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10 mins

Randolph Nesse: It’s Not You – It’s Evolution — Transcript

Read Caitlin's conversation with evolutionary psychiatrist Randolph Nesse about the ancient roots of depression and anxiety.
by Ines Bläsius | Oct 17 2019

Caitlin: Welcome to Simplify. I’m Caitlin Schiller.

Ben: And I’m Ben Schuman-Stoler.

Caitlin: All right, so Ben, question. Before doing background research on today’s guest, had you ever heard of evolutionary Psychiatry?

Ben: No, but I, I mean, you got me. But I’m not super super surprised considering how many people in how many fields, use Evolution as a way, like a lens with which to see the world.

Caitlin: Yeah, true. And, you know, I’m very interested in mental health and well-being and I’ve done quite a bit of reading around it just out of, you know, personal curiosity, but I’d also never heard these words strung together before I found out about the work of today’s guest, who is Randolph Nesse.

Ben: And he’s an evolutionary psychiatrist.

Caitlin: Yep. Exactly.

Ben: So, okay. Let’s explain to everybody what that actually means like, really. Can you break down Evolutionary psychiatry?

Caitlin: You know, I think that it is best if I let Randy do the full explanation of that, himself. It was one of the first things I asked him too, but to put it in really broad terms just to ground us a little bit, Evolutionary psychiatry applies the basic principles of Evolutionary biology to psychiatric problems. So, looking at the human traits created by natural selection and figuring out why, but applied to our minds, not just our bodies.

Ben: Right. Like how our great ancestors, what they went through, affects our brains today.

Caitlin: Exactly. What things, you know, were evolved into us because of what they had to deal with.

Ben: Mm-hmm.

Caitlin: Yeah, uh-huh.

Ben: Right.

Caitlin: I hear the skepticism-

Ben: I’m a little skeptical.

Caitlin: – in your voice.

Ben: So, but before we get to my skepticism, why did you want to have Randy on the show?

Caitlin: I really love the title of his book, Good Reasons for Bad Feelings. I gravitated toward it the same way that I gravitate toward a pretty label on a wine bottle, and I picked it up and, strong, my intuition is good with these things.

But as I read his book, I felt this really tremendous sense of lightness and relief. There’s a real comfort in beginning to understand that the feelings that we categorize as “bad” like anxiety and depression or grief, actually have their roots in adaptive behaviors. It’s terrible to feel like suffering is for nothing and Randy’s book helped me understand that these bad feelings aren’t necessarily for nothing.

They can actually tell us important things about our lives or about our ancestors lives, and how we evolved as humans. We’re not crazy, we’re not broken, we’re not beyond help. We are, just very very human.

Ben: Okay. I mean, I’m glad it’s relieving for you. I have some reservations. Maybe we can get to it in the Bookend, which to remind everybody is when Caitlin and I will make a book list, a reading list, so definitely stick around, but maybe let’s just get to the interview and we can talk about more, afterwards?

Caitlin: Cool. Let’s do it.

Caitlin Interviews Randolph Nesse

Randy: Hi, I’m Randy Nesse at Arizona State University. I’m the director of the Center for Evolution and Medicine. Really I’ve devoted my whole career to bringing Evolutionary biology to medicine.

Caitlin: Very cool. Okay. So your new book is called, Good Reasons for Bad Feelings: Insights from the Frontier of Evolutionary Psychiatry. Psychiatry. So, just a quick primer for anybody who is out there and has no idea what that designation is. What is evolutionary Psychiatry?

Randy: You know, it sounds like some new alternative kind of treatment, doesn’t it?

Caitlin: It does.

Randy: But it’s really not. What it is, is bringing the basic science of Evolutionary biology to bear on mental problems. As you’re probably aware, Psychiatry and trying to understand mental disorders has been such a challenge in recent years, with all kinds of controversy that doesn’t seem to get resolved in slow progress.

And the aim of this, is to try to bring Evolutionary biology to bear, the same way it’s used on the rest of medicine, the same way it’s used to study behavior for other animals.

Caitlin: I wanted to, to start off by talking a little bit about anxiety. It’s something that people, that almost everyone has experienced to differing degrees at some point. What is anxiety technically good for, or maybe, what job does it do for us?

