Good Reasons for Bad Feelings

Insights from the Frontier of Evolutionary Psychiatry

By: Randolph M. Nesse MD

Narrated by: Arthur Morey

A founder of the field of evolutionary medicine uses his decades of experience as a psychiatrist to provide a much-needed new framework for making sense of mental illness.

With his classic book Why We Get Sick, Dr. Randolph Nesse helped to establish the field of evolutionary medicine. Now he returns with a book that transforms our understanding of mental disorders by exploring a fundamentally new question. Instead of asking why certain people suffer from mental illness, Nesse asks why natural selection has left us all with fragile minds.

Drawing on revealing stories from his own clinical practice and insights from evolutionary biology, Nesse shows how negative emotions are useful in certain situations, yet can become excessive. Anxiety protects us from harm in the face of danger, but false alarms are inevitable. Low mood prevents us from wasting effort in pursuit of unreachable goals, but it often escalates into pathological depression. Other mental disorders, such as addiction and anorexia, result from the mismatch between modern environments and our ancient human past. And there are good evolutionary reasons for sexual disorders and for why genes for schizophrenia persist. Taken together, these and many more insights help to explain the pervasiveness of human suffering, and show us new paths for relieving it by understanding individuals as individuals.

Includes a Bonus PDF of charts and visuals.

Cover art © The Josef and Anni Albers Foundation / Artists Rights Society (ARS), New York, 2018

Learned a lot

Very well written and informative about the role of evolutionary psychiatry. The author did a great job discussing the evolutionary roles of anxiety and depression. These conditions are often viewed in a negative context, but the author provides evidence to support the fact that these traits were necessary for survival. Essentially, the brain was made to keep you alive. The section about obesity was a bit dated because the book was published before ozempic and other GLP 1 medications became popular for weight loss. Highly recommend overall.

great ideas

Wow. this is very confirming and validating. i'll listen again. for me it had considerable depth in fields that only a few yrs ago didn't exist.

Ricapitolazione scorrevole ed approfondita.

Ricapitolazione scorrevole ed approfondita. Fornisce le basi per capire i disturbi mentali partendo da premesse teoretiche scientifiche.

A Very Good, if Imperfect, Book

Nesse does a nice job of surveying an impossibly complex mental landscape. And he succeeds in making the ideas interesting and accessible. Truly, the book is an accomplishment. His tone is encouraging, and he approaches professions and theories with an inclusive openness. Unfortunately, that openness breaks down to unboundedness at times. His oddly strident defense of debunked psychoanalytic theory (including a shrill protest of a "purge") did not fit well in a book that claims a position on "the frontier." Similarly out of place were the heroic-insight clinical vignettes; these sophomoric tales almost certainly were forced in per editorial insistence to add human interest. The weaknesses can be forgiven, given the size of the challenge and the genuine value of this effort. Nesse's book is a provocative resource for psychiatric residents, clinical psych interns, and anyone wanting to shake up the way they think about mental health and illness.

Very good resource.

The author goes to great effort to try to provide a balanced view. Much of what he writes deserves to be heard and studied. The explanation, in evolution, leaves room for other causes, e.g., a designer or God, that reaches the same end.