How We Break by Vincent Deary review – look after yourself | Health, mind and body books

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It is refreshing to read a psychology book intended for mainstream audiences that isn’t trying to push you towards a particular goal; to achieve more, to work harder. Thanks to the rapid societal and technological changes of the past century, self-actualisation is now possible for more of us than ever before. As welcome as this might seem, self-actualising is hard work, and possibilities can quickly become standards that we fail to live up to. Consciously or unconsciously, our unlived potential can haunt us and provoke us to strive until we burn out.

In this book, the second in a planned trilogy, and a follow-up to 2015’s How We Are, health psychologist Deary delivers a much-needed message: we have a finite capacity to meet the unpredictable challenges life throws at us. The concept of allostatic load (the wear and tear of chronic stress) crops up repeatedly. In chapter four we are introduced to Anne, a single mother struggling to look after her son and father while working as a probation officer (Deary’s case studies are composites of patients he has treated in a fatigue clinic). Anne looks after everyone except herself. As her life becomes more difficult and complex, her ability to function is gradually eroded until she collapses into a state of chronic fatigue. During a course of psychotherapy she comes to understand the vulnerability that results from doing too much for too long, to the point that a few ordinary difficulties can tip you over the edge.

A particular strength of the book is the way Deary weaves between different schools of thought within psychology, philosophy and religion. The result is not merely a discussion of abstract ideas, but a collection of valuable observations about what it means to be human in the modern world, taking in biological, societal and economic realities. In chapter eight we meet Fred, a freelance editor in his early 30s who is chronically exhausted because of anxiety and panic attacks. We are shown how his anxiety (exacerbated by the Covid-19 lockdown) shrank his world to the size of his house, leaving him effectively a prisoner of his own state of mind. The process of reclaiming his life then proceeds gradually, one small step at a time.

The various chapters work as stand-alone essays and discuss very different questions. How do stories and narratives shape us? What is the difference between useful and destructive thinking? How do dysfunctional psychological processes like anxiety or anorexia come to possess us? What does it mean to have a healthy relationship with yourself? The resulting insights apply whether we have a diagnosable mental health condition or not.

How We Break might not be quite as resonant for people who have yet to meet some of the more punishing aspects of life, or tend to dwell too much in their comfort zones. This kind of existence can be accompanied by its own collection of psychological problems, of course. Human beings are essentially anti-fragile, meaning we do in fact become stronger when exposed to stress and difficulty. Many aspects of modern life have made it easier for us to insulate ourselves from difficulty, and we are only just beginning to see what this could mean for the mental health of younger people. Rather, this book is for those who have experienced too much, too early or for too long, whose reach has exceeded their grasp, who may be hypercompetent and yet have little to no self-esteem.

The third instalment of the trilogy will be called How We Mend. In the meantime, this book offers a cathartic meditation on just how difficult life can be. Although the concept of self-care has become an overused and sometimes unhelpful trope on social media, Deary makes a compelling argument as to the necessity of self-compassion. He leads us to a more humane understanding of our suffering and offers practical advice for navigating life’s ups and downs with greater grace and equanimity.

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Alex Curmi is a psychiatrist and presenter of The Thinking Mind podcast. How We Break is published by Allen Lane (£25). To support the Guardian and the Observer buy a copy at Delivery charges may apply.