but I still felt chronically depressed. I would go out with different friends to different places, only to be deeply hurt by something someone said or crushed by my own anxiety even if nothing went obviously wrong. When it came to dating, I always managed to screw up my romantic relationships, and ended up lonely and miserable. Was I at fault for making the wrong choices that prevented my own fairy-tale ending? Or was it simply a symptom of the universe, such that no matter which choice I made, I was doomed to never reach that earthly paradise of happiness that I chased?

If fairy-tale happiness does exist, there must be some kind of path that any of us can follow to reach it. Many of us have undertaken what we might call the quest for happiness, which is a little like the legendary quest for the Holy Grail. Sir Laze-A-Lot, stifling a mighty yawn, might say, “I think it’s over here, in the land of Sloth!” while Sir Gals-I-Had might yell out, “Well I think it’s over there, in the land of Lust!” and storm off on his horse (rather excitedly, might I add).

The big question is: after all these years of searching, has anyone actually found a path leading to intense happiness that never fades? Who do you think are the happiest people on Earth? We’re going to have a closer look at some life-paths that many of us believe will make us happy. But first: how good are we at actually telling who’s happy and who isn’t?

How to assess the affect of others

So, who among us is truly happy and who isn’t? When I was young, I used to think it was obvious. Were you beautiful, successful, wealthy, or famous? Then of course you were happy. But the more I learned about the world and its many strange and wonderful inhabitants, the more it became clear how incredibly wrong I was. As we’ve seen earlier, it’s already hard to properly assess our own affect (our various joys and aches), so it shouldn’t be surprising that telling how others feel is even tougher. The number of ways we can be wrong about each other is actually quite surprising. These misperceptions can lead us to mistakenly conclude that others are more (or less) happier than they truly are. This in turn makes it harder for us to perceive how suduality affects everyone else.

For starters, we often rely on other people’s facial expressions, tone of voice, and body language to tell how they feel, but these may not always mean what we think they do. For instance:

We often smile or laugh for reasons other than feeling good: A smile is often purely functional—it’s a quick way to say “hi!”, “thank you!” or “goodbye!” without necessarily reflecting how we feel. Certainly, there are happy smiles, but there are also sad smiles and nervous smiles. Most of us can feign a smile or a laugh at any time, even if we feel quite miserable. Some go further and wear a “happy mask” throughout their day despite feeling utterly depressed, a phenomenon psychologists call smiling depression. When someone wants to take a picture, even those that are unhappy or in the middle of an argument will usually stop and at least try to smile for the camera. So when you look at other people’s pictures, do you ever wonder: why am I so miserable but everyone else seems so happy?

We often see celebrities and politicians smiling in the media, and it’s tempting to conclude that they’re happy because they are leading prosperous lives. But are they? In her book Behind the Smile, entertainer Marie Osmond gave us a peek behind her façade: “I was consumed by the idea of never letting anyone see me as anything but happy,” Osmond said, “and it became an ingrained part of my personality.” The fact that these folks are precisely those who are rich, powerful, and famous can easily mislead us into believing that we must possess these attributes to be happy. But what if it was the opposite? That they have simply learned that smiling—whether for the camera or their audience—makes them more appealing and helps advance their careers? So, it may not necessarily be success that leads people to smile, but rather smiling that leads people to success!

We often cry when we aren’t sad: Sometimes we cry tears of joy or tears of relief. Sometimes it happens because we laugh so very hard. Other times, it’s because we feel strongly moved by something, like a majestic sunset at the end of a difficult day. Babies have been shown to cry just to attract the attention of their parents, not necessarily because they are uncomfortable or hurt. Indeed, when my daughter was five I often saw her strategically deploy tears to motivate us to do things for her—or to get her big brother in trouble. Some find these crocodile tears so successful at manipulating others that they continue to cry them as adults. As for authentic tears, I personally find that an authentic cry often feels good, like a release of built-up tension. All in all, crying isn’t always a miserable experience.

In fact, all facial expressions can be misleading: For example, ever notice how someone in the throes of sexual ecstasy can have a highly contorted grimace that looks like they are in agony? Studies also show that we overestimate how clearly we express our emotions through our facial expressions, which is why, according to psychologist Dan Gilbert, we “expect others to recognize our feelings even when we can’t recognize theirs.” Think about it this way: let’s say that three people walk by you. One is lost in a pleasant fantasy, another is planning their work day, and the third is thinking of jumping off a bridge. Could we reliably tell which one was which? Ultimately, our face is like a mask that we can never take off.

Some people love to complain or tell “sob stories,” and we might assume they’re miserable because it sometimes seems that everything is wrong in their lives. But complaining often feels good in itself. It helps us vent and get things off our chest while attracting attention and sympathy. Often, those who complain a lot are doing okay, they just enjoy complaining more than the rest of us.

On the flipside, many of us hide our painful feelings out of sheer habit. Those of us who are shy or stoic might put on a neutral face or a cheery smile every day, regardless of how we feel inside, in the same way others put on their clothes. Some Buddhists, for instance, proclaim that it’s good to endure suffering without showing it—to appear tough instead of weak. Even children as young as three start learning how to hide their feelings, say psychologists James Kalat and Michelle Shiota in their book Emotion. Many individuals, couples, and families put up a happy front, hiding from others the imperfections of their lives—their so-called dirty laundry—which may include financial worries, heated arguments, or even abuse. We see this on social media, such as Instagram or Facebook, where people tend to publish the best looking, most exciting moments of their lives while editing out the boredom, anxiety, and sadness. Australian Instagram star Essena O’Neill admitted that, “online it looked like I had the perfect life. . . yet I was so completely lonely and miserable inside. I hid it from everyone.” The end result is often a heavily distorted picture of others’ lives, which can mislead us into thinking they are much better off than we are. “Keeping up a good front is important in most people’s lives,” observed spiritual leader Deepak Chopra, “yet behind the facade can lurk a good deal of fear.” Think of all the painful personal struggles you’ve gone through and the things you’re most ashamed of. How many others know about these? Many of our struggles are intimate in nature and difficult to reveal. So, anyone we haven’t shared our struggles with might naturally assume our lives are easy. Conversely, what does this say about everyone else out there whose struggles we are not aware of? Among those who struggle the most are the ones suffering from depression, yet Dr. Alex Lickerman of the University of Chicago attests that they often “suffer with it silently,” even “planning suicide without anyone ever knowing.”

Furthermore, when others tell us how their day or their week went, they may distort how good or bad these truly were. This is because:

We like to exaggerate to make our anecdotes more compelling or more entertaining—both when we suffer (“it was the worst pain ever!”) and when we are having a good time (“it was the best vacation ever!”).

We also tend to oversimplify. We might say “my job sucks!” even though we have fantastic coworkers. Or, “my love life is great!” despite having just gotten out of a three-year dry spell. And we might exclaim, “I am super, super happy!” and gloss over the half dozen things that are driving us crazy right now.

Remember the peak-end bias effect we mentioned earlier? Well, others suffer from peak-end bias too. So when they tell us about some episode of their lives, they’ll usually remember the best and worst moments as well as the end, then forget the rest.

There are usually long stretches when we don’t get to see how another person is doing (unless we have a conjoined twin, perhaps). We never see the full picture, and this can skew our perception of how others feel overall. For example:

Some of us love socializing while others love solitude. Those of us who are extroverted tend to be happiest around others and may hate being alone. When we spend time with these people-persons, they tend to feel and act content since they’re in their social element. But later on when they’re all alone, their mood might drop. The problem is, we won’t be there to see that happening. Others may rely on alcohol or drugs to temporarily enhance their mood while socializing. So, these extroverts and substance users may not always be as happy as we think overall. The opposite also happens with introverts. Because they generally prefer solitude, they might sometimes seem tense or uncomfortable around other people. However, when they are alone again their mood might rise. As before, we’ll never witness that part, so introverts may be happier overall than they seem.

And if we weren’t befuddled enough, here are a few more reasons that we should be:

We sometimes confuse our feelings with those of others. If we see someone who seems disadvantaged, ill or helpless, we may naturally feel some degree of compassion for them. But just because we feel bad doesn’t mean that they feel bad. Case in point: “blind people often say that the worst problem they have is that everyone assumes that they are sad,” says psychologist Daniel Gilbert in his book Stumbling on Happiness. “People do feel devastated if they go blind, but it does not last.”

People’s affective reaction to the same situation will vary. As shown in We don’t always react the same way to the same thing, it is impossible to tell exactly how much pleasure or pain a person is feeling by looking at what they are doing or at their particular life circumstances. In a dramatic example, when basketballer Kevin Ware from the University of Louisville broke his leg during a game in early 2013—to the extent that a bone fragment protruded several inches out of his skin—everybody flinched, except Ware. Many team members moaned and agonized, with some even assuming the fetal position. . . just not Ware. “I honestly didn’t feel the pain,” said Ware in a later interview.

Words can be ambiguous and misleading. If someone tells us they are happy, are they having a great week, a great day, or simply a great moment? Or are they just satisfied with their life situation even though they feel lousy? As another example, someone who says they “rarely drink” might mean once a week or once a year—which one is it? Other words such as “never” and “always” often mean different things. If our friend confides in us that they’re “always anxious,” does it really mean every waking moment, or does it mean they’re usually anxious in specific situations?

KEY POINT #54: There are many ways we can misperceive how much joy and suffering others feel, such as when we misinterpret their words and their facial expressions, and when they exaggerate or hide their true feelings. It’s hard to accurately decipher inner feelings from outer appearances.

In my own youth, my closest friend was utterly shocked when I revealed to him that I was suicidal. He always thought I was strong, when the truth was that I often wandered around in a crushing state of depression and anxiety.

I hope that I’ve illustrated how hard it is to know how others truly feel, even those who are the closest to us.

The rich and famous

Now that we better understand how we can misunderstand each other, it’s time to begin our quest to find which “life paths” might lead us to that fairy-tale happiness many of us seek. Let’s start with being rich and famous. Since we will look at several examples across many categories, feel free to skip and skim them as you wish.

To the outside observer, having wealth, fame, and an adoring public may seem like a dream come true. After all, wealth opens the doors to the best homes, vacations, wardrobes, and health care that money can buy. And fame can open the gates to people, places, and events we may not have had access to otherwise. Surely the rich and famous must also be among the happiest? But if that was true, how do we explain the following cases?

Actress Goldie Hawn revealed in her memoir A lotus grows in the mud: “Like most of us, I believed that fame and fortune would make that elusive cocktail of happiness, giving me the elixir I sought. But I have learned that success does not always translate into personal happiness.” She describes how many of the things she thought would lift her up instead brought her down. “Some of the unhappiest people I know are some of the most successful,” she said. “Success is something worth striving for, but be careful what you wish for.”

Sean Parker, co-founder of Facebook, publicly questioned on Twitter whether becoming a billionaire has actually improved his life: “I have a whole new set of problems to deal with now,” he wrote, “security, extortion attempts, kidnapping threats, death threats, etc. Life better b4?”

Elvis Presley, the late “king of rock and roll,” once reportedly opened up to his hairstylist-slash-spiritual advisor Larry Geller about how hollow his Hollywood life felt. “I mean there has to be a purpose . . . why I was chosen to be Elvis Presley,” he was quoted as saying, “I swear to God, no one knows how lonely I get. And how empty I really feel.”

Tas Pappas had a difficult childhood, which fuelled his determination to become the world skateboarding champion. He believed success would cure his mental anguish. Looking back at the year he became the #1 ranked skateboarder in the world, surpassing even famed skateboarder Tony Hawk, he said, “I was like, now what. I still feel like shit and I still hate my guts . . . turning world champion didn’t fix me, like I thought it was going to do.”

Tom Shadyac, accomplished actor, writer, and director, was living in a 17,000-square-foot mansion when he made a life-changing observation: the people cleaning his house and taking care of his yard seemed to be happier than him and other Hollywood millionaires. This led him to sell his mansion, move to a mobile home, donate much of his money to charity, and produce Happy, a film about the search for happiness.

Actor Jim Carrey suffered from chronic depression—“I was on Prozac for a long time,” he confided. Growing up, his mother was often unwell and bedridden. Her illness motivated him to make up comedy routines to try to brighten her spirits, which paved the way for him to become a famous comedian and sought-after actor. Looking back, Carrey described his life as having “peaks and valleys,” and proclaimed: “I think everybody should get rich and famous and do everything they ever dreamed of so they can see that it’s not the answer.”

The parade of rich and famous but not-entirely-happy people goes on and on: radio and TV personality Dick Clark, astronaut Buzz Aldrin, star NFL quarterback Terry Bradshaw, singers Johnny Cash and Lady Gaga, actors Richard Dreyfuss and Roseanne Barr, and the most-decorated Olympian of all time, Michael Phelps, are but a few of those in the spotlight who’ve been brave enough to share their experiences with anxiety, depression, or other painful struggles. Comparing his life to those who are not famous, actor and Buddhist Richard Gere said in a 2016 interview with Lion’s Roar magazine, “It’s like everyone else’s life, too. It just gets into the papers, that’s all. It’s the same emotions. The same suffering. The same issues. No difference.”

“I have yet to meet any extremely successful people who can honestly say they are happier now than when they started their quest for greatness without making some special effort to remain happy,” concluded psychologist Archibald Hart. “If you can honestly say that extreme success by itself and without any other help has brought total and abiding happiness to you, then . . . you deserve to be put on display in the Smithsonian.”

KEY POINT #55: Evidence suggests that being rich and famous is no guarantee of fairy-tale happiness.

Wealth without fame

Though being rich, famous and talented does not guarantee lasting happiness, perhaps fame somehow taints the experience? What about being rich without being famous? After all, many of our problems can be solved with money, and many luxuries—beautiful homes, spa treatments, luxurious vacations—can be ours if we have sufficient funds. This is why many believe that more money translates to more happy. And that’s why, statistically, more than half of all adults in nations across the globe regularly play the lottery.

Let’s start with some who have a comfortable amount of wealth but aren’t quite millionaires:

The self-described minimalists Joshua Millburn and Ryan Nicodemus shared their particular experience with wealth: “A few years ago, while approaching age 30, we had achieved everything that was supposed to make us happy: great six-figure jobs, nice cars, big houses with more bedrooms than inhabitants, pointless masses of toys, scads of superfluous stuff. And yet with all that stuff, we weren’t satisfied with our lives. We weren’t happy. There was a gaping void. And working 70-80 hours a week for a corporation and buying even more stuff didn’t fill the void. In fact, it only brought more debt and stress and anxiety and fear and loneliness and guilt and overwhelm and depression.”

Researchers note that, although inflation-adjusted salaries in the United States have almost tripled between 1945 and 2005, measures of “happiness” have remained more or less flat. Ed Diener, a leading researcher in the field of positive psychology, points out that recent wealth increases in the US have simultaneously increased desire: “What people want in terms of material things and life experiences has increased almost exactly in lockstep with the postwar earnings curve,” he stated, with the result being that people don’t feel any more satisfied despite being richer than before.

What if the people above aren’t quite wealthy enough to truly be happy? Who has millions of dollars without any significant fame or power? How about big lottery winners?

UK resident Callie Rogers won nearly 2 million pounds (roughly USD $3 million) in 2003 at the tender age of 16. She spent her fortune on such things as designer clothing, holidays, cocaine, and cosmetic surgery. She ended up attempting suicide three times due to her riches making her, in her own words, “miserable.” She now says, “I try to forget the ups and downs I’ve been through and just feel like a normal person.” Ten years after the win, Rogers had only £2,000 left but said she’s never felt happier.

William “Bud” Post, who won over USD $16 million in 1988 in the Pennsylvania lottery, spent it all on houses, cars, boats, setting up a failed company, and other expenses. Within one year of hitting the jackpot, Post had not only spent all of his winnings but was actually $1 million in debt. He was sued by his former girlfriend for part of his winnings, and his brother reportedly hired a hit man to kill him. He later admitted that he was happier when he was poor.

The above cases illustrate that the riches that solve many of our problems can also create a whole new set of issues for us to deal with. In other words, having a fortune can generate a lot of misfortune. There are certainly some lottery winners who haven’t suffered the same fate as those above. Yet a highly-cited 1978 study by Brickman and Coates of 22 lottery winners demonstrated that although these lucky few reported a brief surge in happiness after winning, they were ultimately no happier than non-winners a mere few months later.

A 2011 Boston College study entitled The Joys and Dilemmas of Wealth found that those with fortunes exceeding USD $25 million still suffered from various anxieties, dissatisfactions, and worries. These multi-millionaires admitted feeling that many people either despised them or envied them, which led to a sense of isolation. “What you often lose when you have all this money,” said psychologist Robert A. Kenny who headed the study, “is the friendships that support you through the difficult times.” The ultra-wealthy also spent a lot of time worrying about losing their fortune. And surprisingly, the majority felt they would need even more money to feel financially secure.

A similar survey of thousands of millionaires found that, on average, they believed they would need to nearly quadruple their wealth for their life to finally be a “perfect 10,” which illustrates how elusive that perfect happiness is. They reported that having large sums of money led to problems in their romantic relationships, often causing them to break down. One respondent pointed out that many of her less-wealthy peers incorrectly assumed that the rich “are impervious to any bad feelings, tragedy, sorrow or depression.” Dr. Kenny concluded from the responses that “you can’t buy your way out of the human condition . . . This research shows the rest of the world, who often think that if they just made one more bonus or sold one more item or got one more promotion, then their world and their family’s world would be so much better, that this isn’t necessarily true.” Can you guess what the ultra-rich reported to be their single greatest aspiration? If you guessed traveling the world or collecting luxury handbags, you’d be mistaken. The majority simply answered: to be a good parent.

Now let’s consider a hypothetical scenario, in which I’ll assume you’re neither among the richest nor poorest: what if, instead of plunging you into the stratosphere of wealth by making you a multi-billionaire, we plunged everyone else into extreme poverty? In this alternate universe, you get to keep exactly what you already own but your neighbors, your friends, and even the ultra-rich like Bill Gates and Jeff Bezos lose virtually all of their wealth. Wouldn’t you then be considered, relative to everyone else, the wealthiest person alive? But would you be any happier than you are now, since your wealth in that hypothetical universe is exactly the same as in this one?

If happiness was our only goal, and having more money translated to more personal happiness, then why have many top billionaires pledged to donate most of their funds to charity, including Bill Gates, Mark Zuckerberg, Warren Buffett, and others on the site givingpledge.org? The latter, in his pledge to give 99 percent of his wealth to charity, said, “Were we to use more than 1 percent of my claim checks on ourselves, neither our happiness nor our well-being would be enhanced.” Gates offered a similar, though sandwich-themed, view: “once you get much beyond [a few million dollars], I have to tell you, it’s the same hamburger.” He defined success in terms of happiness, love and making a difference in the world rather than making money.

Finally, what about those who give up their material wealth? Does it make them less happy? In an interview with the New York Times, Tammy Strobel, inspired by other minimalists, took the plunge. Instead of accumulating wealth, she and her husband whittled down their material possessions to a mere 100 items. To put that in perspective, my wife and I have over 100 utensils in a single kitchen drawer. They also downsized to a 400-square-foot apartment and sold their two cars. Her conclusion after living the minimalist lifestyle? “The idea that you need to go bigger to be happy is false,” she said. “I really believe that the acquisition of material goods doesn’t bring about happiness.”

KEY POINT #56: The wealthiest among us still suffer from anxiety, loneliness, and other problems, while those who give up their wealth are not necessarily less happy than before.

The powerful

What about those who wield a lot of power and influence over others? Are they happier than the rest of us? Consider these outstanding people in top positions:

Winston Churchill, former Prime Minister of the United Kingdom, is widely regarded as one of the greatest leaders of all time. He was described as passionate and intense, but was also followed by his so-called Black Dog, which was the nickname he gave to the recurring depression that hounded him throughout his life.

Abraham Lincoln, the President of the United States from 1861 to 1865, reportedly suffered from chronic depression and anxiety attacks for most of his life. His many friends and acquaintances in later adulthood described him as the gloomiest and most depressed person they had ever met.

Former US President John F. Kennedy hid from the public that he was on a wide array of medications, according to historian Robert Dallek, who was granted exclusive access to his private records from 1955 to 1963. This included as many as twelve different drugs to fight back pain so severe that he couldn’t put on his own shoes, and others to treat his anxiety and depression. “There was hardly a day that went by that he didn’t suffer terribly,” observed Dallek.

Diana Spencer, the late Princess of Wales, received periodic treatment for her bulimia eating disorder and her depression. Despite worldwide appeal, her family described her as being insecure. She admitted, “I didn’t like myself. I was ashamed because I couldn’t cope with the pressures . . . I felt compelled to perform.” The constant pressure and criticism she endured from the press sometimes drove her to thoughts of suicide.

Abd Al-Rahman III was a tenth century ruler of Córdoba, an ancient Islamic state located in modern-day Spain and Portugal. Al-Rahman III, who lived in absolute luxury, looked back on his lengthy reign and wrote: “I have now reigned above fifty years in victory or peace; beloved by my subjects, dreaded by my enemies, and respected by my allies. Riches and honors, power and pleasure, have waited on my call, nor does any earthly blessing appear to have been wanting to my felicity.” He then went on to say: “I have diligently numbered the days of pure and genuine happiness which have fallen to my lot: They amount to fourteen. – O man! Place not thy confidence in this present world!”

The lovers and newlyweds

What about love? Some of us believe that finding and uniting with the perfect partner, our soulmate, will lead to our “happily ever after.” Though new relationships can be exciting and invigorating, they can also cause us to worry or feel lonely when we are separated from our partner, even if only briefly. Moreover, multiple studies show that the passionate “head over heels” love that we feel at the beginning of a new romantic relationship fades away after two or three years. Similarly, newlyweds experience a self-reported “happiness boost” that lasts on average only two years. Although many of us wish for these intoxicating “in love” or “newlywed” feelings to last forever, that isn’t quite how they work. According to happiness researcher Dr. Sonja Lyubomirsky, anyone claiming to be just as happy years after meeting or marrying their significant other are regrettably either lying to you or lying to themselves.

The gluttons

How else might we tap into that well of happiness that never runs dry? What if we simply consumed as much of our favourite indulgent foods and beverages as we wanted? The trouble is that, as we saw earlier in Inducing positive effects should lead to negative effects, the ingredients that make food taste the most pleasurable, such as high levels of salt, monosodium glutamate (MSG), sugar, and other sweeteners, are the very ingredients that cause the most negative effects such as cognitive decline, body aches, and depression.

The lustful

Would having more sex and more orgasms make us happier?

As we saw earlier, both scientific and anecdotal evidence show that increasing the frequency of sex does not generally increase overall happiness or sexual enjoyment.

What about those who relentlessly pursue fulfillment through sexual activity, at the extreme of which might be sex addicts? Our local Sex Addicts Anonymous describes sex addiction as a progressive disease where the addict uses sex to escape negative feelings and responsibilities, despite causing harm to themselves or others. “The high usually wasn’t as ‘good’ as we hoped it would be,” the group shares, and “often it was only a prelude to the physical and emotional crash that followed.” The resulting feelings of pain, shame, and despair often led them to having even more sex to dull the pain. Robert Weiss, a licensed clinical social worker with extensive experience in sexual addiction, confirms that “sex addicts create and use a neurochemical high to detach and dissociate from depression, anxiety, and other life stressors. They learn to control and abuse their own neurochemistry in the same way that alcoholics and drug addicts learn to abuse alcohol, heroin, and cocaine.”

For those who dream of a wild and uninhibited sex life, being a porn star may seem like a dream come true. But ex-starlet Jessie Rogers paints quite a different picture of what goes on behind the scenes. “I hung out with a lot of people in the adult industry,” she relates. “None of them liked doing what they were doing. They were just doing it for the money, and they dreamed of getting out—doing something else and having a normal life, like being married with kids. This wasn’t just female performers—the male performers and the directors as well. Almost all, if not all the girls, go to their shoots high on something, whether it’s painkillers, weed, ecstasy, or cocaine. So that’s why when people watch it, it looks like the performers are having a blast, but in reality they’re just disassociated and don’t even want to be there.”

Finally, we may be tempted to think that having hundreds of orgasms a day would be great—after all, if one is good, then shouldn’t more be better? Recall the rare condition persistent genital arousal disorder (PGAD), which can cause the afflicted person to experience hundreds of involuntary orgasms per day. Kim Ramsey, a nurse with PGAD, said that while some women struggle to reach orgasms, she struggles to stop having them. Even slight movements such as walking or doing chores could trigger a climax. These ceased to be pleasurable long ago, and instead caused her pain that left her exhausted. Gretchen Molannen, a PGAD sufferer from Florida, described it as relentless and painful: “I know that God wants more out of my life than having me testing out suicide methods, constantly crying and abusing myself.” She eventually took her own life.

KEY POINT #60: Evidence suggests that neither having endless sexual activity nor endless orgasms are the sought-after keys to happiness.

The beautiful

Many of us believe that being physically attractive would make us happier. But is it so? Consider these counterexamples:

Essena O’Neill was a rising Australian social media star who spent half of her adolescence perfecting her looks and building a modeling career. After accumulating a hefty social media following—including half a million followers on Instagram—companies lined up to offer her lucrative brand sponsorships. By many accounts, she had it all: looks, money, and fame. As she approached her nineteenth birthday, however, she abruptly quit all of her social media accounts and posted one last video, an emotional confession she dedicated to her twelve-year-old self. “When I was twelve, I told myself I meant nothing,” she said, “that I was worthy of nothing because I wasn’t popular online, I wasn’t a model, I wasn’t beautiful . . . I told myself that when I have heaps of views, people will view me, I will feel valued, I will feel happiness,” then silently shook her head as if to say, no. “It was never enough. You’d think getting 100,000 followers on Instagram would be amazing, yeah it was for the day, but then you want 200,000 . . . And I’m quitting social media to tell anyone, everyone who’s still watching: I was miserable. I had it all, and I was miserable.” Was Essena alone in feeling this way about her success? “I’ve met people that are far more successful online than I am and they’re just as miserable and lonely and scared and lost—we all are,” she related. “There’s nothing different between you and I other than I ‘made it.’ ”

Many women feel dissatisfied with their natural chest size and seek to undergo breast augmentation—believing that a boob job will not only boost their bust, but also their belief in themselves and their overall bliss. Although many may be pleased with their implants at first, studies have found that in the long term they’ll have a three times higher risk of committing suicide and a three times higher risk of death due to drugs or alcohol. This strongly suggests that many of these women are in fact less happy in the long run. Furthermore, if having larger breasts meant larger happiness, then shouldn’t having the largest breasts in the world make one absolutely ecstatic? Yet the late Lolo Ferrari, the woman with the largest chest in the world—a whopping 54G bust size, according to Guinness World Records—suffered from depression. What motivated her many cosmetic surgeries? “All this stuff has been because I can’t stand life,” she confessed. “But it hasn’t changed anything.”

Margaux Hemingway, the supermodel granddaughter of author Ernest Hemingway, also revealed her own sense of insecurity: “I loved to dance and went to Studio 54 at least twice a week,” she shared. “But I always felt nervous around the people there. I was in awe of that whole Halston-Liza Minnelli crowd. To me, they were the real celebrities and I was just a girl from Idaho. So I drank to loosen up. I never thought then that alcohol would become a problem.” Indeed, her alcohol use progressed to alcoholism, then depression, and eventually her suicide at age 42.

In a 1960 interview, American model and actress Marilyn Monroe shared some of her innermost feelings, “I have a gay side to me and also a sad side . . . I’d like to be happy, but who’s happy? . . . Personally, if I can realize certain things in my work, I come the closest to being happy. But it only happens in moments. I’m not just generally happy. If I’m generally anything, I guess I’m generally miserable,” she said, laughing.

In case we’re ever fooled by all of the smiling models we see on TV and the internet, Dr. Vivian Diller, a former model-turned-psychotherapist who counsels other models, says modeling is “largely about striving for unreal beauty, smiling for the camera and acting happy.” To be sure, models can make good money, travel to exotic places, and meet interesting people, but all in all, she said, “the day-to-day work for most models is truly tedious, even demeaning.”

Indeed, evolutionary psychologist Nancy Etcoff, author of Survival of the Prettiest, concluded in her research on the science of beauty that beautiful people are simply not happier than others. As we can see, even the most beautiful among us find flaws in themselves that can make them feel unhappy and inadequate.

The young and carefree

Some believe that children are the happiest people on the planet. After all, most children are carefree. They don’t have to worry about managing finances, working a full-time job, or going bald. They’re experiencing everything for the first time. To them, the world is new and exciting. And most have few health problems plus boundless energy. Wouldn’t it be great if we could all feel the same way—carefree, enthusiastic, in perfect health, with lots of energy to spare?

Had I never had any children of my own, I’d be tempted to believe that. But I do have two kids, and I’ve been with them nearly every day of their lives. One minute they’re having a great time, the next minute they’re fighting and crying over a toy or their favourite spot on the couch. While they have lots of fun exploring the world, they’re often frustrated by their lack of ability and their limited freedom. They laugh endlessly about potty humour, yet are traumatized by the tiniest bumps or scrapes. They take tremendous pleasure in sweets, yet are horrified by certain vegetables. Clinical psychologist Jennifer Kunst, author of Wisdom from the Couch: Knowing and Growing Yourself from the Inside Out, offers her perspective: “The truth is that all children—even those with very fortunate beginnings—have a mix of pleasant and painful experiences . . . In fact, the less awareness one has as a child, the greater the bliss but also the greater the anxiety.”

KEY POINT #62: Being young, healthy, and carefree is not the magic bullet to happiness either.

The geniuses

What about having an IQ off the charts? Imagine being able to outwit all of your opponents, being admired by everyone for your genius, and easily finding solutions to any and all perplexing problems you might face. Would this enable us to outsmart all of our suffering and end up truly happy? Here are some geniuses who didn’t quite get there:

Marie Curie, two-time Nobel Prize winner for her contributions to the field of radioactivity and for discovering radium and polonium, suffered from recurring depression.

Ernest Hemingway, a Pulitzer and Nobel Prize winning American novelist, reportedly suffered from anxiety, paranoia, and depression. In his last unfinished novel, The Garden of Eden, he wrote that “happiness in intelligent people is the rarest thing I know.”

Similarly, Stephen Fry suffered from manic depression and survived several suicide attempts despite having been voted the Most Intelligent Man on (British) Television. He describes himself as “an uppy-downy, mood-swingy kind of guy” and is attributed as saying that “having a great intellect is no path to being happy.”

Finally, pioneering American psychologist Lewis Terman had followed 1,500 gifted students throughout their lives, each of whom scored at least 140 on standardized IQ tests. Though they did end up making more than twice as much money as the average white-collar worker, they suffered from roughly the same rates of divorce, alcoholism, and suicide as the national averages, suggesting that their personal happiness was no higher than their peers.

In short:

KEY POINT #63: Evidence suggests that being a certified, bona fide genius may help us to make important contributions to society and earn the admiration of others, but it does not enable us to outsmart all of our suffering.

The great artists

What about having unparalleled artistic talent, like being a great painter, a great musician, or a great writer? Having spent five years at an arts school, I know this one is going to be easy.

Charles Dickens, considered the greatest novelist of the Victorian era, suffered from depression according to the book The Key to Genius: Manic Depression and the Creative Life.

Dutch painter Vincent Van Gogh created many memorable works of art, but also suffered from anxiety, depression, and elements of bipolar disorder before taking his own life at age 37.

Modern-day American singer-songwriter Bruce ‘The Boss’ Springsteen opened up in his 2016 autobiography about battling depression on and off for decades.

Additionally, many performing artists strive for the high they get on stage, but admit that when the adoring fans have left, they often feel quite lonely and low. Since most of us only witness the high, we can easily get the wrong impression of how they feel in between shows.

Though we may have great respect for these artists, we must conclude that:

KEY POINT #64: Evidence suggests that being a great artist, bursting with awe-inspiring talent, is simply not a locked-in guarantee for fairy-tale happiness.

The gamers

What would it be like if we had no responsibilities and just played games all day long? Could this be the secret ingredient to lasting happiness? After all, if playing a little bit is fun, shouldn’t playing all of the time be even better?

Consider the case of seventeen-year-old UK resident Zach Richardson who had quit school, lived with his parents, and was unable to find work. To pass the time he turned to video games. At first, he only played two to three hours a day. But his habit quickly escalated to daily fifteen-hour sessions, to the extent that he regularly skipped meals and baths while neglecting his friends. “I know I have an addiction but I cannot help it,” recognized Richardson. The constant playing left him suffering from blackouts and headaches, while doctors warned him of the damage the prolonged gaming sessions were causing to his health.

Richardson is not an unusual case. Research shows that playing video games to excess can lead to many physical and mental health issues, including attention disorders, being overweight, depression, and addiction, all in a dose-dependent manner.

Those who are retired and take it easy

After spending decades toiling away at our jobs, many of us naturally look forward to retiring from work. We might see the freedom from work responsibilities as the ultimate opportunity to finally slow down, relax, and enjoy the easy life. In 2015, Business Insider reported on a young entrepreneur, Jon Carder, who had grown up in a family that struggled to make ends meet. With two business partners, he started a mortgage-shopping company with the intent to become rich so that he wouldn’t have to struggle like his parents had. In 2006, Carder sold the company to pursue what he called “the good life.” “I can’t say exactly how much we sold for,” he said, “but it was large enough that I could travel the world, surf, and never have to work again. So that’s exactly what I decided to do.” After only a few weeks however, Carder had already begun to feel, in his own words, “really freaking bored,” which taught him two important lessons. First: “I learned that money can buy happiness, but it’s a limited-time-only happiness.” And second: “although being an entrepreneur was stressful and excruciating at times, it was so much more fulfilling [than] doing nothing.”

Is Carder an isolated case? One survey of retired people found that the thrill of being retired wore off after an average of only ten months. Over half of the retirees admitted that they eventually missed their workplace or their coworkers. They also missed being challenged, they struggled with less income, or simply felt bored or lonely. Many retired couples bickered much more than when they were working, other researchers found. “Although doing nothing for 6, 12 or 18 months might feel like paradise it will eventually become unbearable,” observed Gary Fitzgibbon, an occupational psychologist who studies retirement. Finally, after interviewing hundreds of people around the world in 2006 to find out what makes them happiest, researchers from Gothenburg University in Sweden concluded the following: “From our research the people who were most active got the most joy. It may sound tempting to relax on a beach, but if you do it for too long it stops being satisfying."

In short:

KEY POINT #66: Evidence suggests that being retired and taking it easy doesn’t guarantee happiness. Some of us might want to rethink our retirement plans.

Conclusion of the quest to find happiness

If pleasure and pain are truly independent of each other, then it should be possible to eventually achieve what we called fairy-tale happiness—a life filled with pleasure and only mild, useful pains like hunger and fatigue. But if suduality is true, then achieving such a blissful state should be simply impossible. We started this quest searching for a path that might guarantee this kind of bliss. Along the way, we caught revealing glimpses of the wealthy and famous, the beautiful and talented, the artists and geniuses, as well as everyday gamers and retirees. These glimpses came in many forms: scientific studies, expert opinions, and candid confessions. Many people do achieve their lifelong dreams, only to realize that the outcome wasn’t quite as great as they had expected. In the end, none of the life-paths we examined seem to guarantee the fairy-tale happiness we sought. Though we haven’t explored every possible path we could take, I hope we’ve seen just enough to demonstrate how elusive our utopian destination truly is.

Is anyone immune to pain and suffering? “There is no such thing as life without pain,” attested pain specialist Erv Hinds. Spiritual leader Deepak Chopra observed that “people tend to fantasize about a perfect life instead of realistically facing the fact that no life is perfect . . . everyone’s existence contains challenges, disappointments, frustration and failed expectations.” Spiritual Hindu teacher Sri Swami Sivananda viewed it this way: “A doctor thinks that the advocate is very happy. The advocate thinks that the businessman is more happy. The businessman thinks that the judge is more happy. The judge thinks that the professor is more happy. No one is happy in this world.” After a lifetime of meditation, renowned Buddhist and Nobel Prize nominee Thich Nhat Han realized that “one of the most difficult things for us to accept is that there is no realm where there’s only happiness and there’s no suffering.”

KEY POINT #67: Being young, beautiful, rich, intelligent, famous, powerful, or talented does not automatically grant us fairy-tale happiness. Neither does indulging in food, games, relaxation, sex, or drugs.

Sustained misery should be impossible

As we’ve just seen, fairy-tale happiness is quite elusive. What about its opposite? If pleasure and pain are truly independent from each other, then it should be possible to experience what we had called sustained misery—that is to say, feeling significant amounts of pain for months on end mixed with only slight amounts of intermittent pleasure. On the other hand, if suduality exists, then sustained misery cannot. Only one of these two can be true. While we can’t conclusively prove that this kind of misery has never occurred in all of human history, we can look at a few situations that many of us believe should cause us to feel this miserable. Does sustained misery always occur in the following cases?

Many torture victims say that prolonged solitary confinement is one of the harshest forms of punishment there is. For instance, Dr. Sharon Shalev documented the experiences of leaders of the Tupamaro movement in Uruguay in her Sourcebook on solitary confinement. These leaders, who were imprisoned in strict solitary confinement for several years in the 1970s, say they would’ve rather been electrocuted: “electricity is mere child’s play in comparison to prolonged solitude,” they revealed. Despite being trapped in a cell, these inmates do end up finding a way to escape—in their fantasies. New York Prisoner Jermaine Archer wrote that many of his fellow inmates spent years “reminiscing on the past or fantasizing about the future.” Similarly, during his three-year imprisonment in various German concentration camps, Viktor Frankl observed many of his starving peers excitedly discussing all of the elaborate meals they would make if they ever escaped. Frankl, who would also spend blissful moments remembering his wife, came to a profound realization: happiness within the barbed-wire fences, even if only for brief spells, was still possible. Indeed, Dr. Shalev, who reviewed many studies of such prisoners, found that they commonly “found reality so painful that they created their own fantasy world.”

A 1991 study conducted on 82 people with Duchenne muscular dystrophy (DMD), a disease which causes gradual muscle degeneration and paralysis, who required ventilators to breathe found that the vast majority of them were satisfied with life despite their dependence on ventilators. The study also found that their health care professionals significantly underestimated their life satisfaction while greatly overestimating their patients’ assessment of the hardship of ventilator-dependence. Roxane Silver’s 1982 study of quadriplegics and paraplegics found that one week following their spinal cord injury, the injured felt more negative affect than positive affect. But as early as week eight, the feelings had reversed. “[Paraplegics] are generally quite happy people,” affirmed psychology researcher Daniel Gilbert.

On those who are blind, Dr. Gilbert had this to say: “blind people often say that the worst problem they have is that everyone assumes they are sad: ‘You can’t read.’ ‘But I can read.’ ‘You can’t get around.’ ‘But I can get around.’ People do feel devastated if they go blind, but it does not last. The human mind is constituted to make the best of the situations in which it finds itself. But people don’t know they have this ability, and that’s the thing that bedevils their predictions about the future.” Indeed, Helen Keller, who became deaf and blind as a toddler, echoed this sentiment in her speech to the American Foundation for the Blind: “The chief handicap of the blind is not blindness, but the attitude of seeing people towards them,” adding that, “when one door of happiness closes, another opens.” In the opposite scenario, happiness researcher Dr. Sonja Lyubomirsky, who was nearly blind for many years, recalls how LASIK laser eye surgery gave her back her vision. How long did she feel elated about regaining her eyesight? About a week, after which she began taking her vision for granted like everyone else.

Some studies, such as a 2011 Ipsos poll of the happiness levels of twenty-one countries, showed that several poorer countries including India and Indonesia rated themselves as the happiest while richer countries like France and Italy rated themselves significantly lower. Similarly, WIN/Gallup International’s global End of Year survey found that “Africa [the least wealthy continent in the world] appears to be the happiest region in 2014 with 83 percent of those surveyed across the continent being content.” While many of us believe that money doesn’t buy happiness, a lack of it doesn’t seem to guarantee misery either.

Journalist James Foley was kidnapped by the Islamic State of Iraq and Syria (ISIS) militant group in wartime Syria in 2012. Kept in a cell with seventeen other captives, he wrote to his family that he and his cellmates had long conversations about trivia, shared stories, played games, and “laughed to break the tension.” “Dreams of family and friends take me away [from this prison] and happiness fills my heart,” wrote Foley. Meanwhile, Dr. Paul Brand served his medical internship in London during World War II while the German Luftwaffe relentlessly bombed the city. As he recalled, “Physical hardship was a constant companion . . . Yet I have never lived among people so buoyant; now I read that sixty percent of Londoners who lived through the Blitz remember it as the happiest period of their lives.” And Dr. Erv Hinds described how commanding a mobile medical station in the Vietnam War was one of the hardest yet most rewarding experiences of his life: “Abandoning myself to the work despite the imminent dangers, I was surprised by feelings of intense joy,” he wrote. “I have never again tasted quite the same joy.”

Finally, those who are sick and dying may not be as miserable as they seem. A 2005 study failed to find any evidence that patients with kidney disease, who must be hooked up to dialysis machines for hours every few days, were any less happy than healthy non-patients. It also showed that healthy people underestimate how happy these patients felt. As for those nearing death, Joan Panke, a registered nurse who traveled to Calcutta to work in Mother Teresa’s hospice for the dying, came out of the experience with the observation that “although there’s death in the room, there is also a great sense of joy.”

Though we can’t explore every possible path to endless misery, I hope the above cross-section is enough to show that many of the people and situations which we tend to assume are filled with endless pain are not necessarily so.

We should adapt to all “positive” or “negative” life changes

Every once in a while, we experience a major life-changing event. Some of these events we think of as “positive”—such as buying a first home or winning a big prize—and others we see as “negative”—like losing a job or becoming disabled. If pleasure and pain are fully disconnected from each other, then we should expect that “positive” events would boost our overall pleasure without affecting the amount of pain we feel. Similarly, “negative” events should increase our overall pain without affecting any of our pleasure. On the other hand, if the theory of suduality is true, then no life-changing event—whether positive or negative—should change our long-term ratio of pleasure to pain. They should always end up balancing each other out. In other words, we should affectively adapt to any and all major life changes.

After major improvements in your life such as a new love, new house, or new job, have you noticed that whatever joy or excitement you may have initially felt simply fades away? That’s the thing—we adapt. “We get accustomed to it . . . we stop getting pleasure from it,” said happiness researcher Dr. Sonja Lyubomirsky in a 2010 interview with the New York Times. Whether these life changes are “good” or “bad,” we eventually return to a neutral baseline. Even the rich aren’t immune. According to a study by Boston College, when wealthy people frequently partake in so-called pleasures of “excessive consumption” such as spa treatments, fancy restaurants, and luxury shopping sprees, they “become so commonplace as to lose all psychological benefit: constant luxury is, in a sense, no luxury at all.” (emphasis added) Dr. Jordi Quoidbach, emotion researcher, has carried out other studies on wealth and concluded that “having access to the best things in life may actually undercut people’s ability to reap enjoyment from life’s small pleasures.” This effect is consistent with previous findings—eating sweeter foods, for example, leads to a reduced enjoyment of blander foods, and taking recreational drugs reduces enjoyment of humdrum daily pleasures like eating and socializing—at least, when not under the influence!

We not only adapt within our own lifetimes but also beyond them. Over the course of history, our ongoing struggle to improve our lives gave rise to many amazing inventions, such as plumbing, electricity, and the automobile. But if we are fortunate enough to have these, we may notice they simply don’t bring us any joy on a typical day. We don’t wake up every morning giddy that we don’t have to walk a mile to fetch water from the town well. However exciting these innovations may have been initially, people who have always had them at their disposal have fully adapted to them. We are more likely to agonize about clogged toilets, power failures, and car breakdowns than sing the praises of these technologies when they work properly. In other words, these life-improving inventions do not appear to have produced permanent increases in our overall happiness. As we solve more problems with technology, instead of becoming more satisfied, smaller problems like traffic jams or gadget glitches tend to bother us more—a phenomenon some call first-world problems.

Adaptation also occurs when we lose things we cherished. In my own personal life, I’ve given up video games, sweets, and other things I enjoyed, but I don’t feel any more miserable than before. As we’ve seen, people even adapt to losing significant things like their health, their mobility, their sight, their relationships, and even their freedom. Some say, “What doesn’t kill you makes you stronger,” but the sudist slogan might be, “What doesn’t kill you, you adapt to.”

In fact, this effect is so commonplace that psychologists have coined a term for it—hedonic adaptation. It was originally referred to as the hedonic treadmill theory, because no matter how many strides forward (or backward) that people made in their lives, their self-reported happiness tended to stay in the same place in the long run. Many psychologists see hedonic adaptation as its own standalone principle, but sudists will recognize it as a predictable side effect of suduality.

Why is the idea of hedonic adaptation so commonly accepted by psychologists, yet so few of us seem aware of it? Part of the problem is that our ability to predict how we will feel in the future, called affective forecasting, is notoriously unreliable. We like to think we’ll finally be happy—and stay that way—when we marry, have kids, attain financial security or retire. Likewise, many of us believe we’ll be forever miserable when we divorce, lose our jobs, or lose a loved one. But there is one little problem, according to Lyubomirsky: there is overwhelming evidence that this is not at all how our thoughts and feelings operate. A two-year study by Eunkook Suh and renowned psychologist Ed Diener, for instance, found that only events in the past three or so months seemed to have any impact on an individual’s present-day well-being. They found that older events, no matter how significant, had almost no influence on how people felt.

KEY POINT #69: In terms of how happy we feel, we eventually adapt to all positive and negative life changes, such as marriage and divorce, promotions and demotions, as well as perfect health and disability.

Hacking the brain

In spite of all the evidence we’ve seen so far, it’s tempting to think that all of the affective sensations we experience are merely due to the way our brains operate. Shouldn’t we be able to boost our joy (or shut off all our pain) just by cracking open our skulls and tampering with the wiring, chemicals, and electrical impulses inside? In other words, can’t we put an end to all human suffering simply by “hacking” our brains using some combination of drugs, surgery, and electrical stimulation? And launch humanity into new realms of unending joy, which some proponents call paradise engineering?

In a 1986 edition of the scientific journal Pain, a case was published about an alcoholic female who had suffered a herniated disc in her spine, which eventually progressed into a source of chronic pain. Antidepressants failed to provide relief, as did painkillers. She attempted many other treatments—acupuncture, transcutaneous electrical nerve stimulation (TENS), and cognitive behavioral therapies (CBT)—all of which failed to provide lasting pain reduction. She then underwent surgical procedures on her spinal cord and the surrounding vertebrae, which provided only temporary relief. Two courses of epidurals had similar results. Five years post-injury, surgeons decided to bypass the spine entirely and go directly for the brain. They inserted an electrode in the thalamic nucleus, which would electrically stimulate the patient’s brain whenever she turned a dial. At first it seemed to work, but by the six-month mark, the electrode had ceased to provide pain relief and was simply abandoned in place. Surgeons then attempted a cordotomy—the severing of some of the pain nerves of the patient’s spine—which relieved her pain for about six weeks before it too stopped working. Six years post-injury, they implanted a second electrode in a different area of the brain, again controlled by the patient. This one worked for a few months, by which time pain returned and would remain indefinitely. However, the patient also noticed that stimulation with this electrode caused erotic sensations, and she quickly developed compulsive use of the electrical self-stimulator. At its peak, she self-stimulated throughout the day, neglecting her personal hygiene, her family commitments, and she developed ulcers on her finger from constantly adjusting the dial. The patient also started experiencing frequent anxiety attacks, excessive thirst that was not relieved by drinking, depersonalization—that is, the sensation that her thoughts and feelings were not her own—and a loss of interest in virtually all other activities. Despite these debilitating side effects, she was completely unable to stop self-stimulating, leading her to be diagnosed with addiction to deep-brain stimulation. The doctors who reviewed her case history admitted that, despite ten years of intensive medical interventions, they had ultimately failed to relieve her pain and should, in their words, “change the focus of therapy from analgesia at all costs to improvement of function.”

Was this an isolated case? Her medical team pointed out that patients like her, for whom various pain relief treatments were ineffective in the long run, were actually fairly common. Therapist Douglas Nelson shared his own insight from a lifetime of treating pain: “Often, no heroic procedure can remove the source [of pain]. Quite often, pain is not just the reflection of a greater problem—in chronic pain, pain itself is the problem.” In his book A Life Larger than Pain, full-time pain specialist Dr. Erv Hinds confirmed the challenges in using traditional medical tools to treat pain: “I have found that exclusive reliance on injections, surgery, or medications usually does not produce significant long-term improvement.” Well, sudists know why pain is so incredibly resistant to physical interventions: pain is not an isolated thing in our brain, spine, or other body part that can be surgically extracted, medicated away, or electrically erased. According to sudism, all pains and pleasures are intrinsically connected, and any attempt to obliterate pain without equal and opposite negative effects is destined to fail.

Conclusion of Part Three

We’ve shown that suduality is based on the ancient idea that pleasure and pain are interconnected, a concept that has surfaced in many cultures throughout history but that modern societies have mostly forgotten. With the scientific studies, anecdotal evidence, and expert opinions now available, it’s possible to make a more compelling case than ever for the existence of suduality.

With the evidence we’ve assembled, we’ve shown that various attempts to experience prolonged, uninterrupted pleasure or to inflict perpetual pain both eventually fail, which suggests that there is a mechanism preventing this from happening. Similarly, we’ve seen that trying to increase the frequency of pleasant or painful activities generally leads to a reduction of their intensity, while decreasing their frequency generally has the opposite effect. This implies that something is preventing us from independently increasing or decreasing our overall pain independently from our overall pleasure, and vice versa. Furthermore, we’ve shown that many sources of “added pleasure”—such as sugar, alcohol, drugs, and various forms of entertainment—have obvious short-term positive effects that are counterbalanced by long-term negative effects. Similarly, sources of short-term discomfort—such as exercise, hard work, and physical pain—appear to be counterbalanced by long-term pleasant effects.

We have shown that being young, beautiful, rich, famous, powerful, or talented does not automatically protect us from profound suffering. Meanwhile, being poor, divorced, imprisoned, blind or even paralyzed does not guarantee endless misery either. We tend to adapt to all life changes, even those that we see as very positive or very negative. And we tend to think other people are happier or more miserable than they truly are, which distorts our view of how others truly feel.

We’ve seen other symmetries between positive and negative feelings. When people indulge in too much pleasure (such as getting high from recreational drugs), they tend to suffer from anhedonia—the inability to feel pleasure. On the other hand, those who suffer too much pain begin to experience analgesia—the inability to feel pain. When the pleasure is too intense, heroin users begin to nod off, going in and out of consciousness as if their minds can’t handle that much ecstasy. Meanwhile, people who have been tortured for prolonged periods also tend to slip in and out of consciousness. Finally, blasting the mind with intense prolonged pain can lead to a surge of highly pleasant “god-like” feelings. On the other hand, blasting the mind with drug-induced euphoria can make us temporarily feel “like a god” but leads to intense depression, nausea, and musculoskeletal pain. Coincidence, or suduality?

Ask yourself this: are all of the above phenomena merely coincidental, or are they all deeply interrelated? We could explain all of the above using a multitude of separate laws and principles. But according to Ockham’s razor, doesn’t it make more sense if they can all be explained by one single unifying principle? Taken together, the simplest and likeliest explanation for all of these properties seems to be that all of the various pleasures and pains we experience balance each other out over time—regardless of our life circumstances or the decisions we make. In other words, one can make a powerful argument that the simplest and likeliest explanation is suduality.

Suduality cannot currently be scientifically proven nor disproven. So it is up to each of us to choose whether or not to believe in it. Is it foolish to believe in suduality? Or is it foolish not to? As we’ll explore in the following parts, suduality brings much clarity and practical use to our daily lives. And that is why I choose to believe.

If all else fails to convince you, simply take a close look inside yourself, at your own day-to-day pleasures and pains, joys and sufferings. Forget how everyone else says you should feel. Forget how you think everyone else feels. How do you feel? The answer lies there.

Summary of Part Three

Here is a summary of all key points from Part Three. It can be used as an optional refresher or an executive summary.

#23: Until we have a working sudumeter, sudism can neither be proven nor disproven. Instead, we will provide evidence of its existence in the form of scientific studies, expert opinions, and anecdotal evidence.

#24: Many thinkers from ancient to modern times have observed that pleasure and pain are tightly interconnected, including Chinese, Greek, French, American, and German philosophers; Buddhists, Christians, Hindus, and Jews; and even the father of modern science and one of the founding fathers of the United States.

#25: Keeping your finger on your affective pulse—that is, your positive and negative feelings from moment to moment—can help you see that all of your pleasant and unpleasant experiences eventually balance out.

#26: Being mindful can increase our awareness of the many varieties and intensities of pain and pleasure we feel every day, which can yield many insights into ourselves.

#27: When we take score of our own pleasant and unpleasant feelings, it is easy to overlook the ones we caused, the ones we blame on other people, and the ones that we are used to, but all of them count.

#28: Negative tension is the tendency to experience more pain than pleasure in the short-term future, due to having experienced more pleasure than pain in our past. Positive tension is the tendency to experience more pleasure than pain, because we’ve had more pain than pleasure in our past. Neutral tension is the tendency to equally experience pleasure and pain in the short-term future, which occurs when there is neither positive nor negative tension.

#29: Evidence suggests it is impossible to obtain continuous pleasure from pleasant activities such as eating, having sex, listening to music, consuming recreational drugs, or other activities.

#30: Evidence suggests it is impossible to obtain continuous pain, as illustrated by prolonged physical exertion, starvation, and even torture.

#31: Evidence suggests that increasing the frequency of pleasurable experiences reduces their pleasurable intensity, while reducing their frequency increases their intensity, which is consistent with suduality.

#32: In general, evidence suggests that increasing the frequency of painful experiences reduces their perceived intensity, and reducing their frequency increases their perceived intensity. In other words, the frequency and intensity of painful activities we partake in tend to inversely correlate. This is consistent with suduality.

#33: Sweeteners (natural or artificial) and savourizers (such as sodium and glutamates) give foods most of their pleasant taste. Foods with little or none of these ingredients taste relatively bland.

#34: Though sweeteners and savourizers can boost the flavours and textures of everything we eat and drink, evidence increasingly shows that they also have many longer-term negative effects.

#35: Commonplace drugs like alcohol, caffeine and nicotine temporarily relieve our stress and elevate our mood, but evidence is increasingly showing they have longer-term negative effects.

#36: Don’t be fooled by their name: many painkillers don’t merely kill pain, but can also make us feel good and even euphoric, just like many recreational drugs.

#37: Prescription drugs may solve some of our aches and medical issues, but evidence increasingly shows they also have multitudes of longer-term negative effects.

#38: Recreational drugs can give us tremendous euphoria and pain relief, but this comes at the cost of pronounced depression, anxiety, withdrawal symptoms, and other painful effects.

#39: Consuming porn may increase our appetite for sexual relations but may also reduce our success with real-life partners, leading to more sexual frustration and loneliness.

#40: Entertainment forms like video games, pornography, and television can be pleasant ways to pass the time and soothe ourselves, but evidence increasingly links them to depression, anxiety, and difficulty enjoying normal everyday activities.

#41: Our constant pleasure-seeking, whether through food, recreational drugs, or entertainment forms such as TV and pornography, progressively numbs us to the simple pleasures in life, such as watching a sunset, joking around with our friends, or holding hands with a loved one.

#42: Prematurely avoiding or eliminating pain (a positive effect) can cause that pain to resurface later on (a negative effect). Continual pain-avoidance (instead of pain-acceptance) tends to cause or worsen long-term chronic post-traumatic conditions.

#43: Solving our larger problems (which is a positive effect) often causes smaller issues to rise to the foreground and become our main source of worry and frustration (which is the counterbalancing negative effect).

#44: Mild, everyday pleasures like eating plain food and lovemaking don’t always have obvious negative side effects since these are often mild in nature or prepaid by painful desires. These usually fit within the mind’s “balanced budget” of joys and aches.

#45: Physical exercise can be tiring and unpleasant, but can later boost our mood and energy, ease our aches, and reduce our risk for many diseases.

#46: As countless people have observed, hard work pays off—not just financially but also in increased satisfaction, love, joy, and other positive emotions. The harder the struggle, the sweeter the reward.

#47: Meditation requires sustained mental effort and the endurance of unpleasant feelings, but leads to lowered pain, anxiety, and depression.

#48: Exposing ourselves to the cold can later relieve our pain and boost our mood.

#49: Bullet ant stings are among the most excruciating pains a human can experience, yet they can lead to an intense and prolonged sense of well-being.

#50: Depriving ourselves of food or air may lead to painful hunger in the short-term, but also to feelings of well-being and euphoria later on.

#51: Generally speaking, exercise, hard work, meditation, and other short-term painful events have been shown to lead to longer-term pleasant effects. Likewise, giving up pleasure from various sources has also been shown to lead to positive effects.

#52: Words like happiness and unhappiness mean different things to different people, leading to misunderstandings. In this book, momentary happiness means feeling pleasure in a given moment, short-term happiness means feeling more pleasure than pain over a period of hours or days, while long-term happiness means feeling more pleasure than pain over a period of months or years.

#53: Fairy-tale happiness means experiencing much pleasure but only mild, useful pains (such as hunger and fatigue) over a period of months or years. Symmetrically, sustained misery means suffering significant pain with only mild intermittent pleasures over the long term.

#54: There are many ways we can misperceive how much joy and suffering others feel, such as when we misinterpret their words and their facial expressions, and when they exaggerate or hide their true feelings. It’s hard to accurately decipher inner feelings from outer appearances.

#55: Evidence suggests that being rich and famous is no guarantee of fairy-tale happiness.

#56: The wealthiest among us still suffer from anxiety, loneliness, and other problems, while those who give up their wealth are not necessarily less happy than before.

#57: Wielding power or influence does not seem to guarantee fairy-tale happiness either.

#58: The “honeymoon high” of new relationships and new marriages generally fades away within a few years.

#59: Regularly indulging in junk food and sweets may feel good in the short term but is also a guaranteed long-term physical and mental health disaster.

#60: Evidence suggests that neither having endless sexual activity nor endless orgasms are the sought-after keys to happiness.

#61: Evidence suggests that beauty does not equal happiness. Even the most beautiful among us find flaws in themselves that can make them feel unhappy and inadequate.

#62: Being young, healthy, and carefree is not the magic bullet to happiness either.

#63: Evidence suggests that being a certified, bona fide genius may help us to make important contributions to society and earn the admiration of others, but it does not enable us to outsmart all of our suffering.

#64: Evidence suggests that being a great artist, bursting with awe-inspiring talent, is simply not a locked-in guarantee for fairy-tale happiness.

#65: Evidence suggests that shunning work to play video games all day long can lead to physical and mental health problems rather than endless joy.

#66: Evidence suggests that being retired and taking it easy doesn’t guarantee happiness. Some of us might want to rethink our retirement plans.

#67: Being young, beautiful, rich, intelligent, famous, powerful, or talented does not automatically grant us fairy-tale happiness. Neither does indulging in food, games, relaxation, sex, or drugs.

#68: Evidence suggests that even the most difficult situations—such as imprisonment, poverty, paralysis, blindness, and sickness—don’t necessarily cause sustained misery (that is to say, sustained intense suffering mixed with only a little joy).

#69: In terms of how happy we feel, we eventually adapt to all positive and negative life changes, such as marriage and divorce, promotions and demotions, as well as perfect health and disability.

#70: Doctors often try to get rid of chronic pain by using drugs, surgery, and electrical stimulation, but these approaches either fail or cause significant side effects.

#71: According to Ockham’s razor, it makes more sense to have one simple theory—such as suduality—to explain all of the phenomena described earlier, rather than a multitude of disjointed explanations.

PART FOUR: THE WORLD THROUGH SUDIST EYES

Introduction—The double-edged sword

What sudism says is impossible

What are induced and non-induced effects?

What sudism says is possible

Sudist perspectives

Conclusion of Part Four—Sudism the destroyer, sudism the liberator

Is sudism useless?

Summary of Part Four

Introduction—The double-edged sword

What can a little theory do? After all, a theory doesn’t change our universe or the way it works. It can only change our perception of the universe. But if we change the way we see things, we change our behaviour. And if we change our behaviour, we chart a new path through life, possibly reaching higher goals than we could have otherwise. Take gravity for example: it was always there, doing its thing, long before Isaac Newton published his theory of gravity back in 1687. However, learning about the theory of gravity permanently changed our understanding of the universe and all of the stars and planets. This new understanding eventually enabled us to build a rocket capable of leaving Earth, travelling hundreds of thousands of kilometres and landing on the moon.

The theory of suduality gives us a unique perspective of what is possible and what isn’t. It is truly a double-edged sword: no matter what we do, we cannot give ourselves a positive effect—that is, more pleasure or less pain—without also causing ourselves an equal and opposite negative effect later on—that is, less pleasure or more pain. The inverse is also true: negative effects always lead to positive effects. This is why the motif of a double-edged sword was chosen to represent suduality. It is also why this sudist sword combines both the positive “+” and negative “-” into one symbol.

As we’ll see later, sudism teaches us that we can learn to wield this symbolic double-edged sword to make changes in our lives that cut in both directions at once. Or, we can keep trying to maximize pleasure and eliminate pain, and be the victim of this powerful force instead of its master.

In this part of the book, we’ll talk about the main things sudism tells us we can and can’t do in the realm of pleasure and pain, with a particular focus on their quantities. Later on, we will focus on their qualities.

Going forward, “happiness” will refer to a person’s life-long happiness—in other words, the sum of all the pleasures and pains they’ve experienced in their life. Also, we’ll no longer question whether or not suduality exists and simply assume that it does.

For many of us, sudism is a paradigm shift and this part of the book may alternately seem obvious, shocking, depressing, uplifting, confusing, or revealing. Ultimately, sudism may help each of us to gain a deeper understanding of humanity. That understanding may help us to make better life choices. And by making better choices, we may ultimately overcome troubling affective disorders that we or our loved ones may have been struggling with, including chronic anxiety and major depression.

What sudism says is impossible

Let’s start by exploring this: what kinds of things do people often believe but, according to sudism, are simply not possible?

We can’t separate pleasure from pain

Back in ancient times, everyone believed the Earth was flat and that we could keep travelling in one direction without ever returning to our starting point. Believing today that pleasure and pain are disconnected is pretty much the same—it’s like believing we can continuously walk towards pleasure and away from pain without ever returning to our starting point of equilibrium.

However, sudism teaches us that these beliefs in hedonism or utilitarianism can never work in the long run. We simply cannot maximize our happiness while also escaping our suffering, as if these were two independent things. “[Man] struggles with all his might to attain pleasure and he fights against pain with immense zeal,” wrote seventh century monk Saint Maximus. “By doing this he hopes to keep the two apart from each other—which is impossible.” Many of us try to separate joy from suffering in the same way we separate sugar from sugarcane, only to eventually discover that eating refined sugar causes us abundant mental and physical health problems, as shown in Part Three. Similarly, we try to extract the romantic or sexual pleasure out of complicated human relationships by creating erotic literature and pornographic videos, only to find out that these also cause their own unintended side effects. In trying to separate the “good” from the “bad,” the bad simply reappears in a different form. As Ralph Waldo Emerson described in his essay Compensation, it’s like trying to have light without shadow. Or like trying to cut off the “left half” of a wooden stick while trying to avoid having a “right half”—no matter how we slice it, the new piece always ends up with two equal halves.

Nothing pleasant in life is truly free

It’s tempting to believe that some pleasant things in life are free, that certain things can make our lives more enjoyable with no hidden cost. It’s natural to think that eating a free dessert sample at a grocery store, or listening to free music on the radio, or even watching free pornography on the Internet are actions without consequences. But sudism says there is always a price to pay for everything that gives us even the tiniest sliver of pleasure or pain relief. With time, we may learn to see this hidden price tag associated with every single pleasurable activity, a price not measured in dollars, euros, or yens, but in future negative effects—in other words, more pain or less pleasure later on. “There is no such thing as pure pleasure,” observed the ancient poet Ovid, “some anxiety always goes with it.” Or as Rabbi Noah Weinberg concluded, “Pain is the price you pay for pleasure.”

We can’t make others “happier”

Those of us who are parents or guardians sometimes believe that, to make our children or dependents happy, we should give them the most pleasurable things life has to offer. Things like fun video games, exciting outings, and delicious food. Although our children will probably enjoy these things, sudism teaches us that there will also be matching long-term negative effects. Therefore, no matter what we give them, we will always fail to increase their overall happiness.

Similarly, we may generously try to improve someone else’s happiness by helping them out in some way. It’s certainly possible to help others be healthier, lighten their workload, or solve their personal problems. Both the helper and the recipient may feel happier in the short term from the selfless act of giving and the gratefulness of receiving. But sudism teaches us that it just isn’t possible to make that other person happier in the long run.

On the global scale, an endless stream of politicians and activists claim they can solve the world’s suffering, if only they can gather enough power, money, or support to carry out their specific plan. There is no doubt that they can make large and powerful changes to our world. Some might even succeed in easing or eradicating war, disease or poverty. But they will never, ever succeed in establishing a utopian society that is free of suffering. The world’s ratio of joy and suffering cannot be fixed, because it isn’t broken. The balance of suduality is always there. This is how the world was intended to be.

We can’t make others less “happy”

From the opposite perspective, many of us who have children or dependents believe that taking away pleasant things from them—such as the television (TV), video games, or delectable meals—will also take away their happiness. Although they may be upset in the short-term, sudism teaches us that removing pleasant things from their lives will by definition cause them to experience positive effects in the long-term, and thus no actual change in their overall happiness. Short-term suffering never transforms into long-term misery. Sudism encourages us to think long-term, not just short-term.

Taken to the extreme—though I hope you can see that I don’t encourage or condone such behaviour—sudism says that even if we lie to others, steal from them, or hurt them physically or emotionally, we may succeed in making them feel horrible for a while, but in the long run we won’t succeed in making them any less happy than before. Suduality helps to make us resilient—what doesn’t kill us, we adapt to.

To many of us, this may seem shocking. But for a sudist, this is simply life’s modus operandi—the way life works.

Others can’t make us less “happy”

Can others affect our happiness? Sometimes we like to blame others for our very own misery. Yet no matter what others do to us, sudism teaches us that they can’t make us less “happy” in the long term. We may be beaten, robbed, lied to, or even tortured, raped, or abandoned. Our loved ones may be abused, and our freedom may be taken away from us—all of which are terrible ways to be treated. We will probably feel utterly horrible for a while, but no matter how terrible the experience, sudism says that pain will inevitably fade away and our pleasure will return, balancing out both sides in due time. To many, this will seem inconceivable. But to sudists, these outcomes are as clear as day. Remember Viktor Frankl’s three long years of incarceration in Nazi concentration camps? Despite being worked like slaves, freezing in the cold, semi-starved, and beaten on a sometimes hourly basis, he and his fellow prisoners became numb to the daily horrors and pains, and they still found moments of joy, each in their own way, in such an unlikely place.

Sometimes we fear the future. We might be afraid that an upcoming change will make us forever miserable. This change might be near and likely to happen such as a change in management at our office, or it may be a distant and unlikely event such as a nuclear war. We may fear that our pleasure will eventually disappear or that our suffering will keep growing forever. Sudism teaches us that such misery is not only unlikely, it’s impossible. There is simply no reason to fear the future in this way.

Products and services won’t make us “happier”

Have you ever counted how many advertisements out there promise us a happier life? A brief sampling of recent North American television ads quickly uncovered a vodka that promised drinkers they would “live happily ever after,” a shampoo that would “take our hair to paradise,” and a brand of soda pop with the amazing power to transform cranky grumps into happy-go-lucky types. If it were this easy, I’d buy everyone I know a lifetime supply of vodka, shampoo, and soda! Companies and organizations often build their products and marketing strategies based on the promise of boosting our happiness or helping us get rid of our aches and frustrations. But can they actually deliver on these promises?

Ads often use music, sex, humour, and depictions of strong, beautiful, happy consumers in order to get us to associate as many positive things as possible to their products or services. Young children are bombarded with images of princesses and superheroes plastered across thousands of products. Food manufacturers and restaurants go a step further and inject pleasure directly into their food by way of sweeteners and savourizers (that is, sodium and glutamates) in order to make their products taste as good as or better than those of the competition. And pharmaceutical companies promise to solve our daily aches and pains with a thousand kinds of medicine.

It is entirely in the commercial interest of these corporations to project a message that is the exact opposite of suduality: that their product or service will indeed make us happier overall, with no unintended side effects. If we all suddenly realized that we didn’t need anywhere near as much as we thought we did to lead a satisfying life, then many of these companies would perish. In his book Stumbling on happiness, psychologist Daniel Gilbert conveyed this idea with the unlikely support of Adam Smith, the father of modern capitalism: “Market economies require that we all have an insatiable hunger for stuff,” Gilbert wrote, “and if everyone were content with the stuff they had, then the economy would grind to a halt . . . Like so many thinkers, Smith believed that people want just one thing—happiness—hence economies can blossom and grow only if people are deluded into believing that the production of wealth will make them happy.”

Since we are not born with the desire for gadgets, jewellery, and exotic vacations, corporations must not only manufacture these things, they must also manufacture the desire for these things. “Modern man is kept in a state of perpetual discontent by the desire-breeding actions of the Advertising Society in which he is immersed,” observed psychologist G. Marian Kinget in her book Pleasure and Pain. Why do many of us believe the following?

That we must buy a diamond engagement ring when proposing to our loved one? We can thank diamond conglomerate De Beers and their advertising agency N.W. Ayer for manufacturing this tradition.

That lovers can’t celebrate Valentine’s Day without buying each other chocolates or flowers?

That Christians can’t celebrate Christmas without buying each other gifts?

That we can’t have a satisfying vacation unless we travel to an expensive, far away location?

The ultimate goal of advertising is persuasion, not truth. Even though we may be keenly aware of advertisers’ attempts to manipulate our desires, over time their messages somehow still successfully infiltrate our collective beliefs. And we end up believing that the way to increase happiness is to increase consumption.

KEY POINT #78: In order to maximize profit, corporations spread the message that long-term happiness can be bought through goods and services. But sudism helps us see through these superficial messages and deeply into the true nature of things—we don’t actually have to buy anything or purchase any experiences in order to be happy.

We can’t make our own lives less happy

Imagine for a moment a world where we, and all our ancestors before us, lived our entire lives in underground caverns. A world where our only sources of light were artificial lamps and that none of us knew about the Sun. We might fear that by leaving our cave we would lose all light and live the rest of our lives in total darkness. But if we took that leap of faith and left the comfort of our cave, we would discover that there is actually a sun shining in the sky. We would also learn that it isn’t always sunny and that night follows day. But if we are patient, the Sun always faithfully returns.

Similarly, many of us fall for the illusion of long-term misery—we are afraid to give up a cherished source of pleasure, worrying that all we’ll have left is our suffering. Those that get a large share of their joy from food—including binge eaters and overeaters—generally believe that without the pleasure of food, they would have nothing to look forward to, according to clinical psychologist Jennifer Kromberg. In my own family, when I cut back our consumption of sugar, salt, music, television, and so on, my wife bitterly complained that I was trying to “take away all the good things in life.” Giving up cherished pleasant activities feels like facing a precipitous drop in happiness—it seems foolish and scary, like jumping off of a cliff. Yet sudism reassures us that this is simply a powerful illusion, that for every ounce of pleasure we give up, and for every ounce of pain we take in, we will eventually receive an equivalent positive reward. In other words, don’t be afraid to leap off of this metaphorical cliff!

Some Buddhists say, “Life is suffering.” But sudists are a cheerier bunch and say instead, “life is equally joy and suffering.” Endless misery and unhappiness are simply not possible, no matter which path we take. “Our tendency is to think that if we let go, we’ll lose the things that make us happy,” observed Nobel Prize-nominated Buddhist Thich Nhat Hanh. “But the opposite is true. The more we let go, the happier we become.”

KEY POINT #79: Many of us fall for the powerful illusion of long-term misery—the belief that giving up cherished pleasures will make us forever miserable. But sudism teaches us that short-term misery never transforms into long-term misery. No sacrifice goes unrewarded.

We can’t make our own lives happier

Many among us will continue to insist, “Some things do make me happier overall!” It’s natural to think so. Many of us seek everlasting happiness. We think we see it somewhere in the distance, a rainbow through a hazy fog, so we start walking in that direction. We believe that every time we upgrade our relationship, our house, our job, or our wardrobe, that we’re taking steps towards that everlasting bliss. And if we buy a cottage, a boat, or perhaps a pet, we’ll inch even closer to it. Because these events give us a little short-term happiness, we tend to believe, by extrapolation, that they cumulatively bring us long-term happiness. We like to think that bigger, better, faster, and more of everything we think is “positive” will lead us to the paradise we seek. So we seek bigger houses, better gadgets, faster cars, and more TV channels. Bigger TVs, better-tasting foods, faster service, and more spray-jets in our showers. We want it all. But what if the belief that more is better was completely wrong? What if we could never reach that distant rainbow we chase?

Sudism teaches us that this is the powerful illusion of long-term happiness. In the dense fog of life, we are each walking on our own invisible hedonic treadmill, taking strides towards pleasure and away from pain. With each step we take, we think: “Clearly, I’m getting closer to long-term happiness.” But every time we take a step forward, the treadmill’s belt moves us an equal amount backwards. We adapt to our new circumstances and are inevitably back to where we began—with our joys and sorrows back in balance. Run as fast as we might, and the belt simply turns faster to compensate. Sudism says that, although momentary happiness (feeling pleasure in the moment) and short-term happiness do exist, long-term happiness simply does not. Short-term happiness never transforms into long-term happiness, no matter how hard we try. It’s like trying to turn lead into gold. “We build castles in the air hoping for endless pleasure which we call happiness,” observed Indian sage Sri Nisargadatta Maharaj. “It is all misunderstanding and misuse. Wake up, go beyond.”

Humanity has a fantastic imagination. We can easily imagine superheroes powerful enough to stop speeding trains, but that doesn’t mean we’ll ever have that kind of ability. Along the same lines, even though we can easily imagine being happy for years on end does not mean we’ll ever have that kind of superhuman happiness. Long-term happiness is just a figment of our collective imagination. For those of us who cling tightly to that possibility, this might seem demotivating or even offensive. But remember: the only thing that is changing here is our perception of life, not life itself. Sudism is not about making our lives worse, it’s about making our perceptions clearer.

Many of us think that the predominant feeling in life should be happiness, that if we aren’t happy most of the time then something must be wrong with us! But sudism teaches us that the default, average mood in life should actually be neutrality—a calmness that is neither joy nor suffering.

If we sometimes wonder why our lives didn’t turn out quite as happily as we had planned, we shouldn’t blame ourselves. Many of us are still looking for the “missing piece” in our lives that will lead to eternal contentment. Some of us jump from one relationship to another, while others hop like a frog from home to home or job to job. But long-term happiness cannot be found in a thing, place, event, or relationship. We can spend our whole lives searching for the key that will magically unlock the gates to everlasting contentment. Even if we scour the breadths of time and the outer reaches of the galaxy, we might find the keys we lost to the shed but we will never find the key to eternal joy. In Part Three, we looked at many common paths people hope will lead to this long-term happiness, yet found them all lacking. Sudism teaches us to stop thinking there is a real-life path to fairy-tale happiness, because there isn’t one.

Instead, we should focus on things that are actually achievable. We should accept both pain and pleasure as our lifelong guides along the way, not as destinations in and of themselves. Our desire to seek pleasure and evade pain works much like the magnetic forces in an electric motor. The inner rotor is constantly trying to reach the outer magnet, turning a little to get closer to it. But every time it turns, the outer magnet moves further away. That the rotor never reaches the outer magnet is irrelevant—the motor turns continuously, achieving its intended purpose. In exactly the same way, the fact that we humans never reach long-term happiness doesn’t matter, it is the fact that we are always striving towards it that matters. Suduality fuels the engine that motivates us to survive and thrive. Long-term happiness is like the rabbit that Alice chases in the story Alice in Wonderland—something we always run after but never actually catch. That is the entire point of it—if we caught it, we’d stop running! Likewise, if the rotor hit the outer magnet, it would seize and stop turning, and the engine would fail. Long-term happiness isn’t something we’re meant to have, it’s something we’re meant to chase. It’s the tempting carrot held up in the air, always just ahead of the donkey. It’s the speeding lure that greyhounds chase around the racetrack. It’s a flying arrow, not a target. It is a direction, not a destination.

KEY POINT #83: Pleasure and pain are directions, not destinations. They are motivators, not goals.

It’s hard to solve all our problems

Ever notice how hard it is to fix all of our problems? To get to the bottom of our never-ending “to-do” list? Why is this?

If we define “problems” very broadly as “any source of pain or suffering,” then suduality is the root problem. We can certainly solve some of our problems, but never the root one. It is simply impossible to eliminate all such problems without unintended side effects because it is our very own minds that generate all of these problems. Our minds live off of problems; they love problems. Sudism teaches us a profound lesson: making all of our painful problems disappear is simply wishful thinking.

