BTRIPP (btripp) wrote,

Must be crazy ...

This is another book that got suggested to me at a DBSA meeting, much like the Kay Jamison book I reviewed a few months back. I certainly liked Ruby Wax's Sane New World: A User's Guide to the Normal-Crazy Mind a lot more … but that is likely because the tone of this is much less oppressive – reflecting, no doubt Wax's background in acting/comedy (primarily in the UK, although hailing from Evanston, IL), as opposed to the other author's psychology roots. Wax, who had suffered from depression and related conditions for most of her life, responded to the dwindling of her performance career by going back to school, and ending up with a Masters from Oxford in “mindfulness-based cognitive therapy”, so she has the chops to really get into the subject here.

While the book does spend a lot of (entertaining) verbiage dealing with specifics of Wax's life, it's not specifically autobiographical, and is in five parts, each (confusingly) containing a differently-named chapter from the name of the “part” (so what's on the Contents page isn't what's up top on the individual pages – go figure – must be the “crazy” manifesting), each containing assorted thematic sub-sections … including her various “my story” bits. Since these are ambiguously titled, I'm just going to give a description: the first part covers the sorts of neuroses that pretty much impact everybody to some extent, the second part's chapter is called “Depression – Broken Brains”, so deals with the more damaged among us, the next part looks at “neuroscience”, which is followed by an overview of mindfulness, and finished with “the manual”, which has (as one might expect) suggested exercises, homework assignments, handy forms, and other useful information.

Rather than trying to summarize all this, I'm going to mainly go with the parts I dropped in bookmarks for – some of which are more for their humor or out-of-the-box approach than being specifically “pithy” as to the actual arc of the book. This starts with the following from the sub-section “The Fix of Happiness”:
… There are some lucky people who feel they experience happiness when they gaze at a cloud or walk on the beach, but the rest of us get that special tingly buzz only when we've bought, won, achieved, hooked, or booked something. Then our own brains give us a bit of dopamine, which makes us feel good. We don't need substances; we are our own drug dealer.
      The problem is, the hit of happiness usually lasts as long as a cigarette, so we have to continually search for the next fix. It's as though as a species we had no brakes, just breakdowns. …
She goes from this to defining her version of Maslow's hierarchy which takes fourteen steps to go from food/water to “Meeting Oprah” (with five steps of increasingly posh air travel in the mix). Did I mention that there's an awful lot of great stuff in here (and much of it's a hoot)? Because I feel guilty flipping through to get to my next little paper slip … but we don't want this review being 20,000 words, do we? Some of these are informative (in the Johnny Carson-esque “I did not know that.” mode), such as:
If you watch a face it will tell you everything. For instance, you cannot fake a smile. There is a muscle under the eye called the periocular that will not become active if you aren't genuinely smiling. The mouth is easy to upturn but if you don't find something funny, that periocular muscle just doesn't move; your eyes are dead as a trout's.
Again, this is a complex mix of what Wax knows from grad school, and what she knows from being saddled with psychological issues … here's a very telling one coming from the latter type of expertise (moving from a discussion of sadness/unhappiness pinned to a particular quote from Hamlet):
      Depression is a whole other beast; it is not situation appropriate. Here's something you get absolutely free with this illness: a real sense of shame; it comes with the package. And you feel such extreme shame because you think, “I'm not being carpet-bombed, I don't have anything to complain about.” Your thoughts become so punishing for your selfishness – like bombs, incoming over Dresden – so loud, so relentless you get not one voice but about a hundred thousand abusive voices; like if the devil had Tourette's. Depression doesn't care if you're famous, if you live in a mud hut, or what culture you come from, it just loves everyone.
(While I really like that bit, it is slightly incoherent – but I'm considering that it's coming from something of a “performance art” place rather that “outtakes from my thesis” on the author's part. A tidbit which does sound like it's from the latter category is: “The World Economic Forum estimates that the global cost of mental illness will be about $16 trillion by 2030.”, and that as many as 1 in 4 people suffer from some degree of clinical depression.) In this section she comes up with what I thought was a great suggestion (actually DBSA is quite a bit like this) following a rant about finding a “buddy” who understands that “you are not making it up and you are not a self-indulgent, self-obsessed narcissist who's looking for pity or an excuse not to show up at work or school”:
Alcoholics Anonymous has a system where you call your buddy when you feel you want a drink and they will talk you down. Why can't we have meeting places like in AA, where they all get together for their twelve-step thing and have cigarettes and cookies? How did they organize these get-togethers so well? They have meeting places on every corner of every block; more places than there are Starbucks. How did they figure all this out? Why can't we do that?
Oddly (given my interest in the subject), I didn't drop a single bookmark in the central “neuroscience” chapter. This is not due to it being lacking … in fact, Wax does a remarkable job of presenting a quite detailed look at brain biology, function, and the like in fifty-some-odd pages. It's more that this has such a “fire hose” of information that it would be hard to sufficiently cherry-pick factoids to give you and adequate sense of what's in there. I did note one thing right at the end of the section, which I thought was important:
… I just want to bring your attention to how misguided we are in insisting the external world is exactly as we see it. Much of what you see out there is manufactured by your brain, painted in like computer-generated graphics in a movie; only a very small part of the inputs to your occipital lobe comes directly from the external world. The rest comes from internal memory stores and other processes. …
The next part of the book is about “mindfulness”, which is where this all is heading. She backgrounds this initially with her own experiences, and then discusses the history of the discipline. This approach started in 1979 with Dr. John Kabat-Zinn, who created a method to use with patients whose pain was too chronic to remedy, those who were given the diagnosis of “You're going to have to live with this.” Obviously, there's a disconnect between physical and emotion pain, and it was a group of researchers (John Teasdale, Zindel Segal, and the professor Wax studied with, Mark Williams) who took Kabat-Zinn's work and applied it to psychology, developing MBCT (mindfulness-based cognitive therapy). I am currently undergoing a course of therapy related to this, and found it amusing that something we were working on this very morning (for managing depression/panic related emotions) is essentially covered in this section as a coping structure with the acronym RAIN – Recognition, Acceptance, Investigation, Nonidentification … along with some suggested exercises.

