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How to Stay SaneReview - How to Stay Sane
by Philippa Perry
Picador, 2012
Review by Dennis Trinkle II
May 22nd 2013 (Volume 17, Issue 21)

When reading a review for a book with a title like How to Stay Sane, I suppose one ought to keep in mind that the proof is yet to come in. Especially with a new title, how can we know if it will deliver the promised results? However, as Philippa Perry, the author, says, staying sane is "an endeavor that is never finished." Taken in that context, we can make projections on how this title aids us in the endeavor.

How to Stay Sane is one of a series of books from The School of Life, a venture started by Alain de Botton dedicated to pointing people to useful ideas to help answer life's big questions. These "Maintenance Manuals for the Mind" offer one resource with the authors attempting to redesign and rehabilitate the self-help book. If How to Stay Sane is representative, the attempt is promising. Perry's book is winsome and well-informed. She makes an effort to balance readability with respectable science as well as balancing her personal experiences with her training as a psychotherapist.

Perry structures the book around two main poles at the boundaries of sanity and four skills for steering a middle course between those poles. Borrowing an idea from Dan Siegel, she simplifies the multitude of disorders described by the DSM into two main groups of people: those "who have strayed into chaos and whose lives lurch from crisis to crisis" and "those who have got themselves into a rut and operate from a limited set of outdated, rigid responses." Perry supplements this picture of insanity with a brief discussion of three parts of the brain: the brain stem/the reptilian brain, the right brain/mammalian brain, and the left brain/neo-mammalian brain. The two poles are used throughout to uncover patterns in the way we can stray from mental well-being, toward unregulated or over-regulated behavior and the three parts of the brain are offered for a developmental explanation as well as guiding us toward the requisite knowledge for changing these patterns by changing the way the parts of the brain interact.

This framework is offered in the introduction then deployed in four chapters. Each chapter discusses one aspect of changes that Perry claims happen in successful courses of psychotherapy. The four areas for change are, "self-observation", "relating to others", "stress", and "personal narrative." In the first chapter she lays out a picture of understanding ourselves that involves recognizing how we are engaging with the world. One major theme is that we tend to offer reasons for our actions that are "post-rationalizations" of our behavior, whereas our behavior is in fact much more driven by emotion than we are wont to recognize. Perry then connects our ability to recognize how we feel to our potential to take responsibility for how we act. This first chapter connects smoothly to the second, since maintaining healthy relationships both fosters and requires mental well-being and the skill of self-observation allows us to understand relationships better. She gives a framework for relationships based in Martin Buber's philosophy, but as is the case throughout the book, the focus in on what works for the reader rather than a formal psychotherapeutic approach grounded in any particular school or theory.

The third chapter gives a distinction between good and bad stress, offering again a set of poles between which we must navigate, in this case between being overwhelmed and being sedentary. Perry offers studies to support the idea that we need some effortful activity to keep us hale, offering examples of physical exercise and mental engagement with problem-solving or learning. In the fourth chapter, she turns to the importance of the stories we tell ourselves. The way we interpret what is going on can affect our self-understanding, our relationships, and our levels of stress. Perry advocates the benefits of optimistic thinking, considers how having the wrong story in our heads can distort our perceptions, and comes back to the importance of upbringing by considering the role our familial stories have in shaping our own.

In addition to the discussion of the main idea of each chapter, Perry offers a simple exercise for putting the idea into practice. Breathing awareness, structured relationship discussion, mapping comfort-zones and good-stress goals, and a genogram (a kind of psychological family tree) offer the reader examples of how to put the ideas to work in staying sane. After the conclusion, she also supplies a list of exercises that offer alternatives and more in-depth instructions for the exercises and suggests that the real work of staying sane requires just that: real work. The exercises provide a starting point for applying the insights of therapy to one's own life. While this would be no substitute for the kind of guidance a qualified therapist could offer, it does provide useful guidance for how to work on self-observation, relationships, stress, and stories.

Little of what Perry offers in the book is novel and the book is short on arguments and evidence for the claims. However, this is not the goal and what the books does supply is a readable account of some of the main ideas and practices of psychotherapy in a jargon-free, theoretically-neutral, and diversely applicable way. The book is brief, yet informative and readable, yet substantive. Perry's prose is simple and clear. She offers clarifying examples and illustrative stories without ever losing the main theme. The book is admirably succinct. In addition to the aesthetic value of the prose, the physical copy of the book is itself quite pleasing. A light, thin book, it would be easily stuffed into a bag or large pocket and brought along for reading on a commute, in a waiting room, or even at a beach. The text is supplemented with several illustrations whose whimsy fits well with the light tone of the text.

While the tone is light, the topic is important and the reader who takes the tasks of changing their habits of thinking, feeling, and doing seriously could easily find herself going beyond these upbeat reflections. Given this, one might wish to have a bit more in the book about what to do if the exercises exhume emotional turmoil in oneself or serious problems in a relationship. Perhaps it would be good to offer suggestions on finding a therapist or at least a list of resources for doing so. The title does make it clear that the target audience is those who are already sane, but when making such judgments about oneself it is easy to have on blinders or overestimate.

One other complaint I'll mention in closing is that Perry often talks about the brain in a pretty loose sense. Talking about focusing attention, for instance, she suggests that mindfulness exercises "literally strengthen and grow the brain." This kind of neuro-speak is not peculiar to Perry, but I found myself worrying that the aim of presenting scientifically-respectable self-help was pretty loosely instituted on the science side. That said, the book achieves its aim of readable yet useful guidance on a few basic ideas and leaves the reader with direction (in the "Homework" appendix) for pursuing them further. The basic exercises also give some practical way to engage with therapy, and I suspect that many readers reluctant to pursue therapy would be able to begin with the practices and ideas in How to Stay Sane without feeling like they must be "insane" to do so. Grounding the book in more theory or empirical study would likely have disrupted this tone and thus the goal of providing a widely-accessible first step to incorporating psychotherapeutic wisdom into one's life. That goal is laudable and How to Stay Sane is a worthwhile contribution in what I hope will be a high-quality series from The School of Life. If all the writers offer as much as Philippa Perry, then they are already off to a good start.


© 2013 Dennis Trinkle


Dennis Trinkle II is a Ph. D. candidate in philosophy at the University of Wisconsin - Madison. He specializes in philosophy of mind, psychology, and psychiatry. At present, he is working on a dissertation about the nature of mental disorders.


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