Article
Comment
Joy
Psychology
5 min read

Dopamine-ing ourselves dilutes the real power of joy

Ditch being happy all the time.

Natalie produces and narrates The Seen & Unseen Aloud podcast. She's an Anglican minister and a trained actor.

Cartoon character Joy looks up with arms held open.
Inside Out's Joy.
Disney.

As I write this, I’m looking out of my window at endless grey. It has been raining almost constantly for several days. The garden is waterlogged, the apples are going mouldy on the tree and my dog, who has just come in, is sitting next to me and smelling of, well, wet dog. And it all looks pretty gloomy.  

One of my most climbed upon soap boxes is the oppressive myth of our age/western culture that we are all supposed to be happy all the time. If we’re not living our best life and posting photos of our happiness on social media, then shame on us. There seems to be a socially acceptable dopamine addiction running rampant – each swipe, like and tweet feeding our habit. 

As someone who lives with the albatross of depression weighing constantly around my neck, I find this compulsory pursuit of very public happiness somewhat trying. And call me Eeyore if you will, but I’d like to point out that sometimes it rains and there isn’t a rainbow. Just puddles. 

There is a place for sorrow and disappointment and frustration in real life, and dopamine-ing ourselves out of those experiences dilutes the real power of joy. 

I haven’t watched the new Inside Out film yet (See Henna Cundill’s great article on it) but the first one is a firm family favourite. It’s so deeply insightful and brilliantly unDisney. For anyone who hasn’t watched it yet, it’s a Disney animation of the adventures of the five core emotions (Fear, Anger, Joy, Disgust and Sadness) belonging to a young girl coping with moving with her parents to live in a new city. 

Happiness is candy floss and joy is a strong cup of tea. 

The main character is Joy. And she’s all about the happy. She refuses to allow Riley (the girl whose emotions they are) to be anything but happy. And that’s the set-up of the film. Joy fighting against the odds to keep Riley happy, even when she’s going through some really tough life stuff. And by the end of the film, it’s Joy who has grown because she recognises that Sadness has an important role in Riley’s life and that when Sadness takes the lead, Joy can join in, honestly, unsentimentally and sincerely. 

I can’t tell you how much I enjoyed seeing Joy’s bouncy, oppressive positivity being acknowledged as really annoying.  

The real strength of the film is that Joy grows from a character that I would call Happy into real Joy. Because, based on no good reasons at all, I have always thought of Joy as a more mature relative to happiness. To me, happiness is lighter, frothier and joy has greater depth and robustness. Happiness is candy floss and joy is a strong cup of tea. Happiness is still naïve while joy has been around the block a few times yet still hangs in there. Happiness is a powerful feeling that eclipses all else. Joy is mature enough to be in the same room as Sadness. 

You see, I also think of joy as a choice, not just a happy feeling. Like thousands of other people, I have benefited hugely from Cognitive Behavioural Therapy (CBT) which says that while you can’t choose your feelings, you can choose your thoughts. And it turns out that our feelings are reactions to our thoughts, not the other way around. 

For instance, if you are woken up in the middle of the night by a loud crash, how would you feel? If you feel scared, it’s probably because your first thought is that a burglar has broken into your home. If you turn over and go back to sleep, it’s probably because you know that the cat has knocked something off the kitchen table, again. Our feelings come after our thoughts, not the other way around. Which changes everything. 

We can’t tell ourselves to be happy, to be excited, to not be afraid. But we can choose our thoughts, what we allow to dwell in our minds. The pursuit of happiness then becomes about training the mind rather than mindlessly reaching for the next “feel good” dopamine hit.  

Joy grows up. She starts out bubblegum-happy-at-all-costs-annoying. And she matures into someone who’s patient and compassionate and strong. 

CBT rose to fame, as it were, during the latter years of the twentieth century and more recently, a lot of research has gone into the correlation of CBT within diverse religious frameworks, including Judaism, Taoism and predominantly, Christianity. The evidence suggests that religious belief has considerable positive impact on mental well-being and psychology. It seems that there is real joy to be found in the Unseen. 

And I don’t think that’s a surprise. The Bible is full of CBT once you start looking for it. For example, St Paul wrote a letter to a church in Philippi, while he was chained up in a prison cell. I think it’s fair to say he wasn’t Insta-ready yet he says (italicised translation my own) "I know what it is to be in need, and I know what it is to have plenty. I have learned the secret of living my best life in any and every situation, whether well fed or hungry, whether living in plenty or in want.” Isn’t that a secret we’d all like to learn? How to have real joy that is completely independent from our circumstances? 

St Paul is not saying don’t worry, be happy. He isn’t saying pretend everything is ok, put your head in the sand and act as if you haven’t a care in the world. He is far more realistic than that. He knows better than most people that real life is very complicated and often very painful. He’s saying that whatever our circumstances, we have a choice. A choice to let ourselves drown in anxiety and sorrow or to fill our minds with, “whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable—if anything is excellent or praiseworthy—think about such things.”  He is of course talking about the goodness and faithfulness of God and what pours out as a result of God’s lovingkindness. When I fill my mind, when I choose to think about such things, it means there is less room for despair and Joy has the space to dance.  

