arts 8/ entertainment

Normal Or Not?

Harvard psychiatrist explains where our personalities come from, why we behave as
we do and how biology determines much of our emotional makeup.

Suzanne Chessler
Contributing Writer

T

here are many reasons why peo-
ple in obvious emotional distress
can't follow the simple advice to
"just get over it." Some of those reasons
have to do with the effects of emotional
problems on body structure and chemis-
try.
Dr. Jordan Smoller explains the connec-
tions in the context of new scientific dis-
coveries through his new book, The Other

Side of Normal: How Biology Is Providing
Clues to Unlock the Secrets of Normal and
Abnormal Behavior (William Morrow;
$27.99).
Smoller, associate professor of psychia-
try at Harvard Medical School and director
of the Psychiatric & Neurodevelopmental
Genetics Unit at Massachusetts General
Hospital, strongly believes the public
should know about the latest findings to
help with understanding themselves and
those they regularly encounter.
"It's often the case when somebody says
get over it' that the person can't get over
it [due to a deeper cause]:' he explains.
"Many of the things that cause trouble
later in life are things that have their roots
a long time ago and took a long time to
develop:"
The doctor, son of a Holocaust survivor,
will discuss his book at 1:15 p.m. Friday,
Nov. 16, during the Jewish Book Fair at
the Jewish Community Center in West
Bloomfield.
Smoller, 50, who has participated in
professional meetings at the University of
Michigan, previewed his talk and com-
mented on current mental health issues
during a phone conversation with the
Detroit Jewish News:

JN What will be your focus in West

Bloomfield?
JS: I'm going to try to give an overview
of the ideas behind the book. Those have
to do with how we are learning about what
I call the "biology of normal" and what
that's teaching us about mental illness.
I talk a little bit about the history of
how we think about normal and abnormal
and where we draw the line. We have to
start with a basic understanding of what
the brain and the mind were designed to
do. With that, we can get a sense of our
own everyday behavior and how things go
awry.
What we think of as mental illness

"Mental-health
difficulties touch
everybody in some
way, either directly
or through family
members."

- Dr. Jordan Smoller

emerges from many of the same brain sys-
tems we use to navigate the challenges of
everyday life.

IN: What are some ways in which
understanding these findings can help
people in general?
JS: These findings help with under-
standing our own behavior in terms of
social relationships and attachments and
make sense of things that are sometimes
mysterious, things we refer to as mental
illness. I go through a number of exam-
ples in the book.
One example has to do with a person's
coming to realize that other people have
their own thoughts and feelings. People
call that having a theory of mind, and
it turns out that it unfolds in children
over a certain age. It's variations of that
we now recognize as autism spectrum
disorders.
By understanding a basic feature of
our brains and variations of that, we can
see how behaviors that are hard to put
together start to make sense and connect
to normal behavior.

JN: How are the new findings impact-
ing mental-health professionals?
JS: They help us point to new ways of
treating conditions, such as fear and anxi-
ety, which cause a lot of suffering. Making
use of this understanding of how the brain
works allows us to explore our normal fear
systems and ultimately help people get
over traumatic fears or phobias.
They also have to do with how we
think of mental illness and psychiatric
disorders. I think it's bewildering to peo-
ple sometimes how the lines are drawn
and how they shift. In the next year,
people are going to be hearing a lot about
this because psychiatry is updating its
manual of psychiatric disorders.

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IN: What experiences motivated you

to write this book?
JS: The book emerged from my experi-
ences living in two overlapping worlds
— as a psychiatrist trying to help people
who are struggling with disorders and as
a scientist trying to understand the roles
that genes and individual experiences play
in causing [emotional] suffering.
What struck me is that over the last
decade or so, a picture was emerging that
provided a convergence of insights from
social science, biology, economics and a
whole variety of fields that was making sense
of a puzzle, and I thought it would be impor-
tant to let people know about that and hear
about the progress that's been made.
It perhaps allows us to have more com-
passion. I also think it's fascinating to have
these insights into how our minds and
relationships work.

IN: How did you go about putting this

information together?
JS: I wrote this over a couple of years,
and it required an enormous amount of
research, which was one of the best parts
of the experience. I feel that I had such an
education myself. It is very connected to
what I do on a day-to-day basis because I
do research on neuroscience, psychiatry,
epidemiology and genetics.

JN: Did you encounter any surprises?

JS: What surprised me was how much
we're learning about the ways experi-
ences change the brain — in particular,
how early experience can have some fairly
long-lasting and dramatic effects on how
our lives turn out.
This is most evident when kids are
exposed to adversity or toxic stress. We're
finding that we see differences in behav-
ior later on and in fascinating ways using
brain imaging and chromosome studies.

JN: Are some mental-health issues
more prevalent today?
JS: We have to think of whether an issue
is more prevalent or just being diagnosed
more. There's been a pretty dramatic
increase in autism spectrum disorders,
and the latest estimates put that at one in
88 children. That's quite a bit higher than
what was reported 20 or 30 years ago.
A diagnosis of bipolar disorder in young
people under age 19 was reported to have
increased 40 fold in the decade starting
with the early 1990s.

IN: Is religious affiliation important
to mental health?
JS: It is for some people. There are
studies that show that those with strong
connections to religious faith have a some-
what lower risk of mental-health difficul-
ties. That sense of belief, community and
groundedness can be really helpful.

IN: How does a person with emotional
issues know that it's time to seek help?
JS: The major factors are suffering and
impairment. If you are suffering because
of anxiety or mood and it's really causing
[lingering] distress, or if you are noticing
it's interfering with your ability to do the
things you usually do or want to do, that's
usually a reason to think about it.
We all experience anxiety, fear and
sadness. Just experiencing those things
doesn't imply a disorder or problem.

JN: What continues to fascinate you
about psychiatry?
JS: What has been so compelling and
sustaining about psychiatry is that mental-
health difficulties touch everybody in
some way, either directly or through fam-
ily members. We have ways of helping,
but there's so much to be done and so
many opportunities to make progress, for
example in research.
I think the field combines so many
aspects of what is important and mean-
ingful about life in terms of helping other
people.

❑

Dr. Jordan Smoller will be among the
nonfiction authors appearing at the
Jewish Community Center's annual
Jewish Book Fair, running Nov. 7-18.
Hear him discuss his book at 1:15
p.m. Friday, Nov.16, at the JCC in
West Bloomfield. (248) 432-5459;
www.bookfair.jcc.org .

iN

October 25 • 2012

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