Randy: And the situation in which anxiety is useful, or fear, is situations of risk, and threat, and danger, where we might be losing something. Now, the obvious one is there’s a lion behind a rock, maybe. Maybe there’s a lion behind the rock. Should you flee?

Well, it turns out that that’s kind of a hard question to answer, because if you flee every time you think there might be a lion, as some people do, then you never get any water from the watering hole. If you never flee, then you become lion lunch.

So, what’s the right answer to that? And the answer to that turns out to be embodied in what’s called the smoke detector principle.

Caitlin: Okay. Could you explain that?

Randy: I’d love to. I know, I helped to run a clinic for anxiety disorders patients, for fully, fully, 30 years. And, after 10 years, I started wondering, how did natural selection shape the mechanisms that regulate anxiety? And it really struck me, finally, that I was also worried, actually, when I’m giving medications to block anxiety, am I interfering with things? Am I doing the same thing as blocking cough? When, when, people need cough.

And so after I thought about that for several years, I figured out that something called Signal Detection Theory offers the answer. Sounds fancy, but it’s just a matter of trying to calculate, what are the chances that there’s a lion behind that rock, and what are the costs of fleeing, if there’s no lion that is a false alarm, and what are the costs of not fleeing if there’s really a lion there? And you can kind of see where this is going. This is called the Smoke Detector Principle because false alarms and fleeing a lot of times when there’s no real danger, is exactly how the system should work. I mean, say it costs a hundred calories to flee, whether or not there’s a lion there, and you’re perfectly safe if you run away, but if you don’t flee and there is a lion there, then that costs maybe a hundred thousand calories, which is about how many calories your lion will put on its Weight Watchers menu for having you for lunch.

So, the ratio there is a thousand to one. So, what does that mean? That, that means that any time the risk of a lion being there, that, that noise is loud enough, to mean if the risk is greater than one in a thousand, you should run away even though 999 times, there will be no need for it, in that particular instance. So, when I realized that, when I calculated that, I suddenly realized that a lot of the anxiety that my anxiety patients were having was perfectly normal, although, useless in the individual instance. So this doesn’t cure people by itself instantly for most people but for some people they say, oh my gosh, so anxiety’s useful sometimes and I’m having false alarms, like my smoke detector. Thank you very much, doctor. I’ll come back and I’ll come back, if I need you. It really transforms their understanding of anxiety.

Caitlin: Yeah, I found that actually very comforting. Everybody has some degree of anxiety and I’ve gone through myself periods where it’s higher and lower, and to know that it’s not only normal but also has been adaptive and has, and serves in some situations, feels really good. Just having an answer about how this thing might have been useful to me in some way, is really really helpful.

Randy: I’m so glad to hear that from you because, for so many of my patients, I used to be reluctant to talk with them about evolution and such things. But, but, once I started talking with them about, you know, you have advantages as well as disadvantages because you have more anxiety than other people, many of my patients said Oh, I always thought I was just a defective person and you’re helping me realize that there’s two sides to this. I think it’s just enormously helpful for people.

Caitlin: When you, when you tell them that they have, I’m not trying to guild anxiety or because I know that it gives a lot of people a lot of serious trouble, but, what are some situations in which having maybe higher presets for anxiety, in what situations is that useful? How is it powerful for people who suffer?

Randy: So people who are anxious, get their work done on time and people who are are completely relaxed, sometimes don’t. There was one patient who came to me, who is a professor, you know, just was, got depressed and anxious and didn’t want to go back to teaching in the fall and I started treating her in the in this early summer. And very quickly her anxiety and everything got under very good control, and she came back to me and September and said I’m so eager to go back to work and she went back to work.

Then she called me again in mid-November and said, you know, I probably should talk with you, again, because although I’ve been feeling just fine, I haven’t graded any student papers all term long. So so there really are advantages and disadvantages to these kinds of things. And we’re talking about anxiety as mostly about lions, but no, in modern times, anxiety is mostly about what you said at the party or what you should wear to work, or what you say when you’re doing a podcast because one false step and who knows who could get after you on Twitter and all the rest, but, that too I think is so useful. I mean, we all have more social anxiety than we think we need. I mean half of people, ‘I have trouble getting up in front of people’ or doing a podcast and things, and and they’re nervous about it, and I think for all of us, being at least somewhat nervous about such things is a good thing, but the key to this, is to look on the other side, to look at people who really, don’t have much Social Anxiety at all. And I don’t know if you know people like that, but most people do, they tend to be insufferable.

