As the title indicates, this book attempts to explain how true satisfaction can be achieved. The author, who is a psychiatrist and neuroscientist, puts forward the thesis that the way in which the brain's striatum operates and the nature of its relationship with the neurotransmitter dopamine indicate that it is not pleasure per se which is the dominant human drive. His research has made him think that satisfaction is derived from one of two things: novelty or being in "flow". The latter concept, made famous by Mihaly Csikszentmihaly in his book Flow: The Psychology of Optimal Experience, is essentially an argument that we humans derive our greatest satisfaction when we are faced with a challenging experience where our skills are just able to cope. Anything less challenging would not satisfy us and anything so much more challenging as to be beyond our ability to cope would be merely frustrating. The book then details a series of mostly autobiographical experiences to illustrate how novelty or flow can be a source of satisfaction.

There is a chapter on money based on research into lottery winners which the author uses to suggest that it is not money in itself that gives satisfaction but rather the possibilities for novelty which it provides. Then there is a chapter on puzzles and jokes which he uses to illustrate both the satisfaction deriving from the 'aha!' moment of a joke and the sense of flow, and thus satisfaction, which arises from the challenge faced by highly skilled crossword solvers when faced with the world's toughest crossword puzzles. Another chapter is dedicated to food and how satisfaction can be obtained from new tastes and the novelty of multi-sensory gustatory experiences. A whole chapter is derived from what many think of as one of the darkest periods in the history of psychiatry — the era of the anesthesia-free frontal lobotomy. The author uses the 1950s work of Robert Heath (who inserted numerous deep-brain electrodes into his patients) to show that the brain craves for novelty. The following chapter picks up on a by-product of Heath's work — that the gap between pleasure and pain can be extremely small. By looking at the aficionados in an S and M club and by following this up with a bit of self-inflicted research, the author shows that stress-induced cortisol linked with novelty-stimulated dopamine can produce intense satisfaction. Continuing with this theme, the next chapter looks at ultramarathon runners and the satisfaction they derive from a combination of pain overcome and an almost unachievable challenge met. The penultimate chapter is a truly strange excursion into Restless Leg Syndrome and the wonders of Iceland's impressive genealogical records. Most of this chapter is spent deep in Icelandic mythology — so deep that it is difficult to see how this links up with the book's thesis. The final chapter looks at sex and how reinvention is the only way for long-term partners to achieve the novelty necessary to keep the spark alive. The author argues that failure to achieve novelty within a relationship will lead either to the relationship becoming atrophied or to the search for novelty outside the relationship.

The epilogue provides a useful summary — the release of dopamine and cortisol, which is triggered by novel and "flow" experiences, is the key to satisfaction. Pleasure on its own is not the key because, like the drug-user, one is always having to up the dose to get the same amount of pleasure as before.

The book has a good index and excellent end-notes. It is well-written but it comes over as one of those popular science books which titillate the reader by introducing a possibly worthwhile idea while never producing any truly clinching proof. Some of the excursions — like the Icelandic mythology chapter — serve only to muddy the already murky waters of the argument. In conclusion, this book is either a "riveting narrative, filled with humor and wisdom" (dust jacket blurb) or a rather indulgent ramble: I leave it to the reader to decide.

© 2007 Kevin M. Purday

Kevin M. Purday, Principal of the Shanghai Rego International School

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