In a book sure to inspire controversy, Gene Heyman argues that conventional wisdom about addiction—that it is a disease, a compulsion beyond conscious control—is wrong.

Drawing on psychiatric epidemiology, addicts’ autobiographies, treatment studies, and advances in behavioral economics, Heyman makes a powerful case that addiction is voluntary. He shows that drug use, like all choices, is influenced by preferences and goals. But just as there are successful dieters, there are successful ex-addicts. In fact, addiction is the psychiatric disorder with the highest rate of recovery. But what ends an addiction?

At the heart of Heyman’s analysis is a startling view of choice and motivation that applies to all choices, not just the choice to use drugs. The conditions that promote quitting a drug addiction include new information, cultural values, and, of course, the costs and benefits of further drug use. Most of us avoid becoming drug dependent, not because we are especially rational, but because we loathe the idea of being an addict.

Heyman’s analysis of well-established but frequently ignored research leads to unexpected insights into how we make choices—from obesity to McMansionization—all rooted in our deep-seated tendency to consume too much of whatever we like best. As wealth increases and technology advances, the dilemma posed by addictive drugs spreads to new products. However, this remarkable and radical book points to a solution. If drug addicts typically beat addiction, then non-addicts can learn to control their natural tendency to take too much.

“A mind-blowing tour de force that unwraps the myriad objects of addiction that surround us…Intelligent, incisive, and sometimes grimly entertaining.”
—Rod Phillips, author of Alcohol: A History

“A fascinating history of corporate America’s efforts to shape our habits and desires.”
—Vox

We live in an age of addiction, from compulsive gaming and shopping to binge eating and opioid abuse. Sugar can be as habit-forming as cocaine, researchers tell us, and social media apps are deliberately hooking our kids. But what can we do to resist temptations that insidiously rewire our brains? A renowned expert on addiction, David Courtwright reveals how global enterprises have both created and catered to our addictions. The Age of Addiction chronicles the triumph of what he calls “limbic capitalism,” the growing network of competitive businesses targeting the brain pathways responsible for feeling, motivation, and long-term memory.

“Compulsively readable…In crisp and playful prose and with plenty of needed humor, Courtwright has written a fascinating history of what we like and why we like it, from the first taste of beer in the ancient Middle East to opioids in West Virginia.”
—American Conservative

“A sweeping, ambitious account of the evolution of addiction…This bold, thought-provoking synthesis will appeal to fans of ‘big history’ in the tradition of Guns, Germs, and Steel.”
—Publishers Weekly

We have made huge progress in understanding the biology of mental illnesses, but comparatively little in interpreting them at the psychological level. The eminent philosopher Jonathan Glover believes that there is real hope of progress in the human interpretation of disordered minds.

The challenge is that the inner worlds of people with psychiatric disorders can seem strange, like alien landscapes, and this strangeness can deter attempts at understanding. Do people with disorders share enough psychology with other people to make interpretation possible? To explore this question, Glover tackles the hard cases—the inner worlds of hospitalized violent criminals, of people with delusions, and of those diagnosed with autism or schizophrenia. Their first-person accounts offer glimpses of inner worlds behind apparently bizarre psychiatric conditions and allow us to begin to learn the “language” used to express psychiatric disturbance. Art by psychiatric patients, or by such complex figures as van Gogh and William Blake, give insight when interpreted from Glover’s unique perspective. He also draws on dark chapters in psychiatry’s past to show the importance of not medicalizing behavior that merely transgresses social norms. And finally, Glover suggests values, especially those linked with agency and identity, to guide how the boundaries of psychiatry should be drawn.

Seamlessly blending philosophy, science, literature, and art, Alien Landscapes? is both a sustained defense of humanistic psychological interpretation and a compelling example of the rich and generous approach to mental life for which it argues.

Through the lens of mimetic theory, distinguished French psychiatrist Jean-Michel Oughourlian shows how to spot and address rivalry in our lives and become open to healthier, more genuine relationships. This important study demonstrates the toxic and pathogenic mechanisms at work in physical ailments and mental disturbances and reveals a common cause: alterity, the other. Oughourlian maintains that the real question in attempting to resolve issues of rivalry is not “What is your problem?” but rather “Who is your problem?” This type of discord with the other—be it a friend, colleague, or family member—becomes visible through generalized stress. This stress manifests in psychosomatic symptoms and may even contribute to the development of organic diseases. The most important factor in healing these maladies, then, is to recognize the other with whom we are in rivalry.

In 1895 there was not a single case of dementia praecox reported in the United States. By 1912 there were tens of thousands of people with this diagnosis locked up in asylums, hospitals, and jails. By 1927 it was fading away . How could such a terrible disease be discovered, affect so many lives, and then turn out to be something else?

In vivid detail, Richard Noll describes how the discovery of this mysterious disorder gave hope to the overworked asylum doctors that they could at last explain—though they could not cure—the miserable patients surrounding them. The story of dementia praecox, and its eventual replacement by the new concept of schizophrenia, also reveals how asylum physicians fought for their own respectability. If what they were observing was a disease, then this biological reality was amenable to scientific research. In the early twentieth century, dementia praecox was psychiatry’s key into an increasingly science-focused medical profession.

But for the moment, nothing could be done to help the sufferers. When the concept of schizophrenia offered a fresh understanding of this disorder, and hope for a cure, psychiatry abandoned the old disease for the new. In this dramatic story of a vanished diagnosis, Noll shows the co-dependency between a disease and the scientific status of the profession that treats it. The ghost of dementia praecox haunts today’s debates about the latest generation of psychiatric disorders.

An examination of diagnostic processes that questions how we can better understand autism as a category and the unique forms of intelligence it glosses.
 
As autism has grown in prevalence, so too have our attempts to make sense of it. From placing unfounded blame on vaccines to seeking a genetic cause, Americans have struggled to understand what autism is and where it comes from. Amidst these efforts, however, a key aspect of autism has been largely overlooked: the diagnostic process itself. That process is the central focus of Autistic Intelligence. The authors ask us to question the norms by which we measure autistic behavior, to probe how that behavior can be considered sensible rather than disordered, and to explore how we can better appreciate the individuality of those who receive the diagnosis.
 
Drawing on hundreds of hours of video recordings and ethnographic observations at a clinic where professionals evaluated children for autism, the authors’ analysis of interactions among clinicians, parents, and children demystifies the categories, tools, and practices involved in the diagnostic process. Autistic Intelligence shows that autism is not a stable category; it is the outcome of complex interactional processes involving professionals, children, families, and facets of the social and clinical environments they inhabit. The authors suggest that diagnosis, in addition to carefully classifying children, also can highlight or include unique and particular contributions those with autism potentially can make to the world around us.
 