When she gets around to addressing stress, there's this which stood out to me:
… Thanks to our ever-speedier culture, most of our lives are now lived in a state of hyperarousal, and almost everything out there seems scary. We're in a constant downpour of adrenaline and cortisol, muscle tension, high blood pressure, and lack of oxygen to the brain – all of which can make us very, very ill. Notice when you feel the beginning of stress; closely explore where it is in your body, the size, the edges, the sensations. Notice how your breathing and your posture change. Notice if your mind starts to kick in with suggestions to get coffee, cigarettes, or tranquilizers. You don't have to suppress the thoughts or the feelings of fear, anger, or hurt but recognize that they are the dandruff of a flaky mind.
The “mindfulness” chapter closes with a fairly lengthy section on “Facts About Mindfulness”, which, while interesting in terms of all the multitudinous conditions and studies she cites, almost approaches “snake oil” territory with the feeling that it “cures what ails ya” no matter what the issue. Or that might just be me being a cynical old coot. The last part of the book is “The Manual” if you're going by the chapter/page headings, or “Alternative Suggestions for Peace of Mind” if you're looking at the Contents, which is more the second of these than what you might expect from the shorter one. A significant portion of this is taken up with looking at Cognitive Behavior Therapy (which she then contrasts with MBCT – claiming the latter is twice as effective), with some other stuff thrown in. I rather liked her framing this part, which I've shortened somewhat:
      If mindfulness isn't for you, I'm going to suggest some alternative practices to help you deal with everything from life's little hiccups to the gale force ten, brain-shattering breakdowns.
      The important thing is that you find something to anchor you when the winds of “shit happens” get rough. So many people I know don't have an antidote for life's turbulent weather and suffer because of it. … Dissatisfaction is part of the deal of living because simple existence is full of contradictions; we want individuality, to stand out from the crowd, yet we want to be part of a tribe. We're driven and busy and yet we want peace. And, worst of all, we want things to stay the same despite the fact that everything changes (that's the ultimate bummer). … Impermanence is the law of the universe – no can do. Even if you rage through the night, before you finish reading this sentence, billions of your cells have died and been reborn. Because we have consciousness, we suffer about the fact we suffer, and this second arrow of suffering is constructed in our brains. But if our brain can create this pain, it can also create happiness.
OK, so I'm not so convinced about that last point, but the rest is pretty much on-target. Sane New World is relatively new (the hardcover came out in 2013, this paperback edition a year later), and (as a “#1 UK Bestseller”) is very likely to be available from brick & mortar book vendors who carry self-help and/or psychology titles. The on-line big boys, of course, have it … and the new/used vendors have “good” copies for as little as a penny, and “like new” for a couple of bucks (plus shipping). I quite enjoyed this, and found it both entertaining and informative, and figure it should be a “must read” for most folks (that's 1 in 4, remember) struggling with depression, and a worthwhile thing to get into for everybody else.

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Tags: book review
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