Good Reasons for Bad Feelings

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 illnessWith his classic book Why We Get Sick, Randolph Nesse established 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. Taken together, these insights and many more help to explain the pervasiveness of human suffering, and show us new paths for relieving it.Good Reasons for Bad Feelings will fascinate anyone who wonders how our minds can be so powerful, yet so fragile, and how love and goodness came to exist in organisms shaped to maximize Darwinian fitness.

“Nesse's book offers fresh thinking in a field that has come to feel stagnant”

The Financial Times
A compelling case for locating mental illness within an evolutionary frame-work . . . an excellent and timely account of the history, development andimplications of evolutionary psychiatry. -- Frank Tallis The Evening Standard
This is a wise, accessible, highly readable exploration of an issue that goes to the heart of human existence. -- Robert M. Sapolsky, author of Behave
This intriguing book turns some age-old questions about the human condition upside down . . . In an engaging, storytelling voice that rests on 30 years of clinical practice, he offers a series of insights. The Observer
Insights that radically reframe psychiatric conditions ... As Good Reasons for Bad Feelings boldly posits, many of the core dysfunctional components of mental illness ultimately help to make us human. -- Adrian Woolfson Nature
Using [...] fascinating insights, Nesse suggests novel and revolutionary ways to treat mental illness. The Daily Mail
[Nesse's] basic conception of the mind feels like good, common sense. The Sunday Times
All psychiatrists and patients who find themselves having occasional "bad feelings" about our current understanding of mental illness will have many "good reasons" to consult this book. I do fully expect that someday nearly all psychiatry will be identified as evolutionary psychiatry. If so, Randolph Nesse's book should be seen as the field's founding document. -- David P. Barash The Wall Street Journal
Highly accessible, scholarly and deeply illuminating . . . this will become a treasured classic; not just for clinicians but for all those interested in how to facilitate well-being and create more moral communities and societies. -- Professor Paul Gilbert OBE, author of Compassionate Mind, and Living like Crazy
Two sets of ideas inform this fine book: one, the cold-hearted logic of natural selection; the other, the practical wisdom of a compassionate psychiatrist. The tension is palpable. The result is riveting. -- Nicholas Humphrey, Emeritus Professor of Psychology, London School of Economics, author of Soul Dust
A personalized and lively but well documented treatise on how we humans function and on needed changes in the way psychiatry thinks about troublesome mental experiences and behavior. . . . Many readers will find it hard to put the book down. -- Eric Klinger, Emeritus Professor of Psychology, University of Minnesota
Those powerful feelings that fill our day, that give us the oomph to act one way or another are the guardrails to living and this wonderful books explains all of them. Randolph Nesse has done it again. -- Michael S. Gazzaniga, Director, Sage Center, UC Santa Barbara
A book as wise and illuminating as it is relevant to our daily lives. -- Sarah Blaffer Hrdy, Professor Emerita of Anthropology, University of California, Davis, author of The Woman that Never Evolved and Mother Nature

In this very accessible book, Nesse explains how an evolutionary framework can be to psychiatry
what physiology is to the rest of medicine. Evolutionary science bridges the gap between
neuroscience and the environment.

Royal College of Psychiatrists newsletter
A bold book that would have made Darwin proud. Cutting-edge and compassionate at the same time. -- Lee Dugatkin, Professor of Biology, University of Louisville, co-author of How to Tame a Fox and Build a Dog
It is no exaggeration to say that Nesse opens the door to a new paradigm in thinking about human beings and their conflicted lives. A pathbreaking book by a man who is truly humane and caring. A privilege to share time with him. -- Michael Ruse, Werkmeister Professor of Philosophy, Florida State University, author of On Purpose

Randolph Nesse, who trained psychiatrists for many years, has for a quarter century been a key leader of evolutionary medicine. Good Reasons for Bad Feelings integrates these two strands of his life and thought in a readable, insightful book, as much a philosophy of emotions as it is a new window on mental illness. All who want to know themselves should read it.