This book lays bare the logic of forgotten abuse. Psychologist Jennifer Freyd's breakthrough theory explaining this phenomenon shows how psychogenic amnesia not only happens but, if the abuse occurred at the hands of a parent or caregiver, is often necessary for survival. Freyd's book will give embattled professionals, beleaguered abuse survivors, and the confused public a new, clear understanding of the lifelong effects and treatment of child abuse.

The drug war that has turned Juárez, Mexico, into a killing field that has claimed more than 7,000 lives since 2008 captures headlines almost daily. But few accounts go all the way down to the streets to investigate the lives of individual drug users. One of those users, Scott Comar, survived years of heroin addiction and failed attempts at detox and finally cleaned up in 2003. Now a graduate student at the University of Texas at El Paso in the history department's borderlands doctoral program, Comar has written Border Junkies, a searingly honest account of his spiraling descent into heroin addiction, surrender, change, and recovery on the U.S.-Mexico border.

Border Junkies is the first book ever written about the lifestyle of active addiction on the streets of Juárez. Comar vividly describes living between the disparate Mexican and American cultures and among the fellow junkies, drug dealers, hookers, coyote smugglers, thieves, and killers who were his friends and neighbors in addiction—and the social workers, missionaries, shelter workers, and doctors who tried to help him escape. With the perspective of his anthropological training, he shows how homelessness, poverty, and addiction all fuel the use of narcotics and the rise in their consumption on the streets of Juárez and contribute to the societal decay of this Mexican urban landscape. Comar also offers significant insights into the U.S.-Mexico borderland's underground and peripheral economy and the ways in which the region's inhabitants adapt to the local economic terrain.

One of the major concerns about the changing U.S. health-care systems is whether they will improve or diminish the quality and cost-effectiveness of medical care. The shift from a fee-for-service to a prepaid method of reimbursement has greatly changed the incentives of patients to seek care as well as those of providers to supply it. This change poses a particular challenge for care of depressed patients, a vulnerable population that often does not advocate for its own care. This book documents the inefficiencies of our national systems--prepaid as well as fee-for-service--for treating depression and explores how they can be improved.

Although depression is a major illness affecting millions of people, it is seriously undertreated in the United States. The ongoing shift of mental-health care away from specialists and toward primary medical-care providers is causing fewer depressed patients to be appropriately diagnosed and treated. Depression is frequently more devastating than other major illnesses, such as arthritis and heart disease, because it often begins at a younger age, when people are at their productive peak and thus at risk of permanently damaging their careers. It also differs from many medical conditions in that its indirect costs are usually much higher than direct treatment costs.

The authors urge the integration of both medical and economic considerations in designing policies for the treatment of depression. They show that by spending more money efficiently on care, the nation will gain greater health improvements per dollar invested and a more productive population.

The hegemonic meaning of depression as a universal mental illness embodied by an individualized subject is propped up by psychiatry’s clinical gaze. Cinemas of Therapeutic Activism turns to the work of contemporary filmmakers who express a shared concern for mental health under global capitalism to explore how else depression can be perceived. In taking their critical visions as intercessors for thought, Adam Szymanski proposes a thoroughly relational understanding of depression attentive to eventful, collective and contingent qualities of subjectivity. What emerges is a melancholy aesthetics attuned to the existential contours and political stakes of health. Cinemas of Therapeutic Activism adventurously builds affinities across the lines of national, linguistic and cultural difference. The films of Angela Schanelec, Kelly Reichardt, Apichatpong Weerasethakul and Kanakan Balintagos are grouped together for the first time, constituting a polystylistic common front of artist-physicians who live, work, and create on the belief that life can be more liveable.

It inspired written testimonials from William McKinley, Thomas Edison, and Sarah Bernhardt; merited a medal from Pope Leo XIII; produced "exhilaration and lasting euphoria" in Sigmund Freud. Once the stimulant of choice of the enlightened and the elite, cocaine has become, a century later, a plague, ravaging the lives of millions. This book is the first to draw together all the facts about this pervasive drug--from its natural occurrence in a tea-like native South American plant to its devastating appearance as crack in the inner cities of the United States.

Drawing on the latest work in medicine, psychiatry, neuroscience, pharmacology, epidemiology, social work, and sociology, the volume is a highly accessible reference on the history and use of cocaine, its physical and psychological effects, and the etiology and epidemiology of cocaine addiction. It also provides a critical evaluation of the pharmaceutical agents and psychosocial interventions that have been used to treat this addiction. Author Jerome J. Platt answers such basic questions as: What is cocaine? What forms does it come in? How is it administered? What does it do? What are the medical complications of cocaine addiction? What are the treatments, and how successful are they?

Uniquely comprehensive, Cocaine Addiction makes all the latest information on this urgent subject readily available to medical professionals and practitioners, social workers and scholars, and anyone who cares to know more about this perennially troubling drug.

Meg Logan has not been farther than two miles from home in six years. She has agoraphobia, a debilitating anxiety disorder that entraps its sufferers in the fear of leaving safe havens such as home. Paradoxically, while at this safe haven, agoraphobics spend much of their time ruminating over past panic experiences and imagining similar hypothetical situations. In doing so, they create a narrative that both describes their experience and locks them into it.

Constructing Panic offers an unprecedented analysis of one patient's experience of agoraphobia. In this novel interdisciplinary collaboration between a clinical psychologist and a linguist, the authors probe Meg's stories for constructions of emotions, actions, and events. They illustrate how Meg uses grammar and narrative structure to create and recreate emotional experiences that maintain her agoraphobic identity.

In this work Capps and Ochs propose a startling new view of agoraphobia as a communicative disorder. Constructing Panic opens up the largely overlooked potential for linguistic and narrative analysis by revealing the roots of panic and by offering a unique framework for therapeutic intervention. Readers will find in these pages hope for managing panic through careful attention to how we tell the story of our lives.

David Healy follows his widely praised study, The Antidepressant Era, with an even more ambitious and dramatic story: the discovery and development of antipsychotic medication. Healy argues that the discovery of chlorpromazine (more generally known as Thorazine) is as significant in the history of medicine as the discovery of penicillin, reminding readers of the worldwide prevalence of insanity within living memory.