Now let’s look at recurring problems. Recurring problems are those that occur over and over. If we find a one-time “quick fix” that completely eliminates a recurring problem, then two things have happened. First, the elimination of the recurring problem is equivalent to a recurring positive effect (because we’ve eliminated not just one instance of future pain but many future instances of that recurring pain). And second, the painful effort to eliminate this problem (if there was any) is merely a one-time negative effect. Assuming that nothing else has changed, then the recurring positive effect will increase the negative tension in our lives until some other frustrating problems naturally take the place of the original one. These problems may be entirely new, or they may have always been there but start bothering us more. To put this idea in perspective, here are some examples:

A person who has always been anxious or ashamed about some perceived imperfection in their body may choose to “fix” it using cosmetic surgery, only to then start noticing some other part of their body that is somehow imperfect, leading to more surgery. Many of those who get caught up on this surgical treadmill, such as Lolo Ferrari, look less and less human with each passing operation.

Someone who is unhappy with the weeds in their lawn might think, “If I can only get rid of all those awful dandelions, I’ll be happy.” Once this is achieved, they may feel content for a while. But it may not be long before they start noticing smaller weeds and start wishing that they too would be gone.

A person might buy a bigger house in a nicer neighbourhood because they feel unhappy about their material status. They might then discover that their bigger house merely looks average compared to other houses in their new neighbourhood, leading them to want even more.

We like to believe that our “problems” are located inside our physical flaws, inside the weeds in our lawns, and inside our imperfect belongings. But they are not there at all. Our problems are in our minds. Many think that if they only had more technology, more beauty, more time, or more money, they could finally make all of their painful problems go away. But sudism teaches us that things like technology, beauty, time, and money can’t erase pain without generating equivalent future negative effects—that is, less pleasure or more pain later on. The erased pain simply morphs into other forms of suffering or anhedonia.

Can money buy happiness? It might buy us short-term happiness, but never long-term happiness. And any short-term happiness we buy will be counterbalanced by equal and opposite effects.

In the end, trying to get rid of all unwanted pains or irritants in our lives is like playing the popular midway game Whack-a-Mole—a game where a mole appears and the player must quickly whack it away, only to have it replaced by yet another mole. Even if we find a quick fix to get rid of one kind of unwanted pain, there is always another that will pop up and take its place. As philosopher Schopenhauer aptly put it, “The ceaseless efforts to banish suffering achieve nothing more than a change in its form.” Problems expand and contract to fill the available space in our minds, regardless of the size of the problem. Psychologist Daniel Gilbert, who published a series of related experiments in 2018, concluded that “solving problems causes us to expand our definitions of them. When problems become rare, we count more things as problems.” Psychologist Abraham Maslow, famed for his theory on humanity’s hierarchy of needs, held a similar view that once we satisfied basic physical needs, “At once other (and “higher”) needs emerge and these, rather than physiological hungers, dominate the organism. And when these in turn are satisfied, again new (and still “higher”) needs emerge and so on.” Sudists know that this sequence of needs never ends.

KEY POINT #84: We will never solve all of our problems. Even if we solve all of today’s problems, our minds will simply come up with new ones tomorrow to fill the void.

KEY POINT #85: Sudism teaches us to accept many of life’s aches and irritations instead of trying to solve them all, thereby enabling us to shift our focus, time, and energy away from impossible goals and towards achievable ones.

We can’t run away from our problems

Pleasure and pain are much like the two sides of a pendulum or swing; the more we push it one way, the more it will swing the other way, balancing out the motion on both sides. When our lives become difficult or unpleasant, we often react by indulging in something pleasant to temporarily escape our pain. Sudism teaches that these indulgences are actually worsening our future suffering, if not causing it entirely. Here are some examples to illustrate this important principle:

Someone who hates their job or their family life may watch TV or daydream in order to escape from their painful reality into a pleasant fantasy world. But this indulgence might lead to the counterbalancing reaction of making their work or family feel even more unbearable, leading to the very circumstances they want to escape from. Would we despise our real lives if we had never visited these fantasy worlds?

Someone who hates cold winters may escape them by vacationing in a warmer country. But the comforting warmth may simply increase their disdain for the cold, making them want to escape even more. Would we hate the cold if all we had ever known was a cold climate?

Someone who hates healthy food may eat junk food to “escape” from healthy food, but the pleasure from consuming junk food may increase their dislike for healthy fare. Would we hate healthy food if it was the only kind of food we’d ever been exposed to?

Someone who is depressed may consume alcohol or recreational drugs to escape these difficult feelings. But the drug-fuelled relief may cause further depression, leading to the very circumstances they want to escape from. Would we have ever been depressed if we had never consumed any of these drugs in the first place?

In other words:

KEY POINT #86: Our solutions often cause our problems. By running away from our problems, we may simply be causing them to reappear later on. The further we run away from a problem, the more we might amplify it. Trying to escape pain by inducing pleasure often causes the pain we run from to come back in the future, thereby creating an endless cycle of excessive pleasure and excessive pain.

By repeatedly escaping our pain by indulging, we amplify both our pleasure and pain, like this:

It’s clear to us that TV, vacations, junk food, and drugs can make us feel better in the short-term. But due to our shortsighted nature, it can be hard for us to notice that these things can also make us feel worse later on.

Reducing our workload

For many of us, modern life has become increasingly complicated. We now have to deal with complex finances, post-secondary education, cars, appliances, insurance, computers, gadgets, and so on. It’s no longer possible for one person to be completely self-sufficient. Not everybody has the time, knowledge, or ability to build their own house, grow their own food, fix their own car, or sew their own clothing. So we rely on each other’s unique skills and abilities to get all of this work done, and we all benefit in the form of an increased standard of living.

With all of the technology at our disposal, it’s tempting to believe that we can make our lives easier by finding clever ways to avoid hard work. Some of us might:

Drive everywhere so we no longer have to walk or bike.

Use a snowblower so we don’t have to shovel snow, a leaf blower so we don’t need to rake leaves, or a dishwasher so we don’t have to wash dishes by hand.

Throw items out to save the hassle of fixing, donating, or selling them.

Pay others to clean our house, make our meals, maintain our yard, and even raise our children.

If we do find a way to reduce our workload and we use that freed-up time to relax or indulge in something we enjoy, we might be tempted to boast, “Look at all the time and effort I’ve saved. Now I can sit back and enjoy life!” But by replacing painful effort and struggle with relaxation and leisure, we inadvertently introduce a counterbalancing negative effect in our future. Will it be more anxiety? Less satisfaction? Sudism does not tell us exactly which negative effects will occur nor when, only that they will occur. There are no exceptions to this rule.

A wealthy person might dream of a utopian life that is entirely devoted to leisure. They may succeed in freeing themselves from all physical and mental work by having people, machines, and computers do all of the so-called heavy lifting for them. However, by eliminating all of these painful struggles, suduality guarantees that this person will suffer equivalent negative effects during their life of leisure—maybe crushing periods of depression—which is hardly the utopia they were aiming for. Furthermore, a day of constantly being served and our every whim being catered to will quickly become an unremarkable, average day. In the words of American oil tycoon John D. Rockefeller, “I can think of nothing less pleasurable than a life devoted to pleasure.” Although we may be tempted to take the easy way out, sudists learn that the easy way always leads to the hard way.

Medicating ourselves

Some of us believe that we can reach the realm of bliss by drifting away on a hazy cloud of drugs. Such was the case of nineteenth century poet Thomas de Quincy. When de Quincy started taking opium, he was convinced that he had discovered the solution to all of humankind’s problems: “Here was a panacea for all human woes,” he wrote. “Here was the secret of happiness, about which philosophers had disputed for so many ages, at once discovered: happiness might now be bought for a penny and carried in a waistcoat pocket.” As his opium use escalated, however, he started suffering from great stomach pains, weakness, and other ills. Realizing that this was not the wonder drug he had initially thought it was, he struggled to quit but never succeeded. He eventually wrote Confessions of an opium eater to educate others about both the highs and lows it had brought him.

During his career spent treating those in chronic pain, Dr. Erv Hinds came to a profound realization, which he called the pain paradox, much like Dr. John Briere did with respect to avoiding traumatic pain. Though many of us believe that pain is the enemy and that medication is our ally, the paradox encourages us to re-think those basic assumptions: “the very thing that is supposed to help you may make the pain worse,” wrote Hinds, “and what you think will hurt you may be the thing that frees you from a pain-dominated life.” Understanding and embracing this paradox can be a challenging but life-altering paradigm shift.

Sudism makes it clear that drugs can’t make us happier in the long-term. It doesn’t matter whether these drugs are commonplace ones like alcohol or nicotine, or prescription drugs, or recreational ones. Millions of us have tried this strategy before. Millions more keep trying in vain. These substances may temporarily succeed in soothing our aches or boosting our mood, but they will never succeed in permanently increasing our ratio of pleasure to pain. Instead, each of these drugs actually works in one of the following ways:

They reduce pain now at the expense of increased pain later. It is well known that drugs generally cause a wide variety of unpleasant side effects. Even more surprising may be the realization that quite a few drugs can cause or aggravate the very pain they are supposed to cure. This includes opioids and headache medications as we saw earlier in Prescription and non-prescription medications. But due to our shortsighted nature, we are quick to praise our medication when it relieves our aches but are unlikely to blame it when the aches return. These drugs merely shift pain around from one form to another. It would therefore be more accurate to call these pain shifters instead of pain relievers or painkillers.

They reduce pain now at the expense of decreased pleasure later. For example, in Prescription and non-prescription medications we showed how many classes of medication rob the user of sexual pleasure and that some drugs like acetaminophen appear to blunt pleasure in general.

They increase pleasure now at the expense of increased pain or decreasing pleasure later, which applies to opiates, cocaine, and marijuana as we illustrated in Recreational drugs. We get our “high” and we pay for it later on with a “low”—perhaps flu symptoms, nausea, or panic attacks, depending on which drug was taken. As we’ve seen earlier, many recreational drugs also cause anhedonia, which drains the pleasure out of our day-to-day experiences. Consuming these drugs is like stealing pleasure from the future.

When we are faced with suffering, sudism teaches us that we must pay for it now or pay for it later—either way, we have to pay. Drugs and medications that promise to make us feel better without counterbalancing effects simply don’t work as advertised. It would be wise to question the widespread use of drugs whose only goal is pain relief.

Even major surgery or other medical interventions purely intended to relieve pain (or increase pleasure, for that matter) will meet the same fate. Even if these succeed in relieving certain aches or boosting certain positive feelings, the patient will inevitably experience equivalent negative effects later on.

KEY POINT #88: Trying to use drugs or other medical interventions to eliminate pain or boost pleasure—without any counterbalancing effect—will always fail.

Having more technology

For those of us fortunate to have access to the latest and greatest technology, we’ve experienced first-hand the many ways in which science has improved our lives:

We can live longer and more able-bodied with medicine sustaining us through diseases (such as diabetes and cancer), injuries (such as from car accidents), and natural aging.

We can do more in less time, such as using computers to quickly find or process information, using power tools to do the work faster, or travelling by motorized vehicles.

We can learn more, by accessing the near-limitless knowledge found in libraries and across the internet.

We can have more thanks to the industrial mass-production of things like food, clothing, furniture, and gadgets.

We can be entertained more by an ever-growing variety of games, videos, music, novels, and so on.

We can reach further with global telecommunication networks and worldwide travel by land, air, and sea.

We like to think that having more of all of these things has brought us more happiness. However, though these technological wonders may have given us moments of joy and solved some of our problems, no invention of mankind can sustainably boost our happiness. Even with thousands of years of technological progress—including everything from fire-making to the internet—sudism says we still aren’t any happier.

Like many things in life, technology is a relative thing. We tend to compare ourselves to prior generations and boast that we have the latest and best technology. But what’s stopping us from comparing ourselves to future generations and concluding that our technology is old and obsolete? Should we feel deprived because we might never see flying cars or interplanetary travel in our lifetime? Our desire for more technology never ends—it is the hedonic technology treadmill on which we can never progress forward in terms of our happiness.

KEY POINT #89: Technology may allow us to do more, have more, and live longer, but it just can’t make us any happier. The more technology changes, the more happiness stays the same.

Other strategies to increase our happiness

Many life coaches, psychologists, philosophers, and others promise that we can boost our long-term joy with no unpleasant side effects, if only we buy their latest book and follow their particular prescription of tips and tricks. Do any of these sound familiar?

Be happy with what you’ve got! Think positive! Cheer up! Don’t dwell on the past! — Sudism tells us that no amount of focusing on the positive side of life will make things more positive than negative in the long term.

Stop and smell the roses! Savour each moment! Let the taste of food linger in your mouth! — Likewise, no amount of extended savouring will tip the scales in the long run.

Just smile and you’ll feel better! — Pretending to be happy when we aren’t also won’t make things more positive than negative in the long term.

Live every day like it was your last! YOLO—you only live once! — These mottos simply encourage us to make reckless short-term decisions, like spending all of our money, while disregarding long-term consequences.

Don’t sweat the small stuff! — This might help us get more done in less time by overlooking nitty-gritty details (and perhaps being a little sloppier) but it won’t make us any happier long-term.

Can the above advice make us feel better for a while? Sure. But any improvement in our mood will be counterbalanced in some way later on. In the long run, we simply can’t “will” ourselves to be happier, just like we can’t lift ourselves up in the air by pulling up on our own bootstraps. There is wisdom in the old saying that if something seems too good to be true, it probably is. If anyone had truly found the magical sequence of steps to reach fairy-tale happiness, wouldn’t this information be so incredibly valuable that it would spread like wildfire from one person to the next? Wouldn’t it quickly become common knowledge instead of remaining buried in the pages of some “happiness” book or in the mind of a “happiness” expert? If books on “how to be happy” actually worked, then why would such authors keep writing more and more of them with ever-changing techniques? Wouldn’t one single book that actually works be enough?

KEY POINT #90: Sudism does not promise us any easy shortcuts to reach a fairy-tale ending. It only helps us see the balance between suffering and joy that’s already there in each and every one of us.

Should we despair at the idea that we can never attain long-term happiness? Not at all. As we’ll see later on, it is entirely possible to live a healthy and fulfilling life despite knowing that long-term happiness is completely out of our reach. In Parts Five, Six and Seven, we’ll also talk about what we can do to improve our lives, even if we can’t improve our overall happiness.

Deciding which option is better

Every day, we are faced with many decisions, big and small. Sometimes we have a hard time figuring out which option is better. For example, we might wonder which of these is best:

Living a tame domesticated family life versus a wild and carefree lifestyle

Being rich, or having average wealth, or being poor

Marrying one person versus another, or simply staying single

Working at one job versus another, or being retired

Wearing one outfit instead of another

Going on one outing versus another, or just staying home

Buying Brand A versus Brand B of something

Giving to others versus taking or receiving from them

Speaking strictly in terms of overall pleasure and pain, sudism teaches us the surprising lesson that, in the long term, no option is ever better than any other. Most of us do believe that, in terms of overall future pleasure and pain, some options are clearly “better” while others are clearly “worse.” But this illusion is simply a result of our shortsightedness—that if we could clearly see the future all the way to the end, it would become evident that none of the options are superior. Though it may seem strange, overall we can be just as happy polishing our latest super-yacht than polishing public urinals. We can feel equally satisfied picking up rare, magical artifacts in a video game than picking up rather unmagical pieces of trash littering our neighborhood park.

KEY POINT #91: In terms of the balance between joy and suffering, every option we might choose in life is the same—in the long run, there is no “better” or “worse.”

To many of us, this will seem obviously wrong. But to a true sudist, it is right as rain.

Reaching all of our goals and achieving our wildest dreams

Many of us believe that it’s possible—through some combination of luck, skill, and effort—to eventually reach fairy-tale happiness in our lifetimes, whether we call it our happily ever after, our domestic bliss, or our utopia. If many of our troubles are somehow tied to money, for instance, then it’s tempting to think that having more money would solve all of our problems. If we feel lonely because we don’t have a romantic partner, then courting the right person might seem like the answer to all our sorrows. So we conclude, “if only so-and-so thing happens, I will finally be happy.”

Sudism says we make two fundamental mistakes when we think this way: first, we assume the blissful feelings of reaching our goals will last forever—forgetting that we hedonically adapt to virtually all life events. And second, we wrongly assume that we won’t encounter any new challenges once we achieve our new “ideal” circumstances. Despite what we may believe, we will never reach fairy-tale happiness, even if we:

Move into our dream home

Acquire every material possession we’ve ever desired—whether they’re gadgets, collectibles, clothing, jewellery, or fancy cars

Get away from it all and go on every exotic vacation we’ve ever dreamed of

Land our dream job

Finally quit our job and retire

Find the romantic partner of our dreams, or own the ultimate sex/romance robot

Find countless romantic partners plus own an entire sex/romance robot factory

Become single and free at last (are you considered single if you own a sex robot?)

Have beautiful, healthy, wonderful children

Have those pesky children finally leave the house so we can regain our sanity

Have our children achieve all of their goals and dreams

Hoard money and become multi-millionaires

Give everything we own to charity

Become famous or anonymous, whichever we prefer

Gain every power we’ve ever dreamed of

Become smarter and wiser

Fix or accept every perceived defect in our bodies

Attain perfect physical and mental health

Become the best athlete, engineer, chef, nurse, lawyer, executive, or whatever it is we aspire to be

Avoid work altogether and laze around our whole life

Create the most beautiful garden, home, song, book, or work of art

Play every game, read every book, watch every movie, and experience every form of entertainment

Complicate our lives by trying to own everything, do everything, experience everything, know everything, and improve everything

Simplify our lives by trying to own less, do less, experience less, think less, and improve less

Achieve every single goal and dream on our “to do list” and our “bucket list”

In doing the above, we will certainly experience many things, learn many things, achieve many things, and possibly acquire many things. And we’ll certainly feel doses of satisfaction, relief, and joy, but none of these feelings will last. Those who have reached even their loftiest goals already know this: as successful actor Jim Carrey insightfully suggested, “I think everybody should get rich and famous and do everything they ever dreamed of so they can see that it’s not the answer.”

We might get a brief thrill if we win the lottery or get something that we didn’t make any effort to obtain, but it won’t last. It is the painful struggle to reach our goals, and the ongoing challenges to maintain all the things we’ve acquired, that is the fuel that makes the resulting positive effects burn brighter. If we quit struggling towards our goals, the corresponding positive effects will cease as well. As happiness researchers from Gothenburg University in Sweden have found, working hard towards a goal—rather than actually attaining it—leads to the most satisfaction of all.

This is liberating because it teaches us that we don’t need to make everything perfect in our lives in order to finally attain fairy-tale happiness—simply because none of us can reach fairy-tale happiness. We don’t need to wait for our perfect soulmate. We don’t need to keep up with the Joneses. We don’t even need to buy or do anything special in order to experience our share of happiness in this world. Sudism unshackles us from all of the things that different people and different corporations have told us that we either must have or must do in order to reach our fairy-tale ending. Neither doing nor not doing any of the above things will make us happier, or less so, in the long run.

What are induced and non-induced effects?

Before moving on, we need to explain the difference between induced effects and non-induced ones. It’s the difference between us choosing pleasure or pain, and them choosing us. For example, we induce positive effects when we choose to eat delicious food and we induce negative effects when we decide to do a hard workout. Or these effects can be non-induced, such as when we suffer from a crippling migraine or when we spontaneously feel happy for no particular reason.

IN-DEPTH: The distinction between what’s induced and non-induced can actually vary from one individual to another. Induced effects are essentially those we believe we control, while non-induced effects are those we believe we don’t control. For instance, one person who fully realizes fried foods give them heartburn will perceive both the pleasure from eating the food and the pain from the heartburn as being induced. On the other hand, someone who has not made that connection may see this stomach ache as being non-induced.

Furthermore, induced effects generally occur shortly after we take some action, whereas non-induced effects aren’t always obviously related to our actions.

What sudism says is possible

We’ve talked about many things that sudism shows us are impossible. Now, what kind of things do people often disbelieve but that sudism says are actually true? Let’s find out.

We can indirectly control non-induced pleasures and pains

As we first showed in Part Two, sudism indicates that for each of us, over time, the following equation is true:

If we separate induced pleasures and pains (i.e. the ones we make happen) from non-induced pleasures and pains (i.e. the ones that happen to us), we can rewrite the formula like this:

This means that:

If we increase (induced pain), then either (non-induced pleasure) will increase and/or (non-induced pain) will decrease. If we instead reduce (induced pain), the opposite will happen.

If we increase (induced pleasure), then either (non-induced pain) will decrease and/or (non-induced pleasure) will increase. If we instead decrease (induced pleasure), the opposite will happen.

The point is that, although we don’t have direct control over our non-induced pleasures and pains, we actually do have indirect control over them by controlling our induced affects. This doesn’t mean we can control exactly which non-induced affects we’ll feel or when we’ll feel them. But we can clearly influence some unpredictable combination of their intensity, duration, and frequency. In other words:

KEY POINT #94: We have some degree of control over all pleasures and pains we experience in our lives, including those we think we have absolutely no control over.

This point is very important. It is the key to solving our current epidemic of unhealthy suffering, as we’ll show later in Parts Six and Seven.

We can induce positive effects to obtain negative effects later

Sudism teaches us that we can indulge in pleasure (or pain relief) at any time, but we will have to pay the price later on in the form of negative effects. A single positive indulgence can lead to negative effects of many shapes and sizes. Some negative effects are mild but prolonged, like this:

While others are short and intense, like this:

And still others are split into several pieces, like this:

The important thing is that, although they might vary in shape and size, negative effects are always equal to the positive effects that caused them.

We can induce negative effects to obtain positive effects later

Do you want more good things and less bad things to happen to you? In other words, do you want to experience more non-induced positive effects in your life? Well, you may be surprised to find out that we actually do have the power to make these things happen to us. As scientist Isaac Newton once famously said, “For every action there is an equal and opposite reaction.” So if we want to receive these kinds of positive effects, we must induce equal and opposite negative effects, which amounts to an equal trade-off. We might say there are two kinds of “currency” we can spend at any time to “buy” these non-induced positive effects—currency that many of us never realized we were carrying all along:

1. We can decrease our induced pleasure. Giving up something we enjoy will cause us to receive more pleasure or less pain later on.

2. We can increase our induced pain. Taking on more pain—more effort, frustration and struggles—will also cause us to receive more pleasure or less pain later on.

The pleasure of anything we ever achieve in life is amplified by all of the sacrifices and hard work we endured along the way. The harder we work for something, the bigger the reward we get out of it. This is exactly why we should embrace hard work, struggling, and effort, regardless of what we’re aiming for. Reflecting on his life, pioneer physician Dr. Paul Brand noticed that his happiest moments didn’t occur in first-world, well-stocked hospitals. They happened instead in India, where he and his medical team struggled to overcome many difficult barriers due to working in primitive hospitals lacking modern tools and supplies. This is why philosopher and teacher Amos Bronson Alcott keenly concluded that “Success is sweet and sweeter if long delayed and gotten through many struggles and defeats.”

KEY POINT #96: The harder we make our lives—through work, struggling, and other means—the easier the rest of our lives become.

It’s hard to predict exactly what we’ll get in exchange for our sacrifices. This is because the correlation between negative effects and positive effects is not always consistent from one person to the next or from one situation to the next. Like for induced positive effects, a single induced negative effect may either lead to a brief but intense positive effect, or a milder but more prolonged positive effect, or anything in between.

KEY POINT #97: Sudism teaches us that less is more: the less we take pleasure from life, the more we receive pleasure from life. The less we take pain from life, the more we receive pain from life.

We can improve or worsen one part of our lives, but not our whole lives

If we put our entire lifetime’s worth of pleasure in one bucket, and our entire lifetime of pain in another, both buckets will weigh the same. But if we divide our lives into cross-sections like “home life,” “work life,” and “social life,” then further split each of these cross-sections into pairs of “pleasure” and “pain” buckets like before, these pairs of buckets are not guaranteed to be equal. We might find our job quite dreary but feel our home life is great. Our relationship with our parents might be in dire straits while all our other relationships are blossoming. In short, we can’t expect each cross-section of our lives to be affectively balanced.

However, one thing we can do is to increase the pleasure-to-pain ratio of one cross-section of our lives at the expense of decreasing this ratio in the other cross-sections. In fact, this happens all the time. For example:

We might make part of our lives more relaxing, fun or exciting by going on luxury vacations or thrilling adventures, at the expense of making the remaining parts of our lives feel more stressful, boring or unsatisfying.

We may take recreational drugs to make part of our lives feel better—even euphoric—but this may come at the expense of more anhedonia (loss of pleasure), withdrawal symptoms, and cravings in the remainder of our lives.

We can make some foods taste better by adding flavour enhancers like sodium, sugar, and monosodium glutamate (MSG), at the expense of making other foods taste less appealing.

We might gain some peace and quiet by letting our kids spend more time in front of TVs and computers, at the expense of making our kids irritate us even more when they aren’t glued to a screen.

Let’s say we divide our lives into “work” and “leisure,” where “work” is all of the things we feel obliged to do, and “leisure” is everything else, including play and relaxation. The more pleasant we make our “leisure” time, the less we will enjoy our “work” time, and vice versa. If we strive to make our leisure time as enjoyable as possible, this will predictably cause our work time to feel even more stressful or unpleasant.

We can also split our lives into “being present” and “not being present,” where “being present” means being focused on what is currently happening within us and around us, while “not being present” means thinking of the past, the future, or being lost in our imagination. We can then say that the more joy we get from not being present—from our cherished memories, future plans, or fantasies—then the less pleasant the present moment will feel. Similarly, the less time we spend anticipating good things, the better those things will feel when they actually occur, and vice versa. “The pleasurableness of the anticipated event tends to be attenuated by the anticipation,” confirms psychologist G. Marian Kinget.

KEY POINT #98: Sudists understand the wisdom of living in the now: to increase our appreciation and enjoyment of the present moment, we need to spend less time enjoying things that are not in the present moment—such as relishing the past, anticipating the future, or fantasizing about alternate realities.

KEY POINT #99: Sudism teaches us that no matter how much we pump up the pleasure or deflate the pain in one part of our lives, pleasure will shrink or pain will balloon up in the other parts to compensate, therefore maintaining the balance.

The more often we experience something pleasant or unpleasant, the less intensely we experience it, and vice versa

Sudism teaches us that pleasure and pain always balance out in the long run. This means that if we increase the frequency of a pleasant activity without changing anything else, the pleasant intensity of that activity will typically diminish in proportion to the frequency. But if we decrease the frequency, the pleasantness will generally increase. In Part Three, we saw this happen with delicious food, humour, sex, and recreational drugs. In the same manner, we showed that the frequency of unpleasant things like eating bitter foods, being cold, and doing hard physical work also tended to inversely correlate with their intensity.

We often fall for the illusion that if something feels great the first time, it’ll continue to feel just as great no matter how often we do it. But sudism shows us that pleasant things don’t add up that way! If we love the beach, for example, then the more often we go, the less pleasant it’s likely to feel. In the same manner, if we have a good friend that we only see occasionally but whose company we always enjoy, we shouldn’t be surprised if we move in with them that we begin to experience more painful conflict and arguments. “Unpopular though the fact may be,” wrote G. Marian Kinget, “pleasures must be spaced if they are to maintain their pleasurable quality, just as dots must be spaced lest they lose their identity as dots and turn into lines or globs.”

This is also the reason why painkillers stop working when a patient takes them every day around-the-clock. As we saw in Prescription and non-prescription medications, these patients almost universally experience pain that breaks through the analgesics, which doctors call breakthrough pain.

This frequency-affects-intensity phenomenon, if we can call it that, helps to explain why the flowers we see all the time—perhaps dandelions and clovers—do not usually give us much enjoyment, while rarer flowers like orchids might fascinate and delight us. It also helps explain why those who spend the most time drinking food and wine for its enjoyment—like food critics and wine connoisseurs—develop what people call a “refined palate.” In other words, they become pickier and have a progressively harder time enjoying the things they love the most.

KEY POINT #102: In summary, increasing the frequency of pleasant or painful activities generally causes them to become less pleasant or painful. Decreasing their frequency generally does the opposite.

Sudism also helps explain why intense feelings—such as rage and orgasms—are short-lived, while milder feelings—such as being in a good or bad mood—can last much longer. This is good to keep in mind whenever we find ourselves suffering intensely—the light at the end of the tunnel will not be far off.

If we try to fully and completely immerse ourselves in something we enjoy, not only will our enjoyment gradually fade, but may gradually begin to experience negative side effects to counteract any surviving enjoyment. Many say, for instance, that true, dedicated artists must suffer for their art. What if they suffered simply because, by losing themselves completely in the joy of creating art, they ended up paying the price for all of that joy, through mental illness or other forms of suffering?

We can increase or decrease both our pleasure and pain

Though sudism tells us we can’t increase or decrease the ratio of the overall pleasure and pain we experience, we can increase or decrease both sides together.

By increasing both our pleasure and pain, we reach intense highs and fall to extreme lows. Whoever wants to “jubilate up to the heavens,” wrote philosopher Friedrich Nietzsche in The Gay Science, should also prepare for “depression unto death.” Scientists, he suggested, could even dedicate themselves to becoming a “great dispenser of pain” in order to generate “new galaxies of joy.”

On the other hand, by decreasing both pleasure and pain in our lives, our every high and our every low would shrink. Nietzsche saw this as a way of diminishing our suffering at the expense of “depriving man of his joys and making him colder, more like a statue.” We can take some steps towards a milder life with smaller highs and smaller lows, by giving up many of our induced pleasures and pains. Some might describe this as approaching tranquility or even inner peace. If we can somehow reach absolute zero levels of pain and pleasure, some might call this Nirvana, which Buddhist monk Bhikkhu Bodhi described as “the state of perfect peace that comes when craving is eliminated.” Though Buddhism promises enlightenment, sudism only promises a better understanding of our world.

We will talk more about this later in Should we maximize or minimize our pleasure and pain?

We can better predict upcoming pleasure and pain

There are countless corporations that boldly claim their product or service will solve our problems and make us happy—without negative consequences, of course. When a company tries to sell us something pleasant but unnecessary and tries to pass it off as healthy or harmless, sudism points us to the invisible price tag.

Sometimes, companies try to convince us that something will make us worse off. Their marketing departments will emphasize how miserable we’ll be if we don’t buy their luxury goods, exotic vacations, pills or lotions. While one company tells us we’ll be miserable unless we go on their tropical vacation, another one insists we’ll be miserable on this very same vacation unless we purchase their traveler’s diarrhea vaccine. Corporations deliberately sow fear, uncertainty, and doubt (FUD) in our minds about any alternatives to their products and services. These are sometimes called FUD tactics. Sudism is an antidote to FUD.

Generally speaking, if someone promises us a positive effect with little or no negative effects, be wary. Assume that some effects are either unknown or are deliberately being downplayed. Here are times when millions of us were sold something with positive effects while the negatives were only revealed years or even centuries later:

The salting of foods has been widespread for centuries but only recently has evidence accumulated of its harmfulness.

Alcohol has been consumed for at least 10,000 years, but widespread awareness of its harmful effects only began in the nineteenth century. Even today, we’re still being told that moderate drinking is healthier than abstinence. But recent and powerful evidence to the contrary is building up, as seen earlier in Alcohol.

Tobacco products have been in use for thousands of years, but it took until the 1920s for lung cancer to be medically linked to tobacco. The tobacco industry fought back for decades by denying or minimizing the harmfulness of their products. Nowadays, hundreds of lawsuits against these companies are making their way through the courts, with some seeking billions of dollars in compensation.

In the nineteenth century, cocaine was promoted as a miracle cure for nearly every illness and therefore widely consumed—even allegedly by Queen Victoria and two catholic popes. Since those exuberant early days, cocaine’s addictive nature and its problematic side effects have become much better understood.

Opium has been cultivated and produced since at least 2000 BCE. As recently as the early 1800s in England, it was still being taken for everything from upset stomachs to menstrual pains to treating children’s hiccups, according to Frances Wilson’s award-winning biography Guilty Thing: A Life of Thomas De Quincey.

As we saw in Part Three, heroin, which is derived from opium poppies, was first promoted by Bayer and other companies in the 1890s as a wonder drug for treating many illnesses in both adults and children. It took several decades for its highly addictive nature and many adverse effects to lead it to be banned by many countries.

OxyContin, a strong prescription narcotic that is also derived from opium, was heavily promoted by Purdue Pharmaceuticals as lasting more than twice as long as the competition while posing a much smaller risk of addiction. These claims were later found to have been significantly and deliberately exaggerated in order to gain market share. Purdue and three of its top executives eventually pled guilty in 2007 to fraud and were ordered to pay over $600 million in fines—a small price to pay for over $30 billion worth of sales. “The drug [OxyContin] is widely blamed for setting off the nation’s prescription opioid epidemic,” reported the Los Angeles Times.

Trans fats, which improve the taste and texture of many foods, were introduced and promoted as being healthier than saturated fats, but decades later they’ve become linked to heart disease, diabetes, and depression, and are now “considered by many doctors to be the worst type of fat you can eat,” according to the Mayo Clinic.

How many decades did it take between the introduction of refined sugars and the realization that they significantly increased our chances of getting dental cavities? Then weight gain? Then a variety of other health problems, as we saw earlier in Natural sugars?

The recurring theme is that there’s often a significant delay—sometimes decades or centuries—between the time a new pleasure-enhancing (or pain-relieving) thing is introduced and the time we discover its full range of negative consequences. Why is that? Maybe it’s because the positives are immediate and therefore obvious, while the negatives occur in the longer-term and are therefore harder to link back to that new product or activity. How do we even know that our best and brightest researchers have discovered all of the problems caused by the above products? We don’t! So, do we want to wait years or even decades before discovering the negative consequences of the choices we make every single day? And, probably more often than we think, never fully realize the price we’ve been paying all along for our choices? Or would we rather be able to predict all of the negative fallout ahead of time and avoid it altogether?

KEY POINT #104: Beware of naïve or deceitful promises of anything that provides more pleasure than pain. Sudism helps us to see through these false promises, making it easier for us to say “no thank you.”

Just because we aren’t aware of long-term negative side effects doesn’t mean there aren’t any. Children for instance will, if given the option, eat all kinds of sweet and salty junk food, blissfully unaware of the consequences. I was personally anxious and depressed for years and simply assumed these were normal and unchangeable parts of my personality, until I discovered that they were actually caused by my diet and other lifestyle choices. In the long-term realm of pleasure and pain, sudism teaches us that ignorance is not bliss.

With this perspective in mind, consider the following pleasant things that many of us don’t think have any negative consequences:

The vast majority of people and the currently available scientific literature views music-listening as essentially harmless, except for the potential of hearing loss. To me, this sounds an awful lot like how we used to view sugar as essentially harmless, except for potentially causing cavities. What will the future reveal? In my case, after having consumed way too much music, my mind has developed an unfortunate preference for thinking about music rather than focusing on real-life things, which has hurt my ability to be fully present in this world.

Dr. Stuart Meloy, pain specialist and founder of the Advanced Interventional Pain Management centre, discovered that applying an electrical stimulator at a specific spot at the base of the spine could induce orgasmic sensations—at least in some patients. He’s interested in bringing this so-called orgasmatron to market to treat those suffering from sexual dysfunction. Sounds like fun, but does it truly work without any side effects?

Refined stevia extracts, which are sold as a natural sweetener and marketed as “the sweetener of the future,” are currently considered safe to consume in various countries. What do you think? What about other novel sweeteners like agave nectar and coconut sugar? Would you say that, unlike the refined cane sugar that people love to demonize, these new sweeteners are totally harmless?

If any of the above things seem to provide positive effects “for free,” sudism helps us to see there will be equivalent negative effects at a later time. This key insight enables us to predict future pleasure and pain with a higher degree of accuracy.

Sudist perspectives

Now let’s look at some of the unique life perspectives that sudism has to offer, which may be quite different from how we are used to seeing things.

The glass half-full, half-empty

We often talk about whether the proverbial glass is “half full” or “half empty.” Optimists focus on the positives, pessimists on the negatives, while realists try to consider both. Sudism teaches us that, in a way, everyone’s right: the glass of life is always half full of pleasant things and half full of unpleasant things. The only difference between us is which of the halves we choose to focus on. So the next time you think of the half-full glass, think of sudism.

We will adapt to all life changes

Sudism teaches us that for any positive life change we go through, we’ll eventually adapt to it and return to the same level of happiness as before. In other words, we eventually take these positive things for granted instead of endlessly appreciating them. This also helps explain why we often only appreciate things once they’re gone.

I recently fell madly in love with “the one,” and I know in my heart this feeling will last forever.

It certainly feels that way at the beginning, doesn’t it? But as we saw in Lovers and Newlyweds, psychologists confirm that it unfortunately won’t last.

If I can finally pay all my debts and move into my own house, I will be happy.

For a little while, certainly.

I hate my job—if I land this new position, I’ll never complain again.

Well, you’ll probably find some new things to bother you.

In a symmetrical fashion, sudism teaches us that for any negative life change that happens to us, we eventually adapt to it and return to the same happiness level as before.

No way! What about sleeping on a hard floor every night?

Holocaust survivor Viktor Frankl and his fellow prisoners slept on wooden boards every night, yet even the lightest sleepers eventually learned to sleep soundly in these conditions.

What about eating bugs? Gross!

It may seem repulsive to some of us, but billions of people eat them as part of their diet. They’re high in protein, you know.

What about going blind or becoming paralyzed, there’s no way I could get used to that!

As researchers showed us in Part Three, those who become blind or paralyzed are, after an adjustment period, essentially as happy as everyone else.

What about dying?

Okay, now you’re going just a bit too far. . .

If you find sudism depressing, please don’t worry. These feelings will pass. Like any other life change, sudism teaches us that we eventually adapt to the idea of sudism.

All pleasures and pains are interconnected

One of the basic sudist lessons is that all pleasures and pains are fundamentally interconnected: we simply can’t change the intensity of one without causing an equal and opposite effect on the others. We often fall for the illusion that the headache or irritation over here is unrelated to the meal or drug over there because they are separated by space and time. However, just because there is distance between two things doesn’t mean they aren’t somehow linked together.

Remember how much Sir Isaac Newton agonized over his “absurd” theory of gravity that said that one particle could have an effect on another one millions of miles away—like the way the Sun pulls on the Earth? Sudism may seem absurd in its own way, but it is what it is. The underlying interconnections between pleasant and unpleasant experiences are not visible to the naked eye or even to the most sophisticated measuring devices. Sudism doesn’t explain why these connections are there or exactly how they operate, it merely says: there they are.

Furthermore, keep in mind that a single negative effect—like a heavy workout—may be linked to multiple positive effects—in this case, a boost in your mood, less fatigue in the future, and less aches and pains, among others. Meanwhile, a single positive effect—such as our favourite treat—might cause multiple negative effects such as headaches, irritability, and depression. These effects can vary from one person to another, and from one situation to another. The complex relationships between positive and negative effects can make it hard for us to see how they are linked. Often, the positives and negatives don’t even seem logically related, yet are still profoundly interconnected. Would you have guessed, for instance, that euphoria-inducing opioids often cause intense itching?

Sudism teaches us that physical and emotional sensations are made of the same affective “essence” and are fundamentally interconnected. So what we eat may impact how we feel, and the degree to which we experience heat or cold can impact how angry or lonely we feel.

KEY POINT #107: All the pleasures and pains we will ever feel—no matter how different or how far apart they are from each other—are all fundamentally interconnected. We can’t alter the intensity or duration of one without triggering a counter-reaction in the others.

We’re living someone else’s dream life right now

It’s tempting for us to think that, if only so-and-so thing happens, then we’ll finally be happy. If you still believe in long-term happiness, what would it take for you to finally reach it? More money, a bigger house, or more leisure time? How about an ideal partner, beautiful children, or a better job? Maybe more talent, more beauty, or perfect health? Now, can you imagine there is someone out there that already has most—or even all—of these things that you truly wish for?

Now what if we flip this entire perspective around? Can you instead imagine someone out there who, compared to you, has less money, a smaller house, has less leisure time, is lonelier and perhaps less attractive? Someone who has a worse job, less talent, more illness, and so on? And that this poor soul has at some point thought that if only they had your life that they would finally be happy? If you can imagine someone out there who has all the things you think you need to achieve happiness, then you should be equally able to imagine someone out there wishing for your life, convinced that it would finally make them happy. Yet, have you achieved long-term happiness in your current life? If the answer is “no,” then what does this say about that other person whose life you’re dreaming of?

The truth is that we’re all living someone else’s dream life. No matter how poor, sick, or lonely we are, there’s always something we have that somebody else desperately wants. That something might be any of the things we already mentioned, or they could be very simple things that we might take for granted like a full head of hair, the ability to have kids, or freedom of speech. While we envy others, others envy us. If there is a quadriplegic out there that dreams of the joy of walking around and holding their loved ones, then all of us that are fortunate enough to have four functioning limbs are living their dream, day after day. But do we feel the happiness that they long for?

How much time do we spend agonizing about not having wings and being unable to fly like birds? Should our feathered friends look down on us earth-bound creatures with pity due to our miserable handicap? Similarly, I’m sure many creatures would do anything to be at the very top of the food chain. Yet despite living our entire lives at its very peak, do we wake up every morning roaring with delight, as the lions of our urban jungle: “Ha! I will never be someone else’s snack, for I am the king (or queen) of the food chain!”

KEY POINT #108: Sudism teaches us there is no reason to envy the long-term happiness of others, not even the happiness of our past and future selves. No matter how great another person’s life may seem, it’s no happier than ours in the long run.

Others’ lives are not “happier” than ours

While some of my friends and relatives held loftier jobs than I did, travelled to exotic locations I’ve never been to, and pampered themselves with luxurious things I never had, I sometimes caught myself wondering—was I missing out? Were they happier than me? Can others have more power, wealth, influence, beauty, intelligence, and stuff than we do? Certainly! However, when it comes to long-term happiness—the one thing people most desire—they just don’t have any more of it than we do. No one is happier overall than anyone else. None of us have exclusive access to the “VIP room” of long-term happiness. It was in this spirit that Benjamin Franklin, one of the founding fathers of America, wrote, “The monarch is not more happy than the slave, nor the beggar more miserable than [ancient king] Croesus.”

All of us, at various times in our lives, suffer hardships, losses, sorrows, and disappointments. And since we’re painfully aware of our own suffering, but often don’t see the suffering of others, it can be tempting to think that we have it worse than everybody else. We might resent our fate: “Why me? What did I do to deserve this?” Realizing that suffering is universal helps us to accept it when it inevitably occurs, sometimes swiftly and suddenly. Knowing that others suffer just as much as we do, often in silence, behind their smiles, behind their façades, and behind closed doors, helps us realize we’re not alone in our pain. In that sense, sudism enables us to see through the smiles, through the façades, and through the closed doors of other people’s lives, to better perceive both the joy and suffering they feel. Suffering and joy are universal and endless.

Sometimes we view the past through rosy glasses, believing that either we or our ancestors used to be happier in the so-called golden days. Or we might look to the future, hoping that when conditions are finally right, it’ll be our turn to climb up the heavenly ladder to lasting happiness. But even those who seem the happiest are simply not happier overall. This is a widespread illusion fueled by the many ways we misperceive each other.

KEY POINT #109: Sudists know the secret to long-term happiness—the secret is that it doesn’t exist.

Many say that life isn’t fair. But sudism teaches that, in the realm of pleasure and pain, life actually is fair in the long run. No one has it any better than anyone else. Knowing that everyone suffers and rejoices equally in their own way helps us to feel less envy and more compassion towards others, no matter how rich, beautiful, talented, or successful they are.

Others’ lives are no less “happy” than ours

It’s tempting to believe that those who are poor, sick, disfigured, oppressed, or helpless are living miserable lives. But with our powerful ability to hedonically adapt to difficult situations, a power few realize they possess, these people are actually feeling okay overall, just like you and I. They certainly have had their share of ups and downs, perhaps even majestic highs and traumatic lows. But in the grand scheme of things, sudism teaches that their highs and lows balance each other out, just like yours and mine. We might feel compassion or a desire to help those who seem less fortunate. But it is a mistake to think that we can permanently pull them out of their suffering by lending a helping hand.

Our ability to feel sympathy and compassion towards others is simply part of our human programming—a genetic trait that helps us thrive as a group. Sympathy and compassion motivate us to help others in order to make our own empathic suffering disappear, not necessarily theirs. If we all lacked compassion, what would the human race be like? Would parents bother to feed, clothe, and take care of their own children? In an imaginary world devoid of empathy, the human race would probably have gone extinct a long time ago. Those that have to work hard and seem to struggle more than others may seem to have drawn the short end of the stick. But struggling is the fuel that makes the joys of life burn brighter. Remember, for example, that physical exercise boosts mental and physical well-being and increases our resilience to pain.

KEY POINT #110: Sudists know that a hard life of poverty, struggling, or sickness is not one of endless, sustained misery.

Pain always comes, pain always goes

Sometimes we like to blame our suffering on external factors. We think we suffer because of bad karma from a previous life, bad luck in our current life, or because of bad people around us. But suffering is an inherent component of living, regardless of luck, karma, or other people. The fundamental lesson we must learn is that pain will inevitably come our way, whether we want it or not. No matter how hard we try to run from pain, to avoid or delay it, it will still come to us. It lives inside of us, sometimes dormant, and sometimes active. Pain and pleasure come and go in waves like the tide. As Buddhists say, everything in life is transient. Whatever pain you are feeling, it will eventually end, no matter what you do or don’t do. Continuous pain that never lets up is simply impossible. When we are in the midst of intense misery, we are so focused on the pain that we forget that things will eventually get better. Yet they always do. “Endure and persist,” penned the ancient poet Ovid, “this pain will turn to good by and by.” Making our pain go away prematurely—such as with medication—simply delays the inevitable and may alter the pain’s form instead of actually eliminating it.

KEY POINT #111: All periods of suffering eventually end. We can’t run away from pain because it lives inside us. We can never outrun pain.

Pleasure always comes, pleasure always goes

Though every pleasure must eventually fade, another wave will come in due time. My mother often told me that “Good things come to those who wait.” If we haven’t felt good in a while, waiting is by itself enough to wash away any pain we might be feeling and bring us our next helping of joy. “Happiness is a butterfly,” said a keen observer in an 1848 Missouri newspaper, “which when pursued, seems always just beyond your grasp, but if you sit down quietly may [land] upon you.” Psychologists such as G. Marian Kinget and Archibald Hart note that while many of us spend a lot of effort and money on big-ticket items to try to guarantee pleasure and happiness, few of us realize that we experience just as much, if not more, meaningful pleasures from simple, ordinary things. When we are devoid of pleasure, we might miss it, but there’s no need to force it to come. Sudism teaches us that every occurrence of pleasure is transient and that pleasure will come back naturally on its own time no matter what happens. Trust that it will happen.

When pleasure starts to fade, there is likewise no need to desperately hang onto it. Like Buddhism teaches, it is unnecessary and pointless to cling to pleasure because it will always leave us no matter how tightly we cling to it.

Conclusion of Part Four—Sudism the destroyer, sudism the liberator

For the optimists and hopeless romantics among us, sudism may be a tough pill to swallow. Accepting sudism might mean that our beautiful dreams of long-term happiness are shattered, with every path leading to this utopia left in ruins. We can run ourselves ragged trying to win the proverbial rat race, trying to improve our happiness by amassing wealth, power or status, but it will never work. Some of us try to inch our way closer to happiness with surgery, newer technology, or stronger drugs. It doesn’t matter from which angle we try to destroy pain or magnify pleasure, we simply can’t separate the “su” (pleasure) from the “du” (pain) in suduality.

Yet sudism is symmetrical; for every utopian dream it destroys, it also annihilates a nightmare. Any path we thought might lead to long-term misery is laid to waste. Those who believe that others lead happier lives than their own may find comfort in sudism’s message that others are in fact no happier than we are. Sudists will inevitably conclude that neither paradise nor hell exist, at least not in this universe.

Sudism is liberating but also imprisoning. It liberates us from many things we may have thought we needed to be happy in the long run—perhaps fame, sloth, or material wealth. It also frees us from the belief that some situations can make us endlessly miserable—such as poverty, illness, or loneliness. There is no need to fear that such things will even make the slightest dent in our overall happiness. The master and his slave are equally happy, and equally miserable. However, in exchange for this liberation, sudism imprisons our perceptions in a balance of pleasure and pain from which we can never escape.

In this part, I tried to illustrate the basic quantitative principles of sudism, the things sudism states we can and can’t do with respect to quantities of pleasure and pain. Understanding sudism can help us make better decisions and understand why certain things happened to us in the past, are happening to us now, or will happen to us in the future. Suduality is the great equalizer of pleasure and pain. In this matter, all lives are equal, all decisions are equal, and all paths we could possibly choose are equal. Life is bittersweet.

KEY POINT #113: Every decision and every path in life is a double-edged sword.

If any of this is upsetting, disorienting or confusing, keep in mind that these are temporary feelings caused by a paradigm shift. If you’re anything like me, it’ll take time to fully digest, understand and perhaps believe what has been said here. And so, reading this book may be like planting a small seed in your mind, a seed that was planted in my own mind long ago, and may take years to germinate, grow, and eventually bloom.

Is sudism useless?

When we first pick up sudism and hold it in the palms of our hands, we notice how unusual and curious-looking it is. Much like a kaleidoscope, looking at the world through the lens of sudism for the first time can make everything look strange and different. What do I do with sudism? What is its use? For some, it’s easy to toss it aside and forget about it forever. For others, it will never leave their minds.

In my youth, I believed that if I only worked hard enough and made the right choices that I would finally reach that fairy-tale happiness I dreamed of. A place where I would finally be free from suffering. I saw myself as a “good guy” and thought that if I met the right person and treated them the right way, then we would be forever happy in love, and that nothing could possibly go wrong because we would do everything right. After all, that’s what I had been told, beginning with the many “happily ever after” fairy tales I heard as a child. How naive was I!

When I got a bit older, I stumbled upon the idea of suduality. Slowly but surely, the paradigm shift completely crushed all of my childhood dreams. It was as if I had spent my youth building a magnificent palace made of pastel paper, only to watch in horror as the bulldozer of sudism dispassionately flattened it to the ground. I realized that I could still reach for the same goals as before but never reach fairy-tale happiness. Or I could just give up on my dreams, live a lazy vagabond life, and be just as “happy.” Though sudism completely changed my perspective, it seemed to offer no practical value. It seemed completely useless.

Some might find this utterly demotivating or even depressing. Why should we bother to strive for the perfect job, mate, car, house, family, or even try to achieve our wildest dreams if none of these things will make us truly happier than we already are? But being alive means being in motion. Even if we believe that each decision we make has no purpose, the trillions of atoms in our bodies keep moving. Our hearts keep beating. Our bodies and minds continue to have basic desires and aversions, which push us ever forward, even if we’ve lost hope. Giving up on our dreams is one option. Continuing to chase them is another.

Consequently, I spent several years aimlessly wandering through the dense fog of life, my spirit broken. I was convinced that sudism was ultimately useless and that it had made every single one of my decisions utterly pointless.

It turns out that I was wrong.

KEY POINT #114: Sudism may seem useless and demotivating, but it only appears that way on the surface. We must look deeper into the nature of sudism to truly understand it.

Summary of Part Four

Here is a summary of all key points from Part Four. It can be used as an optional refresher or an executive summary.

#72: A little theory can have a large impact on our world. It can spark new understandings in our minds, which leads us to new behaviours. This in turn leads us to forge a new path in our lives and reach higher goals than we might have otherwise.

#73: We simply can’t separate pleasure from pain, no matter how hard we try.

#74: There is no such thing as free pleasure or free pain relief. They always have an invisible but equivalent cost that is measured in future negative effects.

#75: No matter how much we try to help others, we simply can’t make them happier overall.

#76: No matter how much we take away from others or try to hurt them, we simply can’t make them less happy in the long run.

#77: Though we sometimes like to blame others for our misery, they are powerless to make us more miserable in the long run.

#78: In order to maximize profit, corporations spread the message that long-term happiness can be bought through goods and services. But sudism helps us see through these superficial messages and deeply into the true nature of things—we don’t actually have to buy anything or purchase any experiences in order to be happy.

#79: Many of us fall for the powerful illusion of long-term misery—the belief that giving up cherished pleasures will make us forever miserable. But sudism teaches us that short-term misery never transforms into long-term misery. No sacrifice goes unrewarded.

#80: We tend to fall for the powerful illusion of long-term happiness—that the more we upgrade our stuff, our jobs, or our relationships, the closer we’ll get to a perfectly happy life. Suduality lifts the fog to help us see clearly.

#81: Short-term happiness never transforms into long-term happiness, because long-term happiness is simply impossible. There isn’t a single decision we can make or action we can undertake that will make us happier overall.

#82: The default, average mood in life is neutrality, not happiness.

#83: Pleasure and pain are directions, not destinations. They are motivators, not goals.

#84: We will never solve all of our problems. Even if we solve all of today’s problems, our minds will simply come up with new ones tomorrow to fill the void.

#85: Sudism teaches us to accept many of life’s aches and irritations instead of trying to solve them all, thereby enabling us to shift our focus, time, and energy away from impossible goals and towards achievable ones.

#86: Our solutions often cause our problems. By running away from our problems, we may simply be causing them to reappear later on. The further we run away from a problem, the more we might amplify it. Trying to escape pain by inducing pleasure often causes the pain we run from to come back in the future, thereby creating an endless cycle of excessive pleasure and excessive pain.

#87: Lightening our workload and replacing it with relaxation and leisure will not make us happier in the long term.

#88: Trying to use drugs or other medical interventions to eliminate pain or boost pleasure—without any counterbalancing effect—will always fail.

#89: Technology may allow us to do more, have more, and live longer, but it just can’t make us any happier. The more technology changes, the more happiness stays the same.

#90: Sudism does not promise us any easy shortcuts to reach a fairy-tale ending. It only helps us see the balance between suffering and joy that’s already there in each and every one of us.

#91: In terms of the balance between joy and suffering, every option we might choose in life is the same—in the long run, there is no “better” or “worse.”

#92: Even if we reach all of our goals and achieve our wildest dreams, we will never achieve fairy-tale happiness. There’s no need to wait for the perfect person, place, or thing in order to experience our share of happiness.

#93: When we choose an action that we know will create a positive or negative effect in our lives, we say we induced these effects. But when positive or negative effects happen to us outside of our control, we say they’re non-induced.

#94: We have some degree of control over all pleasures and pains we experience in our lives, including those we think we have absolutely no control over.

#95: When we induce pleasure or pain relief, we always cause future negative effects. These negative effects may vary in intensity and length but are always in the same amount as the original pleasure or pain relief.

#96: The harder we make our lives—through work, struggling, and other means—the easier the rest of our lives become.

#97: Sudism teaches us that less is more: the less we take pleasure from life, the more we receive pleasure from life. The less we take pain from life, the more we receive pain from life.

#98: Sudists understand the wisdom of living in the now: to increase our appreciation and enjoyment of the present moment, we need to spend less time enjoying things that are not in the present moment—such as relishing the past, anticipating the future, or fantasizing about alternate realities.

#99: Sudism teaches us that no matter how much we pump up the pleasure or deflate the pain in one part of our lives, pleasure will shrink or pain will balloon up in the other parts to compensate, therefore maintaining the balance.

#100: We fall for the illusion that if something is pleasant once, it will be equally pleasant every single time. But sudism teaches us that the more often we partake in it, the less pleasant it will probably feel—in other words, we will develop a tolerance to it. At the extreme, if we completely immerse ourselves for weeks on end in an activity or situation that used to always feel good, it will cease to always feel good.

#101: We often fall for the illusion that if something is very painful once, it’ll be equally painful every time. But sudism teaches us that the more often we partake in it, the less painful it will likely feel—we will develop a tolerance to it. At the extreme, if we completely immerse ourselves for weeks on end in an activity or situation that previously pained us, it will cease to be consistently painful. There will still be good days and bad days, but that activity or situation will no longer, on average, increase our suffering overall.

#102: In summary, increasing the frequency of pleasant or painful activities generally causes them to become less pleasant or painful. Decreasing their frequency generally does the opposite.

#103: We can amplify both positive and negative feelings in our lives, or diminish them both, if we so choose.

#104: Beware of naïve or deceitful promises of anything that provides more pleasure than pain. Sudism helps us to see through these false promises, making it easier for us to say “no thank you.”

#105: Life is like the proverbial half-full glass: it is half full of pleasant things and half full of unpleasant things.

#106: Sudism teaches that, in terms of happiness, we eventually adapt to all life changes, whether they seem positive or negative. Except perhaps death.

#107: All the pleasures and pains we will ever feel—no matter how different or how far apart they are from each other—are all fundamentally interconnected. We can’t alter the intensity or duration of one without triggering a counter-reaction in the others.

#108: Sudism teaches us there is no reason to envy the long-term happiness of others, not even the happiness of our past and future selves. No matter how great another person’s life may seem, it’s no happier than ours in the long run.

#109: Sudists know the secret to long-term happiness—the secret is that it doesn’t exist.

#110: Sudists know that a hard life of poverty, struggling, or sickness is not one of endless, sustained misery.

#111: All periods of suffering eventually end. We can’t run away from pain because it lives inside us. We can never outrun pain.

#112: All periods of joy eventually cease, no matter how tightly we cling to them.

#113: Every decision and every path in life is a double-edged sword.

#114: Sudism may seem useless and demotivating, but it only appears that way on the surface. We must look deeper into the nature of sudism to truly understand it.

PART FIVE: RETHINKING PLEASURE AND PAIN

Introduction—Quality, not quantity

Pain is (usually) good for us

Re-thinking the meaning and purpose of pleasure and pain

What is health?

The gap between affect and health

What are healthy and unhealthy pleasures?

What are healthy and unhealthy pains?

What are indulgences?

We are programmable, like computers

IN-DEPTH: If indulging isn’t healthy, why do we do it?

Conclusion of Part Five

Summary of Part Five

Introduction—Quality, not quantity

In Part Four, we explored the quantitative realm of pleasure and pain. In other words, their quantities and how they relate to each other. Sudism taught us a profound lesson: we can neither improve nor worsen the overall sum of pleasant and unpleasant feelings across our lives. Nor can we improve or worsen anyone else’s, for that matter. Yet life goes on. We continue to be faced with hundreds of decisions, from the mundane (should I wear my purple or green socks today?) to the life-changing (what should I do with my life? Be an emcee, earn an M.D., or win an Emmy?). Has anything really changed?

To those of us who continue to hope for lasting happiness, that sudism tells us we’ll never reach it may seem utterly demotivating. If that was the case, one would think that someone like me—a die-hard sudist for over twenty years—should feel thoroughly depressed by now. But the truth is exactly the opposite: I used to be depressed but, after learning how to properly use sudism, I no longer was. Why is that? In the remaining parts, I will try to show you how you can achieve the same kind of transformation—not just for depression but for every kind of unnecessary ache and meaningless suffering you might ever experience.

If we used to base our decisions on maximizing happiness—that is, maximizing pleasure while minimizing pain—but we now know that this can’t be achieved, then what should we base our decisions on? If we can’t manipulate the quantity of pleasure relative to pain, what can we do? The answer lies in the age-old saying: quality, not quantity. Part Four focused on the quantities of our positive and negative affects, but now we’re going to have a much closer look at their qualities. As we’ll soon see, this is absolutely critical.

KEY POINT #115: Sudism encourages us to look beyond the quantities of pleasure and pain, and instead focus on their qualities.

Pain is (usually) good for us

It doesn’t take much rubber-arm-twisting to convince most people that pleasure is a good thing. At the same time, most of us would say that pain is a bad thing, something we’d rather not have. I would like to propose a different perspective that may or may not surprise you: pain is usually a good thing!

Huh?!

The best way to illustrate the usefulness of pain is to look at what life would be like without it. But how? As it turns out, there is a tiny handful of folks out there—about one in 125 million newborns—who have a rare genetic disorder called congenital insensitivity to pain with anhidrosis (CIPA). These children simply cannot feel any physical pain whatsoever—though they can still feel emotional pain. At first, affected babies may seem like a blessing to their parents since they rarely cry. However, lacking the ability to feel physical pain means they have no built-in motivation to avoid things that physically hurt. This causes a surprising number of problems:

Small children with CIPA practically chew their own tongues and fingers off; not only does this not bother them, they actually enjoy the chewing process. Often, these children need to have all of their teeth removed to prevent further self-injury.

Children with CIPA often injure their own eyes unwittingly, whether from rubbing or scratching them excessively or by nonchalantly letting objects pierce them. Some injure their eyes so badly that they must be surgically removed. To prevent this, parents must make them wear protective goggles around the clock.

Wow, pretty gruesome, right? Wait, it only gets worse. . .

Children with CIPA often don’t feel hunger pains, so they’re not motivated to eat. Some infants with CIPA refuse to eat at all and have to be fed through surgically inserted tubes.

Children with CIPA have difficulty feeling the painful pressure in their bladder or rectum that reminds them that they should urinate or defecate, which makes it very hard to toilet train them.

As we can imagine, children with CIPA can seriously injure themselves without realizing it. In one horrifying example related by researcher Dr. Geoffrey Woods, who discovered the genetic mutation responsible for this disease, a Pakistani boy with CIPA wanted to impress his friends on his birthday so he jumped off the roof of his house. After all, there was no pain—not even the fear of pain—to discourage him from doing so. He dusted himself off, got back up and announced that he was fine. The next day, he died from internal haemorrhaging. “The life span of people with CIP is quite limited due to the number of injuries that can go unattended,” according to therapist Douglas Nelson. “Many die before the age of three; seldom do any of these people live beyond their early twenties.”

Children with CIPA also tend to overwork their joints. Normal folks like you and I, whether we’re awake or asleep, will reduce our activity or adjust our position if some of our joints feel uncomfortable. But a person with CIPA doesn’t since they simply can’t feel that precious discomfort. So they wear down their joints at an accelerated rate. By their twenties (if they survive that long) their joints may be so deteriorated that they need a wheelchair to get around.

And if the above wasn’t enough, the frequency and severity of injuries sustained by these children often lead outsiders to believe they are victims of abuse and to contact child protection agencies to remove these children from what are usually very loving homes.

Nietzsche may have never heard of CIPA, but he was keen enough to realize the profound value of suffering. “There is as much wisdom in pain as there is in pleasure,” wrote the German philosopher, “both belong among the factors that contribute the most to the preservation of the species. If pain did not, it would have perished long ago.” Those who have directly experienced the hardships of CIPA have gained this insight the hard way: “People always think of pain, pain, pain, oh if I could get rid of the pain,” said the mother of an affected child, “I’m thinking ‘you do not even know how lucky you are that you can feel it.’ ”

Those born with CIPA aren’t the only ones who have experienced life without pain. If we look at leprosy, another devastating condition, many of us still believe that this disease directly damages fingers and toes, causing them to eventually fall off. However, pioneering physician Paul Brand discovered the true cause of these mutilations: leprosy damaged the nerves of the extremities, which destroyed the ability to feel pain. Without the protective pain, affected individuals repeatedly injured themselves without realizing it, leading to extensive hand and foot damage. After decades of working with these patients, Dr. Brand came to realize that “pain stands out as an extraordinary feat of engineering valuable beyond measure,” as he wrote in his insightful book, The Gift of Pain.

Pain is usually a good thing, since it helps protect us from many kinds of injury. But there is an important reason why I say pain is usually a good thing, as opposed to always a good thing. As many of us already know, some pains are no good at all.

Re-thinking the meaning and purpose of pleasure and pain

So what is the true purpose of pleasure and pain? Is pleasure there just for our simple amusement? Is pain really here just to torture us arbitrarily? The previous section shed some insight as to the value of pain, but let’s dive even deeper.

Let me ask you this: would you cut off your own hand? Dumb question, right? Well, why wouldn’t you? The immediate gut answer is that it would be so unimaginably painful that we just couldn’t fathom doing it. If we could look beyond the physical agony, we might also realize that we’d mourn the loss of our hand and all of the wonderful things we used to be able to do with it. With only one hand, simple tasks like tying our shoes and buttoning our shirts would suddenly become, shall we say, quite a handful. So there are at least two kinds of pain preventing us from chopping off our own cherished hand: the short-term physical suffering and the longer-term fear of loss. As we’ve illustrated in the previous section, these pains are essentially protecting our hands. Without pain, we wouldn’t be so careful with our bodies and they would quickly get banged up and unusable. This is what happens to those who have leprosy or CIPA. So, it’s tempting to think of pain as simply “a sensation we should avoid.” However. . . there are times when chopping off our own hand is actually the most sensible thing to do.

What?!

Think of an animal whose paw becomes caught in a hunter’s trap in the middle of a forest, and struggles in vain to free itself. As the hours and the days pass, it faces the increasing possibility of either starving to death or of being attacked by a larger predator—including the hunter. What do many trapped animals end up doing in this scenario? By many accounts, such animals often chew off their own paws in order to escape. And if you think that only wild animals would make this kind of gruesome life-or-death decision, think again. In similar circumstances, humans will do exactly the same thing. Take the story of Aron Ralston, the American mountaineer who in 2003 became trapped when a heavy boulder fell and pinned his arm against a canyon wall. He struggled for over five days to free himself while fighting off dehydration and hypothermia. Unable to move the boulder or chip it away with his pocket knife, it eventually dawned on him that the only way to escape would be to amputate his own right forearm. And though this may be unthinkable to most of us, in that extreme situation it is exactly what he chose to do. “The pain was irrelevant,” said Aron, “I was smiling as I was amputating my arm . . . I wanted to be free. I wanted to be with my family.” (emphasis added) When he finally succeeded in detaching himself from his trapped forearm, and he had a second chance at living, he described it as the happiest moment of his life. In other words, he determined that the pain and loss of severing his own limb was far less than the pain of losing the rest of his life. So Aron chose life.

If in the right circumstances we are entirely willing to take on certain pains, even excruciating ones, then pain can’t simply be a “sensation we should always avoid.” What is pain then? The most sensible answer I have is that pain is a measure of perceived cost—the estimated cost to our health and well-being. But what determines the cost of each given action or event? The mind! Well, not the conscious mind, because that would imply we could consciously control every pain we feel, so we’ll have to settle on saying our subconscious minds calculate these costs. Our subconscious then inflicts the calculated dose of pain on our conscious selves. The more intense or prolonged a pain is, the higher the perceived cost of the action or event that caused it. If pain is a measure of cost, then that would make pleasure—you guessed it—a measure of benefit.

KEY POINT #117: Our subconscious minds dangle carrots (pleasure) in front of us, and whacks us in the rear with sticks (pain), in order to make us move in the direction it wants us to move, much like an owner sitting on a donkey might do.

Remember the earlier question about why can’t orgasms last longer or be more intense? Generally speaking, why do our minds assign specific intensities and durations of pleasure (or pain) to each activity or event we experience? The answer, I believe, is deceptively simple: so our minds can do intelligent cost/benefit analysis. You see, every day, our minds have to make hundreds of decisions, and for each of them there are many potential courses of action—What should I eat? Should I do my chores or just watch television? Should I say the ugly truth or a beautiful lie? With so many options available, how can the mind, well, make up its mind on which course of action to take?

To be able to compare a wide variety of potential events and actions, the mind needs to be able to somehow objectively score each course of action using a universal scoring system—that’s where pleasure and pain come into play. For each potential course of action, the mind tries to predict the likely outcome and the associated pleasures or pains incurred along the way, and tallies a final “score” for that option. Then, the mind can compare all possible courses of action, see which of them has the highest “score” and then go with that one. It’s like playing chess: we look at each move we can make, then anticipate how our opponent will respond, and so on, then score each such path. Then we compare all possible moves, and pick the one with the best apparent outcome. Of course, our minds are limited in how far and how accurately into the future they can see. And though some of this cost/benefit analysis happens consciously, much of it likely happens in our subconscious.

What would happen if we could artificially alter the dose of pleasure or pain for a certain activity? If we doubled the intensity of sexual pleasure in every human being, it would lead us to spend more time chasing sex and less time foraging for food or doing other important activities, which might cause us to become somewhat malnourished or less healthy in other ways. If, on the other hand, the intensity of sexual pleasure was cut in half for everyone, we’d probably spend less time procreating and the human race might not reproduce enough to survive in the long run. Here’s another example that might hit closer to home: if food was artificially made twice as tasty, we’d eat more and spend less time and energy pursuing other activities, which would lead to worldwide obesity. We could argue that this is actually happening around the world today.

The point is that the intensities and durations of each pleasant and painful activity or event have to be properly calibrated relative to each other in order for the mind to perform the most effective cost-benefit analysis and therefore maximize our overall long-term health and well-being. This crucial idea, combined with sudism, helps explain why orgasms end, why we don’t laugh forever at a joke, and why long-term happiness and long-term misery don’t exist. These things would make it harder, if not impossible, for our minds to figure out what is the best course of action. And we’d end up making a lot of terrible choices.

If the overall costs-versus-benefits outcome of one option looks more favourable than all the other options, we’re probably willing to pay whatever costs may be involved—even if it means cutting off a part of ourselves. We may choose to endure various aches in the pursuit of a higher goal such as avoiding an even larger pain, or obtaining future pleasures that we believe will outweigh the pain. This is why we might skip our favourite TV show in order to finish an important school or work assignment because it would feel worse to fail our course or lose our job than to miss our show. This is also why athletes subject themselves to countless hours of gruelling training in exchange for a shot at the glory of winning a gold medal—even just imagining winning might be rewarding enough! It is also why a parent might run through a burning house in order to rescue their child—since many parents would find the loss of a child more painful than any number of physical burns. In the extreme, it helps explain why some Tibetan Buddhists set themselves on fire to help liberate their country, and why some terrorists blow themselves and nearby “infidels” up in anticipation of a glorious reward in the after-life.

All in all, pleasure and pain are motivational forces designed with only one purpose: to maximize the long-term health and survival of the species. They act much in the same way that parents raise their children: parents reward their children’s “good” behaviour (such as cleaning up after themselves), and punish “bad” behaviour (like throwing rocks at windows), in order to shape their behaviour. Our own pleasures and pains are like teachers, like parents—it is our very own subconscious steering us in what it thinks is the right direction.

This means that pleasure is not designed for our on-demand amusement. It is designed to steer us towards optimal health by shaping our behaviour. Pleasure is merely a messenger, not an end-goal. Don’t seek the messenger, seek the message. Similarly, pain is not designed to needlessly torment us. Like pleasure, its purpose is simply to steer us towards optimal health. Pain is merely a messenger, not something to mindlessly avoid. Don’t shoot the messenger, listen to its message!

What is health?

By “health,” do you mean what doctors and nutritionists are always nagging us about—eating right, sleeping enough, exercising, and not smoking?

Those are all fundamentally important aspects of health, but they are only part of a bigger picture. Here, I would like to stretch the definition of “health” to be even wider.

Sudism implicitly teaches us that instead of trying to focus on unachievable goals such as getting rid of all of our pain or reaching a utopian state of fairy-tale happiness, we should be focusing instead on goals that are actually achievable. In other words, we should be looking beyond the quantitative realm of pleasure and pain. If we can’t maximize our happiness in the long run, is there anything we can maximize? There’s something that most of us already realize: if we listen carefully to each pain and each pleasure we feel, many of them—hopefully most—carry an underlying message. Being hungry hurts and food generally tastes good: the message is that we should eat. But why should we eat? To continue to live, for Pete’s sake! Being lonely hurts too while being around others often feels good: the message there is that we should spend time with other people. Why? Because we are social creatures that thrive the most when we live and work together.

Pain and pleasure may seem to be opposites but, in fact, they both point in the same direction with the same overarching purpose: to encourage our species to survive and thrive—in other words, to maximize our health. As clinical psychologist Nancy Etcoff neatly summarized, “We didn’t evolve for happiness, we evolved for survival and reproduction.”

If we trust that pain and pleasure—our lifelong guides—are doing their very best to steer us towards optimal health, then what are they telling us is “health?” If we refer to the chart of all pleasures and pains at the end of the book, we can roughly sketch the full scope of health:

Based on feelings such as hunger, thirst, and our urges to expel waste, we should strive to maintain a healthy flow of nutrients through the body.

Based on feelings such as physical restlessness, fatigue, and exertion, we should strive for a healthy balance of physical activity and rest.

Based on our inborn fears (of heights, darkness, and so on), our ability to sense hot and cold, and our various other tissue pains, we should strive to protect our bodies from physical and thermal injury.

Based on our desire to care for and support others as well as our desire to be cared for and supported, we should spend time socially bonding with friends, family, and others, as well as live and work together.

Based on our desire for romantic and sexual relations, we should strive to intimately bond with others—and possibly reproduce, so that our species lives on even after we die.

By way of our feelings of love and empathy, we should help others survive and thrive, such as our children, family members and friends.

Based on our feelings of anger and the satisfaction of appropriate retaliation, we should defend ourselves, the ones we love, and the things we feel are rightfully ours from attack.

Based on our ability to feel bored, curious, and to enjoy being mentally stimulated, we should strive to intellectually explore, discover and interact with the world.

So, health is not only carefully choosing what foods we consume with our mouths, but also carefully choosing what stimulation we consume with our eyes and ears—stimulation that should ultimately serve a useful purpose. Health is not just taking care of ourselves, but also our species by helping loved ones and protecting children. Of course, these also imply we should take care of our natural environment since it provides us with the clean air, water, food, and sunshine we all need to survive. According to our pleasures and pains, all of the above things are part of the larger definition of health.

If we trust our affective system, the gold standard for determining whether any action in life is worth pursuing is whether or not this action ultimately supports health or goes against it.

When we try to maximize pleasure and minimize pain, we fall for the illusion that we can optimize our happiness, but we overlook the simple truth: we are really trying to optimize our health.

The gap between affect and health

The DNA in each of our cells comes from a long lineage that has survived for millions of years. That feisty little scrap of genetic material has had to evolve and adapt time and time again in order to survive countless famines, droughts, wars, ice ages, and other pretty tough living conditions. We could say that our DNA has been rigorously field-tested and packs a mighty amount of wisdom in a tiny package. Alas, this wisdom just isn’t perfect.

Some have calculated that our DNA contains the equivalent of just under one gigabyte of data—which is far smaller than any of the popular computer operating systems in use today, including Linux, Windows and Android. Despite its relatively small size, our DNA “program”—if we think of it as computer software—must be smart enough to know how to grow our bodies and its multiple interconnected systems of organs and tissues starting from a measly little sperm and egg. Somewhere in that program are instructions to lay out thousands of kilometers of nerve fibers, including the human brain in all of its magnificent complexity. And embedded deep within this jumble of wires, there exists a subsystem that generates and modulates every single pleasant and unpleasant sensation we’ll ever feel in our lifetime. It is indeed an “extraordinary feat of engineering,” as physician Paul Brand had marveled.

However, this subsystem is flawed. Should we be surprised when we consider that our DNA “program” is smaller than today’s popular operating systems, yet responsible for so much more? I’ve argued that pleasure should correspond to health benefits—with longer or more intense pleasures representing larger benefits—while pain should correspond to health costs. And they usually line up in this way, but there are also times when they simply don’t. For instance, the reason our tongue can taste bitterness is to help us identify toxic compounds and discourage us from eating them. What many of us don’t realize is that we don’t have one gene to detect a single bitter substance. Over the course of our evolutionary history, we’ve actually accumulated many “bitterness” genes that work together to detect many potentially toxic compounds. At this particular moment in the timeline of evolution, dogs have accumulated sixteen of them so far, humans have gained twenty-five, while lowly rats have outperformed us all with a whopping thirty-seven such genes. I hope this shows that although our DNA is continually evolving to better align affect and health, this alignment was never perfect and probably never will be. Some of the most poisonous mushrooms out there—like the lethal death cap—reportedly taste quite good, while some superfoods like kale taste bitter to us. Oops, a bit of a mix-up there! In other words, there is sometimes a gap, a mismatch between what is bad for us versus what feels bad to us. Similarly, modern-day confections such as ice cream and chocolate bars taste irresistible to many of us but have a largely negative impact on our health. This illustrates that there is sometimes a gap between what is good and what feels good. It looks like this:

If the affective outcomes (i.e. the degree of pleasure or pain) of a thing or activity is roughly proportional to its health outcomes (i.e. health costs or benefits), then we’ll say that thing or activity is aligned. Otherwise, we’ll say it’s misaligned or out of alignment. We’ll look at some examples shortly.

If pleasure always lined up perfectly with health benefits and pain always lined up with health costs, the world wouldn’t have so many health and affect problems. As psychologist Paul Bloom wrote in How Pleasure Works, “Our minds are not modern, and many of our woes have to do with this mismatch between our Stone Age psychologies and the world in which we now live.” It’s crucially important to be aware of this mismatch. As the British love to say, mind the gap! Instead of mindlessly chasing pleasure and dodging pain, we should be focusing on health, especially when health goes out of alignment with affect.

Any gap between health and affect will cause us problems. But one could argue that humankind has tried to exploit that gap by deliberately driving a giant wedge into it and prying it open as wide as possible. Once we discovered how to extract sugar from various plants, we gleefully began adding it to more and more foods—increasing their pleasure yield without increasing their healthiness. My, how clever we are to have found what seems to be a pleasure loophole! But sudism teaches us to think twice, because any attempt to bypass suduality always comes back to bite us in the backside.

