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Doody's Review ServiceReviewer: Brett C. Plyler, M.D.(Northwestern Memorial Hospital)
Description: This is a study of five anxiety/depressive disorders and how their root cause may lie in ancient social instincts that were necessary for survival of our communal DNA.
Purpose: The purpose is to present the author's theory of evolutionary psychiatry and how it results in mental illness today.
Audience: The book is written for the general public, mental health clinicians, and academic researchers.
Features: It explores evolutionary psychiatry and the author's concept that a significant amount of anxiety and depressive disorders may have their origins in instinctual behavior dedicated to preserving our DNA over thousands of years of evolution. The five that he focuses on are: panic anxiety, social anxiety, melancholic depression, atypical depression, and obsessive compulsive disorder. The author contends that our "consciousness" allows us to override these ancient instincts, but this conflict leads to anxiety/depression. For example, social anxiety was meant to keep a person in line in tribal social hierarchies, but in the present time, results in painful embarrassment and shame when we try to step out on our own. Each chapter discusses one of these five and the theoretical and scientific underpinnings supporting it. The second half of the book analyzes the rise of civilization and the clash of societal instincts and an individual's consciousness. The resulting emotional disruption has numerous effects on the individual and society at large. The author explores how these disruptions can both contribute to and slow the growth of a civilization. The book closes with a chapter on instinct and reason and how to balance those choices.
Assessment: This is an interesting book by an author with a wealth of clinical and research experience. He has done a very thorough job on the research behind his theories and expresses them clearly and succinctly. I was intrigued by the evolutionary psychiatric explanation of the various disorders, and they do make sense when you think about them from that perspective — emotional disorders arising from the conflict between societal instincts and our consciousness. It definitely got me to think about these problems in a different way, which will be useful to both me and my patients. However, I found the treatment applications to be lacking and not well described. So, an intriguing and interesting evolution in the way we can understand some emotional problems, but not much in the area of clinical treatment applications. I would recommend the book because it is well written with humor and insight and without too much psychological jargon.