But Healy tells not of the triumph of science but of a stream of fruitful accidents, of technological discovery leading neuroscientific research, of fierce professional competition and the backlash of the antipsychiatry movement of the 1960s. A chemical treatment was developed for one purpose, and as long as some theoretical rationale could be found, doctors administered it to the insane patients in their care to see if it would help. Sometimes it did, dramatically. Why these treatments worked, Healy argues provocatively, was, and often still is, a mystery. Nonetheless, such discoveries made and unmade academic reputations and inspired intense politicking for the Nobel Prize.

Once pharmaceutical companies recognized the commercial potential of antipsychotic medications, financial as well as clinical pressures drove the development of ever more aggressively marketed medications. With verve and immense learning, Healy tells a story with surprising implications in a book that will become the leading scholarly work on its compelling subject.

Throughout the African American community, individuals and organizations ranging from churches to schools to drug treatment centers are fighting the widespread use of crack cocaine. To put that fight in a larger cultural context, Doin' Drugs explores historical patterns of alcohol and drug use from pre-slavery Africa to present-day urban America.

William Henry James and Stephen Lloyd Johnson document the role of alcohol and other drugs in traditional African cultures, among African slaves before the American Civil War, and in contemporary African American society, which has experienced the epidemics of marijuana, heroin, crack cocaine, and gangs since the beginning of this century. The authors zero in on the interplay of addiction and race to uncover the social and psychological factors that underlie addiction.

James and Johnson also highlight many culturally informed programs, particularly those sponsored by African American churches, that are successfully breaking the patterns of addiction. The authors hope that the information in this book will be used to train a new generation of counselors, ministers, social workers, nurses, and physicians to be better prepared to face the epidemic of drug addiction in African American communities.

The recorded use of deadly force against unarmed suspects and sustained protest from the Black Lives Matter movement, among others, have ignited a national debate about excessive violence in American policing. Missing from the debate, however, is any discussion of a factor that is almost certainly contributing to the violence—the use of anabolic steroids by police officers. Mounting evidence from a wide range of credible sources suggests that many cops are abusing testosterone and its synthetic derivatives. This drug use is illegal and encourages a “steroidal” policing style based on aggressive behaviors and hulking physiques that diminishes public trust in law enforcement.

Dopers in Uniform offers the first assessment of the dimensions and consequences of the felony use of anabolic steroids in major urban police departments. Marshalling an array of evidence, John Hoberman refutes the frequent claim that police steroid use is limited to a few “bad apples,” explains how the “Blue Wall of Silence” stymies the collection of data, and introduces readers to the broader marketplace for androgenic drugs. He then turns his attention to the people and organizations at the heart of police culture: the police chiefs who often see scandals involving steroid use as a distraction from dealing with more dramatic forms of misconduct and the police unions that fight against steroid testing by claiming an officer’s “right to privacy” is of greater importance. Hoberman’s findings clearly demonstrate the crucial need to analyze and expose the police steroid culture for the purpose of formulating a public policy to deal with its dysfunctional effects.

"I started out snorting a couple of lines a night and ended up injecting and snorting about three grams a day."--That could be your dentist talking.

"I worked a lot with hangovers and made lots of mistakes when coming down off acid."--That might be your nurse.

"The patient was waking up and I was out cold."--And that was some unlucky patient's anesthesiologist.

Professionals trusted with our well-being are the last people we suspect of drug addiction. And yet they are at least as likely as anyone else to abuse alcohol and other drugs--a well-kept secret finally aired and fully examined in this powerful book. Drawing on more than 120 personal interviews with addicted physicians, dentists, nurses, pharmacists, attorneys, and airline pilots and those who treat them, Robert Coombs gives us a startling picture of drug abuse among "pedestal professionals." He discusses addiction as an occupational hazard for those with the easiest access to drugs, the greatest sense of immunity to their perils, and the most extensive means (and reasons) for hiding their problems. Throughout, the interviewees' eloquent and often harrowing testimony reminds us of the human drama behind the exhaustive research and analysis presented here. Their bittersweet stories bear out Coombs's contention that recovering addicts, free of their magical elixirs, can become more complete people than they were before addiction.

From the biological, psychosocial, and spiritual roots of addiction to the equally diverse approaches to recovery, to the merits and failures of government drug policy, Drug-Impaired Professionals offers a clear and complete overview of a complex problem that affects nearly every family in America.

Teen-aged girls hate their bodies and diet obsessively, or so we hear. News stories and reports of survey research often claim that as many as three girls in five are on a diet at any given time, and they grimly suggest that many are “at risk” for eating disorders. But how much can we believe these frightening stories? What do teenagers mean when they say they are dieting?

Anthropologist Mimi Nichter spent three years interviewing middle school and high school girls—lower-middle to middle class, white, black, and Latina—about their feelings concerning appearance, their eating habits, and dieting. In Fat Talk, she tells us what the girls told her, and explores the influence of peers, family, and the media on girls’ sense of self. Letting girls speak for themselves, she gives us the human side of survey statistics.

Most of the white girls in her study disliked something about their bodies and knew all too well that they did not look like the envied, hated “perfect girl.” But they did not diet so much as talk about dieting. Nichter wryly argues—in fact some of the girls as much as tell her—that “fat talk” is a kind of social ritual among friends, a way of being, or creating solidarity. It allows the girls to show that they are concerned about their weight, but it lessens the urgency to do anything about it, other than diet from breakfast to lunch. Nichter concludes that if anything, girls are watching their weight and what they eat, as well as trying to get some exercise and eat “healthfully” in a way that sounds much less disturbing than stories about the epidemic of eating disorders among American girls.

Black girls, Nichter learned, escape the weight obsession and the “fat talk” that is so pervasive among white girls. The African-American girls she talked with were much more satisfied with their bodies than were the white girls. For them, beauty was a matter of projecting attitude (“’tude”) and moving with confidence and style.

Fat Talk takes the reader into the lives of girls as daughters, providing insights into how parents talk to their teenagers about their changing bodies. The black girls admired their mothers’ strength; the white girls described their mothers’ own “fat talk,” their fathers’ uncomfortable teasing, and the way they and their mothers sometimes dieted together to escape the family “curse”—flabby thighs, ample hips. Moving beyond negative stereotypes of mother–daughter relationships, Nichter sensitively examines the issues and struggles that mothers face in bringing up their daughters, particularly in relation to body image, and considers how they can help their daughters move beyond rigid and stereotyped images of ideal beauty.