You know, they just don’t pay attention to social cues, and and and it’s very hard for them to get along with people. I think, you know, being very sensitive to people’s feelings and trying to, you know, please other people, is one of the deep things that natural selection has shaped in us and generally it’s a good thing, although it causes us a lot of discomfort.

Caitlin: In your book, you have, I have a highlighted page right here, and it says that social anxiety and constant concern about what others think about us, are the price we pay for deep relationships. Would that indicate at all, that people who have high anxiety might have deeper relationships or is that just wild and wrong and assuming too much?

Randy: You know, that is a great topic for study. Let’s find somebody to work on that. I think they do and I think this also, you know a lot of people feel bad about being introverted. They don’t like going to parties, they feel nervous in parties and that kind of thing. But it seems to me, again, this needs evidence, not just my opinion, it seems to me that people who are introverted and people who are somewhat anxious, they have fewer friends, but better friends. And other people have lots of acquaintances and and and relationships, it might not be as deep. But I think the background to this that you were hinting at before, is, how is it that real relationships that involve love are possible? I think one of the reasons that Evolution has not come more quickly to thinking about our relationships and Psychiatry is because people kind of think, ‘oh selfish genes, it implies that people are selfish, there’s no explanation for goodness in this world’. And I’ve worked a lot, and put a whole chapter in the book, to show how social selection shapes us for grief and goodness.

Caitlin: Yeah, I could tell that that was really important to you. Actually. I wanted to talk with you a little bit more about specific bad feelings, namely depression, but I kind of wanted to know, what was your stake in this book? You started with that central question of what is low mood good for, why did that matter to you so much?

Randy: You know, after you see hundreds and even thousands of patients, you have to, you know, step away from the simple thing of ‘what’s wrong with this person’ and you have to ask, you know, who designed this thing? It’s really like, you know, and people have talked about this for centuries, trying to figure out, why on Earth there’s so much suffering. And, you know, I’m able to help people one by one and that’s a great privilege and they get better and it’s very satisfying, but you know, there aren’t enough psychiatrists in the world to begin to deal with the problems. I think, stepping back and taking a larger view of the whole human condition is is a way forward.

Caitlin: So, this book came from seeing all the suffering and wanting to know why it was happening, really.

Randy: That’s right.

Caitlin: So then, we’ve spoken about anxiety a bit and I know that anxiety and depression are sort of, well, it’s a spectrum really.

Randy: Yeah, they go hand-in-hand, just like you say.

Caitlin: So if anxiety helps us get our work done, what is depression good for? I come from a family of depression sufferers, and I myself go through bouts of it. And it really feels like it’s good for nothing most of the time.

Randy: It really does feel like that, and I must say the first, you know, 10-15 years of my practice, when people came in with depression because they were trying to do something that wasn’t working, I would tell them, oh keep trying, don’t give up. Don’t let your depression get in the way of doing what’s useful and important, you know, be positive and let’s figure out ways to relieve your depression. But then I started thinking about it, again, from an evolutionary point of view, and let’s set aside depression for a moment, because that sounds like something that’s just plain bad and have normal, let’s talk about low mood.

Caitlin: Okay.

Randy: Periods where you just don’t want to do anything, and you kind of feel low about yourself and unenthusiastic and no motivation. Are there any situations, asking my favorite question, what is the situation in which low mood might be useful? And once you think about it from that point of view, there are times when the best thing to do is, nothing.

Caitlin: Hmm.

Randy: There are fewer such situations now, but for my ancestors living on a small island off the coast of Norway, I think there may well have been ones that were very enthusiastic in the middle of February, and they said I don’t care about you negative thinkers. There must be food out there. I’m gonna go find it. But a lot of them never came home.

Caitlin: Right.

