S1 Episode 3: Madly in Love

Dr. Helen Fisher, one of the world’s foremost authorities on love, explains what happens in the brain when we experience romantic or sexual attraction, how that changes in long-term relationships, and why anti-depressants can make you fall out of love with your spouse.

Dr. Stieg: You know when you meet someone and the chemistry is right, but feeling those butterflies and hearing the bells isn’t really happening in your heart. It’s because of hormones and neurotransmitters acting up in the brain, which, as a neurosurgeon, is the sexiest organ in the body. Our guest today has taken the study of love and relationships to a new level of science. Dr. Helen Fisher is a senior research fellow at The Kinsey Institute and Chief Scientific Officer to match.com. She has written several books on the evolution, biology and psychology of human sexuality covering the neural chemistry of romantic love and attachment, including the anatomy of love. Dr. Fisher, thank you for joining me today.

Dr. Fisher: I’m delighted to be with you. Thank you for having me.

Dr. Stieg: One of the things you’re most known for is using brain scans of people in various stages of love. Can you describe this research and the neuro activity taking place when we feel that proverbial spark?

Dr. Fisher: You know, I really wanted to know what it was. I mean, people will say, you know, we have chemistry or we don’t have chemistry. And I thought, Oh, what does this mean? I think we’re talking about romantic love. As you know, Phil, I think we’ve evolved three distinctly different brain systems for mating and reproduction, sex drive, feelings of intense romantic love and feelings of deep attachment to a partner. So I think what we’re talking about is that spark of romantic love, not that feeling of attachment. So that’s what I was studying in the brain. And the first thing I did is I actually went through the last, I dunno, 50 years of of biological and social literature, trying to figure out what the main characteristics of romantic love actually are. So once I’d figured that out, what I started doing is I would first interview people for a long period of time.

Dr. Fisher: I mean, you know, as you know very well, these machines are expensive and it’s very time consuming. The first brain scanning study we did was of 17 people who had just fallen happily in love. They were madly in love. And what we found in the brain was activity along a whole pathway of the dopamine system in the brain. But most important was activity in a tiny little factory near the base of the brain in the midbrain called the ventral tegmental area or the VTA. And that brain region actually makes dopamine it and then sends dopamine to many brain regions. And that’s what gives you the focus, the energy, the motivation, the craving, the obsession of intense romantic love. So we ended up finding that romantic love was drive. You know, I had always thought that with all kinds of cognitive processes you, that we think all kinds of things when we’re mad and we feel all kinds of things, lots of emotions, a roller coaster of emotions. But what all these people had in common was activity in this VTA linked with drive. And as a matter of fact, this brain region actually lives very close to brain regions that orchestrates thirst and hunger. So it began to occur to me. My gosh, this has been an ancient drive that evolved millions of years ago in order to enable our, our former relatives. And certainly today giving us the ability to focus on a particular individual, crave that person, be obsessed with that person, think constantly about that person and start the mating process.

Dr. Stieg: I presume that there are animal studies and maybe even humans that have had some kind of a stroke or an injury to this ventral tegmental area to corroborate the fact that if you lose that area, there is a change in that emotional spark.

Dr. Fisher: I don’t know of studies like that. The problem is that this brain region sends out dopamine under lots of circumstances. So it’s not just romantic love, but it is central to the romantic love experience. And by the way, interlink link with all the addiction centers too. And we also found activity in another little factory down near there called the nucleus accumbens. That factory becomes active with all of the substance abuse and with all of the behavioral addiction. So it’s not just the VTA, but it’s a whole combination of factories way down in the base of the brain that create the intense feeling of romantic love. But to answer your question, I think it’s a very important one. There certainly are animal studies that show that other creatures, when they become very intensely interested in in another that the same brain region becomes active.

Dr. Fisher: I mean the same dopamine system becomes active. As a matter of fact, I think that romantic love evolved out of something that I call animal attraction. And so you know when a, an elephant comes in, a female elephant comes into estrus, she doesn’t go with all the males. She locks onto one of them and focuses on them and for about five days they snuggle up and pat each other with their trunks. They show all kinds of sort of affiliative behavior. You can see it in all kinds of animals. I’ve read about over a hundred species, but they have found under — in two species: sheep and in little prairie voles like a field mouse that when a female or a male becomes extremely attracted to a specific other partner that use — find the same kind of activity in the same basic region. So we do have some animal studies now showing that the dopamine system is this particular pathway, becomes active not only in human beings, but in other animals.