First published more than twenty years ago, with almost 150,000 copies sold, The Golden Cage is still the classic book on anorexia nervosa, for patients, parents, mental health trainees, and senior therapists alike. Writing in direct, jargon-free style, often quoting her patients’ descriptions of their own experience of illness and recovery, Bruch describes the relentless pursuit of thinness and the search for superiority in self-denial that characterizes anorexia nervosa. She emphasizes the importance of early diagnosis and offers guidance on danger signs. Little-known when this groundbreaking book was first published, eating disorders have become all too familiar. Sympathetic and astute, The Golden Cage now speaks to a new generation.

Daniel Hodermarsky (1924–1999) was the son of Slovak immigrants who emigrated from Hačava to settle and work in the coal fields of Pennsylvania and later in the auto-manufacturing industries of Ohio. He served in World War II on the Western front and was awarded two presidential citations, two Croix de Guerre, and one combat star. He returned home with severe and persistent posttraumatic stress disorder that left an indelible mark on his life and art. Hodermarsky had a distinguished teaching career at the Cleveland Institute of Art from 1957 to 1969. Throughout the 1960s, he taught in Cleveland's public schools and started an art program for inner-city youth under the Federal Title 3 Act to promote integration through arts education. From 1969 to 1989 he taught at Deerfield Academy in western Massachusetts, founding its art department and serving for several years as department chair and director of the school's Hilson Gallery (now the von Auersperg Gallery). He mentored notable artists, including Stephen Hannock and Michael Tracy. Throughout his career, Hodermarsky's work embraced both the representational and the abstract. His early works experimented with new media (such as Dayglo paint) and new styles such as Op Art and performance. In the 1970s and beyond, he engaged landscape—rural, urban, and imaginary—wherein he explored the interplay of terrain (land or water, horizon, and sky). The human figure—Slovak farmers, wounded or dismembered soldiers, and mythical and historical figures—were among his favorite subjects. He was fascinated by how age, human nature, and personality combine to create the physical form. His eclectic themes mirror his own unique complexities and experiences. Later in his career, he focused on abstract works that reflect the intricate spaces of both his psyche and shared human experience. A deeply spiritual man with a strong religious faith, Hodermarsky's abstract paintings ask the existential questions that have challenged humankind across millennia. By showing us his own experience of these great mysteries, his art underscores life's abiding beauty. Over his long career of interpreting the world in which he lived, Hodermarsky invites us to inhabit a realm filled with joy, reverence, and passion.

Humans are social animals and, in general, don’t thrive in isolated environments. Homeless people, many of whom suffer from serious mental illnesses, often live socially isolated on the streets or in shelters. Homelessness, Housing, and Mental Illness describes a carefully designed large-scale study to assess how well these people do when attempts are made to reduce their social isolation and integrate them into the community.

Should homeless mentally ill people be provided with the type of housing they want or with what clinicians think they need? Is residential staff necessary? Are roommates advantageous? How is community integration affected by substance abuse, psychiatric diagnoses, and cognitive functioning? Homelessness, Housing, and Mental Illness answers these questions and reexamines the assumptions behind housing policies that support the preference of most homeless mentally ill people to live alone in independent apartments. The analysis shows that living alone reduces housing retention as well as cognitive functioning, while group homes improve these critical outcomes. Throughout the book, Russell Schutt explores the meaning and value of community for our most fragile citizens.

“What does it mean to be lonely?” Thomas Dumm asks. His inquiry, documented in this book, takes us beyond social circumstances and into the deeper forces that shape our very existence as modern individuals. The modern individual, Dumm suggests, is fundamentally a lonely self. Through reflections on philosophy, political theory, literature, and tragic drama, he proceeds to illuminate a hidden dimension of the human condition. His book shows how loneliness shapes the contemporary division between public and private, our inability to live with each other honestly and in comity, the estranged forms that our intimate relationships assume, and the weakness of our common bonds.

A reading of the relationship between Cordelia and her father in Shakespeare’s King Lear points to the most basic dynamic of modern loneliness—how it is a response to the problem of the “missing mother.” Dumm goes on to explore the most important dimensions of lonely experience—Being, Having, Loving, and Grieving. As the book unfolds, he juxtaposes new interpretations of iconic cultural texts—Moby-Dick, Death of a Salesman, the film Paris, Texas, Emerson’s “Experience,” to name a few—with his own experiences of loneliness, as a son, as a father, and as a grieving husband and widower.

Written with deceptive simplicity, Loneliness as a Way of Life is something rare—an intellectual study that is passionately personal. It challenges us, not to overcome our loneliness, but to learn how to re-inhabit it in a better way. To fail to do so, this book reveals, will only intensify the power that it holds over us.

On a long dark road in deep East Texas, James Byrd Jr. was dragged to his death behind a pickup truck one summer night in 1998. The brutal modern-day lynching stunned people across America and left everyone at a loss to explain how such a heinous crime could possibly happen in our more racially enlightened times. Many eventually found an answer in the fact that two of the three men convicted of the murder had ties to the white supremacist Confederate Knights of America. In the ex-convict ringleader, Bill King, whose body was covered in racist and satanic tattoos, people saw the ultimate monster, someone so inhuman that his crime could be easily explained as the act of a racist psychopath. Few, if any, asked or cared what long dark road of life experiences had turned Bill King into someone capable of committing such a crime.

In this gripping account of the murder and its aftermath, Ricardo Ainslie builds an unprecedented psychological profile of Bill King that provides the fullest possible explanation of how a man who was not raised in a racist family, who had African American friends in childhood, could end up on death row for viciously killing a black man. Ainslie draws on exclusive in-prison interviews with King, as well as with Shawn Berry (another of the perpetrators), King's father, Jasper residents, and law enforcement and judicial officials, to lay bare the psychological and social forces—as well as mere chance—that converged in a murder on that June night. Ainslie delves into the whole of King's life to discover how his unstable family relationships and emotional vulnerability made him especially susceptible to the white supremacist ideology he adopted while in jail for lesser crimes.

With its depth of insight, Long Dark Road not only answers the question of why such a racially motivated murder happened in our time, but it also offers a frightening, cautionary tale of the urgent need to intervene in troubled young lives and to reform our violent, racist-breeding prisons. As Ainslie chillingly concludes, far from being an inhuman monster whom we can simply dismiss, "Bill King may be more like the rest of us than we care to believe."

Ian Hacking tells the fascinating tale of Albert Dadas, a native of France’s Bordeaux region and the first diagnosed mad traveler. Dadas suffered from a strange compulsion that led him to travel obsessively, often without identification, not knowing who he was or why he traveled. Using the records of Philippe Tissié, Dadas’s physician, Hacking attempts to make sense of this strange epidemic.

