A landmark work on our understanding of how the mind works--and why it sometimes doesn't--by one of the world's most respected psychiatrists and thinkers on mental health
Why is it that all of us are vulnerable to emotions that can make us irrational and unable to cope? Some of us are prone to being overconfident or too happy; some too sad, some too anxious; some of us lose our temper too often. But however your emotional life is going, understanding where everyday emotions come from and how they can become serious problems is profoundly valuable. Randolph Nesse, a towering figure in Darwinian medicine, now sets out his bold new framework for understanding mental health. He makes clear that a fundamental confusion has made good psychiatry all but impossible for long enough. This book offers a comprehensive new approach: evolutionary psychiatry.
When considering if a patient or a friend's mental life has gotten out of hand, professionals have us look to diagnostic manuals for certain symptoms instead of first considering what is happening in that person's life. Nesse proposes a kind of Apgar scale (used to measure a newborn's physiological health) for a person's social resources--do they have friends, a job, family, a home, skills, personal hygiene, love? High scores on that scale have, in Nesse's research, indicated resilience to even very serious mental ailments. If a person has just lost a loved one, being sad is not something that necessarily needs to be fixed with a pill or months of therapy.
Neuroscience has accomplished surprisingly little in the treatment of mental disorders. We have found no physical anomalies in the brain to which we can tie, say, sadness or anxiety. Nesse's framework plainly shows that emotions are useful and necessary for a successful life. Taming them can begin only if we understand what they are for.
This is a sweeping, game-changing argument based on decades of Dr. Nesse's clinical experience. It will serve doctors and anyone who cares about those with mental disorders, and it will fascinate anyone who wonders how our minds work so beautifully and yet remain so fragile.