Table Of ContentTable of Contents
Title Page
Copyright Page
Dedication
Acknowledgements
Introduction
Part One - What’s Wrong
Chapter 1 - The Big Picture
Chapter 2 - Twenty-First-Century Stress
Chapter 3 - Brain and Body
Part Two - What to Do
Chapter 4 - Repairing the Emotional Brain
Chapter 5 - Mindfulness, the Core Skill
Chapter 6 - The World We Create
Chapter 7 - Common Human Miseries: Anxiety, Depression, PTSD, Personality
...
Chapter 8 - Good Thoughts, Bad Thoughts, No Thoughts
Chapter 9 - Getting Along with Your Body
Chapter 10 - Relationships under Stress
Chapter 11 - Adjusting the Brain
Appendix - How to Find Further Help
References
Notes
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Library of Congress Cataloging-in-Publication Data
O’Connor, Richard, Ph.D.
Undoing perpetual stress : the missing connection between depression, anxiety,
and 21st century illness / by Richard O’Connor. p. cm.
Includes bibliographical references and index.
eISBN : 978-1-101-09916-2
1. Stress management. 2. Stress (Psychology) 3. Anxiety. 4. Civilization,
Modern—21st century—Health aspects. I. Title.
RA785.O296 2005
155.9’042—dc22
2004057081
http://us.penguingroup.com
To my children and their generation, who I fear will need this
even more than my generation.
Acknowledgments
I owe a very real debt to two very good friends and skilled therapists—Hope
Payson and Helen Bray-Garretson—who read early versions of the manuscript
and gave me valuable encouragement and direction. In fact, many of the ideas in
this book were initially hatched during case discussions with them, and they
deserve more credit than I can really give here. I also owe a great deal to Irwin
Hoffman and Paul Lippmann, who, at different times in my life, helped me keep
going through dark periods but did it in such a way that it stimulated my own
search for answers.
My agent, Jim Levine, has become a friend, critic, and independent source of
valuable ideas; not bad for one guy. Christine Zika, my editor at Berkley, has
been very patient and helpful; once she finally saw the manuscript, her evident
and sincere liking for the book has helped sustain me through the last dreary
stages of cutting and polishing; and her editorial advice was good too. Sheila
Moody, the copyeditor, did an outstanding job on a complicated book.
My biggest source of inspiration is my patients. You’ll meet some of them in
these pages, in disguised form. Their stories—and those of all my patients—are
profoundly moving. It’s not that I attract a rare breed, but that the process of
therapy brings two people close in such a way that they can’t help but be moved.
Most of my patients these days suffer from depression; I find these people so
courageous, so generous, so kind and loving that I truly wish they could see
themselves through my eyes. Writing a book like this is an attempt.
Since the time of my first book and this one the Internet has arrived, making
the unaffiliated author’s life a lot simpler; so I would like to express my gratitude
to PubMed and MedLine, the American Psychological Association’s online
database, Amazon, and the United Parcel Service.
I’m not a neurologist, nor even a biological scientist, so there may be some
mistakes in the way I present the brain, nervous system, and stress response
system. I’ve relied on some new giants in these fields—Robert Sapolsky, Allan
Schore, Antonio Damasio, Joseph LeDoux, Bruce McEwen, Daniel Siegel,
Jeffrey Schwartz—for the best information I could obtain. If there are errors they
are mine alone, and I hope they are not fatal to the points I’m trying to establish
here. I feel slightly more confident of my skills as a social scientist, but of course
my ideas are based on or influenced by many—Philip Cushman, David Buss,
Martin Seligman, Daniel Goleman, Mihalyi Csikszentmihalyi, Judith Herman,
David Myers, Deborah Tannen—to name only the most prominent influences. I
don’t expect that all these individuals will agree with every idea of mine in
relation to their work but I sincerely hope that I have understood their positions
and treated them fairly. Finally, I should be most confident of my skills as a
therapist, but here again I feel that I’m standing on the shoulders of giants: Irwin
Hoffman, Marsha Linehan, Stephen Mitchell, Zindel Segal, Jeremy Safran,
Barry Magid, James Mann, Jerome Frank, Paul Wachtel, Mark Epstein are some.
I think I’ve stated their ideas clearly, but some of the conclusions I’ve drawn are,
again, strictly my own.
My wife, Robin, has been my biggest cheerleader, source of support and
structure, and skilled editor and wordsmith. She’s been extremely patient as I
spent long winter nights shut up in the study. In our earlier days together, when it
was necessary, she literally kept me alive. What more can you say?
Introduction
THIS is a long book, and some parts of it are complex, but the major ideas are
simple. Let me state them first, explain them a little, and then give the reader
some orientation about how this book is organized.
There are two major ideas.
The first major idea is that our nervous systems are not built for the stresses of
the twenty-first century. This is a result of exponential change in both the nature
of the stresses we face and how we are trained (by parents, schools, mass media,
popular culture) to face them. At the same time, there are powerful influences
that keep telling us this is a wonderful world and we ought to be happy and
healthy. The result is a conflict between how we really feel and how we think we
should feel—which is another major stress. In an effort to cope, we develop what
I call the Perpetual Stress Response—the fight-or-flight response stuck in the
“on” position. We become caught in a vicious circle in which the effects of stress
on our minds damage our bodies and brains in a measurable, physical way; and
these physical changes further affect our minds—the way we think, feel, and
relate—in an invisible, unconscious way. Physical and mental, observable and
unconscious—these injuries reinforce each other, trapping us in a cycle from
which there seems to be no escape. We feel the effects of perpetual stress in
many different ways: as depression and anxiety; as physical symptoms; as
motivations for addictions; as dysfunctional relationships; and as empty,
unhappy lives.
The second major idea is that, just as our brains and nervous systems are
vulnerable to the damage of stress, we have the power to heal that damage by
making deliberate choices about how we live. The new neuroscience is showing
that the brain is constantly changing in reaction to experience; thus, we can
literally rewire our own brains. The brain—and the mind—are both much more
subject to influence than we ever imagined, and that influence can hurt us or heal
us. We can reverse the vicious circle that traps us, and create what I call an
adaptive spiral—a progressive cycle in which the changes we make in how we
think, feel, act, and treat ourselves all reinforce each other, making change
easier, more effective, and more permanent. We can get the observable and the
unconscious, the mind, brain, and body, all working together in synchrony, to
Description:Our brains weren’t built for this. Twenty-first-century life evolves at a breakneck pace—and with it, stress seems to multiply by the day. We work long, harrowing hours. We fret over our families and finances. Our e-mail beeps and our cell phones ring. But our nervous systems were never meant to