In telling this tale, Hacking raises probing questions about the nature of mental disorders, the cultural repercussions of their diagnosis, and the relevance of this century-old case study for today’s overanalyzed society.

To inform improvements to the quality of care delivered by the military health system for posttraumatic stress disorder and major depressive disorder, researchers developed a framework and identified, developed, and described a candidate set of measures for monitoring, assessing, and improving the quality of care. This document describes their research approach and the measure sets that they identified.

How does a parent make sense of a child’s severe mental illness? How does a father meet the daily challenges of caring for his gifted but delusional son, while seeking to overcome the stigma of madness and the limits of psychiatry?  W. J. T. Mitchell’s memoir tells the story—at once representative and unique—of one family’s encounter with mental illness and bears witness to the life of the talented young man who was his son.

 Gabriel Mitchell was diagnosed with schizophrenia at age twenty-one and died by suicide eighteen years later. He left behind a remarkable archive of creative work and a father determined to honor his son’s attempts to conquer his own illness. Before his death, Gabe had been working on a film that would show madness from inside and out, as media stereotype and spectacle, symptom and stigma, malady and minority status, disability and gateway to insight. He was convinced that madness is an extreme form of subjective experience that we all endure at some point in our lives, whether in moments of ecstasy or melancholy, or in the enduring trauma of a broken heart. Gabe’s declared ambition was to transform schizophrenia from a death sentence to a learning experience, and madness from a curse to a critical perspective.    

Shot through with love and pain, Mental Traveler shows how Gabe drew his father into his quest for enlightenment within madness. It is a book that will touch anyone struggling to cope with mental illness, and especially for parents and caregivers of those caught in its grasp.
 

Despite the scope of the threat they pose to Mexico’s security, violent drug-trafficking organizations are not well understood, and optimal strategies to combat them have not been identified. While there is no perfectly analogous case from history, Mexico stands to benefit from historical lessons and efforts that were correlated with improvement in countries facing similar challenges related to violence and corruption.

Despite the scope of the threat they pose to Mexico’s security, violent drug-trafficking organizations are not well understood, and optimal strategies to combat them have not been identified. While there is no perfectly analogous case to Mexico’s current security situation, historical case studies may offer lessons for policymakers as they cope with challenges related to violence and corruption in that country.

It’s the American dream—unfettered freedom to follow our ambitions, to forge our identities, to become self-made. But what if our culture of limitless self-fulfillment is actually making millions desperately ill? One of our leading interpreters of modernity and nationalism, Liah Greenfeld argues that we have overlooked the connection between egalitarian society and mental illness. Intellectually fearless, encompassing philosophy, psychology, and history, Mind, Modernity, Madness challenges the most cherished assumptions about the blessings of living in a land of the free.

Modern nationalism, says Greenfeld, rests on bedrock principles of popular sovereignty, equality, and secularism. Citizens of the twenty-first century enjoy unprecedented freedom to become the authors of their personal destinies. Empowering as this is, it also places them under enormous psychic strain. They must constantly appraise their identities, manage their desires, and calibrate their place within society. For vulnerable individuals, this pressure is too much. Training her analytic eye on extensive case histories in manic depression and schizophrenia, Greenfeld contends that these illnesses are dysfunctions of selfhood caused by society’s overburdening demands for self-realization. In her rigorous diagnosis, madness is a culturally constituted malady.

The culminating volume of Greenfeld’s nationalism trilogy, Mind, Modernity, Madness is a tour de force in the classic tradition of Émile Durkheim—and a bold foray into uncharted territory. Often counter-intuitive, always illuminating, Mind, Modernity, Madness presents a many-sided view of humanity, one that enriches our deepest understanding of who we are and what we aspire to be.

Around the world, more than a million people die by suicide each year. Yet many of us know very little about a tragedy that may strike our own loved ones—and much of what we think we know is wrong. This clear and powerful book dismantles myth after myth to bring compassionate and accurate understanding of a massive international killer.

Drawing on a fascinating array of clinical cases, media reports, literary works, and scientific studies, Thomas Joiner demolishes both moralistic and psychotherapeutic clichés. He shows that suicide is not easy, cowardly, vengeful, or selfish. It is not a manifestation of "suppressed rage" or a side effect of medication. Threats of suicide, far from being idle, are often followed by serious attempts. People who are prevented once from killing themselves will not necessarily try again.

The risk for suicide, Joiner argues, is partly genetic and is influenced by often agonizing mental disorders. Vulnerability to suicide may be anticipated and treated. Most important, suicide can be prevented.

An eminent expert whose own father's death by suicide changed his life, Joiner is relentless in his pursuit of the truth about suicide and deeply sympathetic to such tragic waste of life and the pain it causes those left behind.

When The Natural History of Alcoholism was first published in 1983, it was acclaimed in the press as the single most important contribution to the literature on alcoholism since the first edition of Alcoholic Anonymous’s Big Book. George Vaillant took on the crucial questions of whether alcoholism is a symptom or a disease, whether it is progressive, whether alcoholics differ from others before the onset of their alcoholism, and whether alcoholics can safely drink. Based on an evaluation of more than 600 individuals followed for over forty years, Vaillant’s monumental study offered new and authoritative answers to all of these questions.

In this updated version of his classic book, Vaillant returns to the same subjects with the perspective gained from fifteen years of further follow-up. Alcoholics who had been studied to age 50 in the earlier book have now reached age 65 and beyond, and Vaillant reassesses what we know about alcoholism in light of both their experiences and the many new studies of the disease by other researchers. The result is a sharper focus on the nature and course of this devastating disorder as well as a sounder foundation for the assessment of various treatments.

An Open Letters Review Best Book of the Year

A leading expert in animal behavior takes us into the wild to better understand and manage our fears.

Fear, honed by millions of years of natural selection, kept our ancestors alive. Whether by slithering away, curling up in a ball, or standing still in the presence of a predator, humans and other animals have evolved complex behaviors in order to survive the hazards the world presents. But, despite our evolutionary endurance, we still have much to learn about how to manage our response to danger.

For more than thirty years, Daniel Blumstein has been studying animals’ fear responses. His observations lead to a firm conclusion: fear preserves security, but at great cost. A foraging flock of birds expends valuable energy by quickly taking flight when a raptor appears. And though the birds might successfully escape, they leave their food source behind. Giant clams protect their valuable tissue by retracting their mantles and closing their shells when a shadow passes overhead, but then they are unable to photosynthesize, losing the capacity to grow. Among humans, fear is often an understandable and justifiable response to sources of threat, but it can exact a high toll on health and productivity.

