The authors complain that psychiatry is sort of all over the map without a controlling paradigm by which to measure behavior and provide correlated treatments. They state psychiatry is in disarray, with numerous theories and postulates, but no guiding theory upon which to form a model grounded in science. To rescue psychiatry from this abyss, they recommend that Darwinism be used as the new model that not only grounds theory in fact, but provides a clearer correlate between functional diagnosis (signs and symptoms) and suitable treatment (e.g., psychotropics and/or counseling). Does their new paradigm succeed? I'm convinced.
The book is short, a mere 270 pages. It's not intended as an introduction to psychiatry; in fact it presumes a significant acquaintance with most psychiatric concepts. The book intends that these given concepts be reexamined in light of Darwin's theory. Such concepts discussed in this context are: natural selection, adaptation, function, ultimate causation, individual fitness, self-interest, reciprocal altruism, proximate mechanisms, development, traits, learning, culture, and history strategies. The authors' approach is centered in a functional analysis of behavior that gives causal hypotheses and provides from assumptions that conditions will be more meaningfully classified and their contributing factors more rapidly identified (p. 81). Outward behavior gives events that are usually terms of separate genetic, physiological, and psychological mechanisms turn out to be subparts of infrastructures that contribute to specific functions (p. 92).
They state categorically: "Evolutionary models of mental conditions differ from psychiatry's model in a number of ways. Most critically, they are based on a theory of behavior that includes ultimate causes, biological motivations-goals, sexual selection, infrastructures, trait and trait variation, and the social environment. Proximate even6ts, such as genetic mistakes, predispositions, adverse environments, psychosocial stress, wrong or inadequate learning, dysfunctional physiological systems, and intrapsychic conflicts are sometimes, but not always, part of the explanation. Viewed this way, many conditions turn out to be minimally adaptive; some turn out to be adaptive, and some features of conditions represent attempts to act adaptively" (p. 149). The first half of the book explores these concepts in general, while the second half explores individual conditions such as anxiety, depression, schizophrenia, dysthymia, etc.
For example, "behavioral states, traits, and events are that (1) others' behavior initiates infrastructural activities that have physiological, psychological, and behavioral consequences; (2) interaction sequences can be viewed as functional units; (3) typical interaction sequences are often consequences of compromised infrastructures; and (4) inferences about infrastructure functionality can be made through the observation of behavior and its function" (p. 98). It's Number 3 that distinguishes this text from others in psychiatry. When the authors discuss moods, for example, they understand them as the failure to accurately process emotion-terminating feedback information optimally or functionally. The (in)ability of the species to adapt to its environment is key to understanding its (dys)function.
Two caveats. (1) This book must be read in sequential chapters, as each chapter builds upon the former. Moreover, the technique the authors use is heuristic, which builds their theory from the ground up. The authors find the methodology in DSM-IV unsuited for their purposes, and so begin with different first principles. Thus, in order to understand mood disorders, depression, and anxiety, one must first understand the Darwinian concepts of kin selection, reciprocity, survival, and reproduction presented under Theory of Personality. So, don't expect to go to the chapter on Depression and understand it solo.
Second, (2) while this book is written for and by professionals in the psychiatric field, its benefits and accessibility apply to all in the mental health professions. I have neither a degree in the field nor am I acquainted with some of the theories, disorders, and treatments discussed, but I found the authors' arguments and case histories easy to follow. Indeed, their lucid clarity, heuristic approach, and polished style make their theories stand out vibrantly. I also appreciated its concision. And, unlike so many other works under the appellation of evolutionary psychology, this text actually uses mental conditions to explicate its Darwinian precepts. I have a much clearer idea of what depression is and what kinds of intervention are best suited to treat it from an evolutionary perspective. Highly recommended.
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