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A founder of the field of evolutionary medicine uses his decades of experience as a psychiatrist to provide a much-needed new framework for making sense of mental illness.
Why do I feel bad? There is real power in understanding our bad feelings. With his classic Why We Get Sick, Dr. Randolph Nesse helped to establish the field of evolutionary medicine. Now he returns with a book that transforms our understanding of mental disorders by exploring a fundamentally new question. Instead of asking why certain people suffer from mental illness, Nesse asks why natural selection has left us all with fragile minds.
Drawing on revealing stories from his own clinical practice and insights from evolutionary biology, Nesse shows how negative emotions are useful in certain situations, yet can become overwhelming. Anxiety protects us from harm in the face of danger, but false alarms are inevitable. Low moods prevent us from wasting effort in pursuit of unreachable goals, but they often escalate into pathological depression. Other mental disorders, such as addiction and anorexia, result from the mismatch between modern environment and our ancient human past. And there are good evolutionary reasons for sexual disorders and for why genes for schizophrenia persist. Taken together, these and many more insights help to explain the pervasiveness of human suffering, and show us new paths for relieving it by understanding individuals as individuals.
About the Author
Randolph M. Nesse, MD, is a founder of the field of evolutionary medicine and co-author with George C. Williams of Why We Get Sick. He served for many years as Professor of Psychiatry, Professor of Psychology and Research Professor at the University of Michigan. He currently is the Founding Director of the Center for Evolution & Medicine at Arizona State University where he is also a Foundation Professor in the School of Life Sciences. He is a Fellow of the Association for Psychological Science, a distinguished Life Fellow of the American Psychiatric Association, and an elected Fellow of the AAAS.
“A fascinating study of the evolutionary roots of mental illness.” --The Economist, "The Best Books of 2019"
“All psychiatrists and patients who find themselves having occasional ‘bad feelings’ about our current understanding of mental illness will have many ‘good reasons’ to consult this book. I do fully expect that someday nearly all psychiatry will be identified as evolutionary psychiatry. If so, Randolph Nesse’s book should be seen as the field’s founding document.” --The Wall Street Journal
“If your idea of self-care skews less spiritual and more scientific, Nesse’s new book on why humans are so vulnerable to a variety of mental disorders is a must. In this new work, he covers both why some people get sick, as well as why natural selection left us all so vulnerable to developing mental illness. Topics covered include changes in our environment impact us, how anxiety and low mood sometimes help our genes and how social anxiety is nearly universal.” --Forbes
“Important and fascinating…The future of clinical psychiatry is likely to be embedded in the integration of this [Nesse’s] type of evolutionary theoretical framework.” --Nature
“An ingenious exploration of how Darwinian evolution explains mental disorders.” --Kirkus Reviews (starred review)
“Nesse (Why We Get Sick), director of the Center for Evolutionary Medicine at Arizona State University, thought-provokingly comments on modern medicine’s continuing difficulties in treating mental illness… Nesse fully meets his modest but laudable goal of providing a conversation-starter on why mental illness should be viewed from an evolutionary perspective.” --Publishers Weekly
“Nesse’s book offers fresh thinking in a field that has come to feel stagnant, even if new therapeutic avenues are not immediately obvious... Recasting our psychiatric and psychological shortcomings as the unintended sprawling by-products of evolution seems a useful way of understanding why our minds malfunction in the multiple, messy ways that they do.” --The Financial Times
“An excellent and timely account of the history, development and implications of evolutionary psychiatry.” --Evening Standard
“If you’re curious about why humans seem stuck with emotional suffering, Good Reasons for Bad Feelings provides thoughtful evolutionary commentary. Nesse looks at emotions, addictions, and mental afflictions every which way and, to his credit, does not pretend to have all the answers. The ones he offers and the questions he raises about their likelihood make for highly interesting and enlightening reading.” --New York Journal of Books
"To quote a renowned geneticist, 'Nothing in biology makes sense except in the light of evolution.' A quarter century ago, Randolph Nesse bravely helped apply this dictum to medicine. Now, in Good Reasons For Bad Feelings, he tackles the deeper evolutionary question of why we, our minds, and our brains are so vulnerable to mental illness. He navigates the dangers of either too much or too little adaptationism, deftly handles the false dichotomy between psychological and biological perspectives, and bridges abstract intellectualizing with pressing clinical need. This is a wise, accessible, highly readable exploration of an issue that goes to the heart of human existence." --Robert M. Sapolsky, author of Behave
“Randolph Nesse is one of the key architects of evolutionary medicine. He's been an inspiration to a generation of scientists who explore evolution to understand why we get sick from diseases ranging from cancer to obesity to infectious diseases. Now Nesse has turned his attention from the body to the mind, in a provocative book full of intriguing explanations about human nature in all its strengths and weaknesses.” --Carl Zimmer, author of She Has Her Mother's Laugh: The Powers, Perversions, and Potential of Heredity
“Those powerful feelings that fill our day, that give us the oomph to act one way or another are the guardrails to living and this wonderful books explains all of them. Randolph Nesse has done it again.” --Michael S. Gazzaniga, Director, Sage Center, UC Santa Barbara, author of Tales from Both Sides of the Brain
"[A] testament to Professor Nesse's command of the field of evolution and medicine as well as his extraordinary ability to explain enormously complex ideas in plain English." --Riadh Abed in the The Royal College of Psychiatry Evolutionary Psychiatry Special Interest Group Newsletter