Delving into the evolutionary origins and ecological contexts of fear across species, The Nature of Fear considers what we can learn from our fellow animals—from successes and failures. By observing how animals leverage alarm to their advantage, we can develop new strategies for facing risks without panic.

How researchers understood the atomic bomb’s effects on the human psyche before the recognition of Post-Traumatic Stress Disorder.
 
In 1945, researchers on a mission to Hiroshima with the United States Strategic Bombing Survey canvassed survivors of the nuclear attack. This marked the beginning of global efforts—by psychiatrists, psychologists, and other social scientists—to tackle the complex ways in which human minds were affected by the advent of the nuclear age. A trans-Pacific research network emerged that produced massive amounts of data about the dropping of the bomb and subsequent nuclear tests in and around the Pacific rim.
 
Ran Zwigenberg traces these efforts and the ways they were interpreted differently across communities of researchers and victims. He explores how the bomb’s psychological impact on survivors was understood before we had the concept of post-traumatic stress disorder. In fact, psychological and psychiatric research on Hiroshima and Nagasaki rarely referred to trauma or similar categories. Instead, institutional and political constraints—most notably the psychological sciences’ entanglement with Cold War science—led researchers to concentrate on short-term damage and somatic reactions or even, in some cases, on denial of victims’ suffering. As a result, very few doctors tried to ameliorate suffering.
 
But, Zwigenberg argues, it was not only that doctors “failed” to issue the right diagnosis; the victims’ experiences also did not necessarily conform to our contemporary expectations. As he shows, the category of trauma should not be used uncritically in a non-Western context. Consequently, this book sets out, first, to understand the historical, cultural, and scientific constraints in which researchers and victims were acting and, second, to explore how suffering was understood in different cultural contexts before PTSD was a category of analysis.

Mainstream addiction science sees addiction either as a biomedical disease that renders one incapable of self-control or as a voluntary practice engaged in freely. In On Addiction, Darin Weinberg shows how this dynamic is deeply influenced by a series of binaries (free will/determinism, mind/body, objectivity/subjectivity) that hinder our understanding of addiction. Here, he offers a new theorization of addiction in which he breaks down these contradictions and incompatibilities, calling into question the taken-for-granted distinction between the “biological” and the “social.” To the extent that it is understood as a loss of self-control over one’s behavior, addiction, Weinberg contends, requires a supple theoretical framework that provides for movements into and out of self-control, for the social and natural processes that influence these movements, for the historical contexts within which they occur, and for the ethical ramifications of taking them seriously. To create this framework, Weinberg brings together history, ethnography, and critical theory as well as the clinical and social sciences. In this way, Weinberg takes a more holistic approach to examining the fundamental nature and ethics of addiction.

A Behavioral Scientist Notable Book of the Year
A Guardian “Best Book about Ideas” of the Year

No one likes to be bored. Two leading psychologists explain what causes boredom and how to listen to what it is telling you, so you can live a more engaged life.

We avoid boredom at all costs. It makes us feel restless and agitated. Desperate for something to do, we play games on our phones, retie our shoes, or even count ceiling tiles. And if we escape it this time, eventually it will strike again. But what if we listened to boredom instead of banishing it?

Psychologists James Danckert and John Eastwood contend that boredom isn’t bad for us. It’s just that we do a bad job of heeding its guidance. When we’re bored, our minds are telling us that whatever we are doing isn’t working—we’re failing to satisfy our basic psychological need to be engaged and effective. Too many of us respond poorly. We become prone to accidents, risky activities, loneliness, and ennui, and we waste ever more time on technological distractions. But, Danckert and Eastwood argue, we can let boredom have the opposite effect, motivating the change we need. The latest research suggests that an adaptive approach to boredom will help us avoid its troubling effects and, through its reminder to become aware and involved, might lead us to live fuller lives.

Out of My Skull combines scientific findings with everyday observations to explain an experience we’d like to ignore, but from which we have a lot to learn. Boredom evolved to help us. It’s time we gave it a chance.

Private contractors have been deployed extensively around the globe for the past decade and may be exposed to many of the stressors that are known to have physical and mental health implications for military personnel. Results from a RAND survey offer preliminary findings about the mental and physical health of contractors, their deployment experiences, and their access to and use of health care resources.

This book--first published in 1958, and designed for courses on abnormal psychology and psychiatry--is intended to supplement the usual textbook material in abnormal psychology. Papers have been selected to introduce the student to the active and complex enterprise of investigation and hypothesis in this wide field. Conflicting evidence and allegiances, riddles and ingenuity, are displayed in order to stimulate an appreciation of the task of discovery in behavioral science.

Five general areas are represented in the selections: (i) the problem of the effects of early experience on psychological development; (2) psychosomatic disorders and neurosis; (3) schizophrenic psychosis; (4) somatic factors in psychopathology; and (5) the social context and its effects on the phenomena of behavior. Against a background of systematic study, the graduate or undergraduate student will find in the forty-six papers included here an instructive sampling of the periodical literature.

Says Robert W. White in his introduction to the book: "There is no longer an air that the problem of schizophrenia, or of neurosis, or of psychosomatic disorder is going to be solved by a stroke of insight and a simple theory. Where once it was hoped to unlock the secret of a disorder, we now know that we must creep up slowly upon its many secrets and that we must use to the utmost the help provided by scientific method. In this new climate the present book is an indispensable teaching aid."

Explores how the scientific concepts of information and representation can be used to understand subjective mental phenomena and integrate them in empathic clinical dialogues during interactions with patients.

Psychopathology: An Empathic Representational Approach retraces the foundations of classical phenomenological psychopathology and integrates them with modern ideas drawn from anthropology, cognitive neuroscience, computational science, and evolutionary biology to synthesize a comprehensive framework and provide fresh insights. It explores key issues in clinical psychopathology coherently and systematically, illustrates advanced topics in an accessible manner using clinical case examples, metaphors, and clarifying diagrams, and directly links advanced conceptual frameworks with pragmatic skills in the clinical dialogue process.

This volume is aimed at a broad audience of mental health professionals, researchers, and students in psychiatry, psychology, and social work. Its interdisciplinary treatment of the subject will also interest biologists, anthropologists, cognitive psychologists, neuroscientists, and philosophers.

Fills a gap in research by focusing psychosis studies on those affected in Hong Kong.

