Book Review: Good Reasons for Bad Feelings

Good Reasons for Bad Feelings by Randolph Nesse book cover

Good Reasons for Bad Feelings by Dr. Randolph M. Nesse digs into the science of evolutionary psychiatry to understand why mental illness persists, He explains that while the illnesses themselves aren’t evolutionary adaptations, our vulnerabilities to them may have had evolutionary purposes.

He takes the rather refreshing approach of acknowledging both the good and the bad of the field of psychiatry. For example, he discusses the flaws of the DSM without throwing the baby out with the bathwater. He argues that the biggest problem with current psychiatric research is the lack of acknowledgement of the role of situational factors.

From an evolutionary psychiatry perspective, there are six key areas of vulnerability:

  • a mismatch of genes to current conditions (e.g. diet, alcohol, other substances)
  • infectious organisms evolving more rapidly now than in the past
  • limits on what natural selection can do to select for/against certain characteristics
  • trade-offs between increased vulnerability in one area and decreased vulnerability in another
  • evolution selects for reproduction rather than health
  • the defensive function of certain responses (e.g. pain)

The author argues that emotions have developed to promote survival and reproduction, by increasing our ability to cope with certain situations.  In the face of potential danger, anxiety would increase the chances of survival, while happiness could mean getting eaten by a sabre-toothed tiger. The book includes a handy tree diagram, with different situations branching out to leaves of different emotions that would be suited to those situations; you can view this on the author’s ResearchGate page.

The smoke detector principle is used to describe responses that may seem unnecessarily strong. Just like a smoke detector, protective responses like pain or vomiting get triggered whenever the potential benefits outweigh the downsides, regardless of whether that may cause some false alarms. I’ve heard the same analogy used elsewhere to describe the dysfunctioning mental alarm system in OCD.

The book is very thorough, offering examples of numerous research studies, presented in an easily understandable manner. However, the second half of the book seemed to get a bit bogged down in detail. Chapters on topics like social interactions and sex may have been appealing to some readers, but they weren’t what I was looking for. I found the earlier part of the book more personally relevant/interesting.

In terms of specific mental illnesses, the author suggests that people with psychosis have a lack of repression (i.e. the concept proposed by Freud). He says OCD is similar, although in a more focused way. A chapter on eating includes the assertion that eating disorders don’t result from genetic abnormalities; rather, they’re due to abnormal environments.

This book definitely included some interesting concepts and information. Overall, though, there was more detail than I wanted about too many things that I just wasn’t that interested in. I think that’s in part a reflection of the book itself, but also, it’s just not the mental illness-focused book I’d been hoping for.

Good Reasons for Bad Feelings is available on Amazon (affiliate).

I received a reviewer copy of this book from NetGalley.

You can find my other reviews on the MH@H book review index or on Goodreads.

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