“A book as wise and illuminating as it is relevant to our daily lives." --Sarah Blaffer Hrdy, Professor Emerita of Anthropology, UC Davis, author of The Woman that Never Evolved and Mother Nature
"Randolph Nesse, who trained psychiatrists for many years, has for a quarter century been a key leader of evolutionary medicine. Good Reasons for Bad Feelings integrates these two strands of his life and thought in a readable, insightful book, as much a philosophy of emotions as it is a new window on mental illness. All who want to know themselves should read it." --Melvin Konner, Dobbs Professor of Anthropology, Emory University, author of The Tangled Wing
“Clear and engaging, and the narrative reflects a masterful blend of history, novel ideas, and clinical experience in an insightful and coherent manner. I hope it is widely read and discussed." --Eric Charnov, Distinguished Professor Emeritus of Evolutionary Ecology, University of Utah, MacArthur Fellow
“This will become a treasured classic; not just for clinicians but for all those interested in how to facilitate well-being and create more moral communities and societies." --Professor Paul Gilbert OBE, author of Compassionate Mind, and Living like Crazy
"'Why am I feeling bad?' This is the first burning question of everyone who suffers. This accessible new book will be an essential tool to help patients, their loved ones, and treating professionals arrive at more satisfying answers." --Jonathan Rottenberg, Professor of Psychology, University of South Florida, author of The Depths
"A bold book that would have made Darwin proud. Cutting-edge and compassionate at the same time." --Lee Dugatkin, Professor of Biology, University of Louisville, co-author of How to Tame a Fox and Build a Dog
“A masterful, groundbreaking book that persuasively challenges standard clinical wisdom and provides a roadmap for the transformation of our conceptually confused psychiatric nosology. With crystal clarity, Nesse reviews what we know of our biologically designed emotions and argues for unflinching acceptance of our evolved nature as a baseline for understanding both normal and disordered suffering... Anyone interested in mental health—laypeople, students, clinicians, and scholars—will be grateful for the novel insights to be gained from this important book.” --Jerome C. Wakefield, Professor of Psychiatry, New York University, co-author of The Loss of Sadness
"What is the nature of suffering, its origin and its adaptive significance? Good Reasons for Bad Feelings may well become a legend, as it is a book about psychology, psychiatry, biology and philosophy that is also a good read, and it opens the door to deep questions in a manner that is tender, quizzical, and industrious." --Judith Eve Lipton, MD, co-author of Strength Through Peace
"Very engagingly written for the general reader, Nesse's book is hugely important for the future of mental health care, and Nesse is the pre-eminent person to write it. It provides a personalized and lively but well documented treatise on how we humans function as we do and on needed changes in the way psychiatry thinks about troublesome mental experiences and behavior. It draws on an impressive range of knowledge, from not only psychiatry, including extensive case descriptions, but also psychology, biology, philosophy, and humanistic literature. Many readers will find it hard to put the book down." --Eric Klinger, Emeritus Professor of Psychology, University of Minnesota
"Two sets of ideas inform this fine book: one, the cold-hearted logic of natural selection; the other, the practical wisdom of a compassionate psychiatrist. The tension is palpable. The result is riveting." --Nicholas Humphrey, Emeritus Professor of Psychology, London School of Economics, author of Soul Dust
"Good Reasons for Bad Feelings by Randy Nesse is a delightful book. It is insightful about the human condition, sanguine and not over-stated. And it is written in a straight-forward and delightful manner, personal and professional, and with humor. Neese is one of the originators of the field of evolutionary medicine. This is a welcome book in evolutionary psychiatry and on the biological basis of the emotions and our cultural evolution." --Jay Schulkin, Research Professor of Neuroscience, Georgetown University
"In Good Reasons for Bad Feelings, leading evolutionary theorist, psychiatrist Randolph Nesse, begs us to ask the right question: Why did natural selection make us so prone to mental disorders of so many kinds and intensities? It is no exaggeration to say that he opens the door to a new paradigm in thinking about human beings and their conflicted lives. A pathbreaking book by a man who is truly humane and caring. A privilege to share time with him." --Michael Ruse, Werkmeister Professor of Philosophy, Florida State University, author of On Purpose
"How did we end up recognizing that every system in the body has a function shaped by evolutionary selection and yet thinking that systems in the mind do not? How did physical and mental health drift so far apart? Randolph Nesse explains, in this highly readable book, how 'symptoms' in psychiatry should be seen in their evolutionary context, and that anxiety and depression for example have functions, just as do inflammation, blood clotting, or a cough. Nesse is a pioneer of evolutionary psychiatry, which has the potential to revolutionize mental health care." --Simon Baron-Cohen, Professor of Developmental Psychopathology, Cambridge University
"This book sets out to show how evolution underpins (or should underpin) psychiatry. In doing so, it will surely change the face of medicine -- and deservedly so." --Robin Dunbar, Emeritus Professor of Evolutionary Psychology, University of Oxford
"Randy Nesse has brought a new and important synthesis to the study of illnesses that psychiatrists deal in. This engagingly accessible, pioneering book provides a wide range of answers for how something as maladaptive as bipolar disorders could have evolved. It provides a wide range of answers for why natural selection has left us vulnerable to so many mental disorders, and the “mystery of missing heredity” is identified as a key problem. Nesse shows that by taking into account complex pleiotropic effects, natural selection may push some useful trait close to a fitness peak near a "cliff edge" despite the disabling consequences for a few individuals who go over the edge. Thus a gene may be useful to many, but with bad luck contribute to victimizing the few. This complex problem surely will yield to further research." --Christopher Boehm, Professor of Biological Sciences, USC Dornsife