Psychosis and Schizophrenia in Hong Kong covers some of the most serious mental health conditions that top the global disease burden and affect three percent of the general population. However, most research on psychotic disorders is undertaken in the West, and few studies have been systematically carried out in Asia despite global interest in regional differences. This work offers a unique and coherent account of these disorders and their treatment in Hong Kong over the last thirty years.

Chen and his research program’s pioneering work has ranged from the impact of early intervention on outcomes and relapse prevention to the renaming of psychosis to reduce stigma. The studies have contributed to wider international debates on the optimal management of the condition. Their investigations in semantics and cognition, as well as cognition-enhancing exercise interventions, have provided novel insights into deficits encountered in the treatment of psychotic disorders and how they might be ameliorated. The research has also explored subjective experiences of psychosis and elicited unique perspectives in patients of Asian origin.

Each topic is divided into three sections: a global background of the challenges encountered; research findings from Hong Kong; and reflections that place the data in scientific and clinical contexts and offer future directions.

Understanding the current quality of care for posttraumatic stress disorder (PTSD) and depression delivered to service members is an important step toward improving care across the Military Health System (MHS). T.his report describes the characteristics of active-component service members who received care for PTSD or depression through the MHS and assesses the quality of care received using quality measures derived from administrative data

The authors identified ten standards for the delivery of high-quality care for veterans with posttraumatic stress disorder, depression, substance use disorders, and mild traumatic brain injury. They also provide considerations for implementing and disseminating these standards as a first step to improve access to high-quality care for veterans with invisible wounds.

Hearing about the destructive compulsion of bulimia nervosa, outsiders may wonder, "How could you ever start?" Those suffering from the eating disorder ask themselves in despair, "How can I ever stop?" How do you break the cycle of bingeing, vomiting, laxative abuse, and shame? While many books describe the descent into eating disorders and the resulting emotional and physical damage, this book describes recovery.

Psychologist Sheila Reindl has listened intently to women's accounts of recovering. Reindl argues compellingly that people with bulimia nervosa avoid turning their attention inward to consult their needs, desires, feelings, and aggressive strivings because to do so is to encounter an annihilating sense of shame. Disconnected from internal, sensed experience, bulimic women rely upon external gauges to guide their choices. To recover, bulimic women need to develop a sense of self--to attune to their physical, psychic, and social self-experience. They also need to learn that one's neediness, desire, pain, and aggression are not sources of shame to be kept hidden but essential aspects of humanity necessary for zestful life. The young women with whom Reindl speaks describe, with great feeling, their efforts to know and trust their own experience.

Perceptive, lucid, and above all humane, this book will be welcomed not only by professionals but by people who struggle with an eating disorder and by those who love them.

Dana Crowley Jack offers startling new insights into the roots of female depression as she illuminates why women are far more likely than men to suffer major depression in adulthood. Silencing the Self is the first sweeping overview of depression in women that draws on new understandings of the importance of relationships in women’s lives. Attending closely to what depressed women have to say about their lives, Jack reframes major concepts of depression, freeing them from traditional models that have restricted our ability to listen to women’s perspectives on depression.

Jack weaves these voices of depressed women directly into her discussion, providing new meanings to familiar themes: dependence, pleasing, anger, goodness, low self-esteem. These women clearly articulate a no-win, either/or tension in their lives, a tension between sacrificing their own needs in order to preserve a relationship and acting on their needs and feelings at the risk of losing the relationship. Their stories bring to light the “activity required to be passive”—the way women actively silence themselves in order to cultivate and maintain intimate relationships. To accommodate, they learn to censor themselves, to devalue their experience, to repress anger, to be silent. Examining moral themes in depressed women’s narratives, Jack demonstrates how internalized cultural expectations of feminine goodness affect women’s behavior in relationships and precipitate the plunge into depression. In a brilliant synthesis, Jack draws on myth and fairy tale for metaphors to further the understanding of depressed women.

Silencing the Self makes a major contribution to the psychology of women by drawing from the recent literature on women’s relational self and detailing its relevance to female depression. This insightful approach to the dynamic of female depression forges new pathways to self-change, therapy, and research.

Human beings evolved in the company of others and flourish in proportion to their positive social ties. To understand the human brain, we must situate its biology in the wider context of society. To understand society, we must also consider how the brains and minds of individuals shape interactions with other human beings. Social Neuroscience offers a comprehensive new framework for studying the brain, human development, and human behavior.

In this book, leading researchers in the fields of neurobiology, psychiatry, psychology, and sociology elucidate the connections between brain biology and the brain’s functioning in the social world, providing a state-of-the-art interdisciplinary explanation of how humans think and act, as well as the ways we define and treat pathological behavior. Synthesizing the insights and perspectives of these experts, Social Neuroscience examines how neural processes make the brain sensitive to social experience, how cognition shapes social behavior, and how social networks create a range of responses among different individuals to the same environmental stimuli.

The mutually reinforcing connections between brain, mind, and society have profound implications for human health, from the emotionally damaging effects of severe social deprivation to the neurological impact of parental abuse and neighborhood violence. The authors explore these connections, with special focus on mental illnesses, including schizophrenia—a disorder characterized by marked social deficits in which a neurological basis is now well established.

In 1989 Jennifer Johnson was convicted of delivering a controlled substance to a minor. That the minor happened to be Johnson's unborn child made her case all the more complex, controversial, and ultimately, historical. Stephen R. Kandall, a neonatologist and pediatrician, testified as an expert witness on Johnson's behalf. The experience caused him to wonder how one disadvantaged black woman's case became a prosecutorial battlefield in the war on drugs. This book is the product of Kandall's search through the annals of medicine and history to learn how women have fared in this conflict and how drug-dependent women have been treated for the past century and a half.

Kandall's sleuthing uncovers an intriguing and troubling story. Opium, laudanum, and morphine were primary ingredients in the curative "powders" and strengthening "tonics" that physicians freely prescribed and pharmacists dispensed to women a hundred and fifty years ago. Or a woman could easily dose herself with narcotics and alcohol in the readily available form of "patent" medicines sold in every town and touted in popular magazines ("Over a million bottles sold and in every one a cure!"). For the most part unaware of their dangers, women turned to these remedies for "female complaints," such as "womb disease" and "congestion of the ovaries," as well as for "neurasthenia," a widespread but vague nervous malady attributed to women's weaker, more sensitive natures. Not surprisingly, by the latter half of the nineteenth century the majority of America's opiate addicts were women.

