Good Reasons for Bad Feelings review – a new approach to mental disorder
Randolph Nesse is a pioneer in what he argues is a new way of thinking about psychiatric disorders and the science of mind. He sees his work as a branch of Darwinism. This intriguing book turns some age-old questions about the human condition upside down: “Why,” Nesse wonders at the outset, “do mental disorders exist at all? Why are there so many? Why are they so common?” Surely, he suggests, “natural selection could have eliminated anxiety, depression, addiction, anorexia and the genes that cause autism, schizophrenia and manic depressive illness. But it didn’t. Why not?”
Nesse, formerly both a professor of psychology and psychiatry and now the director of the Center for Evolution and Medicine at Arizona State University was never, of course, going to offer definitive answers to these questions. Rather, in an engaging, storytelling voice that rests on 30 years of clinical practice, he offers a series of insights, both scientific and anecdotal, that begins to show why the vulnerabilities in our psyche are fundamental to the survival of our genes. Nesse is properly dismissive of suggesting a direct evolutionary purpose in depression or anxiety – “disorders don’t have function” – rather, he argues, they represent an excess of what it means to be human. “Our suffering often benefits our genes,” he argues.