Good Reasons for Bad Feelings: Insights from the Frontier of Evolutionary Psychiatry

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Release Date: 
February 12, 2019
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“Emotions are not positive or negative but must be used appropriately in situations—through neither under- nor overuse—to be effective.”

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.

Nesse explains the purpose of evolutionary psychiatry as: “Using the principles of evolutionary biology to improve understanding and treatment of mental disorders in psychiatry, clinical psychology, social work, nursing, and other professions.” He then delves into what evolutionary biology is—the “foundation of understanding normal behavior”—and moves on to addressing natural selection.

He informs us that natural selection cares little about individual happiness and is not about health, fitness, or longevity, as one might think. Its primary concern is to shape the brain and body to maximize reproductive success, aka gene transmission. Nesse describes the limits of natural selection regarding emotions, including its inability to completely eliminate mutations, and admits that, “Our emotions benefit our genes far more than they do us.”

He goes on to describe how humans are an imperfect evolutionary mishmash of pluses and minuses, warning against throwing out the baby with the bath water to reduce emotional suffering when pain and fear are inarguably at times essential defensive responses against threats. He stresses how important it is for psychiatry and its patients to understand that some problems are caused not by genes or brain defects, but that, in many cases, our suffering is due to our bodies and brains being wildly out of sync with our environment.

Though a natural process, Nesse maintains that social selection is also a cause of some mental health problems. It primes us to partner, collaborate, and cooperate with others, but causes friction when people prioritize human goals of food, friends, sex, safety, status, and offspring differently from each other. Moreover, social selection causes us to care a good deal about what others think of us and, therefore, can lead to anxiety and depression when we don’t or think we don’t measure up.

Nesse helps us understand that part of the answer to why human life contains so much suffering is “that natural selection shaped emotions such as anxiety, low mood and grief because they are useful . . .” and that, “Sometimes painful emotions are normal but unnecessary because the cost of not having the emotion could be huge.”

He uses the Smoke Detector Principle and faulty alarms to explain how we put up with false positives from our emotions because the consequences of no alarm when it’s truly necessary could be tragic or fatal. On a more positive note, he states that, “Evolution explains the origins of our amazing capacities for love and goodness and why they carry the price of grief, guilt, and, thank goodness, caring inordinately about what others think about us.”

He explains that, “Emotions are specialized states that adjust physiology, cognition, subjective experience, facial expressions, and behavior in ways that increase the ability to meet the adaptive challenges of situations that have recurred over the evolutionary history of a species.” His point is that emotions are not positive or negative but must be used appropriately in situations—through neither under- nor overuse—to be effective. He provides possible evolutionary functions for guilt, anxiety, grief, high mood, low mood, hopelessness, depression, and even self-deception, stressing that striking a balance among them is what we should aim for.

Nesse admonishes psychiatry for engaging in Viewing Symptoms as Diseases rather than focusing on what is causing emotions to misfire in differing situations. He insists that “Carefully distinguishing symptoms from both syndromes and diseases is crucial for making psychiatric diagnoses like diagnoses in the rest of medicine.”

He views bpolar disorder as being due to a broken “moodostat,” causing mood to escalate or plummet and then, rather than return to stasis, remain that way. He says that “Depression is caused by the situation, the view of the situation, and the brain” and all must be treated. To him, “Addictions are due to a mismatch between our ancestral brain and our modern environment” in which drugs are potent and readily available and there are few cultural prohibitions against them.

Nesse ends the book by saying that researchers have not yet found specific genetic causes for special mental disorders, insisting that they are not due to defective genes although they are influenced by genes. He advocates that psychiatry must use a biopsychosocial approach to assess and treat patients in their situations until science finds better ways of changing our brains to improve emotional management.