Many of us believe that the more pleasure we can get out of each activity, the better. Being a little too clever for our own good, we keep finding more ways of squeezing more pleasure out of activities than we’re supposed to get. This is a critical mistake. We think that pleasure is an end goal in and of itself. But pleasure was never meant to be an end, it was meant to be a means to an end. In other words, each instance of pleasure should serve a useful purpose, and should not be amplified unnecessarily!

Similarly, many of us have come to believe that we should always minimize or avoid pain, and we keep finding more ways to do just that. Again, this is a costly mistake. Pain was never meant to be completely avoided, it was meant to be a means to an end. In other words, each instance of pain should serve a useful purpose, and useful pains should never be arbitrarily reduced! These pains need to happen so that they can serve their purpose.

What are healthy and unhealthy pleasures?

As we’ve just seen, not every “unit” of pleasure or pain actually promotes health. Therefore, we can divide all of these units into two kinds: those that are “healthy” and those that are “unhealthy.”

Healthy pleasures are units of pleasure that correspond to units of actual or potential health benefits. If an event or activity produces pleasure roughly in proportion to its corresponding health benefits, then we say that pleasure is healthy. In other words, the pleasure and health benefits are aligned. Healthy pleasures are meaningful, they encourage specific healthy behaviours like eating and lovemaking. Healthy pleasures are proportional, they are naturally calibrated to a certain intensity and duration that serves its purpose and is sensibly proportioned compared to all the other kinds of pleasure and pain. In short, healthy pleasures are not end goals in and of themselves, they are means to an end.

Unhealthy pleasures, on the other hand, are units of pleasure that don’t correspond to any actual or potential health benefits. Some activities, such as smoking or doing recreational drugs, might give us much pleasure but no health benefits (or worse, damage our health)—therefore, all of the pleasure they provide is unhealthy. In those cases, the pleasure is the end goal instead of being a means to an end. These kinds of unhealthy pleasures lack meaning in the same way that empty calories in junk food lack nutrients. Other activities blend healthy and unhealthy pleasure together, such as the way carrot cake combines carrots, sugar, and other ingredients. In those cases, the overall pleasure of the cake exceeds its health benefits. Since these things feel just as good as—and often better than—healthier alternatives, they can be hard to resist.

What are healthy and unhealthy pains?

Let’s define healthy pains as units of pain that correspond to units of actual or potential health costs. If the amount of pain caused by an event or activity roughly matches the amount of health costs it incurs, then all of that pain is healthy pain. On the other hand, if we feel pain but there is no associated health cost whatsoever, then this pain is entirely unhealthy. To illustrate the difference, if your head hurts because you were distracted and walked right into a steel post, that’s healthy pain. But when you have a pounding migraine despite nothing being wrong with your head, that’s unhealthy pain.

Healthy pain is meaningful—it tells us that certain activities or events incur a health cost. Furthermore, each healthy pain is proportional—it’s sensibly calibrated to an intensity and duration that’s proportional to all other types of pleasure and pain. Healthy pains give us an indication of what we can do to end or minimize the pain, should we wish to, and how to possibly avoid it in the future. Feeling tired after a long work day is healthy because that fatigue encourages us to rest, for instance. And that healthy fatigue should disappear after we’ve rested enough.

Pure unhealthy pain, on the other hand, doesn’t directly tell us what caused this pain to happen or how to end it, thus providing no insight on how to avoid it in the future. Many who suffer from chronic depression or migraines, as well as the doctors that treat them, simply don’t know what’s causing these aches. We can call these pains without purpose since they don’t serve a useful purpose. In other words, they are meaningless pains and they don’t help us thrive and survive.

To determine if a pain is healthy versus unhealthy, we should ask ourselves: what is this pain telling us? What is its purpose? Does it help us thrive either as individuals or as a community? If the answer is no, then it is probably an unhealthy pain. Even if the answer is yes, if the pain seems excessive then it may be partly unhealthy. This can certainly be a subjective exercise, but it’s one worth doing.

In the Appendix, we show that virtually every type of pain can manifest itself in both healthy and unhealthy ways. For instance, a reasonable amount of lower back pain may occur when that area is truly injured or over-worked, thus qualifying it as healthy pain. But it may also occur in the absence of any real injury or overexertion, making it unhealthy pain. Likewise, feeling sad or depressed for a while because of a job loss or a relationship breakdown is quite normal and healthy, but becoming depressed for no reason at all would be considered unhealthy. Finally, feeling panicked because you are running late and might miss an important meeting or flight would probably be healthy, but feeling panic attacks at random times when there is no stressful event would certainly be considered unhealthy.

KEY POINT #133: Virtually all kinds of pain—such as aching joints, sadness, and fear—can manifest in either a meaningful healthy way or a meaningless unhealthy way. All pain is equally real, but not all pain is equally useful.

Unhealthy pains may be either acute, meaning they occur infrequently, or chronic, meaning that they occur regularly. The majority of people consider the term “chronic pain” to mean only chronic physical pain. But sudism has a wider perspective: chronic pain includes both physical aches—such as back pain, itching, and headaches—as well as emotional aches—such as anxiety, anger, and depression.

So, we’ve just defined what healthy and unhealthy pleasure and pain are. Earlier we had also defined anhedonia, which is a lack of pleasure relative to the health benefit of an activity. Finally, analgesia is feeling too little pain relative to the health cost of something. The following chart neatly summarizes how these six concepts are related:

Amount of pleasure or pain

Actions and events that provide health benefits

Actions and events that cause health costs

Too low

Anhedonia

Analgesia

Ideal range

Healthy pleasure

Healthy pain

Too high

Unhealthy pleasure

Unhealthy pain

What are indulgences?

Due to our built-in desire to seek pleasure and avoid pain, some of us look for ways to increase the former and decrease the latter without considering the impact on our health. Let’s define indulgences as any activity that either (A) increases pleasure without increasing health benefits, or (B) reduces pain without reducing health costs. Indulgences are our way of tampering with pleasure and pain in ways that nature never intended. Indulgences widen the gap between affect and health, further separating pleasure from health benefits and pain from health costs. To partake in an indulgence is to indulge, whether or not we’re aware of it. As we’ll soon see, I’ve had more than my share, often without realizing it.

In order for an activity to qualify as an indulgence, it must be a fairly reliable source of positive effects; in other words, it usually provides short-term pleasure or pain relief. On top of that, one of the following two criteria must be true:

The activity does not contribute to health. In other words, if this activity was completely removed from your life, would you survive and thrive—in the long term—at least as well as before? Cigarettes or recreational drugs, for instance, may provide short-term pleasure (or pain relief) but the general medical consensus is that they harm your health.

The activity does contribute to health, but there is another natural activity that is noticeably less pleasurable (or more painful) that provides at least the same contribution to health. For example, salted nuts may contribute to survival by providing necessary nutrients, but there are less pleasurable unblended alternatives available—such as unsalted nuts—that are even healthier.

In other words: an indulgence is any activity that provides more pleasure than required for optimal health, or reduces pain below the amount we need for optimal health. The more unnecessary pleasure (or pain relief) the activity provides, the more indulgent it is. Indulgences are essentially shortcuts that accelerate pleasure or bypass pain.

Here are other useful ways to spot indulgences:

We do the indulgent activity to avoid or relieve anger, loneliness, anxiety, or other painful feelings, without addressing the root cause of these emotions. We might also do it purely to relax or de-stress, without any other underlying health benefit. Generally speaking, we use one kind of pleasure to ease a completely unrelated kind of pain, like eating to soothe loneliness, listening to music to calm our anger, or taking recreational drugs to ease boredom. These could be called crossover pleasures (or crossover pain-relief) since they unnaturally cross over from one category of pleasure to soothe a completely unrelated category of pain.

The activity requires little effort but consistently generates lots of pleasure (or pain relief) in return—think fast food, recreational drugs, and pain medications. In this case, we could call them push-button pleasures—or push-button pain-relievers—because the soothing feeling is nearly as easy to obtain as pushing a button.

Attempting to stop doing that activity is difficult and causes cravings or withdrawal symptoms.

Keep in mind that there is no clear dividing line between healthy and unhealthy activities. As a wise mentor once told me: life is not black and white, it’s a million shades of grey. Does adding a tiny sprinkle of salt to a piece of celery suddenly make it terribly indulgent? What about when manufacturers add a sprinkle of fiber to their boxes of Choco-Flavoured Sugar Bombs cereal? Healthy and unhealthy are simply two ends of a wide spectrum, and everything falls somewhere in between. It can certainly be tricky sometimes to tell where something fits within this range.

What is entertainment?

Whether we want to experience something new and exciting or we want to forget our worries, many of us in the modern world regularly seek out entertainment. But have you ever tried to define what “entertainment” really is? In its purest form, entertainment could be defined as any prepackaged, stimulating, and ultimately unessential activity. This includes movies, music, shows, novels, and even amusement parks. Though the producers of entertainment work hard to create it, consumers generally make little effort to consume it. Entertainment can combine many different pleasures—movies might mix laughs, sex appeal, and thrills, while video games might dazzle us with visual effects while boosting our ego by letting us beat countless enemies and find innumerable treasures.

Entertainment that is purely designed to make us feel better—while providing little or no inspiration, teachings, or other benefits we can take back to the real world—should be considered as indulgent. The more pleasure and the less health benefits provided, the more indulgent it will be. For me personally, this led to the difficult realization that listening to music—one of my lifelong passions—might be very enjoyable but didn’t provide any real benefits. “We have no idea what the adaptive value of listening to music is,” noted American psychologist and music researcher Paul Rozin. Cognitive scientist Steven Pinker simply calls it “auditory cheesecake.” Music is, quite simply, ear candy.

Some would argue that entertainment is valuable since it can help us bond together socially. There is certainly value in bonding with others. But there are many other non-indulgent ways to bond—by simply talking, playing, living, relaxing, and working together. Others say that entertainment helps them unwind and relax, but there are healthier ways to do that too—meditating, going for walks, being playful together, or having a good old-fashioned bitching session.

Beyond this, there are many forms of entertainment that blend together both healthy and unhealthy pleasures. “Edutainment” usually mixes educational lessons with mindless entertainment. Some modern video games, like Pokémon Go or Just Dance, blend the fun of gaming with a healthy dose of physical activity. While packaged entertainment sometimes teaches us about the world and inspires us to do great things, we must be aware that much of what’s out there is pure indulgence that’s primarily designed to excite or delight us.

We are programmable, like computers

Did you shower or take a bath today? The goal of these is simply to wash ourselves, isn’t it? Yet if we take showers in cozy, warm water, it’s easy to shower more frequently and to linger in there longer. In fact, my kids practically need to be dragged out of their toasty showers. We might think to ourselves, “Even though I feel quite clean today, I might as well take a shower just in case I’m a little dirty.” However, if we switch to cold showers, the frequency and length of our showers will almost certainly decrease—simply because we enjoy them less. I should know because I made the switch to cold showers a few years ago. Our attitude might suddenly change: “Well, I’m not so dirty that I need a shower. And I’m pretty sure that spot is a beauty mark.” Yet the goal of a shower, warm or cold, is the same—to wash. The only difference between the two is how pleasant they feel. Yet this simple variable has a remarkably strong influence in how much we seek or avoid it, and how we rationalize our choice to seek or avoid it. The same thing happens with food: after a full meal, we can more easily justify being hungry for a piece of carrot cake than for a plain carrot.

Over the years, scientists have performed numerous lab experiments where rats and monkeys are given unlimited access to pleasure-inducing intravenous drugs simply by pressing a lever. The end result is virtually always the same: these animals quickly develop compulsive drug use, pressing these levers up to thousands of times per hour. They also develop a strong preference for drugs over normal, healthy behaviours. They sometimes even starve themselves to death or completely neglect their own offspring while single-mindedly continuing to reach for the drugs. Why? Because these drugs simply feel better—at least in the short term—than eating or caring for their young. The same phenomenon occurs when they are allowed to press levers to obtain direct electrical stimulation of the pleasure zones in their own brains, a practice called deep brain stimulation. What is the difference between these unfortunate lab animals and us humans? Sadly, the answer seems to be: not much.

When exposed to similar drugs, humans have been found to behave similarly—think of heroin addicts wasting away because they no longer care to eat. I recently read about one particular addict who had run out of money and reportedly offered her underage child to her drug dealer in exchange for heroin. While this is hard for most of us to understand, the addict probably thought it was a sensible decision in her time of desperation. Ultimately, the truth seems to be that our minds are programmable, much like computers are. We learn preferences for certain things—such as preferring drugs over food—and aversions to other things based simply on which of these things give us more pleasure—or less pain—in the short-term.

KEY POINT #137: The degree of pleasure or pain of any activity or thing has a strong influence on how much we seek or avoid it. Regardless of how healthy or unhealthy the things we seek are, we usually find ways to rationalize our behaviour.

Appetite exercise: It’s easy to demonstrate whether the pleasant kick of sodium makes you eat more than you would otherwise. Pick an activity, such as reading or working at a desk, that requires focus but during which you can casually nibble on a snack. Prepare two bowls, one containing half a cup of a salted snack (such as nuts or popcorn) and the other containing the same amount of an unsalted version of the same snack. Start with one. Time how long it takes you to finish the entire bowl. The next day, when you are feeling about the same level of hunger as when you started the first bowl, repeat this exercise with the second bowl. Did you eat one faster than the other? Did you eat more of one than the other?

Sweetness also stimulates our appetite—the Harvard School of Public Health notes that “the human brain responds to sweetness with signals to eat more.” You can try the exercise above with two drinks, one with a sweetened beverage of your choice and one containing the same amount of water.

Our initial programming

Are our minds a blank slate when we are born? It seems reasonable to say no. Among other survival traits, we are born with a basic yet sophisticated set of programming instructions in our minds. These tell us which basic things are good for us (by making those feel good), which things cost something to us (by making those feel bad), with the rest being (and feeling) neutral. That is why newborns instinctively prefer sweetness over bitterness, and cry when they’re painfully hungry. No one had to teach them these things. This built-in programming harnesses pleasure and pain to encourage behaviour that maximizes our health from the very start of our lives.

Our minds are essentially like magnetized compasses that are attracted towards pleasure and shy away from pain. The reason our minds give us these feelings is not so that we can obtain unlimited amounts of joy and as little suffering as possible, it is simply to steer us in the right direction towards optimal health. The reason that I am alive and writing this book, and that you are alive and reading it, is because our millions of ancestors successfully followed their pleasure- and pain-based programming instructions and survived, reproduced, and passed these instructions all the way down our respective family trees to both of us.

We are continuously being reprogrammed

The primal knowledge we’re born with is somewhat simplistic and extremely shortsighted. As infants, we’re only consciously aware of what feels good or bad right now. We don’t yet understand the long-term or even the short-term consequences of our actions. However, it’s clear that the programming we have at birth is not set in stone. In fact, our minds are constantly being reprogrammed. That’s how we learn!

We gradually learn about the short-term (and eventually long-term) consequences of our actions, a little bit every day, as we experience new things. Every time we feel pain, healthy or not, it acts like a branding iron—the old-fashioned kind they used to mark cows with. That is, pain not only hurts, it also leaves a permanent mark on our minds. This mark contains a sort of “map” of the sequence of events, or steps if you will, that shows us how we got from a given starting point to reach that painful thing. This knowledge improves our ability to predict and potentially avoid this pain later on, should similar circumstances arise. The same phenomenon occurs with pleasure, except that we learn to desire and seek that sequence of events that leads to the pleasant thing.

This map-imprinting process is what psychologists call conditioning. “Feelings whether pleasurable or painful have a deeply soul-shaping power,” observed psychologist G. Marian Kinget. “The quality and amount of pleasure and of pain, together with . . . the manner in which they are distributed over the lifespan, are staggeringly powerful in determining what a person ultimately becomes.” The stronger the pleasure or pain, the more powerfully this “map” is imprinted onto our minds. How many times did you have to put your hand on a burning hot stove to learn to never do it again? Conversely, how many times does one need to consume pure heroin in order to always desire it above all else? In both cases, once is usually enough.

KEY POINT #139: Pleasure and pain act like branding irons on our minds, leaving permanent marks in their wake. The stronger the sensation, the deeper the mark. Keep this in mind every single time you choose something pleasurable. The pleasant things that we consume every day are not harmless and inconsequential, they literally alter our minds and change our destiny.

Indulgences are, by their very definition, more pleasurable (or less painful) than the healthier activities they replace. They therefore imprint a “map” leading to that indulgence that is more compelling than those maps leading to healthier activities. In the most extreme cases, they may burn an imprint that will haunt us for the rest of our lives and make everything else pale in comparison. Dave Gahan, lead singer of electronic music group Dépêche Mode, revealed how the powerful highs of heroin still haunt him many years after going sober: “Once you’ve gone to a place like that, it’s in your soul,” he said. “I wouldn’t wish it upon anyone.”

Since these so-called maps are continuously pushing us towards these learned pleasures and away from these learned pains, it could be argued that we do not quite have 100% free will. Indeed, according to the US National Institute on Drug Abuse, drug or alcohol addicts may voluntarily choose to take the first few doses of a given drug, but with each use, their minds get progressively reprogrammed towards drug usage. The compelling urge to take these drugs gradually increases and may eventually overpower their ability to freely and rationally choose whether or not to take them. As we’ve alluded to, for some hard drugs like crack cocaine or heroin, even a single potent dose can be enough to turn the user into an addict. Even those using painkillers exactly as prescribed by their doctors may become addicted to them during the course of a single prescription, according to the US Centers for Disease Control and Prevention.

To make matters worse, switching from a healthy activity to an indulgent one consists of a positive effect, since indulgences are by definition more pleasurable (or less painful) than the healthier activities they replace. Thus, sudism tells us they will cause future negative effects such as making future healthy activities feel less pleasurable (or more painful) than they should. This effect is clearly demonstrated by the fact that many recreational drugs are known to cause anhedonia—a loss of pleasure from normal everyday things. This at least partly explains why hard drug users lose interest in most normal healthy activities. This doesn’t only happen to drug users. Regular consumption of low-calorie sweeteners can reduce our tolerance for plain fruits and vegetables, which are naturally less sweet, according to obesity expert Dr. David Ludwig. Likewise, high sodium intake early in life causes children to prefer salty foods over plain foods later on, according to Health Canada.

Creatures such as moths are designed to rely on pale moonlight in order to navigate, but they run into problems when they see a bright artificial light. This is a stimulus that is much more intense than they were designed to handle. In the same way, we humans have not been designed to handle artificially-enhanced stimuli such as junk food, video games, and pornography. Once we are exposed to these, we keep getting attracted to them over and over, even if we know they’re bad for us. Their powerful attraction often exceeds our ability to resist them. For instance Susan, a former cocaine addict, admitted continuing to use cocaine even though she had begun hallucinating and was aware that it had destroyed her life: “I was ‘exploding’ and unable to stop myself from continuing to seriously abuse cocaine,” she admitted. And so we end up hurtling ourselves towards these powerful attractants over and over again, like moths bashing against a bright light, sometimes until we die.

Indeed, some psychologists use the word superstimulus to describe any artificial thing that is more attractive or pleasant than its natural counterpart. Television entertainment and video games could be seen as superstimuli because they tend to be much more interesting and stimulating than slower-paced day-to-day life. Sweetened and salted foods are superstimuli because they taste better than their naturally unseasoned counterparts. Women who’ve had their breasts, lips, or even their rears enlarged similarly qualify. And pornography is a superstimulus because it depicts an exaggerated view of sexuality without the pesky real-life drawbacks of rejection, pregnancy, or sexually transmitted diseases.

In short, the pleasures and pains we encounter in our daily lives are constantly reprogramming us, whether they are subtly fine-tuning our behaviour or teaching us major life lessons. Indulging can rapidly steer our behaviour towards the indulgent activity and away from healthier alternatives. They can create preferences for the indulgence rather than the healthier and more natural alternative behaviours:

preferring junk food over healthy food

preferring mindless TV over socializing

preferring to drive instead of walking or biking

preferring music over background noise

preferring porn over real-life sexual relationships

preferring virtual tasks in video games over household chores; and

preferring hard drugs over everything else.

It is wise to carefully choose our daily pleasures and indulgences. Even milder indulgences will leave an imprint in our minds that can lead us to wanting it more than healthier options for the rest of our lives. This is why the number one food craved by Americans isn’t spinach, it’s sweetened chocolate.

Addiction

What is addiction, really? Experts tend to define it as having overwhelming urges that compel us to seek the thing we’re addicted to, even if we know it isn’t good for us. Addictions are powerful. They cause long-lasting changes in the brain that are difficult to reverse. Addicts can relapse even after years of abstinence. Indulgences are by definition more rewarding (in the short-term) than the healthier activities they replace. Therefore, they are more likely to be addictive or habit-forming. The more rewarding a substance or activity is, the more it will cause us to make a habit of them or develop addictions to them.

The scientific consensus on what exactly constitutes addiction has evolved over time. Initially, addiction specialists believed only substances, like cocaine or alcohol, could be addictive. Fairly recently, gambling addiction became the first widely recognized behavioural (i.e. non-substance) addiction. Now we are on the verge of other behavioural addictions becoming widely recognized. Valerie Voon, a neuropsychiatrist at the University of Cambridge, reported that the brains of compulsive porn users resembled the brains of alcoholics watching ads for a drink. According to researcher Douglas A. Gentile, who authored many studies on the impact of video games on children, between 7 and 12 percent of youth gamers in many countries could be classified as “addicted”—which he defined as causing damaging effects in two or more areas of their lives. Many had gotten so heavily addicted to the game World of Warcraft (WoW) that it earned the nickname Warcrack. In extreme cases, video gaming has even been fatal: in 2005, South Korean Lee Seung Seop collapsed after playing either StarCraft or WoW for fifty hours non-stop. He was rushed to a hospital where he passed away. “He was so concentrated on his game that he forgot to eat and sleep,” said the hospital psychiatrist. “He died of heart failure brought on by exhaustion and dehydration.” In other cases, an addict may harm others who get in the way of their addiction: Floridian Cody Wygant admitted in 2014 to suffocating his own one-year-old son in order to continue playing his Xbox. Thankfully, gaming disorder—playing video games to the extent that it impairs other areas of our lives—has finally been included in the 2018 Revision of the International Classification of Diseases.

Traditionally, most health professionals would only qualify us as “addicted” if our urge for the addictive thing was so strong that it completely overwhelmed our rational ability to control it despite significant negative health, financial, work, or social consequences. But what if our urge was not quite overwhelming—should we still call it an addiction? Or what if our urge is somewhat mild but happens frequently, like our daily desire for caffeine? Indeed, according to long-time addiction researcher Dr. Roy A. Wise at the American National Institute on Drug Abuse, there has never been a clean distinction between an addiction and a habit—that is, a non-overwhelming urge for something. The distinction may simply be one of quantity rather than quality. Marc Lewis, a man with the unique dual insights of being both a neuroscientist and a former addict, may be in the best position to understand addiction. He argues in his book The Biology of Desire that addiction is not a disease, but is simply a “very bad habit” that one has acquired from repeating the same reinforcing thoughts and behaviours over and over. As such, from these experts’ opinions as well as my own personal experience, I prefer to view addiction not as a black-and-white, you’re-an-addict-and-I’m-not concept but rather as a wide spectrum. And that many of our habits lie somewhere on that spectrum. Mirroring this, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)—the most recent edition of the American psychiatric “bible”—has redefined substance addiction and dependence into a single substance use disorder spectrum ranging from mild, to moderate, to severe.

KEY POINT #140: Addiction is a recurring desire for a pleasurable (or pain-relieving) thing that doesn’t give us any health benefits, or to which there are less-pleasurable (or less pain-relieving) alternatives that are at least as healthy.

In the context of sudism, we can then define addiction as a concept that interlocks with the concept of indulgences, as follows:

KEY POINT #141: Addiction is a recurring desire for an indulgence. In other words, addiction is a recurring need for something we don’t truly need.

On the bottom end of the addiction spectrum are mild habits that don’t noticeably interfere with other parts of our lives. At the other extreme are highly-destructive addictions that generate overwhelming cravings and consume most of our time, money, and energy. One person may simply “like” to have an alcoholic drink every night and function well, while another might spend every day drinking until they pass out, completely unable to maintain any semblance of a job or relationship.

Just as there are healthy pleasures and unhealthy ones, we can say that there are both healthy cravings and unhealthy ones. Cravings are innate desires that push us in the direction of the craved behaviour. The more intensely pleasurable the activity, the more intense the craving for it, and the harder it is to resist.

KEY POINT #143: A healthy craving is a desire for a healthy pleasure at a healthy frequency, such as the desire to eat, sleep, or mate in normal and healthy amounts. An unhealthy craving is a desire for an indulgence—such as sweetened chocolate, music, or nicotine.

At this point, some of us may still be thinking: I’m not addicted to anything, so this whole discussion doesn’t apply to me.

That’s funny, because I used to feel the same way about myself. Not so long ago, I thought of myself as someone who wasn’t addicted to anything. I just thought I had a “sweet tooth” . . . until I realized how hard it was to actually stop eating sugary things. That’s when I realized it could be seen as some degree of addiction. In my youth, my smoker friends insisted they weren’t addicted to cigarettes and that they could stop anytime they wanted—they were just choosing to smoke, day after day, and year after year.

Many of us view sugar and other sweeteners as relatively harmless. But researchers indicate that sugar and sweetness provoke feelings of reward, cravings, and withdrawal similar to addictive drugs. Indeed, nutrition researcher Kris Gunnars revealed that he and other former addicts experienced addiction to, and cravings for, sugar and junk foods in virtually the same way that they used to crave drugs or alcohol.

Many of us believe that we can stop a given habit at any time and that we freely choose to do it on a regular basis. We assume we’re not addicted to anything, because we like to believe we are fully in control of our decisions and that addiction is a bad thing that only happens to bad people. However, I believe that the majority of us, myself included, have at least some mild forms of addiction to things like sweet or salty snacks, alcohol, caffeine, medication, television, or even to certain media that we consume on the internet. I would encourage each one of us to question, with an open mind, whether any of our own personal habits might be re-classified as some degree of addiction.

Exercise on addiction: If you really want to figure out whether something you do regularly is simply a harmless habit instead of an addiction, or to what degree you are addicted to something, a simple and effective self-test is to quit the habit completely for at least one month—preferably two or three. Continue to live your life as before, minus that habit. Avoid taking on any other “bad” habits or indulgences to compensate for the one you eliminated. During this time, if you feel any withdrawal symptoms, cravings for the habit or find yourself obsessively thinking about it—especially when you feel sad, anxious, lonely, or hurt—this may suggest some degree of addiction.

KEY POINT #144: Most of us experience some degree of dependence or addiction in our lives, though many of us do not realize it.

IN-DEPTH: Phobias

When we fear something significantly more than the average, rational person would, we say that we have a phobia. There are many kinds, from being terrified of certain animals and insects to unusual food aversions and intense fear of social situations. The worst phobia of all may be agoraphobia—being so fearful of the outside world that we struggle to ever leave our homes.

Why are phobias relevant? It’s because, interestingly, they could be seen as the very opposite of addictions. We can better see their symmetry if we compare them side by side:

Addictions

Phobias

Are a compulsive, excessive desire for a given thing or activity.

Are a compulsive, excessive avoidance of a given thing or activity.

The thing or activity feels excessively pleasant.

The thing or activity feels excessively unpleasant.

Can be borne from a single event. For instance, winning a single jackpot at a casino is often the event that triggers a gambling addiction.

Can be borne from a single event. For instance, being attacked by a dog as a child may trigger a lifelong fear of dogs.

May be mild, moderate, or strong in intensity.

May be mild, moderate, or strong in intensity.

KEY POINT #145: Phobias are an excessive fear of a thing or activity. Phobias might be seen as the opposite of addictions, which are an excessive desire for a thing or activity.

Healthy and unhealthy mistakes

Everyone makes mistake. And it’s tempting to think that any mistake we make is okay because mistakes are opportunities for us to learn. However, not all mistakes are created equal. On the one hand, when we accidentally injure ourselves or screw up in our relationships, we suffer in a healthy way that helps us learn how to better handle these situations in the future. These are healthy mistakes. These are normal, even desirable, because they teach us how to become a better person overall.

On the other hand, when we partake in something indulgent like delectable sweets or recreational drugs, we are strongly rewarded when we should instead be punished. We receive unwarranted pleasure (or pain relief) for something that incurs a cost to our health, and this encourages us to seek and repeat the same unhealthy behavior over and over again. That’s why these are unhealthy mistakes. It would be wise to avoid them as much as possible, and to learn these important lessons from others instead of making these mistakes ourselves.

We learn from all of our mistakes, but be careful what you learn. Sudism helps us distinguish between healthy and unhealthy mistakes so we can more easily accept the former while better avoiding the latter.

IN-DEPTH: If indulging isn’t healthy, why do we do it?

I’ve lost count of how many medical doctors I’ve seen that are overweight or just don’t look healthy. In fact, about 60 percent of doctors and nurses are overweight or obese according to some studies, rates which are similar to those of the general population. These fine folks, who have years of education and training on how to live healthily, don’t always seem to be following their own advice. Likewise, many diabetics knowingly eat the wrong kinds of food that aggravate their blood sugar. Why is this? Unless we’ve been living in a cave, we’ve all heard the mantra that we should exercise more, eat healthier, make sleep a higher priority, and so on. Yet many of us often fail to do these basic things—myself included!

If indulging isn’t healthy, then why do we indulge? Let’s look at some of the reasons we choose indulgence over health and, with the insights of sudism, try to expose the flaws in our reasoning. Do you recognize any of your own beliefs and behaviours?

We indulge to feel good

To begin, we often indulge for the sake of pleasure:

We might indulge simply to feel good, while overlooking future negative consequences. Based on his research, Dr. David Burns, one of the pioneers of cognitive behavioral therapy (CBT), believes we overindulge in food, drugs, and alcohol not because we have some sort of emotional defect, but simply because these things make us feel very good and are readily available. Children, for instance, will literally beg for sweet and salty foods without the faintest clue about their negative side effects. In 2007, a reality TV show called Kid Nation filmed forty children living in a desert town with minimal adult supervision. In one episode, they were given access to mountains of junk food. The result? They gorged themselves, stopping only when they became nauseous. When children grow into teens, they may experiment with drugs or alcohol because taking risks feels exciting, though they too are often blissfully unaware of the consequences. And as they become adults, they may continue to indulge in so-called guilty pleasures despite knowing some of their problematic consequences. Sudism helps us see the long-term negative effects of all indulgences, even if these have been deliberately or inadvertently hidden from us.

We want to guarantee that an event will go well. For instance, when we organize a social gathering, we often supply some combination of delicious foods, music, entertainment, alcohol, or even drugs to make sure our guests have a good time. At work, someone might drink coffee each morning to guarantee top-notch performance, then take sleeping pills each night to guarantee a good sleep. We’re afraid that things in life won’t go as perfectly as we planned. But sudism says that life cannot be up, up, up all the time. Instead, we should embrace both the ups and the downs, knowing that both may happen at the best and the worst possible times.

We may think that each indulgence brings us a step closer to long-term happiness. But sudism clearly teaches us that we can’t make our lives happier.

On the other hand, we might think that not indulging will make us more miserable in the long run. We don’t want to feel deprived of the indulgences we crave. We’re convinced that eating blander health foods or giving up cigarettes will be a horrible experience. Young people these days also talk about the fear of missing out (FOMO), the fear that not participating in a show, party, or social media event will leave them feeling miserable. Again, sudism gently reminds us that although many things are difficult or unpleasant, none of these things can make our lives less happy overall.

It may have been a long time since we’ve felt really good so we feel it is owed to us. Guaranteed pleasure now is more tempting than waiting for an unknown pleasure to come at an unknown time. And indulgences may be especially tempting when we feel physically or emotionally unwell. It is easy to forget that if we simply wait and let life take its course, pleasure will naturally re-appear without us having to force it to come. In this sense, old sayings such as “patience is a virtue” and “good things come to those who wait” are wise indeed.

We may think we simply deserve the indulgence. A sophisticated or hard-working person may believe they deserve expensive bottles of wine or luxurious meals at five-star restaurants. They have built up these expectations of how their life should be, perhaps based on advertisements or what others around them aspire to achieve. We might justify ourselves by saying, “Hey, we worked hard and we deserve it!” Sudism suggests that we can reward our hard work in many other ways: by resting, spending quality time with others, or feeling proud of what we’ve achieved. There is no need to indulge just because we worked hard—the sweet rewards of hard work will always come to us, but on their own schedule.

We indulge to avoid pain

The next main reason we indulge is to rid ourselves of pain:

We self-medicate to ease our pain, whatever it may be, while overlooking the long-term consequences. We watch TV, listen to music, or have a beer to help us forget all of our problems, at least for a little while. We might also use medication, drugs, sex, or food to numb our feelings of loneliness or distress. But sudism reminds us that all of these choices will cost us later on, whether we like it or not.

Our doctors may be medicating us by prescribing painkillers for our physical pains or psychiatric drugs to dull our emotional aches. Some doctors act as if we should never have to endure any pain. Instead of pushing away pain, sudism encourages us to open our arms and embrace it as much as we can.

If we’ve had a tough day or a difficult week, and we’re frustrated, upset, or simply worn out, we might feel it’s time for a little reward to compensate for all that we’ve had to endure. Some of us indulge to cheer ourselves up after a bad day, then later on to celebrate a good day. But sudism teaches us that we can’t run away from our problems—indulging to escape a current problem often recreates the same problem in the future.

We feel compelled by the painful cravings or withdrawal symptoms of our addiction, so we give in. Being hurt, angry, lonely, or tired (HALT) may trigger powerful cravings, which is why some addiction specialists ask us to “HALT” and think of what we are feeling and why, before we take the plunge. Though cravings may be hard to resist, sudism reassures us that it’s not only possible but inevitable that we’ll feel normal again in due time, without always caving in to our addictive behaviours.

We might be trying to avoid physical work, mental effort, or other kinds of healthy suffering. Picking up fast food at a drive-through window then throwing out the packaging is, after all, much easier than cooking a healthy meal at home then doing the dishes. In Westernized countries, almost everything seems to be mechanized, industrialized, and computerized in order for us to avoid hard work. We might think that avoiding pain and struggles means avoiding long-term misery, but sudism reassures us that this is merely a powerful illusion.

KEY POINT #148: We often indulge because we are impatient and can’t wait to get rid of our pain, but sudism teaches us that suffering patiently is a virtue.

We indulge because we think it is normal or healthy

Often, we believe that an indulgence is normal and healthy—or at the very least, not unhealthy—so it quickly becomes a habit. Whatever environment and habits we were raised in as children tend to become what we consider “normal,” whether or not these are healthy. What habits did you pick up from your family and friends? We tend to think that if our friends do it, and our families do it, then it must be okay. That is why, in the 1950s and 1960s, nearly half of the US population smoked cigarettes (including roughly half of physicians) and most considered it acceptable at the time. Likewise, if we’re raised in a society that always eats salty or sweet foods, then we’ll tend to believe that this is normal, this is how food should taste. And if one day we accidentally taste an unsalted version of a dish we’ve always eaten salted, we’ll probably think there is something wrong with it because it doesn’t taste good enough. But what if the truth was actually the inverse, that there is something wrong with the salted version of the dish because it tastes too good? If we are raised in an environment where everyone considers indulgences normal and healthy, how can we possibly distinguish between healthy and indulgent things? Look back at What are indulgences? for help in telling the difference, and at the upcoming Exercise—healthier foods versus less healthy kinds for side-by-side examples.

Furthermore, even if a part of us is aware that we have an unhealthy habit, it’s often easier for us to stay in denial than to face the difficult process of letting go of our favourite indulgence.

I rarely eat at restaurants—I buy all my food at the grocery store, including many foods labelled low-fat, low-calorie or high-fibre. Doesn’t that mean I’m eating healthy?

As we’ve seen earlier, many companies work hard to convince us that their not-entirely-healthy products are good for us, such as sweetened yoghurts or sweetened whole-grain breakfast cereals. Large food manufacturers will call products low-fat while sneakily boosting their salt and sugar content, as journalist Michael Moss reported in his book Salt Sugar Fat: How the Food Giants Hooked Us. We are often led to believe we are eating healthily when it may not be the case. I fell for it for a long time. One day, I started reading the ingredients and Nutrition Facts of every single food I bought. The amount of added sodium and sugar I discovered in my supposedly “healthy” diet truly shocked me. I finally realized that the reason I preferred the taste of one food over another usually boiled down to them containing more sweeteners, more savourizers (i.e. sodium or monosodium glutamate—MSG), or less fibre. Without realizing it, I had been surreptitiously manipulated by corporations to make me prefer their products over healthier alternatives because theirs simply tasted better. Commercial industries have demonstrated to what lengths they will go to protect their vested interests, regardless of the health consequences of consumers. The sugar industry, for one, has gone to great lengths to discredit scientists who argue that sugar is unhealthy, and to produce their own studies to counter-claim that sugar doesn’t cause any harm. Recent studies show that the alcohol industry funds many organizations that disseminate deceitful information about the health risks of drinking. “It is not just Big Tobacco anymore,” said Margaret Chan, the former director general of the World Health Organization. “Public health must also contend with Big Food, Big Soda, and Big Alcohol. All of these industries fear regulation and protect themselves by using the same tactics. They include front groups, lobbies, promises of self-regulation, lawsuits and industry-funded research that confuses the evidence and keeps the public in doubt.”

KEY POINT #149: Consumers’ health is often a casualty of the war between food sellers, entertainment companies, and other commercial interests.

A doctor may prescribe us medication to ease our physical or emotional aches, and we trust that they have our interests at heart. But as the current opioid epidemic illustrates, some prescribed drugs may actually cause us more problems than they solve. It’s wise to do our own research and question those who insist we take medication. We are the ultimate gatekeepers of everything that enters our bodies and minds.

With this in mind, I challenge everyone to re-evaluate what they think is “normal” and “healthy” in their lives. Be open to the possibility that some things we previously considered normal and healthy may not actually be. I, for one, have been wrong many times.

We indulge against our wishes or to avoid conflict

Even if we try our best to live a healthy lifestyle, there are times when we feel pressured to do things we don’t want to. For instance, many supermarkets play loud music, whether we want to hear it or not. Such second-hand music wafts uninvited into our ears in much the same way second-hand smoke might waft uninvited into our lungs. Perhaps we are planning a meal and we are missing a key item, but the only option we can find is loaded with sugar or salt. When it comes to celebrations, hosting a child’s birthday party without serving cake might upset the guests as well as the birthday child. It may be equally difficult to resist the pressure of partaking in alcohol or drugs in social settings, and abstaining may cast us as an outsider of the group. Going against the grain can certainly cause friction, which is why we tend to go along with the status quo. But remember: the harder our struggle, the greater our reward. “Having the courage to say ‘no’ when all your friends are saying ‘yes’ is one of the most difficult things you’ll ever have to do,” according to motivational speaker Sean Covey. “Doing it, however, is one of the biggest charges you can ever make to your personal battery.”

Conclusion of Part Five

In this part, we’ve seen that there are really two broad categories of pain that we all experience. Healthy pain is a legitimate approximation of health costs, while unhealthy pain acts as a pressure-relief valve when we’ve had too much pleasure or too little pain. Similarly, the two kinds of pleasure are those healthy ones that are proportional to health benefits and those unhealthy indulgences that bring us little or no health benefit. Over time, we may grow wiser in telling all of these feelings apart. This will prove invaluable, as we will see in the remaining parts.

Summary of Part Five

Here is a summary of all key points from Part Five. It can be used as an optional refresher or an executive summary.

#115: Sudism encourages us to look beyond the quantities of pleasure and pain, and instead focus on their qualities.

#116: Pain is usually a good thing, since it helps protect us from many kinds of injury. But it isn’t always a good thing, as we’ll explain later.

#117: Our subconscious minds dangle carrots (pleasure) in front of us, and whacks us in the rear with sticks (pain), in order to make us move in the direction it wants us to move, much like an owner sitting on a donkey might do.

#118: Pain can be seen as a measure of cost to our health, and pleasure as a measure of health benefit.

#119: The mind appears to use pleasure and pain to do intelligent cost-benefit analysis when making decisions. For this to work optimally, the affective intensities and durations of each activity must be carefully calibrated with respect to each other.

#120: Pleasure is not designed for our on-demand amusement. It is designed to steer us towards optimal health by shaping our behaviour. Pleasure is merely a messenger, not an end-goal. Don’t seek the messenger, seek the message.

#121: Pain is not designed to needlessly torment us. Like pleasure, its purpose is to steer us towards optimal health by shaping our behaviour. Pain is merely a messenger, not something to mindlessly avoid. Don’t shoot the messenger, listen to its message.

#122: Our many kinds of pleasant and unpleasant feelings teach us that health is more than just eating and sleeping right, it also includes seeking healthy mental stimulation, healthy social and intimate relations, healthy competition and cooperation, protecting our bodies, and rightfully defending what is ours.

#123: When we try to maximize pleasure and minimize pain, we fall for the illusion that we can optimize our happiness, but we overlook the simple truth that we are really trying to optimize our health.

#124: Our minds and bodies are smart, but only up to a point. Our minds try their best to align pleasure with health benefits, and pain with health costs. But the mind sometimes makes mistakes. Some toxic things (like death cap mushrooms) taste good to many of us, while some healthy things (like kale) can taste bitter.

#125: We say that things or activities are aligned when their affective (i.e. pleasure and pain) outcomes are roughly proportional to their health outcomes. Otherwise, we say they are misaligned or out of alignment.

#126: Beware the gap between what feels good versus what is good for us, and the gap between what feels bad versus what is bad. In other words, be keenly aware when pleasure and health benefits diverge from each other, and likewise when pain and health costs diverge.

#127: Many of us believe that pleasure is an end goal in and of itself. But pleasure was never meant to be an end, it was meant to be a means to an end. In other words, each instance of pleasure should serve a useful purpose, and should not be amplified unnecessarily!

#128: Many of us believe that pain is something we should avoid as much as possible. But pain was never meant to be completely avoided, it was meant to be a means to an end. In other words, each instance of pain should serve a useful purpose, and useful pains should never be arbitrarily reduced. These pains need to happen so they can serve their purpose.

#129: Healthy pleasures are units of pleasure that correspond to units of actual or potential health benefits. If an event or activity produces pleasure roughly in proportion to its corresponding health benefits, then all of that pleasure is healthy.

#130: Unhealthy pleasures are units of pleasure that don’t correspond to any health benefits whatsoever, and may even correspond to health costs. Healthy and unhealthy pleasures can be blended together, such as the way a chocolate bar might combine unsweetened chocolate and sugar.

#131: Healthy pains are units of pain that correspond to units of actual or potential health costs. If the amount of pain caused by an event or activity roughly matches the amount of health costs it incurs, then all of that pain is healthy pain.

#132: Unhealthy pains are units of pain that don’t correspond to any actual or potential health costs.

#133: Virtually all kinds of pain—such as aching joints, sadness, and fear—can manifest in either a meaningful healthy way or a meaningless unhealthy way. All pain is equally real, but not all pain is equally useful.

#134: Sudism teaches us that chronic pain includes both physical aches—such as back pain, itching, and headaches—as well as emotional aches—such as anxiety, anger, and depression.

#135: An indulgence is any activity that provides more pleasure than required for optimal health, or reduces pain below the amount we need for optimal health. Indulgences are essentially shortcuts that accelerate pleasure or bypass pain.

#136: Entertainment in its purest form is often made to excite or delight us and is therefore indulgent. However, many forms of entertainment blend both excitement with healthy teachings, inspiration, or physical activity.

#137: The degree of pleasure or pain of any activity or thing has a strong influence on how much we seek or avoid it. Regardless of how healthy or unhealthy the things we seek are, we usually find ways to rationalize our behaviour.

#138: We are born with a basic set of instructions in our minds, which uses positive and negative affects to try to steer us towards optimal health.

#139: Pleasure and pain act like branding irons on our minds, leaving permanent marks in their wake. The stronger the sensation, the deeper the mark. Keep this in mind every single time you choose something pleasurable. The pleasant things that we consume every day are not harmless and inconsequential, they literally alter our minds and change our destiny.

#140: Addiction is a recurring desire for a pleasurable (or pain-relieving) thing that doesn’t give us any health benefits, or to which there are less-pleasurable (or less pain-relieving) alternatives that are at least as healthy.

#141: Addiction is a recurring desire for an indulgence. In other words, addiction is a recurring need for something we don’t truly need.

#142: Addictions are not black-and-white. They range from mild everyday habits to out-of-control compulsions.

#143: A healthy craving is a desire for a healthy pleasure at a healthy frequency, such as the desire to eat, sleep, or mate in normal and healthy amounts. An unhealthy craving is a desire for an indulgence—such as sweetened chocolate, music, or nicotine.

#144: Most of us experience some degree of dependence or addiction in our lives, though many of us do not realize it.

#145: Phobias are an excessive fear of a thing or activity. Phobias might be seen as the opposite of addictions, which are an excessive desire for a thing or activity.

#146: Not all mistakes are created equal. Healthy mistakes are those that feel appropriately painful to ensure that we learn that we made a costly mistake. On the other hand, unhealthy mistakes are those that feel pleasant and therefore teach us to go down the wrong path. We usually learn from our mistakes, but the wrong lesson might be learned.

#147: We often indulge because we are impatient and want to feel good now, but sudism teaches us we’ll naturally feel just as good in due time without having to force it to happen. We also indulge because we think it will bring us closer to everlasting happiness, but sudism makes it clear that such happiness is impossible.

#148: We often indulge because we are impatient and can’t wait to get rid of our pain, but sudism teaches us that suffering patiently is a virtue.

#149: Consumers’ health is often a casualty of the war between food sellers, entertainment companies, and other commercial interests.

#150: We often indulge in something because we think it is normal, healthy, and everyone else seems to be doing it, without realizing that it is actually abnormal and unhealthy for us.

#151: We often indulge because others pressure us to do so, but deep inside, we have the power to resist and decide what’s truly best for us.

PART SIX: GREAT INDULGENCE, GREAT SUFFERING

Introduction—Modern Times

My own indulgence

The world’s Great Indulgence

The systematic eradication of healthy pain

My darkest hour

The Great Suffering of humankind

My attempts at conventional treatment

Conventionally treating the world

Conclusion of Part Six

Summary of Part Six

Introduction—Modern Times

Over the past several decades, the developed world has seen tremendous increases in the variety, availability, and intensity of indulgences, which we might call the world’s Great Indulgence. At the same time, worldwide rates of depression, anxiety, and chronic pain have skyrocketed, which could fittingly be called the world’s Great Suffering. Are these overlapping events simply coincidental? Or are they inextricably interlinked?

My own indulgence

Let me first tell you a little about my childhood—a small piece that fits within the larger puzzles that are the Great Indulgence and the Great Suffering.

When I was a child, I had no idea what the word indulge meant, but I certainly knew how to do it. I spent a good part of my time chasing one indulgence after another. Having a sweet tooth meant that one of my favourite things was to take a whole row of cookies from a store-bought bag and eat them one after the other with a cold, tall glass of milk. I played hundreds of video games on our home computers and at local coin-operated arcades, often compulsively until I’d reach the end of each game (or ran out of coins). I loved music profoundly and wore out my cassette tapes and later on my CD’s listening to hundreds of artists for countless hours—probably a little too loudly for my poor ears. And when I got older, like too many others, I fell into the honey-trap of pornography. My indulgence load—that is, the sum of all my indulgences put together—kept creeping up. While it may seem obvious to some that I wasn’t making the best decisions, people back then knew far less about the consequences of these activities. And I wasn’t even thinking of consequences—I just wanted to have fun now. A Freudian psychologist might say that my id was in complete control of my life.

My bad habits continued into my adolescence and young adult years, as I saw no compelling reason to stop. I also became progressively lazier. Once my “soccer career” ended at the ripe age of ten, I rarely played sports. When I got my driver’s license, I cast aside my bicycle and started driving everywhere. Sitting on my butt in front of a computer, TV, or piano became my favorite activities. At school I sat, at work I sat, and at play I sat. Other than odd jobs mowing lawns, delivering papers, or shoveling snow, the only times I really moved were to get from one seat to the next. All in all, I became progressively more indulgent. It might not seem like such a bad thing, but as we’ll see in a bit, I nearly paid for it with my life.

The world’s Great Indulgence

Now let’s zoom out from my personal life and look at the bigger picture. We know that pleasure-boosting indulgences aren’t new. Some of our favourite ones, like salted food, have been around since ancient history. What has changed in recent decades, however, is the veritable explosion in their variety, availability, and intensity. Recent discoveries of new and cheaper ways to indulge means it’s easier than ever for us to push the “pleasure button” to receive instant gratification.

For starters, the foods and beverages being produced today are tastier than ever. This creates a growing misalignment between the degree of pleasure versus health benefits that we get from what we consume. Food is simply not supposed to taste this good.

The salting of foods, which dates back to at least 6000 BCE, serves the dual-purpose of preservation and flavour enhancement. These days, many restaurant meals are saturated in sodium to make them as flavourful as possible. Some even deliver up to a whopping 4000mg, which according to World Action on Salt and Health represents a ten day supply of this mineral for a typical adult.

Worldwide sugar consumption has tripled over the past fifty years. In fact, a single can of soda pop today contains more added sugar than an average person would have consumed in an entire year just a few centuries ago. Many healthy foods have essentially been turned into desserts by adding sugar to them, including breakfast cereals and yoghurts. Since 1980, Americans have significantly increased their consumption of liquid calories, particularly soda and energy drinks. In America, most packaged foods contain added sugars, and the average American now consumes—often unknowingly—between a quarter and a half pound of sugar per day.

Food industry flavourists work year-round to squeeze the most pleasure into every bite of food and every gulp of beverage. By creating “addictive” aromas and flavours they give their products a competitive advantage. Their goal is to create foods that provide the most pleasure, called the bliss point, by manipulating ratios of savourizers, sweeteners, fat, and other factors. On this, Dr. David Kessler, former head of the US Food and Drug Administration, declares, “We’re living in a food carnival. These flavors are so stimulating, they hijack our brain.” Journalist Michael Moss spent over four years researching and interviewing hundreds of processed food industry insiders. He uncovered that the industry continued to relentlessly market and sell ever-larger quantities and varieties of maximally-addictive processed foods, despite being fully aware that these foods were making their customers sick.

In many Westernized countries, prepared and processed foods are now available nearly anywhere, anytime from fast food restaurants, vending machines, and grocery stores. Portion sizes at restaurants have increased over time. Beverages that used to be called “large” have been reclassified as “small” to make room for ever-larger drinks. Consumers’ desire for convenience has driven the increase in processed and prepared grocery store items as well as the worldwide proliferation of restaurants. Investigative journalist Eric Schlosser reports that the portion of the average American’s food budget spent on restaurants has doubled from 25 percent to 50 percent in the span of one generation, with similar changes in other Western nations. Even in India, where only 3 percent of meals in 2003 used to be eaten away from home, that percentage roughly tripled by 2015.

Even whole natural foods have been selectively bred over time to become more palatable. Many produce items have been bred to be sweeter, less bitter, or to improve their texture—such as by reducing the amount of fibre in whole wheat, and by eliminating hard seeds in fruits like grapes and watermelons. Did you know even ancient bananas used to contain crunchy seeds? If a botanist succeeded in cross-breeding a tree whose fruit had the exact same taste, texture, and nutritional composition as cake icing, should it be considered healthy simply because it grows on a tree? Indeed, one botanist recently succeeded in breeding extra-sweet grapes that taste just like cotton candy. Not all “natural” things are equally healthy.

Beyond what we eat and drink, we are consuming more stimulation and entertainment than ever:

Before the invention of recorded music, music was a rare treat. We could only experience it by attending live concerts or making it ourselves. Phones and other portable music players now enable us to hear our favourite songs anytime, anywhere. Even when we don’t actively seek it, we often hear music played in stores, gyms, on TV shows, and elsewhere.

Video games have only been around since the mid-1900s but, within that short time span, their quantity and variety have grown exponentially. If we compare early games like Pong (1972) to modern immersive ones like World of Warcraft (2004), it’s easy to argue that video games have become more rewarding. Top video game companies now hire psychologists to help design their games to be more compelling. According to game designer Jane McGonigal, the average young person now plays 10,000 hours of video games by age twenty-one, mostly alone. A majority of youth play video games on a daily basis. Video games are not limited to children and adolescents—they are also popular with adults, with the median age of American gamers actually being in the mid-thirties. One recent survey found 60% of Americans play video games daily.

Erotic material may date back to ancient times—think sexy cave drawings—but true-to-life pornographic pictures and movies have only been available since the invention of the camera and moving pictures in the 1800s. Nowadays, use of pornography is at an all-time high. International studies show that between 50 and 99 percent of men and between 30 and 86 percent of women consume pornography. Pornography’s intensity has also increased over the past few decades, as described in psychiatrist Norman Doidge’s book, The Brain That Changes Itself. What used to be called soft-core is now part of mainstream media, what used to be called hard-core has been downgraded to soft-core, and the newest hard-core porn is more intense than ever before. 3D pornography has recently appeared on the market. With the advent of high-speed internet, we can have more virtual sex partners in one day than our ancestors would have encountered in an entire lifetime.

Stimulation in general has increased exponentially with the widespread advent of television and the internet. A tidal wave of information and entertainment is constantly at our fingertips. The amount of time Americans watch television has gone up dramatically. In 1970, American children began watching TV at around four years of age and consumed 3-4 hours per day, while in 2011, those children began at around four months of age and consumed media for up to eight hours per day. Research by Cornell University psychologist James Cutting and British film scholar Barry Salt showed that, in English-language movies, the average shot length—that is, the average duration of a camera shot before it changes angle or location—has gone from roughly 12 seconds in 1930 to around 2.5 seconds in 2014. Modern movies also incorporate more motion than older films. With the advent of smartphones and tablets, audio-visual stimulation is now available anytime and anywhere. These technologies also make it easier for people to consume two or more different kinds of media at the same time, like using smartphones while watching TV. Furthermore, digital technology enables viewers to instantly skip anything they find less interesting, further increasing the overall potency of the experience. Many viewers now consume large amounts of stimulation in one sitting, such as in the recent phenomenon of “binge watching” an entire television series in a single day. Our consumption of news is also way up. We are no longer limited to what the town crier says. Thanks to the internet, we can spend all day reading news stories from across the globe. We can probably consume more information in one sitting today than our ancestors would have encountered in an entire month. From all of this combined audio-visual stimulation, most of us could be considered hyperstimulated.

Finally, we are consuming more drugs than ever to elevate our moods:

We are consuming many commonplace drugs (such as alcohol, tobacco, and caffeine) to boost our moods or relieve various aches. Alcohol has been produced for at least 10,000 years. Roughly 43 percent of adults now drink alcohol, with 5 percent of them classified as alcoholics, according to the Global statistics on addictive behaviors 2014 report. The concentration of alcoholic beverages has increased in some areas. In England, popular wines have gone from an average of 9 percent alcohol in the 1970s to approximately 13 percent in the 2000s. As for tobacco, its use started some 2000 years ago, and now roughly 22 percent of adults worldwide smoke it. Caffeine also has a long history, with coffee drinkers now consuming an estimated 500 billion cups a year. Furthermore, caffeine is no longer confined to tea and coffee but is now added to soft drinks, energy drinks (whose sales have skyrocketed in the past twenty years), medication, and even some brands of chewing gum and bottled water.

We consume more recreational drugs to increase pleasure or relieve pain. Human cultivation of opium goes at least as far back as 3,400 BCE. Over the past 100 years, opiate production may have dropped significantly but prescription opioid consumption has increased dramatically. Production of amphetamine-type substances have also increased dramatically, with many kinds having been newly discovered within the past century. Cocaine and marijuana production have also profoundly increased. Even the potency of some of these drugs has increased. Based on marijuana samples seized by US law enforcement agencies, the average concentration of its psychoactive ingredient—known as THC—has climbed from less than 1 percent in the 1970s to 8.8 percent in 2006. If beer had undergone the same increase, it would’ve ended up at around 40 percent alcohol and resemble hard liquor. Likewise, illicit use of fentanyl, an opioid drug up to a hundred times more potent than morphine, has skyrocketed in the past few years. In some areas, opioid use—and associated overdoses—has reached crisis levels, with some physicians and nurses asking their governments to declare a state of emergency.

KEY POINT #152: The variety, availability, and intensity of pleasant indulgences have increased significantly in recent years, from bliss-maximized foods and 24/7 entertainment to painkillers and recreational drugs. Our worldwide indulgence load—the sum of all our indulgences—has been steadily rising.

The systematic eradication of healthy pain

For the majority of humankind’s history, we didn’t have any choice but to endure any suffering that fell upon us and to manage as best we could no matter how bad its timing was. And some societies today, such as aboriginals and East Indians, still generally accept suffering as a natural and inevitable part of life. However, with the advent of modern technology and pharmaceuticals to suppress pain, Western nations are trying harder than ever to eradicate suffering. As with pleasure, we Westerners are trying to reach a state where it’s as easy as pushing a button to make pain go away (or avoid it entirely). We have truly become a push-button society, as we can see from these examples:

What could be easier than popping painkillers to make our aches go away? Worldwide opioid consumption—as measured in Morphine Equivalent units—has increased by more than fifteen times between 1980 and 2013, a phenomenon many call the opioid epidemic. Although some of these opioids are used recreationally, the majority of them are prescribed by doctors to treat pain. In the US alone, nearly two million Americans abused prescription painkillers in 2013, with nearly 7,000 a day being treated in emergency departments and forty-four dying daily from overdose. Despite the amount of painkillers prescribed nearly quadrupling between 1999 and 2015, the amount of overall pain reported by Americans according to the Centers for Disease Control and Prevention (CDC) during this timeframe has not changed at all. However, in the US, there has been a recent slowing of opioid prescriptions ever since the CDC issued new opioid prescription guidelines in 2016 intended to curb the opioid epidemic.

Less mental effort: It used to take a lot of mental labour to crunch numbers or find useful information. Nowadays, we let computers and the internet do the bulk of this work for us. In the old days, if we wanted entertainment we usually had to make it ourselves by learning an instrument or practicing our storytelling skills. Nowadays, we can conjure endless entertainment at the push of a button. There are some ways, however, that we have more mental work to do than before. Many of us spend more years in school than prior generations. And we have to mentally resist (or not!) an ever-growing number of tempting indulgences.

Before the dawn of agriculture and farming, we had to work hard to forage or hunt for food, to travel long distances, to build shelters, or to find mates. With technological advances such as industrialized mass-production, cars, and the internet, all of these tasks now require much less physical effort. We push pedals to make cars move us around and to make forklifts raise heavy goods. We click on a few web links or type a few words in a search engine to get the information or stimulation we desire. And we dial up delivery pizza to satisfy our hunger. As a result of this progress, the World Health Organization estimates that 95 percent of adults worldwide are now physically inactive.

KEY POINT #153: The number of ways we have found to numb or entirely avoid pain and effort has significantly increased in recent years.

My darkest hour

We’ve shown how unhealthy indulgences have been rising everywhere around us. Now we’ll show how unhealthy pain has also been on the rise. Let me start by telling you about my own unhealthy suffering—a small piece that fits into the larger jigsaw puzzle that is the Great Suffering that we are trying to solve. But I have to warn you: we’re about to visit some dark places.

In an alternate timeline of events, I’ve been dead for over twenty years. At least as far back as my early teens, I was dogged by chronic clinical depression. Every three or four weeks, for no reason I could understand, I would be plunged into an episode of deep depression.

Before I go on, put yourself in this scenario: if a stranger suddenly jumped out from behind a shrub and physically assaulted you, what would you do? You’d probably either retaliate, yell for help, or run away, wouldn’t you? And if that stranger secretly followed you around everywhere, and attacked you at random times of the day and night, you would likely call the police or find some other way to end this madness. After all, there is no purpose or meaning in enduring this kind of inhumane abuse. Now, let’s make this scenario a few shades darker. Instead of being stalked by a flesh-and-blood human being, what if your attacker was invisible, like a ghost you couldn’t see or touch? One that haunted you everywhere you went, and struck you at unpredictable times? Against this invisible enemy you couldn’t retaliate, you couldn’t run away, and no one could help you fight it. You wouldn’t understand why you’re being haunted and you’d desperately want to escape, but you just could not find a way. That is exactly how chronic pain operates. Unhealthy pain is pure torture—we don’t know why we’re suffering nor how to end it. That’s what can make it so lethal.

During my own episodes of depression, it was as if an endless black cloud had descended upon my life. It overtook my thinking completely. The miserable feelings of clinical depression shouted at me over and over:

Escape! Escape!

And I certainly would’ve liked to, but how? The intense darkness permeated all of my memories, making even the most cherished recollection of my childhood appear painful and pointless. I could no longer perceive anything positive about my past. And I started to wonder: did my family and friends ever really care about me for all of these years?

Escape!! Escape!!

I also couldn’t feel anything positive in anything I did in the present moment. Instead, I felt completely miserable with no indication that my misery would ever go away. I lost all interest in eating, friends, music and other activities I normally enjoyed, because depression drained them of all possible pleasure. To make things worse, I also didn’t feel like not doing anything—even relaxing on a comfortable couch felt painful and pointless.

Escape now, dammit!!

Looking towards the future, there was only absolute darkness as far as my mind could see. The light of hope has been snuffed out. There wasn’t even a glimmer of hope, no matter which course of action I contemplated. This is how I felt, even though I had experienced depression before and the rational part of me knew that each episode of depression eventually faded away. But my rational mind was completely drowned out by depressive thoughts. Any activity I could plan to do today or tomorrow seemed painful and pointless, even if a week earlier I would have looked forward to doing those very same things.

My mind kept shouting at me to escape, but where to? I saw no escape in the past, nor the present, nor any conceivable future. Many people in this pit of despair conclude that the only escape is in death, which leads them to attempt suicide. Sometimes, by the same dark logic, they conclude that their loved ones are also better off dead, which can tragically lead to murder-suicide.

I can’t take it anymore! End it, NOW!!

In March 1995, I finally gathered the guts to do it. I took out a razor blade and repeatedly slashed my left wrist in the shower. Luckily for me, I didn’t do enough damage and I survived. My left arm was crippled though. For the following weeks, while my wrist healed, I had to learn to tie my shoes and button my jackets with only one hand. Some people might think it was a cry for help, but it wasn’t. I didn’t tell anyone for a long time. I simply wanted to die because I could no longer stand being depressed. I still have the scars. They are a reminder of everything I’ve gained from failing—my lovely wife, my beautiful children, and decades of life.

Though I survived the first attempt, the ghost of depression wasn’t done haunting me. In December of 1997, it again pushed me over the edge. This time I tried to asphyxiate myself in the early morning hours by running my parent’s car in the garage with the door closed, but I broke down in tears and shut off the engine before I could pass out.

Obviously, I suck at committing suicide.

My experience with clinical depression is probably not that different from those who suffer from other kinds of debilitating chronic pains. In fact, those who suffer from what are called cluster headaches have nicknamed them suicide headaches, while sufferers of trigeminal neuralgia refer to it as the suicide disease, precisely because the sheer intensity and relentlessness of these conditions sometimes pushes them over that precarious edge.

Aside from chronic depression, I also suffered from chronic anxiety. I was routinely “on edge” and excessively worried about all kinds of things, big and small. I agonized about every little conversation I would have, about sounding stupid or running out of interesting things to say. The anxiety paralyzed me socially and led me to withdraw further into my shell. While I was studying at university, there was a long path in the middle of a field leading from the dormitories to the main campus, which always had a flow of students coming and going. I remember worrying intensely about who I might come across and what I would say to them. My heart would pound with fear, and I suffered panic attacks, feeling like I could barely breathe.

Since I naturally tended to be shy and stoic, I rarely spoke of my depression and anxiety with anyone. I quietly kept toughing these problems out on my own. For most of my youth, I assumed these feelings were entirely normal. Oh, how wrong I was!

The Great Suffering of humankind

No matter how bad my own chronic suffering may have seemed to me, it was but a single drop in the torrential rainfall bearing down on humanity today. There is no denying it: the world is in the midst of a crippling epidemic of unhealthy pain, which I’ve been calling the Great Suffering. This cancerous mass of pain has steadily grown over the past few decades, and in many ways we are all suffering more than ever:

We’re suffering from more anxiety and depression. According to depression researcher Dr. Mark Williams of Oxford University, in 1960 “people would live out most of their life without getting these crushing depressions. But now 35-36 percent get depressed before the age of 18.” Medical doctors aren’t immune to depression, just like they aren’t immune to obesity—a full third of Canadian physicians experienced depression according to a recent Canadian Physician Health survey. Anxiety and depression have significantly increased in the past fifty years, which are now at epidemic proportions. Suicide has also increased, with nearly one million people across our planet dying of suicide every single year—roughly one every thirty seconds. Experts say that these increases aren’t due to genetic changes or improved detection. Dr. Archibald Hart, who has studied depression in children, observes that “children, more so now than in previous times, get depressed. The increase in the incidence of childhood depression is not due just to better diagnostic skills.” The number of emergency room visits by American children and adolescents due to suicidal thoughts or suicide attempts has nearly doubled between 2007 and 2015. “It’s very difficult to understand exactly what is causing [all of this] depression,” concedes Williams. According to the World Health Organization (WHO), for those countries with middle and high income, depression is currently the number one cause of years of life lost to disability. It is on track to become the number two largest health burden for all countries combined by 2020.

We have more mental health problems in general. The Center for Addiction and Mental Health for the Canadian province of Ontario reported that “between 2003 and 2011, there was a significant overall increase in self-rated poor mental health (from 4.7 percent to 7.1 percent).” Some hospitals report that twice as many youth are showing up with psychiatric problems in 2014 than a decade earlier. One in five Canadians experience mental health issues in any given year—more than those living with diabetes or heart disease—and nearly half will experience a mental illness by age 40. According to Marcia Angell, former Editor in Chief of the New England Journal of Medicine, the number of Americans so disabled by mental illness that they qualify for federal assistance has increased by two and a half times between 1987 and 2007. In the same time span, the number of children with mental illness has risen by an astonishing 35 times. Based on recent data, about 33 percent of Americans and 40 percent of Europeans could be classified as mentally ill, with 20 percent of American adults taking at least one psychiatric drug according to Medco Health Solutions, a pharmacy benefit manager. Mental and substance use disorders are now the number one worldwide cause of years lived with disability.

According to Dr. Hart, some researchers believe that anhedonia (the loss of everyday pleasures) is reaching epidemic proportions.

In the US, Dr. John E. Sarno observed a sharp increase in physical pain conditions from the 1960s to the 1980s, most notably involving the back. He wondered: “After a few million years of evolution, has the American back suddenly become incompetent?” Worldwide, pain researchers indicate that over one third of the global population now suffers from persistent or recurring physical chronic pains, and this is the number one reason for individuals to visit their doctor. This includes back pain, migraine headaches, arthritis, temporomandibular joint (TMJ) pain, diabetic neuropathy, and cancer pain. Tellingly, being a pain specialist is one of the fastest growing fields in all of medicine.

We suffer from more diseases and death. Over 3 million people worldwide die of alcohol-related causes per year, according to a 2014 report by the WHO. Worldwide, obesity has nearly doubled between 1980 and 2008. In some countries, the increase is even more dramatic: obesity rates in the UK, for instance, are now ten times what they were since the 1970s. Being overweight or obese increases the risk of heart disease, stroke, type 2 diabetes, and various cancers. Worldwide diabetes incidence has nearly quadrupled between 1980 and 2014, again according to the WHO, while there were nearly eight times as many Americans diagnosed with diabetes per capita in 2013 than in 1958. Thanks to improved drugs, the number of people dying of heart disease has decreased, but the number of those living with it continues to grow. Non-communicable diseases, which primarily consist of cardiovascular diseases, diabetes, cancers, and chronic respiratory diseases, have overtaken communicable diseases and now cause 63 percent of all deaths worldwide—with most deaths occurring in low- and middle-income countries. These diseases and deaths are primarily caused by indulgent lifestyle choices including unhealthy diets, lack of exercise, as well as tobacco and alcohol use, making them largely preventable.

KEY POINT #155: The world is experiencing staggering increases in anxiety, depression, and other physical and mental chronic pains, leading to increased disability and death.

My attempts at conventional treatment

The morning after my second failed suicide attempt, my father went to the garage, noticed the buildup of car exhaust and confronted me, as a concerned parent rightfully should. We were both very upset and, as you might imagine, it wasn’t an easy conversation. Once they realized what had happened, my parents brought me to the local mental health hospital to try to get me some much-needed help. I sat down with a young doctor who was assigned to assess me. For a stoic, shy person such as myself it was no small feat to pour out my darkest feelings and my recurring desire to end my life, but after much hesitation I eventually managed. Then a funny thing happened: a second young doctor came in to assess me, asking me for the same personal details. Did the first one not take good notes? The second doctor left, only to be replaced by a third and then a fourth doctor. It dawned on me that we must have showed up on resident training day. Finally, I was sent to an established psychiatrist, the last one I’d see. She didn’t ask about my diet, exercise regimen, or other lifestyle habits. What she did do was to try her best to match my problematic symptoms to whichever drug she believed would most likely treat them. I was prescribed fluvoxamine—an antidepressant—and was told I’d be on it for at least two years. I now realize that many doctors continue prescribing antidepressants indefinitely as a sort of insurance against the possibility of a future relapse into depression.

So, did the antidepressants actually help me? It’s a little hard to tell. They might have reduced the frequency of my depression, yet I continued to experience periods of intense melancholy despite taking them exactly as prescribed. And on top of this, I now had to deal with several side effects. For starters, my mouth felt constantly dry no matter how much I drank. The drug also zapped my libido and made it nearly impossible to enjoy sex. I was sometimes drowsy during the day, once even falling asleep in the middle of a work meeting, which had never happened to me before—and I had been in lots of boring meetings, let me tell you!

To top it off, I had to deal with more frequent, vivid nightmares. In one of them, which seemed to mirror my waking life, I had been heavily drugged—by my own family, no less. The drug-induced stupor was wearing off and I realized: I’m being medicated against my will. One of my relatives noticed that my speech wasn’t as slurred anymore, so she turned towards the others and told them sternly, “He’s talking too fast—quick, give him more drugs,” and they started surrounding me so I couldn’t escape. One pulled out a needle. I woke up drenched in sweat.

Conventionally treating the world

What about the world at large? Humankind is living through its own nightmarish epidemic of chronic fatigue, chronic migraines, depression, and other forms of unexplained suffering. Doctors worldwide are struggling to understand and treat this deluge of unhealthy pain. Where does it all come from? When attempting to diagnose pain in their patients, doctors often can’t find any underlying physiological cause. In fact, pain researchers worldwide, including the US National Academies of Sciences, Engineering, and Medicine as well as the American Academy of Pain Medicine concede that chronic pain simply does not have any detectable underlying cause.

When it comes to crippling headaches, the US National Institute of Neurological Disorders and Stroke concedes that “there is no absolute cure for migraine since its pathophysiology has yet to be fully understood.” Similarly, doctors admit that they do not know what causes fibromyalgia—a disorder characterized by widespread musculoskeletal pain and fatigue—nor do they have any diagnostic tests for it or effective ways to treat it. The same goes for chronic fatigue syndrome. “Most people with chronic pain are never ‘cured’ [of their pain], and that’s a difficult thing to be told,” says chronic pain specialist Beverly Thorn of the University of Alabama. When it comes to chronic anxiety, the American National Institute of Mental Health admits they simply don’t understand the cause of panic disorder, one of the worst forms of anxiety.

What about other mood disorders? Jennifer Payne, assistant professor of psychiatry at Johns Hopkins School of Medicine and director of the Women’s Mood Disorders Center, says the field of psychiatry doesn’t understand mood disorders very well—including depression—admitting, “We don’t know what the broken part is.” Dr. Joseph Glenmullen, psychiatric medication expert, agrees and says that while there has been “no shortage of alleged biochemical explanations for psychiatric conditions,” such as major depression, anxiety disorders, and attention deficit hyperactivity disorder (ADHD), “not one has been proven. Quite the contrary. In every instance where such a [chemical] imbalance was thought to have been found, it was later proven false.” However, there is growing medical recognition of a new concept called central sensitization, which is the idea that many pain conditions that were previously thought to be unrelated—fibromyalgia, migraines, irritable bowel syndrome, restless legs syndrome, tension-type headaches, some forms of arthritis, chronic depression, and so on—may actually share a single central cause. However, most researchers trying to solve central sensitization are focusing on the nervous system, hunting for a broken part that can be fixed. Sudism suggests that this is the wrong place to look.

Furthermore, many doctors and their patients hold the view that unwelcome pain of any kind must be treated and that the preferred approach is by administering drugs. Diet, exercise, and other natural remedies are rarely invoked by conventionally-trained doctors. According to Marcia Angell, former Editor in Chief of the New England Journal of Medicine, medical doctors used to rely heavily on psychotherapy—talking with the patient about their troubles—to treat mental illness; that is, until psychoactive drugs became available in the 1950s. Nowadays, they nearly always treat mental illness by prescribing such drugs, while therapy has been relegated to occasional use. If the medical approach actually solved these patients’ aches and pains, then the story would have reached its happy ending and there would be no need for this book. However, pain researchers admit that current pain relief therapies either don’t work well or cause severe side effects. Meta-studies have found that antidepressants are generally ineffective except for the most severe cases of depression. In some cases, they actually increase thoughts of suicide. After reviewing a large body of evidence, a multinational team of researchers drew an even starker conclusion: “The weight of current evidence suggests that, in general, antidepressants are neither safe nor effective; they appear to do more harm than good.”

After a lengthy career—including being the first chief of the American National Institute of Mental Health’s Center for Studies of Schizophrenia—psychiatrist Dr. Loren Mosher tended his resignation letter in 1998 to the American Psychiatric Association. In it, he declared that “psychiatrists have become the minions of drug company promotions” and that “we condone and promote the widespread use and misuse of toxic chemicals that we know have serious long term effects—tardive dyskinesia, tardive dementia and serious withdrawal syndromes. So, do I want to be a drug company patsy who treats [patients] with their formulary? No, thank you very much.”

However, there are glimmers of hope: some treatment centers, like the Mayo Clinic Pain Rehabilitation Center, approach chronic pain by getting patients off their pain medications and onto physical therapy instead. They reason that if their pain medications were actually effective, they wouldn’t be seeking their help. In the UK, some doctors are starting to hand out social prescriptions—prescriptions to things like art classes and walking groups—when they feel medication isn’t working. But these approaches, at least in Western societies, appear to currently be the exception rather than the rule.

KEY POINT #156: The majority of Western doctors and researchers don’t truly understand what causes chronic back pain, migraines, depression, and other forms of unhealthy pain, nor how to effectively treat these.

Conclusion of Part Six

The global increase in indulgences has grown roughly in parallel with the world’s Great Suffering. Meaningless suffering is afflicting more of us each and every day. Is this suffering inevitable, or are we simply paying the price for pushing the “pleasure” and “pain relief” buttons over and over? Is there anything we can do to solve this worldwide crisis once and for all? In the next, final part of the book, we’ll try to answer these important questions, the sudist way.

Summary of Part Six

Here is a summary of all key points from Part Six. It can be used as an optional refresher or an executive summary.

#152: The variety, availability, and intensity of pleasant indulgences have increased significantly in recent years, from bliss-maximized foods and 24/7 entertainment to painkillers and recreational drugs. Our worldwide indulgence load—the sum of all our indulgences—has been steadily rising.

#153: The number of ways we have found to numb or entirely avoid pain and effort has significantly increased in recent years.

#154: As illustrated by my own experience, major depression can severely darken our perception of the past, present, and future, to the extent that suicide seems like the only way out of our suffering.

#155: The world is experiencing staggering increases in anxiety, depression, and other physical and mental chronic pains, leading to increased disability and death.

#156: The majority of Western doctors and researchers don’t truly understand what causes chronic back pain, migraines, depression, and other forms of unhealthy pain, nor how to effectively treat these.

PART SEVEN: SOLVING THE PROBLEM WITH SUDISM

Introduction—treating unhealthy pain, the sudist way

The cause of, and solution to, unhealthy pain and anhedonia

The three illusions of indulgence

The secondary effects of indulgence

The ideal world

What are pain signatures?

Sudism versus conventional medicine

Make the connection!

Philosopher, heal thyself

IN-DEPTH: Should we maximize or minimize our pleasure and pain?

Realignment—Applying sudism to optimize our health and our affects

The rewards of applying sudism

The meaning of life

IN-DEPTH: The future

Final conclusion

Summary of Part Seven

Introduction—treating unhealthy pain, the sudist way

At this point, it’s worth restating our initial problem statement about the Great Suffering of humankind, which is affecting countless people in countless societies worldwide, and which award-winning author and mindfulness teacher Danny Penman had summarized like this:

We live in a world filled with material wealth. We have never had so much political and economic freedom. We live longer and healthier lives. And yet, anxiety, stress, unhappiness and depression have never been more common.

In other words, we’ve made so much progress technologically, politically, and materially, yet we seem to be moving backwards when it comes to our mental health.