Randy: And the ones who, you know, were kind of pessimistic and let’s hunker down, and didn’t have much energy for anything in the middle of the winter, they did better. Now again, we have to shift very quickly, from these physical kinds of things to more emotional kinds of things, because what we’re doing now is not mainly trying to figure out when to go out in the winter looking for food. What we’re trying to do now, is much more often trying to figure out whether to go to a party, and whether it’s try to apply for that job again, and whether to keep asking that person out for a date, even though she’s turned us down 5 times. You know, all these kinds of things.

I mean, there’s so many things we try to do in life that just don’t work and the question is, so how long should you persist at that? When should you just keep trying indefinitely, or should, at some point you decrease your motivation for that and move on to something else?

Caitlin: How do we know when we’ve reached that point? Is there, is there any way to check?

Randy: You know, built into us, just like every other organism, is a mechanism for adjusting our motivation and shifting our behavior to do things that are useful, instead of things that are useless. The example I like to give is picking apples. If you and, and picking apples from a tree or nuts from a tree is something our ancestors have done for not just hundreds of years, but thousands and millions of years, and they’d better damn well do it right. The trick is, to figure out whether to go for that last one or two apples on the tree, or whether to look for another tree. And it turns out, there’s some very interesting and fairly simple mathematics about when the optimal time is to give up on this tree and look for another one. It depends on, how long it takes to find a new tree and how many apples you’re going to find on the next tree, and it turns out that it’s not just us, but how about this, Ladybird Beetles, those little orange beetles you see, they live on aphids and they suck the juices out of aphids and they have a decision to make. How long should they suck on one particular aphid before looking for another one? And it turns out, that they make that decision perfectly based on how long it’s going to take them to find another aphid. The key for them and the key for us is, keep doing what you’re doing until the payoffs per minute decline below the average payoffs over many patches or over many hours.

So if you’re out apple-picking, and you want to maximize your apples per hour, keep picking apples in this tree until the number of apples you’re getting per minute is lower than the average number of apples per minute over many trees, and it turns out that our motivation, you, I mean, if you’ve been berry picking or apple picking, you know, there’s such a great feeling when you find something all full and laden with fruit, and you’re, it’s exciting at first, and then it’s less exciting, then after a while you kind of get bored, and you know, that you got to go on to something else. That’s even true for things like podcasts, everybody likes listening to the first few minutes and then it’s less interesting. By the time an hour and a half has gone by, it’s hard to sustain anybody’s interest, in even the even the most interesting topic.

There’s a natural rhythm to our lives, which is, you know, made by natural selection shaping these motivation regulation mechanisms.

Midroll

Caitlin: Our minds, as beautifully evolved as they are, are sensitive creatures that need to be taken care of with little breaks. When you’re taking a moment to de-stress and completely switch gears from whatever you’ve got going on, why not learn something new and awesome? Blinkist, which is where Ben and I work, takes the key ideas from really great non-fiction books, like Randolph Nesse’s Good Reasons for Bad Feelings and transforms them into these powerful little digests of audio or text, that only take about 15 minutes to finish. So if you’re hungry to learn something new, or want to explore a new topic before you figure out which books to dive into in full, Blinkist is your perfect companion.

You can go ahead and read, or hear, what I mean and try it out. Go to blinkist.com/simplify. Click on Try Blinkist up at the top right, and you can try it for free, for 14 days, by using the code evolve. That’s E-V-O-L-V-E. Try it. I think you’ll like it. Okay, now back to my talk with Randolph Nesse.

Interview Cont’d

Caitlin: What would you like people to know about depression and relationships?

Randy: Well you know again, I give all these analogies about apple trees and the like, but what matters and what matters in our lives is our friends, and how they care about us, our groups, whether they value us, our whole social status in a group. And our striving for those things is basically good but we can never succeed to the extent that we want to and we read in, you know, movie magazines about even the most famous people in the world and richest people in the world and there’s a certain Schadenfreude about, you know, how they have troubles, at least as great as ours.

So there’s no really escaping what’s called the Hedonic Treadmill, but we can have good relationships and, just pause for a moment, that is an absolute, wonderful, miracle. People can have absolutely, good, loving, stable relationships, like other species can’t. Other species get attached, but I think the kind of depth of relationship, I’m sure that some people who study dogs and dolphins will disagree with me about this, so I shouldn’t go too far.