Dr. Fisher: The real difference is that in other animals, they’re not composing poems and songs and stories and operas and plays and ballets

and have myths and legends. And love magic that humans do because of course we’ve evolved this big cerebral cortex. And of course they don’t feel romantic love for as long as we do. I’ve done studies that found that some people can remain in love, not as loving, but in love with a partner for two to five years. And in some partnerships it’ll keep coming back. That feeling will keep coming back for years and years into the relationship. And of course when a prairie vole or a sheep becomes instantly attracted, it only could be for 30 seconds or you know, five days depending on the species. So what we’ve evolved is a much stronger feeling, a much longer duration of the feeling. And of course with our big cerebral cortex, enormous number of artifacts that come from this basic feeling. All of our poems, stories, et cetera.

Dr. Stieg: Well, so what I found interesting in your book is that you stated that individuals that have that long term attraction, the same area lights up almost equivalently. And talking about the three separate stages that we go through when we connect with someone and move forward in a relationship, you referred to it earlier, the romantic, the sexual drive and the bonding. What happens during those stages?

Dr. Fisher: Well, actually, you know, I’m not even sure I would call them stages. I just really think that they are brain systems. So for example, you can fall madly in love with somebody before you’ve ever had sex with them. You can feel deeply attached to somebody in the office or in college or in your social circle and years later you fall madly in love with them. Or you can start with having sex with somebody and then trigger feelings of attachment. Or you can start having sex with somebody and then move into feelings of mad, romantic love. So I see them more as brain systems than as stages. But I do think that eventually people do settle down into a sense of real deep attachments and these three brain systems really are different. They interact with each other, but the sex drive really emanates from activity in the hypothalamus and the feelings of attachment to a partner is linked with feelings of cosmic union. They’re different feelings. You behave differently, you think differently, you respond differently to the person and of course with each one of those different kinds of feelings, you’re going to have different brain activity. So these three brain systems really are distinct. I think that most people can pretty easily distinguish between whether they are in love with somebody or whether they just want to sex with somebody, that kind of thing. Or whether they feel deeply attached. We have the feeling that we, we know what we’re feeling when we feel romantic love. It’s very distinctive feeling.

Dr. Stieg: Is this a little bit like the Kübler-Ross death and dying? Can you have a longterm relationship and skip or omit one of those three phases?

Dr. Fisher: Yes. As a matter of fact, I have run into three people. All three of them came up to me, two men and one woman and they all said, you know Helen, I never understood this feeling of romantic love. All three were happily married, all three had adult children. All three basically said, you know, I never got it. But you know, when I read Romeo and Juliet in college, why would you do that? But all three of them in their fifties fell madly in love with somebody other than their spouse. And all three of them said to me, now I get it. Now I understand what you’re talking about. All three of them stayed in their marriage. They went, all three of them went maybe a couple of years into the romantic love and then left that relationship. And it was always secret in all three cases and went back to a full relationship with their spouse.

Dr. Fisher: So there’s some people who feel it all the time, fall in love quite regularly. Other people who have only fallen in love a couple of times in their lives. Men fall in love more often than women do. And I think because they’re so visual and they also fall in love faster than women do because they’re so visual and men are two and a half times more likely to kill themselves when a relationship is over. So, you know, I’ve been trying to tell the women’s magazines for, I don’t know, 30 years that men love and indeed they’re very passionate, not only in America, but everywhere I’ve looked in the world.

Dr. Stieg: Clearly love is an emotional interaction, but it really helps to demystify some and debunk some of the stories that people throw around and really gives credibility to the way an individual may feel about or towards another individual. When did you first get curious about the biology of love?

Dr. Fisher: First of all, I’m an identical twin and I thought to myself, if there’s any part at all of human behavior and feelings that could have a genetic and biological component, it must be in our realm of love because as Darwin said, if you have four children and I have no children, you live on and I die out. So the game of love matters. It matters to survival. And I thought to myself, well, maybe this is something that must have evolved and have some genetic and hormonal and components to it. I did not start with romantic love. I started the fact that we are an animal that forms pair bonds. You know, 97% of mammals do not pair up to rear their young and people do. And I want to know why the human female lost a period of heat, why we can copulate all month long, and why we form pair bonds, monogamy — mono means one and gamy means spouse. It doesn’t mean a fidelity to rear our young. And then one day I was walking along in Greenwich Village by myself. I remember exactly what time it was of day and it was at 3:00 PM in an autumn afternoon. And I thought to myself, Hmm, if we’re an animal that’s driven to form these pair bonds, and I’ve certainly felt romantic love many times, maybe I could look into the brain and see what the brain chemistry is all about. And of course I didn’t know much neuroscience. They don’t teach that in graduate school, in anthropology. So the first thing I did is I bought an awful lot of books on the brain. I love brain architecture and physiology. So it was very easy for me to just pour into that. And then I began to think, well, I’ll put people in brain scanners and see what I can find.