On the other side of the North Sea, we find Dr. Petter Borchgrevink, the head of the National Centre for Complex Disorders and Pain Centre in Trondheim, Norway. Borchgrevink’s country has the unfortunate distinction of having the highest percentage of pain patients in all of Europe. His frustration in trying to manage all of this chronic physical pain is palpable:

In the long term, the hope is that we can solve the great pain puzzle: Why and how does pain occur with no apparent reason? Why haven’t we found the cause of prolonged pain that is not caused by damage to body tissue?

Why is this? With suduality as our foundation, we can answer that question once and for all.

The cause of, and solution to, unhealthy pain and anhedonia

By now, the sudist view on the cause of (and solution to) all of our unhealthy pains and anhedonia may already seem evident. But let’s try to make it as clear as possible. Remember, this isn’t the medical or psychiatric approach to solving unhealthy pain, it’s the back-to-basics philosophical approach.

In Part Two, we defined suduality as the long-term balancing act between pleasure and pain, which can be written as this basic equation:

In Part Four, we broke this simple equation down further, which taught us that we had some control over our non-induced pleasures and pains:

Based on the concepts of healthy and unhealthy pains and pleasures from Part Five, we can break this equation down even more:

We directly control all of our induced pleasures and pains, which make up four of the eight parts in the above equation. And, as we’ve seen before, by manipulating those four induced components we indirectly have some degree of control over the remaining four non-induced components.

Let’s add one last dimension to this equation: size. In the previous diagrams, all components had the same size, which might imply that we experience each of these in equal amounts. This is rarely, if ever, the case. Most of us who seek pleasure and avoid pain will boost our induced pleasures as much as possible, while minimizing our induced pains. Proportionally speaking, it ends up looking like this:

The above is a pretty accurate picture of the average pleasure-seeking, pain-avoiding person. They take in as much indulgent (unhealthy) pleasure as they can, which is why that octagon is large. They avoid pain as much as possible—even legitimate healthy pain—using medication or other means, hence the two healthy pain boxes are small. However, this disproportionate lifestyle has several unintended consequences. The first is that they suffer from anhedonia, which is why the two healthy pleasure boxes are small. The second is that they suffer from extensive chronic pain, which is why the non-induced unhealthy pain octagon is large. And if you’re sharp-eyed, you’ll have noticed that two of the boxes have completely disappeared. Why? Well, non-induced healthy pleasure tends to only happen to those who are deficient in pleasure, which certainly isn’t the case here. And this kind of individual does not seek out unhealthy pain, hence the induced unhealthy pain is also gone.

How can we fix this? How can we get rid of the chronic pain and anhedonia that plague these individuals?

Remember that unhealthy pains occur because we’ve experienced too much pleasure and not enough pain. So if we try to indirectly decrease non-induced pains (by increasing our induced pain or decreasing our induced pleasure), then the unhealthy non-induced pain will decrease before the healthy non-induced pain does.

So, the more we induce healthy pain, the more the following will eventually happen:

A. unhealthy pain will decrease, and

B. overall pleasure will increase

Similarly, the less we induce unhealthy pleasure, the more the following will eventually take place:

A. healthy pleasures will increase, and

B. overall pain will decrease

As we start applying these strategies, the prior diagram will start transforming into something like this:

If we apply the above strategies even more, we’ll eventually approach an optimal lifestyle. One where we stop indulging in unhealthy pleasures, where non-induced unhealthy pains are entirely eliminated, and where non-induced healthy pleasures are maximized. The alignment between health and affect are also maximized. It looks something like this:

If we were to start from this optimal lifestyle and go in the opposite direction by inducing more unhealthy pleasure and decreasing our healthy pains, it would predictably lead to a less optimal lifestyle: more unhealthy pain and less healthy pleasure.

Since indulgences are any activities that either increase unhealthy pleasure or reduce healthy pain, we can reword the above as follows: increasing indulgences leads to either increased unhealthy pain or reduced healthy pleasure (anhedonia).

So, from sudism’s perspective, the cause of all chronic pain and anhedonia is straightforward:

KEY POINT #159: Chronic pain and chronic anhedonia are both caused by chronic indulgence.

Put another way, chronically taking positive effects leads us to chronically receiving negative effects. Pleasure without purpose leads to pain without purpose—or its (equally) evil twin, anhedonia. Sudism shows us how to cure chronic pain and chronic anhedonia by treating the root cause of it, instead of trying in vain to treat the symptoms. Sudism doesn’t say we can’t have any pleasure, it simply advises us to choose our pleasures wisely.

Buddhism tells us to give up all desire in order to give up all suffering, but sudism instead teaches us to give up only unhealthy desires in order to give up only unhealthy suffering and anhedonia. Healthy suffering is still needed for us to be healthy—we don’t want to give it up!

How do we know when we’ve reached perfect alignment between our affect and our health?

Unfortunately, we don’t. There is no way to tell when we’ve reached perfect alignment. Even if we do everything right, our alignment will oscillate over time—sometimes we’ll have a little unhealthy pleasure or pain, or experience less healthy joys and aches than we should. And that’s okay. It’s striving for alignment that is most important of all.

KEY POINT #161: Sudism promotes alignment, not enlightenment.

The three illusions of indulgence

Many of us fall for the three illusions of indulgence. The first illusion happens when we start partaking in the indulgent substance or activity of our choice, whether it’s alcohol, sweets, video games, retail therapy, or otherwise. At the beginning, we might experience pleasure without yet experiencing any side effects. This could be illustrated as follows, where the horizontal axis represents time and the vertical axis represents the affective impact of the indulgence. That is, anything above the horizontal line is pleasure and anything below is pain:

We conclude that our indulgence brings us pleasure at no cost. That’s the first illusion. However, as we continue to regularly indulge, the effects of suduality soon kick in to preserve the long-term balance between our joy and suffering. Gradually, almost imperceptibly, there is a shift in the affective impact of our indulgence. The way we feel now looks like this:

At this point, we may be suffering from counterbalancing depression, anxiety, anhedonia, irritability or any number of aches and pains in between each dose of our indulgence. In addition, our indulgences don’t give us as much pleasure as they used to. It’s easy to believe the second illusion, which is that if we did not have our indulgence to perk us up, we would simply be miserable all of the time. We come to believe that the only way we can escape our aches and our bad moods is to partake in our chosen indulgence. This illusion makes it even more difficult for us to quit our bad habits. What we often don’t realize is that these negative symptoms are in fact caused by our indulgence.

Finally, if we do quit, we’ll probably be miserable for a while, since we’ll have to undergo a period of withdrawal while our minds and bodies adapt to living without the indulgence. This is because we have built up a significant amount of negative tension due to our indulgence. At this stage, we feel rather low, like this:

This only serves to reinforce our belief that we should’ve never quit, and many of us will relapse into our old ways at this stage. The third illusion is that we will never feel better, that our mood will never recover back to normal. But if we tough it through the withdrawal period, which may take days or weeks, our minds and bodies do eventually recover. We will naturally go back to our pre-indulgence, comfortable neutral stance, which looks like this:

Once we reach this final stage, we can finally look back and realize how these three illusions had deceived us. All of this unnecessary misery was in fact caused by our own indulgence.

The secondary effects of indulgence

Indulging on a regular basis can affect us in so many negative ways. Sudism teaches us that the primary long-term effects of indulgence are a decrease in healthy pleasures and an increase in unhealthy pains. However, because indulgences also steer us away from healthy behaviours, they tend to lead to many other long-term health problems, which we’ll call secondary effects. Here’s a partial list of secondary effects that can be caused or aggravated by our many indulgences. Let’s be clear: many of the following issues can also be caused by things completely unrelated to indulgence. Sudden weight loss, for instance, may be due to something as simple as dieting or as drastic as cancer.

That said, indulgences may cause or aggravate the following issues:

Various physical illnesses such as those caused or aggravated by obesity (including diabetes, heart disease, and stroke), by excessive sodium intake (including heart disease and stroke), or by excessive sugar consumption (including tooth decay and weight gain), or by long-term alcohol or nicotine consumption (including various cancers and organ damage). Drugs and alcohol may also lead to congenital defects in unborn children. Altogether, these cost untold billions of dollars in worldwide health care.

Blunted or flat affect, a lack of emotions, including losing our playfulness and our ability to laugh or smile. This may arise from depression, drug use, or medications, among other reasons.

Decreased interest in normal healthy activities, such as a loss of libido, appetite, or interest in former hobbies. Some may begin neglecting their friends and family. This shift may occur due to depression, drug use, or other causes.

Increased interest in less healthy activities, such as gambling, recreational drugs, video games, or watching TV for hours on end. This often occurs due to some degree of addiction.

Decreased ability to carry out daily activities: According to the International Association for the Study of Pain, research shows that the majority of Europeans suffering from chronic pain feel that it impairs their ability to do household chores, drive, or even do simple things like walking and climbing stairs. Chronic pain may also prevent people from doing the things they would normally enjoy, such as exercising, working, or having sex. Meanwhile, anxiety may cause the person to steer clear of all kinds of situations—like avoiding conversations for fear of being ridiculed, or avoiding elevators due to a fear of falling. These fears can have a significant negative impact on their education, work life, family life, and other relationships.

Decreased work productivity: Non-communicable diseases (NCDs) such as cardiovascular disease, diabetes, and cancer have a significant negative impact on worker productivity. Most NCDs are primarily caused by poor diet, lack of exercise, and tobacco or alcohol use. However, the number one cause of workplace disability worldwide isn’t any of these diseases, it is depression, according to the Government of Canada. American doctor John E. Sarno had observed that some of his patients suffering from psychogenic (unhealthy) pain were confined to their beds, therefore significantly more disabled than an average paraplegic.

Increased financial burdens: The above-mentioned diseases place heavy financial pressures on those affected, due to the high costs of treatment as well as the negative impact on their ability to gain income. It also places a huge burden on our health care systems, while increasing wait times for all of us.

Lying to hide bad habits or addictions in order to avoid being judged or punished, or lying to obtain money or other resources to help fuel an addictive habit.

Prostitution, theft, and even murder, to fund drug habits or other expensive addictions. In some cities where accused criminals are routinely tested for drug use, such as Bradford, England, a surprising half of those charged with theft, burglary, and robbery test positive for either heroin or crack cocaine.

Suicide: Have you ever wondered why anyone would want to commit suicide? According to Dr. Alex Lickerman, the majority of suicides are motivated by either persistent depression, or by physical pain that’s so severe that the sufferer sees no escape from it. This includes those with severe chronic pain such as cluster headaches, chronic abdominal pains, and chronic musculoskeletal pains. In other words, severe cases of unhealthy pain may be the primary cause of suicide. Thoughts of suicide may be further increased by sleeping pills, attention deficit hyperactivity disorder (ADHD) medications, immunotherapy drugs, recreational drugs, and alcohol.

Homicide, carried out in the belief that others are suffering as much unhealthy pain as we are, or perhaps that our loved ones are against us, or simply due to reckless disregard of other people’s lives while killing oneself. In a striking example, on March 24, 2015, co-pilot Andreas Lubitz deliberately crashed a Germanwings passenger plane into the French Alps, killing all 150 people on board. He had been suffering from severe depression and anxiety according to sources close to him, and had ignored his doctor’s order that he was mentally unfit to fly. In Finland, an analysis of all homicides between 2003 and 2011 revealed that roughly 80 percent of homicides were carried out under the influence of alcohol, with a further subset of homicides carried out under the influence of other drugs. Mass murderers are often motivated by a vengeful anger against others—how much of their rage is fueled by their indulgences?

Premature death from other causes, like overdosing on recreational or prescription drugs, or dying in a car accident caused by alcohol impairment. For instance, a surprising one in eight deaths in 25- to 34-year-olds in Ontario, Canada is due to opioid overdose. In America, opioids are now the second-leading cause of accidental death after car accidents.

Attention deficit problems (such as the inattentive subtype of ADHD), partly or wholly due to overstimulation from video games, music, other forms of entertainment, internet content, and so on.

Schizophrenia: Several case studies suggest that some cases of schizophrenia occur when the sufferer willingly withdraws into an internal fantasy world because reality has become too difficult to bear. The trigger for this withdrawal may be a traumatic event such as sexual abuse or parental neglect.

Being underweight or overweight, which may be caused by eating unhealthy foods, or a reduction (or increase) in appetite due to drugs, medication, or depression.

Sexual dysfunction as a side effect of certain medications or long-term drug or alcohol consumption.

Increased disharmony in interpersonal relationships: Most people with chronic pain report that it has negatively impacted some of their close relationships. Increased irritability or anxiety caused by indulgences may for instance lead to increased fighting among couples, family members, and friends.

Altered personality: Indulgences over the long-term can change one’s personality in what may be a permanent fashion, persisting even after those indulgences have ceased. Like the way a river gradually carves a space into stone, that space will persist even if the river runs dry. My own river of chronic depression and anxiety carved within me the habit of socially withdrawing from others. And even though I no longer suffer from these illnesses, those habits live on to this day.

KEY POINT #162: Reducing our consumption of unhealthy pleasures may not only lead to a reduction in our unhealthy pains and anhedonia, it may also reduce our likelihood of suffering from the secondary effects of indulgence, including diabetes, heart attacks, strokes, ADHD, relationship troubles, and even suicide and homicide.

The ideal world

Sudism points us in the direction of an ideal lifestyle. One in which our heads and backs ache only when they are actually injured or overworked. One in which our hearts and souls ache only when we’ve lost something truly precious. One in which we are not robbed of our share of healthy pleasure when it is due. Has humankind ever lived in this ideal world? And can we ever reach it again?

The ideal world of the past

As we saw in The rise of unhealthy pain and anhedonia, there is a worldwide trend towards increasing unhealthy pain. This suggests that if we reverse the process and go backwards in time there may have been an ancient era when humanity experienced little or none of these unhealthy aches. Similarly, we saw in The systematic eradication of healthy pain that people are doing less and less physical work while zapping more and more useful pains with all kinds of medications. Again, if we go backwards in time and undo all of this technological progress, we might end up in an era like the Paleolithic. Back then, if we wanted food, we had to chase it down or forage until we found it. If we wanted shelter or clothing, we had no choice but to make these from scratch from whichever materials we could find. There simply were no mass-produced goods. Much hard labour was required to satisfy our basic human needs. “We evolved in a much different world, with much less choice and no sedentary people,” as per evolutionary psychologist Nancy Etcoff.

So, we can hypothesize that, in ancient times before the advent of drugs, technology and modern indulgences, the various pains endured in manual labor, along with our other natural aches such as loneliness or hunger, provided plenty of sudist fuel for the pleasant activities of those times. And those ancient activities were much more modest in intensity and availability compared to our modern maximum-bliss foods and 24/7 entertainment. One can argue that our current physiology, including the way our minds dispense pleasure and pain for each activity, were finely calibrated for maximizing our health in an era like the Paleolithic. This is obvious, for instance, when you look at our strong desire for sugar and sodium, which used to be relatively rare but are now overabundant.

The ideal world today

There are also clues to be found in some modern-day primitive cultures. There is some evidence that modern tribespeople suffer very little unhealthy pains. Researcher Edward L. Schieffelin spent three years studying the Kaluli tribe of New Guinea. Their lives involve much hard labor, where men hunt and fish, erect structures, and pulverize sago-palm trunks to make flour, while women tend to the crops and the pigs, hunt small forest prey, and raise the children. In these three years, after carefully interviewing over 2,000 of these men, women, and children, he only found one single case of depression among all of the Kaluli. In other less-primitive present-day societies, according to some longevity researchers, the people who live the longest—and are thus arguably among the healthiest—generally eat a lot of fresh whole foods (as opposed to savourized and sweetened processed foods) and do most of their physical work manually instead of relying on machines: they walk everywhere and do all of their house work, kitchen work, and yard work by hand.

The divergent world today

It’s becoming clearer how many modern societies, especially Westernized societies, got to where they are today. By chasing pleasure and running away from pain as if they were two independent things, their indulgence load progressively grew. By the balancing principle of suduality, they were then subjected to increasing amounts of unhealthy pains while their healthy pleasures continually dimmed. This is how chronic anhedonia, depression, anxiety, back pain, migraines, fibromyalgia, and the like, rose in lock-step with their indulgences. Their pleasures and pains grew progressively out of alignment with optimal health.

What are pain signatures?

When we are out of alignment and suffer from chronic, unhealthy pain, a curious thing happens: we don’t all experience the same kinds of unhealthy pain. I tend to become highly anxious, while my wife tends to get quite irritable. Some might become profoundly sad and mopey, while others feel their joints or backs flare up. It truly seems that we each have our very own pain signature—our minds’ preferred brand of unhealthy suffering. Certainly, our pain signature might be partly shaped by our genes. But our pain signature also seems to evolve over time. For instance, when we encounter major illnesses or injuries, the pain associated with them may become part of our signature for the rest of our lives. This may help explain why some injury pains linger on even though the area appears to have completely healed. Likewise, if we experience a traumatic loss, our heartache may also join the constellation of aches that make up our pain signature.

This helps explain why the same chronic indulgence can cause different chronic pains in different people. Eating large quantities of sugar may trigger chronic itchiness in one person while causing chronic fatigue in another. It’s no surprise that chronic pain has traditionally been difficult to solve: it is truly a shape-shifter.

What is your pain signature?

Sudism versus conventional medicine

Medical researchers, as we’ve seen, are struggling to find the root cause of chronic pain. While some search for physical anomalies in the body, others hunt for chemical imbalances in the brain. But sudism teaches us that chronic pain is not ultimately caused by a physical anomaly that can be surgically corrected, nor a brain chemical imbalance that can be restored. Rather, chronic pain and chronic anhedonia are both directly caused by chronic indulgence.

To make matters more confusing, sudism doesn’t tell us which indulgence causes which unhealthy pains (or which losses of healthy pleasure). As we’ve touched on in Pain signatures, they could be of any kind and in any combination. A certain chronic pain—such as migraines—may be caused by a mix of indulgences that vary widely from one sufferer to the next. Researchers looking to isolate a single cause may overlook many other potential causes. Analyzing such a wide variety of causes in any single patient, or in any single medical study, poses a significant challenge to doctors and researchers.

At the risk of stating the obvious, sudism doesn’t replace the vast bodies of medical or psychological knowledge. It merely complements these. It’s just another tool in our toolbox. Sudism clearly has its own severe limitations. Though sudism can be used to improve our health, it clearly can’t cure all illnesses or solve all of our problems. It simply can’t help us fix things in our bodies and minds that aren’t somehow connected to pleasure and pain. If our knee cartilage has worn out or we have a torn ligament, sudism obviously can’t fix those body parts. It can only encourage us to bear the pain as much as we can, while leading us to healthier ways to reduce the ache without resorting to painkillers. Conventional medicine, on the other hand, can often help fix these kinds of physical problems that we can actually see and measure.

KEY POINT #165: Science is great at fixing problems we can see and measure, while sudism is great at fixing problems we can feel but neither see nor measure.

As we saw in We don’t always react the same way to the same thing, just because we have a permanently damaged body part does not mean this part of us is destined to ache forever. Many who have extensive damage—such as significant joint damage—do not feel any pain, confirms Daniel Clauw, MD, Director of the Chronic Pain & Fatigue Center at the University of Michigan. Meanwhile, many whose joints look perfectly healthy cause them agony. Tissue damage does not automatically imply pain, and pain does not always imply tissue damage. Even if we have a badly damaged body part, we should not assume it is doomed to ache for the rest of our lives. Conversely, if we have excruciating pain somewhere in our bodies, we should not assume there is something wrong with that physical part of us.

Make the connection!

Friends, colleagues, and people everywhere, please hear me! Most of us, including myself, do the following to varying degrees:

1. We indulge in unhealthy pleasure

2. We indulge by avoiding healthy pain

3. We suffer from anhedonia

4. We suffer from unhealthy pain

We tend to think of these four things as being fundamentally independent from each other, but as we saw in All pleasures and pains are interconnected, sudism teaches us that they are all fundamentally interconnected. Case in point: Dr. Joseph Beasley, author of several books on treating alcoholism, wrote about finally making the connection himself: “At no point in my life did it occur to me that my many car accidents (including fights), failed relationships, medical problems, and depression were a consequence of my drinking. It was only after my alcoholism had been identified and treated that I was able to clearly see the path of carnage that alcoholism had cut through my life.” In her own book Blackout: Remembering the Things I Drank to Forget, Sarah Hepola made a similar realization after becoming sober: “I finally understood alcohol was not a cure for pain; it was merely a postponement.” Similarly, daily adolescent marijuana users often don’t see the connection between their pot consumption and the resulting negative effects, according to the California Society of Addiction Medicine.

It also took me decades to make that precious connection. I thought my chronic anxiety, chronic irritability, and high intake of sweets were all perfectly normal and completely unrelated. It wasn’t until after I gave up added sugars that I realized how wrong I was. Paradoxically, the sweets that I used to help me cope with anxiety and stress were causing most of my anxiety and stress. I didn’t realize until my thirties that (A) my chronic nervousness and irritability were abnormal, (B) they were connected to what I was eating, and (C) I had the power to fix them all along. Connecting these seemingly-unrelated things together was truly a revelation. I hope that you experience the same kind of revelation:

KEY POINT #167: Many of us don’t know what is causing our suffering simply because we don’t realize there is a direct connection between our indulgences and our various aches and anhedonia.

KEY POINT #168: Our habits—what we eat, drink, do, and don’t do—strongly influence our mood: whether we’re irritable or in good spirits, energetic or tired, playful or depressed.

Sudism teaches us that we do have control over our unhealthy pains, whatever they may be.

Exercise—connecting your own pleasures and pains: I strongly encourage you to have a look at the list of the many kinds of pleasures and pains in the Appendix, and try to recognize where you fit in this list. What pleasures and pains do you experience too much of or too little of? Then make the connection between them!

Philosopher, heal thyself

Here is the last relevant piece of my own life story.

In early 1998, my psychiatrist told me matter-of-factly that I would be on antidepressants for at least two years—and possibly forever. But I hated the idea of being medicated, and the side effects of fluvoxamine were just wearing me out. After a year of taking it as prescribed, I chose to wean myself off without my psychiatrists’ consent. And by early 1999, I had completely stopped taking the drug.

For the longest time, I thought sudism was an interesting but rather useless, and even depressing, philosophy. However, at the turn of the millennium, it finally dawned on me that sudism wasn’t just a toy. It was not merely a kaleidoscope that made us see everything differently, that we then put away before going back to serious business. I started to realize its enormous potential. After years of dragging myself through life, with the ball and chain of meaningless suffering clasped to my ankle, the idea finally struck me: what if I used sudism—instead of medication—to get rid of the depression that was weighing me down? So, I started cranking up my healthy pain by exercising more, in fits and starts. Yes, it was tough to get motivated at first! I also started eating somewhat healthier, cutting down on soda pop (though I still ate plenty of other sweets), and making friends with my former arch-nemesis, Brussels sprouts. I even went without a TV for a couple years. After quitting antidepressants and making these changes, I never felt depressed again. Now I can’t fully discredit antidepressants. It is possible they had some sort of long-term impact that prevented me from relapsing into depression. Or maybe my particular streak of the blues would have ended on its own, with or without antidepressants. Who can be 100% sure?

However, any personal doubts I had about the practical value of sudism were laid to rest ten years later. You see, ever since I was a child I had a sweet tooth. I’d have sweet snacks and desserts several times each day. It was my crutch that helped me cope with stress. In 2010, I gathered all of the willpower I had. And in one big push, I said goodbye to all cookies, cakes, chocolate bars, sugary cereals, you name it. I also cut down on sodium. I believed that I’d obtain some sort of positive benefit from sacrificing all of these pleasures. I secretly hoped that my insomnia or my digestive troubles might be cured.

For the first twelve weeks after making these changes, I experienced what one might call “withdrawal symptoms.” The first two weeks included a sore throat, joint pains, muscle weakness, fatigue, and headaches—and I had never experienced headaches before. Many others who’ve quit sugar report having similar withdrawal symptoms. These symptoms then faded away, though the weakness and fatigue persisted for another ten weeks before they too disappeared. Some days, I felt so shaky and weak that I could barely carry my 30-pound toddler. I’m glad I didn’t drop him!

While I went through “withdrawal,” I began to notice my mood improving. In fact, it improved tremendously. I was much less irritable than before, and when I got angry, it was of a much lower intensity and duration. My wife was astonished that I no longer sulked for hours or days after we argued, remarking, “You bounce back so fast now!” And, to my surprise, my lifelong chronic nervousness and anxiety, which I thought was an integral part of me, virtually melted away. That was the moment I realized I had been suffering from chronic anxiety all along.

KEY POINT #169: Even if we have suffered from a given physical or emotional ache for our entire lives, it does not mean it’s an inevitable, unchangeable, or incurable part of us.

This isn’t to say that I no longer worry. I still do from time to time, like when I give presentations in front of large audiences. But the amount of worrying is so mild and brief compared to my former levels of anxiety. And my worries now seemed to serve actual, useful purposes: to motivate me to do my best. I still make stupid mistakes but I no longer agonize endlessly about them. Like Rick Foster, author of Happiness & Health, I felt much more relaxed and at peace after giving up sugar, and I still do ten years after. If you would have told me over twenty years ago that it was possible for me to feel as relaxed as I do now, I simply would not have believed you. I haven’t taken any psychiatric drugs since 1999, and generally avoid all medications—even common ones like acetaminophen. And I feel better than ever.

KEY POINT #170: It’s possible to feel good without drugs or medications. Sudism shows us how to resolve painful problems such as excessive anxiety and depression without relying on psychoactive substances. However, always consult a qualified doctor before altering the dosage of any prescribed treatments.

IN-DEPTH: Should we maximize or minimize our pleasure and pain?

Earlier in We can increase or decrease both our pleasure and pain, we briefly discussed how we can choose to increase both pleasure and pain in our lives, or we can choose to decrease both. Is it best to live a life packed with intense joy and suffering? Or is it better to try to erase all these feelings until we feel nothing at all?

Maximum pleasure and pain

What happens if we amplify both our overall positive and negative feelings as much as we can?

I hope I’ve shown in My darkest hour that feeling pain that’s too intense can be very dangerous. The mind becomes overloaded with agony. In accordance with the concept of blending, such intense pain overpowers all instances of pleasure that might occur. In agony we can no longer enjoy eating, socializing, and other everyday things. “A person consumed by pain has a very contracted view of life,” according to pain specialist Erv Hinds, “virtually all aspects are darkly colored by his perceptions of his pain experience.” Even our twin abilities to anticipate good things in the future and recall cherished memories of our past may both be wiped out. “We cannot feel good about an imaginary future when we are busy feeling bad about an actual present,” says psychologist Daniel Gilbert, “it’s a lot like trying to imagine the taste of marshmallow while chewing liver.” This pervasive darkness may lead to feelings of despair, hopelessness, and ultimately, suicidal thinking.

Surprisingly, experiencing too much pleasure may be just as dangerous. People suffering from bipolar disorder, for instance, periodically undergo what are called “manic” phases of heightened energy and euphoria. Due to blending, this prolonged euphoria appears to cancel out various pains, including healthy doses of fear. No longer being afraid of painful consequences translates to losing many of their inhibitions, which makes them particularly vulnerable, remarks psychologist Louis J. Cozolino, author of The Neuroscience of Human Relationships—“It’s like the CEO in their brain goes off to Bermuda.” They appear to see the world through “rose-colored glasses” and—again due to blending—have difficulty perceiving potential future pain from things like physical injury or financial loss. Feeling invincible, they act recklessly, including consuming excessive alcohol or drugs, having sex with many partners, going on wild spending sprees, making grandiose plans, and exhibiting other forms of poor judgment. Other than those suffering from manic depression, those under the influence of marijuana, alcohol, and other drugs similarly experience reduced pain perception as well as increased recklessness and disregard for negative consequences. This may lead to loss, injury, and in the worst case, even death.

There are many case reports of people who get high on drugs then subsequently drown in bathtubs or suffocate on their own vomit. Could this be because their drug-addled minds are so overwhelmed with pleasure—thus completely numb to pain—that they can no longer sense the painful warning bells of suffocation that would have normally roused them awake and caused them to cough out whatever was obstructing their airways?

From what we’ve seen above, a fascinating symmetry emerges. Feeling too much pain leads to difficulty perceiving pleasure in both the present and future, which results in reckless behaviour such as suicidal or homicidal thoughts. On the other hand, feeling too much pleasure leads to difficulty perceiving pain in both the present and future, causing reckless behaviour such as hypersexuality and reckless, life-threatening choices.

KEY POINT #171: Both extreme pain and extreme pleasure are unhealthy—they can lead us to make reckless, life-endangering decisions.

No pleasure and pain

What if it was possible to chase the other extreme? In other words, to completely eliminate all positive and negative feelings from our lives and achieve a perfectly neutral state—a state that some Buddhists call nirvana?

Well, in Pain is (usually) good for us, we saw that there are actually some people—such as those afflicted with congenital insensitivity to pain with anhidrosis (CIPA) or leprosy—who simply can’t feel certain physical pains. This absence of pain causes them all kinds of problems, including repeatedly injuring their hands, feet, and joints without realizing it, leading to irreversible damage. A lack of pain means there is no built-in alarm to help us avoid dangerous things, which has a powerful negative impact on our health and well-being.

On the other hand, a lack of pleasure would mean there would be no reason to seek pleasant activities. There would be no satisfaction in striving for our goals or falling in love. Without pain and pleasure, we’d be equally happy staring at a wall, dining at the Ritz, or being mauled by an angry bear. Among other things, we’d lose the desire to eat for there would be neither the pain of hunger nor the pleasure of eating to motivate us. We would cease to function properly and would wither and die—unless we were under the constant watch of a dedicated caregiver. We would no longer be human, really. It hardly seems like a worthy goal, does it?

KEY POINT #172: Feeling too little pleasure and pain is also unhealthy—it would lead us to reckless, life-threatening inaction.

The middle way

Ultimately, pleasure and pain in their various forms are a critical part of why we’re alive and thriving today. These are crucial evolutionary traits that have been passed down through thousands of generations to both you and me. Neither maximum pain and pleasure nor the total absence of these are desirable or healthy. Instead, there seems to be a healthy middle ground that we need for optimal health. Nothing more, nothing less. We must feel just enough pleasure and pain to motivate us to do the right things—such as avoid injury and starvation, while seeking shelter and companionship—but not so much that we start making reckless decisions. Living within this healthy range of joy and suffering is somewhat like what Buddhists call The Middle Way, the healthy middle between two unhealthy extremes.

Realignment—Applying sudism to optimize our health and our affects

At this very moment, as we saw in Part Six, flavour engineers are working tirelessly to maximize the flavour of everything we eat and drink. Video game designers are trying to immerse us in the most fun virtual environments that they can dream up. Internet content creators are fighting for our taps, swipes, and clicks by baiting us with alluring content. Drug dealers are trying to get as many clients as high as they can. And pharmaceutical companies are trying to get as many of us on as many prescription drugs as possible for as many conditions as possible, while conjuring up new conditions along the way. Not only are we surrounded by indulgences, we could say that they’re actually invading us from all sides. If we do not resist, we could easily be overtaken by them.

Many of us try to get the most pleasure and the least pain as we can on a daily basis. We are trying desperately to maximize our long term happiness. But sudism tells us that we’re aiming for the wrong thing because that kind of happiness simply does not exist. What’s worse is that our single-minded search for long-term happiness is having unanticipated, disastrous consequences. We should instead focus on aligning our affect with health, which will maximize our overall health.

So exactly how can we use sudism to fix our unhealthy aches and boost our healthy joys? Since sudism transcends any specific technique, it turns out that there are literally hundreds of ways. We can’t cover them all, but we can look at enough of them to give us a good idea of what works. Our ultimate goal is to optimize the alignment of our pleasures with health benefits, and optimize the alignment of our pains with health costs. If you look at the Appendix, this translates to doing less of the pleasant activities classified as “high range” and doing more of the unpleasant activities labelled as “low range.” The more you make these kinds of changes, the less you’ll experience unhealthy pains (that is, those classified as “high range”) and the more you’ll experience healthy pleasures (those stuck in the “low range”). This realignment process, which could be seen as narrowing the gap between affect and health, is what we’ll focus on next.

KEY POINT #174: There are hundreds of ways to apply sudism to maximize our health while minimizing our unhealthy pains and anhedonia. To succeed, we need to stop pushing the “pleasure” and “pain relief” buttons all the time, and instead seek aligned actions and activities.

Changing can be tremendously difficult and fantastically rewarding

We know there are healthier options in life, yet all too often we don’t choose them. This may be due to social pressure, or the desire to reward ourselves after a hard day, or for other reasons mentioned in If indulging isn’t healthy, why do we do it?

Sudism teaches us that hanging on to our favourite indulgences means also hanging on to their corresponding negative effects—which we may not even be aware of. Such a philosophy may seem like a letdown since it encourages us to give up some of our favourite things, but it is fair. If we want something good, we have to pay for it. No pain, no gain.

Simply believing in suduality can make it easier for us to move towards a healthier lifestyle, because we’ll know that giving up our guilty pleasures will not make us forever miserable. Letting go of these can take a lot of willpower, but it always pays off in the long run. It is much like waging a war in our own minds, between the part of us that wants to change and the part of us that wants to keep indulging. Like me, you’ve probably gone through years of forming indulgent habits or addictions, and changing these will be hard. Fighting off intense cravings can sometimes even feel like trying to move a mountain.

One common belief is that if our meals and snacks don’t taste great, well, what’s the point of eating? My Italian father-in-law is a very hard worker, and mealtime is serious business: “If every bite of food doesn’t make you go ‘Mmm, mmm, MMM!!’” he argues passionately, “what’s the point of living?” Is the ultimate goal of eating to maximize the pleasure of every bite, or is it simply to nourish our bodies? Consider herbivores, like rabbits and cows. Do they ever think, “If I have to eat one more blade of grass, that’s it, I’m going to throw myself in front of a car!?” Of course not. Rabbits even eat their own nutrient-rich poop!

Look at kale and spinach, which many nutritionists call superfoods. Did you ever consider rinsing a few leaves and eating them just like that? Many of us think eating such foods without dressings and sauces is odd, but it’s actually quite doable if you give yourself time to adjust. Think you can’t? Try it, you might surprise yourself!

Like most people, I’m a work in progress. I have my share of bad habits and make my share of mistakes. I am what I am, neither a monster nor a saint. My parents warned me that smoking and recreational drugs were bad, which helped me mostly avoid those traps. But then I naively stumbled and fell into other ones instead. However, it’s never too late to change! The more you struggle, the better the end result will be. Even reducing an indulgence—without eliminating it entirely—will yield benefits. It’s hard to succeed if you don’t even try. The power to change is in you and you can start today!

Consider these profound truths:

You ultimately have control over many of the pleasures and pains you experience.

You don’t always have to go along with what others expect from you.

You don’t always have to repeat past habits.

You are the architect of your own joys and sorrows.

Exercise—giving up an indulgence: I challenge you to give up a significant indulgence in your life, perhaps one you’ve already been wanting to stop but haven’t yet gathered the motivation to try. See it as a journey, an adventure! Sudism gives you a sort of guide rope that you can hold onto during this adventure and reassures you that you will not fall into a bottomless pit of despair. Even when things get difficult and you feel that giving up that indulgence was a horrible mistake, hang onto this rope. And keep following it forward until you start seeing the benefits. We’ll go over a step-by-step process on overcoming indulgences in the upcoming How to reduce unhealthy pains and anhedonia.

Indulgences do give us a reliable “fix” of pleasure, and our minds like these. The addicted part of us might fiercely try to protect its fix, and may feel threatened by sudism. Giving up an indulgence that we cherish might feel like we are throwing ourselves off a cliff because we feel we’re taking away something that makes us “happy” (however briefly) and that we’ll be forever miserable without it, but that’s just an illusion. When giving up a tasty but unhealthy food, we have to give ourselves (and our taste buds) time to adjust to the new, milder flavours. In time, those milder foods will taste better and our minds will stop resisting them. The same applies when giving up other unhealthy habits—we have to give ourselves time to adjust. We will see our natural pleasures increase, unnatural pains decrease, and all will be well again. We shouldn’t expect results overnight, but they will occur if we are patient. After giving up an indulgence that we strongly felt we needed, we’ll eventually realize a very important thing: we never needed it in the first place.

This is the absolute hallmark of unhealthy indulgences—we don’t actually need them to thrive and be happy. Yet we often don’t realize this until after giving them up.

It’s never too early to avoid consequences

When it comes to seeing the future, we are all somewhat shortsighted. However, children and adolescents are even more so. It’s not their fault. They just haven’t been around long enough to learn the long-term consequences of their decisions. To make matters worse, they’re blind to their own shortsightedness—after all, how can they see that they are shortsighted when they are shortsighted? So, they often think they “know it all” even though it’s clear to those who are older and wiser that they don’t. In an indulgence-laden world, this makes them particularly vulnerable to making poor choices. So children often choose junk food over healthy food, while adolescents might choose drugs over healthier activities without the faintest worry. They clearly see the short-term positive effects but are devastatingly blind to the long-term negatives. In the process, they may develop lifelong habits or addictions that may be difficult to reverse later on, even after they wisen up. Adults must therefore be the shepherds that guide, teach, and protect the young as they make key choices that may profoundly alter the course of their lives. Being unaware of consequences doesn’t mean there are no consequences. In the realm of pleasure and pain, ignorance is not bliss. Sudism teaches us that it’s never so early in life that we can avoid consequences.

It’s never too late to reap rewards

We might believe that, once we reach a certain age, it’s simply too late to benefit from changing our habits and routines. But suduality isn’t tied to specific time frames and affects us whether we are newborns or are living the last day of our lives. A retired pensioner might think, “There’s no point in trying to make healthy choices. The damage is already done.” Although it may be more challenging to make changes once we’ve become set in our ways, it isn’t impossible. Imagine my pleasant surprise, for instance, when my father-in law—a die-hard Italian—switched from traditional semolina pasta to a low-carb alternative at age seventy to help manage his diabetes. In general, it has been scientifically shown that those past retirement age, and even those already diagnosed with cancer, can improve their health outcomes by exercising more, drinking less, and making other healthy lifestyle changes.

Small actions do have small effects

There’s a widespread belief that everything is okay in moderation. But what exactly does this mean? Maybe we can make it clearer by rephrasing it just a little bit, say, like this:

“Hey you! I’m giving you permission to do and consume anything you want! That’s right, anything! Oh silly me, I almost forgot to warn you: just don’t do or consume too much of those things. Don’t ask me how much too much is, ‘cause I don’t know! Now go have fun!”

It sounds great in principle—we can indulge in anything we want, in moderation of course. And it’s in this very spirit that we welcome with open arms any company that tells us their chocolate bars and frosted cereals can be part of a balanced diet—the wonderful, glorious part!

As you may have noticed, I have a bit of a problem with this belief:

Exactly how much is too much? The idea of “everything in moderation” is so attractive precisely because it lets us decide how much is too much. Indeed, studies confirm that the way each of us interprets “moderation” varies widely. Regardless of how much we do something that might be unhealthy, all we have to do is find someone else doing it more than us and label that amount as “too much.” And there is virtually always someone else doing it more than we are. This gives us a way to justify our habit so we can continue doing it with a clean conscience. Consider alcohol: “Pretty much all the patients who come in to see me whom I identify as drinking to excess have a picture in their mind of what constitutes ‘problem drinking’ or alcoholism,” observed UK physician Sarah Jarvis. “Funnily enough, it’s always a different pattern of drinking from theirs.”

Many things are bad for us even in small amounts: For instance, is it okay to smoke tobacco in moderation? A 2018 review of 141 studies found that smoking even just one cigarette a day increases our risk of heart disease and stroke. How about injecting heroin in moderation? This mantra may actually encourage us to start some bad habits that would be better left alone. Even the commonly-held view that alcohol and marijuana can be safely consumed in moderation is being increasingly criticized by health experts, such as Dr. Tim Stockwell of the University of Victoria’s Centre for Addictions Research.

Suduality offers a different point of view on this mantra. Say you choose to indulge just a little in something (whether it’s drinking alcohol, eating cake, or playing video games), and it gives you a small dose of pleasure or pain relief. Sudism tells us that there will be a small matching negative side effect at some point later on. There is no avoiding this. Every bit of pleasure and pain counts. The main reason we believe that indulging a bit is harmless might simply be because the resulting negative side effects, being small, are hard to detect and difficult to trace back to their cause. We can easily—but mistakenly—conclude that there are no side effects. Things get cumulatively worse as we increase the variety and frequency of things we “moderately” indulge in. All of these indulgences add up, leading to a significant build-up of negative effects that we have to suffer through. It might be wise to re-think this mantra, and instead say, “Everything healthy in moderation.” And, as much as possible, we should simply minimize everything that isn’t healthy.

Some believe that exercise, for instance, is only effective if we do it long enough to break a sweat or ache profoundly. Again, sudism clearly says even a small amount of induced pain (such as a low-intensity workout) will lead to small positive effects. No effort or sacrifice goes unrewarded. A little effort is better than no effort. And doing many little efforts day by day will add up cumulatively to provide larger positive side effects.

The paradigm shift from hedonism to sudism

Our old hedonistic way of thinking may have been to simply seek pleasure and avoid pain, regardless of whether these feelings were healthy or not. However, wrong thoughts lead to wrong actions, which can lead to wrong feelings. A hedonic life, according to sudism, will probably contain lots of meaningless pleasure and pain. On the other hand, a sudist life spent carefully choosing meaningful pleasures and pains should contain little or none of their meaningless counterparts. If the lives of hedonists and sudists both ultimately contain the same amount of pleasure than pain, which one is more desirable? Should we not prefer a life where everything we experience is meaningful, even our suffering? Is it not easier and more fulfilling to go through a life in which all of our suffering has a clear purpose? Don’t we want to feel a strong, meaningful connection with real people, places, and things, instead of connecting with artificial and imaginary things? That is the sudist way.

How to reduce unhealthy pains and anhedonia

The beauty of applying sudism to improve our health and affect is that we can do it as little or as much as we want, whenever we want. On one hand, we can choose to not give anything up. On the other hand, the more we apply it, the more we benefit from it—every little bit counts. Sudism is a trusty tool in our toolbox that’s there when we need it.

The following is a simple step-by-step process that any of us can follow at any time to improve the alignment of our affect and our health. However, please do not alter any prescribed medical treatments without first consulting a health care professional.

1. Become fully aware of every positive and negative feeling in our day-to-day lives, which we had called our affective pulse. One of the best ways to achieve this is by being mindful. This self-awareness will give us a baseline reference-point of our affective pulse that we can compare against later on to measure our progress. If we aren’t fully in tune with our own feelings and we skip this step, we may overlook subtle but important changes that happen to us in later steps.

2. Question each pleasure and pain we experience. Which ones promote health a lot, a little, or not at all? We shouldn’t leave any stones unturned. This will help us identify where we indulge. For each pleasant or unpleasant feeling we experience, we should ask: what is its purpose regarding our personal health and its value towards the overall health of humankind? Is the pleasure excessive for the degree of health benefit it provides? Is the pain excessive for the health cost that it supposedly represents? If the answer to either of these questions is “yes,” then these feelings are likely targets for corrective action. The Appendix can also help us identify which feelings are excessive.

3. Choose which “corrective” negative effects we want to induce. There are two ways to induce negative effects:

a. The first way is to select a pleasant indulgence to reduce. Please refer to What are indulgences? for help identifying them, and refer to the pleasures in the Appendix labeled High Range, which include many examples of indulgences.

b. The second way is to select a healthy pain to increase. Please refer to What is healthy pain? for help in identifying these, and to the pains in the Appendix labeled Healthy Range for real-world examples. There are two ways to increase healthy pain:

i. We can increase the amount of painful activities we do (such as by working harder or facing our fears), or

ii. We can reduce our existing pains less (such as by reducing our intake of pain medication).

4. Apply the chosen negative effects for at least three months to allow for any withdrawal symptoms (if any) to dissipate, and for positive effects to become consistent and obvious. If we are working on a long-standing addiction, it may take a little longer. Patience and persistence will be vital to succeeding.

5. Monitor ourselves for positive effects, which may occur within hours, days, weeks, or even months. The amount of time will depend partly on the amount of negative effects we applied and partly on the amount of negative tension we are under. These may include:

a. The reduction of unhealthy pains (both acute and chronic)

b. The reduction in intensity of healthy pains, and

c. An increase in various healthy pleasures.

Sudism cannot predict which combination of these will occur, only that they will occur in the same proportions as the negative effects we applied in the previous step. These positive effects are generally the inverse of what would happen if we were to increase those indulgences instead of decreasing them.

We can repeat the above steps as often as we wish. Over time, we will probably be surprised at how many indulgences we can cut out, how many unhealthy pains we can reduce and eliminate, and how much natural joy will emerge in our lives.

IN-DEPTH: More advice on overcoming habits and addictions

The following tips may help some of us overcome our unhealthy habits and replace them with new, healthier ones:

Begin by embracing these four fundamental truths, which will make it easier to see a future without our indulgence, and help us eventually let go of it:

We have some degree of addiction—even if it’s just a mild habit

We don’t truly, biologically need the thing we crave—we’ll ultimately be fine without it

Once we give up the indulgence, the cravings and urges will gradually fade away, and

Any pleasure (or pain relief) we’ll lose by giving up our indulgence will sooner or later come back to us in other forms.

Remind ourselves often of the long-term negative aspects of our indulgence, such as the physical and emotional torment they inflict, instead of focusing on the short-term pleasure or pain relief they used to provide. We can get angry at the indulgence and what it has done to us. In the end, we want to associate as many strong negative thoughts to the indulgence as possible to reduce the odds we’ll return to it.

Remind ourselves often of the positive aspects of the healthy behaviour that we plan to replace the indulgent behaviour with. We may want to post inspirational words or pictures in our home or workplace to help motivate us along our journey.

Be fully aware that we’ll miss our indulgence. We may crave or strongly desire it, especially in the midst of suffering. Being mindful can help carry us through these difficult cravings, as we’ll see shortly in Meditation and mindfulness, and help us to let cravings and desires come and go without always reacting to them.

Be especially careful not to replace old indulgences with new ones, otherwise there may not be any net negative effect. Someone who gives up alcohol only to replace it with junk food is simply swapping one bad habit for another. The same thing would occur if we replaced all natural sugars in our diet with alternative sweeteners that tasted as sweet. Carefully choose what you’ll replace the old habit with instead of leaving it to chance.

If an indulgence had created a physical dependence, then reducing it will by definition cause withdrawal symptoms. Withdrawal symptoms may be painful, but they are temporary while the mind adjusts to living without its usual “fix.” On the positive side, the benefits from giving it up will be permanent. If the withdrawal symptoms are too difficult to bear, then gradually tapering off the indulgence may make it easier to succeed.

Have at least one sympathetic friend or professional therapist who is aware of our struggle and can support and encourage us when we need it most.

If a habit is difficult to overcome, we may consider therapy such as cognitive behavioral therapy (CBT). In CBT, we work with a therapist to replace unhealthy thoughts, habits, and coping strategies with healthier ones, thereby moving away from indulgence and towards healthier living.

Even if we fail and fall off the proverbial wagon, that’s okay—we must simply pick ourselves up and start the process over, no matter how many times it takes. Remember that those who ultimately succeed aren’t those who never fail, they’re the ones who get back up every time they fall down and keep trying.

Over the next few sections we’ll cover some of the main corrective negative effects we can apply in our lives. The master list of indulgences can be found in the Appendix, whether they are excessive pleasures (those labelled High Range) or insufficient pain (those labelled Low Range).

Improving our diet

It is widely accepted in conventional medicine that a healthy diet is one of the pillars of physical and mental health. An ideal sudist diet consists of foods and beverages that promote health and are not excessively delicious.

Instead of simply seeking the tastiest foods and beverages we can find, here are some simple sudist ways to better align our diet:

If we drink fruit juice or soda pop, we can mix it with water to dilute its sweetness. Or have nature’s very best thirst-quencher: plain water.

Instead of simply using store-bought salad dressings, we can mix them half-and-half with a combination of olive oil, herbs, plain balsamic or apple cider vinegar, or unsalted passata (strained tomatoes). Better yet, we can use olive oil, herbs, vinegar, or passata all on their own.

If we eat packaged savourized rice or pasta dishes, we can mix them half-half with unseasoned rice or pasta and cook them together. This essentially cuts down the savourizers by half. We can also toss in some plain vegetables or make other healthy additions. Even better, we can eat rice, pasta, and other starches plain or with unsavourized dressings such as those above.

Those of us who eat meat can use home-cooked meats instead of deli meats, which are usually high in sodium, nitrites (which may cause cancer), and other additives.

We can try to eat home-cooked meals made of whole unprocessed foods with the least amount of sodium, sweeteners, trans fats, and monosodium glutamate (MSG) possible, instead of eating fast food, restaurant foods, or prepackaged grocery store foods, which are typically high in savourizers and other flavour enhancers. It’s not only junk food or processed foods that can be indulgent—the most exquisitely crafted meals from the finest restaurants are often even more so.

We shouldn’t shy away from consuming meals and beverages cold when the weather is cold or warm when the weather is warm.

We can continue our daily coffee or tea rituals but consider cutting down on sweeteners, and perhaps going for decaf. Or we can make the switch to plain water.

We can switch from white or milk chocolate treats to 60 percent dark chocolate, 80 percent dark chocolate, or what I eventually learned to enjoy, 100 percent pure baker’s chocolate.

Remember the concept of blending positive and negative experiences together? If a food manufacturer can mask bitter or unpleasant flavours by adding sugar and salt to their foods, we can do the inverse. For instance, we can mask excessively sweet and salty flavours by adding bitter, spicy, or sour ingredients—such as baker’s chocolate, hot peppers, or vinegar—back into the food. While these won’t always make the food healthier, it will help neutralize the excessive pleasure and its corresponding future negative effects.

When others serve us food, instead of thanking them for the delicious meal, we should thank them for the nourishing meal. Otherwise, we are teaching others that we place more importance on pleasure than health.

Keep in mind that if we reduce our intake of savourizers and sweeteners, our taste buds will adapt if we give them the time to. Studies show that taste buds can adapt to lower salt intake in as little as three weeks. It can be challenging, but if I’ve done it, then you can too!

Exactly which foods or diets are the healthiest is the subject of ongoing debates. Most experts agree that, in general, the healthiest foods consist of whole, unprocessed natural foods—in other words, foods in their original form that have had nothing nutritious removed from them (such as fibre). Depending on which expert you ask, this can include fruits, vegetables, nuts, seeds, legumes, grains, lean meats, fish, and dairy. Even within this list, there may be widely varying levels of pleasure potential—from the bitterest vegetables to the sweetest fruits—meaning that not all healthy foods may be equally aligned. Sudism adds that these foods should also have the least amount of savourizers or sweeteners added to them. While there is no specific “sudist diet,” these principles can be combined with other diets, such as a vegan sudist diet, a paleo sudist diet, or a Mediterranean sudist diet.

When it comes to food and beverages, the better it tastes—without providing additional nutrition—the more poorly-aligned it is and the more we should avoid it. Sudists eventually learn to see food more as fuel for our bodies than as a source of pleasure.

We may believe that grocery stores are a relatively safe place to buy food, at least compared to restaurants and vending machines. However, food manufacturers lust after our business and are willing to deceive and manipulate us into choosing their products over their competitors’. Many packaged foods will loudly announce that they are “high in fiber” but would never dare whisper that they are “high in sugar” even if they contain much more of the latter than the former. To make healthy choices, we must overlook all of the marketing gimmicks on the packaging and go straight for the ingredients list and the Nutrition Facts panel—if there is one. I recommend doing this even for foods we’ve been buying for years. It can be an eye-opening experience.

If a packaged food has three or more ingredients, one of them will usually be a savourizer or sweetener. Added sugar, sodium, trans fats, MSG (in its many incarnations), and low fibre levels can each be tell-tale signs that a food’s pleasantness far exceeds its healthiness, but they are not the only factors that determine how pleasant a food will taste. For instance, some sweeteners are hidden under the labels of “natural flavours” or “fibre.” Our mouths (and noses!) always provide the final verdict.

IN-DEPTH: Here are some dietary guidelines on common flavour enhancing ingredients:

For sodium, the international group World Action on Salt and Health (WASH) tells us that adults need less than 400 milligrams of sodium per day, and children need even less. By contrast, some government guidelines define a “tolerable upper limit” of up to 2,300 milligrams, which is six times that amount. We should ask ourselves: why is there such a discrepancy between what health experts say our bodies need and what governments recommend? Surprisingly, bread products are often the largest source of sodium in our diet.

For added sugars, the World Health Organization recommends that we should consume no more than 5 percent of our calories from free sugars. Action on Sugar, a group of specialists concerned with sugar’s effects on health, tell us, “there is absolutely no nutritional requirement for free sugars in our diets.” Yet some packaged foods contain so much sugar that it is their primary ingredient. Some breakfast cereals, for instance, would be more accurately described as “cereal-flavoured sugar.” Finally, not all sugars are equally sweet: 10 grams of sucrose tastes much sweeter than 10 grams of lactose—the kind of sugar naturally found in dairy products.

For trans fats, many nutritionists believe these provide no health benefit and merely increase our risk of illness. They are typically added to foods in the guise of partially hydrogenated oils. We should aim to consume as little of these as possible. Several countries and jurisdictions are in the process of phasing these out of the food supply.

Exercise: healthier versus less healthy foods

For most of my life, I thought the flavour of store-bought olives was how they naturally tasted. Maybe I’m a little slow, but it was only in my thirties that I finally realized that their flavour was mostly derived from the other stuff added to the jar—including vinegar and lots of salt. To this day, I’ve never tasted an unseasoned olive because no stores seem to sell them, but those who have say they’re actually quite bitter. The lesson is that unless we’ve experienced a given food in its original, unseasoned form, we may have quite a skewed impression of the true, natural flavours of food. Many of us have forgotten what real food tastes like!

Time for a taste test! A great way to gain insight is to compare the taste of various foods in their plain state and their flavoured (sweetened or salted) state. Healthy whole foods naturally have milder, more complex flavours than the prepared foods we’d typically find in a restaurant, grocery store, or vending machine. For those of us that haven’t already done so, it can be quite eye-opening to compare the taste of the following items side-by-side:

Flavoured (sweetened) yoghurt versus plain (unsweetened) yoghurt

Regular (salted, sweetened) nut butters versus plain (unsalted, unsweetened) nut butters

Regular (semi-sweet, milk, or white) chocolate versus 100 percent pure unsweetened baking chocolate

Fruit juice versus diluted juice (half juice, half water) versus water

Sweetened lemon-lime sodas versus unsweetened club soda

Vegetable salad topped with commercial salad dressing, bacon, croutons, and cheese versus one topped with olive oil, herbs, and vinegar.

Salted or sweetened nuts or popcorn versus their unseasoned varieties

Prepared (sweetened) oatmeal or cereal versus plain (unsweetened) oatmeal or cereal

Salted potato chips or fries versus an undressed potato or home fries with herbs and spices.

High-sodium vegetable juice versus low-sodium, no-MSG vegetable juice

Seasoned, processed chicken or fish nuggets versus chicken or fish dressed with herbs, spices, oil, and vinegar.

For those of us not used to plainer-tasting, healthier foods, the taste difference may be a bit of a shock. “I can’t eat that!” we might protest, because we miss the extra “kick” of salt or sweetener that we’re used to. But as we saw in Giving up delicious foods, it’s entirely possible with time and practice to go from finding a healthy food repulsive to finding it enjoyable.

KEY POINT #185: Comparing the flavours of sweetened and savourized foods side by side with their healthier, plain versions can open our eyes to what real, healthy food is supposed to taste like.

IN-DEPTH: The cause of worldwide obesity

Why is our world in the middle of an obesity epidemic? Though this book isn’t about curing obesity and excess weight, suduality does help answer this perplexing question. Although genetics play a role in each of our bodies’ shape and composition, experts point out that they can’t be blamed because, while our waists have been expanding, our collective DNA has remained virtually unchanged. Rather than provide a singular answer, I suggest that our recent collective weight gain is due to a combination of factors, which tie heavily into pleasure and pain:

The majority of modern prepared and processed foods are engineered to have optimized flavours that give us average consumers the highest degree of pleasure, called the bliss point. The blissful flavours of processed foods make them more attractive than healthier options, steering us towards them and away from healthier fare. Some of the top industry-funded food scientists go so far as describing many processed foods as being “addictive.”

It’s been scientifically shown that savourizers (i.e. salt and MSG) and sweeteners (real or artificial) boost our appetite, making us eat more than we otherwise would, or making us feel hungry again earlier than we should. This is called hedonic hunger—eating for pleasure rather than nourishment. Farmers have known this for decades and add sweeteners to their animal feed to increase the amount their livestock eats so they can fatten up faster. In short, increasing the pleasure yield in our food predictably increases our desire to eat.

The powerful positive effects of savourizers and sweeteners turn food into “medication” that can soothe our pain. As a result, many of us use blissful foods to self-medicate our stress, fear, boredom, and sadness—feelings that these foods may paradoxically amplify in the long run, leading to a vicious cycle.

Since the “positive” flavours of sweeteners and savourizers boost our appetite, one might guess that “negative” flavours such as bitterness or spiciness would have the opposite effect. Indeed, some studies show that bitter and spicy foods—which many Westerners avoid now more than ever—act as appetite suppressants.

Food industry insiders admit that their snack foods exploit other techniques to trick us into eating as much as possible before we feel full. “Snacks need to be eaten non-stop until the packet is finished,” wrote food industry consultant Thornton Mustard, adding that feeling full or satisfied is “quite a serious enemy for a product.” In addition to the earlier factors, this is accomplished using various tricks such as by making the taste of each bite vanish quickly in our mouth (leading us to want to re-experience it), by making crunchy foods melt quickly (to trick our brain into thinking the calories have “vanished” and must be replaced by more), and by making their foods easier to chew (because the act of chewing makes us feel fuller faster).

Many processed foods and beverages have little or no fiber compared to whole natural foods, meaning that we digest them more quickly. Highly-processed, low-fiber foods do not keep us full as long. By keeping us full, fiber acts as an appetite suppressant. Furthermore, since fiber slows down the absorption of food, our gut bacteria gets a chance to consume some of the calories before we do, which reduces the overall caloric impact of fiber-rich foods (and yes, makes us fart more).

Many of us consume stimulants, such as caffeine or nicotine, after heavy meals in order to counteract the fatigue and lethargy that normally occurs after big or highly processed meals. In this way, these stimulants enable us to eat the wrong kinds and quantities of food by erasing the fatigue that might discourage us from eating this way the next time.

Like stimulants, antacids and other stomach medications enable us to eat the wrong kinds and quantities of food, by counteracting the indigestion and upset stomach these foods might cause.

Some popular medications cause weight gain, including certain antidepressants, antipsychotics, and mood stabilizers.

Finally, for some of us, our pain signature may include hunger pains. This would lead us to eat more than we should when we’re out of alignment.

The end result? We eat when we aren’t hungry. When we are hungry we consume more calories than we need. We get hungry again sooner than we should. And we end up gaining weight. How do we solve obesity? Eat a wide variety of fiber-rich, minimally-processed whole foods, avoid all added sweeteners and savourizers, and avoid stimulants and antacids after meals. This simple approach doesn’t require calorie counting or portion sizing in order to attain and maintain a healthy weight. A note of caution: this dietary advice makes no claims about providing us with an optimal amount of nutrients. It is, however, almost guaranteed to lead to a healthy weight and many other health benefits.

KEY POINT #186: When it comes to excessive weight gain, it would be wise to focus less on “calories in versus calories out” and more on “appetite stimulants versus appetite suppressants.”

Increasing our physical exertion

What if there was a magic pill we could take a few times a week to cure dozens of our health and affect problems? Well there is one: it’s a wonder drug called XR-CZ. Okay, I’ll spell it out: it’s EXERCISE!

As with a proper diet, experts generally agree that physical exercise is one of the cornerstones of optimal physical and mental health. Sudism wholly agrees, but looks at exercise from a different perspective: the more unpleasant and challenging the exertion is, the more future positive effects will be generated. Keep in mind that exercise blended with enjoyable media—such as music, TV, or books—will naturally have less affective impact than pure exercise on its own.

We can exercise for its own sake, like going for a jog in the park or lifting weights at a gym. But any physical effort we make throughout the day counts too. Here are some ways to fit more exercise into our daily schedule:

Instead of relying on elevators to go up and down a building, we can take the stairs.

Instead of driving somewhere, we can try walking or biking. If the distance is too great, perhaps we can drive part way and walk or bike the rest of the way. Parking at the far end of a parking lot also gives us a chance to do more walking. (It also makes it easier to find a parking spot!)

Instead of using a snowblower, leaf blower, or motorized lawn mower, we can shovel, rake, or use a manual reel mower.

When we sit for long hours at a desk, we can consider switching to a sit-stand desk or using a desk cycle.

When we are in meetings, making calls, or simply waiting somewhere, we can stand or pace instead of sitting.

Instead of using devices to cut, mix, wash or dry things in the kitchen or around the house, we can try to do these tasks manually.

Instead of trying to make life easy for those we live with—including children, adolescents, and adults—we can give them meaningful work to do, like yard work, laundry, or doing repairs. Although everyone needs regular down time to rest and recharge, those with too much time on their hands may become bored or aimless and be tempted by indulgences.

Doing physical work by hand usually takes more time and effort than relying on motors, machines and other devices, but based on the tremendous health and affect benefits they provide, this extra effort should really be seen as an investment rather than an expense.

KEY POINT #187: We are designed to struggle and work hard. These are normal and healthy things that we should seek and embrace, rather than reduce and avoid. Boosting our movement can boost our mood.

Increasing our mental exertion

Just like with physical exertion, increasing our mental workouts is another way we can improve our overall alignment and health. We may for instance try to:

Crunch numbers in our minds instead of relying on calculators.

Recall names, places, to-do lists, and upcoming appointments by memory instead of relying on address books, maps, and calendars.

Learn new words, languages, or other useful skills.

Taking on more mentally challenging tasks and projects.

As with physical exertion, instead of trying to make the lives of our children easy, we should strive to give them more meaningful work to do or inspire them to start their own projects.

Practicing meditation and mindfulness

Some doctors believe that the use of meditation and mindfulness, which we covered earlier in Being mindful, is the single biggest step forward in twenty-first century health care. If we are new to these practices, we can start with a few minutes per day then gradually increase the length or frequency as our ability increases.

Mindfulness does provide many affective benefits, but has anyone ever explained why they do? Sudism provides an interesting perspective:

By clearing our minds, we tend to reduce or eliminate indulgent thoughts, such as dwelling on pleasant memories, fantasizing about our future, or simply enjoying a daydream. Some of us even spend hours each day escaping the present moment by immersing ourselves in a fantasy world of romance, riches, or power. Mindfulness is exactly the opposite—immersing ourselves in the present moment and escaping from the fantasy world.

By observing the remaining non-indulgent thoughts and feelings, both positive and negative, without reacting to them or trying to suppress them, we can increase the separation between our feelings and any knee-jerk reactions they might trigger in us. For example, when we feel lonely, hurt, afraid, or angry, we might have the urge to numb ourselves with medicine, alcohol, drugs, or comfort food. But when we are mindful, we simply allow these painful feelings to be, without trying to suppress them. Allowing them to come when they want to and go only when they are ready to go can help us conquer indulgent habits and become stronger, healthier beings.

By turning off both internal stimuli (such as our indulgent thoughts) and external stimuli (such as our TVs and phones), we are reducing the overall amount of stimulation we consume. If it was pleasant in nature, as it often is, cutting back on it would amount to a negative effect. Turning down the degree of stimulation may also help our minds gradually get used to a slower and healthier pace of stimulation, something we’ll explore in the next section.

Indeed, many spiritual people say that they find beauty in simple life moments by mindfully living in the “now” and quieting their chatty minds. This may partly be explained by the fact that they deny themselves many worldly indulgences, such as TV or music, thereby freeing up that pleasure to be available elsewhere. It might then resurface in basic everyday things, such as experiencing the beauty and colours of the world more intensely.

KEY POINT #189: Meditation and mindfulness can help us lessen our indulgent thoughts and behaviours, while increasing our acceptance of suffering.

Improving our stimulation

We should be mindful of everything we consume—not only the foods we taste and smell, but all of the stimulation that we consume through our other senses. Reducing our intake of pleasant but unnecessary stimulation is another way we can realign ourselves. Instead of seeking out the most entertaining hyperstimulation we can feast our eyes and ears on, we may try:

Watching less entertainment on television, in movies, or in other media, and spending more time connecting with real people and seeking real life experiences instead.

Spending less time playing with virtual characters and accomplishing virtual goals in video games. Instead, spending more time being playful with real people and getting satisfaction from accomplishing day-to-day tasks and making progress on our real-life goals.

Spending less time reading mindless or indulgent fiction, and more time learning useful and inspiring things about the world around us.

Likewise, spending less time reading trivial, mindless, or tabloid-like information about the real world, and more time pursuing meaningful, purposeful knowledge.

Reducing our consumption of music, and listening instead to the day-to-day sounds of life, nature, and our very own thoughts. Becoming more comfortable with silence and solitude. If we feel the need to block out distracting noises, then listening to white noise—such as recordings of rain or wind—may be a healthier choice than music.

After a hard day, instead of de-stressing with television, music, or other indulgences, we should seek healthier, natural ways to relax like going for a jog, meditating, or spending quality time with either our human or furry friends.

These days, people worldwide spend incredible amounts of time, passion, and energy accomplishing virtual goals in virtual video game worlds. How many real life goals would get accomplished if all that time, passion, and energy was instead directed at the real world? Some industry insiders estimate that young people play an average of 10,000 hours of video games. Meanwhile, some say it takes 10,000 hours to master a real-life skill or trade. How would we prefer our children to spend those 10,000 hours? You might wonder, aren’t there some video games that are healthy? Like one that teaches math skills? Or a flight simulator for those who want to fly? Yes, such games can be very healthy and teach us useful skills that we might use later in the real world. We must use careful judgment to determine whether something is mindless hyperstimulation, healthy stimulation, or a blend of both.

KEY POINT #190: We can further improve our alignment of affect and health by spending less time hooked up to artificial indulgent stimulation on TV, in music, or in video games, and more time connected with real world sights, sounds, and situations.

Reducing our consumption of drugs

Another important way we can realign our affect and health is to cut down on our consumption of drugs—whether they are commonplace, prescribed, or illicit. “We rely almost entirely on medication to deal with sickness and pain,” observed Buddhist Thich Nhat Hanh in his book No Mud, No Lotus. “Yet the most effective ways to ease and transform our suffering are already available to us without any prescription and at no financial cost.”

We may try the following, under the guidance of a qualified health care professional:

Instead of turning to caffeine or other stimulants to relieve our tiredness, we can choose to endure our fatigue to the extent possible and increase rest as needed. Physical exercise and sunlight exposure are other natural ways to gradually boost our energy and reduce our fatigue.

Instead of relying on painkillers, nicotine, antidepressants, and alcohol to numb our anxiety and pain, we can turn to exercise, meditation and cold-exposure, since these all function as powerful, natural analgesics.

Instead of relying on sleeping aids, we can increase our physical exertion, meditation, and sunlight exposure to increase restful sleep.

Instead of consuming recreational drugs such as marijuana, opioids, or cocaine, we can learn to trust that we’ll eventually feel good naturally, without relying on these substances.

When hosting a party or gathering, instead of serving alcohol or drugs to ensure guests enjoy themselves, try fun board games, card games, party games, or other team games to break the ice.

We can choose to accept headaches, heartburn, joint pain, back pain, post-surgery pains, or other body aches when they occur—listening to what they are trying to tell us, and having faith that they will all fade away in due time.

Experiencing wider temperatures

Another realignment strategy is to allow ourselves to experience a wider range of temperatures, as long as we avoid the extremes of hypothermia, heatstroke, frostbite, and burns. Only a few generations ago, our ancestors did not have luxuries like furnaces, air conditioners, and hot water tanks. They learned to endure wide ranges of air and water temperatures, which varied daily and seasonally. Some of us still don’t own such luxuries, but a growing number of us rely on them each day. Maintaining our core body temperature within its healthy operating range requires significant energy—up to an incredible 60 percent of all calories we consume, according to biology textbook author Deborah T. Goldberg. Some studies calculate that shivering for fifteen minutes is roughly equivalent to one hour of exercise. Since keeping warm can burn even more calories than physical exercise, it would be wise to see our struggle to maintain body warmth as a valuable workout in and of itself. We can give ourselves a thermal workout in many ways, including:

Showering, washing ourselves, and swimming in cooler waters instead of warmer waters, as our ancestors did.

Enduring fever chills without resorting to fever-reducing medication—keeping in mind that high or prolonged fevers may indicate an underlying problem needing medical intervention.

Exercising or walking in the cooler mornings instead of when temperatures are ideal.

Drinking and eating cooler things during winter, and warmer things during summer.

Keeping our houses and vehicles cooler in winter and warmer in the summer, and enduring periods of heat and cold to the extent we can.

Enduring minor irritations

The Danish are quite fond of the word pyt, which means to accept minor frustrations in life and carry on. We can draw inspiration from the Danish spirit and put up with many kinds of irritations and aches instead of always trying to “fix” them, as long as there isn’t any risk of serious harm. We might do this by:

Enduring the pains of illness and injury rather than using medication or other means to make these go away.

Accepting things that are not as easy, comfortable, beautiful, modern, or agreeable as we would like, instead of always trying to upgrade them.

Allowing ourselves to feel hungry for periods of time instead of constantly snacking throughout the day.

Enduring foods that we find bland, bitter, spicy, or disappointing, instead of adding sweeteners, savourizers, or outright rejecting them.

Choosing to carry out tasks that we find “gross” or repulsive instead of always getting someone else to do them (wife, I’m looking at you!).

Accepting the irritating things that our neighbors, coworkers, family, and friends sometimes say, do, or neglect to do, instead of always trying to change the ways of others.

Spending more time in the now

Yet another realignment strategy is to steer ourselves away from indulgent memories and fantasies. We can do this by:

Spending less time fantasizing about pleasant things such as being in love or winning awards, instead spending time with real people or working on real tasks.

Spending less time fantasizing about being someone else, somewhere else, doing something else.

Spending less time fantasizing about revenge or retribution.

Spending less time dwelling on rosy recollections of the past, and living more in the present moment.

Spending less time excitedly anticipating upcoming events and activities, trusting that they will arrive in due time.

Other ways to realign our affect and health

Beyond the many examples we’ve already covered, there are still other corrective negative effects we can leverage to better align our affect and our health, such as:

Allowing ourselves to experience upsetting feelings and painful memories more, rather than trying to suppress them. One great technique, taught by the late Dr. John Sarno, is to make a list of all the things that might be bothering us in our lives, and then spend time each day writing a long essay about each item on that list. This encourages us to process difficult emotions that we may have been avoiding.

Spending less time avoiding things that make us anxious but are unlikely to cause significant harm, and more time facing our fears—whether they are of the smallest bugs, the tallest heights, asking stupid questions, speaking in front of crowds, rejection, or failure in general.

Spending less time admiring ourselves or seeking flattery from others, and spending more time acknowledging and accepting our flaws and shortcomings.

Spending less time seeing ourselves as a helpless victim of our various physical and emotional aches, and realizing that we have a tremendous amount of control over when and how we suffer.

Reducing the time we spend reading erotica, watching pornography, or looking at beautiful people or romantic relationships on TV or the internet. Instead, we can seek and strengthen our real life romantic and sexual relationships.

Reducing the time we spend shopping purely for pleasure despite not having any real need to purchase anything.

Reducing our use of scented products such as perfumes, deodorants, fabric softeners, shampoos, scented cleaning products, and air fresheners. Instead, relying on unscented cleaning products and accepting odours that might not always be as pleasant as we’d like.

Taking on more responsibilities at home, at school, at work, and in the community to the extent that we are able, especially if we spend much of our time playing or relaxing.

Reducing our consumption of professional massages done purely out of pleasure, instead seeking the comforting touch of friends and loved ones.

Being careful not to enable or encourage those around us to indulge, but gently encouraging them instead to make healthier lifestyle choices.

Telling others not only about our good times but also our struggles, so that they get a more balanced view of our lives.

Avoiding the use of food, sex, or other means to cope with loneliness, anxiety, or other forms of emotional anguish.

Over time, as we learn to increasingly say “yes” to suffering, we’ll find it easier to accept and endure things that are less pleasant than we’re used to. Our expectations will become more realistic. It will also have the wonderful counterbalancing effect of making other areas of our lives easier and more pleasant.

Not running away from pain

Certain cultures such as the Native Americans and East Indians, and some religions including Buddhism and Christianity, tend to see suffering as inevitable and often beneficial. For them, it’s simply part of the landscape of life, an earthly teacher. They encourage calmly accepting suffering instead of running away from it. In contrast, many Westernized cultures view pain as a nuisance and an inconvenience. These societies are often systematically organized to avoid suffering as much as possible.

If we live in a pain-fearing culture, the “pain relief” button is often within reach, tempting us to press it over and over again. It’s easy to go along with the prevailing attitude of pain-avoidance. Following a different path may take more of a conscious effort. I spent many years believing that pain was my enemy. But I now realize that trying to run away from pain is like trying to run away from gravity. I have learned to accept suffering—not joyously, but as an inseparable part of me. “Pain is ultimately part of life for all of us,” concluded Douglas Nelson, who spent decades treating patients in pain. When asked in a 2010 interview whether he feels happier now, the late actor Robin Williams responded softly, “I think so. And not afraid to be unhappy. That’s OK too. And then you can be like, all is good. And that is the thing, that is the gift.” Psychoanalyst Barbara Stevens Sullivan concluded that, “You need to start with an attitude that pain is a part of life. It’s not a symptom of failure. It doesn’t mean I’m doing life wrong. . . Many of us have been raised to think: if we just do life right, we won’t suffer. . . . And none of that is true. Because you can do things absolutely as right as anybody can do them and there’s still going to be lots of pain.”

As in Pain always comes, pain always goes, we can’t run away from pain indefinitely. And the more we try to avoid the suffering that awaits us, the more unpleasant it is likely to become. “We may succeed in numbing ourselves from it for a little while,” observes Buddhist leader Thich Nhat Hanh, “but the suffering inside wants our attention and it will fester and churn away until it gets it.” Instead of running away from pain, we should be running with the pain until we’ve outrun it. This applies whether we are toughing out aches due to illness, fatigue from exertion, anger due to relationship troubles, or frustrations at our workplace. Realizing that pain always ends, and that our share of pleasure awaits us not that far in the distance of time, can help us overcome any aversion to pain we may have. As self-help author Douglas Bloch wisely said, “If you’re going through hell, don’t stop.” Or as I like to say: Pain? Bring it on!

KEY POINT #195: There’s always a light at the end of the tunnel of suffering, if you’re willing to go through it. Pain ends—you don’t. To the extent that you are able, tough it out!

Pain is a teacher. We should always listen to our suffering. Healthy pains carry important life-affirming messages. If our knee hurts due to an injury, it’s our bodies’ way of asking us to rest it and protect it while it heals. If we zap the pain with medication and then overwork that joint, we are ignoring this important message and may cause lasting damage. If we consistently overwork, overeat, or under-sleep and then erase all of the resulting aches with pills, we are masking the symptoms without addressing the root problems. As ancient philosopher Aristotle said, “We cannot learn without pain.” And as Sullivan wrote on the goal of Jungian psychoanalysis: “instead of being tormented by meaningless pain, [the patient] will suffer pain constructively. . . . Suffering is a necessary ingredient for psychological growth.” Healthy pain is our trusted advisor. We must listen to it, learn from it, and let it leave only when it is ready to leave.

Life is like a giant rock tumbler and we are the rocks within it. As the tumbler of life turns, we get tossed about and collide repeatedly—with the world around us and with each other. Although this process is often painful, each time we collide we become smoother, better versions of ourselves.

KEY POINT #197: Healthy pain is not useless, it is transformative. The purpose of pain is not for it to merely be relieved, but for it to be experienced.

Many of us are afraid of all pain and suffering, and we try to run away from it. But sudism teaches us that we should instead be running away from everything that is unhealthy, whether it is painful or pleasant.

KEY POINT #198: One of the most important lessons in sudism is to seek and embrace healthy pain rather than try to evade and destroy it with pills, machines, and other means.

This is why we should stop trying to avoid the many mental, emotional, and physical challenges and frustrations of day-to-day living. These useful and predictable pains are precisely what prevents us from suffering in a useless and unpredictable fashion. “Don’t struggle about the struggle,” wrote best-selling author Sean Covey, since everyone else is struggling in their own way too. It is wiser to embrace that struggle as part of a normal, healthy life.

On the other hand, unhealthy pains are not useful, but they are the price we must pay for past indulgent behaviours. If we actively escape unhealthy pains, perhaps by self-medicating, we merely delay the inevitable. Sudism teaches us that the root cause of chronic pain is chronic indulgence, and the proper solution is to reduce indulgence, not indulge further by constantly trying to erase this pain.

Pain can sometimes be quite inconvenient, like when a throbbing headache makes it hard for us to concentrate at work or at school. Ultimately, it’s up to each of us to decide whether or not to treat pain with medication or other methods of indulgence, but if we are constantly running away from pain we may never develop a tolerance for it. When pain is staring you down, be brave. You are probably stronger than you realize.