-- Melvin Konner, Dobbs Professor of Anthropology, Emory University, author of The Tangled Wing
Randolph Nesse is one of the key architects of evolutionary medicine. He's been an inspiration to a generation of scientists, who explore evolution to understand why we get sick from diseases ranging from cancer to obesity to infectious diseases. Now Nesse has turned his attention from the body to the mind, in a provocative book full of intriguing explanations about human nature in all its strengths and weaknesses. -- Carl Zimmer, author of She Has Her Mother's Laugh: The Powers, Perversions, and Potential of Heredity
A masterful, groundbreaking book that persuasively challenges standard clinical wisdom and provides a roadmap for the transformation of our conceptually confused psychiatric nosology . . . Anyone interested in mental health-laypeople, students, clinicians, and scholars-will be grateful for the novel insights to be gained from this important book. The distillation of decades of pathbreaking contributions to evolutionary psychiatry, this book will be an influential watershed in the mental health field, and a worthy successor to Nesse's earlier celebrated book on medical disease. If joy is indeed a biologically programmed emotional response motivating us to take advantage of unexpected bounty and opportunity, then every reader will experience joy in reading Randy Nesse's beautifully written, profound book. -- Jerome C. Wakefield, Professor of Psychiatry, New York University, co-author of The Loss of Sadness
Randolph Nesse's book Why We Get Sick put evolutionary medicine on the map. His follow-up, Good Reasons for Bad Feelings, promises to transform our understanding of mental illnesses in the same way. New Scientist
Randolph Nesse's new book ... is clear and engaging, and the narrative reflects a masterful blend of history, novel ideas, and clinical experience in an insightful and coherent manner. I hope it is widely read and discussed. -- Eric Charnov, Distinguished Professor Emeritus of Evolutionary Ecology, University of Utah, MacArthur Fellow
What is the nature of suffering, its origin and its adaptive significance? Good Reasons for Bad Feelings may well become a legend, as it is a book about psychology, psychiatry, biology and philosophy that is also a good read, and it opens the door to deep questions in a manner that is tender, quizzical, and industrious. -- Judith Eve Lipton, MD, co-author of Strength Through Peace
Good Reasons for Bad Feelings by Randy Nesse is a delightful book. It is insightful about the human condition, sanguine and not over-stated. And it is written in a straight-forward and delightful manner, personal and professional, and with humor. Neese is one of the originators of the field of evolutionary medicine. This is a welcome book in evolutionary psychiatry and on the biological basis of the emotions and our cultural evolution. -- Jay Schulkin, Research Professor of Neuroscience, Georgetown University
In Good Reasons for Bad Feelings, leading evolutionary theorist, psychiatrist Randolph Nesse, begs us to ask the right question: Why did natural selection make us so prone to mental disorders of so many kinds and intensities? It is no exaggeration to say that he opens the door to a new paradigm in thinking about human beings and their conflicted lives. A pathbreaking book by a man who is truly humane and caring. A privilege to share time with him. -- Matthew Ruse, Werkmeister Professor of Philosophy, Florida State University, author of On Purpose
Why I am I feeling bad?' This is the first burning question of everyone who suffers. This accessible new book will be an essential tool to help patients, their loved ones, and treating professionals arrive at more satisfying answers. -- Jonathan Rottenberg, Professor of Psychology, University of South Florida, author of The Depths
How did we end up recognizing that every system in the body has a function shaped by evolutionary selection and yet thinking that systems in the mind do not? How did physical and mental health drift so far apart? Randolph Nesse explains, in this highly readable book, how 'symptoms' in psychiatry should be seen in their evolutionary context, and that anxiety and depression for example have functions, just as do inflammation, blood clotting, or a cough. Nesse is a pioneer of evolutionary psychiatry, which has the potential to revolutionize mental health care. -- Simon Baron-Cohen, Professor of Developmental Psychopathology, Cambridge University
This book sets out to show how evolution underpins (or should underpin) psychiatry. In doing so, it will surely change the face of medicine -- and deservedly so. -- Robin Dunbar, Emeritus Professor of Evolutionary Psychology, University of Oxford
Randy Nesse has brought a new and important synthesis to the study of illnesses that psychiatrists deal in. This engagingly accessible, pioneering book provides a wide range of answers for how something as maladaptive as bipolar disorders could have evolved. It provides a wide range of answers for why natural selection has left us vulnerable to so many mental disorders, and the "mystery of missing heredity" is identified as a key problem. Nesse shows that by taking into account complex pleiotropic effects, natural selection may push some useful trait close to a fitness peak near a "cliff edge" despite the disabling consequences for a few individuals who go over the edge. Thus a gene may be useful to many, but with bad luck contribute to victimizing the few. This complex problem surely will yield to further research. -- Christopher Boehm, Professor of Biological Sciences, USC Dornsife
The book is aimed at a wide audience including the general public. However, it is testament to Professor Nesse's command of the field of evolution and medicine as well as his extra-ordinary ability to explain enormously complex ideas in plain English with minimal use of jargon that the book is just as relevant to psychiatrists, psychologists of all levels as well as to academics interested in evolutionary science. -- Riadh Abed, FRCPsych, Founding Chair of the Evolutionary Psychiatry Special Interest Group, Royal College of Psychiatrists

Randolph Nesse is an American physician, a founder of evolutionary medicine, and co-author with George C. Williams of the acclaimed Why We Get Sick. After a long career as a Professor of Psychiatry and Professor of Psychology at the University of Michigan, Nesse moved in 2014 to become the Founding Director of the Center for Evolution and Medicine at Arizona State University, where he is also a professor in the School of Life Sciences.

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