Dr. Stieg: You mentioned it earlier about love being a little bit like an addiction and I often marvel at individuals that have been married four or five times. How they have the capability and the endurance to do that, just falling in love. Does it trigger the same brain activity as an addiction?

Dr. Fisher: Yes it does. And in fact, you know, having finished my first brain scanning study of people who are happily in love, I began to think to myself, you know, who cares about this? I mean, this is always a lovely thing if the other present returns the love and it works out. The real problem for the individual, for the family and for society at large is when people get dumped because that’s when they dock us, up in the clinical depression and kill themselves or even kill somebody else. So I began putting rejected people into the scan and we put 15 people into this scanner. It was then that I began to think, this has got to be an addiction. It’s got so many of the traits of addiction. The obsessive thinking about it is a lot like drug addiction. They — the willingness to do dangerous and inappropriate things to get your drug, which is the person, your willingness to change where you live, where you work, all kinds of problems. I mean, when you’re rejected in love, boy, what people will do is incredible. So when I, I thought to myself, okay, maybe we’ll see in the brain activity in some of the basic brain regions that are associated with all of the addictions, all of the substance addictions like cocaine and heroin and alcohol and nicotine and all of the behavioral addictions like gambling or food addiction. So anyway, I started looking in the main factory in the brain, also close to the, in the basal ganglia, which is something you would know of course. But, uh, near the base of the brain, I find activity in particular brain region called the nucleus accumbens. And that brain region becomes active in all people who are addicted either to a substance or a behavioral addiction. And then we went back to our people who were happily in love and sure enough, by a different mathematical mechanism, we were able to establish the same brain region linked with addiction. The nucleus accumbens becomes active not only when you’re rejected in love, but also when you’re happily in love. So actually I’m trying to change our understanding of addiction. I think there are some addictions that evolve for reproductive evolutionary reasons. And so I think romantic addiction can be perfectly wonderful when you’re madly in love with somebody and it’s returned, and to see appropriate person and perfectly horrible when you’ve been dumped.

Dr. Stieg: What will be interesting is we are developing surgical techniques for refractory addictions and in thinking about it, we’ll also have to then look at how those patients respond to love situations in the future.

Dr. Fisher: That’s really interesting because one of the things that I worry about, and you’re a neurosurgeon, so I wrote a piece for the MIT Press for a book in which I suggested — hypothesized that these are all the people that are taking these SSRIs, serotonin boosters, everything from the older ones like Prozac and Paxil to the newer ones like Lexapro. They’re driving up the serotonin system in the brain. Generally, most of the academic literature indicates that when you drive up the serotonin system you are, it’s a kind of negative correlation with the dopamine system. You’re driving down the dopamine system and perhaps dampening your ability to feel intense romantic love, and I wrote this article about it and once a week I get a call or an email from somebody around the world who’s read that article says, you know how, “I was madly in love with her? We were been married 11 years. We’ve got two small boys. She wasn’t doing well in school. Doctor gave her an SSRI driving up the serotonin system and six months later she came and she said, I’m not in love with you anymore.” You know, these drugs do dull the emotions, which is perfectly good. It’s important to do if you, if you’re really struggling, but the problem is people stay on them and I really do worry that that is going to dampen their feelings of romantic love. So when you do your experiments, it will be very interesting to see if you kill some of the addictive process to one kind of drug like alcohol or nicotine, you’re going to also dampen a person’s possibilities to fall in love or stay in love.

Dr. Stieg: That’s why I think it’s so important when people are being treated with polypharmacy for their psychological issues that they really need to work with the neuropsychopharmacologists who who I believe understands best the interactions and implications of taking those drugs.

Dr. Fisher: I completely agree with you. I had a girlfriend who, she’s been married for 50 years and you know she got a bad burn in her kitchen and she was in the hospital for almost a month and they then gave her all these SSRI and she said to me, she said, you know, I don’t want to have sex with my husband anymore. I don’t really care about him anymore, and I was able to inform her, at the very least, I think doctors could say, keep an eye on, for a change in your feelings, for your partner and for your children and for your job and for your parents instead of keeping an eye on the fact that, I mean we may be killing this addiction to nicotine, but you got to make sure you’re not also killing your addiction to a sweetheart.