Doctors and patients who believe that pain itself must always be treated need to realize that this is a profound mistake. Pain is a symptom, not a disease. It is like having a fever. A healthy fever tells us that something else is wrong, that something else needs to be addressed—like an infection of some kind. This is the same principle for pain in all of its forms. Pain is just a messenger. Don’t shoot the messenger!

KEY POINT #200: We should be wary of anyone, even doctors and specialists, that encourages us to take pain pills or mood pills—like antidepressants or antianxiety medications—instead of trying to understand and address the root cause of our suffering.

That being said, there is at least one case where it may be dangerous to try to tough out pain: episodes of intense and prolonged unhealthy pains. From clinical depression to cluster headaches, intense pain with no underlying message can push some of us over the edge into suicidal or even homicidal thinking. In My darkest hour I visited these tormented places and feel lucky to have made it out and to be able to share my thoughts with you. Treating this kind of pain to make it at least bearable—and prevent the sufferer from slipping over that precarious edge—would be the only humane approach. Even so, there still remains the hard work of figuring out what caused this horrible pain in order to prevent it from returning.

IN-DEPTH: What parents and caregivers can do

Most parents have good intentions towards their children and try to give them the best childhood they can. But what exactly is the best possible childhood? Many parents would say that it’s the one in which the child’s life is filled with fun and joy and as little suffering as possible.

Beware: comforting our children with indulgences may make them feel better today at the expense of them feeling worse tomorrow. In a striking example reported by The Sun, a teen named Zach from the UK was said to play video games fifteen hours each day, to the extent that he suffered from blackouts and crippling headaches. His mother allowed it because she “[did] not want to upset him by taking his consoles away,” believing that these games were the only things that could make him happy. Parents, please don’t give your children whatever they want, whenever they want. Sudism teaches us that it’s simply impossible to make them happier in the long run, nor to make them forever miserable by taking these things away. There is no need to feel guilty when saying “no” if it’s the right thing to do. A firm but loving “no” with an age-appropriate explanation and an offer of healthier alternatives will help teach children how to continue making those wise choices on their own as they grow older.

We must also realize that all children must suffer, just as we adults do, and that this is entirely normal and healthy! Remember those unfortunate children with CIPA who couldn’t feel any physical pain?

So, what can we give our children? We can teach them about our world and how to get along with others. We can teach them new skills and encourage them to be creative and physically active. We can teach them to be responsible. We can also give them meaningful work to do. The United Nations, while taking a firm stance against child labour, agrees that “children’s or adolescents’ participation in work that does not affect their health and personal development or interfere with their education, is generally regarded as being something positive.” Poor parents may not be able to buy expensive things for their young, but they can give them all of these important life skills, and their children will be just as happy in the end.

Those of us who take care of children influence the many beliefs and habits they will form, which will have a long-term impact on their lives. If we always serve salty meals followed by sweetened desserts, our children will come to believe that this is the norm and will likely continue this tradition long after they have moved out of the family nest. We have to be careful about what our children are exposed to. Unfortunately, just because a product is made for children doesn’t mean it’s actually what’s best for them. According to Julie Mennella, a psychobiologist from Philadelphia specializing in children’s tastes, and Dr. David Lau, an obesity expert at the University of Calgary, babies and toddlers are highly sensitive to sweet and salty foods, and many prepared toddler foods contain too much sodium or added sugars. Giving these foods to them can set them up for life-long preferences for sweet and salty foods, which in turn may put them on the path to obesity, diabetes, and even mental illness. We may have to deal with a picky eater, but as the French approach has shown, it’s possible to make even picky eaters gradually warm up to most foods as long as we don’t force them to eat, or shame them for not eating, or provide them alternative meals when they refuse to eat.

KEY POINT #201: Parents, instead of giving your children the short-term gifts of indulgence, give them the life-long gift of freedom from indulgence and their many negative side effects.

We have the opportunity to teach our children the ways of sudism. While they are still young and open to our influence, we can explain to them for instance that “the mouth likes very sweet and salty foods, but they also hurt the body and mind,” so they begin to see both the positives and negatives together. Adolescents are more susceptible to forming addictions (such as to smoking), so they need to be well prepared ahead of their teen years. Geoff Munro, National Policy Manager of the Australian Drug Foundation, says that parents have a stronger influence on their children than they might realize: “The research shows that if parents make it clear to their children that they don’t want them drinking or smoking, their children are less likely to do that.” But we shouldn’t just tell our kids about drugs and alcohol—we should teach them about all forms of addiction, whether it’s to video games, the internet, pornography, and so on. Setting our children on the right track will have a long-lasting, positive influence on their lives, and eventually, the lives of our children’s children.

IN-DEPTH: What health care workers can do

Those who work in health care—including medical doctors, alternative health care providers, and health researchers—can leverage sudism to better understand, diagnose and treat patients suffering from illnesses and disorders featuring excessive pain or anhedonia. This includes the main syndromes associated with central sensitization. The domain of assessing and treating patients by using sudist principles may be referred to as clinical sudology, and the healthcare practitioners applying these principles may be called sudologists. For such patients, practitioners should not focus exclusively on the aching body part, since the cause of the problem may very well be elsewhere. That is to say, a back specialist investigating a patient’s chronic back ache should not only look at their back, and a joint specialist should not only look at their patients’ joints—otherwise they may miss the forest for the trees. Health care workers should learn that they can’t study pain without also studying pleasure simultaneously, for sudism shows that both are heavily intertwined. Similarly, they should not artificially separate emotional affects from physical affects as these are also often intricately intertwined. The complete spectrum of affects of their patients should be accounted for, or they risk overlooking key factors contributing to their illness. If a patient is suffering and all their medical diagnostic tests come back negative then, regardless of the type of pain, think of suduality.

As we discussed in Pain signatures, a given indulgence might cause different negative effects in one individual compared to another. Similarly, one kind of unhealthy pain may be caused by a wide variety of indulgences. This complex many-to-many relationship between causes and effects makes it somewhat challenging for health care workers to connect these causes to their associated effects. Therefore, vigilance is required when observing all pleasures and pains. When trying to determine whether a drug or treatment has certain negative side effects, it is not enough to ask the patient about a small checklist of common problems. They should always be asked if they have experienced any other physical or emotional aches as well as any losses of everyday pleasures.

The kind of depression I used to suffer from—a few days of intense suicidal depression every few weeks—did not become fully recognized by the Diagnostic and Statistical Manual (DSM) until its fifth edition in 2013. In other words, psychiatrists following the DSM could not officially label me as suffering from depression because my depressive episodes were simply “not long enough.” This may have been an attempt to differentiate between healthy sadness and unhealthy depression. But from sudism’s perspective, the proper distinction between these two feelings is not in their length, frequency, or intensity, but rather in their ratio of suffering to meaning. Pain without meaning and purpose—or pain that far exceeds its purpose—immediately qualifies as unhealthy pain, regardless of how often it occurs or how long it lasts. Once unhealthy pain is identified, caregivers and health workers should then set upon the task of discovering and addressing its root causes.

KEY POINT #202: Sudism teaches us that chronic anxiety, depression, and other unexplained chronic aches are not isolated, idiopathic illnesses. They are symptoms or side effects directly caused by indulgences. To cure those afflictions, the indulgences must be identified and addressed.

Many pain patients are treated with narcotic painkillers such as oxycodone. However, in the absence of pain, these have the equivalent ability to elevate mood and induce euphoria. Therefore, prescribing a regular, daily regimen of these painkillers to a patient that only occasionally feels pain crosses over from the territory of medical pain treatment to that of recreational drug dealing. Since all pain is transient, any prolonged prescription of narcotics will at some point, earlier or later, cross over into the latter territory. The result may be that pain patients turn into drug addicts, a phenomenon we are witnessing in today’s unfolding opioid epidemic. Furthermore, chronic drug-induced euphoria inevitably leads to further chronic pain. In other words, narcotic drugs may actually prolong the pain condition rather than cure it. Some governments have legally mandated pain relief for many chronic pain conditions, taking the stance that all such pain should be eliminated using pain relievers. Sudism teaches us that this is a grave mistake.

IN-DEPTH: What governments can do

Many governments across the world pay for at least part of their populations’ health care, and having sicker citizens translates to higher health care costs. Governments also suffer from lost tax revenue when sick civilians are forced to take extended absences from work and cease generating taxable income. This gives governments at least two strong financial incentives to promote healthier habits across their populations. The Globe and Mail reported that in Canada alone, alcohol consumption by itself “costs the economy $14.6 billion annually, including $7.1 billion in lost productivity, $3.3 billion in direct health care costs and $3.1 billion for alcohol-related law enforcement costs.” The Citizens Commission on Human Rights reports that worldwide sales of psychiatric drugs have topped $76 billion a year. Imagine how much of this money could be saved if mental illnesses such as depression and anxiety could be successfully treated or prevented? In 2004 alone, major depressive disorder (MDD) cost the European Union €118 billion, including the direct cost of drugs, hospitalization, outpatient care, as well as indirect costs. The American College of Preventive Medicine reports that “close to half a trillion U.S. dollars are spent on expenses associated with medical, economic, social, and the criminal impact caused by the use and abuse of addictive substances.” The potential cost savings are enormous. Beyond the financial incentives, many governments consider it their moral responsibility to intervene in free markets when they appear to be causing their populations more harm than good.

Governments in all countries at all levels have the power to gradually steer their populations away from unhealthy habits and towards healthier ones. Granted, this is no small feat. Some attempts to curb unhealthy behaviours have generally failed, such as the US prohibition on alcohol in the early twentieth century. However, other attempts have succeeded and the results of such changes can be dramatic. In Finland, for instance, nation-wide governmental efforts over a span of thirty years have successfully reduced average sodium intake by one third. During the same time period, they observed a 75 to 80 percent decrease in both stroke and coronary heart disease mortality. By any measure, this is an incredible achievement and a major health victory. Governments worldwide, take note—you too can mandate gradual, long-term reductions in not only salt and sugar consumption, but in other unhealthy indulgences as well. Reducing these little by little, year after year, populations would have plenty of time to get accustomed and adapt to these healthy changes.

Governments also have an opportunity to enhance their school education curriculum to educate youth early on about all forms of addiction, such as gambling and video games, sex and pornography, and drugs and alcohol. Some of the practical aspects of sudism could be taught as well. As Benjamin Franklin said, every ounce of prevention is worth a pound of cure. Furthermore, the recent trend of gamifying education—adding exciting video game elements to teaching tools—is much like adding sugar to food. Yes, the children will like it more, but at what cost to their health?

There are many other ways that governments may invest in their populations’ health, such as by:

Designing cities and buildings that encourage walking, jogging, biking, and other forms of exercise.

Providing income tax credits, subsidies, and other incentives towards the cost of joining sports teams, buying gym memberships, eating healthier foods, and so on.

Serving healthier food in school cafeterias, hospitals, and other government-funded institutions.

Placing tighter regulations on the pharmaceutical, alcohol, food, and other industries to reduce the amount of deceptive “scientific” studies and marketing that intentionally mislead both health care workers and the general public.

KEY POINT #203: Civil servants, consider leveraging sudism to help guide your populations towards better health and less chronic pain and disease. This can not only lead to increased productivity, but also tremendous cost savings.

The rewards of applying sudism

By applying the sudist principles of realigning positive affects to be in proportion with health benefits, and realigning negative affects to be proportional to health costs, the root cause of unhealthy pain and anhedonia can finally be addressed. With this approach, sudism can be used to potentially prevent, alleviate, and in some cases cure a large variety of affect-related illnesses and conditions. Here are some of the conditions that may be treated and in some cases cured by applying sudist principles (see the Appendix for further details):

Anhedonia, which is the reduction or complete loss of enjoyment of normally enjoyable activities

Depression, which can include feelings of dysphoria, excessive loneliness, worthlessness, guilt, boredom, and fatigue

Excessive fear, phobias, and anxiety including panic attacks

Obsessive-compulsive and related disorders due to excessive anxiety about things like germs, losing things, or hurting others

Restless legs syndrome (RLS) and hyperactivity due to excessive feelings of restlessness

Chronic fatigue syndrome (CFS), and other forms of abnormally high mental or physical fatigue

Fibromyalgia, including painful tenderness across the body

Tactile allodynia, light physical touch that hurts like a sunburn

Those diagnosed with controversial illnesses such as chronic Lyme disease, tension myositis syndrome (TMS), or multiple chemical sensitivity (MCS), which is a painful heightened sensitivity to environmental chemicals

Heat sensitivity and cold sensitivity, which are feeling abnormally hot or cold

Hot flashes or chills without an underlying cause

Dysgeusia, parosmia, or phantosmia, all of which are amplified or imagined unpleasant tastes and odours

Feelings of stomach overfullness even though the stomach isn’t full

Excessive hunger (polyphagia) despite eating enough

Excessive thirst (polydipsia) despite drinking enough

Dry mouth sensations, despite saliva content being normal

Dyspnea, the feeling of shortness of breath not due to physical causes

Overactive bladder syndrome with no known medical cause, which is a frequent, uncomfortable desire to urinate despite the bladder not being full

Non-ulcer stomach pain, which is indigestion with no known medical cause

Nausea as a medical side effect or with no known cause

Irritable bowel syndrome (IBS), in the form of unexplained pain and discomfort in the digestive tract

Chronic cough hypersensitivity syndrome, coughing without any physical cause

A chronic urge to sneeze (rhinitis) despite a lack of irritants in the nasal passages

Unexplained headaches, including cluster headaches, migraines, and tension-type headaches

Non-cardiac chest pain with no known cause

Temporomandibular joint (TMJ) pain of unknown medical cause

Lower back pain of unknown medical cause

Other physical aches and cramps of unknown medical cause

Some forms of arthritis pain

Allergy symptoms, in some cases

Hyperacusis, which is a painful heightened sensitivity to sounds

Tinnitus with no known medical cause, which is an annoying ringing in the ears not caused by external stimuli

Photophobia, which is a painful heightened sensitivity to lights

Complex regional pain syndrome (CRPS), which is a painful burning, tingling or pressure in one or more limbs

Amplified musculoskeletal pain syndrome (AMPS), which is an umbrella term for any abnormal amplified physical pain, including fibromyalgia and CRPS

Idiopathic otalgia, which is ear pain without any known cause

Chronic itching with no physical cause

Formication, the unpleasant, imaginary feeling that bugs are crawling on or under the skin

Excessive anger and irritability beyond what a normal, healthy person should feel

Anorgasmia, which is the inability to experience sexual pleasure

Excessive sexual desire, which manifests as never feeling sexually satisfied

Excessive guilt or self-hatred for no significant reason

Obsessively ruminating about bad memories

Excessive nightmares that occur at a higher frequency or severity than normal

Applying sudism can also help reduce or prevent many secondary effects caused by the above pain-related conditions, including these:

Being underweight or overweight

Diabetes, heart disease, stroke, cancer, and other illnesses caused or aggravated by various indulgences

Blunted or flat affect, or feeling emotionally numb

Decreased interest in healthy activities and increased interest in unhealthy activities

Decreased worker productivity and decreased ability to carry out daily activities

Increased financial burdens on governments and individuals

Interpersonal relationship disharmony

Schizophrenia, where the individual has withdrawn into an internal fantasy world or is suffering from paranoid delusions

Attention deficit disorders (ADHD, ADD)

Prostitution and theft

Suicide and homicide

Better decision-making

At the end of Part Four, I mentioned how I initially found sudism to be deeply demotivating. For each decision I had to make, I struggled to see the difference between options A, B, and C since they all led to the same amount of long-term happiness. However, the mud in my mind gradually settled and my understanding of how pleasure, pain, and health interoperated grew. I eventually realized that sudism actually makes the difference between options A, B, and C much clearer than before—by helping me identify which option most aligns affect and health. The consequences of actions became much clearer too. This clarity helped me to make better, healthier decisions for myself and with my family. Rather than being beaten down and demotivated by sudism, we can actually feel very much alive and energized! Once we understand the difference between healthy and unhealthy pain and pleasure, and we realize that healthy pleasure and pain are purely designed for promoting our health, making the right decisions often becomes easier than ever.

Increased endurance

Suffering from chronic anxiety or other unhealthy aches makes life that much tougher. Like prisoners with heavy balls chained to our legs, these heavy pains make it hard or even impossible for us to move towards our goals and dreams. Chronic headaches may make it hard for us to concentrate on everyday tasks, while chronic backaches may make it challenging to do manual work or even tie our own shoes. In extreme cases, those of us with agoraphobia may develop such a crippling fear of the whole world that we may not even be able to leave our own homes, forcing us to abandon our dreams altogether. Furthermore, the anhedonia—the lack of pleasure—that often accompanies chronic pain makes achieving our goals less rewarding, giving us less reason to pursue them.

Life is like a maze. As we navigate through our lives, we arrive every day at new junction points where we must choose which path to take. Many of them are unpleasant. When we reject pain and suffering, those painful paths leading to personal growth and hard-fought accomplishments become blocked off since we believe they are too difficult to pass through. So we turn around and go back, trying to find an easier way. For those of us with significant chronic pain, there may be so many blocked passages that we can’t progress any further and we become completely trapped where we are.

However, if we learn to accept healthy pain and pleasure, while avoiding their unhealthy counterparts, we become more resilient to suffering and better able to endure it when it inevitably comes. There are at least two reasons why. First, we feel less pain in any given activity because our pains will not be amplified by indulgences. Second, our accepting attitude towards suffering makes us resist it less and perhaps even have a fearless attitude towards it. We become used to pain, which toughens us up. So we become able to work harder, go further, fight longer, and endure more, pound for pound, compared to those around us who are less resilient. Work feels a little more like play. Arguments feel a little more like jousting with friends. The more pain we embrace with open arms, the less afraid of it we become. We should try to see pain as a challenge we can overcome, like fire-walking through brazen coals. As pain researcher Lance M. McCracken and his team observed, “Accumulating evidence suggests that acceptance of pain results in lower physical and psychological disability and to lower pain intensity than avoidance-oriented coping.” Those who succeed in achieving their goals in life are not those who never encounter painful challenges and setbacks, it is those who, faced with these, push through the pain and keep struggling until they finally succeed.

Once we gain the endurance to tolerate all of the slings and arrows that life throws our way, pain will no longer be able to stop us.

The meaning of life

What is the meaning of life? What exactly is our purpose on this beautiful, fuzzy green planet we call home? This age-old question has stumped many of us since time immemorial.

The funny thing is that when things are going well in our lives, we usually don’t care what the answer is! When we’re laughing with friends, dancing with lovers, or playing with children, this question is usually the furthest thing from our minds. But when we are deeply hurting, we might ponder this profound question and what we are really asking is, “Why am I suffering? What is the purpose of all of this pain?” And sudism helps us to understand why we all must suffer.

On the other hand, many of us believe that our ultimate goal in life is to be happy, but as sudism teaches us, long-term happiness simply does not exist. So why are we here? What should we do with all of the time we are given? If we trust that the only true guidance we have comes from the many joys and aches we feel, and if we believe that their sole purpose is to lead us towards optimal health, then it seems logical to conclude that the meaning of life isn’t to strive for happiness, it is to strive for optimal health. That is, happiness is not an end, it is simply a means to an end, and the true end is health. Due to the gap between affect and health, the pursuit of happiness and the pursuit of health often diverge from each other—beware of this divergence!

To complicate that answer, health is more than just physical health, it’s also having healthy social relationships. It’s having healthy intimate relationships. It’s healthy mental stimulation and challenges. Health is bigger than one individual. It’s the health of each family, of each community, of all of humanity, and ultimately of the entire ecosystem that sustains us. However, the best path to optimal health is not necessarily obvious, nor is it necessarily the same for each of us. So what exactly is optimal health and how do we best reach it? Tough question—I’ll let you figure that one out.

IN-DEPTH: The future

Before we conclude this book, let’s take a quick peek at the future. If we fast-forward time by a few thousand—or even million—years, what might humankind look like? Well, if we manage to collectively improve our habits and cut down on our indulgences, humanity’s health and well-being may very well soar to levels never seen before. Affect and health would come back into close alignment, which is how they were always meant to be. If this worldwide shift in perception and behaviour ever happens, it could perhaps be called the Great Realignment.

If we don’t change our bad habits and our indulgent-laden environment, evolution may come to our rescue. Hard drug users, for instance, are opting out of the gene pool at an accelerated rate, which may shape our future by promoting genes that are more resistant to the effects of these substances. Similarly, our current levels of inactivity—which often lead to disease or illness—may put genetic pressure on us to evolve such that we enjoy physical activity more—or laziness less. The human mind and mouth may also evolve to make today’s sweet and salty foods taste disgusting instead of delicious. Is this the stuff of science fiction? Not really. We’ve already evolved this kind of defense mechanism for sodium: at roughly the concentration of sodium found in salt-water, our perception of food changes from pleasantly salty to disgustingly salty. Arguably, this is to protect us from consuming life-threatening amounts of salt in one sitting. As for sugar, if our ability to taste sweetness is doing us more harm than good, we might eventually lose it entirely. This might seem impossible, but it’s already happened to other species like dolphins and cats.

Of course, our species might not adapt, perhaps finding ever worse ways to indulge, and becoming sicker and more troubled over time. Only time will tell what will ultimately happen to us.

Final conclusion

Many of us have intuitively sensed the balance between our pleasure and our pain without ever putting it into words. We know that we have both good and bad days, ups and downs, but were never quite sure why we couldn’t have the “good” without the “bad.” The principles of sudism help us to better understand this naturally occurring balance. Although the core theory of suduality is simple to describe, it’s hard to fully grasp. It can take years to deeply understand its many ramifications and to reconcile it with all of our other beliefs.

While sudism shows us that we can’t escape to a realm of long-term happiness, it also teaches us how we can escape from a life of unhealthy, chronic pain. Sudism teaches us that for all sacrifice there is an equal reward, and for all indulgence there is an equal penalty.

Though the evidence can’t directly prove suduality, I find it hard not to believe in it. That’s because the alternative—no suduality—makes a lot less sense to me. Though I don’t fully understand sudism myself, it has brought an incredible depth of perspective and practical value to my own life. I hope it will provide the same insight and usefulness in yours. Visit sudism.org to learn more about sudism. If you would like to help and inspire others by sharing your own thoughts and experiences, you can do so at https://sudism.org/mystory .

It is my highest hope that sudism, or some variation of it, gradually gains acceptance alongside conventional disciplines like medicine and psychology. That it becomes recognized as a tool for preventing, treating, and potentially curing those suffering from anhedonia or chronic pain. If you or a loved one is suffering from these conditions and all other treatments have failed, give sudism a try even if you remain skeptical.

Armed with an understanding of these principles, I sometimes wish I could go back in time to my childhood and re-do my life to avoid many of the unhealthy mistakes I’ve made. Do you ever feel this way? The past may be set in stone, but the future is like clay. No matter how old we are, we still have time to make changes. Doing so may seem scary or difficult but remember this: the harder it is, the more rewarding it will be. If we have a young child or dependent, we can teach them what we know and set them on the sudist path to lifelong health and well-being. And they, in turn, may eventually set their own children or dependents down the same path, blazing a trail towards a healthier future.

Imagine a world with little or no indulgence. Imagine being able to erase most, if not all, of the chronic migraines, meaningless back pain, fibromyalgia, depression, anxiety, and suicidal thoughts across the globe. Imagine all of the alcohol- and drug-fuelled accidents, thefts, and homicides that would cease to occur. Imagine the depression-induced thought of crashing Germanwings flight 9525 never crossing co-pilot Andreas Lubitz’ mind, thus saving all 150 people on board. Are you picturing this imaginary world in your mind? Keep holding on to that image. . .

Sudism shows us that there exists a path from the world that we live in today to this imaginary world. Do you see the path?

Will you follow it?

Summary of Part Seven

Here is a summary of all key points from Part Seven. It can be used as an optional refresher or an executive summary.

#157: Increasing our unhealthy pleasure and decreasing our healthy pain both lead to increased unhealthy pain and reduced healthy pleasure (i.e. anhedonia).

#158: Increasing indulgences leads to either increased unhealthy pains or reduced healthy pleasures (anhedonia).

#159: Chronic pain and chronic anhedonia are both caused by chronic indulgence.

#160: We shouldn’t blindly seek all forms of pleasure or blindly avoid all forms of pain. Instead, we should be very selective about which forms and intensities of pleasure we seek and which pains we avoid.

#161: Sudism promotes alignment, not enlightenment.

#162: Reducing our consumption of unhealthy pleasures may not only lead to a reduction in our unhealthy pains and anhedonia, it may also reduce our likelihood of suffering from the secondary effects of indulgence, including diabetes, heart attacks, strokes, ADHD, relationship troubles, and even suicide and homicide.

#163: Many ancient civilizations and some modern tribes appear to rarely indulge, and therefore rarely suffer from unhealthy pleasure, unhealthy pain, or anhedonia.

#164: Each of us seems to have a unique pain signature—our own personal mix of unhealthy aches and pains that flare up when we are out of alignment.

#165: Science is great at fixing problems we can see and measure, while sudism is great at fixing problems we can feel but neither see nor measure.

#166: Many who have tissue damage don’t feel physical pain in the damaged area, while many who feel such pain don’t have tissue damage. Tissue damage does not always imply pain, and pain does not always imply tissue damage. Even if we have a badly damaged body part, we should not assume it is doomed to ache for the rest of our lives. Conversely, if we have excruciating pain somewhere in our bodies, we should not assume there is something wrong with that part of our body.

#167: Many of us don’t know what is causing our suffering simply because we don’t realize there is a direct connection between our indulgences and our various aches and anhedonia.

#168: Our habits—what we eat, drink, do, and don’t do—strongly influence our mood: whether we’re irritable or in good spirits, energetic or tired, playful or depressed.

#169: Even if we have suffered from a given physical or emotional ache for our entire lives, it does not mean it’s an inevitable, unchangeable, or incurable part of us.

#170: It’s possible to feel good without drugs or medications. Sudism shows us how to resolve painful problems such as excessive anxiety and depression without relying on psychoactive substances. However, always consult a qualified doctor before altering the dosage of any prescribed treatments.

#171: Both extreme pain and extreme pleasure are unhealthy—they can lead us to make reckless, life-endangering decisions.

#172: Feeling too little pleasure and pain is also unhealthy—it would lead us to reckless, life-threatening inaction.

#173: To be our healthiest and reach our maximum potential, we need to feel a healthy dose of both joy and suffering in life—not too much, not too little.

#174: There are hundreds of ways to apply sudism to maximize our health while minimizing our unhealthy pains and anhedonia. To succeed, we need to stop pushing the “pleasure” and “pain relief” buttons all the time, and instead seek aligned actions and activities.

#175: The fight against our own indulgent habits is hard but well worth it. The power to change is in you and you can start today!

#176: After giving up an indulgence that we strongly felt we needed, we’ll eventually realize that we never needed it in the first place.

#177: Being unaware of consequences doesn’t mean there aren’t any. In the realm of pleasure and pain, ignorance is not bliss. Sudism teaches us that it’s never too early in life to avoid consequences.

#178: Even if we believe the end is near, sudism teaches us it is never too late in life to make changes that will benefit us.

#179: Sudism teaches us that every pleasure counts, no matter how small. We can’t sneak anything behind suduality’s back. The saying “everything in moderation” should probably be changed to “everything healthy in moderation.” And we should simply minimize everything that isn’t healthy.

#180: Sudism teaches us that every pain counts, no matter how small. No effort or sacrifice goes unrewarded. In the long run, every little effort and sacrifice we make adds up.

#181: The ideal sudist life is one where each joy and every ache is infused with purpose and meaning.

#182: Sudism shows us how to take control of our suffering and how to restore natural joy in our lives, by realigning our affect and health.

#183: When it comes to food and beverages, the better it tastes—without providing additional nutrition—the worse it is for us. Sudists see food more as fuel for our bodies than as a source of pleasure.

#184: Reading the ingredient lists and nutrition facts of all foods we buy helps make us aware of all of the added sweeteners, savourizers, and other flavour enhancers. However, our mouths and noses have the final say on whether a food tastes excessively delicious or not.

#185: Comparing the flavours of sweetened and savourized foods side by side with their healthier, plain versions can open our eyes to what real, healthy food is supposed to taste like.

#186: When it comes to excessive weight gain, it would be wise to focus less on “calories in versus calories out” and more on “appetite stimulants versus appetite suppressants.”

#187: We are designed to struggle and work hard. These are normal and healthy things that we should seek and embrace, rather than reduce and avoid. Boosting our movement can boost our mood.

#188: Like with physical activity, we can better align our affect and our health by adding more mental workouts to our daily lives.

#189: Meditation and mindfulness can help us lessen our indulgent thoughts and behaviours, while increasing our acceptance of suffering.

#190: We can further improve our alignment of affect and health by spending less time hooked up to artificial indulgent stimulation on TV, in music, or in video games, and more time connected with real world sights, sounds, and situations.

#191: By reducing our consumption of certain drugs—whether commonplace, prescription, or recreational—we can further improve the alignment of our affect and health.

#192: By allowing ourselves to experience wider temperature fluctuations, within safe limits, we can further improve the alignment between our affect and health.

#193: By allowing ourselves to experience more of the aches, discomforts, and irritations of daily life, we can further improve the alignment between our affect and health.

#194: There are many other ways to improve the alignment of our affect and health, such as spending less time shopping or eating just for pleasure, facing our fears, and embracing the messy imperfections of our daily lives.

#195: There’s always a light at the end of the tunnel of suffering, if you’re willing to go through it. Pain ends—you don’t. To the extent that you are able, tough it out!

#196: Healthy pain is a teacher delivering us an insightful message. Erasing healthy pain also erases its underlying message, making it likely that we’ll repeat the same mistake in the future.

#197: Healthy pain is not useless, it is transformative. The purpose of pain is not for it to merely be relieved, but for it to be experienced.

#198: One of the most important lessons in sudism is to seek and embrace healthy pain rather than try to evade and destroy it with pills, machines, and other means.

#199: Embrace hard work, frustration, and struggling as an integral part of life. Sudism helps us see the profound value of healthy pain and suffering.

#200: We should be wary of anyone, even doctors and specialists, that encourages us to take pain pills or mood pills—like antidepressants or antianxiety medications—instead of trying to understand and address the root cause of our suffering.

#201: Parents, instead of giving your children the short-term gifts of indulgence, give them the life-long gift of freedom from indulgence and their many negative side effects.

#202: Sudism teaches us that chronic anxiety, depression, and other unexplained chronic aches are not isolated, idiopathic illnesses. They are symptoms or side effects directly caused by indulgences. To cure those afflictions, the indulgences must be identified and addressed.

#203: Civil servants, consider leveraging sudism to help guide your populations towards better health and less chronic pain and disease. This can not only lead to increased productivity, but also tremendous cost savings.

#204: The application of sudism has the potential of alleviating or even curing many of today’s chronic conditions, from depression and anxiety to chronic headaches and backaches. It may also reduce the risk of developing secondary effects of indulgence such as diabetes, obesity, attention deficit disorder, and heart disease.

#205: Sudism may seem at first to make it harder to make decisions in life, but a clear understanding of sudism actually makes many life choices easier.

#206: The more pain we embrace, the more resilient to future pain we will be, and the more successful we’ll become in achieving whatever we set out to accomplish.

#207: Many of us think that happiness is the end goal of life. But happiness is not an end, it is simply a means to an end, and the true end is health. To sudists, the meaning of life isn’t to strive for happiness, it is to strive for optimal health. Due to the gap between affect and health, the pursuit of happiness and health often diverge from each other—beware of this divergence!

#208: The future of humanity is uncertain. If we cut down on our indulgences, humankind may reach a pinnacle of health never seen before. If we don’t, we might evolve to prefer indulgences less, or perhaps we’ll just stagnate as we currently are. In the worst case, we might become more and more troubled by progressively worse indulgences.

#209: The theory of suduality is simple to state but difficult to master. Though it may take years to fully understand its many ramifications, you can start using it today.

ACKNOWLEDGEMENTS

Thank you to my wonderful, loving wife Angela for encouraging me to write this book and for supporting me throughout the entire process. I simply couldn’t have done it without you.

Thank you to Lee McCallum, Jason Ang, and Angela for reviewing early drafts and providing thorough and insightful feedback. You have enabled me to see things from other perspectives everywhere that I was shortsighted. This book could not have been what it is without each of you.

Thank you to my editor, Light Hurley, for his quick and thoughtful feedback, and to Lynne Melcombe for her thorough editorial feedback on the first few parts of the book. Thanks to Angela for the final proofread. You have all brought a wealth of improvements for which I am very grateful.

Thank you to Liette Séguin, Daniel Falcioni, and Karen Carey, who granted me the time off of work that was essential to researching and writing the early drafts, and to Eric Charlebois, Nadia Girgis, James Edwards, Karim Zeineddine, Jaydan Café, and others who covered my work responsibilities while I was on leave.

And finally, this book wouldn’t have been possible without the extensive contributions of all of the scientists, doctors, philosophers, researchers, and everyday individuals worldwide that I’ve cited who’ve graciously shared their knowledge, insights, and personal experiences with the rest of us. As they say, if we can see a little further than those before us, it’s because we’re standing on the shoulders of giants.

APPENDIX: THE MANY KINDS OF PLEASURE AND PAIN

The Pan-Affect Chart—A chart of pleasures and pains

The many kinds of pleasure

The many kinds of pain

Other feelings not in the appendix

At the very beginning of Part One, we had a quick look at the different kinds of pleasure and pain to give us a basic understanding of these two fundamental concepts. Now it’s time to take a closer look at our many joys and sorrows, why we feel them, and how to tell when these feelings are “healthy” versus “unhealthy.” Why go into such detail? Well, there are many good reasons:

To show us that there is a rich variety of pleasures and pains, some we may not have thought much about. Many of us have a narrow definition of pain, for instance, but sudism considers all unpleasant sensations—even hunger and fatigue—to be forms of pain.

To show us that every type of pleasure and pain has an underlying purpose that promotes health, though not every occurrence of pleasure or pain actually promotes health.

To show us that, for virtually all types of healthy pain, there is a corresponding unhealthy version of that pain. These unhealthy pains are all excessive (or entirely unnecessary) for our health. Which ones might you be dealing with now, and which ones have you felt before?

To show us that for some healthy pleasures, there is an unhealthy version of it. Like with unhealthy pains, these unhealthy pleasures aren’t necessary for our health. Which ones might you have partaken in?

Knowing the different flavours and intensities of our many affects also helps us to better understand other people. It could be argued that these feelings motivate most of our daily choices and actions. Understanding them helps us to see why our families, friends, acquaintances, and even we ourselves feel and act the way we do.

The Pan-Affect Chart—A chart of pleasures and pains

Note: This section was also reproduced in Part One.

Pleasure and pain play such a central role in our daily lives. That is why it seemed quite odd that, despite extensive research, I could not find any modern, comprehensive list of all human affects including those that are physical, emotional and intellectual. The closest compilation that I found was over two-hundred years old, for Pete’s sake! So, here is my personal attempt at compiling such a list, though it is by nature subjective. It is essentially a high-level map of all of the fundamental drives that motivates us each day. Green items (in the left half of each column) are pleasures, red items (in the right half of each column) are pains, and opposites are paired up side-by-side.

PHYSICAL ACTIVITY DRIVERS

MENTAL ACTIVITY DRIVERS

Pleasant physical activity

Physical restlessness,
Physical effort

Pleasant mental stimulation

Mirth

Boredom, Curiosity, Mental effort

Physical rest

Physical fatigue

Mental rest

Mental fatigue

THERMAL DRIVERS

SOCIAL DRIVERS

Pleasant core warming

Low core temperature

Pleasant touch

Longing for touch

Pleasant core cooling

High core temperature

Caring for others

Compassion

Pleasant surface warming

Low surface temperature

Feeling cared for

Feeling uncared for

Pleasant surface cooling

High surface temperature

Retribution

Anger

NUTRITIONAL DRIVERS

SEXUAL DRIVERS

Pleasant scents and flavours

Unpleasant scents and flavours

Sexual attraction

Sexual curiosity

Satisfying hunger

Hunger pains,
Stomach overfullness

Sexual activity

Sexual desire,
Sexual overactivity

Quenching thirst

Thirst,
Stomach overfullness

Being in love

Lovesickness

Breathing

Shortness of breath

EXPECTATION DRIVERS

Urinating or defecating

Urge to urinate or defecate

Satisfaction with self

Disappointment in self

Relief from expelling irritants

Nausea and indigestion,
Urge to cough,
Urge to sneeze,

Urge to gag

Satisfaction with others

Disappointment in others

NON-SPECIFIC DRIVERS

OTHER PHYSICAL SAFETY DRIVERS

Joy

Dysphoria

(no opposites)

Headaches
Musculoskeletal pains,
Unpleasant sounds,
Unpleasant brightness,
Other surface pains,
Other physical pains

IMAGINATION DRIVERS (past, present, future)

Remembering pleasure

Remembering pain

Imagining pleasure

Imagining pain

Scratching an itch

Itching

Anticipating pleasure

Anticipating pain

Pan-Affect Chart (version 1.2)

The many kinds of pleasure

Pleasure comes in many wonderful flavours and intensities. How should we split all of these positive feelings into distinct categories? Many thinkers disagree on how to do this, so this is my subjective attempt to organize them all. Also, how much of each of these pleasures are we supposed to feel? Well, the Healthy range sections give us an idea how much a healthy person should feel, whereas the Low range ones are generally insufficient for optimal health while the High range ones are excessive.

PHYSICAL ACTIVITY DRIVERS

Pleasant physical activity (opposite of Physical restlessness)

Description and purpose: The pleasant feeling of physical activity satisfies our desire to be active, especially when we feel restless or energetic. This includes gross motor activities as well as fine motor activities. It includes physical labour, as well as physical play such as sports or horseplay. It also includes acquiring and mastering physical skills and techniques, from a child who is learning to stack toy blocks to a bricklayer learning to lay real bricks. Finally, it includes any activity leading to an increasing sense of power, control, and mastery over our bodies and our physical environments. This encourages us to move around, which boosts our circulatory system, our immune system, and prevents blood clot formation.

Healthy range: Unless we are sick or injured, we should aim to be physically active every day. Physical activity should be enjoyed without resorting to indulgences. Examples are learning and mastering new skills, techniques, or procedures, such as learning carpentry or how to ride a bicycle. Stretching muscles and yawning after prolonged inactivity (such as when we wake up) are also healthy. These help promote blood flow into—and waste flow out of—our muscles while also lubricating our joints.

Low range: Our enjoyment of physical activity can be reduced by depression, the side effects of alcohol and certain drugs, or other causes. Also, being stationary for extended periods of time is suboptimal since the body is designed to move for maximum health.

High range: No data available—some drugs may generate or amplify this sensation.

Physical rest (opposite of Physical fatigue)

Description and purpose: The joy of resting encourages us to physically relax and sleep.

Healthy range: This feeling should occur when we rest due to being physically tired, sick, or injured, and should abate when rest is no longer needed.

Low range: A lack of satisfaction from resting (anhedonia) may be caused by depression, the side effects of alcohol and certain drugs, and other factors.

High range: No data available—some drugs may generate or amplify this sensation.

MENTAL ACTIVITY DRIVERS

Pleasant mental stimulation (opposite of Boredom and Curiosity)

Description and purpose: This is the joy of learning. Having our minds stimulated with new and interesting information is generally enjoyable, which encourages us to explore the world and feed our minds. We are hardwired to be curious. The mind is hungry for information, like the stomach is hungry for food, which is why researchers like Irving Biederman and Edward A. Vessel describe humans as infovores. We enjoy solving puzzles and discovering new relationships between things. By gaining new information about people, places, and things, we may gain a competitive advantage over potential rivals or predators, and become more successful in finding food, building shelters, fending off attackers, and attracting mates. As many say: knowledge is power. This includes acquiring and mastering cognitive skills, techniques, and abilities. On the other hand, when we do not have enough mental stimuli, we can easily become bored.

Healthy range: It is healthy for us to seek and discover new and interesting information that is potentially useful or improves our understanding of the world, such as when we exchange stories, thoughts, and feelings with each other. Healthy sources of mental stimulation also include: learning about the personalities and motives of other people; discovering personal secrets or other prized information; mastering desirable mental skills, abilities, techniques and procedures, such as math, a trade, or a hobby; learning how to use a new toy, tool, gadget, vehicle, and so on. Also, learning how others solved a problem can help us later when we face similar challenges. Curiosity and the joy of learning manifest very strongly in children, in the way they play with toys and with each other. This helps them learn how to move around, manipulate objects, and interact with others. Discovering explanations for worldly phenomena provides satisfaction and even joy. It is better to be fascinated and engage with the real world than to be lost in our own fantasies or in indulgent virtual realities.

Low range: A lack of pleasure from cognitive stimulation (anhedonia) may be caused by depression, the side effects of drugs and alcohol, and other factors.

High range: Excessively stimulating entertainment that provides little or no education or inspiration is considered indulgent. In TV, movies, and video games, this stimulus can take the form of exciting visuals (“eye candy”), enjoyable music (“ear candy”), ever-changing situations, witty dialog, and amusing characters that provide us with a steady stream of pleasant stimulation. Fiction is more stimulating and rewarding than reality, psychologist Paul Bloom argues, since its highly-scripted adventures and dialog are invariably more interesting than our relatively dull day-to-day experiences. Music can be highly enjoyable because it’s filled with many interesting patterns. Consuming media purely for enjoyment or to escape painful feelings is also indulgent, whether we are reading novels, sports trivia, social media, or celebrity gossip. Other examples of indulgent mental stimulation are: amusement parks; so-called “edutainment,” which blends entertainment with quality education; and an enhanced joy of learning while under the influence of marijuana or other drugs.

Mirth (no opposite)

Description and purpose: Mirth is the feeling that occurs when we discover a delightfully surprising incongruence. It is the feeling of amusement and often leads to smiling or laughter.

Healthy range: The joyful fun and laughter that happens when playing and joking with adults, children, and even our pets.

Low range: Reduced mirth (anhedonia) can be caused by depression, the side effects of drugs and alcohol, and other factors.

High range: Fun and laughter can be excessively amplified by comedy shows and stand-up comedians. Alcohol, marijuana, or other drugs can also excessively amplify the fun and laughter we experience from normal social or solitary settings.

Mental rest (opposite of Mental fatigue)

Description and purpose: The enjoyable feeling of resting our minds encourages us to mentally relax or sleep in order to recharge.

Healthy range: Resting our minds or sleeping when we are tired is healthy.

Low range: The pleasant sensation of resting (anhedonia) can be reduced by depression, the side effects of drugs and alcohol, and other factors.

High range: No data available—some drugs may generate or amplify this sensation.

THERMAL DRIVERS

Pleasant core warming (opposite of Low core temperature)

Description and purpose: Feeling pleasantly warm in the center of our bodies encourages us to find ways to attain or maintain optimal core body temperature, such as by seeking shelter or by dressing more warmly. This saves us from resorting to shivering to warm ourselves up (which costs us calories), and ultimately helps us avoid hypothermia.

Healthy range: Feeling warm from being out in the sun on a beautiful day, or from coming indoors after being out in cold weather is healthy, as is occasionally warming ourselves up with hot drinks.

Low range: Reduced feelings of core warmth (anhedonia) can be caused by depression, the side effects of drugs and alcohol, congenital insensitivity to pain with anhidrosis (CIPA), and other factors.

High range: Taking frequent long hot showers, baths, and saunas purely for enjoyment is considered excessive. Also indulgent is the excessive consumption of warm drinks and foods to warm the body up instead of letting the body warm itself up, assuming it is safely able to. Finally, by avoiding natural daily and seasonal temperature fluctuations, we may be taking away healthy “thermal work” from our bodies that they are ultimately designed to handle.

Pleasant core cooling (opposite of High core temperature)

Description and purpose: This pleasant cooling sensation occurs when our core body temperature is elevated and cooling down. This feeling encourages us to find ways to attain or maintain optimal core body temperature, such as by seeking shade from the Sun or by wearing lighter clothing. This saves us from resorting to sweating to cool down (which uses up our water reserves), and ultimately helps us avoid heat stroke.

Healthy range: Healthy behaviors that cool our core include heading for shade or a cool building after being out in hot weather, going for a swim to cool down, as well as drinking cold fluids when we can’t avoid the heat.

Low range: The loss of pleasant cooling sensations (anhedonia) can be caused by depression, the side effects of drugs and alcohol, CIPA, and other factors.

High range: Relying excessively on air conditioning and cold foods and beverages to cool the body down, instead of letting the body cool itself down naturally, may be considered indulgent. By minimizing our exposure to natural daily and seasonal temperature fluctuations, we are taking away healthy “thermal work” from our bodies.

Pleasant surface warming (opposite of Low surface temperature)

Description and purpose: Pleasant surface warming occurs when our skin or other body surfaces are cool and come into contact with warm air or other warm things. This motivates us to try to maintain ideal surface temperatures and helps us prevent frostbite.

Healthy range: It is healthy to feel warmth on our skin from exposure to warm air, other people’s warmth, and other things including sunlight. Sunlight exposure also provides other health benefits such as vitamin D creation, calibrating our circadian clock, boosting our immune system, and improving our sleep.

Low range: Reduced feelings of pleasant warmth (anhedonia) can be caused by depression, the side effects of drugs and alcohol, CIPA, and other factors.

High range: Excessive hot showers, baths, and saunas may be considered indulgent, as might be excessive consumption of warm drinks and foods. Alcohol and some other drugs can also artificially enhance sensations of pleasant warmth.

Pleasant surface cooling (opposite of High surface temperature)

Description and purpose: Pleasant surface cooling occurs when our skin or other body surfaces are overly warm and come into contact with cooler things such as air or water. This motivates us to try to maintain ideal surface temperatures and helps us avoid getting burned.

Healthy range: The pleasant cooling effects of cool air or cold water on our skin are considered beneficial and healthy.

Low range: Reduced cooling sensations (anhedonia) can be caused by depression, the side effects of drugs and alcohol, CIPA, and other factors.

High range: Excessive air conditioning and consumption of cool foods and beverages may be considered indulgent. Cooling agents such as menthol may also cause a pleasant cooling sensation at normal temperatures. Some drugs may also generate or amplify this kind of cooling sensation.

NUTRITIONAL DRIVERS

Pleasant scents and flavours (opposite of Unpleasant scents and flavours)

Description and purpose: Pleasant scents and flavours help us to identify foods and beverages that are edible. The pleasure we get from eating and drinking motivates us to provide various essential nutrients to our bodies. This pleasure comes not only from taste but also from texture (such as crunchy, doughy, or creamy). There are also literally thousands of different volatile aromatic compounds that are released into our nasal passages as we eat or drink, which profoundly impact the scent and flavour of what we consume.

Healthy range: Healthy scents and flavours include those of natural, unprocessed foods with nothing added to them and nothing removed from them. They also include the scent of flowers, fresh air, fresh cut grass, and other natural things. To better understand what flavours fall within and outside of the healthy range, please refer to Improving our diet.

Low range: At least 250 types of medication negatively affect our ability to smell or taste, including various antibiotics, muscle relaxants, antihypertensives, antidepressants, and migraine medications. Anosmia, the loss of sense of smell, can also occur as a side effect of drugs, medication, alcohol use, infections such as novel coronavirus COVID-19, or as a congenital disorder. The loss of enjoyment of food (anhedonia) can also be caused by depression, the side effects of drugs and alcohol, and other factors. Consuming large amounts of sweeteners, salt, and monosodium glutamate (MSG) in the long-term may cause unsweetened, unsalted foods to taste less pleasant than they normally should. The herb Gymnema Sylvestre can numb our ability to taste sweetness for up to an hour after coating the tongue.

High range: The pleasant scents and flavours of sweetened foods is usually excessive—think of the smell of bakeries and the flavours of typical store-bought cakes, ice creams, and soda pop. Also excessive are the scent and taste of foods high in savourizers (i.e. sodium and MSG), such as typical pizzas, chips, salted nuts, hot dogs, and deli meats. Consider foods that have had most of their healthy fibre or other nutrients removed, such as enriched white breads or fruit juices, which may make them pleasantly easy to chew or swallow. Added smoke flavor may also be considered indulgent. Comfort eating and emotional eating in order to relieve our boredom, stress, or other difficult feelings are also indulgent. Hedonic hunger, the desire to eat or drink for pleasure rather than out of hunger or thirst, is also indulgent. Asides from food, the scent of perfumes, soaps, air fresheners, and other scented products are unnecessarily excessive. Finally, some drugs such as marijuana can boost the flavour of foods, while other drugs such as heroin can give users a wonderful flavour sensation despite having nothing in their mouths.

Satisfying hunger (opposite of Hunger pains)

Description and purpose: Feeling pleasantly full after a snack or a meal rewards us for nourishing our bodies.

Healthy range: Satisfaction from relieving hunger is healthy when it is proportional to food intake as well as to the underlying degree of hunger, and fades away after the body is properly fed.

Low range: Reduced feelings of hunger satiation (anhedonia) can be caused by depression, the side effects of drugs and alcohol, and other factors.

High range: No data available—some drugs may generate or amplify this sensation.

Quenching thirst (opposite of Thirst)

Description and purpose: The pleasure we get from quenching our thirst by drinking water or other fluids motivates us to keep our bodies hydrated.

Healthy range: Satisfaction from relieving thirst is healthy when it is proportional to fluid intake and our underlying degree of thirst, then goes away once the body is properly hydrated.

Low range: Reduced enjoyment of quenching thirst (anhedonia) can be caused by depression, the side effects of drugs and alcohol, and other factors.

High range: No data available—some drugs may generate or amplify this sensation.

Breathing (opposite of Shortness of breath)

Description and purpose: The subtle pleasure of breathing clean air encourages us to supply our bodies with oxygen as well as expel excess carbon dioxide.

Healthy range: Due to the frequency with which we breathe and the fact that much of our breathing is done subconsciously, the pleasure we experience from breathing is normally faint or undetectable. However, this feeling becomes more pronounced when we take in a large breath of fresh air after suffocating or holding our breath.

Low range: Reduced pleasant sensation of breathing (anhedonia) can be caused by depression, the side effects of drugs and alcohol, and other factors.

High range: No data available—some drugs may generate or amplify this sensation.

Urinating or defecating (opposite of Urge to urinate or defecate)

Description and purpose: The pleasure of expelling body wastes encourages the continuous flow of nutrients through our digestive tracts.

Healthy range: Feeling this kind of pleasure is healthy when it’s in proportion to expelling normal body waste.

Low range: Reduced enjoyment of expelling waste (anhedonia) can be caused by depression, the side effects of drugs and alcohol, and other factors.

High range: No data available—some drugs may generate or amplify this sensation.

Relief from expelling irritants (opposite of Nausea and indigestion, Urge to cough, and Urge to sneeze)

Description and purpose: The pleasant relief we experience after vomiting, passing diarrhea, coughing, or sneezing encourages us to expel toxins, pathogens, and other irritants out of our bodies.

Healthy range: This feeling of relief is healthy when it occurs in proportion to the degree of toxins or irritants actually expelled, and then fades away.

Low range: Reduced feelings of relief when expelling irritants (anhedonia) can be caused by depression, the side effects of drugs and alcohol, and other factors.

High range: No data available—some drugs may generate or amplify this sensation.

OTHER PHYSICAL SAFETY DRIVERS

Scratching an itch (opposite of Itching)

Description and purpose: The pleasure of scratching a physical itch encourages us to rid our bodies of potential irritants and parasites such as lice, mosquitoes, and ticks.

Healthy range: Feeling satisfaction from scratching an itch is healthy when it occurs in proportion to an itch from natural causes, and then disappears.

Low range: A reduced sense of relief of itchiness (anhedonia) can be caused by depression, the side effects of drugs and alcohol, and other factors.

High range: No data available—some drugs may generate or amplify this sensation.

SOCIAL DRIVERS

Pleasant touch (opposite of Longing for touch)

Description and purpose: Pleasant touch is any non-sexual contact that encourages us to bond with other adults, children, and even animals, such as pets.

Healthy range: Healthy pleasant touch occurs when we make friendly, non-sexual contact with someone we care for, such as rubbing someone’s back or arm, affectionately touching them, or giving them a soothing massage, hug, or kiss. It occurs when we carry a child or cuddle with a pet. It can also manifest as playful romping and roughhousing with others. Play-fighting, which the young of many species partake in, is also a safe way to hone fighting skills without getting seriously injured.

Low range: Reduced pleasure (anhedonia) from physical contact can be caused by depression, the side effects of drugs and alcohol, and other factors.

High range: Indulgent massages that don’t promote bonding or any other practical purpose might be considered indulgent. Pleasant touch can also be artificially enhanced by the short-term effects of certain recreational drugs like ecstasy. Children may also indulge in this kind of pleasure by holding their favourite plush toy or blanket.

Caring for others (opposite of Compassion)

Description and purpose: The joy of making someone else feel good encourages us to protect others and take care of their needs, instead of focusing solely on ourselves. It motivates us to give or show our love, caring and affection to others. It rewards us for giving food, shelter, and other gifts to those we care about. This includes showing others that we understand and accept them, including their flaws. It includes giving our respect and admiration to others. It’s the joy of giving. This feeling encourages us to take care of each other and improve each other’s chances of surviving and thriving. It also extends to animals and other living things that we feel we can nurture and help grow.

Healthy range: Feeling useful by actually helping and providing for others is healthy, such as when we watch out for our friends’ and family’s best interests. Healthy occasions that make us feel this way include: an adult’s joy in nurturing and taking care of their children or dependents; listening with sympathy to what others have to say; smiling at others; being happy when something good happens to someone we care about; and fulfilment from giving help, money, or advice to those in need, perhaps by volunteering or doing other charitable work.

Low range: Having difficulty feeling care and affection for others (anhedonia) can be caused by depression, the side effects of drugs and alcohol, and other factors.

High range: This feeling may be artificially simulated by TV shows, movies, novels, video games, and other forms of entertainment. Fantasizing about helping others or “saving the world,” without any intention of carrying out these actions in real life, may be considered excessive.

Feeling cared for (opposite of Feeling uncared for)

Description and purpose: We feel cared for when we receive love, support, admiration, appreciation, or affection from others. This feeling encourages us to act in such a way that we continue to receive these from others. Some children may act helpless to secure our help or attention even though they are fully able to carry out the task at hand. Some adults continue to act helpless or exaggerate their suffering in order to attract sympathy and help—what Caroline Myss called woundology. Ultimately, this feeling encourages us to spend time together, live together, work together, raise children together, and build communities together.

Healthy range: It is healthy to feel cared for when we receive love, help, support, a compliment, a gift or a special message from someone else. Other healthy things that trigger this feeling include: being liked, appreciated, and respected by others; feeling that someone is listening with sympathy to what we have to say; having the respect and admiration of others; socializing and having fun with real people without relying on alcohol or other drugs; exchanging thoughts and feelings, telling stories, and being playful with each other; connecting at a deep level with others and letting our guard down; building trusting, nurturing relations; receiving smiles from others; bonding with pets or other living things; feeling nurtured and protected, whether by family, friends, or strangers; and receiving food, shelter, or other gifts from others. We feel cared for when we are part of a family, group, gang, team, or community and feel understood and accepted by others, including our flaws.

Low range: Difficulty feeling loved and cared for (anhedonia) can be caused by depression, the side effects of drugs and alcohol, and other factors.

High range: Excessive fantasizing of feeling loved by others may not be healthy. Neither would a feeling of being cared for that is artificially stimulated by TV, movies, novels, or video games. Pleasant socializing that is amplified by alcohol, marijuana, or other drugs would be considered unhealthy. Bonding with inanimate objects such as dolls, plush toys, or imaginary friends may also be considered unhealthy.

Retribution (opposite of Anger)

Description and purpose: Retribution comes in two forms: active and passive. Our anger must first be provoked by someone or something that is causing us some kind of undeserved trouble or threat. Active retribution occurs when we act on our anger by attacking, retaliating, or getting revenge on the thing that has provoked us. This includes verbal threats, insults, angry criticisms, and attacks, as well as laughing at others’ misfortune. It also includes physical threats or attacks, as well as passive-aggressive behaviours. Attacking or punishing someone else motivates that person to reduce or stop their questionable behaviour, such as hurting us, disrespecting us, or stealing from us. Without our desire and ability to lash out and retaliate, others could easily take advantage of us, our property, and our loved ones without fear of retribution. In short, this feeling protects us and what is ours while shaping the behaviour of others. The passive form of retribution, on the other hand, occurs when something bad happens to someone we’re angry with (or jealous of) and we take pleasure in it. This is also called just deserts or schadenfreude.

Healthy range: Threatening or attacking someone or something that has threatened or hurt us is healthy when it is proportional to the severity of the threat and is done to neutralize that threat. This includes: when we verbally attack someone by making them feel bad or wrong, such as bickering with our partner; when we spread malicious information—factual or not—about a perceived enemy, competitor, or someone we are jealous of; when we punish someone for having done something wrong, such as a parent punishing their child for intentionally breaking the rules; when a child pinches or shoves another child for having taken his toy or for some other transgression. Attacks may also be directed at inanimate objects, such as when we slam a door, bang a table, or yell at the TV.

Low range: The numbing of pleasures of retaliation (anhedonia) can be caused by depression, the side effects of drugs and alcohol, and other factors.

High range: Excessive feelings of retribution can occur for instance when: we see the hero of the story get their vengeance on the “bad guys;” we shoot, stomp, or beat up others in a video game; we indulge in sadistic revenge fantasies; we start physical or verbal fights purely to take our aggression out on others; we physically or verbally abuse children, animals, or other defenceless beings just to make ourselves feel better; or when we insult and belittle others for fun, like internet trolls do.

SEXUAL DRIVERS

Sexual attraction (opposite of Sexual curiosity)

Description and purpose: Sexual attraction is the pleasure of viewing and assessing the desirable qualities of potential sexual mates. Symmetrically, it is also the pleasure of feeling desired by potential mates. Precisely what arouses us varies for each of us. It may be anything from physical health, wealth, or social status, to a sense of humour, life skills, or being good with children. It’s one step along the way to bonding and possibly procreating with the person we desire. It includes being attracted to each other, and flirting, charming, romancing, or sexually teasing each other. This feeling motivates us to approach attractive people, pursue them, spend time with them, and build relationships with them.

Healthy range: Feelings of sexual attraction are healthy when we look at, or are admired by, a person we find attractive in some way. These feelings are also healthy when we flirt with a potential mate, or try to impress them by showing off our abilities and attributes.

Low range: Reduced enjoyment (anhedonia) of sexual attraction can be caused by depression, the side effects of drugs and alcohol, and other factors.

High range: Artificial feelings of sexual attraction can be provided by pornography, romance novels, soap operas, characters in video games, and so on. Excessive fantasies of flirting or romance that don’t lead to pursuing real mates may also be considered unhealthy.

Sexual activity (opposite of Sexual desire)

Description and purpose: Pleasant sexual activity includes sexual touch, intercourse, and orgasm. These encourage physical and emotional bonding between two people, as well as procreation in fertile couples of the opposite sex.

Healthy range: Masturbation alone or sex with a willing partner is healthy if it occurs at a frequency that does not take over one’s life and is not used to escape unrelated painful feelings. Sexual activity is healthy when it occurs without alcohol, recreational drugs, pornography, pleasure-enhancing devices, or other artificial stimulants.

Low range: Reduced sexual sensations or inability to orgasm (anorgasmia) can be caused by drugs or medications such as certain antidepressants or analgesics. Reduced interest in sex (anhedonia) can be caused by depression, drugs, alcohol, and other factors. Orgasms that do not feel pleasurable may be due to orgasmic anhedonia (also known as pleasure dissociative orgasmic disorder), which may be caused by certain antidepressants, oral contraceptives, or certain medical conditions.

High range: Examples of indulgent sexual pleasure include: consuming pornographic or erotic pictures, stories, artwork, or videos; using pleasure-enhancing devices, drugs, or alcohol to artificially enhance the experience; using medications that increase libido, including some antidepressants and antianxiety medications; visiting strip clubs or fantasizing excessively about sex; and hypersexuality, which consists of excessive masturbation or intercourse in order to escape negative feelings or as a side effect of some recreational drugs, such as methamphetamines.

Being in love (opposite of Lovesickness)

Description and purpose: Being in love is the initial feeling of falling in love with someone, which may be called “passionate love” or being “head over heels.” This feeling can occur when we are infatuated with someone. It’s one step along the way to pair-bonding and possibly having children.

Healthy range: Falling in love with a real person that might develop into a relationship is healthy, as is expressing our love through words, gestures, and actions. Though many of us wish it would last forever, it is entirely normal for this lovely feeling to fade away within the first two years of a romantic relationship, as we saw in Lovers and newlyweds.

Low range: Reduced feelings of love (anhedonia) can be caused by depression, the side effects of drugs and alcohol, and other factors.

High range: Examples of indulgent feelings of love include: excessive fantasizing of being in love; falling in love with celebrities whom we’ll probably never meet; falling in love with fictional characters in romance novels, soap operas, video games, or television shows; and drug- or alcohol-fuelled passion.

EXPECTATION DRIVERS

Satisfaction with self (opposite of Disappointment in self)

Description and purpose: Satisfaction and pride occur when we meet or exceed our own expectations of ourselves. It can also happen when our ingroup succeeds, that is, our family, friends, and others with whom we closely identify. This feeling comes in two basic flavours: the satisfaction that we (or our ingroup) have done better than expected, and the relief that we (or our ingroup) have not fared as poorly as expected. This may also be called contentment, or in the extreme, triumph. These feelings fuel our determination, give us that “get up and go” feeling, and fill us with inspiration. They reward us for making progress towards our goals and for achieving them, therefore energizing and motivating us to actively pursue and accomplish future goals. Consistently exceeding our self-expectations usually causes these expectations to rise.

Healthy range: These feelings are healthy when they occur in proportion to reaching or exceeding our goals and expectations of ourselves (or our ingroup). Satisfying goals may include: acquiring certain possessions, mastering certain skills, completing educational degrees, and so on. It is the rewarding feeling we may get after completing a hard problem or difficult task, overcoming obstacles, solving a puzzle, or resolving a difficult interpersonal situation. It occurs when we succeed at something challenging, whether it’s a solitary activity or a team accomplishment. It’s the feeling of increasing in power and strength, which gives us an ego-boost and rewards us for having worked hard to increase in status relative to our peers. These feelings of superiority motivate us to do our best to succeed in life relative to our own expectations and that of our peers. It may also occur by association with other individuals, such as feeling proud of our children’s accomplishments. Other healthy examples include: feeling strong, beautiful, or smart; the thrill of shopping for and finding the perfect item at the perfect price; discovering that a task will take much less time and effort than anticipated; feeling relieved when sickness or aches go away so we can get back to our regular activities; and finding out that someone thinks highly of us.

Low range: Numbed feelings of satisfaction (anhedonia) can be caused by depression, the side effects of drugs and alcohol, and other factors.

High range: Indulgent feelings of power and satisfaction can occur when: we accomplish virtual goals in video games, or by associating with fictional characters in a TV show or novel; we complete pleasant but unnecessary tasks—like shopping for shoes or gadgets we don’t really need, which some call retail therapy; we’re pleased that our favourite sports team, over which we have no control, has won a game; we excessively fantasize of winning competitions or achieving important things, including delusions of grandeur; we boost our self-confidence with alcohol, cocaine, or other drugs; we indulge in excessive vanity, self-flattery and narcissism, such as spending inordinate amounts of time admiring our own physique, abilities, or achievements; and when we regularly ask others to flatter us.

Satisfaction with others (opposite of Disappointment in others)

Description and purpose: Satisfaction with others happens when people in our outgroup (that is to say, those who aren’t in our close-knit ingroup of friends and family members) meet or exceed our expectations. In other words, it’s being satisfied with things that are mostly beyond our control. This feeling comes in two basic flavours: the satisfaction that something is better than expected, and the relief that something is not as bad as expected. This feeling may also be called gladness, contentment, or delight. Consistently having our expectations of others exceeded typically causes these expectations to rise.

Healthy range: Satisfaction with others is healthy when it occurs proportionately to real life events, then fades away. It is the relief of having a challenge or hardship removed from our lives so that we no longer have to deal with it. It’s being pleased that something has turned out better than expected, for instance the weather, a meal or social event organized by others, or work carried out by hired contractors. It’s also the relief we feel when difficult life events are resolved in our favour, such as surviving a car crash unscathed or recovering from an illness earlier than expected.

Low range: Reduced satisfaction (anhedonia) can be caused by depression, the side effects of drugs and alcohol, and other factors.

High range: No data available—some drugs may generate or amplify this sensation.

NON-SPECIFIC DRIVERS

Joy (opposite of Dysphoria)

Description and purpose: Joy, which may be called elation or, at its peak, euphoria, encourages us to continue to reach for and maintain those environments or life situations in which everything feels “right” to us. Joy may be seen as a non-specific pleasure where things generally “feel right,” where we feel “high on life,” cheery, or simply in a good mood. The pure feeling of joy, unlike all other pleasures, isn’t tied to any specific physical or emotional function. Being in a good mood, through the principle of blending, can offset other pains and irritants that would normally bother us and help us tolerate them better.

Healthy range: Joy may manifest itself when we see a beautiful nature scene such as a majestic sunrise, a flickering fire, or when the various pieces of our lives finally feel like they are falling into place. Also, pure joy often occurs when our positive tension is high and we are due for pleasure—thus re-establishing the balance between our positive and negative feelings.

Low range: Lack of joy (anhedonia) can be caused by depression, the side effects of drugs and alcohol, and other factors.

High range: Euphoria that is induced by various recreational drugs is considered to be unhealthy.

IMAGINATION DRIVERS (past, present, and future)

Remembering pleasure (i.e. imagining it in the past tense) (opposite of Remembering pain)

Description and purpose: This is the joy of recalling pleasant memories. These happy memories sometimes occur spontaneously, but are often triggered by association with other things such as the perfume of a loved one, a plush toy from our childhood, or a song we heard at an emotionally significant time. The purpose of pleasant memories may be to remind us of good things we had before, but perhaps no longer have, which might encourage us to strive to re-obtain those things.

Healthy range: Recalling pleasant memories of our past is healthy when it occurs in a manner and frequency that does not overtake our lives or prevent us from appreciating the present moment.

Low range: Difficulty perceiving the pleasantness of past memories (anhedonia) can be caused by depression, the side effects of drugs and alcohol, and other factors.

High range: Revelling excessively in cherished memories either for the pure joy of it, or in order to numb our pain, is generally unhealthy.

Imagining pleasure (i.e. imagining it in the present tense) (opposite of Imagining pain)

Description and purpose: Imagining something pleasant, also known as reverie, is pleasant daydreaming in the present tense. In other words, it is imagining pleasant things that are not related to our past or future. It can occur when we imagine being someone else, somewhere else, or doing something else instead of being in the present moment. Daydreaming may occur spontaneously or be triggered by association with particular items, such as a lucky accessory, someone’s picture, or even drug paraphernalia. Such reveries may motivate us to attain the fantasy scenario in our actual lives. Daydreams come in many forms: being the “suffering martyr,” dreams of revenge against those who have betrayed or humiliated us, and fantasies of romance, power, wealth, or status.

Healthy range: Daydreaming can be healthy when it is limited in length and serves to motivate us to attain the fantasized-about scenario in our actual lives. This also includes pleasant dreams we experience while sleeping.

Low range: Having difficulty imagining anything pleasant (anhedonia) can be caused by depression, the side effects of drugs and alcohol, and other factors.

High range: Maladaptive daydreaming, also known as compulsive fantasizing, occurs when we daydream to escape negative feelings, or we daydream excessively each day, which interferes with our daily activities and responsibilities. It may also take the form of hearing pleasant voices, dialog, or music in our minds. It can occur in the form of pleasant hallucinations when taking drugs such as LSD or mescaline. It may also occur in some forms of psychosis such as the delusions of grandeur of a schizophrenic. It includes unrealistic fantasies about being the hero of a situation, such as when kids dream of being superheroes. Some maladaptive daydreamers spend the majority of their time lost in their imaginary world, since they find it more rewarding than the real world. They may even skip meals, sleep, and other responsibilities in favour of daydreaming.

Anticipating pleasure (i.e. imagining it in the future tense) (opposite of Anticipating pain)

Description and purpose: Anticipating pleasure is the anticipation of good things that have yet to come. It may also be called hope, enthusiasm, zeal, eagerness, or simply looking forward to something. At its strongest, we might call it excited anticipation or simply excitement. Like some say, “waiting is half the fun.” In fact, some studies show that those planning to go on a destination vacation actually experience more happiness while anticipating their trip than during their trip. If the anticipated thing turns out to be a complete disappointment, then we could say that waiting was 100 percent of the fun. Anticipation motivates us to do what we think is necessary in order to reach the anticipated event. It may also encourage us to practice ahead of time so we are better prepared when the anticipated event occurs. Finally, the placebo effect is likely due to the anticipation of positive effects from a medical treatment.

Healthy range: Anticipation of things is healthy when its intensity is just enough to motivate us to seek and attain the object of our anticipation, and then fades away. Examples include: the “festive holiday spirit,” which is the anticipation of good food, good company, and good gifts; anticipating winning an upcoming competition; planning to be the hero of a real-life situation; and the pleasure we get just before we’re about to experience something good, like first bite of our favourite food.

Low range: Excessive hopelessness and the feeling that upcoming activities that we previously enjoyed will be pointless (anhedonia) can be caused by depression, the side effects of drugs and alcohol, and other factors. These feelings may also be called dejection, defeat, despair, gloom, helplessness, or discouragement.

High range: Excitement is unhealthy when it is significantly out of proportion to the upcoming event, or when it’s sought purely to escape pain. Artificial excitement provided by entertainment such as video games, gambling, or novels is also indulgent. Equally unhealthy are fantasies that someone will rescue us, take care of us, fix our problems, and so on, despite no evidence that this will actually occur. Finally, anticipating indulgences is also excessive.

The many kinds of pain

The pains we feel throughout life come in a rich variety of flavours and intensities. Exactly how we should divide these feelings into different categories is quite subjective. The list below is my personal attempt to organize them as best as I can.

How much of each pain are we supposed to feel? Well, the Healthy range sections give us an idea how much a healthy person should feel, whereas the Low range sections represent amounts that are usually insufficient for optimal health, and the High range sections represent amounts that are typically excessive for optimal health. Pains were considered High range if they met one or more of the following criteria:

There is evidence that this pain can be caused or aggravated by indulging in excessive pleasure.

There is evidence that this pain can be caused or aggravated by taking certain medications or drugs (e.g. as a side effect).

There is evidence that this pain occurs in tandem with other known unhealthy pains.

This pain sometimes occurs without any known physical or biological cause. These go by many names, including idiopathic pain, psychogenic pain, psychosomatic pain, somatoform pain, centrally sensitized pain, and functional disorders.

PHYSICAL ACTIVITY DRIVERS

Physical restlessness (opposite of Pleasant physical activity)

Description and purpose: Physical restlessness is a sense of discomfort when we have energy but are staying still, thus giving us the urge to move. It motivates us to stop resting, get up, be active, and get things done—whether tending to our home, belongings, family, or job. The body is designed to move, and a lack of physical activity may lead to decreased cardiovascular health, muscle atrophy, and dangerous blood clots.

Healthy range: When we are healthy and rested, we should experience just enough restlessness to prevent us from lazing around all day, and this feeling should fade away once we are sufficiently active. Injury and illness may suppress feelings of restlessness in order to encourage us to rest.

Low range: Restlessness may be numbed by certain medications, alcohol, recreational drugs, or other indulgences.

High range: Caffeine consumption can increase restlessness, as can depression. Akathisia is an intense feeling of restlessness that may provoke the sufferer to fidget or rock back and forth. Restlessness may be a side effect of certain medications such as antipsychotics (neuroleptics) and antidepressants, or may be a withdrawal symptom of various recreational drugs such as cocaine and opioids. Similarly, restless legs syndrome (RLS) consists of uncomfortable sensations in the legs variously described as “pins and needles,” “creepy crawlies,” or itchiness, which are relieved by moving the legs. RLS may be caused or aggravated by caffeine, alcohol, tobacco, certain medications (including antinausea medications, antipsychotics, antidepressants, and antihistamines), improper diet, consuming too much sugar, or a lack of exercise. Those suffering from the hyperactive form of attention deficit hyperactivity disorder (ADHD) also describe feeling abnormally restless.

Physical effort (no opposite)

Description and purpose: The feeling of physical exertion occurs when we do more than light physical work. This feeling becomes more pronounced when we push our muscles and joints to physically do more than we’re accustomed to doing. It may take the form of exercise—such as jogging or weightlifting—or daily tasks, such as raking leaves or chopping wood. Regularly pushing beyond our comfort zone may increase our tolerance for physical effort, while reducing our level of exertion may have the opposite effect.

Healthy range: Exertion pain is healthy when it’s proportional to actual physical work, then fades away when we rest the affected muscles and joints. Feeling pain from using or stretching muscles that are already tired and achy is also healthy.

Low range: The pain of exertion can be numbed by pain relief medications, various drugs, and other indulgences. Those afflicted with CIPA (congenital insensitivity to pain with anhidrosis) have a reduced or complete inability to feel pain. Relying on motors, machines, and other devices to do our physical work may disproportionately reduce the natural levels of physical effort we are meant to experience. Consuming music, TV, or other entertainment while working or exercising can also diminish the discomfort we feel.

High range: Feeling disproportionately sore or achy when carrying out simple, low-impact tasks would be considered excessive. Many people with chronic fatigue syndrome and fibromyalgia find doing basic tasks or chores unusually painful.

Physical fatigue (opposite of Physical rest)

Description and purpose: Physical fatigue motivates us to rest or sleep, so our bodies can recharge for the next period of activity. This may also be referred to as feeling tired, sleepy, and at the extreme, exhausted.

Healthy range: It’s normal for our bodies to feel tired after doing a lot of physical activity, as is feeling sleepy around our normal bedtime. It’s also healthy to feel an increased desire to rest when we are sick or injured.

Low range: Physical fatigue can be numbed by using stimulant drugs such as caffeine and cocaine, and by certain other indulgences.

High range: Fatigue becomes excessive when it does not significantly diminish with adequate amounts of rest or sleep. Medically, this is known as hypersomnia or excessive daytime sleepiness (EDS). Fatigue is also excessive when it is out of proportion with the level of physical activity or injury. Many who suffer from fibromyalgia, for instance, find simple everyday tasks or chores exhausting. Chronic fatigue syndrome (CFS) is defined as unexplained persistent fatigue, and may be worsened by alcohol, caffeine, sugar and sweeteners, though it may be relieved by a graded exercise regime. Excessive fatigue may also occur as a symptom of depression. Using sedatives or sleeping aids to induce relaxation or sleep may also be considered excessive. A large number of medications induce fatigue or somnolence as a side effect, including some ADHD stimulants, NSAIDs, analgesics, antianxiety medications, erectile dysfunction medications, blood-pressure-lowering medications, and antipsychotics.

MENTAL ACTIVITY DRIVERS

Boredom (opposite of Pleasant mental stimulation)

Description and purpose: Boredom, also known as ennui, is a sense of dissatisfaction caused by a lack of sufficient or interesting stimulation. It is a failure to satisfy our natural desire to engage in mentally stimulating tasks. Boredom can be seen as a sort of mental restlessness, and is similar in purpose to physical restlessness. Boredom happens not only when we have nothing to do, but also when we have uninteresting tasks to do, such as reading a boring document at work or talking with someone we have no interest in. As such, boredom motivates us to find something more interesting or useful to do with our time.

Healthy range: Boredom is healthy if it occurs when we have insufficient responsibilities or insufficient sources of stimulation to keep our minds occupied, and fades away once we have found something more interesting to do.

Low range: Boredom may be numbed by certain medications, nicotine, and various other drugs and indulgences.

High range: Excessive boredom may be caused by depression or be a component of attention deficit hyperactivity disorder. Those that often consume large amounts of hyperstimulating video games or other forms of entertainment may experience increased mental restlessness when not actively consuming these.

Curiosity (opposite of Pleasant mental stimulation)

Description and purpose: Curiosity is the uncomfortable desire to find out something specific that we don’t know. It’s hunger for new information about people, relationships, how things work, and so on. It is the desire to find answers to our questions. Curiosity motivates us to explore and learn. Newspapers and magazines often use loud, provocative headlines to stimulate our curiosity, and websites often use tantalizing click-bait titles and images to seduce us into visiting them.

Healthy range: Curiosity is healthy when it arises from us not knowing potentially useful or intriguing information, and fades away once we’ve learned the desired information.

Low range: Curiosity may be numbed by certain medications, nicotine, various other drugs, or other indulgences.

High range: No data available.

Mental effort (no opposite)

Description and purpose: Mental effort occurs when we push ourselves to mentally accomplish more than we are accustomed to doing within a given amount of time. Like with physical exertion, regularly pushing ourselves beyond our cognitive comfort zone may increase our ability and tolerance for mental exertion. On the other hand, regularly reducing our exertion may have the opposite effect.