Caitlin: Get ready for the Twitter storm.

Randy: That you’re right, right, but just to pause, I mean, some people think an evolutionary view of relationships is cynical and means everybody just out to get something, especially matings.

And, and I think we need to go way past that to bring Evolution into Psychiatry and and recognize that, you know, there it’s, we’re capable of good relationships. They’re always problematic. Even the best relationship has its ups and downs of challenges and trying to figure out how to negotiate those is the greatest challenge of life. In fact, you know, some people say that that’s exactly the reason for why our brains are so big, is trying to solve that very difficult problem.

Caitlin: Mm-hmm. You also talk about, about grief. What is grieving good for? Because that is a pain like very little else out there.

Randy: You know, I thought that that question was so important that when I moved to the Institute for Social Research at the University of Michigan, and the director said, what would you really most like to do in your whole life, blue sky, anything?

I told him, you know, I’d really like to know, what’s wrong with people who don’t grieve? Because in my effort to try to figure out what good low mood is useful for, the obvious way of studying that would be to find people who just don’t experience grief and see what’s wrong with their lives. And he gave me this sly look and he said, what would you do if I told you that the world’s biggest, largest, best study on grief had just been completed, that all the data are in the computer, they’ve been cleaned, they’re ready for analysis, and everybody who worked on that project has left for other places. And I think I said, oh damn, I guess I’m going to have to really do the project, because I knew just how large it was going to be. And so I spent the next, you know, four years getting a grant and recruiting a team of statisticians and experts on grief and we combed through the database, trying to figure out, what about these people who don’t experience grief, and it turns out that about a third of people don’t experience much grief after the loss of a loved one. It was a prospective study. That’s why it was so special. That means that everybody was studied before they lost a loved one and then they were studied 6 months, 18 months, and 48 months later to see how they did. And we were pretty sure at the beginning that we were going to find that people who didn’t experience grief had shallow relationships or health problems. It turns out we didn’t find that at all, our whole idea that there was one normal way to grieve, stages or something like that, I was completely wrong. Some people, everybody has their own way of grieving. There’s a wide variation, which from an evolutionary point of view, tells you that while there’s something going on there that has been shaped by natural selection, it’s not something as urgent as breathing or eating food, you know, it’s something else.

So it turns out that there are people who have written about this and they have suggested that maybe it’s just an accident. Maybe it’s just the price we pay for attachment. To my mind, it just seems so severe and long-lasting, that you, there should be some way of having attachments that don’t require you to spend months and even years feeling bad, not eating well, not sleeping well, and and just feeling pain all the time. It just seems so excessive, unless there’s some utility to it. And I think this is one where we do not have an answer yet. Interesting ideas, debate, discussion. What a profound question to not have an answer to.

Caitlin: Indeed. Maybe I’ll call you back in five years and ask if you found it yet.

Randy: Sure.

Caitlin: So then, the thing that really stood out to me throughout this book, is that you’re, not only are you, are you trying to figure out what these bad feelings can be useful for, but you’re also, or when in what situations they can be helpful, you’re asking, are we studying the wrong thing when it comes to mental health problems? Are clinicians asking the right questions?

And it’s really easy to get a laundry list of symptoms and hear one facile cause, and get carried away. So, what can clinicians be doing to better study mental health? What are some, what are some questions they could be asking instead of the way that they do address diagnosing mental health issues?

Randy: You know, some people would imagine an evolutionary view would treat everybody as if they’re the same and in fact, my conclusion is exactly the opposite. It offers a very personalized way of trying to understand each individual as an individual. I think you need to understand a person’s emotions to understand, what’s that, what does this person value in life? What are they trying to do? How is it going? What are the obstacles? What are their plans? What are their expectations about how it’s all going to come out? And I have a fairly specific way of doing that that I proposed in the book, something called a Review of Social Systems.

Now in the regular Medical Clinic, where I worked for many years, there’s something called a Review of Systems. When you come in from some minor ailment, and before you know it, your doctor is asking you whether there’s ever any blood in your urine, and whether you have a cough, and whether you have headaches, even though that doesn’t seem relevant, what your doctors trying to do, is check out all of your bodily systems to see if there might be anything that might be causing your symptoms.