The more things change, the more they remain the same: Substance and Shadow shows how, though attitudes and drugs may vary over time--from the laudanum of yesteryear to the heroin of the thirties and forties, the tranquilizers of the fifties, the consciousness-raising or prescription drugs of the sixties, and the ascendance of crack use in the eighties--dependency remains an issue for women. Kandall traces the history of questionable treatment that has followed this trend. From the maintenance clinics of the early twenties to the "federal farms" of mid-century to the detoxification efforts and methadone maintenance that flourished in the wake of the Women's Movement, attempts to treat drug-dependent women have been far from adequate. As he describes current policies that put money into drug interdiction and prisons, but offer little in the way of treatment or hope for women like Jennifer Johnson, Kandall calls our attention to the social and personal costs of demonizing and punishing women addicts rather than trying to improve their circumstances and give them genuine help.

In 2015, Patricia Roos’s twenty-five-year-old son Alex died of a heroin overdose. Turning her grief into action, Roos, a professor of sociology at Rutgers University, began to research the social factors and institutional failures that contributed to his death. Surviving Alex tells her moving story—and outlines the possibilities of a more compassionate and effective approach to addiction treatment.  

Weaving together a personal narrative and a sociological perspective, Surviving Alex movingly describes how even children from “good families” fall prey to addiction, and recounts the hellish toll it takes on families. Drawing from interviews with Alex’s friends, family members, therapists, teachers, and police officers—as well as files from his stays in hospitals, rehab facilities, and jails—Roos paints a compelling portrait of a young man whose life veered between happiness, anxiety, success, and despair. And as she explores how a punitive system failed her son, she calls for a community of action that would improve care for substance users and reduce addiction, realigning public health policy to address the overdose crisis.

 

Warped Minds explores the transformation of psychopathologies into cultural phenomena in the wake of the transition from an epistemological to an ontological approach to psychopathology. Trifonova considers several major points in this intellectual history: the development of a dynamic model of the self at the fin de siècle, the role of photography and film in the construction of psychopathology, the influence of psychoanalysis on the transition from static, universalizing psychiatric paradigms to dynamic styles of psychiatry foregrounding the socially constructed nature of madness, and the decline of psychoanalysis and the aestheticization of madness into a trope describing the conditions of knowledge in postmodernity as evidenced by the transformation of multiple personality and paranoia into cultural and aesthetic phenomena.Download the Table of Contents and a sample chapter

According to a major health survey, nearly half of all Americans have been mentally ill at some point in their lives—more than a quarter in the last year. Can this be true? What exactly does it mean, anyway? What’s a disorder, and what’s just a struggle with real life?

This lucid and incisive book cuts through both professional jargon and polemical hot air, to describe the intense political and intellectual struggles over what counts as a “real” disorder, and what goes into the “DSM,” the psychiatric bible. Is schizophrenia a disorder? Absolutely. Is homosexuality? It was—till gay rights activists drove it out of the DSM a generation ago. What about new and controversial diagnoses? Is “social anxiety disorder” a way of saying that it’s sick to be shy, or “female sexual arousal disorder” that it’s sick to be tired?

An advisor to the DSM, but also a fierce critic of exaggerated overuse, McNally defends the careful approach of describing disorders by patterns of symptoms that can be seen, and illustrates how often the system medicalizes everyday emotional life.

Neuroscience, genetics, and evolutionary psychology may illuminate the biological bases of mental illness, but at this point, McNally argues, no science can draw a bright line between disorder and distress. In a pragmatic and humane conclusion, he offers questions for patients and professionals alike to help understand, and cope with, the sorrows and psychopathologies of everyday life.

The contemporary opioid crisis is widely seen as new and unprecedented. Not so. It is merely the latest in a long series of drug crises stretching back over a century. In White Market Drugs, David Herzberg explores these crises and the drugs that fueled them, from Bayer’s Heroin to Purdue’s OxyContin and all the drugs in between: barbiturate “goof balls,” amphetamine “thrill pills,” the “love drug” Quaalude, and more. As Herzberg argues, the vast majority of American experiences with drugs and addiction have taken place within what he calls “white markets,”  where legal drugs called medicines are sold to a largely white clientele.

These markets are widely acknowledged but no one has explained how they became so central to the medical system in a nation famous for its “drug wars”—until now. Drawing from federal, state, industry, and medical archives alongside a wealth of published sources, Herzberg re-connects America’s divided drug history, telling the whole story for the first time. He reveals that the driving question for policymakers has never been how to prohibit the use of addictive drugs, but how to ensure their availability in medical contexts, where profitability often outweighs public safety. Access to white markets was thus a double-edged sword for socially privileged consumers, even as communities of color faced exclusion and punitive drug prohibition. To counter this no-win setup, Herzberg advocates for a consumer protection approach that robustly regulates all drug markets to minimize risks while maintaining safe, reliable access (and treatment) for people with addiction.
Accomplishing this requires rethinking a drug/medicine divide born a century ago that, unlike most policies of that racially segregated era, has somehow survived relatively unscathed into the twenty-first century.

By showing how the twenty-first-century opioid crisis is only the most recent in a long history of similar crises of addiction to pharmaceuticals, Herzberg forces us to rethink our most basic ideas about drug policy and addiction itself—ideas that have been failing us catastrophically for over a century.

In the wake of a suicide, the most troubling questions are invariably the most difficult to answer: How could we have known? What could we have done? And always, unremittingly: Why? Written by a clinical psychologist whose own life has been touched by suicide, this book offers the clearest account ever given of why some people choose to die.

Drawing on extensive clinical and epidemiological evidence, as well as personal experience, Thomas Joiner brings a comprehensive understanding to seemingly incomprehensible behavior. Among the many people who have considered, attempted, or died by suicide, he finds three factors that mark those most at risk of death: the feeling of being a burden on loved ones; the sense of isolation; and, chillingly, the learned ability to hurt oneself. Joiner tests his theory against diverse facts taken from clinical anecdotes, history, literature, popular culture, anthropology, epidemiology, genetics, and neurobiology--facts about suicide rates among men and women; white and African-American men; anorexics, athletes, prostitutes, and physicians; members of cults, sports fans, and citizens of nations in crisis.

The result is the most coherent and persuasive explanation ever given of why and how people overcome life's strongest instinct, self-preservation. Joiner's is a work that makes sense of the bewildering array of statistics and stories surrounding suicidal behavior; at the same time, it offers insight, guidance, and essential information to clinicians, scientists, and health practitioners, and to anyone whose life has been affected by suicide.