Healthy range: It’s normal to feel a certain amount of discomfort that’s proportional to a challenging mental task, which then fades away with appropriate rest. This feeling of mental effort may occur in many situations, such as when we: carry out a challenging volume or complexity of thinking; try to mentally achieve more in less time than we’re used to, which could be described as a form of stress; try to solve difficult problems; try to process, understand, memorize, analyze, or recall lengthy, complex, or unusual information; try to recall old information, such as the name or location of something we’ve nearly forgotten; try to juggle multiple tasks and priorities; and when we navigate new places, handle new or challenging situations, or learn new skills. Resisting the temptation to either do or not do something, such as trying to stay focused on a tedious task or resisting the urge to eat junk food, is another form of exertion.

Low range: The discomfort of mental exertion can be reduced by relying on computers or other means to do a large part of our mental work. This feeling may also be numbed by certain medications and various other drugs and indulgences.

High range: Feelings of mental effort may be heightened in those who experience abnormally high mental fatigue—see Mental fatigue.

Mental fatigue (opposite of Mental rest)

Description and purpose: Mental fatigue is to the mind what physical fatigue is to the body. It may manifest as difficulty concentrating on mental tasks due to a lack of mental energy. Its primary purpose is to motivate us to rest or sleep so that our minds can recharge. In the worst case, we may feel mentally exhausted.

Healthy range: It’s normal to feel mentally tired due to lack of sleep, illness, or overexerting our minds. Fatigue is also normal after a long day, or close to our normal bed time, and should fade away after appropriate rest. Fatigue or brain fog after eating a large or heavy meal is also normal, since blood is temporarily redirected from the brain to the digestive tract.

Low range: Fatigue may be numbed by caffeine, certain medications, cocaine, and various other drugs and indulgences.

High range: Fatigue in an otherwise healthy individual that does not significantly diminish with adequate rest or sleep may be considered abnormal. Fatigue that is out of proportion with our level of mental activity may also be considered excessive. High levels of mental fatigue can make various routine mental tasks, such as concentrating on a conversation or written text, feel harder to accomplish. Clouding of consciousness or difficulty concentrating, which are commonly known as brain fog, can be a symptom of depression, chronic fatigue syndrome, and fibromyalgia, where it’s known as fibro fog. This kind of fatigue can sometimes co-occur with headaches, as well as light and sound sensitivity.

THERMAL DRIVERS

Low core temperature (opposite of Pleasant core warming)

Description and purpose: This sensation happens when our core body temperature feels uncomfortably cold, which is a different feeling than when our skin feels cold. We may feel chills and the body may shiver to create warmth. This sensation motivates us to seek a warmer environment or wear warmer clothing in order to preserve the precious calories it would cost us to stay warm. It also helps us avoid the dangers of hypothermia.

Healthy range: Chills are normal when caused by insufficiently warm clothing or insufficient shelter from current environmental conditions. Chills are also normal and healthy when caused by a fever due to an infection, since fevers are our minds’ way of raising our core body temperature to help our immune system fight off the unwanted pathogens.

Low range: The feeling of being cold may be numbed by alcohol, medications, various other drugs and indulgences, and CIPA. Chills due to fever can be lowered by using antipyretic medications. It may be considered excessive to constantly avoid temperature fluctuations by living in climate-controlled environments, or by frequently consuming warm foods and beverages to warm the body up instead of letting our bodies naturally warm themselves.

High range: Chills can occur as a withdrawal effect from recreational drugs such as opiates. Some medications, including thyroid replacement therapy, certain asthma medications, opioids, ADHD stimulants, and antipsychotics can cause fevers or chills. Also, cold sensitivity is a condition where all or part of our bodies feels uncomfortably cold in the same environments where other individuals feel comfortably warm.

High core temperature (opposite of Pleasant core cooling)

Description and purpose: The sensation of feeling uncomfortably hot within our core happens when our core body temperature is too high. This is different from sensing that our skin is too hot. This feeling motivates us to seek a cooler environment, such as the shade of a tree or the inside of a building, or wear lighter clothing in order to avoid sweating. It also helps us avoid the dangers of heat stroke.

Healthy range: It is normal and healthy to feel hot when we spend too much time in hot environments such as in the summer heat, saunas, or hot tubs. It’s also healthy to feel this way when we physically exert our bodies to the point where our core temperature becomes elevated. Sweating in order to cool the body down is a healthy response to an elevated body temperature.

Low range: Feeling hot can be numbed by alcohol, certain medications, various other drugs and indulgences, or having CIPA. It may be excessive to constantly avoid normal temperature fluctuations by living in climate-controlled environments or by frequently consuming cold drinks and foods to cool the body down instead of letting our bodies do that work naturally.

High range: Feeling excessively hot for no apparent reason can be known as hot flashes (or hot flushes), or as night sweats when they occur while sleeping. For those in menopause, the chances of having hot flashes are increased by caffeine, smoking, obesity, eating too much sugar and not enough plant-based foods, as well as physical inactivity. Alcohol and a variety of medications can also cause hot flashes. Feeling too hot can also be due to withdrawal from heroin or other recreational drugs. Heat sensitivity is a related condition, which causes part or all of the body to feel uncomfortably warm in the same environments where other people feel comfortable.

Low surface temperature (opposite of Pleasant surface warming)

Description and purpose: This cool feeling happens when the surface of our bodies are cold. This not only includes external surfaces such as the skin and eyes, but also internal surfaces such as inside the mouth, throat, lungs, reproductive tract, and stomach. This sensation motivates us to protect our skin and other body tissues from temperature loss, and in the extreme, frostbite.

Healthy range: This feeling is healthy when it occurs in the presence of environments that are actually cold, or when something cold, such as ice or cold water, touches the surface of the body. A slightly deeper feeling of cold may also occur due to over-consumption of cold foods or beverages—such as dreaded ice cream headaches.

Low range: Sensations of coolness may be numbed by alcohol, medications, various other drugs and indulgences, or CIPA.

High range: Cold allodynia and cold hyperalgesia are conditions where an individual feels more unpleasantly cold than they should on certain parts of their body. These conditions can be caused by nerve damage due to shingles, and may also co-occur with fibromyalgia, migraines, and diabetes. Cooling agents such as menthol may also cause an intense cooling sensation at normal temperatures.

High surface temperature (opposite of Pleasant surface cooling)

Description and purpose: This unpleasantly hot sensation occurs when we experience elevated heat on the surface of our bodies. Our body surface includes not only external elements such as the skin and eyes, but also internal surfaces such as those inside the mouth, oesophagus, lungs, urinary tract, and stomach. This feeling motivates us to protect our skin and other body tissues from excessive heat and potential burns.

Healthy range: This feeling is healthy when it occurs in the presence of objects or environments that are actually hot, such as coming in contact with fire, a hot stove or a very hot beverage. Eating hot peppers or coming into contact with capsaicin—their active ingredient—can also trigger a burning sensation, despite not causing any actual burns. Burning pains may also be caused by pressure or damage to specific nerves leading to our bodies’ surfaces, which doctors call neuralgia.

Low range: The feeling of heat may be numbed by alcohol, some medications, various other drugs or indulgences, and CIPA.

High range: For those with tactile allodynia, a simple physical touch can trigger a burning sensation even though there is nothing physically wrong with their skin. Some describe it as feeling like they have a sunburn all the time. This kind of allodynia may co-occur with chronic headaches or migraines. Paresthesia may also generate excessive feelings of heat with no obvious physical source. Paresthesia may co-occur with anxiety, diabetes, alcoholism, and as a side effect of certain medications. Other examples of excessive heat sensations with no underlying physical cause include burning mouth syndrome (burning pain in the tongue, lips and mouth), psychogenic dysuria (painful urination), and esophageal hypersensitivity (excessive heartburn or discomfort in the oesophagus).

NUTRITIONAL DRIVERS

Unpleasant scents and flavours (opposite of Pleasant scents and flavours)

Description and purpose: Unpleasant flavours include foods and drinks that taste very bitter or sour. Unpleasant scents include those of foods that are rancid or excessively pungent. At birth, we prefer sweet flavours and dislike bitter ones since sweetness usually corresponds with edible plants, and bitterness usually corresponds with harmful ones. Sourness, on the other hand, can indicate that a fruit isn’t ripe or that a food has spoiled, which is why we tend to find sourness aversive. However, these preferences can be changed by what we eat growing up. Spoiled foods and excrement may also trigger unpleasant feelings of disgust. Scent, not taste, is what mostly determines the overall flavour of foods and beverages. In short, the purpose of unpleasant scents and flavours is to discourage us from consuming things that could make us sick.

Healthy range: It’s normal and healthy to find repulsive the smell of things such as sewage, skunk spray, rotting food, heavy smoke, and strong chemicals. It’s also normal to dislike the unpleasant flavours of unripe fruits, spoiled foods, and inedible or toxic plants. Although mildly or moderately salty foods generally taste pleasant, high levels of salt trigger a different reaction on our tongues which tastes unpleasant, presumably to protect the body from consuming harmful amounts of sodium.

Low range: Unpleasant scents and flavours can be masked (reduced) by adding sugar, salt, and other additives to foods and beverages. Unpleasant odours can be masked by adding pleasant aromatic compounds, such as by spraying air fresheners in our houses, deodorants under our arms, or using scented fabric softeners when washing our clothes. Some conditions also reduce our perception of unpleasant scents and flavours. These include anosmia (the loss of the sense of smell) which may occur as a side effect of drugs, medication, alcohol use, or as a congenital disorder.

High range: At least 250 types of medication can cause unpleasant distortions to our sense of smell or taste (known as dysgeusia), according to Canadian doctors Rebecca Douglass and George Heckman. These include various antibiotics, muscle relaxants, antihypertensives, antidepressants, and migraine medications. In addition, parosmia, which is a distorted (usually unpleasant) perception of actual odours, and phantosmia, which is smelling an (usually unpleasant) odour that isn’t there, can be side effects of smoking, certain drugs, or psychiatric disorders such as schizophrenia.

Hunger pains (opposite of Satisfying hunger)

Description and purpose: The gnawing feeling of hunger in our stomachs motivates us to eat so that we obtain the nutrients we need to continue to live—including carbohydrates, proteins, fats, vitamins, and minerals.

Healthy range: It is normal to feel hungry when our bodies require more calories or nutrients. Doing a lot of physical activity or other forms of energy expenditure normally increases our level of hunger. We may sometimes crave specific foods that contain nutrients in which we are deficient.

Low range: Our appetite can be suppressed by nicotine, various other drugs and indulgences, as well as certain medications such as some ADHD stimulants and antianxiety medications. Those born with CIPA may be entirely unable to feel hunger pains.

High range: Excessive hunger is medically known as polyphagia or hyperphagia, and can be caused by cannabis, certain medications (including antihistamines, antianxiety medications, and thyroid replacement therapy), anxiety, and diabetes.

Stomach overfullness (opposite of Satisfying hunger)

Description and purpose: A sensation that our stomach is overly full motivates us to stop eating or drinking. The primary purpose of this sensation is to limit the amount of matter in the stomach and bowels since these can only process a certain amount of food and liquid at once.

Healthy range: It’s normal to feel overfull after eating a very large meal or drinking a large amount of fluids. We may also feel such fullness due to a buildup of swallowed air or carbonation in the stomach.

Low range: Stomach overfullness may be numbed by certain medications, and various other drugs and indulgences.

High range: Some medications may cause stomach overfullness as a side effect, which is one form of dyspepsia.

Thirst (opposite of Quenching thirst)

Description and purpose: Thirst is the feeling that our throat or mouth feels parched and dry, which increases our desire to drink and quench our thirst. This feeling motivates us to sufficiently hydrate ourselves, since our bodies and minds require adequate amounts of water to function and thrive.

Healthy range: Thirst pains are normal when they occur due to our bodies being dehydrated and needing more fluids, then fade away after we have hydrated ourselves.

Low range: Thirst pains may be numbed by certain medications, various other drugs, and other indulgences. Certain people are congenitally unable to feel thirst, such as those born with CIPA.

High range: Excessive thirst is medically known as polydipsia, which may be triggered by various medications including lithium, and may also be of psychogenic origin. It can also be a symptom of diabetes. Dry mouth, or xerostomia, is a related symptom associated with reduced salivation, which often leads to increased drinking. Dry mouth may occur due to various medications, including antidepressants, opioids, ADHD stimulants, and chronic obstructive pulmonary disease (COPD) medications.

Shortness of breath (opposite of Breathing)

Description and purpose: Shortness of breath, also known as dyspnea or air hunger, is the urgent desire to breathe. This motivates us to seek out and breathe in clean, oxygen-rich air while expelling carbon dioxide so we can continue to live. At the extreme, this feeling is called suffocation. This sensation may vary from chest tightness, to laboured breathing, to starving for air.

Healthy range: The sensation of suffocation is normal when it occurs due to low oxygen or high carbon dioxide levels in the blood. Gasping may also occur due to inhaling contaminants, such as smoke-filled air, or be caused by lung damage that impairs oxygen and carbon dioxide transfer.

Low range: Feelings of suffocation may be alleviated by certain medications, various other drugs, and other indulgences.

High range: Dyspnea may be excessive when it occurs due to anxiety disorders such as panic attacks. A large number of medications can cause dyspnea as a side effect, including some ADHD stimulants.

Urge to urinate or defecate (opposite of Urinating or defecating)

Description and purpose: The uncomfortable feeling of a full bladder or rectum motivates us to go to the bathroom and expel the bodily wastes it contains. This feeling also occurs due to buildup of gasses in the digestive tract.

Healthy range: The urge to urinate or defecate is healthy when it occurs in proportion to the fullness of the bladder or rectum, and fades away after the body wastes have been expelled.

Low range: These urges may be numbed by certain medications, various other drugs, other indulgences, and CIPA.

High range: An excessive urge to urinate is called overactive bladder syndrome (also called irritable bladder or detrusor instability), and can be caused by alcohol, caffeine, smoking, and obesity. Interstitial cystitis (also known as painful bladder syndrome) is another chronic bladder pain condition of unknown cause, which often coincides with other pain disorders such as fibromyalgia. For excessive pain in the rectal area, there are related conditions called proctalgia and functional anorectal pain syndromes, which consist of pain in the anus or rectum that is caused by some medications and may have no physical cause.

Nausea and indigestion (opposite of Relief from expelling irritants)

Description and purpose: Nausea and indigestion are uncomfortable feelings in our stomachs or digestive tracts. Feeling sick to our stomach may tell us there’s something wrong with the food or drinks we have recently consumed, thereby encouraging us to avoid them in the future. Intense nausea may compel us to vomit the offending substances. Indigestion can include intestinal bloating or discomfort. In addition, some of us get nauseous not from food but from certain kinds of motion—which we may call motion sickness, car sickness, or sea sickness depending on the source of motion.

Healthy range: Nausea and indigestion are normal when they are in proportion to eating offensive foods, or to being exposed to infectious pathogens, and go away once the offending substances or pathogens have exited the body. Nausea is also normal in early stages of pregnancy, or when we are exposed to disgusting things.

Low range: Nausea and indigestion can be numbed by certain medications, various other and indulgences, and CIPA.

High range: Many medications cause nausea as a side effect, including some antipsychotics, NSAIDs, opioids, flu shots, and erectile dysfunction medications. Nausea can also occur due to depression and alcohol hangovers. Many medications, such as antibiotics, ADHD stimulants and ulcer medications can cause indigestion and diarrhea. Indigestion pain that has no known medical cause is known as nonulcer stomach pain or as functional dyspepsia (FD), and is usually chronic. Irritable bowel syndrome (IBS), which includes bloating and cramping, tends to correlate with anxiety and depression and is aggravated by certain medications. Unhealthy nausea, bloating and indigestion may lead the sufferer to incorrectly conclude they’re allergic or intolerant to certain foods.

Urge to cough (opposite of Relief from expelling irritants)

Description and purpose: The urge to cough typically feels like an irritation or tickling in our throats or lungs, which motivates us to cough out any offending substances we may have inhaled. This reaction can save us from drowning in water or from inhaling toxic smoke.

Healthy range: The urge to cough is healthy when it occurs in proportion to the presence of air contaminants, such as smoke, chemicals, or excessive dust. It is also healthy to feel this urge in response to liquids or food debris entering the airway and lungs.

Low range: The urge to cough may be numbed by cough-suppressant medication such as dextromethorphan (DM), various other drugs, other indulgences, and CIPA.

High range: Chronic coughing that has no known cause may be called chronic cough hypersensitivity syndrome. An urge to cough is unhealthy if it is disproportionately intense relative to the degree of infection or irritation. An excessive urge to cough may occur during the withdrawal period of certain drugs, such as opiates.

Urge to sneeze (opposite of Relief from expelling irritants)

Description and purpose: The urge to sneeze feels like an irritation or tickling in our noses or nasal passages that motivates us to sneeze out any offending substances in those areas.

Healthy range: The urge to sneeze is healthy when it occurs in proportion to contaminants such as chemicals, dust, or irritants like pepper being inhaled, and goes away once these contaminants are expelled. This urge is also healthy when it occurs in response to liquids or food particles entering the nasal passages. It is also healthy to sneeze when our sinuses are irritated by an infection such as the common cold. Finally, going from dim light to sunlight can trigger an urge to sneeze in some individuals, called the photic sneeze reflex.

Low range: The urge to sneeze may be numbed by certain medications including antihistamines, various other drugs and indulgences, and CIPA.

High range: Having a chronic urge to sneeze despite a lack of irritants in the nasal passages would be considered excessive, and can occur in the form of non-allergic rhinitis. The excessive urge to sneeze may also be a side effect of certain medications—called drug-induced rhinitis—or due to withdrawal from some recreational drugs.

Urge to gag (opposite of Relief from expelling irritants)

Description and purpose: The urge to gag feels like an irritation or tickling in the rear of our throats, and motivates us to push out any large or undesirable items to avoid swallowing them.

Healthy range: It is normal to feel the urge to gag when non-food objects approach the pharynx, like when a doctor inserts a tongue depressor near the back of your mouth.

Low range: The urge to gag may be numbed by certain medications, various other drugs or indulgences, or genetic abnormalities such as CIPA.

High range: Having a chronic urge to gag despite a lack of irritants near the opening of the throat is known as an overactive gag reflex. This may occur as a side effect of certain medications or due to withdrawal from certain drugs.

OTHER PHYSICAL SAFETY DRIVERS

Headaches (no opposite)

Description and purpose: Headaches include many different kinds of pain in the region of the head, which may signal a number of different issues.

Healthy range: Headaches are normal when they occur due to injury to the head or loss of blood flow to the brain (including strokes). They may also be caused by increased pressure within the head due to swelling, tumours, increased blood pressure in the brain, sinus infections, or other causes.

Low range: Headaches may be alleviated by certain medications, various other drugs and indulgences, and CIPA.

High range: There are many types of headaches that occur without any apparent physical cause, including migraines and cluster headaches. According to some doctors, cluster headaches may be the worst type of pain we can experience—worse than even childbirth. Various foods are known to trigger headaches in some sufferers, including: sugar, alcohol, caffeine, chocolate, cheese, processed meats, artificial sweeteners, fatty foods, and excessive sodium. Headaches can also be caused by various medications, such as thyroid replacement therapy, NSAIDs, opioids, and statins. Headaches can also be caused by recreational drugs and may co-occur with depression.

Musculoskeletal pains (no opposite)

Description and purpose: Musculoskeletal pain is a broad category that includes bone pain, muscle pain (including dull aches and cramps), tendon and ligament pain, joint pain (including arthritis and arthralgia), as well as “tunnel” syndromes (such as carpal tunnel syndrome). It also includes back pain, neck pain, temporomandibular joint (TMJ) pain, and so on. These kinds of pain motivate us to avoid injuring and over-using our bodies, and to take special care of any injured or overused parts to allow them to heal. For example, putting too much pressure on a joint for too long normally results in pain that encourages us to shift our bodies and therefore minimize wear and tear on that joint. The pain of physical exertion is covered under Physical effort, but we may also feel achy a day or two later as our muscles repair themselves, which is called delayed onset muscle soreness (DOMS).

Healthy range: Musculoskeletal pain is healthy when it occurs due to injury (such as cuts, tears, piercings, or being crushed), over-use, infection, or cancer, and goes away if and when these conditions have resolved. Pain is also normal when joints are flexed beyond their healthy range of operation, which protects our joints from injury. It’s normal to feel pain when tissues are starving of oxygen and nutrients due to poor blood circulation, such as angina (chest pain) and claudication (of legs, arms, or other body parts), or due to putting pressure on one area for too long (e.g. sitting too long in the same position). It’s also normal for pregnant women to feel pain during contractions and labour due to the stretching of muscles in the cervix and vagina. Furthermore, our muscles may ache all over when we have an illness like the flu, which may be the mind’s sneaky way of encouraging us to lie down and rest.

Low range: Musculoskeletal pain may be numbed by certain medications, various other drugs and indulgences, and CIPA.

High range: Musculoskeletal pains may be excessive if they occur without the presence of the above healthy causes. This would include non-cardiac chest pain, TMJ pain of unknown cause, and lower back pain of unknown cause. Fibromyalgia and some cases of arthritis either aren’t tied to injury, are excessive for the particular injury, or continue long after the related injury has healed. Fibromyalgia sufferers often experience painful tenderness across their bodies in response to light pressure, and may feel flu-like muscular aches. Body aches and cramps may be caused or worsened by alcohol, tobacco, and excessive MSG or sugar consumption. These may also occur as the side effects of certain medications, including some forms of insulin, opioids, analgesics, and other drugs. They may also occur due to depression.

Unpleasant sounds (no opposite)

Description and purpose: Unpleasant sounds include sudden or continuous loud noises—such as grinding, squeaking, or banging—which may damage the delicate parts of our ear. This motivates us to avoid harsh sounds in order to protect our ears from permanent hearing damage.

Healthy range: This discomfort is normal when it occurs due to loud and potentially damaging sounds, and fades away when the offending sounds end. Ear pain may also occur due to a pressure difference between the middle and outer ear, which may happen when airplane passengers rise quickly in altitude.

Low range: Unpleasant sounds may be numbed by certain medications, various other drugs and indulgences, and CIPA.

High range: Hyperacusis is a painfully heightened sensitivity to loud sounds, which may be caused by certain medications, and occurs commonly alongside migraine headaches. Tinnitus is an annoying chronic ringing or other sound heard in the ears, which can be caused or aggravated by many things including antidepressants, aspirin, alcohol, excessive salt consumption, and listening to loud music. It may also co-occur with anxiety and depression.

Unpleasant brightness (no opposite)

Description and purpose: Unpleasant brightness is a painful sensation when we look at lights that are bright enough to damage the delicate parts of our eyes, including the cornea and the retina. This motivates us to protect our eyes from being permanently damaged by overly intense stimuli.

Healthy range: This unpleasant feeling is healthy when it occurs due to staring at the Sun or other very bright lights.

Low range: The unpleasant sensation of brightness might be numbed by certain medications, various other drugs and indulgences, and CIPA.

High range: Photophobia, which is a heightened painful sensitivity to lights, affects some migraine sufferers and is also a side effect of some medications.

Other surface pains (no opposite)

Description and purpose: Other surface pains include any pain located on the surfaces of the body other than high and low surface temperatures. This includes: cuts, scratches, piercings, irritations, rashes, excessive stretching, and excessive pressure (such as from pinching and slapping). The surfaces of the body include both exterior surfaces such as the skin and eyes, as well as internal ones such as the mouth, digestive tract, and lungs.

Healthy range: Surface pains are healthy when they occur in proportion to injury, friction, pressure, infection, or cancer, and go away when these conditions are resolved. Sore throats occur due to colds or other infections are also normal. Surface pain also includes pain from exposure to strong acids and other caustic chemicals, including heartburn due to acid reflux. Stabbing pains may also be caused by pressure or damage to nerves leading to our bodies’ surfaces, which doctors call neuralgia. Pain during birthing contractions and labour due to the stretching of surface tissues in the cervix and vagina also fall into this category.

Low range: Surface pains may be numbed by certain medications, various other drugs and indulgences, and CIPA. Heartburns may be relieved by antacids or other stomach medications.

High range: Surface pains are unhealthy and excessive when they occur in the absence of the above healthy causes, or when they far exceed what would normally be expected. Some medications (such as atorvastatin and certain asthma medications) and some recreational drugs (such as heroin) can cause sore throats and other flu-like symptoms as side effects. Sore throats may also occur as a withdrawal symptom from cutting sugar out of our diets. Complex regional pain syndrome (CRPS), which consists of excessive chronic burning, tingling or pressure in one or more limbs, is considered one of the most painful known disorders.

Other physical pains (no opposite)

Description and purpose: Other physical pains include those not already covered such as headaches, and musculoskeletal pains. This includes a variety of sensations such as ear canal pain, toothaches, internal organ pain, and the discomfort of passing gallstones or kidney stones—which are among the most painful experiences we can have. Internal organ pain is often felt in a different location on our bodies than where the organ lies, which is called referred pain. For instance, heart pain may be felt in our left arm, and gallbladder pain may be felt in our back. Such pains can motivate us to avoid the behaviour or situation that led to the injury, and also instructs us to protect the injured part so it can heal properly.

Healthy range: Such pains are healthy when they occur in proportion to actual injury or illness and fade away when these are resolved. Ear pain is normal when due to ear infections. Toothaches are normal when due to damaged, infected, or decayed teeth. And chest pain is normal when having heart or lung difficulties.

Low range: These physical pains may be numbed by taking certain medications, various other drugs and indulgences, and CIPA.

High range: Such pains are excessive when they happen in the absence of injury and illness, or when they persist after an injury or illness has passed (i.e. when acute pain becomes chronic pain). Fibromyalgia may also cause excessive amounts of these types of pain. Other examples include: idiopathic otalgia, which is ear pain without any known cause; feeling a painfully tight knot in our chest due to anxiety or panic attacks; and the feeling of a painful lump in the throat with no physical cause, known as globus sensation.

Itching (opposite of Scratching an itch)

Description and purpose: The feeling of itchiness can help us detect irritants and pests like mosquitoes, lice or spiders on our bodies. Itching motivates us to pay attention to the affected area and scratch it to dispose of these parasites and irritating substances. This helps to prevent negative impacts on our health, such as the parasitical consumption of our blood or tissues, and being infected with diseases such as malaria. Itching can also happen due to dry, flaking skin or dandruff. Itching can also be caused by irritants or by allergic reactions to foreign substances, certain foods, medications, and insect bites.

Healthy range: When this discomfort occurs due to actual pests or offensive substances on our skin, or when someone or something lightly tickles our skin. It is also normal to feel itchy while surface wounds heal and close.

Low range: Itchiness may be numbed by certain medications including antihistamines and hydrocortisone, various other drugs and indulgences, and CIPA.

High range: About seven percent of the population suffers from some kind of chronic itching. Chronic itching may correlate with diabetes, stress, anxiety, depression, and other conditions. People who experienced negative events and depression tend to have worse itching. Excessive itching, called pruritus, can be a side effect of drug or alcohol intoxication or withdrawal, or of many medications such as opioids, antidepressants, certain analgesics, and blood clotting medications. restless legs syndrome (RLS) may include itchiness as well—see Physical Restlessness for details. There is also a condition called formication (not to be confused with fornication) in which the sufferer feels as if bugs are crawling on or under their skin and may cause them to pick at it obsessively. Formication may be caused by cocaine, crystal meth (where this symptom is known as meth mites) and other stimulants, or may occur as a side effect of some medications.

SOCIAL DRIVERS

Longing for touch (opposite of Pleasant touch)

Description and purpose: The longing for touch is a yearning for non-sexual physical contact, which affection researcher Dr. Kory Floyd calls skin hunger.

Healthy range: This feeling is healthy when it occurs due to a prolonged lack of healthy physical contact with others, whether they are friends, family members, or our pets.

Low range: The longing for physical touch may be numbed by certain medications, various other drugs, or other indulgences. We may also intentionally suppress our longing instead of allowing ourselves to feel it.

High range: No data available.

Compassion (opposite of Caring for others)

Description and purpose: Compassion, a form of empathy, is feeling pain on behalf of someone else. We may feel sorry for someone who we believe is suffering or needs help. This feeling may also occur if we realize we’ve unintentionally hurt someone, either through something we did or neglected to do. We may also feel bad for someone who we think is lonely, misunderstood, or has been rejected by others. Compassion motivates us to not harm others and to do what’s necessary to protect our friends and loved ones from illness or injury. Compassion encourages us to help each other, which benefits the human race as a whole. This feeling and its opposite, the pleasure of caring for others, may be the root motivators of all altruistic behaviour.

Healthy range: It is healthy to feel compassion for those less fortunate than us or those in need of help. For instance, seeing someone who is sick, injured or malnourished may trigger feelings of pity—an empathic desire to help restore their health. Hearing a baby or child cry often triggers an empathic response. Healthy compassion can also extend to animals and other living things that we perceive as suffering or needing help. It’s the feeling of being needed by others. We may feel bad for someone failing miserably at something or otherwise being humiliated. It includes the desire to nurture and protect others, including our friends, our children and our families.

Low range: Feelings of empathy may be numbed by certain medications, and other drugs or indulgences. We may also intentionally suppress or otherwise avoid our feelings of compassion. People who naturally have little or no compassion for others are often referred to as being psychopaths or sociopaths, or as having antisocial personality disorder.

High range: No data available.

Feeling uncared for (opposite of Feeling cared for)

Description and purpose: We feel uncared for when we believe we aren’t liked or loved enough by family, friends, our partners, or others. It is the feeling that nobody cares about us, that we are socially worthless. We may feel unsupported in our endeavours, socially rejected, alienated, or neglected by others. Or we may feel criticized, insulted, or humiliated by others. We may also feel that we aren’t understood or accepted by others. It is social hunger, a longing to be loved, cared for, and helped by others. This feeling motivates us to work harder to gain and maintain the love, admiration, respect, and support of others—whether by strengthening our bonds with those we care about, or by establishing new partnerships, friendships, or romantic relationships. We are, generally speaking, social creatures that enjoy spending time together, and this feeling helps to shape this behaviour. The feeling of loneliness also motivates us to not dissolve friendships or romantic relationships, in order for us to avoid feeling lonely in the future. To avoid rejection, we may try to conform to group standards and make favourable impressions.

Healthy range: This feeling is healthy when it occurs in proportion to actual neglect or rejection by others, or when we lose or yearn for the respect and admiration of others. It is normal to feel this way when others look down on us, when others are unwilling to help or support us, when we’re alone for too long, when we lose a friendship or loved one, and when we lose touch with our friends or family.

Low range: This feeling may be numbed by certain medications, and various other drugs and indulgences. We may also intentionally suppress or otherwise avoid these feelings.

High range: Depression may cause an exaggerated sense that nobody cares about us, or feeling lonely despite being surrounded by loving friends and family. Feeling that others are laughing at us is also excessive if there is no evidence to this effect.

Anger (opposite of Retribution)

Description and purpose: Anger can occur when someone (or something) causes us problems that we don’t feel we deserve, and we believe that we can neutralize these problems by threatening or attacking that person (or thing). Anger motivates us to stand up for ourselves and what we believe in, such as standing up against an actual or potential attack or an invasion of rights. Anger and jealousy motivate us to defend what is “ours,” including our body, our loved ones, our dignity, our territory, our belongings, and even our plans for the future. It may occur when someone prevents us from doing what we want, such as making noise when we’re trying to concentrate. It may also occur when we’re forced to do something we don’t want to do, such as a demeaning task.

At its mildest, anger may be called annoyance, irritation, bitterness, or resentment. At its most intense, it may be called rage or fury. It’s the vengeful desire to verbally, physically, or passively threaten, attack, or hurt the one who has caused our anger. Simply expressing our anger or hostility—without physically acting on it—proactively communicates to others that we’re willing to defend ourselves, our belongings, and our loved ones. This may ward off a threat before it escalates, as well as avert future threats. Expressing our anger teaches others to respect us, showing them they have crossed an invisible line into a territory—emotional, social, physical, or otherwise—that we are willing to defend. Without the useful feeling of anger, others could easily take advantage of us, insult us, steal our things, disrespect our rights, and generally walk all over us without fear of retribution. And since we do not enjoy being the target of other people’s anger, many of us find it difficult to admit our faults and mistakes if we believe they might anger others.

Healthy range: Anger is healthy when it occurs in proportion to an actual or potential threat, attack, or betrayal, then fades away when the source of the anger is withdrawn.

Low range: Anger may be numbed by certain medications, and various other drugs and indulgences. We may also intentionally suppress or otherwise avoid our anger.

High range: Irritability or anger is excessive when it is out of proportion with the threat or event, such as getting extremely upset at a driver cutting us off—known as road rage—or at a waiter making a mistake on our order. Jealousy may be excessive if we believe that our partner is romantically involved with someone else, despite there being no evidence of betrayal. Frequent and excessive anger may be described as having an anger problem or as being grouchy or grumpy. Excessive anger, irritability, or hostility may be caused by depression, certain medications (such as some antidepressants, ADHD stimulants, or antianxiety medications), or alcohol and drug withdrawal (such as from cannabis).

SEXUAL DRIVERS

Sexual curiosity (opposite of Sexual attraction)

Description and purpose: Sexual curiosity is the desire to approach and attract potential romantic and sexual partners. It’s the urge to flirt with them, appraise them or be appraised by them, and otherwise interact with them. It also includes the desire to impress potential mates by showing off our best skills and attributes.

Healthy range: Sexual curiosity is normal and healthy when it occurs with real people at a frequency that does not interfere with other life responsibilities.

Low range: Sexual curiosity may be numbed by certain medications, as well as various other drugs and indulgences. We may also choose to suppress or otherwise avoid our feelings of sexual curiosity.

High range: Sexual curiosity may be excessive when it is stimulated by pornography, erotica, or an extensive amount of fantasies.

Sexual desire (opposite of Sexual activity)

Description and purpose: Sexual desire is a hunger for sexual activity and orgasm. It motivates us to go find a mate, or change our behaviour to better attract and maintain sexual partners. It may be called libido, lust, sexual arousal, sex drive, or simply feeling randy or horny. If it goes on for too long without being satisfied, it may build up and be referred to as sexual frustration.

Healthy range: Sexual desire is healthy when it occurs at a rate that does not interfere with other responsibilities, and is not provoked or intensified by drugs, pornography, or other unhealthy indulgences.

Low range: Libido may be diminished by certain drugs, such as long-term cannabis use, medications such as certain antidepressants, or other indulgences. Depression may also reduce our libido. We may also intentionally suppress or avoid our feelings of sexual desire.

High range: Excessive sexual desire can be provoked by excessive sexual fantasies or by consuming pornography or erotica.

Sexual overactivity (opposite of Sexual activity)

Description and purpose: Sexual overactivity is the painful sensation that can occur if sexual stimulation continues after lengthy sexual activity or orgasm. It encourages us to slow down or entirely stop sexual activity.

Healthy range: Sexual overactivity pain is normal when it occurs after significant sexual activity or orgasm, and then fades away when the activity ends.

Low range: Feelings of sexual overactivity may be numbed by medication, various other drugs, or other indulgences.

High range: No data available.

Lovesickness (opposite of Being in love)

Description and purpose: Lovesickness is a longing or yearning to be with someone we’ve fallen in love with—whether this is our current romantic partner or one we are pursuing. It could perhaps be called our love drive.

Healthy range: Lovesickness is healthy when it happens due to being apart from the one we love. It’s a healthy desire to express our love to someone in words or in gestures.

Low range: Feelings of lovesickness may be numbed by certain medications, various other drugs, or other indulgences. We may also intentionally suppress or avoid our feelings of lovesickness.

High range: No data available.

EXPECTATION DRIVERS

Disappointment in self (opposite of Satisfaction with self)

Description and purpose: Disappointment in ourselves happens when we fail to meet our own expectations. We can also feel this way when friends and family members that we closely identify with—our ingroup—fail to meet their expectations. It can take the form of guilt or shame for not saying or doing something that we should have, or for saying or doing something we shouldn’t have, such as cheating on our lover or indulging in a guilty pleasure. We may also feel humiliated when someone criticizes or rejects us. It can manifest as frustration from encountering setbacks or obstacles that prevent us from progressing towards our goals, like struggling to accomplish something in which we have little experience. It can happen when we lose or damage valuable possessions. It can manifest as feelings of inferiority or low self-esteem due to our abilities, possessions, or status being of a lower standing than we would wish. Or as envying the abilities, possessions, relationships, and successes of others in contrast with our own. Or as feeling stupid, ugly, incompetent, or worthless compared to others. It can occur if we feel we’re decreasing in power and strength, or become unexpectedly sick or injured. Self-hatred and self-criticism make us kick ourselves for making mistakes so that we avoid making similar mistakes in the future. These feelings of remorse and regret may motivate us to tend to things and relationships that have been neglected as well as improve our knowledge and abilities. All of these motivate us to either lower our expectations of ourselves, or to try harder to meet those expectations next time.

Healthy range: Disappointment, guilt, embarrassment, or frustration is healthy when it is proportional to an actual mistake, misjudgement or inaction on our part. It is normal to feel inferior to others when we unexpectedly lose a competition, lose an argument, or are otherwise outperformed by others.

Low range: Guilt and insecurity may be numbed by alcohol, certain medications, and various other drugs and indulgences. We may also intentionally suppress or avoid our feelings of disappointment and inferiority.

High range: Excessive self-loathing for no reason is generally unhealthy, as is embarrassment for small mistakes or shortcomings that is intense enough to interfere with daily functioning. Excessive feelings of guilt, failure, rejection, self-hatred, or inferiority may be caused by depression. Excessive shame may be triggered by overindulgence, such as spending excessive amounts of time fantasizing, binging on unhealthy foods, or going on wild shopping sprees. Disappointment may be excessive when it occurs by association with fictional characters in TV shows, movies, or video games.

Disappointment in others (opposite of Satisfaction with others)

Description and purpose: Disappointment in others occurs when individuals who aren’t in our close-knit ingroup fail to meet our expectations. This feeling comes in two basic flavours: the disappointment that something is less pleasant than expected, and the frustration that something is more painful than expected. It may also be called discontent, dismay, being mortified, or being displeased. In the extreme, we may be shocked or appalled at someone or something. Disappointment may occur when: we don’t get what we wanted; we get something we didn’t want such as new troubles, illnesses, or setbacks; or we get something that’s inferior to what we hoped for, such as poor weather, an unappetizing meal, or shoddy work from a contractor. We might also miss something that previously gave us comfort, such as feeling homesick. Disappointment can motivate us to change our ways to increase the odds our expectations will be met in the future, or to lower our expectations in order to minimize our future disappointment.

Healthy range: Disappointment is healthy when it occurs in proportion to reasonable and realistic expectations that were not met, then eventually fades away.

Low range: Disappointment may be numbed by certain medications, various other drugs, or other indulgences. We may also intentionally suppress or avoid our feelings of disappointment.

High range: Depression may increase feelings of disappointment in everyday events compared to how a healthy individual would perceive those same events.

NON-SPECIFIC DRIVERS

Dysphoria (opposite of Joy)

Description and purpose: Dysphoria is a general pain or unease that isn’t tied to any specific body function or social cause. It may simply be called being in a bad mood. In healthy amounts, its purpose may be to discourage us from certain situations or environments that feel “wrong.” Being in a bad mood, through the principle of blending, can offset other pleasures and make us feel less satisfied with things that would normally please us. Similarly, due to blending, things that would normally irritate us a little may irritate us even more, which helps explain why we have less patience and are more irritable when we’re in a bad mood.

Healthy range: Dysphoria may be normal when it occurs for limited durations and in relation to a situation or environment that somehow feels “wrong.”

Low range: Dysphoria may be numbed by certain medications, various drugs, or other indulgences.

High range: Several medications, including antidepressants and opioids, can cause dysphoria as a side effect. Nicotine can also cause dysphoria.

IMAGINATION DRIVERS (past, present, and future)

Remembering pain (i.e. imagining it in the past tense) (opposite of Remembering pleasure)

Description and purpose: Remembered pain occurs when we recall unpleasant memories from our past. These memories may occur spontaneously, or may be triggered by its association with various items, such as the perfume of an ex-lover, a childhood toy, or a song that we heard at an emotionally significant time. Such memories may range from mildly troubling to profoundly traumatic.

Healthy range: Remembered pain may serve to remind us of a painful scenario so that we don’t repeat it. We may also experience disturbing memories if we have not fully processed the unpleasant event being recalled. Therefore, re-experiencing such memories can be part of the healing process.

Low range: Remembered pain may be numbed by consuming certain medications, various other drugs, or other indulgences. We may also avoid unpleasant memories by distracting ourselves or by shutting them out of our consciousness.

High range: We may obsessively think about an unpleasant memory long after it has served its purpose, which psychologists call ruminating. It may be excessive if we frequently experience painful memories for no reason, such as moments of deep embarrassment, shame, or neglect. Excessive painful flashbacks may be triggered by depression or post-traumatic stress disorder (PTSD).

Imagining pain (i.e. imagining it in the present tense) (opposite of Imagining pleasure)

Description and purpose: Imagined pain occurs when we imagine unpleasant things happening that do not exist. Unpleasant daydreams may occur spontaneously or be triggered by association with various things, such as a name or a picture. This category also includes unpleasant dreams that occur while sleeping, known as nightmares or night terrors. Unpleasant fantasies may be useful in motivating us to avoid the fantasized-about scenario in our day-to-day lives.

Healthy range: Unpleasant daydreams may be healthy when they are limited in length and help motivate us to avoid the feared scenario in our actual lives.

Low range: Painful daydreams may be numbed by certain medications, various other drugs, and other indulgences. We may intentionally suppress or otherwise avoid upsetting feelings that are spurred by our imagination.

High range: Frequent unpleasant daydreams may be unhealthy, as are frequent nightmares—whether we’re being chased by monsters, find ourselves naked at work or school, or face our greatest fears. Frequent nightmares can occur due to drug withdrawal such as from tobacco or cannabis, or as a side effect of various medications such as antianxiety medications, antidepressants, or asthma medications. Excessive imagined pain can occur in the unpleasant daydreams of maladaptive daydreamers. They also manifest as the unpleasant and frightening hallucinations of schizophrenics, such as the frightening feeling of being followed, of our minds being read by others, or the suspicion that everyone is secretly laughing at us. It includes unpleasant drug-induced hallucinations—commonly called bad trips—caused by LSD, mescaline, and certain medications.

Anticipating pain (i.e. imagining it in the future tense) (opposite of Anticipating pleasure)

Description and purpose: Anticipating pain in the future includes fear, worry, and anxiety. Fear discourages us from partaking in risky or unhealthy activities and therefore helps prevent physical and emotional injuries or other negative health consequences, which in turn promotes our survival and our ability to thrive. For instance, a fear of heights helps to prevent falls, and a fear of snakes helps to prevent snakebites. Other common phobias include the fear of germs, needles, blood, crowds, insects, animals, open or confined spaces, and the dark. Fear not only discourages us from risky activities but also discourages us from dangerous inactivity—for instance, worrying about failing a test or an interview motivates us to prepare for it. Fear may be elicited directly from the feared thing, or indirectly through another object, person, or situation that we associate with the feared thing. In its milder form, anticipation of pain may be called unease, feeling tense, nervousness or dreading, while at its most intense it may be called panic, alarm, horror or terror. Fear may also manifest itself in the form of “disgust” of people or animals who appear diseased and possibly contagious, of body excrement that may contain pathogens, or of spoiled food that could make us sick. Fear can encourage us to prepare ahead of time—testing out different alternatives scenarios in our minds to see which one works best—so we are better-equipped when the feared event actually happens. It may also motivate us to do what we can to avoid an anticipated issue. The absence of fear may be referred to as feeling safe and secure. Those who should be afraid but aren’t are often called reckless. The nocebo effect, which is the opposite of the better-known placebo effect, is likely due to the anticipation of negative side effects of a medical treatment. Finally, some physical pains occur before any real tissue injury happens—such as light pinching of our skin, or brief exposure to moderate heat. These kinds of pain might be more accurately called body fear since they represent the body’s anticipation of future tissue damage.

Healthy range: Fear is healthy when it is proportional to an actual or potential threat or challenge and encourages us to formulate an action plan, then fades away when the threat or challenge is gone. It is normal to worry about paying off bills, about important tests or interviews, about big presentations or public performances, or about important life decisions and events. If we are under a lot of stress, we may naturally feel increased anxiety about whether or not we can meet the additional demands placed on us.

Low range: Fear may be numbed by certain medications or other indulgences. We may lose our fears and inhibitions, and even become reckless, from consuming alcohol (which earned it the nickname liquid courage), nicotine, or other drugs. We may also intentionally suppress or avoid our fear or anxiety.

High range: It is unhealthy to have excessive fears or phobias of problems that are unlikely to happen or of things that are unlikely to harm us. An obsessive fear of making mistakes or upsetting someone else can interfere with daily functioning and make us less willing to take on certain tasks or social engagements. Excessive anxiety can co-occur with depression. Excessive anxiety may be caused by certain medications, such as ADHD stimulants, antipsychotics, antidepressants, asthma medications, antianxiety medications, alcohol use, or opioids. Paranoid or delusional fears that are not founded on real evidence are unhealthy, such as obsessively worrying that everyone dislikes us, that our romantic partner is cheating on us, or when a schizophrenic believes they are being poisoned by government spies. Worrying excessively about something without formulating an action plan to deal with the underlying issue is also unhealthy. Despair or hopelessness are excessive if these feelings are not based on reality.

The DSM-V categorizes excessive anxiety into several broad categories, including these:

Generalized anxiety disorder consists of excessive and unrealistic worry about everyday things such as money, health (known as illness anxiety disorder and formerly known as hypochondria), body image (known as body dysmorphic disorder), family, or work. Sufferers often expect the worst when there is no obvious reason for concern.

Social anxiety disorder, also known as social phobia, causes the sufferer to feel excessively nervous in social situations, such as meeting new people. It includes frequently worrying about saying or doing the wrong things. Accompanying physical symptoms may include stomach aches, feeling hot or sweaty, feeling shaky, or a tight knot in the chest.

Panic disorder causes the individual to have panic attacks at unpredictable times, which are sudden intense sensations of fear that can last for minutes or longer. This may include a fear of disaster when there is no real danger. It may be accompanied by intense physical symptoms such as chest pain, stomach pain, a pounding heart, trouble breathing, and feeling excessively hot or cold.

Obsessive-compulsive and related disorders cause the sufferer to feel excessively anxious about specific things, such as a fear of germs, of harming others, of losing things, or of forgetting things. This leads the sufferer to adopt compulsive behaviours to soothe the anxiety, such as compulsive hand washing or triple-checking everything.

Other feelings not in the appendix

Happiness and unhappiness

As we saw in What are happiness and unhappiness, these two words can take on many different meanings in many different cultures. However, all of the main emotions that these may represent have already been described elsewhere in this appendix. As such, happiness and unhappiness were not listed as distinct feelings.

Sadness

Many of us view sadness—which may also be called grief, sorrow, or feeling glum—as a basic emotion. However, it may be more accurate to view it as a mixture of other emotions, in the same way that depression is usually a combination of feelings rather than a single, specific one. Sadness is usually triggered by a loss or failure of some kind. It’s an injury to our soul that makes us slow down and introspect, much like how an injured knee makes us slow down and focus on our knee. Sadness may consist of many feelings, alone or combined, such as feeling uncared for, disappointment, compassion, longing for touch, restlessness, boredom, and anticipation of further suffering. These feelings have all been documented separately in this appendix, which is why sadness was not listed as a distinct feeling.

NOTES

PART ONE: FOUNDATION

Introduction—The problem

Specialists discuss global increase in depression: Mark Williams and Danny Penman, “What is depression?” The University of Oxford, UK, October 21, 2011, http://podcasts.ox.ac.uk/what-depression.

What about the neuroscientific approach?

Pain specialist Douglas Nelson on chronic pain: Douglas Nelson, The Mystery of Pain (London: Singing Dragon, 2013), 113.

Dr. Joseph Glenmullen on how many chemical imbalance theories of depression have been proven false: Joseph Glenmullen, Prozac Backlash (Simon & Schuster, 2000).

Overview of pain research: The US National Institute of Neurological Disorders and Stroke, “Pain: Hope Through Research,” January 2014, https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Pain-Hope-Through-Research.

Chronic pain prognosis and difficulty curing: Eric Metcalf, “When Your Pain Medication Isn't Working,” accessed September 3, 2015, http://www.webmd.com/pain-management/features/when-pain-medications-not-working.

The source of all motivation

Philosopher Jeremy Bentham on how pleasure and pain are our sole motivators: Jeremy Bentham, An Introduction to the Principles of Morals and Legislation (n.p., 1907).

Pleasure and pain are all in our heads

Neuroscientist Lorimer Moseley’s views on the illusions of pain: Lorimer Moseley, “TEDxAdelaide—Why Things Hurt,” TEDxAdelaide, November 21, 2011, https://www.youtube.com/watch?v=gwd-wLdIHjs.

What is anhedonia?

Psychologist Archibald Hart on how our pursuit of ever more pleasure has led to widespread anhedonia: Archibald D. Hart, Thrilled to Death (Nashville: Thomas Nelson, 2007), 184.

What is depression?

The symptoms of depression: The Public Health Agency of Canada, “What is Depression?” last modified December 22, 2014, http://www.phac-aspc.gc.ca/cd-mc/mi-mm/depression-eng.php.

Depression signs and symptoms: The US National Institute of Mental Health, “Depression,” last modified May 2016, https://www.nimh.nih.gov/health/topics/depression/index.shtml.

We don’t always react the same way to the same thing

Overview of pain research: The US National Institute of Neurological Disorders and Stroke, “Pain: Hope Through Research,” January 2014, https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Pain-Hope-Through-Research.

Pain specialist Douglas Nelson on chronic pain: Douglas Nelson, The Mystery of Pain (London: Singing Dragon, 2013), 37.

Depression’s impact on the enjoyment of everyday things: Gary Null, The Food-Mood-Body Connection (New York: Seven Stories Press, December 4, 2001).

Chronic pain prognosis and difficulty curing: Eric Metcalf, “When Your Pain Medication Isn't Working,” accessed September 3, 2015, http://www.webmd.com/pain-management/features/when-pain-medications-not-working.

What happens when we blend pleasure and pain?

Plato’s observations on the connection between pleasure and pain: Plato, Phaedo (n.p., Circa 360 B.C.E.).

Various studies on the interrelationship between pain and pleasure: Siri Leknes and Brock Bastian, “The Benefits of Pain,” The Review of Philosophy and Psychology 5 (2014): 57-70, https://doi.org/10.1007/s13164-014-0178-3.

Laughter’s short- and long-term benefits: The Mayo Clinic, “Healthy Lifestyle—Stress management,” July 23, 2013, http://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress-relief/art-20044456.

Study on laughter’s role in bonding and pain relief: R. I. M. Dunbar, Rebecca Baron, Anna Frangou, Eiluned Pearce, Edwin J. C. van Leeuwin, Julie Stow, Giselle Partridge, Ian MacDonald, Vincent Barra, Mark van Vugt, “Social laughter is correlated with an elevated pain threshold,” Proceedings of the Royal Society B (September 14, 2011), https://doi.org/10.1098/rspb.2011.1373.

Pain specialist Erv Hinds on the nature of pain and the effectiveness of pain treatments: Erv Hinds, A Life Larger Than Pain (New Mexico: Health Press, April 1, 2003), 47.

Can we measure pleasure and pain?

Chronic pain and the difficulty in measuring and describing pain: The American College of Physicians and the American Academy of Pain Medicine, “Managing Chronic Pain: a Guide for Patients,” 2007, https://web.archive.org/web/20150606015344/https://www.acponline.org/patients_families/pdfs/misc/pain.pdf.

PART TWO: WHAT ARE SUDUALITY AND SUDISM?

Introduction—Life is a series of ups and downs

Sean Covey advises teens on life’s struggles: Renee Pratt, “A former teen's advice writes to advice new generation,” Deseret News, January 18, 1999, http://www.deseretnews.com/article/674686/A-former-teens-advice-writes-to-advice-new-generation.html?pg=all.

A paradigm shift

Benjamin Franklin’s discovery of the conservation of charge: Walter Isaacson, Benjamin Franklin: An American Life (New York: Simon and Schuster, 2003).

Benjamin Franklin’s dissertation on the balance of pleasure and pain: H. W. Brands, The First American: The Life and Times of Benjamin Franklin (New York: Anchor Books, 2002).

PART THREE: WHY BELIEVE

Others should have observed suduality before

Ancient Greek Democritus’ views on pleasure and pain: Pamela Gossin, Encyclopedia of Literature and Science (Westport: Greenwood, August 2, 2002).

Rabbi Noah Weinberg’s view of how pain and pleasure are intertwined: Noah Weinberg, The 48 Ways to Wisdom (n.p., undated).

Saint Maximos’ views on the intertwining of pleasure and pain: St Maximos the Confessor, Philokalia (n.p., circa 600-662 CE).

Leonardo da Vinci’s view on the interconnection between pleasure and pain: David B. Morris, The Culture of Pain (Berkeley: University of California Press, April 1993).

Benjamin Franklin’s dissertation on the balance of pleasure and pain: H. W. Brands, The First American: The Life and Times of Benjamin Franklin (New York: Anchor Books, 2002).

Nietzsche’s view on how happiness and unhappiness are interdependent: Friedrich Wilhelm Nietzsche, The Gay Science, trans. Walter Kaufman (New York: Knopf Doubleday, August 18, 2010).

Nietzsche’s view on how pleasure and pain are interdependent: Walter Arnold Kaufmann, Nietzsche, Philosopher, Psychologist, Antichrist (Princeton: Princeton University Press, October 6, 2013).

Bhagavan Das on the equilibrium of pleasure and pain: Bhagavan Das, “Eugenics, Ethics and Metaphysics,” August 1930, http://hpb.narod.ru/EugenicsEthicsandBD.htm.

Psychologist Carl Jung on the inevitable balance of joy and sorrow in life: C. G. Jung, Collected Works of C.G. Jung, Volume 16: Practice of Psychotherapy (Princeton: Princeton University Press, March 1, 2014).

Philosopher Alan Watts on the link between pleasure and pain: Alan Wilson Watts, The Wisdom of Insecurity (New York: Pantheon, 1951).

Philosopher Alan Watts on the impossibility of having pleasure without pain: Alan Wilson Watts, Eastern Wisdom, Modern Life: Collected Talks 1960–1980 (Novato: New World Library, 2006).

Plato’s observations on the connection between pleasure and pain: Plato, Phaedo (n.p., Circa 360 B.C.E.).

Jonathan Swift’s view of how pleasure and pain balance eachother out: Jonathan Swift, Thoughts on various subjects, moral and diverting, ed. Thomas Roscoe (London: Bell and Daldy, 1869).

Philosopher Francisque Bouillier’s views on the relationship between pleasure and pain: Francisque Bouillier, Du plaisir et de la douleur (Paris: Librairie Hachette, 1877).

Ralph Waldo Emerson on the link between pleasure and pain: Ralph Waldo Emerson, Compensation, in Essays: First Series (n.p., 1841).

Poet Kahlil Gibran on the close relationship between sorrow and joy: Kahlil Gibran, The Prophet (New York: Knopf, 1923).

Sri Swami Sivananda on the perpetual balance between pleasure and pain: Sri Swami Sivananda, Bliss Divine (Shivanandanagar, India: Divine Life Society, 1964).

Sri Nisargadatta Maharaj’s views on the relationship between pain and pleasure: Sri Nisargadatta Maharaj, I Am That: talks with Sri Nisargadatta Maharaj, trans. Maurice Frydman (Durham, North Carolina: The Acorn Press, [1973] 1992), 145.

Dr. Paul Brand on living and working in poor and rich countries: Paul W. Brand and Philip Yancey, The Gift of Pain: Why We Hurt & What We Can Do about it (Grand Rapids, Michigan: Zondervan, 1993), 290.

Pain specialist Erv Hinds on the nature of pain and the effectiveness of pain treatments: Erv Hinds, A Life Larger Than Pain (New Mexico: Health Press, April 1, 2003), 110.

Glennon Doyle on the interweaving of beauty and struggles in life: Glennon Doyle Melton, Carry On, Warrior: The Power of Embracing Your Messy, Beautiful Life (New York: Scribner, April 2, 2013).

Glennon Doyle on how the beauty and struggles of life are interconnected: Glennon Doyle, “Meet Glennon,” accessed July 22, 2016, http://momastery.com/blog/about-glennon/.

We should each witness suduality happening within ourselves

Psychologist Paul Bloom on the many kinds and functions of pleasures: Paul Bloom, How Pleasure Works (New York: W. W. Norton Company, 2010).

Psychologist Daniel Gilbert on our misperceptions about pain and happiness: Daniel Gilbert, Stumbling on happiness (New York: Knopf, 2006).

What are negative and positive tension?

Study showing that only events in the past few months affect current wellbeing: Eunkook Suh, Ed Diener, and Frank Fujita, “Events and subjective well-being: Only recent events matter,” Journal of Personality and Social Psychology Vol. 70(5) (May 1996), https://doi.org/10.1037/0022-3514.70.5.1091.

It should be impossible to feel endless pleasure

Philosopher Arthur Schopenhauer on the elusiveness of satisfaction and persistence of suffering: Arthur Schopenhauer, The World as Will and Representation, Volume 1 (North Chelmsford, Massachusetts: Courier Corporation, [1818] 2012).

The inner workings of the processed food industry: Eric Schlosser, Fast Food Nation: The Dark Side of the All-American Meal (Boston: Mariner Books, March 1, 2012).

Researcher Pamela Dalton on olfactory adaptation: Pamela Dalton, “Psychophysical and Behavioral Characteristics of Olfactory Adaptation,” Chemical Senses, August 1, 2000, https://academic.oup.com/chemse/article/25/4/487/342753.

Study on declining erectile response to repeated viewings of the same erotic video: Kim SC, Bang JH, Hyun JS, Seo KK, “Changes in erectile response to repeated audiovisual sexual stimulation,” Eur Urol. 1998;33(3):290-2., 1998, http://www.ncbi.nlm.nih.gov/pubmed/9555554.

Belachew Girma awarded the world record of longest laughter: Golden Book of World Records, “Longest laughter,” 2016, http://goldenbookofrecords.com/longest-laughter/.

Dutch psychologist Nico Frijda on the difficulty of obtaining continuous pleasure: David G. Meyers, “Emotions, stress, and health” in Psychology (New York: Worth Publishers, December 19, 2011), 482.

Psychologist Archibald Hart on how our pursuit of ever more pleasure has led to widespread anhedonia: Archibald D. Hart, Thrilled to Death (Nashville: Thomas Nelson, 2007), 40-41.

Comedian Denis Leary on how happiness comes in small doses: Denis Leary. No cure for cancer. A&M 540 055, January 12, 1993, compact disc.

The limited enjoyment and ensuing despair that can occur after achieving the pinnacle of success: Matthew Syed, Bounce: Mozart, Federer, Picasso, Beckham, and the science of success (New York: Harper, 2010), 213.

It should be impossible to feel endless pain

On the runner’s high and their increased pain tolerance: Gina Kolata, “Yes, Running Can Make You High,” March 27, 2008, http://www.nytimes.com/2008/03/27/health/nutrition/27best.html?_r=0.

Dr. Bonanno on how most people are resilient to traumatic life events: George A Bonanno, “Grief Doesn't Come in Stages and It's Not the Same for Every,” Psychology Today, October 26, 2009, https://www.psychologytoday.com/blog/thriving-in-the-face-trauma/200910/grief-doesnt-come-in-stages-and-its-not-the-same-every.

Fasting often leads to euphoria: Sharman Apt Russell, Hunger: An Unnatural History (New York: Basic Books, 2008).

Extreme cold numbs sensations of pain: The Canadian Centre for Occupational Health & Safety, “Cold Environments - Health Effects and First Aid,” OSH Answers Fact Sheets, last modified September 28, 2016, https://www.ccohs.ca/oshanswers/phys_agents/cold_health.html.

Psychiatrist Viktor Frankl’s experiences in a WWII concentration camp: Victor Frankl, Man's search for meaning (Boston: Beacon Press, [1946] 1992).

How the mind limits pain, even when tortured or severely injured: David Wynick, “Is there a pain 'limit'?” June 4, 2011, http://www.askabiologist.org.uk/answers/viewtopic.php?id=6204.

Fainting can be triggered by pain, fear, stress, and exhaustion: Corey Whelan, “What to Expect During and After a Syncopal Episode,” accessed September 14, 2018, https://www.healthline.com/health/syncopal-episode.

Freezing in response to traumatic events: The University of Michigan Sexual Assault Prevention and Awareness Center, “The Anatomy of Trauma,” 2016, https://web.archive.org/web/20160621212052/https://sapac.umich.edu/article/anatomy-trauma-0.

Dissociation and analgesia during extreme trauma: Babette Rothschild, “Body psychotherapy without touch: applications for trauma therapy” in Body psychotherapy, ed. Tree Staunton (London: Routledge, June 3, 2014).

The freeze response’s analgesic effects: Leon F Seltzer, “Trauma and the Freeze Response: Good, Bad, or Both?” July 8, 2015, https://www.psychologytoday.com/blog/evolution-the-self/201507/trauma-and-the-freeze-response-good-bad-or-both.

The temporary nature of pain: Susan L. Smalley, Fully Present: The Science, Art, and Practice of Mindfulness (Boston: Da Capo Press, 2010), 87.

Chronic pain prognosis and difficulty curing: Eric Metcalf, “When Your Pain Medication Isn't Working,” accessed September 3, 2015, http://www.webmd.com/pain-management/features/when-pain-medications-not-working.

Changing the frequency of pleasure should usually affect its intensity

Dr. Paul Brand on living and working in poor and rich countries: Paul W. Brand and Philip Yancey, The Gift of Pain: Why We Hurt & What We Can Do about it (Grand Rapids, Michigan: Zondervan, 1993).

Professor Wendy Wood on the relation of habits’ frequency with their pleasantness: Rachel Clun, “A case for not doing the things you love,” October 1, 2014, http://www.dailylife.com.au/health-and-fitness/dl-wellbeing/a-case-for-not-doing-the-things-you-love-20141001-3h0ob.html.

Chinese proverb on the inverse relation of eating frequency and flavour: Qamruddin, Smile Your Way to Bliss (Partridge Publishing India, 2014).

Paul Bragg describes the effects of fasting: Paul Chappuis Bragg, The Miracle of Fasting (Health Science Publications, 2004).

How fasting boosts the flavour of even bland foods: Alejandra Ruani, “3 Little-Known Changes You Can Trigger With Intermittent Fasting,” The Health Sciences Academy, August 14, 2014, http://thehealthsciencesacademy.org/health-tips/intermittent-fasting/.

Anorexics describe the excitement and pleasure of eating after fasting: Various contributors, comment on “food orgasm? possible tw,” My Pro Ana, December 2013, http://www.myproana.com/index.php/topic/93078-food-orgasm-possible-tw/.

Various studies on the interrelationship between pain and pleasure: Siri Leknes and Brock Bastian, “The Benefits of Pain,” The Review of Philosophy and Psychology 5 (2014), https://doi.org/10.1007/s13164-014-0178-3.

Study showing increased frequency of sex doesn’t lead to increased happiness: George Loewenstein, Tamar Krishnamurti, Jessica Kopsic, Daniel McDonald, “Does Increased Sexual Frequency Enhance Happiness?” Journal of Economic Behavior & Organization 116 (August 2015), http://www.sciencedirect.com/science/article/pii/S0167268115001316.

Nurse Kim Ramsey’s experience with Persistent Genital Arousal Disorder (PGAD): Lizzie Crocker, “The Endless Orgasm,” September 2012, https://www.newsweek.com/endless-orgasm-64733.

Zara Richardson’s experience with Persistent Sexual Arousal Syndrome: Dulcie Pearce, “Speed bumps, vibrating phones, turnstiles, shopping trolleys and job interviews give me 500 orgasms a day,” October 13, 2012, https://www.thesun.co.uk/archives/news/985991/speed-bumps-vibrating-phones-turnstiles-shopping-trolleys-and-job-interviews-give-me-500-orgasms-a-day/.

Jeannie Allen’s experience with Persistent Genital Arousal Disorder: Jessica Ryen Doyle, “Never Satisfied: The Curse of Persistent Sexual Arousal Syndrome,” FoxNews.com, April 23, 2008, https://www.foxnews.com/story/never-satisfied-the-curse-of-persistent-sexual-arousal-syndrome.

Gretchen Molannen's struggles with persistent genital arousal disorder: Ryan Jaslow, “Gretchen Molannen's suicide spotlights debilitating effects of persistent genital arousal disorder,” CBS News, December 6, 2012, http://www.cbsnews.com/news/gretchen-molannens-suicide-spotlights-debilitating-effects-of-persistent-genital-arousal-disorder/.

Gretchen Molannen’s struggles with persistent genital arousal disorder: Leonora LaPeter Anton, “Woman featured in Times story about sexual disorder commits suicide,” Tampa Bay Times, December 4, 2012, http://www.tampabay.com/news/health/medicine/woman-featured-in-times-story-about-sexual-disorder-commits-suicide/1264559.

Tolerance to nicotine effects: Perkins KA, “Chronic tolerance to nicotine in humans and its relationship to tobacco dependence,” Nicotine & Tobacco Research 4(4) (November 2002): 405-22, http://www.ncbi.nlm.nih.gov/pubmed/12521400.

Tolerance to benzodiazepine effects: Christiaan H. Vinkers and Berend Olivier, “Mechanisms Underlying Tolerance after Long-Term Benzodiazepine Use: A Future for Subtype-Selective Gaba Receptor Modulators?” Advances in Pharmacological Sciences Volume 2012 (2012), https://doi.org/10.1155/2012/416864.

Tolerance to opiate effects: Bernard Segal and Lawrence K. Duffy, “Biobehavioral effects of psychoactive drugs” in Drugs of Abuse and Addiction: Neurobehavioral Toxicology, ed. Raymond Niesink, R.M.A. Jaspers, L.M.W. Kornet, J.M. van Ree (Boca Raton: CRC Press, December 8, 1998).

Tolerance to alcohol’s effects: The US National Institute on Alcohol Abuse and Alcoholism, “Alcohol alert,” National Institute on Alcohol Abuse and Alcoholism No. 28 PH 356 April 1995, April 1995, http://pubs.niaaa.nih.gov/publications/aa28.htm.

Boston College’s study on those with extreme wealth: Graeme Wood, “Secret Fears of the Super-Rich,” The Atlantic, April 2011, http://www.theatlantic.com/magazine/archive/2011/04/secret-fears-of-the-super-rich/308419/.

Giving kids too much makes them unsatisfied: Katherine Kam, “Are Your Children Spoiled?” 2009, http://www.webmd.com/parenting/features/are-your-children-spoiled.

Psychologist Daniel Gilbert on our misperceptions about pain and happiness: Daniel Gilbert, Stumbling on happiness (New York: Knopf, 2006).

Changing the frequency of pain should usually affect its intensity

Exercise’s beneficial effects on the heart and blood vessels: The US National Heart, Lung, and Blood Institute, “Physical Activity and Your Heart,” accessed February 2, 2019, https://www.nhlbi.nih.gov/health-topics/physical-activity-and-your-heart.

Exercise’s beneficial effects on mitochondria: Arsalan Damirchi, Parvin Babaei, Meysam Gholamali, and Kamal Ranjbar, “Mitochondrial Biogenesis in Skeletal Muscle: Exercise and Aging,” August 22, 2012, https://www.intechopen.com/books/skeletal-muscle-from-myogenesis-to-clinical-relations/mitochondrial-biogenesis-in-skeletal-muscle-exercise-and-aging.

The many ways exercise improves health, reduces pain, and gets easier over time: Gina DeMillo Wagner, “Easier by the Day: 9 Ways Exercise Gets Less Difficult (and More Rewarding) As You Go,” Experience Life magazine, January 2011, https://experiencelife.com/article/easier-by-the-day-9-ways-exercise-gets-less-difficult-and-more-rewarding-as-you-go/.

Study on how bed rest worsens back pain: Michael S Wilkes, “Chronic back pain: does bed rest help?” The Western Journal of Medicine 172(2) (February 2000): 121, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1070772/.

Harvard Health on how too much bed rest is harmful for back pain sufferers: Harvard Health Publications – Healthbeat, “Bed rest for back pain? A little bit will do you,” February 26, 2015, http://www.health.harvard.edu/pain/bed-rest-for-back-pain-a-little-bit-will-do-you.

Pain specialist Douglas Nelson on chronic pain: Douglas Nelson, The Mystery of Pain (London: Singing Dragon, 2013), 122-129;37.

Our ability to adapt to bitter flavours: Martha Esersky Lorden, “Why Bitter Is Better: PW Talks with Jennifer McLagan,” September 15, 2014, http://www.publishersweekly.com/pw/by-topic/industry-news/cooking/article/64006-why-bitter-is-better-pw-talks-with-jennifer-mclagan.html.

How joggers get used to running in cold weather: Laura McMullen, “6 rules for working out in cold weather,” US News and World Report, December 5, 2013, http://www.nydailynews.com/life-style/health/exercise-cold-weather-article-1.1538859.

The ability to adapt to walking barefoot in the cold: Steve Bloor, “Winter Barefoot Walking,” blog, December 11, 2013, https://naturalfeet.wordpress.com/2013/12/11/winter-barefoot-walking/.

People’s ability to get used to both pleasant and unpleasant odours: The New York State Department of Health, “Health & Safety in the Home, Workplace and Outdoors—Odors & Health,” April 2014, https://www.health.ny.gov/publications/6500/index.htm.

Journalist gets used to a disgusting-smelling perfume: Allie Conti, “This Is What Happens When You Wear Semen-Scented Perfume,” March 15, 2013, http://www.vice.com/en_ca/read/this-is-what-happens-when-you-wear-semen-scented-perfume.

How parents get used to the smell of their babies’ poop: Various authors, “Why Your Farts Smell Okay And Everybody Else's Farts Stink,” November 10, 2014, http://io9.com/why-your-farts-smell-okay-and-everybody-elses-farts-sti-1656777059.

The inner workings of the processed food industry: Eric Schlosser, Fast Food Nation: The Dark Side of the All-American Meal (Boston: Mariner Books, March 1, 2012).

City Rotorua’s distinctive sulphur smell: New Zealand on the Web Limited, “The Smell of Rotorua,” 2015, http://www.rotorua.nz.com/smelly.aspx.

Study showing we rate our own body odour as more pleasant than everyone else: Donald H. McBurney, John M. Levine, and Patricia H. Cavanaugh, “Psychophysical and Social Ratings of Human Body Odor,” Personality and Social Psychology Bulletin Volume 3, Issue 1 (December 1, 1976), https://doi.org/10.1177/014616727600300126.

Study on exposure to feared scenarios in a virtual environment leading to reduced anxiety: Thomas D. Parsons and Albert A. Rizzo, “Affective outcomes of virtual reality exposure therapy for anxiety and specific phobias: A meta-analysis,” Journal of Behavior Therapy and Experimental Psychiatry 39(3) (September 2008): 250-61, https://www.researchgate.net/publication/6120330_Affective_outcomes_of_virtual_reality_exposure_therapy_for_anxiety_and_specific_phobias_A_meta-analysis.

Exposure therapy’s effectiveness for relieving PTSD and anxiety: Johanna S. Kaplan and David F. Tolin, “Exposure Therapy for Anxiety Disorders,” Psychiatric Times, September 6, 2011, http://www.psychiatrictimes.com/anxiety/exposure-therapy-anxiety-disorders.

Inducing positive effects should lead to negative effects

How food without salt tastes bland: Josh Ozersky, “Chefs Love Salt — Too Much and Not Well,” Time magazine, May 17, 2010, http://content.time.com/time/magazine/article/0,9171,1987591,00.html.

How sugar affects various foods’ taste and texture: The Canadian Sugar Institute, “Functional Properties of Sugar,” accessed July 21, 2015, http://www.sugar.ca/Nutrition-Information-Service/Health-professionals/About-Sugar-and-Role-of-Sugar-in-Foods/Functional-Properties-of-Sugar.aspx.

Sugary drinks increase diabetes risk: de Koning L, Malik VS, Rimm EB, Willett WC, and Hu FB, “Sugar-sweetened and artificially sweetened beverage consumption and risk of type 2 diabetes in men,” The American Journal of Clinical Nutrition 93(6) (June 2011): 1321-7, https://doi.org/10.3945/ajcn.110.007922.

Soda’s impact on human DNA: Jeffrey Norris, “Sugared Soda Consumption, Cell Aging Associated in New Study,” October 16, 2014, https://www.ucsf.edu/news/2014/10/119431/sugared-soda-consumption-cell-aging-associated-new-study.

The potential adverse effects of fructose: Alan R. Gaby, “Adverse Effects of Dietary Fructose,” Alternative Medicine Review Volume 10, Number 4 (December 2005), http://www.c4oh.org/monographs/amr_fructose_10-4.pdf.

The various effects of sugar on health, weight, and hunger: Lauren F Friedman, “15 Terrible Things That Happen If You Eat Too Much Sugar,” March 12, 2014, http://www.businessinsider.com/effects-of-eating-too-much-sugar-2014-3.

Sugar’s impact on health: Barbara V. Howard, and Judith Wylie-Rosett, “AHA Scientific Statement - Sugar and Cardiovascular Disease - A Statement for Healthcare Professionals From the Committee on Nutrition of the Council on Nutrition, Physical Activity, and Metabolism of the American Heart Association,” Circulation 106 (2002): 523-527, https://doi.org/10.1161/01.CIR.0000019552.77778.04.

Study on high-fructose corn syrup’s negative impact on blood lipids: Kimber L Stanhope, Valentina Medici, Andrew A Bremer, Vivien Lee, Hazel D Lam, Marinelle V Nunez, Guoxia X Chen, Nancy L Keim, and Peter J Havel, “A dose-response study of consuming high-fructose corn syrup–sweetened beverages on lipid/lipoprotein risk factors for cardiovascular disease in young adults,” The American Journal of Clinical Nutrition Volume 101, Issue 6 (April 22, 2015), http://ajcn.nutrition.org/content/early/2015/04/22/ajcn.114.100461.

Sugar consumption trends in the US and cardiovascular disease: Quanhe Yang, Zefeng Zhang, Edward W. Gregg, W. Dana Flanders, Robert Merritt, Frank B. Hu, “Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults,” JAMA Internal Medicine 174(4) (2014): 516-524, https://doi.org/10.1001/jamainternmed.2013.13563.

Therapist Frank Gresham’s thoughts on sugar and chronic pain: Frank Gresham, “Chronic Pain: Sugar Will Cause Chronic Pain,” online YouTube video, April 10, 2011, https://www.youtube.com/watch?v=CTCwrnE-PzU.

Sugar and other ingredients to blame for half of migraine headaches: Deborah Khoshaba, “Is Your Holiday Headache Really A Sugar Hangover?” December 16, 2011, http://www.psychologyineverydaylife.net/2011/12/16/is-your-holiday-headache-really-a-sugar-hangover/.

The World Health Organization (WHO) identifies free sugars in the diet as damaging to health: Action on Sugar, “WHO calls for immediate action on sugar,” March 4, 2015, http://www.actiononsugar.org/news-centre/press-releases/2015/items/who-calls-for-immediate-action-on-sugar.html.

Study linking sugar consumption to increased schizophrenia symptoms and depression: Malcolm Peet, “International variations in the outcome of schizophrenia and the prevalence of depression in relation to national dietary practices: an ecological analysis,” The British Journal of Psychiatry. May 2004;184(5):404-408, May 2004, http://bjp.rcpsych.org/content/184/5/404.long.

Study linking consumption of added sugars with mental disorders: Anika Knüppel, Martin J. Shipley, Clare H. Llewellyn, and Eric J. Brunner, “Sugar intake from sweet food and beverages, common mental disorder and depression: prospective findings from the Whitehall II study,” Scientific Reports Volume 7, Issue 1 (July 27, 2017), https://doi.org/10.1038/s41598-017-05649-7.

Registered dietician Brigitte Zeitlin on how sugar can worsen anxiety symptoms: Emily Laurence, “This is Exactly How Sugar Can Mess With Your Anxiety—and What to Do About It,” May 31, 2019, https://www.wellandgood.com/good-food/sugar-and-anxiety/.

Artificial sweeteners’ impact on dietary choices and health: Holly Strawbridge, “Artificial sweeteners: sugar-free, but at what cost?” Harvard Health blog, July 16, 2012, http://www.health.harvard.edu/blog/artificial-sweeteners-sugar-free-but-at-what-cost-201207165030.

Studies linking artificial sweeteners to weight gain and other illnesses: The Harvard School of Public Health, “Artificial Sweeteners,” accessed June 16, 2015, http://www.hsph.harvard.edu/nutritionsource/healthy-drinks/artificial-sweeteners/.

Study linking diet soft drinks to increased risk of stroke: Yasmin Mossavar-Rahmani et al, “Artificially Sweetened Beverages and Stroke, Coronary Heart Disease, and All-Cause Mortality in the Women’s Health Initiative,” Stroke, February 14, 2019, https://www.ahajournals.org/doi/10.1161/STROKEAHA.118.023100.

The link between artificial sweeteners and depression: American Academy of Neurology, “Hold the Diet Soda? Sweetened Drinks Linked to Depression, Coffee Tied to Lower Risk,” January 8, 2013, https://www.aan.com/pressroom/home/pressrelease/1128.