Well, likewise, in Psychiatry, getting that evolutionary point of view encourages us to check each different area of a person’s life and see how things are going in that system. And in particular there’s an acronym for that which allows you to do it fairly systematically. It’s called S-O-C-I-A-L, which is a very easy thing to remember. S stands for social resources, which is friends, or social status. O stands for occupation and things we do that other people value. C stands for children and family and relatives which are the key to happiness for most people. I stands for income and financial resources. A stands for abilities and appearance and health. And finally, L stands for love and sex. Those are the six main areas in which people are trying to do things.

And I didn’t just make those up, actually. Those are basically the exact same categories that people who study animal behavior look at when they’re looking at how other animals allocate their behavior, the different kinds of areas. And asking those questions, gets you to the nubbin of the issue for people much better than just saying, have you experienced stress, which is such a crude crude question.

Caitlin: I was wondering, if there were a central idea about low mood and feelings that cause us pain that you would like to leave people listening with today, what would that central idea be?

Randy: Natural selection shaped these low moods for good reasons, but most of the time, they’re not actually useful for us in the individual instance. But the much larger idea, you know, I wrote this book to try to make it so interesting to read that people are going to insist that their professors and their doctors and their therapists read it, because I have hopes that finally bringing this basic science to Psychiatry and psychology will get us past a lot of the controversies and frustrating obstacles that have slowed progress. Back a few years ago, we all thought we were going to have new treatments for these disorders, and they haven’t showed up. And I think it’s because we’ve taken a narrow-minded view, that there must be something wrong with the brain. Yes, there are brain variations that are very important for many of these disorders, but we can make faster progress it seems to me, if we incorporate thinking about the evolutionary origins and functions of these emotions and evolutionary reasons why we’re vulnerable to substance abuse and eating disorders and evolutionary reasons why the genes for schizophrenia and bipolar disease persist. I think there’s a huge opportunity to add in the missing basic science.

I even say sometimes, that Psychiatry’s only been using half of biology. We’ve been using the half that describes how things work, and the other half, about why things are the way they are, is ready and ripe for application, and offers great opportunities.

Caitlin: Very very cool. Thank you. And then, the last thing that I wanted to ask you, is I always like to see what my guests have been reading lately and what they’ve enjoyed.

Randy: There’s there’s a book about why Buddhism is true.

Caitlin: Oh, yeah!

Randy: Bob Wright, which I talked with him the other day. He’s a friend from way back. So I enjoyed that quite a lot.

Caitlin: Yeah. I’m familiar with that one.

Randy: Yeah, and very, very relevant to what we’ve just been talking about, too.

Caitlin: Indeed. Great. All right, Randolph Nesse. Thank you so much for taking the time to talk today. I really appreciate it.

Randy: Thanks so much, Caitlin, I really enjoyed talking with you.

The Bookend

Ben: All right.

Caitlin: Welcome back.

Ben: Welcome back, welcome, you got me there, to the Bookend, where we end with books.

Caitlin: I just don’t know what I would do if that normal rhythm were disrupted.

Ben: You almost caught, I almost asked you about your book recommendations before saying that.

Caitlin: But there’s so much more to cover before we get there.

Ben: It’s true. Like I want to hear what you remember about this interview, for example.

Caitlin: Well, I think that, there are a couple things. I’ll touch on both of them. Hopefully briefly enough, but I think one of the things that stuck out to me and maybe this is just sort of revealing of my worldview in a way that is either interesting or scary, but I think that that one thing I learned from talking to Nesse and reading his book, was that this gift of deep intimacy and connection with other people, sort of is the original good reason for a lot of the bad feelings that we humans have but that’s also what makes us marvelous, too. Anybody who’s had a close, intimate relationship, knows that it can be really difficult, sometimes. It’s really beautiful. It’s also really hard. And Randy even says that there’s a theory that one of the reasons our brains are so big and complex is that they are built especially to reckon with this super complex work of managing human relationships.

So I thought that was kind of interesting. Yeah, and then I guess the really practical thing that I found super worthwhile and I think, worth thinking about, whether or not you’re a clinician, is this idea of how medical practitioners can start doing emotional inventories of patients, that are very similar to how, you know, your Hausarzt, your just regular doctor does an inventory of your symptoms.

