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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? 

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Gaza
Middle East
5 min read

The human cost of the Israel-Gaza war

A veteran volunteer surgeon laments a well lived life.

Tim Goodacre is a reconstructive plastic surgeon, and volunteer at a hospital in Gaza.

A young doctor wearing scrubs smiles.
AbdulRahman at work.
Tim Goodacre.

The Israel-Gaza war rages on. Every few days a new tragedy hits our dulled senses. The West Bank and now Lebanon are getting dragged into the conflict. Palestinians and hostages continue to die, and hunger and disease threaten Gaza's displaced people as autumn and winter approach. 

Yet what is often lost is the human face of this conflict. This is the story of one such life. 

AbdulRahman was an intelligent, gentle and diligent young third year medical student in his early twenties, with judgement well beyond his peers. Towards the end of 2023, as the war spread more viciously towards southern Gaza, he was one a group of around 10 students who volunteered to join the team of health care workers at the European Gaza Hospital (EGH). I was volunteering there as a reconstructive plastic surgeon and and met him in the hospital.

Both medical schools in Gaza before the war began were in the north alongside their parent universities. They had been destroyed during the onslaught in the early months of fighting. In the southern town of Khan Younis, the EGH was the sole surviving operational facility to which the wounded could be transferred. It was overwhelmed by the vast numbers of families also taking refuge in what was deemed a safer space than most of the surrounding war zone.  

Many of the senior medical staff and surgeons had retreated to scattered parts of the strip, displaced frequently by the ever-moving conflict and driven by the need to support their families and stay together. ‘Live together-die together’ is an understandable feature in the horror show of war. Students, frequently left with no money or resources, started to volunteer to serve in hospitals in exchange for a little food and a sense of worth in the work they could offer. Any functioning hospital, if briefly ‘deconflicted’ so they could provide relatively safe care, found itself staffed by a disparate crew of local staff, displaced students, and an indeterminate number of more senior surgeons from both Gaza and humanitarian agencies. 

His desire to learn all that could be learnt, and to try to become the best surgeon possible, was palpable.

It was into this chaotic mix that young AbdulRahman walked having fled his family home in the east of Khan Younis in November 2023. A bright young man, with great aspirations to qualify as a surgeon and serve his community, he had spent the first six weeks of the war at home, unable to attend his medical school in Gaza City to the north, but working hard at his studies regardless, using every online and library resource available to him.  

At some point in late November, the battle zone moved south, and his family home was shelled along with many dwellings in the vicinity. Caught in crossfire, he sheltered in his neighbouring relative’s house after his parents and other close family had escaped to Rafah. 

Abdulrahman told me the dramatic story of his escape into the house in which he survived for a week alongside his relative’s family when I spoke to him in late January 2024. This young man not only survived an ordeal of indescribable fear and potential slaughter, but he was then arrested and interrogated in brutal fashion by IDF forces.  

On his release after a harrowing week, he made his way barefoot to the nearest hospital, which happened to be the EGH. In that place of safety, he was given food and water and after recuperation, volunteered to work alongside a reconstructive plastic and burns surgeon who had recently returned to Gaza after training in the UK. 

Although his family were still all alive in Rafah in displaced makeshift shelters, he opted to stay and throw his weight into whatever he could do to support the hospital whilst continuing to learn his profession as a doctor. Travelling occasionally at great personal risk to see and support his family, he devoted all his waking hours to surgical work in EGH operating theatres and wards. His excellent command of English made him immensely valuable to any visiting surgeons who managed to access Gaza during the war months. He was always cheerful, always willing to respond to requests for his time, however stressful the surrounding clamour from desperate patients and relatives might become.  

When his working day was done, in the middle of the night he would arrange for his fellow students to have informal teaching seminars from whoever he could cajole to deliver them, and would absorb knowledge and ideas about best practice like a sponge. His desire to learn all that could be learnt, and to try to become the best surgeon possible, was palpable.  

I had every intention of supporting this fine young man in achieving his professional aspirations by whatever means I could once a ceasefire arose and he could be brought safely to Europe to continue his training. 

In the last week of August, AbdulRahman was sheltering in a relative’s house in Khan Younis. In the small hours of the morning an Israeli attack was launched on the neighbourhood and the house took a direct hit. AbdulRahman was killed instantly. 

He knew, as does every Gazan in these troubled times, that nowhere was safe, and all lives in that tragic zone are at risk. His is a story of a life tragically cut short, of the randomness and destructiveness of war. His death strikes right at the heart of my hopes for the remnant of the fine young population of such a desperately sad nation state. He, and those like him, could have been at the heart of the re-building of Gaza, able to live in what now feels a far-off peace. I cannot translate this into anger, as AbdulRahman himself had a passionate concern for peace and reconciliation, and never once spoke to me in many conversations of support for Hamas, or of hatred for those who had destroyed his country.  

What can be done however, is to honour his life and commitment with similar tenacity in supporting the pursuit of peace, justice for his people, learning and education for the remnant of the nation, and reconstruction of a Palestine that can proudly and honourably reflect the finest values it possesses. AbdulRahman was a great Palestinian, and his all too short life was one which I want to celebrate as one of the finest I have seen in many students of the next generation of doctors. May he rest in peace, and may a lasting peace come quickly to Gaza, to all of Palestine and the whole of the Middle East.