The many ways salt can enhance foods: The Salt Association, “Salt and Food Technology,” accessed March 28, 2020, https://www.saltassociation.co.uk/education/salt-health/role-salt-cooking/.

The effects of salt on flavour and texture: The US Institute of Medicine Committee on Strategies to Reduce Sodium Intake, Strategies to Reduce Sodium Intake in the United States, ed. Henney JE, Taylor CL, Boon CS (Washington (DC): National Academies Press (US), 2010).

How the processed food industry creates addictive products that trick us into overeating: Kelly Crowe, “Food cravings engineered by industry,” CBC News, March 6, 2013, https://www.cbc.ca/news/health/food-cravings-engineered-by-industry-1.1395225.

Negative impacts of excess sodium consumption: World Action on Salt and Health (WASH), “Salt and health factsheets—Salt and other conditions,” accessed July 21, 2015, http://www.worldactiononsalt.com/salthealth/factsheets/other/index.html.

Study on excessive sodium’s impact on mortality: David DiSalvo, “Study: Eating Too Much Salt is Killing Us By the Millions,” March 2013, http://www.forbes.com/sites/daviddisalvo/2013/03/24/study-eating-too-much-salt-is-killing-us-by-the-millions/.

High salt consumption linked to increased headaches: Joel Fuhrman, “High Salt Intake Linked to Headaches,” accessed June 24, 2015, http://www.drfuhrman.com/library/high-salt-intake-linked-to-headaches.aspx.

Sodium intake and cognitive performance in older adults: Alexandra J. Fiocco , Bryna Shatenstein, Guylaine Ferland, Hélène Payette, Sylvie Belleville, Marie-Jeanne Kergoat, José A. Morais, Carol E. Greenwood, “Sodium intake and physical activity impact cognitive maintenance in older adults: the NuAge Study,” Neurobiology of Aging Volume 33, Issue 4, April 2012, Pages 829.e21–829.e28, April 2012, http://www.sciencedirect.com/science/article/pii/S0197458011002715.

Study on how salt causes overconsumption of food: Dieuwerke P Bolhuis, Andrew Costanzo, Lisa P Newman, and Russell SJ Keast, “Salt Promotes Passive Overconsumption of Dietary Fat in Humans,” The Journal of Nutrition Volume 146, Issue 4 (April 1, 2016), https://doi.org/10.3945/jn.115.226365.

Sodium intake linked to obesity in humans and animals: Shereen Jegtvig, “Sodium intake tied to obesity among teens,” Reuters, February 4, 2014, http://www.reuters.com/article/2014/02/04/us-sodium-intake-obesity-teens-idUSBREA1314N20140204.

Debby Anglesey’s experience with MSG triggering headaches and asthma: Debby Anglesey, “Deb’s Own MSG Story,” accessed June 24, 2015, https://www.msgmyth.com/msg-story.

Various MSG sensitive individuals share their experiences with MSG: Various authors, “MSG ‘Victims’ Share Stories,” accessed June 24, 2015, https://www.msgmyth.com/msg-and-illnesses.

The negative effects of MSG on the brain: Russell L. Blaylock, Excitotoxins: The Taste that Kills (Santa Fe, New Mexico: Health Press, December 1, 1996).

Study on MSG’s impact on appetite and the brain: Hermanussen M, García AP, Sunder M, Voigt M, Salazar V, Tresguerres JA, “Obesity, voracity, and short stature: the impact of glutamate on the regulation of appetite,” European Journal of Clinical Nutrition 60(1) (January 2006): 25-31, http://www.ncbi.nlm.nih.gov/pubmed/16132059.

A study showing how MSG consumption correlates with body weight: Ka He, Liancheng Zhao, Martha L Daviglus, Alan R Dyer, Linda Van Horn, Daniel Garside, Liguang Zhu, Dongshuang Guo, Yangfeng Wu, Beifan Zhou, Jeremiah Stamler, “Association of monosodium glutamate intake with overweight in Chinese adults: the INTERMAP Study,” Obesity (Silver Spring). 2008 Aug; 16(8): 1875–1880., August 16, 2008, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2610632/.

A study on MSG’s negative impact on fibromyalgia and IBS: Holton KF, Taren DL, Thomson CA, Bennett RM, Jones KD, “The effect of dietary glutamate on fibromyalgia and irritable bowel symptoms,” Clinical and Experimental Rheumatology 30(6 Suppl 74) (2012 Nov-Dec): 10-7, http://www.ncbi.nlm.nih.gov/pubmed/22766026.

A nutritional neuroscientist describes MSG’s multiple impacts on health: Kathleen Holton, “Actually, MSG Is Not Safe for Everyone (Op-Ed),” September 20, 2014, http://www.livescience.com/47931-msg-not-safe-for-everyone.html.

Alcohol’s ability to induce well-being: Norman S. Miller, The Pharmacology of Alcohol and Drugs of Abuse and Addiction (Berlin: Springer Science & Business Media, December 6, 2012).

The history of alcohol consumption: David J. Hanson, “Historical evolution of alcohol consumption in society,” 2013, http://www.oxfordscholarship.com/view/10.1093/acprof:oso/9780199655786.001.0001/acprof-9780199655786-chapter-01.

Recovering alcoholic Caroline Knapp’s story: Caroline Knapp, Drinking: A Love Story (New York: Random House, 1996).

Review of evidence that anxiety disorder and alcohol disorder can each cause the other: Matt G Kushnera, Kenneth Abramsa, and Carrie Borchardta, “The relationship between anxiety disorders and alcohol use disorders: A review of major perspectives and findings,” Clinical Psychology Review Volume 20, Issue 2 (March 2000), https://doi.org/10.1016/S0272-7358(99)00027-6.

Alcohol hangover and withdrawal symptoms: Robert Swift and Dena Davidson, “Alcohol Hangover—Mechanisms and Mediators,” Alcohol health and research world 22(1) (1998): 54-60, http://pubs.niaaa.nih.gov/publications/arh22-1/54-60.pdf.

Alcohol is a causal factor in over 200 diseases and injury conditions: The World Health Organization, “Alcohol,” September 21, 2018, https://www.who.int/news-room/fact-sheets/detail/alcohol.

Moderate alcohol drinking is linked to disease: Kevin Van Paassen, “We need to talk (about our drinking),” The Globe and Mail, June 29, 2014, http://www.theglobeandmail.com/life/health-and-fitness/health/we-need-to-talk-about-our-drinking/article19377132/?cmpid=rss1&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+TheGlobeAndMail-Front+%28The+Globe+and+Mail+-+Latest+News%29.

Study linking moderate alcohol consumption to link to brain atrophy: Anya Topiwala, Charlotte L Allan, Vyara Valkanova, Enikő Zsoldos, Nicola Filippini, Claire Sexton, Abda Mahmood, Peggy Fooks, Archana Singh-Manoux, Clare E Mackay, Mika Kivimäki, and Klaus P Ebmeier, “Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: longitudinal cohort study,” The BMJ 357 (June 2017): j2353, https://doi.org/10.1136/bmj.j2353.

Alcohol hangover symptoms: Drinkaware, “Health effects of alcohol,” accessed August 17, 2015, https://www.drinkaware.co.uk/check-the-facts/health-effects-of-alcohol/hangovers/hangover-symptoms.

Light alcohol use linked to increased cancer risk: The American Society of Clinical Oncology, “Alcohol Linked to Cancer According to Major Oncology Organization: ASCO Cites Evidence and Calls for Reduced Alcohol Consumption,” November 7, 2017, http://view.broadcastemail.asco.org/?qs=baf4342fa20afebaf6b3d2cb62dff1b6c8c3ce899f24277fb5fef7961d3cd94f489a8788778e75ca6ca86f95f9ea90668fc2c05ab087c99e0ee43ff6a6f8d079039294cae485ed12d6c313a8b47dd05f.

Review finds benefits of moderate drinking overstated: CBC News, “Drinking alcohol offers no net health benefits, review finds,” CBC News, March 22, 2016, http://www.cbc.ca/news/health/alcohol-health-1.3501314.

Why coffee makes people feel good: Gary L Wenk, “Why Does Coffee Make Us Feel So Good?” Your Brain on Food, October 28, 2011, https://www.psychologytoday.com/blog/your-brain-food/201110/why-does-coffee-make-us-feel-so-good.

Study on the positive and negative effects of caffeine: Leeana A. Persad, “Energy Drinks and the Neurophysiological Impact of Caffeine,” Frontiers in Neuroscience 5 (October 21, 2011), https://doi.org/10.3389/fnins.2011.00116.

The short- and long-term effects of caffeine: Jasvinder Chawla, “Neurologic Effects of Caffeine,” last modified June 14, 2018, http://emedicine.medscape.com/article/1182710-overview.

Why people smoke: Canadian Cancer Society, “Why people smoke,” accessed June 9, 2015, http://www.cancer.ca/en/prevention-and-screening/live-well/smoking-and-tobacco/help-someone-quit-smoking/why-people-smoke/?region=on.

Why people smoke: Jen Christensen, “We know it can kill us: Why people still smoke,” January 13, 2014, http://www.cnn.com/2014/01/11/health/still-smoking/.

Tobacco withdrawal leads to temporary anhedonia: Cook, Jessica W., Piper, Megan E., Leventhal, Adam M., Schlam, Tanya R., Fiore, Michael C., and Baker, Timothy B., “Anhedonia as a component of the tobacco withdrawal syndrome,” Journal of Abnormal Psychology Vol. 124(1) (February 2015), https://doi.org/10.1037/abn0000016.

Review on the link between tobacco and various pains: Taylor FR, “Tobacco, Nicotine, and Headache,” Headache 55(7) (2015 Jul-Aug): 1028-44, https://doi.org/10.1111/head.12620.

The withdrawal symptoms of cigarette smoking: Breslau N, Kilbey MM, Andreski P, “Nicotine withdrawal symptoms and psychiatric disorders,” 1992, https://www.ncbi.nlm.nih.gov/pubmed/1554030.

Description of nicotine withdrawal symptoms: The Cancer Council, “6.9 Nicotine withdrawal syndrome,” last modified April 2016, https://www.tobaccoinaustralia.org.au/downloads/chapters/Ch6_Addiction.pdf.

The harmful effects of smoking on the body: The US Centers for Disease Control and Prevention, “Health Effects of Cigarette Smoking,” February 6, 2014, http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/.

Alzheimer’s risk factors: Alzheimer’s Society (UK), “High blood sugar may contribute towards Alzheimer's disease, new study finds,” May 5, 2015, http://www.alzheimers.org.uk/site/scripts/news_article.php?newsID=2378.

Smoking causes erectile dysfunction: Varant Kupelian, Carol L. Link, and John B. McKinlay, “Association between Smoking, Passive Smoking, and Erectile Dysfunction: Results from the Boston Area Community Health (BACH) Survey,” European Urology 52(2) (August 2007): 416–422, https://doi.org/10.1016/j.eururo.2007.03.015.

The worldwide top 20 generic drugs: Eric Palmer, “Top 20 generic molecules worldwide,” November 20, 2012, http://www.fiercepharma.com/special-reports/top-20-generic-molecules-worldwide.

The top-selling drugs of all time: Simon King, “The Best Selling Drugs of All Time; Humira Joins The Elite,” January 2013, http://www.forbes.com/sites/simonking/2013/01/28/the-best-selling-drugs-of-all-time-humira-joins-the-elite/.

Atorvastatin’s side effects: The American Society of Health-System Pharmacists, Inc., “Atorvastatin,” accessed June 29, 2015, http://www.nlm.nih.gov/medlineplus/druginfo/meds/a600045.html.

Anti-anxiety drug side effects: Citizens Commission on Human Rights International, “Anti-Anxiety Drug Side Effects,” accessed August 21, 2015, http://www.cchrint.org/psychiatric-drugs/antianxietysideeffects/.

Drugs that impact sex drive: Amanda Gardner, “Low Libido? 11 Drugs That Affect Your Sex Drive,” Health.com, March 21, 2014, http://time.com/23982/low-libido-11-drugs-that-affect-your-sex-drive/.

Long-term benzodiazepine users are often depressed and anhedonic: C Heather Ashton, “Benzodiazepines: How They Work and How to Withdraw,” last modified August 2002, http://www.benzo.org.uk/manual/bzcha01.htm.

How SSRI drugs can blunt both positive and negative emotions: Randy A. Sansone and Lori A. Sansone, “SSRI-Induced Indifference,” Psychiatry (Edgmont) 7(10) (October 2010): 14–18, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989833/.

SSRI antidepressant study showing most participants experienced both reduced positive and negative emotions: Jonathan Price, Victoria Cole and Guy M. Goodwin, “Emotional side-effects of selective serotonin reuptake inhibitors: qualitative study,” The British Journal of Psychiatry 195 (2009): 211–217, https://doi.org/10.1192/bjp.bp.108.051110.

Headaches caused by medication overuse: The Mayo Clinic, “Medication overuse headaches,” November 29, 2018, https://www.mayoclinic.org/diseases-conditions/medication-overuse-headache/symptoms-causes/syc-20377083.

The challenge of separating opiates’ analgesic and addictive properties: Howard L. Fields, “The Doctor's Dilemma: opiate analgesics and chronic pain,” Neuron 69(4) (February 24, 2011): 591–594, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3073133/.

Opioid-induced hyperalgesia: Lee M, Silverman SM, Hansen H, Patel VB, Manchikanti L, “A comprehensive review of opioid-induced hyperalgesia,” Pain Physician. 2011 Mar-Apr;14(2):145-61, March 2011, http://www.ncbi.nlm.nih.gov/pubmed/21412369.

Opioids’ long-term side effects and ineffectiveness: Tara Parker-Pope, “The Problem With Pain Pills,” June 26, 2013, http://well.blogs.nytimes.com/2013/06/26/the-problem-with-pain-pills/?_r=0.

Prescription opioids significantly increase the risk of major depression: Katherine Semenkovich et al, “Prescription Opioid Analgesics Increase Risk of Major Depression: New Evidence, Plausible Neurobiological Mechanisms and Management to Achieve Depression Prophylaxis,” Missouri Medicine 111(2) (2014 Mar-Apr), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6179498/.

Surgeon René Leriche on how painkillers have made people more sensitive to pain: Jean Amery, At the Mind’s Limits: Contemplations by a Survivor on Auschwitz and Its Realities (Bloomington: Indiana University Press, March 12, 1986).

Breakthrough pain occurs despite around-the-clock analgesia: Payne R, “Recognition and diagnosis of breakthrough pain,” Pain Medicine 8 Suppl 1 (2007 Jan-Feb): S3-7, https://doi.org/10.1111/j.1526-4637.2006.00269.x.

Study linking marijuana use and anxiety: Kirsten A. Johnson, Marcel O. Bonn-Miller, Teresa M. Leyro, and Michael J. Zvolensky, “Anxious Arousal and Anhedonic Depression Symptoms and the Frequency of Current Marijuana Use: Testing the Mediating Role of Marijuana-Use Coping Motives Among Active Users,” Journal of Studies on Alcohol and Drugs 70(4) (July 2009): 543–550, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2696295/.

The reasons why people smoke marijuana: Brown University Health Promotion, “Marijuana,” accessed June 23, 2015, http://www.brown.edu/Student_Services/Health_Services/Health_Education/alcohol,_tobacco,_&_other_drugs/marijuana.php.

Users describe the effects of marijuana on their daily lives: Rielle Capler, “Why People Use Cannabis,” Cannabis issue of Visions Journal, 2009, 5 (4), p. 9, 2009, http://www.heretohelp.bc.ca/visions/cannabis-vol5/why-people-use-cannabis.

Study on cannabis’ positive and negative effects: Philip Robson, “Therapeutic aspects of cannabis and cannabinoids,” The British Journal of Psychiatry 178(2) (February 2001), https://doi.org/10.1192/bjp.178.2.107.

Marijuana’s little known side effects: Sue Bailey, “Pot is no risk-free high for teens with developing brains: psychiatrists,” The Canadian Press, June 6, 2015, https://toronto.citynews.ca/2015/06/06/pot-is-no-risk-free-high-for-teens-with-developing-brains-psychiatrists/.

Study showing frequent marijuana use predicts later depression and anxiety: George C Patton, Carolyn Coffey, John B Carlin, Louisa Degenhardt, Michael Lynskey, and Wayne Hall, “Cannabis use and mental health in young people: cohort study,” The BMJ 325(7374) (November 23, 2002): 1195–1198, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC135489/.

Study showing cannabis use increases depression and suicidal ideation: Bovasso GB, “Cannabis abuse as a risk factor for depressive symptoms,” The American Journal of Psychiatry 158(12) (December 2001): 2033-7, http://www.ncbi.nlm.nih.gov/pubmed/11729021.

Study linking heavy marijuana use with decreased cognitive performance even after 28 days of abstinence: K.I. Bolla, K. Brown, D. Eldreth, K. Tate and J.L. Cadet, “Dose-related neurocognitive effects of marijuana use,” Neurology 59(9) (November 12, 2002), https://doi.org/10.1212/01.WNL.0000031422.66442.49.

Marijuana’s short- and long-term effects: The Australian Drug Foundation, “Cannabis facts,” last modified February 6, 2015, http://www.druginfo.adf.org.au/drug-facts/cannabis.

The US National Institute on Drug Abuse describes marijuana’s long-term negative health effects: The US National Institute on Drug Abuse, “DrugFacts: Marijuana,” last modified June 2015, http://www.drugabuse.gov/publications/drugfacts/marijuana.

One user describes his marijuana withdrawal week-by-week: Anonymous, “Marijuana Withdrawal Syndrome,” June 15, 2009, http://brainblogger.com/2009/06/15/marijuana-withdrawal-syndrome/.

The short- and long-term effects of cocaine: The Foundation for a Drug-Free World, “The truth about cocaine,” accessed May 15, 2015, http://www.drugfreeworld.org/drugfacts/cocaine/effects-of-cocaine.html.

Adam Brown relates the intense euphoria of crack cocaine: Adam Tod Brown, “4 Unexpected Things I Learned Smoking Crack Cocaine,” Cracked, July 4, 2014, http://www.cracked.com/blog/4-unexpected-things-i-learned-smoking-crack-cocaine/.

The short- and long-term effects of cocaine: Harvard University Office of Alcohol & Other Drug Services, “Cocaine,” 2020, https://aods.harvard.edu/cocaine.

The analgesic effects of various drugs: Various authors, Trends in Schizophrenia Research, ed. Mary V. Lang (Hauppauge, New York: Nova, 2005).

A history of cocaine’s use in medicines, beverages, and recreationally: Christopher P Holstege, “Cocaine-Related Psychiatric Disorders,” last modified April 14, 2016, http://emedicine.medscape.com/article/290195-overview.

Cocaine’s withdrawal symptoms: MedlinePlus, “Cocaine withdrawal,” accessed March 9, 2020, https://medlineplus.gov/ency/article/000947.htm.

Study linking lifetime stimulant use with lifetime anhedonia and depression: Adam M. Leventhal, Molly Brightman, Katherine J. Ameringer, Jodie Greenberg, Lavonda Mickens, Lara A. Ray, Ping Sun, and Steve Sussman, “Anhedonia Associated With Stimulant Use and Dependence in a Population-Based Sample of American Adults,” Experimental and Clinical Psychopharmacology 18(6) (2010): 562-569, https://doi.org/10.1037/a0021964.

The short- and long-term effects of cocaine: The Cleveland Clinic Foundation, “Drugs & Supplements—Cocaine (Crack),” 2012, http://my.clevelandclinic.org/health/drugs_devices_supplements/hic_Cocaine_and_Crack.

Opiates’ ability to relieve anxiety and depression: R. E. Meyer, The Heroin Stimulus: Implications for a Theory of Addiction (Berlin: Springer Science & Business Media, December 6, 2012).

Dave Gahan describes his experience with heroin: Dave Gahan, “Through That Darkness You’ll Find the Light: A.J. Samuels interviews Depeche Mode’s Dave Gahan,” interview by A.J. Samuels, 2013, http://www.electronicbeats.net/through-that-darkness-youll-find-the-light-a-j-samuels-interviews-depeche-modes-dave-gahan/.

Heroin was initially considered a medical wonder drug: Hosztafi S, “The history of heroin,” Acta pharmaceutica Hungarica 71(2) (August 2001): 233-42, https://www.ncbi.nlm.nih.gov/pubmed/11862675.

Heroin’s early promotion as a non-addictive treatment for various illnesses: Narconon International, “Heroin History: 1900s,” accessed July 23, 2017, https://www.narconon.org/drug-information/heroin-history-1900s.html.

The early use and abuse of various additive substances: Narconon International, “Prescription Drug Abuse History,” accessed September 10, 2017, http://www.narconon.ca/drug-abuse/prescription-drug-history.html.

A drug treatment center director’s experience treating heroin addicts: Blake Herzog, “Inside Heroin: Initial euphoria quickly turns into pain,” November 23, 2014, http://www.yumasun.com/news/inside-heroin-initial-euphoria-quickly-turns-into-pain/article_be5fbe60-7391-11e4-b889-e732a6b78132.html.

Heroin users discuss the pains of withdrawal: Various contributors, comment on “Do you feel physical pain when taking Heroin?” Drugs-Forum, February 18, 2014, https://drugs-forum.com/forum/showthread.php?t=237606.

The short- and long-term effects of heroin: The US National Institute on Drug Abuse, “What are the immediate (short-term) effects of heroin use?” last modified November 2014, http://www.drugabuse.gov/publications/research-reports/heroin/what-are-immediate-short-term-effects-heroin-use.

Study linking pornography consumption with depression and poorer health: Weaver JB III, Weaver SS, Mays D, Hopkins GL, Kannenberg W, and McBride D, “Mental- and physical-health indicators and sexually explicit media use behavior by adults,” The Journal of Sexual Medicine. 2011 Mar;8(3):764-72., March 2011, http://www.ncbi.nlm.nih.gov/pubmed/20946159.

Pornography effects and addictiveness: Kirsten Weir, “Is pornography addictive?” April 2014 Monitor on Psychology, April 2014, https://www.apa.org/monitor/2014/04/pornography.

Studies linking pornography use with sexual difficulties in males: Park BY, Wilson G, Berger J, Christman M, Reina B, Bishop F, Klam WP, and Doan AP, “Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports,” Behavioral sciences (Basel, Switzerland). 2016 Aug 5;6(3) (August 2016), https://doi.org/10.3390/bs6030017.

Study on pornography’s negative impacts on satisfaction with sexual partners: Dolf Zillmann, and Jennings Bryant, “Pornography's Impact on Sexual Satisfaction,” Journal of Applied Social Psychology 18 (June 2015): 438-453, https://doi.org/10.1111/j.1559-1816.1988.tb00027.x.

Screen time’s impact on happiness, self-esteem, anxiety, and depression: Public Health England, “Sedentary lifestyles and too much screen time affect children’s wellbeing,” last modified August 30, 2013, https://www.gov.uk/government/news/sedentary-lifestyles-and-too-much-screen-time-affect-childrens-wellbeing.

Study linking TV and video game use with increased attention problems: Edward L. Swing, Douglas A. Gentile, Craig A. Anderson, David A. Walsh, “Television and Video Game Exposure and the Development of Attention Problems,” Pediatrics Vol. 126 No. 2 (August 1, 2010), https://doi.org/10.1542/peds.2009-1508.

The link between depression and exposure to TV and other media in adolescence: Brian A. Primack, Brandi Swanier, Anna M. Georgiopoulos, Stephanie R. Land, Michael J. Fine, “Association Between Media Use in Adolescence and Depression in Young Adulthood – A Longitudinal Study,” Archives of general psychiatry 66(2) (2009): 181-188, https://doi.org/10.1001/archgenpsychiatry.2008.532.

Study linking TV watching with anxiety and depression: Leonore de Wit, Annemieke van Straten, Femke Lamers, Pim Cuijpers, Brenda Penninx, “Are sedentary television watching and computer use behaviors associated with anxiety and depressive disorders?” Psychiatry Research Volume 186, Issues 2–3 (April 30, 2011), http://www.sciencedirect.com/science/article/pii/S016517811000377X.

Study indicates that video games can improve quick thinking: The University of Rochester, “Video Games Lead to Faster Decisions that are No Less Accurate,” September 13, 2010, https://rochester.edu/news/show.php?id=3679.

Professor Philip Zimbardo discusses how porn and video games negatively impact men: Philip Zimbardo and various contributors, comment on “I am psychology Professor Philip Zimbardo here with Nikita Coulombe AUA!” Reddit, May 8, 2015, https://www.reddit.com/r/IAmA/comments/35b1ye/i_am_psychology_professor_philip_zimbardo_here/.

Wives complaining of their spouses’ preference for video games over helping with the house and kids: Various contributors, “Does Anyone Else's Husband/bf Play Video Games?” last modified March 12, 2013, http://www.mamapedia.com/article/does-anyone-else-tick-s-husband-bf-play-video-games.

Psychologist Phillip Zimbardo on how Internet, video game, and pornography use can cause arousal addictions: Phillip Zimbardo, “The Demise of Guys,” TED, 2011, https://www.youtube.com/watch?t=199&v=FMJgZ4s2E3w.

The various negative effects of excessive video game playing: Mark D Griffiths, “Playing video games seems to have few serious acute adverse effects on health,” BMJ 324(7346) (May 11, 2002): 1159, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123113/.

Dr. Gentile on how some gamers can be classified as addicted, and the negative health impacts: Douglas A. Gentile, “Computer and Video Game Addiction,” accessed June 19, 2015, http://drdouglas.org/issue01.html.

Study on the link between video games and attention problems and impulsiveness: Douglas A. Gentile, Edward L. Swing, Choon Guan Lim, and Angeline Khoo, “Video game playing, attention problems, and impulsiveness: Evidence of bi-directional causality,” Psychology of Popular Media Culture, 1, 62-70, 2012, https://www.apa.org/pubs/journals/releases/ppm-1-1-62.pdf.

Video games’ effects on young men: Fiona Roberts, “America's Lost Boys: Why ARE so many young men failing to grow up?” July 5, 2011, http://www.dailymail.co.uk/news/article-2011261/Americas-Lost-Boys-Why-ARE-young-men-failing-grow-up.html.

Study linking teen video gaming with attention problems: Philip A Chan and Terry Rabinowitz, “A cross-sectional analysis of video games and attention deficit hyperactivity disorder symptoms in adolescents,” Annals of General Psychiatry. 2006, 5:16 (October 24, 2006), https://doi.org/10.1186/1744-859X-5-16.

The negative effects of video games on depression and health: Tiffany O'Callaghan, “Playing too many video games may be bad for you too, grown ups,” Time magazine, August 18, 2009, https://healthland.time.com/2009/08/18/playing-too-many-video-games-is-bad-for-you-too-grown-ups/.

Dr. Gentile on the positive and negative effects of video games: Douglas A. Gentile, “The Five Dimensions of Video Game Effects,” accessed June 19, 2015, http://drdouglas.org/issues2.html.

How video games negatively impact boys’ motivation and connectedness to the real world: Leonard Sax, Boys Adrift (New York: Basic Books, 2009).

Psychologist Archibald Hart on how our pursuit of ever more pleasure has led to widespread anhedonia: Archibald D. Hart, Thrilled to Death (Nashville: Thomas Nelson, 2007).

Pain specialist Erv Hinds on the nature of pain and the effectiveness of pain treatments: Erv Hinds, A Life Larger Than Pain (New Mexico: Health Press, April 1, 2003), 111-112;2.

Therapist John N. Briere on the pain paradox: John N. Briere, Catherine Scott, Principles of Trauma Therapy: A Guide to Symptoms, Evaluation, and Treatment (Thousand Oaks, California: SAGE Publications, March 25, 2014).

Pain specialist Douglas Nelson on chronic pain: Douglas Nelson, The Mystery of Pain (London: Singing Dragon, 2013), 124-125;57-58.

Boston College’s study on those with extreme wealth: Graeme Wood, “Secret Fears of the Super-Rich,” The Atlantic, April 2011, http://www.theatlantic.com/magazine/archive/2011/04/secret-fears-of-the-super-rich/308419/.

Inducing negative effects should lead to positive effects

Social psychologist Brock Bastian discussed the relationship between pain and pleasure: Brock Bastian, “Why Feeling Pain is Key to Our Happiness,” interview by Eric van Bemmel, August 10, 2017, https://pursuit.unimelb.edu.au/podcasts/why-feeling-pain-is-key-to-our-happiness.

The benefits of physical exercise on depression and anxiety: The Anxiety and Depression Association of America, “Exercise for Stress and Anxiety,” accessed July 27, 2015, http://www.adaa.org/living-with-anxiety/managing-anxiety/exercise-stress-and-anxiety.

Study on the dose-response effect of exercise on depression: M Hamer, E Stamatakis, A Steptoe, “Dose-response relationship between physical activity and mental health: the Scottish Health Survey,” The British Journal of Sports Medicine (April 10, 2008), https://www.csus.edu/faculty/m/fred.molitor/docs/physical%20activity%20and%20mental%20%20health.pdf.

Depression symptoms and its relation to chronic pain: The US National Institute of Mental Health, “Depression and Chronic Pain,” accessed December 31, 2014, http://www.nimh.nih.gov/health/publications/depression-and-chronic-pain/index.shtml.

Study showing exercise causing analgesic effects: Einat Kodesh, Irit Weissman-Fogel, “Exercise-induced hypoalgesia – interval versus continuous mode,” Applied Physiology, Nutrition, and Metabolism; volume:39(7); pages: 829-834 (February 12, 2014), https://doi.org/10.1139/apnm-2013-0481.

Physical activity’s positive impact on chronic pain: Ambrose KR, Golightly YM, “Physical exercise as non-pharmacological treatment of chronic pain: Why and when,” Best Practice & Research: Clinical Rheumatology 29(1) (February 2015): 120-30, https://doi.org/10.1016/j.berh.2015.04.022.

Study on physical exercise’s positive impact on neck and back pain: Tom Ivar Lund Nilsen, Andreas Holtermann and Paul J. Mork, “Physical Exercise, Body Mass Index, and Risk of Chronic Pain in the Low Back and Neck/Shoulders: Longitudinal Data From the Nord-Trøndelag Health Study,” American Journal of Epidemiology Volume 174, Issue 3 (August 1, 2011), https://doi.org/10.1093/aje/kwr087.

Study assessing physical exercise’s positive impact on pain in the elderly: Tse MM, Wan VT, Ho SS, “Physical exercise: does it help in relieving pain and increasing mobility among older adults with chronic pain?” Journal of Clinical Nursing 20(5-6) (March 2011): 635-44, https://doi.org/10.1111/j.1365-2702.2010.03548.x.

Exercise’s impact on cognitive performance: Fernando Gomez-Pinilla and Charles Hillman, “The Influence of Exercise on Cognitive Abilities,” Comprehensive Physiology 3 (2013): 403-428, http://kch.illinois.edu/research/labs/neurocognitive-kinesiology/files/Articles/GomezPinilla_2013_TheInfluenceOfExercise.pdf.

The health benefits of exercise: “Exercise: 7 benefits of regular physical activity,” October 13, 2016, http://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/exercise/art-20048389.

Health benefits of exercise according to Harvard Health: Heidi Godman, “Regular exercise changes the brain to improve memory, thinking skills,” Harvard Health Letter, April 9, 2014, http://www.health.harvard.edu/blog/regular-exercise-changes-brain-improve-memory-thinking-skills-201404097110.

Alzheimer’s risk factors: Alzheimer’s Society (UK), “High blood sugar may contribute towards Alzheimer's disease, new study finds,” May 5, 2015, http://www.alzheimers.org.uk/site/scripts/news_article.php?newsID=2378.

Research on lottery wins versus work’s impact on life satisfaction: BBC News, “Why hard work makes people happy,” last modified January 3, 2006, http://news.bbc.co.uk/2/hi/health/4577392.stm.

Research on how the pursuit of goals boosts happiness: Sonja Lyubomirsky, “Hedonic adaptation to positive and negative experiences” in Oxford handbook of stress, health, and coping, ed. S. Folkman (New York: Oxford University Press, 2011).

Parents who sacrifice more for their children get more happiness from parenting: Claire E. Ashton-James, Kostadin Kushlev, and Elizabeth W. Dunn, “Parents Reap What They Sow: Child-Centrism and Parental Well-Being,” Social Psychological and Personality Science 4(6) (2013): 635-642, https://doi.org/10.1177/1948550613479804.

Eugene O'Neill quotes on work and happiness: Eugene O'Neill, Travis Bogard, Jackson R. Bryer, Selected Letters of Eugene O'Neill (New Haven: Yale University Press, 1988), 490.

Researcher Emma Seppälä on the many benefits of meditation: Emma Seppälä, “Benefits of Meditation: 10 Science-Based Reasons To Start Meditating Today,” emmaseppala.com, October 17, 2013, https://emmaseppala.com/10-science-based-reasons-start-meditating-today-infographic/.

Chronic pain and the difficulty in measuring and describing pain: The American College of Physicians and the American Academy of Pain Medicine, “Managing Chronic Pain: a Guide for Patients,” 2007, https://web.archive.org/web/20150606015344/https://www.acponline.org/patients_families/pdfs/misc/pain.pdf.

Wim ‘The Iceman’ Hof on how exposure to cold can treat depression, anxiety, and chronic pain: Evan Carmichael, “How to Never Get Sick Again - The WIM HOF ‘Iceman’ Method - #NeverSick,” February 4, 2017, https://www.youtube.com/watch?v=mxCGDFlH1_k.

Wim ‘The Iceman’ Hof describes how cold creates an internal positive counter-reaction: Wim Hof, “Wim Hof (the Iceman) on Defeating Extreme Cold & Attenuating the Immune Response,” interview by Dr. Rhonda Patrick, October 22, 2015, https://www.youtube.com/watch?v=389c31dD9xg.

Various studies on the interrelationship between pain and pleasure: Siri Leknes and Brock Bastian, “The Benefits of Pain,” The Review of Philosophy and Psychology 5 (2014), https://doi.org/10.1007/s13164-014-0178-3.

Preliminary evidence that cold showers reduce pain and depression: Nikolai A. Shevchuk, “Adapted cold shower as a potential treatment for depression,” Elsevier—Medical Hypotheses Volume 70, Issue 5, 2008, 2008, http://www.sciencedirect.com/science/article/pii/S030698770700566X.

Study showing that painful thermal and mechanical stimulation inhibits itching: G. Yosipovitch, M.I. Duque, K. Fast, A.G. Dawn, and R.C. Coghill, “Scratching and noxious heat stimuli inhibit itch in humans: a psychophysical study,” British Journal of Dermatology 156 (January 2007): 629-634, https://doi.org/10.1111/j.1365-2133.2006.07711.x.

The effects of a bullet ant sting: Cody Sullivan, “This ant's sting is so bad it feels like getting shot—and it put Aussie comedian Hamish Blake in hospital,” Business Insider, July 17, 2015, http://www.businessinsider.com.au/milking-a-bullet-ant-2015-6.

Dr. Terry Wahls on how reducing sugar can significantly reduce chronic pain: Terry Wahls, “The Real Reason You Have Chronic Pain + How To Heal It,” January 8, 2015, http://www.mindbodygreen.com/0-16923/the-real-reason-you-have-chronic-pain-how-to-heal-it.html.

Fasting often leads to euphoria: Sharman Apt Russell, Hunger: An Unnatural History (New York: Basic Books, 2008).

The CDC describes the euphoria and danger of the choking game: The US Centers for Disease Control and Prevention, “Unintentional Strangulation Deaths from the ‘Choking Game’ Among Youths Aged 6--19 Years --- United States, 1995--2007,” accessed August 15, 2016, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5706a1.htm.

What are happiness and unhappiness?

How happiness is interpreted across dozens of countries: Shigehiro Oishi, Jesse Graham, Selin Kesebir, and Iolanda Costa Galinha, “Concepts of Happiness Across Time and Cultures,” Personality and Social Psychology Bulletin Vol. 39, No. 5 (May 2013), https://doi.org/10.1177/0146167213480042.

Psychologist Sonja Lyubomirsky on the myths of happiness: Sonja Lyubomirsky, The Myths of Happiness (London: Penguin Press, January 3, 2013).

Discussion on how happiness is subjective: Martin E. P. Seligman, Tracy A. Steen, and Christopher Peterson, “Positive Psychology Progress: Empirical Validation of Interventions,” April 22, 2005, https://greatergood.berkeley.edu/images/application_uploads/Seligman-PosPsychProgress.pdf.

Fairy-tale happiness should be impossible

Description of smiling depression: Rita Labeaune, Psy.D., “Smiling Depression,” November 2015, https://www.psychologytoday.com/blog/the-guest-room/201411/smiling-depression.

Marie Osmond admits hiding her negative feelings from everyone: Marie Osmond, Marcia Wilkie and Judith Moore, Behind the Smile: My Journey out of Postpartum Depression (New York: Grand Central Publishing, November 15, 2008).

Study showing that we overestimate how well we express our emotions: Barr, Carol L. and Kleck, Robert E., “Self-other perception of the intensity of facial expressions of emotion: Do we know what we show?” Journal of Personality and Social Psychology Vol. 68(4) (April 1995), https://doi.org/10.1037/0022-3514.68.4.608.

Psychologist Daniel Gilbert on our misperceptions about pain and happiness: Daniel Gilbert, Stumbling on happiness (New York: Knopf, 2006), 232.

Children learn to hide their feelings at an early age: James Kalat, Michelle Shiota, Emotion (Boston: Cengage Learning, January 1, 2011).

Former model Essena O’Neill on how she portrayed a perfect life on social media despite feeling miserable: Essena O’Neill, “untitled,” 2016, http://agirlnamedally.tumblr.com/post/136577427665/hello-can-anyone-please-make-this-email-from.

Dr. Lickerman on why people commit suicide: Alex Lickerman, “6 reasons why people commit suicide,” June 3, 2010, http://www.kevinmd.com/blog/2010/06/6-reasons-people-commit-suicide.html.

Basketball player Kevin Ware’s severe but painless leg injury: Alexis Shaw, “Louisville's Kevin Ware 'Didn't Feel the Pain' When His Leg Snapped,” April 3, 2013, http://abcnews.go.com/US/louisvilles-kevin-ware-didnt-feel-pain-leg-snapped/story?id=18871585.

Goldie Hawn on how fame and wealth don’t always translate to happiness: Goldie Hawn, A lotus grows in the mud (New York: G.P. Putnam's Sons, February 10, 2005).

Microsoft founder Bill Gates’ views on being a billionaire: Laurie Whitwell, “'Once you get beyond a million dollars, it's still the same hamburger': Bill Gates says being a billionaire is overrated,” The Daily Mail, October 28, 2011, http://www.dailymail.co.uk/news/article-2054763/Once-million-dollars-hamburger-Bill-Gates-says-billionaire-overrated.html.

Elvis Presley on the emptiness and loneliness of his life: Guralnick, Peter, Careless Love: The Unmaking of Elvis Presley (New York: Back Bay Books, 1999), 174.

Pro skateboarder Tas Pappas on how fame and success didn’t solve his inner turmoil: William McLennan, “Tas Pappas: Skateboarding fame, money... jail and tragedy,” August 3, 2014, http://www.independent.co.uk/news/people/tas-pappas-skateboarding-fame-money-jail-and-tragedy-9644676.html.

Research on what makes people happy: Jenna Goudreau, “Top Seven Ways To C'Mon Get Happy,” Forbes, February 2012, http://www.forbes.com/sites/jennagoudreau/2012/02/10/top-seven-ways-to-cmon-get-happy/.

Jim Carrey on his childhood and his depression: Jim Carrey, “Carrey: 'Life Is Too Beautiful',” interview by Steve Kroft, CBS - 60 Minutes, November 18, 2004, http://www.cbsnews.com/news/carrey-life-is-too-beautiful/.

Actor Jim Carrey’s views on wealth and fame: Jim Carrey, Reader's Digest, Quotable Quotes (New York: Simon & Schuster, March 2006).

Dick Clark talks about his experience with depression: Kathy Cronkite, On the edge of darkness: Conversations About Conquering Depression (Delta, 1994).

Buzz Aldrin on his experiences with alcoholism and depression: Buzz Aldrin, “Buzz Aldrin: Down to Earth,” interview by Robert Epstein Ph.D., May 1, 2001, https://www.psychologytoday.com/us/articles/200105/buzz-aldrin-down-earth.

Quarterback Terry Bradshaw on his experiences with depression and panic attacks: Don Pierson, “Depression-awareness campaign aids Bradshaw too,” Chicago Tribune, October 3, 2003, http://articles.chicagotribune.com/2003-10-03/sports/0310030214_1_depression-awareness-steelers-quarterback-terry-bradshaw-locker-rooms.

Actor Richard Dreyfuss’ struggle with bipolar disorder: Paul Chi, “Richard Dreyfuss Opens Up About His Battle with Bipolar Disorder,” November 2013, http://www.people.com/people/article/0,,20754443,00.html.

Richard Gere on how he has the same issues and suffering as everyone else: Richard Gere, “Richard Gere: My Journey as a Buddhist,” interview by Melvin McLeod, June 9, 2016, http://www.lionsroar.com/richard-gere-my-journey-as-a-buddhist/.

Psychologist Archibald Hart on how our pursuit of ever more pleasure has led to widespread anhedonia: Archibald D. Hart, Thrilled to Death (Nashville: Thomas Nelson, 2007), 12;13.

Joshua Fields Millburn & Ryan Nicodemus’s minimalist views: “About Joshua & Ryan,” accessed May 7, 2015, http://www.theminimalists.com/about/.

Ed Diener’s thoughts on money and life satisfaction: Gregg Easterbrook, “Money: The Real Truth About Money,” Time Magazine, January 9, 2005, http://content.time.com/time/magazine/article/0,9171,1015883-3,00.html.

Lottery winner Callie Rogers describes her experience winning the lottery at age 16: Eleanor Harding, “Britain's youngest lottery winner Callie Rogers: My £2m lotto win at 16 was a curse, now I am broke, I'm happy,” The Daily Mail, July 15, 2013, http://www.dailymail.co.uk/news/article-2364735/Britains-youngest-lottery-winner-Callie-Rogers-My-2m-lotto-win-16-curse-I-broke-Im-happy.html.

The story of lottery winner William Post: Kristen Duvall, “The 10 Worst Lottery Winner Horror Stories In History,” February 23, 2015, https://www.therichest.com/poorest-list/the-10-worst-lottery-winner-horror-stories-in-history/.

The unfortunate demise of some lottery winners: Deborah L. Jacobs, “Winning The Lottery Isn't Always A Happy Ending,” December 18, 2013, http://www.forbes.com/sites/deborahljacobs/2012/11/28/winning-the-lottery-isnt-always-a-happy-ending/.

The happiness of lottery winners versus paraplegics: Philip Brickman and Dan Coates, “Lottery Winners and Accident Victims: Is Happiness Relative?” Journal of Personality and Social Psychology 1978, Vol.36, No.8, 917-927, 1978, https://psycnet.apa.org/record/1980-01001-001.

How much money wealthy individuals would need to for life to be a “perfect 10”: Grant E. Donnelly, Tianyi Zheng, Emily Haisley, and Michael I. Norton, “Towards Happiness, Towards Wealth: Conflicting Desires Among the Wealthy,” 2015, https://www.psychologicalscience.org/convention/program_2014/search/viewProgram.cfm?Abstract_ID=29548&AbType=1&AbAuthor=&Subject_ID=&Day_ID=all&keyword=.

Boston College’s study on those with extreme wealth: Graeme Wood, “Secret Fears of the Super-Rich,” The Atlantic, April 2011, http://www.theatlantic.com/magazine/archive/2011/04/secret-fears-of-the-super-rich/308419/.

Robert Kenny on the Boston College study of multi-millionaires: Amy Novotney, “Money can't buy happiness,” July/August 2012 Monitor on Psychology, July 2012, https://www.apa.org/monitor/2012/07-08/money.

Bill Gates on Warren Buffett’s idea of success: Bill Gates, comment on “I’m Bill Gates, co-chair of the Bill & Melinda Gates Foundation. Ask Me Anything,” Reddit, February 28, 2017, https://www.reddit.com/r/IAmA/comments/5whpqs/im_bill_gates_cochair_of_the_bill_melinda_gates/.

The declining pleasures of consumption and the joys of minimalism: Stephanie Rosenbloom, “But Will It Make You Happy?” New York Times, August 7, 2010, http://www.nytimes.com/2010/08/08/business/08consume.html?pagewanted=1&ref=business&src=me.

Winston Churchill’s black dog of depression: John Gray, “A Point of View: Churchill, chance and the 'black dog',” BBC News, September 23, 2011, http://www.bbc.com/news/magazine-15033046.

Abraham Lincoln’s melancholy: Robert Siegel, “Exploring Abraham Lincoln's 'Melancholy',” October 26, 2005, http://www.npr.org/templates/story/story.php?storyId=4976127.

Former US president JFK was on many drugs: ABC News, “JFK Took Many Drugs for Secret Health Problems,” November 18, 2002, http://abcnews.go.com/GMA/story?id=125593&page=1.

Princess Diana Spencer’s life and struggles: Sally Bedell Smith, Diana in Search of Herself (New York: Crown, 1999).

The impact of fame, wealth, and lust on happiness: Arthur C. Brooks, “Love People, Not Pleasure,” July 18, 2014, http://www.nytimes.com/2014/07/20/opinion/sunday/arthur-c-brooks-love-people-not-pleasure.html?_r=0.

Abd al-Rahman’s difficulty achieving happiness despite enormous wealth and power: Samuel Austin Allibone, Prose Quotations from Socrates to Macaulay (Whitefish, Montana: Kessinger Publishing, [1880] September 10, 2010).

Paper on how the initial romantic attraction phase of a relationship lasts at most three years: Donatella Marazziti and Stefano Baroni, “Romantic love: the mistery of its biological roots,” Clinical Neuropsychiatry 9(1) (2012): 14-19, http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.684.381&rep=rep1&type=pdf.

Marriage boosts happiness for an average of two years: Sonja Lyubomirsky, “New Love: A Short Shelf Life,” December 1, 2012, http://www.nytimes.com/2012/12/02/opinion/sunday/new-love-a-short-shelf-life.html?src=me&ref=general&_r=0.

Psychologist Sonja Lyubomirsky on the myths of happiness: Sonja Lyubomirsky, The Myths of Happiness (London: Penguin Press, January 3, 2013).

Sex addicts’ emotional rollercoaster: Sex Addicts Anonymous Ottawa, “About SAA Ottawa,” accessed August 10, 2016, https://www.saaottawa.org/en/about.

The parallels between sex addiction and drug addiction: Robert Weiss, “Information for Sex Addicts,” 2016, http://www.robertweissmsw.com/about-sex-addiction/information-for-sex-addicts/.

Ex-porn star Jessie Rogers on the unhappiness in the porn industry: Jessica Mendes, “Ex Porn Star Jessie Rogers Exposes Shocking Abuses of Porn Industry & Tells Her Story,” June 9, 2014, https://www.youtube.com/watch?v=ymWVWHOgDFM.

Nurse Kim Ramsey’s experience with Persistent Genital Arousal Disorder (PGAD): Lizzie Crocker, “The Endless Orgasm,” September 2012, https://www.newsweek.com/endless-orgasm-64733.

Gretchen Molannen's struggles with persistent genital arousal disorder: Ryan Jaslow, “Gretchen Molannen's suicide spotlights debilitating effects of persistent genital arousal disorder,” CBS News, December 6, 2012, http://www.cbsnews.com/news/gretchen-molannens-suicide-spotlights-debilitating-effects-of-persistent-genital-arousal-disorder/.

Gretchen Molannen’s struggles with persistent genital arousal disorder: Leonora LaPeter Anton, “Woman featured in Times story about sexual disorder commits suicide,” Tampa Bay Times, December 4, 2012, http://www.tampabay.com/news/health/medicine/woman-featured-in-times-story-about-sexual-disorder-commits-suicide/1264559.

Statistics on breast implants and rates of death: Maggie Fox, “Breast implants linked with suicide in study,” Reuters, August 8, 2007, http://www.reuters.com/article/2007/08/09/us-implants-suicide-idUSN0836919020070809.

Lolo Ferrari’s record-breaking bust and her unhappy life: The Guardian, “Larger than life,” The Guardian, March 16, 2000, http://www.theguardian.com/theguardian/2000/mar/16/features11.g2.

Margaux Hemingway on her insecurities and alcohol use: IMDb, “Margaux Hemingway—biography,” accessed June 20, 2015, http://www.imdb.com/name/nm0000029/bio.

Marilyn Monroe on her happiness and misery: “Marilyn Monroe and the camera,” 1960, https://archive.org/stream/Marilyn_Monroe_and_the_Camera/Marilyn_Monroe_and_the_Camera_djvu.txt.

Psychologist Vivian Diller on how modeling is not very satisfying: Vivian Diller, “Yes Sasha, Models Aren't Smiling for a Reason,” last modified May 2011, http://www.huffingtonpost.com/vivian-diller-phd/yes-sasha-models-arent-sm_b_823633.html.

Leading researchers on what does or doesn’t make people happy: Craig Lambert, “The Science of Happiness,” January 2007, http://harvardmagazine.com/2007/01/the-science-of-happiness.html.

How children of all socioeconomic backgrounds have both pleasant and painful experiences: Jennifer Kunst, “Is Ignorance Bliss?” August 24, 2011, https://www.psychologytoday.com/blog/headshrinkers-guide-the-galaxy/201108/is-ignorance-bliss.

Nobel Prize winner Marie Curie’s depression: Susan Quinn, Marie Curie: A Life (Boston: Addison-Wesley, 1995).

Ernest Hemingway’s alcoholism, anger, anxiety, paranoia, and suicide: Robert Fulford, “An unmovable beast: How depression and anger plagued Ernest Hemingway until the moment 'it was time for him to die',” August 2, 2016, https://nationalpost.com/entertainment/books/ernest-hemingway-depression-anger-plagued-him-until-it-was-time-for-him-to-die.

British personality Stephen Fry discusses his experience with bipolar disease: Stephen Fry, “Can you discuss your experience with bipolar disease?” interview by Big Think, Big Think, July 27, 2011, https://www.youtube.com/watch?v=B2Ta0yFoNG8.

Lewis Terman’s long-term study shows high IQ doesn’t guarantee happiness: David Robson, “The downsides of being clever,” BBC Future, April 14, 2015, http://www.bbc.com/future/story/20150413-the-downsides-of-being-clever.

The role of manic depression in the lives of various luminaries: D. Jablow Hershman and Julian Lieb, The Key to Genius: Manic-Depression and the Creative Life (Buffalo: Prometheus Books, December 31, 1990).

Vincent van Gogh’s mental illness and suicide: Dietrich Blumer, “The Illness of Vincent van Gogh,” The American journal of psychiatry 159 (2002): 519–526, https://doi.org/10.1176/appi.ajp.159.4.519.

Bruce Springsteen on his battle with depression over the years: Bruce Springsteen, “The Book of Bruce Springsteen,” interview by David Kamp, Vanity Fair magazine, October 2016, https://www.vanityfair.com/culture/2016/09/bruce-springsteen-cover-story.

Teen Zach Richardson spends 15 hours a day playing video games: unknown, “Boy's daily 15-hour Xbox habit,” The Scottish Sun, August 25, 2010, http://www.thescottishsun.co.uk/scotsol/homepage/news/3111299/Boys-daily-15-hour-Xbox-habit.html.

Millionaire Joe Carder on the lack of fulfilment in retirement: Jacquelyn Smith, “A millionaire who retired at age 27 explains why he went back to work after only 3 weeks,” Business Insider, May 2, 2015, http://www.businessinsider.com/millionaire-who-retired-at-27-explains-why-he-went-back-to-work-2015-4.

The struggles of those who are retired: British Psychological Society, “The joy of retirement may quickly fade,” November 2013, https://web.archive.org/web/20150419103918/http://www.bps.org.uk/news/joy-retirement-may-fade-fast.

Research on lottery wins versus work’s impact on life satisfaction: BBC News, “Why hard work makes people happy,” last modified January 3, 2006, http://news.bbc.co.uk/2/hi/health/4577392.stm.

Pain specialist Erv Hinds on the nature of pain and the effectiveness of pain treatments: Erv Hinds, A Life Larger Than Pain (New Mexico: Health Press, April 1, 2003).

Deepak Chopra on the fantasy of the perfect life: Deepak Chopra, “Deepak Chopra: How to Get Out of Sad Gear,” accessed August 15, 2016, http://www.oprah.com/spirit/Why-Youre-Sad-How-to-Stop-Being-Sad-Deepak-Chopra.

Sri Swami Sivananda on the perpetual balance between pleasure and pain: Sri Swami Sivananda, Bliss Divine (Shivanandanagar, India: Divine Life Society, 1964).

Buddhist Thich Nhat Hanh on how suffering and happiness are interdependent: Thich Nhat Hanh, No Mud, No Lotus (Berkeley: Parallax Press, December 2, 2014), 10.

Sustained misery should be impossible

The torturous experience of solitary confinement: Robert Ornstein, David Sobel, Healthy Pleasures (Boston: Da Capo Press, 1989).

How much inmates spend time reminiscing and fantasizing: Jermaine Archer, “YES, It Happens. Guards Beat Me Up Out Of Sight Of Cameras,” accessed June 18, 2015, http://www.prisonwriters.com/guards-beat-lifer-takes-life-hands/.

Psychiatrist Viktor Frankl’s experiences in a WWII concentration camp: Victor Frankl, Man's search for meaning (Boston: Beacon Press, [1946] 1992).

Dr. Shalev on isolated inmates’ tendency to fantasize or hallucinate: Sharon Shalev, Sourcebook on solitary confinement (English) (London: Greater London Group, October 2008).

Life satisfaction of those with muscular dystrophy: Bach, John R., Campagnolo, Denise I., Hoeman, Shirley, “Life satisfaction of individuals with duchenne muscular dystrophy using long-term mechanical ventilatory support,” American Journal of Physical Medicine & Rehabilitation (June 1991), http://journals.lww.com/ajpmr/Abstract/1991/06000/Life_Satisfaction_of_Individuals_With_Duchenne.4.aspx.

Happiness adaptation in the poor, the injured, and the bereaved: Robert Biswas-Diener, Ed Diener, “Making the Best of a Bad Situation: Satisfaction in the Slums of Calcutta,” Social Indicators Research (April 2009), https://www.researchgate.net/profile/Robert_Biswas-Diener/publication/226714962_Making_the_Best_of_a_Bad_Situation_Satisfaction_in_the_Slums_of_Calcutta/links/0deec52eeaf0bcdad6000000.pdf.

Leading researchers on what does or doesn’t make people happy: Craig Lambert, “The Science of Happiness,” January 2007, http://harvardmagazine.com/2007/01/the-science-of-happiness.html.

Helen Keller’s thoughts on blindness and happiness: Helen Keller, “Helen Keller Quotations,” various, accessed June 23, 2015, http://www.afb.org/info/about-us/helen-keller/quotes/125.

Psychologist Sonja Lyubomirsky on how she adapted to the elation of being cured of near-blindness: Zak Stambor, “A key to happiness,” Monitor on Psychology Vol. 37, No. 9 (October 2006), https://www.apa.org/monitor/oct06/key.

Ipsos survey on happiness across different countries: “Tracking Global Happiness,” February 2012, https://www.ipsos.com/sites/default/files/news_and_polls/2012-02/5515-ppt.pdf.

Happiness polls around the world: Worldwide Independent Network / Gallup International, “Global Results—WIN/Gallup International’s annual global End of Year survey shows that happiness is on the rise,” December 2014, https://www.gallup-international.bg/en/33145/win-gallup-internationals-annual-global-end-of-year-survey-shows-that-happiness-is-on-the-rise/.

Journalist James Foley on reminiscing in captivity: Josh Visser, “Family releases heartbreaking letter that slain journalist James Foley wrote and had fellow captive memorize,” August 25, 2014, https://torontosun.com/2014/03/10/titanfall-review/wcm/e8312b99-969f-419c-b1c5-3ee0ac305876.

Dr. Paul Brand on living and working in poor and rich countries: Paul W. Brand and Philip Yancey, The Gift of Pain: Why We Hurt & What We Can Do about it (Grand Rapids, Michigan: Zondervan, 1993).

Pain specialist Erv Hinds on the nature of pain and the effectiveness of pain treatments: Erv Hinds, A Life Larger Than Pain (New Mexico: Health Press, April 1, 2003), 141.

Study on the impact of hemodialysis on patients’ happiness: Riis J, Loewenstein G, Baron J, Jepson C, Fagerlin A, Ubel PA, “Ignorance of hedonic adaptation to hemodialysis: a study using ecological momentary assessment,” Journal of Experimental Psychology: General 134(1) (February 2005): 3-9, http://www.ncbi.nlm.nih.gov/pubmed/15702959.

Nurse Joan Panke on caring for the dying with Mother Teresa: Panke, Joan T., “Not a sad place,” 2002, http://journals.lww.com/ajnonline/fulltext/2002/09000/not_a_sad_place.4.aspx.

We should adapt to all “positive” or “negative” life changes

The declining pleasures of consumption and the joys of minimalism: Stephanie Rosenbloom, “But Will It Make You Happy?” New York Times, August 7, 2010, http://www.nytimes.com/2010/08/08/business/08consume.html?pagewanted=1&ref=business&src=me.

Boston College’s study on those with extreme wealth: Graeme Wood, “Secret Fears of the Super-Rich,” The Atlantic, April 2011, http://www.theatlantic.com/magazine/archive/2011/04/secret-fears-of-the-super-rich/308419/.

Study on how wealth reduces people’s ability to enjoy simple pleasures: Jordi Quoidbach, Elizabeth W. Dunn, K.V. Petrides and Moïra Mikolajczak, “Money Giveth, Money Taketh Away,” Psychological Science Volume 21, issue 6 (May 18, 2010), https://doi.org/10.1177/0956797610371963.

Study on how world travel reduces people’s ability to enjoy ordinary destinations: Jordi Quoidbach, Elizabeth W. Dunn, Michel Hansenne, and Gaelle Bustin, “The Price of Abundance,” Personality and Social Psychology Bulletin Vol. 41, No. 3 (March 2015), https://doi.org/10.1177/0146167214566189.

Psychologist Sonja Lyubomirsky on the myths of happiness: Sonja Lyubomirsky, The Myths of Happiness (London: Penguin Press, January 3, 2013).

Study showing that only events in the past few months affect current wellbeing: Eunkook Suh, Ed Diener, and Frank Fujita, “Events and subjective well-being: Only recent events matter,” Journal of Personality and Social Psychology Vol. 70(5) (May 1996), https://doi.org/10.1037/0022-3514.70.5.1091.

Hacking the brain

A female patients’ multiple surgeries and electrical implants to treat her chronic pain: Russell K. Portenoy, Jens O. Jarden, John J. Sidtis, Richard B. Lipton, Kathleen M. Foley and David A. Rottenberg, “Compulsive Thalamic Self-Stimulation: a Case with Metabolic, Electrophysiologic and Behavioral Correlates,” Pain 27 (1986): 277-290, http://www.wireheading.com/intracran/compulsive-selfstimulation.pdf.

Pain specialist Douglas Nelson on chronic pain: Douglas Nelson, The Mystery of Pain (London: Singing Dragon, 2013), 194.

Pain specialist Erv Hinds on the nature of pain and the effectiveness of pain treatments: Erv Hinds, A Life Larger Than Pain (New Mexico: Health Press, April 1, 2003), 122.

Conclusion of Part Three

How opioid overdose leads to nodding off: The US Centre for Addiction and Mental Health, “Opioid Addiction,” accessed March 28, 2020, https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/opioid-addiction.

PART FOUR: THE WORLD THROUGH SUDIST EYES

What sudism says is impossible

Ralph Waldo Emerson on the link between pleasure and pain: Ralph Waldo Emerson, Compensation, in Essays: First Series (n.p., 1841).

Rabbi Noah Weinberg’s view of how pain and pleasure are intertwined: Noah Weinberg, The 48 Ways to Wisdom (n.p., undated).

Psychiatrist Viktor Frankl’s experiences in a WWII concentration camp: Victor Frankl, Man's search for meaning (Boston: Beacon Press, [1946] 1992).

Psychologist Daniel Gilbert on our misperceptions about pain and happiness: Daniel Gilbert, Stumbling on happiness (New York: Knopf, 2006).

Psychologist G. Marian Kinget’s views on pleasure and pain: G. Marian Kinget, On Being Human and Pleasure and Pain (Lanham: UPA, 1999).

How De Beers and N.W. Ayer created the diamond engagement ring market: Uri Friedman, “How an Ad Campaign Invented the Diamond Engagement Ring,” The Atlantic, February 13, 2015, http://www.theatlantic.com/international/archive/2015/02/how-an-ad-campaign-invented-the-diamond-engagement-ring/385376/.

Psychologist Jennifer Kromberg on emotional eating: Jennifer Kromberg, “Emotional Eating? 5 Reasons You Can’t Stop,” Psychology Today, September 18, 2013, https://www.psychologytoday.com/blog/inside-out/201309/emotional-eating-5-reasons-you-can-t-stop.

Buddhist Thich Nhat Hanh on how suffering and happiness are interdependent: Thich Nhat Hanh, No Mud, No Lotus (Berkeley: Parallax Press, December 2, 2014).

Sri Nisargadatta Maharaj’s views on the relationship between pain and pleasure: Sri Nisargadatta Maharaj, I Am That: talks with Sri Nisargadatta Maharaj, trans. Maurice Frydman (Durham, North Carolina: The Acorn Press, [1973] 1992), 146-147.

Philosopher Arthur Schopenhauer on the elusiveness of satisfaction and persistence of suffering: Arthur Schopenhauer, The World as Will and Representation, Volume 1 (North Chelmsford, Massachusetts: Courier Corporation, [1818] 2012).

How solving problems causes their scope to expand: Peter Reuell, “We solved the problem! Now let’s unsolve it,” June 28, 2018, https://news.harvard.edu/gazette/story/2018/06/harvard-researchers-may-have-answer-to-why-youre-never-satisfied/.

Abraham Maslow on the hierarchy of human needs: Abraham Maslow, “A Theory of Human Motivation,” Psychological Review 50 (1943): 370-396, http://psychclassics.yorku.ca/Maslow/motivation.htm.

Thomas de Quincey on the euphoria and aches of daily opium consumption: Thomas de Quincey, Confessions of an English Opium Eater (n.p., 1821).

Pain specialist Erv Hinds on the nature of pain and the effectiveness of pain treatments: Erv Hinds, A Life Larger Than Pain (New Mexico: Health Press, April 1, 2003), 107-108.

Study on acetaminophen’s impact on perception of both positive and negative stimuli: Geoffrey R. O. Durso, Andrew Luttrell, Baldwin M. Way, “Over-the-Counter Relief From Pains and Pleasures Alike,” Psychological Science Vol. 26, No. 6 (June 2015), https://doi.org/10.1177/0956797615570366.

Anhedonia occurring during withdrawal from alcohol and many drugs of abuse: Daniele Stavros Hatzigiakoumis, Giovanni Martinotti, Massimo Di Giannantonio, and Luigi Janiri, “Anhedonia and Substance Dependence: Clinical Correlates and Treatment Options,” Frontiers in Psychiatry 2 (2011): 10, https://doi.org/10.3389/fpsyt.2011.00010.

Actor Jim Carrey’s views on wealth and fame: Jim Carrey, Reader's Digest, Quotable Quotes (New York: Simon & Schuster, March 2006).

Research on lottery wins versus work’s impact on life satisfaction: BBC News, “Why hard work makes people happy,” last modified January 3, 2006, http://news.bbc.co.uk/2/hi/health/4577392.stm.

What sudism says is possible

Dr. Paul Brand on living and working in poor and rich countries: Paul W. Brand and Philip Yancey, The Gift of Pain: Why We Hurt & What We Can Do about it (Grand Rapids, Michigan: Zondervan, 1993).

Amos Bronson Alcott’s quote on struggling and success: Sam Majdi, The Wisdom of the Great: A biographical collection of over 2600 quotations from 450 writers & notables of 50 countries in the span of 3 millenniums (9th centuries B.C. to the present time) (Bloomington, Indiana: iUniverse, March 6, 2012), 238.

Psychologist G. Marian Kinget’s views on pleasure and pain: G. Marian Kinget, On Being Human and Pleasure and Pain (Lanham: UPA, 1999).

Nietzsche’s view on how happiness and unhappiness are interdependent: Friedrich Wilhelm Nietzsche, The Gay Science, trans. Walter Kaufman (New York: Knopf Doubleday, August 18, 2010), 85-86.

The Buddhist concept of nirvana: Bhikkhu Bodhi, The Noble Eightfold Path (Kandy, Sri Lanka: The Buddhist Publication Society, 1994).

The history of alcohol consumption: David J. Hanson, “Historical evolution of alcohol consumption in society,” 2013, http://www.oxfordscholarship.com/view/10.1093/acprof:oso/9780199655786.001.0001/acprof-9780199655786-chapter-01.

Review finds benefits of moderate drinking overstated: CBC News, “Drinking alcohol offers no net health benefits, review finds,” CBC News, March 22, 2016, http://www.cbc.ca/news/health/alcohol-health-1.3501314.

The history of smoking and lung cancer: The Cancer Council New South Wales, “A brief history of smoking,” 2015, https://www.cancercouncil.com.au/31899/uncategorized/a-brief-history-of-smoking/.

The many lawsuits against tobacco companies worldwide: Simon Zekaria, “Tobacco Firms Ordered to Pay $12.5 Billion in Canada,” June 2, 2015, http://www.wsj.com/articles/tobacco-firms-ordered-to-pay-12-5-billion-in-canada-1433242864.

Opium in England in the 1800s: Dan Chiasson, “The Man Who Invented the Drug Memoir,” October 10, 2016, https://www.newyorker.com/magazine/2016/10/17/the-man-who-invented-the-drug-memoir.

Purdue found guilty of misleading the public about OxyContin: Harriet Ryan, Lisa Girion, and Scott Glover, “‘You want a description of hell?’ OxyContin’s 12-hour problem,” Los Angeles Times, May 5, 2016, http://www.latimes.com/projects/oxycontin-part1/.

Trans fat usage and health outcomes: The Mayo Clinic, “Trans fat is double trouble for your heart health,” Mayo Clinic website, August 6, 2014, http://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/trans-fat/art-20046114.

Trans fats’ use in the food supply: The American Heart Association, “Trans Fats,” last modified August 5, 2014, http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/Trans-Fats_UCM_301120_Article.jsp.

Study linking trans fat intake with depression: Sánchez-Villegas A, Verberne L, De Irala J, Ruíz-Canela M, Toledo E, Serra-Majem L, and Martínez-González MA., “Dietary fat intake and the risk of depression: the SUN Project,” PLoS One 6(1) (January 26, 2011): e16268, https://doi.org/10.1371/journal.pone.0016268.

Stevia’s approval despite limited data on safety: Health Canada, “Sugar Substitutes,” accessed July 8, 2015, http://www.hc-sc.gc.ca/fn-an/securit/addit/sweeten-edulcor/index-eng.php.

Safety status of Stevia sweetener in the US: The US Food and Drug Administration, “Has Stevia been approved by FDA to be used as a sweetener?” last modified March 2018, https://www.fda.gov/about-fda/fda-basics/has-stevia-been-approved-fda-be-used-sweetener.

Sudist perspectives

Benjamin Franklin’s dissertation on the balance of pleasure and pain: H. W. Brands, The First American: The Life and Times of Benjamin Franklin (New York: Anchor Books, 2002), 72.

The origin of the metaphor that happiness is like a butterfly: Garson O’Toole, “Happiness Is A Butterfly, Which When Pursued, Seems Always Just Beyond Your Grasp,” April 17, 2014, http://quoteinvestigator.com/2014/04/17/butterfly/.

Psychologist G. Marian Kinget’s views on pleasure and pain: G. Marian Kinget, On Being Human and Pleasure and Pain (Lanham: UPA, 1999).

Psychologist Archibald Hart on how our pursuit of ever more pleasure has led to widespread anhedonia: Archibald D. Hart, Thrilled to Death (Nashville: Thomas Nelson, 2007), 153.

PART FIVE: RETHINKING PLEASURE AND PAIN

Pain is (usually) good for us

Two individuals with CIPA answer common questions: Steven Pete and Paul Waters, “Frequently asked questions,” accessed August 4, 2015, https://web.archive.org/web/20151024075606/http://www.thefactsofpainlesspeople.com/F.A.Q.html.

One family’s experience with Congenital Insensitivity to Pain and Anhidrosis: Chris Gajilan, “World without pain is hell, parent says,” September 28, 2006, http://www.cnn.com/2006/HEALTH/conditions/01/27/rare.conditions/index.html?section=cnn_latest.

Pain specialist Douglas Nelson on chronic pain: Douglas Nelson, The Mystery of Pain (London: Singing Dragon, 2013), 28-29.

The story of Ashlyn Blocker, a child born with CIPA: Justin Heckert, “The Hazards of Growing Up Painlessly,” November 15, 2012, http://www.nytimes.com/2012/11/18/magazine/ashlyn-blocker-feels-no-pain.html?pagewanted=all&_r=0.

Nietzsche’s view on how happiness and unhappiness are interdependent: Friedrich Wilhelm Nietzsche, The Gay Science, trans. Walter Kaufman (New York: Knopf Doubleday, August 18, 2010).

A documentary on children who cannot feel pain: A Life Without Pain, DVD, directed by Melody Gilbert (2005; Frozen Feet Films).

Dr. Paul Brand on living and working in poor and rich countries: Paul W. Brand and Philip Yancey, The Gift of Pain: Why We Hurt & What We Can Do about it (Grand Rapids, Michigan: Zondervan, 1993), 62.

Re-thinking the meaning and purpose of pleasure and pain

Aron Ralston describes amputating his right forearm: Grant Rolling, “I smiled as I cut off my arm. I was grateful to be free,” The Sun UK, December 31, 2010, http://www.thesun.co.uk/sol/homepage/showbiz/film/3326119/I-smiled-as-I-cut-off-my-arm-I-was-just-grateful-to-be-free.html.

Climber Aron Ralston describes amputating his own right forearm: Aron Ralston, “Aron Ralston describes the amputation,” interview by TLC television, TLC television interview, accessed March 15, 2016, https://www.youtube.com/watch?v=B2XLoQ1xYB0.

What is health?

Leading researchers on what does or doesn’t make people happy: Craig Lambert, “The Science of Happiness,” January 2007, http://harvardmagazine.com/2007/01/the-science-of-happiness.html.

The gap between affect and health

Dr. Paul Brand on living and working in poor and rich countries: Paul W. Brand and Philip Yancey, The Gift of Pain: Why We Hurt & What We Can Do about it (Grand Rapids, Michigan: Zondervan, 1993).

The differing numbers of bitter receptors in humans, rats and dogs: The Understanding Evolution team at UC Berkeley, “Evolution accounts for taste,” September 2014, http://evolution.berkeley.edu/evolibrary/news/140903_hummingbirds.

Psychologist Paul Bloom on the many kinds and functions of pleasures: Paul Bloom, How Pleasure Works (New York: W. W. Norton Company, 2010).

What are indulgences?

Psychology research on well-being: Well-Being: The Foundations of Hedonic Psychology, ed. Daniel Kahneman, Ed Diener, Norbert Schwarz (New York: Russell Sage Foundation, 1999).

We are programmable, like computers

Studies linking artificial sweeteners to weight gain and other illnesses: The Harvard School of Public Health, “Artificial Sweeteners,” accessed June 16, 2015, http://www.hsph.harvard.edu/nutritionsource/healthy-drinks/artificial-sweeteners/.

Babies’ preference for sweet over sour and bitter tastes: University of Rochester Medical Center, “Newborn Senses,” accessed August 19, 2015, https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=90&ContentID=P02631.

Psychologist G. Marian Kinget’s views on pleasure and pain: G. Marian Kinget, On Being Human and Pleasure and Pain (Lanham: UPA, 1999).

Dave Gahan describes his experience with heroin: Dave Gahan, “Through That Darkness You’ll Find the Light: A.J. Samuels interviews Depeche Mode’s Dave Gahan,” interview by A.J. Samuels, 2013, http://www.electronicbeats.net/through-that-darkness-youll-find-the-light-a-j-samuels-interviews-depeche-modes-dave-gahan/.

How recreational drugs reinforce addictive behaviour: The US National Institute on Drug Abuse, “DrugFacts: Understanding Drug Abuse and Addiction,” last modified November 2012, http://www.drugabuse.gov/publications/drugfacts/understanding-drug-abuse-addiction.

United States painkiller prescription rates quadrupled in recent years: The US Centers for Disease Control and Prevention, “Injury Prevention & Control: Prescription Drug Overdose,” last modified October 23, 2017, http://www.cdc.gov/drugoverdose/index.html.

The short- and long-term effects of cocaine: The Cleveland Clinic Foundation, “Drugs & Supplements—Cocaine (Crack),” 2012, http://my.clevelandclinic.org/health/drugs_devices_supplements/hic_Cocaine_and_Crack.

Artificial sweeteners’ impact on dietary choices and health: Holly Strawbridge, “Artificial sweeteners: sugar-free, but at what cost?” Harvard Health blog, July 16, 2012, http://www.health.harvard.edu/blog/artificial-sweeteners-sugar-free-but-at-what-cost-201207165030.

Canadians eat high amounts of sodium: Health Canada, “Sodium in Canada,” last modified June 8, 2012, http://www.hc-sc.gc.ca/fn-an/nutrition/sodium/index-eng.php.

Cocaine addict Susan shares her story: Foundation for a drug-free world, “Why is cocaine so highly addictive?” accessed August 19, 2015, http://www.drugfreeworld.org/drugfacts/cocaine/why-is-cocaine-so-highly-addictive.html.

Dr. Gentile on the positive and negative effects of video games: Douglas A. Gentile, “The Five Dimensions of Video Game Effects,” accessed June 19, 2015, http://drdouglas.org/issues2.html.

Psychologist Phillip Zimbardo on how Internet, video game, and pornography use can cause arousal addictions: Phillip Zimbardo, “The Demise of Guys,” TED, 2011, https://www.youtube.com/watch?t=199&v=FMJgZ4s2E3w.

Wives complaining of their spouses’ preference for video games over helping with the house and kids: Various contributors, “Does Anyone Else's Husband/bf Play Video Games?” last modified March 12, 2013, http://www.mamapedia.com/article/does-anyone-else-tick-s-husband-bf-play-video-games.

Addiction and relapse neural mechanisms: Harvard Medical School, “The addicted brain,” Harvard Mental Health Letter, July 2004, http://www.health.harvard.edu/mind-and-mood/the_addicted_brain.

Pornography effects and addictiveness: Kirsten Weir, “Is pornography addictive?” April 2014 Monitor on Psychology, April 2014, https://www.apa.org/monitor/2014/04/pornography.

Dr. Gentile on how some gamers can be classified as addicted, and the negative health impacts: Douglas A. Gentile, “Computer and Video Game Addiction,” accessed June 19, 2015, http://drdouglas.org/issue01.html.

Video gamer dies after 50-hour gaming binge: Barbara Demick, “Gamers Rack Up Losses,” The Los Angeles Times, August 29, 2005, http://articles.latimes.com/2005/aug/29/world/fg-games29.

Father suffocates son to continue playing video games: Fred Barbash, “Man suffocates 1-year-old son to play more video games and watch TV,” April 18, 2014, http://www.washingtonpost.com/news/morning-mix/wp/2014/04/18/florida-man-accused-of-suffocating-toddler-in-order-to-play-more-video-games/?tid=hp_mm.

Gaming Disorder officially being recognized by the WHO as a mental disorder: The World Health Organization, “Gaming disorder,” January 2018, http://www.who.int/features/qa/gaming-disorder/en/.

Research on deep brain stimulation, intravenous drugs, habit formation, and addiction: Roy A. Wise, “Brain Reward Circuitry: Insights from Unsensed Incentives,” Neuron Volume 36, Issue 2 (October 10, 2002), https://doi.org/10.1016/S0896-6273(02)00965-0.

Neurologist and Former addict Marc Lewis’ insights on addiction: Joseph Brean, “Addiction is more similar to racism than cancer, says neurologist who wrote about his past as a junkie,” National Post, August 21, 2015, https://nationalpost.com/news/canada/addiction-is-more-similar-to-racism-than-cancer-says-neurologist-who-wrote-about-his-junkie-past.

Marc David Lewis’ Curriculum Vitae: Marc David Lewis, “Marc David Lewis’ Curriculum Vitae,” July 15, 2011, http://home.oise.utoronto.ca/~mlewis/LewisCV.pdf.

Study exploring the similarities between the addictive properties of sweetness and drugs: Ahmed SH, Guillem K, Vandaele Y, “Sugar addiction: pushing the drug-sugar analogy to the limit,” Current Opinion in Clinical Nutrition & Metabolic Care 16(4) (July 2013): 434-9, https://doi.org/10.1097/MCO.0b013e328361c8b8.

The health risks and addictive nature of sugar: Bonnie Rochman, “Should Sugar Be Regulated like Alcohol and Tobacco?” February 2, 2012, https://healthland.time.com/2012/02/02/should-sugar-be-regulated-like-alcohol-and-tobacco/.