So. He shares his acronym, which is ‘social’. Do you remember what it stands for?

Ben: No.

Caitlin: Okay.

Ben: One was social resources.

Caitlin: Yep. So it’s social, S, social resources, O, occupation, C, is children and family and relatives, I, is income and financial resources, A, is abilities and appearance, this is really long, L is love and sex. So the idea that there are these-

Ben: Nicely done.

Caitlin: Why thank you, I try. There are these six main areas in which people are just trying to do things. We try to do things in these six main areas of life. And if one of them isn’t going well, then we can take a, by asking how each area of life is going, the clinician can get a little bit closer to what maybe the root cause of the problem actually is, instead of just slamming a stamp that says anxiety down upon you. And I think that’s super interesting.

Ben: He gives a specific example in one of the talks I saw, where he said, he recommended to clinicians to ask depressed patients if there’s something really important they’re trying to do but can’t succeed at, and can’t give up.

Caitlin: Right, and who does that sound like? That sounds like Johann Hari a little bit, right?

Ben: Right. Also in this season of Simplify.

Caitlin: Exactly, so, if you haven’t heard that episode yet, give it a listen. Johann Hari talks about how, you know, we need to be connected to people, we need this this this social resource. We need occupations. We need jobs to make us, help us make meaning. We need all these intangible connections that have nothing to do with the insides of our brain chemistry. So in a way, Hari and Nesse are making kind of similar points about how mental health exists, not just inside of your brain and your body, but environmentally and in your social circumstances.

Ben: Right. It’s funny how on Simplify we have this way of, somehow seasons come around a topic.

Caitlin: Yeah.

Ben: Somehow accidentally, but

Caitlin: You would think we planned it.

Ben: Almost, nicely done, Caitlin.

Caitlin: Uh-huh.

Ben: So let’s, should we get into books?

Caitlin: Sure, I mean, yeah, unless there’s anything that you wanted to mention, about what you thought.

Ben: I mean, the only reason why I said I had reservations and I’m a little skeptical was just, I think when we rush to answers about the brain, about emotion, and the idea that because our ancestors felt this, or went through this, is why we’re feeling today just sometimes feels a little bit too simplistic to me. I think the brain is an amazingly complex thing, like you just said, like he also believes. So that’s the only reason why I have this reservation.

Caitlin: Okay, fair.

Ben: So let’s get it, let’s get into books.

Caitlin: All right, let’s do it. I am going to kick things off with recommending a really beautiful book called, The Year of Magical Thinking, by Joan Didion. Have you read it?

Ben: Oh, yeah.

Caitlin: So, anybody who’s ever had to sit with grief, knows that that is one of the Big Mama’s of challenging bad feelings. And this is a book about loss and grieving. Didion’s daughter was hospitalized with pneumonia, which became septic shock and while she was in the hospital, Didion’s husband died. And then, just a couple of years later, Didion lost her daughter, too.

So, she had a lot of contact with death and grief in a very short space of time, and this book is the purging of that grief, and what she did to make meaning of it all. It’s really really beautiful, and it’s it’s beautiful support, as well, for anybody who’s going through that.

Ben: Yeah.

Caitlin: It’s a memoir by the way, so it’s not quite the same as what we usually recommend on Simplify, but I really recommend it.

Ben: And the thing, I mean, the thing that’s the best about the memoir in my opinion is how, there are no answers. And that’s sort of what I mean is, like, she’s as she’s dealing with this, she’s looking for, the title, The Year of Magical Thinking, is exactly that. That she finds herself with maybe ridiculous thoughts, that she realizes are real and not ridiculous, but maybe magical.

Caitlin: Hmm.

Ben: I have sort of a lighter title to, to recommend.

Caitlin: Awesome. Let’s fluff this up, Ben.

Ben: I was going through the Blinkist library, to try and jog my memory, and I saw a book I’ve never heard of before, which is Animal Madness: How Anxious Dogs, Compulsive Parrots and Elephants in Recovery Help Us Understand Ourselves.

Caitlin: That sounds interesting.

Ben: So, I’m going to recommend that one.

