Synopses & Reviews
Why do so many people suffer the slings and arrows of outrageous angst? Some twenty percent of us are afflicted with common Anxiety and Depressive disorders. That's not just nervous or scared or sad - that is painful dysfunction without obvious benefit. This angst comes from an evolutionary inheritance that biologically shaped us into social communities. There are just five specific diagnostic subtypes that account for most of this modern-day angst: Panic Anxiety, Social Anxiety, OCD, Atypical Depression and Melancholic Depression. Each of the five comes from primeval social instincts that told our ancestors how to improve survival of their community DNA. These instincts are also very much alive and unfettered in other species today. Their potential link to our human distress was anticipated by both Darwin and Freud.
We humans have greater instinctive consciousness than other creatures. Rational thoughts let us defy biological social instructions. One result of this uniquely human skill is that over-ridden social instincts complain to us in the painful language of emotional disorders. A few of us even tackle this pain head-on, in ways that can advance our intellectual creativity, social performance, and productivity. Our human intellectual abilities owe as much to our unique social software as to our greater brain processing power. Civilization is built upon our ability to maintain social harmony with ethics and government, and to find solace in technology, religion and beer.
This novel theoretical synthesis offers a new framework for understanding what we already know from psychiatric neuroscience, clinical research, diagnosis and treatment. The central theory is explained in everyday language. It is supported by clinical observation, straightforward accounts of complex science, animal research, and quotes from both ancient writings and modern humor and lyrics. This fascinating new synthesis is written for the general public, mental health professionals and academic researchers alike.
"Why does mental illness persist when it would seem to be counterproductive in an evolutionary sense? Kahn argues that certain traits that promote group fitness can, in a modern context and if exaggerated, manifest as serious mental illness . . . A lively presentation." --Library Journal
Some twenty percent of us are afflicted with common anxiety and depressive disorders--not just brief bouts of nervousness or sorrow, but painful dysfunctions without obvious benefit. Why do so many people suffer from angst?
In this path-breaking volume, engagingly written for the general public, psychiatrist Jeffrey Kahn reveals that angst ultimately results from our transformation, over tens of thousands of years, from biologically shaped, almost herd-like prehistoric tribes, to rational and independent individuals in modern civilization. Kahn looks at five basic types of modern-day angst--Panic Anxiety, Social Anxiety, OCD, Atypical Depression, and Melancholic Depression--and shows how each derives from primeval social instincts that once helped our ancestors survive. For instance, the "panic disorder" which prevents some people from flying may have originally evolved to keep our tribal ancestors from traveling dangerously far from home. Likewise, the increased emotional sensitivity to social rejection that now triggers episodes of "atypical depression" may have helped maintain polite behavior and social harmony in our ancestors. Our distinctly human civilization and rational consciousness lets us defy these social instincts. But those over-ridden instincts can resurface as stressful emotional disorders. Kahn notes that some of us painfully tackle this distress head-on, in ways that can advance intellectual creativity, social performance and productivity. He also describes the interplay of instinct with the advance of civilization, and on how evolutionary perspective explains why modern treatments work.
Ranging from Darwin and Freud to the most cutting-edge medical and scientific findings--drawing from ancient writings, modern humor and popular lyrics, and with many amusing cartoons--Angst offers us an exciting new slant on some of the most pervasive mental health issues of our time.
About the Author
Jeffrey P. Kahn, M.D.'s evolutionary theory of Anxiety and Depression draws on his academic work on anxiety disorders, workplace mental health, and precision diagnosis, and most especially upon observations from clinical practice. A graduate of Swarthmore College and Columbia University Medical School, he is now Clinical Associate Professor of Psychiatry at Weill-Cornell Medical College, with offices in Manhattan and Westchester County.
Table of Contents
Table of Contents
One: Lions and Tigers and Bears are Not Why: Angst is the Modern Echo of Evolved Social Instincts
Part I: Six Social Instincts: Five Usual Suspects and One Missing Think
Two: Don't Stray Far From Family, Home or Safety: Panic Anxiety
Three: Follow the Leader of the Pack: Social Anxiety
Four: A Sure and Tidy Nest (Clean, Arrange, Save and Behave): Obsessive-Compulsive Disorder
Five: Go Along to Get Along: Atypical Depression
Six: Feeling So Useless You Could Die: Melancholic Depression
Seven: Consciousness Lost and Instinct Run Amok: Schizophrenia and Psychosis
Part II: Civilization: The Rise of Reason and the Ascent of Angst
Eight: Happy in the Herd: Instinctive Herds and Primeval Ignorance
Nine: Climbing To Civilization: The Rise of Reason and the Ascent of Angst
Ten: Illness and Instinct: Consciousness Has Consequences
Eleven: Free to Choose: How to Balance Your Reason and Instinct
Appendix of Diagnostic Criteria