New Insights on Emotional and Behavioral Disorders

In Untangling the Mind: Why We Behave the Way We Do, D. Theodore George, M.D., a psychiatrist and neuroscientist at the National Institutes of Health, describes a new model for understanding America’s surge in emotional and behavioral disorders.  Earlier this year, a report by the National Research Council and Institute of Medicine of the National Academies found that comparing a peer group of 17 wealthy countries, Americans under 50 now have the lowest life expectancy and fall at the bottom (i.e. were the worst) of nearly every morbidity category from deaths by substance abuse, sexual-related diseases, infant mortality, violence and sedentary lifestyles that contribute to diabetes and cardiovascular problems. The report points out that in the years following World War II, America was near or at the top of the peer group.  It rightly concludes that something clearly is wrong but, unfortunately, fails to provide a satisfactory explanation.  The problem has become so acute that earlier this month the Centers for Disease Control and Prevention released figures that show suicide rates haven sharply increased so that more Americans now die from suicide than from motor vehicle accidents.

Fortunately, Dr. George’s book helps us understand what’s going wrong.  In his view, traumas experienced by 75 percent of the population result in faulty brain wiring that makes people vulnerable to the stressors, threats and fears we experience in modern life, including the chronic stress many people experience in today’s workplace.  The faulty wiring misinterprets threats and fears by blowing them way out of proportion.  This results in emotional and behavioral disorders.  When people don’t feel well emotionally – i.e. they are angry, anxious, withdrawn, bored, depressed, etc. – they frequently cope in ways that result in addiction (e.g. substance abuse, promiscuity, porn addiction, eating disorders, cutting).  Although these addictive behaviors provide temporary relief, they hijack the brain’s reward system and eventually kick in the anti-reward system so that people need a fix of the coping behavior to feel better from the unpleasant sensations of withdrawal.   

In the last part of the book, Dr. George describes how he helps his patients.  He uses “talk therapy” to connect with them and teach them so they understand what’s going wrong, he coaches them to help develop a plan that features neutral or healthy habits that replace unhealthy ones, and he encourages them to persevere until new healthy habits are formed.  There are many useful parts of the book including Dr. George’s model (focusing on the periaqueductal gray or “PAG” part of the brain), a list of threats and fears which trigger emotional and behavioral disorders, and descriptions of healthy behaviors that can be used to replace unhealthy ones.

My summary doesn’t do the book justice so I highly recommend that anyone who is struggling with emotional or behavioral disorders, and for those who care about them, get this book and read it.  Untangling the Mind is a valuable new resource that provides insight and practical advice to help the many Americans today who are struggling with emotional and behavioral disorders.

Note: In the spirit of full disclosure you should know that I write, speak and teach about reducing stress in the workplace so when I heard about this book I contacted the publisher, HarperOne, and requested, and was sent, a free review copy to consider writing about it.

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