Kris Gunnars’ experience on the similarities of addiction to junk food and drugs: Kris Gunnars, “How Sugar Hijacks Your Brain And Makes You Addicted,” accessed June 30, 2015, https://www.healthy-holistic-living.com/sugar-hijacks-your-brain/.

Researchers’ views on sugar’s addictiveness: Louise Atkinson, “Could a sweet tooth be a warning sign you’re ill?” last modified September 26, 2011, http://www.dailymail.co.uk/health/article-2042182/Could-sweet-tooth-warning-sign-youre-ill.html.

On the true cause of food cravings: Veronique Greenwood, “Why we want food so much it hurts,” April 27, 2015, http://www.bbc.com/future/story/20150424-why-you-want-food-so-much-it-hurts.

IN-DEPTH: If indulging isn’t healthy, why do we do it?

Psychologist David Burns on how the epidemic of obesity may be simply due to an overabundance of delicious foods: David Burns, “Therapist Error #6: Joining a School of Psychotherapy,” 2014, https://feelinggood.com/therapist-error-6-joining-a-school-of-psychotherapy/.

USA smoking statistics over time: Office on Smoking and Health, “Appendix: Cigarette Smoking in the United States, 1950-1978,” accessed May 14, 2015, https://profiles.nlm.nih.gov/spotlight/nn/catalog/nlm:nlmuid-101584932X675-doc.

Physicians are as overweight as the general population, and used to smoke as much as everyone else in the 1950s: Cristine Russell, “Doctors, Practice What You Preach,” June 12, 2012, http://www.theatlantic.com/health/archive/2012/06/doctors-practice-what-you-preach/258379/.

Strategies used by the alcohol industry to mislead the public about cancer risk: Mark Petticrew, Nason Maani Hessari, Cécile Knai, and Elisabete Weiderpass, “How alcohol industry organisations mislead the public about alcohol and cancer,” Drug and Alcohol Review Volume 37, Issue 3 (September 7, 2017), https://doi.org/10.1111/dar.12596.

Sugar’s various health impacts and the food industry’s tactics: Julia Llewellyn Smith, “Sugar’s spurned prophet,” Sunday Telegraph, February 17, 2014, http://www.telegraph.co.uk/lifestyle/wellbeing/diet/10634081/John-Yudkin-the-man-who-tried-to-warn-us-about-sugar.html.

Sean Covey advises teens on life’s struggles: Renee Pratt, “A former teen's advice writes to advice new generation,” Deseret News, January 18, 1999, http://www.deseretnews.com/article/674686/A-former-teens-advice-writes-to-advice-new-generation.html?pg=all.

PART SIX: GREAT INDULGENCE, GREAT SUFFERING

The world’s Great Indulgence

Salt production in antiquity: Olivier Weller and Gheorghe Dumitroaia, “The earliest salt production in the world: an early Neolithic exploitation in Poiana Slatinei-Lunca, Romania,” Antiquity Vol. 79 No 306 December 2005, December 2005, http://www.antiquity.ac.uk/projgall/weller306/.

Salt myths and facts: World Action On Salt and Health (WASH), “Myths and Frequently Asked Questions,” accessed July 27, 2015, http://www.worldactiononsalt.com/less/how/faqs/.

Sodium content in natural versus prepared foods, and taste adaptation: Robert Beck, “Why Low Sodium?” accessed August 18, 2015, http://robertbeckmd.com/Why_Low_Sodium.html.

Article on high sodium levels in Canadian restaurant meals: Avis Favaro, “A salty surprise? Sit-down meals can contain more sodium than fast food,” CTV News, February 27, 2013, https://www.ctvnews.ca/health/health-headlines/a-salty-surprise-sit-down-meals-can-contain-more-sodium-than-fast-food-1.1174443.

The health risks and addictive nature of sugar: Bonnie Rochman, “Should Sugar Be Regulated like Alcohol and Tobacco?” February 2, 2012, https://healthland.time.com/2012/02/02/should-sugar-be-regulated-like-alcohol-and-tobacco/.

Sugar statistics in the USA: James J. DiNicolantonio and Sean C. Lucan, “Sugar Season. It’s Everywhere, and Addictive,” December 22, 2014, http://www.nytimes.com/2014/12/23/opinion/sugar-season-its-everywhere-and-addictive.html?_r=0.

Food flavorists’ quest to make food addictive: Morley Safer, “The Flavorists: Tweaking tastes and creating cravings,” accessed July 14, 2015, http://www.cbsnews.com/news/the-flavorists-tweaking-tastes-and-creating-cravings-27-11-2011/.

Journalist Michael Moss on the food industry’s drive to sell addictive processed foods: Michael Moss, “The extraordinary science of addictive junk food” in Expanding Addiction: Critical Essays, ed. Robert Granfield, Craig Reinarman (London: Routledge, December 9, 2014).

Fast food restaurant portion sizes increased over the decades: Lisa R. Young, “By any other name, it's still a supersize,” last modified October 2007, http://www.nbcnews.com/id/20825325/ns/health-diet_and_nutrition/t/any-other-name-its-still-supersize/.

Food companies often don’t publish their research findings: Keith O. Fuglie, Paul W. Heisey, John L. King, Carl E. Pray, Kelly Day-Rubenstein, David Schimmelpfennig, Sun Ling Wang, Rupa Karmarkar-Deshmukh, “United States Department of Agriculture—Research Investments and Market Structure in the Food Processing, Agricultural Input, and Biofuel Industries Worldwide,” Economic Research Report Number 130 December 2011, December 2011, https://www.ers.usda.gov/webdocs/publications/44644/11359_eib90_1_.pdf?v=41055.

The inner workings of the processed food industry: Eric Schlosser, Fast Food Nation: The Dark Side of the All-American Meal (Boston: Mariner Books, March 1, 2012).

Global trends in consumer restaurant spending: Peter Nowak, “How McDonald's has shaped the food biz,” May 14, 2015, http://www.cbc.ca/news/business/how-mcdonald-s-has-shaped-the-food-biz-1.3074081?cmp=googleeditorspick&google_editors_picks=true.

The evolution of farmed fruits and vegetables: Jo Robinson, “Breeding the Nutrition Out of Our Food,” The New York Times, May 25, 2013, https://www.nytimes.com/2013/05/26/opinion/sunday/breeding-the-nutrition-out-of-our-food.html.

Statistics on video game players: Jane McGonigal, “We spend 3 billion hours a week as a planet playing videogames. Is it worth it? How could it be MORE worth it?” TED conversation, 2011, http://www.ted.com/conversations/44/we_spend_3_billion_hours_a_wee.html.

The top 10 video games of 2014: Erik Kain, “The Top Ten Best-Selling Video Games Of 2014,” Forbes, January 2015, http://www.forbes.com/sites/erikkain/2015/01/19/the-top-ten-best-selling-video-games-of-2014/.

2018 American industry survey on video games: The Entertainment software association, “2018 sales, demographic, and usage data—essential facts about the computer and video game industry,” 2018, http://www.theesa.com/wp-content/uploads/2018/05/EF2018_FINAL.pdf.

Pornography effects and addictiveness: Kirsten Weir, “Is pornography addictive?” April 2014 Monitor on Psychology, April 2014, https://www.apa.org/monitor/2014/04/pornography.

The intensification of pornography over the years: Norman Doidge, The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science (New York: Viking Press, March 15, 2007).

Discussion on the causes of overeating and obesity: Walter Willett, David Kessler, Dariush Mozaffarian, Michael Rich, Meredith Melnic, “Why We Overeat,” September 13, 2013, http://theforum.sph.harvard.edu/events/why-we-overeat/.

The increase in children television watching over time: Dimitri A. Christakis, “The Effects of Fast-Paced Cartoons,” Pediatrics Volume 128, Number 4 (October 2011), https://doi.org/10.1542/peds.2011-2071.

Evolution of motion and shot length in movies: Greg Miller, “Data From a Century of Cinema Reveals How Movies Have Evolved,” December 1899, http://www.wired.com/2014/09/cinema-is-evolving/.

The history of alcohol consumption: David J. Hanson, “Historical evolution of alcohol consumption in society,” 2013, http://www.oxfordscholarship.com/view/10.1093/acprof:oso/9780199655786.001.0001/acprof-9780199655786-chapter-01.

Alcohol trends and abuse in England: Tonight. “Britain’s Secret Drinkers.” Produced by Frazer Sheppard. Reported by Fiona Foster. ITV, undated.

Global tobacco, alcohol, and drug consumption and addiction: Susan Scutti, “Smoking Is The Most Prevalent Addiction Worldwide, With 22.5% Of People Lighting Up,” May 12, 2015, http://www.medicaldaily.com/smoking-most-prevalent-addiction-worldwide-225-people-lighting-333042.

The history of smoking and lung cancer: The Cancer Council New South Wales, “A brief history of smoking,” 2015, https://www.cancercouncil.com.au/31899/uncategorized/a-brief-history-of-smoking/.

Worldwide coffee consumption statistics: Eric Goldschein, “11 Incredible Facts About The Global Coffee Industry,” Business Insider, November 14, 2011, http://www.businessinsider.com/facts-about-the-coffee-industry-2011-11?op=1/.

Study on the positive and negative effects of caffeine: Leeana A. Persad, “Energy Drinks and the Neurophysiological Impact of Caffeine,” Frontiers in Neuroscience 5 (October 21, 2011), https://doi.org/10.3389/fnins.2011.00116.

Humans as infovores: Irving Biederman and Edward A. Vessel, “Perceptual Pleasure and the Brain,” American Scientist, 2006, http://www.cns.nyu.edu/~vessel/pubs/Biederman_Vessel_AmSci06.pdf.

Worldwide illicit drug use statistics over the past century: The United Nations Office on Drugs and Crime (UNODC), “A Century of International Drug Control,” 2008, https://www.unodc.org/documents/data-and-analysis/Studies/100_Years_of_Drug_Control.pdf.

Report on increase in marijuana potency since the 1970s and corresponding health outcomes: Center on Addiction, “New CASA Report Finds: Marijuana Potency Up 175%, Medical Diagnoses, Treatment Admissions, ER Findings for Teen Marijuana Use Up Sharply,” the official site for The National Center on Addiction and Substance Abuse, June 18, 2008, http://www.centeronaddiction.org/newsroom/press-releases/2008-marijuana-3.

Ontario physicians asking the government to declare a state of emergency due to the opioid crisis: Rob Ferguson, “Province won’t call opioid crisis an emergency, but pledges ‘significant’ help,” The Toronto Star, August 28, 2017, https://www.thestar.com/news/gta/2017/08/28/health-care-harm-reduction-workers-call-on-ontario-to-declare-opioid-emergency.html.

The systematic eradication of healthy pain

Pain specialist Erv Hinds on the nature of pain and the effectiveness of pain treatments: Erv Hinds, A Life Larger Than Pain (New Mexico: Health Press, April 1, 2003), 52-53.

1980-2013 global opioid consumption statistics: University of Wisconsin Pain & Policy Studies Group, “Global Opioid Consumption,” 2015, https://web.archive.org/web/20151012045643/http://www.painpolicy.wisc.edu/sites/www.painpolicy.wisc.edu/files/global_me_methadone.pdf.

Increased prescription painkillers linked to increased death rates in Americans: Danielle Paquette, “Prescription painkillers to blame for spike in deaths of white women over past 15 years, study says,” Washington Post, March 6, 2015, https://nationalpost.com/health/prescription-painkillers-to-blame-for-spike-in-deaths-of-white-women-over-past-15-years-study-says.

United States painkiller prescription rates quadrupled in recent years: The US Centers for Disease Control and Prevention, “Injury Prevention & Control: Prescription Drug Overdose,” last modified October 23, 2017, http://www.cdc.gov/drugoverdose/index.html.

The CDC’s 2016 stricter guidelines on prescribing opioids for chronic pain in the US: Deborah Dowell, Tamara M. Haegerich, and Roger Chou, “CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016,” March 18, 2016, https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm.

Global statistics on adult physical inactivity: Brigid Schulte, “Health experts have figured out how much time you should sit each day,” The Washington Post, June 2, 2015, https://www.washingtonpost.com/news/wonk/wp/2015/06/02/medical-researchers-have-figured-out-how-much-time-is-okay-to-spend-sitting-each-day/.

The Great Suffering of humankind

Statistics on Canadian physician depression and burnout rates: Marie-Danielle Smith, “Medical community studying physician burnout, compassion fatigue,” The Ottawa Citizen, August 17, 2014, https://ottawacitizen.com/news/local-news/medical-community-studying-physician-burnout-compassion-fatigue.

Study showing that ER visits due to suicidal ideation has nearly doubled between 2007 and 2015 in the US: Brett Burstein, Holly Agostino, and Brian Greenfield, “Suicidal Attempts and Ideation Among Children and Adolescents in US Emergency Departments, 2007-2015,” JAMA Pediatrics (April 8, 2019), https://doi.org/10.1001/jamapediatrics.2019.0464.

Specialists discuss global increase in depression: Mark Williams and Danny Penman, “What is depression?” The University of Oxford, UK, October 21, 2011, http://podcasts.ox.ac.uk/what-depression.

How mental health is worsening in Ontario: The Center for Addiction and Mental Health, “2013 CAMH Monitor eReport—Substance Use, Mental Health and Well-Being Among Ontario Adults,” 2014, http://www.camh.ca/-/media/files/pdfs---camh-monitor/camh-monitor-2013-trends-ereport-final-pdf.pdf.

Recent increase in mental illness and suicidal ideation in Canadian teens: Alison Auld and Sue Bailey, “Mental health services stretched as increasing number of self-harming teens seek help,” March 15, 2014, https://www.thestar.com/news/canada/2014/03/15/services_stretched_as_selfharming_teens_seek_help_say_doctors.html.

Statistics on mental illness in Canada: The Mental Health Commission of Canada, “Issue brief – Workplace Mental Health,” June 3, 2016, https://www.mentalhealthcommission.ca/sites/default/files/2017-01/Issue_Brief_workplace_mental_health_eng.pdf.

The epidemic of mental illness in America and psychoactive drug treatments: Marcia Angell, “The Epidemic of Mental Illness: Why?” June 23, 2011, http://www.nybooks.com/articles/archives/2011/jun/23/epidemic-mental-illness-why/.

Global statistics on depression and mental illness: Kate Kelland and Ben Hirschler, “Insight: Antidepressants give drugmakers the blues,” Reuters—Health, March 23, 2012, http://www.reuters.com/article/2012/03/23/us-depression-drugs-idUSBRE82M0MK20120323.

Mental illnesses and substance use disorders are the primary causes of disability worldwide: Harvey A Whiteford et al, “Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010,” The Lancet Volume 382, No. 9904 (November 9, 2013), https://doi.org/10.1016/S0140-6736(13)61611-6.

Psychologist Archibald Hart on how our pursuit of ever more pleasure has led to widespread anhedonia: Archibald D. Hart, Thrilled to Death (Nashville: Thomas Nelson, 2007), 13;88.

Dr. John E. Sarno’s book Healing Back Pain, which describes how the Tension Myositis/Myoneural Syndrome (TMS) transforms suppressed emotions into physical pain: John E. Sarno, Healing Back Pain (New York: Warner Books, 1991), xvi.

Chronic pain statistics and therapy effectiveness: Cheryl L. Stucky, Michael S. Gold, and Xu Zhang, “Mechanisms of Pain,” Proceedings of the National Academy of Sciences of the United States of America 98(21) (October 9, 2001): 11845-11846, https://doi.org/10.1073/pnas.211373398.

Statistics on chronic pain and suicide in America: Tara Parker-Pope, “Giving Chronic Pain a Medical Platform of Its Own,” New York Times Blog, July 18, 2011, http://well.blogs.nytimes.com/2011/07/18/giving-chronic-pain-a-medical-platform-of-its-own/.

Pain specialist Erv Hinds on the nature of pain and the effectiveness of pain treatments: Erv Hinds, A Life Larger Than Pain (New Mexico: Health Press, April 1, 2003).

Moderate alcohol drinking is linked to disease: Kevin Van Paassen, “We need to talk (about our drinking),” The Globe and Mail, June 29, 2014, http://www.theglobeandmail.com/life/health-and-fitness/health/we-need-to-talk-about-our-drinking/article19377132/?cmpid=rss1&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+TheGlobeAndMail-Front+%28The+Globe+and+Mail+-+Latest+News%29.

Excess weight statistics and link to diseases: World Health Organization, “Global Health Observatory (GHO) data—Obesity,” accessed August 14, 2015, https://www.who.int/gho/ncd/risk_factors/bmi_text/en/.

Global diabetes trends: The World Health Organization Media Centre, “Diabetes—Fact Sheet,” last modified June 2016, http://www.who.int/mediacentre/factsheets/fs312/en/.

Long-term Trends in Diabetes: The US Centers for Disease Control and Prevention, “Long-term Trends in Diabetes,” October 2014, http://www.cdc.gov/diabetes/statistics/slides/long_term_trends.pdf.

Sugar’s various health impacts and the food industry’s tactics: Julia Llewellyn Smith, “Sugar’s spurned prophet,” Sunday Telegraph, February 17, 2014, http://www.telegraph.co.uk/lifestyle/wellbeing/diet/10634081/John-Yudkin-the-man-who-tried-to-warn-us-about-sugar.html.

Worldwide noncommunicable disease statistics: World Health Organization, “10 facts on noncommunicable diseases,” accessed July 14, 2016, https://www.who.int/features/factfiles/noncommunicable_diseases/facts/en/.

Conventionally treating the world

Statistics on chronic pain and suicide in America: Tara Parker-Pope, “Giving Chronic Pain a Medical Platform of Its Own,” New York Times Blog, July 18, 2011, http://well.blogs.nytimes.com/2011/07/18/giving-chronic-pain-a-medical-platform-of-its-own/.

Chronic pain and the difficulty in measuring and describing pain: The American College of Physicians and the American Academy of Pain Medicine, “Managing Chronic Pain: a Guide for Patients,” 2007, https://web.archive.org/web/20150606015344/https://www.acponline.org/patients_families/pdfs/misc/pain.pdf.

How the mind limits pain, even when tortured or severely injured: David Wynick, “Is there a pain 'limit'?” June 4, 2011, http://www.askabiologist.org.uk/answers/viewtopic.php?id=6204.

The cause of migraines still not fully understood: The US National Institute of Neurological Disorders and Stroke, “Migraine Information Page,” the official NINDS website, last modified June 27, 2018, https://www.ninds.nih.gov/disorders/all-disorders/migraine-information-page.

The challenge of finding the root cause of fibromyalgia: The US National Institute of Arthritis and Musculoskeletal and Skin Diseases, “Questions and Answers about Fibromyalgia,” NIH Publication No. 14–5326, July 2014, https://www.niams.nih.gov/health-topics/fibromyalgia.

How scientists don’t know what causes chronic fatigue syndrome: The Mayo Clinic, “Chronic fatigue syndrome Causes,” August 30, 2016, https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/symptoms-causes/syc-20360490.

Chronic pain prognosis and difficulty curing: Eric Metcalf, “When Your Pain Medication Isn't Working,” accessed September 3, 2015, http://www.webmd.com/pain-management/features/when-pain-medications-not-working.

Overview of panic disorder: The US National Institute of Mental Health, “Anxiety Disorders,” accessed June 8, 2015, http://www.nimh.nih.gov/health/topics/panic-disorder/index.shtml.

Dr. Joseph Glenmullen on how many chemical imbalance theories of depression have been proven false: Joseph Glenmullen, Prozac Backlash (Simon & Schuster, 2000).

Central sensitivity syndrome as a possible explanation for fibromyalgia and other chronic pain syndromes: Muhammad B. Yunus, “Fibromyalgia and Overlapping Disorders: The Unifying Concept of Central Sensitivity Syndromes,” Seminars in Arthritis and Rheumatism Volume 36, Issue 6 (June 2007), https://doi.org/10.1016/j.semarthrit.2006.12.009.

Pain specialist Douglas Nelson on chronic pain: Douglas Nelson, The Mystery of Pain (London: Singing Dragon, 2013), 61.

Pain specialist Erv Hinds on the nature of pain and the effectiveness of pain treatments: Erv Hinds, A Life Larger Than Pain (New Mexico: Health Press, April 1, 2003), 97.

The epidemic of mental illness in America and psychoactive drug treatments: Marcia Angell, “The Epidemic of Mental Illness: Why?” June 23, 2011, http://www.nybooks.com/articles/archives/2011/jun/23/epidemic-mental-illness-why/.

Chronic pain statistics and therapy effectiveness: Cheryl L. Stucky, Michael S. Gold, and Xu Zhang, “Mechanisms of Pain,” Proceedings of the National Academy of Sciences of the United States of America 98(21) (October 9, 2001), https://doi.org/10.1073/pnas.211373398.

Evidence that antidepressants aren’t very effective: Ellen Hendriksen, “Do Antidepressants Work?” February 28, 2014, http://www.quickanddirtytips.com/health-fitness/mental-health/do-antidepressants-work.

Antidepressants are generally ineffective for youth: Steven P. Cuffe, “Do Antidepressants Increase the Risk of Suicide in Children and Adolescents?” accessed June 20, 2015, https://www.aacap.org/AACAP/Medical_Students_and_Residents/Mentorship_Matters/DevelopMentor/Do_Antidepressants_Increase_the_Risk_of_Suicide_in_Children_and_Adolescents.aspx.

The unknown origin of mood disorders and the ineffectiveness of antidepressants: Katherine Kam, “Can Antidepressants Work for Me?” 2010, http://www.webmd.com/depression/features/are-antidepressants-effective?page=4.

Review of antidepressants effectiveness and negative health effects: Paul W. Andrews, J. Anderson Thomson Jr., Ananda Amstadter and Michael C. Neale, “Primum non nocere: an evolutionary analysis of whether antidepressants do more harm than good,” Frontiers in Psychology. (April 24, 2012), https://doi.org/10.3389/fpsyg.2012.00117.

Psychiatrist Dr. Mosher’s resignation letter to the American Psychiatric Association: Loren R. Mosher, “Letter of Resignation from the American Psychiatric Association,” December 4, 1998, http://www.moshersoteria.com/articles/resignation-from-apa/.

The Mayo Clinic’s approach to pain rehabilitation: The Mayo Clinic, “The Mayo Clinic’s Pain Rehabilitation Center in Minnesota,” accessed June 29, 2015, https://www.mayoclinic.org/departments-centers/pain-rehabilitation-center/sections/overview/ovc-20481691.

UK physicians are increasingly prescribing social activities instead of medication to treat mental illness: CBC Radio, “Why U.K. doctors are doling out 'social prescriptions' to treat mental health,” March 27, 2018, http://www.cbc.ca/radio/thecurrent/the-current-for-march-27-2018-1.4594705/why-u-k-doctors-are-doling-out-social-prescriptions-to-treat-mental-health-1.4594830.

PART SEVEN: SOLVING THE PROBLEM WITH SUDISM

Introduction—treating unhealthy pain, the sudist way

Specialists discuss global increase in depression: Mark Williams and Danny Penman, “What is depression?” The University of Oxford, UK, October 21, 2011, http://podcasts.ox.ac.uk/what-depression.

The unknown cause of chronic pain and ineffective treatment options: Synnøve Ressem, “The pain paradox,” Gemini Magazine, February 2, 2011, http://earthsky.org/human-world/the-pain-paradox.

The secondary effects of indulgence

Study on excessive sodium’s impact on mortality: David DiSalvo, “Study: Eating Too Much Salt is Killing Us By the Millions,” March 2013, http://www.forbes.com/sites/daviddisalvo/2013/03/24/study-eating-too-much-salt-is-killing-us-by-the-millions/.

The harmful effects of smoking on the body: The US Centers for Disease Control and Prevention, “Health Effects of Cigarette Smoking,” February 6, 2014, http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/.

Excess sodium’s impact on health: The Harvard School of Public Health, “Health Risks and Disease Related to Salt and Sodium,” accessed June 3, 2015, http://www.hsph.harvard.edu/nutritionsource/salt-and-sodium/sodium-health-risks-and-disease/.

Chronic pain and the difficulty in measuring and describing pain: The American College of Physicians and the American Academy of Pain Medicine, “Managing Chronic Pain: a Guide for Patients,” 2007, https://web.archive.org/web/20150606015344/https://www.acponline.org/patients_families/pdfs/misc/pain.pdf.

Overview of Social Anxiety Disorder: Canadian Mental Health Association, British Columbia Division, “Social Anxiety Disorder,” 2013, http://www.cmha.bc.ca/get-informed/mental-health-information/social-anxiety-disorder.

Overview of panic disorder: The US National Institute of Mental Health, “Anxiety Disorders,” accessed June 8, 2015, http://www.nimh.nih.gov/health/topics/panic-disorder/index.shtml.

Depression as the leading cause of workplace disability in Canada and worldwide: The Government of Canada, “Federal Public Service Workplace Mental Health Strategy,” last modified November 28, 2016, https://www.canada.ca/en/government/publicservice/wellness-inclusion-diversity-public-service/health-wellness-public-servants/mental-health-workplace/federal-public-service-workplace-mental-health-strategy.html.

Dr. John E. Sarno’s book Healing Back Pain, which describes how the Tension Myositis/Myoneural Syndrome (TMS) transforms suppressed emotions into physical pain: John E. Sarno, Healing Back Pain (New York: Warner Books, 1991), 29-30.

Worldwide noncommunicable disease statistics: World Health Organization, “10 facts on noncommunicable diseases,” accessed July 14, 2016, https://www.who.int/features/factfiles/noncommunicable_diseases/facts/en/.

The short- and long-term effects of cocaine: The Foundation for a Drug-Free World, “The truth about cocaine,” accessed May 15, 2015, http://www.drugfreeworld.org/drugfacts/cocaine/effects-of-cocaine.html.

UK statistics and views on drugs, theft, and other crime: Tony Thompson, “Crack turns vice girls into slaves to sex,” October 12, 2003, http://www.theguardian.com/society/2003/oct/12/drugsandalcohol.drugs.

Dr. Lickerman on why people commit suicide: Alex Lickerman, “6 reasons why people commit suicide,” June 3, 2010, http://www.kevinmd.com/blog/2010/06/6-reasons-people-commit-suicide.html.

Statistics, impact, and treatment of acute and chronic pain: The International Association for the Study of Pain, “Unrelieved pain is a major global health care problem,” fact sheet, 2004, http://www.iasp-pain.org/files/Content/ContentFolders/GlobalYearAgainstPain2/20042005RighttoPainRelief/factsheet.pdf.

Statistics on chronic pain and suicide in America: Tara Parker-Pope, “Giving Chronic Pain a Medical Platform of Its Own,” New York Times Blog, July 18, 2011, http://well.blogs.nytimes.com/2011/07/18/giving-chronic-pain-a-medical-platform-of-its-own/.

Ambien’s side effects: Sanofi-aventis US, “Medication Guide–Ambien,” 2013, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c36cadf4-65a4-4466-b409-c82020b42452.

Health Canada warns that ADHD drugs may increase suicidal thoughts: The Canadian Press, “ADHD drugs linked to suicidal thoughts,” March 31, 2015, https://globalnews.ca/news/1912223/adhd-drugs-linked-to-suicidal-thoughts/.

How drug Interferon causes depression: Niall McGee, “Niall McGee didn’t believe in depression – until cancer medication put him in a suicidal spiral,” The Globe and Mail, May 28, 2015, http://www.theglobeandmail.com/life/niall-mcgee-didnt-believe-in-depression-until-cancer-meds-put-him-in-a-suicidal-spiral/article24660218/.

The US National Institute on Drug Abuse describes marijuana’s long-term negative health effects: The US National Institute on Drug Abuse, “DrugFacts: Marijuana,” last modified June 2015, http://www.drugabuse.gov/publications/drugfacts/marijuana.

Dr. Beasley’s struggle with alcoholism, and alcohol’s link to suicide: Katherine Ketcham, William F. Asbury, Mel Schulstad, and Arthur P. Ciaramicoli, Beyond the Influence: Understanding and Defeating Alcoholism (New York: Random House Publishing Group, October 21, 2009).

Co-pilot Andreas Lubitz deliberately crashed Germanwings Flight 9525: Joshua Berlinger, “German newspaper releases timeline of Germanwings flight before crash,” CNN website, last modified March 29, 2015, http://www.cnn.com/2015/03/29/europe/france-germanwings-plane-crash-main/.

Study on the link between alcohol and drug use and committing homicide: Jari Tiihonen, Martti Lehti, Mikko Aaltonen, Janne Kivivuori, Hannu Kautiainen, Lauri J. Virta, Fabian Hoti, Antti Tanskanen and Pasi Korhonen, “Psychotropic drugs and homicide: A prospective cohort study from Finland,” World Psychiatry 14 (June 4, 2015), https://doi.org/10.1002/wps.20220.

One in eight deaths in Ontario’s young adults linked to opioid overdoses: Amina Zafar, “OxyContin and other opioids tied to 1 in 8 deaths in young adults, Ontario study shows,” CBC News, July 7, 2014, http://www.cbc.ca/news/health/oxycontin-and-other-opioids-tied-to-1-in-8-deaths-in-young-adults-ontario-study-shows-1.2696995.

Doctors on how many patients exaggerate or falsify pain to obtain painkillers: Melinda Beck, “Doctors' Challenge: How Real Is That Pain?” Wall Street Journal – Health, July 5, 2011, http://www.wsj.com/articles/SB10001424052702304450604576419810283786774.

Study on the link between video games and attention problems and impulsiveness: Douglas A. Gentile, Edward L. Swing, Choon Guan Lim, and Angeline Khoo, “Video game playing, attention problems, and impulsiveness: Evidence of bi-directional causality,” Psychology of Popular Media Culture, 1, 62-70, 2012, https://www.apa.org/pubs/journals/releases/ppm-1-1-62.pdf.

Video games’ effects on young men: Fiona Roberts, “America's Lost Boys: Why ARE so many young men failing to grow up?” July 5, 2011, http://www.dailymail.co.uk/news/article-2011261/Americas-Lost-Boys-Why-ARE-young-men-failing-grow-up.html.

Study linking teen video gaming with attention problems: Philip A Chan and Terry Rabinowitz, “A cross-sectional analysis of video games and attention deficit hyperactivity disorder symptoms in adolescents,” Annals of General Psychiatry. 2006, 5:16 (October 24, 2006), https://doi.org/10.1186/1744-859X-5-16.

Pain specialist Erv Hinds on the nature of pain and the effectiveness of pain treatments: Erv Hinds, A Life Larger Than Pain (New Mexico: Health Press, April 1, 2003), 16.

The ideal world

Leading researchers on what does or doesn’t make people happy: Craig Lambert, “The Science of Happiness,” January 2007, http://harvardmagazine.com/2007/01/the-science-of-happiness.html.

Low depression rates in primitive Kaluli cultures: Jeanne L. Tsai and Yulia Chentsova-Dutton, “Understanding Depression Across Cultures” in Handbook of Depression, ed. Ian H. Gotlib and Constance L. Hammen (New York: The Guilford Press, May 17, 2002).

Kaluli tribes’ gender-based division of labour: Nancy E. Gratton, “Kaluli,” The Encyclopedia of World Cultures CD-ROM, 1998, http://www.sscnet.ucla.edu/anthro/faculty/fiske/135b/kaluli.htm.

The secrets of longevity of those living in ‘blue zones’: Dan Buettner, “Want Great Longevity and Health? It Takes a Village,” The Wall Street Journal, May 22, 2015, http://www.wsj.com/articles/want-great-longevity-and-health-it-takes-a-village-1432304395?mod=e2tw.

Sudism versus conventional medicine

Dr. Daniel J. Clauw on the causes and treatments of chronic pain: Daniel J. Clauw, “Chronic Pain - Is it All in Their Head?” December 5, 2013, https://www.youtube.com/watch?v=pgCfkA9RLrM.

Overview of pain research: The US National Institute of Neurological Disorders and Stroke, “Pain: Hope Through Research,” January 2014, https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Pain-Hope-Through-Research.

Make the connection!

Dr. Beasley’s struggle with alcoholism, and alcohol’s link to suicide: Katherine Ketcham, William F. Asbury, Mel Schulstad, and Arthur P. Ciaramicoli, Beyond the Influence: Understanding and Defeating Alcoholism (New York: Random House Publishing Group, October 21, 2009).

Former alcoholic Sarah Hepola on the ups and downs of alcoholism: Sarah Hepola, Blackout: Remembering the Things I Drank to Forget (New York: Grand Central Publishing, June 7, 2016).

Children and teens more likely to become dependent on marijuana, and often don’t connect its use to its negative impacts: The California Society of Addiction Medicine, “Impact of Marijuana on Children and Adolescents,” September 2009, https://cdn.ymaws.com/csam-asam.org/resource/resmgr/docs/white_papers/impactofmarijuanaonchildrena.pdf.

Philosopher, heal thyself

Rick Foster discovers quitting sugar eases pains and boosts energy: Rick Foster, “My Year off Sugar,” April 2012, http://www.huffingtonpost.com/rick-foster/no-sugar-diet_b_1397439.html.

IN-DEPTH: Should we maximize or minimize our pleasure and pain?

Pain specialist Erv Hinds on the nature of pain and the effectiveness of pain treatments: Erv Hinds, A Life Larger Than Pain (New Mexico: Health Press, April 1, 2003), 15.

Psychologist Daniel Gilbert on our misperceptions about pain and happiness: Daniel Gilbert, Stumbling on happiness (New York: Knopf, 2006).

Mania and reckless behaviour: Sara Solovitch, “Opening the door on hypersexuality,” accessed December 31, 2014, http://www.bphope.com/Item.aspx/522/opening-the-door-on-hypersexuality.

Bipolar disorder symptoms: MedlinePlus, “Bipolar disorder,” last modified August 31, 2018, http://www.nlm.nih.gov/medlineplus/ency/article/000926.htm.

Doctors’ and teens’ views on marijuana’s addictiveness and its impact on decision-making: Katie Kerwin McCrimmon, “Doctors And Teens At Opposite Ends On Marijuana,” February 21, 2012, http://www.kunc.org/post/doctors-and-teens-opposite-ends-marijuana.

How illicit drugs can increase impulsivity: Perry JL, Carroll ME, “The role of impulsive behavior in drug abuse,” Psychopharmacology (Berlin) 200(1) (September 2008): 1-26, https://doi.org/10.1007/s00213-008-1173-0.

Realignment—Applying sudism to optimize our health and our affects

How reducing alcohol intake benefits even those who are retired or have cancer: Erin Ellis, “Put down that drink, take a walk to help prevent cancer, experts say,” Vancouver Sun, May 27, 2015, http://www.vancouversun.com/health/down+that+drink+take+walk+help+prevent+cancer+experts/11085232/story.html.

Mars promotes their Snickers chocolate bars as part of a balanced diet: Mars Inc, “Snickers—Healthy, active lifestyles,” Mars/Snickers website, 2016, http://www.snickers.com/nutritional-info.

Study illustrating how ‘everything in moderation’ varies for each person: Alan Flurry, “Just a few more bites: Defining moderate eating varies by individual, study finds,” UGA Today—News and Information from the University of Georgia, June 6, 2016, http://news.uga.edu/releases/article/moderate-eating-varies-by-individual-0616/.

Alcohol trends and abuse in England: Tonight. “Britain’s Secret Drinkers.” Produced by Frazer Sheppard. Reported by Fiona Foster. ITV, undated.

Smoking only one cigarette per day increases risk of heart disease and stroke: Allan Hackshaw et al, “Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reports,” BMJ, January 24, 2018, http://www.bmj.com/content/360/bmj.j5855.

US National Institute on Drug Abuse on using Cognitive-Behavioral Therapy to treat cocaine addiction: The US National Institute on Drug Abuse, “A Cognitive-Behavioral Approach: Treating Cocaine Addiction,” accessed August 26, 2015, https://archives.drugabuse.gov/publications/cognitive-behavioral-approach-treating-cocaine-addiction.

Sodium levels in packaged grocery store foods: HealthDay, “Packaged Grocery Foods Often High in Salt, Study Finds,” April 2, 2015, https://www.webmd.com/diet/news/20150402/packaged-grocery-foods-often-high-in-salt-study-finds.

Sodium content in natural versus prepared foods, and taste adaptation: Robert Beck, “Why Low Sodium?” accessed August 18, 2015, http://robertbeckmd.com/Why_Low_Sodium.html.

Sodium taste perception and adaptation: O'Mahony M, “Salt taste adaptation: the psychophysical effects of adapting solutions and residual stimuli from prior tastings on the taste of sodium chloride,” Perception 8(4) (1979): 441-76, http://www.ncbi.nlm.nih.gov/pubmed/503775.

The keys to a healthy life according to the WHO: The World Health Organization, “World Health Organization - Social determinants of health - The solid facts, second edition,” 2003, http://www.euro.who.int/__data/assets/pdf_file/0005/98438/e81384.pdf.

Alternative sweetener labelling and sweetness perception: Donald E. Pszczola, “Why Today’s Sweetener ‘Rush’?” Food Technology, Volume 67, No.5, May 2013, http://www.ift.org/food-technology/past-issues/2013/may/columns/ingredients.aspx?page=viewall.

Salt myths and facts: World Action On Salt and Health (WASH), “Myths and Frequently Asked Questions,” accessed July 27, 2015, http://www.worldactiononsalt.com/less/how/faqs/.

Negative impacts of excess sodium consumption: World Action on Salt and Health (WASH), “Salt and health factsheets—Salt and other conditions,” accessed July 21, 2015, http://www.worldactiononsalt.com/salthealth/factsheets/other/index.html.

The World Health Organization (WHO) identifies free sugars in the diet as damaging to health: Action on Sugar, “WHO calls for immediate action on sugar,” March 4, 2015, http://www.actiononsugar.org/news-centre/press-releases/2015/items/who-calls-for-immediate-action-on-sugar.html.

Trans fats’ use in the food supply: The American Heart Association, “Trans Fats,” last modified August 5, 2014, http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/Trans-Fats_UCM_301120_Article.jsp.

How the processed food industry creates addictive products that trick us into overeating: Kelly Crowe, “Food cravings engineered by industry,” CBC News, March 6, 2013, https://www.cbc.ca/news/health/food-cravings-engineered-by-industry-1.1395225.

Study on the Satiety Index of different foods: Holt SH, Miller JC, Petocz P, and Farmakalidis E, “A satiety index of common foods,” European Journal of Clinical Nutrition 49(9) (September 1995): 675-90, https://www.ncbi.nlm.nih.gov/pubmed/7498104.

Study on how salt causes overconsumption of food: Dieuwerke P Bolhuis, Andrew Costanzo, Lisa P Newman, and Russell SJ Keast, “Salt Promotes Passive Overconsumption of Dietary Fat in Humans,” The Journal of Nutrition Volume 146, Issue 4 (April 1, 2016), https://doi.org/10.3945/jn.115.226365.

The palatability of food increases hunger and food intake: Laurette Dube, Obesity Prevention: The Role of Brain and Society on Individual Behavior (Cambridge, Massachusetts: Academic Press, June 25, 2010).

How sweeteners are often added to farm animal feed in order to increase feeding intake: Caitlyn Merrill, “The evaluation of a flavor enhancer on intake and production of high producing, lactating dairy cows,” 2013, http://udspace.udel.edu/handle/19716/12967.

Study showing that bitter substances reduce appetite: Andreozzi P, Sarnelli G, Pesce M, Zito FP, Alessandro AD, Verlezza V, Palumbo I, Turco F, Esposito K, and Cuomo R, “The Bitter Taste Receptor Agonist Quinine Reduces Calorie Intake and Increases the Postprandial Release of Cholecystokinin in Healthy Subjects,” Journal of Neurogastroenterology and Motility 21(4) (October 1, 2015): 511-9, https://doi.org/10.5056/jnm15028.

Evidence that spicy foods can suppress appetite: Lisa Drayer, “Foods that can suppress appetite, aid weight loss,” CNN, last modified July 21, 2017, http://www.cnn.com/2017/07/21/health/food-suppress-appetite-drayer/index.html.

A review of the various classes of drugs that can cause weight gain: Ness-Abramof R, Apovian CM, “Drug-induced weight gain,” Drugs of Today (Barcelona) 41(8) (August 2005): 547-55, https://doi.org/10.1358/dot.2005.41.8.893630.

Statistics on video game players: Jane McGonigal, “We spend 3 billion hours a week as a planet playing videogames. Is it worth it? How could it be MORE worth it?” TED conversation, 2011, http://www.ted.com/conversations/44/we_spend_3_billion_hours_a_wee.html.

How many calories humans use to maintain body heat: Deborah T. Goldberg, Barron's AP Biology (Hauppauge, New York: Barron’s Educational Series, February 1, 2010).

Cold exposure can be just as effective as exercise: Jeremy Berlin, “To Burn Fat, You Could Exercise … or Shiver,” National Geographic, February 13, 2014, https://www.nationalgeographic.com/news/2014/2/140211-shivering-cold-exercise-brown-fat-white-fat-irisin-metabolism-weight-loss/.

Pain specialist Erv Hinds on the nature of pain and the effectiveness of pain treatments: Erv Hinds, A Life Larger Than Pain (New Mexico: Health Press, April 1, 2003).

Pain specialist Douglas Nelson on chronic pain: Douglas Nelson, The Mystery of Pain (London: Singing Dragon, 2013), 192.

Robin Williams on his fear, loneliness, and acceptance of both happiness and unhappiness: “Robin Williams: 'I was shameful, did stuff that caused disgust – that's hard to recover from',” The Guardian, September 20, 2010, http://www.theguardian.com/film/2010/sep/20/robin-williams-worlds-greatest-dad-alcohol-drugs.

Psychoanalyst Barbara Stevens Sullivan on how pain is integral to life: Barbara Stevens Sullivan, “The Clinical Hour as a Dream: A Feminine Perspective,” March 30, 2012, https://www.youtube.com/watch?v=1EhtG6_WoDE.

Buddhist Thich Nhat Hanh on how suffering and happiness are interdependent: Thich Nhat Hanh, No Mud, No Lotus (Berkeley: Parallax Press, December 2, 2014), 25;16.

The Jungian view that pain is an unavoidable and growth-promoting aspect of life: Barbara Stevens Sullivan, The Mystery of Analytical Work: Weavings from Jung and Bion (London: Routledge, November 11, 2009).

Teen Zach Richardson spends 15 hours a day playing video games: unknown, “Boy's daily 15-hour Xbox habit,” The Scottish Sun, August 25, 2010, http://www.thescottishsun.co.uk/scotsol/homepage/news/3111299/Boys-daily-15-hour-Xbox-habit.html.

Putting children and teens to work can be positive: International Programme on the Elimination of Child Labour (IPEC), “Child Labour,” 2008, http://www.ilo.org/ipec/facts/lang--en/index.htm.

Toddlers innate desire for salt and sweetness and how it shapes their eating habits: Daniel Schwartz, “Why toddler foods have so much sugar and salt,” CBC News, February 7, 2015, http://www.cbc.ca/news/health/why-toddler-foods-have-so-much-sugar-and-salt-1.2945353?cmp=googleeditorspick&google_editors_picks=true.

The French approach to teaching kids to eat almost anything: Adam McDowell, “Death to the chicken finger,” National Post, February 23, 2015, http://www.theprovince.com/health/Death+chicken+finger/10835982/story.html.

Addiction and relapse neural mechanisms: Harvard Medical School, “The addicted brain,” Harvard Mental Health Letter, July 2004, http://www.health.harvard.edu/mind-and-mood/the_addicted_brain.

Children and teens more likely to become dependent on marijuana, and often don’t connect its use to its negative impacts: The California Society of Addiction Medicine, “Impact of Marijuana on Children and Adolescents,” September 2009, https://cdn.ymaws.com/csam-asam.org/resource/resmgr/docs/white_papers/impactofmarijuanaonchildrena.pdf.

Cannabis effects and parental influence on children: Livia Gamble, “The drugs kids are actually using,” June 16, 2014, http://www.essentialkids.com.au/older-kids/teens/the-drugs-kids-are-actually-using-20140616-3a6z0.html.

The challenge of separating opiates’ analgesic and addictive properties: Howard L. Fields, “The Doctor's Dilemma: opiate analgesics and chronic pain,” Neuron 69(4) (February 24, 2011), http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3073133/.

Moderate alcohol drinking is linked to disease: Kevin Van Paassen, “We need to talk (about our drinking),” The Globe and Mail, June 29, 2014, http://www.theglobeandmail.com/life/health-and-fitness/health/we-need-to-talk-about-our-drinking/article19377132/?cmpid=rss1&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+TheGlobeAndMail-Front+%28The+Globe+and+Mail+-+Latest+News%29.

Jan Eastgate on the epidemic of psychiatric drugs: Jan Eastgate, “Psychiatry: Hooking Your World on Drugs,” accessed September 3, 2018, https://www.cchr.org/cchr-reports/psychiatry/introduction.html.

The prevalence and cost of major depression in Europe: Pauline Turner, Rakesh Kantaria, and Allan H Young, “A systematic review and meta-analysis of the evidence base for add-on treatment for patients with major depressive disorder who have not responded to antidepressant treatment: A European perspective,” Journal of Psychopharmacology Volume 28, issue 2 (October 9, 2013), https://doi.org/10.1177/0269881113507640.

The economic cost of the use and abuse of addictive substances: The American College of Preventive Medicine, “Use, Abuse, Misuse & Disposal of Prescription Pain Medication Clinical Reference,” The American College of Preventive Medicine, 2011, http://www.acpm.org/?UseAbuseRxClinRef.

Drop in salt intake leads to massive decrease in stroke and heart disease mortality in Finland: Karppanen H, Mervaala E, “Sodium intake and hypertension,” Progress in Cardiovascular Diseases 49(2) (2006 Sep-Oct): 59-75, https://doi.org/10.1016/j.pcad.2006.07.001.

The rewards of applying sudism

Mindfulness and pain-acceptance leads to reduced pain and disability: W. Jack Rejeski, “Mindfulness: Reconnecting the Body and Mind in Geriatric Medicine and Gerontology,” Gerontologist 48(2) (April 2008): 135–141, https://doi.org/10.1093/geront/48.2.135.

Final conclusion

Study on the link between alcohol and drug use and committing homicide: Jari Tiihonen, Martti Lehti, Mikko Aaltonen, Janne Kivivuori, Hannu Kautiainen, Lauri J. Virta, Fabian Hoti, Antti Tanskanen and Pasi Korhonen, “Psychotropic drugs and homicide: A prospective cohort study from Finland,” World Psychiatry 14 (June 4, 2015), https://doi.org/10.1002/wps.20220.

Co-pilot Andreas Lubitz deliberately crashed Germanwings Flight 9525: Joshua Berlinger, “German newspaper releases timeline of Germanwings flight before crash,” CNN website, last modified March 29, 2015, http://www.cnn.com/2015/03/29/europe/france-germanwings-plane-crash-main/.

APPENDIX: THE MANY KINDS OF PLEASURE AND PAIN

The many kinds of pleasure

Humans as infovores: Irving Biederman and Edward A. Vessel, “Perceptual Pleasure and the Brain,” American Scientist, 2006, http://www.cns.nyu.edu/~vessel/pubs/Biederman_Vessel_AmSci06.pdf.

Alison Gopnik on the pleasure of discovery and learning: Alison Gopnik, “Explanation as orgasm and the drive for causal understanding: The evolution, function and phenomenology of the theory-formation system” in Cognition and explanation, ed. F. Keil & R. Wilson (Cambridge, Massachusetts: MIT Press, 2000).

Food flavorists’ quest to make food addictive: Morley Safer, “The Flavorists: Tweaking tastes and creating cravings,” accessed July 14, 2015, http://www.cbsnews.com/news/the-flavorists-tweaking-tastes-and-creating-cravings-27-11-2011/.

The many drugs that negatively impact smell or taste: Rebecca Douglass and George Heckman, “Drug-related taste disturbance,” Canadian Family Physician 56(11) (November 2010): 1142–1147, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2980431/.

Anosmia symptoms and causes: United Kingdom National Health Service, “Anosmia,” accessed September 16, 2015, http://www.nhs.uk/conditions/anosmia/Pages/Introduction.aspx.

Dr. Robert Lustig on fiber and fructose’s impact on hunger: Robert H. Lustig, “Sugar: the bitter truth,” July 2009, http://www.uctv.tv/shows/Sugar-The-Bitter-Truth-16717.

Psychologist Paul Bloom on the many kinds and functions of pleasures: Paul Bloom, How Pleasure Works (New York: W. W. Norton Company, 2010).

Ecstasy drug’s various effects: The University of California, Santa Barbara, “Sex and Ecstasy,” SexInfo Online, last modified March 2, 2017, https://sexinfo.soc.ucsb.edu/article/sex-and-ecstasy.

The pleasures and pains of social interaction: Pascal Vrticka, “Evolution of the 'Social Brain' in Humans: What Are the Benefits and Costs of Belonging to a Social Species?” September 2013, http://www.huffingtonpost.com/pascal-vrticka/human-social-development_b_3921942.html.

Study on laughter’s role in bonding and pain relief: R. I. M. Dunbar, Rebecca Baron, Anna Frangou, Eiluned Pearce, Edwin J. C. van Leeuwin, Julie Stow, Giselle Partridge, Ian MacDonald, Vincent Barra, Mark van Vugt, “Social laughter is correlated with an elevated pain threshold,” Proceedings of the Royal Society B (September 14, 2011), https://doi.org/10.1098/rspb.2011.1373.

Marijuana’s short- and long-term effects: The Australian Drug Foundation, “Cannabis facts,” last modified February 6, 2015, http://www.druginfo.adf.org.au/drug-facts/cannabis.

Most antidepressants linked to anorgasmia: Robert Taylor Segraws, “Antidepressant-induced orgasm disorder,” Journal of Sex & Marital Therapy 21(3) (January 2008): 192-201, http://www.tandfonline.com/doi/abs/10.1080/00926239508404398.

Side effect rates for various drugs: Side Effect Resource (SIDER), “SIDER 4: Side Effect Resource,” accessed August 2015, http://sideeffects.embl.de.

Psychologist G. Marian Kinget’s views on pleasure and pain: G. Marian Kinget, On Being Human and Pleasure and Pain (Lanham: UPA, 1999).

Depression and anhedonia mechanisms: Bruce Goldman, “Why the thrill is gone: Scientists identify potential target for treating major system of depression,” July 11, 2012, https://med.stanford.edu/news/all-news/2012/07/why-the-thrill-is-gone-scientists-identify-potential-target-for-treating-major-system-of-depression.html.

Depression symptoms in children and teens: David Smith, “Part Three: Youth Dealing with Depression,” December 19, 2014, http://www.thefreepress.ca/lifestyles/286395181.html.

Jayne Bigelsen on how daydreaming overtook her life: Jayne Bigelsen, “When Daydreaming Replaces Real Life,” The Atlantic, April 2015, http://www.theatlantic.com/health/archive/2015/04/when-daydreaming-replaces-real-life/391319/.

Research into maladaptive daydreaming’s origins and functions: Eli Somer, “Maladaptive Daydreaming: A Qualitative Inquiry,” Journal of Contemporary Psychotherapy Vol. 32, Nos. 2/3 (Fall 2002), https://doi.org/10.1023/A:1020597026919.

Study indicating that the anticipation and recollection of a trip are usually better than the experience itself: Mitchell, T. R., et al, “Temporal adjustments in the evaluation of events: The ‘rosy view.’,” Journal of Experimental Social Psychology, 33, 421–448., 1997, https://www.sciencedirect.com/science/article/pii/S0022103197913330.

Study on the pleasure of anticipation: David E. Gard, Marja Germans Gard, Ann M. Kring, Oliver P. John, “Anticipatory and consummatory components of the experience of pleasure: A scale development study,” Journal of Research in Personality 40 (2006), https://doi.org/10.1016/j.jrp.2005.11.001.

Depression symptoms and its relation to chronic pain: The US National Institute of Mental Health, “Depression and Chronic Pain,” accessed December 31, 2014, http://www.nimh.nih.gov/health/publications/depression-and-chronic-pain/index.shtml.

The many kinds of pain

Restlessness as a side effect of antipsychotic drugs: Miller CH, Fleischhacker WW, “Managing antipsychotic-induced acute and chronic akathisia,” Drug safety 22(1) (January 2000): 73-81, http://www.ncbi.nlm.nih.gov/pubmed/10647977.

Akathisia (restlessness) induced by drugs: Stahl SM, Lonnen AJ, “The Mechanism of Drug-induced Akathisia,” CNS Spectrums. 2011 Jan 15 (January 15, 2011), https://www.ncbi.nlm.nih.gov/pubmed/21406165.

Lifestyle factors that may increase or decrease restless leg syndrome: The US National Institute of Neurological Disorders and Stroke, “Restless Legs Syndrome Fact Sheet,” September 2010, http://www.ninds.nih.gov/disorders/restless_legs/detail_restless_legs.htm.

Drugs that worsen restless legs syndrome: WebMD Medical Reference, “Restless Legs Syndrome,” last modified April 15, 2015, http://www.webmd.com/brain/restless-legs-syndrome/restless-legs-syndrome-rls?page=2.

Caffeine and sugar’s impact on restless legs syndrome: Melvyn R. Werbach, “Nutritional Influences on Illness,” Townsend Letter for Doctors and Patients, 2002, http://www.tldp.com/issue/179/restless_legs_syndrome.htm.

Chronic fatigue syndrome and fibromyalgia symptoms and treatment options: Jacob Teitelbaum, “CFS & Fibromyalgia,” 2015, https://secure.endfatigue.com/cfs-fibromyalgia/chronic-fatigue-syndrome-and-fibromyalgia.

The short- and long-term effects of caffeine: Jasvinder Chawla, “Neurologic Effects of Caffeine,” last modified June 14, 2018, http://emedicine.medscape.com/article/1182710-overview.

Lifestyle factors that can improve or worsen chronic fatigue syndrome: The UK National Health Service, “Chronic fatigue syndrome - Treatment,” last modified February 2015, http://www.nhs.uk/Conditions/Chronic-fatigue-syndrome/Pages/Treatment.aspx.

Study on mental resistance and fatigue in drug and alcohol users: S J Moeller, D Tomasi, J Honorio, N D Volkow, and R Z Goldstein, “Dopaminergic involvement during mental fatigue in health and cocaine addiction,” Translational Psychiatry 2(10) (October 2012): e176, https://doi.org/10.1038/tp.2012.110.

Article on mental fatigue: Samuele M. Marcora, Walter Staiano, and Victoria Manning, “Mental fatigue impairs physical performance in humans,” Journal of Applied Physiology Vol. 106 no. 3 (March 1, 2009), https://doi.org/10.1152/japplphysiol.91324.2008.

Discussion on mental fatigue: Rae Lynn Mitchell, “The body and the brain: The impact of mental and physical exertion on fatigue development,” June 12, 2015, https://news.tamhsc.edu/?post=texas-am-researcher-studies-the-impact-of-joint-mental-and-physical-fatigue.

Mental fatigue causes and associated symptoms: unspecified, “Mental fatigue or brain fatigue,” University of Gothenburg website, accessed September 10, 2015, http://mf.gu.se/english.

Opiate users on experiencing chills during withdrawal: Pema, comment on “Opiate Withdrawal Symptoms - What causes the Chills?” Drugs-Forum, March 23, 2012, https://drugs-forum.com/forum/showthread.php?t=180616.

Risk factors for menopausal hot flashes: The Mayo Clinic, “Hot flashes,” May 16, 2014, https://www.mayoclinic.org/diseases-conditions/hot-flashes/symptoms-causes/syc-20352790.

Lifestyle factors that can worsen hot flashes: The Cleveland Clinic Foundation, “Non-Hormonal Ways to Cope with Hot Flashes & Menopause,” 2013, http://my.clevelandclinic.org/health/diseases_conditions/hic-what-is-perimenopause-menopause-postmenopause/hic-non-hormonal-ways-to-cope-with-hot-flashes-and-menopause.

A drug treatment center director’s experience treating heroin addicts: Blake Herzog, “Inside Heroin: Initial euphoria quickly turns into pain,” November 23, 2014, http://www.yumasun.com/news/inside-heroin-initial-euphoria-quickly-turns-into-pain/article_be5fbe60-7391-11e4-b889-e732a6b78132.html.

Heroin users discuss the pains of withdrawal: Various contributors, comment on “Do you feel physical pain when taking Heroin?” Drugs-Forum, February 18, 2014, https://drugs-forum.com/forum/showthread.php?t=237606.

Temperature sensitivity causes and symptoms: Adrienne Dellwo, “Temperature Sensitivity in Fibromyalgia & Chronic Fatigue Syndrome,” last modified December 16, 2014, http://chronicfatigue.about.com/od/symptoms/p/Temperature-Sensitivity-In-Fibromyalgia-And-Chronic-Fatigue-Syndrome.htm.

Allodynia and chronic headache risk factors: Paolo Martelletti, Timothy J. Steiner, Handbook of Headache: Practical Management (Berlin: Springer Science & Business Media, August 14, 2011).

Causes of paresthesia: Mahdi Sharif-Alhoseini, Vafa Rahimi-Movaghar and Alexander R. Vaccaro, “Underlying Causes of Paresthesia,” February 2012, http://cdn.intechopen.com/pdfs-wm/29764.pdf.

The evolution of sweet, salty, sour, and bitter taste receptors: Ewen Callaway, “Evolutionary biology: The lost appetites,” Nature 486 (June 21, 2012): S16–S17, https://doi.org/10.1038/486S16a.

Food flavorists’ quest to make food addictive: Morley Safer, “The Flavorists: Tweaking tastes and creating cravings,” accessed July 14, 2015, http://www.cbsnews.com/news/the-flavorists-tweaking-tastes-and-creating-cravings-27-11-2011/.

The inner workings of the processed food industry: Eric Schlosser, Fast Food Nation: The Dark Side of the All-American Meal (Boston: Mariner Books, March 1, 2012).

Anosmia symptoms and causes: United Kingdom National Health Service, “Anosmia,” accessed September 16, 2015, http://www.nhs.uk/conditions/anosmia/Pages/Introduction.aspx.

The many drugs that negatively impact smell or taste: Rebecca Douglass and George Heckman, “Drug-related taste disturbance,” Canadian Family Physician 56(11) (November 2010), http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2980431/.

Medical description of phantosmia and parosmia: Landis BN, Frasnelli J, Hummel T, “Euosmia: a rare form of parosmia,” Acta Otolaryngol 126(1) (January 2006): 101-3, http://www.ncbi.nlm.nih.gov/pubmed/16308262.

Phantosmia symptoms, causes and risk factors: unspecified, “Phantosmia (smelling odours that aren't there),” accessed September 9, 2015, http://www.nhs.uk/conditions/phantosmia/Pages/Introduction.aspx.

The causes of increased appetite: Linda J. Vorvick, “Appetite - increased,” November 2014, http://www.nlm.nih.gov/medlineplus/ency/article/003134.htm.

Dyspnea causes and symptoms: Committee of the Nursing Assembly, “Dyspnea,” American Journal of Respiratory and Critical Care Medicine Vol. 159, No. 1 (1999), https://doi.org/10.1164/ajrccm.159.1.ats898.

Perception and mechanism of dyspnea: Nausherwan K. Burki and Lu-Yuan Lee, “Mechanisms of Dyspnea,” Chest 138(5) (November 2010): 1196–1201, https://doi.org/10.1378/chest.10-0534.

Causes of dyspnea (shortness of breath): Steven A. Wahls, “Causes and Evaluation of Chronic Dyspnea,” American Family Physician 86(2) (July 15, 2012): 173-180, http://www.aafp.org/afp/2012/0715/p173.html.

Overactive bladder syndrome symptoms and risk factors: Janine Arnold, Nicholas McLeod, Ruban Thani-Gasalam, Prem Rashid, “Overactive bladder syndrome,” Australian Family Physician Volume 41, No.11 (November 2012), http://www.racgp.org.au/afp/2012/november/overactive-bladder-syndrome/.

Interstitial cystitis symptoms, causes, and risk factors: The Mayo Clinic, “Interstitial cystitis,” January 2, 2014, http://www.mayoclinic.org/diseases-conditions/interstitial-cystitis/basics/definition/con-20022439.

Medical review on how most rectal and pelvic pains are of unknown origin: Giuseppe Chiarioni, Corrado Asteria, and William E Whitehead, “Chronic proctalgia and chronic pelvic pain syndromes: New etiologic insights and treatment options,” World Journal of Gastroenterology 17(40) (October 28, 2011): 4447–4455, https://doi.org/10.3748/wjg.v17.i40.4447.

The causes of nonulcer stomach pain: The Mayo Clinic, “Nonulcer stomach pain,” February 6, 2015, https://www.mayoclinic.org/diseases-conditions/functional-dyspepsia/symptoms-causes/syc-20375709.

The causes of functional dyspepsia: Brian E. Lacy and Michael P. Jones, “Dyspepsia,” International Foundation for Functional Gastrointestinal Disorders, Inc. (IFFGD), January 15, 2015, http://www.iffgd.org/site/gi-disorders/functional-gi-disorders/dyspepsia.

Risk factors for irritable bowel syndrome: The Mayo Clinic, “Diseases and Conditions—Irritable bowel syndrome,” July 31, 2014, https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-causes/syc-20360016.

How cluster headaches might be the worst pain humans can experience: Nick Kilvert, “Suicide headaches: How the failed war on drugs is perpetuating ‘the worst pain that humans experience’,” January 24, 2013, http://newsciencejournalism.com/01/2013/suicide-headaches-how-the-failed-war-on-drugs-is-perpetuating-the-worst-pain-that-humans-experience/.

High salt consumption linked to increased headaches: Joel Fuhrman, “High Salt Intake Linked to Headaches,” accessed June 24, 2015, http://www.drfuhrman.com/library/high-salt-intake-linked-to-headaches.aspx.

Study on the positive and negative effects of caffeine: Leeana A. Persad, “Energy Drinks and the Neurophysiological Impact of Caffeine,” Frontiers in Neuroscience 5 (October 21, 2011), https://doi.org/10.3389/fnins.2011.00116.

Gabrielle’s experiences with sugar leading to cluster headaches: Gabrielle, comment on “Pepsi,” November 5, 2012, https://www.clusterheadaches.com.au/forum_posts.php?id=2898.

Synthroid’s side effects: Rexall pharmacies, “Synthroid,” accessed August 27, 2015, http://www.rexall.ca/articles/view/2300/Synthroid.

Musculoskeletal pain causes, symptoms, and treatments: The Cleveland Clinic, “Musculoskeletal Pain,” 2014, http://my.clevelandclinic.org/health/diseases_conditions/hic_musculoskeletal_pain.

Osteoarthritis, low back pain, and fibromyalgia are only weakly correlated to physical abnormalities: Staud R, “Evidence for shared pain mechanisms in osteoarthritis, low back pain, and fibromyalgia,” Current Rheumatology Reports 13(6) (December 2011): 513-20, https://doi.org/10.1007/s11926-011-0206-6.

Pain specialist Douglas Nelson on chronic pain: Douglas Nelson, The Mystery of Pain (London: Singing Dragon, 2013), 176.

Lifestyle risk factors for menstrual pain: Karen van Rensburg, “Managing dysmenorrhoea in the pharmacy,” South African pharmaceutical journal Vol. 78 No 1 (2011), https://journals.co.za/content/mp_sapj/78/1/EJC82496.

Debby Anglesey’s experience with MSG triggering headaches and asthma: Debby Anglesey, “Deb’s Own MSG Story,” accessed June 24, 2015, https://www.msgmyth.com/msg-story.

Various MSG sensitive individuals share their experiences with MSG: Various authors, “MSG ‘Victims’ Share Stories,” accessed June 24, 2015, https://www.msgmyth.com/msg-and-illnesses.

Therapist Frank Gresham’s thoughts on sugar and chronic pain: Frank Gresham, “Chronic Pain: Sugar Will Cause Chronic Pain,” online YouTube video, April 10, 2011, https://www.youtube.com/watch?v=CTCwrnE-PzU.

Individuals discuss how sugar affects their arthritis pain: Various contributors, comment on “Do you find that sugar affects your arthritis pain?” SparkPeople, 2011, http://www.sparkpeople.com/myspark/team_messageboard_thread.asp?board=0x4663x10570954.

Hyperacusis description, causes, and risk factors: David M Baguley, “Hyperacusis,” The Journal of the Royal Society of Medicine 96(12) (December 2003): 582–585, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC539655/.

How hyperacusis (sensitivity to sound) is common in migraines: Timothy C. Hain, “Migraine Associated Vertigo (MAV),” The American Hearing Research Foundation website, last modified October 2012, http://american-hearing.org/disorders/migraine-associated-vertigo-mav/.

The WHO on music’s impact on hearing: James Gallagher, “Cut music to 'an hour a day' - WHO,” BBC News, February 27, 2015, http://www.bbc.com/news/health-31661789.

Tinnitus causes and risk factors: The Mayo Clinic, “Tinnitus,” accessed September 9, 2015, https://www.mayoclinic.org/diseases-conditions/tinnitus/symptoms-causes/syc-20350156.

Tinnitus and hyperacusis causes and therapy: Canadian Hearing Society, “Tinnitus and Hyperacusis,” November 14, 2013, https://www.chs.ca/tinnitus-and-hyperacusis.

The many causes of chest pain: Satish S. C. Rao, “Diagnosis and Management of Esophageal Chest Pain,” Gastroenterology & hepatology (New York) 7(1) (January 2011): 50–52, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3038318/.

Neuralgia symptoms and causes: The Victorian Government, “Neuralgia,” last modified January 2015, https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/neuralgia.

Atorvastatin’s side effects: The American Society of Health-System Pharmacists, Inc., “Atorvastatin,” accessed June 29, 2015, http://www.nlm.nih.gov/medlineplus/druginfo/meds/a600045.html.

Dr. Daniel J. Clauw on the causes and treatments of chronic pain: Daniel J. Clauw, “Chronic Pain - Is it All in Their Head?” December 5, 2013, https://www.youtube.com/watch?v=pgCfkA9RLrM.

Idiopathic otalgia diagnosis: John W. Ely, Marlan R. Hansen, and Elizabeth C. Clark, “Diagnosis of Ear Pain,” American Academy of Family Physicians 77(5) (March 1, 2008): 621-628, https://www.aafp.org/afp/2008/0301/p621.html.

The evolutionary purpose of itching: Michael D. Lemonick, “Solved! The Mystery of the Maddening Itch,” May 23, 2013, https://science.time.com/2013/05/23/solved-the-mystery-of-the-maddening-itch/.

The various causes of itching: Roger Dobson, “Got an itch?: Experts baffled by the urge to scratch,” March 4, 2008, http://www.independent.co.uk/life-style/health-and-families/features/got-an-itch-experts-baffled-by-the-urge-to-scratch-790838.html.

Psychologists on the human drive for social relationships: Hara Estroff Marano, “The Dangers of Loneliness,” July 1, 2003, https://www.psychologytoday.com/articles/200308/the-dangers-loneliness.

Psychology research on well-being: Well-Being: The Foundations of Hedonic Psychology, ed. Daniel Kahneman, Ed Diener, Norbert Schwarz (New York: Russell Sage Foundation, 1999).

Alcohol hangover symptoms: The Mayo Clinic, “Hangovers Symptoms,” Mayo Clinic, last modified December 16, 2017, https://www.mayoclinic.org/diseases-conditions/hangovers/symptoms-causes/syc-20373012.

Marijuana’s short- and long-term effects: The Australian Drug Foundation, “Cannabis facts,” last modified February 6, 2015, http://www.druginfo.adf.org.au/drug-facts/cannabis.

The short- and long-term effects of cocaine: Harvard University Office of Alcohol & Other Drug Services, “Cocaine,” 2020, https://aods.harvard.edu/cocaine.

Study of maladaptive fantasizers: Jayne Bigelsen, Cynthia Schupak, “Compulsive fantasy: Proposed evidence of an under-reported syndrome through a systematic study of 90 self-identified non-normative fantasizers,” Consciousness and Cognition Volume 20, Issue 4 (December 2011), https://doi.org/10.1016/j.concog.2011.08.013.

The withdrawal symptoms of cigarette smoking: Breslau N, Kilbey MM, Andreski P, “Nicotine withdrawal symptoms and psychiatric disorders,” 1992, https://www.ncbi.nlm.nih.gov/pubmed/1554030.

Those with depression or PTSD tend to suffer from recurring painful memories: Harvard Health Publishing, “Forgetfulness — 7 types of normal memory problems,” last modified May 24, 2017, https://www.health.harvard.edu/healthbeat/forgetfulness-7-types-of-normal-memory-problems.

Study on how anticipation of pain can worsen existing pain: Alexander Ploghaus, Irene Tracey, Joseph S. Gati, Stuart Clare, Ravi S. Menon, Paul M. Matthews, J. Nicholas P. Rawlins, “Dissociating Pain from Its Anticipation in the Human Brain,” Science Vol. 284, Issue 5422 (June 18, 1999), https://doi.org/10.1126/science.284.5422.1979.

The differences between everyday anxiety and anxiety disorders: The Anxiety and Depression Association of America, “Understanding the facts of anxiety disorders and depression,” last modified May 2014, http://www.adaa.org/understanding-anxiety.

Depression symptoms in children and teens: David Smith, “Part Three: Youth Dealing with Depression,” December 19, 2014, http://www.thefreepress.ca/lifestyles/286395181.html.

Depression symptoms and its relation to chronic pain: The US National Institute of Mental Health, “Depression and Chronic Pain,” accessed December 31, 2014, http://www.nimh.nih.gov/health/publications/depression-and-chronic-pain/index.shtml.

Side effect rates for various drugs: Side Effect Resource (SIDER), “SIDER 4: Side Effect Resource,” accessed August 2015, http://sideeffects.embl.de.

Drug Singulair’s potential side effects: Merck, “Singulair—Highlights of Prescribing Information,” last modified April 2020, https://www.merck.com/product/usa/pi_circulars/s/singulair/singulair_pi.pdf.

Review of evidence that anxiety disorder and alcohol disorder can each cause the other: Matt G Kushnera, Kenneth Abramsa, and Carrie Borchardta, “The relationship between anxiety disorders and alcohol use disorders: A review of major perspectives and findings,” Clinical Psychology Review Volume 20, Issue 2 (March 2000), https://doi.org/10.1016/S0272-7358(99)00027-6.

Overview of Generalized Anxiety Disorder: The Anxiety and Depression Association of America, “Generalized Anxiety Disorder (GAD),” last modified June 2015, http://www.adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad.

Overview of Social Anxiety Disorder: Canadian Mental Health Association, British Columbia Division, “Social Anxiety Disorder,” 2013, http://www.cmha.bc.ca/get-informed/mental-health-information/social-anxiety-disorder.

Overview of panic disorder: The US National Institute of Mental Health, “Anxiety Disorders,” accessed June 8, 2015, http://www.nimh.nih.gov/health/topics/panic-disorder/index.shtml.

GLOSSARY

Addiction: A habit formed by one or more exposures to an indulgent stimulus. The more rewarding the indulgence, the stronger the degree of addiction. Contrast with phobia.

Affect: Any pleasant sensation (positive affect) or unpleasant sensation (negative affect). The absence of both is called neutral affect. Includes both emotional and physical sensations.

Affective pulse: An individual’s affects as they change from moment to moment.

Alignment: For a given event or activity, the degree to which the amount of positive effect matches the amount of health benefits it provides, or the degree to which the amount of negative effect matches the amount of health costs it incurs. Aligned events and activities generate a positive (or negative) effect in us that is proportional to the health benefits they provide (or the health costs they incur).

Analgesia: Feeling less pain than one naturally should for a given activity or event, typically due to medication or other drugs. Compare with anhedonia and unhealthy pain.

Anhedonia: Feeling less pleasure than one naturally should for a given activity or event, typically as a side effect of overindulgence. Compare with analgesia and unhealthy pleasure.

Blending: The way that pleasant and unpleasant sensations offset each other when they happen at the same time. Stronger sensations generally neutralize weaker ones.

Body fear: Physical pains that do not represent actual tissue damage, but rather the body’s anticipation (fear) of potential upcoming damage.

Depression: An episode consisting of a mixture of various unhealthy pains as well as anhedonia.

Fairy-tale happiness: The hypothetical ability to feel significant pleasure and only minimal pain for several months or longer.

The Great Indulgence: The tremendous increase in the variety, availability, and intensity of indulgences worldwide.

The Great Suffering: The tremendous increase in the amount of chronic physical and emotional pains suffered worldwide.

Health: The combination of physical, intellectual, social, emotional, and sexual health at the individual, family, community, and global level.

Health benefit: Any improvement to physical, cognitive, social, sexual, or emotional health provided by a given event or activity.

Health cost: Any cost to physical, cognitive, social, sexual, or emotional health incurred by a given event or activity.

Healthy craving: A desire for a healthy (aligned) thing at a healthy frequency.

Healthy pain: Pain that roughly aligns with the actual or potential health costs it represents.

Healthy pleasure: Pleasure that roughly aligns with the actual or potential health benefits it represents.

Hedonic adaptation: The long-term tendency for our happiness to always return to the same level, regardless of any positive or negative life changes.

Hedonism: The pursuit of the most pleasure and the least pain for oneself, regardless of how it impacts others. Compare with utilitarianism.

Hyperstimulation: An unnaturally high degree of stimulation, whether visual, auditory, tactile, or otherwise. Often comes from prepackaged entertainment.

Induced effect: A positive or negative effect that we deliberately cause. Opposite of non-induced effect.

Indulgence: An activity that causes much more pleasure than it provides health benefits, or causes much less pain than it incurs in health costs.

Indulgence load: The cumulative amount of all indulgences an individual partakes in over a given period of time.

Long-term happiness: The ability to feel more pleasure than pain during a period of several months or longer. Compare with momentary happiness and short-term happiness.

Momentary happiness: Feeling pleasure of any kind in a given moment. Compare with short-term happiness and long-term happiness.

Negative effect: An increase in pain or a reduction of pleasure. Can be induced or non-induced.

Neutrality: The absence of all pain and pleasure in an individual for a given period of time.

Non-induced effect: A positive or negative effect that we experience but did not deliberately cause. Opposite of induced effect.

Pain: Any unpleasant sensation or feeling, regardless of type, intensity, or duration. Includes emotional suffering and physical pain. Can be either healthy or unhealthy pain.

Pain signature: The tendency for each of us to experience our own personalized combination of painful feelings when we have to endure unhealthy pain due to high negative tension. This combination tends to differ between individuals, but tends to stay consistent over time for the same individual.

Phobia: A strong aversion to something, which may be instinctive or formed by one or more exposures to a highly-unpleasant stimulus. Contrast with addiction.

Pleasure: Any pleasant feeling or sensation, regardless of type, intensity, or duration. Includes pleasant emotions and physical sensations. Can be either healthy or unhealthy pleasure.

Positive effect: An increase in pleasure or a decrease in pain. Can be induced or non-induced.

Realignment: The process of deliberately changing the events and activities in our lives from being less aligned to being more aligned, in order to reduce our unhealthy pains.

Savourizer: Any additive that enhances the savoury flavour of food, including sodium and monosodium glutamate (MSG).

Short-term happiness: Feeling more pleasure than pain over a period of minutes, hours, or days. Compare with momentary happiness and long-term happiness.

Sudism: The belief in suduality and the application of its related principles.

Sudist: One who believes in and practices sudism.

The sudist sword: The double-edged sword motif consisting of the positive (+) and negative (-) symbols combined, which represents sudism.

Sudology: The application of sudist principles to diagnose and treat affective disorders such as chronic pain, anxiety, or depression.

Sudologist: A health care practitioner that practices sudology, potentially in combination with other health care modalities.

Suduality: The hypothetical force that keeps pleasant and unpleasant sensations in balance within each individual over time.

Sudumeter: A hypothetical device that can precisely measure the affect of an individual over time. This device does not exist as of this writing.

Superstimulus: Any artificial or altered thing that is more attractive or pleasant than its natural counterpart.

Sustained misery: The hypothetical ability to feel significant pain but very little pleasure during a period lasting several months or longer.

Tension: The probability that an individual will feel more pain in the short-term future (negative tension), or more pleasure (positive tension), or neither (neutral tension). This tension is theoretically governed by the entire sum of that individual’s past pleasures and pains.

Unblended pain: A single, specific form of pain that is not blended with any other pleasant or unpleasant feelings.

Unblended pleasure: A single, specific form of pleasure that is not blended with any other pleasant or unpleasant feelings.

Unhealthy craving: A desire for a healthy thing at an excessive frequency, or for an unhealthy thing regardless of frequency.

Unhealthy pain: Pain that doesn’t correspond to actual or potential health costs. When an instance of pain far exceeds the associated health costs, the sensible portion of pain is considered healthy and the rest of it is considered unhealthy. Compare with healthy pain and analgesia.

Unhealthy pleasure: Pleasure that doesn’t correspond to actual or potential health benefits. When an instance of pleasure far exceeds the associated health benefits, the sensible portion of pleasure is considered healthy but the rest of it is considered unhealthy. Compare with healthy pleasure and anhedonia.

Utilitarianism: The pursuit of the most pleasure and the least pain for the greatest number of people. Compare with hedonism.

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