Caitlin: Okay. Have you, have you read it?

Ben: I read through the Blinks, I haven’t got the book yet.

Caitlin: Cool.

Ben: Fantastic.

Caitlin: But the Blinks were enough to make you want to actually read it?

Ben: Absolutely.

Caitlin: Awesome.

Ben: Animal Madness.

Caitlin: All right, I’ll check it out, too.

Ben: And, on a more serious tone, the book that, the other book I wanted to recommend, can I recommend a second, a third one?

Caitlin: You can, although, do you know who wrote Animal Madness?

Ben: Yes, obviously. Animal Madness by Laurel Braitman.

Caitlin: And then, so you had another book, too, what was it?

Ben: It’s called, I’m OK- You’re OK, by Thomas Anthony Harris.

Caitlin: That’s a classic.

Ben: Right. So this book was published in 1976. It was a bestseller, a self-help hit, you could call it. And the reason why I wanted to recommend this, is it’s also, like Nesse’s book, I think part of the history of psychological approaches to clinical treatment, Nesse is really interested in why we still struggle to diagnose and treat, why after hundreds of years of human practice, we can’t seem to nail it down.

So this book introduces something called transactional analysis, which involves understanding who we are, diagnosing ourselves as a result of our experiences, like our childhood, and our adult phase irrational self. A lot of transactional analysis has been challenged, and maybe isn’t in practice anymore.

But I think, if, it was such a big hit, I think if, I mean, I’m interested in sort of the history of how we think about our emotions and brains. I think a lot of people out there who are listening are also, I know you are, Caitlin. So, I think it’s worth checking out, kind of seeing what he said.

Caitlin: Cool.

Ben: For example, one interesting thing. There are four life positions.

Caitlin: Four of them.

Ben: Right. So the title of the book is, I’m OK- You’re OK.

Caitlin: Uh-huh.

Ben: There are four life positions. One, I’m not OK- you’re OK.

Caitlin: Mm-hmm.

Ben: Two, I’m not OK- you’re not OK. Three, I’m OK- you’re not OK. And four- I’m okay- you’re okay.

Caitlin: Okay, three sounds the meanest.

Ben: I’m OK- you’re not OK? Well, yeah. So, transactional analysis, check it out, Google it if you’re interested, or check out the book. I’m OK- You’re OK, by Thomas Anthony Harris.

Caitlin: Cool. And maybe don’t tell anybody I’m OK, you’re not OK. It feels really bad. Even when Ben just said it aloud. I was like, oh.

Ben: I thought of it as like, empathetic.

Caitlin: Oh, really? I just thought of it as judgmental. What does that say about us?

Ben: There you go.

Caitlin: Awesome. All right, so, I guess that’s a wrap on this episode. But, got a little bit of housekeeping to do. We want to tell you all that, Simplify was produced by me, Caitlin Schiller, Ben Schuman-Stoler and Florian Tippe.

Ben: Yeah, if you enjoyed this episode of Simplify, please do give us a rating in Apple Podcasts. It helps other people find us. It makes us really happy. That would be great. And for those who don’t know, Caitlin and I work here at Blinkist. We’re recording this at Blinkist HQ and Blinkist is an App, but you can find us on the web. Your favorite App store.

If you’d like the Apps, iOS, Android, we basically take the key insights from the world’s best non-fiction books and distill them into little capsules that you can read or listen to in, like, 15 minutes. So, definitely check it out. Especially if you liked this interview, you can find Good Reasons for Bad Feelings on Blinkist and also all the other books we discussed.

If you want to try it out, this sounds good, go to Blinkist.com/simplify, find the Try Blinkist link, type in Social, S-O-C-I-A-L, social. Nailed it. And yeah, you can try, with that code, you can try Blinkist out for 14 days for free.

Caitlin: Awesome. All right, so, and if you want to tell us about what you thought about this interview, or Evolutionary Psychiatry, or anxious chickens or whatever else. We are on Twitter. I’m @CaitlinSchiller and Ben is @bsto. Also, you can email us at podcast@blinkist.com.

Ben: Cool. So, that’s it. We’ll be back with more Simplify next week.

Caitlin: Great. Checkin’ out.

Ben: Checkin’ out.

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