And this is why I think Inside Out is so good. Joy grows up. She starts out bubblegum-happy-at-all-costs-annoying. And she matures into someone who’s patient and compassionate and strong. Joy can hold you while you give airtime to Sadness, Disgust, Fear and even Anger. And she’s there to celebrate and commiserate with you when that’s done. This may not meet the need for a party-popper-emoji-style happiness, but I for one say, Yes, please, can I have some of that? 

Article
Care
Comment
Economics
Ethics
4 min read

NHS: How far do we go to feed the sacred system?

Balancing safeguards and economic expediencies after the assisted dying vote.

Callum is a pastor, based on a barge, in London's Docklands.

A patient eye view of six surgeons looking down.
National Cancer Institute via Unsplash.

“Die cheaply, protect the NHS” It sounds extreme, but it could become an unspoken policy. With MPs voting on 29th November to advance the assisted dying bill, Britain stands at a crossroads. Framed as a compassionate choice for the terminally ill, the bill raises profound ethical, societal, and economic concerns. In a nation where the NHS holds near-sacred status, this legislation risks leading us to a grim reality: lives sacrificed to sustain an overstretched healthcare system. 

The passage of this legislation demands vigilance. To avoid human lives being sacrificed at the altar of an insatiable healthcare system, we must confront the potential dangers of assisted dying becoming an economic expedient cloaked in compassion. 

The NHS has been part of British identity since its founding, offering universal care, free at the point of use. To be clear, this is a good thing—extraordinary levels of medical care are accessible to all, regardless of income. When my wife needed medical intervention while in labour, the NHS ensured we were not left with an unpayable bill. 

Yet the NHS is more than a healthcare system; it has become a cultural icon. During the COVID-19 pandemic, it was elevated to near-religious status with weekly clapping, rainbow posters, and public declarations of loyalty. To criticise or call for reform often invites accusations of cruelty or inhumanity. A 2020 Ipsos MORI poll found that 74 per cent of Britons cited the NHS as a source of pride, more than any other institution. 

However, the NHS’s demands continue to grow: waiting lists stretch ever longer, staff are overworked and underpaid, and funding is perpetually under strain. Like any idol, it demands sacrifices to sustain its appetite. In this context, the introduction of assisted dying legislation raises troubling questions about how far society might go to feed this sacred system. 

Supporters of the Assisted Dying Bill argue that it will remain limited to exceptional cases, governed by strict safeguards. However, international evidence suggests otherwise. 

In Belgium, the number of euthanasia cases rose by 267 per cent in less than a decade, with 2,656 cases in 2019 compared to 954 in 2010. Increasingly, these cases involve patients with psychiatric disorders or non-terminal illnesses. Canada has seen similar trends since legalising medical assistance in dying (MAiD) in 2016. By 2021, over 10,000 people had opted for MAiD, with eligibility expanding to include individuals with disabilities, mental health conditions, and even financial hardships. 

The argument for safeguards is hardly reassuring, history shows they are often eroded over time. In Belgium and Canada, assisted dying has evolved from a last resort for the terminally ill to an option offered to the vulnerable and struggling. This raises an urgent question: how do we ensure Britain doesn’t follow this trajectory? 

The NHS is under immense strain. With limited resources and growing demand, the temptation to frame assisted dying as an economic solution is real. While supporters present the legislation as compassionate, the potential for financial incentives to influence its application cannot be ignored. 

Healthcare systems exist to uphold human dignity, not reduce life to an economic equation.

Consider a scenario: you are diagnosed with a complex, long-term, ultimately terminal illness. Option one involves intricate surgery, a lengthy hospital stay, and gruelling physiotherapy. The risks are high, the recovery tough, life not significantly lengthened, and the costs significant. Opting for this could be perceived as selfish—haven’t you heard how overstretched the NHS is? Don’t you care about real emergencies? Option two offers a "dignified" exit: assisted dying. It spares NHS resources and relieves your family of the burden of prolonged care. What starts as a choice may soon feel like an obligation for the vulnerable, elderly, or disabled—those who might already feel they are a financial or emotional burden. 

This economic argument is unspoken but undeniable. When a system is stretched to breaking point, compassion risks becoming a convenient cloak for expedience. 

The Assisted Dying Bill marks a critical moment for Britain. If passed into law, as now seems inevitable, it could redefine not only how we view healthcare but how we value life itself. To prevent this legislation from becoming a slippery slope, we must remain vigilant against the erosion of safeguards and the pressure of economic incentives. 

At the same time, we must reassess our relationship with the NHS. It must no longer occupy a place of unquestioning reverence. Instead, we should view it with a balance of admiration and accountability. Reforming the NHS isn’t about dismantling it but ensuring it serves its true purpose: to protect life, not demand it. 

Healthcare systems exist to uphold human dignity, not reduce life to an economic equation. If we continue to treat the NHS as sacred, the costs—moral, spiritual, and human—will become unbearable. 

This moment requires courage: the courage to confront economic realities without compromising our moral foundations. As a society, we must advocate for policies that prioritise care, defend the vulnerable, and resist the reduction of life to an equation. Sacrifices will always be necessary in a healthcare system, but they must be sacrifices of commitment to care, not lives surrendered to convenience. 

The path forward demands thoughtful reform and a collective reimagining of our values. If we value dignity and compassion, we must ensure that they remain more than rhetoric—they must be the principles that guide our every decision.